bluuebunny/crossref_metadata_2025 huggingface dataset:
Phenomenologies of care: Integrating patient and caregiver narratives into clinical care
Authors: Krutzinna Jenny , Gotlib Anna
Published: May 2024

This special issue aims to spotlight the individual, lived experiences of caregivers and those receiving care–areas often overshadowed by clinical and medicalized narratives within clinical ethics. Our aim is to enrich the discourse by incorporating stories and narratives of medical care and challenge existing clinical practices by emphasizing patient and practitioner experiences. Through a blend of clinical and academic insights, this issue provides phenomenological narratives, highlighting the importance of lived experiences in understanding and improving clinical caregiving practices. The contributions, ranging from theoretical analyses to personal narratives, explore various aspects of caregiving. Each article contributes to a deeper understanding of the phenomenologies of care, advocating for a more inclusive, patient-centered approach in clinical ethics and practice.
Effect of boron and nitrogen on the corrosion properties of modified 9Cr–1Mo steel in alkali and chloride medium
Authors: Upadhyay Namrata , Shankar Anne Ravi , Ningshen Sublime
Published: May 2024

The present investigation involved the execution of electrochemical corrosion tests on three distinct modified 9Cr–1Mo steel alloys, each characterised by varying nitrogen and boron contents. These alloys, denoted as P91 (B=0, N=330 ppm), P91B (B=100 and N=20 ppm) and P91BN (B=60 and N=110 ppm), underwent exposure to varying concentrations of NaOH (0.1, 0.2 and 0.5 M) solutions. Additionally, the study explored the influence of chloride (0.1 M NaCl) on the occurrence of pitting corrosion within an alkali environment. The results indicated that the passive current density in all the concentrations of NaOH studied is maximum for alloy P91 followed by P91B and P91BN, respectively, indicating alloy P91 is more prone to corrosion than alloy P91B and P91BN. Electrochemical impedance spectroscopy demonstrated a higher polarisation resistance value for P91BN and the lowest for P91. Scanning electron microscopy analysis revealed that in alloy P91B and P91BN, pits are formed at the M23C6 carbide/matrix interface whereas in alloy P91 apart from carbides, pits are formed at inclusions. Energy-dispersive X-ray mapping identified the elemental composition of the inclusion in P91 which is found to be complex Al2O3–MnS inclusions enriched with Mo. P91BN demonstrated better pitting corrosion resistance compared to alloys P91 and P91B when exposed to NaOH+NaCl medium.
Presence of Self-Reported Sleep Alterations After Stroke and Their Relationship With Disability: A Longitudinal Study
Authors: Rangel Marcela Ferreira de Andrade , Silva Leonardo Carvalho , Gonçalves Estefany Horrany , Silva Andressa , Teixeira-Salmela Luci Fuscaldi , Scianni Aline Alvim
Published: May 2024

Background

Sleep disorders have a prevalence of 30% to 70% in post-stroke individuals. The presence of sleep disorders and poor sleep quality after stroke can affect important functions and lead to worse outcomes. However, most studies are restricted to the acute post-stroke stage only.

Objective

To investigate the frequency of self-reported sleep alterations in a sample of chronic stroke individuals and to identify which self-reported sleep alterations were associated with disability.

Methods

Prospective exploratory study. Self-reported sleep alterations were measured by the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and STOP-Bang Questionnaire. The dependent variable was measured 3 years after the first contact by the Modified Rankin Scale (mRS). Step-wise multiple linear regression analysis was employed to identify which sleep alterations were associated with disability.

Results

Sixty-five individuals with stroke participated. About 67.7% of participants had poor sleep quality, 52.4% reported insomnia symptoms, 33.9% reported excessive daytime sleepiness, and 80.0% were classified as intermediate or high risk for obstructive sleep apnea. Only risk for obstructive sleep apnea was significantly associated with disability and explained 5% of the variance in the mRS scores.

Conclusion

Self-reported sleep alterations had a considerable frequency in a sample of chronic stroke individuals. The risk of obstructive sleep apnea was associated with disability in the chronic stage of stroke. Sleep alterations must be considered and evaluated in the rehabilitation process even after a long period since the stroke onset.
Exploring the relationship between case volume and intracranial aneurysm treatments with flow-diverters and flow-disruptors: Insights from the 2020 to 2021 Database of the German Society for Interventional Radiology National Registry in Germany
Authors: Yapici Furkan , Maus Volker , Weber Werner , Acikel Cengizhan , Berlis Ansgar , Fischer Sebastian
Published: May 2024

Background and Purpose

Intracranial aneurysm treatment using flow-diverters and flow-disruptors requires a higher level of expertise when compared to more traditional methods. Our hypothesis was that the procedural success and the rate of complications are dependent on the annual case load of a center.

Materials and Methods

Conducting a retrospective analysis on the Database of the German Society for Interventional Radiology for the years 2020 to 2021, we examined flow-diverter and flow-disruptor procedures. We categorized centers into four groups according to their annual case load and proceeded to analyze success rates, complication rates, and fluoroscopy times across these centers.

Results

No statistically significant differences were observed among the groups in both flow-diverter and flow-disruptor cases concerning fluoroscopy time and the incidence of technical complications. However, within the subgroup of flow-disruptor cases, centers with lower case load exhibited significantly higher rates of hemorrhagic and clinically relevant complications. Additionally, it was noted that the rate of therapeutic success in the flow-diverter group significantly increased in centers with higher case volumes.

Conclusion

Our findings support the intention towards centralization of medical care especially for complex neuroendovascular procedures. Furthermore, our findings are an argument to further develop a standardized educational and procedural algorithm based on defined case numbers and training modules for complex neurovascular procedures as already implemented by the Database of the German Society for Interventional Radiology.
Planar curved path following controller for a small fixed-wing unmanned aerial vehicle with constrained parameters optimized by nonlinear model predictive control
Authors: Chen Yang , Zeng Wei , Wang Chaolei , Wu Yongliang
Published: May 2024

Path following presents a pivotal challenge within the realm of small fixed-wing unmanned aerial vehicles. Firstly, a Lyapunov-stable path guidance law was formulated to follow specific planar curved paths. To ensure differentiability of the guidance law, a modified, smooth saturation function was derived. Secondly, an analysis was conducted to ascertain the interrelationship between control parameters and input constraints, thereby identifying the relevant parameter domains. Thirdly, the nonlinear model predictive control technique was harnessed to optimize both guidance law parameters, enhancing the unmanned aerial vehicle’s capacity to achieve optimal performance in both straight-line and circular path following, hereafter referred to as PFC_NMPC. By leveraging Lyapunov stability arguments for switched systems, the stability of the corresponding nonlinear switched system was guaranteed. In this study, square and circular paths were generated to assess the path-following control of a simulated fixed-wing unmanned aerial vehicle. The performance of various guidance laws, including those with fixed parameters (PFC), those with parameters tuned using fuzzy logic (PFC_FL), PFC_NMPC, vector field, and pure pursuit with line-of-sight, was compared. Notably, the proposed PFC_NMPC method exhibited the ability to expedite the unmanned aerial vehicle’s convergence to the desired path while maximizing the effective flight path length.
Prevalence and prognostic impact of stroke in a national cohort of infective endocarditis
Authors: Álvarez-Zaballos Sara , Vázquez-Alen Pilar , Muñoz Patricia , de Alarcón Arístides , Gutiérrez Carretero Encarnación , Álvarez-Uría Ana , Fariñas Mª Carmen , Rodríguez-García Raquel , Goenaga Miguel Ángel , Cuervo Guillermo , Plata-Ciezar Antonio , Hidalgo-Tenorio Carmen , Aldamiz-Echevarría Gonzalo , Martínez-Sellés Manuel
Published: May 2024

Background:

Stroke is a common complication of infective endocarditis (IE). Our aim was to describe the prevalence and prognostic impact of stroke in a national cohort of IE.

Methods:

Consecutive inclusion at 46 Spanish hospitals between 2008 and 2021.

Results:

Out of 5667 IE cases, 1125 had acute stroke (19.8%): 818 ischemic strokes (811 cardioembolic strokes (193 with hemorrhagic transformation), 4 transient ischemic attacks, 3 lacunar infarctions), 127 intracranial hemorrhages, and 27 other neurological complications (cerebral abscesses, encephalitis, and meningitis). Compared to patients without stroke, those with stroke had a similar mean age (69 years) but were more frequently female (68.2% vs 63.7%, p = 0.04) and had a higher incidence of intracardiac complications (35% vs 30%, p = 0.01), surgical indication (69.9% vs 65.9%, p = 0.001), in-hospital mortality (40.9% vs 22.0%, p < 0.001), and 1-year mortality (46.2% vs 27.9%, p < 0.001). The following variables were independently associated with stroke: mitral location (odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.34–1.8, p < 0.001), vascular phenomenon (OR = 2.9, 95% CI = 2.4–3.6, p = 0.0001), acute renal failure (OR = 1.2, 95% CI = 1.0–1.4, p = 0.021), septic shock (OR = 1.3, 95% CI = 1.1–1.6, p = 0.007), sepsis (OR = 1.3, 95% CI = 1.1–1.6, p = 0.005), surgery indicated but not performed (OR = 1.4, 95% CI = 1.2–1.7, p < 0.001), community-acquired IE (OR = 1.2, 95% CI = 1–1.4, p = 0.017), and peripheral embolization (OR = 1.6, 95% CI = 1.4–1.9, p < 0.001). Stroke was an independent predictor of in-hospital (OR = 2.1, 95% CI = 1.78–2.51, p < 0.001) and 1-year mortality (hazard ratio = 1.9, 95% CI = 1.6–2.5).

Conclusion:

One-fifth of patients with IE have concomitant stroke. Stroke is associated with mortality.
Use of coronary artery calcium score and coronary CT angiography to guide cardiovascular prevention and treatment
Authors: Lima Maria Rita , Lopes Pedro M. , Ferreira António M.
Published: May 2024

Currently, cardiovascular risk stratification to guide preventive therapy relies on clinical scores based on cardiovascular risk factors. However, the discriminative power of these scores is relatively modest. The use of coronary artery calcium score (CACS) and coronary CT angiography (CCTA) has surfaced as methods for enhancing the estimation of risk and potentially providing insights for personalized treatment in individual patients. CACS improves overall cardiovascular risk prediction and may be used to improve the yield of statin therapy in primary prevention, and possibly identify patients with a favorable risk/benefit relationship for antiplatelet therapies. CCTA holds promise to guide anti-atherosclerotic therapies and to monitor individual response to these treatments by assessing individual plaque features, quantifying total plaque volume and composition, and assessing peri-coronary adipose tissue. In this review, we aim to summarize current evidence regarding the use of CACS and CCTA for guiding lipid-lowering and antiplatelet therapy and discuss the possibility of using plaque burden and plaque phenotyping to monitor response to anti-atherosclerotic therapies.
Role of immunotherapy in pulmonary sarcomatoid carcinoma: review of current approaches and related biomarkers
Authors: Ding Kaibo , Peng Zhongsheng , Xu Yanjun
Published: May 2024

Pulmonary sarcomatoid carcinoma (PSC), a rare subtype of non-small cell lung cancer, is highly malignant and has a poor prognosis. Treatments for PSC are presently limited. Traditional treatments provide fewer benefits to PSC patients and are associated with early recurrence and metastasis. Surgical intervention is the preferred option for early-stage PSC patients, whereas chemotherapy, radiotherapy, immunotherapy, and other targeted therapies are recommended for advanced PSC patients. Targeted therapy is only effective in a small number of PSC patients. The initial efficacy of immune checkpoint inhibitors has been acceptable in patients with advanced PSC; therefore, much attention on related biomarkers has been sought. This article aimed to review the research progress of PSC immunotherapy and related diagnostic and prognostic biomarkers in recent years.
Influence of the External Workload on Calf Muscle Strain Injuries in Professional Football Players: A Pilot Study
Authors: Soler Aitor , Agulló Fidel , Hernández-Davó Jose , Raya-González Javier , Del Coso Juan , González-Ródenas Joaquín , Moreno-Pérez Víctor
Published: May 2024

Background:

The influence of external workload variables on the development of calf muscle strainsin football players has not been previously explored.

Hypothesis:

Overloaded players would have an increased risk of calf muscle strain injury.

Study Design:

Prospective observational study.

Level of Evidence:

Level 4.

Methods:

A total of 41 professional football players from 1 team were monitored for 2 consecutive seasons. Total distance covered (TD), and distances covered at high-intensity running, high sprint running, low (LACC) and high (HACC) acceleration, low (LDEC) and high (HDEC) deceleration, and at high metabolic load distance (HMLD) were monitored with GPS units. Accumulated players’ external workload in the week before injury was compared with the weekly mean value of the 6 weeks before injury occurred for each player.

Results:

Ten players (24.3%) suffered 16 calf muscle strain injuries (3.1 injuries per 1000 hours of match play; 0.5 injuries per 1000 hours of training exposure). Players with a calf muscle injury were older ( p = 0.03), with higher body weight ( p = 0.01) and height ( p = 0.03). Injured players displayed substantially higher total training volume ( p < 0.01), TD ( p < 0.01), LACC ( p < 0.01), LDEC ( p < 0.01), HACC ( p < 0.01), HDEC ( p < 0.01), and HMLD ( p = 0.03) in the week before injury, in comparison with the mean values of these variables in the 6 weeks before injury.

Conclusion:

A week with a higher-than-habitual external workload might increase the risk of calf muscle strain injury in professional football players. Calf muscle injuries were preceded by a week with unusually high workloads associated with accelerating and decelerating distances and higher training volumes.

Clinical Relevance:

Monitoring external workload indicators may be helpful in determine players with a higher risk of calf muscle strain injury due to excessive workload during training/competition.
Effect of Heat Acclimatization, Heat Acclimation, and Intermittent Heat Training on Maximal Oxygen Uptake
Authors: Dunn Ryan A. , Fry Lauren A. , Sekiguchi Yasuki , Benjamin Courteney L. , Manning Ciara N. , Huggins Robert A. , Stearns Rebecca L. , Casa Douglas J.
Published: May 2024

Background:

Maximal oxygen uptake (VO2max) is an important determinant of endurance performance. Heat acclimation/acclimatization (HA/HAz) elicits improvements in endurance performance. Upon heat exposure reduction, intermittent heat training (IHT) may alleviate HA/HAz adaptation decay; however, corresponding VO2max responses are unknown.

Hypothesis:

VO2max is maintained after HAz/HA; IHT mitigates decrements in aerobic power after HAz/HA.

Study Design:

Interventional study.

Level of Evidence:

Level 3.

Methods:

A total of 27 male endurance runners (mean ± SD; age, 36 ± 12 years; body mass, 73.03 ± 8.97 kg; height, 178.81 ± 6.39 cm) completed VO2max testing at 5 timepoints; baseline, post-HAz, post-HA, and weeks 4 and 8 of IHT (IHT4, IHT8). After baseline testing, participants completed HAz, preceded by 5 days of HA involving exercise to induce hyperthermia for 60 minutes in the heat (ambient temperature, 39.13 ± 1.37°C; relative humidity, 51.08 ± 8.42%). Participants were assigned randomly to 1 of 3 IHT groups: once-weekly, twice-weekly, or no IHT. Differences in VO2max, velocity at VO2max (vVO2), and maximal heart rate (HRmax) at all 5 timepoints were analyzed using repeated-measure analyses of variance with Bonferroni corrections post hoc.

Results:

No significant VO2max or vVO2 differences were observed between baseline, post-HAz, or post-HA ( P = 0.36 and P = 0.09, respectively). No significant group or time effects were identified for VO2max or vVO2 at post-HA, IHT4, and IHT8 ( P = 0.67 and P = 0.21, respectively). Significant HRmax differences were observed between baseline and post-HA tests ( P < 0.01). No significant group or time HRmax differences shown for post-HA, IHT4, and IHT8 ( P = 0.59).

Conclusion:

VO2max was not reduced among endurance runners after HA/HAz and IHT potentially due to participants’ similar aerobic training status and high aerobic fitness levels.

Clinical Relevance:

HAz/HA and IHT maintain aerobic power in endurance runners, with HAz/HA procuring reductions in HRmax.
Eve
Authors: Heiner-Wright Jai , McNicholl Cat
Published: May 2024

The arts have had a historical relationship with holding technology accountable through artists’ speculation on its harmful and redemptive characteristics. As young futurists born into an age where Artificial Intelligence (AI) and related processes have become increasingly integrated into society, we wished to utilise this tradition to engage with contemporary anxieties concerning AI’s role in the potential automation of the creative industries. Using the comic book medium, we speculate on how this automation may prove to be an extension of capitalist exploitation through the story of Eve. Simultaneously, we embrace the more redemptive aspects of this technology’s use. We celebrate non-exploitative ‘machine’ art and the potential modes of expression that it may herald. This is as we do not wish to entirely foreclose the involvement of AI in art but simply question the effects such art may have under capitalism.
The Presidents of the Institute of Wood Science
Authors: True Andrew , Ridley-Ellis Dan , Spear Morwenna , Ansell Martin P
Published: May 2024

The Institute of Wood Science (IWSc) represented the interests and knowledge of wood scientists and wood technologists in the UK and beyond between 1955 and 2009 when it merged with the Institute of Materials, Minerals and Mining (IOM3). In that time 27 presidents served, from industry or academia, leading the IWSc and guiding decisions relating to education, communication and the award of professional qualifications. The broad history of the Institute has been documented in 30th- and 50th-anniversary reviews published in the IWSc Journal. However, the contribution of the presidents to the success of the institute, as well as their reputations in wood science, wood technology or industry, has not been recorded. Approaching the 70th anniversary of what is now the Wood Technology Group of IOM3, this paper reviews the circumstances under which the IWSc was created and examines the contribution of each of the presidents to the health and success of the institute.
Job satisfaction among midwives in low and middle-income countries: A protocol for systematic review and meta-analysis
Authors: Deressa Jembere Tesfaye , Negeri Haweni Adugna , Gurmessa Teshome Oljira , Tesfaye Biruk Hailu , Habteyes Abrham Tesfaye , Kassa Roza Teshome
Published: May 2024

Objectives:

The main objective of this study is to assess the level of midwives’ job satisfaction in low- and middle-income countries.

Methods:

A comprehensive literature search will be carried out using the following databases: Google Scholar, PubMed/Medline, Embase, CINHAL, SCOPUS, Web of Science, and Science Direct. This systematic review and meta-analysis will be carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All identified observational studies reporting the level of job satisfaction among midwives in low- and middle-income countries will be considered. The extracted quantitative data will be analyzed using STATA version 17. Heterogeneity among the included studies will be assessed through the I2 test statistics. Finally, a random-effects meta-analysis model will be computed to estimate the pooled level of job satisfaction among midwives. Furthermore, publication bias will be assessed using a funnel plot and Egger’s regression test, and sensitivity analysis will be conducted to evaluate the stability of the overall effects in the presence of outliers. The protocol has been registered in the PROSPERO-International Prospective Register of Systematic Reviews, with the registration number CRD42023400122.

Conclusion:

This systematic review and meta-analysis will be an important source to identify the level of job satisfaction among midwives working in the health facilities of low- and middle-income countries. Researchers, stakeholders, and healthcare systems also use these and managers to determine why midwives’ levels of job satisfaction are high or low compared to other studies in the future.
Reclaiming artificial intelligence accounts: A plea for a participatory turn in artificial intelligence inquiries
Authors: Gourlet Pauline , Ricci Donato , Crépel Maxime
Published: May 2024

How to participate in artificial intelligence otherwise? Put simply, when it comes to technological developments, participation is either understood as public debates with non-expert voices to anticipate risks and potential harms, or as a way to better design technical systems by involving diverse stakeholders in the design process. We advocate for a third path that considers participation as crucial to problematise what is at stake and to get a grip on the situated developments of artificial intelligence technologies.

This study addresses how the production of accounts shape problems that arise with artificial intelligence technologies. Taking France as a field of study, we first inspected how media narratives account for the entities and issues of artificial intelligence, as reported by the national press over the last decade. From this inspection, we identified four genres and described their performative effects. We then conducted a participatory inquiry with 25 French artificial intelligence practitioners’ to ground artificial intelligence in situated experiences and trajectories. These experiential accounts enabled a plural problematisation of artificial intelligence, playing with the geometries of artificial intelligence and its constituencies, while diversifying and thickening its problems.

To conclude, we discuss how participatory inquiries, through experiential and plural accounts offer a refreshing weaving of artificial intelligence problems into the fabric of its deployments. Our participatory approach seeks to re-politicise artificial intelligence from practitioners’ situated experiences, by making the ongoing relationships between past trajectories, current frictions and future developments tangible and contestable, opening avenues to contribute otherwise.
The patient-reported wearing-off phenomenon with monoclonal antibody treatments for multiple sclerosis
Authors: Marian Lindsey M , Harris Kathleen A , Conway Devon S
Published: May 2024

Background

Many patients report a wearing-off phenomenon with monoclonal antibody treatment for multiple sclerosis in which perceived benefits wear off before the next dose is due.

Objectives

To determine prevalence of the wearing-off effect, symptoms experienced, impact on treatment satisfaction, and associated patient characteristics.

Methods

Patients receiving natalizumab, ocrelizumab, ofatumumab, or rituximab at a tertiary multiple sclerosis center were invited to take an online survey interrogating their monoclonal antibody experience. Additional history and patient characteristic data were collected. Logistic regression was used to determine if patient characteristics predicted the wearing-off effect and linear regression to evaluate the impact of the wearing-off effect on treatment satisfaction. The models were adjusted for age, disease duration, race, sex, body mass index, education, and depression as measured by the Patient Health Questionnaire-9.

Results

We received 258 qualifying responses and 141 (54.7%) patients reported the wearing-off phenomenon. The most common symptom was fatigue (47.7%). Higher Patient Health Questionnaire-9 scores were significantly associated with the wearing-off phenomenon (OR = 1.02, p = 0.005). The wearing-off effect (β = −0.52, p = 0.04) and higher Patient Health Questionnaire-9 (β = −0.09, p < 0.01) scores were associated with significantly reduced treatment satisfaction.

Conclusion

The wearing-off phenomenon is common, associated with depression, and reduces treatment satisfaction. Research addressing mitigation strategies is needed.
Atrial Septal Defect Closure: Not Always Straightforward
Authors: Wallen W. Jack , Backer Carl L.
Published: May 2024

A nine-year old boy presented following a chest x-ray for COVID-19 infection that showed cardiomegaly. Transthoracic echocardiogram revealed a large atrial septal defect, dilated right heart, and normal function. Surgical repair was performed eight weeks after his COVID diagnosis. After weaning from cardiopulmonary bypass, pulmonary artery pressures were 2/3 systemic and ectopy was seen, requiring inotropes, nitric oxide, lidocaine, and amiodarone. He was discharged on postoperative day (POD) 5. On POD 6, he presented with acute right foot ischemia. Computed tomography showed a large aortic thrombus, requiring emergent thrombectomy. Coagulopathy workup was negative. Cardiac magnetic resonance imaging (CMR) and catheterization showed reduced biventricular function and diastolic dysfunction. Diuretics and β blockers were started, with gradual improvement in left ventricular systolic function.
Factor Structure and Psychometric Properties of the Digital Stress Scale in a Chinese College Sample
Authors: Gao Chunlei , Jian Mingqing , Yuan Ailin
Published: May 2024

The Digital Stress Scale (DSS) is used to measure digital stress, which is the perceived stress and anxiety associated with social media use. In this study, the Chinese version of the DSS was validated using a sample of 721 Chinese college students, 321 males and 400 females (KMO = 0.923; Bartlett = 5,058.492, p < .001). Confirmatory factor analysis (CFA) and item response theory (IRT) revealed that the five-factor model fits our data best. And the good criterion validity was shown through the association of the Chinese version of the DSS with anxiety and depression. The results of measurement invariance supported that the scale has measurement equivalence across the region (rural or urban). However, they did not support strict measurement invariance across gender. Overall, our results suggest that the DSS is an ideal tool for measuring digital stress in a Chinese sample. People can benefit from assessing digital stress, which has the potential to moderate the relationship between social media use and mental health. These psychometric investigations of the DSS will allow future research to investigate construct validity better.
Predictive Factors of Cloxacillin Susceptibility in Primary Bacterial Spinal Infection
Authors: Tang Chris Yuk Kwan , Ho Pak Leung
Published: May 2024

Study Design

Prognostic study.

Objectives

The objective of this study is to identify predictive factors for cloxacillin susceptibility in spinal infections.

Methods

A retrospective analysis was conducted using data from January 1, 1997, to December 31, 2021. The study included patients presenting with back pain and either a positive bacterial culture from the spine or radiological evidence of spinal infection (spondylodiscitis and/or epidural abscess) along with positive bacterial blood culture.

Results

Among 171 patients (127 males, 44 females), 53.2% had Staphylococcus isolates, with 40.4% showing cloxacillin resistance. Lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, and residence in an old age home predicted gram-positive bacteria with cloxacillin resistance and gram-negative bacteria as causative organisms ( P<.05). The 30-day and 1-year all-cause mortality rates were 0% and 8.2%, respectively. Higher red cell distribution width (RDW >16.1%) and Charlson comorbidity index (CCI) scores predicted 1-year all-cause mortality ( P<.05). Intensive care unit admission was required for 9.9% of patients.

Conclusions

This study identified predictive factors for spinal infection by gram-positive bacteria with cloxacillin resistance and gram-negative bacteria. Patients with lower globulin levels (<33.5 g/L), recent hospitalization within 90 days, or residency in an old age home upon admission should avoid standalone cloxacillin therapy and consider antibiotics with gram-negative coverage. Higher RDW (>16.1%) and CCI scores were associated with increased 1-year all-cause mortality. These findings contribute to treatment decision-making and improving patient outcomes in spinal infections.
Predictors and components of inpatient asthma hospital cost: A retrospective cohort study. Analysis from a sample of 14 Belgian hospitals
Authors: Seret Jehan , Bruyneel Arnaud , Larcin Lionel , Gooset Fabienne , Azzi Djohra , Martins Dimitri , Van Den Bulcke Julie , Leclercq Pol , Pirson Magali
Published: May 2024

Background:

Addressing the challenges of asthma has involved various approaches, including the examination of costs associated with hospitalization. However, there is a limited number of studies that have investigated the actual expenses incurred by hospital settings in caring for asthma patients. This study aims to describe the costs, predictors, and breakdown of expenditures in different categories.

Design and methods:

A retrospective cohort study was conducted, involving 314 hospital stays of patients over 12 years old who were admitted for asthma and classified under APR-DRG 141 (asthma). Univariate and multiple linear regression analyses were performed.

Results:

The median cost, regardless of DRG severity, amounted to 2.314€ (1.550€−3.847€). Significant variations were observed when the sample was stratified based on the severity of DRG, revealing a cost gradient that increases with severity. The length of stay followed a similar trend. Six predictors were identified: age, admission to intensive care, asthma severity, severity level of the DRG, winter admission, and length of stay. The cost breakdown showed that 44% constituted direct costs, 25% were indirect costs, 26% were attributed to medical procedures performed outside the patient unit, and 5% were related to medication administration.

Conclusions:

This study initiates a discussion on the role of reducing hospital costs in strategies aiming at controlling asthma-related costs. We argue that cost reduction cannot be achieved solely at the hospital level but must be approached from a public health perspective. This includes promoting high-quality outpatient care and addressing factors leading to poor adherence to the care plan.
Peer Mentorship Enhances Coping in Children, Adolescents, and Young Adults with Pectus Excavatum and Adolescent Idiopathic Scoliosis
Authors: Hill Allyson , Sanchez Amanda , Turni Lisa , Hayakawa Jennifer , Barrows Jennifer , Schomberg John , Noskoff Kara , Kabeer Mustafa H. , Aminian Afshin
Published: May 2024

Purpose: Children and adolescents and young adults (AYA) with pectus excavatum (PE) and adolescent idiopathic scoliosis (AIS) experience similar journeys regarding pain, body image, and self- and peer acceptance. Peer mentoring may address some of the challenges faced regarding diagnosis and treatment of PE and AIS. Before implementing a mentor program, our hospital noted an increased length of stay (LOS) and difficulty coping in those undergoing surgery for PE and AIS, emphasizing the need for additional support. The purpose of this study was to evaluate the impact of a peer mentor program for children/AYAs with PE or AIS and their parents on coping, pain, and LOS. Design and Methods: This non-randomized controlled trial included a prospective intervention group that received peer mentorship and a retrospective control group that received standard care. Self-reported surveys assessed the effect of the mentor program on coping. Qualitative data on coping were analyzed descriptively. Postoperative pain and LOS were obtained from the health record. Bivariate inferential statistics were used to compare the distribution of pain scores and LOS between intervention and control groups. Results: Children/AYAs, parents, and mentors reported enhanced coping and found peer mentorship beneficial, though it did not have a statistically significant impact on pain or LOS. Conclusions: Peer mentorship facilitates coping in children/AYAs with PE or AIS undergoing corrective surgery. Parents and mentors also perceived benefits. Practice Implications: Pediatric nurses and child life specialists can help children/AYAs, and their families prepare for surgery by connecting them with peer mentors and social support.
Preliminary Development of the Racial Equity-Oriented Social-Emotional Learning Practices Measure
Authors: Rivas-Drake Deborah , Channey Jozet , McGovern Gina , Pinetta Bernardette J.
Published: May 2024

This article delineates the development of a measure to assess teachers’ reported engagement in practices that center on issues of racial equity as part of their SEL instruction. An iterative mixed-method approach included theoretical grounding, literature reviews, content expert evaluation, focus groups, cognitive interviews, and multiple survey administrations. Exploratory and confirmatory factor analyses were conducted using data from three independent samples of fifth- to eighth-grade teachers (N range = 240–260; White = 67–89%; Black = 3–7%; Latinx = 5–23%). Test-retest reliability was assessed in a fourth national sample from the RAND American Education Panels (N = 482; Black/African American = 19.9%, Latino/Hispanic = 16.2%, Asian/Asian American = 2.7%, American Indian/Native American = 1.9%, White = 66.0%, Middle Eastern/North African = 0.6%, and Other = 2.7%). Results suggest (1) evidence of strong internal consistency for the 41-item Racial Equity-oriented Social Emotional Learning (REQSEL) measure; (2) REQSEL scores correlated with multiple relevant measures of teachers’ beliefs and behaviors regarding race, ethnicity, culture, and social justice; and (3) REQSEL scores correlated with teachers’ own ethnic-racial identity beliefs.
The Effectiveness of High-Fidelity Simulation on Clinical Competence Among Nursing Students
Authors: Nair Manju Avinash , Muthu Priyalatha , Abuijlan Israa A. M.
Published: May 2024

Introduction

Clinical competence is a pre-requisite for every student nurse to showcase their proficiency in providing quality nursing care. Effective clinical experience during the study period plays a pivotal role in developing clinical competence among nursing students. Hence, the purpose of the study was to find the effectiveness of high fidelity simulation (HFS) on clinical competence among nursing students.

Objectives

The objectives of the study were to determine the impact of HFS on level of clinical competence among nursing students, to find the association between selected demographic characteristics of nursing students with their level of clinical competence and also, to find the association between academic performances of nursing students with their level of competence.

Method

The current study employed a quasi-experimental study design. Sixty-five nursing students from second year Bachelor of Science in Nursing (BSN) program were selected using consecutive sampling technique. The data was collected using demographic data form, objective structured clinical examination (OSCE) grade performa, and academic score sheet. SPSS version 24 was used to analyze data.

Results

The study revealed a significant impact of HFS on clinical competence of nursing students. Majority (52.3%) of the nursing students obtained high level clinical competence following the HFS. The findings showed a significant association between gender and medium of instruction with the level of clinical competence of nursing students. Further, there was a significant correlation between academic performance and level of clinical competence of the nursing students.

Conclusion

HFS served as a useful pedagogical approach in fulfilling the clinical learning outcomes. It further facilitated readiness of nursing students in second year BSN in terms of developing competence and confidence for clinical placement at the hospital for the third year of their study. However, further research is required to determine if HFS can be used in developing clinical reasoning skills in nursing students.
How I Do It: Esophageal Stenting for Benign and Malignant Conditions
Authors: Phung Jenson , Bilal Mohammad
Published: May 2024

Esophageal stent placement is an effective technique used in the management of different benign and malignant conditions. Over time, various types of stents and techniques have been developed and optimized to treat distinct pathologies. With the extensive array of strategies available for utilizing esophageal stenting, a thorough understanding of the characteristics of each stent type and usage is paramount in choosing the ideal stent in a particular case. This article presents a brief review of esophageal stenting as well as tips and tricks for clinical practice.
Tiered Licensure for Pharmacy Technicians: Is the Advanced Pharmacy Technician (APhT) License the Model for State Regulators?
Authors: Adams Alex J. , Frost Timothy P.
Published: May 2024

Two states—Connecticut and New Hampshire—have created or attempted to create advanced pharmacy technician (APhT) licenses. Both licenses, proposed and actual, have high barriers to entry, such as requiring 1 to 3 years of prior technician experience and passage of various assessments or trainings, such as a state-specific jurisprudence exam. Those obtaining APhT licensure are granted additional authority, such as performing final product verification (e.g., tech-check-tech) and vaccine administration. Compared with practices in other states, the APhT role in CT and NH provides minimal scope gains relative to the requirements imposed; as a result, there has been limited uptake (<1%) among current technicians. As such, it appears unlikely that tiered licensure for technicians will be the preferred mechanism for states to expand the role of pharmacy technicians in the future.
The additive value of complementing diagnostic idiopathic intracranial hypertension criteria by MRI – an external validation study
Authors: Macher Stefan , Marik Wolfgang , Krajnc Nik , Mitsch Christoph , Michl Martin , Mueller Nina , Novak Klaus , Zaic Sina , Woeber Christian , Pemp Berthold , Bsteh Gabriel
Published: May 2024

Background

Recently, diagnostic criteria including a standardized MRI criterion were presented to identify patients suffering from idiopathic intracranial hypertension (IIH) proposing that IIH might be defined by two out of three objective findings (papilledema, ≥ 25 cm cerebrospinal fluid opening pressure (CSF-OP) and ≥ 3/4 neuroimaging signs).

Methods

To provide independent external validation, we retrospectively applied the proposed diagnostic criteria to our cohort of patients with clinical suspicion of IIH from the Vienna IIH database. Neuroimaging was reevaluated for IIH signs according to standardized definitions by a blinded expert neuroradiologist. We determined isolated diagnostic accuracy of the neuroimaging criterion (≥ 3/4 signs) as well as overall accuracy of the new proposed criteria.

Results

We included patients with IIH (n = 102) and patients without IIH (no-IIH, n = 23). Baseline characteristics were balanced between IIH and no-IIH groups, but papilledema and CSF-OP were significantly higher in IIH. For the presence of ≥ 3/4 MRI signs, sensitivity was 39.2% and specificity was 91.3% with positive predictive value (PPV) of 95.2% and negative predictive value (NPV) 25.3%. Reclassifying our cohort according to the 2/3 IIH definition correctly identified 100% of patients without IIH, with definite IIH and suggested to have IIH without papilledema by Friedman criteria, respectively.

Conclusion

The standardized neuroimaging criteria are easily applicable in clinical routine and provide moderate sensitivity and excellent specificity to identify patients with IIH. Defining IIH by 2/3 criteria significantly simplifies diagnosis without compromising accuracy.
Integrated transcriptome and metabolome analysis reveals the regulation of phlorizin synthesis in Lithocarpus polystachyus under nitrogen fertilization
Authors: Zeng Suping , Yu Longhua , He Ping , Feng Hui , Wang Jia , Zhang Huacong , Song Yunxia , Liu Ren , Li Yueqiao
Published: May 2024

Background

Nitrogen (N) is essential for plant growth and development. InLithocarpus polystachyusRehd., a species known for its medicinal and food value, phlorizin is the major bioactive compound with pharmacological activity. Research has revealed a positive correlation between plant nitrogen (N) content and phlorizin synthesis in this species. However, no study has analyzed the effect of N fertilization on phlorizin content and elucidated the molecular mechanisms underlying phlorizin synthesis inL. polystachyus.

Results

A comparison of theL. polystachyusplants grown without (0 mg/plant) and with N fertilization (25, 75, 125, 175, 225, and 275 mg/plant) revealed that 75 mg N/plant fertilization resulted in the greatest seedling height, ground diameter, crown width, and total phlorizin content. Subsequent analysis of the leaves using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) detected 150 metabolites, including 42 flavonoids, that were differentially accumulated between the plants grown without and with 75 mg/plant N fertilization. Transcriptomic analysis of theL. polystachyusplants via RNA sequencing revealed 162 genes involved in flavonoid biosynthesis, among which 53 significantly differed between the N-treated and untreated plants. Fertilization (75 mg N/plant) specifically upregulated the expression of the genes phenylalanine ammonia-lyase (PAL), 4-coumarate-CoA ligase (4CL), and phlorizin synthase (PGT1) but downregulated the expression of trans-cinnamate 4-monooxygenase (C4H), shikimate O-hydroxycinnamoyltransferase (HCT), and chalcone isomerase (CHI), which are related to phlorizin synthesis. Finally, an integrated analysis of the transcriptome and metabolome revealed that the increase in phlorizin after N fertilization was consistent with the upregulation of phlorizin biosynthetic genes. Quantitative real-time PCR (qRT‒PCR) was used to validate the RNA sequencing data. Thus, our results indicated that N fertilization increased phlorizin metabolism inL. polystachyusby regulating the expression levels of thePAL,PGT1, 5-O-(4-coumaroyl)-D-quinate 3’-monooxygenase (C3’H),C4H, andHCTgenes.

Conclusions

Our results demonstrated that the addition of 75 mg/plant N toL. polystachyussignificantly promoted the accumulation of flavonoids, including phlorizin, and the expression of flavonoid synthesis-related genes. Under these conditions, the genesPAL,4CL, andPGT1were positively correlated with phlorizin accumulation, whileC4H,CHI, andHCTwere negatively correlated with phlorizin accumulation. Therefore, we speculate thatPAL,4CL, andPGT1participate in the phlorizin pathway under an optimal N environment, regulating phlorizin biosynthesis. These findings provide a basis for improving plant bioactive constituents and serve as a reference for further pharmacological studies.
Lipids, apolipoproteins and gestational diabetes mellitus: a Mendelian randomization study
Authors: Shan Dan , Wang Ao , Yi Ke
Published: May 2024

Background

This study investigates the causal relationship between lipid traits and GDM in an effort to better understand the aetiology of GDM.

Methods

Employing a two-sample Mendelian Randomization (MR) framework, we used Single Nucleotide Polymorphisms (SNPs) as instrumental variables to examine the impact of lipids and apolipoproteins on GDM. The research comprised univariable and multivariable MR analyses, with a prime focus on individual and combined effects of lipid-related traits. Statistical techniques included the fixed-effect inverse variance weighted (IVW) method and supplementary methods such as MR-Egger for comprehensive assessment.

Results

Our findings revealed the following significant associations: apoA-I and HDL cholesterol were inversely correlated with GDM risk, while triglycerides showed a positive correlation. In multivariable analysis, apoA-I consistently exhibited a strong causal link with GDM, even after adjusting for other lipids and Body Mass Index (BMI).

Conclusion

The study demonstrates a significant causal relationship between apoA-I and GDM risk.
Tenascin C as a novel zinc finger protein 750 target regulating the immunogenicity via DNA damage in lung squamous cell carcinoma
Authors: Xia Lu , Lin Hexin , Cao Huifen , Lian Jiabian
Published: May 2024

Modulation of DNA damage repair in lung squamous cell carcinoma (LUSC) can result in the generation of neoantigens and heightened immunogenicity. Therefore, understanding DNA damage repair mechanisms holds significant clinical relevance for identifying targets for immunotherapy and devising therapeutic strategies. Our research has unveiled that the tumor suppressor zinc finger protein 750 (ZNF750) in LUSC binds to the promoter region of tenascin C (TNC), leading to reduced TNC expression. This modulation may impact the malignant behavior of tumor cells and is associated with patient prognosis. Additionally, single-cell RNA sequencing (scRNA-seq) of LUSC tissues has demonstrated an inverse correlation between ZNF750/TNC expression levels and immunogenicity. Manipulation of the ZNF750-TNC axis in vitro within LUSC cells has shown differential sensitivity to CD8+cells, underscoring its pivotal role in regulating cellular immunogenicity. Further transcriptome sequencing analysis, DNA damage repair assay, and single-strand break analyses have revealed the involvement of the ZNF750-TNC axis in determining the preference for homologous recombination (HR) repair or non-homologous end joining (NHEJ) repair of DNA damage. with involvement of the Hippo/ERK signaling pathway. In summary, this study sheds light on the ZNF750-TNC axis's role in DNA damage repair regulation in LUSC, laying a groundwork for future translational research in immune cell therapy for LUSC.