bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing and Modeling Network Travel Patterns During the Ukraine Invasion Using Crowd-Sourced Pervasive Traffic Data
Authors: Waller S. Travis , Qurashi Moeid , Sotnikova Anna , Karva Lavina , Chand Sai
Published: April 2023

In 2022, Ukraine is suffering an invasion which has resulted in acute impacts playing out over time and geography. This paper examines the impact of the ongoing disruption on traffic behavior using analytics as well as zonal-based network models. The methodology is a data-driven approach that utilizes obtained travel-time conditions within an evolutionary algorithm framework which infers origin–destination demand values in an automated process based on traffic assignment. Because of the automation of the implementation, numerous daily models can be approximated for multiple cities. The novelty of this paper versus the previously published core methodology includes an analysis to ensure the obtained data is appropriate, since some data sources were disabled because of the ongoing disruption. Further novelty includes a direct linkage of the analysis to the timeline of disruptions to examine the interaction in a new way. Finally, specific network metrics are identified which are particularly suited for conceptualizing the impact of conflict disruptions on traffic network conditions. The ultimate aim is to establish processes, concepts, and analysis to advance the broader activity of rapidly quantifying the traffic impacts of conflict scenarios.
Diagnostics Value of Quantitative Magnetic Resonance Imaging (MRI) in Neonatal Acute Bilirubin Encephalopathy
Authors: Liu Hua , Zhang Ruolin , Zhang Min , Zheng Huanji , Li Xiuxiu , Chen Jun
Published: April 2023

Background: This study was designed to investigate the diagnostic value of relative signal intensity of globus pallidus on T1-weighted magnetic resonance imaging (MRI) in neonatal acute bilirubin encephalopathy (ABE). Methods: Participants who were recruited in hospital from April 2019 to May 2020 were grouped into mildly increased total serum bilirubin (TSB) group (n = 30), severely increased TSB group (n = 25), or extremely increased TSB group (n = 10) based on the total serum bilirubin level. Bilirubin-induced neurologic dysfunction scale score was used to determine if participants had acute bilirubin encephalopathy. All neonates underwent conventional brain MRI and the relative signal intensity of globus pallidus was measured on T1-weighted images. The diagnostic value of these 3 indices was assessed by receiver operating characteristic curve analysis. Results: There was a significant correlation between relative signal intensity of globus pallidus and total serum bilirubin level in neonates with hyperbilirubinemia (r = 0.551, P < .001). Relative signal intensity of globus pallidus in the extremely increased TSB group was significantly higher than that in severely increased TSB, mildly increased TSB, and healthy control groups. Relative signal intensity of globus pallidus in the acute bilirubin encephalopathy group was significantly higher than that in the non-acute bilirubin encephalopathy group ( P < .01). The area under the receiver operating characteristic curve of the relative signal intensity of globus pallidus was 0.765 ( P < .01), with sensitivity of 0.655 and specificity of 0.861. The area under the curve of the total serum bilirubin and visual inspection of globus pallidus signal was 0.621 and 0.579, respectively. The area under the curve of relative signal intensity was significantly greater than that of total serum bilirubin and visual inspection ( P = .04 for both). Conclusion: Relative signal intensity of globus pallidus, which is an objective assessment, has the potential to be used as a diagnostic tool for acute bilirubin encephalopathy.
Free vibration analysis of functionally graded composite rectangular plates reinforced with graphene nanoplatelets (GPLs) using full layerwise finite element method
Authors: Tayebi Mohammad Sadegh , Jedari Salami Sattar , Tavakolian Majid
Published: April 2023

The current investigation is the first endeavor to apply the full layerwise finite element method (FEM) in free vibration analysis of functionally graded (FG) composite plates reinforced with graphene nanoplatelets (GPLs). Unlike the equivalent single-layer (ESL) theories, the layerwise FEM focuses on all three-dimensional (3D) effects. Therefore, it can compute interlaminar stresses and other local effects with the same accuracy as 3D FEM, requiring a lower computational cost. The GPLs weight fraction is presumed invariable in each layer but varies through the plate thickness in a layerwise model. The modified Halpin-Tsai model is employed to acquire the effective Young’s modulus. The rule of mixtures is applied to specify the effective Poisson’s ratio and mass density. First, the current method is validated by comparing the numerical results with those stated in the available works. Next, a thorough numerical study is performed to examine how various factors involving the pattern of distribution, weight fraction, geometry, and size of GPLs, together with the thickness-to-span ratio and boundary conditions of the plate, affect its free vibration behaviors. Numerical results demonstrate that employing a small percentage of GPL as reinforcement considerably grows the natural frequencies of the pure epoxy. Also, distributing more square-shaped GPLs, involving a smaller amount of graphene layers, and vicinity to the upper and lower surfaces make it the most efficient method to enhance the free vibration behaviors of the plate.
Dreaming biometrics in Niger: The security techniques of migration control in West Africa
Authors: Dauchy Alizée
Published: April 2023

Since 2015, Niger has been actively committed to migration control in West Africa in the context of the European Union Emergency Trust Fund for Africa. To enable better comprehension of the making of security in Niger, this article studies the implementation of biometrics under the EU Trust Fund by international agencies (Interpol, the International Organization for Migration, UNHCR) and national actors. Drawing on in-depth interviews, observation and anthropology of aid studies, I argue that biometrics is a travelling organizational model translated into a multiscalar process by state and non-state actors embedded in relations of power. Biometric technologies cannot be reduced to an added-value instrument for Nigerien authorities in order to enhance legibility, to better identify Nigeriens and foreigners crossing Niger’s borders within the free-movement area of ECOWAS (Economic Community of West African States). I focus on heterogeneous actors’ situated discourses and practices to demonstrate that they do not share the same dream about biometrics. In practice, however, biometrics helps international actors to produce their own security knowledge in Niger that, in the end, augments the capacity to trace ECOWAS citizens and reinforce the EU border regime.
Cross-sectional survey of smartphone addiction and its relationship with personality traits among medical students
Authors: Huang Xing , Yang Haijun , Wei Sha , Wang Yan
Published: April 2023

Objective

To understand the current smart phone addiction tendency (SPAT) in medical university students and relationship with personality traits.

Methods

A cross-sectional study from September 2019 to December 2019 selected medical students from Hubei University of China by cluster sampling. Questionnaires were administered to measure smart phone addiction tendency and personality traits.

Results

The prevalence of SPAT among 972 medical students was 24.3%. The prevalence was higher in students from one-child family than those with siblings (28.2% vs. 21.7%), and higher among students from urban families than those from rural ones (29.2% vs. 19.7%).Multivariate logistic regression analysis showed that extraversion and neuroticism were correlated with SPAT, with odds ratio and 95% confidence interval being equal to 1.070 (1.011–1.133) and 0.838 (0.795–0.844), respectively.

Conclusions

The prevalence of SPAT was high in medical college students. Extraversion and neuroticism were risk and protective factors for SPAT. Long duration phone use and a low number of physical workouts predicted high SPAT.
Clinicopathologic Classification of Renal Cell Carcinoma in Patients ≤40 Years Old From Peru
Authors: Kamanda Sonia , Huanca-Amesquita Lourdes , Milla Esperanza , Argani Pedram , Epstein Jonathan I.
Published: April 2023

Introduction

There are scant data on renal cell carcinoma (RCC) from relatively younger patients in South America using contemporary classification.

Methods

Fifty-nine consecutively treated patients with RCC (≤40 years old) were assessed from the National Institute of Neoplastic Diseases in Peru from 2008 to 2020 (34 males; 25 females), age range of 13 to 40 years.

Results

Most common presenting symptoms were flank pain (n = 40), hematuria (n = 19), and weight loss (n = 12). Associated conditions included 4 patients with proven or presumed tuberous sclerosis and 1 patient with von Hippel Lindau syndrome, all with clear cell RCC. Tumor histopathology was clear cell RCC in 32 of 59 (54%), chromophobe RCC in 6 of 59 (10%), and 5 of 59 (8%) each of papillary RCC and MiT family translocation-associated RCC. Four of 59 (7%) were FH-deficient RCC and 2 of 59 (3%) remained unclassified. The remaining tumors were isolated examples of clear cell papillary renal cell tumor, eosinophilic solid and cystic RCC (ESC RCC), RCC with fibromyomatous stroma, sarcomatoid RCC, and sarcomatoid clear cell RCC. Of the 4 FH-deficient RCCs, none had the classic morphology. The 5 MiT family translocation RCCs had variable morphology. There were 41 tumors without recurrence or metastases, 3 tumors with local recurrence only, 8 tumors with metastases only, and 7 tumors with both local recurrence and metastases.

Conclusions

The current study demonstrates the importance of special studies in accurately classifying RCC in younger individuals. The distribution of RCC subtypes in younger individuals is similar between 2 representative large institutions of the United States and Peru.
Tele-assessment of activities and participation in chronic phase of stroke: Is use valid and viable in a developing country?
Authors: Oliveira Léia Cordeiro de , dos Santos Heyriane Martins , da Silva Mariana Acciarini , de Oliveira Bianca Stefany Lima , de Lima Taiane Silva , Pereira Gabriela Santos , Silva Soraia Micaela
Published: April 2023

Background

SATISPART-Stroke (SATIS-Stroke) is the most complete instrument for the assessment of activity and participation following a stroke. However, its use in a developing country has only been tested through in-person interviews.

Objective

To determine the validity, reproducibility and viability of the SATIS-Stroke scale administered in two tele-assessment modalities: self-assessment of an electronic form versus videoconference.

Methods

Methodological study with Brazilian chronic stroke survivors was conducted. Stage I comprised an in-person interview to apply the SATIS-Stroke and a self-assessment by completing an electronic form to respond to the SATIS-Stroke items. Step II occurred 6 to 8 months after Step I, during which SATIS-Stroke was administered again in-person and via videoconference. The order was randomized.

Results

Ninety-five stroke survivors were recruited, but only 50 answered the electronic form (adherence: 52.6%). Mean scores were higher in the self-administration of electronic form compared to the in-person interview (mean difference = −0.36 ± 0.93; P = 0.009). Adequate reliability was found in the comparison of the in-person and self-assessment of electronic form (ICC2,1 = 0.66; 95%CI: 0.40–0.81). Fifty stroke survivors participated in Step II, during which adequate reliability was found in the comparison of the in-person administration and videoconference (ICC2,1 = 0.55; 95%CI: 0.21–0.74) and a moderate correlation was found between the assessment methods ( r = 0.43; P = 0.02).

Discussion

Adequate validity and reliability were found in the tele-assessment. Thus, this method is appropriate and viable for use in developing countries. Although reliable, the self-assessment did not have good adherence in the Brazilian population due to internet access problems, lack of familiarity with the digital form and lack of autonomy to answer the questions alone.
The privilege of taken for grantedness: On precarity and mobile media
Authors: Ingraham Chris , Grandinetti Justin
Published: April 2023

This essay makes a case for more critical inquiry in mobile media research around the privilege of taken for grantedness. As a critical supplement to Richard Ling’s important work on the taken for granted dispersion and embedment of technologies such as the mobile phone or automobile into everyday life, we examine the precarity that such reliance involves. Taking certain media for granted makes other, more invisible vulnerabilities harder to see and acknowledge. We make this case using the example of TikTok, a short-form mobile streaming app that has rapidly become a go-to social media platform worldwide—as well as a massively “visible” infrastructure due to its associated geopolitical tensions and security concerns. In light of recent conversations about banning the platform, TikTok offers an instructive case study for the privilege of taken for grantedness and the deceptively precarious nature of our mobile media practices.
Dispositions of dis/trust: Fourth-wave mobile communication for a world in flux
Authors: Chib Arul , Ang Ming Wei
Published: April 2023

Mobile scholarship has highlighted the embeddedness of mobile media practices within power hierarchies and sociostructural conditions. We enrich the critical approach by examining how trust, as a future-oriented disposition that deals with uncertainty and social vulnerability, conditions mobile practices and vice versa. We interviewed 29 Syrian refugees residing in the Netherlands, examining how different levels of vulnerability and uncertainty in refugees’ experiences shape mobile use and non-use. We found that low vulnerability–low uncertainty situations were associated with habitual, everyday use; low vulnerability–high uncertainty corresponded to anxiety-expunging non-use; high vulnerability–low uncertainty influenced harm-mitigating mobile practices that sometimes acquiesced to hierarchies; and high vulnerability–high uncertainty circumstances incited radical forms of dependence and collaboration between mobile users. We posit that this framework is not limited to refugee contexts, but mobile-mediated relationships in general. We underscore the importance of mobile scholarship in understanding and offering solutions to contemporary global crises of distrust.
Between conspicuous and conscious consumption: The sustainability paradox in the intermediary promotional work of an online lifestyle site
Authors: Frig Meri-Maaria , Jaakkola Maarit
Published: April 2023

This article examines the representation of sustainability on the online lifestyle site Goop as a case study of how promotional media deal with environmental and social concerns. Specifically, the paper presents how promotional intermediaries address or conceal a tension between (1) the promotion of conspicuous consumption and (2) the advocacy of sustainable living. The paper contributes to cultural intermediary scholarship by showing how promotional intermediaries attempt to reconcile this tension, advocating consumerism favorable to them while still enhancing critical cultural citizenship. By presenting sustainable brands and environmental advocates, and different—at times, incommensurable—narratives on the relationship between sustainability and consumption, promotional intermediaries signal that sustainability is important while promoting actions that can be considered to contradict the idea of sustainability, such as excessive consumption. In this way they produce a safe space for brands and consumers but arrive at a sustainability paradox.
Bronchoscopic interventions for bronchopleural fistulas
Authors: Jin Lingli , Li Yaqing
Published: April 2023

Bronchopleural fistula is a potentially fatal disease most often caused after pneumonectomy. Concomitant problems such as pulmonary infection and respiratory failure are typically the main contributors to patient mortality because of the improper contact between the bronchial and pleural cavity. Therefore, bronchopleural fistulas need immediate treatment, which requires the accurate location and timely closure of the fistula. Currently, bronchoscopic interventions, because of their flexibility and versatility, are reliable alternative therapies in patients for whom surgical intervention is unsuitable. Possible interventions include bronchoscopic placement of blocking agents, atrial septal defect (ASD)/ventricular septal defect (VSD) occluders, airway stents, endobronchial valves (EBVs) and endobronchial Watanabe spigots (EWSs). Recent developments in mesenchymal stem cells (MSCs) transplantation technology and three-dimensional (3D) printed stents have also contributed to the treatment of bronchopleural fistula, but more research is needed to investigate the long-term benefits. This review focuses on the effectiveness of various bronchoscopic measures for the treatment of bronchopleural fistula and the directions for future development.
Homelessness and primary care: Problems and solutions
Authors: Huey Alex
Published: April 2023

As the housing circumstances of a person or family become uncertain, they often encounter a variety of people and services before losing their home. Each point of contact can be an opportunity to identify or prevent homelessness. They might have a social worker, attend addiction services, visit a food bank, or contact their GP. GP practices are embedded in local communities, and with many daily patient contacts primary care has potential to connect those at risk with appropriate services before a crisis point.
Climate-Smart Conservation Agriculture, Farm Values and Tenure Security: Implications for Climate Change Adaptation and Mitigation in the Congo Basin
Authors: Molua Ernest L. , Sonwa Denis , Bele Youssoufa , Foahom Bernard , Mate Mweru Jean Pierre , Wa Bassa Salomon Mampeta , Gapia Martial , Ngana Felix , Joe Assoua Eyong , Masumbuko Emile Mulotwa
Published: April 2023

Background and Research Aims: Agriculture through deforestation is an important threat to biodiversity conservation in the Congo Basin’s tropical forest. The policy challenge is not only to promote adaptation to perceived climate change but also to promote forest conservation. The aim of this study is to provide empirical evidence on the impact of farm-level investments in climate-smart agricultural practices related to conservation agriculture in some Congo Basin countries. The hypothesis is that property rights to land and trees play a fundamental role in governing the patterns of investment, forestland management for conservation, as well as in the profitability of agriculture. Methods: A Simulated Maximum Likelihood Estimation using a Mixed Logit model is used to test farmers’ choice of agricultural system and a farmland value model for each agricultural system which includes determinants of tenure or property rights, climate, soils, and socioeconomic variables such as education and gender. The data was collected from more than 600 farms covering 12 regions and 45 divisions in 3 countries, Cameroon, the Central African Republic and the Democratic Republic of Congo. Results: Farmers choose one of three agricultural systems to maximize farm profit mindful of the current tenure regime and environmental conditions. Conservation agriculture techniques within climate-smart practices show benefits for smallholder farmers through improvements in soil health, soil moisture retention and enhanced crop yields. The rights to access, withdraw, manage, as well as exclude others from land and trees affect both the farmers' choice of system and the profit earned from the chosen system. Conclusion: Farm-level investments improve farm incomes and enhance conservation effort for farmers perceiving climate change. Implications for Conservation: Climate change adaptation through planting of trees improves soil stability, restores ecosystems and creates a safe haven for biodiversity. Secure land tenure promotes better forestland management and reduces land degradation in vulnerable communities.
Binocular portraiture
Authors: Wade Nicholas J.
Published: April 2023

Pictorial portraits are viewed with two eyes despite the fact that they are mostly monocular: they have been produced from a single viewpoint (either by painters or photographers). The differences between the images on each eye are a consequence of the separation between them rather than differences in two pictorial images. Viewing with two eyes detracts from the monocular cues to depth within the singular portrait because of information for the flatness of the pictorial surface. Binocular portraits, on the other hand, incorporate differences between two pictorial images producing perceptual effects that cannot be seen by a single eye alone. The differences can consist of small disparities that yield stereoscopic depth or large ones that produce binocular rivalry. Binocular portraits require viewing with a stereoscope, many varieties of which exist. Those shown here are anaglyphs which can be observed through red/cyan filters. They are not conventional stereoscopic portraits where the sitter is imaged from two slightly different locations. Rather, the binocular processes of cooperation (stereoscopic depth perception) and competition (binocular rivalry) are manipulated in the binocular portraits. The subjects shown in the anaglyphic portraits have been involved in the science and art of binocular vision.
On the way to a more global urban study of China
Authors: Li Zhigang
Published: April 2023

Teo et al.'s (2024) article effectively highlights that producing new narratives or imaginations is key to developing a deeper understanding of both Chinese cities and those of other contexts. However, certain ‘information cocoons’ still require closer consideration, such as the lack of attention given to narratives produced within the state territory of China, over-reliance on political economic analysis, and the impact of disciplinary boundaries.
The Mistranslation of 1 Corinthians 11.26 in Vietnamese
Authors: Coxhead Steven Ross
Published: April 2023

This paper is concerned with the mistranslation of the Greek word καταγγέλλετε katangellete “you proclaim” in 1 Cor 11.26 in the first major Protestant translation of the Bible into Vietnamese, a problem that has continued to be reproduced in subsequent translations. The paper identifies the problem and discusses the importance of context in distinguishing the Greek second-person plural present active indicative and imperative forms. A solution to this historical translation problem is also suggested, involving the use of a particle indicating progressive aspect.
Annulus Fibrosus Repair for Lumbar Disc Herniation: A Meta-Analysis of Clinical Outcomes From Controlled Studies
Authors: Wang Yangbin , He Xiaoyu , Chen Shupeng , Weng Yiyong , Liu Zhihua , Pan Qunlong , Zhang Rongmou , Li Yizhong , Wang Hanshi , Lin Shu , Yu Haiming
Published: April 2023

Study Design

Meta-analysis .

Objectives

This study aimed to summarize the clinical efficacy and safety of the various annular defect repair methods that have emerged in recent years.

Methods

A meta-analysis of randomized and non-randomized controlled trials was conducted. Articles from PubMed, Embase, and the Cochrane Library (CENTRAL) on Lumbar disc herniation treatment with annular repair published from inception to April 2, 2022 were included. We summarized the clinical efficacy and safety of annular repair techniques based on a random-effects model meta-analysis.

Results

7 randomized controlled studies and 8 observational studies with a total of 2161 participants met the inclusion criteria. The pooled data analysis showed that adding the annular repair technique reduced postoperative recurrence rate, reoperation rate, and loss of intervertebral height compared with lumbar discectomy alone. Subgroup analysis based on different annular repair techniques showed that the Barricaid Annular Closure Device (ACD) was effective in preventing re-protrusion and reducing reoperation rates, while there was no significant difference between the other subgroups. The annulus fibrosus suture (AFS) did not improve the postoperative Oswestry Disability Index (ODI). No statistically significant difference was observed in the incidence of adverse events between the annular repair and control groups.

Conclusions

Lumbar discectomy combined with ACD can effectively reduce postoperative recurrence and reoperation rates in patients with LDH. AFS alone was less effective in reducing recurrence and reoperation rates and did not improve postoperative pain and function.
Recurrent Allergic Contact Dermatitis to Bacitracin Used in Pocket Irrigation During Breast Reconstruction Surgery
Authors: Liu Chaocheng , de Gannes Gillian
Published: April 2023

Allergic contact dermatitis (ACD) is a delayed-type hypersensitivity reaction that presents as a pruritic eczematous rash occurring 24 to 48 h after allergen exposure. It is a surgical complication that can impact people's quality of life after plastic surgeries. A 44-year-old female with right breast cancer presented with three recurrent episodes of severe pruritic cutaneous eczematous eruption over her right breast extending down to her trunk and vulva each time soon after her multiple breast surgeries. She was labeled as having allergies to several intravenous antibiotics received perioperatively. She was then patch tested with a positive reaction to bacitracin, a component of a modified double antibiotic solution used for pocket irrigation intraoperatively. It highlights the need for plastic surgeons to consider ACD to bacitracin in patients with dermatitis soon after having bacitracin for pocket irrigation or implant soaking during breast surgeries. Comprehensive patch testing can delineate the cause of surgery-related ACD.
A learning agent that acquires social norms from public sanctions in decentralized multi-agent settings
Authors: Vinitsky Eugene , Köster Raphael , Agapiou John P , Duéñez-Guzmán Edgar A , Vezhnevets Alexander S , Leibo Joel Z
Published: April 2023

Society is characterized by the presence of a variety of social norms: collective patterns of sanctioning that can prevent miscoordination and free-riding. Inspired by this, we aim to construct learning dynamics where potentially beneficial social norms can emerge. Since social norms are underpinned by sanctioning, we introduce a training regime where agents can access all sanctioning events but learning is otherwise decentralized. This setting is technologically interesting because sanctioning events may be the only available public signal in decentralized multi-agent systems where reward or policy-sharing is infeasible or undesirable. To achieve collective action in this setting, we construct an agent architecture containing a classifier module that categorizes observed behaviors as approved or disapproved, and a motivation to punish in accord with the group. We show that social norms emerge in multi-agent systems containing this agent and investigate the conditions under which this helps them achieve socially beneficial outcomes.
Comparison between Ultrasound and Fluoroscopy-guided Percutaneous Nephrolithotomy (PCNL) at Raden Mattaher Jambi Hospital
Authors: Fauzan Randy , Manduaru Raga , Sitompul Ardiansyah Periadi , Rachman Wendi , Herman Hendra
Published: April 2023

Purpose

To investigate the effectiveness and safety of ultrasound-guided and Percutaneous Nephrolithotomy (PCNL) compared to the standard fluoroscopy-guided PCNL.

Methods

This study is a comparative retrospective study obtained from medical records within the last 5 years of Raden Mattaher Hospital, Jambi. Patients were divided into 2 groups, fluoroscopy- and ultrasonography-guided PCNL with large kidney stone > 20 mm. Patient characteristics were divided into pre- and post-operative procedures and analyzed using SPSS ver. 25.0 (SPSS Inc., Chicago, IL, USA). Data were analyzed using Kolmogorov–Smirnov, chi-square and/ Fischer’s exact test and p value < 0.05 was considered statistically significant.

Results

Of 201 patients’ data from medical records were divided into ultrasound-guided and fluoroscopy-guided groups. Ultrasound-guided group were consisted of 89 patients and fluoroscopy-guided were of 112 patients. US Guided significantly identifies the severity of hydronephrosis compared to PCNL. The demographic data obtained age, sex, body mass index, and preoperative hemoglobin levels showed a normal distribution. On the post-operative results, significant results occurred in post-PCNL stent placement. Installation of a DJ stent alone is more commonly performed on fluoroscopy-guided PCNL procedures compared to ultrasound-guided PCNL. This had a positive impact on post-procedure outcomes, meaning that the post-operative outcome of ultrasound-guided PCNL was better than that of fluoroscopy-guided PCNL.

Conclusion

The reported data demonstrate that PCNL and ultrasound-guided has similar efficacy and complication rates with PCNL fluoroscopy-guided. This could be a good alternative in urological centers with no access to fluoroscopy. However, ultrasound-guided group was still associated with higher rate nephrostomy tube placement and longer surgery duration.
Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study)
Authors: Dziegielewski Janina , Schulte Falko C. , Jung Christian , Wolff Georg , Hannappel Oliver , Kümpers Philipp , Bernhard Michael , Michael Mark
Published: April 2023

Background

Few studies address the care of critically ill non-traumatic patients in the emergency department (ED). The aim of this study was to assess the epidemiology, management, and outcome of these patients.

Methods

In this retrospective study, we identified and analyzed data from all consecutive adult critically ill non-traumatic ED patients treated from March 2018 to February 2019. Patient characteristics, major complaint leading to admission, out-of-hospital, and in-hospital interventions and 30-day mortality were extracted from medical records of the electronic patient data management system.

Results

During the study period, we analyzed 40,764 patients admitted to the ED. Of these, 621 (1.5%) critically ill non-traumatic patients were admitted for life-threatening emergencies to the resuscitation room (age: 70 ± 16 years, 52% male). Leading problem on admission was disability/unconsciousness (D), shock (C), respiratory failure (B), airway obstruction (A), and environment problems (E) in 41%, 31%, 25%, 2%, and 1%, respectively. Out-of-hospital and in-hospital measures included: intravenous access (61% vs. 99%), 12-lead ECG (55% vs. 87%), invasive airway management (21% vs. 34%) invasive ventilation (21% vs. 34%), catecholamines (9% vs. 30%), arterial access (0% vs. 52%), and cardiopulmonary resuscitation (11% vs. 6%). The underlying diagnoses were mainly neurological (29%), followed by cardiological (28%), and pulmonological (20%) emergencies. The mean length of stay (LOS) in the resuscitation room and ED was 123 ± 122 and 415 ± 479 min, respectively. The 30-day mortality was 18.5%.

Conclusion

The data describe the care of critically ill non-traumatic patients in the resuscitation room. Based on these data, algorithms for the structured care of critically ill non-traumatic patients need to be developed.
‘I believe respect means providing necessary treatment on time’ - a qualitative study of health care providers’ perspectives on disrespect and abuse during childbirth in Southwest Ethiopia
Authors: Werdofa Hirut Megersa , Thoresen Lisbeth , Lulseged Belayneh , Lindahl Anne Karin
Published: April 2023

Background

The majority of maternal deaths occur in low-income countries, and facility-based childbirth is recognised as a strategy to reduce maternal mortality. However, experiences of disrespect and abuse during childbirth are reported as deterrents to women’s utilisation of health care facilities. Health care providers play a critical role in women’s experiences during childbirth; yet, there is limited research on service providers’ views of disrespect and abuse in Ethiopia. Therefore, this study aimed to explore providers’ perspectives on disrespect and abuse during childbirth in a teaching hospital in Southwest Ethiopia.

Method

Qualitative study was conducted in a tertiary teaching hospital in Jimma Ethiopia. In-depth interviews were conducted with 32 purposefully selected health care providers, including midwives, obstetrics and genecology resident’s, senior obstetricians and nurses. Interviews were audio-recorded, transcribed and thematically analysed using the qualitative data analysis software program MAXQDA.

Results

Three major themes were identified from the health care providers’ perspectives: (1) respectful and abuse-free care, (2) recognised disrespect and abuse; and (3) drivers of women’s feelings of disrespect and abuse. The first theme indicates that most of the participants perceived that women were treated with respect and had not experienced abuse during childbirth. The second theme showed that a minority of the participants recognised that women experienced disrespect and abuse during childbirth. The third theme covered situations in which providers thought that drivers for women felt disrespected.

Conclusion

Most providers perceived women’s experiences as respectful, and they normalized, and rationalized disrespect and abuse. The effect of teaching environment, the scarcity of resources has been reported as a driver for disrespect and abuse. To ensure respectful maternity care, a collaborative effort of administrators, teaching institutions, professional associations and researchers is needed. Such collaboration is essential to create a respectful teaching environment, ensure availability of resources, sustained in-service training for providers, and establishing an accountability mechanism for respectful maternity care.
The V protein in oncolytic Newcastle disease virus promotes HepG2 hepatoma cell proliferation at the single-cell level
Authors: Chu Zhili , Yang Sihui , Li Qianru , Shang Jianing , Ren Zilong , Ren Feng
Published: April 2023

Background

Newcastle disease virus (NDV) is an oncolytic virus that can inhibit cancer cell proliferation and kill cancer cells. The NDV nonstructural V protein can regulate viral replication; however, whether the V protein contributes to NDV oncolysis is unclear.

Results

This study revealed that NDV inhibited tumor cell proliferation and that V protein expression promoted the proliferation of HepG2 cells, as determined at the single-cell level. In addition, to identify the regulatory mechanism of the V protein in HepG2 cells, transcriptome sequencing was performed and indicated that the expression/activation of multiple cell proliferation-related genes/signaling pathways were changed in cells overexpressing the V protein. Hence, the MAPK and WNT signaling pathways were selected for verification, and after blocking these two signaling pathways with inhibitors, the V protein promotion of cell proliferation was found to be attenuated.

Conclusions

The results showed that the V protein regulated the proliferation of cancer cells through multiple signaling pathways, providing valuable references for future studies on the mechanism by which the V protein regulates cancer cell proliferation.
First assistant experience in total laparoscopic pancreaticoduodenectomy: accelerating the learning curve for an operator
Authors: Li Dongrui , Du Chengxu , Wang Wenbin , Zhang Jiansheng , Liu Jianhua
Published: April 2023

Objective

Compare and analyze clinical data of total laparoscopic pancreaticoduodenectomy (TLPD) cases for surgeons with / without first assistant experience (FAE) in TLPD. Probe influence of FAE in TLPD on the learning curve for an operator.

Methods

The clinical data of 239 patients, that underwent TLPD performed by two surgeons between January 2017 and January 2022) in our department, were consecutively collected and divided into two groups (A and B). Group A cases were operated by Surgeon A, with FAE of 57 TLPDs in our department prior to initial TLPD as an operator. Group B cases were operated by Surgeon B with no FAE of TLPD. Cumulative sum (CUSUM) method developed learning curves. Clinical data and both surgeons’ learning curves were statistically compared between both groups.

Results

Between both groups, no statistically significant variations were observed for pre-operative health conditions. Reduced surgical duration, blood loss and transfusion volume during surgery, together with reductions in major post–operative complication rates and reduced hospital/ICU stays were identified within Group A, having statistically significant variations. The technical plateau phases of the learning curves were approximately 25–41 cases and 35–51 cases, for Surgeon A and Surgeon B, respectively.

Conclusion

FAE in TLPD can accelerate the learning curve of TLPD for an operator, with safer surgical procedures and enhanced post–operative recovery.
How does ethnicity affect presence of advance care planning in care records for individuals with advanced disease? A mixed-methods systematic review
Authors: Crooks Jodie , Trotter Sophie ,   Patient Public Involvement Consortium, OBE Ruby Bhatti , Monaghan Elizabeth , Clarke Gemma
Published: April 2023

Background

Advance care planning (ACP) is the process supporting individuals with life-limiting illness to make informed decisions about their future healthcare. Ethnic disparities in ACP have been widely highlighted, but interpretation is challenging due to methodological heterogeneity. This review aims to examine differences in the presence of documented ACP in individuals’ care records for people with advanced disease by ethnic group, and identify patient and clinician related factors contributing to this.

Methods

Mixed-methods systematic review. Keyword searches on six electronic databases were conducted (01/2000–04/2022). The primary outcome measure was statistically significant differences in the presence of ACP in patients’ care records by ethnicity: quantitative data was summarised and tabulated. The secondary outcome measures were patient and clinician-based factors affecting ACP. Data was analysed qualitatively through thematic analysis; themes were developed and presented in a narrative synthesis. Feedback on themes was gained from Patient and Public Involvement (PPI) representatives. Study quality was assessed through Joanna Briggs Institute Critical Appraisal tools and Gough’s Weight of Evidence.

Results

N=35
papers were included in total; all had Medium/High Weight of Evidence. Fifteen
papers (comparing two or more ethnic groups) addressed the primary outcome
measure. Twelve of the fifteen papers reported White patients had statistically
higher rates of formally documented ACP in their care records than patients
from other ethnic groups. There were no significant differences in the presence
of informal ACP between ethnic groups. Nineteen papers addressed the secondary
outcome measure; thirteen discussed patient-based factors impacting ACP
presence with four key themes: poor awareness and understanding of ACP; financial
constraints; faith and religion; and family involvement. Eight papers discussed
clinician-based factors with three key themes: poor clinician confidence around
cultural values and ideals; exacerbation of institutional constraints; and
pre-conceived ideas of patients’ wishes.

Conclusions

This review found differences in the presence of legal ACP across ethnic groups despite similar presence of informal end of life conversations. Factors including low clinician confidence to deliver culturally sensitive, individualised conversations around ACP, and patients reasons for not wishing to engage in ACP (including, faith, religion or family preferences) may begin to explain some documented differences.

Trial registration

PROSPERO-CRD42022315252.
Early clinical exposure in medical education: the experience from Debre Tabor University
Authors: Ewnte Biniam , Yigzaw Tegbar
Published: April 2023

Background

The idea of early clinical exposure in Ethiopian medical schools is a young concept. Old and newly established universities across the nation are shifting towards incorporation of early clinical exposure (ECE) in their curricula. Debre Tabor University introduced ECE in undergraduate medical education from inception. This study generated evidence on students’ experience and academic leaders’ reflection on early clinical exposure implementation.

Objective

This study was carried out to investigate medical students’ perception towards early clinical exposure and its implementation process by instructors in undergraduate medical education at Debre Tabor University.

Method

A cross-sectional survey design that combines quantitative and qualitative methods was conducted in 2021. We asked fifth year medical students (42) to complete a self-administered questionnaire on 5-point Likert scale. The data were supplemented by semi-structured interview with 6 purposively selected academic leaders on the factors that facilitate or impede early clinical exposure implementation. The quantitative data were entered and analyzed using SPSS 20 to compute frequency, median and interquartile range. The qualitative data were analyzed thematically.

Results

The study findings suggest that early clinical exposure (ECE) has a positive impact on the development of students’ professional knowledge, problem-solving skills, motivation, active learning, and community orientation. Specifically, 64.3% of the surveyed students believed that ECE was effective in constructing their professional knowledge, while 52.4% felt that it improved their problem-solving skills and facilitated constructive/active learning. Additionally, 57.1% of students reported that ECE improved their motivation and 50% noted that it facilitated community orientation. The study also identified several barriers to the implementation of ECE, with the heavy workload being the most commonly mentioned (78.6%). Other challenges included a loose linkage between academic and healthcare institutions (59.5%) and a lack of orientation on the implementation process (35.7%). Academic leaders reflected that ECE was beneficial in familiarizing students with the clinical environment, but staff commitment was crucial for its successful implementation. The study also found that heavy workload, lack of assessment dedicated to ECE on the curriculum, and poorly oriented staff about the program impeded its implementation.

Conclusion and recommendations

The findings of this study suggest that early clinical exposure was beneficial learning method. Teachers’ commitment to their roles with adequate preparation, and the contribution of curriculum in providing the learning objective and cases for each session were factors that facilitate effective implementation of ECE. Heavy workload and poor orientation about the program could impede ECE implementation.
Phylogenomics of the Olea europaea complex using 15 whole genomes supports recurrent genetic admixture together with differentiation into seven subspecies
Authors: Julca Irene , Vargas Pablo , Gabaldón Toni
Published: April 2023

Background

The last taxonomic account ofOlearecognises six subspecies withinOlea europaeaL., including the Mediterranean olive tree (subsp.europaea) and five other subspecies (laperrinei,guanchica,maroccana,cerasiformis, andcuspidata) distributed across the Old World, including Macaronesian islands. The evolutionary history of this monophyletic group (O. europaeacomplex) has revealed a reticulated scenario involving hybridization and polyploidization events, leading to the presence of a polyploid series associated with the subspecies. However, how the polyploids originated, and how the different subspecies contributed to the domestication of the cultivated olive are questions still debated. Tracing the recent evolution and genetic diversification of the species is key for the management and preservation of its genetic resources. To study the recent history of theO. europaeacomplex, we compared newly sequenced and available genomes for 27 individuals representing the six subspecies.

Results

Our results show discordance between current subspecies distributions and phylogenomic patterns, which support intricate biogeographic patterns. The subspeciesguanchica, restricted to the Canary Islands, is closely related to subsp.europaea, and shows a high genetic diversity. The subsp.laperrinei, restricted now to high mountains of the Sahara desert, and the Canarian subsp.guanchicacontributed to the formation of the allotetraploid subsp.cerasiformis(Madeira islands) and the allohexaploid subsp.maroccana(western Sahara region). Our phylogenomic data support the recognition of one more taxon (subsp.ferruginea) for the Asian populations, which is clearly segregated from the African subsp.cuspidata.

Conclusions

In sum, theO. europaeacomplex underwent several processes of hybridization, polyploidy, and geographical isolation resulting in seven independent lineages with certain morphological traits recognised into subspecies.
Haplotype-resolved genomes of two buckwheat crops provide insights into their contrasted rutin concentrations and reproductive systems
Authors: Lin Hao , Yao Yingjun , Sun Pengchuan , Feng Landi , Wang Shuo , Ren Yumeng , Yu Xi , Xi Zhengxiang , Liu Jianquan
Published: April 2023

Background

Two widely cultivated annual buckwheat crops,Fagopyrum esculentumandF. tataricum, differ from each other in both rutin concentration and reproductive system. However, the underlying genetic mechanisms remain poorly elucidated.

Results

Here, we report the first haplotype-resolved chromosome-level genome assemblies of the two species. Two haplotype genomes ofF. esculentumwere assembled as 1.23 and 1.19 Gb with N50 = 9.8 and 12.4 Mb, respectively; the two haplotype genomes ofF. tataricumwere 453.7 and 446.2 Mb with N50 = 50 and 30 Mb, respectively. We further annotated protein-coding genes of each haplotype genome based on available gene sets and 48 newly sequenced transcriptomes. We found that more repetitive sequences, especially expansion of long terminal repeat retrotransposons (LTR-RTs), contributed to the large genome size ofF. esculentum. Based on the well-annotated sequences, gene expressions, and luciferase experiments, we identified the sequence mutations of the promoter regions of two key genes that are likely to have greatly contributed to the high rutin concentration and selfing reproduction inF. tartaricum.

Conclusions

Our results highlight the importance of high-quality genomes to identify genetic mutations underlying phenotypic differences between closely related species.F. tataricummay have been experienced stronger selection thanF. esculentumthrough choosing these two non-coding alleles for the desired cultivation traits. These findings further suggest that genetic manipulation of the non-coding promoter regions could be widely employed for breeding buckwheat and other crops.