bluuebunny/crossref_metadata_2025 huggingface dataset:
Motivações para o uso do smartphone e tempo de uso por adultos durante a pandemia COVID-19
Authors: Callou Filho Cesario Rui , Branco July Grassiely de Oliveira , Oliveira Tatiana de Queiroz , Brilhante Aline Veras Morais , Silva Carlos Antonio Bruno da , Abdon Ana Paula Vasconcellos
Published: August 2023

Introdução: Padrões e motivações para o uso de smartphones não são consistentes, variando assim com o uso da internet, que tem sido um aliado, ajudando pessoas com medidas de distanciamento social. Objetivo: Investigar motivações para o uso do smartphone e o tempo de uso por adultos durante a pandemia da COVID-19. Métodos: Estudo transversal, realizado entre maio e junho de 2020, com adultos que utilizaram smartphones durante a pandemia. As informações foram obtidas por meio de um questionário online, o Google Forms®, contendo as variáveis socioeconômicas, as motivações para o uso do smartphone e o tempo gasto com ele (em horas). Os dados categóricos foram analisados por meio do software SPSS, e foram expressos como frequências absolutas e relativas, por meio da análise bivariada, aplicadas para avaliar associações entre o “aumento do uso de smartphones” e variáveis socioeconômicas e motivações utilizando o qui-quadrado de Pearson, considerando o nível de significância de 5%. Resultados: 658 indivíduos participaram do estudo, dos quais (84,2%) disseram estar usando o celular por períodos mais longos devido a medidas de distanciamento social, enquanto parte da população utilizou o smartphone por motivos de lazer (27,3%); 30,7% utilizaram o dispositivo de 7 a 12 horas, com 77,0% relatando que o smartphone os ajudou com o distanciamento social; e 35,6% relataram que essa tecnologia os ajudou a manter seu bem- estar mental; esses valores apresentaram significância estatística, com p <0.001. Conclusão: O tempo de uso do smartphone aumentou com a pandemia, que teve um efeito satisfatório na continuidade do distanciamento social, pois remotamente permite a interação social.
Queimar para esquecer: as formas de esquecimento percebidas no espetáculo Museu Nacional [todas as Vozes do Fogo]
Authors: Simões Leonardo Cândido
Published: August 2023

O espetáculo teatral Museu Nacional [todas as Vozes do Fogo], escrito e dirigido por Vinicius Calderoni, puxa para o palco uma das maiores tragédias da cultura brasileira, o incêndio do Museu Nacional, no Rio de Janeiro. Apoiado pelos conceitos de Marc Augé em As Formas do Esquecimento, é possível olhar a peça como um resgate importante da memória do país e parte do processo necessário de esquecimento para que esta memória seja criada e preservada. Ao longo desta resenha crítica, procurei identificar os pontos comuns entre a obra do pesquisador francês e o texto teatral brasileiro, analisando como o espetáculo dramatizou o esquecimento como ferramenta de preservação da história.
Patrimônio como ruína, repatriação como direito: questões sobre arte, geografia e coleção
Authors: Santos Iaci d'Assunção
Published: August 2023

Reflexões sobre repatriação de objetos artísticos e culturais se entrelaçam com considerações sobre arte e sistemas de arte, coleção e o conceito de território. Na leitura crítica aqui apresentada o que se coloca como questão é a própria noção de patrimônio e sua abordagem enquanto ruína em diálogo com a abordagem de Walter Benjamin e suas célebres teses sobre o conceito de história.
Mapeamento de cursos e programas de formação em saúde pública oferecidos no Brasil
Authors: Peres Frederico , Centurión Maria Pasionaria Blanco , Silva Juliana Monteiro Bastos da , Brandão Ana Laura
Published: August 2023

OBJETIVO: Mapear as ofertas formativas em saúde pública no Brasil e identificar, em seus currículos e planos de estudo, as aproximações entre as competências e habilidades neles desenvolvidas e as funções essenciais de saúde pública. MÉTODOS: Estudo descritivo, exploratório, baseado em levantamento e análise de informações disponíveis nos sites de instituições formadoras que ofertam cursos e programas de formação em saúde pública, no Brasil. Os dados foram levantados no âmbito do I Mapeo de Cursos y Programas de Formación en Salud Pública de América Latina. RESULTADOS: Foram identificados 1.222 cursos e programas de formação em saúde pública oferecidos no país, com distribuição desigual no território, porém com ocorrência em todas as unidades da federação. Os resultados desvelaram um conjunto de desafios à formação de sanitaristas, organizados em torno do distanciamento entre as ofertas e as demandas formativas em saúde pública (distribuição desigual de cursos, concentração de capacidades formativas nas capitais e em determinadas regiões, entre outros) e do distanciamento entre teorias e práticas formativas (baixa vinculação das competências desenvolvidas com as funções essenciais de saúde pública, predomínio da lógica disciplinar orientada por núcleos de competência profissional, entre outros). CONCLUSÕES: A superação desses desafios requer esforços estruturais, políticos e de apropriação tecnológica, ampliando o acesso dos atores da prática a uma formação vinculada com as demandas dos serviços e programas de saúde no país.
Temporal Trends and Lesion Sets for Persistent Atrial Fibrillation Ablation: A Meta-Analysis With Trial Sequential Analysis and Meta-Regression
Authors: Sau Arunashis , Kapadia Sharan , Al-Aidarous Sayed , Howard James , Sohaib Afzal , Sikkel Markus B. , Arnold Ahran , Waks Jonathan W. , Kramer Daniel B. , Peters Nicholas S. , Ng Fu Siong
Published: August 2023

BACKGROUND:

Ablation for persistent atrial fibrillation (PsAF) has been performed for over 20 years, although success rates have remained modest. Several adjunctive lesion sets have been studied but none have become standard of practice. We sought to describe how the efficacy of ablation for PsAF has evolved in this time period with a focus on the effect of adjunctive ablation strategies.

METHODS:

Databases were searched for prospective studies of PsAF ablation. We performed meta-regression and trial sequential analysis.

RESULTS:

A total of 99 studies (15 424 patients) were included. Ablation for PsAF achieved the primary outcome (freedom of atrial fibrillation/atrial tachycardia rate at 12 months follow-up) in 48.2% (5% CI, 44.0–52.3). Meta-regression showed freedom from atrial arrhythmia at 12 months has improved over time, while procedure time and fluoroscopy time have significantly reduced. Through the use of cumulative meta-analyses and trial sequential analysis, we show that some ablation strategies may initially seem promising, but after several randomized controlled trials may be found to be ineffective. Trial sequential analysis showed that complex fractionated atrial electrogram ablation is ineffective and further study of this treatment would be futile, while posterior wall isolation currently does not have sufficient evidence for routine use in PsAF ablation.

CONCLUSIONS:

Overall success rates from PsAF ablation and procedure/fluoroscopy times have improved over time. However, no adjunctive lesion set, in addition to pulmonary vein isolation, has been conclusively demonstrated to be beneficial. Through the use of trial sequential analysis, we highlight the importance of adequately powered randomized controlled trials, to avoid reaching premature conclusions, before widespread adoption of novel therapies.
Empirically Identifying and Computationally Modeling the Brain–Behavior Relationship for Human Scene Categorization
Authors: Karapetian Agnessa , Boyanova Antoniya , Pandaram Muthukumar , Obermayer Klaus , Kietzmann Tim C. , Cichy Radoslaw M.
Published: August 2023

Humans effortlessly make quick and accurate perceptual decisions about the nature of their immediate visual environment, such as the category of the scene they face. Previous research has revealed a rich set of cortical representations potentially underlying this feat. However, it remains unknown which of these representations are suitably formatted for decision-making. Here, we approached this question empirically and computationally, using neuroimaging and computational modeling. For the empirical part, we collected EEG data and RTs from human participants during a scene categorization task (natural vs. man-made). We then related EEG data to behavior to behavior using a multivariate extension of signal detection theory. We observed a correlation between neural data and behavior specifically between ∼100 msec and ∼200 msec after stimulus onset, suggesting that the neural scene representations in this time period are suitably formatted for decision-making. For the computational part, we evaluated a recurrent convolutional neural network (RCNN) as a model of brain and behavior. Unifying our previous observations in an image-computable model, the RCNN predicted well the neural representations, the behavioral scene categorization data, as well as the relationship between them. Our results identify and computationally characterize the neural and behavioral correlates of scene categorization in humans.
Classifying and counting the Dalits in the late colonial period: The conundrum of the Jatavs
Authors: Duncan Ian
Published: August 2023

The Jatavs of the United Provinces were not legally recognised as a separate caste until 1942; and then only as a consequence of an exceptional revision of legislation. Yet, for some considerable time before, the provincial authorities had routinely treated Jatavs as if they had already been granted the status of an officially recognised distinct caste grouping. This was despite a ruling in 1933, endorsed jointly by the India Office, the Government of India, and the provincial government, that the Jatavs were not a separate caste. The case of the Jatavs is examined here in the context of the contradictions and confusion in the policies of the colonial authorities, first towards the Depressed Classes, and later in the construction of the category that eventually became the Scheduled Castes. In addition, it is argued that those contradictions also created interstices of ambiguity that many Dalit representatives explored, interrogated, and exploited as they generated the space in which to assert their agency. The history of the Jatavs is an important instance of subaltern politics participating in the procedures of the colonial regime rather than operating in some separate autonomous domain of activity. By engaging with the existing power structures and processes, Jatav leaders created the opportunity to expose and take advantage of the contradictions generated by the confusion in the exercises of classifying and counting conducted by the colonial state.
Hippocampal and parahippocampal volume and function predict antidepressant response in patients with major depression: A multimodal neuroimaging study
Authors: Paolini Marco , Harrington Yasmin , Colombo Federica , Bettonagli Valentina , Poletti Sara , Carminati Matteo , Colombo Cristina , Benedetti Francesco , Zanardi Raffaella
Published: August 2023

Background:

For many patients with major depressive disorder (MDD) adequate treatment remains elusive. Neuroimaging techniques received attention for their potential use in guiding and predicting response, but were rarely investigated in real-world psychiatric settings.

Aims:

To identify structural and functional Magnetic Resonance Imaging (MRI) biomarkers associated with antidepressant response in a real-world clinical sample.

Methods:

We studied 100 MDD inpatients admitted to our psychiatric ward, treated with various antidepressants upon clinical need. Hamilton Depression Rating Scale percentage decrease from admission to discharge was used as a measure of response. All patients underwent 3.0 T MRI scanning. Grey matter (GM) volumes were investigated both in a voxel-based morphometry (VBM), and in a regions of interest (ROI) analysis. In a subsample of patients, functional resting-state connectivity patterns were also explored.

Results:

In the VBM analysis, worse response was associated to lower GM volumes in two clusters, encompassing the left hippocampus and parahippocampal gyrus, and the right superior and middle temporal gyrus. Investigating ROIs, lower bilateral hippocampi and amygdalae volumes predicted worse treatment outcomes. Functional connectivity in the right temporal and parahippocampal gyrus was also associated to response.

Conclusion:

Our results expand existing literature on the relationship between the structure and function of several brain regions and treatment response in MDD. While we are still far from routine use of MRI biomarkers in clinical practice, we confirm a possible role of these techniques in guiding treatment choices and predicting their efficacy.
Meaning Autonomy and Objective Meaning in Life
Authors: Kügler Peter
Published: August 2023

Subjectivism states that meaning in life is determined by what subjects regard as meaningful. Objectivism denies this. The main argument against subjectivism is that it allows for seemingly worthless, or even immoral, sources of meaning. Objectivism, on the other hand, does not do justice to the role of subjective perspectives in the quest for meaning. This paper addresses the shortcomings of both positions by referring to the objective value of ‘meaning autonomy’, defined here as the freedom to determine for oneself what is meaningful in life. While the notion of meaning autonomy is compatible with realist objectivism, objectivity is understood in a non-realist sense in this paper, as being based on cultural standards of meaningfulness. Subjective meaning may be attached to ‘worthless’ activities, but it cannot contradict the moral norms of the society that grants its members meaning autonomy.
Effectiveness of Psychosocial Intervention and Psychoeducation in Improving Psychological Well-being and Cognitive Functioning in Caregivers of Substance Use Issues: A Pilot Study
Authors: Ashmitha K.A. Agnes , Gopal C.N. Ram , Sridhar O.T. Sabari , Kancharla Kinjari
Published: August 2023

Background

Family caregivers of individuals with substance use disorder (SUD) face significant challenges that can impact their well-being, coping abilities, and cognitive functioning. However, the empowerment of these caregivers often goes unnoticed, highlighting the need for supportive interventions.

Purpose

To develop and evaluate the effectiveness of a one-on-one intervention program for family caregivers of SUD patients using pre-test and post-test assessments.

Methods

A pilot study was conducted using a randomized controlled trial design with 40 family caregivers of individuals with SUD. Through a lottery method, participants were randomly assigned to either the control or experimental groups, with each group consisting of 20 caregivers. The intervention program consisted of 12 one-on-one sessions. Pre-test and post-test assessments utilized the Ryff Psychological Well-being Scale, Ways of Coping, revised by Lazarus and Folkman, the Hamilton Anxiety Rating Scale, and the Kingston Caregiver Stress Scale. Descriptive and inferential statistics were analyzed using SPSS software.

Results

Significant differences were observed between the control and experimental groups in psychological well-being, cognitive functioning, coping, anxiety, and stress ( p < .01). The one-on-one intervention program significantly improved well-being and coping skills while reducing anxiety and stress levels. Consequently, the program empowered caregivers and enhanced their psychological resilience in the caregiving process.

Conclusion

The findings support the effectiveness of the one-on-one intervention program in enhancing the well-being, coping skills, cognitive functioning, anxiety, and stress levels of family caregivers of individuals with SUD. This intervention program has the potential to empower caregivers and enable them to better cope with the challenges they face in providing care.
Local Food Entrepreneurship in Rural India: Modelling the Challenges
Authors: Panghal Anupama , Sindhu Shilpa , Sarao Jessica , Dahiya Shweta
Published: August 2023

Local food entrepreneurship plays a vital role in promoting and distributing regional foods. To link local food with the market, there is a need to develop local food systems that promote and support local food, its distribution and consumption. Local food entrepreneurs are constrained due to various factors prevailing in the entire rural ecosystem, which hinders their prospects of business expansion. This study focussed on identifying the commercially feasible local food products that can be produced and marketed by local entrepreneurs. Also, this study is an effort towards identifying and analysing the challenges perceived by local food entrepreneurs in rural India. The challenges were identified through a literature review and the personal interviews of the rural entrepreneurs and were then modelled through the DEMATEL (decision-making trial and evaluation laboratory) approach. The modelling of challenges helped in identifying the priority areas, based on which focused strategies were suggested for the promotion of local food entrepreneurs. From this study, it emerged that product quality issues, lack of buyers and inconsistent government policies are the most significant challenges perceived by entrepreneurs. This study also includes resource mapping for the local entrepreneurs to present a comprehensive scenario of the prevailing ecosystem.
Prevalence of SLEC-negative spontaneous intracranial hypotension in patients with spinal nerve root sleeve diverticula on MRI
Authors: Schartz Derrek , Ellens Nathaniel , Ismail Rahim , Houk Clifton , Kessler Alex , Ellika Shehanaz , Bender Matthew T
Published: August 2023

Purpose

While there is thought to be an association between spinal nerve root diverticula (NRD) and spontaneous intracranial hypotension (SIH) without a spinal longitudinal epidural collection (SLEC), it remains unclear what the overall prevalence of SLEC-negative SIH is in patients with NRD on MRI.

Methods

Spine MRI imaging reports from our single institution were electronically screened for instances of NRD over a 9-year period (2016–2023). From these cases, patients with brain MRIs consistent with SIH were also identified. Subsequently, the overall proportion of SLEC-negative SIH was determined as a function of total cases with NRD based on spinal level.

Results

In total, 83,843 patients with spinal MRIs were screened which identified 4174 (4.97%) with NRD. From these, there were 1203 cervical, 622 thoracic, and 2979 lumbosacral spine MRIs. In total, 16 patients (0.38%; Standard Error [SE]: 0.48%–0.28%) had a brain MRI compatible with SLEC-negative SIH and met ICHD-3 criteria. Patients with cervical NRD had SIH in 2 cases (0.16%; SE: 0.27%–0.05%). SLEC-negative SIH was present in 11 patients with lumbosacral NRD (0.34%; SE: 0.44%–0.24%). In patients with diverticula in the thoracic spine, 14 (2.3%; SE: 2.8%–1.8%) had SLEC-negative SIH. SLEC-negative SIH was significantly more prevalent in patients with thoracic diverticula compared to those with cervical ( p<.0001) or lumbosacral NRD ( p<.0001).

Conclusion

In patients with spinal NRD, concurrent SLEC-negative SIH is present in approximately 0.38% of patients, suggesting that in the vast majority of cases, they are an incidental finding. However, SIH is present in approximately 2.3% of patients with thoracic NRD and may be more specific for leak localization.
Nationwide Analysis of Sacroiliac Joint Fusion Trends: Regional Variations in Utilization and Population Characteristics
Authors: Ton Andy , Mertz Kevin , Abdou Marc , Hang Nicole , Mills Emily S. , Hah Raymond J. , Alluri Ram K. , Wang Jeffrey C.
Published: August 2023

Study Design/Setting

Retrospective cohort analysis

Objectives

This study evaluates utilization and demographic trends for sacroiliac joint (SIJ) fusions across the United States (US).

Methods

Patients who underwent SIJ fusion from 2010-2021 were identified within the PearlDiver national database using International Classification of Disease (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes. Indications for trauma, malignancy, or infection were excluded. Demographic, clinical, and procedure characteristics were recorded along with annual utilization rates. Annual percent change (APC) was calculated to identify increasing or decreasing utilization from prior years. Negative binomial regression was performed to project subsequent utilization for 2022-2028. Chi-squared analysis followed by post-hoc comparisons were used to compare differences in diagnostic indications and clinical features associated with SIJ fusion across regions. Bonferroni adjustments were applied to P-values for pairwise analyses.

Results

Overall, 18 032 patients (69.8% female, mean age = 51.0 + 13.4 years) underwent SIJ fusion between 2010 and 2021. Annual utilization increased by 33.5% on average. The South comprised the largest proportion of cases (48.9%). Projections for 2022-2028 predict continued growth in procedures, with an overall increase of 1100% from 1350 cases in 2021 to 16 195 by end of 2028. Spondyloarthropathy-induced sacroilitis was the most prevalent diagnostic indication nationwide (51%). Of patients undergoing SIJ fusion, 18% had a prior lumbar fusion, and only 45% received a preoperative diagnostic SIJ injection.

Conclusion

As SIJ fusion is increasingly utilized to treat refractory SIJ-based pain, establishing evidence-based guidelines, improving diagnostic strategies, and defining indications are imperative to support growing applications within clinical practice.
Not all questions are created equal: the weight of the Oxford Knee Scores questions in a multicentric validation study
Authors: Luger Matthias , Schopper Clemens , Krottenthaler Eliana S. , Mahmoud Mahmoud , Heyse Thomas , Gotterbarm Tobias , Klasan Antonio
Published: August 2023

Background

The Oxford Knee Score (OKS) has been designed for patients with knee osteoarthritis and has a widespread use. It has 12 questions, with each question having the same weight for the overall score. Some authors have observed a significant ceiling effect, especially when distinguishing slight postoperative differences. We hypothesized that each questions’ weight will depend significantly on the patient’s sociodemographic data and lifestyle.

Methods

In this international multicentric prospective study, we included patients attending a specialist outpatient knee clinic. Each patient filled out 3 questionnaires: (a) demographic data and data pertaining to the OKS, (b) the standard OKS, and (c) the patient gave a mark on the weight of the importance of each question, using a 5-point Likert scale (G OKS). Linear regression models were used for the analysis.

Results

In total 203 patients (106 female and 97 male) with a mean age of 64.5 (±12.7) years and a mean body mass index (BMI) of 29.34 (±5.45) kg/m2 were included. The most important questions for the patients were the questions for pain, washing, night pain, stability, and walking stairs with a median of 5. In the regression models, age, gender, and driving ability were the most important factors for the weight of each of the question.

Conclusion

The questions in the OKS differ significantly in weight for each patient, based on sociodemographic data, such as age, self-use of a car, and employment. With these differences, the Oxford Knee Score might be limited as an outcome measure. Adjustment of the OKS that incorporates the demographic differences into the final score might be useful if the ceiling effect is to be mitigated.

Level of Evidence: Level II prospective prognostic study
Genetic characterisation of the Connemara pony and the Warmblood horse using a within-breed clustering approach
Authors: Lindsay-McGee Victoria , Sanchez-Molano Enrique , Banos Georgios , Clark Emily L. , Piercy Richard J. , Psifidi Androniki
Published: August 2023

Background

The Connemara pony (CP) is an Irish breed that has experienced varied selection by breeders over the last fifty years, with objectives ranging from the traditional hardy pony to an agile athlete. We compared these ponies with well-studied Warmblood (WB) horses, which are also selectively bred for athletic performance but with a much larger census population. Using genome-wide single nucleotide polymorphism (SNP) and whole-genome sequencing data from 116 WB (94 UK WB and 22 European WB) and 36 CP (33 UK CP and 3 US CP), we studied the genomic diversity, inbreeding and population structure of these breeds.

Results

The k-means clustering approach divided both the CP and WB populations into four genetic groups, among which the CP genetic group 1 (C1) associated with non-registered CP, C4 with US CP, WB genetic group 1 (W1) with Holsteiners, and W3 with Anglo European and British WB. Maximum and mean linkage disequilibrium (LD) varied significantly between the two breeds (mean from 0.077 to 0.130 for CP and from 0.016 to 0.370 for WB), but the rate of LD decay was generally slower in CP than WB. The LD block size distribution peaked at 225 kb for all genetic groups, with most of the LD blocks not exceeding 1 Mb. The top 0.5% harmonic mean pairwise fixation index (FST) values identified ontology terms related to cancer risk when the four CP genetic groups were compared. The four CP genetic groups were less inbred than the WB genetic groups, but C2, C3 and C4 had a lower proportion of shorter runs of homozygosity (ROH) (74 to 76% < 4 Mb) than the four WB genetic groups (80 to 85% < 4 Mb), indicating more recent inbreeding. The CP and WB genetic groups had a similar ratio of effective number of breeders (Neb) to effective population size (Ne).

Conclusions

Distinct genetic groups of individuals were revealed within each breed, and in WB these genetic groups reflected population substructure better than studbook or country of origin. Ontology terms associated with immune and inflammatory responses were identified from the signatures of selection between CP genetic groups, and while CP were less inbred than WB, the evidence pointed to a greater degree of recent inbreeding. The ratio of Nebto Newas similar in CP and WB, indicating the influence of popular sires is similar in CP and WB.
Effect of exposed-to-air frequency of cryopreserved embryo on clinical outcomes of vitrified-warmed embryo transfer cycles: a retrospective analysis of 9,200 vitrified-warmed transfer cycles
Authors: Zhang Huan , Ye Danna , Wu Yonggen , Li Yan , Huang Xuefeng
Published: August 2023

Background

Cryopreservation of embryos plays a major role in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. However, the storage condition of the cryopreserved embryo can change temporarily due to repeated retrieval of the embryo from the liquid nitrogen (LN2) tank during the practical application during cryopreservation. Whether the implantation potential of a cryopreserved embryo will be damaged when the cane containing it is temporarily exposed to air due to the transfer between the LN2 tank and LN2 container is yet to be elucidated. Also, whether the exposed-to-air frequency (EAF) of cryopreserved embryos influences the clinical outcomes is unclear.

Objective

To investigate whether the EAF of cryopreserved embryo affects the clinical outcomes of vitrified-warmed embryo transfer.

Methods

A total of 9200 vitrified-warmed embryo transfer cycles were included in this study. All cycles were divided into five groups according to different EAFs (2, 4, 6, 8, or ≥ 10). Post-warming survival rates and clinical outcomes, including implantation, clinical pregnancy and live birth rates were investigated. Kruskal–Wallis test and Pearson’s chi-squared tests were used to compare the patient characteristics and clinical outcomes among the five groups. Furthermore, multivariate logistic regression analyses were conducted to investigate the association between EAF and clinical outcomes.

Results

No significant differences were observed in the positive HCG rate, implantation rate and live birth rate (P > 0.05) among five EAF groups with respect to D3 embryo, D5 blastocyst and D6 blastocyst. Post-warmed survival rate of D3 embryos (P = 0.015) differed significantly among the five EAF groups, but it was not EAF-dependent. Although clinical pregnancy was different among the five groups with respect to D5 blastocyst (P = 0.042), multivariate logistic regression analysis adjusted for confounding variables suggested that EAF did not adversely affect clinical pregnancy or live birth.

Conclusion

These findings indicated that human vitrified embryos in the open system could be repeatedly retrieved from the LN2 tank without affecting the implantation potential of the embryo.
A pediatric virtual care evaluation framework and its evolution using consensus methods
Authors: Dulude Catherine , Sutherland Stephanie , Vanderhout Shelley , King W. James , Zuijdwijk Caroline , Major Nathalie , Audcent Tobey , Howley Heather , Cloutier Paula , Buba Melanie , Jain Raagini , Litwinska Justyna , Findlay Leanne , Malic Claudia , Macaulay Karen , Parker Kasey , Kouri Christine , Goldbloom Ellen B.
Published: August 2023

Background

The use of virtual care has increased dramatically in response to the COVID-19 pandemic, yet evidence is lacking regarding the impact of virtual care on patient outcomes, particularly in pediatrics. A standardized evaluation approach is required to support the integration of virtual care into pediatric health care delivery programs. The objective of this work was to develop a comprehensive and structured framework for pediatric virtual care evaluation. This framework is intended to engage and guide care providers, health centres, and stakeholders towards the development of a standardized approach to the evaluation of pediatric virtual care.

Methods

We brought together a diverse multidisciplinary team, including pediatric clinicians, researchers, digital health leads and analysts, program leaders, a human factors engineer, a family advisor and our manager of health equity and diversity. The team reviewed the literature, including published evaluation frameworks, and used a consensus-based method to develop a virtual care evaluation framework applicable to a broad spectrum of pediatric virtual care programs. We used an iterative process to develop framework components, including domains and sub-domains, examples of evaluation questions, measures, and data sources. Team members met repeatedly over seven months to generate and provide feedback on all components of the framework, making revision as needed until consensus was reached. The framework was then applied to an existing virtual care program.

Results

The resulting framework includes four domains (health outcomes, health delivery, individual experience, and program implementation) and 19 sub-domains designed to support the development and evaluation of pediatric virtual care programs. We also developed guidance on how to use the framework and illustrate its utility by applying it to an existing pediatric virtual care program.

Conclusions

This virtual care evaluation framework expands on previously developed frameworks by providing additional detail and a structure that supports practical application. It can be used to evaluate a wide range of pediatric virtual care programs in a standardized manner. Use of this comprehensive yet easy to use evaluation framework will inform appropriate implementation and integration of virtual care into routine practice and support its sustainability and continuous improvement.
Economic burden of non-communicable diseases on households in Nigeria: evidence from the Nigeria living standard survey 2018-19
Authors: Odunyemi Adelakun , Rahman Taslima , Alam Khurshid
Published: August 2023

Background

The importance of non-communicable diseases (NCDs) in Nigeria is reflected in their growing burden that is fast overtaking that of infectious diseases. As most NCD care is paid for through out-of-pocket (OOP) expenses, and NCDs tend to cause substantial income losses through chronic disabilities, the rising NCD-related health burden may also be economically detrimental. Given the lack of updated national-level evidence on the economic burden of NCDs in Nigeria, this study aims to produce new evidence on the extent of financial hardship experienced by households with NCDs in Nigeria due to OOP expenditure and productivity loss.

Methods

This study analysed cross-sectional data from the most recent round (2018–19) of the Nigeria Living Standard Survey (NLSS). Household-level health and consumption data were used to estimate catastrophic health expenditure (CHE) and impoverishing effects due to OOP health spending, using a more equitable method recently developed by the World Health Organization European region in 2018. The productivity loss by individuals with NCDs was also estimated from income and work-time loss data, applying the input-based human capital approach.

Results

On average, a household with NCDs spent ₦ 122,313.60 or $ 398.52 per year on NCD care, representing 24% of household food expenditure. The study found that OOP on cancer treatment, mental problems, and renal diseases significantly contribute to the cost of NCD care. The OOP expenditure led to catastrophic and impoverishing outcomes for households. The estimations showed that about 30% of households with NCDs experienced CHE in 2018, using the WHO Europe method at the 40% threshold. The study also found that the cost of NCD medications was a significant driver of CHE among NCD-affected households. The results showed heterogeneity in CHE and impoverishment across states and geographical regions in Nigeria, with a higher concentration in rural and North East geopolitical locations. The study also found that 20% of NCD-affected households were impoverished or further impoverished by OOP payment, and another 10% were on the verge of impoverishment. The results showed a negligible rate of unmet needs among households with NCDs.

Conclusions

The study highlights the significant effect of NCDs on Nigerian households and the need for effective policy interventions to address this challenge, particularly among the poor and vulnerable.
Association between cumulative atherogenic index of plasma exposure and risk of myocardial infarction in the general population
Authors: Zhang Yijun , Chen Shuohua , Tian Xue , Wang Penglian , Xu Qin , Xia Xue , Zhang Xiaoli , Li Jing , Liu Fen , Wu Shouling , Wang Anxin
Published: August 2023

Background

Atherogenic index of plasma (AIP) has been confirmed as a novel marker for myocardial infarction (MI), but few evidence on the long-term AIP and MI risk in general populations. We thus aimed to evaluate the relationships of cumulative exposure to AIP and its accumulation time course with the risk of MI.

Methods

A total of 54,440 participants were enrolled in the Kailuan study. Time-weighted cumulative AIP was calculated as the weighted sum of the mean AIP value for each time interval, then normalized by total exposure duration, the exposure duration was from 2006 to 2010. Duration of high AIP exposure was defined as the duration with high AIP and ranged from 0 to 6 years. The time course of AIP accumulation was categorized by the combination of time-weighted cumulative AIP < or ≥ median (− 0.12) and AIP slope.

Results

After 11.05 years of follow-up, 766 incident MI cases were documented. After adjustment for potential confounders, higher risk of MI was observed in participants with the highest time-weighted cumulative AIP quartile (HR, 1.89; 95% CI 1.47–2.43), the longest exposure duration of high AIP (HR, 1.52; 95% CI 1.18–1.95), and those with high time-weighted cumulative AIP and negative slope (HR, 1.42; 95% CI 1.13–1.79).

Conclusions

Long-term cumulative exposure to AIP and the time course of AIP accumulation increased the risk of MI. High AIP earlier resulted in a greater risk increase than later in life with the same time-weighted cumulative AIP, emphasizing the importance of controlling atherogenic dyslipidemia early in life.
Endothelial MICU1 alleviates diabetic cardiomyopathy by attenuating nitrative stress-mediated cardiac microvascular injury
Authors: Shi Xide , Liu Chao , Chen Jiangwei , Zhou Shiqiang , Li Yajuan , Zhao Xingcheng , Xing Jinliang , Xue Junhui , Liu Fengzhou , Li Fei
Published: August 2023

Background

Myocardial microvascular injury is the key event in early diabetic heart disease. The injury of myocardial microvascular endothelial cells (CMECs) is the main cause and trigger of myocardial microvascular disease. Mitochondrial calcium homeostasis plays an important role in maintaining the normal function, survival and death of endothelial cells. Considering that mitochondrial calcium uptake 1 (MICU1) is a key molecule in mitochondrial calcium regulation, this study aimed to investigate the role of MICU1 in CMECs and explore its underlying mechanisms.

Methods

To examine the role of endothelial MICU1 in diabetic cardiomyopathy (DCM), we used endothelial-specific MICU1ecKO mice to establish a diabetic mouse model and evaluate the cardiac function. In addition, MICU1 overexpression was conducted by injecting adeno-associated virus 9 carrying MICU1 (AAV9-MICU1). Transcriptome sequencing technology was used to explore underlying molecular mechanisms.

Results

Here, we found that MICU1 expression is decreased in CMECs of diabetic mice. Moreover, we demonstrated that endothelial cell MICU1 knockout exacerbated the levels of cardiac hypertrophy and interstitial myocardial fibrosis and led to a further reduction in left ventricular function in diabetic mice. Notably, we found that AAV9-MICU1 specifically upregulated the expression of MICU1 in CMECs of diabetic mice, which inhibited nitrification stress, inflammatory reaction, and apoptosis of the CMECs, ameliorated myocardial hypertrophy and fibrosis, and promoted cardiac function. Further mechanistic analysis suggested that MICU1 deficiency result in excessive mitochondrial calcium uptake and homeostasis imbalance which caused nitrification stress-induced endothelial damage and inflammation that disrupted myocardial microvascular endothelial barrier function and ultimately promoted DCM progression.

Conclusions

Our findings demonstrate that MICU1 expression was downregulated in the CMECs of diabetic mice. Overexpression of endothelial MICU1 reduced nitrification stress induced apoptosis and inflammation by inhibiting mitochondrial calcium uptake, which improved myocardial microvascular function and inhibited DCM progression. Our findings suggest that endothelial MICU1 is a molecular intervention target for the potential treatment of DCM.
Disparities in cervical cancer screening programs in Cameroon: a scoping review of facilitators and barriers to implementation and uptake of screening
Authors: Woks Namanou Ines Emma , Anwi Musi Merveille , Kefiye Taal Bernard , Sama Dohbit Julius , Phuti Angel
Published: August 2023

Background

Cervical cancer is the fourth most common cancer worldwide. Organized screening has achieved significant reductions in cervical cancer incidence and mortality in many high-income countries (HICs). But the gap between HICs and low-and-middle-income countries (LMICs) is still substantial as the highest burden of the disease is in LMICs. Cameroon is a LMIC, where cervical cancer is the leading cause of cancer-related deaths among women, only 3–5% of eligible women have been screened and there is no effective national cervical cancer prevention program.

Objective(s)

Identify facilitators and barriers to the implementation and uptake of existing cervical cancer screening programs in Cameroon to inform the implementation of a comprehensive national program.

Methods

We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews (PRISMA-ScR). Google Scholar and five electronic databases (PubMed, CINAHL, Embase, Cochrane library and Web of Science) were searched systematically from 2012 to 2022. Articles on cervical cancer screening programs in Cameroon were eligible for inclusion. Two reviewers independently screened search results and extracted relevant data.

Results

A total of 182 articles were identified using our search strategy, and 20 were included. There was scarcity of publications from the North, Adamawa, East and South regions of Cameroon. Barriers and facilitators found were presented using the World Health Organisation framework for health systems. Cross-cutting barriers were: (1) the lack of a national training curriculum for screening providers with no elaborate, harmonized screening and treatment algorithm for cervical precancers; and (2) women’s lack of information about cervical cancer screening activities. Conversely, provision of screening services at a low or no cost to women in some programs and the feasibility of using novel point of care screening methods like the Human Papillomavirus DNA test were identified as facilitators.

Conclusion

This scoping review indicates that there are knowledge and research gaps concerning the state of cervical cancer screening services in some regions of Cameroon. Moreover, it underlines the need for comprehensive cancer control policies and practices integrating all six-health system building blocks to reduce disparities between regions, and rural versus urban areas in Cameroon.
Advances in treatment strategies based on scavenging reactive oxygen species of nanoparticles for atherosclerosis
Authors: Wu Chengxi , Mao Jingying , Wang Xueqin , Yang Ronghao , Wang Chenglong , Li Chunhong , Zhou Xiangyu
Published: August 2023

The development of atherosclerosis (AS) is closely linked to changes in the plaque microenvironment, which consists primarily of the cells that form plaque and the associated factors they secrete. The onset of inflammation, lipid deposition, and various pathological changes in cellular metabolism that accompany the plaque microenvironment will promote the development of AS. Numerous studies have shown that oxidative stress is an important condition that promotes AS. The accumulation of reactive oxygen species (ROS) is oxidative stress’s most important pathological change. In turn, the effects of ROS on the plaque microenvironment are complex and varied, and these effects are ultimately reflected in the promotion or inhibition of AS. This article reviews the effects of ROS on the microenvironment of atherosclerotic plaques and their impact on disease progression over the past five years and focuses on the progress of treatment strategies based on scavenging ROS of nanoparticles for AS. Finally, we also discuss the prospects and challenges of AS treatment.
Existence results for fractional neutral functional differential equations with infinite delay and nonlocal boundary conditions
Authors: Alghanmi Madeaha , Alqurayqiri Shahad
Published: August 2023

In this paper, we establish sufficient criteria for ensuring the existence of solutions and uniqueness for a class of nonlinear neutral Caputo fractional differential equations supplemented with infinite delay and nonlocal boundary conditions involving fractional derivatives. The theory of infinite delay and standard fixed point theorems are employed to obtain the existence results for the given problem. Examples will be constructed to illustrate the obtained results.
Health financing challenges in Southeast Asian countries for universal health coverage: a systematic review
Authors: Lim Ming Yao , Kamaruzaman Hanin Farhana , Wu Olivia , Geue Claudia
Published: August 2023

Background

Universal Health Coverage (UHC) has received much attention and many countries are striving to achieve it. The Southeast Asian region, in particular, comprises many developing countries with limited resources, exacerbating challenges around attaining UHC. This paper aims to specifically explore the health financing challenges these countries face in achieving UHC via a systematic review approach and formulate recommendations that will be useful for policymakers.

Methods

The systematic review followed the guidelines as recommended by PRISMA. The narrative synthesis approach was used for data synthesis, followed by identifying common themes.

Results

The initial search returned 160 articles, and 32 articles were included after the screening process. The identified challenges in health financing towards achieving UHC in the Southeast Asian region are categorised into six main themes, namely (1) Unsustainability of revenue-raising methods, (2) Fragmented health insurance schemes, (3) Incongruity between insurance benefits and people’s needs, (4) Political and legislative indifference, (5) Intractable and rapidly rising healthcare cost, (6) Morally reprehensible behaviours.

Conclusions

The challenges identified are diverse and therefore require a multifaceted approach. Regional collaborative efforts between countries will play an essential role in the progress towards UHC and in narrowing the inequity gap. At the national level, individual countries must work towards sustainable health financing strategies by leveraging innovative digital technologies and constantly adapting to dynamic health trends.

Registration

This study is registered with PROSPERO, under registration number CRD42022336624.
Effects of Bariatric Surgery on Blood and Vascular Large Extracellular Vesicles According to Type 2 Diabetes Status
Authors: Pané Adriana , Viaplana Judith , Giró Oriol , Llopis Jaume , Ibarzabal Ainitze , de Hollanda Ana , Vidal Josep , Ortega Emilio , Jiménez Amanda , Chiva-Blanch Gemma
Published: August 2023

Context

Large extracellular vesicles (lEVs) enriched for endothelial and blood cell markers are increased in metabolic conditions such as obesity or type 2 diabetes (T2D), actively contribute to the atherosclerotic process, and have been identified as diagnostic and prognostic biomarkers for cardiovascular disease (CVD). Although bariatric surgery (BS) in individuals with obesity is related to decreased cardiovascular (CV) risk and increased life expectancy, after BS these subjects are still at higher CV risk than the general population.

Objective

We aimed to compare the lEV profiles between individuals with obesity, with or without T2D, before and 1 year after BS, and normal-weight controls.

Methods

Prospective longitudinal study with individuals eligible for BS, with or without T2D (T2D and OB groups, respectively) and healthy controls (HC group) matched by age and sex. The concentration and phenotype of lEVs were assessed by flow cytometry.

Results

The study cohort included 108 individuals (age 48.0 ± 10.5 years; 84.3% females). Before BS, the OB group presented higher concentrations of lEV enriched for endothelial and blood cell biomarkers than the HC group, but lower concentrations than those observed in the T2D group (P < .05). BS resulted in a significant reduction in most of the lEVs enriched for cell-specific markers in both subgroups. lEV differences between OB and T2D groups were no longer observed after BS (P > .05). However, compared with HC group, OB and T2D groups still showed increased concentrations of lEVs enriched for platelet and endothelial cell markers (P < .05).

Conclusion

At 1 year after BS, lEV concentrations remain above the physiological range. These abnormalities might contribute to explaining the increased CV risk after BS and underscore the importance of long-term CV risk factor control in post-BS individuals.
Substance Use Disorders: Basic Overview for the Anesthesiologist
Authors: Jimenez Ruiz Federico , Warner Nafisseh S. , Acampora Gregory , Coleman John R. , Kohan Lynn
Published: August 2023

Substance use disorders (SUDs) represent a current major public health concern in the United States and around the world. Social and economic stressors secondary to the coronavirus disease 2019 (COVID-19) pandemic have likely led to an increase in SUDs around the world. This chronic, debilitating disease is a prevalent health problem, and yet many clinicians do not have adequate training or clinical experience diagnosing and treating SUDs. Anesthesiologists and other perioperative medical staff frequently encounter patients with co-occurring SUDs. By such, through increased awareness and education, physicians and other health care providers have a unique opportunity to positively impact the lives and improve the perioperative outcomes of patients with SUDs. Understanding commonly used terms, potentially effective perioperative screening tools, diagnostic criteria, basics of treatment, and the perioperative implications of SUDs is essential to providing adequate care to patients experiencing this illness.