bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategic Communication for Local Public Health Services in Portugal: A Delphi Study
Authors: Vital Brito Duarte
Published: April 2024

Introduction: Strategic communication plays a decisive role in public health planning and project implementation. However, Portuguese Local Public Health Units, which are responsible for community interventions, still lack guidance models, tools, specialized resources, and training in health communication. The aim of this study was to develop a conceptual model of strategic organizational communication for local public health services, in Portugal.Methods: This study presents a conceptual model of strategic organizational communication for Local Public Health Units, which was developed through a three-round, modified Delphi online panel. Thirty-seven Portuguese specialists in public health, communication, and community members were invited to analyse a proposed framework, based on an up-to-date literature review. High retention rates were observed in all rounds (first = 22 valid participations;second = 21 valid participations; third = 18 valid participations).Results: Most participants believed that Portuguese Public Health Units were not prepared to communicate effectively and that they would benefit from adequate planning and identification of a communication lead or team. Websites and social media were also identified as essential for effective communication. The validated conceptual model integrated different partners in health and in the community, with emphasis on the relationships with the national network of health authorities, other Public Health Units, primary health care units, municipalities, and schools. The preferred channels identified for communicating with these partners included interpersonal relationships, email, and mobile phone. No consensus was obtained for preferred communication channels between Local Public Health Units and the media.Conclusion: Strategic planning based on the proposed conceptual model involving different stakeholders, has potential to improve the effectiveness of internal and external communication and facilitate the implementation of public health programs and projects. The proposed model needs to be validated in Local Public Health Units, considering the potential human, material, and financial constraints.
Reforesting the Coastal Deserts of the World: A Peruvian Case-Study
Authors: Torres-Zorrilla Jorge
Published: April 2024

This paper discusses the technical and economic possibilities of adapting new technologies for harvesting water from clouds for the purposes of reforestation of vast arid areas of the Peruvian coastline. Peru is the climatical synthesis of the world, with great diversity of climates due to numerous factors such as its latitude, the Andes, the Peruvian sea, and the El Niño current. Although the cold waters of the Peruvian sea have influenced the climate converting the coast into a desert strip, it contributes, paradoxically, to the formation of dense layers of stratum clouds that cover the Peruvian coastal sky most of the year.The viability of adapting the water-harvesting technologies for reforestation of Peru’s coastline is shown to be valid in the paper. The discussion suggests that a social cost-benefit analysis of a 1000-hectares pilot reforestation project would show fairly low monetary costs and very important potential economic benefits. The main use that the new forest areas may be put to is agroforestry production systems, including timber, perennial semi-tropical crops (lucuma, pacay, pepino, basul), medicinal herbs, pasture crops and south american camelidae. The emphasis should be on desert plants such as cactus. The environmental benefits, stemming from the mere existence of forest and a greater biodiversity even if no commercial output is extracted from them, are more difficult to evaluate. Because, how are we to value the benefits on climate and on people brought about by the rebirth of a forest?
Information Security and Cybersecurity Policy
Authors: Bocharova A.
Published: April 2024

Information security is a critical issue in today’s world, as the constant threat of cyber-attacks and breaches continues to pose a serious threat to individuals, businesses and governments. To address this issue, it is necessary to evaluate the existing security measures and their effectiveness in protecting against cyber threats, as well as the decisionmaking processes that drive information security policy at the national and international levels. The classification of existing security measures and decision-making actors is an essential step in identifying areas of weakness and improving security policies. By taking a comprehensive approach to the subject, this research has provided insight into different levels of policy development and implementation, as well as the key actors involved at each stage. The review, classification and analysis of existing cybersecurity ratings have also contributed to the identification of areas for improvement. Despite the lack of transparency in the methodology and robustness issues of most ratings, this work has provided some important insights into the overall effectiveness of different cybersecurity and information security policies. Finally, the finding that gaps and theoretical-methodological inconsistencies in the field of national information and cybersecurity research can be explained by the opaque and non-objective methodology used to evaluate the effectiveness of policies is crucial. It shows that there is a need for more transparent and objective methodologies that can accurately evaluate cybersecurity policies at the national and international levels, taking into account the unique challenges and contexts within which they operate.
Financial Contagion Propagation in Europe under the Impact of Global Shocks
Authors: Ovcharov A.
Published: April 2024

This article examines the impact of global shocks of various nature on the development of the European economy within the framework of the theory and methodology of financial contagion. The content of the concept of “financial contagion” is revealed. The variety of methods of its detection is considered. It is shown that the methodology of financial contagion is useful in the study of financial crises. Based on data on local crises, the crisis burden indicator for the European region is calculated for the period from 1960 to 2019. In Europe, compared with other regions, this indicator takes on the lowest values, so the European economy is more resilient to crises. At the same time, the analysis of some empirical studies shows numerous episodes of financial contagion in the European zone. The results of original investigation which is based on large scale array of empirical data on stock indices and international trade are presented in the article. An advanced dynamic financial contagion test is used for analysis in this study. For situations caused by four global shocks contagion estimates are calculated which show different susceptibility levels of European countries to these shocks. On the other hand, the results of the analysis suggest that the COVID‑19 pandemic has the strongest impact on European countries because the calculated values of test statistics more often and significantly exceed the threshold level during this period (compared with other shocks such as the global financial crisis, BREXIT and the energy crisis). The main channel of contagion is the stock market, not trading. In addition, it can be noted that large European economies are not immune to financial contagion. They are as much its recipients as the weaker countries of the region. At the same time, they play the role of a damper, i. e. they do not transmit financial contagion within the European zone. Finally, the study identifies some directions of financial contagion counteractions in European countries that are linked to its transmission channels. Examples of the transformation of European economic policy caused by the impact of global shocks, contagion effects and stressful situations are given.
Investment Activity of the PRC in the Kyrgyz Republic
Authors: Omurova J. , Sharshembieva T. , Sharshenbek kyzy A.
Published: April 2024

The article discusses the investment infusion of China into the economy of Kyrgyzstan in 1992–2022. The independence of the countries of Central Asia in 1991 meant a fundamental change in the geopolitical environment for the PRC: small sovereign countries appeared in the Western part of China, internal and external courses and development prospects were connected with each other. The Chinese government was sure that this region would play an important role for them, especially they could act as a source of resources for the Chinese economy. In addition to the common border with the west of China, this region has overland communication routes with China, which contribute to maintaining very close trade and economic relations, Central Asia exports energy and natural resources, and the region is a market for Chinese investment and sales of material goods. China’s investment activity has developed in Kyrgyzstan mainly in the mining industry, energy, promotion of infrastructure projects, construction of joint ventures and other sectors of the economy. The authors, analyzing the investment relations of the two countries, classified them into three stages, show their specific impact on bilateral relations, and also consider the impact of investment cooperation on partners, which has been developing rapidly since 2013 under the One Belt, One Road project. Investment relations between China and Kyrgyzstan are accompanied by both successes and contradictions. From here they face many problems, and in this regard, both sides must adjust their approaches to cooperation. The study as a whole is based on extensive factual material, the latest sources, including data from the National Statistical Committee of the Kyrgyz Republic, and legal documents of the two countries. The analysis shows that the development of investment relations is part of the strategy of China’s foreign policy and foreign economic progress – the formation of stable states, including Kyrgyzstan, around its own borders, for which Beijing implements investment projects at the regional level. Also, the presence in the country of a large Uyghur diaspora, as well as the Muslim population of the Kyrgyz as a whole, requires China to make great efforts and various tools to establish cooperation and implement joint projects. In addition, Kyrgyzstan is one of the main channels for diversifying energy supplies to China. However, the fall in the pace of economic development on a global scale due to the pandemic, fluctuations in world prices for energy resources lead to the fact that Kyrgyzstan is also interested in cooperation with China. It is obvious that China’s influence in the region as a whole and in Kyrgyzstan in particular will grow, and, consequently, investment cooperation between the two countries will also develop.
Storm in a Teacup: Populist Attitudes and Voting for Populists in Croatia
Authors: Vuksan-Ćusa Bartul , Šalaj Berto
Published: April 2024

In comparative research on voting behavior, populist attitudes increasingly appear to be an unavoidable research construct. Nevertheless, the evidence on the effects of populist attitudes on voting for populists is still inconclusive, with the effects of other concepts often being conflated with populism. At the same time, populism remains an under-researched topic in Croatia, especially at the level of citizens' attitudes. This study aims to research the effects of populist attitudes on voting for populist parties and candidates in Croatia, a country that can be considered a relevant case study. For these purposes, survey data from Croatian Election Studies (2018 and 2020 edition) is used. The results of multinomial logistic regressions show that populist attitudes have no effect on voting for populists in the context of parliamentary and presidential elections. It is also shown that populist attitudes increase the probability of electoral abstention and decrease the probability of voting for the ruling party (HDZ). These findings raise questions about the usefulness and functionality of existing scales of populist attitudes and indicate the need for a different framing of the items used to measure populism.
II. Meşrutiyet’in İlanı ve 31 Mart Olayı Arasında Toplumsal Karşıtlığın Oluşumu
Authors: Şimşek Yusuf Sabri
Published: April 2024

II. Meşrutiyet’in ilanı ve 31 Mart Olayı arasındaki sürede birçok toplumsal olay meydana gelmiştir. Bu olaylar ilgili literatürde 31 Mart Olayı’nın hazırlayıcıları olduğu şeklinde sunulmuştur. Bu literatürün eksik bıraktığı noktalardan biri ise meşrutiyet karşıtlığının oluşumunda toplumsal olayların ve grupların muhalefeti ve bu muhalefetin oluşumudur. Çalışmamızda, dönemin toplumsal olaylarıyla sonuçlanan karşıtlığına neyin sebep olduğu anlamaya çalışıldı. Toplumsal gruplar ve karşıtlıklarının kökenleri incelendi. II. Abdülhamid döneminde şekillenmiş siyaset ve toplum ilişkilerinin, meşrutiyet döneminde geçirdiği değişiklikler üzerinden toplumsal karşıtlık ele alındı. Muhalif toplumsal grupların basındaki faaliyetleri incelendi. Toplumsal çatışmayı doğuran sebeplerin neler olduğunu ve hangi mekanlarda çatışma ihtimalinin yükseldiği ele alındı. Birçok toplumsal grubun süreç içerisinde farklı sebeplerle karşıt hale geldiği ve bunun çoğu grupta meşrutiyet karşıtlığı olarak ortaya çıkmadığı anlaşıldı. Türkiye siyasal ve toplumsal hayatı üzerinde uzun soluklu etkileri olan dönemin olaylarının, ilericilik-gericilik ikileminin düğüm noktası olduğu tespit edildi. Bugüne miras kalan birçok kavramın ve toplumsal gruplar arası karşıtlığın kökenleri, modern siyasal ortamda oluşan karşıtlık üzerinden anlamaya çalışıldı. Nitel çalışma yöntemi kullanarak hazırladığımız çalışmamızda arşiv kaynakları ve dönemin gazetelerinden faydalanıldı.
Распространение вариантов вируса SARS-COV-2, вызывающих интерес (VOI) и находящихся под наблюдением (VUM), на основе количества их геномов, депонированных в базу данных GISAID за неделю с 6 по 12 апреля 2024 г.
Authors: Зимирова Анастасия , Дмитриева Людмила , Краснов Ярослав , Осина Наталья , Чумачкова Елена , Иванова Александра , Карнаухов Игорь , Караваева Татьяна , Щербакова Светлана , Кутырев Владимир
Published: April 2024

В обзоре представлена информация по циркулирующим в настоящее время вариантам вируса SARS-COV-2 вызывающих интерес (VOI) и субвариантов Omicron, находящихся под наблюдением (VUM), геномные последовательности которых размещены в международной базе данных GISAID за неделю с 6 по 12 апреля 2024 г.
Myoepithelial Carcinoma of Soft Tissue
Authors: Richards Alexandra R. , Vijayakumar Gayathri , Braun Ankica , Gitelis Steven , Blank Alan T.
Published: April 2024

Case:

A 40-year-old man was evaluated for a painful mass on his right calf, and a 36-year-old woman presented with a painless mass on her right foot. Final pathology revealed marked nuclear atypia and positivity for S100/SOX10 and AE1/AE3 confirming diagnoses of myoepithelial carcinoma. Both patients underwent surgical resection and are without evidence of local recurrence or metastatic disease at 1-year follow-up.

Conclusion:

Soft-tissue tumors presenting in the extremities warrant careful evaluation and timely histopathologic diagnosis. Myoepithelial carcinomas are rare, aggressive tumors with a propensity for local recurrence and metastasis. Treatment of these tumors should be discussed by a multidisciplinary tumor team.
Bilateral Total Knee Arthroplasties in a Patient with Bilateral Below-Knee Amputations and Osseointegration Limb Replacements
Authors: Al Badi Hamid , Tanzer Michael , Turcotte Robert , Hart Adam
Published: April 2024

Case:

A 38-year-old man with congenital pain insensitivity underwent bilateral below-knee amputations. After his subsequent bilateral osseointegration (OI) limb replacements, he rapidly developed severe bilateral knee arthritis and varus deformity. In lieu of performing bilateral above-knee amputations, he underwent bilateral staged total knee arthroplasties (TKA) with excellent clinical and radiographic evaluation at 1-year follow-up.

Conclusion:

To address both the limited bone stock and OI implant stem location, TKA after OI limb replacement in congenital pain insensitivity patients can be successfully achieved with a nonkeeled cementless tibial component and augmentation with a tibial cone.
New Oil and Gas Plays in the Cis-Urals
Authors: Sobornov K.O.
Published: April 2024

—The search for oil and gas in folded zones and in the foredeep of the cis-Uralian region for many decades was reduced to testing of easy-to-find closures and reefs located at shallow depths. Many important discoveries were made as a result, but the overall performance of the work remained relatively low. On the one hand, this was due to the poor subsurface imaging of the data for reliable preparation of structures in regions of complex structure. On the other hand, the peculiarities of the development of oil and gas systems in these regions were ignored during the assessment of prospecting sites. In comparison with traditional production hubs centers in the platform regions of the Volga–Ural and Timan–Pechora basins, this distinguishing feature was caused by a thicker sedimentary cover, the variability of its composition and structure, and multiple phases of structural development. Many failures were due to the formation of traps after the passage of the primary migration flow of oil and gas, low capacity of reservoirs, and their fracturing by faults. As shown by interpretation of new geodata using modern knowledge about the oil and gas potential of regions of similar structure, the cis-Uralian region contains poorly studied oil and gas accumulation zones that can contain large deposits. These include blind thrust regions, subsalt traps in development zones of dislocated diapirs, and also stratigraphic and combined traps associated with unconformities and facies changes. The utmost attention is paid to new prospecting objects in the Timan–Pechora basin in which the thickness of the Paleozoic cover has increased. The preparation of new promising objects in these zones has become possible due to new knowledge and better geophysical data.
Satisfacción laboral y riesgos psicosociales en el sector de la construcción en Montería (Colombia)
Authors: Durango-Goez Santiago , Plaza-Gómez María Trinidad , Hernández-Riaño Helman Enrique
Published: April 2024

La presente investigación tiene como objetivo determinar las relaciones existentes entre los factores de riesgo psicosocial y la satisfacción laboral en trabajadores operativos del sector de la construcción de Montería, Colombia. Se realizó una investigación cuantitativa no experimental de cohorte transversal durante 6 meses, analizando datos de las variables de estudio, en una muestra no probabilística de 47 trabajadores operativos de las empresas constructoras, usando tres instrumentos de medición: 1) un cuestionario de datos sociodemográficos con el fin de conocer características generales de los entrevistados; 2) un cuestionario dado por 3 dimensiones (condiciones ambientales y de esfuerzo físico, participación y manejo del cambio y relaciones sociales en el trabajo) de la batería de factores de riesgo psicosocial del Ministerio de Trabajo en la forma B; y 3) una encuesta de satisfacción laboral de Spector JSS. Como resultado, se determinó la relación de las variables de estudio a través de un modelo de regresión logística y los instrumentos utilizados fueron sometidos a un análisis de validez y confiabilidad. Se concluyó que, las demandas ambientales, el esfuerzo físico y el nivel de estudio tienen efecto sobre la satisfacción laboral en la población estudiada.
Community structure of saproxylic arthropods in urban fragmented forests and large-scale forests in a warm-temperate zone of East Asia
Authors: Miyazaki Satoshi , Koike Fumito
Published: April 2024

Saproxylic arthropods play an essential role in the detritus food chains of forest ecosystems by contributing to wood decomposition and nutrient cycling. However,little is known about the effects of urbanization on saproxylic arthropod communities. This study examined saproxylic arthropod communities in various landscapes, ranging from large to fragmented urban forests, and compared the structure and composition of these communities. The results showed that communities could be classified into three types based on species composition and that arthropod community types were correlated with forest size. The fragmented urban forest community contained a large number of individuals of a few facultative saproxylic species, whereas many obligate saproxylic species were present in the large forest community. Rarefaction curves based on the cumulative number of individuals revealed that fragmented urban forest communities had significantly lower species richness than large forested area communities. However, this difference was not significant when the curve was based on the cumulative wood volume. Therefore, large forests must be protected to conserve the overall diversity of saproxylic arthropods. However, the stag beetle,Dorcus rectus,was found to prefer urban fragmented forests over large-scale forests. As this species is popular among Japanese children, it is suitable for encouraging urban children to engage with natural ecosystems.
WITHDRAWN: Influence of carbonization process parameters on copper (II) ion adsorption performance of biochar from exhausted coffee husk (ECH)
Authors: Das S. K.
Published: April 2024

12 April, 2024. Research Square has withdrawn this preprint due to significant overlap with work previously submitted to a journal by another author. While the submitted work is not publicly accessible, we have received confirmation of the submission from the journal's handling editor.
Complete chloroplast genome of the medicinal plant Eupatorium chinense: gene organization, comparative analysis, and phylogenetic relationships within Eupatorieae (Asteraceae)
Authors: Li Tingyu , Chen Hui , Qu Tianmeng , Zheng Xinyi , Chen Xinyu , Li Bo , Gu Xianhua , Fu Zhixi
Published: April 2024

The species of Eupatorium chinense L. is an economically important traditional Chinese medicinal plant. The complete chloroplast (cp) genome of the Eupatorium chinense species and a comparative genomic analysis of Eupatorium chinense and its closely related species within the Eupatorieae family are presented in this study. The results indicated that the cp genome had a typical circular structure of 151,393 bp in length, consisting of a long single-copy (LSC) region with 83,044 bp, a short single-copy (SSC) region with 18,295 bp, and two inverted repeat (IR) regions of 50,054 bp. A total of 133 genes were identified, including 37 tRNA genes, 8 rRNA genes and 87 protein-coding genes, with the GC content of 37.6%. The gene content, organization, and GC values found here were comparable to those of the other species of Eupatorieae. Phylogenetic analysis reveals the systematic position of Eupatorium chinense is sister to Eupatorium fortunei Turcz. For the purposes of analysis of this genus identification, evolution, and comparative genomic study, the chloroplast genome sequence of the Eupatorium chinense species offers a useful genetic resource.
Preoperative Vaginal Microbiome as a Predictor of Postoperative Urinary Tract Infection
Authors: OCCHINO John A. , D.O Jenifer N. BYRNES , Wu Pei-Ying , WALTHER-ANTONIO Marina R. , CHEN Jun
Published: April 2024

This is a single Institute, prospective cohort study. We collected twenty- two postmenopausal women with pelvic organ prolapse planning to undergo vaginal hysterectomy with transvaginal pelvic reconstructive surgery, with or without a concomitant anti-incontinence procedure. Vaginal swabs and urine samples were longitudinally collected at five time points: preoperative consult visit (T1), day of surgery prior to surgical scrub (T2), immediately postoperative (T3), day of hospital discharge (T4), and at the postoperative exam visit (T5). Women experiencing urinary tract infection symptoms provided a sample set prior to antibiotic administration (T6). Microbiome analysis on vaginal and urinary specimens at each time point. Region V3-V5 of the 16S ribosomal RNA gene was amplified and sequenced. Sample DNA was analyzed with visit T1, T2, T5 and T6. Six (27.3%) participants developed postoperative urinary tract infection whose vaginal sample at first clinical visit (T1) revealed beta-diversity analysis with significant differences in microbiome structure and composition. Women diagnosed with a postoperative urinary tract infection had a vaginal microbiome characterized by low abundance of Lactobacillus and high prevalence of Prevotella and Gardnerella species. In our cohort, preoperative vaginal swabs can predict who will develop a urinary tract infection following transvaginal surgery for pelvic organ prolapse.
The influence of selected grain size fractions of coal fly ash on properties of clay-cement mortars used for the flood levees construction
Authors: Delihowski Jurij , Izak Piotr , Wójcik Łukasz , Stempkowska Agata , Jarosz Marcin
Published: April 2024

This study examines the influence of different grain size fractions of coal fly ash on the properties of clay-cement mortars used in flood levee construction. Dry aerodynamic separation and mesh sieving were employed to obtain ultra-fine, fine, and medium fractions of high-calcium and silicious fly ash. The experimental results reveal that the rheological properties of fresh mortars are significantly influenced by these fractions. High-calcium fly ash mortars exhibit high reactivity and rapid viscosity increase, with finer fractions showing the highest reactivity. Silica ashes show increased reactivity in the later stages of suspension hardening. Their spherical shape contributes to reducing internal friction during flow in initial technological operations. Furthermore, the compressive strength of hardened mortars improves as the particle size decreases for both ashes resulting in dense and uniform microstructure. The separation and fractionation of fly ashes contribute to obtaining fractions that influence clay-cement suspension application parameters at different scales. Results show the potential benefits of the separation of ash which can bring advantages in terms of economic viability, engineering performance, and ecological sustainability.
Synthesis of novel anti-biofilm agent TiO2@GO for reducing the formation of Streptococcus mitis biofilm on teeth
Authors: Ali Md. Romzan , Hassan Md. Sakib , Ridoy Dipto Debnath , Mozumder Prity Lata , Bacchu Md. Sadek , Das Shilpi , Moon Md. Eashanul Karim , Anannya Tamanna Jerin , Hasan Tamim , Aly Mohamed Aly Saad , Akter Selina , Khan Md. Zaved Hossain
Published: April 2024

Treatment of global infectious diseases is becoming trickier due to the biofilm formation of bacteria. A novel therapeutic approach is urgently required to address the problems posed by pathogens' persistent infections linked with biofilms. Oral biofilm caused by Streptococcus mitis may generate several dental health issues such as dental caries and periodontal disease. Here, a novel nanomaterial (TiO2@GO) had proposed as an anti-biofilm agent to hinder the formation of biofilm of S. mitis. TiO2 was synthesized by following the sol-gel method and attached with GO through the Teflon line reactor-assisted method. The interaction of TiO2@GO was confirmed through scanning electron microscopy, Fourier transforms infra-ray spectroscopy, and UV-vis spectroscopy analysis. The inhibition of biofilm was confirmed by measuring the OD of S. mitis after and before treatment through an ELISA reader and performing SEM of teeth after and before treatment. The TiO2@GO inhibited the rate of biofilm formation (89% of biofilm was reduced after 8h of treatment). The TiO2@GO can reduce 70% biofilm formation for 24h which is effective to prevent dental caries. To conclude, the proposed nanomaterial will be the potential agent to inhibit the formation of oral biofilm and treat dental caries.
Factors critical for the successful delivery of telehealth to rural populations: A descriptive qualitative study.
Authors: Barry Rebecca , Green Elyce , Robson Kristy , Nott Melissa
Published: April 2024

Background:
The use of telehealth has proliferated to the point of being a common and accepted method of healthcare service delivery. Due to the rapidity of telehealth implementation, the evidence underpinning this approach to healthcare delivery is lagging, particularly when considering the uniqueness of some service users, such as those in rural areas. This research aimed to address the current gap in knowledge related to the factors critical for the successful delivery of telehealth to rural populations.
Methods:
This research used a qualitative descriptive design to explore telehealth service provision in rural areas from the perspective of clinicians and describe factors critical to the effective delivery of telehealth in rural contexts. Semi-structured interviews were conducted with clinicians from allied health and nursing backgrounds working in child and family nursing, allied health services, and mental health services. A manifest content analysis was undertaken using the Framework approach.
Results:
Sixteen health professionals from nursing, clinical psychology, and social work were interviewed.
Participants mostly identified as female (88%) and ranged in age from 26-65 years with a mean age of 47 years. Three overarching themes were identified: 1) Navigating the role of telehealth to support rural healthcare; 2) Preparing clinicians to engage in telehealth service delivery; and 3) Appreciating the complexities of telehealth implementation across services and environments.
Conclusions:
This research suggests that successful delivery of telehealth to rural populations requires consideration of the context in which telehealth services are being delivered, particularly in rural and remote communities where there are challenges with resourcing and training to support health professionals. Rural populations, like all communities, need choice in healthcare service delivery and models to increase accessibility. Preparation and specific, intentional training for health professionals on how to transition to, and maintain telehealth services is a critical factor for delivery of telehealth to rural populations. Future research should further investigate the training and supports required for telehealth service provision, including who, when and what training will equip health professionals with the appropriate skill set to deliver rural telehealth services.
A novel tissue-engineered corneal epithelium based on ultra-thin amniotic membrane and mesenchymal stem cells
Authors: long qiurong , Huang Chao , Ou Shangkun , Jiang Hao , Zhao Su , Zhang Lingli , Zheng Xueer , Zhang Liying , Gu Hao
Published: April 2024

Purpose: Currently, in vitro cultured corneal epithelial transplantation is effective for treating limbal stem cell dysfunction (LSCD). Selecting carriers is crucial for constructing the corneal epithelium through tissue engineering. This study aimed to effectively simulate the limbal stem cells (LSCs) microenvironment by inoculating mesenchymal stem cells (MSCs) on the basal surface of an ultra-thin amniotic membrane (UAM) to develop an improved tissue-engineered corneal epithelial carrier.
Methods: Traditional AM was modified, and MSCs were inoculated into the UAM stroma to construct a novel UAM-MSC tissue-engineered corneal epithelial carrier. The tissue-engineered corneal epithelium structure and rabbit LSCD model corneas cultured on different carriers were observed through hematoxylin and eosin staining. Cell phenotypes were evaluated through fluorescence staining, WB, and RT-qPCR. Additionally, cell junction genes and expression markers related to anti-neovascularization were evaluated using RT-qPCR. Corneal epithelium cell junctions were observed via an electron microscope. The tissue-engineered corneal epithelium culture medium was analyzed through mass spectrometry.
Results: Tissue-engineered corneal epithelial cells expanded by LSCs on UAM-MSCs had good transparency. Simultaneously, progenitor cell (K14, PNCA, p63) and corneal epithelial (PAX6) gene expression in tissue-engineered corneal epithelium constructed using UAM-MSCs was higher than that in corneal epithelial cells amplified by UAM and de-epithelialized amniotic membrane. Electron microscopy revealed that corneal epithelial cells grafted with UAM-MSCs were closely connected.
Conclusions: The UAM-MSCs vector we constructed can better simulate the limbal microenvironment, and the cultured tissue-engineered corneal epithelium had better transparency, anti-neovascularization properties, closer intercellular connections, and closer resemblance to the natural corneal epithelial tissue phenotype.
Short-term hospitalisation and early readmission of older patients: A case-control study
Authors: Christensen Lasse , Kristensen Kasper , Madsen Mathias Hakon , Danielsen Mathias Brix , Lorenzen Liudmila , Andersen Stig , Jorgensen Martin Gronbech
Published: April 2024

Background Pressure on health care capacity pushes for shorter hospital stays with early discharge from Emergency Departments (ED), leading to a vicious discharge-readmissions circle toxic to the rising number of older patients. Thus, risk factors for early readmission following short-term ED-stays of older patients needs attention.
Methods This case-control study scrutinised hospital records and the prescription database for data on demography, marital status, disability, Charlson comorbidity index (CCI), and redeemed systemic prescription drugs. Patients included were aged ≥70 years, had a primary hospitalisation with discharge from the ED <48 hours, and were readmitted within 7 or 30 days. Exclusion criteria were readmission for specialised treatment and multi-trauma. Data covered hospitalisations for 12-months, and the setting was publicly funded health care.
Results Among 2,343 patients aged ≥70 years with short-term hospitalisation, 266 (11.4%) were readmitted within 30 days, nearly half within 7 days, and one in three with similar diagnosis. Fifty patients were excluded leading to comparison with 432 cases and matched controls. Polypharmacy (≥8 drugs), CCI, marital status, and disability differed markedly with odds ratios for early readmission of 4.3 (95%-CI: 1.4-17, polypharmacy); 2.0 (95%-CI: 1.3-3.0, CCI ≥2); 1.8 (95%-CI: 1.1-2.8, unwed status); 1.6 (95%-CI: 1.0-2.5, disability).
Conclusion Four major risk factors for early readmission of older patients discharged from the ED within 48 hours were identified and relevant as one in three had similar diagnosis at discharge and readmission. These findings should guide the ED attending physician’s focus to prevent early readmission.
Socio-Economic Challenges of Physically Disabled Street Beggars: the case of Debre Markos city . It’s implication for Social protection Policy /directives towards the inclusion of PWDs beggars
Authors: Admas Getachew
Published: April 2024

This study examined the socio-economic challenges of physically disabled street beggars in the case of Debre Markos city. The researcher employed mixed research approaches with a cross-sectional research design. In addition, both probability and non-probability sampling techniques were employed. From the probability sampling techniques, stratified random sampling techniques were used to select the study participants (physical disabled street beggars) and from non-probability sampling techniques, purposive sampling technique was used to select the key informants. And the researcher collected the quantitative data from 133 sample respondents through survey questionnaire which analyzed by descriptive statistics basically through frequency and percentage. While the collected qualitative data through in-depth interview guide, key informant interview guides, and observation checklist were analyzed thematic method of data analysis. The finding reveled that in line with the increasing number of beggars in general and physically disabled street beggars in particular by migrant beggars though large number of them have able bodied (physically strong) and participate other income generating activities, people with different types of physical disabilities practice several socio economic challenges. For instance, lack of income, lack of educational opportunities, negative societal attitude, health, low/no social interaction with their family and community. Due to this fact, physically disabled individuals lives in the street through begging are vulnerable to other challenges.
Grb2 Y160F mutant mimics the wild-type monomeric state dynamics and
the monomer-dimer equilibrium
Authors: Melo Fernando , Casteluci Giovana , Dias Raphael Rodrigues , Martins Ingrid Bernardes Santana , de Almeida Rodrigo Fernandes , Tedesco Jessica Andrade , Caruso Ícaro , de Araujo Alexandre Suman , Itri Rosangela
Published: April 2024

The Growth factor receptor-bound protein 2 (Grb2) participates in early signaling complexes and regulates tyrosine kinase-mediated signal transduction through a monomer-dimer equilibrium. Grb2 dimeric state inhibits signal transduction whereas the monomer promotes signaling downstream. Since Grb2 dimer KD is ~ 0.8 μM, in vitro studies with the monomer are still challenging and require mutations or interaction with phosphotyrosine peptides. However, these mutants were never characterized considering their effects on protein structure and dynamics in solution. Here, we present the biophysical characterization of Grb2Y160F, the first Grb2 mutant to induce protein monomerization without disrupting its native behavior in solution due to net charge modifications or interaction with peptides. We also identified that Grb2Y160F exists in a monomer-dimer equilibrium. Grb2Y160F ability to dimerize implies that different dimerization interfaces might regulate signaling pathways in distinct ways since this mutation has already been reported as functional in other in vitro studies.
Osteonecrosis of the Jaw in Patients with Clear Cell Renal Cell Carcinoma Treated with Targeted Agents: A Case Series and Large-Scale Pharmacovigilance Analysis
Authors: Wang Shuyun , Song Yan , Yin Donghong , Xiao Feng , Xue Lili , Wang Xuyan
Published: April 2024

Objective: We use the public database to describe and evaluate ONJ related to various tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) treated for renal cell carcinoma. To provide evidence for optimizing drug administration in the clinic.
Methods: We analyzed spontaneous reports submitted to the FAERS in an observational and retrospective manner between January 2004 and December 2022. Selecting ONJ' adverse events to TKIs and ICIs. Associations between TKIs, ICIs and ONJ were assessed using reporting odds ratios (ROR), drug interaction signals based on the Ω shrinkage measure.
Results: 29 patients with ONJ events while on TKIs and ICIs were included in our case series. 240 were related to ONJ AEs. Specifically, 32.1% ICSRs were linked to sunitinib, 16.7% to lenvatinib, 12.9% to pazopanib, 12.5% to nivolumab, 10.0% to axitinib, 5.4% to sorafenib, 5.0% to pembrolizumab, 4.2% to cabozantinib, and 1.3% to ipilimumab. More ICSRs were generally seen in male and reported in Europe. The median age was 63 years. Renal cancer and lung cancer was the most common indication for TKIs and ICIs, respectively. Excluding missing data, the prevalence of mortality was highest for sunitinib-related ONJ ICSRs (18.5%), followed by sorafenib-related ONJ ICSRs (15.4%). With the criteria of ROR, sunitinib and lenvatinib were significantly associated with ONJ AEs. With the criteria of Ω, nivolumab + cabozantinib was significantly associated with ONJ AEs.
Conclusions: TKIs and ICIs have been reported to have significant ONJ side effects. Patients and physicians need to recognize and monitor these potentially fatal adverse events.
Complex Interplay of Sulfate Aerosols and Atmospheric Dynamics on Precipitation Vertical Structure and Latent Heat in the Beijing-Tianjin-Hebei Region: A Satellite Perspective
Authors: Li Rui , Zhu Hongxia , Yang Shuping , Zhao Hongwei , Wang Yu
Published: April 2024

An eight-year satellite observation dataset reveals that sulfate aerosols significantly influence the vertical structure of precipitation and latent heat (LH) in the Beijing-Tianjin-Hebei (BTH) region during summer. In this period, prevalent sulfate aerosols combine with warm, humid southerly winds and elevated convective available potential energy (CAPE), influencing precipitation dynamics. Under polluted conditions with specific CAPE and precipitation top temperature (PTT) ranges, precipitation particles experience accelerated growth within the mixed-phase layer, delineated by the -5°C to 2°C isotherms, compared to pristine environments. This results in a marked increase in both the intensity and height at which the maximum LH is released. Subsequent analysis reveals that hygroscopic sulfate aerosols, acting as cloud condensation nuclei (CCN), amplify the collision-coalescence process within the mixed layer amid high cloud water content, propelling rapid precipitation particle growth and elevating the PTT. This warming effect surpasses the cooling contribution from robust CAPE, culminating in a net elevation of PTT under polluted scenarios compared to pristine ones. Additionally, quantification of PTT sensitivity to both CAPE and aerosol optical depth (AOD) unveils a high consistency between satellite-detected PTT responses to CAPE and those predicted by cloud-resolving model simulations. The study deduces that the role of aerosols as CCN in either invigorating or diminishing the collision-coalescence process is contingent on the available cloud water.
Assessment of psychological distress in patients with cervical dysplasia according to age, education, information acquisition and information level
Authors: Scherer-Quenzer Anne Cathrine , Herbert Saskia Laureen , Schlaiss Tanja , Wöckel Achim , Diessner Joachim , Grunz Jan-Peter , Findeis Jelena , Kiesel Matthias
Published: April 2024

Purpose: This study aims to investigate the psychological distress experienced by patients with initial diagnosis of abnormal Pap smears or dysplastic changes of the cervix uteri. It is investigated whether patients' age, education, information level and approach to information acquisition have an impact on their psychological distress.
Methods: A total of 364 female patients, aged 20-80 years, referred to the special dysplasia consultation hour at the Department of Obstetrics and Gynecology, Wuerzburg, completed a questionnaire containing validated items to assess information level, information acquisition, information needs and psychological distress, including a distress thermometer. Data from questionnaires and medical reports were used for analysis.
Results: The study found that 56.9% of patients experienced psychological distress before their first visit. Patients under 44 years of age, especially those with concerns about fertility and sexuality, and those with lower levels of education showed higher levels of distress (p-value=0.018 and p-value=0.037). 40.9% of patients felt poorly informed and 53.7% of patients wanted more information before their visit. Correlational analysis showed that the method of obtaining information correlated with the desire for more information (p-value <0.001). Those who received information via the Internet felt less informed, wanted more information and experienced more anxiety.
Conclusion: These findings highlight the need for improved patient education strategies and effective doctor-patient communication to address the knowledge gap and reduce patient distress. In addition, healthcare providers should ensure that patients have access to reliable online resources for accurate information.
Exploring a quantitative formula for the total surgical amount in patients with type III acute acquired concomitant esotropia
Authors: Ren Xiaojun , Li Dongkan , Li Xian , Wang Pengjun , Chen Siyu , Huang Shiling , Jiang Naikun , Pan Meihua , He Huan , Chiang Yi-Chen
Published: April 2024

Background: To provide an amount-response reference for surgical planning in type III acute acquired concomitant esotropia (AACE).
Methods: Consecutive patients who underwent unilateral or bilateral medial rectus recession (MRrec) for AACE or common forms of esotropia (ET) correction from January 2019 to August 2023. All patients with a minimum follow-up of 3 months were analyzed. A pre- and post-surgical healthy eye behavior questionnaire was conducted on patients with AACE.
Results: In this study, we found that preoperative horizontal deviation had a significant effect on the total surgical amount of the patients. When predicting the total surgical amount of AACE patients, the recommended regression equation is Y = 3.259 + 0.174 preoperative horizontal deviation. Additionally, for AACE patients with preoperative horizontal deviation less than 40, the quantified reference formula for the total surgical amount was Y = 1.746 + 0.236 × preoperative horizontal deviation. For AACE patients with preoperative horizontal deviation greater than or equal to 40, the quantified reference formula for the total surgical amount was Y = 4.600 + 0.143 × preoperative horizontal deviation. The results of the questionnaire survey showed that the postoperative eye behaviors of AACE patients haveimproved.
Conclusions: This study conducted a detailed quantitative analysis of the impact of preoperative horizontal deviation levels on the total surgical amount for AACE patients, and established specific quantitative reference formulas to inform surgeons’ surgical planning. In addition, we suggest providing health education to patients after surgery, which can have a positive effect on their postoperative ocular behavior.
Nipple adenoma in prepubescent boy：a case report and review
Authors: Chen Jianzhe , Xia Tian , Chen Xiaomei , Yin Ansi , Xiong Jie , Duan Zhicai , Pan Guangrui , Zuo Huaiquan
Published: April 2024

Background：Nipple adenoma is a rare benign nipple tumor that is seldom seen in males and can be challenging to differentiate from Paget's disease.
Case report：We report the case of a boy with nipple adenoma who was initially misdiagnosed with Syringocystadenoma papilliferum combined with a tubular apocrine adenoma. Six months post-diagnosis, a nipple-areolar resection was conducted, followed by a purse-string suture technique to restore and reshape the nipple's appearance. Histopathological examination confirmed the diagnosis of nipple adenoma.
Conclusion：Nipple adenomas often prove difficult to alleviate without surgical intervention; surgical excision is deemed the gold standard for treatment. It is vital to establish a clear pathological diagnosis for nipple adenomas, as they are benign tumors, to prevent unnecessary overtreatment.