bluuebunny/crossref_metadata_2025 huggingface dataset:
Household Expenditure on Education in China: Key Findings From the China Institute for Educational Finance Research-Household Surveys (CIEFR-HS)
Authors: Wei (魏易) Yi
Published: May 2024

Purpose

This study uses data from the 2019 China Institute for Educational Finance Research-Household Survey to investigate expenditure on children's education in China.

Design/Approach/Methods

Using descriptive and regression analysis, this study analyzes the level and structure of household expenditure on children's education, the associated disparities, and household financial burden.

Findings

The average household expenditure on regular full-time education nationwide was RMB 8,139 per child, accounting for 10.8% of total household expenditure. On average, 24.4% and 15.5% of elementary and high school students participated in out-of-school subject- and interest-oriented tutoring in AY 2018–2019, respectively. On an average, it costs a household approximately RMB 233,000 to educate a child from preschool to the undergraduate level. The total investments in regular full-time education nationwide were estimated to be RMB 6.2 billion—6.87% of the national Gross Domestic product. Moreover, based on an overview of various statistics on school funding, this study found that several years of public investments in compulsory education and rural schools have significantly reduced the disparities in school funding among income groups.

Originality/Value

This research is the first report giving a comprehensive picture of household expenditures on education nationwide in China. It provides empirical evidence for exploring policy tools to realize the balanced development of education.
Unveiling the Social Life of SuperAgers: A Narrative Review of Social Profiles of Exceptional Cognitive Aging
Authors: Trnka Radek , Schneiderova Melisa , Vojtechova Iveta , Dadova Klara , Georgi Hana
Published: May 2024

SuperAging deserves special attention from researchers in the field of the psychology of aging, because it denotes the preservation of multiple cognitive abilities in very old age. Currently, very little is known about lifestyle factors that could be related to SuperAging. The main goal of the present narrative review was to bring together available evidence involving social factors related to SuperAging and to target avenues for future research. The review summarizes the findings of studies published between 2005 and 2022. Low social participation in midlife age and high social participation in older age were found to be related to SuperAging. In contrast, social network size and diversity did not differ between SuperAgers and cognitively normal older adults. The synthesis of the results indicates that having positive, close, high-quality relationships and a high frequency of social contact may be considered to be hypothetical predictors of superior cognitive performance in later life.
Democracy for Sale: Examining the Phenomenon of the Cost of Expression of Interest and Nomination Forms for Major Parties in Nigeria’s 2023 General Election
Authors: Sambo Usman , Sule Babayo , Adamu Umar , Septiadi Muhammad Andi
Published: May 2024

Elections in Nigeria are increasingly turning democratic practice into a bazaar for the highest bidder. Preparations for the 2023 General Election, especially the purchase of statements of interest and nomination forms, as well as party primaries, threaten to squeeze non-super-rich candidates out of participation. This study examines how Nigerian democracy is being manipulated into a business of the highest bidder by examining the costs of the entire process of nomination and party primaries in the All Progressives Congress and the Peoples Democratic Party. The study draws on face-to-face in-depth interviews selected on the basis of criteria such as accessibility, relevance, and quality of information. The informants were classified into different categories. The data obtained from the interviews were analyzed using thematic content analysis. Clientelism is adopted as a framework to explain this phenomenon. The study found that APC and PDP deliberately drive up the cost of nomination to displace poor and non-rich competitors. The impact is evident in the reckless use of money during the parties’ primaries where the process was conducted in dollars. Transparency is being circumvented and to restore integrity to nomination and party primaries in Nigeria, reforms that go beyond politics to include civil society, the electorate, international partners, and other stakeholders are needed.
Are Variable Screw Angle Change and Screw-to-Vertebral Body Ratio Associated With Radiographic Subsidence Following Anterior Cervical Discectomy and Fusion?
Authors: Louie Philip K. , Kumar Rakesh , Bansal Aiyush , Raub Spencer , Alostaz Murad , Vivelo Nicole , Gilbert Michelle , Leveque Jean-Christophe , Nemani Venu
Published: May 2024

Study Design

Retrospective Cohort.

Objective

This study aims to assess the easily measurable radiographic landmarks of screw-to-vertebral body ratio and changes in screw angle to identify if they are associated with early subsidence following an Anterior cervical discectomy and fusion (ACDF).

Methods

A retrospective cohort study was conducted on patients undergoing 1-3 level ACDF with allograft or PEEK cages. Preoperative, immediate postoperative, and 6-month postoperative radiographs were analyzed to measure intradiscal height (or distance between 2 vertebral bodies) as an anterior vertebral distance (AVD), middle (MVD), and posterior (PVD), screw angle, screw-to-vertebral body length ratio, and interscrew distance. Multivariate stepwise regression analyses were performed.

Results

92 patients were included (42 single-level, 32 two-level, and 18 3-level ACDFs). In single-level ACDFs, a decrease in the caudal screw angle was associated with a decrease in AVD (=.001) and MVD ( P = .03). A decrease in the PVD was associated with a decrease in segmental lordosis ( P < .001). For two-level ACDFs, a higher caudal screw-to-body ratio was associated with a lower MVD ( P = .01).

Conclusion

Six months following an ACDF for degenerative pathology, a decrease in the caudal screw angle was associated with an increase in radiographic subsidence at the antero-medial aspect of the disc space albeit largely subclinical. This suggests that the caudal screw angle change may serve as a reliable radiographic marker for early radiographic subsidence. Furthermore, a greater screw-to-vertebral body ratio may be protective against radiographic subsidence in two-level ACDF procedures.
Exploring Use of Peristeen® Transanal Irrigation for Pediatric Bowel Management
Authors: Mantel Connie , Carlin Kristen , Walsh Elaine
Published: May 2024

Introduction: Children born with certain anorectal malformations, spinal anomalies, and other conditions may require rectal enemas as a non-surgical bowel management option. The purpose of this study was to explore benefits and problems using Peristeen® transanal irrigation for bowel management, and to determine factors that influence whether Peristeen® is preferred over previous methods used as a non-surgical method for bowel management. Methods: An IRB-approved cross-sectional survey was conducted. Children and their caregivers, trained on use of Peristeen®, were invited to participate via MyChart® and mail to reflect on their experience with bowel management programs. Participants completed a 33-item confidential online survey. Results: Of the 49 eligible participants invited to participate, 13 completed the survey. The mean age child for children was 12.2 years. Most frequently identified diagnoses were imperforate anus (39%) and spina bifida (31%). Ninety-two percent used gravity enemas prior to switching to Peristeen®. Most frequently identified barriers for use of gravity enemas were taking too long (61%) and pain or cramping (54%). These barriers were reported less frequently related to Peristeen® use. Barriers reported most frequently for Peristeen® included holding balloon in rectum (31%) and bathroom space or layout (31%). Median time to administer Peristeen® was 45 min compared to 60 min with gravity enema. Discussion: Overall, Peristeen® users were satisfied with the system and reported barriers less frequently. Cost and use of Peristeen® was reported as a significant barrier. Further studies are needed to compare various options for transanal irrigations.
Coexistence of Allergic Diseases in Pediatric Systemic Lupus Erythematosus Patients: Prevalence, Clinical manifestation and Severity
Authors: Suebsarakam Porntipa , kaweeyanont Kitiporn , Srisutthikamol Sureeporn , Mairiang Dara
Published: May 2024

Objective. This study aimed to evaluate allergic diseases in pediatric patients with SLE and their association with SLE disease activity. Method. Patients with SLE aged ≤18 years were enrolled. Allergic diseases were screened using the International Study of Asthma and Allergies in Childhood questionnaire. Patients with a positive allergic disease screen were evaluated by a pediatric allergist for diagnostic confirmation and severity assessment. Results. Out of 118 patients, 16 patients (13.56%) were confirmed to have 1 or more allergic diseases; fourteen with allergic rhinitis, 4 with asthma, and 2 with atopic dermatitis. Two patients had severe-persistent allergic rhinitis and one patient had undiagnosed, uncontrolled severe asthma. No statistically significant correlations between the severity of allergic diseases and SLE disease activity were identified. Conclusions. The overall prevalence of allergic disease among pediatric patients with SLE is within the range of the general population. Severe and undiagnosed allergic diseases and SLE can coexist.
Cross-Cultural Exchange of Visual and Material Cultures: Case Studies from the North Indian Terracotta Figures
Authors: Bawa Seema
Published: May 2024

This article offers an investigation into sculptural artefacts from the early historic period. Most of the objects under study are small in size and are often found dismembered or in pieces. This is partly because of the fragility of the material—baked clay—but more often, because of the techniques of manufacture—whether owing to a weak armature (where used), incomplete baking or/and the pressing together of elements in the mould that has yielded to the passage of time and rough handling. The following analysis seeks to locate these fragments by contextualising them in the spaces/regions they were found in, as well as in the estimated time periods. This contextualisation is specifically attempted through some typologically categorised case studies pursued through the lens of ‘transculturality’ and ‘materiality’.
Knowledge and Attitude of Nursing Interns Toward Pressure Injury Prevention in Saudi Arabia: A Multiregional Cross-Sectional Study
Authors: Al Gharash Hassan , Alharbi Abdulhafith , Alshahrani Yousef , Mousa Ola
Published: May 2024

Introduction

Nursing students in internship programs can play a role in preventing pressure injuries as they engage in real clinical situations and are assigned to conduct clinical tasks. Thus, nursing students in internship programs should be adequately prepared in terms of their knowledge and attitudes to contribute to pressure injury prevention.

Objective

To explore and understand the knowledge and attitudes of nursing interns toward pressure injury prevention in Saudi Arabia.

Methods

This cross-sectional study included 161 nursing interns from various public hospitals across three provinces in Saudi Arabia and used an online questionnaire. The Pressure Ulcer Knowledge Assessment Tool and Attitude toward Pressure Ulcer Prevention instrument were used to collect data from nursing students in the internship program. The Statistical Package of the Social Sciences Program version 28 was used for the data analysis.

Results

Participants reported inadequate knowledge regarding the prevention of pressure injuries, with a mean knowledge score of 48.15%. Additionally, the participants showed unsatisfactory attitudes toward the prevention of pressure injuries, with a mean score of 61.36%. Significant differences were observed in knowledge ( P = 0.008) and attitude ( P < 0.001) levels between sexes, with female participants scoring higher than male participants. Additionally, students who completed longer internships had better knowledge levels than those who completed shorter internships ( P = 0.007). In the open-response question, participants reported a lack of preparation and support during the internship and suggested recommendations to address these deficiencies in preparation and support.

Conclusion

Nursing interns need pre-internship preparation and continuous learning and support during the internship to manage and prevent pressure injuries.
Culinary Medicine: Needs and Strategies for Incorporating Nutrition into Medical Education in the United States
Authors: Thomas Olivia W. , Reilly Jo Marie , Wood Nathan I. , Albin Jaclyn
Published: May 2024

In the past decade, medical education has increasingly incorporated evidence-based lifestyle interventions as primary strategies for preventing and managing noncommunicable diseases. This shift embraces the growing recognition of the significant impact of lifestyle on health outcomes, driving diseases including obesity, diabetes, heart disease, and cancer. Now deemed “food is medicine” (FIM), diet-related interventions witnessed integration into healthcare systems and recognition in the United States’ White House Conference on Hunger, Nutrition, and Health in 2023. As FIM gains traction, investigating optimal strategies for team-based education becomes essential. Healthcare teams need the necessary knowledge and tools to effectively administer FIM services and collaborate across disciplines, ultimately enhancing disease prevention, chronic disease management, health quality, value, and overall wellness. Culinary medicine (CM), a vital component of FIM, bridges nutrition education, pragmatic culinary skills, and conventional strategies to improve chronic disease management. CM involves experiential learning, imparts practical skills, and encourages behavior change by addressing food-related determinants of health and promoting equitable access. Teaching kitchens serve as physical or virtual learning spaces and as a didactic and experiential method (skills lab), playing a crucial role by integrating culinary, lifestyle, integrative, and conventional medicine. A growing number of medical schools in the United States and globally offer CM education via diverse methods including interest groups, electives, and specialty tracks, encompassing didactic sessions, hands-on kitchen education, and virtual teaching methods. Given the rising demand for CM programs, this article aims to describe, map, and compare existing CM education types in medical education. It provides actionable recommendations for medical schools to establish and expand CM programs by fostering service-learning partnerships, clinical innovation, and interdisciplinary research. As FIM gains prominence, cultivating a robust foundation of educational strategies is vital to ensure seamless integration into both medical education and collaborative medical practice.
The Application of Problem-Based Learning Combined With Case-Based Learning in EEG Teaching
Authors: Li Feng , Luo Jing , Zhang Hua
Published: May 2024

OBJECTIVE

The aim of this study is to explore the application effectiveness and value of combining problem-based learning (PBL) and case-based learning (CBL) in clinical electroencephalography (EEG) education.

METHODS

A total of 104 standardized training for residents and refresher physicians from the Neurology Department of the First Affiliated Hospital of Chongqing Medical University, Neurology Department of Chongqing Yubei Hospital, and Neurology Department of Banan Hospital of Chongqing Medical University were enrolled. According to randomization principles, 52 participants were assigned into the PBL-CBL combination group and 52 subjects were assigned into the control group. We used statistical methods to compare the differences between the 2 groups in basic theory, case analysis, practical assessment scores, and teaching satisfaction.

RESULTS

In terms of basic theory, case analysis, practical assessment scores, and teaching satisfaction, there were significant differences between the 2 groups, and the PBL-CBL combination group was superior to the control group ( P < .05).

CONCLUSION

In clinical EEG education, the teaching model of combining PBL and CBL has certain application effects and value.
Towards carceral protectionist territories: Relational geographies of anti-trafficking confinement in Nepal
Authors: Bhagat Ayushman , Yea Sallie
Published: May 2024

The article draws on labour and migration bans in Nepal as a case study to advance nascent, yet growing attention towards trafficking borders in critical geographical research on anti-trafficking. It does so by highlighting a relational geography of carceral protectionist spaces which are encountered, navigated, and sometimes escaped by women citizens on the move who are pre-emptively rescued/‘saved’ from the possibility of being ‘trafficked.’ Specifically, we aim to extend these critical interventions on carceral protectionism in two interconnected ways. First, whilst extant research mainly focuses on institutions and actors within migrant destination states, we examine the operations of carceral protectionist spaces within the home countries of migrant women. Second, we tease out the ways carceral protectionist spaces can actively produce the very subjects they seek to deter or eradicate as they navigate and challenge these institutional spaces. Through the discussion, we develop threads of the conceptualisation of a carceral protectionist territory to indicate the multiple and diffuse, yet interconnected, sites through which women’s mobility aspirations are constrained by anti-trafficking infrastructures.
Cardiology Quiz
Authors: Jadhav Kartik Pandurang
Published: May 2024

These 20 questions are meant for DM/DNB/Post SS-Fellow residents/associate consultants.
Establishing resources and increasing awareness to advance research on Dentatorubral-pallidoluysian atrophy toward a treatment: a patient organization perspective
Authors: Prades Silvia , Compton Andrea , Carroll Jeffrey B.
Published: May 2024

Dentatorubral-pallidoluysian atrophy (DRPLA) is an ultra-rare neurodegenerative disorder characterized by ataxia, cognitive decline, myoclonus, chorea, epilepsy, and psychiatric manifestations. This article delves into the multifaceted efforts of CureDRPLA, a family-driven non-profit organization, in advancing research, raising awareness, and developing therapeutic strategies for this complex condition. CureDRPLA’s inception in 2019 led to the establishment of the DRPLA Research Program, and since then have funded research projects to advance the understanding of DRPLA including but not limited to human cellular and mouse models, a natural history and biomarkers study, and a patient registry. There are currently no disease-modifying treatments for DRPLA, motivating a concerted effort on behalf of CureDRPLA to hasten their development by funding and coordinating preclinical studies of therapies in multiple modalities. Of particular interest are therapies focused on lowering the expression (or downregulation) of ATN1, the mutant gene that causes DRPLA, in hopes of tackling the pathology at its root. As with many ultra-rare diseases, a key challenge in DRPLA remains the complexity of coordinating both basic and clinical research efforts across multiple sites around the world. Finally, despite the generous financial support provided by CureDRPLA, more funding and collective efforts are still required to advance research toward the clinic and develop effective treatments for individuals with DRPLA.
The utility of indigenous knowledge in the pursuit of a UN sustainable development goal
Authors: Beckett Ronald C , O’Loughlin Andrew
Published: May 2024

In this paper, indigenous knowledge is viewed as a form of collective intelligence that may inform situational action. We consider knowledge associated with the use of fire by Indigenous Australians as a land management tool that may help moderate the impact of climate change. Scientific study of the foundation of such knowledge has enhanced our understanding of it, and combination with new technology tools can enhance traditional practices. We draw on the concept of a ‘collective intelligence genome’ identified in the literature to examine aspects of indigenous knowledge capture and application, and an enhanced representation of this concept is presented. We observe knowledge application draws on a set of rules, selection from which is dependent on the state of fauna and weather in a particular microcosm. A representation of multiple if-then decision-making is presented as an example of genome component application.
Urban bias in political tournaments in China: Implications for urban land markets
Authors: Deng Feng
Published: May 2024

This paper studies the applicability and implications of the political tournament model in Chinese cities by arguing that there is urban bias in political tournaments, especially in prefecture-level cities. Urban district leaders have to cooperate more and compete less than their counterparts in counties. The implication is that the percentage of urban districts is positively associated with monopolistic behavior of local government. Based on land leasing data of 290 prefecture-level cities from 2004 to 2014 (except 2012), it is found that the percentage of districts is positively associated with the speed of land price decline in leases through tender, auction and listing (TAL). This result supports the urban bias hypothesis in the context of the Coase Conjecture. It is also found that the total number of districts or population size is negatively associated with the speed of land price decline.
Potential use of crop water stress index (CWSI) and spectral vegetation indices for black cumin under deficit irrigation
Authors: Irik Hasan Ali , Kaymaz Engin , Saban Polu Pembe , Beyzi Erman , Varol İhsan Serkan , Unlukara Ali , Kirnak Halil
Published: May 2024

This study was carried out in 2022 to examine the yield, yield components and changes in crop water stress index (CWSI) and vegetation index in black cumin with deficit irrigation. Five different irrigation water levels (I0, I25, I50, I75, I100) were used. The amount of irrigation water applied changed between 20 and 276 mm. Plant water consumption (ET) values varied between 182 and 425 mm. The highest seed yields were obtained from I100 treatments (692 t ha−1) and the lowest from I0 treatments (25 t ha−1). Biological yield, plant height, stem diameter, first capsule height, number of capsules per plant, number of branches per plant, number of seeds per capsule and 1000-seed weight of black cumin were affected by deficit irrigation. CWSI lower limit equation to be used in irrigation scheduling was identified Tc−Ta = − 1.7524 × VPD + 0.7698 (R2 = 0.54) and the upper limit 10.9 ℃. For black cumin plants, irrigation is recommended when the CWSI value is between 0.08 and 0.12. 9 different spectral vegetation indices were evaluated in this study. It has been determined that there are significant correlations between yield, yield components and CWSI and spectral vegetation indices.
Anesthetic management for cesarean section in two parturient with ascending aortic aneurysm: a case-based discussion
Authors: Trajkovski Ana Vuzdar , Reiner Krešimir , Džaja Nikolina , Mamić Gloria , Mažar Mirabel , Peršec Jasminka , Gluncic Vicko , Lukic Anita
Published: May 2024

Background

The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture.

Case presentation

We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability.

Conclusion

Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.
Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care
Authors: Fernandes Carolina , Campbell-Scherer Denise , Lofters Aisha , Grunfeld Eva , Aubrey-Bassler Kris , Cheung Heidi , Latko Katherine , Tink Wendy , Lewanczuk Richard , Shea-Budgell Melissa , Heisey Ruth , Wong Tracy , Yang Huiming , Walji Sakina , Wilson Margo , Holmes Elizabeth , Lang-Robertson Kelly , DeLonghi Christina , Manca Donna Patricia
Published: May 2024

Background

Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations. We describe the process used to harmonize high-quality cancer and chronic disease prevention and screening (CCDPS) CPGs to update the BETTER program.

Methods

A review of CPG databases, repositories, and grey literature was conducted to identify international and Canadian (national and provincial) CPGs for CCDPS in adults 40–69 years of age across 19 topic areas: cancers, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, hepatitis C, obesity, osteoporosis, depression, and associated risk factors (i.e., diet, physical activity, alcohol, cannabis, drug, tobacco, and vaping/e-cigarette use). CPGs published in English between 2016 and 2021, applicable to adults, and containing CCDPS recommendations were included. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and a three-step process involving patients, health policy, content experts, primary care providers, and researchers was used to identify and synthesize recommendations.

Results

We identified 51 international and Canadian CPGs and 22 guidelines developed by provincial organizations that provided relevant CCDPS recommendations. Clinical recommendations were extracted and reviewed for inclusion using the following criteria: 1) pertinence to primary prevention and screening, 2) relevance to adults ages 40–69, and 3) applicability to diverse primary care settings. Recommendations were synthesized and integrated into the BETTER toolkit alongside resources to support shared decision-making and care paths for the BETTER program.

Conclusions

Comprehensive care requires the ability to address a person’s overall health. An approach to identify high-quality clinical guidance to comprehensively address CCDPS is described. The process used to synthesize and harmonize implementable clinical recommendations may be useful to others wanting to integrate evidence across broad content areas to provide comprehensive care. The BETTER toolkit provides resources that clearly and succinctly present a breadth of clinical evidence that providers can use to assist with implementing CCDPS guidance in primary care.
Trends in the mobility of primary healthcare human resources in underdeveloped regions of western China from 2000 to 2021: Evidence from Nanning
Authors: Xu Xinyi , Huang Jingyi , Zhao Xiaoqian , Luo Yumin , Wang Linxuan , Ge Yishan , Yu Xingyin , Zhu Pinghua
Published: May 2024

Objective

This research aimed to identify the fundamental and geographic characteristics of the primary healthcare personnel mobility in Nanning from 2000 to 2021 and clarify the determinants that affect their transition to non-primary healthcare institutions.

Methods

Through utilizing the Primary Healthcare Personnel Database (PHPD) for 2000–2021, the study conducts descriptive statistical analysis on demographic, economic, and professional aspects of healthcare personnel mobility across healthcare reform phases. Geographic Information Systems (QGIS) were used to map mobility patterns, and R software was employed to calculate spatial autocorrelation (Moran’s I). Logistic regression identified factors that influenced the transition to non-primary institutions.

Results

Primary healthcare personnel mobility is divided into four phases: initial (2000–2008), turning point (2009–2011), rapid development (2012–2020), and decline (2021). The rapid development stage saw increased mobility with no spatial clustering in inflow and outflow. From 2016 to 2020, primary healthcare worker mobility reached its peak, in which the most significant movement occurred between township health centers and other institutions. Aside from their transition to primary medical institutions, the primary movement of grassroots health personnel predominantly directs towards secondary general hospitals, tertiary general hospitals, and secondary specialized hospitals. Since 2012, the number and mobility distance of primary healthcare workers have become noticeably larger and remained at a higher level from 2016 to 2020. The main migration of primary healthcare personnel occurred in their districts (counties). Key transition factors include gender, education, ethnicity, professional category, general practice registration, and administrative division.

Conclusions

This study provides evidence of the features of primary healthcare personnel mobility in the less developed western regions of China, in which Nanning was taken as a case study. It uncovers the factors that impact the flow of primary healthcare personnel to non-primary healthcare institutions. These findings are helpful to policy refinement and support the retention of primary healthcare workers.
Diagnostic accuracy of pancreatic stone protein in patients with sepsis: a systematic review and meta-analysis
Authors: Mai Biwei , Zhou Lirong , Wang Qi , Ding Bo , Zhan Yifeng , Qin Shanqing , Zhu Naiyun , Li Zhuangxing , Lei Zhixian
Published: May 2024

Background

Sepsis is a common syndrome of multiorgan system dysfunction secondary to the dysregulated inflammatory response to infection. The role of pancreatic stone protein (PSP) in diagnosing sepsis has been investigated in previous studies. The meta-analysis aimed to comprehensively investigate the diagnostic value of PSP in identifying sepsis.

Methods

PubMed, Web of Science, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI), were systematically searched. Studies investigating the diagnostic performance of PSP were included. Pooled sensitivity, specificity, positive Likelihood Ratio (+ LR) and negative Likelihood Ratio (-LR), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic (SROC) were calculated.

Results

The sensitivity of PSP was 0.88 (95% CI: 0.77–0.94), and the pooled specificity was 0.78 (95% CI: 0.65–0.87). Pooled + LR, -LR, and DOR were 4.1 (2.3, 7.3), 0.16 (0.07, 0.34), and 26 (7, 98). The AUC value for the SROC of PSP was 0.90 (0.87, 0.92). The pooled sensitivity, specificity, + LR and - LR, and DOR for PSP among neonates were 0.91 (95% CI: 0.84, 0.96), 0.66 (95% CI: 0.58, 0.74), 3.97 (95% CI: 0.53, 29.58), 0.13 (95% CI: 0.02, 1.00), and 31.27 (95% CI: 0.97, 1004.60).

Conclusions

This study indicates that PSP demonstrated favorable diagnostic accuracy in detecting sepsis. Well-designed studies are warranted to ascertain the value of PSP measurement to guide early empirical antibiotic treatment, particularly in neonates.
A first trimester prediction model and nomogram for gestational diabetes mellitus based on maternal clinical risk factors in a resource-poor setting
Authors: Basil Bruno , Mba Izuchukwu Nnachi , Myke-Mbata Blessing Kenechi , Adebisi Simeon Adelani , Oghagbon Efosa Kenneth
Published: May 2024

Background

The implementation of universal screening for Gestational Diabetes Mellitus (GDM) is challenged by several factors key amongst which is limited resources, hence the continued reliance on risk factor-based screening. Effective identification of high-risk women early in pregnancy may enable preventive intervention. This study aimed at developing a GDM prediction model based on maternal clinical risk factors that are easily assessable in the first trimester of pregnancy in a population of Nigerian women.

Methods

This was a multi-hospital prospective observational cohort study of 253 consecutively selected pregnant women from which maternal clinical data was collected at 8–12 weeks gestational age. Diagnosis of GDM was made via a one-step 75-gram Oral Glucose Tolerance Test (OGTT) at 24–28 weeks of gestation. A GDM prediction model and nomogram based on selected maternal clinical risk factors was developed using multiple logistic regression analysis, and its performance was assessed by Receiver Operator Curve (ROC) analysis. Data analysis was carried out using Statistical Package for Social Sciences (SPSS) version 25 and Python programming language (version 3.0).

Results

Increasing maternal age, higher body mass index (BMI), a family history of diabetes mellitus in first-degree relative and previous history of foetal macrosomia were the major predictors of GDM. The model equation was: LogitP = 6.358 − 0.066 × Age − 0.075 × First trimester BMI − 1.879 × First-degree relative with diabetes mellitus − 0.522 × History of foetal macrosomia. It had an area under the receiver operator characteristic (ROC) curve (AUC) of 0.814 (95% CI: 0.751–0.877; p-value < 0.001), and at a predicted probability threshold of 0.745, it had a sensitivity of 79.2% and specificity of 74.5%.

Conclusion

This first trimester prediction model reliably identifies women at high risk for GDM development in the first trimester, and the nomogram enhances its practical applicability, contributing to improved clinical outcomes in the study population.
The Ergonomic Behaviors Evaluation Tool (EBET) based on social cognitive theory for the assembly line workers: development and psychometric assessment
Authors: Hosseini Zakieh Sadat , Tavafian Sedigheh Sadat , Ahmadi Omran , Maghbouli Reza
Published: May 2024

Background

Ergonomic behaviors play a crucial role in preventing work-related musculoskeletal disorders (WMSDs). To measure these behaviors, this research aimed to develop and evaluate an ergonomic behaviors tool (EBET) based on the Social Cognitive Theory (SCT) among women workers on assembly lines (WwAL).

Methods

The study was conducted from December 2022 to January 2023 with a focus on the psychometric assessment of EBET. Initially, a literature review and interviews were carried out to identify crucial concepts and primary items. The questionnaire’s validity was evaluated using the Content Validity Ratio (CVR) and the Content Validity Index (CVI). To determine the domains of the tool, construct validity was examined by administering the items to 270 eligible women. The reliability of the tool was assessed using McDonald’s Omega coefficient.

Results

From a total of 67 primary items, 50 were confirmed. The study demonstrated good validity with CVR = 0.92 and CVI = 0.97, along with reliable results indicated by McDonald’s Omega coefficient of 0.74. The exploratory factor analysis (EFA) revealed ten distinct dimensions: outcome expectations, outcome expectancies, normative beliefs, perceived barriers, social support, observational learning, reinforcement, behavioral skills, self-efficacy, and intention. Together, these dimensions accounted for 66.25% of the variance in the data. Additionally, the confirmatory factor analysis results supported the presence of these ten constructs and demonstrated a satisfactory fit.

Conclusions

EBET is a dependable and valid instrument for evaluating the ergonomic behaviors of workers, utilizing the principles of SCT. Researchers can employ EBET to gather data and implement suitable training interventions to enhance ergonomic behavior among WwAL. However, it is crucial to recognize that EBET may not encompass all facets of ergonomic behaviors. Therefore, it is imperative for future research to prioritize the evaluation of EBET’s suitability among diverse worker populations and to consider additional dimensions of ergonomics to ensure its wider applicability and effectiveness.
Abnormal coagulation after hepatectomy in patients with normal preoperative coagulation function
Authors: Kuang Liting , Lin Weibin , Wang Dahui , Chen Bin
Published: May 2024

Background

To explore the risk factors for postoperative abnormal coagulation (PAC) and establish a predictive model for patients with normal preoperative coagulation function who underwent hepatectomy.

Materials and Methods

A total of 661 patients with normal preoperative coagulation function who underwent hepatectomy between January 2015 and December 2021 at the First Affiliated Hospital of Sun Yat-sen University were divided into two groups: the postoperative abnormal coagulation group (PAC group, n = 362) and the normal coagulation group (non-PAC group, n = 299). Univariate and multivariate logistic analyses were used to identify the risk factors for PAC.

Results

The incidence of PAC in 661 patients who underwent hepatectomy was 54.8% (362/661). The least absolute shrinkage and selection operator (LASSO) method was used for multivariate logistic regression analysis. The preoperative international normalized ratio (INR), intraoperative succinyl gelatin infusion and major hepatectomy were found to be independent risk factors for PAC. A nomogram for predicting the PAC after hepatectomy was constructed. The model presented a receiver operating characteristic (ROC) curve of 0.742 (95% confidence interval (CI): 0.697–0.786) in the training cohort. The validation set demonstrated a promising ROC of 0.711 (95% CI: 0.639–0.783), and the calibration curve closely approximated the true incidence. Decision curve analysis (DCA) was performed to assess the clinical usefulness of the predictive model. The risk of PAC increased when the preoperative international normalized ratio (INR) was greater than 1.025 and the volume of intraoperative succinyl gelatin infusion was greater than 1500 ml.

Conclusion

The PAC is closely related to the preoperative INR, intraoperative succinyl gelatin infusion and major hepatectomy. A three-factor prediction model was successfully established for predicting the PAC after hepatectomy.
Breaking bad news: A mix methods study reporting the need for improving communication skills among doctors in Pakistan
Authors: Abdullah Muhammad Ahmed , Shaikh Babar Tasneem , Khan Kashif Rehman , Yasin Muhammad Asif
Published: May 2024

Background

Effective skills and training for physicians are essential for communicating difficult or distressing information, also known as breaking bad news (BBN). This study aimed to assess both the capacity and the practices of clinicians in Pakistan regarding BBN.

Methods

A cross-sectional study was conducted involving 151 clinicians. Quantitative component used a structured questionnaire, while qualitative data were obtained through in-depth interviews with 13 medical educationists. The responses were analyzed using descriptive statistics and thematic analysis.

Results

While most clinicians acknowledged their responsibility of delivering difficult news, only a small percentage had received formal training in BBN. Areas for improvement include time and interruption management, rapport building, and understanding the patients’ point of view. Prognosis and treatment options were not consistently discussed. Limited importance is given to BBN in medical education.

Discussion

Training in BBN will lead to improved patient and attendants’ satisfaction, and empathetic support during difficult times.
A case study of a liver transplant-treated patient with glycogen storage disease type Ia presenting with multiple inflammatory hepatic adenomas: an analysis of clinicopathologic and genetic data
Authors: Wang Ao , Wu Jiamei , Yuan Xiaohui , Liu Jianping , Lu Changli
Published: May 2024

Background

Glycogen storage disease (GSD) is a disease caused by excessive deposition of glycogen in tissues due to genetic disorders in glycogen metabolism. Glycogen storage disease type I (GSD-I) is also known as VonGeirk disease and glucose-6-phosphatase deficiency. This disease is inherited in an autosomal recessive manner, and both sexes can be affected. The main symptoms include hypoglycaemia, hepatomegaly, acidosis, hyperlipidaemia, hyperuricaemia, hyperlactataemia, coagulopathy and developmental delay.

Case presentation

Here, we present the case of a 13-year-old female patient with GSD Ia complicated with multiple inflammatory hepatic adenomas. She presented to the hospital with hepatomegaly, hypoglycaemia, and epistaxis. By clinical manifestations and imaging and laboratory examinations, we suspected that the patient suffered from GSD I. Finally, the diagnosis was confirmed by liver pathology and whole-exome sequencing (WES).

WES revealed a synonymous mutation, c.648 G > T (p.L216 = , NM_000151.4), in exon 5 and a frameshift mutation, c.262delG (p.Val88Phefs*14, NM_000151.4), in exon 2 of the G6PC gene. According to the pedigree analysis results of first-generation sequencing, heterozygous mutations of c.648 G > T and c.262delG were obtained from the patient's father and mother.

Liver pathology revealed that the solid nodules were hepatocellular hyperplastic lesions, and immunohistochemical (IHC) results revealed positive expression of CD34 (incomplete vascularization), liver fatty acid binding protein (L-FABP) and C-reactive protein (CRP) in nodule hepatocytes and negative expression of β-catenin and glutamine synthetase (GS). These findings suggest multiple inflammatory hepatocellular adenomas. PAS-stained peripheral hepatocytes that were mostly digested by PAS-D were strongly positive.

This patient was finally diagnosed with GSD-Ia complicated with multiple inflammatory hepatic adenomas, briefly treated with nutritional therapy after diagnosis and then underwent living-donor liver allotransplantation.

After 14 months of follow-up, the patient recovered well, liver function and blood glucose levels remained normal, and no complications occurred.

Conclusion

The patient was diagnosed with GSD-Ia combined with multiple inflammatory hepatic adenomas and received liver transplant treatment. For childhood patients who present with hepatomegaly, growth retardation, and laboratory test abnormalities, including hypoglycaemia, hyperuricaemia, and hyperlipidaemia, a diagnosis of GSD should be considered. Gene sequencing and liver pathology play important roles in the diagnosis and typing of GSD.
Development of a scalable recombinant system for cyclic beta-1,2-glucans production
Authors: Guidolin L. Soledad , Caillava A. Josefina , Landoni Malena , Couto Alicia S. , Comerci Diego J. , Ciocchini Andrés E.
Published: May 2024

Background

Cyclic β-1,2-glucans (CβG) are bacterial cyclic homopolysaccharides with interesting biotechnological applications. These ring-shaped molecules have a hydrophilic surface that confers high solubility and a hydrophobic cavity able to include poorly soluble molecules. Several studies demonstrate that CβG and many derivatives can be applied in drug solubilization and stabilization, enantiomer separation, catalysis, synthesis of nanomaterials and even as immunomodulators, suggesting these molecules have great potential for their industrial and commercial exploitation. Nowadays, there is no method to produce CβG by chemical synthesis and bacteria that synthesize them are slow-growing or even pathogenic, which makes the scaling up of the process difficult and expensive. Therefore, scalable production and purification methods are needed to afford the demand and expand the repertoire of applications of CβG.

Results

We present the production of CβG in specially designed E. coli strains by means of the deletion of intrinsic polysaccharide biosynthetic genes and the heterologous expression of enzymes involved in CβG synthesis, transport and succinilation. These strains produce different types of CβG: unsubstituted CβG, anionic CβG and CβG of high size. Unsubstituted CβG with a degree of polymerization of 17 to 24 glucoses were produced and secreted to the culture medium by one of the strains. Through high cell density culture (HCDC) of that strain we were able to produce 4,5 g of pure unsubstituted CβG /L in culture medium within 48 h culture.

Conclusions

We have developed a new recombinant bacterial system for the synthesis of cyclic β-1,2-glucans, expanding the use of bacteria as a platform for the production of new polysaccharides with biotechnological applications. This new approach allowed us to produce CβG in E. coli with high yields and the highest volumetric productivity reported to date. We expect this new highly scalable system facilitates CβG availability for further research and the widespread use of these promising molecules across many application fields.
Flavokawain C inhibits glucose metabolism and tumor angiogenesis in nasopharyngeal carcinoma by targeting the HSP90B1/STAT3/HK2 signaling axis
Authors: Hu YuQiang , Yu ChenJie , Cheng LiangJun , Zhong Chang , An Jun , Zou MingZhen , Liu Bing , Gao Xia
Published: May 2024

Objective

Over the past decade, heat shock protein 90 (HSP90) inhibitors have emerged as promising anticancer drugs in solid and hematological malignancies. Flavokawain C (FKC) is a naturally occurring chalcone that has been found to exert considerable anti-tumor efficacy by targeting multiple molecular pathways. However, the efficacy of FKC has not been studied in nasopharyngeal carcinoma (NPC). Metabolic abnormalities and uncontrolled angiogenesis are two important features of malignant tumors, and the occurrence of these two events may involve the regulation of HSP90B1. Therefore, this study aimed to explore the effects of FKC on NPC proliferation, glycolysis, and angiogenesis by regulating HSP90B1 and the underlying molecular regulatory mechanisms.

Methods

HSP90B1 expression was analyzed in NPC tissues and its relationship with patient’s prognosis was further identified. Afterward, the effects of HSP90B1 on proliferation, apoptosis, glycolysis, and angiogenesis in NPC were studied by loss-of-function assays. Next, the interaction of FKC, HSP90B1, and epidermal growth factor receptor (EGFR) was evaluated. Then, in vitro experiments were designed to analyze the effect of FKC treatment on NPC cells. Finally, in vivo experiments were allowed to investigate whether FKC treatment regulates proliferation, glycolysis, and angiogenesis of NPC cells by HSP90B1/EGFR pathway.

Results

HSP90B1 was highly expressed in NPC tissues and was identified as a poor prognostic factor in NPC. At the same time, knockdown of HSP90B1 can inhibit the proliferation of NPC cells, trigger apoptosis, and reduce glycolysis and angiogenesis. Mechanistically, FKC affects downstream EGFR phosphorylation by regulating HSP90B1, thereby regulating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway. FKC treatment inhibited the proliferation, glycolysis, and angiogenesis of NPC cells, which was reversed by introducing overexpression of HSP90B1. In addition, FKC can affect NPC tumor growth and metastasis in vivo by regulating the HSP90B1/EGFR pathway.

Conclusion

Collectively, FKC inhibits glucose metabolism and tumor angiogenesis in NPC by targeting the HSP90B1/EGFR/PI3K/Akt/mTOR signaling axis.