bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring gender impact on collaborative care planning: insights from a community mental health service study in Italy
Authors: Martinelli Alessandra , Bonetto Chiara , Pozzan Tecla , Procura Elena , Cristofalo Doriana , Ruggeri Mirella , Killaspy Helen
Published: November 2023

Introduction

Personal recovery is associated with socio-demographic and clinical factors, and gender seems to influence the recovery process. This study aimed to investigate: i) differences in the recovery goals of men and women users of a community mental health service in Italy; ii) any differences by gender in recovery over six months using the Mental Health Recovery Star (MHRS).

Methods

Service users and staff completed the MHRS together at recruitment and six months later to agree the recovery goals they wished to focus on. Socio-demographic and clinical characteristics and ratings of symptoms (BPRS), needs (CAN), functioning (FPS), and functional autonomy (MPR) were collected at recruitment and six months follow-up. Comparisons between men and women were made using t-tests.

Results

Ten women and 15 men completed the MHRS with 19 mental health professionals. Other than gender, men and women had similar socio-demographic, and clinical characteristics at recruitment. Women tended to choose recovery goals that focused on relationships whereas men tended to focus on work related goals. At follow-up, both men and women showed improvement in their recovery (MHRS) and women were less likely to focus on relationship related goals, perhaps because some had found romantic partners. There were also gains for both men and women in engagement with work related activities. Ratings of functional autonomy (MPR) improved for both men and women, and men also showed improvement in symptoms (BPRS) and functioning (FPS).

Conclusions

Our findings suggest that collaborative care planning tools such as the MHRS can assist in identifying individualized recovery goals for men and women with severe mental health problems as part of their rehabilitation.
Women’s awareness of perinatal mental health conditions and the acceptability of being asked about mental health in two regions in India: a qualitative study
Authors: Fellmeth Gracia , Kanwar Pankaj , Sharma Diksha , Chawla Komal , DasGupta Neha , Chhajed Shreyash , Chandrakant  , Jose Emily C , Thakur Anita , Gupta Vikesh , Bharti Omesh Kumar , Singh Sukhjit , Desai Geetha , Thippeswamy Harish , Kurinczuk Jennifer J , Chandra Prabha , Nair Manisha , Verma Ashok , Kishore M Thomas , Alderdice Fiona
Published: November 2023

Background

Mental health conditions are common during pregnancy and the first year after childbirth. Early detection allows timely support and treatment to be offered, but identifying perinatal mental health conditions may be challenging due to stigma and under-recognition of symptoms. Asking about symptoms of mental health conditions during routine antenatal and postnatal appointments can help to identify women at risk. This study explores women’s awareness of perinatal mental health conditions, their views on the acceptability of being asked about mental health and any preference for specific assessment tools in two regions in India.

Methods

Focus group discussions (FGDs) were conducted with pregnant, post-partum and non-perinatal women in Kangra, Himachal Pradesh (northern India) and Bengaluru, Karnataka (southern India). Settings included a hospital antenatal clinic and obstetric ward, Anganwadi Centres and Primary Health Centres. FGDs were facilitated, audio-recorded and transcribed. Narratives were coded for emerging themes and analysed using thematic analysis.

Results

Seven FGDs including 36 participants were conducted. Emerging themes were: manifestations of and contributors to mental health conditions; challenges in talking about mental health; and the acceptability of being asked about mental health. Difficult familial relationships, prioritising the needs of others and pressure to have a male infant were cited as key stressors. Being asked about mental health was generally reported to be acceptable, though some women felt uncomfortable with questions about suicidality. No preference for any specific assessment tool was reported.

Conclusions

Women face many stressors during the perinatal period including difficult familial relationships and societal pressure to bear a male infant. Being asked about mental health was generally considered to be acceptable, but questions relating to suicidality may be challenging in a community setting, requiring sensitivity by the interviewer. Future studies should assess the acceptability of mental health assessments in ‘real world’ antenatal and postnatal clinics and explore ways of overcoming the associated challenges in resource-constrained settings.
Schizophrenia: jinn, magic or disease? Experiences of family caregivers of patients with schizophrenia in Baloch ethnicity
Authors: Darban Fatemeh , Safarzai Enayatollah , Sabzevari Sakineh , Heydarikhayat Nastaran
Published: November 2023

Background

Cultural and religious beliefs are effective on people’s attitudes towards schizophrenia and their help-seeking behaviors. This study aimed to explain the experiences of family caregivers of patients with schizophrenia in Baloch ethnicity.

Methods

This is a qualitative study with conventional content analysis approach. Purposive sampling was used and 21 participants, including family caregiver for patients with schizophrenia, a psychologist, a prayer-writer, and a normal person were interviewed in Sistan and Balochistan province in the southeast of Iran. Qualitative data were analyzed by Granheim and Lundman method.

Results

One main theme, three categories, and 10 Sub-categories were extracted from analysis of interviews. “Immersion in the cultural beliefs” was the main theme of the study with categories of “Belief in the superstitious and supernatural nature of the psychological disease”, “Superstitious beliefs, an attempt to free the patient”, and “Conflict between cultural beliefs and science”.

Conclusions

Help-seeking behaviors of family caregivers in Baloch ethnicity are influenced by their religious, superstitious, and cultural beliefs. Psycho-education should be part of all mental health education programs in these communities, as delays in treatment worsen the prognosis of people with schizophrenia. Training the medical staff to consider the culture, religion and therapeutic preferences of the Baloch people can be effective in advancing the goals. In addition, local influencers should stress the importance of health care alongside harmless local remedies.
Skin cancer prevention behaviors, beliefs, distress, and worry among hispanics in Florida and Puerto Rico
Authors: Lacson John Charles A. , Soto-Torres Brenda , Sutton Steven K. , Doyle Scarlet H. , Kim Youngchul , Roetzheim Richard G. , Vadaparampil Susan T. , Kanetsky Peter A.
Published: November 2023

Background

Incidence of skin cancer has been increasing among U.S. Hispanics, who often are diagnosed with larger lesions and at later stage disease. Behaviors to decrease exposure to ultraviolet radiation can reduce risk of skin cancer. We describe skin cancer prevention behaviors and psychosocial variables among Hispanic participants recruited into a skin cancer prevention trial.

Methods

Self-reported Hispanic participants from eight primary care clinics in Tampa, Florida and Ponce, Puerto Rico were recruited into a randomized controlled prevention trial. Information on demographics, sun-related behaviors, and psychosocial variables were collected before intervention materials were provided. Multivariable regression models were used to compare baseline sun-related behaviors and psychosocial variables across groups defined by geographic location and language preference.

Results

Participants reported low levels of intentional outdoor tanning, weekday and weekend sun exposure, and very low levels of indoor tanning. However, only a minority of participants practiced sun-protective behaviors often or always, and about 30% experienced a sunburn in the past year. Participants had low levels of recent worry and concern about skin cancer, modest levels of perceived risk and severity, and high levels of response efficacy and self-efficacy. When comparing across groups defined by geographic location and language preference, English-preferring Tampa residents (hereafter referred to as Tampeños) had the highest proportion who were sunburned (35.9%) and tended toward more risky behavior but also had higher protective behavior than did Spanish-preferring Tampeños or Puerto Ricans. Spanish-preferring Puerto Ricans had higher recent concern about skin cancer, comparative chance of getting skin cancer, and response efficacy compared to either English- or Spanish-preferring Tampeños. Spanish-preferring Tampeños had the highest levels of familism and recent distress about skin cancer.

Conclusions

Our results mirror previous observations of low levels of sun-protective behavior among U.S. Hispanics compelling the need for culturally appropriate and translated awareness campaigns targeted to this population. Because Hispanics in Tampa and Puerto Rico reported modest levels of perceived risk and severity, and high levels of response efficacy and self-efficacy, interventions aiming to improve skin cancer prevention activities that are anchored in Protection Motivation Theory may be particularly effective in this population subgroup.
Barriers and facilitators of people living with HIV receiving optimal care for hypertension and diabetes in Tanzania: a qualitative study with healthcare professionals and people living with HIV
Authors: Gooden Tiffany E. , Mkhoi Mkhoi L. , Mdoe Mwajuma , Mwalukunga Lusajo J. , Senkoro Elizabeth , Kibusi Stephen M. , Thomas G Neil , Nirantharakumar Krishnarajah , Manaseki-Holland Semira , Greenfield Sheila
Published: November 2023

Background

People living with HIV (PLWH) are at a higher risk for developing diabetes and hypertension. Often services are separate for HIV and non-communicable diseases (NCDs), but how this impacts NCD care among PLWH is unknown. We aimed to understand the barriers and facilitators for prevention, early diagnosis and safe effective care for diabetes and hypertension among PLWH.

Methods

Semi-structured interviews (SSIs) were conducted with 10 healthcare professionals (HCPs) that care for PLWH, 10 HCPs that care for people with diabetes and hypertension and 16 PLWH with a comorbidity of diabetes and/or hypertension. Participants were recruited from two healthcare facilities in Dodoma, Tanzania and purposively sampled based on age and sex. Interviews were conducted in Swahili using pre-developed topic guides, audio recorded then translated verbatim into English. An inductive thematic analysis was conducted using The Framework Method.

Results

Three themes were found: organisational/healthcare system factors, individual factors and syndemic factors. Organisational/healthcare system factors comprised the only facilitators for prevention (education on lifestyle behaviours and counselling on adherence), but included the most barriers overall: fragmented services, no protocol for NCD screening and lack of access to diagnostic equipment were barriers for early diagnosis whereas the former plus lack of continuity of NCD care were barriers for safe effective care. Individual factors comprised four sub-themes, three of which were considered facilitators: HCPs’ knowledge of NCDs for early diagnosis, self-monitoring of NCDs for safe effective care and HCPs’ personal practice for both early diagnosis and safe effective care. HCPs’ knowledge was simultaneously a barrier for prevention and PLWH knowledge was a barrier for prevention and safe effective care. Syndemic factors comprised three sub-themes; all were barriers for prevention, early diagnosis and/or safe effective care: poverty and mental health of PLWH and HIV stigma.

Conclusions

Organisational/healthcare system, individual and syndemic factors were found to be interlinked with barriers and facilitators that contribute to the prevention, early diagnosis and safe effective care of diabetes and hypertension among PLWH in Tanzania; these findings can inform future initiatives for making small and large health system changes to improve the health of aging PLWH.
Association between depression, anemia and physical activity using isotemporal substitution analysis
Authors: Nam Hee-kyoung , Park Jungmi , Cho Sung-il
Published: November 2023

Background

Depression is a leading cause of disability and mortality, with estimated number of deaths exceeding 2.2 million worldwide. We examined depression in relation to anemia and physical activity, both of which have an impact on depression mechanisms.

Methods

This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey, including 18,622 participants. Depression was measured by The Patient Health Questionnaire-9, and physical activity was assessed by the Global Physical Activity Questionnaire. Anemia was defined by World Health Organization criteria for blood hemoglobin levels. Isotemporal substitution model for physical activity was used to assess the effect of replacing sedentary behavior to each intensity level of physical activity. Logistic regression was applied to estimate the association on depression.

Results

Replacing sedentary behavior with moderate or vigorous physical activity was associated with a lower risk of depression in the anemic (OR: 0.875, 95% CI: 0.782–0.978) and non-anemic groups (OR: 0.943, 95% CI: 0.919–0.967). Depression risk was significantly reduced by replacing walking with moderate to vigorous physical activity in both anemic (OR: 0.877, 95% CI: 0.784–0.982) and non-anemic groups (OR: 0.951, 95% CI: 0.927–0.976).

Conclusions

Moderate to vigorous physical activity had a protective association against depression in both anemic and non-anemic groups. Anemic patients are recommended to perform physical activity for any duration acceptable to them to prevent depression.
The global economic burden of health anxiety/hypochondriasis- a systematic review
Authors: Hannah Kawka , Marie Kurtz , Olaf Horstick , Stephan Brenner , Andreas Deckert , Wilson Michael Lowery , Till Baernighausen , Peter Dambach
Published: November 2023

Background

Recent studies have shown a lifetime prevalence of 5.7% for health anxiety/hypochondriasis resulting in increased healthcare service utilisation and disability as consequences. To the best of our knowledge, there has been no systematic review examining the global costs of hypochondriasis, encompassing both direct and indirect costs. Our objective was to synthesize the available evidence on the economic burden of health anxiety and hypochondriasis to identify research gaps and provide guidance and insights for policymakers and future research.

Methods

A systematic literature search was conducted using PubMed, Web of Science, PsycInfo, EconLit, IBSS and Google Scholar without any time limit, up until April 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this search and the following article selection process. The included studies were systematically analysed and summarized using a predefined data extraction sheet.

Results

Of the 3044 articles identified; 10 publications met our inclusion criteria. The results displayed significant variance in the overall costs listed among the studies. The reported economic burden of hypochondriasis ranged from 857.19 to 21137.55 US$ per capita per year. Most of the investigated costs were direct costs, whereas the assessment of indirect costs was strongly underrepresented.

Conclusion

This systematic review suggests that existing studies underestimate the costs of hypochondriasis due to missing information on indirect costs. Furthermore, there is no uniform data collection of the costs and definition of the disease, so that the few existing data are not comparable and difficult to evaluate. There is a need for standardised data collection and definition of hypochondriasis in future studies to identify major cost drivers as potential target point for interventions.
Developing public health competency statements and frameworks: a scoping review and thematic analysis of approaches
Authors: MacKay Melissa , Ford Caitlin , Grant Lauren E. , Papadopoulos Andrew , McWhirter Jennifer E.
Published: November 2023

Competencies ensure public health students and professionals have the necessary knowledge, skills, values, and behaviours to do their jobs effectively. Public health is a dynamic and complex field requiring robust competency statements and frameworks that are regularly renewed. Many countries have public health competencies, but there has been no evidence synthesis on how these are developed. Our research aim was to synthesize the extent and nature of the literature on approaches and best practices for competencies statement and framework development in the context of public health, including identifying the relevant literature on approaches for developing competency statements and frameworks for public health students and professionals using a scoping review; and, synthesizing and describing approaches and best practices for developing public health competency statements and frameworks using a thematic analysis of the literature identified by the scoping review. We conducted a scoping review and thematic analysis of the academic and grey literature to synthesize and describe approaches and best practices for developing public health competency statements and frameworks. A systematic search of six databases uncovered 13 articles for inclusion. To scope the literature, articles were assessed for characteristics including study aim, design, methods, key results, gaps, and future research recommendations. Most included articles were peer-reviewed journal articles, used qualitative or mixed method design, and were focused on general, rather than specialist, public health practitioners. Thematic analysis resulted in the generation of six analytical themes that describe the multi-method approaches utilized in developing competency statements and frameworks including literature reviews, expert consultation, and consensus-building. There was variability in the transparency of competency framework development, with challenges balancing foundational and discipline-specific competencies. Governance, and intersectoral and interdisciplinary competency, are needed to address complex public health issues. Understanding approaches and best practices for competency statement and framework development will support future evidence-informed iterations of public health competencies.
Modified Kirschner wire percutaneous rotation prying reduction combined with elastic stable intramedullary nailing in children with Judet IV radial neck fracture
Authors: Fan YongFei , Xu WenQiang , Liu QiXin , Liu ChaoYu , Wang Wei
Published: November 2023

Purpose

This study was to investigate the feasibility and treatment effect of using modified Kirschner wire (K-wire) percutaneous rotation prying reduction combined with Elastic Stable Intramedullary Nailing (ESIN) in children with Judet IV radial neck fracture.

Methods

A retrospective analysis was conducted on 47 children with Judet IV radial neck fracture who underwent treatment with modified K-wire percutaneous rotation prying reduction combined with ESIN from April 2019 to November 2022, including 25 males and 22 females, with an average age of 8.79 years old (ranging from 5 to 14). The study recorded the surgical time, fluoroscopy time, reduction time, and reduction quality evaluated according to the Metaizeau radiological standard. During the last follow-up, the flexion-extension and forearm rotation function of the affected and healthy sides were recorded, and the Mayo Elbow Performance index was used to evaluate the elbow joint function.

Results

The average duration of the operation was 25.51 min (ranging from 14 to 43 min), with a mode of 2 reset times (ranging from 1 to 5) and 8 fluoroscopic times (ranging from 4 to 15). Based on the Metaizeau radiological standard for assessing reduction quality, 45 cases were deemed excellent, while 2 cases were considered good. Following 3–4 weeks of postoperative long-arm cast immobilization, exercises were performed to promote elbow joint and forearm rotation. The ESIN was removed after satisfactory fracture healing around 4 months postoperatively. The average follow-up period was 26.79 months (ranging from 5 to 48). At the final follow-up, the range of motion for the affected limb in flexion, extension, pronation, and supination was (140.23 ± 4.80)°, (4.43 ± 3.98)°, (84.09 ± 4.97)°, and (83.83 ± 4.55)°, respectively. There was no statistically significant difference compared to the healthy side, which had a range of motion of (141.36 ± 3.27)°, (5.28 ± 2.25)°, (85.66 ± 3.20)°, and (84.98 ± 2.57)° (P > 0.05). According to the Mayo Elbow Performance index, 44 cases were rated as excellent and 1 case was considered good.

Conclusion

The modified K-wire percutaneous rotation prying reduction combined with ESIN is an effective treatment for severe radial neck fractures in children. This technique offers several advantages, including the ability to easily “capture” significantly displaced radial heads, achieve rapid and accurate reduction, and reduce radiation exposure.
Association of root morphology of mandibular second molars on panoramic-like and axial views of cone-beam computed tomography
Authors: Karkhaneh Mahsa , Karkehabadi Hamed , Alafchi Behnaz , Shokri Abbas
Published: November 2023

Background

Knowledge about the anatomy and morphology of the root canal system is essential for successful surgical and non-surgical root canal treatments. However, precise assessment of the root morphology and anatomy is not often possible on two-dimensional radiographs. This study aimed to investigate the association of root morphology of mandibular second molars on panoramic-like and axial views of cone-beam computed tomography (CBCT).

Methods

This cross-sectional study evaluated 1,231 CBCT scans of mandibular second molars obtained between October 2018 and February 2022 that were retrieved from the archives of a private radiology clinic. Panoramic-like images were reconstructed from the CBCT scans. The root morphology of mandibular second molars was classified on panoramic-like images as type 1, 2, 3, 4, or 5. The root pattern on axial CBCT images was classified into three types of single, double and C-shaped. The association of root morphology on panoramic-like and axial CBCT views was analyzed by the Chi-square test and Fisher’s exact test at 0.05 level of significance.

Results

Of all, 62.7% of mandibular second molars were type 1; out of which, 97.3% had a double-root pattern on axial CBCT images. Also, 28.6% of them were type 2; of which, 92.6% had a double-root pattern. Moreover, 3.9% were type 3; of which, 47.9% had a C-shaped pattern; 0.9% were type 4, and 45.5% of them showed a single-root pattern; 3.8% were type 5 with 76.6% of them showing a single-root pattern. The prevalence of C-shaped canals was higher in females, and most C-shaped canals had a C3 pattern.

Conclusion

Root morphology on panoramic-like CBCT views had a strong association with the root canal pattern on axial CBCT views. According to the results, mandibular second molars with a type 3 morphology on panoramic-like CBCT images are highly probable to have a C-shaped canal.
Correlation between salivary cytokine profiles and white spot lesions in adolescent patients receiving clear aligner orthodontic treatment
Authors: Liu Qian , Guo Tao , Dang Wei , Song Zhixin , Wen Yi , Luo Houzhuo , Wang Axian
Published: November 2023

Background

To explore the relationship between changes in salivary cytokine levels and the occurrence of white spot lesions in adolescents receiving clear aligner orthodontic treatment and investigate the predictive value of various factors for lesion occurrence.

Methods

We retrospectively analyzed sixthy eight adolescent in the permanent dentition period, who received clear aligner orthodontics in our hospital were randomly divided into two groups according to the occurrence or aggravation of white spot lesions after treatment. The general condition of the oral cavity was analyzed, saliva was collected, and inflammation-related cytokines with varying transcription levels between groups were screened by transcriptome analysis. The expression levels of inflammatory cytokines in the saliva of the patients in the two groups were measured, and the risk factors for white spot lesions were screened by correlation analysis and binary logistic regression analysis. The value of the independent and combined application of risk factors for predicting the occurrence of white spot lesions in adolescent patients after invisible orthodontic treatment was analyzed by receiver operating characteristic (ROC) curve analysis.

Results

Transcriptome and GO and KEGG pathway analyses showed that there were differences in the transcription levels of inflammatory cytokines such as CXCL1, CXCL2, CXCL8, CCL3, CCL4, IL-1β and IL-2 between groups. The levels of CXCL8, CCL3, CCL4, IL-1β and IL-2 in the saliva of patients with white spot lesions were significantly higher in patients after invisible orthodontic treatment (P < 0.05). Correlation analysis and binary logistic regression analysis showed that elevated levels of CXCL8, IL-1β and IL-2 were independent risk factors for the occurrence of white spot lesions (P < 0.05). CXCL8 had the highest independent predictive value for the occurrence of white spot lesions (AUC = 0.773, P < 0.05), and the combination of IL-1β and IL-2 was also of high value in predicting the occurrence of white spot lesions.

Conclusion

After invisible orthodontic treatment, the oral microenvironment, including inflammatory cytokine levels, in adolescent patients changes; in particular, the levels of inflammatory cytokines such as CXCLs and ILs change. CXCL8 expression is significantly associated with the occurrence of white spot lesions and is an important potential target for the prevention and treatment of white spot lesions in the future.
Assessment of gubernacular canal frequency with CBCT in a group of Turkish population
Authors: Dogan Mehmet Emin , Uluısık Nurbanu , Dogan Mehmet Sinan
Published: November 2023

Objective

The aim of this study is to investigate the frequency of the gubernacular canal observed on cone-beam computed tomography (CBCT) images in a group of Turkish populations according to age and gender.

Materials and methods

CBCT images of 500 cases were evaluated retrospectively, and a total of 117 impacted or erupting teeth were included in the study, and the presence of gubernacular canal was recorded according to age, gender and eruption status of the tooth. SPSS program was used for statistical analysis.

Results

The mean age of 117 buried/continuing patients was 17 ± 15.32, 55 (47%) were female and were 62 (53%) male patients. Presence of gubernacular canal was observed in 91 (77.8%) cases and this duct was not detected in 26 (22.2%) cases. While 40.2% of female were found to have canals, 37.6% of male had canals. When the presence of canals was examined, the presence of canals was found to be significantly higher in the erupting teeth. A significant difference was found when analyzed according to the mean age.

Conclusions

CBCT is a useful method of detecting the gubernacular canal. The presence of gubernacular canal was significantly higher in erupting teeth.
Machine learning classification of polycystic ovary syndrome based on radial pulse wave analysis
Authors: Lim Jiekee , Li Jieyun , Feng Xiao , Feng Lu , Xia Yumo , Xiao Xinang , Wang Yiqin , Xu Zhaoxia
Published: November 2023

Background

Patients with Polycystic ovary syndrome (PCOS) experienced endocrine disorders that may present vascular function changes. This study aimed to classify and predict PCOS by radial pulse wave parameters using machine learning (ML) methods and to provide evidence for objectifying pulse diagnosis in traditional Chinese medicine (TCM).

Methods

A case-control study with 459 subjects divided into a PCOS group and a healthy (non-PCOS) group. The pulse wave parameters were measured and analyzed between the two groups. Seven supervised ML classification models were applied, including K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Decision Trees, Random Forest, Logistic Regression, Voting, and Long Short Term Memory networks (LSTM). Parameters that were significantly different were selected as input features and stratified k-fold cross-validations training was applied to the models.

Results

There were 316 subjects in the PCOS group and 143 subjects in the healthy group. Compared to the healthy group, the pulse wave parameters h3/h1 and w/t from both left and right sides were increased while h4, t4, t, As, h4/h1 from both sides and right t1 were decreased in the PCOS group (P < 0.01). Among the ML models evaluated, both the Voting and LSTM with ensemble learning capabilities, demonstrated competitive performance. These models achieved the highest results across all evaluation metrics. Specifically, they both attained a testing accuracy of 72.174% and an F1 score of 0.818, their respective AUC values were 0.715 for the Voting and 0.722 for the LSTM.

Conclusion

Radial pulse wave signal could identify most PCOS patients accurately (with a good F1 score) and is valuable for early detection and monitoring of PCOS with acceptable overall accuracy. This technique can stimulate the development of individualized PCOS risk assessment using mobile detection technology, furthermore, gives physicians an intuitive understanding of the objective pulse diagnosis of TCM.

Trial registration

Not applicable.
Cross-border simulation training for German and Polish emergency medical teams is feasible: conception and evaluation of a bilingual simulation training
Authors: Ruebsam Marie-Luise , Orsson Dorota , Metelmann Bibiana , Orsson Jakub , Hahnenkamp Klaus , Metelmann Camilla
Published: November 2023

Background

Cross-border cooperation of emergency medical services, institutions and hospitals helps to reduce negative impact of national borders and consecutive discrimination of persons living and working in border regions. This study aims to explore the feasibility and effectiveness of a cross-border bilingual simulation training for emergency medical services within an INTERREG-VA-funded project.

Methods

Five days of simulation training for German and Polish paramedics in mixed groups were planned. Effectiveness of training and main learning objectives were evaluated as pre-post-comparisons and self-assessment by participants.

Results

Due to COVID-19 pandemic, only three of nine training modules with n = 16 participants could be realised. Cross-border-simulation training was ranked more positively and was perceived as more useful after the training compared to pretraining. Primary survey has been performed using ABCDE scheme in 18 of 21 scenarios, whereas schemes to obtain medical history have been applied incompletely. However, participants stated to be able to communicate with patients and relatives in 10 of 21 scenarios.

Conclusion

This study demonstrates feasibility of a bilingual cross-border simulation training for German and Polish rescue teams. Further research is highly needed to evaluate communication processes and intra-team interaction during bilingual simulation training and in cross-border emergency medical services rescue operations.
Early prediction of in-hospital mortality utilizing multivariate predictive modelling of electronic medical records and socio-determinants of health of the first day of hospitalization
Authors: Stoessel Daniel , Fa Rui , Artemova Svetlana , von Schenck Ursula , Nowparast Rostami Hadiseh , Madiot Pierre-Ephrem , Landelle Caroline , Olive Fréderic , Foote Alison , Moreau-Gaudry Alexandre , Bosson Jean-Luc
Published: November 2023

Background

In France an average of 4% of hospitalized patients die during their hospital stay. To aid medical decision making and the attribution of resources, within a few days of admission the identification of patients at high risk of dying in hospital is essential.

Methods

We used de-identified routine patient data available in the first 2 days of hospitalization in a French University Hospital (between 2016 and 2018) to build models predicting in-hospital mortality (at ≥ 2 and ≤ 30 days after admission). We tested nine different machine learning algorithms with repeated 10-fold cross-validation. Models were trained with 283 variables including age, sex, socio-determinants of health, laboratory test results, procedures (Classification of Medical Acts), medications (Anatomical Therapeutic Chemical code), hospital department/unit and home address (urban, rural etc.). The models were evaluated using various performance metrics. The dataset contained 123,729 admissions, of which the outcome for 3542 was all-cause in-hospital mortality and 120,187 admissions (no death reported within 30 days) were controls.

Results

The support vector machine, logistic regression and Xgboost algorithms demonstrated high discrimination with a balanced accuracy of 0.81 (95%CI 0.80–0.82), 0.82 (95%CI 0.80–0.83) and 0.83 (95%CI 0.80–0.83) and AUC of 0.90 (95%CI 0.88–0.91), 0.90 (95%CI 0.89–0.91) and 0.90 (95%CI 0.89–0.91) respectively. The most predictive variables for in-hospital mortality in all three models were older age (greater risk), and admission with a confirmed appointment (reduced risk).

Conclusion

We propose three highly discriminating machine-learning models that could improve clinical and organizational decision making for adult patients at hospital admission.
A systematic review of the development and application of home cage monitoring in laboratory mice and rats
Authors: Kahnau Pia , Mieske Paul , Wilzopolski Jenny , Kalliokoski Otto , Mandillo Silvia , Hölter Sabine M. , Voikar Vootele , Amfim Adriana , Badurek Sylvia , Bartelik Aleksandra , Caruso Angela , Čater Maša , Ey Elodie , Golini Elisabetta , Jaap Anne , Hrncic Dragan , Kiryk Anna , Lang Benjamin , Loncarevic-Vasiljkovic Natasa , Meziane Hamid , Radzevičienė Aurelija , Rivalan Marion , Scattoni Maria Luisa , Torquet Nicolas , Trifkovic Julijana , Ulfhake Brun , Thöne-Reineke Christa , Diederich Kai , Lewejohann Lars , Hohlbaum Katharina
Published: November 2023

Background

Traditionally, in biomedical animal research, laboratory rodents are individually examined in test apparatuses outside of their home cages at selected time points. However, the outcome of such tests can be influenced by various factors and valuable information may be missed when the animals are only monitored for short periods. These issues can be overcome by longitudinally monitoring mice and rats in their home cages. To shed light on the development of home cage monitoring (HCM) and the current state-of-the-art, a systematic review was carried out on 521 publications retrieved through PubMed and Web of Science.

Results

Both the absolute (~ × 26) and relative (~ × 7) number of HCM-related publications increased from 1974 to 2020. There was a clear bias towards males and individually housed animals, but during the past decade (2011–2020), an increasing number of studies used both sexes and group housing. In most studies, animals were kept for short (up to 4 weeks) time periods in the HCM systems; intermediate time periods (4–12 weeks) increased in frequency in the years between 2011 and 2020. Before the 2000s, HCM techniques were predominantly applied for less than 12 h, while 24-h measurements have been more frequent since the 2000s. The systematic review demonstrated that manual monitoring is decreasing in relation to automatic techniques but still relevant. Until (and including) the 1990s, most techniques were applied manually but have been progressively replaced by automation since the 2000s. Independent of the year of publication, the main behavioral parameters measured were locomotor activity, feeding, and social behaviors; the main physiological parameters were heart rate and electrocardiography. External appearance-related parameters were rarely examined in the home cages. Due to technological progress and application of artificial intelligence, more refined and detailed behavioral parameters have been investigated in the home cage more recently.

Conclusions

Over the period covered in this study, techniques for HCM of mice and rats have improved considerably. This development is ongoing and further progress as well as validation of HCM systems will extend the applications to allow for continuous, longitudinal, non-invasive monitoring of an increasing range of parameters in group-housed small rodents in their home cages.
Cardiovascular events and venous thromboembolism after primary malignant or non-malignant brain tumour diagnosis: a population matched cohort study in Wales (United Kingdom)
Authors: Poon Michael T. C. , Brennan Paul M. , Jin Kai , Sudlow Cathie L. M. , Figueroa Jonine D.
Published: November 2023

Background

Elevated standardised mortality ratio of cardiovascular diseases (CVD) in patients with brain tumours may result from differences in the CVD incidences and cardiovascular risk factors. We compared the risk of CVD among patients with a primary malignant or non-malignant brain tumour to a matched general population cohort, accounting for other co-morbidities.

Methods

Using data from the Secured Anonymised Information Linkage (SAIL) Databank in Wales (United Kingdom), we identified all adults aged ≥ 18 years in the primary care database with first diagnosis of malignant or non-malignant brain tumour identified in the cancer registry in 2000–2014 and a matched cohort (case-to-control ratio 1:5) by age, sex and primary care provider from the general population without any cancer diagnosis. Outcomes included fatal and non-fatal major vascular events (stroke, ischaemic heart disease, aortic and peripheral vascular diseases) and venous thromboembolism (VTE). We used multivariable Cox models adjusted for clinical risk factors to compare risks, stratified by tumour behaviour (malignant or non-malignant) and follow-up period.

Results

There were 2869 and 3931 people diagnosed with malignant or non-malignant brain tumours, respectively, between 2000 and 2014 in Wales. They were matched to 33,785 controls. Within the first year of tumour diagnosis, malignant tumour was associated with a higher risk of VTE (hazard ratio [HR] 21.58, 95% confidence interval 16.12–28.88) and stroke (HR 3.32, 2.44–4.53). After the first year, the risks of VTE (HR 2.20, 1.52–3.18) and stroke (HR 1.45, 1.00–2.10) remained higher than controls. Patients with non-malignant tumours had higher risks of VTE (HR 3.72, 2.73–5.06), stroke (HR 4.06, 3.35–4.93) and aortic and peripheral arterial disease (HR 2.09, 1.26–3.48) within the first year of diagnosis compared with their controls.

Conclusions

The elevated CVD and VTE risks suggested risk reduction may be a strategy to improve life quality and survival in people with a brain tumour.
The impact of SARS-CoV-2 infection in patients with cystic fibrosis undergoing CFTR channel modulators treatment: a literature review
Authors: Vitiello Antonio , Sabbatucci Michela , Silenzi Andrea , Capuano Annalisa , Rossi Francesco , Zovi Andrea , Blasi Francesco , Rezza Giovanni
Published: November 2023

Several risk factors for Coronavirus-2019 (COVID-19) disease have been highlighted in clinical evidence. Among the various risk factors are advanced age, metabolic illness such as diabetes, heart disease, and diseases of the respiratory system. Cystic Fibrosis (CF) is a rare disease with autosomal recessive transmission, characterised by a lack of synthesis of the CFTR channel protein, and multi-organ clinical symptoms mainly affecting the respiratory tract with recurrent pulmonary exacerbations. In view of the pathophysiological mechanisms, CF disease should be in theory considered a risk factor for SARS-CoV2 or severe COVID-19. However, recent clinical evidence seems to point in the opposite direction, suggesting that CF could be a protective factor against severe COVID-19. Possibly, the lack of presence or function of the CFTR channel protein could be linked to the expression of the membrane glycoprotein ACE-2, a key enzyme for the endocellular penetration of SARS-CoV-2 and related to the pathophysiology of COVID-19 disease. Furthermore, CFTR channel modulating agents could indirectly influence the expression of ACE-2, playing an important role in restoring the proper functioning of mucociliary clearance and the pulmonary microbiome in the host response to SARS-CoV-2 infection. In this review, the authors attempt to shed light on these important associations of issues that are not yet fully elucidated.
The synergy of serum SFRP5 levels and the TyG index in predicting coronary artery disease and prognosing major adverse cardiovascular events
Authors: Jia Lin , Shang Shimei , Yang Yu , Zhang Jian , Lin Xianhe
Published: November 2023

Background and aims

Secreted frizzled-related protein 5 (SFRP5) is a member of the SFRP family that is known for its potent anti-inflammatory properties. Nevertheless, little is known regarding the relevance of SFRP5 in coronary artery disease (CAD). The current study examined the correlation between serum levels of SFRP5 and the triglyceride-glucose (TyG) index in patients who underwent coronary angiography (CAG) as a component of cardiovascular assessment and for the purpose of prognosis evaluation.

Methods

A total of 310 hospitalized patients were enrolled in this study between May 2021 and March 2022 and were divided into three groups based on their CAG results and SYNTAX (synergy between PCI with TAXUS drug-eluting stent and cardiac surgery) scores: the control group, mild lesion group, and moderate-severe lesion group. Univariate and multivariate analyses were employed to investigate the relationships between changes in patients and clinical variables. To investigate the impact of the TyG index and serum SFRP5 levels on the occurrence of major adverse cardiovascular events (MACEs), Kaplan‒Meier curves were plotted. Serum SFRP5 levels were measured utilizing an enzyme-linked immunosorbent assay (ELISA) kit.

Results

The serum SFRP5 levels significantly decreased with the increasing severity and complexity of CAD, while the TyG index significantly increased (P < 0.001). Moreover, a significant negative correlation was observed between the serum SFRP5 levels and the TyG index (r = -0.312, P < 0.001). SFRP5 exerts a protective role in different groups of patients. The area under the receiver operating characteristic (ROC) curve indicated that an SFRP5 concentration > 115.58 pg/mL was the best predictive value for CAD (OR:0.87, P < 0.001). MACEs were significantly associated with serum SFRP5 levels and the TyG index, as indicated by both univariate and multivariate Cox regression analyses (P < 0.001). Furthermore, Kaplan‒Meier analysis indicated that as the TyG index decreased and SFRP5 levels increased, the occurrence of MACEs decreased (P < 0.001). Patients with a concentration of SFRP5 > 115.58 pg/mL and a TyG index < 8.49 exhibited a better prognosis for avoiding MACEs (P < 0.001).

Conclusion

These results suggest that the collaboration between serum SFRP5 levels and the TyG index holds promise in predicting CAD and its prognosis.
USP39 interacts with SIRT7 to promote cervical squamous cell carcinoma by modulating autophagy and oxidative stress via FOXM1
Authors: Yu Juanpeng , Yuan Shuai , Song Jinglin , Yu Shengsheng
Published: November 2023

Background

Sirtuin 7 (SIRT7) is an oncogene that promotes tumor progression in various malignancies, however, its role and regulatory mechanism in cervical squamous cell carcinoma (CSCC) is unknown. Herein, we attempted to investigate the functional role and molecular mechanism of SIRT7 underlying CSCC progression.

Methods

SIRT7 expression was evaluated in CSCC cells using various assays. We then used a series of function gain-and-loss experiments to determine the role of SIRT7 in CSCC progression. Furthermore, mechanism experiments were conducted to assess the interaction between SIRT7/USP39/FOXM1 in CSCC cells. Additionally, rescue assays were conducted to explore the regulatory function of USP39/FOXM1 in CSCC cellular processes.

Results

SIRT7 was highly expressed in CSCC patient tissues and cell lines. SIRT7 deficiency showed significant repression on the proliferation, and autophagy of CSCC cells in vitro and tumorigenesis in vivo. Similarly, apoptosis and ROS production in CSCC cells were accelerated after the SIRT7 knockdown. Moreover, SIRT7 and USP39 were found colocalized in the cell nucleus. Interestingly, SIRT7 was revealed to deacetylate USP39 to promote its protein stability in CSCC cells. USP39 protein was also verified to be upregulated in CSCC tissues and cells. USP39 silencing showed suppressive effects on CSCC cell growth. Mechanistically, USP39 was revealed to upregulate SIRT7 by promoting the transcriptional activity of FOXM1. Rescue assays also indicated that SIRT7 promoted autophagy and inhibited ROS production in CSCC cells by regulating USP39/FOXM1.

Conclusion

The SIRT7/USP39/FOXM1 positive feedback network regulates autophagy and oxidative stress in CSCC, thus providing a new direction for CSCC-targeted therapy.

Graphical Abstract
Research progress on the mechanism of traditional Chinese medicine regulating intestinal microbiota to combat influenza a virus infection
Authors: Ma LanYing , Ji Lingyun , Wang Tong , Zhai Zhe , Su PeiWei , Zhang YaNan , Wang Yuan , Zhao WenXiao , Wu ZhiChun , Yu HuaYun , Zhao HaiJun
Published: November 2023

Influenza A viruses (IAV) are a prevalent respiratory pathogen that can cause seasonal flu and global pandemics, posing a significant global public health threat. Emerging research suggests that IAV infections may disrupt the balance of gut microbiota, while gut dysbiosis can affect disease progression in IAV patients. Therefore, restoring gut microbiota balance may represent a promising therapeutic target for IAV infections. Traditional Chinese medicine, with its ability to regulate gut microbiota, offers significant potential in preventing and treating IAV. This article provides a comprehensive review of the relationship between IAV and gut microbiota, highlighting the impact of gut microbiota on IAV infections. It also explores the mechanisms and role of traditional Chinese medicine in regulating gut microbiota for the prevention and treatment of IAV, presenting novel research avenues for traditional Chinese medicine-based IAV treatments.