bluuebunny/crossref_metadata_2025 huggingface dataset:
Aging and Driving: A Comparison of Driving Performance Between Older and Younger Drivers in an On-Road Driving Test
Authors: Robertsen Rolf , Lorås Håvard W. , Polman Remco , Simsekoglu Ozlem , Sigmundsson Hermundur
Published: May 2022

It is important to examine changes in driving performance and driver behavior with increasing age to improve road safety. The main purpose of this study was to explore if there were any differences in a group of young drivers ( n = 36, Mage = 32) and a group of elderly drivers ( n = 40, Mage = 72) on driving performance and driving skills on a number of driving tasks. An on-road driving test was conducted using a fixed 25-km route lasting approximately 30 minutes. Expert examiners assessed the participants’ driving skills and performance using assessment form measuring seven categories: car handling, observation/overview, signaling, positioning, speed adaption/risk, traffic flow/assessing gaps, and give way/traffic flow. Younger drivers reported significantly longer annual mileage (mean = 24,719 km) than older drivers (mean = 12,750 km). There were no significant group differences on self-reported number of accidents the last 3 years, driving frequency, or self-assessment scores. Independent sample t-test results show that compared to older drivers, the younger drivers scored significantly higher on 4 out of totally 32 category items in the assessment form. Two of them were in category total scores; car handling total score and speed adaption/risk total score, the other two were subcategory scores; use of controls and following traffic flow. The results indicate that aging itself and/or potential negative age-related decline in certain functions important for safe driving do effect driving performance, but less than expected and commonly assumed. One plausible explanation is that older drivers use compensatory actions related to factors like maturity and a behavioral adaptation to overcome difficulties in driving.
Exploring and Critiquing Women’s Academic Identity in Higher Education: A Narrative Review
Authors: Phillips Matthew J. , Dzidic Peta L. , Castell Emily L.
Published: May 2022

Academia has been characterized as traditional, hierarchical, and selective, founded on patriarchal, imperial, and colonial values that construct and maintain gendered roles and regulations. This has been proposed to disadvantage how women experience, and identify within, academia. A narrative review was conducted to review the literature on women’s academic identities and experiences, and critique the dominant ways of knowing, being, and doing in academia. Thematic synthesis was conducted on 56 qualitative studies (published 2010–2019), illustrating the impact of these values on women’s academic identities and experiences, and normative gendered stereotypes and practices that impact women academics. Furthermore, existing literature is critiqued, exploring the influence of dominant ways of being and knowing (on how questions are asked, the constructs explored, the design decisions made). By providing this commentary, future research can focus on problematizing the system and dismantling the problematic conditions (e.g., underrepresentation, discrimination, and gendered stereotyping) for women in academia.
Confusion Over Models: Exploring Discourse in a STEM Professional Development
Authors: Reynolds Todd , Burrows Andrea C. , Borowczak Mike
Published: May 2022

For 2 weeks in the summer of 2018, K-12 science, technology, engineering, and mathematics (STEM) teachers ( n = 40) attended a professional development (PD) that included four sessions focused on computer science modeling with follow-up academic year sessions; however, overall, the teachers did not incorporate or utilize modeling means or how as the instructors intended. The purpose of the study is to examine why this occurred, and the authors looked at the teachers’ modeling discourse. Using two theories to connect to practice (terministic screens, and schema theory), the authors collected data via the surveys, interviews, and email reflections. The authors analyzed the results via coding to explore participants’ concept of models and the potential difficulties of implementing computer modeling in their classrooms. Findings show that the term model was interpreted differently by the PD’s faculty team and participants. Further, the authors found that the majority of presenters held differing theories of models than the participants. Participant concepts of models did improve slightly after the PD, but lingering model concepts caused confusion with the anticipated PD results. Conclusions include five general modeling concepts which are presented and explained. Implications are provided showcasing articulated keys for delivering PD that assists in eliminating discursive and theoretical issues. Included are considerations for STEM teacher educators, PD providers, and K-12 teachers. The main study limitations include mixed K-12 teaching participants, distance between participants, a self-selected population, and non-generalizable findings based on qualitative work. Future directions are outlined.
Three Decades of Consumer Ethnocentrism Research: A Bibliometric Analysis
Authors: Baber Ruturaj , Upadhyay Yogesh , Baber Prerana , Kaurav Rahul Pratap Singh
Published: May 2022

Consumer ethnocentric tendencies (CET) is a field of study that has developed a distinct identity among marketing researchers and practitioners. The construct has been used in consumer research for over three decades. This study uses two bibliometric methods to understand consumer ethnocentrism. The analysis reviewed 255 consumer ethnocentrism publications from the last three decades (1989–2020). The co-citation analysis revealed regional development and replication of consumer ethnocentrism research. Following that, the article used co-word analysis to determine the evolution of consumer ethnocentrism study themes. The research findings point to five research themes on consumer ethnocentrism, namely foundations, methods of measuring ethnocentrism, culture, managerial applications, and emerging trends. Finally, the study maps called for a future research agenda on consumer ethnocentrism.
Promoting Businesses Beyond Borders: Multinationals’ Perspectives
Authors: Prashar Sanjeev , Hamid Abu Bakar Abdul
Published: May 2022

This study conceptualizes and critically examines the business-level digital transformation and hinges on to the examination of business-level digital transformation from a strategy perspective. Using the conceptual review design, the study further explores the contents of the digital transformation process. We answer two key research questions: (a) what is the business model of a multinational company promoting through digital sources? (b) Is it relevant for multinationals in the digital economy? The study triggers determining the necessary steps to digitally transform a business and organizing them into categories of phases leading to the digital transformation process. In conclusion, this work allowed spotlighting the strategic character of the digital transformation and, above all, to grasp its multidimensional reach.
The Effect of Different Fiber Post-Application Techniques on Fracture Resistance of Structurally Compromised Premolars with Flared Root Canals: An In Vitro Study
Authors: Kanyılmaz Ata Nisa Çoban , Akman Melek , Şişmanoğlu Soner , Belli Sema
Published: May 2022

Aim:

Intraradicular post systems have become an important treatment method for endodontically treated teeth as they provide retention for restoration to the remaining tooth structure. The objective of the present in vitro study was to evaluate the effect of different fiber post-application techniques on the fracture resistance of premolars with flared root canals and no ferrule.

Materials and Methods:

Sixty freshly extracted, single-rooted mandibular premolars with no ferrule were endodontically treated by an experienced endodontist, and their root canals were experimentally flared. The specimens with flared root canals were divided into five groups according to fiber post-application techniques ( n = 12): a prefabricated fiber post (G1), G1 + two auxiliary posts (G2), i-TFC post system (G3), G1 + quartz splint (G4), and Ribbond (G5). The data were analyzed with analysis of variance and Tukey tests.

Results:

The findings were revealed that no significant difference was found among four groups, except G5 ( P > .05), which demonstrated the lowest fracture resistance ( P < .05). G2, G3, G4, and G5 exhibited dominantly restorable fracture pattern, whereas G1 exhibited nonrestorable fracture pattern.

Conclusion:

Within the limitations of this study, the placement of auxiliary posts, i-TFC post system, quartz splint placement, and Ribbond increased the incidence of restorable fracture compared with the controls.
Sarcoidosis-Associated Immune Thrombocytopenic Purpura and Focal Segmental Glomerulosclerosis
Authors: Korogodina Anna , Kaur Navneet , Kumthekar Anand
Published: May 2022

Sarcoidosis is well known for heterogeneity of its presentation and multisystem organ involvement. It commonly involves respiratory tract, skin, eyes, and lymph nodes, as well as hematologic and renal systems. While anemia and lymphopenia are the most common hematologic abnormalities seen in sarcoidosis, immune thrombocytopenic purpura (ITP) is considered rare. Renal abnormalities, although infrequent, are usually more likely to involve tubules rather than glomeruli. In this report, we present a case of sarcoidosis-associated ITP and focal segmental glomerulosclerosis (FSGS), refractory to first-line therapy, but successfully treated with Rituximab and thrombopoietin-receptor agonist.
Open Bristow Versus Open Latarjet for Anterior Shoulder Instability in Rugby Players: Radiological and Clinical Outcomes
Authors: Tanaka Makoto , Hanai Hiroto , Kotani Yuki , Kuratani Kosuke , Nakai Hidekazu , Kinoshita Shuma , Hirose Takehito , Hayashida Kenji
Published: May 2022

Background:

Coracoid transfer is a reliable method for managing anterior shoulder instability in athletes who play contact sports; however, differences between the Bristow and Latarjet procedures are unclear.

Purpose:

To compare clinical outcomes and rates of bone union and bone resorption of the coracoid process between the open Bristow and open Latarjet procedures in rugby players.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Rugby players who underwent an open Bristow or an open Latarjet procedure were retrospectively reviewed for anterior shoulder instability, and 66 shoulders in the Bristow group and 35 in the Latarjet group were included. Graft union and resorption were evaluated using computed tomography at 3 months to 1 year postoperatively. Patient-reported outcome measures (American Shoulder and Elbow Surgeons score, Rowe score, and satisfaction rate) were obtained at a mean follow-up of 74 months (range, 45-160 months) for Bristow and 64 months (range, 50-76 months) for Latarjet procedures. Recurrence and the rate of return to play (RTP), frequency of pain after RTP, and retirement rate after RTP were also assessed.

Results:

In 97.1% of the Latarjet procedure cases, bone union of the coracoid was achieved at 3 months postoperatively; however, bone union was achieved in only 72.7% of the Bristow procedure cases at 6 months postoperatively. Bone resorption of the coracoid process occurred in 6.1% of shoulders after the Bristow procedure, whereas 100% of shoulders showed bone resorption after the Latarjet procedure. No statistical differences were found in outcome scores between the 2 procedures. Subluxation and persistent pain after returning to sports were identified at a significantly higher rate in the Latarjet group (5 shoulders [14%] and 9 shoulders [26%], respectively) than in the Bristow group (2 shoulders [3%] and 2 shoulders [3%]) ( P = .0471 and P = .001, respectively).

Conclusion:

The Latarjet procedure had an advantage in the early and high rate of bone union but was at a disadvantage in bone resorption compared with the Bristow procedure. Subluxation and pain after returning to sports were more frequent in patients who underwent the open Latarjet procedure than in those who underwent the open Bristow procedure.
Blood Pressure Profile and Trends in the Neonatal Transitioning Period: A Comparative Study of Term Asphyxiated and Healthy Newborns
Authors: Taiwo Adekunle Bamidele , Okeniyi John Akintunde , Ogundare Olatunde Ezra , Fatunla Odunayo Adebukola , Babatola Olarinre Adefunke , Akibu Oyelami Oyeku
Published: May 2022

Background. Extra-uterine transition difficulties including BP abnormalities have been documented following perinatal asphyxia. Aim. The study aimed to determine the BP changes in the early neonatal transitioning period. Method. This comparative, cross-sectional study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Result. A total of 246 term babies were analyzed. Their mean (standard deviation) systolic, diastolic and mean arterial blood pressures (SBP, DBP, and MBP) at birth were 68.2 (9.0), 39.9 (7.0), and 49.4 (6.9) mmHg and 67.4 (7.9), 37.1 (6.1), and 47.2 (5.8) mmHg, respectively. Asphyxiated neonates had significantly higher initial DBP ( P < .001) and MAP ( P = .008), lower SBP ( P < .001) and MAP ( P = .024) at 6 hours and lower SBP at 12 hours after birth, statistically. Conclusion. This study showed that while the BP of healthy neonates steadily increases in the first 48 hours after birth, it fluctuated markedly within the first 12 hours of birth among asphyxiated babies.
Co-developing evidence-informed adaptation actions for resilient citywide sanitation: Local government response to climate change in Indonesia
Authors: Willetts Juliet , Priadi Cindy , Ombasta Osha , Wulandari Dwica , Imtiyaz Inas , Sudhiastiningsih Ni Nyoman Sri Natih , Kohlitz Jeremy , Mills Freya , Listyasari Maraita
Published: May 2022

Already climate-related hazards are impacting sanitation systems in Indonesia and elsewhere, and climate models indicate these hazards are likely to increase in frequency and intensity. Without due attention, to maintain existing progress on Sustainable Development Goal 6’s target 6.2 and to increase it to meet ambitions for 2030 will be difficult. City governments need new forms of evidence to respond, as well as approaches to enable them to consider sufficient breadth of strategies to adapt effectively. This paper describes a co-production research process which engaged local governments in four cities in Indonesia experiencing different climate hazards. Local government engagement took place across three stages of (i) inception and design, (ii) participation as key informants and (iii) joint analysis and engagement on the findings. We adapted and simplified a risk prioritisation process based on current literature and employed a novel framework of a ‘climate resilient sanitation system’ to prompt articulation of current and proposed climate change adaptation response actions. In contrast to many current framings of climate resilience in sanitation that focus narrowly on technical responses, the results paint a rich picture of efforts needed by city governments across all domains, including planning, institutions, financing, infrastructure and management options, user awareness, water cycle management and monitoring and evaluation. Local government commitment and improved comprehension on the implications of climate change for sanitation service delivery were key outcomes arising from the co-production process. With strengthened policy and capacity building initiatives from national level, this foundation can be supported, and Indonesian city governments will be equipped to move forward with adaptation actions that protect on-going access to sanitation services, public health and the environment.
Reperfusion Injury in the Cord—Rare Case of Pediatric White Cord Syndrome
Authors: Sundaram Geethanjali , Balasubramanian Rohit , Christopher Navya , Varadharajan Shriram , Cannane Seetharaman
Published: May 2022

Background:

Postoperative neurological deficits following spinal decompression are often caused due to an expanding hematoma or other iatrogenic injuries. When a definitive etiology could not be identified, it may rarely be related to a reperfusion injury. Such unexplained neurological deficits are often associated with the presence of cord signal changes on imaging. It is assumed to result from ischemia-reperfusion injury and is often designated as “white cord syndrome” due to its imaging appearance. Such a diagnosis is made after excluding other differentials. Outcomes are variable based on the current literature. We report a patient with possible white cord syndrome following decompression and excision of cervicodorsal osteochondroma.

Case Description:

In this case report, we present a young patient who was admitted with slowly progressive paraplegia, and initial imaging showed C7-D1 pedunculated osteochondroma. He underwent an uneventful spinal laminectomy accompanied by tumor excision. In the immediate postoperative period, the patient became paraplegic and a follow-up magnetic resonance imaging was taken. It showed re-expansion of cord in the region of compression by the mass lesion at C7-D1 level with interval abnormal T2/IR hyper intensity extending from C6 to D1 levels.

Conclusion:

White cord syndrome is an extremely rare condition. It is postulated to be caused by reperfusion injury to the cord within areas of chronic ischemia due to compressive causes. We describe a child with white cord syndrome following decompression and excision of an osteochondroma.
Sexual Addiction Disorder— A Review With Recent Updates
Authors: Sahithya B. R. , Kashyap Rithvik S.
Published: May 2022

Sexual addiction, hypersexuality, sexual compulsivity, and sexual impulsivity are all terms that describe a psychological disorder that is characterized by a person’s inability to control his or her sexual behavior. This spectrum of symptoms are often referred to as sexual addiction disorder. Whether excessive sexual behavior should be regarded as an addiction, or a compulsion, or an impulse control disorder is arguable, as each label indicates a specific etiological model and treatment plan. Sexual addiction disorder has been largely ignored by the clinicians, although it causes significant emotional and behavioral problems among the patients. Fortunately, in the recent years, this disorder is gaining recognition, and attempts have been made to understand it through research. The present article aims to systematically review and summarize the recent understanding and research on phenomenology, clinical characteristics, etiology, assessment, and management of sexual addiction disorder.
Segmental strain for scar detection in acute myocardial infarcts and in follow-up exams using non-contrast CMR cine sequences
Authors: Polacin Malgorzata , Karolyi Mihaly , Eberhard Matthias , Matziris Ioannis , Alkadhi Hatem , Kozerke Sebastian , Manka Robert
Published: May 2022

Background

The purpose of the study was to investigate feasibility of infarct detection in segmental strain derived from non-contrast cardiac magnetic resonance (CMR) cine sequences in patients with acute myocardial infarction (AMI) and in follow-up (FU) exams.

Methods

57 patients with AMI (mean age 61 ± 12 years, CMR 2.8 ± 2 days after infarction) were retrospectively included, FU exams were available in 32 patients (35 ± 14 days after first CMR). 43 patients with normal CMR (54 ± 11 years) served as controls. Dedicated software (Segment CMR, Medviso) was used to calculate global and segmental strain derived from cine sequences. Cine short axis stacks and segmental circumferential strain calculations of every patient and control were presented to two blinded readers in random order, who were advised to identify potentially infarcted segments, blinded to LGE and clinical information.

Results

Impaired global strain was measured in AMI patients compared to controls (global peak circumferential strain [GPCS] p = 0.01; global peak longitudinal strain [GPLS] p = 0.04; global peak radial strain [GPRS] p = 0.01). In both imaging time points, mean segmental peak circumferential strain [SPCS] was impaired in infarcted tissue compared to remote segments (AMI: p = 0.03, FU: p = 0.02). SPCS values in infarcted segments were similar between AMI and FU (p = 0.8). In SPCS calculations, 141 from 189 acutely infarcted segments were accurately detected (74.6%), visual evaluation of correlating cine images detected 43.4% infarcts. In FU, 80% infarcted segments (91/114 segments) were detected in SPCS and 51.8% by visual evaluation of correlating short axis cine images (p = 0.01).

Conclusion

Segmental circumferential strain derived from routinely acquired native cine sequences detects nearly 75% of acute infarcts and 80% of infarcts in subacute follow-up CMR, significantly more than visual evaluation of correlating cine images alone. Acute infarcts may display only subtle impairment of wall motion and no obvious wall thinning, thus SPCS calculation might be helpful for scar detection in patients with acute infarcts, when LGE images are not available.
Primary healthcare professionals’ perspectives on patient help-seeking for lung cancer warning signs and symptoms: a qualitative study
Authors: Saab Mohamad M. , O’Driscoll Michelle , FitzGerald Serena , Sahm Laura J. , Leahy-Warren Patricia , Noonan Brendan , Kilty Caroline , Lyons Noreen , Burns Heather E. , Kennedy Una , Lyng Áine , Hegarty Josephine
Published: May 2022

Background

Lung cancer is the leading cause of cancer incidence and mortality worldwide. Prompt patient help-seeking for signs and symptoms suggestive of lung cancer is crucial for early referral, diagnosis, and survivorship. However, individuals with potential lung cancer symptoms tend to delay help-seeking. This qualitative study explored perceived barriers to patient help-seeking and strategies to enhance help-seeking for lung cancer warning signs and symptoms from the perspective of primary healthcare professionals.

Methods

Semi-structured focus groups and individual interviews were conducted with 36 primary healthcare professionals. Data were collected via videoconferencing. Inductive thematic analysis was conducted.

Results

The following two themes were created from the data: (i) perceived barriers to patient help-seeking for signs and symptoms of concern and (ii) facilitating early patient presentation for signs and symptoms of concern. Some participants believed that the high cost of a general practitioner visit, long waiting times, and previous bad experiences with the healthcare system would deter patients from seeking help for symptoms of lung cancer. Perceived patient-related barriers to help-seeking related to the different emotions associated with a potential cancer diagnosis as well as stigma, embarrassment, and guilt felt by smokers. Sociodemographic factors such as drug use, homelessness, living in rural areas, and being male and older were also perceived to impede patient help-seeking. The negative impact of the COVID-19 pandemic on cancer help-seeking also featured strongly. Participants recommended several strategies to enable patients to seek help for symptoms of concern including targeted educational campaigns focussing on symptoms (e.g., cough) rather than behaviours (e.g., smoking), accessible and free health services, and using patients’ support networks.

Conclusions

Patient-related and healthcare system-related barriers to help-seeking for lung cancer warning signs and symptoms include cost of healthcare, cancer fear, and various sociodemographic factors. Participants suggested that increased awareness and early patient help-seeking for symptoms of concern could be achieved through targeted patient education, national campaigns, the use of community support networks, and free and accessible targeted screening services.
Association of acute kidney disease with the prognosis of ischemic stroke in the Third China National Stroke Registry
Authors: Zhou Yilun , Wang Dongxue , Li Hao , Pan Yuesong , Xiang Xianglong , Wu Yu , Xie Xuewei , Wang Xianwei , Luo Yang , Meng Xia , Lin Jinxi , Wang Hong , Huo Yong , Matsushita Kunihiro , Chen Jing , Hou Fan Fan , Wang Yongjun
Published: May 2022

Background

Acute kidney disease (AKD) evolves a spectrum of acute and subacute kidney disease requiring a global strategy to address. The present study aimed to explore the impact of AKD on the prognosis of ischemic stroke.

Methods

The Third China National Stroke Registry (CNSR-III) was a nationwide registry of ischemic stroke or transient ischemic attack between August 2015 and March 2018. As a subgroup of CNSR-III, the patients who had serum creatinine (sCr) and serum cystatin C (sCysC) centrally tested on admission and at 3-month, and with 1-year follow-up data were enrolled. Modified AKD criteria were applied to identify patients with AKD during the first 3 months post stroke according to the guidelines developed by the Kidney Disease: Improving Global Outcomes in 2012. The primary clinical outcome was 1-year all-cause death, and secondary outcomes were stroke recurrence and post stroke disability.

Results

Five thousand sixty-five patients were recruited in the study. AKD was identified in 3.9%, 6.7%, 9.9% and 6.2% of the patients by using sCr, sCr-based estimated glomerular filtration rate (eGFRsCr), sCysC-based eGFR (eGFRsCysC), and combined sCr and sCysC-based eGFR (eGFRsCr+sCysC) criteria, respectively. AKD defined as sCr or eGFRsCr criteria significantly increased the risk of all-cause mortality (adjusted HR 2.67, 95% CI: 1.27–5.61; adjusted HR 2.19, 95% CI: 1.17–4.10) and post stroke disability (adjusted OR 1.60, 95% CI: 1.04–2.44; adjusted OR 1.51, 95% CI: 1.08–2.11). AKD diagnosed by eGFRsCysC or eGFRsCr+sCysC criteria had no significant impact on the risk of all-cause death and post stroke disability. AKD, defined by whichever criteria, was not associated with the risk of stroke recurrence in the adjusted model.

Conclusions

AKD, diagnosed by sCr or eGFRsCr criteria, were independently associated with 1-year all-cause death and post stroke disability in Chinese ischemic stroke patients.
A qualitative study of minority ethnic women’s experiences of access to and engagement with perinatal mental health care
Authors: Pilav Sabrina , De Backer Kaat , Easter Abigail , Silverio Sergio A. , Sundaresh Sushma , Roberts Sara , Howard Louise M.
Published: May 2022

Background

Approximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.

Aims

To explore minority ethnic women’s experiences of access to and engagement with perinatal mental health care.

Methods

Semi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.

Results

Three distinct overarching themes were identified, each with two or three subthemes: ‘Expectations and Experiences of Womanhood as an Ethnic Minority’ (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), ‘Family and Community Influences’ (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and ‘Cultural Understanding, Empowerment, and Validation’ (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).

Conclusion

Women of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women’s perinatal mental health needs.
A theory driven, pragmatic trial implementing changes to routine antenatal care that supports recommended pregnancy weight gain
Authors: de Jersey Susan , Guthrie Taylor , Callaway Leonie , Tyler Jeanette , New Karen , Nicholson Jan
Published: May 2022

Background

Prevention of weight gain outside recommendations is a challenge for health services, with several barriers to best practice care identified. The aim of this pragmatic implementation study with a historical control was to examine the impact of implementing a service wide education program, and antenatal care pregnancy weight gain chart combined with brief advice on women’s knowledge of recommended gestational weight gain (GWG), the advice received and actual GWG.

Methods

The PRECEDE PROCEED Model of Health Program planning guided intervention and evaluation targets and an implementation science approach facilitated service changes. Pregnant women < 22 weeks’ gestation attending the antenatal clinic at a metropolitan birthing hospital in Australia were recruited pre (2010, n = 715) and post (2016, n = 478) implementation of service changes. Weight measurements and questionnaires were completed at recruitment and 36 weeks’ gestation. Questionnaires assessed advice received from health professionals related to healthy eating, physical activity, GWG, and at recruitment only, pre-pregnancy weight and knowledge of GWG recommendations.

Results

Women who correctly reported their recommended GWG increased from 34% (pre) to 53% (post) (p < 0.001). Between pre and post implementation, the advice women received from midwives on recommended GWG was significantly improved at both recruitment- and 36-weeks’ gestation. For normal weight women there was a reduction in GWG (14.2 ± 5.3 vs 13.3 ± 4.7 kg, p = 0.04) and clinically important reduction in excess GWG between pre and post implementation (31% vs 24%, p = 0.035) which remained significant after adjustment (AOR 0.53 [95%CI 0.29–0.96]) (p = 0.005).

Conclusions

Service wide changes to routine antenatal care that address identified barriers to supporting recommended GWG are likely to improve the care and advice women receive and prevent excess GWG for normal weight women.
Securing peripheral intravenous catheters in babies without applying adhesive dressings to the skin: a proof-of-concept study
Authors: Harris Deborah L. , Schlegel Melissa , Markovitz Anna , Woods Lisa , Miles Tamara
Published: May 2022

Background

Most babies admitted to a Neonatal Intensive Care Unit (NICU) require a peripheral intravenous catheter (PIVC). PIVCs are secured using splints and adhesive dressings applied to the skin. Removing the dressings causes skin injury, pain, and risks infection. We designed the Pēpi Splint, which supports PIVCs without the application of adhesive dressings to the skin. We sought to determine the effectiveness and acceptability of the Pēpi Splint using a proof-of-concept design.

Methods

Eligible babies were > 1000 g and > 30 weeks’ corrected gestation admitted to Wellington Regional NICU and who required a PIVC. All babies received the same care as those not in the study, with the addition of the Pēpi Splint. Primary outcomes were the proportion of babies in which the Pēpi Splint secured the PIVC for the required time and proportion of babies who experience an adverse event. Secondary outcomes were the acceptability of the Pēpi Splint as reported by the parents.

Results

Thirty-eight babies, median (range) birth weight 2625 g (396—4970) and gestation 37wk (22—41). When the Pēpi was applied the postnatal weight was 2969 g (1145 – 4970) and gestation 37wk (29 – 41). The Pēpi Splint held the PIVC secure for 34/38 babies (89%), for a duration of 37 h (6 to 97). There were no adverse events. Of the four babies reported to have unsecure PIVCs, two were due to the securement two were displaced during feeding. Fifty-eight parents responded to a questionnaire (32 mothers, 26 fathers). Of these parents 52 (90%) would participate again and 52 (90%) would recommend participating to others. Overall, clinicians reported the Pēpi Splint was easy to use 33/38 (87%).

Conclusion

The Pēpi Splint safely secures PIVCs without adhesive dressings being applied to the skin and is acceptable to both parents and clinicians. Our findings provide support for a larger multicentred randomised controlled trial.

Trial registration

Registered with the Australian and New Zealand Clinical Trials Registry Reference ACTRN12620001335987.
A retrospective observational study of patients on maintenance hemodialysis receiving parathyroidectomy by ultrasonic scalpel
Authors: Gao Dan , Hu Fengqi , Gao Zhao , Yuan Hai
Published: May 2022

Background

Secondary hyperparathyroidism (SHPT) remains a common complication in many patients on maintenance hemodialysis. Kidney Disease Improve Global Outcomes (KDIGO) 2017 guidelines suggest that parathyroidectomy (PTX) should be performed in severe SHPT patients with chronic kidney disease stage 3a-stage 5D. In the present study, we observed the efficacy of ultrasonic scalpel for PTX in SHPT patients on maintenance hemodialysis.

Methods

A total of 74 patients on maintenance hemodialysis who underwent PTX (34 with traditional electrocautery and 40 with an ultrasonic scalpel) were observed between August 2020 and August 2021 at Xiangyang Central Hospital (Hubei University of Arts and Science). Baseline demographic and clinic characteristics were collected pre- and post-PTX. Moreover, the postoperative complications and operation time were assessed between the two groups.

Results

The univariate analysis showed that there was no statistical significance in weight, dialysis duration, serum potassium, serum calcium, serum magnesium, alkaline phosphate, triglyceride, and intact parathyroid hormone (iPTH) before and after PTX between the two groups (P > 0.05). The operation time in the ultrasonic scalpel group was significantly decreased compared with the traditional electrocautery group (P < 0.05). Compared with the traditional electrocautery group, the drainage amount was significantly reduced in the ultrasonic scalpel group, and the number of days with drain and postoperative hospital stay were also remarkably decreased (P < 0.05).

Conclusions

The use of ultrasonic scalpel significantly reduced the operation time and postoperative hospital stay in patients on maintenance hemodialysis undergoing PTX.
The impact of tumor burden at the initial hepatectomy on the recurrence-to-death survival after repeat surgical resection/radiofrequency ablation: a retrospective study
Authors: Wu Youwei , Peng Wei , Shen Junyi , Zhang Xiaoyun , Li Chuan , Wen Tianfu
Published: May 2022

Background

Previous studies have reported the surgical resection (SR) and radiofrequency ablation (RFA) could achieve comparable recurrence-to-death survival (RTDS). However, the impact of primary tumor burden on RTDS of patients with recurrent hepatocellular carcinoma (HCC) following SR or RFA has not been clarified.

Methods

From January 2009 to March 2015, 171 patients who underwent initial hepatectomy and second curative treatments in West China Hospital were retrospectively analyzed. Survival analysis was performed by the Kaplan–Meier method. Risk factors were identified using the Cox proportional hazard model.

Results

At initial hepatectomy, 96 patients (56.1%) were diagnosed with HCC within the Milan criteria (MC), and 75 patients (43.9%) were HCC beyond the MC. The clinicopathological features and re-treatment methods of recurrent HCC were similar between patients with primary HCC within or beyond the MC. Patients with primary HCC within the MC had longer recurrence time (31.4 ± 24.2 months vs. 20.2 ± 16 months, P < 0.001). The 1- and 3- year RTDS within and beyond the MC group were 88.8%, 57.6% and 79.0%, 46.3%, respectively (P = 0.093). In multivariate analysis, the recurrence time, tumor size and AFP > 400 ng/mL at the time of recurrence were associated with RTDS.

Conclusions

The primary tumor burden had no impact on RTDS, but had an impact on recurrence time. The recurrence time had an impact on RTDS and might be a good index to reflect the biology of recurrent HCC.
The effects of amalgam contamination and different surface modifications on microleakage of dentin bonded to bulk fill composite when using different adhesive protocols
Authors: Alshehri Nojoud , Aljamhan Abdullah , Bin-Shuwaish Mohammed
Published: May 2022

Background

To evaluate the effect of amalgam contamination, different surface treatments, and adhesive protocols on dentin microleakage to bulk-fill composite resin material.

Methods

Forty teeth were fixed in (polyvinyl siloxane) PVS molds, and the Class II cavities were placed on mesial and distal aspects. Thirty teeth were restored by amalgam and thermocycled to 10,000 cycles (5 and 55 °C, 30-s dwell time). The rest were restored with Filtek one Bulk Fill composite without amalgam predecessor. Samples were divided into: G1 (dentin pretreated with 2% chlorhexidine gluconate), G2 (0.5 mm of dentin was removed), G3 (no surface modification), and G4 (control, where composite was bonded to sound dentin without amalgam predecessor.). Single Bond Universal Adhesive system was used to bond the composite material, by using the etch-and-rinse protocol in the mesial cavity preparation and self-etch protocol in the distal. Specimens underwent thermocycling for 5000 cycles, then embedded in silver nitrate and sectioned for stereomicroscope examination. Descriptive statistics, Mann–Whitney U test, and Kruskal–Wallis test were used to analyze the results at p < 0.05.

Results

The highest microleakage score values (4.00) were found in the G2, and G4 in etch-and-rinse protocol. While the lowest scores were found in G2 when using self-etching protocol (1.5). Lower microleakage values were associated with the chlorhexidine treatment group for both adhesive protocols. No significant differences were found between amalgam contaminated and non-contaminated groups.

Conclusions

Amalgam contamination did not affect microleakage. Self-etching adhesive protocol significantly reduced microleakage for all groups irrespective of the surface treatment. Chlorhexidine pretreatment improved microleakage for both adhesive protocols but had no significant effect.
Knowledge on risk factors and practice of early detection methods of breast cancer among graduating students of Debre Tabor University, Northcentral Ethiopia
Authors: Mehiret Gashaw , Molla Amsalu , Tesfaw Aragaw
Published: May 2022

Background

Breast cancer is the greatest common cancer in women worldwide, with approximately 1.7 million new cases diagnosed each year in the world which accounts for 12% of all new cancer cases and 25% of all cancers in women. Even though the higher mortality rate of breast cancer in low and middle-income countries, the practice of early detection methods is low and the majority of the patients who appeared at an advanced stage of the disease need palliative care with little survival rates. However, evidence is scarce on the knowledge and practice of breast cancer early detection methods among women of reproductive age in Ethiopia. Therefore we aimed to assess the knowledge on risk factors and practice of early detection methods of breast cancer among female graduating students of Debre Tabor University.

Methods

Institution-based cross-sectional study was conducted. A stratified random sampling technique was used. Data were collected with a self-administer questionnaire. The collected data were processed and analyzed with the computer using SPSS version 25 software. Descriptive statistics were used to describe the socio-demographic information of participants. Binary and multivariable logistic regression with an adjusted odds ratio (AOR) and 95% confidence interval (CI) was used to identify factors associated with the outcome variable. Statistical significance was stated at p < 0.05.

Result

A total of 270 female students participated in the study. The median age (± SD) was 24.63 years (± 1.26). All of the students heard about breast cancer and early detection methods. About 206 (76.67%) of the participants had good knowledge of breast self-examination. Mass media, health professionals, and friends in combination were the main source of information 172 (63.77%), only 110 (40.70%) of students performed a breast-self-examination and the rest did not perform it due to forgetting fullness and lack of knowledge. About 208 (77.1%) of the respondents respond family history is a risk factor for breast cancer. Being a health science student (AOR = 2.32; 95% CI: 2.12, 3.52), family history of breast problems (AOR = 3.41; 95% CI: 3.22, 8.33), and having a good level of knowledge (AOR = 1.83; 95% CI: 1.01, 5.68) were the factors associated with the practice of breast self-examination.

Conclusion

Most of the participants were unaware of the benefits, appropriate timing, and techniques of doing a breast self-examination. Health science students had better awareness & practice of breast self-examination than non-health science students. Trained health professionals must give focus on giving health information regarding risk factors of breast cancer and methods of early detection of breast cancer to the public & their clients.
Applying spectral fractal dimension index to predict the SPAD value of rice leaves under bacterial blight disease stress
Authors: Cao YiFei , Xu Huanliang , Song Jin , Yang Yao , Hu Xiaohui , Wiyao Korohou Tchalla , Zhai Zhaoyu
Published: May 2022

Background

The chlorophyll content is a vital indicator for reflecting the photosynthesis ability of plants and it plays a significant role in monitoring the general health of plants. Since the chlorophyll content and the soil–plant analysis development (SPAD) value are positively correlated, it is feasible to predict the SPAD value by calculating the vegetation indices (VIs) through hyperspectral images, thereby evaluating the severity of plant diseases. However, current indices simply adopt few wavelengths of the hyperspectral information, which may decrease the prediction accuracy. Besides, few researches explored the applicability of VIs over rice under the bacterial blight disease stress.

Methods

In this study, the SPAD value was predicted by calculating the spectral fractal dimension index (SFDI) from a hyperspectral curve (420 to 950 nm). The correlation between the SPAD value and hyperspectral information was further analyzed for determining the sensitive bands that correspond to different disease levels. In addition, a SPAD prediction model was built upon the combination of selected indices and four machine learning methods.

Results

The results suggested that the SPAD value of rice leaves under different disease levels are sensitive to different wavelengths. Compared with current VIs, a stronger positive correlation was detected between the SPAD value and the SFDI, reaching an average correlation coefficient of 0.8263. For the prediction model, the one built with support vector regression and SFDI achieved the best performance, reaching R2, RMSE, and RE at 0.8752, 3.7715, and 7.8614%, respectively.

Conclusions

This work provides an in-depth insight for accurately and robustly predicting the SPAD value of rice leaves under the bacterial blight disease stress, and the SFDI is of great significance for monitoring the chlorophyll content in large-scale fields non-destructively.
Immunosuppressive cells in cancer: mechanisms and potential therapeutic targets
Authors: Tie Yan , Tang Fan , Wei Yu-quan , Wei Xia-wei
Published: May 2022

Immunotherapies like the adoptive transfer of gene-engineered T cells and immune checkpoint inhibitors are novel therapeutic modalities for advanced cancers. However, some patients are refractory or resistant to these therapies, and the mechanisms underlying tumor immune resistance have not been fully elucidated. Immunosuppressive cells such as myeloid-derived suppressive cells, tumor-associated macrophages, tumor-associated neutrophils, regulatory T cells (Tregs), and tumor-associated dendritic cells are critical factors correlated with immune resistance. In addition, cytokines and factors secreted by tumor cells or these immunosuppressive cells also mediate the tumor progression and immune escape of cancers. Thus, targeting these immunosuppressive cells and the related signals is the promising therapy to improve the efficacy of immunotherapies and reverse the immune resistance. However, even with certain success in preclinical studies or in some specific types of cancer, large perspectives are unknown for these immunosuppressive cells, and the related therapies have undesirable outcomes for clinical patients. In this review, we comprehensively summarized the phenotype, function, and potential therapeutic targets of these immunosuppressive cells in the tumor microenvironment.
Homologous recombination deficiency (HRD) can predict the therapeutic outcomes of immuno-neoadjuvant therapy in NSCLC patients
Authors: Zhou Zhen , Ding Zhengping , Yuan Jie , Shen Shengping , Jian Hong , Tan Qiang , Yang Yunhai , Chen Zhiwei , Luo Qingquan , Cheng Xinghua , Yu Yongfeng , Niu Xiaomin , Qian Liqiang , Chen Xiaoke , Gu Linping , Liu Ruijun , Ma Shenglin , Huang Jia , Chen Tianxiang , Li Ziming , Ji Wenxiang , Song Liwei , Shen Lan , Jiang Long , Yu Zicheng , Zhang Chao , Tai Zaixian , Wang Changxi , Chen Rongrong , Carbone David P. , Xia Xuefeng , Lu Shun
Published: May 2022

Background

Neoadjuvant immunotherapy is emerging as novel effective intervention in lung cancer, but study to unearth effective surrogates indicating its therapeutic outcomes is limited. We investigated the genetic changes between non-small cell lung cancer (NSCLC) patients with varied response to neoadjuvant immunotherapy and discovered highly potential biomarkers with indicative capability in predicting outcomes.

Methods

In this study, 3 adenocarcinoma and 11 squamous cell carcinoma NSCLC patients were treated by neoadjuvant immunotherapy with variated regimens followed by surgical resection. Treatment-naive FFPE or fresh tissues and blood samples were subjected to whole-exome sequencing (WES). Genetic alternations were compared between differently-responded patients. Findings were further validated in multiple public cohorts.

Results

DNA damage repair (DDR)-related InDel signatures and DDR-related gene mutations were enriched in better-responded patients, i.e., major pathological response (MPR) group. Besides, MPR patients exhibited provoked genome instability and unique homologous recombination deficiency (HRD) events. By further inspecting alternation status of homology-dependent recombination (HR) pathway genes, the clonal alternations were exclusively enriched in MPR group. Additionally, associations between HR gene alternations, percentage of viable tumor cells and HRD event were identified, which orchestrated tumor mutational burden (TMB), mutational intratumor heterogeneity (ITH), somatic copy number alteration (SCNA) ITH and clonal neoantigen load in patients. Validations in public cohorts further supported the generality of our findings.

Conclusions

We reported for the first time the association between HRD event and enhanced neoadjuvant immunotherapy response in lung cancer. The power of HRD event in patient therapeutic stratification persisted in multifaceted public cohorts. We propose that HR pathway gene status could serve as novel and additional indicators guiding immune-neoadjuvant and immunotherapy treatment decisions for NSCLC patients.