bluuebunny/crossref_metadata_2025 huggingface dataset:
Biomedical laboratory scientists and technicians in digital pathology – Is there a need for professional development?
Authors: Jensen Charlotte Lerbech , Thomsen Lisbeth Koch , Zeuthen Mette , Johnsen Sys , El Jashi Rima , Nielsen Michael Friberg Bruun , Hemstra Line E , Smith Julie
Published: March 2024

Objective

Digital pathology (DP) is moving into Danish pathology departments at high pace. Conventionally, biomedical laboratory scientists (BLS) and technicians have prepared tissue sections for light microscopy, but workflow alterations are required for the new digital era with whole slide imaging (WSI); digitally assisted image analysis (DAIA) and artificial intelligence (AI). We aim to explore the role of BLS in DP and assess a potential need for professional development.

Methods

We investigated the roles of BLS in the new digital era through qualitative interviews at Danish Pathology Departments in 2019/2020 before DP implementation (supported by a questionnaire); and in 2022 after DP implementation. Additionally, senior lecturers from three Danish University Colleges reported on how DP was integrated into the 2023 bachelor's degree educational curricula for BLS students.

Results

At some Danish pathology departments, BLS were involved in the implementation process of DP and their greatest concerns were lack of physical laboratory requirements (69%) and implementation strategies (63%). BLS were generally positive towards working with DP, however, some expressed concern about extended working hours for scanning. Work-task transfers from pathologists were generally greeted positively from both management and pathologists; however, at follow-up interviews after DP implementation, job transfers had not been effectuated. At Danish university colleges, DP had been integrated systematically in the curricula for BLS students, especially WSI.

Conclusion

Involving BLS in DP implementation and development may benefit the process, as BLS have a hands-on workflow perspective with a focus on quality assurance. Several new work opportunities for BLS may occur with DP including WSI, DAIA and AI, and therefore new qualifications are warranted, which must be considered in future undergraduate programmes for BLS students or postgraduate programmes for BLS.
Application of standardized management and effect evaluation of chronic obstructive pulmonary disease patients using the big data center of the Internet of Things
Authors: Chen Xiaoping , He Fei , Jiang Yan , Chen Xuezhen , Yan Yubing
Published: March 2024

Objective

Early detection, diagnosis, treatment and management of chronic obstructive pulmonary disease can lower morbidity and perhaps mortality. This study aimed to evaluate the effect of the application of standardized management against the background of the rapid development of the big data center of modern internet of things technology.

Methods

Participants ≥40 years of age with chronic obstructive pulmonary disease presenting at Xiamen Medical College Affiliated Haicang Hospital from October 2019 to October 2020 were selected as the observation patients based on the Internet of Things big data center for chronic obstructive pulmonary disease standardized management, and control patients from the community were selected for without down to the chronic obstructive pulmonary disease standardized management. Follow-up after 2 years of patient health records and acute episodes using the World Health Organization Quality of Life Questionnaire-Brief version to evaluate the quality of life of the two groups revealed differences.

Results

The results of comparative analysis of the number of acute attacks before and after follow-up in the observation and control groups after propensity score matching showed that the decrease in acute episodes before and after in the observation group was significant compared with that in the control group ( t = −3.664, P < 0.001). The quality of life of chronic obstructive pulmonary disease patients indicated that the effect in the observation group was greater than that in the control group according to the World Health Organization Quality of Life Questionnaire-Brief version.

Conclusion

In this study, we analyzed the application of modern internet of things technology in the management of chronic obstructive pulmonary disease patients, discussed the effect of standardized management, and promoted the self-management of chronic obstructive pulmonary disease patients. The effectiveness and continuity of the standardized management model for chronic obstructive pulmonary disease implemented in Xiamen city based on the internet of things big data center were considered true and effective.
mHealth intervention including text messaging and behaviour change techniques to support maintenance of physical activity after cardiac rehabilitation: A single-arm feasibility study
Authors: Hamborg Trine G , Andersen Rune M , Skou Søren T , Clausen Mikkel B , Jäger Madalina , Zangger Graziella , Simonÿ Charlotte , Grøntved Anders , Brønd Jan C , Soja Anne M B , Tang Lars H
Published: March 2024

Objective

To evaluate the feasibility of a mobile health-supported intervention in patients with cardiovascular diseases after completion of a cardiac rehabilitation programme.

Methods

The feasibility study was performed in two hospitals and one municipality in Region Zealand, Denmark. Eligible participants were ≥18 years old, participated in a supervised cardiac rehabilitation programme, had access to a mobile phone, and could walk 3 m independently. Participants received a 12-week intervention utilizing behaviour change techniques, consisting of action planning, text messages, and phone support. Feasibility was assessed using pre-defined progression criteria, which included recruitment (≥75%), retention (≥80%), accelerometer data completeness (≥80%), coordinator (phone support) time (≤30 min), the response rate on patient-reported outcomes (≥90%), adherence (≥75% respond to ≥75% of messages), and acceptability (≥75%). The secondary outcome of objective physical activity was assessed with accelerometers.

Results

Ten women and 30 men with cardiovascular diseases aged 63.5 (±9.8 SD) participated. The progression criteria for retention (90%), accelerometer data completeness (83%), coordinator time (9.9 min), adherence (83%), and acceptability (82%) were at acceptable levels, exceptions were progression criteria for recruitment (35%) being below acceptable levels for recruitment, and response rate on patient-reported outcomes (75%). High satisfaction (92.6%) with the intervention was found. All objectively measured physical activity levels remained unchanged from baseline to follow-up. No serious adverse events related to the intervention were reported.

Conclusion

Mobile health-supported maintenance of physical activity after cardiac rehabilitation completion was feasible, safe, and acceptable. Yet, changes to improve recruitment and response rate are needed before conducting a large-scale effect evaluation.
Development and Validation of a Cultural and Linguistic Diversity Scale to Measure Pre-service EFL Teachers’ Self-Efficacy Beliefs
Authors: Kırcalı Melih , Cesur Kürşat
Published: March 2024

The study aims to develop and validate an affordable and generalizable survey design tool to measure pre-service EFL teachers’ self-efficacy beliefs about cultural and linguistic diversity. It is significant as there are relatively low number of studies aiming to measure such beliefs in today’s changing demographic conditions which are beyond its limits especially in some countries due to the massive flow of migrants. Most of these studies are qualitative which are not cost-effective and flexible. In this study, exploratory sequential mixed method was conducted. Initially, qualitative research design was employed. Findings were used to develop a valid and reliable survey design tool in a second quantitative phase in which data was gathered quantitatively to reduce the number of the variables to a few values representing self-efficacy beliefs and determine the latent components in the scale. Final version of the scale included 20 items across five factors after Exploratory Factor Analysis through principal axis factoring and Confirmatory Factor Analysis through maximum likelihood analysis. Findings supported that a set of 20 items in the final scale form was statistically valid and reliable in measuring pre-service EFL teachers’ self-efficacy beliefs about teaching in culturally and linguistically diverse student groups.
Secularization, De-secularization and Re-secularization in Bangladesh: Does the ‘Third Image’ Matter?
Authors: Hossain Delwar
Published: March 2024

This article analyses the trajectories of secularization, de-secularization and re-secularization in Bangladesh. It is about mapping broad historical developments with reference to basic understanding of secularization and its progress in Bangladesh. The central question in the article is: How have the trajectories of secularization, de-secularization and re-secularization in Bangladesh been influenced by the nexus of internal–external dynamics of political and social forces developed in the 1980s? The article argues that a decisive attempt to rediscover liberal and secular character of politics is currently evident in Bangladesh. The attempt to reestablish secularism in the society also faces a host of challenges, stemming from national, regional and global contexts that echo the 1980s. Methodologically, it is based on policy outlook and trend analysis.
Effect of Varus-Producing Distal Femoral Osteotomy and High Tibial Osteotomy on Compartment Pressures and Contact Area at Varying Degrees of Knee Flexion
Authors: Liles Jordan , Brown Justin , Hollenbeck Justin , Foster Michael , Su Charles , Vopat Matthew , Garcia Alex , Vidal Armando
Published: March 2024

Background:

In patients with valgus alignment and degenerative changes in the lateral compartment, both distal femoral osteotomy (DFO) and high tibial osteotomy (HTO) can be used to unload the lateral compartment. Prior studies have shown that in valgus knees, the tibial wear is posterior and DFO exerts the greatest effect in extension; however, its effect is decreased as flexion angle rises.

Hypothesis:

Medial closing-wedge (MCW) HTO would significantly decrease contact area, mean contact pressure (MCP), and peak contact pressure (PCP) in the lateral knee compartment through knee flexion to a greater extent compared with lateral opening-wedge (LOW) DFO.

Study Design:

Controlled laboratory study.

Methods:

MCWHTO and LOWDFO were performed, correcting a mean of 8° of valgus alignment, in 10 cadaveric knees using plate fixation. Tibiofemoral contact pressure of the medial and lateral compartments was measured in 0°, 30°, 60°, and 90° of knee flexion before and after osteotomy using thin electronic sensors and load applied through an Instron device. PCP, MCP, and contact area were measured for each condition.

Results:

The lateral MCP was significantly decreased in the HTO state compared with the native state in 30° ( P = .015), 60° ( P = .0199), and 90° ( P < .0001) of flexion. The lateral MCP was also significantly decreased in the HTO state when compared with the DFO state in 60° ( P = .0093) and 90° of flexion ( P < .0001). After DFO, the lateral MCP returned to that of the native state in 60° ( P > .999) and 90° ( P > .999) of flexion. The lateral PCP decreased for all test states in all degrees of flexion; the HTO state was significantly decreased when compared with the native state in 60° ( P < .0001) and 90° ( P < .0001).

Conclusion:

With varus corrections of 8°, MCWHTO was more effective at unloading the lateral compartment than LOWDFO. This effect was significant as the knee flexion angle increased. This study should be considered as one aspect of the surgical decision-making process.

Clinical Relevance:

In patients with mild to moderate valgus deformity without hypoplastic lateral femoral condyle and without significant joint line obliquity, MCWHTO may improve offloading of the lateral compartment in flexion.
Exploring values implicit in Ghanaian Senior High School mathematics textbooks
Authors: Essien Nicholas , Davis Ernest Kofi
Published: March 2024

Values are pivotal in mathematics education. Coming to grips with values in mathematics as a means of understanding them well enough to enculturate children in the subject has been highlighted in the literature. Valuing in mathematics has been positioned as the key driver of both the content of the mathematics curriculum and its teaching. This study explored values implicit in Ghanaian Senior High School mathematics textbooks. A sample of four best-selling Ghanaian Senior High School Form 1 Core Mathematics textbooks were purposely selected for this study. Using a checklist, the study explored mathematical values and mathematics educational values implicit in these textbooks. Findings from the study revealed that mathematical values of Objectism, Progress and Openness were emphasized more in the textbooks, while mathematics educational values namely Formalist View, Theoretical Knowledge, Instrumental learning, Accessibility and Evaluation were also emphasized more. How these values were conveyed is presented and the implications of the results of the study for policy and practice are also discussed, especially the need to use an array of mathematics books rather than only one to teach students in order to expose them to the values they need to become life-long learners in mathematics.
Socioeconomic Position, Pre-Obesity and Obesity in Latin American Cities: A Systematic Review
Authors: de Menezes Mariana Carvalho , Duran Ana C. , Langellier Brent , Pérez-Ferrer Carolina , Barnoya Joaquin , Mayén Ana-Lucia
Published: March 2024

Currently the socioeconomic gradient of obesity it is not well understood in the urban population in Latin American. This study reviewed the literature assessing associations between pre-obesity, obesity, and socioeconomic position (SEP) in adults living in urban areas in Latin American countries. PubMed and SciELO databases were used. Data extraction was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We extracted data on the association between SEP (e.g., education, income), pre-obesity (body mass index [BMI] ≥ 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2). Relative differences between low and high SEP groups were assessed and defined a priori as significant at p < 0.05. Thirty-one studies met our inclusion criteria and most were conducted in Brazil and Mexico (22 and 3 studies, respectively). One study presented nonsignificant associations. Forty-seven percent of associations between education or income and pre-obesity were negative. Regarding obesity, 80 percent were negative and 20 percent positive. Most negative associations were found in women while in men they varied depending on the indicator used. Pre-obesity and obesity by SEP did not follow the same pattern, revealing a reversal of the obesity social gradient by SEP, especially for women in Latin America, highlighting the need for articulated policies that target structural and agentic interventions.
Emergency airway management in resource limited setting
Authors: Olatunji Gbolahan , Kokori Emmanuel , Aderinto Nicholas , Alsabri Mohammed Alsabri Hussein
Published: March 2024

Background

Emergency airway management in resource-limited settings presents multifaceted challenges due to shortages in essential medical resources, healthcare professionals, and infrastructure.

Methods

We conducted a literature search using keywords “Emergency Airway Management” “Low Resource” “Africa” “Asia” from databases such as Pubmed, and Google Scholar, from where we extracted relevant literature for our study.

Findings

These limitations resulted in delayed interventions, suboptimal care, and higher complication rates during intubation procedures. However, innovative solutions have emerged to address these challenges, including cost-effective airway management devices and training programs tailored for non-medical personnel. Capacity building and local empowerment are critical components of improving emergency airway management in these settings. Additionally, advocating for policy support and investment in healthcare infrastructure is essential to ensure access to essential equipment and adequate staffing. Collaboration and knowledge-sharing networks among healthcare professionals and organisations are pivotal in disseminating best practices and advancing healthcare delivery in resource-limited regions.

Conclusion

Future efforts should focus on tailored training programs, rigorous research, innovative device development, telemedicine solutions, sustainable capacity building, and advocacy to enhance emergency airway management in resource-limited settings.
Influence of age on nicotinic cholinergic regulation of blood flow in rat’s olfactory bulb and neocortex
Authors: Uchida Sae , Kagitani Fusako
Published: March 2024

The olfactory bulb receives cholinergic basal forebrain inputs as does the neocortex. With a focus on nicotinic acetylcholine receptors (nAChRs), this review article provides an overview and discussion of the following findings: (1) the nAChRs-mediated regulation of regional blood flow in the neocortex and olfactory bulb, (2) the nAChR subtypes that mediate their responses, and (3) their activity in old rats. The activation of the α4β2-like subtype of nAChRs produces vasodilation in the neocortex, and potentiates olfactory bulb vasodilation induced by olfactory stimulation. The nAChR activity producing neocortical vasodilation was similarly maintained in 2-year-old rats as in adult rats, but was clearly reduced in 3-year-old rats. In contrast, nAChR activity in the olfactory bulb was reduced already in 2-year-old rats. Thus, age-related impairment of α4β2-like nAChR function may occur earlier in the olfactory bulb than in the neocortex. Given the findings, the vasodilation induced by α4β2-like nAChR activation may be beneficial for neuroprotection in the neocortex and the olfactory bulb.
Including microbiome information in a multi-trait genomic evaluation: a case study on longitudinal growth performance in beef cattle
Authors: Martínez-Álvaro Marina , Mattock Jennifer , González-Recio Óscar , Saborío-Montero Alejandro , Weng Ziqing , Lima Joana , Duthie Carol-Anne , Dewhurst Richard , Cleveland Matthew A. , Watson Mick , Roehe Rainer
Published: March 2024

Background

Growth rate is an important component of feed conversion efficiency in cattle and varies across the different stages of the finishing period. The metabolic effect of the rumen microbiome is essential for cattle growth, and investigating the genomic and microbial factors that underlie this temporal variation can help maximize feed conversion efficiency at each growth stage.

Results

By analysing longitudinal body weights during the finishing period and genomic and metagenomic data from 359 beef cattle, our study demonstrates that the influence of the host genome on the functional rumen microbiome contributes to the temporal variation in average daily gain (ADG) in different months (ADG1, ADG2, ADG3, ADG4). Five hundred and thirty-three additive log-ratio transformed microbial genes (alr-MG) had non-zero genomic correlations (rg) with at least one ADG-trait (ranging from |0.21| to |0.42|). Only a few alr-MG correlated with more than one ADG-trait, which suggests that a differential host-microbiome determinism underlies ADG at different stages. These alr-MG were involved in ribosomal biosynthesis, energy processes, sulphur and aminoacid metabolism and transport, or lipopolysaccharide signalling, among others. We selected two alternative subsets of 32 alr-MG that had a non-uniform or a uniform rg sign with all the ADG-traits, regardless of the rg magnitude, and used them to develop a microbiome-driven breeding strategy based on alr-MG only, or combined with ADG-traits, which was aimed at shaping the rumen microbiome towards increased ADG at all finishing stages. Combining alr-MG information with ADG records increased prediction accuracy of genomic estimated breeding values (GEBV) by 11 to 22% relative to the direct breeding strategy (using ADG-traits only), whereas using microbiome information, only, achieved lower accuracies (from 7 to 41%). Predicted selection responses varied consistently with accuracies. Restricting alr-MG based on their rg sign (uniform subset) did not yield a gain in the predicted response compared to the non-uniform subset, which is explained by the absence of alr-MG showing non-zero rg at least with more than one of the ADG-traits.

Conclusions

Our work sheds light on the role of the microbial metabolism in the growth trajectory of beef cattle at the genomic level and provides insights into the potential benefits of using microbiome information in future genomic breeding programs to accurately estimate GEBV and increase ADG at each finishing stage in beef cattle.
Genome-wide identification and in silico characterization of major RNAi gene families in date palm (Phoenix dactylifera)
Authors: Naim Darun , Ahsan Asif , Imtiaj Ahmed , Mollah Nurul Haque
Published: March 2024

Background

Dates contain various minerals that are essential for good health. The major RNA interference (RNAi) gene families play a vital role in plant growth and development by controlling the expression of protein-coding genes against different biotic and abiotic stresses. However, these gene families for date palm are not yet studied. Therefore, this study has explored major RNAi genes and their characteristics in date palm.

Results

We have identified 4 PdDCLs, 7 PdAGOs, and 3 PdRDRs as RNAi proteins from the date palm genome by using AtRNAi genes as query sequences in BLASTp search. Domain analysis of predicted RNAi genes has revealed the Helicase_C, Dicer_dimer, PAZ, RNase III, and Piwi domains that are associated with the gene silencing mechanisms. Most PdRNAi proteins have been found in the nucleus and cytosol associated with the gene silencing actions. The gene ontology (GO) enrichment analysis has revealed some important GO terms including RNA interference, dsRNA fragmentation, and ribonuclease_III activity that are related to the protein-coding gene silencing mechanisms. Gene regulatory network (GRN) analysis has identified PAZ and SNF2 as the transcriptional regulators of PdRNAi genes. Top-ranked 10 microRNAs including Pda-miR156b, Pda-miR396a, Pda-miR166a, Pda-miR167d, and Pda-miR529a have been identified as the key post-transcriptional regulators of PdRNAi genes that are associated with different biotic/abiotic stresses. The cis-acting regulatory element analysis of PdRNAi genes has detected some vital cis-acting elements including ABRE, MBS, MYB, MYC, Box-4, G-box, I-box, and STRE that are linked with different abiotic stresses.

Conclusion

The results of this study might be valuable resources for the improvement of different characteristics in date palm by further studies in wet-lab.
The potential role of Listeria monocytogenes in promoting colorectal adenocarcinoma tumorigenic process
Authors: Baldelli Giulia , De Santi Mauro , Ateba Collins Njie , Cifola Giorgia , Amagliani Giulia , Tchatchouang Christ-Donald Kaptchouang , Montso Peter Kotsoana , Brandi Giorgio , Schiavano Giuditta Fiorella
Published: March 2024

Background

Listeria monocytogenes is a foodborne pathogen, which can cause a severe illness, especially in people with a weakened immune system or comorbidities. The interactions between host and pathogens and between pathogens and tumor cells have been debated in recent years. However, it is still unclear how bacteria can interact with tumor cells, and if this interaction can affect tumor progression and therapy.

Methods

In this study, we evaluated the involvement of L. monocytogenes in pre-neoplastic and colorectal cancer cell proliferation and tumorigenic potential.

Results

Our findings showed that the interaction between heat-killed L. monocytogenes and pre-neoplastic or colorectal cancer cells led to a proliferative induction; furthermore, by using a three-dimensional cell culture model, the obtained data indicated that L. monocytogenes was able to increase the tumorigenic potential of both pre-neoplastic and colorectal cancer cells. The observed effects were then confirmed as L. monocytogenes-specific, using Listeria innocua as negative control. Lastly, data suggested the Insulin Growth Factor 1 Receptor (IGF1R) cascade as one of the possible mechanisms involved in the effects induced by L. monocytogenes in the human colorectal adenocarcinoma cell line.

Conclusions

These findings, although preliminary, suggest that the presence of pathogenic bacterial cells in the tumor niches may directly induce, increase, and stimulate tumor progression.
Auditory brainstem responses are resistant to pharmacological modulation in Sprague Dawley wild-type and Neurexin1α knockout rats
Authors: Marashli Samuel , Janz Philipp , Redondo Roger L
Published: March 2024

Sensory processing in the auditory brainstem can be studied with auditory brainstem responses (ABRs) across species. There is, however, a limited understanding of ABRs as tools to assess the effect of pharmacological interventions. Therefore, we set out to understand how pharmacological agents that target key transmitter systems of the auditory brainstem circuitry affect ABRs in rats. Given previous studies, demonstrating that Nrxn1α KO Sprague Dawley rats show substantial auditory processing deficits and altered sensitivity to GABAergic modulators, we used both Nrxn1α KO and wild-type littermates in our study. First, we probed how different commonly used anesthetics (isoflurane, ketamine/xylazine, medetomidine) affect ABRs. In the next step, we assessed the effects of different pharmacological compounds (diazepam, gaboxadol, retigabine, nicotine, baclofen, and bitopertin) either under isoflurane or medetomidine anesthesia. We found that under our experimental conditions, ABRs are largely unaffected by diverse pharmacological modulation. Significant modulation was observed with (i) nicotine, affecting the late ABRs components at 90 dB stimulus intensity under isoflurane anesthesia in both genotypes and (ii) retigabine, showing a slight decrease in late ABRs deflections at 80 dB stimulus intensity, mainly in isoflurane anesthetized Nrxn1α KO rats. Our study suggests that ABRs in anesthetized rats are resistant to a wide range of pharmacological modulators, which has important implications for the applicability of ABRs to study auditory brainstem physiology.
Apolipoprotein E E3/E4 genotype is associated with an increased risk of type 2 diabetes mellitus complicated with coronary artery disease
Authors: Chen Wenhao , Li Bin , Wang Hao , Wei Guoliang , Chen Kehui , Wang Weihong , Wang Shen , Liu Yuanliang
Published: March 2024

Objective

Dyslipidemia is a co-existing problem in patients with diabetes mellitus (DM) and coronary artery disease (CAD), and apolipoprotein E (APOE) plays an important role in lipid metabolism. However, the relationship between the APOE gene polymorphisms and the risk of developing CAD in type 2 DM (T2DM) patients remains controversial. The aim of this study was to assess this relationship and provide a reference for further risk assessment of CAD in T2DM patients.

Methods

The study included 378 patients with T2DM complicated with CAD (T2DM + CAD) and 431 patients with T2DM alone in the case group, and 351 individuals without DM and CAD were set as controls. The APOE rs429358 and rs7412 polymorphisms were genotyped by polymerase chain reaction (PCR) - microarray. Differences in APOE genotypes and alleles between patients and controls were compared. Multiple logistic regression analysis was performed after adjusting for age, gender, body mass index (BMI), history of smoking, and history of drinking to access the relationship between APOE genotypes and T2DM + CAD risk.

Results

The frequencies of the APOE ɛ3/ɛ4 genotype and ε4 allele were higher in the T2DM + CAD patients, and the frequencies of the APOE ɛ3/ɛ3 genotype and ε3 allele were lower than those in the controls (all p < 0.05). The T2DM + CAD patients with ɛ4 allele had higher level in low-density lipoprotein cholesterol (LDL-C) than those in patients with ɛ2 and ɛ3 allele (p < 0.05). The results of logistic regression analysis showed that age ≥ 60 years old, and BMI ≥ 24.0 kg/m2 were independent risk factors for T2DM and T2DM + CAD, and APOE ɛ3/ɛ4 genotype (adjusted odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.18–3.14, p = 0.008) and ɛ4 allele (adjusted OR = 1.97, 95% CI = 1.23–3.17) were independent risk factors for T2DM + CAD. However, the APOE genotypes and alleles were not found to have relationship with the risk of T2DM.

Conclusions

APOE ε3/ε4 genotype and ε4 allele were independent risk factors for T2DM complicated with CAD, but not for T2DM.
Exploring treatment burden in people with type 2 diabetes mellitus: a thematic analysis in china's primary care settings
Authors: Lin Kai , Yao Mi , Andrew Lesley , Li Rouyan , Chen Yilin , Oosthuizen Jacques , Sim Moira , Chen Yongsong
Published: March 2024

Background

Understanding treatment burden is a critical element to the effective management of Type 2 Diabetes Mellitus (T2DM). The current study aims to address the knowledge gap surrounding treatment burden of T2DM from the patient’s perspective in China’s primary care settings.

Methods

A narrative review informed the creation of an a priori coding structure to identify aspects of T2DM treatment burden. Focus groups were conducted, employing a maximum variation sampling strategy to select participants from diverse sociodemographic backgrounds across urban, suburban, rural, and remote areas in China. Participants included adults with T2DM care in primary care settings for over a year and a Treatment Burden Questionnaire score of 25 or higher. Deductive thematic analysis, guided by the coding structure, facilitated a comprehensive exploration and further development of the conceptual framework of T2DM treatment burden.

Results

Four focus groups, each comprising five participants from diverse areas, were conducted. Utilising the Cumulative Complexity Model and Normalisation Process Theory as theoretical underpinnings, the thematic analysis refined the conceptual framework based on the coding structure from the narrative review. Five key themes were refined, encompassing medical information, medication, administration, healthcare system, and lifestyle. Additionally, the financial and time/travel themes merged into a new theme termed "personal resources", illustrating their overlapping within the framework. Participants in these focus groups highlighted challenges in managing medical information, an aspect often underrepresented in prior treatment burden research. The thematic analysis culminated in a finalised conceptual framework, offering a comprehensive understanding of the treatment burden experiences of people with T2DM in China’s primary care settings. This framework includes six key constructs, delineating T2DM treatment burden and associated factors, such as antecedents and consequences.

Conclusions

This study provides insights into the treatment burden of T2DM. A conceptual framework was finalised to deepen the understanding of the multifaceted constructs and the nature of treatment burden in people with T2DM. Furthermore, it emphasises the need to tailor T2DM treatment to individual capacities, considering their personal resource allocation and treatment utilisation.
Development of the national consensus statement on ear health and hearing check recommendations for Aboriginal and Torres Strait Islander children aged under 6 years attending primary care: systematic scoping review and e-Delphi
Authors: Harkus Samantha , Marnane Vivienne , O’Keeffe Isabel , Kung Carmen , Ward Meagan , Orr Neil , Skinner John , Hughes Jessica Kate , Fonua Lose , Kennedy Michelle , Kong Kelvin , Belfrage Mary
Published: March 2024

Background

Early detection of long-term, often asymptomatic, middle ear infection in young Aboriginal and Torres Strait Islander children is more likely to be achieved when ear health and hearing checks are routinely undertaken in primary healthcare. Evidence consistently demonstrates the adverse impacts of this condition on the development and wellbeing of children and their families. We aimed to develop feasible, evidence- and consensus-based primary healthcare recommendations addressing the components and timing of ear health and hearing checks for Aboriginal and Torres Strait Islander children aged under 6 years, not already known to have, nor being actively managed for, ear and hearing problems.

Methods

A 22-person working group comprising Aboriginal and Torres Strait Islander and non-Indigenous members from the primary healthcare, ear, hearing, and research sectors provided guidance of the project. A systematic scoping review addressed research questions relating to primary health ear health and hearing checks for Aboriginal and Torres Strait Islander and other populations at increased risk of persistent ear health problems. Twelve primary studies and eleven guidelines published between 1998 and 2020 were identified and reviewed. Quality and certainty of evidence and risk of bias ratings were completed for studies and guidelines. In the absence of certain and direct evidence, findings and draft recommendations were presented for consensus input to a 79-member expert panel using a modified e-Delphi process. Recommendations were finalised in consultation with working group members and presented to expert panel members for input on considerations relating to implementation.

Results

Overall, the quality, certainty, and directness of evidence in the studies and guidelines reviewed was low. However, the findings provided a basis and structure for the draft recommendations presented during the consensus-building process. After two e-Delphi rounds, seven goals and eight recommendations on the components and timing of Ear Health and Hearing Checks in primary healthcare for young Aboriginal and Torres Strait Islander children were developed.

Conclusions

The systematic scoping review and consensus-building process provided a pragmatic approach for producing strong recommendations within a reasonably short timeframe, despite the low quality and certainty of evidence, and paucity of studies pertaining to primary healthcare settings.
Clinical presentation and management of multisystem inflammatory syndrome in children associated with covid-19: a retrospective observational descriptive study in a pediatric hospital in Syria
Authors: Shhada Eman , Hamdar Hussein , Nahle Ali Alakbar , Mourad Diana , Khalil Basheer , Ali Sawssan
Published: March 2024

Objective

Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 is a rare and serious medical condition. This study aims to review the clinical presentation, laboratory parameters, outcomes, and management of MIS-C cases in a pediatric hospital in Syria.

Methods

This retrospective observational study aimed to investigate MIS-C between May 2020 and October 2021. Data collection involved extracting information from medical records, and patients were identified based on the case definition established by the World Health Organization (WHO). Various laboratory investigations, diagnostic evaluations, clinical presentations, and treatments were performed to assess patients. Descriptive statistical analysis was conducted using Microsoft Excel.

Results

A total of 232 COVID-19 cases were reported with COVID-19 Infection. Among these cases, 25 (10.77%) were identified as MIS-C. The median age of the patients was 5.5 years, with the majority being male patients (72%). Patients experienced fever (100%), bilateral conjunctivitis (88%), rash (84%), gastrointestinal symptoms (76%), and cardiac dysfunction (72%). Other notable findings included oral cavity changes (64%), edema (36%), cervical lymphadenopathy (36%), and neurological manifestations (28%). Respiratory symptoms were uncommon (16%). All patients recovered, with no recorded deaths.

Conclusion

The predominant presence of positive SARS-CoV-2 IgG in the majority of patients in this study supports the post-infectious nature of MIS-C. Respiratory symptoms were less prevalent in both pediatric COVID-19 and MIS-C patients. Early supportive care is crucial in management, although additional research is needed to establish definitive guidelines. Larger studies are necessary to overcome the limitations of this study and to enhance our understanding of MIS-C in pediatric COVID-19 patients.
Dengue encephalopathy in an adult due to dengue virus type 1 infection
Authors: Leng Xingyu , Yang Huiqin , Zhao Lingzhai , Feng Jiamin , Jin Kanghong , Liao Lu , Zhang Fuchun
Published: March 2024

Background

Dengue is an important public health problem, which caused by the dengue virus (DENV), a single-stranded RNA virus consisted of four serotypes. Central nervus system (CNS) impairment in dengue usually results from DENV-2 or DENV-3 infection, which lead to life-threatening outcomes. Furthermore, neurological complications due to DENV-1 was rare especially in adult patients.

Case presentation

A 44-year-old man without comorbidities had lethargy after hyperpyrexia and a positive DENV NS1 antigen was detected for confirming the diagnosis of dengue on day 8 of onset. Then logagnosia, decreased muscle strength, delirium and irritability were occurred even radiographic examination were normal. He was treated with low-dose hormone, sedatives and gamma goblin with a short duration of 6 days. The cerebrospinal fluid (CSF) tests were persistent normal. However, presence of DENV-1 RNA was confirmed both in CSF and serum. Furthermore, the complete sequence of the DENV isolated from the patient’s serum was performed (GenBank No.: MW261838). The cytokines as IL-6, IL-10 and sVCAM-1 were increased in critical phase of disease. Finally, the patient was discharged on day 24 of onset without any neurological sequelae.

Conclusion

Encephalopathy caused by a direct CNS invasion due to DENV-1 during viremia was described in an adult patient. Treatment with low-dose hormone and gamma goblin was helpful for admission.
Rare case of septic shock combined with meningitis caused by Pasteurella multocida without a history of cat and dog bites
Authors: Zhu Yijun , Zhu Fang , Shan Xiaoyun , Shi Jingchao
Published: March 2024

Background

Pasteurella multocida is a zoonotic pathogen that mainly causes local skin and soft tissue infections in the human body through cat and dog bites. It rarely causes bacteraemia (or sepsis) and meningitis. We reported a case of septic shock and meningitis caused by P. multocida in a patient without a history of cat and dog bites.

Case presentation

An 84-year-old male patient was urgently sent to the emergency department after he was found with unclear consciousness for 8 h, accompanied by limb tremors and urinary incontinence. In the subsequent examination, P. multocida was detected in the blood culture and wound secretion samples of the patient. However, it was not detected in the cerebrospinal fluid culture, but its DNA sequence was detected. Therefore, the patient was clearly diagnosed with septic shock and meningitis caused by P. multocida. The patient had no history of cat or dog contact or bite. The patient was subsequently treated with a combination of penicillin G, doxycycline, and ceftriaxone, and he was discharged after 35 days of hospitalisation.

Conclusion

This report presented a rare case of septic shock and meningitis caused by P. multocida, which was not related to a cat or dog bite. Clinical doctors should consider P. multocida as a possible cause of sepsis or meningitis and should be aware of its potential seriousness even in the absence of animal bites.
Defining clinical endpoints in limb girdle muscular dystrophy: a GRASP-LGMD study
Authors: Doody Amy , Alfano Lindsay , Diaz-Manera Jordi , Lowes Linda , Mozaffar Tahseen , Mathews Katherine D. , Weihl Conrad C. , Wicklund Matthew , Hung Man , Statland Jeffrey , Johnson Nicholas E. ,   On behalf of the GRASP-LGMD Consortium, Mathews Kathy , Leung Doris , Kang Peter , Desai Urvi , Vissing John , Zingariello Carla , Dixon Stacy
Published: March 2024

Background

The Limb Girdle Muscular Dystrophies (LGMDs) are characterized by progressive weakness of the shoulder and hip girdle muscles as a result of over 30 different genetic mutations. This study is designed to develop clinical outcome assessments across the group of disorders.

Methods/design

The primary goal of this study is to evaluate the utility of a set of outcome measures on a wide range of LGMD phenotypes and ability levels to determine if it would be possible to use similar outcomes between individuals with different phenotypes. We will perform a multi-center, 12-month study of 188 LGMD patients within the established Genetic Resolution and Assessments Solving Phenotypes in LGMD (GRASP-LGMD) Research Consortium, which is comprised of 11 sites in the United States and 2 sites in Europe. Enrolled patients will be clinically affected and have mutations in CAPN3 (LGMDR1), ANO5 (LGMDR12), DYSF (LGMDR2), DNAJB6 (LGMDD1), SGCA (LGMDR3), SGCB (LGMDR4), SGCD (LGMDR6), or SGCG (LGMDR5, or FKRP-related (LGMDR9).

Discussion

To the best of our knowledge, this will be the largest consortium organized to prospectively validate clinical outcome assessments (COAs) in LGMD at its completion. These assessments will help clinical trial readiness by identifying reliable, valid, and responsive outcome measures as well as providing data driven clinical trial decision making for future clinical trials on therapeutic agents for LGMD. The results of this study will permit more efficient clinical trial design. All relevant data will be made available for investigators or companies involved in LGMD therapeutic development upon conclusion of this study as applicable.

Trial registration

Clinicaltrials.gov NCT03981289; Date of registration: 6/10/2019.
Establishment of a risk prediction model for bowel preparation failure prior to colonoscopy
Authors: Zhang Na , Xu Miaomiao , Chen Xing
Published: March 2024

Background

This study aimed to determine the factors that contribute to the failure of bowel preparation in patients undergoing colonoscopy and to develop a risk prediction model.

Methods

A total of 1115 outpatients were included. Patients were randomly divided into two groups: the modeling group (669 patients) and the validation group (446 patients). In the modeling group, patients were further divided into two groups based on their success and failure in bowel preparation using the Boston Bowel Preparation Scale. A logistic regression analysis model was used to determine the risk factors of bowel preparation failure, which was subsequently visualized using an alignment diagram.

Results

After controlling for relevant confounders, multifactorial logistic regression results showed that age ≥ 60 years (OR = 2.246), male (OR = 2.449), body mass index ≥ 24 (OR = 2.311), smoking (OR = 2.467), chronic constipation (OR = 5.199), diabetes mellitus (OR = 5.396) and history of colorectal surgery (OR = 5.170) were influencing factors of bowel preparation failure. The area under the ROC curve was 0.732 in the modeling group and 0.713 in the validation group. According to the calibration plot, the predictive effect of the model and the actual results were in good agreement.

Conclusions

Age ≥ 60 years, male, body mass index ≥ 24, smoking, chronic constipation, diabetes mellitus, and history of colorectal surgery are independent risk factors for bowel preparation failure. The established prediction model has a good predictive efficacy and can be used as a simple and effective tool for screening patients at high risk for bowel preparation failure.
Effect of silicone oil versus gas tamponade on macular layer microstructure after pars plana vitrectomy for macula on rhegmatogenous retinal detachment
Authors: Al-Shehri Abdulaziz Mohammed , Aljohani Saud , Aldihan Khalid Abdulaziz , Alrashedi Musa Johaiman , Alrasheed Saad , Schatz Patrik
Published: March 2024

Purpose

To analyze structural changes in the macular retinal layers and sub-foveal choroidal thickness (SFCT) in eyes after macula-on rhegmatogenous retinal detachment (RRD) repair by pars plana vitrectomy with either silicone oil (SO) or gas tamponade, and the effect of these changes on visual acuity.

Patients and methods

Retrospective study which included 26 eyes in the SO Group and 32 in the Gas Group. Optical coherence tomography (OCT) scans of the affected eyes were obtained before surgery, and 3 months after PPV in the Gas Group, and during silicone oil in situ and 3 months after SO removal, in the SO Group. Qualitative assessment of photoreceptor layer and foveal contour, along with quantitative assessment of macular retinal thickness and SFCT was performed. Postoperative OCT macular microstructural changes were recorded and correlated to corrected distance visual acuity (CDVA). Intraocular pressure (IOP) was measured preoperative and at 3 months post operative.

Results

There was a 2-line loss (from 20/28 preoperatively to 20/40 at final follow-up) of CDVA in the SO Group (p=0.051), while there was no statistically significant change in CDVA in the Gas Group (p=0.786). There was no significant correlation between CDVA loss and duration of silicon tamponade (r=-0.031, p=0.893). There was a statistically significant increase in IOP from its baseline to final follow-up of 0.7 mmHg in the SO Group (p=0.023) while there was no statistically significant change in IOP in the Gas Group. During silicone oil tamponade, there was approximately 11% and 5% of retinal and sub-foveal choroidal thinning respectively, which was moderately resolved following silicone oil removal. 20% (5/24) of eyes in the SO Group had qualitative flattening of foveal contour during SO tamponade that resolved after SO removal.

Conclusion

Thinning of the macula was noticed after macula-on RRD repair with SO tamponade. Such thinning was only partially reversible after the removal of SO.
Persian version of brief infant sleep questionnaire (BISQ): a psychometric evaluation
Authors: Yazdi Maryam , Bemanalizadeh Maryam , Kelishadi Roya
Published: March 2024

Background

The high prevalence of sleep problems and their negative consequences on children and parents highlight the need to design early screening instruments to evaluate sleep problems in early childhood. We aimed to determine the validity and reliability of the Brief Infant Sleep Questionnaire (BISQ) among the Iranian population.

Methods and materials

This study included 646 one-year-old infants by random sampling from the PERSIAN birth cohort study. Following the forward-backward translation of the BISQ, its psychometric properties, including construct validity in terms of concurrent and convergent validities as well as reliability, were evaluated.

Results

The CVIs and CVR ranged between 0.8 and 1.00 for all items. Therefore, we keep all the items of the original version of the BISQ in the Persian BISQ. Concurrent validity was assessed by comparing items of the Persian BISQ among different maternal views regarding their infant’s sleep. All BISQ items were significantly different among the two levels of maternal view about the infant’s sleep problem except daytime sleep duration. The convergent validity of the BISQ was evaluated by calculating the correlation between BISQ items and the ISQ (infant sleep questionnaire) total score as a similar tool. ISQ score was adequately correlated with nocturnal sleep latency and the number of waking at night (rs ranged from 0.59 to 0.72). In addition, the associations of mothers’ and infants’ demographic variables and nutritional and gestational variables with BISQ items were presented to confirm construct validity. Strong correlations were found between the repeated sleep measures for sleep arrangement, sleep position, and sleep situation (kappa ranged from 0.65 to 0.84), nocturnal sleep duration, daytime sleep duration number of wakings at night, night waking duration, nocturnal sleep latency and sleep-onset time (ICC ranged 0.91 to 0.99).

Conclusion

The Persian version of the BISQ is a reliable and valid measure for assessing sleep problems in infants. It would be helpful to be utilized for the early diagnosis of infants’ sleep problems.