bluuebunny/crossref_metadata_2025 huggingface dataset:
Decision-making assessments in youth team invasion game athletes: A systematic scoping review
Authors: Inns Joshua , Petancevski Emma L , Novak Andrew R , Fransen Job
Published: July 2023

Decision-making is critical to team invasion game performance. As such, understanding how to measure and develop it is important to researchers and practitioners. However, due to the abundance of assessments available in this area, the optimal use of these assessments is still unclear. The current systematic scoping review summarises and examines the quality of reporting of the available literature on decision-making assessments that can be used in the context of youth team invasion games. It uses an ecological dynamics perspective to evaluate the extent to which the included decision-making tasks adhered to principles of representative task design, specificity of perception and action components and constraints present in each task. The results revealed that soccer was the most frequently studied invasion game (70% of studies). While realistic task (85% of studies) and individual constraints (68% of studies) were often present in decision-making tasks, environmental constraints received far less attention (9% of studies). About one-third of studies were situated on either end of the controlled laboratory in situ study continuum (controlled laboratory = 35%, in situ = 33%). In total, 39% of studies coupled sport-specific perception and action components. Furthermore, studies that implemented sport-specific perception–action coupling featured much smaller sample sizes than those without. The findings of this systematic review can aid researchers and practitioners who want to measure decision-making skill in youth team invasion game athletes by allowing them to make informed choices about which assessment to use based on the extent to which an assessment matches a set of pre-determined criteria.
Foreign Investment, State Capitalism, and National Development in Borneo: Rethinking Brunei–China Economic Relations
Authors: Lim Guanie , Hoon Chang-Yau , Zhao Kaili
Published: July 2023

Faced with dwindling oil and gas reserves, Brunei has been hard-pressed to diversify its reliance on hydrocarbon. China has emerged as an attractive prospect to the Brunei government, especially since the launch of the Belt and Road Initiative. This article analyses a few major Chinese projects in Brunei and postulates three interrelated arguments. Firstly, Chinese investors have targeted Brunei's natural resources and fiscal incentives. These firms have minimal interest in the Sultanate's small domestic market as they eye the export sector. Secondly, these projects have been orchestrated by China's provincially-owned state-owned enterprises (SOE) and private firms, instead of centrally- controlled SOEs. State support has generally been channelled to these projects in an at-arm's length manner. Thirdly, while Brunei is relatively skilled in attracting Chinese investors to further its own political economic goals, at least in the short-run, it is uncertain whether such capital exports have helped in ameliorating the structural limits of the country’s economy.
Mortality risk prediction of the electrocardiogram as an informative indicator of cardiovascular diseases
Authors: Tsai Dung-Jang , Lou Yu-Sheng , Lin Chin-Sheng , Fang Wen-Hui , Lee Chia-Cheng , Ho Ching-Liang , Wang Chih-Hung , Lin Chin
Published: July 2023

Background

The electrocardiogram (ECG) may be the most popular test in the management of cardiovascular disease (CVD). Although wide applications of artificial intelligence (AI)-enabled ECG have been developed, an integrating indicator for CVD risk stratification was not investigated. Since mortality may be the most important global outcome, this study aimed to develop a survival deep learning model (DLM) to establish a critical ECG value and explore the associations with various CVD events.

Methods

We trained a DLM with 451,950 12-lead resting ECGs obtained from 210,552 patients, for whom 23,592 events occurred. The internal validation set included 27,808 patients with one ECG for each patient. The external validations were performed in a community hospital with 33,047 patients and two transnational data sets with 233,647 and 1631 ECGs. We distinguished the cause of mortality and additionally investigated CVD-related outcomes, including new-onset acute myocardial infarction (AMI), stroke (STK), and heart failure (HF).

Results

The DLM achieved C-indices of 0.858/0.836 in internal/external validation sets by using ECG over a 10-year period. The high-mortality-risk group identified by the proposed DLM presented a hazard ratio (HR) of 14.16 (95% confidence interval (CI): 11.33–17.70) compared to the low-risk group in the internal validation and presented a higher risk of cardiovascular (CV) mortality (HR: 18.50, 95% CI: 9.82–34.84), non-CV mortality (HR: 13.68, 95% CI: 10.76–17.38), AMI (HR: 4.01, 95% CI: 2.24–7.17), STK (HR: 2.15, 95% CI: 1.70–2.72), and HF (HR: 6.66, 95% CI: 4.54–9.77), which was consistent in an independent community hospital. The transnational validation also revealed HRs of 4.91 (95% CI: 2.63–9.16) and 2.29 (95% CI: 2.15–2.44) for all-cause mortality in the SaMi-Trop and Clinical Outcomes in Digital Electrocardiography 15% (CODE15) cohorts.

Conclusions

The mortality risk by AI-enabled ECG may be applied in passive electronic-health-record-based CVD risk screening, which may identify more asymptomatic and unaware high-risk patients.
“Caring for Breast Cancer Patients Is a Work That Brings Sorrow”: A Qualitative Interview Study with Nurses in Tanzania
Authors: Kidayi Paulo L. , Manhica Hélio , Nakazzi Sandra , Mtuya Christina C. , Aune Ragnhild E. , Serventi Furaha , Mahande Michael Johnson , Björling Gunilla
Published: July 2023

Introduction

Breast cancer is increasing in sub-Saharan Africa (SSA), and most women are diagnosed at a late stage. This leads to increased suffering for the patients and challenging care situations for nurses. Limited resources in healthcare, lack of oncology training, and low health literacy in society result in even more demanding situations for nurses.

Objective

The objective was to explore nurses’ experiences of caring women for with breast cancer in Tanzania.

Methods

The study employed a descriptive qualitative design. Fifteen nurses, working in oncology units in three major hospitals in Tanzania were interviewed using a semistructured interview guide. The participants had a minimum of 6 months experience of caring for breast cancer patients. Purposive sampling was used. Data were analyzed by qualitative content analysis.

Results

Two main themes emerged: Challenges in caring for breast cancer patients and Nurses’ psychological distress. The late diagnosis was very challenging for the nurses. Low health literacy regarding breast cancer disease and treatment, patients’ financial difficulties, minimal oncology nursing education, and technology in healthcare systems were also major challenges. The nurses experienced psychological distress, lost hope, and faced ethical dilemmas while providing cancer care.

Conclusion

The findings of this study conclude that nurses face emotional distress and ethical dilemmas while caring for patients with breast cancer. Late diagnosis, lack of infrastructure and resources, and low health literacy among patients, family, and healthcare providers have a great impact on the stress that the nurses experience.
Factors Affecting Mechanical Ventilator Weaning Success and 28-Day Survival Among Patients With Acute Respiratory Distress Syndrome Secondary to COVID-19
Authors: Aldabayan Yousef Saad , Tolba Asmaa Atiaa , Alrajeh Ahmed Mansour , Ahmed Ahmed Talaat , Mahgoub Asmaa Aly , Glalah Ayman A. Abou , Abdelhafez Amal Ismael
Published: July 2023

Introduction

The process of weaning patients off mechanical ventilation (MV) is difficult and complex. Critical care nurses must maintain continuity of care for patients undergoing MV weaning, assess patients’ overall condition, and meet patients’ needs.

Objectives

The study aimed to explore clinical factors of MV weaning success and 28-day survival among patients with acute respiratory distress syndrome secondary to COVID-19.

Methods

This prospective observational study was conducted on 90 newly admitted patients in the general intensive care unit Assiut Univeristy Main Hospital in Egypt from October 2021 to March 2022. The researchers applied a standard weaning protocol for all of the patients in this study and then assessed the outcome variables: success or failure of weaning trials from a mechanical ventilator, and 28-day survival.

Results

In total, 50 (55.6%) patients were successfully weaned from MV, and 45 (50%) patients survived at 28 days. In a multivariate regression analysis, dynamic compliance (OR, 1.115; 95% CI, 1.010–1.230, p = .031*), lymphocyte count (OR, 3.025; 95% CI, 1.322–6.923, p = .009*), urine output (OR, 1.002; 95% CI, 1.001–1.004, p = .002*), and alanine aminotransferase (ALT; OR, 0.993; 95% CI, 0.988–0.999, p = .017*) were significantly associated with weaning success. In addition, age (OR, 1.058; 95% CI, 1.015–1.102; p = .007*), lymphocyte count (OR, 3.304; 95% CI, 1.348–8.100; p = .009*), urine output (OR, 1.003; 95% CI, 1.001–1.004; p = .001*), and ALT (OR, 0.994; 95% CI, 0.989–0.99, p = .015*) were significantly associated with survival at 28 days.

Conclusion

Dynamic lung compliance, lymphocyte count, urine output, and ALT were found to be predictive parameters that may affect the success of weaning off MV. Additionally, it was found that age, lymphocyte count, urine output, and ALT are predictors of survival at 28 days. We recommend further studies with larger, more systematic samples and complete follow-up, focusing on pulmonary function and quality of life in postweaning patients with acute respiratory distress syndrome.
Breathing Rooms: A Strategy to Improve the Performance of Healthcare Workers During COVID-19 and Future Pandemics
Authors: Sarkhani Naeimeh , Zarei Nafiseh , Nikpeyma Nasrin
Published: July 2023

Healthcare workers (HCWs), as frontline soldiers in the fight against COVID-19, were more exposed to the risk of contracting this disease. In addition to facing psychological, social, and physical trauma and post-traumatic stress due to the corona pandemic, HCWs were also exposed to complications due to the use of personal protective equipment (PPE). The impermeable and confining nature of some PPE poses complications for HCWs that can endanger their physical health, while also affecting the quality of healthcare they provide. Among the complications of using PPE, respiratory problems are more worrisome than other complications. This article makes a suggestion of a breathing room (BR) to improve the health and performance of HCWs in caring for patients with infectious respiratory diseases. A debate on the strengths of the implementation of a BR in hospitals is described.
Inpatient hospice admissions. Who is admitted and why: a mixed-method prospective study
Authors: Haraldsdottir Erna , Lloyd Anna , Bijak Martyn , Milton Libby , Finucane Anne M.
Published: July 2023

Background:

Over the next two decades, the numbers of people who will need palliative care in the United Kingdom and Ireland is projected to increase. Hospices play a vital role supporting people who require specialist palliative care input through community-based and inpatient palliative care services. Evidence is needed to understand the role of these different services to inform future service development.

Objectives:

To describe the reasons for admission, and outcomes at the end of the stay, for patients admitted to two hospice inpatient units (IPUs).

Design:

This was a mixed-methods study using a convergent, parallel mixed-methods design.

Methods:

We reviewed the case notes of all patients admitted to two hospice inpatient units from July to November 2019; conducted semi-structured interviews with patients and families; as well as brief structured interviews with inpatient unit staff.

Results:

Two hundred fifty-nine patients were admitted to a hospice IPU, accounting for 276 admissions in total. Overall, 53% were female; median age was 71 years (range: 26–95 years). Most patients (95%) were White British or Scottish, and 95% had a cancer diagnosis. Most patients were admitted from the community, under one-third were admitted from hospital. Most (85%) had previous palliative care involvement. Nearly, half had district nurse support (48%). Worry and anxiety was frequently reported as a reason for admission, alongside physical concerns. Median length of stay was 12 days, and 68% died during their stay. Hospice was recorded as the preferred place of care for 56% of those who died there.

Conclusions:

Sustained efforts to promote the hospice as place of care for people with conditions other than cancer are needed alongside greater clarity regarding of the role of the hospice IPU, and who would benefit most from IPU support.
Aconite Toxicity Presenting as Electrical Storm: A Diagnostic and Therapeutic Challenge
Authors: Ravikanth G. , Rao B. Hygriv , Azam Mohammed Sadiq
Published: July 2023

Aconite is a plant with deceptively beautiful flowers that contain a deadly cardiotoxin. Aconite toxicity presents with often fatal ventricular arrhythmias that are refractory to conventional antiarrhythmic medications. An electrical storm (ES) is an acute cardiac emergency that carries a high mortality. We report one such case of acute aconite toxicity presenting with ES that was managed successfully with hemodynamic support, overdrive pacing, and charcoal hemoperfusion with high-flux ultrafiltration.
The Importance of Developing the Child’s Sense of Touch in the Music Classroom
Authors: Jacobi Bonnie S.
Published: July 2023

Sensory learning can be traced back to ancient Greek times, and the sense of touch holds multiple types of benefits for classroom music learning. Touch is also a prerequisite for children’s future intellectual and social development. Between ages three and seven, a child’s physical and perceptual development is in a formational stage. Despite challenges that can sometimes be associated with touch, for example, behavior issues, overcrowded classrooms, increased student needs related to touching, teacher liability, and spread of viral germs, tactile activities involving human touch and manipulatives can prepare students to play musical instruments, think abstractly, and achieve socioemotional competency. Human touch activities can foster self-awareness, awareness of others, and even empathy. This article examines past theories and practices involving tactile learning, discusses research findings relevant to music instruction, offers strategies and ideas for using tactile activities, and proposes a rationale for integrating tactile learning within general music instruction.
Estimation of migraine prevalence considering active and inactive states across different age groups
Authors: Piccininni Marco , Brinks Ralph , Rohmann Jessica L. , Kurth Tobias
Published: July 2023

Background

Migraine is a very common headache disorder on the population level, characterized by symptomatic attacks (activity). For many people with migraine, the migraine symptoms intermittently or permanently cease during their lifetime (inactive migraine). The current diagnostic classification of migraine considers two states: active migraine (having migraine symptoms within the last year) and not having active migraine (including both individuals with inactive migraine and those who never had migraine). Defining a state of inactive migraine that has gone into remission may better capture the trajectories of migraine across the lifespan and contribute to a better understanding of its biological processes. We aimed to quantify the prevalence of never, active, and inactive migraine separately, using modern prevalence and incidence estimation methodology to better describe the complexity of migraine trajectories at the population level.

Methods

Using a multistate modeling approach, data from the Global Burden of Disease (GBD) study, and results from a population-based study, we estimated the transition rates by which individuals moved between migraine disease states and estimated prevalences of never, active and inactive migraine. We used data from the GBD project and a hypothetical cohort of 100,000 people with a starting age of 30 and 30 years of follow-up, both in Germany and globally, stratified by sex.

Results

In Germany, the estimated rate of transition from active to inactive migraine (remission rate) increased after the age of 22.5 in women and 27.5 in men. The pattern for men in Germany was similar to the one observed on the global level. The prevalence of inactive migraine among women reaches 25.7% in Germany and 16.5% globally at age 60. For men, the inactive migraine prevalence estimates at the same age were 10.4% in Germany and 7.1% globally.

Conclusions

Considering an inactive migraine state explicitly reflects a different epidemiological picture of migraine across the lifecourse. We have demonstrated that many women of older ages may be in an inactive migraine state. Many pressing research questions can only be answered if population-based cohort studies collect information not only on active migraine but also on inactive migraine states.
Routine developmental screening in Australian general practice: a pilot study
Authors: Alexander Karyn , Mazza Danielle
Published: July 2023

Background

Parents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations.

Methods

The study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners.

Results

Documented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints.

Conclusions

A team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices.
Association of reproductive risk factors and breast cancer molecular subtypes: a systematic review and meta-analysis
Authors: Mao Xihua , Omeogu Chioma , Karanth Shama , Joshi Ashwini , Meernik Clare , Wilson Lauren , Clark Amy , Deveaux April , He Chunyan , Johnson Tisha , Barton Karen , Kaplan Samantha , Akinyemiju Tomi
Published: July 2023

Background

Associations between reproductive factors and breast cancer (BC) risk vary by molecular subtype (i.e., luminal A, luminal B, HER2, and triple negative/basal-like [TNBC]). In this systematic review and meta-analysis, we summarized the associations between reproductive factors and BC subtypes.

Methods

Studies from 2000 to 2021 were included if BC subtype was examined in relation to one of 11 reproductive risk factors: age at menarche, age at menopause, age at first birth, menopausal status, parity, breastfeeding, oral contraceptive (OC) use, hormone replacement therapy (HRT), pregnancy, years since last birth and abortion. For each reproductive risk factor, BC subtype, and study design (case–control/cohort or case-case), random-effects models were used to estimate pooled relative risks and 95% confidence intervals.

Results

A total of 75 studies met the inclusion criteria for systematic review. Among the case–control/cohort studies, later age at menarche and breastfeeding were consistently associated with decreased risk of BC across all subtypes, while later age at menopause, later age of first childbirth, and nulliparity/low parity were associated with increased risk of luminal A, luminal B, and HER2 subtypes. In the case-only analysis, compared to luminal A, postmenopausal status increased the risk of HER2 and TNBC. Associations were less consistent across subtypes for OC and HRT use.

Conclusion

Identifying common risk factors across BC subtypes can enhance the tailoring of prevention strategies, and risk stratification models can benefit from subtype specificity. Adding breastfeeding status to current BC risk prediction models can enhance predictive ability, given the consistency of the associations across subtypes.
Interoceptive awareness in a Norwegian population: psychometric properties of the Multidimensional Assessment of Interoceptive Awareness (MAIA) 2
Authors: Fiskum Charlotte , Eik-Nes Trine Tetlie , Abdollahpour Ranjbar Hamed , Andersen Jannicke , Habibi Asgarabad Mojtaba
Published: July 2023

Background

Interoception plays a vital role in human cognition and emotion and is an increasingly important part of clinical studies of mind–body approaches and mental health. Interoceptive awareness (IA) encompasses numerous mind–body components and can be assessed by employing a self-report measure such as the Multidimensional Assessment of Interoceptive Awareness (MAIA), which has been adapted and validated across several countries and is used in experimental and clinical settings. In this study, the MAIA-2, which was developed due to the psychometric shortages of MAIA, was thoroughly translated, and its psychometric features were examined in a sample of 306 Norwegian-speaking participants (81% females, ages 16 through 66 plus).

Methods

The participants completed the MAIA-2 Norwegian version (MAIA-2-N) and the COOP/WONCA Functional Assessment Charts measuring psychological, physical, and overall health. The following psychometric qualities of the MAIA-2 were investigated: factor structure, internal consistency, and the moderating role of gender.

Results

Confirmatory Factor Analysis (CFA) revealed that an 8-factor model of MAIA-2-N provided the best fit. Also, a bifactor model revealed a proper fit. Good internal consistency and a moderating role of gender, age, and education on the relationships between certain MAIA-2-N factors and health were observed.

Conclusions

The MAIA-2-N is an adequate measure of IA in Norwegian-speaking individuals. The factor-structure corresponds with the original MAIA-2 and it shows good internal consistency. Some moderating effects of gender were observed, particularly related to the relationship between IA and physical and psychological state, with the physical state/fitness more closely linked to IA in males and psychological state in females.
Association between psychological stress, anxiety and oral health status among college students during the Omicron wave: a cross-sectional study
Authors: Cao Rongkai , Lai Junyu , Fu Xiaoxin , Qiu Piaopiao , Chen Jinghong , Liu Weicai
Published: July 2023

Background

Within 3 years of the COVID-19 pandemic, increasing interest has been given to its potential influence on health status due to lockdowns caused by the pandemic. However, the impact is inadequately understood, especially for college students. This study aimed to investigate the potential association between psychological stress, anxiety and oral health of college students during the Omicron wave of the COVID-19 pandemic.

Methods

An online survey with measurements of psychological stress, anxiety and oral health was completed by 1770 Chinese college students. The Perceived Stress Scale-14 (PSS-14) and Generalized Anxiety Disorder-7 (GAD-7) were used to measure psychological stress and anxiety, respectively. Oral health status was self-reported including toothache, gingival bleeding, and oral ulcer. Multivariable logistic regressions were performed to determine underlying associations for outcome variables. Structural equation modeling (SEM) was performed to confirm the relationship between mental and oral health status.

Results

Of the 1770 subjects, 39.2% presented high psychological stress and only 41.2% expressed no anxiety. A significant association was found between psychological stress, anxiety and oral health status. Anxiety has significant impacts on toothache (OR = 0.36; 95%CI: 0.23–0.55;p < 0.01), gingival bleeding (OR = 0.43; 95%CI: 0.29–0.65;p < 0.01), and oral ulcer (OR = 0.54; 95%CI: 0.36–0.80;p < 0.01). Anxiety significantly mediated the association between psychological stress and self-reported oral symptoms.

Conclusions

Anxiety may be a significant risk indicator for mental health among college students and demonstrates a significant relationship with the occurrence of self-reported oral symptoms. Concerns about academic and life changes caused by the pandemic were the two most significant sources of stress.
Effect of chemical disinfection on the dimensional stability of polyvinyl ether siloxane impression material: a systemic review and meta-analysis
Authors: Awod Bin Hassan Saeed , Ali F Alshadidi Abdulkhaliq , Ibrahim N Aldosari Lujain , Heboyan Artak , S Saini Ravinder
Published: July 2023

Background and objectives

Polyvinyl ether siloxane (PVES) possesses ideal characteristics for making precise and accurate dental impressions. PVES dimensional stability owes to its better polymeric properties derived from its parent materials poly ethers and polyvinyl siloxanes. As recommended use of chemical disinfecting agents is getting more popular, there is a growing concern associated with the effect of disinfectants on PVES dimensional stability. This study was aimed to understand the PVES behavior when subjected to chemical disinfectants.

Materials and methodology

The data was collected from research studies retrieved from Google Scholar, Scopus, and PubMed using MeSH terms of keywords “vinyl polyether siloxane AND Disinfection” or (Vinyl polyether siloxane OR polyvinyl siloxane ether OR PVES) AND (disinfectant OR disinfection)” without any restriction to publication date. The PRISMA (Preferred Reporting Items for Systemic Review and Meta-Analysis) directions were observed during the data collection, screening of studies, and meta-analysis. The primary data were retrieved, and batch exported from databases using Harzing’s Publish or Perish software; primary analysis was performed in Microsoft Excel, while statistical analysis for effect size, two-tailed p-values, and heterogeneity among studies was performed using Meta Essentials. The effect size was calculated using Hedge’s g values at the 95% confidence level using the random-effects model. Heterogeneity among studies was measured using the Cochrane Q and I2.

Results and conclusion

Dental impressions made from the PVES elastomeric impression materials showed no significant changes in dimensional stability. Immersion in the chemical disinfectant for 10 min was associated with clinically irrelevant changes in the dimensions of the PVES impressions. Disinfection with sodium hypochlorite was associated with clinically significant changes in dimensions, with a two-tailed p-value of 0.049. Disinfection with 2–2.5% glutaraldehyde solution was not associated with any significant dimensional variability.
How does the work-life balance impact stress on primary healthcare workers during the COVID-19 pandemic?
Authors: Putri Nuzulul Kusuma , Melania M. Karomah Nastiti , Fatmawati Sia Mawan Yulia , Lim Yin Cheng
Published: July 2023

Background

Most studies in advanced care settings reported that the increasing workload increases the work-life imbalance and harms the mental health of health workers. The COVID-19 Pandemic's tracing, testing, treatment, and mass vaccination also have multiplied the primary healthcare workers' workload. Nevertheless, studies on primary care workers are scarce. This study aimed to investigate how the COVID-19-related work-life balance impact stress on primary healthcare workers in the third years of the pandemic.

Methods

The study was a cross-sectional, web-based survey conducted on primary healthcare workers in Kediri Regency, Indonesia, with the highest Omicron case surge worldwide. It was conducted right after the surge between July and August 2022, the third year of the COVID-19 pandemic hit Indonesia. Under coordination with the local government health officials, primary healthcare workers were invited to participate in an online survey. The respondents were asked to evaluate their sociodemography, work conditions, personal life, and perceived stress (using the Perceived Stress Scale) during the pandemic. Their work-life balance was evaluated using the Work/Non-work Interference and Enhancement Scale. We used several hierarchical linear regression models to determine which variables contribute to work stress among primary healthcare workers.

Results

Sociodemographic characteristics, including gender, age, marital status, years of professional experience, and educational level, were not significantly associated with stress levels among our respondents. Separately, work conditions and personal life variables did not associate with stress levels. However, primary healthcare workers' work and personal lives interfere with each other during the pandemic and are associated with their higher stress.

Conclusion

During the pandemic, the work life of primary health workers interferes with their personal life more than the interference of personal life on their work life. At the same time, the work life's enhancement on the personal life and vice versa were lower than its interference. Those conditions are associated with higher perceived stress of primary health workers.
A lipid metabolism-related gene signature reveals dynamic immune infiltration of the colorectal adenoma-carcinoma sequence
Authors: Chen Jie , Ye Jianfang , Lai Renxu
Published: July 2023

Background

Lipid metabolism-related genes (LMRGs) have been reported to be correlated with the immune infiltration of colorectal cancer (CRC). This study aimed to investigate the immune infiltration characteristics along the colorectal adenoma-carcinoma sequence (ACS) based on LMRGs.

Methods

Gene expression data of colorectal adenoma and carcinoma samples were obtained from the public databases. The “limma” package was applied to determine the differentially expressed LMRGs. Unsupervised consensus clustering was used to cluster colorectal samples. The features of the tumor microenvironment were analyzed by the “ESTIMATE”, “GSVA”, and “TIDE” algorithms.

Results

The expression of 149 differentially expressed LMRGs was defined as the LMRG signature. Based on this signature, the adenoma and carcinoma samples were divided into three clusters. Unexpectedly, these sequential clusters showed a directional relationship and collectively constituted the progressive course of colorectal ACS. Interestingly, the LMRG signature revealed that adenoma progression was accompanied by a progressive loss of immune infiltration and a stepwise establishment of a cold microenvironment, but carcinoma progression was characterized by a progressive gain of immune infiltration and a gradual establishment of a hot microenvironment.

Conclusions

The LMRG signature reveals dynamic immune infiltration along the colorectal ACS, which substantially changes the understanding of the tumor microenvironment of CRC carcinogenesis and provides novel insight into the role of lipid metabolism in this process.
The occurrence and development of radiation-induced lung injury after interstitial brachytherapy and stereotactic radiotherapy in SD rats
Authors: Chen Zhuo , Wang Bin , Wu Zhouxue , Xiao Hua , Yang Yang , Fan Junying , Gu Yingjiang , Chen Chuan , Wu Jingbo
Published: July 2023

Background

To compare the severity of radiation-induced lung injury (RILI) after the right lung of SD rats received interstitial brachytherapy and stereotactic radiotherapy (SBRT).

Methods

RILI rat model was established using interstitial brachytherapy and SBRT methods, respectively. CT scan was performed to analyze the lung volume and the CT value difference between the left and right lungs in rats. Then the lung tissues were analyzed through H&E staining, peripheral blood was extracted to detect the expression levels of serum inflammatory cytokines, pro-fibrotic cytokines, and fibrotic-inhibiting cytokines by ELISA.

Results

The difference between right and left lung CT values was significantly elevated in the SBRT group when compared with the control group and the interstitial brachytherapy group (P < 0.05). The IFN-γ expression in the interstitial brachytherapy group was significantly different from that in the SBRT group at week 1, 4, 8 and 16. Besides, the expressions of IL-2, IL-6 and IL-10 in SBRT group were significantly higher than that of interstitial brachytherapy group (P < 0.05). The TGF-β expression in interstitial brachytherapy group reached its peak with the increase of time from week 1 to week 16, and it was significantly lower than SBRT group (P < 0.05). The mortality rate in the SBRT group was 16.7%, which was significantly higher than that in the interstitial brachytherapy group.

Conclusion

The treatment method of interstitial brachytherapy is considered as an effective and safe tool by reducing the side effects of radiotherapy and increasing the radiation dose of radiotherapy.
Does diabetes mellitus impair the clinical results of total knee arthroplasty under enhanced recovery after surgery?
Authors: Li Shuai , Si Haibo , Zhang Shaoyun , Xu Jiawen , Liu Yuan , Shen Bin
Published: July 2023

Background

Diabetes mellitus (DM) and osteoarthritis (OA) are common diseases that are predicted to increase in prevalence, and DM is a risk factor for OA progression and has a negative impact on the outcome. However, the evidence remains unclear on how it affects patients’ clinical results of total knee arthroplasty (TKA) under enhanced recovery after surgery (ERAS).

Methods

A retrospective single-center study was conducted comparing diabetic and non-diabetic patients who underwent TKA in West China Hospital of Sichuan University between September 2016 to December 2017 under ERAS. Consecutive propensity score matching (PSM) was conducted by 1:1 (DM: non-DM) matching analysis with all baselines as covariates. The primary clinical results were the improvement of knee joint function, the incidence of postoperative complications, and the FJS-12 sensory results 5 years after the operation between DM and Non-DM groups. The secondary clinical results were the postoperative length of stay (LOS), postoperative blood test and total blood loss (TBL).

Result

After PSM, the final analysis included 84 diabetic patients and 84 non-diabetic patients. Diabetic patients were more likely to experience early postoperative complications (21.4% vs. 4.8%, P = 0.003), of which wound complications are the most significant (10.7% vs. 1.2%, P = 0.022). Diabetic patients experienced longer postoperative LOS with a significant increase in patients with LOS exceeding 3 days (66.7% vs. 50%, P = 0.028) and showed less postoperative range of motion (ROM) (106.43 ± 7.88 vs. 109.50 ± 6.33 degrees, P = 0. 011). Diabetic patients also reported lower Forgotten joint score (FJS-12) than non-diabetic patients (68.16 + 12.16 vs. 71.57 + 10.75, P = 0.020) in the 5-year follow-up and were less likely to achieve a forgotten knee joint (10.7% vs. 1.2%, P = 0.022). In additional, Compared with non-diabetics, diabetic patients showed lower hemoglobin (Hb) (P < 0.001) and hematocrit (HCT) (P < 0.001) and were more likely to suffer from hypertension before TKA (P < 0.001).

Conclusion

Diabetic patients show increased risk for postoperative complications, and have lower lower postoperative ROM and lower FJS-12 compared with non-diabetic patients after TKA under ERAS. More perioperative protocols are still needed to be investigated and optimized for diabetic patients.
Retrospective single-arm cohort study of video-assisted thoracic surgery for treatment of idiopathic peripherally located simple type pulmonary arteriovenous malformation in 23 consecutive patients
Authors: Irie Toshiyuki , Ishibashi Osamu , Kuramochi Masashi , Ichimura Hideo , Endo Katsuyuki
Published: July 2023

Background

Although case reports of video-assisted thoracic surgery (VATS) for pulmonary arteriovenous malformation (PAVM) have been published, studies analyzing more than 10 cases were limited. A retrospective single-arm cohort study was performed to investigate the efficacy of VATS in 23 consecutive patients with idiopathic peripherally located simple type PAVM.

Methods

VATS was performed for wedge resection of 24 PAVMs in 23 patients, which included 4 males and 19 females with an age range of 25 to 80 years (mean: 59.6 ± 13.0). Two patients underwent simultaneous resection of lung carcinoma, one by wedge resection and another by lobectomy. Each medical record was analyzed according to the resected specimen, bleeding volume, postsurgical hospital stay length, duration of chest tube placement, and VATS time. The distance between pleural surface/fissure and PAVM was measured on CT, and the influence of this distance on identification of PAVM was investigated.

Results

In all 23 patients, VATS was successfully performed, and the venous sac was included in each resected specimen. Bleeding volume was less than 10mL in all but one with 1900 mL bleeding volume due to simultaneous lobectomy for carcinoma, not wedge resection of PAVM. Postsurgical hospital stay length, duration of chest tube placement, and VATS time were 5.0 ± 1.4 days, 2.7 ± 0.7 days, and 49.3 ± 39.9 min, respectively. In 21 PAVMs with a distance of 1 mm or less, purple vessel or pleural bulge of PAVM was identified soon after insertion of a thoracoscope. In the remaining 3 PAVMs with a distance of 2.5 mm or more, additional efforts were needed for identification.

Conclusion

VATS was found to be a safe and effective to treatment for idiopathic peripherally located simple type PAVM. When the distance between pleural surface/fissure and PAVM was 2.5 mm or more, a plan and strategy for identification of PAVM should be prepared before VATS.
Therapeutic effect of Duhuo Jisheng Decoction add-on Tui-na manipulation on osteoarthritis of knee: a randomized controlled trial
Authors: Chan Kin Ho , Ching Jessica Y. L. , Chan Kam Leung , Lau Hoi Yi , Chu Ka Man , Chan Kenny , Pang Hon Fai , Wong Lok Chi , Chia Chon Pin , Zhang Hong Wei , Song Tianhe , Leung Sin Bond , Ng Bacon Fung Leung , Lin Zhi-Xiu
Published: July 2023

Background

Knee osteoarthritis (KOA) is a common degenerative joint condition that causes disability and pain in the elderly population. The prevalence of KOA among persons aged 63 or above is approximately 30%. Previous studies have reported the positive effects of Tui-na treatment and the Chinese herbal formula Du-Huo-Ji-Sheng Decoction (DHJSD) for KOA treatment. The current study aims to evaluate the add-on therapeutic effect of oral administration of DHJSD on KOA in addition to Tui-na.

Methods

We conducted a prospective, randomized, controlled clinical trial. Seventy study subjects with KOA were randomly assigned to the treatment and control groups in a 1:1 ratio. Both two groups received eight sessions of Tui-na manipulation for 4 weeks. The DHJSD was only administered to the study subjects in the treatment group. The primary outcome measure was rated using the WOMAC at the end of treatment (4 weeks). Secondary outcomes were assessed using EQ-5D-5L, a health-related quality of life with 5-level EQ-5D version at end of treatment (week 4) and follow-up (week 8).

Results

No statistically significant difference was found between two groups on WOMAC scores at the end of treatment. The mean WOMAC Pain subscale score was significantly lower in the treatment group than control group at week 8 follow up (mean difference, MD − 1.8, 95% CI − 3.5 to − 0.02, P = 0.048). The mean WOMAC Stiffness subscale score was significantly lower in the treatment group than in the control group at week 2 (MD 0.74, 95% CI 0.05 to 1.42, P = 0.035) and week 8 follow up (MD 0.95, 95% CI 0.26 to 1.65, P = 0.008). The mean EQ-5D index value was significantly improved in the treatment group than in the control group at week 2 (MD 0.17, 95% CI 0.02 to 0.31, P = 0.022). The analysis of WOMAC scores and EQ-5D-5L in both groups showed statistically significant improvement with time. No significant adverse effect was found during the trial.

Conclusion

DHJSD may have an add-on effect in addition to Tui-na manipulation relieving pain and improving stiffness as well as quality of life (QOL) in patients with KOA. The combined treatment was generally safe and well tolerated.

Trial registration The study was registered at the ClinicalTrials.gov (website: https://clinicaltrials.gov/ct2/show/NCT04492670, registry number: NCT04492670), registered on 30 July 2020.
EDA ligand triggers plasma membrane trafficking of its receptor EDAR via PKA activation and SNAP23-containing complexes
Authors: Yao Yuyuan , Yang Ruihan , Zhu Jian , Schlessinger David , Sima Jian
Published: July 2023

Background

Ectodysplasin-A (EDA), a skin-specific TNF ligand, interacts with its membrane receptor EDAR to trigger EDA signaling in skin appendage formation. Gene mutations in EDA signaling cause Anhidrotic/Hypohidrotic Ectodermal Dysplasia (A/HED), which affects the formation of skin appendages including hair, teeth, and several exocrine glands.

Results

We report that EDA triggers the translocation of its receptor EDAR from a cytosolic compartment into the plasma membrane. We use protein affinity purification to show that upon EDA stimulation EDAR associates with SNAP23-STX6-VAMP1/2/3 vesicle trafficking complexes. We find that EDA-dependent PKA activation is critical for the association. Notably, either of two HED-linked EDAR mutations, T346M and R420W, prevents EDA-induced EDAR translocation; and both EDA-induced PKA activation and SNAP23 are required for Meibomian gland (MG) growth in a skin appendage model.

Conclusions

Overall, in a novel regulatory mechanism, EDA increases plasma membrane translocation of its own receptor EDAR, augmenting EDA-EDAR signaling in skin appendage formation. Our findings also provide PKA and SNAP23 as potential targets for the intervention of HED.
Determining an unknown source in a time-fractional diffusion equation based on Jacobi polynomials expansion with a modified Tiknonov regularization
Authors: Tang Hao-Dong , Zhao Zhen-Yu , Yu Kai , Gong Ben-Xue , Jia Xian-Zhen
Published: July 2023

In this paper, we try to recover an unknown source in a time-fractional diffusion equation. In order to overcome the influence of boundary conditions on source conditions, we introduce the Jacobi polynomials to construct the approximation and a modified Tikhonov regularization method is proposed to deal with the illposedness. Error estimates are obtained under a discrepancy principle as the parameter choice rule. Numerical results are also presented to demonstrate the effectiveness of the proposed method.
Intermittent circulation of simplified deep flow technique hydroponic system increases yield efficiency and allows application of systems without electricity in Haiti
Authors: Vega Isabella , Bien-Amié Dunerose , Augustin Girlo , Heiden William , Heiden Nathaniel
Published: July 2023

Background

Many Haitians face severe food insecurity driven in part by a lack of adequate land for agriculture. Hydroponic systems can produce food without the requirement of arable land but are often prohibitively expensive and require electricity and water inputs that are impractical in most of Haiti.

Results

A deep flow technique (DFT) system named the Levo International, Inc. Victory Garden was tested with lettuce under constant and intermittent circulation. The average per-system yield of BSS from both treatments was 3631.75, 5013.75 and 2836.25 g in three experimental replicates. In replicates one and two, there were no significant differences in yield per circulation regiment. For the third replicate, we found a greater yield in constantly circulating systems. Each constantly and intermittently circulated system used 2.3814 kWh of energy for an estimated cost of $0.45 and 0.1386 kWh of energy for an estimated cost of $0.03, respectively. There was a significantly greater yield of BSS per energy input (g/kWh) in intermittently circulating systems compared to constantly circulating systems. There were no significant differences in water usage according to circulation. Electrical conductivity (E.C.) and pH were not significantly different between circulation treatment groups, except for pH in our third replicate which was significantly higher in constantly circulating systems. E.C. decreased and pH increased between the first week and last reading. The Victory Garden was tested with bell peppers under constant circulation and systems yielded an average of 3592.94 g of fruit. An adapted version of the Victory Garden was tested in Pignon, Haiti with bell peppers under manual twice-daily circulation and yielded an average of 2574.13 g and 3308.35 g in two experimental replicates.

Conclusions

Simplified DFT systems can produce both lettuce and peppers on par with field production. In this system type, we did not see a benefit to constantly circulating the nutrient solution.
Depressive symptoms and anxiety among women with a history of abortion living in urban slums of Bangladesh
Authors: Koly Kamrun Nahar , Saba Jobaida , Billah Md Arif , McGirr Alba , Sarker Tithi , Haque Mahbubul , Mustary Elvina , Hanifi S. M. Manzoor Ahmed , Begum Farzana
Published: July 2023

Background

Globally, major emphasis has been placed on understanding the physiological consequences of losing a pregnancy. However, its mental health impact on socially disadvantaged women remains unexplored. To further inform the field the present study investigated the prevalence and factors associated with the development of depressive symptoms and anxiety among women with a history of spontaneous abortion living in the urban slums of Dhaka, Bangladesh.

Methods

Information was obtained from 240 women who experienced a spontaneous abortion from July 2020 to December 2021. It was obtained through the urban health and demographic surveillance system (UHDSS) survey. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to measure mental health symptoms. Bivariate and multivariate linear regression analyses were performed to assess the associated factors with the mental health outcomes.

Results

Of the 240 women, majority (77.50%) of the women experienced mild to severe depressive symptoms and more than half (58.75%) of the respondants experienced mild to severe anxiety, within one and half years of experiencing spontaneous abortion. A higher level of education and being employed were protective factors for anxiety and depressive symptoms, respectively. However, women with higher sexual and reproductive health rights (SRHR) knowledge had significantly increased anxiety and depressive symptoms. In contrast, receiving post-abortion care (PAC) was associated with decreased anxiety and depressive symptoms.

Conclusion

The findings indicate that ensuring access to affordable PAC services and integrating mental health services into the standard PAC service package is crucial. This study also emphasizes the importance of providing education for women living in urban slums and encouraging them to participate in economic activities.