bluuebunny/crossref_metadata_2025 huggingface dataset:
The Conceptualization of anger through Metaphors, Metonymies and Metaphtonymies in Jordanian Arabic and English: A Contrastive Study
Authors: Alazazmeh Hadeel Mohammad , Zibin Aseel
Published: March 2023

This study aims to examine the metaphors, metonymies and their interaction in Jordanian Arabic (ja) to conceptualize anger. It also investigates the differences/similarities in the conceptualization of anger in ja and English to determine if culture has a role in its metaphorical and metonymical conceptualization. The study adopts Conceptual Metaphor Theory (cmt) and Cultural Linguistics (cl) as theoretical frameworks to identify and analyze the target metaphors and metonymies. The ja data was collected from two sources: 20 female and male ja native-speaker informants and a Jordanian comedy show called ‘Female’. The English anger metaphors and metonymies were collected from Lakoff and Kövecses’s (1987) study. The qualitative data analysis has revealed that anger is conceptualized in ja through conceptual metaphors with a metonymic basis, pure conceptual metaphors, pure conceptual metonymies and conceptual metonymies with a metaphorical interpretation. The results show that similarities were found in the conceptualization of anger through metaphor and metonymy in both languages which were ascribed to universal embodied cognition. Differences were also detected between the two languages, especially in the use of culture-specific source domains and in the use of metaphtonymies (conceptual metonymies with metaphorical interpretation) that may reflect cultural beliefs related to anger.
Some Afterward Remarks
Authors: Ning Chunyan
Published: March 2023

Science, substantially different from technology and engineering, is to give explanations for why-questions about the Nature, and science of language is to give explanations for why-question about the part of the Nature Noam Chomsky has circumscribed as fl and I-language. His current talk reinforces the conceptual necessity of the separation of the system of thought from externalization, and offers explanations for some in-depth questions concerning with the basic properties of human language, by virtue of a stronger version of smt. In these remarks I present my understanding of the ideas encoded in his development of smt, and tentative solutions to some of the unsolved problems or mysteries.
What do Trauma Surgery Textbooks Teach About Racial Disparities and the Roots of Violence?
Authors: Yoon Kyung , Eroraha Ajiri , Lutton Evan , Kington Daniella , Bonsu Janice M. , Lawani Phyllis E. , Smith Randi N. , Bliton John N.
Published: March 2023

This study presents a formal text analysis of trauma surgery textbooks. We examine passages that describe disparities or mechanisms of injury, and we report types of underlying causes and preventative interventions discussed. Trauma textbooks were drawn from an industry-standard list used by medical libraries. Chi-square testing was used to determine whether different types of underlying causes or preventative interventions were discussed by disparity type (those affecting racial minorities vs rural populations) and injury mechanism (accidental injuries vs intentional interpersonal injury). 146 passages were extracted from 7 textbooks, totaling 5576 pages of text. Passages discussing rural disadvantages or unintentional injury were substantially more likely to describe structural risk factors or governmental interventions than those discussing racial disadvantages or intentional injury, respectively. Textbook authors should consider enriching discussion of violence prevention or racial disparities to emphasize structural causes and interventions.
Digital Language Teaching 5.0: Technologies, Trends and Competencies
Authors: Meniado Joel C.
Published: March 2023

Digital Language Teaching 5.0, a new language teaching paradigm that applies the digital pedagogies and technologies of the fifth Industrial Revolution (Industry 5.0), is expected to transform the English language teaching and learning landscape soon, as the world continuously seeks innovative solutions to the educational challenges brought by the COVID-19 pandemic. As a new concept, it draws inquiries and discussions on how it will influence language curriculum, instruction and assessment in the post-pandemic digital age, what technologies and practices will be adopted in schools to align with its purposes, and what competencies pre-service and in-service language teachers will need to be able to actualize it in their own contexts. This paper aims to address the foregoing issues by discussing relevant concepts, trends and practices. It begins by providing a brief background about Education 4.0, its key features, technologies and trends as applied in English language teaching. It then proceeds to the discussion of Education 5.0 and Digital Language Teaching 5.0 with their distinct features, purposes, technologies and practices. Lastly, it explores the skills and competencies under Digital Language Teaching 5.0 and discusses how pre-service and in-service language teachers can develop and enhance such competencies through various formal and alternative language teacher development activities. It concludes with insights on some issues raised and recommendations for successful implementation.
Outcomes for children and adolescents with Juvenile idiopathic arthritis addressed by occupational therapy services in specialist rheumatology clinics in South Africa
Authors: Moodley Darrel , Jacobs Lizelle , Franzsen Denise , de Witt Patricia
Published: March 2023

Introduction:

International guidelines for best practice indicate specialised treatment is required for Juvenile idiopathic arthritis (JIA). While occupational therapy intervention for functional limitations in this chronic condition is conditionally recommended, the extent to which this is provided in public specialist rheumatology clinics in South Africa is unknown. The aim of this study was to determine which needs related to outcomes for occupational performance or functional status, condition-related factors and health-related quality of life, reported by children and adolescents with JIA were addressed by current occupational therapy services.

Methods:

The study used two descriptive, quantitative studies with limited samples of 37 clients with JIA attending specialist rheumatology clinics and nine occupational therapists who currently provide intervention for clients with JIA.

Results:

Functional deficits reported by 30–63% of clients with JIA were increased symptoms of active disease and difficulties with school activities. Occupational therapy services addressed condition-related factors and participation in personal management but not many related to the social, educational and psychosocial needs of clients with JIA.

Conclusion:

Occupational therapy services followed international guidelines but based on the reductionist biomedical model approach used within specialist services in tertiary hospitals, which limit context-based therapy for children and adolescents with JIA in the community.
Effects of hollow fiber packing density and housing shape on the albumin filtration performance of CRRT filters
Authors: Mu Changjun , Yamashita Akihiro C.
Published: March 2023

Continuous renal replacement therapy (CRRT) has become the most commonly used acute blood purification therapy for critically ill patients. As a key point of extracorporeal blood circulation, the CRRT filter plays a decisive role in therapeutic efficacy. However, few in vitro studies have been conducted on CRRT filters, particularly concerning the effects of design factors on filter effectiveness and safety profile; no comprehensive evaluation system has been established. Here, we designed nine CRRT filters with various combinations of hollow fiber packing density ( PD) and housing shape (effective hollow fiber length ( L) and inner housing diameter ( D) ratio ( L/ D ratio)) and introduced a high-frequency sampling pressure monitor to accurately monitor small changes in transmembrane pressure ( TMP) and ultrafiltration rate ( UFR) over time. We also used concentration polarization mass transfer resistance ( Rc), change in sieving coefficient ( S) of albumin over time, and amount of albumin removed ( Mfld) to investigate the effects of two design factors on albumin filtration performance and analyze the mechanism of protein filtration performance over time, thereby establishing a comprehensive in vitro evaluation system to explore the safety profile of CRRT filters. Our results showed that the nine CRRT filters designed with different combinations of PD (50%, 55%, and 60%) and L/ D ratio (2.9, 5.3, and 9.3) were able to maintain stability in terms of hemodynamics and water permeability; the lowest Mfld was PD = 60% and L/ D ratio = 9.3, which indicates that design factor optimization can effectively control albumin filtration, thereby improving the safety profile of CRRT filters.
Evaluation of triacetin on mechanical strength and free surface energy of PHBHHx: The prevention of intra-abdominal adhesion
Authors: Akkurt Yıldırım Meryem , Demirbilek Murat , Kızılbey Kadriye , Kaplan Engin , Türkoğlu Nelisa
Published: March 2023

Several polymers are used for the preparation of biomaterials as membranes and films for tissue engineering applications. The most common plasticizer is PEG to obtain polymer-based biomaterials. On the other hand, triacetin is a non-toxic, FDA-approved plasticizer mostly used in the food industry. In this study, we used triacetin as a plasticizer to obtain hydrophobic membranes for the prevention of intra-abdominal adhesion. We selected a well-known polymer named PHBHHx which is a bacterial polyester generally used as supporting material for cell attachments in regenerative tissue applications. We evaluated the triacetin as a plasticizer and its effect on mechanical, thermal, surface area, pore size, and surface energy. The hydrophobic/hydrophilic contrast of a biomaterial surface determines the biological response. Surface hydrophobicity is critical for the cellular response. The contact angle tests of PHBHHx revealed that the hydrophilicity of the membrane was decreased following triacetin blending. Modification of the PHBHHx membrane by blending with triacetin caused a significant decrease in cell adhesion. The cell attachment rates of PHBHHx membranes were as 95 ± 5% on the first day, 34.5 ± 0.9% on third day, and 23 ± 1.5% on the fifth day, respectively. The rates of cell attachments on PHBHHx/triacetin membranes were determined as 79 ± 2.5% for the first day, 33 ± 2.7% for the third day, and 13 ± 2.1% for the fifth day, respectively. Besides, triacetin blending decreased the surface area from 38.790 to 32.379 m2/g. The elongation at breaks was observed as 128% for PHBHHx and 171% for PHBHHx/triacetin.

Graphical abstract

[Formula: see text]
Co-axial electrospinning of PLLA shell, collagen core nanofibers for skin tissue engineering
Authors: Baran Erkan T , Tahmasebifar Aydin , Yilmaz Bengi
Published: March 2023

The main functions of wound dressing biomaterials are to promote a moist environment in the wound while protecting the area from mechanical injury and microbial contamination. Furthermore, the scaffold used for skin tissue engineering must mimic epidermal and dermal layers as well as support the growth of keratinocytes and fibroblasts. In this study, PLLA (shell) and EGF-encapsulated collagen (core) nanofibers were produced by coaxial electrospinning at 25 kV potential, 12 cm collector distance, and 0.125 mL/h flow rate of PLLA (15%) and collagen (4%). The bilayer structure was produced by gelling GeIMA in between two nanofiber membranes to imitate the epidermal and dermal layers of skin. Cytocompatibility properties of nanofiber membrane and bilayer structure were characterized by mono- and coculture of keratinocytes (HaCaT) and fibroblasts (3T3), respectively. TEM revealed that the PLLA shell and collagen core thicknesses were about 60 and 115 nm, respectively. Oxygen and water vapor could pass through the GeIMA- integrated bilayer nanofiber membranes. The presence of EGF in nanofibers could increase cell proliferation. Fluorescence and SEM imaging showed that HaCaT and 3T3 could cover the membrane after 14 days of monoculture. Cocultures showed a reduction in the proliferation of cells in the first week and a recovery during the second and third weeks. In a mechanical bioreactor, cocultured bilayer membranes formed interlocked polygonal keratinocyte cells. These results showed that the bilayer nanofiber membrane and GeIMA combination provided cell compatibility. Furthermore, the use of a mechanical reactor was found to be effective in the formation of a functional keratinocyte layer by stimulating cells.
Kidney Donor Perspectives on Acute Postoperative Pain Management
Authors: Dreesmann Nathan J. , Jung Wonkyung , Shebaili Makiah , Thompson Hilaire J.
Published: March 2023

This study employed a qualitative descriptive approach to examine living kidney donor’s experience of postoperative pain. Thirteen living kidney donors aged 46.5 (±14.4) years participated in this study. Semi-structured interviews were conducted and transcribed. Transcripts were inductively coded and reviewed for trends, patterns, and insights into donor’s experience of postoperative pain. Donors experienced postoperative pain from a variety of sources that hindered recovery and created anxiety and fear in some. Donors managed pain with opioid and non-opioid medications, social support, and ambulation. Donor’s past experiences with and expectations about pain, relationships with intended recipients, social support, as well as motivations for and meaning of donation informed their experience of postoperative pain. Prompt pharmacologic intervention for pain, as well as further coaching and education about pain management should be emphasized for nurses caring for living kidney donors. Further study of how donor’s motivation might mediate their pain experience is needed.
Hypogammaglobulinemia after front-line immunochemotherapy in patients with follicular lymphoma
Authors: Díaz Acedo Rocío , Artacho Criado Silvia , Ríos Herranz Eduardo , Gutiérrez Pizarraya Antonio , Sánchez Romero Irene , Márquez Saavedra Esther
Published: March 2023

Introduction

Hypogammaglobulinemia after front-line immunochemotherapy for follicular lymphoma is a poorly studied adverse event that could be related to the appearance of severe and/or recurrent non-neutropenic infections which could affect the quality of life of the patients, even motivating a need of long-term replacement therapy with human immunoglobulins.

Methods

Observational, retrospective study aiming to estimate the incidence of hypogammaglobulinemia, as well as its severity and clinical consequences, and to explore possible predictive factors for its development. Specific immunoglobulin deficiencies were also studied.

Results

76.5% of patients had hypogammaglobulinemia during or after front-line treatment, mostly grade 1-2; with 38.8% patients who developed clinically relevant infections and 20% patients requiring human immunoglobulins replacement therapy. A high-risk FLIPI score was identified as a risk factor for hypogammaglobulinemia (ods ratio: 4.51; 95% confidence interval: 1.29–15.68; p < 0.001) and basal gamma globulin level as a protective factor (odds ratio: 0.92; 95% confidence interval: 0.988–0.996; p  =  0.018). Any type of immunochemotherapy regimen was associated with different risks of hypogammaglobulinemia in our study.

Conclusions

Hypogammaglobulinemia appears in a high percentage of patients with follicular lymphoma in a real-world population, identifying a high-risk FLIPI score as a risk factor for its development and basal gamma globulins as a protective factor.
Factors Associated With Contact Sexual Offending Among a Non-Forensic Sample of Women With Sexual Interest in Children – Results From an Anonymous Online Survey
Authors: Erkan Viola , Schröder Johanna , Briken Peer , Tozdan Safiye
Published: March 2023

This study aimed at assessing the extent to which factors associated with male child sexual offending may also be applicable to women with a self-identified sexual interest in children. Participants ( n = 42) took part in an anonymous online survey covering questions about general characteristics, general sexuality, sexual interest in children, and previously-perpetrated contact child sexual abuse. Group comparisons between women who reported committing contact child sexual abuse compared to those who had not were conducted in terms of sample characteristics. Furthermore, the two groups were compared regarding the factors of high sexual activity, use of child abuse material, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, emotional congruence with children, and childhood maltreatment. Our results revealed that high sexual activity, indication of ICD-11 pedophilic disorder diagnosis, exclusivity of sexual interest in children, and emotional congruence with children were associated with previous contact child sexual abuse perpetration. We recommend further research on potential risk factors relating to child sexual abuse on the part of women.
Malnutrition: A risk factor for vascular access problems
Authors: Badak Tolga Onur , Ada Sibel
Published: March 2023

Background:

Vascular access problems are leading causes of morbidity, hospitalization, and impaired quality of life in chronic hemodialysis patients. Native arteriovenous fistula is the gold standard of vascular access. Geriatric nutritional risk index (GNRI), has recently been shown to be an easy and objective instrument for assessing nutritional status in these patient groups. Considering the association between arteria-venous fistula patency and inflammation, as well as the fact that inflammation is a component of malnutrition, the objective of this study was to determine the relation of malnutrition identified by GNRI with fistula patency.

Methods:

This is a single-center, retrospective, observational study. Hemodialysis patients with AVF were included in the research. Preoperative and postoperative GNRI values were computed and laboratory data were recorded. The patients were analyzed in two groups as the ones without thrombosis history (Group 1) and with thrombosis history (Group 2). According to GNRI, patients were investigated in four groups: G0 (non-risk group, >98), G1 (low risk, 92–98), G2 (moderate risk, 82–91), and G3 (high risk, 82).

Results:

Of the 331 patients, 60.1% (199) were male and the average age was 55 ± 15 years. Preoperative GNRI levels were significantly higher in group 1. In correlation analysis, patency time was positively correlated with preoperative GNRI values. Among the preoperative GNRI groups, the G3 group had a patency duration of 6 months (4.9–7.04), whereas the G0 group had a patency length of 37.59 (35.5–39.65) months. By linear regression analysis, preoperative GNRI and postoperative albumin level were determined to be the significant indicators of patency time.

Conclusion:

GNRI a new tool for detecting malnutrition was strongly associated with fistula patency in hemodialysis patients. Detection of malnutrition before fistula operation may be helpful for the future follow up of the patients in terms of fistula patency.
Early prediction of 30- and 14-day all-cause unplanned readmissions
Authors: Lin Chaohsin , Pan Li-Fei , He Zuo-Quan , Hsu Shuofen
Published: March 2023

Background

An unplanned readmission is a dual metric for both the cost and quality of medical care.

Methods

We employed the random forest (RF) method to build a prediction model using a large dataset from patients’ electronic health records (EHRs) from a medical center in Taiwan. The discrimination abilities between the RF and regression-based models were compared using the areas under the ROC curves (AUROC).

Results

When compared with standardized risk prediction tools, the RF constructed using data readily available at admission had a marginally yet significantly better ability to identify high-risk readmissions within 30 and 14 days without compromising sensitivity and specificity. The most important predictor for 30-day readmissions was directly related to the representing factors of index hospitalization, whereas for 14-day readmissions the most important predictor was associated with a higher chronic illness burden.

Conclusions

Identifying dominant risk factors based on index admission and different readmission time intervals is crucial for healthcare planning.
Middle meningeal artery embolization as a perioperative adjunct to surgical evacuation of nonacute subdural hematomas: An multicenter analysis of safety and efficacy
Authors: Salah Walid K. , Baker Cordell , Scoville Jonathan P. , Hunsaker Joshua C. , Ogilvy Christopher S. , Moore Justin M. , Riina Howard A. , Levy Elad I. , Spiotta Alejandro M. , Jankowitz Brian T. , Michael Cawley C. , Khalessi Alexander A. , Tanweer Omar , Hanel Ricardo , Gross Bradley A. , Kuybu Okkes , Hoang Alex Nguyen , Baig Ammad A. , Khorasanizadeh Mir Hojjat , Mendez Aldo A. , Cortez Gustavo , Davies Jason M. , Narayanan Sandra , Howard Brian M. , Lang Michael J. , Siddiqui Adnan H. , Thomas Ajith , Kan Peter , Burkhardt Jan-Karl , Salem Mohamed M. , Grandhi Ramesh
Published: March 2023

Background

By 2030, nonacute subdural hematomas (NASHs) will likely be the most common cranial neurosurgery pathology. Treatment with surgical evacuation may be necessary, but the recurrence rate after surgery is as high as 30%. Minimally invasive middle meningeal artery embolization (MMAE) during the perioperative period has been posited as an adjunctive treatment to decrease the potential for recurrence after surgical evacuation. We evaluated the safety and efficacy of concurrent MMAE in a multi-institutional cohort.

Methods

Data from 145 patients (median age 73 years) with NASH who underwent surgical evacuation and MMAE in the perioperative period were retrospectively collected from 15 institutions. The primary outcome was the rate of recurrence requiring repeat surgical intervention. We collected clinical, treatment, and radiographic data at initial presentation, after evacuation, and at 90-day follow-up. Outcomes data were also collected.

Results

Preoperatively, the median hematoma width was 18 mm, and subdural membranes were present on imaging in 87.3% of patients. At 90-day follow-up, median NASH width was 6 mm, and 51.4% of patients had at least a 50% decrease of NASH size on imaging. Eight percent of treated NASHs had recurrence that required additional surgical intervention. Of patients with a modified Rankin Scale score at last follow-up, 87.2% had the same or improved mRS score. The total all-cause mortality was 6.0%.

Conclusion

This study provides evidence from a multi-institutional cohort that performing MMAE in the perioperative period as an adjunct to surgical evacuation is a safe and effective means to reduce recurrence in patients with NASHs.
Risk of hemorrhagic transformation with early use of direct oral anticoagulants after acute ischemic stroke: A pooled analysis of prospective studies and randomized trials
Authors: Alrohimi Anas , Rose David Z , Burgin W Scott , Renati Swetha , Hilker Nicholas Corbin , Deng Wei , Oliveira Guilherme H , Beckie Theresa M , Labovitz Arthur J , Fradley Michael G , Tran Nhi , Gioia Laura C , Kate Mahesh , Ng Kelvin , Dowlatshahi Dar , Field Thalia S , Coutts Shelagh B , Siddiqui Muzzafar , Hill Michael D , Miller Jodi , Jickling Glen , Shuaib Ashfaq , Buck Brian , Sharma Mike , Butcher Ken S
Published: March 2023

Introduction:

Precise risk of hemorrhagic transformation (HT) in acute ischemic stroke (AIS) remains unknown, leading to delays in anticoagulation initiation for secondary stroke prevention. We sought to assess the rate of HT associated with direct oral anticoagulant (DOAC) initiation within and beyond 48 h post-AIS.

Methods:

A pooled analysis of DOAC initiation within 14 days of AIS or transient ischemic attack (TIA) was conducted with six studies (four prospective open label treatment, blinded outcome studies and two randomized trials; NCT02295826 and NCT02283294). The primary endpoint was incident radiographic HT on follow-up imaging (days 7–30). Secondary endpoints included symptomatic HT, new parenchymal hemorrhage, recurrent ischemic events, extracranial hemorrhage, study period mortality, and follow-up modified Rankin Scale score. The results were reported as odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI).

Results:

We evaluated 509 patients; median infarct volume was 1.5 (0.1–7.8) ml, and median National Institutes of Health Stroke Scale was 2 (0–3). Incident radiographic HT was seen on follow-up scan in 34 (6.8%) patients. DOAC initiation within 48 h from index event was not associated with incident HT (adjusted OR 0.67, [0.30–1.50] P = 0.32). No patients developed symptomatic HT. Conversely, 31 (6.1%) patients developed recurrent ischemic events, 64% of which occurred within 14 days. Initiating a DOAC within 48 h of onset was associated with similar recurrent ischemic event rates compared with those in which treatment was delayed (HR: 0.42, [0.17–1.008] P = 0.052). In contrast to HT, recurrent ischemic events were associated with poor functional outcomes (OR = 6.8, [2.84–16.24], p < 0.001).

Conclusions:

In this pooled analysis, initiation of DOAC within 48 h post-stroke was not associated with increased incident risk of HT, and none developed symptomatic HT. The analysis was underpowered to determine the effect of early DOAC use upon recurrent ischemic events.
Process mapping of hip fracture orthogeriatric care: Experience from a tertiary hospital in Malaysia
Authors: Lim Hong Tak , Khor Hui Min , Chandrasekaran C.S. Kumar , Singh Simmrat , Adnan Yohan Khirusman , Draman Mohd Rusdi , Ong Terence
Published: March 2023

Background: Early surgical repair and mobilization postoperatively is associated with improved outcomes for older people with hip fractures. A process mapping exercise was performed to identify the delivery of this aspect of care in a tertiary center. Methods: Analysis was done on electronic health record data of those ≥65 years who had surgery over a 3-month period. Barriers to surgery within 48 h of admission, and mobilized within the day after surgery were identified. Results: Fourty-two patients had surgery where the majority were female, had an average age of 78 years, frail, and multimorbid. 10/42 (23.8%) and 9/42 (21.4%) patients were operated on and mobilized early. Eighteen (42.9%) patients had pre-operative cardiology assessment and 19 patients (45.2%) had pre-operative echocardiogram. None led to a change in the surgical management plan. Other reasons for the delay to early surgery included the need for further medical optimization, financial constraints, blood transfusion, and being on antiplatelet/anticoagulant. Barriers to early mobilization postoperatively were lack of weekend service, delayed referral to therapists, pain, hypotension, anemia, and delirium. Conclusions: Streamlining referrals, agreed clinical pathways, consolidating multidisciplinary involvement, and continuous audit would address the barriers identified in delivering early surgical repair and mobilization post-operatively.
Time-frequency Feature Extraction Method of the Multi-Source Shock Signal Based on Improved VMD and Bilateral Adaptive Laplace Wavelet
Authors: Zhao Nanyang , Zhang Jinjie , Mao Zhiwei , Jiang Zhinong , Li He
Published: March 2023

Vibration signals have the characteristics of multi-source strong shock coupling and strong noise interference owing to the complex structure of reciprocating machinery. Therefore, it is difficult to extract, analyze, and diagnose mechanical fault features. To accurately extract sensitive features from the strong noise interference and unsteady monitoring signals of reciprocating machinery, a study on the time-frequency feature extraction method of multi-source shock signals is conducted. Combining the characteristics of reciprocating mechanical vibration signals, a targeted optimization method considering the variational modal decomposition (VMD) mode number and second penalty factor is proposed, which completed the adaptive decomposition of coupled signals. Aiming at the bilateral asymmetric attenuation characteristics of reciprocating mechanical shock signals, a new bilateral adaptive Laplace wavelet (BALW) is established. A search strategy for wavelet local parameters of multi-shock signals is proposed using the harmony search (HS) method. A multi-source shock simulation signal is established, and actual data on the valve fault are obtained through diesel engine fault experiments. The fault recognition rate of the intake and exhaust valve clearance is above 90% and the extraction accuracy of the shock start position is improved by 10°.
Improving family health climate, effect of role modeling and maternal support in female students
Authors: Ostovarfar Jeyran , Kaveh Mohammad Hossein , Vardanjani Hossein Molavi , Ghahramani Leila , Karimi Masoud , Asadollahi Abdolrahim , Zare Razie
Published: March 2023

Introduction

Girls can use their mother’s emotional, informational and behavioral support to perform healthy behaviors due to their constant access to their mothers. This study aimed to evaluate the effect of role modeling and maternal support in the family to improve healthy behaviors and perceived Family Health Climate (FHC) in female students.

Methods

In this educational quasi-experimental study, 261 female students (133 in the intervention group and 128 in the control group) and 223 mothers (109 intervention and 114 control) were selected using the cluster multi-stages sampling method and entered the study. Participants (intervention and control groups) completed the FHC scale at three stages (before intervention, immediately after the intervention, and 2 months after intervention). A training program that comprised 12 sessions for students and six sessions for their mothers using collaborative learning techniques and printed materials was conducted with the experimental group. Also after completing the questionnaire in the follow-up phase, pamphlets and educational videos were given to the control group. Data were analyzed using SPSS20 via a chi-square test, independent t-test, and Repeated Measures ANOVA at a significance level of 0.05.

Results

Before the intervention, there was no significant difference between demographic variables and the score of the FHC scale in both groups (p < 0.05). Immediately and 2 months after the intervention, the experimental group (female students and their mothers) showed a significant increase in dimensions of FHC, including FHC-NU (Family Health Climate-Nutrition) and FHC-PA (Family Health Climate-Physical Activity), compared to the control group (p < 0.05).

Conclusions

Educating and informing mothers about the impact of their role modeling on their children, especially girls, can make them more aware of health-oriented behaviors towards their children. Such findings reinforced the importance of focusing on actions to encourage a healthy lifestyle (healthy diet and physical activity) in students with a focus on role modeling and parental support, especially mothers.
The voice of healthcare: introducing digital decision support systems into clinical practice - a qualitative study
Authors: Frisinger Ann , Papachristou Panagiotis
Published: March 2023

Background

There is a need to accelerate digital transformation in healthcare to meet increasing needs and demands. The accuracy of medical digital diagnosis tools is improving. The introduction of new technology in healthcare can however be challenging and it is unclear how it should be done to reach desired results. The aim of this study was to explore perceptions and experiences of introducing new Information Technology (IT) in a primary healthcare organisation, exemplified with a Clinical Decision Support System (CDSS) for malignant melanoma.

Methods

A qualitative interview-based study was performed in Region Stockholm, Sweden, with fifteen medical doctors representing three different organisational levels – primary care physician, primary healthcare centre manager, and regional manager/chief medical officer. In addition, one software provider was included. Interview data were analysed according to content analysis.

Results

One central theme “Introduction of digital CDSS in primary healthcare requires a multidimensional perspective and handling” along with seven main categories and thirty-three subcategories emerged from the analysis. Digital transformation showed to be key for current healthcare providers to stay relevant and competitive. However, healthcare represents a closed community, very capable but with lack of time, fostered to be sceptical to new why change needs to bring true value and be inspired by people with medical background to motivate the powerful frontline.

Conclusions

This qualitative study revealed structured information of what goes wrong and right and what needs to be considered when driving digital change in primary care organisations. The task shows to be complex and the importance of listening to the voice of healthcare is valuable for understanding the conditions that need to be fulfilled when adopting new technology into a healthcare organization. By considering the findings of this study upcoming digital transformations can improve their success-rate. The information may also be used in developing a holistic approach or framework model, adapted to primary health care, that can support and accelerate the needed digitalization in healthcare as such.
Preoperative CA19-9 and GGT ratio as a prognostic indicator in ampullary carcinoma
Authors: Chen Rui-Qiu , Zhang Zhi-Lei , Jia Yu-Ming , Chen Rui-Xiang , Peng Li
Published: March 2023

Background and aims

In recent years, more and more inflammatory indicators have been studied to predict the long-term survival of patients with ampullary carcinoma (AC) after radical resection, but these prognostic indicators are still controversial. Therefore, based on previous inflammation scores, this study established a novel, easily accessible, more feasible and more predictive prognostic marker [Carbohydrate antigen199 to gamma-glutamyltransferase ratio (CA19-9/GGT)] to better assess the prognostic significance in AC patients undergoing radical resection.

Methods

Overall survival (OS) and recurrence-free survival (RFS) were analyzed by Cox regression model. Correlation between CA19-9/GGT and clinicopathological variables were analyzed by Chi-squared test, Fisher ' s exact test, independent sample t test and Mann–Whitney U test. The performance of prognostic indexes is compared by the consistency index (C-index). The prediction accuracy of nomogram is further confirmed by calibration curve and decision curve analysis (DCA).

Results

CA19-9/GGT was an independent risk factor affecting OS [P = 0.001, hazard ratio (HR) 2.459, 95% confidence intervals (CI) 1.450–4.167] and RFS (P = 0.002, HR 2.333, 95% CI 1.371–3.971) in multivariate analysis. The optimal cut-off value of CA19-9/GGT was 0.14. In CA19-9/GGT correlation analysis, high risk group (> 0.14) was significantly associated with poor prognosis. The predictive performance of CA19-9/GGT (OS: C-index = 0.753, RFS: C-index = 0.745) was confirmed to be superior to other prognostic indicators according to the C-index. Compared with the simple AJCC staging system, the Nomogram prediction model (OS: C-index = 0.787, RFS: C-index = 0.795) established by the combination of CA19-9/GGT and AJCC 8th TNM staging system has higher prediction accuracy.

Conclusions

CA19-9/GGT was an independent prognostic indicator after radical resection of AC. Incorporating CA19-9/GGT into the AJCC TNM staging system optimized the prediction accuracy of the TNM staging system, and further verified the predictive value of CA19-9/GGT.
Live birth in woman with premature ovarian insufficiency and 46, XY karyotype after chemotherapy and bone marrow transplant: a case report
Authors: Zhang Yaojia , Wang Haiyan , Pan Xiaoqin
Published: March 2023

Background

Premature ovarian insufficiency (POI) is a clinical syndrome defined by loss of ovarian function before the age of 40 years, characterized by elevated serum gonadotropin levels and decreased estrogen levels with menstrual disturbance. POI can be natural or iatrogenic such as after chemotherapy, radiotherapy and surgery.

Case presentation

In this study, we describe a successful live birth in a 31-year-old woman with POI and 46, XY Karyotype after being treated with chemotherapy and bone marrow transplant (BMT) for acute non-lymphocytic leukemia when she was 17 years old. With amenorrhea or oligomenorrhea for 11 years, her serum level of FSH was up to 35.0 IU/L and 53.0 IU/L taken 4 weeks apart, which can be diagnosed as POI. After controlled ovarian stimulation treatment for three cycles with different protocols and frozen-thawed embryo transfer (FET), she finally got a successful pregnancy and had a live birth later.

Conclusions

This case report serves as a reminder that karyotype of peripheral blood may mislead the diagnosis as disorders of sex development (DSD). It also demonstrates that it is possible for a woman with chemotherapy and bone marrow transplant induced POI can have successful pregnancy and live birth with appropriate therapy. Furthermore, as age may plays a predominant role in fertility rather than residual ovarian reserve, active treatment may be concerned for women with POI at younger age.
TACE versus TACE + entecavir versus TACE + tenofovir in the treatment of HBV associated hepatocellular carcinoma
Authors: Lu Haohao , Zheng Chuansheng , Xiong Bin , Xia Xiangwen
Published: March 2023

Background

At present, there are a variety of antiviral drugs for HBV in clinical practice, but there is no standard scheme for transcatheter arterial chemoembolization(TACE) combined with antiviral drugs. The aim of this study was to investigate whether TACE must be combined with antiviral therapy in patients of HBV-related hepatocellular carcinoma(HCC). Meanwhile, the efficacy and safety of TACE combined with entecavir and TACE combined with tenofovir in the treatment of HBV-related HCC were compared.

Method

This study included 536 patients with HBV-related HCC who underwent TACE in Union Hospital from March 2017 to March 2020, and they met the criteria. They were divided into three groups: control group (N = 212): TACE alone; Entecavir group (N = 220): TACE combined with entecavir; and Tenofovir group (N = 228): TACE combined with tenofovir. We conducted a retrospective study to analyze the efficacy and safety of the three groups of patients.

Results

Objective response rate(ORR): 29.2% in control group, 54.1% in entecavir group, and 63.2% in tenofovir group (P < 0.05). Disease control rate(DCR): 63.7% in control group, 80.9% in entecavir group, and 88.1% in tenofovir group (P < 0.05). Median overall survival(mOS): control group, 12.2 months; entecavir group, 17.3 months; tenofovir group, 22.5 months (p < 0.05). Median progression-free survival (mPFS): control group, 9.3 months; entecavir group, 15.5 months; tenofovir group, 16.6 months (p < 0.05). At 6 months, there was an increase in creatinine(Cr) and a decrease in glomeruar filtration rate(GFR) in tenofovir group, which were statistically different from control and entecavir groups (p < 0.05).

Conclusion

TACE combined with entecavir and TACE combined with tenofovir had higher ORR and DCR, longer OS and PFS than TACE alone. The OS of TACE combined with tenofovir was higher than that of TACE combined with entecavir. TACE combined with tenofovir is a safe strategy, but we cannot completely ignore the impact of tenofovir on renal function.
Towards best practice in developing motor skills: a systematic review on spacing in VR simulator-based psychomotor training for surgical novices
Authors: Fahl Jan Torge , Duvivier Robbert , Reinke Laurens , Pierie Jean-Pierre E. N. , Schönrock-Adema Johanna
Published: March 2023

Objective

Repeated practice, or spacing, can improve various types of skill acquisition. Similarly, virtual reality (VR) simulators have demonstrated their effectiveness in fostering surgical skill acquisition and provide a promising, realistic environment for spaced training. To explore how spacing impacts VR simulator-based acquisition of surgical psychomotor skills, we performed a systematic literature review.

Methods

We systematically searched the databases PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, ERIC and CINAHL for studies investigating the influence of spacing on the effectiveness of VR simulator training focused on psychomotor skill acquisition in healthcare professionals. We assessed the quality of all included studies using the Medical Education Research Study Quality Instrument (MERSQI) and the risk of bias using the Cochrane Collaboration’s risk of bias assessment tool. We extracted and aggregated qualitative data regarding spacing interval, psychomotor task performance and several other performance metrics.

Results

The searches yielded 1662 unique publications. After screening the titles and abstracts, 53 publications were retained for full text screening and 7 met the inclusion criteria. Spaced training resulted in better performance scores and faster skill acquisition when compared to control groups with a single day (massed) training session. Spacing across consecutive days seemed more effective than shorter or longer spacing intervals. However, the included studies were too heterogeneous in terms of spacing interval, obtained performance metrics and psychomotor skills analysed to allow for a meta-analysis to substantiate our outcomes.

Conclusion

Spacing in VR simulator-based surgical training improved skill acquisition when compared to massed training. The overall number and quality of available studies were only moderate, limiting the validity and generalizability of our findings.
Intervention-related, contextual and personal factors affecting the implementation of an evidence-based digital system for prevention and treatment of malnutrition in elderly institutionalized patients: a qualitative study
Authors: Varsi Cecilie , Andersen Lene Frost , Koksvik Gunhild Tellebon , Severinsen Frida , Paulsen Mari Mohn
Published: March 2023

Background

Malnutrition in elderly institutionalized patients is a significant challenge associated with adverse health outcomes. The ‘MyFood’ decision support system was designed to prevent and treat malnutrition and has previously been studied in a hospital setting. The aim of this study was to explore the experiences of nursing staff regarding the implementation of MyFood in settings treating elderly patients.

Methods

The study was conducted in two settings treating elderly patients in Norway. Nursing staff received training in how to follow-up patients with MyFood. Qualitative interviews were conducted with 12 nursing staff. The Consolidated Framework for Implementation Research (CFIR) was used to guide the data collection and the thematic data analysis.

Results

The implementation of a digital decision support system to prevent and treat malnutrition into settings treating elderly patients was found to be affected by intervention-related, contextual, and personal factors. Although nursing staff experienced several advantages, the leadership engagement was low and hampered the implementation.

Conclusion

Nursing staff experienced several advantages with implementing a digital decision support system for the prevention and treatment of malnutrition in institutionalized elderly patients, including quality improvements and time savings. The results indicate that the leadership engagement was weak and that some nursing staff experienced low self-efficacy in digital competence. Future improvements include increasing the level of training, using MyFood throughout the patient course and involving the patient’s next-of-kin.

Trial registration

The study was acknowledged by The Norwegian Centre for Research Data (NSD), ref. number 135175.
Multimolecular characteristics and role of BRCA1 interacting protein C-terminal helicase 1 (BRIP1) in human tumors: a pan-cancer analysis
Authors: Wang Ruohuang , Zhang Jisheng , Cui Xin , Wang Shun , Chen Ting , Niu Yanfang , Du Xiaoyun , Kong Jingwen , Wang Lin , Jiang Yan
Published: March 2023

Background

The aberrant expression of BRIP1 was associated with several cancers; however, the panoramic picture of BRIP1 in human tumors remains unclear. This study aims to explore the pan-cancerous picture of the expression of BRIP1 across 33 human cancers.

Methods

Based on the data from TCGA and GTEx, a series of bioinformatic analyses were applied to systematically explore the genetic landscape and biologic function of BRIP1 in 33 human tumors.

Results

We observed prognosis-related differential BRIP1 expressions between various carcinomas and the corresponding normal tissues. “Basal transcription factors,” “homologous recombination,” “nucleotide excision repair,” and DNA metabolism pathways may play a role in the functional mechanisms of BRIP1. Patients with uterine corpus endometrial carcinoma presented with the highest alteration frequency of BRIP1 (nearly 10%). Single-nucleotide and copy number variations of BRIP1 were noticed in multiple cancers, and the expression of BRIP1 is significantly regulated by copy number variation in breast invasive carcinoma and lung squamous cell carcinoma. BRIP1 expression is negatively correlated with the DNA methylation levels in many tumors and is associated with the activation of apoptosis, cell cycle, DNA damage response, and inhibition of hormone ER and RNS/MARK signaling pathways. Moreover, a positive correlation was observed between BRIP1 expression and the immune infiltration levels of cancer-associated fibroblasts and CD8+ T cells in lung adenocarcinoma.

Conclusion

Our pan-cancer analysis of BRIP1 provides a valuable resource for understanding the multimolecular characteristics and biological function of BRIP1 across human cancers.
An EMT-based gene signature enhances the clinical understanding and prognostic prediction of patients with ovarian cancers
Authors: Li Qi-jia , Wu Zi-liang , Wang Juan , Jiang Jing , Lin Bing
Published: March 2023

Background

Ovarian cancer (OC) is one of the most common gynecological cancers with malignant metastasis and poor prognosis. Current evidence substantiates that epithelial-mesenchymal transition (EMT) is a critical mechanism that drives OC progression. In this study, we aspire to identify pivotal EMT-related genes (EMTG) in OC development, and establish an EMT gene-based model for prognosis prediction.

Methods

We constructed the risk score model by screening EMT genes via univariate/LASSO/step multivariate Cox regressions in the OC cohort from TCGA database. The efficacy of the EMTG model was tested in external GEO cohort, and quantified by the nomogram. Moreover, the immune infiltration and chemotherapy sensitivity were analyzed in different risk score groups.

Results

We established a 11-EMTGs risk score model to predict the prognosis of OC patients. Based on the model, OC patients were split into high- and low- risk score groups, and the high-risk score group had an inevitably poor survival. The predictive power of the model was verified by external OC cohort. The nomogram showed that the model was an independent factor for prognosis prediction. Moreover, immune infiltration analysis revealed the immunosuppressive microenvironment in the high-risk score group. Finally, the EMTG model can be used to predict the sensitivity to chemotherapy drugs.

Conclusions

This study demonstrated that EMTG model was a powerful tool for prognostic prediction of OC patients. Our work not only provide a novel insight into the etiology of OC tumorigenesis, but also can be used in the clinical decisions on OC treatment.