bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling the layers of data activism: The organising of civic innovation to fight corruption in Brazil
Authors: Odilla Fernanda , Mattoni Alice
Published: November 2023

Developed by tech-savvy citizens, Rosie is a bot that autonomously checks the public spending of elected representatives of the Brazilian Lower Chamber and uses Twitter to engage peoplein discussing suspicious findings. Rosie is the most visible face of Operação Serenata de Amor (Operation Love Serenade), a data-enabled activism initiative that revolves around the creation, use and dissemination of open data to hold politicians accountable and empower citizens to react against the misuse of public funds. The article draws on an original data set – including interviews, participant online observation notes and secondary qualitative materials – to examine Operação Serenata de Amor, focusing on how material and symbolic elements related to both human and non-human actors shape the organisational patterns of this type of initiative. The findings suggest that there are three organisational patterns, each with further specific challenges, based on the presence of three modes of participation that depend on different types of engagement with digital technologies and data. Findings indicate that data-enabled activism can emerge with typical characteristics and values of tech startups, such as the goal of creating a sustainable budget and providing strategic content by validating it with user feedback, while also retaining some traits of online activism, such as ad hoc and temporal networks of highly autonomous actors concerned with specific contentious issues. In this respect, the eventual demobilisation of Operação Serenata de Amor's initiators due to commercial values and struggles to maintain it active and engaging can be seen as a cautionary tale for data-enabled activism, particularly for initiatives closely associated with civic innovation and social tech startups.
Intrathoracic eosinophilic sclerosing fibroplasia with intralesional bacteria in a cat
Authors: Duclos Antoine A , Wolfe Alan , Mooney Carmel T
Published: November 2023

Case summary

A 9-year-old neutered female domestic shorthair cat was presented for investigation of a cranial mediastinal mass. Moderate peripheral eosinophilia and mild-to-moderate polyclonal gammopathy were identified. A thoracoabdominal CT scan documented a cranial mediastinal mass encircling the trachea. Ultrasound-guided fine-needle aspiration and core-needle biopsy were performed, but cytology and histopathology were inconclusive. Surgical debulking was performed. Further histological samples identified severe pyogranulomatous and eosinophilic fibrosing mediastinitis, consistent with feline eosinophilic sclerosing fibroplasia. Gram staining and fluorescence in situ hybridisation (FISH) identified numerous Gram-positive coccoid bacteria. Eosinophilia and hyperglobulinaemia resolved after surgery and combined antimicrobial and immunosuppressive therapy. The cat died 3 months later after developing acute haemorrhagic diarrhoea and dyspnoea.

Relevance and novel information

Eosinophilic sclerosing fibroplasia is reportedly mainly confined to the gastrointestinal tract in cats. Less commonly, extragastrointestinal cases have been described. Lesions in the mediastinal or sternal lymph nodes have been reported, all in association with evident gastrointestinal involvement. The presence of pleural effusion was variable in these cases. To the authors’ knowledge, this is the first report of eosinophilic sclerosing fibroplasia presenting due to lower respiratory signs in a cat. Intralesional bacteria were identified using Gram staining and FISH examination. The presence of intralesional bacteria in the normally sterile mediastinal tissue may support the involvement of penetrating injuries in the pathogenesis of the disease. Eosinophilic sclerosing fibroplasia should be suspected in any cat with abdominal and/or thoracic masses, particularly if associated with peripheral eosinophilia and polyclonal gammopathy.
Virtual reality use and patient outcomes in palliative care: A scoping review
Authors: Moloney Mairead , Doody Owen , O’Reilly Martina , Lucey Michael , Callinan Joanne , Exton Chris , Colreavy Simon , O’Mahony Frances , Meskell Pauline , Coffey Alice
Published: November 2023

Objective

Virtual reality is increasingly used in healthcare settings. Potentially, it's use in palliative carecould have a positive impact; however, there is limited evidence on the scope, purpose and patient outcomes relating to virtual reality use in this context. The objective of this scoping review is to chart the literature on virtual reality use in palliative care, identifying any evidence relating to biopsychosocial patient outcomes which could support its use in practice.

Methods

A scoping review of the literature, involving . a systematic search across 10 electronic bibliographic databases in December 2021, . Eligibility criteria were primary research studies, of any research designwithin a 10-year timeframe, which reported on virtual reality use and patient outcomes in palliative care. A total of 993 papers were identified, andcomprehensive screening resulted in 10 papers for inclusion.

Results

This scoping review identified 10 papers addressing virtual reality in palliative care, published within a three-year timeframe 2019–2021. Research methodologies included mixed methods, quantitative and qualitative. The evidence highlightsvirtual reality use with patients receiving palliative care in a variety of settings, and data around useability, feasibility and acceptability is positive. However, the evidence regarding biopsychosocial patient outcomes linked to virtual reality use is limited.

Conclusion

Virtual reality is gathering momentum in palliative care and is potentially a helpful intervention; however more research is needed to underpin the evidence base supporting its application, particularly in understanding the impact on biopsychosocial patient outcomes and ascertaining the best approach for measuring intervention effectiveness.
Rancor Computer-Based Procedures – A Framework For Task Level Human Performance Data Collection
Authors: Ulrich Thomas A. , Boring Ronald L. , Lew Roger , Whiting Timothy A.
Published: November 2023

To support new and novel concepts of operations for the anticipated wave of advanced nuclear reactor deployments, human factors and human reliability analysis researchers need to develop advanced simulationbased approaches. The lack of standardized HRA models and human performance data is not new and has outlasted numerous potential solutions. This paper presents a Rancor microworld simulation with computerbased procedures that serve as a framework to classify human behaviors without manual or subjective experimenter coding during scenarios. This method supports a detailed level of analysis at the task level. It is feasible for the collecting large sample sizes required to develop quantitative modelling elements that have historically challenged traditional full-scope simulator study approaches.
From Embezzlement to Antitrust: White Collar Crime Preferences of the Dark Triad
Authors: Karandikar Sampada , Jones Daniel N.
Published: November 2023

Not all White-Collar Crimes (WCCs) are the same with respect to complexity and risk. Using previous rankings of WCC complexity, we examined associations between the Dark Triad traits and the likelihood and self-perceived efficacy of committing these different WCCs. Study 1 ( N = 167) found that those high in Machiavellianism reported higher likelihood of committing the most complex (antitrust violations) but not simplest (embezzlement) WCCs. Individuals high in psychopathy reported a different pattern: a higher likelihood of committing the simplest but not most complex WCCs. Study 2 ( n = 257) replicated this effect among financial professionals. These results are consistent with the impulsive nature of psychopathy and the strategic nature of Machiavellianism. These findings have implications for profiling WCC offenders.
Development and Implementation of Educational Material by Nurses for Parents/Caregivers of Children With Cancer: A Peruvian National Study
Authors: Hilario Rosmery , Cosme Melitta , Barzola Isela , Bejarano Giovanna , Benavente Annaly , Sabrera Gina , Celis Edinho , Mirabal Flor , Huerta María del Pilar , Carpio Zulma , Quispe Yuly , Elera Elizabeth , Ascue Kathy , Jesús Maritza , Grados Ivonne , Allauca Nora , Escobedo Milagros , Muñoz Sara , Ruda Lourdes , Velandres María del Carmen , Olarte-Sierra María Fernanda , Maradiegue Essy , Pascual Claudia , Vasquez Liliana
Published: November 2023

Background: Education for parents and caregivers of children with cancer is one of the fundamental roles of nurses to avoid complications, provide quality care, promote adherence to treatment and maintain basic standards of care. This study aimed to design educational material for parents and caregivers of children with cancer in Peru on general information about childhood cancer and its care. Method: Within the framework of the WHO Global Initiative for Childhood Cancer in Peru, a multicenter working group was convened by the Peruvian Ministry of Health. A comprehensive needs assessment of parents and caregivers of children with cancer was performed through a survey in June and July 2020. The survey was conducted online (via Google Forms) and in person at nine hospitals to examine the preferred method of delivery and content of information. Results: Based on the findings from the parent needs assessment, a national nursing working group developed Spanish-language audiovisual materials (i.e., diagnosis and treatment videos for nurses to educate parents and caregivers). A total of 365 parents and caregivers were included. Most respondents (56.9%) were parents of children receiving treatment. Main topics were childhood cancer overview and side effects (85%), food and nutrition (75%), and palliative care (67%); most (70.9%) preferred information through talks and videos (64.7%). Twenty-three videos were developed with support by the Pan American Health Organization and the Ministry of Health. Discussion: Assessing the educational needs of parents and caregivers of children with cancer provides a starting point in the design of targeted strategies.
DIY, fanzines and ecofeminism in the Global South: ‘This city is my sister’
Authors: Guerra Paula
Published: November 2023

In late modernity, artistic-social movements play a central role in renewing societal processes. This article aims to understand how the do-it-yourself (DIY) ethos builds bridges of understanding for these challenges, taking the artistic practice of fanzine production of Fernanda Meireles as a starting point. Based on a qualitative methodology, we analyse Meirele's use of a DIY ethos and practice, contextualised within ecofeminism, the Anthropocene and the Phallocene, as well as in the city of Fortaleza, Brazil, where Meireles resides. Through a DIY lens, we highlight the perspectives that favour the resignification of urban spaces in new territorialities, giving rise to new ways of relating to the city and criticising or contesting it using an ecofeminist perspective of (re)existence in the face of the Anthropocene and the Phallocene.
Self-management interventions for people with pulmonary fibrosis: a scoping review
Authors: Lee Joanna Y.T. , Tikellis Gabriella , Dowman Leona , Jones Arwel W. , Hoffman Mariana , Mellerick Christie R. , Malaguti Carla , Khor Yet H. , Holland Anne E.
Published: November 2023

Background

The most effective method for encouraging self-management in individuals with pulmonary fibrosis (PF) is unclear. This review aimed to identify common self-management components, the outcome measures used and the impact of these components in PF.

Methods

A scoping review was conducted according to theJoanna Briggs Institute Manual for Evidence Synthesisusing Medline, Embase, PsychInfo, CINAHL and the Cochrane Central Register of Controlled Trials. Eligible studies included those with educational, behavioural or support components aimed at facilitating self-management among adults with PF and employed quantitative and/or qualitative methods.

Results

87 studies were included. Common self-management components included education (78%), managing physical symptoms (66%) and enhancing psychosocial wellbeing (54%). Components were predominantly delivered in a pulmonary rehabilitation setting (71%). No studies tested a PF-specific self-management package. Common outcome measures were 6-min walk distance (60%), St George's Respiratory Questionnaire (37%) and the Medical Research Council Dyspnoea scale (34%). Clinically significant improvements in these outcomes were seen in ≥50% of randomised controlled trials. Qualitative data highlighted the importance of healthcare professional and peer support and increased confidence in managing PF.

Conclusion

Self-management components are commonly incorporated into pulmonary rehabilitation programmes rather than being offered as standalone packages. Future research should focus on testing PF-specific self-management packages and employ standardised outcome assessments that include self-efficacy and health-related behaviours.
Effect of Micro Abrasive Slurry Jet Polishing on Properties of Coated Cemented Carbide Tools
Authors: Wang Rongjuan , Wang Chengyong
Published: November 2023

Owing to the popularization of coating technology, physical Vapor Deposition (PVD) coated tools have become indispensable in the cutting process. Additionally, the post-treatment of coated tools applied to industrial production can effectively enhance the surface quality of coating. To improve the processing performance of coated tools, micro abrasive slurry jet (MASJ) polishing technology is first applied to the post-treatment of coated tools. Subsequently, the effects of process parameters on the surface quality and cutting thickness of coating are investigated via single-factor experiments. In the experiment, the best surface roughness is obtained by setting the working pressure to 0.4 MPa, particle size to 3 μm, incidence angle to 30°, and abrasive mass concentration to 100 g/L. Based on the results of the single-factor experiments, combination experiments are designed, and three types of coated tools with different surface qualities and coating thicknesses are obtained. The MASJ process for the post-treatment of coated tools is investigated based on a tool wear experiment and the effects of cutting parameters on the cutting force and workpiece surface quality of three types of cutting tools. The result indicates that MASJ machining can effectively improve the machining performance of coated tools.
Test, evidence, transition projects in Scotland: developing the evidence needed for transition of effective interventions in cancer care from innovation into mainstream practice
Authors: Gadsby Erica Wirrmann , Brown Carson , Crawford Claire , Dale Glen , Duncan Edward , Galbraith Linda , Gold Karen , Hibberd Carina , McFarland Agi , McGlashan Jennifer , McInnes Melanie , McNaughton Joanne , Murray Juliette , Radin Esme , Teodorowski Piotr , Thomson Jane
Published: November 2023

Background

A robust evidence base is required to assist healthcare commissioners and providers in selecting effective and sustainable approaches to improve cancer diagnosis and treatment. Such evidence can be difficult to build, given the fast-paced and highly pressured nature of healthcare delivery, the absence of incentives, and the presence of barriers in conducting pragmatic yet robust research evaluations. Cancer Research UK (CRUK) has played an active part in building the evidence base through its funding of programmes to identify, evaluate and scale-up innovative approaches across the UK. The aim of this paper is to describe and explain the research design and intended approach and activities for two cancer services improvement projects in Scotland funded by CRUK.

Methods

A hybrid effectiveness-implementation study design will assess both the efficiency of the new pathways and their implementation strategies, with the aim of generating knowledge for scale-up. A range of implementation, service and clinical outcomes will be assessed as determined by the projects’ Theories of Change (ToCs). A naturalistic case study approach will enable in-depth exploration of context and process, and the collection and synthesis of data from multiple sources including routine datasets, patient and staff surveys, in-depth interviews and observational and other data. The evaluations are informed throughout by a patient/public representatives’ group, and by small group discussions with volunteer cancer patients.

Discussion

Our approach has been designed to provide a holistic understanding of how (well) the improvement projects work (in relation to their anticipated outcomes), and how they interact with their wider contexts. The evaluations will help identify barriers, facilitators, and unanticipated consequences that can impact scalability, sustainability and spread. By opting for a pragmatic, participatory evaluation research design, we hope to inform strategies for scaling up successful innovations while addressing challenges in a targeted manner.
Preoperative management comprising tube irrigation using a trans-anal indwelling tube for infants with hirschsprung disease can allow single-stage radical surgery
Authors: Nakagawa Yoichi , Uchida Hiroo , Hinoki Akinari , Tainaka Takahisa , Shirota Chiyoe , Sumida Wataru , Makita Satoshi , Yokota Kazuki , Amano Hizuru , Yasui Akihiro , Maeda Takuya , Kato Daiki , Gohda Yousuke
Published: November 2023

Background

Preoperative management of Hirschsprung’s disease (HD) is currently being conducted with the goal of performing single-stage radical surgery without ileostomy.

Methods

We retrospectively reviewed HD cases between 2013 and 2022, as well as their outcomes related to preoperative management.

Results

Thirty-nine patients with HD were included in this study, including short-segment HD (30 cases), long-segment HD (4 cases), and total colonic aganglionosis (5 cases). Among these 39 patients, 95% (37 of 39 patients) underwent single-stage radical surgery after management with glycerin enema use (n = 13), irrigation with tube insertion each time irrigation was performed (n = 13), and irrigation using a tube placed in the bowel (n = 11).

Conclusions

Preoperative management of patients with HD allowed for single-stage surgery of long-segment HD and total colonic aganglionosis. Cases that could be managed without performing an emergency enterostomy during the neonatal period were managed with irrigation until radical surgery was performed.
Characteristics and survival of patients with gynecological cancers who refuse radiotherapy: a retrospective cohort study
Authors: Zhang Shuangli , He Jie , Liu Jun
Published: November 2023

Background

Radiotherapy improves survival for many cancer patients. However, some patients still refuse radiotherapy despite the recommendations of their physicians. We aimed to investigate the impact of refusing recommended radiotherapy on overall survival in patients with gynecological cancers (GC) and attempted to describe what characteristics are associated with the refusal of radiotherapy.

Methods

Data were extracted from the Surveillance, Epidemiology and End Result (SEER) database for patients who were diagnosed with GC and recommended for radiotherapy between 1988 and 2016. Kaplan–Meier and multivariate Cox regression analyses were utilized to analyze the impact of refusal of radiotherapy on overall survival. Univariate and multivariate logistic regression analyses were used to identify characteristics associated with refusal of radiotherapy.

Results

In total, 1,226 of 208,093 patients (0.6%) refused radiotherapy. Multivariate Cox regression analysis showed that refusal of radiotherapy was associated with poorer overall survival in GC patients with stage I/II [hazard ratio (HR) = 1.64; 95% confidence interval (CI), 1.50–1.79], but may not affect overall survival in patients with stage III/IV (HR = 1.03; 95%CI, 0.84–1.25). Multivariate logistic regression analysis demonstrated that factors such as older age (40–65 years, > 65 years), unmarried status (divorced, single, widowed), higher foreign-born rate (1.87-2.82%, 1.51–2.19), refusal of surgery (recommended but not performed), and higher grade (poorly differentiated, undifferentiated/anaplastic) may increase the likelihood of refusing radiotherapy (all P < 0.05). Factors that may reduce the likelihood of refusing radiotherapy include higher income (> 42,810$), lower grade (well-differentiated), primary site of ovarian cancer, and no/unknown chemotherapy (all P < 0.05).

Conclusion

Refusal of radiotherapy is related to worse overall survival in GC patients with stage I/II, and many characteristics may affect a patient’s choice of refusal of radiotherapy.
Impact of an online learning by concordance program on reflection
Authors: Charton Léa , Lahmar Abdelkader , Hernandez Elodie , Rougerie Fabien , Lorenzo Mathieu
Published: November 2023

Background

Learning by concordance (LbC) is a recent approach that introduces learners to the complexity and uncertainty of clinical practice. Some data on LbC suggest that it stimulates reflection in future clinicians. We developed an online LbC training program on electrocardiogram (ECG) interpretation in general practice at the University of Strasbourg, France, and conducted an exploratory qualitative study to document the impact of this ECG learning-by-concordance training program on reflection in participants.

Methods

We created 18 clinical vignettes on ECG interpretation based on a review of the literature on frequent and serious cardiovascular diseases that can be identified using an ECG in general practice. The training program was delivered online to postgraduate general practice students in two faculties of medicine. We conducted a qualitative study based on thematic analysis of two focus groups and six individual interviews. Inductive and deductive coding were performed. The five major components of reflection in the Nguyen model were used in the deductive coding: (i) thoughts and actions, (ii) attentive, critical, exploratory, and iterative processes (ACEI), (iii) underlying conceptual frame, (iv) change and (v) self.

Results

Two focus groups and six individual interviews were conducted. The qualitative analysis indicated 203 codes in the focus groups and 206 codes in the individual interviews, which were divided into five groups based on the components of reflection in the Nguyen model: (i) the self; (ii) attentive, critical, exploratory, and iterative interactions with (iii) one’s thoughts and actions; and (iv) a view on both the change itself and (v) the underlying conceptual frame. Inductive coding revealed interesting insights into the impact of the identity of the panel members, the absence of a scoring system and the question of uncertainty in ECG reading.

Conclusions

This study supports the claim that the use of LbC in the context of ECG interpretation could foster reflection in future general practitioners. We discuss future research avenues on instructional design of LbC and reflection.
Conceptualizing lifer versus destination patients for optimized care delivery
Authors: Lambrecht Jacob , Abir Mahshid , Seiler Kristian , Kamdar Neil , Peterson Tim , Lin Paul , Nham Wilson , Greenwood-Ericksen Margaret
Published: November 2023

Background

Patients presenting to academic medical centers (AMC) typically receive primary care, specialty care, or both. Resources needed for each type of care vary, requiring different levels of care coordination. We propose a novel method to determine whether a patient primarily receives primary or specialty care to allow for optimization of care coordination.

Objectives

We aimed to define the concepts of a Lifer Patient and Destination Patient and analyze the current state of care utilization in those groups to inform opportunities for improving care coordination.

Methods

Using AMC data for a 36-month study period (FY17-19), we evaluated the number of unique patients by residence zip code. Patients with at least one primary care visit and patients without a primary care visit were classified as Lifer and Destination patients, respectively. Cohen’s effect sizes were used to evaluate differences in mean utilization of different care delivery settings.

Results

The AMC saw 35,909 Lifer patients and 744,037 Destination patients during the study period. Most patients were white, non-Hispanic females; however, the average age of a Lifer was seventy-two years whereas that of a Destination patient was thirty-eight. On average, a Lifer had three times more ambulatory care visits than a Destination patient. The proportion of Inpatient encounters is similar between the groups. Mean Inpatient length of stay (LOS) is similar between the groups, but Destination patients have more variance in LOS. The rate of admission from the emergency department (ED) for Destination patients is nearly double Lifers’.

Conclusion

There were differences in ED, ambulatory care, and inpatient utilization between the Lifer and Destination patients. Furthermore, there were incongruities between rate of hospital admissions and LOS between two groups. The Lifer and Destination patient definitions allow for identification of opportunities to tailor care coordination to these unique groups and to allocate resources more efficiently.
Deep learning algorithm performance in contouring head and neck organs at risk: a systematic review and single-arm meta-analysis
Authors: Liu Peiru , Sun Ying , Zhao Xinzhuo , Yan Ying
Published: November 2023

Purpose

The contouring of organs at risk (OARs) in head and neck cancer radiation treatment planning is a crucial, yet repetitive and time-consuming process. Recent studies have applied deep learning (DL) algorithms to automatically contour head and neck OARs. This study aims to conduct a systematic review and meta-analysis to summarize and analyze the performance of DL algorithms in contouring head and neck OARs. The objective is to assess the advantages and limitations of DL algorithms in contour planning of head and neck OARs.

Methods

This study conducted a literature search of Pubmed, Embase and Cochrane Library databases, to include studies related to DL contouring head and neck OARs, and the dice similarity coefficient (DSC) of four categories of OARs from the results of each study are selected as effect sizes for meta-analysis. Furthermore, this study conducted a subgroup analysis of OARs characterized by image modality and image type.

Results

149 articles were retrieved, and 22 studies were included in the meta-analysis after excluding duplicate literature, primary screening, and re-screening. The combined effect sizes of DSC for brainstem, spinal cord, mandible, left eye, right eye, left optic nerve, right optic nerve, optic chiasm, left parotid, right parotid, left submandibular, and right submandibular are 0.87, 0.83, 0.92, 0.90, 0.90, 0.71, 0.74, 0.62, 0.85, 0.85, 0.82, and 0.82, respectively. For subgroup analysis, the combined effect sizes for segmentation of the brainstem, mandible, left optic nerve, and left parotid gland using CT and MRI images are 0.86/0.92, 0.92/0.90, 0.71/0.73, and 0.84/0.87, respectively. Pooled effect sizes using 2D and 3D images of the brainstem, mandible, left optic nerve, and left parotid gland for contouring are 0.88/0.87, 0.92/0.92, 0.75/0.71 and 0.87/0.85.

Conclusions

The use of automated contouring technology based on DL algorithms is an essential tool for contouring head and neck OARs, achieving high accuracy, reducing the workload of clinical radiation oncologists, and providing individualized, standardized, and refined treatment plans for implementing "precision radiotherapy". Improving DL performance requires the construction of high-quality data sets and enhancing algorithm optimization and innovation.
Supervised on-site dosing in injectable opioid agonist treatment-considering the patient perspective. Findings from a cross-sectional interview study in two German cities
Authors: Friedmann Zoe , Kinkel Hans-Tilmann , Kühner Claudia , Zsolnai Andreas , Mick Inge , Binder Annette
Published: November 2023

Background

Injectable opioid agonist treatment (iOAT) is an effective option to support people living with opioid use disorder (OUD) who have not sufficiently benefitted from oral OAT. However, iOAT has been criticised based on theoretical and practical grounds for its dosing policies: Current regulations demand supervised, on-site application and require patients to frequently visit their treatment facility. The current study aims to investigate how patients experience on-site application and derive strategies to enhance the acceptability and effectiveness of iOAT-delivery.

Methods

This article is based on semi-structured interviews with 27 individuals currently or previously in iOAT in two German outpatient iOAT-clinics. We undertook an inductive qualitative content analysis, which included blinded, independent coding and the analysis of individual cases.

Results

Comments regarding on-site application and daily visits to the clinic were grouped intopositive and negative aspects,iOAT as the best alternative option, facilitators of daily visits, andsuggestions for improvement. Positive aspects took the factors stability and social support in regard. Negative aspects ranged from general inconveniences to major impediments to individuals' daily lives and towards achieving psychosocial goals. Participants reported rigorous adherence to iOAT's treatment regime, often due to a perceived lack of alternative options. Meeting iOAT's demands was eased by the patients’ coping-strategies and through facilitating measures implemented by iOAT-clinics. Despite acknowledgement of the potential detriments from easing regulations, take-home arrangements were frequently suggested by participants to improve iOAT.

Conclusions

Being required to attend the clinic for supervised iOAT-application is not experienced uniformly. While clinics can support their patients to cope with strict regulations, alternative approaches to iOAT-application should be considered to accommodate patients' individual needs. Examples from other treatment modalities (e.g., remote supervision and delivery services) might aid to reconcile individualisation while providing adequate safety measures and improve iOAT in the long term.
The mechanisms of nerve injury caused by viral infection in the occurrence of gastrointestinal motility disorder-related diseases
Authors: Li Yaqian , Chen Qiuyu , Wang Liwei , Chen Xin , Wang Bangmao , Zhong Weilong
Published: November 2023

Gastrointestinal motility refers to the peristalsis and contractility of gastrointestinal muscles, including the force and frequency of gastrointestinal muscle contraction. Gastrointestinal motility maintains the normal digestive function of the human body and is a critical component of the physiological function of the digestive tract. At present, gastrointestinal motility disorder-related diseases are gradually affecting human production and life. In recent years, it has been consistently reported that the enteric nervous system has a coordinating and controlling role in gastrointestinal motility. Motility disorders are closely related to functional or anatomical changes in the gastrointestinal nervous system. At the same time, some viral infections, such as herpes simplex virus and varicella-zoster virus infections, can cause damage to the gastrointestinal nervous system. Therefore, this paper describes the mechanisms of viral infection in the gastrointestinal nervous system and the associated clinical manifestations. Studies have indicated that the means by which viruses can cause the infection of the enteric nervous system are various, including retrograde transport, hematogenous transmission and centrifugal transmission from the central nervous system. When viruses infect the enteric nervous system, they can cause clinical symptoms, such as abdominal pain, abdominal distension, early satiation, belching, diarrhea, and constipation, by recruiting macrophages, lymphocytes and neutrophils and regulating intestinal microbes. The findings of several case‒control studies suggest that viruses are the cause of some gastrointestinal motility disorders. It is concluded that one of the causes of gastrointestinal motility disorders is viral infection of the enteric nervous system. In such disorders, the relationships between viruses and nerves remain to be studied more deeply. Further studies are necessary to evaluate whether prophylactic antiviral therapy is feasible in gastrointestinal motility disorders.
A practical guide to in situ and ex situ characterisation of arabinogalactan proteins (AGPs) in fruits
Authors: Kutyrieva-Nowak Nataliia , Leszczuk Agata , Zdunek Artur
Published: November 2023

Background

Arabinogalactan proteins (AGPs) are plant cell components found in the extracellular matrix that play crucial roles in fruit growth and development. AGPs demonstrate structural diversity due to the presence of a protein domain and an expanded carbohydrate moiety. Considering their molecular structure, the modification of glycosylation is a primary factor contributing to the functional variety of AGPs.

Main body

Immunocytochemical methods are used for qualitative and quantitative analyses of AGPs in fruit tissues. These include in situ techniques such as immunofluorescence and immunogold labelling for visualising AGP distribution at different cellular levels and ex situ methods such as Western blotting and enzyme-linked immunoenzymatic assays (ELISA) for molecular characterisation and quantitative detection of isolated AGPs. The presented techniques were modified by considering the structure of AGPs and the changes that occur in fruit tissues during the development and ripening processes. These methods are based on antibodies that recognise carbohydrate chains, which are the only commercially available highly AGP-specific tools. These probes recognise AGP epitopes and identify structural modifications and changes in spatio-temporal distribution, shedding light on their functions in fruit.

Conclusion

This paper provides a concise overview of AGP research methods, emphasising their use in fruit tissue analysis and demonstrating the accessibility gaps in other tools used in such research (e.g. antibodies against protein moieties). It underscores fruit tissue as a valuable source of AGPs and emphasises the potential for future research to understand of AGP synthesis, degradation, and their roles in various physiological processes. Moreover, the application of advanced probes for AGP visualisation is a milestone in obtaining more detailed insights into the localisation and function of these proteins within fruit.
Variability of temperature measurements recorded by a wearable device by biological sex
Authors: Bruce Lauryn Keeler , Kasl Patrick , Soltani Severine , Viswanath Varun K. , Hartogensis Wendy , Dilchert Stephan , Hecht Frederick M. , Chowdhary Anoushka , Anglo Claudine , Pandya Leena , Dasgupta Subhasis , Altintas Ilkay , Gupta Amarnath , Mason Ashley E. , Smarr Benjamin L.
Published: November 2023

Background

Females have been historically excluded from biomedical research due in part to the documented presumption that results with male subjects will generalize effectively to females. This has been justified in part by the assumption that ovarian rhythms will increase the overall variance of pooled random samples. But not all variance in samples is random. Human biometrics are continuously changing in response to stimuli and biological rhythms; single measurements taken sporadically do not easily support exploration of variance across time scales. Recently we reported that in mice, core body temperature measured longitudinally shows higher variance in males than cycling females, both within and across individuals at multiple time scales.

Methods

Here, we explore longitudinal human distal body temperature, measured by a wearable sensor device (Oura Ring), for 6 months in females and males ranging in age from 20 to 79 years. In this study, we did not limit the comparisons to female versus male, but instead we developed a method for categorizing individuals as cyclic or acyclic depending on the presence of a roughly monthly pattern to their nightly temperature. We then compared structure and variance across time scales using multiple standard instruments.

Results

Sex differences exist as expected, but across multiple statistical comparisons and timescales, there was no one group that consistently exceeded the others in variance. When variability was assessed across time, females, whether or not their temperature contained monthly cycles, did not significantly differ from males both on daily and monthly time scales.

Conclusions

These findings contradict the viewpoint that human females are too variable across menstrual cycles to include in biomedical research. Longitudinal temperature of females does not accumulate greater measurement error over time than do males and the majority of unexplained variance is within sex category, not between them.
Using the Elixhauser risk adjustment model to predict outcomes among patients hospitalized in internal medicine at a large, tertiary-care hospital in Israel
Authors: Katz David E. , Leibner Gideon , Esayag Yaakov , Kaufman Nechama , Brammli-Greenberg Shuli , Rose Adam J.
Published: November 2023

Background

In Israel, internal medicine admissions are currently reimbursed without accounting for patient complexity. This is at odds with most other developed countries and has the potential to lead to market distortions such as avoiding sicker patients. Our objective was to apply a well-known, freely available risk adjustment model, the Elixhauser model, to predict relevant outcomes among patients hospitalized on the internal medicine service of a large, Israeli tertiary-care hospital.

Methods

We used data from the Shaare Zedek Medical Center, a large tertiary referral hospital in Jerusalem. The study included 55,946 hospitalizations between 01.01.2016 and 31.12.2019. We modeled four patient outcomes: in-hospital mortality, escalation of care (intensive care unit (ICU) transfer, mechanical ventilation, daytime bi-level positive pressure ventilation, or vasopressors), 30-day readmission, and length of stay (LOS). We log-transformed LOS to address right skew. As is usual with the Elixhauser model, we identified 29 comorbid conditions using international classification of diseases codes, clinical modification, version 9. We derived and validated the coefficients for these 29 variables using split-sample derivation and validation. We checked model fit using c-statistics and R2, and model calibration using a Hosmer–Lemeshow test.

Results

The Elixhauser model achieved acceptable prediction of the three binary outcomes, with c-statistics of 0.712, 0.681, and 0.605 to predict in-hospital mortality, escalation of care, and 30-day readmission respectively. The c-statistic did not decrease in the validation set (0.707, 0.687, and 0.603, respectively), suggesting that the models are not overfitted. The model to predict log length of stay achieved an R2 of 0.102 in the derivation set and 0.101 in the validation set. The Hosmer–Lemeshow test did not suggest issues with model calibration.

Conclusion

We demonstrated that a freely-available risk adjustment model can achieve acceptable prediction of important clinical outcomes in a dataset of patients admitted to a large, Israeli tertiary-care hospital. This model could potentially be used as a basis for differential payment by patient complexity.
Business resilience and growth strategy transformation post crisis
Authors: Bachtiar Nia Kurniati , Setiawan Agus , Prastyan Galih Adi , Kijkasiwat Ploypailin
Published: November 2023

The recent crisis world experienced (Covid-19) undoubtedly changed many aspects of business, such as operations, growth, sales, etc. A business needs capability and strategy to survive, and this paper considers resilience and growth suitable for encountering a crisis. Following that, this paper argues that resilience not only results from a crisis, as mentioned in previous studies but is a process. We also argue that growth strategy and its stages differ between regular times and times of crisis. This paper aims to elaborate on changes in business resilience and growth strategies as a reaction to a crisis by building line-by-line coding, patterns, and themes. This study develops a conceptual model for forming business sustainability after a crisis with resilience and growth as pillars. This qualitative study used snowball sampling with 13 case studies and conducted semi-structured interviews, Focus Group Discussion (FGD), and observation with dependability, credibility, confirmability, and transferability as the triangulation processes. This inductive study demonstrates resilience and growth steps that can assist entrepreneurs in avoiding misleading strategies. The findings also indicated that digital imperatives could hasten both processes to attain sustainability. This paper draws on organizational resilience theory to discuss the theoretical implications of this research. This study discovers three main stages in the resilience process: resilience awareness, adaptation, and action, and growth stages in crisis time, namely no growth, growth support, growth force, and sustainable growth. On a practical level, the proposed model can also assist entrepreneurs in dealing with a crisis regarding what to do and understanding their conditions. This study contributes to the ongoing debate on how to respond to crisis and provides complete stages in resilience response and growth strategies for a business. For future research, this paper recommends a longitudinal study to understand and analyse the implementation and effectiveness of the models.
Psychological distress, anxiety, depression, stress level, and coping style in HIV-pregnant women in Mexico
Authors: Meza-Rodríguez María del Pilar , Farfan-Labonne Blanca , Avila-García Miroslava , Figueroa-Damian Ricardo , Plazola-Camacho Noemí , Pellón-Díaz Gabriela , Ríos-Flores Braulio Alfonso , Olivas-Peña Efraín , Leff-Gelman Phillipe , Camacho-Arroyo Ignacio
Published: November 2023

Purpose

To evaluate the presence of psychological distress (PD) and its association with the mental health and coping styles of pregnant women living with HIV (PWLWH).

Method

An observational, cross-sectional descriptive study was performed. Seventy-three PWLWH were included. Patients responded to a psychometric battery for PD, depression, anxiety, stress, and coping style evaluation. The scales used in the study were: Goldberg’s 30-item General Health Questionnaire (GHQ-30), State-Trait Anxiety Inventory (STAI), Zung Depression Self-Measurement Scale (ZDS), Nowack Stress Profile, Lazarus and Folkman’s Coping Styles Questionnaire.

Results

PD was observed in 31.5% of the participants. PD-positive patients showed a higher probability of presenting traits of depression and anxiety and medium/high stress levels. Besides, they preferentially used emotion-focused coping styles.

Conclusion

PD is associated with a higher probability of presenting anxiety and depression in PWLWH. Emotion-focused coping style could be a factor in decision-making associated with risk behaviors in PWLWH.
IgG4-related mastitis characterized by skin thickening of the breast: a case report
Authors: Itakura Moe , Horimoto Yoshiya , Ishizuka Yumiko , Onagi Hiroko , Hayashi Takuo , Kawamoto Toshio , Watanabe Junichiro , Iijima Kotaro
Published: November 2023

Background

IgG4-related diseases are characterized by marked infiltration and IgG4-positive plasma cells and fibrosis, and involve multiple organs. However, IgG4-related mastitis is rare. We report a case of mastitis associated with IgG4-related disease.

Case presentation

A 78-year-old woman visited our hospital with a complaint of multiple subcutaneous nodules. A biopsy of a dorsal subcutaneous mass was performed but did not yield a definitive diagnosis. However, blood tests showed a high level of IgG4, thus she was referred to the department of collagen disease for further examination. Computed tomography (CT) showed a thickening of the skin of the right breast, and the patient was referred to our department. On physical examination, a large area of thickened skin was observed in the right breast without inflammatory breast cancer-like redness, and no mass was palpable. A needle biopsy was performed on an indistinct hypoechoic area in the breast, and she was diagnosed with mastitis associated with IgG4-related disease. Systemic steroid therapy was then administered and the symptoms of multiple skin nodules and mastitis improved.

Conclusions

We reached the diagnosis based on a biopsy of the mammary gland enabling the patient to begin treatment for IgG4-related disease. This case was characterized by breast skin thickening, which is different from inflammatory breast cancer.
Resistant hypertension: consensus document from the Korean society of hypertension
Authors: Park Sungha , Shin Jinho , Ihm Sang Hyun , Kim Kwang-il , Kim Hack-Lyoung , Kim Hyeon Chang , Lee Eun Mi , Lee Jang Hoon , Ahn Shin Young , Cho Eun Joo , Kim Ju Han , Kang Hee-Taik , Lee Hae-Young , Lee Sunki , Kim Woohyeun , Park Jong-Moo
Published: November 2023

Although reports vary, the prevalence of true resistant hypertension and apparent treatment-resistant hypertension (aTRH) has been reported to be 10.3% and 14.7%, respectively. As there is a rapid increase in the prevalence of obesity, chronic kidney disease, and diabetes mellitus, factors that are associated with resistant hypertension, the prevalence of resistant hypertension is expected to rise as well. Frequently, patients with aTRH have pseudoresistant hypertension [aTRH due to white-coat uncontrolled hypertension (WUCH), drug underdosing, poor adherence, and inaccurate office blood pressure (BP) measurements]. As the prevalence of WUCH is high among patients with aTRH, the use of out-of-office BP measurements, both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), is essential to exclude WUCH. Non-adherence is especially problematic, and methods to assess adherence remain limited and often not clinically feasible. Therefore, the use of HBPM and higher utilization of single-pill fixed-dose combination treatments should be emphasized to improve drug adherence. In addition, primary aldosteronism and symptomatic obstructive sleep apnea are quite common in patients with hypertension and more so in patients with resistant hypertension. Screening for these diseases is essential, as the treatment of these secondary causes may help control BP in patients who are otherwise difficult to treat. Finally, a proper drug regimen combined with lifestyle modifications is essential to control BP in these patients.

Graphical Abstract