bluuebunny/crossref_metadata_2025 huggingface dataset:
The Loki Equipment Exercise Part 2: Crisis Management
Authors: Romney Alexander C. , Hartwell Christopher J. , Harrison Jake T. , Pound Mitchell
Published: May 2022

We present a case-based role-play exercise that effectively simulates a crisis students must manage. In the exercise, a farm equipment manufacturing company has decided to redirect its product line, and this change requires laying off a significant portion of its workforce. Students must grapple with the fact that a local news report will be released soon to inform the public about the company’s plans, possibly before the company’s employees learn about them. Students assume one of five roles in the executive team and discuss how to resolve the crisis. The objective of the exercise is to help students learn ways to lead in an organizational crisis. To meet this objective, we discuss how instructors can implement and debrief the exercise. This exercise was designed as the second in a two-part series (the first part focusing on organizational change), but it can also be used as a stand-alone exercise.
Protestant Missionaries and Humanitarianism in the DRC: The Politics of Aid in Cold War Africa
Authors: Baker Dwight P.
Published: May 2022

Organizations, including missionary NGOs, have both an inside and an outside: external circumstances and pressures to which they react, as well as core values that define them and guide, even impel, their actions. In Protestant Missionaries and Humanitarianism in the DRC, Jeremy Rich provides a longitudinal study of the Congo Protestant Relief Agency, a mission-sponsored humanitarian NGO. He documents both the extraordinary pressures within which the CPRA operated and the revisions the CPRA made, over the course of a half century, to its original focus in order to continue to address critical human needs.
Congregation for the Evangelization of Peoples: Four Hundred Years in the Service of the Missionary World
Authors: Rostkowski Marek Adam
Published: May 2022

The Congregation for the Evangelization of Peoples, commonly called Propaganda Fide, turned four hundred years old on January 6, 2022. Here we try to answer three fundamental questions about the Congregation: Why? For what purpose? Has it succeeded in reaching its objectives? We present here only the highlights of the history and activity of this organ of the Holy See in the service of the missionary world, including its coordination of the work of evangelization, missionary formation, and missionary cooperation.
Sites of conscience redressing disability institutional violence
Authors: Steele Linda
Published: May 2022

Australian victim-survivors of disability institutional violence have been unable to obtain public recognition and justice through conventional court-based processes and legal remedies. Redressing or ‘setting right’ the ongoing and structural phenomenon of disability institutional violence requires a new approach. This article introduces one dimension that might form part of such an approach: re-engaging through sites of conscience practices with former disability institutions. Sites of conscience practices engage the broader community in memories and histories of places of injustice in order to prompt collective action to prevent further injustice through broader social and legal change. The article proposes that through sites of conscience practices former disability institutions in Australia can be part of how we collectively recognise and ‘set right’ disability institutional violence. The article begins by explaining the approach to ‘disability institutions', ‘disability institutional violence’ and ‘redress'. Next, the article uses the example of Peat and Milson Island Hospital (New South Wales, Australia) to discuss how former disability institutions – through demolition/dereliction, repurposing or redevelopment – might sustain disability institutional violence. The article then introduces the concept of ‘sites of conscience’ and presents examples of sites of conscience practices in relation to former disability institutions across United States, Canada, United Kingdom and Denmark. Reflecting on these examples, the article makes preliminary suggestions of how we might re-position engagement with the memories, places and materiality of former disability institutions as integral to redressing disability institutional violence in Australia.
Multi-morbidity and patient-reported functional limitations: a population-based cohort study
Authors: Chamberlain Alanna M , St Sauver Jennifer L , Boyd Cynthia M , Finney Rutten Lila J , Fan Chun , Jacobson Debra J , Rocca Walter A
Published: May 2022

Background

Persons who accumulate chronic conditions at a rate faster than their peers may experience accelerated aging and poor health outcomes, including functional limitations.

Methods

Adults aged ≥40 years who resided in Olmsted County, Minnesota on 1 January 2006 were identified. The prevalence of 21 chronic conditions was ascertained, and age-specific quartiles of the number of chronic conditions was estimated within 4 age groups: 40–54, 55–64, 65–74, and ≥75 years. Difficulty with nine patient-reported functional limitations (including basic and instrumental activities of daily living and mobility activities) were ascertained through 31 October 2018. Cox regression was used to model associations of chronic condition quartiles with new-onset functional limitations considered separately. We estimated absolute risk differences and hazard ratios stratified by age group, and adjusted for sex, race, ethnicity, marital status, education, and the residual effect of age.

Results

Among 39,624 persons (44.5% men, 93.2% white), the most common reported new functional limitations were difficulty with climbing stairs, walking, and housekeeping. For all functional limitations, the absolute risk differences were largest among the oldest age group (≥75 years). Approximately twofold increased hazard ratios were observed among those in the highest vs. lowest quartile for the three oldest age groups, and approximately threefold or higher hazard ratios were observed for persons aged 40-54 years.

Conclusion

Persons with increased accumulation of chronic conditions experience increased risks of developing functional limitations compared to their peers. These findings underscore the importance of assessing health status and of employing interventions to prevent and effectively manage multi-morbidity at all ages.
Examining Rural School Implementation of Positive Behavioral Supports Across Tiers
Authors: Chaparro Erin A. , Kittelman Angus , McDaniel Sara C. , Peshak George Heather , VanLone Janet , So SoLing
Published: May 2022

Positive Behavioral Interventions and Supports (PBIS) is a prevention-oriented multitiered system of support. In this article, we discuss how PBIS implementation might be different for schools in rural settings. We used two subsamples of an extant data set of 11,561 schools in 44 U.S. states reporting on PBIS implementation fidelity during the 2018-19 school year. We examined PBIS implementation in rural and nonrural settings using a subsample of 6,631 schools during their first five years of PBIS implementation (2014-15 to 2018-19 school years). Further, we used a subsample of 2,266 schools to examine differences in implementation for rural schools, specifically ( n = 1,215) in their first five years of PBIS implementation (2014-15 to 2018-19) compared to rural schools ( n = 1,051) implementing six or more years (2000-01 to 2013-14). Rural schools differ from other school locales in the implementation of Tiers 2 and 3 systems during initial implementation. When examining the implementation in rural schools implementing PBIS for five or fewer years to those implementing for six years or more, those implementing longer had higher scores at Tiers 2 and 3. Practical implications across all three tiers, special education, and rural locales are presented.
Nickolayite, FeMoP, a new natural molybdenum phosphide
Authors: Murashko Mikhail N. , Britvin Sergey N. , Vapnik Yevgeny , Polekhovsky Yury S. , Shilovskikh Vladimir V. , Zaitsev Anatoly N. , Vereshchagin Oleg S.
Published: May 2022

Nickolayite, FeMoP, is a new terrestrial phosphide structurally related to allabogdanite (high-pressure modification of (Fe,Ni)2P), and the meteoritic phosphides florenskyite, FeTiP and andreyivanovite, FeCrP. From the point of view of chemical composition, nickolayite is an Fe-analogue of monipite, MoNiP. The mineral was discovered in the Daba-Siwaqa complex, Central Jordan, a part of the pyrometamorphic Hatrurim Formation (the Mottled Zone), whose outcrops encompass a 150 × 200 km area around the Dead Sea in the Middle East. Nickolayite appears as an accessory phase in the fused clinopyroxene–plagioclase rocks texturally resembling gabbro–dolerite. The irregularly shaped grains of the mineral, up to 80 μm in size are associated with baryte, tridymite, chromite, hematite, pyrrhotite, fluorapatite, titanite and powellite. Macroscopically, nickolayite grains possess light-grey to greyish-white colour and metallic lustre. The mineral is ductile. The mean VHN hardness (50 g load) is 538 kg mm–2. The calculated density based on the empirical formula and the unit-cell parameters is 7.819 g cm–1. In reflected light, nickolayite has a white colour, with no bireflectance or pleochroism. The COM approved reflectance values [Rmax/Rmin(%), λ(nm)] are: 48.5/46.5 (470), 50.5/48.5 (546), 51.8/49.9 (589) and 53.9/52.0 (650). The chemical composition of the holotype crystal is (electron microprobe, average of 4 analyses, wt.%): Fe 32.21, Mo 47.06, Ni 3.69, Co 0.13, P 17.45, total 100.54, that corresponds to the empirical formula Fe1.00(Mo0.87Ni0.11Fe0.02)Σ1.00P1.00and an ideal formula of FeMoP. Nickolayite is orthorhombic, space groupPnma, unit-cell parameters of holotype material are:a= 5.9519(5),b= 3.7070(3),c= 6.8465(6) Å,V= 151.06(2) Å3andZ= 4. The crystal structure of holotype material was solved and refined toR1= 0.0174 based on 251 unique observed reflections. The origin of the mineral is probably connected to the processes of co-reduction of molybdenum- and phosphorus-bearing minerals during high-temperature pyrometamorphic processes.
Modeling cancer immunoediting in tumor microenvironment with system characterization through the ising-model Hamiltonian
Authors: Rojas-Domínguez Alfonso , Arroyo-Duarte Renato , Rincón-Vieyra Fernando , Alvarado-Mentado Matías
Published: May 2022

Background and objective

Cancer Immunoediting (CI) describes the cellular-level interaction between tumor cells and the Immune System (IS) that takes place in the Tumor Micro-Environment (TME). CI is a highly dynamic and complex process comprising three distinct phases (Elimination, Equilibrium and Escape) wherein the IS can both protect against cancer development as well as, over time, promote the appearance of tumors with reduced immunogenicity. Herein we present an agent-based model for the simulation of CI in the TME, with the objective of promoting the understanding of this process.

Methods

Our model includes agents for tumor cells and for elements of the IS. The actions of these agents are governed by probabilistic rules, and agent recruitment (including cancer growth) is modeled via logistic functions. The system is formalized as an analogue of the Ising model from statistical mechanics to facilitate its analysis. The model was implemented in the Netlogo modeling environment and simulations were performed to verify, illustrate and characterize its operation.

Results

A main result from our simulations is the generation of emergent behavior in silico that is very difficult to observe directly in vivo or even in vitro. Our model is capable of generating the three phases of CI; it requires only a couple of control parameters and is robust to these. We demonstrate how our simulated system can be characterized through the Ising-model energy function, or Hamiltonian, which captures the “energy” involved in the interaction between agents and presents it in clear and distinct patterns for the different phases of CI.

Conclusions

The presented model is very flexible and robust, captures well the behaviors of the target system and can be easily extended to incorporate more variables such as those pertaining to different anti-cancer therapies. System characterization via the Ising-model Hamiltonian is a novel and powerful tool for a better understanding of CI and the development of more effective treatments. Since data of CI at the cellular level is very hard to procure, our hope is that tools such as this may be adopted to shed light on CI and related developing theories.
Neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections during pregnancy: a national prospective study in Kuwait
Authors: Ayed Mariam , Embaireeg Alia , Kartam Mais , More Kiran , Alqallaf Mafaza , AlNafisi Abdullah , Alsaffar Zainab , Bahzad Zainab , Buhamad Yasmeen , Alsayegh Haneen , Al-Fouzan Wadha , Alkandari Hessa
Published: May 2022

Background

An increasing proportion of women are infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Intrauterine viral infections induce an increase in the levels of proinflammatory cytokines, which inhibit the proliferation of neuronal precursor cells and stimulate oligodendrocyte cell death, leading to abnormal neurodevelopment. Whether a maternal cytokine storm can affect neonatal brain development is unclear. The objective of the present study was to assess neurodevelopmental outcomes in neonates born to mothers with SARS-CoV-2 infections during pregnancy.

Methods

In this prospective cohort study, the neurodevelopmental status of infants (N = 298) born to women with SARS-CoV-2 infections during pregnancy was assessed at 10–12 months post-discharge using the Ages and Stages Questionnaire, 3rd edition (ASQ-3). The ASQ-3 scores were classified into developmental delays (cutoff scores ≤ 2 standard deviations (SDs) below the population mean) and no delays (scores > 2 SDs above the population mean).

Results

The majority (90%) of the infants born to mothers with SARS-CoV-2 infections during pregnancy had favorable outcomes and only 10% showed developmental delays. Two of the 298 infants tested positive for SARS-CoV-2, and both had normal ASQ-3 scores. The majority of the pregnant women had SARS-CoV-2 infections during their third trimester. The risk of developmental delays among infants was higher in those whose mothers had SARS-CoV-2 infections during the first (P = 0.039) and second trimesters (P = 0.001) than in those whose mothers had SARS-CoV-2 infections during the third trimester.

Conclusion

The neurodevelopmental outcomes of infants born to mothers with SARS-CoV-2 infections seem favorable. However, more studies with larger sample sizes and longer follow-up periods are required.
Regional estimates of noncommunicable diseases associated risk factors among adults in India: results from National Noncommunicable Disease Monitoring Survey
Authors: Ramamoorthy Thilagavathi , Leburu Sravya , Kulothungan Vaitheeswaran , Mathur Prashant
Published: May 2022

Background

This study describes regional differences and determinants on key noncommunicable disease (NCD) risk factors in adults from the National NCD Monitoring Survey (NNMS) across six geographic regions of India.

Methods

The NNMS was a cross-sectional multistage cluster survey conducted in 2017–18, on a representative sample of 300 urban and 300 rural primary sampling units (PSU) covering 20 households per PSU. One adult aged 18–69 years per household was selected using the KISH grid. Globally standard survey tools were adapted for data collection. To arrive at regional estimates, the country was divided into six regions (south, north, central, west, east and northeast) based on the distribution of a national sample. The results are presented as proportion with 95% confidence intervals (CI). Univariable and multivariable logistic regression analyses were performed to identify NCD risk factor determinants significant in the regions. A p-value < 0.05 was considered for statistical significance.

Results

The overall survey response rate was 96.3%. The prevalence of current tobacco (45.7%) and alcohol use (22.3%) was significantly high in the northeast region. The highest proportion of adults from northern India showed low levels of physical activity (49.6%). The prevalence of metabolic risk factors — obesity (12.5%), raised fasting blood glucose (21.2%) and raised blood pressure (35.6%) was highest in south India. The prevalence of raised blood pressure was high in north India (35.2%) similar in proportion to south India. Clustering of ≥3 risk factors (50.1%) and ten-year CVD risk of ≥30% or with existing CVD (18.1%) was highest in south India when compared to other regions. Older age, urban residents, alcohol consumption and overweight/obesity were significantly associated with higher odds of raised blood pressure and raised fasting blood glucose.

Conclusion

The NNMS presents variations in NCD risk factors within the regions of India. It contributes to robust evidence for strengthening interventions and monitoring the progress in reducing NCDs and their associated risk factors.
Chronic spontaneous epidural hematoma in the lumbar spine with cauda equina syndrome and severe vertebral scalloping mimicking a spinal tumor: a case report
Authors: Fukatsu Shusaku , Ogihara Satoshi , Imada Hiroki , Ikemune Satoshi , Tamaru Jun-Ichi , Saita Kazuo
Published: May 2022

Background

Chronic spinal epidural hematomas (SEHs) are rare clinical entities. SEH with vertebral scalloping is extremely rare, with only a few cases having been reported to date. We report a unique case of spontaneous chronic SEH in the lumbar spine with severe vertebral scalloping mimicking an epidural tumor.

Case presentation

A 71-year-old man presented with a 2-month history of lumbar pain and a 3-week history of paresthesia and pain in the right lower extremity, hypesthesia in the perineal and perianal regions, and bladder dysfunction. Computed tomography following myelography revealed an epidural mass lesion on the right side that compressed the dural sac and was associated with severe bony scalloping on the posterior wall of the L4 vertebral body. Magnetic resonance imaging (MRI) on T1- and T2-weighted images revealed a space-occupying lesion with heterogeneous intensity, and T1-gadolinium images showed an intralesional heterogeneous enhancement effect. A tumoral lesion in the spinal canal was suspected, based on preoperative imaging; therefore, a total spinal tumor resection was planned. Intraoperative findings revealed that the brownish lesion adhered to the dura and epidural tissues in the spinal canal, and the space-occupying mass in the scalloped cavity of the posterior wall of the L4 vertebra was encapsulated in red-brownish soft tissues. The lesion was totally resected in a piecemeal fashion, and pathological examination revealed a mixture of tissues that contained a relatively new hematoma with hemoglobin, as well as an obsolete hematoma with hemosiderin and amyloid deposits. The mass was diagnosed as a chronic epidural hematoma with recurrent hemorrhage. The postoperative course was uneventful, and the preoperative neurological symptoms immediately improved.

Conclusions

The preoperative diagnosis of chronic SEHs is challenging, as MRI results may not be conclusive, particularly in patients with scalloping of bony structures. Thus, chronic SEHs should be considered as a differential diagnosis in cases of suspected tumoral lesions in the spinal canal. To the best of our knowledge, this is the first reported case of acute exacerbation of chronic SEH with cauda equina syndrome and severe vertebral scalloping.
Development of convolutional neural network model for diagnosing meniscus tear using magnetic resonance image
Authors: Shin Hyunkwang , Choi Gyu Sang , Shon Oog-Jin , Kim Gi Beom , Chang Min Cheol
Published: May 2022

Background

Deep learning (DL) is an advanced machine learning approach used in diverse areas, such as image analysis, bioinformatics, and natural language processing. A convolutional neural network (CNN) is a representative DL model that is advantageous for image recognition and classification. In this study, we aimed to develop a CNN to detect meniscal tears and classify tear types using coronal and sagittal magnetic resonance (MR) images of each patient.

Methods

We retrospectively collected 599 cases (medial meniscus tear = 384, lateral meniscus tear = 167, and medial and lateral meniscus tear = 48) of knee MR images from patients with meniscal tears and 449 cases of knee MR images from patients without meniscal tears. To develop the DL model for evaluating the presence of meniscal tears, all the collected knee MR images of 1048 cases were used. To develop the DL model for evaluating the type of meniscal tear, 538 cases with meniscal tears (horizontal tear = 268, complex tear = 147, radial tear = 48, and longitudinal tear = 75) and 449 cases without meniscal tears were used. Additionally, a CNN algorithm was used. To measure the model’s performance, 70% of the included data were randomly assigned to the training set, and the remaining 30% were assigned to the test set.

Results

The area under the curves (AUCs) of our model were 0.889, 0.817, and 0.924 for medial meniscal tears, lateral meniscal tears, and medial and lateral meniscal tears, respectively. The AUCs of the horizontal, complex, radial, and longitudinal tears were 0.761, 0.850, 0.601, and 0.858, respectively.

Conclusion

Our study showed that the CNN model has the potential to be used in diagnosing the presence of meniscal tears and differentiating the types of meniscal tears.
The mechanism by which enoxaparin sodium–high-viscosity bone cement reduces thrombosis by regulating CD40 expression in endothelial cells
Authors: Sang Linchao , Hao Kangning , Ding Luobin , Shen Xiaoyu , Sun Hui , Fu Dehao , Qi Xiangbei
Published: May 2022

Objective

PMMA bone cement leads to the development of local thrombi. Our study found that ES-PMMA bone cement, a novel material, can reduce local thrombosis. We used a simple and reproducible animal model to confirm the reduction in local thrombosis and preliminarily explored the associated molecular mechanism.

Methods

New Zealand rabbits, which were used to model thrombosis using extracorporeal carotid artery shunts, were divided into the following three groups, with 10 rabbits in each group: the sham group, PMMA group and ES-PMMA group. Four hours after modelling, experimental samples were collected, and the degree of thrombosis was compared between the groups. The expression of thrombomodulin in endothelial cells was quantified in vascular tissues samples.

Results

Thrombosis was observed in the PMMA group and ES-PMMA group but not in the sham group. The thrombosis weight was 0.00732 ± 0.00089 g/cm in the PMMA group and 0.00554 ± 0.00077 g/cm in the ES-PMMA group (P < 0.001). Quantitative real-time polymerase chain reaction (RT–qPCR) and Western blotting revealed that the expression of CD40, which can regulate thrombosis in vascular endothelial cells, was significantly lower in the ES-PMMA group than in the PMMA group.

Conclusion

Compared with PMMA bone cement, ES-PMMA bone cement can reduce local thrombosis by decreasing the expression of the thrombus-associated regulatory protein CD40 in vascular endothelial cells.
Evaluation of implementation and effectiveness of neck-specific exercise for persistent disability and pain after whiplash injury: study protocol for a randomized controlled study using a hybrid 2 design
Authors: Peterson Gunnel , Carlfjord Siw , Nilsing Strid Emma , Ask Sofia , Jönsson Margaretha , Peolsson Anneli
Published: May 2022

Background

Persistent pain and disability in whiplash-associated disorders (WAD) grades II and III are common. In two randomized controlled trials (RCTs) of neck-specific exercises (NSE), we have seen promising results in chronic WAD, with a sustained clinically important reduction in pain and disability. NSE can also be delivered through internet support (NSEIT) and a few visits to a physiotherapist, saving time and cost for both patients and providers. NSE have been shown to have positive effects in other neck pain disorders and we will evaluate the diffusion of the exercises to other patients. The aims of the proposed study are to evaluate an implementation strategy for NSEIT and NSE in primary health care and to evaluate the effectiveness of NSEIT and NSE in clinical practice.

Methods

The proposed study is a prospective cluster-randomized mixed-design study with hybrid 2 trial design. Reg. physiotherapists working in twenty physiotherapy clinics will be included. The primary implementation outcome is proportion of patients with neck pain receiving neck-specific exercise. Secondary outcomes are; physiotherapists attitudes to implementation of evidence-based practice, their self-efficacy and confidence in performing NSEIT/NSE, number of patients visits, and use of additional or other exercises or treatment. To further evaluate the implementation strategy, two qualitative studies will be performed with a sample of the physiotherapists. The primary outcome in the patient effectiveness evaluation is self-reported neck disability according to the Neck Disability Index (NDI). Secondary outcomes are pain intensity in the neck, arm, and head; dizziness; work- and health-related issues; and patient’s improvement or deterioration over time. All measurements will be conducted at baseline and at 3 and 12 months. Physiotherapists´ self-efficacy and confidence in diagnosing and treating patients with neck pain will also be evaluated directly after their instruction in NSEIT/NSE.

Discussion

This trial will evaluate the implementation strategy in terms of adoption of and adherence to NSEIT and NSE in clinical primary health care, and measure diffusion of the method to other patients. In parallel, the effectiveness of the method will be evaluated. The results may guide physiotherapists and health care providers to sustainable and effective implementation of effective exercise programs.

Trial registration

The randomized trial is registered on ClinicalTrials.gov, NCT05198258, initial release date January 20, 2022.
Learning curve for the acquisition of 20 standard two-dimensional images in advanced perioperative transesophageal echocardiography: a prospective observational study
Authors: Sawasdiwipachai Prasert , Thanasriphakdeekul Sasithorn , Raksamani Kasana , Vacharaksa Kamheang , Chaithiraphan Vithaya
Published: May 2022

Background

Learning to perform intraoperative transesophageal echocardiography takes time and practice. We aimed to determine the cumulative success rate in the first 20 intraoperative transesophageal echocardiography cases performed by trainee anesthesiologists with no transesophageal echocardiography experience.

Methods

This prospective observational study included nine anesthesiologists (four cardiovascular and thoracic anesthesia fellows and five short-course perioperative intraoperative transesophageal echocardiography trainees). Overall, 180 studies self-performed by the trainees were reviewed by certified reviewers. A study was considered successful when at least 15 qualified images were collected within 30 min. The cumulative success of each trainee was used as a surrogate of a basic two-dimensional intraoperative transesophageal echocardiography learning curve.

Results

The participants comprised three male and six female anesthesiologists aged 29–43 years with 2–13 years of work experience. Most studies (146/180, 81.11%) were completed within 30 min, and the cumulative success rate was 70–90% (average 82.78 ± 6.71%). The average cumulative success rate in the short-course group (85 ± 7.07%) was higher than that in the official cardiovascular and thoracic fellow trainee group (80 ± 7.07%). The recommended caseload for a 80–100% success rate was 18–20 cases (95% confidence interval, 0.652–0.973). The CUSUM method analysis confirmed that the lower decision limit was crossed after 20 TEE studies among those achieved competence.

Conclusions

We recommended a 18–20 caseload for a target success rate of 80–100% in studies performed by trainees with no previous experience. Our findings will enable the development of programs to train anesthesiologists in intraoperative transesophageal echocardiography.
Psychometric properties and measurement invariance of Short-Form Life Attitude Inventory for hospital staff
Authors: Chou Kang-Ju , Cheng Ying-Yao , Fang Hua-Chang , Wu Fu-Zong , Lin Pei-Chin , Tsai Chun-Teng
Published: May 2022

Background

The life attitude of health care workers can deeply influence the quality of care. Examining the performance of the Short-Form Life Attitude Inventory (SF-LAI), this study analyzes the factorial structure, reliability, and invariance of the revised SF-LAI across genders and professions among the staff of a teaching medical center.

Methods

The SF-LAI was developed for university students in Taiwan. From January to February 2019, we administered a cross-sectional survey of life attitudes by distributing the SF-LAI to all staff members of a medical center in Taiwan. The construct validity was evaluated using a confirmatory factor analysis (CFA). Model fit was assessed in terms of the comparative fit index (CFI), Tucker–Lewis index (TFI), standardized root mean square residual (SRMR), and root mean square of error of approximation (RMSEA). Internal consistency was calculated using Cronbach’s alpha and McDonald’s omega. We also performed the CFA invariance analysis for the SF-LAI-R across genders and professions (physician, nurse and other hospital staff).

Results

Of 884 (24.62%) responses, 835 were valid. The participants had a mean age of 47.8 years, and 20.12% were male. In a comparison of multiple CFAs, a second-order model with six factors outperformed other models. The goodness of fit indices revealed the CFI was 0.955, TFI was 0.952, RMSEA was 0.071, and SRMR was 0.038. The Cronbach’s alphas, McDonald’s omega coefficients for internal consistency were all greater than 0.8. The first and second-order model had metric and scalar invariance across genders and professions.

Conclusions

As health care demands evolve, humanities are becoming more important in medical education. Life attitude of hospital care worker is a crucial indicator of whether one embodies the ideals of a humanistic education. The revised SF-LAI has acceptable structural validity, internal consistency, and invariance across genders and professions among staff members of a teaching medical center.
Competency assessment for community health nurses: a focus group expert panel discussion
Authors: Kisut Ramlah , Haji Awang Sulaiman Hajah Dayang Jamilah , Abdul Rahman Hanif , Abdul-Mumin Khadizah H.
Published: May 2022

Background

General Practice setting in the Primary Health Care Services are the utmost visited by the public. It is important that the nurses’ competencies in this area be assessed to ensure provision of safe and quality services.

Aim/objective

To explore perceptions and experiences of competencies assessment tool for community health nurses working at the General Practice setting in the Primary Health Care Services.

Methods

An exploratory qualitative study utilizing focus group discussions were conducted on purposive sample of 12 officers with expertise in competency assessment and community health nursing from higher nursing education institutions, the Nursing Training and Development Centre, the Nursing Board and the Community Health Nursing Services in Brunei Darussalam. The existing competencies assessment tool was revised, the participants were divided into two groups of expert panel review team and two focus group discussions were held with each team. The focus group discussions encompassed components and methods of assessment; methods of grading; and overall organization and structure of the revised competency assessment tool.

Findings

Four themes emerged: 1) International equivalent core competencies components; 2) Multi-methods approach to assessment; 3) Definitive guidelines as framework for assessment; and 4) Understanding and acceptability of the competency assessment tool.

Conclusions/implications to practice

The expert panel reviews provide practical input that were inculcated in the preliminary developed competencies assessment tool. Identification of eligible assessors were recommended based on standardized criteria, and socialization and training held to set direction and guidance for implementing the utilization of the competencies assessment tool. Further studies are deemed important to critically evaluate and validate the preliminary competencies assessment tool for development of a more robust assessment instrument.
Quality of life (QoL) among COVID-19 recovered healthcare workers in Bangladesh
Authors: Rashid Md Utba , Khan Md Abdullah Saeed , Dalal Koustuv , Sagar Soumik Kha , Hossian Mosharop , Barsha Sabrina Yesmin , Haque Miah Md. Akiful , Ali Hossain Mohammad , Hayatun Nabi Mohammad , Hawlader Mohammad Delwer Hossain
Published: May 2022

Background

The Coronavirus Disease 2019 (COVID-19) caused by the SARS-CoV-2 virus has taken the lives of more than 100,000 healthcare workers (HCWs) so far. Those who survived continuously work under immense physical and psychological pressure, and their quality of life (QoL) is impacted. The study aimed to assess the QoL among HCWs in Bangladesh who recovered from COVID-19.

Methods

This cross-sectional, telephonic interview-based study was conducted among 322 randomly selected HCWs from Bangladesh who were positive for COVID-19 and recovered from the infection before the interview. Data were collected from June to November 2020. We examined the impact of COVID on the QoL of the participants using the validated Bangladesh version of the World Health Organization (WHO) Quality of life questionnaire brief (WHOQOL-BREF). All analyses were done by STATA (Version 16.1).

Results

More than half of the health care professionals were male (56.0%), aged between 26–35 years (51%), and completed graduation (49%). The majority of the study participants in the four domains were married (n = 263, 81%) and living in Dhaka. The average score of the participants was 70.91 ± 13.07, 62.68 ± 14.99, 66.93 ± 15.14, and 63.56 ± 12.11 in physical, psychological, social relationship and environmental domains, respectively. HCWs in urban areas enjoyed 2.4 times better socially stable lives (OR: 2.42, 95% CI: 1.18–4.96) but 72% less psychologically satisfactory lives.

Conclusion

HCWs' post-COVID quality of life depended on variable interaction of demographic socioeconomic, including old age, female sex, graduation, and higher monthly income. The findings indicate the issues which should be addressed to improve the quality of life of frontline workers who fight against the pandemic.
Picturing healthcare: a photovoice study of how healthcare is experienced by service users in a mental-health low threshold service
Authors: Høgås Mariell , Elstad Toril Anne , Ness Ottar , Alsaker Sissel
Published: May 2022

Background

A recent policy change dictates that all mental healthcare in Norway must be referred and documented in the medical record of the service users. This has not been the case within low threshold mental health services, which is services without referrals, social arenas where healthcare professionals are available and where service users themselves can choose to attend based on their self-reported needs. This challenges the idea of “healthcare” being a medical term as opposed to experienced and expressed by the service user.

A new healthcare understanding that includes the service users’ voices are thus needed, and the aim of this study is to explore how service users within low threshold services, understand, describe, and experience healthcare.

Methods

The present study has used the photovoice approach to explore how four service users perceive and experience healthcare in a low threshold context. The chosen photovoice method enabled service users to reflect upon and communicate their experiences first visually by individual pictures and thereafter reflective texts emerged through seven workshops. A qualitative thematic analysis was performed based on the pictures, notes and audiotaped material from the workshops.

Results

The analysis found three main themes showing how healthcare is experienced: availability of people, availability of places and availability of activities. This is illustrated through the following sub-themes: First, common community, good relations and fellowship, second, flexible and easily accessible support, which includes the opportunity to spend time and to try things out in a safe environment, and third, facilitation and motivation for participation and activity, given the opportunity to have a meaningful role and be seen as a resourceful human being.

Conclusions

A new understanding of healthcare is needed in the context of recovery-oriented low threshold services, as today`s largely medical understanding of healthcare is challenging to connect to a relational, recovery-oriented understanding of healthcare. As healthcare are to be documented in service users medical record, further research should explore how to document healthcare based on a new or extended, relational understanding of healthcare.
Willingness of health care providers to offer HIV self-testing from specialized HIV care services in the northeast of Brazil
Authors: Jordão Tiago , Magno Laio , Pereira Marcos , Rossi Thais Regis Aranha , de Almeida Silva Pedro , Figueiredo Maria Aparecida Araújo , de Brito Lima Prado Nília Maria , dos Santos Adriano Maia , Cangussu Maria Cristina , Dourado Inês
Published: May 2022

Background

The insufficient knowledge regarding the serological status of people affected with human immunodeficiency virus (HIV) is a concern in Brazil. HIV self-testing (HIVST) has been proved to have great potential for increasing testing, especially among vulnerable populations. The large-scale distribution of HIVST by the Brazilian public health system has increased in recent years. We aimed to investigate the awareness of HIVST among health care providers (HCP) from specialized HIV/AIDS care services in the state of Bahia, Northeast Brazil. Further we investigated HCP acceptability and willingness to offer its use.

Methods

A cross-sectional study on HCP from 29 specialized care services (SCS) located in 21 cities in the state of Bahia. HCP working in the service for at least 6 months were included. Sociodemographic, occupational, and behavioral data were collected using a questionnaire. Descriptive statistics were carried out. Bivariate, and multivariate analyses estimating adjusted odds ratios (aOR) and 95% confidence intervals (95% CI) using logistic regression were conducted.

Results

The awareness and acceptability of HIVST and the willingness to provide it were 79.8, 55.2, and 47.1%, respectively. Few HCP reported that the SCS where they worked dispensed HIVST (3.6%), and 13.5% received some information or training on HIVST. Factors associated with willingness to offer HIVST were: HIVST acceptability (aOR = 9.45; 95% CI: 4.53–19.71), willingness to use HIVST on themselves (aOR = 4.45; 95% CI: 1.62–12.24), confidence in offering HIVST to clients (aOR = 5.73; 95% CI: 2.26–12.72), and considering everyone eligible for HIVST (aOR = 2.88; 95% CI: 1.25–6.59).

Conclusions

Although most HCP were aware of HIVST, acceptability and willingness to provide it to the clients was moderate. The scale up of HIVST as a mean for the HIV prevention and control policy in Brazil, requires further training of HCP and better implementation of this program.
TRIM4-mediated ubiquitination of NSP2 restricts porcine reproductive and respiratory syndrome virus proliferation
Authors: Zhao Mengmeng , Sha Huiyang , Zhang Hang , Wang Ruining
Published: May 2022

Porcine reproductive and respiratory syndrome (PRRS) is a highly contagious and virulent infectious disease caused by the porcine reproductive and respiratory syndrome virus (PRRSV), which has substantial economic losses in the pig industry worldwide, and PRRSV attenuated vaccines and inactivated vaccines do have limitations in immune protection. The discovery of new antiviral targets has become a new research field. The proteomic studies have shown that the PRRSV NSP2 protein interacts with tripartite motif protein 4 (TRIM4), but it was still unknown whether TRIM4 regulates PRRSV infections. In this study, the TRIM4 gene from Marc-145 cells was cloned, and it was proved that TRIM4 overexpression inhibits PRRSV replication, whereas TRIM4 small-interfering-RNA knockdown resulted in increased virus titers. Mechanism investigation indicated that TRIM4 inhibits PRRSV replication through ubiquitination and degradation of the NSP2 protein. Protease inhibitor MG132 (carbobenzoxy-Leu-Leu-leucinal) attenuated the TRIM4-driven degradation of NSP2. Taken together, TRIM4 impairs PRRSV proliferation via ubiquitination and degradation of NSP2.
TGF-β1 regulates chondrocyte proliferation and extracellular matrix synthesis via circPhf21a-Vegfa axis in osteoarthritis
Authors: Lin Shiyuan , Li Huizi , Wu Biao , Shang Jie , Jiang Ning , Peng Rong , Xing Baizhou , Xu Xianghe , Lu Huading
Published: May 2022

Background

The transforming growth factor-beta (TGF-β) signaling pathway is an important pathway associated with the pathogenesis of osteoarthritis (OA). This study was to investigate the involvement of circRNAs in the TGF-β signaling pathway.

Methods

Cell Counting Kit-8 (CCK-8) assay and 5-ethynyl-2′-deoxyuridine (EdU) assay were used to detect the proliferation of primary mouse chondrocytes (PMCs). RNA-sequencing together with bioinformatics analysis were used to systematically clarify TGF-β1 induced alternations of circRNAs in PMCs. The regulatory and functional role of circPhf21a was examined in PMCs. Downstream targets of circPhf21a were explored by RNA-sequencing after overexpression of circPhf21a and verified by RT-qPCR in PMCs. Finally, the role and mechanism of circPhf21a in OA were explored in mouse models.

Results

We found that TGF-β1 promoted the proliferation of PMCs. Meanwhile, RT-qPCR and western blotting indicated that TGF-β1 promoted extracellular matrix (ECM) anabolism. RNA-sequencing revealed that a total of 36 circRNAs were differentially expressed between PMCs treated with and without TGF-β1. Of these, circPhf21a was significantly decreased by TGF-β1. Furthermore, circPhf21a knockdown promoted the proliferation and ECM synthesis of PMCs, whereas overexpression of circPhf21a showed the opposite effects. Mechanically, the expression profiles of the mRNAs revealed that Vegfa may be the target of circPhf21a. Additionally, we found that circPhf21a was significantly upregulated in the mouse OA model, and inhibition of circPhf21a significantly relieved the progression of OA.

Conclusions

Our results found that TGF-β1 promoted the proliferation and ECM synthesis of PMCs via the circPhf21a-Vegfa axis, which may provide novel therapeutic targets for OA treatment.
Comparative analysis of the gut microbiota composition between knee osteoarthritis and Kashin-Beck disease in Northwest China
Authors: Ning Yujie , Hu Minhan , Gong Yi , Huang Ruitian , Xu Ke , Chen Sijie , Zhang Feiyu , Liu Yanli , Chen Feihong , Chang Yanhai , Zhao Guanghui , Li Cheng , Zhou Rong , Lammi Mikko J. , Guo Xiong , Wang Xi
Published: May 2022

Background

Osteoarthritis (OA) and Kashin-Beck disease (KBD) both are two severe osteochondral disorders. In this study, we aimed to compare the gut microbiota structure between OA and KBD patients.

Methods

Fecal samples collected from OA and KBD patients were used to characterize the gut microbiota using 16S rDNA gene sequencing. To identify whether gut microbial changes at the species level are associated with the genes or functions of the gut bacteria between OA and KBD groups, metagenomic sequencing of fecal samples from OA and KBD subjects was performed.

Results

The OA group was characterized by elevated Epsilonbacteraeota and Firmicutes levels. A total of 52 genera were identified to be significantly differentially abundant between the two groups. The genera Raoultella, Citrobacter, Flavonifractor, g__Lachnospiraceae_UCG-004, and Burkholderia-Caballeronia-Paraburkholderia were more abundant in the OA group. The KBD group was characterized by higher Prevotella_9, Lactobacillus, Coprococcus_2, Senegalimassilia, and Holdemanella. The metagenomic sequencing showed that the Subdoligranulum_sp._APC924/74, Streptococcus_parasanguinis, and Streptococcus_salivarius were significantly increased in abundance in the OA group compared to those in the KBD group, and the species Prevotella_copri, Prevotella_sp._CAG:386, and Prevotella_stercorea were significantly decreased in abundance in the OA group compared to those in the KBD group by using metagenomic sequencing.

Conclusion

Our study provides a comprehensive landscape of the gut microbiota between OA and KBD patients and provides clues for better understanding the mechanisms underlying the pathogenesis of OA and KBD.
Apolipoprotein C-III is linked to the insulin resistance and beta-cell dysfunction that are present in rheumatoid arthritis
Authors: Martín-González Candelaria , Martín-Folgueras Tomás , Quevedo-Abeledo Juan Carlos , de Vera-González Antonia , González-Delgado Alejandra , de Armas-Rillo Laura , González-Gay Miguel Á. , Ferraz-Amaro Iván
Published: May 2022

Background

Insulin resistance and beta-cell dysfunction are manifestations of rheumatoid arthritis (RA). Apolipoprotein C-III (ApoC3) has been associated with such insulin resistance and beta-cell dysfunction in the general population. Our purpose was to study whether ApoC3 is also related to the insulin resistance and beta-cell dysfunction that are present in patients with RA.

Methods

Three hundred thirty-eight non-diabetic patients with RA who had a glycemia lower than 110 mg/dl were recruited. Insulin, C-peptide, and ApoC3 were assessed. Insulin resistance and beta-cell function were calculated using the Homeostasis Model Assessment (HOMA2) indices. A multivariable regression analysis was performed to study the relationship of ApoC3 with those molecules and indices adjusting for classic factors associated with insulin resistance that included glucocorticoids.

Results

ApoC3 was related to significant higher levels of circulating insulin (beta coef. 0.37 [95%CI 0.01–0.73] µU/ml, p = 0.044) and C-peptide (beta coef. 0.13 [95%CI 0.05–0.22] ng/ml, p = 0.003), and higher insulin resistance —HOMA2-IR— (beta coef. 0.05 [95%CI 0.00–0.09], p = 0.041) and beta-cell dysfunction —HOMA2-%B— (beta coef. 2.94 [95%CI 0.07–5.80], p = 0.044) indices. This was found after a fully multivariable analysis that included, among others, prednisone intake and the classic factors associated with carbohydrate metabolism such as triglycerides, waist circumference, and obesity.

Conclusion

ApoC3, insulin resistance, and beta-cell dysfunction are independently associated in patients RA.