bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and performance of polypyrrole modified filter paper humidity sensor by in situ polymerization
Authors: Li Xiaoqiang , Meng Jianying , Guo Yuanhao , Li Xinke , Li Mengjuan , Gao Dekang
Published: October 2022

Polypyrrole (PPy) has high electrical conductivity, good environmental stability, and reversible electrochemical redox characteristics, which makes PPy responsive to changes in environmental humidity values. In this work, a humidity sensor with a good response to humidity was prepared using in situ polymerization of PPy in filter paper doping with acetic acid. A possible sensing mechanism of conductive polymers is proposed and the conjecture is verified by experiments. The results demonstrated that the PPy/filter paper-based humidity sensor provides an electron migration channel with the capability of detecting the relative humidity. External humidity stimulation can regulate the electrochemical reaction of PPy. The reduction reaction occurs near the water side to generate the nucleophilic product OH–. The PPy system loses electrons to form carrier directional channels, resulting in changes in the output voltage measured between the two electrodes. The PPy/filter paper-based humidity sensor exhibits the moisture dependent voltage response over a wide range from a relative humidity of 11–98%, and a response/recovery time of 43/51 s as it was placed between relative humidity of 33% and 98%. In addition, unlike the traditional sensing mechanism, the voltage sensing mechanism raised here shows self-powered ability with no need for an additional power unit. This provides a new idea for self-powered sensor devices, and this sensor shows good performance in non-contact sensing applications such as breath detection.
Conscientiousness and Cognitive Ability as Predictors of Academic Achievement: Evidence of Synergistic Effects From Integrative Data Analysis
Authors: Meyer Jennifer , Lüdtke Oliver , Schmidt Fabian T. C. , Fleckenstein Johanna , Trautwein Ulrich , Köller Olaf
Published: October 2022

Cognitive ability is the most powerful predictor of academic achievement. However, increasing attention is being paid to the role of personality traits in students’ academic achievement. Results indicate incremental effects beyond cognitive ability, especially for conscientiousness. Investigating the interplay of conscientiousness and cognitive ability can increase understanding of students’ academic achievement and learning. This study examined whether there are interaction effects of a synergistic or compensatory nature. We applied the approach of integrative data analysis, using four highly powered data sets with a total of 18,637 upper secondary school students in Germany to investigate this research question across four different achievement measures and three educational domains (i.e., school subjects). We used an integrative approach and pooled the results across the four samples to obtain an average estimate of the hypothesized interaction effects. Findings support a small synergistic interaction, indicating that conscientiousness moderates the association between cognitive ability and achievement. This means conscientiousness can enhance the positive effects of cognitive ability. In conclusion, results highlight the role of the type of academic measure used and the domain investigated in understanding how personality and achievement are related, providing evidence of the interplay between effort-related traits such as conscientiousness and cognitive ability.
Examining Different Viewer Engagement Patterns for Social Capital on Streaming Communities
Authors: Yuan Chien Wen (Tina) , Lee Yu-Hao
Published: October 2022

Live streaming is not only a popular form of entertainment but also a channel through which streamers and users can engage in social interactions and develop social capital. The current study surveyed 522 users of live streaming videos to examine how different engagement patterns (e.g., cognitive, affective, and behavioral) are associated with factors that contribute to social capital, including trust, identification, norms, volunteerism, and collective efficacy. Our findings indicate that affective and behavioral engagement were associated with increased social capital through different paths. However, cognitive engagement was not associated with any of the factors that predict social capital. The study argues that live streaming platforms, like other social networking platforms, can build social capital that can be mobilized for potential collective action. More importantly, the study expands our theoretical understanding of how different live streaming engagement patterns affect social capital through distinct factors.
Fully developed forced convection H2O-CuO nanofluid flow through concentric pipes annular sector duct by using KKL model
Authors: Ahmed Farhan
Published: October 2022

Fully developed hydro-thermal H2 O- CuO nanofluid flow through concentric pipes annular sector duct is carried out. Koo–Kleinstreuer–Li ( KKL) model correlations are taken into account to discuss the forced convection flow under the effect of Brownian motion. For discretizing and numerical simulation of governing mathematical problem, finite volume based method, ( FVBM) and well known technique “semi implicit procedure for pressure linked equations, ( SIMPLE) revised” are utilized, whereas constant axial wall heat flux with uniform peripheral wall temperature and, constant and uniform wall temperature known as H1 and T thermally fully developed conditions respectively, are used to discuss the heat transfer rate for different contribution of “Copper Oxide ( CuO)” nanoparticles, n, in base fluid “pure water”. By adding the contribution of nanoparticles, the enhancement in fanning friction factor, fRe, and average Nusselt number, Nu, has been estimated upto 7.72% and 7.54% respectively, in H1 thermal case, whereas 7.71% and 7.16% respectively, in T thermal case.
What distinguishes radical right welfare chauvinism? Excluding different migrant groups from the welfare state
Authors: Chueri Juliana
Published: October 2022

Literature posits that mainstream right-wing parties have adopted restrictive positions on immigrants’ entitlements to social rights to avoid losing votes to populist radical right-wing parties (PRRPs). Although studies recognize that this co-option is only partial, we know little about the remaining differences between PRRPs’ and mainstream right-wing parties’ welfare chauvinism strategies. This article fills this knowledge gap by comparing how mainstream and populist right-wing governments approach different migrant groups’ entitlements to social rights. The article combines an event history analysis of the Determinants of International Migration Policy database with a qualitative examination of the indexation of family benefits in selected European Countries to compare PRRPs’ and mainstream parties’ impact on the social rights of different migrant groups. The results reveal that the main difference between PRRPs and mainstream right-wing parties in Western Europe is the formers’ support for restrictions on intra-EU migrants’ entitlements to social benefits. This finding has important implications for the study of the European social policy agenda, as PRRPs’ increasing politicization of intra-EU migrants’ access to social rights may compromise the future of intra-European solidarity.
Adequacy of Healthcare by Insurance Type in Traumatic Brain Injury Patients
Authors: Smith Drew , Santiago Juan , Castro Grettel , de la Vega Pura Rodriguez , Barengo Noël C.
Published: October 2022

Traumatic brain injury (TBI) is a significant contributor to disability, especially among patients younger than 18 years old in the United States. While insurance is often needed to receive services, studies investigating whether TBI treatment adequacy is dependent on the insurance type are scant. Our objective was to determine whether private insurance in paediatric TBI patients is associated with a higher perceived adequacy of healthcare compared with non-private insurance. This was a cross-sectional study utilising secondary data collected from the National Survey of Children Health 2011/12. The main exposure of interest was the insurance status of children at the time of a TBI (private vs non-private). The study outcome was the perceived adequacy of healthcare, defined as having coverage needs that were usually or always met by insurance. Unadjusted and adjusted logistic regression analysis were used. After adjustments for the covariates, the odds of adequate healthcare among those with non-private insurance compared with those with private were not statistically significant (OR 1.49; 95% CI 0.87–2.55). This study implicates paediatric TBI patients do not believe they receive adequate healthcare independent of insurance status. Clinicians, policy makers, and researchers need to better evaluate and address this issue.
Scoping recent investment in evaluation education in Australian universities
Authors: Quadrelli Carol , Staheli Jessica , Cook-Watkins Clarissa , Alderman Lyn
Published: October 2022

This article explores the current evaluation education program opportunities in the Australian higher education market and identifies potential research areas to inform pathways for future investment. Findings from our initial scoping phase are provided as a prelude to future work required in this space. The overarching research question investigates whether there is an opportunity to deliver further evaluation education programs in Australian higher education. Emerging from this question are three objectives: (a) to determine the current landscape of Australian university evaluation education program offerings; (b) to gain an understanding of the evaluation education discourse articulated within six selected evaluation journals and (c) to consider whether evaluation is a viable and meaningful discipline within higher education programs. An action research approach was adopted commencing with a benchmarking activity of Australian university offerings, followed by a bibliometric analysis of six evaluation journals, and concluding with a rapid scan of the literature. The selected methodologies reveal a potential gap in the higher education market, with the literature identifying inconsistent and mismatched programs while emphasising the need to invest in evaluation education. This article seeks to stimulate debate about formal higher education qualifications in evaluation and highlights the importance of potential future curriculum structure that can offer evaluators value, utility and growth.
Increased dislocation rates following total hip arthroplasty in patients with ankylosing spondylitis
Authors: Chung Brian C , Stefl Michael , Kang Hyunwoo Paco , Hah Raymond J , Wang Jeffrey C , Dorr Lawrence D , Heckmann Nathanael D
Published: October 2022

Background:

Patients with ankylosing spondylitis (AS) experience abnormal spinopelvic motion due to chronic inflammation of the axial skeleton, predisposing them to impingement and dislocation. The purpose of this study was to evaluate total hip arthroplasty (THA) dislocation rates in AS patients and evaluate the effects of age and gender on dislocation risk.

Methods:

Patients who underwent primary THA from 2005 to 2014 were identified using the PearlDiver database. AS patients were compared to age- and gender-matched controls without AS. Patients with a history of spine pathology or spine surgery were excluded. Univariate analyses were performed based on age and sex to evaluate dislocation rates at 90 days, 6 months, 1 year, and 5 years postoperatively.

Results:

A total of 2792 THA patients (59.6% male) with AS were identified and compared to an age- and gender-matched control group of 5582 THA patients (59.5% male) without AS or known spine pathology. At final follow-up, there were 96 dislocations (3.4%) in the AS group and 138 (2.5%) dislocations in the control group (OR 1.40; 95% CI, 1.08–1.83; p = 0.0118). AS patients ⩾70 years old had higher dislocation rates at all time points (OR range, 1.75–2.09; p < 0.05) compared to controls. At 5-year follow-up, dislocation-free survivorship was 95.7% (95% CI, 94.5–96.9%) for AS patients ⩾70 years old compared to 97.3% (95% CI, 96.6–98.0%) for patients ⩾70 years old without AS.

Conclusions:

Older AS patients have higher dislocation rates following THA. This effect is likely related to decreased spinopelvic motion in the sagittal plane, predisposing patients to impinge and dislocate.
Barbarians at the gate: Nativist religious rhetoric and defining the “people” by who they are not
Authors: Rosenberg Emma
Published: October 2022

The rise of nativist parties in Europe has been accompanied by an increase in religious rhetoric. There is no reason to suggest that voters for nativist parties are motivated by religion; to the contrary, more Christian voters tend to vote for Christian Democratic parties. This article argues that religious rhetoric allows nativist parties to pursue ethno-centric agendas in an acceptable way and differently from Christian Democratic parties. Through the compilation of an original dataset of religious appeals from Austrian, German, and Swiss nativist and Christian Democratic party platforms between 1990–2021, this article demonstrates that changes in the distribution of the religious demographics of Muslims rather than Christians provide a catalyst for religious rhetoric but not an explanation for type of appeal. Instead, the historical role religious identities played in the development of nationalities explains how nativist parties deploy religious rhetoric in the present.
Impact of Isometric Exercise in Adolescents With End Stage Kidney Disease and Unsuitable Vessels For An Autologous Arteriovenous Fistula
Authors: Ramírez-Senent Belén , Aragoncillo Inés , Ligero José Manuel
Published: October 2022

Introduction

Despite the lack of calcification, to perform a native Arteriovenous Fistula (AVF) in young patients may pose a challenge due to small vessel diameter. We report a case series with no options of AVF in which vessel caliber improvement after isometric exercise allowed for radiocephalic fistula creation in all of them.

Methods

Since 2017 to 2019, four patients were referred to our unit to create an AVF. Following a first assessment with physical examination and doppler ultrasound, none of them were eligible for AVF performance due to small vessel caliber. Once they were considered unsuitable for it, they started an isometric exercise program.

Results

Age ranged from 13 to 19 years. There were three males and one female. Two were in predialysis and two in hemodialysis program. Initial diameters of the forearm cephalic vein and the radial artery respectively were: case A < 1.5/2.3 mm, case B 1.5/1.6 mm, case C < 1.5/1.6 mm and case D 2.1/1.3 mm. Median duration of exercise program was 13 weeks (range 5-23). Post-exercise vessel diameters were: case A 2.7/2.3 mm, case B 2.5/2 mm, case C 2.8/1.8 mm and case D 2.7/2 mm. Radiocephalic AVF were performed in the four cases. After a median follow up of 19 months (range 9-30 months), 75% of patients required further interventions but all of them had a functional AVF.

Conclusions

In these four cases isometric preoperative exercise allowed the creation of AVF. Without the improvement in vessel diameter observed afterwards, all of them would have been rejected for AVF performance. Despite the high rate of adjunctive interventions needed, given the safety of the program and the potential risks of Central Venous Catheters, we consider it a valuable option.
Prognostic factors for persistent pain after a distal radius fracture: a systematic review
Authors: Rolls Catherine , Van der Windt Danielle A , McCabe Candy , Babatunde Opeyemi O , Bradshaw Elizabeth
Published: October 2022

Introduction

The aim of this systematic review was to synthesize the evidence regarding prognostic factors for persistent pain, including Complex Regional Pain Syndrome (CRPS), after a distal radius fracture (DRF), a common condition after which persistent pain can develop.

Methods

Medline, Pubmed, Embase, Psychinfo, CINAHL, BNI, AMED and the Cochrane Register of Clinical Trials were searched from inception to May 2021 for prospective longitudinal prognostic factor studies investigating persistent pain in adults who had sustained a DRF. The Quality in Prognostic Studies (QUIPS) tool and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were used to assess the strength of evidence.

Results

A search yielded 440 studies of which 7 studies met full eligibility criteria. From five studies we found low evidence for high baseline pain or an ulnar styloid fracture as prognostic factors for persistent pain, and very low evidence for diabetes or older age. From two studies, investigating an outcome of CRPS, there was low evidence for high baseline pain, slow reaction time, dysynchiria, swelling and catastrophising as prognostic factors, and very low evidence for depression. Sex was found not to be a prognostic factor for CRPS or persistent pain.

Conclusions

The associations between prognostic factors and persistent pain following a DRF are unclear. The small number of factors investigated in more than one study, along with poor reporting and methodological limitations contributed to an assessment of low to very low strength of evidence. Further prospective studies, investigating psychosocial factors as candidate predictors of multidimensional pain outcomes are recommended.
Change of Threat Expectancy as Mechanism of Exposure-Based Psychotherapy for Anxiety Disorders: Evidence From 8,484 Exposure Exercises of 605 Patients
Authors: Pittig Andre , Heinig Ingmar , Goerigk Stephan , Richter Jan , Hollandt Maike , Lueken Ulrike , Pauli Paul , Deckert Jürgen , Kircher Tilo , Straube Benjamin , Neudeck Peter , Koelkebeck Katja , Dannlowski Udo , Arolt Volker , Fydrich Thomas , Fehm Lydia , Ströhle Andreas , Totzeck Christina , Margraf Jürgen , Schneider Silvia , Hoyer Jürgen , Rief Winfried , Craske Michelle G. , Hamm Alfons O. , Wittchen Hans-Ulrich
Published: October 2022

Individual responses to behavioral treatment of anxiety disorders vary considerably, which requires a better understanding of underlying processes. In this study, we examined the violation and change of threat beliefs during exposure. From 8,484 standardized exposure records of 605 patients with different anxiety disorders, learning indicators were derived: expectancy violation as mismatch between threat expectancy before exposure and threat occurrence, expectancy change as difference between original and adjusted expectancy after exposure, and prediction-error learning rate as extent to which expectancy violation transferred into change. Throughout sessions, high threat expectancy but low occurrence and adjusted expectancy indicated successful violation and change of threat beliefs by exposure. Expectancy violation, change, and learning rate substantially varied between patients. Not expectancy violation itself, but higher learning rate and expectancy change predicted better treatment outcome. Successful exposure thus requires expectancy violation to induce actual expectancy change, supporting learning from prediction error as transdiagnostic mechanism underlying successful exposure therapy.
Evaluating the Attitude of Employees from the Practice of Exclusive Talent Management: A Study of Hotel Employees in Delhi
Authors: Bhatia Rajneet , Baruah Papori
Published: October 2022

Understanding employees’ attitude towards the practice of exclusive talent management (ETM) has become increasingly important for ethical concerns. Despite its significant importance, this study is one of its kind, which first aims to examine the positive and negative attitude arising from the practice of ETM and also checks for the difference between the talented and non-talented employees. Based on social exchange and signalling theories, past studies have conceptually proposed that there may exist a difference in talented and non-talented employees because of their perception of justice and support, as this practice follows workforce discrimination in the organisation. Second, this article also aims to analyse how perceived justice and perceived support affect the attitude of employees towards ETM practices. Data was collected through the questionnaire method by applying convenience sampling technique, and responses of 735 employees were collected across 15 luxury hotels in New Delhi. Structural equation modelling and mediation analysis were conducted in AMOS to test various relationships. The findings suggest that ETM practices significantly affect both positive and negative attitude of employees. Also, talented employees perceive higher levels of positive attitude than non-talented employees, whereas no significant difference was found in their perception of negative attitude. Further, it was proposed that the differences in the attitude of the employees are because of their perception of justice and support towards ETM practices. It was found that perceived justice mediates the relationship of ETM with both positive and negative attitudes, but perceived support only mediates the relationship of ETM practices and the negative attitude.
Giant Enhancement of Second-Harmonic Generation in Hybrid Metasurface Coupled MoS2 with Fano-Resonance Effect
Authors: Xie Yunfei , Yang Liuli , Du Juan , Li Ziwei
Published: October 2022

Plasmonic nanostructures have been regarded as potential candidates for boosting the nonlinear up-conversion rate at the nanoscale level due to their strong near-field enhancement and inherent high design freedom. Here, we design a hybrid metasurface to realize the moderate interaction of Fano resonance and create the dual-resonant mode-matching condition to facilitate the nonlinear process of second harmonic generation (SHG). The hybrid metasurface presents dipolar and octupolar plasmonic modes near the fundamental and doubled-frequency wavelengths, respectively, further utilized to enhance the SHG of low-dimensional MoS2 semiconductors. The maximum intensity of SHG in hybrid metasurface coupled MoS2 is more than ten thousand times larger than that of other structure-units coupled MoS2. The conversion efficiency is reported to be as high as 3.27 × 10−7. This work paves the way to optimize nonlinear light–matter interactions in low-dimensional structures coupled with semiconductors.
Microbial features of mature and abandoned soils in refractory clay deposits
Authors: Zverev Aleksei , Kimeklis Anastasiia , Kichko Arina , Gladkov Grigory , Andronov Evgeny , Abakumov Evgeny
Published: October 2022

Processes of soil restoration in anthropogenically disturbed soils is an urgent topic in modern ecology and nature management. Being mediator between mineral soil composition and plant vegetation, soil microbial community is important factor of soil restoration processes. Analysis of main soil nutrition components followed by 16S amplicon sequencing are sufficient methods for primary analysis of novel locations. Here is the primary analysis in a novel location in Northwest Europe (Russia). Main nutrition parameters (pH, P, Na and NH4+) and 16S rDNA Illumina amplicons were explored in abandoned soils from sandy pit quarry (2 sites) and refractory clay mining dumps (4 sites).

Microbial communities of mature soils and dumps are variable and different in terms both nutritional and microbial components. pH, N and TOC are strong predictors for microbial composition. Dumps of refractory clays pQ_2 are non-developed soils, highly acidic and form specific microbial community. Differences between dumps and mature soils in both pre-quaternary and quaternary soils are connected with specific bacterial taxa. Those taxa are connected more with plant composition, not the soil properties themselves. The exact changes in microbial community are unique for different soils and areas.

Graphical Abstract
The diurnal emission of floral scent in Oncidium hybrid orchid is controlled by CIRCADIAN CLOCK ASSOCIATED 1 (CCA1) through the direct regulation on terpene synthase
Authors: Yeh Chao-Wei , Zhong Hui-Qin , Ho Yung-Feng , Tian Zhi-Hong , Yeh Kai-Wun
Published: October 2022

Background

To adapt the periodic fluctuation of environmental factors, plants are subtle to monitor the natural variation for the growth and development. The daily activities and physiological functions in coordination with the natural variation are regulated by circadian clock genes. The circadian emission of floral scents is one of the rhythmic physiological activities controlled by circadian clock genes. Here, we study the molecular mechanism of circadian emission pattern of ocimene and linalool compounds in Oncidium Sharry Baby (Onc. SB) orchid.

Results

GC-Mass analysis revealed that Onc. SB periodically emitted ocimene and linalool during 6 to 14 o’clock daily. Terpene synthase, one of the key gene in the terpenoid biosynthetic pathway is expressed in coordination with scent emission. The promoter structure of terpene synthase revealed a circadian binding sequence (CBS), 5’-AGATTTTT-3’ for CIRCADIAN CLOCK ASSOCIATED1 (CCA1) transcription factor. EMSA data confirms the binding affinity of CCA1. Transactivation assay further verified that TPS expression is regulated by CCA1. It suggests that the emission of floral scents is controlled by CCA1.

Conclusions

The work validates that the mechanism of circadian emission of floral scents in Onc. Sharry Baby is controlled by the oscillator gene, CCA1(CIRCADIAN CLOCK ASSOCIATED 1) under light condition. CCA1 transcription factor up-regulates terpene synthase (TPS) by binding on CBS motif, 5’-AGATTTTT-3’ of promoter region to affect the circadian emission of floral scents in Onc. SB.
Model-based evaluation of the impact of prophylactic vaccination applied to Ebola epidemics in Sierra Leone and Democratic Republic of Congo
Authors: Potluri Ravi , Kumar Amit , Oriol-mathieu Valérie , Van Effelterre Thierry , Metz Laurent , Bhandari Hitesh
Published: October 2022

Background

Protection by preventive Ebola vaccines has been demonstrated in clinical trials, but a complete picture of real-world effectiveness is lacking. Our previous study modeling the impact of preventively vaccinating healthcare workers (HCW) alone or with a proportion of the general population (GP) estimated significant reductions in incidence and mortality. The model assumed 100% vaccine efficacy, which is unlikely in the real world. We enhanced this model to account for lower vaccine efficacy and to factor in reduced infectiousness and lower case fatality rate in vaccinated individuals with breakthrough infections.

Methods

The previous model was enhanced to still permit a risk, although lower, for vaccinated individuals to become infected. The enhanced model, calibrated with data from epidemics in Sierra Leone (SL) and North Kivu, Democratic Republic of the Congo, helped evaluate the impact of preventive Ebola vaccination in different scenarios based on different vaccine efficacy rates (90% and 30% reductions in infection risk in the base and conservative scenarios, respectively; additionally, both scenarios with 50% reductions in infectiousness and mortality) and vaccination coverage among HCWs (30%, 90%) and GP (0%, 5%, and 10%).

Results

The base scenario estimated that, depending upon the proportions of vaccinated HCWs and GP, 33–85% of cases and 34–87% of deaths during the 2014 SL epidemic and 42–89% of cases and 41–89% of deaths during the 2018 North Kivu epidemic would be averted versus no vaccination. Corresponding estimates for the conservative scenario were: 23–74% of cases and 23–77% of deaths averted during the SL epidemic and 31–80% of both cases and deaths averted during the North Kivu epidemic.

Conclusions

Preventive vaccination targeting HCW alone or with GP may significantly reduce the size and mortality of an EVD outbreak, even with modest efficacy and coverage. Vaccines may also confer additional benefits through reduced infectiousness and mortality in breakthrough cases.
A retrospective review of genital fistula occurrence in nine African countries
Authors: Ngongo Carrie J. , Raassen Thomas J. I. P. , Mahendeka Marietta , Lombard Ladeisha , van Roosmalen Jos , Temmerman Marleen
Published: October 2022

Background

Female genital fistulas are abnormal communications that lead to urinary and/or fecal incontinence. This analysis compares the characteristics of women with fistulas to understand how countries differ from one another in the circumstances of genital fistula development.

Methods

This retrospective records review evaluated demographics and circumstances of fistula development for 6,787 women who sought fistula treatment between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia, and Ethiopia.

Results

Most women developed fistula during childbirth, whether vaginal (3,234/6,787, 47.6%) or by cesarean section (3,262/6,787, 48.1%). Others had fistulas attributable to gynecological surgery (215/6,787, 3.2%) or rare causes (76/6,787, 1.1%). Somalia, South Sudan, and Ethiopia had comparatively high proportions following vaginal birth and birth at home, where access to care was extremely difficult. Fistulas with live births were most common in Kenya, Malawi, Rwanda, Uganda, Tanzania, and Zambia, indicating more easily accessible care.

Conclusions

Characteristics of women who develop genital fistula point to geographic differences in obstetric care. Access to care remains a clear challenge in South Sudan, Somalia, and Ethiopia. Higher proportions of fistula after cesarean birth and gynecological surgery in Kenya, Malawi, Rwanda, Uganda, Tanzania, and Zambia signal potential progress in obstetric fistula prevention while compelling attention to surgical safety and quality of care.
Development and validation of an ECM-related prognostic signature to predict the immune landscape of human hepatocellular carcinoma
Authors: Wu Guozhi , Yang Yuan , Ye Rong , Yue Hanxun , Zhang Huiyun , Huang Taobi , Liu Min , Zheng Ya , Wang Yuping , Zhou Yongning , Guo Qinghong
Published: October 2022

Background

The global burden of hepatocellular carcinoma (HCC) is increasing, negatively impacting social health and economies. The discovery of novel and valuable biomarkers for the early diagnosis and therapeutic guidance of HCC is urgently needed.

Methods

Extracellular matrix (ECM)-related gene sets, transcriptome data and mutation profiles were downloaded from the Matrisome Project and The Cancer Genome Atlas (TCGA)-LIHC datasets. Coexpression analysis was initially performed with the aim of identifying ECM-related lncRNAs (r > 0.4, p < 0.001). The screened lncRNAs were subjected to univariate analysis to obtain a series of prognosis-related lncRNA sets, which were incorporated into least absolute selection and shrinkage operator (LASSO) regression for signature establishment. Following the grouping of LIHC samples according to risk score, the correlations between the signature and clinicopathological, tumour immune infiltration, and mutational characteristics as well as therapeutic response were also analysed. lncRNA expression levels used for modelling were finally examined at the cellular and tissue levels by real-time PCR. All analyses were based on R software.

Results

AL031985.3 and MKLN1-AS were ultimately identified as signature-related lncRNAs, and both were significantly upregulated in HCC tissue samples and cell lines. The prognostic value of the signature reflected by the AUC value was superior to that of age, sex, grade and stage. Correlation analysis results demonstrated that high-risk groups exhibited significant enrichment of immune cells (DCs, macrophages and Tregs) and increased expression levels of all immune checkpoint genes. Prominent differences in clinicopathological profiles, immune functions, tumour mutation burden (TMB) and drug sensitivity were noted between the two risk groups.

Conclusions

Our signature represents a valuable predictive tool in the prognostic management of HCC patients. Further validation of the mechanisms involved is needed.
Liquid biopsy for detecting epidermal growth factor receptor mutation among patients with non-small cell lung cancer treated with afatinib: a multicenter prospective study
Authors: Fujii Hiroaki , Nagakura Hideyuki , Kobayashi Nobuaki , Kubo Sousuke , Tanaka Katsushi , Watanabe Keisuke , Horita Nobuyuki , Hara Yu , Nishikawa Masanori , Miura Kenji , Koizumi Harumi , Ito Yu , Tsubakihara Motofumi , Miyazawa Naoki , Kudo Makoto , Shinkai Masaharu , Kaneko Takeshi
Published: October 2022

Background

This study aimed to determine the effectiveness of liquid biopsy in detecting epidermal growth factor receptor (EGFR) mutations at diagnosis, disease progression, and intermediate stages.

Methods

This prospective, multicenter, observational study included 30 patients with non-small cell lung cancer treated with afatinib, harboring a major EGFR mutation confirmed by tumor tissue biopsy. We collected blood samples for liquid biopsy at diagnosis, intermediate stage, and progressive disease. Tissue and liquid biopsies were examined using Cobas ® EGFR Mutation Test v2.

Results

Liquid biopsy detected EGFR mutations in 63.6% of the patients at diagnosis. The presence of metastasis in the extrathoracic, brain, and adrenal glands correlated positively with the detection of EGFR mutations. Patients with positive EGFR mutations at diagnosis had significantly shorter overall and progression-free survival than patients with negative EGFR mutations. Four of the 18 patients (22.2%) who reached progressive disease had positive EGFR T790M mutations. Three of 10 patients (30.0%) with progressive disease were positive and negative for T790M using tumor re-biopsy and liquid biopsy, respectively. The results of EGFR mutation by tissue re-biopsy were the same as those of liquid biopsy in the three patients who were positive for significant EGFR mutations but negative for the T790M mutation using liquid biopsy at progressing disease. Only two patients were positive for major EGFR mutations at intermediate levels.

Conclusions

Liquid biopsy can be a prognostic factor in EGFR-tyrosine kinase inhibitor treatments at diagnosis. Tumor re-biopsy can be omitted in patients with positive EGFR mutations by liquid biopsy at PD.
Botulinum toxin treatment for bielschowsky acquired comitant esotropia in adults
Authors: Ai Likun , Chen Xiaoli , Guo Ruilin , Li Jing , Wang Jinghui , Feng Yi , Guo Yiqin , Wang Jianan
Published: October 2022

Background

Many researchers have noticed that there is an increasing trend of Bielschowsky acquired comitant esotropia (ACE) in recent years related to excessive near work, but the exact pathogenesis and treatment methods have not been reported yet. Therefore, we aimed to characterize the clinical features of this ACE in adults and to evaluate the efficacy of botulinum toxin (BTX) injections in these patients.

Methods

This was a prospective consecutive case series of 47 patients with Bielschowsky ACE. BTX was injected bilaterally into the medial rectus muscle of 45 patients, and twenty-seven of them (27/45) completed 10 months of follow-up after their last injection. Angle of deviation, fusion, stereopsis, subjective assessment of diplopia were documented before and after BTX treatment, and repeated measures data were compared by the Wilcoxon signed-rank test or Analysis of variance. The relationship between BTX dosage and corrected esotropia was explored by the Regression analysis. Meanwhile, possible risk factors for ACE including time spent on near work, refraction error, patients’ personality, glasses wearing habits and duration of symptoms were recorded and analyzed with General Linear Models.

Results

The patients aged 32.32 ± 10.96 (range 15–53) years spent 8.34 ± 2.38 h on near work each day, and most myope habitually removed their glasses at near. Their chief complaint was distance diplopia, with more significant esotropia at distance (around 20 PD) than at near. This series of patients also exhibited perfectionist tendencies. However, most patients achieved orthophoria after BTX treatment, only with a mild residual esotropia (+ 3.96 ± 5.79 PD), which left them asymptomatic most of the time.

Conclusion

This group of ACE patients was characterized by diplopia with more significant esotropia at distance. Besides excessive near-work, habitually removing myopic glasses and perfectionist tendencies may also contribute to this type of ACE. Fortunately, bilateral BTX injection safely and effectively reduced the esotropia with complete resolution of symptoms, especially for those treated at an early stage.
The burden of flashes and floaters in traditional general emergency services and utilization of ophthalmology on-call consultation: a cross-sectional study
Authors: Shen Carl , Liu Alicia , Farrokhyar Forough , Fava Mark
Published: October 2022

Purpose

To characterize the healthcare utilization and clinical characteristics of patients presenting with flashes and/or floaters (F/F) in general emergency service (GES) settings.

Methods

All adults presenting to GESs (emergency departments (EDs) and urgent care centers (UCCs)) with symptoms of F/F in Hamilton, Ontario between Jan. 1 – Dec. 31, 2018 were reviewed. Primary outcome was the proportion of patients presenting to GESs with F/F for which ophthalmology emergency services (OESs) were consulted. Secondary outcomes included features predictive of OES consultation by logistic regression and cost of GES utilization.

Results

Of 6590 primary eye-related visits to GESs, 10.4% (687) involved symptoms of F/F. Mean age of patients with F/F was 57 ± 15 years, and 61% were female. Consultation rate to OESs for F/F presentations was 89% (608/687). Logistic regression identified symptoms ≤ 2 weeks (OR 8.0; 95% CI 2.3–28), ≥ 45 years age (OR 2.4; 95% CI 1.4–4.3), UCC setting (OR 2.7; 95% CI 1.6–4.6), headache (OR 0.22; 95% CI 0.12–0.41), and neurologic symptoms (OR 0.1; 95% CI 0.19–0.49) as variables predictive of OES consultation. Mean time from triage to discharge in GESs for F/F patients was 2.43 ± 2.36 h. Mean cost per visit was $139.11 ± $113.93 Canadian dollars. Patients for which OES were consulted waited a total of 1345 h in GESs and accounted for $81,879.70 in costs.

Conclusion

Patients presenting with F/F in GESs consume considerable resources in healthcare expenditure and time spent in GESs and most receive OES consultation. Identifying these patients at triage may allow for increased efficiency for the healthcare system and patients.
Reply to: differential diagnosis of pseudohypopyon and discussion of extranodal natural killer/T-cell lymphoma presenting as hypopyon panuveitis
Authors: Sukon Nutchaya , Tesavibul Nattaporn , Choopong Pitipol , Panyayingyong Noppakhun , Boonsopon Sutasinee
Published: October 2022

Extranodal natural killer/T-cell lymphoma rarely presents as intraocular masquerade syndrome. We thank Dr. Evereklioglu for bringing up the importance of a thorough ocular examination, differential diagnosis, and consideration of the characteristics of ocular masquerade syndrome.
Epidemiology of revision hip replacement in Italy: a 15-year study
Authors: Longo Umile Giuseppe , Papalia Rocco , Salvatore Giuseppe , Tecce Salvatore Maria , Jedrzejczak Alexander , Marcozzi Martina , Piergentili Ilaria , Denaro Vincenzo
Published: October 2022

Background

Over the past two decades, there has been an increase in the amount of primary total hip arthroscopies (THA) which in turn has increased the need for THA revision surgeries. The purpose of this study was to quantify the increase in THA revision in Italy, evaluate the causes and types of THA procedures performed.

Methods

The data regarding revision hip prosthetic replacements performed both in public and private structures between 2001 and 2015 was collected by the National Hospital Discharge reports (SDO) carried out by the Italian Ministry of Health.

Results

Overall, 109,746 Revision Hip Replacements (RHR) were performed in Italy from 2001 to 2015 in the adult population. The study shows a greater number of female patients underwent surgery between 2001 and 2015 and the 75- to 79-year age group had the highest incidence of THA revision. The main causes for THA revision were found to be “Mechanical complication of internal orthopedic device implant and graft” (31.5%), “Infection and inflammatory reaction due to internal joint prosthesis” (10.5%) and “Mechanical loosening of prosthetic joint” (8.3%).

Conclusions

Revision hip replacement is growing and heavily affecting the population between 65 and 89 years and the main causes of THA revision have been quantified. The average length of hospitalization (LOS) was found to have decreased over the 14-year study period. Understanding the causes and risk factors for revision is essential in identifying avoidable complications and improving preventative care for patients undergoing primary implantation to decrease the revision burden.
Status of female sexual dysfunction among postmenopausal women in Bangladesh
Authors: Amin Mohammad Ashraful , Mozid Nusrat-E , Ahmed Sanjana Binte , Sharmin Shakila , Monju Imran Hossain , Jhumur Shirin Shahadat , Sarker Wharesha , Dalal Koustuv , Hawlader Mohammad Delwer Hossain
Published: October 2022

Background

Women's sexual health and physical desire for sex are most important for their emotional and physical well-being. This study aimed to examine the status of sexual dysfunction among postmenopausal women in Bangladesh and assess the significant risk factors behind this.

Methods

A cross-sectional study was conducted among 45–55 years in four public and private hospitals in Bangladesh from April 2021 to June 2021 using a multi-stage sampling technique to enroll the study participants. The female sexual function index (FSFI) scale measured the prevalence of FSD, and the relationship of independent risk factors were assessed using a multivariate logistic regression model.

Results

The total score of FSFI among postmenopausal Bangladeshi women was 18.07 ± 8.51. Among 260 participants, the prevalence of FSD was 56.9%. Out of all the significant risk factors, increasing age, urban population group, multiparous, homemakers, duration of menopause, and postmenopausal women with no hormone therapy were significantly associated with FSD. In contrast, those with regular physical activity were protective of FSD.

Conclusion

In conclusion, a significant proportion of postmenopausal Bangladeshi women are enduring sexual dysfunction. Proper hormonal therapy and non-hormonal therapies such as physical activity and pelvic floor muscle (Kegel) exercise with adequate counseling are helpful to cope in this distressing situation.
Prior degree and academic performance in medical school: evidence for prioritising health students and moving away from a bio-medical science-focused entry stream
Authors: Aston-Mourney Kathryn , McLeod Janet , Rivera Leni R. , McNeill Bryony A. , Baldi Deborah L.
Published: October 2022

Background

Given the importance of the selection process, many medical schools are reviewing their selection criteria. The traditional pathway for post-graduate medicine has been from science-based undergraduate degrees, however some programs are expanding their criteria. In this study we investigated academic success across all years and themes of the Deakin University medical degree, based on the type of degree undertaken prior to admission. We evaluated whether the traditional pathway of biomedical science into medicine should remain the undergraduate degree of choice, or whether other disciplines should be encouraged.

Methods

Data from 1159 students entering the degree from 2008 to 2016 was collected including undergraduate degree, grade point average (GPA), Graduate Medical Schools Admission Test (GAMSAT) score and academic outcomes during the 4 years of the degree. Z-scores were calculated for each assessment within each cohort and analysed using a one sample t-test to determine if they differed from the cohort average. Z-scores between groups were analysed by 1-way ANOVA with LSD post-hoc analysis correcting for multiple comparisons.

Results

The majority of students had Science (34.3%) or Biomedical Science (31.0%) backgrounds. 27.9% of students had a Health-related undergraduate degree with smaller numbers of students from Business (3.5%) and Humanities (3.4%) backgrounds. At entry, GPA and GAMSAT scores varied significantly with Biomedical Science and Science students having significantly higher scores than Health students. Health students consistently outperformed students from other disciplines in all themes while Biomedical Science students underperformed.

Conclusions

Our data suggest that a Health-related undergraduate degree results in the best performance throughout medical school, whereas a Biomedical Science background is associated with lower performance. These findings challenge the traditional Biomedical Science pathway into medicine and suggest that a health background might be more favourable when determining the selection criteria for graduate entry into medicine.
Evaluating the effects of supplementing ward nurses on quality of newborn care in Kenyan neonatal units: protocol for a prospective workforce intervention study
Authors: Imam Abdulazeez , Gathara David , Aluvaala Jalemba , Maina Michuki , English Mike
Published: October 2022

Background

Data from High Income Countries have now linked low nurse staff to patient ratios to poor quality patient care. Adequately staffing hospitals is however still a challenge in resource-constrained Low-middle income countries (LMICs) and poor staff-to-patient ratios are largely taken as a norm. This in part relates to limited evidence on the relationship between staffing and quality of patient care in these settings and also an absence of research on benefits that might occur from improving hospital staff numbers in LMICs. This study will determine the effect on the quality of patient care of prospectively adding extra nursing staff to newborn units in a resource constrained LMIC setting and describe the relationship between staffing and quality of care.

Methods

This prospective workforce intervention study will involve a multi-method approach. We will conduct a before and after study in newborn units of 4 intervention hospitals and a single time-point comparison in 4 non-intervention hospitals to determine if there is a change in the level of missed nursing care, a process measure of the quality of patient care. We will also determine the effect of our intervention on routinely collected quality indicators using interrupted time series analysis. Using three nurse staffing metrics (Total nursing hours, nursing hours per patient day and nursing hours per patient per shift), we will describe the relationship between staffing and the quality of patient care.

Discussion

There is an urgent need for the implementation of staffing policies in resource constrained LMICs that are guided by relevant contextual data. To the best of our knowledge, this is the first study to evaluate the prospective addition of nursing staff in resource-constrained care settings. Our findings are likely to provide the much-needed evidence for better staffing in these settings.

Trial registration

This study was retrospectively registered in the Pan African Clinical Trial Registry (https://pactr.samrc.ac.za/Default.aspx?Logout=True) database on the 10th of June 2022 with a unique identification number-PACTR202206477083141.