bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in Anterior Cruciate Ligament Repair: A Bibliometric and Visualized Analysis
Authors: Li Jinfei , Rothrauff Benjamin , Chen Shuyi , Zhao Shuying , Wu Zhaoxi , Chen Qi , He Jinshen
Published: October 2022

Background:

Bibliometrics is a methodology that measures the scientific output of an author, institution, or country. Visualized analysis is the transformation of data into visible form by software, highlighting important features, including commonalities and anomalies, allowing users to easily and quickly perceive significant aspects of their data.

Purpose:

To conduct a bibliometric analysis of the literature on anterior cruciate ligament (ACL) repair, with visualization of trends, in order to identify the areas of interest and the primary researchers involved in ACL repair.

Study Design:

Cross-sectional study.

Methods:

The PubMed database was queried on April 14, 2022, for publications that reported on ACL repair from 1960 onward. The initial search resulted in 1392 publications. Filter settings were applied to remove publications with weak correlation, such as those on meniscal repair and ACL reconstruction. Publication information, citations, authors, commonly used terms, and affiliated institutions and countries were analyzed by VOSviewer and Python.

Results:

A total of 553 articles were included for analysis. Three techniques were visualized: bridge-enhanced ACL repair, internal brace, and dynamic intraligamentary stabilization. The most published authors were Martha Murray (51 articles), Gregory Difelice (35 articles), and Braden Fleming (31 articles). The most cited article was “Collagen–Platelet Rich Plasma Hydrogel Enhances Primary Repair of the Porcine Anterior Cruciate Ligament” by Murray et al. The journals with the most publications on ACL repair were the American Journal of Sports Medicine (n = 49); Knee Surgery, Sports Traumatology, Arthroscopy (n = 49); and Arthroscopy (n = 48). The top 3 institutions by publication number were the Hospital for Special Surgery (n = 51), Boston Children’s Hospital (n = 49), and Brown University (n = 31), with the most publications coming from the United States (n = 242), Germany (n = 83), and the United Kingdom (n = 47).

Conclusion:

The results demonstrate that the research on ACL repair comes from a small number of authors and corresponding institutions; the top sports medicine journals and the developed countries have an interest in this topic.
Big Five Personality Traits and Predicting Mental Health among Iranian Older Adults
Authors: Rostami Mohammad , Ahmadboukani Soliman , Saleh Manijeh Hiwa
Published: October 2022

Aging has been a major issue for experts, policymakers, and even the general public in recent years. There is a growing body of evidence highlighting the role of personality traits in the health of older adults, but this evidence is still in its infancy. This study aimed to investigate the role of the big five personality traits in predicting the mental health among older adults. In this cross-sectional study, 150 community-residing older adults were selected and completed the Ten Item Personality Inventory, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Short-Form Health Survey. According to the results, extraversion and openness to experience can explain 11% of the variances of hope, extraversion and conscientiousness account for 16% of the variances in perceived social support, and all the big five personality traits together predict 34% of the variances in the health-related quality of life. Given the role of personality traits in predicting the mental health of older adults, counselors and psychologists working with these people can pay attention to the personality traits of older adults in designing their psychological, educational, and research programs to achieve more desirable outcomes.
The Pragmatic Neighbour: China’s Afghanistan Policy 2001–2021
Authors: Westcott Stephen P.
Published: October 2022

China has remained detached from the events in Afghanistan, generally playing a passive role during the US-led war in its neighbour and refusing to actively support any parties in the conflict. However, Beijing was prompt to embrace Taliban 2.0 as the new power in Kabul as Ashraf Ghani’s regime collapsed in the wake of the US withdrawal in August 2021. At first glance, this appears to be a shift in policy from China’s previous apathetic stance to actively taking the Taliban’s side. Yet, a closer look at China’s actions reveal that it has maintained a consistently narrow and pragmatic policy towards its neighbour since 2002. This article unpacks China’s remarkably consistent Afghanistan policy, identifying its basis in two primary interests: ensuring stability in its Xinjiang province and trade with Central Asia. As long as Beijing is able to secure the willing cooperation from the main parties within Afghanistan to securing these interests, it is indifferent as to who the authority in Kabul is.
Reluctant or Pragmatic? The GCC’s Policy towards Taliban-Led Afghanistan
Authors: Poornima B
Published: October 2022

The Taliban’s capture of Kabul in 2021 has presented the neighbourhood and beyond with layers of challenges to deal with, particularly for the Persian Gulf. On the one hand, the Gulf Cooperation Council (GCC) members are concerned about the repercussions of the change of guard in Kabul vis-à-vis terrorism and refugee-related instability. On the other, the withdrawal of US forces has questioned their policy priorities, leading them to consider variegating their international partners for their security imperatives. The developing situation in Afghanistan can alter the geopolitical equations in the Persian Gulf. The growing importance that Qatar has received from the US and the Taliban due to its status as a mediator and Turkey’s entry using the Doha card are among the main influencing factors. The GCC governments neither praised nor criticised the Taliban’s takeover of Afghanistan. Their responses so far, though cautious and limited, have been pragmatic, putting their national interest first. However, Saudi Arabia, UAE and Qatar will continue to be relevant in Afghan affairs either directly or indirectly through diplomatic and economic overtures as they realise that a stable Afghanistan is in the best interest of the GCC. Such moves are crucial to ensure the crisis does not spill over to the Gulf. Through its diplomatic, economic and religious clout, the GCC can catalyse the international community to devise a multi-pronged approach to bring peace and stability to Afghanistan.
How to Help Your Complex Patient If You Don't Know What Is Wrong
Authors: Clark Sarah
Published: October 2022

Perspectives from a complex patient point-of-view on how clinicians can improve therapeutic empathy skills and how to help a complex patient who is undiagnosed and you do not know what is wrong.
Institutional Constraints as an Obstacle for Prioritizing Nursing Interventions During the COVID-19 Pandemic—Critical Care Nurses’ Experiences
Authors: Engström Åsa , Fredholm Angelica , Nordin Anna , Andersson Maria
Published: October 2022

Introduction

The demands of the pandemic such as staff shortages and limited resources combined with new guidelines regarding infection control may have required the prioritizing of nursing interventions.

Objectives

The aim of this study was to describe critical care nurses’ experiences of prioritizing nursing interventions for patients with COVID-19 in intensive care units (ICUs) during the pandemic.

Method

A qualitative descriptive study was gathered from open-ended questions included in a cross-sectional online questionnaire. Characteristics were presented using descriptive statistics, and open-ended questions were analyzed using qualitative content analysis with an inductive approach. The study was conducted in Sweden and focused on critical care nurses working in ICUs during spring 2021 and the second year of the COVID-19 pandemic.

Results

During the COVID-19 pandemic, 87% of the critical care nurses had provided orientations for new co-workers, and 52% had supervised intensive care nursing students. In all, 70 answered the question of whether they had prioritized nursing care differently during the pandemic; 86% reported that they had and 14% had not. The qualitative analysis resulted in one theme, Institutional constraints as an obstacle for nursing interventions, with three categories: Prioritizing lifesaving interventions, Performing nursing interventions less frequently, and Not able to provide the nursing care I wish to provide.

Conclusion

Institutional constraints as an obstacle for nursing interventions is the overall theme. It illustrates how critical care nurses have been forced to prioritize, thereby not being able to provide the nursing interventions they wanted to do provide, and it describes their feelings in this situation. The nurses need recovery and possibilities for reflection. The organization must also recover and not only return to how it was before the pandemic but also to learn from recent events and take actions to reduce the long-term effects on staffing.
A 10-Year Review of Designated Leadership Positions of the American Orthopaedic Foot & Ankle Society (AOFAS)
Authors: Chrea Bopha , Johnson Holly , Baumhauer Judith , Holleran Amanda , Atwater Lara C. , Poon Selina
Published: October 2022

Background:

In 2019 the majority of US medical students were women (50.5%). However, despite this representation, female representation within orthopaedic surgery remains low when compared to male counterparts. Previously, the American Society for Surgery of the Hand (ASSH) and Pediatric Orthopaedic Society of North America (POSNA) published their gender diversity data. No such study has been conducted in the American Orthopaedic Foot & Ankle Society (AOFAS), which is the largest membership organization for foot and ankle–trained orthopaedic surgeons. This study sought to investigate whether increased female representation in the AOFAS membership roster is reflected in different levels within the organization.

Methods:

The 2012-2022 membership rosters were obtained from the AOFAS and compared by gender. Volunteer, elected, and appointed leadership positions as well as rates of engagement were compared for each of the activities. Leadership positions were defined as committee chair, vice chair, or board of directors (BOD). When available, time for advancement through leadership positions to the presidential role was analyzed by gender. Comparative data were available for 2 other respective subspecialty groups, ASSH and POSNA, from previously published studies.

Results:

Between 2012 and 2022, the percentage of female membership in the AOFAS has continued to increase from 7.5% (n=76) to 13% (n=163). Engagement in committee membership positions during this time has more than doubled from 11 of 26 (14.4%) to 57 of 163 (34.9%). When participation trends were evaluated by gender, women showed higher rates of committee involvement than their male counterparts. In 2021 compared to 2012, the percentage of female committee members more than doubled compared with their male counterparts (female 34.9% to male 23.2% vs female 14.4% to male 16.8%). This increase in female gender committee composition trend has been seen in the ASSH and POSNA, but it is more pronounced in the AOFAS. Representation of women in committee chair positions and elected positions has not seen this same parallel increase.

Conclusion:

The female membership of the AOFAS has a similar gender composition to other orthopaedic subspecialities. Female membership within the society has increased over the past 10 years. The rates of female involvement within committee membership positions have seen a parallel increase. It will take time to mature into leadership roles as we continue to increase diversity within our respective subspecialty organizations. Inception of the AOFAS Diversity Equity and Inclusion and Women’s Subcommittee demonstrate a continued emphasis on this core value within the society.

Level of Evidence:

Level IV, cohort study.
The importance of an early onset of migraine preventive disease control: A roundtable discussion
Authors: Gottschalk Christopher , Basu Anirban , Blumenfeld Andrew , Torphy Bradley , Marmura Michael J , Pavlovic Jelena M , Dumas Paula K , Lalvani Nim , Buse Dawn C
Published: October 2022

Background:

Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy.

Methods:

A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop corresponding recommendations.

Evidence from clinical studies of anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and the chemodenervation agent onabotulinumtoxinA indicate that patients may experience reduction of migraine activity within 7 days of drug administration and early attainment of disease control is associated with improvements in clinically important outcomes. The roundtable of experts proposes that early onset be defined as demonstration of preventive benefits within 1 week of treatment initiation. We recommend focusing discussion with patients around “disease control” and potential benefits of early onset of prevention, so patients can set realistic preventive therapy goals and expectations.
Management and Leadership: Insights from Yoga Philosophy and Practice
Authors: Bodhananda Swami
Published: October 2022

This article discusses insights from yoga philosophy and practise that will contribute to defining management and leadership in India. If India has to truly and authentically progress, she has to dig deeper roots into her own rich cultural past—like even a tree that grows taller digs its roots deeper. What we need is a critical review of our past integrating what is relevant and eschewing that is redundant. A highly motivated and enlightened workforce disciplined on the lines of yoga alone can accomplish such company goals. A yogi-worker is detached from the notion of oneself being just a combination of gunas and the hapless victim of the body-mind-ego complex. Sustained teamwork is not possible without being inspired by a higher goal such as the glory of one’s country, consumer satisfaction, wellbeing of all, reduced carbon footprint, green growth, stakeholder value, God realisation and self-actualization.
Lymph Nodes With Germinal Centers Are Not Associated With Tumor Response After Neoadjuvant Treatment in Locally Advanced Rectal Cancer
Authors: Otmani Ihsane El , Effared Boubacar , Agy Fatima El , Abkari Mohammed El , Mazaz Khalid , Benjelloun El Bachir , Ousadden Abdelmalek , Benbrahim Zineb , Bouhafa Touria , Chbani Laila
Published: October 2022

In patients with locally advanced rectal cancer, neoadjuvant radiotherapy or chemoradiotherapy followed by total mesorectal excision as a standard of care. We aimed to explore the number, size, germinal centers, extracapsular invasion of lymph nodes (LN), and their impact on overall survival and disease free survival. Furthermore we also investigated the characteristics of lymph nodes in patients who received neoadjuvant therapy and those who underwent surgery between 2011 and 2018. The count and measurement of lymph nodes was assessed by careful visual inspection and manual palpation. The predictive cut-off value of the lymph node ratio (LNR) was determined based on the receiver operating characteristic (ROC), method and the survival outcomes based on Kaplan-Meier curves. We found that the size and the number of lymph nodes decreased significantly after neoadjuvant treatment. The mean LN for patients who received neoadjuvant therapy was 12.68 ± 6.69 and for patients who did not receive neoadjuvant therapy was 16.29 ± 5.61 ( P = .012). The average size for patients who received neoadjuvant therapy followed by surgery was 3.30 ± 1.10 versus 4.22 ± 1.18 mm for control group (surgery only) ( P < .001), an LNR of 0.13 (sensitivity: 86%, specificity: 47%, AUC: 60%, 95% CI, 0.41%-0.76%) predicted recurrence and metastasis. Presence of lymph nodes with germinal centers was significantly associated with absence of vascular invasion, nodal tumor deposits, distant metastasis, and lower age group (<50 years). However there was no association seen between overall survival and relapse free, total number of lymph nodes enlarged and extracapsular invasion in positive nodes.

Finally there is no association between lymph nodes with germinal centers and tumor response after neoadjuvant treatment in locally advanced rectal cancer.
Impact of Lockdown Measures During the COVID-19 Pandemic on the Number and Nature of Trauma Presentations to Oral and Maxillofacial Surgery of a Level I Trauma Center—A Study
Authors: Kanna V. E. Shanthosh , Maurya Harshita , Singh Vibha , Singh Geeta , Agarwal Amiya , Veerasekaran Anuradha
Published: October 2022

Introduction:

The COVID-19 pandemic triggered unprecedented nationwide regulations aimed primarily at slowing the spread of the virus. The objective of this study was to describe the effect of these regulations on the number and natures of trauma presentations to oral and maxillofacial department of level I trauma center in the city of Lucknow, Uttar Pradesh.

Methods:

A retrospective cohort study of the triage register at Trauma Centre of King George Medical University, Lucknow was conducted, comparing all trauma presentations from March 23, 2020 to July 31, 2020 with those from the preceding 5 months. The number of patients, mechanism of trauma, and severity of illness was recorded and compared.

Results:

A reduction in the number of trauma cases was recorded for the particular period. The statistical analysis was done with SPSS software (version 1.1). The incidence of maxillofacial trauma was more in males than females. During the study period, data shows that road traffic accidents (91.68%) was the most common cause of trauma followed by fall from height (4.06%) and physical assault (2.34%), respectively. The most common injury was soft tissue lacerations (38.07%), followed by hard tissue injury (LeFort: 20.6%, zygomaticomaxillary complex fractures: 9.44%, parasymphysis: 8.02%), respectively.

Conclusion:

This study shows that the burden of trauma presenting to the emergency department was decreased during lockdown period by the regulations implemented in response to the COVID-19 pandemic.
Is There a Role for Pneumatic Dilation in Primary Treatment of Achalasia? Con: PD Outcomes are Too Variable and Surgical Myotomy With POEM or Heller is Better
Authors: Dunst Christy M.
Published: October 2022

Presently, we have 3 acceptable options for the treatment of achalasia: pneumatic dilation (PD), endoscopic myotomy (POEM), and laparoscopic myotomy (LM). Results from multicenter randomized trials demonstrate the superiority of myotomy over pneumatic dilation. While myotomy may be superior at relief of dysphagia, there may be circumstances where a thoughtful, individualized patient approach is more important.
Sketching and sampling approaches for fast and accurate long read classification
Authors: Das Arun , Schatz Michael C.
Published: October 2022

Background

In modern sequencing experiments, quickly and accurately identifying the sources of the reads is a crucial need. In metagenomics, where each read comes from one of potentially many members of a community, it can be important to identify the exact species the read is from. In other settings, it is important to distinguish which reads are from the targeted sample and which are from potential contaminants. In both cases, identification of the correct source of a read enables further investigation of relevant reads, while minimizing wasted work. This task is particularly challenging for long reads, which can have a substantial error rate that obscures the origins of each read.

Results

Existing tools for the read classification problem are often alignment or index-based, but such methods can have large time and/or space overheads. In this work, we investigate the effectiveness of several sampling and sketching-based approaches for read classification. In these approaches, a chosen sampling or sketching algorithm is used to generate a reduced representation (a “screen”) of potential source genomes for a query readset before reads are streamed in and compared against this screen. Using a query read’s similarity to the elements of the screen, the methods predict the source of the read. Such an approach requires limited pre-processing, stores and works with only a subset of the input data, and is able to perform classification with a high degree of accuracy.

Conclusions

The sampling and sketching approaches investigated include uniform sampling, methods based on MinHash and its weighted and order variants, a minimizer-based technique, and a novel clustering-based sketching approach. We demonstrate the effectiveness of these techniques both in identifying the source microbial genomes for reads from a metagenomic long read sequencing experiment, and in distinguishing between long reads from organisms of interest and potential contaminant reads. We then compare these approaches to existing alignment, index and sketching-based tools for read classification, and demonstrate how such a method is a viable alternative for determining the source of query reads. Finally, we present a reference implementation of these approaches at https://github.com/arun96/sketching.
Genome-wide detection of RNA editing events during the hair follicles cycle of Tianzhu white yak
Authors: Zhou Xuelan , Bao Pengjia , Zhang Xiaolan , Guo Xian , Liang Chunnian , Chu Min , Wu Xiaoyun , Yan Ping
Published: October 2022

Background

The hair coat is available for the yak to live in the harsh environment of the plateau. Besides, improving the hair production of yak is necessary for its textile industry development. Hair grows from hair follicles (HFs). The HFs undergo periodic growth after birth and are regulated by the complex gene regulatory network. However, the molecular mechanism of HFs regeneration in the Tianzhu white yak remains unclear. RNA editing is a post-transcriptional mechanism that regulates gene expression and produces new transcripts. Hence, we investigated the influence of the A-to-I RNA editing events on the HFs cycle of the Tianzhu white yak.

Results

We finally identified 54,707 adenosine-to-inosine (A-to-I) RNA editing sites (RESs) from RNA sequencing data of the HFs cycle in the Tianzhu white yak. Annotation results showed RESs caused missense amino acid changes in 7 known genes. And 202 A-to-I editing sites altered 23 target genes of 140 microRNAs. A total of 1,722 differential RESs were identified during the HFs cycle of Tianzhu white yak. GO and KEGG enrichment analysis revealed several signaling pathways and GO terms involved skin development, hair growth, and HFs cycle. Such as genes with differential RNA editing levels were significantly enriched in the peroxisome, metabolic pathways, Notch signaling pathway, and PPAR signaling pathway. Besides, the editing sites in HFs development-related genesFAS,APCDD1,WWOX,MPZL3,RUNX1,KANK2,DCN,DSC2,LEPR,HEPHL1, andPTK2Bwere suggested as the potential RESs involving HFs development.

Conclusion

This study investigated the global A-to-I RNA editing events during the HFs cycle of yak skin tissue and expanded the knowledge of A-to-I RNA editing on the HFs cycle. Furthermore, this study revealed that RNA editing-influenced genes may regulate the HFs cycle by participating in the HFs development-related pathways. The findings might provide new insight into the regulation of RNA editing in hair growth.
Drug-related adverse events potentially predict the efficacy of apatinib on advanced hepatocellular carcinoma
Authors: Gu Xiaoying , Zhang Su , Yang Xuejiao , Guan Tao , Hou Zhenyu , Cao Manqing , Li Huikai , Zhang Ti
Published: October 2022

Background

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths worldwide every year, and most HCC patients are diagnosed with advanced disease and can only receive systemic treatment. TKIs are the most important components of the systemic treatment of HCC and have both good efficacy and adverse events (AEs). 

Methods

This analysis included 207 patients with locally advanced unresectable or metastatic HCC who received oral treatment with apatinib. We analyzed the overall survival (OS) and progression-free survival (PFS) of patients with or without corresponding AEs to evaluate which AEs can predict the efficacy of apatinib.

Results

Patients with hand-foot syndrome (HFS; p = 0.005), proteinuria (p = 0.006) and diarrhea (p < 0.001) had significantly better OS than those without corresponding AEs, and the appearance of HFS (p = 0.006) and proteinuria (p = 0.004) was associated with longer PFS.

Conclusion

Among all the AEs induced by apatinib in the treatment of advanced HCC, proteinuria could potentially predict PFS, and diarrhea was a potential predictor of OS.
Evaluation of qualitative and semi-quantitative cut offs for rapid diagnostic lateral flow test in relation to serology for the detection of SARS-CoV-2 antibodies: findings of a prospective study
Authors: Peghin Maddalena , Bontempo Giulia , De Martino Maria , Palese Alvisa , Gerussi Valentina , Graziano Elena , Fabris Martina , D’Aurizio Federica , Sbrana Francesco , Ripoli Andrea , Curcio Francesco , Isola Miriam , Tascini Carlo
Published: October 2022

Background:

There is limited information to compare the qualitative and semi-quantitative performance of rapid diagnostic tests (RDT) and serology for the assessment of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, the objective of the study was (a) to compare the efficacy of SARS-CoV-2 antibody detection between RDT and laboratory serology, trying to identify appropriate semi-quantitative cut-offs for RDT in relation with quantitative serology values and to (b) evaluate diagnostic accuracy of RDT compared to the NAAT gold standard in an unselected adult population.

Methods:

SARS-CoV-2 antibodies were simultaneously measured with lateral flow immunochromatographic assays (LFA), the Cellex qSARS-CoV-2 IgG/IgM Rapid Test (by capillary blood), the iFlash-SARS-CoV-2 IgG/IgM chemiluminescent immunoassay (CLIA) (by venous blood) and the nucleic acid amplification test (NAAT) in samples from in- and out-patients with confirmed, suspected and negative diagnosis of coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) (March-May 2020). Interpretation of RDT was qualitative (positive/negative) and semi-quantitative based on a chromatographic intensity scale (negative, weak positive, positive).

Results:

Overall, 720 paired antibody measures were performed on 858 patients. The qualitative and semiquantitative agreement analysis performed in the whole sample between LFA and CLIA provided a Kendall’s tau of 0.578 (p < 0.001) and of 0.623 (p < 0.001), respectively, for IgM and IgG. In patients with a diagnosis of COVID-19, accordance between LFA and CLIA was maintained as a function of time from the onset of COVID-19 disease and the severity of disease both for qualitative and semi-quantitative assessments. RDT compared to the NAAT gold standard in 858 patients showed 78.5% sensitivity (95% CI 75.1%-81.7%) and 94.1% specificity (95% CI 90.4%-96.8%), with variable accordance depending on the timing from symptom onset.

Conclusion:

The RDT used in our study can be a non-invasive and reliable alternative to serological tests and facilitate both qualitative and a semi-quantitative antibody detection in COVID-19.
Correlation between radial peripapillary vascular density and reduced central corneal thickness in glaucoma suspect patients
Authors: Lotfy Ayman , Mattout Hala Kamal , Fouda Sameh Mosaad , Hemeda Sahar
Published: October 2022

Background

Optical coherence tomography (OCT) angiography (OCTA) provides a quantitative assessment of the microcirculation of the retina and choroid. It may precede the retinal nerve layer (RNFL) and optic disc head defects. Retinal nerve fiber layer defects and reduced central corneal thickness (CCT) are important parameters in the assessment of a glaucoma suspect patients. The aim of this study is to investigate any possible relationship between the reduced central corneal thickness and the radial peripapillary capillary (RPC) density defect in glaucoma suspect.

Methods

In this cross sectional study, 92 eyes were incorporated. Peripapillary OCT angiography (4.5 mm) and Anterior segment OCT for corneal pachymetry were done. C/D Ratio, thickness of nerve fiber layer, the blood flow indices and central corneal thickness also were evaluated.

Results

In eyes of glaucoma suspect patients; a significant positive correlation between CCT and total RPC density was detected (r = 0.38, P < 0.001). A strong positive correlation was also found between total RPC and peripapillary RNFL thickness (r = 0.55, P < 0.001).

Conclusion

Reduced central corneal thickness and peripapillary capillary density are two screening parameters for glaucoma suspect patients. The radial peripapillary capillary density is a valid diagnostic tool for glaucoma.
A digital Norwegian version of the client satisfaction questionnaire 8: factor validity and internal reliability in outpatient mental health care
Authors: Pedersen Henrik , Havnen Audun , Brattmyr Martin , Attkisson C. Clifford , Lara-Cabrera Mariela L.
Published: October 2022

Background

Validated measures of patient-reported experiences are essential for assessing and improving the quality of mental health services and interventions. In Norwegian mental healthcare settings, the Client Satisfaction Questionnaire (CSQ-8) is increasingly being used for this purpose, but the validity and reliability of the Norwegian translation have not been investigated.

Methods

We examined the factor structure and internal consistency of a digitally administrated Norwegian translation of the CSQ-8 in a sample of 338 patients recruited from outpatient treatment. The relationship between satisfaction scores and the change in symptom severity during treatment, measured by the Patient Health Questionnaire-4, was also investigated.

Results

The Norwegian CSQ-8 showed a clear unidimensional structure with one factor explaining 74% of the variance. Internal consistency was very high, with a Cronbach’s alpha of 0.95. Satisfaction showed a small-to-moderate negative relationship with change in symptom severity. Satisfaction scores were negatively skewed, and the presence of ceiling effects is discussed.

Conclusion

Our results support the use of the Norwegian CSQ-8 as a valid and reliable measure of satisfaction with mental healthcare services. Further studies are needed to determine the test-retest reliability of the questionnaire, its sensitivity to change, and to assess its propensity to ceiling effects.
The COVID-19 pandemic’s intersectional impact on work life, home life and wellbeing: an exploratory mixed-methods analysis of Georgia women’s experiences during the pandemic
Authors: McCool-Myers Megan , Grasso Damion , Kozlowski Debra , Cordes Sarah , Jean Valerie , Gold Heather , Goedken Peggy
Published: October 2022

Background

Women have been especially impacted by the COVID-19 pandemic. This exploratory study aimed to characterize women’s adverse experiences related to their work, home lives, and wellbeing during the height of the COVID-19 pandemic and to describe demographic differences of those lived experiences.

Methods

Using the validated Epidemic-Pandemic Impacts Inventory, we collected data from reproductive-aged women in the state of Georgia about their exposure to adverse events during the pandemic. A latent class analysis (LCA) was performed to identify subgroups of women reporting similar adverse experiences and describe their sociodemographic characteristics. An optional open-ended question yielded qualitative data that were analyzed thematically and merged with subgroup findings. Data were collected from September 2020 to January 2021.

Results

423 individuals aged 18–49 completed the survey with 314 (74.2%) providing qualitative responses. The LCA yielded 4 subgroups: (1) a “low exposure” subgroup (n = 123, 29.1%) with relatively low probability of adverse experiences across domains (e.g. financial insecurity, health challenges, barriers to access to healthcare, intimate partner violence (IPV)); (2) a “high exposure” subgroup (n = 46, 10.9%) with high probability of experiencing multiple adversities across domains including the loss of loved ones to COVID-19; (3) a “caregiving stress” subgroup (n = 104, 24.6%) with high probability of experiencing challenges with home and work life including increased partner conflict; and (4) a “mental health changes” subgroup (n = 150, 35.5%) characterized by relatively low probability of adverse experiences but high probability of negative changes in mental health and lifestyle. Individuals in subgroups 1 and 4, which had low probabilities of adverse experiences, were significantly more likely to be non-Hispanic white. Individuals in subgroup 2 were more likely to identify with a sexual or racial/ethnic minority population. Inductive coding of qualitative data yielded themes such as stress, mental health, financial impact, and adaptation/resilience, providing context for pandemic-related adversity.

Conclusion

Though many individuals in our sample experienced hardship, minority populations were unequally impacted by pandemic-related adversity in work life, home life, and wellbeing. Recovery and future emergency preparedness efforts in Georgia must incorporate support mechanisms for mental health and IPV, focusing especially on the intersectional needs of racial, ethnic, and sexual minorities.
The targets of aspirin in bladder cancer: bioinformatics analysis
Authors: Li Xiao , Tai Yanghao , Liu Shuying , Gao Yating , Zhang Kaining , Yin Jierong , Zhang Huijuan , Wang Xia , Li Xiaofei , Zhang Dongfeng , Zhang Dong-feng
Published: October 2022

Background

The anti-carcinogenic properties of aspirin have been observed in some solid tumors. However, the molecular mechanism of therapeutic effects of aspirin on bladder cancer is still indistinct. We introduced a bioinformatics analysis approach, to explore the targets of aspirin in bladder cancer (BC).

Methods

To find out the potential targets of aspirin in BC, we analyzed direct protein targets (DPTs) of aspirin in Drug Bank 5.0. The protein-protein interaction (PPI) network and signaling pathway of aspirin DPTs were then analyzed subsequently. A detailed analysis of the KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway has shown that aspirin is linked to BC. We identified overexpressed genes in BC comparing with normal samples by Oncomine and genes that interlinked with aspirin target genes in BC by STRING.

Results

Firstly, we explored 16 direct protein targets (DPT) of aspirin. We analyzed the protein-protein interaction (PPI) network and signaling pathways of aspirin DPT. We found that aspirin is closely associated with a variety of cancers, including BC. Then, we classified mutations in 3 aspirin DPTs (CCND1, MYC and TP53) in BC using the cBio Portal database. In addition, we extracted the top 50 overexpressed genes in bladder cancer by Oncomine and predicted the genes associated with the 3 aspirin DPTs (CCND1, MYC and TP53) in BC by STRING. Finally, 5 exact genes were identified as potential therapeutic targets of aspirin in bladder cancer.

Conclusion

The analysis of relevant databases will improve our mechanistic understanding of the role of aspirin in bladder cancer. This will guide the direction of our next drug-disease interaction studies.
Work station learning activities (WSLA) through the ICAP framework: a qualitative study
Authors: Sánchez Judit , Lesmes Marta , Azpeleta Clara , Gal Beatriz
Published: October 2022

Background

Engaging, student-centered active learning activities, such as team-based learning (TBL) and laboratory practices, is beneficial to integrate knowledge, particularly in Medicine degree. Previously, we designed and implemented workstation learning activities (WSLA) inspired by TBL, which proved effective for learning requiring higher-order thinking skills. We now hypothesize that WSLA may also have the potential to be framed into a theoretical model that stratifies learning into interactive, constructive, active and passive modes (ICAP hypothesis).

Methods

An interpretive qualitative research study was conducted to evaluate this idea. Semi-structured interviews were conducted with students enrolled in health science programs after WSLA sessions, consisting of a series of activities accompanying a traditional lecture. Interviews were analyzed according to a deductive approach. Theoretical themes and subthemes driving the analysis were organized around the ICAP modes: passive, active, constructive, and interactive. An inductive approach was applied to provide additional insights.

Results

Students valued preparatory lectures as well as corresponding WSLA activities as highly motivating, especially for the ability to integrate concepts. Although previous research shows that not all activities require high levels of cognitive engagement, students appreciated the opportunity the WSLA provided to discuss and clarify concepts as a group. Furthermore, feedback from professors and peers was highly appreciated, and helped students to construct new knowledge.

Conclusion

In this work, by focusing in understanding the student’s experience, we have evaluated for the first time the WSLA approach in relation to the ICAP model. We found that not only the activity type determines the learning mode, but also the environment accompanying WSLA is a determining factor. Our findings can guide future development of the WSLA approach, which represents an interactive learning methodology with strong potential within the ICAP framework.

Trial registration

Not applicable.
Combined effects of cues influencing patients’ purchasing behavior in online health-care communities: qualitative comparative analysis based on cue utilization theory
Authors: Ren Dixuan , Ma Baolong
Published: October 2022

Background

The sudden outbreak of COVID-19 in early 2020 pushed the online health-care communities (OHCs) into the public eye in China. However, OHCs is an emerging service model, which still has many problems such as low patient trust and low patient utilization rate. Patients are the users and recipients of web-based medical services, as well as the core of medical services. Thus, based on cue utilization theory, this paper studies combination effect of influencing factors in patients’ purchase of web-based medical services through the qualitative comparative analysis method of fuzzy sets (fsQCA).

Methods

This paper discards statistical methods based on variance theory-based relationships between explanatory and explained variables and uses a construct theory-based fuzzy set qualitative comparative analysis (fsQCA) approach to elucidate such complex relationships of patients' online purchasing behavior. We use a crawler to automatically download information from Haodf.com. This study crawled data in August 2020, involving 1210 physicians.

Results

Service price, reputation and service quality are the key factors for patients’ purchasing behavior. Physician’s online reputation, online medical service price, number of published articles, mutual-help group, and appointment registration affect patients' purchasing behavior by means of weighted variation. Only when a high scope of internal attribute-related cue elements and a low scope of external attribute-related cue elements are combined with each other in a specific form, patients will generate purchase behavior.

Conclusion

This paper clarifies the complex causes that promote to patients' purchasing behavior of web-based medical services, enriches and develops the relevant theories in the field of consumer purchasing behavior and online health-care communities market research, and has implications for governments, platforms, physicians and patients in the event of web-based medical service purchases.
Memory of social experience affects female fecundity via perception of fly deposits
Authors: Fowler E. K. , Leigh S. , Rostant W. G. , Thomas A. , Bretman A. , Chapman T.
Published: October 2022

Background

Animals can exhibit remarkable reproductive plasticity in response  to their social surroundings, with profound fitness consequences. The presence of same-sex conspecifics can signal current or future expected competition for resources or mates. Plastic responses to elevated sexual competition caused by exposure to same-sex individuals have been well-studied in males. However, much less is known about such plastic responses in females, whether this represents sexual or resource competition, or if it leads to changes in investment in mating behaviour and/or reproduction. Here, we usedDrosophila melanogasterto measure the impact of experimentally varying female exposure to other females prior to mating on fecundity before and after mating. We then deployed physical and genetic methods to manipulate the perception of different social cues and sensory pathways and reveal the potential mechanisms involved.

Results

The results showed that females maintained in social isolation prior to mating were significantly more likely to retain unfertilised eggs before mating, but to show the opposite and lay significantly more fertilised eggs in the 24h after mating. More than 48h of exposure to other females was necessary for this social memory response to be expressed. Neither olfactory nor visual cues were involved in mediating fecundity plasticity—instead, the relevant cues were perceived through direct contact with the non-egg deposits left behind by other females.

Conclusions

The results demonstrate that females show reproductive plasticity in response to their social surroundings and can carry this memory of their social experience forward through mating. Comparisons of our results with previous work show that the nature of female plastic reproductive responses and the cues they use differ markedly from those of males. The results emphasise the deep divergence in how each sex realises its reproductive success.
One day versus two days of hepatic arterial infusion with oxaliplatin and fluorouracil for patients with unresectable hepatocellular carcinoma
Authors: Lai Zhicheng , Huang Yexing , Wen Dongsheng , Lin Xuanjia , Kan Anna , Li Qijiong , Wei Wei , Chen Minshan , Xu Li , He Minke , Shi Ming
Published: October 2022

Background

Hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin and 5-fluorouracil was effective in unresectable hepatocellular carcinoma (HCC). The program of FOLFOX-HAIC in HCC was performed for 1 day (HAIC 1d) or 2 days (HAIC 2d). We hereby retrospectively compared the efficacy and safety between these two treatment regimens and explored the predictive power of thymidylate synthase (TYMS), an enzyme involved in the DNA synthesis process and metabolism of fluorouracil.

Methods

This study included patients with a primary diagnosis of unresectable HCC. These patients received HAIC for 1 day or 2 days. The overall survival (OS), progression-free survival (PFS), tumor response, and adverse events were compared. The propensity score matching (PSM) was used to reduce bias. Peripheral blood samples before the treatments were collected and used to measure the concentration of TYMS through enzyme-linked immunosorbent assay (ELISA). ELISA was performed according to the manufacturers’ guidelines.

Results

We included 368 patients for this study: 248 in the HAIC 1d group and 120 in the HAIC 2d group. There was no significant difference of OS between the two groups (14.5 for HAIC 1d vs 15.3 months for HAIC 2d, p=0.46). Compared with the HAIC 1d group, the HAIC 2d group did not prolong the PFS (7.3 vs 7.5 months, p=0.91) or elevate the tumor response (42.5% vs 39.1%, p=0.53) per RECIST 1.1. In the PSM cohort, the efficacy between the two groups was similar. The total frequencies of grade 3–4 events were higher with the HAIC 2d group than with the HAIC 1d group, especially in the PSM cohort (p=0.043). Additionally, patients with TYMS low level might benefit longer OS from the HAIC 2d group (18.7 vs 13.6 months, p=0.014).

Conclusions

There was not much of a difference in efficacy between the two groups, but the HAIC for 1 day might be safer, which needed further research. The level of TYMS might be the predictive biomarkers.
The adverse effect of ambient temperature on respiratory deaths in a high population density area: the case of Malta
Authors: Jahan Shafkat , Cauchi John Paul , Galdies Charles , England Kathleen , Wraith Darren
Published: October 2022

Background

The effect of ambient temperature on respiratory mortality has been consistently observed throughout the world under different climate change scenarios. Countries experiencing greater inter–annual variability in winter temperatures (and may not be lowest winter temperatures) have greater excess winter mortality compared to countries with colder winters. This study investigates the association between temperature and respiratory deaths in Malta which has one of the highest population densities in the world with a climate that is very hot in summer and mild in winter.

Methods

Daily number of respiratory deaths (7679 deaths) and meteorological data (daily average temperature, daily average humidity) were obtained from January 1992 to December 2017. The hot and cold effects were estimated at different temperatures using distributed lag non-linear models (DLNM) with a Poisson distribution, controlling for time trend, relative humidity and holidays. The reference temperature (MMT) for the minimum response-exposure relationship was estimated and the harvesting effects of daily temperature (0–27 lag days) were investigated for daily respiratory mortality. Effects were also explored for different age groups, gender and time periods.

Results

Cooler temperatures (8–15 °C) were significantly related to higher respiratory mortality. At 8.9 °C (1st percentile), the overall effect of daily mean temperature was related to respiratory deaths (RR 2.24, 95%CI 1.10–4.54). These effects were also found for males (95%CI 1.06–7.77) and males across different age groups (Males Over 65 years: RR 4.85, 95%CI 2.02–11.63 vs Males between 16 and 64 years: RR 5.00, 95%CI 2.08–12.03) but not for females. Interestingly, colder temperatures were related to respiratory deaths in the earliest time period (1992–2000), however, no strong cold effect was observed for later periods (2000–2017). In contrast, no heat effect was observed during the study period and across other groups.

Conclusions

The higher risk for cold-related respiratory mortality observed in this study could be due to greater inter-annual variability in winter temperatures which needs further exploration after adjusting for potential physical and socio-demographic attributes. The study provides useful evidence for policymakers to improve local warning systems, adaptation, and intervention strategies to reduce the impact of cold temperatures.