bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of e-health on neonatal intensive care unit discharged preterm infants and their parents: Protocol for systematic review and meta-analysis
Authors: Yang Xinyi , Zhang Jun , Cao Mi , Pan Yujie , Zhang Yijia
Published: October 2023

Background

After preterm birth, parents often conformed with difficulties such as negative emotions, lack of care knowledge and skills, and insufficient professional support. As a remote health guidance method, e-health can provide a series of support for premature infants and their parents during the transition period from neonatal intensive care unit (NICU) to home care.

Objectives

To determine the efficacy of e-health interventions in discharged preterm infants as well as their parents, and to describe the process outcomes and elements of these e-health interventions to inform the effective design of future interventions.

Methods

The systematic review of the randomized and non-randomized controlled trials on the follow-up effect of e-health on preterm infants and their parents discharged from NICU between the inception to May 2023 will be electronically searched in the following nine databases: Web of Science, CINAHL Complete (EBSCO), PubMed, Embase, the Cochrane Library, Ovid MEDLINE, China National Knowledge Infrastructure, WANFANG DATA, and SinoMed. Quality will be appraised, respectively, via the revised tool to assess risk of bias (RoB 2) and the tool for risk of bias in non-randomized studies of interventions (ROBINS-I). The main outcome indicators of preterm infants are breastfeeding rate, readmission rate, neurobehavioral development, and premature infant's body mass. The outcome indicators for parents of premature infants are anxiety, depression scale, and parenting competency scale. The RevMan 5.4 software provided by the Cochrane Collaboration will be used for statistical analysis of the data.

Conclusion

The results of this study may provide future development opportunities for e-health follow-up prevention in preterm infants and may support evidence-based decision-making for e-health interventions of post-discharge developmental support in preterm infants.

PROSPERO registration number

CRD42023410334.
The effect of web based type 2 diabetes education on diabetes self management
Authors: Selen Filiz , Polat Ülkü
Published: October 2023

Objective

This study is a control group intervention study to determine the effect of web-based education on diabetes self-management in individuals with type 2 diabetes.

Methods

The study was conducted in the Training and Research Hospital Diabetes Education Unit of Hitit University. The study was completed with 75 people (intervention 38, control 37). The data were obtained in the web site through patient identification form, self-management perception scale in diabetes, diabetes attitude, self-care scale and HbA1c, HDL, LDL values were followed by providing training and counseling. The values followed were viewed at the third and sixth months. Written permission was obtained from ethics committee and participants. The data of the study were evaluated with number, percentage, mean, pearson chi-square, independent t-test, repetitive analysis and variance analysis.

Results

Statistically significant decrease in HbA1c and LDL values, diabetes self-management scale, diabetes attitude scale and self-care scale scores were found to be significantly different between the intervention and control groups.

Conclusion

Web-based education and follow-up studies are effective in decreasing HbA1c values in increasing diabetes self-management skills of individuals with type 2 diabetes. It is recommended to use as a complementary tool in health care services for type 2 diabetes management.
Vividness and Use of Imagery Related to Music and Movement in People with Parkinson's: A Mixed-methods Survey Study
Authors: Poliakoff Ellen , Bek Judith , Phillips Michelle , Young William R. , Rose Dawn C.
Published: October 2023

Parkinson's disease affects multiple aspects of movement, impacting significantly on everyday tasks. Music is used in interventions for people with Parkinson's, either to pace movements, or as an integral element of activities such as dance. This study explored self-reported vividness of two forms of imagery – motor imagery evoked by music and auditory (including musical) imagery – in people with Parkinson's, and whether and how they use these types of imagery in everyday life. Participants ( N = 199) completed: (i) vividness ratings of visual and kinesthetic music-evoked motor imagery, (ii) vividness ratings of auditory imagery, and (iii) ratings and open questions about their everyday use of these types of imagery. While most participants reported experiencing music-evoked motor imagery (with more vivid visual than kinesthetic motor imagery), <20% reported actively using music to support motor imagery in daily activities. In contrast, participants reported a broad range of contexts and uses for musical imagery (imagined music), from supporting movement (e.g., walking or exercise) to emotion regulation, and concentration. Correlational analyses associated vividness of music-evoked motor imagery with an urge to dance and musical training, while the use of musical imagery was associated with singing ability. A minority of participants reported not experiencing either motor or musical imagery, suggesting that interventions based on imagery may not be suitable for all. Nonetheless, even participants with more severe motor symptoms reported experiencing and using both types of imagery, indicating promise for their strategic use at different stages of Parkinson's. Therefore, musical and motor imagery have the potential to support rehabilitation strategies for Parkinson's, either separately or in combination.
Psychometrics Validation of the WHO-5 Wellbeing Index in Botswana, Zimbabwe, and Malaysia: Coping With COVID-19 Pandemic in the Global South Study
Authors: Pheko Mpho M. , Mhaka-Mutepfa Magen , Mfolwe Leonne M. , Mathoothe Kesego D. , Chua Bee Seok , Low Wah Yun
Published: October 2023

COVID-19 and the actions to curtail its spread have elevated the value of mental health as well as public health crises and pandemics. This calls for increased research in this area and the use of consistent and valid instruments to measure diverse aspects of mental health in different populations. This study presents preliminary psychometric properties (i.e., factor structure, internal consistency, convergent and discriminant validity) of the WHO-5 index as compared to other mental health instruments used in three countries (Botswana, Zimbabwe, and Malaysia). Data was collected from three countries during the first 5 months after the onset of COVID-19 in the Southern African and Southeast Asia regions: Botswana ( N = 422; Mean Wellbeing = 9.8; SD = 5.4), Zimbabwe ( N = 325; Mean = 9.4; SD = 5.3), and Malaysia ( N = 425; Mean = 13; SD = 5.3). After data quality and scaling properties were evaluated, factor structures were assessed using principal component analysis and internal consistency of the extracted components were examined using Cronbach’s alpha (α). Construct validity was examined using Pearson’s correlations to establish both convergent validity and discriminant validity among the three mental health constructs (i.e., well-being, generalized anxiety, and loneliness). With Cronbach’s alpha of the total WHO-5 Wellbeing index of .86 (Botswana sample), α = .85 (Zimbabwean data) and α = .88 (Malaysian data), as well as (α > .7) for the selected demographic subgroups, the findings broadly suggest that WHO-5 is a unique, reliable, and valid instrument for measuring subjective well-being, and by extension mental health among diverse subgroups—in Botswana, Zimbabwe, Malaysia, and possibly, other similar settings.
Automatic Calculation of Cervical Spine Parameters Using Deep Learning: Development and Validation on an External Dataset
Authors: Nakarai Hiroyuki , Cina Andrea , Jutzeler Catherine , Grob Alexandra , Haschtmann Daniel , Loibl Markus , Fekete Tamas F. , Kleinstück Frank , Wilke Hans-Joachim , Tao Youping , Galbusera Fabio
Published: October 2023

Study design

Retrospective data analysis.

Objectives

This study aims to develop a deep learning model for the automatic calculation of some important spine parameters from lateral cervical radiographs.

Methods

We collected two datasets from two different institutions. The first dataset of 1498 images was used to train and optimize the model to find the best hyperparameters while the second dataset of 79 images was used as an external validation set to evaluate the robustness and generalizability of our model. The performance of the model was assessed by calculating the median absolute errors between the model prediction and the ground truth for the following parameters: T1 slope, C7 slope, C2-C7 angle, C2-C6 angle, Sagittal Vertical Axis (SVA), C0-C2, Redlund-Johnell distance (RJD), the cranial tilting (CT) and the craniocervical angle (CCA).

Results

Regarding the angles, we found median errors of 1.66° (SD 2.46°), 1.56° (1.95°), 2.46° (SD 2.55), 1.85° (SD 3.93°), 1.25° (SD 1.83°), .29° (SD .31°) and .67° (SD .77°) for T1 slope, C7 slope, C2-C7, C2-C6, C0-C2, CT, and CCA respectively. As concerns the distances, we found median errors of .55 mm (SD .47 mm) and .47 mm (.62 mm) for SVA and RJD respectively.

Conclusions

In this work, we developed a model that was able to accurately predict cervical spine parameters from lateral cervical radiographs. In particular, the performances on the external validation set demonstrate the robustness and the high degree of generalizability of our model on images acquired in a different institution.
Occupational exposure to silicon dioxide and prevalence of chronic respiratory symptoms in the cement manufacturing industries: A review
Authors: Rathebe Phoka C
Published: October 2023

The aim of this review was to assess the association between occupational exposure to silicon dioxide and chronic respiratory symptoms among workers in the cement manufacturing industries. Approximately 60 articles published from 2010 to 2021 were found and four independent reviewers extracted the data from each eligible study using PubMed, Google scholar etc. The following terms were used: exposure to cement dust, exposure to silicon dioxide etc. Inclusion and exclusion criteria were considered while searching for the studies. In this review, a total of 14 articles were included in this study. Chronic cough was the most prevalence exposure symptoms (OR 1.90; CI 9.90, 0.78), with wheezing reported to be the least experienced symptom (OR 1.34; CI 11.5, 0.50). Two studies reported exposure concentration ranging from 0.026 to 0.044 mg/m3, and 0.27 mg/m3 was also reported in one study. The FEV1 and FVC was lower in exposed workers when compared to the control group. Studies reported the crystalline silica quartz to be 21.5% in limestone, 22.5% in bauxite, 21.22% in clinker, and 21.22% in raw cement. Chronic cough, phlegm, wheezing, and shortness of breath or dyspnea was found to be significantly prevalence among workers, particularly cleaning personnel, in the cement manufacturing industries.
Impact of Learning Digitization on Business Education Quality: The Moderating Role of International Accreditation Bodies
Authors: Alromaihi Ali Ateya Ali , Hamdan Allam , Bakir Ali
Published: October 2023

The digitization of higher education (HE), particularly general and business education, is increasingly becoming a necessity in the post–COVID-19 pandemic period, forcing higher education institutions (HEIs) to switch to digital learning, with all of its accompanying challenges. This study focused on investigating the effect of digitizing HE learning on the quality of business education and the moderating influence of international accreditation bodies on this relationship. A questionnaire survey was used to collect data from a convenient sample of 232 business HEI faculties in the Kingdom of Bahrain. A simple regression analysis was used to test the study’s hypotheses. The findings indicate that learning management systems, student assessment and student interaction have a significant impact on the quality of education in a digital classroom setting. It was further found that international accreditation bodies have a significant positive moderating influence in maintaining and enhancing the quality of digital business education during pandemic and post-pandemic periods. Additionally, these bodies provide support to HEIs to help overcome challenges in ensuring the quality of digital learning. The implications and potential contributions of the study are discussed along with its limitations and areas for future research.
Dyspnea Secondary to Mediastinal Mass: A Rare Presentation of Metastatic Penile Squamous Cell Carcinoma
Authors: Niforatos Stephanie , Sandhu Michael , Siegenthaler Alanna , Bordas Jozsef , Loon Taylor , Akhtar Komal
Published: October 2023

Penile squamous cell carcinoma is a rare diagnosis in the United States; however, the incidence is significantly higher in developing countries. This cancer is categorized into human papilloma virus (HPV)-associated and independent disease. In this article, we present a rare case of HPV-independent penile squamous cell carcinoma. Our patient was a 75-year-old Caucasian male who initially presented with a penile ulcer which was managed with partial penectomy and adjuvant chemotherapy. The patient was monitored on surveillance and did not pursue lymph node dissection. He was noted to have recurrence with metastatic disease 5 years after his initial presentation. Due to the aggressive nature of his disease, the patient was admitted to the hospital and treated with chemotherapy and immunotherapy.
Association of Hip Dysplasia With Trochlear Dysplasia in Skeletally Mature Patients
Authors: Fithian Andrew T. , Richey Ann E. , Sherman Seth L. , Shea Kevin G. , Pun Stephanie Y.
Published: October 2023

Background:

Developmental dysplasia of the hip (DDH) and trochlear dysplasia (TD) are distinct pathologies with several important features in common. In addition to shared risk factors, both forms of dysplasia cause abnormal joint kinematics and force transmission, predisposing patients to pain, injuries to cartilage and soft tissue stabilizers, and ultimately arthritis.

Purpose:

To evaluate for an association between hip dysplasia and TD in skeletally mature patients with symptomatic hip dysplasia.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 48 patients with DDH who underwent periacetabular osteotomy were compared with 48 sex-matched patients who underwent hip arthroscopy for femoroacetabular impingement (FAI) between July 2014 and February 2021. All patients were skeletally mature. The Tönnis angle and lateral center-edge angle were measured on preoperative pelvis radiographs. Femoral version, trochlear depth, lateral trochlear inclination (LTI), tibial tubercle–trochlear groove distance (TTTG-d), and posterior lateral condylar angle (PLCA) were measured on preoperative magnetic resonance imaging scans of the symptomatic hip and ipsilateral knee. Continuous variables were compared between the patient groups using 2-sample t tests. Interobserver reliability was measured using the intraclass correlation coefficient.

Results:

Patients with DDH demonstrated a reduced trochlear depth compared with patients with FAI (3.6 vs 4.6 mm; P < .001). There were no differences between groups in femoral anteversion, LTI, TTTG-d, or PLCA. Two (4.2%) patients with FAI and 17 (35.4%) patients with DDH had a trochlear depth <3 mm ( P < .001). One (2.1%) patient with FAI and 7 (14.6%) patients with DDH had an LTI <11° ( P = .027). There was no difference between groups in frequency of a convex proximal trochlea, patient-reported ipsilateral knee pain, or ipsilateral knee procedures.

Conclusion:

Patients with DDH had reduced trochlear depth compared with patients with FAI, demonstrating a higher incidence of dysplastic trochlear features that may predispose patients to patellofemoral joint disease. Further research is needed to determine whether screening at-risk patients and treating TD will help to prevent symptomatic patellofemoral disease.
Development, Validity and Reliability of Objective Structured Clinical Examination in Nursing Students
Authors: Chabrera Carolina , Diago Eva , Curell Laura
Published: October 2023

Introduction

The adoption of measurement instruments such as the Objective Structured Clinical Examination (OSCE) is essential to assess clinical competencies in nursing students.

Objective

The purpose of this study is to develop an OSCE, analyze its validity and reliability in the nursing curriculum and measure self-assessment, stress and satisfaction.

Methods

The observational validation study of a measurement instrument was carried out in two phases: the design and development of the OSCE and validity and reliability analysis.

Results

A total of 118 students participated in the study. Ten scenarios were designed that incorporated six competency components extracted from the curriculum. Good results were obtained in face validity, content validity (CVI .82-.95), criterion validity (r = .71, p < .001), and reliability (α Cronbach .84). Satisfaction and stress scores were high, and self-assessment scores were lower than the scores obtained.

Conclusion

A rigorously designed OSCE provides a reliable and valid method for assessing the clinical competence of nursing students.
Safe discharge for patients admitted for lower gastrointestinal bleeding (LGITB): derivation and validation of a novel scoring system
Authors: Zhao Yue , Chee Madeline Yen Min , Sultana Rehena , Tan Winson Jianhong
Published: October 2023

Aim

Bleeding from the lower gastrointestinal tract (LGITB) is a common clinical presentation. Recent guidelines have recommended for incorporation of clinical risk assessment tools in the management for LGITB. We derived and validated a novel clinical scoring system to predict safe discharge after LGITB admission, and compared it to other published scoring systems in current literature.

Methods

A retrospective cohort of 798 patients with LGITB from August 2018 to March 2021 was included in the derivation cohort. Multivariate binary logistic regression was performed to identify significant clinical variables predictive of safe discharge. A clinical scoring system was developed based on the results, and validated on a prospective cohort of 312 consecutive patients with LGITB from April 2021 to March 2022. The performance of the novel scoring system was compared to other LGITB clinical risk assessment scores via area under the receiver operating characteristics curve (AUROC) analysis.

Results

Variables predictive of safe discharge included the following; absence of previous LGITB admission, absence of ischemic heart disease, absence of blood on digital rectal examination, absence of dizziness or syncope at presentation and the systolic blood pressure and haemoglobin levels at presentation. The novel score had an AUROC of 0.907. A cut-off point of 4 provided a sensitivity of 41.9%, specificity of 97.5%, positive predictive value of 96.4% and negative predictive value of 51.5% for prediction of safe discharge. The score performs comparably to the Oakland score.

Conclusion

The novel LGITB clinical risk score has good predictive performance for safe discharge in patients admitted for LGITB.
DMF-Net: a deep multi-level semantic fusion network for high-resolution chest CT and X-ray image de-noising
Authors: Nayak Tapan Kumar , Annavarappu Chandra Sekhara Rao , Nayak Soumya Ranjan , Gedefaw Berihun Molla
Published: October 2023

Medical images such as CT and X-ray have been widely used for the detection of several chest infections and lung diseases. However, these images are susceptible to different types of noise, and it is hard to remove these noises due to their complex distribution. The presence of such noise significantly deteriorates the quality of the images and significantly affects the diagnosis performance. Hence, the design of an effective de-noising technique is highly essential to remove the noise from chest CT and X-ray images prior to further processing. Deep learning methods, mainly, CNN have shown tremendous progress on de-noising tasks. However, existing CNN based models estimate the noise from the final layers, which may not carry adequate details of the image. To tackle this issue, in this paper a deep multi-level semantic fusion network is proposed, called DMF-Net for the removal of noise from chest CT and X-ray images. The DMF-Net mainly comprises of a dilated convolutional feature extraction block, a cascaded feature learning block (CFLB) and a noise fusion block (NFB) followed by a prominent feature extraction block. The CFLB cascades the features from different levels (convolutional layers) which are later fed to NFB to attain correct noise prediction. Finally, the Prominent Feature Extraction Block(PFEB) produces the clean image. To validate the proposed de-noising technique, a separate and a mixed dataset containing high-resolution CT and X-ray images with specific and blind noise are used. Experimental results indicate the effectiveness of the DMF-Net compared to other state-of-the-art methods in the context of peak signal-to-noise ratio (PSNR) and structural similarity measurement (SSIM) while drastically cutting down on the processing power needed.
Post-stroke limitations in daily activities: experience from a tertiary care hospital in Ethiopia
Authors: Mohammed Salhadin , Haidar Jemal , Ayele Biniyam A. , Yifru Yared Mamushet
Published: October 2023

Background

The disability of stroke patients remains an important global health problem; yet information on the extent of restriction from basic and instrumental activities of daily living is limited, particularly in lower-and middle-income (LMIC) countries. Therefore, we examined the issue under the caption, since it is the first step in planning several rehabilitation services.

Method

A facility-based cross-sectional study was done to assess the magnitude and predictors of post-stroke limitations in basic activities of daily living (BADL) using the Barthel Index (BI) scale and instrumental activities of daily living (IADL) using the Frenchay Activities Index (FAI) scale among patients who visited Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, Neurology Clinic from April-October, 2022. All patients having a diagnosis of stroke for more than six months duration were enrolled. Descriptive and inferential statistical analyses were done, and measures of estimated crude and adjusted odds ratio with 95% CI were constructed and a p-value less than 0.05 was considered statistically significant. The results are presented in figures and tables.

Results

A total of 150 stroke patients were enrolled in the present study. The mean age of participants was 53 (14.9) years with slight male preponderance (51.3%). Ischemic stroke was present in 106 (70.7%) of them, while 44 (29.3%) had hemorrhagic stroke. Of this, 57 (38%) and 115 (79.3%) of them had limitations in basic and instrumental ADL, respectively. Comorbid cardiac disease (AOR = 6.9; 95%CI = 1.3–37.5) and regular substance use (AOR = 11.1; 95%CI = 1.1–115) were associated with limitations in BADL, while an increase in age (AOR = 1.1; 95%CI = 1.04–1.15) was associated with severe limitations in BADL. Initial stroke severity (AOR = 7.3; 95%CI = 1.2–44.7) was associated with limitations in IADL, whereas depression (AOR = 5.1; 95%CI = 1.1–23.2) was identified as a predictor of severe limitation in IADL.

Conclusion

Limitation in activities of daily living (ADL) after stroke is common among Ethiopian patients. Therefore, screening for post-stroke limitations in daily activities is essential for further management and rehabilitative plans.
Preoperative anxiety and associated factors among women admitted for elective obstetric and gynecologic surgery in public hospitals, Southern Ethiopia: a cross-sectional study
Authors: Dibabu Abera Mamo , Ketema Teklemariam Gultie , Beyene Maechel Maile , Belachew Dereje Zeleke , Abocherugn Hailegiyorgis Geleta , Mohammed Abdu Seid
Published: October 2023

Background

Preoperative anxiety is a major mental health problem during the preoperative period. Admission of women to surgery is stressful, and a high level of anxiety was associated with increased perioperative morbidity and mortality, poor treatment satisfaction, and bad obstetric outcomes, including long-term cognitive impairment in children. Despite its negative consequences, little is known on this area, particularly in the study area.

Objective

To assess preoperative anxiety and associated factors among women admitted for elective obstetrics and gynecologic surgeries in public hospitals in Southern Ethiopia, 2022.

Methods and Materials

An institution-based cross-sectional study design was conducted among 389 women using structured interviewer-administered samples who were selected by systematic random sampling from May 20th to June 20th, 2022. The Amsterdam preoperative anxiety and information scale (APAIS) was used to assess the level of anxiety. Data were collected electronically using the Open Data Kit version 2022.2.3 and analyzed with the Statistical Package for Social Sciences version 26.0. Bivariate and multivariable logistic regression analyses were done. The strength of the association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval, and a statistical significance of P < 0.05.

Results

The magnitude of preoperative anxiety was 57.1% (95% CI = 51.4–61.5), and 48.1% of women required an average amount of information. Being a gynecologic patient (AOR = 2.0, 95% CI = 1.21, 3.32), having previous anesthesia and surgery (AOR = 2.09, 95% CI = 1.10, 3.96), having fear of postoperative pain (AOR = 1.96, 95% CI = 1.08, 3.53), having concern for family (AOR = 2.56, 95% CI = 1.49, 4.37), having poor social support (AOR = 3.75, 95% CI = 1.99, 7.09), and moderate social supports (AOR = 3.27, 95% CI = 1.74, 6.17), and having a high information requirement about anesthesia and surgery (AOR = 4.68, 95%CI = 2.16, 10.13) were statistically associated with preoperative anxiety.

Conclusion

Preoperative anxiety was often high in the region. Associated factors were the type of surgery, previous anesthesia and surgery, fear of postoperative pain, fear for family, social support, and a high information need. So the national and regional health bureau should develop guidelines and implement strategies to reduce women preoperative anxiety as part of midwifery care. The women should be assessed regularly during the preoperative visits; and appropriate anxiety reduction and information regarding surgery, and anesthesia should be provided.
Model development of dose and volume predictors for esophagitis induced during chemoradiotherapy for lung cancer as a step towards radiobiological treatment planning
Authors: He Rui , Duggar William N. , Yang Claus Chunli , Vijayakumar Srinivasan
Published: October 2023

Background

Currently, radiation therapy treatment planning system intends biological optimization that relies heavily upon plan metrics from tumor control probability (TCP) and normal tissue complication probability (NTCP) modeling. Implementation and expansion of TCP and NTCP models with alternative data is an important step towards reliable radiobiological treatment planning. In this retrospective single institution study, the treatment charts of 139 lung cancer patients treated with chemo-radiotherapy were reviewed and correlated dosimetric predictors with the incidence of esophagitis and established NTCP model of esophagitis grade 1 and 2 for lung cancer patients.

Methods

Esophagus is an organ at risk (OAR) in lung cancer radiotherapy (RT). Esophagitis is a common toxicity induced by RT. In this study, dose volume parameters Vx (Vx: percentage esophageal volume receiving ≥ x Gy) and mean esophagus dose (MED) as quantitative dose-volume metrics, the esophagitis grade 1 and 2 as endpoints, were reviewed and derived from the treatment planning system and the electronic medical record system. Statistical analysis of binary logistic regression and probit were performed to have correlated the probability of grade 1 and 2 esophagitis to MED and Vx. IBM SPSS software version 24 at 5% significant level (α = 0.05) was used in the statistical analysis.

Results

The probabilities of incidence of grade 1 and 2 esophagitis proportionally increased with increasing the values of Vx and MED. V20, V30, V40, V50 and MED are statistically significant good dosimetric predictors of esophagitis grade 1. 50% incidence probability (TD50) of MED for grade 1 and 2 esophagitis were determined. Lyman Kutcher Burman model parameters, such as, n, m and TD50, were fitted and compared with other published findings. Furthermore, the sigmoid shaped dose responding curve between probability of esophagitis grade 1 and MED were generated respecting to races, gender, age and smoking status.

Conclusions

V20, V30, V40 and V50 were added onto Quantitative Analysis of Normal Tissue Effects in the clinic, or QUANTEC group’s dose constrains of V35, V50, V70 and MED. Our findings may be useful as both validation of 3-Dimensional planning era models and also additional clinical guidelines in treatment planning and plan evaluation using radiobiology optimization.
Fotagliptin monotherapy with alogliptin as an active comparator in patients with uncontrolled type 2 diabetes mellitus: a randomized, multicenter, double-blind, placebo-controlled, phase 3 trial
Authors: Xu Mingtong , Sun Kan , Xu Wenjie , Wang Chuan , Yan Dewen , Li Shu , Cong Li , Pi Yinzhen , Song Weihong , Sun Qingyuan , Xiao Rijun , Peng Weixia , Wang Jianping , Peng Hui , Zhang Yawei , Duan Peng , Zhang Meiying , Liu Jianying , Huang Qingmei , Li Xuefeng , Bao Yan , Zeng Tianshu , Wang Kun , Qin Li , Wu Chaoming , Deng Chunying , Huang Chenghu , Yan Shuang , Zhang Wei , Li Meizi , Sun Li , Wang Yanjun , Li HongMei , Wang Guang , Pang Shuguang , Zheng Xianling , Wang Haifang , Wang Fujun , Su Xiuhai , Ma Yujin , Zhang Wei , Li Ziling , Xie Zuoling , Xu Ning , Ni Lin , Zhang Li , Deng Xiangqun , Pan Tianrong , Dong Qijuan , Wu Xiaohong , Shen Xingping , Zhang Xin , Zou Qijing , Jiang Chengxia , Xi Jue , Ma Jianhua , Sun Jingchao , Yan Li
Published: October 2023

Background

Dipeptidyl peptidase-4 inhibitors (DPP-4i) have become firmly established in treatment algorithms and national guidelines for improving glycemic control in type 2 diabetes mellitus (T2DM).To report the findings from a multicenter, randomized, double-blind, placebo-controlled phase 3 clinical trial, which was designed to assess the efficacy and safety of a novel DPP-4 inhibitor fotagliptin in treatment-naive patients with T2DM.

Methods

Patients with T2DM were randomized to receive fotagliptin (n = 230), alogliptin (n = 113) or placebo (n = 115) at a 2:1:1 ratio for 24 weeks of double-blind treatment period, followed by an open-label treatment period, making up a total of 52 weeks. The primary efficacy endpoint was to determine the superiority of fotagliptin over placebo in the change of HbA1c from baseline to Week 24. All serious or significant adverse events were recorded.

Results

After 24 weeks, mean decreases in HbA1c from baseline were -0.70% for fotagliptin, -0.72% for alogliptin and -0.26% for placebo. Estimated mean treatment differences in HbA1c were -0.44% (95% confidence interval [CI]: -0.62% to -0.27%) for fotagliptin versus placebo, and -0.46% (95% CI: -0.67% to -0.26%) for alogliptin versus placebo, and 0.02% (95%CI: -0.16% to 0.19%; upper limit of 95%CI < margin of 0.4%) for fotagliptin versus alogliptin. So fotagliptin was non-inferior to alogliptin. Compared with subjects with placebo (15.5%), significantly more patients with fotagliptin (37.0%) and alogliptin (35.5%) achieved HbA1c < 7.0% after 24 weeks of treatment. During the whole 52 weeks of treatment, the overall incidence of hypoglycemia was low for both of the fotagliptin and alogliptin groups (1.0% each). No drug-related serious adverse events were observed in any treatment group.

Conclusions

In summary, the study demonstrated improvement in glycemic control and a favorable safety profile for fotagliptin in treatment-naive patients with T2DM.

Trial registration

ClinicalTrail.gov NCT05782192.
The association between social integration and utilization of primary health care among migrants in China: a nationwide cross-sectional study
Authors: Wang Xueyao , Liu Jue , Zhu Jingmin , Bai Yang , Wang Jun
Published: October 2023

Background

Migrants is a large population in China. To improve the health and wellbeing of migrants is a critical policy and social issue in China, and to enhance the utilization of primary health care by migrants is one of the most important approaches in promoting equity in health. However, there exists little research about the association between social integration and the utilization of primary health care. To address the research gap, this research aims at exploring the relation between social integration and the utilization of primary health care among migrants in China.

Methods

Using the national data from China Migrants Dynamic Survey (CMDS) in 2017, 169,989 migrants were included in this study. Social integration was measured by social communication, acculturation and self-identity, with 8 indicators. The utilization of primary health care was measured by the receiving of health education on infectious diseases (ID) and noncommunicable diseases (NCD) as well as the first visit institution when migrants were sick. After the descriptive statistical analysis, binary logistic regression was employed to evaluate the association between social integration and the utilization of primary health care.

Results

65.99% of the migrants received health education on infectious diseases (ID), 40.11% of the migrants received health education on noncommunicable diseases (NCD) and 8.48% of the migrants chose to go to Community Health Center (CHC) seeking for health services. There was a positive effect of social organization participation, the influence of hometown customs, differences of hygiene habits between migrants and local people, integration willingness and evaluation of identity on the receiving of health education on ID and NCD, as well as a positive effect of civil activities engagement and differences of hygiene habits between migrants and local people on the utilization of CHC after getting sick.

Conclusions

Social integration was associated with the utilization of primary health care among migrants in China. Generally speaking, greater social integration was associated with higher possibility of receiving health education on ID and NCD. However, the effect of social integration on the utilization of CHC was more complex among different indicators. There should be more policy interventions to improve the social integration of migrant which help them to get familiar with the health resource available, as well as improve the capacity of CHC.
Blockade of TGF-β signalling alleviates human adipose stem cell senescence induced by native ECM in obesity visceral white adipose tissue
Authors: Han Xueya , Li Weihong , He Xu , Lu Xin , Zhang Yu , Li Yaqiong , Bi Guoyun , Ma Xuqing , Huang Xiaowu , Bai Rixing , Zhang Haiyan
Published: October 2023

Background

Abdominal obesity is appreciated as a major player in insulin resistance and metabolically dysfunctional adipose tissue. Inappropriate extracellular matrix (ECM) remodelling and functional alterations in human adipose stromal/stem cells (hASCs) have been linked with visceral white adipose tissue (vWAT) dysfunction in obesity. Understanding the interactions between hASCs and the native ECM environment in obese vWAT is required for the development of future therapeutic approaches for obesity-associated metabolic complications.

Methods

The phenotypes and transcriptome properties of hASCs from the vWAT of obese patients and lean donors were assessed. The hASC-derived matrix from vWAT of obese or lean patients was generated in vitro using a decellularized method. The topography and the major components of the hASC-derived matrix were determined. The effects of the obese hASC-derived matrix on cell senescence and mitochondrial function were further determined.

Results

We showed that hASCs derived from the vWAT of obese patients exhibited senescence and were accompanied by the increased production of ECM. The matrix secreted by obese hASCs formed a fibrillar suprastructure with an abundance of fibronectin, type I collagen, and transforming growth factor beta 1 (TGF-β1), which resembles the native matrix microenvironment of hASCs in vWAT derived from obese patients. Furthermore, the obese hASC-derived matrix promoted lean hASC ageing and induced mitochondrial dysfunction compared to the lean hASC-derived matrix. Blockade of TGF-β1 signalling using an anti-TGF-β1 neutralizing antibody alleviated the lean hASC senescence and mitochondrial dysfunction induced by the obese hASC-derived matrix.

Conclusions

Native ECM in obesity vWAT initiates hASC senescence through TGF-β1-mediated mitochondrial dysfunction. These data provide a key mechanism for understanding the importance of cell-ECM interactions in hASCs senescence in obesity.
The impact of salps (Salpa thompsoni) on the Antarctic krill population (Euphausia superba): an individual-based modelling study
Authors: Pietzsch Bruno Walter , Schmidt Aaron , Groeneveld Jürgen , Bahlburg Dominik , Meyer Bettina , Berger Uta
Published: October 2023

Background

Krill (Euphausia superba) and salps (Salpa thompsoni) are key macrozooplankton grazers in the Southern Ocean ecosystem. However, due to differing habitat requirements, both species previously exhibited little spatial overlap. With ongoing climate change-induced seawater temperature increase and regional sea ice loss, salps can now extend their spatial distribution into historically krill-dominated areas and increase rapidly due to asexual reproduction when environmental conditions are favorable. Understanding the potential effects on krill is crucial, since krill is a species of exceptional trophic significance in the Southern Ocean food web. Negative impacts on krill could trigger cascading effects on its predators and prey. To address this question, we combined two individual-based models on salps and krill, which describe the whole life cycle of salp individuals and the dynamic energy budget of individual krill. The resulting new model PEKRIS (PErformance of KRIll vs. Salps) simulates a krill population for 100 years under varying chlorophyll-a concentrations in the presence or absence of salps.

Results

All of the investigated krill population properties (abundance, mean length, and yearly egg production) were significantly impacted by the presence of salps. On the other hand, salp density was not impacted if krill were present. The medians of krill population properties deviated during variable maximum chlorophyll-a density per year when salps were introduced by − 99.9% (− 234 individuals per 1000 m3) for krill density, − 100% (− 22,062 eggs per 1000 m3) for krill eggs and − 0.9% (− 0.3 mm) for mean length of krill.

Conclusions

If both species compete for the same food resource in a closed space, salps seem to inhibit krill populations. Further simulation studies should investigate whether this effect prevails if different phytoplankton sizes and consumption preferences of krill are implemented. Furthermore, direct predation of the two species or consumption of krill fecal pellets by salps could change the impact size of the food competition.
Perioperative chemotherapy versus adjuvant chemotherapy treatment for resectable locally advanced gastric cancer: a retrospective cohort study
Authors: Su Pengfei , Jiang Lin , Zhang Yingjing , Yu Tian , Huang Hongyun , Chen Moxi , Cao Can , Kang Weiming , Liu Yuqin , Yu Jianchun
Published: October 2023

Background

Neoadjuvant chemotherapy (NAC) is increasingly used in locally advanced gastric cancer (LAGC), but the clinical safety and efficacy are still controversial. This study aims to compare perioperative chemotherapy (PEC) with adjuvant chemotherapy (AC) for resectable LAGC.

Methods

Patients who underwent D2 gastrectomy for resectable LAGC were retrospectively reviewed, and divided into NSA group (NAC plus surgery and AC) and SA group (surgery followed by AC). The baseline characteristics and perioperative data were compared. Survival analysis was based on Kaplan–Meier method. Multivariate analyses for prognostic factors were based on the Cox regression.

Results

A total of 450 patients were eligible for this study. 218 patients received NAC plus surgery and AC, while 232 upfront surgery followed by AC. The baseline characteristics were comparable between the two groups. NSA group showed significant superiority in R0 resection rate (P = 0.014), excised tumor size (P = 0.038), and tumor downstage (all P < 0.001). NAC did not affect postoperative complications or AC-related grade 3/4 adverse events. Patients in NSA group achieved significantly longer OS (P = 0.021) and DFS (P = 0.002). The Cox regression model showed that NAC was independently associated with better OS (HR 0.245, P = 0.039) and DFS (HR 0.591, P = 0.031).

Conclusions

Compared with SA, the administration of NSA was considered safe and feasible for achieving higher R0 resection rate without increasing the postoperative complications or AC-related grade 3/4 adverse events, and NAC was independently associated with better OS and DFS for resectable LAGC.
Sustainability of community-based workers in multisectoral food security programs: a case study of producer leaders, village vaccinators, mother leaders, and community health workers in Burkina Faso
Authors: Wilson K. R. , Rogers B. L. , Carroll D. A. , Ezaki A. , Coates J.
Published: October 2023

The community-based worker (CBW) model is commonly used by food security projects as an approach to catalyze community-driven development and to enhance long-term sustainability of project impacts in rural areas of low-income countries. However, there is limited follow-up research exploring how CBWs continue to carry out expected activities in the years that follow project exit. This case study examines how four different CBW roles—producer leaders, village vaccinators, community healthcare workers, mother leaders—all trained to contribute to the food security goals of a multi-year initiative in Kaya, Burkina Faso, sustained their respective activities post-project. Two years after the project ended, we collected qualitative data to examine how well these CBWs continued providing the activities that they had been trained to provide as expected by the project. We employ a conceptual framework of sustainability and exit strategies to assess what factors contributed to sustained activities and, where activities ceased, what caused them to stop. We find that where activities were sustained, all four hypothesized factors—sustained capacities, resources, motivation, and linkages—were present. We conclude by discussing key lessons and considerations for using the CBW model: (1) gradually transition to independent operation during project lifetime; (2) integrate CBWs into permanent and functional systems through gradual project exit; (3) professionalize the CBW role (re-think the volunteer approach); (4) what to do about resources and (5) co-develop endogenous definitions and indicators from the project onset.
Experimental Study on Effect of Recycled Reinforced Concrete Waste on Mechanical Properties and Structural behaviour of the Sandy Soil
Authors: Basha Ali , khalifa Fatma , Fayed Sabry
Published: October 2023

In recent years, constructing natural aggregates as a base layer for the roads has increased. Natural resources will run out as long as human consumption of them continues. Recycled concrete aggregate (RC) has thus emerged as a substitute material for the building of road base layers. Additionally, RC can be utilized to create interior city highways. The base layer for roads must have sufficient strength to support the working load on the pavement surface without damage deforming. As a result, the focus of this paper is on enhancing the structural performance of sandy soil reinforced with various RC percentages. The three key factors are relative soil density (Dr = 83 and 97%), recycled concrete aggregate reinforcing levels (RC = 0,5,10,15,20,25,30,40,50 and 100%), and reinforcement layer thickness (Rd = 0.0B, 0.5B, B, and 2B where B is the footing model width). Numerous laboratory experiments were conducted in order to examine the impact of important parameters on the properties of the mixtures. The plate bearing tests were carried out using a footing model (250 × 250 mm) inside a tank (1500 × 1500x1000 mm) to ascertain the stress–strain response, bearing capacity ratio (BCR), ultimate bearing capacity, and modulus of elasticity of the tested mixtures. It is clear that raising the RC has no effect on the diameters of the grains. It was found that as RC increased, the mixture's bulk density increased but specific gravity decreased. Maximum dry density rose as RC rose, whereas water content fell. It was noted that BCR unquestionably increased as RC increased for all RC levels and all values of settlement ratios. The appropriate reinforcing layer thickness is suggested to be no more than 2B. As the RC concentration in the sand and Rd increased, the difference between two pressure-settlement curves of densities 83% and 97% significantly decreased. Furthermore, when RC reaches 50%, two curves are roughly comparable. At RC = 50%, it is advised that the relative density of 83% is sufficient to produce the same behavior as the relative density of 97%. It was found that as RC and Rd grew, the tested mixtures' ultimate bearing capacity and elasticity modulus increased as well. A novel proposed formulas are developed to compute bearing capacity ratio, ultimate bearing capacity, and elasticity modulus of the tested mixtures taking into account the influence of RC, reinforcement layer depth, settlement ratio, and the relative density, and its results agree with the experimental results.