bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic and functional enrichments associated with
Enterococcus faecalis
isolated from the urinary tract
Authors: Sharon Belle M. , Arute Amanda P. , Nguyen Amber , Tiwari Suman , Reddy Bonthu Sri Snehita , Hulyalkar Neha V. , Neugent Michael L. , Palacios Araya Dennise , Dillon Nicholas A. , Zimmern Philippe E. , Palmer Kelli L. , De Nisco Nicole J.
Published: November 2023

Enterococcus faecalis
is the leading Gram-positive bacterial species implicated in urinary tract infection (UTI). An opportunistic pathogen,
E. faecalis
is a commensal of the human gastrointestinal tract (GIT), and its presence in the GIT is a predisposing factor for UTI. How
E. faecalis
colonizes and survives in the urinary tract (UT) is poorly understood, especially in uncomplicated or recurrent UTI. The UT is distinct from the GIT and is characterized by a sparse nutrient landscape and unique environmental stressors. In this study, we isolated and sequenced a collection of 37 clinical
E. faecalis
strains from the urine of primarily postmenopausal women. We generated 33 closed genome assemblies and 4 highly contiguous draft assemblies and conducted a comparative genomics analysis study to identify genetic features enriched in urinary
E. faecalis
with respect to
E. faecalis
isolated from the human GIT and blood. Phylogenetic analysis revealed high diversity among urinary strains and a closer relatedness between urine and gut isolates than blood isolates. Plasmid replicon (rep) typing further underscored possible UT-GIT interconnection, identifying nine shared rep types between urine and gut
E. faecalis
. Both genotypic and phenotypic analyses of antimicrobial resistance among urinary
E. faecalis
revealed infrequent resistance to the front-line UTI antibiotics nitrofurantoin and fluoroquinolones and no vancomycin resistance. Finally, comparing gene presence and absence among urinary and gut strains, we identified 19 candidate genes enriched among urinary strains. These genes are involved in the core processes of sugar transport, cobalamin import, glucose metabolism, and post-transcriptional regulation of gene expression.

IMPORTANCE

Urinary tract infection (UTI) is a global health issue that imposes a substantial burden on healthcare systems. Women are disproportionately affected by UTI, with >60% of women experiencing at least one UTI in their lifetime. UTIs can recur, particularly in postmenopausal women, leading to diminished quality of life and potentially life-threatening complications. Understanding how pathogens colonize and survive in the urinary tract is necessary to identify new therapeutic targets that are urgently needed due to rising rates of antimicrobial resistance. How
Enterococcus faecalis
, a bacterium commonly associated with UTI, adapts to the urinary tract remains understudied. Here, we generated a collection of high-quality closed genome assemblies of clinical urinary
E. faecalis
isolated from the urine of postmenopausal women that we used alongside detailed clinical metadata to perform a robust comparative genomic investigation of genetic factors that may be involved in
E. faecalis
survival in the urinary tract.
A CAF01-adjuvanted whole asexual blood-stage liposomal malaria vaccine induces a CD4
+
T-cell-dependent strain-transcending protective immunity in rodent models
Authors: Okoth Winter A. , Ho Mei-Fong , Zaman Mehfuz , Cooper Emily , Som Priyanka , Burgess Mark , Walton Maddison , Nevagi Reshma J. , Beattie Lynette , Murphy Declan , Stanisic Danielle I. , Good Michael F.
Published: November 2023

Malaria is a leading cause of illness and death in children under 5 years of age in Sub-Saharan Africa. Currently, there is no highly efficacious malaria vaccine capable of inducing long-lasting immunity. This has increased interest in exploring different vaccine development strategies, including whole-parasite vaccines, and utilizing more effective adjuvant delivery systems. Here, we evaluate the immunogenicity and protective efficacy of a whole-parasite
Plasmodium yoelii
17X blood-stage vaccine formulated with the clinically tested cationic adjuvant formulation, CAF01. The vaccine protected both inbred and outbred mice, and protected mice from homologous and heterologous challenge infections. Tracking of RBC subsets in vaccinated mice demonstrated that vaccine-induced immunity cleared parasitized normocytes as well as reticulocytes. Infection prior to vaccination led to an augmented level of protection and boosted immunity post vaccination. The vaccine induced parasite-specific IgG, mainly of the IgG1 subclass, and cellular responses, with a mixed Th1/Th2/Th17 cytokine profile. Mechanistic studies demonstrated that CD4
+
T-cells (but not CD8
+
T-cells), and Th1 and Th2 cytokines (interferon gamma and tumor necrosis factor, IL-10) were critical in controlling parasitemia and survival following challenge. Vaccinated µMT mice were not protected, suggesting that B-cells also play a role in protective immunity. Depletion of splenic macrophages with clodronate did not affect vaccine efficacy. These pre-clinical findings will inform the transition of this vaccine candidate into clinical trials.

IMPORTANCE

Malaria is a devastating disease that has claimed many lives, especially children <5 years of age in Sub-Saharan Africa, as documented in World Malaria Reports by WHO. Even though vector control and chemoprevention tools have helped with elimination efforts in some, if not all, endemic areas, these efforts have been hampered by serious issues (including drug and insecticide resistance and disruption to social cohesion caused by the COVID-19 pandemic). Development of an effective malaria vaccine is the alternative preventative tool in the fight against malaria. Vaccines save millions of lives each year and have helped in elimination and/or eradication of global diseases. Development of a highly efficacious malaria vaccine that will ensure long-lasting protective immunity will be a “game-changing” prevention strategy to finally eradicate the disease. Such a vaccine will need to counteract the significant obstacles that have been hampering subunit vaccine development to date, including antigenic polymorphism, sub-optimal immunogenicity, and waning vaccine efficacy.
Genomics data of
L. borgpetersenii
strain HP364 and
L. weilii
strain SC295 isolated from rodents captured from human leptospirosis outbreak areas in Selangor, Malaysia
Authors: Neela Vasantha Kumari , Philip Noraini , Raja Pappitha , Sekawi Zamberi
Published: November 2023

We report complete genome sequences of two
Leptospira
isolates,
Leptospira borgpetersenii
strain HP364 and
Leptospira weilii
strain SC295. The genome sizes of
L. borgpetersenii
strain HP364 and
L. weilii
strain SC295 were 3,874,738 bp and 4,063,712 bp, respectively. Both genomes have been deposited in NCBI GenBank.
Synthesis of 4-Methyl-6-N-(4-R-phenyl)-1-azabicyclo[3.2.1]octane-3-enes
Authors: Shadrikova V. A. , Shumkova A. A. , Shiryaev V. A. , Klimochkin Yu. N.
Published: November 2023

1-Azabicyclo[3.2.1]oct-3-ene were synthesized by the intramolecular carbocationic cyclization of 1-[2-hydroxy-2-(4-R-phenyl)ethyl]-1,2,3,6-tetrahydropyridines in a trifluoromethanesulfonic acid medium
Double Acylation Product in the SnCl4-promoted Reaction of 4,5-Dichlorocyclopent-4-en-1,3-dione with 1,3,5-Trimethoxybenzene
Authors: Egorov V. A. , Khasanova L. S. , Gimalova F. A. , Miftakhov M. S.
Published: November 2023

The reaction of 4,5-dichlorocyclopent-4-en-1,3-dione with 1,3,5-trimethoxybenzene under Friedel–Crafts reaction conditions gave, along with the expected 5-(2,4,6-trimethoxyphenyl)-4-chlorocyclopent-4-ene-1,3-dione, a disubstituted product―3,4-bis-(2,4,6-trimethoxyphenyl)-2-chlorocyclopent-2-en-1-one.
Chondrosarcoma of the maxilla
Authors: Shah Kshitij D , Ezzy Mustafa Kamruddin , Patekar Shivali K , Bradoo Renuka
Published: November 2023

A woman in her 70s reported to the outpatient department of our tertiary care hospital with chief complaints of painless swelling in the right cheek and palatal area. The patient was a known case of diabetes mellitus and hypertension on medications with controlled sugars and blood pressure. The swelling was 10×8 cm in size extending from right infraorbital region up to the lower mandible. CT demonstrated a permeative lytic pattern of bone destruction noted involving the hard palate and maxillary bone.

Using the Weber Ferguson approach, a surgical resection was carried out under general anaesthesia. Resection included from right total maxillectomy (excluding roof of maxilla), nasal septum up to left medial maxillectomy including hard palate and the tumour was resected en bloc. The palatal obturator was fixed. On the basis of histopathology, grade 1 well-differentiated chondrosarcoma was diagnosed. The patient received postoperative radiotherapy and had a good recovery.
Patient-reported outcome measures in diabetes outpatient care: a scoping review
Authors: Torbjørnsen Astrid , Jensen Annesofie Lunde , Singstad Tone , Weldingh Nina Mickelson , Holmen Heidi
Published: November 2023

Background

Patient-reported outcome (PRO) measures are increasingly used in clinical diabetes care to increase patient involvement and improve healthcare services. The objectives were to identify instruments used to measure PROs in outpatient diabetes clinics and to investigate the use of these PRO measures alongside the experiences of patients and healthcare personnel in a clinical setting.

Research Design and Methods

A scoping review was conducted according to the framework of Arksey and O’Malley with scoping searches of Cinahl, EMBASE, Medline and Health and Psychosocial Instruments. Studies reporting on adults with diabetes in a clinical setting where the PRO measure response directly affected patient care were eligible for inclusion.

Results

In total, 35 197 citations were identified, of which 7 reports presenting 4 different PRO measures were included in the review. All four of the included items measured psychosocial aspects of diabetes, and three included elements of the Problem Areas in Diabetes scale. All the patients were satisfied with the use of PRO measures in clinical care, whereas the level of satisfaction among healthcare personnel with PRO measures varied within and among studies.

Conclusions

The limited number of eligible studies in this review suggests that research on PRO measures for diabetes outpatient care is scarce. Patients welcome the opportunity to express their concerns through the systematic collection of PRO measures, and some healthcare personnel value the broader insight that PRO measures provide into the impact of diabetes on patients’ lives. However, the heterogeneity among services and among patients challenges the implementation of PRO measures. Research is needed to explore how PRO measures in clinical outpatient care affect healthcare personnel workflow.

Review registration

https://doi.org/10.17605/OSF.IO/46AHC
Prioritising and planning scale-up research projects targeting non-communicable diseases: a mixed-method study by the Global Alliance for Chronic Diseases upscaling working group
Authors: Ramani-Chander Anusha , Thrift Amanda , van Olmen Josefien , Wouters Edwin , Delobelle Peter , Vedanthan Rajesh , Miranda J Jaime , Sherwood Stephen , Teede Helena J , Joshi Rohina
Published: November 2023

Introduction

Governments must scale-up evidence-based interventions to reduce the burden of non-communicable diseases (NCDs). Implementation research can help develop contextually appropriate strategies and optimise interventions for scale-up. We aimed to determine the priorities of the Global Alliance for Chronic Diseases (GACD) 2019 funding round for scale-up research targeting NCD interventions. The research questions were: (a) What was the purpose of the call and what were the specific issues considered by funders when supporting the selected projects? (b) How did the selected research projects align with the objectives of GACD scale-up call?

Methods

We undertook a mixed-methods study to examine the projects funded by the GACD in 2019. We completed semistructured interviews with representatives from 5 out of 8 funding agencies and complemented this by reviewing project documents from 21 (78%) of the 27 funded studies. A literature review of scale-up frameworks informed the interview guide and data extraction template. The transcripts were open-coded using thematic analysis to identify critical issues for funders. Data were extracted to identify the common elements considered when planning, implementing and evaluating interventions for scale-up.

Results

Interviews with the funders revealed three enabling themes related to scale-up: local research priorities (contextualisation through engagement), capacity building (developing knowledge base) and connections (networking opportunities). We further identified that timelines (more flexibility) and equity (funding low-income and middle-income researchers) could be considered for future funding investments. Multidisciplinary international research teams led the development of diverse studies to address funder’s priorities. The detailed plans included a range of implementation frameworks to help develop contextual scale-up strategies.

Conclusions

Fundamental to NCD scale-up research are (1) funding opportunities that reflect the complexity and time necessary to enable contextualisation; (2) investment in building multidisciplinary research capacity and leadership and (3) better networking to encourage cohesive action and align NCD-related scale-up research activities globally.
‘I feel that I should decide on my own….’: who should be involved in the decision-making process for adolescent involvement in HIV research?
Authors: Mukumbang Ferdinand C , Beima-Sofie Kristen , Neary Jillian , Li Huangqianyu , Agot Kawango , Healy Elise , Wilson Kate S , Badia Jacinta , Kibugi James , Inwani Irene , Chhun Nok , John-Stewart Grace , Kohler Pamela , Shah Seema K
Published: November 2023

Introduction

Efforts to improve health outcomes among adolescents and young adults living with HIV (ALHs) are hampered by limited adolescent engagement in HIV-related research. We sought to understand the views of adolescents, caregivers and healthcare workers (HCWs) about who should make decisions regarding ALHs’ research participation.

Methods

We conducted focus group discussions (FGDs) and in-depth interviews (IDIs) with ALHs (aged 14–24 years), caregivers of ALHs and HCWs from six HIV care clinics in Western Kenya. We used semi-structured guides to explore ALHs’ involvement in research decisions. Transcripts were analysed using thematic analysis; perspectives were triangulated between groups.

Results

We conducted 24 FGDs and 44 IDIs: 12 FGDs with ALHs, 12 with caregivers, and 44 IDIs with HCWs, involving 216 participants. HCWs often suggested that HIV research decision-making should involve caregivers and ALHs deciding together. In contrast, ALHs and parents generally thought decisions should be made individually, whether by HCWs/research teams (although this is likely ethically problematic), adolescents or caregivers. Caregiver and ALH preferences depended on ALHs’ age, with younger ALHs requiring more support. A few caregivers felt that ALHs should consult with the research team/HCWs due to their greater knowledge of clinical care. ALHs emphasised that they should independently decide because they thought they had the right to do so and the capacity to consent. Poor communication and parental non-disclosure of HIV status influenced ALHs’ views to exclude caregivers from decision-making. Regarding influences on research decision-making, ALHs were more willing to participate based on perceived contribution to science and less interested in participating in studies with potential risks, including loss of confidentiality.

Discussion

While research teams and HCWs felt that adolescents and caregivers should jointly make research decisions, ALHs and caregivers generally felt individuals should make decisions. As ALHs sometimes find caregiver support lacking, improving family dynamics might enhance research engagement.
Physiotherapy-led telehealth and exercise intervention to improve mobility in older people receiving aged care services (TOP UP): protocol for a randomised controlled type 1 hybrid effectiveness-implementation trial
Authors: Dawson Rik , Pinheiro Marina , Nagathan Vasikaran , Taylor Morag , Delbaere Kim , Olivera Juliana , Haynes Abby , Rayner Jenny , Hassett Leanne , Sherrington Catherine
Published: November 2023

Introduction

Deteriorating mobility and falls reduce independence and quality of life for older people receiving aged care services. This trial aims to establish effectiveness on the mobility of older people, and explore cost-effectiveness and implementation of a telehealth physiotherapy programme.

Method and analysis

This type 1 hybrid effectiveness-implementation randomised controlled trial will involve 240 people aged 65+ years receiving aged care services in community or residential settings. Participants will be randomised to either: (1) the Telehealth Physiotherapy for Older People (TOP UP) Program or (2) a wait-list control group. The 6-month intervention includes 10 physiotherapy sessions delivered by videocall (Zoom). The intervention will include the local support of an aged care worker and online exercise resources. Primary outcome is mobility at 6 months post randomisation measured by the Short Physical Performance Battery. Secondary outcomes include rate of falls, sit-to-stand, quality of life, and goal attainment at 6 months after randomisation. Regression models will assess the effect of group allocation on mobility and the other continuously scored secondary outcomes, adjusting for baseline scores. The number of falls per person over 6 months will be analysed using negative binomial regression models to estimate between-group differences. An economic analysis will explore the cost-effectiveness of the TOP UP programme compared with usual care. Implementation outcomes and determinants relating to the intervention’s reach, fidelity, exercise dose delivered, adoption, feasibility, acceptability, barriers and facilitators will be explored using mixed methods.

Conclusion

This is the first trial to investigate the effectiveness, cost-effectiveness and implementation of a physiotherapy intervention in aged care delivered solely by telehealth internationally. The study has strong aged care co-design and governance and is guided by steering and advisory committees that include staff from aged care service providers and end-users. Trial results will be disseminated via peer-reviewed articles, conference presentations and lay summaries.

Trial registration number

The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN 12621000734864).
Effects of behavioural change communication (BCC) on menstrual hygiene practices among urban school adolescent girls: a pilot study
Authors: Saleh Farzana , Ahmed Kazi Rumana , Khatun Taslima , Roy Nandini , Uddin Sadia , Kabir Md Rowshan
Published: November 2023

Background

Research on menstrual hygiene management practices (MHMP) has yet to be conducted among adolescent girls in Bangladesh who have gained services from the Urban Primary Health Care Project (UPHCP). This study aimed to assess the effects of behavioural change communication activities on MHMP among urban school adolescent girls.

Methods

A convenience sample of 270 adolescent girls (aged 10–19) who had no chronic diseases from 5 schools in Dhaka city was selected using a descriptive cross-sectional design from February to May 2018. A semistructured (interviewer-administered) questionnaire was used. Frequencies were calculated for descriptive analysis.

Results

About 17% of girls had irregular menstrual cycles, 57% felt uneasy and 27% had >7 days of menstrual flow. Fifty-five per cent of the girls used sanitary napkins. Most (95%) and 26% of the girls did not change their pads during school and at night, respectively. Sixty-five per cent of girls disposed of the used pads at the public dustbin, and 83% bathed during menstrual. Only 4% of girls were aware of the iron folic acid tablets.

Conclusions

Despite the availability of services from UPHCP, the acceptance and adherence to MHMP among adolescent girls still need to be improved.
Effects of a 5-week intake of erythritol and xylitol on vascular function, abdominal fat and glucose tolerance in humans with obesity: a pilot trial
Authors: Bordier Valentine , Teysseire Fabienne , Drewe Jürgen , Madörin Philipp , Bieri Oliver , Schmidt-Trucksäss Arno , Hanssen Henner , Beglinger Christoph , Meyer-Gerspach Anne Christin , Wölnerhanssen Bettina K
Published: November 2023

Introduction

Previous studies in humans and rats suggest that erythritol might positively affect vascular function, xylitol decrease visceral fat mass and both substances improve glycaemic control. The objective of this study was to investigate the impact of a 5-week intake of erythritol and xylitol on vascular function, abdominal fat and blood lipids, glucose tolerance, uric acid, hepatic enzymes, creatinine, gastrointestinal tolerance and dietary patterns in humans with obesity.

Methods

Forty-two participants were randomised to consume either 36 g erythritol, 24 g xylitol, or no substance daily for 5 weeks. Before and after the intervention, arterial stiffness (pulse wave velocity, arteriolar-to-venular diameter ratio), abdominal fat (liver volume, liver fat percentage, visceral and subcutaneous adipose tissue, blood lipids), glucose tolerance (glucose and insulin concentrations), uric acid, hepatic enzymes, creatinine, gastrointestinal tolerance and dietary patterns were assessed. Data were analysed by linear mixed effect model.

Results

The 5-week intake of erythritol and xylitol showed no statistically significant effect on vascular function. Neither the time nor the treatment effects were significantly different for pulse wave velocity (time effect: p=0.079, Cohen’s D (95% CI) −0.14 (−0.54–0.25); treatment effect: p=0.792, Cohen’s D (95% CI) control versus xylitol: −0.11 (–0.61–0.35), control versus erythritol: 0.05 (0.44–0.54), erythritol versus xylitol: 0.07 (–0.41–0.54)). There was no statistically significant effect on abdominal fat, glucose tolerance, uric acid, hepatic enzymes and creatinine. Gastrointestinal tolerance was good except for a few diarrhoea-related symptoms. Participants of all groups reduced their consumption of sweetened beverages and sweets compared with preintervention.

Conclusions

The 5-week intake of erythritol and xylitol showed no statistically significant effects on vascular function, abdominal fat, or glucose tolerance in people with obesity.

Clinical trial registration

NCT02821923.
Maternal near-miss prediction model development among pregnant women in Bahir Dar City administration, northwest Ethiopia: a study protocol
Authors: Workineh Yinager , Alene Getu Degu , Fekadu Gedefaw Abeje
Published: November 2023

Introduction

Maternal near-miss is a condition when a woman nearly died but survived from complications that happened during pregnancy, childbirth or within 42 days after delivery. Maternal near-miss is more prevalent among women in developing nations. Previous studies have identified the impact of different predictor variables on maternal near-miss but shared prognostic predictors are not adequately explored in Ethiopia. It is therefore necessary to build a clinical prediction model for maternal near-misses in Ethiopia. Hence, the aim of this study is to develop and validate a prognostic prediction model, and generate a risk score for maternal near-miss among pregnant women in Bahir Dar City Administration.

Methods and analysis

A prospective follow-up study design will be employed among 2110 selected pregnant women in the Bahir Dar City administration from 1 May 2023 to 1 April 2024. At the initial antenatal visit, pregnant women will be systematically selected. Then, they will be followed until 42 days following birth. Data will be collected using structured questionnaires and data extraction sheet. The model will be created using Cox proportional hazard regression analysis. The performance of the model will be assessed based on its capacity for discrimination using c-index and calibration using calibration plot, intercept and slope. The model’s internal validity will be evaluated through the bootstrapping method. Ultimately, the model will be illustrated through a nomogram and decision tree, which will be made available to prospective users.

Ethics and dissemination

Ethical approval has been obtained from the Institutional Review Board of the College of Medicine and Health Sciences, Bahir Dar University (protocol number 704/2023). Findings will be published in peer-reviewed journals and local and international seminars, conferences, symposiums and workshops. Manuscripts will be prepared and published in scientifically reputable journals. In addition, policy briefs will be prepared.
What is the aetiology of dysnatraemia in COVID-19 and how is this related to outcomes in patients admitted during earlier and later COVID-19 waves? A multicentre, retrospective observational study in 11 Dutch hospitals
Authors: de Haan Lianne , ten Wolde Marije , Beudel Martijn , Olde Engberink Rik H G , Appelman Brent , Haspels-Hogervorst Esther K , Rusch Daisy , Gritters van den Oever Niels C , Simsek Suat , Paternotte Nienke , van den Bergh Joop P , Wyers Caroline E , de Kruif Martijn D , Dormans Tom , Moeniralam Hazra , Bokhizzou Neyma , Brinkman Kees , Douma Renee
Published: November 2023

Objectives

To evaluate the relationship among dysnatraemia at hospital presentation and duration of admission, risk of intensive care unit (ICU) admission and all-cause mortality and to assess the underlying pathophysiological mechanism of hyponatraemia in patients with COVID-19. Our hypothesis is that both hyponatraemia and hypernatraemia at presentation are associated with adverse outcomes.

Design

Observational study.

Setting

Secondary care; 11 Dutch hospitals (2 university and 9 general hospitals).

Participants

An analysis was performed within the retrospective multicentre cohort study COVIDPredict. 7811 patients were included (60% men, 40% women) between 24 February 2020 and 9 August 2022. Patients who were ≥18 years with PCR-confirmed COVID-19 or CT with COVID-19 reporting and data system score≥4 and alternative diagnosis were included. Patients were excluded when serum sodium levels at presentation were not registered in the database or when they had been transferred from another participating hospital.

Outcome measures

We studied demographics, medical history, symptoms and outcomes. Patients were stratified according to serum sodium concentration and urinary sodium excretion.

Results

Hyponatraemia was present in 2677 (34.2%) patients and hypernatraemia in 126 (1.6%) patients. Patients with hyponatraemia presented more frequently with diarrhoea, lower blood pressure and tachycardia. Hyponatraemia was, despite a higher risk for ICU admission (OR 1.27 (1.11–1.46; p<0.001)), not associated with mortality or the risk for intubation. Patients with hypernatraemia had higher mortality rates (OR 2.25 (1.49–3.41; p<0.001)) and were at risk for ICU admission (OR 2.89 (1.83–4.58)) and intubation (OR 2.95 (1.83–4.74)).

Conclusions

Hypernatraemia at presentation was associated with adverse outcomes in patients with COVID-19. Hypovolaemic hyponatraemia was found to be the most common aetiology of hyponatraemia. Hyponatraemia of unknown aetiology was associated with a higher risk for ICU admission and intubation and longer duration of admission.
Workplace-based learning about health promotion in individual patient care: a scoping review
Authors: Verhees Myrthe J M , Engbers Rik , Landstra Anneke M , Bremer Anne E , van de Pol Marjolein , Laan Roland F J M , Assendelft Willem J J
Published: November 2023

Objective

To outline current knowledge regarding workplace-based learning about health promotion in individual patient care.

Design

Scoping review.

Data sources

PubMed, ERIC, CINAHL and Web of Science from January 2000 to August 2023.

Eligibility criteria

We included articles about learning (activities) for healthcare professionals (in training), about health promotion in individual patient care and in the context of workplace-based learning.

Data extraction and synthesis

The studies were evaluated using a charting template and were analysed thematically using a template based on Designable Elements of Learning Environments model.

Results

From 7159 studies, we included 31 that described evaluations of workplace-based learning about health promotion, around a variety of health promotion topics, for different health professions. In the articles, health promotion was operationalised as knowledge, skills or attitudes related to specific lifestyle factors or more broadly, with concepts such as health literacy, advocacy and social determinants of health. We assembled an overview of spatial and instrumental, social, epistemic and temporal elements of learning environments in which health promotion is learnt.

Conclusions

The studies included in our analysis varied greatly in their approach to health promotion topics and the evaluation of learning outcomes. Our findings suggest the importance of providing opportunities for health profession learners to engage in authentic practice situations and address potential challenges they may experience translating related theory into practice. Additionally, our results highlight the need for conscious and articulated integration of health promotion in curricula and assessment structures. We recommend the exploration of opportunities for health profession students, professionals and patients to learn about health promotion together. Additionally, we see potential in using participatory research methods to study future health promotion learning.

Study registration

Open Science Framework,https://doi.org/10.17605/OSF.IO/6QPTV.
Impact of a quality programme on overindication of surgeries for endometriosis and cholecystectomies
Authors: Conte de Oliveira Mauro Dirlando , Fernandes Haggeas da Silveira , Vasconcelos Ana Luiz , Russo Fernanda Aparecida de Paula , Malheiro Daniel Tavares , Colombo Giancarlo , Pelegrini Paula , Berwanger Otavio , Teich Vanessa , Marra Alexandre , Menezes Fernando Gatti de , Cendoroglo Neto Miguel , Klajner Sidney
Published: November 2023

Approximately 45% of patients receive medical services with minimal or no benefit (low-value care). In addition to the increasing costs to the health system, performing invasive procedures without an indication poses a potentially preventable risk to patient safety. This study aimed to determine whether a managed quality improvement programme could prevent cholecystectomy and surgery for endometriosis treatment with minimal or no benefit to patients.

This before-and-after study was conducted at a private hospital in São Paulo, Brazil, which has a main medical remuneration model of fee for service. All patients who underwent cholecystectomy or surgery for endometriosis between 1 August 2020 and 31 May 2021 were evaluated.

The intervention consisted of allowing the performance of procedures that met previously defined criteria or for which the indications were validated by a board of experts.

A total of 430 patients were included in this analysis. The programme prevented the unnecessary performance of 13% of cholecystectomies (p=0.0001) and 22.2% (p=0.0006) of surgeries for the treatment of endometriosis. This resulted in an estimated annual cost reduction to the health system of US$466 094.93.

In a hospital with a private practice and fee-for-service medical remuneration, the definition of clear criteria for indicating surgery and the analysis of cases that did not meet these criteria by a board of reputable experts at the institution resulted in a statistically significant reduction in low-value cholecystectomies and endometriosis surgeries.
Hospital staff reports of coworker positive and unprofessional behaviours across eight hospitals: who reports what about whom?
Authors: Urwin Rachel , Pavithra Antoinette , McMullan Ryan D , Churruca Kate , Loh Erwin , Moore Carolyn , Li Ling , Westbrook Johanna I
Published: November 2023

Background

Workplace behaviours of healthcare staff impact patient safety, staff well-being and organisational outcomes. A whole-of-hospital culture change programme, Ethos, was implemented by St. Vincent’s Health Australia across eight hospitals. Ethos includes a secure online submission system that allows staff across all professional groups to report positive (Feedback for Recognition) and negative (Feedback for Reflection) coworker behaviours. We analysed these submissions to determine patterns and rates of submissions and identify the coworker behaviours reported.

Method

All Ethos submissions between 2017 and 2020 were deidentified and analysed. Submissions include structured data elements (eg, professional role of the reporter and subjects, event and report dates) and a narrative account of the event and coworker behaviours. Descriptive statistics were calculated to assess use and reporting patterns. Coding of the content of submissions was performed to classify types of reported coworker behaviours.

Results

There were a total of 2504 Ethos submissions, including 1194 (47.7%) Recognition and 1310 (52.3%) Reflection submissions. Use of the submission tool was highest among nurses (20.14 submissions/100 nursing staff) and lowest among non-clinical services staff (5.07/100 non-clinical services staff). Nurses were most frequently the subject of Recognition submissions (7.56/100 nurses) while management and administrative staff were the least (4.25/100 staff). Frequently reported positive coworker behaviours were non-technical skills (79.3%, N=947); values-driven behaviours (72.5%, N=866); and actions that enhanced patient care (51.3%, N=612). Medical staff were the most frequent subjects of Reflection submissions (12.59/100 medical staff), and non-clinical services staff the least (4.53/100 staff). Overall, the most frequently reported unprofessional behaviours were being rude (53.8%, N=705); humiliating or ridiculing others (26%, N=346); and ignoring others’ opinions (24.6%, N=322).

Conclusion

Hospital staff across all professional groups used the Ethos messaging system to report both positive and negative coworker behaviours. High rates of Recognition submissions demonstrate a strong desire of staff to reward and encourage positive workplace behaviours, highlighting the importance of culture change programmes which emphasise these behaviours. The unprofessional behaviours identified in submissions are consistent with behaviours previously reported in surveys of hospital staff, suggesting that submissions are a reliable indicator of staff experiences.
Early Peanut Immunotherapy in Children (EPIC) trial: protocol for a pragmatic randomised controlled trial of peanut oral immunotherapy in children under 5 years of age
Authors: O'Sullivan Michael David , Bear Natasha , Metcalfe Jessica
Published: November 2023

Introduction

Food allergy is a major public health challenge in Australia. Despite widespread uptake of infant feeding and allergy prevention guidelines the incidence of peanut allergy in infants has not fallen, and prevalence of peanut allergy in school-aged children continues to rise. Therefore, effective and accessible treatments for peanut allergy are required. There is high-quality evidence for efficacy of oral immunotherapy in children aged 4–17 years old; however, few randomised trials have investigated peanut oral immunotherapy (OIT) in young children. Furthermore, the use of food products for OIT with doses prepared and administered by parents without requiring pharmacy compounding has the potential to reduce costs associated with the OIT product.

Methods and Analysis

Early Peanut Immunotherapy in Children is an open-label randomised controlled trial of peanut OIT compared with standard care (avoidance) to induce desensitisation in children aged 1–4 years old with peanut allergy. n=50 participants will be randomised 1:1 to intervention (daily peanut OIT for 12 months) or control (peanut avoidance). The primary outcome is the proportion of children in each group with a peanut eliciting dose >600 mg peanut protein as assessed by open peanut challenge after 12 months, analysed by intention to treat. Secondary outcomes include safety as assessed by frequency and severity of treatment-related adverse events, quality of life measured using age-appropriate food allergy-specific questionnaires and immunological changes during OIT.

Ethics

The trial is approved by the Child and Adolescent Health Service Human Research Ethics Committee and prospectively registered with the Australia and New Zealand Clinical Trials Registry.

Dissemination

Trial outcomes will be published in a peer-review journal and presented and local and national scientific meetings.

Trial registration number

ACTRN12621001001886.
Physical inactivity 5–8 years after anterior cruciate ligament reconstruction is associated with knee-related self-efficacy and psychological readiness to return to sport
Authors: Stigert Maja , Ashnai Farshad , Thomeé Roland , Hamrin Senorski Eric , Beischer Susanne
Published: November 2023

Objectives

To investigate whether patient demographics and patient-reported outcomes (PROs), respectively, are associated with physical inactivity (PI) 5–8 years after primary anterior cruciate ligament reconstruction (ACLR).

Methods

This case control observational study included individuals who had undergone primary ACLR between the ages of 15 and 65 years and had responded to PROs 18 months postoperatively. These individuals were asked to answer a questionnaire regarding their present level of physical activity (PA) at 5–8 years after ACLR. Patient-demographic data and results from the Knee injury and Osteoarthritis Outcome Score, the Knee Self-Efficacy Scale and the ACL Return to Sport (RTS) after Injury scale from 18 months after ACLR were extracted from a rehabilitation-specific register. Univariable logistic regression analyses were performed with PI (<150 min PA per week/≥150 min PA/week) as the dependent variable.

Results

Of 292 eligible participants, 173 (47% women; mean±SD age = 31±11 years) responded to the PA questionnaire. In all, 14% (n=25; 28% women) were classified as physically inactive. Participants with lower levels of present and future self-efficacy, OR 1.35 (CI 1.05 to 1.72) and OR 1.20 (CI 1.12 to 1.45), and lower levels of psychological readiness to RTS, OR 1.19 (CI 1 to 1.43), at the 18-month follow-up, had higher odds of being physically inactive 5–8 years after ACLR. None of the patient demographic variables was able to predict PI.

Conclusion

Lower levels of knee-related self-efficacy and psychological readiness to RTS, 18 months after ACLR, were associated with PI 5–8 years after surgery.
Eosinophilic myocarditis: systematic review
Authors: Techasatian Witina , Gozun Maan , Vo Kristine , Yokoyama Jennifer , Nagamine Todd , Shah Parthav , Vu Kimberly , Zhang James , Nishimura Yoshito
Published: November 2023

Objective

In clinical practice, patients with eosinophilic myocarditis (EM) may forgo the gold standard diagnostic procedure, endomyocardial biopsy (EMB), although it is highly recommended in guidelines. This systematic review aims to summarise current approaches in diagnosing and treating EM with a particular emphasis on the utilisation and value of alternative diagnostic methods.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we searched MEDLINE and EMBASE for all peer-reviewed articles using the keywords “eosinophilic myocarditis” from their inception to 10 September 2022.

Results

We included 239 articles, including 8 observational studies and 274 cases, in this review. The median patient age was 45 years. Initial presentations were non-specific, including dyspnoea (50.0%) and chest pain (39.4%). The aetiologies of EM were variable with the most common being idiopathic (28.8%) and eosinophilic granulomatosis polyangiitis (19.3%); others included drug-induced (13.1%) and hypereosinophilic syndrome (12.8%). 82.4% received an EM diagnosis by EMB while 17.6% were diagnosed based on clinical reasoning and cardiac MRI (CMR). CMR-diagnosed patients exhibited a better risk profile at diagnosis, particularly higher left ventricular ejection fraction and less need for inotropic or mechanical circulatory supports. Glucocorticoids were the primary treatment with variability in dosages and regimens.

Conclusion

EMB is the mainstay for diagnostic testing for EM. CMR is potentially helpful for screening in appropriate clinical scenarios. Regarding treatment, there is no consensus regarding the optimal dosage of corticosteroids. Large clinical trials are warranted to further explore the utility of CMR in the diagnosis of EM and steroid regimen in treating EM.
MULTIPLE SOLITONS, BIFURCATIONS, CHAOTIC PATTERNS AND FISSION/FUSION, ROGUE WAVES SOLUTIONS OF TWO-COMPONENT EXTENDED (2+1)-D ITÔ CALCULUS SYSTEM
Authors: KARACA YELİZ , UR RAHMAN MATI , EL-SHORBAGY MOHAMMED A. , BALEANU DUMITRU
Published: November 2023

The exploration of nonlinear phenomena entails the representation of intricate systems with space-time variables, and across this line, Itô calculus, as the stochastic calculus version of the change pertaining to the variables formula and chain rules, involves the second derivative of f, coming from the property that Brownian motion has non-zero quadratic variation. To this end, the extended ([Formula: see text])-dimensional two-component Itô equation, as an applicable mathematical tool employed in this study for enhancing our understanding of the complex dynamics inherent in multidimensional physical systems, serves the purpose of modeling and understanding dynamic phenomena pervading various disciplines. For modeling complex phenomena, fractional differential equations (FDEs), ordinary differential equations (ODEs), partial differential equations (PDEs) as well as the other ones provide benefits in terms of accuracy and tractability. Accordingly, our study provides the analysis of the two-component nonlinear extended ([Formula: see text])-dimensional Itô equation using the Hirota bilinear method to derive multiple soliton solutions, including novel variations along with their dispersion coefficients, which shed light into the intriguing attributes of the Itô equation. The investigation further encompasses diverse soliton types, such as the general first-order soliton, second-order soliton with fission and bifurcation, third-order soliton, and fourth-order soliton with fission and bifurcation. Besides these, the study also explores the rogue wave and lump solutions by varying parameters across distinct planes. Consequently, these results validate the characteristics and utility of the two-component nonlinear extended ([Formula: see text])-dimensional Itô equation and its relevance to related systems. The novel findings based on the Itô calculus systems revealed, through the analyses, theoretical and experimental aspects in combination with the graphical presentation of the parameter effects on solitons in line with the analyses obtained. These have enhanced the understanding of the dynamics of intricate attributes governed by the two-component nonlinear extended ([Formula: see text])-dimensional Itô equation, particularly concerning chaotic patterns, fission and bifurcation soliton nonlinear complexities.
Component Edge Connectivity and Extra Edge Connectivity of Bubble-Sort Star Graphs
Authors: Hua Xiaohui , Lai Yonghao
Published: November 2023

Connectivity is an important parameter for evaluating the reliability and stability of an interconnection network. Based on the edge connectivity, more refined connectivities have been proposed. The [Formula: see text]-component edge connectivity [Formula: see text] and the [Formula: see text]-extra edge connectivity [Formula: see text] are two important parameters to assess the robustness of an interconnection network, which received attention extensively. In this paper, we determine the [Formula: see text]-component edge connectivity and the [Formula: see text]-extra edge connectivity of bubble-sort star graphs [Formula: see text]. For [Formula: see text]-component edge connectivity, we prove that [Formula: see text], [Formula: see text], and [Formula: see text] for [Formula: see text]. For [Formula: see text]-extra edge connectivity, we prove that [Formula: see text], [Formula: see text], and [Formula: see text] for [Formula: see text].
Ontology-Based Natural Language Processing for Sentimental Knowledge Analysis Using Deep Learning Architectures
Authors: Jain Deepak Kumar , Qamar Shamimul , Sangwan Saurabh Raj , Ding Weiping , Kulkarni Anand J.
Published: November 2023

When tested with popular datasets, sentiment categorization using deep learning (DL) algorithms will produce positive results. Building a corpus on novel themes to train machine learning methods in sentiment classification with high assurance, however, will be difficult. This study proposes a way for representing efficient features of a dataset into a word embedding layer of DL methods in sentiment classification known as KPRO (knowledge processing and representation based on ontology), a procedure to embed knowledge in the ontology of opinion datasets. This research proposes novel methods in ontology-based natural language processing utilizing feature extraction as well as classification by a DL technique. Here, input text has been taken as web ontology based text and is processed for word embedding. Then the feature mapping is carried out for this processed text using least square mapping in which the sentiment-based text has been mapped for feature extraction. The feature extraction is carried out using a Markov model based auto-feature encoder (MarMod_AuFeaEnCod). Extracted features are classified by utilizing hierarchical convolutional attention networks. Based on this classified output, the sentiment of the text obtained from web data has been analyzed. Results are carried out for Twitter and Facebook ontology-based sentimental analysis datasets in terms of accuracy, precision, recall, F-1 score, RMSE, and loss curve analysis. For the Twitter dataset, the proposed MarMod_AuFeaEnCod_HCAN attains an accuracy of 98%, precision of 95%, recall of 93%, F-1 score of 91%, RMSE of 88%, and loss curve of 70.2%. For Facebook, ontology web dataset analysis is also carried out with the same parameters in which the proposed MarMod_AuFeaEnCod_HCAN acquires accuracy of 96%, precision of 92%, recall of 94%, F-1 score of 91%, RMSE of 77%, and loss curve of 68.2%.
Software Managers' Guide to Operational Excellence
Authors: Matsudaira Kate
Published: November 2023

Software engineering managers (or any senior technical leaders) have many responsibilities: the care and feeding of the team, delivering on business outcomes, and keeping the product/system/application up and running and in good order. Each of these areas can benefit from a systematic approach. The one I present here is setting up checks and balances for the team's operational excellence.