bluuebunny/crossref_metadata_2025 huggingface dataset:
Patient safety attitudes of frontline healthcare workers in Lahore: A multicenter study
Authors: Akram Javed , Azhar Shehnoor , Khan Khalid Saeed , Aman Arifa
Published: November 2021

Objectives: To evaluate patient safety attitudes of the frontline health workers in hospitals of Lahore, Pakistan.

Methods: A self-administered Safety Attitudes Questionnaire (SAQ) survey was deployed in five hospitals across Lahore, Pakistan (July 2019 to June 2020). A total of 1250 consecutive consenting nurses and postgraduate trainee physicians of under five years working experience were recruited. Assessment for each of the six subdomains (teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, working conditions) was done on a 0-100 scale. Multivariate analyses examined their relationship with job cadre (nurses and physicians), duration of respondents’ work experience (< 2 years, 3 - 4 years, > 4 years), and hospital sector (private and public).

Results: The response rate was 97% (1212 individuals; 765 nurses, 447 physicians). Nurses scored less than physicians in teamwork climate (-2.4, 95% CI -4.5 – -0.2, p=0.02) and stress recognition (-10.6, 95% CI -13.5 – -7.7, p<0.001), but more in perception of management (4.2, 95% CI 1.5 – 6.8, p=0.002) and working conditions (3.4, 95% CI 0.66 – 6.2, p=0.01). Increasing work experience was related to greater scores in all subdomains. Private hospitals scored generally higher than public ones.

Conclusion: Duration of job experience was positively correlated with patient safety attitudes of hospital staff. These finding could serve as the baseline to shape staff perceptions by cadre in both public and private sector hospitals.

doi: https://doi.org/10.12669/pjms.38.1.4964

How to cite this:Arkam J, Azhar S, Khan KS, Aman A. Patient safety attitudes of frontline healthcare workers in Lahore: A multicenter study. Pak J Med Sci. 2022;38(1):40-46. doi: https://doi.org/10.12669/pjms.38.1.4964

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
MUC4 is not expressed in cell lines used for live cell imaging
Authors: Athmane Naouel , Williamson Iain , Boyle Shelagh , Biddie Simon C. , Bickmore Wendy A.
Published: November 2021

Background: The ability to visualise specific mammalian gene loci in living cells is important for understanding the dynamic processes linked to transcription. However, some of the tools used to target mammalian genes for live cell imaging, such as dCas9, have been reported to themselves impede processes linked to transcription. The MUC4 gene is a popular target for live cell imaging studies due to the repetitive nature of sequences within some exons of this gene.

Methods: We set out to compare the impact of dCas9 and TALE-based imaging tools on MUC4 expression, including in human cell lines previously reported as expressing MUC4.

Results: We were unable to detect MUC4 mRNA in these cell lines. Moreover, analysis of publicly available data for histone modifications associated with transcription, and data for transcription itself, indicate that neither MUC4, nor any of the mucin gene family are significantly expressed in the cell lines where dCas9 targeting has been reported to repress MUC4 and MUC1 expression, or in the cell lines where dCas13 has been used to report MUC4 RNA detection in live cells.

Conclusions: Methods for visualising specific gene loci and gene transcripts in live human cells are very challenging. Our data suggest that care should be given to the choice of the most appropriate cell lines for these analyses and that orthogonal methods of assaying gene expression be carefully compared.
Engineering Social Learning: Information Design of Time-Locked Sales Campaigns for Online Platforms
Authors: Küçükgül Can , Özer Özalp , Wang Shouqiang
Published: November 2021

Many online platforms offer time-locked sales campaigns, whereby products are sold at fixed prices for prespecified lengths of time. Platforms often display some information about previous customers’ purchase decisions during campaigns. Using a dynamic Bayesian persuasion framework, we study how a revenue-maximizing platform should optimize its information policy for such a setting. We reformulate the platform’s problem equivalently by reducing the dimensionality of its message space and proprietary history. Specifically, three messages suffice: a neutral recommendation that induces a customer to make her purchase decision according to her private signal about the product and a positive (respectively (resp.), negative) recommendation that induces her to purchase (resp., not purchase) by ignoring her signal. The platform’s proprietary history can be represented by the net purchase position, a single-dimensional summary statistic that computes the cumulative difference between purchases and nonpurchases made by customers having received the neutral recommendation. Subsequently, we establish structural properties of the optimal policy and uncover the platform’s fundamental trade-off: long-term information (and revenue) generation versus short-term revenue extraction. Further, we propose and optimize over a class of heuristic policies. The optimal heuristic policy provides only neutral recommendations up to a cutoff customer and provides only positive or negative recommendations afterward, with the recommendation being positive if and only if the net purchase position after the cutoff customer exceeds a threshold. This policy is easy to implement and numerically shown to perform well. Finally, we demonstrate the generality of our methodology and the robustness of our findings by relaxing some informational assumptions.

This paper was accepted by Gabriel Weintraub, revenue management and market analytics.
Manufacturing Process Innovation in the Pharmaceutical Industry
Authors: Lugovoi Ivan , Andritsos Dimitrios A. , Senot Claire
Published: November 2021

Problem definition: Process innovation is commonly claimed to be a major source of competitive advantage for firms. Despite this perceived influence, it has received substantially less attention than product innovation, and much uncertainty remains about its true association with firm performance. We investigate the relationship between a pharmaceutical firm’s portfolio of manufacturing process innovations and its economic performance. Academic/practical relevance: We uniquely conduct a multidimensional evaluation of a firm’s portfolio of manufacturing process innovations at the product level. This allows a quantitative evaluation of both the relative benefit of the different dimensions of a portfolio as well as the potential complementarities between these in different technological landscapes. Methodology: Through a collaboration with expert patent attorneys, we develop a unique longitudinal data set that combines secondary data and evaluations of a firm’s portfolio of process patents along two key dimensions: novelty and scope. We conduct econometric analyses for a large-scale sample of active pharmaceutical ingredients (APIs) whose product patents have expired and for which process innovation is thus the main source of competitive advantage. Results: We find a positive association between the presence of manufacturing process innovation and firm performance. However, although portfolio’s scope appears to always be beneficial to performance, the effect of novelty alone depends on the ruggedness of the technological landscape: negative in smoother landscapes and positive in more rugged landscapes. Results further suggest that novelty and scope of a portfolio of process innovations are complementary across technological landscapes. Managerial implications: Our results provide important practical insights that can inform the organization and execution of the research and development process across high-technology industries. In particular, although process innovations can be economically beneficial, investing in high-novelty process innovations without a corresponding high scope could jeopardize payoffs, especially in technological landscapes that are relatively smooth.
Parental leave across the world: How does it compare?
Authors: Roberts Delilah Kealy
Published: November 2021

While many countries still have traditional gender roles, with mothers entitled to more time on leave than fathers, some are challenging this norm. Are parenting roles across the world evolving?
Exploring the lived experiences of mothers who identify with ‘gender disappointment’
Authors: Young Nina , Hallam Jenny , Jackson Jessica , Barnes Christopher , Montague Jane
Published: November 2021

In a western context, little is known about the term ‘gender disappointment’, which describes feelings of despair around not having a child of the desired sex. This study aimed to explore the lived experiences of British women who identify with the concept. Six mothers with only sons, who also desired a daughter, participated in a semi-structured interview via an online platform. An interpretative phenomenological analysis identified themes related to pity, societal expectations of unfulfillment, and concerns relating to the future mother-son relationship, feelings of guilt and shame, barriers to seeking help and the benefits of talking. The study concludes that there is a need for greater awareness of gender disappointment and the negative impact it has on maternal wellbeing. In addition, mothers who identify with gender disappointment would benefit from support from health visitors to enable them to access the help they need.
The influence of the health visitor
Authors: Oldman Crystal
Published: November 2021

Crystal Oldman discusses why health visitors need to be able to tell their stories in a way that demonstrates their knowledge and skills, and the real impact they have on the communities they serve
Development and Testing of a Cam Disc Comb-Type Picking Machine for Chrysanthemum (Dendranthema morifolium Ramat. Tzvelev)
Authors: Wang Rongyan , Zheng Zhian , Gao Lei , Chen Andi , Wang Shanyu , Xu Yiyao
Published: November 2021

Highlights

A practical cam disc comb-type chrysanthemum picking machine was developed.

A three-dimensional model of the picking machine was designed in SolidWorks.

The working principle and motion trajectory of the picking comb teeth were analyzed.

The best working parameters of the picking machine were obtained with field tests.

Abstract. Aiming at the problems of labor, picking efficiency, and mechanization, a small practical cam disc comb-type chrysanthemum picking machine was designed. The picking machine, mainly composed of a wheeled frame, power transmission system, cam disc, picking comb, and cleaning comb sleeve, uses the pulling force of comb teeth to pick chrysanthemum flowers. The comb teeth rotate on a central shaft, and their swing angle is determined by a groove on the cam disc. One rotation of the comb teeth completes the process of picking, lifting, and unloading. In this study, the parameters of the cam profile were designed using an analytical method. To ensure reliability of the components, the trajectory of the comb teeth and their structure and motion parameters were analyzed, and the conditions for picking chrysanthemums were determined. The physical parameters of chrysanthemum plants were measured, and a prototype picking machine was built. Field tests were conducted using the comb rotational speed, comb teeth spacing, and comb working depth as the test factors and the picking rate, impurity rate, breakage rate, and drop rate as the evaluation indexes. The effects of each factor and the interaction of any two factors on the picking effectiveness were obtained. The test results suggested that the most effective harvesting was achieved when the comb rotational speed was 40 rpm, the comb teeth spacing was 8 mm, and the comb working depth was 200 mm. With these parameters, the picking rate was 93.28%, the breakage rate was 1.21%, the impurity rate was 8.38%, and the drop rate was 6.61%. The prototype machine achieved good picking effectiveness, and this study provides a technical foundation for the realization of mechanized chrysanthemum harvesting. Keywords: Cam, Chrysanthemum, Comb teeth, Motion track, Picking machine.
Interferometric orbital angular momentum mode detection in turbulence with deep learning
Authors: Cox Mitchell A. , Celik Turgay , Genga Yuval , Drozdov Alice V.
Published: November 2021

Orbital angular momentum (OAM) modes are topical due to their versatility, and they have been used in several applications including free-space optical communication systems. The classification of OAM modes is a common requirement, and there are several methods available for this. One such method makes use of deep learning, specifically convolutional neural networks, which distinguishes between modes using their intensities. However, OAM mode intensities are very similar if they have the same radius or if they have opposite topological charges, and as such, intensity-only approaches cannot be used exclusively for individual modes. Since the phase of each OAM mode is unique, deep learning can be used in conjugation with interferometry to distinguish between different modes. In this paper, we demonstrate a very high classification accuracy of a range of OAM modes in turbulence using a shear interferometer, which crucially removes the requirement of a reference beam. For comparison, we show only marginally higher accuracy with a more conventional Mach–Zehnder interferometer, making the technique a promising candidate towards real-time, low-cost modal decomposition in turbulence.
Thank you: editorial
Authors: Carney P. Scott
Published: November 2021

Editor-in-Chief P. Scott Carney offers a closing editorial at the end of his term.
Non-reciprocal optical transmission in cavity optomagnonics
Authors: Ren Ya-long , Ma Sheng-li , Xie Ji-kun , Li Xin-ke , Li Fu-li
Published: November 2021

We study the non-reciprocal optical transmission in a cavity optomagnonic system, where a ferromagnetic sphere can support both the whispering gallery modes (WGMs) for photons and the magnetostatic modes for magnons. Our scheme is based on the non-reciprocal Brillouin light scattering, where the WGMs are unidirectionally coupled to the Kittel mode with a nonzero z component of the total angular momentum. We show that a weak probe field can be transmitted or amplified in a given propagation direction, but completely absorbed in the opposite direction. The present work may provide an alternative method for the development of chiral optical devices.
Surface finishing method based on laser re-melting using a cone annular beam for additive manufacturing
Authors: Wan Le , Zou Yibo , Shi Shihong , Tao Wenfei , Ju Yusheng
Published: November 2021

In this paper, a novel surface finishing method of cone annular beam laser re-melting (CALR) is proposed which aims at optimizing the side surface quality of AlSi10Mg parts produced by directed energy deposition. Meanwhile, a feature-based characterization method was conducted to realize the multiscale analysis of the topographic features. The results show that the developed CALR is a powerful tool which can greatly reduce the surface roughness: the final optimal aluminum alloy thin-walled parts with a roughness of 7.1 µm was obtained, which was 68.3% less than the original roughness of 22.4 µm without the implementation of CALR. The optimization mechanism reveals the roughness reduction was mainly attributed to the elimination of the stair-step effect, while the role of powder particle features was much less significant on roughness reduction of the overall surface. The CALR method together with the feature-based surface characterization provides an innovative solution for side surface quality optimization for laser additive manufacturing.
Deep-learning-based time–frequency domain signal recovery for fiber-connected radar networks
Authors: Zhou Yuewen , Zhang Fangzheng , Pan Shilong
Published: November 2021

A deep-learning-based time–frequency domain signal recovery method is proposed to deal with the signal distortion in fiber-connected radar networks. In this method, the deteriorated signal is converted to the time–frequency domain, and a two-dimensional convolutional neural network is used to conduct signal recovery before inverse conversion to the time domain. This method can achieve high-accuracy signal recovery by learning the complete features in both time and frequency domains. In the experiment, distorted linear frequency modulated radar signals with a bandwidth of 2 GHz after 8-km fiber transmission are recovered with the noise effectively suppressed. The proposed signal recovery method works well under different input signal-to-noise ratios. Specially, the average peak to floor ratio after radar pulse compression is improved by 25.5 dB. In addition, the method is proved to be able to recover radar signals of multiple targets.
Attractive internuclear force drives the collective behavior of nuclear arrays in Drosophila embryos
Authors: Wu Xiaoxuan , Kong Kakit , Xiao Wenlei , Liu Feng
Published: November 2021

The collective behavior of the nuclear array in Drosophila embryos during nuclear cycle (NC) 11 to NC14 is crucial in controlling cell size, establishing developmental patterns, and coordinating morphogenesis. After live imaging on Drosophila embryos with light sheet microscopy, we extract the nuclear trajectory, speed, and internuclear distance with an automatic nuclear tracing method. We find that the nuclear speed shows a period of standing waves along the anterior-posterior (AP) axis after each metaphase as the nuclei collectively migrate towards the embryo poles and partially move back. And the maximum nuclear speed dampens by 28-45% in the second half of the standing wave. Moreover, the nuclear density is 22–42% lower in the pole region than the middle of the embryo during the interphase of NC12-14. To find mechanical rules controlling the collective motion and packing patterns of the nuclear array, we use a deep neural network (DNN) to learn the underlying force field from data. We apply the learned spatiotemporal attractive force field in the simulations with a particle-based model. And the simulations recapitulate nearly all the observed characteristic collective behaviors of nuclear arrays in Drosophila embryos.
Control of tissue homeostasis, tumorigenesis, and degeneration by coupled bidirectional bistable switches
Authors: Barra Avila Diego , Melendez-Alvarez Juan R. , Tian Xiao-Jun
Published: November 2021

The Hippo-YAP/TAZ signaling pathway plays a critical role in tissue homeostasis, tumorigenesis, and degeneration disorders. The regulation of YAP/TAZ levels is controlled by a complex regulatory network, where several feedback loops have been identified. However, it remains elusive how these feedback loops contain the YAP/TAZ levels and maintain the system in a healthy physiological state or trap the system in pathological conditions. Here, a mathematical model was developed to represent the YAP/TAZ regulatory network. Through theoretical analyses, three distinct states that designate the one physiological and two pathological outcomes were found. The transition from the physiological state to the two pathological states is mechanistically controlled by coupled bidirectional bistable switches, which are robust to parametric variation and stochastic fluctuations at the molecular level. This work provides a mechanistic understanding of the regulation and dysregulation of YAP/TAZ levels in tissue state transitions.
Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania
Authors: Wolle Meraf A. , Muñoz Beatriz E. , Naufal Fahd , Kashaf Michael Saheb , Mkocha Harran , West Sheila K.
Published: November 2021

Background

Trachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. Trachoma has been targeted for elimination as a public health problem which includes reducing trachomatous inflammation—follicular prevalence in children and reducing trachomatous trichiasis prevalence in adults. The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. Few studies to date have evaluated the progression of trachomatous scarring in communities that have recently transitioned to a low trachomatous inflammation—follicular prevalence.

Methodology/Principal findings

Women aged 15 and older were randomly selected from households in 48 communities within Kongwa district, Tanzania and followed over 3.5 years for this longitudinal study. Trachomatous inflammation—follicular prevalence was 5% at baseline and at follow-up in children aged 1–9 in Kongwa, Tanzania. 1018 women aged 15 and older had trachomatous scarring at baseline and were at risk for trachomatous scarring progression; 691 (68%) completed follow-up assessments. Photographs of the upper tarsal conjunctiva were obtained at baseline and follow-up and graded for trachomatous scarring using a previously published four-step severity scale. The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6–39.1). The odds of TS progression increased with an increase in age in women younger than 50, (OR 1.03, 95% CI 1.01–1.05, p = 0.005) as well as an increase in the household poverty index (OR 1.29, 95% CI 1.13–1.48, p = 0.0002).

Conclusions/Significance

The 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence. This suggests that the drivers of scarring progression are likely not related to on-going trachoma transmission in this district.
Exploring the provision and motives behind the adoption of health-promotion programmes in professional football clubs across four European countries
Authors: Røynesdal Øystein B. , van Nassau Femke , Chng Nai Rui , Pereira Hugo , Andersen Eivind , Bunn Christopher , Jelsma Judith G. M. , Nijhuis-van der Sanden Maria W. G. , Roberts Glyn C. , Sørensen Marit , van de Glind Irene , van Actherberg Theo , Gray Cindy M.
Published: November 2021

This study mapped existing health-promotion provisions targeting adults in professional football clubs across England, the Netherlands, Norway, and Portugal, and explored motives behind the clubs’ adoption of the European Fans in Training (EuroFIT) programme. We surveyed top-tier football clubs in the four countries and interviewed representatives from football clubs and the clubs’ charitable foundation who delivered EuroFIT. The findings showed large between-country differences, with football clubs in England reporting far greater healthy lifestyle provision than other countries. Relatively few health-promotion programmes targeted adults, particularly in the Netherlands, Portugal, and Norway. Club representatives reported that the motives for adopting the EuroFIT programme often involved adhering to both the social objectives of the football club or club’s foundation and business-related objectives. They viewed the scientific evidence and evaluation underpinning EuroFIT as helpful in demonstrating the value and potential future impact of both the programme and the clubs’ wider corporate social responsibility provision.
Porcine reproductive and respiratory syndrome virus 2 (PRRSV-2) genetic diversity and occurrence of wild type and vaccine-like strains in the United States swine industry
Authors: Kikuti Mariana , Sanhueza Juan , Vilalta Carles , Paploski Igor Adolfo Dexheimer , VanderWaal Kimberly , Corzo Cesar A.
Published: November 2021

Porcine reproductive and respiratory syndrome virus genotype 2 (PRRSV-2) genetic diversity in the U.S. was assessed using a database comprising 10 years’ worth of sequence data obtained from swine production systems routine monitoring and outbreak investigations. A total of 26,831 ORF5 PRRSV-2 sequences from 34 production systems were included in this analysis. Within group mean genetic distance (i.e. mean proportion of nucleotide differences within ORF5) per year according to herd type was calculated for all PRRSV-2 sequences. The percent nucleotide difference between each sequence and the ORF5 sequences from four commercially available PRRSV-2 vaccines (Ingelvac PRRS MLV, Ingelvac PRRS ATP, Fostera PRRS, and Prevacent PRRS) within the same lineage over time was used to classify sequences in wild-type or vaccine-like. The mean ORF5 genetic distance fluctuated from 0.09 to 0.13, being generally smaller in years in which there was a relative higher frequency of dominant lineage. Vaccine-like sequences comprised about one fourth of sequences obtained through routine monitoring of PRRS. We found that lineage 5 sequences were mostly Ingelvac PRRS MLV-like. Lineage 8 sequences up to 2011 were 62.9% Ingelvac PRRS ATP-like while the remaining were wild-type viruses. From 2012 onwards, 51.9% of lineage 8 sequences were Ingelvac PRRS ATP-like, 45.0% were Fostera PRRS-like, and only 3.2% were wild-type. For lineage 1 sequences, 0.1% and 1.7% of the sequences were Prevacent PRRS-like in 2009–2018 and 2019, respectively. These results suggest that repeated introductions of vaccine-like viruses through use of modified live vaccines might decrease within-lineage viral diversity as vaccine-like strains become more prevalent. Overall, this compilation of private data from routine monitoring provides valuable information on PRRSV viral diversity.
Using a One Health approach to prioritize zoonotic diseases in China, 2019
Authors: Wang Xin , Rainey Jeanette J. , Goryoka Grace W. , Liang Zuoru , Wu Shuyu , Wen Liming , Duan Ran , Qin Shuai , Huang Haodi , Kharod Grishma , Rao Carol Y. , Salyer Stephanie J. , Behravesh Casey Barton , Jing Huaiqi
Published: November 2021

Background

China is vulnerable to zoonotic disease transmission due to a large agricultural work force, sizable domestic livestock population, and a highly biodiverse ecology. To better address this threat, representatives from the human, animal, and environmental health sectors in China held a One Health Zoonotic Disease Prioritization (OHZDP) workshop in May 2019 to develop a list of priority zoonotic diseases for multisectoral, One Health collaboration.

Methods

Representatives used the OHZDP Process, developed by the US Centers for Disease Control and Prevention (US CDC), to prioritize zoonotic diseases for China. Representatives defined the criteria used for prioritization and determined questions and weights for each individual criterion. A review of English and Chinese literature was conducted prior to the workshop to collect disease specific information on prevalence, morbidity, mortality, and Disability-Adjusted Life Years (DALYs) from China and the Western Pacific Region for zoonotic diseases considered for prioritization.

Results

Thirty zoonotic diseases were evaluated for prioritization. Criteria selected included: 1) disease hazard/severity (case fatality rate) in humans, 2) epidemic scale and intensity (in humans and animals) in China, 3) economic impact, 4) prevention and control, and 5) social impact. Disease specific information was obtained from 792 articles (637 in English and 155 in Chinese) and subject matter experts for the prioritization process. Following discussion of the OHZDP Tool output among disease experts, five priority zoonotic diseases were identified for China: avian influenza, echinococcosis, rabies, plague, and brucellosis.

Conclusion

Representatives agreed on a list of five priority zoonotic diseases that can serve as a foundation to strengthen One Health collaboration for disease prevention and control in China; this list was developed prior to the emergence of SARS-CoV-2 and the COVID-19 pandemic. Next steps focused on establishing a multisectoral, One Health coordination mechanism, improving multisectoral linkages in laboratory testing and surveillance platforms, creating multisectoral preparedness and response plans, and increasing workforce capacity.
The role of the immunoescape in colorectal cancer liver metastasis
Authors: Takasu Chie , Yamashita Shoko , Morine Yuji , Yoshikawa Kozo , Tokunaga Takuya , Nishi Masaaki , Kashihara Hideya , Yoshimoto Toshiaki , Shimada Mitsuo
Published: November 2021

The expression of programmed death 1 (PD-1) and programmed death-ligand 1 (PD-L1) indicate the efficacy of anti-PD-1/PD-L1 therapy in colorectal cancer (CRC), but are less useful for monitoring the efficacy of therapy of CRC liver metastasis (CRLM). This study investigated the effects of immune molecules on the prognosis of CRLM. We enrolled 71 patients with CRLM who underwent curative resection for CRC. We used immunohistochemistry to analyze the expression of PD-1, PD-L1, indoleamine-pyrrole 2,3-dioxygenase (IDO), and CD163 (a marker of tumor-associated macrophages [TAMs]) in metastatic tumors. The immune molecules PD-1, PD-L1, IDO, and TAMs were expressed in 32.3%, 47.8%, 45.0%, and 47.9% of metastatic CRC samples, respectively. The 5-year overall survival rates associated with immune molecule-positive groups were significantly better than in the negative groups (PD-1: 87.7% vs 53.2%, p = 0.023; PD-L1: 82.4% vs 42.3%, p = 0.007; IDO: 80.7% vs 43.5%, p = 0.007; TAMs: 82.6% vs 48.0%, p = 0.005). Multivariate analysis revealed PD-1 expression (p = 0.032, hazard ratio: 0.19), IDO expression (p = 0.049, hazard ratio: 0.37), and tumor differentiation (p<0.001, hazard ratio: 0.02) as independent prognostic indicators. PD-1 and TAMs in metastases were associated with less aggressive features such as smaller tumors. Furthermore, TAMs positively and significantly correlated with PD-1 expression (p = 0.011), PD-L1 expression (p = 0.024), and tended to correlate with IDO expression (p = 0.078). PD-1, PD-L1, IDO, and TAMs in CRLM were associated with less aggressive features and better prognosis of patients with CRC, indicating adaptive antitumor immunity vs immune tolerance. These molecules may therefore serve as prognostic markers for CRLM.
Iota-carrageenan and xylitol inhibit SARS-CoV-2 in Vero cell culture
Authors: Bansal Shruti , Jonsson Colleen B. , Taylor Shannon L. , Figueroa Juan Manuel , Dugour Andrea Vanesa , Palacios Carlos , Vega Julio César
Published: November 2021

Last year observed a global pandemic caused by SARS-CoV-2 (severe acute respiratory syndrome-coronavirus 2) infection affecting millions of individuals worldwide. There is an urgent unmet need to provide an easily producible and affordable medicine to prevent transmission and provide early treatment for this disease. Since the nasal cavity and the rhinopharynx are the sites of initial replication of SARS-CoV-2, a nasal spray may be an effective option to target SARS-CoV-2 infection. In this study, we tested the antiviral action of three candidate nasal spray formulations against SARS-CoV-2in vitro. We determined that iota-carrageenan in concentrations as low as 6 μg/mL inhibits SARS-CoV-2in vitro. The concentrations of iota-carrageenan with activity against SARS-CoV-2in vitromay be easily achieved through the application of nasal sprays as commonly used in several countries. Recently a double-blind, placebo-controlled study showed that iota-carrageenan in isotonic sodium chloride reduces ca. five times the risk of infection by SARS-CoV-2 in health care personnel. Further, xylitol at a concentration of 50 mg/mL (ca. 329 mM) was found to exert some antiviral action, though this preliminary finding needs further confirmation.
Impact of clinical supervision on healthcare organisational outcomes: A mixed methods systematic review
Authors: Martin Priya , Lizarondo Lucylynn , Kumar Saravana , Snowdon David
Published: November 2021

Objective

To review the impact of clinical supervision of post-registration/qualification healthcare professionals on healthcare organisational outcomes.

Background

Clinical supervision is a professional support mechanism that benefits patients, healthcare professionals and healthcare organisations. Whilst evidence is growing on the impact of clinical supervision on patient and healthcare professional outcomes, the evidence base for the impact of clinical supervision on organisational outcomes remains weak.

Methods

This review used a convergent segregated approach to synthesise and integrate quantitative and qualitative research findings, as per the Joanna Briggs Institute’s recommendations for mixed methods systematic reviews. Databases searched included CINAHL, Embase, PubMed, PschINFO, and Scopus. Whilst a narrative synthesis was performed to present the findings of the quantitative and qualitative studies, the evidence from both quantitative and qualitative studies was subsequently integrated for a combined presentation. The review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Results

Thirty-two studies including 27 quantitative, two qualitative and three mixed methods studies, were included in the review. The results of the quantitative analysis showed that effective clinical supervision was associated with lower burnout and greater staff retention, and effective supervisor was associated with lower burnout and greater job satisfaction. Qualitative findings showed that healthcare professionals believed that adequate clinical supervision could mitigate the risk of burnout, facilitate staff retention, and improve the work environment, while inadequate clinical supervision can lead to stress and burnout. The evidence from quantitative and qualitative studies were complementary of each other.

Conclusion

Clinical supervision can have a variable effect on healthcare organisational outcomes. The direction of this effect appears to be influenced by the effectiveness of both the clinical supervision provided and that of the clinical supervisor. This highlights the need for organisations to invest in high quality supervision practices if maximal gains from clinical supervision are to be attained.
The importance of motivation in selecting undergraduate medical students for extracurricular research programmes
Authors: Ommering Belinda W. C. , Van Blankenstein Floris M. , van Diepen Merel , Gruis Nelleke A. , Kool Ada , Dekker Friedo W.
Published: November 2021

Introduction

Extracurricular research programmes (ERPs) may contribute to reducing the current shortage in physician-scientists, but usually select students based on grades only. The question arises if students should be selected based on their motivation, regardless of their previous academic performance. Focusing on grades and lacking to take motivation into account when selecting students for ERPs might exclude an important target group when aiming to cultivate future physician-scientists. Therefore, this study compared ERP students with lower and higher previous academic performance on subsequent academic performance, ERP performance, and motivational factors.

Methods

Prospective cohort study with undergraduate medical students who filled in a yearly questionnaire on motivational factors. Two student groups participating in an ERP were compared: students with first-year grade point average (GPA) ≥7 versus <7 on a 10-point grading scale. Linear and logistic regressions analyses were used to compare groups on subsequent academic performance (i.e. third-year GPA, in-time bachelor completion), ERP performance (i.e. drop-out, number of credits), and motivational factors (i.e. intrinsic motivation for research, research self-efficacy beliefs, perceptions of research, curiosity), while adjusting for gender and motivational factors at baseline.

Results

The <7 group had significantly lower third-year GPA, and significantly higher odds for ERP drop-out than the ≥7 group. However, there was no significant between-group difference on in-time bachelor completion and the <7 group was not inferior to the ≥7 group in terms of intrinsic motivation for research, perceptions of research, and curiosity.

Conclusions

Since intrinsic motivation for research, perceptions of research, and curiosity are prerequisites of future research involvement, it seems beneficial to focus on motivation when selecting students for ERPS, allowing students with lower current academic performance to participate in ERPs as well.
Analysis of the mandibular canal course using unsupervised machine learning algorithm
Authors: Kim Young Hyun , Jeon Kug Jin , Lee Chena , Choi Yoon Joo , Jung Hoi-In , Han Sang-Sun
Published: November 2021

Objectives

Anatomical structure classification is necessary task in medical field, but the inevitable variability of interpretation among experts makes reliable classification difficult. This study aims to introduce cluster analysis, unsupervised machine learning method, for classification of three-dimensional (3D) mandibular canal (MC) courses, and to visualize standard MC courses derived from cluster analysis in the Korean population.

Materials and methods

A total of 429 cone-beam computed tomography images were used. Four sites in the mandible were selected for the measurement of the MC course and four parameters, two vertical and two horizontal parameters were measured per site. Cluster analysis was carried out as follows: parameter measurement, parameter normalization, cluster tendency evaluation, optimal number of clusters determination, and k-means cluster analysis. The 3D MC courses were classified into three types with statistically significant mean differences by cluster analysis.

Results

Cluster 1 showed a smooth line running towards the lingual side in the axial view and a steep slope in the sagittal view. Cluster 2 ran in an almost straight line closest to the lingual and inferior border of mandible. Cluster 3 showed the pathway with a bent buccally in the axial view and an increasing slope in the sagittal view in the posterior area. Cluster 2 showed the highest distribution (42.1%), and males were more widely distributed (57.1%) than the females (42.9%). Cluster 3 comprised similar ratio of male and female cases and accounted for 31.9% of the total distribution. Cluster 1 had the least distribution (26.0%) Distributions of the right and left sides did not show a statistically significant difference.

Conclusion

The MC courses were automatically classified as three types through cluster analysis. Cluster analysis enables the unbiased classification of the anatomical structures by reducing observer variability and can present representative standard information for each classified group.
Management practice, quality of life and associated factors in psoriasis patients attending a dermatological center in Ethiopia
Authors: Kumsa Seefu Megarsa , Tadesse Tamrat Assefa , Woldu Minyahil Alebachew
Published: November 2021

Background

Psoriasis is a chronic inflammatory disease characterized by keratinocyte hyperproliferation and aberrant differentiation with great negative impact on patients’ quality of life (QoL). This study aimed at assessing factors influencing management practice, and QoL and its associated factors among ambulatory psoriatic patients visiting All Africa Leprosy, Tuberculosis and Rehabilitation Training (ALERT) Center in Addis Ababa, Ethiopia.

Materials and methods

A cross sectional study was conducted in 207 patients with psoriasis attending the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Data were collected using structured questionnaire and patients’ chart review. Dermatology Life Quality Index (DLQI) was used to measure patients’ QoL. Patients’ characteristics were summarized using descriptive statistics and predictors of QoL were identified by binary logistic regression.

Results

Among 207 study participants, 122 (58.9%) were females. The mean age of the study population was 37.92 (SD = 14.86) years (ranging from 16 to 68 years). The mean age at which diagnosis of psoriasis made was 32 (SD = 13.7) years ranging from 10 to 62 years. The duration of the disease in 112 (54.1%) patients were more than or equal to 5 years. Majority of study participants 145 (70.0%) had plaque psoriasis followed by sebopsoriasis, 24 (11.6%). The majority of plaque psoriasis (80%) cases were managed by topical corticosteroids with or without salicylic acid or coal tar and only 21 (14.5%) treated by methotrexate alone. The mean DLQI was 6.25 corresponding to a moderate effect. Symptoms and feelings were the most affected domains of QoL. Factors associated with poor QoL were female [AOR = 0.17 (95%CI: 0.06, 0.48)], low, above average and high family income ([AOR = 0.12 (95% CI: 0.02, 0.56)], [AOR = 0.06 (95% CI:0.01, 0.32)], and [AOR = 0.03 (95% CI: 0.01, 0.22)]), respectively, and primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)] while being on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] was predictor of better QoL. Poor QoL was predominant in females [AOR = 0.17 (95%CI: 0.06, 0.48)], low income [AOR = 0.12 (95% CI: 0.02, 0.56] patients, and patients with primary education level [AOR = 0.14 (95% CI: 0.03, 0.64)]. Patients on systemic therapy [AOR = 4.26 (CI: 1.18, 15.35)] had good QoL.

Conclusion

Our study identified that topical corticosteroids were the mainstay of psoriasis treatment in the dermatology clinic of ALERT Center in Addis Ababa, Ethiopia. Moderate effect QoL was achieved by study participants based on DLQL score.
Development and validation of a scale to evaluate students’ future impact perception related to the coronavirus pandemic (C-19FIPS)
Authors: Cardella Giuseppina Maria , Hernández-Sánchez Brizeida Raquel , Sánchez-García José Carlos
Published: November 2021

During the outbreak of the novel COVID-19 pandemic, economies around the world underwent unprecedented changes, which negatively limited young people’s perceptions of their future. The study aims to describe the development and validation of the 10-item COVID-19 Future Impact Perception Scale (C-19FIPS), a measurement tool to assess future impact perception related to COVID-19, among university students. Inductive and deductive approaches were used at the phase of the scale development process. Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA) applying two different SEM based analytical methods, covariance-based SEM (CB-SEM) and variance based SEM (PLS-SEM) were used to explore and predict the data. The EFA output generated two dimensions with 10 items. The dimensions are Personal Perception (C-19 PF) and Country Perception (C-19 CF) that reflects the notion of Future Impact Perception related to COVID-19. The result of the CFA confirmed the EFA result. Based on the reliability and validity check results, it is apparent that the scale demonstrates good psychometric properties. Evidence was also provided for convergent and discriminant validity. The study provided a short, valid and reliable measure to assess the impact of the COVID-19 pandemic on college students’ future perceptions. Knowing how external situations influence the world of young people is useful for the development of targeted interventions that favor their well-being and that can support them in situations perceived as uncertain and risky. Limitations and future lines are discussed.
Genetic variations of CYP2R1 (rs10741657) in Bangladeshi adults with low serum 25(OH)D level—A pilot study
Authors: Rahman Kazi Lutfar , Akhter Qazi Shamima , Rahman Md. Sayedur , Rahman Ridwana , Rahman (Sami) Samina , Mukta Farzana Yeasmin , Sarker Sudipta
Published: November 2021

Background

Some studies revealed that despite having sufficient sun exposure and dietary supply, the level of serum 25(OH)D in Bangladeshi adults is lower than its normal range. Genetic pattern of an individual is also an essential factor that regulates the level of serum 25(OH)D. However, the genetic variations of CYP2R1 (rs10741657) and their association with low serum 25(OH)D level in Bangladeshi adults are yet to be explored.

Objective

This study was conducted to determine the frequency of variants of rs10741657 of CYP2R1 gene and its association with low serum 25(OH)D level among Bangladeshi adults.

Method

This pilot study was conducted among thirty individuals with low serum 25(OH)D level as the study population and ten subjects with sufficient serum 25(OH)D level as controls based on the inclusion and exclusion criteria. Genetic analysis of rs10741657 of CYP2R1 including primer designing, DNA extraction, PCR of target region with purification and Sanger sequencing of the PCR products were done accordingly. For statistical analysis, One-way ANOVA followed by LSD test, Freeman-Halton extension of Fisher’s exact test, Chi-square test (χ2) test and unpaired student t-test were performed.

Results

In this study, genetic variants of CYP2R1 (rs10741657) among the study population were genotype GG (63.30%), GA (30%) and AA (6.7%). Minor allele frequency of the study population was 0.217. The association between GG and GA genotypes of CYP2R1 (rs10741657) with low serum 25(OH)D level among the study population was found and it was statistically significant. Statistically significant differences were also observed between the genotypes and alleles of the study population and controls.

Conclusions

The presence of ‘GG’ and ‘GA’ genotypes of rs1041657 in CYP2R1 gene is associated with low serum 25(OH)D level among Bangladeshi adults in this pilot study.
A method for remotely measuring physical function in large epidemiologic cohorts: Feasibility and validity of a video-guided sit-to-stand test
Authors: Rees-Punia Erika , Rittase Melissa H. , Patel Alpa V.
Published: November 2021

Introduction

Traditional measures of muscular strength require in-person visits, making administration in large epidemiologic cohorts difficult. This has left gaps in the literature regarding relationships between strength and long-term health outcomes. The aim of this study was to test the feasibility and validity of a video-led, self-administered 30-second sit-to-stand (STS) test in a sub-cohort of the U.S.-based Cancer Prevention Study-3.

Methods

A video was created to guide participants through the STS test. Participants submitted self-reported scores (n = 1851), and optional video recordings of tests (n = 134). Two reviewers scored all video tests. Means and standard deviations (SD) were calculated for self-reported and video-observed scores. Mean differences (95% confidence intervals (CI)) and Spearman correlation coefficients between self-reported and observed scores were calculated, stratifying by demographic characteristics.

Results

Participants who uploaded a video reported 14.1 (SD = 3.5) stands, which was not significantly different from the number of stands achieved by the full cohort (13.9 (SD = 4.2),P-difference = 0.39). Self-reported and video-observed scores were highly correlated (ρ = 0.97, mean difference = 0.3, 95% CI = 0.1–0.5). There were no significant differences in correlations by sociodemographic factors (allP-differences ≥0.42).

Conclusions

This study suggests that the self-administered, video-guided STS test may be appropriate for participants of varying ages, body sizes, and activity levels, and is feasible for implementation within large, longitudinal studies. This video-guided test would also be useful for remote adaptation of the STS test during the COVID-19 pandemic.