bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimizing delays to hemodialysis access maturation: A quality improvement analysis
Authors: Warren Andrew S , Wolf Hannah , Hillenbrand Charles J , Tang Gale L
Published: April 2024

Introduction:

Pre-operative process optimization can expedite time-to-intervention and reduce overall health care costs. We hypothesized that the longest delay to hemodialysis (HD) access creation would be from pre-operative vessel mapping (mandatory in our practice), and that this would be correlated with increased catheter days.

Methods:

One hundred thirty patients (24 inpatients, 106 outpatients) who received initial hemodialysis (HD) access from 01/01/2017 to 12/31/2021, at the Veterans Affairs Puget Sound, Seattle, Washington, were identified. Median time differences between pre-operative events were compared between inpatients and outpatients using the Mann-Whitney U test. Outpatients were then stratified by time of catheter-based HD initiation (no catheter, pre-referral catheter, post-referral catheter) and compared. The impacts of mapping-related delays on catheter use were evaluated using regression.

Results:

Inpatients had shorter referral to access maturation times (125 days inpatient vs 146 days outpatient; p = 0.03). This was driven by shorter referral to mapping (2 days inpatient vs 27 days outpatient; p < 0.01) and mapping to pre-surgical evaluation (1-day inpatient vs 6 days outpatients; p < 0.01) times. Pre-surgical evaluation to OR times represented the longest pre-operative delay in both groups (51 days inpatient vs 29 days outpatient; p = 0.59). Among outpatients, tunneled catheter placement post-referral resulted in longer maturation times (74 days no catheter vs 67 days pre-referral vs 149 days post-referral; p < 0.01) but not additional pre-operative delays. No trend existed between increased mapping times and catheter-based dialysis duration ( R2 = 0.08).

Conclusion:

Preoperative vein mapping contributed up to 21% of referral to maturation times but was not associated with increased tunneled catheter duration. While tunneled catheter placement impacted access maturation it did not cause additional pre-operative delays. Earlier referrals for access creation and reduction of outpatient wait-time from referral to OR and increased AV graft placement may minimize catheter days in our system thereby mitigating the added delays caused by pre-operative vein mapping.
Validating the anatomical landmark technique for bedside tunneled central venous catheter placement in the medical intensive care unit
Authors: Sawaf Hanny , Lane James , Shingarev Roman , Siuba Matthew , Kwon Alvin G , Hanane Tarik , Vachharajani Tushar J
Published: April 2024

Background:

A non-tunneled dialysis catheter (nTDC) is often the vascular access of choice to initiate dialysis in an intensive care unit (ICU). In the absence of contraindications, if a patient remains dialysis dependent beyond 2-weeks, the options are either to replace the nTDC with another nTDC or convert to a tunneled dialysis catheter (TDC). As a standard of care, TDCs are placed under fluoroscopic guidance.

Objectives:

To determine if TDCs and other tunneled central venous catheters (tCVC) can be placed safely using anatomical landmark techniques without the use of fluoroscopy.

Research design:

Subjects that met a predetermined selection criteria underwent placement of tunneled catheters with the use of the anatomical landmark technique. We looked at various outcomes to determine the safety and effectiveness of this technique.

Subjects:

One hundred eleven TDCs and other tCVCs were placed using the anatomical landmark technique in the intensive care unit.

Results:

All but one (110/111) of the catheters placed had recommended tip placement confirmed by at least one blinded physician. Major complications encountered were bleeding (two cases), pneumothorax (one case), and line associated blood stream infection (one case). We did find a higher-than-expected rate of “unnecessary procedures” with 18/111 lines placed in patients who did not survive beyond 7 days after placement of the catheter.

Conclusions:

Using the anatomical landmark technique for bedside tunneled catheter placement can be an effective approach in the right population.
Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007–2019
Authors: Oftung Bendik , Tyssen Reidar
Published: April 2024

Aims:

There are signs of increased stress at work among Norwegian physicians over the last decades, not least among general practitioners (GPs). In this review, we identify trends in both occupational stress and adverse work-related predictors of such stress and burnout in Norwegian physicians.

Methods:

We performed an extensive literature search using MEDLINE, Embase and PsycINFO. We included prospective and repeated cross-sectional studies of work stress among Norwegian physicians published in 2007–2019.

Results:

Nine studies with observation periods of 1–20 years were included. Occupational stress (global measure) among all doctors decreased gradually from medical school to 20 years later. The prevalence of an effort–reward imbalance increased fourfold among GPs during the period 2010–2019. Five studies reported higher levels of occupational stress among female physicians than among their male colleagues. Work–home conflict levels increased after graduation until 10 years after leaving medical school and plateaued thereafter. Physicians who graduated in a later cohort reported lower levels of work–home conflict and less workplace violence. Work–home conflict, low colleague support, number of work hours and workload/low autonomy were all independent predictors of occupational stress.

Conclusions:

The reduction in occupational stress during the years after leaving medical school may result from increased competency in clinical work and decreased on-call work. The Co-ordination Act implemented in 2012 may explain the increase in occupational stress among GPs. These findings suggest that both reducing work–home conflict and increasing colleague support are important for doctors’ well-being.
Overview of health research in Greenland from 2001 to 2020
Authors: Ipsen Emil Ø. , Dalvad Jos , Koch Anders , Bundgaad Johan S.
Published: April 2024

Aims:

Health research in Greenlanders is challenged by a small population, few dedicated researchers and limited funding. Some research areas have proven impactful but gaps in knowledge are unknown. We aimed to quantify health research in Greenland, providing insights for researchers, policymakers and funding agencies to guide future research.

Methods:

We identified all peer-reviewed health research publications with the term ‘Greenland***’ in title or abstract from 2001 to 2020 through the platform entitled The Lens. Our bibliometric analysis included number of publications, publication rate, research types, research topics, citations and author affiliations, as well as funding.

Results:

From 2001 to 2020, a total of 640 health research publications concerning Greenland or Greenlanders were identified, with an average annual publication growth rate of 2.9%. The major health research topics studied in Greenland were infectious diseases, environmental health and general health. Several research fields, including rheumatology, nephrology and dermatology among others proved understudied at best. Three Danish universities contributed with 33% of all publications, with the International Journal of Circumpolar Health ( N=176, 28%) being the top journal destination. The most productive author had 119 article authorships during the period.

Conclusion:

During the past 20 years, Greenland’s annual publication rate has been steadily increasing, with an average of 32 articles about health research published each year, which is a higher publication rate than world average. The health research in Greenland is primarily epidemiologic with infectious disease being the most studied research area. Most publications were anchored in Denmark and centred around a few highly productive authors.
Queering Rainbow Social Marketing: Ensuring Equitable Outcomes for Rainbow Communities
Authors: Smith Johnpaul , Kennedy Ann-Marie , Veer Ekant
Published: April 2024

Unfortunately, though we are seeing more acceptance/tolerance in society, Rainbow communities/LGBTQIA+ community continue to be marginalised and discriminated against. Many of these negative pressures and barriers create negative outcomes. Rainbow communities represent an umbrella term for sexually and gender diverse people including but not limited to transgender, non-binary, gay, lesbian and bisexual individuals. Social marketing offers a medium for pro-social change. However, interventions focused on Rainbow communities are comparatively scant, and little critiques have been put forward to ensure inclusion and facilitate appropriate representation and engagement. Therefore, the aim of this paper is to critique and evaluate existing Rainbow social marketing literature. To complete this evaluation, queering was used to highlight gaps, inaccuracies or limitations in the literature. Given reflection on the literature, three main problem areas emerged (1) a heavily skewed focus on the sexual health of gay men and MSM (men who have sex with men), (2) issues surrounding the individual(s) leading the intervention and (3) misrepresentation of identities in analysis and reporting. In identifying these issues, areas for further development, scrutiny and investigation can be revealed. Synthesising this, the other major contribution of this article is a discussion regarding vital future research that highlights areas of focus for Rainbow research and social marketing. The queering approach used supposes an emancipatory disposition and aims to highlight practical changes for that normative environment. Therefore, complementing the overarching aim, an objective and contribution of this paper are practical recommendations to ensure that social marketers appropriately support and engage Rainbow communities.
Optical study on a heavy-duty natural gas dual-fuel engine applying POMDME as pilot fuel
Authors: Mühlthaler Markus , Prager Maximilian , Jaensch Malte
Published: April 2024

In this study, a fully optically accessible single-cylinder research engine is the basis for the visualization and generation of extensive knowledge about the in-cylinder processes of mixture formation, ignition, and combustion of alternative fuels for the dual-fuel combustion process. POMDME substitutes the fossil pilot fuel as a drop-in, non-sooting alternative to widely eliminate the NOx-PM tradeoff. Furthermore, an optimized ignition behavior, increased degrees of freedom in combustion phasing, and the pilot’s energy content are expected. The flame luminosity transmitted via an optical piston was split in the optical path to record the natural flame luminosity simultaneously with an RGB high-speed camera. The second channel consisted of OH chemiluminescence recording, isolated by a bandpass filter via an intensified monochrome high-speed camera. To investigate the combustion process spectrally, spatially, and temporally resolved in more detail, selected operating points were re-recorded via a high-speed imaging spectrograph. POMDME is benchmarked against regular diesel oil, according to EN590. Synthetic natural gas is applied as the primary gaseous fuel. Experimental sweeps along the overall pilot’s energy content (2%, 5%, 10%), injection pressure (500–1600 bar), and start of energizing (5–55 CAD bFTDC) are carried out. The given conditions result in decreased liquid-penetration length between 25% and 30% for the oxygenate, larger for earlier SOE and higher dilution. The lift-off length is nearer the liquid penetration length, increasing for higher rail pressures. The light-based ignition delay for EN590 is enlarged by 0.8 CAD after adding methane, while the oxygenate is not visibly retarded. Without methane, the oxygenate preceded EN590 by 0.6 CAD. The temporal and spatial position and extent of premixed, diffusive, and OH*, change significantly. RCCI operation at practically relevant 18.4 bar IMEP is demonstrated, highlighting the influence of the start of energizing variation with 51% decreased burn duration in the first half of combustion.
Differences in Daily Activity Performance Between Inpatient Rehabilitation Facility and Home Among Stroke Survivors
Authors: Somerville Emily , Blenden Gabrielle , Kretzer Danielle , Holden Brianna , Bollinger Rebecca M. , Krauss Melissa J. , Haxton Meghan , Martin Noah , Carter Alexandre , Stark Susan L.
Published: April 2024

Background

Stroke survivors are one of the largest consumer groups of rehabilitation services. Despite improvement in daily activities while in inpatient rehabilitation, many have difficulty performing daily activities at home after discharge. The difference in performance between a standard clinical context and at home is poorly understood.

Objective

To better understand differences in activity performance during transition from inpatient rehabilitation facility (IRF) to home, we examined daily activity performance scores from 2 different environments (IRF and home) at the same time point (discharge).

Methods

This was a cross-sectional analysis using baseline data from a randomized controlled trial. Participants were stroke survivors aged ≥50 who planned to discharge home from the IRF. The Functional Independence Measure and Section GG codes (both converted to International Classification of Functioning, Disability, and Health scores) were conducted per protocol first at home and then in the IRF at discharge (≤3 days apart, order not randomized).

Results

Among 57 participants, activity scores at home were significantly worse than scores at IRF discharge. Over 40% of participants had discharge scores indicating no-to-mild impairment for shower/tub transfer, walking, and going up/down stairs, while home visit scores indicated moderate-to-complete impairment for those activities. The greatest differences in scores were for shower/tub transfer (median difference 1.5, 95% CI 1.00-2.00) and going up/down stairs (median difference 1.50, 95% CI 1.00-2.00).

Conclusion

The environment plays an important role in stroke survivors’ functioning at home. Future studies should further examine how the environment impacts activity performance upon returning home following stroke.
Clinicopathologic characteristics of HPV-associated head and neck squamous cell carcinoma in Southern China: long-term retrospective study of 400 cases
Authors: Du Mingyuan , Lin Qiaohong , Yan Shida , Gao Xianlu , Yang Chulin , Li Zhaoyang , Liao Wei , Yang Ankui , Chen Shuwei
Published: April 2024

Background:

Human papillomavirus (HPV)-associated head and neck squamous cell carcinoma (HNSCC) is an evolving and growing disease, especially in developing countries. However, the clinical characteristics of HPV-associated HNSCC in regard to HPV infection rates, patient features, and prognosis are under-reported in the Asian population.

Methods:

In this study, we retrospectively enrolled a 400-case cohort of HNSCC with p16 immunochemistry and analyzed with long-term follow-up. We investigate the current HPV prevalence of HNSCC, unique HPV-associated patient clinical characteristics, and patient prognosis in the southern China population.

Results:

HPV infection exhibited a 15% prevalence in all HNSCC cases, notably higher in oropharyngeal cases (30.7%), followed by oral cavity (11.8%), laryngeal (10.1%), and hypopharyngeal (2.5%). HPV status, gender, old age, and location of tumor were significantly associated with the patient’s survival. Tonsil invasion was found more frequent in HPV-positive oropharyngeal HNSCC than in HPV-negative cases. HPV-associated HNSCC patients tend to possess stronger tobacco and alcohol habits, which were correlated to poor survival. HPV status’s correlation with gender, age, and anatomical location is associated intricately with patient survival. The secondary primary tumor rate was found higher within the HPV-negative group, compared to the HPV-positive group (9.12% versus 1.67%).

Conclusion:

Our study provided a current picture of HPV-associated HNSCC in the southern China population and elaborated the understanding of key factors that correlate to HNSCC prognosis. Our findings indicated a strong susceptibility of HPV-associated oropharyngeal HNSCC in the tonsil and the difference in secondary primary tumor rates associated with HPV status.
Automated Insulin Delivery in Adults With Type 1 Diabetes and Suboptimal HbA1c During Prior Use of Insulin Pump and Continuous Glucose Monitoring: A Randomized Controlled Trial
Authors: Christensen Merete B. , Ranjan Ajenthen G. , Rytter Karen , McCarthy Olivia M. , Schmidt Signe , Nørgaard Kirsten
Published: April 2024

Background:

Automated insulin delivery (AID) systems offer promise in improving glycemic outcomes for individuals with type 1 diabetes. However, data on those who struggle with suboptimal glycemic levels despite insulin pump and continuous glucose monitoring (CGM) are limited. We conducted a randomized controlled trial to assess the effects of an AID system in this population.

Methods:

Participants with hemoglobin A1c (HbA1c) ≥ 58 mmol/mol (7.5%) were allocated 1:1 to 14 weeks of treatment with the MiniMed 780G system (AID) or continuation of usual care (UC). The primary endpoint was change in time in range (TIR: 3·9-10·0 mmol/L) from baseline to week 14. After this trial period, the UC group switched to AID treatment while the AID group continued using the system. Both groups were monitored for a total of 28 weeks.

Results:

Forty adults (mean ± SD: age 52 ± 11 years, HbA1c 67 ± 7 mmol/mol [8.3% ± 0.6%], diabetes duration 29 ±13 years) were included. After 14 weeks, TIR increased by 18.7% (95% confidence interval [CI] = 14.5, 22.9%) in the AID group and remained unchanged in the UC group ( P < .0001). Hemoglobin A1c decreased by 10.0 mmol/mol (95% CI = 7.0, 13.0 mmol/mol) (0.9% [95% CI = 0.6%, 1.2%]) in the AID group but remained unchanged in the UC group ( P < .0001). The glycemic benefits of AID treatment were reproduced after the 14-week extension phase. There were no episodes of severe hypoglycemia or diabetic ketoacidosis during the study.

Conclusions:

For adults with type 1 diabetes not meeting glycemic targets despite use of insulin pump and CGM, transitioning to an AID system confers considerable glycemic benefits.
Surface shape alters perceived material softness
Authors: Wang Hongbo , Sun Qingyu , Okamoto Shogo
Published: April 2024

When a human strokes the surface of an object with his/her finger, the surface shape influences the perceived softness of the object. This study introduced a curved surface softness illusion, which alters the perception of material softness. When a surface with curvature is felt by sliding a finger over it, it feels softer than a flat surface made of the same material. In contrast, a rugged surface is perceived as harder. This illusion indicates that, in addition to mechanical hardness, humans judge an object’s softness based on its surface shape.
Extending dialogues on the urban
Authors: Simone AbdouMaliq , Somda Dominique , Torino Giulia , Irawati Miya , Ramesh Niranjana , Bathla Nitin , Castriota Rodrigo , Vegliò Simone , Chandra Tanya
Published: April 2024

Across the different vernaculars of the world's urban majorities, there is renewed bewilderment as to what is going on in the cities in which they reside and frequently self-build. Prices are unaffordable and they are either pushed out or strongly lured away from central locations. Work is increasingly temporary, if available at all, and there is often just too much labour involved to keep lives viably in place. Not only do they look for affordability and new opportunities in increasingly distant suburbs and hinterlands, but for orientations, for ways of reading where things are heading, increasingly hedging their bets across multiple locations and affiliations. Coming together to write this piece from our own multiple orientations, we are eight researchers who, over the past year, joined to consider how variegated trajectories of expansion unsettle the current logic of city-making. We have used the notion of extensions as a way of thinking about operating in the middle of things, as both a reflection of and a way of dealing with this unsettling. An unsettling that disrupts clear designations of points of departure and arrival, movement and settlement, centre and periphery, and time and space.
Uncommon type 3 Monteggia equivalent lesion due to an ulnar shaft nonunion in adults: A case report
Authors: Mhiri Amir , Chermiti Wajdi , Hanafi Aymen , Kaziz Hamdi , Naouar Nader , Bouattour Karim
Published: April 2024

It is uncommon to observe a nonunion of an isolated ulnar shaft fracture after surgical treatment; therefore, complications due to this nonunion are very rare. Adults are more likely to develop nonunions compared to children. We report the case of a 34-year-old man, who had a left ulnar shaft fracture, treated with a screwed plate. Four months later, a septic nonunion occurred causing a type 3 Monteggia equivalent lesion with a lateral dislocation of the radial head. We describe the consecutive methods of treatment that resulted in complete bone consolidation. The case report aims to underline the diagnostic particularities and the therapeutic challenges of this rare complication.
Primary Care Providers’ Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic
Authors: Marshall Sarah Alexandra , Siebenmorgen Lachan E. , Youngen Katherine , Borders Tyrone , Zaller Nickolas
Published: April 2024

Background:

The COVID-19 pandemic catalyzed a rapid shift in healthcare delivery towards telehealth services, impacting patient care, including opioid use disorder (OUD) treatment. Regulatory changes eliminated the in-person evaluation requirement for buprenorphine treatment, encouraging adoption of telehealth. This study focused on understanding experiences of primary care providers in predominantly rural areas who used telehealth for OUD treatment during the pandemic.

Methods:

Semi-structured interviews were conducted with 22 primary care providers. Participants practiced in 13 rural and 9 urban counties in Kentucky and Arkansas. Data were analyzed using conventional content analysis.

Results:

The pandemic significantly impacted healthcare delivery. While telehealth was integrated for behavioral health counseling, in-person visits remained crucial, especially for urine drug screenings. Telehealth experiences varied, with some facing technology issues, while others found it efficient. Telehealth proved valuable for behavioral health counseling and sustaining relationships with established patients. Patients with OUD faced unique challenges, including housing, internet, transportation, and counseling needs. Stigma surrounding OUD affected clinical relationships. Building strong patient-provider relationships emerged as a central theme, emphasizing the value of face-to-face interactions. Regarding buprenorphine training, most found waiver training helpful but lacked formal education.

Conclusion:

This research offers vital guidance for improving OUD treatment services, especially in rural areas during crises like the COVID-19 pandemic. It highlights telehealth’s value as a tool while acknowledging its limitations. The study underscores the significance of strong patient-provider relationships, the importance of reducing stigma, and the potential for training programs to elevate quality of care in OUD treatment.
Cross-cultural Research of Speech Codes: Transitivity Processes in Corporate Social Responsibility Reports
Authors: Gai Feihong , Yang Lianrui , Chen Shifa
Published: April 2024

Evolving from ethnographic research that determines what meanings are shared within a culture, studies regarding Speech Codes Theory have been conducted with implications for intercultural communication. Arguing for transitivity as speech codes in diverse cultures, this paper aims to describe and explain the transitivity attributes of English-medium Corporate Social Responsibility (CSR) reports by Chinese and British/American corporations, and the transitivity variances between industries by Chinese corporations. Results reveal that frequencies of transitivity features in the Chinese CSR reports are significantly lower than those in the British/American reports, and that the relational process dominates in the corpus under investigation. Also, cross-industrial comparisons among Chinese corporations show that the mechanical manufacturing enterprises and the iron & steel enterprises share similar transitivity codes, but they differ from the energy enterprises distinctively. The paper concludes that linguistic/cultural contexts, translation strategies, moves in the CSR reports, and industry attributes together contribute to the transitivity codes and communicative conducts in different cultural and industrial backgrounds. This paper might help writers/translators of CSR reports in China better understand lexical and functional conformities and peculiarities reflected in Chinese and British/American CSR reports, enhance their corporate narration in the international communities, and thus reinforce communication with the general public by appropriately expressing and accurately translating transitivity processes.
Development and Validation of the Artificial Intelligence Learning Intention Scale (AILIS) for University Students
Authors: Chai Ching Sing , Yu Ding , King Ronnel B. , Zhou Ying
Published: April 2024

As artificial intelligence (AI) permeates almost all aspects of our lives, university students need to acquire relevant knowledge, skills, and attitudes to adapt to the challenges it poses. This study reports the development and validation of a scale called the Artificial Intelligence Learning Intention Scale (AILIS). AILIS was designed to measure the different factors that shape university students’ behavioral intentions to learn about AI and their AI learning. We recruited 907 Chinese university students who answered the survey. The scale is comprised of 9 factors that are categorized into various dimensions pertaining to epistemic capacity (AI basic knowledge, programming efficacy, designing AI for social good), facilitating environments (actual use of AI systems, subjective norms, access to support and technology), psychological attitudes (resilience, optimism, personal relevance), and focal outcomes (behavioral intention to learn AI, actual learning of AI). Reliability analyses and confirmatory factor analyses indicated that the scale has acceptable reliability and construct validity. Structural equational modeling results demonstrated the critical role played by epistemic capacity, facilitating environments, and psychological attitudes in promoting students’ behavioral intentions and actual learning of AI. Overall, the findings revealed that university students express a strong intention to learn about AI, and this behavioral intention is positively associated with actual learning. The study contextualizes the theory of planned behavior for university AI education, provides guidelines on the design of AI curriculum courses, and proposes a possible tool to evaluate university AI curriculum.
Interprofessional Communication of Combatant First-Aid Personnel: Emotional Co-construction in Training Framework
Authors: Liubashenko Olesia
Published: April 2024

First-aid personnel who engage in initial dialogues with injured combatants on the front lines become participants in interprofessional communication and need training courses that address their requirements for effective communication and dialogic interaction in combat environments. The primary objective of this research is to integrate emotional co-construction strategies into the training curriculum for First Aid Services (FAS). The study explores various emotional language devices and communication strategies that impact the trauma resolution process. The practical aim of this research is to offer insights for the development of workplace communication courses for FAS, fostering dialogues that contribute to personal stabilization, resilience, resistance, and relief for the combatant.
Prognostic Nutritional Index Enhances the Discriminatory Ability of Procalcitonin for Predicting Pediatric Sepsis
Authors: Hongya Deng , Linfan Deng , Chunyuan He , Jun Jiang , Bin Liu , Jian Zhao , Gang Li
Published: April 2024

Objective. Improving diagnostic ability of pediatric sepsis is of great significance for reducing the mortality of sepsis. This study explored the discriminatory capacity of nutritional index (PNI) in pediatric sepsis. Methods. We retrospectively enrolled 134 children with suspected sepsis and collected their clinical and laboratory data. Receiver operating characteristic curves (ROC), decision curve analysis (DCA) and net reclassification improvement (NRI) were performed to compare the predictive significance of the PNI, procalcitonin (PCT) and their combination. Results. Among 134 patients, 65 children were diagnosed with sepsis and 69 children with non-sepsis. PCT and PNI were independently associated with pediatric sepsis. PCT was superior to PNI to predict pediatric sepsis. The model based on PCT + PNI improved the predictive capacity than them alone, as demonstrated by ROC, DCA and NRI, respectively. Conclusion. PNI was independently associated with pediatric sepsis, and addition of PNI could improve the capacity of PCT to predict pediatric sepsis.
Determinants of Nurses’ Knowledge Toward the Elderly Care, Southwest, Ethiopia
Authors: Abdu Mehd , Daniel Tariku , Yesuf Mohammed
Published: April 2024

Introduction

Elderly individuals are the segment of the population that needs special care. The quality of care provided for elderly individuals is highly determined by the knowledge of nurses in elderly care. Hence, there are limited studies conducted to determine the level of knowledge of nurses regarding elderly care. Therefore, this study aimed to assess determinant factors of nurses’ knowledge of elderly care.

Methods

A facility-based cross-sectional study design was employed from April 1 to 10, 2021, among 345 nurses. Respondents were selected by a simple random sampling technique. The data were collected through a self-administered structured questionnaire. The collected data were entered and analyzed by using Statistical Package for Social Science software version 25.0. A multivariable binary logistic regression was used to identify factors significantly associated with the knowledge of nurses about elderly care.

Result

The response rate of this study was 98.3%. More than half of the respondents were female (51.6%) and 38.3% were single in marital status. Being knowledgeable among nurses about elderly care was 51.9%. Ever living with the elderly (adjusted odd ratio [AOR]: 3.62; 95% CI: 1.661, 7.89) and taking geriatric care training (AOR: 5.209, 95% CI: 2.771, 9.79) were positively associated with the knowledge of nurses toward elderly care while work experience <5 years (AOR: 0.305; 95% CI: 0.134, 0,696), and work experience 5–10 years (AOR: 0.359; 95% CI: 0.15, 0.864) were negatively associated with the knowledge of nurses toward elderly care.

Conclusion

The knowledge of nurses about elderly care was moderate. Ever lived with the elderly, work experience, and taking geriatric care training contributed to nurses’ knowledge about elderly care. Therefore, hospital administrators and the Ministry of Health should facilitate training, design, and implement standard guidelines on nursing practice for elderly care.
Nonpigmented Adenoma of the Retinal Pigment Epithelium Mimicking a Retinal Vasoproliferative Tumor Managed With Endoresection
Authors: Coussa Razek G. , Mansoor Mahsaw , Boldt H. Culver , Binkley Elaine M.
Published: April 2024

Purpose: To present a case with signs suggestive of a retinal vasoproliferative tumor. Methods: A case report was evaluated and a surgical video presented. Results: A 61-year-old White man presented with an amelanotic retinal tumor associated with exudation, retinal edema, and overlying telangiectatic vessels, suggestive of a retinal vasoproliferative tumor. Standardized echography showed an irregular mass with medium-to-high internal reflectivity and internal calcification, which suggested chronicity. He was initially treated for an exudative retinal detachment (RD) in the context of a presumed vasoproliferative tumor but later developed combined exudative and rhegmatogenous RD, prompting surgical repair with tumor endoresection. Pathology showed nonpigmented adenoma of the retinal pigment epithelium (RPE). Conclusions: Nonpigmented adenoma of the RPE is a rare tumor, and its clinical similarity to a vasoproliferative tumor should be noted. Endoresection may be considered in cases resulting in RD.
Fresh meat: Women's motivations to hunt and how they challenge hunting structures
Authors: Tickle Lara , von Essen Erica , Fischer Anke
Published: April 2024

Hunting has a unique status as a sport and leisure activity alongside its practices having high stakes for society related to ecology, biosecurity, animal welfare and public safety. As such, hunting must increasingly legitimate itself before the public both in terms of ethically justifiable motivations for why to hunt and ethical standards for how to hunt. One way in which public acceptance has been sought in recent years has been to frontline ‘women hunters’ as the hunting community's indirect ambassadors. An effort to recruit more women is also seen as imperative to the survival of hunting in a practical, demographic sense. When women enter hunting, they enter an arena that is opaque and difficult to navigate along with heavy baggage from gender roles, expectations about proximity to wildlife and nature, and masculine norms on behaviour. In this study, we demonstrate through semi-structured interviews, participant observation and auto-ethnography of a hunting license education in Sweden, how women navigate spaces carved out for men. The findings show traps of emphasised femininity, expectations of women as ‘softening influences’ on male hunters to rein in their potentially unethical behaviour, and as differentially positioned in the learning process of hunting. However, using Bourdieu's social capital, findings also reveal that women negotiate and trade attributes in creative ways – such as landownership, meat handling skills and knowledge – to gain an advantage, status or level the playing field. We argue that regardless of gender, being in a position of sufficient capital to be able to call out unethical behaviour in the hunting team is crucial insofar as it serves the hunting community's ultimate interest.
A machine vision approach for detecting changes in drill core textures using optical images
Authors: Gu Xiaomeng , Cook Nigel J. , Metcalfe Andrew V. , Aldrich Chris
Published: April 2024

Drill core images offer valuable insights into the texture, structure and mineralogy of ores and their host rocks, which can be used to optimise downstream processes in the mining industry. The impact on downstream processes from particles of similar composition and mineralogy but different textures has been examined by several previous researchers through the application of supervised machine-learning techniques. This study proposes a novel approach for detecting changes in drill core textures through the analysis of optical images. This approach compares three widely used image feature extraction techniques (local binary patterns, grey-level co-occurrence matrix and convolutional neural network), followed by calculation of a uniqueness measure, based on the Hotelling statistic, designed to identify anomalous segments of core. The effectiveness of the uniqueness measure is validated on a test core comprising six sections with different textures. Two drill cores, from the Brukunga test site in South Australia, were selected as case studies. Of the three feature extraction methods, local binary patterns were found to give the strongest signals of change. There exist two main regimes that separate halfway along both drill cores, indicating a change in lithology or the presence of mineralisation.
Origins of the Glandular Mucosae in the Gastro-Esophageal Junction—A Study in a South Asian Population With Low Incidence of Esophageal Adenocarcinoma
Authors: Wijetunge Sulochana , De Silva Lakvahandhi Damindra Saseekalani , Kotakadeniya Rasika , Halahakoon Vijitha Chandima , Galketiya Kuda Banda , Samarasingha Bandula , Dharmapala Arinda
Published: April 2024

Introduction:

Gastro-esophageal junction (GEJ) is subjected to controversy due to limited knowledge of its anatomy and histology. We conducted a study to determine the origins of the glandular mucosa at GEJ.

Methods:

Three groups were used, groups A and B, with grossly normal GEJs and Group C with endoscopic evidence of reflux damage. Group A comprised 23 esophago-gastrectomies, group B, 112 dyspeptic patients with normal GEJ and group C, 46 dyspeptic patients with reflux damaged GEJs. Origins of cardiac mucosa (CM), intestinal metaplasia (IM), and oxyntocardiac mucosa (OCM) were determined by studying their associations with esophageal markers (EM): esophageal glands and ducts, multilayered epithelium and squamous islands highlighted with immunohistochemistry. The histological gap between esophageal squamous and gastric oxyntic mucosa containing CM/IM/OCM was considered as squamo-oxyntic (SO) gap.

Results:

In Group A and B, a microscopic SO gap was detected in 58.1% and the prevalence of CM was 43% and IM 4.4% and CM 89.7%; 100% IM were associated with EM. Prevalence of CM and IM, in group C was 56.5% and 15.2% respectively and EM were present in 85.7% IM and 88.5% CM. When only OCM is present, 41.2% were proven to be metaplastic.

Conclusions:

Even when GEJ is grossly normal, microscopic columnar lined esophagus was common at the GEJ and with increased sampling and using several EM almost all CM and IM at the GEJ could be proven to be metaplastic in origin.
Electron density changes accompanying high-pressure phase transition in AlOOH
Authors: Gajda Roman , Parafiniuk Jan , Fertey Pierre , Dera Przemysław , Woźniak Krzysztof
Published: April 2024

An attempt to compare and describe the differences in the electron density distribution between two phase structures of AlOOH has been made. High-resolution, high-pressure experiments with α-AlOOH diaspore were conducted using single-crystal synchrotron X-ray diffraction data. A multipole model of experimental electron density in the α-AlOOH single crystal was refined. Simultaneously, similar multipole refinement was conducted for another phase of diaspore (δ-AlOOH), this time based on a previously published data set. Both results were compared and supported by density functional theory (DFT) calculations. Although the results are affected by the limited quality of the data, it is clear that the phase transition caused significant changes in the shape and arrangement of the atomic basins.

Atomic basins are a much better tool to present subtle electron density distribution changes than traditional polyhedra. Straightforward comparison of datasets available in older scientific papers and current datasets is challenging because of differences in data quality and collection parameters. However, augmenting experimental data with computational results can help reveal important information in even incomplete datasets.
The science behind the nose: correlating volatile organic compound characterisation with canine biodetection of COVID-19
Authors: Charles Marthe , Ruszkiewicz Dorota , Eckbo Eric , Bryce Elizabeth , Zurberg Teresa , Meister Austin , Aksu Lâle , Navas Leonardo , Myers Renelle
Published: April 2024

Background

The SARS-CoV-2 pandemic stimulated the advancement and research in the field of canine scent detection of COVID-19 and volatile organic compound (VOC) breath sampling. It remains unclear which VOCs are associated with positive canine alerts. This study aimed to confirm that the training aids used for COVID-19 canine scent detection were indeed releasing discriminant COVID-19 VOCs detectable and identifiable by gas chromatography (GC-MS).

Methods

Inexperienced dogs (two Labradors and one English Springer Spaniel) were trained over 19 weeks to discriminate between COVID-19 infected and uninfected individuals and then independently validated. Getxent tubes, impregnated with the odours from clinical gargle samples, used during the canines’ maintenance training process were also analysed using GC-MS.

Results

Three dogs were successfully trained to detect COVID-19. A principal components analysis model was created and confirmed the ability to discriminate between VOCs from positive and negative COVID-19 Getxent tubes with a sensitivity of 78% and a specificity of 77%. Two VOCs were found to be very predictive of positive COVID-19 cases. When comparing the dogs with GC-MS, F1 and Matthew's correlation coefficient, correlation scores of 0.69 and 0.37 were observed, respectively, demonstrating good concordance between the two methods.

Interpretation

This study provides analytical confirmation that canine training aids can be safely and reliably produced with good discrimination between positive samples and negative controls. It is also a further step towards better understanding of canine odour discrimination of COVID-19 as the scent of interest and defining what VOC elements the canines interpret as “essential”.
Standards of care and educational gaps in adult cystic fibrosis units: a European Respiratory Society survey
Authors: Felipe Montiel Almudena , Álvarez Fernández Antonio , Culebras Amigo Mario , Blasi Francesco , Gramegna Andrea , Elborn Stuart , Horsley Alexander , Madge Susan , Stolz Daiana , Tabin Nathalie , Pannetier Carine , Polverino Eva
Published: April 2024

Background

Significant progress in the field of cystic fibrosis (CF) has substantially extended the life expectancy of patients with CF (pwCF). Consequently, the population of adult pwCF has outnumbered paediatric patients in most developed countries. Ageing is a new factor that can contribute to disease complexity and can require adaptation of CF units. Therefore, the necessity for standardised, specialised and multidisciplinary care is imperative. Concerns arise regarding the adequacy of current healthcare, therapeutic and educational offerings.

Methods

To address these concerns, a multinational survey was conducted to assess the current state of care in specialised multidisciplinary adult and paediatric CF units and identify areas for improvement. Responses were collected from 44 centres providing regular care to CF patients.

Results

The survey unveiled considerable disparities in the availability of critical resources, including diagnostic access, supplementary testing, treatment modalities, transplant and transition programmes, and healthcare professionals’ training.

Conclusion

This study underscores the urgent need to standardise care across these centres in order to minimise disparities in terms of available resources and training with a particular emphasis on adult pwCF who are becoming more numerous and showing different needs with ageing. The changing landscape of CF in adulthood will require constant monitoring to ensure proper adaptation of the current model of care.
Genomic epidemiology ofMycobacterium abscessusat an adult cystic fibrosis programme reveals low potential for healthcare-associated transmission
Authors: Gross Jane E. , Finklea James D. , Caceres Silvia M. , Poch Katie R. , Hasan Nabeeh A. , Jia Fan , Epperson L. Elaine , Lipner Ettie M. , Vang Charmie K. , Honda Jennifer R. , Strand Matthew J. , Nogueira de Moura Vinicius Calado , Daley Charles L. , Strong Michael , Nick Jerry A.
Published: April 2024

Rationale

Nontuberculous mycobacteria (NTM) has been reported to be transmitted between people with cystic fibrosis (CF) attending CF centres. A suspectedMycobacterium abscessusoutbreak was investigated at the University of Texas Southwestern (UTSW) Adult CF Program using a combination of pathogen genomic sequencing and epidemiologic methods. The objectives of the present study were to apply the Healthcare-Associated Links in Transmission of NTM (HALT NTM) study to investigate the occurrence of potential healthcare-associated transmission and/or acquisition of NTM among people with CF infected with genetically similar NTM isolates.

Methods

Whole-genome sequencing of respiratoryM. abscessusisolates from 50 people with CF receiving care at UTSW was performed to identify genetically similar isolates. Epidemiologic investigation, comparison of respiratory and environmental isolates, and home residence watershed mapping were studied.

Measurements and main results

Whole-genome sequencing analysis demonstrated seven clusters of genetically similarM. abscessus(four ssp. abscessusand three ssp.massiliense). Epidemiologic investigation revealed potential opportunities for healthcare-associated transmission within three of these clusters. Healthcare environmental sampling did not recoverM. abscessus, but did recover four human disease-causing species of NTM. No subjects having clustered infections lived in the same home residence watershed. Some subjects were infected with more than oneM. abscessusgenotype, both within and outside of the dominant circulating clones.

Conclusions

Healthcare-associated person-to-person transmission ofM. abscessusappears to be rare at this centre. However, polyclonal infections ofM. abscessusspecies and subspecies, not originating from the endemic hospital environment, suggest multiple shared modes of acquisition outside the healthcare setting.
Environmental, healthcare and societal impacts of asthma: a UK model-based assessment
Authors: Orlovic Martina , Tzelis Dimitrios , Guerra Inês , Bar-Katz Vladislava , Woolley Nicholas , Bray Hannah , Hanslot Mohammed , Usmani Omar , Madoni Alessandra
Published: April 2024

Background

This study aimed to assess the broader environmental, healthcare and societal impacts across the entire asthma pathway from diagnosis to treatment in the UK.

Methods

A comprehensive cost-of-illness framework was developed considering the effects of the full asthma patient pathway, including greenhouse gas emissions generated from inhalers, National Health Service (NHS) costs, health-related quality of life and productivity losses. The model was based on published literature and clinical expert opinion to accurately estimate, in monetary terms, the net present value of the asthma pathway impacts for 2022–2031.

Results

The estimated net present value of the environmental, healthcare and societal impacts of the asthma pathway was £47 billion over the 2022–2031 period in the UK. Loss of disease control was a key contributor to higher greenhouse gas emissions and NHS costs. In 2022, a patient with non-severe uncontrolled asthma was estimated to incur 22% higher NHS costs than a patient with controlled asthma, while generating 0.1 t more of CO2equivalent emissions. In the same year, the total direct impacts per patient with severe asthma were four times higher than for a patient with non-severe controlled asthma, with 0.54 t CO2equivalent of greenhouse gas emissions. Moreover, as much as 77% of the total economic impact was driven by worsening health-related quality of life and productivity impacts occurring when patients’ symptoms were uncontrolled.

Conclusions

Uncontrolled asthma significantly impacts patients, the economy and the environment in the UK. Our results emphasise the need for a holistic approach in controlling asthma and should be carefully considered when developing policies to mitigate the overall burden of the disease.