bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic and Genomic Researchers’ Perspectives on Biological Sample Sharing in Collaborative Research in Uganda: A Qualitative Study
Authors: Kaawa-Mafigiri David , Ekusai Sebatta Deborah , Munabi Ian , Mwaka Erisa Sabakaki
Published: May 2023

Numerous ethical, legal, and social issues arise with biological sample sharing. The study explored the perspectives of genetic and genomic researchers on the sharing of biological samples in international collaborative research. Qualitative in-depth interviews were conducted with 15 researchers. Participants expressed positive attitudes towards biobanking and appreciated the benefits of cross-border sharing of biological samples but noted that this practice had adversely affected local capacity building efforts. There was limited understanding of the ethical and regulatory frameworks governing sample sharing. Researchers emphasized the importance of respecting cultural values in biobanking research. Issues concerning poor governance and inequitable benefit sharing were also raised. There is a need for fair and equitable international collaborations where all researchers are treated with respect and as equal partners.
Effect of routine inflammatory markers on clinical outcomes in acute basilar artery occlusion after endovascular thrombectomy: Results from ATTENTION registry
Authors: Li Rui , Yin Yamei , Cai Xueli , Zhu Yuyou , Feng Shuo , Sun Jun , Tao Chunrong , Xu Pengfei , Wang Li , Song Jianlong , Zhou Qingqing , Liu Wenhua , Hu Wei
Published: May 2023

Background:

To investigate the relationship between clinical routine inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), white blood cell count (WBC), neutrophils, lymphocytes, and platelets with clinical outcomes in acute basilar artery occlusion (BAO) patients receiving endovascular treatment (EVT).

Methods:

We recruited 2134 acute BAO patients from 48 stroke centers across 22 Chinese provinces in the ATTENTION registry from 2017 to 2021. Blood samples were drawn at admission. An unfavorable functional outcome was defined using a modified Rankin Scale (mRS) of 4–6 at 90 days. Safety outcomes included mortality within 90 days and symptomatic intracerebral hemorrhage within 3 days.

Results:

A total of 1044 patients were included in the final study. After adjusting for confounding factors, the upper quartiles of WBC and NLR were related to 90-day unfavorable functional outcome (mRS = 4–6) compared with those in the lowest quartile (WBC: quartile 4, odds ratio (OR) = 1.85, 95% confidence interval (CI) = 1.22–2.80; NLR: quartile 4, OR = 2.02, 95% CI = 1.34–3.06). The higher quartiles of WBC and NLR were also related to the increased risk of mortality at 90 days. Restricted cubic spline regression analysis showed an incremental trend between NLR and 90-day unfavorable functional outcome (Pnonlinearity = 0.055). In subgroup analysis, a significant interaction was found between NLR and bridging therapy for predicting unfavorable functional outcome (P = 0.006).

Conclusion:

Higher WBC and NLR on admission are significantly related to unfavorable functional outcome and mortality at 90 days in acute BAO patients receiving EVT. Significant interaction was found between increased NLR and bridging therapy on these outcome measures.
Results of an international survey on the status of prehospital care
Authors: Rudd Anthony G , Zhao Jing , Ford Gary , Melifonwu Rita , Abraham Siju V , Fisher Marc , Andersen Grethe , Waters David , Li Dou , Liu Renyu
Published: May 2023

Background:

Prehospital care including recognition of stroke symptoms by the public and professionals combined with an efficient and effective emergency medical service (EMS) is essential to increase access to effective acute stroke care. We undertook a survey to document the status of stroke prehospital care globally.

Methods:

A survey was distributed via email to the World Stroke Organization (WSO) members. Information was sought on the current status of stroke prehospital delay globally, including (1) ambulance availability and whether payment for use is required, (2) ambulance response times and the proportion of patients arriving at hospital by ambulance, (3) the proportion of patients arriving within 3 h and more than 24 h after symptom, (4) whether stroke care training of paramedics, call handlers, and primary care staff, (5) availability of specialist centers, and (6) the proportion of patients taken to specialist centers. Respondents were also asked to identify the top three changes in prehospital care that would benefit their population. Data were analyzed descriptively at both country and continent level.

Results:

Responses were received from 116 individuals in 43 countries, with a response rate of 4.7%. Most respondents (90%) reported access to ambulances, but 40% of respondents reported payment was required by the patient. Where an ambulance service was available (105 respondents) 37% of respondents reported that less than 50% of patients used an ambulance and 12% less than 20% of patients used an ambulance. Large variations in ambulance response times were reported both within and between countries. Most of the participating high-income countries (HIC) offered a service used by patients, but this was rarely the case for the low- and middle-income countries (LMIC). Time to admission was often much longer in LMIC, and there was less access to stroke training for EMS and primary care staff.

Conclusions:

Significant deficiencies in stroke prehospital care exist globally especially in LMIC. In all countries, there are opportunities to improve the quality of the service in ways that would likely result in improved outcomes after acute stroke.
Kazakhstan’s Quest for Status: A Secondary State’s Strategy to Shape Its International Image
Authors: O'Neill Daniel C. , Primiano Christopher B.
Published: May 2023

Since becoming an independent country in 1991, Kazakhstan has demonstrated a strong desire for international status and recognition by, for example, hosting numerous international events, such as chairing the OSCE and hosting EXPO 2017; creating the Conference on Interaction and Confidence Building Measures in Asia; and, most notably, presenting the abandonment of its nuclear weapons as a model for other states to emulate. Surprisingly, Kazakhstan has received scant attention by scholars regarding its desire for status, especially considering how the government has framed its decision to relinquish its nuclear weapons in terms of advancing international peace at the expense of its own security self-interest. Kazakhstan’s status-seeking raises two questions. First, how can a mid-level power strategically frame its foreign and domestic policies in order to improve its global status? And second, how can it improve its international status when domestic priorities (such as economic development and political stability) lead to policies that meet disapproval abroad? In this article, we answer these questions by examining issue areas (security, democratization, and the environment) that contain variation in our dependent variable, Kazakhstan’s quest for status. In doing so, we reveal patterns of how a secondary or mid-level state lacking substantial material capabilities can, through its words and actions, construct an image that may enhance its international status. We also show variation by issue area in the reception of these efforts by developed and developing countries. Lastly, we reveal in what issue areas Kazakhstan’s desire for status internationally is constrained by the government’s desire to maintain power domestically.
A study protocol for a single-centred randomized trial to investigate the effect of pre-treatment communication methods on dental anxiety among adult dental patients
Authors: Gbadebo Shakeerah Olaide , Oke Gbemisola Aderemi , Dosumu Oluwole Oyekunle
Published: May 2023

Objective:

Optimal oral health is an essential component of good quality of life. However, this may be hindered by dental anxiety (DA), thereby, affecting the utilization of dental services. DA could be alleviated by pre-treatment information; however, the method of delivering this information is yet to be explored. It is, therefore, necessary to assess the modes of presenting pre-treatment information to ascertain the one with significant effect on DA. This will improve treatment outcomes and quality of life for individuals. Hence, the primary objective is to assess the effect of audiovisual and written forms of pre-treatment information on DA, while the secondary objective will compare the subjective and objective methods of assessing DA with psychometric anxiety scale (Index of Dental Anxiety and Fear (IDAF)-4C+) and salivary alpha-amylase respectively.

Study design:

Single-centred, single-blind, parallel-group, four-arm randomized clinical trial.

Methods:

The study will compare the effects of audiovisual and written forms of pre-treatment information on DA among adults. Patients 18 years and above scheduled for dental treatment will be screened for eligibility. Written informed consent will be sought before participation. Participants will be allocated randomly using block randomization, to the groups; G1: audiovisual and G2: a written form of pre-treatment information. At the visit, participants will complete the DA questionnaires (IDAF-4C+, Modified Dental Anxiety Scale and Visual Analogue Scale). Physiological anxiety-related changes of salivary alpha-amylase will be measured using a point-of-care kit (iPro oral fluid collector) at baseline, and 10 min after intervention. Furthermore, blood pressure will be taken at baseline and 20 min into the treatment. The mean changes of physiologic anxiety levels and 95% confidence intervals will be compared between the methods of pre-treatment information.

Discussion:

This study hopes to establish pre-treatment information as a method for reducing DA among the populace. Also, to assess the relationship between questionnaire-based and physiologic methods of assessing DA.
The marketization of educational resources and individual choice: Examining the heterogeneous treatment effect of private tutoring in middle schools
Authors: Li Angran
Published: May 2023

In recent decades, with the rapid marketization of educational resources in K–12 education, private tutoring has become extremely popular in China, yet the previous research has not yet reached a consensus on the impact of private tutoring on academic outcomes, and has also overlooked the influence of individual choice under the exam-oriented educational system in China. By using data drawn from the China Education Panel Survey, this study examines the heterogeneous treatment effect of private tutoring on 8th graders’ academic performance from the perspective of individual choice. The results show that a propensity to attend private tutoring can differentiate the class disparities among middle school students in terms of individual, family, school, and other factors. Furthermore, the results indicate that private tutoring generally has limited impacts on academic achievement, net of all background factors. However, students whose propensity to attend private tutoring lies in the intermediate range tend to benefit the most from private tutoring. For both students from socioeconomically disadvantaged families with a low propensity and their advantaged counterparts with a high propensity, private tutoring has little effect on their academic performance. Sensitivity analysis further shows that the heterogeneous effects of private tutoring differs across cognitive ability, subject types, and tutoring periods. The finding has important implications for understanding the consequences of China's policy interventions in terms of reducing educational inequality.
A Follow Up to the AARP Age-Friendly Community Survey Through a Focus Group Study
Authors: Glasser Irene , Smith Mary Alice
Published: May 2023

Introduction: In an effort to help communities plan for their burgeoning aging population, the American Association of Retired Persons (AARP) has facilitated community surveys to enable older adults to rate the current state of their own community for “aging in place.” This Focus Group Study extended the findings of the AARP Age-Friendly Community Survey in a small-sized New England City, adding to our knowledge of an older adult population. Aim: In order to elicit the points of view of older adults in one small New England city, six focus groups were conducted via Zoom during the height of the pandemic, from the spring and fall of 2020 on the topic of aging in place. Method: The six focus groups had a total of 32 participants, all of whom were 65 years and older and living in the same New England city. Results: The challenges to aging in place small New England city that the focus group participants described included: knowing where to get complete and reliable information about vital services, the barriers to walkability, and the challenge of transportation when one can no longer safely drive. Conclusion: The Focus Group Study extended the findings of the AARP Age-Friendly Community Survey in a small-sized New England City through the voices of the older adults which led to a more nuanced understanding of what it takes to age in place. The results of the study were utilized by the city in order to write an action plan as a guide to becoming more age-friendly.
Prevalence of preoperative deep vein thrombosis in long bone fractures of lower limbs: a systematic review and meta-analysis
Authors: Hu Yaowen , Zhu Liwen , Tian Xuan , Duan Fangfang
Published: May 2023

Background

There is a paucity of data regarding the prevalence of preoperative deep vein thrombosis (DVT) in patients with long bone (including femur, tibia and fibula) fractures of the lower limbs. We performed a meta-analysis to address the issue.

Methods

Electronic databases, including PubMed, EMBASE, the Web of Science, the Cochrane Library, the VIP database, CNKI, and the Wanfang database, were systematic searched for original articles that reported the prevalence of preoperative DVT in long bone fractures of the lower limbs from January 2016 to September 2021. The prevalence of preoperative DVT was pooled using random-effects models, and subgroups were established according to study type, detection method, sample size and fracture site.

Results

Twenty-three articles reporting on 18,119 patients were eligible. The overall pooled preoperative DVT prevalence was 24.1% (95% CI 19.3–28.8%). In different subgroups, the preoperative DVT prevalences were 18.2–27.3%, 15.2–28.6%, 23.1–24.9%, 18.2–26.0% and 23.2–23.4% for different study designs, sample sizes, age groups, detection methods and fracture sites, respectively.

Conclusions

Despite the heterogeneity among studies, this systematic review suggests that the prevalence of preoperative DVT, which may seriously affect the prognosis of patients, is high. Therefore, greater efforts should be devoted to the improvement of screening and prevention strategies for preoperative DVT in lower-extremity long bone fractures.

Level of Evidence: Level III.

Trial Registration The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database with the registration number CRD42022324706.
Formulation and optimization of folate-bovine serum albumin-coated ethoniosomes of pterostilbene as a targeted drug delivery system for lung cancer: In vitro and in vivo demonstrations
Authors: Hanafy Nemany A. N. , Abdelbadea Reham H. , Abdelaziz Abdelaziz E. , Mazyed Eman A.
Published: May 2023

This study aimed to overcome the poor solubility of pterostilbene (PTS) by developing promising reconstituted proethoniosomes (PENs). The reconstituted PENs loaded with PTS were fabricated according to a 23 factorial design by Design-Expert® software. The prepared ethoniosomes were assessed for entrapment efficiency (EE %) and % PTS released after 24 h (Q24h). According to the desirability criteria, the ethoniosomal formula (F4) was chosen as the optimized formulation with EE% of 93.19 ± 0.66 and Q24h of 75.10 ± 1.90%. The optimum ethoniosomal formulation was further coated with folic acid (FA) using bovine serum albumin (BSA) as a carrier and stabilizing agent and further evaluated for transmission electron microscopy (TEM), particle size, zeta potential, elasticity, Fourier transform infrared spectroscopy (FTIR), and stability. The targeted ethoniosomal formula appeared as spherical nanovesicles with a size of 144.05 ± 1.77 nm size and a zeta potential of -38.6 mV. The elasticity of the targeted ethoniosomal formula 19.27 ± 1.2 was higher than that of the corresponding niosome 1.48 ± 0.02. The targeted ethoniosomal formula showed high stability for three months. Fluorescence microscopy demonstrated an accumulation of FA-BSA-ethoniosomes in the cytoplasm of A549 cell lines. The observed therapeutic activity of the targeted ethoniosomal formula on lung cancer was explored by in vitro cytotoxicity on A549 lung cancer cells and in vivo animal models. The in vivo results were supported by histopathological analysis and immunohistochemical caspase-3 staining. FA-BSA-ethoniosomal formulation allowed specific targeting of cancer tissues overexpressing folate receptors. Overall, these results confirmed that the targeted ethoniosomal formula could be a promising nano-carrier for potential application as targeted cancer chemotherapy in clinical studies.

Graphical Abstract
The relationships between physical function, nutrition, cognitive function, depression, and sleep quality for facility-dwelling older adults with dynapenia
Authors: Lin Tzu-Hui , Chang Shu-Fang , Liao Min-Tser , Chen Yen-Hung , Tsai Hsiao-Chi
Published: May 2023

Background

The growing population of older adults worldwide is associated with an extended life expectancy and an increasing proportion of older adults with dynapenia. Most research on dynapenia has involved only populations of older adults living in the community; little research has examined the effects of risk factors on sleep quality among older adults with dynapenia residing in assisted living facilities.

Aim

This study examined the relationships among physical function, nutrition, cognitive function, depression, and sleep quality among older adults with dynapenia residing in assisted living facilities.

Methods

In this cross-sectional study, data on physical function, nutrition, cognitive function, depression, and sleep quality was collected from 178 older adults with dynapenia residing in assisted living facilities, who were selected using purposive sampling. Descriptive statistical analysis, independent-sample t tests, chi-squared tests, and logistic regression analysis were performed using SPSS 25.0.

Results

The statistical analyses revealed correlations between sleep quality and age (t = 2.37, p < 0.05), level of education (χ2 = 3.85, p < 0.05), grip strength (t = 3.40, p < 0.01), activities of daily living (t = 4.29, p < 0.001), instrumental activities of daily living (t = 2.23, p < 0.001), calf circumference (t = 2.89, p < 0.01), Mini Nutritional Assessment scores (t = 2.29, p < 0.05), Mini Mental State Exam (MMSE) scores (t = 4.50, p < 0.001), and Geriatric Depression Scale (GDS) scores (t = − 4.20, p < 0.001). Calf circumference (OR = 0.8, 95% CI = 0.650.97, p < 0.05), GDS score (OR = 1.42, 95% CI = 1.05–1.92, p < 0.05), and MMSE score (OR = 0.85, 95% CI = 0.73–0.97, p < 0.05) were related to sleep quality among the sample population.

Conclusion

Physical function, nutrition, cognitive function, and depression affect the sleep quality of older adults with dynapenia residing in assisted living facilities. Facility nurses must regularly assess these aspects of their patients to ensure that facility-dwelling older adults can maintain their physical function and improve their health to improve the quality of their sleep.
Hemichorea secondary to isolated temporal infarction with severe middle cerebral artery stenosis: a case report and review of literature
Authors: Dong Hanrong , Zhao Jingmin , Lee Kwee-Yum , Shen Guangxun
Published: May 2023

Background

Hemichorea typically results from a contralateral subthalamic nuclei (STN) lesion, although it has been reported in the cortex in a minority of cases. However, to our best knowledge, there are no documented cases in literature of hemichorea occurring as a secondary condition to an isolated temporal stroke.

Case presentation

We present a case of an elderly female who sustained a sudden onset of hemichorea in her right extremities, predominantly in the distal region, lasting over a period of two days. Brain diffuse weighted image (DWI) demonstrated a high signal in the temporal region, while magnetic resonance angiography (MRA) revealed severe stenosis of the middle cerebral artery. During the symptomatic phase, computed tomography perfusion (CTP) revealed delayed perfusion in the left middle cerebral artery territory, characterized by the time-to-peak (TTP) measure. Based on the results of her medical history and laboratory tests, we were able to rule out the possibility of infectious, toxic, or metabolic encephalopathy. Her symptoms gradually improved with antithrombotic and symptomatic treatment.

Conclusions

It is important to recognize and consider acute onset hemichorea as an initial symptom of stroke to avoid misdiagnosis and delays in appropriate treatment. Further research on temporal lesion that lead to hemichorea is warranted to gain a better understanding of the underlying mechanisms.
Anti-synthetase syndrome-associated interstitial lung disease possibly caused by atezolizumab in a patient with lung adenocarcinoma: a case report
Authors: Miyamoto Ippei , Shimizu Tetsuo , Kusahana Ryo , Nomoto Masayuki , Fujiwara Daishi , Nishizawa Tsukasa , Hayashi Kentaro , Nakagawa Yoshiko , Gon Yasuhiro
Published: May 2023

Background

Anti-aminoacyl-tRNA synthetase (ARS) antibody-positive patients present with a variety of symptoms, including interstitial lung disease (ILD), which is termed anti-synthetase syndrome (ASS). But it is rare that ASS-ILD is considered an immune-related adverse event after the use of immune checkpoint inhibitors (ICIs).

Case presentation

A 47-year-old male with advanced lung adenocarcinoma was treated with platinum and ICI combination immunotherapy and was followed up as an outpatient. Nine months after the start of treatment, he developed a fever and cough, and imaging findings showed lung consolidations in the bilateral lower lung fields. The patient was positive for anti- ARS antibodies and was considered to have developed ASS-ILD due to ICIs remitted with steroid therapy. The patient was found to be positive for anti-ARS antibodies before ICI administration, and the antibody titer was elevated compared to that before ICI administration.

Conclusions

The examination of anti-ARS antibodies pior to the administration of ICIs may be useful in predicting the development of ASS-ILD.
Are torso asymmetry and torso displacements in a computer brace model associated with initial in-brace correction in adolescent idiopathic scoliosis?
Authors: Peeters Charles M. M. , Pijpker Peter A. J. , Wapstra Frits-Hein , Kempen Diederik H. R. , Faber Chris
Published: May 2023

Background

Lack of initial in-brace correction is strongly predictive for brace treatment failure in adolescent idiopathic scoliosis (AIS) patients. Computer-aided design (CAD) technology could be useful in quantifying the trunk in 3D and brace characteristics in order to further investigate the effect of brace modifications on initial in-brace correction and subsequently long-term brace treatment success. The purpose of this pilot study was to identify parameters obtained from 3D surface scans which influence the initial in-brace correction (IBC) in a Boston brace in patients with AIS.

Methods

Twenty-five
AIS patients receiving a CAD-based Boston brace were included in this pilot study consisting of 11 patients with Lenke classification type 1 and 14 with type 5 curves. The degree of torso asymmetry and segmental peak positive and negative torso displacements were analyzed with the use of patients’ 3D surface scans and brace models for potential correlations with IBC.

Results

The mean IBC of the major curve on AP view was 15.9% (SD = 9.1%) for the Lenke type 1 curves, and 20.1% (SD = 13.9%) for the type 5 curves. The degree of torso asymmetry was weakly correlated with patient’s pre-brace major curve Cobb angle and negligible correlated with major curve IBC. Mostly weak or negligible correlations were observed between IBC and the twelve segmental peak displacements for both Lenke type 1 and 5 curves.

Conclusion

Based on the results of this pilot study, the degree of torso asymmetry and segmental peak torso displacements in the brace model alone are not clearly associated with IBC.
IRAK4 inhibition: an effective strategy for immunomodulating peri-implant osseointegration via reciprocally-shifted polarization in the monocyte-macrophage lineage cells
Authors: Zhao Juan , Li Jia , Xu Antian , Xu Yangbo , He Fuming , Mao Yingjie
Published: May 2023

Background

The biomaterial integration depends on its interaction with the host immune system. Monocyte-macrophage lineage cells are immediately recruited to the implant site, polarized into different phenotypes, and fused into multinucleated cells, thus playing roles in tissue regeneration. IL-1R-associated kinase 4 (IRAK4) inhibition was reported to antagonize inflammatory osteolysis and regulate osteoclasts and foreign body giant cells (FBGCs), which may be a potential target in implant osseointegration.

Methods

In in-vitro experiments, we established simulated physiological and inflammatory circumstances in which bone-marrow-derived macrophages were cultured on sand-blasted and acid-etched (SLA) titanium surfaces to evaluate the induced macrophage polarization, multinucleated cells formation, and biological behaviors in the presence or absence of IRAK4i. Then, bone marrow stromal stem cells (BMSCs) were cultured in the conditioned media collected from the aforementioned induced osteoclasts or FBGCs cultures to clarify the indirect coupling effect of multinucleated cells on BMSCs. We further established a rat implantation model, which integrates IRAK4i treatment with implant placement, to verify the positive effect of IRAK4 inhibition on the macrophage polarization, osteoclast differentiation, and ultimately the early peri-implant osseointegration in vivo.

Results

Under inflammatory conditions, by transforming the monocyte-macrophage lineage cells from M1 to M2, IRAK4i treatment could down-regulate the formation and activity of osteoclast and relieve the inhibition of FBGC generation, thus promoting osteogenic differentiation in BMSCs and improve the osseointegration.

Conclusion

This study may improve our understanding of the function of multinucleated cells and offer IRAK4i as a therapeutic strategy to improve early implant osseointegration and help to eliminate the initial implant failure.
Online education and improvement of caring behaviors of nurses in pediatric wards: a quasi-experimental study
Authors: Monemi Elnaz , Nematollahi Monirsadat
Published: May 2023

Background

Nurses working in pediatric wards should communicate with children well and have appropriate caring behaviors according to the age of their patients, so distance education is very suitable for them due to its availability. This study aimed to determine the effect of online education on the principles of pediatric nursing care on the caring behaviors of nurses working in pediatric wards.

Methods

This interventional (quasi-experimental) study used a simple random method to select 70 nurses working in pediatric wards and pediatric intensive care units in Kerman. The nurses in the intervention group received online training in the sky room three days a week, while nurses in the control group received routine pediatric care. The study instruments were the demographic information questionnaire and the Caring behaviors Questionnaire, which were completed by two groups before and one month after the intervention. Data were analyzed with SPSS 25. The significance level was set at P < 0.05.

Results

The independent samples t-test indicated no significant differences in the mean scores of care behaviors between the intervention (256.61 ± 5.16) and control groups (257.52 ± 3.99) before the intervention (P = 0.23) but indicated a significant difference in the mean scores of caring behaviors between the intervention (275.69 ± 6.52) and control groups (254.21 ± 3.15) after the intervention. Therefore, online education increased the score of caring behaviors in the intervention group.

Conclusion

Distance education had an impact on the caring behaviors of nurses in pediatric wards and we recommend the use of e-learning to improve the caring behaviors and the quality of care of nurses.
Community engagement processes in low- and middle-income countries health research settings: a systematic review of the literature
Authors: Mthembu Zinhle , Mogaka John J. O. , Chimbari Moses J.
Published: May 2023

Background

Community Engagement is an important ethical imperative in research. Although substantial research emphasizes its real value and strategic importance, much of the available literature focuses primarily on the success of community participation, with little emphasis given to specific community engagement processes, mechanisms and strategies in relation to intended outcomes in research environments. The systematic literature review’s objective was to explore the nature of community engagement processes, strategies and approaches in health research settings in low- and middle-income countries.

Methods

The systematic literature review design was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched for peer-reviewed, English-language literature published between January 2011 and December 2021 through three databases on the internet (PubMed, Web of Science and Google Scholar). The terms "community engagement," "community involvement," "participation," "research settings," and "low- and middle-income countries" were merged in the search.

Results

The majority of publications [8/10] were led by authors from low- and middle-income countries, with many of them, [9/10] failing to continuously include important aspects of study quality. Even though consultation and information sessions were less participatory, articles were most likely to describe community engagement in these types of events. The articles covered a wide range of health issues, but the majority were concerned with infectious diseases such as malaria, human immunodeficiency virus, and tuberculosis, followed by studies on the environment and broader health factors. Articles were largely under-theorized.

Conclusions

Despite the lack of theoretical underpinnings for various community engagement processes, strategies and approaches, community engagement in research settings was variable. Future studies should go deeper into community engagement theory, acknowledge the power dynamics underpin community engagement, and be more practical about the extent to which communities may participate.
Experiences of Assyrian refugee women seeking care for chronic pain: a qualitative study
Authors: Altun Areni , Brown Helen , Sturgiss Elizabeth , Russell Grant
Published: May 2023

Background

Refugee women exhibit some of the highest rates of chronic pain yet the diversity and challenges of health care systems across countries pose numerous challenges for refugee women trying to access quality health care.

Objective

We sought to explore the experiences of Assyrian refugee women seeking care for chronic pain.

Methods

Semi-structured interviews (face-to-face and virtual) were undertaken with 10 Assyrian women of refugee background living in Melbourne, Australia. Audio recordings and field notes of interviews were collected and themes were identified using a phenomenological approach. Women were required to be conversant in English or Arabic and willing to use a translator if necessary.

Results

We identified five major themes of women’s experiences accessing care for chronic pain: (1) the story of pain; (2) the experience of help seeking in Australia and home country; (3) factors shaping the ability to access appropriate care; (4) support seeking systems; and (5) influence of culture and gender roles.

Conclusion

Exploring refugee women’s experience of seeking care for chronic pain reinforces the need to explore hard to reach population’s perspectives in research and helps to understand how vectors of disadvantage may intersect. For successful integration into health care systems of host countries, particularly for complex conditions such as chronic pain, there is a need to work with women community members to develop programs that are culturally aligned to enhance access pathways to care.
Automatic detection and recognition of nasopharynx gross tumour volume (GTVnx) by deep learning for nasopharyngeal cancer radiotherapy through magnetic resonance imaging
Authors: Wang Yandan , Chen Hehe , Lin Jie , Dong Shi , Zhang Wenyi
Published: May 2023

Background

In this study, we propose the deep learning model-based framework to automatically delineate nasopharynx gross tumor volume (GTVnx) in MRI images.

Methods

MRI images from 200 patients were collected for training-validation and testing set. Three popular deep learning models (FCN, U-Net, Deeplabv3) are proposed to automatically delineate GTVnx. FCN was the first and simplest fully convolutional model. U-Net was proposed specifically for medical image segmentation. In Deeplabv3, the proposed Atrous Spatial Pyramid Pooling (ASPP) block, and fully connected Conditional Random Field(CRF) may improve the detection of the small scattered distributed tumor parts due to its different scale of spatial pyramid layers. The three models are compared under same fair criteria, except the learning rate set for the U-Net. Two widely applied evaluation standards, mIoU and mPA, are employed for the detection result evaluation.

Results

The extensive experiments show that the results of FCN and Deeplabv3 are promising as the benchmark of automatic nasopharyngeal cancer detection. Deeplabv3 performs best with the detection of mIoU 0.8529 ± 0.0017 and mPA 0.9103 ± 0.0039. FCN performs slightly worse in term of detection accuracy. However, both consume similar GPU memory and training time. U-Net performs obviously worst in both detection accuracy and memory consumption. Thus U-Net is not suggested for automatic GTVnx delineation.

Conclusions

The proposed framework for automatic target delineation of GTVnx in nasopharynx bring us the desirable and promising results, which could not only be labor-saving, but also make the contour evaluation more objective. This preliminary results provide us with clear directions for further study.
Surgical site infection in spinal surgery: a bibliometric analysis
Authors: Wang Xun , Lin Yanze , Yao Wenchao , Zhang Aiqi , Gao Liqing , Feng Fabo
Published: May 2023

Background

Surgical site infection (SSI) is a common complication in spinal surgery that can significantly affect the patient's prognosis. Despite advances in surgical techniques and infection control measures, SSI remains a considerable concern for healthcare providers and patients alike. In recent years, there has been a steady increase in studies related to SSI in spine surgery, leading to the publication of numerous informative articles. However, the current state and trends of research in the field of spinal SSI remain unclear. This study aims to conduct a bibliometric analysis of SSI-related articles in spine surgery to identify research status and trends. Meanwhile, we identify the top 100 most cited articles for further analysis.

Methods

We searched for all articles related to spinal SSI in the Web of Science Core Collection, recording the publication year, country, journal, institution, keywords, and citation frequency for further analysis. In addition, we identified and analyzed the top 100 most cited articles.

Results

A total of 307 articles related to spinal SSI were identified. All of these articles were published between 2008 and 2022, with the number of publications showing an increasing trend over the years. The related articles originated from 37 countries, with the USA contributing the most (n = 138). The institution with the highest number of publications and citations was Johns Hopkins University (14 articles; 835 citations). Among the journals, Spine had the highest number of articles (n = 47). The prevention of spinal SSI has been a research hotspot in recent years. Among the top 100 most cited articles, the most common research theme was the risk factors associated with spinal SSI.

Conclusions

In recent years, research related to spinal SSI has attracted the attention of numerous clinicians and scholars. As the first bibliometric analysis of spinal SSI, our study aims to provide pragmatic guidance for clinicians to learn the research status and trends in this field and improve their vigilance toward SSI.
Stimuli-responsive polymer-based bioinspired soft robots
Authors: Panda Swati , Hajra Sugato , Rajaitha P. Mary , Kim Hoe Joon
Published: May 2023

Soft robotics enables various applications in certain environments where conventional rigid robotics cannot deliver the same performance due to their form factor and stiffness. Animals use their soft external organs to carry out activities in response to challenging natural environments efficiently. The objective of soft robots is to provide biologically inspired abilities and enable adaptable and flexible interactions with complex objects and surroundings. Recent advances in stimuli-responsive soft robot technology have heavily used polymer-based multifunctional materials. Soft robots with incredibly sophisticated multi-mechanical, electrical, or optical capabilities have demonstrated the ability to modify their shape intelligently in response to external stimuli, such as light, electricity, thermal gradient, and magnetic fields. This short review covers recent advances in scientific techniques for incorporating multifunctional polymeric materials into stimuli-responsive bioinspired soft robots and their applications. We also discuss how biological inspiration and environmental effects can provide a viable viewpoint for bioinspired design in the innovative field of soft robotics. Lastly, we highlight the future outlooks and prospects for soft, stimuli-responsive, bio-inspired robots.
Data infrastructures for AI in medical imaging: a report on the experiences of five EU projects
Authors: Kondylakis Haridimos , Kalokyri Varvara , Sfakianakis Stelios , Marias Kostas , Tsiknakis Manolis , Jimenez-Pastor Ana , Camacho-Ramos Eduardo , Blanquer Ignacio , Segrelles J. Damian , López-Huguet Sergio , Barelle Caroline , Kogut-Czarkowska Magdalena , Tsakou Gianna , Siopis Nikolaos , Sakellariou Zisis , Bizopoulos Paschalis , Drossou Vicky , Lalas Antonios , Votis Konstantinos , Mallol Pedro , Marti-Bonmati Luis , Alberich Leonor Cerdá , Seymour Karine , Boucher Samuel , Ciarrocchi Esther , Fromont Lauren , Rambla Jordi , Harms Alexander , Gutierrez Andrea , Starmans Martijn P. A. , Prior Fred , Gelpi Josep Ll. , Lekadir Karim
Published: May 2023

Artificial intelligence (AI) is transforming the field of medical imaging and has the potential to bring medicine from the era of ‘sick-care’ to the era of healthcare and prevention. The development of AI requires access to large, complete, and harmonized real-world datasets, representative of the population, and disease diversity. However, to date, efforts are fragmented, based on single–institution, size-limited, and annotation-limited datasets. Available public datasets (e.g., The Cancer Imaging Archive, TCIA, USA) are limited in scope, making model generalizability really difficult. In this direction, five European Union projects are currently working on the development of big data infrastructures that will enable European, ethically and General Data Protection Regulation-compliant, quality-controlled, cancer-related, medical imaging platforms, in which both large-scale data and AI algorithms will coexist. The vision is to create sustainable AI cloud-based platforms for the development, implementation, verification, and validation of trustable, usable, and reliable AI models for addressing specific unmet needs regarding cancer care provision. In this paper, we present an overview of the development efforts highlighting challenges and approaches selected providing valuable feedback to future attempts in the area.

Key points

• Artificial intelligence models for health imaging require access to large amounts of harmonized imaging data and metadata.

• Main infrastructures adopted either collect centrally anonymized data or enable access to pseudonymized distributed data.

• Developing a common data model for storing all relevant information is a challenge.

• Trust of data providers in data sharing initiatives is essential.

• An online European Union meta-tool-repository is a necessity minimizing effort duplication for the various projects in the area.
Hemostasis assessment in Fontan patients using the new thrombodynamics test
Authors: Minaev Anton V. , Gushchin Dmitry K. , Kovalev Dmitry V. , Mwela Bupe M.
Published: May 2023

Background

Thromboembolic events are a well-known risk for Fontan patients and often lead to morbidity and mortality in cyanotic patients and patients with a single ventricle. Coagulopathy and thrombophilia, in addition to disturbed Fontan blood flow and endothelial injury, are major contributors to thromboembolic complications. However, there is currently no consensus regarding the optimal medication to prevent or treat these events. Identification of coagulation disorders is therefore crucial for selecting appropriate management strategies and evaluating long-term outcomes in these patients.

Case presentation

We present the case of a 35-year-old male who underwent the Fontan procedure with a total cavopulmonary modification during childhood due to tricuspid atresia. He was admitted with complaints of headaches and visual disturbances, but no clear cardiovascular cause was identified. Standard coagulation test parameters were normal, but the thrombodynamics test indicated severe hypercoagulation and spontaneous clot formation. Anticoagulation therapy was initiated, and a subsequent thrombodynamics assay showed normalization of the coagulation parameters. The patient remained asymptomatic during the six-month follow-up period.

Conclusions

The thrombodynamics test is a valuable tool for the diagnosis of coagulation disorders, as it can assess coagulation parameters and clot growth in vitro. This method can also aid in the optimization of antithrombotic therapy. The presented clinical case highlights the potential use of the thrombodynamics test in Fontan patients to diagnose coagulation disorders and improve long-term outcomes.
Biochemical Markers of Bone Fragility in Patients With Diabetes
Authors: Meier Christian , Eastell Richard , Pierroz Dominique D , Lane Nancy E , Al-Daghri Nasser , Suzuki Atsushi , Napoli Nicola , Mithal Ambrish , Chakhtoura Marlene , Fuleihan Ghada El-Hajj , Ferrari Serge
Published: May 2023

Context

The risk of fragility fractures is increased in both type 1 and type 2 diabetes. Numerous biochemical markers reflecting bone and/or glucose metabolism have been evaluated in this context.

Objective

This review summarizes current data on biochemical markers in relation to bone fragility and fracture risk in diabetes.

Methods

A group of experts from the International Osteoporosis Foundation and European Calcified Tissue Society reviewed the literature focusing on biochemical markers, diabetes, diabetes treatments, and bone in adults.

Results

Although bone resorption and bone formation markers are low and poorly predictive of fracture risk in diabetes, osteoporosis drugs seem to change bone turnover markers (BTMs) in diabetics similarly to nondiabetics, with similar reductions in fracture risk. Several other biochemical markers related to bone and glucose metabolism have been correlated with bone mineral density and/or fracture risk in diabetes, including osteocyte-related markers such as sclerostin, glycated hemoglobin A1c (HbA1c) and advanced glycation end products, inflammatory markers, and adipokines, as well as insulin-like growth factor-1 and calciotropic hormones.

Conclusion

Several biochemical markers and hormonal levels related to bone and/or glucose metabolism have been associated with skeletal parameters in diabetes. Currently, only HbA1c levels seem to provide a reliable estimate of fracture risk, while BTMs could be used to monitor the effects of antiosteoporosis therapy.
CONSUMO E QUESTÕES SOCIOAMBIENTAIS: A REPRESENTAÇÃO DO EU COMO PROCESSO SOCIAL
Authors: Calgaro Cleide , Ruscheinsky Aloisio
Published: May 2023

Objetivo: A dimensão analítica, levando em consideração a obra de autor como base especificada, possui como objetivo explorar as performances em face do consumo perdulário, a representação que consolida fachadas e as questões socioambientais.Metodologia: Como metodologia, adota-se uma abordagem qualitativa, por meio de revisão da literatura especializada e de legislação, tendo como método o analítico.Resultados: Ao término, conclui-se que a expansão do consumo requisita a criação de um conjunto de máscaras manejadas pelos atores na sociedade contemporânea para representar e aparentar, concomitantemente emergem os dilemas socioambientais, porém relegados a um segundo plano e deixados de lado. Sob a dimensão do consumidor, a maioria dos problemas socioambientais são engendrados pela adesão ao fenômeno da circulação de mercadorias.Contribuições: O presente trabalho aborda o nexo entre as representações do eu na vida cotidiana (Goffman) e a conformação da sua possível conexão com o consumo, com envolvimento de questões socioambientais prementes.
A APLICAÇÃO DA ANÁLISE CRÍTICA DO DISCURSO NO ESTUDO DA INVIOLABILIDADE DOMICILIAR
Authors: Carvalho Alexander Perazo Nunes de , Lobo Júlio César Matias , Carvalho Augusto Amaral Borgongino de
Published: May 2023

Contextualização: No tema 280, o Supremo Tribunal Federal (STF) fixou a tese de que a entrada forçada em domicílio sem mandado judicial pressupõe a existência de fundadas razões. O Superior Tribunal de Justiça (STJ), além de fixar a ideia de standard probatório para ingresso no domicílio do suspeito sem mandado judicial, passou a exigir também a demonstração de urgência para o ingresso e o consentimento voluntário e livre de qualquer tipo de constrangimento ou coação, cabendo à autoridade estatal o ônus de provar a legalidade e a voluntariedade do consentimento do morador.Objetivo: Apesar da mudança de entendimento dos tribunais superiores, faz-se necessário verificar se há comunicação entre o entendimento dos tribunais superiores e o posicionamento do Tribunal de Justiça do Estado do Ceará (TJCE), utilizando-se, para tanto, a Análise Crítica do Discurso (ACD), que se mostra útil ao revelar a ideologia por trás do discurso jurídico.Método: A pesquisa se utilizará da revisão bibliográfica, legislativa e jurisprudencial sobre o assunto, valendo-se de obras da Teoria do Direito, da Hermenêutica Filosófica e da ACD, vislumbrando uma análise dialética sobre a atuação do TJCE.Conclusão: entende-se que o Direito deve ser aplicado, tendo em vista a realidade do seu operador. Assim, o entendimento atual dos Tribunais Superiores tem representado um avanço na proteção dos direitos fundamentais, refletindo nas decisões do TJCE, com o intuito de inibir situações em que autoridades policiais atuam, insistentemente, à margem dos entendimentos das Cortes.
Η αστική ιατρική ευθύνη στο πεδίο της ανθρώπινης αναπαραγωγής
Authors: Φύτρου Παρασκευή
Published: May 2023

Η παρούσα διατριβή επιχειρεί τη νομική αξιολόγηση της ιατρικής πράξης αναπαραγωγής σε ένα ευρύτατο πεδίο εφαρμογών, με βάση τη χρονική σταδιοποίηση της διαδικασίας, τόσο κατά τη φυσική όσο και κατά την υποβοηθούμενη αναπαραγωγή, δυνάμει του υφιστάμενου νομοθετικού πλαισίου και της αντίστοιχης νομολογίας και με την παράθεση δικαιοσυγκριτικών στοιχείων αλλοδαπών εννόμων τάξεων. Ειδικότερα ερευνά, υπό ποιες προϋποθέσεις μια ιατρική συμπεριφορά συνιστά ιατρικό σφάλμα που επισύρει νομικές συνέπειες αστικής φύσης για τον ιατρό και θεμελιώνει αποζημιωτικές αξιώσεις για τον ασθενή.