bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving knowledge about breast cancer and breast self examination in female Nigerian adolescents using peer education: a pre-post interventional study
Authors: Sadoh Ayebo E. , Osime Clement , Nwaneri Damian U. , Ogboghodo Bamidele C. , Eregie Charles O. , Oviawe Osawaru
Published: September 2021

Background

Prevention of BC of which the cornerstone is creating awareness and early detection is important in adolescents and young women because of their worse outcomes. Early detection strategies such as mammography are currently beyond the reach of most women in sub-Saharan Africa.. Lack of awareness and late presentation contribute to the poor outcomes. Awareness creation among adolescents may result in modification of some risk factors for BC with adoption of healthy life styles including accessing early detection activities. This study determined the effect of peer education as a strategy to create awareness on BC and breast self examination (BSE) among in-school female adolescents in Benin City.

Methods

This was a pre-post interventional study carried out in October –December 2016 on female students of four secondary schools in Benin City. Pre-peer training, using a pre-tested self-administered questionnaire, knowledge about BC and BSE was assessed in about 30% of each school population. This was followed by training of 124 students selected from the schools (one student per class) as peer trainers. The peer trainers provided training on BC and BSE (the intervention) for their classmates. Within two weeks of peer training knowledge about BC and BSE was reassessed in 30% of each school population. Selection of students for assessment pre and post intervention was by systematic sampling. Correct knowledge was scored and presented as percentages. Chi square test, student t test and ANOVA were used to assess associations and test differences with level of significance set at p < 0.05.

Results

There were 1337 and 1201 students who responded to the pre and post-training questionnaires respectively. The mean BC knowledge score (20.61 ± 13.4) prior to training was low and it statistically significantly improved to 55.93 ± 10.86 following training p < 0.0001 Following peer training, statistically significant improvement (p 0.037- < 0.001) occurred in most knowledge domains apart from symptomatology. Pre-peer training 906(67.8%) students knew about BSE but only 67(4.8%). Significantly more students 1134(94.7%) knew about BSE following peer training.

Conclusions

Peer education strategy can be used to improve BC and BSE knowledge in adolescents. This strategy is low cost and could be very useful in low resource settings.
Transfer of training from an internal medicine boot camp to the workplace: enhancing and hindering factors
Authors: Kerins Joanne , Smith Samantha Eve , Stirling Suzanne Anderson , Wakeling Judy , Tallentire Victoria Ruth
Published: September 2021

Background

The transfer of training to the workplace is the aim of training interventions. Three primary factors influence transfer: trainee characteristics, training design and work environment influences. Within medical education, the work environment factors influencing transfer of training remain underexplored. Burke and Hutchins’ review of training transfer outlined five work environment influences: opportunity to perform, supervisor/peer support, strategic link, transfer climate and accountability. This study aimed to explore the ways in which work environment factors influence the transfer of training for medical trainees.

Methods

Internal Medicine Training in Scotland includes a three-day boot camp involving simulation-based mastery learning of procedural skills, immersive simulation scenarios and communication workshops. Following ethical approval, trainees were invited to take part in interviews at least three months after following their boot camp. Interviews were semi-structured, anonymised, transcribed verbatim and analysed using template analysis. Member checking interviews were performed to verify findings.

Results

A total of 26 trainees took part in interviews between January 2020 and January 2021. Trainees reported a lack of opportunities to perform procedures in the workplace and challenges relating to the transfer climate, including a lack of appropriate equipment and resistance to change in the workplace. Trainees described a strong sense of personal responsibility to transfer and they felt empowered to change practice in response to the challenges faced.

Conclusions

This study highlights barriers to transfer of training within the clinical workplace including procedural opportunities, a transfer climate with challenging equipment availability and, at times, an unsupportive workplace culture. Trainees are driven by their own sense of personal responsibility; medical educators and healthcare leaders must harness this enthusiasm and take heed of the barriers to assist in the development of strategies to overcome them.
Discharging the complex patient - changing our focus to patients’ networks of care providers
Authors: Perrault-Sequeira Laurent , Torti Jacqueline , Appleton Andrew , Mathews Maria , Goldszmidt Mark
Published: September 2021

Background

A disconnect exists between the idealized model of every patient having a family physician (FP) who acts as the central hub for care, and the reality of health care where patients must navigate a network of different providers. This disconnect is particularly evident when hospitalized multimorbid patients transition back into the community. These discharges are identified as high-risk due to lapses in care continuity. The aim of this study was to identify and explore the networks of care providers in a sample of hospitalized, complex patients, and better understand the nature of their attachments to these providers as a means of discovering novel approaches for improving discharge planning.

Methods

This was a constructivist grounded theory study. Data included interviews from 30 patients admitted to an inpatient internal medicine service of a midsized academic hospital in Ontario, Canada. Analysis and data collection proceeded iteratively with sampling progressing from purposive to theoretical.

Results

We identified network of care configurations commonly found in patients with multiple medical comorbidities receiving care from multiple different providers admitted to an internal medicine service. FPs and specialists form the network’s scaffold. The involvement of physicians in the network dictated not only how patients experienced transitions in care but the degree of reliance on social supports and personal capacities. The ideal for the multimorbid patient is an optimally involved FP that remains at the centre, even when patients require more subspecialized care. However, in cases where a rostered FP is non-existent or inadequate, increased involvement and advocacy from specialists is crucial.

Conclusions

Our results have implications for transition planning in hospitalized complex patients. Recognizing salient network features can help identify patients who would benefit from enhanced discharge support.
Adjusting health care: practicing care for socially vulnerable type 2 diabetes patients
Authors: Rogvi Sofie á , Guassora Ann Dorrit , Wind Gitte , Tvistholm Nina , Jansen Solveig May-Britt , Hansen Inge Birgitte , Perrild Hans Joergen Duckert , Christensen Ulla
Published: September 2021

Background

Type 2 diabetes cluster in lower social groups and people with type 2 diabetes from lower social groups experience more complications, benefit less from health services and live shorter lives than people with type 2 diabetes from higher social groups. Different logics govern diabetes care and potentially influence the possibility of socially vulnerable type 2 diabetes patients to access and benefit from health services. In order to understand which practice and underlying logic enable socially vulnerable type 2 diabetes patients to access and benefit from diabetes care we aim to describe what professionals at a specialized diabetes clinic do to adjust services to patient’s needs and make the tasks involved in diabetes care doable for socially vulnerable patients and how this work is embedded in an organizational and moral context.

Methods

Ethnographic fieldwork combining participant observation and interviews was carried out between February 2017 and March 2018 in a specialized diabetes clinic located in a socially deprived area in the capital region of Denmark. Sixteen patients (9 male, 7 female, aged 35-73 years) and 12 professionals (7 doctors, 4 nurses, 1 secretary) participated in the study. We used Annemarie Mol’s concept of “the logic of care” to guide our analysis.

Results

Our analysis shows that the logic of care and the care practices in this clinic are characterized by a needs-based approach to treatment involving adjustment of services (permeability, timing, and content) and seeing the patient as a person with many needs. Throughout our description of selected care practices, we both characterize how health professionals practice this particular logic of care and the organizational and normative conditions that this logic is entangled with.

Conclusions

Practicing diabetes care based on patients’ needs involves individualization, something often described as an element of patient centred care. Our study shows that this ideal of individualization and adjustment of treatment is possible in practice. Organizational flexibility and an organizational culture that values patient needs enable needs-based care. In order for socially vulnerable type 2 diabetes patients to benefit from health services it is necessary to create conditions under which professionals can attend to these patients’ multiple and complex needs. Adjusting care to these needs demand a variety of professional efforts some of which are hardly predictable or standardisable.
Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey
Authors: Ssetaala Ali , Ssempiira Julius , Nanyonjo Gertrude , Okech Brenda , Chinyenze Kundai , Bagaya Bernard , Price Matt A , Kiwanuka Noah , Degomme Olivier
Published: September 2021

Background

Maternal mortality is still a challenge in Uganda, at 336 deaths per 100,000 live births, especially in rural hard to reach communities. Distance to a health facility influences maternal deaths. We explored women’s mobility for maternal health, distances travelled for antenatal care (ANC) and childbirth among hard-to-reach Lake Victoria islands fishing communities (FCs) of Kalangala district, Uganda.

Methods

A cross sectional survey among 450 consenting women aged 15–49 years, with a prior childbirth was conducted in 6 islands FCs, during January-May 2018. Data was collected on socio-demographics, ANC, birth attendance, and distances travelled from residence to ANC or childbirth during the most recent childbirth. Regression modeling was used to determine factors associated with over 5 km travel distance and mobility for childbirth.

Results

The majority of women were residing in communities with a government (public) health facility [84.2 %, (379/450)]. Most ANC was at facilities within 5 km distance [72 %, (157/218)], while most women had travelled outside their communities for childbirth [58.9 %, (265/450)]. The longest distance travelled was 257.5 km for ANC and 426 km for childbirth attendance.

Travel of over 5 km for childbirth was associated with adolescent girls and young women (AGYW) [AOR = 1.9, 95 % CI (1.1–3.6)], up to five years residency duration [AOR = 1.8, 95 % CI (1.0-3.3)], and absence of a public health facility in the community [AOR = 6.1, 95 % CI (1.4–27.1)].

Women who had stayed in the communities for up to 5 years [AOR = 3.0, 95 % CI (1.3–6.7)], those whose partners had completed at least eight years of formal education [AOR = 2.2, 95 % CI (1.0-4.7)], and those with up to one lifetime birth [AOR = 6.0, 95 % CI (2.0-18.1)] were likely to have moved to away from their communities for childbirth.

Conclusions

Despite most women who attended ANC doing so within their communities, we observed that majority chose to give birth outside their communities. Longer travel distances were more likely among AGYW, among shorter term community residents and where public health facilities were absent.

Trial registration

PACTR201903906459874 (Retrospectively registered). https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=5977.
Genome-wide analysis of blood lipid metabolites in over 5000 South Asians reveals biological insights at cardiometabolic disease loci
Authors: Harshfield Eric L. , Fauman Eric B. , Stacey David , Paul Dirk S. , Ziemek Daniel , Ong Rachel M. Y. , Danesh John , Butterworth Adam S. , Rasheed Asif , Sattar Taniya , Zameer-ul-Asar  , Saleem Imran , Hina Zoubia , Ishtiaq Unzila , Qamar Nadeem , Mallick Nadeem Hayat , Yaqub Zia , Saghir Tahir , Rizvi Syed Nadeem Hasan , Memon Anis , Ishaq Mohammad , Rasheed Syed Zahed , Memon Fazal-ur-Rehman , Jalal Anjum , Abbas Shahid , Frossard Philippe , Saleheen Danish , Wood Angela M. , Griffin Julian L. , Koulman Albert
Published: September 2021

Background

Genetic, lifestyle, and environmental factors can lead to perturbations in circulating lipid levels and increase the risk of cardiovascular and metabolic diseases. However, how changes in individual lipid species contribute to disease risk is often unclear. Moreover, little is known about the role of lipids on cardiovascular disease in Pakistan, a population historically underrepresented in cardiovascular studies.

Methods

We characterised the genetic architecture of the human blood lipidome in 5662 hospital controls from the Pakistan Risk of Myocardial Infarction Study (PROMIS) and 13,814 healthy British blood donors from the INTERVAL study. We applied a candidate causal gene prioritisation tool to link the genetic variants associated with each lipid to the most likely causal genes, and Gaussian Graphical Modelling network analysis to identify and illustrate relationships between lipids and genetic loci.

Results

We identified 253 genetic associations with 181 lipids measured using direct infusion high-resolution mass spectrometry in PROMIS, and 502 genetic associations with 244 lipids in INTERVAL. Our analyses revealed new biological insights at genetic loci associated with cardiometabolic diseases, including novel lipid associations at the LPL, MBOAT7, LIPC, APOE-C1-C2-C4, SGPP1, and SPTLC3 loci.

Conclusions

Our findings, generated using a distinctive lipidomics platform in an understudied South Asian population, strengthen and expand the knowledge base of the genetic determinants of lipids and their association with cardiometabolic disease-related loci.
Platelet transcriptome profiles provide potential therapeutic targets for elderly acute myelocytic leukemia patients
Authors: Bao Jizhang , Zhao Xinhua , Lu Jiahui , Hu Zhaoyang , Hu Minghui , Hu Xiaoxia , Wang Libing , Hu Qi , Sun Weiling , Wang Jie , Chen Hailin , Lu Hao , Li Changgui , Xu Jing , Zhou Yongming , Zhu Wenwei
Published: September 2021

Background

Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with a median age of 68 in clinical diagnosis. About 60% patients are over 60 years old. There are various treatment options for AML patients. But for elderly patients, the complete remission rates are disappointing due to genetic, molecular, and age-related factors. Development of next-generation sequencing technologies makes it possible to seek individual strategies for patients in different ages. This study analyzed transcriptome profiles in platelets of AML patients in different ages for the first time.

Methods

Platelet RNA sequencing in AML of ten elderly and seven young patients were performed with Illumina TruSeq Stranded mRNA library Prep Kit and Illumina HiSeq4000 sequencing instrument. With the FASTQ sequencing data obtained, statistical analyses between elderly with young AML patients were analyzed by R program. GO and KEGG enrichment analyses were performed via R package clusterProfiler. TOP 10 down-regulated/up-regulated genes in elderly patients compared to young patients were selected with the threshold of |L2FC| > 2 and padj ≤ 0.0001. The down-regulated gene ATF4 was chosen by GSEA analysis and ROC analysis with AUC > 0.95.

Results

We found 3059 genes with differential transcript levels (GDTLs) in AML patients of different age. Among them, 2048 genes are down-regulated and 651 genes are up-regulated in elderly patients. We found that gene transcript profiles in elderly patients is obviously different from those in young patients, including a collection of down-regulated genes related to proteins processing in endoplasmic reticulum and immunity. We further identified that genes of pathway in cancer and mitogen activated protein kinase (MAPK) pathway, involved in natural immunity and metabolism, are significantly down-regulated in elderly patients. Among all screened genes with decreased transcript levels, we believe that activating transcription factor 4 (ATF4) is a biomarker indicating different chemotherapy strategies for elderly patients.

Conclusions

In summary, gene transcript profiles are different in platelets of elderly and young AML patients. And ATF4 can be a useful biomarker indicating different chemotherapy strategies for AML patients with different ages.
Coinfection with dengue and hepatitis A complicated with infective endocarditis in a Yemeni patient: a case report
Authors: Alemad Shafiq A. , Halboup Abdulsalam M. , Aladeeb Khaled , Al-Saleh Mohamed , Al-Kufiley Nuha
Published: September 2021

Introduction

Coinfection with dengue and hepatitis A is rare and challenging for physicians since their clinical features can be overlapping. These infections are self-limiting but can become complicated by subsequent infective endocarditis. We report a case of infective endocarditis following a coinfection with dengue and hepatitis A.

Case presentation

A 17-year-old Yemeni male patient was admitted to the hospital complaining of yellowish discoloration of the skin and sclera associated with dark urine and a diffuse skin rash on the trunk and upper limbs followed by intermittent high-grade fever. Coinfection was confirmed by hepatitis A immunoglobulin M and dengue immunoglobulin M. At the time of diagnosis, white blood cells were normal, with mild neutrophilia and thrombocytopenia along with elevated C-reactive protein. Five days later, the patient was readmitted to the emergency department, complaining of high-grade fever, fatigue, myalgia, nausea, and vomiting. A systolic heart murmur was heard, and infective endocarditis was confirmed by the visualization of two vegetations on the mitral valve and coagulase-negative staphylococci after blood culture. Supportive therapies were initiated for hepatitis A and dengue fever, whereas infective endocarditis was treated with antibiotics for 4 weeks. The patient recovered completely from dengue, hepatitis A, and infective endocarditis.

Conclusion

In endemic areas, it is reasonable to screen for coinfection with dengue and hepatitis A since they are superimposed on each other. Subacute infective endocarditis may occur following initial dengue and hepatitis A coinfection, especially among patients with rheumatic heart disease. An echocardiogram is a pivotal workup for evaluating a patient with persistent fever of unknown origin.
On a half-discrete Hilbert-type inequality related to hyperbolic functions
Authors: You Minghui
Published: September 2021

By the introduction of a new half-discrete kernel which is composed of several exponent functions, and using the method of weight coefficient, a Hilbert-type inequality and its equivalent forms involving multiple parameters are established. In addition, it is proved that the constant factors of the newly obtained inequalities are the best possible. Furthermore, by the use of the rational fraction expansion of the tangent function and introducing the Bernoulli numbers, some interesting and special half-discrete Hilbert-type inequalities are presented at the end of the paper.
Scaled-up ethyl formate fumigation to replace methyl bromide on traded mushroom to disinfest mushroom fly (Lycoriella mali)
Authors: Kwon Tae hyung , Kim Dong bin , Kim Kyung won , Park Min goo , Roh Gwang hyun , Lee Byung ho
Published: September 2021

Mushroom fly, Lycoriella mali (Diptera: Sciaridae), is the primary pest in imported mushrooms. The amount of Tricholoma matsutake imported from China increases every fall when it is harvested. When importing T. matsutake, disinfestation using methyl bromide (MB) or phosphine (PH3) is performed to prevent the introduction of L. mali. However, MB will be phased out due to ozone-depletion, chronic toxicity to workers, and residual issues. PH3 fumigation in mushroom disinfestation requires a long exposure time (24 h). In this study, we used ethyl formate (EF), which can replace MB and reduce exposure time. The efficacy of EF, PH3 and EF + PH3 on L. mali was evaluated. Using 4-h EF fumigation at 5 °C, the 3rd and 4th instar was the most tolerant stage in terms of 99% killed lethal concentration × time products (LCt99%). When 4-h EF fumigation at 5 °C was applied on all stages of L. mali, the LCt99% values of EF were 73.1 g h/m3 to the 1st and 2nd instar, 112.9 g h/m3 to the 3rd and 4th instar, 68.9 g h/m3 to pupae, and 20.1 g h/m3 to adult. It was confirmed that combination treatment with EF + PH3 had a synergistic effect on L. mali. The LCt99% of EF + 0.5 g/m3 of PH3 to the 3rd and 4th instar was 48.3 g h/m3. When only 140 g/m3 of EF was applied for 4 h at > 5 °C and 35 g/m3 of EF + 0.5 g/m3 of PH3 for 4 h at > 5 °C in commercial trials containing T. matsutake, proven efficacy (100%) on L. mali was confirmed. In the case of EF treatment only, phytotoxic damage occurred due to high Ct products, and there was no phytotoxic damage in combination treatment with EF + PH3. This study provides a new guideline for EF + PH3 combination treatment within a shorter exposure time (4 h) than existing PH3 treatment (24 h) and replacement of MB use.
The participatory development of a national core set of person-centred diabetes outcome constructs for use in routine diabetes care across healthcare sectors
Authors: Skovlund Soren Eik , Troelsen Lise H. , Klim Lotte , Jakobsen Poul Erik , Ejskjaer Niels
Published: September 2021

Background

This study sought to utilise participatory research methods to identify the perspectives of people with diabetes regarding which diabetes outcomes were most important to them. These findings were then used to support an expert working group representing multiple health sectors and healthcare disciplines and people with diabetes to establish a core set of patient-important outcome constructs for use in routine diabetes care.

Methods

26 people with diabetes and family members were recruited through purposive sampling to participate in interviews, focus groups, voting and plenary activities in order to be part of identifying outcome constructs. Content and qualitative analysis methods were used with literature reviews to inform a national multi-stakeholder consensus process for a core set of person-centred diabetes outcome constructs to be used in routine diabetes care across health care settings.

Results

21 people with diabetes and 5 family members representing type 1 and 2 diabetes and a range of age groups, treatment regimens and disease burden identified the following patient-reported outcome constructs as an important supplement to clinical indicators for outcome assessment in routine diabetes care: self-rated health, psychological well-being, diabetes related emotional distress and quality of life, symptom distress, treatment burden, blood sugar regulation and hypoglycemia burden, confidence in self-management and confidence in access to person-centred care and support. Consensus was reached by a national multi-stakeholder expert group to adopt measures of these constructs as a national core diabetes outcome set for use in routine value-based diabetes care.

Conclusions

We found that patient-reported outcome (PRO) constructs and clinical indicators are needed in core diabetes outcome sets to evaluate outcomes of diabetes care which reflect key needs and priorities of people with diabetes. The incorporation of patient-reported outcome constructs should be considered complementary to clinical indicators in multi-stakeholder value-based health care strategies. We found participatory research methods were useful in facilitating the identification of a core prioritised set of diabetes outcome constructs for routine value-based diabetes care. The use of our method for involving patients may be useful for similar efforts in other disease areas aimed at defining suitable outcomes of person-centred value-based care. Future research should focus on developing acceptable and psychometrically valid measurement instruments to evaluate these outcome constructs as part of routine diabetes care.
Improved precision of noise estimation in CT with a volume-based approach
Authors: Wisselink Hendrik Joost , Pelgrim Gert Jan , Rook Mieneke , Dudurych Ivan , van den Berge Maarten , de Bock Geertruida H. , Vliegenthart Rozemarijn
Published: September 2021

Assessment of image noise is a relevant issue in computed tomography (CT). Noise is routinely measured by the standard deviation of density values (Hounsfield units, HU) within a circular region of interest (ROI). We explored the effect of a spherical volume of interest (VOI) on noise measurements. Forty-nine chronic obstructive pulmonary disease patients underwent CT with clinical protocol (regular dose [RD], volumetric CT dose index [CTDIvol] 3.04 mGy, 64-slice unit), and ultra-low dose (ULD) protocol (median CTDIvol 0.38 mGy, dual-source unit). Noise was measured in 27 1-cm2 ROIs and 27 0.75-cm3 VOIs inside the trachea. Median true noise was 21 HU (range 17-29) for RD-CT and 33 HU (26-39) for ULD-CT. The VOI approach resulted in a lower mean distance between limits of agreement compared to ROI: 5.9 versus 10.0 HU for RD-CT (−40%); 4.7 versus 9.9 HU for ULD-CT (−53%). Mean systematic bias barely changed: −1.6 versus −0.9HU for RD-CT; 0.0 to 0.4HU for ULD-CT. The average measurement time was 6.8 s (ROI) versus 9.7 (VOI), independent of dose level. For chest CT, measuring noise with a VOI-based instead of a ROI-based approach reduces variability by 40-53%, without a relevant effect on systematic bias and measurement time.
Wading through water: effects of water depth and speed on the drag and kinematics of walking Chilean flamingos, Phoenicopterus chilensis
Authors: Palecek Amanda M. , Novak Megan V. , Blob Richard W.
Published: September 2021

Wading behaviours, in which an animal walks while partially submerged in water, are present in a variety of taxa including amphibians, reptiles, mammals and birds. Despite the ubiquity of wading behaviours, few data are available to evaluate how animals adjust their locomotion to accommodate changes in water depth. Because drag from water might impose additional locomotor costs, wading animals might be expected to raise their feet above the water up to a certain point until such behaviours lead to awkward steps and are abandoned. To test for such mechanisms, we measured drag on models of the limbs of Chilean flamingos (Phoenicopterus chilensis) and measured their limb and body kinematics as they walked and waded through increasing depths of water in a zoo enclosure. Substantial drag was incurred by models of both open- and closed-toed feet, suggesting that flamingos could avoid some locomotor costs by stepping over water, rather than through it, during wading. Step height was highest while wading through intermediate water depths and while wading at a faster speed. Stride length increased with increasing water depth and velocity, and the limb joints generally flexed more while moving through intermediate water depths. However, movements of the head and neck were not strongly correlated with water depth or velocity. Our results show a wide range of kinematic changes that occur to allow wading birds to walk through different water depths, and have implications for better understanding the locomotor strategies employed by semi-aquatic species.
Oriented Films of Metal-Organic Frameworks on Metal Hydroxides via Heteroepitaxial Growth
Authors: Takahashi Masahide
Published: September 2021

Framework compounds such as metal-organic frameworks (MOFs) are characterized by their micropores, which provide a large accessible surface for applications such as gas storage and catalysis. Additional functionalities for electronics, photonics, and magnetic applications can be attained by accommodating functional guests (molecules, ions, or nano-objects) into the pores. Device-scale MOF thin films with controlled crystallographic orientations must be achieved to enhance these sophisticated functionalities for practical applications. Recently, we reported the heteroepitaxial growth of MOFs via solution processing of precursor metal hydroxide-oriented films. The resultant MOF film exhibited crystallographic orientation along all three axes, which can be used as quasi-single crystals because the pores are aligned in specific directions at the macroscopic scale. The orientation primarily depends on the crystallographic plane of the seed metal hydroxide layer. In this article, recent advances in the fabrication and application of oriented MOF films are reviewed.
Expression Level of IL-17 in Peripheral Blood of Patients with Late Pregnancy and Diagnosis of Maternal-Fetal Tolerance Based on Brain MRI Image Segmentation Algorithm
Authors: Yu Zenying , Zhou Shengyan , Tan Zhen , Lu Guangmin
Published: September 2021

Objectives: To study the expression of IL-17 in peripheral blood and its effect on maternal-fetal tolerance in patients with eclampsia in late pregnancy using MRI image segmentation algorithm.

Methods: Thirty-nine patients with severe preeclampsia and eclampsia with brain symptoms were examined by cranial MRI. Pregnant women with 32 weeks of pregnancy were selected to detect the percentage of Th17 and Treg cells in CD4 + T lymphocytes and the expression of cytokines IL-17 and IL-10 in peripheral blood.

Results: MRI examination was normal in 26 cases, 9 cases showed reversible posterior encephalopathy syndrome, three cases were cerebral hemorrhage, and one case was intracranial cavernous sinus thrombosis. two. Compared with the mild preeclampsia group, the relative number of Thl7 cells increased and that of Treg cells decreased in the severe preeclampsia group (P>0.05).

Conclusion: The major types of cerebrovascular diseases (CVD) in severe preeclampsia and eclampsia were reversible posterior encephalopathy syndrome and cerebral hemorrhage. It was speculated that the damage to the blood-brain barrier may play an important role in the pathogenesis. The balance of the number of Th17 cells/the number of Treg cells was more inclined to the Th17 cell-mediated pro-inflammatory state, Treg cell-mediated immune tolerance decreases, and it becomes more obvious with the worsening of the disease.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4828

How to cite this:Yu Z, Zhou S, Tan Z, Lu G. Expression Level of IL-17 in Peripheral Blood of Patients with Late Pregnancy and Diagnosis of Maternal-Fetal Tolerance Based on Brain MRI Image Segmentation Algorithm. Pak J Med Sci. 2021;37(6):1553-1557.  doi: https://doi.org/10.12669/pjms.37.6-WIT.4828

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The efficacy of Rhodiola Rosea based on DTI image Segmentation Algorithm for patients with delayed Encephalopathy caused by CO poisoning
Authors: Gao Yuming , Cui Haitao , Ren Wei , Han Bing
Published: September 2021

Objectives: By using DTI image segmentation algorithm investigate the effect of large plants Rhodiola injection on myocardial injury in patients with acute severe CO poisoning (ACOP), and to explore the clinical and CT delayed encephalopathy after ACOP.

Methods: Seventy-two ACOP patients were randomly divided into control and observation group, 36 cases in each group from December 2015 – December 2017. The control group received hyperbaric oxygen, mannitol, dexamethasone, citicoline injection, gangliosides, dracone; observation group were large strain Rhodiola injection treatment group based on the once daily for two weeks of continuous treatment. The head CT, head MRI results were analyzed retrospectively.

Results: (1) hsCRP and ET-1 in the observation group were significantly lower than those in the control group, and VEGF was significantly higher than that in the control group (P<0.01). No, NOS, and iNOS were significantly lower than those of the control group (P<0.01); (2) CT images of 16 cases showed bilateral symmetrical fusion lesions with blurred edges, low density, and oval center around the ventricle; (3) MRI showed that the lesion was located in the cerebral cortex, white matter lateral ventricle and/or basal ganglia in 12 cases.

Conclusion: Rhodiola can reduce myocardial vascular endothelial cell injury, improve cardiac function, and protect the damaged myocardium. Meanwhile, after acute CO poisoning delayed encephalopathy early for CT and MRI examination facilitate analysis and prognosis of the disease.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4830

How to cite this:Gao Y, Cui H, Ren W, Han B. The efficacy of Rhodiola Rosea based on DTI image Segmentation Algorithm for patients with delayed Encephalopathy caused by CO poisoning. Pak J Med Sci. 2021;37(6):1558-1563. doi: https://doi.org/10.12669/pjms.37.6-WIT.4830

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Application of CEEMD noise reduction algorithm in ultrasound imaging in evaluating fetuses with abnormal glucose metabolism in late pregnancy
Authors: Huang Junfeng , Wang Cuiting , Li Xianxia , Jing Yuqin
Published: September 2021

Objectives: To explore the predictive effect of abnormal glucose metabolism and fetal hemodynamic parameters on adverse pregnancy outcome.

Methods: One hundred and nine pregnant women with abnormal glucose metabolism during pregnancy from June 2016 to October 2018 were selected and divided into poor prognosis group (34 cases) and good prognosis group (75 cases). The hemodynamic parameters of fetal cerebral artery (MCA), umbilical artery (UA) and uterine artery of pregnancy (UT-A), including peak systolic velocity (s / D), resistance index (RI) and plasticity index (PI), were measured by color Doppler ultrasound. The receiver operating characteristic (ROC) curve of adverse pregnancy outcomes was drawn and the best threshold index was determined.

Results: MCA-PI poor prognosis group, MCA-RI, RI ratio (MCA/UA) are lower than the good prognosis group, Ut-A-PI is higher than the good prognosis group (P<0.05,). ROC curve analysis results show that when the MCA-PI 1.56, the sensitivity of the predicted adverse outcomes of pregnancy, the highest specificity<, was 91.18%, 80.00%, respectively. Logistic regression analysis of risk factors shows poor pregnancy outcomes include: pregnant women, older age, body mass index ≥24.0kg/m2 and a family history of diabetes. Protective factors include exercise during pregnancy, MCA-PI≥1.56, MCA-RI≥0.63 and RI The ratio (MCA/UA) ≥0.84.

Conclusion: Color Doppler ultrasound measured MCA-PI<1.56 the most important indicators of poor pregnancy outcomes as abnormal glucose metabolism during pregnancy and predict the exact cutoff. Pregnant women, older age, body mass index ≥24.0kg/m2 and a family history of diabetes and abnormal glucose metabolism during pregnancy risk factors for adverse outcomes of pregnancy.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4844

How to cite this:Huang J, Wang C, Li X, Jing Y. Application of CEEMD noise reduction algorithm in ultrasound imaging in evaluating fetuses with abnormal glucose metabolism in late pregnancy. Pak J Med Sci. 2021;37(6):1590-1594. doi: https://doi.org/10.12669/pjms.37.6-WIT.4844

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Analysis of pathological characteristics and nursing intervention of patients with gastric polyps based on image stitching algorithm and endoscopy
Authors: Zhu Linzhen , Zhu Linlin , Yu Weihua
Published: September 2021

Original Article

Linzhen Zhu1, Linlin Zhu2, Weihua Yu3

ABSTRACTObjectives: The paper uses image stitching algorithm to understand the clinical and pathological characteristics of gastric polyps under gastroscope, and provides objective basis for the clinical diagnosis and treatment of gastric polyps and nursing intervention. Methods: The endoscopic, pathological data and surgical conditions of 111 patients with gastric polyps detected in the hospital from January 2017 to August 2019 were retrospectively analyzed. Results: The elderly patients (≥60 years old) in this group were those with high incidence of gastric polyps (56.8%); 80 patients with single polyps (72.1%), 31 patients with multiple polyps (27.9%); polyps were mainly located in the stomach (53.2%); polyps diameter ≤0.5cm are more common (69.4%); polyps are mainly hyperplastic polyps (40.5%) and inflammatory polyps in 37 cases (33.3%). Polyps were removed by biopsy forceps in 30 cases, endoscopic submucosal injection of 0.9% NaCl solution combined with high-frequency electrosurgical removal of 54 cases, endoscopic mucosal resection (EMR) in 6 cases, and endoscopic submucosal dissection (ESD) in treatment of the 4 cases, the remaining 17 cases were treated with surgery, and 12 patients were followed up, 2 of whom relapsed. Conclusion: Gastric polyps are small in diameter and mostly single; polyps are mainly located in the stomach body, mainly hyperplastic polyps; treatment methods are mostly endoscopic resection, and there is a possibility of recurrence after polypectomy, and follow-up should be strengthened. Full preparation before the operation, close cooperation during the operation, and careful postoperative care are important links to ensure the safety of the operation and reduce complications such as upper gastrointestinal bleeding.

KEYWORDS: Pathological characteristics; Nursing; Gastric polyps; Image stitching algorithm; Endoscopy.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4854How to cite this:Zhu L, Zhu L, Yu W. Analysis of pathological characteristics and nursing intervention of patients with gastric polyps based on image stitching algorithm and endoscopy. Pak J Med Sci. 2021;37(6):1620-1624. doi: https://doi.org/10.12669/pjms.37.6-WIT.4854

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Machine learning algorithm of ultrasound-mediated intestinal function recovery and nursing efficacy analysis of lower gastrointestinal malignant tumor after surgery
Authors: Ma Lei , Zhang Hao
Published: September 2021

Objectives: In this paper, machine learning algorithms was used to explore the application value of ultrasound contrast in the early evaluation of neoadjuvant chemotherapy in patients with gastrointestinal malignant liver metastases, and analyzes the effect of sports nursing methods on intestinal function recovery.

Methods: Forty-seven patients with gastrointestinal malignancies were divided into 25 patients (combined chemotherapy group) and 22 cases (chemotherapy group) from April 2018 to April 2019. Two groups of patients were treated with CEUS. The effective lesion patients and invalid quantitative parameters were compared between the two groups before and after treatment, and the postoperative routine nursing was implemented.

Results: Chemotherapy group effective in 18 cases, accounting for 81.82%; 4 cases, 18.18%. Combination chemotherapy patients 21 cases, accounting for 84.00%; 4 cases, accounting for 16.00%.

Conclusion: Based on early is important to assess the efficacy of neoadjuvant chemotherapy in patients with liver metastases peak intensity ultrasound contrast parameters of the machine learning algorithms malignant tumors in the gastrointestinal tract, post-operative care movement helps to restore bowel function.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4866

How to cite this:Ma L, Zhang H. Machine learning algorithm of ultrasound-mediated intestinal function recovery and nursing efficacy analysis of lower gastrointestinal malignant tumor after surgery. Pak J Med Sci. 2021;37(6):1662-1666. doi: https://doi.org/10.12669/pjms.37.6-WIT.4866

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Correlation analysis of epicardial adipose tissue volume quantified by computed tomography images and coronary heart disease under optimized reconstruction algorithm
Authors: Miao Zhenwei , Yang Hongyan , Liu Bofen , Li Wengui
Published: September 2021

Objectives: This paper was aimed to explore the adoption value of low-dose computed tomography (CT) imaging based on optimized ordered subset expectation maximization (OSEM) reconstruction algorithm in the correlation analysis between epicardial adipose tissue (EAT) volume and coronary heart disease (CHD).

Methods: A total of 110 patients with CHD were selected for CT angiography (CTA) and coronary arteriography (CAG) examinations from October 2017 to October 2019. The predictive value of EAT for CHD was analyzed via receiver operating characteristic (ROC) curve.

Results: The results showed that the iteration time and error of the improved OSEM reconstruction algorithm were better than that of MLEM algorithm under the same number of iterations. Age, smoking, hypertension, diabetes, and EAT in control group were obviously lower in contrast to those in CHD group (P<0.05). EAT in control group was (124.50±26.72) mL, and EAT in the CHD group was (159.41±38.51) mL. EAT (B=0.023, P=0.003) was an independent risk factor for CHD, which was suggested by Multiple linear regression analysis. Moreover, EAT was a risk factor for CHD, and was positively correlated with the degree and NSCV.

Conclusion: The optimized OSEM algorithm was used to improve the reconstruction quality of low-dose CT images and used in quantitative measurement of epicardial fat volume. Results showed EAT was an independent risk factor for CHD, and was positively correlated with the number of coronary lesions and Gensini score. It was of great value for the prediction of CHD.

doi: https://doi.org/10.12669/pjms.37.6-WIT.4882

How to cite this:Miao Z, Yang H, Liu B, Li W. Correlation analysis of epicardial adipose tissue volume quantified by computed tomography images and coronary heart disease under optimized reconstruction algorithm. Pak J Med Sci. 2021;37(6):1677-1681.  doi: https://doi.org/10.12669/pjms.37.6-WIT.4882

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The “new-normal” OSCE examination: Executing in the COVID-19 era
Authors: Matin Shazia Babar , Afzal Azam Saeed
Published: September 2021

In this unprecedented situation of COVID-19 era, the educational institutions have to attune not only the teaching strategies but also the assessment. Similarly, just as COVID precautions have become the “new normal” practice, hence implementation changes during face-to-face examinations may become standard practice in the Post- COVID era. The Objective structured clinical exams (OSCEs) which usually require a face-to-face assessment of skills, posed a special challenge to health professionals in COVID-19. This commentary paper is written on shared experiences of the examination cell principal resource faculty for OSCE and exam coordinators. It addresses how to plan and implement objective, valid, feasible and reliable clinical skills examinations (OSCEs) keeping in place COVID precautions to ensure the utmost wellbeing of all stakeholders involved.

doi: https://doi.org/10.12669/pjms.37.7.4568

How to cite this:Babar S, Afzal A. The “new-normal” OSCE examination: Executing in the COVID-19 era. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4568

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Clinical analysis of 33 cases with neonatal cerebral infarction
Authors: Yang Ning , He Xiaojun , Yin Cuixia , Zhao Lihua
Published: September 2021

Objective: To investigate the etiology, clinical manifestations, diagnosis, treatment and prognosis of neonatal cerebral infarction (NCI) to further improve the understanding of the disease.

Methods: Clinical data and follow-up results of 33 cases of NCI in neonatal intensive care unit of a first-class hospital from September 2009 to September 2019 were retrospectively analyzed.

Results: All 33 patients were diagnosed with NCI by MRI. Among them, 31 cases (93.94%) were full-term infants, 25 cases (75.76%) were mother’s first birth, and 18 (54.55%) cases were males. Pregnancy complications were reported in 18 cases (54.55%), and 19 cases (57.58%) had perinatal hypoxia history. Seizures were the most common first symptom and clinical manifestation in the course of disease (81.8%). There were 27 cases (81.82%) of patent foramen ovale (PFO) among NCI cohort. Ischemic cerebral infarction occurred in 32 cases (96.97%). The middle cerebral artery and its branches were more frequently involved, mainly on the left side. The acute stage of NCI was managed by symptomatic support treatment, and the recovery stage involved mainly rehabilitation treatment. Among the 33 cases, five cases were lost to follow-up, two patients died, 26 patients survived without complications, one case had cerebral palsy, one case had language retardation, and six cases had dyskinesia. Poor prognosis was associated with the involvement of deep gray matter nuclei or multiple lobes, and intrapartum complications. Vaginal mode of delivery and longer hospital stay were associated with better prognosis.

Conclusions: Complications leading to placental circulation disorder during pregnancy and perinatal hypoxia are common high-risk factors of NCI. The seizure is the most common clinical manifestation. There is a possible correlation between PFO and NCI. Involvement of deep gray matter or multiple lobes and intrapartum complications may indicate poor prognosis, while vaginal delivery and prolonged hospitalizations are associated with better prognosis of NCI.

doi: https://doi.org/10.12669/pjms.37.7.4720

How to cite this:Yang N, He X, Yin C, Zhao L. Clinical analysis of 33 cases with neonatal cerebral infarction. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4720

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.