bluuebunny/crossref_metadata_2025 huggingface dataset:
A literature review on political uncertainty and stock market behaviour
Authors: Sharma Sugandha , Bangur Peeyush
Published: May 2023

The political event-related literature has been growing over the past decades, generating a continuous stream of research and journal publications. This article aims to systematically review the impact of the political events on stock market literature to outline its current state, trends, gaps, and discrepancies. To this end, 111 political events-related articles published in 68 finance, economic and political journals were extracted. The retrieved pieces of literature were thoroughly examined using a comprehensive classification framework that emphasized broadly conceptual, theoretical, and methodological aspects. Finally, building on this literature, the paper proposes an extensive research agenda to help move the political event literature forward.
Exploring Factors Affecting Consumer’s Impulse Buying Behavior in Live-Streaming Shopping: An Interactive Research Based Upon SOR Model
Authors: Huo Chunhui , Wang Xiaorui , Sadiq Muhammad Waqas , Pang Ming
Published: May 2023

The emergence of live-streaming commerce has fueled the phenomena of impulse buying. However, existing understanding of this phenomenon is relatively limited. In this study, we adopted the stimulus-organism-response (SOR) paradigm to create an influence mechanism of impulse buying behavior in live streaming shopping. We investigated the influence of social presence and sales promotion (stimuli) on impulse buying behavior (response) through flow experience (organism). In addition, we also examined time availability and money availability, two situational variables, as moderators of flow experience and impulse buying behavior. To explore the factors that contribute to consumers’ impulse buying behavior, an online survey ( n = 375) was done in China. The empirical findings indicate that social presence and sales promotion positively affect flow experience, subsequently triggering consumers’ impulse buying behavior in live streaming. The results also indicated the positive moderation of money availability and time availability. Theoretically, the findings contribute to live- streaming commerce literature and impulse-buying literature. The findings also provide insightful managerial implications for live-streaming merchants to better understand impulse buying behavior to develop an effective marketing strategy.
Agroecology and Agrarian Transitions: Current Debate in India
Authors: Abrol Dinesh
Published: May 2023

The article critically evaluates the attempt by the Modi government to promote the model of zero-budget natural farming (ZBNF) as an alternate path to agrarian development in India. It is well apparent from the analysis of the National Mission on Natural Farming (NMNF) guidelines that the advocates of natural farming have chosen to turn a blind eye to the constraints of Indian agrarian structures in the shift away from selective delinking for food security to global integration, with landlord capitalists and corporate capital in control of the path formation. The cheap nature and cheap labor outlook is built in the input correction emphasis of natural farming and in the assumption of “zero budgets” for the farmer and the government. The ZBNF model will prevent the NMNF from tackling the landscape, structural, and system-level challenges of agrarian transformation. Significant barriers to the adoption of agroecological approaches can be expected to arise due to the lack of commitment to help the peasants and landless proletariat with the protection of the commons and the public investment needed for the promotion of agroecological approaches.
An Empirical Analysis of the Dimension of Loyalty to Determine Customer Retention for E-Commerce
Authors: Dwivedi Sunita
Published: May 2023

COVID-19 has fostered the growth and transformation of digital media in every aspect, importantly in the area of electronic commerce. During these days, many new practices inhabiting in human behaviour bring new norms for the marketers. Use of online shopping has increased incrementally due to the government advisory, changing consumer buying behaviour as well. An amalgamation of the old and new medium of selling goods and services are now bringing new business challenges post pandemic for the marketer, and customer retention is one of them. Henceforth, there is a dearth of studies addressing the impact of dimension of loyalty (behaviour/ attitude) on customer retention in online shopping platforms post pandemic. This study considers post pandemic as the context of research to determine the impact of behavioural and attitudinal loyalty on customer retention for the online shopping platforms. Further research also aims to determine whether the brand image plays a critical role in mediating the relationship between dimensions (Behavioural/ Attitudinal) of loyalty and customer retention for online shopping platforms or not? In the research, primary data represent the respondent from Delhi NCR. The author applied linear regression to validate the research idea. The findings indicate that attitudinal loyalty significantly enforces customer retention over behavioural loyalty. Also, brand image mediates the impact of attitudinal loyalty on retention.
Does Economic Basis of Reservation Weaken Constitutionalism in India?
Authors: Sethuraman Venkatanarayanan
Published: May 2023

Reservations and affirmative action are significant Constitutional intervention in India to compensate the historical injustices based on discriminatory caste system. The independent India saw various challenges to these policies and has further strengthened the foundations of them. But the recent judgement in upholding the reservation for economically weaker sections has challenged some of the founding principles of social justice in India, by moving away from compensatory discrimination basis of our reservation policy. This article explains the foundations of reservations in India and questions the Constitutional validity of the recent judgement in upholding reservation based solely on economic criteria.
Risk for Surgical Team Hearing Loss With Vitrectomy
Authors: Ruparelia Sunil , Orr Samantha , Choudhry Netan , Wong Robert W. , Smith Corey A. , Taylor S. Mark , Gupta R. Rishi
Published: May 2023

Purpose: To assess sound-level exposure during vitrectomy using 3 of the most common commercially available machines. Methods: This noninterventional cross-sectional study examined sound emission from the Constellation, Stellaris, and EVA vitrector systems. For each machine, a noise dosimeter was used to measure the sound-level exposure of the surgeon during 3 surgical cases in which vitrectomy was performed. Sound levels associated with progressively increasing cut rates and vacuum pressures were also measured. Finally, sound measurements were taken during the use of various additional functions of each machine, including diathermy, laser, and extrusion. Sound levels were compared with occupational health guidelines in Canada and the United States. Results: The maximum sound level recorded during vitrectomy surgery was 88.2 dBA. The mean sound level during vitrectomy surgical cases ranged from 58.5 to 66.8 dBA. A strong positive linear correlation was found between the cut rate and sound level ( r = 0.88-0.98) and the vacuum pressure and sound level ( r = 0.83-0.97). This relationship was consistent across the 3 vitrector systems ( P < .001). Conclusions: Noise exposure during vitrectomy procedures was acceptable but may be sufficient for surgical team activity interference, as described by World Health Organization recommendations. A strong correlation was found between the cut rate and noise exposure. If cut rates continue to increase, attention should be given to ensure that the resulting noise exposure does not threaten the hearing of vitreoretinal surgeons and the operating room staff.
Arts Engagement as a Health Behavior: An Opportunity to Address Mental Health Inequities
Authors: Rodriguez Alexandra K. , Akram Seher , Colverson Aaron J. , Hack George , Golden Tasha L. , Sonke Jill
Published: May 2023

The significance of mental health inequities globally is illustrated by higher rates of anxiety and depression amongst racial and ethnic minority populations as well as individuals of lower socioeconomic status. The COVID-19 pandemic has further exacerbated these pre-existing mental health inequities. With rising mental health concerns, arts engagement offers an accessible, equitable opportunity to combat mental health inequities and impact upstream determinants of health. As the field of public health continues to shift its focus toward social ecological strategies, the social ecological model of health offers an approach that prioritizes social and structural determinants of health. To capture the impacts of arts engagement, this paper creates an applied social ecological model of health while aiming to advocate that engaging in the arts is a protective and rehabilitative behavior for mental health.
Phenotype overlap in the natural history of asthma
Authors: Ricciardolo Fabio L.M. , Guida Giuseppe , Bertolini Francesca , Di Stefano Antonino , Carriero Vitina
Published: May 2023

The heterogeneity of asthma makes it challenging to unravel the pathophysiologic mechanisms of the disease. Despite the wealth of research identifying diverse phenotypes, many gaps still remain in our knowledge of the disease's complexity. A crucial aspect is the impact of airborne factors over a lifetime, which often results in a complex overlap of phenotypes associated with type 2 (T2), non-T2 and mixed inflammation. Evidence now shows overlaps between the phenotypes associated with T2, non-T2 and mixed T2/non-T2 inflammation. These interconnections could be induced by different determinants such as recurrent infections, environmental factors, T-helper plasticity and comorbidities, collectively resulting in a complex network of distinct pathways generally considered as mutually exclusive. In this scenario, we need to abandon the concept of asthma as a disease characterised by distinct traits grouped into static segregated categories. It is now evident that there are multiple interplays between the various physiologic, cellular and molecular features of asthma, and the overlap of phenotypes cannot be ignored.
RNA-seq analysis to identify genes related to resting egg production of panarctic Daphnia pulex
Authors: Maruoka Natsumi , Makino Takashi , Urabe Jotaro
Published: May 2023

Background

The genus Daphnia switches its reproductive mode from subitaneous egg production to resting egg production in response to environmental stimuli. Although this life history trait is essential for surviving unsuitable environments, the molecular mechanism of resting egg production is little understood. In this study, we examined genes related to induction of resting egg production using two genotypes of panarctic Daphnia pulex, the JPN1 and JPN2 lineages, which differ genetically in the frequency of resting egg production. We reared these genotypes under high and low food levels. At the high food level, individuals of both genotypes continually produced subitaneous eggs, whereas at the low food level, only the JPN2 genotype produced resting eggs. Then, we performed RNA-seq analysis on specimens of three instars, including before and after egg production.

Results

These results showed that expressed genes differed significantly between individuals grown under high and low food levels and among individuals of different instars and genotypes. Among these differentially expressed genes (DEGs), we found 16 that changed expression level before resting egg production. Some of these genes showed high-level expression only before resting egg production and one gene was an ortholog of bubblegum (bgm), which is reportedly up-regulated before diapause in bumblebees. According to gene ontology (GO) enrichment analysis, one GO term annotated as long-chain fatty acid biosynthetic process was enriched among these 16 genes. In addition, GO terms related to glycometabolism were enriched among down-regulated genes of individuals holding resting eggs, compared to those before resting egg production.

Conclusions

We found candidate genes highly expressed only before resting egg production. Although functions of candidate genes found in this study have not been reported previously in Daphnia, catabolism of long-chain fatty acids and metabolism of glycerates are related to diapause in other organisms. Thus, it is highly probable that candidate genes identified in this study are related to the molecular mechanism regulating resting egg production in Daphnia.
Comparison between central and automated peripheral blood pressure measurement for early detection of kidney dysfunction in hypertensive patients
Authors: Abdel-Galeel Ahmed , Fawzy Nader N. , Ali Wageeh A. , Fouad Doaa A.
Published: May 2023

Background

There is a close relationship between blood pressure levels and the risk of cardiovascular events, strokes, and kidney disease. For many years, the gold standard instrument for blood pressure measurement was a mercury sphygmomanometer and a stethoscope, but this century-old technique of Riva-Rocci/Korotkov is being progressively removed from clinical practice. Central blood pressure is considered better than peripheral blood pressure in predicting cardiovascular events, as it assesses wave reflections and viscoelastic properties of the arterial wall which make systolic and pulse pressures vary from central to peripheral arteries, but mean blood pressure is constant in the conduit arteries.

Methods

The study included 201 patients with primary hypertension (108 patients with chronic kidney disease and 93 patients without kidney disease). All patients underwent blood pressure measurement by OMRON M2 and Mobil-O-Graph devices, kidney function assessment and abdominal ultrasonography.

Results

Patients with chronic kidney disease were significantly older (60.02 ± 9.1 vs. 55.33 ± 8.5; P < 0.001), with longer duration of hypertension (7.56 ± 5.9 vs. 6.05 ± 5.8; P = 0.020) in comparison to those without chronic kidney disease. Automated peripheral measurement of systolic blood pressure, diastolic blood pressure and pulse pressure were significantly higher in comparison to central blood pressure. Patients with chronic kidney disease had significantly higher augmentation index (24.06 ± 12.6 vs. 19.02 ± 10.8; P < 0.001) and pulsed wave velocity (8.66 ± 1.5 vs. 8.69 ± 6.8; P = 0.004) in comparison to those without chronic kidney disease. Augmentation index had positive correlation with pulse wave velocity (r = 0.183, P = 0.005). There was negative correlation between both pulse wave velocity and augmentation index and estimated glomerular filtration rate (r = -0.318, P < 0.001), and (r = -0.236, P < 0.001), respectively. Hence, arterial stiffness parameters are good positive test for prediction of chronic kidney disease.

Conclusion

There is a strong agreement between non-invasive centrally and automated peripherally measured blood pressure in diagnosis of hypertension. But non-invasive central measurements are preferred over automated measurements for early prediction and detection of renal impairment.
Sucrosomial® iron effectiveness in recovering from mild and moderate iron-deficiency anemia in the postpartum period
Authors: Antoine Edu , Mehedintu Claudia , Mitran Mihai , Diculescu Doru
Published: May 2023

Background

Postpartum iron deficiency anemia (PPIDA) is highly prevalent in developing countries where it constitutes an important cause of maternal morbidity and mortality. Potential determinants of PPIDA are prepartum iron deficiency or iron deficiency anemia in association with severe blood loss during delivery. We investigated the efficacy of oral Sucrosomial® iron for recover from mild-to-moderate PPIDA.

Methods

This pilot study was conducted in three medical centers in Romania.

Adult women (≥ 18y) with mild (hemoglobin [Hb] 9–11 g/dL) or moderate (Hb 7–9 g/dL) PPIDA diagnosed at screening (2–24 h after delivery) were eligible.

Women with mild PPIDA received oral Sucrosomial® iron (Pharmanutra, S.p.A, Italy) once daily (30 mg elemental iron per capsule) for 60 days. Those with moderate PPIDA received oral Sucrosomial® iron twice daily (60 mg elemental iron) for 10 days, followed by a 50-day course of oral Sucrosomial® iron once daily (30 mg elemental iron). Laboratory parameters, as well as subjective clinical symptoms using a 3-point Likert Scale, were assessed at baseline and on study days 10, 30 and 60.

Results

Sixty anemic women entered the study, but three were missed during follow-up. At day 60, a Hb rise was observed in both groups (+ 3.6 ± 1.5 g/dL; p < 0.01), 81% experienced correction of anemia (Hb ≥ 12 g/dL), 36% achieved a ferritin concentration ≥ 30 ng/mL (p < 0.05), and 54% a transferrin saturation (TSAT) ≥ 20% (p < 0.01). For women still anemic at day 60, mean Hb was close to normality (11.3 ± 0.8 g/dL). Resolution of IDA-associated clinical symptoms was already observed just 10 days after treatment initiation. No patient discontinued treatment due to gastrointestinal adverse events.

Conclusions

Sucrosomial® iron was shown to be potentially effective and well tolerated at treating mild and moderate PPIDA. These results encourage the use of oral Sucrosomial® iron as a treatment option for PPIDA, but larger studies with longer follow-up are warrant.
A randomized trial to evaluate the effects of a supervised exercise program on insomnia in patients with non-metastatic breast cancer undergoing chemotherapy: design of the FATSOMCAN study
Authors: Drozd Chloé , Curtit Elsa , Jacquinot Quentin , Marquine Charlène , Mansi Laura , Chaigneau Loïc , Dobi Erion , Viot Julien , Meynard Guillaume , Paillard Marie-Justine , Goujon Morgan , Roux Pauline , Vernerey Dewi , Gillet Valérie , Bourdin Hubert , Galli Silvio , Meneveau Nathalie , Mougin Fabienne
Published: May 2023

Background

Up to 70% of breast cancer patients report symptoms of insomnia during and after treatment. Despite the ubiquity of insomnia symptoms, they are under-screened, under-diagnosed and poorly managed in breast cancer patients. Sleep medications treat symptoms but are ineffective to cure insomnia. Other approaches such as cognitive behavioral therapy for insomnia, relaxation through yoga and mindfulness are often not available for patients and are complex to implement. An aerobic exercise program could be a promising treatment and a feasible option for insomnia management in breast cancer patients, but few studies have investigated the effects of such a program on insomnia.

Methods

This multicenter, randomized clinical trial evaluate the effectiveness of a moderate to high intensity physical activity program (45 min, 3 times per week), lasting 12 weeks, in minimizing insomnia, sleep disturbances, anxiety/depression, fatigue, and pain, and in enhancing cardiorespiratory fitness. Patients with breast cancer be recruited from six hospitals in France and randomly allocated to either the “training” or the “control” group. Baseline assessments include questionnaires [Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index questionnaire (PSQI), Hospital Anxiety Depression Scale (HADS), Epworth Sleepiness Scale (ESS)], home polysomnography (PSG), and 7-day actigraphy coupled with completion of a sleep diary. Assessments are repeated at the end of training program and at six-month follow-up.

Discussion

This clinical trial will provide additional evidence regarding the effectiveness of physical exercise in minimizing insomnia during and after chemotherapy. If shown to be effective, exercise intervention programs will be welcome addition to the standard program of care offered to patients with breast cancer receiving chemotherapy.

Trial registration

: National Clinical Trials Number (NCT04867096).
Spontaneous regression of secondary vitreoretinal lymphoma after diagnostic vitrectomy: case report
Authors: Gan Linyang , Ye Junjie
Published: May 2023

Purpose

Our purpose is to report a patient with secondary intraocular mucosa-associated lymphoid tissue (MALT) who experienced spontaneous regression after diagnostic vitrectomy.

Methods

We retrospectively reviewed the clinical and imaging features of the case. Multimodal imaging, including fundus photograph, optical coherence tomography, fundus fluorescein angiography and ultrasound scan was presented.

Results

A 71-year-old female presented with a subretinal lesion temporal to macula and scattered multifocal creamy lesions deep to retina in her left eye. Optical coherence tomography of the left eye showed multifocal nodular hyper-reflective signals between the Bruch’s membrane and RPE. She had a history of gastric MALT lymphoma. Diagnostic vitrectomy was performed. IL-10 level of aqueous was 187.7pg/ml. Cytology, gene rearrangement and flow cytometry of the vitreous were inconclusive. Systemic evaluation was normal. Secondary vitreoretinal MALT lymphoma was considered. Interestingly, her subretinal lesions regressed gradually without any chemotherapy. And IL-10 level of aqueous declined to 64.3pg/ml.

Conclusions

Secondary vitreoretinal MALT lymphoma is extremely rare. Spontaneous regression of intraocular lymphoma does occur.
Asymmetric presentation with a novel RP2 gene mutation in X-Linked retinitis pigmentosa: a case report
Authors: Lee Hyun Woo , Lee Eun Kyoung
Published: May 2023

Background

We present the detailed multimodal imaging analysis in a case of X-linked retinitis pigmentosa (XLRP) exhibiting a markedly asymmetric presentation with a novel RP2 mutation.

Case presentation

A 25-year-old woman complained of decreased vision in the right eye as well as night blindness. Her visual acuity was 20/100 (OD) and 20/20 (OS). Fundus examination revealed bone spicule pigmentation with tessellated changes in the fundus within the posterior pole. Optical coherence tomography (OCT) showed generalized disruption of foveal microstructures in the OD. No abnormal findings were identified, but localized ellipsoid zone band losses were observed on OCT in the OS. Fundus autofluorescence revealed multiple patchy hypo-autofluorescent lesions in the OD and a tapetal-like radial reflex against a dark background in the OS. Fluorescein angiography and OCT angiography revealed diffuse mottled hyperfluorescence with reduced retinal vessel density in the OD and no evidence of vascular compromise in the OS. Goldmann perimetry demonstrated a constricted visual field, and electrophysiological assessment revealed an extinguished rod response and a severely impaired cone response in the OD. Molecular genetic tests via next-generation sequencing revealed the pathogenic variant to be a heterozygous frameshift mutation in RP2 (RP2, p.Glu269Glyfs*7), resulting in premature termination of the protein.

Conclusions

Random X-inactivation may be attributed to interocular differences in the severity of XLRP in female carriers. A novel frameshift mutation in the RP2 gene and a comprehensive phenotypic evaluation in the current study may broaden the spectrum of the disease in XLRP carriers.
Systematic orientation of fresh rectal suction biopsies improves histopathological diagnostics in hirschsprung’s disease – a method description and preliminary report
Authors: Fransson Emma , Gottberg Emilia , Mitev Rodrigo Munoz , Gisselsson David , Hagelsteen Kristine , Tofft Louise , Stenström Pernilla , Granéli Christina
Published: May 2023

Background

Optimizing rectal suction biopsy (RSB) diagnostics in Hirschsprung’s disease (HD) may shorten diagnostic time and prevent need for repeated biopsies.

Aim

To explore whether systematic orientation of fresh RSB specimens increased biopsy quality, diagnostic times, diagnostic efficacy, and histopathologic workload, and to explore these outcome measures for aganglionic specimens.

Materials/Methods

This was an observational case-control study conducted at a national referral center for HD on data collected from the local HD-diagnostic register. From 2019 each fresh RSB was oriented by the collector in a notch in a foam cushion, placed in a separate cassette, and sent in formalin for pathological analysis. Outcome measures of oriented RSB samples collected 2019–2021 were compared to those of non-oriented RSB samples collected 2015–2018. Staining/immunohistochemistry consisted of hematoxylin eosin, S-100 and calretinin.

Results

78 children with 81 RSBs and 242 biopsy analyzes were included. The frequency of high-quality RSB specimens was higher in oriented: 40% (42/106) versus non-oriented 25% (34/136) (p = 0.018), the diagnostic turnaround time was shorter: 2 days (1–5) versus 3 days (2–8) (p = 0.015), and the number of additional sectioning/leveling/re-orientation per biopsy was lower: 7 (3–26) versus 16 (7–72) (p = 0.011). Specifically for aganglionic specimens, the frequency of high-quality biopsies was generally higher in oriented than in non-oriented RSB specimens: 47% (28/59) versus 14% (7/50) (p < 0.001); the diagnostic efficacy was higher 95% (19/20) versus 60% (9/15) (p = 0.027) and the diagnostic turnaround time shorter: 2 days (2–3) versus 3 days (2–8) (p = 0.036).

Conclusions

Systematic orientation of fresh RSB specimens improves HD diagnostics. Improvement was consistent in aganglionic specimens.
Construct validity of the Mini-BESTest in individuals with chronic pain in specialized pain care
Authors: Wagner Sofia , Bring Annika , Åsenlöf Pernilla
Published: May 2023

Background

Balance assessment scales are important clinical tests to identify balance impairments. Chronic pain (> 3 months) is associated with impaired dynamic balance; however, very few balance assessment scales are psychometrically evaluated for the population. The purpose of this study was to evaluate the construct validity and internal consistency of the Mini-BESTest for individuals with chronic pain in specialized pain care.

Methods

In this cross-sectional study, 180 individuals with chronic pain (> 3 months) were assessed with the Mini-BESTest and included in the analyses. For construct validity, five alternative factor structures were evaluated using a confirmatory factor analysis. In addition, we tested the a priori hypotheses about convergent validity with the 10-meter walk test, and divergent validity with the Brief Pain Inventory (BPI): pain intensity, the Tampa Scale of Kinesiophobia-11 (TSK-11), and the Pain Catastrophizing Scale (PCS-SW). Internal consistency was evaluated for the model with the best fit.

Results

A one-factor model with added covariance via the modification indices showed adequate fit indices. In line with our hypotheses, Mini-BESTest showed convergent validity (rs = > 0.70) with the 10-meter walk test, and divergent validity (rs = < 0.50) with BPI pain intensity, TSK-11, and PCS-SW. Internal consistency for the one-factor model was good (α = 0.92).

Conclusions

Our study supported the construct validity and internal consistency of the Mini-BESTest for measuring balance in individuals with chronic pain, who were referred to specialized pain care. The one-factor model showed an adequate fit. In comparison, models with subscales did not reach convergence, or showed high correlations between subscales, implying that Mini-BESTest is measuring one construct in this sample. We, therefore, propose using the total score, instead of subscale scores, for individuals with chronic pain. However, further studies are necessary to establish the reliability of the Mini-BESTest in the population.
Identification of critical quality factors and critical satisfaction gaps in emergency training courses for new nurses by the multi-criteria network structure model
Authors: Hu Wei-Ling , Chuang Yen-Ching , Jiesisibieke Zhu Liduzi , Tung Tao-Hsin
Published: May 2023

Objective

To identify critical quality factors and critical satisfaction gaps in emergency training courses for new nurses through a systematic decision-making model.

Methods

Firstly, the service quality (SERVQUAL) was used in the evaluation index system of this study. Then, the decision-making trial and evaluation laboratory (DEMATEL) method was used to analyze the relationship structure and the corresponding weights between the indicators. Finally, the importance-performance analysis (IPA) method was used to identify the categories of all indicators and the corresponding strategic directions. Fifteen new nurses in Taizhou Hospital of Zhejiang Province were selected as participants in this study.

Results

The IPA results showed that “(C13),” “(C22),” “(C52),” “(C53),” “(C54),” “(C55),” “(C56),”and “(C57)” are critical satisfaction gaps. From the results of influence network and weight, empathy (C5) was the critical quality factor of the entire training course. The influence network relationship structure and weight had a 98.1% significant confidence level, indicating good stability.

Conclusion

Teachers’ empathy is key to the learning outcomes of new nurses in emergency nursing training courses. Hence, teachers should be attentive to the empathetic quality of their teaching methods to help new nurses gain knowledge and experience in emergency care, especially when they come from different professions and departments.
Understanding caregiver burden with accessing sickle cell care in the Midwest and their perspective on telemedicine
Authors: Jacob Seethal A. , Bouck Jillian , Daas Roua , Jackson Meghan Drayton , LaMotte Julia E. , Carroll Aaron E.
Published: May 2023

Background

Survival for children with sickle cell disease (SCD) has improved significantly. However, patients with SCD still encounter several impediments to accessing adequate healthcare. Rural and medically underserved areas, such as parts of the Midwest, can exacerbate these barriers, separating children with SCD from subspecialists even further. Telemedicine has been a means to close these gaps in care for children with other special healthcare needs, but few studies have discussed how caregivers of children with SCD perceive its use.

Methods

The objective of this study is to understand the experiences of caregivers of pediatric SCD patients in a geographically diverse area in the Midwest in accessing care, and their perspectives of telemedicine. Caregivers of children with SCD completed an 88-item survey via a secured REDCap link either in-person or via secure text. Descriptive statistics (means, medians, ranges, frequencies) were performed for all responses. Univariate chi square tests were performed to analyze associations, particularly with telemedicine responses.

Results

The survey was completed by 101 caregivers. Nearly 20% of families traveled more than 1 hour to reach the comprehensive SCD center. Other than their SCD provider, caregivers reported their child having at least 2 other healthcare providers. Most barriers caregivers identified were financial or resource based. Almost a quarter of caregivers expressed feeling as though these barriers impacted their and/or their child’s mental health. Ease of access to team members, as well as scheduling, were common facilitators of care cited by caregivers. The majority were willing to participate in telemedicine visits, regardless of how far they lived from the SCD center, though many noted aspects requiring adaptation.

Conclusion

This cross-sectional study describes barriers to care experienced by caregivers of children with SCD, regardless of proximity to an SCD center, as well as caregiver perceptions of the usefulness and acceptability of telemedicine for SCD care.
Effects of care of multimorbid patients in general practices by advanced practice nurses (FAMOUS): study protocol for a nonrandomized controlled trial
Authors: Stemmer Renate , Büchler Britta , Büttner Matthias , Dera-Ströhm Christina , Klein Joachim , Gianicolo Emilio
Published: May 2023

Background

Multimorbidity is a common phenomenon among patients treated in general practices. Key challenges within this group include functional difficulties, polypharmacy, treatment burden, fragmentation of care, reduced quality of life and increased health care utilization. These problems cannot be solved in the short consultation time of a general practitioner (GP) since there is an increasing shortage of GPs. In many countries, advanced practice nurses (APNs) are successfully integrated into primary health care for multimorbid patients.

The objective of this study is to examine whether the integration of APNs in the primary care of multimorbid patients in Germany leads to optimized care of the target group and to a reduction in the workload of the GPs.

Methods

The intervention includes the integration of APNs into the care for multimorbid patients in general practice for twelve months. Qualifications for APNs include a master's level academic degree and 500 hours of project-specific training. Their tasks include in-depth assessment, preparation, implementation, monitoring and evaluation of a person-centred and evidence-based care plan.

In this nonrandomized controlled trial, a prospective multicentre mixed methods study will be performed. The main inclusion criterion was the cooccurrence of three chronic diseases. For data collection in the intervention group (n = 817), routine data from health insurance companies and association of statutory health insurance physicians (ASHIP) will be used, as well as qualitative interviews. In addition, the intervention will be assessed through documentation of the care process and standardized questionnaires using a longitudinal design. The control group (n = 1634) will receive standard care. For the evaluation, routine data from health insurance companies are matched at a ratio of 1:2.

Outcomes will be measured using emergency contacts and GP visits, treatment costs, health status of the patients and the satisfaction of parties involved.

The statistical analyses will include Poisson regression to compare outcomes between the intervention and control groups. Descriptive and analytical statistical methods will be used in the longitudinal analysis of the intervention group data. Cost analysis will compare total costs and subgroup costs between the intervention and control groups. Qualitative data will be analysed using content analysis.

Discussion

Challenges to this protocol could include the political and strategic environment as well as the planned number of participants.

Trial registration

DRKS00026172 on DRKS.
Alterations in the microenvironment and the effects produced of TRPV5 in osteoporosis
Authors: Luo Zhi-heng , Ma Jian-xiong , Zhang Wei , Tian Ai-xian , Gong Shu-wei , Li Yan , Lai Yu-xiao , Ma Xin-long
Published: May 2023

The pathogenesis of osteoporosis involves multiple factors, among which alterations in the bone microenvironment play a crucial role in disrupting normal bone metabolic balance. Transient receptor potential vanilloid 5 (TRPV5), a member of the TRPV family, is an essential determinant of the bone microenvironment, acting at multiple levels to influence its properties. TRPV5 exerts a pivotal influence on bone through the regulation of calcium reabsorption and transportation while also responding to steroid hormones and agonists. Although the metabolic consequences of osteoporosis, such as loss of bone calcium, reduced mineralization capacity, and active osteoclasts, have received significant attention, this review focuses on the changes in the osteoporotic microenvironment and the specific effects of TRPV5 at various levels.
Pulmonary adenoid cystic carcinoma: molecular characteristics and literature review
Authors: Chen Zhixin , Jiang Jiapeng , Fan Ying , Lu Hongyang
Published: May 2023

Background

Pulmonary adenoid cystic carcinoma (PACC) is an exceptionally rare salivary gland-type malignant neoplasm. Because of its clinical manifestations, imaging features are not different from other types of non-small cell lung cancer, which is a diagnostic challenge for most doctors.

Conclusions

A review of the literature shows that high amounts of immunohistochemical (IHC) markers, such as CK7, CD117, P63, SMA, CK5/6, and S-100 are helpful for PACC diagnosis. Surgical resection is the main treatment of PACC, but treatment options for advanced PACC patients are limited and the research of molecular targeted drugs is ongoing in advanced cases not eligible for surgery. Currently, research on PACC targeted therapy mainly focuses on the exploration of v-myb avian myeloblastosis virus oncogene homolog (MYB) and its downstream target genes. In addition, median tumor mutation burden and PD-1/PD-L1 were lower in PACC, which may indicate poor efficacy of immunotherapy in PACC patients. This review focuses on the pathologic features, molecular characteristics, diagnosis, treatment and prognosis of PACC to establish a comprehensive understanding of PACC.
Optimization of in-brace corrective force in adolescents with Lenke type 5 curve using finite element model
Authors: Li Kepeng , Wu Jincheng , Yang Dongmei , Xu Hanpeng , Wen Wangqiang , Xu Haoxiang , Ma Guoju , Han Ye
Published: May 2023

Background

Pelvic parameters have been taken into consideration for the evaluation of the outcomes of bracing in AIS. To discuss the stress required to correct the pelvic deformity related to Lenke5 adolescent idiopathic scoliosis (AIS) by finite element analysis, and provide a reference for the shaping of the pelvic region of the brace.

Methods

An three-dimensional (3D) corrective force on the pelvic area was defined. Computed tomography images were used to reconstruct a 3D model of Lenke5 AIS. Computer-aided engineering software Abaqus was used to implement finite element analysis. By adjusting the magnitude and position of corrective forces, coronal pelvic coronal plane rotation (PCPR) and Cobb angle (CA) of lumbar curve in the coronal plane, horizontal pelvic axial plane rotation, and apical vertebra rotation (AVR) were minimized to achieve the best effect on the spine and pelvic deformity correction. The proposed corrective conditions were divided into three groups: (1) forces applied on X-axis; (2) forces applied both in the X- and Y-axis; and (3) forces applied along the X-, Y-, and Z-axis at the same time.

Results

In three groups, CA correction reduced by 31.5%, 42.5%, and 59.8%, and the PCPR changed to 12°, 13°, and 1° from 6.5°, respectively. The best groups of correction forces should simultaneously locate on the sagittal, transverse, and coronal planes of the pelvis.

Conclusions

For Lenke5 AIS, 3D correction forces can sufficiently reduce scoliosis and pelvic asymmetrical state. Force applied along the Z-axis is vital to correct the pelvic coronal pelvic tilt associated with Lenke5 AIS.
RabbitTClust: enabling fast clustering analysis of millions of bacteria genomes with MinHash sketches
Authors: Xu Xiaoming , Yin Zekun , Yan Lifeng , Zhang Hao , Xu Borui , Wei Yanjie , Niu Beifang , Schmidt Bertil , Liu Weiguo
Published: May 2023

We present RabbitTClust, a fast and memory-efficient genome clustering tool based on sketch-based distance estimation. Our approach enables efficient processing of large-scale datasets by combining dimensionality reduction techniques with streaming and parallelization on modern multi-core platforms. 113,674 complete bacterial genome sequences from RefSeq, 455 GB in FASTA format, can be clustered within less than 6 min and 1,009,738 GenBank assembled bacterial genomes, 4.0 TB in FASTA format, within only 34 min on a 128-core workstation. Our results further identify 1269 redundant genomes, with identical nucleotide content, in the RefSeq bacterial genomes database.
The influence of the environment on the patient-centered therapeutic relationship in physical therapy: a qualitative study
Authors: Morera-Balaguer Jaume , Martínez-González Mª Carmen , Río-Medina Sonia , Zamora-Conesa Víctor , Leal-Clavel Marina , Botella-Rico José Martín , Leirós-Rodríguez Raquel , Rodríguez-Nogueira Óscar
Published: May 2023

Background

Currently, in the scientific literature there is a great interest on the study of strategies to implement patient-centered care. One of the main tools for this is the therapeutic relationship. Some studies suggest that the perception of the environment in which the treatment takes place can influence the perception of its quality, but this is not explored in physical therapy. For all these reasons, the aim of this study was to understand the influence of the environment in which physical therapy treatment takes place on the patients’ perception of the quality of the patient-centered therapeutic relationship in public health centers in Spain.

Methods

A qualitative study analysed thematically using a modified grounded theory approach. Data collection used semistructured interviewing during focus groups.

Results

We conducted four focus groups. The size of the focus groups ranged from six to nine participants. In total, 31 patients participated in these focus groups. Participants described a series of specific experiences and perceptions relating to the environment, which they felt were influential in the establishment of therapeutic patient-centered relationships, including six physical factors (Architectural barriers, Furniture, Use of the computer, Physical space, Ambiet conditions, and Privacy) and six organizational factors (Patient-physical therapist ratio, Treatment interruptions, Social factors, Continuity with the professional, Lack of professional autonomy, and Coordination or communication among team members).

Conclusion

The results of this study highlight environmental factors that affect the quality of the therapeutic patient-centered relationship in physical therapy from the patient’s point of view, and emphasize the need for physical therapists and administrators to underline the need to review these factors and take them into account in their service delivery.
Decoupling effect and driving factors of carbon footprint in megacity Wuhan, Central China
Authors: Pan Gao , Li Xinhang , Pan Deng , Liu Wensheng
Published: May 2023

Background

China’s 35 largest cities, including Wuhan, are inhabited by approximately 18% of the Chinese population, and account for 40% energy consumption and greenhouse gas emissions. Wuhan is the only sub-provincial city in Central China and, as the eighth largest economy nationwide, has experienced a notable increase in energy consumption. However, major knowledge gaps exist in understanding the nexus of economic development and carbon footprint and their drivers in Wuhan.

Methods

We studied Wuhan for the evolutionary characteristics of its carbon footprint (CF), the decoupling relationship between economic development and CF, and the essential drivers of CF. Based on the CF model, we quantified the dynamic trends of CF, carbon carrying capacity, carbon deficit, and carbon deficit pressure index from 2001 to 2020. We also adopted a decoupling model to clarify the coupled dynamics among total CF, its accounts, and economic development. We used the partial least squares method to analyze the influencing factors of Wuhan’s CF and determine the main drivers.

Results

The CF of Wuhan increased from 36.01 million t CO2eq in 2001 to 70.07 million t CO2eq in 2020, a growth rate of 94.61%, which was much faster than that of the carbon carrying capacity. The energy consumption account (84.15%) far exceeded other accounts, and was mostly contributed by raw coal, coke, and crude oil. The carbon deficit pressure index fluctuated in the range of 8.44–6.74%, indicating that Wuhan was in the relief zone and the mild enhancement zone during 2001–2020. Around the same time, Wuhan was in a transition stage between weak and strong CF decoupling and economic growth. The main driving factor of CF growth was the urban per capita residential building area, while energy consumption per unit of GDP was responsible for the CF decline.

Conclusions

Our research highlights the interaction of urban ecological and economic systems, and that Wuhan’s CF changes were mainly affected by four factors: city size, economic development, social consumption, and technological progress. The findings are of realistic significance in promoting low-carbon urban development and improving the city’s sustainability, and the related policies can offer an excellent benchmark for other cities with similar challenges.
Appropriate antibiotic use and antimicrobial resistance: knowledge, attitudes and behaviour of medical students and their needs and preferences for learning
Authors: Wiese-Posselt Miriam , Lâm Thiên-Trí , Schröder Christin , Schneider Sandra , Kurzai Oliver , Feufel Markus A. , Gastmeier Petra
Published: May 2023

Background

The impact of an appropriate use of antibiotics on the prevention of antimicrobial resistance (AMR) has been demonstrated. Surveys have shown, however, that medical students do not feel sufficiently trained to use antibiotics wisely. The aims of our study were (1) to describe what medical students currently know about appropriate antibiotic use, and (2) to identify students’ learning preferences as a basis for developing student-centred teaching modules to convey the basics of AMR prevention.

Methods

We performed an online survey at Charité Universitätsmedizin Berlin and the Julius-Maximilians-University Würzburg on the knowledge, attitudes, and behaviour (KAB) of medical students concerning AMR, antibiotic treatment options, and their perceptions of AMR topics addressed in the medical curriculum. Participants were able to fill out an online questionnaire between December 2019 and February 2020. In addition, we conducted focus group discussions with lecturers and medical students in winter 2019/2020 to identify AMR-related learning needs and preferences. Data were analysed descriptively.

Results

Overall, 356 students (response rate 5.1%) participated in the KAB survey. Of these, 192 (54%) strongly agreed that the topic of AMR is relevant to students’ clinical practice and 48% (171/355) stated that their future antibiotic prescription behaviour will have an influence on AMR development in their region. Participating students seemed to be interested in the topic of AMR and antibiotic therapy. But even of them, only 46% answered the question about the length of antibiotic use for community-acquired pneumonia correctly and 57% the question about the appropriate use of antibiotics in Staphylococcus aureus infections. Focus group discussions with students (n = 7) and lecturers (n = 9) identified a lack of competence in the responsible use of antibiotics and the prevention of AMR. Respondents stated that the teaching formats and AMR-related content should emphasize clinical applications, interaction with peers/clinicians, and repeated formative feedback from instructors.

Conclusions

Our results show that even medical students who were interested in the AMR problem were not able to use antibiotics appropriately due to gaps in knowledge and a lack of clinical skills. Based on the insights gained in the learning preferences of students and their content priorities, improved student-centred teaching materials should be developed.