bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors affecting patient satisfaction at a plastic surgery outpatient department at a tertiary centre in South Africa
Authors: Sofianos Chrysis
Published: September 2023

Background

The main purpose of a medical facility is to improve the welfare of patients, and user satisfaction is one of its primary goals. This study aimed to identify variables influencing patient satisfaction at the Plastic Surgery Outpatient Department of Chris Hani Baragwanath Academic Hospital, Gauteng, South Africa. By identifying factors affecting patient satisfaction, the services provided to patients may be improved.

Methods

A questionnaire was compiled focusing on patients over 18 years of age and using a Likert scale to measure factors influencing patients’ satisfaction with the services received. Descriptive statistics were applied.

Results

A total of 142 participants, 69% of whom were under age 40 and 52.8% were male, were recruited using a systematic sampling technique. In 78% of cases, this was the patient’s first visit to the clinic. The results revealed that the patients were not satisfied with the ease of appointment scheduling and waiting times. A high level of satisfaction was reported for both nursing staff and doctors, aside from a lack of clear and prominent display of name badges. Overall satisfaction was at the “satisfied” level, and no participants reported lower than neutral feelings. The CSAT score was 79.5%, which is considered “good” for healthcare. The participant’s level of education was significant in multiple items; those with the lowest education reported higher overall satisfaction. A model produced by regression analysis was found to be strongly significant statistically.

Discussion

Batho Pele principles in South Africa provide a framework for consulting with service consumers, ascertaining their happiness, and identifying methods to enhance their experience. According to this survey, people are happy with the human part of the services received, although areas such as scheduling appointments and the physical surroundings still need much work.

Conclusion

These aspects of treatment are occasionally disregarded in a medical organisation with insufficient finances. Developing these areas can help turn patients into devoted patrons of a healthcare facility. An effective strategy to boost customer satisfaction has been suggested to enhance service quality and, especially in South Africa, conform to Batho Pele service standards.
Comprehensive bioinformatics analysis of the solute carrier family and preliminary exploration of SLC25A29 in lung adenocarcinoma
Authors: Zheng Pengdou , Mao Zhenyu , Luo Miao , Zhou Ling , Wang Lingling , Liu Huiguo , Liu Wei , Wei Shuang
Published: September 2023

According to the latest epidemiological investigation, lung adenocarcinoma (LUAD) is one of the most fatal cancer among both men and women. Despite continuous advancements in treatment approaches in recent years, the prognosis for LUAD remains relatively poor. Given the crucial role of the solute carrier (SLC) family in maintaining cellular energy metabolism stability, we conducted a comprehensive analysis of the association between SLC genes and LUAD prognosis. In the present study, we identified 71 genes among the SLC family members, of which 32 were downregulated and 39 were upregulated in LUAD samples. Based on these differentially expressed genes, a prognostic risk scoring model was established that was composed of five genes (SLC16A7, SLC16A4, SLC16A3, SLC12A8, and SLC25A15) and clinical characteristics; this model could effectively predict the survival and prognosis of patients in the cohort. Notably, SLC2A1, SLC25A29, and SLC27A4 were identified as key genes associated with survival and tumor stage. Further analysis revealed that SLC25A29 was underexpressed in LUAD tissue and regulated the phenotype of endothelial cells. Endothelial cell proliferation and migration increased and apoptosis decreased with a decrease in SLC25A29 expression. Investigation of the upstream regulatory mechanisms of SLC25A29 revealed that SLC25A29 expression gradually decreased as the lactate concentration increased. This phenomenon suggested that the expression of SLC25A29 may be related to lactylation modification. ChIP-qPCR experiments confirmed the critical regulatory role played by H3K14la and H3K18la modifications in the promoter region of SLC25A29. In conclusion, this study confirmed the role of SLC family genes in LUAD prognosis and revealed the role of SLC25A29 in regulating endothelial cell phenotypes. These study results provided important clues to further understand LUAD pathogenesis and develop appropriate therapeutic strategies.
Cytosine–phosphate–guanine oligodeoxynucleotides alleviate radiation-induced kidney injury in cervical cancer by inhibiting DNA damage and oxidative stress through blockade of PARP1/XRCC1 axis
Authors: Zhang Deyu , Zhang Shitai , He Zheng , Chen Ying
Published: September 2023

Background

Radiotherapy can cause kidney injury in patients with cervical cancer. This study aims to investigate the possible molecular mechanisms by which CpG-ODNs (Cytosine phosphate guanine-oligodeoxynucleotides) regulate the PARP1 (poly (ADP-ribose) polymerase 1)/XRCC1 (X-ray repair cross-complementing 1) signaling axis and its impact on radiation kidney injury (RKI) in cervical cancer radiotherapy.

Methods

The GSE90627 dataset related to cervical cancer RKI was obtained from the Gene Expression Omnibus (GEO) database. Bioinformatics databases and R software packages were used to analyze the target genes regulated by CpG-ODNs. A mouse model of RKI was established by subjecting C57BL/6JNifdc mice to X-ray irradiation. Serum blood urea nitrogen (BUN) and creatinine levels were measured using an automated biochemical analyzer. Renal tissue morphology was observed through HE staining, while TUNEL staining was performed to detect apoptosis in renal tubular cells. ELISA was conducted to measure levels of oxidative stress-related factors in mouse serum and cell supernatant. An in vitro cell model of RKI was established using X-ray irradiation on HK-2 cells for mechanism validation. RT-qPCR was performed to determine the relative expression of PARP1 mRNA. Cell proliferation activity was assessed using the CCK-8 assay, and Caspase 3 activity was measured in HK-2 cells. Immunofluorescence was used to determine γH2AX expression.

Results

Bioinformatics analysis revealed that the downstream targets regulated by CpG-ODNs in cervical cancer RKI were primarily PARP1 and XRCC1. CpG-ODNs may alleviate RKI by inhibiting DNA damage and oxidative stress levels. This resulted in significantly decreased levels of BUN and creatinine in RKI mice, as well as reduced renal tubular and glomerular damage, lower apoptosis rate, decreased DNA damage index (8-OHdG), and increased levels of antioxidant factors associated with oxidative stress (SOD, CAT, GSH, GPx). Among the CpG-ODNs, CpG-ODN2006 had a more pronounced effect. CpG-ODNs mediated the inhibition of PARP1, thereby suppressing DNA damage and oxidative stress response in vitro in HK-2 cells. Additionally, PARP1 promoted the formation of the PARP1 and XRCC1 complex by recruiting XRCC1, which in turn facilitated DNA damage and oxidative stress response in renal tubular cells. Overexpression of either PARP1 or XRCC1 reversed the inhibitory effects of CpG-ODN2006 on DNA damage and oxidative stress in the HK-2 cell model and RKI mouse model.

Conclusion

CpG-ODNs may mitigate cervical cancer RKI by blocking the activation of the PARP1/XRCC1 signaling axis, inhibiting DNA damage and oxidative stress response in renal tubule epithelial cells.
Oxamate enhances the efficacy of CAR-T therapy against glioblastoma via suppressing ectonucleotidases and CCR8 lactylation
Authors: Sun Ting , Liu Bin , Li Yanyan , Wu Jie , Cao Yufei , Yang Shuangyu , Tan Huiling , Cai Lize , Zhang Shiqi , Qi Xinyue , Yu Dingjia , Yang Wei
Published: September 2023

Background

Chimeric antigen receptor (CAR)-T immunotherapy fails to treat solid tumors due in part to immunosuppressive microenvironment. Excess lactate produced by tumor glycolysis increases CAR-T immunosuppression. The mechanism of lactate inducing the formation of immunosuppressive microenvironment remains to be further explored.

Methods

Immunocyte subpopulations and molecular characteristics were analyzed in the orthotopic xenografts of nude mice using flow cytometry assay and immunohistochemical staining after oxamate, a lactate dehydrogenase A (LDHA) inhibitor, and control T or CAR-T cells injection alone or in combination. RT-qPCR, western blot, flow cytometry, immunofluorescence, luciferase reporter assay, chromatin immunoprecipitation and ELISA were performed to measure the effect of lactate on the regulation of CD39, CD73 and CCR8 in cultured glioma stem cells, CD4 + T cells or macrophages.

Results

Oxamate promoted immune activation of tumor-infiltrating CAR-T cells through altering the phenotypes of immune molecules and increasing regulatory T (Treg) cells infiltration in a glioblastoma mouse model. Lactate accumulation within cells upregulated CD39, CD73 and CCR8 expressions in both lactate-treated cells and glioma stem cells-co-cultured CD4 + T cells and macrophages, and intracellular lactate directly elevated the activities of these gene promotors through histone H3K18 lactylation.

Conclusions

Utilizing lactate generation inhibitor not only reprogramed glucose metabolism of cancer stem cells, but also alleviated immunosuppression of tumor microenvironment and reduced tumor-infiltrating CAR-Treg cells, which may be a potential strategy to enhance CAR-T function in glioblastoma therapy.
Assessment of radio(chemo)therapy-related dysphagia in head and neck cancer patients based on cough-related acoustic features: a prospective phase II national clinical trial (ACCOUGH-P/A trial)
Authors: Mootassim-Billah Sofiana , Van Nuffelen Gwen , Schoentgen Jean , De Bodt Marc , Van Gestel Dirk
Published: September 2023

Background

Radiation-associated dysphagia is defined as impaired swallowing efficiency/safety following (chemo)radiotherapy in head and neck cancer patients. In a dysphagia framework, impaired coughing may lead to lung aspiration and fatal lung infection. Although cough efficacy is a predictor of the risk of aspiration, cough investigation is minimal in patients with radiation-associated dysphagia. Because cough is a transient signal, existing software for speech analysis are not appropriate. The goal of our project is to develop an assessment method using acoustic features related to voluntary and reflexive coughs as biomarkers of the risk of penetration/aspiration in patients with radiation-associated dysphagia.

Methods

Healthy subjects and head and neck cancer patients with and without dysphagia will produce voluntary coughs, throat clearings and reflexive coughs. Recordings will be made using an acoustic microphone and a throat microphone. The recorded signals will be manually segmented and subsequently analysed with a software under development. Automatic final segmentation enables to measure cough duration. The first method of analysis includes temporal features: the amplitude contour, the sample entropy and the kurtosis. These features report respectively the strength, the unpredictability (turbulence noise due to the air jet) and the impulsive quality (burst) of the signal. The second method of analysis consists of a spectral decomposition of the relative cough signal energy into several frequency bands (0–400 Hz, 400–800 Hz, 800–1600 Hz, 1600–3200 Hz, > 3200 Hz). The primary outcome of this exploratory research project is the identification of a set of descriptive acoustic cough features in healthy subjects as reference data (ACCOUGH). The secondary outcome of this research in head and neck cancer patients with radiation-associated dysphagia includes the identification of (1) a set of descriptive acoustic cough features as biomarkers of penetration-aspiration (ACCOUGH-P/A), (2) swallowing scores, (3) voice features and (4) aerodynamic cough features.

Discussion

This study is expected to develop methods of acoustic cough analysis to enhance the assessment of radiation-associated dysphagia in head and neck cancer patients following (chemo)radiation.

Trial registration

International Standard Randomized Controlled Trials Number (ISRCTN) registry ISRCTN16540497. Accepted on 23 June 2023.
Association of knee and hip osteoarthritis with the risk of falls and fractures: a systematic review and meta-analysis
Authors: Zhang Youyou , Li Xiaoxi , Wang Yining , Ge Liru , Pan Faming , Winzenberg Tania , Cai Guoqi
Published: September 2023

Objective

Studies evaluating the association of knee and hip osteoarthritis (OA) with falls and fractures have inconsistent findings. We aimed to investigate associations of symptomatic and radiographic knee and hip OA with risk of falls, recurrent falls, and fractures.

Methods

We conducted an electronic search of databases from inception to February 2023. Two authors independently screened studies, extracted data, and assessed the risk of bias using the Newcastle-Ottawa Scale tool in eligible studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models.

Results

Of 17 studies included (n = 862849), 2 had a high risk of bias. Among studies that evaluated falls or fractures as outcomes, 7/8 (87.5%) and 5/11 (45.5%) were self-reported, respectively. Both symptomatic knee and hip OA were associated with increased risk of recurrent falls (knee: OR = 1.55, 95% CI 1.10 to 2.18; hip: OR = 1.50, 95% CI 1.28 to 1.75) but not falls or fractures. Radiographic knee OA increased risk of falls (OR = 1.28, 95% CI 1.03 to 1.59) and did not significantly increase risk of recurrent falls (OR = 1.39, 95% CI 0.97 to 1.97) or fractures (OR = 1.22, 95% CI 0.99 to 1.52). Radiographic hip OA decreased the risk of recurrent falls (OR = 0.70, 95% CI 0.51 to 0.96) but had no statistically significant association with fractures (OR = 1.16, 95% CI 0.79 to 1.71).

Conclusion

Symptomatic knee and hip OA were both associated with an increased risk of recurrent falls, and radiographic knee OA was associated with an increased risk of falls. No statistically significant associations of radiographic and symptomatic knee or hip OA with fractures were found.
Detection of Parvovirus B19 genome in human heart tissue samples
Authors: Kloc Anna , Campbell Kenneth S. , Espinoza Yarida A. Urbina
Published: September 2023

Objective

Identifying viral genomes in human heart tissues is critical for disease diagnosis and assessment of cardiovascular damage. Human heart tissue samples obtained during a biopsy procedure are routinely used to test for the presence of viruses, as guided by clinical manifestations and prognosis. Furthermore, heart tissue samples obtained post-mortem or during a cardiac transplant procedure serve as a valuable research tool, as they allow for an in-depth assessment of cardiac pathology that can aid in our understanding of molecular pathways associated with disease. Because viral nucleic acid constitutes only a small portion of each sample’s genetic material, appropriate methods are necessary for positive viral genome identification.

Results

Snap-frozen heart tissue samples obtained either post-mortem or during a cardiac transplant procedure were used to develop conditions for detection of Parvovirus B19. Briefly, total DNA was isolated from the heart tissue under varying conditions. A PCR-based assay with Parvovirus B19 specific primers was implemented to detect the presence of the viral genome, followed by Sanger Sequencing. The mechanical disruption of the heart tissue, as well as the cardiac tissue processing methods, had a significant effect on the DNA quality and the ability to detect the Parvovirus B19 genome.
Curtailing political short-termism in legislatures: a trade-off between influence and institutionalization?
Authors: Koskimaa Vesa , Raunio Tapio
Published: September 2023

Legislatures have recently started to invest in anticipatory governance. Alongside new practices, they have introduced designated future committees and organs that connect MPs to future-regarding visioning and advice. Two decades ago, only Finland had a ‘future committee’, today broadly similar organs exist in 10 countries around the world. While signaling an important attempt to take expert-driven anticipatory governance closer to voters, legislative future organs may become short-lasting or remain politically weak, as their efforts to gain power typically threaten established legislative actors. To examine this emerging tension, we theoretically distinguish the unorthodox methods of future committees from traditional legislative practices and empirically compare the operation of all existing legislative future committees and similar organs. We uncover a considerable similarity between these institutions that mostly operate outside of the ordinary legislative process. To survive, they must add value to MPs without endangering the existing division of power. Finding this balance enhances the consolidation of legislative future organs, but it simultaneously limits their conventional political impact.
Views of democracy and society and support for political violence in the USA: findings from a nationally representative survey
Authors: Wintemute Garen J. , Robinson Sonia L. , Crawford Andrew , Tancredi Daniel , Schleimer Julia P. , Tomsich Elizabeth A. , Reeping Paul M. , Shev Aaron B. , Pear Veronica A.
Published: September 2023

Background

Current conditions in the USA suggest an increasing risk for political violence. Little is known about the prevalence of beliefs that might lead to political violence, about support for and personal willingness to engage in political violence, and about how those measures vary with individual characteristics, lethality of violence, political objectives that violence might advance, or specific populations as targets.

Methods

This cross-sectional US nationally representative survey was conducted on May 13 to June 2, 2022, of adult members of the Ipsos KnowledgePanel. Outcomes are weighted, population-representative proportions of respondents endorsing selected beliefs about American democracy and society and violence to advance political objectives.

Results

The analytic sample included 8620 respondents; 50.5% (95% confidence interval (CI) 49.3%, 51.7%) were female; and weighted mean (± standard deviation) age was 48.4 (± 18.0) years. Nearly 1 in 5 (18.9%, 95% CI 18.0%, 19.9%) agreed strongly or very strongly that “having a strong leader for America is more important than having a democracy”; 16.2% (95% CI 15.3%, 17.1%) agreed strongly or very strongly that “in America, native-born white people are being replaced by immigrants,” and 13.7% (95% CI 12.9%, 14.6%) agreed strongly or very strongly that “in the next few years, there will be civil war in the United States.” One-third of respondents (32.8%, 95% CI 31.7%, 33.9%) considered violence to be usually or always justified to advance at least 1 of 17 specific political objectives. Among all respondents, 7.7% (95% CI 7.0%, 8.4%) thought it very or extremely likely that within the next few years, in a situation where they believe political violence is justified, “I will be armed with a gun”; 1.1% (95% CI 0.9%, 1.4%) thought it very or extremely likely that “I will shoot someone with a gun.” Support for political violence and for the use of firearms in such violence frequently declined with increasing age, education, and income.

Conclusions

Small but concerning proportions of the population consider violence, including lethal violence, to be usually or always justified to advance political objectives. Prevention efforts should proceed urgently based on the best evidence available.
The Sasaki-W anastomosis for recurrent Crohn’s disease stenosis after the Kono-S anastomosis
Authors: Asai Takahiro , Shinozaki Hiroharu , Shinozaki Satoshi , Makino Akitsugu , Nakagawa Masashi , Kobayashi Kenji , Lefor Alan Kawarai , Yukisawa Seigo , Ogata Yoshiro
Published: September 2023

Background

Postoperative recurrence is frequently encountered in the management of patients with Crohn’s disease and is most often found at the anastomotic site. A novel technique, the Sasaki-W anastomosis, is an antimesenteric cutback end-to-end isoperistaltic anastomosis. We report a patient with Crohn’s disease who underwent partial intestinal resection for postoperative anastomotic stenosis, reconstructed with the Sasaki-W anastomosis, after initial intestinal resection reconstructed with a Kono-S anastomosis.

Case presentation

A 30-year-old male was diagnosed with Crohn’s disease and treated with mesalamine and adalimumab, and he underwent ileocecal resection using the Kono-S anastomosis at the time of diagnosis. He was treated with infliximab without any symptoms or recurrence for 7 years. He was admitted presenting with upper abdominal pain. Physical examination showed mild tenderness and distension in the upper abdomen. Laboratory data showed no remarkable findings. Computed tomography scan showed wall thickening in the ileum with proximal dilation and fluid retention. Non-operative management with antibiotics and fasting did not improve the symptoms within 7 days. Ten days after admission, ileocecal resection reconstructed with the Sasaki-W anastomosis was performed. At operation, there was a 15-cm intestinal stenosis at the site of the previous Kono-S anastomosis. The transverse colon and ileum were reconstructed with the Sasaki-W anastomosis. The postoperative course was uneventful, and the patient was discharged 17 days postoperatively. The patient had no obstructive symptoms and no findings consistent with bowel obstruction were observed on computed tomography scan one year postoperatively.

Conclusions

The Sasaki-W anastomosis is a viable option for intestinal reconstruction in patients with postoperative recurrence after a Kono-S anastomosis.
Burden of mental disorders by gender in Pakistan: analysis of Global Burden of Disease Study data for 1990–2019
Authors: Alvi Mohsin Hassan , Ashraf Tehmina , Naz Farah , Sardar Asif , Ullah Akbar , Patel Anita , Kiran Tayyeba , Gumber Anil , Husain Nusrat
Published: September 2023

Aims and method

We aimed to examine the burden of mental disorders in Pakistan over the past three decades. We used the crude data of disability-adjusted life-years (DALYs) obtained from the Global Burden of Disease Study database (1990–2019) to represent burden. Data were retrieved on 26 January 2021. Data for adults of reproductive age (aged 15–49 years) were analysed to discuss and interpret the disease burden. An analysis was conducted on total DALYs separately for the genders for ten mental disorders reported in Pakistan.

Results

DALYs increased drastically with the onset of reproductive age. Depressive disorder was the most reported mental disorder, contributing 3.13% (95% CI 2.25–4.24) of total DALYs, and varied significantly between genders: females 3.89% (95% CI 2.73–5.29) versus males 2.37% (95% CI 1.62–3.25).

Clinical implications

A nationwide high-quality epidemiological surveillance system should be implemented to monitor mental disorders and offer culturally appropriate preventive services.
Time-resolved proximity biotinylation implicates a porin protein in export of transmembrane malaria parasite effectors
Authors: Anaguano David , Dedkhad Watcharatip , Brooks Carrie F. , Cobb David W. , Muralidharan Vasant
Published: September 2023

The malaria-causing parasite, Plasmodium falciparum completely remodels its host red blood cell (RBC) through the export of several hundred parasite proteins, including transmembrane proteins, across multiple membranes to the RBC. However, the process by which these exported membrane proteins are extracted from the parasite plasma membrane for export remains unknown. To address this question, we fused the exported membrane protein, skeleton binding protein 1 (SBP1), with TurboID, a rapid, efficient and promiscuous biotin ligase (SBP1TbID). Using time-resolved proximity biotinylation and label-free quantitative proteomics, we identified two groups of SBP1TbID interactors – early interactors (pre-export) and late interactors (post-export). Notably, two promising membrane-associated proteins were identified as pre-export interactors, one of which possesses a predicted translocon domain, that could facilitate the export of membrane proteins. Further investigation using conditional mutants of these candidate proteins showed that these proteins were essential for asexual growth and localize to the host–parasite interface during early stages of the intraerythrocytic cycle. These data suggest that they might play a role in ushering membrane proteins from the parasite plasma membrane for export to the host RBC.
Centrosome amplification promotes cell invasion via cell–cell contact disruption and Rap-1 activation
Authors: Prakash Anu , Paunikar Shishir , Webber Mark , McDermott Emma , Vellanki Sri H. , Thompson Kerry , Dockery Peter , Jahns Hanne , Brown James A. L. , Hopkins Ann M. , Bourke Emer
Published: September 2023

Centrosome amplification (CA) is a prominent feature of human cancers linked to tumorigenesis in vivo. Here, we report mechanistic contributions of CA induction alone to tumour architecture and extracellular matrix (ECM) remodelling. CA induction in non-tumorigenic breast cells MCF10A causes cell migration and invasion, with underlying disruption of epithelial cell–cell junction integrity and dysregulation of expression and subcellular localisation of cell junction proteins. CA also elevates expression of integrin β-3, its binding partner fibronectin-1 and matrix metalloproteinase enzymes, promoting cell–ECM attachment, ECM degradation, and a migratory and invasive cell phenotype. Using a chicken embryo xenograft model for in vivo validation, we show that CA-induced (+CA) MCF10A cells invade into the chick mesodermal layer, with inflammatory cell infiltration and marked focal reactions between chorioallantoic membrane and cell graft. We also demonstrate a key role of small GTPase Rap-1 signalling through inhibition using GGTI-298, which blocked various CA-induced effects. These insights reveal that in normal cells, CA induction alone (without additional oncogenic alterations) is sufficient to confer early pro-tumorigenic changes within days, acting through Rap-1-dependent signalling to alter cell–cell contacts and ECM disruption.
Eating Disorder Risk and Common Mental Disorders in British Servicewomen: A Cross-Sectional Observational Study
Authors: O’LEARY THOMAS J. , COOMBS CHARLOTTE V. , PERRETT CAITLIN , GIFFORD ROBERT M. , WARDLE SOPHIE L. , GREEVES JULIE P.
Published: September 2023

Purpose

Servicewomen are at increased risk of common mental disorders compared with servicemen and their female civilian counterparts. The prevalence of eating disorder risk and common mental disorders, and associated risk factors in British servicewomen are poorly understood.

Methods

All women younger than 45 yr in the UK Armed Forces were invited to complete a survey about demographics, exercise behaviors, eating behaviors, and common mental disorders.

Results

A total of 3022 women participated; 13% of participants were at high risk of an eating disorder based on Brief Eating Disorder in Athletes Questionnaire and Female Athlete Screening Tool scores. Twenty-five percent of participants had symptoms of anxiety (seven-item Generalized Anxiety Disorder Assessment score ≥10), and 26% had symptoms of depression (nine-item Patient Health Questionnaire score ≥10). Older age was associated with a lower risk, and heavier body mass was associated with a higher risk, of eating disorders (P ≤ 0.043). Older age and higher rank were associated with a lower risk of symptoms of anxiety and depression (P ≤ 0.031), and a heavier body mass was associated with a higher risk of symptoms of depression (P ≤ 0.012). Longer habitual sleep duration was associated with a lower risk of eating disorders and symptoms of anxiety and depression (P ≤ 0.028). A higher volume of field exercise was associated with a lower risk, and a higher volume of military physical training and personal physical training was associated with a higher risk, of eating disorders (P ≤ 0.024). Job role and deployment history were not associated with any outcome.

Conclusions

Sleeping and training habits provide potential novel targets for exploring how common mental disorders can be managed in British servicewomen.
Shared Service Delivery Can Increase Client Engagement: A Study of Shared Medical Appointments
Authors: Buell Ryan W. , Ramdas Kamalini , Sönmez Nazlı , Srinivasan Kavitha , Venkatesh Rengaraj
Published: September 2023

Problem definition: Clients and service providers alike often consider one-on-one service delivery to be ideal, assuming, perhaps unquestioningly, that devoting individualized attention best improves client outcomes. In contrast, in shared service delivery, clients are served in batches and the dynamics of group interaction could lead to increased client engagement, which could improve outcomes. However, the loss of privacy and personal connection might undermine engagement. The engagement dynamics in one-on-one and shared delivery models have not been rigorously studied. To the extent that shared delivery may result in comparable or better engagement than one-on-one delivery, service providers in a broad array of contexts may be able to create more value for clients by delivering service in batches. Methodology/results: We conducted a randomized controlled trial with 1,000 patients who were undergoing glaucoma treatment over a three-year period at a large eye hospital. Using verbatim and behavioral transcripts from more than 20,000 minutes of video recorded during our trial, we examine how shared medical appointments (SMAs), in which patients are served in batches, impact engagement. On average, a patient who experienced SMAs asked 33.3% more questions per minute and made 8.6% more nonquestion comments per minute. Because there were multiple patients in an SMA, this increase in engagement at the individual patient level resulted in patients hearing far more comments in the group setting. Patients in SMAs also exhibited higher levels of nonverbal engagement across a wide array of measures (attentiveness, positivity, head wobbling, or “thalai aattam” in Tamil: a South Indian gesture to signal agreement or understanding, eye contact, and end-of-appointment happiness), relative to patients who attended one-on-one appointments. Managerial implications: These results shed light on the potential for shared service delivery models to increase client engagement and thus enhance service performance.

Funding: This work was supported by the Wheeler Institute at London Business School (WIBAD Ramdas_Sonmez CFP19), the Institute of Entrepreneurship and Private Capital at London Business School (IIE_3432_2019), Aravind Eye Hospital, and Harvard Business School.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2021.0012 .
Evaluation of parents’ knowledge of mandatory and recommended vaccinations for children in the city of Zielona Góra, taking into account medical and non-medical professions
Authors: Skrzypek Agnieszka Sara , Grzywacz Elżbieta , Chmielowiec Jolanta , Masiak Jolanta , Sosnowski Michał , Mazur Rafał , Chmielowiec Krzysztof
Published: September 2023

All children born and temporarily residing in Poland are required to be vaccinated. Parents have a choice between free vaccines, which are funded by the state budget, and recommended multivalent vaccines for which they have to pay. The number of parents who refuse to have their children vaccinated remains relatively low. Unfortunately, the percentage of unvaccinated children increases every year, despite the best efforts of healthcare professionals and comprehensive public health education. It can be assumed that the reason for the increasing number of refusals to vaccinate children is the lack of knowledge of vaccination demonstrated by their parents and guardians.
The study was conducted in 2022 using a proprietary, anonymous survey of 138 parents who had their children vaccinated.

Keywords: knowledge, vaccination, medical staff, adverse post-vaccination reaction.
Hubungan pengetahuan dan personal hygiene dengan kejadian pediculosis capitis pada anak SD Mutihan di Banguntapan, Bantul
Authors: Shoniya Shoniya , Adnani Hariza
Published: September 2023

The prevalence of pediculosis capitis among Yogyakarta's rural elementary school students was 19.6%. The circumstance in urban area was slightly better with prevalence of 12.3% among similar group of students. The aim of this study was to seek the association of the knowledge and personal hygiene with the incidence of pediculosis capitis among students in SD Negeri Mutihan Yogyakarta. This study employed a cross-sectional design and nonprobability sampling to collect the research sample. A questionnaire was distributed to 111 students who agreed to participate in the study. Data was analysed with the Chi-Square Test and Relative Risk. Participants consisted of 65 boys (58.6%) and 46 girls (41.4%). The number of participants who had sufficient knowledge on pediculosis capitis, had good personal hygiene, and suffered pediculosis capitis were 58.6%, 63%, and 36.9%, respectively. Poor knowledge increased the risk of developing pediculosis capitis by 5.9 times. In contrary, poor personal hygiene can reduced its risk. Knowledge and personally hygiene are important factors to determine the incidence of Pediculosis Capitis.
Análisis del perfil familiar y sociodemográfico de los acogimientos en familia extensa en la ciudad de Madrid
Authors: García-Bermejo Tania , Fuentes Juan Luis
Published: September 2023

INTRODUCCIÓN. El acogimiento en familia extensa es una de las medidas de protección a la infancia más utilizada actualmente en España y, paradójicamente, ha recibido una escasa atención por la producción científica en los últimos años. Por ello, el objetivo de este trabajo es analizar el perfil familiar y sociodemográfico de las familias acogedoras en la totalidad de los distritos de la ciudad de Madrid, donde, a diferencia de otros municipios españoles, no se ha realizado hasta el momento ninguna investigación descriptiva sobre esta medida. MÉTODO. Se utiliza un método no experimental, descriptivo y explicativo, encaminado a examinar las principales variables de esta configuración familiar. La muestra analizada coincide con la población total de los acogimientos en familia extensa en la ciudad de Madrid, estando compuesta por 702 acogidos en 569 familias con 821 acogedores. RESULTADOS. Los resultados señalan que los acogimientos tienen lugar con menores en su segunda infancia y adolescencia, formalizados principalmente por abuelas, en la familia materna y hogares monoparentales en los que se acoge principalmente a un único menor; la diferencia intergeneracional entre acogidos y acogedores es significativa; se formalizan principalmente como administrativos permanentes, bajo una medida protectora de tutela y el motivo mayoritario de baja es la mayoría de edad de los acogidos. Además, se observa que a mayor nivel de renta y mayor nivel formativo del contexto social el número de acogimientos en familia extensa es menor, y a mayor número de solicitudes de ayudas económicas asciende su proporción. DISCUSIÓN. Esta medida de protección posee unas características singulares en su configuración familiar que comparten aspectos con estudios similares, pero que poseen elementos distintivos susceptibles de aumentar las situaciones de vulnerabilidad en la infancia y la adolescencia, por lo que su conocimiento en profundidad resulta necesario para articular propuestas de intervención socioeducativa realistas y especializadas.
Comparative Study of Chemically and Green Synthesized Titanium Dioxide Nanoparticles using Leucas aspera Leaf Extract
Authors: B. Blessymol  , V. Kalaiselvi  , P. Yasotha  , S. Gopi
Published: September 2023

In this research work, the chemical synthesis and green synthesis of Titanium dioxide nanoparticles using Leucas aspera leaf extract were successfully carried out with titanium isopropoxide as the precursor. Titanium dioxide nanoparticles are widely used in various fields such as biomedical applications (antibacterial, antifungal, anticancer, etc.). For the Titanium dioxide nanoparticles thus synthesized using a low-cost and eco-friendly approach, the morphology, crystalline size, functional group and bandgap were confirmed by Scanning Electron Microscope (SEM), X-ray Diffraction, Fourier Transform Infrared Spectroscopy (FTIR) and UV Spectroscopy techniques and antibacterial applications were carried out by Disc diffusion method.
Shakespearean Resonances in Contemporary British Drama: Political and Adaptational Borders in William Shakespeare’s Macbeth and David Greig’s Dunsinane
Authors: Hartl Anja
Published: September 2023

Abstract: Using Wai Chee Dimock’s theory of “resonance,” this article argues that the potential of Shakespeare’s works to reverberate across centuries and across contexts resides not so much in their universality as in their historical specificity and therefore in the ways in which the meaning and significance of the plays have necessarily changed over time. This argument is illustrated through Scottish playwright David Greig’s 2010 play Dunsinane , a sequel to Shakespeare’s Macbeth . Dimock’s concept of resonance helps to identify specific concerns that the two plays share—above all, an interest in nationhood that is expressed through the border. At the same time, it draws attention to Dunsinane ’s considerable dissonances with Macbeth , which are above all evident in Greig’s rewriting of major parts of Shakespeare’s plot. As such, the border is not only a central theme and aesthetic device in both plays, but also an apt metaphor for Greig’s adaptational approach. As an example of a textual borderscape (in Chiara Brambilla’s sense of the term), Dunsinane probes the borders of adaptation—and of adapting Shakespeare—in the current moment.
X-ray generation by fs-laser processing of biological material
Authors: Mosel P. , Düsing J. , Johannesmeier S. , Patzlaff-Günther M. , Fröhlich S. , Mapa J. , Kalies S. , Bahlmann J. , Püster T. , Vahlbruch J. , Dittmar G. , Merdji H. , Fajardo M. , Trabattoni A. , Heisterkamp A. , Morgner U. , Kovacev M.
Published: September 2023

The use of ultrashort pulse lasers in medical treatments is increasing and is already an essential tool, particularly in the treatment of eyes, bones and skin. One of the main advantages of laser treatment is that it is fast and minimally invasive. Due to the interaction of ultrashort laser pulses with matter, X-rays can be generated during the laser ablation process. This is important not only for the safety of the patient, but also for the practitioner to ensure that the legally permissible dose is not exceeded. Although our results do not raise safety concerns for existing clinical applications, they might impact future developments at higher peak powers. In order to provide guidance to laser users in the medical field, this paper examines the X-ray emission spectra and dose of several biological materials and describes their dependence on the laser pulse energy.
All-in-focus large-FOV GRIN lens imaging by multi-focus image fusion
Authors: Xiao Dafei , Lin Zhige , Shechtman Yoav
Published: September 2023

Gradient refractive index (GRIN) lenses are useful for miniaturized and in-vivo imaging. However, the intrinsic field-dependent aberrations of these lenses can deteriorate imaging resolution and limit the effective field of view. To address these aberrations, adaptive optics (AO) has been applied which inevitably requires the incorporation of additional hardware. Here we focus on field curvature aberration and propose a computational correction scheme which fuses a z-stack of images into a single in-focus image over the entire field of view (FOV), with no AO required. We validate our method by all-in-focus wide-field imaging of a printed letter sample and fluorescently labeled mouse brain slices. The method can also provide what we believe to be a new and valuable option for imaging enhancement in the scanning-modality use of GRIN lens microscopy.
Integrating a tailored recurrent neural network with Bayesian experimental design to optimize microbial community functions
Authors: Thompson Jaron C. , Zavala Victor M. , Venturelli Ophelia S.
Published: September 2023

Microbiomes interact dynamically with their environment to perform exploitable functions such as production of valuable metabolites and degradation of toxic metabolites for a wide range of applications in human health, agriculture, and environmental cleanup. Developing computational models to predict the key bacterial species and environmental factors to build and optimize such functions are crucial to accelerate microbial community engineering. However, there is an unknown web of interactions that determine the highly complex and dynamic behavior of these systems, which precludes the development of models based on known mechanisms. By contrast, entirely data-driven machine learning models can produce physically unrealistic predictions and often require significant amounts of experimental data to learn system behavior. We develop a physically-constrained recurrent neural network that preserves model flexibility but is constrained to produce physically consistent predictions and show that it can outperform existing machine learning methods in the prediction of certain experimentally measured species abundance and metabolite concentrations. Further, we present a closed-loop, Bayesian experimental design algorithm to guide data collection by selecting experimental conditions that simultaneously maximize information gain and target microbial community functions. Using a bioreactor case study, we demonstrate how the proposed framework can be used to efficiently navigate a large design space to identify optimal operating conditions. The proposed methodology offers a flexible machine learning approach specifically tailored to optimize microbiome target functions through the sequential design of informative experiments that seek to explore and exploit community functions.
Understanding vegetable farmers’ adoption, dis-adoption, and non-adoption decisions of pest management by pheromone trapping
Authors: Kabir Muhammad Humayun , Nur-e-Alam Sk. Md. , Datta Avishek , Tan Mou Leong , Rahman Md. Sadique
Published: September 2023

The use of pheromone traps can minimize the excess application of synthetic insecticides, while can also benefit the environment. The use of pheromone traps has been promoted and suggested to vegetable farmers of Bangladesh for widespread adoption. However, the majority of farmers have continued to spray insecticides instead of using pheromone traps. The present study investigated the factors influencing farmers’ adoption, dis-adoption, and non-adoption behavior of pheromone traps for managing insect pests. Primary data were collected from 438 vegetable growers. Data were analyzed using descriptive statistics and multinomial logistic regression. About 27% of the farmers abandoned the technique shortly after it was adopted as it was time-consuming to manage insect pests. Marginal effect analysis revealed that the likelihood of continued adoption was 34.6% higher for farmers who perceived that pheromone traps were useful in controlling insect pests. In contrast, the likelihood of dis-adoption was 16.5% and 10.4% higher for farmers who maintained communication with private pesticide company agents and neighbor farmers, respectively. Extension services by government extension personnel might be encouraged and maintained as a key component in increasing farmer awareness regarding the use of pheromone trap. Strategies to promote pheromone traps in vegetable production should highlight the positive impacts to farmers and the environment, as this would most likely lead to their continued and widespread use after initial adoption.
Using life cycle assessments to guide reduction in the carbon footprint of single-use lab consumables
Authors: Ragazzi Isabella , Farley Martin , Jeffery Kate , Butnar Isabela
Published: September 2023

Scientific research pushes forward the boundaries of human knowledge, but often at a sizable environmental cost. The reliance of researchers on single-use plastics and disposable consumables has come under increased scrutiny as decarbonisation and environmental sustainability have become a growing priority. However, there has been very little exploration of the contribution of laboratory consumables to ‘greenhouse gas’ (GHG) carbon emissions. Carbon footprint exercises, if capturing consumables at all, typically rely on analyses of inventory spend which broadly aggregate plastic and chemical products, providing inaccurate data and thus limited insight as to how changes to procurement can reduce emissions.

This paper documents the first effort to quantify the carbon footprint of common, single-use lab consumables through emission factors derived from life cycle assessments (LCAs). A literature review of LCAs was conducted to develop emission factors for lab consumables, considering the emission hotspots along each product’s life cycle to identify where emission reduction policies can be most effective. Results can be used as inputs for lab practitioners seeking to understand and mitigate their carbon footprint.
Negotiating Multiple Risks: Health, safety, and well-being among internal migrant sex workers in Brazil during COVID-19
Authors: Martins Jr Angelo , Brito Larissa , Scatena Thiago Pizzo
Published: September 2023

During the COVID-19 pandemic, experts called attention to the fact that the pandemic was disproportionately affecting socially vulnerable groups. Research suggested that structural inequalities resulted in unequal access to healthcare and that infection prevention measures increased precarious working conditions in illegal, informal, or unregulated sectors, such as the sex industry. This article reports on research findings that examined the impact of the COVID-19 pandemic on the lives and working conditions of 25 women internal migrant sex workers in the city of Ribeirão Preto, Brazil. It demonstrates that the pandemic and measures to control it severely impacted the lives of internal migrant sex workers, their affective and work relationships, as well as their income, safety, and physical and mental health. Furthermore, sex workers suffered from disturbing levels of violence and precariousness as well as a lack of effective policies aimed at protecting their health and well-being. This was exacerbated by the stigma, lack of labour rights, and the fact that they were migrants, which impacted them financially and emotionally during movement restrictions.
Pemberdayaan komunitas purna Pekerja Migran Indonesia melalui organisasi berbasis komunitas Forum Warga Buruh Migran
Authors: Saleh Rahmat , Adnan Ricardi S. , Raharto Aswatini
Published: September 2023

Nowadays, Community-Based Organisation (CBO) has been admitted as a more successful activity to empower the community than other organisations, such as Non-Governmental Organisation (NGO). This article aims to emphasise how activism of the Forum of Indonesian Migrant Workers or the Forum Warga Buruh Migran (FWBM), as a CBO initiated by Nahdlatul Ulama (NU) at the grassroots level, works to empower ex-Indonesian migrant workers and their families in their areas of origin. This article used the qualitative methodology of the CBO framework and the perspective of community empowerment with a case study in Cilacap Regency, Central Java. Primary data was collected by in-depth interviews and focus group discussions, while secondary data was collected by literature review. The data was processed using content analysis techniques. This research found that the activism of  FWBM has been manifested in four holistic community empowerment programmes. Through these programmes, ex Indonesian Migrant Workers and their families can improve their quality of life. They can be more empowered, economically independent, and wealthier. However, the FWBM still has limitations in terms of volunteers and financial resources to support sustainable activities.