bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Surgical Oncology Case Volume Within the Public Sector in Tanzania
Authors: Brand Nathan R. , Akoko Larry , Kotecha Vihar , Mwakyembe Theresia , Mwashambwa Masumbuko , Hamid Rukia , Hando Deo , Komba Charles , Mwanga Ally , Mbele Peter , Itule Paul , Jackson Joshua , Misidai Mungeni , Gaskill Cameron , Ozgediz Doruk
Published: March 2024

PURPOSE

Surgery provides vital services to diagnose, treat, and palliate patients suffering from malignancies. However, despite its importance, there is little information on the delivery of surgical oncology services in Tanzania.

METHODS

Operative logbooks were reviewed at all national referral hospitals that offer surgery, all zonal referral hospitals in Mainland Tanganyika and Zanzibar, and a convenience sampling of regional referral hospitals in 2022. Cancer cases were identified by postoperative diagnosis and deidentified data were abstracted for each cancer surgery. The proportion of the procedures conducted for patients with cancer and the total number of cancer surgeries done within the public sector were calculated and compared with a previously published estimate of the surgical oncology need for the country.

RESULTS

In total, 69,195 operations were reviewed at 10 hospitals, including two national referral hospitals, five zonal referral hospitals, and three regional referral hospitals. Of the cases reviewed, 4,248 (6.1%) were for the treatment of cancer. We estimate that 4,938 cancer surgeries occurred in the public sector in Tanzania accounting for operations conducted at hospitals not included in our study. Prostate, breast, head and neck, esophageal, and bladder cancers were the five most common diagnoses. Although 387 (83%) of all breast cancer procedures were done with curative intent, 506 (87%) of patients with prostate and 273 (81%) of patients with esophageal cancer underwent palliative surgery.

CONCLUSION

In this comprehensive assessment of surgical oncology service delivery in Tanzania, we identified 4,248 cancer surgeries and estimate that 4,938 likely occurred in 2022. This represents only 25% of the estimated 19,726 cancer surgeries that are annually needed in Tanzania. These results highlight the need to identify strategies for increasing surgical oncology capacity in the country.
Care Models and Barriers to Long-Term Follow-Up Care Among Childhood Cancer Survivors and Health Care Providers in Asia: A Literature Review
Authors: Cai Jiaoyang , Cheung Yin Ting , Hudson Melissa M.
Published: March 2024

Most available data evaluating childhood cancer survivorship care focus on the experiences of high-income Western countries, whereas data from Asian countries are limited. To address this knowledge deficit, we aimed to characterize survivorship care models and barriers to participation in long-term follow-up (LTFU) care among childhood cancer survivors (CCSs) and health care providers in Asian countries. Twenty-four studies were identified. Most institutions in China and Turkey adopt the oncology specialist care model, whereas in Japan, India, Singapore, and South Korea, after completion of therapy LTFU programs are available in some institutions. In terms of survivor barriers, findings highlight the need for comprehensive age-appropriate education and support and personalized approaches in addressing individual preferences and challenges during survivorship. Health care professionals need education about potential late effects of cancer treatment, recommended guidance for health surveillance and follow-up care, and their role in facilitating the transition from pediatric to adult-focused care. To optimize the delivery of cancer survivorship care, efforts are needed to increase patient and family awareness about the purpose and potential benefits of LTFU care, improve provider education and training, and promote policy change to ensure that CCSs have access to essential services and resources to optimize quality of survival.
B-Cell–Mediated Immunity Predicts Survival of Patients With Estrogen Receptor–Positive Breast Cancer
Authors: Lee Seungbok , Kang Byung-Hee , Lee Han-Byoel , Jang Bum-Sup , Han Wonshik , Kim In Ah
Published: March 2024

PURPOSE

The estrogen receptor–positive (ER+) breast cancer (BC), which constitutes the majority of BC cases, exhibits highly heterogeneous clinical behavior. To aid precision treatments, we aimed to find molecular subtypes of ER+ BC representing the tumor microenvironment and prognosis.

METHODS

We analyzed RNA-seq data of 113 patients with BC and classified them according to the PAM50 intrinsic subtypes using gene expression profiles. Among them, we further focused on 44 patients with luminal-type (ER+) BC for subclassification. The Cancer Genome Atlas (TCGA) data of patients with BC were used as a validation data set to verify the new classification. We estimated the immune cell composition using CIBERSORT and further analyzed its association with clinical or molecular parameters.

RESULTS

Principal component analysis clearly divided the patients into two subgroups separately from the luminal A and B classification. The top differentially expressed genes between the subgroups were distinctly characterized by immunoglobulin and B-cell–related genes. We could also cluster a separate cohort of patients with luminal-type BC from TCGA into two subgroups on the basis of the expression of a B-cell–specific gene set, and patients who were predicted to have high B-cell immune activity had better prognoses than other patients.

CONCLUSION

Our transcriptomic approach emphasize a molecular phenotype of B-cell immunity in ER+ BC that may help to predict disease prognosis. Although further researches are required, B-cell immunity for patients with ER+ BC may be helpful for identifying patients who are good responders to chemotherapy or immunotherapy.
Microsurgical Resection of a Lateral Pontine Arteriovenous Malformation Masquerading as a Cavernous Malformation: 2-Dimensional Operative Video
Authors: Graffeo Christopher S. , Scherschinski Lea , Baranoski Jacob F. , Srinivasan Visish M. , Lawton Michael T.
Published: March 2024

Although cavernous malformations (CMs) often demonstrate characteristic T2 heterogeneity and gadolinium enhancement, whereas arteriovenous malformations (AVMs) appear as tangles of T2 hypointense flow voids, small lesions in deep locations may have equivocal features on preoperative imaging.
1-4
This video presents an unusual case of a lateral pontine AVM masquerading as a CM. The patient presented with sudden-onset headache, dizziness, double vision, and left facial numbness. Diagnostic imaging findings suggested a hemorrhagic left lateral pontine mass lesion, most consistent with brainstem CM. Resection through a left extended retrosigmoid craniotomy was recommended. Patient consent was obtained. During dissection, a prominent petrosal vein tributary was noted to be arterialized, which was concerning for AVM. Indocyanine green videoangiography (ICG-VA) was performed to confirm the diagnosis, and the intraoperative plan was dynamically adjusted in accordance with the principles of AVM resection. The small superficial feeding arteries were identified and disconnected, and the nidus was dissected circumferentially with the pial resection technique. After dearterialization, the draining petrosal vein was noted to darken, and repeat ICG-VA confirmed complete occlusion of the AVM without residual shunting. The patient recovered well, with no neurological deficits, and postoperative angiography confirmed complete resection of the Spetzler-Martin grade III AVM. Key learning points for this unusual case include the importance of dynamic interpretation of intraoperative findings, openness to alterations of the surgical plan when integrating new diagnostic information, and the integration of ICG-VA as a critical tool for differentiating CMs and AVMs during microsurgical resection.

Images in Surgical Video © 2024 Barrow Neurological Institute. Used with permission.
Intercollicular Approach for Midbrain Cavernous Malformation: 2-Dimensional Operative Video
Authors: Goto Yukihiro , Inoue Takuro
Published: March 2024

Previously reported midbrain cavernous malformations often exhibit lateral expansion, making their excision through the nearest brain surface incision easier.
1-5
Nevertheless, excising a midbrain cavernous malformation that lacks lateral extension can be particularly challenging because of limited access.
5
The anterior midline approach is typically conducted through the interpeduncular fossa zone.
3,5
Still, it restricts surgical maneuverability because of the presence of the posterior communicating artery, the posterior cerebral artery, and the oculomotor nerve. On the other hand, the posterior midline approach through the intercollicular region, although reported in only a single case, lacks technical details and postoperative neurological status.
3,5
In this report, we elaborate on the feasibility of surgical manipulations for midline-located midbrain cavernous angiomas through the intercollicular region and discuss the resulting postoperative neurological outcomes.
Sex matters in preclinical research
Authors: Justice Monica J.
Published: March 2024

International Women's Day 2024 has a theme of inclusion. As publishers of preclinical research, we aim to show how inclusion of females in research advances scientific rigor and improves treatment reliability. Sexual reproduction is key to all life across the plant and animal kingdoms. Biological sex takes many forms that are morphologically differentiated during development: stamens versus pistils in plants; color and plumage in birds; fallopian tubes versus vas deferens in mammals; and differences in size, for instance, males are smaller in the fruit fly Drosophila melanogaster. Physical differences may be obvious, but many traits may be more obscure, including hormonal, physiological and metabolic factors. These traits have a big influence on disease and responses to treatment. Thus, we call for improved inclusion, analysis and reporting of sex as a biological variable in preclinical animal modeling research.
Mediation, Military, and Money: The Promises and Pitfalls of Outside Interventions to End Armed Conflicts
Authors: Rohner Dominic
Published: March 2024

Wars impose tremendous costs on societies and the question of how to end them is of foremost importance. Several hundred books and scientific articles have been written on peace agreements and third-party interventions. In this article I provide a critical literature survey on what policies foreign countries have at their disposal if they wish to foster peace abroad. Ranging from pure (nonmilitarized) mediation, over a range of military options to economic policies, the promises and pitfalls of these types of interventions are critically assessed in the light of cutting-edge theoretical and empirical literature. A series of take-home messages emerge: (i) establishing a causal effect of mediation has proven difficult; (ii) military peacekeeping operations can play a key role, to the extent that security guarantees, the sharing of political and military power, and trust-building measures are well coordinated; and (iii) money matters—fostering human capital and economic opportunities contributes to fertile ground for lasting peace. (JEL C78, D74, D82, F13, F51, F52)
Publishing Economics: How Slow? Why Slow? Is Slow Productive? How to Fix Slow?
Authors: Hadavand Aboozar , Hamermesh Daniel S. , Wilson Wesley W.
Published: March 2024

Economics publishing proceeds much more slowly than in the natural sciences, and more slowly than in the other social sciences and finance. It is relatively even slower at the extremes. Much of the lag, especially at the extremes, arises from authors’ dilatory behavior in revisions. Additional rounds of resubmissions at top economics journals are related to additional citations; but conditional on resubmission, the delays are unrelated to greater scholarly attention. We offer several proposals for speeding publication, including no-revision policies such as Economic Inquiry’s, the use of “cascading referee reports,” limits on authors’ time revising, and limits on editors waiting for dilatory referees. (JEL A11, B29)
The Unequal Effects of Globalization
Authors: Leamer Ed
Published: March 2024

Ed Leamer of University of California, Los Angeles reviews “The Unequal Effects of Globalization” by Pinelopi Koujianou Goldberg. The Econlit abstract of this book begins: “Assesses the recent evolution of global trade, highlighting its unequal effects between and within countries.”
Comparison of USG guided with Anatomical Landmark guided TAP Block following Total Abdominal Hysterectomy
Authors: GHOSH ANGAN , Ninave Sanjot
Published: March 2024

A crucial part of a multimodal anaesthetic strategy utilized to accelerate recovery following lower abdominal procedures is the Transversus Abdominis Plane (TAP) Block. The TAP Block is administered in the petit triangle, with its base being formed by the iliac crest, the external oblique in front of it, and the latissimus dorsi at its rear. The intercostal, subcostal, iliohypogastric, and ilioinguinal nerves are housed in this interfascial plane. The TAP block reduces pain from the incision site during both inpatient and outpatient surgical procedures, as well as open and laparoscopic abdominal operations, by obstructing sensory signals from the nerves providing the anterior wall of the abdomen (anterior division of the segment of the spinal cord responsible for T6-L1). Postoperative pain can be effectively alleviated with TAP blocks. Through the use of supplementary drugs such as opioids, opioid agonist antagonists, ketamine, and alpha-2 agonists, including Nalbuphine, clonidine, and dexmedetomidine in blockade of peripheral nerves and field blocks, the duration of pain relief following surgery can be extended. Specifically, a combination of 10 mg of Nalbuphine and bupivacaine, on either side with a volume of 20 ml, improves patient comfort and pain management, allows for early patient mobilization, prolongs postsurgical pain relief, and lowers the need for rescue analgesia. This research aims to assess the efficacy of the Anatomical Landmark against Ultrasound-Guided TAP Block for patients undergoing Total Abdominal Hysterectomy under Subarachnoid Block.
On the (Im-)Possibility of Representing Probability Distributions as a Difference of I.I.D. Noise Terms
Authors: Ewerhart Christian , Serena Marco
Published: March 2024

A random variable is difference-form decomposable (DFD) if it may be written as the difference of two i.i.d. random terms. We show that densities of such variables exhibit a remarkable degree of structure. Specifically, a DFD density can be neither approximately uniform, nor quasiconvex, nor strictly concave. On the other hand, a DFD density need, in general, be neither unimodal nor logconcave. Regarding smoothness, we show that a compactly supported DFD density cannot be analytic and will often exhibit a kink even if its components are smooth. The analysis highlights the risks for model consistency resulting from the strategy widely adopted in the economics literature of imposing assumptions directly on a difference of noise terms rather than on its components.
Understanding compassionate leadership
Authors: Thomas Vinice
Published: March 2024

In a culture of compassion and care, the benefits to the individual and the organisation are vast—these include: creating a positive working environment; staff wellbeing; high morale; engaged workforce; and commitment to the organisation. All these factors will ultimately lead to a high quality of care for patients, and a better patient experience and outcomes.

The challenges faced by society and the workforce today heighten our need for compassionate leaders across health and social care. A compassionate leader is an individual who embodies care, kindness, consideration, wisdom and integrity in their treatment of themselves and others.

The article looks at compassionate leadership—its definition, characteristics, and traits. While the benefits are well documented in the literature, this article discusses the challenges that compassionate leaders may encounter and how best to support their development accordingly. The importance of self-awareness and self-care is vital to sustain the energy levels and effectiveness of the compassionate leader.

Compassionate leadership has the ability to make individuals feel supported, valued and dignified. It is the author's view that it is one of the most important leadership styles within 21st century health care.
Elements of care, part 3: communicating
Authors: Peate Ian
Published: March 2024

This article considers communication. Communication is one of the key activities of living in the Roper-Logan-Tierney model (2000) . Effective communication is crucial when offering people care and support, as it assists in understanding the needs and concerns of the patient, building a therapeutic relationship between the patient and support staff, and planning and delivering individualised care. Communication is more than the verbal exchanges that take place, it also includes non-verbal cues, written communication and the appropriate use of silence. When the healthcare assistant and assistant practitioner engage in effective communication, they can create an environment where the patient feels comfortable in expressing how they are feeling, divulging their fears and making known their expectations.
Autism and the HCA, 3: communication and sensory processing
Authors: Barber Chris
Published: March 2024

This series of articles will explore the neurodivergent condition of autism from a range of different perspectives. This third article will explore communication and sensory-processing issues relating to autism.
Decarbonising Road Mobility
Authors: Rodriguez Temoc
Published: March 2024

Why the next generation of propulsion inverters are using wide bandgap semiconductors. By DR. TEMOC RODRIGUEZ
Changing hearts instead of changing minds – another take on climate action
Authors: Pearce BinBin J.
Published: March 2024

This piece elaborates on a ‘new way of thinking’ (Einstein, 1946) that would contribute to overcoming the challenge of climate change and its impacts. This ‘new way’ will have us go beyond using facts and figures alone to persuade and cajole. It will have us stretching our moral imagination (Johnson, 2016) and empathising with people very different from ourselves. It will have us investing in processes of exchange which support the co-creation of knowledge and the future we want together.
Flexible waveband routing node architecture for spatial-division and multi-band optical networks [Invited]
Authors: Hasegawa Hiroshi
Published: March 2024

We propose a network architecture named flexible waveband routing (FWR) that adopts flexible path bundling and bundled path routing. This two-stage routing scheme can be implemented by a combination of small degree wavelength selective switches (WSSs) and optical matrix switches. As the optical-cross-connect (OXC) scale depends on just that of the matrix switches adopted, large-scale OXC nodes are realized by introducing recently developed high-port-count switches. FWR supports spatial division multiplexing efficiently through its introduction of spatially joint switching at WSSs. Multi-band transmission can also be supported by the use of WSSs handling different frequency bands. Numerical simulations and transmission experiments confirm its validity.
Nonparaxial accelerating waves as a superposition of nondiffracting Bessel-lattice optical fields
Authors: Julián-Macías Israel , Martínez-Niconoff Gabriel , Silva-Ortigoza Gilberto , Rickenstorff-Parrao Carolina
Published: March 2024

In the first part of this work, we introduce a monochromatic solution to the scalar wave equation in free space, defined by a superposition of monochromatic nondiffracting half Bessel-lattice optical fields, which is determined by two scalar functions; one is defined on frequency space, and the other is a complete integral to the eikonal equation in free space. We obtain expressions for the geometrical wavefronts, the caustic region, and the Poynting vector. We highlight that this solution is stable under small perturbations because it is characterized by a caustic of the hyperbolic umbilical type. In the second part, we introduce the corresponding solution to the Maxwell equations in free space.
Computational modeling of Chlamydomonas reinhardtii cellular radiation properties with synergistic consideration of complex structures and compositions
Authors: Lin Li , Jiang Miao , Li Xingcan , Yang Jia-Yue
Published: March 2024

The radiation characteristics of microalgae are of great significance for the design of photobioreactors and ocean optical remote sensing. Yet the complex structure of microalgae makes it difficult to theoretically predict its radiation characteristics based on traditional Mie theory. In this work, taking Chlamydomonas reinhardtii as an example, a multi-component cell model with a complex structure is proposed, which considers the organelles and shape of microalgae, and the volume change during the production of Chlamydomonas reinhardtii lipids. The theoretical calculation is carried out using the discrete dipole approximation method, and an improved transmission method is used for experimental measurement. The experimental data are compared and analyzed with the multi-component complex structure model, the homogeneous sphere model and the coated sphere model. The results show that the calculation accuracy of the multi-component complex structure model is higher, the error of the scattering cross-section is reduced by more than 8.6% compared with the homogeneous sphere model and coated sphere model, and the absorption cross-section and the scattering phase function are in good agreement with the experimental results. With the increase of lipids, the absorption cross-section and the scattering phase function vary slightly. However, the scattering cross-section has an observed change with increasing wavelength. In addition, the theoretical calculation error can be reduced when the influence of the culture medium is taken into account.
Transmission Matrix Approach to Turbulence Profiling
Authors: Sorelli Giacomo , Bachmann David , Isoard Mathieu , Shatokhin Vyacheslav , McDonald Douglas , Gladysz Szymon , Treps Nicolas , Buchleitner Andreas
Published: March 2024

We consider transmission-matrix methods for the characterization of the atmosphere. First, we investigate the temporal stability of highly-transmitting modes of instantaneous realizations of atmospheric channels. Then, we discuss the real-time estimation of the transmission matrix.
Factors associated with diabetes knowledge, attitudes and practices among people aged 18 and over in the commune of Niakhene in Senegal
Authors: Diallo Amadou Ibra , Dieng Cheikh Mbacke , Tine Jean Augustin Diegane , Bassoum Oumar , Diongue Fatoumata Binetou , Ba Mouhamadou Faly , Ndiaye Ibrahima , Ndiaye Mbayang , Faye Adama , Seck Ibrahima
Published: March 2024

More than 422 million people worldwide have diabetes in 2016, and 1.6 million deaths are attributed to diabetes each year. Knowledge of preventive measures would enable the adjustment of preventive policies. Hence this study on knowledge and practices in rural Senegal. This was a cross-sectional, descriptive and analytical survey of subjects aged at least 18 and living in the commune of Niakhene, carried out in October 2020. A systematic random sample, stratified by sex and age group, was used. The questionnaire was based on the STEPS 2015 tool and a review of the literature. In addition to personal characteristics, the questionnaire was used to measure knowledge of symptoms, complications, risk factors, attitude to the disease and screening practices. Descriptive and analytical analyses were performed using R 4.0.2 software. A total of 300 subjects were surveyed. The average age was 35.3 years (+/-16.9), and 52.3% were women. Knowledge (62.7%) was associated with higher education (ORaj2.46{1.16–3.44}), awareness by healthcare staff (ORaj2.88{1.60–5.34}), and a family history of diabetes (ORaj3.09{1.06–11.3}). The positive attitude (53%) was associated with male sex (ORaj1.98{2.07–7.52}), awareness via audio-visual information sources (ORaj3.87{2.07–7.52}), community awareness (ORaj 3.87{2.07–7.52}), existence of a family history of hypertension and knowledge of diabetes (ORaj3.34{2.5–7.69}). Screening was carried out in 34.3% of patients. The associated risk factors were male sex (ORaj 1.95{1.12–3.34}), higher education (ORaj2.49{1.12–559}) and positive attitudes to diabetes (ORaj1.83{1.04–3.26}). One of the most effective interventions against this disease is the adoption of preventive measures which involve early detection and strengthening communication for more effective prevention.
Experiences of children’s self-wetting (including urinary incontinence) in Cox’s Bazar’s Rohingya refugee camps, Bangladesh
Authors: Alam Mahbub-Ul , Gupta Sudipta Das , Rosato-Scott Claire , Shoaib Dewan Muhammad , Ritu Asmaul Husna , Nowshin Rifat , Rahat Md Assaduzzaman , Akram Nowshad , Rose Joanne , Evans Barbara E. , Barrington Dani J.
Published: March 2024

Self-wetting is the leakage of urine, either due to the medical condition of urinary incontinence (UI), or because a person does not want to, or cannot, access a toileting facility in time. This study explored the attitudes towards self-wetting and experiences of children (aged five to 11), their caregivers, community leaders and humanitarian practitioners in the Rohingya refugee camps in Cox’s Bazar, Bangladesh. We particularly focused on how water, sanitation and hygiene (WASH) and protection interventions might assist in improving these experiences. We purposively selected participants from two camps where our partner organisation works. We conducted Key Informant Interviews (KIIs) with community leaders and camp officials, Story Book (SB) sessions with Rohingya children and in-depth Interviews (IDIs) with caregivers of children who participated in the SB sessions, as well as surveying communal toilets. Self-wetting by children was common and resulted in them feeling embarrassed, upset and uncomfortable, and frightened to use the toilet at night; many children also indicated that they would be punished by their caregivers for self-wetting. Key informants indicated that caregivers have difficulty handling children’s self-wetting due to a limited amount of clothing, pillows, and blankets, and difficulty cleaning these items. It was evident that the available toilets are often not appropriate and/or accessible for children. Children in the Rohingya camps appear to self-wet due to both the medical condition of UI and because the sanitation facilities are inappropriate. They are teased by their peers and punished by their caregivers. Although WASH and protection practitioners are unable to drastically alter camp conditions or treat UI, the lives of children who self-wet in these camps could likely be improved by increasing awareness on self-wetting to decrease stigma and ease the concerns of caregivers, increasing the number of child-friendly toilets and increasing the provision of continence management materials.
Diagnosis of human brucellosis: Systematic review and meta-analysis
Authors: Freire Mariana Lourenço , Machado de Assis Tália Santana , Silva Sarah Nascimento , Cota Gláucia
Published: March 2024

Background

Brucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking.

Methodology/Principal findings

This systematic review addressed the following question: ‘What is the accuracy of the available tests to confirm human brucellosis?’ Two independent reviewers examined articles published up to January 2023. The review included original studies reporting symptomatic patients with brucellosis suspicion, through any index test, with sensitivity and/or specificity as outcomes. As exclusion criteria were considered: sample size smaller than 10 patients, studies focusing on complicated brucellosis, and those lacking essential information about index or comparator tests. Sensitivity and specificity were assessed, with consideration for the index test, and ‘culture’ and ‘culture and standard tube agglutination test (SAT)’ were used as reference standards. Bias assessment and certainty of evidence were carried out using the QUADAS-2 and GRADE tools, respectively. A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. Regarding the reference test, culture and/or SAT are deemed more appropriate than culture alone. Rose Bengal, IgG/IgM ELISA, and PCR exhibited equally high performances, indicating superior overall diagnostic accuracy, with very low certainty of the evidence.

Conclusions/Significance

This systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.
The impact of COVID-19 workload on psychological distress amongst Canadian intensive care unit healthcare workers during the 1st wave of the COVID-19 pandemic: A longitudinal cohort study
Authors: Pestana Daniel , Moura Kyra , Moura Claire , Mouliakis Taylor , D’Aragon Frédérick , Tsang Jennifer L. Y. , Binnie Alexandra
Published: March 2024

Intensive care unit healthcare workers (ICU HCW) are at risk of mental health disorders during emerging disease outbreaks. Numerous cross-sectional studies have reported psychological distress, anxiety, and depression amongst ICU HCW during the COVID-19 pandemic. However, few studies have followed HCW longitudinally, and none of these have examined the association between COVID-19 workload and mental health. We conducted a longitudinal cohort study of 309 Canadian ICU HCW from April 2020 to August 2020, during the 1st wave of the COVID-19 pandemic. Psychological distress was assessed using the General Health Questionnaire 12-item scale (GHQ-12) at 3 timepoints: during the acceleration phase of the 1st wave (T1), the deceleration phase of the 1st wave (T2), and after the 1st wave had passed (T3). Clinically relevant psychological distress, defined as a GHQ-12 score ≥ 3, was identified in 64.7% of participants at T1, 41.0% at T2, and 34.6% at T3. Psychological distress was not associated with COVID-19 workload at T1. At T2, psychological distress was associated with the number of COVID-19 patients in the ICU (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.00, 1.13) while at T3, when COVID-19 patient numbers were low, it was associated with the number of weekly hospital shifts with COVID-19 exposure (OR: 1.33, 95% CI: 1.09, 1.64). When analyzed longitudinally in a mixed effects model, pandemic timepoint was a stronger predictor of psychological distress (OR: 0.24, 95% CI: 0.15, 0.40 for T2 and OR: 0.16, 95% CI: 0.09, 0.27 for T3) than COVID-19 workload. Participants who showed persistent psychological distress at T3 were compared with those who showed recovery at T3. Persistent psychological distress was associated with a higher number of weekly shifts with COVID-19 exposure (OR: 1.97, 95% CI:1.33, 3.09) but not with a higher number of COVID-19 patients in the ICU (OR: 0.86, 95% CI: 0.76, 0.95). In summary, clinically relevant psychological distress was observed in a majority of ICU HCW during the acceleration phase of the 1st wave of the COVID-19 pandemic but decreased rapidly as the 1st wave progressed. Persistent psychological distress was associated with working more weekly shifts with COVID-19 exposure but not with higher numbers of COVID-19 patients in the ICU. In future emerging disease outbreaks, minimizing shifts with direct disease exposure may help alleviate symptoms for individuals with persistent psychological distress.
An epigenetic change in a moth is generated by temperature and transmitted to many subsequent generations mediated by RNA
Authors: Pavelka Jaroslav , Poláková Simona , Pavelková Věra , Galeta Patrik
Published: March 2024

Epigenetic changes in sexually reproducing animals may be transmitted usually only through a few generations. Here we discovered a case where epigenetic change lasts 40 generations. This epigenetic phenomenon occurs in the short antennae (sa) mutation of the flour moth (Ephestia kuehniella). We demonstrate that is probably determined by a small RNA (e.g., piRNA, miRNA, tsRNA) and transmitted in this way to subsequent generations through the male and female gametes. The observed epigenetic change cancels sa mutation and creates a wild phenotype (a moth that appears to have no mutation). It persists for many generations (40 recorded). This epigenetic transgenerational effect (suppression homozygous mutation for short antennae) in the flour moth is induced by changes during ontogenetic development, such as increased temperature on pupae development, food, different salts in food, or injection of RNA from the sperm of already affected individuals into the eggs. The epigenetic effect may occasionally disappear in some individuals and/or progeny of a pair in the generation chain in which the effect transfers. We consider that the survival of RNA over many generations has adaptive consequences. It is mainly a response to environmental change that is transmitted to offspring via RNA. In this study, we test an interesting epigenetic effect with an unexpected length after 40 generations and test what is its cause. Such transfer of RNA to subsequent generations may have a greater evolutionary significance than previously thought. Based on some analogies, we also discuss of the connection with the SIR2 gene.
Research on the dust-control technology of a double-wall attached-ring air curtain on an excavation face
Authors: Yan Jingxue , Jia Baoshan , Pan Xuerong , Zhang Jinyi , Jia Niujun
Published: March 2024

On the basis of the jet theory of airflow fields and the gas–solid two-phase flow theory, we studied the law of dust migration in a simulated dusting space. We used the control variable method and numerical simulation software to explore the airflow field and dust concentration distribution on the working surface of the dusting under different inlet wind speeds and different attached blades of the double-walled annular air curtain. We determined the speed of the inlet of the annular air curtain to be 30 m/s. When the angle of the attached blade was 30°, the dust concentration of the driver and other workers was controlled below 100 mg/m3, which produced the best dust control effect is the best. Using real data, we built a similar test platform to test the airflow field and dust concentration. Through data measurement and analysis, we proved that a dust control system with a double-wall attached-ring air curtain formed a circulating airflow field that could shield dust and effectively reduce dust concentration in the simulated space. The dust removal efficiency of total dust and exhaled dust reached 98.5% and 97.5%, respectively. We compared the test data and simulation results and concluded that the double-wall attached-ring air curtain could effectively ensure the safety of mine production and provide a better underground working environment for operators.
Investigating capital flight in South Asian countries: The dual influence of terrorism and corruption
Authors: Khan Farina , Abbass Kashif , Qun Wu , Asif Muhammad
Published: March 2024

This specific research initiative aims to intricately examine the intricate dynamics connecting terrorism, corruption, and capital flight within the context of South Asian economies, encompassing countries including Bangladesh, India, Pakistan, and Sri Lanka. The principal objectives of this study entail a comprehensive investigation into the synergistic impacts of terrorism and corruption on the prevalence of capital flight. To realize these objectives, the study employs longitudinal data from 1990 to 2019, adopting the portfolio choice framework as its theoretical underpinning. In terms of methodology, the empirical inquiry uses the Generalized Method of Moments (GMM) estimation technique. The empirical findings derived from this analysis distinctly establish a statistically noteworthy and positive correlation between terrorism, corruption, and the occurrence of capital flight across multiple South Asian nations. In light of these discerning outcomes, it is strongly recommended that the governments of South Asian countries prioritize and actively pursue the fortification of their institutional governance mechanisms. This strategic approach is deemed crucial in efficaciously counteracting the escalation of capital flight. Specifically, a targeted focus on augmenting institutional governance practices, fostering transparency, fortifying anti-corruption measures, and intensifying counterterrorism efforts could collectively contribute to reducing capital flight tendencies. By undertaking these recommendations, South Asian governments can foster an environment of enhanced economic stability, attractiveness for investment, and sustainable growth, thereby deterring the adverse impact of capital flight while concurrently combatting the underlying challenges posed by terrorism and corruption.
Clinical nurse managers’ leadership styles and staff nurses’ work engagement in Saudi Arabia: A cross-sectional study
Authors: Alluhaybi Amal , Usher Kim , Durkin Joanne , Wilson Amanda
Published: March 2024

Background

Effective nurse leadership enhances nurse welfare, improves patient care, and increases organisational success. A lack of adequate, supportive leadership significantly contributes to many nurses leaving the profession. Nurse managers need to prioritise engagement and retention as significant focus areas to address the nursing shortage in Saudi Arabia and accomplish the national program’s objectives.

Aim

To examine the correlation between the leadership styles of clinical nurse managers and staff engagement.

Method

This study used a descriptive, cross-sectional, correlational design. The leadership styles of clinical nurse managers were evaluated using the Multifactor Leadership Questionnaire (MLQ-5X). Work engagement was assessed using the Utrecht Work Engagement Scale (UWES). Questionnaires were distributed to 450 nurses in four public hospitals in western Saudi Arabia. Non-probability convenience sampling was used to collect the data.

Results

A total of 278 nurses from a range of clinical areas participated in the survey, which revealed that the leadership styles of clinical nurse managers positively or negatively impact nurse work engagement. Most clinical nurse managers exhibit transformational leadership, followed by transactional, then passive-avoidant styles. Respondents displayed a high level of work engagement, emphasising the positive impact of transformational and transactional leadership on work engagement outcomes. The findings showed significant differences in leadership styles and work engagement levels between Saudi and non-Saudi nurses across various dimensions.

Conclusion

Understanding the effect of leadership styles employed by nurse managers on work engagement can positively impact staff retention rates and the quality of patient care. Nurse managers should participate in training programs to enhance their practical leadership skills to enhance the work engagement levels of nurses.

Implication

Nurse work engagement can be improved by establishing training programs that promote effective leadership and highlight the significance of various leadership styles and their subsequent impact on nurse work engagement. Nursing students should receive education on leadership styles. Nursing leaders should be given access to mentoring programs and opportunities for career advancement to support the introduction of effective leadership styles.
Understanding uptake of COVID-19 testing, vaccination, and boosters among Spanish-speaking Latines in the United States: Qualitative insights from Spanish speakers and key informants
Authors: Tanner Amanda E. , Hall Mark A. , Aguilar-Palma Sandy K. , Mann-Jackson Lilli , Alonzo Jorge , Bertoni Alain G. , McCoy Thomas P. , Garcia Manuel , Sucaldito Ana D. , Turner Mari Jo , Robles Arvizu Jose , Russell Laurie P. , Rhodes Scott D.
Published: March 2024

Background

Latine communities in the United States have been disproportionately affected by COVID-19. It is critical to gain a better understanding of the sociocultural determinants that challenge and facilitate COVID-19 testing, vaccination, and booster uptake within these vulnerable communities to inform culturally congruent strategies and interventions.

Methods

In summer 2022, our community-based participatory research partnership conducted 30 key informant interviews and 7 focus groups with 64 Spanish-speaking Latine participants in North Carolina. Interviewees consisted of representatives from health and service organizations, most of whom were engaged with direct service to Spanish speakers. Interviews were conducted in either English or Spanish, depending on the preference of the participant; all focus groups were conducted in Spanish. Interviews and focus groups were conducted in person or by videoconference.

Results

Twenty themes emerged that we organize into four domains: general perceptions about COVID-19; barriers to COVID-19 testing, vaccination, and booster uptake; facilitators to COVID-19 testing, vaccination, and booster uptake; and recommendations to promote testing, vaccination, and booster uptake.

Discussion

Results underscore important sociocultural determinants of ongoing COVID-19 testing, vaccination, and booster uptake to consider in developing interventions for Spanish-speaking Latines in the United States. Based on this formative work, our partnership developed Nuestra Comunidad Saludable (Our Healthy Community). We are implementing the intervention to test whether trained peer navigators can increase COVID-19 testing, vaccination, and booster uptake among Spanish-speaking Latines through blending in-person interactions and mHealth (mobile health) strategies using social media.
Analysis of prognosis and background liver disease in non-advanced hepatocellular carcinoma in two decades
Authors: Kaneko Shun , Asahina Yasuhiro , Murakawa Miyako , Azuma Seishin , Inada Kento , Mochida Tomohiro , Watakabe Keiya , Shimizu Taro , Tsuchiya Jun , Miyoshi Masato , Kawai-Kitahata Fukiko , Nitta Sayuri , Takahashi Marie , Fujioka Tomoyuki , Kishino Mitsuhiro , Anzai Tatsuhiko , Kakinuma Sei , Nakagawa Mina , Okamoto Ryuichi
Published: March 2024

Background/Aim

Antiviral hepatitis and systemic therapies for hepatocellular carcinoma (HCC) remarkably progressed in the recent 10 years. This study aimed to reveal the actual transition and changes in the prognosis and background liver disease in non-advanced HCC in the past 20 years.

Methods

This retrospectively recruited 566 patients who were diagnosed with non-advanced HCC from February 2002 to February 2022. The prognosis was analyzed by subdividing according to the diagnosis date (period I: February 2002–April 2009 and period Ⅱ: May 2009–February 2022).

Results

Patients in period II (n = 351) were significantly older, with lower albumin-bilirubin (ALBI) scores and alpha-fetoprotein (AFP) and more anti-viral therapy, systemic therapy, and hepatic arterial infusion chemotherapy as compared with those in period I (n = 215). The etiology ratio of the background liver disease revealed decreased hepatitis C virus from 70.6% to 49.0% and increased non-B, non-C from 17.7% to 39.9% from periods I to Ⅱ. The multivariate analysis revealed older age and higher ALBI score in Barcelona Clinic Liver Cancer (BCLC) 0/A stage, AFP of >20 ng/mL, and higher ALBI score in BCLC B stage as independent prognosis factors. Fine-Gray competing risk model analysis revealed that liver-related deaths significantly decreased in period II as compared to period I, especially for BCLC stage 0/A (HR: 0.656; 95%CI: 0.442–0.972, P = 0.036).

Conclusion

The characteristics of patients with non-advanced HCC have changed over time. Appropriate background liver management led to better liver-related prognoses in BCLC 0/A.
Pain management after tonsil surgery in children and adults—A national survey related to pain outcome measures from the Swedish Quality Register for tonsil surgery
Authors: Roskvist Maria , Alm Fredrik , Nerfeldt Pia , Ericsson Elisabeth
Published: March 2024

Objective

The primary aim of this study was to describe the current practice regarding pain management in relation to tonsil surgery among Ear Nose and Throat (ENT) clinics in Sweden. The secondary aim was to determine the impact of the provider’s regime of rescue analgesics on the pain related Patient Reported Outcome Measures (pain-PROMs) from the Swedish Quality Register for Tonsil Surgery (SQTS).

Materials & methods

A descriptive cross-sectional study originating from a validated web-based questionnaire. The survey enrolled one respondent from each ENT clinic (47/48 participated) nationally. Pain-PROMs from the SQTS, recorded from October 2019 to October 2022, were included (8163 tonsil surgeries).

Results

Paracetamol was used by all enrolled ENT clinics as preemptive analgesia. The addition of COX inhibitors was used in 40% of the clinics. Betamethasone was usually administered, to prevent pain and nausea (92%). All clinics gave postdischarge instructions on multimodal analgesia with COX inhibitors and paracetamol. Rescue analgesics were prescribed after tonsillectomy for 77% of adults, 62% of older children, 43% of young children and less often after tonsillotomy. The most frequently prescribed rescue analgesic was clonidine in children (55%) and oxycodone in adults (72%).

A high proportion of patients reported contact with health care services due to postoperative pain (pain-PROMs/ SQTS). Tonsillectomy procedures were associated with the highest rates of contacts (children/adolescents 13–15%; adults 26%), while tonsillotomy were associated with lower rates, (5–7% of children/adolescents). There was no significant difference in the frequency of health care contacts due to pain regarding whether clinics routinely prescribed rescue analgesics or not after tonsillectomy.

Conclusion

The Swedish analgesic regimen after tonsil surgery is good overall. Nevertheless, there is a need for increased awareness and knowledge to achieve optimal patient recovery. Pain-PROM data demonstrate the call for improvement in pain management after tonsil surgery.