bluuebunny/crossref_metadata_2025 huggingface dataset:
Pathogenesis of Kasokero virus in experimentally infected Egyptian rousette bats (Rousettus aegyptiacus)
Authors: Kirejczyk Shannon G. M. , Schuh Amy J. , Zhang Jian , Amman Brian R. , Guito Jonathan C. , Sealy Tara K. , Graziano James C. , Brown Corrie C. , Towner Jonathan S.
Published: March 2023

Egyptian rousette bats (ERBs; Rousettus aegyptiacus; family Pteropodidae) are associated with a growing number of bunyaviruses of public health importance, including Kasokero virus (KASV), which was first identified as a zoonosis in Uganda in 1977. In this study, formalin-fixed paraffin-embedded tissues from a previous experiment in which KASV infection was confirmed in 18 experimentally infected ERBs were used for an in-depth analysis using histopathology, in situ hybridization (ISH) for detection of viral RNA, immunohistochemistry (IHC) to assess the mononuclear phagocyte system response, and quantitative digital image analysis to investigate virus clearance from the liver and spleen within a spatial context. Significant gross and histological lesions were limited to the liver, where KASV-infected bats developed mild to moderate, acute viral hepatitis, which was first observed at 3 days postinfection (DPI), peaked at 6 DPI, and was resolved by 20 DPI. A subset of bats had glycogen depletion ( n = 10) and hepatic necrosis ( n = 3), rarely with intralesional bacteria ( n = 1). Virus replication was confirmed by ISH in the liver, spleen, lymph nodes, and tongue. In the liver, KASV replicated in the cytoplasm of hepatocytes, to a lesser extent in mononuclear phagocytes, and rarely in presumptive endothelial cells. Most KASV RNA, as detected by ISH, was cleared from the spleen and liver by 6 DPI. It is concluded that ERBs have effective mechanisms to respond to this virus, clearing it without evidence of clinical disease.
Attention to inattention: Effect of the other’s attentional state on visual search performance in chimpanzees
Authors: Tomonaga Masaki , Imura Tomoko
Published: March 2023

In the present study, we examined the effects of the other’s triadic attention to objects on visual search performances in chimpanzees. We found the search-asymmetry-like effect of the other’s attentional state; the chimpanzees searched a target object not attended by the other individual more efficiently than that attended (Experiment 1). Additional experiments explored the possibility that the other individual “holding an object but not looking at it” led to expectancy violation (Experiment 2) or the role of nonsocial cues such as the proximity relation between the head and the object (Experiment 3). Still, these accounts alone did not explain this effect. It was also shown that the other’s attentional state affected the chimpanzees’ performances more readily as the interference effect than the facilitation effect (Experiment 4). Furthermore, the same effect was observed in the visual search for the gaze (head direction) of others (Experiment 5). We obtained the same results using photographs of chimpanzees (Experiment 6). Contrary to the chimpanzees, humans detected the object to which attention was directed more efficiently than vice versa (Experiment 7). The present results may reflect species differences between chimpanzees and humans in processing triadic social attention.
Race, Merit, and the Moral Economy of International Relations
Authors: Krishna Sankaran
Published: March 2023

International Relations (IR) as a discipline explains the fact of global inequality through a discourse of meritocracy. In the early decades of the discipline, such explanations were explicitly racial, and justified empire and Western dominance on the basis of their innate superiority over the rest of the world. In later and in contemporary times, such racialized explanations for inequality have been replaced by ostensibly merit-based explanations that turn out, on closer examination, to replicate the inner logic and exclusionary claims of earlier ones. The notion of meritocracy has been a key element in the ideological appeal of IR as a discourse to elites and aspiring middle classes central to nation-building efforts in the global South. This latter fact complicates efforts that equate decolonizing the discipline with the promotion of diversity in its membership and the widening of its empirical and theoretical concerns. Central to any notion of a genuinely decolonial IR must be an attack on the very idea of merit as explaining and justifying international and domestic inequality.
Optimization of sound absorbing material by using Taguchi and ANOVA
Authors: Bhingare Nirmala H , Subramaniam Prakash
Published: March 2023

At present, target on eco-friendly acoustic material is decorated to diminish impact on environment due to adoption of synthetic material in acoustic application. In this paper, Taguchi method is enforced to find optimum parameters for sound absorbing coefficient of coconut fiber-based sound absorbing material. The influence of the various process parameters, i.e. Thickness, density, air gap and fiber percentage (%) on sound absorption coefficient (SAC) was studied. The settings of the parameters were determined by using Taguchi’s experimental design method. Orthogonal arrays (L25) of Taguchi, the signal-to-noise (S/N) ratio, the analysis of variance (ANOVA), and regression analyses were employed to find the optimal process parameter levels and to analyze the effect of these parameters on sound absorption coefficient values. Confirmation test with the optimal levels of parameters was carried out in order to illustrate the effectiveness of the Taguchi optimization method. Optimum parameters were found by using Taguchi method are which have 50 mm thickness, 0.0002539 g/mm3 density, 70% fiber percentage and 0 mm air gap. Also significant parameters are found which are thickness and density having p-value less than 0.05 and followed by fiber percentage and air gap. By using optimum parameters sound absorption coefficient is increased to 0.98 at frequency 2800–3500 Hz.
Genotoxicity of oxidative hair dye precursors: A systematic review
Authors: Babić Željka , Hallmann Sarah , Havmose Martin S , Johansen Jeanne D , John Swen M , Symanzik Cara , Uter Wolfgang , Weinert Patricia , van der Molen Henk F , Kezic Sanja , Macan Jelena , Turk Rajka
Published: March 2023

This systematic review, conducted according to the PRISMA guidelines, focuses on genotoxicity of oxidative hair dye precursors. The search for original papers published from 2000 to 2021 was performed in Medline, Web of Science, Cochrane registry, Scientific Committee on Consumer Safety of the European Commission and German MAK Commission opinions. Nine publications on genotoxicity of p-phenylenediamine (PPD) and toluene-2,5-diamine ( p-toluylenediamine; PTD) were included, reporting results of 17 assays covering main genotoxicity endpoints. PPD and PTD were positive in bacterial mutation in vitro assay, and PPD tested positive also for somatic cell mutations in the Rodent Pig-a assay in vivo. Clastogenicity of PPD and PTD was revealed by in vitro chromosomal aberration assay. The alkaline comet assay in vitro showed DNA damage after PPD exposure, which was not confirmed in vivo , where PTD exhibited positive results. PPD induced micronucleus formation in vitro, and increased micronucleus frequencies in mice erythrocytes following high dose oral exposure in vivo. Based on the results of a limited number of data from the classical genotoxicity assay battery, this systematic review indicates genotoxic potential of hair dye precursors PPD and PTD, which may present an important health concern for consumers and in particular for professional hairdressers.
A comprehensive experimental review of strain rate, size effect, creep and confinement in concrete: Part III
Authors: Ahmed Bilal , Park Taehyo , Voyiadjis George Z
Published: March 2023

A comprehensive review of destructive testing techniques to understand concrete behavior is presented in this work. The main objective of this article is to summarize the literature from the last three decades related to the following topics: 1) the size effect in plain and reinforced concrete, 2) the crack estimation and propagation in concrete under various loading conditions, 3) the determination of material properties of concrete using triaxial testing techniques, 4) the behavior of concrete under creep and early age shrinkage which eventually affect the properties of concrete and lastly 5) the strain rate effect in concrete using various experimental techniques such as Split Hopkinson pressure bar, impact loading, drop hammer and the literature related to cyclic loading on concrete. The scope of the presented work is limited to destructive testing related to the topics defined above. To completely understand the behavior of material, at least three aspects must be required: the material’s theoretical basics, experimental validation, and numerical implementation. The authors presented the review articles related to theoretical basics and numerical implementation in parts I and II of this article. The presented work is part III, which is related to experimental work. In the upcoming section, the research related to specific topics is presented, and a summary is provided at the end of each section. Finally, the future works and the research directions are shown in the conclusion section.
Medication Decision Making in Low-Income Families of Black Children With ADHD: A Mixed Methods Study
Authors: Glasofer Amy , Dingley Catherine , Kim Jinyoung , Colosimo Roseann , Gordon Howard R. D.
Published: March 2023

Objectives:

The purpose of this study was to explore how and why some low-income Black caregivers seek medication treatment for their children with ADHD.

Methods:

Using a sequential exploratory mixed method design, Phase 1 comprised an indepth case study design of seven low-income Black caregivers of children receiving medication for ADHD. Based on findings from Phase 1, the second phase involved a secondary analysis of data on Black uninsured or publicly insured children age 6 to 17 with ADHD ( n = 450).

Results:

Factors influencing medication decision-making included child safety and volatility, caregiver mental health, caregiver aggravation, family centered care (FCC), shared decision making (SDM), sole caregiver status, and school involvement. After adjusting for ADHD severity, previous receipt of special education services and experiences of FCC and SDM were independently associated with receipt of a medication for ADHD.

Conclusions:

Clinicians and school personnel can intervene to decrease disparities in the treatment of ADHD.
Analysis of ultrasonic nonlinearity for bolt hole crack detection in rail joints by wavelet packet decomposition
Authors: Zhang Weiwei , Wang Chuang , Li Jun , Hao Hong , Ma Hongwei
Published: March 2023

This paper proposes a crack detection method for rail joint screw holes based on the ultrasonic nonlinearity. Experimental and numerical studies are conducted to validate the performance of the proposed approach. The ultrasonic signals excited and received at the rail head are processed by spectral analysis and Wavelet Packet Decomposition (WPD). The third harmonic can be clearly observed from the spectrum analysis, which is supposed to be the nonlinearity of structures. Further, WPD is used to decompose the frequency components of the received signals. A damage index (DI) is defined based on the energy percentage of the energy in the WPD node containing the third harmonic with respect to the total energy of the received signal. It is found that the DI relating to the third harmonic increases with an approximately linear relationship when the crack grows bigger. It can provide a basis for the crack detection and quantification for the rail joint screw holes. A finite element model of the experimentally tested rail is also developed and numerical studies are conducted to verify the ultrasonic nonlinearity in the rail structure. Numerical results have the same trend with the experimental results, which verifies the effectiveness of the proposed method for crack detection in rail joints based on the high order ultrasonic nonlinear harmonics.
Grandparent-Implemented Interventions to Reduce Challenging Behavior of an Adult With Autism: A Pilot Telehealth Case Study
Authors: Gregori Emily , Drew Christine , Lory Catharine , Kim Namhee
Published: March 2023

Adults with autism spectrum disorder (ASD) often engage in challenging behavior that requires individualized intervention to remediate. However, access to high-quality services is limited for adults, leaving this population without necessary behavioral healthcare. This study addressed the needs of a 22-year-old man with ASD and intellectual disability (ID) who lived with his grandmother and engaged in tangibly maintained challenging behavior. The interventionist coached his grandmother via telehealth in the implementation of two behavior analytic interventions: signaled multiple schedule arrangement and a modified contingency contract. The effects of the interventions were evaluated using an alternating treatments design with baseline. While both interventions were effective at decreasing challenging behavior when compared to baseline, the signaled multiple schedule arrangement resulted in zero instances of challenging behavior. Both the participant and the grandparent completed post-intervention social validity assessments and reported overall positive satisfaction with the interventions. Practice recommendations are presented.
Clinical Accuracy of a Glucose Oxidase–Based Blood Glucose Test-Strip Across Extremes of Oxygen Partial Pressure
Authors: Setford Steven , Phillips Stuart , Cameron Hilary , Grady Mike
Published: March 2023

Background:

Glucose oxidase (GOx)-based blood glucose monitors (BGMs) are influenced by the partial pressure of oxygen (Po2) within the applied sample. Limited in-clinic data exists regarding the quantitative effect of Po2 in unmanipulated capillary fingertip blood samples across physiologically representative glucose and Po2 ranges.

Method:

Clinical accuracy data were collected as part of a BGM manufacturer’s ongoing post-market surveillance program for a commercially available GOx-based BGM test-strip. The data set comprised 29 901 paired BGM-comparator readings and corresponding Po2 values from 5 428 blood samples from a panel of 975 subjects.

Results:

A linear regression-calculated bias range of 5.22% (+0.72% [low Po2: 45 mm Hg] to −4.5% [high Po2: 105 mm Hg]); biases calculated as absolute at <100 mg/dL glucose was found. Below the nominal Po2 of 75 mm Hg, a linear regression bias of +3.14% was calculated at low Po2, while negligible impact on bias (regression slope: +0.002%) was observed at higher than nominal levels (>75 mm Hg). When evaluating BGM performance under corner conditions of low (<70 mg/dL) and high (>180 mg/dL) glucose, combined with low and high Po2, linear regression biases ranged from +1.52% to −5.32% within this small group of subjects and with no readings recorded at <70 mg/dL glucose at low and high Po2.

Conclusions:

Data from this large-scale clinical study, performed on unmanipulated fingertip capillary bloods from a diverse diabetes population, indicate Po2 sensitivity of the BGM to be markedly lower than published studies, which are mainly laboratory-based, requiring artificial manipulation of oxygen levels in aliquots of venous blood.
Commentary—Much ado About Something Else. Donald Trump, the US Stock Market, and the Public Interest Ethics of Social Media Communication
Authors: Gori Leonella , Luigi Sacco Pier , Teti Emanuele , Triveri Francesca
Published: March 2023

We analyze Donald J. Trump’s Twitter activity over the last months of the 2016 presidential campaign, his period as President Elect, and his Presidential term until Fall 2019, shortly before the outbreak of the pandemic. Trump weaponized social networks as a communication tool to build influence on the financial market and the public opinion. We relate Trump’s communication on Twitter to the dynamics of the NASDAQ100 trend over the whole period of study as well as two subperiods, pre-presidential versus presidential. We find that Trump’s hyperactivity on Twitter is followed by a negative market trend, and that tweets covering politically, and economically sensitive topics seem to negatively impact the market, except for real economy-related tweets. Some topics positively received by the market in the pre-presidential phase (e.g., China) become anticipators of negative trading days during the presidential one. We also consider the emotional tone of Trump’s tweets and find an unexpected reversal of the communicative valence of the tweets as to their expected impact on the stock market. Positive sentiment tweets seem to be followed by negative market performance and, maybe more surprisingly, vice versa. It seems that, during the period of observation, the market has learnt to interpret the emotional tone of Trump’s tweets as instrumental to Trump’s political strategy. In particular, the market seems to have realized that negative sentiment in Trump’s communication was entirely functional to political consensus building and not meant to convey market-relevant information. This is at odds with the idea that presidential communication should reflect the public interest, and especially so when it has major implications for the economy. Trump’s use of social media during both his presidential campaign and term questions the principle that institutional responsibility in the digital realm implies treating the infosphere as a commons. We discuss the implications for the functioning of the stock market and the emerging public interest ethical issues related to the breakdown of such principle.
Mental Health Services in Colombia: A National Implementation Study
Authors: Agudelo-Hernández Felipe , Rojas-Andrade Rodrigo
Published: March 2023

Laws in Latin American countries are based on scientific evidence that calls for mental health services to move to the community. These care modalities have implementation problems. The objective of this article is to describe the implementation of the services proposed in Law 1616 of 2013 of Colombia (Mental Health Law): emergencies, hospitalization, community-based rehabilitation, pre-hospital care, day hospital for children and adults, Drug Addiction Care Center, groups support and mutual aid, telemedicine, and home and outpatient care. We used a mixed study, with a cross-sectional descriptive quantitative component, where an instrument was used to determine the level of implementation of these services, consisting of a scale that established the availability and use of these services, in addition to the climate of implementation of the services and community mental health strategies, in addition to a qualitative determination of barriers and facilitators of implementation. We found a low availability of all services in departments such as Amazonas, Vaupés, Putumayo, and Meta and an implementation of services in Bogotá and Caldas. The least implemented services are the community ones, and those with the greatest presence at the territorial level are emergencies and hospitalization. We conclude that low- and middle-income countries have few community models and invest a large part of their technical and economic effort in emergencies and hospitalization. There are difficulties in the implementation of most of the services proposed by Colombian legislation related to mental health.
Restorative Justice and Classroom Management in Elementary General Music Classrooms
Authors: Gee Jennifer , Ryan Melissa
Published: March 2023

The purpose of this pilot study was to examine elementary general music teachers’ familiarity with, agreement with, and perceptions of restorative justice practices. Participants ( N = 49) included practicing elementary general music teachers who were members of the California Music Educators Association, the Florida Music Educators Association, the Missouri Music Educators Association, the New England Orff chapter, and an Orff chapter in Southern California. Findings indicated that participants were moderately familiar with their perceived ideas of restorative justice. They reported moderately high levels of agreement with a restorative justice ideology but held largely negative perceptions regarding the approach and its implementation in elementary music classrooms. Results suggest that although many elementary music teachers generally agree with a restorative justice ideology, they face challenges in implementing restorative justice–based approaches in their classrooms. Administrative support, professional development opportunities, and future research on the topic are needed.
Comparison of clinical safety and efficacy of ultrasound-guided local lauromacrogol injection versus uterine artery embolization in the treatment of caesarean scar pregnancy: a systematic review and meta-analysis
Authors: Du Ziwei , Xu Wenjian , Lu Jingyuan , Li Cheng
Published: March 2023

Background

The aim of this systematic review and meta-analysis was to introduce the relatively novel method of ultrasound-guided local lauromacrogol injection (USG-LLI) followed by dilatation and curettage for caesarean scar pregnancy (CSP) and to investigate the clinical safety and efficacy between uterine artery embolization (UAE) and USG-LLI in the treatment of CSP.

Methods

The relevant literature and articles about USG-LLI, UAE and CSP published in eight electronic databases were searched to extract the primary outcomes for the selected articles. Review Manager Software(RevMan) V.5.2 was used for quantitative data synthesis and data analysis. Forest plots, sensitivity analysis and bias analysis were also performed on the included articles.

Results

Of 10 studies included in our search, 623 patients were in the USG-LLI group and 627 patients were in the UAE groups. There were no significant differences between the two groups in terms of success rate, blood loss and time to human chorionic gonadotropin (hCG) normalization. However, USG-LLI group patients than UAE group patients had a shorter duration of hospital stay (mean difference [MD] = -1.97; 95% confidence intervals [CI] -2.63 to -1.31; P < 0.05; I2 = 95%), shorter restored menses (MD = -4.84; 95%CI -5.78 to -3.90; P < 0.05; I2 = 95%), and lower complication rates [odds ratio(OR) = 0.21; 95%CI:0.15 to 0.30; P < 0.05]; and cheaper on expenses of hospitalization (MD = -8028.29; 95%CI -10,311.18 to -5745.40; P < 0.05; I2 = 100%).

Conclusions

The results demonstrate that USG-LLI is comparable in curative effect and success rates with UAE in the therapy of CSP, but patients in the USG-LLI group seem to have fewer complications rates, shorter duration of hospital stays and lower costs.
Undiagnosed hypertension and its determinants among hypertensive patients in rural districts of northwest Ethiopia: a mediation analysis
Authors: Teshome Destaw Fetene , Balcha Shitaye Alemu , Ayele Tadesse Awoke , Atnafu Asmamaw , Gelaye Kassahun Alemu
Published: March 2023

Background

Early detection of hypertension is associated with improved blood pressure control and a reduced risk of cardiovascular diseases. However, in rural areas of Ethiopia, evidence is scarce where access to healthcare services is low. This study aimed to estimate the proportion of undiagnosed hypertension and identify its determinants and mediators among patients with hypertension in rural northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from September to November 2020. A three-stage sampling technique was used to select a total of 2436 study participants. Blood pressure was measured using an aneroid sphygmomanometer two times, 30 min apart. A validated tool was used to assess participants’ beliefs and knowledge of hypertension. The proportion, determinants, and mediators of undiagnosed hypertension were determined among patients with hypertension. The regression-based approach used to calculate the direct and indirect effects of determinants of undiagnosed hypertension. Joint significance testing was used to determine the significance of the indirect effect.

Results

The proportion of undiagnosed hypertension was 84.0% (95% CI: 81.4–86.7%). Participants aged 25–34 years (AOR = 6.03; 95% CI: 2.11, 17.29), who drank alcohol (AOR = 2.40; 95% CI: 1.37, 4.20), were overweight (AOR = 0.41; 95% CI: 0.18, 0.98), had a family history of hypertension (AOR = 0.32; 95% CI: 0.20, 0.53), and had comorbidities (AOR = 0.28; 95% CI: 0.15, 0.54) were significantly associated with undiagnosed hypertension. The mediation analysis revealed that hypertension health information mediated 64.1% and 68.2% of the effect of family history of hypertension and comorbidities on undiagnosed hypertension, respectively. Perceived susceptibility to hypertensive disease mediated 33.3% of the total effect of age on undiagnosed hypertension. Health facility visits also mediated the effect of alcohol drinking (14.2%) and comorbidities (12.3%) on undiagnosed hypertension.

Conclusion

A higher proportion of hypertensive patients remain undiagnosed. Being young, drinking alcohol, being overweight, having a family history of hypertension, and having comorbidities were significant factors. Hypertension health information, knowledge of hypertensive symptoms, and perceived susceptibility to hypertension were identified as important mediators. Public health interventions aimed at providing adequate hypertension health information, particularly to young adults and drinkers, could improve knowledge and perceived susceptibility to hypertensive disease and reduce the burden of undiagnosed hypertension.
Comparative treatment outcomes after bilateral extractions of maxillary second molars or first premolars in patients with class II malocclusion: a retrospective study
Authors: Paddenberg Eva , Braun Maria Christina , Proff Peter , Lippold Carsten , Kirschneck Christian
Published: March 2023

Background

This retrospective cohort study aimed to compare treatment results between bilateral extraction of upper second molars (M2) and first premolars (P1) in terms of treatment timing, cephalometry, upper third molar alignment and relapse in the long-term.

Methods

Fifty-three consecutively treated Caucasian patients with a brachyfacial pattern, skeletal class I and dental class II requiring extraction in the maxilla due to crowding were retrospectively divided into group I (M2 extracted; N = 31) and II (P1 extracted; N = 22). Fixed appliances were inserted after extraction and after distalisation of the first molars in group I. Post-treatment lateral cephalograms were digitally analysed and compared between groups. Six to seven years later relapse and success of upper third molar alignment were clinically evaluated as well as orthodontic treatment duration, pre-treatment age and gender recorded.

Results

After debonding patients with second molar extraction showed significantly smaller values for the Wits-appraisal, but higher values for index and facial axis. Extracting first premolars caused significantly more retroinclination/−position of anterior teeth and an increased profile concavity, more relapse and less successful alignment of upper third molars. Orthodontic treatment duration, pre-treatment age and gender were not significantly different between groups.

Conclusions

Bilateral extraction of upper first premolars or second molars may solve dental crowding in skeletal class I dental class II patients with a brachyfacial growth pattern. Upper second molar extraction seems to affect maxillary third molar alignment, long-term stability and dental and soft-tissue cephalometric parameters positively, but no intervention proved to be clearly superior.
Effect of posterior cruciate ligament on knee pressure and gap measured by an electronic sensor during total knee arthroplasty
Authors: Zhao Ran , Liu Yanqing , Tian Hua
Published: March 2023

Purpose

The purpose of this study was to evaluate the change in posterior cruciate ligament (PCL) tension by directly measuring the pressure changes in the knee joint when the ligament was released or resected during total knee arthroplasty.

Methods

We prospectively analyzed 54 patients who underwent primary total knee arthroplasty (67 knees) from October 2019 to January 2022. An electronic pressure sensor was used to measure the pressure changes in the medial and lateral chambers on PCL retention, recession or resection.

Results

At 0°, 45°, 90° and 120° of flexion, the total pressure in the knee joint of PCL retention was significantly higher than with PCL recession, and even higher than PCL resection. PCL recession or resection affected knee joint extension, and the medial/lateral pressure in the knee joint decreased. Pressure in the lateral compartment showed no significant change during knee flexion, whereas pressure in the medial compartment was significantly decreased, which also led to a change in the ratios of the medial and lateral pressures in the knee joint. After PCL resection, the flexion gap (90°) increased significantly more than the extension (0°) gap, while 46 cases displayed the same change in the flexion and extension gaps after PCL resection of the 67 cases.

Conclusion

The PCL retained partial function after tibial recession. PCL resection affected both the flexion and extension gaps; although the average flexion gap increased more than the extension gap, the change in most cases of these two gaps was the same.
The impact of online design thinking-based learning on entrepreneurial intention: the case of vocational college
Authors: Woraphiphat Issariya , Roopsuwankun Pattama
Published: March 2023

Entrepreneurial intention is fundamental to decision-making and the behaviors needed to become entrepreneurs, with subsequent effects on economic development. However, the COVID-19 pandemic calls for a novel approach to teaching entrepreneurship owing to the shift to online learning. The current study explores entrepreneurial intention and the satisfaction derived from the entrepreneurship education program. In particular, we offer a framework that explains students’ satisfaction and entrepreneurial intention by integrating the theory of planned behavior with design thinking-based entrepreneurship courses, peer interactions, and speaker interactions. The entrepreneurship education program was for vocational college students located in Southeast Asia. The online questionnaire was distributed to participants (N = 263, MAGE = 18.64) at the end of the online entrepreneurship education program. The model was tested using a structural equation model analysis. Attitude, subject norm, and satisfaction were found to predict higher entrepreneurial intention among vocational college students. Moreover, design thinking-based entrepreneurship courses, peer interaction, and speaker interaction indirectly affect entrepreneurial intention through satisfaction. This research extends the literature on entrepreneurship education by proposing a novel learning approach, that is, the online design thinking-based learning approach, which could be applied to entrepreneurship education programs to enhance students’ entrepreneurial intention.
Specific TCR profiles predict clinical outcome of adjuvant EGFR-TKIs for resected EGFR-mutant non-small cell lung cancer
Authors: Liu Si-Yang Maggie , Chen Cunte , Zhang Yi-Kai , Zhong Wen-Zhao , Wu Yi-Long , Liu Si-Yang , Li Yangqiu
Published: March 2023

Background

ADJUVANT-CTONG1104 reported a favorable survival outcome from adjuvant gefitinib treatment over chemotherapy in EGFR-mutant non-small cell lung cancer (NSCLC) patients. However, heterogeneous benefit from EGFR-TKIs and chemotherapy demands further biomarker exploration for patient selection. Previously, we identified certain TCR sequences with predictive value for adjuvant therapies from the CTONG1104 trial and found a relationship between the TCR repertoire and genetic variations. It remains unknown which TCR sequences could further enhance the prediction for only adjuvant EGFR-TKI.

Methods

In this study, 57 tumor and 12 tumor-adjacent samples, respectively, from gefitinib-treated patients in the CTONG1104 were collected for TCR β gene sequencing. We attempted to constitute a predictive model for prognosis and favorable adjuvant EGFR-TKI outcome for patients with early-stage NSCLC and EGFR mutations.

Results

The TCR rearrangements demonstrated significant prediction for overall survival (OS). A combined model of high frequent Vβ7-3Jβ2-5 and Vβ24-1Jβ2-1 with lower frequent Vβ5-6Jβ2-7 and Vβ28Jβ2-2 constituted the best value for predicting OS (P < 0.001; Hazard Ratio [HR] = 9.65, 95% confidence interval [CI]: 2.27 to 41.12) or DFS (P = 0.02; HR = 2.61, 95% CI: 1.13 to 6.03). In Cox regression analyses, when multiple clinical data were included, the risk score remained an independent prognostic predictor for OS (P = 0.003; HR = 9.49; 95% CI: 2.21 to 40.92) and DFS (P = 0.015; HR = 3.13; 95% CI: 1.25 to 7.87).

Conclusions

In this study, a predictive model was constituted with specific TCR sequences for prognosis prediction and gefitinib benefit in the ADJUVANT-CTONG1104 trial. We provide a potential immune biomarker for EGFR-mutant NSCLC patients who might benefit from an adjuvant EGFR-TKI.
Medical professionals’ job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt
Authors: El-Mazahy Hanan , Mekky Jaidaa , Elshaer Noha
Published: March 2023

Background

The COVID-19 pandemic has impacted medical professionals’ job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice.

Methods

Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice.

Results

The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%).

Conclusions

During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.
A Case of Bilateral Hyperglycemic Nonketotic Chorea in an 83-year-old Woman With Normal Brain Imaging
Authors: Khan Fahad , Matta Siddharth , Malik Komal , Shayuk Maryna
Published: March 2023

Bilateral hyperglycemic nonketotic chorea is a rare complication of hyperglycemia. In most cases, the literature illustrates patients presenting with unilateral chorea with image findings significant for hyperintense lesions in the basal ganglia on magnetic resonance imaging (MRI) or hyperdensities on computerized tomography (CT). Here, we present a case of an 83-year-old patient who was admitted to the hospital due to acute onset of orofacial and bilateral upper extremity chorea. She had no previous history of infection, genetic mutation, neoplasms, neurodegeneration, stroke, metabolic disease, drug exposure, or autoimmune disease. Surprisingly, her MRI showed only chronic microvascular changes in periventricular white matter without basal ganglia abnormalities. However, she was noted to have marked worsening of her glycemic control over the preceding 12 months based on worsening glycated hemoglobin (HbA1c) levels and elevated serum glucose on presentation. A literature review indicates that chorea caused by hyperglycemia is at times reversible with glycemic control, but as demonstrated in our patient, this is not always necessarily the case. A similar course has only been elaborated in a few other cases in the literature. We will also review the pathogenesis, the usual disease clinical course and standard treatment from the literature.
Labor Neuraxial Analgesia and Its Association With Perinatal Outcomes in China in 2015–2016: A Propensity Score–Matched Analysis
Authors: Meng Xi , Ye Jiangfeng , Qiao Ping , Ren Tai , Luo Qing , Hu Ling-qun , Zhang Jun
Published: March 2023

BACKGROUND:

The use of labor neuraxial analgesia (NA) in China has increased significantly in the past decade, and the current rate of use is unknown. This study aimed to describe the epidemiology of NA based on a large multicenter cross-sectional survey, the China Labor and Delivery Survey (CLDS) (2015–2016), and to evaluate the association between NA and intrapartum caesarean delivery (CD) and maternal and neonatal outcomes.

METHODS:

The CLDS was a facility-based cross-sectional investigation with a cluster random sampling scheme conducted from 2015 to 2016. A specific weight was assigned to each individual based on the sampling frame. Logistic regression was adopted to analyze the factors associated with the use of NA. A propensity score matching scheme was used to analyze the associations between NA and intrapartum CD and perinatal outcomes.

RESULTS:

A total of 51,488 vaginal deliveries or intrapartum CD were included in our study, excluding prelabor CDs. The weighted NA rate was 17.3% (95% confidence interval [CI], 16.6–18.0) in this survey population. Nulliparous, previous CD, hypertensive disorders, and labor augmentation were associated with higher use of NA. In the propensity score–matched analysis, NA was associated with reduced risks of intrapartum CD, especially intrapartum CD by maternal request (adjusted odds ratio [aOR], 0.68; 95% CI, 0.60–0.78 and aOR, 0.48; 95% CI, 0.30–0.76, respectively), 3rd or 4th degree perineal laceration (aOR, 0.36; 95% CI, 0.15–0.89), and 5-minute Apgar score ≤3 (aOR, 0.15; 95% CI, 0.03–0.66).

CONCLUSIONS:

The use of NA may be associated with improved obstetric outcomes, including fewer intrapartum CD, less birth canal trauma, and better neonatal outcomes in China.
Stellate Ganglion Blocks for Refractory Central Poststroke Pain: A Case Series
Authors: Purohit Gaurav , Kumar Ajit , Sharma Ravi Shankar , Bhandari Baibhav , Mahiswar Aditya , Singh Girish Kumar , Gupta Shiwam
Published: March 2023

Central poststroke pain (CPSP) is a neuropathic pain secondary to cerebrovascular accidents. This is characterized by pain and other sensory abnormalities, which correspond with the area of the injured brain. Despite advancements in therapeutic options, this clinical entity is still challenging to treat. We present 5 patients with CPSP, who were refractory to pharmacotherapy and were successfully managed with stellate ganglion blocks. A significant decrease in pain scores and improvement in functional disabilities were noted in all patients following the intervention.
Initial Clinical Experience and Biomechanical Analysis of a Novel Gravity Unit–Assisted Valve (M.blue) in Pediatric Patients With Hydrocephalus: A Retrospective Study With Two Years of Follow-up
Authors: Issa Mohammed , Paggetti Filippo , Seitz Angelika , von Hardenberg August , Unterberg Andreas W. , El Damaty Ahmed
Published: March 2023

BACKGROUND:

Overdrainage is a widely reported complication representing common indication for shunt revision. Despite recent advances in valve design, repeated shunt revisions represent burden on healthcare systems.

OBJECTIVE:

To investigate the efficiency of a novel gravity unit–assisted programmable valve “M.blue” in pediatric hydrocephalus using clinical and biomechanical analyses.

METHODS:

Thisretrospective single-center study included pediatric patients who received M.blue valve between April 2019 and 2021. Several clinical and biomechanical parameters were documented including complications and revision rates. Flow rate, functional assessment in vertical and horizontal positions, and extent of depositions inside valve were analyzed in explanted valves.

RESULTS:

Thirty-seven M.blue valves in 34 pediatric patients with hydrocephalus (mean age 2.82 ± 3.91 years) were included. Twelve valves (32.4%) were explanted during a follow-up period of 27.3 ± 7.9 months. One-year survival rate of 89% and overall survival rate of 67.6% with a valve survival average of 23.8 ± 9.7 months were observed. Patients with explanted valves (n = 12) were significantly younger, with 0.91 ± 0.54 years of age in average (P= .004), and showed significantly more adjustments difficulties (
P= .009). 58.3% of explanted valves showed deposits in more than 75% of the valve surface despite normal cerebrospinal fluid findings and were associated with dysfunctional flow rate in vertical, horizontal, or both positions.

CONCLUSION:

The novel M.blue valve with integrated gravity unit is efficient in pediatric hydrocephalus with comparable survival rate. Deposits inside valves could affect its flow rate in different body positions and might lead to dysfunction or difficulties in valve adjustments.
Evidence-based operational model for conducting an online, synchronous, proctored, closed book professional examination during the COVID-19 pandemic lockdown
Authors: Mohanraj Jaiprakash , Rolland Karkada Ivan , Nordin Rusli
Published: March 2023

Background: Medical education has migrated online as a result of the COVID-19 pandemic. Formative and summative evaluation are critical in medical education to support the learning process. However, many problems occur during online assessment, such as internet access, proctoring, and reliable software. To mitigate this situation, there is presently no standardised model available that demonstrates reliability and validity, particularly when it involves high-stake examinations. The goal of this study was to introduce an evidence-based operational model that was used to conduct a comprehensive high stake online examination to Year 2 MBBS students during the COVID-19 pandemic. Prior to entering the clinical years (year 3-5), year 2 MBBS students were expected to pass their high-stake examination earlier conducted as face-to-face session which is now administered online.

Methods: The model proposed enables the conduct of an online, synchronous, proctored, closed-book examination in real-time that is comparable to the face-to-face (FTF) manual examination. The examination and invigilation were carried out using the Learning Management System (LMS) and Google Meet applications with the existing information technology (IT) facilities and the Standard Operating Procedure (SOP) was developed to optimise and integrate the technology effectively.

Results: Both students and faculty were satisfied with the online examination, with the latter being more so. The online examination with a Cronbach alpha score of 0.71 suggested good internal consistency and reliability and various test of validity ensured this online model was dependable, reproducible and concurrent with other examinations.

Conclusions: We concluded that this operational model is a credible alternative to the FTF examination that requires new learning technology and is very cost effective. Thus, we highly recommend this model for all examinations that involve participation of off campus students.
Lumefantrine pressure selects nonsynonymous mutation in cysteine desulfurase IscS gene in the rodent malaria parasite Plasmodium berghei ANKA
Authors: Gachie Beatrice , Chepngetich Jean , Muriithi Brenda , Thiong’o Kelvin , Gathirwa Jeremiah , Kimani Francis , Mwitari Peter , Magoma Gabriel , Kiboi Daniel
Published: March 2023

Background: Lumefantrine (LM), piperaquine (PQ), and amodiaquine (AQ) are the essential long-acting partner drugs in the artemisinin-based combination therapies (ACTs) treatment regimens globally. The recent report on the emergence of artemisinin-resistant parasites portends an imminent failure of the partner drug in clearing the high residual parasite densities. Understanding the resistance mechanisms to partner drugs remains critical for tracking resistant parasites. Cysteine desulfurase IscS (nfs1), one of the proteins involved in the iron-sulfur (FeS) biogenesis pathway, has been implicated in mediating malaria parasite drug resistance.  

Methods: Using the rodent malaria parasites Plasmodium berghei ANKA in mice, we assessed whether the nfs1 gene is associated with LM, PQ, and AQ resistance. We first verified the stability of the LM, PQ, and AQ-resistant parasites in the standard 4-Day Suppressive Test. By means of PCR and sequencing analysis, we probed for single nucleotide polymorphisms (SNPs) in the nfs1 gene. Using qPCR, we then measured the expression of the nfs1 gene in resistant parasites relative to the drug-sensitive parent parasites. 

Results: Our analyses of nfs1 reveal a non-synonymous Gln142Arg mutation in the LM and PQ-resistant parasites. This mutation was not detected in the AQ-resistant parasites. The mRNA quantification of the nfs1 gene reveals differential expression in both LM and PQ-resistant parasites. Conversely, nfs1 expression remained unchanged in the AQ-resistant parasites.

Conclusion: Our data suggest that LM and PQ selection pressure induces nonsynonymous mutation and differential expression of the nfs1 gene in Plasmodium berghei. Collectively, these findings provide a premise for investigating LM and PQ resistance mechanisms in both P. berghei and P. falciparum.
Sudden cardiac death in athletes – can we prevent it?
Authors: Słowiaczek Anna , Matyka Kamila , Wojnar Marcin , Wilczewska Ewelina , Sutkowski Jakub , Matyszewska Aleksandra , Baranowska Alicja
Published: March 2023

Introduction and purpose: Sudden cardiac death (SCD) is a rare condition, however it is the leading medical cause of death in population of athletes. This study reviews the epidemiology and common causes of SCD in this group. The literature on the role of pre-participation screening and of the other preventive measures was also reviewed.
Review methods: A review of the available literature on sudden cardiac death in athletes was conducted using PubMed and Google Scholar databases.
Description of the state of knowledge: SCD is the leading cause of death in athletes. However, the incidence is difficult to estimate and varies in different populations. The etiology is age-dependent, in young individuals the most common cause of sudden cardiac death are hypertrophic cardiomyopathy and congenital coronary artery anomalies. In the older athlete population (over 35 years old) atherosclerotic coronary artery disease is the main cause. Screening process varies between countries and besides taking the medical history and physical examination can involve electrocardiogram, echocardiography and other examinations.
Conclusions: A review of the following studies has shown, that pre-participation screening of athletes may help to reduce the incidence of sudden death. Equal focus should be put on the availability of medical facilities during sports events, including experienced medical team and access to automated external defibrillation.
Abelianization of the Cartwright-Steger lattice
Authors:   Bar Ilan University, Blachar Guy , Sela–Ben-David Orit ,   Kinneret Academic College, Vishne Uzi ,   Bar Ilan University
Published: March 2023

The Cartwright-Steger lattice is a group whose Cayley graph can be identified with the Bruhat-Tits building of PGLd over a local field of positive characteristic. We give a lower bound on the abelianization of this lattice, and report that the bound is tight in all computationally accessible cases.