bluuebunny/crossref_metadata_2025 huggingface dataset:
Profilaxia pós-exposição ocupacional contra o vírus da imunodeficiência humana para trabalhadores da área de saúde vítimas de acidentes com material biológico
Authors: Frison Fernanda Sucasas , Alonzo Herling Gregório Aguilar , Pavan Maria Helena , Guerreiro Inajara de Cássia
Published: December 2024

Introduction: Postexposure prophylaxis (PEP) reduces the risk of human immunodeficiencyvirus (HIV) transmission after workplace exposure of health care workers. Objectives: Toevaluate adherence to postexposure prophylaxis for HIV, incident characteristics, post-incidentinitiation of therapy, and reported adverse effects among treated health care workers. Methods: Epidemiologic, descriptive, retrospective study based on analysis of workplace incident reports involving exposure to biological materials from 2011 to 2020 at a university hospital. Data were analyzed using descriptive statistics, odds ratio using simple logistic regression, and comparison of variables using Fisher’s exact test (p<0.05). Results: A total of 516 cases eligible for prophylaxis were analyzed and divided into three risk groups: 168 (32.6%) involving HIV-positive source patients, 263 (50.9%) involving source patients with unknown infection status, and 85 (16.4%) involving source patients in the window period. Most cases involved females (74.80%), injuries from percutaneous exposure (80.42%), contact with blood (56.59%), and nursing technicians (30.46%). Full compliance and adherence with drug therapy (28 days) was reported in 77.45% of the workers, and the time between the incident and the start of prophylaxis was within 24 hours of the incident in 94.27% of the workers. In total, 205 (39.73%) of the workers discontinued outpatient follow-up, which was associated with education, risk group, and occupation. Conclusions: Incidents involving contaminated sharp instruments pose an increased risk of infection by pathogens transmitted primarily by blood. Workplace HIV infection can be prevented by providing mandatory training programs for workers on proper work practices, use of devices with retractable needles and needle protection systems, safe and proper disposal of materials,use of personal protective equipment, and appropriate workplace postexposure interventions, including PEP. None of the workers who completed outpatient follow-up  seroconverted to HIV, thus demonstrating the protective effect of PEP. Regular training is recommended, with an emphasis on incident prevention, infection control, and health education, combined with case reporting strategies.
Finite to Non-finite through Impersonalization
Authors: Kozhanov Kirill
Published: December 2024

This study examines the contact-induced emergence of an infinitive in Russian Romani, a northeastern Romani dialect spoken in Russia and neighboring countries. Romani, like other Balkan languages, lacks an infinitival verbal form and instead uses finite subjunctive phrases in complements and purpose clauses. However, in some Romani dialects that have been in contact with infinitival languages (e.g., Slavic, Germanic, Finnish), a new infinitive form has emerged. This new form, derived from the subjunctive, lacks agreement with the controller. Drawing on spoken and literary corpus data, this article explores the development of several new non-agreeing verbal forms from generic impersonal uses. Unlike other Romani dialects, in Russian Romani, this new form has not fully grammaticalized into an infinitive but mainly functions as a default in generic and agent-demoted contexts.
Sacred Spaces
Authors: Wibowo Waskito
Published: December 2024

It is familiarly known among Muslims that Sharīʿa suggests the prohibition of participating in church construction. However, in historical accounts, a number of churches in Arab countries were built during the era of Islam. This led to ambiguities and the perception that the caliphs did not abide by Sharīʿa law then. Therefore, this essay aims to reveal the reasons and motives of those caliphs or other Muslim authority holders allowing the building of churches in Cairo during the Mamluk dynasty. Furthermore, this article seeks the extent to which Muslim authority holders contribute to the church building for Christians and the responses, attitudes and dynamics of Muslim residents around the churches built in their area. By employing the qualitative library method, by making primary and secondary pieces of literature as objects of study and then interpreting them from a historical point of view, this article indicates that life under the Mamluk dynasty was so dynamic. There was a different application for the restriction of building, rebuilding, or reopening churches between society and some sultans. While citizens acted massive attacks and destruction of the churches provoked by the fatwā of the elite, it seems there were also defenses from the authorities for this act of vandalism.
Aromatase inhibitors for short stature in male children and adolescents treated with growth hormone: a meta-analysis of randomized controlled trials
Authors: Wang Kan , Ye Fei , Wang Da-Yan , Lai Pan-Jian , Zhang Lin-Qian
Published: December 2024

Whether the addition of aromatase inhibitors (AIs) to recombinant human growth hormone (rhGH) could yield additional benefit for short stature is controversial. We aimed to assess the effects of combined AIs and rhGH versus those of rhGH alone for short stature using a meta-analytic approach. The PubMed, Embase, and the Cochrane library electronic databases were searched systematically for eligible randomized controlled trials (RCTs) from inception until December 2021. The pooled effect estimates (weighted mean difference [WMD] and odds ratio [OR]) with 95% confidence intervals (CIs) were calculated using a random-effects model. Eight RCTs that provided data on 433 participants were selected. The addition of AIs to rhGH, compared with rhGH alone, resulted in higher growth velocity (WMD: 3.19 cm/year; 95% CI: 2.75–3.63; P < 0.001), higher predicted adult height (WMD: 5.50 cm; 95% CI: 3.52–7.49; P < 0.001), and younger bone age (WMD: -0.80 years; 95% CI: -1.06–-0.54; P < 0.001). There were no significant differences between the groups for insulin-like growth factor I (WMD: 0.85 nmol/L; 95% CI: -2.08–3.79; P = 0.569), serum estradiol level (WMD: -19.19 pmol/L; 95% CI: -46.25–7.88; P = 0.165), and serum testosterone level (WMD: 14.88 nmol/L; 95% CI: -14.13–43.88; P = 0.315). There was no significant difference between the groups for the risk of adverse events (OR: 1.08; 95% CI: 0.44–2.66; P = 0.873). This study found that the addition of AIs to rhGH had greater benefits for growth velocity, predicted adult height, and bone age. The safety profiles were comparable.
Beyond early warning: towards greater granularity in the use of event-based surveillance for public health emergencies
Authors: McKnight C. J. , Aboushady A. T. , Lane C. R.
Published: December 2024

Background

The international health emergency caused by the emergence of the SARS-CoV-2 virus demonstrated the expanding usefulness of multi-country disease outbreak information gathered through event-based surveillance (EBS) as an extension beyond the main purposes of early warning, alert, and response (EWAR). In this article, previous events of multi-country outbreaks from 2010–2019 were reviewed for how EBS, within an expanded sphere of Epidemic Intelligence (EI), may help to enhance the understanding of outbreaks for a more timely and nuanced, multiple-point trigger approach to health emergencies.

Methods

The public, open-source database of ProMed reports were reviewed for the date of first notification on major outbreaks of infectious diseases and then compared for subsequent dates of any new, exceptional epidemiological findings (novel host, settings, transmission characteristics) as a determining factor for prolonged, multi-country events later acknowledged on the WHO disease outbreak news (DON) website, or by peer-reviewed journal publication if no related DON information became available.

Results

During the preceding decade, there was an ongoing occurrence of unexpected outbreaks requiring new information about previously unknown pathogens, such as MERS-CoV, and longstanding threats from multiple neglected tropical diseases. During these international outbreaks, key scientific insights about new host species, viral persistence, occurrence of human-to-human spread, and transmission setting, became known over the course of the response.

Conclusion

The timeliness between initial alerts of early outbreak detection and key epidemiological evidence about the emerging threat reached far beyond the first warning for the global community. To improve on the best knowledge available for an immediate response, it is recommended that further gathering and documentation from event-based surveillance is engaged to create a more complete assessment for uncontrollable infectious disease outbreaks and epidemics. Enhanced EBS (through modern tools, e.g., Epidemic Intelligence from Open Sources (EIOS) are critical for timely detection and response to such events.
Three-dimensional digital anatomical measurements of pterygoid plates and posterior maxillary region
Authors: Kwon Dohyun , Kim Soung Min , Lee Jong-Ho
Published: December 2024

Background

The posterior maxilla and skull base is a region with a complex anatomy. Accurate resection of the pterygoid plate is critical during a maxillectomy procedure. However, there is a paucity of functional and anatomical studies on the pterygoid plate and skull base. This study aimed to investigate functional anatomy of the pterygoid plate and its surrounding structures in the posterior maxilla to provide a better understanding of surgical procedures in this region.

Methods

3D software was used to measure 3D distances, angles, and areas of key anatomical landmarks on CT images of 100 hemifaces. Morphological classification of pterygoid plates was then performed.

Results

Results of comparing right and left pterygoid plates revealed no significant differences in dimensions or angles. Comparisons between sexes revealed that a few parameters were significantly different (P
< 0.01), including pterygoid height on the left side, distance from the zygomatico-maxillary buttress to the infraorbital fissure (Zy-IOF), and area of the left lateral pterygoid plate. The morphology of the lateral pterygoid plate was classified into four types based on the shape of the middle region: middle convex (42%), double concave (36%), flattened (10%), and middle concave (12%). The morphology of pterygoid plates was classified based on the divergence of medial and lateral pterygoid plates, with the narrow type (56%) being more common than the wide type in this study cohort.

Conclusions

This 3D digital anatomical study measured key landmarks for maxillary resection. Such measurement has never been reported. This anatomical study provides surgeons with information on the anatomy of the posterior maxilla and allows for safer and more accurate resection of the difficult-to-resect posterior maxilla.
BABINE: An original and user-friendly scale for the simple and quick management of herb-drug interactions in clinical practice
Authors: Cnudde Anthony , Allely Camille , Biset Natacha , Champy Pierre , Fouilhé Nathalie , Huret Fanny , Lawson Sibi , Mercan Aline , Noukela Noumi Doris Pascale , Michalet Serge , Montis Andrea , Pochet Stephanie , Schils Audrey , Tangeten Cecilia , Tod Michel , Van Antwerpen Pierre , Vervacke Audrey , Souard Florence
Published: December 2024

Background

While more and more people tend to use herbal products thinking they are safer than conventional western medicine, the reality is other. If natural products are bio-active and possess potential therapeutic activities, then the benefit/risk balance should be considered like any other health product. Some herbs are known to have the potential to interact with patient’s treatment and to cause adverse drug reactions. While these are scarce, they are potentially harmful, and can lead to major sequels and even death in some cases. Despite these known facts, little guidelines about how to evaluate the risk of interaction and to handle them exist in literature. Notably, few scales allowing to assess the risk of a specific combination of herbs and drugs exist.

Method

We propose a new scoring method BABINE (Boosting Analysis of Bibliography for herb- drug INteraction Evaluation) and discuss a scale to evaluate this risk based on iterative rounds of experts’ discussion.

Results

After 6 rounds of case reports/clinical studies evaluation, we analyzed and synthesized criteria identified as important by the experts and developed a corresponding evaluation scale.

Conclusion

Even if our scale greatly simplifies pharmacological events, we believe it provides a robust and transparent way to rapidly assess the risk of adverse event.
Recommendations for the optimization of student led free vision screening programs
Authors: Devanathan Nirupama , Scheive Melanie , Selvam Amrish , Nawash Baraa S. , Murphy Alec , Morrow McKenna , Anant Shruti , Kruger Jessica S. , Yung Chi-Wah Rudy , Johnson Thomas V.
Published: December 2024

Purpose

To report the summary characteristics of operational models associated with Student Led Free Vision Screening Programs (SLFVSP) and to identify opportunities for program optimization.

Methods

An 81-question mixed methods survey was distributed to SLFVSP leaders nationwide and Medical Student Educators within the American University Ophthalmology Professors (AUPO) Association. Survey responses were analyzed using Mann Whitney U and Fisher’s Exact tests. Themes considering the assets and liabilities of SLFVSPs were summarized using self-reported qualitative data from survey responses. Qualitative and quantitative themes considering were then synthesized into a Strengths, Weaknesses, Opportunities, & Threats (SWOT) analysis for a collective appraisal of SLFVSP operations. Finally, drivers were identified to generate change ideas to improve SLFVP operations through a collaborative, quality improvement model.

Results

A total of 16 survey responses were included from programs operational for a median of 6 years. Most respondent programs (n = 9) reported year-long operations; no preference between weekday (n = 8) and weekend (n = 7) screening activities was identified. Programs obtained funding from a diverse array of internal and external sources. There was no significant difference in wait time for scheduled appointments compared to a walk-in strategy; overall door-to-door visit times ranged from 15 min to 120 min. Screenings were held in several locations, most commonly in Federally Qualified Health Centers (n = 8) and religious centers (n = 6). Most screening event volunteers were first- and second-year medical students. The qualitative thematic analysis demonstrated that the most commonly self-reported asset was improving access to scarce vision screening services (n = 7) while the most commonly self-reported liability was difficulty recruiting faculty and/or resident for oversight (n = 5). The SWOT analysis revealed while the participant SLFVSPs were bolstered by site experience, community and corporate partnerships for glasses and space to hold vision screening, and institutional support from academic ophthalmology departments, limitations included difficulty with recruitment, space limitations, and poor follow-up care infrastructure.

Conclusion

Collaborative standardization of SLFVSP operations can promote targeted staff training, organizational stewardship, and consensus building to ensure SLFVSP can offer sustainable vision screening programs that build vision equity at the community level.
Training technical or non-technical skills: an arbitrary distinction? A scoping review
Authors: Gamborg Maria Louise , Salling Lisa Beicker , Rölfing Jan Duedal , Jensen Rune Dall
Published: December 2024

Introduction

Medical education often aims to improve either technical skills (TS) or ‘non-technical skills’ (NTS) and how these skills influence adverse events and patient safety. The two skill sets are often investigated independently, and little is known about how TS and NTS influence each other. In this scoping review, we therefore aim to investigate the association between TS and NTS.

Method

We conducted a scoping review of four databases in order to summarize, analyse, and collate findings from the included studies.

Results

In total, 203 of 2676 identified studies were included in the final analysis. The first study was published in 1991, but the majority of studies were published in the last decade. The majority were intervention studies including 41 randomized controlled trials. The the objective structured assessment of technical skills (OSATS) was the most common assessment tool with strong validity evidence within TS, but many variations without validity evidence were used. Conversely, Non-Technical Skills for Surgeons (NOTSS) was the most used tool with strong validity evidence for assessing NTS. However, the majority of studies used non-validated self-assessment tools to investigate NTS. The correlation between TS and NTS was assessed in 46 of 203 studies, whereof 40 found a positive correlation.

Discussion

Our findings echo previous literature suggesting that empirical literature investigating the interaction between TS and NTS lack methodological depth. In this review only a minority of the identified studies (n = 46) investigated this correlation. However, the results strongly indicate a correlation between TS and NTS skills, suggesting that physicians who are proficient in their NTS, also perform well on their TS. Thus, the distinction between them in learning designs may seem arbitrary. While this result is promising, the limited methodological rigour indicates a lack of proper understanding of NTS and how to properly assess them.
Views on the well-being of groups of informal caregivers. A cluster analysis using the example of Saxony
Authors: Tischendorf Tim , Geithner Silke , Schaal Tom
Published: December 2024

Background

As a result of demographic change, a further increase in the number of people in need of care in Germany can be expected in the future. Nursing activities performed by family members are a central component of care provision. Providing care for people in need of care is increasingly associated with additional physical and psychological stress for informal caregivers. The aim of this study is to identify and characterize groups of informal caregivers with regard to their well-being.

Methodology

The empirical study was based on a cross-sectional survey on home care in Saxony from 2019, which was intended as exploratory work to provide insights into the care situation in Saxony. The central component is a two-step cluster analysis with exclusively informal caregivers.

Results

The net sample size for the cluster analysis comprised 178 subjects who were involved in caring for relatives. The cluster analysis revealed two groups of caregiving relatives in Saxony, which were differentiated by a different experience of stress and various sociodemographic factors.

Discussion

Informal caregivers in Saxony are not a homogeneous group. Depending on various sociodemographic factors or the care effort and situation, they are confronted with different challenges in caring for relatives, which are directly reflected in their well-being. In order to achieve a targeted reduction in the burden on family caregivers, cooperation and constructive collaboration between political decision-makers, care and health insurers, and the various players in health and care provision is required.
Evaluating the home-based intervention strategy (HIS-UK) to reduce new chlamydia infection among young men aged 16–25 years by promoting correct and consistent condom use: findings from a randomised controlled trial
Authors: Stone Nicole , Graham Cynthia , Bremner Stephen , McGrath Nuala , Bedford Rowena , Brown Katherine E , Newby Katie , Clarke Amanda , Jackson Louise , Morrison Leanne , Nadarzynski Tom , To Ye
Published: December 2024

Background

Correct and consistent condom use is the most effective method to reduce transmission of sexually transmitted infections (STIs).

Objective

To compare the HIS-UK intervention to usual condom information and distribution care for effect on chlamydia test positivity.

Methods

Trial design A 3-parallel arm randomised controlled trial (1:1:1 allocation, two intervention arms vs. control). Randomisation using permuted blocks of varying lengths, with stratification by site, ethnicity and sexual-partnering risk. Repeated measures design with monthly follow-up to six months post-randomisation.

Setting Sexual health services in seven NHS Trusts and one university medical centre. Telephone and video consultations, online and in participants’ homes in England, UK.

Participants Target sample of 2231 men and people with penises, aged 16-25, at risk of STIs.

Intervention HIS-UK delivered (1) face-to-face by health professionals (proHIS) or (2) digitally (eHIS). Two-weeks self-practice and experimentation using the HIS-UK condom kit.

Primary health outcome Chlamydia test positivity by six-months.

Secondary outcomes Frequency of unprotected sexual intercourse, reported condom use errors and problems, attitudes and use experience.

Analyses Chlamydia test positivity by six months analysed by logistic regression. Secondary outcomes analysed using linear mixed effects models with fixed effects and a random effect for the repeated measures, and generalised estimating equations with a logit link, adjusting for fixed effects and specifying an autoregressive-1 correlation structure.

Results

Seven hundred twenty-five participants (proHIS:241, eHIS:243, control:241) randomised. 575 participants completed all baseline activities, 189 (32.9%) reached six-months post-randomisation. The absolute difference in chlamydia test positivity between arms was -4.9 percentage points at six months (7.9% HIS-UK, 12.8% control). The odds of chlamydia test positivity during follow-up were 55% lower for HIS-UK participants (p=.261).

HIS-UK showed a positive impact on recent condom use over time (p<.001). Significant reductions in condom errors and problems among HIS-UK participants were observed (p=.035). Lubricant use increased among HIS-UK participants, with evidence of an intervention-by-time interaction (p=.051), and a decline in poor condom fit and feel reports, but without intervention effect.

Conclusions

This study provides valuable insights into the potential of HIS-UK to enhance sexual health practices among at-risk populations at-risk of STI transmission.

Trial registration

ISRCTN registration: 11400820 (23/10/2019).
How to deliver person-centred care for people living with heart failure: a multi stakeholder interview study with patients, caregivers and healthcare professionals in Thailand
Authors: Giusti Alessandra , Pukrittayakamee Panate , Wannarit Kamonporn , Thongchot Lakkana , Janwanishstaporn Satit , Nkhoma Kennedy , Venkatapuram Sridhar , Harding Richard
Published: December 2024

Context

Heart failure has high, growing global prevalence, morbidity and mortality, and is a leading cause of death with serious health-related suffering in low- and middle-income countries. Person-centred care (PCC) is a critical component of high-quality healthcare and is particularly vital in the context of a serious illness such as heart failure. However, there are limited data exploring PCC in this population in low- and middle-income settings.

Aim

The aim of this study was to explore how clinical services could respond to the PCC needs of individuals living with heart failure in Thailand, with potential for adaptation in other settings. The specific objectives were (i) to understand the experiences and needs of persons living with heart failure, their caregivers and HCPs; (ii) to explore specific practical actions that can help deliver PCC for heart failure patients in this setting.

Methods

Cross-sectional qualitative study. In depth, semi-structured interviews were conducted in Thailand with heart failure patients (n = 14), their caregivers (n = 10) and healthcare professionals (n = 12). Framework analysis was conducted with deductive coding to populate an a priori coding frame based on Santana et al’s PCC model (2018) and Giusti et al’s systematic review (2020), with further inductive coding of novel findings to expand the frame. The study is reported in accordance with the consolidated criteria for reporting qualitative research guidelines (COREQ).

Results

The findings reveal specific practice actions that deliver PCC for persons living with heart failure in Thailand, such as (i) compassionate communication by healthcare professionals; (ii) effective teamwork amongst multidisciplinary healthcare professionals; (iii) proactive responses to physical, psychosocial, relational and information needs of patients and caregivers; (iv) engaging patients and families in symptom management; (v) providing opportunities for patients to be cared for in the community; and (vi) responding to the social determinants of health, illness and healthcare access.

Conclusion

Person-centred healthcare systems must aim to address the social determinants of illness and place focus on community- and home-based care. Heart failure patients and caregivers must be supported to self-manage, including how to recognise symptoms and take appropriate action. Delivering PCC in such a way has the potential to improve outcomes for patients, enhance patients’ sense of agency and experiences of care, improve health equity, and reduce hospital admissions, relieving pressure on the hospital system and reducing overall costs of care.
Developing a theory of change to guide the design and implementation of a caregiver-centric support service
Authors: Wu Ling Ting , Glass George Frederick , Chew Esther Yin Hui , Ng Emmalene Joo Yong , Chan Ee Yuee
Published: December 2024

Background

Set against the backdrop of a rapidly ageing population and growing emphasis on the importance of ageing-in-place, family members often assume the role of a caregiver. Navigating through a complex healthcare system while simultaneously juggling the daily care needs of their care-recipients, caregivers often become worn out by the intense caregiver stress and burden, neglecting their own well-being. This translates to adverse health and economic outcomes such as prolonged hospital stays and increased nursing home placement of care-recipients. Seeking to better support caregivers, we developed a theory of change to guide the design and implementation of a caregiver support programme – Project Carer Matters.

Methods

We applied theory of change methodology to explain how the Project’s interventions were hypothesised to lead to their identified short-to-long term goals, drawing on a causal analysis based on available evidence. The theory of change was developed with insights garnered from previous research studies conducted on caregiver stress, stakeholder engagement sessions and multiple dialogues with clinical experts and hospital leaders.

Results

Our final theory of change is the result of the evaluation of the Project in its pilot phase. It is populated with the resources, activities and short-to-long term outcomes that can be attributed or linked to the Project. Multiple meetings and discussion with stakeholders over the pilot prompted frequent practice of the Plan, Do, Study, Act model to refine the ongoing implementation process and the theory of change itself.

Conclusions

A theory of change is essential in guiding the design, implementation and evaluation of a complex health care intervention such as Project Carer Matters. The development of the theory of change is a journey and not a resultant product. This journey has also led us to learn that 1) a theory of change needs to be dynamic and ever evolving with time and context, 2) the perspectives of relevant stakeholders need to be included in this process to ensure the feasibility and sustainability of the project in the long run and 3) frequent stakeholder engagements are essential in enabling the implementation team to fine-tune the Project in an effective manner.

Trial registration

ClinicalTrials.gov, NCT05205135, registered on 24/01/2022.
Experiences of older adult Filipino-Americans surrounding eye surgery and factors in health decision-making: a qualitative study
Authors: Jiro Marycon C. , Sigua Michael , Dio Migel , Hennein Lauren , Cocohoba Jennifer
Published: December 2024

Background

The greater San Francisco metropolitan bay area is home to 270,000 Filipino immigrants and the second largest Filipino-American population in the United States. Despite this, Filipino-Americans are aggregated with the general “Asian-American” category, making it a challenge to obtain accurate population health data on social determinants of health. One area that is concerning is the lack of research on Filipino-American eye health experiences. The Filipino-American population is an older community with a median age of 48 years old that experiences a high prevalence of diabetes and hypertension. Preserving sight in high risk patients against age-related eye disease depends on routine eye examinations and timely treatment. Therefore, it is important to explore older adult Filipino-American eye surgery experiences and factors in eye health decision-making.

Methods

An exploratory qualitative study was conducted with thirteen Filipino-American adults residing in the nine San Francisco Bay Area counties who had a history of eye surgery (cataract, glaucoma, or retinal). Data were collected through semi-structured in-depth interviews. A thematic analysis was performed informed by critical race theory and PEN3 cultural model. Standard methods of coding followed by determination of themes were conducted and consensus was reached among the three coders.

Results

The mean participant age was 73.3 years old (95% CI 69.7–76.9). All participants were born in the Philippines, and 85% identified as female. Four themes emerged: the value of social networks and self-efficacy in decision-making; the importance of informed communication; the integral role of trust and the physician–patient relationship; and the impact of cultural humility, beliefs, and concordance on ocular care. Communication with trusted peers, clinicians and clinical staff prior to surgery was a key factor in alleviating worries and misconceptions, yet interpreter services were inconsistently offered. Many saw clinicians as experts, which dampened their agency in asking questions or elicited shame in obtaining a professional second opinion.

Conclusions

How clinicians convey information is crucial. Filipino-Americans patients can interpret eye surgery expectations through a cultural lens, which may result in lasting impressions about the surgical experience and outcomes. Expanding cultural humility training and improved incorporating interpreter services can help patients feel supported.
Associations of care continuity and care coordination with the overuse of healthcare services: a nationwide population-based study
Authors: Chang Guann-Ming , Chang Hsien-Yen , Kuo Wen-Yu , Tung Yu-Chi
Published: December 2024

Background

Care continuity and care coordination have received increased attention as important ways of decreasing overuse/low-value care. Prior research has verified an association between care continuity and overuse or an association between care coordination and overuse. However, little is known about the relative influences of care continuity and care coordination on overuse. We used nationwide population-based data from Taiwan to examine the relative associations of care continuity and care coordination with overuse.

Methods

We analyzed 1,462,960 beneficiaries in 2015 randomly sampled from all people enrolled in the Taiwan National Health Insurance. Having adjusted for patient characteristics, the multivariable logistic regression model was used to examine the associations of the Continuity of Care (COC) Index and care density on overuse, using a previously validated set of 18 potentially low-value care services.

Results

Higher COC index was associated with lower overuse (low vs. medium: odds ratio [OR], 1.11; 95% confidence interval [CI], 1.09–1.12; high vs. medium: OR, 0.80; 95% CI, 0.795–0.813). Higher care density was associated with lower overuse (low vs. medium: OR, 1.01; 95% CI, 1.001–1.024; high vs. medium: OR, 0.88; 95% CI, 0.87–0.89).

Conclusions

Increased care continuity and care coordination are associated with decreased overuse. Facilitating care continuity and care coordination may be an important strategy for reducing overuse/low-value care.
Effects of pre-pregnancy body mass index on cardiometabolic biomarkers in pregnant emirati women
Authors: Almekhaini Lolowa A. , Awar Shamsa A. , Zoubeidi Taoufik , Al Hamad Sania , Yasin Javed , George Junu V. , Khaled Maha , Qasem Nehaya , Bahwan Fatima , Narchi Hassib , Aburawi Elhadi H.
Published: December 2024

Background

To study effect of pregnancy on obese women’s maternal cardiometabolic biomarkers as a signature for maternal morbidity and complications.

Methods

This cross-sectional cohort study involved pregnant Emirati women who had regular menstrual cycles and had normal blood pressure. Pre-pregnancy body mass index was calculated using height and weight measurements recorded within three months before current pregnancy. Average systolic and diastolic blood pressure measurements were calculated from each visit. Blood samples were collected randomly once and following cardiometabolic biomarkers were measured.

Results

We enrolled 178 pregnant women, with a mean age ± standard deviation of cohort was 29.9 ± 4.97 years and Pre-pregnancy body mass index 28.11 ± 6.58 kg/m2. None of blood pressure measurements or biomarkers serum concentrations were statistically different across Pre-pregnancy body mass index groups except for soluble intercellular cytoadhesive molecule-1levels which were the highest in underweight women. Pregnant women with pre-gestational obesity had higher systolic and diastolic blood pressure levels compared to women with normal or overweight. All variables were statistically significantly different by trimesters except systolic blood pressure, random blood glucose, lipoprotein-A, and high-sensitivity C-Reactive Protein. After adjusting, in a multivariate linear regression model, for maternal age, trimester of pregnancy, education level, parity and smoking, none of biomarkers or blood pressure were found to be significantly associated with Pre-pregnancy body mass index. In a multivariate linear regression model adjusting for maternal age, Pre-pregnancy body mass index, education level, parity and smoking, gamma-glutamyl transferase, total cholesterol, high density lipoprotein, low-density lipoprotein, triglycerides, apolipoprotein A & B, interleukin-6, tumor necrosis factor-alpha and insulin-like growth factor-1 concentrations remained significantly associated with advancing trimester of pregnancy. There was a significant interaction between Pre-pregnancy body mass index and trimester of pregnancy for serum gamma-glutamyl transferase and soluble intercellular cytoadhesive molecule-1concentration.

Conclusion

This study emphasizes how pregnancy has a significant impact on cardiometabolic markers in obese women, indicating both hyperlipidemic status of pregnancy and diabetogenic tendency in obese patients who are not diabetics. These findings may suggest that pregnancy in obese patients increases risk of developing metabolic syndrome in future, therefore more attention is recommended of pregnant obese women and further study of establishing specific cardiometabolic biomarkers screening program.
Numerical study of the effects of minor structures and mean velocity fields in the cerebrospinal fluid flow
Authors: Wang Ziyu , Majidi Mohammad , Li Chenji , Ardekani Arezoo
Published: December 2024

The importance of optimizing intrathecal drug delivery is highlighted by its potential to improve patient health outcomes. Findings from previous computational studies, based on an individual or a small group, may not be applicable to the wider population due to substantial geometric variability. Our study aims to circumvent this problem by evaluating an individual’s cycle-averaged Lagrangian velocity field based on the geometry of their spinal subarachnoid space. It has been shown by Lawrence et al. (J Fluid Mech 861:679–720, 2019) that dominant physical mechanisms, such as steady streaming and Stokes drift, are key to facilitating mass transport within the spinal canal. In this study, we computationally modeled pulsatile cerebrospinal fluid flow fields and Lagrangian velocity field within the spinal subarachnoid space. Our findings highlight the essential role of minor structures, such as nerve roots, denticulate ligaments, and the wavy arachnoid membrane, in modulating flow and transport dynamics within the spinal subarachnoid space. We found that these structures can enhance fluid transport. We also emphasized the need for particle tracking in computational studies of mass transport within the spinal subarachnoid space. Our research illuminates the relationship between the geometry of the spinal canal and transport dynamics, characterized by a large upward cycle-averaged Lagrangian velocity zone in the wider region of the geometry, as opposed to a downward zone in the narrower region and areas close to the wall. This highlights the potential for optimizing intrathecal injection protocols by harnessing natural flow dynamics within the spinal canal.
Diagnostic imaging in the management of older adults with low back pain: analysis from the BAck Complaints in Elders: Chiropractic – Australia cohort study
Authors: Jenkins Hazel J. , Grace Kristin , Young Anika , Parker Felix , Hartvigsen Jan , Rubinstein Sidney M. , French Simon D. , de Luca Katie
Published: December 2024

Background

Diagnostic imaging is commonly used in the management of low back pain (LBP), with approximately one-quarter of those who present to primary care referred for imaging. Current estimates of imaging frequency commonly exclude older adults; however, pathology detected with imaging (e.g., osteoporosis, cancer) may occur more frequently in older populations. The aims of this study were to: (i) determine the frequency and forms of diagnostic imaging use in older adults presenting for chiropractic care for LBP in Australia; (ii) describe participant characteristics associated with imaging use; and (iii) describe the types of radiographic findings.

Methods

Data were collected from the BAck Complaints in Elders: Chiropractic-Australia (BACE: C-A) study, a 12-month, prospective cohort study of adults aged ≥ 55 years with a new episode of LBP. Self-reported frequency of imaging use (baseline, 2 and 6 weeks, 3, 6, 9, and 12 months) was reported descriptively by imaging modality. Imaging reports were obtained, and imaging findings were independently extracted and categorised. Baseline characteristics were assessed for differences in those who received imaging compared to those who did not. Proportions of imaging use and imaging findings were presented descriptively with 95% confidence intervals.

Results

The BACE: C-A cohort comprised 217 participants of whom 60.8% reported receiving diagnostic imaging for their current episode of LBP. X-ray was performed most (44.7%), followed by computed tomography (CT) (30.8%). Participants receiving imaging reported higher low back disability, more healthcare use for LBP, more frequent leg pain, more suspected serious pathology, and stronger beliefs that imaging was important. Degenerative changes were the most common imaging finding (96.6%). Pathology of possible clinical significance, including compression fracture or suspected osteoporosis, was present in 15.5% of participants.

Conclusion

Three out of five older adults with LBP who sought chiropractic care received imaging over one-year. Participants receiving imaging tended to have more complex presentations (e.g., more disability, suspected underlying pathology) or stronger beliefs that imaging was necessary for the management of LBP. Degenerative changes were the most common imaging finding. Pathology of potential clinical relevance was present on approximately 15% of imaging reports received. No conditions requiring immediate medical attention were reported.
Identification of phytomolecules as isoform and mutation specific PI3K-α inhibitor for protection against breast cancer using e-pharmacophore modeling and molecular dynamics simulations
Authors: Mili Ajay , Birangal Sumit , Giridhar Jyothi , Nandakumar Krishnadas , Lobo Richard
Published: December 2024

PI3K-α mutation plays a critical role in cancer development, notably in breast cancer, particularly within HR + /HER2- subtypes. These mutations drive tumor growth and survival by activating the PI3K/AKT/mTOR pathway, which is essential for cell proliferation and survival. Our research aimed to identify natural compounds that can inhibit mutant and specific isoforms of PI3K-α to prevent tumor progression. e-Pharmacophore model was generated using Receptor-Ligand complex using the Inavolisib drug (PDB:8EXV) and phase screening was performed using the Molport database of natural compounds. Through molecular docking studies we identified seven promising compounds for further molecular dynamics simulations. Among these, three compounds—STOCK1N-85097, STOCK1N-85998, and STOCK1N-86060—showed significant stability and interaction with PI3K-α. These compounds demonstrated favorable results in several parameters, including RMSD, RMSF, Rg, SASA, PCA, FEL, and total energy evaluations. Therefore, these compounds are projected to function as PI3K-α inhibitors and because of its natural origin it can possess fewer side effects than the conventional medicine, which should be validated by proper in vivo and in vitro models.

Graphical Abstract
Enhancing vector control: AI-based identification and counting of Aedes albopictus (Diptera: Culicidae) mosquito eggs
Authors: Wang Minghao , Zhou Yibin , Yao Shenjun , Wu Jianping , Zhu Minhui , Dong Linjuan , Wang Dunjia
Published: December 2024

Background

Dengue fever poses a significant global public health concern, necessitating the monitoring of Aedes mosquito population density. These mosquitoes serve as the disease vectors, making their surveillance crucial for dengue prevention. The objective of this study was to address the difficulty associated with identifying and counting mosquito eggs of wild strains during the monitoring of Aedes albopictus (Diptera: Culicidae) density via ovitraps in field surveys.

Methods

We constructed a dataset comprising 1729 images of Ae. albopictus mosquito eggs from wild strains and employed the Segment Anything Model to enhance the applicability of the detection model in complex environments. A two-stage Faster Region-based Convolutional Neural Network model was used to establish a detection model for Ae. albopictus mosquito eggs. The identification and counting process involved applying the tile overlapping method, while morphological filtering was employed to remove impurities. The model’s performance was evaluated in terms of precision, recall, and F1 score, and counting accuracy was assessed using R-squared and root mean square error (RMSE).

Results

The experimental results revealed the model’s remarkable identification capabilities, achieving precision of 0.977, recall of 0.978, and an F1 score of 0.977. The R-squared value between the actual and identified egg counts was 0.997, with an RMSE of 1.742. The average detection time for a single tile was 0.48 s, which was more than 10 times as fast as the human–computer interaction method in counting an entire image.

Conclusions

The model demonstrated excellent performance in recognizing and counting Ae. albopictus mosquito eggs, indicating great application potential. This study offers novel technological support for enhancing vector control effectiveness and public health standards.

Graphical Abstract
Canine vector-borne parasites in the Galapagos
Authors: Culda Carla Andreea , Rodriguez Nathalie G. Tejena , Puleo Fortunato , Sosa Rafael M. Polit , Panait Luciana Cătălina , Cazan Cristina Daniela , Deak Georgiana , Leon Renato , Vinueza Rommel Lenin , Páez-Rosas Diego , Mihalca Andrei Daniel
Published: December 2024

Background

The extraordinary Galapagos Islands, with an impressive number of endemic and native species, maintain the interest and curiosity for researchers from all over the world. The native species are known to be vulnerable to new pathogens, cointroduced with their invasive hosts. In the case of invasive parasitic arthropods, their evolutionary success is related to the association with other invasive hosts (such as domestic animals). These associations could become a significant driver of change, as occasionally they can seek another hosts and have the capacity to transmit pathogens between domestic and wild animals. The current study aims to identify the distribution and abundance of canine vector-borne parasites in the Galapagos Islands based on the possibility that some of them could spill over to endemic mammals.

Methods

A total of 1221 blood samples were randomly collected from privately owned dogs on San Cristóbal, Isabela, Santa Cruz, and Floreana Islands during the years 2021 and 2022. All samples were examined for vector-borne pathogens using the modified Knott’s test and conventional, nested, and multiplex polymerase chain reactions (PCRs), followed by sequencing.

Results

The PCR and Knott tests confirmed the presence of Dirofilaria immitis (2%, 25/1221) in all islands. While molecular analyses showed heartworm DNA only in dogs from the San Cristóbal (3.3%) and Isabela (2.4%) Islands. Moreover, other pathogens Babesia vogeli (3%, 37/1221) and Hepatozoon canis (0.2%, 2/1221) were detected for the first time by molecular analyses.

Conclusions

Dogs from Galapagos are hosts to various pathogens, of which some are potentially zoonotic while some other could be spill-over to endemic endangered carnivores, such as sea lions. To understand and limit their impact, long-term surveillance, control, and awareness is needed.

Graphical abstract