bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the Impact of Innovations on Economic Growth in BRICS Countries
Authors: Mussaiyib Azharuddin Mohammad , Pradhan Kailash Chandra
Published: June 2023

The study investigated the causal nexus between innovations and economic growth of Brazil, Russia, India, China and South Africa (BRICS) countries using panel data for the period 2004–2019. The total number of patent applications, the total number of trademark applications and percentages share of research and development expenditures to GDP are used as a proxy to measure innovations. The study used a panel regression with a fixed and random effect model, panel vector autoregression (VAR) model and impulse response function for the analysis. Further, the study checked both the symmetric and asymmetric impacts of innovations on economic growth using the panel autoregressive distributed lag (ARDL) model. The results from different econometric approaches are consistent and found that innovations positively and significantly impact economic growth. The results have also shown that there is a unidirectional causality running from innovations to per capita GDP in the short run. Finally, the results have shown the asymmetric causal linkage between innovations and economic growth. The study suggests that policymakers must encourage more investments in innovations for high economic growth in BRICS countries.
Jane Crow and the Abolition of Family Policing
Authors: Stoesz David
Published: June 2023

The Texas governor's weaponization of caseworkers to investigate parents of transgender minors combined with the murder of six adoptees in 2018 is an inflection point of child welfare. Since 2000, multiple investigations have depicted child welfare as racist surveillance of poor families. The Detlaff affair demonstrates the existence of a cartel in child welfare, protecting a retrograde status quo. Restructuring children's services is proposed, ending a half-century experiment of low-income, minority families.
“Psychological Injuries Are Not Visible”: Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy
Authors: Simsek-Cetinkaya Şahika , Evrenol Ocal Simge
Published: June 2023

This study aimed to describe perceptions and experiences of nurses and midwives working in primary care about domestic violence (DV) in pregnancy. Data were collected by conducting in-depth face-to-face interviews with 10 midwives and 7 nurses working in seven family health centers between July 17 and August 28, 2020. Five main themes emerged: “The causes of domestic violence,” “Difficulty recognizing domestic violence,” “Obstacles to revealing domestic violence,” “Obstacles to Assisting/Supporting domestic violence in pregnant women,” and “Solutions to prevent domestic violence in pregnancy.” Midwives/nurses feel inadequate and unprepared to recognize the symptoms of DV and to guide and support women and they are willing to take an active role in managing DV. It is recommended that they should be trained on DV, a monitoring system should be established including primary healthcare services and a measurement tool should be developed.
Social Media's Impact on Rape Myth Acceptance and Negative Affect in College Women: Examining the #MeToo and #HimToo Movement
Authors: Nomamiukor Faith O. , Wisco Blair E.
Published: June 2023

This study examined how the #MeToo movement, and backlash against it (#HimToo), influence rape myth acceptance (RMA) and negative affect among female sexual trauma survivors and controls. We randomly assigned college women ( N  =  389) to three social media conditions that either promoted RMA (#HimToo), challenged RMA (#MeToo), or did not address rape myths (general social media (GSM)). The findings demonstrated that women in the #HimToo condition reported more RMA, whereas women in the #MeToo and GSM conditions reported less negative affect. The results highlight that the way we talk about rape on social media influences momentary affect and RMA.
Survival Analysis of 159 Patients With Advanced Non-Small-Cell Lung Cancer Resistant to First-Generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor
Authors: Hu Aimin , Li Kun , Zheng Hua , Rao Haitao , Zhang Tongmei , Li Baolan
Published: June 2023

Background:

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have limited or no response in some certain patients of non-small-cell lung cancer (NSCLC). However, real-world survival analyses comparing clinical data and EGFR-plasma mutation are still lacking.

Methods:

In total, 159 patients with advanced NSCLC resistant to first-generation EGFR-TKIs were included for consecutive blood sampling in this study. Super-amplification refractory mutation system (Super-ARMS) was used to detect EGFR-plasma mutations and correlations between survival and circulating tumor DNA (ctDNA) were analyzed.

Results:

Among 159 eligible patients, the T790M mutation was detected in 27.0% (43/159) of patients. The median progression-free survival (mPFS) was 10.7 months in all patients. Survival analysis revealed that patients with the T790M mutation had shorter progression-free survival (PFS) than those with the T790M wild-type (10.6 months vs 10.8 months, P = .038). Patients who cleared EGFR-plasma mutation had prolonged PFS compared with those with nonclearing EGFR-plasma mutation (11.6 months vs 9.0 months, P = .001). Cox multivariate analysis showed that the nonclearance of EGFR-plasma mutations was an independent risk factor for PFS (RR = 1.745, 95% CI: [1.184, 2.571], P = .005). The T790M mutation was associated with nonclearance of the EGFR-plasma mutation ( χ2 = 10.407, P = .001).

Conclusion:

Patients with advanced NSCLC who were resistant to the first-generation EGFR-TKI had a prolonged PFS with clearance of EGFR-plasma mutation. Those nonclearers were more likely to harbor T790M mutations in plasma.
“Survival classes for a neurotypical world”: What French autistic adults want and need after receiving an autism diagnosis
Authors: Bureau Raven , Clément Céline
Published: June 2023

Research on how adults react to receiving an autism diagnosis is focused on the United States or the United Kingdom context even though cultural differences might have an impact on these experiences. Few interventions for autistic adults exist, and when they do, they are often described as inappropriate. Our study aimed to explore the experiences of French adults diagnosed with autism and the needs they identified following this diagnosis as well as to ask them directly what type of interventions they would have wanted. We conducted semi-structured interviews with 12 adults and identified three recurring themes: (1) reactions to the diagnosis, (2) relations with others and society, and (3) wants and needs. Results indicated that some experiences were congruent with existing Anglophone literature, while others were heavily influenced by the specific cultural context. Our participants also highlighted a number of unmet needs and offered suggestions for adequate interventions.

Lay abstract

Adults receiving an autism diagnosis might not react the same depending on their countries or cultures. We also know that autistic people are rarely asked what they think would be best for them following this diagnosis. In this study, we asked 12 French autistic adults about their experiences of receiving an autism diagnosis as well as what they thought might be useful afterwards. Overall, we found that some experiences were similar to experiences related by English or American participants, but some were specific to the French culture, suggesting that such research should expand into new territories and cultures, especially non-European ones. Our participants also had quite a few ideas as to what would be useful for people in the same situation. Some of the suggestions can be put into action by peers and professionals alike, while others are wishes relating to how our participants would like society to behave toward them and people like them, for example. This article allows for a better comprehension of how cultural differences can impact the experience of receiving an autism diagnosis as an adult and provides some insight into what these adults want and desire following such a diagnosis.
Bilingualism but not bidialectalism influences cognitive control among young adult Chinese–English bilinguals
Authors: Xie Zhilong , Zhong Qianyun
Published: June 2023

Aims and objectives/purpose/research questions:

This study investigates whether bilingualism and bidialectalism influence cognitive control, and whether the two variables interact.

Design/methodology/approach:

The study compared two matched groups differing in second language (L2) proficiency through the Flanker and Wisconsin Card Sorting Test (WCST). The two groups were further divided into four groups differing in dialect proficiency, so that the effects of L2 proficiency and dialect proficiency and the interactive effect were examined.

Data and analysis:

A mixed analysis of variance (ANOVA) was applied to the Flanker task data, with the task condition as the within-subject variable and the participant group as the between-subject variable. Independent t-test and ANOVA analyses were used to compare the performance differences between groups on the WCST.

Findings/conclusion:

The high L2 proficiency group performed better than the low L2 proficiency group both in the Flanker task and the WCST, reflecting better monitoring and shifting ability. L2 proficiency effect on cognitive control was significant. However, no dialect effect was observed, and no interaction effect was found. Further multiple regression results confirmed the role of L2 proficiency but not dialect proficiency.

Originality:

This is one of the first bilingual studies to incorporate both bilingualism and bidialectalism simultaneously.

Significance/implications:

The current research provides robust evidence that bilingualism is related to the enhancement of cognitive control, but questions the effect of bidialectalism.
When the dancing went wrong, the evening went right: An argument for ageing and changing cultural practice
Authors: Ball Mark
Published: June 2023

Inspired by a line dancing club in Stoke-on-Trent, and drawing principally on cultural theorist Raymond Williams, this article makes the case for appreciating the ways that cultural practices age and change over time. This group of line dancers held a deep, long, and collective familiarity with their practice, and through this intimacy an idiosyncratic attitude to dancing mistakes emerged. Taking these mistakes, collectively recast by dancers as ‘variations’, as the central empirical focus, I describe a sense of collective agency manifesting a solidaristic style of ageing together. Raymond Williams helps make this articulation political: in defending the time and space needed for such attitudes around practice to emerge, and the attitudes themselves.
Drug treatment service procurement: A systematic review of models, goals, and outcomes
Authors: Schneider Taina , Kuussaari Kristiina , Virtanen Petri
Published: June 2023

Aim: To explore the goals and outcomes of public procurement of drug treatment services in OECD countries. The study explores how these complex services are procured and delivered. Methods and data: A systematic review of the literature (1990–2020) identified four partly overlapping models of drug treatment service procurement that are here labelled traditional, value-based, outcome-based, and innovative. Results: Even though different forms of drug treatment services procurement are common, only 12 empirical studies that focused on procurement were found. The four models differ in their approaches to design and performance specifications and the role of competition and collaboration in the co-creation of value. Conclusions: Competition and incentives improve neither the efficiency nor the quality or the outcomes of complex drug treatment services. Whereas many studies focus on payment mechanisms, there are important research gaps that relate to the co-creation of value with and for the service-users and other stakeholders.
Co-creating organizational welfare through action-research: Insights from the case of a social cooperative
Authors: Gazzaroli Diletta , Corvino Chiara , D'Angelo Chiara
Published: June 2023

Based on co-creation theory, the value of any human resource (HR) practice is defined by any stakeholder who uses it; hence, to maximize its value, HR practices should be co-created by HR and users. However, when it comes to organizational welfare, in most of the cases, decision-makers rely on standardized processes and workers are involved mainly in terms of needs-analysis through standardized tools resulting in less incisive choices and policies. The current work takes on the challenge to apply action-research (AR) in the field of organizational welfare and show how AR can be used as a valuable methodological approach to sustain the co-creation of more relevant organizational welfare choices. We worked in collaboration with an Italian social cooperative with the purpose to adjust its representations and practices around organizational welfare through organizational actors’ participation. Results showed that AR allowed a complex welfare picture to be built, supporting awareness around several priorities from the bottom that would have otherwise remained invisible: the need to define an operational direction and the identification of a dedicated role to coordinate the process; development of a context-based welfare-need questionnaire. Our findings support the contribution of AR to the co-creation process of more effective HR practices.
mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe
Authors: Aboye Genet Tadese , Vande Walle Martijn , Simegn Gizeaddis Lamesgin , Aerts Jean-Marie
Published: June 2023

Background

mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system.

Objective

This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions.

Methods

The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet.

Results

The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure.

Conclusion

Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
Examining the Schenck KD I Classification in Patients With Documented Tibiofemoral Knee Dislocations: A Multicenter Retrospective Case Series
Authors: Green Joshua S. , Yalcin Sercan , Moran Jay , Vasavada Kinjal , Kahan Joseph B. , Li Zachary I. , Alaia Michael J. , Medvecky Michael J.
Published: June 2023

Background:

Acute tibiofemoral knee dislocations (KDs) with a single cruciate ligament remaining intact are rare and can be classified as Schenck KD I. The inclusion of multiligament knee injuries (MLKIs) has contributed to a recent surge in Schenck KD I prevalence and has convoluted the original definition of the classification.

Purpose:

To (1) report on a series of true Schenck KD I injuries with radiologically confirmed tibiofemoral dislocation and (2) introduce suffix modifications to further subclassify these injuries based on the reported cases.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective chart review identified all Schenck KD I MLKIs at 2 separate institutions between January 2001 and June 2022. Single-cruciate tears were included if a concomitant complete disruption of a collateral injury was present or injuries to the posterolateral corner, posteromedial corner, or extensor mechanism. All knee radiographs and magnetic resonance imaging scans were retrospectively reviewed by 2 board-certified orthopaedic sports medicine fellowship-trained surgeons. Only documented cases consistent with a complete tibiofemoral dislocation were included.

Results:

Of the 227 MLKIs, 63 (27.8%) were classified as KD I, and 12 (19.0%) of the 63 KD I injuries had a radiologically confirmed tibiofemoral dislocation. These 12 injuries were subclassified based on the following proposed suffix modifications: KD I-DA (anterior cruciate ligament [ACL] only; n = 3), KD I-DAM (ACL + medial collateral ligament [MCL]; n = 3), KD I-DPM (posterior cruciate ligament [PCL] + MCL; n = 2), KD I-DAL (ACL + lateral collateral ligament [LCL]; n = 1), and KD I-DPL (PCL + LCL; n = 3).

Conclusion:

The Schenck classification system should only be used to describe dislocations with bicruciate injuries or with single-cruciate injuries that have clinical and/or radiological evidence of tibiofemoral dislocation. Based on the presented cases, the authors recommend the suffix modifications for subclassifying Schenck KD I injuries with the goal of improving communication, surgical management, and the design of future outcome studies.
Dual Bracing for Ulnar Collateral Ligament Injuries Restores Native Valgus Laxity and Native Medial Joint Gapping of the Elbow
Authors: Otto Alexander , Muench Lukas N. , Mehl Julian , Baldino Joshua B. , Murphy Matthew , Obopilwe Elifho , Cote Mark P. , Scheiderer Bastian , Imhoff Andreas B. , Mazzocca Augustus D. , Siebenlist Sebastian
Published: June 2023

Background:

Despite growing evidence on the role of the posterior ulnar collateral ligament (pUCL) in elbow stability, current ligament bracing techniques are mainly focused on the anterior ulnar collateral ligament (aUCL). A dual-bracing technique combines the repair of the pUCL and aUCL with a suture augmentation of both bundles.

Purpose:

To biomechanically assess a dual-bracing approach addressing aUCL and pUCL for humeral-sided complete UCL lesions to restore medial elbow laxity without overconstraining.

Study Design:

Controlled laboratory study.

Methods:

A total of 21 unpaired human elbows (11 right, 10 left; 57.19 ± 11.7 years) were randomized into 3 groups to compare dual bracing with aUCL suture augmentation and aUCL graft reconstruction. Laxity testing was performed with 25 N applied 12 cm distal to the elbow joint for 30 seconds at randomized flexion angles (0°, 30°, 60°, 90°, and 120°) for the native condition and then for each surgical technique. A calibrated motion capture system was used for assessment, allowing the 3-dimensional displacement during the complete valgus stress cycle between the optical trackers to be quantified as joint gap and laxity. The repaired constructs were then cyclically tested through a materials testing machine starting with 20 N for 200 cycles at a rate of 0.5 Hz. The load was increased stepwise by 10 N for 200 cycles until displacement reached 5.0 mm or complete failure occurred.

Results:

Dual bracing and aUCL bracing resulted in significantly ( P = .045) less joint gapping at 120° of flexion compared with aUCL reconstruction. No significant differences in valgus laxity were found among the surgical techniques. Within each technique, there were no significant differences between the native and the postoperative state in valgus laxity and joint gapping. No significant differences between the techniques were observed in cycles to failure and failure load.

Conclusion:

Dual bracing restored native valgus joint laxity and medial joint gapping without overconstraining and provided similar primary stability regarding failure outcomes as established techniques. Furthermore, it was able to restore joint gapping in 120° of flexion significantly better than aUCL reconstruction.

Clinical Relevance:

This study provides biomechanical data on the dual-bracing approach that may help surgeons to consider this new method of addressing acute humeral UCL lesions.
Impact of vessel tortuosity and radiological thrombus characteristics on the choice of first-line thrombectomy strategy: Results from the ESCAPE-NA1 trial
Authors: Bala Fouzi , Cimflova Petra , Singh Nishita , Zhang Jianhai , Kappelhof Manon , Kim Beom Joon , Najm Mohamed , Golan Rotem , Elebute Ibukun , Benali Faysal , Terreros Nerea Arrarte , Marquering Henk , Majoie Charles , Almekhlafi Mohammed , Goyal Mayank , Hill Michael D , Qiu Wu , Menon Bijoy K
Published: June 2023

Introduction:

Despite improvements in device technology, only one-third of stroke patients undergoing endovascular thrombectomy (EVT) achieve first-pass effect (FPE). We investigated the effect of arterial tortuosity and thrombus characteristics on the relationship between first-line EVT strategy and angiographic outcomes.

Patients and methods:

Patients with thin-slice baseline CT-angiography from the ESCAPE-NA1 trial (Efficacy and safety of nerinetide for the treatment of acute ischemic stroke) were included. Tortuosity was estimated using the tortuosity index extracted from catheter pathway, and radiological thrombus characteristics were length, non-contrast density, perviousness and hyperdense artery sign. We assessed the association of first-line EVT strategy (stent-retriever [SR] versus contact aspiration [CA] versus combined SR+CA) with FPE (eTICI score 2c/3 after one pass), final eTICI 2b/3, number of passes and procedure duration using multivariable regression. Interaction of tortuosity and thrombus characteristics with first-line technique were assessed using interaction terms.

Results:

Among 520 included patients, SR as a first-line modality was used in 165 (31.7%) patients, CA in 132 (25.4%), and combined SR+CA in 223 (42.9%). FPE was observed in 166 patients (31.9%). First-line strategy was not associated with FPE. Tortuosity had a significant effect on FPE only in the CA group (aOR = 0.90 [95% CI 0.83–0.98]) compared with stent-retrievers and combined first-line approach (p interaction = 0.03). There was an interaction between thrombus length and first-line strategy for number of passes (p interaction = 0.04). Longer thrombi were associated with higher number of passes only in the CA group (acOR 1.03 [95% CI 1.00–1.06]).

Conclusion:

Our study suggests that vessel tortuosity and longer thrombi may negatively affect the performance of first-line contact aspiration catheters in acute stroke patients undergoing EVT.
Proliferating Trichilemmal Tumor of Scalp—An Eye Opener for a Pathologist
Authors: Kaushik Bhoomika , Azad Shweta , Kumar Arvind , Kishore Sanjeev
Published: June 2023

Proliferating trichilemmal tumor is a rare tumor of external root sheath of hair follicles, originating mainly from the scalp of middle-aged females. Grossly and microscopically, it mimics squamous cell carcinoma; hence, it is important to understand the cytological as well as histological features of this tumor diligently. In addition, there are no standard guidelines present for the treatment of these tumors and recurrence is not uncommon which make its management a challenge. Here we are reporting a case of a 65-year-old woman with proliferating trichilemmal tumor in a form of an ulcerated lobulated mass on her occipital area of the scalp.
A Review of the History of Sonography and its Effect on the Center for Medical Ultrasound at Wake Forest University
Authors: Bullins Adelia Thal
Published: June 2023

A tremendous need for sonographers and vascular technologists exists, however it would be informative to look back at a time when a similar demand occurred. A review of the history of sonography is provided and how it impacted the Center for Medical Ultrasound at Wake Forest University. This historical review also marks the rise of early sonography education and how it evolved into a range of options such as a 4-year Bachelor of Science degree, a 2-year Associate Science degree, or a multiweek certificate program. No matter the length of the program, or the style in which it is delivered, the following basic key ingredients are considered requisite:

 • Access to newer model ultrasound equipment systems

 • Dynamic classroom lectures (online, live, or a combination of both)

 • Active clinical experiences under the guidance of an experienced and enthusiastic sonography expert, specific to a sonographic specialty (OB, cardiac, abdominal, etc.).

Without all these key ingredients, the educational program will not be effective and sustainable. Sonography is a visual science and vital to display images, for the interpreting physician. The sonographer and physicians must work closely as a unified team. An effective working team (physician and sonographer) allows for trading ideas and suggesting possible answers to the diagnostically difficult patient cases.
Cognitive behavioural therapy combined with physical activity behavioural modification strategies during pulmonary rehabilitation in patients with COPD
Authors: Armstrong Matthew , Hume Emily , McNeillie Laura , Chambers Francesca , Wakenshaw Lynsey , Burns Graham , Heslop Marshall Karen , Vogiatzis Ioannis
Published: June 2023

Introduction

Patients with COPD who exhibit elevated levels of anxiety and/or depression are typically less able to improve symptoms and physical activity levels following a programme of pulmonary rehabilitation (PR). The objective of the present study was to provide proof of concept that offering an intervention comprising cognitive behavioural therapy (CBT) alongside physical activity behavioural modification strategies (BPA) during PR is more effective in improving physical activity outcomes compared to PR and CBT alone.

Methods

32 patients with COPD (mean±sdforced expiratory volume in 1 s 42±14% predicted) were assigned 1:1 to receive PR+CBT+BPA or PR+CBT. BPA comprised motivational interviews, step-count monitoring, feedback using a pedometer and goal setting. Assessments included accelerometer-derived steps per day, movement intensity, 6-min walk distance (6MWD) and Hospital Anxiety and Depression Scale (HADS) scores.

Results

The magnitude of improvement across physical activity outcomes was greater for the PR+CBT+BPA compared to the PR+CBT intervention (by 829 steps per day (p=0.029) and by 80±39 vector magnitude units (p=0.042), respectively). Compared to PR and CBT alone, the PR+CBT+BPA intervention induced greater clinically meaningful improvements in HADS anxiety scores (by −2 units, 95% CI −4–1 units) and 6MWD (by 33±20 m).

Conclusions

Providing anxious and/or depressed patients with COPD with a combined intervention of CBT and BPA during PR presents more favourable improvements in physical activity outcome measures compared to CBT alone during PR.
A pilot, prospective trial of IntuBrite® versus Macintosh direct laryngoscopy for paramedic endotracheal intubation in out of hospital cardiac arrest
Authors: Kluj Przemysław , Fedorczak Michał , Gaszyński Tomasz , Ratajczyk Paweł
Published: June 2023

Background

Intubation in the case of out-of-hospital cardiac arrest (OHCA) is one of the most difficult procedures for Emergency Medical Services (EMS). The use of a laryngoscope with a dual light source is an interesting alternative to classic laryngoscopes. However, there are as yet no prospective data concerning the use of double light direct laryngoscopy (DL) by paramedics in traditional ground ambulance agencies in OHCA.

Methods

We performed a non-blinded trial in a single EMS in Poland within ambulances crews, comparing time and first pass success (FPS) for endotracheal intubation (ETI) in DL using the IntuBrite® (INT) and Macintosh laryngoscope (MCL) during cardiopulmonary resuscitation (CPR). We collected both patient and provider demographic information along with intubation details. The time and success rates were compared using an intention-to-treat analysis.

Results

Over a period of 40 months, a total of 86 intubations were performed using 42 INT and 44 MCL based on an intention-to-treat analysis. The FPS time of the ETI attempt (13.49 vs. 15.55 s) using an INT which was shorter than MCL was used (p < 0.05). First attempt success (34/42, 80.9% vs. 29/44, 64.4%) was comparable for INT and MCL with no statistical significance.

Conclusions

We found a statistically significant difference in intubation attempt time when the INT laryngoscope was used. Intubation first attempt success rates with INT and MCL were comparable with no statistical significance during CPR performed by paramedics.

Trial Registration

Trial was registered in Clinical Trials: NCT05607836 (10/28/2022)
Risk factors for recurrent wheezing after bronchiolitis
Authors: Fan YH , Zhang PL , Huang YJ , Xie C , Ai T
Published: June 2023

Background

This study aimed to determine whether there was an association between certain factors in patients with bronchiolitis and recurrent wheezing in childhood.

Method

In 2021 we tracked children hospitalized for bronchiolitis at Chengdu Women’s and Children’s Central Hospital in 2017. The patients were classified into recurrent wheezing group (RWG) and non-recurrent wheezing group (NRWG). Possible risk factors including maternal age, school-age siblings, allergic history, atopic dermatitis, allergic rhinitis, atopic family history, severity of the condition, duration of hospitalization, nasopharyngeal secretions culture, blood eosinophil counts, FeNO and skin prick test were compared between the two groups. Continuous variables were analyzed by independent sample t-test for normal distribution and Mann-Whitney U-test for non-normal distribution. Categorical variables were tested using chi-square tests. Multifactor analysis was conducted by stepwise logistics regression analysis.

Results

In total 167 participants were included, of which 26 and 141 were in RWG and NRWG respectively. In RWG children represented higher maternal age (P = 0.02) and greater probability of allergic history, atopic dermatitis, allergic rhinitis, atopic family history (odds ratio [OR] = 4.0,3.7, 7.8, 10.9 respectively, P < 0.01). However, school-age siblings, severity of the condition, duration of hospitalization, blood eosinophil counts, fractional exhaled nitric oxide and skin prick test results seemed unrelated to recurrent wheezing. In the subgroup analysis of nasopharyngeal secretion culture, there were more Moraxella catarrhalis-positive in RWG(P = 0.043). Atopic dermatitis, allergic rhinitis and atopic family history were identified as independent risk factors for recurrent wheezing.

Conclusion

Some children with bronchiolitis will develop recurrent wheezing, and the risk factors are allergic history, Moraxella catarrhalis infection or colonization, atopic dermatitis, allergic rhinitis and atopic family history; the latter three are independent risk factors.
Practical contribution of women development army on growth monitoring and promotion service at Dembya and Gondar Zuria districts, Central Gondar Zone, North West Ethiopia: a community based mixed study
Authors: Muhammad Esmael Ali , Hunegnaw Melkamu Tamir , Gonete Kedir Abdela , Worku Netsanet , Alemu Kasahun , Abebe Zegeye , Astale Tigist , Mitike Getnet , Belew Aysheshim Kassahun
Published: June 2023

Background

The United Nations’ Sustainable Development Goal (SDG)-2 aims to eliminate child hunger or end all forms of child malnutrition by 2030. To achieve this goal the cost-effective method is the implementation of growth monitoring and promotion service with the contribution of Women Development Army (WDA) as community volunteers. However, According to the data, the program’s implementation varies throughout the country and lack of evidence on the practical contribution of the WDA to enhancing child nutritional care outcomes. Therefore this study aimed to determine practical contribution of WDA and associated factors on growth monitoring and promotion service in two rural districts of central Gondar zone, Northwest Ethiopia.

Methods

A community based mixed study was conducted from March 6 to April 7, 2022 among 615 Women Development Army. Multistage sampling technique was used to select study participants. A structured questionnaire was used to collect quantitative data and in-depth interview were used to generate qualitative information. Qualitative data were coded and grouped and discussed using identified themes. Binary logistic regression was fitted, odds ratio with 95% confidence interval was estimated to identify factors of practical contribution of WDA and qualitative data was analyzed using thematic analysis.

Results

In this study practical contribution of WDA on growth monitoring was 31.4% (95% CI: 28.0-35.3%). Having GMP training (AOR = 4.2, 95%CI: 1.63, 10.58), regular community conversation (AOR = 6.0, 95%CI: 3.12, 11.54), good knowledge about GMP (AOR = 2.1, 95%CI: 1.17, 3.83) and not having regular schedule of GMP service in the area (AOR = 0.04, 95%CI: 0.02, 0.09), were statistically significantly associated with practical contribution of growth monitoring. During in-depth interview, lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were mentioned among the problems faced during growth monitoring service.

Conclusion

In this study, practical contribution of growth monitoring among WDA was low. GMP training regular community conversation, knowledge about GMP and regular schedule of GMP service in the local area were significantly associated for practical contribution of growth monitoring service. Lack of training, low motivation or commitment among WDA and low communication between WDA and health extension workers were reasons for did not contribute effectively for GMP service. Therefore, giving training for WDA and improving community conversation at kebeles level are important to improve GM service. .
Global, regional, and national burden of kidney dysfunction from 1990 to 2019: a systematic analysis from the global burden of disease study 2019
Authors: Zhang Shu , Ren Hui-Fang , Du Rong-Xin , Sun Wei-Li , Fu Mei-Li , Zhang Xiao-Chao
Published: June 2023

Objective

We aim to explore the prevalence and temporal trends of the burden of kidney dysfunction (KD) in global, regional and national level, since a lack of related studies.

Design

Cross-sectional study.

Materials

The data of this research was obtained from Global Burden of Diseases Study 2019. The estimation of the prevalence, which was measured by the summary exposure value (SEV), and attributable burden of KD was performed by DisMod-MR 2.1, a Bayesian meta-regression tool. The Spearman rank order correlation method was adopted to perform correlation analysis. The temporal trends were represented by the estimated annual percentage change (EAPC).

Results

In 2019, there were total 3.16 million deaths and 76.5 million disability-adjusted life years (DALYs) attributable to KD, increased by 101.1% and 81.7% compared with that in 1990, respectively. From 1990 to 2019, the prevalence of KD has increased in worldwide, but decreased in High-income Asia Pacific. Nearly 48.5% of countries globally, such as South Africa, Egypt and Mexico had increased mortality rates of KD from 1990 to 2019 while 44.6% for disability rate. Countries with lower socio-demographic index (SDI) are facing a higher prevalence as well as mortality and disability rate compared with those with higher SDI. Compared with females, the prevalence of KD was lower in males, however the attributable mortality and disability rate were higher in all years from 1990 to 2019.

Conclusion

With the progress of senescent, we will face more severe challenges of reducing the prevalence and attributable burden of KD, especially in regions with lower SDI. Effective measures are urgently required to alleviate the prevalence and burden of KD.
Complications associated with single-level bone transport for the treatment of tibial bone defects caused by fracture-related infection
Authors: Liu Kai , Jia Qiyu , Wang Xin , Bahesutihan Yemenlehan , Ma Chuang , Ren Peng , Liu Yanshi , Yusufu Aihemaitijiang
Published: June 2023

Background

The purpose of this study was to report the outcomes of single-level bone transport with a unilateral external fixator for treatment of proximal, intermediate and distal tibial bone defects caused by fracture-related infection (FRI) and compare their complications.

Methods

The clinical records and consecutive X-ray photographs of patients with tibial bone defects treated by single-level bone transport using a unilateral external fixator (Orthofix Limb Reconstruction System) were analyzed retrospectively, from January 2012 to December 2018. Patients were divided into the proximal group (P, n = 19), intermediate group (I, n = 25), and distal group (D, n = 18) according to the location of the tibial bone defect. The Association for the Study and Application of the Method of Ilizarov (ASAMI) standard was applied to assess the bone and functional outcomes and postoperative complications evaluated by the Paley classification.

Results

A total of 62 participants were included in this study, with a median age of 36 ± 7.14 years. Sixty patients with tibial bone defects caused by FRI were successfully treated by single-level bone transport using a unilateral external fixator, with a mean bone union time (BUT) of 7.3 ± 1.71 months. According to the ASAMI criteria, there were statistical differences in bone and function results between the three groups (P vs. I vs. D, P < 0.001). The excellent and good rate of bone result in the intermediate group was higher than the other (P vs. I vs. D, 73.6% vs. 84% vs. 66.7%), and the excellent and good rate of function result in the proximal group was the highest (P vs. I vs. D, 84.2% vs. 80% vs. 73.3%). Complications were observed in 29 out of 62 patients (46.7%), with pin tract infection being the most common (14.8%), followed by axial deviation (14.8%), muscle contractures (12.7%), joint stiffness (12.7%), and soft tissue incarceration (12.7%). Other complications included delayed consolidation (12.7%), delayed union (6.3%), nonunion (4.2%), and neurological injury (8.5%). Two patients (3.2%) required below-knee amputation due to uncontrollable infection and previous surgery failure.

Conclusions

Pin tract infection was the most common complication in tibial bone transport using an external fixator. Complications of distal tibial bone transport are more severe and occur at a higher rate than in other parts. Axial deviation mostly occurred in the intermediate tibial bone transport.
Death doula working practices and models of care: the views of death doula training organisations
Authors: Rawlings Deb , Miller-Lewis Lauren , Tieman Jennifer , Swetenham Kate
Published: June 2023

Background

The role of death doula has emerged in recent years, arguably as a result of overwhelming demands on carers, healthcare professionals and service providers in end-of-life care. Death doulas work independently without governing oversight and enact the role in various ways. The main driver of this evolving role is the organisations that train them. The aim of this study was to examine death doula training organisations’ views with regard to DD business models, incorporating the death doula role into other existing models of care, and role enactment.

Methods

An electronic survey was administered to 15 death doula training organisations in 5 countries asking additionally that they disseminate the survey. Responses were received from 13 organisations, based in Australia (n = 4), the US (n = 4), Canada (n = 2), the UK (n = 1), Sweden (n = 1) and New Zealand (n = 1). This paper provides the qualitative findings from four open-text questions posed within the survey related to models of care.

Results

Qualitative data analysis was inductive, themes were determined in relation to: (1) standardised business model for death doulas, (2) death doulas incorporated into existing models of care or existing funding options, (3) death doulas who volunteer their services rather than charge money, and (4) role specialisation such as has occurred with birth doulas.

Conclusions

The death doula role has the potential to be formally recognised in the future under national registration schemes, accompanied by death doula training required via certification. Until such time the death doula role will continue to evolve much as the birth doula role has, organically and unstructured. How and if death doulas are incorporated into existing models of health or social care remains to be seen as the organisations that train them push for independence, flexibility and fiscal independence.
Immediate impact of Mindfulness-Based Cognitive Therapy (MBCT) among women with breast cancer: a systematic review and meta-analysis
Authors: Chang Yun-Chen , Tseng Tzuhui Angie , Lin Gen-Min , Hu Wen-Yu , Wang Chih-Kai , Chang Yuh-Ming
Published: June 2023

Background

Mindfulness-based cognitive therapy (MBCT) may have positive physiological and psychological benefits for breast cancer survivors. However, few studies involved a combination of the relevant literatures to confirm the effects.

Methods

Our study included randomized controlled trials (RCTs) and non-RCTs comparing interventions of MBCT and control protocols for alleviation of symptoms among breast cancer survivors. We calculated pooled mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) by using random effects models to estimate summary effect sizes.

Results

Thirteen trials with 20–245 participants were considered in our studies; for the meta-analysis, 11 of these studies were eligible for assessment. The pooled meta-analysis results revealed that at the end of the MBCT intervention, participants’ anxiety (SMD, − 0.70; 95% CI, − 1.26 to − 0.13; I2 = 69%), pain (SMD, − 0.64; 95% CI, − 0.92 to − 0.37; I2 = 0%), and depression (SMD, − 0.65; 95% CI, − 1.14 to − 0.17; I2 = 75%) levels significantly decreased, and their mindfulness (MD, 8.83; 95% CI, 3.88 to 13.78; I2 = 68%) levels significantly increased.

Conclusion

The MBCT may be associated with improved pain, anxiety, depression, and mindfulness. However, the quantitative analysis pointed to an inconclusive result due to moderate to high levels of heterogeneity among indicator of anxiety, depression, and mindfulness. Future work requires more studies to better elucidate the clinical significance of this possible association. The results suggest that MBCT is highly beneficial as an intervention for patients who have received treatment for breast cancer.
Current postgraduate training in emergency medicine in the Nordic countries
Authors: Björnsson Hjalti Már , Bjørnsen Lars Petter , Skjærbæk Christian Baaner , Hruska Katrin , Palomäki Ari ,   Nordic EM Study Group, Andersson Tommy , Rasmussen Christian , Hørlyk Ulf Grue , Hällberg Ville , Koivistoinen Teemu , Unga Jonni , Shams Bahram , Härtel Cornelia
Published: June 2023

Background

Emergency Medicine (EM) is an independent specialty in all five Nordic countries. This study aims to evaluate the structure of post-graduate EM training in the area.

Methods

A leading hospital or hospitals in EM training in each country were identified. An e-survey was sent to each hospital to gather data on patient volume and physician staffing, curriculum, trainee supervision, and monitoring of progression in training.

Results

Data were collected from one center in Iceland and Norway, two in Finland and Sweden, and four centers in Denmark. The data from each country in Denmark, Finland, and Sweden, were pooled to represent that country. The percentage of consultants with EM specialist recognition ranged from 49–100% of all consultants working in the participating departments. The number of patients seen annually per each full time EM consultant was almost three times higher in Finland than in Sweden. In Iceland, Denmark, and Sweden a consultant was present 24/7 in the ED but not in all centers in the other countries. The level of trainee autonomy in clinical practice varied between countries. Requirements for completing standardized courses, completing final exams, scientific and quality improvement projects, and evaluation of trainee progression, varied between the countries.

Conclusions

All Nordic countries have established EM training programs. Despite cultural similarities, there are significant differences in how the EM training is structured between the countries. Writing and implementing a standardized training curriculum and assessment system for EM training in the Nordic countries should be considered.
Genetic deletion of hepatic NCOR1 protects from atherosclerosis by promoting alternative bile acid-metabolism and sterol excretion
Authors: Geiger Martin , Oppi Sara , Nusser-Stein Stefanie , Costantino Sarah , Mohammed Shafeeq Ahmed , Gorica Era , Hoogerland Joanne A. , Matter Christian M. , Guillaumon Ana T. , Ruschitzka Frank , Paneni Francesco , Oosterveer Maaike H. , Stein Sokrates
Published: June 2023

Background

The nuclear receptor corepressor 1 (NCOR1) plays an important role in the regulation of gene expression in immunometabolic conditions by connecting chromatin-modifying enzymes, coregulators and transcription factors. NCOR1 has been shown to be involved in cardiometabolic diseases. Recently, we demonstrated that the deletion of macrophage NCOR1 aggravates atherosclerosis by promoting CD36-triggered foam cell formation via PPARG derepression.

Purpose

Since NCOR1 modulates the function of several key regulators involved in hepatic lipid and bile acid metabolism, we hypothesized that its deletion in hepatocytes alters lipid metabolism and atherogenesis.

Methods

To test this hypothesis, we generated hepatocyte-specific Ncor1 knockout mice on a Ldlr-/- background. Besides assessing the progression of the disease in thoracoabdominal aortae en face, we analyzed hepatic cholesterol and bile acid metabolism at expression and functional levels.

Results

Our data demonstrate that liver-specific Ncor1 knockout mice on an atherosclerosis-prone background develop less atherosclerotic lesions than controls. Interestingly, under chow diet, plasma cholesterol levels of liver-specific Ncor1 knockout mice were slightly higher compared to control, but strongly reduced compared to control mice after feeding them an atherogenic diet for 12 weeks. Moreover, the hepatic cholesterol content was decreased in liver-specific Ncor1 knockout compared to control mice. Our mechanistic data revealed that NCOR1 reprograms the synthesis of bile acids towards the alternative pathway, which in turn reduce bile hydrophobicity and enhances fecal cholesterol excretion.

Conclusions

Our data suggest that hepatic Ncor1 deletion in mice decreases atherosclerosis development by reprograming bile acid metabolism and enhancing fecal cholesterol excretion.