bluuebunny/crossref_metadata_2025 huggingface dataset:
The Shift to Toxicological-Related Deaths Over Natural During the COVID-19 Pandemic—An Ontario, Canada, Experience
Authors: French Karissa , Jhirad Reuven , Herath Jayantha
Published: March 2024

Study Design:

Retrospective review of deaths in Ontario where there was Coroner’s investigation and a postmortem examination between 2018 and 2021 to compare year by year changes before and during the COVID-19 pandemic.

Objective:

To establish the changes in patterns of toxicological deaths over the pandemic.

Methods:

Using the database of the Office of the Chief Coroner for Ontario to determine the numbers of postmortem examinations for the province of Ontario as well as the primary cause and manner of death. Those with a toxicological primary cause of death were isolated from 2003 to the first half of 2022 and divided by year. For those between the years 2018 and 2021 deaths were divided by manner of death. Further all deaths with either a toxicological primary cause of death or unfinalized investigations which were highly suspicious for a toxicological cause based on circumstance with a positive toxicology were isolated. From these the data on demographics and substances detected were compiled by year for comparison.

Results:

Comparing two years prior to the COVID-19 pandemic to the following two years there was an increase in total case load of 22%. Comparing the year before the pandemic to the first year of the pandemic deaths from natural causes fell from 52% to 47% of total cases, while drug-related cases increased from 24% to 36%. Fentanyl remained as the most prevalent detected substance in toxicological deaths. Combined opioid toxicity with stimulants increased, as well as the detection of nonpharmaceutical benzodiazepines. Deaths in men increased to comprise 3 in 4 drug-related deaths with the 30 to 39 years age-group remaining the most impacted.

Conclusions:

There was an increase in numbers and relative proportions of cases attributed to drug-related deaths which remained high over the two years of the pandemic.
Relationship Between Postural Stability and Proprioception, Pain, Quadriceps Strength, and Muscle Tightness in Athletes With Patellar Tendinopathy
Authors: Fendri Thouraya , Beaune Bruno , Kasmi Sofien , Chaari Fatma , Sahli Sonia , Boyas Sébastien
Published: March 2024

Background:

Athletes with patellar tendinopathy (PT) have postural stability deficits; however, the underlying mechanisms and factors responsible remain unknown. The effect on postural stability in PT of decreased quadriceps strength, altered proprioception, lower-limb muscle tightness, and knee pain, which explain postural stability deficiency in other populations, is uninvestigated.

Hypothesis:

Proprioceptive acuity, muscle tightness, quadriceps strength, and pain predict postural stability in athletes with PT.

Study Design:

Cross-sectional comparative study.

Level of Evidence:

Level 2.

Methods:

A total of 43 athletes with PT and 43 healthy athletes were enrolled. Static and dynamic postural stability, proprioceptive acuity, muscle tightness, quadriceps strength, and pain were evaluated using a force platform, Y-balance test (YBT), a weight discrimination protocol, a goniometer, an isometric dynamometer, and a valid questionnaire, respectively.

Results:

Athletes with PT had significantly worse static and dynamic postural stability in the affected limb (AL) compared with the nonaffected limb (NAL) ( P < 0.01) and the control group ( P < 0.01). Athletes suffering from PT revealed lower quadriceps strength ( P < 0.01), proprioceptive acuity ( P = 0.02), and higher muscle tightness in the AL compared with the NAL and controls. Quadriceps weakness of the AL and pain in athletes with PT explained the variance of dynamic postural stability impairment.

Conclusion:

Athletes with PT have postural stability deficiency compared with healthy peers. Our results demonstrate that quadriceps muscle weakness and pain are the factors that explain postural stability impairment.

Clinical Relevance:

These results can assist clinicians in the design of therapeutic balance rehabilitation programs by acting not only on pain relief but also on quadriceps strengthening through resistance training to avoid subsequent injuries in athletes with PT.
Changes in Risk Reporting by Japanese and U.S. Corporations, 2010-2019
Authors: Suzuki Shinobu
Published: March 2024

This study undertakes a cross-cultural examination of corporate risk reporting to test for convergence and divergence perspectives on risk communication. It asks whether the frequencies of risk topics communicated by globalizing organizations from different national cultures become isomorphic or remain culturally distinct. It analyzed longitudinal data on risk factors reported by Japanese and U.S. corporations in their annual reports. It focused on the effects of time and national culture on the frequencies of risk topics. The results provided evidence to support the convergence perspective for the risk topics and the divergence perspective for one of the topics, respectively.
Simulating urban scaling with a term linkages network of a university
Authors: van Raan Anthony FJ
Published: March 2024

In this paper, we make an attempt to increase our understanding of the urban scaling phenomenon. The aim is to investigate how superlinear scaling emerges if a network increases in size and how this scaling depends on the occurrence of elements that constitute the network. To this end, we consider a city as a complex network structure and simulate this structure by the network of all publications of a research intensive university. In this simulation, the publications take the role of the city inhabitants and the concepts (terms and keywords) in the publications represent all kinds of abilities and qualities of the inhabitants. We use in this experiment all author- and database-given terms of the scientific publications of Leiden University from 2022. We calculate the co-occurrence of terms, and on the basis of these connections, we create a network and let this network grow by successively adding publications from the total set of publications. In this way, we get a series of networks with different sizes and this simulates a series of cities with different number of inhabitants. This procedure is performed for different values of the term occurrence threshold. We then analyze how four important network parameters, namely, number of terms, number of clusters, number of links, and total link strength increase with increasing size of the network. Particularly the number of network links and the total network linkage strength are in our opinion the parameters that dominate the scaling phenomenon and can be considered as a simulation of the socioeconomic strength of a city, that is, its gross urban product. We find a significant power law dependence of these network parameters on network size and the power law exponents for the lowest occurrence threshold are within the range that is typical for urban scaling. In our approach, the number of clusters can be interpreted as a measure of complexity within the network. Since the occurrence threshold determines the diversity of terms, we may expect a special relation between the occurrence threshold and the number of clusters. This is indeed the case: whereas for the three other network parameters the scaling exponent increases with increasing occurrence threshold, the number of clusters is the only network parameter of which the scaling exponent decreases with increasing occurrence threshold. Finally, we discuss how our publication term network approach relates to scaling phenomena in cities.
Plastid genome data provide new insights into the dynamic evolution of the tribe Ampelopsideae (Vitaceae)
Authors: Zhang Lei , Meng Ying , Wang Da , He Guan-Hao , Zhang Jun-Ming , Wen Jun , Nie Ze-Long
Published: March 2024

Background

Ampelopsideae J. Wen & Z.L. Nie is a small-sized tribe of Vitaceae Juss., including ca. 47 species from four genera showing a disjunct distribution worldwide across all the continents except Antarctica. There are numerous species from the tribe that are commonly used as medicinal plants with immune-modulating, antimicrobial, and anti-hypertensive properties. The tribe is usually recognized into three clades, i.e., Ampelopsis Michx., Nekemias Raf., and the Southern Hemisphere clade. However, the relationships of the three clades differ greatly between the nuclear and the plastid topologies. There has been limited exploration of the chloroplast phylogenetic relationships within Ampelopsideae, and studies on the chloroplast genome structure of this tribe are only available for a few individuals. In this study, we aimed to investigate the evolutionary characteristics of plastid genomes of the tribe, including their genome structure and evolutionary insights.

Results

We sequenced, assembled, and annotated plastid genomes of 36 species from the tribe and related taxa in the family. Three main clades were recognized within Ampelopsideae, corresponding to Ampelopsis, Nekemias, and the Southern Hemisphere lineage, respectively, and all with 100% bootstrap supports. The genome sequences and content of the tribe are highly conserved. However, comparative analyses suggested that the plastomes of Nekemias demonstrate a contraction in the large single copy region and an expansion in the inverted repeat region, and possess a high number of forward and palindromic repeat sequences distinct from both Ampelopsis and the Southern Hemisphere taxa.

Conclusions

Our results highlighted plastome variations in genome length, expansion or contraction of the inverted repeat region, codon usage bias, and repeat sequences, are corresponding to the three lineages of the tribe, which probably faced with different environmental selection pressures and evolutionary history. This study provides valuable insights into understanding the evolutionary patterns of plastid genomes within the Ampelopsideae of Vitaceae.
Global longitudinal strain and plasma biomarkers for prognosis in heart failure complicated by diabetes: a prospective observational study
Authors: Iyer Nithin R. , Chan Siew-Pang , Liew Oi Wah , Chong Jenny P.C. , Bryant Jennifer A. , Le Thu-Thao , Chandramouli Chanchal , Cozzone Patrick J. , Eisenhaber Frank , Foo Roger , Richards A. Mark , Lam Carolyn S.P. , Ugander Martin , Chin Calvin W-L. ,   on behalf of the ATTRaCT investigators
Published: March 2024

Background

Heart failure (HF) and diabetes are associated with increased incidence and worse prognosis of each other. The prognostic value of global longitudinal strain (GLS) measured by cardiovascular magnetic resonance (CMR) has not been established in HF patients with diabetes.

Methods

In this prospective, observational study, consecutive patients (n = 315) with HF underwent CMR at 3T, including GLS, late gadolinium enhancement (LGE), native T1, and extracellular volume fraction (ECV) mapping. Plasma biomarker concentrations were measured including: N-terminal pro B-type natriuretic peptide(NT-proBNP), high-sensitivity troponin T(hs-TnT), growth differentiation factor 15(GDF-15), soluble ST2(sST2), and galectin 3(Gal-3). The primary outcome was a composite of all-cause mortality or HF hospitalisation.

Results

Compared to those without diabetes (n = 156), the diabetes group (n = 159) had a higher LGE prevalence (76 vs. 60%, p < 0.05), higher T1 (1285±42 vs. 1269±42ms, p < 0.001), and higher ECV (30.5±3.5 vs. 28.8±4.1%, p < 0.001). The diabetes group had higher NT-pro-BNP, hs-TnT, GDF-15, sST2, and Gal-3. Diabetes conferred worse prognosis (hazard ratio (HR) 2.33 [95% confidence interval (CI) 1.43–3.79], p < 0.001). In multivariable Cox regression analysis including clinical markers and plasma biomarkers, sST2 alone remained independently associated with the primary outcome (HR per 1 ng/mL 1.04 [95% CI 1.02–1.07], p = 0.001). In multivariable Cox regression models in the diabetes group, both GLS and sST2 remained prognostic (GLS: HR 1.12 [95% CI 1.03–1.21], p = 0.01; sST2: HR per 1 ng/mL 1.03 [95% CI 1.00-1.06], p = 0.02).

Conclusions

Compared to HF patients without diabetes, those with diabetes have worse plasma and CMR markers of fibrosis and a more adverse prognosis. GLS by CMR is a powerful and independent prognostic marker in HF patients with diabetes.
Association between social support and ambulance use among older people in Japan: an empirical cross-sectional study
Authors: Asano Yotaro , Takasugi Tomo , Ueno Keiko , Kondo Naoki , Yoshino Atsuto , Ojima Toshiyuki
Published: March 2024

Background

Ambulance service demand and utilization are increasing worldwide. To address this issue, the factors that affect ambulance use must be identified. Few studies have examined factors that can intervene and thus reduce the frequency of ambulance use. This study aimed to examine the association between social support and ambulance use among older adults in Japan. We hypothesize that social support is associated with reduced ambulance use.

Methods

This cross-sectional study was conducted as part of the Japan Gerontological Evaluation Study. In December 2019 and January 2020, we collaborated with individuals aged 65 years or above with no long-term care needs. A total of 24,581 participants were included in the analysis. The objective and explanatory variables were ambulance use and social support, respectively. Binomial regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs).

Results

Social support was associated with ambulance use. People who had no one to listen to their complaints or worries were significantly more likely to use ambulance services than those who did (OR [95% CI] = 1.26 [1.03–1.53]). People with no one to take care of them when they were ill were also significantly more likely to use ambulance services than those who had someone to provide care (1.15 [1.01–1.31]). Moreover, the results of binomial logistic regression analysis indicated that individuals who called an ambulance but were not hospitalized had significantly lower social support compared to those who did not call an ambulance.

Conclusions

The results suggest that the presence and quality of social support play a significant role in ambulance use among older adults in Japan. Our findings can help policymakers to plan and implement strategies for reducing the burden on emergency medical care.
A colonial serrated polyp classification model using white-light ordinary endoscopy images with an artificial intelligence model and TensorFlow chart
Authors: Chen Tsung-Hsing , Wang Yu-Tzu , Wu Chi-Huan , Kuo Chang-Fu , Cheng Hao-Tsai , Huang Shu-Wei , Lee Chieh
Published: March 2024

In this study, we implemented a combination of data augmentation and artificial intelligence (AI) model—Convolutional Neural Network (CNN)—to help physicians classify colonic polyps into traditional adenoma (TA), sessile serrated adenoma (SSA), and hyperplastic polyp (HP). We collected ordinary endoscopy images under both white and NBI lights. Under white light, we collected 257 images of HP, 423 images of SSA, and 60 images of TA. Under NBI light, were collected 238 images of HP, 284 images of SSA, and 71 images of TA. We implemented the CNN-based artificial intelligence model, Inception V4, to build a classification model for the types of colon polyps. Our final AI classification model with data augmentation process is constructed only with white light images. Our classification prediction accuracy of colon polyp type is 94%, and the discriminability of the model (area under the curve) was 98%. Thus, we can conclude that our model can help physicians distinguish between TA, SSA, and HPs and correctly identify precancerous lesions such as TA and SSA.
Does the intensity of pain and disability affect health-related quality of life of older adults with back pain? Multilevel analysis between Brazil and Netherlands: a cross-sectional study of the BACE consortium
Authors: de Oliveira Grigorini Adriana Estela , Pereira Leani Souza Máximo , Koes Bart , da Silva Silvia Lanzioti Azevedo , Chiarotto Alessandro , Felício Diogo Carvalho , Leopoldino Amanda Aparecida Oliveira
Published: March 2024

Background

The prognosis of back pain (BP) in the older adults is less favorable than in younger adults and progress to adverse outcomes and consequent worsening of health-related quality of life (HRQoL). The present study aimed to verify the association between BP intensity, disability and HRQoL in older adults residents in Brazil and Netherlands, and to evaluate whether the country of residence influences the associations.

Methods

Data were collected from 602 Brazilian and 675 Dutch participants with a new episode of BP from the Back Complaints in Elders (BACE) consortium. For the present study, a cross section was used. Pain intensity and disability were assessed using the Numerical Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. HRQoL was assessed using the Short Form Health Survey (SF-36) quality of life questionnaire. Age, sex, and education were descriptive variables. Pain intensity (NPS score) and country were the independent variables and quality of life assessed by each SF domain − 36 was the dependent variable. Analysis of models at the individual level was performed to verify the association between pain and disability, also HRQoL in Netherlands and Brazil in the total sample. The multilevel model was used to verify whether the older adults person’s country of residence influenced this relationship.

Results

The average age of the participants was 67.00 (7.33) years. In the total sample, linear regression analysis adjusted for sex and age showed a significant association between BP intensity scores and HRQoL, for all domains. There was no association between disability and HRQoL. In the multilevel analysis, there was an association between BP intensity and HRQoL in all domains and an association between the country of residence and HRQoL, influencing the effect of pain, in all domains, except for the physical functioning.

Conclusion

Socioeconomic and cultural aspects of different countries can affect the perception of the elderly about their HRQoL in the presence of BP. Pain and disability in Brazilian and Dutch older adults ones are experienced differently in relation to their HRQoL.
Polymicrobial bloodstream infections per se do not increase mortality compared to monomicrobial bloodstream infections in sepsis patients: a Korean nationwide sepsis cohort study
Authors: Lee Su Yeon , Park Mi Hyeon , Oh Dong Kyu , Lim Chae-Man ,   on behalf of the Korean Sepsis Alliance (KSA) investigators, Hong Sang-Bum , Suh Gee Young , Jeon Kyeongman , Ko Ryoung-Eun , Cho Young-Jae , Lee Yeon Joo , Lim Sung Yoon , Park Sunghoon , Heo Jeongwon , Lee Jae-myeong , Kim Kyung Chan , Chang Youjin , Lee Sang-Min , Hong Suk-Kyung , Cho Woo Hyun , Kwak Sang Hyun , Lee Heung Bum , Ahn Jong-Joon , Seong Gil Myeong , Lee Song-I. , Park Tai Sun , Lee Su Hwan , Choi Eun Young , Moon Jae Young , Kang Hyung Koo
Published: March 2024

Background

There is limited information about the outcomes of polymicrobial bloodstream infections in patients with sepsis. We aimed to investigate outcomes of polymicrobial bloodstream infections compared to monomicrobial bloodstream infections.

Methods

This study used data from the Korean Sepsis Alliance Registry, a nationwide database of prospective observational sepsis cohort. Adult sepsis patients with bloodstream infections from September 2019 to December 2021 at 20 tertiary or university-affiliated hospitals in South Korea were analyzed.

Results

Among the 3,823 patients with bloodstream infections, 429 of them (11.2%) had polymicrobial bloodstream infections. The crude hospital mortality of patients with sepsis with polymicrobial bloodstream infection and monomicrobial bloodstream infection was 35.7% and 30.1%, respectively (p = 0.021). However, polymicrobial bloodstream infections were not associated with hospital mortality in the proportional hazard analysis (HR 1.15 [0.97–1.36], p = 0.11). The inappropriate use of antibiotics was associated with increased mortality (HR 1.37 [1.19–1.57], p < 0.001), and source control was associated with decreased mortality (HR 0.51 [0.42–0.62], p < 0.001).

Conclusions

Polymicrobial bloodstream infections per se were not associated with hospital mortality in patients with sepsis as compared to monomicrobial bloodstream infections. The appropriate use of antibiotics and source control were associated with decreased mortality in bloodstream infections regardless of the number of microbial pathogens.
Influenza a H1N1 infection complicated with encephalopathy and acute pancreatitis: a case report
Authors: Cui Junhao , Jia Wanyu , Li Peng , Zhang Xue , Li Zheng , Song Chunlan
Published: March 2024

This paper reports a case of influenza complicated with influenza associated encephalopathy complicated with acute pancreatitis. This kind of disease is relatively rare, we hope to draw people’s attention to it in order to improve early detection and prognosis.
Evaluating the relationship between conditional cash transfer programme on preterm births: a retrospective longitudinal study using the 100 million Brazilian cohort
Authors: Ortelan Naiá , de Almeida Márcia Furquim , Pinto Júnior Elzo Pereira , Bispo Nivea , Fiaccone Rosemeire L. , Falcão Ila Rocha , Rocha Aline dos Santos , Ramos Dandara , Paixão Enny S. , de Cássia Ribeiro-Silva Rita , Rodrigues Laura C. , Barreto Mauricio L. , Ichihara Maria Yury T.
Published: March 2024

Background

Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births, including their severity categories, and explored how this association differs according to prenatal care and the quality of Bolsa Familia Programme management.

Methods

A retrospective cohort study was performed involving the first live singleton births to mothersenrolled in the 100 Million Brazilian Cohort from 2004 to 2015, who had at least one child before cohort enrollment. Only the first birth during the cohort period was included, but born from 2012 onward. A deterministic linkage with the Bolsa Familia Programme payroll dataset and a similarity linkage with the Brazilian Live Birth Information System were performed. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age < 37 weeks: (i) all preterm births, (ii) moderate-to-late (32–36), (iii) severe (28–31), and (iv) extreme (< 28) preterm births compared to at-term newborns. We combined propensity score-based methods and weighted logistic regressions to compare newborns to mothers who did and did not receive Bolsa Familia, controlling for socioeconomic conditions. We also estimated these effects separately, according to the adequacy of prenatal care and the index of quality of Bolsa Familia Programme management.

Results

1,031,053 infants were analyzed; 65.9% of the mothers were beneficiaries. Bolsa Familia Programme was not associated with all sets of preterm births, moderate-to-late, and severe preterm births, but was associated with a reduction in extreme preterm births (weighted OR: 0.69; 95%CI: 0.63–0.76). This reduction can also be observed among mothers receiving adequate prenatal care (weighted OR: 0.66; 95%CI: 0.59–0.74) and living in better Bolsa Familia management municipalities (weighted OR: 0.56; 95%CI: 0.43–0.74).

Conclusions

An income transfer programme for pregnant women of low-socioeconomic status, conditional to attending prenatal care appointments, has been associated with a reduction in extremely preterm births. These programmes could be essential in achieving Sustainable Development Goals.
Exploring attitudes and variation by sociodemographic factors in consent provided for financial data linkage in an experimental birth cohort study
Authors: Reece Sian , Dickerson Josie , Pickett Kate E.
Published: March 2024

Background

Improving our understanding of household incomes and what constitutes financial insecurity can help us to better understand how financial insecurity is experienced and how this can change over time within and between individuals and populations. However, financial circumstances are often perceived as sensitive and stigmatising, particularly within some ethnic minority groups. This research aims to explore attitudes and variation by sociodemographic factors in consent provided for financial data linkage in an experimental birth cohort study, in order to obtain validated income and benefits data and to better understand the impact of community interventions on the financial security of its participants and their families.

Methods

This research utilises an observational study design to explore consent rates, attitudes and variation in sociodemographic factors between participants of an experimental birth cohort in a deprived and ethnically diverse setting who consent and do not consent to financial data linkage.

Results

Overall, participants were equally likely to consent and decline consent for financial data linkage. Measures of socioeconomic insecurity were associated with being more likely to provide consent for financial data linkage. Participants who were not employed (OR 1.49 95% CI 0.93, 2.40) and were more financially insecure (OR 1.85 95% CI 1.14, 3.93) were more likely to provide consent for financial data linkage. Where the participant’s first language was a language other than English, participants were also less likely to provide consent for data linkage (OR 0.65 95% CI 0.39, 0.98). The choice of consent for financial data linkage was not associated with: ethnicity; relationship factors; employment status of the participant’s partner; person present at time of recruitment; and measures of health, such as general health, mental health, wellbeing and health-related quality of life.

Conclusions

This research sets out an approach to obtaining validated income and benefits data, as a proxy measure for financial security, within an experimental birth cohort study in a deprived and ethnically diverse setting. It achieves good consent rates and demonstrates greater input from those who report greater potential need for financial support. Further research should be conducted to further understand the interplay of language spoken in this context.
Identification of biomarkers and pathways for the SARS-CoV-2 infections in obstructive sleep apnea patients based on machine learning and proteomic analysis
Authors: Luo Hong , Yan Jisong , Gong Rui , Zhang Dingyu , Zhou Xia , Wang Xianguang
Published: March 2024

Background

The prevalence of obstructive sleep apnea (OSA) was found to be higher in individuals following COVID-19 infection. However, the intricate mechanisms that underscore this concomitance remain partially elucidated. The aim of this study was to delve deeper into the molecular mechanisms that underpin this comorbidity.

Methods

We acquired gene expression profiles for COVID-19 (GSE157103) and OSA (GSE75097) from the Gene Expression Omnibus (GEO) database. Upon identifying shared feature genes between OSA and COVID-19 utilizing LASSO, Random forest and Support vector machines algorithms, we advanced to functional annotation, analysis of protein–protein interaction networks, module construction, and identification of pivotal genes. Furthermore, we established regulatory networks encompassing transcription factor (TF)-gene and TF-miRNA interactions, and searched for promising drug targets. Subsequently, the expression levels of pivotal genes were validated through proteomics data from COVID-19 cases.

Results

Fourteen feature genes shared between OSA and COVID-19 were selected for further investigation. Through functional annotation, it was indicated that metabolic pathways play a role in the pathogenesis of both disorders. Subsequently, employing the cytoHubba plugin, ten hub genes were recognized, namely TP53, CCND1, MDM2, RB1, HIF1A, EP300, STAT3, CDK2, HSP90AA1, and PPARG. The finding of proteomics unveiled a substantial augmentation in the expression level of HSP90AA1 in COVID-19 patient samples, especially in severe conditions.

Conclusions

Our investigation illuminate a mutual pathogenic mechanism that underlies both OSA and COVID-19, which may provide novel perspectives for future investigations into the underlying mechanisms.
TPP (totally preperitoneal) making single incision laparoscopic inguinal hernia repair more feasible: a comparison with single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP)
Authors: Huang Qing , Wang Xiaojun , Xiang Xionghua , Qi Changlei , Fei Ting , Zhou Encheng
Published: March 2024

Background

Totally preperitoneal hernioplasty (TPP) is a concept which was introduced for distinguishing with totally extraperitoneal (TEP). There is few evidence reflecting the single incision laparoscopic totally preperitoneal (SIL-TPP) characteristic. The aim of study is to demonstrate the feasibility of single incision laparoscopic totally preperitoneal hernioplasty (SIL-TPP) and compare the outcomes with the single incision laparoscopic totally extraperitoneal hernioplasty (SIL-TEP) technique.

Methods

During August 2018 and July 2022, 200 inguinal hernia patients received SIL-TPP and 56 patients received SIL-TEP in the First hospital of Ningbo university. The demographics, clinical characteristics, intraoperative and postoperative parameters were retrospectively analysed.

Results

SIL-TPP and SIL-TEP hernia repair were successfully conducted in all patients. There was no conversation happened in two group. Patients’ demographics were comparable when compared between the two groups adding the comparison initial 52 cases analysis (P > 0.05). The mean unilateral hernia operative time was significant shorter in the SIL-TPP group than SIL-TEP group (unilateral: 81.38 ± 25.32 vs. 95.96 ± 28.54, P: 0.001). Further study of unilateral hernia operative time revealed the mean indirect hernia operative time was significant shorter in the SIL-TPP group than SIL-TEP group (indirect: 81.38 ± 25.33 vs. 95.87 ± 28.54, P: 0.001). The unilateral hernia operation time trend of initial 52 cases of two group analysis revealed the operation time of SIL-TPP reduced faster than SIL-TEP along with treating number increasing (Figs. 2 and 3). The comparison of initial equal quantity unilateral hernia patient mean operative time revealed the SIL-TPP group was significant shorter than SIL-TEP group (85.77 ± 22.76 vs. 95.87 ± 28.54, P: 0.049). The rate of peritoneum tearing of SIL-TPP group was significant high than SIL-TEP (P = 0.005).

Conclusion

SIL-TPP hernia repair is a superior procedure and possess its own distinguished advantages. We recommend it rather than SIL-TEP for treating inguinal hernia, especially for indirect hernia. However, large-scale randomized controlled trials comparing SIL-TPP and SIL-TEP are needed to confirm these results.
COVID 19 vaccination as a trigger of acute genital ulcers in an immunocompromised adolescent—case study and literature review
Authors: Pokora Karolina , Kowalczyk Karolina , Peterek Robert , Cwynar Marlena , Stojko Rafał , Madej Paweł , Drosdzol-Cop Agnieszka
Published: March 2024

Acute genital ulcers can affect females of all ages. In children, they often appear as an emergency and remain a diagnostic challenge for pediatricians, gynecologists and dermatologists. Prompt diagnosis and identification of disease- related factors help to implement appropriate treatment. Firstly, it is crucial to properly compile the past medical history of the patient. Past infectious, autoimmune, malignant or traumatic conditions, as well as vaccinations may contribute to the occurrence of acute genital ulcers. Moreover, new infectious agents, such as severe acute respiratory syndrome coronavirus 2 and vaccinations against Coronavirus disease of 2019, may play a significant role in the development of atypical clinical symptoms. Here we present a case of a 12-year-old girl with acute genital ulcers. Additional symptoms accompanying the ulcer included: abdominal pain, nausea, vomiting, dysuria, vulvar pain and fever. Blood test showed leukocytosis, especially neutrophilia and monocytosis and increased levels of c-reactive protein and procalcitonin. Serological tests for the most common infections were negative. Moreover, the patient had a history of autoimmune diseases. She had periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, and IgA vasculitis, also known as Henoch-Schönlein purpura in her past medical history. Additionally, she was vaccinated against SARS-CoV-2 shortly before the lesions appeared.
Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI
Authors: Hershberger Paul J. , Pei Yong , Bricker Dean A. , Crawford Timothy N. , Shivakumar Ashutosh , Castle Angie , Conway Katharine , Medaramitta Raveendra , Rechtin Maria , Wilson Josephine F.
Published: March 2024

Background

Finding time in the medical curriculum to focus on motivational interviewing (MI) training is a challenge in many medical schools. We developed a software-based training tool, “Real-time Assessment of Dialogue in Motivational Interviewing” (ReadMI), that aims to advance the skill acquisition of medical students as they learn the MI approach. This human-artificial intelligence teaming may help reduce the cognitive load on a training facilitator.

Methods

During their Family Medicine clerkship, 125 third-year medical students were scheduled in pairs to participate in a 90-minute MI training session, with each student doing two role-plays as the physician. Intervention group students received both facilitator feedback and ReadMI metrics after their first role-play, while control group students received only facilitator feedback.

Results

While students in both conditions improved their MI approach from the first to the second role-play, those in the intervention condition used significantly more open-ended questions, fewer closed-ended questions, and had a higher ratio of open to closed questions.

Conclusion

MI skills practice can be gained with a relatively small investment of student time, and artificial intelligence can be utilized both for the measurement of MI skill acquisition and as an instructional aid.
“How is social media used for learning?”: relationships between social media use by medical students with their self-regulated learning skills
Authors: Findyartini Ardi , Greviana Nadia , Hanum Chaina , Wiyarta Elvan , Novarianto Justinus Kurniabudhi , Nugroho Supranoto Yehuda Tri , Rafa Ayusha Maritza Andreanne , Oktaria Dwita , Sueningrum AASA Santhi , Pratiwi Yuni Susanti , Pamungkasari Eti Poncorini , Prihanti Gita Sekar , Zhuhra Rahma Tsania , Widjaja Yoanita , Wijaya Diani Puspa , Atta Komal
Published: March 2024

Background

Social media is widely used by medical students, including for learning purposes since it facilitates their involvement in the communities of inquiry where they can share, express, and engage in the development of knowledge. Navigating the use of social media requires self-regulated learning (SRL) skills. Hence, studies on the relationships between social media use and SRL skills are necessary.

Aim

This study aims to investigate the relationships between social media use and students’ SRL skills.

Methods

A cross-sectional study was conducted using two validated questionnaires: the Social Networking Sites for Medical Education questionnaire (SNSME, 19 items) and the Motivated Strategies for Learning Questionnaire (MSLQ, 81 items). Cross-cultural adaptation and exploratory factor analysis (EFA) were also completed for the SNSME questionnaire, followed by descriptive and bivariate analysis.

Results and discussion

The SNSME questionnaire is valid for use in the current setting and consists of three subscales: (1) attitudes towards the use of social media for learning and knowledge development, (2) the use of social media for information sharing and interaction, and (3) the use of social media for knowledge development and research. Among 1,122 respondents, male students presented lower scores than female students in the total score of social media for learning (80 vs. 82, p 0.007), and public medical students showed higher scores in terms of attitudes towards the use of social media for learning and knowledge development compared to private medical students (83 vs. 81, p 0.007). The differences in SRL scores for different education stages and among students from public and private medical schools were statistically significant (426 vs. 418, p 0.003, and 436 vs. 418, p < 0.001, respectively). Levels of correlation between social media use and SRL scores were low to moderate (R 0.195–0.462, p < 0.001).

Conclusions

The adapted SNSME questionnaire in the current setting is valid and the use of social media for learning is influenced by gender and the learning environment. This study highlights the importance of supporting students in using social media for learning purposes as well as using social media as a means to increase their SRL skills.
Ethics of early detection of disease risk factors: A scoping review
Authors: Jansen Sammie N. G. , Kamphorst Bart A. , Mulder Bob C. , van Kamp Irene , Boekhold Sandra , van den Hazel Peter , Verweij Marcel F.
Published: March 2024

Background

Scientific and technological advancements in mapping and understanding the interrelated pathways through which biological and environmental exposures affect disease development create new possibilities for detecting disease risk factors. Early detection of such risk factors may help prevent disease onset or moderate the disease course, thereby decreasing associated disease burden, morbidity, and mortality. However, the ethical implications of screening for disease risk factors are unclear and the current literature provides a fragmented and case-by-case picture.

Methods

To identify key ethical considerations arising from the early detection of disease risk factors, we performed a systematic scoping review. The Scopus, Embase, and Philosopher’s Index databases were searched for peer-reviewed, academic records, which were included if they were written in English or Dutch and concerned the ethics of (1) early detection of (2) disease risk factors for (3) disease caused by environmental factors or gene-environment interactions. All records were reviewed independently by at least two researchers.

Results

After screening 2034 titles and abstracts, and 112 full papers, 55 articles were included in the thematic synthesis of the results. We identified eight common ethical themes: (1) Reliability and uncertainty in early detection, (2) autonomy, (3) privacy, (4) beneficence and non-maleficence, (5) downstream burdens on others, (6) responsibility, (7) justice, and (8) medicalization and conceptual disruption. We identified several gaps in the literature, including a relative scarcity of research on ethical considerations associated with environmental preventive health interventions, a dearth of practical suggestions on how to address expressed concerns about overestimating health capacities, and a lack of insights into preventing undue attribution of health responsibility to individuals.

Conclusions

The ethical concerns arising with the early detection of risk factors are often interrelated and complex. Comprehensive ethical analyses are needed that are better embedded in normative frameworks and also assess and weigh the expected benefits of early risk factor detection. Such research is necessary for developing and implementing responsible and fair preventive health policies.
Feasibility of a wearable self-management application for patients with COPD at home: a pilot study
Authors: Wu Robert , de Lara Eyal , Liaqat Daniyal , Liaqat Salaar , Chen Jun Lin , Son Tanya , Gershon Andrea S.
Published: March 2024

Background

Among people with COPD, smartphone and wearable technology may provide an effective method to improve care at home by supporting, encouraging, and sustaining self-management. The current study was conducted to determine if patients with COPD will use a dedicated smartphone and smartwatch app to help manage their COPD and to determine the effects on their self-management.

Methods

We developed a COPD self-management application for smartphones and smartwatches. Participants were provided with the app on a smartphone and a smartwatch, as well as a cellular data plan and followed for 6 months. We measured usage of the different smartphone app functions. For the primary outcome, we examined the change in self-management from baseline to the end of follow up. Secondary outcomes include changes in self-efficacy, quality of life, and COPD disease control.

Results

Thirty-four patients were enrolled and followed. Mean age was 69.8 years, and half of the participants were women. The most used functions were recording steps through the smartwatch, entering a daily symptom questionnaire, checking oxygen saturation, and performing breathing exercises. There was no significant difference in the primary outcome of change in self-management after use of the app or in overall total scores of health-related quality of life, disease control or self-efficacy.

Conclusion

We found older patients with COPD would engage with a COPD smartphone and smartwatch application, but this did not result in improved self-management. More research is needed to determine if a smartphone and smartwatch application can improve self-management in people with COPD.

Trial registration

ClinicalTrials.Gov NCT03857061, First Posted February 27, 2019.
Cross-sectional analysis of primary care clinics’ policies, practices, and availability of patient support services during the COVID-19 pandemic
Authors: Ratnapradipa Kendra L. , Wang Runqiu , Kabayundo Josiane , Marquez Lavenant Walter , Nelson Eleanore , Ahuja Muskan , Zhang Ying , Wang Hongmei
Published: March 2024

Background

Healthcare accessibility and utilization are important social determinants of health. Lack of access to healthcare, including missed or no-show appointments, can have negative health effects and be costly to patients and providers. Various office-based approaches and community partnerships can address patient access barriers.

Objectives

(1) To understand provider perceptions of patient barriers; (2) to describe the policies and practices used to address late or missed appointments, and (3) to evaluate access to patient support services, both in-clinic and with community partners.

Methods

Mailed cross-sectional survey with online response option, sent to all Nebraska primary care clinics (n = 577) conducted April 2020 and January through April 2021. Chi-square tests compared rural-urban differences; logistic regression of clinical factors associated with policies and support services computed odds ratios (OR) and 95% confidence intervals (CI).

Results

Response rate was 20.3% (n = 117), with 49 returns in 2020. Perceived patient barriers included finances, higher among rural versus urban clinics (81.6% vs. 56.1%, p =.009), and time (overall 52.3%). Welcoming environment (95.5%), telephone appointment reminders (74.8%) and streamlined admissions (69.4%) were the top three clinic practices to reduce missed appointments. Telehealth was the most commonly available patient support service in rural (79.6%) and urban (81.8%, p =.90) clinics. Number of providers was positively associated with having a patient navigator/care coordinator (OR = 1.20, CI = 1.02–1.40). For each percent increase in the number of privately insured patients, the odds of providing legal aid decreased by 4% (OR = 0.96, CI = 0.92-1.00). Urban clinics were less likely than rural clinics to provide social work services (OR = 0.16, CI = 0.04–0.67) or assist with applications for government aid (OR = 0.22, CI = 0.06–0.90).

Conclusions

Practices to reduce missed appointments included a variety of reminders. Although finances and inability to take time off work were the most frequently reported perceived barriers for patients’ access to timely healthcare, most clinics did not directly address them. Rural clinics appeared to have more community partnerships to address underlying social determinants of health, such as transportation and assistance applying for government aid. Taking such a wholistic partnership approach is an area for future study to improve patient access.
Consideration of image guidance in patterns of failure analyses of intensity-modulated radiotherapy for head and neck cancer: a systematic review
Authors: Mackeprang Paul-Henry , Bryjova Katarina , Heusel Astrid E. , Henzen Dominik , Scricciolo Melissa , Elicin Olgun ,   on behalf of the EORTC Head & Neck Young Investigators Group
Published: March 2024

Background

Intensity-modulated radiation therapy (IMRT) is considered standard of care for head and neck squamous cell carcinoma (HNSCC). Improved conformity of IMRT and smaller margins, however, have led to concerns of increased rates of marginal failures. We hypothesize that while patterns of failure (PoF) after IMRT for HNSCC have been published before, the quality of patient positioning and image guided radiotherapy (IGRT) have rarely been taken into account, and their importance remains unclear. This work provides a systematic review of the consideration of IGRT in PoF studies after IMRT for HNSCC.

Materials and methods

A systematic literature search according to PRISMA guidelines was performed on PubMed for HNSCC, IMRT and PoF terms and conference abstracts from ESTRO and ASTRO 2020 and 2021 were screened. Studies were included if they related PoF of HNSCC after IMRT to the treated volumes. Data on patient and treatment characteristics, IGRT, treatment adaptation, PoF and correlation of PoF to IGRT was extracted, categorized and analyzed.

Results

One-hundred ten studies were included. The majority (70) did not report any information on IGRT. The remainder reported daily IGRT (18), daily on day 1–3 or 1–5, then weekly (7), at least weekly (12), or other schemes (3). Immobilization was performed with masks (78), non-invasive frames (4), or not reported (28). The most common PoF classification was “in-field/marginal/out-of-field”, reported by 76 studies. Only one study correlated PoF in nasopharyngeal cancer patients to IGRT.

Conclusion

The impact of IGRT on PoF in HNSCC is severely underreported in existing literature. Only one study correlated PoF to IGRT measures and setup uncertainty. Further, most PoF studies relied on outdated terminology (“in/out-of-field”). A clearly defined and up-to-date PoF terminology is necessary to evaluate PoFs properly, as is systematic and preferably prospective data generation. PoF studies should consistently and comprehensively consider and report on IGRT.