bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of employment on attendance: A response to ‘Identifying and understanding the drivers of student engagement’
Authors: Hanretty Chris
Published: January 2023

I challenge Strong’s findings that student employment is not related to attendance. I argue that the original analysis is guilty of controlling for a post-treatment variable. As a result, the coefficients in the regression model do not show how employment causes changes in attendance. I show that employment likely has a negative effect on attendance even given severe confounding. Academics should, if asked, tell students that their attendance will likely suffer the more paid work they do.
Administration, labor, and love
Authors: Ginther April
Published: January 2023

Great opportunities for language testing practitioners are enabled through language program administration. Local language tests lend themselves to multiple purposes—for placement and diagnosis, as a means of tracking progress, and as a contribution to program evaluation and revision. Administrative choices, especially those involving a test, are strategic and can be used to transform a program’s identity and effectiveness over time.
Intimate Partner Violence: A New Cognitive, Interpersonal and Motivational Framework for the Rehabilitation of Perpetrators in Portugal
Authors: Capinha Marta , Pereira Marco , Sousa Maria do Natal , Rijo Daniel
Published: January 2023

Intimate partner violence (IPV) has been targeted as a significant concern worldwide, but evidence for the efficacy of perpetrators’ interventions is not undisputable. This article briefly summarizes the evidence about perpetrators’ intervention efficacy, factors associated with recidivism, and evidence-based recommendations, before outlining the assumptions of a new community-delivered intervention aiming to rehabilitate IPV perpetrators: the CONTIGO Program. This program uses an innovative framework, focused on early maladaptive schemas, and combining cognitive, interpersonal, and motivational interview principles. The features of this intervention are discussed, and exploratory results regarding drop-out rates (8%) and recidivism (15.4%) in a sample of 162 court-mandated males are exposed. The detailed presentation of the CONTIGO Program and its intervention model represents a novel contribution that is sorely lacking in the IPV literature and could foster further research and debate about what can be done to effectively intervene with IPV perpetrators.
Does Employee Pay Variation Increase Government Performance? Evidence From a Cross-National Analysis
Authors: Han Xu , Ma Liang , Perry James L.
Published: January 2023

Pay variation across positions, functions, and ranks can affect government performance by influencing the ability of the government to recruit and incentivize civil servants, but this proposition has not been systematically examined. Taking advantage of a new panel dataset, we develop and test the theoretical linkage between pay variation of civil servants and government performance. Our findings show a contingency-based relationship between pay variation and government performance. On average, neither total pay variation nor vertical pay variation is significantly related to government performance measured by the World Bank’s Worldwide Governance Indicators. However, total pay variation is consistently and negatively correlated with government performance in low-income countries. The findings suggest the importance of accounting for national contexts in implementing administrative reforms and are a cautionary lesson about applying theories based on research on private firms to the public sector.
The Association Between Frailty and a Nurse-Identified Need for Comprehensive Geriatric Assessment Referral from the Emergency Department
Authors: Mowbray Fabrice I. , Ellis Brittany , Schumacher Connie , Heckman George , de Wit Kerstin , Strum Ryan P. , Jones Aaron , Correia Rebecca H. , Mercier Eric , Costa Andrew P.
Published: January 2023

Background

Emergency nurses commonly conduct geriatric assessments in the emergency department (ED). However, little is known about what geriatric syndromes or clinical presentations prompt a nurse to document an identified need for comprehensive geriatric assessment (CGA).

Objectives

To examine the association between geriatric syndromes, like frailty, and a nurse-identified need for a CGA following emergency care.

Methods

We conducted a secondary analysis of a multi-province Canadian cohort from the InterRAI Multinational Cohort Study. We collected data at ED registration from patients 75 years of age and older (n = 2,274) from eight ED sites across Canada between November 2009 and April 2012. Geriatric syndromes were assessed by trained emergency nurses using the interRAI ED Contact Assessment; and we retrospectively calculated the ED frailty index. We employed binary logistic regression to determine the adjusted associations between geriatric syndromes and a nurse-identified need for a CGA.

Results

Approximately one-quarter (28%) of older adults were identified to need a CGA following emergency care. A 0.1 unit increase in the ED frailty index increased the likelihood of a nurse identify a need for CGA (RD: 6.6; 95% CI = 5.5–7.9). Most geriatric syndromes increased the probability of a nurse documenting the need for a CGA.

Conclusion

When assessed by emergency nurses, the identified need for CGA is strongly linked to the presence of geriatric syndromes, including frailty. We provide face validity for the continued use of emergency nurses for screening and assessing older ED patients.
Anti-SARS-CoV-2 antibodies following vaccination are associated with lymphocyte count and serum immunoglobulins in SLE
Authors: Reynolds John A , Faustini Sian E , Tosounidou Sofia , Plant Tim , Ubhi Mandeep , Gilman Rebecca , Richter Alex G , Gordon Caroline
Published: January 2023

Objectives

Patients with Systemic Lupus Erythematosus are known to have dysregulated immune responses and may have reduced response to vaccination against COVID-19 while being at risk of severe COVID-19 disease. The aim of this study was to identify whether vaccine responses were attenuated in SLE and to assess disease- and treatment-specific associations.

Methods

Patients with SLE were matched by age, sex and ethnic background to healthcare worker healthy controls (HC). Anti-SARS-CoV-2 spike glycoprotein antibodies were measured at 4–8 weeks following the second COVID-19 vaccine dose (either BNT162b2 or ChAdOx1 nCoV-19) using a CE-marked combined ELISA detecting IgG, IgA and IgM (IgGAM). Antibody levels were considered as a continuous variable and in tertiles and compared between SLE patients and HC and associations with medication, disease activity and serological parameters were determined.

Results

Antibody levels were lower in 43 SLE patients compared to 40 HC ( p < 0.001). There was no association between antibody levels and medication, lupus disease activity, vaccine type or prior COVID infection. Higher serum IgA, but not IgG or IgM, was associated with being in a higher anti-SARS-CoV-2 antibody level tertile (OR [95% CI] 1.820 [1.050, 3.156] p = 0.033). Similarly, higher lymphocyte count was also associated with being in a higher tertile of anti-SARS-CoV-2 (OR 3.330 [1.505, 7.366] p = 0.003)

Conclusion

Patients with SLE have lower antibody levels following 2 doses of COVID-19 vaccines compared to HC. In SLE lower lymphocyte counts and serum IgA levels are associated with lower antibody levels post vaccination, potentially identifying a subgroup of patients who may therefore be at increased risk of infection.
Analysis of core-shell magnetic micropillars for reconfigurable bending actuation
Authors: Hu Baohong , Ni Ke , Wang Zhengzhi
Published: January 2023

Magnetic micropillars that can reversibly and dynamically bend actuated by external magnetic field have been increasingly studied for functional interfacial engineering and soft-robotics applications. Existing micropillars are usually fabricated by solidifying magnetic media (most often nanoparticles) premixed within elastomer solvent, thus the bent configurations of the pillars are fixed upon applying the magnetic stimuli. In this work, we study the fundamental mechanics of the reconfigurable and recyclable bending actuation for the recently proposed liquid-core/solid-shell magnetic micropillars. By dynamically modulating the spatial distribution of the magnetic nanoparticles inside the liquid resin cores of individual micropillars, the bending deformation can be reversibly tuned by near one order magnitude under the same actuation conditions. The regulated bending deformation is achieved by the different distributions of the magnetic actuation force applied on the solid shells of the micropillars. The liquid-core/solid-shell magnetic micropillars reported here provide a generic prototype for reconfigurable and recyclable stimuli-responsive microstructures.
Clinicopathologic Study of Sialadenoma Papilliferum of the Minor Salivary Glands: A Series of 8 New Cases With BRAF V600E Mutation-specific Immunohistochemical Analysis
Authors: Owosho Adepitan A. , Shasteen Alivia M. , Aguirre Sarah E. , Summersgill Kurt F.
Published: January 2023

Introduction. Sialadenoma papilliferum (SP) is a rare benign neoplasm that usually arises in the minor salivary glands. Recently, it was demonstrated that SP shares similar molecular genetic alterations ( BRAF V600E or HRAS mutations) with its morphologic analog, syringocystadenoma papilliferum. Methods. We sought to perform clinicopathologic and immunophenotypic (BRAF V600E and SOX10) analyses on 8 new cases of SP. Results. The cases were from 4 males and 4 females, with ages ranging from 28 to 81 years (average: 64 years). The common locations were the hard palate (n = 3) and buccal mucosa (n = 3). Histopathologically, 7 cases were classic and 1 case was oncocytic. BRAF V600E immunohistochemistry (IHC) was positive in all classic SP, involving both the exophytic and endophytic components, but negative in the oncocytic SP. SOX10 was positive in the endophytic ductal cells of the evaluated classic SP but was negative in the oncocytic SP. Conclusions. We report 8 new cases of this rare salivary gland neoplasm, using BRAF V600E and SOX10 IHC to further support the following points: (1) the functional role of BRAF V600E mutation, RAS/mitogen-activated protein kinase signaling pathway in the pathogenesis of classic SP of salivary glands by IHC; (2) the analogous relationship between SP, syringocystadenoma papilliferum, and papillary seromucinous adenocarcinoma with sinonasal papilloma-like surface component (PSASP-like surface); (3) endophytic ductal component in classic SP arises from the intercalated ducts and not the excretory ducts; and (4) oncocytic SP is distinct from classic SP.
Quantitative analysis of time-varying delay for real-time hybrid simulation
Authors: Li Ning , Teng Xue , Zhou Zihao
Published: January 2023

Real-time hybrid simulation is an effective method to study the seismic performance of large or complex structures. Time delay of the hydraulic servo system is unavoidable, which affects test accuracy and may cause instability. Previous studies shown that the reality of time-varying delay has a substantial negative effect on system stability than the assumption of constant delay. However, there is currently a lack of research for the actuating system with time-varying delay in the reality time domain. Therefore, a quantitative analysis method of time-varying delay is proposed in this study. The advantage is that only the command and the measured displacement signals are needed to obtain the time-varying delay in the time domain without any prior knowledge of the system. To overcome the influence of the amplitude error on the solution results, a processing method for the amplitude modulation of the measured displacement is proposed. To accurately search for the command corresponding to the measured signal, it is proposed to solve the time-varying delay by taking segment operation on the signal according to the maximum and minimum points. The efficiency of the proposed method is verified by numerical simulation, actuator displacement tracking test, and RTHS.
Evolution of edge dislocations under elastic and inelastic strains: A nanoscale phase-field study
Authors: Bakhtiyari Ensiye , Javanbakht Mahdi , Asle Zaeem Mohsen
Published: January 2023

A phase-field approach is used to study the evolution of edge dislocations in single crystals at the nanoscale. The characteristics of an advanced phase-field approach for dislocation evolution are investigated, and some advancements are made to make it more accurate in predicting the dislocation evolution. To verify the model and numerical procedure, the height of a slip system, the Burgers vector, and the distance between the cores of dislocations are calculated, which show a very good agreement with those of the existing theoretical solutions. The analytical and numerical solutions for the equilibrium shear stress versus order parameter are obtained, and in contrast to the previous models, the current model represents a physical model for the dislocation growth. Different methods are investigated to prevent dislocation widening, revealing that the periodic step-wise function of crystalline energy coefficient performs better than the periodic step-wise function of the Burgers vector and can keep dislocations inside their physical height. Several functions for the coefficient of normal gradient energy are investigated to prevent dislocation localization inside the dislocation band. The sample size effect on the dislocation evolution is also studied which reveals a non-linear variation of the number of dislocations inside the slip system versus the sample size. The presented model and results are useful for understanding and predicting the dislocation evolution and its interaction with other phenomena such as phase transformation.
Role of short-dwell daily ethanol-lock therapy in the management of hemodialysis tunneled cuffed catheter-related bloodstream infection
Authors: Gang Sishir , Konnur Abhijit , Rajapurkar Mohan , Hegde Umapati , Patel Hardik , Patel Jigar , Shete Nitiraj
Published: January 2023

Background:

Catheter-Related Blood Stream Infection (CRBSI) is the major limitation of using Tunneled cuffed catheter (TCC) for long-term Hemodialysis. The standard therapy of CRBSI involves systemic antibiotics with catheter replacement/removal. As antibiotic alone is rarely effective therapy for CRBSI, biofilm eradication using antimicrobial locking solutions is a promising modality for CRBSI treatment, hence catheter salvage. The present study evaluated the efficacy and safety of Ethanol-lock therapy (ELT) in combination with systemic antibiotics for the management of CRBSI associated with hemodialysis TCC.

Method:

56 patients with CRBSI were treated with 70% ELT (1 h daily for 5 days) along with systemic antibiotics. Seventeen patients with CRBSI who didn’t consent to ELT were treated with antibiotics alone. The effect of ELT was evaluated as clinical cure (fever resolution and negative surveillance cultures), infection-free TCC survival duration and adverse events of ELT among patients with CRBSI. The parameters were compared with 17 patients treated with antibiotics alone.

Results:

ELT was successful in 50 out of 56 patients (89.28%); compared to 41.17% (seven out of 17) with antibiotics alone ( p < 0.001). Mean TCC survival was also significantly higher with ELT combined with systemic antibiotics (126.23 ± 18.67 days) compared to antibiotics alone (38.76 ± 9.91) ( p = 0.006). No systemic adverse effects were noted with ELT; two patients receiving ELT had catheter breakage during the study period.

Conclusion:

We conclude that short-dwell daily ELT with systemic antibiotics is an effective therapy for CRBSI in hemodialysis patients with TCC.
Plasma neurofilament light chain in children with relapsing MS receiving teriflunomide or placebo: A post hoc analysis of the randomized TERIKIDS trial
Authors: Kuhle Jens , Chitnis Tanuja , Banwell Brenda , Tardieu Marc , Arnold Douglas L , Rawlings Andreea M , Geertsen Svend S , Lublin Alex L , Saubadu Stephane , Truffinet Philippe , Kappos Ludwig
Published: January 2023

Background:

The phase 3 TERIKIDS study demonstrated efficacy and manageable safety for teriflunomide versus placebo in children with relapsing multiple sclerosis (RMS).

Objective:

Evaluate plasma neurofilament light chain (pNfL) concentrations in TERIKIDS.

Methods:

Patients received placebo or teriflunomide (14 mg adult equivalent) for up to 96 weeks in the double-blind (DB) period. In the open-label extension (OLE), all patients received teriflunomide until up to 192 weeks after randomization. pNfL was measured using single-molecule array assay (Simoa® NF-light™).

Results:

Baseline mean age was 14.5 years; 69.4% were female. Baseline geometric least square mean pNfL levels were similar for teriflunomide ( n = 78) and placebo ( n = 33) patients (19.83 vs 18.30 pg/mL). Over the combined DB and OLE periods, pNfL values were lower for teriflunomide versus placebo (analysis of variance p < 0.01; Week 192: 10.61 vs 17.32 pg/mL). Observed between-group pNfL differences were attenuated upon adjustment for gadolinium (Gd)-enhancing or new/enlarged T2 lesion counts at DB Week 24. Higher baseline pNfL levels were associated with shorter time since first MS symptom onset, higher baseline Gd-enhancing lesion counts and T2 lesion volume, and increased hazard of high magnetic resonance imaging activity or clinical relapse during the DB period.

Conclusion:

Teriflunomide treatment was associated with significantly reduced pNfL levels in children with RMS.

ClinicalTrials.gov identifier:

NCT02201108.
(De)constructing machines as critical technical practice
Authors: Soon Winnie , Velasco Pablo R
Published: January 2023

This paper discusses the role of technology under the framework of Critical Technical Practice specifically in the form of constructing artefacts and deconstructing tools in order to produce what Philip Agre would describe as ‘reflexive work of critique’ (Agre, 1997:155). By presenting the activities and methods used in the teaching and shaping of undergraduate courses, this paper aims to show how technical objects, such as data, datasets, application programming interfaces and machine learning models, can be considered as discursive subjects, demonstrating pedagogical understanding across fields. The courses operate in the humanities tradition and take critical technical practice as a didactic approach, insofar as software and data are understood and manipulated on an instrumental level, while encouraging critical engagement and embodied reflection that bridge the technical and social/cultural domains. Within this pedagogical approach, critical is not only understood as a paradigm of rationality or quantitative, data-driven argumentation, but as adopting a critical position – that is, to research and reflect on the social structures and cultural phenomena entangled with digital objects, bodies, tools, methods and software production. By embracing work-in-progress and reflexive exploration, we aim to extend the notion of critical technical practice by unfolding how (de)constructing machines can be achieved beyond thinking of technology as neutral instrumentalisation. The challenge is how to find a balance, not only as researchers but as educators, unfolding aspects of both formality and functionality as well as questioning and understanding technology at a discursive and critical level. We argue that learning technical practice in an educational setting is not an end, but rather a means to question existing technological structures and create further changes in socio-technical systems.
A novel vibration indicator to monitor gear natural fatigue pitting propagation
Authors: Feng Ke , Ji JC , Ni Qing , Yun Hongguang , Zheng Jinde , Liu Zheng
Published: January 2023

Fatigue pitting can reduce the gear surface durability and induce other severe failures, which will eventually lead to the complete loss of transmission function of the transmission system. Thus, monitoring fatigue pitting progression is vital to avoid unexpected economic losses and incidents. Thanks to the unique characteristics of the gear meshing process, there is a close relationship between the tribological features of fatigue pitting and gear vibration cyclostationarity. Based on the vibration cyclostationarity, this paper develops a novel second-order cyclostationary (CS2) fatigue pitting monitoring indicator, which can accurately assess the degradation status of the gear system and benefit subsequent health management. The advantage of the developed cyclostationary indicator in evaluating and monitoring the process of fatigue pitting propagation is demonstrated with the natural fatigue pitting progression test, through comparisons with other conventional indicators.
A cyclostationarity-based wear monitoring framework of spur gears in intelligent manufacturing systems
Authors: Feng Ke , Ni Qing , Chen Yuejian , Ge Jian , Liu Zheng
Published: January 2023

The gearbox is widely applied as the mechanical transmission system of intelligent manufacturing systems, such as machine tools and robotics. The harsh working environments make the gear surface prone to wear. The progression of surface wear can bring severe failures to the gear tooth, including gear tooth root crack, surface spalling of gear tooth, and tooth breaking, all of which could damage the whole transmission system. Hence, it is essential to monitor and evaluate the gear surface wear propagation. The gear wear has been proven highly relevant with the vibration second-order cyclostationary (CS2) characteristics. Therefore, this paper develops a novel cyclostationarity-based framework to monitor and evaluate gear wear propagation. More specifically, the squared envelope (SE) of the residual signal, removing deterministic components, is utilized to identify the gear wear distribution and its propagation trends, validated using the measured gear surface morphology. Moreover, a new CS2-based indicator is proposed to assess the severity of gear surface wear, achieving a high correlation with measured surface roughness: [Formula: see text] is more than 0.9. The developed cyclostationarity-based framework can comprehensively evaluate the degradation status of the gear system caused by surface wear, significantly benefiting the health management of the gear transmission system, which is of great practical value for the health management of intelligent manufacturing systems. A series of endurance tests are conducted to verify the effectiveness and superiority of the developed framework for gear wear monitoring compared with the conventional indicators.
Identification of cashmere and wool based on LBP and GLCM texture feature selection
Authors: Zhu Yaolin , Zhao Lu , Chen Xin , Li Yunhong , Wang Jinmei
Published: January 2023

There are invalid and redundant features in the texture feature extraction method of cashmere and wool fibers, which leads to the low recognition accuracy. In this paper, a novel texture feature selection method based on local binary pattern, the gray level co-occurrence matrix algorithm and chi-square test was proposed to sufficiently extract the effective features of these two fibers. Firstly, the collected images of cashmere and wool fibers are processed to obtain the clear texture images with background removed by pre-processing algorithm and local binary pattern. Then, the texture features are calculated by the gray level co-occurrence matrix, and the optimal 5-dimensional features are extracted by chi-square test to represent the texture information of cashmere and wool. Finally, the two fibers are automatically classified and recognized based on the support vector machine. The experimental results show that the proposed method obtained a high recognition accuracy with the percent of 94.39. It verifies that the method based on texture feature selection is effective to identify cashmere and wool fibers.
“The change was as big as night and day”: Experiences of professors teaching students with intellectual disabilities
Authors: Watts Gavin W. , López Eric J. , Davis Mariya T.
Published: January 2023

Since the inception of the Higher Education Opportunity Act in 2008, there has been an increase in the number of post-secondary education institutions in the United States that have established inclusive postsecondary programs for individuals with intellectual disabilities to attend college and achieve higher levels of employment. Previous studies have investigated the development and outcomes of these programs, however, less has been explored related to professors' experiences and perceptions regarding this unique student population, particularly within Hispanic Serving Institutions (HSI). The current study focused on professors teaching inclusive courses within a new Comprehensive Transition and Postsecondary Program at a HSI and aimed to identify their perceptions and experiences related to instructing students with intellectual disabilities. Six professors participated in pre- and post-semester in-depth interviews. Findings from applied thematic analysis included: (a) barriers to success; (b) academic supports and strategies; (c) successful outcomes and (d) considerations for future, related programming.
Current concepts in the treatment of first-time patella dislocation in children and adolescents
Authors: Sinikumpu Jaakko , Nicolaou Nicolas
Published: January 2023

Background:

Lateral dislocation of the patella is a common injury in children. It can occur in previously healthy and anatomically normal knees, but there are several abnormalities that predispose to patellar instability. Magnetic resonance imaging is an essential part of assessing for associated injuries and risk of further instability. Treatment aims to prevent redislocation, residual instability, osteoarthritis, and allow return to previous activities. The purpose of this review was to assess evidence for management of first-time patella dislocation in children and adolescents.

Methods:

Literature review was performed, accompanied by the current best practice by the authors.

Results:

Non-operative treatment is preferred, except where there are associated injuries such as osteochondral fractures that would benefit from surgery. The exact method of ideal non-operative management is not clearly defined but should focus on restoration of range of movement and strength with bracing as indicated. There seems to be a trend toward operative intervention that may well be inappropriate.

Conclusion:

Further prospective studies are required with focus on the younger patient to fully understand if there is an at-risk group that would benefit from early surgery.

Level of evidence:

level III.
Designing a mobile health smokeless tobacco cessation intervention in Odisha, India: User and provider perspectives
Authors: Panda Rajmohan , Lahoti Supriya , Mishra Arti , Prabhu Rajath R , Das Sangeeta , Satapathy Durga Madhab , Nazareth Irwin
Published: January 2023

Objective

There is limited evidence on the development of mobile health (mHealth) interventions for smokeless tobacco (SLT) cessation, despite its widespread use in South Asia. This formative qualitative study explored the perceptions of tobacco users and healthcare providers (HCPs) regarding developing a mHealth intervention for SLT cessation.

Methods

This was a qualitative study using in-depth interviews (IDIs) with tobacco users (n = 26) and primary care physicians (PCPs) (n = 5) and focus group discussions (FGDs) with counsellors (n = 2) in four urban primary health centres (UPHCs) in Berhampur, Odisha from February to March 2020. The data were coded and analysed by two researchers using a framework analysis method. The discussion guides and initial codes were developed based on the Transtheoretical Model (TTM) of behaviour change.

Results

The results were elaborated under four themes: (1) Current scenario of SLT use; (2) Barriers and facilitators for quitting SLT; (3) Barriers and facilitators for mHealth counselling; and (4) Design and delivery of the proposed intervention. SLT use was prevalent in the community regardless of sociodemographic factors. Peer factors accounted for both tobacco consumption as well as considering cessation. Participants considered mobile message counselling helpful and acceptable. Not having a mobile phone and illiteracy were identified as barriers while ease of access and rising popularity of social media applications were considered facilitators to the use of mHealth for quitting tobacco. Participants preferred messages that were pictorial, short and simple, in the local language, and tailored to individual's needs.

Conclusions

This is the first study that provides evidence within the Indian context that the text messaging platform may be used for delivering an SLT cessation intervention. The integration of a theoretical basis and research findings from target users can guide future intervention development.
LDPE-Nanoclay films for food packaging with improved barrier properties
Authors: Barros Carolina , Miranda Sónia , Castro Olga , Carneiro OS , Machado AV
Published: January 2023

This study focuses on the development of low-density polyethylene matrix nanocomposite films for food packaging industry and aims at improving low-density polyethylene oxygen barrier properties while maintaining other relevant characteristics, such as processability, easy post-processing, optical and mechanical properties.

low-density polyethylene nanocomposites, with 1 and 2.5 wt.% nanoclay (NC) and also compatibilized with 5 wt.% polyethylene grafted with maleic anhydride (PE-g-MA), were prepared and used to produce blown films. The nanocomposites were characterized in terms of their morphology, thermal, rheological, mechanical, barrier and optical properties, through scanning electron microscopy (SEM), X-ray diffraction (XRD), differential scanning calorimetry (DSC), rheological measurements, tensile tests, water vapor transmission, oxygen permeability tests and spectrophotometry. The results demonstrated good NC dispersion in the polymer matrix and decreased oxygen permeability in the compatibilized nanocomposite films. All the other properties did not significantly change when compared to neat low-density polyethylene.

Overall, the film properties were improved with the added nanoclay and PE-g-MA and, have potential for food packaging.
Evaluation of two laboratory model methods for diarrheal irritable bowel syndrome
Authors: Chen Qian , Zhang Hua , Sun Chang-Yue , He Qing-Ying , Zhang Rui-Rong , Luo Bin-Fei , Zhou Zi-Hao , Chen Xiao-Fan
Published: January 2023

Background

Diarrheal irritable bowel syndrome (IBS-D) is a common chronic functional gastrointestinal disorder, and the underlying pathogenic mechanism is still unclear. Animal models that mimic the pathological state of IBS-D patients were constructed to provide a reference for later drug research and model development.

Methods

The IBS-D model was induced using restraint stress and chemical stimulation (rhubarb), and rats were divided into normal control group (NC), chemically stimulated group (CS), and restraint stress group (RS). Visceral motility responses to Colorectal Balloon Dilation (CRD) were measured by Abdominal Withdrawal Reflex (AWR); evaluation of faecal properties and water content; determination of colonic tissue tight junction (TJ) mRNA expression by RT-PCR; measurement of inflammatory cytokines by ELISA; and intestinal flora and short chain fatty acids.

Results

Compared to NC group, CS and RS group rats showed increased intestinal sensitivity and Bristol stool score, significant diarrheal symptoms and weight loss. Mucin 2, ZO-1, OCLN, CLDN4 mRNA expression was reduced and the intestinal mucosal barrier function was diminished. In addition, the levels of inflammatory factors IL-1β, IL-6, IL-8, IL-10 and TNF-α increased, the abundance and diversity of intestinal flora decreased, the content of beneficial bacteria such as Bifidobacteria decreased, and SCFAs such as acetic acid, propionic acid and butyric acid decreased to different degrees. Although, no significant difference was observed for any molecular and inflammatory marker, but compared to CS group, RS group had less water in the stool, higher visceral sensitivity, and higher relative abundance of beneficial intestinal bacteria such as Actinobacteria.

Conclusion

In conclusion, restraint stress combined with chemical stimulation can mimic the pathological state of diarrhoea symptoms, visceral hypersensitivity, reduced intestinal mucosal barrier permeability, immune regulatory dysfunction and dysbiosis in IBS-D patients. However, herbs with antibacterial effects such as rhubarb and senna, for example, are not suitable as the first choice for chemical stimulation, as they may lead to a decrease in harmful bacteria and an increase in beneficial bacteria in the intestinal fraction and do not perfectly mimic the imbalanced state of intestinal flora in IBS-D patients, while restraint stress may be a key factor in modelling.
Addition of preoperative transversus abdominis plane block to multimodal analgesia in open gynecological surgery: a randomized controlled trial
Authors: Geng Zhi Yu , Zhang Yan , Bi Hui , Zhang Dai , Li Zheng , Jiang Lu , Song Lin Lin , Li Xue Ying
Published: January 2023

Background

Transversus abdominis plane (TAP) block can provide effective analgesia for abdominal surgery. However, it was questionable whether TAP had additional effect in the context of multimodal analgesia (MMA). Therefore, this study aimed to assess the additional analgesic effect of preoperative TAP block when added to MMA protocol in open gynecological surgery.

Methods

In this prospective, randomized-controlled trial, 64 patients scheduled for open gynecological surgery were randomized to receive preoperative TAP block (Study group, n = 32) or placebo (Control group, n = 32) in addition to MMA protocol comprising dexamethasone, acetaminophen, flurbiprofen and celecoxib, and rescued morphine analgesia. The primary outcome was rescued morphine within 24 h after surgery. Secondary outcomes included pain scores, adverse effects, quality of recovery measured by 40-item quality of recovery questionnaire score (QoR-40) at 24 h, and quality of life measured with short-form health survey (SF − 36) on postoperative day (POD) 30.

Results

The Study group had less rescued morphine than the control group within 24 h [5 (2–9) vs. 8.5 (5–12.8) mg, P = 0.013]. The Study group had lower pain scores at 1 h [3 (2–4) vs. 4 (3–5), P = 0.007], 2 h [3 (2–4) vs. 3.5 (3–5), P = 0.010] and 6 h [3 (2–3) vs. 3 (2.3–4), P = 0.028], lower incidence of nausea at 48 h (25.8% vs. 50%, P = 0.039), and higher satisfaction score [10 (10–10) vs. 10 (8–10), P = 0.041]. The SF-36 bodily pain score on POD 30 was higher in the Study group (59 ± 13 vs. 49 ± 16, P = 0.023).

Conclusions

Preoperative TAP block had additional analgesic effect for open gynecological surgery when used as part of multimodal analgesia. Rescued morphine within 24 h was significantly reduced and the SF-36 bodily pain dimension at 30 days after surgery was significantly improved.

Trial registration

www.chictr.org.cn (ChiCTR2000040343, on Nov 28 2020).
Effects of different doses of glucocorticoids on postoperative atrial fibrillation: a meta-analysis
Authors: Zhou Zhongzheng , Long Yi , He Xin , Li Yong
Published: January 2023

Background

Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery, and its occurrence is closely related to inflammation. This paper intends to apply meta-analysis to investigate the effect of glucocorticoids on POAF.

Methods

PubMed, Embase, Web of Science, and Cochrane Library were searched using the internationally recognized systematic evaluation and retrieval strategy. Two review authors independently selected relevant studies and extracted data based on the Cochrane handbook for systematic reviews of interventions approach. Stata 17 was used for data analysis. In the subgroup analysis, we grouped the participant data according to differences in glucocorticoids dose and type of surgery. At the same time, we also conducted a meta-analysis on the possible infection and gastrointestinal injury caused by glucocorticoids use.

Results

27 studies and 14,442 patients were finally included. Results from the random-effects model indicated that the incidence of POAF was lower in glucocorticoid group (RR 0.80, 95% CI 0.71–0.92, P = 0.001). According to the subgroup analysis result, low doses of glucocorticoids reduced the incidence of POAF (RR 0.81, 95% CI 0.71–0.92, P = 0.001). The effect of high doses glucocorticoids on the POAF was not statistically significant (RR 0.81, 95% CI 0.56–1.19, P = 0.286). In the coronary artery bypass grafting (CABG) subgroup, the glucocorticoids reduced the incidence of POAF (RR 0.71, 95% CI 0.58–0.87, P = 0.001). In the CABG OR Valvular Surgery group, the effect of glucocorticoids on POAF was not statistically significant (RR 0.88, 95% CI 0.75–1.03, P = 0.108). 15 studies documented postoperative complications of infection, two studies were excluded from the system because the end point event was 0, and meta-analysis showed no increased risk of infection from glucocorticoid use (RR 0.85, 95% CI 0.68–1.06, P = 0.158). Eight studies documented the effects of glucocorticoids on gastrointestinal diseases, and meta-analysis showed no differences between the two groups (RR 1.12, 95% CI 0.83–1.50, P = 0.450).

Conclusion

The use of glucocorticoids can reduce the incidence of POAF. The subgroup analysis result showed that low-dose glucocorticoids were more effective than high-dose glucocorticoids in inhibiting POAF. The use of glucocorticoids in CABG alone can better inhibit the occurrence of POAF. The effects of glucocorticoids on infection and gastrointestinal injury were not statistically significant.

Review registration: PROSPERO, CRD42022304521.
Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
Authors: Qingyan Zhang , Yangyang Xia , Miao Zhang , Chunming Jiang
Published: January 2023

Background

Overt eosinophilic peritonitis (EP) is a relatively uncommon complication of peritoneal dialysis (PD), although not rare. Here we reported a case of EP relieved after changing dialysate. 

Case presentation

A 28-year old male patient developed cloudy PD effluents within the first month after PD started. Cytological study of PD effluents showed elevated white blood cells and polynuclear cells. Bacteria culture of PD effluents repeated for several times were all negative, and no pathogen was found by metagenomics next generation sequencing (mNGS). Antibiotic therapy for 28-day was ineffective. Based on these and increased eosinophils in peritoneal fluid, he was finally diagnosed as EP. PD dialysate was changed (consists of the same buffer agent and electrolytes, but is packed in bags that do not contain PVC), and the patient’s PD effluent became clear. Of note, EP did not relapse 5 months later when the patient started to use the former PD solution again.

Conclusion

Although PD effluent turbidity almost always represents infectious peritonitis, there are other differential diagnoses including EP. For patients with cloudy fluid accompanied by mild symptoms who do not response to antibiotic therapy, it is reasonable to consider the possibility of this disease. EP tends to heal spontaneously, however, antihistamines or glucocorticoids are required sometimes to avoid catheter obstruction. For patients with no obvious incentives, replacement of dialysate may be useful.
Cross-cultural adaptation, reliability and validity tests of the Chinese version of the Profile Fitness Mapping neck questionnaire
Authors: Qi Lu , Chang Rui , Zhang Enming
Published: January 2023

Objective

To translate and culturally adapt the Profile Fitness Mapping neck questionnaire (ProFitMap-neck) into the Chinese version and evaluate its psychometric properties.

Methods

The procedure of translation and cross-cultural adaptation was performed according to the recommended guidelines. A total of 220 patients with chronic neck pain (CNP) and 100 individuals without neck pain participated in the study. Internal consistency, test-retest reliability, content validity and construct validity were investigated.

Results

The Chinese version of ProFitMap-neck (CHN-ProFitMap-neck) showed adequate internal consistency (Cronbach’s α = 0.88–0.95). A good test-retest reliability was proven by the intraclass correlation coefficient (ICC3A,1 = 0.78–0.86). Floor-ceiling effects were absent. Exploratory factor analysis revealed 6 factors for the symptom scale and 4 factors for the function scale. The CHN-ProFitMap-neck showed a moderate to high negative correlation with NDI (r = 0.46–0.60, P < 0.01), a small to moderate negative correlation with VAS (r = 0.29–0.36, P < 0.01), and a small to high positive correlation with SF-36 (r = 0.21–0.52, P < 0.01). No significant correlation between the CHN-ProFitMap-neck function scale and VAS (P > 0.05) or the mental health domain of the SF-36 was found (P > 0.05). The CHN-ProFitMap-neck scores were significantly lower in the CNP group than in the non-CNP group (P < 0.01).

Conclusions

The CHN-ProFitMap-neck had acceptable psychometric properties and could be used as a reliable and valid instrument in the assessment of patients with chronic neck pain in mainland China.
The effect of skin traction on pain relief in patients with isolated intertrochanteric fractures, a randomized clinical trial
Authors: Kheiri Sara , Akbari Aghdam Hossein , Motififard Mehdi , Gharib Gashteh Shahi Navid , Saleki Mehrjardi Mohammad , Rezaei Tayebe
Published: January 2023

Background

Hip fractures are common in elderly patients. The surgery is usually delayed due to underlying conditions, and pain control is crucial while the patient is cleared for surgery. In this randomized controlled trial (RCT) study, we hypothesized that the application of skin traction in patients with intertrochanteric fracture does not significantly change the Visual Analogue Score (VAS) of pain.

Methods

This is a prospective, single institution, parallel randomized controlled trial. Two hundred and twenty-nine patients with isolated intertrochanteric fractures were enrolled in the study. Patients with neurologic issues, drug addiction, scars or swelling, or vascular issues at the site of skin traction application were excluded from the study. Patients were divided into two groups: group A included 97 patients, and group B included 95 patients. Skin traction was applied for group A, while only a soft pillow was put beneath the patients’ knees in the other group. The VAS score was measured after the diagnosis, two hours before the operation, and 24 h after the surgery. The morphine dosage administered per day was documented for both groups.

Results

After excluding patients with postoperative delirium, 154 patients (55 males and 99 females) with isolated intertrochanteric fractures (69 right-sided and 85 left-sided), and a mean age of 70 ± 10 remained in the study. There were no significant differences between the two groups regarding age, gender, and mean time from injury to admission (P > .05). The mean VAS score measures and morphine dosage administered per day were not significantly different between the two groups (P > .05). Both groups experienced significant pain relief 24 h postoperatively (P < .001).

Conclusion

Pre-operative skin traction application affected neither the patients' VAS scores nor the mean morphine dosage per day in patients with isolated intertrochanteric fractures. Our data does not support the routine application of pre-operative skin traction in patients with intertrochanteric fractures.

Trial registration

The project was registered in the Iranian Registry of Clinical Trials (registration reference: IRCT20180729040636N3, registration date: 01/07/2020).

Level of evidence

1.
An exploratory study of communication training for Chinese medicine practitioners in Hong Kong to integrate patients’ conventional medical history
Authors: Pun Jack , Kong Brandon
Published: January 2023

Background

Despite Traditional Chinese medicine’s (TCM) historical roles in Chinese society, few research has been investigated the nature of TCM practitioner–patient interactions. Improved communication skills among TCM practitioners will result higher-quality interactions and better clinical outcomes.

Methods

To investigate the changes in TCM practitioners’ communication practices after communications training focused on promoting their awareness of integrating a patient’s medical history from conventional medicine in TCM treatment, Eight registered Cantonese-speaking TCM practitioners in Hong Kong were randomly recruited from local clinics and randomised into control (n = 12) and experimental groups (n = 12), with a total of 24 consultations. The experimental group was given training focused on patient-centred communication, with an internationally recognised and communication framework validated in global consultation settings (i.e. the Calgary-Cambridge Guide) on how to take a patient’s medical history from conventional medicine and communicate diagnosis and treatment plans. Consultations before and after training were audio-recorded and rated. The efficacy of the training was evaluated by comparing the two groups before training (pre-test), immediately after training (post-test) and after a 3-month delay (delayed post-test). Using validated scales, the primary outcomes were measured for the practitioners’ clinical communication skills and the quality of interactions.

Results

The communication training significantly improved the TCM providers’ patient-centred communication and communication proficiency. The results indicate that the team developed an effective communication model for integrating TCM and conventional medicine in Hong Kong. The framework helps trained TCM practitioners to integrate their patients’ conventional medical history when delivering patient care. The findings shed light on how interpersonal relationships between TCM practitioners and patients can be constructed after communication training to better care for patients’ psychological concerns in addition to their physical needs.

Conclusion

Trained TCM practitioners can provide an integrated model that takes patients’ conventional medical history into account when delivering a holistic patient-centred care. The findings can enhance our understanding of better ways to train the future TCM practitioners and to develop a continuing professional training for the current TCM practitioners to expand our understanding of TCM communication in acute clinical contexts and, thus offer a firm evidence-based foundation upon which to develop communication strategies that improve their clinical cpractices.