bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative reproductive results of infertile patients with intrauterine adhesions: A retrospective analysis
Authors: Weng Xiu-Lan , Xie Xi , Liu Chao-Bin , Yi Jing-Song
Published: September 2022

Objective

To explore the reproductive outcomes after hysteroscopic separation of intrauterine adhesions (IUA) in infertile patients due to IUA.

Methods

This retrospective study enrolled patients with fertility requirements and infertility due to IUA. Data were collected from the hospital medical records and by follow-up by telephone. The impact on pregnancy and pregnancy outcome of preoperative adhesion, menstrual conditions before and after surgery and postoperative re-adhesion was analysed.

Results

A total of 106 patients (median age, 28 years) were enrolled in the study. There was a significant correlation between preoperative menstrual patterns and pregnancy rate. There were 56 pregnancies (pregnancy rate 52.83%) after the operation. Patients with improved menstruation after the operation had a significantly higher pregnancy rate (pregnancy rate 56.25%; 45 of 80 patients) compared with the patients that did not experience any improvement in their postoperative menstrual status (pregnancy rate 21.43%; three of 14 patients). Of the 56 pregnancies, 40 (71.43%) resulted in live births and six (10.71%) patients had miscarriages. A total of 54 of 56 patients (96.43%) became pregnant within 2 years.

Conclusion

Pregnancy after intrauterine adhesion separation has a high rate of miscarriage and obstetric complications, so close monitoring of the patient is required.
Rearing performance of black soldier fly (Hermetia illucens) on municipal biowaste in the outdoor ambient weather conditions of Pakistan and Indonesia
Authors: Mahmood Saleha , Ali Azhar , Zurbrügg Christian , Dortmans Bram , Asmara Dinda Rosalita
Published: September 2022

The availability and continuous supply of black soldier fly larvae (BSFL) is crucial for efficient operation of a BSF biowaste recycling facility. Its rearing performance was for the first time investigated in Pakistan under outdoor ambient weather conditions. Comparison of the findings with the BSF rearing performance of Indonesia’s facility highlights the life stages needing special attention. In Pakistan, mean BSF emergence, hatching and survival rate of 58.8% (SD 15.2), 44.5% (SD 21.8) and 91.4% (SD 1.68) were achieved respectively. A positive significant correlation was found between the number of emerged flies and prepupae ( R = 0.75) and the number of eggs produced and hatched ( R = 0.92). On average, BSF took 49.5 days (SD 3.20) to complete one life cycle (LC) under ambient temperature and relative humidity (RH) between (22–35 °C) and (24.7–89.3%) respectively. The mean duration of eclosion, pre-oviposition, egg hatching, larval feeding and pupation was 15.6 days (SD 1.6), 3.5 days (SD 0.5), 3 days (SD 0.6), 22 days (SD 2.5), 3.8 days (SD 1.2) respectively. In Pakistan, the LC duration was longer with a smaller number of eggs/fly, lower BSF emergence and hatching rates as compared to Indonesia. BSF tolerated the semiarid weather conditions of Pakistan, successfully developed into all instars and completed all LCs under observation. It is suggested to provide controlled environmental conditions at the nursery stage to improve BSFL rearing performance for sustainable biowaste management.
Tissues and organ printing: An evolution of technology and materials
Authors: Singh Gurminder , Singh Sunpreet , Kumar Raman , Parkash Chander , Pruncu Catalin , Ramakrishna Seeram
Published: September 2022

Since its beginnings, three-dimensional printing (3DP) technology has been successful because of ongoing advances in operating principles, the range of materials and cost-saving measures. However, the 3DP technological progressions in the biomedical sector have majorly taken place in the last decade after the evolution of novel 3DP systems, generally categorised as bioprinters and biomaterials to provide a replacement, transplantation or regeneration of the damaged organs and tissue constructs of the human body. There is now substantial scientific literature accessible to support the benefits of digital healthcare procedures with the help of bioprinters. It is of the highest significance to know the fundamental principles of the available printers and the compatibility of biomaterials as their feedstock, notwithstanding the huge potential of bioprinting systems to manufacture organs and other human body components. This paper provides a precise and helpful reading of the different categories of bioprinters, suitable biomaterials, numerical simulations and modelling and examples of much acknowledged clinical practices. The paper will also cite the prominent issues that still have not received desired solutions. Overall, the article will be of great use for all the professionals, scholars and engineers concerned with the 3DP, bioprinting and biomaterials.
Flipped Classroom Models: A Rapid Review From Recent Literatures
Authors: Poudel Navin , Sharma Lekhnath
Published: September 2022

Purpose

This rapid review is based on 14 articles published in the year 2019 and 2020 that report on the flipped classroom. This review study aims to examine underpinning theories to design flipped classroom and the models of the flipped classroom utilized in the different disciplinary, curricular, and technological contexts.

Design/Approach/Methods

The ProQuest database was used to search the articles for the study with the keyword “flipped classroom” and “Flipped learning.” Cochrane rapid review method was used as a methodology to investigate theoretical underpinnings, models, and the disciplinary and technological context of the studies.

Findings

This study found that flipped classroom approach was practiced in various disciplinary contexts and was mostly based on the theory of constructivism. Technological use in the flipped classroom models ranges from just using videos to fully online using different applications and learning management systems. The findings of the studies showed that there is a positive impact of the flipped classroom on learning, motivation, and anxiety.

Originality/Value

This study utilized the Cochrane rapid review method in the educational setting.
Yes or No: Using Narrative Therapy to Help Couples With Childbearing Decision Conflict
Authors: Yu Fangzhou , Ahmed Imaan , Salerno Rachel , Sarli Tracy
Published: September 2022

There is a lack of literature on effective theories to assist couples with childbearing decision conflict. Authors address the ways how Narrative Therapy could serve as a helpful framework to address this particular problem. The literature will review the topic of childbearing conflict amongst couples, and provide background on Narrative Therapy with a focus on Narrative Couple Therapy. A case example is presented to demonstrate the ways Narrative Therapy deals with a couple's conflict on childbearing decision, showing how its techniques can be used to navigate the decision-making process.
The Association Between Resources, Accessibility, and Female Victim Intimate Partner Homicide at the County-Level in Florida
Authors: Toohy Kayla , Reckdenwald Amy , Peebles Ciara , Ford Jason
Published: September 2022

Limited research has been conducted to understand possible relationships that exist between IPH and access to DV services. The current study adds to the literature by expanding traditional measures of DV services to capture presence, as well as access, and examines the impact on female IPH victimization across 67 Florida counties between 2005 and 2015. Using exposure reduction arguments, we shed light on factors associated with female victim IPH rates and support previous research findings showing a continuation in the disparity of IPH rates between urban and rural areas within county boundaries. We also demonstrate the importance of accessible shelter and safe homes in combating IPV and IPH rates.
Experimental and analytical study on eccentric compressive behavior of concrete columns strengthened with high-strength reinforcement of HRB600
Authors: Ni Xiangyong , Yuan Cheng , Li Yizhu
Published: September 2022

This study examines the influence of initial eccentricity, volume stirrup ratio, and the strength of longitudinal reinforcement and stirrup on the eccentric compressive performance of concrete columns strengthened with HRB600-high-strength-reinforcement. Ten concrete columns are tested under eccentric compression. The compressive mechanism evaluates and compares the failure characteristics, load-deformation curve, reinforcement strain, and eccentric compression performance. As part of the numerical study, the finite element modeling of OpenSees is used to predict the response of HRB600 specimens under eccentric compressive loading, and parametric analysis is subsequently conducted. The research findings illustrate that HRB600 longitudinal reinforcement can yield in tension and compression with large eccentricity when approaching the ultimate bearing capacity state. After normal strength longitudinal reinforcement is supplanted, the reinforcement amount is saved. Lastly, semi-empirical models have been proposed to predict the compressive performance of concrete columns with high-strength reinforcement.
Behavioral Biases in Daily Fantasy Baseball: The Case of the Hot Hand
Authors: Losak Jeremy M. , Weinbach Andrew P. , Paul Rodney J.
Published: September 2022

Despite mixed evidence, sport participants and fans heavily believe in the existence of the hot hand. Prior literature examining NBA and NFL betting markets found betters were biased towards hot teams. Using a unique market and data set, this study identifies if the hot hand is prevalent in daily fantasy baseball contests, if there is a profitable hot hand selection strategy, and if consumers believe in its existence. Results show that while there is no evidence of a hot hand effect, and no evidence of a profitable hot hand strategy, consumers believe in and incorporate it in their lineup decisions.
Risk Level and Variation in Social Support Access Among Justice-Involved Youth
Authors: Young Brae , Brady Caitlin M. , Lloyd Kristin M.
Published: September 2022

Social support is important for the average incarcerated person, although variation exists. The amount of support received and whether improvements in support are made over confinement can vary across numerous factors including sentence length and quality of family relationships. Preliminary evidence suggests that risk level might also be an important factor to consider, though no study has examined this possibility. Accordingly, the current study examines whether access to social support (family contact, willingness to support, treatment participation, and non-family support) differs based on risk level classification (low, moderate, moderate-high, high). Additionally, we assess how risk level is associated with changes in social support during confinement. Using a sample of incarcerated youth, results show that access to social support, and to a lesser extent changes in social support during confinement, differ across risk level. The findings have important implications for juvenile justice system responses and efforts to promote support.
Simulation of the attack helicopter Mil Mi-24 conducting anti-surface air operations in support of a battalion task group
Authors: Korecki Zbyšek , Hoika Tomas , Ulvr Jiří , Janošek Miroslav , Grega Matuš
Published: September 2022

The paper presents an experiment of air support of ground units at the level of battalion task force in an offensive operation. Statistical techniques were used in this approach to estimate the outcomes of the operation from the data generated by a simulation model. The experiment was conducted with the support of the Masa SWORD simulation technology for different scenarios involving the pilot characteristics, firing distances, range of air defense, and the use of different unit sensor capacities. As part of the different scenarios, we present sensor results for use in different attack scenarios with different enemy capabilities at the tactical level and the impact of air support of the battalion’s task force in destroying a company-sized enemy. The experiment allows evaluation of different pilot training levels, stress levels, and other climatic influences. These factors provide information on when and how (with what desired effect) a strike can be executed, by what means (systems) it is to be executed, and what the constraints are in executing it. The constraints are imposed by electronic warfare (EW), level of camouflage, and air defense. We have determined using the Masa SWORD simulation program that the use of helicopters to support the battalion task group will significantly reduce the loss of life and reduce the time to destroy the enemy.
Research on irregular wear mechanism of planar multi-body mechanical system with multi-clearance joints
Authors: Wang Zhimin , Jin Guoguang , Wei Zhan , Liang Dong , Chang Boyan , Zhou Yang
Published: September 2022

An approach for analyzing and quantifying the irregular wear effect of planar multi-body mechanical system with multi-clearances is proposed. The classical planar four-bar linkage is used as a demonstrative example to study the mechanism of irregular wear effect of multi-body system with multi-clearances. The system dynamic equation is established using Lagrange multiplier method, the contact force and friction in the process of contact collision are respectively modeled using the Lankarani-Nikravesh (L-N) nonlinear contact force and LuGre models, and the wear depth prediction model for multi-clearance joints is built based on Archard’s equation. The influence of the crank speed, clearance number, clearance position and clearance size on the wear effect of multi-clearances system is comprehensively studied. Numerical simulation results show that the wear depth joint increases with increase of crank speed, and there are significant differences in the wear depth of different clearance joints. When the clearance size changes, the significant nonlinear wear phenomenon appears at different joints, when the clearance size of different joints meets a certain proportion, the system wear phenomenon is the least. The obtained valuable results provide important theoretical support for the optimal design of multi-clearance joints system.
Snapping Out of Autopilot: Overriding Habits in Real Time and the Role of Ventrolateral Prefrontal Cortex
Authors: Korponay Cole
Published: September 2022

Habits allow environmental and interoceptive cues to trigger behavior in an automatized fashion, making them liable to deployment in inappropriate or outdated contexts. Over the long term, repeated failure of a once-adaptive habit to satisfy current goals produces extinction learning that suppresses the habit’s execution. Less attention has been afforded to the mechanisms underlying real-time habit suppression: the capacity to stop the execution of a cued habit that is goal conflicting. Here, I first posit a model by which goal-relevant stimuli can (a) bring unfolding habits and their projected outcomes into awareness, (b) prompt evaluation of the habit outcome with respect to current goals, and (c) trigger cessation of the habit response if it is determined to be goal conflicting. Second, I propose a modified stop-signal task to test this model of goal-directed stopping of habit execution. Finally, I marshal evidence indicating that the ventrolateral prefrontal cortex, situated at the nexus of salience detection, action-plan assessment, and motor inhibition networks, is uniquely positioned to coordinate the overriding of habitual behaviors in real time. In sum, this perspective presents a testable model and candidate neurobiological substrate for our capacity to “snap out of autopilot” and override goal-conflicting habits in real time.
Therapeutic Options for the SARS-CoV-2 Virus: Is There a Key in Herbal Medicine?
Authors: Sharma Nitin , Kulkarni Giriraj T. , Bhatt Anant Narayan , Satija Saurabh , Singh Lubhan , Sharma Anjana , Dua Kamal , Karwasra Ritu , Khan Asim Ali , Ahmad Nadeem , Raza Khalid
Published: September 2022

SARS-CoV-2 has been responsible for over 500 million cumulative cases all over the world since December 2019 and has marked the third introduction of a highly pathogenic virus after SARS-CoV and MERS-CoV. This virus is in a winning situation because scientists are still racing to explore effective therapeutics, vaccines, and event treatment regimens. In view of progress in current disease management, until now none of the preventive/treatment measures can be considered entirely effective to treat SARS-CoV-2 infection. Therefore, it is required to look up substitute ways for the management of this disease. In this context, herbal medicines could be a good choice. This article emphasizes the antiviral potential of some herbal constituents which further can be a drug of choice in SARS-CoV-2 treatment. This article may be a ready reference for discovering natural lead compounds and targets in SARS-CoV-2 associated works.
Ossifying fibromyxoid tumour with an unusually prominent central ossification harbouring EPC1-PHF1 gene fusion: A case report and literature review
Authors: Chua Tzy Harn , Lai Siang Hui , Sittampalam Kesavan
Published: September 2022

Ossifying fibromyxoid tumour (OFMT) is a soft tissue neoplasm of uncertain differentiation, with potential for recurrences and metastases depending on the presence of atypical or malignant histological features. Most cases show an incomplete shell of mature bone in the periphery of the lesion. Recurrent PHF1 gene rearrangements were also recently reported in OFMTs, with the most common rearrangement involving a fusion to EP400. We report a case of a 75-year-old male that was diagnosed with an OFMT showing an unusually prominent central ossification. Further, this lesion also harboured the less commonly reported EPC1-PHF1 gene fusion, thus further characterising the morphological features that are associated with this molecular event in this entity. Differential diagnoses of lesions with prominent ossification and emerging molecular findings associated with this entity are discussed.
Self-care practice, lived experience of type 1 diabetes mellitus patients at Kemisse General Hospital, North Eastern Ethiopia: Phenomenological study
Authors: Bogale Eyob Ketema , Wondiye Habtamu , Debela Yamrot , Fentabil Anagaw Tadele , Worku Lelisa , Kebede Natnael
Published: September 2022

Objectives:

To explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital, North east Ethiopia.

Methods:

A phenomenological study was conducted to explore self-care experience of type 1 diabetes mellitus patients at Kemisse General Hospital from 28 February 2020 to 15 March 2020. Participants were selected using a heterogeneous type of purposive sampling technique. Data were collected using in-depth interviews and observation with the aid of an audio recorder and interview guide by the principal investigator. The thematic analysis approach was used to analyze the data. To facilitate the data analysis process, Atlas. ti software version 7 was used.

Results:

The six interconnected themes that were emerged from the analysis are: (1) physical exercise, (2) dietary practice, (3) medication adherence, (4) self-monitoring of blood sugar, (5) problem-solving skill during hypoglycemia and hyperglycemia, and (6) diabetic foot care.

Conclusion:

The study described that type 1 diabetic patients at Kemisse general hospital faced difficulty in self-care practice, which were difficulty in medication adherence; foot care was neglected diabetes self-care, did not practice diabetes recommended dietary plan and lack of regular physical exercises. In addition to this, self-monitoring of blood sugar was not practiced regularly due to the absence of glucometer machine and financial constraints to buy test strips. In addition to diabetic patient’s role to manage hyperglycemia and hypoglycemic episode, family support was crucial to managing hypoglycemia because most of the respondent’s experience loss of consciousness during a hypoglycemic attack.
circ_0086296 induced atherosclerotic lesions via the IFIT1/STAT1 feedback loop by sponging miR-576-3p
Authors: Zhang Min , Zhu Yiqian , Zhu Jie , Xie Yi , Wu Ruihao , Zhong JiaYin , Qiu Zhaohui , Jiang Li
Published: September 2022

Extensive inflammation of endothelial cells (ECs) facilitates atherosclerotic lesion formation. Circular RNA (circRNA) participates in atherosclerosis (AS)-related inflammation responses; however, whether and how circ_0086296 regulates atherosclerotic inflammation and lesions have not been investigated. Microarray analysis, quantitative real-time polymerase chain reaction, and fluorescence in situ hybridization assay were performed to detect the expression and location of hsa_circ_0086296 in human carotid artery plaques, aorta of atherosclerotic mice, and human umbilical vein endothelial cells (HUVECs). Sanger sequencing was used to verify the loop structure of circ_0086296. The relationship among circ_0086296, miR-576-3p, IFIT1, STAT1, and EIF4A3 was validated using bioinformatics, luciferase assay, RNA pull-down assay, and RNA immunoprecipitation. The atherosclerosis mouse model was used to evaluate the function of circ_0086296 in vivo. circ_0086296 expression was significantly upregulated in human carotid artery plaques, oxidized low-density lipoprotein (ox-LDL)-treated HUVECs, and the aorta of atherosclerotic mice. Functional analysis indicated that circ_0086296 promotes ECs injury in vitro and atherosclerosis progression in vivo. The mechanism analysis indicated that circ_0086296 sponged miR-576-3p to promote IFIT1–STAT1 expression. Moreover, STAT1 upregulated circ_0086296 expression, forming the circ_0086296/miR-576-3p/IFIT1/STAT1 feedback loop. Notably, inhibition of the circ_0086296/miR-576-3p/IFIT1 axis could block atherosclerotic lesion formation both in vivo and in vitro. Finally, circ_0086296 was overexpressed in exosomes of patients with atherosclerosis and exosomes of ox-LDL-treated ECs. Therefore, the circ_0086296/miR-576-3p/IFIT1/STAT1 feedback loop participates in atherosclerosis progression and contributes to the high circ_0086296 expression observed in the exosomes of serum of patients with atherosclerosis. This study sought to provide a deep understanding of the mechanisms underlying the aberrant EC phenotype in AS.
Genome-wide identification and expression analysis of the calmodulin-binding transcription activator (CAMTA) family genes in tea plant
Authors: Li Bo , He Shan , Zheng Yiqian , Wang Yu , Lang Xuxu , Wang Huan , Fan Kai , Hu Jianhui , Ding Zhaotang , Qian Wenjun
Published: September 2022

Background

As a type of calmodulin binding protein, CAMTAs are widely involved in vegetative and reproductive processes as well as various hormonal and stress responses in plants. To study the functions of CAMTA genes in tea plants, we investigated bioinformatics analysis and performed qRT-PCR analysis of the CAMTA gene family by using the genomes of ‘ShuChaZao’ tea plant cultivar.

Results

In this study, 6 CsCAMTAs were identified from tea plant genome. Bioinformatics analysis results showed that all CsCAMTAs contained six highly conserved functional domains. Tissue-specific analysis results found that CsCAMTAs played great roles in mediating tea plant aging and flowering periods. Under hormone and abiotic stress conditions, most CsCAMTAs were upregulated at different time points under different treatment conditions. In addition, the expression levels of CsCAMTA1/3/4/6 were higher in cold-resistant cultivar ‘LongJing43’ than in the cold-susceptible cultivar ‘DaMianBai’ at cold acclimation stage, while CsCAMTA2/5 showed higher expression levels in ‘DaMianBai’ than in ‘LongJing43’ during entire cold acclimation periods.

Conclusions

In brief, the present results revealed that CsCAMTAs played great roles in tea plant growth, development and stress responses, which laid the foundation for deeply exploring their molecular regulation mechanisms.
Response of soil microecology to different cropping practice under Bupleurum chinense cultivation
Authors: Liu Li , Cao Hailu , Geng Yannan , Zhang Quanfang , Bu Xun , Gao Demin
Published: September 2022

The effects of cropping practices on the rhizosphere soil physical properties and microbial communities of Bupleurum chinense have not been studied in detail. The chemical properties and the microbiome of rhizosphere soil of B. chinense were assessed in the field trial with three cropping practices (continuous monocropping, Bupleurum-corn intercropping and Bupleurum-corn rotation). The results showed cropping practices changed the chemical properties of the rhizosphere soil and composition, structure and diversity of the rhizosphere microbial communities. Continuous monocropping of B. chinense not only decreased soil pH and the contents of NO3−-N and available K, but also decreased the alpha diversity of bacteria and beneficial microorganisms. However, Bupleurum-corn rotation improved soil chemical properties and reduced the abundance of harmful microorganisms. Soil chemical properties, especially the contents of NH4+-N, soil organic matter (SOM) and available K, were the key factors affecting the structure and composition of microbial communities in the rhizosphere soil. These findings could provide a new basis for overcoming problems associated with continuous cropping and promote development of B. chinense planting industry by improving soil microbial communities.
Patterns of genetic variation and QTLs controlling grain traits in a collection of global wheat germplasm revealed by high-quality SNP markers
Authors: Chou Chia-Hui , Lin Hsun-Shih , Wen Chen-Hsin , Tung Chih-Wei
Published: September 2022

Background

Establish a molecular breeding program involved assembling a diverse germplasm collection and generating accurate genotypes to characterize their genetic potential and associate them with agronomic traits. In this study, we acquired over eight hundred wheat accessions from international gene banks and assessed their genetic relatedness using high-quality SNP genotypes. Understanding the scope of genomic variation in this collection allows the breeders to utilize the genetic resources efficiently while improving wheat yield and quality.

Results

A wheat diversity panel comprising 39 durum wheat, 60 spelt wheat, and 765 bread wheat accessions was genotyped on iSelect 90 K wheat SNP arrays. A total of 57,398 SNP markers were mapped to IWGSC RefSeq v2.1 assembly, over 30,000 polymorphic SNPs in the A, B, D genomes were used to analyze population structure and diversity, the results revealed the separation of the three species and the differentiation of CIMMYT improved breeding lines and landraces or widely grown cultivars. In addition, several chromosomal regions under selection were detected. A subset of 280 bread wheat accessions was evaluated for grain traits, including grain length, width, surface area, and color. Genome-wide association studies (GWAS) revealed that several chromosomal regions were significantly linked to known quantitative trait loci (QTL) controlling grain-related traits. One of the SNP peaks at the end of chromosome 7A was in strong linkage disequilibrium (LD) withWAPO-A1, a gene that governs yield components.

Conclusions

Here, the most updated and accurate physical positions of SNPs on 90 K genotyping array are provided for the first time. The diverse germplasm collection and associated genotypes are available for the wheat researchers to use in their molecular breeding program. We expect these resources to broaden the genetic basis of original breeding and pre-breeding materials and ultimately identify molecular markers associated with important agronomic traits which are evaluated in diverse environmental conditions.
Continuous monitoring of brain perfusion by cerebral oximetry after spontaneous return of circulation in cardiac arrest: a case report
Authors: Zhou Heng , Lin Caiwei , Liu Jiawei , Wang Xudong
Published: September 2022

Background

Cerebral resuscitation determines the prognosis for patients who have experienced sudden death, and brain protection is the focus of clinical treatment. Cerebral resuscitation depends on the timing and quality of cardiopulmonary resuscitation (CPR). At present, cerebral oxygen monitoring is used mainly to monitor the quality of external cardiac compression and provide a prognosis for the nervous system. However, after the return of autonomous circulation, it is necessary to conduct continuous monitoring to ensure measures are taken timeously since hemodynamic instability, brain edema, and other factors may cause occult brain injury, and invasive arterial pressure cannot represent cerebral perfusion.

Case presentation

By using continuous cerebral oxygen monitoring after CPR and the return of spontaneous circulation, a patient who was witnessed to have experienced sudden death in the hospital was found to have insufficient cerebral perfusion; he underwent timely intra-aortic balloon counterpulsation to improve his hemodynamics and cerebral perfusion. The patient went on to achieve a good neurological prognosis.

Conclusion

Cerebral oxygen monitoring should be conducted throughout the treatment period; physicians should understand cerebral perfusion in real time and implement timely intervention measures to reduce occult brain injury and improve the neurological prognosis of patients.
Population health trends analysis and burden of disease profile observed in Sierra Leone from 1990 to 2017
Authors: Zembe Jolleen , Senkubuge Flavia , Botha Tanita , Achoki Tom
Published: September 2022

Background

Sierra Leone, in West Africa, is one of the poorest developing countries in the world. Sierra Leone has experienced several recent challenges namely, a civil war from 1991 to 2002, a massive Ebola outbreak from 2014 to 2016, followed by floods and landslides in 2017.In this study, we quantified the burden of disease in Sierra Leone over a 27-year period, from 1990 to 2017.

Methodology

In this descriptive study, we analysed secondary data from the Institute of Health Metrics and Evaluation, Global Burden of Disease (GBD) study. We quantified patterns of burden of disease, injuries, and risk factors in Sierra Leone. We report GBD data and metrics including mortality rates, years of life lost and risk factors for all ages and both sexes from 1990 to 2017.

Results

From 1990 to 2017, trends of mortality rates for all ages and sexes have declined in Sierra Leone although mortality rates remain some of the highest when compared to other developing countries. The burden of communicable, maternal, neonatal, and nutritional (CMNN) diseases are greater than the burden of non-communicable diseases (NCDs) due to the prevalence of endemic diseases in Sierra Leone. The most important CMNNs associated with premature mortality included respiratory infections, neglected tropical diseases, malaria, and HIV-Aids. Life expectancy has increased from 37 to 52 years.

Conclusion

Sierra Leone’s health status is gradually improving following the civil war and Ebola outbreak. Sierra Leone has a double burden of disease with CMNNs leading and NCDs progressively increasing. Despite these challenges, Sierra Leone has promising initiatives and programs pursuing the Universal Health Coverage 2030 Sustainable Developmental Goals Agenda. There is need for accountability of available resources, clear rules and expected roles for non-governmental organisations to ensure a level playing field for all actors to rebuild the health system.
Advance care planning and goals of care discussion: the perspectives of Brazilian oncologists
Authors: Dias Laiane Moraes , Bezerra Mirella Rebello , Barra Williams Fernandes , Carvalho Ana Emília Vita , Castro Luísa , Rego Francisca
Published: September 2022

Background

Advance care planning (ACP) and goals of care discussions are important instruments that enable respect for patient autonomy, especially in patients with a life-threatening disease, such as cancer. Despite their well-established benefits, ACP and goals of care discussions are still not frequently performed in clinical oncology practice. Understanding the barriers to this topic is the first step toward developing future interventions that are more likely to improve professional practice and patient satisfaction with care.

Aim

To explore Brazilian oncologists’ barriers to discuss goals of care and advance care planning.

Methods

A cross-sectional study was developed to identify Brazilian oncologists’ barriers to discussing goals of care and ACP. The Decide-Oncology questionnaire was used to identify the importance of these barriers according to oncologists’ perceptions. Participants were asked to rank the importance of various barriers to discussing goals of care, ranging from 1 (extremely unimportant) to 7 (extremely important). A quantitative analysis using descriptive statistics was used, including median and interquartile intervals and a qualitative analysis based on Bardin content analysis of the two open questions.

Results

Sixty-six oncologists participated in this study. Most of them perceived the patient and family’s related barriers as the most important, such as patients’ difficulty in understanding their diagnosis and accepting their prognosis. Physician and external related factors, such as lack of training and lack of time for this conversation, were also described as important barriers. Participants with formal training regarding goals of care communication and with experience in palliative care perceived the lack of patients’ advanced directives as a significant barrier and manifested more willingness to participate in decision-making about goals of care. The lack of access and of support for referral to palliative care was also considered a significant barrier for ACP and goals of care discussion.

Conclusion

The identification of barriers that limit the discussion of ACP and early palliative care referrals can certainly help to prioritise the next steps for future studies aimed at improving ACP and helping clinicians to better support patients through shared decision-making based on the patient’s values and experiences.
Successful laparoscopic management of acute abdominal pain due to spontaneous rupture of subserosal vessels overlying a uterine fibroid: a case report and surgical video
Authors: Maemura Toshimitsu , Fujita Shigeru , Morita Noriko , Furusawa Keiichi , Mitamura Kayo , Nishizawa Kenji , Ota Kuniaki
Published: September 2022

Background

Acute abdomen comprises several emergencies. Hemoperitoneum associated with uterine fibroids, which can present as acute abdominal pain, is rare and difficult to diagnose. Especially, spontaneous hemorrhage from the rupture of the superficial vessels overlying a uterine fibroid is extremely rare, and its diagnosis and management have not been established.

Case presentation

We report a case of a 55-year-old woman who presented at our hospital with acute abdomen. After performing a computed tomography scan, we conducted a laparoscopic examination and diagnosed hemoperitoneum of ambiguous origin. We treated the patient surgically, performing a laparoscopic myomectomy to remove the origin of the hemorrhage. The patient recovered well.

Conclusions

We report a case of hemoperitoneum of ambiguous origin that was diagnosed laparoscopically and treated by laparoscopic myomectomy to remove the origin of the hemorrhage. Surgeons should rapidly diagnose and manage acute abdominal pain in women with a history of uterine fibroids to prevent severe morbidity or even mortality. Therefore, laparoscopic surgery is recommended in patients with stable hemodynamics.
Satisfied or not satisfied? Electronic health records system implementation in Ghana: Health leaders’ perspective
Authors: Attafuah Priscilla Y. A. , Abor Patience Aseweh , Abuosi Aaron Asibi , Nketiah-Amponsah Edward , Tenza Immaculate Sabelile
Published: September 2022

Background

Electronic Health Records (EHR) has been espoused to be an innovation from the paper-based system, with benefits such as fast access to patient information thereby facilitating healthcare provider communication, healthcare continuity and improved quality of care. However, it is the extent of the quality of the electronic health records that determines the access to these stated benefits. The quality of health care records indirectly contributes to patient safety because inaccurate patient data can lead to improper diagnosis and consequently wrong treatment of patients. Most hospitals in Ghana, have recently transitioned into the EHR system, hence, there is a need to assess its accuracy, impact on workflow, staff training on usage, support from the EHR team, and the overall satisfaction of the EHR system. As health leaders are at the frontline of its implementation, their views on the challenges and successes of the EHR system are imperative.

Method

This qualitative study sought to explore the views of the health leaders on the implemented electronic health records system in nine (9) hospitals within three (3) regions in Ghana. Following ethical approval, GHS-ERC:007/04/21, focus group discussions were conducted with a minimum of 10 hospital leaders in each facility. These included quasi, government and private hospitals. Data was collected between September and November 2021.

Results

The study found poor quality of records, lack of involvement of frontline clinicians in the development of the EHR system, inadequate training of staff and limited workstations as some of the challenges associated with the use of EHR in hospitals. Health leaders were generally not satisfied with the EHR system.

Conclusion

It is recommended that addressing inputs from end-users as well as circulating more computers will motivate EHR usage and acceptance. Provision of additional workstations for the various units and involvement of staff in the system development would be most prudent to enable health workers to accept the EHR system in improving the quality of care.
The Medical Orders for Scope of Treatment (MOST) form completion: a retrospective study
Authors: Mallidou Anastasia A. , Tschanz Coby , Antifeau Elisabeth , Lee Kyoung Young , Mtambo Jenipher Kayuni , Heckl Holly
Published: September 2022

Background

Advance care planning (ACP) involves discussions about patient and families’ wishes and preferences for future healthcare respecting autonomy, improving quality of care, and reducing overtreatment. The Medical Orders for Scope of Treatment (MOST) form records person preferred level and types of treatment and intervention.

Purpose

To examine the MOST form use in inpatient units within a British Columbia (Canada) hospital, estimate and compare its completion rate, and inform health policies for continuous, quality and individualized patient care.

Methods

About 5,000 patients admitted to the participating tertiary acute care hospital during October 2020. Data from 780 eligible participants in medical, surgical, or psychiatry unit were analyzed with descriptive statistics, the chi-square test for group comparisons, and logistic regression to assess predictors of the MOST form completion.

Results

Participants’ (54% men) age ranged from 20–97 years (mean = 59.53, SD = 19.54). Mainly physicians (99.1%) completed the MOST form for about 60% of them. A statistically significant difference of MOST completion found among the units [Pearson χ2(df=2, n=780) = 79.53, p < .001, φ = .319]. Multivariate logistic regression analysis demonstrated that age (OR = 1.05, 95% CI 1.04 to 1.06) and unit admission (OR = .60, 95% CI 0.36 to 0.99 in psychiatry; and OR = .21, 95% CI 0.14 to 0.31 in surgery) were independently associated with the MOST form completion.

Conclusion

Our findings demonstrate a need for consistent and broad completion of the MOST form across all jurisdictions using, desirably, advanced electronic systems. Healthcare providers need to raise awareness of the MOST completion benefits and be prepared to discuss topics relevant to end-of-life. Further research is required on the MOST form completion.
Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China
Authors: Su Wanmin , Du Liulin , Fan Yujun , Wang Peixi
Published: September 2022

Background

To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation.

Methods

Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions.

Results

From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion.

Conclusion

The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.
Intention to get naloxone among patients prescribed opioids for chronic pain
Authors: Huang Yinan , Lyu Ning , Gohil Shrey , Bapat Shweta , Essien E. James , Thornton J. Douglas
Published: September 2022

Background

Prescription opioids have been increasingly prescribed for chronic pain while the opioid-related death rates grow. Naloxone, an opioid antagonist, is increasingly recommended in these patients, yet there is limited research that investigates the intention to get naloxone. This study aimed to investigate intention toward getting naloxone in patients prescribed opioids for chronic pain and to assess the predictive utility of the theory of reasoned action (TRA) constructs in explaining intention to get naloxone.

Methods

This was a cross-sectional study of a panel of U.S. adult patients prescribed opioids for chronic pain using a Qualtrics®XM survey. These patients participated in the study during February to March 2020. The online internet survey assessed the main outcome of intention to get naloxone and constructs of TRA (attitudes and subjective norms); additional measures assessed the characteristics of patients’ opioid overdose risk factors, knowledge of naloxone, and their demographics. The relationship between TRA constructs, namely, attitudes and subjective norms, and the intention variable was examined using logistic regression analyses with the intention outcome contrasted as follows: high intention (scores ≥ 5) and non-high intention (scores < 5).

Results

A total of 549 participants completed the survey. Most of them were female (53.01%), White or Caucasian (83.61%), non-Hispanic (87.57%) and had a mean age of 44.16 years (SD = 13.37). Of these, 167 (30.42%) had high intention to get naloxone. The TRA construct of subjective norm was significantly associated with increased likelihood of higher intentions to get naloxone (OR 3.04, 95% CI 2.50–3.70, P < 0.0001).

Conclusions

Our study provides empirical support of the TRA in predicting intention to get naloxone among chronic pain patients currently taking opioids. Subjective norms significantly predicted intention to get naloxone in these patients. The interventions targeting important reference groups of these patients would have greater impact on increasing intention to get naloxone in this population. Future studies should test whether theory-based interventions focusing on strengthening subjective norms increase intention to get naloxone in this population.
Enhancing allocation of visual attention with emotional cues presented in two sensory modalities
Authors: Zimmer Ulrike , Wendt Mike , Pacharra Marlene
Published: September 2022

Background

Responses to a visual target stimulus in an exogenous spatial cueing paradigm are usually faster if cue and target occur in the same rather than in different locations (i.e., valid vs. invalid), although perceptual conditions for cue and target processing are otherwise equivalent. This cueing validity effect can be increased by adding emotional (task-unrelated) content to the cue. In contrast, adding a secondary non-emotional sensory modality to the cue (bimodal), has not consistently yielded increased cueing effects in previous studies. Here, we examined the interplay of bimodally presented cue content (i.e., emotional vs. neutral), by using combined visual-auditory cues. Specifically, the current ERP-study investigated whether bimodal presentation of fear-related content amplifies deployment of spatial attention to the cued location.

Results

A behavioral cueing validity effect occurred selectively in trials in which both aspects of the cue (i.e., face and voice) were related to fear. Likewise, the posterior contra-ipsilateral P1-activity in valid trials was significantly larger when both cues were fear-related than in all other cue conditions. Although the P3a component appeared uniformly increased in invalidly cued trials, regardless of cue content, a positive LPC deflection, starting about 450 ms after target onset, was, again, maximal for the validity contrast in trials associated with bimodal presentation of fear-related cues.

Conclusions

Simultaneous presentation of fear-related stimulus information in the visual and auditory modality appears to increase sustained visual attention (impairing disengagement of attention from the cued location) and to affect relatively late stages of target processing.