bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of Agile in healthcare: methodology for a multisite home hospital accelerator
Authors: Desai Meghna , Tardif-Douglin Miriam , Miller Indigo , Blitzer Stephanie , Gardner David L , Thompson Teresa , Edmondson LaPonda , Levine David M
Published: May 2024

Background

The diffusion of innovation in healthcare is sluggish. Evidence-based care models and interventions take years to reach patients. We believe the healthcare community could deliver innovation to the bedside faster if it followed other sectors by employing an organisational framework for efficiently accomplishing work. Home hospital is an example of sluggish diffusion. This model provides hospital-level care in a patient’s home instead of in a traditional hospital with equal or better outcomes. Home hospital uptake has steadily grown during the COVID-19 pandemic, yet barriers to launch remain for healthcare organisations, including access to expertise and implementation tools. The Home Hospital Early Adopters Accelerator was created to bring together a network of healthcare organisations to develop tools necessary for programme implementation.

Methods

The accelerator used the Agile framework known as Scrum to rapidly coordinate work across many different specialised skill sets and blend individuals who had no experience with one another into efficient teams. Its goal was to take 40 weeks to develop 20 ‘knowledge products’,or tools critical to the development of a home hospital programme such as workflows, inclusion criteria and protocols. We conducted a mixed-methods evaluation of the accelerator’s implementation, measuring teams’ productivity and experience.

Results

18 healthcare organisations participated in the accelerator to produce the expected 20 knowledge products in only 32 working weeks, a 20% reduction in time. Nearly all (97.4%) participants agreed or strongly agreed the Scrum teams worked well together, and 96.8% felt the teams produced a high-quality product. Participants consistently remarked that the Scrum team developed products much faster than their respective organisational teams. The accelerator was not a panacea: it was challenging for some participants to become familiar with the Scrum framework and some participants struggled with balancing participation in the Accelerator with their job duties.

Conclusions

Implementation of an Agile-based accelerator that joined disparate healthcare organisations into teams equipped to create knowledge products for home hospitals proved both efficient and effective. We demonstrate that implementing an organisational framework to accomplish work is a valuable approach that may be transformative for the sector.
Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa
Authors: He Qianqian , Zheng Hui , Zhang Jialin , Yue Ling , Kang Qing , Lian Cheng , Guo Lei , Chen Yan , Hu Yanran , Wang Yuping , Peng Sufang , Wang Zhen , Liu Qiang , Chen Jue
Published: May 2024

Background

Anorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are known to be resistant to treatment. It has been established that the frontoparietal control network (FPCN) is the direct counterpart of the executive control network. Therefore, the resting-state brain activity of the FPCN may serve as a biomarker to predict treatment response in AN.

Aims

The study aimed to investigate the association between resting-state functional connectivity (RSFC) of the FPCN, clinical symptoms and treatment response in patients with AN.

Methods

In this case-control study, 79 female patients with AN and no prior treatment from the Shanghai Mental Health Center and 40 matched healthy controls (HCs) were recruited from January 2015 to March 2022. All participants completed the Questionnaire Version of the Eating Disorder Examination (version 6.0) to assess the severity of their eating disorder symptoms. Additionally, RSFC data were obtained from all participants at baseline by functional magnetic resonance imaging. Patients with AN underwent routine outpatient treatment at the 4th and 12th week, during which time their clinical symptoms were evaluated using the same measures as at baseline.

Results

Among the 79 patients, 40 completed the 4-week follow-up and 35 completed the 12-week follow-up. The RSFC from the right posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (dlPFC) increased in 79 patients with AN vs 40 HCs after controlling for depression and anxiety symptoms. By multiple linear regression, the RSFC of the PPC to the inferior frontal gyrus was found to be a significant factor for self-reported eating disorder symptoms at baseline and the treatment response to cognitive preoccupations about eating and body image, after controlling for age, age of onset and body mass index. The RSFC in the dlPFC to the middle temporal gyrus and the superior frontal gyrus may be significant factors in the treatment response to binge eating and loss of control/overeating in patients with AN.

Conclusions

Alterations in RSFC in the FPCN appear to affect self-reported eating disorder symptoms and treatment response in patients with AN. Our findings offer new insight into the pathogenesis of AN and could promote early prevention and treatment.
Association of initial assessment variables and mortality in severe pediatric traumatic brain injury
Authors: Bergus Katherine C , Patterson Kelli N , Asti Lindsey , Bricker Josh , Beyene Tariku J , Schulz Lauren N , Schwartz Dana M , Thakkar Rajan K , Sribnick Eric A
Published: May 2024

Background

Predictive scales have been used to prognosticate long-term outcomes of traumatic brain injury (TBI), but gaps remain in predicting mortality using initial trauma resuscitation data. We sought to evaluate the association of clinical variables collected during the initial resuscitation of intubated pediatric severe patients with TBI with in-hospital mortality.

Methods

Intubated pediatric trauma patients <18 years with severe TBI (Glasgow coma scale (GCS) score ≤8) from January 2011 to December 2020 were included. Associations between initial trauma resuscitation variables (temperature, pulse, mean arterial blood pressure, GCS score, hemoglobin, international normalized ratio (INR), platelet count, oxygen saturation, end tidal carbon dioxide, blood glucose and pupillary response) and mortality were evaluated with multivariable logistic regression.

Results

Among 314 patients, median age was 5.5 years (interquartile range (IQR): 2.2–12.8), GCS score was 3 (IQR: 3–6), Head Abbreviated Injury Score (hAIS) was 4 (IQR: 3-5), and most had a severe (25-49) Injury Severity Score (ISS) (48.7%, 153/314). Overall mortality was 26.8%. GCS score, hAIS, ISS, INR, platelet count, and blood glucose were associated with in-hospital mortality (allp<0.05). As age and GCS score increased, the odds of mortality decreased. Each 1-point increase in GCS score was associated with a 35% decrease in odds of mortality. As hAIS, INR, and blood glucose increased, the odds of mortality increased. With each 1.0 unit increase in INR, the odds of mortality increased by 1427%.

Conclusions

Pediatric patients with severe TBI are at substantial risk for in-hospital mortality. Studies are needed to examine whether earlier interventions targeting specific parameters of INR and blood glucose impact mortality.
Sensitive analysis of heat transfer enhancement in ternary Casson nanofluid flow between a conical surface and disk
Authors: Manaswini R. , Hanumagowda B. N. , Tanuja T. N. , Kavitha L. , Abdulrahman Amal , Punith Gowda R. J. , Varma S. V. K.
Published: May 2024

This study explores the ternary nanofluid flow within the canonical gap between a cone and a disk with particle deposition and magnetic field effects. Reduced titanium dioxide, magnetite, and graphene oxide are used as nanoparticles in the base fluid ethylene glycol. The governing equations of the problem are in the form of partial differential equations, which are converted to nonlinear ordinary differential equations by using appropriate similarity transformations, and they are solved numerically by using Runge–Kutta–Fehlberg fourth fifth-order (RKF 45) technique. The main agenda of this work is to discuss the impacts of parameters on three cases. The effects of essential aspects on fluid flow, heat and mass transfer rates were studied and analyzed using a graphical representation. Additionally, the response surface methodology and sensitivity analysis are carried out to enhance the importance of the heat transfer rate. The results reveal that the flow field increases significantly with increased Reynolds numbers for both cone and disk rotations. It is observed that the sensitivity analysis of the Nusselt number toward the Eckert number is more for all the radiation parameter values and the Eckert number’s middle level.
Some Simple Groups Which are Determined by Their Orders and Degree-Patterns
Authors: Guo Qinghong , Liu Weijun
Published: May 2024

Let [Formula: see text] be a finite group and [Formula: see text] the set of all irreducible complex characters of [Formula: see text]. Let [Formula: see text] be the set of all irreducible complex character degrees of [Formula: see text] and denote by [Formula: see text] the set of all primes which divide some character degree of [Formula: see text]. The character-prime graph [Formula: see text] associated to [Formula: see text] is a simple undirected graph whose vertex set is [Formula: see text] and there is an edge between two distinct primes [Formula: see text] and [Formula: see text] if and only if the product [Formula: see text] divides some character degree of [Formula: see text]. We show that the finite nonabelian simple groups [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] and [Formula: see text] are uniquely determined by their degree-patterns and orders.
Case 325: Persistent Craniopharyngeal Canal
Authors: Suthar Pokhraj Prakashchandra , Nagarajan Murali , Bhabad Sudeep
Published: May 2024

History

A 76-year-old female patient with a history of rheumatoid arthritis, Sjögren syndrome, and hypertension presented with headache, fever, and dysphagia. The patient was taking prednisone and leflunomide to treat rheumatoid arthritis. The headache was primarily left sided and occasionally radiated to the occipital region. The patient had a high-grade fever spike, with a temperature of 104 °F (40 °C). Results of a prior lumbar puncture and temporal artery biopsy from an outside hospital were negative. Findings of a neurologic examination were unremarkable. Oropharyngeal examination for dysphagia revealed minimal pharyngeal motility, with pooling of food in the pharynx, which was thought to be due to cranial nerve dysfunction. Laboratory analysis revealed that, except for anemia, complete blood count parameters were within normal limits. C-reactive protein level (49.7 mg/L; reference range, 0.0–8.0 mg/L), erythrocyte sedimentation rate (>140 mm/h with Westergren method; reference range, 0–27 mm/h), and brain-type natriuretic peptide level (145 pg/mL; reference range, 0–100 pg/mL) were elevated. Blood and urine cultures were negative. A lumbar puncture was performed, which revealed cloudy cerebrospinal fluid (CSF), with an elevated CSF protein level (78 mg/dL; reference range, 7.0–35.0 mg/dL) and a low CSF glucose level (37 mg/dL [2.05 mmol/L]; reference range, 45–70 mg/dL [2.50–3.89 mmol/L]); otherwise, CSF encephalopathy, an autoimmune panel, and cultures were negative. CT and MRI of the brain with paranasal sinus were performed. Nasal endoscopy-guided drainage of the preclival fluid collection was performed, and biopsy of nasopharyngeal tissue was performed. Fluid culture revealed the growth of Candida albicans, as well as Pseudomonas and Enterobacter aerogenes. The patient received fluconazole, ceftriaxone, vancomycin, and metronidazole. Follow-up MRI was performed after 2 weeks.
Extending a Multiphysics Li-Ion Battery Model from Normal Operation to Short Circuit and Venting
Authors: Tran Vivian , Siegel Jason B. , Stefanopoulou Anna G.
Published: May 2024

Mitigation of Li-ion battery system fires consists of reliable fault detection and proactive, fast discharge control. Both require modeling of failure modes due to high temperatures and currents between normal operation and thermal runaway. In this work, we present a control-oriented, reduced-order, multiphysics model that captures the electrochemical, thermal, gas generation, mechanical expansion, and venting behavior of NMC pouch cells undergoing an external short circuit (ESC) from different initial state-of-charge (SOC). The model is parameterized through experiments by fitting the solid-electrolyte interphase (SEI) decomposition rate, the cell’s thermal parameters, and the particle solid-phase diffusion parameters to capture the first venting timing, peak temperature, and diffusion-limited electrical behavior at high currents. Using a single parameter set, the multiphysics model can capture behavior during an ESC to predict whether a cell will generate gas and vent, predict the vent timing within 10 seconds of it occurring in the experiment, and maximum cell expansion pressure within 10 kPa for cells that did not vent. The model can also predict the SOC trajectory for cells with a high initial SOC within 6% SOC for the 15-minute discharge or until the cell vents.
Airway Management for Massive Anterior Mediastinal Tumor Resection in an Infant: A Strategy Involving Spontaneous Breathing‐Preserving Endotracheal Intubation under Intravenous Anesthesia
Authors: Matsuda Hiromi , Ito Ei , Katsuike Akiko , Okamoto Hirotsugu
Published: May 2024

Tracheal intubation under sedation in uncooperative infants is challenging. The case of a 4‐month‐old infant with a massive anterior mediastinal tumor and upper respiratory tract symptoms, for whom effective preoxygenation was provided with a high‐flow nasal cannula (HFNC), allowing for safe tracheal intubation in combination with a supraglottic device and local anesthetic, is reported. With careful planning of anesthesia and creative problem solving, airway management for anterior mediastinal tumors can be performed safely with the selection of an appropriate airway device. This may be a good airway management strategy for infants with mediastinal tumors or who may be expected to have ventilation difficulties.
Evaluation of Helical Pile Performance in TRcM for Soft Ground Improvement: Insights from Field Test and Application
Authors: Hyeong-Joo Kim , Tae-Gew Ham , Sadiq Shamsher , Rey Dinoy Peter , Gi-Cheol Youn
Published: May 2024

The tabular roof construction method (TRcM) is an alternative to open‐cut and cover tunnels commonly used in constructing underground structures. The open‐cut tunnels often lead to traffic congestion and ground settlement, especially in densely populated areas. However, when dealing with very soft ground that allows minimal settlement, piling becomes necessary to distribute the load. Implementing ground improvement solutions in such scenarios poses challenges in terms of space and time constraints. This study presents a unique case study that explores the combination of helical piles with the TRcM, offering a viable solution for ground improvement under challenging ground, limited space, and time constraint conditions. A robust helical pile loading system design for static compression tests inside TRcM ensuring TRcM pipe stability is presented. Also, the validation of the helical pile‐bearing capacity interpretation using various factors through static field test inside the TRcM is presented.
An Improved Boundary Element Method for Predicting Half-Space Scattered Noise Combined with Permeable Boundaries
Authors: Zheng Wensi , Wang Fang
Published: May 2024

The boundary element method is widely used in practical engineering problems, especially in the field of acoustics. For flow-induced noise, the main target of acoustic calculations is to solve the wave equation with the flow field information. However, the sound field distribution of noncompact structures in half-space is especially complex because of the strong scattering effect, while the object surface boundary integration often brings a large workload and generates numerical singularities. In this paper, an improved boundary element method for predicting the aeroacoustic noise of noncompact structures is proposed, which can consider the characteristic distribution of sound field induced by complex structures in half-space. The smooth permeable boundary surrounding the object is used as the integration boundary, while the scattering effect of the ground boundary is investigated by combining the mirror Green’s function method, and the numerical prediction of aeroacoustic noise is carried out for the dipole source and NACA0012 airfoil in half-space. Numerical results show that the far-field noise obtained by using the permeable surface is consistent with that obtained by integrating the direct object boundary under the influence of ground boundary scattering. The mirror image Green’s function method is able to finely capture the ground scattering effect, which has a significant effect on the sound field as the frequency increases.
Table S3 from Comparative Epigenetic Profiling Reveals Distinct Features of Mucosal Melanomas Associated with Immune Cell Infiltration and Their Clinical Implications
Authors: Dai Jie , Jia Jia , Zhang Fanshuang , Liu Kaihua , Xi Yanfeng , Yuan Pei , Mao Lili , Bai Xue , Wei Xiaoting , Wang Bingning , Li Jiangtao , Xu Yang , Liu Ting , Chang Shuang , Shao Yang , Guo Jun , Ying Jianming , Si Lu
Published: May 2024

Supplementary Table 3. The immune-related pathways that were enriched in TERT methylation high group versus TERT methylation low group using GSEA analysis.
Table S1 from Comparative Epigenetic Profiling Reveals Distinct Features of Mucosal Melanomas Associated with Immune Cell Infiltration and Their Clinical Implications
Authors: Dai Jie , Jia Jia , Zhang Fanshuang , Liu Kaihua , Xi Yanfeng , Yuan Pei , Mao Lili , Bai Xue , Wei Xiaoting , Wang Bingning , Li Jiangtao , Xu Yang , Liu Ting , Chang Shuang , Shao Yang , Guo Jun , Ying Jianming , Si Lu
Published: May 2024

Supplementary Table 1. The univariate and multivariate COX analyses for OS associated DMRs in PMME patients.
Congenital hyperinsulinism of a large Italian cohort: a retrospective study
Authors: Tagliaferri Francesco , Iannuzzi Roberta , Canciani Gabriele , Bernabei Silvia M. , Campana Carmen , Caviglia Stefania , Greco Benedetta , Lepri Francesca R. , Novelli Antonio , Pizzoferro Milena , Garganese Maria C. , Spada Marco , Francalanci Paola , Dionisi-Vici Carlo , Maiorana Arianna
Published: May 2024

Introduction. To evaluate and describe the diagnostic process, medical, nutritional and surgical approach, and neurological outcome, we report data from a large Italian cohort of patients with Congenital hyperinsulinism (CHI).
Methods. We retrospectively analyzed 154 CHI patients admitted to Ospedale Pediatrico Bambino Gesù from 1985 to 2022.
Results. Hypoglycemia occurred within the first year of life in 85.5% of patients, median time to diagnosis was 1 day (IQR 14 days). Ninety-two percent of patients were treated with diazoxide, 66.9% were responsive. Octreotide was administered to 28.6% of patients, 61.4% were responsive. Forty percent of patients were off-therapy, mostly from diazoxide. Thirty-four percent of patients carried mutations in ABCC8, 12.6% were syndromic, and 9.2% were transient CHI. Surgery was performed in 23/47 diazoxide-unresponsive and 2/95 diazoxide-responsive patients: 64.0% were focal at histology. Combining data from genetics, pancreatic venous sampling, 18F-DOPA PET/CT and histology, 80.6% resulted diffuse, 16.7% focal, and 2.8% atypical CHI. Post-surgical diabetes developed in 6 patients. Neurocognitive evaluation revealed developmental delay or intellectual disability in 15.7% of 70 patients, mostly of a mild degree. Epilepsy was documented in 13.7% of 139 patients.
Conclusion. Our diagnostic and therapeutic results are mainly consistent with the international indications and the CHI Global Registry data, with relatively low rates of neurological outcomes. Good outcomes were likely associated with early diagnosis and prompt management of patients because the majority of patients were diagnosed within 2 weeks. Remarkably, it is of utmost importance to spread the knowledge and refer CHI patients to multidisciplinary expert centers.
Improvement of the antioxidant potential: impact of drying and extraction techniques on polyphenols in Arbutus unedo L. leaf aqueous extract
Authors: Zemour Kamel , Chouhim Kadda Mohamed Amine , Labdelli Amina , Mairif Mohamed , Ardjane Tedj Eddine Adda , Moussaoui Badreddine , Zemour Hafidh , Laafer Mohammed
Published: May 2024

The search for alternatives to chemical pharmaceutical products remains an urgent and crucial step for humanity. In this regard, the use of plants presents an ideal approach for such biological studies. Arbutus unedo L., which belongs to the family Ericaceae, is one of the species that holds significant importance in traditional pharmaceutical uses. In Algeria, the use of this species in traditional treatment is generally rare. Therefore, this study aims to highlight its medicinal importance and the proper method for extracting its bioactive elements. To achieve this, the biological activity of leaves including total phenolic content (TPC), DPPH assay, and total flavonoid content (TFC), were assessed under four different drying temperatures (shade-drying, sun-drying, 40°C and 60C°) and two extraction methods after maceration (centrifugation, filtration). The results have indicated that these processes have affected the final accumulation of polyphenols and antioxidant activity in the leaf extracts. Additionally, it has been highlighted that the centrifugation method extracts a higher biochemical amount, especially after drying at 40°C. Furthermore, Arbutus unedo L. leaves should be considered a promising source of natural compounds to be used as ingredients in various fields.
Movilización y organización de jóvenes campesinos y su incidencia en la construcción de subjetividades políticas
Authors: Restrepo Rodríguez Jorge Eduardo
Published: May 2024

Con el ánimo de abordar la problemática social del desplazamiento de los jóvenes campesinos a las ciudades, desde la construcción de subjetividades políticas, este artículo describe y caracteriza el proceso de movilización y organización de jóvenes de la organización Asojuprov, con la pretensión de analizar la manera como dicho proceso promueve la construcción de esa personalidad política que los vincula y compromete con su proyecto de vida y el futuro de su comunidad. De esta manera se pretende generar conocimientos que permitan identificar propuestas de intervención orientadas a fortalecer los vínculos de los jóvenes con la vida rural y campesina. Se optó por el método estudio de caso, el cual permitió concluir que esta experiencia organizativa promueve espacios de interacción y participación que visibilizan las áreas que requieren del impulso de una política social; posibilitan la ampliación del círculo ético; y fortalecen las relaciones intergeneracionales, la autonomía y el pensamiento crítico. En Asojuprovel sujeto político juvenil desarrolla sus capacidades organizativas, participativas, sociales y políticas, circunstancia que lo lleva a realizar acciones que aportan a la transformación de las dinámicas de la comunidad rural a la que pertenecen; estas acciones implican el trabajo mancomunado, de tal manera que los jóvenes comparten experiencias de vida que fortalecen sus relaciones y lazos afectivos, a la vez que crean identidad campesina en torno auna idea de proyecto de vida común que finalmente los conecta con su comunidad.
Vínculo afectivo: discapacidad e inclusión. Una experiencia en jardines del Distrito
Authors: Sáchica Cepeda Leidy Cristina , Moreno Peña Diana Emilse , González Mendoza Dorián Iván
Published: May 2024

El artículo presenta los procesos y reflexiones de la investigación “Vínculo afectivo: discapacidad e inclusión. Una experiencia en jardines del Distrito”. Este proyecto de tipo cualitativo con enfoque hermenéutico, identifica las relaciones existentes en la triada familia, jardín y niños con discapacidad, inmersas en procesos de inclusión de dos instituciones: la Fundación para la Adopción de la Niñez Abandonada (FANA) y el Jardín Infantil Casa Vecinal Nuevos Timanquitos de la localidad de Suba en Bogotá. Su desarrollo metodológico se centró en el análisis e interpretación de catorce entrevistas semiestructuradas; seis a familias y ocho a maestras. Como conclusión se resalta que el vínculo afectivoes indispensable en la creación y fortalecimiento de los procesos de inclusiónde niños y niñas con discapacidad y es punto de partida en la articulación de los procesos educativos orientados en el jardín. Finalmente se señalan recomendacionesen torno al abordaje, comunicación y acompañamiento.
Subjetividad política indígena desde la resistencia y pervivencia del Cabildo Muisca de Suba
Authors: Mususú Baquero Yuly Paola
Published: May 2024

Este artículo, enmarcado bajo el enfoque deinvestigación cualitativa con una metodología de estudio de caso, tiene como propósito describir y analizar la construcción de la subjetividad política del Cabildo Indígena Muisca de Suba como organización social. Con ello se pretende explicar la organización, la vinculación al movimiento social, y la acción y formación política de los sujetos vinculados al Cabildo, como elementos constituyentes de la subjetividad política que se estructuran bajo laresistencia y la pervivencia como marcos del ser y el actuar de esta comunidad.
Expanding the Treatable Imaging Profile in Patients With Large Ischemic Stroke: Subanalysis From a Randomized Clinical Trial
Authors: Inoue Manabu , Yoshimoto Takeshi , Yamagami Hiroshi , Toyoda Kazunori , Sakai Nobuyuki , Matsumaru Yuji , Matsumoto Yasushi , Kimura Kazumi , Ishikura Reiichi , Uchida Kazutaka , Beppu Mikiya , Sakakibara Fumihiro , Morimoto Takeshi , Yoshimura Shinichi ,   for the RESCUE-Japan LIMIT Investigators
Published: May 2024

BACKGROUND:

We aimed to examine the boundary of the ischemic core volume in patients undergoing endovascular thrombectomy (EVT) versus those receiving medical management to determine the minimum optimal size for favorable treatment outcomes.

METHODS:

This is a prespecified substudy of the RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism-Japan Large Ischemic Core Trial). Patients with large vessel occlusion were enrolled between November 2018 and September 2021 with a National Institutes of Health Stroke Scale score of at least 6 on admission and an Alberta Stroke Program Early Computed Tomography Score value of 3 to 5. We investigated the correlation between optimal quantified ischemic core volume, assessed solely using magnetic resonance diffusion-weighted imaging, and functional outcomes (modified Rankin Scale score, 0–3) at 90 days by predictive marginal plots. Final infarct volume and safety outcomes (symptomatic intracerebral hemorrhage and mortality) were also assessed.

RESULTS:

Of the 203 cases, 168 patients (85 in the EVT group versus 83 in the medical management group) were included. The median (interquartile range) core volume was 94 (65–160) mL in patients with EVT and 115 (71–141) mL in the medical management group (
P
=0.72). The predictive marginal probabilities of the 2 groups intersected at 128 mL for estimating functional outcomes. Symptomatic intracerebral hemorrhage and mortality within 90 days had overlay margins through all core volumes in both groups. The median final infarct volume (interquartile range) was smaller in the EVT group (142 [80–223] mL versus 211 [123–289] mL in the medical management group;
P
<0.001).

CONCLUSIONS:

In this prespecified analysis of a randomized clinical trial involving patients with large ischemic strokes, patients with an estimated core volume of up to 128 mL on diffusion-weighted imaging benefit from EVT.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03702413.
Judean Reception of the Elisha Narratives
Authors: Skaria Jobymon
Published: May 2024

Scholars have noted scribal attempts to undermine Elisha’s prophetic reputation in his promise to the Shunammite woman (2 Kgs 4:8–17). However, these readings fail to adequately consider the intertextual links between Elisha’s promise and Yahweh’s promise to Abraham (Gen 18:1–15): Why did the scribes link Elisha’s promise with Yahweh’s promise, especially when the narrative is largely hostile against Elisha? Paying attention to the possible context in Achaemenid Yehud, this article proposes a new interpretation of Elisha’s promise: It highlights scribal efforts to subjugate and silence Bethel, a northern Israelite cultic site believed to be the repository for Elisha traditions during this period. And it argues that the Judean scribes deliberately linked Elisha’s promise with Yahweh’s promise, as an “antithetical parallelism” to support their attempts to stigmatise Bethel’s traditions by pointing readers toward Elisha’s human weaknesses and limitations in his prophetic career.
Impacts of COVID-19 on Intimate Partner Violence Service Provision
Authors: Giwa Aisha , Kandemiri Myra , Tulli-Shah Mia , Sayadi Ghada , Hurley Nat , Salami Bukola
Published: May 2024

COVID-19 policies like stay-at-home orders impacted intimate partner violence (IPV) service provision in Alberta. Using intersectionality and qualitative semi-structured interviews, this article situates IPV and access to services and supports within multiple overlapping factors such as race, gender, class, and ethnic minority status. Two main themes were identified. First, the challenges within IPV service provision reflect the sectors’ traditional and binary understanding and response to violence. Second, the move to virtual services brought challenges related to access to telecommunication facilities and zoom fatigue. Thematic analysis also shows the impact of the pandemic in a sector with existing structural/institutional challenges. We conclude by recommending a multi-level intersectional approach to IPV service provision in Alberta.
Workplace Ostracism and Turnover Intention in Organizations: A Meta-analytic Review
Authors: Das Sudhir Chandra , Ekka Deepmala
Published: May 2024

Workplace ostracism (WO) poses a significant threat to organizational well-being, with implications for employee turnover intention (TI). This meta-analysis explores the relationship between WO and TI across 32 studies involving 10,553 participants from diverse sectors and countries. The findings reveal a significant positive correlation (r = 0.31) between WO and TI, indicating that employees experiencing ostracism are more likely to contemplate leaving their jobs. Despite substantial heterogeneity (I² = 93.07%), moderators such as participants’ average age and the percentage of females show limited impact on the relationship. Sector-based subgroup analysis suggests a consistent impact of WO on TI across various employment sectors. The study provides practical insights for managers, emphasizing the importance of addressing WO to enhance employee retention and well-being. Recommendations include fostering inclusive cultures and implementing targeted interventions to mitigate the negative effects of ostracism in diverse organizational settings.
Identifying potential provenances for climate-change adaptation using spatially variable coefficient models
Authors: Wesselkamp Marieke , Roberts David R. , Dormann Carsten F.
Published: May 2024

Background

Selection of climate-change adapted ecotypes of commercially valuable species to date relies on DNA-assisted screening followed by growth trials. For trees, such trials can take decades, hence any approach that supports focussing on a likely set of candidates may save time and money. We use a non-stationary statistical analysis with spatially varying coefficients to identify ecotypes that indicate first regions of similarly adapted varieties of Douglas-fir (Pseudotsuga menziesii (Mirbel) Franco) in North America. For over 70,000 plot-level presence-absences, spatial differences in the survival response to climatic conditions are identified.

Results

The spatially-variable coefficient model fits the data substantially better than a stationary, i.e. constant-effect analysis (as measured by AIC to account for differences in model complexity). Also, clustering the model terms identifies several potential ecotypes that could not be derived from clustering climatic conditions itself. Comparing these six identified ecotypes to known genetically diverging regions shows some congruence, as well as some mismatches. However, comparing ecotypes among each other, we find clear differences in their climate niches.

Conclusion

While our approach is data-demanding and computationally expensive, with the increasing availability of data on species distributions this may be a useful first screening step during the search for climate-change adapted varieties. With our unsupervised learning approach being explorative, finely resolved genotypic data would be helpful to improve its quantitative validation.
Deep learning for risk stratification of thymoma pathological subtypes based on preoperative CT images
Authors: Liu Wei , Wang Wei , Guo Ruihua , Zhang Hanyi , Guo Miaoran
Published: May 2024

Objectives

This study aims to develop an innovative, deep model for thymoma risk stratification using preoperative CT images. Current algorithms predominantly focus on radiomic features or 2D deep features and require manual tumor segmentation by radiologists, limiting their practical applicability.

Methods

The deep model was trained and tested on a dataset comprising CT images from 147 patients (82 female; mean age, 54 years ± 10) who underwent surgical resection and received subsequent pathological confirmation. The eligible participants were divided into a training cohort (117 patients) and a testing cohort (30 patients) based on the CT scan time. The model consists of two stages: 3D tumor segmentation and risk stratification. The radiomic model and deep model (2D) were constructed for comparative analysis. Model performance was evaluated through dice coefficient, area under the curve (AUC), and accuracy.

Results

In both the training and testing cohorts, the deep model demonstrated better performance in differentiating thymoma risk, boasting AUCs of 0.998 and 0.893 respectively. This was compared to the radiomic model (AUCs of 0.773 and 0.769) and deep model (2D) (AUCs of 0.981 and 0.760). Notably, the deep model was capable of simultaneously identifying lesions, segmenting the region of interest (ROI), and differentiating the risk of thymoma on arterial phase CT images. Its diagnostic prowess outperformed that of the baseline model.

Conclusions

The deep model has the potential to serve as an innovative decision-making tool, assisting on clinical prognosis evaluation and the discernment of suitable treatments for different thymoma pathological subtypes.

Key Points

• This study incorporated both tumor segmentation and risk stratification.

• The deep model, using clinical and 3D deep features, effectively predicted thymoma risk.

• The deep model improved AUCs by 16.1pt and 17.5pt compared to radiomic model and deep model (2D) respectively.
Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania
Authors: Samila Immaculata Alphonce , Mboineki Joanes Faustine
Published: May 2024

Background

Unsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion.

Objectives

To assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region.

Methodology

It is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics.

Results

The practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion.

Conclusion

The majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone’s attitude towards unsafe abortion.
Limited discectomy versus aggressive discectomy by spinal endoscopy with the transforaminal approach for lumbar disc herniation: a retrospective study
Authors: Reheman Sulaiman , Meng XiangYu , Abudurexiti Tuerhongjiang , Haibier Abuduwupuer , Sheng Weibin
Published: May 2024

Objective

To compare the clinical and radiological outcomes of limited discectomy (LD) and aggressive discectomy (AD) performed via spinal endoscopy using the transforaminal approach in patients with lumbar disc herniation(LDH)

Methods

We conducted a retrospective review of patients who underwent percutaneous endoscopic transforaminal discectomy (PETD) at the L4-L5 lumbar spine segments in our department from January 2017 to December 2020. The follow-up period extended to 24 months postoperatively. Patients were categorized into the LD and AD groups based on the extent of intraoperative disc removal. We retrospectively collected and analyzed clinical and radiological data.

Results

The study followed 65 patients, with 36 in the LD group and 29 in the AD group. No statistically significant differences were noted in recurrence rates, the excellent and good Macnab rates, preoperative Disc Height Index (DHI), and preoperative Modic changes between the groups (P >0.05). However, significant differences were observed in operation duration, postoperative DHI and postoperative Modic change (P<0.05). No significant differences in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were detected between the groups preoperatively, or one and two years postoperatively (P>0.05). Nevertheless, notable differences in VAS and ODI scores were present one month postoperatively (P<0.05).

Conclusion

As a conventional surgical method for treating LDH, PETD can achieve satisfactory clinical results in both LD and AD, with no significant variance in recurrence rates. However, AD is associated with longer operation times, and greater postoperative reductions in DHI and greater postoperative Modic changes compared to LD.
Development, validation and reliability testing of the hospice care environment scale
Authors: Zhong Junping , Zhang Wei , Xu Rong , Wang Huifen , Zhao Jing , Huang Yingjuan , Chen Yanlin , Chen Xiaoli , Chen Jianfei , Zhang Qing , Zou Zhijie , Zhang Yingzi
Published: May 2024

Background

WHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses.

Methods

Literature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed.

Result

The Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach’s α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach’s α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility.

Conclusion

The Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.
Factors associated with work engagement among specialist nurses in china: a cross-sectional study
Authors: Xu Lichun , Lin Liyu , Guan Aixuan , Wang Qingqing , Lin Feng , Lin Weicong , Li Jing
Published: May 2024

Background

The positive impacts of work engagement among specialist nurses on retention, organizational commitment, and quality of care are well-documented. However, there is a lack of research on the specific differences in work engagement among specialist nurses. Therefore, the purpose of this study is to assess the level of work engagement among specialist nurses in China and identify its influencing factors.

Methods

A descriptive cross-sectional study was conducted in China from April to July, 2023, with 724 nurses selected from 22 hospitals through convenience sampling involved. The survey was conducted by using self-administered general information questionnaires and work engagement scales. Questionnaire Star was employed as the online data collection tool. The collected data was analyzed by using descriptive statistics and stepwise regression analysis to draw meaningful conclusions from the study.

Results

Among specialist nurses in Xiamen, China, who had a response rate of 97.10%, an average work engagement score is 140.35 (SD=18.17), with the highest score for the work attitude at 4.65 (SD=0.52) and the lowest score for the work recognition at 4.09 (SD=0.85). It was shown through regression analysis that factors such as career satisfaction, involvement in challenging case discussions, marital status, gender, presence of promotion advantage and title accounted for 14.5% of the total variance in the model and were significant explanatory variables that could predict work engagement.

Conclusion

It is shown that specialist nurses in Xiamen, China have a high level of work engagement. It is imperative for nursing managers to prioritize the work engagement of specialist nurses, provide the specialist nurses with ample development opportunities and room for growth, and effectively promote the overall development of specialist nurses by improving work engagement in various aspects.
Situational analysis of hypertension management at primary health care level in São Paulo, Brazil: population, healthcare professional and health system perspectives
Authors: Palmeirim Marta S. , Baxter Yara C. , Silveira Mariana , Maggion Rafael V. , Aquino Beatriz , Avezum Álvaro , Saric Jasmina , Morgan Louise , Drager Luciano F. , Bortolotto Luiz A. , Rollemberg Suely Miya S. , de Lima Marcia M. C. , Albuquerque Edmir P. R. , Jones Olivia , Steinmann Peter , Reiker Theresa , Boch Johannes
Published: May 2024

Background

Government-led, population-wide initiatives are crucial for advancing the management of hypertension − a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control.

Methods

First, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city– Itaquera and Penha– which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents.

Results

Data gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans.

Conclusions

This situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.