bluuebunny/crossref_metadata_2025 huggingface dataset:
Film(i) Culture after Film: Lip-sync Media and the Expanded Archive of Hindi Cinema
Authors: Chakravarty Amrita
Published: November 2023

This article considers the remediation of Hindi cinema’s filmi culture in the citational practices of digital media. Foregrounding a case study of the lip-sync video on platforms such as Dubsmash and TikTok, it traces the formation of an expanded archive of Hindi cinema, one which reveals this cinema as less a canon of films than a repertoire of gestures, expressions and style offered up for use to a non-traditional cinephiliac public. The article argues, however, that such an archival view of a historical filmi culture is possible only because of the recession of a filmi culture organised around the sign of cinema to one organised around the sociality of platforms. Among other things, it attributes this shift to the passing of the masala film. The article then pays particular attention to this form as an assemblage of detachable parts primed for circulation. It finally addresses the emergence of a new industrial reflexivity in response to the currency of filmi style in an age of platforms.
Nursing Support for Caregiver Burden in Family Caregivers of Patients With Cancer: A Scoping Review
Authors: Kajiwara Kohei , Kobayashi Masamitsu , Morikawa Miharu , Kanno Yusuke , Nakano Kimiko , Matsuda Yoshinobu , Shimizu Yoichi , Shimazu Taichi , Kako Jun
Published: November 2023

Purpose: To identify nursing support for caregiver burden in family caregivers of patients with cancer. Methods: This scoping review was guided by Arksey and O’Malley’s six-stage scoping review framework. All available published articles from database inception to July 31, 2023 were systematically searched through PubMed, CINAHL, CENTRAL, and Ichushi-Web of the Japan Medical Abstract Society databases with additional relevant studies from the article list. Each key journal was manually searched. Results: Overall, 502 articles were screened, and 34 were finally included. The results of the qualitative thematic analysis were categorized into 7 components of nursing support: psychological and educational support, psychological and educational support using mainly non-face-to-face (Information and Communication Technology), psychological and educational support mainly using non-face-to-face (telephone) methods, mindfulness to support, support aimed at reducing caregiver stress, support for both patients and caregivers, and others. Of the 34 studies, 23 were randomized controlled trials (RCT), and the remaining 11 were non-RCTs. Conclusion: The results of the scoping review categorized nursing support for caregiver burden in the family caregivers of patients with cancer into 7 components. Future research should examine the feasibility of implementing these components.
Acute infusion-related reactions in pediatric patients receiving etoposide at a tertiary cancer center
Authors: McBride Patrick , Degar Barbara
Published: November 2023

Introduction

Etoposide is a key component of many pediatric chemotherapy regimens for both hematologic and solid tumors. It is well documented that patients receiving etoposide may experience infusion-related reactions.

Methods

In this study, total doses of etoposide and etoposide phosphate were identified, and infusion-related reactions were retrospectively evaluated at a large pediatric oncology ambulatory clinic. The primary outcome was to determine the rate of acute infusion-related reactions to etoposide. A secondary objective was to identify potential risk factors associated with such reactions.

Results

Overall, 1463 doses of etoposide were dispensed to 150 unique patients and 15 patients (10%) experienced etoposide infusion-related reactions. Of the 15 patients that experienced etoposide infusion-related reaction, two were successfully able to tolerate subsequent infusions with a slower etoposide infusion rate and pre-medications. The remaining patients changed drug formulation to etoposide phosphate ( n = 12) or continued therapy without any formulation of etoposide ( n = 1). Patients with classical Hodgkin's lymphoma experienced a higher incidence of infusion-related reactions compared to the overall patient population (30.5% vs. 10%) and made up 73.3% of all infusion-related reactions during the study period.

Conclusions

During the examined study period, 10% of patients experienced an acute infusion-related reaction to etoposide. This review builds on previous literature concluding that additional monitoring may be warranted in patients with classical Hodgkin's lymphoma receiving etoposide.
Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators
Authors: Kurbatfinski Stefan , Letourneau Nicole , Dewey Deborah , Hayes Andrew F. , Hayden K. Alix , Anis Lubna , Dosani Aliyah
Published: November 2023

Background

Adverse childhood experiences (ACEs) are pernicious events (e.g., physical abuse) that occur before 18 years of age within the household. Mothers’ ACEs are associated intergenerationally with their preschool children’s (two-to-five-year-old) behavioural problems, impacting lifelong mental health trajectories. Mediators (e.g., mental health) may explain how mothers’ ACEs exert their influence on children's behavioural development whereas moderators (e.g., child sex) may affect the strength and direction of the association, revealing potential points of intervention. Therefore, this study aimed to: (1) identify mediators and moderators of this association; and (2) describe and compare moderation and mediation outcomes.

Methods

This review (#CRD42022307214) extracted data from peer-reviewed literature formally analyzing at least one moderating or mediating variable of the association between maternal ACEs and preschool children’s behavioural problems using MEDLINE, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, SCOPUS, and Web of Science databases (n = 7). Validity was assessed using the Joanna Briggs Institute checklists.

Results

Thirteen full-text studies with moderate-to-high validity were identified. Most studies examined mediating variables, with unanimous support for mediation through maternal depression. The mediating roles of adult attachment styles and anxiety were conflicting. No studies examined environmental factors (e.g., neurotoxins).

Conclusions

Mothers’ depression is a significant contributor to children’s behavioural problems in the context of ACEs and should be a target of early intervention to prevent lifelong challenges. Future research should focus on examining more moderating variables and consider the roles of environmental factors. More research is needed on the moderating and mediating roles of genes.
Peptic ulcer disease burden, trends, and inequalities in 204 countries and territories, 1990–2019: a population-based study
Authors: Zhang Zhongmian , Yan Weitian , Zhang Xiyan , Wang Jiaqi , Zhang Zhonghan , Lin Zili , Wang Lan , Chen Jiaqin , Liu Daming , Zhang Wen , Li Zhihong
Published: November 2023

Background:

Peptic ulcer disease has been a major threat to the world’s population, which remains a significant cause of hospitalization worldwide and healthcare resource utilization.

Objectives:

We aimed to describe the global burden, trends, and inequalities of peptic ulcer disease.

Design:

An observational study was conducted.

Methods:

In this secondary analysis of the Global Burden of Disease, Injuries, and Risk Factors Study 2019, we extracted data for age-standardized incidence rates (ASIRs), disability-adjusted life year rates (ASDRs), and mortality rates (ASMRs); then, we stratified by age, level of regionals, and country; subsequently, we calculated estimated annual percentage changes (EAPC) of ASIR, ASDR, ASMR, and quantified cross-country inequalities in peptic ulcer disease mortality.

Results:

Globally, ASIR showed a continuous downward trend, from 63.84 in 1990 to 44.26 per 100,000 population in 2019, with an annual decrease of 1.42% [EAPC = −1.42 (95% CI: −1.55 to −1.29)]. ASDR showed a continuing downward trend, and the EAPC was −3.47% (−3.58 to −3.37). ASMR showed a persistent decline, declining by nearly half in 2019 compared to 1990 (3.0 versus 7.39 per 100,000 population), with an annual decrease of 2.55% [EAPC = −3.36 (95% CI: −3.47 to −3.25)]. A significant reduction in sociodemographic index (SDI)-related inequality, from an excess of 190.43 disability-adjusted life years (DALY) per 100,000 (95% CI: −190.83 to −190.02) between the poorest and richest countries in 1990 to 62.85 DALY per 100,000 (95% CI −62.81 to −62.35) in 2019.

Conclusion:

Global peptic ulcer disease morbidity and mortality rates decreased significantly from 1990 to 2019. These health gains were in accordance with a substantial reduction in the magnitude of SDI-related inequalities across countries, which is paired with overall socioeconomic and health improvements observed in the region.
Changes in the physiological activity of parenchyma cells in Dalbergia odorifera xylem and its relationship with heartwood formation
Authors: Ma Ruoke , Luo Jia , Wang Weijie , Fu Yunlin
Published: November 2023

Background

The formation of a tree’s heartwood gives the wood properties such as natural decay resistance and aesthetic color, and often directly determines the value of wood products. Regulating the quantity and quality of heartwood is of great importance to the use of wood. However, the mechanism of heartwood formation has been poorly understood.

Results

Using Dalbergia odorifera as the study species, the number of starch grains, the morphology of the nuclei, the changes in the content of water and secondary metabolites were observed continuously in the radial direction of the xylem. The results show that from the outer toward inner sapwood, the starch grains are abundant, the length to diameter ratio of the nuclei is decreasing, and the morphology changes from elongated elliptical and then to round. In the outer transition zone, the starch grains begin to decrease abruptly and the nuclei shrink at a slower rate, with a radial width of approximately 2 mm. In the inner transition zone, the heartwood color begins to appear, the starch grains disappear and a few nuclei with reduced fluorescence are present, with a radial width of approximately 1 mm. Heartwood formation after complete disappearance of the nuclei. The moisture content of the heartwood is higher than that of the sapwood, and the inner transition zone is where the content rises. The secondary metabolites of the heartwood begin to accumulate in large quantities in the inner transition zone.

Conclusion

Based on the physiological changes of parenchyma cells in the xylem, the radial width of the transition zone of Dalbergia odorifera is clearly defined as approximately 3 mm. Both the water and secondary metabolite abrupt changes occur at the final stage of programmed cell death, and neither is a direct cause of programmed cell death in parenchyma cells.
Personalized surveillance and aftercare for non-metastasized breast cancer: the NABOR study protocol of a multiple interrupted time series design
Authors: Klaassen-Dekker A. , Drossaert C. H. C. , Van Maaren M. C. , Van Leeuwen-Stok A. E. , Retel V. P. , Korevaar J. C. , Siesling S. ,   on behalf of the NABOR project group, Knottnerus B. , Guerrero-Paez C. , Burgers J. , Zeillemaker A. , Vrancken M. J. , Van Hezewijk M. , Siemerink E. , Honkoop A. , Veltman J. , Mann R. , Wiegersma J. , Claassen S. , Van der Lee M. , Van Uden N.
Published: November 2023

Background

Follow-up of curatively treated primary breast cancer patients consists of surveillance and aftercare and is currently mostly the same for all patients. A more personalized approach, based on patients’ individual risk of recurrence and personal needs and preferences, may reduce patient burden and reduce (healthcare) costs. The NABOR study will examine the (cost-)effectiveness of personalized surveillance (PSP) and personalized aftercare plans (PAP) on patient-reported cancer worry, self-rated and overall quality of life and (cost-)effectiveness.

Methods

A prospective multicenter multiple interrupted time series (MITs) design is being used. In this design, 10 participating hospitals will be observed for a period of eighteen months, while they -stepwise- will transit from care as usual to PSPs and PAPs. The PSP contains decisions on the surveillance trajectory based on individual risks and needs, assessed with the ‘Breast Cancer Surveillance Decision Aid’ including the INFLUENCE prediction tool. The PAP contains decisions on the aftercare trajectory based on individual needs and preferences and available care resources, which decision-making is supported by a patient decision aid. Patients are non-metastasized female primary breast cancer patients (N = 1040) who are curatively treated and start follow-up care. Patient reported outcomes will be measured at five points in time during two years of follow-up care (starting about one year after treatment and every six months thereafter). In addition, data on diagnostics and hospital visits from patients’ Electronical Health Records (EHR) will be gathered. Primary outcomes are patient-reported cancer worry (Cancer Worry Scale) and overall quality of life (as assessed with EQ-VAS score). Secondary outcomes include health care costs and resource use, health-related quality of life (as measured with EQ5D-5L/SF-12/EORTC-QLQ-C30), risk perception, shared decision-making, patient satisfaction, societal participation, and cost-effectiveness. Next, the uptake and appreciation of personalized plans and patients’ experiences of their decision-making process will be evaluated.

Discussion

This study will contribute to insight in the (cost-)effectiveness of personalized follow-up care and contributes to development of uniform evidence-based guidelines, stimulating sustainable implementation of personalized surveillance and aftercare plans.

Trial registration

Study sponsor: ZonMw. Retrospectively registered at ClinicalTrials.gov (2023), ID: NCT05975437.
The combination of PD-L1 expression and the neutrophil-to-lymphocyte ratio as a prognostic factor of postoperative recurrence in non-small-cell lung cancer: a retrospective cohort study
Authors: Samejima Hironobu , Kojima Kensuke , Fujiwara Ayako , Tokunaga Toshiteru , Okishio Kyoichi , Yoon Hyungeun
Published: November 2023

Background

While PD-L1 expression and neutrophil-to-lymphocyte ratio (NLR) are prognostic biomarkers for lung cancer, few studies have considered their interaction. We hypothesized that the product of PD-L1 expression (tumor proportion score) and the NLR (PD-L1 × NLR) might be a postoperative prognostic marker reflecting the immune microenvironment of lung cancer.

Methods

We analyzed the association between PD-L1 × NLR and postoperative recurrence-free survival in 647 patients with NSCLC using multivariable Cox proportional hazards models.

Results

In the analysis of PD-L1 × NLR as a categorical variable, the group with PD-L1 × NLR ≥ 25.8 had a significantly higher hazard ratio (HR) than the group with < 25.8 (adjusted HR 1.78, 95% confidence interval [CI] 1.23–2.60). The adjusted HR for PD-L1 × NLR, considered a continuous variable, was 1.004 (95% CI, 1.002–1.006). The risk of postoperative recurrence increased by 1.004-fold for each unit increase in PD-L1 × NLR, and a more than 2-fold increase in risk was observed for values ≥ 170.

Conclusions

PD-L1 × NLR may be used in real-world clinical practice as a novel factor for predicting the risk of postoperative recurrence after lung cancer surgery.
An explorative single-arm clinical study to assess craving in patients with alcohol use disorder using Virtual Reality exposure (CRAVE)—study protocol
Authors: Lütt A. , Tsamitros N. , Wolbers T. , Rosenthal A. , Bröcker A. L. , Schöneck R. , Bermpohl F. , Heinz A. , Beck A. , Gutwinski S.
Published: November 2023

Background

Alcohol use disorder (AUD) belongs to the most burdensome clinical disorders worldwide. Current treatment approaches yield unsatisfactory long-term effects with relapse rates up to 85%. Craving for alcohol is a major predictor for relapse and can be intentionally induced via cue exposure in real life as well as in Virtual Reality (VR). The induction and habituation of craving via conditioned cues as well as extinction learning is used in Cue Exposure Therapy (CET), a long-known but rarely used strategy in Cognitive Behavioral Therapy (CBT) of AUD. VR scenarios with alcohol related cues offer several advantages over real life scenarios and are within the focus of current efforts to develop new treatment options. As a first step, we aim to analyze if the VR scenarios elicit a transient change in craving levels and if this is measurable via subjective and psychophysiological parameters.

Methods

A single-arm clinical study will be conducted including n = 60 patients with AUD. Data on severity of AUD and craving, comorbidities, demographics, side effects and the feeling of presence in VR will be assessed. Patients will use a head-mounted display (HMD) to immerse themselves into three different scenarios (neutral vs. two target situations: a living room and a bar) while heart rate, heart rate variability, pupillometry and electrodermal activity will be measured continuously. Subjective craving levels will be assessed before, during and after the VR session.

Discussion

Results of this study will yield insight into the induction of alcohol craving in VR cue exposure paradigms and its measurement via subjective and psychophysiological parameters. This might be an important step in the development of innovative therapeutic approaches in the treatment of patients with AUD.

Trial registration

This study was approved by the Charité—Universitätsmedizin Berlin Institutional Review Board (EA1/190/22, 23.05.2023). It was registered on ClinicalTrials.gov (NCT05861843).
Low profile posterior lumbar-sacral interbody fusion for lumbosacral degenerative diseases: a technical note
Authors: Pan Aixing , Cheng Fengqi , Ding Zihao , Guan Li , Xie Wenguan , Hai Yong , Liu Yuzeng
Published: November 2023

Background

The purpose of this study was to report our surgical experience in patients with lumbosacral degenerative diseases who underwent posterior decompression and interbody fusion fixed with cortical bone trajectory screw and sacral alar screw, which is known as low-profile posterior lumbosacral interbody fusion (LP-PLSIF).

Methods

Patients with lumbosacral degenerative disease who underwent LP-PLSIF and traditional PLSIF (control group) internally fixed with pedicle screws were included retrospectively. Patients’ demographic data, operative parameters, and perioperative complications were recorded and analyzed.

Results

A total of 18 patients were enrolled in this study, which included 9 patients (5 male and 4 female) who underwent LP-PLSIF, and 9 patients (4 male and 5 female) who underwent traditional PLSIF. There wasn’t a significant difference in the average age between the two groups, 56.78 ± 10.92 years in the LP-PLSIF group and 60.22 ± 8.21 years in the PLSIF group (p = 0.460). The bone mineral density (BMD) of the two groups of patients were -2.00 ± 0.26 T and -2.13 ± 0.19 T, respectively (P = 0.239). The mean postoperative follow-up time was 12.7 months (range, 12–14 months). The mean operation time was 142.78 ± 11.21 min and 156.11 ± 13.41 min in the LP-PLSIF group and PLSIF group respectively (P < 0.05). The average blood loss was 137.78 ± 37.09 ml in the LP-PLSIF group, and 150.00 ± 27.84 ml in the PLSIF group (P = 0.441). The average postoperative drainage was 85.56 ± 37.45 ml and 122.22 ± 22.24 ml in the LP-PLSIF group and control group respectively (P < 0.05). Patients in the LP-PLSIF group had shorter incision length compared with the control group, 61.44 ± 10.56 mm vs. 74.56 ± 10.22 mm (P < 0.05). The average length of hospitalization of 11.33 ± 2.92 days in the LP-PLSIF group, and 11.11 ± 1.62 days in the PLSIF group (p = 0.844). All patients had significant improvement in VAS pain score, ODI, and JOA evaluation. However, patients in the LP-PLSIF group had better improvement in terms of VAS back pain and ODI in the short term after the operation. There were no neurological complications or wound infection. The fusion rate at the last follow-up was 100% (9 of 9) in the LP-PLSIF group, and 88.89% (8 of 9) in the control group based on CT scans. 1 patient in the control group had asymptomatic sacral pedicle screw loosening.

Conclusions

LP-PLSIF is a safe and effective surgical technique for patients with lumbosacral degenerative disease, which has the potential strength of less invasive and better clinical improvement.
A novel hypoxia-associated gene signature for prognosis prediction in head and neck squamous cell carcinoma
Authors: Luo Jingyi , Huang Yuejiao , Wu Jiahe , Dai Lin , Dong Mingyou , Cheng Bo
Published: November 2023

Background

Head and neck squamous cell carcinoma (HNSCC) is the most common malignant tumor of head and neck, which seriously threatens human life and health. However, the mechanism of hypoxia-associated genes (HAGs) in HNSCC remains unelucidated. This study aims to establish a hypoxia-associated gene signature and the nomogram for predicting the prognosis of patients with HNSCC.

Methods

Previous literature reports provided a list of HAGs. The TCGA database provided genetic and clinical information on HNSCC patients. First, a hypoxia-associated gene risk model was constructed for predicting overall survival (OS) in HNSCC patients and externally validated in four GEO datasets (GSE27020, GSE41613, GSE42743, and GSE117973). Then, immune status and metabolic pathways were analyzed. A nomogram was constructed and assessed the predictive value. Finally, experimental validation of the core genes was performed by qRT-PCR.

Results

A HNSCC prognostic model was constructed based on 8 HAGs. This risk model was validated in four external datasets and exhibited high predictive value in various clinical subgroups. Significant differences in immune cell infiltration levels and metabolic pathways were found between high and low risk subgroups. The nomogram was highly accurate for predicting OS in HNSCC patients.

Conclusions

The 8 hypoxia-associated gene signature can serve as novel independent prognostic indicators in HNSCC patients. The nomogram combining the risk score and clinical stage enhanced predictive performance in predicting OS compared to the risk model and clinical characteristics alone.
Separate and combined effects of famine exposure and menarche age on metabolic syndrome among the elderly: a cross-sectional study in China
Authors: Wang Congzhi , Wang Jiazhi , Wan Rui , Yuan Ting , Yang Liu , Zhang Dongmei , Li Xiaoping , Liu Haiyang , Zhang Lin
Published: November 2023

Background

Epidemiological studies have revealed multiple risk factors for metabolic syndrome. However, there are no consistent findings on the association between famine exposure, age at menarche, and the prevalence of metabolic syndrome. This cross-sectional study aimed to reveal the individual and combined effects of famine exposure and age at menarche on the prevalence of metabolic syndrome among elderly women.

Methods

Four thousand seven hundred seventy participants between 60 and 93 years of age were selected from the China Health and Retirement Longitudinal Study. Statistical differences between the baseline characteristics of famine exposure, age at menarche, and metabolic syndrome were evaluated using the t-test, F-test, and Chi-square test. Three multivariable-adjusted logistic regression models were used to test the association between famine exposure, age of menarche, and the odds ratio of metabolic syndrome.

Results

Two thousand one hundred ninety-eight (46.08%) participants had metabolic syndrome, while 2572 (53.92%) participants did not. Furthermore, 3068 (64.32%) women reported onset of menarche under 15 years of age, while 1702 (35.68%) women reported onset of menarche above 16 years of age. Regarding the separate association of famine exposure and age of menarche with metabolic syndrome, in model three, the adolescence/adulthood famine exposure group vs. no famine exposure group odds ratio was 2.45 (95% CI 2.02, 2.97), and the older than 16 years vs. younger than 15 years group odds ratio was 1.23 (95% CI 1.09, 1.39), which was the highest odds ratio among the three models. Regarding the combined association of famine exposure and age of menarche with metabolic syndrome, in model three, among the age of menarche ≤ 15 years group, the adolescence/adulthood famine exposure vs. no famine exposure group odds ratio was 2.45 (95% CI: 1.91, 3.14); among the menarche age ≥ 16 years group, the adolescence/adulthood famine exposure stages vs. exposed group odds ratio was 3.27 (95% CI: 2.44, 4.38), which was the highest odds ratio among the three models.

Conclusion

These findings suggested that famine exposure and age at menarche, either separately or in combination, were positively associated with the prevalence of metabolic syndrome among older women.
Health professionals’ and beauty therapists’ perspectives on female genital cosmetic surgery: an interview study
Authors: Kirkman Maggie , Dobson Amy , McDonald Karalyn , Webster Amy , Wijaya Pramasari , Fisher Jane
Published: November 2023

Background

Female genital cosmetic surgery (FGCS) changes the structure and appearance of healthy external genitalia. We aimed to identify discourses that help explain and rationalise FGCS and to derive from them possibilities for informing clinical education.

Methods

We interviewed 16 health professionals and 5 non-health professionals who deal with women’s bodies using a study-specific semi-structured interview guide. We analysed transcripts using a three-step iterative process: identifying themes relevant to indications for FGCS, identifying the discourses within which they were positioned, and categorising and theorising discourses.

Results

We identified discourses that we categorised within four themes: Diversity and the Normal Vulva (diversity was both acknowledged and rejected); Indications for FGCS (Functional, Psychological, Appearance); Ethical Perspectives; and Reasons Women Seek FGCS (Pubic Depilation, Media Representation, Pornography, Advertising Regulations, Social Pressure, Genital Unfamiliarity).

Conclusions

Vulvar aesthetics constitute a social construct to which medical practice and opinion contribute and by which they are influenced; education and reform need to occur on all fronts. Resources that not only establish genital diversity but also challenge limited vulvar aesthetics could be developed in consultation with women, healthcare practitioners, mental health specialists, and others with knowledge of social constructs of women’s bodies.
Factors influencing multicultural acceptance of Korean nursing students
Authors: Gu Minkyung , Sok Sohyune
Published: November 2023

Background

South Korea has already become a multicultural society due to immigration, marriage, and employment of foreigners, and the use of medical institutions by foreigners is increasing. In order to establish a therapeutic rapport relationship with foreigners, it is necessary to study multicultural acceptance. This study aimed to examine and identify the factors influencing the degree of multicultural acceptance of Korean nursing students.

Methods

This study used a cross-sectional descriptive design. Study participants included 147 nursing students at University in Seoul or Gyeonggi-do, South Korea. Data included demographics, multicultural acceptance, cultural empathy, and multicultural attitude. Data were collected from March to June 2021. Data was analyzed using linear regression model in SPSS PC + version 23.0 statistical software program.

Results

The adjusted R-squared representing the explanatory power of the model was 72.5%. The strongest predictor was cultural empathy (β = 0.55, P < 0.001), followed by multicultural attitude (β = 0.26, P = 0.001), residential area where they lived for the past 5 years (β = 0.19, P = 0.001), accessibility to multicultural internet and media (β = 0.17, P = 0.003), whether they have foreign friends (β = 0.16, P = 0.003), and multicultural education experience (β = 0.02, P = 0.002).

Conclusion

This study suggests that to improve the degree of multicultural acceptance of Korean nursing students, their cultural empathy and multicultural attitude should be strengthened. Nurses need to pay attention the influencing factors to improve the multicultural acceptance of Korean nursing students.
Effect of an educational program about mentorship competencies on nurse mentors’ performance: a quasi-experimental study
Authors: Hagrass Heba Moussa , Ibrahim Sanaa Abd El-Azeem , Anany Rasha Ibrahim El-Sayed , El-Gazar Heba E.
Published: November 2023

Background

Mentorship is a vital part of the nursing profession to improve role transition, job satisfaction, and job retention while facilitating socialization, emotional well-being, and the acquisition of new skills.

Aim

The present study aimed to evaluate the effect of an educational program about mentorship competencies on nurse mentors’ performance at Port Said Healthcare Authority hospitals.

Methods

A quasi-experimental study design (pre-test and post-test one group) was used to conduct the study at seven Healthcare Authority hospitals in Port Said Governorate, Egypt. The study subjects were consisted of a purposive sample of 30 nurse mentors and 60 intern nursing students. Data were collected using three tools consisted of the Mentor Knowledge Questionnaire, Mentor Competencies Instrument (MCI), and Nurse Mentor Performance Assessment. Data analysis was performed using SPSS version 20, Student’s t-test was used to measure differences between the pretest and post-test, and Qualitative categorical variables were compared using the chi-square test. A significant level value was considered when the p-value ≤ 0.05, and Cohen’s d was used to measure the effect size.

Results

the post-test scores of mentorship competencies and performance after implementation of the educational program significantly improved in the studied nurse mentors 56.1 ± 13.2, 60.5 ± 4.9 compared with pre-test scores with 37.1 ± 4.1, 49.7 ± 6.9 (P < 0.001). As determined by Cohen’s d test, the effect size of an educational program is quite large on the nurse mentors’ performance.

Conclusion

The educational program about mentorship competencies was significantly improve mentorship performance of the studied nurse mentors. The study recommended dissemination and generalization of the new and innovative mentorship program to the different stages of nursing education to foster the continued growth and development of nurse mentors and nurse students. Also, recommended developing a valid mentor assessment instrument consisting of and specific to the Egyptian context to assess the Egyptian mentorship model.

Trial Registration Number (TRN)

The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University (code number: NUR 13/2/2022) [10].
Nursing students’ attitudes towards the use of digital technology in the healthcare of older adults- a cross-sectional study in Norway and Sweden
Authors: Leonardsen Ann-Chatrin Linqvist , Hardeland Camilla , Hallgren Jenny , Femdal Ingrid , Thapa Dip Raj , Helgesen Ann Karin , Bååth Carina , Halvorsrud Liv , Grøndahl Vigdis Abrahamsen , Gillsjö Catharina
Published: November 2023

Background

Implementation of digital technology has been suggested as a potential solution to future healthcare challenges. Healthcare personnel’s attitudes are important in the acceptance and implementation of digital technologies.

Aim

The aims of this study were to (1) translate and validate two different questionnaires to Norwegian and Swedish respectively, and then (2) use these to examine nursing students’ attitudes towards digital technology in healthcare, as well as their attitudes towards older adults’ abilities to use digital technology.

Design

Cross-sectional.

Methods

A web-based questionnaire was distributed in first year nursing students in a Norwegian and a Swedish university college, respectively. The questionnaire consisted of the short form of the ‘Information Technology Attitude Scales for Health (ITASH)’ and the ‘Attitudes Towards Older Adults Using Digital technology (ATOAUT-11)’ questionnaire. The questionnaires were translated and validated in both countries. Frequencies, Student’s t-test, and one-way ANOVA were used to analyze the data.

Results

In total 236 students responded to the questionnaire in the period September 2022 to April 2023. Students mainly reported positive attitudes towards digital technology use in general. They most agreed with the items ‘Using digital technology devices makes my communication with other health professionals faster’, ‘The sort of information I can get from the digital technology devices helps me give better care to patient’, and ‘Digital technology skills are becoming more and more necessary for healthcare professionals’. However, they reported more negative attitudes towards older adults using digital technology. They most agreed with the items ‘One needs a lot of patience to explain to an older adult how to use digital technologies’, ‘It’s hard to explain to older adults how to use digital technology’, ‘Using digital technology is harder for most older adults’, and ‘Most older adults fear using digital technology because they fear of being scammed or cheated’.

Conclusion

The ITASH and the ATOAUT-11 is appropriate for use in a Norwegian and Swedish setting. Even if nursing students are positive to digital technology in healthcare in general, they are sceptical to older adults using digital technology. This may impact on their attitudes to using digital technology in the healthcare of older adults. These aspects need emphasis when revising nursing education curricula focusing on developing technological competencies in nursing, and gaining knowledge regarding older adults’ use of digital technology.
Protecting healthcare workers and patients during the COVID-19 pandemic: a comparison of baseline and follow-up infection prevention and control needs in Nigerian military healthcare facilities delivering HIV services
Authors: Lee Elizabeth H. , Rashid Ayesha , Lawal Ismail , Adekanye Usman , Adamu Yakubu , Godfrey Catherine , Agaba Patricia A. , Okeji Nathan , Desai Priyanka
Published: November 2023

Background

Protecting the HIV health workforce is critical for continuity of services for people living with HIV, particularly during a pandemic. Early in the COVID-19 pandemic, the Nigerian Ministry of Defence, in partnership with the US Military HIV Research Program, took steps to improve infection prevention and control (IPC) practices among staff working in select PEPFAR-supported Nigerian military health facilities.

Methods

We identified a set of IPC activities a priori for implementation at four Nigerian military hospitals in HIV and related departments in early 2021, including continuous medical masking, physical distancing, placement of additional hand washing stations and hand sanitizers throughout facilities, and training. We fine-tuned planned intervention activities through a baseline needs assessment conducted in December 2020 that covered eight IPC components: ‘IPC program structure, funding and leadership engagement’; ‘IPC policies, guidelines and standard operating procedures (SOPs)’; ‘infrastructure’; ‘triage and screening’; ‘training, knowledge and practice’; ‘personal protective equipment (PPE) materials, availability and adequacy’; ‘biosafety and waste management’; and ‘monitoring and remediation’ prior to implementation. Baseline results were compared with those of a follow up assessment administered in August 2021, following intervention implementation.

Results

IPC readiness remained high at both baseline and follow-up assessments for ‘IPC guidelines, policies, and SOPs’ (96.7%). The components ‘infrastructure’ and ‘monitoring and remediation’, which needed improvement at baseline, saw modest improvements at follow-up, by 2% and 7.5%, respectively. At follow-up, declines from high scoring at baseline were seen in ‘IPC program structure, funding and leadership engagement’, ‘training, knowledge and practice’, and ‘biosafety and waste management’. ‘PPE materials availability and adequacy’ improved to 88.9% at follow-up. Although unidirectional client flow was newly implemented, the score for ‘triage and screening’ did not change from baseline to follow-up (73%).

Conclusion

Variability in IPC component readiness and across facilities highlights the importance of building resilience and employing a quality improvement approach to IPC that includes regular monitoring, re-assessment and re-training at set intervals. Results can be used to encourage solutions-oriented dialogue between staff and leadership, determine needs and implement action plans to protect staff and people with HIV.
Metabolic engineering in Streptomyces albidoflavus for the biosynthesis of the methylated flavonoids sakuranetin, acacetin, and genkwanin
Authors: Pérez-Valero Álvaro , Ye Suhui , Magadán-Corpas Patricia , Villar Claudio J. , Lombó Felipe
Published: November 2023

Flavonoids are important plant secondary metabolites showing antioxidant, antitumor, anti-inflammatory, and antiviral activities, among others. Methylated flavonoids are particularly interesting compared to non-methylated ones due to their greater stability and intestinal absorption, which improves their oral bioavailability. In this work we have stablished a metabolic engineered strain of Streptomyces albidoflavus with enhanced capabilities for flavonoid production, achieving a 1.6-fold increase in the biosynthesis of naringenin with respect to the parental strain. This improved strain, S. albidoflavus UO-FLAV-004, has been used for the heterologous biosynthesis of the methylated flavonoids sakuranetin, acacetin and genkwanin. The achieved titers of sakuranetin and acacetin were 8.2 mg/L and 5.8 mg/L, respectively. The genkwanin titers were 0.8 mg/L, with a bottleneck identified in this producing strain. After applying a co-culture strategy, genkwanin production titers reached 3.5 mg/L, which represents a 4.4-fold increase. To our knowledge, this study presents the first biosynthesis of methylated flavonoids in not only any Streptomyces species, but also in any Gram-positive bacteria.
A bedside to bench study of anti-PD-1, anti-CD40, and anti-CSF1R indicates that more is not necessarily better
Authors: Djureinovic Dijana , Weiss Sarah A. , Krykbaeva Irina , Qu Rihao , Vathiotis Ioannis , Moutafi Myrto , Zhang Lin , Perdigoto Ana L. , Wei Wei , Anderson Gail , Damsky William , Hurwitz Michael , Johnson Barbara , Schoenfeld David , Mahajan Amit , Hsu Frank , Miller-Jensen Kathryn , Kluger Yuval , Sznol Mario , Kaech Susan M. , Bosenberg Marcus , Jilaveanu Lucia B. , Kluger Harriet M.
Published: November 2023

Background

Stimulating inflammatory tumor associated macrophages can overcome resistance to PD-(L)1 blockade. We previously conducted a phase I trial of cabiralizumab (anti-CSF1R), sotigalimab (CD40-agonist) and nivolumab. Our current purpose was to study the activity and cellular effects of this three-drug regimen in anti-PD-1-resistant melanoma.

Methods

We employed a Simon’s two-stage design and analyzed circulating immune cells from patients treated with this regimen for treatment-related changes. We assessed various dose levels of anti-CSF1R in murine melanoma models and studied the cellular and molecular effects.

Results

Thirteen patients were enrolled in the first stage. We observed one (7.7%) confirmed and one (7.7%) unconfirmed partial response, 5 patients had stable disease (38.5%) and 6 disease progression (42.6%). We elected not to proceed to the second stage. CyTOF analysis revealed a reduction in non-classical monocytes. Patients with prolonged stable disease or partial response who remained on study for longer had increased markers of antigen presentation after treatment compared to patients whose disease progressed rapidly. In a murine model, higher anti-CSF1R doses resulted in increased tumor growth and worse survival. Using single-cell RNA-sequencing, we identified a suppressive monocyte/macrophage population in murine tumors exposed to higher doses.

Conclusions

Higher anti-CSF1R doses are inferior to lower doses in a preclinical model, inducing a suppressive macrophage population, and potentially explaining the disappointing results observed in patients. While it is impossible to directly infer human doses from murine studies, careful intra-species evaluation can provide important insight. Cabiralizumab dose optimization is necessary for this patient population with limited treatment options.

Trial registration

ClinicalTrials.gov Identifier: NCT03502330.
Risky working conditions and chronic kidney disease
Authors: Lan Rui , Qin Yao , Chen Xiangjun , Hu Jinbo , Luo Wenjin , Shen Yan , Li Xue , Mao Lina , Ye Hanwen , Wang Zhihong
Published: November 2023

Background

Individuals in the workplace are exposed to various environments, tasks, and schedules. Previous studies have indicated a link between occupational exposures and an increased risk of chronic kidney disease (CKD). However, the social conditions of the work environment may also be a crucial contributing factor to CKD. Furthermore, individuals may encounter multiple occupational-related risk factors simultaneously, underscoring the importance of investigating the joint risk of different working conditions on CKD.

Methods

A prospective analysis of 65,069 UK Biobank participants aged 40 to 69 years without CKD at baseline (2006–2010) was performed. A self-administered questionnaire assessed working conditions and a working conditions risk score were developed. Participants who answered “sometimes” or “often” exposure to occupational heat or occupational secondhand cigarette smoke; involved in shift work or heavy workloads (“usually” or “always”), were grouped as high-risk working conditions. Each working condition was scored as 1 if grouped as high-risk, and 0 if not. The working conditions risk score was equal to the sum of these four working conditions. Cox proportional hazard regression models were used to estimate the associations between working conditions and CKD incidence.

Results

The mean follow-up time was 6.7 years. After adjusting for demographic, lifestyle, and working time factors, the hazard ratios for the development of CKD for heavy workloads, shift work, occupational secondhand cigarette smoke exposure, and occupational heat exposure were 1.24 (95%CI = 1.03, 1.51), 1.33 (95%CI = 1.10, 1.62), 1.13 (95%CI = 1.01, 1.26), 1.11 (95%CI = 0.99, 1.24), respectively. The risk of CKD was found to be significantly associated with an increasing working conditions risk score. Individuals with a working conditions risk score of 4 had an 88.0% (95% CI = 1.05, 3.35) higher risk of developing CKD when compared to those with a working conditions risk score of 0.

Conclusions

Adverse working conditions, particularly when considered in combination, can significantly elevate the risk of chronic kidney disease (CKD). These results provide a reference for implementing measures to prevent CKD.
Early outcome of simplified total arch reconstruction under mild hypothermia (30–32 °C) with distal aortic perfusion
Authors: Zheng Hua-Jie , Liu Xin , He Ping , Li Jun , Zhang Xian-Pu , Cheng Yong-Bo , Lin De-Qing , Yan Chao-Jun , Yu San-Jiu , Cheng Wei
Published: November 2023

Objective

We designed a simplified total arch reconstruction (s-TAR) technique which could be performed under mild hypothermia (30–32 °C) with distal aortic perfusion. This study aimed to compare its efficacy of organ protection with the conventional total arch reconstruction (c-TAR).

Methods

We reviewed the clinical data of 195 patients who had ascending aortic aneurysm with extended aortic arch dilation and underwent simultaneous ascending aorta replacement and TAR procedure between January 2018 and December 2022 in our center. 105 received c-TAR under moderate hypothermia (25–28 °C) with circulatory arrest (c-TAR group); rest 90 received s-TAR under mild hypothermia (30–32 °C) with distal aortic perfusion (s-TAR group).

Results

The s-TAR group demonstrated shorter CPB time, cross-clamp time and lower body circulatory arrest time compared with the c-TAR group. The 30-day mortality was 2.9% for the c-TAR group and 1.1% for the s-TAR group (P = 0.043). The mean duration of mechanical ventilation was shorter in the s-TAR group. Paraplegia was observed in 4 of 105 patients (3.8%) in the c-TAR group, while no such events were observed in the s-TAR group. The incidence of temporary neurologic dysfunction was significantly higher in the c-TAR group. The incidence of permanent neurologic dysfunction also showed a tendency to be higher in the c-TAR group, without statistical significance. Furthermore, the incidence of reoperation for bleeding were significantly lower in the s-TAR group. The rate of postoperative hepatic dysfunction and all grades of AKI was remarkably lower in the s-TAR group. The 3-year survival rate was 95.6% in the s-TAR group and 91.4% in the c-TAR group.

Conclusions

s-TAR under mild hypothermia (30–32℃) with distal aortic perfusion is associated with lower mortality and morbidity, offering better neurological and visceral organ protection compared with c-TAR.
Investigating the quality of Iranian hospitals’ websites and their association to the Province’s share of medical tourism
Authors: Shaygani Fatemeh , Jahangiri Soodeh , Roozegar Mohammad Hassan Zahed , Kavosi Zahra , Marzaleh Milad Ahmadi
Published: November 2023

Background

Nowadays, virtual methods are among the most important and influential marketing instruments in various industries, such as medical tourism. This study aims to investigate the quality of Iranian hospitals’ web pages and their association with the province’s share of the medical tourism industry in Iran and the ownership type of hospitals.

Methods

In this analytical cross-sectional study, the quality of hospitals’ websites was investigated through a 36-item self-administered questionnaire which was validated, and its reliability was verified (Cronbach’s alpha = 74%.). The questionnaire was categorized into three sections: hospital services and facilities, hospital’s medical tourism-related services, and tourism information of the destination province. The census method was used for data collection. Data analysis was performed using the independent t-test and analysis of variance in SPSS software (version 25), and a P-value < 0.05 was considered statistically significant.

Results

A total of, 102 hospitals with an IPD (International Patients Department) were included in the study, and 21.6% did not have an English-language page and were excluded from the study. The mean total score was 47 ± 7.5, indicating low-quality content. Public hospitals had lower quality scores than semi-private and private hospitals. The total quality score, information about the hospital and its services, and the score of information about medical tourism-related services were associated with the province’s share of national medical tourism.

Conclusion

According to the obtained results and the possible role of website quality in increasing provinces’ medical tourism development, the IPD page on hospital websites should be revised and regularly updated to make them more informative for prospective medical tourists.