bluuebunny/crossref_metadata_2025 huggingface dataset:
Ballistic injuries of the humerus: A matched cohort analysis
Authors: Smith Walter , Schick Samuel , Arthur Rodney , Paul Kyle , Elphingstone Joseph , Prahad Srihari , Luque-Sanchez Kevin , Momaya Amit , Spitler Clay , Brabston Eugene
Published: October 2023

Introduction

Ballistic fractures of the humerus secondary to gunshot wounds are increasingly common injuries that pose challenges for orthopedic surgeons. The primary purpose of this study was to examine the rates of neurovascular injury, compartment syndrome, and infection of ballistic humerus fractures relative to blunt, non-penetrating fractures.

Methods

A consecutive cohort of 135 patients with ballistic humerus fractures and 167 patients with blunt humerus fractures treated at a level 1 trauma center were identified. A review of patient medical records and radiographic studies was performed to obtain demographic information, injury mechanism, fracture location, choice of treatment, and complications. Statistical analysis was performed using independent sample t-tests, chi-square tests, and odds ratios ( p < 0.05 significance).

Results

Compared with blunt fractures, patients in the ballistic fracture cohort were younger, male, African American, test positive for illicit drug use, and sustain proximal fractures. Ballistic fractures had significantly lower Injury Severity Scores and New Injury Severity Scores. Ballistic fractures were three times as likely to present with neurovascular injury than blunt fractures (OR: 2.927, p < 0.001). The overall rate of spontaneous recovery of significant motor function for ballistic fractures with neurologic injury was 55%. There were no statistically significant differences in rates of vascular injury, compartment syndrome, infection, non-union, or the need for soft tissue reconstruction.

Conclusion

Compared with blunt humeral fractures, ballistic fractures appear to have a significantly higher rate of neurologic injury but no increased risk for compartment syndrome or infection. Surgical treatment of ballistic humeral injuries was not associated with increased neurological recovery compared to non-operatively managed fractures.
An effective modelling approach for multi-body dynamic analysis of epicyclic gear train of GTF considering both structural flexibility and mechanical interactions
Authors: Liu Chao , Du Jinfu , Fang Zongde , Xiang Long , Hu Shengyang , Guo Fang , Li Pengfei
Published: October 2023

In this paper, a new modelling approach is proposed for the dynamic investigation of epicyclic gear train, and the novelty of this work lies in consideration of both structural flexibility and mechanical interactions during the analysis procedure. The method is of capacity to directly present the dynamic results of the supporting structure for convenient practical engineering evaluation and reduce the dimension of the system reasonably with appropriate assumptions for better computational efficiency. Firstly, the mechanical interactions among components are discussed in detail, and the principle that the structural flexibility works is also explained at length. Secondly, taking the epicyclic gear train of the geared turbofan (GTF) engine; for example, the dynamic model of the system is then established based on the developed hybrid user-defined elements. For model validation, the governing equations of the system are also derived by the lumped mass method. Thirdly, with the same values of the parameters, the results of normal dynamic meshing force obtained by the proposed model are compared with the ones by the lumped mass model. It can be stated from the data that (1) the maximum relative error between the theoretical value and the average value calculated by the two models is 8.28%, (2) the gear mesh frequency obtained by the two models are sufficiently close to the theoretical value, and (3) the fluctuation trends of the dynamic force keep basically consistent with each other. In summary, the comparison presented clearly indicates that the proposed model is indeed reasonable, which provides a new way for dynamic investigation and structural redesign of a large epicyclic gear train. Finally, as a practical engineering application, the vibration result of the deformable supporting structure of the GTF gear train is also presented, which directly provides valuable reference for vibration monitoring, fault diagnosis and other engineering problems in practice.
Modified Tubeless Ureterocutaneostomy in High-Risk Patients After Radical Cystectomy and its Long-Term Clinical Outcomes
Authors: Li Mingyong , Fu Xiaowen , Zu Xiongbing , Chen Jinbo , Chen Minfeng
Published: October 2023

Objectives

This work aimed to prevent stoma stenosis and achieve tubeless cutaneous ureterostomy in elderly and high-risk patients with our modified cutaneous ureterostomy.

Methods

We retrospectively analyzed 40 and 49 patients (176 renal units) who underwent Toyoda (group 1) and modified cutaneous ureterostomy (group 2) between 2012 and 2021. The average follow-up period was 44 months. The primary results of our study were the catheter-free rate and clinical outcomes, especially renal function and urinary diversion-related complications. Significant differences in catheter-free rate and urinary diversion-related complications were found between our modified method and the Toyoda technique.

Results

A total of 56 (71.8%) of 78 renal units in group 1 and 89 (90.8%) of 98 renal units in group 2 remained catheter free. Compared with group 1, group 2 had a higher catheter-free rate ( P = .001). Multivariate analysis indicated that the surgical procedure (HR = 0.268; P = .001) and body mass index (HR = 3.127; P = .002) were the predictors independently associated with catheter insertion. During follow-up, renal deterioration was observed in 32 (36.0%) patients. Patients with catheter insertion were more likely to suffer from renal deterioration ( P < .001), postoperative pyelonephritis ( P < .001), and urolithiasis ( P < .001) than their counterparts.

Conclusion

Our modified cutaneous ureterostomy method may provide an effective and simple approach to tubeless cutaneous ureterostomy in elderly and high-risk patients.
Virtual implantation of Derivo Embolization Devices using PreSize Neurovascular software: Accuracy evaluation and size selection comparison study
Authors: Ngo Ngoc T. , Flottmann Fabian , Iori Francesco , Bonfanti Mirko , Mandaltsi Aikaterini , Fiehler Jens , Bester Maxim
Published: October 2023

Background

Evaluating the deployed length of flow diverting stents (FDs) to select the optimal device size remains a challenging, yet crucial, task in aneurysm treatment. This study reports on the accuracy of PreSize Neurovascular (Oxford Heartbeat Ltd), a visualization and simulation software for FD intervention planning, in predicting FD deployed length, and on its impact on device size selection.

Methods

Imaging data from consecutive patients treated with Derivo Embolization Device (Acandis GmbH) were collected from University Medical Center Hamburg-Eppendorf and retrospectively analyzed. Accuracy evaluation: prediction accuracy was calculated by comparing deployed FD lengths measured from imaging data and simulated by PreSize. Size selection comparison: two Interventional Neuroradiologists (INR1, INR2), blinded to the devices deployed, used PreSize to select the optimal device size (diameter and length). Their choices were compared against the deployed devices selected by conventional planning.

Results

Among 98 implanted devices, PreSize predicted deployed FD length with a mean accuracy of 94.54% (95% confidence interval [93.72%, 95.35%]). Among 98 aneurysm cases, PreSize-informed device lengths were significantly shorter (Wilcoxon signed-rank test, INR1: W = 394, P < .001, INR2: W = 305, P < .001) by 4.13 and 4.18 mm on average, and up to 20 and 25 mm, for INR1 and INR2, respectively, than the conventionally selected FDs. In 32% of cases, PreSize-informed devices resulted in fewer vessel bends covered by the FD while achieving sufficient aneurysm coverage.

Conclusions

PreSize retrospectively predicted deployed FD lengths with high accuracy. Moreover, INRs in this study were more inclined to select shorter stent length in the simulation than they would have done conventionally.
Capturing Habitus: Reflections on the Use of Narrative Inquiry to Explore Female Learner Identities in Chinese STEM Higher Education
Authors: Hu Yating , Stahl Garth
Published: October 2023

Pierre Bourdieu’s concept of habitus remains an important theoretical framework educational researchers draw upon to explore the learner identities of students as well as their learning trajectories. As scholars grapple with habitus, as both a theory and a method of working with the data, they have drawn upon different research methodologies. To date, what has been largely absent in Bourdieusian educational research is how narrative inquiry can enhance our understanding of how habitus shapes learner identities. Narrative inquiry, as a research approach, seeks to understand and interpret human experiences through the collection and analysis of participants’ life stories. This article first explains how to operationalise Bourdieu’s habitus to understand learner identities and aspirations. Second, narrative inquiry is introduced as a methodology. Third, the paper offers a case study of Chinese female STEM students’ experiences in higher education where the first author reflects on how narrative inquiry allowed for a deeper exploration of the formation and maintenance of their habitus as learners. Lastly, the paper concludes with the first author’s own reflexive deliberations on what narrative inquiry can offer researchers interested in habitus. In exploring the relationship between narrative inquiry and habitus the paper highlights the continual dialectical relationship between theory and method.
Participation in Online Research: Towards a Typology of Research Subjects with Regard to Digital Access and Literacy
Authors: Hannemann Matthias , Henn Sebastian , Schäfer Susann
Published: October 2023

The Covid-19 pandemic has severely impacted empirical research practices relying on face-to-face interactions, such as interviews and group discussions. Confronted with pandemic management measures such as lockdowns, researchers at the height of the pandemic were widely limited to the use of online methods that did not enable direct contact with their research subjects. Even as the pandemic subsides, online data collection procedures are being widely applied, in many cases possibly recklessly. In this paper, we urge the implementation of a reflective approach to online research. In particular, we argue that both digital access and the research subjects’ digital literacy affect participation in online research and thus also the quality of the research. By combining these two dimensions, we develop a typology of four types of research subjects (digital outcasts, illiterates, sceptics and natives) that allows researchers to adapt their data collection to the specifics of each research situation. We illustrate these types in the context of our own research projects and discuss them with regard to three main challenges of empirical research, i.e., acquiring participants, establishing a basis for conversation, and maintaining ethical standards. We conclude by developing recommendations that help researchers to deal with these challenges in the context of online research to avoid unintended biases.
The promotion of distributed leadership in education at national level: Discursive change to maintain the old order – Lessons from Ireland
Authors: O’Sullivan John , Mac Ruairc Gerry
Published: October 2023

There is increasing evidence of the influence of neoliberal and New Public Management (NPM) agendas in education systems around the world. Research shows the associated restricted drive for efficiency and effectiveness has induced negative effects on students, teachers and school leaders. Distributed leadership features prominently in policy frameworks in such countries. Despite this, research shows it manifests in limited forms of delegation. Taking Ireland as an example, this study extends this via interrogation of discourses of educational leadership advanced by the Department of Education there. This allows for an understanding of not just what is occurring but illuminates why, thereby opening up opportunities for alternative practices. Specifically, having explicated the contested term ‘distributed leadership’, this research reports on a thematic and discourse analysis of the Department's Whole School Evaluation (WSE) reports on a sample of 12 post-primary schools. Key findings reveal the Department's espoused ‘enhanced’ model of ‘distributed leadership’ belies its advancement of delegated leadership and ‘discursive twists’ that enable ‘unleaderful’ activities of teachers and routine educational experiences of students to masquerade as leadership. Leadership implications for the Department that would enable, rather than constrain, enhanced educational leadership practice in schools are highlighted.
Toward Understanding of the Social Hysteresis: Insights From Agent-Based Modeling
Authors: Sznajd-Weron Katarzyna , Jȩdrzejewski Arkadiusz , Kamińska Barbara
Published: October 2023

Hysteresis has been used to understand various social phenomena, such as political polarization, the persistence of the vaccination-compliance problem, or the delayed response of employees in a firm to wage incentives. The aim of this article is to show the insights that can be gained from using agent-based models (ABMs) to study hysteresis. To build up an intuition about hysteresis, we start with an illustrative example from physics that demonstrates how hysteresis manifests as collective memory. Next, we present examples of hysteresis in psychology and social systems. We then present two simple ABMs of binary decisions—the Ising model and the q-voter model—to explain how hysteresis can be observed in ABMs. Specifically, we show that hysteresis can result from the influence of various external factors present in social systems, such as organizational polices, governmental laws, or mass media campaigns, as well as internal noise associated with random changes in agent decisions. Finally, we clarify the relationship between several closely related concepts such as order–disorder transitions or bifurcation, and we conclude the article with a discussion of the advantages of ABMs.
Add dexmedetomidine to levobupivacaine for transversus abdominis plane block in elderly patients undergoing inguinal hernia repair: Could it make a difference? A randomised trial
Authors: Abo Elfadl Ghada Mohammad , Ali Wesam Nashat , Ahmed Fatma Nabil , Abd el-Rady Nessren M , Ali Ahmed Mohammed , Abdel Rady Marwa Mahmoud
Published: October 2023

Background:

Transversus abdominis plane block is becoming more common as part of multimodal analgesia for post-abdominal operation pain relief. This study compared the analgesic effects of adding dexmedetomidine to levobupivacaine (transversus abdominis plane) block in elderly patients undergoing inguinal hernia surgery to adding fentanyl.

Methods:

Overall, 90 elderly patients with a simple inguinal hernia repair were randomly assigned to one of three groups. After spinal anaesthesia, an ultrasound-guided transversus abdominis plane block was performed. Transversus abdominis plane block was accomplished with 0.25% levobupivacaine + 0.9% normal saline in Group L (n = 30) (20mL). Transversus abdominis plane block was accomplished with 0.25% levobupivacaine + 1 µg/kg dexmedetomidine in Group D (n = 30) (20mL). Transversus abdominis plane block was obtained with 0.25% levobupivacaine + 1 µg/kg fentanyl in Group F (n = 30) (20mL). The primary outcome was the first analgesic request, and the secondary outcomes were the visual analog scale, postoperative analgesic requirements, sedation, hemodynamic stability, and related complications 24 hours postoperatively. 1gm paracetamol intravenously was provided as rescue analgesia.

Results:

The time to first analgesic request in the dexmedetomidine group was substantially more prolonged than in the fentanyl and control groups (516.5±27.8, 451.2±11.1, and 403.9±10.5min, respectively; p < 0.05). Postoperative analgesic requirements were significantly decreased in dexmedetomidine 1(1-2) than control 2(1-3) and fentanyl 1.5(1-2) respectively (P<0.01). VAS was significantly lower in Group D and Group F than in Group L postoperatively. No significant difference in side effects was noted between the groups.

Conclusion:

The transversus abdominis plane block is the best multimodal analgesia choice for inguinal hernia repair in older patients. Combining dexmedetomidine with levobupivacaine in the transversus abdominis plane block can improve the quality of postoperative analgesia while avoiding significant side effects.
Curcumin Protects Pheochromocytoma Cells Against Hydrogen Peroxide-Induced Oxidative Stress
Authors: Sun Xiaoting , Chen Lu , Lin Lingli , Ho Kuo-Ting , Huang Shi-Ying , Li Jian , Liu Jingwen , Zhang Zhengxiao , Li Guiling
Published: October 2023

Objective: Oxidative stress represents a characteristic of neurodegenerative diseases, which may be alleviated by the functional food component—curcumin. However, the underlying mechanism remains unclear. The current study aimed to address how curcumin protects variant differentiated pheochromocytoma (PC12) cells against hydrogen peroxide (H2O2)-induced cell stress, using low- and high-differentiated PC12 cells, and validated in old-aged mice. Methods: The MTT assay was first carried out to test the cell viability upon H2O2 and/or curcumin treatment and cellular lipid peroxidation was assessed as cellular damages by quantifying the amount of cellular malondialdehyde. Cellular oxidative stress was determined by measuring the cellular and mitochondrial ROS levels, and total cellular antioxidant capacities were determined as the ABTS free radical scavenging ability (ABTS) and Fe3+ reduction ability of cells. The activities and expression of major antioxidant enzymes, including glutathione peroxidase (GPx), superoxidase dismutase (SOD) and catalase (CAT), were also tested. Furthermore, oxidative phosphorylation of mitochondria was assessed by measuring the ATP level and the ADP/ATP ratio. Finally, the antioxidant activity of curcumin was determined in 6-month-old mice by measuring cellular antioxidant capacity and antioxidant enzyme activities. Results: H2O2 caused oxidative damage and decreased cell viability, which was reversed by curcumin with different dosed effects in variant differentiated PC12 cells. Moreover, curcumin's protective effect was attributed to an enhanced antioxidant enzyme system. In consistent, curcumin recovered H2O2-deteriorated oxidative phosphorylation. Further studies verified that curcumin significantly improved the antioxidant capacity of old-aged mice, which may have elevated oxidative stress. Conclusion: Taken together, curcumin improved the antioxidant capacity of variant differentiated PC12 cells and old-aged mice, which was closely associated with the modulation of mitochondrial function and antioxidant enzyme system. This study may shed light on the molecular mechanism underlying the alleviation of neurodegenerative diseases by natural polyphenols.
Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease before and during COVID-19 pandemic
Authors: Liu Ligang , Silva Almodóvar Armando , Nahata Milap C.
Published: October 2023

Background:

Medication adherence in Medicare-enrolled older adults with asthma and chronic obstructive pulmonary disease (COPD) before and during the coronavirus disease 2019 (COVID-19) pandemic is unknown.

Objectives:

To evaluate medication adherence and determinants of high adherence before and during the COVID-19 pandemic in this population.

Design:

Retrospective cohort study.

Methods:

The proportion of days covered (PDC) reflected medication adherence from January to July 2019 and from January to July 2020. Patients <65 years of age, with COPD or asthma alone, or with cystic fibrosis were excluded. Paired t tests were used to assess adherence changes. Logistic regression explored association of age, sex, diagnosis of depression, number of medications, medication-related problems, prescribers, pharmacies, controller medication classes, albuterol rescue inhaler fills, oral corticosteroid fills, and having a 90-day supply with high adherence (PDC ⩾ 80%).

Results:

This analysis included 989 patients. In this cohort, 61.2% of patients received oral corticosteroids. Over 60% of patients had ⩾3 rescue fills in both 2019 and 2020. Medication adherence to controller medications significantly decreased for all controller medications ( p < 0.001) in 2020. In 2019 and 2020, number of controller medication classes and having a 90-day supply were associated with high adherence ( p < 0.001). In 2019, variables associated with high adherence also included number of medication-related problems and having ⩾3 albuterol rescue inhalers ( p < 0.001).

Conclusion:

Medication adherence to controllers significantly decreased during the pandemic among older adults with asthma and COPD. Patients with multiple controller classes and a 90-day supply were more likely to be highly adherent. A 90-day supply of medications should be used to facilitate access to medication during the pandemic. Healthcare professionals should assess medication adherence, resolve the barriers of adherence and medication-related problems to achieve desired clinical outcomes among older adults with both asthma and COPD.
Intersectional approaches to data: The importance of an articulation mindset for intersectional data science
Authors: Bentley Caitlin , Muyoya Chisenga , Vannini Sara , Oman Susan , Jimenez Andrea
Published: October 2023

Data's increasing role in society and high profile reproduction of inequalities is in tension with traditional methods of using social data for social justice. Alongside this, ‘intersectionality’ has increased in prominence as a critical social theory and praxis to address inequalities. Yet, there is not a comprehensive review of how intersectionality is operationalized in research data practice. In this study, we examined how intersectionality researchers across a range of disciplines conduct intersectional analysis as a means of unpacking how intersectional praxis may advance an intersectional data science agenda. To explore how intersectionality researchers collect and analyze data, we conducted a critical discourse analysis approach in a review of 172 articles that stated using an intersectional approach in some way. We contemplated whether and how Collins’ three frames of relationality were evident in their approach. We found an over-reliance on the additive thinking frame in quantitative research, which poses limits on the potential for this research to address structural inequality. We suggest ways in which intersectional data science could adopt an articulation mindset to improve on this tendency.
Public procurement for innovation: Lessons and challenges of a COVID-19 vaccine contract
Authors: Foss Maria Carolina , Coutinho Diogo R
Published: October 2023

During the COVID-19 pandemic, which triggered a worldwide emergency call to pursue new drugs and devices to treat and cure the disease, vaccines began to be developed mid-2020, as a promising weapon and shield. Fiocruz, a Brazilian government science and technology institute, signed a public procurement for innovation contract with the foreign pharmaceutical company AstraZeneca to purchase, at that time, vaccines still under development. It was the first public procurement for innovation contract in the Brazilian public health system (SUS). This paper analyzes how the Brazilian public procurement contracts for the COVID-19 vaccine dealt with technology and institutional risks and uncertainties. It also aims to describe how such agreements (and the legal apparatus behind them) relate to the Brazilian system of innovation and to the theoretical approach of contracting for innovation. A key question is: how does the public procurement for innovation vaccine contract signed by Fiocruz deal with the intrinsic nature of uncertainty that characterizes innovation, and what lessons and challenges can be drawn?
The epidemiology and clinical features of pediatric acute pancreatitis in north of Guizhou, China
Authors: Bo Shixing , Gao Jingyan , Zhou Yanna , Wang Chaohui , Liang Wenmei , Fu Xiaoyun
Published: October 2023

Background:

The epidemiological data on distribution of pediatric acute pancreatitis was deficiency. And the purpose of this research was to investigate the epidemiology and clinical features of pediatric acute pancreatitis in the population in north of Guizhou, China.

Design and methods:

A retrospective case analysis was conducted to accomplish the aim. Patients who were under 18 years old with acute pancreatitis were recruited. Data were collected directly from Hospital Information System (HIS) after patients were discharged from the hospital.

Results:

A total of 95 children aged from 3 to 17 years were collected, 49 patients were boys and 46 were girls. In addition, the percentage of acute pancreatitis occurring in girls aged 15–17 years was significantly higher than that of boys (54.3% vs 36.7%). Meanwhile, the percentage of severe patients over 12 years exceeded 90.0%. Moreover, the proportion of severe acute pancreatitis in girls was significantly higher than that in boys (26.1% vs 10.2%), and 64.7% of severe patients were from 12 to 14. What’s more, more patients occurred in May, June, and December and on weekends, 47.1% (8/17) severe cases occurred in May, June, and July, and 47.1% (8/17) severe patients occurred on weekend. The length of hospitalization and hospitalization costs of severe patients were found higher compared to mild patients.

Conclusions:

Higher risk of pediatric acute pancreatitis, especially severe acute pancreatitis, in north of Guizhou, China occurred on weekend, during May and June, and among children aged 12–17 years, especially girls. Additionally, severe acute pancreatitis was associated with higher hospitalization costs and longer hospitalization length.
Food access narratives as told by consumers and retailers engaging in a COVID-19-stricken urban food system: A brief report
Authors: Lewis Emma C , Pei Penny , Gittelsohn Joel
Published: October 2023

Small food retail (“corner”) stores in many underserved urban settings face challenges to stocking healthy, affordable foods. The food supply chain is considered one of the most important sectors of the economy and has suffered recent negative impacts due to the Coronavirus disease 2019 (COVID-19) pandemic, from farm to consumer. As part of the larger Baltimore Urban food Distribution (BUD) Study, we examine corner store owner and consumer perceptions of the impact of COVID-19 on navigating an urban food environment using a brief, reflective, semi-structured oral interview framed as “storytelling.” Open-ended responses are documented, transcribed, and analyzed for key themes. Presently, we discuss initial key findings in hopes of helping to ensure sufficient value added for corner store owners and consumers who will interact with the BUD mobile application as part of a full-scale trial being implemented in Baltimore, Maryland.
Caring for Informal Dementia Caregivers and Their Loved Ones Via the HOMeCARE Exercise and Mindfulness for Health Program (HOMeCARE): A Randomized, Single-Blind, Controlled Trial
Authors: Lang Tommy , Daniel Kenneth , Inskip Michael , Mavros Yorgi , Fiatarone Singh AM Maria A.
Published: October 2023

Objective: To investigate the effects of a dyadic intervention of mindfulness-based stress reduction (MBSR) for informal dementia caregivers and home-based balance and progressive resistance training (PRT) for their loved ones. Methods: The study was a two arm, randomized, controlled, single-blinded, parallel-group trial. Dyads were randomized to an intervention group: an 8-week MBSR course (daily) and an 8-week PRT and balance training (3 days/week) for their loved ones or a waiting list control group. Results: Nine dyads were randomized [caregivers: median age 75 (40–81) years, loved ones: 77 (73–88) years]. The intervention significantly improved caregiver mindfulness [relative effect size (95% confidence interval) 1.35 (−0.10, 2.81); p = .009] and functional mobility in their loved ones [mean difference (95% confidence interval) 1.53 (−3.09, 6.14)] with no significant effects on caregiver burden [relative effect size (95% confidence interval) 0.22 (−1.09, 1.54); p = .622]. Conclusion: The study appeared feasible in the home environment and future large and longer trials should test the efficacy of a more abbreviated MBSR intervention to optimize adoption and sustain adherence over time.

Trial registry name: HOMeCare: Caring for the Dementia Caregiver and their Loved One via the HOMeCare Exercise and Mindfulness for Health Program

Trial URL: https://www.australianclinicaltrials.gov.au/anzctr/trial/ACTRN12617000347369

Registration number: ACTRN12617000347369
Enduring Relationships: Social Aspects of Perceived Interactions with the Dead
Authors: Cerulo Karen A.
Published: October 2023

Is it possible to interact with the dead? Belief in such encounters is more widespread than we might think. Yet sociologists, unlike other disciplines, have not fully engaged the question. Here, I review both long-standing theoretical objections to such research and recent theories that encourage attention to the issue. Leaning on the latter, I use closed- and open-ended survey data collected from 535 Americans to explore what I call “living-deceased perceived interaction.” My data show that nearly half of my study participants report meaningful and regular interactions with deceased relatives and friends who were important in their lives. I examine the characteristics of such interactions—how and when they are performed and what these experiences mean to respondents. I also investigate the role of one’s social location in initiating interactions with the dead. Finally, I explore the social benefits, if any, these interactions provide for individuals who engage in them.
Advancing Equity in Graduate Medical Education Recruitment Through a Diversity Equity and Inclusion (DEI) Toolkit for Program Directors
Authors: Nabhan Zeina M. , Scott Nicole , Kara Areeba , Mullis Leilani , Dams Travis , Giblin Mark , Williamson Francesca , Wright Curtis
Published: October 2023

Objectives

To increase diversity and inclusion in graduate medical education (GME), the Accreditation Council for Graduate Medical Education (ACGME) issued new diversity standards requiring programs to engage in practices that focus on systematic recruitment and retention of a diverse workforce of trainees and faculty. The literature on how program directors (PDs) can incorporate and prepare for this standard is limited.

Methods

We developed a diversity, equity, and inclusion (DEI) toolkit for PDs as an example of an institutional GME-led effort to promote inclusive recruitment and DEI awareness among residency and fellowship programs at a large academic center.

Results

A survey was sent to 80 PDs before the launch of the toolkit and 6 months afterwards with response rates of 27% (22/80) and 97% (78/80), respectively. At baseline, 45% (10/22) anticipated that the DEI toolkit might provide better resources than those currently available to them and 41% (9/22) perceived that the toolkit might improve recruitment outcomes. At 6 months, 63% (49/78) found the toolkit helpful in the 2021-2022 recruitment season. By contrast, 2% (2/78) of PDs did not find the toolkit helpful, and 33% (26/78) said they did not access the toolkit. When asked if a PD changed their program's recruitment practices because of the toolkit, 31% (24/78) responded yes. Programs that changed recruitment practices started to require unconscious bias training for all faculty and residents involved in the residency interviews and ranking. Others worked on creating a standardized scoring rubric for interviews focused on four main domains: Experiences, Attributes, Competencies, and Academic Metrics.

Conclusion

There is a need to support PDs in their DEI journey and their work to recruit a diverse workforce in medicine. Utilizing a DEI toolkit is one option to increase DEI knowledge, skills, awareness, and self-efficacy among PDs and can be adopted by other institutions and leaders in academic medicine.
Novel In-Training Evaluation Report in an Internal Medicine Residency Program: Improving the Quality of the Narrative Assessment
Authors: Gutierrez Marc , Wilson Kelsey , Bickford Brant , Yuhas Joseph , Markert Ronald , Burtson Kathryn M
Published: October 2023

OBJECTIVE

To determine whether incorporating our novel in-training evaluation report (ITER), which prompts each resident to list at least three self-identified learning goals, improved the quality of narrative assessments as measured by the Narrative Evaluation Quality Instrument (NEQI).

METHODS

A total of 1468 narrative assessments from a single institution from 2017 to 2021 were deidentified, compiled, and sorted into the pre-intervention form arm and post-intervention form arm. Due to limitations in our residency management suite, incorporating learning goals required switching from an electronic form to a hand-deliver form. Comments were graded by two research personnel utilizing the NEQI's scale of 0–12, with 12 representing the maximum quality for a comment. The outcome of the study was the mean difference in NEQI score between the electronic pre-intervention period and paper post-intervention period.

RESULTS

The mean NEQI score for the pre-intervention period was 2.43 ± 3.34, and the mean NEQI score for the post-intervention period was 3.31 ± 1.71, with a mean difference of 0.88 (p < 0.001). In the pre-intervention period, 46% of evaluations were submitted without a narrative assessment (scored as a zero) while 1% of post-intervention period evaluations had no narrative assessment. Internal consistency reliability, as measured by Ebel's intraclass correlation coefficient (ICC), showed high agreement between the two raters (ICC = 0.92).

CONCLUSIONS

Our findings suggest that implementing a timely, hand-delivered paper ITER that incorporates resident learning goals can lead to overall higher-quality narrative assessments.
Vested Interests and Implementational Issues of the Policy of Social Justice and Development in India: A Critical Review
Authors: Hantal Bhimasen
Published: October 2023

One of the main agendas of our freedom struggle was to have socio-economic freedom and equality for all irrespective of the caste, race, religion, sex or so on. Thus, ever since India got Independence and Constitution of India was enacted, the hopes and aspirations of the weaker sections increased manifold for socio-economic development, social freedom and social transformations. The Government of India too, inspired by the struggle for independence, attempted within its limited economic and other resources to ameliorate the destitute conditions of the downtrodden India, with various plans, schemes and programmes, apart from the socio-economic reservations. In this article, thus, an attempt is being made to examine the developmental process of India with references to the weaker sections such as Scheduled Tribes, Scheduled Castes and other backward classes. It is observed from various studies that despite some noble schemes and programmes, the plight of the weaker sections has not transformed into satisfactory levels mainly on account of the failure of implementation process. These issues are critically examined here in this small piece of article.
Determining minimum number of valid days for accurate estimation of sedentary behaviour and awake-time movement behaviours using the ActivPAL3 in nursing home residents
Authors: Farrés-Godayol Pau , Ruiz-Díaz Miguel Ángel , Dall Philippa , Skelton Dawn A. , Minobes-Molina Eduard , Jerez-Roig Javier , Giné-Garriga Maria
Published: October 2023

Introduction

Scarce evidence is available about the minimum number of valid days wearing the activPAL3 to obtain a precise estimate of sedentary behaviour (SB) and awake-time movement behaviours (ATMB) in nursing home (NH) residents. The study aimed to determine the minimum number of valid days required for accurately estimate SB and ATMB using the activPAL3 device in NH residents. It also investigated how the starting point of a day (the 24-h period) impacted reliability.

Methods

Participants wore an activPAL3 for 7 consecutive days. The data was classified in two-time blocks (00:00 Ante Meridiem (AM)—00:00 AM midnight vs 12:00 Post Meridiam (PM) -12:00 PM midday) and the sample was stratified into two groups according to their capacity to stand and walk, to examine if timing of sampling or physical functioning affected minimum wear time. SB, ATMB, sociodemographic, and health-related variables were collected. Sensitivity of the time-blocks were tested through the dispersion frequencies and differences between blocks through Kolmogorov–Smirnov test for normality; parametric variables through two-related means T-test and Wilcoxon test for non-parametric data. Reliability was assessed with the Cronbach's Alpha and the intra-class correlation coefficient (ICC), using a one-factor model estimating the reliability for each measurement day loading in the same latent factor.

Results

Ninety-five NH residents (81.1% women; age = 85.8 ± 7.2 years) were included. The midnight block had higher reliability, sensitivity and no statistically significant differences between days were found. At least three consecutive days of monitoring were necessary to achieve a reliability of ICC ≥ 0.8 for those NH residents able to stand and walk and six days for those unable.

Conclusions

NH residents who are able to stand and walk require a minimum of three consecutive days wearing the device, while those who are unable require at least six days due to their highly homogenous daily routines and sensitivity to PA events. Regardless of the activPAL3 recording start time, data processing should reference the midnight time block.
lncRNA Helf promotes hepatic inflammation and fibrosis by interacting with PTBP1 to facilitate PIK3R5 mRNA stabilization
Authors: Han Xiaohui , Guo Beichen , Zhao Sicong , Li Yehua , Zhu Jing , He Yifan , Wang Jiajun , Yao Qingbin , Shao Shuai , Zheng Lina , Shi Zhemin , Han Tao , Hong Wei , Zhang Kun
Published: October 2023

Background

Hepatic fibrosis is a common consequence of chronic liver diseases without approved antifibrotic therapies. Long noncoding RNAs (lncRNAs) play an important role in various pathophysiological processes. However, the functions of certain lncRNAs involved in mediating the antifibrotic role remain largely unclear.

Methods

The RNA level of lnc-High Expressed in Liver Fibrosis (Helf) was detected in both mouse and human fibrotic livers. Furthermore, lnc-Helf-silenced mice were treated with carbon tetrachloride (CCl4) or bile duct ligation (BDL) to investigate the function of lnc-Helf in liver fibrosis.

Results

We found that lnc-Helf has significantly higher expression in human and mouse fibrotic livers as well as M1 polarized hepatic macrophages (HMs) and activated hepatic stellate cells (HSCs). In vivo studies showed that silencing lnc-Helf by AAV8 vector alleviates CCl4- and BDL-induced hepatic inflammation and fibrosis. Furthermore, in vitro experiments revealed that lnc-Helf promotes HSCs activation and proliferation, as well as HMs M1 polarization and proliferation in the absence or presence of cytokine stimulation. Mechanistically, our data illustrated that lnc-Helf interacts with RNA binding protein PTBP1 to promote its interaction with PIK3R5 mRNA, resulting in increased stability and activating the AKT pathway, thus promoting HSCs and HMs activation and proliferation, which augments hepatic inflammation and fibrosis.

Conclusion

Our results unveil a lnc-Helf/PTBP1/PIK3R5/AKT feedforward, amplifying signaling that exacerbates the process of hepatic inflammation and fibrosis, thus providing a possible therapeutic strategy for hepatic fibrosis.
Identification and analysis of differentially expressed microRNAs in endometrium to explore the regulation of sheep fecundity
Authors: Dong Jihong , Jiang Xuecheng , Liu Nan , Li Hegang , Zhao Jinshan , He Jianning , Gao Xiaoxiao
Published: October 2023

Background

MicroRNAs (miRNAs) play an important regulatory role in mammalian reproduction. Currently, most studies are primarily concentrated on ovarian miRNAs, ignoring the influence of endometrial miRNAs on the fecundity of female sheep. To uncover potential regulators of sheep fecundity, RNA-seq was used to comparatively analyze miRNA expression profiles of endometrium between high prolificacy sheep (HP, litter size = 3) and low prolificacy sheep (LP, litter size = 1) withFecBgenotype.

Results

Firstly, genomic features of miRNAs from endometrium were analyzed. Furthermore, 58 differentially expressed (DE) miRNAs were found in the endometrium of Hu sheep with different litter size. A co-expression network of DE miRNAs and target genes has been constructed, and hub genes related litter size are included, such as DE miRNA unconservative_NC_019472.2_1229533 and unconservative_NC_019481.2_1637827 target to estrogen receptor α (ESR1) and unconservative_NC_019481.2_1637827 targets to transcription factor 7 (TCF7). Moreover, functional annotation analysis showed that the target genes (NRCAMandNEGR1) of the DE miRNAs were significantly enriched in cell adhesion molecules (CAMs) signaling pathway, which was related to uterine receptivity.

Conclusion

Taken together, this study provides a new valuable resource for understanding the molecular mechanisms underlying Hu sheep prolificacy.
Antimicrobial and anti-aflatoxigenic activities of nanoemulsions based on Achillea millefolium and Crocus sativus flower extracts as green promising agents for food preservatives
Authors: Abu Safe Feriala A. , Badr Ahmed N. , Shehata Mohamed G. , El-Sayyad Gharieb S.
Published: October 2023

Background

Although the mechanism of action of nanoemulsion is still unclear, the modern use of nanoemulsions made from natural extracts as antimicrobial and anti-aflatoxigenic agents represents a potential food preservation and a safety target.

Methods

Two natural nanoemulsion extracts of Crocus sativus (the saffron flower) and Achillea millefolium (the yarrow flower) were produced in the current study using a low-energy method that included carboxymethylcellulose and Arabic gum. The synthesized nanoemulsion was fully identified by different analytical methods. Detection of the volatile content was completed using GC-MS analysis. The antioxidant potential, and phenolic compounds content were analyzed in the extractions. The synthesized nanoemulsions were screened for their antimicrobial potential in addition to their anti-aflatoxigenic activity.

Results

The droplet size of Saffron flowers was finer (121.64 ± 2.18 nm) than yarrow flowers (151.21 ± 1.12 nm). The Zeta potential measurements of the yarrow flower (-16.31 ± 2.54 mV) and the saffron flower (-18.55 ± 2.31 mV) both showed high stability, along with low PDI values (0.34–0.41). The nanoemulsion of yarrow flower revealed 51 compounds using gas chromatography-mass spectrometry (GCMS), with hexanal (16.25%), β-Pinene (7.41%), β-Myrcene (5.24%), D-Limonene (5.58%) and Caryophyllene (4.38%) being the most prevalent. Additionally, 31 compounds were detected in the saffron nanoemulsion, with D-limonene (4.89%), isophorone (12.29%), 4-oxy isophorone (8.19%), and safranal (44.84%) being the most abundant. Compared to the nanoemulsion of the yarrow flower, the saffron nanoemulsion had good antibacterial and antifungal activity. Saffron nanoemulsion inhibited total fungal growth by 69.64–71.90% in a simulated liquid medium and demonstrated the most significant decrease in aflatoxin production. Infected strawberry fruits coated with nanoemulsion extracts exhibited high antimicrobial activity in the form of saffron flower and yarrow flower extract nanoemulsions, which inhibited and/or controlled the growth of Aspergillus fungi. Due to this inhibition, the lag phase was noticeably prolonged, the cell load decreased, and the stability time increased.

Conclusion

This study will contribute to expanding the theoretical research and utilization of nanoemulsions as green protective agents in agricultural and food industries for a promising protection from the invasion of some pathogenic bacteria and fungi.
Low cost maize stover biochar as an alternative to inorganic fertilizer for improvement of soil chemical properties, growth and yield of tomatoes on degraded soil of Northern Uganda
Authors: Wacal Cosmas , Basalirwa Daniel , Byalebeka John , Tsubo Mitsuri , Nishihara Eiji
Published: October 2023

Background

Soil fertility decline due to nutrient mining coupled with low inorganic fertilizer usage is a major cause of low crop yields across sub-Saharan Africa. Recently, biochar potential to improve soil fertility has gained significant attention but there are limited studies on the use of biochar as an alternative to inorganic fertilizers. In this study, we determined the effect of maize stover biochar without inorganic fertilizers on soil chemical properties, growth and yield of tomatoes (Solanum lycopersicum L.). A field experiment was conducted in 2022 for two consecutive seasons in Northern Uganda. The experiment included five treatments; inorganic fertilizer (control), biochar applied at rates of 3.5, 6.9, 13.8 and 27.6 t ha−1.

Results

In this study, maize stover biochar improved all the soil chemical properties. Compared to the control, pH significantly increased by 27% in the 27.6 t ha−1 while total N increased by 35.6% in the 13.8 t ha−1. Although P was significantly low in the 3.5 t ha−1, 6.9 t ha−1 and 13.8 t ha−1, it increased by 3.9% in the 27.6 t ha−1. Exchangeable K was significantly increased by 42.7% and 56.7% in the 13.8 t ha−1 and 27.6 t ha−1 respectively. Exchangeable Ca and Mg were also higher in the biochar treatment than the control. Results also showed that plant height, shoot weight, and all yield parameters were significantly higher in the inorganic fertilizer treatment than in the 3.5, 6.9, and 13.8 t ha−1 treatments. Interestingly, maize stover biochar at 27. 6 t ha−1 increased fruit yield by 16.1% compared to the control suggesting it could be used as an alternative to inorganic fertilizer.

Conclusions

Maize stover biochar applied at 27.6 t ha−1 improved soil chemical properties especially pH, N, P and K promoting growth and yield of tomatoes. Therefore, maize stover biochar could be recommended as an alternative to expensive inorganic fertilizers for tomato production in Northern Uganda.