bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental analysis of a diesel engine run on non-conventional fuel blend at different preheating temperatures
Authors: Kumar Rahul , Yadav Anil Singh , Sharma Abhishek , Rajak Upendra , Verma Tikendra Nath , Alam Tabish , Tiwari Nishant , Jawahar C P
Published: August 2023

Due to urbanisation, the reuse of scrap tyres in the form of energy has gained attention for the disposal of waste tyres. Among the numerous methods, pyrolysis appears to be possible, appealing and viable for generating products such as pyrolysis oil, which can be combined with petroleum oils and used as a source of energy. In a prior study, a mixture of jatropha methyl ester (JME) and tyre pyrolysis oil (TPO) was used as a diesel engine fuel, and it was discovered that the JMETPO20 (JME80% + TPO20%) blend gave better results among all the test blends but inferior than diesel operation. Also, it was reported that due to higher viscosity of the JMETPO20 blend, engine gave inferior performance than diesel operated engine. In this context, an attempt has been made to utilize the JMETPO20 blend at different preheating temperatures to substitute conventional diesel. The blend was preheated at three different temperatures, that is, 50, 60 and 70°C and experiments were carried out in a single-cylinder diesel engine with a rated output of 4.4 kW. The results of the investigations were analysed and compared with diesel and presented in this study.
Circular RNA 0000157 depletion protects human bronchial epithelioid cells from cigarette smoke extract-induced human bronchial epithelioid cell injury through the microRNA-149-5p/bromodomain containing 4 pathway
Authors: Song B , Wu S , Ye L , Jing Z , Cao J
Published: August 2023

Background

Circular RNA (circRNA) has been reported to regulate respiratory diseases. In the study, we aimed to elucidate the role of circ_0000157 in smoke-related chronic obstructive pulmonary disease (COPD) and the inner mechanism.

Methods

COPD-like cell injury was induced by treating human bronchial epithelioid cells (16HBE) with cigarette smoke extract (CSE). The expression of circ_0000157, miR-149-5p, bromodomain containing 4 (BRD4), BCL2-associated x protein (Bax) and B-cell lymphoma-2 (Bcl-2) was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) or Western blotting. Enzyme-linked immunosorbent assay was performed to detect interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels. Malondialdehyde (MDA) production was detected by a lipid peroxidation MDA assay kit. Superoxide dismutase (SOD) activity was analyzed by a SOD activity assay kit.

Results

Circ_0000157 and BRD4 expression were upregulated, while miR-149-5p expression was downregulated in the blood of smokers with COPD and CSE-induced 16HBE cells compared with control groups. CSE treatment inhibited 16HBE cell proliferation and induced cell apoptosis, inflammation, and oxidative stress; however, these effects were remitted when circ_0000157 expression was decreased. In addition, circ_0000157 acted as a miR-149-5p sponge and regulated CSE-caused 16HBE cell damage by targeting miR-149-5p. The overexpression of BRD4, a target gene of miR-149-5p, attenuated the inhibitory effects of miR-149-5p introduction on CSE-induced cell damage. Further, circ_0000157 modulated BRD4 expression by associating with miR-149-5p in CSE-treated 16HBE cells.

Conclusion

Circ_0000157 knockdown ameliorated CSE-caused 16HBE cell damage by targeting the miR-149-5p/BRD4 pathway, providing a potential therapeutic strategy for clinic intervention in COPD.
Impacts of Training Rural Dairy Producers in India: Role of Dairy Vigyan Kendra
Authors: Misra Harekrishna , Parida Yashobanta , Yadav Deepika , Prajapti J. B. , Sontakke Ankit , Krishnan Shweta , Jadav Sanjay J.
Published: August 2023

The state of Gujarat, home to a vibrant network of dairy cooperatives, plays a significant role in milk production, accounting for 7.69% of the country’s total milk output. It ranked fifth in milk production among all Indian states and union territories in 2017–18. The state piloted a unique and specialised dairy extension program for dairy farmers through Dairy Vigyan Kendra (DVK) to promote dairy farming in its Panchmahal district. The DVK aimed to train rural dairy farmers and improve their socio-economic conditions. This study examines how DVK interventions increase the income from dairy, the herd size and milk production of the beneficiary farmers in the Panchmahal district. The result shows that farmers’ participation in DVK training increased their income from dairying. Further, the results highlighted that DVK intervention significantly increased milk production in the Panchmahal district. Our results conclude that the government can replicate the DVK training model in other districts of Gujarat, helping millions of dairy farmers enhance their skills and obtain more output and income from dairy farming.
Proper Tweeting Etiquette Guidelines for Pathologists, Trainees, and Medical Students on #PathTwitter
Authors: Schukow Casey , Abdul-Karim Fadi W. , Crane Genevieve M.
Published: August 2023

The use of social media in pathology has broadly had a positive impact on pathology education and outreach with the frequent posting of high-quality educational material of potential value to trainees, practicing pathologists, and other clinical and laboratory specialists. These posts are also of potential utility and interest to members of the public, who are now more than ever able to gain a window into the field and the role of pathologists in their medical care. There can be a lighthearted aspect to teaching material with the use of food items/analogies, emojis, or other descriptors, which may cross over into the classroom. However, when pathology discussion is taken to a public forum, such as on Twitter (parent company: X Corp.), there is the potential for posted material to be misunderstood, such as when certain emojis or adjectives may be used to describe a human disease state or patient sample. The authors present examples of potential areas of caution, suggestions of how to create a positive impact, and brief guidelines for social media etiquette on #PathTwitter that may apply to other social media platforms widely used by pathologists (including, but not limited to, Facebook, Instagram, YouTube, and KiKo). While the points discussed here may be common knowledge and well-known to pathologists who use social media for virtual medical education, the concerns mentioned here (such as using language like “beautiful” to describe abnormal mitotic figures and cancer cells) still exist and, henceforth, bear reinforcing.
Immersive Virtual Reality, Tool for Accessible Design: Perceived Usability in an Interior Design Studio Setting
Authors: Lee Jisun , Miri Marjan , Newberry Mary
Published: August 2023

Despite the benefits of virtual reality (VR), there has been limited exploration of how immersive VR can be implemented in interior design course content and how students perceive its use. For this study, we investigated how an immersive VR tool can be incorporated into the interior design studio to support second-year students’ ( n = 18) design process and outcomes and examined its perceived usability (i.e., measured as usefulness, ease of use, enjoyment, and intention to use) for accessible space design. We also explored VR’s impact on advancing the interaction with space, understanding spatial information and problem-solving (PS), and how students accept the use of this technology. The students used immersive VR throughout the design process for one semester and then participated in a questionnaire. We found that immersive VR is helpful by enhancing students’ interaction with the designed space, developing better spatial understanding, and advancing PS. VR was also perceived to be highly enjoyable and moderately improved job performance but was slightly less easy to use. Participants showed a high intention to utilize VR, and spatial interaction and perceived enjoyment were significantly associated with that intention. Our findings suggest that immersive VR has potential benefits for teaching and learning accessible design and can be used more generally in diverse contexts of interior design pedagogy. While these results are promising, continued research to more effectively adopt the use of this technology in the interior design studio is needed.
Altruistic help or taking advantage of the situation? Social representations of surrogate motherhood
Authors: Šuľová Mária , Popper Miroslav
Published: August 2023

Concerning Europe, the lay public, mainly in Central regions, still lacks information about what surrogacy is and how the process works in practice. It is one of the most controversial methods of assisted reproduction precisely because it goes against traditional social norms and ideas about the conception of life. The main aim of our study was to map the social representations of lay people that are formed in internet discussions. We focused on discussion forums over a time span of the last 10 years, from 2013 to 2022. We were also interested in whether perceived risks or benefits formed the core of social representations. Through a reflexive thematic analysis, we identified two distinct constructions of social representations of surrogacy, finding that value settings in terms of liberalism and conservatism appear to have the greatest influence on the anchoring and objectification of surrogacy.
Middle England’s empire: Social reproduction in the colonial global economy
Authors: Richardson Ben
Published: August 2023

This article brings feminist critiques of capitalism into conversation with race-conscious International Political Economy to highlight the place of social reproduction in the colonial global economy. It does so by taking a provincial perspective, using Royal Leamington Spa as a case study to reveal how the provision of care for the elderly and the ill sustained colonial elites across the life course, while religious and educational practices helped transmit cultural values across generations and reproduce imperialism as an institutionalised social order. Whereas the finance houses of London, the factories of Manchester, and the ports of Liverpool and Bristol constitute nodal points for imperial circuits of capital, the spa town condenses the everyday practices through which bourgeois metropolitan empire was lived and made liveable. These findings point to a functional differentiation of economic space within the metropole and offer a critical reinterpretation of Middle England as a Whitened site of middle-class respectability.
Approaches to Assessment and Intervention With Children and Young People Who Engage in Harmful Sexual Behavior: A Scoping Review
Authors: McPherson Lynne , Vosz Meaghan , Gatwiri Kathomi , Hitchcock Clarissa , Tucci Joe , Mitchell Janise , Fernandes Cyra , Macnamara Noel
Published: August 2023

This paper reports the findings of a project that conducted a rapid review of evidence regarding assessment and intervention approaches responding to children and young people who engage in harmful sexual behaviors. A literature review was conducted using a systematic search of academic databases and consultation with subject matter experts. The process resulted in 27 scholarly publications being included and analyzed to explore what was known about effective approaches with children and young people who have engaged in harmful sexual behavior. The review found that the current state of knowledge was limited, with few of the included papers reporting research outcomes. In the absence of a sound evidence base, additional theoretical literature and expert commentary have been drawn upon to better understand issues in this complex practice area. A key finding of this review was that growing awareness that children and young people who engage in harmful sexual behaviors are, first and foremost, children. They should not be regarded as soon-to-be-adults who are engaging in adult offending. This shift in thinking informs contemporary assessment and intervention approaches, challenging those models that previously focused on measuring risk using forensic approaches to predict the likelihood of future offending. A critical failure to understand the needs of specific cohorts of children and young people was also evident.
Fantasies of Adequacy: Mythologies of Capital in Dark Souls
Authors: Dooghan Daniel M.
Published: August 2023

Dark Souls, FromSoftware's 2011 action-RPG, has become synonymous with extreme difficulty. The game's success and influence despite its ostensibly niche appeal make it an outlier in an era of increasingly accessible gaming. Yet in eschewing accessibility Dark Souls offers a different, compensatory appeal. Through an analysis of the game's aesthetics from philological, economic, and postcolonial perspectives, this research argues that Dark Souls’ gameplay constitutes an economic fantasy. The game's difficulty can be overcome in the manner celebrated by capital: hard work. Moreover, this fantasy offers a level playing field, a quantitative accounting of progress, and the opportunity to be better than one's neighbors. Dark Souls offers a fantastic economic simulation in which all of capital's demands are justly and predictably rewarded. It both legitimizes the mythologies of capital and invites players to content themselves with the precarious labor of the loyal employee rather than the power of the owners.
Factors affecting lower extremity venous insufficiency recurrence following radiofrequency ablation
Authors: Cetin Hakki Kursat , Kanber Eyup Murat
Published: August 2023

Objective

To clarify possible factors for recurrence of venous insufficiency following radiofrequency ablation (RFA) for the treatment of lower extremity chronic venous insufficiency (CVI).

Methods

Patients with lower extremity CVI who underwent RFA therapy were reviewed for inclusion in the study. Patients’ characteristics, operative parameters and follow-up outcomes were recorded. Patients were divided into two groups (patients with successful RFA and patients with recurrent venous insufficiency). Groups were compared according to patient demographic features, treated vein characteristics, operative data and follow-up duration.

Results

In total, 313 patients matched the study inclusion criteria and 48 patients encountered RFA failure during follow-up. Mean BMI and ratio of COPD were significantly higher in patients with RFA failure ( p = .002 and p = .007). The CEAP classification was significantly different between the groups ( p = .007). Mean follow-up time was significantly longer in patients with RFA failure ( p = .011). Presence of COPD and BMI ≥30 kg/m2 increased RFA failure 4.187 times and 2.255 times, respectively ( p = .002 and p = .022). Additionally, CEAP C4 significantly increased RFA failure ( p = .001). Lastly, longer follow-up time was a predictive factor for RF failure ( p = .024).

Conclusion

Our study findings demonstrated for the first time that obesity, presence of COPD, presence of veins classified as CEAP C4 before RFA, and follow-up period longer than 48 months were predictive factors for venous insufficiency recurrence following RFA.
Isometric shoulder strength: Normative Australian population data and associated factors
Authors: Duke Phillip FR , Bennett Darcy , Strauss Ruby , Peters Susan E , Ross Mark
Published: August 2023

Background

Age and sex are known predictors of isometric shoulder strength and therefore must be accounted for when noting strength values or administering assessments such as the Constant Score. Given the popularity of the Constant Score, it is important to ensure protocols and values remain clinically relevant and are representative of the intended population.

Method

Isometric shoulder strength was recorded for 511 participants without shoulder pathology using the ChatillonTM hand-held dynamometer. Data were stratified by age and sex for comparison with published normative strength series. Other demographic variables were evaluated using linear regression models.

Results

Normative values for shoulder strength were generated. Age ( p = .003, [Formula: see text]) and sex ( p < .001, [Formula: see text]) were significant predictors of shoulder strength. Height ( p = .03, [Formula: see text] was a significant predictor of strength in females and weight was a significant predictor of strength in males ( p < .001, [Formula: see text]). Hand dominance was also significant, with non-dominant shoulder strength associated with higher strength in females ( p < .001, [Formula: see text]) and lower strength in males ( p < .001, [Formula: see text]).

Conclusion

This study generated normative shoulder strength values for a sample of the Australian population and provided a comparison between other normative scores. Significant demographic predictors in addition to age and sex were identified.

Level of Evidence

III.
Mundane Participation: Power Imbalances in Youth Media Use
Authors: Chu Donna
Published: August 2023

This study aims at revisiting the notion of participatory culture at a time when social media use is deemed even more central and hence mundane in our everyday lives. Through 10 focus group interviews with 67 secondary students in Hong Kong, the study focuses on the experiences of a generation of young people who are generally savvy social media users, yet facing immense uncertainties brought by political and social changes in recent years. The research analyzed participation through a framework proposed by Carpentier, which considered various factors in participatory processes. It was found that the high hopes for more civic and democratic participation in digital media remained unfulfilled. On the contrary, our findings showed consistent passive participation in youths’ media use, which greatly benefited platforms and media organizations in maintaining “an architecture of passive participation.” The young knew about these mechanisms but there was little resentment or resistance. Despite the remarkable power imbalances in their everyday media participation, the young users were not only indifferent but showed tendencies to practice self-surveillance through passive participation and active non-participation.
The Thoracolumbar Inflection Point in a Population of Asymptomatic Volunteers: A Multi-Ethnic Alignment Normative Study Cohort Study
Authors: Malka Matan , Sardar Zeeshan M. , Czerwonka Natalia , Coury Josephine R. , Reyes Justin L. , Le Huec Jean-Charles , Bourret Stephane , Hasegawa Kazuhiro , Wong Hee-Kit , Liu Gabriel , Hey Hwee Weng Dennis , Riahi Hend , Kelly Michael , Lenke Lawrence G.
Published: August 2023

Study Design

Prospective cohort study.

Objectives

To show population variance in the Inflection Point (IP) and its role in defining maximum Thoracic Kyphosis (TK) and Lumbar Lordosis (LL).

Methods

468 asymptomatic adult volunteers were included in the Multi-Ethnic Normative Alignment Study (MEANS). To find parameters correlating with IP, the vertebrae and discs were numbered such that C7 was 0, T1 was 1, with T1-T2 disc being 1.5, etc. Statistical analysis was performed by a correlation matrix for IP and the 9 other selected parameters along with linear regressions.

Results

The overall mean IP was 12.44 approximately corresponding to T12-L1 disc with the median being 12.50, range was T8-L4. The cohort was then stratified by sex and ethnicity, but there was no significant difference in IP between groups. IP in younger subjects was 13 (L1), compared to 12.5 (T12-L1 disc) in older subjects ( P < .05). IP was moderately correlated with the TK apex (r = .66). No strong correlation was found between IP and LL magnitude or apex, TK magnitude, sacral slope, or Pelvic Incidence (PI). In terms of other sagittal parameters, PI and LL demonstrated a significant positive correlation. PI and TK did not have a strong association.

Conclusions

The mean IP was at the T12-L1 disc, however IP ranged from T8 to L4. Older subjects tended to have a relatively more cephalad IP. No radiographic variable was found to be a strong predictor of the IP. TK apex was found to have a moderate correlation.
Why Do Employees Negotiate Personalised Work Arrangements? Examining the Motives and Outcomes of Idiosyncratic Deals in an Indian IT Industry Context
Authors: R Maithily , Soumyaja Devi
Published: August 2023

Idiosyncratic deals (i-deals) are personalised work arrangements negotiated between employees and employers. In most contemporary organisations, i-deals have achieved desirable employee behaviour and positive work-related outcomes. Although recent literature has given increased attention to i-deals, a lack of clarity exists regarding what drives i-deal negotiations and the perceived outcomes of such individualised negotiations in emerging economies like India, which falls in the middle zone of negotiability. Therefore, the study investigates what motivates employees for i-deal negotiations and the outcomes of such i-deals from an employee perspective by following a qualitative methodology. Data for the study were collected through in-depth interviews among 30 IT sector employees in India who successfully negotiated i-deals. Axial coding was used for data coding, resulting in two main themes for the study: motives for i-deal negotiation and outcomes of those negotiations. The study findings show that career advancement and job autonomy are the critical drivers of i-deal negotiations. Besides, the benefits experienced by the employees from such negotiations include reduced work–family conflict, enhanced work engagement and job satisfaction. Theoretical and managerial implications are also discussed.
Linking Workplace Incivility and Emotional Exhaustion: A Moderated Mediation Examination
Authors: Tarab Sheema
Published: August 2023

Ignorance in cultivating a harmonious work culture and not addressing the negative misconduct at the workplace is highly undesirable for the organisations and taxing for individual and team-level performances. Drawing upon conservation of resources theory, a moderated mediation framework is hypothesised where workplace incivility predicts emotional exhaustion in employees, and organisational social capital is identified as a critical resource mediating the mechanism. In addition, irresponsible leadership is tested as a boundary condition influencing this relationship. A cross-sectional study using an online questionnaire collected data from a heterogeneous sample of 410 Indian service sector employees providing evidence for the hypothesised relationships. Results confirm that participants experiencing higher levels of incivility reported greater levels of emotional burnout. This outcome is affected by irresponsible leadership such that the higher the levels of irresponsible leadership, the more the social capital is undermined and emotional exhaustion rises in employees.
Wernicke’s Encephalopathy in Type 2 Achalasia: Case Report and Literature Review
Authors: Rodriguez Diana N. , Gera Kriti , Paudel Bishal , Pham Angela
Published: August 2023

Achalasia is primarily a smooth muscle motility disorder of the esophagus driven by aberrant peristalsis and failure of sphincter relaxation. Notably, achalasia is a heterogeneous disease with primarily 3 possible pattern subtypes. According to the review of current cases and literature regarding achalasia, patients primarily present with dysphagia, usually to solids and, if progressed, to solids and liquids. Rarely, untreated achalasia may result in thiamine deficiency and present as Wernicke-Korsakoff syndrome (WKS). This acute neurologic condition primarily affects the central and peripheral nervous system and is known by the triad of ataxia, ophthalmoplegia, and confusion. Individuals who present with WKS typically have a notable history of chronic alcohol abuse with decreased thiamine intake and metabolism. Although less common, individuals with WKS may have a pertinent history of starvation, anorexia nervosa, and malnutrition. This case highlights a unique presentation of Wernicke’s encephalopathy (WE) in a 30-year-old woman with severe type II achalasia complicated by a 60-pound weight loss in a span of 2 months. According to our literature review, there have only been 2 previously reported cases of severe achalasia leading to the development of WE. Considering the limited number of case reports available, WE must be in the differentials in patients with underlying achalasia, and our case report highlights this unusual presentation with corresponding brain imaging and manometry testing.
What parents want: A qualitative analysis of a parent-implemented intervention for autistic children
Authors: Im-Bolter Nancie , de la Roche Laura
Published: August 2023

Background and aims

Guidelines regarding social cognitive interventions for autistic children suggest incorporating a holistic approach. This includes increasing the family’s understanding of difficulties associated with autism, integrations of natural environments, and parents as active agents in the intervention while being supported for their well-being. The current availability of holistic parent-implemented interventions for autistic children is limited, with no qualitative understanding of how parents view the benefits for themselves or their children.

Method

The current study expands the literature regarding holistic approaches through a qualitative understanding of parent perceptions of a parent-implemented social communication intervention for autistic children (TalkAbility™), which incorporates a 6-month follow-up. This study sought to gain a deeper understanding from parents on their perceptions of a holistic approach, including the impact on themselves, their families, and their autistic child.

Results

Following Braun and Clarke’s model of thematic analysis, data was coded into four themes: (a) communication difficulties, frustrations, and progress, (b) social relationships and concerns, (c) communication strategies, and (d) thoughts and emotions surrounding TalkAbility™.

Conclusions

Parents report that many components of a holistic approach are instrumental in encouraging social communication in their autistic child. Results highlight the importance of considering parent experiences regarding interventions for their child’s social communication skills through a qualitative viewpoint.

Implications

Knowing the intervention aspects that parents view as most valuable allows targeted program modifications that reflect actual parent needs. Further understanding regarding the influence of holistic parent-implemented social communication interventions on child communication skills, parenting frustrations, and parent–child relationships is needed.
The Appropriateness of Outlier Exclusion Approaches Depends on the Expected Contamination: Commentary on André (2022)
Authors: Villanova Daniel
Published: August 2023

In a recent article, André (2022) addressed the decision to exclude outliers using a threshold across conditions or within conditions and offered a clear recommendation to avoid within-conditions exclusions because of the possibility for large false-positive inflation. In this commentary, I note that André’s simulations did not include the situation for which within-conditions exclusion has previously been recommended—when across-conditions exclusion would exacerbate selection bias. Examining test performance in this situation confirms the recommendation for within-conditions exclusion in such a circumstance. Critically, the suitability of exclusion criteria must be considered in relationship to assumptions about data-generating mechanisms.
Combined femoral and tibial component total knee arthroplasty device rotation measurement is reliable and predicts clinical outcome
Authors: Hernández-Hermoso José A. , Nescolarde Lexa , Yañez-Siller Federico , Calle-García Juan , Garcia-Perdomo Damian , Pérez-Andres Ricard
Published: August 2023

Background

The optimal total knee arthroplasty (TKA) rotational alignment and how best to obtain and measure it are debatable. The aim was to analyse the reliability of the Berger femoral, three different tibial and four different combined two-dimensional computer tomography (2D-CT) TKA component rotation measurements, and to ascertain which rotational values best predict a successful clinical outcome.

Methods

The 2D-CT scans were obtained post-operatively on 60 patients who had TKA. We determined one femoral [Berger’s femoral angle (BFA)], three tibial [Berger’s tibial angle (BTA), anatomical tibial angle (ATA) and bimalleolar posterior tibial component angle (BM_PTCA)] and four combined [transepicondylar posterior tibial component angle (TE_PTCA), bicondylar posterior tibial component angle (BC_PTCA, transepicondylar bimalleolar angle (TE_BM) and bicondylar bimalleolar angle (BC_BM)] TKA rotation angles. We made all measures in 23 patients twice by three observers and determined inter- and intra-observer agreement using the Bland–Altman plot method. We analysed measures of 55 patients using the area under the ROC curve (AUC) analysis to ascertain the discriminative capacity of BFA, ATA, TE_PTCA and BC_PTCA for predicting a successful clinical outcome according to the Knee Society Score (KSS) threshold.

Results

ATA showed the smaller inter- and intra-observer average of differences (−0.1° and 1.6°, respectively) of the studied methods followed by BFA (−0.9° and 1.4°), TE_PTCA (−2.1° and 2.7°) and BC_PTCA (−0.5° and 1.8°). BFA (−4° to 2.1° and −6.1° to 8.8°) and BC_PTCA (−4.4° to 3.4° and −7.9° to 4.4°) showed the narrower inter- and intra-observer limits of agreement. A TKA device rotation (BC_PTCA) < 0.8° of external rotation (ER) predicted a KSS and KSS knee successful outcome, and < 3.8° ER for KSS functional (AUC = 0.889; 0.907 and 0.764, respectively). BFA and ATA < 0.9° ER and < 3.9° internal rotation (IR) predicted a successful KSS knee outcome (AUC = 0.796 and 0.889, respectively).

Conclusion

The ATA tibial component rotation measurement was the most reliable of those studied. BFA, TE_PTCA and BC_PTCA were reliable measures for TKA femoral and combined rotation. The presence of a minimal rotation between the TKA components (BC_PTCA) and a small femoral ER or tibial IR predicted a successful KSS outcome.

Level of evidence II.
Feasibility and safety of deep sedation with propofol and remifentanil in spontaneous breathing during endoscopic retrograde cholangiopancreatography: an observational prospective study
Authors: De Vico Pasquale , Biasucci Daniele G. , Aversano Lucia , Polidoro Roberto , Zingaro Alessia , Millarelli Francesca Romana , Del Vecchio Blanco Giovanna , Paoluzi Omero Alessandro , Troncone Edoardo , Monteleone Giovanni , Dauri Mario
Published: August 2023

Background

Endoscopic retrograde cholangiopancreatography (ERCP) is an interventional procedure that requires deep sedation or general anaesthesia. The purpose of this prospective observational study was to assess the feasibility and safety of deep sedation in ERCP to maintain spontaneous breathing.

Methods

This is a single-centre observational prospective cohort study conducted in a tertiary referral university hospital. All consecutive patients who needed sedation or general anaesthesia for ERCP were included from January 2021 to June 2021. Deep sedation was achieved and maintained by continuous infusion of an association of propofol and remifentanil. The primary endpoint was to assess the prevalence of major anaesthesia-related complications, such as arrhythmias, hypotension, gas exchange dysfunction, and vomiting (safety endpoint). Secondary endpoints were: (a) to assess the prevalence of signs of an insufficient level of sedation, such as movement, cough, and hiccups (feasibility endpoint): (b) time needed to achieve the target level of sedation and for recovery from anaesthesia. In order to do so we collect the following parameters: peripheral oxygen saturation, fraction of inspired oxygen, noninvasive systemic blood pressure, heart rate, number of breaths per minute, neurological functions with the use of the bispectral index to determine depth of anaesthesia, and partially exhaustive CO2 end pressure to continuously assess the ventilatory status. The collected data were analysed by several tests: Shapiro-Wilk, Student’s t, Tuckey post-hoc, Wilcoxon rank-sum and Kruskall-Wallis ran. Statistical analysis was performed using Stata/BE 17.0 (StataCorp LLC).

Results

114 patients were enroled. Eight patients were excluded because they did not meet the inclusion criteria. We found that all patients were hemodynamically stable: intraoperative mean systolic blood pressure was 139,23 mmHg, mean arterial pressure was on average 106,66 mmHg, mean heart rate was 74,471 bpm. The mean time to achieve the target level of sedation was 63 s, while the mean time for the awakening after having stopped drug infusion was 92 s.

Conclusions

During ERCP, deep sedation and analgesia using the association of propofol and remifentanil and maintaining spontaneous breathing are safe and feasible, allowing for a safe and quick recovery from anaesthesia.
Iranian nurses’ perceptions of core competencies required for disaster risk management
Authors: Soltani Goki Faezeh , Farahmandnia Hojjat , Sabzi Amirreza , Taskiran Eskici Gulcan , Farokhzadian Jamileh
Published: August 2023

Background

With an increase in the incidence and severity of disasters, disaster risk management receives an important priority in the health system. Nurses at all levels of healthcare play an important role in disaster risk management and they must have core preparation and competencies to respond to disasters. This study aimed to evaluate Iranian nurses’ core competencies required for disaster risk management.

Methods

This cross-sectional study was conducted on 277 nurses working in three hospitals affiliated to Kerman University of Medical Sciences in 2022. The demographic information questionnaire and the nurses’ perceptions of disaster core competencies scale (NPDCC) were used to collect data, and SPSS21 was used to analyze data.

Results

Nurses’ competencies in disaster risk management were favorable (3.67 ± 0.77), with the subscales of technical skills and special diagnostic skills receiving the highest (3.91 ± 0.65) and the lowest mean scores, respectively (3.46 ± 0.87). The results found a significant difference between the scores of nurses’ competencies in disaster risk management in terms of education level, age, work experience, employment status, participation in training courses related to disaster risk management, work experience in incidents and disasters.

Conclusion

The study results suggested nurses’ high level of competency in disaster risk management, but indicated gaps in their core competencies. The study results recommend authorities provide various training courses related to disaster risk management for all nurses.
Use of complementary and integrative health in Finland: a cross-sectional survey
Authors: Pyykkönen Maija , Aarva Pauliina , Ahola Salla , Pasanen Matti , Helin Kaija
Published: August 2023

Background

Population based studies have shown large differences in the estimated prevalence of complementary and integrative health (CIH) usage between studies. This is in part due to there being no golden standard definition for CIH. In Finland, an updated and internationally comparable study on the prevalence of CIH usage is needed. In the present study, a modified Finnish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-QFI) was utilised to examine prevalence of use of different CIH modalities and their experienced helpfulness in the general Finnish population.

Methods

Respondents aged 16 and above were invited to take part in this descriptive cross-sectional study through an online panel in December 2022. The usage of CIH and the experienced helpfulness were calculated with SPSS (v28) as the proportion of users per each modality. The data were weighted based on gender, age and place of residence.

Results

A total of 3244 respondents completed the survey. CIH was used by 51.1% (95%CI: 49.4–52.8) of the respondents in the 12 months prior to the survey. Self-help practices were the most used category of CIH (28.8%; 95%CI: 27.3–30.4). The prevalence of usage of CIH natural remedies excluding vitamins and minerals was 27.0% (95%CI: 25.5–28.6). CIH providers were visited by 20.4% of the respondents (95%CI: 19.0–21.8). Getting help for a long-term illness or improvement of well-being were often mentioned as the most important reason for the use of different CIH modalities. CIH was generally used more by women compared to men. The large majority found the modalities they used helpful.

Conclusions

The results increase current understanding on CIH usage in Finland. As the majority of users experience CIH as helpful, there is a need to study CIH in the context of public health policies. The estimates of CIH usage are highly dependent on what is considered as CIH, and this should be paid attention to in future studies.
The effect and comparison of training in ethical decision-making through lectures and group discussions on moral reasoning, moral distress and moral sensitivity in nurses: a clinical randomized controlled trial
Authors: Khaghanizadeh Morteza , Koohi Aliakbar , Ebadi Abbas , Vahedian-Azimi Amir
Published: August 2023

Background

Ethical decision‑making and behavior of nurses are major factors that can affect the quality of nursing care. Moral development of nurses to making better ethical decision-making is an essential element for managing the care process. The main aim of this study was to examine and comparison the effect of training in ethical decision-making through lectures and group discussions on nurses’ moral reasoning, moral distress and moral sensitivity.

Methods

In this randomized clinical trial study with a pre- and post-test design, 66 nurses with moral reasoning scores lower than the average of the community were randomly assigned into three equal groups (n = 22) including two experimental groups and one control group. Ethical decision-making training to experimental groups was provided through the lectures and group discussions. While, the control group did not receive any training. Data were collected using sociodemographic questionnaire, the nursing dilemma test (NDT), the moral distress scale (MDS) and the moral sensitivity questionnaire (MSQ). Unadjusted and adjusted binary logistic regression analysis was reported using the odds ratio (OR) and 95% confidence intervals.

Results

Adjusted regression analysis showed that the probability of increasing the nursing principle thinking (NPT) score through discussion training was significantly higher than lecture (OR: 13.078, 95% CI: 3.238–15.954, P = 0.008), as well as lecture (OR: 14.329, 95% CI: 16.171–2.005, P < 0.001) and discussion groups compared to the control group (OR: 18.01, 95% CI: 22.15–5.834, P < 0.001). The possibility of increasing moral sensitivity score through discussion training was significantly higher than lecture (OR: 10.874, 95%CI: 6.043–12.886, P = 0.005) and control group (OR: 13.077, 95%CI: 8.454–16.774, P = 0.002). Moreover, the moral distress score was significantly reduced only in the trained group compared to the control, and no significant difference was observed between the experimental groups; lecture group vs. control group (OR: 0.105, 95% CI: 0.015–0.717, P = 0.021) and discussion group vs. control group (OR: 0.089, 95% CI: 0.015–0.547, P = 0.009).

Conclusions

The results of this study indicate that ethical decision-making training is effective on empowerment of ethical reasoning. Whereas the group discussion was also effective on increasing the ethical sensitivity, it is recommended the training plan provided in this study to be held as workshop for all nurses in health and treatment centers and placed in curricular plan of nursing students.

Registration

This randomized clinical trial was registered in Iranian Registry of Clinical Trials under code (IRCT2015122116163N5) in 02/07/2016.
Remote patient monitoring for COVID-19 patients: comparisons and framework for reporting
Authors: Joyce David , De Brún Aoife , Symmons Sophie Mulcahy , Fox Robert , McAuliffe Eilish
Published: August 2023

Background

COVID-19 has challenged health services throughout the world in terms of hospital capacity and put staff and vulnerable populations at risk of infection. In the face of these challenges, many health providers have implemented remote patient monitoring (RPM) of COVID-19 patients in their own homes. However systematic reviews of the literature on these implementations have revealed wide variations in how RPM is implemented; along with variations in particulars of RPM reported on, making comparison and evaluation difficult. A review of reported items is warranted to develop a framework of key items to enhance reporting consistency.

The aims of this review of remote monitoring for COVID-19 patients are twofold:

(1) to facilitate comparison between RPM implementations by tabulating information and values under common domains.

(2) to develop a reporting framework to enhance reporting consistency.

Method

A review of the literature for RPM for COVID-19 patients was conducted following PRISMA guidelines. The Medline database was searched for articles published between 2020 to February 2023 and studies reporting on items with sufficient detail to compare one with another were included. Relevant data was extracted and synthesized by the lead author. Quality appraisal was not conducted as the the articles considered were evaluated as informational reports of clinical implementations rather than as studies designed to answer a research question.

Results

From 305 studies retrieved, 23 studies were included in the review: fourteen from the US, two from the UK and one each from Africa, Ireland, China, the Netherlands, Belgium, Australia and Italy. Sixteen generally reported items were identified, shown with the percentage of studies reporting in brackets: Reporting Period (82%), Rationale (100%), Patients (100%), Medical Team (91%) Provider / Infrastructure (91%), Communications Platform (100%), Patient Equipment (100%), Training (48%), Markers (96%), Frequency of prompt / Input (96%),Thresholds (82%), Discharge (61%), Enrolled (96%), Alerts/Escalated (78%), Patient acceptance (43%), and Patient Adherence (52%).

Whilst some studies reported on patient training and acceptance, just one reported on staff training and none on staff acceptance.

Conclusions

Variations in reported items were found. Pending the establishment of a robust set of reporting guidelines, we propose a reporting framework consisting of eighteen reporting items under the following four domains: Context, Technology, Process and Metrics.
New tuberculosis vaccines in India: modelling the potential health and economic impacts of adolescent/adult vaccination with M72/AS01E and BCG-revaccination
Authors: Clark Rebecca A. , Weerasuriya Chathika K. , Portnoy Allison , Mukandavire Christinah , Quaife Matthew , Bakker Roel , Scarponi Danny , Harris Rebecca C. , Rade Kirankumar , Mattoo Sanjay Kumar , Tumu Dheeraj , Menzies Nicolas A. , White Richard G.
Published: August 2023

Background

India had an estimated 2.9 million tuberculosis cases and 506 thousand deaths in 2021. Novel vaccines effective in adolescents and adults could reduce this burden. M72/AS01Eand BCG-revaccination have recently completed phase IIb trials and estimates of their population-level impact are needed. We estimated the potential health and economic impact of M72/AS01Eand BCG-revaccination in India and investigated the impact of variation in vaccine characteristics and delivery strategies.

Methods

We developed an age-stratified compartmental tuberculosis transmission model for India calibrated to country-specific epidemiology. We projected baseline epidemiology to 2050 assuming no-new-vaccine introduction, and M72/AS01Eand BCG-revaccination scenarios over 2025–2050 exploring uncertainty in product characteristics (vaccine efficacy, mechanism of effect, infection status required for vaccine efficacy, duration of protection) and implementation (achieved vaccine coverage and ages targeted).We estimated reductions in tuberculosis cases and deaths by each scenario compared to the no-new-vaccine baseline, as well as costs and cost-effectiveness from health-system and societal perspectives.

Results

M72/AS01Escenarios were predicted to avert 40% more tuberculosis cases and deaths by 2050 compared to BCG-revaccination scenarios. Cost-effectiveness ratios for M72/AS01Evaccines were around seven times higher than BCG-revaccination, but nearly all scenarios were cost-effective. The estimated average incremental cost was US$190 million for M72/AS01Eand US$23 million for BCG-revaccination per year. Sources of uncertainty included whether M72/AS01Ewas efficacious in uninfected individuals at vaccination, and if BCG-revaccination could prevent disease.

Conclusions

M72/AS01Eand BCG-revaccination could be impactful and cost-effective in India. However, there is great uncertainty in impact, especially given the unknowns surrounding the mechanism of effect and infection status required for vaccine efficacy. Greater investment in vaccine development and delivery is needed to resolve these unknowns in vaccine product characteristics.
Racial differences in long-term social, physical, and psychological health among adolescent and young adult cancer survivors
Authors: Kim Sooyeon , Cho Juhee , Shin Dong Wook , Jeong Su-Min , Kang Danbee
Published: August 2023

Background

The current guidelines for survivorship in adolescents and young adults (AYA) cancer are based on studies conducted in the United States and European AYA survivors. However, previous studies have shown that the health-related quality of life in cancer survivors can vary depending on race, yet the long-term health differences among AYA survivors by race/ethnicity have not been fully explored. Therefore, our aim is to compare the psychosocial and physical health of AYA survivors and their matched controls across different racial and ethnic groups.

Methods

We conducted a cross-sectional study using US National Health and Nutrition Examination Survey (NHANES) and the Korea NHANES from 2007 to 2018. We included AYA cancer survivors who were diagnosed with any type of cancer aged between 15 and 39 years, and who were adult with aged over 18 years old at survey year. We then stratified the study population by race/ethnicity with Non-Hispanic White (NHW,n = 310), African American (AA,n = 42), Hispanic (n = 81) from NHANES, and Asian (n = 389) from the Korea NHANES. We also selected 5 times age-, sex-, race-, and survey year-matched general population among participants who had never been diagnosed with cancer (N = 4110). Variables were defined using questionnaire data, physical exams, and laboratory tests.

Results

Compared to NHW, Hispanics (aOR 1.15, 95% CI 1.00–1.32) had poor or fair general health, lower education (aOR 1.23, 95% CI 1.07–1.40), and lower household income (aOR 1.16, 95% CI 1.01–1.33). AA survivors were more likely to be non-coupled (aOR 1.35, 95% 1.15–1.60) and have hypertension (aOR 1.18, 95% CI 1.03–1.36). Asians were more former/current drinkers (aOR 1.21, 95% CI 1.05–1.40). NHW are more likely to experience psychological limitation. Compared to matched general, NHW and Asian survivors had poor general health and psychological health.

Conclusions

This study provides evidence for future studies concerning long-term health after AYA cancer survivorship that may vary according to race.