Development and Validation of a questionnaire on human dignity in nursing cares: an exploratory sequential mixed study / Desarrollo y validación de un cuestionario sobre dignidad humana en los cuidados de enfermería. Un estudio exploratorio secuencial mixto / Desenvolvimento e validação de um questionário sobre a dignidade humana nos cuidados de enfermagem. Um estudo exploratório misto sequencial exploratório

Objective.The current study aimed to develop and validate of human dignity questionnaire in nursing care. Methods. The present research is a sequential exploratory mixed method study. The questionnaire was developed and validated in three phases: (1) the concept of human dignity was defined through conventional content analysis qualitative approach, (2) early items of questionnaire was generated according to findings of the first phase, (3) validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. The study was conducted with the participation of 13 nurses in the qualitative section and 203 nurses in the quantitative section in teaching hospitals affiliated to Jahrom University of Medical Sciences (Iran). Results. In the qualitative section, the definition and dimensions of the concept of human dignity in nursing care were discovered. In the quantitative section, the initial pool of items for the questionnaire of human dignity in nursing care was formed using the results of the qualitative section of the study and review of texts and related questionnaires. In factor analysis, four subscales including: respectful communication, equality of patient human value, preservation of privacy and patient-centered care were extracted by Eigen value above one. Internal consistency and stability of the questionnaire were calculated as 0.85 and 0.80, respectively, indicating an excellent reliability. Conclusions. The 20-item developed questionnaire is valid and reliable for measurement of human dignity questionnaire in nursing cares.

Objetivo. Elaborar y validar un cuestionario sobre la dignidad humana en los cuidados de enfermería. Métodos. Estudio exploratorio secuencial de método mixto. El cuestionario se desarrolló y validó en tres fases: (1) se definió el concepto de dignidad humana mediante un enfoque cualitativo de análisis de contenido convencional, (2) se generaron los primeros ítems del cuestionario de acuerdo con los resultados de la primera fase, (3) se evaluó la validación del cuestionario mediante la validez facial, de contenido y de constructo, así como la fiabilidad. El estudio se llevó a cabo con la participación de 13 enfermeras en la sección cualitativa y 203 enfermeras en la sección cuantitativa en hospitales docentes afiliados a la Universidad de Ciencias Médicas de Jahrom (Irán). Resultados. En la fase cualitativa emergieron las dimensiones del concepto de dignidad humana en los cuidados de enfermería. En la sección cuantitativa, el grupo inicial de ítems para el cuestionario de dignidad humana en los cuidados de enfermería se formó utilizando los resultados de la sección cualitativa y de la revisión instrumentos relacionados. En el análisis factorial, se extrajeron cuatro subescalas con un valor Eigen superior a uno: comunicación respetuosa, igualdad del valor humano del paciente, preservación de la intimidad y cuidados centrados en el paciente, consistencia interna y la estabilidad del cuestionario se calcularon en 0.85 y 0.80, respectivamente, lo que indica una excelente fiabilidad. Conclusión.El cuestionario de 20 ítems desarrollado es válido y fiable para medir la dignidad humana en los cuidados de enfermería.

Objectivo. Desenvolver e validar um questionário sobre a dignidade humana nos cuidados de enfermagem. Métodos. Estudo exploratório sequencial misto de métodos exploratórios. O questionário foi desenvolvido e validado em três fases: (1) o conceito de dignidade humana foi definido utilizando uma abordagem de análise de conteúdo qualitativa convencional, (2) os primeiros itens do questionário foram gerados com base nos resultados da primeira fase, (3) a validação do questionário foi avaliada através da validade de face, de conteúdo e de construção, bem como da fiabilidade. O estudo foi realizado com a participação de 13 enfermeiros na secção qualitativa e 203 enfermeiros na secção quantitativa em hospitais universitários filiados na Universidade de Ciências Médicas de Jahrom (Irão). Resultados. Na fase qualitativa, emergiram as dimensões do conceito de dignidade humana nos cuidados de enfermagem. Na secção quantitativa, o conjunto inicial de itens para o questionário sobre a dignidade humana nos cuidados de enfermagem foi formado utilizando os resultados da secção qualitativa e a revisão de instrumentos relacionados. Na análise fatorial, foram extraídas quatro subescalas com um valor Eigen superior a 1: comunicação respeitosa, igual valor humano do doente, preservação da privacidade e cuidados centrados no doente. A consistência interna e a estabilidade do questionário foram calculadas em 0.85 e 0.80, respetivamente, indicando uma excelente fiabilidade. Conclusão. O questionário de 20 itens desenvolvido é válido e fiável para medir a dignidade humana nos cuidados de enfermagem.

The Effect of the Team Members Teaching Design vs. Regular Lectures method on the Self-efficacy of the Multiple sclerosis Patients in Iran. Randomised Controlled Trial / El efecto del diseño de enseñanza colaborativa frente al método de clases regulares sobre la autoeficacia de los pacientes con esclerosis múltiple en Irán. Ensayo Controlado Aleatorizado / O efeito do design de ensino colaborativo versus método de aula regular na autoeficácia de pacientes com esclerose múltipla no Irã. Teste controlado e aleatório

Objective. This study was conducted with the aim of the effect of team members teaching design (TMTD) vs. regular Lectures method on the self-efficacy of the multiple sclerosis patients. Methods. This research is a randomized controlled trial study. In this study, 48 multiple sclerosis persons of members of Jahrom MS Society participated. The persons were selected by simple random sampling and then divided into three groups of: TMTD (n=16), regular lecture method (n=16), and control (n=16), by random allocation method. In the intervention groups, six training sessions were held twice a week; control group did not receive education. Data was collected by the MS self-efficacy questionnaire of Rigby et al. in the before, immediately and one month after the intervention. Results. Patients in three intervention and control groups were similar in terms of demographic variables. The results of the repeated measurement test before, immediately and one month after the intervention showed that the mean of the all dimensions of self-efficacy in two intervention groups had increased significantly (p<0.05). While these changes were not significant in the control group (p ≥ 0.05). Also, there was a significant difference in the mean of the all dimensions of self-efficacy between the intervention groups of TMTD and regular lectures. Conclusion. Based on the findings, TMTD compared to regular lectures method had a more significant effect on improving the self-efficacy of multiple sclerosis patients. Therefore, it is recommended that nursing use this educational approach to increase patients' self-efficacy.

Objetivo. Determinar el efecto del diseño de la enseñanza colaborativa de los miembros del equipo (En inglés: Team Members Teaching Design -TMTD) frente al método de las clases regulares sobre la autoeficacia de los pacientes con esclerosis múltiple (EM).Métodos. Ensayo controlado aleatorizado realizado con la participación de 48 personas con esclerosis múltiple afiliados a la Sociedad de Esclerosis Múltiple de Jahrom (Iran), que fueron seleccionados por muestreo aleatorio simple y luego asignados en forma randomizada en tres grupos, dos de intervención: TMTD (n=16) y método de clases regulares (n=16), y un grupo control (n=16). En los grupos de intervención se impartieron seis sesiones educativas (dos por semana); mientras que el grupo control no recibió educación. Se empleó el cuestionario de autoeficacia en EM de Rigby et al. en los momentos: antes, inmediatamente después de terminada la intervención y un mes de finalizada la misma.Resultados. Los pacientes de los tres grupos de intervención y control eran similares en cuanto a variables demográficas. Los resultados de la prueba de medidas repetidas antes, inmediatamente y un mes después de la intervención mostraron que la media de todas las dimensiones de autoeficacia en los dos grupos de intervención había aumentado significativamente (p<0.05). Mientras que estos cambios no fueron significativos en el grupo de control (p ≥ 0.05). Además, hubo una diferencia significativa en la media de todas las dimensiones de autoeficacia entre los grupos de intervención de TMTD y clases regulares, siendo mayor en TMTD. Conclusión. El TMTD comparado con el método de clases regulares, tuvo un mejor efecto en el aumento de la autoeficacia de los pacientes con EM. Por lo tanto, se sugiere a enfermería utilizar este enfoque educativo para aumentar la autoeficacia de los pacientes.

Objetivo. Determinar o efeito do desenho de ensino colaborativo dos membros da equipe (em inglês: Team Members Teaching Design -TMTD) comparado ao método de aulas regulares na autoeficácia de pacientes com esclerose múltipla (EM). Métodos. Ensaio controlado randomizado realizado com a participação de 48 pessoas com esclerose múltipla afiliadas à Sociedade de Esclerose Múltipla de Jahrom (Irã), que foram selecionadas por amostragem aleatória simples e depois distribuídas aleatoriamente em três grupos, dois grupos de intervenção: TMTD (n=16 ) e método de aula regular (n=16), e um grupo controle (n=16). Foram ministradas seis sessões educativas nos grupos de intervenção (duas por semana); enquanto o grupo de controle não recebeu educação. Foi utilizado o questionário de autoeficácia em SM de Rigby et al. nos momentos: antes, imediatamente após o término da intervenção e um mês após seu término. Resultados. Os pacientes dos três grupos intervenção e controle foram semelhantes em termos de variáveis demográficas. Os resultados do teste de medidas repetidas antes, imediatamente e um mês após a intervenção mostraram que a média de todas as dimensões da autoeficácia nos dois grupos de intervenção aumentou significativamente (p<0.05). Embora essas alterações não tenham sido significativas no grupo controle (p ≥ 0.05). Além disso, houve diferença significativa na média de todas as dimensões de autoeficácia entre os grupos de intervenção TMTD e aulas regulares, sendo maior no TMTD. Conclusão. O TMTD comparado ao método de aula regular teve melhor efeito no aumento da autoeficácia dos pacientes com EM. Portanto, sugere-se que a enfermagem utilize essa abordagem educativa para aumentar a autoeficácia dos pacientes.

Utilidad y confiabilidad del cuestionario PreViAs para la evaluación de la visión en neonatos y lactantes turcos / The utility and reliability of the PreViAs questionnaire for the assessment of vision in Turkish neonates and infants

Introducción. La evaluación de la visión en los niños durante el periodo preverbal, con un método fácil de usar y basado en la evidencia, permitiría el diagnóstico temprano y la intervención en los trastornos visuales. El objetivo del estudio fue determinar la utilidad y confiabilidad de la versión en idioma turco del cuestionario Preverbal Visual Assessment (PreViAs), desarrollado para evaluar la visión en niños preverbales. Población y métodos. El cuestionario PreViAs se administró a los cuidadores primarios de niños nacidos de término, antes de los 24 meses de edad. Se registraron sus respuestas. Resultados. Se analizaron los datos de 278 participantes para evaluar la consistencia interna del cuestionario PreViAs. Se encontró un alto nivel de consistencia con un alfa de Cronbach de 0,958 para el puntaje total, lo que sugiere una fuerte coherencia interna. Los valores del alfa de Cronbach para cada dominio fueron: 0,890 ­ 0,913 ­ 0,951 y 0,922 para la atención visual, la comunicación visual, el procesamiento visual y la coordinación visomotora respectivamente; esto indica una buena consistencia interna para cada subdominio. Conclusión. La versión en idioma turco del cuestionario PreViAs es útil y confiable para evaluar la visión durante el periodo preverbal.

Introduction: Evaluating the visual functions of children with an easy-to-use and evidence-based method during the preverbal period will enable early diagnosis and intervention of visual impairments. The aim of this study is to determine the utility and reliability of the Turkish version of the Preverbal Visual Assessment (PreViAs) questionnaire, which was developed to evaluate the visual functioning of preverbal infants. Population and Methods: The PreViAs questionnaire was administered to primary caregivers of term infants under 24 months of age, and their responses were recorded. Results: Data from the 278 participating infants were analyzed to assess the internal consistency of the PreViAs questionnaire. Results showed a high level of consistency with Cronbach's alpha value of 0.958 for the total score, suggesting strong internal coherence. In addition, the Cronbach's alpha values for each domain were 0.890, 0.913, 0.951, and 0.922 for visual attention, visual communication, visual processing, and visual-motor coordination, respectively, indicating good internal consistency for each subdomain. Conclusion: The Turkish version of the PreViAs questionnaire is useful and reliable for assessing functional vision during the preverbal period.

Pharmacotherapeutic potential of Vitis vinifera(grape) in age-related neurological diseases / Potencial farmacoterapéutico de Vitis vinifera(uva) en enfermedades neurológicas asociadas a la edad

Age-related neurological disorders (ANDs), including neurodegenerative diseases, are complex illnesses with an increasing risk with advancing years. The central nervous system's neuropathological conditions, including oxidative stress, neuroinflammation, and protein misfolding, are what define ANDs. Due to the rise in age-dependent prevalence, efforts have been made to combat ANDs. Vitis viniferahas a long history of usageto treat a variety of illness symptoms. Because multiple ligand sites may be targeted, Vitis viniferacomponents can be employed to treat ANDs. This is demonstrated by the link between the structure and action of these compounds. This review demonstrates that Vitis viniferaand its constituents, including flavonoids, phenolic compounds, stilbenoidsandaromatic acids, are effective at reducing the neurological symptoms and pathological conditions of ANDs. This is done by acting as an antioxidant and anti-inflammatory. The active Vitis vinifera ingredients have therapeutic effects on ANDs, as this review explains.

Las enfermedades neurológicas asociadas a la edad (AND, por su sigla en inglés) incluyendo las enfermedades neurodegenerativas, son enfermedades complejas con un riesgo creciente con la edad. Las condiciones neuropatológicas del sistema nervioso central, que incluyen el estrés oxidativo, la neuro inflamación, y el plegado erróneo de proteínas, son lo que define las AND. Debido al aumento en la prevalencia dependiente de la edad, se han hecho esfuerzos para combatir las AND. Vitis vinifera tiene una larga historia de uso para el tratamiento de síntomas. Puesto que puede hacer objetivo a muchos sitios ligando, los componentes de Vitis viniferase pueden utilizar para tratar AND. Esto se demuestra por el vínculo entre la estructura y la acción de estos compuestos. Esta revisión demuestra que la Vitis viniferay sus constituyentes, incluídos los flavonoides, componentes fenólicos, estilbenoides, y ácidos aromáticos, son efectivos para reducir los síntomas neurológicos y las condiciones patológicas de AND. Esto se produce por su acción como antioxidante y antiinflamatorio. Los ingredientes activos de Vitis vinifera tienen efectos terapéuticos en AND, y esta revisión lo explica.

Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units / Desarrollo y Validación del Cuestionario de Satisfacción del Acompañante de Pacientes Hospitalizados en Unidades de Cuidados Intensivos / Desenvolvimento e Validação do Questionário de Satisfação do Acompanhante para Pacientes Hospitalizados em Unidades de Terapia Intensiva

Objective. The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs. Methods. This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. Results. In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability. Conclusion. The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs.

Objetivo. Desarrollar y validar un cuestionario de satisfacción de acompañantes de pacientes hospitalizados en UCIs. Métodos. Estudio de validación que se realizó en tres fases: en la primera se definió el concepto de satisfacción de los acompañantes de pacientes hospitalizados en UCI mediante el método de análisis de contenido cualitativo; en la segunda fase se generaron los primeros ítems del cuestionario a partir de los resultados de la primera fase; y en la tercera fase se evaluó la validación del cuestionario mediante la validez facial, de contenido y de constructo, así como la fiabilidad. Resultados. En el análisis factorial exploratorio, se extrajeron tres subescalas que incluían: satisfacción con la comunicación del personal de enfermería (5 ítems), satisfacción con los cuidados de enfermería (12 ítems) y satisfacción con la toma de decisiones (5 ítems) con un valor Eigen superior a uno y una carga factorial superior a 0.5. La consistencia interna y la estabilidad del cuestionario desarrollado se confirmaron con 0.94 y 0.95 respectivamente, lo que indicaba una fiabilidad aceptable. Conclusión. El cuestionario desarrollado de 22 ítems es válido y fiable para medir los niveles de satisfacción de los acompañantes de pacientes iraníes hospitalizados en UCI.

Objetivo. Desenvolver e validar um questionário sobre a satisfação dos acompanhantes de pacientes hospitalizados em UTIs. Métodos. Estudo de validação realizado em três fases: na primeira fase, o conceito de satisfação de acompanhantes de pacientes internados em UTIs foi definido por meio do método de análise qualitativa de conteúdo; na segunda fase, os primeiros itens do questionário foram gerados a partir dos resultados da primeira fase; e na terceira fase, a validação do questionário foi avaliada por meio da validade de face, de conteúdo e de construto, bem como da confiabilidade. Resultados. Na análise fatorial exploratória, três subescalas foram extraídas, incluindo: satisfação com a comunicação da equipe de enfermagem (5 itens), satisfação com a assistência de enfermagem (12 itens) e satisfação com a tomada de decisões (5 itens) com um valor Eigen maior que um e uma carga fatorial maior que 0.5. A consistência interna e a estabilidade do questionário desenvolvido foram confirmadas com 0.94 e 0.95, respectivamente, indicando confiabilidade aceitável. Conclusão. O questionário de 22 itens desenvolvido é válido e confiável para medir os níveis de satisfação dos acompanhantes de pacientes iranianos hospitalizados em UTI.

The Effect of an Educational Intervention Based on the Health Action Process Approach on Nurses' Communication Skills / Efecto de una intervención educativa basada en el enfoque del proceso de acción en salud sobre las habilidades comunicativas de las enfermeras / Efeito de uma intervenção educativa baseada na abordagem do processo de ação em saúde nas habilidades de comunicação do enfermeiro. Estudo quase experimental com grupo controle

Objective. This study aimed to the effects of the Health Action Process Approach (HAPA) in promoting the quality of nurses' communication skills among nurses. Methods.The present quasi-experimental research was conducted on 148 nurses (76 in the intervention and 72 in the control group) in Yazd province (Iran). In this study, the total number of nurses in one hospital was selected as the intervention group, while the nurses from another hospital were chosen as the control group. The participants were recruited from public hospitals in Ardakan and Meibod cities. The data collection instrument was a questionnaire based on the Health Action Process Approach (HAPA) Constructs and a communicative skill questionnaire. The data were collected from the two groups before, one month after, and four months after the intervention. The control group did not receive any educational training during the course of the study. Results. In the pretest, no statistically significant difference was found between the intervention and control groups regarding the behavioral stages of effective communication with patients. In the posttest, the mean task self-efficacy score was significantly increased in the intervention group compared to the control (p<0.001). The mean coping self-efficacy score was also significantly higher in the intervention group than the control in the posttest (p<0.001). Moreover, the mean coping planning score was significantly increased in the post-test intervention group(p<0.001). The mean communicative skill score was also significantly increased in the intervention group compared to the post-test control (p=0.03). Conclusion. The intervention used in the present study based on the target model (HAPA) significantly affected nurses' self-efficacy and communicative skills in the experimental group.

Objetivo. Evaluar el efecto del enfoque del proceso de acción sanitaria (Health Action Process Approach (HAPA), en inglés) en la promoción de la calidad de las habilidades de comunicación de las enfermeras. Métodos. La presente investigación cuasiexperimental se llevó a cabo con 148 enfermeras (76 en el grupo de intervención y 72 en el de control) de la provincia de Yazd (Irán). Los participantes fueron reclutados en los hospitales públicos de las ciudades de Ardakan y Meibod. El instrumento de recogida de datos fue un cuestionario basado en los constructos HAPA y un cuestionario de habilidades comunicativas. Se recogieron datos de los dos grupos antes, un mes después y cuatro meses después de la intervención. El grupo de control no recibió ninguna formación educativa durante el estudio. Resultados. En la preprueba, no se encontraron diferencias estadísticamente significativas entre los grupos de intervención y de control en cuanto a las etapas conductuales de la comunicación eficaz con los pacientes. En la prueba posterior, la puntuación media de autoeficacia en la tarea aumentó significativamente en el grupo de intervención en comparación con el grupo de control (p<0.001). La puntuación media de autoeficacia en el afrontamiento también fue significativamente mayor en el grupo de intervención que en el grupo de control en el postest (p<0.001). Además, la puntuación media en planificación del afrontamiento aumentó significativamente en el grupo de intervención después de la prueba (p<0.001). La puntuación media en habilidades comunicativas también aumentó significativamente en el grupo de intervención en comparación con el grupo de control después de la prueba (p=0.03). Conclusión.La intervención utilizada en el presente estudio basada en el modelo HAPA mejoró significativamente la autoeficacia y las habilidades comunicativas de las enfermeras del grupo experimental.

Objetivo. Avaliar o efeito da Abordagem do Processo de Ação em Saúde (HAPA) na promoção da qualidade das habilidades de comunicação dos enfermeiros. Métodos. A presente pesquisa quase-experimental foi realizada com 148 enfermeiros (76 no grupo de intervenção e 72 no grupo de controle) da província de Yazd (Irã). Os participantes foram recrutados em hospitais públicos nas cidades de Ardakan e Meibod. O instrumento de coleta de dados foi um questionário baseado nos construtos do HAPA e um questionário de habilidades de comunicação. Os dados foram coletados dos dois grupos antes, um mês depois e quatro meses após a intervenção. O grupo de controle não recebeu nenhum treinamento educacional durante o estudo. Resultados. No pré-teste, não foram encontradas diferenças estatisticamente significativas entre os grupos de intervenção e controle em termos de estágios comportamentais da comunicação eficaz com os pacientes. No pós-teste, a pontuação média de autoeficácia na tarefa aumentou significativamente no grupo de intervenção em comparação com o grupo de controle (p<0.001). A pontuação média de autoeficácia de enfrentamento também foi significativamente maior no grupo de intervenção do que no grupo de controle no pós-teste (p<0.001). Além disso, a pontuação média do planejamento de enfrentamento aumentou significativamente no grupo de intervenção após o pós-teste (p<0.001). A pontuação média em habilidades de comunicação também aumentou significativamente no grupo de intervenção em comparação com o grupo de controle no pós-teste (p=0.03). Conclusão. A intervenção usada no presente estudo com base no modelo HAPA melhorou significativamente a autoeficácia e as habilidades de comunicação dos enfermeiros do grupo experimental.

Network meta-analysis of pembrolizumab as monotherapy and in combination with chemotherapy for first-line treatment of recurrent or metastatic head and neck squamous cell carcinoma / Metanálise em rede comparativa de pembrolizumabe como monoterapia e em combinação com quimioterapia para tratamento de primeira linha de carcinoma de células escamosas da cabeça e pescoço recorrente ou metastático

Pembrolizumab monotherapy or in combination with chemotherapy is approved as first-line treatment in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) based on improved overall survival (OS) versus EXTREME regimen in the KEYNOTE-048 trial. The clinical outcomes of pembrolizumab were compared with other recommended first-line treatments in R/M HNSCC in this study through a Bayesian network meta-analysis. A systematic literature review was conducted in July 2022, from which six trials that matched the KEYNOTE-048 patient eligibility criteria were included in the network. The OS and progression-free survival (PFS) outcomes were compared in the approved pembrolizumab indication (i.e., total population for pembrolizumab in combination with chemotherapy and combined positive score [CPS] ≥ 1 population for pembrolizumab monotherapy). A significant OS improvement was observed for pembrolizumab in combination with chemotherapy and pembrolizumab monotherapy versus EXTREME regimen (hazard ratio, 95% credible interval: 0.72, 0.60-0.86; 0.73, 0.60-0.88), platinum+5- FU (0.58, 0.43-0.76; 0.58, 0.44-0.78), and platinum+paclitaxel (0.53, 0.35-0.79; 0.53, 0.35-0.81), respectively. A non-significant numeric trend in OS improvement was observed versus the TPEx regimen. PFS was comparable with most first-line treatments and was improved versus platinum+5-FU (0.48, 0.36-0.64; 0.59, 0.45-0.79). Additional analyses in higher CPS subgroups also showed consistent results. Overall, our study results showed an improvement in OS outcomes versus alternative first-line treatments, consistent with the findings of the KEYNOTE-048 trial. These data support using pembrolizumab as a suitable firstline treatment option in R/M HNSCC.

Pembrolizumabe em monoterapia ou em combinação com quimioterapia é aprovado como tratamento de primeira linha em carcinoma de células escamosas recorrente/metastático de cabeça e pescoço (CECCP R/M) com base na melhora da sobrevida global (OS), em comparação com o esquema EXTREME no estudo KEYNOTE-048. Esse estudo comparou os resultados clínicos de pembrolizumabe com outros tratamentos recomendados de primeira linha em CECCP R/M por meio de uma metanálise de rede bayesiana. Uma revisão sistemática da literatura foi conduzida em julho de 2022, a partir da qual seis ensaios clínicos que atendiam aos critérios de elegibilidade de pacientes do KEYNOTE-048 foram incluídos na rede. Os desfechos de OS e sobrevida livre de progressão (PFS) foram comparados na indicação de pembrolizumabe (população total para pembrolizumabe em combinação com quimioterapia e população com escore positivo combinado [CPS] ≥ 1 em monoterapia com pembrolizumabe). Foi observada melhora significativa na OS para pembrolizumabe em combinação com quimioterapia e monoterapia com pembrolizumabe versus o esquema EXTREME (razão de risco, intervalo de confiança de 95%: 0,72, 0,60-0,86; 0,73, 0,60-0,88), platina+5-FU (0,58, 0,43-0,76; 0,58, 0,44-0,78) e platina+paclitaxel (0,53, 0,35-0,79; 0,53, 0,35-0,81), respectivamente. Uma tendência numérica não significativa de melhoria na OS foi observada em relação ao esquema TPEx. A PFS foi comparável com a maioria dos tratamentos de primeira linha e melhor em relação à platina+5-FU (0,48, 0,36-0,64; 0,59, 0,45-0,79). Análises adicionais em subgrupos com CPS mais elevado também mostraram resultados consistentes. No geral, os resultados de nosso estudo mostraram melhora nos desfechos de OS em comparação aos tratamentos de primeira linha alternativos, consistentes com os achados do estudo KEYNOTE-048. Esses dados apoiam o uso de pembrolizumabe como opção de tratamento em primeira linha em pacientes com CECCP R/M.

Community-acquired neonatal SARS-CoV-2 infection: case report / Infecção neonatal por SARS-CoV-2 adquirida na comunidade: relato de caso / Infección neonatal por SARS-CoV-2 adquirida en la comunidad: reporte de caso

Background and Objectives: Data collection on the incidence of COVID-19 is conducted less frequently in newborns (NB) than in adults. In view of the small number of described neonatal SARS-CoV-2 infections, in this study, we report a clinical case of community-acquired COVID-19 infection in a newborn. Methods: Clinical characteristics were collected from the medical records from April 2021 until the final outcome of the newborn in May 2021. Results: This article discusses the case of a full-term male newborn aged 38 weeks. On the 17th day of life, this newborn was admitted to the pediatric unit with fever and zone 4 jaundice, mild lower chest retraction and tachypnea. The mother was diagnosed with COVID-19. Late neonatal sepsis with pulmonary focus was detected. The newborn was hospitalized and the antigen test for COVID-19 came back positive. The condition of the neonate rapidly deteriorated and he was referred to the neonatal intensive care unit (NICU), where he was intubated and placed on pressure-controlled mechanical ventilation. During his second week in the NICU, he developed severe pulmonary hypertension with decreased peripheral oxygen saturation and tachycardia. The newborn required blood transfusion and was put into prone position during part of the treatment. Reductions in mechanical ventilation parameters were not tolerated by the NB's organism and he developed progressive hypoxemia. The newborn died 1 month and 3 days after hospitalization. Conclusion: Our study shows a case of community-acquired COVID-19 that progressed to the severe form of the disease.(AU)

Justificativa e Objetivos: A coleta de dados sobre a ocorrência de covid-19 em recém-nascidos (RN) não é tão frequente quanto em adultos. Portanto, devido ao baixo número de infecções neonatais por SARS-CoV-2 descritas, relatamos, neste estudo, um caso clínico de infecção por covid-19 adquirida na comunidade em um recém-nascido. Métodos: As características clínicas foram coletadas dos prontuários desde abril de 2021 até o último desfecho do RN, em maio de 2021. Resultados: Este artigo abordará um RN do sexo masculino, a termo, com 38 semanas. No 17º dia de vida, o RN deu entrada na unidade pediátrica com quadro de febre e icterícia zona 4, leve retração torácica inferior e taquipneia. A mãe foi diagnosticada com covid-19. Foi detectada sepse neonatal tardia com foco pulmonar. O RN foi internado e o teste de antígeno para covid-19 foi positivo. O quadro do RN regrediu rapidamente, sendo encaminhado à unidade de terapia intensiva neonatal (UTIN), onde foi entubado e adaptado à ventilação mecânica em modo pressão controlada. Na segunda semana de internação na UTIN, desenvolveu hipertensão pulmonar grave com diminuição da saturação periférica de oxigênio e taquicardia. O RN necessitou de transfusão sanguínea e a posição prona foi realizada por períodos. Reduções nos parâmetros do ventilador mecânico não foram toleradas e o RN apresentou hipoxemia progressiva. O RN faleceu um mês e três dias após a internação. Conclusão: Nossos achados apresentam um caso de covid-19 adquirida na comunidade que evoluiu para a forma grave da doença.(AU)

Justificación y Objetivos: La recolección de datos sobre los contagios por covid-19 en recién nacidos (RN) no es tan frecuente como en adultos. En este contexto, y debido al bajo número de infecciones neonatales por SARSCoV-2 descritas, en este estudio se describe un caso clínico de infección posnatal por covid-19 en un recién nacido en la comunidad. Métodos: Se recogieron características médicas de las historias clínicas desde abril de 2021 hasta el último resultado del RN en mayo de 2021. Resultados: Este artículo reporta el caso de un RN del sexo masculino, a término de 38 semanas. Al 17.º día de vida, el RN ingresó a la unidad de pediatría con fiebre e ictericia zona 4, leve retracción torácica inferior y taquipnea. La madre dio positivo para covid-19. En el RN se detectó sepsis neonatal tardía con foco pulmonar. Lo hospitalizaron, y la prueba de antígenos para covid-19 dio como resultado positivo. El estado del RN empeoró rápidamente, lo remitieron a la unidad de cuidados intensivos neonatales (UCIN), donde requirió intubación y ventilación mecánica controlada por presión. En la segunda semana en la UCIN, desarrolló hipertensión pulmonar grave con disminución de la saturación periférica de oxígeno y taquicardia. El RN requirió transfusión sanguínea, y lo pusieron en posición prona por períodos. El paciente no soportó las reducciones en los parámetros del ventilador mecánico y presentó una hipoxemia progresiva. El RN falleció un mes y tres días después de la hospitalización. Conclusión: Los hallazgos muestran un caso del covid-19 adquirido en la comunidad que progresó a la forma grave de la enfermedad.(AU)

Importancia de las determinaciones inmunohematológicas en el control prenatal de gestantes con grupo sanguíneo RhD negativo

La guía para la atención prenatal es el marco regulatorio de las normas de obstetricia para el control y cuidado de las gestantes, con énfasis en aquellas que poseen el grupo sanguíneo RhD negativo. La aloinmunización por anti-D es la causa más frecuente y grave de la enfermedad hemolítica del recién nacido. Para un diagnóstico temprano de la embarazada con dicho grupo sanguíneo, resulta necesario determinar los anticuerpos antieritrocitarios involucrados. En la presente comunicación se resalta la función del laboratorio de inmunohematología en el seguimiento de la gestante con grupo de sangre RhD negativo.

The guide for prenatal care is the regulatory mark of obstetrics norms for the control and care of pregnant women, with emphasis on those who have the RhD negative blood group. Alloimmunization by anti-D is the most frequent and serious cause of hemolytic disease of the newborn. For an early diagnosis of the pregnant woman with said blood group, it is necessary to determine the red blood cell antibodies involved. This communication highlights the role of the immunohematology laboratory in the follow-up of pregnant woman with RhD negative blood type.

The value of exponential apparent diffusion coefficient value in predicting progression-free survival in patients with FIGO stage Ⅰ/Ⅱ cervical cancer / 实用放射学杂志

Objective To explore the correlation between exponential apparent diffusion coefficient(eADC)value before radical hysterectomy and postoperative clinical results in patients with International Federation of Gynecology and Obstetrics(FIGO)stageⅠ/Ⅱ cervical cancer,and to find MR quantitative indicators for predicting the prognosis of patients with early stage cervical cancer.Methods Patients with FIGO stage Ⅰ/Ⅱ cervical cancer who underwent surgical treatment were retrospectively collected.All patients underwent MRI plain scan and diffusion weighted imaging(DWI)scan before surgery.Baseline parameters included age,menopause,stage,tumor size,pathological differentiation and type,lymph node involvement,and postoperative adjuvant therapy.MR parameters included mean apparent diffusion coefficient(ADCmean),normalized apparent diffusion coefficient(nADC),eADC,SIDWI,and SIT2.Baseline and MRI parameters associated with recurrence were determined by Cox regression analysis.Results The progression-free survival(PFS)in the low eADC group was longer than that in the high eADC group(P=0.010).Univariate analysis showed that ADC,nADC and eADC were associated with recurrence(P<0.05).In multivariate analysis,only eADC[hazard ratio(HR)3.610;95%confidence interval(CI)1.467-8.886;P=0.005]was associated with recurrence.Conclusion Preoperative eADC is associated with PFS in patients with surgically treated FIGO stage Ⅰ/Ⅱ cervical cancer and is helpful in evaluating the prognosis of patients with cervical cancer.

Antibiotic resistance modulation of Clostridium perfringens type D using indigenous plants extracts

Aims@#The study was aimed to explore the antimicrobial potential of ethanolic leaf extracts of Eucalyptus globulus, Moringa oliefera, Syzygium cumini and Citrus limon against antibiotic-resistant Clostridium perfringens type D (n=5).@*Methodology and results@#Antibiotic resistance pattern of C. perfringens type D isolates against tetracycline, gentamicin, ceftriaxone, amoxicillin and streptomycin was evaluated by disc diffusion method. Well diffusion and micro broth dilution methods were used to determine the anti-bacterial activity, sub-inhibitory concentrations and antibiotic resistance modulating effects of the plant extracts. Ethanolic extract of E. globules was selected to evaluate its modulatory impact and subjected to GC-MS analysis to separate and identify the phytochemicals. The results showed that the isolates were resistant to gentamicin (0 ± 0.00 mm), streptomycin (0 ± 0.00 mm), tetracycline (13.2 ± 2.28 mm) and ceftriaxone (0 ± 0.00 mm) while sensitive to amoxicillin (23.8 ± 1.30 mm) and tetracycline (13.2 ± 2.28 mm). Eucalyptus globulus exhibited the maximum anti-bacterial activity with a zone of inhibition (ZOI) of 14.6 ± 0.54 mm and minimum inhibitory concentration (MIC) (1500 ± 947.85 µg/mL). Other plant extracts (M. oliefera, S. cumini and C. limon) also showed anti-bacterial activity but couldn’t modulate the resistance. The activity of ceftriaxone associated with E. globulus extract was improved with 20.2 ± 0.20 mm ZOI at 78.125 µg/mL sub-inhibitory concentration.@*Conclusion, significance and impact of study: @#The study results indicate the possible use of the ethanolic extract of E. globulus alone or in combination with common antibiotics for the treatment of C. perfringens infections in small ruminants.

Molecular differentiation of coagulase-positive staphylococcal isolates carrying mecA- and PVL-encoding genes among healthy males

Aims@#This study was aimed to monitor the asymptomatic carriage of coagulase-positive staphylococcal bacteria among university male students and detect the prevalence of virulence marker genes that encode methicillin resistance (mecA) and Panton-Valentine leukocidin (PVL) toxin among the isolates.@*Methodology and results@#Single nasal swaps were collected from 144 participating students who resided at four different locations within Al-Madinah city. A total of 112 Gram-positive staphylococcal isolates were recovered from the 144 participants (carriage rate of 77.8%). Coagulase-positive staphylococci were differentiated using duplex PCR amplification of the 16S rRNA and nuc genes and accounted for 30 isolates (carriage rate of 20.8%). These isolates were most prevalent in the northern and southern parts of Al-Madinah city, while the lowest numbers of isolates were detected in students of the eastern part. Coagulase-positive isolates were further phenotypically characterized for methicillin resistance by the disc diffusion method. Uniplex PCR assays were conducted to screen for mecA- and PVL toxin-encoding genes. The mecA gene was amplified from all 15 (50%) methicillin-resistant coagulase-positive isolates, while the PVL toxin-encoding gene was detected in 19 isolates (63.3%), 10 (33.3%) of which contained the mecA gene. Lastly, PCR amplification of the NRPS gene from coagulase-positive isolates revealed the absence of Staphylococcus argenteus, the recently discovered genetically divergent lineage of Staphylococcus aureus.@*Conclusion, significance and impact of study@#An elevated prevalence of coagulase-positive isolates harboring mecA and PVL virulence genes was observed compared with previous investigations. This poses a potential threat if they spread among the population, resulting in outbreaks of community-acquired infections.

Preparation of anti-staphylococcal packaging material using antimicrobial metabolite from Lactiplantibacillus plantarum strain N1 isolated from fermented sausage from Egypt

Aims@#This study was aimed to produce biodegradable cellulose acetate films impregnated with bacteriocin-like inhibitory substances to be used in food packaging.@*Methodology and results@#Bacterial isolates were isolated from different sources and tested for their antimicrobial activity by agar well diffusion assay. The isolate that showed the highest antimicrobial activity against Staphylococcus aureus ATCC 29213, Escherichia coli ATCC 51659, Pseudomonas aeruginosa MG847103 and Streptococcus mutans ATCC 25175 was identified as Lactiplantibacillus plantarum strain N1 (OM019104) based on 16S rRNA based method of identification. The extracted bacteriocin-like inhibitory substances were partially purified with acetone precipitation and SP-Sephroase cation exchange chromatography. There was no change in the antimicrobial activity after treatment with the catalase enzyme, but there was a total loss in the activity after treatment with proteolytic enzymes. The obtained bacteriocin-like inhibitory substances showed pH stability over a wide range of pH values and thermal stability as it recovered 95% of its antimicrobial activity even after autoclaving for 15 min. Different concentrations of cellulose acetate (3 to 12%) were tested to develop the active antimicrobial films. The most flexible concentrations for food packaging were prepared and impregnated with partially purified bacteriocin-like inhibitory substances. The prepared films showed promising antimicrobial activity against S. aureus. @*Conclusion, significance and impact of study@#This study highlights the usage of active packaging in food preservation. Cellulose acetate films activated with the partially purified bacteriocin-like inhibitory substances have anti-staphylococcal activity, which can potentially be used in food packaging to prolong the shelf-life of perishable foo

Pyronaridine combined with diminazene aceturate inhibits Babesia in vitro and in vivo

@#Objective: To evaluate the combination therapy of pyronaridine tetraphosphate and diminazene aceturate against Babesia in vitro and in vivo. Methods: Bioinformatic analysis was performed using atom pair fingerprints. An in vitro combination test was performed against Babesia bovis and Theileria equi. Moreover, the in vivo chemotherapeutic efficacy of pyronaridine tetraphosphate in combination with diminazene aceturate was investigated against the growth of Babesia microti in mice using a fluorescence inhibitory assay. Results: Pyronaridine tetraphosphate and diminazene aceturate exhibited nearly similar molecular weights. The in vitro combination of pyronaridine tetraphosphate and diminazene aceturate was synergistic on Babesia bovis and additive on Theileria equi. In addition, 5 mg/kg pyronaridine tetraphosphate combined with 10 mg/kg diminazene aceturate inhibited Babesia microti growth significantly compared with those observed after treatment with 25 mg/kg diminazene aceturate alone from day 6 post treatment to day 12 post treatment. The combination therapy also normalized the hematological parameters of infected mice. Conclusions: An oral dose of pyronaridine tetraphosphate combined with a subcutaneous dose of diminazene aceturate inhibits Babesia in vitro and in mice, suggesting it might be a new paradigm for the treatment of babesiosis.

Primary hyperparathyroidism during pregnancy: Two tales with different outcomes / Journal of the ASEAN Federation of Endocrine Societies

@#Primary hyperparathyroidism (PHPT) is rare in pregnancy. This condition is challenging to diagnose and manage due to the limited diagnostic and therapeutic options that are safe during pregnancy. If not diagnosed and managed in a timely manner, serious maternal and foetal complications may occur. We report two cases, one with surgical intervention and one without, to show the importance of timely surgical intervention and discuss the challenges in the management of PHPT in pregnancy.

Association between prosthesis use to the physical functioning and quality of life among adult unilateral lower limb amputees: An analytical cross-sectional study / Health Sciences Journal

Introduction@#A prosthesis is an artificial assistive device designed to replace a missing body part (e.g., limb), secondary to a disease, injury or congenital deformities. Prostheses are often used to restore functional capacity while improving the quality of life (QoL). @*Methods@#An analytical cross-sectional study was conducted among adults aged 19 to 64 years who were permanent residents in Luzon who had undergone unilateral lower leg amputation. This epidemiologic study employed the Modified Barthel Index for activities of daily living (ADLs), the Frenchay Activities Index for instrumental activities of daily living (IADLs), and the WHOQOL-BREF for QoL. Descriptive and analytical statistics of the responses of the Lower Limb Amputees (LLA) were done. Prevalence odds ratio (POR) was calculated, and statistical significance was determined.@*Results@#Among 165 LLA respondents, only 47.88% used prostheses. Unilateral LLA who exhibited greater independence in ADLs (POR=19.22), more actively performed IADLs (POR=5.51), and had good QoL (POR=3.83) were more likely to have been using prosthesis. All these findings were statistically significant. @*Conclusion@#This study revealed a statistically significant association between prosthesis use to the physical functioning and QoL among adult unilateral LLAs. It showed that prosthetic use was likely linked with improved performance in ADLs and IADLs, and better QoL compared to those without.

Unraveling the Sugar Rush: A Cross-sectional Study of Knowledge, Attitudes, and Practices Related to Sugar- Sweetened Beverages Consumption among Malaysian Young Adults

@#Introduction: The consumption of sugar-sweetened beverages (SSBs) among young adults in Malaysia has witnessed a notable increase in recent years, giving rise to concerns regarding the potential adverse health effects, including obesity and diabetes. Despite the urgent need for targeted interventions, there is a dearth of research examining the knowledge, attitudes, and practices (KAP) related to SSBs among Malaysian young adults. To address this research gap, the present study aims to assess the level of KAP concerning SSB intake and its associated factors in this specific population. Methods: A cross-sectional study was conducted involving 408 Malaysian young adults aged between 15 and 29 years. Respondents completed an online questionnaire survey, which encompassed the assessment of socio-demographic characteristics and KAP regarding SSB consumption. The collected data were analyzed using IBM’s Statistical Package for the Social Sciences (SPSS) version 22.0. Spearman correlation tests were performed at a significance level of 0.05. Results: The majority of respondents demonstrated moderate knowledge (60%) and practices (60%), while exhibiting a high positive attitude (100%) towards reducing SSB consumption. Significant correlations were observed between knowledge and attitude (p = 0.003, rs = 0.148) and between knowledge and practice (p = 0.005, rs = 0.138). Moreover, the attitude scores were found to be significantly associated with gender (χ2 (1, N = 408) = 10.421, p = 0.001) and locality (χ2 (1, N = 408) = 4.106, p = 0.043), while the practice scores exhibited a significant association with ethnicity (p = 0.006). Conclusion: This study provides valuable insights into the relationship between KAP related to SSB consumption and socio-demographic factors among Malaysian young adults. The findings underscore the importance of utilizing these insights to develop strategic interventions that aim to curtail SSB consumption and promote a healthy lifestyle, ultimately contributing to the reduction of non-communicable diseases. Health authorities are encouraged to capitalize on these findings to design targeted interventions tailored to the unique needs and circumstances of this population.

Effect of corneoscleral lenses on visual acuity and corneal parameters in patients with keratoconus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the effect of wearing corneoscleral contact lens on visual acuity, and corneal parameters in keratoconus patients.METHODS:In this prospective study, 43 cases(83 eyes)with keratoconus were included and examined. A corneoscleral contact lens was fitted, and thorough exams were carried out at baseline, 3 and 6 mo after wearing lenses, including slit lamp examination, objective and subjective refraction, uncorrected visual acuity(UCVA), and best-corrected visual acuity(BCVA), keratometry(Kmax, K1 and K2), central corneal thickness and endothelial cells count.RESULTS: Mean BCVA(LogMAR)improved from 0.34±0.23 with the spectacles to 0.03±0.05 with the corneoscleral contact lenses in 6 mo(P&#x003C;0.001). Kmax changed from 52.80±5.93 D to 51.51±5.64 D in 6 mo(P&#x003C;0.001), central corneal thickness changed from 483.84±34.69 μm to 476.28±35.38 μm(P&#x003C;0.001), and endothelial cell count changed from 2559.18±275.7 cells/mm2 to 2572.73±274.3 cells/mm2 after wearing corneoscleral contact lens for 6 mo(P&#x003C;0.001).CONCLUSION: Corneoscleral lenses could significantly increase visual acuity, since there were no clinical noticeable changes in the corneal parameters, this lenses can be used safely in patients with keratoconus.

Deep learning-based radiomics allows for a more accurate assessment of sarcopenia as a prognostic factor in hepatocellular carcinoma / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Hepatocellular carcinoma (HCC) is one of the most common malignancies and is a major cause of cancer-related mortalities worldwide (Forner et al., 2018; He et al., 2023). Sarcopenia is a syndrome characterized by an accelerated loss of skeletal muscle (SM) mass that may be age-related or the result of malnutrition in cancer patients (Cruz-Jentoft and Sayer, 2019). Preoperative sarcopenia in HCC patients treated with hepatectomy or liver transplantation is an independent risk factor for poor survival (Voron et al., 2015; van Vugt et al., 2016). Previous studies have used various criteria to define sarcopenia, including muscle area and density. However, the lack of standardized diagnostic methods for sarcopenia limits their clinical use. In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP) renewed a consensus on the definition of sarcopenia: low muscle strength, loss of muscle quantity, and poor physical performance (Cruz-Jentoft et al., 2019). Radiological imaging-based measurement of muscle quantity or mass is most commonly used to evaluate the degree of sarcopenia. The gold standard is to measure the SM and/or psoas muscle (PM) area using abdominal computed tomography (CT) at the third lumbar vertebra (L3), as it is linearly correlated to whole-body SM mass (van Vugt et al., 2016). According to a "North American Expert Opinion Statement on Sarcopenia," SM index (SMI) is the preferred measure of sarcopenia (Carey et al., 2019). The variability between morphometric muscle indexes revealed that they have different clinical relevance and are generally not applicable to broader populations (Esser et al., 2019).