bluuebunny/crossref_metadata_2025 huggingface dataset:
On Social Media, Solidarity, and the Catastrophe of Climate Change
Authors: Couldry Nick
Published: June 2023

This short article reflects on the implications of the political challenge of combatting climate change. For this, greater political solidarity will be needed. But what if our current model of social media platforms is generally toxic for solidarity? This article explores that possibility and its implications for the domain and practice of social media.
Implementation of a Multidisciplinary Preoperative Protocol for Geriatric Hip Fractures Improves Time to Surgery at a Level III Trauma Center
Authors: Meyer Jacob R. , Earnest Ryan E. , Johnson Brian M. , Steffensmeier Andrew M. , Vyas Dheer A. , Laughlin Richard T.
Published: June 2023

Introduction

Hip fractures are common among the elderly, and delays in time to surgery (TTS) and length of stay (LOS) are known to increase mortality risk in these patients. Preoperative multidisciplinary protocols for hip fracture management are effective at larger trauma hospitals. The purpose of this study is to evaluate the effect of a similar multidisciplinary preoperative protocol for geriatric hip fracture patients at our Level III trauma center.

Materials and Methods

In this single-center retrospective study, patients aged 65 and older who were admitted from March 2016 to December 2018 (pre-protocol group, Cohort #1, n = 247) and from August 2021 to September 2022 (post-protocol group, Cohort #2, n = 169) were included. Demographic information, TTS, and LOS were obtained and compared using Student’s t-test and Chi-square testing.

Results

There was a significant decrease in TTS in Cohort #2 compared to Cohort #1 ( P < .001). There was a significant increase in LOS in Cohort #2 compared to Cohort #1 ( P < .05), but when comparing a subset of Cohort #2 (Subgroup 2B, patients admitted from May to September 2022 when the effects of COVID-19 were likely dissipated) to Cohort #1, there was no significant difference in LOS ( P = .13). For patients admitted to skilled nursing facilities (SNF), LOS in Cohort #2 was significantly longer than in Cohort #1 ( P = .001).

Discussion

In general, Level III hospitals have fewer perioperative resources compared to larger Level I hospitals. Despite this fact, this multidisciplinary preoperative protocol effectively reduced TTS which improves mortality risk in elderly patients. LOS is a multifactorial variable, and we believe the COVID-19 pandemic was a significant confounder that reduced available SNF beds in our area which prolonged the average LOS in Cohort #2.

Conclusion

A multidisciplinary preoperative protocol for geriatric hip fracture management can improve efficiency of getting patients to surgery at Level III trauma centers.
The Perspectives of Senior Researchers in Applied Disciplines on the Current State of Developmental Attachment Research: An Interview Study
Authors: Mann Alissa , Thompson Megan , Foster Sarah , Beckwith Helen , Madigan Sheri , Fearon R. Pasco , Schuengel Carlo , Duschinsky Robbie
Published: June 2023

Based on interviews with leading researchers and researcher-clinicians in fields allied to attachment research, this paper describes participants’ perceptions of contemporary attachment research in the developmental tradition. Semi-structured qualitative interviews were conducted with 13 research leaders in applied disciplines cognate to attachment research. Participants perceived attachment research as having played a foundational role for developmental science, including highlighting the importance of a developmental perspective and attention to early caregiving experiences. They also identified important contemporary strengths in developmental attachment research, including the observational acuity and insightfulness of its measures, its attention to dyadic processes in contrast to much of biomedicine, the development of a number of attachment-based interventions with well-articulated mechanisms of action, and the capacity of developmental attachment concepts to resonate with clinical and popular audiences. However, participants suggested that the developmental tradition is also perceived as having a comparatively high “cost of entry,” and consequently they warned that it has become somewhat separated from wider developmental science, with its growing prominence of biological research, scalability of methods, and less reliance on theory. Participants perceived both strengths and weaknesses to contemporary developmental attachment research. However they felt that the classic concerns of developmental attachment research were placing the field potentially at odds with current trends in developmental science.
The Value of Reading Circles in EMI Class: Engagement, Usefulness, and Outcomes
Authors: Kang Alin , Lim Yoona , Murdoch Yvette Denise
Published: June 2023

The present study examined the instructional outcomes of the use of Reading Circles (RC) in first year English-Mediated Instruction (EMI) College of Education classes at a university in Korea using a mixed method approach using independent samples t-tests and correlations of survey data and thematic analysis of semi-structured interview data. Thirty-nine first-year students participated in the survey examining engagement, usefulness, and outcomes, and interviews. While students who perceived their English as proficient had lower apprehension, students with previous RC experience showed less apprehension than those without RC experience. More engaged students were found to be less anxious, more positive, and claimed the RC approach to learning was more useful. The results of the interviews showed that RC lessened anxiety and increased learner autonomy and opportunities for collaborative learning. The study recommended EMI class instructors incorporate RC in EMI classes, as well as presented implications for the online EMI learning environment.
Validation of the French-Language Version of the Sense of Community Index-2
Authors: Richard Marie-Claude , Lavoie Émélie , Watters Brendon
Published: June 2023

This article reports on a study to verify the psychometric qualities of the Sense of Community Index-2 revised with young people aged 18 to 30. The validation procedure used in this project was comprised of four steps. A sample of 67 respondents participated in the pretest of the translated version, and another sample of 166 participants in the test of the revised version. The two data collections took place on line over a 1-year period. The results indicate that the original multidimensional structure of the instrument is confirmed but has different dimensions. This article proposes new dimensions. Cross-cultural validation can verify the external validity of the results of English-language scientific publications in Quebec culture. The validated instrument could be used in projects examining innovative topics, such as the increasing complexity of identity construction due to the integration of communication technologies in everyday life.
The Significance of Odontoid Incidence in Patients With Cervical Spondylotic Myelopathy
Authors: Qin Hongyu , Chen Weiyou , Huang Longao , Xiao Xin , Yang Qinghua , Jiang Hua
Published: June 2023

Study Design

Observational study.

Objective

To analyze the cervical sagittal parameters for standing Digital radiography (DR) and supine Magnetic resonance imaging (MRI), and to further clarify the relationship between odontoid incidence (OI) and cervical spondylotic myelopathy (CSM).

Methods

52 CSM patients aged 54.46 ± 2.89 years underwent both standing DR and supine MRI scans of cervical spine between November 2021 and November 2022. OI, odontoid tilt (OT), C2 slope (C2S), T1 slope (T1S), C0-2 angle, C2-7 angle (cervical lordosis [CL]), and T1S-CL were measured in both DR and MRI images using Surgimap ( Version 2.3.2.1). Pearson correlation and linear regression were used to compare these parameters between the two modalities.

Results

Cervical sagittal parameters, including OI, OT, C2S, C0-2 angle, T1S, C2-7 angle (CL) and T1S-CL, showed no significant differences in the measurements between the two modalities. Based on the DR images, OI was related to OT (r = .386, P < .01), C2S (r = .505, P < .01), CL (r = -.412, P < .01), and T1S-CL (r = .320, P < .05), and OI was matched with CL (r2 = .170) and T1S-CL (r2 = .102). Based on MRI images, OI was related to OT (r = .433, P < .01), C2S (r = .516, P < .01), CL (r = -.355, P < .01), and T1S-CL (r = .271, P < .05), and OI matched with C2-7 (r2 = .126) and T1S-CL (r2 = .073).

Conclusion

OI is an independent parameter related to cervical anatomy and its measurement is unaffected by external factors. In patients with CSM, odontoid parameters may effectively describe the sagittal alignment of the cervical spine on DR and MRI images.
Leptospirosis-Induced Myocarditis and Arrhythmias
Authors: Swarath Steven , Maharaj Nicole , Seecheran Rajeev , Seecheran Valmiki , Kawall Jessica , Giddings Stanley , Seecheran Naveen Anand
Published: June 2023

Cardiac manifestations in leptospirosis usually involve atrial arrhythmias, conduction abnormalities, and nonspecific ST-T changes, while left ventricular dysfunction is rare. We present the case of a 45-year-old male without a pre-existing cardiovascular history who developed atrial fibrillation and atrial and ventricular tachycardia, in addition to new-onset cardiomyopathy in the setting of fulminant leptospirosis infection.
Outcomes of Revision Arthroscopic Posterior Labral Repair and Capsulorrhaphy: A Systematic Review
Authors: Jewett Callie A. , Reardon Patrick , Cox Charles , Bowman Eric , Wright Rick W. , Dickens Jonathan , LeClere Lance
Published: June 2023

Background:

Failure rates up to 14% have been reported after arthroscopic posterior capsulolabral repair. It is unknown if revision arthroscopic posterior capsulolabral stabilization has inferior restoration of stability and return to sport when compared with primary repair. Optimal management of failed posterior capsulolabral stabilization is unknown.

Purpose:

To report outcomes of revision posterior capsulolabral repair and factors that contribute to failure and to determine optimal management of failed posterior stabilization procedures.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A computerized search of the PubMed, EMBASE, and Web of Science databases and manual screening of selected article reference lists were performed in January 2022. Randomized controlled trial, cohort, case-control, and case series studies reporting clinical outcomes of revision arthroscopic posterior capsulolabral repair were eligible. Patient characteristics, indications for revision, intraoperative findings, surgical techniques, and patient-reported outcomes were recorded. Owing to heterogeneity of reported outcomes, data were summarized and presented without pooled statistics.

Results:

Only 3 of the 990 identified studies met inclusion criteria. The included studies encompassed 26 revision arthroscopic posterior capsulolabral repairs, with follow-up ranging from 2.3 to 5.3 years. The failed index procedure was arthroscopic capsulolabral repair with suture anchors (n = 22) or posterior thermal capsulorrhaphy (n = 4). The primary indications for revision were recurrent instability and pain. Six patients experienced recurrent instability after revision. Patient satisfaction ranged from 15% to 25%.

Conclusion:

This systematic review of 3 studies demonstrated that the incidence of persistent pain and recurrent instability after revision arthroscopic posterior shoulder stabilization is common, and despite slight improvement in patient-reported outcomes, many patients are dissatisfied with their clinical outcomes. Revision arthroscopic posterior shoulder stabilization appears to have a significant failure rate, and there is need for additional prospective studies to help determine the best intervention for these patients.
Visualizing Beliefs in Biological Racial Difference and Ordering across Europe
Authors: Triguero Roura Mireia
Published: June 2023

The author plots the proportions of people in 20 European countries who believe in biological racial differences, contributing to debates about the role of race and racism in Europe: whether Europeans think in biological racial terms and whether thinking about racism is an adequate framework in the European context. The main new insight is simply providing concrete empirical evidence that beliefs in biological race are widely spread in Europe. Second, this visualization highlights that ideas about races being born “more hardworking” are a more socially acceptable and widely spread form of belief in racial differences than beliefs in races being born “less intelligent”. Third, it shows how the difference between the two types of biological racial beliefs organizes countries into an east-west axis, whereas no such division is apparent when looking only at the magnitudes of the proportions of people who hold racial beliefs.
Three-dimensional land-use configuration and property prices: A spatially filtered multi-level modelling perspective
Authors: Zheng Wei , Wang Mingshu
Published: June 2023

The influence of neighbourhood characteristics on housing prices has gained increasing attention from scholars in recent decades. However, studies on the three-dimensional nature of urban space, and particularly the vertical dimension, have remained limited. This study investigates previously unexplored variables that can capture the vertical and horizontal dimensions of land-use configuration. In addition, this study proposes a spatially filtered multi-level approach to modelling variations in property values which can capture both spatial and multi-level effects. The research findings reveal a price premium for housing located in immediate neighbourhoods with more open mid-rise buildings and low plants. The results also demonstrate the varying effects of determinants of house pricing in spatially heterogeneous zones.
Sustainability and urban climate: How Metaverse can influence urban planning?
Authors: Dorostkar Ehsan , Najarsadeghi Mahsa
Published: June 2023

Metaverse is a unique space in a virtual world that with many capabilities and features shows us a world in which we can experience life in all its dimensions. The presence of Metaverse in the global arena and the use of the facilities of this technology are effective in improving living conditions in developing cities. In this study, two sample projects that Metaverse can support are presented in India and Ghana. The remarkable thing is its innovative method that can solve many problems in the cities of the world. One of the most important challenges in the world today is saving cities from climate change and its adverse effects. Metaverse is one of the innovative methods to reduce the effects of greenhouse gas emissions in the cities of the world. The question is whether Metaverse can influence the urban planning of many cities in the world and change urban planning in the world internationally? And can Metaverse challenge the theoretical foundations in the city? The purpose of this study is to clarify the effects of the Metaverse on the city level. This study aims to introduce a new way to solve the problems of today and the future of world cities by examining Upland and its effects on urban sustainability and ways to prevent climate change. In this context, Metaverse technology has been used as a new solution to provide jobs, reduce poverty, increase public health, prevent climate change and, as a result, realize a better life for future generations. The results of this study, due to being cross-border and creating a global perspective on the Metaverse in urban planning, can create a new scientific perspective based on technological advances in urban studies.
Fluorbritholite-(Nd), Ca2Nd3(SiO4)3F, a new and key mineral for neodymium sequestration in REE skarns
Authors: Holtstam Dan , Casey Patrick , Bindi Luca , Förster Hans-Jürgen , Karlsson Andreas , Appelt Oona
Published: June 2023

Fluorbritholite-(Nd), ideally Ca2Nd3(SiO4)3F, has been approved by the International Mineralogical Association (IMA2023–001) and constitutes a new member of the britholite group of the apatite supergroup. It occurs in skarn from the Malmkärra iron mine, Norberg, Västmanland (one of the Bastnäs-type deposits in Sweden), associated with calcite, dolomite, magnetite, lizardite, talc, fluorite, baryte, scheelite, gadolinite-(Nd) and other REE minerals. Fluorbritholite-(Nd) forms anhedral and small grains, rarely up to 250 μm across. They are brownish pink and transparent with a vitreous to greasy lustre. The mineral is brittle, with an uneven or subconchoidal fracture and lacks a cleavage. In thin section, the mineral is nonpleochroic, uniaxial (–). Dcalc = 4.92(1) g⋅cm−3 and ncalc = 1.795. The empirical chemical formula from electron microprobe (WDS) point analyses is (Ca1.62Nd0.97Ce0.83Y0.52Sm0.30Gd0.23Pr0.17La0.16Dy0.11Er0.03Tb0.03Ho0.01Yb0.01)Σ4.99(Si2.92P0.08As0.01)Σ3.01O12.00[O0.48F0.26(OH)0.14Cl0.10Br0.02]Σ1.00. The crystal structure of fluorbritholite-(Nd) was refined from single-crystal X-ray diffraction data to R1= 0.043 for 704 unique reflections. It belongs to the hexagonal system, space group P63/m, with unit cell parameters a = 9.5994(3), c = 6.9892(4) Å and V = 557.76(5) Å3 for Z = 2. Fluorbritholite-(Nd) and other britholite-group minerals are a major sink for neodymium in REE-bearing skarns of Bastnäs type.
A survival case of visceral disseminated varicella zoster virus infection in a patient with systemic lupus erythematosus
Authors: Ishino Yuri , Fukasawa Hirotaka , Kitamoto Shuhei , Nakagami Daisuke , Kaneko Mai , Yasuda Hideo , Furuya Ryuichi
Published: June 2023

Background

Visceral disseminated varicella zoster virus (VZV) infection is a rare but life-threatening complication in immunosuppressed patients. Herein, we report a survival case of visceral disseminated VZV infection in a patient with systemic lupus erythematosus (SLE).

Case presentation

A 37-year-old woman was diagnosed as SLE and initial induction therapy was started. Two months after starting the immunosuppressive therapy consisting of 40 mg of prednisolone (PSL) and 1500 mg of mycophenolate mofetil (MMF) daily, she suddenly developed strong abdominal pain, which was required opioid analgesics, followed by systemic skin blisters, which were diagnosed as varicella. Laboratory findings showed rapid exacerbation of severe liver failure, coagulation abnormalities and increased numbers of blood VZV deoxyribonucleic acid (DNA). Therefore, she was diagnosed as visceral disseminated VZV infection. Multidisciplinary treatment with acyclovir, immunoglobulin and antibiotics was started, the dose of PSL was reduced, and MMF was withdrawn. By their treatment, her symptoms were resolved and she finally discharged.

Conclusions

Our case highlights the importance of a clinical suspicion of visceral disseminated VZV infections, and the necessity of immediate administration of acyclovir and reduced doses of immunosuppressant to save patients with SLE.
An Indian perspective for umbilical cord blood haematological parameters reference interval
Authors: Sabnis Keyur , Ghanghurde Swati , Shukla Akash , Sukheja Dhriti , Rojekar Mohit V.
Published: June 2023

Background

The Haematological Reference Intervals (RIs) are prone to vary on the basis of various factors such as altitude, age, sex, socioeconomic status, etc. These values play a major role in laboratory data interpretation and determine the necessary clinical treatment. Currently, India has no well–established RI for cord blood haematological parameters of newborns. This study aims to establish these intervals from Mumbai, India.

Method

A cross sectional study was conducted in a tertiary care hospital of India from October 2022 to December 2022 on healthy and term neonates having normal birth weight and born to healthy pregnant mothers. About 2 – 3 mL of cord blood was collected from the clamped cord into EDTA tubes from 127 term neonates. The samples were analysed in the haematology laboratory of the institute and the data was analysed. The upper and lower limits were determined using non-parametric method. The Mann–Whitney U test was used to compare the distribution of the parameters between sex of infant, modes of deliveries, maternal age and obstetric history. P value less than 0.05 was considered to declare statistical significance.

Result

The median values and 95% RI for umbilical cord blood haematological parameters of newborns were as follows: WBC = 12.35 [2.56–21.19] × 109/L, RBC = 4.34 [2.45–6.27] × 1012/L, HGB = 14.7 [8.08–21.44] g/dL, HCT = 48 [29–67]%, MCV = 109.6 [59.04–159.1] fL, MCH = 34.5 [30.54–37.79] pg, MCHC = 31.3 [29.87–32.75] %, PLT = 249 [16.97–479.46] × 109/L,LYM = 38 [17–62] %, NEU = 50 [26–74] %, EOS = 2.3 [0.1–4.8] %, MON = 7.3 [3.1–11.4], BAS = 0 [0–1]. This study found no statistically significant difference between sex of infants, except MCHC, and obstetric history. A significant difference was observed in WBC, EOS% and absolute NEU, LYM, MON and BAS by delivery type. A higher platelet count and absolute LYM was observed in the cord blood compared to venous blood.

Conclusions

For the first time, haematological reference intervals in cord blood were established for newborns in Mumbai, India. The values are applicable for newborns from this area. Larger study throughout the country is required.
The lived experience of clozapine discontinuation in patients and carers following suspected clozapine-induced neutropenia
Authors: Oloyede Ebenezer , Dunnett Danielle , Taylor David , Clark Ivana , MacCabe James H , Whiskey Eromona , Onwumere Juliana
Published: June 2023

Background

Clozapine is the treatment of choice in refractory psychosis. In most countries, clozapine must be stopped indefinitely if white blood cells fall below a defined threshold during routine monitoring. Despite evidence of severe adverse consequences of clozapine discontinuation, published accounts on the lived experiences and perspectives of patients and carers are scarce.

Method

We completed semi-structured interviews with patients (n = 4) and family carers (n = 4) on experiences of clozapine cessation following suspected drug-induced neutropenia. Interviews were audio-recorded, transcribed and analysed thematically.

Results

The two overarching themes comprised:(i) stress of clozapine below threshold neutrophil results and (ii) patient and carer priorities.

Conclusions

There is a suggested need for evidence-based pharmacological and psychological approaches to support patients and carers after clozapine cessation. Such approaches will minimise the potentially negative physical and emotional sequela in the aftermath of a below threshold neutrophil result and reduce the likelihood of experiencing additional health and social inequalities after clozapine discontinuation.
Linking the demographic, socio-economic and oral health status to oral health-related quality of life of the sudanese older adults: a cross sectional study
Authors: Salih Mayson Ahmed , Ali Raouf Wahab , Nasir Elwalid Fadul
Published: June 2023

Background

Oral Health-Related Quality of Life (OHRQoL) is an important measure of patients’ needs and progress. Identifying the links between clinical and non-clinical factors with OHRQoL in a specific population will facilitate the development of effective preventive strategies. The aim of the study was to assess the OHRQoL of Sudanese older adults, and to identify the possible relations between clinical and non-clinical predictors with OHRQoL using Wilson and Cleary model.

Methods

This cross-sectional study was conducted among older adults attending the out-patient clinics in Khartoum State’s Health Care Centers, Sudan. OHRQoL was assessed using the Geriatric Oral Health Assessment Index (GOHAI). Two modifications of Wilson and Cleary’s conceptual model were tested using structural equations modeling including: oral health status, symptom status, perceived difficulty of chewing, oral health perceptions, and OHRQoL.

Results

249 older adults participated in the study. Their mean age was 68.24 (± 6.7) years. The mean GOHAI score was 53.96 (± 6.31) and trouble biting/chewing was the most commonly reported negative impact. Wilson and Cleary models showed that pain, Perceived Difficulty Chewing (PDC), and Perceived Oral Health had a direct effect on OHRQoL. In model 1, age and gender had direct effects on oral health status, while education had direct effects on OHRQoL. In model 2, poor oral health status is associated indirectly with poor OHRQoL.

Conclusions

The OHRQoL of the studied Sudanese older adults was relatively good. The study partially confirmed Wilson and Cleary model as Oral Health Status was related directly to PDC and indirectly to OHRQoL through functional status.
Identifying at risk populations amongst breast cancer survivors and their common symptoms and concerns
Authors: Roy Pooja , Kovalenko Iuliia , Gomez Janet Chan , Lu Kit , Rudge Beth , Wert Yijin , Torp Lisa
Published: June 2023

Purpose

The survival rate amongst breast cancer survivors (BCS) have been increasing, with a 5-year survival rate of almost 90%. These women face many quality of life (QOL) issues either due to either cancer itself or the complex treatment regimen. Our retrospective analysis aims to identify at risk populations among the BCS and their most common concerns.

Methods

This is a single-institution, retrospective, descriptive analysis of patients who were seen at our Breast Cancer Survivorship Program from October 2016 to May 2021. Patients completed a comprehensive survey which assessed self-reported symptoms, their concerns and degree of worry and recovery to baseline. The descriptive analysis on the patient characteristics included age, cancer stage and treatment type. The bivariate analysis included the relationship between the patient characteristics and their outcomes. Analysis of group differences was completed with Chi-square test. When the expected frequencies were five or less, Fisher exact test was used. Logistic regression models were developed to identify significant predictors for outcomes.

Results

902 patients (age 26–94; median 64) were evaluated. Majority of women had stage 1 breast cancer. The most common self-reported concerns affecting the patients were fatigue (34%), insomnia (33%), hot flashes (26%), night sweats (23%), pain (22%), trouble concentrating (19%), and neuropathy (21%). Though 13% of BCS felt isolated at least 50% of their time, the majority of patients (91%) reported having a positive outlook and felt that they have a sense of purpose (89%). Younger patients were more likely to worry about their cancer more than 50% of the time (p < 0.0001). Patients that were less likely to return back to at least 50% of their pre-treatment baseline were younger (age ≤ 45) (p = 0.0280), had higher stage breast cancer (Stage 2–4) (p = 0.0061), and had chemotherapy either alone or as part of their multi-modality treatment (p < 0.0001).

Conclusion

According to our study, younger patients, those with higher stage breast cancer and survivors who had chemotherapy may experience significant QOL issues. Fortunately, majority of BCS report a positive and optimistic outlook post treatment. Identifying common concerns after treatments and vulnerable populations are especially important to deliver quality care and to optimize interventions.

Implications for Cancer Survivors

Our study identified the most common self-reported concerns affecting BCS. In addition, our results suggest that younger patients, patients with higher stage breast cancer and survivors who had chemotherapy were more likely to have QOL issues. Despite this, our study showed, the majority of BCS reported positive outlooks and emotions.
Construction of a virtual simulation laboratory for gene detection
Authors: Yu Lin , Wang Wenjun , Liu Zhongmin , Liu Ze , Xu Yunjian , Lin Yongping
Published: June 2023

Objective

The current paper aims to discuss the development of a virtual simulation experiment teaching system and review its effectiveness in improving the teaching of clinical skills to college medical students.

Methods

Collaborators used 3D Studio Max, Unity 3D and Visual Studio to develop four modules: laboratory thinking training, biosafety training, gene testing and experimental assessment. Teaching was conducted and a virtual software program was used for evaluation of the students.

Results

The laboratory safety training system, virtual gene experiment system and experimental assessment system were developed. The results of the questionnaire survey show that the software provides good interactivity and guidance. The interest of medical students in study is improved and they received training in clinical experimental thinking. Student evaluation assists their scientific research practice, and can improve the awareness of biosafety.

Conclusion

The virtual simulation experiment teaching system, when applied in the teaching of undergraduate and postgraduate experiment courses, can bring about rapid improvements in the following areas: biosafety awareness, interest in learning about experiments and experimental skills, clinical experimental thinking, and comprehensive experimental ability.
Educators’ perspectives of adopting virtual patient online learning tools to teach clinical reasoning in medical schools: a qualitative study
Authors: Kassianos A.P , Plackett R , Kambouri M.A , Sheringham J
Published: June 2023

Background

Learning tools using virtual patients can be used to teach clinical reasoning (CR) skills and overcome limitations of using face-to-face methods. However, the adoption of new tools is often challenging. The aim of this study was to explore UK medical educators’ perspectives of what influences the adoption of virtual patient learning tools to teach CR.

Methods

A qualitative research study using semi-structured telephone interviews with medical educators in the UK with control over teaching materials of CR was conducted. The Consolidated Framework for Implementation Research (CFIR), commonly used in healthcare services implementation research was adapted to inform the analysis. Thematic analysis was used to analyse the data.

Results

Thirteen medical educators participated in the study. Three themes were identified from the data that influenced adoption: the wider context (outer setting); perceptions about the innovation; and the medical school (inner context). Participants’ recognition of situations as opportunities or barriers related to their prior experiences of implementing online learning tools. For example, participants with experience of teaching using online tools viewed limited face-to-face placements as opportunities to introduce innovations using virtual patients. Beliefs that virtual patients may not mirror real-life consultations and perceptions of a lack of evidence for them could be barriers to adoption. Adoption was also influenced by the implementation climate of the setting, including positioning of CR in curricula; relationships between faculty, particularly where faculty were dispersed.

Conclusions

By adapting an implementation framework for health services, we were able to identify features of educators, teaching processes and medical schools that may determine the adoption of teaching innovations using virtual patients. These include access to face-to-face teaching opportunities, positioning of clinical reasoning in the curriculum, relationship between educators and institutions and decision-making processes. Framing virtual patient learning tools as additional rather than as a replacement for face-to-face teaching could reduce resistance. Our adapted framework from healthcare implementation science may be useful in future studies of implementation in medical education.
The relationship between emotional intelligence and organizational commitment among nurses working in governmental hospitals in Jordan
Authors: Al-Oweidat Islam , Shosha Ghada Abu , Baker Tasneem Abu , Nashwan Abdulqadir J.
Published: June 2023

Introduction

Nurses’ emotions and feelings in response to their environment and their ability to manage their emotions can significantly affect several aspects of their job. In Jordan, studies are still investigating whether emotional intelligence is significantly related to organizational commitment.

Aim

To investigate whether a significant relationship exists between emotional intelligence and organizational commitment among Jordanian nurses working in governmental hospitals in Jordan.

Methods

The study used a descriptive cross-sectional correlational design. A convenience sampling method was used to recruit participants working in governmental hospitals. A total of 200 nurses participated in the study. A participant information sheet developed by the researcher was used to obtain the participants’ socio-demographic characteristics, the Emotional Intelligence Scale (EIS) developed by Schutte and colleagues, and the Organizational Commitment Scale developed by Meyer and Allen were utilized for data collection.

Results

Participants had high levels of emotional intelligence (M, SD = 122.3, 14.0) and moderate levels of organizational commitment (M, SD = 81.6, 15.7). Emotional intelligence had a significant, positive relationship with organizational commitment (r = 0.53, p < 0.01). Male nurses, widowed nurses, and nurses with higher postgraduate qualifications demonstrated significantly higher levels of emotional intelligence and organizational commitment than female nurses, single nurses, and nurses with undergraduate degrees (p < 0.05).

Conclusion

Participants in the current study were highly emotionally intelligent and moderately committed to their organizations. Policies supporting the implementation of interventions to improve organizational commitment and maintain a high level of emotional intelligence should be developed and promoted by nurse managers and hospital administrators, as well as decision-makers should magnet the nurses with postgraduate degrees at clinical sites.
Factors affecting the implementation of employee whole health in the veterans health administration: a qualitative evaluation
Authors: Adjognon Omonyêlé L. , Cohen-Bearak Adena , Kaitz Jenesse , Bokhour Barbara G. , Chatelain Leslie , Charns Martin P. , Mohr David C.
Published: June 2023

Background

There is increasing recognition of the need to focus on the health and well-being of healthcare employees given high rates of burnout and turnover. Employee wellness programs are effective at addressing these issues; however, participation in these programs is often a challenge and requires large scale organizational transformation. The Veterans Health Administration (VA) has begun to roll out their own employee wellness program—Employee Whole Health (EWH)—focused on the holistic needs of all employees. This evaluation’s goal was to use the Lean Enterprise Transformation (LET) model for organizational transformation to identify key factors—facilitators and barriers—affecting the implementation of VA EWH.

Methods

This cross-sectional qualitative evaluation based on the action research model reflects on the organizational implementation of EWH. Semi-structured 60-minute phone interviews were conducted in February-April 2021 with 27 key informants (e.g., EWH coordinator, wellness/occupational health staff) knowledgeable about EWH implementation across 10 VA medical centers. Operational partner provided a list of potential participants, eligible because of their involvement in EWH implementation at their site. The interview guide was informed by the LET model. Interviews were recorded and professionally transcribed. Constant comparative review with a combination of a priori coding based on the model and emergent thematic analysis was used to identify themes from transcripts. Matrix analysis and rapid turnaround qualitative methods were used to identify cross-site factors to EWH implementation.

Results

Eight common factors in the conceptual model were found to facilitate and/or hinder EWH implementation efforts: [1] EWH initiatives, [2] multilevel leadership support, [3] alignment, [4] integration, [5] employee engagement, [6] communication, [7] staffing, and [8] culture. An emergent factor was [9] the impact of the COVID-19 pandemic on EWH implementation.

Conclusions

As VA expands its EWH cultural transformation nationwide, evaluation findings can (a) enable existing programs to address known implementation barriers, and (b) inform new sites to capitalize on known facilitators, anticipate and address barriers, and leverage evaluation recommendations through concerted implementation at the organization, process, and employee levels to jump-start their EWH program implementation.
Designing a knowledge translation tool for women’s health research in the U.S. Military Health System
Authors: Janvrin Miranda Lynn , Korona-Bailey Jessica , Koehlmoos Tracey Perez
Published: June 2023

Background

Current United States Department of Defense (DoD) estimates indicate that women comprise 17% of the total active duty component. Despite this, the specific health needs of service women have often been neglected. The Center for Health Services Research (CHSR) at the Uniformed Services University (USU) has been working to create a portfolio of rapid research synthesis briefs on topics including, but not limited to reproductive health, infertility, pregnancy loss, and contraceptive use among active duty service women. The goal of these briefs is to condense and translate the existing research literature for a non-academic audience. The aim of this study is to evaluate the utility of the research briefs to inform decision making around service women’s health issues and impart an overall understanding of the current literature surrounding these topics to a non-academic audience.

Methods

Adopting a previously tested knowledge translation evaluation tool, we conducted a series of key informant interviews in July–August 2022 with decision makers in the Military Health System and the US DoD to elicit feedback regarding the overall utility of the research brief, as well as its ability to meet standards of usefulness, usability, desirability, credibility, and value.

Results

We interviewed a total of 17 participants of a diverse range of healthcare occupations and educational backgrounds, but all currently were working within the Department of Defense in support of the Military Health System. User feedback on the research brief was thematically evaluated based on the predetermined themes of usefulness, desirability, credibility, value, and two emergent themes—findability and language.

Conclusions

This study allowed us to gather key insights from decision makers to better tailor future iterations of our research brief toward rapidly disseminating information for improving the healthcare and policy of active duty service women. The key themes ascertained from this study may help others when adapting their own knowledge translation tools.
Crucial role of the transcription factors family activator protein 2 in cancer: current clue and views
Authors: Jin Chen , Luo Yuxiao , Liang Zhu , Li Xi , Kołat Damian , Zhao Linyong , Xiong Weixi
Published: June 2023

The transcription factor family activator protein 2 (TFAP2) is vital for regulating both embryonic and oncogenic development. The TFAP2 family consists of five DNA-binding proteins, including TFAP2A, TFAP2B, TFAP2C, TFAP2D and TFAP2E. The importance of TFAP2 in tumor biology is becoming more widely recognized. While TFAP2D is not well studied, here, we mainly focus on the other four TFAP2 members. As a transcription factor, TFAP2 regulates the downstream targets directly by binding to their regulatory region. In addition, the regulation of downstream targets by epigenetic modification, posttranslational regulation, and interaction with noncoding RNA have also been identified. According to the pathways in which the downstream targets are involved in, the regulatory effects of TFAP2 on tumorigenesis are generally summarized as follows: stemness and EMT, interaction between TFAP2 and tumor microenvironment, cell cycle and DNA damage repair, ER- and ERBB2-related signaling pathway, ferroptosis and therapeutic response. Moreover, the factors that affect TFAP2 expression in oncogenesis are also summarized. Here, we review and discuss the most recent studies on TFAP2 and its effects on carcinogenesis and regulatory mechanisms.
Exploring the molecular mechanism of comorbidity of autism spectrum disorder and inflammatory bowel disease by combining multiple data sets
Authors: Zhu Jinyi , Meng Haoran , Zhang Li , Li Yan
Published: June 2023

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is difficult to diagnose. Inflammatory bowel disease (IBD) is a common chronic digestive disease. Previous studies have shown a potential correlation between ASD and IBD, but the pathophysiological mechanism remains unclear. The purpose of this research was to examine the biological mechanisms underlying the differentially expressed genes (DEGs) of ASD and IBD using bioinformatics tools.

Methods

Limma software was used to evaluate the DEGs between ASD and IBD. The GSE3365, GSE18123, and GSE150115 microarray data sets were acquired from the Gene Expression Omnibus (GEO) database. We then performed 6 analyses, namely, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional annotation; weighted gene coexpression network analysis; correlation analysis of hub genes with autophagy, ferroptosis and immunity; transcriptional regulation analysis of hub genes; single-cell sequencing analysis; and potential therapeutic drug prediction.

Results

A total of 505 DEGs associated with ASD and 616 DEGs associated with IBD were identified, and 7 genes overlapped between these sets. GO and KEGG analyses revealed several pathways enriched in both diseases. A total of 98 common genes related to ASD and IBD were identified by weighted gene coexpression network analysis (WGCNA), and 4 hub genes were obtained by intersection with the 7 intersecting DEGs, which were PDGFC, CA2, GUCY1B3 and SDPR. We also found that 4 hub genes in the two diseases were related to autophagy, ferroptosis or immune factors. In addition, motif–TF annotation analysis showed that cisbp__M0080 was the most relevant motif. We also used the Connectivity Map (CMap) database to identify 4 potential therapeutic agents.

Conclusion

This research reveals the shared pathogenesis of ASD and IBD. In the future, these common hub genes may provide new targets for further mechanistic research as well as new therapies for patients with ASD and IBD.
The relevance of pacing strategies in managing symptoms of post-COVID-19 syndrome
Authors: Ghali Alaa , Lacombe Valentin , Ravaiau Camille , Delattre Estelle , Ghali Maria , Urbanski Geoffrey , Lavigne Christian
Published: June 2023

Background

Post-COVID-19 syndrome (PCS) shares many features with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). PCS represents a major health issue worldwide because it severely impacts patients’ work activities and their quality of life. In the absence of treatment for both conditions and given the beneficial effect of pacing strategies in ME/CFS, we conducted this study to assess the effectiveness of pacing in PCS patients.

Methods

We retrospectively included patients meeting the World Health Organization definition of PCS who attended the Internal Medicine Department of Angers University Hospital, France between June 2020 and June 2022, and were followed up until December 2022. Pacing strategies were systematically proposed for all patients. Their medical records were reviewed and data related to baseline and follow-up assessments were collected. This included epidemiological characteristics, COVID-19 symptoms and associated conditions, fatigue features, perceived health status, employment activity, and the degree of pacing adherence assessed by the engagement in pacing subscale (EPS). Recovery was defined as the ability to return to work, and improvement was regarded as the reduction of the number and severity of symptoms.

Results

A total of 86 patients were included and followed-up for a median time of 10 [6–13] months. Recovery and improvement rates were 33.7% and 23.3%, respectively. The EPS score was the only variable significantly associated with recovery on multivariate analysis (OR 40.43 [95% CI 6.22–262.6], p < 0.001). Patients who better adhered to pacing (high EPS scores) experienced significantly higher recovery and improvement rates (60–33.3% respectively) than those with low (5.5–5.5% respectively), or moderate (4.3–17.4% respectively) scores.

Conclusion

Our findings demonstrated that pacing is effective in the management of patients with PCS, and that high levels of adherence to pacing are associated with better outcomes.
Predominantly defective CD8+ T cell immunity to SARS-CoV-2 mRNA vaccination in lung transplant recipients
Authors: Taus Ellie , Shino Michael Y. , Ibarrondo F. Javier , Hausner Mary Ann , Hofmann Christian , Yang Otto O.
Published: June 2023

Background

Although mRNA vaccines have overall efficacy preventing morbidity/mortality from SARS-CoV-2 infection, immunocompromised persons remain at risk. Antibodies mostly prevent early symptomatic infection, but cellular immunity, particularly the virus-specific CD8+ T cell response, is protective against disease. Defects in T cell responses to vaccination have not been well characterized in immunocompromised hosts; persons with lung transplantation are particularly vulnerable to vaccine failure with severe illness.

Methods

Comparison groups included persons with lung transplantation and no history of COVID-19 (21 and 19 persons after initial mRNA vaccination and a third booster vaccination respectively), 8 lung transplantation participants recovered from COVID-19, and 22 non-immunocompromised healthy control individuals after initial mRNA vaccination (without history of COVID-19). Anti-spike T cell responses were assayed by stimulating peripheral blood mononuclear cells (PBMCs) with pooled small overlapping peptides spanning the SARS-CoV-2 spike protein, followed by intracellular cytokine staining (ICS) and flow cytometry for release of cytokines in response to stimulation, including negative controls (no peptide stimulation) and positive controls (phorbol myristate acetate [PMA] and ionomycin stimulation). To evaluate for low frequency memory responses, PBMCs were cultured in the presence of the mRNA-1273 vaccine for 14 days before this evaluation.

Results

Ionophore stimulation of PBMCs revealed a less inflammatory milieu in terms of interleukin (IL)-2, IL-4, and IL-10 profiling in lung transplantation individuals, reflecting the effect of immunosuppressive treatments. Similar to what we previously reported in healthy vaccinees, spike-specific responses in lung transplantation recipients were undetectable (< 0.01%) when tested 2 weeks after vaccination or later, but were detectable after in vitro culture of PBMCs with mRNA-1273 vaccine to enrich memory T cell responses. This was also seen in COVID-19-recovered lung transplantation recipients. Comparison of their enriched memory responses to controls revealed relatively similar CD4+ T cell memory, but markedly reduced CD8+ T cell memory both after primary vaccination or a booster dose. These responses were not correlated to age or time after transplantation. The vaccine-induced CD4+ and CD8+ responses correlated well in the healthy control group, but poorly in the transplantation groups.

Conclusions

These results reveal a specific defect in CD8+ T cells, which have key roles both in transplanted organ rejection but also antiviral effector responses. Overcoming this defect will require strategies to enhance vaccine immunogenicity in immunocompromised persons.