bluuebunny/crossref_metadata_2025 huggingface dataset:
Applying the consolidated framework for implementation research to evaluate the community rapid intervention service
Authors: Moult Alice , Baker Dereth , Twohig Helen , Missen Matthew , Iqbal Zafar , Duffy Helen , Paskins Zoe
Published: August 2023

Background

Developed in 2019, the Community Rapid Intervention Service (CRIS) is a community intervention service aiming to prevent hospital admissions. CRIS provides a response within two hours to patients with sub-acute medical needs in their usual place of residence. This evaluation aimed to identify challenges and facilitators to implementation of the service, with a view to informing future service development, optimising patient care and disseminating learning to other areas looking to implement similar services.

Methods

This study used the Consolidated Framework for Implementation Research (CFIR) as an evaluation framework. We conducted semi-structured interviews with local healthcare system leaders, clinicians that worked within the CRIS, and clinicians who interfaced with the CRIS. The CFIR was used to guide data collection and analysis. Two Community of Practice (CoP) meetings were held to gather stakeholders’ perspectives of the evaluation.

Results

Three key themes were identified from the analysis of 13 interviews: contextual factors influencing implementation, service identity and navigating complexity. Contextual factors such the influence of the Covid 19 pandemic upon health services and the expansion of the CRIS were discussed by participants. The adaptability of the service was deemed both a facilitator and challenge of implementation. Ways to build-on and improve the existing CRIS model were suggested.

Conclusion

This evaluation has shown that the CRIS may need to be redefined with clarity provided as to how the service interfaces with other urgent and planned care offered in acute, primary, community and social services. Structuring the evaluation around the CFIR was helpful in identifying facilitators and challenges that influenced the implementation of the CRIS.
Perturbations in gut microbiota composition in patients with polycystic ovary syndrome: a systematic review and meta-analysis
Authors: Li Pan , Shuai Ping , Shen Sj , Zheng Huimin , Sun Ping , Zhang Renfang , Lan Shanwei , Lan Zixin , Jayawardana Thisun , Yang Yumei , Zhao Jianhui , Liu Yuping , Chen Xia , El-Omar Emad M. , Wan Zhengwei
Published: August 2023

Background

The results of human observational studies on the correlation between gut microbiota perturbations and polycystic ovary syndrome (PCOS) have been contradictory. This study aimed to perform the first systematic review and meta-analysis to evaluate the specificity of the gut microbiota in PCOS patients compared to healthy women.

Methods

Literature through May 22, 2023, was searched on PubMed, Web of Science, Medline, Embase, Cochrane Library, and Wiley Online Library databases. Unreported data in diversity indices were filled by downloading and processing raw sequencing data. Systematic review inclusion: original studies were eligible if they applied an observational case-control design, performed gut microbiota analysis and reported diversity or abundance measures, sampled general pre-menopausal women with PCOS, and are longitudinal studies with baseline comparison between PCOS patients and healthy females. Systematic review exclusion: studies that conducted interventional or longitudinal comparisons in the absence of a control group. Two researchers made abstract, full-text, and data extraction decisions, independently. The Joanna Briggs Institute Critical Appraisal Checklist was used to assess the methodologic quality. Hedge’s g standardized mean difference (SMD), confidence intervals (CIs), and heterogeneity (I2) for alpha diversity were calculated. Qualitative syntheses of beta-diversity and microbe alterations were performed.

Results

Twenty-eight studies (n = 1022 patients, n = 928 control) that investigated gut microbiota by collecting stool samples were included, with 26 and 27 studies having provided alpha-diversity and beta-diversity results respectively. A significant decrease in microbial evenness and phylogenetic diversity was observed in PCOS patients when compared with control participants (Shannon index: SMD = − 0.27; 95% CI, − 0.37 to − 0.16; phylogenetic diversity: SMD = − 0.39; 95% CI, -− 0.74 to − 0.03). We also found that reported beta-diversity was inconsistent between studies. Despite heterogeneity in bacterial relative abundance, we observed depletion of Lachnospira and Prevotella and enrichment of Bacteroides, Parabacteroides, Lactobacillus, Fusobacterium, and Escherichia/Shigella in PCOS. Gut dysbiosis in PCOS, which might be characterized by the reduction of short-chain fatty acid (SCFA)-producing and bile-acid-metabolizing bacteria, suggests a shift in balance to favor pro-inflammatory rather than anti-inflammatory bacteria.

Conclusions

Gut dysbiosis in PCOS is associated with decreased diversity and alterations in bacteria involved in microbiota-host crosstalk.

Trial registration

PROSPERO registration: CRD42021285206, May 22, 2023.
Pyrotinib plus capecitabine for trastuzumab-resistant, HER2-positive advanced breast cancer (PICTURE): a single-arm, multicenter phase 2 trial
Authors: Cao Jun , Teng Yuee , Li Huiping , Zhang Lili , Ouyang Quchang , Xie Weimin , Pan Yueyin , Song Zhenchuan , Ling Xiaoling , Wu Xiaohong , Xu Jingwei , Li Li , Ren Liping , Wang Hong , Zhou Dongxian , Luo Jing , Hu Xichun
Published: August 2023

Background

Patients with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer and primary resistance to trastuzumab have a poor clinical outcome and lack good evidence to inform clinical decision. This study investigated the efficacy and safety of pyrotinib plus capecitabine in this population.

Methods

This phase 2 trial was conducted at 16 sites in China. Patients received oral pyrotinib 400 mg once daily and capecitabine 1000 mg/m2 twice a day on days 1–14 of each 21-day cycle until disease progression or intolerable toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS).

Results

Between June 2019 and September 2021, 100 patients were enrolled with a median age of 51 years (range, 24–69). All patients had been treated with trastuzumab and 21 (21.0%) patients had prior use of pertuzumab. As of August 31, 2022, the median follow-up duration was 20.1 months (range, 1.3–38.2). The median PFS was 11.8 months (95% confidence interval [CI], 8.4–15.1), which crossed the pre-specified efficacy boundary of 8.0 months. The objective response rate was 70.0% (70/100), with a median duration of response of 13.8 months (95% CI, 10.2–19.3). The disease control rate was 87.0% (87/100). The median overall survival was not reached. The most common grade ≥ 3 treatment-emergent adverse event was diarrhea (24 [24.0%]). No treatment-related deaths occurred.

Conclusions

Pyrotinib plus capecitabine can be considered to be a treatment option in HER2-positive advanced breast cancer patients who have shown primary resistance to trastuzumab. Even in the era of modern anti-HER2 treatments, this clinical setting warrants more investigations to meet unmet needs.

Trial registration

ClinicalTrials.gov, NCT04001621. Retrospectively registered on June 28, 2019.
Education and clinical pharmacist-led management strategies for the risk and prophylaxis of venous thromboembolism in general surgery
Authors: Kiracı Zeynep Karaburç , Yalçın Nadir , Cennet Ömer , Demirkan Kutay , Yorgancı Kaya
Published: August 2023

Background

Despite the risks of venous thromboembolism (VTE) in surgical patients are well defined, primary thromboprophylaxis (TP) can be neglected. The aim of this study was to evaluate the risk of VTE and appropriateness of TP and to assess the effects of education and clinical pharmacy (CP) services.

Methods

This study was conducted in a total of 3 periods (n = 800): pre-education (n = 340), post-education (n = 269) and CP intervention period (n = 191) and the risk of VTE and the appropriateness of TP were evaluated. At the end of pre-education period, patients were re-evaluated after education was given about the guidelines on TP and an educative poster was posted in the services (post-education period). During the CP intervention period, the CP made recommendations in terms of optimal TP use to the physicians in charge.

Results

While there was no significant difference in the optimal TP rate administered to the patients before and after education (138/340, 40.6% vs. 122/269, 45.4%; p = 0.238); this rate was increased to 113/191 (59.2%) in the CP intervention period (p = 0.004). High-risk patients who received one type of TP constituted the majority of patients who did not receive optimal TP. While the ratio of high-risk patients undergoing a single type of TP in the pre- and post-education periods (104/340, 30.6% vs. 83/269, 30.9%), was similar (p = 0.819); with the CP interventions, this rate was reduced to 35/191 (18.3%) (p = 0.001).

Conclusion

Even though education has positive influence on surgeons, the implementation of CP practices is more effective especially in terms of maintaining optimal TP.
Consequences of using poly-ether-ether-ketone versus traditional implant on tibial cement penetration and short-term clinical outcomes during total knee arthroplasty: a randomized controlled trial
Authors: Zhao Guanghui , Yao Shuxin , Sun Xiangxiang , Ma Jianbing , Wang Jianpeng
Published: August 2023

Background

The use of poly-ether-ether-ketone (PEEK) prosthesis during total knee arthroplasty (TKA) is a relatively new concept. Several studies have suggested that the thickness of cement penetration during TKA may affect the stability of the implants. The present study aimed to compare the cement penetration and clinical performance between PEEK and traditional cobalt chromium molybdenum (CoCrMo) prosthesis during TKA.

Methods

This study was a randomized controlled trial with level I of evidence. A total of 48 patients were randomly assigned to either the PEEK group (n = 24) or the CoCrMo group (n = 24). Mean bone cement penetration under the tibial baseplate was assessed radiographically in four zones in the anteroposterior view and two zones in the lateral view, in accordance with the Knee Society Scoring System. Furthermore, parameters such as the Knee Society Score (KSS), visual analogue scale (VAS) scores, complications and survivorship at 1 year postoperatively were also compared.

Results

According to the results of this study, the mean bone cement penetration exhibited no significant difference between PEEK and CoCrMo groups (2.49 ± 0.61 mm vs. 2.53 ± 0.68 mm, p = 0.85). Additionally, there were no remarkable differences in the KSS clinical score, functional score, and VAS score between the two groups. Moreover, complications and survivorship were also statistically compared between the groups and presented no significant differences.

Conclusions

Based on the current findings, it can be concluded that PEEK implant present similar bone cement penetration, short-term clinical outcomes, and survivorship with traditional CoCrMo implant in TKA without added complications.

Trial registration Chinese Clinical Trial Registry (ChiCTR2100047563).
Different neuroprognostication thresholds of neuron-specific enolase in shockable and non-shockable out-of-hospital cardiac arrest: a prospective multicenter observational study in Korea (the KORHN-PRO registry)
Authors: Kim Youn-Jung , Kim Yong Hwan , Youn Chun Song , Cho In Soo , Kim Su Jin , Wee Jung Hee , Park Yoo Seok , Oh Joo Suk , Lee Byung Kook , Kim Won Young
Published: August 2023

Background

Serum neuron-specific enolase (NSE) is the only recommended biomarker for multimodal prognostication in postcardiac arrest patients, but low sensitivity of absolute NSE threshold limits its utility. This study aimed to evaluate the prognostic performance of serum NSE for poor neurologic outcome in out-of-hospital cardiac arrest (OHCA) survivors based on their initial rhythm and to determine the NSE cutoff values with false positive rate (FPR) < 1% for each group.

Methods

This study included OHCA survivors who received targeted temperature management (TTM) and had serum NSE levels measured at 48 h after return of spontaneous circulation in the Korean Hypothermia Network, a prospective multicenter registry from 22 university-affiliated teaching hospitals in South Korea between October 2015 and December 2018. The primary outcome was poor outcome at 6 month, defined as a cerebral performance category of 3–5.

Results

Of 623 patients who underwent TTM with NSE measured 48 h after the return of spontaneous circulation, 245 had an initial shockable rhythm. Median NSE level was significantly higher in the non-shockable group than in the shockable group (104.6 [40.6–228.4] vs. 25.9 [16.7–53.4] ng/mL, P < 0.001). Prognostic performance of NSE assessed by area under the receiver operating characteristic curve to predict poor outcome was significantly higher in the non-shockable group than in the shockable group (0.92 vs 0.86). NSE cutoff values with an FPR < 1% in the non-shockable and shockable groups were 69.3 ng/mL (sensitivity of 76.0%) and 102.7 ng/mL (sensitivity of 42.1%), respectively.

Conclusion

NSE prognostic performance and its cutoff values with FPR < 1% for predicting poor outcome in OHCA survivors who underwent TTM differed between shockable and non-shockable rhythms, suggesting postcardiac arrest survivor heterogeneity.

Trial registration KORHN-PRO, NCT02827422. Registered 11 September 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02827422
LAST-seq: single-cell RNA sequencing by direct amplification of single-stranded RNA without prior reverse transcription and second-strand synthesis
Authors: Lyu Jun , Chen Chongyi
Published: August 2023

Existing single-cell RNA sequencing (scRNA-seq) methods rely on reverse transcription (RT) and second-strand synthesis (SSS) to convert single-stranded RNA into double-stranded DNA prior to amplification, with the limited RT/SSS efficiency compromising RNA detectability. Here, we develop a new scRNA-seq method, Linearly Amplified Single-stranded-RNA-derived Transcriptome sequencing (LAST-seq), which directly amplifies the original single-stranded RNA molecules without prior RT/SSS. LAST-seq offers a high single-molecule capture efficiency and a low level of technical noise for single-cell transcriptome analyses. Using LAST-seq, we characterize transcriptional bursting kinetics in human cells, revealing a role of topologically associating domains in transcription regulation.
A randomized controlled trial on using predictive algorithm to adapt level of psychological care for community college students: STAND triaging and adapting to level of care study protocol
Authors: Wen Alainna , Wolitzky-Taylor Kate , Gibbons Robert D. , Craske Michelle
Published: August 2023

Background

There is growing interest in using personalized mental health care to treat disorders like depression and anxiety to improve treatment engagement and efficacy. This randomized controlled trial will compare a traditional symptom severity decision-making algorithm to a novel multivariate decision-making algorithm for triage to and adaptation of mental health care. The stratified levels of care include a self-guided online wellness program, coach-guided online cognitive behavioral therapy, and clinician-delivered psychotherapy with or without pharmacotherapy. The novel multivariate algorithm will be comprised of baseline (for triage and adaptation) and time-varying variables (for adaptation) in four areas: social determinants of mental health, early adversity and life stressors, predisposing, enabling, and need influences on health service use, and comprehensive mental health status. The overarching goal is to evaluate whether the multivariate algorithm improves adherence to treatment, symptoms, and functioning above and beyond the symptom-based algorithm.

Methods/design

This trial will recruit a total of 1000 participants over the course of 5 years in the greater Los Angeles Metropolitan Area. Participants will be recruited from a highly diverse sample of community college students. For the symptom severity approach, initial triaging to level of care will be based on symptom severity, whereas for the multivariate approach, the triaging will be based on a comprehensive set of baseline measures. After the initial triaging, level of care will be adapted throughout the duration of the treatment, utilizing either symptom severity or multivariate statistical approaches. Participants will complete computerized assessments and self-report questionnaires at baseline and up to 40 weeks. The multivariate decision-making algorithm will be updated annually to improve predictive outcomes.

Discussion

Results will provide a comparison on the traditional symptom severity decision-making and the novel multivariate decision-making with respect to treatment adherence, symptom improvement, and functional recovery. Moreover, the developed multivariate decision-making algorithms may be used as a template in other community college settings. Ultimately, findings will inform the practice of level of care triage and adaptation in psychological treatments, as well as the use of personalized mental health care broadly.

Trial registration

ClinicalTrials.gov NCT05591937, submitted August 2022, published October 2022.
Goals for Adherence with Low-cost Incentives (GOALS): a protocol for a randomized controlled trial evaluating the impact of small airtime incentives on ART adherence among young people living with HIV in Kampala, Uganda
Authors: Linnemayr Sebastian , Huang Haijing Crystal , Wagner Zachary , Onkundi Faith Kemunto , Mukasa Barbara , Odiit Mary
Published: August 2023

Background

Treatment outcomes of HIV-positive individuals are threatened by low antiretroviral therapy (ART) adherence, a problem that is particularly acute among youth. Incentives are a promising tool to support ART adherence, but traditional incentive designs rewarding uniformly high levels of the desired health behavior may demotivate those with low levels of the behavior. In this study, we investigate the effectiveness of alternative approaches to target-setting for incentive eligibility using subgoals (i.e., individual-specific, interim targets leading up to the optimal target).

Methods / design

We will enroll 628 HIV-positive youth between ages 15 and 30 into a 3-year randomized controlled trial. Participants will be randomized 1:1:1:1 to a control arm or one of three intervention arms (n = 157 each) that allow them to enter a prize drawing for small incentives if their ART adherence meets the given goal. In the first arm (T1, assigned subgoal), goals will be externally assigned and adapted to their initial adherence level. In the second arm (T2, participatory subgoal), participants can set their own interim goals. In the third arm (T3, fixed goal), all participants must reach the same target goal of 90% adherence. T1 and T2 participants are required to reach 90% adherence by month 12 to participate in a larger prize drawing. The control group receives the usual standard of care. All four groups will receive weekly motivational messages; the three treatment groups will additionally receive reminders of their upcoming prize drawing. Adherence will be measured continuously throughout the intervention period using electronic devices and for 12 months post-intervention. Surveys will be conducted at baseline and every 6 months. Viral loads will be measured annually. The primary outcome is Wisepill-measured adherence and a binary measure for whether the person took at least 90% of their pills. The secondary outcome is the log-transformed viral load as a continuous measure.

Discussion

Our study is one of the first to apply insights about the psychology and behavioral economics of goal-setting to the design of incentives, by testing whether conditioning the eligibility threshold for incentives on subgoals (interim goals leading up to the ultimate, high goal) improves motivation and adherence more than setting a uniformly highly goal, and a comparison group.

Trial registration

ClinicalTrials.gov NCT05378607. Date of registration: May 18, 2022.
A community-based intervention to improve screening, referral and follow-up of non-communicable diseases and anaemia amongst pregnant and postpartum women in rural India: study protocol for a cluster randomised trial
Authors: Hirst Jane Elizabeth , Votruba Nicole , Billot Laurent , Arora Varun , Rajan Eldho , Thout Sudhir Raj , Peiris David , Patel Anushka , Norton Robyn , Mullins Edward , Sharma Ankita , Kennedy Stephen , Jha Vivekanand , Praveen Devarsetty
Published: August 2023

Background

Medical complications during pregnancy, including anaemia, gestational diabetes mellitus and hypertensive disorders of pregnancy place women are at higher risk of long-term complications. Scalable and low-cost strategies to integrate non-communicable disease screening into pregnancy care are needed. We aim to determine the effectiveness and implementation components of a community-based, digitally enabled approach, “SMARThealth Pregnancy,” to improve health during pregnancy and the first year after birth.

Methods

A pragmatic, parallel-group, cluster randomised, type 2 hybrid effectiveness-implementation trial of a community-based, complex intervention in rural India to decrease anaemia (primary outcome, defined as haemoglobin < 12g/dL) and increase testing for haemoglobin, glucose and blood pressure (secondary outcomes) in the first year after birth. Primary Health Centres (PHCs) are the unit of randomisation. PHCs are eligible with (1) > 1 medical officer and > 2 community health workers; and (2) capability to administer intravenous iron sucrose. Thirty PHCs in Telangana and Haryana will be randomised 1:1 using a matched-pair design accounting for cluster size and distance from the regional centre. The intervention comprises (i) an education programme for community health workers and PHC doctors; (ii) the SMARThealth Pregnancy app for health workers to support community-based screening, referral and follow-up of high-risk cases; (iii) a dashboard for PHC doctors to monitor high-risk women in the community; (iv) supply chain monitoring for consumables and medications and (v) stakeholder engagement to co-develop implementation and sustainability pathways. The comparator is usual care with additional health worker education. Secondary outcomes include implementation outcomes assessed by the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), clinical endpoints (anaemia, diabetes, hypertension), clinical service delivery indicators (quality of care score), mental health and lactation practice (PHQ9, GAD7, EuroQoL-5D, WHO IYCF questionnaire).

Discussion

Engaging women with screening after a high-risk pregnancy is a challenge and has been highlighted as a missed opportunity for the prevention of non-communicable diseases. The SMARThealth Pregnancy trial is powered for the primary outcome and will address gaps in the evidence around how pregnancy can be used as an opportunity to improve women’s lifelong health. If successful, this approach could improve the health of women living in resource-limited settings around the world.

Trial registration

ClinicalTrials.gov NCT05752955. Date of registration 3 March 2023.
Production, consumption, and market supply of edible crickets: insights from East Africa
Authors: Musungu Arnold L. , Muriithi Beatrice W. , Ghemoh Changeh J. , Nakimbugwe Dorothy , Tanga Chrysantus M.
Published: August 2023

Globally, crickets are gaining recognition as a valuable alternative protein source for human consumption due to their lower resource requirement and ecological footprint compared to traditional livestock. In this paper, we examine strategies that may expedite the sustainable domestication of crickets as a food source. Using survey data from 306 households in western Kenya, we find that supplying cricket production starter kits, granting access to credit facilities, encouraging participation in farmer groups, and fostering partnerships can enhance the adoption of cricket farming. Moreover, we provide new evidence that institutional training significantly increases cricket yields while embracing cricket consumption (i.e. entomophagy) increases market supply. These findings underscore the importance of technical training, provision of production starter kits, and raising awareness about entomophagy to achieve sustainable mass production and adoption of cricket farming.
Magnetospirillum magneticum triggers apoptotic pathways in human breast cancer cells
Authors: Menghini Stefano , Vizovisek Matej , Enders Jonathas , Schuerle Simone
Published: August 2023

The use of bacteria in cancer immunotherapy has the potential to bypass many shortcomings of conventional treatments. The ability of anaerobic bacteria to preferentially accumulate and replicate in hypoxic regions of solid tumors, as a consequence of bacterial metabolic needs, is particularly advantageous and key to boosting their immunostimulatory therapeutic actions in situ. While several of these bacterial traits are well-studied, little is known about their competition for nutrients and its effect on cancer cells which could serve as another potent and innate antineoplastic action. Here, we explored the consequences of the iron-scavenging abilities of a particular species of bacteria, Magnetospirillum magneticum, which has been studied as a potential new class of bacteria for magnetically targeted bacterial cancer therapy. We investigated their influence in hypoxic regions of solid tumors by studying the consequential metabolic effects exerted on cancer cells. To do so, we established an in vitro co-culture system consisting of the bacterial strain AMB-1 incubated under hypoxic conditions with human breast cancer cells MDA-MB-231. We first quantified the number of viable cells after incubation with magnetotactic bacteria demonstrating a lower rate of cellular proliferation that correlated with increasing bacteria-to-cancer cells ratio. Further experiments showed increasing populations of apoptotic cells when cancer cells were incubated with AMB-1 over a period of 24 h. Analysis of the metabolic effects induced by bacteria suggest an increase in the activation of executioner caspases as well as changes in levels of apoptosis-related proteins. Finally, the level of several human apoptosis-related proteins was investigated, confirming a bacteria-dependent triggering of apoptotic pathways in breast cancer cells. Overall, our findings support that magnetotactic bacteria could act as self-replicating iron-chelating agents and indicate that they interfere with proliferation and lead to increased apoptosis of cancer cells. This bacterial feature could serve as an additional antineoplastic mechanism to reinforce current bacterial cancer therapies.
Digital inpainting of mural images based on DC-CycleGAN
Authors: Xu Zhigang , Zhang Chenmin , Wu Yanpeng
Published: August 2023

Located in Dunhuang, northwest China, the Mogao Grottoes are a cultural treasure of China and the world. However, after more than 2000 years of weathering and destruction, many murals faded and were damaged. This treasure of human art is in danger. Mural inpainting through deep learning can permanently preserve mural information. Therefore, a digital restoration method combining the Deformable Convolution (DCN), ECANet, ResNet and Cycle Generative Adversarial Network (CycleGAN) is proposed. We name it DC-CycleGAN. Compared with other image digital inpainting methods, the proposed DC-CycleGAN based mural image color inpainting method has better inpainting effects and higher model performance. Compared with the current repair network, the Frechet Inception Distance (FID) value and the two-image structural similarity metric (SSIM) value are increased by 52.61% and 7.08%, respectively. Image color inpainting of Dunhuang murals can not only protect and inherit Chinese culture, but also promote academic research and development in related fields.
Alactic base excess predicts the use of renal replacement therapy in patients with septic shock
Authors: Díaz Jesús S. Sánchez , Moguel Karla Gabriela Peniche , Gaxiola Fabiola Buelna , Ruiz José M. Reyes , Nieto Orlando R. Pérez , Sánchez María V. Calyeca
Published: August 2023

Background

Alactic base excess (ABE) is a novel biomarker that estimates the renal capability of handling acid–base alterations during the sepsis. Hence, the aim of this study was to evaluate the use of ABE to predict the renal replacement therapy (RRT) in patients with septic shock.

Methods

A total of 164 patients admitted to the intensive care units with a diagnosis of septic shock according to the third international consensus on sepsis and septic shock (Sepsis-3) were included. This study was retrospective, single center, and conducted between January 1, 2016, and December 31, 2020. The individuals were stratified in patients who did [n = 68] or did not [n = 96] receive the RRT. The diagnostic performed of the variables for the classification into patients who required RRT was evaluated by receiver operating characteristic (ROC) analysis and area under curve (AUC) was calculated. Univariate and multivariate logistic regression models were used to identify risk factors for RRT.

Results

The median age of the patients was 59 years and female sex (51.8%) predominated. ABE (odds ratio [OR] 1.2270, [95% confidence interval [CI] 1.0453–1.4403], p = 0.0124) and urea (OR 1.0114, [95% CI 1.0053–1.0176], p = 0.0002) were associated with risk of RRT. HCO3− (OR 0.6967, [95% CI 0.5771–0.8410], p = 0.0002) was a protective factor of RRT. ABE (AUC = 0.649, p < 0.0008), HCO3− (AUC = 0.729, p < 0.0001), and urea (AUC = 0.76, p < 0.0001) had a cutoff point of ≤ − 5.7 mmol/L, ≤ 19.36 mmol/L and > 75 mg/dL, respectively.

Conclusion

Although HCO3− is associated with low risk, ABE and urea are independent risk factors for RRT in the patients with septic shock.
Reducing harm and promoting positive media use strategies: new perspectives in understanding the impact of preschooler media use on health and development
Authors: Fitzpatrick Caroline , Binet Marie-Andrée , Cristini Emma , Almeida Maíra Lopes , Bégin Mathieu , Frizzo Giana Bitencourt
Published: August 2023

Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent’s own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.
How do drivers mitigate the effects of naturalistic visual complexity?
Authors: Kondyli Vasiliki , Bhatt Mehul , Levin Daniel , Suchan Jakob
Published: August 2023

How do the limits of high-level visual processing affect human performance in naturalistic, dynamic settings of (multimodal) interaction where observers can draw on experience to strategically adapt attention to familiar forms of complexity? In this backdrop, we investigate change detection in a driving context to study attentional allocation aimed at overcoming environmental complexity and temporal load. Results indicate that visuospatial complexity substantially increases change blindness but also that participants effectively respond to this load by increasing their focus on safety-relevant events, by adjusting their driving, and by avoiding non-productive forms of attentional elaboration, thereby also controlling “looked-but-failed-to-see” errors. Furthermore, analyses of gaze patterns reveal that drivers occasionally, but effectively, limit attentional monitoring and lingering for irrelevant changes. Overall, the experimental outcomes reveal how drivers exhibit effective attentional compensation in highly complex situations. Our findings uncover implications for driving education and development of driving skill-testing methods, as well as for human-factors guided development of AI-based driving assistance systems.
Magnetic resonance imaging manifestations of vascular complications in patients with acute invasive fungal rhinosinusitis
Authors: Abokoura Sameh , Youssef Ayda , Nada Ayman , Abdelhalim Heba Ahmed
Published: August 2023

Background

Owing to significant morbidity and mortality with the development of vascular complications in patients with acute invasive fungal rhinosinusitis (AIFRS), early identification, and rapid medical or surgical interventions that are essential for improving patients’ outcomes. For the purpose of presurgical mapping and management planning, magnetic resonance imaging (MRI) is essential for the early identification and improved delineation of disease extent.

Objective

To evaluate variable MRI manifestations in the detection of the vascular complications in patients with AIFRS and its impact on patients’ survival.

Methods

A retrospective study, included 24 patients with histopathological proven AIFRS to review the para nasal sinus MRI findings. MRI were evaluated for the sinus involvement and the extrasinus extension into the orbit and/or the brain. Vascular structures were assessed for the development of vascular complications, like ICA for thrombosis, attenuation or pseudoaneurysm, cavernous sinus and superior ophthalmic veins for thrombosis.

Results

Of the reviewed 24 patients, 16 had cavernous sinus thrombosis, 15 had ICA thrombosis, 10 had ophthalmic vein thrombosis, 4 had ICA attenuation and only two cases had pseudoaneurysm of the ICA. Vascular thrombosis was more common with mucormycosis with cavernous sinus and ophthalmic vein thrombosis which were significantly increased among non survivor patients (90%, 70%), as compared to the survivor patients (50%, 14.29%), with P = 0.04 and 0.005 respectively.

Conclusions

Vascular complications are common in patients with AIFRS. MRI is helpful in accurate detection of vascular complications in patients with AIFRS.
Pulmonary mycoses among pulmonary tuberculosis in Kebbi State North Western Nigeria
Authors: Danlami Mohammed Bashar , Adefowepo Adesina Muibi , Manga Sahabi Sule , Yahaya Tajudeen Olanrewaju , Mshelia Mari Bata , Kalgo Zaharaddin Muhammad
Published: August 2023

Background

Pathogenic fungi are the source of the fungal illness known as pulmonary mycosis. The prevalence of pulmonary mycoses among patients with pulmonary tuberculosis is continuously rising, despite improvements in the disease’s diagnosis, treatment, and management. Three hundred clinically confirmed patients with pulmonary tuberculosis were recruited for this study. Sputum samples were collected and analyzed to detect M. tuberculosis using the GeneXpert machine. Fungal elements were determined using microscopy, culture, and fungal biochemical analysis. Fungal isolates were confirmed using nested PCR with the internal transcribed sequence region of the ribosomal cistron of the fungal species.

Results

Of the 300 sputum samples analyzed, 50 (16.7%) patients had pulmonary tuberculosis. Fungi pathogens were found in 142 patients (47.3%), with 99/142 (71.2%) primary infections, and 40/139 (29.5%) secondary infections. Among the secondary infections, 33 (11%) were fungi coinfections with rifampicin-sensitive MTB coinfections, while 7 (2.3%) were fungi co-infected with rifampicin-resistant MTB. Candida albican was the most common fungus isolate, accounting for 44 (31.7%), while non-Candidal albicans accounted for only 2 (1.4%). Of the 99 species responsible for primary infection, 33 (23.7%) were Blastomyces precursors, 30 (21.6%) were Candida species, and 21 (15.1%) were Aspergillus fumigatus. The fungal pathogen with the highest frequency of secondary infection was Candida species 14 (10.1%), followed by Aspergillus fumigatus 11 (7.9%), then Blastomyces precursors, and then 09 (6.5%).

Conclusion

In conclusion, this study determined the prevalence rate of fungal pathogens among pulmonary tuberculosis patients. The most dominant species observed were Blastomyces species, which are seldom reported in Africa and Nigeria. The two others were Aspergillus and Candida species. The study showed that a high percentage of cases of this species, responsible for pulmonary mycosis, were misdiagnosed and treated as pulmonary tuberculosis. Thus, there is a need for improved surveillance and accurate diagnosis of pulmonary infections for proper treatment.
A design of new wind power forecasting approach based on IVMD-WSA-IC-LSTM model
Authors: Li Zhenhui , Xiang Shuchen
Published: August 2023

The wind power forecasting (WPF) technology can reduce the adverse impact of wind power grid connection. Based on the characteristics of wind power data, an algorithm based on improved variational mode decomposition (IVMD) and long short-term memory (LSTM) Network is proposed to predict the wind power, and hyper parameter optimization search of LSTM using Whale Swarm Algorithm with Iterative Counter (WSA-IC). Firstly, through correlation analysis, the characteristics of 10 different wind power data are screened, and two kinds of data with large correlation with wind power are determined as input of the mode. Secondly, IVMD is used to calculate the maximum envelope kurtosis, determine the best decomposition parameters of the variational mode decomposition (VMD), and the original wind power and wind speed sequences are decomposed to obtain the IMF with different time scales. Finally, to address the problems of difficult optimization of hyper parameter and difficulty in obtaining optimal solutions for LSTM neural network modes, the WSA-IC algorithm is proposed to optimize its key hyper parameter, and the IVMD-WSA-IC-LSTM forecasting mode is established to obtain the short-term forecasting results of wind power. The algorithm is tested with the data of China Longyuan Power Group Corporation Limited. Compared with other common forecasting approaches using same data, the mean absolute error (MAE) of the forecasting approach is reduced to 0.007859, the mean square error (MSE) is reduced to 0.00011, and the determination coefficient is improved to 0.998828, which has higher forecasting accuracy.
Matrisome AnalyzeR – a suite of tools to annotate and quantify ECM molecules in big datasets across organisms
Authors: Petrov Petar B. , Considine James M. , Izzi Valerio , Naba Alexandra
Published: August 2023

The extracellular matrix (ECM) is a complex meshwork of proteins that forms the scaffold of all tissues in multicellular organisms. It plays crucial roles in all aspects of life – from orchestrating cell migration during development, to supporting tissue repair. It also plays critical roles in the etiology or progression of diseases. To study this compartment, we have previously defined the compendium of all genes encoding ECM and ECM-associated proteins for multiple organisms. We termed this compendium the ‘matrisome’ and further classified matrisome components into different structural or functional categories. This nomenclature is now largely adopted by the research community to annotate ‘-omics’ datasets and has contributed to advance both fundamental and translational ECM research. Here, we report the development of Matrisome AnalyzeR, a suite of tools including a web-based application and an R package. The web application can be used by anyone interested in annotating, classifying and tabulating matrisome molecules in large datasets without requiring programming knowledge. The companion R package is available to more experienced users, interested in processing larger datasets or in additional data visualization options.
CULTURAL AND EDUCATIONAL TOURISM AS A DIRECTION OF USING AND PROTECTING THE CULTURAL HERITAGE OF THE REPUBLIC OF CRIMEA
Authors: Ibragimov Ernest E. , Anokhin Viktor S.
Published: August 2023

The article substantiates the role of cultural and educational tourism in the popularization of the cultural heritage of the Republic of Crimea, reflects the importance of cultural tourism for the formation of national consciousness of citizens, examines the main objects of cultural heritage of the region, identifies the problems and prospects of using the cultural heritage of the region in tourism.

Cultural heritage is the most important resource for regional development, including cultural and educational tourism, which can be considered as an effective factor contributing to familiarization with the cultural heritage of the region, therefore, research aimed at developing methodological foundations for a balanced interaction of cultural heritage management processes and the development of tourism activities based on its use is relevant.

The purpose of the study: to substantiate the importance of cultural and educational tourism in promoting the cultural heritage of the Republic of Crimea and to identify current problems of their use in tourism.

The methodological basis of the research is the philosophical principles of cognition; dialectical, logical and systematic approaches to the consideration of phenomena and processes, as well as general scientific methods: analysis and synthesis to substantiate theoretical propositions, generalization, systematic approach and formal logic to deduce the content of relevant concepts.

The preservation of cultural heritage and its rational use are crucial for the sustainable attraction of tourist flows and the improvement of socio-economic indicators of the region. The activation of cultural and educational tourism throughout the Crimean region can contribute to the development of other sectors of the tourism industry and, of course, will have a positive impact on the preservation of cultural heritage.
Nidificação de abelhas nativas sem ferrão (Apidae, Meliponini) em substratos arbóreos em áreas antropizadas no município de Inconfidentes, Brasil
Authors: Menino Cibelle Cristine dos Santos , Guedes Gabriel Teófilo , Souza Marcos Magalhães de
Published: August 2023

As abelhas da tribo Meliponini, conhecidas popularmente por indígenas ou sem ferrão (ASF), constituem uma tribo de insetos eussociais que utilizam diferentes substratos para nidificação, como ocos e forquilhas de árvore, cavidades no solo e construções humanas. Visando uma melhor compreensão da seleção de substrato para nidificação, o objetivo do presente estudo foi relatar as espécies de Meliponini e as respectivas espécies vegetais utilizadas para nidificação, em áreas antropizadas, no município de Inconfidentes - Minas Gerais. O trabalho foi conduzido em três áreas no período de abril de 2021 a fevereiro de 2022. Foram registrados 13 ninhos de cinco gêneros/espécies de meliponíneos ocupando diferentes famílias/espécies arbóreas. Os meliponínios encontrados foram Scaptotrigona sp., Tetragonisca angustula (Latreille), Plebeia droryana (Friese), Tetragona clavipes (Fabricius) e Cephalotrigona capitata (Smith), corroborando estudos que apontam os gêneros como bem sucedidos em ocupação de matas perturbadas, com exceção de Cephalotrigona (Schwarz). As árvores mais utilizadas para nidificação de Meliponini foram Eucalyptus sp. e indivíduos da família Lauraceae, Pinaceae e Fabaceae. Os resultados se relacionam ao maior fornecimento de substratos pelos indivíduos de Eucalyptus sp. em área de silvicultura abandonada, com árvores de grande porte com possibilidade de formação de cavidades, e histórico de sucesso de nidificação de ASF em indivíduos das famílias Lauraceae e Fabaceae.
Evaluation of remote services and patient satisfaction - a qualitative study
Authors: Laskowski Jakub , Kister Klaudia , Mazur Magdalena , Rektor Natalia , Małolepsza Aleksandra , Zach-Źródlak Monika , Rosa Lidia , Czechowska Julia , Bronst Paulina , Szabrańska Anna
Published: August 2023

BACKGROUND: Telemedicine is among the most modern branches of medicine. In the field of mental health, telepsychiatry makes it possible to replace the traditional conversation with a specialist with an e-visit. With the development of remote services, qualitative studies evaluating this type of service have begun to be conducted. The studies involve both patients and clinicians. The purpose of this study is to show the advantages perceived by patients who use telepsychiatry services, as well as concerns that may discourage further use of digital therapy. The study also includes an evaluation of telemedicine services.
Material and methods: The authors created a proprietary structured questionnaire that consisted of two parts. The first concerned sociodemographic data, while the second addressed the subject of patients' evaluation with the use of telepsychiatry services, possible difficulties during e-visits and satisfaction with this type of consultation. Before completing the survey, patients filled out informed consent. The survey was conducted from November 2022 to May 2023.
Results: The final group of respondents was formed by 432 people. The largest group of respondents were patients with the diagnosis: affective disorders - 24.07%. The vast majority of respondents - 81.94% - indicated the possibility of teleportation from anywhere in the world as the greatest advantage of telepsychiatry. Another advantage is not having to take time off from work or school - 78.94%. Major disadvantages included: limited treatment methods (71.07% of respondents), made it more difficult to build a therapeutic alliance 59.03%, privacy and cybersecurity concerns 43.06%. Overall, patients rate telepsychiatry well - 66% of respondents were satisfied.
Conclusions: Telepsychiatry is well rated among most patients.  More research is needed to develop clear guidelines for digital therapy.  Patients receiving remote therapy should be screened for the development of addiction to mobile devices and the Internet.
Cardiac rehabilitation after myocardial infarction - role, goals and effects
Authors: Misiło Adriana , Olczyk Krzysztof , Sosna Monika , Mordoń Krzysztof
Published: August 2023

Cardiovascular diseases, in particular ischemic heart disease, are the leading cause of death worldwide. According to the current guidelines of scientific societies, the most important target group, in which preventive actions play a key role, are e.g. patients with ischemic heart disease.
The actions taken aimed at slowing down the progression of the disease, optimizing therapy, including its individualization, education and counseling in the field of pro-health behaviors. Preventive measures are also cost-effective in relation to the costs incurred for a number of measures taken in the event of an acute cardiovascular event. As a result, comprehensive care programs with secondary prevention as the primary objective are now considered the standard of care, particularly in patients with acute coronary artery disease (ACS).