bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of Gender Stereotypes in Nurse Clinicians’ Metaphors and Concepts of Patients
Authors: Bezgin Selver , Odabaşı Koç Özge
Published: November 2024

Aim: The present study aims to analyze the presence of gender stereotypes in the metaphors nurse clinicians use to describe their patients.

Methods: This study was conducted with 149 nurse clinicians working at a university hospital. Data were collected using a metaphor survey.

Results: The most common metaphors for female patients were “flower” (f: 23) and “mother/my mother” (f: 8), whereas the most common metaphors for male patients were “wood” (f: 10) and “cactus” (f: 7). These metaphors were more frequently produced by female nurses. Female patients were often described as “delicate, in need of attention and help, and fragile,” while male patients were described as “strong, authoritative, head of the family, and tough.” Female nurses likened a more delicate male patient to a “delicate woman,” and male nurses likened the strength of a male patient to a “man.” Furthermore, eight nurses, five male nurses and three female nurses, frequently used the metaphor of “patient” (f: 6) while stating that they did not view patients as female or male. Male nurses (f: 4) produced the metaphor of “patient” (f: 6) the most.

Conclusion: It is important not to overlook the factors underlying the metaphors produced by nurse clinicians. In this regard, extensive studies are needed to take into account additional factors such as cultural background, experience, or specific patient interactions that may have a major impact on how nurses perceive gender.

Implications for Nursing Management: This study evaluates nurse clinicians’ perceptions of patients in the context of gender stereotypes and highlights some important points in terms of nursing and patient care.
Scavenger Receptor CD36 in Tumor-Associated Macrophages Promotes Cancer Progression by Dampening Type-I IFN Signaling
Authors: Xu Ziyan , Kuhlmann-Hogan Alexandra , Xu Shihao , Tseng Hubert , Chen Dan , Tan Shirong , Sun Ming , Tripple Victoria , Bosenberg Marcus , Miller-Jensen Kathryn , Kaech Susan M.
Published: November 2024

Tumor-associated macrophages (TAM) are a heterogeneous population of myeloid cells that dictate the inflammatory tone of the tumor microenvironment. In this study, we unveiled a mechanism by which scavenger receptor cluster of differentiation 36 (CD36) suppresses TAM inflammatory states. CD36 was upregulated in TAMs and associated with immunosuppressive features, and myeloid-specific deletion of CD36 significantly reduced tumor growth. Moreover, CD36-deficient TAMs acquired inflammatory signatures including elevated type-I IFN (IFNI) production, mirroring the inverse correlation between CD36 and IFNI response observed in patients with cancer. IFNI, especially IFNβ, produced by CD36-deficient TAMs directly induced tumor cell quiescence and delayed tumor growth. Mechanistically, CD36 acted as a natural suppressor of IFNI signaling in macrophages through p38 activation downstream of oxidized lipid signaling. These findings establish CD36 as a critical regulator of TAM function and the tumor inflammatory microenvironment, providing additional rationale for pharmacologic inhibition of CD36 to rejuvenate antitumor immunity.

Significance: CD36 in tumor-associated macrophages mediates immunosuppression and can be targeted as a therapeutic avenue for stimulating interferon production and increasing the efficacy of immunotherapy.
Lipid-Laden Macrophages Recycle Myelin to Feed Glioblastoma
Authors: Pang Lizhi , Zhou Fei , Chen Peiwen
Published: November 2024

Tumor-associated microglia and macrophages (TAM) make up the largest immune cell population in the glioblastoma (GBM) tumor microenvironment. Given the heterogeneity and plasticity of TAMs in the GBM tumor microenvironment, understanding the context-dependent cancer cell–TAM symbiotic interaction is crucial for understanding GBM biology and developing effective therapies. In a recent issue of Cell, Kloosterman and colleagues identified a subpopulation of glycoprotein nonmetastatic melanoma protein Bhigh lipid-laden microglia and macrophages (LLM) in GBM. Mesenchymal-like GBM cells help generate the LLM phenotype. Reciprocally, LLMs are epigenetically rewired to recycle myelin and transfer the lipid from myelin to cancer cells, fueling mesenchymal-like GBM progression in a liver X receptor/ABCA1-dependent manner. Together, leveraging LLMs opens new therapeutic possibilities for rewiring the metabolism-mediated tumor–TAM interaction during GBM progression.
Tumor Heterogeneity and Cooperating Cancer Hallmarks Driven by Divergent EMT Programs
Authors: Carter Phoebe , Kang Yibin
Published: November 2024

Epithelial-to-mesenchymal transition (EMT) is known to play roles in orchestrating cellular plasticity across many physiological and pathological contexts. Partial EMT, wherein cells maintain both epithelial and mesenchymal features, is gaining recognition for its functional importance in cancer in recent years. There are many factors regulating both partial and full EMT, and the precise mechanisms underlying these processes vary depending on the biological context. Furthermore, how different EMT states cooperate to create a heterogeneous tumor population and promote different pro-malignant features remains largely undefined. In a recent study published in Nature Cancer, Youssef and colleagues described how two disparate EMT programs, active in either organ fibrosis or embryonic development, are utilized within different cells within the same murine mammary tumor model. This work provides mechanistic insight into the development of intratumoral heterogeneity, providing evidence for the cooperation between the two EMT trajectories.
Tumor-Derived EBV-miR-BART2-5p Promotes Nasopharyngeal Carcinoma Metastasis by Inducing Premetastatic Endothelial Cell Pyroptosis
Authors: Chen Xingrui , Li Qiqi , Fu Xiaoyan , Li Jike , Deng Jun , Zhang Qianbing , Qiu Mengying , Lyu Xiaoming , Cai Linbo , Li Hainan , Li Xin , Yao Kaitai , Wang Jiahong , Huang Zhongxi , Chen Liang , Zhang Jiangyu , Li Dengke
Published: November 2024

Extravasation is a key step in tumor metastasis. Epstein‒Barr virus plays a crucial role in nasopharyngeal carcinoma (NPC) metastasis. However, the functions and molecular mechanisms of Epstein‒Barr virus during tumor cell extravasation remain unclear. Here, we showed that the expression of pyroptosis-associated proteins is greater in the endothelial cells of metastatic NPC tissues than in those of nontumor tissues exosomes derived from NPC cells promoted endothelial cell pyroptosis, vascular permeability, and tumor cell extravasation. Moreover, we found that BART2-5p is abundant in serum exosomes from patients with NPC metastasis and in NPC cells and that it regulates endothelial cell pyroptosis in premetastatic organs via MRE11A. Exosomes containing a BART2-5p inhibitor and AAV-MRE11A attenuated endothelial cell pyroptosis and tumor metastasis. Moreover, in the endothelial cells of metastatic tissues from patients with NPC, the BART2-5p level was positively associated with pyroptosis-related protein expression. Collectively, our findings suggest that exosomal BART2-5p is involved in premetastatic niche formation, identifying secreted BART2-5p as a potential therapeutic target for NPC metastasis.

Implications: The finding that secreted BART2-5p is involved in premetastatic niche formation may aid the development of a potential therapeutic target for NPC metastasis.
Speckle Tracking Echocardiography in Twin Pregnancies and the Role of Global Longitudinal Strain and Peak Systolic Strain: A Systematic Review and Meta-Analysis
Authors: Meireson Eline , van Oostrum Noortje H.M. , van Laar Judith O.E.H. , Roets Ellen , Bijnens Esmée M. , Lewi Liesbeth , Roelens Kristien
Published: November 2024

Introduction: Twin pregnancies are associated with an increased risk of perinatal morbidity and mortality. Pregnancy complications related to twins, such as fetal growth restriction, and twin-to-twin transfusion syndrome (TTTS), are associated with hemodynamic changes in the fetal heart. Two-dimensional speckle tracking echocardiography (2D STE) is a tool to evaluate fetal cardiac function. This paper aims to review the literature regarding global longitudinal strain (rate) and peak systolic strain (rate) assessed with 2D STE in twin pregnancies. Feasibility, frame rate, and angle of the fetal heart at the time of measurement were selected as secondary outcomes. Methods: The databases Medline, Embase, Scopus, and Web of Science were searched. Results: Seven articles met the inclusion criteria and selected all monochorionic diamniotic (MCDA) twins with TTTS as the study population. The global longitudinal strain in the right and left ventricle and the peak systolic strain in the right ventricle of the recipient MCDA twin are significantly decreased compared to the donor MCDA twin. 2D STE assessment was shown feasible and reproducible in MCDA pregnancies. Large heterogeneity in technical characteristics between the articles induces inconsistent results. Conclusion: Although feasible, the knowledge of 2D STE is very limited in twin pregnancy. Prospective studies are needed to evaluate the 2D STE assessment in uncomplicated twin pregnancies considering its possible additive value in the diagnostics of pregnancy-related pathologies.
Palbociclib in Combination with either Aromatase Inhibitors or Fulvestrant for Patients with Advanced HR+/HER2− Breast Cancer in Germany: Final Results of the Phase 2 Multicohort INGE-B Trial
Authors: Welslau Manfred , Potthoff Karin , Zaiss Matthias , Müller Lothar , Brucker Cosima , Salat Christoph , Untch Michael , Meiler Johannes , Lüftner Diana , Welt Anja , Dörfel Steffen , Hagen Volker , Stein Alexander , Liersch Rüdiger , Kuhn Thomas , Siebenbach Hans Ulrich , Bing Gerlinde , Vannier Corinne , Marschner Norbert , Gratzke Katja
Published: November 2024

Introduction: The INGE-B trial (NCT02894398) aimed to confirm the efficacy and safety data from the PALOMA trials for patients treated first line (1L) with palbociclib (PAL) and letrozole or 1L and later line with PAL and fulvestrant. In addition, so far lacking evidence for efficacy and safety on the combination of PAL with anastrozole, exemestane (1L), or letrozole (later line) was investigated. Methods: The prospective, multicenter, multicohort phase 2 trial INGE-B enrolled adult patients with locally advanced, inoperable, or metastatic HR+/HER2− breast cancer in Germany. The primary endpoint was the clinical benefit rate (CBR) in patients with measurable disease according to RECIST v1.1. Secondary endpoints were overall response rate, progression-free survival (PFS), overall survival (OS), safety, and quality of life. Data were analyzed with descriptive statistics. Results: Between 2016 and 2018, 388 patients were enrolled at 64 German sites. Among patients with measurable disease treated with PAL in 1L (n = 157), the CBR was 63.7% (100/157). Among all patients treated with PAL 1L (n = 219), PFS was 20.1 months (95% CI 14.6–24.0), and OS was 40.9 months (95% CI 35.1–49.2). The most common grade 3/4 adverse event was neutropenia (33.4% n = 77). There were no treatment-related deaths. Conclusion: The INGE-B trial demonstrated good efficacy and tolerability of PAL with letrozole (1L) or fulvestrant (first and later line) in accordance with the PALOMA trials. In addition, the so far lacking proof of efficacy and safety of PAL in combination with anastrozole or exemestane in 1L and with letrozole in later line was provided by INGE-B.
The Care of Preterm and Term Newborns with Respiratory Conditions: A Systematic Synthesis of Evidence from Low- and Middle-Income Countries
Authors: Dominguez Georgia , Muralidharan Oviya , Lee Him Rachel , Harrison Leila , Vaivada Tyler , Bhutta Zulfiqar A.
Published: November 2024

Introduction: Neonatal respiratory conditions are leading causes of mortality and morbidity during the neonatal period. This review evaluated 11 management interventions for respiratory distress syndrome (RDS), apnoea of prematurity (AOP), meconium aspiration syndrome (MAS), transient tachypnea of the newborn (TTN), as well as bronchopulmonary dysplasia (BPD) as a potential complication from respiratory care in low- and middle-income countries (LMICs). Methods: Two different methodological approaches were completed: (1) updating outdated reviews and pooling all LMIC studies and (2) re-analysis of LMIC studies from up-to-date reviews. Review updates were conducted between October 2022 and February 2023 and followed systematic methodology. A total of 50 studies were included across four review updates and seven review re-analyses. Results: Findings indicate that bubble CPAP (RR 0.74, 95% CI: 0.58–0.96) and prophylactic CPAP (RR 0.39, 95% CI: 0.26–0.57) for RDS reduced the risk of treatment failure compared to other ventilation types or supportive care, respectively. Postnatal corticosteroids reduced BPD assessed as oxygen requirement at 36 weeks’ postmenstrual age (RR 0.56, 95% CI: 0.41–0.77). All other outcomes were found to be non-significant across remaining interventions. Conclusions: Our findings indicate that prophylactic and bubble CPAP may provide some benefit by reducing treatment failure compared to other pressure sources. The safety and efficacy of other management interventions for RDS, AOP, BPD, MAS, and TTN remains uncertain given limited evaluations in LMICs. Future research should conduct adequately powered trials in underrepresented LMIC regions, investigate long-term outcomes, and evaluate cost-effectiveness.
Onkologie im Dialog: Integrative Medizin als Brücke zwischen Therapie und Patientenwünschen
Authors: Voiß Petra
Published: November 2024

Purpose: Many cancer patients wish for complementary and integrative medicine (CIM) consultations led by their oncology physician. Within the KOKON-KTO study, oncology physicians in the intervention group were trained in a blended learning to provide CIM consultations to their cancer patients in addition to distributing a leaflet about CIM websites. Control oncology physicians only distributed the leaflet. The training showed positive effects on the patient-level. As of now, no consistent evidence exists on the long-term effects of such one-time-only CIM consultation during cancer treatment. Methods: In the KOKON-KTO follow-up study, cancer patients previously participating in the KOKON-KTO study (intervention group:IG and control group: CG) received, at least 24 months later, a follow-up questionnaire by post, evaluating long-term effects of the KOKON-KTO consultation using the measures provided in the original study (patient-physician communication (EORTC-QLQ-COMU2), satisfaction with cancer treatment (PS-CaTE), CIM disclosure with healthcare provider (HCP), and need for CIM consultation during cancer therapy). Results: In total, 102 cancer patients participated in the follow-up study (IG n = 62; CG n = 40). The overall reponse rate was around 36% (IG: 48.4%; CG: 23.7%). In the follow-up study, differences between groups had increased and were still shown (EORTC-QLQ-COMU26, 0–100 point scale, ≥10-point-group difference) in some subscales: patient's active behavior (in means; IG:73.6 (95% CI, 63.8–83.5); CG:61.1 (95% CI, 52.4–69.8)); clinician-patient relationship (IG:80.9 (95% CI, 71.8–90.0); CG:68.7 (95% CI, 59.3–78.0)). For some outcomes, differences decreased over time (e.g., EORTC-QLQ-COMU26 subscales “takes into account patient's preference” and “corrects misunderstandings”). More patients in the CG used CIM without oncology physicians' knowledge (IG: 13.7%, CG: 24.0%).
Ultrasound Diagnosis of Bowel Endometriosis
Authors: Ferrero Simone , Barra Fabio , Perrone Umberto , Paudice Michele , Vellone Valerio Gaetano
Published: November 2024

Background: Bowel endometriosis is one of the more severe manifestations of deep endometriosis; it may cause pain and intestinal symptoms. The noninvasive diagnosis of bowel endometriosis is of crucial importance in planning the management of patients affected by this condition. Objectives: This review aims to describe how transvaginal ultrasonography (TVS) is performed in patients with suspicion of rectosigmoid endometriosis, the diagnostic performance, and the strengths and limitations of this technique. Methods: To identify relevant literature, a literature search was performed across the PubMed and Google Scholar databases up to July 2024. Outcome: Numerous meta-analyses have demonstrated that TVS has high diagnostic accuracy in diagnosing rectosigmoid endometriosis. Rectosigmoid nodules can present with different morphological characteristics, but they are typically described as irregular, hypoechoic nodules located in the anterior wall of the rectosigmoid colon. The presence of “soft markers,” such as a negative sliding sign and kissing ovaries, can further reinforce the diagnosis of this condition. Posterolateral parametrial involvement often coexists with large rectal nodules. Introducing water contrast into the rectosigmoid does not improve the performance of TVS in diagnosing rectosigmoid endometriosis. Conclusions and Outlook: TVS should be the first-line investigation in women suspected of having rectosigmoid endometriosis. The widespread use of TVS for the diagnosis of intestinal endometriosis can reduce diagnostic delays and facilitate the treatment of patients affected by this condition.
Disease Burden of Parkinson’s Disease in Asia and Its 34 Countries and Territories from 1990 to 2021: Findings from the Global Burden of Disease Study 2021
Authors: Yang Qifan , Chang Xuehui , Li Shijin , Li Xiao , Kang Changyuan , Yuan Weiwei , Lv Guiying
Published: November 2024

Introduction: The increasing global population and aging have made Parkinson’s disease (PD) a significant public health concern. Comprehensive evaluations of PD burden trends in Asian subregions and countries are lacking. This study investigated PD burden in Asia from 1990 to 2021, categorized by age, sex, and region. Methods: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were analyzed to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) across five Asian subregions and 34 countries/territories, using joinpoint regression, decomposition analysis, frontier analysis, and Bayesian models to examine changes, influencing factors, and predict future trends. Results: In 2021, the age-standardized PD incidence and prevalence in Asia were higher than the global average, particularly in East Asia (24.16 and 243.46/100,000, respectively). From 1990 to 2021, the incidence of PD in Asia rose by 198.01%, its prevalence rose by 284.35%, mortality rose by 111.27%, and DALY rose by 144.45%. Males consistently presented a greater PD burden than females did, with a growing sex gap over time. PD burden increased with age, especially among those aged 65 years and older. Population aging was the primary driver of new PD cases, and increasing etiological factors led to more patients. Inequalities in the PD burden have increased between high- and low-income areas, with low-income regions being more affected. By 2036, PD incidence is projected to increase in all subregions except the high-income Asia-Pacific region, with males experiencing a higher rate of increase. Conclusion: The PD burden in Asia has significantly increased over the past three decades, particularly in middle-aged and elderly males, middle- and low-SDI countries, and individuals already suffering from PD. The increasing incidence and aging population necessitate the reallocation of medical resources, improved chronic disease management systems, stronger public health interventions, and sustainable development efforts. Research into etiological factors, pathogenesis, early diagnosis, preventive interventions, and regional management is critical.
Efeitos do treinamento resistido na força muscular e na capacidade funcional de sobreviventes de acidente vascular cerebral: uma revisão sistemática
Authors: Ribeiro Taynah Souza , Ferreira Ivan de Araújo , Mariano Joana Beatriz Midões , Cavalcante Leandro Lanchotti , Silva Vitor Loureiro da , Cichon Flavio Rodrigo , Mota Cristiane Gonçalves
Published: November 2024

Objective: The objectives of this systematic review are to verify the effects of strength training on muscular strength and functional capacity in adults with stroke sequelae. Method: Systematic review study, carried out with published articles on strength training, applied to adults with sequelae of acute or chronic stroke, indexed in the PubMed, SciELO, PEDro and LILACS databases. Descriptors in Portuguese and English were used (Stroke and Strength Training; Stroke and Exercise; Stroke and Physical Fitness; Stroke and Exercise), published between January/2014 and January/2023. Results: 11 clinical trials were included. The studies used different strength training methods. The studies observed an increase in maximum dynamic and isometric strength and in functional capacity tests in all groups that performed strength training. Conclusion: Strength exercise can contribute to increasing muscle strength and improving the functional capacity of people with stroke sequelae, but studies with a larger number of participants are necessary.
Os benefícios do exercício físico no processo de reabilitação da Síndrome de Guillain-Barré: uma revisão sistemática
Authors: Castro Bárbara Gabriela de Carvalho , Melo Patrícia Belém , Bataglion Giandra Anceski , Ponce Keegan Bezerra , Lopes Kathya Augusta Thomé , Amorim Minerva Leopoldina de Castro
Published: November 2024

A Síndrome de Guillain-Barré (SGB) atinge nervos periféricos, se caracterizando pela perda de força dos membros inferiores e diminuindo os reflexos tendinosos, por ser de caráter autoimune e inflamatória, afeta a bainha de mielina da porção proximal, sendo uma polineuropatia progressiva e de rápida evolução podendo levar o paciente a óbito por insuficiência respiratória. Objetivo: Revisar e sintetizar estudos sobre a prática do exercício físico em indivíduos diagnosticados com Síndrome de Guillain-Barré. Método: Trata-se de uma revisão sistemática onde a busca foi realizada nas bases de dados Portal de Periódicos da Capes, LILACS, PubMed, SciELO, Google Acadêmico e Biblioteca Virtual em Saúde (BVS). Considerando estudos publicados nos períodos de 2010 a 2022, que tem como objetivo identificar, selecionar, reunir, avaliar e sintetizar evidências científicas, possibilitando uma análise consistente e assim, aumentando a validade dos estudos e consequentemente fornecendo evidências válidas e confiáveis. Resultados: Oito estudos foram incluídos na revisão sistemática. No geral, a análise dos resultados/dados dos estudos demonstrou que o exercício físico é benéfico para reabilitação da SGB. Todos os estudos selecionados e revisados tiveram resultado positivo sobre o exercício físico no processo de reabilitação. Conclusão: Devido à escassez da literatura atual, de alta qualidade e de amostras maiores, não é possível tirar conclusões consistentes apesar dos resultados eficazes para a melhora de pacientes com SGB, evoluindo nos aspectos de mobilidade, amplitude de movimento (ADM), força muscular, função cardiopulmonar e na redução da fadiga.
Reabilitação e cuidados no paciente com tração halo-gravitacional para correção de cifoescoliose secundária a neurofibromatose: relato de caso
Authors: Mendoza Márcia Almeida Lima , Pontin José Carlos Baldocchi , Kischy Bianca de Souza Antunes , Jacob Alberto Emanuel Gerbi , Mafra Andrea Dias Lamas
Published: November 2024

A neurofibromatose tipo 1 pode estar associada a cifoescoliose rígida com alto valor angular e necessidade de uso tração halo-gravitacional prévia à artrodese definitiva. Os resultados deste tipo de tratamento com tração halo-gravitacional estão bem estabelecidos, entretanto, resultados sobre o manejo assistencial neste paciente é escasso na literatura. Objetivo: Descrever a assistência a um paciente com cifoescoliose sob tração halo-gravitacional pré artrodese. Métodos: Estudo retrospectivo tipo relato de caso. Os dados foram coletados do prontuário do paciente. Após instalação da tração, o paciente foi submetido a um plano de cuidados e reabilitação que incluiu avaliações sensitivo-motoras diárias, reabilitação e cuidados com a tração. Resultados: O peso máximo atingido foi 32% do peso corporal do paciente, em 42 dias com o uso de tração, as complicações observadas foram dor forte pós-operatória, infecção de sítio cirúrgico e parestesia de membros inferiores após incremento de peso. Mediante complicações, as sessões de reabilitação foram intensificas e o paciente recebeu alta após 79 dias sem sequelas. Conclusão: Em virtude de um plano terapêutico multidisciplinar, foi possível a identificação e intervenção precoce de complicações relacionadas à cirurgia, progressão de pesos e a prevenção de complicações do imobilismo, possibilitando a recuperação integral do paciente na alta hospitalar.
A taxon under siege from multiple threats: results of analysis of chytrid fungi on the Calabrian Alpine newt
Authors: Bernabò Ilaria , Cittadino Viviana , Iannella Mattia , Corapi Anna , Tiberti Rocco , Dondero Lorenzo , Grasselli Elena , Romano Antonio
Published: November 2024

The fungi Batrachochytrium dendrobatidis (Bd) and B. salamandrivorans (Bsal) and their associated disease, i.e., chytridiomycosis, pose significant threats to amphibians occurring in the Western Palearctic. This study aims to assess the prevalence and infection load of Bd and Bsal in the Calabrian Alpine newt, Ichthyosaura alpestris inexpectata, a micro-endemic and endangered subspecies from the Catena Costiera, Calabria, Southern Italy. Ninety newts were sampled from May to October 2023 from five breeding sites, representing the core distribution area of the Calabrian Alpine newt. Molecular analyses revealed that over 50% of the samples tested positive for Bd, while none tested positive for Bsal. No gross external signs of disease were detected in tested individuals. Bd prevalence and load were balanced between sexes but varied significantly among sites and were negatively associated with newt size, likely indicating site-specific and age variations in infection. Although Bsal was not detected, the high prevalence of Bd presents a new conservation challenge for the cold-loving Calabrian Alpine newt, which is already threatened by climate change and the introduction of alien fish in its main breeding sites. Therefore, it is crucial that future conservation actions, including monitoring for potential outbreaks of chytridiomycosis, are implemented adopting rigorous biosecurity measures to prevent further spread of the pathogen and safeguard the entire amphibian community.
China’s Global Governance as a Tool for Accelerating International Sustainable Development and Pandemic Security
Authors: Lee Brice Tseen Fu , Darke Walker , Schubert Jan-Niclas F.
Published: November 2024

This study explores China’s robust response to the Coronavirus Disease-2019 pandemic, employing health diplomacy and soft power strategies to boost international relations and global health outcomes. China’s contributions to international organisations, investments in biotechnology and provision of medical aid underline its pivotal role in health diplomacy. The country’s approach, encompassing the Health Silk Road and vaccine diplomacy, is viewed through the lens of soft power theory and health diplomacy theory. It is revealed that China’s initiatives, while offering valuable global health benefits, also strategically enhance its global influence and international relations. This article offers policy recommendations and underscores the importance of international cooperation, equitable access to health interventions, and the embrace of digital health technologies.
The Dilemma and Promotion of Chinese Nationalism: Xinjiang Cotton Incident as a Case Study
Authors: Mok Wing-hung , Choi Franky Ka-hin
Published: November 2024

This article explores the mechanisms and experiences of how nationalism in post-Deng Xiaoping China’s leadership played a role in the Xinjiang Cotton Incident in March 2021. By adopting reflective approach and various theories, it depicts how nationalism consolidates the legitimacy of authority, revealing two sides of the coin. Influenced by ideopolitical education and the emphasis on the internet in guiding public opinion since the Jiang Zemin era, people’s general response to the incident was basically on a par with official discourse, which is sentimental. The article concludes by commenting on China’s advantages and difficulties in governance by controlling irrational nationalism.
Barriers and Facilitators for Addressing Sex Education for Autistic Individuals: A Systematic Review
Authors: Ngo Anh M. , Donaghue Abigail , Weng Kayla H. , Crehan Eileen T.
Published: November 2024

Autistic individuals face challenges in expressing their sexuality and understanding social norms, exacerbated by inadequate sex education. To improve the acquisition of sex education programs, this systematic review identified and synthesized the barriers and facilitators to addressing sex education for autistic learners. A comprehensive database search included five articles after screening the title, abstract, and full-text using the Population, Intervention, Comparison, Outcome, Study (PICOS) framework-guided eligibility criteria. Inductive thematic analysis revealed four key themes of “Resource Availability,” “ASD-specific Curriculum,” “Parent-child interaction,” and “Perception of Sexuality and Disability.” These findings underscore the need for inclusive, accessible sex education to enhance comprehension and applicability for autistic individuals, using visual stimulus, personalized learning, and technological integrations.
Personality and Interpersonal Influence: Low Adjustment and Low Competitiveness is Associated With Low Assertiveness
Authors: Furnham Adrian , Cuppello Stephen , Semmelink David S.
Published: November 2024

This study examined the relationship between personality and interpersonal assertiveness styles, an important and neglected topic. In all, 396 working adults completed a six-factor personality test measuring work-related traits (HPTI) and a two-dimensional assessment of interpersonal styles (III) assessing four styles: Assertiveness, Passiveness, Hostile aggression, and Manipulative aggression. We were particularly interested in the correlates of aggressive and passive behaviour, as opposed to assertive behaviour. The results suggested that those with low Conscientiousness and Adjustment (i.e. Neuroticism) but high Competitiveness (low Agreeableness) were more interpersonally aggressive, while passivity was negatively associated with all traits, particularly Adjustment, but not with Conscientiousness. Regressions indicated very different traits associated with each of the four interpersonal styles. Assertiveness was associated with sex and age, but only one trait, Risk Approach (or Courage). Limitations of these findings and implications of assessing and teaching assertiveness are discussed and considered.
The Relationship Between Work Engagement, Depression, Anxiety, and COVID-19 Anxiety in Physician Assistant Students
Authors: Pepper Sydney N. , Farrell Emily T. , Dawson Robin M. , Wirth Michael D.
Published: November 2024

Introduction: Physician assistants (PAs) are subject to high levels of burnout, depressive symptoms, and anxiety, which can negatively impact quality of care and patient outcomes. Learning how to handle stress in the classroom may increase success and engagement in PA programs. The goal of this study was to characterize burnout, depressive symptoms, and anxiety in current PA students and examine the relationship between these factors and work engagement.

Methods: This cross-sectional study surveyed PA students ( n = 42) via convenience sampling from eighteen different PA programs across North and South Carolina in October, 2021. Questionnaires included the Utrecht Work Engagement Scale (UWES-17), the Patient Health Questionnaire (PHQ-2), the General Anxiety Disorder scale (GAD-7), and the COVID-19 Anxiety Scale (CIAS). Adjusted linear regression was used to assess associations between the GAD-7, PHQ-2, and CIAS and the three subscales of the UWES-17 (vigor, dedication, and absorption).

Results: Students were primarily female (79%), white (79%), second-year students (62%), and had an average body mass index of 21.0 ± 3.9 kg/m2. A one-unit increase in the GAD-7 was associated with a decrease in the vigor (β = −0.94, SE = 0.19, p < .01) and dedication (β = −0.42, SE = 0.15, p = .01) subscales. A one-unit increase in the PHQ-2 was associated with a decrease in the vigor subscale (β = −2.94, SE = 0.60, p < .01).

Conclusions: Recognizing warning signs of declining mental health early among PA school students may be key to increasing resilience, enthusiasm, and concentration, which may enhance school/work engagement. More work is needed to elucidate potential intervention targets to increase school/work engagement in PA students.
Development and validation of an LC-MS/MS method for the detection of sodium pentachlorophenolate residues on cutting boards
Authors: Liao Shicheng , Xu Wanna , Jiang Jie , Liu Honghe , Zeng Zhuoying
Published: November 2024

Objectives

The objective of this study was to develop and validate an automated solid-phase extraction (SPE) coupled with ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the detection of sodium pentachlorophenolate (PCP-Na) residues on cutting boards. Given the potential hazards and environmental persistence of PCP-Na, a sensitive and reliable method is crucial for monitoring its residues in food contact materials to ensure consumer safety.

Methods

Wood shavings from cutting boards were extracted using 10% methanol in water, followed by purification using an automated SPE system. The eluent was concentrated, reconstituted, and analyzed by UPLC-MS/MS. An isotope-labeled internal standard was used to mitigate matrix effects, enhancing detection sensitivity. The method was validated by assessing linearity, limit of detection (LOD), limit of quantification (LOQ), recovery rates, and relative standard deviations (RSDs) across various concentration levels.

Results

The method demonstrated excellent linearity over a concentration range of 0 to 100 μg/L with a regression equation of Y = 1.035X−0.7771 and an R² of 0.9996. The LOD and LOQ were determined to be 0.4 and 1.0 μg/kg, respectively. Recovery rates ranged from 71.75% to 96.50% with RSDs between 5.19% and 16.66%. When applied to 30 market cutting board samples, PCP-Na residues were detected in 50% of the samples, with concentrations ranging from 0 to 83,990 µg/kg.

Conclusion

This study presents a robust UPLC-MS/MS method for the detection of PCP-Na on cutting boards, offering improved sensitivity and simplified sample preparation. The high detection rate in commercial samples underscores the need for stringent monitoring and regulatory measures to mitigate the exposure risk to consumers.
The terrible other: Wisdom from Mother Maria of Paris for contemporary missional engagement across boundaries
Authors: Rooms Nigel
Published: November 2024

This article takes up a discussion which began in the journal Missiology around the employment of the concept of the ‘person of peace,’ taken from Luke 10: 6, in contemporary mission. It recognises the difficulties and pitfalls of encountering and engaging others, as neighbours across the boundary of the local church and rehearses some of the extant literature in the field. To develop the discussion the essay engages the writings of Mother Maria Skobtsova or Mother Maria of Paris (1891-1945), a 20th-century Orthodox saint and martyr, via some additional reflection of Rowan Williams upon her work. Several original ideas emerge from Mother Maria’s theology, not least, our solidarity as Christians with both Christ and his mother Mary. Such solidarity transfigures our possible relations with the neighbour as an icon of God, a ‘terrible’ (i.e. awesome) irreducible other. Encountering the neighbor is then an ascetic task which requires de-centering of the self/ego in order that the relationship may be entered into ‘free of mercenary desire’ and open up the life of Christ for all participants. Such a theology creates a fresh space for conviviality, in Ivan Illich’s terms across the boundary of the church.
Does opinion really matter: World Trade Organization’s members’ stance on India’s anti-dumping policy?
Authors: Arora Vartika , Narayanan K
Published: November 2024

India’s foreign trade policy has considerably evolved in the past 70 years. The trade policy choices reflect the changing rationale for using trade barriers over a period of time. In the past 27 years, anti-dumping (AD) measures have been used extensively among many trade instruments. India has filed 17% of the total global AD petitions, that is, 1130 out of 6582 cases between 1995 and 2022. The current study attempts to understand India’s AD policy position through the World Trade Organization’s Trade Policy Review Mechanism. Though a popular method for qualitative and quantitative analyses in management, psychology, health care sciences and communications, content analysis has been sparingly used in the international trade policy domain. An attempt has been made to apply qualitative content analysis research techniques in assessing the Minutes of the Meeting documents of the Trade Policy Reviews conducted for India. Several issues raised by the Members and potential explanations by India are identified that could enhance the government’s AD policy decisions.
Heart Rate Variability for Supplementing Withdrawal Assessment in Patients with Opioid Dependence: An Exploratory Study
Authors: Sarkar Siddharth , Kochhar Kanwal Preet , Sood Esha , Chandran Dinu , Jangra Sunil , Verma Adit
Published: November 2024

Background:

Management of opioid dependence requires titrating medication doses based on withdrawal symptoms, but its clinical assessment presents challenges when it comes to subjective reporting. This study aimed to find out the relationship between heart rate variability (HRV) and opioid withdrawal in patients with opioid dependence.

Methods:

Three groups of adult males were recruited: (a) patients with opioid dependence undergoing inpatient detoxification, (b) patients with opioid dependence stabilized on buprenorphine-based opioid substitution treatment, and (c) healthy controls. Frequency and time-domain parameters of HRV were used in the analysis. The opioid withdrawal was assessed using the Subjective Opiate Withdrawal Scale (SOWS).

Results:

Resting heart rate was found to be significantly different across the three groups (higher in patients stabilized on buprenorphine than the other two groups). In time-domain parameters, the detoxification group had the highest beat-to-beat variability. In frequency-domain parameters, the total power was highest for the detoxification group and lowest for the opioid substitution treatment group. In contrast, the relative power of frequency bands (very low, low, and high) did not vary across the groups at baseline. The SOWS had a weak negative correlation with root mean square of successive differences (RMSSD) in the opioid substitution group and did not have any relationship with HRV parameters in the detoxification group.

Conclusions:

This exploratory study did not find HRV parameters to be robustly associated with subjective withdrawal, except for a negative association with the beat-to-beat variability among patients on opioid substitution treatment. This study adds to information on HRV in patients with opioid dependence.
Shift Work, Sleep and Well-Being: A Qualitative Study on the Experience of Rotating Shift Workers
Authors: Das Moitrayee , Palo Sasmita
Published: November 2024

This study critically investigates the impact of sleep deprivation on the well-being of shift workers in a Mumbai-based manufacturing facility, highlighting a significant yet often overlooked occupational health concern. Employing a robust, two-phase mixed-methods approach, phase 1 quantitatively assessed the sleep patterns, quality and daytime sleepiness of 85 shop floor workers using sleep diaries, Fitbit wristbands, Actigraphy and validated tools such as the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index. Phase 2 comprised in-depth qualitative interviews with 14 workers experiencing poor sleep, alongside interviews with four plant managers and family members. Thematic analysis of the interview data revealed a compelling narrative: shift work fundamentally disrupts circadian rhythms, precipitating irregular sleep patterns, chronic sleep deprivation and a marked decline in workers’ physical and psychological well-being. The study also identifies effective strategies to mitigate the adverse effects of shift work. It contributes valuable insights, proposing a framework for future studies to develop targeted, evidence-based interventions that address the critical issue of sleep deprivation among shift workers.
Book review: MK Raghavendra, The Politics of Modern Indian Language Literature: Implicit and Symptomatic Readings
Authors: Rattu Serena
Published: November 2024

MK Raghavendra, The Politics of Modern Indian Language Literature: Implicit and Symptomatic Readings (New York: Routledge, 2024), ix + 274 pp.
Body adiposity index and other indexes of body composition in predicting cardiovascular disease in the Chinese population: A Cohort study
Authors: Luo Wen-Shu , Ding Yi , Guo Zhi- Rong
Published: November 2024

Objective

The purpose of this study was to compare the ability of four obesity indicators, including waist circumference (WC), body mass index (BMI), body adiposity index (BAI), and waist-to-height ratio (WHtR) on prediction for incident cardiovascular disease (CVD) in Chinese Han population.

Methods

We analyzed data from a prospective population cohort of 3598 participants aged 35 to 74 years from Jiangsu China. The logistic regression model was used to analyze the association between four obesity indicators and CVD risk. The ROC curve was used to assess and compare the diagnostic performance of four obesity indicators.

Results

During 8 years (median 6.3 years) of follow-up time, 82 CVD endpoints were collected during follow up (36 men and 46 women). After adjustment for age, smoking status, alcohol consumption and family history of CVD, in men, WC, BMI, and BAI were associated with triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and hypertension. In women, WC, BMI and WHtR were associated with TG, HDL-C, hyperglycemia and hypertension, BAI was only associated with HDL-C, hyperglycemia, and hypertension. ROC curve analysis indicated that BAI have the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese males. WHtR has the highest area under the curve to identify CVD, and BMI has the lowest area under the curve to identify CVD in Chinese females.

Conclusions

CVD risk was more consistently correlated with BAI in Chinese men and more consistently correlated with WHtR and WC in Chinese women.
A Sequential Calibration Approach to Address Challenges of Repeated Calibration of a COVID-19 Model
Authors: Enns Eva A. , Li Zongbo , McKearnan Shannon B. , Kao Szu-Yu Zoe , Sanstead Erinn C. , Simon Alisha Baines , Mink Pamela J. , Gildemeister Stefan , Kuntz Karen M.
Published: November 2024

Background

Mathematical models served a critical role in COVID-19 decision making throughout the pandemic. Model calibration is an essential, but often computationally burdensome, step in model development that provides estimates for difficult-to-measure parameters and establishes an up-to-date modeling platform for scenario analysis. In the evolving COVID-19 pandemic, frequent recalibration was necessary to provide ongoing support to decision makers. In this study, we address the computational challenges of frequent recalibration with a new calibration approach.

Methods

We calibrated and recalibrated an age-stratified dynamic compartmental model of COVID-19 in Minnesota to statewide COVID-19 cumulative mortality and prevalent age-specific hospitalizations from March 22, 2020 through August 20, 2021. This period was divided into 10 calibration periods, reflecting significant changes in policies, messaging, and/or epidemiological conditions in Minnesota. When recalibrating the model from one period to the next, we employed a sequential calibration approach that leveraged calibration results from previous periods and adjusted only parameters most relevant to the calibration target data of the new calibration period to improve computational efficiency. We compared computational burden and performance of the sequential calibration approach to a more traditional calibration method, in which all parameters were readjusted with each recalibration.

Results

Both calibration methods identified parameter sets closely reproducing prevalent hospitalizations and cumulative deaths over time. By the last calibration period, both approaches converged to similar parameter values. However, the sequential calibration approach identified parameter sets that more tightly fit calibration targets and required substantially less computation time than traditional calibration.

Conclusions

Sequential calibration is an efficient approach to maintaining up-to-date models with evolving, time-varying parameters and potentially identifies better-fitting parameter sets than traditional calibration.

Highlights

This study used a sequential calibration approach, which takes advantage of previous calibration results to reduce the number of parameters to be estimated in each round of calibration, improving computational efficiency and algorithm convergence to best-fitting parameter values. Both sequential and traditional calibration approaches were able to identify parameter sets that closely reproduced calibration targets. However, the sequential calibration approach generated parameter sets that yielded tighter fits and was less computationally burdensome. Sequential calibration is an efficient approach to maintaining up-to-date models with evolving, time-varying parameters.
Heuristic Approach Based on a K-Means Algorithm to Reduce the Cost of Macroscopic Fundamental Diagram Estimation
Authors: Guamán M. Diego Germán , Herrera M. Juan Carlos
Published: November 2024

The macroscopic fundamental diagram (MFD) is a simple aggregate model useful for characterizing a network’s operation. Constructing the MFD requires straightforward yet costly data collection, as it involves data not readily available in many places. This work proposes and validates a methodology for identifying a group of links in a network whose subsequent monitoring is sufficient to reasonably estimate its MFD. The proposed methodology uses traffic data available to any user with internet access and the K-means algorithm to identify clusters of links in the network and select the most representative for each cluster. Once these representative links are equipped with technology able to measure flows and densities, providing the reduced MFD for these links, the methodology proposes a heuristic to expand these values to construct the MFD for the entire network. The methodology is validated with simulated data. The MFD estimation errors obtained are comparable to those obtained with other similar methodologies reported in the literature. However, this methodology has the advantage of not requiring fixed sensors or a dedicated fleet of probe vehicles to identify a representative link, which is a crucial aspect in several cities. The proposed methodology is finally partially applied using real data from a zone of Santiago, Chile, yielding promising results in the clusters and representative links identified.