bluuebunny/crossref_metadata_2025 huggingface dataset:
Women's Romantic Jealousy Predicts Risky Appearance Enhancement Effort
Authors: Arnocky Steven , MacKinnon Megan , Clarke Sadie , McPherson Grant , Kapitanchuk Emily
Published: July 2023

Human appearance enhancement effort has recently been considered from an evolutionary perspective as an adaptive and sexually dimorphic strategy for effective female intrasexual and intersexual competition. Most writing and research on the topic to date has focused on appearance enhancement as a means of mate attraction, with relatively less research examining its role in mate retention. The present study considered whether romantic jealousy, as a negative emotion experienced in response to perceived threat to a desired relationship, predicts costly and/or risky appearance enhancement independent of the closely related emotion of envy. In a sample of 189 undergraduate women, results showed that romantic jealousy and dispositional envy were positively correlated with one another. Results further demonstrated that romantic jealousy predicted women's positive attitude toward cosmetic surgery, willingness to use a one-week free tanning membership, willingness to use a risky diet pill, and intent on spending a greater proportion of their income on appearance enhancement, but not intended use of facial cosmetics. Results held independent of participants’ dispositional envy, suggesting that romantic jealousy is a unique predictor of women's efforts at enhancing their physical appearance, which could extend into costly and physically risky mate retention efforts.
A Network Approach to Investigate the Dynamics of Individual and Collective Beliefs: Advances and Applications of the BENDING Model
Authors: Vlasceanu Madalina , Dyckovsky Ari M. , Coman Alin
Published: July 2023

Changing entrenched beliefs to alter people’s behavior and increase societal welfare has been at the forefront of behavioral-science research, but with limited success. Here, we propose a new framework of characterizing beliefs as a multidimensional system of interdependent mental representations across three cognitive structures (e.g., beliefs, evidence, and perceived norms) that are dynamically influenced by complex informational landscapes: the BENDING (Beliefs, Evidence, Norms, Dynamic Information Networked Graphs) model. This account of individual and collective beliefs helps explain beliefs’ resilience to interventions and suggests that a promising avenue for increasing the effectiveness of misinformation-reduction efforts might involve graph-based representations of communities’ belief systems. This framework also opens new avenues for future research with meaningful implications for some of the most critical challenges facing modern society, from the climate crisis to pandemic preparedness.
Evaluating the impact of a digitally implemented subjective standard on professional rugby union player management decision-making
Authors: Ranaweera Jayamini , Weaving Dan , Zanin Marco , Roe Gregory
Published: July 2023

Using a pre-post-test design, this study evaluated the impact of implementing a standard on the reliability of player management decision-making within a professional rugby union environment. Five practitioners from a High-Performance Unit (HPU) rated 22 instances of Global Positioning System (GPS)–based external training load information of 14 players across the 2021–2022 season. This rating was whether a peak/trough/normal exposure in load had occurred. The ratings were repeated at four time points (separated by 2 weeks) before (Pre1, Pre2) and after (Post1, Post2) implementing a consensus statement as a subjective standard (using a dashboard) developed previously within the same environment to identify peaks/troughs in player external training loads. Inter-rater agreement between individuals at each voting round was assessed using Light's Kappa, while pre-post-standard intra-rater agreement was determined from Cohen's Kappa (both with 95% confidence intervals). Changes to dashboard usability from implementing the standard were assessed by administering the System Usability Scale to 11 HPU staff at the four time points. Pre-standard moderate inter-rater agreement (Pre1: 0.53 (0.36–0.69), Pre2: 0.60 (0.42–0.77)) increased to almost perfect agreement (Post1: 0.74 (0.57–0.89), Post2: 0.90 (0.79–1)) post-standard. The intra-rater agreement of 2/5 participants was almost perfect post-standard, while it remained within substantial levels for the others. A linear mixed model ( χ2(3) = 8.85, p = 0.03) illustrated a slight increase in dashboard usability after incorporating the standard (Pre1: 84.09, Pre2: 81.36; Post1: 87.73, Post2: 87.27). Overall, the results highlighted that the subjective standard enhanced reliability of practitioner agreement for the selected decision.
The Effects of Privacy and Data Breaches on Consumers’ Online Self-Disclosure, Protection Behavior, and Message Valence
Authors: Ho Foo Nin , Ho-Dac Nga , Huang J. Sonia
Published: July 2023

This study investigates Facebook users’ perceived benefits and risks on their self-disclosure, likelihood of protection behavior and message valence before, during and after its data breach scandal. A framework based on Protection Motivation Theory was used to test these relationships with trust as a mediator. The model was tested using data from three national consumer panel surveys. The results show that while there is temporal invariance in the model structure, Facebook users are more cautious of the risks and are more likely to engage in protection behavior due to the data breach. However, users are also more likely to weigh the benefits of social media higher than the perceived risks, which supports the consumer privacy paradox. Implications from this study such as consumer protection, privacy laws, private and public policies, and regulations are discussed.
A Study on the Representation of Global Competence in English Textbooks for Higher Vocational Education in China
Authors: Ping Xiaomei , Wang Jingying
Published: July 2023

This study aims to analyze the representation of global competence in English textbooks for higher vocational education in China. A two-dimensional textbook theoretical framework based on global competence was developed, including four indicators of global competence (vertical) and 3 dimensions of textbook content (horizontal). Through a combination of qualitative and quantitative content analysis, we analyzed the representation of global competence in a set of Chinese higher vocational English textbooks (D version textbooks) in terms of content level, rendering location, and representation form. The results showed that the D version textbooks covered all of global competence indicators, among which the indicator of knowledge and understanding of global competence is the most and the attitudes and values is the least. The 16 sub-indicators of global competence presented differently in content levels, implicitly in the rendering location, and with “reading comprehension,”“oral communication” and “integrated application” as the main representation forms. This theoretical framework is an extension of global competence theory in textbook study and is also a useful tool for content analysis on non-linguistic knowledge of English textbooks.
The Relevance of Initial Trust and Social Influence in the Intention to Use Open Banking-Based Services: An Empirical Study
Authors: Briones de Araluze Gorka , Cassinello Plaza Natalia
Published: July 2023

Open banking is one of the main transformational levers to improve competitiveness in retail banking by enabling client data sharing with third-party providers. This study enhances the traditional Technology Acceptance Model (TAM) constructs with two additional factors, initial trust and social influence, to understand clients’ behavioral intention to adopt open banking. The study analyzes a sample of 553 surveys in Spain, a country with an established open banking regulation (European Union’s Second Payment Services Directive). The proposed model showed robust explanatory capacity ( R2 = 85%). Results show that perceived usefulness, social influence, and initial trust are essential in determining the behavioral intention to embrace open banking. Nevertheless, perceived ease of use plays a minor role, an outcome aligned with current fintech adoption literature. Our study implies that private agents should focus on highlighting the benefits of open banking while policymakers should work on regulatory frameworks to increase clients’ initial confidence.
Republication of “Open Repair of Acute Achilles Tendon Ruptures: Is the Incidence of Clinically Significant Wound Complications Overestimated?”
Authors: Bishop Meghan E. , Comer Carly D. , Kane Justin M. , Maltenfort Mitchell G. , Raikin Steven M.
Published: July 2023

Background:

Conflicting evidence exists regarding the optimal management of acute Achilles tendon ruptures. Operative repair is thought to afford patients a lower risk of rerupture, albeit at a higher overall risk of wound complications.

Methods:

A retrospective chart review of 369 consecutive patients undergoing open repair of acute Achilles tendon ruptures performed by a single foot and ankle fellowship-trained orthopedic surgeon was undertaken. Healing was classified as no complications, complications without prolonging treatment, complications requiring prolonged local treatment, and complications requiring operative intervention. A statistical analysis comparing the rates of complications in this cohort to that reported in the literature was conducted.

Results:

There were a total of 33 (8.94%) wound complications. Compared to the rates reported in the literature, no significant difference was detected ( P = .3943; CI 6.24-12.33). However, when the complications not requiring additional treatment or prolonged care were excluded, only 9 wound complications (2.44%) were identified—a significantly lower complication rate than that reported in the literature ( P < .0001; CI 1.12-4.58). There were only 2 (0.54%) major complications requiring operative intervention, also a significantly lower rate than in the literature ( P < .0001; CI 0.067-1.94).

Conclusion:

In the past, wound-healing complications have been cited as a concern when treating patients operatively. We found that when solely looking at healing complications prolonging the patients’ overall recovery, a significantly lower rate of complications existed compared to that reported in the literature.

Level of Evidence:

Level IV.
In Vitro Antiproliferative Effects and Phytochemical Characterization of Carissa edulis ((Forssk) Vahl) and Pappea capensis (Eckyl and Zeyh) Extracts
Authors: Muruthi Carolyn Wanjira , Ngugi Mathew Piero , Runo Steven Maina , Mwitari Peter Githaiga
Published: July 2023

Cancer mortality is a global concern. The current therapeutic approaches despite showing efficacy are characterized by several limitations. Search for alternatives has led to the use of herbal plants including C. edulis and P. capensis. However, there is limited research on antiproliferative effects of these medicinal plants. The study sought to evaluate antiproliferative effects of the plants against human breast and prostate cancers using cell viability, and gene expression assays to determine modulation of apoptotic genes. Further, Liquid Chromatography Mass Spectrophotometer (LC-MS) and Gas Chromatography Mass Spectrophotometer (GC-MS) analyses were performed to confirm phytocompounds in the extracts. The results indicated that ethylacetate extracts of C. edulis and P. capensis had the highest activity against cancer cells with IC50 values of 2.12 ± 0.02, and 6.57 ± 0.03 μg/ml on HCC 1395 and 2.92 ± 0.17 and 5.00 ± 0.17 μg/ml on DU145, respectively. Moreover, the plants extracts exhibited relatively less cytotoxic activities against Vero cell lines (IC50 > 20 μg/ml). The extracts also exhibit selectivity against the cancer cells (SI > 3). Further, mRNA expression of p53 in the treated HCC 1395 was increased by 7 and 3-fold, whereas by 3 and 2-fold in DU145 cells, upon treatment with ethylacetate extracts of C. edulis and P. capensis, respectively. Similarly, several-fold increases were observed in the number of transcripts of Bax in HCC 1395 and HOXB13 in DU145 cells. Phytochemical analyses detected presence of phytocompounds including flavonoids, phenolics, tocopherols and terpenoids which are associated with anticancer activity. Findings from this study provide a scientific validation for the folklore use of these plants in management of cancer.
Arthroscopic Posterior Labral Repair for Posterior Shoulder Instability
Authors: Nammour Michael A. , James Michael , Arner Justin W. , Bradley James P.
Published: July 2023

Background:

Posterior shoulder instability occurs in 2% to 10% of shoulder instability cases and is more commonly due to repetitive microtrauma as opposed to the more traumatic onset seen in anterior shoulder instability. In posterior instability, the posterior capsulolabral complex becomes attenuated or torn. Thus, surgical treatment aims to restore the posterior soft-tissue stabilizers typically with an arthroscopic, suture-anchor-based labral repair.

Indications:

Surgical indications include posterior instability with traumatic cause and associated soft-tissue and/or osseous pathology and for those patients with repetitive microtrauma who have failed nonsurgical management.

Technique Description:

Following diagnostic arthroscopy, the glenoid is prepared using an arthroscopic elevator, rasp, and chisel first viewing from the posterior portal, then from the anterior portal using a 70° arthroscope. An all-suture anchor is placed at the 7 o’clock position using a curved guide which obviates the need for an accessory 7 o’clock portal. The repair suture is then shuttled through the labrum using a suture lasso and monofilament. This repair suture is then shuttled through the suture anchor using the inbuilt shuttling fiberlink. The repair suture is then tightened to secure the labrum. The remainder of the repair uses knotless 2.9-mm biocomposite suture anchors and free suture tape as the all-suture anchor and associated curved guide are typically only necessary for the angle of the most inferior portal. Following a 3 to 5 anchor repair, the posterior portal capsular rent is closed to avoid leaving a stress riser. Posterior capsular closure is achieved using monofilament suture passed with a birdbeak and tied blindly in the subacromial space.

Results:

In a study of 200 shoulders at 36 months, patients undergoing posterior stabilization had improvements in their American Shoulder and Elbow Surgeons (ASES) scores and improvements in stability, pain and function. Ninety percent of patients were able to return to sport and 64% of patients returned to the same level. Failure rate was low at 6%.

Discussion/Conclusion:

Posterior labral repair is a technically nuanced but reliable procedure for the management of posterior instability.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Investigating the anticancer and anti-angiogenic effects of graphene oxide nanoparticles containing 6-gingerol modified with chitosan and folate
Authors: Al-Janabi Angham Hakim Abdulzahra , Hayati Roodbari Nasim , Homayouni Tabrizi Masoud
Published: July 2023

Objective

The use of nanocarriers to improve the targeting of treatment plays a key role in the treatment of many diseases, including cancer. This study was carried out to synthesize graphene oxide (GO) containing 6-gingerol (Ging) modified with chitosan (CS)-folic acid (FA) nanoparticles (Ging-GO-CS-FA) to improve the anti-cancer effects of Ging.

Methods

After the synthesis of nanoparticles, the average size, surface charge, and dispersion index (DPI) of nanoparticles were analyzed by the dynamic light scattering (DLS) method. Field emission scanning electron microscope (FESEM) and Fourier transform infrared spectroscopy (FTIR) were utilized to assess the morphology and functional groups of synthesized nanoparticles, respectively. The 2,5-diphenyl-2H-tetrazolium bromide (MTT) method was performed to assess the toxicity effect of nanoparticles on different types of cancer cells. The antioxidant power of nanoparticles was evaluated by ABTS and DPPH methods. In addition, the chorioallantoic membrane (CAM) test was conducted to investigate the anti-angiogenic effects of nanoparticles. Finally, the real-time quantitative PCR (qPCR) method was carried out to detect the changes in the expression of angiogenic and antioxidant genes in cancer cells.

Results

The nanoparticles have an average size of 73.21 nm, a DPI of 0.27, and a surface charge of 29.5. The encapsulation rate of Ging in nanoparticles was reported to be 81.7%. According to the MTT test, the most sensitive cell line to the Ging-GO-CS-FA nanoparticles was reported to be gastric cancer cells (IC50 ~ 27). The results of the antioxidant test showed the high antioxidant power of nanoparticles in the laboratory environment by inhibiting ABTS and DPPH free radicals. The pro-oxidant power of Ging-GO-CS-FA against cancer cells was confirmed by reducing the amount of the superoxide dismutase (SOD) gene in the treated cells. The decreasing effects of Ging-GO-CS-FA on angiogenesis were observed by reducing the average length, the number of blood vessels, average height, and weight of treated embryos. In addition, the decrease in the expression of VEGF and VEGF-R genes confirmed the anti-angiogenic of Ging-GO-CS-FA.

Conclusions

These results show the promising effect of Ging-GO-CS-FA on gastric cancer cells by inhibiting angiogenesis and increasing the level of oxidants.
Brief cognitive behavior therapy for stigmatization, depression, quality of life, social support and adherence to treatment among patients with HIV/AIDS: a randomized control trial
Authors: Abbas Qasir , Nisa Mehru , Khan Muhammad Umar , Anwar Nida , Aljhani Sumayah , Ramzan Zoobia , Shahzadi Mafia
Published: July 2023

Objective

Individuals living with HIV/AIDs are at a high risk of many problems like depression, stigma, quality of life, decreased adherence to treatment, and lack of social support. The present study aimed to investigate the impact of brief-cognitive behavior therapy (B-CBT) on reducing depression and stigma and improving treatment adherence, quality of life, and social support among patients with HIV/AIDS attending antiretroviral therapy (ART).

Materials and methods

This randomized clinical trial was conducted at ART Clinic in the Tehsil Headquarters Hospital Shahkot Nankana Sahib from July 2021 to October 2021. After baseline screening, 126 patients met the eligibility criteria and 63 were allocated to the experimental group (EXPg = 63) and 63 to waitlist-control group (WLCg = 63). Participants’ age range was from 20 to 55 years. Participants who were taking ART treatment were enrolled for the CBT treatment. Before this, all the participants completed a baseline assessment to ensure a level of severity and diagnosis. A total of eight CBT based therapeutic sessions were conducted individually with EXPg. To assess the outcomes among patients receiving ART, we used Demographic form, Patient health questionnaire, HIV stigma scale, General medication adherence scale, Multidimensional scale of perceived social support, and WHOQOL BREF scale.

Results

Findings suggest that B-CBT significantly reduced the level of depression (i.e. F (1, 78) = 101.38, p < .000, η2 = .599), and social stigma (i.e. F (1, 78) = 208.47, p < .000, η2 = .787) among patients with HIV/AIDS. Furthermore, CBT substantially improved the level of adherence to treatment (i.e. F(1,78) = 24.75, p < .000, η2 = .503), social support (i.e. F (1, 78) = 128.33, p < .000, η2 = .606), and quality of life (i.e. F (1, 78) = 373.39, p < .000, η2 = .837) among patients with HIV/AIDS. Significant mean difference M(SD) on PHQ at post-analysis in the EXPg vs. WLCg was seen 1.22(0.47) vs. 2.30(0.68) and similarly, on MPSS at a post-analysis in the EXPg vs. WLCg 2.85(0.36) vs. 1.70(0.51) which indicates sound therapeutic outcomes.

Conclusions

Cognitive behavioral therapy effectively decreases the level of depression and stigma and enhances the level of social support, quality of life, and adherence to treatment among HIV/AIDS patients. It is concluded that cognitive behavior therapy is an effective treatment approach for patients with HIV/AIDS.

Trial registration

Thai clinical trial registry (i.e. TCTR = TCTR20210702002).
Is fixation of both clavicle and scapula better than clavicle alone in surgical treatment of floating shoulder injury? A retrospective study
Authors: Shao Yijie , Zhu Xu , Liu Bo , Ji Chenchen , Sun Jiajia , Chen Guangdong
Published: July 2023

Background & objective

Little research was available to explore which surgical fixation was better between fixation of both clavicle and scapula and clavicle alone in management of floating shoulder injury.

Methods

Total 69 patients with floating shoulder injury receiving surgery from February 2005 to July 2020 participated in the study. 49 patients underwent fixation of the clavicle alone (Group C) while 20 patients underwent fixation of both clavicle and scapula (Group C + S). They were further divided into subgroups according to age: Group C1, Group C + S1 (age ≤ 55 years old) and Group C2, Group C + S2 (age>55 years old). The radiological parameter (glenopolar angle (GPA)) and clinical outcomes (Herscovici score, Constant-Murley shoulder outcome score (CSS score), and Visual Analogue Scale score (VAS score)) were collected and compared between these groups. The correlation between age and radiological parameter and clinical outcomes was calculated by the Spearman correlation analysis.

Results

All people were followed up for at least 1 year. The degree of change in GPA before and after surgery in Group C + S is significantly better than that in Group C. The Herscovici and CSS score in Group C + S2 were significantly higher than those in Group C2 at 1 month, 3 months and 1 year after surgery. However, no significant difference in Herscovici and CSS score was found at final follow-up (1 year after surgery) between Group C + S1 and Group C1. The VAS score in Group C + S2 at final follow-up was significantly lower than that in Group C2. No significant difference in VAS score at final follow-up was found between Group C + S1 and Group C1. In addition, the VAS score was negatively correlated with Herscovici and CSS score. No correlation was found between VAS score and GPA.

Conclusions

Both types of surgical fixation are effective in management of floating shoulder injury. For young people with floating shoulder injury, both types of surgical fixation are equally effective. However, for older people with floating shoulder injury, fixation of both clavicle and scapula is better in prognosis than fixation of clavicle alone.
Evaluation of the effectiveness of four alternative approaches for the classical cough test during a urodynamic study in the context of the COVID-19 global pandemic
Authors: Zeng Xiao , Liu Shuang , Shen SiHong , Shen Hong , Luo De-yi
Published: July 2023

Backgroud

To evaluate four different alternatives to the classical cough test during a urodynamic study in the context of the COVID-19 pandemic.

Methods

Patients who needed to undergo a urodynamic study (UDS) at the West China Hospital of Sichuan University between April 2021 and May 2021 were randomly selected according to the inclusion and exclusion criteria. During the UDS process, we used four alternative methods to the “cough test”: 1) quickly pressing the bladder area, 2) performing the Valsalva maneuver, 3) performing the Kegel maneuver, and 4) letting the patient close their mouth while performing the cough test. The "cough" waveform amplitudes and characteristics of the graphics were obtained and compared with the classical cough test.

Results

A total of 120 patients (89 men, 31 women) were included in the study. There was no significant difference between the cough waveform amplitude induced by the Valsalva maneuver compared with the classical cough test (P = 0.182); there was no significant difference between the cough waveform amplitude induced by the cough test with the mouth closed and the classical cough test (P = 0.342); there was no significant difference between pressing quickly on the bladder area and the classical method (P = 0.076); and there was a significant difference between the data obtained by the Kegel maneuver and the classical method (P < 0.05). The average "cough" amplitudes obtained were 73.14 ± 22.48 cm H2O, 66.17 ± 17.12 cm H2O, 82.93 ± 18.95 cm H2O, 26.50 ± 8.68 cm H2O, and 68.90 ± 20.32 cm H2O by the classical cough test, by quickly pressing the bladder area, by the Valsalva maneuver, by the Kegel maneuver, and by coughing with a closed mouth, respectively.

Conclusion

Quickly pressing the bladder area, performing the Valsalva maneuver, and letting the patient close their mouth while performing the cough test can all provide effective cough waveforms and amplitudes.

Trial registration

No. 2021–183.
FSCN1 promotes proliferation, invasion and glycolysis via the IRF4/AKT signaling pathway in oral squamous cell carcinoma
Authors: Li Liang , Chen Lihui , Li Zhangwei , Huang Shiqin , Chen Yaoyao , Li Zhiyong , Chen Wenkuan
Published: July 2023

Background

Oral squamous cell carcinoma (OSCC) is a disease with increasing incidence worldwide that leads to deformity and death. In OSCC, fascin actin-bundling protein 1 (FSCN1) is an oncogene involved in the tumorigenesis process. However, the functions and potential mechanisms of FSCN1 in the OSCC tumorigenesis process have not been reported thus far.

Methods

We used qRT‒PCR to detect the expression of FSCN1 in 40 paired OSCC tumor tissues (tumor) and neighboring noncancerous tissues. The role of FSCN1 was also assessed in vitro through colony formation, CCK-8, and transwell assays. Moreover, glucose consumption was detected. Western blotting was used to confirm the interaction of FSCN1, IRF4 and AKT.

Results

FSCN1 was remarkably overexpressed in OSCC tissues and cell lines compared to corresponding controls. In addition, colony formation, CCK-8, and transwell assays revealed a notable reduction in OSCC growth and invasion when FSCN1 was silenced. FSCN1 silencing remarkably suppressed OSCC glycolysis. Mechanistic studies showed that FSCN1 achieves its function partially by activating interferon regulatory factor 4 (IRF4) and the AKT pathway in OSCC.

Conclusion

In conclusion, our study investigated the functions and mechanisms of the FSCN1/IRF4/AKT pathway in OSCC progression. In OSCC, FSCN1 is likely to be a biomarker and therapeutic target.
Effect of N-Acetylcysteine on initial Carious Enamel Lesions in primary teeth: an In-vitro study
Authors: Mahfouz Omer Shaimaa M. , El-Sherbiny Randa H. , EL-Desouky Shaimaa S.
Published: July 2023

Background

Dental caries initiates with non-cavitated enamel lesions as the first stage. The cariogenic potential of N-Acetylcysteine (NAC) may be due to its usage frequency and form. This study aimed to evaluate the impact of exposure time of NAC on initial enamel caries-like lesions in primary teeth by assessing the morphological alteration using a scanning electron microscope (SEM) and mineral content using energy dispersive x-ray spectroscopy (EDX).

Methods

Forty primary incisor teeth were randomly divided into 4 groups S, S1, S2, and S3 (10 specimens/group). Teeth crowns were cut from their roots and inserted into an acrylic mold with its buccal surface directed upward. Centrally isolated enamel window (2 × 2 mm) on the tooth was done. Ten specimens were selected to evaluate normal enamel while the remaining thirty specimens were immersed in demineralizing solution for 96 h to produce enamel caries-like lesions. PH cycling was performed by immersing each tooth sample in 20 mL of demineralizing solution for 3 h then, preserved for the remaining day hours in 10 ml of artificial saliva interspersed with treatments applications with 10 ml NAC for 10 min twice a day for one- or three-months different treatment modalities. Thermocycling was done for all specimens then they were subjected to SEM and EDX analysis. ANOVA and Bonferroni post hoc tests were utilized in data analysis.

Results

In teeth treated by NAC for 3 months (group-S3), SEM images showed severe loss of enamel architecture with large NAC deposits detected. A meaningful difference was observed among different groups concerning calcium, phosphorus, fluoride, ca/P ratio, carbon, nitrogen, and oxygen contents (P < 0.05).

Conclusion

NAC had a detrimental impact on enamel caries-like lesions in human primary teeth.
Structured viva validity, reliability, and acceptability as an assessment tool in health professions education: a systematic review and meta-analysis
Authors: Abuzied Abdelhamid Ibrahim Hassan , Nabag Wisal Omer Mohamed
Published: July 2023

Background

The viva, or traditional oral examination, is a process where the examiners ask questions and the candidate answers them. While traditional viva has many disadvantages, including subjectivity, low validity, and low reliability, it is advantageous for assessing knowledge, clinical reasoning, and self-confidence, which cannot be assessed by written tests. In order to overcome these disadvantages, structured viva was invented and is claimed to be highly valid, reliable, and acceptable, but this was not confirmed by an overall systematic review or meta-analysis of the studies. The research aims to investigate the studies to reach an overall decision regarding the quality of structured viva as an assessment tool according to the agreed standards in medical education in terms of validity, reliability, and acceptability.

Methods

This systematic review was done following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. PubMed, Best Evidence Medical Education (BEME) website reviews, Google Scholars, and ScienceDirect databases were searched for any article addressing the research questions from inception to December 2022. Data analysis was done by the OpenMeta Analyst open-source app, version Windows 10.

Results

A total of 1385 studies were identified. Of them, 24 were included in the review. Three of the reviewed studies showed higher validity of structured viva by a positive linear correlation coefficient compared with MCQs, MCQs and Objective Structured Clinical Examination (OSCE), and structured theory exam. In the reviewed studies, the reliability of structured viva was high by Cronbach alpha α = 0.80 and α = 0.75 in two different settings, while it was low α = 0.50 for the traditional viva. In the meta-analysis, structured viva was found to be acceptable by overall acceptability of (79.8%, P < 0.001) out of all learners who participated in structured viva as examinees at different levels in health professions education using the available numeric data of 12 studies. The heterogeneity of the data was high (I^2 = 93.506, P < 0.001) thus the analysis was done using the binary random-effects model.

Conclusion

Structured viva or structured oral examination has high levels of validity, reliability, and acceptability as an assessment tool in health professions education compared to traditional viva.
Preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers: an exploratory factor analysis
Authors: Calabrese Mario , Suparaku Shefqet , Santovito Savino , Hysa Xhimi
Published: July 2023

Background

UN Sustainable Development Goals are part of the political agenda of most developed countries. Being a developing country, Albania has only recently adhered to this trend. Prior research at national level has sporadically focused on environmental sustainability, neglecting a holistic view of the phenomenon. To fill this gap, this study aims to explore preventing and developmental factors of sustainability in healthcare organisations from the perspective of decision makers by relying to a Triple Bottom Line approach.

Methods

Data were collected through a questionnaire administered to healthcare facilities and analysed through the Exploratory Factor Analysis. Findings revealed that the factors influencing the sustainability of the national healthcare system were five: Barriers of Organisational Sustainability; Stakeholders Pressure (regarding sustainable issues); Awareness (knowledge and measures taken for sustainability); Institutional Engagement; and Personal Interest and Involvement. The underlying factors included 19 items suitable for this sample, representing 64.371% of the total variance.

Results

The findings show the existence of 4 factors: Barriers of Organisational Sustainability, Stakeholders Pressure regarding Sustainable issues, Awareness/knowledge and measures taken for sustainability, Personal Interest and Involvement.

Conclusions

It is evident that national health organisations should continuously improve its strategies to be consistent with the sustainable development goals of international organisations, so that their initiatives could reflect the integration of sustainability approaches at the organisational level.
Barriers to adherence to cytology exam: a case study in low-income Colombian women
Authors: Bermúdez Paula C. , Arrivillaga Marcela , Torres Poveda Kirvis , Castrillón Libreros Diana M. , Castillo Castillo Lorena E. , Neira Acevedo Daniela
Published: July 2023

Background

Cervical cytology is essential for the early detection of cervical cancer. However, in Colombia, only 50% of women with subsidized health insurance were screened in 2019, compared to 100% of women with contributory insurance. This disparity highlights significant barriers that must be addressed. This study aimed to identify the factors that contribute to or hinder adherence to cervical cytology screening among low-income women with subsidized health insurance in a public primary care network in Cali, Colombia, from 2014 to 2018.

Methods

In a qualitative case study, the experience of women and health care and administrative personnel was recovered. Forty-seven women participated in seven focus group discussions. Five other women using the program participated in in-depth interviews. Finally, we interviewed eight people from the healthcare area and the health services administration. The qualitative data collected underwent content analysis, guided by the theoretical framework of Social Determinants of Health. Within this framework, five interconnected dimensions that influence adherence were incorporated.

Results

Adherence is a multifactorial phenomenon, and in relation to attendance at cervical cytology, the analysis delved into the mechanisms that affect it in a low-income context. Barriers to adherence were identified across multiple dimensions, including social and economic factors, health conditions, and patient-related factors, among both adherent and non-adherent women. Among adherent women, barriers and facilitators related to the healthcare team and system, as well as patient-related factors, were identified.

Conclusions

The findings of this research can be useful in developing personalized interventions and strategies to improve adherence and screening outcomes in low-income settings. It is necessary to increase the resources of health insurance entities to establish effective communication channels with women who attend the cervical cancer prevention program.
Defining and reporting activity patterns: a modified Delphi study
Authors: Ridgers Nicola D. , Denniss Emily , Burnett Alissa J. , Salmon Jo , Verswijveren Simone J.J.M.
Published: July 2023

Background

Despite significant interest in assessing activity patterns in different populations, there has been no consensus concerning the definition and operationalisation of this term. This has limited the comparability, interpretability, and synthesis of study findings to date. The aim of this study was to establish a consensus regarding the way in which activity patterns and activity pattern components are defined and reported.

Methods

The activity patterns literature was searched to identify experts to be invited to participate and to develop a proposed definition of activity patterns and activity pattern components. A three-round modified Delphi survey was conducted online (November 2021 to May 2022). In Round 1, participants were asked to rate their agreement with a proposed activity patterns definition, which also included six activity pattern components (e.g., activity intensity, activity bout, transitions), six examples of activity patterns (e.g., frequency of postural transitions in discrete time periods) and eight items for reporting activity patterns in future research (n = 21 items). Open-ended questions enabled participants to provide further comments and suggestions for additional items. Consensus was defined a priori as ≥ 80% participants rating their agreement with an item. In Round 2, participants were asked to rate their agreement with 25 items (13 original items, eight amended, and four new). In Round 3, participants rated their agreement with 10 items (five original items, four amended, and one new).

Results

Twenty experts in activity patterns research participated in Round 1, with response rates of 80% and 60% in Rounds 2 and 3, respectively. The proposed activity pattern definition, all activity pattern components definitions, four of the six activity pattern examples, and 10 items in the activity patterns reporting framework achieved consensus. The removal of one activity component item between Rounds 1 and 2 achieved consensus.

Conclusion

This modified Delphi study achieved consensus for defining and reporting activity patterns for the first time. This consensus definition enables standardisation of activity patterns terminology, which is important given the significant interest in quantifying how individuals accumulate their physical activity and sedentary behaviour across the lifespan to inform the development of future public health guidelines and interventions efforts.
Oncolytic virotherapy evolved into the fourth generation as tumor immunotherapy
Authors: Wang Xianwang , Shen Yihua , Wan Xingxia , Hu Xiaoqing , Cai Wen-Qi , Wu Zijun , Xin Qiang , Liu Xiaoqing , Gui Jingang , Xin Hong-Yi , Xin Hong-Wu
Published: July 2023

Background

Oncolytic virotherapy (OVT) is a promising anti-tumor modality that utilizes oncolytic viruses (OVs) to preferentially attack cancers rather than normal tissues. With the understanding particularly in the characteristics of viruses and tumor cells, numerous innovative OVs have been engineered to conquer cancers, such as Talimogene Laherparepvec (T-VEC) and tasadenoturev (DNX-2401). However, the therapeutic safety and efficacy must be further optimized and balanced to ensure the superior safe and efficient OVT in clinics, and reasonable combination therapy strategies are also important challenges worthy to be explored.

Main body

Here we provided a critical review of the development history and status of OVT, emphasizing the mechanisms of enhancing both safety and efficacy. We propose that oncolytic virotherapy has evolved into the fourth generation as tumor immunotherapy. Particularly, to arouse T cells by designing OVs expressing bi-specific T cell activator (BiTA) is a promising strategy of killing two birds with one stone. Amazing combination of therapeutic strategies of OVs and immune cells confers immense potential for managing cancers. Moreover, the attractive preclinical OVT addressed recently, and the OVT in clinical trials were systematically reviewed.

Conclusion

OVs, which are advancing into clinical trials, are being envisioned as the frontier clinical anti-tumor agents coming soon.
Objectively-measured movement behaviors, systemic low-grade inflammation, and plasma neurofilament light chain in older adults: a population-based study
Authors: Wang Yongxiang , Han Qi , Han Xiaolei , Dong Yi , Mao Ming , Wang Chaoqun , Wang Xiaojie , Tang Shi , Liu Cuicui , Li Yuanjing , Hou Tingting , Cong Lin , Du Yifeng , Qiu Chengxuan
Published: July 2023

Background

Evidence has linked self-reported sedentary behavior (SB) and physical activity (PA) with cognitive impairment; however, the underlying mechanisms are poorly understood. We examined the associations of the accelerometer-measured movement behaviors with plasma neurofilament light chain (NfL) among older adults and the role of systemic low-grade inflammation in the associations.

Results

This population-based study included 1,029 dementia-free older adults (age ≥ 60 years, range 60–88 years; 59.48% women) who undertook the ActiGraph substudy (March 2018-December 2020) in MIND-China. There were nonlinear relationships of daily SB and PA time with plasma NfL concentration, such that more daily SB time or less time spent in daily light-intensity physical activity (LPA) and moderate-to-vigorous-intensity physical activity (MVPA) was significantly associated with increased plasma NfL only when SB time ≥ 8.00 h/day or LPA time < 5.00 h/day or MVPA time < 2.00 h/day. Furthermore, more daily SB time or less daily LPA and MVPA time was significantly associated with higher serum low-grade inflammation score, a composite measure generated from serum IL-6, IL-8, TNF-α, and ICAM-1 (P < 0.05). Finally, low-grade inflammation score accounted for 14.5% to 17.8% of the associations between movement behaviors and plasma NfL.

Conclusions

More daily SB and less PA time are associated with neurodegeneration and systemic low-grade inflammation in older adults. The association of movement behaviors with neurodegeneration is partially mediated by low-grade inflammation.
Surgical management and the prognosis of iatrogenic facial nerve injury in middle ear surgery: a 20-year experience
Authors: Sun Jianbin , Wang Ruoya , Chen Xingrui , Wang Jianze , Liu Da , Sai Na , Zhu Yuhua , Liu Jun , Shen Weidong , Dai Pu , Yang Shiming , Han Dongyi , Han Weiju
Published: July 2023

Background

Iatrogenic facial nerve injury is one of the severest complications of middle ear surgery, this study aims to evaluate surgical management and prognosis in the era of improved surgical instruments.

Methods

Patients suffered from facial nerve paralysis after middle ear surgery between January 2000 and December 2019 were retrospectively collected. Demographic characters, primary disease and surgery, details of revision surgery were analyzed.

Results

Forty-five patients were collected, of whom 8 were injured at our center and 37 were transferred.

For 8 patients injured at our center, seven (87.5%) ranked House-Brackmann (H-B) grade V and one (12.5%) ranked H-B VI before revision surgery; postoperatively, two (25.0%) patients recovered to H-B grade I, four (50.0%) recovered to H-B II, and the other two (25.0%) recovered to H-B III. For 37 patients transferred, thirteen (35.1%) ranked H-B grade V and 24 (64.9%) ranked H-B VI preoperatively, final postoperative grade ranked from H-B grade I to grade V, with H-B I 6 (16.2%) cases, H-B II 6 (16.2%) cases, H-B III 18 (48.6%) cases, H-B IV 5 (13.5%) cases and H-B V 2 (5.4%) cases. The most vulnerable site was tympanic segment (5, 62.5% and 27, 73.0% respectively). Twenty-one (46.7%) patients suffered from mild injury and 24 (53.3%) suffered from partial or complete nerve transection. For surgical management, twenty-one (46.7%) patients received decompression, nineteen (42.2%) received graft and 5 (11.1%) received anastomosis. Those decompressed within 2 months after paralysis had higher possibility of H-B grade I or II recovery (P = 0.026), those received graft within 6 months were more likely to get H-B grade III recovery (P = 0.041), and for patients underwent anastomosis within 6 months, all recovered to H-B grade III.

Conclusions

Tympanic segment is the vulnerable site. If facial nerve paralysis happens, high-resolution computed tomography could help identify the injured site. Timely treatment is important, decompression within 2 months after paralysis, graft and anastomosis within 6 months lead to better recovery.
Experience with intraoperative radiation therapy in an urban cancer center
Authors: Andraos Therese Youssef , Skalina Karin A. , Feldman Sheldon , Mehta Keyur , Tome Wolfgang A. , McEvoy Maureen P. , Gupta Anjuli M. , Fox Jana L.
Published: July 2023

Background/objective

Intra-operative radiation therapy (IORT) is a newer partial breast irradiation technique that has been well studied in 2 large randomized trials, the TARGIT-A and ELIOT trials. We initiated our IORT program in 2018 in the context of a registry trial, and aim to report our early results thus far.

Methods

We instituted an IORT practice using Intrabeam® low energy 50kVp x-rays for selected breast cancer cases in 2018. Patients were enrolled on our institutional registry protocol which allowed for IORT in ER + patients with grade 1–2 DCIS ≤ 2.5 cm or invasive disease ≤ 3.5 cm in patients of at least 45 years of age.

Results

Between January 2018 and December 2021, 181 patients with clinical stage 0-IIA ER + breast cancer were evaluated. One hundred sixty-seven patients ultimately received IORT to 172 sites. The majority of patients received IORT at the time of initial diagnosis and surgery (160/167; 95.8%). Re-excision post IORT occurred in 16/167 patients (9.6%) due to positive margins. Adjuvant RT to the whole breast +/- LN was ultimately given to 23/167 (13.8%) patients mainly due to positive sentinel LN found on final pathology (12/23; 52%); other reasons were close margins for DCIS (3/23; 13%), tumor size (3/23; 4.3%), and multifactorial (5/23; 17.4%). Five patients (3%) had post-operative complications of wound dehiscence. There were 3 local recurrences (1.6%) at a median follow-up of 27.9 months (range: 0.7– 54.8 months).

Conclusions

IORT has been proven to be a safe and patient-centered form of local adjuvant RT for our population, in whom compliance with a longer course of external beam radiation can be an issue. Long term efficacy remains to be evaluated through continued follow up. In the era of COVID-19 and beyond, IORT has been an increasingly attractive option, as it greatly minimizes toxicities and patient visits to the clinic.

Trial registration

All patients were prospectively enrolled on an institutional review board-approved registry trial (IRB number: 2018–9409).