bluuebunny/crossref_metadata_2025 huggingface dataset:
Nurse managers’ assessments about nursing education and work life's competence demands: A European multi-country cross-sectional survey
Authors: Kukkonen Pia , Koskinen Sanna , Fatkulina Natalja , Fuster Pilar , Lehwaldt Daniela , Löyttyniemi Eliisa , Salminen Leena , Stubner Juliane , Sveinsdóttir Herdís , Leino-Kilpi Helena
Published: January 2023

As future employers, nurse managers are in a key position to assess the correspondence between the competence of graduating nursing students and work life demands. The aim of the present study was to assess the competence of graduating nursing students from the perspective of managers, and analyze the factors linked to it. Among European managers in six countries, a cross-sectional survey design with a convenience sample was applied. Data were collected using the Nurse Competence Scale. The study was reported using the STROBE guidelines. Managers (n = 538, 65.8%) assessed the level of competence of graduating nursing students as good, but there were statistically significant differences between countries. In a multivariable analysis, managers who had a Doctoral/Master's degree and were dissatisfied with the nursing program in their country assessed the level of competence as lower. Overall, graduating nursing students seem to meet the competence demands of current work life rather well. Further research is needed to confirm the connection between the managers’ competence assessment and their individual background factors.
Examining the Impact of Polygenic Risk Information in Primary Care
Authors: Pacyna Joel E. , Ennis Jackson S. , Kullo Iftikhar J. , Sharp Richard R.
Published: January 2023

Background:

Polygenic risk testing examines variation across multiple genes to estimate a risk score for a particular disease, including risk scores for many common, chronic health conditions. Although polygenic risk information (PRI) may be a promising tool for enhancing preventive counseling and facilitating early identification of disease, its potential impact on primary-care encounters and disease prevention efforts has not been well characterized.

Methods:

We conducted in-depth, semi-structured interviews of patients to assess their understandings of PRI and their beliefs about its relevance to disease prevention.

Results:

We completed interviews with 19 participants. Participants described enthusiasm for the generation of PRI and recognized its utility for disease prevention. Participants also described the value of PRI as limited if not corroborated by non-genetic risk factors. Finally, participants noted that PRI, by itself, would be insufficient as a trigger for initiating many preventive interventions.

Conclusion:

PRI has the potential to become an important tool in primary care. However, patient views about PRI as well as the complexities of disease prevention in the primary care context may limit the impact of PRI on disease prevention.
The Olympic Games and Judo Diplomacy: An Exploratory Discussion on Country Image in Tokyo 2020
Authors: Dubinsky Yoav
Published: January 2023

The purpose of the article is to explore the use of judo for nation branding, public diplomacy, and country image in the postponed Tokyo 2020 Olympic Games. Judo was founded in Japan in 1882 as a martial art that embodies educational values of peace, respect, and controlling mind and body. Judo made its Olympic debut in Tokyo 1964 and gradually became one of the most internationally diverse sports in the Olympic Games. The study uses theoretical lenses drawn from nation branding, public diplomacy, country image, and related fields. The qualitative research is based on content analysis of press conferences, media guides, and international coverage of the judo competitions held in July 2021 at the Nippon Budokan. Based on three coding rounds of manual thematic analysis, four themes emerged from the data: (a) the sport and the host, (b) universal values, (c) geopolitics, and (d) the individual and the collective. The study is significant as it expands literature and adds value to practitioners on the role of judo, nation branding, public diplomacy, and country image, during a global pandemic and as the Olympic Movement enters a new era.
Beyond the adjacent possible: On the irreducibility of human creativity to biology and physics
Authors: Corazza Giovanni Emanuele
Published: January 2023

In this article, the problem of understanding multiple layers of complexity in our universe is addressed, with particular emphasis on explaining creative evolutions in the material, biological, and psycho-social layers. Perspectives from physics, biology, psychology, and philosophy are utilized in the discussion. Process philosophy is used to justify the theoretical foundation of the dynamic universal creativity process. The concepts of unified and final theories are discussed from a position that criticizes reductionism. The concept of the adjacent possible is reviewed as introduced by Kauffman to exclude the possibility that a theory from physics could be extended to explain the biological layer. In a similar way, the adjacent possible is shown to be useful but insufficient to explain the psycho-social layer of complexity, missing fundamental human abilities such as thinking of long-term futures, wisdom, and dynamic creativity leaps that use the impossible as an inspiration.
Performance space and independent music: The role of cultural entrepreneur in music placemaking in China
Authors: Fung Anthony , Zhang Qian
Published: January 2023

The digitalization and platformization of pop music (e.g. Tencent Music Entertainment and Netease Cloud Music in China or Spotify) and gentrification of urban space, not to mention political control, have threatened the survival of independent music in global cities. This paper aims to illustrate how musicians attempt to create music space and continue to incubate new bands and sustain a performance economy in order to perpetuate local creativity and music cultures. We argue that all these efforts are owing to the rise of cultural entrepreneurs in China who attempt to strategize to create a music market and withstand political pressure from the authorities.
Doing it with others: The social dynamics of Do-It-Yourself musicking
Authors: Crossley Nick
Published: January 2023

This article reflects upon Do It Yourself (DIY) musical activities in an effort to open them up to critical academic inquiry. It begins with a discussion of what ‘DIY’ means in a musical context, which is embellished with a brief historical account of early DIY ‘musicking’ and its subsequent development and diversification. The second part of the article uses Howard Becker’s account of the importance of resources, conventions and networks to the doing of art to bring a sociological perspective to bear upon DIY musicking. Each of these three factors is important in relation to DIY musicking and a consideration of them both allows us to ask questions about it and suggests potentially fruitful lines of inquiry for future research.
Chloroplast genome sequence of triploid Toxicodendron vernicifluum and comparative analyses with other lacquer chloroplast genomes
Authors: Zong Dan , Qiao Zhensheng , Zhou Jintao , Li Peiling , Gan Peihua , Ren Meirong , He Chengzhong
Published: January 2023

Background

Toxicodendron vernicifluum, belonging to the family Anacardiaceae, is an important commercial arbor species, which can provide us with the raw lacquer, an excellent adhesive and painting material used to make lacquer ware. Compared with diploid, triploid lacquer tree has a higher yield of raw lacquer and stronger resistance to stress.TriploidT. vernicifluumwas a newly discovered natural triploid lacquer tree. However, the taxonomy of triploidT. vernicifluumhas remained uncertain. Here, we sequenced and analyzed the complete chloroplast (cp) genome of triploidT. vernicifluumand compared it with related species ofToxicodendrongenus based on chloroplast genome and SSR markers.

Results

The plastome of triploidT. vernicifluumis 158,221 bp in length, including a pair of inverted repeats (IRs) of 26,462 bp, separated by a large single-copy region of 86,951 bp and a small single-copy region of 18,346 bp. In total, 132 genes including 87 protein-coding genes, 37 tRNA genes and 8 rRNA genes were identified in the triploidT. vernicifluum. Among these, 16 genes were duplicated in the IR regions, 14 genes contain one intron, while three genes contain two introns. After nucleotide substitutions, seven small inversions were analyzed in the chloroplast genomes, eight hotspot regions were found, which could be useful molecular genetic markers for future population genetics. Phylogenetic analyses showed that triploidT. vernicifluumwas a sister toT. vernicifluumcv. Dahongpao andT. vernicifluumcv. Hongpigaobachi. Moreover, phylogenetic clustering based on the SSR markers showed that all the samples of triploidT. vernicifluum,T. vernicifluumcv. Dahongpao andT. vernicifluumcv. Hongpigaobachi in one group, while the samples ofT. vernicifluumandT. succedaneumin another group, which is consistent with the cp genome and morphological analysis.

Conclusions

The current genomic datasets provide pivotal genetic resources to determine the phylogenetic relationships, variety identification, breeding and resource exploitation, and future genetic diversity-related studies ofT. vernicifluum.
Reliability of bioreactance and pulse power analysis in measuring cardiac index during cytoreductive abdominal surgery with hyperthermic intraperitoneal chemotherapy (HIPEC)
Authors: Ylikauma Laura Anneli , Tuovila Mari Johanna , Ohtonen Pasi Petteri , Erkinaro Tiina Maria , Vakkala Merja Annika , Takala Heikki Timo , Liisanantti Janne Henrik , Kaakinen Timo Ilari
Published: January 2023

Purpose

Various malignancies with peritoneal carcinomatosis are treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). The hemodynamic instability resulting from fluid balance alterations during the procedure necessitates reliable hemodynamic monitoring. The aim of the study was to compare the accuracy, precision and trending ability of two less invasive hemodynamic monitors, bioreactance-based Starling SV and pulse power device LiDCOrapid with bolus thermodilution technique with pulmonary artery catheter in the setting of cytoreductive surgery with HIPEC.

Methods

Thirty-one patients scheduled for cytoreductive surgery were recruited. Twenty-three of them proceeded to HIPEC and were included to the study. Altogether 439 and 430 intraoperative bolus thermodilution injections were compared to simultaneous cardiac index readings obtained with Starling SV and LiDCOrapid, respectively. Bland-Altman method, four-quadrant plots and error grids were used to assess the agreement of the devices.

Results

Comparing Starling SV with bolus thermodilution, the bias was acceptable (0.13 l min− 1 m− 2, 95% CI 0.05 to 0.20), but the limits of agreement were wide (− 1.55 to 1.71 l min− 1 m− 2) and the percentage error was high (60.0%). Comparing LiDCOrapid with bolus thermodilution, the bias was acceptable (− 0.26 l min− 1 m− 2, 95% CI − 0.34 to − 0.18), but the limits of agreement were wide (− 1.99 to 1.39 l min− 1 m− 2) and the percentage error was high (57.1%). Trending ability was inadequate with both devices.

Conclusion

Starling SV and LiDCOrapid were not interchangeable with bolus thermodilution technique limiting their usefulness in the setting of cytoreductive surgery with HIPEC.
Exploring barriers to dementia screening and management services by general practitioners in China: a qualitative study using the COM-B model
Authors: Gong Ni , Yang Dan , Zou Jianfeng , He Qianyu , Hu Lei , Chen Weiju , Liao Jing
Published: January 2023

Background

Dementia has become a global public health problem, and general practitioners (GPs) play a key role in diagnosing and managing dementia. However, in Chinese primary care settings, dementia is underdiagnosed and inefficiently managed, and dementia screening and management services provided by GPs are suboptimal. The reasons underlying this gap are poorly understood. This study aimed to determine the barriers that hinder GPs from actively promoting dementia screening and management, and thereby provide insights for the successful promotion of dementia screening and management services in primary care.

Methods

Purposive sampling was used. And focus groups and in-depth interviews were conducted face-to-face among GPs from community health service centers (CHSCs) in South China. Thematic analysis was used to identify barriers to screening and managing dementia and map them to the Capability/Opportunity/Motivation-Behavior model (COM-B model).

Results

Fifty-two GPs were included. The COM-B model found nine barriers to implementing dementia screening and management services in primary healthcare: (1) poor capability: lack of systematic knowledge of dementia and inadequate dementia screening skills; (2) little opportunity: unclear pathways for referral, insufficient time for dementia screening and management, lack of dementia-specific leaders, and no guarantee of services continuity; (3) low motivation: outside of GP scope, worries associated with dementia stigma rooted in culture beliefs, and insufficient financial incentives.

Conclusions

Our study concluded that GPs were not yet ready to provide dementia screening and management services due to poor capability related to knowledge and skills of dementia, little opportunity associated with an unsupportive working environment, and low motivation due to unclear duty and social pressure. Accordingly, systematic implementation strategies should be taken, including standardized dementia training programs, standardized community-based dementia guidelines, expansion of primary care workforces, development of dedicated leaders, and the eradication of stigma attached to dementia to promote dementia screening and management services in primary care.
Characterising complex health needs and the use of preventive therapies in the older population: a population-based cohort analysis of UK primary care and hospital linked data
Authors: Elhussein Leena , Jödicke Annika M. , He Ying , Delmestri Antonella , Robinson Danielle E. , Strauss Victoria Y. , Prieto-Alhambra Daniel
Published: January 2023

Background

While several definitions exist for multimorbidity, frailty or polypharmacy, it is yet unclear to what extent single healthcare markers capture the complexity of health-related needs in older people in the community. We aimed to identify and characterise older people with complex health needs based on healthcare resource use (unplanned hospitalisations or polypharmacy) or frailty using large population-based linked records.

Methods

In this cohort study, data was extracted from UK primary care records (CPRD GOLD), with linked Hospital Episode Statistics inpatient data. People aged > 65 on 1st January 2010, registered in CPRD for ≥ 1 year were included. We identified complex health needs as the top quintile of unplanned hospitalisations, number of prescribed medicines, and electronic frailty index. We characterised all three cohorts, and quantified point-prevalence and incidence rates of preventive medicines use.

Results

Overall, 90,597, 110,225 and 116,076 individuals were included in the hospitalisation, frailty, and polypharmacy cohorts respectively; 28,259 (5.9%) were in all three cohorts, while 277,332 (58.3%) were not in any (background population). Frailty and polypharmacy cohorts had the highest bi-directional overlap. Most comorbidities such as diabetes and chronic kidney disease were more common in the frailty and polypharmacy cohorts compared to the hospitalisation cohort. Generally, prevalence of preventive medicines use was highest in the polypharmacy cohort compared to the other two cohorts: For instance, one-year point-prevalence of statins was 64.2% in the polypharmacy cohort vs. 60.5% in the frailty cohort.

Conclusions

Three distinct groups of older people with complex health needs were identified. Compared to the hospitalisation cohort, frailty and polypharmacy cohorts had more comorbidities and higher preventive therapies use. Research is needed into the benefit-risk of different definitions of complex health needs and use of preventive therapies in the older population.
Gustatory dysfunction perceptions versus objective gustatory dysfunction among older adults
Authors: Park Seung Yong , Kim Kyung Soo , Min Hyun Jin
Published: January 2023

Background

Research on gustatory dysfunction among older adults has been scarce relative to research on olfactory dysfunction, and the relationship between subjective and objective gustatory dysfunction has not been studied in detail. We aimed to evaluate whether subjective recognition of gustatory dysfunction correlates with objective diagnosis of gustatory dysfunction among older adults.

Methods

In this retrospective, cross-sectional study, we reviewed the medical records of 138 patients of ages ≥ 60 years for whom data were available on self-reported and objectively measured gustatory and olfactory function from January 2018 through April 2021 at a specialized smell/taste center of a single institution.

We reviewed self-reported and measured outcomes of gustatory and olfactory function using patient data including clinical characteristics, including age, sex, smoking history, and medical history.

Results

We found that the subjective recognition of gustatory dysfunction does not correlate with the objective diagnosis of gustatory dysfunction based on the measured results of gustatory function tests. Subjective gustatory dysfunction, however, was correlated with subjective olfactory dysfunction. Among clinical and demographic characteristics, age and sex were significantly associated with measured gustatory function outcomes.

Conclusion

We suggest that subjective gustatory dysfunction underestimates objective dysfunction and recommend that older men with diminished olfactory function undergo gustatory function testing regardless of their self-reported gustatory function status.
Using HbA1c measurements and the Finnish Diabetes Risk Score to identify undiagnosed individuals and those at risk of diabetes in primary care
Authors: Arnardóttir Elín , Sigurðardóttir Árún K. , Graue Marit , Kolltveit Beate-Christin Hope , Skinner Timothy
Published: January 2023

Background

Prevalence of prediabetes and type 2 diabetes mellitus (T2DM) is increasing worldwide. The objective of this study was to determine the proportion of people in Northern Iceland with prediabetes, at risk of developing T2DM or with manifest undiagnosed T2DM, as this information is lacking in Iceland.

Methods

A cross-sectional study. Clients of the three largest primary health care centres in the Health Care Institution of North Iceland (HSN) were invited to participate if fulfilling the following inclusion criteria: a) aged between 18 and 75 years, b) not diagnosed with diabetes, c) speaking and understanding Icelandic or English fluently and d) living in the included service area.

Data collection took place via face-to-face interviews between 1 March 2020 and 15 May 2021. Participation included answering the Finnish Diabetes Risk Score (FINDRISC), measuring the HbA1c levels and background information.

Results

Of the 220 participants, 65.9% were women. The mean age was 52.1 years (SD ± 14.1) and FINDRISC scores were as follows: 47.3% scored ≤8 points, 37.2% scored between 9 and 14 points, and 15.5% scored between 15 and 26 points. The mean HbA1c levels in mmol/mol, were 35.5 (SD ± 3.9) for men and 34.4 (SD ± 3.4) for women, ranging from 24 to 47. Body mass index ≥30 kg/m2 was found in 32% of men and 35.9% of women. Prevalence of prediabetes in this cohort was 13.2%. None of the participants had undiagnosed T2DM. Best sensitivity and specificity for finding prediabetes was by using cut-off points of ≥11 on FINDRISC, which gave a ROC curve of 0.814.

Conclusions

The FINDRISC is a non-invasive and easily applied screening instrument for prediabetes. Used in advance of other more expensive and invasive testing, it can enable earlier intervention by assisting decision making, health promotion actions and prevention of the disease burden within primary health care.

Trial registration

This study is a pre-phase of the registered study “Effectiveness of Nurse-coordinated Follow up Program in Primary Care for People at risk of T2DM” at www.ClinicalTrials.gov (NCT01688359). Registered 30 December 2020.
Influencing factors on the health of nurses—a regression analysis considering individual and organizational determinants in Germany
Authors: Lützerath Jasmin , Bleier Hannah , Stassen Gerrit , Schaller Andrea
Published: January 2023

Background

The care sector is characterized by high absenteeism of nursing care employees due to illness. Organizational determinants that can affect the mental health of nurses are known. Although nurses are confronted with different framework conditions in different care settings, there is a lack of comparative data in Germany.

Methods

The purpose of this study was to examined the relationship between work demands and employee health in different care settings. This cross-sectional survey was conducted between June and October 2021 in four acute care hospitals, seven inpatient care facilities, and five outpatient care services in Germany. 528 nursing care employees (acute care hospitals n = 234; inpatient care facilities n = 152; outpatient care services n = 142) participated in the survey (participation rate: 22.6%-27.9%). For each care setting, data was collected via questionnaire on individual determinants (gender, age, profession, working time), organizational work demands (quantitative workload, qualitative workload, organization of work, social work climate, after work situation, verbal violence, threats, physical violence) and employee health (subjective health status and work ability). Descriptive statistics and binary logistic regressions were performed.

Results

Increasing age (OR = 0.650, 95% CI = 0.424—0.996) as an individual determinant and organization of work (OR = 0.595, CI = 0.362—0.978) as an organizational determinant were negatively associated with subjective health. Furthermore, age (OR = 0.555, 95% CI = 0.353—0.875), a demanding organization of work (OR = 0.520, CI = 0.315—0.858), increasing quantitative workloads (OR = 0.565, CI = 0.343—0.930) and a poorer perceived social work climate (OR = 0.610, CI = 0.376—0.991) were associated with lower work ability.

Conclusions

Based on the study results, health programs should target both individual and organizational factors. The findings seem to support the importance to include nursing care employees in the planning process, as it can have an impact on their health.

Trial registration

The project was registered in the German Clinical Trial Register (DRKS00024961, 09/04/2021).
Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis
Authors: Myasoedova Veronika A. , Parisi Valentina , Moschetta Donato , Valerio Vincenza , Conte Maddalena , Massaiu Ilaria , Bozzi Michele , Celeste Fabrizio , Leosco Dario , Iaccarino Guido , Genovese Stefano , Poggio Paolo
Published: January 2023

Background

Epicardial adipose tissue (EAT) plays an important role in cardiometabolic risk. EAT is a modifiable risk factor and could be a potential therapeutic target for drugs that already show cardiovascular benefits. The aim of this study is to evaluate the effect of cardiometabolic drugs on EAT reduction.

Methods

A detailed search related to the effect on EAT reduction due to cardiometabolic drugs, such as glucagon-like peptide-1 receptor agonist (GLP-1 RA), sodium-glucose cotransporter-2 inhibitors (SGLT2-i), and statins was conducted according to PRISMA guidelines. Eighteen studies enrolling 1064 patients were included in the qualitative and quantitative analyses.

Results

All three analyzed drug classes, in particular GLP-1 RA, show a significant effect on EAT reduction (GLP-1 RA standardize mean difference (SMD) = − 1.005; p < 0.001; SGLT2-i SMD = − 0.552; p < 0.001, and statin SMD = − 0.195; p < 0.001). The sensitivity analysis showed that cardiometabolic drugs strongly benefit EAT thickness reduction, measured by ultrasound (overall SMD of − 0.663; 95%CI − 0.79, − 0.52; p < 0.001). Meta-regression analysis revealed younger age and higher BMI as significant effect modifiers of the association between cardiometabolic drugs and EAT reduction for both composite effect and effect on EAT thickness, (age Z: 3.99; p < 0.001 and Z: 1.97; p = 0.001, respectively; BMI Z: − 4.40; p < 0.001 and Z: − 2.85; p = 0.004, respectively).

Conclusions

Cardiometabolic drugs show a significant beneficial effect on EAT reduction. GLP-1 RA was more effective than SGLT2-i, while statins had a rather mild effect. We believe that the most effective treatment with these drugs should target younger patients with high BMI.

Graphical Abstract
Exploring behavioral intervention components for African American/Black and Latino persons living with HIV with non-suppressed HIV viral load in the United States: a qualitative study
Authors: Cluesman Sabrina R. , Gwadz Marya , Freeman Robin , Collins Linda M. , Cleland Charles M. , Wilton Leo , Hawkins Robert L. , Leonard Noelle R. , Silverman Elizabeth , Maslow Carey B. , Israel Khadija , Ritchie Amanda , Ory Sarah
Published: January 2023

Background

The persistence of racial/ethnic inequities in rates of engagement along the HIV care continuum signals the need for novel approaches. We developed six behavioral intervention components for use in an optimization trial, grounded in a model that integrates critical race theory, harm reduction, and self-determination theory, designed to address various barriers that African American/Black and Latino persons living with HIV (PLWH) experience to the HIV care continuum. The components were: health education, motivational interviewing sessions, pre-adherence skill building, peer mentorship, focused support groups, and navigation. The present qualitative exploratory study describes participants’ perspectives on the components’ acceptability, feasibility, and impact.

Methods

Participants were African American/Black and Latino PLWH poorly engaged in HIV care and with non-suppressed HIV viral load in New York City. From a larger trial, we randomly selected 46 participants for in-depth semi-structured interviews. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using directed content analysis. Quantitative data on sociodemographic and background characteristics and components’ acceptability and feasibility were also collected.

Results

On average, participants were 49 years old and had lived with HIV for 19 years. Most were cisgender-male and African American/Black. Participants reported a constellation of serious social and structural challenges to HIV management including chronic poverty, unstable housing, and stigma. Across components, a non-judgmental and pressure-free approach and attention to structural and cultural factors were seen as vital to high levels of engagement, but lacking in most medical/social service settings. Prominent aspects of individual components included establishing trust (health education); developing intrinsic motivation, goals, and self-reflection (motivational interviewing sessions); learning/practicing adherence strategies and habits (pre-adherence skill building); reducing social isolation via peer role models (peer mentorship); reflecting on salient goals and common challenges with peers without stigma (focused support groups); and circumventing structural barriers to HIV management with support (navigation). Components were found acceptable and feasible. Findings suggested ways components could be improved.

Conclusions

The present study advances research on interventions for African American/Black and Latino PLWH, who experience complex barriers to engagement along the HIV care continuum. Future study of the components is warranted to address racial/ethnic health inequities in HIV.
Can transthoracic echocardiography be used to a greater extent in the diagnostics of infective endocarditis to avoid unnecessary transoesophageal examinations without jeopardising accuracy?
Authors: Damlin Anna , Eriksson Maria J. , Maret Eva
Published: January 2023

Background

Infective endocarditis (IE) is a serious condition that requires prompt diagnosis and treatment. Transthoracic echocardiography (TTE) is usually the initial imaging modality, however transoesophageal echocardiography (TOE) is sometimes necessary because of its higher sensitivity for IE. Yet, TOE may imply an increased risk of complications. This project aims to evaluate whether TTE can be used to a greater extent in the diagnostics of IE to avoid unnecessary TOE examinations without jeopardizing diagnostic accuracy.

Methods

Data from all TOE examinations performed on patients hospitalized with clinical suspicion of IE between 2019–05-01 and 2020–04-30 at a university hospital in Stockholm, Sweden, were obtained and analysed. Variables included for analysis were age, sex, blood culture results, aetiology, results from TOE, number of TOEs during the inclusion period, results from positron emission tomography/computed tomography (PET/CT), new regurgitation, cardiac murmur, previous IE, prosthetic valve, predisposing factors, i.e. cardiac comorbidities, injection drug use, fever, vascular phenomena, and immunological phenomena. To assess associations between predisposing factors or aetiology of IE and TOE findings, chi square tests and logistic regression models were used. For continuous variables, linear regression was used for comparisons of means and quantile regression was used for comparisons of medians. P < 0.05 was considered significant.

Results

In total 195 TOE examinations (Table 1) from 160 patients were included, of which 61 (31%) were positive for IE. In total, 36 examinations had negative TTE prior to TOE of which 32 (86%) also had negative TOE. Of the 5 (14%) negative TTE prior to TOE that had positive TOE, all had cardiovascular implantable electronic device (CIED) and/or prosthetic valves.

Conclusions

The existing recommendations for TOE in patients with clinical suspicion of IE are probably broad enough not to miss patients with IE, but there might be an unnecessarily large number of patients being referred for TOE with negative results. Negative TTE examination with good image quality and no CIED or prosthetic valves, may be sufficient without jeopardizing the IE diagnosis.

Graphical Abstract
Association between overweight, obesity, and quality of life of patients receiving an anticancer treatment for prostate cancer: a systematic literature review
Authors: Depotte Léonard , Caroux Maryline , Gligorov Joseph , Canouï-Poitrine Florence , Belkacemi Yazid , De La Taille Alexandre , Tournigand Christophe , Kempf Emmanuelle
Published: January 2023

Background

Prostate cancer (PCa) and obesity are two ever-increasing public health issues that can independently impair the quality of life (QOL) of affected patients. Our objective was to evaluate the impact of overweight and obesity on the QOL of patients with PCa receiving an anticancer treatment.

Methods

We performed a systematic review of the literature using PubMed, Embase, Cochrane Library and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The search equation targeted studies that included PCa patients who had a body mass index (BMI) greater than 25 kg/m2, who were receiving anticancer therapy, and whose QOL was analyzed according to validated or non-validated scores.

Results

Of 759 identified articles, we selected 20 studies published between 2000 and 2019 of 12,529 patients treated for PCa, including 5549 overweight or obese patients. QOL assessment was performed using nine validated scales and two non-validated questionnaires. Of seven studies on radiotherapy, six found obesity to have a negative impact on patients' QOL (especially urinary, sexual, and bowel-related QOL). Thirteen studies assessed the QOL of patients who underwent radical prostatectomy, with a BMI > 25 kg/m2 having no observed impact. In obese patients under 65 years of age and without comorbidities, nerve-sparing surgery appeared to limit the deterioration of QOL. Four studies on brachytherapy found discordant results. One study showed greater QOL impairment in obese patients receiving first-generation hormone therapy than in those with normal or decreased BMI. No study evaluated the QOL of overweight or obese patients receiving other types of systemic treatment.

Conclusion

Based on the published data, the level of evidence for an association between QOL and overweight or obesity in patients treated for PCa is not high. Prospective cohort studies including this type of patient population are warranted to answer this topical public health issue.
Survival benefits of para-aortic lymphadenectomy in colorectal cancer with clinically suspected para-aortic lymph node metastasis: a meta-analysis and systematic review
Authors: Wang Rong-Chang , Wang Jian-Qi , Zhou Xiao-Yu , Zhong Chu-lin , Chen Jin-Xu , Chen Jing-Song
Published: January 2023

Background and objectives

In patients with colorectal cancer and clinically suspected para-aortic lymph node metastasis, the survival benefit of para-aortic lymphadenectomy is unknown. We conducted a meta-analysis and systematic review to investigate it.

Methods

PubMed, Web of Science, and EMBASE were searched until January 2000 to April 2022 to identify studies reporting overall survivals, complication rates, and hazard ratios of prognostic factors in patients with colorectal cancer undergoing para-aortic lymphadenectomy, and those data were pooled.

Results

Twenty retrospective studies (1021 patients undergoing para-aortic lymphadenectomy) met the inclusion criteria. Meta-analysis indicates that participants undergoing para-aortic lymphadenectomy were associated with 5-year survival benefit, compared to those not receiving para-aortic lymphadenectomy (odds ratio = 3.73, 95% confidence interval: 2.05–6.78), but there was no significant difference in complication rate (odds ratio = 0.97, 95% confidence interval: 0.46–2.08). Further analysis of para-aortic lymphadenectomy group showed that 5-year survival of the positive group with pathologically para-aortic lymph node metastasis was lower than that of the negative group (odds ratio = 0.19, 95% confidence interval: 0.11–0.31). Moreover, complete resection (odds ratio = 5.26, 95% confidence interval: 2.02–13.69), para-aortic lymph node metastasis (≤4) (hazard ratio = 1.88, 95% confidence interval: 0.97–3.62), and medium-high differentiation (hazard ratio = 2.98, 95% confidence interval: 1.48–5.99) were protective factors for survival. Preoperative extra-retroperitoneal metastasis was associated with poorer relapse-free survival (hazard ratio = 1.85, 95% confidence interval: 1.10–3.10).

Conclusion

Para-aortic lymphadenectomy had promising clinical efficacy in prolonging survival rather than complication rate in patients with colorectal cancer and clinically diagnostic para-aortic lymph node metastasis. Further prospective studies should be performed.

Trial registration

PROSPERO: CRD42022379276.
Effects of bacterial and viral pathogen-associated molecular patterns (PAMPs) on multidrug resistance (MDR) transporters in brain endothelial cells of the developing human blood–brain barrier
Authors: Lye Phetcharawan , Bloise Enrrico , Matthews Stephen G.
Published: January 2023

Background

The multidrug resistance (MDR) transporters, P-glycoprotein (P-gp, encoded by ABCB1) and breast cancer resistance protein (BCRP/ABCG2) contribute to the blood–brain barrier (BBB), protecting the brain from drug exposure. The impact of infection on MDR in the developing human BBB remains to be determined. We hypothesized that exposure to bacterial and viral pathogen-associated molecular patterns (PAMPs) modify MDR expression and activity in human fetal brain endothelial cells (hfBECs) isolated from early and mid-gestation brain microvessels.

Methods

We modelled infection (4 h and 24 h) using the bacterial PAMP, lipopolysaccharide (LPS; a toll-like receptor [TLR]-4 ligand) or the viral PAMPs, polyinosinic polycytidylic acid (Poly I:C; TLR-3 ligand) and single-stranded RNA (ssRNA; TLR-7/8 ligand). mRNA expression was assessed by qPCR, whereas protein expression was assessed by Western blot or immunofluorescence. P-gp and BCRP activity was evaluated by Calcein-AM and Chlorin-6 assays.

Results

TLRs-3,4 and 8 were expressed by the isolated hfBECs. Infection mimics induced specific pro-inflammatory responses as well as changes in P-gp/ABCB1 or BCRP/ABCG2 expression (P < 0.05). LPS and ssRNA significantly decreased P-gp activity at 4 and 24 h in early and mid-gestation (P < 0.03-P < 0.001), but significantly increased BCRP activity in hfBECs in a dose-dependent pattern (P < 0.05-P < 0.002). In contrast, Poly-IC significantly decreased P-gp activity after 4 h in early (P < 0.01) and mid gestation (P < 0.04), but not 24 h, and had no overall effect on BCRP activity, though BCRP activity was increased with the highest dose at 24 h in mid-gestation (P < 0.05).

Conclusions

Infectious PAMPs significantly modify the expression and function of MDR transporters in hfBECs, though effects are PAMP-, time- and dose-specific. In conclusion, bacterial and viral infections during pregnancy likely have profound effects on exposure of the fetal brain to physiological and pharmacological substrates of P-gp and BCRP, potentially leading to altered trajectories of fetal brain development.
Developing guidance for a risk-proportionate approach to blinding statisticians within clinical trials: a mixed methods study
Authors: Iflaifel Mais , Sprange Kirsty , Bell Jennifer , Cook Andrew , Gamble Carrol , Julious Steven A. , Juszczak Edmund , Linsell Louise , Montgomery Alan , Partlett Christopher
Published: January 2023

Background

Existing guidelines recommend statisticians remain blinded to treatment allocation prior to the final analysis and that any interim analyses should be conducted by a separate team from the one undertaking the final analysis. However, there remains substantial variation in practice between UK Clinical Trials Units (CTUs) when it comes to blinding statisticians. Therefore, the aim of this study was to develop guidance to advise CTUs on a risk-proportionate approach to blinding statisticians within clinical trials.

Methods

This study employed a mixed methods approach involving three stages: (I) a quantitative study using a cohort of 200 studies (from a major UK funder published between 2016 and 2020) to assess the impact of blinding statisticians on the proportion of trials reporting a statistically significant finding for the primary outcome(s); (II) a qualitative study using focus groups to determine the perspectives of key stakeholders on the practice of blinding trial statisticians; and (III) combining the results of stages I and II, along with a stakeholder meeting, to develop guidance for UK CTUs.

Results

After screening abstracts, 179 trials were included for review. The results of the primary analysis showed no evidence that involvement of an unblinded trial statistician was associated with the likelihood of statistically significant findings being reported, odds ratio (OR) 1.02 (95% confidence interval (CI) 0.49 to 2.13). Six focus groups were conducted, with 37 participants. The triangulation between stages I and II resulted in developing 40 provisional statements. These were rated independently by the stakeholder group prior to the meeting. Ten statements reached agreement with no agreement on 30 statements. At the meeting, various factors were identified that could influence the decision of blinding the statistician, including timing, study design, types of intervention and practicalities. Guidance including 21 recommendations/considerations was developed alongside a Risk Assessment Tool to provide CTUs with a framework for assessing the risks associated with blinding/not blinding statisticians and for identifying appropriate mitigation strategies.

Conclusions

This is the first study to develop a guidance document to enhance the understanding of blinding statisticians and to provide a framework for the decision-making process. The key finding was that the decision to blind statisticians should be based on the benefits and risks associated with a particular trial.
Transitions in Metabolic Health Status and Obesity Over Time and Risk of Diabetes: The Dongfeng–Tongji Cohort Study
Authors: Wei Yue , Wang Ruixin , Wang Jing , Han Xu , Wang Fei , Zhang Zefang , Xu Yali , Zhang Xiaomin , Guo Huan , Yang Handong , Li Xiulou , He Meian
Published: January 2023

Context

Evidence regarding the association between metabolically healthy overweight or obesity (MHOO) and diabetes is controversial, and mostly ignores the dynamic change of metabolic health status and obesity.

Objective

To explore the association between transitions of metabolic health status and obesity over 5 years and diabetes incidence.

Methods

We examined 17 309 participants derived from the Dongfeng–Tongji cohort and followed from 2008 to 2018 (median follow-up 9.9 years). All participants were categorized into 4 phenotypes based on body mass index (BMI) and metabolic health status: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), MHOO, and metabolically unhealthy overweight or obesity (MUOO). The associations of changes in BMI–metabolic health status (2008-2013) with diabetes incidence (2018) were performed among 12 206 individuals with 2 follow-up examinations.

Results

Compared with stable MHNW, stable MHOO (hazard ratio [HR] 1.76; 95% CI 1.26, 2.45) and transition from MHOO to metabolically unhealthy phenotypes were associated with higher risk for diabetes (HR 2.97; 95% CI 1.79, 4.93 in MHOO to MUNW group and HR 3.38; 95% CI 2.54, 4.49 in MHOO to MUOO group). Instead, improvements to metabolic healthy phenotypes or weight loss occurring in MUOO reduced the risk of diabetes compared with stable MUOO, changing from MUOO to MHNW, MUNW, and MHOO resulted in HRs of 0.57 (95% CI 0.37, 0.87), 0.68 (95% CI 0.50, 0.93), and 0.45 (95% CI 0.34, 0.60), respectively.

Conclusion

People with MHOO, even stable MHOO, or its transition to metabolically unhealthy phenotypes were at increased risk of diabetes. Metabolic improvements and weight control may reduce the risk of diabetes.
Student Performance, Peer Effects, and Friend Networks: Evidence from a Randomized Peer Intervention
Authors: Wu Jia , Zhang Junsen , Wang Chunchao
Published: January 2023

We estimate the effects of an educational peer intervention in which previously high- and low-achieving students are randomly paired as deskmates in elementary schools in China. Our treatment boosts the mathematics scores of the low-achieving students. Moreover, the treatment enhances the extraversion and agreeableness of high- and low-achieving students, thereby providing evidence that peers can influence personality traits. The positive treatment effects can be attributed to the deskmate-level peer effects. We document friend network structure changes and present additional evidence on how friendship ties help us better understand the mechanisms behind peer effects. (JEL I21, I26, J24, O15, P36, Z13)
Η διάσταση της διαπολιτισμικότητας στην πρωτοβάθμια εκπαίδευση
Authors: Θεοδοσιάδου Κυριακή
Published: January 2023

Η παρούσα διδακτορική διατριβή μελετά και αναδεικνύει τις προσωπικές θεωρίες εκπαιδευτικών που εργάζονται σε δημόσια κοινά και διαπολιτισμικά δημοτικά σχολεία αναφορικά με τον τρόπο που αντιλαμβάνονται και διαχειρίζονται την πολιτισμική και γλωσσική ετερότητα. Ο εκπαιδευτικός που καλείται να διδάξει σε τάξεις με ανομοιογενή εθνοπολιτισμική και γλωσσική σύνθεση οφείλει να λαμβάνει υπόψη τα διαφορετικά πολιτισμικά και γλωσσικά χαρακτηριστικά των μαθητών και των μαθητριών του και να διαμορφώνει ανάλογα τις μεθόδους που χρησιμοποιεί, προκειμένου να τις καταστήσει λειτουργικές και αποτελεσματικές (Coelho, 2007). Ο σημαντικός ρόλος του εκπαιδευτικού, λοιπόν, στον τρόπο που διαχειρίζεται την εθνοπολιτισμική ετερότητα στην τάξη του δικαιολογεί τη σπουδαιότητα της μελέτης της προσωπικής θεωρίας του. Η σημασία της μελέτης των προσωπικών θεωριών έγκειται στο γεγονός ότι σε αρκετές περιπτώσεις ο εκπαιδευτικός δεν είναι σε θέση να προσδιορίσει με ακρίβεια τη θεωρία που βρίσκεται πίσω από τη δράση του και η οποία την κατευθύνει. Έτσι, η μελέτη της προσωπικής θεωρίας του εκπαιδευτικού τον βοηθά να την συστηματοποιεί και ανάλογα να την τροποποιεί ή να την εμπλουτίζει, συσχετίζοντάς την με τη διδακτική πράξη. Αυτή η διαδικασία βοηθά τον εκπαιδευτικό να αυτοβελτιώνεται και να αντιμετωπίζει με μεγαλύτερη γνώση και αυτοπεποίθηση προβληματικές καταστάσεις στην τάξη (Ματσαγγούρας, 2006). Στην έρευνα γίνεται χρήση της τριγωνοποίησης με τον συνδυασμό δύο μεθοδολογικών εργαλείων. Αφενός της ανασκόπησης, από την οποία προκύπτει η προσωπική θεωρία με βάση τις αναφορές των ίδιων των εκπαιδευτικών και η οποία περιλαμβάνει μια σειρά από διαλόγους της ερευνήτριας με τους εκπαιδευτικούς στη διάρκεια των οποίων τους ζητείται να ανακαλέσουν στη μνήμη τους, ακούγοντας την ηχογραφημένη διδασκαλία τους, σκέψεις που έκαναν κατά τη διάρκειά της. Αφετέρου της παρατήρησης διδασκαλίας, από την οποία προκύπτουν δεδομένα που συγκρίνονται με τις αυτοαναφορές των εκπαιδευτικών με σκοπό να διαφανεί η συνέπεια θεωρίας και διδακτικής πράξης. Στους σκοπούς της έρευνας εντάσσεται, εκτός από την ανάδειξη της προσωπικής θεωρίας των εκπαιδευτικών με βάση της οποία κατανοούν, ερμηνεύουν και διαχειρίζονται την πολιτισμική και γλωσσική ετερότητα στην τάξη τους και τον έλεγχο ενδεχόμενων αντιφάσεων στη θεωρία και τη διδακτική πράξη, και η σύγκριση των προσωπικών θεωριών και των πρακτικών ανάμεσα στους εκπαιδευτικούς των κοινών και αυτούς των διαπολιτισμικών δημοτικών σχολείων.
The genome of Roselle's flesh fly Sarcophaga (Helicophagella) rosellei (Böttcher, 1912)
Authors: Falk Steven ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective, Mulley John F. ,   Darwin Tree of Life Consortium
Published: January 2023

We present a genome assembly from an individual male Sarcophaga rosellei (Roselle's flesh fly; Arthropoda; Insecta; Diptera; Sarcophagidae). The genome sequence is 541 megabases in span. Most of the assembly is scaffolded into six chromosomal pseudomolecules, with the X sex chromosome assembled. The mitochondrial genome has also been assembled and is 19.5 kilobases in length. Gene annotation of this assembly on Ensembl has identified 15,437 protein coding genes.
The genome sequence of the Brick, Agrochola circellaris (Hufnagel, 1766)
Authors: Boyes Douglas ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective, Hoile Asia ,   Darwin Tree of Life Consortium
Published: January 2023

We present a genome assembly from an individual male Agrochola circellaris (the Brick; Arthropoda; Insecta; Lepidoptera; Noctuidae). The genome sequence is 572 megabases in span. Most of the assembly is scaffolded into 30 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.5 kilobases in length. Gene annotation of this assembly on Ensembl has identified 18,319 protein coding genes.