bluuebunny/crossref_metadata_2025 huggingface dataset:
Genomic profiling and molecular characterization of non-clear cell renal cell carcinoma: a narrative review from a clinical perspective
Authors: Pezzicoli Gaetano , Musci Vittoria , Ciciriello Federica , Salonne Francesco , Cafforio Paola , Lionetti Nicoletta , Ragno Anna , Rizzo Mimma
Published: November 2024

While the clear-cell renal cell carcinoma (ccRCC) treatment has undergone several paradigm shifts in recent years, the non-clear cell renal cell carcinoma (nccRCC) therapeutic approach has yet to be extensively investigated and improved. The WHO 2022 classification of renal neoplasms redefined the most common nccRCC subtypes (papillary and chromophobe RCC) and introduced the molecularly defined RCC class, which is a first step in the direction of better molecular profiling of nccRCC. We reviewed the literature data on known genomic alterations of clinical interest in nccRCC and discussed their potential role in guiding therapeutic choices in each nccRCC entity. Among the alterations discussed, we focused on the ones that could be treated with already available drugs, such as MET-driven papillary RCC, mechanistic target of rapamycin altered chromophobe RCC, anaplastic lymphoma kinase-rearranged RCC, and fumarate-hydratase deficient RCC. Furthermore, we focused on the currently ongoing clinical trials and further evidence for all the other entities, such as SMARCB1-deficient RCC, TFE3 and transcription factorEB (TFEB)-altered RCC, and Elongin C (ELOC)-mutated RCC. The vast heterogeneity of nccRCC does not allow a one-size-fits-all solution; therefore, molecular characterization is the path toward effective therapies and fully personalized medicine for these entities.
Conglomeration, Digital Disruption, and COVID-19: Upheaval-Driven Changes to the Roles of U.S. Local Television News Directors
Authors: Lysak Suzanne , Henderson Keren
Published: November 2024

This mixed methods study analyzes how broadcast news directors renegotiate their roles under organizational and cultural times of change. Even before COVID-19, local television news directors, one of the two predominant groups of journalism managers in the United States, were experiencing shifts in roles related to their growing work responsibilities. These changes were the result of long-term workplace upheavals including conglomeration and digital disruption. When the COVID-19 pandemic hit, news directors found themselves managing through this additional, short-term upheaval. The authors of this study sought to discover how industry upheavals impact broadcast newsroom management roles.
Telehealth “Verzuz” Radical Telehealing: Reimagining Social Media as Virtual Healing Spaces for Black Communities
Authors: Allen Chelsea A. , Henderson Zuleka R. , Harris Jalana , Chang Rae L. , Williams Errica L. , Cogburn Courtney D.
Published: November 2024

Evidence suggests that the conception of “mental health,” as well as Western health care models, needs to be reimagined to better reflect the unique care needs of Black people. Within these systems, Black people are more likely to experience secondary victimization and retraumatization. Despite these systemic failings, Black people often find ways to manage self-care, wellness, and healing. Within the context of dueling pandemics (COVID-19 and racial injustice), Black people turned to social media applications to develop community-led, culturally-congruent care models. This study aims to explore the ways Black people experienced virtual engagements on social media during the dueling pandemics. This exploratory study employed a six-phase thematic analysis approach, while utilizing publicly available textual data (Instagram comments) from two key social media engagements targeting Black audiences. Prominent themes gleaned from this analysis elucidate the healing and therapeutic value of these virtual gatherings. These include: (1) Expression of Gratitude and Appreciation, (2) Necessity, (3) Timeliness, (4) Accessibility, (5) Emotional and Spiritual Impact of the Virtual Space, (6) Ancestral and Culturally-Grounded Healing Practices, (7) Reprieve within the Virtual Space, and (8) Community and Collectivism. Our analysis reveals that when elaborating on their experience participating in two key social media engagements targeting Black audiences, attendees’ responses reflect key aspects of empirically-grounded, culturally-congruent care models for Black people (i.e., radical healing). We contend our findings demonstrate the unique ways social media applications might be more intentionally leveraged to create culturally-congruent care for Black people.
The (Un)Hidden Effects of Digitalization on Enterprise Performance During Covid-19 Pandemic
Authors: Kalaj Ermira
Published: November 2024

This paper focuses on the analysis of digitalization of enterprises and its performance impact in Albania. Using the World Bank Enterprise Survey of 2019 merged with the ES follow-up on Covid-19 for Albania, we investigate the overall performance of enterprises during Covid-19 pandemic and the role of digitalization. The objective of the survey is to better understand the firm’s experience in the private sector. The collected data are based on firms’ experiences and perception of the environment in which they operate. The paper uses these specific questions to study digitalization prior to and during Covid-19 pandemic. ES questionnaires focus on the following questions: (a) Does the establishment have its own website? (b) Started or increased business activity online? (c) Started or increased remote work arrangement for its workforce? The dependent variable is performance of the enterprises measured in terms of sales growth, employment growth, closure, and production adjustment. While the vector of independent variables is composed by enterprise characteristics such as firm size, ownership structure, legal status, region, etc. Moreover, dummy variables are used to capture access to formal banking service, and gender ownership.

JEL Classification: L25, L26, L86,
Customer Participation in the Value Co-creation of Hotel Service Robot Interaction
Authors: Tian Zemin , Liu Xiaoli
Published: November 2024

Service robots are becoming increasingly popular in hotels, mainly providing services such as welcome, check-in, and meal delivery. This study examines the relationships among customer participation, perceived value, and behavioral intention in a hotel service robot context. We collected 321 valid samples and performed the Partial Least Squares (PLS) path analysis. The results show that customer participation is positively related to utilitarian and hedonic values, which further lead to service robot satisfaction. Service robot satisfaction is also related to hotel satisfaction, and both service robot satisfaction and hotel satisfaction have positive effects on behavioral intention. This study helps to deepen the understanding of the influence of customer participation in value co-creation on behavioral intention in human-robot interaction context.
Ethics: The 2019 Firing of McDonald’s CEO, Steve Easterbrook
Authors: Bliss Lisa
Published: November 2024

The #MeToo movement prompted businesses to revamp their workplace dating policies. McDonald’s is one of many companies with a dating policy that prohibits consensual relationships and requires disclosure of the same. In November 2019, McDonald’s fired its CEO, Steve Easterbrook, for violating that policy. The ousting of such a high-level executive for violating a dating policy was surprising to some. Others were shocked by the severance package Easterbrook received: $42 million plus $23.8 million in stock options. The purpose of this case study is to discuss the ethical implications of Easterbrook’s termination and severance package and to analyze the decision making and consequences thereof, considering the later discovery of three additional consensual sexual relationships between Easterbrook and three subordinates.
Postoperative Opioid Reduction Using a Multimodal Pain Protocol for Outpatient Orthopaedic Sports Medicine Surgery
Authors: Bernstein Ethan M. , Van Buren J. Preston , Wolf Kieran S.M. , Cantor Addison G. , Wei Wu Wei , Bailey James R. , Smith Jennifer L.
Published: November 2024

Background:

Orthopaedic surgery regularly employs opioids for postoperative pain management. Multimodal pain protocols have been shown to reduce opioid prescriptions in orthopaedic surgery.

Purpose:

To analyze the impact of a division-level multimodal pain protocol for orthopaedic sports medicine surgery on opioid prescription reduction and pain level postoperatively.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All orthopaedic sports medicine procedures at a military treatment facility were categorized into 1 of 3 pain tiers. A pain protocol emphasizing multimodal pain control was implemented for each tier. A retrospective cohort study compared pre- and postprotocol pain groups for each respective tier (n = 40 in each) for visual analog scale (VAS) for pain scores 2 weeks postoperatively, postoperative opioid prescription, and time to discontinuation of postoperative opioids.

Results:

The mean number of opioid pills prescribed for all tiers decreased by 43.6% (preprotocol 35.7 ± 3.1; postprotocol 20.1 ± 1.5; P < .0001) after pain protocol implementation. Of the total opioids prescribed in the postprotocol cohort, a mean of 64.1% were consumed. There was no significant difference in overall visual analog scale for pain scores at 2 weeks postoperatively (preprotocol 2.72 ± 0.41; postprotocol 2.99 ± 0.43; P = .40). At 2 weeks postoperatively, only 1 patient continued opioids in the postprotocol group compared with 20 patients with continued opioid use in the preprotocol group ( P < .001).

Conclusion:

A division-level multimodal pain protocol applied to orthopaedic sports medicine procedures led to decreased opioid prescription postoperatively with no significant difference in 2-week postoperative pain scores compared with more opioid reliant and variable protocols in a cohort of military service members. Despite the reduced prescription, patients consumed a mean of 64.1% of pills, indicating continued overprescription.
Delivery of Oral Health Services at Medical Visits through 3 Medical Dental Integration Models
Authors: Braun P.A. , Flowerday C. , Bienstock A. , Callaghan T. , Freeman K. , Gable M. , Ramirez L. , Dickinson L.M.
Published: November 2024

Introduction:

The Rocky Mountain Network of Oral Health is 1 of 3 regional projects funded by the Health Resources and Services Administration (2019 to 2024) focusing on caries prevention through medical-dental integration (MDI) in community health centers (CHCs). MDI models included provision of preventive oral health services (POHS) at medical visits by the medical team (model 1), by integrated dental hygienists (DHs; model 2), or a hybrid of these models (model 3). The overarching aim is to evaluate the effectiveness of these models on 3 objectives: (1) ≥50% receive POHS, (2) ≥75% with high caries risk receives dental referral, and (3) ≥30% of parents/caregivers set an oral health goal for the child.

Methods:

Primary care association practice facilitators (PFs) recruited 22 CHCs to participate from Arizona, Colorado, Montana, and Wyoming. CHCs completed oral health needs assessments prior to participating. PFs coached CHCs using an MDI change package. CHCs submitted monthly and 6-mo, aggregated, deidentified population metrics for children aged 0 to 40 mo receiving well-child care visits. Monthly CHC-specific reports were used by PFs with teams in continuous quality improvement activities. POHS delivery trends over time were assessed using a linear mixed model, adjusting for number of eligible patients during each 6-mo reporting period.

Results:

Participating CHCs were urban (55%), rural (36%), and frontier (8%). Twelve (55%) had co-located dental clinics. Ten CHCs implemented model 1, 5 implemented model 2, and 7 implemented model 3. From September 2020 to August 2023, CHCs reported providing 91,604 POHS to eligible children. After adjustment, there was significant improvement over time for all objectives: objective 1: F(5, 90) = 4.66, P = 0.0008; objective 2: F(5, 90) = 2.99, P = 0.0151; objective 3: F(5, 90) = 4.56, P = 0.0009.

Conclusions:

The implementation of 3 MDI models across 22 CHCs in 4 states resulted in a meaningful increase in POHS delivery. POHS delivery by both medical and embedded DHs was associated with the most substantial increase in POHS delivery.

Knowledge Transfer Statement:

The results of this study can be used by medical and dental providers when deciding which approach they wish to use when planning the delivery of preventive oral health services at medical visits.
Medical-Dental-Behavioral Integration: Embracing Whole-Person Health in Research and Practice
Authors: Heaton L.J. , Tiwari T. , Tranby E.P.
Published: November 2024

This editorial describes the 9 articles in this supplement that emphasize and support establishing and maintaining integrated health care systems that address all aspects of a person’s health, given the complex links between oral, behavioral, and systemic health. The 9 articles in this supplement represent original data collection from clinical and big data studies, a theoretical discussion of the implementation of medical-dental-behavioral integration models, and a scoping review of the links between oral health and one health. These articles involve providers representing oral health care, primary care, nursing, behavioral health, and other health care providers in the delivery of integrated, whole-person care. This editorial discusses barriers and opportunities that emerge when we understand overall health as a complex interplay of factors, including individual, emotional, social, and environmental. The articles described briefly in this editorial provide strong evidence for the importance, feasibility, and necessity of integrated health care and concept of overall health.

Knowledge Transfer Statement:

The goal of this editorial and following supplement articles is to present different perspectives on the implementation of medical-dental-behavioral integration to provide comprehensive, whole-person care. Through a discussion of barriers to and opportunities that emerge from this type of integrated care, this editorial and supplement provide strong evidence for the importance, feasibility, and necessity of integrated health care and concept of overall health.
Periodontitis and Metabolic Control of Adults with Type 1 Diabetes
Authors: Jeftha A. , Suliman A. , Conradie-Smit M. , Kimmie-Dhansay F.
Published: November 2024

Introduction:

Periodontitis has been reported with increased incidence and prevalence in patients with diabetes mellitus (DM). Noncommunicable diseases burden the South African public health system, and there are no data reporting on this relationship in this population. This is required to inform management protocols in type 1 diabetes mellitus (T1DM), which currently exclude the importance of periodontal treatment.

Objectives:

The aim of this study was to determine whether there was an association between periodontitis and the glycemic control of adult patients with T1DM at a tertiary institution in South Africa.

Methods:

A cross-sectional study was conducted on adults diagnosed with T1DM. Bleeding on probing, periodontal pocket depth, and radiographical bone loss were assessed and the periodontal status of the patient was compared to their glycemic control, measured by HbA1c. An HbA1c level of ≤7% was considered to indicate adequate glycemic control.

Results:

There were 120 adult participants, of whom 61.7% (74) were female and 38.3% (46) were male. The majority were nonsmokers and younger than 44 y. There were 78 (65%) participants with uncontrolled blood glucose and 42 (35%) with good control (HbA1c ≤ 7%). The median HbA1c level was 8.75 (range, 6.1 to 12.2). Most participants (94%) had periodontitis, and 97% of them had uncontrolled blood glucose.

Conclusion:

There was an association between percentage bleeding score (P < 0.001) and metabolic control in adults with T1DM treated at a tertiary hospital in Cape Town, South Africa. Periodontitis severity as described by staging was not associated with T1DM in this sample. The high prevalence of periodontitis in this sample (94%) highlights the need for periodontal management to form a part of holistic patient care in patients with T1DM in this setting.

Knowledge Transfer Statement:

The study results highlight the role of periodontitis severity and gingival bleeding scores on the metabolic control of adults with T1DM and thus emphasizes the importance of periodontal care in whole-person health in this patient population.
Global Capability Centres in India: A Futuristic Analysis
Authors: Kanupriya Mrs
Published: November 2024

Global Capability Centres (GCCs) have evolved from being regarded merely as instruments for cost reduction to being the drivers of innovation and transformation. This article seeks to give a broad-based perspective on the prospects of GCCs in India. The outlook for GCCs in India is optimistic, as a growing number of international firms are seeking to establish their GCCs in the country. This trend is anticipated to create job opportunities and increase socio-economic benefits for India. With a skilled English-speaking workforce, India is on the cusp of becoming the next ‘Silicon Valley of GCCs’, with various innovation and talent hubs developing throughout the country. This progress may lead to enhanced socio-economic conditions in both Tier-I and Tier-II cities. However, despite significant advancements, GCCs have not yet attained widespread recognition in the country. They encounter several challenges, including inadequate collaboration between parent organisations and GCCs, difficulties in transitioning back to on-site work from hybrid or remote arrangements, decline in service quality due to prolonged remote work, hurdles in implementing transformation and automation initiatives at the necessary speed, obstacles in scaling or resuming support services and reduced worker productivity stemming from extended remote work and weakened cross-functional collaboration. To overcome these challenges, proactive measures from industry stakeholders will be essential. These may involve monitoring employee productivity and satisfaction through online proctoring and regular meetings in hybrid or remote work environments and improving collaboration between GCCs and their parent organisations through consistent communication and feedback.
Development of ALL-Hematotox (ALL-HT): Predicting post CAR T-cell hematotoxicity in B-cell acute lymphoblastic leukemia
Authors: Nair Monica S , Silbert Sara K , Rejeski Kai , Wilson Karilynn A , Lamble Adam Joseph , Valtis Yannis K. , Yates Bonnie , Morales Arana Alexa , Shouval Roni , Curran Kevin J. , Gardner Rebecca A , Shalabi Haneen , Annesley Colleen , Park Jae H. , Subklewe Marion , Shah Nirali N
Published: November 2024

Immune effector cell-associated hematotoxicity (ICAHT) is a major B-cell targeted chimeric antigen receptor (CAR) T-cell related toxicity. While ICAHT incidence and severity is documented in large B-cell lymphoma (LBCL), mantle cell lymphoma (MCL), and multiple myeloma (MM), ICAHT has not been described in B-cell acute lymphoblastic leukemia (B-ALL). Similarly, the CAR-HEMATOTOX (CAR-HT) model, designed to predict severe prolonged neutropenia (>14 days of ANC <500/µl), has been validated in LBCL, MCL, and MM, but not in B-ALL. As B-ALL bone marrow (BM) infiltration can impact cytopenias, we sought to describe ICAHT and assess CAR-HT for predicting hematotoxicity in B-ALL. In a cohort of 156 children and young adults with relapsed/refractory B-ALL, the median duration of severe neutropenia (ANC <500/µl) was 13 days (95% CI 10-16), with 83 (53%) experiencing grade >3 ICAHT. Applying CAR-HT, nearly 90% were classified as high-risk, demonstrating limited discriminative power and prompting further development. Using the association identified between BM disease burden and post-infusion neutropenia (r=0.64, p<0.0001), we developed the ALL-Hematotox (ALL-HT) score which substitutes BM disease burden for ferritin in CAR-HT. The ALL-HT score associated with severe prolonged neutropenia (area under the curve=0.84, p<0.0001), and appropriately discriminated high-risk patients (47%) who had more cumulative days of neutropenia (26 vs 4 days, p<0.0001), fewer rates of complete response (88% vs 98%, p=0.03), and shorter median overall survival (9.8 vs 24 months, logrank p=0.0002). ALL-HT was also validated in two independent cohorts. The ALL-HT score refines a widely accepted predictive model of post-infusion hematotoxicity, applicable in B-ALL.
Role of molecular alterations in transplantation decisions for patients with primary myelofibrosis
Authors: Luque Paz Damien , Gagelmann Nico , Benajiba Lina , Riou Jérémie , Salit Rachel , Orvain Corentin , Schroeder Thomas , Bories Claire , Gurnari Carmelo , Badbaran Anita , Boyer Françoise , Pagliuca Simona , Rautenberg Christina , Tavitian Suzanne , Pangiota Victoria , Ianotto Jean-Christophe , Thol Felicitas , Cayssials Emilie , Heuser Michael , Rubio Marie-Thérèse , Cassinat Bruno , Daltro de Oliveira Rafael , Sauter Craig , Maciejewski Jaroslaw P. , Reinhardt Hans Christian , Scott Bart L. , Ugo Valérie , Kröger Nicolaus , Kiladjian Jean-Jacques , Robin Marie
Published: November 2024

The aim of our study was to analyze the potential survival benefit associated with hematopoietic stem cell transplantation (HSCT) according to clinicobiological scores, which incorporate mutation-enhanced international prognostic score system (MIPSS) to facilitate decision-making in this context. One transplant (n = 241) and 1 nontransplant cohort (n = 239) were used to test the hypothesis that patients with primary myelofibrosis with higher risk molecular score benefit from HSCT. A weighted propensity score was applied to balance confounding factors with the transplanted cohort as reference. Weighted Cox proportional hazard models and logistic regression analyses were performed. Overall, 105 patients who did not receive transplant could be matched to the 239 patients who did receive transplants. HSCT was associated with a higher 6-year overall survival rate in intermediate-2 (60.1% vs 41.5%) and high-risk DIPSS patients (44.4% vs 6.55%), high-risk MIPSS70 (46.5% vs 23.9%), high-risk (73.2% vs 39.7%) or very high-risk MIPSS70+V2 (51.8% vs 24%). Patients with intermediate MIPSS70 scores have an advantage of survival with HSCT only when their myelofibrosis transplant scoring system (MTSS) were low or intermediate. Patients who received transplant had an increased mortality risk the first year, but a significant benefit with HSCT after the 1-year landmark was observed in higher risk patients. This study confirms that, similar to DIPSS, MIPSS70 and MIPSS70+V2 risk score in addition to MTSS can be used to determine which patients with primary myelofibrosis have survival benefit from HSCT over non-HSCT strategies.
BMSC-derived exosomes promote osteoporosis alleviation via M2 macrophage polarization
Authors: Zhang Yanbin , Bai Jing , Xiao Bin , Li Chunyan
Published: November 2024

Osteoporosis is characterized by reduced bone mass due to imbalanced bone metabolism. Exosomes derived from bone mesenchymal stem cells (BMSCs) have been shown to play roles in various diseases. This study aimed to clarify the regulatory function and molecular mechanism of BMSCs-derived exosomes in osteogenic differentiation and their potential therapeutic effects on osteoporosis. Exosomes were extracted from BMSCs. Bone marrow-derived macrophages (BMDMs) were cultured and internalized with BMSCs-derived exosomes. Real-time quantitative PCR was used to detect the expression of macrophage surface markers and tripartite motif (TRIM) family genes. BMDMs were co-cultured with human osteoblasts to assess osteogenic differentiation. Western blot was performed to analyze the ubiquitination of triggering receptor expressed on myeloid cell 1 (TREM1) mediated by TRIM25. An ovariectomized mice model was established to evaluate the role of TRIM25 and exosomes in osteoporosis. Exosomes were successfully isolated from BMSCs. BMSCs-derived exosomes upregulated TRIM25 expression, promoting M2 macrophage polarization and osteogenic differentiation. TRIM25 facilitated the ubiquitination and degradation of TREM1. Overexpression of TREM1 reversed the enhanced M2 macrophage polarization and osteogenic differentiation caused by TRIM25 overexpression. TRIM25 enhanced the protective effect of BMSCs-derived exosomes against bone loss in mice. These findings suggested that BMSCs-derived exosomes promoted osteogenic differentiation by regulating M2 macrophage polarization through TRIM25-mediated ubiquitination and degradation of TREM1. This mechanism might provide a novel approach for treating osteoporosis.
Genetically predicted circulating linoleic acid levels and risk of osteoarthritis: a two-sample mendelian randomization study
Authors: Yang Wen , Xiao Wenwu , Liu Hailong
Published: November 2024

Objectives

This study aimed to provide insight into the effect of genetically predicted linoleic acid (LA) levels on osteoarthritis (OA).

Methods

The LA dataset was obtained from the UK Biobank (UKBB) consortium and contained 114,999 samples. The OA discovery dataset was derived from MRC-IEU consortium and included 38,472 cases and 424,461 controls. The OA validation set was derived from a summary-level genome-wide association study (GWAS) and included 39,427 cases and 378,169 controls. Genetic variants strongly associated with LA (p < 5 × 10− 8) were extracted as instrumental variables (IVs). The inverse variance weighted (IVW) approach was adopted as the primary analysis method in this study. In addition, multiple sensitivity analysis methods were used to assess the reliability of our results.

Results

The IVW approach showed that circulating LA levels were negatively associated with OA risk in the discovery set (odds ratio (OR) = 0.993, 95% confidence interval (95% CI): 0.988–0.998, p = 0.011). A consistent result was obtained in the validation set (OR = 0.904, 95%CI: 0.845–0.967, p = 0.003). These results were validated by sensitivity analysis.

Conclusion

This study provides new evidence for the causal relationship between LA and OA, which provides new insights for the treatment of OA.
Early clinical efficacy of 3D-printed artificial vertebral body in spinal reconstruction after total en bloc spondylectomy for spinal tumors
Authors: Wang Xiaodong , Sun Shaosong , Jiang Yuanyuan , Ren Bao , Zhang Xiong , Miao Jun , Ji Jingtao , Han Ye
Published: November 2024

Background

Total en bloc spondylectomy (TES) is a recognized surgical approach for managing spinal tumors. With advancements in three-dimensional (3D) printing technology, the use of 3D-printed prosthetics for vertebral reconstruction post-tumor resection has gained traction. However, research on the clinical implications of these prosthetics remains limited.

Methods

This retrospective study evaluated patients who underwent TES for primary and metastatic thoracolumbar tumors at the Department of Spinal Surgery, Tianjin Hospital, between October 2017 and September 2020. These patients received anterior reconstruction with 3D-printed artificial vertebral bodies.

Results

14 patients completed the surgery, with intraoperative blood loss ranging from 1,400 to 4,200 ml (mean 2,767 ± 790 ml) and operative duration between 240 and 520 min (mean 382 ± 75.9 min). The follow-up period extended from 7 to 43 months, with an average of 19.9 ± 9.5 months. Standardized prefabricated prosthetics were utilized in nine patients, while five received customized prosthetics. Throughout the follow-up, there were no reports of posterior connecting rod, 3D-printed prosthetic, or pedicle screw failures. Notably, one patient presented with significant prosthetic subsidence resulting in screw loosening, and three cases of prosthetic subsidence were observed.

Conclusion

The incorporation of 3D-printed prosthetics in TES procedures yielded favorable clinical outcomes. Further research is warranted to optimize these prosthetics for enhanced postoperative stability and patient-specific applications.
Factors influencing job performance of nurses in COVID-19 care: a study in Egypt
Authors: Senosy Ayman Muhammad Kamel
Published: November 2024

Coronavirus disease (COVID-19) is an illness that has critical effects on public health and overall circumstances across the world. The performance of nurses represents the vital actions in providing care for COVID-19 patients. The aim of this study was to assess job performance and associated nurses, patients, and environmental-related factors among nurses providing care to COVID-19 patients in Egypt through the following: assessing the nurses’ knowledge regarding care of COVID-19 patients; assessing the nurses’ practice regarding care of COVID-19 patients; assessing different factors that affect different types of nurses' job performance; and assessing the factors associated with the job performance of nurses providing care to COVID-19 patients.

Design A descriptive exploratory study was used to meet the aim of the study.

Setting The study was conducted at Ain Shams University COVID-19 Hospital.

Study subjects A convenient sample of all 52 available nurses working at Ain Shams University COVID-19 Hospital. Data collection tools: The data was collected using a self-administered questionnaire. It consisted of the following: A. Self-administered nurses’ questionnaire: Part I: Demographic characteristics of nurses. Part II: Nurses knowledge assessment. Part III: Factors associated with nurses' job performance. B. Narses’s practice observational checklist. Results: The mean age (mean ± SD) of the study population was 40.59 ± 6.90. As regards their years of experience working as nurses, only 32.7% of them have more than ten years of experience. In relation to the total satisfactory level of knowledge about coronavirus, the study reveals that 55.8% of the nurses have unsatisfactory knowledge regarding coronavirus, There is a highly significant relationship between level of practice and years of experience (p-value < 0.001**), while there is a significant relationship between level of practice and educational level and attending the training courses about caring for COVID-19 patients (P-value 0.033*, P-value 0.025*), respectively.

Conclusion The study concluded that most of the studied nurses had unsatisfactory knowledge, and more than half had incompetent practice scores about nursing care practices for patients with COVID-19. There was a positive linear correlation between the nurses' knowledge and practice. The factors affecting their performance in caring for patients with COVID-19, lack of cooperation between nurses and patients, lack of supplies and equipment during care were the most frequently reported factors, as were an unequal nurse-patient ratio, many nursing tasks, and a lack of patients' knowledge.

Recommendation The study recommends the importance of promoting the nursing care guidelines as a standard procedure in ICUs, and the nursing care guideline educational program for patients with COVID-19 should be scheduled regularly for nurses. Providing the hospitals with supplies to avoid the shortage's effect on nurses’ performance.
Regulation, modification, and evolution of remote sign language interpreting in Sweden – a service in progress
Authors: Warnicke Camilla , Matérne Marie
Published: November 2024

Background

The sign language interpreting service has undergone a tremendous change due to COVID-19 and remote interpreting has become a more frequent alternative to the face-to-face format. The aim of the study is to investigate how the interpreters perceive the organisation of remote interpreting in Sweden and how it has evolved since the COVID-19 pandemic.

Method

Interviews with 26 experienced remote interpreters, representing 19 of Sweden’s 21 counties, were analysed with qualitative content analysis.

Results

Three themes were revealed in the analysis. The first theme was regulation. It was stated that directives and regulatory decisions concerning provision of remote interpreting services were varied and unclear. Several different platforms were used when interpreting remotely. Some of the services had conducted risk analyses, whereas others had not. The second theme was modification, including adjusting interactions to suit the preferences and capabilities of the users (both signing and speaking parties), as well as adjustments to work environments and workplaces. The third theme, evolution of remote interpreting, showed that support and training were rare and varied. Although the processes and organisation of remote interpreting are not yet fully established in Sweden, remote interpreting is here to stay.

Conclusions

In Sweden, remote interpreting is a service that varies according to regulations and the type of assignments. The service would benefit from being more uniform and streamlined across Sweden, although consideration must be given to those involved with the service.
Clinician attitudes towards adoption of evidence-based practice: a nationwide multiprofessional cross-sectional study of child and adolescent mental health services in Sweden
Authors: Santesson Anna Helena Elisabeth , Holmberg Robert , Bäckström Martin , Gustafsson Peik , Jarbin Håkan , Perrin Sean
Published: November 2024

Background

Implementation of evidence-based practice (EBP) in child and adolescent mental health services (CAMHS) is a priority to improve service delivery and outcomes. Clinicians’ EBP attitudes are likely to play a crucial role in implementation but are poorly understood. This study aimed to assess variation in EBP attitudes in a large national sample of CAMHS clinicians in Sweden, and to compare these findings to findings from the United States of America (USA).

Methods

CAMHS clinicians (n = 799; 60% response rate) completed the Evidence-Based Practice Attitude Scale (EBPAS) and items from the Organizational Readiness for Change Scale (ORC) ahead of an EBP for depression implementation effort across Sweden. EBPAS scores were compared with the USA study. Predictors of global and specific attitudes (gender, age, working years, education, profession, perceived benefit of diagnosis and organizational readiness and type of service) were examined using simple and multiple linear regressions.

Results

Clinicians had positive attitudes towards EBP on the four-dimensional subscales of the EBPAS, somewhat more so than their American counterparts. Clinician and organizational characteristics were related to at least one attitudinal dimension in both models, with perceived utility of diagnosis being the strongest and most consistent predictor across dimensions and models.

Conclusions

Results from this large-scale national study underscore the need to consider cultural, contextual, and individual variations in attitudes towards EBP when planning implementation efforts. Such efforts may need to be tailored to the working contexts, needs, and values of CAMHS clinicians, particularly their views on the utility of diagnosis.
Levonorgestrel at emergency contraception dose has no effect on ciliary beat frequency and muscular contraction of the human fallopian tube: an in vitro experimental study
Authors: Li Raymond Hang Wun , Liao Su-Bin , Yeung William Shu Biu , Ng Ernest Hung Yu , O Wai Sum , Ho Pak Chung
Published: November 2024

Background

Levonorgestrel (LNG) acts as an emergency contraceptive mainly by inhibiting or postponing ovulation. We carried out this study to investigate whether LNG at concentration relevant for emergency contraception (EC) affect ciliary beat frequency and muscular contraction of the human Fallopian tube, which might contribute additional actions for EC.

Methods

This was an in vitro experimental study on human Fallopian tube tissue collected from ten women undergoing hysterectomy. The tubal explants were cultured in vitro, primed with oestradiol and progesterone at concentrations resembling the physiological early luteal phase, and treated with LNG at 0, 1, 10 and 100 ng/ml concentrations. Ciliary beat frequency was measured from the tubal epithelial strips, and the basal tone, amplitude and frequency of contractions were recorded from longitudinal smooth muscle strips. These parameters at different LNG concentrations were compared against the control (LNG 0 ng/ml).

Results

Treatment of tubal tissue strips with LNG at all concentrations studied did not significantly alter the ciliary beat frequency nor basal muscle tone (p > 0.05 for both) compared with control. Significant reduction in the amplitude and frequency of tubal muscular contractions was shown after treatment with LNG only at 100 ng/ml (p < 0.05 for both) but not lower concentrations (p > 0.05) compared with control.

Conclusion

LNG did not significantly inhibit ciliary beat frequency and muscular contraction of the human Fallopian tube at the doses used for EC, suggesting that the Fallopian tube is unlikely a target for the EC action of LNG.
Metabolomics and proteomics analyses of Chrysanthemi Flos: a mechanism study of changes in proteins and metabolites by processing methods
Authors: Zhang Wei , Qin Yu-wen , Ding Yang-fei , Xiong Jun-wei , Chang Xiang-wei , Zhao Hong-su , Xia Cheng-kai , Zhang Jiu-ba , Li Yu , Mao Chun-qin , Lu Tu-lin , Wu De-ling
Published: November 2024

Background

Chrysanthemi Flos is a traditional Chinese medicine with a long history of medicinal use. Prior research suggests that the intrinsic composition of Chrysanthemi Flos is affected by shade-drying and oven-drying methods. Nevertheless, the effects of these methods on the proteins and metabolites of Chrysanthemi Flos have not been extensively studied.

Methods

The TMT (tandem mass tag) quantitative proteomics method and the LC–MS/MS (liquid chromatography-tandem mass spectrometry) non-targeted metabolomics method were used to systematically study the differences in the proteins and metabolites during the process of drying Chrysanthemi Flos in the shade and an oven.

Results

Differentially accumulated metabolites and abundant proteins were primarily enriched in the purine metabolism, pyrimidine metabolism, cyanogenic amino acid metabolism, phenylpropanoid biosynthesis, and starch and sucrose metabolism pathways. Primary metabolites, such as guanine, xanthine, cytidine 5'-diphosphate serine, L-isoleucine, stearidonic acid, alginate, and inulin, play a crucial role in providing energy for Chrysanthemi Flos to withstand desiccation stress. The upregulation of ferulate-5- hydroxylase (F5H), shikimate O hydroxycinnamoyltransferase (HCT), caffeoyl-CoA O-methyltransferase (CCoAOMT), and chalcone isomerase (CHI) enzymes promotes the synthesis of flavonoids, including sinapic acid, caffeoyl shikimic acid, and naringenin chalcone, which possess antioxidant properties. Despite the notable improvements in energy metabolism and antioxidant capacity, these enhancements proved insufficient in halting the senescence and ultimate demise of Chrysanthemi Flos. Moreover, the shade-drying method can inhibit protein expression and promote the accumulation of bioactive components, but the drying efficiency is low, while the oven-drying method exhibits rapid drying efficiency, it does not effectively preserve the components.

Conclusion

Our study offers a comprehensive explanation for the changes in protein expression and metabolite conversion observed in shade-dried and oven-dried Chrysanthemi Flos, also providing a foundation for optimizing the drying process of Chrysanthemi Flos.
Electrical impedance tomography monitoring in adult ICU patients: state-of-the-art, recommendations for standardized acquisition, processing, and clinical use, and future directions
Authors: Scaramuzzo Gaetano , Pavlovsky Bertrand , Adler Andy , Baccinelli Walter , Bodor Dani L. , Damiani L. Felipe , Franchineau Guillaume , Francovich Juliette , Frerichs Inéz , Giralt Juan A. Sánchez , Grychtol Bartłomiej , He Huaiwu , Katira Bhushan H. , Koopman Alette A. , Leonhardt Steffen , Menga Luca S. , Mousa Amne , Pellegrini Mariangela , Piraino Thomas , Priani Paolo , Somhorst Peter , Spinelli Elena , Händel Claas , Suárez-Sipmann Fernando , Wisse Jantine J. , Becher Tobias , Jonkman Annemijn H.
Published: November 2024

Electrical impedance tomography (EIT) is an emerging technology for the non-invasive monitoring of regional distribution of ventilation and perfusion, offering real-time and continuous data that can greatly enhance our understanding and management of various respiratory conditions and lung perfusion. Its application may be especially beneficial for critically ill mechanically ventilated patients. Despite its potential, clear evidence of clinical benefits is still lacking, in part due to a lack of standardization and transparent reporting, which is essential for ensuring reproducible research and enhancing the use of EIT for personalized mechanical ventilation. This report is the result of a four-day expert meeting where we aimed to promote the consistent and reliable use of EIT, facilitating its integration into both clinical practice and research, focusing on the adult intensive care patient. We discuss the state-of-the-art regarding EIT acquisition and processing, applications during controlled ventilation and spontaneous breathing, ventilation-perfusion assessment, and novel future directions.
Navigating crisis: exploring the links between threat perceptions, well-being, individual and workplace resilience among general hospital staff
Authors: Shmul Chen Sharon , Berzon Baruch , Adini Bruria
Published: November 2024

Background

Hospital staff frequently encounter high-stress situations, emergencies, and disasters, which profoundly impact their well-being and resilience. The aim of the study was to examine associations between perceived threats, well-being, individual resilience, and resilience at work among staff of a general hospital, following the unexpected Hamas assault on Israel on October 7, 2023, and during the Israel-Gaza conflict.

Methods

This cross-sectional study was conducted at a central Israeli public hospital, a level-two trauma center, surveying 434 staff members. Validated questionnaires were used to assess perceived threats, well-being, individual and work resilience, alongside demographic and professional characteristics. Data was collected via Qualtrics and paper questionnaires. Descriptive statistics, Pearson’s correlation, T-tests, ANOVA, Chi-square, and linear regression models were used to analyze relationships, differences, and key factors associated with well-being, personal resilience, and work resilience.

Results

Key findings revealed that higher resilience at work and well-being are linked to greater individual resilience, while higher threat perception negatively affected well-being. Israeli-born individuals and those identifying as Jewish showed higher resilience. Men reported higher well-being than women, and physicians demonstrated higher well-being compared to nurses. Resilience at work was higher among administrative staff compared to nurses, with employment in the emergency department showing a significant negative relationship with resilience at work.

Conclusions

The study revealed significant predictors of well-being, individual resilience, and workplace resilience among hospital staff in conflict situations. The immediate threat of war was perceived as most significant, highlighting the dynamic nature of threat perceptions. Prolonged emergencies can severely impact well-being, necessitating timely support. The findings emphasize the importance of integrated programs that enhance individual well-being and foster resilience in both personal and professional domains. Significant gender differences and the positive role of religiosity in resilience underscore the need for targeted interventions and systemic organizational changes to better support healthcare workers during crises. These insights highlight the importance of a comprehensive approach for cultivating a robust and resilient medical staff capable of effectively managing future crises.
Global surveillance of circulating microRNA for diagnostic and prognostic assessment of acute myocardial infarction based on the plasma small RNA sequencing
Authors: Wang Xiaomin , Lu Yaojun , Zhao Ruiping , Zhu Bing , Liu Jian , Yue Qiang , Wu Rina , Han Shuwen , Gao Yuanyuan , Chen Juan , Gong Jie , He Danna , Xu Teng , Ying Jianchao
Published: November 2024

Background

Circulating microRNAs (miRNAs) are recently a rapidly increasing of interest as non-invasive biomarkers for diagnosis and prognosis of acute myocardial infarction (AMI). Previous studies revealed that several miRNAs exhibited the capacity for diagnosis and prognosis of AMI, the reasons why these circulating miRNAs are concerned as targets for investigation are quite cryptogenic, presumably due to the lack of clues provided by global surveillance at the transcriptome level, and the current data for some miRNAs are controversial and inconsistent among independent studies.

Methods

To comprehensively profiling the potential miRNAs for diagnosis and prognosis of AMI, we reported transcriptomes of circulating miRNAs in the plasma of 27 healthy controls, 64 AMI patients (37 STEMI and 27 NSTEMI) and 20 AMI patients who were subjected to reperfusion therapy. Meanwhile, the cTnI of AMI patients was parallel determined. Differentially-circulated miRNAs were analyzed between each group. All detected circulating miRNAs were examined by ROC analysis and then LASSO dimension reduction to obtain an optimal panel for diagnosis of AMI. A five-year period follow-up towards the AMI and reperfusion patients was performed, and the prognostic value of circulating miRNAs in these patients was estimated by using the Cox regression model, ROC and Kaplan-Meier curves.

Results

Comprehensive global differences of miRNAs transcriptome among AMI, reperfusion patients and healthy controls were identified. A total of 40 miRNAs, called high diagnostic performance miRNAs, including several previous well-studied miRNAs with AUC greater than 0.85 were shown to discriminate AMI with healthy controls. In addition, 29 miRNAs were analyzed to be strongly correlated with the plasma cTnI level, of which 20 overlapped with high diagnostic performance miRNAs. These overlapped miRNAs are over-represented in the pathways which actually reflect the pathological cause of myocardial infarction, as well as the regulation of gene expression and energetic pathway of cellular response to hypoxia. Finally, two miRNAs were analyzed to be significantly correlated to all-cause mortality.

Conclusion

This is the first time to survey plasma miRNAs for the development of AMI diagnostic and prognostic biomarkers at the transcriptome level. A subset of miRNAs exhibited potential diagnostic and prognostic merits for AMI.
Integrating expert patients perspectives on the processes of engaging them in early medical education
Authors: Saif Jaimy , Mellor Duane , Rogers David , Stocker Claire
Published: November 2024

In the practice of healthcare, a new paradigm has emerged that perhaps challenges traditional notions of patient-clinician relationships. This shift involves recognising the invaluable role of expert patients, individuals who possess first-hand experience of life with their specific health conditions or chronic illnesses. These individuals have gained deep practical insights, knowledge, and coping strategies through their personal journeys. Modern healthcare practice focusing on individualised care necessitates that patients and their experiences become integral to the education of future healthcare professionals, from the start of their learning journeys, steering us toward more compassionate and person-centred approaches. This communication article underscores the importance of developing structured, coordinated programs that involve patients in curriculum design, implementation, and evaluation. By fostering authentic partnerships, medical education can create richer learning environments that promote compassionate care and better prepare future healthcare professionals. Ultimately, embracing patient perspectives as integral to the educational process is essential for improving healthcare delivery and outcomes.