bluuebunny/crossref_metadata_2025 huggingface dataset:
Rhinologist Use of Antibiotics With Nasal Packing for Epistaxis
Authors: Mallen Jonathan Ross , Aasen Davis M. , Vuncannon Jackson Ross , Kuo Chia-Ling , Mu Jinjian , Tessema Belachew , Brown Seth M.
Published: May 2023

Background

There is limited evidence supporting the usage of prophylactic antibiotics in the setting of nasal packing for epistaxis. It is unclear what current antiobiotic usage patterns are by otolaryngologists.

Objectives

Characterize the antibiotic prescribing practices employed by otolaryngologists in the management of epistaxis patients treated with packing as well as the underlying rationale. Explore the impact of experience, geography, and academic affiliation on treatment decisions.

Methods

An anonymous survey of antibiotic prescribing patterns for patients with epistaxis requiring nasal packing was distributed to all physician members of the American Rhinologic Society. Responses to each question were descriptively summarized including 95% confidence intervals and were linked to demographics using Fisher's exact tests.

Results

One thousand one hundred and thirteen surveys were distributed with 307 responses (27.6%). Antibiotic prescription rates varied based on packing type, with 20.0% prescribing antibiotics for dissolvable packing compared to 84.2% to 84.6% for nondissolvable packing. The absorbance of nondissolvable packing does not impact the decision to prescribe antibiotics ( P > .999). Precisely 69.7% (95% CI: 64.0%-74.8%) stop antibiotics immediately following packing removal. Precisely 85.6% (95% CI: 81.6%-89.9%) cite the risk of toxic shock syndrome (TSS) when prescribing antibiotics. Notable regional differences include greater utilization of amoxicillin-clavulanate in the Midwest (67.6%) and Northeast (61.4%) as compared with the South (42.1%) and West (45.1%) ( P = .013). Further, years in practice were positively associated with several patterns including prescribing antibiotics for patients with dissolvable packing ( P = .008), citing prevention of sinusitis as a rationale for antibiotic use ( P < .001), and a higher likelihood of having treated a patient with TSS ( P = .002).

Conclusions

Antibiotic use in patients with epistaxis controlled with nondissolvable packing is common. Treatment patterns are influenced by geography, years in practice, and practice type.

Level of Evidence

4.
World population growth over millennia: Ancient and present phases with a temporary halt in-between
Authors: Taagepera Rein , Nemčok Miroslav
Published: May 2023

Enormous growth of the world population during the last two centuries and its present slowing down pose questions about precedents in history and broader forces shaping the population size. Population estimates collected in an extensive survey of literature (873 estimates from 25 studies covering 1,000,000 BCE to 2100 CE) show that world population growth has proceeded in two distinct phases of acceleration followed by stoppage—from at least 25,000 BCE to 100 BCE, and from 400 CE to the present, interrupted by centuries of standstill and 10% decrease. Both phases can be fitted with a mathematical function that projects to a peak at 11.2 ± 1.5 billion around 2100 CE. An interaction model can account for this acceleration-stoppage pattern in quantitative detail: Technology grows exponentially, with rate boosted by population. Population grows exponentially, capped by Earth’s carrying capacity. Technology raises this cap, but only until it approaches Earth’s ultimate carrying capacity.
Do concussed and non-concussed head trauma individuals have similar symptoms? A retrospective chart review of chronic post-concussive symptomatology
Authors: Malik Shazia , Ahmed Rahim , Gambale Teresa , Rathbone Michel P
Published: May 2023

Many head trauma patients who present with prolonged post-concussion symptoms do not meet the American Congress of Rehabilitation Medicine (ACRM) diagnostic criteria for mild traumatic brain injuries (mTBI). This population has not been extensively studied and its clinical characteristics are currently uncertain. A retrospective chart review was conducted to explore the symptomatic differences between mTBI and non-mTBI head trauma patients presenting at a concussion clinic with chronic post-concussion symptoms (PCSx). Patient information was extracted from 161 charts, of which 128 subjects met the ACRM criteria for mTBI (ACRM + PCSx), while 33 did not (non-ACRM + PCSx). These two groups were compared for demographic variables and symptomology. This study found that 20.5% of subjects presenting with chronic post-concussion symptoms do not meet ACRM criteria. No symptom-specific differences were found between the two populations in any of the categories tested. These results show that chronic post-concussion symptoms are similar in both mTBI and non-mTBI head trauma patients in the general population, suggesting a need for further research focusing on this group.
Designing User Interfaces for Illiterate and Semi-Literate Users: A Systematic Review and Future Research Agenda
Authors: Islam Muhammad Nazrul , Khan Nafiz Imtiaz , Inan Toki Tahmid , Sarker Iqbal H.
Published: May 2023

Using a systematic literature review, this review examines existing studies on the design, usability, user experience (UX), and adoption of computer applications designed for illiterate and semi-literate users. A total of 45 articles were reviewed from an initial set of 527 articles following an inclusion-exclusion criterion. As outcomes, in addition to synthesizing the present research activities, this review revealed a total of 16 design considerations or guidelines that may improve the usability, user experience, and adoption of software systems to illiterate and semi-literate people. The revealed design considerations were also investigated concerning the country context and application platform. Finally, a set of good rules categorized into five perspectives (uses of text, interaction pattern, uses of pictography, uses of audio-video, and info-architecture) were revealed to design and evaluate software systems to make them more usable to the illiterate and semi-literate users. The review also reveals future research opportunities that include: exploring the design considerations with respect to context-dependent applications; investigating the design requirements for public IT (e.g., vending machines and kiosks) systems; adopting the semiotic concept in UI design; developing a new usability evaluation framework; and exploring the effects of multi-platform and cross-country app design. Thus, the implication of this study is to discover the research gaps and provide future research directions aiming to design applications for illiterate and semi-literate users with enhanced usability and UX.
For Future Investment, Empirical Study on Enterprise Participation in Basic Research in the Process of Digital Transformation
Authors: Xiao Fengjun , Wang Jiaxin , Li Jie , Wang Hongwu , Zhu Weihua , Chen Hekun
Published: May 2023

Basic research is the driver of advanced productivity and is an important guarantee for the market competitiveness of enterprise. In order to understand the influence of basic research on the development of China’s digital economy industry, this paper, based on structural equation model by collecting data from 209 enterprises in digital economy industry, explores the relationship between enterprise participation in basic research and four factors: enterprise efficiency, perceived risk, priority, and technological innovation, together with function mechanism. The results show that, first enterprises can improve efficiency, reduce potential risk concerns, and enhance technology level by expanding business revenue, enlarging scale, and upgrading R&D institutions, thus promoting participation in basic research. At the same time, the government can provide more subsidies for enterprise R&D funds to reduce enterprise concern about the risk of basic research, and guide them to expand their investment in R&D and focus on basic research so as to expand their participation in this field. Secondly, the optimization of enterprise participation in basic research, the upgrading of R&D institutions and the number of invention patents have mutually-reinforced effect, while the expansion of enterprise scale help to reduce the constraint of return risk to a certain extent. Finally, this paper proposes some policies and suggestions to enhance enterprise participation in basic research from the perspective of promoting industrial development and social equity.
“Why did our kids become out-of-school children?” A narrative inquiry of parents of children with severe and multiple disabilities in China informed by game theory
Authors: Li Huan , An Ning , Deng Li , Niu Chutian
Published: May 2023

Children with severe and multiple disabilities (SMD) becoming out-of-school children (OOSC) is a common issue in developing countries. Researchers have reported that the out-of-school issue results from multiple factors; however, few studies have explored how the interactions of these factors lead to children becoming OOSC. This study aimed to explore the causes of out-of-school issues among children with SMD in China based on game theory. Interview data from six parents of children with SMD who had become OOSC were collected as the primary source of research data, with interview data from school personnel at the six schools that children with SMD in our study had attended or applied to, education policy documents for children with SMD, and relevant news as secondary sources of research data. Narrative inquiry and thematic analysis were combined to investigate the out-of-school experiences of children with SMD and analyze how the strategic interactions of three “players” (i.e., the policy, schools, and families) led to these children becoming OOSC. The findings indicated that the three players successively interacted with each other by adopting different strategies to pursue their respective goals, and the families of children with SMD inferred by reverse induction that no strategy they adopted would change the outcome of their children becoming OOSC if the strategies of the other players were unchanged. Finally, an innovative cooperation model with an emphasis on the interactions of all players is proposed to address the out-of-school crisis.
‘Does Confidence Matter?’: Impact of Entrepreneurs’ Confidence on Fear of Failure
Authors: Srinivasan Brindha , Hazarika Latasri , Nandakumar M.K.
Published: May 2023

Obstacles and threats are common occurrences for entrepreneurs in their journey of starting and surviving a venture. These challenges often induce a fear of failure in entrepreneurs, sometimes affecting their mental well-being. Although coping literature lists several explicit mechanisms to mitigate the adverse impact of entrepreneurial fear of failure, empirical evidence suggesting the role of some intrinsic typical entrepreneurial characteristics such as overconfidence and optimism is missing from the extant knowledge bank. Our study joins those missing links by studying the role of entrepreneurs’ confidence elements—overconfidence and optimism in entrepreneurial fear of failure. We adopted stress appraisal theory and experience sampling methodology to explore the hypothesized relations. We triangulate our results with semi-structured interviews with entrepreneurs. Our findings reveal the positive side of entrepreneurs’ confidence in dealing with stress and fear of failure. Therefore, we contribute to the entrepreneurial well-being literature and provide a reason for practicing entrepreneurs to build on their confidence.
How did COVID-19 Pandemic Affect the Rural (Tribal) Livelihoods? A Case Study of Khaprakhol Block
Authors: Rout Baijayanti
Published: May 2023

The COVID-19 epidemic has devastated human existence over the planet, shocking people with the new sickness and almost bringing countries to their knees. It was a never-before-seen scene of limited human movements and changing behaviours. Although the good consequences benefit the environment and wild animals by reducing pollution, the adverse effects have a direct impact on the economic status of human beings. The situation was new to all living beings, and difficulties were generated globally, irrespective of rural and urban. The study attempts to discover the key problems of the rural people faced during the lockdown and the effects of the COVID-19 pandemic on their livelihoods. This article also aims to figure out the difficulties faced by rural living for their livelihood. This study is based on primary data and the data collected from the rural living of Balangir (khaprakhol block) district of Odisha. The data collection method was based on random sampling, and a total number of 100 rural living households were interviewed. The data were analysed by descriptive statistics and suitable statistical tools. The outcome of this study is that rural living has faced movement difficulties and trouble for getting work. It has been witnessed that they could not get the marketing facilities to sell their agricultural products. Moreover, rural households were paid higher prices for daily stuff in their locality or village shops. As a result, it was a terrible period for them since employment and money resources made it possible to cope with the increased market price of everyday items. Though the study area is near the forest area and situated in the foothill of Gandhamardan hill, most of the local people depend on forest products as their source of income. The collection of forest products is also affected badly during the collection season by the COVID-19 pandemic and lockdown. Regardless of the movement concerns, they were unable to work. Due to employment loss, the disturbance altered the dietary and nutrition profile of rural residents. At the same time, they claimed that MGNREGS work was ongoing but that it was not preferable to work owing to late payment to the bank account. Finally, this article focuses on the rural residents’ livelihoods, which were negatively impacted by the lockdown, and job loss was a constraint for them during the lockdown.
Retinopathy of Prematurity Screening of Preterm Infants With Icteric Vitreous
Authors: López-Cañizares Ashley , da Cruz Natasha Ferreira Santos , Al-khersan Hasenin , Berrocal Audina Maria
Published: May 2023

Purpose: To present 2 cases of premature newborns with hyperbilirubinemia and retinopathy of prematurity (ROP) who could not be examined properly to assess for disease progression because of vitreous opacification in the setting of an icteric vitreous and frail health status. Methods: The cases and their findings were analyzed. Results: Given the sickness of the neonates and examination difficulty, intravitreal bevacizumab was administered in both eyes to prevent disease progression. During subsequent examinations, the patients remained stable until discharge from the neonatal intensive care unit and were followed in the outpatient clinic without complication. Conclusions: The ROP and vitreous opacification in our cases were thought to be caused by hyperbilirubinemia. Because of vitreous opacification, these patients could not be properly examined for ROP. Treatment with an intravitreal antivascular endothelial growth factor injection might be considered to delay disease development until the newborn is healthier and able to be examined.
Uncontrolled blood pressure and associated factors in adult hypertensive patients undergoing follow-up at public health facility ambulatory clinics in Bishoftu town, Ethiopia: a multi-center study
Authors: Solomon Menawork , Negussie Yohannes Mekuria , Bekele Nardos Tilahun , Getahun Mihiret Shawel , Gurara Abenet Menene
Published: May 2023

Background

Uncontrolled blood pressure is an important medical and public health problem in developing countries like Ethiopia. Improving the management of hypertension requires a better comprehension of the factors influencing blood pressure control and the application of interventions. But in clinical practice, blood pressure is still not adequately controlled. Thus, this study aimed to assess uncontrolled blood pressure and associated among adult hypertensive patients on follow-up at public health facility ambulatory clinics in Bishoftu, Ethiopia.

Methods

A hospital-based cross-sectional study was conducted among 398 adult hypertensive patients who were on treatment and follow-up from April to May 31, 2022. Systematic random sampling was used to select study participants. Data were collected using an interviewer-administered, semi-structured questionnaire and chart review. The Eighth Joint National Committee (JNC 8) criteria was applied to define blood pressure control status. Binary logistic regression analysis was used to model the association between dependent and independent variables. An adjusted odds ratio and 95% confidence interval were used to measure the strength of the association. Finally, at a p-value < 0.05, statistical significance was proclaimed.

Result

Of the total study participants, 249(62.6%) were male. The mean age was 62.26 ± 11.55 years. The overall proportion of uncontrolled blood pressure was 58.8% (95% CI: 54–64). Salt intake (AOR = 2.51; 95% CI: 1.49–4.24), lack of physical activity (AOR = 1.40; 95% CI: 1.10–2.62), habitual coffee consumption (AOR = 4.52; 95% CI: 2.67–7.64), higher BMI (AOR = 2.08; 95% CI: 1.24–3.49), and non-adherence to antihypertensive medications (AOR = 2.31; 95% CI: 1.3–3.89) were independent predictors of uncontrolled blood pressure.

Conclusion

More than half of the hypertensive patients in this study had uncontrolled blood pressure. Healthcare providers and other accountable stakeholders should urge patients to follow salt restriction, physical activity, and antihypertensive medication regimes. Reduced coffee consumption and weight maintenance are other crucial blood pressure control measures.
The effect of perturbation-based balance training on balance control and fear of falling in older adults: a single-blind randomised controlled trial
Authors: Gerards Marissa , Marcellis Rik , Senden Rachel , Poeze Martijn , de Bie Rob , Meijer Kenneth , Lenssen Antoine
Published: May 2023

Background

Perturbation-based balance training (PBT) is an emerging intervention shown to improve balance recovery responses and reduce falls in everyday life in older adults. However, perturbation interventions were heterogeneous in nature and need improvement. This study aims to investigate the effects of a PBT protocol that was designed to address previously identified challenges of PBT, in addition to usual care, on balance control and fear of falling in older adults at increased risk of falling.

Methods

Community-dwelling older adults (age ≥ 65 years) who visited the hospital outpatient clinic due to a fall incident were included. Participants received PBT in addition to usual care (referral to a physiotherapist) versus usual care alone. PBT consisted of three 30-minute sessions in three weeks. Unilateral treadmill belt accelerations and decelerations and platform perturbations (shifts and tilts) were applied during standing and walking on the Computer Assisted Rehabilitation Environment (CAREN, Motek Medical BV). This dual-belt treadmill embedded in a motion platform with 6 degrees of freedom is surrounded by a 180° screen on which virtual reality environments are projected. Duration and contents of the training were standardised, while training progression was individualised. Fear of falling (FES-I) and balance control (Mini-BESTest) were assessed at baseline and one week post-intervention. Primary analysis compared changes in outcome measures between groups using Mann-Whitney U tests.

Results

Eighty-two participants were included (PBT group n = 39), with a median age of 73 years (IQR 8 years). Median Mini-BESTest scores did not clinically relevantly improve and were not significantly different between groups post-intervention (p = 0.87). FES-I scores did not change in either group.

Conclusions

Participation in a PBT program including multiple perturbation types and directions did not lead to different effects than usual care on clinical measures of balance control or fear of falling in community-dwelling older adults with a recent history of falls. More research is needed to explore how to modulate PBT training dose, and which clinical outcomes are most suitable to measure training effects on balance control.

Trial registration

Nederlands Trial Register NL7680. Registered 17-04-2019 – retrospectively registered. https://www.trialregister.nl/trial/7680.
Bartholin’s gland cyst caused by Sneathia amnii: a case report
Authors: Zhang Ranran , Zhang Zhezhong , Xu Minjing , Li Wenjie , Sun Yanwen , Dai Yuliang , Yang Xuejing , Lin Shaohua
Published: May 2023

Background

Sneathia amnii is a conditional pathogen of the female genital tract that is involved in bacterial vaginosis and poor reproductive and perinatal outcomes. Few studies have reported subcutaneous cysts following invasive infection caused by S amnii.

Case presentation

Here we report the case of a 27-year-old woman who presented with Bartholin’s gland cyst due to S amnii infection, and was successfully treated with surgical neostomy and antibiotic agents. The isolate was gram-negative, bacillary, anaerobic, and was identified by polymerase chain reaction (PCR) amplification of the 16 S rRNA.

Conclusions

S amni is an important but underappreciated pathogen that needs further investigation. This report describes the microbial and pathogenic characteristics of S amnii and is expected to provide a valuable reference in obstetric and gynecologic clinical practice.
Is there a relation between stillbirth and low levels of vitamin D in the population? A bi-national follow-up study of vitamin D fortification
Authors: Lindqvist Pelle G. , Gissler Mika , Essén Birgitta
Published: May 2023

Background

Stillbirth has been associated with low plasma vitamin D. Both Sweden and Finland have a high proportion of low plasma vitamin D levels (< 50 nmol/L). We aimed to assess the odds of stillbirth in relation to changes in national vitamin D fortification.

Methods

We surveyed all pregnancies in Finland between 1994 and 2021 (n = 1,569,739) and Sweden (n = 2,800,730) with live or stillbirth registered in the Medical Birth Registries. The mean incidences before and after changes in the vitamin D food fortification programs in Finland (2003 and 2009) and Sweden (2018) were compared with cross-tabulation with 95% confidence intervals (CI).

Results

In Finland, the stillbirth rate declined from ~ 4.1/1000 prior to 2003, to 3.4/1000 between 2004 and 2009 (odds ratio [OR] 0.87, 95% CI 0.81–0.93), and to 2.8/1000 after 2010 (OR 0.84, 95% CI 0.78–0.91). In Sweden, the stillbirth rate decreased from 3.9/1000 between 2008 and 2017 to 3.2/1000 after 2018 (OR 0.83, 95% CI 0.78–0.89). When the level of the dose-dependent difference in Finland in a large sample with correct temporal associations decreased, it remained steady in Sweden, and vice versa, indicating that the effect may be due to vitamin D. These are observational findings that may not be causal.

Conclusion

Each increment of vitamin D fortification was associated with a 15% drop in stillbirths on a national level. If true, and if fortification reaches the entire population, it may represent a milestone in preventing stillbirths and reducing health inequalities.
Post-progression treatment in cancer randomized trials: a cross-sectional study of trials leading to FDA approval and published trials between 2018 and 2020
Authors: Olivier Timothée , Haslam Alyson , Prasad Vinay
Published: May 2023

Background

Suboptimal treatment upon progression may affect overall survival (OS) results in oncology randomized controlled trials (RCTs). We aim to assess the proportion of trials reporting post-progression treatment.

Methods

This cross-sectional analysis included two concurrent analyses. The first one examined all published RCTs of anti-cancer drugs in six high impact medical/oncology journals between January 2018 and December 2020. The second studied all US Food and Drug Administration (FDA) approved anti-cancer drugs during the same period. Included trials needed to study an anti-cancer drug in the advanced or metastatic setting. Data abstracted included the tumor type, characteristics of trials, and reporting and assessment of post-progression treatment.

Results

There were 275 published trials and 77 US FDA registration trials meeting inclusion criteria. Assessable post-progression data were reported in 100/275 publications (36.4%) and 37/77 approvals (48.1%). Treatment was considered substandard in 55 publications (n = 55/100, 55.0%) and 28 approvals (n = 28/37, 75.7%). Among trials with assessable post-progression data and positive OS results, a subgroup analysis identified substandard post-progression treatment in 29 publications (n = 29/42, 69.0%) and 20 approvals (n = 20/26, 76.9%). Overall, 16.4% of publications (45/275) and 11.7% of registration trials (9/77) had available post-progression data assessed as appropriate.

Conclusion

We found that most anti-cancer RCTs do not report assessable post-progression treatment. When reported, post-progression treatment was substandard in most trials. In trials reporting positive OS results and with assessable post-progression data, the proportion of trials with subpar post-progression treatment was even higher. Discrepancies between post-progression therapy in trials and the standard of care can limit RCT results’ applicability. Regulatory rules should enforce higher requirements regarding post-progression treatment access and reporting.
Stereoptic serious games as a visual rehabilitation tool for individuals with a residual amblyopia (AMBER trial): a protocol for a crossover randomized controlled trial
Authors: Simon-Martinez Cristina , Antoniou Maria-Paraskevi , Bouthour Walid , Bavelier Daphne , Levi Dennis , Backus Benjamin T. , Dornbos Brian , Blaha James J. , Kropp Martina , Müller Henning , Murray Micah , Thumann Gabriele , Steffen Heimo , Matusz Pawel J.
Published: May 2023

Background

Amblyopia is the most common developmental vision disorder in children. The initial treatment consists of refractive correction. When insufficient, occlusion therapy may further improve visual acuity. However, the challenges and compliance issues associated with occlusion therapy may result in treatment failure and residual amblyopia. Virtual reality (VR) games developed to improve visual function have shown positive preliminary results. The aim of this study is to determine the efficacy of these games to improve vision, attention, and motor skills in patients with residual amblyopia and identify brain-related changes. We hypothesize that a VR-based training with the suggested ingredients (3D cues and rich feedback), combined with increasing the difficulty level and the use of various games in a home-based environment is crucial for treatment efficacy of vision recovery, and may be particularly effective in children.

Methods

The AMBER study is a randomized, cross-over, controlled trial designed to assess the effect of binocular stimulation (VR-based stereoptic serious games) in individuals with residual amblyopia (n = 30, 6–35 years of age), compared to refractive correction on vision, selective attention and motor control skills. Additionally, they will be compared to a control group of age-matched healthy individuals (n = 30) to account for the unique benefit of VR-based serious games. All participants will play serious games 30 min per day, 5 days per week, for 8 weeks. The games are delivered with the Vivid Vision Home software. The amblyopic cohort will receive both treatments in a randomized order according to the type of amblyopia, while the control group will only receive the VR-based stereoscopic serious games. The primary outcome is visual acuity in the amblyopic eye. Secondary outcomes include stereoacuity, functional vision, cortical visual responses, selective attention, and motor control. The outcomes will be measured before and after each treatment with 8-week follow-up.

Discussion

The VR-based games used in this study have been conceived to deliver binocular visual stimulation tailored to the individual visual needs of the patient, which will potentially result in improved basic and functional vision skills as well as visual attention and motor control skills.

Trial registration

This protocol is registered on ClinicalTrials.gov (identifier: NCT05114252) and in the Swiss National Clinical Trials Portal (identifier: SNCTP000005024).
Enhanced in vitro antibacterial effect against Enterococcus faecalis by using both low-dose cetylpyridinium chloride and silver ions
Authors: Lv Silei , Fan Wei , Fan Bing
Published: May 2023

Background

Enterococcus faecalis (E. faecalis) is frequently isolated from root canals with failed root canal treatments. Due to the strong ability of E. faecalis to resist many often-used antimicrobials, coping with E. faecalis infections remains a challenge. The aim of this study was to investigate the synergistic antibacterial effect of low-dose cetylpyridinium chloride (CPC) and silver ions (Ag+) against E. faecalis in vitro.

Methods

The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the fractional inhibitory concentration index (FICI) were used to confirm the existence of the synergic antibacterial activity between low-dose CPC and Ag+. Colony-forming unit (CFU) counting, time-killing curve and dynamic growth curve were used to evaluate the antimicrobial effects of CPC and Ag+ combinations against planktonic E. faecalis. Four weeks biofilms were treated with drug-contained gels to determine the antimicrobial effect on biofilm-resident E.faecalis, and the integrity of E.faecalis and its biofilms were observed by FE-SEM. CCK-8 assays was used to test the cytotoxicity of CPC and Ag+ combinations on MC3T3-E1 cells.

Results

The results confirmed the synergistic antibacterial effect of low-dose CPC and Ag+ against both planktonic and 4-week biofilm E. faecalis. After the addition of CPC, the sensitivity of both planktonic and biofilm-resident E. faecalis to Ag+ improved, and the combination showed good biocompatibility on MC3T3-E1 cells.

Conclusions

Low-dose CPC enhanced the antibacterial ability of Ag+ against both planktonic and biofilm E.faecalis with good biocompatibility. It may be developed into a novel and potent antibacterial agent against E.faecalis, with low toxicity for root canal disinfection or other related medical applications.
Practice education facilitators perceptions and experiences of their role in the clinical learning environment for nursing students: a qualitative study
Authors: Mathisen Cathrine , Bjørk Ida T. , Heyn Lena G. , Jacobsen Turid-Iren , Hansen Elisabeth H.
Published: May 2023

Background

Clinical placement is recognised as essential for nursing students’ development of clinical competence. However, difficulties in providing supportive clinical learning environments are a well-known challenge in nursing education. In Norway, the use of nurse educators in joint university and clinical roles has been recommended as an initiative to strengthen the clinical learning environment and enhance the educational quality. In this study we use the term practice education facilitator in a generic sense for these roles. The aim of this study was to explore how practice education facilitators can contribute to strengthen the clinical learning environments for nursing students.

Methods

This study has a qualitative explorative design with a purposive sample of practice education facilitators affiliated to three different universities located in southeast, mid-, and northern Norway. Individual in-depth interviews with 12 participants were conducted during spring 2021.

Results

A thematic analysis resulted in four themes: “coherence between theory and practice”; “student support and guidance during placement”; “supporting the supervisors to support the students” and “factors influencing the practice education facilitators’ performance in their role”. The participants experienced that the practice education facilitator role contributed to strengthened clinical learning environments. However, their performance in the role was found to be contingent upon factors such as time allocated for the role, personal and professional attributes of the post holder, and a common understanding within the organisations regarding practice learning and role remits for the practice education facilitator.

Conclusions

Findings indicate that the practice education facilitator role can be a valuable resource for clinical supervisors and nursing students in clinical placement. Moreover, nurse educators who are familiar with the clinical area, and who are insiders in both settings, are ideally placed to contribute to bridge the theory-practice gap. The benefits of using these roles, however, were influenced by personal attributes of the post holder, time allocated for the role and the number of practice education facilitators positions, and management anchorage. Thus, to achieve the full potential of these roles, efforts to reduce these barriers should be considered.
Evaluating person-centered care in residential care facilities from the perspective of caregivers in South Korea: a survey
Authors: Chin Young-Ran , Lee Hyo Young
Published: May 2023

Background

As many older people spend their time in residential care facilities, the demand for person-centered care (PCC), which affects their quality of life, is increasing. Many residential care facility residents have cognitive problems, such as dementia and strokes. Providing quality care upholds their rights as human beings. Currently, the PCC tools used in South Korea are only translations of foreign tools into Korean, so it is necessary to develop tools for older adult care facilities that reflect the reality of Korean care facilities for older adults. This study aims to develop a tool for measuring PCC in residential care facilities for older people from the perspectives of care givers.

Methods

The draft of 34 questions was developed through literature reviews, interviews with LTC practitioners and researchers. This developed questionnaire was then administered to 402 direct caregivers working in the residential care facilities because many of the residents had cognitive problems. By measuring the interrater reliability, the items with high levels of agreement were selected and the validity of the construct was checked through factor analysis. To determine whether the domains adequately measured each concept, we calculated correlation coefficients and Cronbach’s α.

Results

Four domains and 32 items concerning service conditions, resident’s right to self-determination, a comfortable living environment for all residents, and resident and staff satisfaction are derived, thus explaining 24.7%, 23.6%, 14.6%, and 8.00% of the total variance, respectively. Cronbach’s alphas for each domain are 0.965, 0.948, 0.652, and 0.525, respectively, thus demonstrating internal consistency. The inter-rater agreement is high (66.7%~100.0%). The correlation between service conditions and resident’s right to self-determination (r = 0.643, p < 0.001), a comfortable living environment for all residents, resident and staff satisfaction (r = 0.674, p < 0.001), and resident’s right to self-determination and comfortable living environment (r = 0.695, p < 0.001) is strong.

Conclusions

It is important that caregivers recognize PCC and provide services. When evaluating the residential care services, measuring the degree of PCC should be made compulsory. If the facility becomes more person-centered, it will be possible to promote quality of life for older people.

Trial registration

Not applicable.
Infectious disease hotlines to provide advice to general practitioners: a prospective study
Authors: Sette Anna Luce , François Patrice , Lesprit Philippe , Vitrat Virginie , Rogeaux Olivier , Breugnon Emma , Baldeyrou Marion , Mondain Véronique , Issartel Bertrand , Kerneis Solen , Diamantis Sylvain , Poitrenaud Delphine , Boussat Bastien , Pavese Patricia
Published: May 2023

Background

Telephone hotlines in infectious diseases (ID) are part of antimicrobial stewardship programs designed to provide support and expertise in ID and to control antibiotic resistance. The aim of the study was to characterize the activity of the ID hotlines and estimate their usefulness for general practitioners (GPs).

Methods

This was a multicenter prospective observational study in different French regions. ID teams involved in antimicrobial stewardship with a hotline for GPs were asked to record their advice from April 2019 to June 2022. In these regions, all GPs were informed of the ID hotline’s operating procedures. The main outcome was usage rate of the hotlines by GPs.

Results

Ten volunteer ID teams collected 4138 requests for advice from 2171 GPs. The proportion of GPs using the hotline varied pronouncedly by region, from 54% in the Isere department, to less than 1% in departments with the lowest usage. These differences were associated with the number of physicians in ID teams and with the age of the hotline. These results highlighted the value of working time as a means of ensuring the permanence of expertise. The main reasons for calling were: a diagnostic question (44%); choice of antibiotic (31%). The ID specialist provided advice on antibiotic therapy (43%) or a proposal for specialized consultation or hospitalization (11%).

Conclusions

ID hotlines could help to strengthen cooperation between primary care and hospital medicine. However, the deployment and perpetuation of this activity require reflection concerning its institutional and financial support.
Family caregiver involvement and role in hospital at home for adults: the patients’ and family caregivers’ perspective - a Norwegian qualitative study
Authors: Karlsen Lillian , Mjølstad Bente Prytz , Løfaldli Bjarte Bye , Helvik Anne-Sofie
Published: May 2023

Background

Hospital at home (HaH) provides acute healthcare services in patients’ homes instead of traditional in-patient care. Research has reported positive outcomes for patients and reduced costs. Although HaH has developed into a global concept, we have little knowledge about the involvement and role of family caregivers (FCs) of adults. The aim of this study was to explore FC involvement and role during HaH treatment as perceived by patients and FCs in a Norwegian healthcare context.

Methods

A qualitative study was carried out among seven patients and nine FCs in Mid-Norway. The data was obtained through fifteen semi-structured interviews; fourteen were performed individually and one as duad interview. The age of the participants varied between 31 and 73 years, and mean age of 57 years. A hermeneutic phenomenological approach was used, and the analysis was performed according to Kvale and Brinkmann’s description of interpretation.

Results

We identified three main categories and seven subcategories regarding FC involvement and role in HaH: (1) Preparing for something new and unfamiliar, including the subcategories `Lack of involvement in the decision process` and `Information overload affecting caregiver readiness`, (2) Adjusting to a new everyday life at home, including the subcategories `The critical first days at home`, `Coherent care and support in a novel situation`, and `Prior established family roles influencing the new everyday life at home`, (3) FCs` role gradually diminishes and looking back, including the subcategories `A smooth transition to life beyond hospital at home` and `Finding meaning and motivation in providing care`.

Conclusions

FCs played an important role in HaH, although their tasks, involvement and effort varied across different phases during HaH treatment. The study findings contribute to a greater understanding of the dynamic nature of the caregiver experiences during HaH treatment, which can guide healthcare professionals on how they can provide timely and appropriate support to FCs in HaH over time. Such knowledge is important to decrease the risk of caregiver distress during HaH treatment. Further work, such as longitudinal studies, should be done to examine the course of caregiving in HaH over time to correct or support the phases described in this study.
Manufacture and evaluation of a HER2-positive breast cancer immunotoxin 4D5Fv-PE25
Authors: Peng Yanjie , Wu Zhengli , Pang Zheng , Zhang Lin , Song Dandan , Liu Fang , Li Yanhong , Lin Tongjun
Published: May 2023

Background

Human epidermal growth factor receptor 2 (HER2) positive breast cancer is an aggressive subtype, accounting for around 20% of all breast cancers. The development of HER2-targeted therapy has substantially improved patient outcomes. Nevertheless, the increasing rate of side effects and resistance to targeted drugs limit their efficacy in clinical practice. In this study, we designed and synthesized a new immunotoxin, 4D5Fv-PE25, which targets HER2-positive breast cancer, and evaluated its effectiveness in vitro and in vivo.

Results

The 4D5Fv-PE25 was expressed in high-density Escherichia coli (E. coli.) using the fermentor method and refined via hydrophobicity, ion exchange, and filtration chromatography, achieving a 56.06% recovery rate. Additionally, the semi-manufactured product with 96% purity was prepared into freeze-dried powder by the lyophilized process. Flow cytometry was used to detect the expression of HER2 in SK-BR-3, BT-474, MDA-MB-231, and MDA-MB-468 breast cancer cell lines. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) method was used for cytotoxicity assay, and the half-maximal inhibitory concentration (IC50) of 4D5Fv-PE25 lyophilized products to HER2-positive cell line SK-BR-3 was 12.53 ng/mL. The 4D5Fv-PE25 was injected into xenograft tumor mice via the tail vein on the 1st, 4th, and 8th day, it indicated that the growth of tumor volume was effectively inhibited for 24 days, although the 4D5Fv-PE25 was metabolized within 60 min by measuring the release of 3 H-Thymidine radiation.

Conclusion

we succeeded in producing the 4D5Fv-PE25 freeze-dried powder using the prokaryotic expression method, and it could be employed as a potential drug for treating HER2-positive breast cancer.

Graphical abstract
Realising radical potential: building community power in primary health care through Participatory Action Research
Authors: Mabetha Denny , Ojewola Temitope , van der Merwe Maria , Mabika Reflect , Goosen Gerhard , Sigudla Jerry , Hove Jennifer , Witter Sophie , D’Ambruoso Lucia ,   On behalf in collab the Verbal Autopsy with Participatory Action Research (VAPAR)/Wits/Mpumalanga Department of Health Learning Platform
Published: May 2023

Background

While community participation is an established pro-equity approach in Primary Health Care (PHC), it can take many forms, and the central category of power is under-theorised. The objectives were to (a) conduct theory-informed analysis of community power-building in PHC in a setting of structural deprivation and (b) develop practical guidance to support participation as a sustainable PHC component.

Methods

Stakeholders representing rural communities, government departments and non-governmental organisations engaged through a participatory action research (PAR) process in a rural sub-district in South Africa. Three reiterative cycles of evidence generation, analysis, action, and reflection were progressed. Local health concerns were raised and framed by community stakeholders, who generated new data and evidence with researchers. Dialogue was then initiated between communities and the authorities, with local action plans coproduced, implemented, and monitored. Throughout, efforts were made to shift and share power, and to adapt the process to improve practical, local relevance. We analysed participant and researcher reflections, project documents, and other project data using power-building and power-limiting frameworks.

Results

Co-constructing evidence among community stakeholders in safe spaces for dialogue and cooperative action-learning built collective capabilities. The authorities embraced the platform as a space to safely engage with communities and the process was taken up in the district health system. Responding to COVID-19, the process was collectively re-designed to include a training package for community health workers (CHWs) in rapid PAR. New skills and competencies, new community and facility-based alliances and explicit recognition of CHW roles, value, and contribution at higher levels of the system were reported following the adaptations. The process was subsequently scaled across the sub-district.

Conclusions

Community power-building in rural PHC was multidimensional, non-linear, and deeply relational. Collective mindsets and capabilities for joint action and learning were built through a pragmatic, cooperative, adaptive process, creating spaces where people could produce and use evidence to make decisions. Impacts were seen in demand for implementation outside the study setting. We offer a practice framework to expand community power in PHC: (1) prioritising community capability-building, (2) navigating social and institutional contexts, and (3) developing and sustaining authentic learning spaces.
Menstruation and social inequities in Spain: a cross-sectional online survey-based study
Authors: Medina-Perucha Laura , López-Jiménez Tomàs , Jacques-Aviñó Constanza , Holst Anna Sofie , Valls-Llobet Carme , Munrós-Feliu Jordina , Martínez-Bueno Cristina , Pinzón-Sanabria Diana , Vicente-Hernández Mª Mercedes , Berenguera Anna
Published: May 2023

Background

Available research suggests that menstrual inequity has an impact on (menstrual) health outcomes and emotional wellbeing. It is also a significant barrier to achieve social and gender equity and compromises human rights and social justice. The aim of this study was to describe menstrual inequities and their associations with sociodemographic factors, among women and people who menstruate (PWM) aged 18–55 in Spain.

Methods

A cross-sectional survey-based study was conducted in Spain between March and July 2021. Descriptive statistical analyses and multivariate logistic regression models were performed.

Results

A total of 22,823 women and PWM were included in the analyses (Mean age = 33.2, SD = 8.7). Over half of the participants had accessed healthcare services for menstruation (61.9%). The odds for accessing menstrual-related services were significantly higher among participants with university education (aOR: 1.48, 95% CI, 1.13–1.95). Also, 57.8% reported having had partial or no menstrual education pre-menarche, with odds being higher among participants born in non-European or Latin American countries (aOR: 0.58, 95% CI, 0.36–0.93). Lifetime self-reported menstrual poverty was between 22.2–39.9%. Main risk factors for menstrual poverty were identifying as non-binary (aOR: 1.67, 95% CI, 1.32–2.11), being born in non-European or Latin American countries (aOR: 2.74, 95% CI, 1.77–4.24), and not having a permit to reside in Spain (aOR: 4.27, 95% CI, 1.94–9.38). Completed university education (aOR: 0.61, 95% CI, 0.44–0.84) and no financial hardship < 12 months (aOR: 0.06, 95% CI, 0.06–0.07) were protective factors for menstrual poverty. Besides, 75.2% reported having overused menstrual products due to lack of access to adequate menstrual management facilities. Menstrual-related discrimination was reported by 44.5% of the participants. Non-binary participants (aOR: 1.88, 95% CI, 1.52–2.33) and those who did not have a permit to reside in Spain (aOR: 2.11, 95% CI, 1.10-4.03) had higher odds of reporting menstrual-related discrimination. Work and education absenteeism were reported by 20.3% and 62.7% of the participants, respectively.

Conclusions

Our study suggests that menstrual inequities affect a high number of women and PWM in Spain, especially those more socioeconomically deprived, vulnerabilised migrant populations and non-binary and trans menstruators. Findings from this study can be valuable to inform future research and menstrual inequity policies.