bluuebunny/crossref_metadata_2025 huggingface dataset:
Dongchuanite, a new phosphate mineral with a new structure, from Dongchuan copper mine, Yunnan Province, China
Authors: Li Guowu , Sun Ningyue , Shen Hongtao , Xue Yuan , Hao Jinhua , de Fourestier Jeffrey
Published: May 2023

Dongchuanite, ideally Pb4VIZnIVZn2(PO4)2(PO4)2(OH)2, is a new phosphate mineral with a new type of structure. It was found at the Dongchuan copper mine, Yunnan Province, People's Republic of China. Dongchuanite generally occurs as spherical aggregates with microscopic lamellar crystals, characterised by a turquoise–greenish blue colour. It is transparent, with a colourless streak and has a vitreous lustre without fluorescence. It is brittle with a Mohs hardness of 2–2½, and has good parallel cleavage to {011}, with insignificant parting and even fracture. According to the empirical formula and cell volume, it has a calculated density of 6.06 g/cm3. It easily dissolves in acid without gas being emitted. The mineral is biaxial (–), calculated n = 1.90 and maximum birefringence: δ = 0.010 and 2V=70°. Dispersion of the optical axes r < v is very weak. The mineral is pale blue to light blue and very weakly pleochroic in transmitted light. Dongchuanite crystallises in the triclinic space group P$\bar{1}$, with unit-cell parameters a = 4.7620(10) Å, b = 8.5070(20) Å, c = 10.3641(19) Å, α = 97.110(17)°, β = 101.465(17)°, γ = 92.273(18)°, V = 407.44(15) Å3 and Z = 1. The eight strongest reflections in the powder X-ray diffraction pattern [dobs, Å (I/I0) (hkl)] are: 3.442 (100) ($\bar{1}$12), 3.035 (50) (120), 4.652 (45) (100), 2.923 (40) ($\bar{1}\bar{1}$3), 2.384 (35) ($\bar{2}$01), 3.130 (30) ($\bar{1}$21), 2.811 (30) (030) and 2.316 (18) (032). The crystal structure (solved and refined from single-crystal X-ray diffraction data, R1 = 0.07) is a new layered structure consisting of corner-sharing tetrahedrons and octahedrons, where [PO4] tetrahedra and [ZnO4] tetrahedra share corners to form a double chain, and the another [PO4] tetrahedra is connected by corner-sharing with a [ZnO4(OH)2] octahedra to form a tetrahedral–octahedral chain, extending along the a-axis direction. The two types of chains are connected by corner-sharing between [ZnO4] and [PO4] tetrahedra forming a wrinkled layer parallel to (011). The Pb atoms occupy two independent sites between the wrinkled layers, both of which have typical lopsided coordination of Pb2+ with stereoactive 6s2 lone-pair electrons.
An interdisciplinary course on evolution and sustainability increases acceptance of evolutionary theory and increases understanding of interdisciplinary application of evolutionary theory
Authors: Kreher Scott A. , McManus Ellen
Published: May 2023

Background

Although evolutionary theory is foundational and integrative in modern biology, there remains widespread lack of acceptance among U.S. residents. An interdisciplinary approach to teaching evolutionary theory at the undergraduate level has many advantages, such as giving students a context for learning about evolution and application of evolutionary theory to other academic disciplines and everyday life. While there are foundational examples of interdisciplinary approaches to teaching evolutionary theory, there are few examples of courses with application of evolutionary theory to issues of sustainability, such as conservation or global climate change. We build on the practical and theoretical work of others to create an interdisciplinary course on evolutionary theory for non-science majors, with ties to sustainability. Our course is taught in three modules, with extensive readings and hands-on lab activities. The first module is focused on honey bee biology, with hands-on beekeeping experiences; the second module on native plants and community education on sustainability; and the third module on the evolution of the subjective human experience of free will.

Results

We found that students in our course experienced an increased acceptance of evolutionary theory. We found that students also met the course leaning objectives, of basic knowledge of evolutionary theory and application of evolutionary theory to other disciplines, assessed through group and individual major assignments. We also found that students had an expanded perspective on interdisciplinary application of evolutionary theory, assessed through closed-ended survey questions and analysis of open-ended writing.

Conclusions

Students in our course experienced an increase of acceptance of evolutionary theory and an expanded perspective on interdisciplinary application of evolutionary theory, despite the fact that many students were not science majors.
Economic evaluations of radioembolization with yttrium-90 microspheres in liver metastases of colorectal cancer: a systematic review
Authors: Alonso JC , Casans I , González FM , Fuster D , Rodríguez A , Sánchez N , Oyagüez I , Williams AO , Espinoza N
Published: May 2023

Background

Transarterial radioembolization with yttrium-90 (Y-90 TARE) microspheres therapy has demonstrated positive clinical benefits for the treatment of liver metastases from colorectal cancer (lmCRC). This study aims to conduct a systematic review of the available economic evaluations of Y-90 TARE for lmCRC.

Methods

English and Spanish publications were identified from PubMed, Embase, Cochrane, MEDES health technology assessment agencies, and scientific congress databases published up to May 2021. The inclusion criteria considered only economic evaluations; thus, other types of studies were excluded. Purchasing-power-parity exchange rates for the year 2020 ($US PPP) were applied for cost harmonisation.

Results

From 423 records screened, seven economic evaluations (2 cost-analyses [CA] and 5 cost-utility-analyses [CUA]) were included (6 European and 1 USA). All included studies (n = 7) were evaluated from a payer and the social perspective (n = 1). Included studies evaluated patients with unresectable liver-predominant metastases of CRC, refractory to chemotherapy (n = 6), or chemotherapy-naïve (n = 1). Y-90 TARE was compared to best supportive care (BSC) (n = 4), an association of folinic acid, fluorouracil and oxaliplatin (FOLFOX) (n = 1), and hepatic artery infusion (HAI) (n = 2). Y-90 TARE increased life-years gained (LYG) versus BSC (1.12 and 1.35 LYG) and versus HAI (0.37 LYG). Y-90 TARE increased the quality-adjusted-life-year (QALY) versus BSC (0.81 and 0.83 QALY) and versus HAI (0.35 QALY). When considering a lifetime horizon, Y-90 TARE reported incremental cost compared to BSC (range 19,225 to 25,320 $US PPP) and versus HAI (14,307 $US PPP). Y-90 TARE reported incremental cost-utility ratios (ICURs) between 23,875 $US PPP/QALY to 31,185 $US PPP/QALY. The probability of Y-90 TARE being cost-effective at £ 30,000/QALY threshold was between 56% and 57%.

Conclusions

Our review highlights that Y-90 TARE could be a cost-effective therapy either as a monotherapy or when combined with systemic therapy for treating ImCRC. However, despite the current clinical evidence on Y-90 TARE in the treatment of ImCRC, the global economic evaluation reported for Y-90 TARE in ImCRC is limited (n = 7), therefore, we recommend future economic evaluations on Y-90 TARE versus alternative options in treating ImCRC from the societal perspective.
Eye-masks and earplugs compared to headband in nulliparas on increasing spontaneous vaginal delivery: a randomized trial
Authors: Hong Jesrine Gek Shan , Vimaladevi Annamalai , Razif Noor Adeebah , Omar Siti Zawiah , Tan Peng Chiong
Published: May 2023

Background

A majority of pregnant women experience sleep disruption during pregnancy, especially in the third trimester. Lack of sleep is associated with preterm birth, prolonged labor and higher cesarean section rate. Six or less hours of night sleep in the last month of pregnancy is associated with a higher rate of caesarean births. Eye-masks and earplugs compared to headband improve night sleep by 30 or more minutes. We sought to evaluate eye-mask and earplugs compared to sham/placebo headbands on spontaneous vaginal delivery.

Methods

This randomized trial was conducted from December 2019-June 2020. 234 nulliparas, 34–36 weeks’ gestation with self-reported night sleep < 6 h were randomized to eye-mask and earplugs or sham/placebo headband (both characterized as sleep aids) to be worn each night to delivery. After two weeks, interim outcome data of the average night sleep duration and the trial sleep related questionnaire was answered through the telephone.

Results

Spontaneous vaginal delivery rates were 60/117(51.3%) vs. 52/117(44.4%) RR 1.15 95% CI 0.88–1.51 P = 0.30 for eye-mask and earplugs or headband respectively. At 2-weeks into the intervention period, the eye-mask and earplugs arm reported longer night sleep duration 7.0 ± 1.2 vs. 6.6 ± 1.5 h P = 0.04, expressed increased satisfaction with the allocated aid 7[6.0–8.0] vs. 6[5.0–7.5] P < 0.001, agreed they slept better 87/117(74.4%) vs. 48/117(41.0%) RR 1.81 95% CI 1.42–2.30 NNTb 4 (2.2–4.7) P < 0.001 and higher compliance median[interquartile range] 5[3–7] vs. 4[ 2–5] times per week of sleep aid use P = 0.002.

Conclusion

Eye-mask and earplugs use at home in late third trimester do not increase the spontaneous vaginal delivery rate even though self-reported night sleep duration, sleep quality, satisfaction and compliance with allocated sleep aid were significantly better than for sham/placebo headband.

Trial registration

This trial was registered with ISRCTN on June 11, 2019 with trial identification number: ISRCTN99834087.
The effectiveness of motivational interviewing on the oral health of leukemic children and oral health care knowledge, attitude and practice of their mothers: a hospital-based intervention
Authors: Falahinia Niloofar , Razeghi Samaneh , Shamshiri Ahmad Reza , Firoozi Manijeh , Mohebbi Simin Zahra
Published: May 2023

Background

Some studies suggest a higher effectiveness of motivational interviewing compared to common oral health instruction in healthy individuals. As regards to higher prevalence of dental diseases like early childhood caries, oral mucositis, and gingivitis are reported for leukemic children, the present study aims to compare the effectiveness of educating mothers through MI with the common instruction (CI) for the oral health of children with leukemia under six years old.

Method

This quasi-experimental study was designed in Tehran University of Medical Sciences, School of Dentistry and conducted on 61 mothers with leukemic children under age six hospitalized in Mahak Hospital and Rehabilitation Complex which is a Pediatric Cancer Research and Hospital Center, in 2021. Mother and child pairs were allocated to MI or CI (using pamphlets) groups. Data was collected using a questionnaire of mothers’ knowledge, attitude, motivation, and practice concerning oral health care in leukemic children. The children underwent clinical examination to assess plaque index before and three months after the intervention. The data were analyzed using SPSS version 25 (IBM, Armonk, NY, USA) by ANCOVA test.

Results

The preschoolers mean ages were 4.23 ± 1.41 and 4.32 ± 1.33 (ranged from 2 to 6 years old) in the MI and CI group, respectively. There were 16 girls (53.3%) and 14 boys (46.7%) in the MI group, and 15 girls (48.4%) and 16 boys (51.6%) in the CI group. Significant differences were observed in the amount of plaque index between the MI group and the CI group (0.20 ± 0.04, p-value < 0.001). A significant increase was observed in the mean of changes in scores of knowledge, attitude, motivation, mother’s practice concerning child’s oral health, mother’s practice concerning personal oral health in the MI group (p-value < 0.001).

Conclusions

Considering that instruction using MI showed to be effective in improving oral health adherence in mothers and reducing plaque in children with Leukemia, it may be recommended as a promising method to promote the oral health of such susceptible children in places that they are constantly present for treatment.

Trial registration

The study was registered in the Iranian Registry of Clinical Trials (IRCT) on 11.03.2021 (code: IRCT20131102015238N5).
The impact of insomnia on anxiety and depression: a longitudinal study of non-clinical young Chinese adult males
Authors: Mao Xiaofei , Zhang Fan , Wei Cun , Li Ziqiang , Huang Chenwei , Sun Zuoer , Zhang Jianguo , Deng Wenxi , Hou Tianya , Dong Wei
Published: May 2023

Insomnia, anxiety, and depression commonly co-occured and were closely related. Most of the prior studies were cross-sectional, with a poor ability to infer causality. Longitudinal study was needed to classify the relationships. The present study conducted a longitudinal study of non-clinical young Chinese males to investigate whether insomnia predicted the likelihood of future anxiety and depression, and vice versa. Convenient sampling method was applied, and 288 participants was recruited from Shanghai in October 2017 with Athens Insomnia Scale (AIS), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). 120 of them were re-tested in June 2018. The drop-out rate was 58.33%. Correlation analyses and cross-lagged analysis showed that AIS global score was significantly positively related with scores of depression and anxiety at baseline and follow-up. Insomnia was a predictive factor of anxiety, but it can’t predict depression. In sum, insomnia may be an important cause of anxiety, while no predictive relationship was found between insomnia and depression.
Client predictors of therapy dropout in a primary care setting: a prospective cohort study
Authors: Hanevik Elin , Røvik Frida M. G. , Bøe Tormod , Knapstad Marit , Smith Otto R. F.
Published: May 2023

Background

Therapy dropout poses a major challenge. Considerable research has been conducted on predictors of dropout, however none in the context of primary mental health services in Norway. The purpose of this study was to investigate which client characteristics can predict dropout from the service Prompt Mental Health Care (PMHC).

Methods

We performed a secondary analysis of a Randomized Controlled Trial (RCT). Our sample consisted of 526 adult participants receiving PMHC-treatment in the municipalities of Sandnes and Kristiansand, between November 2015 to August 2017. Using logistic regression, we investigated the association between nine client characteristics and dropout.

Results

The dropout rate was 25.3%. The adjusted analysis indicated that older clients had a lower odds ratio (OR) of dropping out compared to younger clients (OR = 0.43, [95% CI = 0.26, 0.71]). Moreover, clients with higher education had a lower odds ratio of dropping out compared to clients with lower levels of education (OR = 00.55, 95% CI [0.34, 0.88]), while clients who were unemployed were more likely to drop-out as compared the regularly employed (OR = 2.30, [95% CI = 1.18, 4.48]). Finally, clients experiencing poor social support had a higher odds ratio of dropping out compared to clients who reported good social support (OR = 1.81, [95% CI = 1.14, 2.87]). Sex, immigrant background, daily functioning, symptom severity and duration of problems did not predict dropout.

Conclusion

The predictors found in this prospective study might help PMHC-therapists identify clients at risk of dropout. Strategies for preventing dropout are discussed.
Identification of potential biomarkers for ankylosing spondylitis based on bioinformatics analysis
Authors: Li Dongxu , Cao Ruichao , Dong Wei , Cheng Minghuang , Pan Xiaohan , Hu Zhenming , Hao Jie
Published: May 2023

Objective

The aim of this study was to search for key genes in ankylosing spondylitis (AS) through comprehensive bioinformatics analysis, thus providing some theoretical support for future diagnosis and treatment of AS and further research.

Methods

Gene expression profiles were collected from Gene Expression Omnibus (GEO, http://www.ncbi.nlm.nih.gov/geo/) by searching for the term "ankylosing spondylitis". Ultimately, two microarray datasets (GSE73754 and GSE11886) were downloaded from the GEO database. A bioinformatic approach was used to screen differentially expressed genes and perform functional enrichment analysis to obtain biological functions and signalling pathways associated with the disease. Weighted correlation network analysis (WGCNA) was used to further obtain key genes. Immune infiltration analysis was performed using the CIBERSORT algorithm to conduct a correlation analysis of key genes with immune cells. The GWAS data of AS were analysed to identify the pathogenic regions of key genes in AS. Finally, potential therapeutic agents for AS were predicted using these key genes.

Results

A total of 7 potential biomarkers were identified: DYSF, BASP1, PYGL, SPI1, C5AR1, ANPEP and SORL1. ROC curves showed good prediction for each gene. T cell, CD4 naïve cell, and neutrophil levels were significantly higher in the disease group than in the paired normal group, and key gene expression was strongly correlated with immune cells. CMap results showed that the expression profiles of ibuprofen, forskolin, bongkrek-acid, and cimaterol showed the most significant negative correlation with the expression profiles of disease perturbations, suggesting that these drugs may play a role in AS treatment.

Conclusion

The potential biomarkers of AS screened in this study are closely related to the level of immune cell infiltration and play an important role in the immune microenvironment. This may provide help in the clinical diagnosis and treatment of AS and provide new ideas for further research.
Nonanatomical reduction of femoral neck fractures in young patients treated with femoral neck system: a retrospective cohort study
Authors: Jiang Qilong , Liu Yang , Bai Xinwen , Deng Yu , Cao Yong , Yu Chengxiang , Song Qizhi , Li Yan
Published: May 2023

Purpose

Negative buttress reduction should be avoided in the treatment of femoral neck fractures (FNFs) using conventional fixation. As the femoral neck system (FNS) has been recently developed and utilized widely to treat FNFs, the association of reduction quality with postoperative complications and clinical function has not been clarified. The purpose of this study was to evaluate the clinical effect of nonanatomical reduction in young patients with FNFs treated with FNS.

Methods

This multicenter, retrospective cohort study included 58 patients with FNFs treated with FNS between September 2019 and December 2021. According to the reduction quality immediately following surgery, patients were classified into positive, anatomical, and negative buttress reduction groups. Postoperative complications were assessed with 12 months of follow-up. The logistic regression model was used to identify risk factors for postoperative complications. The postoperative hip function was assessed using the Harris hip scores (HHS) system.

Results

At a follow-up of 12 months, a total of eight patients (8/58, 13.8%) had postoperative complications in three groups. Compared with the anatomical reduction group, negative buttress reduction was significantly associated with a higher complication rate (OR = 2.99, 95%CI 1.10–8.10, P = 0.03). No significant associations were found between positive buttress reduction and the incidence of postoperative complications (OR = 1.21, 95%CI 0.35–4.14, P = 0.76). The difference was not statistically significant in Harris hip scores.

Conclusion

Negative buttress reduction should be avoided in young patients with FNFs treated with FNS.
Are early career family physicians prepared for practice in Canada? A qualitative study
Authors: Aggarwal Monica , Abdelhalim Reham
Published: May 2023

Background

In Canada, the College of Family Physicians of Canada (CFPC) introduced Competency Based Medical Education to prepare and train family medicine residents to be competent to enter and adapt to the independent practice of comprehensive family medicine. Despite its implementation, the scope of practice is narrowing. This study aims to understand the degree to which early career Family Physicians (FPs) are prepared for independent practice.

Method

A qualitative design was used for this study. A survey and focus groups were conducted with early-career FPs who completed residency training in Canada. The survey and focus groups examined the degree of preparedness of early career FPs in relation to 37 core professional activities identified by the CFPC’s Residency Training Profile. Descriptive statistics and qualitative content analysis were conducted.

Results

Seventy-five participants from across Canada participated in the survey, and 59 participated in the focus groups. Early career FPs reported being well prepared to provide continuous and coordinated care for patients with common presentations and deliver various services to different populations. FPs were also well prepared to manage the electronic medical record, participate in team-based care, provide regular and after-hours coverage, and assume leadership and teaching roles. However, FPs reported being less prepared for virtual care, business management, providing culturally safe care, delivering specific services in emergency care hospitals, obstetrics, self-care, engaging with the local communities, and conducting research activities.

Conclusions

Early career FPs do not feel fully prepared for practice in all 37 core activities in the Residency Training Profile. As part of the introduction of the three-year program by the CFPC, the postgraduate family medicine training should consider providing more exposure to learning opportunities and developing curricula in the areas where FPs are unprepared for practice. These changes could facilitate the production of a FP workforce better prepared to manage the dynamic and complex challenges and dilemmas faced in independent practice.
Mentorship of young researchers in resource-limited settings: experiences of the mentees from selected health sciences Universities in Tanzania
Authors: Mremi Alex , Pancras Godwin , Mrema Dorah , Morris Baraka , Mwakyandile Tosi , Msanga Delfina R , Mundamshimu James S , Nicholaus Bartholomeo , Massawe Honest H , Matiko Mwita , Amour Maryam , Malindisa Evangelista
Published: May 2023

Introduction

Mentorship is an essential component of research capacity building for young researchers in the health sciences. The mentorship environment in resource-limited settings is gradually improving. This article describes mentees’ experiences in a mentorship program for junior academicians amid the COVID-19 pandemic in Tanzania.

Methods

This is a survey study that examined the experiences of mentees who participated in a mentorship program developed as part of the Transforming Health Education in Tanzania (THET) project. The THET project was funded by the US National Institutes of Health (NIH) under a consortium of three partnering academic institutions in Tanzania and two collaborating US-based institutions. Senior faculty members of respective academic institutions were designated as mentors of junior faculty. Quarterly reports submitted by mentees for the first four years of the mentorship program from 2018 to 2022 were used as data sources.

Results

The mentorship program included a total of 12 mentees equally selected from each of the three health training institutions in Tanzania. The majority (7/12) of the mentees in the program were males. All mentees had a master’s degree, and the majorities (8/12) were members of Schools/Faculties of Medicine. Most mentors (9/10) were from Tanzania’s three partnering health training institutions. All mentors had an academic rank of senior lecturer or professor. Despite the onset of the COVID-19 pandemic, the regular weekly meetings between mentors and mentees were not affected. By the fourth year of the mentorship program, more than three-quarters of mentees had published research related to the mentorship program in a peer-reviewed journal, over half had enrolled in Ph.D. studies, and half had applied for and won competitive grant awards. Almost all mentees reported being satisfied with the mentorship program and their achievements.

Conclusion

The mentorship program enhanced the skills and experiences of the mentees as evidenced by the quality of their research outputs and their dissemination of research findings. The mentorship program encouraged mentees to further their education and enhanced other skills such as grant writing. These results support the initiation of similar mentorship programs in other institutions to expand their capacity in biomedical, social, and clinical research, especially in resource-limited settings, such as Sub-Saharan Africa.
Survey to measure the quality of life of patients with tuberculosis in Alexandria, Egypt: a cross-sectional study
Authors: Hammouda Esraa Abdellatif , Gobran Wahib Fayez , Tawfeek Reem Mohamed , Esmail Ola Fahmy , Ashmawy Rasha , Youssef Naglaa , Ghazy Ramy Mohamed
Published: May 2023

Background

Assessment of quality of life (QoL) in patients with tuberculosis (TB) may improve healthcare providers’ understanding of the disease burden. This study aimed to investigate the QoL of patients with TB in Alexandria, Egypt.

Methods

This cross-sectional study was conducted in chest clinics and main chest hospitals in Alexandria, Egypt. A structured interview questionnaire was used to collect data from participants through face-to-face interviews from November 20, 2021, until the June 30, 2022. We included all adult patients aged 18 years or above during the intensive or continuation phase of treatment. The World Health Organization (WHO) WHOQOL-BREF instrument was used to measure QoL, which includes the physical, psychological, social relationships, and environmental health domains. Using propensity score matching, a group of TB free population was recruited from the same setting and completed the questionnaire.

Results

A total of 180 patients participated in the study: 74.4% were males, 54.4% were married, 60.0% were 18–40 years old, 83.3% lived in urban areas, 31.7% were illiterate, 69.5% reported insufficient income, and 10.0% had multidrug-resistant TB. The TB-free population group had higher QoL scores than the TB patients’ group: (65.0 ± 17.5 vs. 42.4 ± 17.8) for the physical domain, (59.2 ± 13.6 vs. 41.9 ± 15.1) for the psychological domain, (61.8 ± 19.9 vs. 50.3 ± 20.6) for the social domain, (56.3 ± 19.3 vs. 44.5 ± 12.8) for the environment domain, (4.0(3.0–4.0) vs. 3.0(2.0–4.0)) for general health, and (4.0(3.0–4.0) vs. 2.0(2.0–3.0)) for the general QoL, P < 0.0001. Patients with TB aged 18–30 years had the highest environmental score compared with the other age groups (P = 0.021).

Conclusions

TB had a significant negative impact on QoL, with the physical and psychological domains being the most affected. This finding necessitates strategies to improve QoL of patients with to enhance their compliance to treatment.
A mixed methods evaluation of Quit for new life, a smoking cessation initiative for women having an Aboriginal baby
Authors: Cameron Emilie , Bryant Jamie , Cashmore Aaron , Passmore Erin , Oldmeadow Christopher , Neill Sarah , Milat Andrew , Mitchell Jo , Gatt Nicole , Macoun Edwina , Ioannides Sally J , Murray Carolyn
Published: May 2023

Background

Quit for new life (QFNL) is a smoking cessation initiative developed to support mothers of Aboriginal babies to quit smoking during pregnancy. The state-wide initiative provides support for pregnant women and their households including free nicotine replacement therapy (NRT) and follow up cessation advice. Services are also supported to implement systems-level changes and integrate QFNL into routine care. This study aimed to evaluate: (1) models of implementation of QFNL; (2) the uptake of QFNL; (3) the impact of QFNL on smoking behaviours; and (4) stakeholder perceptions of the initiative.

Methods

A mixed methods study was conducted comprising semi-structured interviews and analysis of routinely collected data. Interviews were conducted with 6 clients and 35 stakeholders involved in program implementation. Data were analysed using inductive content analysis. Aboriginal Maternal and Infant Health Service Data Collection (AMDC) records for the period July 2012-June 2015 were investigated to examine how many eligible women attended a service implementing QFNL and how many women took up a QFNL support. Smoking cessation rates were compared in women attending a service offering QFNL with women attending the same service prior to the implementation of QFNL to determine program impact.

Results

QFNL was implemented in 70 services located in 13 LHDs across New South Wales. Over 430 staff attended QFNL training, including 101 staff in Aboriginal-identified roles. In the period July 2012-June 2015 27% (n = 1549) of eligible women attended a service implementing QFNL and 21% (n = 320) of these were recorded as taking up a QFNL support. While stakeholders shared stories of success, no statistically significant impact of QFNL on smoking cessation rates was identified (N = 3502; Odds ratio (OR) = 1.28; 95% Confidence Interval (CI) = 0.96–1.70; p-value = 0.0905). QFNL was acceptable to both clients and stakeholders, increased awareness about smoking cessation, and gave staff resources to support clients.

Conclusion

QFNL was perceived as acceptable by stakeholders and clients and provided care providers with knowledge and tangible support to offer women who presented at antenatal care as smokers, however, no statistically significant impact on rates of smoking cessation were found using the measures available.
Sodium-glucose cotransporter 2 inhibitor may not prevent atrial fibrillation in patients with heart failure: a systematic review
Authors: Ouyang Xiaolan , Wang Jiafu , Chen Qian , Peng Long , Li Suhua , Tang Xixiang
Published: May 2023

Background

Atrial fibrillation (AF) and heart failure (HF) frequently coexist because of their similar pathological basis. However, whether sodium-glucose cotransporter 2 inhibitor (SGLT2i), a novel class of anti-HF medication, decreases the risk of AF in HF patients remains unclear.

Objectives

The aim of this study was to assess the relationship between SGLT2i and AF in HF patients.

Methods

A meta-analysis of randomized controlled trails evaluating the effects of SGLT2i on AF in HF patients was performed. PubMed and ClinicalTrails.gov were searched for eligible studies until 27 November 2022. The risk of bias and quality of evidence were assessed through the Cochrane tool. Pooled risk ratio of AF for SGLT2i versus placebo in eligible studies was calculated.

Results

A total of 10 eligible RCTs examining 16,579 patients were included in the analysis. AF events occurred in 4.20% (348/8292) patients treated with SGLT2i, and in 4.57% (379/8287) patients treated with placebo. Meta-analysis showed that SGLT2i did not significantly reduce the risk of AF (RR 0.92; 95% CI 0.80–1.06; p = 0.23) in HF patients when compared to placebo. Similar results remained in the subgroup analyses, regardless of the type of SGLT2i, the type of HF, and the duration of follow-up.

Conclusions

Current evidences showed that SGLT2i may have no preventive effects on the risk of AF in patients with HF.

Translational perspective

Despite HF being one of the most common heart diseases and conferring increased risk for AF, affective prevention of AF in HF patients is still unresolved. The present meta-analysis demonstrated that SGLT2i may have no preventive effects on reducing AF in patients with HF. How to effectively prevent and early detect the occurrence of AF is worth discussing.
Poor performance of malaria rapid diagnostic tests for the detection of Plasmodium malariae among returned international travellers in China
Authors: Wu Jingyao , Tang Jianxia , Wang Weiming , Chen Gangcheng , He Xiaoqin , Xu Sui , Cao Yuanyuan , Gu Yaping , Zhu Guoding , Cao Jun
Published: May 2023

Background

Malaria is a worldwide infectious disease. For countries that have achieved malaria elimination, the prevention of re-establishment due to infections in returned travellers has become important. The accurate and timely diagnosis of malaria is the key in preventing re-establishment, and malaria rapid diagnostic tests (RDTs) are frequently used due to their convenience. However, the RDT performance in Plasmodium malariae (P. malariae) infection diagnosis remains unknown.

Methods

This study analysed epidemiological features and diagnosis patterns of imported P. malariae cases from 2013 to 2020 in Jiangsu Province and evaluated the sensitivity of four parasite enzyme lactate dehydrogenase (pLDH)-targeting RDTs (Wondfo, SD BIONLINE, CareStart and BioPerfectus) and one aldolase-targeting RDT(BinaxNOW) for P. malariae detection. Furthermore, influential factors were investigated, including parasitaemia load, pLDH concentration and target gene polymorphisms.

Results

The median duration from symptom onset to diagnosis among patients with P. malariae infection was 3 days, which was longer than that with Plasmodium falciparum (P. falciparum) infection. The RDTs had a low detection rate (39/69, 56.5%) among P. malariae cases. All tested RDT brands had poor performance in P. malariae detection. All the brands except the worst-performing SD BIOLINE, achieved 75% sensitivity only when the parasite density was higher than 5000 parasites/μL. Both pLDH and aldolase showed relatively conserved and low gene polymorphism rates.

Conclusions

The diagnosis of imported P. malariae cases was delayed. The RDTs had poor performance in P. malariae diagnosis and may threaten the prevention of malaria re-establishment from returned travellers. The improved RDTs or nucleic acid tests for P. malariae cases are urgently needed for the detection of imported cases in the future.
Touraine-Solente-Gole syndrome: pathogenic variant in SLCO2A1 presented with polyarthralgia and digital clubbing
Authors: Nicolau Rafaela , Beirão Tiago , Guimarães Francisca , Aguiar Francisca , Ganhão Sara , Rodrigues Mariana , Grangeia Ana , Brito Iva
Published: May 2023

Background

Primary Hypertrophic Osteoarthropathy (PHO), also known as Touraine-Solente-Gole Syndrome, is a rare, multisystemic autosomal recessive disorder caused by pathogenic variants in the 15-hydroxyprostaglandin dehydrogenase (HPGD) or Solute Carrier Organic Anion Transporter Family Member 2A1 (SLCO2A1) genes. However, autosomal dominant transmission has also been described in some families with incomplete penetrance. PHO usually starts in childhood or adolescence, presenting with digital clubbing, osteoarthropathy, and pachydermia. We described a complete form of the syndrome in a male patient with a homozygous variant in the SLCO2A1 gene (c.1259G > T).

Case presentation

A 20-year-old male was referred to our Pediatric Rheumatology Clinic with a five-year history of painful and swollen hands, knees, ankles and feet, prolonged morning stiffness and relief with non-steroidal antiinflammatory drugs. He also reported late onset facial acne and palmoplantar hyperhidrosis. Family history was irrelevant and parents were non-consanguineous. On clinical examination, he presented clubbing of the fingers and toes, moderate acne and marked facial skin thickening with prominent scalp folds. He had hand, knee, ankles and feet swelling. Laboratory investigations showed elevated inflammatory markers. Complete blood count, renal and hepatic function, bone biochemistry were normal, as well as immunological panel. Plain radiographs revealed soft tissue swelling, periosteal ossification and cortical thickening of the skull, phalanges, femur and toe acroosteolysis. Due to the absence of other clinical signs suggesting a secondary cause, we suspected PHO. A genetic study revealed a likely pathogenic variant, c.1259G > T(p.Cys420Phe), in homozygosity in the SLCO2A1 gene, thus confirming the diagnosis. The patient started oral naproxen with significant clinical improvement.

Conclusions

PHO should be kept in the differential diagnosis of inflammatory arthritis affecting children, often misdiagnosed as Juvenile Idiopathic Arthritis (JIA). To the best of our knowledge, this is the second genetically confirmed case of PHO in a Portuguese patient (first variant c.644 C > T), both made at our department.
Utility of the Parkland Grading Scale to determine intraoperative challenges during laparoscopic cholecystectomy: a validation study on 206 patients at an academic medical center in Nepal
Authors: Shrestha Anup , Bhattarai Abhishek , Tamrakar Kishor Kumar , Chand Manoj , Yonjan Tamang Samjhana , Adhikari Sampada , Neupane Harish Chandra
Published: May 2023

Background

Most of the scoring systems to predict difficult laparoscopic cholecystectomy are based on pre-operative clinical and radiological findings. Recently the Parkland Grading Scale system was introduced as a simple intra-operative grading scale. This study aims to utilize the Parkland Grading Scale system to assess the intraoperative challenges during laparoscopic cholecystectomy.

Method

This was a prospective, cross-sectional study done at Chitwan Medical College and Teaching Hospital, Chitwan, Nepal. All the patients underwent laparoscopic cholecystectomy from April 2020 to March 2021. Based on the initial intra-operative finding, Parkland Grading Scale was noted and at the end of the surgery, the level of difficulty was given by the operating surgeon. All the pre-operative, intra-operative, and post-operative findings were compared with the scale.

Results

Out of 206 patients, there were 176 (85.4%) females, and 30 (14.6%) males. The median age was 41 years (Range 19–75). The median body mass index was 23.67 kg/m2. There were 35(17%) patients with a history of previous surgery. The rate of conversion to open surgery was 5.8%. According to Parkland Grading Scale, 67(32.5%), 75(36.4%), 42(20.4%), 15(7.3%), and 7(3.4%) were graded as grade 1, 2, 3, 4, and 5 respectively. There was a difference in the Parkland grading scale in patients with a history of acute cholecystitis, gallbladder wall thickness, pericholecystic collection, stone size, and body mass index (p < 0.05). The total operative time, level of difficulty in surgery, rate of help needed from colleagues or replacement as the main surgeon, bile spillage, drain placement, gallbladder decompression, and conversion rate all increased with an increase in scale (p < 0.05). There was a significant increase in the development of post-operative fever, and post-operative hospital stay as the scale increased (p < 0.05). The Tukey-Kramer test for all pair-wise comparisons revealed that each grade was significantly different from each other (p < 0.05) on the difficulty of surgery except for grade 4 from 5.

Conclusion

Parkland Grading Scale system is a reliable intra-operative grading system to assess the difficulty in laparoscopic cholecystectomy and helps the surgeon to change the strategy of surgery. An increase in scale is associated with an increased difficulty level of the surgery.
Integration of multiomics data shows down regulation of mismatch repair and tubulin pathways in triple-negative chemotherapy-resistant breast tumors
Authors: Tang Xiaojia , Thompson Kevin J. , Kalari Krishna R. , Sinnwell Jason P. , Suman Vera J. , Vedell Peter T. , McLaughlin Sarah A. , Northfelt Donald W. , Aspitia Alvaro Moreno , Gray Richard J. , Carter Jodi M. , Weinshilboum Richard , Wang Liewei , Boughey Judy C. , Goetz Matthew P.
Published: May 2023

Background

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype. Patients with TNBC are primarily treated with neoadjuvant chemotherapy (NAC). The response to NAC is prognostic, with reductions in overall survival and disease-free survival rates in those patients who do not achieve a pathological complete response (pCR). Based on this premise, we hypothesized that paired analysis of primary and residual TNBC tumors following NAC could identify unique biomarkers associated with post-NAC recurrence.

Methods and results

We investigated 24 samples from 12 non-LAR TNBC patients with paired pre- and post-NAC data, including four patients with recurrence shortly after surgery (< 24 months) and eight who remained recurrence-free (> 48 months). These tumors were collected from a prospective NAC breast cancer study (BEAUTY) conducted at the Mayo Clinic. Differential expression analysis of pre-NAC biopsies showed minimal gene expression differences between early recurrent and nonrecurrent TNBC tumors; however, post-NAC samples demonstrated significant alterations in expression patterns in response to intervention. Topological-level differences associated with early recurrence were implicated in 251 gene sets, and an independent assessment of microarray gene expression data from the 9 paired non-LAR samples available in the NAC I-SPY1 trial confirmed 56 gene sets. Within these 56 gene sets, 113 genes were observed to be differentially expressed in the I-SPY1 and BEAUTY post-NAC studies. An independent (n = 392) breast cancer dataset with relapse-free survival (RFS) data was used to refine our gene list to a 17-gene signature. A threefold cross-validation analysis of the gene signature with the combined BEAUTY and I-SPY1 data yielded an average AUC of 0.88 for six machine-learning models. Due to the limited number of studies with pre- and post-NAC TNBC tumor data, further validation of the signature is needed.

Conclusion

Analysis of multiomics data from post-NAC TNBC chemoresistant tumors showed down regulation of mismatch repair and tubulin pathways. Additionally, we identified a 17-gene signature in TNBC associated with post-NAC recurrence enriched with down-regulated immune genes.
Efficacy of stretching exercises versus transcranial direct current stimulation (tDCS) on task performance, kinematic and electroencephalography (EEG) spectrum in subjects with slump posture: a study protocol
Authors: Abdollahzade Zahra , Hadian Mohammad Reza , Khanmohammadi Roya , Talebian Saeed
Published: May 2023

Background

Slump sitting is a common posture in workplaces. There is limited evidence that poor posture impacts the mental state. This study aims to investigate whether slump posture results in more mental fatigue during computer typing, compared with normal posture and also to compare the effectiveness of stretching exercises with tDCS in fatigue monitoring.

Methods

The sample size for this study is set at 36 participants with slump posture and 36 participants with normal posture. In the first step, to find out the differences between normal and poor posture, they will be asked to perform the typewriting task for 60 min. During the first and last 3 min of typing, mental fatigue as the primary outcome using EEG signals and further measures including kinematic behavior of neck, visual analog fatigue scale, and musculoskeletal discomfort will be assessed. Post-experiment task performance will be calculated based on typing speed and typing errors. In the next step, to compare the effect of tDCS and stretching exercises on the outcome measures, the slump posture group will receive these interventions in two separate sessions before the typing task.

Discussion

With the assumption of showing significant differences in terms of outcome measures between slump and normal posture groups and also by showing the possible changes of the measures, by using either tDCS as a central modality or stretching exercises as a peripheral modality; the findings may provide evidence to indicate that poor posture has adverse effect on mental state and to introduce the effective method to overcome mental fatigue and promote work productivity.

Trial registration

Registered on the Iranian Registry of Clinical Trials on 21 September 2022, IRCT Identifier: IRCT20161026030516N2.
Sifting through the Ashes and the Fragments of Bone
Authors: Konrád György , Sherwood Peter
Published: May 2023

In this autobiographical essay, written in 2018 and previously unpublished, the late György Konrád intertwines his memories as a child during World War II with more theoretical reflections (and unanswered questions) on the war, its repercussions, its lessons. Written in Hungarian not long before his death in 2019, Konrád goes back in this essay to the period following the arrest of his parents after the German invasion of Hungary. Aged eleven, he was able to escape the small town where he was born—and hence the fate of its entire Jewish community. “The others had been turned to ash,” in Konrád's chilling words. Seventy years later, he proceeds from these events to reflect on guilt and contrition, on sympathy and empathetic suffering, on how friends can become enemies during war, as well as on the Jewish heritage underlying Christian culture.
Bridging Traditions
Authors: Kin Ostap
Published: May 2023

This brief essay introduces the work of three contemporary Ukrainian writers whose poems appear here in English translation. The introduction situates their work in the context of modernist and contemporary Ukrainian poetry as well as in the context of Russian invasions of Ukraine in 2022 and 2014.
Stone: The Stone Abandoned by the Builder Becomes the Cornerstone - The Self-appearance of the Stone Reborn as a Diamond -
Authors: Gug Sunhee
Published: May 2023

When intact, rocks can represent harmony and unity with oneself, but if shattered, they can symbolize death, extinction, and psychological weakness. Yet, the pain that a rock endures to be transformed holds numerous possibilities for change. Through perseverance over time, being eroded by wind and water, and tempered by high pressure and heat, the transformed rock becomes a pearl or diamond that embodies a sublime and exquisite beauty. This transformation can represent the ultimate integration of consciousness and unconsciousness. The existence of a rock that just rolls around on the street can symbolize trauma in our lives. Similarly, the stones shown in a client's box can represent more profound meanings, such as overcoming inferiority and finding confidence, or the beauty and struggles of motherhood. These symbols can serve as a reminder that the process of overcoming inner wounds can be painful and difficult. However, by facing our traumas and persevering through the journey, we can discover our true selves, transforming our pain into a source of growth and strength.
Do nurses participate in end-of-life decision making?
Authors: Othman Elham H , Zeilani Ruqayya , AlOsta Mohammad R , Khalaf Inaam A
Published: May 2023

Background:

To explore how Jordanian nurses participate in the end-of-life (EoL) decision-making process.

Methods:

Interviews with 10 patients and family caregivers, and focus group discussions with seven healthcare professionals (HCPs), were conducted. Interviews were audio-recorded, transcribed and analysed following inductive thematic analysis.

Findings:

The participants agreed that nurses are not fully engaged and did not have a direct role in the EoL decision-making process. However, the participants highlighted that ‘nurses bridge the gaps in the decision-making process', where nurses act as mediators to facilitate the decision-making process. Lastly, nurses were viewed as ‘nurturers and supporters during the journey of the patient's illness’; they were always available to answer their questions, offer help and advise when necessary during palliative referral and throughout the illness.

Conclusions:

Although nurses did not directly participate in EoL decisions, they have several vital contributions that need to be rearranged into structured decisional coaching.
Multitasking FBG sensors for condition monitoring with a wide-band (DC-MHz) interrogation system
Authors: Glasser Ziv , Liokumovitch Egor , Bank Stas , Simor Nadav , Kalnitsky Ziv , Sternklar Shmuel
Published: May 2023

We demonstrate diagnosis of several machine-condition failures using wide frequency-band interrogation of FBG sensors. In collaboration with Israel's national water company Mekorot Ltd., a scaled-down version of a semi-submerged pumping system was constructed. By monitoring broadband signals from DC to ultrasound (>MHz), at different points of the engine and the submersed pump, the system was able to diagnose incipient cavitation, faulty bearings and submerged dynamic water-level measurements. In addition, a metal embedded FBG sensor was investigated revealing the potential of using FBGs in applications where bonding is problematic such as bearing housing. These results prove that wide-band data acquisition, together with advanced analytics, could open a variety of new applications in the fields of structural health and machine-condition monitoring.