bluuebunny/crossref_metadata_2025_split huggingface dataset:
Launching continuous kangaroo mother care through participatory action research in Iran
Authors: Mohammadi Marzieh , Bergh Anne-Marie , Jahdi Niloufar Sattarzadeh , Valizadeh Leila , Hosseini Mohammadbagher , Hakimi Sevil 
Published: May 2023

Abstract
Background
This study describes the launching of a unit for continuous kangaroo mother care (KMC) in a teaching hospital (Taleghani) in Iran.

Methods
We used a participatory three-stage action research approach to establish a unit for continuous KMC: design (needs identification and planning for change); implementation (and reflection); and evaluation (and institutionalization). As part of the design and implementation stages, individual and focus group interviews were conducted with mothers, physicians, nurses, other healthcare personnel and policy makers. The evaluation was done by means of a standardized tool specifically developed for monitoring progress with the implementation of KMC.

Results
Four themes relating to potential barriers to implementation emerged from the analysis of the staff interviews, namely barriers associated with the mother, the father, the physician and the health system. Mothers’ experiences of barriers were grouped into five themes: personal discomfort, fear, healthcare provider attitudes and actions, infrastructure constraints and family matters. An implementation progress score of 27.05 out of 30 was achieved, indicating that the continuous KMC unit was on the path to institutionalization. Some of the gaps identified related to policies on resource allocation, the discharge and follow-up system, and the transportation of infants in the KMC position.

Conclusion
The study findings indicated that participatory action research is a suitable method for studying the establishment of a continuous KMC unit. When action research is practiced, there is a prospect of turning knowledge into action in the real world.
Microbial dysbiosis and the host airway epithelial response: insights into HIV-associated COPD using multi’omics profiling
Authors: Jude Marcia Smiti , Yang Chen Xi , Filho Fernando Studart Leitao , Hernandez Cordero Ana I. , Yang Julia , Shaipanich Tawimas , Li Xuan , Lin David , MacIsaac Julie , Kobor Michael S. , Sinha Sunita , Nislow Corey , Singh Amrit , Lam Wan , Lam Stephen , Guillemi Silvia , Harris Marianne , Montaner Julio , Ng Raymond T. , Carlsten Christopher , Paul Man S. F. , Sin Don D. , Leung Janice M. 
Published: May 2023

Abstract
Background
People living with HIV (PLWH) are at increased risk of developing Chronic Obstructive Pulmonary Disease (COPD) independent of cigarette smoking. We hypothesized that dysbiosis in PLWH is associated with epigenetic and transcriptomic disruptions in the airway epithelium.

Methods
Airway epithelial brushings were collected from 18 COPD + HIV + , 16 COPD − HIV + , 22 COPD + HIV − and 20 COPD – HIV − subjects. The microbiome, methylome, and transcriptome were profiled using 16S sequencing, Illumina Infinium Methylation EPIC chip, and RNA sequencing, respectively. Multi ‘omic integration was performed using Data Integration Analysis for Biomarker discovery using Latent cOmponents. A correlation > 0.7 was used to identify key interactions between the ’omes.

Results
The COPD + HIV −, COPD −HIV + , and COPD + HIV + groups had reduced Shannon Diversity (p = 0.004, p = 0.023, and p = 5.5e−06, respectively) compared to individuals with neither COPD nor HIV, with the COPD + HIV + group demonstrating the most reduced diversity. Microbial communities were significantly different between the four groups (p = 0.001). Multi ‘omic integration identified correlations between Bacteroidetes Prevotella, genes FUZ, FASTKD3, and ACVR1B, and epigenetic features CpG-FUZ and CpG-PHLDB3.

Conclusion
PLWH with COPD manifest decreased diversity and altered microbial communities in their airway epithelial microbiome. The reduction in Prevotella in this group was linked with epigenetic and transcriptomic disruptions in host genes including FUZ, FASTKD3, and ACVR1B.
Cooperative phototherapy based on bimodal imaging guidance for the treatment of uveal melanoma
Authors: Huang Tong , Xu Xinzhi , Cheng Chen , Wang Jianxin , Yang Liping 
Published: May 2023

Abstract
Background
Uveal melanoma (UM) is adults’ most common primary intraocular malignant tumor, prone to metastasis and high mortality. Eyeball enucleation commonly used in the clinic will lead to permanent blindness and mental disorders. Thus, new methods are urgently needed to diagnose and treat UM early to preserve patients’ vision.

Methods and results
Herein, multifunctional nanoparticles (NPs) were synthesized by loading chlorin e6 (Ce6) in poly-lactic-co-glycolic acid (PLGA) NPs and wrapping FeIII-tannic acid (FeIII-TA) on the outside (FeIII-TA/PLGA/Ce6, designated as FTCPNPs). Then, the synergistic photothermal therapy (PTT) and photodynamic therapy (PDT) antitumor effects of FTCPNPs excited by near-infrared (NIR) laser were evaluated. Moreover, we verified the mechanism of synergistic PTT/PDT leading to mitochondrial dysfunction and inducing tumor cell apoptosis. Additionally, FTCPNPs can be used as excellent magnetic resonance (MR)/photoacoustic (PA) imaging contrast agents, enabling imaging-guided cancer treatment. Finally, The NPs have good biological safety.

Conclusion
This noninvasive NIR light-triggered cooperative phototherapy can easily penetrate eye tissue and overcome the disadvantage of limited penetration of phototherapy. Therefore, cooperative phototherapy is expected to be used in fundus tumors. This treatment model is applied to UM for the first time, providing a promising strategy and new idea for integrating the diagnosis and treatment of UM.
Insulin injection practice and health related quality of life among individuals with diabetes at Tikur Anbessa Specialized Hospital, Ethiopia: a cross-sectional study
Authors: Negash Zenebe , Tadiwos Aklasiya , Urgessa Eliyas Mulatu , Gebretekle Gebremedhin Beedemariam , Abebe Ephrem , Fentie Atalay Mulu 
Published: May 2023

Abstract
Background
Insulin therapy can be inconvenient, painful, burdensome, and restrict patients' daily activities and health related quality of life (HRQOL) due to improper injection techniques or the nature of administration.

Objective
This study aimed to assess insulin injection practice, HRQOL and predictors among patients treated with insulin at Tikur Anbessa Specialized Hospital (TASH).

Methods
An institutional-based cross-sectional study was conducted among diabetes patients on insulin therapy from May to June 2022. A structured questionnaire was used to collect patient characteristics and insulin injection practice. The validated Amharic version of an EQ-5D-5L tool was used to assess the HRQOL. The data was analyzed using SPSS version 26. The patient data were summarized using descriptive statistics. One-way ANOVA using Kruskal–Wallis H tests was used to assess factors that predict insulin handling practice scores. Multivariate linear regression analysis was used to assess factors affecting HRQOL among diabetes patients treated with insulin. The EQ5D-5L utility scores of the patients were calculated using disutility coefficients taken from the Ethiopian general population. Statistical significance was declared at p-value < 0.05.

Results
Of 319 patients who agreed and completed the survey, 51.1% of them were males. Almost half of the participants (n = 158) were > 50 years of age. Among the study participants, 62.1% were only on intermediate acting insulin. A significantly higher proportion of participants 291(91.2%) in this study were taking insulin two times per day. Most of the participants 234(73.4%) had fair practice with a median insulin handling practice score of 38 out of 56. Patient characteristics such as age, educational status, occupation, disease duration, and type of diabetes were significantly association with insulin injection practice (p < 0.05). The mean ± SD utility score of patients were 0.89 ± 0.19 (ranged from -0.04 to 1). Being female (β = -5.42, 95%CI:-8.63,-2.21, p = 0.001) and treated for type-I diabetes mellitus (β =  + 9.04, 95%CI: 4.23,13.85, p-value < 0.0001) were significantly associated with HRQOL of patients on insulin therapy.

Conclusion
The study participants had fair practices in insulin handling, storage, and administration techniques, and it was seen that male and type one diabetes patients have a better quality of life compared to their counterparts.
Small heterodimer partner interacting leucine zipper protein (SMILE) ameliorates autoimmune arthritis via AMPK signaling pathway and the regulation of B cell activation
Authors: Jhun JooYeon , Moon Jeonghyeon , Kwon Ji Ye , Cho Keun-Hyung , Lee Seang Yoon , Na Hyun Sik , Cho Mi-La , Min Jun-Ki 
Published: May 2023

AbstractRheumatoid arthritis (RA) is an autoimmune disease that causes joint swelling and inflammation and can involve the entire body. RA is characterized by the increase of pro-inflammatory cytokines such as interleukin (IL) and tumor necrosis factor, and the over-activation of T lymphocytes and B lymphocytes, which may lead to severe chronic inflammation of joints. However, despite numerous studies the pathogenesis and treatment of RA remain unresolved. This study investigated the use of small heterodimer partner-interacting leucine zipper protein (SMILE) overexpression to treat a mouse model of RA. SMILE is an insulin-inducible corepressor through adenosine monophosphate-activated kinase (AMPK) signaling pathway. The injection of a SMILE overexpression vector to mice with collagen induced-arthritis resulted in a milder clinical pathology and a reduced incidence of arthritis, less joint tissue damage, and lower levels of Th17 cells and plasma B cells in the spleen. Immunohistochemistry of the joint tissue showed that SMILE decreased B-cell activating factor (BAFF) receptor (BAFF-R), mTOR, and STAT3 expression but increased AMPK expression. In SMILE-overexpressing transgenic mice with collagen antibody-induced arthritis (CAIA), a decrease in the arthritis score and reductions in tissue damage, the number of B cells, and antibody production were observed. The treatment of immune cells in vitro with curcumin, a known SMILE-inducing agent, led to decreases in plasma B cells, germinal center B cells, IL-17-producing B cells, and BAFF-R-positive B cells. Taken together, our findings demonstrate the therapeutic potential of SMILE in RA, based on its inhibition of B cell activation mediated by the AMPK/mTOR and STAT3 signaling pathway and BAFF-R expression.
Opinion: more mouse models and more translation needed for ALS
Authors: Fisher Elizabeth M.C. , Greensmith Linda , Malaspina Andrea , Fratta Pietro , Hanna Michael G. , Schiavo Giampietro , Isaacs Adrian M. , Orrell Richard W. , Cunningham Thomas J. , Arozena Abraham Acevedo 
Published: May 2023

AbstractAmyotrophic lateral sclerosis is a complex disorder most of which is ‘sporadic’ of unknown origin but approximately 10% is familial, arising from single mutations in any of more than 30 genes. Thus, there are more than 30 familial ALS subtypes, with different, often unknown, molecular pathologies leading to a complex constellation of clinical phenotypes. We have mouse models for many genetic forms of the disorder, but these do not, on their own, necessarily show us the key pathological pathways at work in human patients. To date, we have no models for the 90% of ALS that is ‘sporadic’. Potential therapies have been developed mainly using a limited set of mouse models, and through lack of alternatives, in the past these have been tested on patients regardless of aetiology. Cancer researchers have undertaken therapy development with similar challenges; they have responded by producing complex mouse models that have transformed understanding of pathological processes, and they have implemented patient stratification in multi-centre trials, leading to the effective translation of basic research findings to the clinic. ALS researchers have successfully adopted this combined approach, and now to increase our understanding of key disease pathologies, and our rate of progress for moving from mouse models to mechanism to ALS therapies we need more, innovative, complex mouse models to address specific questions.
Research note changes in the number of outpatient visits in Japan during the COVID-19 pandemic
Authors: Machida Munehito , Nishioka Yuichi , Noda Tatsuya , Imamura Tomoaki 
Published: May 2023

Abstract
Objective
This study aimed to determine the change in the number of outpatient visits in Japan since the beginning of the COVID-19 pandemic, using data on the outpatient claims submitted by medical institutions to insurers in 2019 and 2020, from the National Database of Health Insurance Claims and Specific Health Check-ups. We calculated the total number of outpatient visits, and number of visits for individual diseases according to the International Classification of Diseases-10 codes on the claim form.

Results
The number of outpatient visits per million people decreased by 9.98% in 2020 compared to 2019. Of the diseases included in the analysis, 71 showed a decrease in the number of visits by ≥ 1%. There were significant decreases in the number of visits related to infectious diseases (influenza, acute bronchitis, and acute laryngitis, etc.), and chronic diseases (hemorrhoids, cystic kidney disease, dyspepsia, and chronic sinusitis, etc.). The observed decreased rate of outpatient visit might have been due to, a decrease in the incidence of disease, a decreased frequency of visit by patients with the disease, or both. Our analysis method using actual health insurance claim data can be applied worldwide, where researchers have access to national information on health insurance claims.
The era of technology in healthcare: an evaluation of telerehabilitation on patient outcomes—a systematic review and meta-analysis protocol
Authors: Jaswal Sharan , Lo Joyce , Sithamparanathan Gobika , Nowrouzi-Kia Behdin 
Published: May 2023

Abstract
Background
The World Health Organization announced the outbreak of the Coronavirus disease as a global pandemic on March 11, 2020. Since then, rapid implementation of telehealth approaches into the healthcare system have been evident. The pandemic has drastically impacted the lives of many around the globe and has detrimentally affected our healthcare systems, specifically with the delivery of healthcare. This has had many implications on rehabilitation services such as, occupational therapy, physiotherapy, and speech therapy. The delivery of mental health services remotely may be referred to as teletherapy, telemental health, telepsychiatry, and telepsychology. Telerehabilitation has become a necessity over the course of the pandemic due to safety concerns with COVID-19 transmission. The primary aim of this systematic review protocol is to evaluate the literature on the effect of telerehabilitation on patient outcomes and propose directives for future research based on the evidence reviewed.

Methods
A systematic review and meta-analysis will be conducted to examine the literature on the effect of telerehabilitation on patient outcomes following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PRISMA, 2015). The systematic review will use the following databases to examine the literature on telerehabilitation and patient outcomes: APA PsychINFO, Embase (Ovid), MEDLINE (Ovid), CINAHL, and Scopus.

Discussion
The utilization of telerehabilitation and similar telehealth treatments has increased throughout the COVID-19 pandemic. However, much is still unclear regarding the effectiveness of these methods in the delivery and service of healthcare, and their effect on health outcomes. This review will identify and address the knowledge gaps in the literature, which will provide further directions for future research.

Trial registration
This systematic review has been registered with PROSPERO under registration number CRD42022297849.
Early prediction of MODS interventions in the intensive care unit using machine learning
Authors: Liu Chang , Yao Zhenjie , Liu Pengfei , Tu Yanhui , Chen Hu , Cheng Haibo , Xie Lixin , Xiao Kun 
Published: May 2023

Abstract
Background
Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in critically ill patients. MODS is the result of a dysregulated inflammatory response that can be triggered by various causes. Owing to the lack of an effective treatment for patients with MODS, early identification and intervention are the most effective strategies. Therefore, we have developed a variety of early warning models whose prediction results can be interpreted by Kernel SHapley Additive exPlanations (Kernel-SHAP) and reversed by diverse counterfactual explanations (DiCE). So we can predict the probability of MODS 12 h in advance, quantify the risk factors, and automatically recommend relevant interventions.

Methods
We used various machine learning algorithms to complete the early risk assessment of MODS, and used a stacked ensemble to improve the prediction performance. The kernel-SHAP algorithm was used to quantify the positive and minus factors corresponding to the individual prediction results, and finally, the DiCE method was used to automatically recommend interventions. We completed the model training and testing based on the MIMIC-III and MIMIC-IV databases, in which the sample features in the model training included the patients’ vital signs, laboratory test results, test reports, and data related to the use of ventilators.

Results
The customizable model called SuperLearner, which integrated multiple machine learning algorithms, had the highest authenticity of screening, and its Yordon index (YI), sensitivity, accuracy, and utility_score on the MIMIC-IV test set were 0.813, 0.884, 0.893, and 0.763, respectively, which were all maximum values of eleven models. The area under the curve of the deep–wide neural network (DWNN) model on the MIMIC-IV test set was 0.960, and the specificity was 0.935, which were both the maximum values of all these models. The Kernel-SHAP algorithm combined with SuperLearner was used to determine the minimum value of glasgow coma scale (GCS) in the current hour (OR = 0.609, 95% CI   0.606–0.612), maximum value of MODS score corresponding to GCS in the past 24 h (OR = 2.632, 95% CI 2.588–2.676), and maximum score of MODS corresponding to creatinine in the past 24 h (OR = 3.281, 95% CI   3.267–3.295) were generally the most influential factors.

Conclusion
The MODS early warning model based on machine learning algorithms has considerable application value, and the prediction efficiency of SuperLearner is superior to those of SubSuperLearner, DWNN, and other eight common machine learning models. Considering that the attribution analysis of Kernel-SHAP is a static analysis of the prediction results, we introduce the DiCE algorithm to automatically recommend counterfactuals to reverse the prediction results, which will be an important step towards the practical application of automatic MODS early intervention.
Fixation devices for anterior shoulder instability
Authors: Collins Lacee K. , Cole Matthew W. , Savoie Felix H. , Sherman William F. , O’Brien Michael J. 
Published: May 2023

AbstractPurposeOver the past 40 years, advances in the development of anchors and sutures have contributed to the improvement in surgical outcomes for treatment of shoulder instability. Important choices in surgery when treating instability include the use of knotless versus knotted suture anchors, and bony versus soft tissue reconstruction techniques.MethodsA literature review was conducted to evaluate the history of instability of the shoulder and the results of specific fixation techniques including bony and soft tissue reconstructions as well as knotted and knotless suture anchors.ResultsAs knotless suture anchors have continued to grow in popularity since their development in 2001, many studies have compared this newer technique to that of the standard knotted suture anchors. In general, these studies have demonstrated no difference in patient‐reported outcome measures between the two options. Additionally, the choice of bony versus soft tissue reconstructions is patient specific as it depends on the specific pathology or combination of injuries.ConclusionIn each surgery performed for shoulder instability, it is vitally important that we try to restore normal anatomy. The normal anatomy is best established by knotted mattress sutures. However, loop laxity and tear through by the sutures in the capsule can eliminate this restoration, increasing risk of failure. Knotless anchors may allow better soft tissue fixation of the labrum and capsule to the glenoid, but without complete restoration of normal anatomy.
Hemodiafiltration in Japan: current status and future directions
Authors: Naganuma Toshihide , Takemoto Yoshiaki , Kamada Naohiro , Kawanishi Hideki 
Published: May 2023

AbstractHemodiafiltration (HDF) therapy has become standard treatment in Japan and Europe, but evidence from Europe is not directly applicable to HDF in Japan because HDF therapy differs greatly in the two regions. Japanese dialysis membranes vary widely, including use of protein-leaking and non-leaking membranes, and the molecular weight of solutes that can be removed is generally larger in Japan than in Europe. Given the characteristics of pre-dilution, the volume of replacement fluid itself cannot be used as a marker for solute removal, and the relationship of this volume to life prognosis is still unknown. Under these circumstances, the JAMREDS, a multicenter study led by the Japanese Society for Hemodiafiltration, was started in April 2020. The goal of the study is to determine whether α1-microglobulin reduction rate can be used as a marker for the prognosis of hemodialysis patients, including life prognosis and cardiovascular event onset. The JAMREDS is being performed from a new perspective of solute removal by HDF. This research design is reasonable and highly original for HDF in Japan, in view of the wide variety of membrane types and treatment modes, and the results of the study will be of particular interest.