bluuebunny/crossref_metadata_2025 huggingface dataset:
Peer-to-Peer Accommodation User Experience: Evidence From Sri Lanka
Authors: Munasinghe Lasika Madhawa , Gunawardhana Terans , Wickramaarachchi Nishani Champika , Ariyawansa Ranthilaka Gedara
Published: October 2023

With the emergence of the sharing economy, Airbnb has become the poster child for the digital peer-to-peer accommodation market in the hospitality industry. The study explores the attributes influencing Airbnb user experiences in Sri Lanka by analyzing online guest reviews. The study uses an exploratory research design to examine a large data set of Airbnb user reviews utilizing text mining and sentiment analysis. According to the analysis, five key themes emerged from the review comments: “recommend,”“host,”“experience,”“room,” and “location.” Furthermore, the relationship between the host and the guest greatly impacts the Airbnb user experience in Sri Lanka. Most Airbnb user reviews are positive and primarily focus on the host, while negative ones typically focus on the property’s indoor environmental quality. The study contributes to the literature on the sharing economy by offering a structured and extensive analysis of actual online reviews from Airbnb customers to understand their experiences better while providing valuable insights for various stakeholders in the industry.
Consumers’ Perception of Risk Facets Associated With Fintech Use: Evidence From Pakistan
Authors: Li Chunling , Khaliq Nosherwan , Chinove Leslie , Khaliq Usama , Oláh Judit
Published: October 2023

Studies illustrate progress in financial technology in Pakistan; nevertheless, the uncertain obstacle that prevents clients from adopting financial technology remains unclear. The research on the perceived risk, particularly in using financial technology in Pakistan, is limited. Therefore, this research bridges this gap. Two hundred ten members partook in this exploration. We have used the structural equation modeling approach to probe the acquired information and hypothesis. Empirical results show that three of eight perceived risk factors: performance risk, financial risk, and overall risk, have a substantial adverse effect on the intention to utilize financial technology. The highest impact was performance risk, followed by financial risk and overall risk. Whereas the other five risks: social risk, time risk, security risk, legal risk, and psychological risk, statistically have no substantial adverse effect on intent to utilize financial technology. The outcomes help experts better conceptualize and diminish hazard boundaries in planning for the disturbance of financial technology (fintech). Experts are likewise encouraged to focus on fintech’s operational aptitudes and utilitarian framework execution in fintech administrations.
Entrepreneurial Passion Matters: The Relationship Between Proactive Personality and Entrepreneurial Intention
Authors: Hu Rui , Shen Zuxian , Kang Tae-Won , Wang Li , Bin Peng , Sun Shan
Published: October 2023

The multiple mechanisms of entrepreneurial intention are still an open issue, and few have explored whether the relationship between entrepreneurial intention and proactive personality is influenced by entrepreneurial passion. This study aims to reveal the mediation role of entrepreneurial passion between proactive personality and entrepreneurial intention with the application of the classic structural equation modeling. A questionnaire survey was conducted on Chinese undergraduates and 647 questionnaires were collected for the further analysis. The main findings shed light on the mechanisms that underpin entrepreneurial passion and contribute to the growing body of knowledge on entrepreneurial intention and will raise implications for both academic entrepreneurial theory and practice.
Characterization and evaluation of Bletilla striata polysaccharide/konjac glucomannan blend hydrogel for wound healing
Authors: Shang Jin , Duan Liangliang , Zhang Weimin , Li Xiangwen , Ma Cheng , Xin Bao
Published: October 2023

Bletilla striata polysaccharide (BSP) is effective for wound healing and has important applications in health care. A series of blend hydrogels was designed with BSP and konjac glucomannan (KGM) in this study to overcome the deficient mechanical performance caused by the excessive dissolution of BSP without affecting its physiological activity. The interplay between them, as well as the effects of KGM concentration on the physical properties and microstructures of hydrogels, were also explored. It was proved that the frame of the hydrogel was primarily formed by KGM. BSP was dispersed uniformly and linked to KGM through hydrogen bonding, which effectively improved the physical properties, such as increasing the water-holding capacity, improving the swelling degree, and enhancing the mechanical properties. Blend hydrogel BK2-2 (containing 1.0% BSP and 1.0% KGM, w/v) was found to be the optimal formulation based on the thermal stability and microstructure, which was used for further research. In vitro experiments revealed the L929 cell proliferative effects of the blend hydrogel, and no difference was found with BSP sponge extract after 72 h of exposure. In vivo animal studies indicated that the BK2-2 accelerated wound healing compared with the control group; however, no difference was found with dressings only made of BSP. These results demonstrated that KGM improved the physical properties of BSP-based material without negatively affecting its physiological properties. Also, the BSP/KGM blend hydrogel had good comprehensive properties and is expected to be used as a wound healing material in the future.
Shoulder and Elbow Injuries in National Basketball Association Athletes and Their Effects on Player Performance
Authors: Morikawa Landon H. , Tummala Sailesh V. , Brinkman Joseph C. , Crijns Tom J. , Lai Cara H. , Chhabra Anikar
Published: October 2023

Background:

Shoulder and elbow function is essential to basic basketball actions. Outside of anterior shoulder instability, injuries in these joints are not well characterized in National Basketball Association (NBA) players.

Purpose:

To describe the epidemiology and associated risk factors of shoulder and elbow injuries in NBA players and identify factors that influence player performance upon return to play.

Study Design:

Descriptive epidemiology study.

Methods:

Historical injury data from the 2015-2020 NBA seasons were retrieved from Pro Sports Transactions, a public online database. An injury was defined as a health-related concern resulting in an absence of ≥1 NBA games. Primary measures included pre- and postinjury player efficiency rating (PER) and true shooting percentage (TS%) with interquartile ranges (IQRs), stratified by extremity dominance. Multivariate logistic regression analyses with stepwise regression were performed to identify risk factors associated with return-to-play performance.

Results:

A total of 192 shoulder and elbow injuries were sustained among 126 NBA athletes, with incidence rates of 1.11 per 1000 game exposures (GEs) and 0.30 per 1000 GEs, respectively. Sprain/strain and general soreness were the most common injury types in both the shoulder and the elbow. In the 2 years after injury, baseline PER was achieved in all groups, except for players with dominant shoulder injuries (baseline PER, 16 [IQR, 14-18] vs 2-year PER, 13 [IQR 11-16]; P = .012). Younger age was associated with quicker return to baseline PER (odds ratio, 0.77 [95% CI, 0.67-0.88]). Shoulder and elbow injuries did not negatively influence TS% upon return to play (baseline TS%, 0.55% [IQR, 0.51%-0.58%] vs 1-year TS%, 0.55% [IQR, 0.52%-0.58%]; P = .13).

Conclusion:

Dominant shoulder injuries negatively influenced PER during the first 2 seasons upon return to play in NBA players. Therefore, expectations that players with this type of injury immediately achieve baseline statistical production should be tempered. Shooting accuracy appears to remain unaffected after shoulder or elbow injury.
Utilization of Flexible Ureteroscopy in Renal Stones Management in Pediatrics: Single Tertiary Center Experience
Authors: Elbakary Mohamed , Alruwaili Saleh
Published: October 2023

Objectives. To assess the effectiveness and safety of flexible ureteroscopy in children treated at our center during the last 5 years. Methods. Retrospectively, we have studied 41 children that suffered 51 stone episodes, and FURS for renal calculi <2 cm. Preoperative, operative, and postoperative data were gathered. Results. The mean age of the 41 kids who experienced 51 stone episodes was 9.6 [2.8] years (4.2-16 years). The mean stone diameter was 12.8 [3.3] mm (6-20 mm). The mean operative time was 79.9 [19.9] minutes. The mean hospital stay was 27.6 [12.9] hours. The SFR after the first session was 64.7% and 80.4% after the second session. The overall complications had been recorded in 25 cases (49%) with low morbidity (Clavien grade I-III). Conclusions. Pediatric FURS is a minimally invasive option with a high SFR and a low percentage of high-grade complications in the management of pediatric renal stones.
Genetically determined blood pressure, antihypertensive medications, and risk of intracranial aneurysms and aneurysmal subarachnoid hemorrhage: A Mendelian randomization study
Authors: Liu Hanchen , Zuo Huiqin , Johanna Ospel , Zhao Rui , Yang Pengfei , Chen Weixing , Li Qiang , Lin Xiaolei , Zhou Yu , Liu Jianmin
Published: October 2023

Introduction:

Observational studies suggest that different classes of antihypertensive drugs may have different effects on the occurrence of intracranial aneurysms (IA) and subarachnoid hemorrhage (SAH). However, the reported results in previous studies are inconsistent, and randomized data are absent. We performed a two-sample Mendelian randomization (MR) analysis to study the causal effects of genetically determined blood pressure (BP) and genetic proxies for antihypertensive drug classes on the risk of IA and SAH.

Materials and methods:

Genetic instruments and outcome data were obtained from independent genome-wide association studies (GWAS) or published data, which were exclusively restricted to European ancestry. Causal relationships were identified using inverse-variance weighted MR analyses and a series of statistical sensitivity analyses. The FinnGen consortium was used for repeated analysis to verify results obtained from the above GWAS.

Results:

Two-sample MR analysis showed that genetically determined Systolic BP, Dystolic BP, and Pulse Pressure were related to a higher risk of IA and SAH. Based on identified single nucleotide polymorphisms (SNPs) that influence the effect of calcium channel blockers (CCB, 42 SNPs), beta-blockers (BB, 8 SNPs), angiotensin-converting enzyme inhibitors (ACEI, 2 SNPs), angiotensin receptor blockers (ARB, 1 SNPs), and thiazides (5 SNPs), genetically determined effect of CCBs was associated with a higher risk of IA (OR, 1.07 [95% CI, 1.03–1.10], p = 5.02 × 10−5) and SAH (OR, 1.06 [95% CI, 1.03–1.09], p = 1.84 × 10−3). No associations were found between other antihypertensive drugs and the risk of IA or SAH. The effect of CCBs on SAH was confirmed in FinnGenconsortium samples (OR, 1.04 [95% CI, 1.00–1.08], p = 0.042).

Discussion and conclusion:

This MR analysis supports the role of elevated blood pressure in the occurrence of intracranial aneurysms and subarachnoid hemorrhage. However, genetic proxies for calcium channel blockers were associated with an increased risk of intracranial aneurysms and subarachnoid hemorrhage. Further studies are required to confirm these findings and investigate the underlying mechanisms.
Hemodynamic significance of intracranial atherosclerotic disease and ipsilateral imaging markers of cerebral small vessel disease
Authors: Zheng Lina , Tian Xuan , Abrigo Jill , Fang Hui , Ip Bonaventure YM , Liu Yuying , Li Shuang , Liu Yu , Lan Linfang , Liu Haipeng , Ip Hing Lung , Fan Florence SY , Ma Sze Ho , Ma Karen , Lau Alexander Y , Soo Yannie OY , Leung Howan , Mok Vincent CT , Wong Lawrence KS , Xu Yuming , Liu Liping , Leng Xinyi , Leung Thomas W
Published: October 2023

Introduction:

Cerebral small vessel disease (CSVD) commonly exists in patients with symptomatic intracranial atherosclerotic disease (sICAD). We aimed to investigate the associations of hemodynamic features of sICAD lesions with imaging markers and overall burden of CSVD.

Patients and methods:

Patients with anterior-circulation sICAD (50%–99% stenosis) were analyzed in this cross-sectional study. Hemodynamic features of a sICAD lesion were quantified by translesional pressure ratio (PR = Pressurepost-stenotic/Pressurepre-stenotic) and wall shear stress ratio (WSSR = WSSstenotic-throat/WSSpre-stenotic) via CT angiography-based computational fluid dynamics modeling. PR ⩽median was defined as low (“abnormal”) PR, and WSSR ⩾ fourth quartile as high (“abnormal”) WSSR. For primary analyses, white matter hyperintensities (WMHs), lacunes, and cortical microinfarcts (CMIs) were assessed in MRI and summed up as overall CSVD burden, respectively in ipsilateral and contralateral hemispheres to sICAD. Enlarged perivascular spaces (EPVSs) and cerebral microbleeds (CMBs) were assessed for secondary analyses.

Results:

Among 112 sICAD patients, there were more severe WMHs, more lacunes and CMIs, and more severe overall CSVD burden ipsilaterally than contralaterally (all p < 0.05). Abnormal PR and WSSR (vs normal PR and WSSR) was significantly associated with moderate-to-severe WMHs (adjusted odds ratio = 10.12, p = 0.018), CMI presence (5.25, p = 0.003), and moderate-to-severe CSVD burden (12.55; p = 0.033), ipsilaterally, respectively independent of contralateral WMHs, CMI(s), and CSVD burden. EPVSs and CMBs were comparable between the two hemispheres, with no association found with the hemodynamic metrics.

Discussion and conclusion:

There are more severe WMHs and CMI(s) in the hemisphere ipsilateral than contralateral to sICAD. The hemodynamic significance of sICAD lesions was independently associated with severities of WMHs and CMI(s) ipsilaterally.
Changes in the basic structure and strength deterioration of clay minerals with different hydration degrees
Authors: Lin Jiyu , Wu Daoyong , Jia Jiwei , Yan Jing , Cai Lingtong
Published: October 2023

To investigate the influence of clay mineral microstructures on mechanical properties across varying hydration levels, this study employed molecular dynamics simulations to conduct uniaxial tensile strength tests in three orthogonal directions (x, y, z) using illite, montmorillonite and kaolinite. The moisture content was varied from 0% to 10% in 1% increments and from 0% to 50% in 10% increments. The observations highlight the role of water molecules in disrupting the inherent microscopic atomic structure of clay minerals, leading to diminished stability and a decline in tensile strength. As moisture content increased, there was a pronounced increase in the layer spacing of all three clay minerals, indicative of their hydration expansion behaviour. Concurrently, discernible reductions in both the tensile strength and Young's modulus of the clay minerals were observed.
Molecular mechanisms of drought resistance using genome-wide association mapping in maize (Zea mays L.)
Authors: Ningning Zhang , Binbin Liu , Fan Ye , Jianzhong Chang , Yuqian Zhou , Yejian Wang , Wenjie Zhang , Xinghua Zhang , Shutu Xu , Jiquan Xue
Published: October 2023

Background

Drought is a critical abiotic stress that influences maize yield and reduces grain yield when it occurs at the flowering or filling stage. To dissect the genetic architecture of grain yield under drought stress (DS), a genome-wide association analysis was conducted in a maize population composed of diverse inbred lines from five locations under well-watered and DS conditions at flowering in 2019 and 2020.

Results

Using a fixed and random model circulating probability unification model, a total of 147 loci associated with grain yield or the drought resistance index (DRI) were identified, of which 54 loci were associated with a DRI with an average phenotypic variation explanation of 4.03%. Further, 10 of these loci explained more than 10% of the phenotypic variation. By integrating two public transcriptome datasets, 22 differentially expressed genes were considered as candidate genes, including the cloned gene ZmNAC49, which responds to drought by regulating stomatal density. Enrichment and protein interaction network showed that signaling pathways responded to drought resistance, including jasmonic acid and salicylic acid, mitogen-activated protein kinase, and abscisic acid-activated. Additionally, several transcription factors involved in DS were identified, including basic leucine zipper (GRMZM2G370026), NAC (GRMZM2G347043), and ethylene-responsive element binding protein (GRMZM2G169654).

Conclusions

In this study, we nominated several genes as candidate genes for drought resistance by intergrating association maping and transcription analysis. These results provide valuable information for understanding the genetic basis of drought tolerance at the mature stage and for designing drought-tolerant maize breeding.
Risk factors for epidural anesthesia blockade failure in cesarean section: a retrospective study
Authors: Chao Wei-Hsiang , Cheng Wen-Shan , Hu Li-Ming , Liao Chia-Chih
Published: October 2023

Background

Epidural anesthesia (EA) is the regional anesthesia technique preferred over spinal anesthesia for pregnant women requiring cesarean section and post-operative pain control. EA failure requires additional sedation or conversion to general anesthesia (GA). This may be hazardous during sedation or GA conversion because of potentially difficult airways. Therefore, this retrospective study aimed to determine the risk factors for epidural failure during cesarean section anesthesia.

Methods

We retrospectively analyzed parturients who underwent cesarean section under EA and catheterization at the Chang Gung Memorial Hospital in Taiwan between January 1 and December 31, 2018. Patient data were collected from the medical records. EA failure was defined as the administration of any intravenous anesthetic at any time during a cesarean section, converting it into GA.

Results

A total of 534 parturients who underwent cesarean section were recruited for this study. Of them, 94 (17.6%) experienced EA failure during cesarean section. Compared to the patients with successful EA, those with EA failure were younger (33.0 years vs. 34.7 years), had received EA previously (60.6% vs. 37%), were parous (72.3% vs. 55%), and had a shorter waiting time (14.9 min vs. 16.5 min) (p < 0.05). Younger age (OR 0.91, 95% CI 0.86–0.95), history of epidural analgesia (OR 2.61, 95% CI 1.38–4.94), and shorter waiting time (OR 0.91, 95% CI 0.87–0.97) were estimated to be significantly associated with a higher risk of epidural anesthesia failure.

Conclusion

The retrospective study found that parturients of younger age, previous epidural catheterization history, and inadequate waiting time may have a higher risk of EA failure. Previous epidural catheterization increased the risk of EA failure by 2.6-fold compared to patient with no history of catheterization.
Left atrial appendage thrombus in an elderly patient with atrial fibrillation during non-cardiac surgery- a case report-
Authors: Li Yaru , Jiang Luyang , Wang Lu , Yin Xinrui , Han Qiaoyu , Feng Yi
Published: October 2023

Background

Perioperative newly developed left atrial appendage (LAA) thrombus is a rare but extremely challenging event for anesthesia management. It’s important to identify and diagnose thrombosis in high-risk populations promptly.

Case presentation

In the case of an elderly patient with atrial fibrillation undergoing non-cardiac surgery, we recorded the findings before and after thrombosis during the operation using transesophageal echocardiography (TEE). Through timely detection of the thrombus and proactive management, a satisfactory therapeutic effect was ultimately achieved.

Conclusions

Clinicians should be aware of the potential risk of LAA clot formation during surgery, even if it was not detected preoperatively. And TEE is valuable for monitoring newly developed perioperative thrombosis.
Emotions, action strategies and expectations of health professionals and people with dementia regarding COVID-19 in different care settings in Switzerland: a mixed methods study
Authors: Heinrich Steffen , Weissenfels Inga , Zeller Adelheid
Published: October 2023

Background

More than 55 million people are currently affected by dementia worldwide and over 144 thousand in Switzerland. In Swiss nursing homes, 47.6% of the residents had a medical diagnosis of dementia in 2014. Due to cognitive impairment, they have difficulties remembering hygiene measures or placing them in the epidemic context. This results in a higher infection risk. There are COVID-19-associated recommendations focused on dementia care management but studies simultaneously surveying and correlating perspectives of health professionals as well as people with dementia across care settings are largely lacking. This study is focused on COVID-19-associated perspectives and needs of health professionals and people with dementia across different care settings. Lessons learned from the pandemic shall be pointed out.

Methods

We conducted a mixed-methods approach based on an exploratory sequential design. Two qualitative interview rounds (n = 15 participants) and a quantitative online survey (n = 148 participants) with people with dementia, caring relatives, Advanced Practice Nurses and nursing home managers (health professionals) were performed. Data collected was performed in nursing home and home-care settings. The SQRQ checklist was used.

Results

Fear and uncertainty were highest at the beginning of the pandemic among the interviewed nursing professionals and nursing home managers. As a positive side effect of the pandemic, increased cohesion in care teams was reported. Some people with dementia experienced the decelerated outside world as pleasant and less challenging to master. Particularly during the first wave, nursing home managers rated political decision-making processes as being too slow, partly non-transparent, inconsistent, and sometimes inappropriate for people with dementia.

Conclusions

Although the identified emotional and physical consequences of the COVID-19 pandemic are mostly negative for health professionals and people with dementia, research should also investigate potential positive side effects. Furthermore, political decisions should be passed on to care institutions as promptly, transparently, and comprehensibly as possible. The results provide guidance on dementia-focused COVID-19 management interventions incorporating lessons learned and considering the emotional impact of the pandemic in Switzerland and beyond.
Decreased intracellular water is associated with sarcopenic obesity in chronic haemodialysis patients
Authors: Tian Maolu , Yuan Jing , Yu Fangfang , He Pinghong , Zhang Qian , Zha Yan
Published: October 2023

Objective

To explore the association between intracellular water (ICW) and sarcopenic obesity in patients undergoing chronic haemodialysis (HD).

Methods

A multicentre, cross-sectional study of 3354 adult chronic HD patients was conducted in 20 haemodialysis centres from June 1, 2021, to August 30, 2021. The diagnosis of sarcopenic obesity was made according to the revised Asian Working Group’s definition of sarcopenia combined with obesity per the body fat percentage definition. Body composition was evaluated by a body composition monitor using bioimpedance spectroscopy. Multiple logistic regression models, stratified analyses, interactive analyses, and receiver-operating characteristic analyses were conducted.

Results

A total of 752 patients were diagnosed with sarcopenic obesity among 3354 participants. The patients were grouped by sex-specific ICW median levels, and the prevalence of sarcopenic obesity was significantly higher in the low ICW group than in the high ICW group (41.3%vs 3.0%). Decreased ICW was significantly associated with sarcopenic obesity. The association remained statistically significant even after adjusting for dialysis vintage, age, body mass index, biochemical indicators, and various medical histories. The odds ratios of the low ICW group were much higher than those of the high ICW group in both males and females (P for trend < 0.001). The association was stable across subgroups, and the interaction analysis showed that age, body mass index and history of diabetes had interactive roles in the association between ICW and sarcopenic obesity (P for interaction < 0.05). Furthermore, the ICW cut-off values for identifying sarcopenic obesity were 19.1 kg and 14.5 kg for males and females, respectively.

Conclusion

Decreased ICW was an independent risk factor for sarcopenic obesity in chronic HD patients. The measurement of ICW by bioimpedance spectroscopy might be a non-invasive and valid means for identifying the risk of future sarcopenic obesity in HD patients.
Prime time for chronic kidney disease
Authors: Weisman David S. , Thavarajah Sumeska , Jaar Bernard G.
Published: October 2023

Chronic kidney disease (CKD) represents a public health burden worldwide and is associated with significant morbidity and mortality. Most patients with CKD are managed by primary care practitioners and this educational series hope to improve knowledge and delivery of care to this high-risk patient population with CKD.
Factors affecting the provision of high-quality postnatal care services in Zanzibar: a qualitative study
Authors: Öjendal Anna , Holter Herborg , Elden Helen , Salim Sanura , Bogren Malin
Published: October 2023

Background

In Sub-Saharan Africa, the postnatal period is associated with high mortality and accounts for a substantial proportion of maternal deaths. Although postnatal care has been identified as critical in reducing maternal mortality, the quality of care provided is often inadequate. Tanzania and Zanzibar have not made sufficient progress towards achieving the Sustainable Development Goals on maternal health, and there is limited knowledge about the utilization and quality of postnatal follow-up. The aim of this study was therefore to explore factors affecting the provision of high-quality postnatal care services in the urban area of Zanzibar.

Methods

Five focus group discussions were performed in Swahili with 25 healthcare providers from primary healthcare units in urban Zanzibar. Interviews were audio-recorded, transcribed verbatim, translated into English, and analysed using qualitative content analysis with an inductive approach.

Results

Factors affecting provision of high-quality postpartum care services could be divided into three generic categories. Difficulty achieving high attendance comprised three subcategories: long waiting times, low awareness among women, and out-of-pocket payment. Lack of basic resources also comprised three subcategories: shortage of healthcare providers, lack of adequate space, and inadequate medical equipment. Insufficient care routines comprised two subcategories: lack of guidelines and deficient chain of information.

Conclusions

The present findings suggest that the women’s perceptions of postnatal care do not align with the intended purpose of routine postnatal care. Instead, the postnatal period primarily leads to visits to health facilities only when urgent care is required, and there is a lack of awareness about the importance of postnatal care. Moreover, limited resources, including equipment, staff, and space, as well as long waiting times, hinder the delivery of high-quality care and contribute to a negative reputation of postnatal care services. To effectively reach all women and improve postnatal care, it is necessary to increase basic resources, modify health education approaches, and enhance the flow of information between different levels of care using context-specific strategies.
The influence of iris -ciliary angle (ICA) on the vault after implantation of V4c implantable collamer lens: a chain mediation model of ICL haptic related factors
Authors: Tan Weina , Wang Zheng , Zeng Qingyan , Lei Xiaohua , Pan Chao , Shu Bao , Jin Lina , Chen Qian
Published: October 2023

Background

This study aims to identify the relationship between iris -ciliary angle (ICA) and the vault. Additionally, we also seek to investigate the chain mediating effects of the ICL haptic related factors on this relationship.

Methods

The participants were categorized into three groups according to the ICA value as follows: low ICA group (< 35°); moderate ICA group (35°-70°); high ICA group (> 70°). We compared the preoperative ocular characteristics and postoperative examinations among the three groups. Multiple variable stepwise regression was performed to establish the vault prediction formula. The Process V4.0 in SPSS and Hayes’s PROCESS model 6 was conducted to further elucidate the mediating effects of the final tip point of ICL haptic and the ICL arc-lens arc on the relationship between the ICA and vault.

Results

There was a significant difference in the positions of the ICL haptic among three ICA groups. The regression vault equation was Vault = 679.42–7.26*TCA + 192.30*ACD-196.37*CLR + 73.21* STS(horizontal).A significant negative correlation was found between the ICA and vault (P < 0.01).The chain mediation model revealed that the final tip point of ICL haptic and the ICL arc-Lens arc were sequential mediators between ICA and vault (effect = -1.63, 95% CI = -2.72–-0.73).

Conclusion

The ICA was associated with vault via the mediation effect of the final tip point of the ICL haptic and the ICL arc -lens arc. Assessment of ICL haptic related parameters adds significant information to interpret the vault after surgery.
Clinical features, epidemiology, and treatment of Shwachman-Diamond syndrome: a systematic review
Authors: Han Xue , Lu Shuanglong , Gu Changjuan , Bian Zhuli , Xie Xiaotian , Qiao Xiaohong
Published: October 2023

Background

Shwachman-Diamond syndrome (SDS) is an autosomal recessive disease which results in inherited bone marrow failure (IBMF) and is characterized by exocrine pancreatic dysfunction and diverse clinical phenotypes. In the present study, we reviewed the internationally published reports on SDS patients, in order to summarize the clinical features, epidemiology, and treatment of SDS.

Methods

We searched the WangFang and China National Knowledge Infrastructure databases with the keywords “Shwachman-Diamond syndrome,” “SDS,” “SBDS gene” and “inherited bone marrow failure” for relevant articles published from January 2002 to October 2022. In addition, studies published from January 2002 to October 2022 were searched from the Web of Science, PubMed, and MEDLINE databases, using “Shwachman-diamond syndrome” as the keyword. Finally, one child with SDS treated in Tongji Hospital was also included.

Results

The clinical features of 156 patients with SDS were summarized. The three major clinical features of SDS were found to be peripheral blood cytopenia (96.8%), exocrine pancreatic dysfunction (83.3%), and failure to thrive (83.3%). The detection rate of SDS mutations was 94.6% (125/132). Mutations in SBDS, DNAJC21, SRP54, ELF6, and ELF1 have been reported. The male-to-female ratio was approximately 1.3/1. The median age of onset was 0.16 years, but the diagnostic age lagged by a median age of 1.3 years.

Conclusions

Pancreatic exocrine insufficiency and growth failure were common initial symptoms. SDS onset occurred early in childhood, and individual differences were obvious. Comprehensive collection and analysis of case-related data can help clinicians understand the clinical characteristics of SDS, which may improve early diagnosis and promote effective clinical intervention.
The impact of household wealth gap on individual’s mental health
Authors: Zhang Rui , Feng Dawei , Xia Jiahui , Wang Yao
Published: October 2023

Background

Improving the individual’s mental health is important for sustainable economic and social development. Although some studies found that household wealth gap may affect individuals’ mental health, few studies have clarified the causal relationship between household wealth gap between mental health in China. This study examines the impact of the household wealth gap on individuals’ mental health using data from the 2012–2018 China Family Panel Survey.

Methods

This study first used the two-way fixed effects model to investigate the impact of household wealth gap on individuals’ mental health. Considering the endogeneity, the two-stage least square and propensity score matching were employed to examine the impact of household wealth inequality on individuals’ mental health.

Results

The results show that the household wealth gap has negative impact on individuals’ mental health. A series of robustness tests support this conclusion. The results of heterogeneity analysis show that the impact of household wealth gap on mental health is more pronounced among middle-aged and elderly individuals, residents with lower education levels, and rural residents. The results of the mechanism analysis suggest that the household wealth gap may affect individuals’ mental health by influencing the individual’s health insurance investment and neighborhood relations. In addition, the household wealth gap not only significantly negatively affects individuals’ mental health in the short term but also in the medium- to long-term.

Conclusion

These findings suggest that the government should take various measures to narrow the wealth inequality between families, which may effectively improve the mental health of residents.
An innovative method for occluding the urethral meatus and accessing urethra strictures in retrograde urethrography in males
Authors: Li Wei , Man Libo , Huang Guanglin
Published: October 2023

Objectives

To observe and evaluate the effectiveness and safety of using a sponge plug method to occlude the urethral meatus during retrograde urethrography (RUG) for accessing male urethral strictures.

Methods

40 male patients with a mean age of 51.4 years and a history of urethral injury were primarily diagnosed with urethral stricture using a urethrocystoscope. RUG was performed using a ureteral catheter with a sponge plug inserted into the external meatus. Iodixanol, a contrast medium, was injected into the urethra or bladder for performing RUG and voiding cystourethrography (VCUG). The patients were positioned obliquely to obtain urethrograms.

Results

All X-ray radiologic procedures for performing urethrography were successful without any overflow of contrast liquid observed. In all cases, the sponge plugs became visible in the resulting images. The external meatuses were directly visualized in all cases on the obtained images, allowing identification of the number, location, and length of strictures as well as coexistent pathologies such as fistulas. In one case, the plug slipped off the meatus immediately after completing the procedure. The pain Visual Analogue Scale (VAS) was 0 to 2, mean 0.35. No instances of complication or adverse reactions was observed.

Conclusions

The sponge plug effectively occludes the external urethral meatus for retrograde urethrography, enabling visualization of the actual caliber of the entire urethra, including the strictures and external meatus, by filling it with contrast liquid. This technique is safe and well-tolerated by patients.
Household food insecurity, family size and their interactions on depression prevalence among teenage pregnant girls in Ghana, a population based cluster survey
Authors: Doglikuu Dominic Be-Ikuu , Annan John Kwasi , Asare Stephen , Yawson Hannah , Takyi Ohene , Dzidzornu Francisca Akpene , Koram Henrietta Oye , Johnson Edna Ayishetu
Published: October 2023

Background

Household food insecurity is the situation where individuals and families have limited/uncertain access to nutritionally adequate and safe foods for healthy living. Family size is the number of persons in the family. Household food insecurity and family size are risk factors for depression. However, their synergistic and/or multiplicative effect on depression is not well investigated. This study investigated/examined household food insecurity, family size and their interaction on depression prevalence among teenaged pregnant girls in Ghana.

Methods

Population based cluster survey was conducted among 225 teenaged pregnant girls in 20-electoral areas at Twifo-Atti-Morkwa district in the central region of Ghana. Simple random sampling was used to recruit study participants and structured questionnaire used to collect demographic variables. Household Food Insecurity Access Scale (HFIAS) and Revised Children’s Anxiety and Depression Scale (RCADS-25) were used to collect data. Multinomial logistic regression models were used to analyzed the data.

Results

Moderate and high depression prevalence reported among teenaged pregnant girls in Twifo-Atti-Morkwa district were 35.1(28.1–42.1) and 33.5 (26.5–40.5) respectively. Moderate family size (AOR = 1.08, 95%CI = 1.17–3.71) and large-family-size (AOR = 2.78, 95%CI = 3.98–10.19) were significant for depression. Moderate food insecurity (AOR = 0.12, 95%CI = 0.41 − 0.35) and high food insecurity (AOR = 0.27, 95%CI = 0.11–0.71) were significant for depression. Interaction between moderate food insecurity and moderate family size (AOR = 1.69, 95%CI = 2.79–17.51), interaction between high food insecurity and low family size (AOR = 1.24, 95%CI 1.57–11.41) and interaction between high food insecurity and large family size (AOR = 1.01, 95%CI = 1.72–14.57) were significant for depression among teenaged pregnant girls.

Conclusion

There is moderate and high depression prevalence among teenaged pregnant girls in Twifo-Atti-Morkwa district. Interaction between household food insecurity and family size are the major predictors for depression among the teenaged girls in the district. We therefore recommend that public health officers should be up with health education campaigns in the district to create awareness on the depression prevalence among teenaged girls, and urge them to come out and seek support to prevent the catastrophic effect of depression.
HPLC-ESI/MS-MS characterization of compounds in Dolomiaea costus extract and evaluation of cytotoxic and antiviral properties: molecular mechanisms underlying apoptosis-inducing effect on breast cancer
Authors: El-Nashar Heba A. S. , Eldahshan Omayma A. , Fattah Nasra F Abdel , Loutfy Samah A , Abdel-Salam Ibrahim M
Published: October 2023

Background

Dolomiaea costus (syn: Saussurea costus; Family Asteraceae) occupies an important place in the traditional Chinese medicinal plants and is prescribed for a wide range of disorders. The current study aimed to tentatively identify the phytoconstituents of D. costus extract and to explore antiproliferative activity against human breast cancer cells and its possible apoptotic mechanism along with antiviral activity against human adenovirus 5 (Adv-5).

Methods

The phytoconstituents of 70% ethanol extract of D. costus were assessed using HPLC/ESI-MS/MS technique. The cell viability was investigated against breast cancer cell line (MCF-7) via 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Mechanistically, the apoptotic effects on the Bax, Bcl2 and Caspase 3 were determined via quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR). Further, the antiviral activity was assessed against Adv-5 based on virucidal and adsorption mechanisms.

Results

The HPLC/MS analysis of the extract revealed tentative identification of twenty compounds of polyphenolic nature, mainly flavonoids, lignans, coumarins, and anthocyanidins. The plant extract showed a cytotoxic effect against MCF-7 and Vero cells with IC50 values of 15.50 and 44 µg/ml, respectively, indicating its aggressiveness against the proliferation of breast cancer cells as confirmed by apoptotic genes expression which revealed upregulation of Bax and Caspase 3 but further insight analysis is needed to explore exact mechanistic pathway. Antiviral activity against Adv-5 was observed at a non-toxic concentration of the tested extract.

Conclusions

Such observations against human breast cancer and viral replication supported further studies for nanoformulations in drug delivery systems as targeting therapy and in vivo studies before biomedical applications.
Pre-clerkship procedural training in venipuncture: a prospective cohort study on skills acquisition and durability
Authors: Kodikara Kaumudee , Seneviratne Thilanka , Premaratna Ranjan
Published: October 2023

Background

The effectiveness of simulation-based training for skill acquisition is widely recognized. However, the impact of simulation-based procedural training (SBPT) on pre-clerkship medical students and the retention of procedural skills learned through this modality are rarely investigated.

Methods

A prospective cohort study was conducted among pre-clerkship medical students. Learners underwent SBPT in venipuncture in the skills laboratory. Assessments were conducted at two main points: 1) immediate assessment following the training and 2) delayed assessment one year after training. Learner self-assessments, independent assessor assessments for procedural competency, and communication skills assessments were conducted in both instances. The students were assessed for their competency in performing venipuncture by an independent assessor immediately following the training in the simulated setting and one-year post-training in the clinical setting, using the Integrated Procedural Protocol Instrument (IPPI). The student’s communication skills were assessed by standardized patients (SP) and actual patients in the simulated and clinical settings, respectively, using the Communication Assessment Tool (CAT).

Results

Fifty-five pre-clerkship medical students were recruited for the study. A significant increase was observed in self-confidence [mean: 2.89 SD (Standard Deviation) (0.69)] and self-perceived competency [mean: 2.42 SD (0.57)] in performing venipuncture, which further improved at the delayed assessment conducted in the clinical setting (p < 0.001). Similarly, the IPPI ratings showed an improvement [immediate assessment: mean: 2.25 SD (1.62); delayed assessment: mean: 2.78 SD (0.53); p < 0.01] in venipuncture skills when assessed by an independent assessor blinded to the study design. A significant difference (p < 0.01) was also observed in doctor-patient communication when evaluated by SPs [mean: 2.49 SD (0.57)] and patients [mean: 3.76 SD (0.74)].

Conclusion

Simulation-based venipuncture training enabled students to perform the procedure with confidence and technical accuracy. Improved rating scores received at a one-year interval denote the impact of clinical training on skills acquisition. The durability of skills learned via SBPT needs to be further investigated.
Chinese version of Yoon Critical Thinking Disposition Instrument: validation using classical test theory and Rasch analysis
Authors: Au Mio Leng , Li Yue Yi , Tong Lai Kun , Wang Si Chen , Ng Wai I
Published: October 2023

Background

Despite the availability of a wide range of critical thinking instruments, there was no original design for nurses that has been translated into Chinese. However, only instruments designed specifically for the nursing discipline would be reliable. This study aimed to translate, culturally adapt, and validate the Yoon Critical Thinking Disposition Instrument in the Chinese context.

Methods

A four-step translation process was implemented according to Word Health Organization guidelines, which included forward translation, expert panel review, backward translation, and pre-testing. Experts and nursing students participated in testing the validity and reliability of the Chinese version.

Results

The translation of the instrument went smoothly. According to a confirmatory factor analysis, there was an acceptable fit for the seven-factor model. Content validity indices ranged from 0.6 to 1 at item level, and 0.94 at scale level. In addition, there was extremely high internal consistency and test-retest reliability in the translated instrument. There was a good fit for the items with both person and item reliabilities greater than 0.6 and a separation index of 2.19, respectively. The item location was identified from the wright map as not covering person ability, but the scale did not have a gender-related differential item functioning.

Conclusions

In this study, a critical thinking disposition instrument for nursing students was translated into Chinese for the first time. This translated instrument is a reliable tool with satisfactory validity and reliability. It could provide opportunities for building a cross-cultural understanding of critical thinking disposition.
Fundamentals of end-of-life communication as part of advance care planning from the perspective of nursing staff, older people, and family caregivers: a scoping review
Authors: Peerboom Fran B.A.L. , Friesen-Storms Jolanda H.H.M. , Coenegracht Bénédicte J.E.G. , Pieters Sabine , van der Steen Jenny T. , Janssen Daisy J.A. , Meijers Judith M.M.
Published: October 2023

Background

Nursing staff is ideally positioned to play a central role in end-of-life communication as part of advance care planning for older people. However, this requires specific skills and competences. Only fragmented knowledge is available concerning important fundamentals in end-of-life communication performed by nursing staff.

Objective

This review aimed to explore the fundamentals of end-of-life communication as part of advance care planning in the hospital, nursing home and home care setting, from the perspective of the nursing staff, the older person, and the family caregiver.

Design

Scoping review.

Methods

A literature search in PubMed, PsycINFO, CINAHL and Google (Scholar) was conducted on August 20, 2022. The search strategy followed the sequential steps as described in the Joanna Briggs Institute Manual. Peer-reviewed articles of empirical research and gray literature written in English or Dutch and published from 2010 containing fundamentals of end-of-life communication as part of advance care planning from the perspective of nursing staff, older people, and family caregivers in the hospital nursing home or home care setting were considered eligible for review.

Results

Nine studies were included, and four themes were composed, reflecting 11 categories. Nursing staff attunes end-of-life communication to the values and needs of older people to approach the process in a person-centered manner. This approach requires additional fundamentals: building a relationship, assessing readiness, timing and methods to start the conversation, communication based on information needs, attention to family relationships, a professional attitude, improving communication skills, listening and non-verbal observation skills, and verbal communication skills.

Conclusions

This review is the first to compile an overview of the fundamentals of end-of-life communication performed by nursing staff. Building a nursing staff-older-person relationship is the most important foundation for engaging in a person-centered end-of-life communication process. Knowing each other enables nursing staff to have a sense of older people’s readiness, determine the right timing to initiate an end-of-life conversation, identify specific needs, and accurately apply (non-)verbal observation skills. end-of-life communication is not a one-time conversation, but a complex process that takes time, effort, and genuine interest in each other.