bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing the tendency of residual symptoms in patients with depressive disorders: a longitudinal study
Authors: Li Yuwei , Wang Dong , Fang Jiexin , Zu Si , Xiao Le , Zhu Xuequan , Wang Gang , Hu Yongdong
Published: August 2024

Background

Residual symptoms of depressive disorders are serious health problems. However, the progression process is hardly predictable due to high heterogeneity of the disease. This study aims to: (1) classify the patterns of changes in residual symptoms based on homogeneous data, and (2) identify potential predictors for these patterns.

Methods

In this study, we conducted a data-driven Latent Class Growth Analysis (LCGA) to identify distinct tendencies of changes in residual symptoms, which were longitudinally quantified using the QIDS-SR16 at baseline and 1/3/6 months post-baseline for depressed patients. The association between baseline characteristics (e.g. clinical features and cognitive functions) and different progression tendencies were also identified.

Results

The tendency of changes in residual symptoms was categorized into four classes: “light residual symptom decline (15.4%)”, “residual symptom disappears (39.3%)”, “steady residual symptom (6.3%)” and “severe residual symptom decline (39.0%)”. We observed that the second class displayed more favorable recuperation outcomes than the rest of patients. The severity, recurrence, polypharmacy, and medication adherence of symptoms are intricately linked to the duration of residual symptoms’ persistence. Additionally, clinical characteristics including sleep disturbances, depressive moods, alterations in appetite or weight, and difficulties with concentration have been identified as significant factors in the recovery process.

Conclusions

Our research findings indicate that certain clinical characteristics in patients with depressive disorders are associated with poor recovery from residual symptoms following acute treatment. This revelation holds significant value in the targeted attention to specific patients and the development of early intervention strategies for residual symptoms accordingly.
Reexamination of the relationships among neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in a sample of patients diagnosed with chronic schizophrenia and schizoaffective disorder
Authors: Lee Kun-Hua , Yu Chuan-Hsun
Published: August 2024

Purpose

This study proposed and evaluated a theoretical model for exploring the relationships between neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in individuals with chronic schizophrenia.

Method

The study recruited 229 individuals given a diagnosis of schizophrenia and schizoaffective disorders from outpatient clinics and the day ward of a mental health hospital. After informed consent was obtained, the participants underwent assessments using the backward digit span, the digit symbol, and measures of self-defeatist beliefs, experiential negative symptoms, and social functioning. A structural equation model was applied to assess the fitness of the hypothesized model, with indices such as the goodness-of-fit index, comparative fit index, root mean square error of approximation, and standardized root mean square residual being used for model evaluation.

Results

The hypothesized model had an adequate fit. The study findings indicated that neurocognition might indirectly influence self-defeatist beliefs through its effect on experiential negative symptoms. Contrary to expectations, the study did not observe a direct influence of neurocognition, self-defeatist beliefs, or negative symptoms on social functioning. The revised model revealed the role of experiential negative symptoms in mediating the association between neurocognition and social functioning. However, self-defeatist beliefs did not significantly affect social functioning.

Discussion

Before modifying negative thoughts, enhancement of self-awareness ability can help improve negative symptoms and thereby improve the performance of social functions. Future research should develop a hierarchical program of negative symptoms, from cognition rehabilitation to enhancement of self-awareness, and end with modifying maladaptive beliefs.
Peripheral giant cell granuloma in a child with ectrodactyly-ectodermal dysplasia-cleft lip/palate syndrome: a case report
Authors: Kumar Aman , Srivastava Vinay Kumar , Sonal Sannu , Bhati Vaishali
Published: August 2024

Background

Ectrodactyly-ectodermal dysplasia-cleft lip/palate (EEC) syndrome mainly affects ectodermal and mesodermal tissues. It is usually manifested as split hands and feet, ectodermal dysplasia, and orofacial clefting, along with other signs and symptoms. A multidisciplinary approach to treatment is required, in which dentists play an important role in identifying and treating various oral conditions that may be genetically linked to or may be the result of EEC syndrome.

Case presentation

The present case describes the oral condition of a young child suffering from EEC syndrome and presenting with peripheral giant cell granuloma (PGCG) in the mandibular anterior region. After obtaining a thorough medical and family history and a clinical examination, the lesion was surgically excised under local anesthesia. The patient was followed up at periodic intervals for the next twenty four months, during which no recurrence of the lesion was observed.

Conclusion

This report highlights the role of a dentist in the management of the oral conditions of patients suffering from EEC syndrome.
Physicians’ experiences and perceptions about withholding and withdrawal life-sustaining treatment in Chiang Mai University Hospital: a cross-sectional study
Authors: Ketchaikosol Nattanit , Pinyopornpanish Kanokporn , Angkurawaranon Chaisiri , Dejkriengkraikul Nisachol , Chutarattanakul Lalita
Published: August 2024

Background

Withholding or withdrawing life-sustaining treatment in end-of-life patients is a challenging ethical issue faced by physicians. Understanding physicians’ experiences and factors influencing their decisions can lead to improvement in end-of-life care.

Objectives

To investigate the experiences of Thai physicians when making decisions regarding the withholding or withdrawal of life-sustaining treatments in end-of-life situations. Additionally, the study aims to assess the consensus among physicians regarding the factors that influence these decisions and to explore the influence of families or surrogates on the decision-making process of physicians, utilizing case-based surveys.

Methods

A web-based survey was conducted among physicians practicing in Chiang Mai University Hospital (June - October 2022).

Results

Among 251 physicians (response rate 38.3%), most of the respondents (60.6%) reported that they experienced withholding or withdrawal treatment in end-of-life patients. Factors that influence their decision-making include patient’s preferences (100%), prognosis (93.4%), patients’ quality of life (92.8%), treatment burden (89.5%), and families’ request (87.5%). For a chronic disease with comatose condition, the majority of the physicians (47%) chose to continue treatments, including cardiopulmonary resuscitation (CPR). In contrast, only 2 physicians (0.8%) would do everything, in cases when families or surrogates insisted on stopping the treatment. This increased to 78.1% if the families insisted on continuing treatment.

Conclusion

Withholding and withdrawal of life-sustaining treatments are common in Thailand. The key factors influencing their decision-making process included patient’s preferences and medical conditions and families’ requests. Effective communication and early engagement in advanced care planning between physicians, patients, and families empower them to align treatment choices with personal values.
A systematic mapping of public health master’s and structured doctoral programs in Germany
Authors: Saturska Hanna , Kufer Katrina , Pedron Sara , Meyer Gesa , Emmert-Fees Karl , Laxy Michael , Stephan Anna-Janina
Published: August 2024

Background

Well-trained public health professionals are key to addressing both global and local public health challenges of the twenty-first century. Though availability of programs has increased, the population health science (PHS) and public health (PH) higher education landscape in Germany remains scattered. To date, no comprehensive overview of programs exists.

Objectives

This study aimed to map PHS and PH master’s and structured doctoral programs in Germany, including selected program characteristics, curricula and target competencies.

Methods

We conducted a systematic mapping of PHS and PH programs in Germany following a prospectively registered protocol (https://doi.org/10.17605/OSF.IO/KTCBA). Relevant master’s and doctoral programs were identified by two study authors independently searching a comprehensive higher education database, which was, for doctoral programs, supplemented with a google search. For PHS programs, general characteristics were mapped and for the subset of PH programs, in-depth characteristics were extracted.

Results

Overall, 75 master’s and 18 structured doctoral PHS programs were included. Of these, 23 master’s and 8 doctoral programs focused specifically on PH. The majority of PHS master’s programs awarded a Master of Science degree (55 out of 75 programs). The PH master’s program curricula offered various courses, allowing for different specializations. Courses on topics like public health, epidemiology, health systems (research) and research methods were common for the majority of the master’s programs, while courses on physical activity, behavioral science, nutrition, and mental health were offered less frequently. Structured PH doctoral programs were mainly offered by medical faculties (6 out of 8 programs) and awarded a doctorate of philosophy (Ph.D.) (6 out of 8 programs). PH doctoral programs were very heterogeneous regarding curricula, entry, and publication requirements. There was a broad geographical distribution of programs across Germany, with educational clusters in Munich, Berlin, Bielefeld and Düsseldorf.

Conclusion

Germany offers a diverse landscape of PHS and PH master’s programs, but only few structured doctoral programs. The variety of mandatory courses and competencies in these programs reflect Germany’s higher education system’s answer to the evolving demands of the PH sector. This review may aid in advancing PH education both in Germany and globally.
Patient profiled data for treatment decision-making: valuable as an add-on to hepatitis C clinical guidelines?
Authors: Brakenhoff Sylvia M. , Theijse Thymen , van Wijngaarden Peter , Trautwein Christian , Brozat Jonathan F. , Tacke Frank , Honkoop Pieter , Vanwolleghem Thomas , Posthouwer Dirk , Zeuzem Stefan , Mihm Ulrike , Wedemeyer Heiner , Berg Thomas , Schalm Solko W. , de Knegt Robert J.
Published: August 2024

Background and Aims

Systematic reviews and medical guidelines are widely used in clinical practice. However, these are often not up-to-date and focussed on the average patient. We therefore aimed to evaluate a guideline add-on, TherapySelector (TS), which is based on monthly updated data of all available high-quality studies, classified in specific patient profiles.

Methods

We evaluated the TS for the treatment of hepatitis C (HCV) in an international cohort of patients treated with direct-acting antivirals between 2015 and 2020. The primary outcome was the number of patients receiving one of the two preferred treatment options of the HCV TS, based on the highest level of evidence, cure rate, absence of ribavirin-associated adverse effects, and treatment duration.

Results

We enrolled 567 patients. The number of patients treated with one of the two preferred treatment options according to the HCV TS ranged between 27% (2015) and 60% (2020; p < 0.001). Most of the patients received a regimen with a longer treatment-duration (up to 34%) and/or addition of ribavirin (up to 14%). The effect on the expected cure-rate was minimal (1–6% higher) when the first preferred TherapySelector option was given compared to the actual treatment.

Conclusions

Medical decision-making can be optimised by a guideline add-on; in HCV its use appears to minimise adverse effects and cost. The use of such an add-on might have a greater impact in diseases with suboptimal cure-rates, high costs or adverse effects, for which treatment options rely on specific patient characteristics.
The effect of balint practice on reducing stress, anxiety and depression levels of psychiatric nurses and improving empathy level
Authors: Mao Yunnan , Zhang Fenghong , Wang Yanyan , Hu Qiuyue , Fan Lingyun
Published: August 2024

Objective

To explore the effect of Balint Group in improving stress, negative mood and empathy of psychiatric nurses.

Method

In March 2022-March 2023, 150 psychiatric nurses from four hospitals in Lanzhou were selected for the study, randomly grouped into experimental group and control groups (75 per group), the experimental group participated the Balint Group activities biweekly, the control group only attended mental health knowledge lectures. Job stress, negative emotion and empathy of the two groups before and after the intervention were evaluated and compared by using job stressor Scale, coping style Assessment Scale, self-assessment scale for depression, self-assessment Scale for anxiety and Jefferson Empathy Scale.

Results

After intervention, the job stressor scale and coping style evaluation of nurses in the two groups were significantly decreased, and the experimental group was lower than the control group (P < 0.05). The depression and anxiety of nurses in the two groups were significantly improved, and the experimental group was better than the control group (P < 0.05). The differences in the total score and dimensions of Jefferson Empathy scale in the experimental group after intervention were higher than those in the control group (P < 0.05).

Conclusion

Balint group activities can effectively relieve the stress, depression and anxiety of psychiatric nurses, and improve the ability of empathy at work.
Using formative process evaluation to improve program implementation and accessibility of competitive group-based physical activity in the TEAM-PA trial
Authors: Sweeney Allison M. , Wilson Dawn K. , Zarrett Nicole , Simmons Timothy , Mansfield Makayla , Decker Lindsay
Published: August 2024

Background

This study demonstrates how formative process evaluation was used to assess implementation and improve dose and fidelity in the Together Everyone Achieves More Physical Activity (TEAM-PA) randomized controlled trial. TEAM-PA uses a randomized group cohort design to evaluate the efficacy of a group-based intervention for increasing physical activity among African American women.

Methods

Intervention groups met for 10 weeks and were co-led by female African American facilitators, with intervention sessions consisting of group feedback, a health curriculum, group-based physical activity games, and group-based goal-setting. Drawing from a multi-theoretical framework, the intervention targeted social affiliation using collaborative and competitive group strategies, including essential elements focused on group-based behavioral skills, peer-to-peer positive communication, collectivism, optimal challenge, social facilitation, and peer to peer challenges. Formative process evaluation was used to monitor reach, dose, and fidelity, and implement feedback and solutions.

Results

Across two cohorts, four groups (n = 54) were randomized to the TEAM-PA intervention. On average 84.8% of participants attended each week, which exceeded the a priori criteria. Results from the systematic observations indicated that on average 93% of the dose items were completed in each session and adequate levels of fidelity were achieved at both the facilitator and group-levels. Participants were compliant with wearing the FitBits (6.73 ± 0.42 days/week) and most participants successfully contributed to meeting the group-based goals. The use of open-ended items also revealed the need for additional modifications to the group-based PA games, including allowing for individuals to take breaks, incorporating a broader range of exercises, minimizing activities that required bending/reaching down without assistance, and providing facilitators with additional training for implementing the games. Initial evidence suggests that these changes were successful in increasing participants’ comprehension of the games from Cohort 1 (M = 1.83, SD = 0.71) to Cohort 2 (M = 3.33, SD = 0.69).

Conclusion

Findings from this study demonstrated high levels of reach, dose, and fidelity, while also highlighting strategies for implementing competitive group-based PA games that are accessible across physical fitness levels. Formative process evaluation, including open-ended items and collaborative brainstorming, holds tremendous potential for improving future interventions.

Trial registration

This study was registered on Clinicaltrials.gov (# NCT05519696) on August 22, 2022 prior to the enrollment of the first participant on September 12, 2022 (https://clinicaltrials.gov/study/NCT05519696?term=NCT05519696&rank=1).
Accuracy of the surgical execution of virtually planned deep circumflex iliac artery flaps and their appropriateness for masticatory rehabilitation
Authors: Peters Florian , Raith Stefan , Bock Anna , Kniha Kristian , Ooms Mark , Möhlhenrich Stephan Christian , Hölzle Frank , Modabber Ali
Published: August 2024

Background

Tumorous diseases of the jaw demand effective treatments, often involving continuity resection of the jaw. Reconstruction via microvascular bone flaps, like deep circumflex iliac artery flaps (DCIA), is standard. Computer aided planning (CAD) enhances accuracy in reconstruction using patient-specific CT images to create three-dimensional (3D) models. Data on the accuracy of CAD-planned DCIA flaps is scarce. Moreover, the data on accuracy should be combined with data on the exact positioning of the implants for well-fitting dental prosthetics. This study focuses on CAD-planned DCIA flaps accuracy and proper positioning for prosthetic rehabilitation.

Methods

Patients post-mandible resection with CAD-planned DCIA flap reconstruction were evaluated. Postoperative radiograph-derived 3D models were aligned with 3D models from the CAD plans for osteotomy position, angle, and flap volume comparison. To evaluate the DCIA flap’s suitability for prosthetic dental rehabilitation, a plane was created in the support zone and crestal in the middle of the DCIA flap. The lower jaw was rotated to close the mouth and the distance between the two planes was measured.

Results

20 patients (12 males, 8 females) were included. Mean defect size was 73.28 ± 4.87 mm; 11 L defects, 9 LC defects. Planned vs. actual DCIA transplant volume difference was 3.814 ± 3.856 cm³ (p = 0.2223). The deviation from the planned angle was significantly larger at the dorsal osteotomy than at the ventral (p = 0.035). Linear differences between the planned DCIA transplant and the actual DCIA transplant were 1.294 ± 1.197 mm for the ventral osteotomy and 2.680 ± 3.449 mm for the dorsal (p = 0.1078). The difference between the dental axis and the middle of the DCIA transplant ranged from 0.2 mm to 14.8 mm. The mean lateral difference was 2.695 ± 3.667 mm in the region of the first premolar.

Conclusion

The CAD-planned DCIA flap is a solution for reconstructing the mandible. CAD planning results in an accurate reconstruction enabling dental implant placement and dental prosthetics.
Clinical implications of the serum platelet-to-lymphocyte ratio in the modern radiation oncology era: research update and literature review
Authors: Lee Dong Soo
Published: August 2024

Radiation therapy (RT) continues to be the primary approach for treating cancer, and numerous cancer biomarkers associated with oncological outcomes have been investigated in the context of RT. The serum platelet-to-lymphocyte ratio (PLR) is one of the emerging landmark biomarker in the oncologic field. Mounting evidence indicates that an elevated serum PLR may function as a marker of unfavorable tumor characteristics, adverse treatment outcomes and treatment-related toxicities among individuals undergoing RT. However, the findings of these investigations have revealed a few disparities among researchers, highlighting the need for further meticulously planned studies to draw conclusive results. This article provides a comprehensive literature review and in-depth discussion regarding the clinical implications of the serum PLR in the modern RT era.
Hygiene performance rating at farm level - an auditing scheme for evaluation of biosecurity measures’ effect on prevalence of Campylobacter from selected broiler producers
Authors: Nagel-Alne Gunvor Elise , Røtterud Ole-Johan , Refsum Thorbjørn , Holthe Janne , Garner Miriam , Skjerve Eystein , Hauge Sigrun J.
Published: August 2024

Background

Preventing pathogens from entering the broiler premises is the main biosecurity measure at farm level. In conventional broiler production, chickens are kept indoors during the entire production period. Pathogens can enter the broiler-producing unit from sources such as water, equipment, personnel, insects, and rodents. The possible routes must be controlled, and corrective measures applied when necessary. The objective of this study was to (1) develop a hygiene protocol and test the scheme on 30 farms, and (2) compare the results to their Campylobacter-colonised status. A Hygiene Performance Rating protocol at farm level (HPR-F) was developed to systematically review the production to identify risk areas to biosecurity. The HPR-F consists of 13 categories with related questions. For each question, a score was given from 1 to 3, where 1 meant “acceptable”, 2 was “potential for improvements”, and 3 was “not acceptable”. Scores for each question were multiplied with weight factors for hygienic impact and economic consequences describing whether the necessary improvement depends on a significant investment or is a cheap quick-fix and calculated into a percentage where 100% is perfect hygiene. The 30 farms in the study were selected from one county in Norway. The Campylobacter-results for each of the 30 farms in 2019–2021 were given according to rules in the Norwegian Action Plan against Campylobacter faecal sampling on-farm 3–6 days prior to slaughter.

Results

The overall results from the HPR-F showed that the general hygiene level was high in all farms. The mean total hygiene score was 82% and varied from 70 to 92%. The category Handling dead chicken had the highest hygiene score (93%), and Ventilation had the lowest score (55%). The HPR-F results were compared to the Campylobacter-status for the 30 farms: Campylobacter-negative flocks had slightly higher total scores than Campylobacter-positive flocks (P = 0.19). Among others, the category Outdoor area (vegetation close to the premises’ walls) was identified as the most stable factor in relation to be colonised with Campylobacter.

Conclusions

The HPR-F tested in this research trial provides a tool for veterinarians, advisors, and poultry farmers to improve biosecurity at farm level and enhance the preventive animal health initiatives.
Characterization of mosquito host-biting networks of potential Rift Valley fever virus vectors in north-eastern KwaZulu-Natal province, South Africa
Authors: Makhanthisa Takalani I. , Guarido Milehna M. , Kemp Alan , Weyer Jacqueline , Rostal Melinda K. , Karesh William B. , Thompson Peter N.
Published: August 2024

Background

Rift Valley fever virus (RVFV) is a zoonotic mosquito-borne virus with serious implications for livestock health, human health, and the economy in Africa, and is suspected to be endemic in north-eastern KwaZulu-Natal (KZN), South Africa. The vectors of RVFV in this area are poorly known, although several species, such as Aedes (Neomelaniconion) mcintoshi, Aedes (Neomelaniconion) circumluteolus, Aedes (Aedimorphus) durbanensis, and Culex (Lasioconops) poicilipes may be involved. The aim of the study was to determine the vertebrate blood meal sources of potential RVFV mosquito vectors in north-eastern KZN and to characterize the host-biting network.

Methods

Blood-fed mosquitoes were collected monthly from November 2019 to February 2023 using a backpack aspirator, CO2-baited Centers for Disease Control and Prevention (CDC) miniature light traps and tent traps, in the vicinity of water bodies and livestock farming households. The mosquitoes were morphologically identified. DNA was extracted from individual mosquitoes and used as templates to amplify the vertebrate cytochrome c oxidase I (COI) and cytochrome b (cytb) genes using conventional polymerase chain reaction (PCR). Amplicons were sequenced and queried in GenBank and the Barcode of Life Data systems to identify the vertebrate blood meal sources and confirm mosquito identifications. All mosquitoes were screened for RVFV using real time reverse transcription (RT)-PCR.

Results

We identified the mammalian (88.8%) and avian (11.3%) blood meal sources from 409 blood-fed mosquitoes. Aedes circumluteolus (n = 128) made up the largest proportion of collected mosquitoes. Cattle (n = 195) and nyala (n = 61) were the most frequent domestic and wild hosts, respectively. Bipartite network analysis showed that the rural network consisted of more host-biting interactions than the reserve network. All mosquitoes tested negative for RVFV.

Conclusions

Several mosquito species, including Ae. circumluteolus, and vertebrate host species, including cattle and nyala, could play a central role in RVFV transmission. Future research in this region should focus on these species to better understand RVFV amplification.

Graphical Abstract
M2-like tumor-associated macrophage-secreted CCL2 facilitates gallbladder cancer stemness and metastasis
Authors: Chen Weihong , Chen Mingyuan , Hong Lingju , Xiahenazi Abudukeremu , Huang Maotuan , Tang Nanhong , Yang Xinyue , She Feifei , Chen Yanling
Published: August 2024

Background

The predominant immune cells in solid tumors are M2-like tumor-associated macrophages (M2-like TAMs), which significantly impact the promotion of epithelial-mesenchymal transition (EMT) in tumors, enhancing stemness and facilitating tumor invasion and metastasis. However, the contribution of M2-like TAMs to tumor progression in gallbladder cancer (GBC) is partially known.

Methods

Immunohistochemistry was used to evaluate the expression of M2-like TAMs and cancer stem cell (CSC) markers in 24 pairs of GBC and adjacent noncancerous tissues from patients with GBC. Subsequently, GBC cells and M2-like TAMs were co-cultured to examine the expression of CSC markers, EMT markers, and migratory behavior. Proteomics was performed on the culture supernatant of M2-like TAMs. The mechanisms underlying the induction of EMT, stemness, and metastasis in GBC by M2-like TAMs were elucidated using proteomics and transcriptomics. GBC cells were co-cultured with undifferentiated macrophages (M0) and analyzed. The therapeutic effect of gemcitabine combined with a chemokine (C-C motif) receptor 2 (CCR2) antagonist on GBC was observed in vivo.

Results

The expression levels of CD68 and CD163 in M2-like TAMs and CD44 and CD133 in gallbladder cancer stem cells (GBCSCs) were increased and positively correlated in GBC tissues compared with those in neighboring noncancerous tissues. M2-like TAMs secreted a significant amount of chemotactic cytokine ligand 2 (CCL2), which activated the MEK/extracellular regulated protein kinase (ERK) pathway and enhanced SNAIL expression after binding to the receptor CCR2 on GBC cells. Activation of the ERK pathway caused nuclear translocation of ELK1, which subsequently led to increased SNAIL expression. GBCSCs mediated the recruitment and polarization of M0 into M2-like TAMs within the GBC microenvironment via CCL2 secretion. In the murine models, the combination of a CCR2 antagonist and gemcitabine efficiently inhibited the growth of subcutaneous tumors in GBC.

Conclusions

The interaction between M2-like TAMs and GBC cells is mediated by the chemokine CCL2, which activates the MEK/ERK/ELK1/SNAIL pathway in GBC cells, promoting EMT, stemness, and metastasis. A combination of a CCR2 inhibitor and gemcitabine effectively suppressed the growth of subcutaneous tumors. Consequently, our study identified promising therapeutic targets and strategies for treating GBC.
Development and validation of a secondary vocational school students’ digital learning competence scale
Authors: Tan Xijin , Lin Xiaoxi , Zhuang Rongxia
Published: August 2024

The rapid advancement of digital technology has not only affected the world of work but also students' learning. Digital learning competence (DLC) is one of the essential skills students need for effective learning in a digital environment. Despite the significant presence of secondary vocational school students in China, constituting one-third of the high school demographic, research on their digital learning needs remains sparse. Addressing this gap, this paper attempted to propose the elements and structural model of digital learning competence for secondary vocational school students (V-DLC). A corresponding questionnaire was compiled, and an analysis was carried out with 872 valid survey data of secondary vocational school students achieved by convenient sampling. A five-factor model for the V-DLC was established through exploratory and confirmatory factor analyses, cross-validity, and criterion validity tests. This paper suggests that evaluating students' digital learning competence in secondary vocational schools can be achieved by considering the dimensions of cognitive processing and reading, technology use, thinking skills, activity management, and will management, combined with students' learning experiences in school and other fields. Given the global focus on digital learning competence, this framework will pave the way for empirical research on digital learning and guide the enhancement of student learning ability in vocational settings, adapting to the digital era. Furthermore, transitioning to a digitalized vocational education system is essential for preparing students for a digitally-driven workforce, aligning with modern job market demands and global trends.
Characterising aetiologies and clinical-radiological factors of non-resolving pneumonia in a tertiary care centre
Authors: Raj Ajitha , Venugopal Kummannor Parameswaran Pillai , Musthafa Sajitha , Narayan Kiran Vishnu
Published: August 2024

Background

Non-resolving pneumonia poses a significant clinical challenge. It is common to treat non-resolving pneumonia over an extended period of time, without evaluating the cause of failure or eliciting the exact aetiology.

Objective

To determine the aetiology and clinical-radiological profile of non-resolving pneumonia.

Materials and methods

Analytical, observational study done among 77 consecutive patients with non-resolving pneumonia, who attended a tertiary care centre over 1 year. Clinical details were obtained using prefixed questionnaires. Necessary diagnostic procedures like bronchoscopy and image guided transthoracic sampling along with histopathological and microbiological investigations were done to obtain final diagnosis.

Results

The most common aetiology was lung malignancy (44.2%) followed by chronic infections (40.3%) dominated by tuberculosis (14.3%). Adenocarcinoma (32.5%) was the commonest malignancy presenting as non-resolving consolidation. History of smoking (p value 0.001), chest pain (p value 0.001), and haemoptysis (p value 0.006) was associated with a diagnosis of malignancy. Actinomycosis (7%) had a significant association with chest pain (p value 0.032). Transthoracic image-guided tissue sampling had a high diagnostic yield of 84.8% and bronchoscopy of 66.9%.

Conclusion

Malignancy needs to be considered promptly once we encounter with non-resolution of consolidation. The clinical pointers like advanced age, smoking history, symptoms more than 8 weeks, symptoms like chest pain, and haemoptysis mandate evaluation for malignancy in non-resolving pneumonia. The labyrinth of diabetes mellitus impedes the timely resolution of infections.
VV-ECMO in critical COVID-19 obese patients: a cohort study
Authors: Nogueira Joana , Freitas Ricardo , Sousa José Eduardo , Santos Luís Linhares
Published: August 2024

Background

Obesity causes significant difficulties in successful extracorporeal membrane oxygenation (ECMO) support and may interfere with patient outcomes. During the COVID-19 pandemic, we experienced an increased number of obese patients supported with ECMO in our intensive care unit due to severe illness in this population.

Methods

We designed a single-center retrospective study to identify prognostic factors for 180-day survival in obese critical COVID-19 patients receiving venovenous ECMO (VV-ECMO). We included adult critical COVID-19 patients on VV-ECMO, who were obese and overweight (according to the World Health Organization) and admitted to a tertiary hospital’s intensive care unit from April 1, 2020, to May 31, 2022. Univariate logistic regression analysis was performed to assess differences in 180-day mortality.

Results

Forty-one patients were included. The median age was 55 (IQR 45–60) years, and 70.7% of the patients were male. The median body mass index (BMI) was 36 (IQR 31–42.5) kg/m2; 39% of patients had a BMI ≥ 40 kg/m2. The participants had 3 (IQR 1.5–4) days of mechanical ventilation prior to ECMO, and 63.4% were weaned from VV-ECMO support after a median of 19 (IQR 10–34) days. The median ICU length of stay was 31.9 (IQR 17.5–44.5) days. The duration of mechanical ventilation was 30 (IQR 19–49.5) days. The 180-day mortality rate was 41.5%. Univariate logistic regression analysis revealed that a higher BMI was associated with greater 180-day survival (OR 1.157 [1.038–1.291], p = 0.009). Younger age, female sex, less invasive ventilation time before ECMO, and fewer complications at the time of ECMO cannulation were associated with greater 180-day survival [OR 0.858 (0.774–0.953), p 0.004; OR 0.074 (0.008–0.650), p 0.019; OR 0.612 (0.401–0.933), p 0.022; OR 0.13 (0.03–0.740), p 0.022), respectively].

Conclusion

In this retrospective cohort of critical COVID-19 obese adult patients supported by VV-ECMO, a higher BMI, younger age, and female sex were associated with greater 180-day survival. A shorter invasive ventilation time before ECMO and fewer complications at ECMO cannulation were also associated with increased survival.
REALIZATION OF THE EXPORT POTENTIAL OF THE AGRICULTURAL INDUSTRIAL COMPLEX OF RUSSIA IN THE CONDITIONS OF DIGITAL ECONOMY DEVELOPMENT
Authors: Minakov Andrey , Safiullin Il'nur , Amirova Elmira
Published: August 2024

The agro-industrial complex of Russia is designed to ensure the country’s food security and significantly influences the social and economic development of society. In recent years, the state’s economic policy has been aimed at intensifying the export of agricultural products, which requires serious investments and introduction of innovative technologies, including digitalization, to increase the competitiveness and quality of manufactured goods. During 2018-2023, the volume of exports of agricultural products of the Russian Federation increased by more than 2/3, which to a certain extent was a consequence of the stimulation of commodity producers as a result of the implementation of the federal project “Export of agricultural products.” The structure of exports of Russian agro-industrial complex products is dominated by grains, oil and fat products, fish and seafood, and products of the food and processing industry. The five main importing countries (China, Turkey, Kazakhstan, Belarus and Egypt) accounted for almost half of all Russian agricultural exports in 2023, with China’s share increasing from 12.3 to 17.5% in the last two years alone. During 2020-2022 in Russia, the rate of increase in the volume of exports of agricultural products is higher, as a result of which the share of domestic products in the global total has increased slightly, but is only slightly more than 2%. Russia’s lag behind leading countries in terms of digitalization in agriculture is explained by such factors as: natural and climatic conditions, rising costs of means of production, decreased investment and slower implementation of innovative technologies, and disruption of supply chains. In order to increase and realize the export potential of the Russian agro-industrial complex, it is necessary to improve government support measures, stimulate import substitution and support manufacturers who effectively use production resources, primarily land and digital technologies.
Prawo w epoce antropocenu
Authors: Zirk-Sadowski Marek
Published: August 2024

Anthropocene studies are often identified in Poland with ecology. In this work, the Anthropocene is a much more dynamic category that touches the very ontology of our world. The starting point for taking up the issue of the Anthropocene was a scientific description of the effects of changes in the nature surrounding man. The awareness of the crisis in the relationship between civilization and nature has triggered many cultural phenomena. The reaction to the scientific description itself was based on the clash of these scientific relations with the myths of progress, which contributed to the ideological impact of the Anthropocene and allowed it to occupy an important position also in popular (mass) culture. Socio-political phenomena have become another important dimension of the process of assimilating the category of the Anthropocene. The Anthropocene began to play a fundamental role in the generational exchange of ideas giving birth to social movements of the generation of young people born around the year 2000. Against the background of the discussion on the model of the relationship between man and nature, the philosophical dimension has become established as the third type of reaction to the problem of the Anthropocene. Similar discussions have arisen in the humanities. The fourth, specific dimension of the reaction to the Anthropocene are changes in the law and a significant part of the discussion has been devoted to them. It has been demonstrated that the law has a better chance of empowering nature as postulated in other areas of culture, although only in the legal sense. At the same time, it has been shown that local legal discourses are not able to solve the problems that the Anthropocene reveals. They must be taken at international level. The main problem is the creation of an international construction of the so-called Rights of Nature (RoN). Its essence is the autonomous construction of rights granted to nature on the model of the concept of human rights and the construction of institutional forms for them.
Wykładnia rozszerzająca a logika
Authors: Woleński Jan
Published: August 2024

The paper presents model theoretic (in the sense of model theory as a branch of mathematical logic) account of legal interpretation. It is defined as a conservative extension of the initial model of a legal prescription.
Wykładnia zwężająca (interpretatio restrictiva)
Authors: Próchnicki Maciej
Published: August 2024

Restrictive interpretation as the inversion of extensive interpretation remains a marginal problem in the literature. This may be due to three factors: the symmetry thesis – the belief that the restrictive interpretation is a simple counterpart of the extensive interpretation; the greater importance of the practical application of the canons prohibiting the use of the extensive interpretation as compared to the rarely proposed limitations of the restrictive interpretation; and the controversy arising from going beyond the scope of the law (absent with restrictive interpretation). These issues become apparent in the thought of Jerzy Wróblewski (who adopts symmetry) and Alf Ross (who assumes asymmetry). The asymmetry of restrictive vs. extensive interpretation manifests itself primarily in the absence of a counterpart to the prohibition of interpretation of exceptions, and the specificity of applying a given interpretation in different branches of law.
Problemy wykładni rozszerzającej w orzecznictwie Trybunału Sprawiedliwości Unii Europejskiej na przykładzie wyroku TSUE w sprawie C-383/18 Lexitor
Authors: Spyra Tomasz
Published: August 2024

The subject of the article is the analysis of the expansive interpretation applied by the CJEU in consumer law. Firstly, the author discusses the concept of expansive interpretation, recapitulating the analysis carried out by Krzysztof Płeszka in the work "Expansive Interpretation." The author also examines the application of the concept of expansive interpretation to the CJEU case law, concluding that the free interpretative methodology adopted by the CJEU following the example of French courts calls into question the rationale of such application. Furthermore, the author points out that in the case of consumer law, axiological conditions for exceeding the linguistic boundary remain relevant. Consumer law has a quasipublic character, and thus similar restrictions on interpretative freedom apply as in public law. Expanding consumer rights must be consistent with the principle of proportionality and must not lead to excessive infringement of the rights of entrepreneurs. However, in CJEU case law, the conditions for the admissibility of expansive interpretation are often not analyzed in practice. An example is the judgment in case C-383/18 regarding Lexitor. A closer analysis of this judgment leads to the conclusion that it represents a clear case of overtly exceeding the linguistic boundaries of interpretation. Consequently, the author concludes that there is an asymmetry between national case law, characterized by far-reaching rigor in interpretation, and CJEU case law, characterized by a high degree of methodological freedom. The only way to rectify this is to apply the same methodological rigor to the assessment and interpretation of CJEU judgments as the CJEU applies to the interpretation of European law.
Reprezentacja reguły lex specialis za pomocą formalnego modelu argumentacji
Authors: Żurek Tomasz
Published: August 2024

The main aim of this work is to formalize the lex specialis… doctrine, the mechanism of resolving conflicts between statutory legal rules with a view to incorporating them into a legal advisory system. The model is built on the basis of the ASPIC+ argument modeling framework. The paper presents a discussion and a formal model of the mechanism of conflict resolution.
Legalizm liberalny, pluralizm wartości i etyka troski
Authors: Polanowska-Sygulska Beata
Published: August 2024

The background to my reflections developed in this article is the controversial legal philosophy of Scott Veitch, which challenges conventional thinking about law and its institutions. In his first book Moral Conflict and Legal Reasoning, Veitch confronts liberal legalism with Isaiah Berlin’s pluralistic perspective in ethics and concludes that it is not possible to reconcile the two positions. In his later work, Law and Irresponsibility, Veitch argues that legal institutions are often used as a means of organised irresponsibility. Starting with a reconstruction of Veitch’s iconoclastic theses, I then move on to present two situational contexts that occurred in Poland and that have direct relevance to the issue of euthanasia. The two states of affairs are strikingly different, although in both cases the indication for euthanasia comes into play. I then confront both of these situational contexts with two distinct moral keys identified within feminism – an ethic of justice and an ethic of care. I show that each of the distinct cases described aligns with different moral keys. This is a strong argument for adopting a pluralist perspective in ethics, which, however, does not go in pair with liberal legalism. It is for this reason that Ronald Dworkin’s position, as an embodiment of ethical monism, liberal legalism and an ethic of justice, may prove particularly damaging in its effects. And it is one that can teach lawyers an invaluable lesson in humility.
O dystrybucji szczepień przeciwko COVID -19 w warunkach deficytu – pytanie o zasadę pierwszeństwa seniorów
Authors: Ciszewski Wojciech
Published: August 2024

The first vaccines against COVID -19 were released at the end of 2020. Unfortunately, at that time, the number of people willing to vaccinate significantly exceeded the number of available vaccine doses. Because of that, state authorities faced the challenge of how to distribute these resources in a fair manner. The political solution to this problem usually included a policy based on the ‘older people first’ principle, according to which older citizens should be granted a priority access to COVID -19 vaccines. The principle was commonly perceived as uncontroversial, however contemporary bioethics questions its legitimacy. In the paper, the author takes a closer look at the ‘older people first’ principle, and its possible criticisms.
Etyka przekonań prawodawcy – zaczątek rozważań
Authors: Juzaszek Maciej
Published: August 2024

Ethics of belief is a normative discipline, concerned with what norms and criteria we should apply to accept and reject beliefs. Traditionally, it focuses on the beliefs of individuals, but the literature emphasizes that groups and institutions can also hold beliefs, know or lie. Therefore, it seems that some form of belief ethics should apply to them as well. In this paper, I will be interested in the belief ethics of a rational legislator. Thus, I present an example of such a concept, referring to the theory from the field of ethics of beliefs of individuals – evidentialism, as well as the basic objections that can be formulated against it. Finally, I present a way to reconcile the legislator’s evidentialism with pragmatic or moral factors.
Odpowiedzialność za działania w afekcie. Problem asymetrii
Authors: Załuski Wojciech
Published: August 2024

An experimental research (conducted by D. Pizarro et al.) has revealed an asymmetry in assigning responsibility for morally bad and morally good actions taken under the influence of emotions. The asymmetry consists in that people tend to assign less responsibility to the agent if his/her morally bad action was made under the influence of emotions, but if his/her action was morally good then the fact that he/she took this action under the influence of emotions is not treated as justifying the diminishing his/her responsibility. This asymmetry is a puzzle that requires explanation. The article discusses the explanation proposed by the authors of the experiment (based on the concept of ‘meta-desires’) and offers an alternative explanation drawing on the distinction between an antecedent emotion (passio antecedens) and consequent emotions (passio consequens) proposed by Thomas Aquinas in his Summa Theologiae.