bluuebunny/crossref_metadata_2025 huggingface dataset:
Taking a detailed look at early childhood educators’ worktime
Authors: Harrison Linda J , Wong Sandie , Brown Judith E , Gibson Megan , Cumming Tamara , Bittman Michael , Press Frances
Published: December 2023

Despite the acknowledged complexity and time pressures of early childhood educators’ work, very few studies have examined the nature of this work, minute-by-minute, over the working day. This paper reports on data gathered through 10,155 time-use diary (TUD) records provided by 321 educators participating in the Exemplary Early Childhood Educators at Work Australian Research Council Linkage Project. Participants were recruited from preschool/kindergarten and long day care centres that had achieved a rating of Exceeding the Australian National Quality Standard on all seven Quality Areas. Analyses of this extensive dataset illustrate the rhythm and diversity of educators’ work across a typical day and identify the similarities and differences in worktime distributions for educators working in preschool vs. long day care settings, and for educators with different qualifications and positional responsibilities. The findings suggest differential allocations of worktime that raise important considerations for achieving high quality early childhood education and care services.
Getting to the Objective: Analyzing Navigation, Automation, and Situation Awareness from a Soldier’s Perspective
Authors: Walters Jacob S.
Published: December 2023

Land navigation ability is essential for US Army soldiers, who must use it both when planning routes to an objective and while executing the mission itself. Soldiers use automation to offload the cognitive effort of navigation, but if the system fails soldiers must expend precious time and mental energy reacquiring their location on a map. Despite this risk, soldiers still over-trust automated navigation and lose their location-related situation awareness. Loss of situation awareness leads to an inability to acquire the necessary spatial knowledge required to manually navigate. This paper reviews existing research to examine the effects of automation on situation awareness and a user’s ability to build a cognitive map from a soldier’s perspective. It further identifies issues with current technology and suggests possible directions for future research.
Exploring Use of Explanative Illustrations to Communicate Differential Privacy Models
Authors: Xiong Aiping , Wu Chuhao , Wang Tianhao , Proctor Robert W. , Blocki Jeremiah , Li Ninghui , Jha Somesh
Published: December 2023

Proper communication is key to the adoption and implementation of differential privacy (DP). In this work, we designed explanative illustrations of three DP models (Central DP, Local DP, Shuffler DP) to help laypeople conceptualize how random noise is added to protect individuals’ privacy and preserve group utility. Following a pilot survey and an interview, we conducted an online experiment ( N = 300) exploring participants’ comprehension, privacy and utility perception, and data-sharing decisions across the three DP models. We obtained empirical evidence showing participants’ acceptance of the Shuffler DP model for data privacy protection. We discuss the implications of our findings.
Designing Visual Displays for Deep Space Habitats: Challenges and Opportunities from a Cognitive Task Analysis with ISS Mission Control
Authors: Zhang Zixu , Parsons Paul
Published: December 2023

This paper explores some challenges and opportunities in designing visual interfaces for deep space habitats with communication delays to Earth. The study first examines how Mission Control for the International Space Station (ISS) operates in detecting and responding to anomalous events. Interviews with participants who have held roles as flight controllers, backroom engineers, astronauts, or flight instructors for ISS and shuttle missions were conducted to gain insights into the responses to anomalous events. The collected anomalous scenarios were then re-considered under the context of deep space missions, where communication delays and other environmental factors are substantially different. Findings and insights on data analysis of the anomalous scenarios were then presented subsequently. Based on the findings, four areas of challenges and opportunities for visual interfaces design were identified. The paper suggests that these design challenges and opportunities be considered in more detail in future research.
A 2-Year Outcomes and Complications of Various Techniques of Lumbar Discectomy: A Multicentric Prospective Study
Authors: Goparaju Praveen , Rajamani Pritem A. , Kulkarni Arvind G. , Kumar Priyambada , Adbalwad Yogesh M. , Bhojraj Shekhar , Nene Abhay , Rajasekaran S. , Acharya Shankar , Bhanot Arun , Lokhande Pramod , Patel Priyank , Chandra Dey Paresh , Chhabra Harvinder Singh , Rajamani Achimuthu , Rajendraprasad Dave Bharat , Krishnan Ajay
Published: December 2023

Study Design

Prospective Study.

Objectives

There are numerous techniques for performing lumbar discectomy, each with its own rationale and stated benefits. The authors set out to evaluate and compare the perioperative variables, results, and complications of each treatment in a group of patients provided by ten hospitals and operated on by experienced surgeons.

Methods

This prospective study comprised of 591 patients operated between February-2017 to February-2019. The procedures included open discectomy, microdiscectomy, tubular microdiscectomy, interlaminar endoscopic lumbar discectomy, transforaminal endoscopic lumbar discectomy and Destandau techniques with a follow-up of minimum 2 years. VAS (Visual Analogue Score) for back and leg pain, ODI (Oswestry Disability Index), duration of surgery, hospital stay, length of scar, operative blood loss and peri-operative complications were recorded in each group.

Results

Post-operatively, there was a significant improvement in the VAS score for back pain as well as leg pain, and ODI scores spanning all groups, with no significant distinction amongst them. When compared to open procedures (open discectomy and microdiscectomy), minimally invasive surgeries (tubular discectomy, interlaminar endoscopic lumbar discectomy, transforaminal endoscopic lumbar discectomy, and Destandau techniques) reported shorter operative time, duration of hospital stays, better cosmesis, and lower blood loss. Overall, the complication rate was reported to be 8.62%. Complication rates differed slightly across approaches.

Conclusion

Minimally invasive surgeries have citable advantages over open approaches in terms of perioperative variables. However, all approaches are successful and provide comparable pain relief with similar functional outcomes at long term follow up.
“They Masked our Children”: School District Communication Officers’ Sensemaking of Parent Activists During the COVID-19 Pandemic
Authors: Richardson Brian K. , Cosgrove Samantha , Elkhalid Amnee
Published: December 2023

Since the COVID-19 pandemic emerged, school board meetings were regularly featured on news broadcasts and social media platforms, depicting scenes of conflict, controversy, and disruption. We wondered how school district communication officers made sense of and remembered parent activists during the pandemic. Using sensemaking theory as a guiding framework, we analyzed data from interviews with 22 school district public information officers (PIOs) in Texas. Data analysis revealed what PIOs noticed (e.g. uncertainty, school board politicization, and closing/opening schools), their meaning-making (e.g. “return-to-normalcy” parents and “risk-averse” parents), and their actions (high vs. low engagement). With regard to remembering, or legacy, emergent themes included “strengthened relationships and learning” and the “domino effect,” which describes school districts where parent activism has persisted with new issues. In light of these findings, we offer theoretical and practical implications including recognition of several sensemaking tensions and impacts on PIOs of sensemaking under prolonged, stressful conditions.
Taiwan Plains Austronesian Latin scripts and documents from the 17th to the 19th century: A bibliographical survey
Authors: Tai Chung-pui
Published: December 2023

In this paper, we aim to describe the evolution, from birth to extinction, of the Latin scripts of the Taiwan Plains Austronesians, which record the Siraya, Taivoan, Makatau, Favorlang and Basay languages, based on a comprehensive bibliographical survey of the documents, surviving and lost, written in these scripts. We first discuss the background of, motivations for and process of creating the scripts. Using the Siraya script as an example, the paper demonstrates how different usage layers can affect the spelling and document format of a script. From a survey based on published Dutch and Spanish archival materials and other records from the 17th to the 19th century, we compile a total of 51 items of Plains Austronesian Latin documents. A comparison of these items reveals the text formation process of the documents. We suggest that the contribution of Daniël Gravius in the Siraya translation of the Gospels of Matthew and John and the Christian formulary may not have been significant, although he was often later credited as the author. The survey also provides clues when searching for ‘lost’ items, such as the Siraya ABC Book. In addition, we collate Plains Austronesian Latin script accounts in Chinese records. These provide strong evidence of the use of Latin script in Makatau villages during the Qing dynasty. The records also reveal that during the 18th century, there were Plains Austronesian people who knew the Latin script, called ‘teachers’. It may have originated from the schoolteachers of the Dutch colonial period. After the Dutch withdrew, these ‘teachers’ became responsible for the villages’ accounting and administrative documents. The education of Plains Austronesian children was then conducted by schools established in the Qing dynasty, with Han Chinese teachers recruited to teach the children Chinese classics.
Housing for talents: Highly skilled migrants’ strategies for accessing affordable rental housing
Authors: Lu Qianyu , Burgess Gemma
Published: December 2023

Aligned with industrial restructuring and upgrading in China, many cities have issued favourable ‘talent’ policies, including ‘talent housing’ policies, to attract and absorb highly skilled rural-to-urban migrants. One such policy has been for local governments to offer Affordable Rental Housing (ARH) for talents and their families. While the migration motives and labour market positions of highly skilled migrants are well-understood, significantly less attention has been paid to their housing circumstances. This paper explores the housing strategies of highly skilled newcomers in accessing subsidised housing in Shanghai (from rural-to-urban migrants’ perspective). The qualitative data was drawn from 62 in-depth interviews with migrants and analysed thematically using NVivo.

This study extends existing theories by demonstrating that highly skilled migrants adopt multi-layered and multi-phased coping strategies. In their pursuit of desired housing outcomes, migrant applicants initiated multi-layered strategies, seeking information from diverse sources and evaluating their prospects. However, findings reveal that the actual institutional policy landscape sometimes conflicts with the proclaimed talent-oriented target, resulting in unexpected structural barriers and constraints. Consequently, highly skilled migrants are compelled to employ additional and ad hoc solutions, often deemed unsatisfactory and compromising. The paper then illustrates how coping becomes multi-phased as migrants grapple with these additional structural barriers, which their initial coping strategies alone cannot sufficiently address. By introducing the innovative concept of ‘coping with coping’, this paper enriches existing coping strategies and structuration theories, offering valuable insights for policymakers and government authorities.
Dementia subtypes, cognitive decline and survival among older adults attending a memory clinic in Cape Town, South Africa: a retrospective study
Authors: Ssonko Michael , Hardy Anneli , Naganathan Vasi , Kalula Sebastiana , Combrinck Marc
Published: December 2023

Background

There are no published longitudinal studies from Africa of people with dementia seen in memory clinics. The aim of this study was to determine the proportions of the different dementia subtypes, rates of cognitive decline, and predictors of survival in patients diagnosed with dementia and seen in a memory clinic.

Methods

Data were collected retrospectively from clinic records of patients aged ≥ 60 seen in the memory clinic at Groote Schuur Hospital, Cape Town, South Africa over a 10-year period. Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria were used to identify patients with Major Neurocognitive Disorders (dementia). Additional diagnostic criteria were used to determine the specific subtypes of dementia. Linear regression analysis was used to determine crude rates of cognitive decline, expressed as mini-mental state examination (MMSE) points lost per year. Changes in MMSE scores were derived using mixed effects modelling to curvilinear models of cognitive change, with time as the dependent variable. Multivariable cox survival analysis was used to determine factors at baseline that predicted mortality.

Results

Of the 165 patients who met inclusion criteria, 117(70.9%) had Major Neurocognitive Disorder due to Alzheimer’s disease (AD), 24(14.6%) Vascular Neurocognitive Disorder (VND), 6(3.6%) Dementia with Lewy Bodies (DLB), 5(3%) Parkinson disease-associated dementia (PDD), 3(1.8%) fronto-temporal dementia, 4(2.4%) mixed dementia and 6(3.6%) other types of dementia. The average annual decline in MMSE points was 2.2(DLB/PDD), 2.1(AD) and 1.3(VND). Cognitive scores at baseline were significantly lower in patients with 8 compared to 13 years of education and in those with VND compared with AD. Factors associated with shorter survival included age at onset greater than 65 (HR = 1.82, 95% C.I. 1.11, 2.99, p = 0.017), lower baseline MMSE (HR = 1.05, 95% C.I. 1.01, 1.10, p = 0.029), Charlson’s comorbidity scores of 3 to 4 (HR = 1.88, 95% C.I. 1.14, 3.10, p = 0.014), scores of 5 or more (HR = 1.97, 95% C.I. 1.16, 3.34, p = 0.012) and DLB/PDD (HR = 3.07, 95% C.I. 1.50, 6.29, p = 0.002). Being female (HR = 0.59, 95% C.I.0.36, 0.95, p = 0.029) was associated with longer survival.

Conclusions

Knowledge of dementia subtypes, the rate and factors affecting cognitive decline and survival outcomes will help inform decisions about patient selection for potential future therapies and for planning dementia services in resource-poor settings.
Prevention, testing, and treatment interventions for hepatitis B and C in refugee populations: results of a scoping review
Authors: Saseetharran Ankeeta , Hiebert Lindsey , Gupta Neil , Nyirahabihirwe Françoise , Kamali Innocent , Ward John W.
Published: December 2023

Background and aims

Refugees are at higher risk for hepatitis B (HBV) and hepatitis C (HCV), but often face unique healthcare barriers to vaccination, testing, and treatment. This scoping review aimed to identify and characterize HBV and HCV prevention and care services serving refugee populations globally.

Methods

A literature search was conducted on Embase, Cochrane, and PubMed databases. Research studies published in English between January 2010 to July 2022 describing an HBV or HCV prevention, testing, or treatment intervention for refugees were included.

Results

There were a total of 69 articles reporting viral hepatitis prevalence, implementation of services, or economic modelling. Of the 38 implementation studies, 14 were stand-alone HBV and/or HCV interventions, while 24 studies included HBV and/or HCV in an intervention targeting multiple infectious diseases and/or parasitic infections. Interventions commonly included a testing (n = 30) or referral (n = 24) component. Frequently reported features to promote program accessibility included bilingual services (n = 25), community partnerships (n = 21), and multidisciplinary staff members (n = 18), such as cultural and/or linguistic mediators, community health workers, community health leaders, lay health workers, local health staff, members of the refugee community, and social workers. The most commonly reported challenge was the transience of refugees (n = 5). Twenty studies noted funding sources, of which twelve reported governmental funding (not including national health insurance) and eight reported that refugees received national health insurance.

Conclusions

This is the first scoping review to characterize the types of hepatitis prevention, screening, and treatment interventions serving refugee populations globally. Published experiences of HBV and HCV services for refugee populations remain limited. Additional efforts are needed to disseminate models of hepatitis interventions for refugees to ensure access to care for this key population. To achieve hepatitis elimination globally, best practices must be identified and shared to expand access to hepatitis services for refugee populations.
Anticipating undiagnosed asthma in symptomatic adults with normal pre- and post-bronchodilator spirometry: a decision tool for bronchial challenge testing
Authors: Shin Sheojung , Whitmore George Alex , Boulet Louis-Philippe , Boulay Marie-Ève , Côté Andréanne , Bergeron Céline , Lemière Catherine , Lougheed M. Diane , Vandemheen Katherine L. , Alvarez Gonzalo G. , Mulpuru Sunita , Aaron Shawn D.
Published: December 2023

Background

Some patients with asthma demonstrate normal spirometry and remain undiagnosed without further testing.

Objective

To determine clinical predictors of asthma in symptomatic adults with normal spirometry, and to generate a tool to help clinicians decide who should undergo bronchial challenge testing (BCT).

Methods

Using random-digit dialling and population-based case-finding, we recruited adults from the community with respiratory symptoms and no previous history of diagnosed lung disease. Participants with normal pre- and post-bronchodilator spirometry subsequently underwent BCT. Asthma was diagnosed in those with symptoms and a methacholine provocative concentration (PC20) of < 8 mg/ml. Sputum and blood eosinophils, and exhaled nitric oxide were measured. Univariate analyses identified potentially predictive variables, which were then used to construct a multivariable logistic regression model to predict asthma. Model sensitivity, specificity, and area under the receiver operating curve (AUC) were calculated.

Results

Of 132 symptomatic individuals with normal spirometry, 34 (26%) had asthma. Of those ultimately diagnosed with asthma, 33 (97%) answered ‘yes’ to a question asking whether they experienced cough, chest tightness or wheezing provoked by exercise or cold air. Other univariate predictors of asthma included female sex, pre-bronchodilator FEV1 percentage predicted, and percent positive change in FEV1 post bronchodilator. A multivariable model containing these predictive variables yielded an AUC of 0.82 (95% CI: 0.72–0.91), a sensitivity of 82%, and a specificity of 66%. The model was used to construct a nomogram to advise clinicians which patients should be prioritized for BCT.

Conclusions

Four readily available patient characteristics demonstrated a high sensitivity and AUC for predicting undiagnosed asthma in symptomatic adults with normal pre- and post-bronchodilator spirometry. These characteristics can potentially help clinicians to decide which individuals with normal spirometry should be investigated with bronchial challenge testing. However, further prospective validation of our decision tool is required.
Introduction of 3D-classification and its derived surgical sequence of Schatzker type IV tibial plateau fractures
Authors: Liu Zihao , Zhang Yanlong , Wang Shengjie , Wang Shuai , Peng AQin
Published: December 2023

Introduction

Schatzker IV tibial plateau fractures usually have a worse prognosis due to their high variability and the accompanied bony and soft tissue injuries. This study aimed to introduce an injury mechanism-based new classification of Schatzker IV tibial plateau fractures and evaluate its reliability. Additionally, this study aimed to evaluate the outcomes of operative Schatzker IV tibial plateau fractures treated according to the surgical sequences determined by the new classification.

Materials and methods

A total of 63 cases of operative Schatzker IV tibial plateau fractures that were treated following the new surgical sequences were enrolled in our study. The CT images of these patients were reviewed and classified twice according to the new 3D classification by 4 independent observers. The reliability of the classification was calculated through kappa analysis. The classification-determined surgical sequence was evaluated by observing the postoperative efficacy during the follow-up.

Results

Both the intra-observer (the mean k = 0.897, CI 0.806–0.971) and inter-observer (the mean k = 0.883, CI 0.786–0.961) reliability of 3D-classification showed excellent agreement according to Landis and Koch. All the patients were followed up for 6–28 months (average 12.8 months). As for the evaluation of the postoperative efficacy, according to KSS, 53 cases were rated as excellent, 8 cases as good, and 2 cases as fair results.

Conclusions

The new proposed classification showed high intra-observer and inter-observer reliability in our study. The surgical sequence determined by the classification can help surgeons to acquire good reduction and rigid internal fixation. Therefore the new classification of Schatzker IV tibial plateau fractures and the derived surgical sequences are worthy of further popularization and application in clinical trials.
Unveiling professional and personal preferences of early career dentists during first year of employment at the Thai dental public sector: a one-year cross-sectional study
Authors: Arunratanothai Tanit , Booncharoen Ravisorn , Suwankomolkul Sirapop , Limpuangthip Nareudee
Published: December 2023

Background

Despite the implementation of various government policies to retain Thai dentists in public sector, a high turnover rate among early career dentists has persisted for decades. This study aims to explore factors relating to early career dentists’ choice of the public sector as their preferred workplace and decisions relating to staying, resigning, or relocating from the workplace after one-year employment.

Methods

A one-year cross-sectional survey was conducted among Thai early career dentists who began working in 2020 using two sets of online questionnaires. The first survey assessed factors influencing dentists’ decision to choose the public sector as their preferred workplace at the beginning of the year. The second survey investigated factors influencing dentists’ decision to stay, resign, or relocate from the same workplace at one-year after employment. Descriptive statistics and multivariable binary logistic regression were used for data analysis.

Results

A total of 198 early career dentists completed the online survey questionnaire at the starting point (December 2020–January 2021), and 186 dentists completed the one-year employment questionnaire. The living environment and provided amenities and facilities were the most influential factors in their decision to choose and remain in the public sector. Conversely, their attitude toward unrelated job descriptions and an increased opportunity to pursue postgraduate studies were the most relevant factors when deciding to relocate to a new workplace. Factors such as delayed authority in bureaucracy, hometown location, and being in relationship status were the most significant contributors to resignation from the public sector.

Conclusions

The major factors influencing dentists’ choice and retention in the public sector include the living environment, supportive supervisors and colleagues, and the availability of opportunities for further postgraduate education. Meanwhile, factors impacting retention after one year of work are related to hometown location and the bureaucracy system. Collaborations among ministries, tailored to each local community’s specific requirements, may enhance dentists’ retention in public sectors.
“Being prevented from providing good care: a conceptual analysis of moral stress among health care workers during the COVID-19 pandemic”
Authors: Gustavsson Martina E. , von Schreeb Johan , Arnberg Filip K. , Juth Niklas
Published: December 2023

Background

Health care workers (HCWs) are susceptible to moral stress and distress when they are faced with morally challenging situations where it is difficult to act in line with their moral standards. In times of crisis, such as disasters and pandemics, morally challenging situations are more frequent, due to the increased imbalance between patient needs and resources. However, the concepts of moral stress and distress vary and there is unclarity regarding the definitions used in the literature. This study aims to map and analyze the descriptions used by HCWs regarding morally challenging situations (moral stress) and refine a definition through conceptual analysis.

Methods

Qualitative data were collected in a survey of 16,044 Swedish HCWs who attended a COVID-19 online course in autumn 2020. In total, 643 free-text answers with descriptions of moral stress were analyzed through content analysis.

Results

Three themes emerged from the content analysis (1) “Seeing, but being prevented to act; feeling insufficient/inadequate and constrained in the profession,” (2) “Someone or something hindered me; organizational structures as an obstacle,” and (3) “The pandemic hindered us; pandemic-related obstacles.” The three themes correspond to the main theme, “Being prevented from providing good care.”

Discussion

The main theme describes moral stress as various obstacles to providing good care to patients in need and acting upon empathic ability within the professional role. The themes are discussed in relation to established definitions of moral stress and are assessed through conceptual analysis. A definition of moral stress was refined, based on one of the established definitions.

Conclusions

On the basis of the study results and conceptual analysis, it is argued that the presented definition fulfils certain conditions of adequacy. It is essential to frame the concept of moral stress, which has been defined in different ways in different disciplines, in order to know what we are talking about and move forward in developing prevention measures for the negative outcomes of this phenomenon.
Morphologic, phenotypic, and genotypic similarities between primary tumors and corresponding 3D cell cultures grown in a repeatable system—preliminary results
Authors: Muscatello Luisa Vera , Frabetti Stella , Avallone Giancarlo , Gobbo Francesca , Pasquini Arianna , D’Annunzio Giulia , Pisoni Luciano , Marconato Laura , Terragni Rossella , De Biase Dario , Candini Olivia , Sarli Giuseppe
Published: December 2023

Background

Three-dimensional (3D) cell cultures are the new frontier for reproducing the tumor micro-environment in vitro. The aims of the study were (1) to establish primary 3D cell cultures from canine spontaneous neoplasms and (2) to demonstrate the morphological, phenotypic and genotypic similarities between the primary canine neoplasms and the corresponding 3D cultures, through the expression of tumor differentiation markers.

Results

Seven primary tumors were collected, including 4 carcinomas and 3 soft tissue sarcomas. 3D cell cultures reproduced the morphological features of the primary tumors and showed an overlapping immunophenotype of the primary epithelial tumors. Immunohistochemistry demonstrated the growth of stromal cells and macrophages admixed with the neoplastic epithelial component, reproducing the tumor microenvironment. Mesenchymal 3D cultures reproduced the immunophenotype of the primary tumor completely in 2 out of 3 examined cases while a discordant expression was documented for a single marker in one case. No single nucleotide variants or small indel were detected inTP53orMDM2genes, both in primary tumors and in 3D cell cultures specimens. In one sample,MDM2amplicons were preferentially increased in number compared toTP53ones, indicating amplification ofMDM2, detectable both in the primary tumor and in the corresponding cell culture specimen.

Conclusion

Here we demonstrate a good cell morphology, phenotype and genetic profile overlap between primary tumors and the corresponding 3D cultures grown in a repeatable system.
Targeting the Endothelin-1 pathway to reduce invasion and chemoresistance in gallbladder cancer cells
Authors: Rodas Francisco , Vidal-Vidal Jetzabel A. , Herrera Daniela , Brown-Brown David A. , Vera Diego , Veliz Joaquín , Püschel Pilar , Erices José I. , Sánchez Hinojosa Verónica , Tapia Julio C. , Silva-Pavez Eduardo , Quezada-Monrás Claudia , Mendoza-Soto Pablo , Salazar-Onfray Flavio , Carrasco Cristian , Niechi Ignacio
Published: December 2023

Background

Gallbladder cancer (GBC) is a prevalent and deadly biliary tract carcinoma, often diagnosed at advanced stages with limited treatment options. The 5-year survival rate varies widely from 4 to 60%, mainly due to differences in disease stage detection. With only a small fraction of patients having resectable tumors and a high incidence of metastasis, advanced GBC stages are characterized by significant chemoresistance. Identification of new therapeutic targets is crucial, and recent studies have shown that the Endothelin-1 (ET-1) signaling pathway, involving ETAR and/or ETBR receptors (ETRs), plays a crucial role in promoting tumor aggressiveness in various cancer models. Blocking one or both receptors has been reported to reduce invasiveness and chemoresistance in cancers like ovarian, prostate, and colon. Furthermore, transcriptomic studies have associated ET-1 levels with late stages of GBC; however, it remains unclear whether its signaling or its inhibition has implications for its aggressiveness. Although the role of ET-1 signaling in gallbladder physiology is minimally understood, its significance in other tumor models leads us to hypothesize its involvement in GBC malignancy.

Results

In this study, we investigated the expression of ET-1 pathway proteins in three GBC cell lines and a primary GBC culture. Our findings demonstrated that both ETAR and ETBR receptors are expressed in GBC cells and tumor samples. Moreover, we successfully down-regulated ET-1 signaling using a non-selective ETR antagonist, Macitentan, which resulted in reduced migratory and invasive capacities of GBC cells. Additionally, Macitentan treatment chemosensitized the cells to Gemcitabine, a commonly used therapy for GBC.

Conclusion

For the first time, we reveal the role of the ET-1 pathway in GBC cells, providing insight into the potential therapeutic targeting of its receptors to mitigate invasion and chemoresistance in this cancer with limited treatment options. These findings pave the way for further exploration of Macitentan or other ETR antagonists as potential therapeutic strategies for GBC management. In summary, our study represents a groundbreaking contribution to the field by providing the first evidence of the ET 1 pathway's pivotal role in modulating the behavior and aggressiveness of GBC cells, shedding new light on potential therapeutic targets.
Bactericidal effect of low-temperature atmospheric plasma against the Shigella flexneri
Authors: Chen Yan , He Yuanyuan , Jin Tao , Dai Chenwei , Xu Qinghua , Wu Zhengwei
Published: December 2023

Background

Shigella flexneri(S. flexneri) is a common intestinal pathogenic bacteria that mainly causes bacillary dysentery, especially in low socioeconomic countries. This study aimed to apply cold atmospheric plasma (CAP) onS. flexneridirectly to achieve rapid, efficient and environmentally friendly sterilization.

Methods

The operating parameters of the equipment were determined by plasma diagnostics. The plate count and transmission electron microscope were employed to calculate bacterial mortality rates and observe the morphological damage of bacterial cells. Measurement of intracellular reactive oxygen species (ROS) and superoxide anions were detected by 2,7-dichlorodihydrofluorescein (DCFH) and Dihydroethidium fluorescence probes, respectively. The fluorescence intensity (a. u.) reflects the relative contents. Additionally, the experiment about the single effect of temperature, ultraviolet (UV), and ROS on bacteria was conducted.

Results

The peak discharge voltage and current during plasma operation were 3.92kV and 66mA. After discharge, the bacterial mortality rate of 10, 20, 30 and 40 s of plasma treatment was 60.71%, 74.02%, 88.11% and 98.76%, respectively. It was shown that the intracellular ROS content was proportional to the plasma treatment time and ROS was the major contributor to bacterial death.

Conclusion

In summary, our results illustrated that the plasma treatment could inactivateS. flexneriefficiently, and the ROS produced by plasma is the leading cause of bacterial mortality. This highly efficient sterilization method renders plasma a highly promising solution for hospitals, clinics, and daily life.
Unsalaried health workers in Sierra Leone: a scoping review of the literature to establish their impact on healthcare delivery
Authors: Pieterse Pieternella , Saracini Federico
Published: December 2023

Background

The World Health Organisation (WHO) estimates a 10 million health worker shortage by 2030. Despite this shortage, some low-income African countries paradoxically struggle with health worker surpluses. Technically, these health workers are needed to meet the minimum health worker-population ratio, but insufficient job opportunities in the public and private sector leaves available health workers unemployed. This results in emigration and un- or underemployment, as few countries have policies or plans in place to absorb this excess capacity. Sierra Leone, Liberia and Guinea have taken a different approach; health authorities and/or public hospitals ‘recruit’ medical and nursing graduates on an unsalaried basis, promising eventual paid public employment. 50% Sierra Leone’s health workforce is currently unsalaried. This scoping review examines the existing evidence on Sierra Leone’s unsalaried health workers (UHWs) to establish what impact they have on the equitable delivery of care.

Methods

A scoping review was conducted using Joanna Briggs Institute guidance. Medline, PubMed, Scopus, Web of Science were searched to identify relevant literature. Grey literature (reports) and Ministry of Health and Sanitation policy documents were also included.

Results

36 texts, containing UHW related data, met the inclusion criteria. The findings divide into two categories and nine sub-categories: Charging for care and medicines that should be free; Trust and mistrust; Accountability; Informal provision of care, Private practice and lack of regulation. Over-production of health workers; UHW issues within policy and strategy; Lack of personnel data undermines MoHS planning; Health sector finance.

Conclusion

Sierra Leone’s example demonstrates that UHWs undermine equitable access to healthcare, if they resort to employing a range of coping strategies to survive financially, which some do. Their impact is wide ranging and will undermine Sierra Leone’s efforts to achieve Universal Health Coverage if unaddressed. These findings are relevant to other LICs with similar health worker surpluses.
Comparison of the inoculum effect of in vitro antibacterial activity of Imipenem/relebactam and Ceftazidime/avibactam against ESBL-, KPC- and AmpC-producing Escherichia coli and Klebsiella pneumoniae
Authors: Wang Xueting , Xiong Luying , Wang Yuan , Yang Kai , Xiao Tingting , Chi Xiaohui , Chen Tao , Zhou Yanzi , Lu Ping , Dilinuer Dilimulati , Shen Pin , Chen Yunbo , Xiao Yonghong
Published: December 2023

Objective

To evaluate effect of inoculum size of extended-spectrum β-Lactamase (ESBL)-producing-, AmpC-producing-, and KPC-producing Escherichia coli and Klebsiella pneumoniae on the in vitro antibacterial effects of imipenem/relebactam (IMR) and ceftazidime/avibactam (CZA).

Methods

We compared the impact of inoculum size on IMR and CZA of sixteen clinical isolates and three standard isolates through antimicrobial susceptibility tests, time-kill assays and in vitro PK/PD studies.

Results

When inoculum size increased from 105 to 107 CFU/mL, an inoculum effect was observed for 26.3% (5/19) and 52.6% (10/19) of IMR and CZA, respectively; time-kill assays revealed that the concentration of CZA increased from ≥ 4 × MIC to 16 × MIC to reach 99.9% killing rate against K. pneumoniae ATCC-BAA 1705 (KPC-2-, OXA-9- and SHV-182-producing) and 60,700 (SHV-27- and DHA-1-producing). While for IMR, a concentration from 1 × MIC to 4 × MIC killed 99.9% of the four strains. When the inoculum size increased to 109 CFU/mL, neither IMR nor CZA showed a detectable antibacterial effect, even at a high concentration. An in vitro PK/PD study revealed a clear bactericidal effect when IMR administered as 1.25 g q6h when inoculum size increased.

Conclusion

An inoculum effect on CZA was observed more frequent than that on IMR. Among the β-lactamase-producing strains, the inoculum effect was most common for SHV-producing and KPC-producing strains.
Temporally and spatially resolved molecular profiling in fingerprint analysis using indium vanadate nanosheets-assisted laser desorption ionization mass spectrometry
Authors: Zhu Yanli , Wang Jikai , Fu Chengxiao , Liu Shuangquan , Awasthi Pragati , Zeng Pengfei , Chen Danjun , Sun Yiyang , Mo Ziyi , Liu Hailing
Published: December 2023

This study presents the first-ever synthesis of samarium-doped indium vanadate nanosheets (IVONSs:Sm) via microemulsion-mediated solvothermal method. The nanosheets were subsequently utilized as a nano-matrix in laser desorption/ionization mass spectrometry (LDI-MS). It was discovered that the as-synthesized IVONSs:Sm possessed the following advantages: improved mass spectrometry signal, minimal matrix-related background, and exceptional stability in negative-ion mode. These qualities overcame the limitations of conventional matrices and enabled the sensitive detection of small biomolecules such as fatty acids. The negative-ion LDI mechanism of IVONSs:Sm was examined through the implementation of density functional theory simulation. Using IVONSs:Sm-assisted LDI-MS, fingerprint recognitions based on morphology and chemical profiles of endogenous/exogenous compounds were also achieved. Notably, crucial characteristics such as the age of an individual’s fingerprints and their physical state could be assessed through the longitudinal monitoring of particular biomolecules (e.g., ascorbic acid, fatty acid) or the specific biomarker bilirubin glucuronide. Critical information pertinent to the identification of an individual would thus be facilitated by the analysis of the compounds underlying the fingerprint patterns.

Graphical Abstract
Biocompatible copper formate-based nanoparticles with strong antibacterial properties for wound healing
Authors: Zhou Yue , Sun Ping , Cao Yongbin , Yang Jiahao , Wu Qingzhi , Peng Jian
Published: December 2023

Copper-based antibacterial materials have emerged as a potential alternative for combating bacterial infections, which continue to pose significant health risks. Nevertheless, the use of copper-based nanoparticles as antibacterial agents has faced challenges due to their toxicity towards cells and tissues. To overcome this obstacle, we propose a new approach using a contact-active copper-based nanoparticles called polydopamine (PDA)-coated copper-amine (Cuf-TMB@PDA). The positively charged surface of Cuf-TMB@PDA enables efficient targeting of negatively charged bacteria, allowing controlled release of Cu(II) into the bacterial cell membrane. Moreover, Cuf-TMB@PDA exhibits similar ·OH signals as Cuf-TMB suspensions in previous work. In cytotoxicity assays conducted over 72 h, Cuf-TMB@PDA demonstrated an efficacy of 98.56%, while releasing lower levels of Cu(II) that were less harmful to cells, resulting in enhanced antimicrobial effects. These antimicrobial properties are attributed to the synergistic effects of charge-contact activity of PDA, controlled release of Cu(II), and free radicals. Subsequent in vivo experiments confirmed the strong antimicrobial potency of Cuf-TMB@PDA and its ability to promote wound healing.
Comparative effectiveness and cost evaluation of Risankizumab and Adalimumab in the management of psoriasis: a real-world study in Saudi Arabia
Authors: AlRuthia Yazed , Alfakhri Almaha H. , Alharbi Ibtisam , Alghamdi Fadi Ali , Alanazi Miteb A. , Alrabiah Abdullah Abdulrahman , Alsouan Anwar Abdulrazzag , Alshaikh Abdulrahman Abdullah , Almasaoud Majed Ali
Published: December 2023

Background

Psoriasis, an immune-mediated chronic inflammatory disease primarily affecting skin and joints, has varying prevalence rates globally. It manifests in five types, with chronic plaque psoriasis being the most common. Treatment, which has no definitive cure, aims for complete resolution of skin symptoms and depends on disease extent, severity, and impact on patients’ lives. Biologics are an emerging treatment for psoriasis, targeting specific inflammatory pathways for potentially safer, more effective outcomes. However, these come with significant costs, necessitating more research to ensure value for money. This study aimed to compare the effectiveness of Risankizumab versus Adalimumab, the most commonly utilized biologic for managing psoriasis in Saudi Arabia.

Methods

This study retrospectively compared the effectiveness and direct medical cost of Risankizumab and Adalimumab in treating chronic plaque psoriasis in adults from two Saudi Arabian healthcare centers. The Psoriasis Area and Severity Index (PASI) and body surface area (BSA) were used to assess treatment effectiveness, with patient data sourced from electronic medical records. Multiple regression analysis was performed to examine various factors affecting treatment outcomes. An economic evaluation was conducted to examine the cost-effectiveness of the two drugs, considering four scenarios with varying dosage patterns and costs. Analysis was performed from the perspective of public healthcare payers and considered all utilized health services.

Results

The data for 70 patients were analyzed, with comparable baseline characteristics between groups. While Risankizumab led to a greater reduction in PASI scores and BSA affected, these results were not statistically significant. The annual treatment cost for Risankizumab was higher than Adalimumab. Various scenarios were studied, considering real acquisition costs, double dosing for Adalimumab, and the use of biosimilars. A scenario assuming double dosing for Adalimumab and a 40% discount for Risankizumab demonstrated both cost and efficacy advantages in 71.25% of cases.

Conclusions

This study compared the effectiveness and cost of Risankizumab and Adalimumab for treating chronic plaque psoriasis in Saudi Arabian hospitals. Although Risankizumab showed a greater reduction in symptoms, the difference was not statistically significant. However, under certain scenarios, Risankizumab demonstrated cost and efficacy advantages. These findings may influence treatment decisions for psoriasis, but further research is needed.
Concomitant radiosurgical and targeted oncological treatment improves the outcome of patients with brain metastases from gastrointestinal cancer
Authors: Khalaveh Farjad , Cho Anna , Shaltout Abdallah , Untersteiner Helena , Kranawetter Beate , Hirschmann Dorian , Göbl Philipp , Marik Wolfgang , Gatterbauer Brigitte , Rössler Karl , Dorfer Christian , Frischer Josa M.
Published: December 2023

Background

So far, only limited studies exist that evaluate patients with brain metastases (BM) from GI cancer and associated primary cancers who were treated by Gamma Knife Radiosurgery (GKRS) and concomitant immunotherapy (IT) or targeted therapy (TT).

Methods

Survival after GKRS was compared to the general and specific Graded Prognostic Assessment (GPA) and Score Index for Radiosurgery (SIR). Further, the influence of age, sex, Karnofsky Performance Status Scale (KPS), extracranial metastases (ECM) status at BM diagnosis, number of BM, the Recursive Partitioning Analysis (RPA) classes, GKRS1 treatment mode and concomitant treatment with IT or TT on the survival after GKRS was analyzed. Moreover, complication rates after concomitant GKRS and mainly TT treatment are reported.

Results

Multivariate Cox regression analysis revealed IT or TT at or after the first Gamma Knife Radiosurgery (GKRS1) treatment as the only significant predictor for overall survival after GKRS1, even after adjusting for sex, KPS group, age group, number of BM at GKRS1, RPA class, ECM status at BM diagnosis and GKRS treatment mode. Concomitant treatment with IT or TT did not increase the rate of adverse radiation effects. There was no significant difference in local BM progression after GKRS between patients who received IT or TT and patients without IT or TT.

Conclusion

Good local tumor control rates and low rates of side effects demonstrate the safety and efficacy of GKRS in patients with BM from GI cancers. The concomitant radiosurgical and targeted oncological treatment significantly improves the survival after GKRS without increasing the rate of adverse radiation effects. To provide local tumor control, radiosurgery remains of utmost importance in modern GI BM management.
Association between imaging parameter changes and triangular fibrocartilage complex injury after distal radius fractures
Authors: Tan Chunye , Wang Zeyu , Li Linwei
Published: December 2023

Background

Triangular fibrocartilage complex (TFCC) injury is a frequent soft tissue injury that has been observed to accompany distal radius fractures (DRFs) with concomitant changes in radiologic parameters. The aim of this study was to investigate the relevance of distal radial radiologic parameters associated with DRF and traumatic TFCC injury.

Methods

A total of 172 patients with distal radius fractures who underwent X-ray, CT, and MRI before undergoing volar locking plate or external splint fixation between October 2021 and December 2022 were included in this study. An analysis of various radiologic parameters and the classification of fracture type and TFCC injuries by CT and MRI was performed. All patients were divided into the TFCC uninjured group and the injured group. The incidence and relevant radiologic parameters were compared.

Results

This study included 76 males and 96 females with a mean age of 56.1 years. Among all patients, 33 (19.2%), 40 (23.2%), and 99 (57.6%) had DRF with A, B, and C fractures, respectively, according to the AO/OTA classification. In patients with fractures, the TFCC was found to be injured in 54.1% (93/172) of patients (type 1A in 21, 1B in 46, 1C in 39, and 1D in 35) but uninjured in 45.9% (79/172). There were significant differences between the TFCC injured and uninjured groups regarding the radius length (p = 0.044) and DRUJ distance (p = 0.040) of radiologic parameters that changed with DRF, although there were no differences between the two groups regarding gender, age, injured side, intra- and extra-articular, radius inclination and palmer tilt angle, or sagittal translation. Within the TFCC injured group, the radius length and DRUJ distance were 4.83 mm and 2.95 mm less or wider than 7.19 mm and 1.83 mm of the uninjured group. Moreover, shorter radius length was related to type lB TFCC injury (p = 0.041). Both radius length (AUC = 0.658) and DRUJ distance (AUC = 0.582) had no convincing predictive value for TFCC injury in DRF.

Conclusion

1B TFCC injury is most common in patients with DRF and concomitant TFCC injury. Both radius length and DRUJ distance have a significant statistical correlation with TFCC injury, and patients with TFCC injury tend to have a shortened radius and wider DRUJ distance, although they have no predictive value for TFCC injury in DRF. In addition, a shorter radius length was related to type lB TFCC injury.