bluuebunny/crossref_metadata_2025 huggingface dataset:
The Paradox of Choice in Palliative Care Decision-Making in Managed Long-Term Care: A Qualitative Study
Authors: Song Jiyoun , Ramlogan Lynette , Vergez Sasha , Davoudi Anahita , Sridharan Sridevi , Cho Hannah , Stanley June , McDonald Margaret V. , Bowles Kathryn H. , Shang Jingjing , Stone Patricia W. , Topaz Maxim
Published: April 2024

Palliative care offers undeniable advantages to elderly patients with multiple chronic illnesses in managed long-term care. However, only approximately 14% of those who require palliative care actually receive it. To investigate factors influencing decision-making regarding palliative care acceptance, and healthcare providers’ communication strategies, which patients or family caregivers perceive during managed long-term care. Qualitative thematic content analysis study. Two data sources from home and community-based health care organization in a metropolitical city in the Northeastern United States were used: (a) retrospectively collected 79 phone call audio recordings between patients and/or family caregivers with healthcare providers when initiate palliative care option, and (b) prospectively collected 10 exploratory qualitative interviews with patients and/or family caregivers for this study purpose. From a total of 89 conversations, 7 themes emerged during palliative care decision-making: (a) capability for self-management; (b) symptom severity; (c) perceptions of chronic disease; (d) satisfaction with current health services; (e) code status; (f) caregiver burden and (g) other reasons, including financial considerations and service affiliations. In addition, from 10 qualitative interviews, 4 key themes in healthcare providers’ communication that optimize palliative care conversations were indicated: (i) trust and relationship dynamics; (ii) positive reinforcement and personal connection; (iii) conversation setting and initiator; and (iv) collaborative approach to care coordination. Enhancing decision-making around palliative care and improving acceptance of palliative care services may be improved through the integration of personalized care plans, empathetic communication, use of symptom-inclusive assessments for timely care, and proactively addressing caregiver burden.
How Do Implausible Tensile Price Claims Affect Consumer Perceptions of Deceptiveness and Consumer Willingness to Purchase in Online Environments?
Authors: Chang Xinyu , Zheng Hualu , Yang Shuai , Huang Lu , Ross William T.
Published: April 2024

The study explores how and why an embedded implausible tensile price claim (TPC) affects consumers’ decisions as to whether to click on the associated online advertisement and their subsequent purchases. The authors conduct a field experiment by designing a structured set of search advertisements with implausible TPCs for a global apparel brand and launching them on Baidu, the largest search engine in China. Using a hierarchical Bayesian model, the authors quantify how implausible TPCs influence consumers’ two-stage decisions: clicking on the advertisement and purchasing the product. Using two laboratory experiments, the authors further demonstrate that the purchase decision is mediated by consumers’ perceptions of deception in the advertisement, despite the fact that the click decision is not. Results show that implausible TPCs in a search advertisement motivate consumers to click on the promotion. However, the discrepancy between the advertised and the actual discounts makes the advertisement seem deceptive to consumers, which reduces their likelihood of purchasing the product and leads them to search for other products and promotions. The results address advertising deception in online price claims, offer critical policy implications regarding implausible TPCs, and shed light on designing and executing implausible TPCs in online advertising.
The Impact of Resistance Exercise Training on Glycemic Control Among Adults with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Wan Yuwen , Su Zhanguo
Published: April 2024

Background: The prevalence of type 2 diabetes mellitus (T2DM) presents a challenge for health organizations because of its high likelihood of morbidity and mortality. There is an increasing body of evidence exploring the efficacy of resistance training (RT) alone on glycemic control. Objective: To update the effectiveness of RT on glycosylated hemoglobin (HbA1c) and fasting glucose in adults diagnosed with T2DM. Methods: CINAHL (EBSDCO), PubMed, MEDLINE (Ovid), and EMBASE (Ovid) databases were searched from inception to 30 January 2024. Published randomized controlled trials (RCTs) of adult humans with T2DM assessing the impact of RT on HbA1c and fasting glucose compared with control condition were included. Data were pooled by the inverse-variance method and reported as mean differences (MDs) with 95% confidence intervals (CIs). Results: Forty-six RCTs totaling 2130 participants met the inclusion criteria. Meta-analysis demonstrated RT significantly reduced HbA1c (MD -0.50% [95% CI, −0.67, −0.34 %], p < .00,001) and fasting glucose (MD -12.03 mg/dl [95% CI, −19.36, −4.69 mg/dl], p = .001). Subgroup analyses found that exercise training durations, gender, and risk of bias had statistically significant effects on HbA1c levels and fasting glucose concentrations after resistance training. However, meta-regression analyses revealed that variables including year of publication, number of sessions per week, mean sample age, sample size, and study quality scores did not significantly affect the change in either HbA1c or glucose. Conclusion: Our meta-analysis with meta-regression delivers further evidence that RT programs are effective approach in attenuation of HbA1c and fasting glucose in individuals with T2DM.
Validation of intraocular pressure measurement using tonometer AVIA across different postures: A Bland Altman analysis
Authors: Muhsen Sana’ , Rabadi Alexander , Alqudah Mahmoud , Obiedat Abdelrahman , Owies Liyana , Alhawaniah Ibrahim , Abdel Hafez Sufian , Al-Ani Abdallah
Published: April 2024

Aims/Objectives

Tonometry is a fundamental procedure in the diagnosis and management of glaucoma. Different tonometers have been proposed but none are as accurate as the Goldman applanation tonometry (GAT). Nonetheless, due to the limitations of GAT, mobile tonometry methods became prevalent. This study aims to examine the reliability of the Tono-Pen AVIA® (TPA) in measuring intraocular pressure (IOP) across different postures.

Methods

A total of 196 eyes were prospectively examined for IOP changes using GAT and TPA. IOP measurements were taken across different postures using the TPA. Reliability of measurements was compared using interclass correlation coefficients (ICC), while agreement was represented using Bland-Altman analysis. Pearson r coefficient was used to measure correlations.

Results

When compared to GAT (14.5 ± 4.4 mmHg), IOP readings were significantly higher for TPA at both seated (16.5 ± 4.5 mmHg; p < 0.001) and supine (16.9 ± 5.7; p < 0.001) positions. The ICC values for GAT and TPA among seated and supine patients were 0.79 (0.54–0.90) and 0.76 (0.48–0.87) indicating good reliability between the readings. There were significantly positive correlations between GAT and TPA at both seated ( r = 0.626, p < 0.001) and supine ( r = 0.727, p < 0.001) positions. Per Bland-Altman analysis, limits of agreement were −8.57 to 4.37 for GAT and seated TPA and −10.34 and 5.34 for GAT and supine TPA.

Conclusion

Good reliability exists between IOP measurements using GAT and TPA. However, the devices are not interchangeable and therefore cannot be used reciprocally in the same patient.
Prediction of High-Risk Gastrointestinal Stromal Tumor Recurrence Based on Delta-CT Radiomics Modeling: A 3-Year Follow-up Study After Surgery
Authors: Ji Xianqun , Shang Yu , Tan Lin , Hu Yan , Liu Junjie , Song Lina , Zhang Junyan , Wang Jingxian , Ye Yingjian , Zhang Haidong , Peng Tianfang , An Peng
Published: April 2024

Background:

Medium- to high-risk classification-gastrointestinal stromal tumors (MH-GIST) have a high recurrence rate and are difficult to treat. This study aims to predict the recurrence of MH-GIST within 3 years after surgery based on clinical data and preoperative Delta-CT Radiomics modeling.

Methods:

A retrospective analysis was conducted on clinical imaging data of 242 cases confirmed to have MH-GIST after surgery, including 92 cases of recurrence and 150 cases of normal. The training set and test set were established using a 7:3 ratio and time cutoff point. In the training set, multiple prediction models were established based on clinical data of MH-GIST and the changes in radiomics texture of enhanced computed tomography (CT) at different time periods (Delta-CT radiomics). The area under curve (AUC) values of each model were compared using the Delong test, and the clinical net benefit of the model was tested using decision curve analysis (DCA). Then, the model was externally validated in the test set, and a novel nomogram predicting the recurrence of MH-GIST was finally created.

Results:

Univariate analysis confirmed that tumor volume, tumor location, neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), diabetes, spicy hot pot, CT enhancement mode, and Radscore 1/2 were predictive factors for MH-GIST recurrence ( P < .05). The combined model based on these above factors had significantly higher predictive performance (AUC = 0.895, 95% confidence interval [CI] = [0.839-0.937]) than the clinical data model (AUC = 0.735, 95% CI = [0.6 62-0.800]) and radiomics model (AUC = 0.842, 95% CI = [0.779-0.894]). Decision curve analysis also confirmed the higher clinical net benefit of the combined model, and the same results were validated in the test set. The novel nomogram developed based on the combined model helps predict the recurrence of MH-GIST.

Conclusions:

The nomogram of clinical and Delta-CT radiomics has important clinical value in predicting the recurrence of MH-GIST, providing reliable data reference for its diagnosis, treatment, and clinical decision-making.
Ranting in emotional public spheres: Publicizing participatory challenges on YouTube
Authors: Lange Patricia G
Published: April 2024

Ranting has a bad reputation. But is it always deserved? Online ranting has been alternatively decried for its emotion-laden hostility and praised as a beloved video genre. By exploring a qualitative corpus of YouTube rant videos, this article analyzes how problem-centric rants may serve as forms of proto civic engagement. The article shows that problem-centric rants contribute to emotional public spheres, in which emotions and logic combine to publicize personally-experienced participatory problems and to contribute to civic discourse for others similarly impacted. It reveals the discourse strategies that ranters use to persuade viewers that the site’s policies and the behavior of other participants are complicating self-expression through video. Discourse strategies include counter-balancing criticism with praise, interpellating addressees into a civic public, and focusing criticisms on the powerful. The article contributes to research on social media-based civic engagement and emotional public spheres by analyzing rant videos that expose issues with tech- nologized and commercialized communicative frameworks in digital spaces.
Alleviating iatrogenic effects of paclitaxel via antiinflammatory treatment
Authors: Zhang Mengwei , Lotfollahzadeh Saran , Elzinad Nagla , Yang Xiaosheng , Elsadawi Murad , Gower Adam C , Belghasem Mostafa , Shazly Tarek , Kolachalama Vijaya B , Chitalia Vipul C
Published: April 2024

Background:

Paclitaxel (PTX) is touted as an essential medicine due to its extensive use as a chemotherapeutic agent for various cancers and an antiproliferative agent for endovascular applications. Emerging studies in cardio-oncology implicate various vascular complications of chemotherapeutic agents.

Methods:

We evaluated the inflammatory response induced by the systemic administration of PTX. The investigation included RNAseq analysis of primary human endothelial cells (ECs) treated with PTX to identify transcriptional changes in pro-inflammatory mediators. Additionally, we used dexamethasone (DEX), a well-known antiinflammatory compound, to assess its effectiveness in counteracting these PTX-induced changes. Further, we studied the effects of PTX on monocyte chemoattractant protein-1 (MCP-1) levels in the media of ECs. The study also extended to in vivo analysis, where a group of mice was injected with PTX and subsequently harvested at different times to assess the immediate and delayed effects of PTX on inflammatory mediators in blood and aortic ECs.

Results:

Our RNAseq analysis revealed that PTX treatment led to significant transcriptional perturbations in pro-inflammatory mediators such as MCP-1 and CD137 within primary human ECs. These changes were effectively abrogated when DEX was administered. In vitro experiments showed a marked increase in MCP-1 levels in EC media following PTX treatment, which returned to baseline upon treatment with DEX. In vivo, we observed a threefold increase in MCP-1 levels in blood and aortic ECs 12 h post-PTX administration. Similar trends were noted for CD137 and other downstream mediators like tissue factor, vascular cell adhesion molecule 1, and E-selectin in aortic ECs.

Conclusion:

Our findings illustrate that PTX exposure induces an upregulation of atherothrombotic mediators, which can be alleviated with concurrent administration of DEX. Considering these observations, further long-term investigations should focus on understanding the systemic implications associated with PTX-based therapies and explore the clinical relevance of DEX in mitigating such risks.
Acknowledging and legitimizing the embarrassment: Responding to embarrassment-telling
Authors: Yu Guodong , Xin Lijun
Published: April 2024

Sharing embarrassing experiences is an ordinary and recurrent social phenomenon, and this article carries out a conversation analytic study on how embarrassment-telling is interactionally co-constructed in talk-in-interaction. It is found that embarrassment-telling is delivered as an incident that should not have happened happens by accident to the teller due to the embarrassment-teller’s unintended violation of a normative practice. In response, the co-interactant acknowledges the experience’s being embarrassing, while legitimizes the teller’s being embarrassed, thus making the response to embarrassment-telling a nuanced issue by maneuvering between affiliation and disaffiliation with the teller. Data are in Mandarin Chinese with English translation.
Influence of workpiece geometry and natural frequencies on ultrasonic metal welding
Authors: Müller FW , Liu J , Schiebahn A , Reisgen U
Published: April 2024

Ultrasonic metal welding is a well-established solid state joining process for electrical applications. The process relies on the friction between workpieces and welding tools for joint formation. This friction is generated by the process force and the ultrasonic oscillation of the welding tools imposed on the workpieces. At such high frequencies, the occurrence of resonances in actual workpiece geometries is not surprising. It is known that critical dimensions in length and width lead to nearly no bond, depending on the welding frequency and the mechanical properties of the material. In real applications, this limits the possible designs of terminals and leads to extensive testing of clamping devices. It is also known that machine learning (ML) models for quality prediction based on power signals or tool oscillation can account for changes in welding position. In this study, we investigated the impact of part resonance and antiresonance on horn and anvil oscillation, power consumption and bond strength to identify typical behaviors induced by the workpieces. The influence of material thickness and roughness was considered, and numerical analysis of the natural frequencies of the workpieces was conducted. It can be shown that the results allow a distinction between the welding positions and workpiece geometries without directly measuring the oscillation patterns of the workpieces, allowing a simple validation of geometry weldability and clamping device in applications. Furthermore, the investigation allows the knowledge based specific deduction of signal parameters for future ML models, allowing a consideration of welding position and workpieces geometry with reduced test data.
Transcending paradigmatic schisms and building ontological bridges: How Russ Belk’s “extended self” became canonical consumer research
Authors: Thompson Craig J
Published: April 2024

This essay gives closer historical consideration to the unprecedented disciplinary impact of Belk’s (1988) conceptualization of the extended self. This canonical article initially appeared to be another flashpoint in the paradigmatic conflict between positivist and interpretivist consumer researchers. However, Belk’s portrayal of consumers as agentic actors who produce their own identities through a network of possessions and symbolic artefacts proved to be highly compatible with interdisciplinary trends toward a more holistic and socio-culturally situated understanding of consumer behavior. Accordingly, Belk’s “extended self” created an ontological bridge between interpretivist studies of consumers’ co-constituting relations to the socio-material world and consumer psychologists’ quest to expand their research interests beyond the study of rational decision making processes. While some marketing historians have suggested that the extended self’s seminal influence derives from its generative “vagueness,” I propose that its transformational effects on the broader field of consumer research trace to a genius of mythopoesis and a genius of timing. I then discuss how the logic of ontological reconfiguration, manifest in Belk’s conceptualization, can foster more synergistic and innovative inter-paradigmatic dialogues between consumer culture theory (CCT) and consumer psychology.
Understanding the Epistemic Diversity and Essential Components of the Grounded Theory Method: Empowering Human Resource Development Researchers
Authors: Lee Jin
Published: April 2024

This article addresses the challenges faced by HRD researchers in selecting a qualitative approach, particularly Grounded Theory Method (GTM), which is underrepresented in the field. The author discusses the epistemological foundations of the four major GTM versions and outlines the six essential elements. The article emphasizes GTM’s flexible yet structured nature and explains differences among Glaserian, Straussian, Charmazian, and Clarkean methods. It also summarizes common GTM features like concurrent data collection, constant comparison, theoretical sampling, phased coding, memoing, and theoretical saturation. The article concludes by providing suggestions to promote GTM’s adoption and popularization. In essence, this article offers guidelines to assist HRD researchers, especially newcomers or those with limited qualitative research experience, in understanding and effectively using GTM.
The Effect of Melatonin on Increasing the Health Related Quality of Life in Non-Metastatic Breast Cancer Patients: Three-Year Follow up a Clinical Trial
Authors: Keshtpour Amlashi Zahra , Sheida Fateme , Anbiaee Robab , Tapak Leili , Hosseini Seyed Rohallah , Mosaedian Hossein , Barati Nastaran
Published: April 2024

Introduction:

Although breast cancer is common worldwide, if diagnosed early and treated on time, the probability of recovery is high and patients often experience a long life. Reducing the quality of life is a common side effect in patients. Melatonin may have an important role in fatigue, sleep disorders and, as a result, the health-related quality of life (HRQoL) in people. About 184 patients with breast cancer were enrolled in 2 groups: intervention with daily melatonin intake of 18 mg for 3 years (93 patients) and the control group with placebo intake (91 patients). Health-related quality of life and the effect of melatonin on increasing that were evaluated with the EORTC QLQ-C30 questionnaire, third edition at the beginning, 2 months later and 3 years after the beginning of the study.

Results:

The general score of the HRQoL was significantly different both in the passage of time and in the comparative study of the 2 groups, and it was better in the melatonin group ( P < .05).

Conclusion:

Long-term use of 18 mg of melatonin for 3 years in patients with non-metastatic breast cancer can lead to an increase in the patients’ quality of life.
Measuring Small Bowel Length in Bariatric Surgery: An Ex Vivo Laparoscopic Training Experiment
Authors: Kaijser Mirjam A. , Slagter Nienke , de Heide Loek J.M. , van Beek André P. , Pierie Jean-Pierre E.N. , Emous Marloes
Published: April 2024

Introduction

Determining limb length in gastric bypass procedures is a crucial step to ensure significant weight loss without risking malnutrition. This study investigated the effect of ex vivo training on the skills needed to determine limb lengths.

Materials and Methods

This was a single-center ex vivo training experiment in a teaching hospital in the Netherlands. We designed a training exercise with marked ropes in a laparoscopic trainer box. All ten surgical residents participated and practiced the skill of estimating limb length. Before and after the two-week period their results on a 150-centimeter limb length task were evaluated.

Results

Before training, 10 surgical residents estimated 150 centimeters of small bowel with an absolute deviation of 21% [range 9-30]. After the training experiment, the residents measured with 8% [2-20] deviation ( P = .17). The 8 residents who trained sufficiently improved statistically significantly to an absolute deviation of 5% [2-17] ( P = .012). Over 70% of the participants felt their skills had improved.

Conclusions

With sufficient training, surgical residents’ skills in measuring small bowel length improved when tested in an ex vivo model. Residents became more confident in their laparoscopic measurement skills. This ex vivo training model is a alternative and addition to on-site training.
Gastroesophageal reflux disease and idiopathic pulmonary fibrosis risk: A mendelian randomization study
Authors: Lin Minjie , Wang Junjie , Wei Jie , Yao Yu , Tang Cheng , Jin Wenfang , Yuan Weihong , Lv Yanling
Published: April 2024

Background: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with unknown etiology and treatment options for it were limited. Whether Gastroesophageal reflux disease (GERD) could affect the occurrence of IPF remains unclear.

Methods: Using available data from FINNGEN and IEU OpenGWAS, we performed Two-sample mendelian randomization (MR) to explore the causal relationship between GERD and IPF.

Results: Using 65 GERD-related SNPs, we found the association between GERD and the risk of IPF was not statistically significant with IVW approach (OR = 1.20, 95% CI = 0.84-1.70, p = .32), MR-Egger regression (OR = 1.65, 95% CI = 0.19-14.43, p = .65) and weighted median approaches (OR = 1.44, 95% CI = 0.94-2.23, p = .09). However, heterogeneity was observed with MR-Egger ( p = .001) and IVW ( p = .001) analysis. Similar results were obtained with MR-PRESSO (global heterogeneity test p value <.01). After removing one outlier (rs9636202), with weighted median method, we found GERD increased the risk of IPF (OR 1.55, 95% CI: 1.01-2.36, p = .045) while not with the IVW (OR: 1.27, 95% CI: 0.91-1.78, p = .16) and MR-Egger method (OR: 2.01, 95% CI: 0.26-15.8, p = .51). Hence, we set a stricter instrument p value threshold to a level of <1 × 10−8, there was no statistical significance with MR estimates. Additionally, there was no directional pleiotropy observed (intercept = −0.01; SE = 0.036. p = .772). To validate causal effect of GERD on IPF, we identified three SNPs (rs79348626, rs12759463 and rs4269485) from another GWAS data that were significantly associated with GERD independently. The analysis showed no evidence of causality between GERD and IPF using the IVW method (OR = 0.91, 95% CI = 0.42-1.97, p = .814), MR-Egger regression (OR = 0.43, 95% CI = 0.06-3.07, p = .553) and weighted median approaches (OR = 0.90, 95% CI = 0.36-2.27, p = 0 0.819).

Conclusions: Our analysis using MR does not support GERD could significantly increase the incidence of IPF, which suggests that treating GERD cannot reduce the risk of developing IPF.
Teachers’ and parents’ perspectives on citizenship education in Turkey: Consensus and disagreements
Authors: Kuş Zafer
Published: April 2024

Citizenship education (CE) in Turkey holds a pivotal role in shaping the civic consciousness of forthcoming generations. This study employs Q methodology to analyze the perspectives of teachers and parents regarding CE in Turkey, examining their viewpoints in the context of the political structure. The research reveals both consensus and disagreement among teachers and parents. Despite significant differences between teachers and parents, a consensus emerges on the importance of reinforcing national identity through CE. Moreover, there is a prevalent perspective on citizenship that exhibits limited tolerance for differences. The perspectives identified in the study reflect the political polarization present in Turkey. Some perspectives adopt a nationalist understanding rooted in Islamic foundations, influenced by the political power in the country, while others adhere to a secular nationalism based on the principles of Kemalism. These findings underscore the necessity for all facets of CE to embrace a more comprehensive perspective that promotes tolerance and democratic values.
The geographies and complexities of online networks in the off-street sex market
Authors: Kjellgren Richard
Published: April 2024

Exploitation and human trafficking in sex markets tend to include both online and offline spaces. Understanding the scale, complexity and geography of networks is important in policing human trafficking and online escort adverts are often used to identify organised crime in this context. This article aims to make a methodological contribution to how data relating to online networks in the sex market can be collected and analysed. Through the application of web scraping, social network analysis and principal component analysis, the digital traces of 15,016 online networks operating on an adult services website were analysed in relation to their complexity and geographical patterning. The findings suggest that structural and geographical characteristics are useful for understanding the heterogeneity of online networks. Analysing networks, as opposed to assessing escort adverts, offers a more robust approach to understanding the sex market, which is more sensitive to the continuum of experiences encapsulated therein.
Study on the Protective Effect of Flavonoids in Vernonia anthelmintica (L.) Willd on Oxidative Stress Damage of HaCaT Cells
Authors: Eibulayin Guliqiehere , Rahman Nurgul , Fu Jian H , Turxuntayi Adila
Published: April 2024

Background: Vitiligo, a prevalent hypopigmented skin disorder, profoundly impacts patients’ psychological well-being and quality of life. Therefore, the development of more efficacious antivitiligo drugs is imperative. Objectives: The aim of this study was to investigate the protective effects of four flavonoids found in Vernonia anthelmintica (L.) Willd such as Butin, Butein, Eriodictyol, and Liquiritigenin—against H2O2-induced oxidative stress damage in human immortalized epidermal cells (HaCaT cells). Materials & Methods: Cytotoxicity was assessed using the MTT kit. Superoxide dismutase (SOD) activity was measured via the WST-1 method, while the content of malondialdehyde (MDA) was determined using the thiobarbituric acid method. Transcription and protein expression of nuclear transcription-related factors (Nrf2), heme oxidase-1 (HO-1), and Quinone oxidoreductase (NQO1) were analyzed through quantitative real-time polymerase chain reaction and Western Blotting. Results: Upon treatment with the four flavonoids, SOD activity exhibited a significant increase compared to the H2O2 induction model ( P < .01), and MDA content was significantly lower ( P < .01). This effect showed a dose-dependent relationship, with an increment in SOD activity and a reduction in MDA content. All four flavonoids upregulated the expression levels of nuclear transcription-related factor, HO-1, and NQO1 genes, as well as their corresponding proteins. Conclusion: The identified flavonoids in V anthelmintica (L.) Willd demonstrate a protective effect against H2O2-induced oxidative stress damage in HaCaT cells.
A Contemporary Framework Update for Today’s School Nursing Landscape: Introducing the School Nursing Practice Framework™
Authors:   National Association of School Nurses, Tanner Andrea , Griffin Renee , Stanislo Kimberly J. , Hinkley Terri , Walsh Carol A. , Clark Elizabeth , Graf Karen , La Point Rodney , D’Souza-Vazirani Deborah
Published: April 2024

School nursing is a unique nursing specialty that benefits from a practice framework that aids school nurses in explaining and accomplishing their role. In 2016, the NASN debuted its Framework for 21st Century School Nursing Practice™, which has shaped school nursing practice as well as education, leadership, research, and collaboration with stakeholders. However, practice frameworks are not meant to remain the same indefinitely. Therefore, NASN evaluated and updated the Framework to ensure its continued alignment with the education and healthcare landscape. The purpose of this article is to share the history of the Framework for 21st Century School Nursing Practice™ development, provide the rationale for the update, and discuss the strategic process NASN used to update its Framework now entitled the School Nursing Practice Framework™.
Stent plus balloon-assisted coiling with low-profile braided stents in the treatment of complex wide-necked intracranial bifurcation aneurysms
Authors: Gunkan Ahmet , Onal Yilmaz , Ramazanoglu Leyla , Fouad Mohamed EM , Kahraman Ahmet Nedim , Derin Cicek Esin , Demirhindi Hakan , Velioglu Murat
Published: April 2024

Introduction

Wide-necked bifurcation aneurysms pose significant challenges for endovascular treatment. A recent innovation, the stent plus balloon-assisted coiling technique, combines a stent and a balloon to address these aneurysms effectively.

Purpose

To evaluate the safety and efficacy of the stent plus balloon-assisted coiling for the treatment of wide-necked bifurcation aneurysms.

Methods

We conducted a retrospective review of our endovascular database to identify patients who were treated with this technique and had a satisfactory angiographic follow-up of at least 24 months. Technical success, initial clinical and angiographic outcomes, procedural complications, and follow-up results were analyzed. Angiographic and clinical outcomes were assessed using Modified Raymond-Roy Classification and Modified Rankin Scale, respectively.

Results

Our study included 37 aneurysms in 36 patients (26 females) with a mean age of 56.6 years. Mean aneurysm and neck sizes were 7.3 ± 3.5 mm and 3.7 ± 1.0 mm, respectively. Technical success reached 97.2%, with an immediate occlusion rate of 65.7%. At a mean follow-up of 36.5 ± 9.7 months, final angiographic follow-up showed a 91.9% complete occlusion rate. Three aneurysms did not achieve complete occlusion; however, none required retreatment. Complications developed in 32.4% of the procedures. Mortality and morbidity rates were 5.4% and 2.7%, respectively. A good clinical outcome was observed in 91.9% of patients.

Conclusion

Our results showed that stent plus balloon-assisted coiling technique allows good angiographic outcomes for wide-necked bifurcation aneurysms. However, overall complication rate is high. Subgroup analysis indicated promising safety and efficacy for MCA bifurcation aneurysms, suggesting this technique could be a valuable option for select aneurysms.
It's about the process, not the product: A meta-analytic investigation of team demographic diversity and processes
Authors: Traylor Allison M. , Dinh Julie V. , Ng Linnea C. , Reyes Denise L. , Cheng Shannon K. , Croitoru Natalie C. , Salas Eduardo
Published: April 2024

To better understand the effects of demographic diversity on teams, we conducted a meta-analytic investigation of the relationship between team demographic diversity and team processes. Drawing from the categorization-elaboration model, we hypothesized that team demographic diversity elicits opposing effects on team performance via information elaboration and social categorization processes. We also explored several team-level and contextual moderators on these relationships. In our meta-analysis of 406 effects from 38,304 teams, we found that team demographic diversity is related to increased social categorization processes, but we did not find support for a relationship between team demographic diversity and information elaboration. In addition, we identified team education level and occupational and industry context as moderators of these relationships, finding stronger support for moderators of the relationship between diversity and social categorization than the relationship between diversity and information elaboration. We discuss implications of our findings for research and practice.
Clinical course of patients with conservatively managed cerebral cavernous malformations
Authors: Sandmann Abel Clemens Adriaan , Kempeneers Marinus Abraham , van den Berg René , Verbaan Dagmar , Vandertop William Peter , Coutinho Jonathan M.
Published: April 2024

Introduction:

There is uncertainty whether patients with a cerebral cavernous malformation (CCM) should undergo conservative or surgical treatment, resulting in practice variation among hospitals. Our objective was to report clinical outcomes of patients with primarily conservatively managed CCMs.

Patients and methods:

This single-center cohort study included consecutive adult CCM patients, diagnosed in 2000–2023, who underwent conservative management as primary treatment strategy. Data were extracted from medical records, and we systematically conducted telephone and questionnaire follow-up. Functional status was assessed on the modified Rankin Scale (mRS).

Results:

Of 345 patients, we included 265 patients with a CCM (median age 46 years; 45% male). At baseline, 131 (49%) patients presented with symptomatic hemorrhage (SH), and 134 (51%) with other symptoms or asymptomatically. During 58 months (IQR 35–94) median follow-up, 51 (19%) patients experienced a SH, 33 (12%) a seizure, and 13 (5%) focal neurological deficits. Fourteen (5%) patients underwent intervention (surgery n = 11, radiosurgery n = 4). Presentation with SH was associated with higher annual bleeding rates (6.0% vs 1.5%, p < 0.001), and higher cumulative 5-/10-year bleeding risks (31%/41% vs 7%, p < 0.001). Brainstem CCM was associated with higher cumulative 5-/10-year bleeding risks (27%/38% vs 17%/21%, p = 0.038). Nineteen (7%) patients died; two (0.8%) directly attributable to CCM. Of 246 surviving patients, 205 (83%) completed the questionnaire. At follow-up, 172/224 (77%) patients were functionally independent (mRS score ⩽2).

Discussion and conclusion:

The majority of conservatively managed CCM patients remained free of a SH during follow-up. Few patients required intervention, and death attributable to the CCM was rare. These data may help patient counseling and treatment decisions.
Construction and Consolidation of Caste System Through Ideological State Apparatuses: A Study of Girish Karnad’s Talé-Dan˙d˙a
Authors: Singh Ruchi , Gibu Sabu M.
Published: April 2024

This article critically examines Girish Karnad’s play Talé-Dan˙d˙a as a lens through which the construction and consolidation of the caste system in India is explored. The study focuses on the utilization of ideological state apparatuses (ISA) by the ‘upper-caste’ to suppress attempts at social reform and the creation of a casteless society. By analysing the characters and their interactions within the play, the article argues that repressive and non-violent state apparatuses, such as religion, family, identity formation and language are employed to perpetuate caste-based discrimination and maintain the existing social hierarchy. Drawing on Louis Althusser’s concept of ideological and repressive state apparatuses, the article provides a comprehensive analysis of how these apparatuses are instrumental in preserving caste-based inequalities and solidification of the caste system.
Medical Accuracy of Reddit in Patient Discussions of Prospective Ocular Stem Cell Therapies for Retinal Degenerative Diseases
Authors: Perez Alejandro M. , Chau Viet Q. , Sridhar Jayanth
Published: April 2024

Purpose: To evaluate the medical accuracy in discussions of stem cell therapy for retinal diseases on a social media internet forum (Reddit). Methods: A cross-sectional study assessed 11 Reddit forums and 411 unique comments from 2017 to 2022. Evaluated participants were all anonymous Reddit users. Discussions were independently examined for medical accuracy by a board-certified, fellowship-trained retina surgeon in active practice. Results: Reddit users self-identified mainly as prospective patients followed by research students and physicians or healthcare workers. Inquiries mostly regarded stem cell treatment for macular degeneration. Thirty-six percent of the forum’s content was found to be inaccurate or misleading. When specifically considering factual comments, the inaccuracy rate increased to 54%. Identified gaps in knowledge mostly regarded the current state of the technology (25%) followed by misinterpretation of trial results (16%) and scam treatments (14%). Most inaccurate or misleading comments favored stem cell advancements (72%). Conclusions: This study highlights the gaps in knowledge and areas of medical misinformation regarding ocular stem cell therapies shared by individuals on Reddit.
Tabelecleucel for EBV+ PTLD after allogeneic HCT or SOT in a multicenter expanded access protocol
Authors: Nikiforow Sarah , Whangbo Jennifer S. , Reshef Ran , Tsai Donald E. , Bunin Nancy , Abu-Arja Rolla , Mahadeo Kris Michael , Weng Wen-Kai , Van Besien Koen , Loeb David , Nasta Sunita Dwivedy , Nemecek Eneida R. , Zhao Weizhi , Sun Yan , Galderisi Faith , Wahlstrom Justin , Mehta Aditi , Gamelin Laurence , Dinavahi Rajani , Prockop Susan
Published: April 2024

Patients with Epstein-Barr virus (EBV)–positive posttransplant lymphoproliferative disease (EBV+ PTLD) in whom initial treatment fails have few options and historically low median overall survival (OS) of 0.7 months after allogeneic hematopoietic cell transplant (HCT) and 4.1 months after solid organ transplant (SOT). Tabelecleucel is an off-the-shelf, allogeneic EBV-specific cytotoxic T-lymphocyte immunotherapy for EBV+ PTLD. Previous single-center experience showed responses in patients with EBV+ PTLD after HCT or SOT. We now report outcomes from a multicenter expanded access protocol in HCT (n = 14) and SOT (n = 12) recipients treated with tabelecleucel for EBV+ PTLD that was relapsed/refractory (R/R) to rituximab with/without chemotherapy. The investigator-assessed objective response rate was 65.4% overall (including 38.5% with a complete and 26.9% with a partial response), 50.0% in HCT, and 83.3% in SOT. The estimated 1- and 2-year OS rates were both 70.0% (95% confidence interval [CI], 46.5-84.7) overall, both 61.5% (95% CI, 30.8-81.8) in HCT, and both 81.5% (95% CI, 43.5-95.1) in SOT (median follow-up: 8.2, 2.8, and 22.5 months, respectively). Patients responding to tabelecleucel had higher 1- and 2-year OS rates (94.1%) than nonresponders (0%). Treatment was well tolerated, with no reports of tumor flare, cytokine release syndrome, or rejection of marrow and SOT. Results demonstrate clinically meaningful outcomes across a broad population treated with tabelecleucel, indicating a potentially transformative and accessible treatment advance for R/R EBV+ PTLD after HCT or SOT. This trial was registered at www.ClinicalTrials.gov as #NCT02822495.
Evaluation of the impacts of seawater integration to electrocoagulation for the removal of pollutants from textile wastewater
Authors: Ahmed Tahmeed , Khan Md. Habibur Rahman Bejoy , Ahsan Amimul , Islam Nafis , El-Sergany Moetaz , Shafiquzzaman Md. , Imteaz Monzur , Al-Ansari Nadhir
Published: April 2024

Recent textile industry expansion has a major environmental impact if not addressed. Being a water intensive industry, textile manufacturing is usually associated with wastewater management challenges. Electrocoagulation (EC) is recognized as one of the effective solutions to address these challenges. This study aims to investigate the potential of integrating seawater into the EC process for textile wastewater treatment, targeting optimal pollutant removal efficiencies. A simple electrolytic reactor was designed to investigate the removal efficiency of these treatments for chemical oxygen demand (COD), total suspended solids (TSS), turbidity, and color from textile wastewater at different seawater percentages and retention times. Notably, the addition of seawater not only improves the EC process efficiency but also significantly dilutes pollutants, reducing their concentrations. This dual effect enhances removal efficiency and dilution optimizes the treatment outcome. The highest removal efficiencies were achieved for COD (47.26%), TSS (99.52%), turbidity (99.30%), and color (98.19%). However, pH, dissolved oxygen (DO), and electrical conductivity increased with increasing retention times and seawater percentages in the EC process. Moreover, Seawater − EC integration reduces power usage to 15.769 Am−2 and costs approximately 0.20 USD/m3. To assess the effects of the retention times and seawater percentages on pollutant removal from textile wastewater, an analysis of variance (ANOVA) was conducted utilizing the Design-Expert 11 software. The best model obtained using Central Composite Design (CCD) was quadratic for COD (R2 = 0.9121), color (R2 = 0.9535), turbidity (R2 = 0.9525), and TSS (R2 = 0.9433). This study suggests that higher seawater percentages and longer retention times effectively eliminate contaminants but increase ion concentrations.
Regrettable substitution? Comparative study of the effect profile of bisphenol A and eleven analogues in an in vitro test battery
Authors: Reininger Natalie , Oehlmann Jörg
Published: April 2024

Background

Bisphenol A (BPA) is currently one of the most widely used synthetic chemicals in the production of a wide range of plastics. Due to its diverse endocrine disrupting potential alternative bisphenols, also referred to as analogues, have been developed. Although the toxicity of BPA is well studied, the (eco)toxicological effects of the bisphenol analogues are largely unknown. The similar molecular structure of the analogues suggests comparable toxicological effects. This study aims to extend the (eco)toxicological knowledge on the bisphenol analogues by evaluating eleven bisphenol analogues compared to the reference substance BPA in in vitro bioassays. The examined endpoints are endocrine potential on three nuclear receptors in recombinant yeast cells of Saccharomyces cerevisiae, baseline toxicity (also referred to as non-specific toxicity, describing the minimal toxicity of a chemical) in the luminescent bacterium Aliivibrio fischeri, and mutagenicity in two strains of Salmonella typhimurium.

Results

Bisphenol A showed estrogenic and anti-androgenic activity at EC50 concentrations of 0.516 mg/L (2.26 × 10–6 M) and 1.06 mg/L (4.63 × 10–6 M), respectively. The assays confirmed notable estrogenic and anti-androgenic activity for the vast majority of analogues in comparable, and often higher, efficacies to BPA. Some analogues showed anti-estrogenic instead of estrogenic activity in a range from 0.789 mg/L (1.45 × 10–6 M; TBBPA) to 2.69 mg/L (2.46 × 10–6 M; BADGE). The baseline toxicity of the analogues revealed a similar tendency of comparable to more prominent effects compared to BPA, ranging from 5.81 mg/L (1.73 × 10–5 M; BPAF) to 39.1 mg/L (1.56 × 10–4 M; BPS). There was no evidence of mutagenicity found.

Conclusion

The examined bisphenol analogues prove to be equally, if not more, problematic in endocrine activities than the reference bisphenol A. Based on these results, the tested bisphenols cannot be regarded as safer alternatives and reinforce the notion of bisphenol analogues being considered as regrettable substitutions.
Estimating genetic parameters of digital behavior traits and their relationship with production traits in purebred pigs
Authors: Hollifield Mary Kate , Chen Ching-Yi , Psota Eric , Holl Justin , Lourenco Daniela , Misztal Ignacy
Published: April 2024

Background

With the introduction of digital phenotyping and high-throughput data, traits that were previously difficult or impossible to measure directly have become easily accessible, offering the opportunity to enhance the efficiency and rate of genetic gain in animal production. It is of interest to assess how behavioral traits are indirectly related to the production traits during the performance testing period. The aim of this study was to assess the quality of behavior data extracted from day-wise video recordings and estimate the genetic parameters of behavior traits and their phenotypic and genetic correlations with production traits in pigs. Behavior was recorded for 70 days after on-test at about 10 weeks of age and ended at off-test for 2008 female purebred pigs, totaling 119,812 day-wise records. Behavior traits included time spent eating, drinking, laterally lying, sternally lying, sitting, standing, and meters of distance traveled. A quality control procedure was created for algorithm training and adjustment, standardizing recording hours, removing culled animals, and filtering unrealistic records.

Results

Production traits included average daily gain (ADG), back fat thickness (BF), and loin depth (LD). Single-trait linear models were used to estimate heritabilities of the behavior traits and two-trait linear models were used to estimate genetic correlations between behavior and production traits. The results indicated that all behavior traits are heritable, with heritability estimates ranging from 0.19 to 0.57, and showed low-to-moderate phenotypic and genetic correlations with production traits. Two-trait linear models were also used to compare traits at different intervals of the recording period. To analyze the redundancies in behavior data during the recording period, the averages of various recording time intervals for the behavior and production traits were compared. Overall, the average of the 55- to 68-day recording interval had the strongest phenotypic and genetic correlation estimates with the production traits.

Conclusions

Digital phenotyping is a new and low-cost method to record behavior phenotypes, but thorough data cleaning procedures are needed. Evaluating behavioral traits at different time intervals offers a deeper insight into their changes throughout the growth periods and their relationship with production traits, which may be recorded at a less frequent basis.