bluuebunny/crossref_metadata_2025 huggingface dataset:
Commentary: The Boy Who Cried Wolf or Cassandra? A Consideration of the Correct Characterization of Critics of Neoliberal Reforms to the English NHS
Authors: Benbow David I.
Published: January 2023

Peter Roderick and Allyson Pollock's article, “Dismantling the National Health Service in England,” provides a history of the market incrementalism that has dominated UK government policy pertaining to the English National Health System (NHS), in recent decades. It also contains an analysis of the latest statute to reform the English NHS, namely the Health and Care Act 2022. It is often argued that the concerns—for example, about privatization—of those who critique neoliberal reforms to the English NHS are misplaced. I highlight that such neoliberal reforms have increased the proportion of the budget of the English NHS that is being diverted to private providers. Consequently, I aver that the term privatization accurately describes what has been occurring within the English NHS. I contend that the arguments of those who deny or downplay the privatization of the English NHS are indicative of some of the ideological strategies that the sociologist John B. Thompson identified. My commentary suggests that the concerns of critics of neoliberal reforms to the English NHS, such as Roderick and Pollock, are not misplaced and that more heed should be given to their analyses and warnings.
ERS International Congress 2022: highlights from the Interstitial Lung Diseases Assembly
Authors: Karampitsakos Theodoros , Diep Phuong Phuong , Loth Daan W. , Nadeem Iftikhar , Khurtsidze Elene , Wijsenbeek Marlies S. , Wuyts Wim A. , Bargagli Elena , Froidure Antoine , Spagnolo Paolo , Veltkamp Marcel , Molina-Molina Maria , McCarthy Cormac , Antoniou Katerina M. , Kreuter Michael , Moor Catharina C.
Published: January 2023

This article contains a selection of scientific highlights in the field of interstitial lung diseases (ILDs) presented at the hybrid European Respiratory Society International Congress 2022. Early Career Members of Assembly 12 summarise recent advances in translational and clinical research in idiopathic interstitial pneumonias, ILDs of known origin, sarcoidosis and other granulomatous diseases, and rare ILDs. Many studies focused on evaluation of diagnostic and prognostic (bio)markers, and novel pharmacological and nonpharmacological treatment options for different ILDs. In addition, new insights in clinical, physiological and radiological features of various rare ILDs were presented.
Transcription factors: key regulatory targets of vascular smooth muscle cell in atherosclerosis
Authors: Jiang Yu , Qian Hai-Yan
Published: January 2023

Atherosclerosis (AS), leading to gradual occlusion of the arterial lumen, refers to the accumulation of lipids and inflammatory debris in the arterial wall. Despite therapeutic advances over past decades including intervention or surgery, atherosclerosis is still the most common cause of cardiovascular diseases and the main mechanism of death and disability worldwide. Vascular smooth muscle cells (VSMCs) play an imperative role in the occurrence of atherosclerosis and throughout the whole stages. In the past, there was a lack of comprehensive understanding of VSMCs, but the development of identification technology, including in vivo single-cell sequencing technology and lineage tracing with the CreERT2-loxP system, suggests that VSMCs have remarkable plasticity and reevaluates well-established concepts about the contribution of VSMCs. Transcription factors, a kind of protein molecule that specifically recognizes and binds DNA upstream promoter regions or distal enhancer DNA elements, play a key role in the transcription initiation of the coding genes and are necessary for RNA polymerase to bind gene promoters. In this review, we highlight that, except for environmental factors, VSMC genes are transcriptionally regulated through complex interactions of multiple conserved cis-regulatory elements and transcription factors. In addition, through a series of transcription-related regulatory processes, VSMCs could undergo phenotypic transformation, proliferation, migration, calcification and apoptosis. Finally, enhancing or inhibiting transcription factors can regulate the development of atherosclerotic lesions, and the downstream molecular mechanism of transcriptional regulation has also been widely studied.
LINC00963 promotes the malignancy and metastasis of lung adenocarcinoma by stabilizing Zeb1 and exosomes-induced M2 macrophage polarization
Authors: Hu Ronghang , Xu Baobin , Ma Jiajun , Li Linfeng , Zhang Liming , Wang Li , Zhu Jiebo , Guo Tao , Zhang Heng , Wang Shaoqiang
Published: January 2023

Background

Long intergenic non-coding RNA 00963 (LINC00963) is an oncogenic lncRNA in human cancers. However, little is known on how it impacts the pathogenesis of lung adenocarcinoma (LUAD).

Methods

Biological effects on proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) were examined by CCK-8, colony formation, EdU incorporation, transwell, and immunofluorescence assays, respectively. Macrophage polarization was evaluated by flow cytometry. Ubiquitination of Zeb1 was examined by co-immunoprecipitation. The location of LINC00963 in LUAD tissues and cell lines was tested by FISH assay. The LINC00963/HNRNPA2B1/Siah1 mRNA complex interaction was verified using RNA pull-down and immunoprecipitation assays. The exact roles of LINC00963 were further validated in metastasis and xenograft models.

Results

Higher LINC00963 expression in LUAD patients positively correlated with shorter overall survival, higher stages, and metastasis. LINC00963 mainly localized in the cytoplasm and aggravated malignant phenotypes of LUAD cells in vitro and metastasis in vivo. Mechanistically, LINC00963 directly interacted HNRNPA2B1 protein to trigger the degradation of Siah1 mRNA, which inhibited the ubiquitination and degradation of Zeb1. Moreover, exosomal LINC00963 derived from LUAD cells induced M2 macrophage polarization and promoted LUAD growth and metastasis.

Conclusion

By stabilizing Zeb1 in cancer cells and delivering exosomes to induce M2 macrophage polarization, LINC00963 promoted the malignancy and metastasis of LUAD. Targeting LINC00963 may become a valuable therapeutic target for LUAD.
Evaluation of Surface Roughness of Aluminum Alloy in Burnishing Process Based on Chaos Theory
Authors: Yuan Zhipeng , Zhou Zhenyu , Jiang Zhiguo , Zhao Zeyu , Ding Cong , Piao Zhongyu
Published: January 2023

Burnishing experiments with different burnishing parameters were performed on a computer numerical control milling machine to characterize the surface roughness of an aluminum alloy during burnishing. The chaos theory was employed to investigate the nonlinear features of the burnishing system. The experimental results show that the power spectrum is broadband and continuous, and the Lyapunov exponent λ is positive, proving that burnishing has chaotic characteristics. The chaotic characteristic parameter, the correlation dimension D, is sensitive to the time behavior of the system and is used to establish the corresponding relationship with the surface roughness. The correlation dimension was the largest, when the surface roughness was the smallest. Furthermore, when the correlation dimension curve decreases, the roughness curve increases. The correlation dimension and surface roughness exhibit opposite variation trends. The higher the correlation dimension, the lower the surface roughness. The surface roughness of the aluminum alloy can be characterized online by calculating the correlation dimension during burnishing.
ASV portal: an interface to DNA-based biodiversity data in the Living Atlas
Authors: Prager Maria , Lundin Daniel , Ronquist Fredrik , Andersson Anders F.
Published: January 2023

Background

The Living Atlas is an open source platform used to collect, visualise and analyse biodiversity data from multiple sources, and serves as the national biodiversity data hub in many countries. Although powerful, the Living Atlas has had limited functionality for species occurrence data derived from DNA sequences. As a step toward integrating this fast-growing data source into the platform, we developed the Amplicon Sequence Variant (ASV) portal: a web interface to sequence-based biodiversity observations in the Living Atlas.

Results

The ASV portal allows data providers to submit denoised metabarcoding output to the Living Atlas platform via an intermediary ASV database. It also enables users to search for existing ASVs and associated Living Atlas records using the Basic Local Alignment Search Tool, or via filters on taxonomy and sequencing details. The ASV portal is a Python-Flask/jQuery web interface, implemented as a multi-container docker service, and is an integral part of the Swedish Biodiversity Data Infrastructure.

Conclusion

The ASV portal is a web interface that effectively integrates biodiversity data derived from DNA sequences into the Living Atlas platform.
N-Acetyl-L-cysteine facilitates tendon repair and promotes the tenogenic differentiation of tendon stem/progenitor cells by enhancing the integrin α5/β1/PI3K/AKT signaling
Authors: Lu Kang , Zhou Mei , Wang Liyuan , Wang Yang , Tang Hong , He Gang , Wang Huan , Tang Chuyue , He Jie , Wang Wei , Tang Kanglai , Wang Yunjiao , Deng Zhongliang
Published: January 2023

Background

Tendon injury is associated with oxidative stress, leading to reactive oxygen species (ROS) production and inflammation. N-acetyl-L-cysteine (NAC) is a potent antioxidant. However, how NAC affects the biological functions of tendon stem/progenitor cells (TSPCs) and tendon repair has not been clarified. 

Method

The impacts of NAC on the viability, ROS production, and differentiation of TSPCs were determined with the cell counting kit-8, fluorescence staining, Western blotting, and immunofluorescence. The effect of NAC on gene transcription in TSPCs was analyzed by transcriptomes and bioinformatics and validated by Western blotting. The potential therapeutic effect of NAC on tendon repair was tested in a rat model of Achilles tendon injury.

Results

Compared with the untreated control, treatment with 500 µM NAC greatly promoted the proliferation of TSPCs and significantly mitigated hydrogen peroxide-induced ROS production and cytotoxicity in vitro. NAC treatment significantly increased the relative protein expression of collagen type 1 alpha 1 (COL1A1), tenascin C (TNC), scleraxis (SCX), and tenomodulin (TNMD) in TPSCs. Bioinformatics analyses revealed that NAC modulated transcriptomes, particularly in the integrin-related phosphoinositide 3-kinase (PI3K)/AKT signaling, and Western blotting revealed that NAC enhanced integrin α5β1 expression and PI3K/AKT activation in TSPCs. Finally, NAC treatment mitigated the tendon injury, but enhanced the protein expression of SCX, TNC, TNMD, and COLIA1 in the injured tissue regions of the rats.

Conclusion

NAC treatment promoted the survival and differentiation of TSPCs to facilitate tendon repair after tendon injury in rats. Thus, NAC may be valuable for the treatment of tendon injury.
Enviromic-based kernels may optimize resource allocation with multi-trait multi-environment genomic prediction for tropical Maize
Authors: Gevartosky Raysa , Carvalho Humberto Fanelli , Costa-Neto Germano , Montesinos-López Osval A. , Crossa José , Fritsche-Neto Roberto
Published: January 2023

Background

Success in any genomic prediction platform is directly dependent on establishing a representative training set. This is a complex task, even in single-trait single-environment conditions and tends to be even more intricated wherein additional information from envirotyping and correlated traits are considered. Here, we aimed to design optimized training sets focused on genomic prediction, considering multi-trait multi-environment trials, and how those methods may increase accuracy reducing phenotyping costs. For that, we considered single-trait multi-environment trials and multi-trait multi-environment trials for three traits: grain yield, plant height, and ear height, two datasets, and two cross-validation schemes. Next, two strategies for designing optimized training sets were conceived, first considering only the genomic by environment by trait interaction (GET), while a second including large-scale environmental data (W, enviromics) as genomic by enviromic by trait interaction (GWT). The effective number of individuals (genotypes × environments × traits) was assumed as those that represent at least 98% of each kernel (GET or GWT) variation, in which those individuals were then selected by a genetic algorithm based on prediction error variance criteria to compose an optimized training set for genomic prediction purposes.

Results

The combined use of genomic and enviromic data efficiently designs optimized training sets for genomic prediction, improving the response to selection per dollar invested by up to 145% when compared to the model without enviromic data, and even more when compared to cross validation scheme with 70% of training set or pure phenotypic selection. Prediction models that include G × E or enviromic data + G × E yielded better prediction ability.

Conclusions

Our findings indicate that a genomic by enviromic by trait interaction kernel associated with genetic algorithms is efficient and can be proposed as a promising approach to designing optimized training sets for genomic prediction when the variance-covariance matrix of traits is available. Additionally, great improvements in the genetic gains per dollar invested were observed, suggesting that a good allocation of resources can be deployed by using the proposed approach.
Transcriptomic and metabolomic data reveal key genes that are involved in the phenylpropanoid pathway and regulate the floral fragrance of Rhododendron fortunei
Authors: Yang Guoxia , Qin Yi , Jia Yonghong , Xie Xiaohong , Li Dongbin , Jiang Baoxin , Wang Qu , Feng Siyu , Wu Yueyan
Published: January 2023

Background

To reveal the key genes involved in the phenylpropanoid pathway, which ultimately governs the fragrance of Rhododendron fortunei, we performed a comprehensive transcriptome and metabolomic analysis of the petals of two different varieties of two alpine rhododendrons: the scented R. fortunei and the unscented Rhododendron ‘Nova Zembla’.

Results

Our transcriptomic and qRT–PCR data showed that nine candidate genes were highly expressed in R. fortunei but were downregulated in Rhododendron ‘Nova Zembla’. Among these genes, EGS expression was significantly positively correlated with various volatile benzene/phenylpropanoid compounds and significantly negatively correlated with the contents of various nonvolatile compounds, whereas CCoAOMT, PAL, C4H, and BALDH expression was significantly negatively correlated with the contents of various volatile benzene/phenylpropanoid compounds and significantly positively correlated with the contents of various nonvolatile compounds. CCR, CAD, 4CL, and SAMT expression was significantly negatively correlated with the contents of various benzene/phenylpropanoid compounds. The validation of RfSAMT showed that the RfSAMT gene regulates the synthesis of aromatic metabolites in R. fortunei.

Conclusion

The findings of this study indicated that key candidate genes and metabolites involved in the phenylpropanoid biosynthesis pathway may govern the fragrance of R. fortunei. This lays a foundation for further research on the molecular mechanism underlying fragrance in the genus Rhododendron.
Socioeconomic inequality in cognitive impairment among India’s older adults and its determinants: a decomposition analysis
Authors: Sharma Madhurima , Pradhan Manas Ranjan
Published: January 2023

Background

Cognitive impairment (CoI) is a significant risk factor for ill-health status among the older adults and a major burden on public health. This study unearths the degree of socioeconomic inequalities and assesses the determinants of CoI among the older adults in India.

Methods

Data on cognitive impairment of older adults aged 60 + years (n = 31,646) gathered in a nationally representative Longitudinal Ageing Study in India (2017–18) was analyzed through STATA with a significance level of 5%. Binary logistic regression, the concentration index, concentration curve, and Shapley decomposition analysis were performed to assess the socioeconomic inequalities and the determinants of CoI.

Results

Sixteen percent of the older adults had CoI. Females (OR = 1.88, 95% CI = 1.70–2.09), those aged 80 plus years (OR = 3.98, 95%CI = 3.56–4.44), from ST (OR = 2.65, 95%CI = 2.32–3.02), with perceived poor health (OR = 1.61,95%CI = 1.45–1.79), with depression (OR = 1.32, 95%CI = 1.21–1.43), with no schooling (OR = 16.46, 95%CI = 11.31–23.97) with 1 + ADL (OR = 1.43, 95%CI = 1.31–1.57) and 1 + IADL (OR = 1.30, 95%CI = 1.19–1.41) had higher odds of CoI than their respective counterparts. Older adults from urban areas (OR = 0.63, 95%CI = 0.57–0.70), higher income groups (OR = 0.61, 95%CI = 0.53- 0.70) and higher education level with sources of financial support (OR = 0.68, 95%CI = 0.61- 0.76) less likely to experience CoI. Economic inequalities exist in the distribution of CoI-the poorest being the most disadvantaged (concentration index value = -0.118).

Conclusions

There are socioeconomic-related inequalities in CoI among the older adults. The socioeconomically vulnerable older adults, including those illiterates, with poor economic status, women, not-in-union, the older, and those without social support, are more likely to develop CoI. The results suggest awareness generation and more customized policies and programs to reduce the socioeconomic inequalities in CoI among the older adults in India. The improved mental health of the older adults will contribute to achieving Sustainable Development Goals, including Goal 3 on guaranteeing good health and well-being for all.
Epidemiology of tuberculosis and susceptibility to antituberculosis drugs in Reunion Island
Authors: Loukman Moreea , Olivier Belmonte , Vincent Boulay , Rachid Dekkak , Cyril Ferdynus , Morgane Verduyn , Nathalie Coolen-Allou
Published: January 2023

Background

Tuberculosis is the first fatal infectious agent in the world with 1.2 million annual deaths for 10 million cases. Little is known about the epidemiology of tuberculosis and its resistance in Reunion Island, which is at the heart of migratory flows from highly endemic Indian Ocean territories.

Methods

We carried out a retrospective observational study of cases of tuberculosis disease in Reunion Island between 2014 and 2018. The epidemiological, demographic, microbiological, clinical and social characteristics were analyzed from mandatory declarations, microbiology database and medical files.

Results

265 cases of tuberculosis disease were recorded over the period, ie an incidence of 6.2 / 100,000 inhabitants. 114 patients (43%) were born or resided > 6 months in the rest of the Indian Ocean area. The risk of infection was increased if birth in Madagascar (OR 23.5), Comoros (OR 8.9) or Mayotte (OR 6.8). The prevalence of HIV co-infection was low (2.5%). There were 31 cases (14.4%) of resistance to antituberculosis including 3 (1.4%) of multidrug-resistant tuberculosis and 0 case of extensively drug-resistant tuberculosis. The female gender (61.3% of resistant) was associated with resistance. The resistance rate was not significantly different depending on the geographic origin.

Conclusion

This is the first exhaustive epidemiological study of tuberculosis in Reunion Island. The incidence there is relatively low but increased for people with links to neighboring islands, particularly Madagascar. The prevalence of multidrug resistance is low, with no associated increased risk for patients from the Indian Ocean area.
Management of massive cerebral infarction as a complication of post-tonsillectomy and analysis of the risk factors: a case report
Authors: Zhao Jinghao , Lei Yubo , Hu Na , Xia Lang , Zeng Liyang , Zhang Yongheng , Qin Wei
Published: January 2023

Background

The majority of postoperative complications of tonsillectomy are bleeding. However, massive cerebral infarction following haemostasis is a very rare and serious complication and has rarely been reported clinically.

Case presentation

We performed a left tonsillectomy on a patient with chronic tonsillitis. After that, active bleeding was found under the tonsillar fossa, so an exploratory hypopharyngeal haemostasis was performed. However, the bleeding worsened intraoperatively, so the patient was converted to a cervical angiographic embolization. The interventional procedure was completed successfully without an ectopic embolic event. After the procedure, the patient was transferred to the intensive care unit (ICU) and was diagnosed with acute massive cerebral infarction in the left cerebral hemisphere after awakening symptoms combined with cranial computed tomography angiography (CTA) results. Symptomatic treatment such as sedation and analgesia, dehydration to lower intracranial pressure, and maintenance of respiratory and circulatory stability was then administered. After treatment, the patient’s condition stabilized and he was transferred to the rehabilitation physiotherapy unit for rehabilitation.

Conclusion

Post-tonsillectomy haemorrhage can be augmented with a carotid arteriogram to clarify whether the tonsillar fossa is at a safe distance from the posterior internal carotid artery. Furthermore, interventional haemostasis can also be performed as early as possible to reduce the incidence of complications in cases of persistent post-tonsillectomy bleeding.
The trace that is valuable: serum copper and copper to zinc ratio for survival prediction in younger patients with newly diagnosed acute myeloid leukaemia
Authors: Li Taotao , Shi Liming , Wei Wei , Xu Jiancheng , Liu Qiuju
Published: January 2023

Purpose

No data on predicting the survival of AML patients based on the level of trace elements in the serum have been presented to date. The aims of this prospective cohort study were as follows: (i) to evaluate the serum Cu and Zn levels in people from Northeast China, (ii) to assess the association between the serum Cu level (SCL) and Cu to Zn ratio (SCZR) and clinical and nutrition data, and (iii) to investigate the predictive values of the SCL and SCZR in newly diagnosed de novo AML patients.

Methods

A total of 105 newly diagnosed AML patients and 82 healthy controls were recruited. The serum Cu and Zn levels were determined by inductively coupled plasma spectrometry. The associations of SCL and SCZR with the survival of these AML patients were assessed by Cox proportional hazards models.

Results

Both SCL and SCZR were positively related to the blast percentage of bone marrow and C-reactive protein, negatively related to albumin level andCEBPAdouble mutation and were significantly associated with worse overall survival and disease-free survival. Meanwhile, patients with higher SCL had worse CTCAE levels, and patients with higher SCZR showed less complete remission during the first course of induction chemotherapy. Moreover, higher SCZR was positively associated with ELN risk stratification, and was negatively associated with haemoglobin level and prognostic nutritional index (PNI).

Conclusion

The SCL and SCZR are associated with long-term survival in patients with newly diagnosed AML undergoing intensive induction and may serve as important predictive biomarkers.
Pseudoaneurysm of the brachial artery in an infant due to vaccination: a case report
Authors: Shi Hai-fei , Yuan Shuai , Liang Ke-jiong , Ye Po , Yang Hu
Published: January 2023

Background

Pseudoaneurysm is a known complication of penetrating arterial injuries such as catheterization, gunshot wounds, and open fractures. Vaccination is an effective method for preventing multiple, serious, infectious diseases in children. Common adverse reactions related to vaccination include fever, swelling, redness, and pain. Brachial pseudoaneurysm after vaccination has not been previously reported.

Case presentation

Herein we describe a novel case of brachial pseudoaneurysm after vaccination in a child aged 1 year and 3 months. A pulsatile mass was formed in the medial left arm of the infant 10 days after vaccination at a community hospital and gradually grew larger. Preoperative images depicted an eccentric aneurysm in the brachial artery and a swirling flow pattern in the mass. The pseudoaneurysm was excised, and vein graft interpositioning was successfully performed. There were no short-term or long-term complications during the follow-up period.

Conclusions

Brachial pseudoaneurysm is a rare complication of vaccination via intramuscular injection. Medical staff should avoid puncture wounds to the brachial artery during vaccination, especially in infants.
Effective factors of improved helmet use in motorcyclists: a systematic review
Authors: Mahdavi Sharif Pouya , Najafi Pazooki Sara , Ghodsi Zahra , Nouri Ahmad , Ghoroghchi Hamed Abbasizade , Tabrizi Reza , Shafieian Mehdi , Heydari Seyed Taghi , Atlasi Rasha , Sharif-Alhoseini Mahdi , Ansari-Moghaddam Alireza , O’Reilly Gerard , Rahimi-Movaghar Vafa
Published: January 2023

Background

Road traffic injuries (RTI) are one of the most prominent causes of morbidity and mortality, especially among children and young adults. Motorcycle crashes constitute a significant part of RTIs. Policymakers believe that safety helmets are the single most important protection against motorcycle-related injuries. However, motorcyclists are not wearing helmets at desirable rates. This study systematically investigated factors that are positively associated with helmet usage among two-wheeled motorcycle riders.

Methods

We performed a systematic search on PubMed, Scopus, Web of Science, Embase, and Cochrane library with relevant keywords. No language, date of publication, or methodological restrictions were applied. All the articles that had evaluated the factors associated with helmet-wearing behavior and were published before December 31, 2021, were included in our study and underwent data extraction. We assessed the quality of the included articles using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for observational studies.

Results

A total of 50 articles were included. Most evidence suggests that helmet usage is more common among drivers (compared to passengers), women, middle-aged adults, those with higher educations, married individuals, license holders, and helmet owners. Moreover, the helmet usage rate is higher on highways and central city roads and during mornings and weekdays. Travelers of longer distances, more frequent users, and riders of motorcycles with larger engines use safety helmets more commonly. Non-helmet-using drivers seem to have acceptable awareness of mandatory helmet laws and knowledge about their protective role against head injuries. Importantly, complaint about helmet discomfort is somehow common among helmet-using drivers.

Conclusions

To enhance helmet usage, policymakers should emphasize the vulnerability of passengers and children to RTIs, and that fatal crashes occur on low-capacity roads and during cruising at low speeds. Monitoring by police should expand to late hours of the day, weekends, and lower capacity and less-trafficked roads. Aiming to enhance the acceptance of other law-abiding behaviors (e.g., wearing seat belts, riding within the speed limits, etc.), especially among youth and young adults, will enhance the prevalence of helmet-wearing behavior among motorcycle riders. Interventions should put their focus on improving the attitudes of riders regarding safety helmets, as there is acceptable knowledge of their benefits.
Long-term trend of antibiotic use at public health care institutions in northwest China, 2012–20 —— a case study of Gansu Province
Authors: Cao Wenxuan , Feng Hu , Ma Yongheng , Zhao Defang , Hu Xiaobin
Published: January 2023

Background

Over the past 20 years, excessive antibiotic use has led to serious antimicrobial resistance (AMR) worldwide, and the phenomenon is particularly serious in China. To this end, the Chinese health sector took a series of measures to promote rational antibiotic use. In this study, to reveal the impact of policies on antibiotic use, we explored the long-term trend and patterns of antibiotic use at public health care institutions from 2012 to 2020 in northwest China, taking Gansu Province as an example.

Methods

Antibiotic procurement data were obtained from the provincial centralized bidding procurement (CBP) platform between 2012 and 2020. Antibiotic use was quantified using the Anatomical Therapeutic Chemical (ATC)/defined daily doses (DDD) methodology and standardized using the DDD per 1000 inhabitants per day (DID). Twelve relevant quality indicators were calculated for comparison with the European Surveillance of Antimicrobial Consumption (ESAC) project monitoring results.

Results

Total antibiotic use increased from 18.75 DID to 57.07 DID and then decreased to 19.11 DID, a turning point in 2014. The top three antibiotics used were J01C (beta-lactam antibacterials, penicillins), J01F (macrolides, lincosamides and streptogramins), and J01D (other beta-lactam antibacterials, cephalosporins), accounting for 45.15%, 31.40%, and 11.99% respectively. The oral antibiotics used were approximately 2.5 times the parenteral antibiotics, accounting for 71.81% and 28.19%, respectively. Different use preferences were shown in public hospitals and primary health care centres (PHCs), and the latter accounted for more than half of total use. The absolute use of all classes of antibiotics in Gansu is almost higher than any of the 31 European countries included in the ESAC, but the relative use of some focused antibiotics is lower than theirs.

Conclusions

The intervention policies of the health department reduced antibiotic use in Gansu Province, but the proportion of broad-spectrum and parenteral antibiotics was still high. It is necessary to further improve the quality of antibiotic prescriptions and pay more attention to the rationality of antibiotic use in PHCs.
Vulnerability to violence against women or girls during COVID-19 in Uganda
Authors: Bukuluki Paul , Kisaakye Peter , Bulenzi-Gulere Grace , Mulindwa Beatrice , Bazira Dan , Letiyo Evelyn , Namirembe Hellen Nviiri Laetitia , Schmidt Isabella , Kakande Pamela Nabukhonzo , Nissling Simon
Published: January 2023

At the height of the COVID-19 pandemic, gender-based violence (GBV) was reported to have increased worldwide. We build on existing literature to examine the factors that increased vulnerability to GBV during the COVID-19 pandemic in Uganda. We use data from the Rapid Gender Assessment (RGA) survey that was conducted during COVID-19, which was designed to provide information to guide policymaking and offer appropriate interventions that address the needs of people in Uganda during the pandemic. The results show that the following respondents are more likely to experience increased risk and vulnerability to gender-based violence: those with primary level of education (OR = 1.49; 95% CI = 1.10–2.01), those who received information about GBV (OR = 1.30; 95% CI = 1.08–1.57), and those who needed help or medical support as a prevention measure against GBV (OR = 1.29; 95% CI = 1.04–1.61). However, respondents who would need financial support to prevent GBV were less likely to experience increased GBV (OR = 0.83; 95% CI = 0.70–0.98). Our results align with evidence from other studies that risk and vulnerability to GBV in Uganda increased since the onset of COVID-19. The findings provide an understanding of the interrelationship between GBV and COVID-19,which can help with designing GBV preventive measures, particularly during pandemics among those most at-risk.
“Antibiotic prescribing etiquette” an elective course for medical students: could we recruit potential physicians to fight resistance?
Authors: El-sokkary Rehab H. , Badran Shahenda G. , El Seifi Omnia S. , El-Fakharany Yara M. , Tash Rehab M. Elsaid
Published: January 2023

Background

A better understanding of medical students’ competencies about antimicrobial resistance and their use could facilitate a more effective education for them as future prescribers. The aim is to explore the educational impact of an elective course on medical students’ knowledge, perception, and attitude toward antibiotic resistance and use.

Methods

Between December 2021 and January 2022, when a 2-credit hours elective course was designed and implemented, this interventional study was conducted. The primary outcome measure was the change in medical students’ knowledge, perception, and attitude about antibiotic resistance and use. Using a pre-post course questionnaire, this outcome was assessed. The secondary measure included students’ perception of the course; assessed by a post-course online survey.

Results

Among the 50 enrolled students, the total knowledge score had significantly increased after the course with 95% CI After the course, with medium effect size ( Cohen’s d= -0.7 ) the participants’ mean ± SD total perception and attitude scores had significantly increased (52.38 ± 5.53 vs. 56.84 ± 5.86) respectively, (p = 0.000) with large effect size (( Cohen’s d= -0.8) There was a significant positive correlation between the total knowledge, attitude, and perception after the course (r = 0.542, p < 0.01). The mean ± SD of the overall course satisfaction was 4.20 ± 0.94. out of 5.

Conclusion

Medical students’ knowledge, perceptions, and attitudes towards antimicrobial prescription have been improved after the elective antibiotic prescribing etiquette course. Elective courses could offer a great opportunity to enable the students to understand the extent of the problem, stand on the facts, and take responsibility for the antibiotic resistance crisis.

Trial registration

NA
Digital learning designs in occupational therapy education: a scoping review
Authors: Hwang Na-Kyoung , Shim Sun-Hwa , Cheon Hye-Won
Published: January 2023

Background

Digital learning is a rapidly advancing method for teaching and learning in professional health education. Although various digital learning designs have been tried in OT education, studies on digital learning designs are still limited.

Methods

We conducted a scoping study that aimed to identify the digital learning designs used in occupational therapy (OT) education and review the effectiveness, learner perceptions, clinical skills integrated, and technology-based learning strategies used to facilitate learning. Four databases were searched using subheadings and terms relating to digital learning, occupational therapy, and education. The included studies were mapped according to the types of digital learning design, subjects, key clinical skills, and outcomes.

Results

Twenty-two studies were included in this review, most of which were qualitative, observational, or mixed studies of the two designs. The digital learning designs identified in OT education were flipped, blended, hybrid, and distance learning, including e-learning and massive open online courses (MOOC). Among the components of clinical skills, professional reasoning and procedural knowledge were the most integrated into digital learning, and covered various OT subjects. Digital learning designs were reported to be equivalent to or more effective than the traditional face-to-face (F2F) class in learning outcomes of knowledge and skill acquisition, enhancing learning participation, reflection, and collaboration between learners. Various technologies have been used to promote synchronous or asynchronous active learning, providing learning strategies such as thinking, reflection, discussion, peer learning-group activity, and gamifying online learning.

Conclusions

In OT digital learning, appropriate learning subjects, the arrangement of clinical skill components that can be well integrated into digital learning, and the selection of appropriate technologies for effective learning are important. The results should be confirmed within an experimental study design.
Perception from students regarding online synchronous interactive teaching in the clinical year during COVID-19 pandemic
Authors: Cheung Billy H. H. , Foo Dominic C. C. , Chu Kent Man , Co Michael , Lee Lok Sze
Published: January 2023

Aim

The global pandemic of COVID-19 has led to extensive practice of online learning. Our main objective is to compare different online synchronous interactive learning activities to evaluate students’ perceptions. Moreover, we also aim to identify factors influencing their perceptions in these classes.

Methods

A cross-sectional, questionnaire-based study focusing on clinical year medical students’ perceptions and feedback was conducted between February 2021 –June 2021 at the University of Hong Kong. Online learning activities were divided into bedside teaching, practical skill session, problem-based learning (PBL) or tutorial, and lecture. A questionnaire based on the Dundee Ready Education Environment Measure (DREEM) was distributed to 716 clinical year students to document their perceptions.

Results

One hundred responses were received with a response rate of 15.4% (110/716, including 96 from bedside teaching, 67 from practical skill session, 104 from PBL/tutorial, and 101 from lecture).

For the mean score of the DREEM-extracted questionnaire, online PBL/tutorial scored the highest (2.72 ± 0.54), while bedside scored the lowest (2.38 ± 0.68, p = 0.001). Meanwhile, there was no significant difference when we compared different school years (p = 0.39), age (p = 0.37), gender (p = 1.00), year of internet experience (<17 vs ≥17 years p = 0.59), or prior online class experience (p = 0.62).

When asked about students’ preference for online vs face-to-face classes. Students showed higher preferences for online PBL/tutorial (2.06 ± 0.75) and lectures (2.27 ± 0.81). Distraction remains a significant problem across all four learning activities.

A multivariate analysis was performed regarding students’ reported behavior in comparison with their perception through the DREEM-extracted questionnaire. The results showed that good audio and video quality had a significant and positive correlation with their perception of online bedside teaching, practical skill sessions, and PBL/tutorial. It also showed that the use of the video camera correlated with an increase in perception scores for lectures.

Conclusion

The present analysis has demonstrated that students’ perception of different online synchronous interactive learning activities varies. Further investigations are required on minimizing distraction during online classes.
Medical residents’ and teachers’ perceptions of the digital format of nation-wide didactic courses for psychiatry residents in Sweden: a survey-based observational study
Authors: Knez Rajna , El Alaoui Samir , Ivarson Josefin , Risö Bergerlind Lise-Lotte , Stasinakis Sarantos , Ahlgren Anna-Maria , Maripuu Martin , Talaee Mofrad Danielle , Bolander Laksov Klara , Jayaram-Lindström Nitya , Sörman Karolina
Published: January 2023

Background

This study aimed to explore residents’ and teachers’ perceptions of the digital format of Metis (a national education network in Sweden) didactic courses for psychiatry residents in Sweden to guide post-pandemic curriculum development.

Methods

An online attitude survey was developed and sent out to 725 residents in psychiatry and 237 course directors/teachers. Data were examined descriptively and group differences were analysed with independent sample t-tests.

Results

The survey was completed by 112 residents and 72 course directors/teachers. Perceptions of digital formats were quite similar between the two groups with some significant differences i.e., residents agreed more strongly than directors/teachers with the statement that Metis courses in digital format were of the same quality (or better) than the classroom-based format. Residents perceived the positive effects of using interactive tools more than directors/teachers. More than 40% of the responders in both groups preferred a return to classroom-based course meetings. Responders in both groups suggested that different forms of digital elements (e.g., video-based and sound-recorded lectures, digital-group discussions, virtual patients) could be incorporated into different phases in the courses.

Conclusions

The study represents the current largest survey among residents in psychiatry and a teaching faculty in Sweden, to understand the impact of digitalization on the quality of residents’ education during the pandemic. The results point towards applying a mixed format for training and education going forward, incorporating digital aspects into the national curriculum.
Introduction and implementation of an immunization information system in the Indonesian province of Daerah Istimewa Yogyakarta: lessons for scaling-up
Authors: Sulistyawati Sulistyawati , Wibowo Trisno Agung , Rokhmayanti Rokhmayanti , Nugroho Andri Setyo Dwi , Sukesi Tri Wahyuni , Hastuti Siti Kurnia Widi , Mulasari Surahma Asti , Feletto Marta
Published: January 2023

Background

Immunization is critical to saving children from infections. To increase vaccination coverage, valid and real-time data are needed. Accordingly, it is essential to have a good report system that serves as defaulter tracking to prevent children's immunization failure. The Daerah Istimewa Yogyakarta (DIY) Health Office introduced an electronic immunization registry and successfully implemented it for more than five years. It is the only individual-based record system in Indonesia that has been sustainably operated for a long time. Yet, no systematic assessment of this system has been conducted to date. This study examines the Sistem Informasi Imunisasi Terpadu (SIMUNDU) introduction and implementation process with a view to extracting lessons that could inform scalability and sustainability across the country.

Methods

This study used an explanatory sequential mixed-method design, which collected quantitative data from 142 participants and qualitative data from nine participants. The data entry clerk at a health facility was systematically selected to participate in the survey, while in the key informant interview, the informant was selected based on the survey result. A descriptive and thematic approach was adopted to analyze the quantitative and qualitative data. Results from across the two approaches were integrated for comparison and contrast.

Results

Findings are presented according to three core themes that emerged from the data: system strengths, potential threats, weakness and opportunities for scaling-up. Strengths, i.e., factors contributing to the success of SIMUNDU, include management, system performance, people’s behavior, and resources. Potential threats to sustaining the system include individual capacity, technical or system issues, and high workload. Opportunities – i.e., a promising factor that influences the SIMUNDU ability to operate sustainably – such as continuity, expectation, and the possibility of scaling up.

Conclusions

SIMUNDU is a promising innovation for Indonesia, beyond DIY. There is agreement about the potential for scaling up this IIS to other provinces. The experience of implementing this system in DIY over the past five years has shown that the benefits outweigh the challenges, and SIMUNDU has grown into a robust yet user-friendly system.
Bereavement in childhood and young adulthood and the risk of atrial fibrillation: a population-based cohort study from Denmark and Sweden
Authors: Chen Hua , Janszky Imre , Rostila Mikael , Wei Dang , Yang Fen , Li Jiong , László Krisztina D.
Published: January 2023

Background

Adverse childhood life events are associated with increased risks of hypertension, ischemic heart disease, and stroke later in life. Limited evidence also suggests that stress in adulthood may increase the risk of atrial fibrillation (AF). Whether childhood adversity may lead to the development of AF is unknown. We investigated whether the loss of a parent or sibling in childhood is associated with an increased risk of AF and compared this effect to that of similar losses in young adulthood.

Methods

We studied 6,394,975 live-born individuals included in the Danish (1973–2018) and Swedish Medical Birth Registers (1973–2014). We linked data from several national registers to obtain information on the death of parents and siblings and on personal and familial sociodemographic and health-related factors. We analyzed the association between bereavement and AF using Poisson regression.

Results

Loss of a parent or sibling was associated with an increased AF risk both when the loss occurred in childhood and in adulthood; the adjusted incident rate ratios and 95% confidence intervals were 1.24 (1.14–1.35) and 1.24 (1.16–1.33), respectively. Bereavement in childhood was associated with AF only if losses were due to cardiovascular diseases or other natural causes, while loss in adulthood was associated with AF not only in case of natural deaths, but also unnatural deaths. The associations did not differ substantially according to age at loss and whether the deceased was a parent or a sibling.

Conclusions

Bereavement both in childhood and in adulthood was associated with an increased AF risk.
Interstitial pneumonitis associated with combined regimen of immunotherapy and conventional therapies—pharmacovigilance database analysis with real-world data validation
Authors: Guo Xue-Jun , Cai Xiao-Ting , Rong Zi-Xuan , Zhang Yan-Pei , Wen Yu-Xiang , Bai Xue , Wang Jian , Fu Qiang John , Guo Ze-Qin , Long Li-Li , Ma Si-Cong , Tang Xin-Ran , Liu Li , Guan Jian , Dong Zhong-Yi , Wu De-Hua
Published: January 2023

Background

Immune checkpoint inhibitor (ICI) therapy combined with conventional therapies is being broadly applied in non-small cell lung cancer (NSCLC) patients. However, the risk of interstitial pneumonitis (IP) following a combined regimen is incompletely characterized.

Methods

A total of 46,127 NSCLC patients were extracted for disproportionality analyses of IP from the Food and Drug Administration’s Adverse Event Reporting System (FAERS) database. A total of 1108 NSCLC patients who received ICI treatment at Nanfang Hospital of Southern Medical University were collected and utilized for real-world validation.

Results

Of the 46,127 patients with NSCLC, 3830 cases (8.3%; 95% confidence interval [CI], 8.05–8.56) developed IP. Multivariable logistic regression analyses revealed that the adjusted ROR of ICI combined with radiation (RT) was the highest (121.69; 95% CI, 83.60–184.96; P < 0.0001) among all therapies, while that of ICI combined with chemotherapy (CHEMO) or targeted therapy (TARGET) was 0.90 (95% CI, 0.78–1.04; P = 0.160) and 1.49 (95% CI, 0.95–2.23; P = 0.065), respectively, using ICI monotherapy as reference. Furthermore, analyses from our validation cohort of 1108 cases showed that the adjusted odds ratio of ICI combined with RT was the highest (12.25; 95% CI, 3.34–50.22; P < 0.01) among all the therapies, while that of ICI combined with CHEMO or TARGET was 2.32 (95% CI, 0.89–7.92; P = 0.12) and 0.66 (95% CI, 0.03–4.55; P = 0.71), respectively, using ICI monotherapy as reference.

Conclusions

Compared with ICI monotherapy, ICI combined with RT, rather than with CHEMO or TARGET, is associated with a higher risk of IP in NSCLC patients. Hence, patients receiving these treatments should be carefully monitored for IP.