bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress and Resilience of Nursing Students in Clinical Training During the COVID-19 Pandemic: Palestinian Perspective
Authors: Bsharat Fekry
Published: September 2023

Introduction

Stress reduces nursing students’ capacity to think critically, impedes decision-making, and eventually lowers academic performance and limits success. The circumstances surrounding the COVID-19 outbreak drove students into new virtual learning settings, adding stress to their academic responsibilities.

Objectives

The purpose of this study was to assess the perceived stress and resilience among nursing students in clinical training during the COVID-19 pandemic.

Method

A cross-sectional study was conducted on 315 students studying nursing. Data collection utilized the Perceived Stress Scale and the Connor–Davidson Resilience Scale.

Results

The analysis revealed that the stress score mean was 75.2 ± 6.6 and the resilience score mean was 26.0 ± 3.4. Also, there was a weak negative association between nursing students’ stress and their resilience ( p < 0.05). Additionally, the results indicated statistically significant differences between stress and gender, study year level, and age ( p < 0.05).

Conclusion

Stress was high and resilience was moderate during the COVID-19 pandemic among nursing students.
Medical emergencies at sea: an analysis of ambulance-supported and autonomously performed operations by lifeboat crews
Authors: Messelink Daphne M. , van der Ploeg Gert-Jan , van der Linden Theo , Flameling Roos D. , Bierens Joost J. L. M.
Published: September 2023

Background

Very little data is available about the involvement of lifeboat crews in medical emergencies at sea. The aim of this study is to analyze the medical operations at sea performed by the Royal Netherlands Sea Rescue Institution (KNRM).

Methods

This is a retrospective descriptive analysis of all medical operations at sea performed by the KNRM between January 2017 and January 2020. The operations were divided in three groups: with ambulance crew aboard the lifeboat, ambulance crew on land waiting for the arrival of the lifeboat, and autonomous operations (without ambulance crew involvement). The main outcome measures were circumstances, encountered medical problems, follow-up and crew departure time.

Results

The KNRM performed 282 medical operations, involving 361 persons. Operations with ambulance crew aboard the lifeboat (n = 39; 42 persons) consisted mainly of persons with serious trauma or injuries; 32 persons (76.2%) were transported to a hospital. Operations with ambulance crew on land (n = 153; 188 persons) mainly consisted of situations where time was essential, such as persons who were still in the water, with risk of drowning (n = 45, 23.9%), on-going resuscitations (n = 9, 4.8%) or suicide attempts (n = 7, 3.7%). 101 persons (53,7%) were transported to a hospital. All persons involved in the autonomous operations (n = 90; 131 persons) had minor injuries. 38 persons (29%) needed additional medical care, mainly for (suspected) fractures or stitches. In 115 (40.8%) of all operations lifeboat crews did not know that there was a medical problem at the time of departure. Crew departure time in operations with ambulance crew aboard the lifeboat (13.7 min, min. 0, max. 25, SD 5.74 min.) was significantly longer than in operations with ambulance crew on land (7.7 min, min. 0, max 21, SD 4.82 min., p < 0.001).

Conclusion

This study provides new information about the large variety of medical emergencies at sea and the way that lifeboat and ambulance crews are involved. Crew departure time in operations with ambulance crew aboard the lifeboat was significantly longer than in operations with ambulance crew on land. This study may provide useful indications for improvement of future medical operations at sea, such as triage, because in 40.8% of operations, it was not known at the time of departure that there was a medical problem.
Editorial: Optimizing opioid prescriptions in the emergency department
Authors: Dahaba Ashraf A. , Nannan Panday Rishi S.
Published: September 2023

Optimizing opioid prescriptions in the emergency department is essential to address the opioid pandemic while ensuring patient wellbeing. This requires a comprehensive approach that includes exploring alternatives to opioids for pain management, identifying individuals at risk for opioid addiction, implementing evidence-based guidelines, and involving doctors in the management of opioid addiction.
Factors influencing shared decision-making in long-term care facilities
Authors: Kim Da Eun , Kim Min Jung
Published: September 2023

Background

Shared decision-making, a communicative process to reach decisions based on informed preferences, evidence, and co-created goals, improves care satisfaction and patients’ quality of life. However, shared decision-making has not been widely implemented in long-term care facilities, and few studies have examined how to promote the shared decision-making practice. This study aimed to identify the influencing factors of shared decision-making based on the Person-centered Practice Framework in long-term care facilities.

Methods

A total of 300 staff (nursing staff, social workers, and personal care workers) in 13 Korean long-term care facilities participated in this study. Data from 280 respondents were finally analyzed, excluding respondents with missing values. Data were collected using structured questionnaires that included items on shared decision-making, personal factors (e.g., knowledge about dementia, person-centered care education, person-centered attitude, communication behavior, and job tenure), and care environment factors (e.g., person-centered climate, staffing level, effective staff relationships, supportive supervisors, and power-sharing). Multilevel linear regression analyses were performed using Mplus Version 8.8.

Results

The mean shared decision-making score was 35.78 (range 8–45). Staff with experience of person-centered care education (β = 0.198, p = 0.034), a higher person-centered attitude score (β = 0.201, p = 0.007), and a higher communication behavior score (β = 0.242, p < 0.001) were more likely to report a higher shared decision-making score. In addition, staff who viewed their care environment as more person-centered were more likely to report a higher shared decision-making score (β = 0.416, p < 0.001).

Conclusions

This study highlights that personal (e.g., person-centered care education, person-centered attitude, and communication behavior) and care environment (e.g., person-centered climate) factors could influence shared decision-making for long-term care residents. These findings could be foundational evidence for facilitating shared decision-making practice in long-term care settings.
Progression of comorbidities in youth with overweight or obesity during the COVID-19 pandemic
Authors: Wee Erica , Sherman Ashley K. , Farrukh Safa , Clements Mark A. , Halpin Kelsee , Yan Yun
Published: September 2023

Background

Childhood obesity rates have continued to increase with the COVID-19 pandemic. However, data are limited on the impact of increasing obesity on associated comorbidities.

Methods

We evaluated the progression of overweight- or obesity-associated comorbidities by investigating change in laboratory results pre–COVID-19 pandemic and post–COVID-19 pandemic onset in youth with overweight or obesity. We defined progression of comorbidities based on increase in category rather than absolute change in value.

Results

HbA1c progression was seen in 19%, and LDL cholesterol progression was seen in 26%, as defined by categories. HbA1c progression and LDL cholesterol progression were significantly correlated. HbA1c and LDL cholesterol progression were significantly associated with older age and Hispanics, respectively.

Conclusion

The results indicate youths with overweight or obesity have experienced progression of comorbidities during the COVID-19 pandemic. This study emphasizes the importance of early detection of comorbidities among a high-risk pediatric population.
Psychometric properties of an Arabic translation of the short 9-item drive for muscularity scale (DMS-9)
Authors: Fekih-Romdhane Feten , Malaeb Diana , Dabbous Mariam , Hallit Rabih , Obeid Sahar , Hallit Souheil
Published: September 2023

Background

After the original 15-item Drive for Muscularity Scale developed by McCreary et al. in 2004, a more theoretically based scale that replicates the original DMS subscales with a better conceptual clarity and a shorter number of items, i.e., the DMS-9, has recently been developed by Chaba et al. in 2018. We sought to contribute to the literature especially under the Arab context, by investigating the psychometric properties of an Arabic translation of the DMS-9 in a sample of Arabic-speaking Lebanese university students of both genders.

Methods

University students (N = 402; 55.2% females) from multiple universities in Lebanon were invited to fill the survey in this cross-sectional designed study (December 2022 and January 2023). Our sample was chosen using the snowball technique; a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection.

Results

Using an Exploratory Factor Analysis-to- Confirmatory Factor Analysis strategy, we found that the original two-factor model of the DMS proposed in the parent study was adequately replicated in our sample. The two DMS-9 factor scores showed very good McDonald’s omega values (ω > 0.8). Findings also showed that gender invariance was achieved at the configural, metric, and scalar levels. Additionally, drive for muscularity scores correlated in the expected way with other study variables, providing support for the convergent and divergent validity of the Arabic DMS-9. Specifically, we found that greater drive for muscularity attitudes and behaviors significantly correlated with more severe muscle dysmorphic symptoms, inappropriate eating attitudes, muscle bias internalization, and lower body appreciation.

Conclusion

Findings preliminarily suggest that the Arabic DMS-9 is psychometrically sound and suitable tool to assess the drive for muscularity construct among Arabic-speaking community adults. Making the Arabic DMS-9 available will hopefully benefit the scientific community working in Arab settings, promote local and international research in this area, and offer descriptive data on how drive for muscularity may interfere with health indicators in the general Arab population.
Sick sinus syndrome diagnosed after a sinus arrest during treatment for zygomatic fracture: a case report
Authors: Hayashi Hiroki , Abe Atsushi , Oguma Tetsushi , Ito Yu , Nakayama Atsushi
Published: September 2023

Background

Intraoperative sinus arrest is rarely seen during zygomatic fracture treatment. The patient was diagnosed with sick sinus syndrome based on repeated postoperative sinus arrest, which could have resulted in death if diagnosed late, making this case very significant to report.

Case presentation

Sick sinus syndrome is an arrhythmia associated with reduced automaticity of the sinoatrial node or impaired sinoatrial node conduction. We report the case of a 67-year-old man diagnosed with the syndrome after a sinus arrest that occurred during a zygomatic fracture treatment. The patient had cheek pain and mouth opening disorder, dizziness after fainting and sustaining a facial injury. Preoperative examination determined that the syncope was due to drug-induced arrhythmia, and surgery was authorized after drug withdrawal. During the operation, sinus arrest was observed due to trigeminal vagal reflex, and heart rate was restarted by stopping the operation and chest compressions. After the surgery, the patient showed symptoms of dizziness and palpitations, and sinus arrest following atrial fibrillation and supraventricular tachycardia, which was diagnosed as sick sinus syndrome, and a pacemaker was implanted. Currently, 8 years have passed since the surgery, and there are no symptoms of mouth opening disorder, dizziness, or palpitations.

Conclusions

In the case of maxillofacial injuries due to syncope, cardiogenic syncope is a possibility, and repeated syncope is a risk for death due to delayed diagnosis. There are no reports of maxillofacial trauma leading to a diagnosis of sick sinus syndrome. The purpose of this case report is to disseminate the importance of diagnosing the cause of syncope as well as injury treatment.
Ovarian hyperstimulation syndrome with carotid artery dissection and cerebral infarction: a case report
Authors: Fan Tianhua , Ma Liansheng
Published: September 2023

Background and purpose

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious iatrogenic complications in assisted reproductive technology, which seem rarely associated with cerebrovascular diseases. We reported a patient diagnosed with OHSS combined with carotid artery dissection and massive cerebral infarction.

Case presentation

We reported a unique case of a 31-year-old woman who experienced abdominal pain, blurred consciousness, and speech inability after 15-day continuous injection of human gonadotropin for infertility. Imaging examination showed hyperacute cerebral infarction in the left frontotemporal island parietal lobe and left internal carotid artery dissection. After therapeutic use of low-molecular-weight heparin calcium anticoagulation and other conventional cerebrovascular treatments, she eventually achieved a good prognosis.

Conclusions

OHSS seemd rarely associated with cerebrovascular diseases, such as infarction and carotid artery dissection. Encountering abdominal symptoms combined with neurologic symptoms, a detailed history and a thorough examination are essential. It is necessary to comprehensively analyze the pathogenesis and formulate individualized therapy according to the specific conditions of patients.
The challenges imposed by artificial intelligence: are we ready in medical education?
Authors: Azer Samy A. , Guerrero Anthony P. S.
Published: September 2023

Artificial intelligence (AI) is the science and engineering of making intelligent machines. In medical education, the usefulness of AI and its applications is being explored in training, learning, simulation, curriculum, and developing new assessment tools. This editorial encourages authors to submit their research on AI concerning medical education to enrich our knowledge.
Engineering Comamonas testosteroni for the production of 2-pyrone-4,6-dicarboxylic acid as a promising building block
Authors: Delmulle Tom , Bovijn Stijn , Deketelaere Sari , Castelein Martijn , Erauw Tom , D’hooghe Matthias , Soetaert Wim K.
Published: September 2023

Background

Plastics are an indispensable part of our daily life. However, mismanagement at their end-of-life results in severe environmental consequences. The microbial conversion of these polymers into new value-added products offers a promising alternative. In this study, we engineered the soil-bacterium Comamonas testosteroni KF-1, a natural degrader of terephthalic acid, for the conversion of the latter to the high-value product 2-pyrone-4,6-dicarboxylic acid.

Results

In order to convert terephthalic acid to 2-pyrone-4,6-dicarboxylic acid, we deleted the native PDC hydrolase and observed only a limited amount of product formation. To test whether this was the result of an inhibition of terephthalic acid uptake by the carbon source for growth (i.e. glycolic acid), the consumption of both carbon sources was monitored in the wild-type strain. Both carbon sources were consumed at the same time, indicating that catabolite repression was not the case. Next, we investigated if the activity of pathway enzymes remained the same in the wild-type and mutant strain. Here again, no statistical differences could be observed. Finally, we hypothesized that the presence of a pmdK variant in the degradation operon could be responsible for the observed phenotype and created a double deletion mutant strain. This newly created strain accumulated PDC to a larger extent and again consumed both carbon sources. The double deletion strain was then used in a bioreactor experiment, leading to the accumulation of 6.5 g/L of product in 24 h with an overall productivity of 0.27 g/L/h.

Conclusions

This study shows the production of the chemical building block 2-pyrone-4,6-dicarboxylic acid from terephthalic acid through an engineered C. testosteroni KF-1 strain. It was observed that both a deletion of the native PDC hydrolase as well as a pmdK variant is needed to achieve high conversion yields. A product titer of 6.5 g/L in 24 h with an overall productivity of 0.27 g/L/h was achieved.
Association between MTTP genotype (-493G/T) polymorphism and hepatic steatosis in hepatitis C: a systematic review and meta-analysis
Authors: Wang Xiaoxia , Cao Yu , Guo Jia , Li Dezhao , Zhang Haitao , Song Qingkun , Lu Jun
Published: September 2023

Background

Hepatitis C has been associated with the development of hepatic steatosis, which increases the risk of liver cancer. The microsomal triglyceride transporter protein (MTTP), is a lipid transport protein that mediates lipid metabolism and CD1d antigen presentation. The study aimed to explore the association between MTTP genotype (-493G/T) polymorphism and hepatic steatosis in hepatitis C.

Methods

The database “Pubmed, Cochrane library, CNKI, Web of science, Embase and CBM” were retrieved to identify the literature. The quality of the selected literature was evaluated using the “the Newcastle–Ottawa Scale” (NOS). Relevant data was extracted and analyzed using the Stata software. Heterogeneity was expressed by “Cochran's Q and I2”, with I2 ≥ 50% or P < 0.05 indicating high heterogeneity. A random-effects model and subgroup analysis were conducted to identify the sources of heterogeneity. We also used “Funnel plots”, “Egger’s tests” and “Begg’s tests” to evaluate biases in the literature.

Results

The study found a significant and positive association between liver steatosis and the HCV genotype 3 with a dominant model of the MTTP genotype (-493G/T) (OR = 11.57, 95%CI: 4.467–29.962, P < 0.001). In contrast, no correlation was found between hepatic steatosis and either the recessive, homozygous or heterozygous models (OR = 1.142, P = 0.5; OR = 1.581, P = 0.081; OR = 1.029, P = 0.86). There was no significant publication biases, as measured by the Funnel plot, and the Egger’s and Begg's tests. Finally, sensitivity analysis showed the obtained results are stable.

Conclusions

Dominant mutations in the T allele of the MTTP genotype (-493G/T) increase susceptibility to hepatic steatosis in patients presenting with the HCV genotype 3.
HIV viral load suppression among people with mental disorders at two urban HIV clinics in Uganda: a parallel convergent mixed methods study using the social ecological model
Authors: Ndagire Regina , Wangi Rachel Nante , Ojiambo Kevin Ouma , Nangendo Joanita , Nakku Juliet , Muyinda Herbert , Semitala Fred C.
Published: September 2023

Background

Uganda adopted and implemented the Universal Test and Treat (UTT) guidelines in 2017, which require HIV-infected persons to be initiated on antiretroviral therapy (ART) at any CD4 + cell count, and to be routinely monitored for viral load to assess response to ART. However, there is paucity of data on viral load suppression (VLS) among people living with HIV (PLHIV) with mental disorders. We conducted a parallel convergent mixed methods study to determine HIV VLS among people with a mental disorder and explored the socio-cultural determinants of VLS at Butabika hospital and Mulago (ISS) HIV Clinics in Uganda.

Methods

We conducted a retrospective medical records review; seven key informant interviews (KII) among purposively selected healthcare providers and 12 in-depth interviews (IDI) among clinically stable PLHIV with a mental disorder. Data was collected on demographics, mental disorder, ART, viral load status, social support, stigma, and disclosure of HIV status. Quantitative data was analysed using descriptive statistics and modified Poisson regression, while Inductive thematic analysis was used for the qualitative data.

Results

Of the 240 PLHIV with a mental disorder who were enrolled, 161 (67.1%) were female with mean age 38.9 (± 11.2) years. Overall, 88.8% (95% Cl: 84.0 – 92.2%) achieved VLS. Age (aPR = 1.00, 95%Cl = 1.00–1.00), male gender (aPR = 0.90, 95%Cl = 0.82–0.98), divorced (aPR = 0.88, 95%Cl = 0.82–0.94), widowed (aPR = 0.84, 95%Cl = 0.83–0.86), baseline CD4 count < 200 (aPR = 0.89, 95%Cl = 0.85–0.94), psychotic mental disorders (aPR = 1.11; 95%CI = 1.08–1.13) and fair (85–94%) ART adherence level (aPR = 0.69, 95%Cl = 0.55–0.87) and TDF/3TC/DTG (aPR = 0.92; 95%CI = 0.91–0.94) were associated with HIV VLS. Social support from family members, knowledge of impact of negative thoughts on VLS, fear of breaking up with partners and compassionate healthcare providers positively influenced VLS. Stigma and discrimination from the community, self-perceived stigma hindering social relations, socio-economic challenges and psychiatric drug stock-outs negatively affected VLS.

Conclusion and recommendations

HIV VLS among PLHIV with mental disorders at institutions that provide integrated HIV and mental health care is still below the UNAIDS 95% target. Health promotion messaging focusing on benefits of VLS and countering stigma to create a safe environment; and active involvement of family members in care could improve HIV treatment outcomes for PLHIV with mental disorders.
A descriptive analysis of the contents of Care Response, an international data set of patient-reported outcomes for chiropractic patients
Authors: Young Kenneth J , Fitzgerald Jane , Field Jonathan , Newell David , Richards Jim
Published: September 2023

Background

Databases have become an important tool in understanding trends and correlations in health care by collecting demographic and clinical information. Analysis of data collected from large cohorts of patients can have the potential to generate insights into factors identifying treatments and the characteristics of subgroups of patients who respond to certain types of care. The Care Response (CR) database was designed to capture patient-reported outcome measures (PROMs) for chiropractic patients internationally. Although several papers have been published analysing some of the data, its contents have not yet been comprehensively documented. The primary aim of this study was to describe the information in the CR database. The secondary aim was to determine whether there was suitable information available to better understand subgroups of chiropractic patients and responsiveness to care. This would be achieved by enabling correlations among patient demographics, diagnoses, and therapeutic interventions with machine learning approaches.

Methods

Data in all available fields were requested with no date restriction. Data were collected on 12 April 2022. The output was manually scanned for scope and completeness. Tables were created with categories of information. Descriptive statistics were applied.

Results

The CR database collects information from patients at the first clinical visit, 14, 30, and 90 days subsequently. There were 32,468 patient responses; 3210 patients completed all fields through the 90 day follow up period. 45% of respondents were male; 54% were female; the average age was 49. There was little demographic information, and no information on diagnoses or therapeutic interventions. We received StartBack, numerical pain scale, patient global impression of change, and Bournemouth questionnaire data, but no other PROMs.

Conclusions

The CR database is a large set of PROMs for chiropractic patients internationally. We found it unsuitable for machine learning analysis for our purposes; its utility is limited by a lack of demographic information, diagnoses, and therapeutic interventions. However, it can offer information about chiropractic care in general and patient satisfaction. It could form the basis for a useful clinical tool in the future, if reformed to be more accessible to researchers and expanded with more information collected.
Transcriptomic, 16S ribosomal ribonucleic acid and network pharmacology analyses shed light on the anticoccidial mechanism of green tea polyphenols against Eimeria tenella infection in Wuliangshan black-boned chickens
Authors: Song Hai-Yang , Deng Meng-Ling , Yang Jian-Fa , Ma Jun , Shu Fan-Fan , Cheng Wen-Jie , Zhu Xing-Quan , Zou Feng-Cai , He Jun-Jun
Published: September 2023

Background

Eimeria tenella is an obligate intracellular parasitic protozoan that invades the chicken cecum and causes coccidiosis, which induces acute lesions and weight loss. Elucidating the anticoccidial mechanism of action of green tea polyphenols could aid the development of anticoccidial drugs and resolve the problem of drug resistance in E. tenella.

Methods

We constructed a model of E. tenella infection in Wuliangshan black-boned chickens, an indigenous breed of Yunnan Province, China, to study the efficacy of green tea polyphenols against the infection. Alterations in gene expression and in the microbial flora in the cecum were analyzed by ribonucleic acid (RNA) sequencing and 16S ribosomal RNA (rRNA) sequencing. Quantitative real-time polymerase chain reaction was used to verify the host gene expression data obtained by RNA sequencing. Network pharmacology and molecular docking were used to clarify the interactions between the component green tea polyphenols and the targeted proteins; potential anticoccidial herbs were also analyzed.

Results

Treatment with the green tea polyphenols led to a reduction in the lesion score and weight loss of the chickens induced by E. tenella infection. The expression of matrix metalloproteinase 7 (MMP7), MMP1, nitric oxide synthase 2 and ephrin type-A receptor 2 was significantly altered in the E. tenella infection plus green tea polyphenol-treated group and in the E. tenella infection group compared with the control group; these genes were also predicted targets of tea polyphenols. Furthermore, the tea polyphenol (-)-epigallocatechin gallate acted on most of the targets, and the molecular docking analysis showed that it has good affinity with interferon induced with helicase C domain 1 protein. 16S ribosomal RNA sequencing showed that the green tea polyphenols had a regulatory effect on changes in the fecal microbiota induced by E. tenella infection. In total, 171 herbs were predicted to act on two or three targets in MMP7, MMP1, nitric oxide synthase 2 and ephrin type-A receptor 2.

Conclusions

Green tea polyphenols can directly or indirectly regulate host gene expression and alter the growth of microbiota. The results presented here shed light on the mechanism of action of green tea polyphenols against E. tenella infection in chickens, and have implications for the development of novel anticoccidial products.

Graphical Abstract
In-hospital outcomes after acute myocardial infarction with obstructive coronary artery disease in critically ill patients hospitalized for non-cardiac disease
Authors: Roué Morgan , Guédon Alexis F. , Lapidus Nathanaël , Razazi Keyvan , Hariri Geoffroy , Morawiec Elise , Desnos Cyrielle , Ederhy Stéphane , Cohen Ariel , Mekontso Dessap Armand , Fartoukh Muriel , Labbé Vincent
Published: September 2023

Background

Acute myocardial infarction (AMI) is one of the major cardiac complications in patients hospitalized in the intensive care unit (ICU) for non-cardiac disease. A better knowledge of ischemic and bleeding risks in these patients is needed to identify those most likely to benefit from specific cardiac management. We therefore assessed the incidence and predictors of a composite outcome of severe ischemic event (AMI recurrence, ischemic stroke), major bleeding, or all-cause death in this setting.

Methods

In this multicenter retrospective study, all consecutive adult patients admitted for non-cardiac disease to four French university hospital ICUs between January 2012 and December 2018 who had an AMI with obstructive coronary artery disease (OCAD) during the ICU stay were considered for inclusion. AMI with OCAD was defined as an elevated cardiac troponin value associated with at least one sign (clinical, electrocardiographic, or echocardiographic) suggestive of myocardial ischemia and presence of OCAD on coronary angiography. The primary endpoint was in-hospital occurrence of the composite outcome.

Results

Ninety-six patients [median age 69 years, 22 women (23%), 59 with sepsis (61%), 35 with ST elevation (37%), median sequential organ failure assessment (SOFA) of 8 on the day of AMI] were included. The median peak cardiac troponin value was 131 (IQR 44–303) times the upper reference limit. Dual antiplatelet, therapeutic anticoagulation, and early mechanical reperfusion therapies were administered in 61 (64%), 68 (71%), and 47 (49%) patients, respectively. The composite outcome occurred in 48 (50%) patients. Severe ischemic events occurred in 17 (18%) patients and major bleeding in 26 (27%) patients; 26 patients (27%) died in the hospital. AMI management was not significantly different in patients with and without the composite outcome. A history of arterial hypertension (HR 2.05, 95% CI 1.01–4.16) and high SOFA score at the time of AMI (HR 1.07, 95% CI 1.00–1.15) were independent risk factors for the composite outcome.

Conclusions

Patients who have an AMI with OCAD during an ICU stay for non-cardiac disease are at risk of a composite outcome of severe ischemia, major bleeding, and death. A history of arterial hypertension and high SOFA scores were independent hazards for poor prognosis.

Graphical Abstract
Differences of SOC storage and stability between soil layers influenced by long-term fertilization in a typical paddy soil of Southern China
Authors: Chen Xianni , Xu Hu , Mustafa Adnan , Huang Qinghai , Liu Kailou , Sun Nan , Xu Minggang
Published: September 2023

Background

The contribution of long-term fertilization to soil organic carbon (SOC) storage has been of great concern. To assess the effects of long-term fertilization on SOC storage and stability in top and sub-soil layers, soil samples were collected from a 29-year field experimental station in a typical paddy soil in southern China. The SOC storage of whole soil and SOC fractions was quantified at three soil depths (0–20, 20–40, 40–60 cm) under four treatments: no fertilization (Control), a combination of nitrogen, phosphorus and potassium (NPK), double the rates of NPK (2NPK), NPK plus manure (NPKM).

Results

The increase of Cinput-total was significantly higher than that of SOC storage among different treatments (p < 0.05), indicating that soil fixation of exogenous carbon is limited. Besides, the SOC accumulation and sequestration rates patterned as NPKM > 2NPK > NPK, and these rates were higher at 0–20 cm depth as compared to other depth intervals. Furthermore, for the whole profile, the SOC storage of active pool was higher in the Control (39.6 t C ha−1) than in other treatment (36.2 t C ha−1, p < 0.05). Whereas, fertilization increased the SOC storage of passive pool, ranked as NPKM > 2NPK≈NPK > Control (p < 0.05), indicating that fertilization, especially organic combined with inorganic fertilization, improved SOC stability. From the perspective of soil layers, the difference of SOC storage among treatments for passive pool was mainly resulted from the difference at surface soil, and for active pool were the deeper layers. Additionally, manure application increased the difference among soil layers.

Conclusion

This study concluded that non-fertilized treatment could improve the SOC storage of active pool especially in deep soil layers, while fertilization especially manure application could improve the SOC storage and stability in surface soil and increased the difference among soil layers.

Graphical Abstract
Comparative diagnosis of the alveolar antral artery canal in the lateral maxillary sinus wall in corresponding panoramic radiography and cone-beam computed tomography
Authors: Ketabi Ali-Reza , Hassfeld Stefan , Lauer Hans-Christoph , Piwowarczyk Andree
Published: September 2023

Purpose

Sinus lift operations are a tried and tested means of providing adequate implant prosthetics to patients with compromised jawbones. Knowledge of the arterial supply of the maxillary sinus region is essential for surgical treatment in this area. The aim of the present comparative study was to determine whether alveolar antral artery (AAA) canal can be diagnosed both in corresponding panoramic radiography (PR) and cone-beam computed tomography (CBCT).

Methods

A total of 335 patients with 635 sites and corresponding maxillary sinus in both PR and CBCT were selected and examined for AAA canal visibility.

Results

The visibility of the AAA canal was significantly higher in CBCT than in PR. A total of 154 (46.0%) AAA canals could be identified in the maxillary sinus on the right. However, only four (1.2%) of these were also visible in PR. The detected values of the AAA canals in the maxillary sinus on the left in the PR and CBCT images were similar to those of the right. While 164 AAA canals (49%) were observed in CBCT images, only 1 (0.3%) was identifiable in PR.

Conclusions

The results show that CBCT can be recommended for visualising the AAA canal when surgically planning sinus augmentation procedures.

Graphical Abstract
Comparison of therapeutic strategies for aortic stenosis between transcatheter and surgical aortic valve implantation: a retrospective cohort study in Japanese dialysis patients
Authors: Sakai Masahiro , Hayashi Koichi , Hara Yuki , Miyake Akihiro , Takano Keisuke , Hirai Taro , Kobayashi Michi , Endo Keita , Yoshino Kaede , Kitamura Koichi , Ito Shinsuke , Ikeda Tatsuya , Suzuki Yasuhiro , Ito Joji , Obunai Kotaro , Watanabe Hiroyuki , Suzuki Toshihiko
Published: September 2023

Background

Although transcatheter aortic valve implantation (TAVI) is assumed to be a less invasive therapy in high-risk patients with aortic valve stenosis (AS), there have been limited data suggesting its beneficial effects on cardiovascular mortality in Japanese patients receiving dialysis therapy.

Methods

Hemodialysis patients with severe AS underwent either TAVI (n = 33) or surgical aortic valve replacement (SAVR, n = 25). We compared the postoperative outcomes and perioperative complications, including dialysis-associated parameters [e.g., intradialytic hypotension (IDH)], between TAVI and SAVR.

Results

A 30-day and 1-year mortality rate was nearly the same among the TAVI and the SAVR group. Incidence of permanent pacemaker implantation or other events, including stroke, bleeding and vascular complications, in the TAVI group were not different from those in SAVR patients during the 30-day or 1-year postoperative period. The incidence of IDH was increased following SAVR (odds ratio (OR) = 11.29 [95% CI 1.29–98.89]) but was not affected by TAVI (OR = 1.55 [95% CI 0.24–9.94]). Among the patients aged 75 or older, the incidence of IDH was particularly conspicuous in the SAVR group (OR = 15.75 [95% CI 2.30–107.93]). Because there were differences in background data (age, EuroSCORE II, and dialysis duration) between these groups, propensity score-matched analysis was conducted and showed no difference in the composite event-free probability between the TAVI and the SAVR group over one year (p = 0.816).

Conclusions

TAVI offers an alternative strategy to Japanese hemodialysis patients with severe AS, with nearly the same incidence of complications as SAVR during 1-year observation.
Management of Var sources for the reactive power planning problem by oppositional Harris Hawk optimizer
Authors: G Swetha Shekarappa , Mahapatra Sheila , Raj Saurav
Published: September 2023

Reactive power management has grown more crucial for increased synchronization in modern power systems, since transmission loss minimization is a basic condition for secure power system operation. This paper proposes the Oppositional-based Harris Hawk Optimizer technique as an advanced meta-heuristic nature inspired methodology, which is applied on the conventional Ward Hale 6 bus system and the IEEE 30 bus system. The solution space is further altered by combining HHO with the Oppositional Based Learning technique in order to enhance approximation for the current solution. The suggested OHHO outperforms HHO as well as other optimization methodologies recently published articles, according to simulation results obtained on typical test systems.
Do corporate values have value? The impact of corporate values on financial performance
Authors: Taher Ahmed
Published: September 2023

Do corporate values affect financial performance? The observed corporate values of the Fortune Global 500 companies were inductively clustered under key attributes, and then, the attributes were grouped under value orientations. The variables used to measure financial performance were given by Fortune 500 report. Finally, the research developed and tested a new model that explored if and how the declared corporate value orientations impacted the financial performance of their organizations. The model showed that all values indirectly affected income and operational performance through human values. The paper reconciled and explained inconsistent findings in the literature over decades, redefined corporate values, and established their impact on financial performance when human values are implemented. The attention to human values is the key to harnessing the positive impact of visionary, ethical, work, and customer-oriented values.
Homicide in the context of psychosis: analysis of prior service utilisation and age at onset of illness and violence
Authors: Penney Stephanie R. , Lam Austin A. , Kolla Nathan , Martin Krystle , Belfry Kimberly , Simpson Alexander I. F.
Published: September 2023

Background

Public stigma and fear are heightened in cases of extreme violence perpetrated by persons with serious mental illness (SMI). Prevention efforts require understanding of illness patterns and treatment needs prior to these events unfolding.

Aims

To examine mental health service utilisation by persons who committed homicide and entered into forensic care, to investigate the adequacy of mental healthcare preceding these offences.

Method

Forensic patients across two mental health hospitals in Ontario with an admitting offence of homicide between 2011 and 2021 were identified (n = 112). Sociodemographic, clinical and offence-related variables were coded from the health record and reports prepared for the forensic tribunal.

Results

Most patients (75.7%) had mental health contacts preceding the homicide, with 28.4% having a psychiatric in-patient admission in the year prior. For those with service contacts in the year preceding, 50.9% had had only sporadic contact and 70.7% were non-adherent with prescribed medications. Victims were commonly known to the individual (35.7%) and were often family members in care-providing roles (55.4%). Examination of age at onset of illness and offending patterns suggested that most persons admitted to forensic care for homicide act in the context of illness and exhibit a low frequency of pre-homicide offending.

Conclusions

Many individuals admitted to forensic care for homicide have had inadequate mental healthcare leading up to this point. Effective responses to reduce and manage risk should encompass services that proactively address illness-related (e.g. earlier access and better maintenance in care) and criminogenic (e.g. substance use treatment, employment and psychosocial supports) domains.
Feasibility and Clinical Acceptability of Automation-Assisted 3D Conformal Radiotherapy Planning for Patients With Cervical Cancer in a Resource-Constrained Setting
Authors: Muya Sikudhani , Ndumbalo Jerry , Kutika Nyagabona Sarah , Yusuf Shaid , Rhee Dong Joo , Mushi Beatrice Paul , Li Benjamin , Zhang Li , Grover Surbhi , Feng Mary , Hsu I-Chow , Mmbaga Elia , Van Loon Katherine , Court Laurence , Xu Melody
Published: September 2023

Automation may enable high-quality cervical cancer radiation on shorter treatment planning timelines.
The History of the Cytoplasmic Elements during Vitellogenesis in Drosophila melanogaster
Authors: HSU W. SIANG
Published: September 2023

At least two kinds of yolk are developed in the eggs of Drosophila melanogaster. The origin of the proteid yolk has been traced to precursors sent into the oocyte by the nurse cells, while the minute fatty yolk granules are transformed chondriomites also contributed by the nurses. The behaviour and morphology of Golgi material in the nurses indicate that it may be responsible for a third type of yolk. A yolk nucleus has been found in oocytes of an age when the germinal disk has been pushed to one side. So long as such a structure exists, all the proteid yolk precursors are concentrated and matured within its confine. Soon this structure disintegrates and disappears. But after its disappearance, yolk precursors continue to be sent by the nurses into the oocyte, and there they develop into mature granules apparently without the benefit of a yolk nucleus. On the basis of facts thus far obtained, it is, therefore, difficult to say just what role the so-called yolk nucleus plays in vitellogenesis in Drosophila melanogaster. Golgi material in the nurse cells has been observed to undergo two distinct proliferations. In young nurses, Golgi material occurs in a few discrete bits which, as the nurses grow in size, proliferate into a large number of intertwining threads so arranged as to suggest a net. Then follows a period in which only very few minute granules of Golgi material can be seen. This is definitely a period of scarcity. After this, a second proliferation takes place. This one is carried to such an extreme extent that the cytoplasm of the cells is just black with Golgi material. The Golgi threads, arranged more or less in a parallel fashion and very closely together, present the appearance of pieces of Golgi ‘tissue’. Next, the pieces of ‘tissue’ loosen up into separate threads from which individual Golgi granules arise. These granules enlarge to become vesicles. In the course of development of the nurse cells, the mitochondria also undergo a proliferation. Finally, the chondrioconts break up into granules which enlarge and eventually all transform into droplets of unsaturated fat. My observations point to the conclusion that the oocyte depends upon its nurses for the production of fatty yolk. Proteid yolk granules, however, are developed within the oocyte, though from precursors sent in also by the nurse cells. The follicular cells do not appear to contribute anything to vitellogenesis in Drosophila. An idiosome-like granule has been observed in oogonia, and also in oocytes up to a certain stage of development. For reasons stated elsewhere, it cannot be regarded as an idiosome nor as a centrosome. This structure has not been observed in nurse cells.
Software-defined networking strategies for efficient next-generation applications
Authors: Καλαφατίδης Σαράντης
Published: September 2023

Οι Διαδικτυακές Εφαρμογές Επόμενης Γενιάς (Next-generation Internet Applications, NIA), όπως εφαρμογές του Διαδικτύου των Πραγμάτων (ΙοΤ) και οι εφαρμογές πολυμέσων (π.χ., εικονική πραγματικότητα), παρέχουν την τεχνολογική βάση και τις δυνατότητες που απαιτούνται για τον ψηφιακό μετασχηματισμό σε διάφορους τομείς της οικονομίας. Συνεπώς, με την ευρεία υιοθέτηση αυτών των εφαρμογών οι δικτυακές απαιτήσεις αυξάνονται σημαντικά, π.χ. οι NIA συχνά απαιτούν εξαιρετικά χαμηλή καθυστέρηση για γρήγορη λήψη αποφάσεων, και υψηλή απόδοση για τη μεταφορά μεγάλου όγκου δεδομένων. Σε αυτή τη διατριβή, εστιάζουμε στην ανάπτυξη δικτυακών στρατηγικών για τη βελτίωση της απόδοσης δύο συγκεκριμένων τύπων NIA: (i) εφαρμογές του Διαδικτύου των Πραγμάτων και (ii) εφαρμογές που παρέχονται στο υπολογιστικό νέφος. Η παρούσα διατριβή, επικεντρώνει σε δύο κύρια δικτυακά περιβάλλοντα που απαιτούν προσαρμοστικότητα για την κάλυψη των αναγκών των προαναφερθεισών NIA: (i) μεγάλης κλίμακας ασύρματες αναπτύξεις IoT (π.χ., έξυπνες πόλεις) και (ii) περιβάλλοντα υπολογιστικού νέφους που φιλοξενούν εφαρμογές βασισμένες σε μικροϋπηρεσίες με ετερογενείς απαιτήσεις για υπολογιστικούς πόρους. Σε αυτό το πλαίσιο, ερευνούμε τα πιθανά πλεονεκτήματα που προκύπτουν από τη συνέργεια του: (i) υπολογιστικού νέφους, (ii) των προγραμματιζόμενων δικτύων (Sofrware-Defined Networks, SDN), (iii) της δικτύωσης που βασίζεται σε ονοματοποιημένα δεδομένα (Named-Data Networking, NDN) και (iv) της αρχιτεκτονικής των μικροϋπηρεσιών, στοχεύοντας τη βελτίωση της απόδοσης των NIA μέσω αποτελεσματικής διαχείρισης της κυκλοφορίας. Επίσης, υποστηρίζουμε ότι η δυνατότητα του κεντροποιημένου ελέγχου των SDN είναι κατάλληλη λύση για την ενσωμάτωση των προαναφερθέντων τεχνολογιών επιτρέποντας τη δημιουργία ενός εξαιρετικά προσαρμοστικού δικτυακού οικοσυστήματος. Εστιάζουμε σε τρεις βασικούς άξονες: (i) στη βελτίωση της προσαρμοστικότητας των εφαρμογών IoT που παρέχονται πάνω από δίκτυα ασύρματου πλέγματος, για τη διασφάλιση συνεπούς και αξιόπιστης επικοινωνίας, (ii) στην εφαρμογή εξισορρόπησης φορτίου που προσαρμόζεται στο είδος των μικροϋπηρεσιών, η οποία υλοποιεί αποτελεσματική κατανομή και αξιοποίηση πόρων, επιτρέποντας στις εφαρμογές να ανταποκρίνονται σε μεγαλύτερο αριθμό ταυτόχρονων αιτημάτων χωρίς περιορισμούς στην απόδοση, και (iii) στην πρόβλεψη του αντίκτυπου των μικροϋπηρεσιών στους πόρους, υποστηρίζοντας έτσι τις αποφάσεις των μηχανισμών ελέγχου της κατανομής πόρων. Προκειμένου να αντιμετωπιστούν οι προαναφερθείσες προκλήσεις, η έρευνα περιλαμβάνει την ανάπτυξη και αξιολόγηση πραγματικών εφαρμογών και SDN δικτυακών περιβαλλόντων, συμπεριλαμβανομένου και του πειραματισμού σε πραγματικά δίκτυα ασύρματου πλέγματος. Ο στόχος είναι να προωθηθεί ένα πλαίσιο όπου οι NIA θα μπορούν να επιδείξουν μεγαλύτερη απόδοση και αποτελεσματικότερη κατανομή πόρων, προσαρμόζοντας ‘τες στις δυναμικές συνθήκες του εκάστοτε δικτυακού περιβάλλοντος.
Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District
Authors: Ajankar Vaishnavi V. , Mude Gaurav
Published: September 2023

Background:Due to a lack of knowledge about risk factors and symptoms lung cancer is often found at later stages. A total of 19.3 million new cancer cases were recorded last year and resulted in nearly 10 million fatalities. The aim of this study is to evaluate the level of awareness among the general population about lung cancer, its risk factor, symptoms, and available screening methods, as well as to assess the attitude toward screening practice for early detection among a common population in the Wardha district.

Protocol:This study focuses on assessing the level of awareness of lung cancer in Wardha district. It is an observational cross-sectional study design that will be conducted using a standardized questionnaire. The study aims to recruit 400 subjects, both male and female, aged between 18 and 65 years old, from various communities. The participant should be capable of providing informed consent and responding to the survey question. Age, sex, educational level, occupation this are the variable. Participants will be randomly selected from different communities in Wardha district. A structured questionnaire will be administered to collect data on awareness, attitudes, knowledge, and other relevant variables. Chi-squared test will be used to explore associations between awareness, attitudes, and demographic variables (e.g., age, sex, education).

Conclusions:It is hoped that this study will encourage people to participate in screening programs in order to detect cancer at early stages and lead to better treatment outcomes.