bluuebunny/crossref_metadata_2025 huggingface dataset:
Quercetin ameliorates acute lung injury in a rat model of hepatopulmonary syndrome
Authors: Nassef Noha Abdel-Aziz , Abd-El Hamid Manal S. , Abusikkien Samy A. , Ahmed Asmaa Ibrahim
Published: December 2022

Background

Common bile duct ligation (BDL) is a rat experimental model to induce biliary cirrhosis. Lung fibrosis and pulmonary vascular angiogenesis and congestion are the most common complications of biliary cirrhosis that is known as hepatopulmonary syndrome. The aim of the present work is to investigate the acute lung injury in a BDL model and to investigate the possible protective effect of quercetin on this injury.

Methods

Twenty-four adult male albino rats of the Wister strain (weighing 150–250 g). Animals were divided into 3 groups, with 8 rats each: Group I: Sham-operated group (control). Group II: Bile duct ligation group (BDL) sacrificed after 28 days from the surgery. Group III: Quercetin-treated bile duct ligation group (Q-BDL) was given orally by gastric gavage in a dose of 50 mg/kg/day, starting from the 4th day of the operation until the 28th day. At the end of the experiment, at day 28, all rats were sacrificed. Lung specimens were processed to measure Endothelin B receptor gene expression by PCR, lung surfactant by ELISA, “eNO” s by immunohistochemistry. Histological assessment was done using; H&E, Masson’s trichrome, PAS, toluidine blue-stained semi-thin sections, transmission electron microscope. Histomorphometric and statistical studies were done.

Results

BDL group showed significant increase in lung index together with mononuclear cellular infiltration denoting lung inflammatory state. Also, the significant increase in pulmonary endothelial nitric oxide synthase ("eNO" s) area percent and endothelin B receptor (ETB) gene expression indicates enhanced angiogenesis. Pulmonary surfactant concentration was significantly decreased together with thickening of interalveolar septa denoting lung injury and fibrosis. Quercetin led to significant decrease in lung index, pulmonary "eNO" s area percent, ETB gene expression and significant increase in pulmonary surfactant concentration. Quercetin treatment improved histological changes and morphometric measurements, limited mononuclear cellular infiltration and decreased perivascular and perialveolar collagen deposition.

Conclusion

Quercetin ameliorates the hepatopulmonary syndrome-induced lung injury through its anti-inflammatory, antioxidative and antifibrotic effects.
Assessing knowledge of herbal medicine course for dental students
Authors: Natto Zuhair S.
Published: December 2022

Background

The aims of this article are to assess dental students’ knowledge about herbal medicine usage and the potential benefits and side effects, and to conduct a short course about herbal medicine.

Methods

All fourth-year pre-doctoral students were invited to participate in a herbal medicine course as a test while the sixth-year students were the control group. A survey was tested for validity and reliability. It comprised of 16 multiple choice questions was given before the course and one month after the course. The sum score of knowledge for each participant was calcuated based on the ability to identify the use of herbs in dentistry with high-quality evidence (correct answer) or total answer for periodontal disease and caries.

Results

The response rate for completing the study was 112 fourth-year students (73.7%) and 64 sixth-year students (39.0%). More than half of the participants (52.5%) were unsure about the importance of herbal medicine in dentistry. However, the majority also stated that the most common herbs used in dentistry were clove (62.9%), followed by curcuma turmeric (54.7%) and meswak (43.0%). The fourth-year students displayed evidence of a higher overall knowledge score after the course in herbal medicine related to periodontal disease in total and correct answers (mean 4.48 ± 4.13, 3.73 ± 3.31, respectively) compared to before the course (mean 0.84 ± 1.23, 0.74 ± 1.16, respectively) (p-value < 0.001). The post-course periodontal disease total and correct answers were statistically significant between fourth- and sixth-year students.

Conclusion

Herbal medicine has a potential positive impact on dentistry. However, these effects are not fully investigated and received full attention in academic institute. This short educational program related to medicinal herbs can improve the knowledge of dental students. This will help increase the awareness about the use and potential side effects of herbal medicine in the dental field.
Effects of technology-based educational tools on nursing learning outcomes in intensive care units: a systematic review and meta-analysis
Authors: Rezayi Sorayya , Amanollahi Alireza , Shahmoradi Leila , Rezaei Nafiseh , Katigari Meysam Rahmani , Zolfaghari Mitra , Manafi Babak
Published: December 2022

Background

Nurses working in the Intensive Care Unit (ICU), due to the sensitivity and difficulty of tasks, need continuous and scientific training to be able to offer the best performance in difficult situations and use their knowledge in the best way. Also, nursing students spend internships in ICUs and receive special training in practice in the actual center. Educational tools based on new technologies can potentially improve the educational outcomes of nursing in ICUs.

Objectives

 The present study aims to review and evaluate the effect of using technology-based educational tools for training critical care nurses and nursing students.

Methods

 A comprehensive search was conducted to identify peer-reviewed English language articles in Embase, Medline (through PubMed), Scopus, and ISI web of science published from 2010 to Feb 18, 2022. The studies that examined the effectiveness of technology-based educational interventions with control groups were included. The risk of bias in each study was assessed using the Cochrane Collaboration’s tool. Also, we used Standard Mean Difference (SMD) to estimate the effect of technology-based educational tools on learning outcomes. All meta-analyses were performed with a random effects model in Stata Ver.16.

Results

 Altogether, ten studies were eligible for the quality assessment and systematic review, while one study that had not reported the pre-intervention analysis was excluded from the meta-analysis. Nine studies were considered to have a low RoB regarding reporting ways, and one of them showed a high risk. Performance and selection bias caused a high risk in six and five of the studies, respectively. In the meta-analysis, improvement in knowledge (SMD = 0.91), skills (SMD = 0.52), and self-confidence (SMD = 0.96) was noticed by applying technology-based educational tools.

Conclusion

It can be offered that if the learning method based on the new technologies tested is more effective than conventional teaching methods, they are likely to improve the learning outcome significantly. The new-developed tools also have great potential in improving health care functions among nurses or nursing students as well as enhancing the quality of life and patient satisfaction.
Would you consider donating your left-over embryos to treat Parkinson’s disease? Interviews with individuals that underwent IVF in Sweden
Authors: Bywall Karin Schölin , Holte Jan , Brodin Thomas , Hansson Mats , Drevin Jennifer
Published: December 2022

Background

Parkinson’s disease (PD) has been considered to be one of the most promising target diseases for forthcoming cell-based therapy. The aim of this study is to explore the views of individuals with cryopreserved embryos on using human embryonic stem cells for treating PD.

Methods

The study was performed as a qualitative, semi-structured interview study in June–October 2020. Participants were recruited at a private fertility clinic located in one of the larger Swedish cities. The clinic provides both publicly financed and privately financed IVF-treatments. All interviews were performed by telephone and analyzed using thematic content analysis. Five main categories emerged from 27 sub-categories.

Results

In total, 18 interviews were performed with 22 individuals, as either a couple (n = 16) or separately (n = 6). Participants had different views on what a cryopreserved embryo is. Some participants addressed cryopreserved embryos as ‘a lump of cells’, and some in terms of their ‘unborn child’. Conditions for donation of cryopreserved embryos for cell-based treatment in PD were: not losing control of what is happening to the embryo, that donating must be voluntary and based on informed consent with time for reflection, that reimbursement, equality and transparency.

Conclusions

Using cryopreserved embryos to treat PD is associated with fundamental ethical and practical issues. This study shows that IVF couples with left-over embryos may be supportive but there is a need for future research to assess people’s views on using cryopreserved embryos for cell-based treatment in PD on a more aggregated level.
General practitioner residents and patients end-of life: involvement and consequences
Authors: Haardt Victoire , Cambriel Amélie , Hubert Sidonie , Tran Marc , Bruel Cédric , Philippart Francois ,   for the REQUIEM Study group
Published: December 2022

Background

The ageing of the population and the increased number of chronic diseases are associated with an increased frequency of end of life care in hospital settings. Residents rotating in hospital wards play a major part in their care, regardless of their specialty. General practitioner (GP) residents are confronted to such activities in hospital settings during their training. Our aim was to know how they feel about taking care of dying patients, as end-of-life care are very different from the clinical activity they are trained to.

Methods

We surveyed all GP trainees of “Ile de France”. The survey was made of 41 questions regarding advanced directives divided in 7 sections about patients’ care, communication, mentoring and repercussion on personal life. The survey was done one time, during two pre-specified days.

Results

525 residents (53.8%) accepted to fulfill the survey. 74.1% of the residents thought that palliative care could have been better. Possible ways of improvements were: a reduction of unreasonable obstinacy (or therapeutic overkill, two terms defined in French law as curative treatment without reasonable hope of efficiency) (59.6%), patient’s (210 answers, 40%) and relative’s communication (information of patients and relatives about the severity of the disease and risk of death) (199 answers 37.9%). Residents also reported a lack of knowledge regarding end-of-life care specific treatments (411 answers, 79.3%) and 298 (47.2%) wished for better mentoring. Those difficulties were associated with repercussion on their private life (353 answers, 67.2%), particularly with their close relatives (55.4%). Finally, 56.2% of trainees thought that a systematic psychologic follow up should be instituted for those working in “at risk” hospital settings.

Conclusion

Self-perception management of dying patients by GP resident emphasize their lack of training and supervision. The feeling of suboptimal care is associated with consequences on personal life.
Neural-signature methods for structured EHR prediction
Authors: Vauvelle Andre , Creed Paidi , Denaxas Spiros
Published: December 2022

Models that can effectively represent structured Electronic Healthcare Records (EHR) are central to an increasing range of applications in healthcare. Due to the sequential nature of health data, Recurrent Neural Networks have emerged as the dominant component within state-of-the-art architectures. The signature transform represents an alternative modelling paradigm for sequential data. This transform provides a non-learnt approach to creating a fixed vector representation of temporal features and has shown strong performances across an increasing number of domains, including medical data. However, the signature method has not yet been applied to structured EHR data. To this end, we follow recent work that enables the signature to be used as a differentiable layer within a neural architecture enabling application in high dimensional domains where calculation would have previously been intractable. Using a heart failure prediction task as an exemplar, we provide an empirical evaluation of different variations of the signature method and compare against state-of-the-art baselines. This first application of neural-signature methods in real-world healthcare data shows a competitive performance when compared to strong baselines and thus warrants further investigation within the health domain.
Integrating private health facilities in government-led health systems: a case study of the public–private mix approach in Ethiopia
Authors: Ali Disha , Woldegiorgis Asfawesen Gebre-Yohannes , Tilaye Mesfin , Yilma Yonas , Berhane Hanna Y. , Tewahido Dagmawit , Abelti Gebeyehu , Neill Rachel , Silla Ndeye , Gilliss Lauren , Mandal Mahua
Published: December 2022

Background

Private health care facilities working in partnership with the public health sector is one option to create sustainable health systems and ensure health and well-being for all in low-income countries. As the second-most populous country in Africa with a rapidly growing economy, demand for health services in Ethiopia is increasing and one-quarter of its health facilities are privately owned. The Private Health Sector Program (PHSP), funded by the United States Agency for International Development, implemented a series of public–private partnership in health projects from 2004 to 2020 to address several public health priorities, including tuberculosis, malaria, HIV/AIDS, and family planning. We assessed PHSP’s performance in leadership and governance, access to medicines, health management information systems, human resources, service provision, and finance.

Methods

The World Health Organization’s health systems strengthening framework, which is organized around six health system building blocks, guided the assessment. We conducted 50 key informant interviews and a health facility assessment at 106 private health facilities supported by the PHSP to evaluate its performance.

Results

All six building blocks were addressed by the program and key informants shared that several policy and strategic changes were conducive to supporting the functioning of private health facilities. The provision of free medicines from the public pharmaceutical logistics system, relaxation of strict regulatory policies that restricted service provision through the private sector, training of private providers, and public–private mix guidelines developed for tuberculosis, malaria, and reproductive, maternal, newborn, child, and adolescent health helped increase the use of services at health facilities.

Conclusions

Some challenges and threats to sustainability remain, including fragile partnerships between public and private bodies, resource constraints, mistrust between the public and private sectors, limited incentives for the private sector, and oversight of the quality of services. To continue with gains in the policy environment, service accessibility, and other aspects of the health system, the government and international communities must work collaboratively to address public–private partnerships in health areas that can be strengthened. Future efforts should emphasize a mechanism to ensure that the private sector is capable, incentivized, and supervised to deliver continuous, high-quality and equitable services.
A qualitative study exploring hospital-based team dynamics in discharge planning for patients experiencing delayed care transitions in Ontario, Canada
Authors: Cadel Lauren , Sandercock Jane , Marcinow Michelle , Guilcher Sara J. T. , Kuluski Kerry
Published: December 2022

Background

In attempt to improve continuity of patient care and reduce length of stay, hospitals have placed an increased focus on reducing delayed discharges through discharge planning. Several benefits and challenges to team-based approaches for discharge planning have been identified. Despite this, professional hierarchies and power dynamics are common challenges experienced by healthcare providers who are trying to work as a team when dealing with delayed discharges. The objective of this study was to explore what was working well with formal care team-based discharge processes, as well as challenges experienced, in order to outline how teams can function to better support transitions for patients experiencing a delayed discharge. 

Methods

We conducted a descriptive qualitative study with hospital-based healthcare providers, managers and organizational leaders who had experience with delayed discharges. Participants were recruited from two diverse health regions in Ontario, Canada. In-depth, semi-structured interviews were conducted in-person, by telephone or teleconference between December 2019 and October 2020. All interviews were recorded and transcribed. A codebook was developed by the research team and applied to all transcripts. Data were analyzed inductively, as well as deductively through directed content analysis.

Results

We organized our findings into three main categories – (1) collaboration with physicians makes a difference; (2) leadership should meaningfully engage with frontline providers and (3) partnerships across sectors are critical. Regular physician engagement, as equal members of the team, was recommended to improve consistent communication, relationship building between providers, accessibility, and in-person communication. Participants highlighted the need for a dedicated senior leader who ensured members of the team were treated as equals and advocated for the team. Improved partnerships across sectors included the enhanced integration of community-based providers into discharge planning by placing more focus on collaborative practice, combined discharge planning meetings, and having embedded and physically accessible care coordinators in the hospital.

Conclusions

Team-based approaches for delayed discharge can offer benefits. However, to optimize how teams function in supporting these processes, it is important to consistently collaborate with physicians, ensure senior leadership engage with and seek feedback from frontline providers through co-design, and actively integrate the community sector in discharge planning.
Negative emotions experienced by healthcare staff following medication administration errors: a descriptive study using text-mining and content analysis of incident data
Authors: Mahat Sanu , Rafferty Anne Marie , Vehviläinen-Julkunen Katri , Härkänen Marja
Published: December 2022

Background

Medication errors regardless of the degree of patient harm can have a negative emotional impact on the healthcare staff involved. The potential for self-victimization of healthcare staff following medication errors can add to the moral distress of healthcare staff. The stigma associated with errors and their disclosure often haunts healthcare professionals, leading them to question their own professional competence. This paper investigates the negative emotions expressed by healthcare staff in their reported medication administration error incidents along with the immediate responses they received from their seniors and colleagues after the incident.

Method

This is a retrospective study using a qualitative descriptive design and text mining. This study includes free-text descriptions of medication administration error incidents (n = 72,390) reported to National Reporting & Learning System in 2016 from England and Wales. Text-mining by SAS text miner and content analysis was used to analyse the data.

Results

Analysis of data led to the extraction of 93 initial codes and two categories i.e., 1) negative emotions expressed by healthcare staff which included 4 sub-categories of feelings: (i) fear; (ii) disturbed; (iii) sadness; (iv) guilt and 2) Immediate response from seniors and colleagues which included 2 sub-categories: (i) Reassurance and support and (ii) Guidance on what to do after an error.

Conclusion

Negative emotions expressed by healthcare staff when reporting medication errors could be a catalyst for learning and system change. However, negative emotions when internalized as fear, guilt, or self-blame, could have a negative impact on the mental health of individuals concerned, reporting culture, and opportunities for learning from the error. Findings from this study, hence, call for future research to investigate the impact of negative emotions on healthcare staff well-being and identify ways to mitigate these in practice.
Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway
Authors: Leclair Marichelle C. , Charette Yanick , Seto Michael , Nicholls Tonia L. , Roy Laurence , Dufour Mathieu , Crocker Anne G.
Published: December 2022

Background

The verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the present study is to identify individual and contextual barriers and facilitators of access to mental health services during the period preceding an offense leading to a verdict of NCRMD.

Methods

The sample includes 753 people found NCRMD in Québec, Canada. All episodes of mental health hospitalizations and service use before the index offense were identified using provincial administrative health data, for an average period of 4.5 years. Access was conceptualized as a function of the possibility of seeking, reaching and receiving appropriate health care services, based on Lévesque and colleagues patient-centred model of access to care.

Generalized linear models were computed to identify the individual and contextual predictors of: (1) seeking mental healthcare (at least one contact with any type of services for mental health reasons); (2) reaching psychiatric care (at least one contact with a psychiatrist); (3) receiving psychiatric care, operationalized as (3a) continuity and (3b) intensity. Factors associated with volume of emergency mental health services were examined as exploratory analysis.

Results

Geographical considerations were highly important in determining who reached, and who received specialized mental health care – above and beyond individual factors related to need. Those who lived outside of major urban centres were 2.6 times as likely to reach psychiatric services as those who lived in major urban centres, and made greater use of emergency mental health services by 2.1 times. Living with family decreased the odds of seeking mental healthcare by half and the intensity of psychiatric care received, even when adjusting for level of need.

Conclusions

Findings support efforts to engage with the family of service users and highlights the importance of providing resources to make family-centred services sustainable for health practitioners. Health policies should also focus on the implementation of outreach programs, such as Forensic Assertive Community Treatment teams as part of prevention initiatives.
Impact of COVID-19 on HIV service delivery in Miami-Dade County: a mixed methods study
Authors: Harkness Audrey , Morales Vanessa , Defreitas Wayne , Atuluru Pranusha , Jaramillo Jahn , Weinstein Elliott R. , Feaster Daniel J. , Safren Steven , Balise Raymond
Published: December 2022

Background

Facilitating access to HIV prevention and treatment is imperative in Miami-Dade County (MDC), a U.S. HIV epicenter. With COVID-19, disruptions to these services have occurred, leading HIV organizations to innovate and demonstrate resilience. This study documented COVID-19 related disruptions and resilient innovations in HIV services within MDC.

Methods

This mixed methods cross-sectional study included HIV test counselors in MDC. In the quantitative component (N=106), participants reported COVID-19 impacts on HIV service delivery. Data visualization examined patterns within organizations and throughout the study period. Generalized estimating equation modeling examined differences in service disruptions and innovations. In the qualitative component, participants (N=20) completed interviews regarding COVID-19 impacts on HIV services. Rapid qualitative analysis was employed to analyze interviews.

Results

Quantitative data showed that innovations generally matched or outpaced disruptions, demonstrating resilience on HIV service delivery during COVID-19. HIV testing (36%, 95%CI[28%, 46%]) and STI testing (42%, 95%CI[33%, 52%]) were most likely to be disrupted. Sexual/reproductive health (45%, 95%CI[35%, 55%]), HIV testing (57%, 95%CI[47%,66%]), HIV case management (51%, 95%CI[41%, 60%]), PrEP initiation (47%, 95%CI[37%,57%]), and STI testing (47%, 95%CI[37%, 57%]) were most likely to be innovated. Qualitative analysis revealed three orthogonal themes related to 1) disruptions (with five sub-components), 2) resilient innovations (with four sub-components), and 3) emerging and ongoing health disparities.

Conclusions

HIV organizations faced service disruptions during COVID-19 while also meaningfully innovating. Our findings point to potential changes in policy and practice that could be maintained beyond the immediate impacts of COVID-19 to enhance the resilience of HIV services. Aligning with the US Ending the HIV Epidemic Plan and the National Strategy for HIV/AIDS, capitalizing on the observed innovations would facilitate improved HIV-related health services for people living in MDC and beyond.
Were economic evaluations well reported for the newly listed oncology drugs in China’s national reimbursement drug list
Authors: Liu Liu , Jiang Zhixin , Li Fuming , Wei Yan , Ming Jian , Yang Yi , Liu Shimeng , Shi Lizheng , Chen Yingyao
Published: December 2022

Purpose

To assess the reporting quality of published economic evaluations of the negotiated oncology drugs listed for China’s 2020 National Reimbursement Drug List (NRDL).

Methods

A comprehensive search was conducted to identify economic evaluation studies of negotiated oncology drugs listed in China’s 2020 NRDL using the PubMed/MEDLINE, Embase, Web of Science, CNKI, SinoMed, and WanFang Database up to March 31, 2021. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist scored the reporting quality between 0 and 100. A linear regression analysis was employed to examine the influence of various characteristics on the reporting quality scores.

Results

Eighty papers were included in the study, with the majority published during the past decade. Furthermore, more than half of the articles (57.5%, or 46 out of 80) were written in English. The average CHEERS score was 74.63 ± 12.75 and ranged from 43.48 to 93.75. The most inadequately reported items included choice of model, characterization of heterogeneity, and discussion, as well as currency, price date and conversion. Higher scores were associated with articles published from 2019 to 2021 and English publications.

Conclusion

The economic evaluation studies of negotiated oncology drugs listed in 2020 NRDL had moderate reporting quality. The Chinese economic evaluation publications could improve the reporting quality if the CHEERS checklist is consistently implemented. Also, the Chinese journals maybe explore introducing a reporting standard for economic evaluations.
Preference and willingness to receive non-communicable disease services from primary healthcare facilities in Bangladesh: A qualitative study
Authors: Kabir Ashraful , Karim Nazmul , Billah Baki
Published: December 2022

Background

In Bangladesh, non-communicable diseases (NCDs) are increasing rapidly and account for approximately 68% of mortality and 64% of disease burden. NCD services have been significantly mobilized to primary healthcare (PHC) facilities to better manage the rising burden of NCDs. However, little is known about community members’ preference and willingness to receive NCD services from PHC facilities; therefore, this particular subject is the focus of this study.

Methods

A qualitative study was conducted from May 2021 to October 2021. Data were collected via 16 focus group discussions involving community members and 14 key informant interviews with healthcare professionals, facility managers, and public health practitioners. Based on a social-ecological model (SEM), data were analyzed thematically. The triangulation of methods and participants was conducted to validate the information provided.

Results

Preference and willingness to receive NCD services from PHC facilities were influenced by a range of individual, interpersonal, societal, and organizational factors that were interconnected and influenced each other. Knowledge and the perceived need for NCD care, misperception, self-management, interpersonal, and family-level factors played important roles in using PHC facilities. Community and societal factors (i.e., the availability of alternative and complementary services, traditional practices, social norms) and organizational and health system factors (i.e., a shortage of medicines, diagnostic capacity, untrained human resources, and poor quality of care) also emerged as key aspects that influenced preference and willingness to receive NCD services from PHC facilities.

Conclusion

Despite their substantial potential, PHC facilities may not take full advantage of managing NCDs. All four factors need to be considered when developing NCD service interventions in the primary healthcare system to better address the rising burden of NCDs.
Identification and functional characterization of a novel homozygous intronic variant in the fumarylacetoacetate hydrolase gene in a Chinese patient with tyrosinemia type 1
Authors: Chen Jiao , Sun Junhui , Li Xuefang , Du Mengmeng
Published: December 2022

Background

Hereditary tyrosinemia type 1 (HT1; OMIM# 276700) is a genetic metabolism disorder caused by disease-causing variants in the fumarylacetoacetate hydrolase (FAH) gene encoding the last enzyme of the tyrosine catabolic pathway. Herein, we describe the clinical features and genetic characteristics of HT1 in a five years and seven months old Chinese patient.

Methods

After clinical diagnosis of the proband with HT1, genetic testing was performed by Sanger sequencing of the FAH gene in all family members. Functional analysis of the disease-causing variant was performed by cDNA sequencing to understand the effect of the variant on FAH transcript. To further predict the variant effect, we used Human Splicing Finder (HSF) and PyMol in silico analysis.

Results

We identified a novel previously undescribed intronic variant in the FAH gene (c.914-1G>A). It was detected in a child who was homozygous for the variant and had the clinical presentation of HT1. cDNA sequencing showed that this splice-junction variant affected the transcription of FAH by formation of two different transcripts. Our observations and laboratory experiments were in line with in silico methods.

Conclusions

Our study provides new insight into the HT1 variant spectrum and a better understanding of this disease in the Chinese population. This will be useful for molecular diagnosis in our country in cases where premarital screening, prenatal diagnosis and preimplantation genetic diagnosis are planned.
Effects of long-term tobramycin inhalation solution (TIS) once daily on exacerbation rate in patients with non-cystic fibrosis bronchiectasis
Authors: Terpstra Lotte C. , Altenburg Josje , Bronsveld Inez , de Kruif Martijn D. , Berk Yvonne , Snijders Dominic , Rozemeijer Wouter , Heijerman Harry G. M. , Boersma Wim G.
Published: December 2022

Background

Use of long-term tobramycin inhalation solution (TIS) has been shown beneficial in cystic fibrosis (CF) and earlier findings also suggest a benefit in non-CF bronchiectasis. We investigated the efficacy and safety of maintenance TIS once daily (OD) in frequent exacerbating bronchiectasis patients chronically infected by different pathogens sensitive for tobramycin.

Objective

The primary outcome was the frequency of exacerbations during the 12-month study period. Secondary outcomes were time to first exacerbation, change in lung function and quality of life (QoL), bacterial analysis and safety.

Materials/patients

In this multicenter RCT patients aged ≥ 18-year-old were included with confirmed bronchiectasis and ≥ 2 exacerbations in the preceding year. Patients were assigned (1:1) to receive TIS or placebo OD for 1-year.

Results

58 patients were included of which 52 were analyzed in the mITT analysis. TIS reduced exacerbation frequency with a RR of 0.74 (95% CI 0.49–1.14) (p = 0.15). Within the TIS population a decrease in number of exacerbations was found (2; p = 0.00), which was also seen in the placebo-treated patients (1.5; p = 0.00). In the TIS-treated patients the QoL improved (LRTI-VAS p = 0.02 Leicester Cough p = 0.02) without additional safety concerns. No differences were found for the other secondary outcomes.

Conclusion

Long-term TIS OD is a safe treatment modality and showed a non-significant reduced exacerbation frequency of 0.74 as compared to placebo in bronchiectasis patients chronically infected by tobramycin sensitive pathogens. TIS OD may be a potential therapeutic strategy in selected patients with bronchiectasis suffering from a high burden of disease.

Trail registration number: The BATTLE study was registered at Clinical trials.gov number: NCT02657473. Date: 13 august 2016.
Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention
Authors: Zhou Xiao-Dong , Cai Jingjing , Targher Giovanni , Byrne Christopher D. , Shapiro Michael D. , Sung Ki-Chul , Somers Virend K. , Chahal C. Anwar A. , George Jacob , Chen Li-Li , Zhou Yong , Zheng Ming-Hua ,   CHESS-MAFLD consortium
Published: December 2022

The newly proposed term “metabolic dysfunction-associated fatty liver disease” (MAFLD) is replacing the old term “non-alcoholic fatty liver disease” (NAFLD) in many global regions, because it better reflects the pathophysiology and cardiometabolic implications of this common liver disease. The proposed change in terminology from NAFLD to MAFLD is not simply a single-letter change in an acronym, since MAFLD is defined by a set of specific and positive diagnostic criteria. In particular, the MAFLD definition specifically incorporates within the classification recognized cardiovascular risk factors. Although convincing evidence supports a significant association between both NAFLD and MAFLD, with increased risk of CVD morbidity and mortality, neither NAFLD nor MAFLD have received sufficient attention from the Cardiology community. In fact, there is a paucity of scientific guidelines focusing on this common and burdensome liver disease from cardiovascular professional societies. This Perspective article discusses the rationale and clinical relevance for Cardiologists of the newly proposed MAFLD definition.
Multi-country review of ITN routine distribution data: are ANC and EPI channels achieving their potential?
Authors: Miller Jane E. , Malm Kezia , Serge Aimain Alexis , Ateba Marcellin Joel , Gitanya Peter , Sene Doudou , Kooma Emmanuel H. , Kandeh Balla , Gerberg Lilia , Nuñez Luigi
Published: December 2022

Background

Routine continuous distribution (CD) of insecticide-treated nets (ITNs) has been an important part of an overall ITN strategy to complement mass campaigns since the early 2000s. The backbone of CD implementation for many sub-Saharan African countries is distribution through antenatal care (ANC) and Expanded Programme for Immunizations (EPI) channels. Performance of these channels is often not monitored closely at the national level, nor is it reviewed globally, unlike the oversight provided to mass campaigns. The question as to why every eligible pregnant woman and child attending these services does not get an ITN remains important and yet, unanswered.

Methods

ANC and EPI issuing rates from seven countries were reviewed with the aim of conducting a blinded multi-country analysis. Monthly data from January to December 2021 was extracted from each country’s health management information system and analysed jointly with a National Malaria Control Programme (NMCP) focal point. VectorLink CD assessment reports were also reviewed to glean key findings.

Results

ITN issuing rates varied across countries at ANC (31% to 93%) and EPI (39% to 92%). Across the seven countries, the median ITN issuing rate was 64% at ANC and 78% at EPI. Results varied greatly across months per country at both ANC and EPI. NMCP focal points are aware that mass campaigns often negatively affect implementation of ITN distribution through ANC and EPI, even though global and national guidelines emphasize sustaining CD during campaigns. Concerns were also raised about the standard ITN issuing rate indicator at ANC and even more so at EPI due to the denominator.

Findings from CD assessments were similar across countries: ITN stock was inconsistent and sometimes inadequate, and updated guidelines on ITN distribution and utilization and funding for social behaviour change activities were lacking at the facility level.

Conclusion

The importance of optimizing ANC and EPI routine channels cannot be underscored enough. They are at the frontline to protect the most biologically vulnerable populations, i.e., pregnant women and unborn and young children. Although there are encouraging signs of improvement in issuing rates with some countries reaching optimal rates, further improvements are needed to ensure that every pregnant woman and young child receives the ITN to which they are entitled.
A qualitative study on community perceptions on quality of healthcare services they received in the Malaria Elimination Demonstration Project in district Mandla, India
Authors: Singh Mrigendra P. , Rajvanshi Harsh , Bharti Praveen K. , Das Aparup , Thakre Vikesh , Jayswar Himanshu , Sahu Ram Shankar , Telasey Vinay K. , Lal Altaf A.
Published: December 2022

Background

The utilization and impact of the healthcare services depend on the perceived quality, appropriateness, ease of availability, and cost of the services. This study aimed to understand the community's perception of the quality of healthcare services delivered as part of the Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh, India.

Methods

The study used qualitative techniques to analyze the community perceptions that emerged from the participants’ narratives during the Focus Group Discussions (FGDs) and in-depth Interviews with Key Informants (IKIs) on the promptness and quality of healthcare service delivery, the behaviour of MEDP staff, Information, Education and Communication, and Behavioural Change Communication activities, coordination with community members and other health personnel, and capacity building of healthcare workers and the community.

Results

36 FGDs and 63 IKIs with 419 respondents were conducted in nine blocks of district Mandla. Overall, 97% to 100% of beneficiaries associated MEDP with regularity and prompt service delivery, availability of diagnostics and drugs, friendly behaviour, good coordination, and community mobilization to enhance treatment-seeking behaviour.

Conclusions

The study's findings highlighted the importance of building and maintaining the community's participation and promoting the demand for optimal utilization of healthcare services inside the village to promptly achieve the malaria elimination goal.
Effects of vaccine registration on disease prophylaxis: a systematic review
Authors: Rosa Suelia de Siqueira Rodrigues Fleury , da Silva Ana Karoline Almeida , dos Santos Carolina Ramos , Silva Mayla dos Santos , Perillo Ana Luísa Pereira , Mendonça Arthur Faria , Rosa Mario Fabrício Fleury , Sampaio Thatiane Lima , Carneiro Marcella Lemos Brettas , Rocha José Carlos Tatmatsu , Piratelli-Filho Antônio , de Oliveira Allisson Lopes
Published: December 2022

Background

The impact of the pandemic caused by the coronavirus (SARS-CoV-2), causing the disease COVID-19, has brought losses to the world in terms of deaths, economic and health problems. The expected return of the public to activities adapted to the new health situation led to discussions about the use of vaccination and its effects. However, the demand for proof of vaccination showed how inconsistent, unregistered, and uncontrolled this health process is with current technologies. Despite the proven effectiveness of vaccines in reducing infection rates, mortality, and morbidity, there are still doubts about their use in preventing certain infections and injuries, as well as the use of digital medical records for identification at public events and disease prevention. Therefore, this review aims to analyze the use of digital immunization cards in disease prevention in general.

Methods

A systematic review of Science, PubMed/MEDLINE, LILACS /BSV, CINALH, and IEEE and Xplore was performed using PRISMA guidelines. The authors summarized the studies conducted over the last decade on the impacts of prophylaxis by control through immunization cards. Studies were selected using the following terms: Vaccination; Mobile Applications; Health Smarts Cards; Immunization Programs; Vaccination Coverage. For data analysis, we used Mendeley, Excel, RStudio, and Bibliometrix software among others.

Results

A total of 1828 publications were found. After applying eligibility criteria (Articles published in Portuguese, Spanish or English in the last 10 years). Studies that only dealt with paper or physical records were excluded, as well as studies that were not linked to their country’s health Department, as a possibility of bias exists with these types of information). After removing duplicates and applying filters 1 and 2, we included 18 studies in this review. This resulted in 18 papers that met our priori inclusion criteria; it was found that the most relevant sources were from the databases of the Institute of Electrical and Electronics Engineers (IEEE).

Conclusions

Considering the selected studies, we found that scientific evidence and epidemiological surveillance are essential tools to characterize the efficiency and effectiveness of immunization passport protection intervention and to ethically justify them. Technological development of digital vaccine passports can assist in vaccination programs and positively impact disease prophylaxis.
Assessment of demineralized tooth lesions using optical coherence tomography and other state-of-the-art technologies: a review
Authors: Mohamad Saberi Fatin Najwa , Sukumaran Prema , Ung Ngie Min , Liew Yih Miin
Published: December 2022

Tooth demineralization is one of the most common intraoral diseases, encompassing (1) caries caused by acid-producing bacteria and (2) erosion induced by acid of non-bacterial origin from intrinsic sources (e.g. stomach acid reflux) and extrinsic sources (e.g. carbonated drinks). Current clinical assessment based on visual-tactile examination and standardized scoring systems is insufficient for early detection. A combination of clinical examination and technology is therefore increasingly adapted. This paper reviews various procedures and technologies that have been invented to diagnose and assess the severity of tooth demineralization, with focus on optical coherence tomography (OCT). As a micron-resolution non-invasive 3D imaging modality, variants of OCT are now available, offering many advantages under different working principles for detailed analytical assessment of tooth demineralization. The roles, capabilities and impact of OCT against other state-of-the-art technologies in both clinical and research settings are described. (139 words).
The blood monocyte to high density lipoprotein cholesterol ratio (MHR) is a possible marker of carotid artery plaque
Authors: Xi Jie , Men Shasha , Nan Jingzhu , Yang Qiuliang , Dong Jin
Published: December 2022

Background

MHR is the ratio of monocyte to high-density lipoprotein cholesterol (HDL-C). It has been reported that MHR changes are associated with cardiovascular and cerebrovascular disease. Carotid plaque is a common vascular lesion of the carotid artery and is a manifestation of atherogenesis. This study investigated the relationships between the MHR and the incidence of carotid plaques.

Methods

The data of 3848 physical examiners were analyzed for retrospective analysis, which included 1428 patients with noncarotid plaque, 1133 patients with single carotid plaque, and 1287 patients with bilateral or multiple carotid plaques. Statistical analysis was performed on SPSS 22.0 0 software and statistical software R and its GAM package.

Results

The difference was statistically significant in the levels of MHR, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), blood lipids (HDL-C, low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (Tg)), blood glucose (Glu), hemoglobin A1c (HbA1c), renal function (urea, creatinine (Crea)), estimated glomerular filtration rate (eGFR), and uric acid (Ua) in the carotid plaque groups (P < 0.001, respectively). There was no significant difference between the sex (P = 0.635) and age (P = 0.063) in the different groups. MHR levels were positively correlated with BMI (r = 0.364, P < 0.001), hs-CRP (r = 0.320, P < 0.001), Tg (r = 0.417, P < 0.001), Crea (r = 0.323, P < 0.001), eGFR (r = − 0.248, P < 0.001), Ua (r = 0.383, P < 0.001) and HbA1c (r = 0.197, P < 0.001). Levels of TC, Glu, and urea were slightly correlated with the MHR level (r = − 0.150, P < 0.001; r = 0.187, P < 0.001; r = 0.137, P < 0.001, respectively). The MHR level increased with elevated severity of carotid plaque in subjects without hypertension or diabetes (P < 0.001). In adjusted models, with the rise of MHR level, the probability of occurrence of carotid plaque had a 1.871-fold (95% CI: 1.015–3.450, P = 0.045) increase; the probability of multiple occurrences of carotid plaques had a 2.896-fold (95% CI: 1.415–5.928, P < 0.001) increase. The GAM curve showed a nonlinear correlation between the normalized MHR and the probability of carotid plaque occurrence.

Conclusions

MHR could be used as a possible marker for plaque formation and severity.
The monocyte to high-density lipoprotein cholesterol ratio is a risk factor for frequent premature ventricular complexes: a retrospective cohort study
Authors: Wang Yunfei , Li Deming , Zhu Xuetao , Li Jing , Yue Cui , Wu Ling , Zhuan Qingqing , Dou Xiaomeng , Duan Wei
Published: December 2022

Background

Little is known about the link between the monocyte to high-density lipoprotein cholesterol ratio (MHR) and frequent premature ventricular complexes (PVCs). This investigation aimed to evaluate the link between the MHR and frequent PVCs in patients, as well as their outcomes, using the axis, burden, coupling interval–ventricular tachycardia (ABC-VT) risk score (ARS).

Methods

Two hundred patients with frequent PVCs and 70 controls were retrospectively enrolled, and their general data were gathered. The MHR and ARS were calculated. Then, patients developing frequent PVCs were classified into a medium−/high-risk subgroup and a low-risk subgroup according to ARS. The results were evaluated employing comparative statistical analyses, Spearman’s correlation, logistic regression analyses, and receiver operating characteristic (ROC) curves.

Results

The MHR in the controls was obviously lower than that in the frequent PVC group. In addition, the MHR was the lowest in the control group and highest in the medium−/high-risk subgroup, with that of the low-risk subgroup falling in the middle. Spearman’s correlation analyses showed that the MHR was positively correlated with the ARS (ρ = 0.307, P < 0.001). Ultimately, the MHR was found to be a risk factor for frequent PVCs in the multivariate analysis. In addition, an MHR cutoff point of 254.6 featured 67.50% sensitivity and 67.14% specificity for predicting frequent PVCs, and the area under the curve (AUC) reached 0.694 (95% confidence interval: 0.623–0.766) (P < 0.001).

Conclusions

The MHR is positively and independently correlated with frequent PVCs and can be used as a practical, cost-saving and simple biomarker of inflammation owing to its value in predicting frequent PVCs. In addition, the MHR is crucial to risk stratification and prognosis, which may give it clinical value in the prevention and management of frequent PVCs.