bluuebunny/crossref_metadata_2025 huggingface dataset:
Competence and Stress of Medication Administration Practices for School Nurses in K-12 Taiwan Schools
Authors: Yu Hsing-Yi , Huang Chun-Hsia , Liao Li-Ling , Lin Hui-Ling , Chang Li-Chun
Published: July 2023

We investigated school nurses’ experiences, perceived government support, school nurses’ acceptance of responsibility for medication administration, perceived stress, and perceived competence of medication administration and analyzed factors associated with perceived competence. In this cross-sectional study, from February to April 2023, we conducted an online survey of 269 school nurses serving at K-12 schools in Taiwan. The results revealed that although 71% of the participants had prior experience with medication administration, they reported low competence and high stress in areas such as drug interactions, adverse drug effects, and referrals. The school nurses’ disagreement with responsibilities for medication administration emerged as the only factor to be significantly associated with perceived medication administration competence, accounting for 22.8% of the variance. We recommend implementing continuing training programs to provide school nurses with up-to-date medication information. Additionally, the development of practice guidelines is suggested as a means of enhancing nurses’ competence and reducing their stress levels for the administration of medications.
International Conflict Involvement, Domestic Repression, and the Escalation of Civil Conflict
Authors: Kopp Heather M. , Reeder Bryce W. , Wright Thorin M.
Published: July 2023

Does participation in conflicts abroad lead to a great risk of conflict escalation at home? We contend that involvement in interstate conflict can impact the likelihood of civil conflict escalation via international conflict’s effects on domestic repression. During international conflict, states employ their military abroad to cope with an external threat, so they may have fewer resources with which to repress. Insurgencies may thus seize the opportunity to target the state. We predict that states that maintain high levels of repression during international conflict will be less likely to experience civil conflict escalation, but that states whose repressive output weakens increase their risk of such escalation. Utilizing mediation analysis, we find evidence that involvement in international conflict shifts repressive patterns, influencing internal conflict intensity. Specifically, governments that increase repression in the shadow of international conflict are less likely to witness civil conflict escalation while states that maintain or decrease repression are more likely.
Sinonasal Oxalosis due to Fungal Rhinosinusitis: A Unique Case of a Destructive Pseudotumor
Authors: Christensen Daniel , Tuluc Madalina , Faro Scott H. , Udare Ashlesha , Gargano Stacey
Published: July 2023

Oxalosis refers to the accumulation of calcium oxalate crystals in various organs and tissues, most commonly due to Aspergillus infection involving the lung or sinonasal tract. Both invasive and noninvasive forms of fungal rhinosinusitis can be associated with calcium oxalate crystal deposition. Here, we report a unique case of sinonasal oxalosis presenting as a destructive lesion in the absence of invasive fungal disease. Due to the clinical and pathologic significance of calcium oxalate crystals as seen in this patient, specimens from the sinonasal tract should be evaluated for the presence of these crystals, which may be a surrogate marker for fungal infection and may also independently cause tissue destruction.
Survival of small-cell lung cancer patients after surgery: A single-center retrospective cohort study
Authors: Zheng Zhibo , Zhu Danyang , Liu Lei , Chen Michael W , Li Guiping , Geng Ruixuan , Zhang Ying , Huang Cheng , Tian Zhenhuan , Liu Hongsheng , Li Shanqing , Chen Yeye
Published: July 2023

This study summarized and analyzed the clinical characteristics and prognosis of small-cell lung cancer (SCLC) patients after surgical treatment. The clinical data of 130 patients (99 males and 31 females) with SCLC treated by surgery and confirmed by postoperative pathological examination at Peking Union Medical College Hospital from April 2004 to April 2019 were retrospectively analyzed. Clinical characteristics, surgery, pathological stage, and perioperative treatment were summarized. Kaplan–Meier survival curve and Cox regression analysis were performed. Pathological examination revealed that 36 (27.69%) patients had stage I SCLC, 22 (16.92%) patients had stage II SCLC, 65 (50.00%) patients had stage III SCLC, and 7 (5.39%) patients had stage IV SCLC. The overall median survival time was 50 months (95% confidence interval, 10.8–89.2 months). The median survival time of stage I, II, III and IV SCLC patients was 148, 42, 32, and 10 months, respectively. In patients who underwent surgical treatment, postoperative adjuvant therapy and tumor stage were independent prognostic factors for survival (p < 0.05).Lobectomy and lymph nodes resection combined with adjuvant therapy were cautiously recommended for stage I–IIIa SCLC patients.
Role of multimodal imaging in coexistent pachychoroid spectrum disease
Authors: Sweta Shubhra , Sagar Pradeep , Biswal Suchitra , HN Ravishankar , PS Parvathy
Published: July 2023

Purpose

To describe the role of multimodal imaging in a case of coexisting pachychoroid diseases

Case description

We report a case of a 43 year old lady with coexistent central serous chorioretinopathy (CSC) and pachychoroid neovasculopathy (PNV) in the same eye which posed a diagnostic challenge. Fundus examination showed neurosensory detachment (NSD) at the macula along with retinal pigment epithelial alterations. Optical coherence tomography (OCT) showed a shallow pigment epithelial detachment and OCT angiography showed the presence of vascular network in outer retina choriocapillaris slab suggesting a diagnosis of PNV. However, fundus fluorescein angiography (FFA) showed a smoke stack leak adjacent to the site of vascular network. Focal laser photocoagulation of the leaky point resulted in resolution of NSD pointing towards a diagnosis of CSC.

Conclusion

This case emphasises the role of multimodal imaging in identifying the source of leak in coexistent pachychoroid spectrum diseases.
Optical coherence tomography angiography findings in optic disc drusen and idiopathic intracranial hypertension
Authors: Yalcinkaya Cakir Gulay , Solmaz Banu , Cakir Ihsan , Pasaoglu Isil Basgil , Taskapili Muhittin
Published: July 2023

Purpose

To evaluate the changes in peripapillary microvascularity in idiopathic intracranial hypertension (IIH) and optic disc drusen (ODD) patients, by comparing them with those in healthy individuals, via optical coherence tomography angiography (OCTA).

Methods

Sixty-two eyes of 33 patients with ODD, 58 eyes of 30 patients with IIH, and 70 eyes of 70 healthy people were imaged for 6 × 6-mm optic disc scans on a spectral-domain OCTA. Vascular densities in superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC) of ODD, IIH, and healthy eyes were compared with a one-way analysis of variance. Post-hoc analysis was performed with the Gabriel test.

Results

There was a significant decrease in peripapillary vessel density in SCP, DCP, and CC in patients with IIH compared to the control group ( p < 0.05). In ODD patients, especially peripapillary vessel density in DCP was significantly reduced compared to the control group ( p < 0.05). Peripapillary vessel density in DCP was significantly lower in the IIH group than ODD group ( p < 0.05).

Conclusions

Peripapillary vascular density may be affected during the course of the disease in both IIH and ODD. Compared to healthy individuals, the decrease in vascular density in these patients and the consequent decrease in perfusion in the peripapillary region may guide the pathogenesis of the complications in the course of these two diseases. Although vascular density in DCP and CC differs significantly between IIH and ODD, case-controlled studies are needed to evaluate the role of OCTA in the differential diagnosis of IHH and ODD.
The Genomic and Proteomic Profiles of NTRK Genes and Trk Receptors in Liver Hepatocellular Carcinoma
Authors: Wang Hejing , Qi Lina , Zhong Chenhan , Fang Xuefeng , Yuan Ying
Published: July 2023

Background:

The neurotrophic tyrosine kinase (NTRK) gene family includes NTRK1, NTRK2, and NTRK3, which encode tropomyosin receptor kinases TrkA, TrkB, and TrkC, respectively. This study aimed to initially assess the genomic and proteomic profiles of NTRK genes and Trk receptors in liver hepatocellular carcinoma (LIHC).

Methods:

The ONCOMINE, UALCAN, GEPIA, cBioPortal, FusionGDB, SurvivalMeth, and the Human Protein Atlas databases were searched for NTRK gene expression and protein data in LIHC. Immunohistochemistry was used to detect pan-Trk expression across a commercial microarray containing 96 hepatocellular carcinoma (HCC) and 94 para-cancerous tissue spots. A modified histological score (H-score) with a maximum score of 300 was used to quantify immunohistochemical staining for pan-Trk. Student’s t- and chi-square tests were the main statistical analyses used.

Results:

The transcriptional levels of NTRK genes in LIHC were not significantly different from healthy controls. Using UALCAN and GEPIA, only high expression of NTRK2 was significantly associated with longer disease-free survival (P = 0.004). The alteration frequencies were low (7% in NTRK1, 1.7% in NTRK2, and 2% in NTRK3). The methylation levels of NTRK genes were all significantly different as analyzed by UALCAN; the high-risk group displayed an unfavorable prognosis compared with the low-risk group for NTRK1 (P = 0.033) and NTRK3 (P = 0.005). The median H-score of pan-Trk in HCC and para-cancerous tissues was not statistically different (186.31 ± 23.86 and 192.38 ± 21.06, P = 0.065). No differences were observed in clinicopathological features of HCC with the median H-score for pan-Trk expression (p > 0.05). The survival rate of patients with pan-Trk expression was also not significantly different.

Conclusion:

The alteration frequency was low in NTRK genes, including gene fusion and methylation levels. Therefore, pan-Trk expression in HCC tissue has limited value in clinicopathological features and prognosis.
Sexualising characteristics of adolescent on TikTok. Comparative study Great Britain–Spain
Authors: Suárez-Álvarez Rebeca , García-Jiménez Antonio , Urbina Montana María L
Published: July 2023

The research addresses whether adolescents are increasing their self-sexualisation on TikTok through content analysis. It has studied the type and number of sexualising features present in the videos that Spanish and British teenagers share on the social network TikTok, offering a comparative view. A total of 447 videos from 12 British and 12 Spanish tiktokers aged 11 to 17 have been analysed, considering their gender and age and comparing both nationalities. A high level of self-sexualisation has been found in the videos of adolescents of both genders and nationalities. The results show that age and gender determine the sexualising characteristics included in their videos and that British and Spanish minors do not use the same sexualising codes, although neither nationality is more sexualised than the other. It has been confirmed that boys and girls self-sexualise in similar proportions. Age determines sexualising characteristics they incorporate in their audio–visual productions, which indicate the blurring of traditional stereotyped roles and the unification of sexual codes that have traditionally been considered a female domain.
Flourishing through The Spectrum: Toward an affective-oriented composite pedagogical model?
Authors: Brunsdon Jamie Jacob
Published: July 2023

The concept of models-based practice has arguably provided the field of sport pedagogy with the means, lens, and tools with which to start to transform the discipline into a more desirable, equitable, and purposeful space. Despite this, there remains a need to experiment with this concept further in non-traditional ways and to continue to construct new pedagogical models meant to serve youth in ever-changing pluralist societies. The purpose of this paper, therefore, was to outline an affective-oriented composite pedagogical model, titled The Spectrum Model, by drawing from Mosston and Ashworth's theory for the spectrum of teaching and learning and neo-Aristotelian virtue ethics. To achieve this goal, I begin by highlighting the need for studying the synergy between the spectrum and models-based practice more closely. Thereafter, I attempt to clarify spectrum theory, virtue ethics, and the concept of models-based practice. Finally, I conclude by presenting two broad main ideas, three critical elements, six intended learning aspirations, and a series of suggested pedagogies acting to inform the proposed Spectrum Model. This model has the potential to influence how practitioners and scholars understand the spectrum of teaching and learning within the broader notion of models-based practice. The application and integration of moral philosophy into a well-established pedagogical framework might also help pedagogues of all kinds to envision how they could help youth to obtain a fully flourishing lifestyle through their teaching.
The research on an electronic evidence forensic system for cross-border cybercrime
Authors: Zhang Hengyue , Gong Xiangqian
Published: July 2023

In response to cross-border cybercrime, investigative organs have adopted cross-border criminal forensic measures such as online public extraction, remote electronic data inspection and real-time monitoring, which may violate the principles of data sovereignty and judicial assistance. While promoting the establishment of a cross-border cooperation mechanism, China should establish a new cross-border electronic evidence criminal forensics model by promoting the procedural justification of cross-border search and monitoring measures. To better regulate cross-border criminal forensics activities, it is necessary to improve the cross-border cybercrime procuratorial organs system to intervene in advance and guide investigations.
Behold the metaverse: Facebook’s Meta imaginary and the circulation of elite discourse
Authors: Lucia Brent , Vetter Matthew A , Adubofour Isaac Kwabena
Published: July 2023

Despite pushback from regulatory and non-governmental entities, Meta’s control over the public narrative remains consistent. Using a method of corpus analysis, this study investigated the company’s sociotechnical imaginary as it circulates in media artifacts (428) responding to Zuckerberg’s 2021 Metaverse announcement. Analysis of how these artifacts respond to issues related to identity, security, and connectivity revealed that the majority amplify Meta’s corporate messaging, empowering its elite discourse and solidifying its socio-technological power. As it relates to user privacy, however, this study uncovered a limited number of artifacts in which journalists challenged rather than repeated Meta’s rhetoric. As an implication of this finding, future tech journalism should consider privacy as a starting point for critiques that also interrogate the underlying logic of surveillance capitalism and user exploitation. Ultimately, this article addresses the rhetorical functions deployed in the circulation of elite discourse while acknowledging the dynamism of sociotechnical imaginaries.
Successful treatment of severe calciphylaxis in a renal transplant patient with previous total parathyroidectomy
Authors: Smith Rachel , Bulteel Naomi , Alfonzo Annette , Gupta Sampada
Published: July 2023

Calciphylaxis is a rare dermatological condition strongly associated with chronic kidney disease. The pathophysiology and optimum treatment remain uncertain. Calciphylaxis is known mostly to affect dialysis patients but is less frequently reported in renal transplant recipients. We report the case of a renal transplant recipient who had undergone previous total parathyroidectomy.
Integrating Autoethnography and Dynamic P-Technique: A Convergent Explanatory Bidirectional Single-Subject Study on Embodying Mindfulness as an Instructor
Authors: Clubbs Brooke Hildebrand , Chin Eu Gene
Published: July 2023

Structural equation modeling and autoethnography have rarely been integrated in scientific studies. The example employs a convergent intensive longitudinal data collection strategy and an explanatory bidirectional framework for data merging analysis to examine one instructor’s practices of incorporating social-emotional learning (SEL) and mindfulness to reduce burnout. By examining results from the dynamic p-technique (a special case of structural equation modeling) and reflexive journaling resulting in autoethnography, a clearer picture of one faculty member’s lived experience emerged. The study concretely demonstrates how structural equation modeling and autoethnography methods can create an integrated, longitudinal picture of reality.
Conceptualising principal resilience: Development and validation of the Principal Resilience Inventory
Authors: Chen Junjun
Published: July 2023

Leading a school during the uncertainties of challenges, changes, and crises requires school principals to respond and react effectively, cohesively and proactively using resilience. Rather than using discrete contracts or dimensions to measure principal resilience, this paper tended to develop and validate a multidimensional instrument of principal resilience. Derived from the existing literature and three empirical studies, a 20-item Principal Resilience Inventory has been established by using a rational-theoretical approach of test construction with various samples of school principals from Hong Kong and Mainland China. The Principal Resilience Inventory encompasses five dimensions that capture the most salient resilience experience of school principals including physical, emotional, psychological, cognitive, and social resilience. Given a robust validation procedure, this instrument offers solid proof of the psychometric properties. It is expected that this validated measure can serve as a more robust means for gauging comprehensive investigations of principal resilience. Indeed, principal resilience is not just a buzzword, but an important quality that supports principals to infuse themselves into their professional lives in pursuit of the collective good.
Challenges in Understanding Human-Algorithm Entanglement During Online Information Consumption
Authors: Lewandowsky Stephan , Robertson Ronald E. , DiResta Renee
Published: July 2023

Most content consumed online is curated by proprietary algorithms deployed by social media platforms and search engines. In this article, we explore the interplay between these algorithms and human agency. Specifically, we consider the extent of entanglement or coupling between humans and algorithms along a continuum from implicit to explicit demand. We emphasize that the interactions people have with algorithms not only shape users’ experiences in that moment but because of the mutually shaping nature of such systems can also have longer-term effects through modifications of the underlying social-network structure. Understanding these mutually shaping systems is challenging given that researchers presently lack access to relevant platform data. We argue that increased transparency, more data sharing, and greater protections for external researchers examining the algorithms are required to help researchers better understand the entanglement between humans and algorithms. This better understanding is essential to support the development of algorithms with greater benefits and fewer risks to the public.
There is no substitute for hard work! Elite tennis coaches’ reflections, learning and development
Authors: Martínez-Gallego Rafael , Nash Christine , Crespo Miguel
Published: July 2023

Engaging with learning and development opportunities is the hall mark of a committed lifelong learner. In this study, we aimed to highlight the benefits of the learning and development achieved by participating coaches on the Olympic Solidarity (OS) Tennis programme. This coach development programme is a joint venture between OS, the International Tennis Federation, and its member nations to deliver certification courses for the coaches of advanced as well as high-performance players. This study is presented in two progressive parts: a web-based survey (Part 1) and semi-structured interviews (Part 2). In Part 2, we interviewed 12 participants from 12 different countries and four coach developers/tutors involved in programme delivery. The coaches in Part 1 were characterised by long-term engagement with tennis coaching and enhancing their own learning and development. Statistical analyses showed no significant difference between any of the variables examined. The interview analyses revealed three main themes: direction and strength of effort; perceived status and prestige of completion; and positivity and purpose. We conclude by discussing short-, medium-, and long-term advantages coaches identified from the programme.
MiR-21 and Tocilizumab interactions improve COVID-19 myocarditis outcomes
Authors: Hossein Heydari Amir , Ghaffari Saeid , Khani Zahra , Heydari Sophia , Eskandari Zakaria , Esmaeil Heidari Mohammad
Published: July 2023

Background:

Myocarditis is now one of the most fatal and morbid complications of COVID-19. Many scientists have recently concentrated on this problem.

Objectives:

This study assessed the effects of Remdesivir (RMS) and Tocilizumab (TCZ) in COVID-19 myocarditis.

Design:

Observational, cohort study.

Methods:

Patients with COVID-19 myocarditis were enrolled in the study and divided into three groups, TCZ-treated, RMS-treated, and Dexamethasone-treated patients. After 7 days of treatment, patients were reassessed for improvement.

Results:

TCZ significantly improved patients’ ejection fraction in 7 days, but it had limited efficacy. RMS improved inflammatory characteristics of the disease, but RMS-treated patients showed exacerbated cardiac function over 7 days, and the mortality rate with RMS was higher than TCZ. TCZ protects the heart by decreasing the miR-21 expression rate.

Conclusion:

Using Tocilizumab in early diagnosed COVID-19 myocarditis patients can save their cardiac function after hospitalization and decrease the mortality rate. miR-21 level determines the outcome and responsiveness of COVID-19 myocarditis to treatment.
Factors affecting customer-supplier electronic relationship (ER): A customers’ perspective
Authors: Alshurideh Muhammad Turki , Al Kurdi Barween , Alzoubi Haitham M , Akour Iman A , Hamadneh Samer , Alhamad Ahmad , Joghee Shanmugan
Published: July 2023

Maintaining durable and long-lasting relationships with customers is a key factor that is widely considered by marketing practitioners and company management. Therefore, this study aims to explore and examine the factors (personal interest, trust, safety perceptions, E-transaction acceptance, and privacy concerns) influencing electronic relationship ER from the customers’ perspectives. The study selected the sample from university students (456 respondents) and was conducted in United Arab Emirates UAE, to analyze their perspectives about these factors. The study findings found significantly positive effect of all these factors on ER. And the most influential one was the personal interest followed by trust. Our research concludes by mentioning customers’ communication experiences and perceptions with their companies in order to assess their ability to meet expectations and maintain ongoing relationships. The research implications offer the marketing practitioners with insight to diversify their interaction ways with their key customers.
State Responses to Autonomy Demands: Indigenous Movements and Regional Threats in Bolivia and Ecuador
Authors: Alberti Carla , Mattiace Shannan
Published: July 2023

In this paper, we examine the political factors that explain state responses to demands for indigenous territorial autonomy in Ecuador and Bolivia. Specifically, we aim to explain why the 2009 Bolivian constitution limited indigenous territorial autonomy to the departmental level, not allowing indigenous peoples to establish autonomous regions that lay beyond a single departmental jurisdiction, whereas the 2008 Ecuadorian constitution allows indigenous jurisdictions to exceed provincial boundaries. We argue that, in Bolivia, a strong conservative autonomy movement led by the country's eastern departments forced state officials to negotiate with regional elites, thus limiting the window of opportunity for indigenous movements and their allies to demand territorial autonomy. In the absence of a strong territorialized threat in Ecuador, indigenous movements and their allies had larger windows of opportunity to press their claims for territorial autonomy. This study contributes to comparative research on how states have simultaneously affirmed and limited indigenous autonomy.
Elevations in Norclobazam Concentrations and Altered Mental Status in CYP2C19 Poor Metabolizer Phenotype: A Case Report
Authors: Phillips Kristy M. , Rodriguez-Lopez Josanna M. , Webb Andrew J.
Published: July 2023

Clobazam is a 1,5-benzodiazepine frequently used as an adjunctive agent for refractory seizures and status epilepticus. Clobazam undergoes metabolism to an active metabolite norclobazam which is subsequently hydroxylated by CYP2C19, a cytochrome with several pharmacogenetic variants. Patients with poor metabolizer phenotypes may have elevated norclobazam levels and subsequent adverse effects. We present a case of an Asian American male receiving clobazam at a standard therapeutic dose for seizure disorder who became comatose secondary to significantly elevated norclobazam concentrations. Genetic testing revealed the patient was a poor CYP2C19 metabolizer, accounting for the impaired clearance. Clinicians should be aware of the patient populations at risk for these genetic polymorphisms and adjust initial doses based on package labeling or consider therapeutic drug monitoring to avoid adverse effects.
An international study to explore the feasibility of collecting standardised outcome data for Complex Regional Pain Syndrome: recommendations for an international clinical research registry
Authors: Grieve Sharon , Brunner Florian , Cabral Danylo F , Connett Robyn , Hirata Hitoshi , Iwasaki Norimasa , Nakagawa Yasunobu , Sagir Afrin , Sousa Gudson , Vatine Jean-Jacques , Vaughan-Spickers Nicole , Xu Jijun , Buckle Lisa , McCabe Candida
Published: July 2023

Introduction

Complex Regional Pain Syndrome (CRPS) is a persistent pain condition with low prevalence. Multi-centre collaborative research is needed to attain sufficient sample sizes for meaningful studies. This international observational study: (1) tested the feasibility and acceptability of collecting outcome data using an agreed core measurement set (2) tested and refined an electronic data management system to collect and manage the data.

Methods

Adults with CRPS, meeting the Budapest diagnostic clinical criteria, were recruited to the study from 7 international research centres. After informed consent, a questionnaire comprising the core set outcome measures was completed: on paper at baseline (T1), and at 3 or 6 months (T2) using a paper or e-version. Participants and clinicians provided feedback on the data collection process. Clinicians completed the CRPS severity score at T1 and optionally, at T2. Ethical approval was obtained at each international centre.

Results

Ninety-eight adults were recruited (female n=66; mean age 46.6 years, range 19-89), of whom 32% chose to receive the T2 questionnaire in an electronic format. Fifty-five participants completed both T1 and T2. Eighteen participants and nine clinicians provided feedback on their data collection experience.

Conclusion

This study confirmed the questionnaire core outcome data are feasible and practicable to collect in clinical practice. The electronic data management system provided a robust means of collecting and managing the data across an international population. The findings have informed the final data collection tools and processes which will comprise the first international, clinical research registry and data bank for CRPS.
Intersectionality as a theoretical framework for researching health inequities in chronic pain
Authors: Macgregor Cassandra , Walumbe Jackie , Tulle Emmanuelle , Seenan Christopher , Blane David N
Published: July 2023

Chronic pain is experienced unequally by different population groups; we outline examples from the pain literature of inequities related to gender, ethnicity, socioeconomic and migration status. Health inequities are systematic, avoidable and unfair differences in health outcomes between groups of people, with the fundamental ‘causes of causes’ recognised as unequal distribution of income, power and wealth. Intersectionality can add further theory to health inequities literature; collective social identities including class/socioeconomic status, race/ethnicity, gender, migration status, age, sexuality and disabled status intersect in multiple interconnected systems of power leading to differing experiences of privilege and oppression which can be understood as axes of health inequities. The process of knowledge creation in pain research is shaped by these interconnected systems of power, and may perpetuate inequities in pain care as it is largely based on majority white, middle class, Eurocentric populations. Intersectionality can inform research epistemology (ways of knowing), priorities, methodology and methods. We give examples from the literature where intersectionality has informed a justice oriented approach across different research methods and we offer suggestions for further development. The use of a reductionist frame can force unachievable objectivity on to complex health concepts, and we note increasing realisation in the field of the need to understand the individuals within their social world, and recognise the fluid and contextual nature of this.
The impact of inhibitors on the quality of life in patients with hemophilia
Authors: Haghpanah Sezaneh , Naderi Majid , Kamalian Sepideh , Tavoosi Hakimeh , Parand Shirin , Javanmardi Neda , Karimi Mehran
Published: July 2023

Objective:

To investigate the association of health-related quality of life in hemophilia patients with inhibitor and clinical and demographic characteristics.

Methods:

In this multi-center cross-sectional study, 41 male patients with hemophilia A were investigated from May to October 2021. All patients were registered at the Hemophilia Clinic affiliated with Shiraz and Zahedan Universities of Medical Sciences in Iran. Health-related quality of life of the patients was evaluated by the Short Form-36 questionnaire.

Results:

The patients’ mean ± SD of age was 36.9 ± 13.2 (range: 18–76) years. Eleven patients (26.8%) were inhibitor positive. In univariate analysis, physical function, mental health dimension, and total Short Form-36 scores were significantly lower in the inhibitor-positive patients ( p < 0.001, p = 0.045, and p = 0.035, respectively). Moreover, patients with severe disease showed significantly lower scores in physical function ( p < 0.001), physical health dimension ( p = 0.018), and total Short Form-36 ( p = 0.031) than those with mild and moderate hemophilia. Also, blood-borne infections showed a significant association with lower score in physical health dimension ( p = 0.038). In addition, annual bleeding rate showed significant negative correlations with physical health dimension ( rs = −0.609, p < 0.001), mental health dimension ( r = −0.317, p = 0.044), and total Short Form-36 ( r = −0.455, p = 0.003) scores. In multiple linear regression analysis, disease severity revealed a significant negative relationship with scores in physical function ( p = 0.001), role physical (RP) ( p = 0.015), general health (GH) ( p = 0.006), physical health dimension ( p = 0.006), and marginally in total Short Form-36 score ( p = 0.054). Also, age of the patients showed a significant negative association with physical function and GH scores ( p < 0.001 and p = 0.015, respectively).

Conclusion:

Disease severity and age were shown as independent factors affecting health-related quality of life, but inhibitor alone was not an independent influencing factor. Reduced health-related quality of life was also observed in hemophilia patients with higher annual bleeding rate and blood-borne infections. Therefore, it is necessary to pay more attention to these subgroups. Further studies with larger sample size are needed for more accurate results.
Analysis of the opinions of individuals on the COVID-19 vaccination on social media
Authors: Kaushal Akshay , Mandal Anandadeep , Khanna Diksha , Acharjee Animesh
Published: July 2023

The COVID-19 pandemic continues to threaten public health globally. To develop effective interventions and campaigns to raise vaccination rates, policy makers need to understand people's attitudes towards vaccination. We examine the perspectives of people in India, the United States, Canada, and the United Kingdom on the administration of different COVID-19 vaccines. We analyse how public opinion and emotional tendencies regarding the COVID-19 vaccines relate to popular issues on social media. We employ machine learning algorithms to forecast thoughts based on the social media posts. The prevailing emotional tendency indicates that individuals have faith in immunisation. However, there is a likelihood that significant statements or events on a national, international, or political scale influence public perception of vaccinations. We show how public health officials can track public attitudes and opinions towards vaccine-related information in a geo-aware manner, respond to the sceptics, and increase the level of vaccine trust in a particular region or community.
Prediction of intrapartum fever using continuously monitored vital signs and heart rate variability
Authors: Debnath Shubham , Koppel Robert , Saadi Nafeesa , Potak Debra , Weinberger Barry , Zanos Theodoros P
Published: July 2023

Objectives

Neonatal early onset sepsis (EOS), bacterial infection during the first seven days of life, is difficult to diagnose because presenting signs are non-specific, but early diagnosis before birth can direct life-saving treatment for mother and baby. Specifically, maternal fever during labor from placental infection is the strongest predictor of EOS. Alterations in maternal heart rate variability (HRV) may precede development of intrapartum fever, enabling incipient EOS detection. The objective of this work was to build a predictive model for intrapartum fever.

Methods

Continuously measured temperature, heart rate, and beat-to-beat RR intervals were obtained from wireless sensors on women ( n = 141) in labor; traditional manual vital signs were taken every 3–6 hours. Validated measures of HRV were calculated in moving 5-minute windows of RR intervals: standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive differences (RMSSD) between normal heartbeats.

Results

Fever (>38.0 °C) was detected by manual or continuous measurements in 48 women. Compared to afebrile mothers, average SDNN and RMSSD in febrile mothers decreased significantly ( p < 0.001) at 2 and 3 hours before fever onset, respectively. This observed HRV divergence and raw recorded vitals were applied to a logistic regression model at various time horizons, up to 4–5 hours before fever onset. Model performance increased with decreasing time horizons, and a model built using continuous vital signs as input variables consistently outperformed a model built from episodic vital signs.

Conclusions

HRV-based predictive models could identify mothers at risk for fever and infants at risk for EOS, guiding maternal antibiotic prophylaxis and neonatal monitoring.
Science diplomacy in China: Past, present and future
Authors: Li Xin
Published: July 2023

Science diplomacy has played an important role in Chinese history, including in the history of science and technology (S&T) development. While we may consider science diplomacy as simply a part of China's Reform and Opening-up policy, the fact is that even in the Kuomintang period (1925–1949) or the Maoist period (1949–1976) it was a key element of Chinese foreign relations. The targets and nature of science diplomacy were shaped by the prevailing politics and economic issues of the times. For example, the Cold War limited the breadth and depth of S&T cooperation between China and the West. Nonetheless, the People's Republic of China pursued cooperation with the Soviet Union and newly independent countries in a very steadfast manner and continues to engage with Russia and developing countries today. This article analyses the nature of science diplomacy as an element of both China's S&T development and its foreign relations. The interactions and practices at the intersection of science and foreign policy in China are manifold. In addition to providing a comprehensive overview, this article also highlights evolving trends, especially in terms of the deepening of China's linkages across the international S&T system. Finally, the article examines the recent impact of the apparent rise of techno-nationalism and how this has affected the nature of China's international S&T activities regarding Beijing's use of science diplomacy.
Frailty and Pre-Frailty in the Setting of Total Joint Arthroplasty: A Narrative Review
Authors: Pearl Adam , Ismail Aya , Alsadi Tariq , Crespi Zachary , Daher Mohammad , Saleh Khaled
Published: July 2023

Background

Total joint arthroplasties are among the most common surgical procedures performed in the United States. Although numerous safeguards are in place to optimize patient health and safety pre-, intra-, and postoperatively, patient frailty is often incompletely assessed or not assessed at all. Frailty has been shown to increase rates of adverse events and length of stay. We discuss the impact of frailty on patient outcomes and healthcare economics as well as provide widely accepted models to assess frailty and their optimal usage.

Methods

Several databases were searched using the keywords “frailty,” “TJA,” “THA,” “frailty index,” “frailty assessment,” and “frailty risk.” A total of 45 articles were used in this literature review.

Results

It is estimated that nearly half of patients over the age of 85 meet criteria for frailty. Frailty in surgical patients has been shown to increase total costs as well as length of stay. Additionally, increased rates of numerous adverse events are associated with increased frailty.

Conclusions

The literature demonstrates that frailty poses increased risk of adverse events, increased length of stay, and increased cost. There are several models that accurately assess frailty and can feasibly be implemented into preoperative screening.
Exploring Chinese STEM college students’ expectations of effective online courses
Authors: Lin Xi , Luan Lingfei , Dai Yan
Published: July 2023

STEM learning aims to prepare students with hands-on and problem-based learning. However, teacher-centered instruction has been the predominant course delivery technique in STEM education regardless face-to-face or online learning context. Using both quantitative and qualitative research methods, this study explores the expectations of effective online courses based on Moore’s three types of interactions among Chinese STEM college students taking synchronous teacher-centered lecture-based online courses. A total of 175 undergraduate STEM students were recruited at one Chinese university. Results indicate that these students expect their instructors to integrate activities to motivate interactions with their instructor, peers, and the learning content. Students’ perceptions of the advantages and challenges of taking synchronous lecture-based courses are also discussed. It is expected that the findings would enlighten professionals of higher education in China to adjust teacher-centered instruction and to adequately prepare and train online instructors to foster an active online learning environment in STEM fields.
Head Shape After Sagittal Craniosynostosis Surgery: Open Versus Endoscopic Strip Craniectomy
Authors: Crofts Helen , Mankowski Peter , Tamber Mandeep , Courtemanche Douglas J.
Published: July 2023

Purpose: Nonsyndromic sagittal craniosynostosis is treated surgically to improve skull cosmesis and to decrease the risk of raised intracranial pressure. The purpose of this study is to compare the outcomes of two current surgical techniques for craniosynostosis treatment, open and endoscopic strip craniectomy. Methods: A single institution retrospective chart review was conducted of patients with nonsyndromic sagittal craniosynostosis treated surgically from 2011 to 2016. Patients were divided into two groups based on surgical technique: open or endoscopic strip craniectomy. The head shape was assessed using pre- and postoperative cephalic index (CI). Complications and operative details were compared. Mean absolute CI over time and 95% confidence intervals were graphed. Results: A total of 51 children (36 male, 15 female; 13 open, 38 endoscopic) were included with an average length of follow-up of 27.2 months (range 4-60). The median age at surgery was 4.0 months for open and 3.0 months for endoscopic. There was no significant difference in preoperative CI between endoscopic and open groups (0.67 vs 0.66). The largest improvements in CI were seen 3 to 6 months postoperatively. There was a significant improvement in postoperative CI for both groups (endoscopic 0.75, P = .02; open = 0.74, P < .01). From maximal postoperative CI to >2 year follow up there was no significant regression in CI for the endoscopic group ( P = .12) and a small regression for the open group (−0.02, P = .01). There were no transfusions, brain injuries, or deaths. Patients in the endoscopic group had significantly less blood loss intraoperatively ( P = .01) and a significantly shorter duration of hospital stay compared to the open group ( P < .001). Conclusions: Endoscopic and open surgical techniques are both effective treatments for nonsyndromic sagittal synostosis, with no difference in initial postoperative CI. These findings support the use of either technique and corroborate previous literature.
Bibliometric Analysis of the Top 50 Most Influential Studies on Patellar Tendon Injury
Authors: Boddu Sayi P. , Gill Vikram S. , Moore M. Lane , Haglin Jack M. , Lai Cara H. , Brinkman Joseph C. , Chhabra Anikar
Published: July 2023

Background:

There is a wide range of literature on patellar tendon injury, making it increasingly difficult to stay informed on the most influential studies in this field. It is essential to be familiar with the foundational articles of patellar tendon injury research to understand the current state of the literature and deliver high quality care.

Purpose:

To objectively identify the 50 most influential articles relating to patellar tendon injury and conduct a bibliometric analysis to identify key features of these articles.

Study Design:

Cross-sectional study.

Methods:

The Clarivate Analytics Web of Knowledge database was utilized to gather metrics on the 50 most cited articles on patellar tendon injury on June 27, 2022. The information extracted from each article included publication year, number of citations, author information, article type, level of evidence, country of origin, journal name, study focus, and industry influence.

Results:

The top 50 studies were cited a total of 8543 times and published between 1977 and 2015. The majority of articles were published after 2003, and the majority of citations were accrued after 2011. The most prevalent article types were cohort studies (n = 23), and the majority of studies were of evidence level 2 (n = 14) or 4 (n = 13). Australia and the United States (US) each published the most studies (n = 11). Only 4 (8%) studies focused on patellar tendon rupture, and 12 (24%) of the top 50 studies were associated with industry.

Conclusion:

The majority of the top 50 most influential articles in patellar tendon injury were published and accumulated citations in the past 10 to 20 years. Non-US countries, institutions, and journals published many of the top 50 studies, reflecting a global interest and commitment to research in this field. Patellar tendon rupture and surgical repair represents a minority of research in the top 50 studies and could be a point of growth in the future.
Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review
Authors: Teli Margareta , Thato Ratsiri , Rias Yohanes Andy
Published: July 2023

Introduction

One of the most important outcomes of diabetes care and treatment is an improvement in patients’ health-related quality of life (HRQoL).

Objective

This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM).

Methods

To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included “type 2 diabetes” OR “T2DM” AND “health-related quality of life” OR “HRQoL” AND (“predicting factors” OR “influencing factors” OR “associated factors”). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229.

Results

The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL.

Conclusion

A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.