bluuebunny/crossref_metadata_2025 huggingface dataset:
Ten years countdown to hepatitis C elimination in Belgium: a mathematical modeling approach
Authors: Busschots Dana , Ho Erwin , Blach Sarah , Nevens Frederik , Razavi Homie , Van Damme Brieuc , Vanwolleghem Thomas , Robaeys Geert
Published: April 2022

Background

Chronic infection with the hepatitis C virus (HCV) remains a worldwide health problem. As a result, the World Health Organization (WHO) has set elimination targets by 2030. This study aims to examine the position of Belgium in meeting the WHO's targets by 2030.

Methods

A Markov disease progression model, constructed in Microsoft Excel, was utilized to quantify the size of the HCV-infected population, by the liver disease stages, from 2015 to 2030. Two scenarios were developed to (1) forecast the disease burden in Belgium under the 2019 Base and (2) see what is needed to achieve the WHO targets.

Results

It was estimated that the number of HCV RNA-positive individuals in Belgium in 2015 was 18,800. To achieve the WHO goals, Belgium needs to treat at least 1200 patients per year. This will only be feasible if the number of screening tests increases.

Conclusions

Belgium is on target to reach the WHO targets by 2030 but will have to make sustained efforts. However, eradicating HCV requires policy changes to significantly increase prevention, screening, and treatment, alongside public health promotion, to raise awareness among high-risk populations and health care providers.
Fatigue, stigma, and mood in patients with multiple sclerosis: effectiveness of guided imagery
Authors: Beitollahi Mina , Forouzi Mansooreh Azizzadeh , Tirgari Batool , Jahani Yunes
Published: April 2022

Background and objectives

The present study aimed to assess the effectiveness of guided imagery on fatigue, stigma, and mood in patients with multiple sclerosis.

Methods

This clinical trial is a double-blind study that was conducted on 60 patients with multiple sclerosis referred to the largest center for special diseases in the southeast of Iran in 2020. The convenience sampling method was used to select the participants who were later divided into two groups of intervention (n = 30) and control (n = 30) using block randomization method. The intervention group listened to the guided imagery audio file at home for 25 min. The control group did not receive any intervention. Data were collected by demographic information questionnaires, Fatigue Severity Scale (FSS), Reece Stigma Scale for Multiple Sclerosis (RSS-MS), and the Profile of Mood States (POMS) before and one month after the intervention.

Results

According to the results, there was no significant difference between the two groups before the intervention in terms of the score of fatigue (P < 0.0 = 67), stigma (P < 0.64), and mood (P < 0.17). However, after the intervention, a significant differences was observed in this regard (P < 0.0001). In the intervention group, the mean score of fatigue decreased from 59.72 ± 18.32 to 35.8 ± 16.15, and the mean score of stigma decreased from 17.31 ± 15.62 to 5.09 ± 8.06, showing a significant reduction in the levels of fatigue (P < 0.0001) and stigma (P < 0.0001) compared to before intervention. Also, the mean score of mood decreased from 36.90 ± 12.21 to 28.55 ± 11.87, indicating an improvement in the mood of samples in the intervention group (P < 0.0001).

Conclusions

The results indicated that guided imagery, as a cost-effective method, can decrease the fatigue and stigma, and enhance the mood of patients with MS. Therefore, nursing staff can use this method to improve MS patients’ mood and decrease their fatigue and stigma.
Oral cryotherapy for management of chemotherapy‐induced oral mucositis in haematopoietic cell transplantation: a systematic review
Authors: Alsulami Faizah Jabr , Shaheed Sadr ul
Published: April 2022

Background

Oral mucositis (OM) is known to be the most common and challenging side effect of conditioning chemotherapy in haematopoietic cell transplant (HCT). This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses. There are few clinical trials in the literature that indicate any kind of treatment or prevention methods are effective. Therefore, the aim of this study is to perform a systematic review of literature and examine the effectiveness of oral cryotherapy (OC) in management of chemotherapy-induced OM in patients with haematological malignancies undergoing a HCT.

Methods

A systematic literature search was conducted, using the electronic databases PubMed, Embase, MEDLINE and Scopus. A total of 322 papers were identified and 9 papers were analysed based on defined inclusion and exclusion criteria. The quality of the chosen primary studies was appraised using the COCHRANE risk of bias assessment tool.

Results

Nine randomized controlled trials, analysing 658 participants; control group (n = 289, age mean ± SD; 41.15 ± 21) and treatment group (n = 369, age mean ± SD; 39.15 ± 20), were included in this systematic review. Seven studies had significantly addressed the effectiveness of OC (p value < 0.05), in reducing the incidence of developing severe OM in the adult population undergoing HCT, especially when the conditioning regimen protocols included high dose of alkylating agent such as melphalan.

Conclusion

This review supports the use of OC for prevention of OM in patients undergoing HCT, with high-dose of melphalan conditioning protocols. It is recommended that more studies be conducted to compare efficacy and duration of OC with other chemotherapeutic agents with relatively short plasma half-lives. The heterogeneity of the trials demonstrated the need to regulate the validated assessment tools and similar interventions that would enable comparisons and analyses of treatment effects based on well-designed RCTs.
Smoking: a leading factor for the death of chronic respiratory diseases derived from Global Burden of Disease Study 2019
Authors: Gan Hui , Hou Xiangqing , Zhu Zheng , Xue Mingshan , Zhang Teng , Huang Zhifeng , Cheng Zhangkai Jason , Sun Baoqing
Published: April 2022

Background

Smoking is believed as one of the major risk factors resulting in a variety of non-communicable diseases, such as lung cancer and chronic respiratory diseases (CRDs). However, the global burden of CRDs attributed to smoking has not been systematically studied, particularly across different temporal and spatial scales.

Methods

We conducted a systematic analysis of the Global Burden of CRDs and related risk factors using data from the Global Burden of Disease Study 2019. Incidence, death, risk factors, and other parameters such as estimated annual percentage change have been analyzed. We also compared various risk factors across regions, countries, and genders.

Results

Globally, the incidence of CRDs and deaths cases have increased in the last 30 years, while the corresponding age-standardized incidence rate (ASIR) and death rate (ASDR) have declined. Smoking was the leading risk factor for the death of CRDs all over the world. However, in low and low-middle Socio-demographic Index (SDI) areas, particulate matter pollution was the main risk factor leading to death from CRDs, while smoking was ranked first among the major risk factors in areas with middle, middle-high, or high SDI. Globally, gender differences in morbidity and mortality from CRDs were observed. Males had slightly more cases and ASIR of chronic respiratory diseases than females over the last 30 years. However, the mortality cases and ASDR in males were significantly higher than that of females. Furthermore, the ASDR of all major risk factors, specially smoking, was higher in men than in women.

Conclusions

CRDs were still major threats human health. The current study highlights the dominating roles of smoking for death risks resulting from CRDs, followed by PM pollution. Therefore, tobacco control and improving air quality are key to reducing deaths from CRDs.
Treatment outcome of tardy ulnar nerve palsy associated with traumatic cubitus valgus by supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release
Authors: Fan Chenchen , Yushan Maimaiaili , Liu Yanshi , Bahesutihan Yemenlehan , Liu Kai , Yusufu Aihemaitijiang
Published: April 2022

Background

Tardy ulnar nerve palsy is a common late complication of traumatic cubitus valgus. At present, the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus is still controversial, whether these two problems can be corrected safely and effectively in one operation is still unclear. To investigate the supracondylar shortening wedge rotary osteotomy combined with in situ tension release of the ulnar nerve in the treatment of tardy ulnar nerve palsy associated with traumatic cubitus valgus.

Methods

Between 2012 and 2019, 16 patients who had traumatic cubitus valgus deformities with tardy ulnar nerve palsy were treated with simultaneous supracondylar shortening wedge rotary osteotomy and ulnar nerve in situ tension release. we compared a series of indicators of preoperative and postoperative follow-up for at least 24 months, (1) elbow range of motion; (2) the radiographic correction of the preoperative and postoperative humerus-elbow-wrist angles; (3) the static two-point discrimination and grip strength; and (4) the preoperative and postoperative DASH scores of upper limb function. The minimum follow-up was 24 months postoperative (mean, 33 months; range, 24 ~ 44 months).

Results

The mean ROM was improved from 107 ° preoperatively to 122 ° postoperatively (P = 0.001). The mean preoperative elbow wrist angle was 24.6 °, and the mean postoperative humerus-elbow wrist angle was 12.1 ° (P < 0.001). The average grip strength and static two-point discrimination improved from 21 kgf and 8 mm to 28 kgf and 4.0 mm (P < 0.001 and P < 0.001, respectively). The ulnar nerve symptoms were improved in all patients except one. The mean HASH score improved from 29 to 16 (P < 0.001).

Conclusion

Supracondylar shortening wedge rotary osteotomy combined with in situ tension release of ulnar nerve is an effective method for the treatment of traumatic cubitus valgus with tardy ulnar nerve palsy, which restored the normal biomechanical characteristics of the affected limb and improved the elbow joint function.
Useful diagnostic histogenetic features of ectopic odontogenic ghost cell tumours
Authors: Noda Yuri , Ohe Chisato , Ishida Mitsuaki , Okano Kimiaki , Sando Kaori , Hada Naoya , Ebisu Yusuke , Fujisawa Takuo , Yagi Masao , Iwai Hiroshi , Tsuta Koji
Published: April 2022

Background

Ectopic odontogenic tumours are rare and difficult to diagnose. Consequently, they are occasionally misdiagnosed as other tumours and overtreated. Dentinogenic ghost cell tumours (DGCTs) are odontogenic neoplasms characterised by a CTNNB1 mutation, ghost cell appearance, and dentinoid-like calcification. Herein, we present a case of ectopic DGCT on the floor of a patient’s mouth, providing reliable clinicopathological and genetic evidence of its odontogenicity for the first time.

Case presentation

A 72-year-old man presented with painless sublingual swelling. Imaging revealed a multi-lobulated, solid-cystic mass on the floor of his mouth. Cytological evaluation showed folded epithelial clusters composed of basaloid cells, keratinised material, and calcification. Histological analysis revealed a multi-cystic, cribriform to solid nest, with an odontogenic satellate reticulum-like epithelium, including ghost cells and dentinoid matrix deposition. Immunohistochemical analysis found that CK19, CK5/6, bcl-2, and p63 were diffuse positive, β-catenin was focal positive in the nuclei, and the cells in the dentinoid matrix were positive for DMP1. The CTNTTB1 mutation was detected, leading to the final diagnosis of ectopic DGCT. There was no recurrence during the 6-month follow-up.

Conclusions

Overall, we have presented a comprehensive clinical overview of DGCT and identified its pathological and genetic features. This report will aid in the recognition of this rare disease in the future and help to avoid misdiagnosis and overtreatment.
Long term tailored implementation of structured “TREAT” journal clubs in allied health: a hybrid effectiveness-implementation study
Authors: Wenke Rachel , Wiseman Jodie , Brandenburg Caitlin , Stehlik Paulina , Hughes Ian , Richards Katherine , Mickan Sharon
Published: April 2022

Background

Allied Health Professionals (AHPs) commonly use journal clubs (JCs) to support Evidence-Based Practice (EBP). There is however little research regarding implementing and sustaining JCs in the long term, and their impact on EBP use and skills in AHPs. This study investigated the impact of implementing a structured JC format, called “TREAT” (previously only investigated across 6 sessions), over a longer period of 16 sessions for AHPs in a public health service. The study also investigated AHP’s attendance, adherence, satisfaction and barriers and enablers to implementing the format.

Methods

A mixed methods hybrid-effectiveness implementation design was employed, guided by the Knowledge-to-Action cycle. EBP skills, confidence, use, and attitudes were assessed (Adapted Fresno Test, EBPQ, tailored journal club culture questionnaire) at baseline, and after 10 and 16-monthly sessions. Satisfaction and impact on clinical practice were explored using questionnaires at 10 and 16-months, with free-form responses identifying enablers and barriers to EBP culture and implementation. Data on attendance and adherence to the TREAT format were also collected.

Results

Six JCs comprising a total of 132 unique participants from seven Allied Health professions were assessed across three time points. EBP skills improved on the Adapted Fresno Test after 10-monthly (6.6 points: 95% CI, 0.43 to 12.7) and 16-monthly sessions (7.8 points, 95% CI, 0.85 to 14.7), and on self-reported total EBPQ ratings of confidence at 10-months (4.9 points: 95% CI, 2.2 to 7.5) and 16-months (5.7 points: 95% CI 2.7 to 8.7). Of 132 AHPs, 88 reported adopting new treatments/resources and 64 reported updating clinical procedures. Mean attendance was 5.7 sessions (SD = 3.8). Adherence to TREAT components in each session was 86% (95% CI, 83% to 89%). Most participants recommended the format and reported a desire to continue. Enablers to the JC included using clinically relevant topics and active participation while reported barriers included limited time to prepare.

Conclusions

Despite variable attendance, TREAT JCs can continue to be implemented within a service for 16 monthly-sessions, and may contribute to improved EBP skills and confidence and changes in clinical practice over time. Tailoring of implementation strategies was shown to be important to address local enablers and barriers.
The life history narrative of clinical nurses with more than 30 years of experience
Authors: Shin Bong Ja , Park Eun Young
Published: April 2022

Background

The nurses with long-term careers in clinical settings shows a clear declining trend. Recording the specific period in Korea’s nursing history is also important from a historical perspective. The aim of this study was to analyze the life history narrative of clinical nurses who have been in service for more than 30 years and to explore the strength and structure of their experience that enabled them to retain their long-term careers.

Methods

This study conducted qualitative research with a life history narrative. For data collection, biographical-narrative interview through in-depth personal interviews with six participants. The participants were clinical nurses who had worked at a general hospital for more than 30 years. The interviews were conducted in three sessions per participant, each session lasting 90–180 min. Qualitative thematic analysis was used to analyze the data.

Results

The narrative of their life stories were analyzed by dividing them into “Dimensions,” “Turnings” and “Adaptations”. The dimensions were categorized into individual and career dimensions. Turning points were empirical and environmental conditions that posed a threat to their career retention as nurse clinicians. Adaptations were illustrated individual methods and social interactions. Twenty-four themes were derived from the 94 thematic statements. After the abstract, four comprehensive categories emerged. The core theme for retaining long-term careers, with “Finding value in myself” comprising four themes: “acknowledgement and support from families,” “healthy relationship at work,” “trusting myself’,” and “accumulation of small achievements.”

Conclusions

The life narratives of participants reveal a close connection with and relationship between the changes in the social aspects, the fields of healthcare and nursing, their individual predispositions, family recognition, and organizational support at that time in Korea. The healthy interpersonal relationships in work place are the most important condition in maintaining the long-term work of nurses. The experience of nurses in one era may not be able to represent experiences in another era, so an in-depth study exploring the social context seems to be necessary. There is a need for policies and changes in the field that can keep the lives of professional women working as nurses proudly.
Mapping evidence on knowledge of breast cancer screening and its uptake among women in Ghana: a scoping review
Authors: Afaya Agani , Seidu Abdul-Aziz , Sang Somin , Yakong Vida Nyagre , Afaya Richard Adongo , Shin Jinhee , Ahinkorah Bright Opoku
Published: April 2022

Introduction

Female breast cancer is currently the most commonly diagnosed cancer globally with an estimated 2.3 million new cases in 2020. Due to its rising frequency and high mortality rate in both high- and low-income countries, breast cancer has become a global public health issue. This review sought to map literature to present evidence on knowledge of breast cancer screening and its uptake among women in Ghana.

Methods

Five databases (PubMed, CINAHL, PsycINFO, Web of Science, and EMBASE) were searched to identify relevant published studies between January 2012 and August 2021 on knowledge of breast cancer screening and its uptake among women. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews and the six-stage model by Arksey and O’Malley were used to select and report findings.

Results

Of the 65 articles retrieved, 14 records were included for synthesis. The review revealed varied knowledge levels and practices of breast cancer screening among women across a few regions in Ghana. The knowledge level of women on breast cancer screening was high, especially in breast cancer screening practice. Breast cancer screening practice among women was observed to be low and the most identified barriers were lack of technique to practice breast self-examination, having no breast problem, lack of awareness of breast cancer screening, and not having breast cancer risk. The results further showed that good knowledge of breast cancer screening, higher educational level, increasing age, physician recommendation, and household monthly income were enabling factors for breast cancer screening uptake.

Conclusion

This review showed varied discrepancies in breast cancer screening uptake across the regions in Ghana. Despite the benefits of breast cancer screening, the utilization of the screening methods across the regions is very low due to some varied barriers from the different regions. To increase the uptake of breast cancer screening, health workers could employ various strategies such as community education and sensitization on the importance of breast cancer screening.
Availability and affordability of priority lifesaving maternal health medicines in Addis Ababa, Ethiopia
Authors: Dinkashe Fantaye Teka , Haile Kinfe , Adem Fatimetu Mohammed
Published: April 2022

Background

Access to life-saving medicines for maternal health remains a major challenge in numerous developing nations. Periodic and continuous assessment of access to lifesaving commodities is of enormous importance to measure progress and ensure sustainable supply. This study aimed to assess the availability and affordability of priority lifesaving maternal medicines in Addis Ababa in January 2021.

Methods

An institutional-based cross-sectional study design was employed to assess 33 representative private pharmacies, public health facilities, NGO and private hospitals providing maternal health care and dispensing medicines from January 12 to 27, 2021 in Addis Ababa, the capital city of Ethiopia. WHO and Health Action International procedures were followed to determine sample size, sampling of health facilities, and data collection. WHO and UNFPA priority lifesaving maternal health medicines included in the Ethiopia essential medicine list were included in the study. Data were cleaned and entered into SPSS version 25 for analysis.

Result

The overall mean availability of maternal health medicines was fairly high, 59% (range 6%-94%), as per the WHO availability index. Among the four sectors, the private pharmacy had the lowest availability (40%), while the mean availability in private hospitals, public and NGO/mission sector facilities were 70%, 72% and 72% respectively. Medicines used only for the management of maternal health conditions had lower availability (47%) compared to commodities used for the broader indication (65%). Compared based on source, the average availability of maternal health medicines which could be sourced locally was (68%) higher than imported medicines (55%). Affordability was not an issue in the public sector, public facilities offered maternal health medicines at no cost to the client. On the other hand, the private hospitals dispensed only 13% of the medicines at affordable prices followed by the private pharmacies (17%) and NGO/Mission facilities (29%). Furthermore, key challenges to access maternal health medicines were frequent stockouts in the public sector and the high cost of medicines in the private sector.

Conclusion

Even though it was below the recommended 80% availability, fairly high availability with variabilities across sectors was observed. Except in the public sector, maternal health medicines were unaffordable in Addis Ababa.
Organizational readiness to implement the Serious Illness Care Program in hospital settings in Sweden
Authors: Andersson Sofia , Sandgren Anna
Published: April 2022

Background

The Serious Illness Care Program (SICP) is a model developed for structured communication, identifying patients, and training physicians to use a structured guide for conversations with patients and family members. However, there is a lack of knowledge regarding the sustainable implementation of this conversation model. Therefore, the aim of this study was to identify barriers and enablers during the implementation of the SICP in hospital settings.

Methods

The SICP was implemented at 20 units in two hospitals in Sweden. During the implementation process, seven individual interviews and two group interviews were conducted with seven facilitators (five physicians, one behavioral therapist, and one administrator). Data were analyzed using qualitative content analysis, first inductively, and then deductively using the organizational readiness for change as a theoretical framework.

Result

The analysis resulted in three factors acting as enablers and eight factors acting as enablers and/or barriers during the implementation of the SICP. The three factors considered as enablers were preliminaries, identifying patients, and facilitator’s role. The eight factors considered as enablers and/or barriers were broad implementation, leadership, time, confidence, building foundation, motivation to work change, motivation for training in serious illness conversations, and attitudes.

Conclusion

This study indicates limited readiness to implement the SICP in hospital settings due to considerable variation in organizational contextual factors, change efficacy, and change commitment. The identified enablers and barriers for implementation of the SICP could guide and support future implementations to be sustainable over time.
Molecular investigation and clinical management of Hepatozoon Canis infection in an Indian jackal – a case report
Authors: Kolangath S.M. , Upadhye S.V. , Dhoot V.M. , Pawshe M.D. , Shalini A.S. , Kolangath R.M.
Published: April 2022

Background

Hepatozoonosis is a common tick-borne illness reported from all over the world. The infection has been well documented in dogs and cats, and has also been identified in wild canids and felids. India is home to many canid species; however, the incidence of Hepatozoonosis in wild canids is rarely reported. A wide variety of protocols have been discussed for the clinical management of the infection in companion animals; however, the suitability of treatment protocols in wild canids is understudied. The current case report highlights the clinical management of Hepatozoonosis in an Indian jackal and molecular investigation to provide vital insights into the epidemiology of the disease.

Case Presentation

A paraplegic Indian jackal was rescued from Melghat Tiger Reserve, Maharashtra, India. The animal had extensive decubital ulcers on the left pin bone and could not walk; however, the animal was active and dragged the hindlimb during locomotion. The vital parameters, blood and serum investigations were normal. Post physiotherapy, massage and infrared therapy, the animal could walk but started knuckling, resulting in injuries. Eight weeks into rehabilitation, the animal had a steep fall in haemoglobin concentration, platelet count, weight loss and was diagnosed with Hepatozoonosis. Considering the altered vital parameters, the jackal was rationally treated with Doxycyclin @ 20 mg/Kg O.D. (Once Daily) for 45 days along with supportive therapy. The jackal recovered after the treatment and led a normal life.

Conclusion

Mono-drug regime using Doxycycline was effective in the alleviation ofH.canisinfection in jackal. The drug was effective in alleviating the clinical presentation without alteration of vital parameters. The molecular investigation provided qualitative inputs in understanding the epidemiology ofHepatozoonin wild canids.
The association between health-promoting-lifestyles, and socioeconomic, family relationships, social support, health-related quality of life among older adults in china: a cross sectional study
Authors: Zheng Xiao , Xue Yaqing , Dong Fang , Shi Lei , Xiao Shujuan , Zhang Jiachi , Xue Benli , Qian Yi , Zhu Hong , Man Qiang , Zhang Chichen
Published: April 2022

Objectives

Lifestyles, accounting for 53% in determining death, play a vital role in improving the health of older adults. Thus, this study aimed to explore the influencing factors of the health-promoting-lifestyles and interaction mechanisms among older adults.

Methods

A total of 8526 elders were selected by a three-stage stratified random cluster sampling method. Socioeconomic status, family relationships, social support, health-related quality of life (QOL), and health-promoting-lifestyles (HPLP) of older adults were assessed with the Social Support Rating Scale, the short form 36 health survey (SF-36) and Health-Promoting Lifestyle Profile. A structural equation model (SEM) was conducted to test the direct and indirect association between influencing factors with HPLP.

Results

In this study, there were 4901 older adults who were empty nesters, and 3625 were non-empty nesters. Of all respondents, the average QOL score of older adults was 62.28 ± 16.51, average social support score was 78.06 ± 7.50. The HPLP score of older adults was 105.9 ± 19.6, and the average score of subscales was 2.5 ± 0.5, which was at the medium level. Social support had a positive and direct effect on HPLP of older adults (total effect, 0.34). Meanwhile, social support mediated the relationship between socioeconomic (total effect, 0.17), QOL (total effect, 0.33) and HPLP. Family relationships had a small indirect effect on HPLP via social support (0.01).

Conclusions

Social support is the strongest influencing factor in the health-promoting-lifestyles among older adults, followed by socioeconomic, health-related quality of life and family support. Thus, maintaining higher social support was important to improve the HPLP of older adults.
Applying pytorch toolkit to plan optimization for circular cone based robotic radiotherapy
Authors: Liang Bin , Wei Ran , Zhang Jianghu , Li Yongbao , Yang Tao , Xu Shouping , Zhang Ke , Xia Wenlong , Guo Bin , Liu Bo , Zhou Fugen , Wu Qiuwen , Dai Jianrong
Published: April 2022

Background

Robotic linac is ideally suited to deliver hypo-fractionated radiotherapy due to its compact head and flexible positioning. The non-coplanar treatment space improves the delivery versatility but the complexity also leads to prolonged optimization and treatment time.

Methods

In this study, we attempted to use the deep learning (pytorch) framework for the plan optimization of circular cone based robotic radiotherapy. The optimization problem was topologized into a simple feedforward neural network, thus the treatment plan optimization was transformed into network training. With this transformation, the pytorch toolkit with high-efficiency automatic differentiation (AD) for gradient calculation was used as the optimization solver. To improve the treatment efficiency, plans with fewer nodes and beams were sought. The least absolute shrinkage and selection operator (lasso) and thegroup lassowere employed to address the “sparsity” issue.

Results

The AD-S (AD sparse) approach was validated on 6 brain and 6 liver cancer cases and the results were compared with the commercial MultiPlan (MLP) system. It was found that the AD-S plans achieved rapid dose fall-off and satisfactory sparing of organs at risk (OARs). Treatment efficiency was improved by the reduction in the number of nodes (28%) and beams (18%), and monitor unit (MU, 24%), respectively. The computational time was shortened to 47.3 s on average.

Conclusions

In summary, this first attempt of applying deep learning framework to the robotic radiotherapy plan optimization is promising and has the potential to be used clinically.
Treatment results for patients with squamous-cell carcinoma of the anus, a single institution retrospective analysis
Authors: Neelis Karen J. , Kip Django M. , Speetjens Frank M. , van der Linden Yvette M.
Published: April 2022

Background and purpose

To gain insight into the treatment outcomes for anal cancer a retrospective analysis was performed with a special emphasis on trends in outcome and toxicities over time and on treatment of elderly patients.

Materials and methods

Medical records of 98 consecutive patients with squamous cell carcinoma of the anus of all stages treated with curative intent between 01-01-2009 and 31-12-2018 were analyzed with follow up until 31-12-2020. Standard tumor and pathological lymph node dose were 59.4 Gy (median 59.4 Gy, range 59.4–70 Gy) or 60 Gy (no deviation from intended dose), elective nodal regions were treated with 45 Gy (no deviations). Radiotherapy techniques in this period evolved from 3D-conformal to IMRT and VMAT. In 23 patients electron beams were used.

Results

Median age was 63 years (range 41–88), the majority of patients were female (60%). Twenty three patients were > 75 years old. The TNM stages were I, II, IIIA, and IIIB in 18%, 40%, 15% and 27%, 58% of patients had N0 status. Concurrent mitomycin C and 5-fluoruracil-based chemotherapy was given in 63 patients (64%). Five-year overall survival (OS), disease free survival (DFS), locoregional control (LRC) and colostomy free survival (CFS) were 71%, 80%, 82%, and 82% for the whole group. Results in patients > 75 years of age were not statistically different from those in younger patients. With the introduction of more conformal techniques DFS did not change and toxicities decreased.

Conclusion

Real word treatment outcomes per disease stage were in line with what is reported in literature. Older patients should also be offered treatment with curative intent.
A clinical randomized controlled trial: moxibustion at Laogong interval with Panax notoginseng promoted the maturation of arteriovenous fistulae
Authors: Chen Yurou , Xu Lin , Huang Di , Chen Dongping , Wu Feng , Wang Luobing , Zhou Jie , Lan Tianying , Qin Xuehua , Ye Chaoyang
Published: April 2022

Background

We aim to study the clinical effect of moxibustion at Laogong interval with Panax notoginseng on the short-term maturation and long-term patency of arteriovenous fistula.

Methods

Seventy-four pre-dialysis uremic patients who received distal forearm radial-cephalic fistula creations were enrolled in this study and randomly assigned to the control group and experimental group. After arteriovenous fistula creations, the control group underwent handgrip exercise, and the experimental group received moxibustion at Laogong acupoint interval with Panax notoginseng. Both groups received a 12-week treatment and were followed up for 24 weeks in all at the following time points: before creations and 2, 4, 8, 12, 24 weeks after creations. The diameter of anastomosis, the diameter and outflow of draining-veins 5 cm above anastomosis, the diameter and outflow of brachial arteries evaluated the maturation and patency of arteriovenous fistula. Enzyme linked immunosorbent assay determined serum levels of endothelin and nitric oxide.

Results

The maturity rate in the experimental group was significantly higher than that in the control group at 4 weeks after arteriovenous fistula creations (P = 0.048). The diameter of anastomosis, the diameter of draining veins, and the blood flow of draining veins increased in both groups during the whole 24 weeks. The diameter and blood flow of brachial arteries ascended in both groups during the previous 12 weeks. Compared with the control group, moxibustion at Laogong interval with Panax notoginseng significantly improved the value of the diameter of draining-veins (P = 0.016), the blood flow of draining-veins (P = 0.015), the diameter of brachial arteries (P < 0.001), and the blood flow of brachial arteries (P = 0. 012) at 2 weeks, and enhanced the blood flow of draining-veins (P = 0.029) and brachial arteries (P < 0.001) at 12 weeks. Serum levels of endothelin were significantly lower (P = 0.047), and serum levels of nitric oxide were markedly higher (P < 0.001) in the experimental group than that in the control group at 2 weeks after creations.

Conclusions

Moxibustion at Laogong interval with Panax notoginseng was non-invasive and promoted the maturation of arteriovenous fistula at 4 weeks after creations. However, its long-term beneficial effect on patency at 24 weeks after creations was not significant.

Trial registration Chinese Clinical Trial Registry, No. ChiCTR1900024042. Registered, http://www.chictr.org.cn/index.aspx
Developing a taxonomy of care coordination for people living with rare conditions: a qualitative study
Authors: Walton Holly , Simpson Amy , Ramsay Angus I. G. , Hudson Emma , Hunter Amy , Jones Jennifer , Ng Pei Li , Leeson-Beevers Kerry , Bloom Lara , Kai Joe , Kerecuk Larissa , Kokocinska Maria , Sutcliffe Alastair G. , Morris Stephen , Fulop Naomi J.
Published: April 2022

Background

Improving care coordination is particularly important for individuals with rare conditions (who may experience multiple inputs into their care, across different providers and settings). To develop and evaluate strategies to potentially improve care coordination, it is necessary to develop a method for organising different ways of coordinating care for rare conditions. Developing a taxonomy would help to describe different ways of coordinating care and in turn facilitate development and evaluation of pre-existing and new models of care coordination for rare conditions. To the authors’ knowledge, no studies have previously developed taxonomies of care coordination for rare conditions. This research aimed to develop and refine a care coordination taxonomy for people with rare conditions.

Methods

This study had a qualitative design and was conducted in the United Kingdom. To develop a taxonomy, six stages of taxonomy development were followed. We conducted interviews (n = 30 health care professionals/charity representatives/commissioners) and focus groups (n = 4 focus groups, 22 patients/carers with rare/ultra-rare/undiagnosed conditions). Interviews and focus groups were audio-recorded with consent, and professionally transcribed. Findings were analysed using thematic analysis. Themes were used to develop a taxonomy, and to identify which types of coordination may work best in which situations. To refine the taxonomy, we conducted two workshops (n = 12 patients and carers group; n = 15 professional stakeholder group).

Results

Our taxonomy has six domains, each with different options. The six domains are: (1) Ways of organising care (local, hybrid, national), (2) Ways of organising those involved in care (collaboration between many or all individuals, collaboration between some individuals, a lack of collaborative approach), (3) Responsibility for coordination (administrative support, formal roles and responsibilities, supportive roles and no responsibility), (4) How often appointments and coordination take place (regular, on demand, hybrid), (5) Access to records (full or filtered access), and (6) Mode of care coordination (face-to-face, digital, telephone).

Conclusions

Findings indicate that there are different ways of coordinating care across the six domains outlined in our taxonomy. This may help to facilitate the development and evaluation of existing and new models of care coordination for people living with rare conditions.
Brown adipose tissue thermogenesis among a small sample of reindeer herders from sub-Arctic Finland
Authors: Ocobock Cara , Soppela Päivi , Turunen Minna , Stenbäck Ville , Herzig Karl-Heinz
Published: April 2022

Introduction

Interest in human physiological responses to cold stress have seen a resurgence in recent years with a focus on brown adipose tissue (BAT), a mitochondria dense fat specialized for heat production. However, a majority of the work examining BAT has been conducted among temperate climate populations.

Methods

To expand our understanding of BAT thermogenesis in a cold climate population, we measured, using indirect calorimetry and thermal imaging, metabolic rate and body surface temperatures of BAT-positive and BAT-negative regions at room temperature, and mild cold exposure of resting participants from a small sample of reindeer herders (N = 22, 6 females) from sub-Arctic Finland.

Results

We found that most herders experienced a significant mean 8.7% increase in metabolic rates, preferentially metabolized fatty acids, and maintained relatively warmer body surface temperatures at the supraclavicular region (known BAT location) compared to the sternum, which has no associated BAT. These results indicate that the herders in this sample exhibit active BAT thermogenesis in response to mild cold exposure.

Conclusions

This study adds to the rapidly growing body of work looking at the physiological and thermoregulatory significance of BAT and the important role it may play among cold stressed populations.
Amino Acid Metabolism and Protein Turnover in Lean and Obese Humans During Exercise—Effect of IL-6 Receptor Blockade
Authors: Trinh Beckey , Peletier Merel , Simonsen Casper , Plomgaard Peter , Karstoft Kristian , Pedersen Bente Klarlund , van Hall Gerrit , Ellingsgaard Helga
Published: April 2022

Context

Interleukin-6 (IL-6) is implicated in skeletal muscle wasting and in regulating skeletal muscle hypertrophy in the healthy state.

Objective

This work aimed to determine the role of IL-6 in regulating systemic protein and amino acid metabolism during rest, exercise, and recovery in lean and obese humans.

Methods

In a nonrandomized, single-blind design, 12 lean and 9 obese individuals were infused first with 0.9% saline (Saline), secondly with the IL-6 receptor antibody tocilizumab (Acute IL-6R ab), and 21 days later with saline while still under tocilizumab influence (Chronic IL-6R ab). Outcome measures were determined before, during, and after 90 minutes of exercise at 40% Wattmax by isotope dilution technique, using primed continuous infusion of L-[ring-D5]phenylalanine and L-[D2]tyrosine. Main outcomes measures included systemic protein turnover and plasma amino acid concentrations.

Results

We saw no effect of acute or chronic IL-6 receptor blockade on protein turnover. In lean individuals, chronic IL-6 receptor blockade increased plasma concentrations of total amino acids (rest Δ + 186 μmol/L; 95% CI, 40-332; recovery Δ + 201 μmol/L; 95% CI, 55-347) and essential amino acids (rest Δ + 43 μmol/L; 95% CI, 12-76; recovery Δ + 45 μmol/L; 95% CI, 13-77) independently of exercise but had no such effect in obese individuals (total amino acids rest Δ + 63 μmol/L; 95% CI, –170 to 295, recovery Δ – 23 μmol/L, 95% CI, –256 to 210; essential amino acids rest Δ + 26 μmol/L; 95% CI, –21 to 73, recovery Δ + 11 μmol/L; 95% CI, –36 to 58).

Conclusion

IL-6 receptor blockade has no effect on protein turnover in fasting lean and obese humans during rest, exercise, and recovery. Chronic IL-6 receptor blockade increases total and essential amino acid concentrations only in lean individuals.
Didactic Complexity of Various Topics School Physics Course and Its Evaluation
Authors: Mayer Robert
Published: April 2022

The article discusses the actual problem of assessing the didactic complexity of sufficiently large educational texts on the example of topics and sections of a school physics course. To determine the complexity of the text, the expert must: 1) divide the text into fragments of 3–4 pages; 2) for each fragment, write out 10 key terms in a file, knowledge of which is necessary for understanding the text; 2) collect key concepts in one file Slovar.txt and evaluate the complexity of each term; 3) using a special program Slozhnost.pas, accessing the file Slovar.txt, analyze files with keywords and calculate their average information capacity; 4) for each topic, estimate the proportion of mathematical and other formulas relative to the total volume; 5) write out the key terms present in mathematical formulas from each topic in a special file and evaluate their complexity; 7) using the Slozhnost.pas program, determine the total amount of information in the key terms included in the formulas, as well as the information folding coefficient; 8) find the average number of words in sentences, the average word length, and calculate the structural complexity of the text; 9) calculate differential and integral didactic complexity for each topic. The results of the analysis are presented in a table and histograms characterizing the didactic complexity of various sections and topics of the school physics course.
Evaluation of a Student’s Academic Achievements by the Moodle System and a Teacher: a Trend for Convergence
Authors: Konnova Larisa , Stepanyan I.
Published: April 2022

The system of electronic interaction with students LMS Moodle is actively used in many universities. The fairness of automated assessment and the possibility of using it to assess the academic achievements of students are discussed in the article. It is based on the idea that along with the assessment of the test by the system, it is necessary to check the student's solutions on paper by the teacher. The authors consider the process of introducing blended learning at the Financial University in the study of Mathematics, describe the experience of conducting current and intermediate control using LMS Moodle. The dynamics of the indicator of the difference between the marks given by the teacher and the system is presented in the study. A clear trend towards convergence of these estimates has been identified, and conditions have been formulated that ensure such a trend: adaptation of students to an electronic training course, organization of trainings and various forms of current control, encouragement of a responsible student to learning activities.
Sistemas de Información Geográfica para arquitectos. Aprendizaje en la «nube» de cartografías geotécnicas para la asignatura de Complementos de Mecánica del Suelo
Authors: Mascort-Albea Emilio J.
Published: April 2022

A través de este trabajo se ha realizado la aplicación de un nuevo Ciclo de Mejora en el Aula (CIMA) para la asignatura de Complementos de Mecánica del Suelo (CMS) durante el primer cuatrimestre del curso 2021-22. Esta asignatura op- tativa del Grado de Fundamentos de Arquitectura se imparte dentro del Departa- mento de Estructuras e Ingeniería del Terreno, y tiene como principales objetivos competenciales la profesionalización y la digitalización de los estudiantes. En esta ocasión este CIMA parcial se ha enfocado hacia el fomento del aprendizaje colaborativo de los Sistemas de Información Geográfica (SIG) mediante el diseño de cartografías geotécnicas en la nube (Cloud-learning). Todo ello a través del uso de la plataforma Arc Gis On Line (AGOL), mediante el empleo de las licencias académicas proporcionadas por la empresa ESRI. Esta actividad ha sido coordi- nada de modo conjunto con el CIMA desarrollado por la profesora Rocío Romero- Hernández para la misma asignatura, en el marco del presente curso académico. Palabras clave: Complementos de mecánica del suelo, grado en fundamentos de arquitectura, docencia universitaria, desarrollo profesional docente, asignatu- ras técnicas en arquitectura.
Hacia una mejora en la docencia de las instalaciones en Arquitectura
Authors: Aguilar Carrasco María Teresa
Published: April 2022

En este capítulo se presenta un Ciclo de Mejora en el Aula aplicado en la asig- natura de Acondicionamiento e Instalaciones 3 del grado en Fundamentos de Arquitectura, concretamente en la docencia de los Sistemas Hidrónicos. La alta carga técnica y especialización de dicha asignatura complejiza el aprendizaje de los estudiantes. Además, a eso se le une el fuerte carácter transmisivo de la parte teórica en la que el alumno se convierte la mayoría de las veces en un sujeto pasivo. Por ello es fundamental la aplicación de este CIMA para la mejora de la docencia. El objetivo principal de esta experiencia docente es mejorar el aprendi- zaje de los estudiantes convirtiéndolos en sujetos activos, promoviendo un razo- namiento crítico en contra de la memorización y repetición mecánica. Palabras clave: Acondicionamiento e instalaciones 3, grado en fundamentos de arquitectura, docencia universitaria, desarrollo profesional docente, ciclo de mejora en el aula.
Nuevas perspectivas en el laboratorio de Construcción de primer curso de Arquitectura
Authors: López Cabeza Victoria Patricia
Published: April 2022

Este Ciclo de Mejora en el Aula tiene lugar en las horas de práctica de labo- ratorio de la asignatura de Construcción I del primer curso del Grado en Funda- mentos de la Arquitectura de la Universidad de Sevilla. Estas prácticas suponen el primer contacto de los alumnos con los materiales de construcción que estu- dian de forma teórica en la asignatura. Los principios didácticos que guían esta propuesta son la participación activa de los estudiantes en su aprendizaje, me- diante la gamificación y la clase invertida, la mejor vinculación de las prácticas con el resto de la asignatura, reforzar el concepto de sostenibilidad como ele- mento transversal en toda la arquitectura y proponer un cambio en la forma de evaluación de las prácticas, que sea más continua, útil y apropiada al contexto tecnológico actual. Palabras clave: Construcción I, grado en arquitectura, docencia universitaria, desarrollo profesional docente, laboratorio.