bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstructing the ‘Reconquista’: Students’ negotiation of a Spanish master narrative
Authors: van Alphen Floor , Wagoner Brady
Published: August 2021

To analyse the different appropriations of the ‘Reconquest’ narrative schema in Spanish collective memory, this paper proposes a study following Bartlett’s method of repeated reproduction. Students from different backgrounds, within and outside of Spain, were presented historical narratives from less familiar perspectives than the traditional nationalist perspective. One week and again several months later they were asked to reproduce it. Over time their reconstructions tend to be progressively conventionalised, fitting it to the form of the traditional national historical narrative familiar to them. However, students simultaneously reflect on the term ‘Reconquest’ and its narrative schema. They turn around upon this schema, negotiate critical narrative elements or personalise the narrative they had read. These findings encourage further research into the complexity of schematic reconstructions and, ultimately, the reconstruction of schemas through reflection from other points of view.
Thromboelastography demonstrates progressive hypercoagulability in COVID-19 patients admitted to ICU with respiratory failure
Authors: Joshi Kunal , Fabes Jeremy , Melikian Clare , Spiro Michael
Published: August 2021

Thromboembolic complications are associated with COVID-19 owing to the hypercoagulable nature of the disease. Although patients with COVID-19 often have higher levels of fibrinogen and D-dimers, hypercoagulability has been attributed to various other factors too. In this prospective observational study conducted between April 2020 and June 2020, we compared coagulation parameters using thromboelastography in COVID-19 patients to non-COVID-19 patients admitted to ICU with respiratory failure. This study demonstrated a significant difference between the cohorts in functional fibrinogen (CFF) progressively from third day of ICU admission whilst there was no difference in the Clauss fibrinogen levels. COVID-19 patients also demonstarted supranormal R time indicating hypocoagulability. These mixed coagulation changes suggest targeting fibrinogen or platelets may prevent thromboembolic complications in COVID-19.
A balanced view of mindfulness at work
Authors: Choi Ellen , Gruman Jamie A. , Leonard Craig M.
Published: August 2021

Mindfulness has grown from an obscure subject to an immensely popular topic that is associated with numerous performance, health, and well-being benefits in organizations. However, this growth in popularity has generated a number of criticisms of mindfulness and a rather piecemeal approach to organizational research and practice on the subject. To advance both investigation and application, the present paper applies The Balance Framework to serve as an integrative scaffolding for considering mindfulness in organizations, helping to address some of the criticisms leveled against it. The Balance Framework specifies five forms of balance: 1) balance as tempered view, 2) balance as mid-range, 3) balance as complementarity, 4) balance as contextual sensitivity, and 5) balance among different levels of consciousness. Each form is applied to mindfulness at work with a discussion of relevant conceptual issues in addition to implications for research and practice.

Plain Language Summary

In order to appreciate the value of mindfulness at work researchers and practitioners might want to consider both the benefits and potential drawbacks of mindfulness. This paper presents a discussion of both the advantages and possible disadvantages of mindfulness at work organized in terms of the five dimensions of an organizing structure called The Balance Framework.
Establishing growth charts for proposed body shape and size index of the Pakistani population, using quantile regression approach
Authors: Hussain Waqas Ghulam , Shehzad Farrukh , Ahmad Rashid , Akbar Atif
Published: August 2021

Background:

Obesity leads to other fatal diseases like diabetes, cardiovascular diseases, depression, and some forms of cancer. Still, the well-known tool to measure obesity is the body mass index. But it usually failed in the measurement of adipose tissues. So, we present a novel anthropometric measure, called body shape and size index which is developed by the combination of major anthropometric determinants: body surface area, body mass index, weight, and height.

Methods:

This study is based on cross-sectional data consisting of 7224 individuals that were taken from the city Multan, Punjab, Pakistan. All the individuals, both males, and females, of age 2 years and above were included in the study except the pregnant women. The variables included in this study are gender, area (urban and rural), age (years), weight (kg), and height (meters). Growth charts of quantile regression are used for the inferential analysis of data. Comparison of proposed body shape and size index at different obesity levels has also been made to access the relationship of proposed body shape and size index with obesity.

Results:

The results show that the proposed body shape and size index has a great association with body surface area, body mass index, weight, height, and age. The proposed body shape and size index has a high negative association with body surface area, moderate negative association with body mass index and weight, and low negative association with height and age. According to growth charts of body shape and size index, after the age of 25 years, body shape and size index curves go upward while it smoothly goes downward at the age of 50 years but decreases in earlier ages. Body shape and size index showed a significant association with body shape and body size (body development) at the same time.

Conclusion:

Body shape and size index is found, generally linear with age, and increased with decreasing body mass index and body surface area. The proposed index has an indirect relationship with obesity. Body shape and size index with low values indicates a high risk of obesity. While, however, body shape and size index with high values indicates a low risk of obesity. Applications of the proposed body shape and size index are also presented in statistical modeling.
Online survey into developing a model for a legal cannabis market in the United Kingdom
Authors: James Edward , Robertshaw Thomas L , Pascoe Michael J , Chapman Fiona M , Westwell Andrew D , Hoskins Mathew , Barrow Jacob , Sessa Ben , Doblin Rick , Rosky Renee , Smith Andrew P
Published: August 2021

Background

Despite rescheduling of cannabis to Schedule 2 and amendments to the law permitting legal availability of cannabis for the treatment of medical conditions, access to cannabis for medical use remains challenging for patients in the United Kingdom (UK). Recreational use is widespread despite laws stating users can be sentenced to prison for up to 5 years for possession.

Objective

The aim of the study was to develop a model for a legal cannabis market in the UK building upon the results of a preceding study in which a UK population sample determined that pharmacies are the most suitable primary legal vendor of cannabis as opposed to regulated shops or the black market.

Methods

An online survey was developed using Qualtrics software and advertised via the Multidisciplinary Association for Psychedelic Studies’ Facebook, Twitter and Instagram social media accounts and monthly newsletter.

Results

Three hundred and ninety seven individuals, a majority having used cannabis at least once, consented to participate in the study. The participants concluded that there is enough evidence for cannabis to be prescribed to treat a range of medical conditions. In addition to pharmacies providing cannabis to patients with a prescription, a majority of participants supported cannabis being sold in pharmacies for harm reduction purposes and allowing access to medicinal cannabis in cases where supporting evidence is insufficient to merit a prescription. Participants supported greater integration between dispensing pharmacies and mental health services. Overall, the participants did not oppose a consultation or screening for potential cannabis users prior to obtaining access from licensed vendors. UK participants were supportive of the concept of a cannabis card, which users can present to licensed vendors such as pharmacies, with specific recommendations (such as strains relevant to a patient’s medical condition) being coded into the card. A majority of participants supported the existence of shisha-type bars for the purchase and onsite consumption of cannabis and determined that such vendors should not be part of a pharmacy chain of stores or regulated by pharmacy regulators. The participants generally preferred that laws regarding public consumption are in line with existing smoking legislation. Participants determined that it should be legally permitted to grow cannabis at home for personal medical and non-medical purposes but not to sell for profit.

Conclusion

The results are suggestive of a regulatory system that medical and non-medical cannabis users can use which aims to maximise therapeutic applications, minimise harms and respect individual liberty.
Naming the Ghost: Self-Naming, Pseudonyms, and Identities of Phantoms on Zimbabwean Twitter
Authors: Chibuwe Albert , Mpofu Phillip , Bhowa Kudakwashe
Published: August 2021

In Zimbabwean online spaces, especially Twitter, use of phantom names is widespread. It is arguable that this is partially a result of the country’s repressive political environment. It is the names that the nameless Twitter characters select and the motivations for using specific names that are the focus of this present study. The study is grounded in anthroponomastic concepts of pseudonymity and self-naming, and self-presentation and identity theory as well as semiotics of names while methodologically it is qualitative. Specifically, the study deploys archival research and netnography to gather data. The study found out that the ghosts’ adopted names are reflective of what they tweeted. The messages they tweeted were reflective of the online identity that they assumed; however, over and beyond that, their tweets exposed their political, and to an extent, religious inclinations. The tweets also exposed their origins and the spaces they once occupied or currently occupy. Finally, the article concludes that hiding behind a ghost name may hide the name of the person but it certainly does not hide the identity/identities of the person behind the phantom name. His or her being is self-evident in his or her tweets—they imprint themselves into their tweets. The anonymity in online spaces may, after all, be just superficial.
Orthopaedic Surgeon Mental Health During the COVID-19 Pandemic
Authors: Al-Humadi Samer M. , Cáceda Ricardo , Bronson Brian , Paulus Megan , Hong Houlin , Muhlrad Samantha
Published: August 2021

Introduction: This study compares rates of depression, suicidal ideation, and burnout among resident/fellow and attending physicians in orthopaedic surgery to other specialties during height/end of the first wave of the coronavirus disease 2019 (COVID-19) pandemic at our institution. Main outcomes and measures included suicidal ideation, Patient Health Questionnaire for Depression (PHQ-9) scores for depression, and 2 single-item measures for emotional exhaustion and depersonalization. This study provides valuable information regarding orthopaedic surgeon mental health during world crises. Methods: This is a cross-sectional survey-based study of resident, fellow, and attending physicians from 26 specialties during and after the first wave of the COVID-19 pandemic at our institution from April 24, 2020 to May 15, 2020. The survey contained 22 items. This includes consent, demographics and general data, 2 single-item questions of emotional exhaustion and depersonalization, and the PHQ-9. Subjects were eligible if they were a resident/fellow or attending physician at our institution. Results: The response rate for the study was 16.31%. Across all specialties rates were 6.2% depression, 19.6% burnout, and 6.6% suicidal ideation. The results for orthopaedic surgeons are as follows: 0% tentative diagnosis of depression, 3.8% suicidal ideation, and 4% burnout. Anesthesiology had the highest rate of depression (14.3%). Internal medicine and other non-surgical specialties had the highest rate of suicidal ideation (10.2%). Orthopaedic surgeons were significantly more likely to achieve work–life balance and experience less burnout than anesthesiologists and pediatricians. Discussion: Depression, suicidal ideation, and burnout continue to affect physicians across all specialties. These issues are amplified in light of crisis. Job satisfaction and rigorous training may be protective factors that allow orthopaedic surgeons to adapt to novel clinical settings under stress when compared to anesthesiologists and pediatricians. Resilience training and stress management strategies should continue to be investigated to better prepare physicians for world crises.
Similar recovery in mobility and quality of life after cemented and cementless hemiarthroplasty for hip fractures
Authors: Ruixiang Toh , Akshay Padki , Andy Yew , Shan Yeo H , Joyce Koh , Sen Howe T , Kenny Tay
Published: August 2021

Summary: Patients who suffer hip fractures become immobile with reduced quality of life. Our study aims to assess which cemented or cementless hemiarthroplasty resulted in better mobility or quality-of-life scores. Our retrospective review showed that both have similar scores after matching for age, gender, body mass index and comorbidities. Introduction: Hip fractures have mortality rates of up to 10% at 1 month and 30% at 1 year, as well as significant morbidity. This paper seeks to compare mobility and quality-of-life scores of cemented against uncemented hemiarthroplasty for the displaced neck of femur fractures. Our hypothesis is that there is no difference between the mobility and quality of life of patients treated with cemented or uncemented bipolar hemiarthroplasty. Methods: A retrospective review of registry data on hemiarthroplasties performed in our institution between 2011 and 2019 was conducted. From this dataset, 70 cemented hemiarthroplasties and 238 uncemented hemiarthroplasties were identified. Patients were assessed pre- and post-operatively, at 6 weeks, 3 months, 6 months and 12 months to determine functional recovery through mobility and quality-of-life scores. Results: On propensity score matching, both groups showed a reduction in Parker mobility score from 6.5 to 4 ( p = 0.91), SF-36 physical function scores from 52.5 (cemented) to 30 and 57.5 (uncemented) to 25 ( p = 0.79). Comparing the delta changes from pre-fall after matching, no significant differences were observed. From the analysis of the matched set of data, treatment of neck of femur using cemented or non-cemented bipolar hip prosthesis resulted in similar mobility and quality-of-life scores. Conclusion: In our analysis, there was no statistically significant difference in the mobility or quality-of-life scores of the patients undergoing cemented versus uncemented hemiarthroplasty for the displaced neck of femur fractures.
A Case Study on the Entrepreneurial Process of Push and Pull Women Entrepreneurs
Authors: Alam M. Sayeed , Biswas Kohinoor , Sulphey M. M.
Published: August 2021

The study presents two entrepreneurship typologies: necessity-driven and opportunity-driven. ‘Opportunity’ entrepreneurs start a business to pursue an opportunity, while ‘necessity’ entrepreneurship is requirement-based and attempts for the best option available in the absence of alternate employment opportunities. Push and pull effects are analogous to necessity-based and opportunity-based entrepreneurship. The study explored success through stages of the entrepreneurial process. The push entrepreneur proved her resilience despite the absence of spousal support. Behind the pull entrepreneur’s success was spousal support. The key findings are that success is influenced by the entrepreneur’s grit, willpower and attitude.

The objective of the case is to study two typologies of entrepreneurship, based on their motivation to become an entrepreneur—necessity-driven and opportunity-driven. It also examines the various factors that could influence the success of entrepreneurship.

Both entrepreneurs discussed in the study had several common factors. The two succeeded in their entrepreneurship due to their sheer grit, determination and a feeling of higher purpose. Multiple pieces of evidences exist to show that grit is a success factor linked to positive outcomes.

The phenomenon studied in this case include ‘opportunity’ and ‘necessity’ entrepreneurs. It also studied the push and pull effects in entrepreneurship, which are analogous to opportunity-based and necessity-based entrepreneurship. The push entrepreneur was involved in boutique business, and pull entrepreneur was in catering business.

The findings are that the push entrepreneur demonstrated resilience despite many drawbacks. The success of the pull entrepreneur’s involved spousal support too. In both cases, the critical finding is that success is influenced by the entrepreneur’s grit, willpower and attitude. Further, neither of the women entrepreneurs took any loan to fund their business.

Both entrepreneurs discussed in the study had a few common factors. Both of them were educated. The two entrepreneurs exhibited grit, determination and a feeling of higher purpose. Grit has been found to be a success factor and linked to positive outcomes.
Preparation, morphology, FTIR and performance properties of foaming particleboard
Authors: Bi Xiaoyu , Huang Runzhou
Published: August 2021

The application of light weight particleboard in furniture industry becomes more inevitable because of the requirement to facilitate transportation and assembly by the customer. Herein, a novel method for the fabrication of foaming particleboard was proposed, which is achieved by adding azodicarbonamide (AC) foaming agent into the formulation that consist of oven-dry poplar (Populus alba) particles (with the moisture content about 4%) and phenol formaldehyde resin (PF resin) (solid content of 48%). In this study, the effects of AC foaming agent and adhesive contents incorporation and its content on mechanical, physical and chemical properties of particleboards were investigated. The results showed that the addition of AC foaming agent played a critical role in properties of particleboard and the optimal particleboard performance was achieved at the particleboard density of 0.6 g/cm3, the PF resin amount of 12%, and the AC foaming agent amount of 1%. Furthermore, the pores appeared on the particle surface were the products of the radical pyrolysis of the foaming agent, which has been proved by the FTIR results and the pores also affect the properties of the particleboards.
Ge N-Channel MOSFETs with ZrO2 Dielectric Achieving Improved Mobility
Authors: Chou Lulu , Liu Yan , Xu Yang , Peng Yue , Liu Huan , Yu Xiao , Han Genquan , Hao Yue
Published: August 2021

High-mobility Ge nMOSFETs with ZrO2 gate dielectric are demonstrated and compared against transistors with different interfacial properties of ozone (O3) treatment, O3 post-treatment and without O3 treatment. It is found that with O3 treatment, the Ge nMOSFETs with ZrO2 dielectric having a EOT of 0.83 nm obtain a peak effective electron mobility (μeff) of 682 cm2/Vs, which is higher than that of the Si universal mobility at the medium inversion charge density (Qinv). On the other hand, the O3 post-treatment with Al2O3 interfacial layer can provide dramatically enhanced-μeff, achieving about 50% μeff improvement as compared to the Si universal mobility at medium Qinv of 5 × 1012 cm−2. These results indicate the potential utilization of ZrO2 dielectric in high-performance Ge nMOSFETs.
A Genome Doubling Event Reshapes Rice Morphology and Products by Modulating Chromatin Signatures and Gene Expression Profiling
Authors: Zhou Chao , Liu Xiaoyun , Li Xinglei , Zhou Hanlin , Wang Sijia , Yuan Zhu , Zhang Yonghong , Li Sanhe , You Aiqing , Zhou Lei , He Zhengquan
Published: August 2021

Evolutionarily, polyploidy represents a smart method for adjusting agronomically important in crops through impacts on genomic abundance and chromatin condensation. Autopolyploids have a relatively concise genetic background with great diversity and provide an ideal system to understand genetic and epigenetic mechanisms attributed to the genome-dosage effect. However, whether and how genome duplication events during autopolyploidization impact chromatin signatures are less understood in crops. To address it, we generated an autotetraploid rice line from a diploid progenitor, Oryza sativa ssp. indica 93-11. Using transposase-accessible chromatin sequencing, we found that autopolyploids lead to a higher number of accessible chromatin regions (ACRs) in euchromatin, most of which encode protein-coding genes. As expected, the profiling of ACR densities supported that the effect of ACRs on transcriptional gene activities relies on their positions in the rice genome, regardless of genome doubling. However, we noticed that genome duplication favors genic ACRs as the main drivers of transcriptional changes. In addition, we probed intricate crosstalk among various kinds of epigenetic marks and expression patterns of ACR-associated gene expression in both diploid and autotetraploid rice plants by integrating multiple-omics analyses, including chromatin immunoprecipitation sequencing and RNA-seq. Our data suggested that the combination of H3K36me2 and H3K36me3 may be associated with dynamic perturbation of ACRs introduced by autopolyploidization. As a consequence, we found that numerous metabolites were stimulated by genome doubling. Collectively, our findings suggest that autotetraploids reshape rice morphology and products by modulating chromatin signatures and transcriptional profiling, resulting in a pragmatic means of crop genetic improvement.
Effects of vitamin D supplementation in extender on sperm kinematics and apoptosis following the freeze-thaw process in normozoospermic and asthenozoospermic Holstein bulls
Authors: Asadpour Reza , Taravat Morteza , Rahbar Maryam , Khoshniyat Mohammadrasoul , Hamidian Gholamreza
Published: August 2021

Background

Asthenozoospermia is a usual male infertility factor, characterized by decreased semen quality. It has been revealed that antioxidants improve sperm function, enhance endogenous antioxidant activities, and protect spermatozoa against oxidative damage during cryopreservation. This aimed to evaluate the effects of vitamin D on sperm kinematics and apoptosis in the semen of bulls with normozoospermia and asthenozoospermia after the freeze-thaw process. For this purpose, 32 semen samples of four Holstein bulls (normozoospermic, progressive motility > 70 %) and 32 semen samples of four bull (asthenozoospermic progressive motility < 40 %) were collected and pooled separately (normozoospermic and asthenozoospermic). Samples were then diluted into four equal aliquots of extender containing different vitamin D concentrations (0, 5, 10, and 50 ng/mL) and aspirated into a 0.5 mL straw.

Results

The percentages of sperm progressive motility and viability were significantly higher (P < 0.05) in 50 ng/mL of vitamin D in normozoospermic group. Sperm kinematics parameters including curvilinear velocity (VCL), straight-line velocity (VSL), and average path velocity (VAP) were significantly higher in the high dose (50 ng/mL) vitamin D-treated group compared to the low dose vitamin D-treated group (5ng/mL) in normozoospermic bull semen samples. The supplementation of the semen extender with different concentrations of vitamin D could not increase the rate of acrosome integrity in normozoospermic bulls compared to the control group (P < 0.05). In the asthenozoospermic group, 10 ng/mL vitamin D-treated group could increase the rate of plasma membrane integrity compared to 5 ng/mL vitamin D-treated group (P < 0.05). The percentages of early-apoptosis (P = 0.049) and late-apoptosis (P = 0.005) were significantly higher in the asthenozoospermic than the normozoospermic group.

Conclusions

The present study revealed that a high dose (50 ng/mL) of vitamin D protected normozoospermic bulls’ sperms from the freezing procedure and lead to higher quality of frozen-thawed bull sperm.
Maximum parsimony reconciliation in the DTLOR model
Authors: Liu Jingyi , Mawhorter Ross , Liu Nuo , Santichaivekin Santi , Bush Eliot , Libeskind-Hadas Ran
Published: August 2021

Background

Analyses of microbial evolution often use reconciliation methods. However, the standard duplication-transfer-loss (DTL) model does not account for the fact that species trees are often not fully sampled and thus, from the perspective of reconciliation, a gene family may enter the species tree from the outside. Moreover, within the genome, genes are often rearranged, causing them to move to new syntenic regions.

Results

We extend the DTL model to account for two events that commonly arise in the evolution of microbes: origin of a gene from outside the sampled species tree and rearrangement of gene syntenic regions. We describe an efficient algorithm for maximum parsimony reconciliation in this new DTLOR model and then show how it can be extended to account for non-binary gene trees to handle uncertainty in gene tree topologies. Finally, we describe preliminary experimental results from the integration of our algorithm into the existing xenoGI tool for reconstructing the histories of genomic islands in closely related bacteria.

Conclusions

Reconciliation in the DTLOR model can offer new insights into the evolution of microbes that is not currently possible under the DTL model.
The characteristics of average abundance function with mutation of multi-player threshold public goods evolutionary game model under redistribution mechanism
Authors: Xia Ke
Published: August 2021

Background

In recent years, the average abundance function has attracted much attention as it reflects the degree of cooperation in the population. Then it is significant to analyse how average abundance functions can be increased to promote the proliferation of cooperative behaviour. However, further theoretical analysis for average abundance function with mutation under redistribution mechanism is still lacking. Furthermore, the theoretical basis for the corresponding numerical simulation is not sufficiently understood.

Results

We have deduced the approximate expressions of average abundance function with mutation under redistribution mechanism on the basis of different levels of selection intensity$$\omega$$ω(sufficiently small and large enough). In addition, we have analysed the influence of the size of groupd, multiplication factorr, costc, aspiration level$$\alpha$$αon average abundance function from both quantitative and qualitative aspects.

Conclusions

(1) The approximate expression will become the linear equation related to selection intensity when$$\omega$$ωis sufficiently small. (2) On one hand, approximation expression when$$\omega$$ωis large enough is not available whenris small andmis large. On the other hand, this approximation expression will become more reliable when$$\omega$$ωis larger. (3) On the basis of the expected payoff function$$\pi \left( \centerdot \right)$$π⋅and function$$h(i,\omega )$$h(i,ω), the corresponding results for the effects of parameters (d,r,c,$$\alpha$$α) on average abundance function$$X_{A}(\omega )$$XA(ω)have been explained.
Diet-derived transmission of MicroRNAs from host plant into honey bee Midgut
Authors: Gharehdaghi Leila , Bakhtiarizadeh Mohammad Reza , He Kang , Harkinezhad Taher , Tahmasbi Gholamhosein , Li Fei
Published: August 2021

Background

MicroRNA (miRNA) is a class of small noncoding RNAs, which targets on thousands of mRNA and thus plays important roles in many biological processes. It has been reported that miRNA has cross-species regulation functions between parasitoid-host, or plant-animal, etc. For example, several plant miRNAs enter into the honey bees and regulate gene expression. However, whether cross-species regulation function of miRNAs is a universal mechanism remains a debate question.

Results

We have evaluated transmission of miRNAs from sunflower and sedr plants into the midgut of honey bee using RNA-Seq analyses complemented with confirmation by RT-qPCR. The results showed that at least 11 plant miRNAs were found in the midgut of honey bee feeding by sunflower and sedr pollen. Among which, nine miRNAs, including miR-30d, miR-143, miR-148a, miR-21, let-7 g, miR-26a, miR-126, miR-27a, and miR-203, were shared between the sunflower- and sedr-fed honey bees, suggesting they might have essential roles in plant-insect interactions. Moreover, existence of these co-shared miRNAs presents a strong evidence to support the successful transmission of miRNAs into the midgut of the insect. In total, 121 honeybee mRNAs were predicted to be the target of these 11 plant-derived miRNAs. Interestingly, a sedr-derived miRNA, miR-206, targets on 53 honeybee genes. Kyoto Encyclopedia of Genes and Genome (KEGG) analyses showed that these target genes are significantly involved in hippo signaling pathway-fly, Wnt signaling pathway, and N-Glycan biosynthesis.

Conclusions

In summary, these results provide evidence of cross-species regulation function of miRNA between honeybee and flowering host plants, extending our understanding of the molecular interactions between plants and animals.
Time-to-event prediction analysis of patients with chronic heart failure comorbid with atrial fibrillation: a LightGBM model
Authors: Zheng Chu , Tian Jing , Wang Ke , Han Linai , Yang Hong , Ren Jia , Li Chenhao , Zhang Qing , Han Qinghua , Zhang Yanbo
Published: August 2021

Background

Chronic heart failure (CHF) comorbid with atrial fibrillation (AF) is a serious threat to human health and has become a major clinical burden. This prospective cohort study was performed to design a risk stratification system based on the light gradient boosting machine (LightGBM) model to accurately predict the 1- to 3-year all-cause mortality of patients with CHF comorbid with AF.

Methods

Electronic medical records of hospitalized patients with CHF comorbid with AF from January 2014 to April 2019 were collected. The data set was randomly divided into a training set and test set at a 3:1 ratio. In the training set, the synthetic minority over-sampling technique (SMOTE) algorithm and fivefold cross validation were used for LightGBM model training, and the model performance was performed on the test set and compared using the logistic regression method. The survival rate was presented on a Kaplan–Meier curve and compared by a log-rank test, and the hazard ratio was calculated by a Cox proportional hazard model.

Results

Of the included 1796 patients, the 1-, 2-, and 3-year cumulative mortality rates were 7.74%, 10.63%, and 12.43%, respectively. Compared with the logistic regression model, the LightGBM model showed better predictive performance, the area under the receiver operating characteristic curve for 1-, 2-, and 3-year all-cause mortality was 0.718 (95%CI, 0.710–0.727), 0.744(95%CI, 0.737–0.751), and 0.757 (95%CI, 0.751–0.763), respectively. The net reclassification index was 0.062 (95%CI, 0.044–0.079), 0.154 (95%CI, 0.138–0.172), and 0.148 (95%CI, 0.133–0.164), respectively. The differences between the two models were statistically significant (P < 0.05). Patients in the high-risk group had a significantly higher hazard of death than those in the low-risk group (hazard ratios: 12.68, 13.13, 14.82, P < 0.05).

Conclusion

Risk stratification based on the LightGBM model showed better discriminative ability than traditional model in predicting 1- to 3-year all-cause mortality of patients with CHF comorbid with AF. Individual patients’ prognosis could also be obtained, and the subgroup of patients with a higher risk of mortality could be identified. It can help clinicians identify and manage high- and low-risk patients and carry out more targeted intervention measures to realize precision medicine and the optimal allocation of health care resources.
A national intervention to support frail older adults in primary care: a protocol for an adapted implementation framework
Authors: Sims-Gould Joanie , Elliott Jacobi , Tong Catherine E , Giguère Anik , Mallinson Sara , Stolee Paul
Published: August 2021

Background

Older Canadians are high users of health care services, however the health care system is not well-designed to meet the complex needs of many older adults. Older persons often look to their primary care practitioners to assess their needs and coordinate their care. The intervention seeks to improve primary care for older persons living with frailty and will be implemented in six primary care clinics in three Canadian provinces. Presently, more than 1.6 million older Canadians are living with frailty, and this is projected to increase to 2.5 million within a decade (Canadian Frailty Network, Frailty Matters, 2020). The model will include frailty screening, an online portal to expedite referrals and improve coordination with community services, and several tools and techniques to support patient and family engagement and shared decision-making. Our project is guided by the Consolidated Framework for Implementation Research (CFIR) (Damschroder LJ, et al. Implement Scil, 4, 50, 2009). As others have done, we adapted the CFIR for our work. Our adapted framework combines elements of the socio-ecological model, key concepts from the CFIR, and elements from other implementation science frameworks. Nested within a broader mixed-method implementation study, the focus of this paper is to outline our guiding conceptual framework and qualitative methods protocol.

Methods

We will use the adapted CFIR framework to inform the data we collect and our analytic approach. Our work is divided into three phases: (1) baseline assessment of ‘usual care’; (2) tailoring and implementing a new primary care model; and (3) evaluation. In each of these phases we will engage in qualitative data collection, including clinical observations, focus groups, in-depth interviews and extensive field notes. At each site we will collect data with health care providers, key informants (e.g., executive directors), and rostered patients ≥ 70 years. We will engage in team-based analysis across multiple sites, three provinces and two languages through regular telephone conferences, a comprehensive analysis codebook, leadership from our Qualitative Working Group and a collective appreciation that “science is a team sport” (Clinical Orthopaedics and Related Research 471, 701-702, 2013).

Discussion

Outcomes of this research may be used by other research teams who chose to adapt the CFIR framework to reflect the unique contexts of their work, and clinicians seeking to implement our model, or other models of care for frail older patients in primary care.

Trial Registration

U.S. National Library of Medicine,NCT03442426. Registered 22 February 2018– Retrospectively registered.
Misdiagnosed tuberculosis being corrected as Nocardia farcinica infection by metagenomic sequencing: a case report
Authors: Pan Lei , Pan Xiao-hong , Xu Jie-kun , Huang Xiao-qing , Qiu Jun-ke , Wang Cai-hong , Ji Xiao-bo , Zhou Yang , Mao Min-jie
Published: August 2021

Background

Disseminated nocardiosis is liable to be misdiagnosed owing to the non-specific clinical manifestations and laboratory/imaging findings. Metagenomic next-generation sequencing (mNGS) is a culture-independent and rapid method for direct identification of all microorganisms in clinical specimens.

Case presentation

A 72-year-old man was admitted to our hospital on February 20, 2019 with a history of recurrent cough, expectoration, fever, and diarrhea since 1 month, and unconsciousness since 1 week. Contrast-enhanced magnetic resonance imaging of head showed multiple lesions in the bilateral cerebral hemispheres, brainstem, and cerebellar hemispheres. The presumptive diagnosis was disseminated tuberculosis, although all tests for mycobacterium were negative. However, the patient did not benefit from antituberculosis treatment. Repeat MRI showed multiple abnormal signals in the brain and progression of meningeal thickening. Cerebrospinal fluid and bronchoalveolar lavage fluid specimens were subsequently sent for PMSeq metagenomics sequencing; the results indicated Nocardia. farcinica as the predominant pathogen. The anti-TB treatment was stopped and the patient was prescribed sulphamethoxazole in combination with linezolid and meropenem for nocardiosis. He showed gradual neurological improvement and was transferred to Huashan Hospital. He was discharged from the hospital on April 19, 2019, but died of persistent diarrhea on May 26, 2019.

Conclusions

Patients with suspected nocardiosis do not always respond to conventional treatment; therefore, mNGS can facilitate diagnosis and timely treatment decision-making.
Factors affecting implementation and pass rates of surgical instrument moistening
Authors: Huang Yongdeng , Huang Yan , Chen Yanhua , Pan Wei , Hu Juan , Yi Liangying
Published: August 2021

Background

Moistening of surgical instruments affects the quality of instrument cleaning, thereby affecting the degree of cross-contamination and in-hospital infection among patients. Surgical instruments should be kept moist immediately after use in order to avoid concentrations of contamination remaining on surgical instrument surfaces. Implementation and pass rates of surgical instrument moistening have been rarely studied. We aimed to investigate the factors affecting implementation and pass rates of surgical instrument moistening.

Methods

A cross-sectional study was conducted to investigate surgical instrument moistening procedures within 22 clinical departments of the West China Second University Hospital, Sichuan University over 122 days between September and December 2019. We collected data from departmental staff using an interviewer-administrated questionnaire. Data about implementation and pass rates of surgical instrument moistening was analyzed in SPSS20.0.

Results

Implementation and pass rates of surgical instrument moistening were 57.25% and 31.98%, respectively. Factor analysis showed that implementation rates of moistening were affected by instrument structure (X2 = 143.670; P = 0.001), the number of instruments inside the pack (X2 = 140.135; P = 0.001), and the person responsible for keeping surgical instruments moist (X2 = 8.052; P = 0.005). Correlation analysis showed that instrument structure and the number of instruments inside the pack were negatively correlated with implementation rates of moistening. The more complex the structure and the greater the number of the instruments inside the pack, the lower implementation rates of moistening.

Conclusion

Implementation and pass rates of surgical instrument moistening were low, and failed to meet the central sterile supply department applicable industrial standard, hence the potential risk of hospital-acquired infection was considerable. Staff that manipulate reusable surgical instruments should be trained to properly moisten the instruments and institutional protocols should be established to ensure standardization and respect of guidelines.
Determination of hand grip strength and its correlates during pregnancy: a cross-sectional study
Authors: Abdullahi Auwal , Bala Amina Shuaib , Danazumi Sani Musa , Abubakar Saadatu Maiwada , Adamu Rislanu Isyaku , Truijen Steven , Zakari Musa Kani , Akosile Christopher Olusanjo , Saeys Wim , Lawal Isa Usman , Etoom Mohammed , Nuhu Jibril Mohammed , Oyeniran Mukadas Akindele , Mayana Kabir Isah , Useh Ushotanefe
Published: August 2021

Background

Pregnancy results in many changes, including reduced hand grip strength (HGS). However, good HGS is required for physical functions such as carrying and breastfeeding the baby after birth. The aim of this study was to determine the factors that may predict HGS during pregnancy.

Methods

The study was a cross-sectional study approved by the Research Ethics Committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital in Kano, north-west, Nigeria. Pregnant women at the designated hospitals were included in the study if they had no serious comorbidities or any known neurological condition that affects the hands and the neck. Demographic characteristics and independent (predictor) variables (age, weight, height, BMI, maternity leave status, number of full-term deliveries, number of preterm deliveries, number of live births, number of abortuses, gravidity, trimester, systolic blood pressure, diastolic blood pressure, inter arm systolic BP difference [IASBP], inter arm diastolic BP difference [IADBP], and heart rate) of each of the participants were recorded by experienced therapists. The data were analysed using descriptive statistics, t-test, Pearson correlation coefficient and standard multiple regression.

Result

One hundred and sixty-one pregnant women with mean age, 25.04 ± 4.83 years participated in the study. In the dominant hand, 120 participants (74.5%) had weak grip strength. In the non-dominant hand, 135 participants (83.9%) had weak grip strength. For the dominant hand, the total variance explained by the whole model was significant, 28.5%, F(11, 161) = 1.187, R2 = 0.081, p = 0.300 . In the final model, none of the variables significantly predicted HGS. However, systolic blood pressure contributed to the model more than any other variable (Beta = -0.155). For the non-dominant hand, the total variance explained by the whole model was not significant, 33.1%, F(11, 161) = 1.675, R2 = 0.111, p = 0.089 . In the final model, only systolic blood pressure (Beta = -0.254, p = 0.023) significantly predicted hand grip strength.

Conclusion

Cardiovascular events or changes during pregnancy (such as change in systolic blood pressure) may be related to HGS in pregnant women. It is therefore, important for clinicians to pay attention to this, in planning rehabilitation strategies for pregnant women.
Prevalence and risk factors for non-suicidal self-injury among patients with depression or bipolar disorder in China
Authors: Wang Lu , Liu Jun , Yang Yuan , Zou Haiou
Published: August 2021

Backgrounds

Non-suicidal self-injury is a serious health problem among patients with depression or bipolar disorder. However, few studies within the Chinese context have investigated the prevalence of NSSI and its risk factors in above populations. The purpose of this study was to investigate the prevalence of non-suicidal self-injury and its risk factors in patients with depression or bipolar disorder in China.

Methods

The final sample comprised of 394 inpatients(Mage = 29.71; SDage = 11.95) with depression or bipolar disorder from two psychiatric hospitals in Beijing, China. A General Demographic Data Form, the Non-suicidal Self-injury Questionnaire(NSSI-Q), Impulsivity Item and the Adverse Childhood Experiences-International Questionnaire(ACE-IQ) were completed by all patients.

Results

Of the 394 patients examined, 245(62.2%) of this sample reported NSSI in past year. Of the 245 patients with NSSI, 135(55.1%) were diagnosed with depression and 110(44.9%) were diagnosed with bipolar disorder. The most common methods of NSSI for female was “pinching”(23.1%) and “scratching”(22.8%), while for male it was “hiting hard objects”(12.7%). By multivariate regression analysis, young age, unemployment, a higher monthly family income, single, impulsivity, long duration of illness and ACEs were risk factors for NSSI in patients with depression and bipolar disorder(P<0.05).

Conclusions

Our study points to the fact that there was an unfortunate message about the prevalence of NSSI among patients with depression or bipolar disorder in China. It is necessary not only to raise the awareness of NSSI in families and society, but also to formulate targeted assessment and intervention. Moreover, future research should not only focus on individuals being hospitalized, but should be representative of individuals treated at home or in the community because there are no national statistics on NSSI among such patients in China.
The influence of personality, alexithymia and work engagement on burnout among village doctors in China: a cross-sectional study
Authors: Zhang Xuewen , Bai Xue , Bian Liyan , Wang Min
Published: August 2021

Background

In China, as the “gatekeepers”of rural residents’ health, the primary-level village doctors, play a very crucial role in ensuring and serving the health level of rural residents. However, the burnout of village doctors is gravely threatening the stability of rural primary medical system step by step. This study systematically evaluated the effects of personality, work engagement and alexithymia on burnout of village doctors, and further measured and assessed the mediating effect of alexithymia and work engagement in the association between personality and burnout.

Methods

The subjects were 2684 village doctors in Jining, Shandong Province, China, from May to June 2019. Sociodemographic characteristics, alexithymia, personality, work engagement and job burnout were quantitated by self-completed questionnaire and measured by Likert 5–7 scale. One-way ANOVA, Person correlation analysis, and Structural Equation Modelling (SEM) were used for statistical analysis and mediating effect evaluation.

Results

2693 questionnaires were collected in total, of which 2684 were valid, with an effective rate of 96.2%. 65.2% of village doctors were diagnosed with burnout, and 54.3% showed moderate to severe emotional exhaustion, 61.6% showed moderate to severe low sense of personal achievement, and 33.9% showed moderate to severe depersonalization burnout. Personality had a direct positive effect on work engagement (β = 0.50, p < 0.001), a direct negative effect on alexithymia (β = − 0.52, p < 0.001) and burnout (β = − 0.50, p < 0.001) respectively. Work engagement had a direct negative effect on burnout (β = − 0.10, p < 0.001), while alexithymia had a direct positive effect on burnout (β = 0.16, p < 0.001). In the path between personality and burnout, both work engagement 95%CI:(− 0.17)–(− 0.08), and alexithymia 95%CI:(− 0.36)–(− 0.09), have significant mediating effects. These results strongly confirm that personality, alexithymia, and work engagement are early and powerful predicators of burnout.

Conclusion

According to the results, medical administrators should pay attention to the personality characteristics of village doctors in vocational training, practice selection and job assignment, encourage village doctors to reflect on their own personality actively, and to reduce job burnout by obtaining necessary social support, constructing reasonable achievable career expectations, improving time management ability, and participating in psychological counselling programs.