bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on gearbox compound fault diagnosis method and system development based on entire gearbox health maintenance
Authors: Yan Lu , Qin-Xiao Chen , Cheng Zhong , Xian Tao , Wei Zhang , Chi Yuan
Published: September 2023

In general, gearbox is prone to occur compound fault due to its harsh working environment and its fault vibration signal contains multi-components which correspond to each gearbox parts. As the multi-components are often coupled with each other and accompanied by strong noise which brings great difficulties to diagnose fault, however, the existing diagnosis methods are mainly applied on single fault rather than the entire gearbox health maintenance, therefore, this paper presents a gearbox compound fault diagnosis method and develops a diagnosis system which has potential value for gearbox health maintenance. In specific, on account of the morphological difference between multi-components, this paper uses resonance sparse signal decomposition (RSSD) to decompose the fault vibration signal into high and low resonance components respectively for achieving gearbox compound fault separation. Furthermore, as for low resonance component containing rolling bearing fault information, a weak fault feature extraction algorithm based on singular value decomposition (SVD) and cepstrum pre-whitening stochastic resonance is proposed, besides, aiming at the high resonance component containing gear fault information, an early gear fault warning algorithm based on local mean decomposition and two-dimensional approximate entropy of chaotic oscillator is also given. Finally, a gearbox fault diagnosis system, which has the ability such as the gearbox vibration signal acquisition, fault indicator warning, health status evaluation, fault signal storage is developed. Simulation validation and comparison prove the effectiveness of proposed method in this paper.
Usefulness of interactive video-based instruction on learning performance in relation to cognitive development of children with moderate intellectual disability
Authors: Barman Munmi , Jena Ananta Kumar
Published: September 2023

The usefulness of information and communication technology has been witnessed around the globe with the occurrence of rapid changes in the field of education i.e. through the formal or informal way. For this, the researchers have assessed Interactive video-based instruction (IVBI) on ( N = 95; males = 47 & females = 48 age range between 12 and 15 years) moderate intellectual disability children in Guwahati, Assam, India from three day-care rehabilitation centres. The main objective was to examine the effect of IVBI intervention (IIVBI & CIVBI) on academic performance in association with the cognitive development of children with moderate intellectual disability in a comfortable setting within working hours. The findings conclude that children in the CIVBI group performed more actively as compared to IIVBI and comparison group, and it was due to the involvement of video-based instruction that helped understand the topic more precisely and acts effectively for CIVBI children in an experimental setting.
Associations between motor competence and physical activity levels of children with intellectual disabilities and/or autism spectrum disorder: Movement matters
Authors: Taylor Sarah L , Downs Samantha J , Rudd James R , McGrane Bronagh , Melville Craig A , McGarty Arlene M , Boddy Lynne M , Foweather Lawrence
Published: September 2023

Motor competence is important for lifelong physical activity (PA). The current study aimed to examine associations between PA and motor competence. In total, 43 children aged 7–12 years with intellectual disabilities and/or autism spectrum disorder completed anthropometric measures, the Bruininks-Oseretsky Test of Motor Proficiency-2, and wore a wrist accelerometer to capture total PA, moderate-to-vigorous PA (MVPA), average acceleration, and intensity gradient. No significant associations were found between PA outcomes and motor competence. Motor competence performance was commonly ‘below average’ or ‘average’. The weakest subtests were upper limb coordination and strength. The strongest subtest was running speed and agility. Total weekly MVPA was 336.1 ± 150.3 min, higher than UK recommendations of 120-180 per week for disabled children and young people. Larger scale studies are needed to better understand the relationship between PA and motor competence. Future research should also consider the influence of environmental factors on PA in this group.
Nebuliser therapy in critical care: The past, present and future
Authors: Arnott Andrew , Watson Malcolm , Sim Malcolm
Published: September 2023

Nebulisers are devices that reduce a body of liquid into a fine aerosol suitable for inhalation. Utilising the efficiency of pulmonary drug absorption, they offer a safe and powerful modality for local and systemic drug delivery in the treatment of critical illness. In comparison to conventional jet (JN) and ultrasonic nebulisers (USN), the advent of vibrating mesh nebulisers (VMN) has significantly improved the therapeutic potential of modern devices. This review article aims to summarise the history and evolution of nebulisers from first inception through to the modern vibrating mesh technology. It provides an overview on the basic science of nebulisation and pulmonary drug delivery, and the current use of nebulised therapies in critical care.
A multi-national survey to identify health professionals’ opinions for the appropriate frequency of urine output monitoring in post-operative patients
Authors: Baggot Hannah , Whyte Martin , Forni Lui , Hodgson Luke , Koulouglioti Christina
Published: September 2023

Urine output is an important clinical measurement and oliguria may highlight the development of acute kidney injury (AKI) earlier than serum creatinine (sCr). Despite the importance of urine output monitoring, there are no definitive guidelines or recommendations for best practice. A survey was sent to healthcare professionals with a specialist interest in AKI to gather opinions of what constitutes a good standard of urine output monitoring and by corollary missed care, post- major surgery. Data was gathered from 221 respondents. Results will inform audit and improvement projects in post-operative nursing care.
Hand Hygiene Messaging Design in the Workplace: Views From the Workforce—Introduction
Authors: Stones Catherine , Ai Wenbo , Rutter Sophie , Madden Andrew
Published: September 2023

Aims:

The study aimed to (1) discover workers’ attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers’ preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences.

Background:

Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the “why” rather than the “what” and can highlight areas of cynicism, concern and overall attitudes to HH.

Methods:

A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods.

Results:

Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued.

Conclusion:

This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging.
Treating the Neurologic Manifestations of Wilson’s Disease With Liver Transplantation
Authors: Marmol Sarah , Maeder-York Paul Walker , Hislop Jennifer , Shpiner Danielle S. , Margolesky Jason
Published: September 2023

Wilson’s Disease (WD) manifests with systemic and neuropsychiatric symptoms, caused by an ATP7B genetic mutation, leading to an accumulation of copper. Presentations are diverse and the diagnosis should be considered in anyone under 50 with a new onset movement disorder. Early recognition and treatment can limit morbidity. While liver transplantation (LT) is recommended in WD patients with hepatic failure, its use for pure neurologic indication remains controversial. We present a patient who failed medical management and underwent LT for pure neurologic indications. Subsequent neurologic symptom improvement supports the use of LT for patients with pure neurologic manifestations of WD.
Association and Repair of Right Aortic Arch With Aberrant Left Subclavian Artery With Subclavian Stenosis
Authors: Cheong Daniel , Jhaveri Simone , Smerling Jonathan , Rajagopal Hari , Misra Nilanjana , Meyer David B.
Published: September 2023

Surgical repair of right aortic arch and aberrant left subclavian artery has traditionally involved ligamentum division. Such patients can have stenosis at the origin of the aberrant subclavian artery either at the time of presentation or later. The more recently popularized repair involving resection of Kommerell diverticulum with transfer of the subclavian artery to the left carotid artery allows resection of the stenotic segment and serves as an effective treatment for subclavian stenosis as well. We present three cases of early repair of this arch anomaly with associated subclavian stenosis repaired successfully in that manner.
Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease and an Incidental Thyroid Nodule
Authors: Henriquez C. J. , Ahmad S. F.
Published: September 2023

Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare, immune-mediated demyelinating disease of the central nervous system (CNS) that has a predilection for children. Its association with malignancy or other autoimmune diseases is unclear. We present a case of MOGAD in a teenager with a coincidental thyroid malignancy and elevated intracranial pressure.
How the Hospital Works: An Interdisciplinary, Systems-Based Practice Medical Student Elective
Authors: Hale Andrew J , Bartsch Jason , Stapleton Renee D , Parsons Polly E
Published: September 2023

OBJECTIVES

Although proficient systems-based practice is a foundational skill for physicians, how best to teach it has not been well established. An elective course for fourth-year medical students wherein participants had an immersive experience with multiple interprofessional staff was created and analyzed. The authors hypothesized that participating students and interprofessional staff would show gains in systems-based knowledge and interprofessional communication.

METHODS

The course was a 2-week elective experience for fourth-year medical students at the Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Participants integrated into a variety of interprofessional, non-physician, and administrative roles within the hospital system. Pre- and post-elective systems-based knowledge and interprofessional communication were assessed. Participating interprofessional staff were also surveyed on their experiences

RESULTS

From 2019 through 2022, 14 students participated in the elective, all of whom provided data. All participating students showed a quantitative improvement in systems-based knowledge and qualitatively commented on the high value of the elective in furthering their understanding of interdisciplinary care and communication. Of the 22 participating interprofessional staff surveyed, 17 responded (response rate 77%), and data showed high satisfaction with the experience and that having students learn more about their jobs improved their own job satisfaction.

CONCLUSIONS

An immersive, hands-on experience with interprofessional colleagues showed dual benefits for both students and staff alike. Such an elective experience is scalable to other institutions nationally and should become a standard part of medical student curricula.
School truancy and welfare receipt dynamics in early adulthood: A longitudinal study
Authors: Collingwood Patricia , Mazerolle Lorraine , Cardwell Stephanie M.
Published: September 2023

School truancy is associated with many negative life outcomes, including violent, property, and drug offending, lower levels of education, and subsequently lower status and lower-paying jobs. These negative life outcomes are also related to future reliance on government welfare payments. This research sought to identify how high school truancy affects young people's welfare receipt dynamics in emerging adulthood. It uses longitudinal data from a nationally representative household panel survey (the Household Income and Labour Dynamics in Australia Survey) to estimate the effect of truancy on young people's likelihood of receiving government-paid cash transfers in emerging adulthood. We find that young people who are truant are over four times more likely to receive cash transfers than young people who are not truant. Findings also show that the extent of truancy does not impact the likelihood of welfare receipt, even when differentiating between infrequent and problem truants. We conclude with some comments on truancy's role in welfare dynamics.
Integrated epigenetic and transcriptional single-cell analysis of t(11;14) multiple myeloma and its BCL2 dependency
Authors: Leblay Noémie , Ahn Sungwoo , Tilmont Rémi , Poorebrahim Mansour , Maity Ranjan , Lee Holly , Barakat Elie , Alberge Jean-Baptiste , Sinha Sarthak , Jaffer Arzina , Barwick Benjamin G. , Boise Lawrence H. , Bahlis Nizar , Neri Paola
Published: September 2023

The translocation t(11;14) occurs in 20% of patients with multiple myeloma (MM) and results in the upregulation of CCND1. Nearly two-thirds of t(11;14) MM cells are BCL2 primed and highly responsive to the oral BCL2 inhibitor venetoclax. Although it is evident that this unique sensitivity to venetoclax depends on the Bcl-2 homology domain 3– proapoptotic protein priming of BCL2, the biology underlying t(11;14) MM dependency on BCL2 is poorly defined. Importantly, the epigenetic regulation of t(11;14) transcriptomes and its impact on gene regulation and clinical response to venetoclax remain elusive. In this study, by integrating assay for transposase-accessible chromatin by sequencing (ATAC-seq) and RNA-seq at the single-cell level in primary MM samples, we have defined the epigenetic regulome and transcriptome associated with t(11;14) MM. A B-cell–like epigenetic signature was enriched in t(11;14) MM, confirming its phylogeny link to B-cell rather than plasma cell biology. Of note, a loss of a B-cell–like epigenetic signature with a gain of canonical plasma cell transcription factors was observed at the time of resistance to venetoclax. In addition, MCL1 and BCL2L1 copy number gains and structural rearrangements were linked to venetoclax resistance in patients with t(11;14) MM. To date, this is the first study in which both single-cell (sc) ATAC-seq and scRNA-seq analysis are integrated into primary MM cells to obtain a deeper resolution of the epigenetic regulome and transcriptome associated with t(11;14) MM biology and venetoclax resistance.
Transmembrane protein 184B (TMEM184B) promotes expression of synaptic gene networks in the mouse hippocampus
Authors: Wright Elizabeth B. , Larsen Erik G. , Coloma-Roessle Cecilia M. , Hart Hannah R. , Bhattacharya Martha R.C.
Published: September 2023

In Alzheimer’s Disease (AD) and other dementias, hippocampal synaptic dysfunction and loss contribute to the progression of memory impairment. Recent analysis of human AD transcriptomes has provided a list of gene candidates that may serve as drivers of disease. One such candidate is the membrane protein TMEM184B. To evaluate whether TMEM184B contributes to neurological impairment, we asked whether loss of TMEM184B in mice causes gene expression or behavior alterations, focusing on the hippocampus. Because one major risk factor for AD is age, we compared young adult (5-month-old) and aged (15-month-old) wild type and Tmem184b-mutant mice to assess the dual contributions of age and genotype. TMEM184B loss altered expression of pre- and post-synaptic transcripts by 5 months and continued through 15 months, specifically affecting genes involved in synapse assembly and neural development. Wnt-activated enhancer elements were enriched among differentially expressed genes, suggesting an intersection with this pathway. Few differences existed between young adult and aged mutants, suggesting that transcriptional effects of TMEM184B loss are relatively constant. To understand how TMEM184B disruption may impact behaviors, we evaluated memory using the novel object recognition test and anxiety using the elevated plus maze. Young adult Tmem184b-mutant mice show normal object discrimination, suggesting a lack of memory impairment at this age. However, mutant mice showed decreased anxiety, a phenotype seen in some neurodevelopmental disorders. Taken together, our data suggest that TMEM184B is required for proper synaptic gene expression and anxiety-related behavior and is more likely to be linked to neurodevelopmental disorders than to dementia.
MiR-206 may regulate mitochondrial ROS contribute to the progression of Myocardial infarction via TREM1
Authors: Lin Hao , Chu Jiapeng , Yuan Deqiang , Wang Kangwei , Chen Fei , Liu Xuebo
Published: September 2023

Myocardial infarction (MI) is a leading cause of mortality. To better understand its molecular and cellular mechanisms, we used bioinformatic tools and molecular experiments to explore the pathogenesis and prognostic markers. Differential gene expression analysis was conducted using GSE60993 and GSE66360 datasets. Hub genes were identified through pathway enrichment analysis and PPI network construction, and four hub genes (AQP9, MMP9, FPR1, and TREM1) were evaluated for their predictive performance using AUC and qRT-PCR. miR-206 was identified as a potential regulator of TREM1. Finally, miR-206 was found to induce EC senescence and ER stress through upregulating mitochondrial ROS levels via TREM1. These findings may contribute to understanding the pathogenesis of MI and identifying potential prognostic markers.
Family physicians’ questions about the COVID-19 pandemic: a content analysis of 2,272 helpline calls
Authors: McDougall Allan , Fortier Jacqueline H. , Zhang Cathy , Ehrat Caroline , Best Kerri , Blois Heather , Garber Gary
Published: September 2023

Background

During the COVID-19 pandemic, family physicians faced challenges including travel restrictions for patients, lockdowns, diagnostic testing delays, and changing public health guidelines. Given that 95% of Canadian physicians are members of the Canadian Medical Protective Association (CMPA), the CMPA’s telephone helpline — which offers peer-to-peer support — provides valuable insights into family physicians’ experiences during the pandemic.

Methods

We used a content analysis approach to identify and understand family physicians’ questions and concerns related to the COVID-19 pandemic expressed during calls to the Canadian Medical Protective Association (CMPA) telephone helpline. Calls were classified with preliminary codes and subsequently organized into themes. We collected aggregated data on calls, including province, call date, and whether the physician self-identified having hospital-based activities as part of their practice. Findings from the analysis were explored alongside family physician calls per month (call volume).

Results

Between 01 and 2020 and 31 December 2021, 2,272 family physician calls related to the pandemic were included for content analysis. We identified six major themes across these calls: challenging patient interactions; COVID-related care; the impact of the pandemic on the healthcare system; virtual care; physician obligations and rights; and public health matters. COVID-related call volumes were highest early in the pandemic especially among physicians without major hospital affiliation when family physicians practiced with little guidance on how to balance patient care and scarce resources in the face of a novel pandemic.

Conclusions

This research provides unique insight on the effects the COVID-19 pandemic had on family medicine in Canada. These results provide insights on the needs and information gaps of family physicians in a public health crisis and can inform preparedness efforts by public health agencies, professional organizations, educators, and practitioners.
Influence of research evidence on the use of cardiovascular clinical prediction rules in primary care: an exploratory qualitative interview study
Authors: Ban Jong- Wook , Perera Rafael , Williams Veronika
Published: September 2023

Background

Cardiovascular clinical prediction rules (CPRs) are widely used in primary care. They accumulate research evidence through derivation, external validation, and impact studies. However, existing knowledge about the influence of research evidence on the use of CPRs is limited. Therefore, we explored how primary care clinicians’ perceptions of and experiences with research influence their use of cardiovascular CPRs.

Methods

We conducted an exploratory qualitative interview study with thematic analysis. Primary care clinicians were recruited from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). We used purposeful sampling to ensure maximum variation within the participant group. Data were collected by conducting semi-structured online interviews. We analyzed data using inductive thematic analysis to identify commonalities and differences within themes.

Results

Of 29 primary care clinicians who completed the questionnaire, 15 participated in the interview. We identified two main themes relating to the influence of clinicians’ perceptions of and experiences with cardiovascular CPR research on their decisions about using cardiovascular CPRs: “Seek and judge” and “be acquainted and assume.” When clinicians are familiar with, trust, and feel confident in using research evidence, they might actively search and assess the evidence, which may then influence their decisions about using cardiovascular CPRs. However, clinicians, who are unfamiliar with, distrust, or find it challenging to use research evidence, might be passively acquainted with evidence but do not make their own judgment on the trustworthiness of such evidence. Therefore, these clinicians might not rely on research evidence when making decisions about using cardiovascular CPRs.

Conclusions

Clinicians’ perceptions and experiences could influence how they use research evidence in decisions about using cardiovascular CPRs. This implies, when promoting evidence-based decisions, it might be useful to target clinicians’ unfamiliarity, distrust, and challenges regarding the use of research evidence rather than focusing only on their knowledge and skills. Further, because clinicians often rely on evidence-unrelated factors, guideline developers and policymakers should recommend cardiovascular CPRs supported by high-quality evidence.
A large-scale study on the prevalence of intestinal parasites in patients referred to medical laboratories in Urmia, Northwest Iran
Authors: Zeinali Shiva , Rezgi Mahsa , Gholinejad Morteza , Jafari Rasool
Published: September 2023

Introduction

Intestinal parasitic infections (IPIs), caused by helminths and protozoans, are among the most prevalent infections in humans in developing countries. This study aimed to determine the prevalence of IPIs in patients referred to three educational and medical centers affiliated with Urmia University of Medical Sciences in Urmia.

Materials and methods

In this cross-sectional study, 2845 stool samples, including 2174 (76.4%) males and 671 (23.6%) females, were collected from patients referred to Imam Khomeini and Shahid Motahhari hospitals and Shahid Nikkhah Health Center in Urmia, Northwest Iran, from January 2020 to February 2022. The microscopic examination for IPIs was carried out using the wet mount method, and the hard-to-identify samples were stained by trichrome for accurate identification of protozoa. For diagnosis of infections by coccidian parasites modified Ziehl-Neelsen (mZN) staining was used.

Results

Based on the results, two hundred nine intestinal parasites were identified in 184 out of 2845 (6.5%) patients of which 136 out of 2174 males (6.3%) and 48 out of 671 females (7.2%) were positive. Some patients had tested positive for multiple protozoa. The observed intestinal protozoa are as follows: Blastocystis spp. 118 (4.1%), Endolimax Nana 42 (1.5%), Entamoeba coli 24 (0.8%), Giardia lamblia 13 (0.5%), Cryptosporidium spp. 6 (0.2%), Iodamoeba butschlii 3 (0.1%), Chilomastix mesnili 2 (0.1%), and an accidentally detected helminthic infection Enterobius vermicularis 1 (0.05%).

Conclusion

According to the results, the most prevalent IPIs in West Azerbaijan Province are caused by Blastocystis spp., and Giardia lamblia. Most intestinal protozoa observed in the study were nonpathogenic and commensal, which shows water or food contamination in the area. Thus, medical technologists in the parasitology section must be trained and aware of IPIs in medical laboratories.
Network meta-analysis of adjuvant treatments for patients with hepatocellular carcinoma after curative resection
Authors: Ye Yanyan , Wang Ying , Xu Haoqian , Yi Fengming
Published: September 2023

Purpose

The prevention of recurrence for patients with hepatocellular carcinoma after curative resection is still a great challenge in clinical practice. There are numerous studies that trying to search for favorable strategies to decrease the recurrence and prolong life span for these patients, whereas no consensus is reached till now. Herein, we aim to compare the efficacy between different reported treatments by network meta-analysis(NMA).

Methods

We searched Pubmed, Web of Science and Cochrane Library for abstracts and full-text articles published from database inception through February 2023. All of the random controlled trials(RCTs) were evaluated and collected as eligible studies. The primary outcome was the prevention of recurrence between different procedures. The second outcomes were one-year survival, three-year survival and five-year survival.

Results

Thirty-two RCTs including 5783 patients were selected, and 12 treatments were classified. Most of the studies were high quality with low bias. Thirty-one studies including 5629 patients were recruited for recurrence analysis. The network meta-analysis showed benefits from transarterial chemoembolization(TACE) + portal vein chemotherapy(PVC)[OR, 2.84 (1.15,6.99)] and internal radiotherapy(IRT) [OR, 2.63 (1.41,4.91)] compared to non-adjuvant(NA) treatment when considering prevention of recurrence. Seventeen studies including 2047 patients were collected for one-year survival analysis. The network meta-analysis showed benefit from TACE[OR, 0.33 (0.14,0.75)] when considering one-year survival. Twenty-one studies including 2463 patients were collected for three-year survival analysis. The network meta-analysis showed TACE [OR, 0.51 (0.30,0.86)], IRT[OR, 0.41 (0.20,0.83)] and dendritic cell(DC) [OR, 0.09 (0.01,0.98)] were better than NA when considering three-year survival. Sixteen studies including 1915 patients were collected for five-year survival analysis. The network meta-analysis didn’t show any benefit from different treatments when considering five-year survival. Other strategies including external radiotherapy(ERT), branched-chain amino acids(BCAA), hepatic artery infusion chemotherapy(HAIC), cytokine-induced killer(CIK), adoptive immunotherapy(AIT), Huaier, interferon(IFN), oral chemotherapy(OCT) and sorafenib(SOR) didn’t show significant benefit regardless of prevention of recurrence or short-, long- time survival.

Conclusion

This NMA found that TACE + PVC and IRT were considered as the procedures to decrease HCC recurrence rate. TACE, IRT and DC were preferred when considering the extending of life span for post-operative patients with HCC. Large scale of RCTs are needed to verify it.
Older adults’ experiences during the COVID-19 pandemic: a qualitative systematic literature review
Authors: Derrer-Merk Elfriede , Reyes-Rodriguez Maria-Fernanda , Soulsby Laura K. , Roper Louise , Bennett Kate M.
Published: September 2023

Objectives

Relatively little is known about the lived experiences of older adults during the COVID-19 pandemic. We systematically review the international literature to understand the lived experiences of older adult’s experiences during the pandemic.

Design and methodology

This study uses a meta-ethnographical approach to investigate the included studies. The analyses were undertaken with constructivist grounded theory.

Results

Thirty-two studies met the inclusion criteria and only five papers were of low quality. Most, but not all studies, were from the global north. We identified three themes: desired and challenged wellbeing; coping and adaptation; and discrimination and intersectionality.

Overall, the studies’ findings were varied and reflected different times during the pandemic. Studies reported the impact of mass media messaging and its mostly negative impact on older adults. Many studies highlighted the impact of the COVID-19 pandemic on participants' social connectivity and well-being including missing the proximity of loved ones and in consequence experienced an increase in anxiety, feeling of depression, or loneliness. However, many studies reported how participants adapted to the change of lifestyle including new ways of communication, and social distancing. Some studies focused on discrimination and the experiences of sexual and gender minority and ethnic minority participants. Studies found that the pandemic impacted the participants’ well-being including suicidal risk behaviour, friendship loss, and increased mental health issues.

Conclusion

The COVID-19 pandemic disrupted and impacted older adults’ well-being worldwide. Despite the cultural and socio-economic differences many commonalities were found. Studies described the impact of mass media reporting, social connectivity, impact of confinement on well-being, coping, and on discrimination. The authors suggest that these findings need to be acknowledged for future pandemic strategies. Additionally, policy-making processes need to include older adults to address their needs. PROSPERO record [CRD42022331714], (Derrer-Merk et al., Older adults’ lived experiences during the COVID-19 pandemic: a systematic review, 2022).
A decennial cross-sectional review of assisted reproductive technology in a Tertiary Hospital in Southwest Nigeria
Authors: Ottun Tawaqualit Abimbola , Adewunmi Adeniyi Abiodun , Jinadu Faosat Olayiwola , Olumodeji Ayokunle Moses , Akinlusi Fatimat Motunrayo , Rabiu Kabiru Afolarin , Akinola Oluwarotimi Ireti , Fabamwo Adetokunbo Olusegun
Published: September 2023

Background

The World Health Organization recommends that Assisted Reproductive Technology be complementary to other ethically acceptable solutions to infertility. Whereas fertility centres are increasing in number in urban regions of Africa, published reports of their performance are sparse. We present a 10-year review of assisted reproductive technology performed in a public tertiary centre in Lagos, Nigeria.

Methods

This was a hospital-based, retrospective, cross-sectional review of 604 women, over a 10-year period that had in-vitro fertilization or in-vitro fertilization with intra-cytoplasmic sperm injection at the Institute of Fertility Medicine, Lagos State University Teaching Hospital. Data obtained were expressed in descriptive statistics and Pearson correlation was used to determine the strength of linear relationship between two continuous variables at a significance level of p < 0.05.

Results

The mean age of the women was of 37.7 ± 6.2 years and 89.7% had no previous parous experience. About 27.2% of the male partners had normal seminal fluid parameters while 4.6% had azoospermia. Median serum follicle stimulating hormone of the women was 8.1 IU/L and median serum anti-mullerian hormone was 6.3 pmol/L. There was weak positive correlation between age and serum follicle stimulating hormone (r = 0.306, p < 0.001); weak negative correlation between age and serum anti-mullerian hormone (r = -0.48, p < 0.001) and very weak correlation between body mass index and serum follicle stimulating hormone (r = 0.173, p = 0.011). In-vitro fertilization and intra-cytoplasmic sperm injection was the method of fertilization used in 97.4% of the cases and 81.8% of embryos formed were of good quality. Most women (94.5%) had 2 embryos transferred and 89.9% had day-5 embryo transfer done. About 1 in 4 of the women (143/604, 23.7%) had clinical pregnancy and 49.7% of women who got pregnant had delivery of a live baby at term while 11.9% had preterm delivery of a live baby.

Conclusion

Despite increasing use and success of assisted reproductive technology in south-western Nigeria, there is room for improvement in clinical pregnancy rates and live birth rates post- assisted reproductive technology. Complication rates are desirably low.
Psychometric properties and normative values of the revised demoralization scale (DS-II) in a representative sample of the German general population
Authors: Ramm Markus , Jedamzik Johanna , Lenz Philipp , Poopana Anileeta , Heuft Gereon , Conrad Rupert
Published: September 2023

Background

Demoralization is a clinically relevant syndrome in chronic diseases. The demoralization scale (DS-II) was recently developed as an economic screening tool in clinical populations. Main aim of this study was to provide normative data of DS-II scores in the general population.

Methods

We developed a new German version, the DS-II Münster, and tested internal consistency as well as the previously proposed two-factor structure with confirmatory factor analyses. The DS-II was applied in a household survey of the general population. Associations between DS-II scores and age, gender and other sociodemographic variables were explored.

Results

The final sample consisted of N = 2471 participants (mean age = 49.8 years, range: 18–96; 50.1% men, 49.8% women). The DS-II Münster showed nearly excellent internal consistency. The model fit indices of the two-factor structure were not superior to those of the one-factor model. Mean scores of the DS-II were as follows. Total score: M = 3.76 (SD = 5.56), Meaning and Purpose subscale: M = 1.65 (SD = 2.77), Distress and Coping Ability subscale: M = 2.11 (SD = 3.02). DS-II scores were increased in women with an effect size of Cohen’s d = 0.19. An age-related increase was specifically found for the Meaning and Purpose subscale (d = 0.21).

Conclusions

The study provides normative values of the DS-II with respect to age and gender in the general population to facilitate interpretation of DS-II scores in clinical samples. A DS-II total score > 5 is suggested as a cut-off value. The findings further our understanding of significant symptom burden that was previously suggested in young patients with cancer.
Analysis of clinical characteristics and risk factors of community-acquired pneumonia complicated by parapneumonic pleural effusion in elderly patients
Authors: Zhong Mingmei , Ni Ruiqin , Zhang Huizhen , Sun Yangyang
Published: September 2023

Background

Community-acquired pneumonia (CAP) patients usually present with parapneumonic pleural effusion (PPE), which complicates the treatment of pneumonia. This study aims to investigate the clinical characteristics and risk factors of elderly CAP patients hospitalised with PPE.

Methods

The clinical data of 132 elderly patients with CAP were retrospectively analysed. A total of 54 patients with PPE (PPE group) and 78 patients without PPE (NPPE group) were included in this study. Clinical data, laboratory examinations, treatments and other relevant indicators were collected. Univariate analysis and multivariate logistic regression analysis will be used to explore the possible risk factors for PPE.

Results

The proportion of PPE in elderly patients with CAP was 40.9%. PPE patients were significantly more likely to be older, have comorbid neurological diseases, experience chest tightness, and have a lasting fever (P < 0.05). In contrast to NPPE patients, the total number of lymphocytes, serum albumin and blood sodium levels in the PPE group were significantly lower (P < 0.05). The blood D-dimer, C-reactive protein and CURB-65 score of PPE patients were significantly higher (P < 0.05) than those of NPPE patients. Multivariate logistic regression identified chest tightness (OR = 3.964, 95% CI: 1.254–12.537, P = 0.019), long duration of fever (OR = 1.108, 95%CI: 1.009–1.217, P = 0.03), low serum albumin (OR = 0.876, 95%CI: 0.790– 0.971, P = 0.012) or low blood sodium (OR = 0.896, 95%CI: 0.828–0.969, P = 0.006) as independently associated with the development of parapneumonic pleural effusion in the elderly.

Conclusion

This study has identified several clinical factors, such as chest tightness, long duration of fever, low serum albumin, and low blood sodium, as risk factors for the development of pleural effusion in elderly patients with CAP. Early identification and prompt management of these patients can prevent inappropriate treatment and reduce morbidity and mortality.
Using machine learning to determine age over 16 based on development of third molar and periodontal ligament of second molar
Authors: Shen Shihui , Zhou Zhuojun , Wang Jian , Fan Linfeng , Han Junli , Tao Jiang
Published: September 2023

Background

Having a reliable and feasible method to estimate whether an individual has reached 16 years of age would greatly benefit forensic analysis. The study of age using dental information has matured recently. In addition, machine learning (ML) is gradually being applied for dental age estimation.

Aim

The purpose of this study was to evaluate the development of the third molar using the Demirjian method (Demirjian3M), measure the development index of the third molar (I3M) using the method by Cameriere, and assess the periodontal ligament development of the second molar (PL2M). This study aimed to predict whether Chinese adolescents have reached the age of criminal responsibility (16 years) by combining the above measurements with ML techniques.

Subjects & methods

A total of 665 Chinese adolescents aged between 12 and 20 years were recruited for this study. The development of the second and third molars was evaluated by taking orthopantomographs. ML algorithms, including random forests (RF), decision trees (DT), support vector machines (SVM), K-nearest neighbours (KNN), Bernoulli Naive Bayes (BNB), and logistic regression (LR), were used for training and testing to determine the dental age. This is the first study to combine ML with an evaluation of periodontal ligament and tooth development to predict whether individuals are over 16 years of age.

Results and conclusions

The study showed that SVM had the highest Bayesian posterior probability at 0.917 and a Youden index of 0.752. This finding provides an important reference for forensic identification, and the combination of traditional methods and ML is expected to improve the accuracy of age determination for this population, which is of substantial significance for criminal litigation.
Inhibitory effect of O-propargyllawsone in A549 lung adenocarcinoma cells
Authors: dos Santos Edmilson Willian Propheta , de Sousa Rauan Cruz , de Franca Mariana Nobre Farias , Santos Jileno Ferreira , Ottoni Flaviano Melo , Isidório Raquel Geralda , de Lucca Junior Waldecy , Alves Ricardo José , Scher Ricardo , Corrêa Cristiane Bani
Published: September 2023

Background

Lung cancer is the deadliest type of cancer in the world and the search for compounds that can treat this disease is highly important. Lawsone (2-hydroxy-1,4-naphtoquinone) is a naphthoquinone found in plants from the Lawsone genus that show a high cytotoxic effect in cancer cell lines and its derivatives show an even higher cytotoxic effect.

Methods

Sulforhodamine B was used to evaluate the cytotoxic activity of compounds on tumor cells. Clonogenic assay was used to analyze the reduction of colonies and wound healing assay to the migratory capacity of A549 cells. Apoptosis and necrosis were analyzed by flow cytometer and Giemsa staining. Hemolysis assay to determine toxicity in human erythrocytes.

Results

Lawsone derivatives were evaluated and compound 1 (O-propargyllawsone) was the one with the highest cytotoxic effect, with IC50 below 2.5 µM in A549 cells. The compound was able to reduce colony formation and inhibit cell migration. Morphological changes and cytometry analysis show that the compound induces apoptosis and necrosis in A549 cells.

Conclusions

These results show that O-propargyllawsone show a cytotoxic effect and may induce apoptosis in A549 cells.
Identification of an oncological clinical pathway through questionnaires to health professionals
Authors: Forrester Mario , Breitenfeld Luiza , Castelo-Branco Miguel , Aperta Jorge
Published: September 2023

Background

Clinical Pathways in Oncology can benefit patients using organized interventions to standardize and increase care efficiency. Healthcare systems should have tools to identify their oncological clinical pathways for a better institutional organization to reduce mortality rates and contain costs without compromising quality. Our objective is to determine the regional Oncology Clinical Pathway from a first basic hypothesis using questionnaires directed to healthcare professionals considered key deciders within the Pathway.

Methods

Study design consisted of data analysis of two structured region-wide questionnaires; built using available literature on Oncology Clinical Pathways, in a Portuguese Healthcare context and pre-tested in a focus group of key deciders (Physicians and nurses with management functions) from which a design was created. Queries analyzed the patients: tumor staging at service arrival; time intervals on tumor suspicion/diagnosis confirmation and diagnosis/first treatment; referral pathway; diagnostic networks and patient Follow-up. One questionnaire was sent to key deciders directly involved with Oncology patients at a Regional Hospital. 15 physicians and 18 nurses of this sample answered the questionnaire (approx. response rate = 67%). Another questionnaire sent to healthcare professionals in Primary Healthcare Centers yielded response rate 19.2%, N = 29 physicians and 46 nurses. Finally, we performed a descriptive analysis and a Cronbach Alpha reliability analysis.

Results

Our findings reveal: different appreciations of tumor staging at arrival in Primary Healthcare Centers and Regional Hospitals (the latter receiving more metastatic cases); approximately 4 weeks between tumor suspicion-diagnostic and divided opinions regarding diagnostic-treatment time intervals. Primary Healthcare Centers depend on private laboratories for diagnostics confirmation, while the Hospitals resolve this locally. Referral pathways indicate almost half of the patients being sent from primary healthcare centers to National Reference Hospitals instead of a Regional Hospital. Patient follow-up is developed throughout the institutions, however, is more established at Regional Hospitals. As patients advance through the Oncology Clinical Pathway and toward treatment stages the number of healthcare professionals involved reduce.

Conclusion

Our questionnaires enable us to understand the real pathway between the different institutions involved and the main entry points of the patients into the Oncology Clinical Pathway.
Barriers and facilitators to implementing advanced HIV disease screening at a secondary referral hospital -Malawi: a convergent parallel study
Authors: Mithi Brany , Bula Agatha , Kapanda Lester , Ngwalangwa Fatsani , Sambala Evanson Z.
Published: September 2023

Background

Malawi continues to register HIV/AIDS mortality despite increased expansion of ART services and as well as advanced HIV screening as outlined in the 2020 -2025 Malawi National HIV Strategic Plan (NSP). This study aimed to explore factors influencing the implementation of the advanced HIV disease (AHD) screening package at Rumphi District Hospital, Malawi.

Methods

We conducted a mixed method, convergent study at a secondary referral hospital with 8 659 clients on ART. Guided by a consolidated framework for implementation research (CFIR) we conducted semi-structured Interviews with healthcare professionals, purposively selected from various key departments that were actively involved in AHD screening. Transcripts were organized and coded using NVivo 12 software with thematically predefined CFIR constructs. Newly HIV-positive client records extracted from ART cards (July –Dec, 2021) were analyzed using STATA 14 software.

Results

One hundred one ART records met inclusion criteria for review and analysis of which 60% (n = 61) of the newly diagnosed HIV clients had no documented results for CD4 Cell count. Barriers to AHD screening emerged from four major CFIR constructs: intervention complexity, communication, availability of resources and access to knowledge and information. The specific barriers included poor work coordination among implementers, limited resources to support the expansion of AHD screening, and knowledge gap among providers. External support from Ministry of Health implementing partners and the availability of committed focal leaders coordinating HIV programs emerged as major enablers of AHD screening package.

Conclusion

The study has identified major contextual barriers to AHD screening including knowledge gap, poor communication systems and inadequate supporting resources. Improving uptake of AHD screening services would therefore require overcoming the existing barriers by adopting a comprehensive approach in developing barrier-tailored strategies.
Microalgal upgrading of the fermentative biohydrogen produced from Bacillus coagulans via non-pretreated plant biomass
Authors: Aldaby Eman S. E. , Mahmoud Aya H. A. , El-Bery Haitham M. , Ali Maysa M. , Shoreit Ahmed A. , Mawad Asmaa M. M.
Published: September 2023

Background

Hydrogen is a promising source of alternative energy. Fermentative production is more feasible because of its high hydrogen generation rate, simple operating conditions, and utilization of various organic wastes as substrates. The most significant constraint for biohydrogen production is supplying it at a low cost with fewer impurities.

Results

Leaf biomass of Calotropis procera was used as a feedstock for a dark fermentative production of hydrogen by Bacillus coagulans AH1 (MN923076). The optimum operation conditions for biohydrogen production were 5.0% substrate concentrationand pH 9.0, at 35 °C. In which the biohydrogen yield was 3.231 mmol H2/g dry biomass without any pretreatments of the biomass. A freshwater microalga Oscillatroia sp was used for upgrading of the produced biohydrogen. It sequestrated 97 and 99% % of CO2 from the gas mixture when it was cultivated in BG11 and BG11-N media, respectively After upgrading process, the residual microalgal cells exhibited 0.21mg/mL of biomass yield,high content of chlorophyll-a (4.8 µg/mL) and carotenoid (11.1 µg/mL). In addition to Oscillatroia sp residual biomass showed a lipid yield (7.5–8.7%) on the tested media.

Conclusion

Bacillus coagulans AH1 is a promising tool for biohydrogen production avoiding the drawbacks of biomass pretreatment. Oscillatroia sp is encouraged as a potent tool for upgrading and purification of biohydrogen. These findings led to the development of a multiproduct biorefinery with zero waste that is more economically sustainable.

Graphical Abstract