bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementing falls prevention patient education in hospitals - older people’s views on barriers and enablers
Authors: Hill Anne-Marie , Francis-Coad J. , Vaz S. , Morris M. E. , Flicker L. , Weselman T. , Hang J. A.
Published: September 2024

Background

World falls guidelines recommend that hospitalised older patients receive individualised falls prevention education, yet no studies have sought older people’s feedback on how best to deliver falls prevention education in hospitals. The objective of the study was to explore the perspectives of older people and their caregivers about barriers and enablers to implementation of a tailored hospital falls education program.

Methods

A qualitative descriptive design was used. Three focus groups and 16 semi-structured interviews were conducted. A purposive sample of older people who had previous hospital admissions and caregivers of older people were selected to review a co-designed patient falls education program (the revised Safe Recovery program). They provided feedback on how to implement the program in hospital settings. Data were thematically analysed taking an deductive-inductive approach.

Results

Participants were 37 older people [female n = 24 (64.9%), age range 64 to 89 years] and nine caregivers (female n = 8). The first theme was that the Safe Recovery Program resources were of high quality, enabling strong patient engagement and increased knowledge and awareness about falls prevention in hospitals. The second theme identified practical strategies to enable program delivery in hospital wards. The key enablers identified were: timing of delivery around wellness and the patient’s mobility; tailoring messages for each older patient; key staff members being assigned to lead program delivery. Participants recommended that staff assist older patients to set appropriate behavioural goals in relation to preventing falls in hospitals. They also recommended that staff raise older patients’ confidence and motivation to take action to reduce the risk of falls. Providing resources in other languages and alternative shorter versions was recommended to enable broad dissemination.

Conclusions

Older people and their caregivers advised that implementing falls education in hospitals can be enabled by using high quality resources, delivering falls education in a timely manner and personalising the education and support to individual needs.
Workplace resilience and compassionate care among Jordanian private sector nurses
Authors: Nassar Yousef Mohammad , Eshah Nidal , Al-Maqableh Hindya O. , Nashwan Abdulqadir J. , Rayan Ahmad , Alhawajreh Mohammad J.
Published: September 2024

Background

Compassionate care is a hallmark of the nursing profession. Yet, nursing is beset by perennial problems, not the least of which is nursing shortage and increased workload. As such, resilience becomes a critical ingredient that nurses must possess to overcome such challenges. However, there needs to be more evidence of the relationship between compassionate care and resilience within the Jordanian nursing context.

Aim

To explore the relationship between workplace resilience and compassionate care among Jordanian nurses working in the private sector.

Methods

The study utilized a descriptive cross-sectional correlational design. Convenience sampling with inclusion-exclusion criteria was used to select participants from three private hospitals in Jordan. The Compassionate Care Questionnaire was used to measure levels of compassionate care, and the Resilience at Work Scale was used to measure workplace resilience. Ethical approval was obtained before data collection.

Results

A total of 161 nurses participated in the study. Participants had high levels of compassionate care and workplace resilience. Male nurses and nurses with lower workloads had significantly higher levels of compassionate care. Likewise, older nurses, nurses with postgraduate degrees, and nurses with experience of less than 5 years in the current area had significantly higher levels of workplace resilience. Compassionate care had a mordantly solid and significant positive relationship with workplace resilience and all its seven dimensions (living authentically, finding one’s calling, maintaining perspective, managing stress, interacting cooperatively, staying healthy, and building networks.

Conclusion

Developing workplace resilience can support nurses in implementing compassionate care. Nurse Managers and hospital administrators must consider the effects of compassionate care and workplace resilience on nurses and patients. Future research can include a longitudinal exploration of compassionate care and workplace resilience and an investigation of the levels of these variables outside a hospital setting.
Preventing illegal seafood trade using machine-learning assisted microbiome analysis
Authors: Peruzza Luca , Cicala Francesco , Milan Massimo , Rovere Giulia Dalla , Patarnello Tomaso , Boffo Luciano , Smits Morgan , Iori Silvia , De Bortoli Angelo , Schiavon Federica , Zentilin Aurelio , Fariselli Piero , Cardazzo Barbara , Bargelloni Luca
Published: September 2024

Background

Seafood is increasingly traded worldwide, but its supply chain is particularly prone to frauds. To increase consumer confidence, prevent illegal trade, and provide independent validation for eco-labelling, accurate tools for seafood traceability are needed. Here we show that the use of microbiome profiling (MP) coupled with machine learning (ML) allows precise tracing the origin of Manila clams harvested in areas separated by small geographic distances. The study was designed to represent a real-world scenario. Clams were collected in different seasons across the most important production area in Europe (lagoons along the northern Adriatic coast) to cover the known seasonal variation in microbiome composition for the species. DNA extracted from samples underwent the same depuration process as commercial products (i.e. at least 12 h in open flow systems).

Results

Machine learning-based analysis of microbiome profiles was carried out using two completely independent sets of data (collected at the same locations but in different years), one for training the algorithm, and the other for testing its accuracy and assessing the temporal stability signal. Briefly, gills (GI) and digestive gland (DG) of clams were collected in summer and winter over two different years (i.e. from 2018 to 2020) in one banned area and four farming sites. 16S DNA metabarcoding was performed on clam tissues and the obtained amplicon sequence variants (ASVs) table was used as input for ML MP. The best-predicting performances were obtained using the combined information of GI and DG (consensus analysis), showing a Cohen K-score > 0.95 when the target was the classification of samples collected from the banned area and those harvested at farming sites. Classification of the four different farming areas showed slightly lower accuracy with a 0.76 score.

Conclusions

We show here that MP coupled with ML is an effective tool to trace the origin of shellfish products. The tool is extremely robust against seasonal and inter-annual variability, as well as product depuration, and is ready for implementation in routine assessment to prevent the trade of illegally harvested or mislabeled shellfish.
Olfactory performance and odor liking are negatively associated with food neophobia in children aged between 3 and 9 years
Authors: Sorokowska Agnieszka , Chabin Dominika , Kamieńska Aleksandra , Barszcz Sabina , Byczyńska Katarzyna , Fuławka Klaudia , Urbanek Arkadiusz , Oleszkiewicz Anna
Published: September 2024

Background

Child food neophobia, i.e., rejection or avoidance of novel foods at a young age, is a prevalent nutrition problem that affects the quality of children’s diet and impedes the development of healthy food preferences. Sensory sensitivity can relate to the degree of food neophobia, but previous studies rarely focused on the olfactory component of this problem in children.

Objective

We aimed to thoroughly examine the relationship between various aspects of olfactory sensitivity and food neophobia in children.

Methods

246 children aged between three and nine years took part in a food neophobia assessment as well as in a comprehensive, psychophysical olfactory testing.

Results

We found that certain smell perception aspects such as lower odor liking, poorer odor identification ability as well as lower sensitivity to an unknown non-food odor all significantly predicted higher food neophobia in children. Among individual characteristics of either a child or a caregiver, only the child’s age significantly and positively predicted food neophobia. The exploratory model looking into the role of family environment factors predicting self-reported food neophobia in children revealed that food neophobia was associated with lower control given to a child in this child’s feeding process, as well as with a more frequent use of food as a reward in feeding.

Conclusions

We suggest that suppressed olfactory perception and performance can play a unique role in child nutritional difficulties. The study inspires further considerations of olfaction-engaging interventions to counteract food-neophobia in children.
Equity considerations for the implementation of health insurance benefit package in Ethiopia: result of expert Delphi exercise
Authors: Memirie Solomon Tessema , Argaw Muluken , Tolla Mieraf Taddesse , Abebe Frehiwot , Dagnaw Wubaye Walelgne , Norheim Ole F. , Yigezu Amanuel
Published: September 2024

Background

Efficiency, equity and financial risk protection are key health systems objectives. Equitable distribution of health care is among the priority strategic initiative of the government of Ethiopia. However, data on the distribution of interventions benefits or on disease burden disaggregated by subpopulations to guide health care priority setting is not available in Ethiopia.

Methods

Aligned with policy documents, we identified the following groups to be the worse off in the Ethiopian context: under-five children, women of reproductive age, the poor, and rural residents. We used the Delphi technique by a panel of 28 experts to assign a score for 253 diseases/conditions over a period of two days, in phases. The expert panel represented different institutes and professional mix. Experts assigned a score 1 to 4; where 4 indicates disease/condition predominantly affecting the poor and rural residents and 1 indicates a condition more prevalent among the wealthy and urban residents. Subsequently, the average equity score was computed for each disease/condition.

Results

The average scores ranged from 1.11 (for vitiligo) to 3.79 (for obstetric fistula). We standardized the scores to be bounded between 1 and 2; 1 the lowest equity score and 2 the highest equity score. The scores for each disease/condition were then assigned to their corresponding interventions. We used these equity scores to adjust the CEA values for each of the interventions. To adjust the CEA values for equity, we multiplied the health benefits (the denominator of the cost-effectiveness value) of each intervention by the corresponding equity scores, resulting in equity adjusted CEA values. The equity adjusted CEA was then used to rank the interventions using a league table.

Conclusions

The Delphi method can be useful in generating equity scores for prioritizing health interventions where disaggregated data on the distribution of diseases or access to interventions by subpopulation groups are not available.
Validation of the parents’ version of the KINDLR and Kiddy Parents questionnaire in a South African context
Authors: Deacon Elmari , Jansen van Vuren Esmé , Bothma Elizabeth , Volschenk Chanelle , Kruger Ruan
Published: September 2024

Background

This study aimed to assess the usefulness of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire in the South-African context and to validate it as an appropriate tool for measuring health-related quality of life (HRQoL).

Method

The ExAMIN Youth SA study was designed to investigate lifestyle behaviours, including psychosocial factors that may adversely impact on cardiovascular health of children. Construct validity was examined by using exploratory and confirmatory factor analysis, while internal consistency was tested by Cronbach’s alpha. The final factor structure was confirmed by model fit indices.

Results

The study included children (n = 1088) aged between 5 and 10 years in North-West, South Africa. The reliability coefficients of the original factors could not be reproduced in this data set, with the Cronbach’s alphas ranging between 0.46 and 0.78. With exploratory factor analysis, including the additional items, our data supported a 7-factor structure with acceptable internal consistency (Cronbach’s alpha: 0.68–0.79; Omega: 0.75–0.85) and acceptable model fit indices (CFI: 0.91; TLI: 0.90; RMSEA: 0.05; SRMR: 0.07). Two factors (emotional wellbeing and everyday functioning) further split into separate factors for positive and negative experiences related to each of these dimensions.

Conclusion

We confirmed a new factor structure of the parent version of the KINDLR and the additional items of the Kiddy Parents questionnaire, which can be used in the African context. Although the new factor structure has great overlap with the original structure, some items did not contribute to the factors as expected. Language and cultural differences between the original German group and the current South African study group resulted in a different factor structure.
How are maternal and fetal outcomes incorporated when measuring benefits of interventions in pregnancy? Findings from a systematic review of cost-utility analyses
Authors: Abel Lucy , Dakin Helen , Cai Ting , McManus Richard J. , McNiven Abigail , Rivero-Arias Oliver
Published: September 2024

Objective

Medical interventions used in pregnancy can affect the length and quality of life of both the pregnant person and fetus. The aim of this systematic review was to identify and describe the theoretical frameworks that underpin outcome measurement in cost-utility analyses of pregnancy interventions.

Methods

Searches were conducted in the Paediatric Economic Database Evaluation (PEDE) database (up to 2017), as well as Medline, Embase and EconLit (2017–2019). We included all cost-utility analyses of any intervention given during pregnancy, published in English. We conducted a narrative synthesis of: study design; outcome construction (life expectancy, quality adjustment, discount rate); and whether the Incremental Cost-Effectiveness Ratio (ICER) was constructed using maternal or fetal outcomes. Where both outcomes were included, methods for combining them were extracted.

Results

We identified 127 cost-utility analyses in pregnancy, of which 89 reported QALYs and 38 DALYs. Outcomes were considered solely for the fetus in 59 studies (47%), solely for the pregnant person in 13 studies (10%), and for both in 49 studies (39%). The choice to include or exclude one or both sets of outcomes was not consistent within particular clinical areas. Where outcomes for both mother and baby were included, methods for combining these outcomes varied. Twenty-nine studies summed QALYs/DALYs for maternal and fetal outcomes, with no adjustment. The remaining 20 took a variety of approaches designed to weigh maternal and fetal outcomes differently. These include (1) treating fetal outcomes as a component of maternal quality of life, rather than (or in addition to) an independent individual health outcome; (2) treating the maternal-fetal dyad as a single entity and applying a single utility value to each combination of outcomes; and (3) assigning a shorter time horizon to fetal outcomes to reduce the weight of lifetime fetal outcomes. Each approach made different assumptions about the relative value of maternal and fetal health outcomes, demonstrating a lack of consistency and the need for guidance.

Conclusion

Methods for capturing QALY/DALY outcomes in cost-utility analysis in pregnancy vary widely. This lack of consistency indicates a need for new methods to support the valuation of maternal and fetal health outcomes.
Dynamic changes in quality of life in older patients with chronic obstructive pulmonary disease: a 7-year follow up
Authors: Yu Chun-Hsiang , Tsai Sheng-Han , Hung Jo-Ying , Su Pei-Fang , Hsu Chih-Hui , Liao Xin-Min , Hsiue Tzuen-Ren , Chen Chiung-Zuei
Published: September 2024

Purposes

: Chronic obstructive pulmonary disease (COPD) is a major cause of the rapid decline of health-related quality of life (HRQoL), associated with accelerated frailty in older populations. This study aimed to analyse the long-term dynamic changes of HRQoL and the predictive factors for the rapid decline of HRQoL in older patients with COPD.

Methods

Overall 244 patients with COPD, aged ≧ 65 years from one medical centre were enrolled between March 2012 and July 2020. Further, we prospectively assessed HRQoL scores with utility values, using EuroQol Five-Dimension (EQ-5D) questionnaires. Additionally, long-term dynamic changes in HRQoL were analysed using the Kernel smoothing method and examined the factors contributing to the deterioration of HRQoL using a linear mixed effects model.

Results

Older patients with COPD with forced expiration volume (FEV1) < 50% of prediction entered the phase of rapid and continuous decline of HRQoL ~ 2 years after enrolment, but patients with FEV1 ≥ 50% of prediction without rapidly declined HRQoL during 7 years follow up. Therefore, FEV1 < 50% of prediction is a novel predictor for the rapid decline of HRQoL. The course of rapidly declining HRQoL occurred, initially in the usual activities and pain/discomfort domains, followed by the morbidity, self-care, and depression/anxiety domains ~ 2 and 4 years after enrolment, respectively. The mixed effects model indicated that both FEV1 < 50% of prediction and a history of severe acute exacerbation (SAE) requiring hospitalisation were contributing factors for deterioration in HRQoL .

Conclusions

Both FEV1 < 50% of prediction and exacerbations requiring hospitalisation were contributing factors for the deterioration of HRQoL in long-term follow up. Additionally, FEV1 < 50% of prediction was a novel predictor for patients entering the phase of rapid decline of HRQoL.
A partitioned polygenic risk score reveals distinct contributions to psoriasis clinical phenotypes across a multi-ethnic cohort
Authors: Orcales Faye , Kumar Sugandh , Bui Audrey , Johnson Chandler , Liu Jared , Huang Zhi-Ming , Liao Wilson
Published: September 2024

Psoriasis is a chronic, immune-mediated inflammatory skin disease associated with a polygenic mode of inheritance. There are few studies that explore the association of a psoriasis Polygenic Risk Score (PRS) with patient clinical characteristics, and to our knowledge there are no studies examining psoriasis PRS associations across different ethnicities. In this study, we used a multi-racial psoriasis cohort to investigate PRS associations with clinical phenotypes including age of onset, psoriatic arthritis, other comorbidities, psoriasis body location, psoriasis subtype, environmental triggers, and response to therapies. We collected patient data and Affymetrix genome-wide SNP data from a cohort of 607 psoriasis patients and calculated an 88-loci PRS (PRS-ALL), also partitioned between genetic loci within the HLA region (PRS-HLA; 11 SNPS) and loci outside the HLA region (PRS-NoHLA; 77 SNPS). We used t-test and logistic regression to analyze the association of PRS with clinical phenotypes. We found that PRS-HLA and PRS-noHLA had differing effects on psoriasis age of onset, psoriatic arthritis, psoriasis located on the ears, genitals, nails, soles of feet, skin folds, and palms, skin injury as an environmental trigger, cardiovascular comorbidities, and response to phototherapy. In some cases these PRS associations were ethnicity specific. Overall, these results show that the genetic basis for clinical manifestations of psoriasis are driven by distinct HLA and non-HLA effects, and that these PRS associations can be dependent on ethnicity.
Exploring comprehensive sexuality education experiences and barriers among students, teachers and principals in Nepal: a qualitative study
Authors: Rivenes Lafontan Sara , Jones Felicia , Lama Niru
Published: September 2024

Background

Comprehensive sexuality education (CSE) is essential in empowering adolescents with the knowledge and confidence to manage their sexual and reproductive health. Despite its recognized benefits, access to quality CSE remains limited, especially in low-income countries, where societal norms and structural barriers hinder effective delivery. The aim of this study is to investigate the experiences and perceptions among students, teachers, and principals in Nepal about comprehensive sexuality education.

Methods

Qualitative methods were used. 13 Semi-structured interviews and 1 focus group discussion were carried out with 15 teachers and principals working at higher secondary schools and two focus group discussions were conducted with a total of 13 adolescents. Thematic analysis was used to analyze the data.

Results

Four themes were developed: Resistance to Teaching and Learning, Preparation and Engagement Strategies, Taboos and Silencing and Structural Barriers. Students, teachers, principals and students reported discomfort and embarrassment when discussing sensitive topics, with gender dynamics playing a significant role. Strategies like warm-up sessions and continuous interaction with students and parents were used to create a supportive learning environment. However, socio-cultural barriers and family attitudes continued to hinder open discussions about sexuality. Structural barriers, including the lack of formal training for teachers and inadequate instructional materials, further impeded effective CSE delivery.

Conclusion

The experiences of CSE in Nepal among students, teachers and principals highlight significant barriers including cultural taboos, gender dynamics and insufficient resources. Addressing these barriers through comprehensive teacher training, curriculum reform, and societal engagement is critical to ensure access to CSE.
Mechanisms of manipulation: a systematic review of the literature on immediate anatomical structural or positional changes in response to manually delivered high-velocity, low-amplitude spinal manipulation
Authors: Young Kenneth J. , Leboeuf-Yde Charlotte , Gorrell Lindsay , Bergström Cecilia , Evans David W. , Axén Iben , Chance-Larsen Kenneth , Gagey Olivier , Georgopoulos Vasileios , Goncalves Guillaume , Harris Catherine , Harsted Steen , Kerry Roger , Lee Edward , McCarthy Christopher , Nim Casper , Nyirö Luana , Schweinhardt Petra , Vogel Steven
Published: September 2024

Background

Spinal manipulation (SM) has been claimed to change anatomy, either in structure or position, and that these changes may be the cause of clinical improvements. The aim of this systematic review was to evaluate and synthesise the peer-reviewed literature on the current evidence of anatomical changes in response to SM.

Methods

The review was registered with PROSPERO (CRD42022304971) and reporting was guided by the standards of the PRISMA Statement. We searched Medline, Embase, CINAHL, AMED, Cochrane Library all databases, PEDro, and the Index to Chiropractic Literature from inception to 11 March 2022 and updated on 06 June 2023. Search terms included manipulation, adjustment, chiropractic, osteopathy, spine and spine-related structures. We included primary research studies that compared outcomes with and without SM regardless of study design. Manipulation was defined as high-velocity, low-amplitude thrust delivered by hand to the spine or directly related joints. Included studies objectively measured a potential change in an anatomical structure or in position. We developed a novel list of methodological quality items in addition to a short, customized list of risk of bias (RoB) items. We used quality and RoB items together to determine whether an article was credible or not credible. We sought differences in outcomes between SM and control groups for randomised controlled trials and crossover studies, and between pre- and post-SM outcomes for other study designs. We reported, in narrative form, whether there was a change or not.

Results

The search retrieved 19,572 articles and 20 of those were included for review. Study topics included vertebral position (n = 3) facet joint space (n = 5), spinal stiffness (n = 3), resting muscle thickness (n = 6), intervertebral disc pressure (n = 1), myofascial hysteresis (n = 1), and further damage to already damaged arteries (n = 1). Eight articles were considered credible. The credible articles indicated that lumbar facet joint space increased and spinal stiffness decreased but that the resting muscle thickness did not change.

Conclusion

We found few studies on this topic. However, there are two promising areas for future study: facet joint space and spinal stiffness. A research strategy should be developed with funding for high quality research centres.
Epidemiology of Wilson disease in Germany – real-world insights from a claims data study
Authors: Fang Shona , Hedera Peter , Borchert Julia , Schultze Michael , Weiss Karl Heinz
Published: September 2024

Background

Wilson disease (WD) is a rare disorder of copper metabolism, causing copper accumulation mainly in the liver and the brain. The prevalence of WD was previously estimated around 20 to 33.3 patients per million for the United States, Europe, and Asia, but data on the prevalence of WD in Germany are limited.

Objectives

To describe patient characteristics and to assess prevalence of WD in Germany using a representative claims database.

Methods

WD patients were identified in the WIG2 (Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung; Scientific Institute for Health Economics and Health Systems Research) benchmark database of 4.5 million insured Germans by combining ICD-10-coding with WD-specific lab tests and treatments. The study period ranged from 2013 to 2016 for assessing patient characteristics, and to 2018 for prevalence, respectively.

Results

Seventy unique patients were identified. Most patients (86%) were between 18 and 64 years of age and more often male (60%) than female. Two patients (3%) younger than 18 years were included, as well as 8 patients (11%) older than 64 years. Most common WD subtypes were hepatic (57%), psychiatric (49%), and neurologic (44%). Average prevalence was 20.3 patients per million (range: 17.8–24.4), with similar results for two-year prevalence. Generally, prevalence increased steadily over the study period. Observed mortality was low, with only one death during the study period.

Conclusions

This study adds valuable real-world data on the prevalence and patient characteristics of WD in Germany. Generally, our findings align with other reports and contribute to the global understanding of WD epidemiology. Still, regional and temporal trends remain to be investigated more thoroughly to further the understanding of the natural history and epidemiology of this rare disease.
Real-time PCR for malaria diagnosis and identification of Plasmodium species in febrile patients in Cubal, Angola
Authors: Mediavilla Alejandro , Silgado Aroa , Febrer-Sendra Begoña , Crego-Vicente Beatriz , Martínez-Vallejo Patricia , Maturana Carles Rubio , Goterris Lidia , Nindia Arlette , Martínez-Campreciós Joan , Aixut Sandra , Aznar-Ruiz-de-Alegría María Luisa , Fernández-Soto Pedro , Muro Antonio , Salvador Fernando , Molina Israel , Berzosa Pedro , Oliveira-Souto Inés , Sulleiro Elena
Published: September 2024

Background

Malaria is the parasitic disease with the highest morbimortality worldwide. The World Health Organization (WHO) estimates that there were approximately 249 million cases in 2022, of which 3.4% were in Angola. Diagnosis is based on parasite identification by microscopy examination, antigen detection, and/or molecular tests, such as polymerase chain reaction (PCR). This study aimed to evaluate the usefulness of real-time PCR as a diagnostic method for malaria in an endemic area (Cubal, Angola).

Methods

A cross-sectional study was carried out at the Hospital Nossa Senhora da Paz in Cubal, Angola, including 200 patients who consulted for febrile syndrome between May and July 2022. From each patient, a capillary blood sample was obtained by finger prick for malaria field diagnosis [microscopy and rapid diagnostic test (RDT)] and venous blood sample for real-time PCR performed at the Hospital Universitario Vall d’Hebron in Barcelona, Spain. Any participant with a positive result from at least one of these three methods was diagnosed with malaria.

Results

Of the 200 participants included, 54% were female and the median age was 7 years. Malaria was diagnosed by at least one of the three techniques (microscopy, RDT, and/or real-time PCR) in 58% of the participants, with RDT having the highest percentage of positivity (49%), followed by real-time PCR (39.5%) and microscopy (33.5%). Of the 61 discordant samples, 4 were only positive by microscopy, 13 by real-time PCR, and 26 by RDT. Plasmodium falciparum was the most frequent species detected (90.63%), followed by P. malariae (17.19%) and P. ovale (9.38%). Coinfections were detected in ten participants (15.63%): six (60%) were caused by P. falciparum and P. malariae, three (30%) by P. falciparum and P. ovale, and one (10%) triple infection with these three species. In addition, it was observed that P. falciparum and P. malariae coinfection significantly increased the parasite density of the latter.

Conclusions

RDT was the technique with the highest positivity rate, followed by real-time PCR and microscopy. The results of the real-time PCR may have been underestimated due to suboptimal storage conditions during the transportation of the DNA eluates. However, real-time PCR techniques have an important role in the surveillance of circulating Plasmodium species, given the epidemiological importance of the increase in non-falciparum species in the country, and can provide an estimate of the intensity of infection.

Graphical abstract
Continued decitabine/all-trans retinoic acid treatment: extended complete remission in an elderly AML patient with multi-hit TP53 lesions and complex-monosomal karyotype
Authors: Thomas Johanna , Rehman Usama-Ur , Bresser Helena , Grishina Olga , Pfeifer Dietmar , Sollier Etienne , Döhner Konstanze , Plass Christoph , Becker Heiko , Schmoor Claudia , de Wit Maike , Lübbert Michael
Published: September 2024

DNA-hypomethylating agents (HMAs) induce notable remission rates in AML/MDS patients withTP53mutations; however, secondary resistance often develops rapidly. In the DECIDER trial (NCT00867672), elderly AML patients (also those with adverse genetics) randomized to all-transretinoic acid (ATRA) added to decitabine (DEC) attained significantly delayed time-to-resistance. An 82-year-old patient with a non-disruptive, in-frameTP53mutation (p.Cys238_Asn239delinsTyr, VAF 90%) and complex-monosomal karyotype attained a complete hematologic and cytogenetic remission with DEC + ATRA, with 3.7 years survival after 30 treatment cycles that were well-tolerated. Further HMA + ATRA studies appear warranted in AML/MDS patients of different genetic risk groups ineligible for more intensive treatment.

Trial registration: This trial was registered at ClinicalTrials.gov identifier: NCT00867672
A redescription of Brouffia orientalis Carroll & Baird, 1972 from the Upper Carboniferous of the Czech Republic and the status and affinities of protorothyridid amniotes
Authors: Klembara Jozef , Ruta Marcello , Anderson Jason , Mayer Taran , Hain Miroslav , Valaška Daniel
Published: September 2024

The Upper Carboniferous protorothyridid amniote Brouffia orientalis from Czech Republic is redescribed. Photogrammetric scanning of the holotype and only known specimen yields considerable new information on the skull and postcranium of this tetrapod and allows us to amend previous morphological descriptions to a substantial degree. A virtual 3D model built from photogrammetry scan data is used as the basis for a new reconstruction of the skull in dorsal, lateral, and ventral aspects and the lower jaw in lateral aspect. We expand and refine the diagnosis of Brouffia and compare it with other protorothyridids. We discuss the affinities of this taxon by coding it in a recently published data matrix of early amniotes, which we subject to maximum parsimony and Bayesian fossilized birth–death analyses. Brouffia emerges as the sister taxon to Coelostegus in all analyses, but the position of these two taxa within amniotes varies. In a parsimony analysis with unweighted characters, the (Brouffia + Coelostegus) clade forms the sister group to Synapsida. In various experiments of character reweighting, that clade is placed crownward of Captorhinidae on the stem-group of Reptilia, but anticrownward of remaining protorothyridids. The latter constitute either a paraphyletic array relative to Diapsida or their monophyletic sister group. The Bayesian analysis retrieves (Brouffia + Coelostegus) as the most basal plesion on the stem-group of Reptilia.
Peripheral perfusion index of pulse oximetry in adult patients: a narrative review
Authors: Sun Xiaotong , He Huaiwu , Xu Mengru , Long Yun
Published: September 2024

The peripheral perfusion index (PI) is derived from pulse oximetry and is defined as the ratio of the pulse wave of the pulsatile portion (arteries) to the non-pulsatile portion (venous and other tissues). A growing number of clinical studies have supported the use of PI in various clinical scenarios, such as guiding hemodynamic management and serving as an indicator of outcome and organ function. In this review, we will introduce and discuss this traditional but neglected indicator of the peripheral microcirculatory perfusion. Further clinical trials are required to clarify the normal and critical values of PI for different monitoring devices in various clinical conditions, to establish different standards of PI-guided strategies, and to determine the effect of PI-guided therapy on outcome.
Adapting EFL materials and its influences on Indonesia secondary school students’ language learning
Authors: Hanifa Rizaldy , Yusuf Fazri Nur , Yusra Siti Rahimah , Suherdi Didi
Published: September 2024

Educators encounter challenges in performing materials adaptation stemming from time limitations, institutional responsibilities, administrative demands, and a dearth of formal training in materials development resulting in improper adaptation and ineffective learning activities. This research investigated the process of adapting materials as a qualitative case study. The data were gathered from a senior high school teacher in Banda Aceh, Indonesia, by means of document analysis (e.g., teaching materials), observation, and interview. The results revealed that the instructor frequently added and modified educational resources to facilitate learning through several modalities. The act of deleting, simplifying, and rearranging was occasionally performed. Nevertheless, students’ reflection on course contents, inadequate level of difficulty, demanding tasks, and excessive reliance on first language remained as issues. This study emphasizes the role of adaptation in promoting meaningful learning experiences and urges the integration of culturally relevant themes with a variety of learning activities. Educators can use these findings to support professional developments focused on effective material adaption tactics, allowing them to reflect on their existing methods, try new approaches, and interact with colleagues to share successful practices.
TEAMs go VR—validating the TEAM in a virtual reality (VR) medical team training
Authors: Wespi Rafael , Schwendimann Lukas , Neher Andrea , Birrenbach Tanja , Schauber Stefan K. , Manser Tanja , Sauter Thomas C. , Kämmer Juliane E.
Published: September 2024

Background

Inadequate collaboration in healthcare can lead to medical errors, highlighting the importance of interdisciplinary teamwork training. Virtual reality (VR) simulation-based training presents a promising, cost-effective approach. This study evaluates the effectiveness of the Team Emergency Assessment Measure (TEAM) for assessing healthcare student teams in VR environments to improve training methodologies.

Methods

Forty-two medical and nursing students participated in a VR-based neurological emergency scenario as part of an interprofessional team training program. Their performances were assessed using a modified TEAM tool by two trained coders. Reliability, internal consistency, and concurrent validity of the tool were evaluated using intraclass correlation coefficients (ICC) and Cronbach’s alpha.

Results

Rater agreement on TEAM’s leadership, teamwork, and task management domains was high, with ICC values between 0.75 and 0.90. Leadership demonstrated strong internal consistency (Cronbach’s alpha = 0.90), while teamwork and task management showed moderate to acceptable consistency (alpha = 0.78 and 0.72, respectively). Overall, the TEAM tool exhibited high internal consistency (alpha = 0.89) and strong concurrent validity with significant correlations to global performance ratings.

Conclusion

The TEAM tool proved to be a reliable and valid instrument for evaluating team dynamics in VR-based training scenarios. This study highlights VR’s potential in enhancing medical education, especially in remote or distanced learning contexts. It demonstrates a dependable approach for team performance assessment, adding value to VR-based medical training. These findings pave the way for more effective, accessible interdisciplinary team assessments, contributing significantly to the advancement of medical education.
Reclaiming identities: exploring the influence of simulation on refugee doctors’ workforce integration
Authors: Smith Samantha Eve , Tallentire Victoria Ruth , Doverty Julie , Elaibaid Mohamed , Mardon Julie , Livingston Patricia
Published: September 2024

Background

Healthcare professionals are a precious resource, however, if they fail to integrate into the workforce, they are likely to relocate. Refugee doctors face workforce integration challenges including differences in language and culture, educational background, reduced confidence, and sense of identity. It has been proposed that simulation programmes may have the power to influence workforce integration. This study aimed to explore how an immersive simulation programme influenced workforce integration for refugee doctors joining a new healthcare system.

Methods

Doctors were referred to a six-day immersive simulation programme by a refugee doctor charity. Following the simulation programme, they were invited to participate in the study. Semi-structured interviews, based on the ‘pillars’ conceptual model of workforce integration, were undertaken. Data were analysed using template analysis, with the workforce integration conceptual model forming the initial coding template. Themes and sub-themes were modified according to the data, and new codes were constructed. Data were presented as an elaborated pillars model, exploring the relationship between simulation and workforce integration.

Results

Fourteen doctors participated. The ‘learning pillar’ comprised communication, culture, clinical skills and knowledge, healthcare systems and assessment, with a new sub-theme of role expectations. The ‘connecting pillar’ comprised bonds and bridges, which were strengthened by the simulation programme. The ‘being pillar’ encompassed the reclaiming of the doctor’s identity and the formation of a new social identity as an international medical graduate. Simulation opportunities sometimes provided ‘building blocks’ for the pillars, but at other times opportunities were missed. There was also an example of the simulation programme threatening one of the integration pillars.

Conclusions

Opportunities provided within simulation programmes may help refugee doctors form social connections and aid learning in a variety of domains. Learning, social connections, and skills application in simulation may help doctors to reclaim their professional identities, and forge new identities as international medical graduates. Fundamentally, simulation experiences allow newcomers to understand what is expected of them. These processes are key to successful workforce integration. The simulation community should be curious about the potential of simulation experiences to influence integration, whilst also considering the possibility of unintentional ‘othering’ between faculty and participants.
Efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation: an observational study
Authors: Shono Takefumi , Hyakutake Hiroyuki
Published: September 2024

Background

Constipation is a common complication in hemodialysis patients and can impact their quality of life. Elobixibat selectively inhibits ileal bile acid transporter to suppress bile acid reabsorption, increase the amount of bile acid entering the colonic lumen, and promote water secretion and colonic motility in the large intestine. While the efficacy and safety of elobixibat in hemodialysis patients up to 12 weeks after administration have been reported, the long-term efficacy and safety of elobixibat in hemodialysis patients with chronic constipation are yet to be elucidated. This study evaluates the efficacy and safety of long-term treatment with elobixibat in hemodialysis patients with chronic constipation.

Methods

This was a single-center observational study. A total of 54 patients who had received elobixibat for at least 24 weeks were enrolled. Data on the frequency of spontaneous bowel movements (SBM), Bristol stool form scale (BSFS), patient satisfaction, constipation scoring system (CSS), interdialytic weight gain, laboratory values including blood electrolyte levels, controlling nutritional status (CONUT) score, and adverse events were collected and retrospectively compared between baseline and the last observation.

Results

Long-term elobixibat treatment in the 54 hemodialysis patients with chronic constipation significantly increased (p < 0.05) the frequency of SBM and mean stool form score assessed as per the BSFS at the last observation (duration of treatment, 24.4 to 240.0 weeks). Patient satisfaction and CSS also improved (p < 0.05). Mean serum phosphorus levels decreased (p < 0.05). The treatment was well tolerated.

Conclusions

Long-term treatment with elobixibat maintained good bowel movement status and patient satisfaction in hemodialysis patients with chronic constipation. Improved dialysis-related laboratory levels were also demonstrated.

Trial registration: UMIN Clinical Trials Registry, UMIN000049865, 22 December 2022, retrospectively registered.
Audiovisual messages may improve the processing of traffic information and driver attention during partially automated driving: An EEG study
Authors: Pi-Ruano Marina , Fort Alexandra , Tejero Pilar , Jallais Christophe , Roca Javier
Published: September 2024

Partially autonomous vehicles can help minimize human errors. However, being free from some driving subtasks can result in a low vigilance state, which can affect the driver’s attention towards the road. The present study first tested whether drivers of partially autonomous vehicles would benefit from the addition of auditory versions of the messages presented in variable message signs (VMS), particularly, when they find themselves in a monotonous driving situation. A second aim was to test whether the addition of auditory messages would also produce an indirect effect on the driver’s vigilance, improving performance on other driving subtasks not related to the message processing. Forty-three volunteers participated in a driving simulator study. They completed two tasks: (a) a VMS task, where they had to regain manual control of the car if the VMS message was critical, and (b) a car-following task, where they had to pay attention to the preceding car to respond to occasional brake events. Behavioral and EEG data were registered. Overall, results indicated that the addition of audio messages helped drivers process VMS information more effectively and maintain a higher level of vigilance throughout the driving time. These findings would provide useful information for the development of partially automated vehicles, as their design must guarantee that the driver remains attentive enough to assume control when necessary.
Reliable but multi-dimensional cognitive demand in operating partially automated vehicles: implications for real-world automation research
Authors: Lohani Monika , Cooper Joel M. , McDonnell Amy S. , Erickson Gus G. , Simmons Trent G. , Carriero Amanda E. , Crabtree Kaedyn W. , Strayer David L.
Published: September 2024

The reliability of cognitive demand measures in controlled laboratory settings is well-documented; however, limited research has directly established their stability under real-life and high-stakes conditions, such as operating automated technology on actual highways. Partially automated vehicles have advanced to become an everyday mode of transportation, and research on driving these advanced vehicles requires reliable tools for evaluating the cognitive demand on motorists to sustain optimal engagement in the driving process. This study examined the reliability of five cognitive demand measures, while participants operated partially automated vehicles on real roads across four occasions. Seventy-one participants (aged 18–64 years) drove on actual highways while their heart rate, heart rate variability, electroencephalogram (EEG) alpha power, and behavioral performance on the Detection Response Task were measured simultaneously. Findings revealed that EEG alpha power had excellent test–retest reliability, heart rate and its variability were good, and Detection Response Task reaction time and hit-rate had moderate reliabilities. Thus, the current study addresses concerns regarding the reliability of these measures in assessing cognitive demand in real-world automation research, as acceptable test–retest reliabilities were found across all measures for drivers across occasions. Despite the high reliability of each measure, low intercorrelations among measures were observed, and internal consistency was better when cognitive demand was estimated as a multi-factorial construct. This suggests that they tap into different aspects of cognitive demand while operating automation in real life. The findings highlight that a combination of psychophysiological and behavioral methods can reliably capture multi-faceted cognitive demand in real-world automation research.