bluuebunny/crossref_metadata_2025 huggingface dataset:
Prolonged Exposure to Intimate Partner Violence and Depressive Symptoms Among Korean Married Couples: The Intersection of Gender and Education
Authors: Song Kyungeun , Kim Jinho
Published: July 2023

This study investigates whether there is a longitudinal association between prolonged exposure to intimate partner violence (IPV) and depressive symptoms and whether this association differs depending on the intersection of gender and education. Using data collected from 3,285 individuals aged 30 to 49 across 12 waves of the Korean Welfare Panel Study (KoWePS) between 2009 and 2020, gender-by-education-stratified fixed-effects models were estimated. IPV victims continued to experience increased depressive symptoms for four or more consecutive years of exposure. However, gender-specific patterns were observed. Persistently victimized women continued to experience increased depressive symptoms for four or more years, whereas the levels of depressive symptoms among men with prolonged IPV exposure increased only until the second year of exposure. Gender-by-education stratified analyses suggested that low-educated women are the most vulnerable to prolonged IPV victimization. Only low-educated women experienced an increase in depressive symptoms for four or more consecutive years.
Predicting m-Commerce Continuance Intention and Price Sensitivity in Indonesia by Integrating of Expectation-Confirmation and Post-acceptance Model
Authors: Susanto Perengki , Hoque Mohammad Enamul , Nisaa Verselly , Islam Md Asadul , Kamarulzaman Yusniza
Published: July 2023

This study explored the antecedents of m-commerce continuance usage intention and their impact on the price sensitivity of Indonesian m-commerce customers. The study also incorporates contextual factors, such as perceived risk, trust, efficiency, and functional benefits, into the model to investigate their impact on the satisfaction of m-commerce users. Moreover, it examines how the efficient and functional benefits of m-commerce affect price sensitivity. The study employed online questionnaires to gather data from m-commerce users in Indonesia. The hypothesis was tested using a partial least squares technique with Smart-PLS. This study demonstrates that user satisfaction with mobile commerce has a significant impact on their intention to continue using it, which in turn affects their price sensitivity. The study found perceived risk, trust, efficiency, and functional benefit to be significant determinants of satisfaction in m-commerce usage. The study also found that trust, efficiency, and functional benefits influence the continuance use of m-commerce, while perceived risk is not an intervening variable for continuance intention among m-commerce users. Furthermore, the results show that perceived risk, trust, and functional benefit influence a user’s price sensitivity, whereas efficiency was not found to be a determinant in influencing price sensitivity. However, the study found that continuance usage intention and satisfaction serially mediated the link between efficiency and price sensitivity, as well as the link between functional benefit and price sensitivity. The outcome of this study would be useful for managers and practitioners who find it difficult to retain their customers’ continued intention to purchase their products and services.
Depression and Associated Factors Among the Elderly Population in an Urban Tertiary Geriatric Hospital in Bangladesh
Authors: Tabassum Taharima , Suzuki Takefumi , Iwata Yusuke , Ishiguro Hiroki
Published: July 2023

Background: Geriatric depression becoming a serious concern worldwide, but no studies addressed depression among patients attending outpatient department of a tertiary geriatric care hospital in Bangladesh. Methods: This cross-sectional study was conducted in face-to-face interview using the Geriatric Depression Scale (GDS-15) to measure depression among 230 elderly outpatients (60–80 years old) who visited the hospital for medical reasons in Dhaka city; a variety of socio-demographic, behavioral, and psycho-social variables as well as history of chronic diseases were assessed to detect factors associated with depression. Results: The prevalence of depression was 81.7%; 52.6%, 25.2%, and 3.9% showed mild, moderate and severe depression (the GDS scores 5–8, 9–11, and 12–15), respectively. In logistic regression models, the associated factors included marital status, occupational status, educational status, physical activity, and history of cerebrovascular diseases or stroke. The prevalence of depression was generally higher than other reports elsewhere, and the reason behind this may include the use of the GDS-15 and the setting to carry out this study. Conclusion: Nationally representative investigations are warranted to further address depression among the elderly in Bangladesh; these findings would be helpful for future studies and intervention programs.
E-waste is toxic, but for whom? The body politics of knowing toxic flows in Delhi
Authors: Perczel Julia
Published: July 2023

Bodily knowledge and lived experience of toxic exposures in e-waste markets are central to policies and legal frameworks that are being rolled out globally enforcing the “polluter pays” principle. Yet, the sensory experience of toxicity is far from the straightforward, narratable knowledge, which it is often made out to be. This article builds on twelve months of research into the process of establishing formal e-waste recycling channels in New Delhi, India. Environmental practitioners and e-waste workers, each in a different relation to power and toxicity, presented contradictory understandings and challenged the continuity between sensing bodies posed by environmental advocacy narratives. Acknowledging the difficulty to pin down lived experience, I compare the certainty with which employees of a producer responsibility organisation present toxicity for the purpose of spreading awareness to the ambivalence with which informal e-waste recyclers relate to the toxicity in their own environment. The paper highlights the process of turning bodily experience into knowledge and proposes that knowing toxicity is the result of socially and economically inflected relations between bodies, chemicals, forms of knowledge, and the material dismantling process. Rather than accepting the immediacy of sensory experiences, or looking to find the authentic witness, I suggest a triangulation of bodies differently positioned in relation to the processes and places in question.
Role of Employer-sponsored Health Insurance Benefits in Employer Attractiveness: Literature Review and Emerging Issues
Authors: Reshmi  , Mulla Zubin R.
Published: July 2023

Employer-sponsored health insurance benefits are essential for employee productivity, performance and employee well-being. However, increasing health insurance costs are a primary concern for employers and employees alike. Despite its importance, there is a lack of research on employer-sponsored health insurance benefits from the perspective of employer attractiveness. To address this gap, we reviewed the literature on the importance of health insurance benefits in enhancing employer attractiveness. In addition, we discussed emerging issues related to health insurance benefits for future research. These issues involve increasing employee contribution to employer-sponsored health insurance benefits, customised health insurance benefits plans, health benefits communication and the issue of health benefits administration sludge which impacts employer attractiveness. We also proposed a model related to employer-sponsored health insurance benefits variables and employer attractiveness, which can be tested in future research.
Reimagining HR Practices to Attract and Engage Gig Talent: An Organisational Perspective
Authors: Unnikrishnan Preethy , Baral Rupashree
Published: July 2023

At a time when the gig economy and gig work are getting increasingly popular and offering infinite possibilities and solutions to age-old staffing and skilling problems, this article aims to explore the challenges and opportunities posed by this new model of engagement from the lens of information technology industry and the need for a paradigm shift in HR practices in such organisations to attract and engage gig workers. The article extensively relies on a review of the extant literature on the topic, including papers published in reputed journals, reports, news articles, podcasts, TEDx talks and perspectives of HR practitioners gathered through one-to-one interviews. The findings corroborate the need for a completely different approach to managing gig workers, including reimagining workplace structures and organisational systems, designing inclusive policies and adopting progressive HR practices to create an employer brand that resonates with gig workers.
Gamification as an Effective Employer Branding Strategy for Gen Z
Authors: Varghese John , Deepa R.
Published: July 2023

This study explores the effectiveness of gamification as an employer branding strategy on applicant engagement, talent attraction and candidate selection in the Gen Z workforce. Specifically, through a comprehensive literature review, the research identifies person-organisation (P-O) fit and organisational identification as intervening mechanisms for the above outcomes. A pilot study was conducted on 40 Gen Z postgraduate students who had undergone a gamified assessment in their placement process. The participants were asked to rank the top 10 attributes they perceive their organisation to stand for when using gamification as part of the employee selection process. These attributes can also be used to brand their organisation as an employer of choice. This research provides valuable insights for organisations and HR professionals seeking to win the war for talent by enhancing their recruitment efforts through gamification. It underscores the importance of considering factors such as P-O fit and organisational identification in recruitment.
The IRDiRC Chrysalis Task Force: making rare disease research attractive to companies
Authors: Beaverson Katherine L. , Julkowska Daria , Letinturier Mary Catherine V. , Aartsma-Rus Annemieke , Austin Jennifer , Bueren Juan , Frost Simon , Hamamura Misako , Larkindale Jane , LaRosa Greg , Magenheim Rita , Merico Annamaria , Pasmooij Anna Maria Gerdina , Pirard Vinciane , Ekow Thomford Nicholas , Wada Michihiko , Wong-Rieger Durhane , Hartman Adam L.
Published: July 2023

Background:

The International Rare Diseases Research Consortium (IRDiRC) is an international initiative that aims to use research to facilitate rapid diagnosis and treatment of rare diseases.

Objective:

IRDiRC launched the Chrysalis Task Force to identify key financial and nonfinancial factors that make rare disease research and development attractive to companies.

Methods:

The Chrysalis Task Force was comprised of thought leaders from companies, patient advocacy groups, regulatory agencies, and research funders. The Task Force created a survey that was distributed to companies of different sizes with varied investment portfolios and interests in rare disease research. Based on the survey results, the Task Force then conducted targeted interviews.

Results:

The survey and interview respondents identified several factors that make rare disease research and development attractive (e.g. a good understanding of the underlying biology) as well as barriers (e.g. absence of an advocacy organization representing the affected community’s needs). The concept of Return On Investment allowed the exploration of factors that were weighed differently by survey and interview respondents, depending on a number of intrinsic and extrinsic issues.

Conclusions:

The Chrysalis Task Force identified factors attributable to rare disease research and development that may be of interest to and actionable by funders, academic researchers, patients and their families, companies, regulators, and payers in the medium term to short term. By addressing the identified challenges, involved parties may seek solutions to significantly advance the research and development of treatments for rare diseases.
Class Piano: A Review of Literature
Authors: Morrison Melody
Published: July 2023

Class piano has been a subset of piano pedagogy that has been growing in popularity since its establishment 200 years ago. The purpose of this literature review was to synthesize the research and materials related to the history of class piano and its function in (a) K-12 school settings, (b) collegiate student settings, and (c) adult student settings. Results from previous studies suggest that class piano has benefits for students such as increased musical creativity and motivation. Previous studies also indicate that it is important for class piano teachers to successfully handle the aspects of a group class and be aware of goals and resources among different age groups. Further evidence suggests that although there are a considerable number of resources in collegiate class piano teaching, there is less available in K-12 school settings. Based on these findings, I offer recommendations for potential and current class piano educators of all levels.
Cabazitaxel-loaded human serum albumin nanoparticles combined with TGFβ-1 siRNA lipid nanoparticles for the treatment of paclitaxel-resistant non-small cell lung cancer
Authors: Tan Tiantian , Feng Yuxin , Wang Weimin , Wang Rongrong , Yin Liyan , Zeng Yiying , Zeng Zhaowu , Xie Tian
Published: July 2023

Background

In the current treatment of non-small cell lung cancer (NSCLC), traditional chemotherapy causes high toxicity, so it is necessary to develop safe chemical drug delivery vehicles clinically. Chemotherapy monotherapy is prone to drug resistance. Chemotherapy combined with other therapies such as nucleic acid drugs is an effective way to avoid drug resistance and the toxicity of continuous chemotherapy. In this study, chemotherapy and siRNA therapy were combined to treat paclitaxel-resistant NSCLC in order to increase efficacy and reduce toxicity. This study aims to develop a cabazitaxel-loaded human serum albumin nanoparticles (CTX-HSA-NPs) to improve the toxicity of traditional CTX-Tween 80 and increase targeting, and to develop a TGFβ-1 siRNA lipid Nanoparticles (TGFβ-1 siRNA LNP) combined with chemotherapy in the treatment of paclitaxel-resistant NSCLC.

Results

This study prepared CTX-HSA-NPs and TGFβ-1 siRNA LNP had small particle size, high encapsulation efficiency (EE). CTX-HSA-NPs lyophilized powder has high stability after dissolved. The antitumor effect of CTX-HSA-NPs on paclitaxel-resistant NSCLC was higher than that of CTX-Tween, and the toxicity was 1.8 times lower than that of CTX-Tween. More importantly, the combined treatment of TGFβ-1 siRNA LNP and CTX-HSA-NPs could effectively improve the antitumor efficacy of paclitaxel-resistant NSCLC in vivo and in vitro. The results of tumor immunohistochemistry showed that TGFβ-1 siRNA LNP significantly inhibited the expression of TGFβ-1, and compared with other groups, the expression of P-gp after low-dose CTX-HSA-NPs treatment was lower, which did not cause obvious drug resistance.

Conclusions

The antitumor effect of CTX-HSA-NPs on paclitaxel-resistant NSCLC was higher than that of CTX-Tween, and the toxicity was lower than that of CTX-Tween. TGFβ-1 siRNA LNP can treat paclitaxel-resistant NSCLC by inhibiting the express of TGFβ-1 mRNA. The combined treatment of TGFβ-1 siRNA LNP and CTX-HSA-NPs could effectively improve the antitumor efficacy of paclitaxel-resistant NSCLC. A combination therapy of chemotherapy and nucleic acid drugs could be an effective approach for treating paclitaxel-resistant NSCLC.
Netrank: network-based approach for biomarker discovery
Authors: Al-Fatlawi Ali , Rusadze Eka , Shmelkin Alexander , Malekian Negin , Ozen Cigdem , Pilarsky Christian , Schroeder Michael
Published: July 2023

Background

Integrating multi-omics data is fast becoming a powerful approach for predicting disease progression and treatment outcomes. In light of that, we introduce a modified version of the NetRank algorithm, a network-based algorithm for biomarker discovery that incorporates the protein associations, co-expressions, and functions with its phenotypic association to differentiate different types of cancer. NetRank is introduced here as a robust feature selection method for biomarker selection in cancer prediction. We assess the robustness and suitability of the RNA gene expression data through scanning genomic data for 19 cancer types with more than 3000 patients from The Cancer Genome Atlas (TCGA).

Results

The results of evaluating different cancer type profiles from the TCGA data demonstrate the strength of our approach to identifying interpretable biomarker signatures for cancer outcome prediction. NetRank’s biomarkers segregate most cancer types with an area under the curve (AUC) above 90% using compact signatures.

Conclusion

In this paper we provide a fast and efficient implementation of NetRank, with a case study from The Cancer Genome Atlas, to assess the performance. We incorporated complete functionality for pre and post-processing for RNA-seq gene expression data with functions for building protein-protein interaction networks. The source code of NetRank is freely available (at github.com/Alfatlawi/Omics-NetRank) with an installable R library. We also deliver a comprehensive practical user manual with examples and data attached to this paper.
ROGUE: an R Shiny app for RNA sequencing analysis and biomarker discovery
Authors: Farrel Alvin , Li Peng , Veenbergen Sharon , Patel Khushbu , Maris John M. , Leonard Warren J.
Published: July 2023

Background

The growing power and ever decreasing cost of RNA sequencing (RNA-Seq) technologies have resulted in an explosion of RNA-Seq data production. Comparing gene expression values within RNA-Seq datasets is relatively easy for many interdisciplinary biomedical researchers; however, user-friendly software applications increase the ability of biologists to efficiently explore available datasets.

Results

Here, we describe ROGUE (RNA-Seq Ontology Graphic User Environment,https://marisshiny.research.chop.edu/ROGUE/), a user-friendly R Shiny application that allows a biologist to perform differentially expressed gene analysis, gene ontology and pathway enrichment analysis, potential biomarker identification, and advanced statistical analyses. We use ROGUE to identify potential biomarkers and show unique enriched pathways between various immune cells.

Conclusions

User-friendly tools for the analysis of next generation sequencing data, such as ROGUE, will allow biologists to efficiently explore their datasets, discover expression patterns, and advance their research by allowing them to develop and test hypotheses.
Network embedding framework for driver gene discovery by combining functional and structural information
Authors: Chu Xin , Guan Boxin , Dai Lingyun , Liu Jin-xing , Li Feng , Shang Junliang
Published: July 2023

Comprehensive analysis of multiple data sets can identify potential driver genes for various cancers. In recent years, driver gene discovery based on massive mutation data and gene interaction networks has attracted increasing attention, but there is still a need to explore combining functional and structural information of genes in protein interaction networks to identify driver genes. Therefore, we propose a network embedding framework combining functional and structural information to identify driver genes. Firstly, we combine the mutation data and gene interaction networks to construct mutation integration network using network propagation algorithm. Secondly, the struc2vec model is used for extracting gene features from the mutation integration network, which contains both gene's functional and structural information. Finally, machine learning algorithms are utilized to identify the driver genes. Compared with the previous four excellent methods, our method can find gene pairs that are distant from each other through structural similarities and has better performance in identifying driver genes for 12 cancers in the cancer genome atlas. At the same time, we also conduct a comparative analysis of three gene interaction networks, three gene standard sets, and five machine learning algorithms. Our framework provides a new perspective for feature selection to identify novel driver genes.
A Chinese scoring system for predicting successful retrograde collateral traverse in patients with chronic total coronary occlusion
Authors: Li Qiu Yu , Lin Xiao Long , Li Fan Qi , Cheng Zi Chao , Tian Jia Yu , Zhao Dong Hui , Lau Wayne Bond , Liu Jing Hua , Fan Qian
Published: July 2023

Background

Retrograde approach technique has been challenging in percutaneous coronary interventional treatment of chronic total occlusion (CTO) coronary disease. The present study endeavors to determine a novel Chinese scoring system for predicting successful collateral channels traverse via retrograde approach.

Methods

The demographic characteristics and angiographic characteristics of 309 CTO patient were analyzed by univariable and multivariable analysis for selecting potential predictors. And the nomogram was used to establish the scoring system. Then it was evaluated by the internal and external validation.

Results

The predictors of Age, Connections between collateral channels and recipient vessels, and Channel Tortuosity (ACT) were identified with univariable and multivariable analysis and employed to the ACT score system. With acceptable calibrations, the area under curve of the scoring system and the external validation were 0.826 and 0.816 respectively. Based on score, the predictors were divided into three risk categories and it showed a consistent prediction power in the validation cohort.

Conclusions

The novel Chinese ACT score is a reliable tool for predicting successful retrograde collateral traverse.
Capturing the variety of clinical pathways in patients with schizophrenic disorders through state sequences analysis
Authors: Savaré Laura , Ieva Francesca , Corrao Giovanni , Lora Antonio
Published: July 2023

Background

Care pathways are increasingly being used to enhance the quality of care and optimize the use of resources for health care. Nevertheless, recommendations regarding the sequence of care are mostly based on consensus-based decisions as there is a lack of evidence on effective treatment sequences. In a real-world setting, classical statistical tools were insufficient to consider a phenomenon with such high variability adequately and have to be integrated with novel data mining techniques suitable for identifying patterns in complex data structures. Data-driven techniques can potentially support empirically identifying effective care sequences by extracting them from data collected routinely. The purpose of this study is to perform a state sequence analysis (SSA) to identify different patterns of treatment and to asses whether sequence analysis may be a useful tool for profiling patients according to the treatment pattern.

Methods

The clinical application that motivated the study of this method concerns the mental health field. In fact, the care pathways of patients affected by severe mental disorders often do not correspond to the standards required by the guidelines in this field. In particular, we analyzed patients with schizophrenic disorders (i.e., schizophrenia, schizotypal or delusional disorders) using administrative data from 2015 to 2018 from Lombardy Region. This methodology considers the patient’s therapeutic path as a conceptual unit, composed of a succession of different states, and we show how SSA can be used to describe longitudinal patient status.

Results

We define the states to be the weekly coverage of different treatments (psychiatric visits, psychosocial interventions, and anti-psychotic drugs), and we use the longest common subsequences (dis)similarity measure to compare and cluster the sequences. We obtained three different clusters with very different patterns of treatments.

Conclusions

This kind of information, such as common patterns of care that allowed us to risk profile patients, can provide health policymakers an opportunity to plan optimum and individualized patient care by allocating appropriate resources, analyzing trends in the health status of a population, and finding the risk factors that can be leveraged to prevent the decline of mental health status at the population level.
Increase in birthweight coverage of neonatal deaths is needed to monitor low birthweight prevalence in India: lessons from the National Family Health Survey
Authors: Dandona Rakhi , Paul Arpita , Kumar G. Anil
Published: July 2023

Background

Low birthweight (LBW), defined as birthweight < 2500gms, is the largest contributor to the malnutrition disability-adjusted-live-years in India. We report on the inadequacy of birthweight data, which is a significant barrier in the understanding of LBW epidemiology, to address malnutrition in India.

Methods

Data from the recent round of the National Family Survey (NFHS-5) were utilised. Birthweight of livebirths in the last 5 years was documented in grams either from the health card or based on mother’s recall. We computed the coverage of birthweight measurement availability and the extent of heaping (values of 2500, 3000 and 3500gms) by the place of delivery and by the survival of newborn during the neonatal period. Heaping of > 55% was considered as poor-quality birthweight data. LBW prevalence per 100 livebirths was estimated and extrapolated for under-reporting of birthweight. Findings are reported for India and its 30 states.

Results

Birthweight measurement coverage irrespective of the place of delivery was (89·8%; 95% CI 89·7–90) for India, and varied by 2 times among the states with the highest coverage in Tamil Nadu (99·3%) and the lowest in Nagaland (49·7%). Home deliveries had the least coverage of birthweight measurement (49.6%; 95% CI 49.0–50.1) as compared with public health facility (96.3%; 95% CI 96.2–96.3) and private health facility (96%; 95% CI 95.8–96.1) deliveries. This coverage was 66·5% (95% CI 65·2–67·7) among neonatal deaths as compared with 90.4 (95% CI 90.3–90.6) for livebirths who survived the neonatal period for India. The proportion of health card as the data source increased for livebirths born in year 2015 to year 2020 but then dropped for livebirths born in year 2021 (p < 0.001). The proportion of heaping was 52·0% (95% CI 51·7–52·2) in the recorded birthweight for India, and heaping > 55% was seen in 10 states irrespective of the type data source; and 3 states in addition had heaping > 55% in mother’s recall. LBW prevalence was estimated at 17·4% (95% CI 17·3–17·6) for India, and ranged from 4.5% in Nagaland and Mizoram to 22.5% in Punjab for livebirths for whom birthweight was available. We estimated LBW at 77.8% for whom birthweight was not available, and the adjusted LBW prevalence for all livebirths was estimated at 23.5% (95% CI 23.3–23.8) for India.

Conclusions

Without measuring birthweight for every newborn irrespective of the survival and place of delivery, India may not able to address reduction in low birthweight and neonatal mortality effectively to meet global or national targets.
Hypofractionated stereotactic radiotherapy (HFSRT) versus single fraction stereotactic radiosurgery (SRS) to the resection cavity of brain metastases after surgical resection (SATURNUS): study protocol for a randomized phase III trial
Authors: Waltenberger Maria , Bernhardt Denise , Diehl Christian , Gempt Jens , Meyer Bernhard , Straube Christoph , Wiestler Benedikt , Wilkens Jan J. , Zimmer Claus , Combs Stephanie E.
Published: July 2023

Background

The brain is a common site for cancer metastases. In case of large and/or symptomatic brain metastases, neurosurgical resection is performed. Adjuvant radiotherapy is a standard procedure to minimize the risk of local recurrence and is increasingly performed as local stereotactic radiotherapy to the resection cavity. Both hypofractionated stereotactic radiotherapy (HFSRT) and single fraction stereotactic radiosurgery (SRS) can be applied in this case. Although adjuvant stereotactic radiotherapy to the resection cavity is widely used in clinical routine and recommended in international guidelines, the optimal fractionation scheme still remains unclear. The SATURNUS trial prospectively compares adjuvant HFSRT with SRS and seeks to detect the superiority of HFSRT over SRS in terms of local tumor control.

Methods

In this single center two-armed randomized phase III trial, adjuvant radiotherapy to the resection cavity of brain metastases with HFSRT (6 – 7 × 5 Gy prescribed to the surrounding isodose) is compared to SRS (1 × 12–20 Gy prescribed to the surrounding isodose). Patients are randomized 1:1 into the two different treatment arms. The primary endpoint of the trial is local control at the resected site at 12 months. The trial is based on the hypothesis that HFSRT is superior to SRS in terms of local tumor control.

Discussion

Although adjuvant stereotactic radiotherapy after resection of brain metastases is considered standard of care treatment, there is a need for further prospective research to determine the optimal fractionation scheme. To the best of our knowledge, the SATURNUS study is the only randomized phase III study comparing different regimes of postoperative stereotactic radiotherapy to the resection cavity adequately powered to detect the superiority of HFSRT regarding local control.

Trial registration

The study was retrospectively registered with ClinicalTrials.gov, number NCT05160818, on December 16, 2021. The trial registry record is available on https://clinicaltrials.gov/study/NCT05160818. The presented protocol refers to version V1.3 from March 21, 2021.
A multicomponent family intervention, combined with salt reduction for children with obesity: a factorial randomized study protocol
Authors: Assemany Cinthia Guimarães , Cunha Diana Barbosa , Brandão Joana Maia , Paravidino Vitor Barreto , Garcia Magno Conceição , Rêgo Ana Lúcia Viégas , Pereira Rosangela Alves , Sichieri Rosely
Published: July 2023

Background

Clinical trials to treat childhood obesity show modest results, weight regain and high dropout rates. Children with obesity often live in families with habits that contribute to unhealthy weight gain. This study will test whether a family intervention with a Brazilian-adapted Planetary Healthy Diet (PHD) and reduced portion sizes, along with increased physical activity and reduced sedentary behavior, can reduce excessive weight gain. The protocol promotes the intake of in natura products and water and reduces ultra-processed foods, sugar, and sodium. It encourages family lifestyle changes and physical activities, with randomized allocation to experimental and control groups. The responsible family member will be evaluated during follow-up. The control group will receive a print of the Brazilian dietary guideline.

Methods

A factorial crossover design will also allocate families to receive reduced sodium salt plus anti-inflammatory herbs and a placebo salt. Both the control and intervention groups will be randomly assigned to the sequence of both salts. The approach aims to reduce body weight expectations and evaluate salt's impact on blood pressure. It includes a 1-month intervention, 1-month washout, and 1-month intervention with monthly clinic visits and teleservice by health professionals. The primary outcomes will be the variation in the Body Mass Index (BMI) of the children. BMI and the variation in the blood pressure of the pair (child/mother or father) as well as waist circumference (WC) and waist-to-height ratio (WHtR) will also be measured.

Discussion

The project will test the effectiveness of the use of the recommendations of the PHD, physical activity and a salt-reduced sodium. The results of the present study will allow the refinement of interventions aimed at the treatment of childhood obesity and may help develop guidelines for the treatment of obesity in Brazilian children.

Trial registration

The study is registered in the Brazilian Registry of Clinical Trials (RBR-10 mm62vs). Registered 10 February 2023.
RETRACTED ARTICLE: Oxytocin versus a combination of tranexamic acid and ethamsylate in reducing intraoperative bleeding during abdominal myomectomy: a randomized clinical trial
Authors: Abdou Ahmed Mahmoud , Eldesouky Elsayed , Farag Elsayed , Mohammed Attia , Abdelaziz Doaa Fathy Mohamed , Shaaban A. , Ellaban Mostafa , Elhalim Abd Elhalim Mohamed Abd , Elsror Ahmed Gamal Abo , Marai Alrefaai Abd Elfattah , Abdel-Hakam Faiza , Abd-ElGawad Mohamed , Elrashedy Asmaa Ahmed , Abdelmonem Hanaa , Kamel Mohamed Abdelmonem , Afiffi Ibtesam K. , Elsayed Hazem Galal Abdelhameed , Abdelhamed Sameh Abdelmoneim , Bosilah Almandouh H. , Marie Heba
Published: July 2023

Objective

Myomectomy is the preferred surgical approach to manage uterine fibroids. However, uterine fibroids are highly vascular tumors and, consequently, extremely susceptible to problems from myomectomy-related hemorrhage. Hence, we aim to compare oxytocin efficacy and safety profile versus tranexamic acid (TA) with ethamsylate for reducing bleeding during myomectomy.

Methods

This randomized, double-blinded multicenter study was performed between 20th August 2020 and 20th October 2020 at El-Galaa Teaching Hospital, El Hussein University Hospital, Al-Azhar University Hospitals of Assiut, and Al-Azhar University Hospitals of Damietta. One hundred and eighty patients were enrolled and divided into three groups: group (1) received an injection of 30 IU of oxytocin in 500 ml of normal saline; group (2) received injections of 1 g of TA, 250 mg of Ethamsylate, and 110 ml of normal saline IV; and group (3) received an injection of 110 ml of normal saline IV just before surgical incision.

Results

In 180 premenopausal women, oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy (666.25 ± 183.03, 630.72 ± 145.83, and 646.67 ± 168.92, respectively (P = 0.506)). Non-significant trends were observed for a reduction in operation time (P = 0.760), intra/postoperative blood transfusion (P = 0.624), hospital stay (P = 0.986), postoperative fever (P = 0.659), and wound infection (P = 1).

Conclusion

Oxytocin and TA with ethamsylate had no significant value in lowering intraoperative blood loss compared with the placebo for abdominal myomectomy which opens a new question about the role of the use of the hemostatic drug during myomectomy especially in centers with limited resources and had higher rates.

Trial registration

The study was registered on Pan African Clinical Trials Registry with the following number: PACTR202008739887429 and was approved on 24/08/2020.
Anticancer potential of Carica papaya Linn black seed extract against human colon cancer cell line: in vitro study
Authors: Mahrous Nadia S. , Noseer Enas A.
Published: July 2023

Background

Since cancer is one of the most prevalent diseases in the world, further studies are needed to identify the effective therapeutic modalities. The second deadliest and third most common cancer is colorectal cancer (CRC). Papaya (Carica papaya Linn) seeds offer anti-cancer properties that can cure various types of cancer, such as liver and prostate cancer.

Methods

The study aimed to evaluate the anti-cancer activity of Carica papaya seed extract on colorectal cancer cell lines (Caco-2) and used techniques to assess the anti-cancer potential. The effectiveness of SE on cell proliferation and the viability of HTB-37 Caco-2 and C-166 cells were assessed using the MTT test. Real-time RT-PCR was used to measure gene expression levels and evaluate the activity of genes involved in apoptosis, including caspase-3, p53, Cycs, and Bcl-2. Finally, flow cytometry was used to analyze apoptosis induction by detecting changes in cell morphology and DNA content.

Results

The study showed that the MTT reduction assay was dependent on cancer cell type and concentration of SE compared to the control cells and C-166, with a mean IC50 value of 9.734 ug/ml. The cytotoxicity was accompanied by some morphological alterations in the colorectal cancer cell line (Caco-2). The expression of the genes for p53, Cycs, and caspase-3 was substantially up-regulated, while Bcl-2 was dramatically down-regulated compared to control cells. The cell cycle arrested at the G2-M phase and the presence of early and late apoptotic characteristics post-treatment increased the apoptotic profile.

Conclusion

It concluded that papaya seeds aqueous extract could act as a novel therapeutic option for colorectal cancer (CRC).
Communication of patients’ and family members’ ethical concerns to their healthcare providers
Authors: Noorulhuda Mariam , Grady Christine , Wakim Paul , Bernhard Talia , Cho Hae Lin , Danis Marion
Published: July 2023

Background

Little is known about communication between patients, families, and healthcare providers regarding ethical concerns that patients and families experience in the course of illness and medical care. To address this gap in the literature, we surveyed patients and family members to learn about their ethical concerns and the extent to which they discussed them with their healthcare providers.

Methods

We surveyed adult, English-speaking patients and family members receiving inpatient care in five hospitals in the Washington DC-Baltimore metropolitan area from July 2017 to March 2020. Descriptive statistics were used to determine the frequency, comfortableness, and helpfulness of discussions regarding ethical concerns experienced when sick or receiving medical care. Univariable and multivariable stepwise logistic regression models were used to identify associations between healthcare provider and respondent characteristics and attitudes and (1) the likelihood of speaking to a healthcare provider about their ethical concern and (2) their level of comfort during these discussions.

Results

Of 468 respondents who experienced ethical issues, 299 (64%) reported discussing the situation with a member of their healthcare team; 74% (197/265) of respondents who had such a discussion found the discussion comfortable, and 77% (176/230) of respondents found the discussion helpful. To make discussions more comfortable and helpful, respondents proposed suggestions in open-ended responses involving (1) content and quality of communication; (2) positive healthcare provider qualities such as empathy, open-mindedness, knowledge, honesty, and trustworthiness; and (3) other contextual factors including having adequate time and available resources.

Conclusions

Patients and families often have ethical concerns that they discuss with clinicians, and they want clinicians to be routinely receptive and attentive to such discussions.
Prediction performance of the machine learning model in predicting mortality risk in patients with traumatic brain injuries: a systematic review and meta-analysis
Authors: Wang Jue , Yin Ming Jing , Wen Han Chun
Published: July 2023

Purpose

With the in-depth application of machine learning(ML) in clinical practice, it has been used to predict the mortality risk in patients with traumatic brain injuries(TBI). However, there are disputes over its predictive accuracy. Therefore, we implemented this systematic review and meta-analysis, to explore the predictive value of ML for TBI.

Methodology

We systematically retrieved literature published in PubMed, Embase.com, Cochrane, and Web of Science as of November 27, 2022. The prediction model risk of bias(ROB) assessment tool (PROBAST) was used to assess the ROB of models and the applicability of reviewed questions. The random-effects model was adopted for the meta-analysis of the C-index and accuracy of ML models, and a bivariate mixed-effects model for the meta-analysis of the sensitivity and specificity.

Result

A total of 47 papers were eligible, including 156 model, with 122 newly developed ML models and 34 clinically recommended mature tools. There were 98 ML models predicting the in-hospital mortality in patients with TBI; the pooled C-index, sensitivity, and specificity were 0.86 (95% CI: 0.84, 0.87), 0.79 (95% CI: 0.75, 0.82), and 0.89 (95% CI: 0.86, 0.92), respectively. There were 24 ML models predicting the out-of-hospital mortality; the pooled C-index, sensitivity, and specificity were 0.83 (95% CI: 0.81, 0.85), 0.74 (95% CI: 0.67, 0.81), and 0.75 (95% CI: 0.66, 0.82), respectively. According to multivariate analysis, GCS score, age, CT classification, pupil size/light reflex, glucose, and systolic blood pressure (SBP) exerted the greatest impact on the model performance.

Conclusion

According to the systematic review and meta-analysis, ML models are relatively accurate in predicting the mortality of TBI. A single model often outperforms traditional scoring tools, but the pooled accuracy of models is close to that of traditional scoring tools. The key factors related to model performance include the accepted clinical variables of TBI and the use of CT imaging.
Healthcare services efficiency and its intrinsic drivers in China: based on the three-stage super-efficiency SBM model
Authors: Sun Mengya , Ye Yaojun , Zhang Guangdi , Shang Xiuling , Xue Yuan
Published: July 2023

Background

The purpose of this study is to examine the development of healthcare services efficiency in China since the reform of the healthcare system. By examining the development environment of healthcare services in China and examining the driving factors affecting the efficiency of healthcare services, we provide a reference for the future high-quality development of healthcare services in China.

Methods

A three-stage super-efficient slack-based measure (SBM) model with undesirable outputs was used to measure the efficiency of healthcae services in 31 Chinese provinces from 2009 to 2021, and a global Malmquist-Luenberger (GML) index was used to assess their spatiotemporal evolution characteristics and internal influencing mechanisms of healthcare services efficiency.

Results

The empirical results showed that the efficiency of China's healthcare services changed significantly from 2009–2014 and then remained stable. During the study period, the efficiency of healthcare services in the eastern region was higher than the national level, while it was lower in the western region. The results of the analysis of environmental factors indicated that an increase in population density reduced the redundancy of healthcare input resources and that economic development as well as an increase in government subsidies, contributed to an increase in the redundancy of healthcare input resources. The main contribution to the growth of healthcare sercices efficiency in China came from the technological innovation effect, and the growth was most significant in the western region.

Conclusion

From 2009 to 2021, the efficiency of national healthcare services generally showed a slow upward trend, and the efficiency of healthcare services varied widely among regions. Under the existing environmental constraints, relevant departments in each region should strengthen technological innovation in healthcare services, completely focus on the regional catch-up effect, and promote the balanced development of regional health.
Impact of body weight and sex in selected dog breeds on the canine adrenal gland dimensions measured by computed tomographic imaging
Authors: Büttelmann Gerrit , Harder Lisa Katharina , Nolte Ingo , Wefstaedt Patrick
Published: July 2023

Background

The present study aimed to investigate possible influences of body weight and sex on adrenal gland size in endocrinologically healthy dogs. Possible factors influencing the adrenal size are discussed in relation to a universal upper reference value from the literature of 7.4 mm as the thickness in the caudal pole of the adrenal gland. The adrenal size was measured by computed tomography (CT) from 66 normal dogs of six different breeds (Labrador Retriever (n = 16), German Shepherd (n = 10), Boxer (n = 8), Beagle (n = 14), Dachshund (n = 6) and Jack Russell Terrier (n = 12); male n = 38 (thereof neutered n = 23), female n = 28 (thereof neutered n = 17)) based on volume quantification and linear measurements using the data processing software Amira. For interbreed comparability, a ratio consisting of the third root of adrenal volume to aortic diameter (Ratio volume-aorta, RVA) was introduced. Additionally, breed-related attenuation values in contrast-enhanced CT data sets were measured.

Results

The measured volumes ranged from 0.34 to 1.93 cm3for the right and from 0.39 to 2.23 cm3for the left adrenal gland. The present study was able to demonstrate a body weight effect on the adrenal volume as well as on length and height. In terms of adrenal size, no significant differences between male and female, nor between intact and neutered dogs were obtained due to the RVA. In addition, for the weight classes, a breed independent threshold for dogs less (left 1.4; right gland 1.5) or more than 20 kg body weight (left 1.1; right gland 1.2) based on RVA was defined. Breed-related significant differences with respect to attenuation were determined only for the left adrenal gland, with lower attenuation values in large dog breeds.

Conclusion

The present study points out the importance of weight-related data when assessing CT data of the canine adrenal gland regarding volume, size and attenuation. The use of a universal reference value for the assessment of adrenal size appears unsuitable considering weight-related volume and linear measurements. Sex seems not to affect adrenal gland size.
Modified staging system of positive lymph nodes based nomogram in intrahepatic cholangiocarcinoma
Authors: Zhao Chongyu , Li Xiyuan , Luo Li , Chen Cheng , He Chaobin
Published: July 2023

Background

Intrahepatic cholangiocarcinoma (iCCA) presents the similar trend and prevalence of lymph node metastasis to other biliary tract cancer. There is still a necessity and possibility for the current classification of lymph node in the 8th TNM of iCCA, which is the same as the criteria of hepatoma carcinoma (HCC), to further improve the prognostic capacity. We aim to explore the optimal positive lymph nodes cutoff value that could predict the survival outcomes of patients with iCCA and further establish a prognostic nomogram.

Method

Clinical characteristics were retrospectively collected in 292 patients with iCCA from Sun Yat-sen University Cancer Center (SYSUCC) for preliminary analysis. A retrospective analysis of 107 patients with iCCA in the First Hospital of Dalian Medical University (FHDMU) was performed for verification. R software was used to determine the optimal cutoff value of positive lymph nodes (PLN) and further establish the nomogram with the Cox regression model in the primary cohort.

Results

In those patients who were graded into the N1 stage in 8th TNM staging system, the patients with PLN between 1 and 3 showed significantly better overall survival than those patients with more than 4 PLN (P < 0.0001). Moreover, there was a significant correlation between the new PLN classification and adverse clinical characteristic including Micro Invasion (P = 0.001), Lymph Vessel Invasion (P = 0.040), Satellite Sites (P < 0.001), and Tumor Size (P = 0.005). The PLN and ELN were both independent prognostic factors for survival outcomes in the multivariate analysis, and further showed large contribution to the nomogram. The nomogram achieved a satisfied C-index of 0.813 for overall survival (OS), 0.869 for progression-free survival (PFS) in the primary cohort, and 0.787 for OS, 0.762 for PFS in the validation cohort.

Conclusion

The modified classification of PLN in iCCA could accurately stratify the N1 stage patients in 8th TNM staging system into two groups with significantly different overall survival. The development of this nomogram can offer new evidence to precisely post-operative management of iCCA patients.