bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpreting 7-year-old beginner cellists’ experiences of practice
Authors: MacArthur Stephanie L R , Davidson Jane W , Krause Amanda E
Published: November 2023

Practice is essential to the acquisition and development of musical skills, requiring musicians’ time, investment, application, motivation, metacognitive strategies, and ability to self-regulate. Research in children’s music practice indicates the type, quality, and duration of practice, along with adult support, contributes to fluency in musical development; and when progress occurs, children invest in further practice. However, nuances in children’s lived experiences of musical practice that influence these critical factors are largely unknown. To understand the complex issues in children’s practice, this study employed a unique pairing of Interpretative Phenomenological Analysis and Participatory Action Research to investigate 14 seven-year-old beginner cellists’ practice during early learning and explored how their thoughts and experiences evolved over the first 18 months of lessons. Providing rare insight into children’s perceptions of musical development and the vital role of parents and teachers in nurturing engagement, three superordinate themes emerged: (a) four approaches to practice, characterized by practice structure, learner behavior, and family support, (b) a three-phase practice process, and (c) perfection ideation. Positive experiences, including creative activities, within these thematic contexts fostered children’s enjoyment in early musical development, supported productive learning interactions, and sustained engagement. Together, the findings have meaningful pedagogical implications for instrumental music teaching practice.
Green electoral performance and national climate change commitment: The conditional effect of EU membership
Authors: Clegg Liam , Galindo-Gutierrez Julio
Published: November 2023

Does Green party electoral success lead to increased climate change commitment, and if so how? Drawing on a new OECD database on climate change outlays, we probe indirect influence from Green electoral success as mediated by inter-party competition, and direct mechanisms of influence from elected Green representatives. Our headline finding is that EU membership functions as a contextual catalyst for inter-party competition, with EU governing parties responding to Greens’ strong electoral performance by increasing climate change outlays to appeal to environmentally motivated voters. We also find evidence that, both across the OECD cohort and the EU sub-grouping, Green coalition presence is associated with increased climate spending over a political cycle. While direct Green influence through coalition presence is widespread, indirect influence mediated by inter-party competition is conditional on EU membership. Findings fit with literature highlighting systematic difference between EU members’ climate performance, and that of other advanced-industrialised states.
What’s identity got to do with it? The social life of sexual identity in the Netherlands
Authors: Harmsen Silva Luna , Spronk Rachel
Published: November 2023

Same-sex erotic desire, or same-sex orientation, has become commonly understood and expressed through the notion of sexual identity. This article takes an intergenerational perspective to study the genealogy of sexual identity in the Netherlands. The authors explore how queer people perceive their feelings of same-sex desire and whether or not they come to understand their erotic desire in terms of sexual classifications. Their research shows that when discourses on gender and sexuality shift, the way people make sense of their erotic desire takes different forms. It appears that people’s lived reality is messier than the notion of sexual identity presumes.
Main activity trajectory clusters of unemployed people with partial work ability and cluster features
Authors: Poutanen Joonas , Gluschkoff Kia , Kausto Johanna , Joensuu Matti
Published: November 2023

Background:

The early identification of different subgroups of individuals with partial work ability is important for the development of appropriate and effective services in order to prevent exclusion from working life and prolongation of unemployment.

Aims:

This study aimed to identify different main activity trajectory clusters of people with partial work ability before their participation in work ability support services and to examine sociodemographic, health, work ability and functioning features of the identified clusters.

Methods:

The sample consisted of clients who had participated in the Finnish Work Ability Programme during 2020–2022. Using the main activity data spanning from 2005 to 2021, optimal matching was applied to examine the similarity between the participants’ main activity trajectories. Second, using cluster analysis, participants were categorised into four main activity trajectory clusters. Finally, the sociodemographic, health, work ability and functioning features of clusters were examined.

Results:

A total of 643 individuals participated in the study. Four clusters were identified: (a) early-onset retirement, (b) from studies to outside the workforce, (c) from employment to unemployment and (d) long-term employment. Individuals in the ‘early-onset retirement’ cluster had the best perceived work ability and functioning. Problems relating to health, work ability, functioning and well-being were highlighted in the ‘from employment to unemployment’ cluster.

Conclusions:

Unemployed individuals with partial work ability form a heterogeneous population who often have several different underlying reasons for decreased work ability. Multiple data sources are needed to identify the special characteristics and needs of the people with partial work ability.
Book review: Bliesemann de Guevara, B., & Bøås, M. (eds), Doing Fieldwork in Areas of International Intervention: A Guide to Research in Violent and Closed Contexts
Authors: Jaber Nihaya
Published: November 2023

Bliesemann de Guevara, B., & Bøås, M. (eds), Doing Fieldwork in Areas of International Intervention: A Guide to Research in Violent and Closed Contexts (Bristol: Bristol University Press, 2022), 288 pp. Hardback £75.00 and US $115.00. ISBN 9781529206883
How many worlds are there? One, but also many: Decolonial theory, comparison, ‘reality’
Authors: Zúñiga Didier
Published: November 2023

Contemporary political theory (CPT) has approached questions of plurality and diversity by drawing rather implicitly on anthropological accounts of difference. This was the case with the ‘cultural turn’, which significantly shaped theories of multiculturalism. Similarly, the current ‘ontological turn’ is gaining influence and leaving a marked impact on CPT. I examine the recent turn and assess both the possibilities it offers and the challenges it poses for decentering CPT and opening radical, decolonial avenues for thinking difference otherwise. I take Paul Nadasdy's critique of the ontological turn as an invitation to reflect on the methodological precepts that inform how the field frames the scope and limits of comparison. In pursuit of this, I examine the Zapatistas’ notion of a ‘world of many worlds’, which provides a way of approaching difference that captures the generative aspects of the ontological turn while avoiding the pitfalls of relativism and political inertia. I argue that the Zapatistas’ insights offer ethical guidance towards social and ecological thriving. Ultimately, my goal is to move CPT towards a more capacious form of making sense of what is out there in the world, and thus make room for better ways of inhabiting the Earth.
Surgical Outcome of Proximal Isolated Subclavian Artery Aneurysms: A Single-Center Retrospective Observational Study
Authors: Gu Yuanrui , Zhang Ke , Zhou Zeming , Sun Yangxue , Li Mingyao , Wang Yunhong , Ouyang Chenxi
Published: November 2023

Objective:

The objective of this study was to introduce our institutional experience of treatment strategies (cervical subclavian artery reconstruction, thoracotomy subclavian artery reconstruction and endovascular treatment) for proximal isolated subclavian artery aneurysms (PISAAs).

Methods:

we retrospectively analyzed 15 consecutive patients with PISAAs treated by different treatment strategies (cervical reconstruction, thoracotomy reconstruction and endovascular treatment) in our institution from May 2016 to May 2022. Baseline data, surgery-related data, postoperative information and long-term follow-up were assessed.

Results:

A total of 17 PISAAs in 15 consecutive patients were treated in our institution. The success rates of subclavian artery reconstruction in the cervical reconstruction, the thoracotomy reconstruction and the endovascular treatment were 100%, 100 and 83.33%, respectively. About the involved vertebral artery, the reconstruction rates in the cervical reconstruction, the thoracotomy reconstruction, and the endovascular treatment were 80%, 75%, and 0, respectively. The intraoperative blood loss in the thoracotomy reconstruction was significantly higher than that in the cervical reconstruction and the endovascular treatment ( p<0.05). The total operation time of the thoracotomy reconstruction was significantly longer than that of the cervical reconstruction and the endovascular treatment ( p<0.05). In terms of postoperative ventilator use time, total postoperative drainage fluid, total postoperative drainage time, and ICU duration, both the thoracotomy reconstruction and the cervical reconstruction were significantly more than the endovascular treatment ( p<0.05). During the follow-up, one patient in the endovascular treatment underwent re-intervention 22 months after surgery due to in-stent occlusion.

Conclusions:

For patients with PISAAs, different treatment strategies are recommended depending on the size of the aneurysms and whether the involved vertebral arteries require reconstruction.

Clinical impact

This article is the largest study on the treatment strategies of PISAAs. By comparing the prognosis and complications of endovascular treatment with those of open surgery, it provides a certain reference basis for the choice of treatment for patients with PISAAs. For patients with aneurysms’ diameter of >50 mm, the thoracotomy subclavian artery reconstruction is recommended; for patients with aneurysms’ diameter of <30 mm requiring reconstruction of the involved vertebral arteries, the cervical subclavian artery reconstruction is recommended; for patients with aneurysms’ diameter of <30 mm not requiring reconstruction of the involved vertebral arteries, the endovascular treatment is recommended.
Incidence and Risk Factors for Revision Within 1 Year of Primary Carpal Tunnel Release
Authors: Schloemann Derek T. , Thirukumaran Caroline P. , Hammert Warren C.
Published: November 2023

Background:

The annual volume of carpal tunnel release (CTR) in the United States has been estimated to be 577 000 per year. Our objectives were to evaluate the incidence and risk factors for revision CTR within 1 year of primary CTR.

Methods:

We identified all adult patients undergoing primary CTR from October 2015 to September 2019 in the New York Statewide Planning and Research Cooperative System database using Current Procedural Terminology ( CPT) codes. We used the CPT modifier codes to determine laterality of index and revision procedures. We estimated multivariable hierarchical logistic regression models to evaluate risk factors for revision CTR within 1 year.

Results:

Of the 80 423 primary CTR procedures, 178 (0.22%) underwent a revision CTR within 1 year of the index surgery. The mean (SD) age of the entire cohort was 58.69 (14.43) years, 61.1% were women, 73.2% were non-Hispanic white, 42.9% were covered through private insurance, and 9.5% had diabetes mellitus. Workers’ compensation insurance (odds ratio [OR] = 1.83, 95% confidence interval [CI], 1.13-2.98, P = .02) and simultaneous bilateral CTR (OR = 14.91, 95% CI, 9.62-23.12, P < .001) were associated with revision CTR within 1 year of the index procedure. No models demonstrated an association between endoscopic technique or surgeon volume and revision CTR.

Conclusions:

The incidence of revision CTR within 1 year was lower than that previously reported. Patients covered by workers’ compensation and those undergoing simultaneous bilateral CTR had higher likelihood of a revision CTR within 1 year, whereas endoscopic technique and surgeon volume were not associated with revision CTR within 1 year.
Learning Landscape in Gamification: The Need for a Methodological Protocol in Research Applications
Authors: Orsoni Matteo , Dubé Adam , Prandi Catia , Giovagnoli Sara , Benassi Mariagrazia , Mazzoni Elvis , Benvenuti Martina
Published: November 2023

In education, the term “gamification” refers to of the use of game-design elements and gaming experiences in the learning processes to enhance learners’ motivation and engagement. Despite researchers’ efforts to evaluate the impact of gamification in educational settings, several methodological drawbacks are still present. Indeed, the number of studies with high methodological rigor is reduced and, consequently, so are the reliability of results. In this work, we identified the key concepts explaining the methodological issues in the use of gamification in learning and education, and we exploited the controverses identified in the extant literature. Our final goal was to set up a checklist protocol that will facilitate the design of more rigorous studies in the gamified-learning framework. The checklist suggests potential moderators explaining the link between gamification, learning, and education identified by recent reviews, systematic reviews, and meta-analyses: study design, theory foundations, personalization, motivation and engagement, game elements, game design, and learning outcomes.
The association of plasma pancreastatin levels with insulin resistance in patients with gestational diabetes mellitus
Authors: Unal Kocabas Gokcen , Yildirim Simsir Ilgin , Sarer Yurekli Banu , Suner Karakulah Asli , Durmaz Burak , Pehlivan Koroglu Esma , Yeral Sena , Ozcan Busra , Akdemir Ali
Published: November 2023

Introduction

Gestational diabetes mellitus (GDM) occurs on the background of increased insulin resistance. We aimed to investigate the levels of plasma pancreastatin (PST) levels and its association with metabolic, demographic, and anthropometric parameters in gestational diabetic and normal glucose-tolerant pregnant women.

Materials and methods

A total of 165 pregnant women in the 24th–28th week of pregnancy were enrolled in this cross-sectional study. PST levels were measured using ELISA method.

Results

Median PST levels were similar between GDM (n = 62, 37.6%) and normal glucose-tolerant control group (n = 103, 62.4%). In the GDM group, PST level showed a significant positive correlation with fasting insulin and the homeostasis model assessment of insulin resistance (HOMA-IR). In binary logistic regression analysis, PST levels did not predict the presence of GDM significantly.

Conclusion

Positive correlation of PST with fasting insulin and HOMA-IR suggests that PST could be associated with insulin resistance. Further studies are needed as regards to the role of PST in GDM pathogenesis.
COVID-19 and Grade Inflation: Analysis of Undergraduate GPAs During the Pandemic
Authors: Tillinghast Jonathan A. , Mjelde Dr. James W. , Yeritsyan Anna
Published: November 2023

The COVID-19 pandemic required adaptation to a new learning environment creating challenges for students and instructors. A reduction in student-teacher contact and the lack of supervision should have led to a decline in students’ academic performance. Nonetheless, studies report increases in grades during the pandemic. Yet, limited information is available regarding the persistence of this impact. This study utilizes a hierarchical mixed effect model to estimate the impact of the COVID-19 pandemic on university grades. Using unique class-level data containing chronological variables and institutional, instructor, and student characteristics, spanning Fall 2010 to Spring 2021 of 7,852 undergraduate classes, it is shown class average grade point averages (GPAs) in the College of Agriculture at Texas A&M University increased for the three semesters most impacted by COVID-19. Average class GPAs increased by 0.22 points in Spring 2020 because of COVID-19 and then approximately 0.18 points in the subsequent next two semesters. The negative effect of class size decreased during COVID-19, implying online classes have different size effects than traditional classes. Additionally, the positive effect of SAT scores on grades decreased. One implication of this study is that COVID-19 may not only have a direct, significant, impact on GPAs but may also indirectly affect GPAs through altering the effects of variables on GPAs. The causal mechanisms by which the changes occurred are an area for further research.

JEL Codes: I21, I29
Investigating Pre-Service EFL Teachers’ Initial Motivations and Identity Formation: Evidence From an Indonesian University
Authors: Dewi Sri Surya , Fajri Muchamad Sholakhuddin Al
Published: November 2023

This study aims to explore the initial motivations of pre-service teachers to enroll in a teacher education program and investigate how the teaching practice within the program contributes to the development of their professional identity. The research was conducted as a case study within the English Teacher Education Department (ETED) at a university in Indonesia. A qualitative approach was employed, and data were collected through written narratives and semi-structured telephone interviews. The findings reveal that pre-service teacher’ initial motivations to pursue studies at ETED can be categorized into eight distinct factors: personal interest in teaching and English, social influences, personal ability, the desire to make a social contribution, sufficient time for family, interest in working with children or young learners, prior learning experiences, and engaging in role-playing as a teacher during childhood. Additionally, the teaching practice component of the program plays a significant role in shaping the pre-service teachers’ professional identity by enhancing their confidence, providing insights into the responsibilities of English teachers, strengthening their motivation to pursue teaching careers, and deepening their understanding of the qualities and skills required to be an effective English teacher. This study suggests that by considering the initial motivations of students, offering personalized support, and incorporating supplementary activities that address practical aspects of the teaching profession, the ETED can enhance the overall learning experience and better equip student teachers for their future roles as English teachers.
Becoming a Researcher in Academic Medicine: An Autoethnography of Research Faculty Development
Authors: Alwazzan Lulu
Published: November 2023

In the literature, research education is insufficiently addressed. Existing studies often document pre-/post-educational interventions. Accounts of individual scholars colored by their views and experience are rarely considered. This study describes the research experience of a faculty member in academic medicine and examines the values and practices that make up the subculture of research. Drawing on Hafler’s conceptual framework and autoethnography as a method, professional experiences related to research education are described and analyzed. Data were collected through the author’s journaled self-reflections. The findings were organized according to Hafler’s three suggested areas of faculty development. The first was the experience of formal professional development activities. There was a dearth of research education activities provided to faculty. The second was the experience of informal mentorship. Despite the tapestry of mentors, the types of relationships involved were unclear. The third theme is the experience of the culture surrounding promotion and funding. The quality of the research was challenged by the lack of funding. Current research education for faculty members are, in the author’s experience, modest. The research subculture encourages tacit strategies that orient faculty toward producing research on their own and influence scholarship decisions that produce works that do not necessarily have value and may not be considered impactful. A clearer purpose and more structured professional development that takes into consideration the three levels of faculty development—formal, informal, and cultural—are needed to help faculty fully realize their roles as researchers.
Who Hacked My Car? Designing Autonomous Vehicles to Support Driver Response to Security Threats
Authors: Lim Cherin , Rajivan Prashanth
Published: November 2023

Modern vehicles have evolved into intelligent and autonomous transportation systems, yet such computer-driven developments also create opportunities for unforeseen cyber-security attacks on self-driving cars. These threats may pose critical risks to human lives but there is a considerable lack of understanding in designing vehicle systems to support driver response during rare and hazardous security events. We conducted an interview with autonomous vehicle drivers to understand their perception of automotive threats and design needs for effective response during security events. Results show that drivers expect information relating to malfunction detection, trouble-shooting instructions, and log data from the vehicle. Moreover, drivers were more likely to act based on instincts the more the driver perceives the threat to be urgent, rather than process the situation during the initial stages of an attack. We thus propose a ‘Driver Response Phase’ and corresponding design implications for future vehicles that support user response to security risks.
Responsiveness and Minimal Clinically Important Difference of the Thai Version of the International Knee Documentation Committee Subjective Knee Form in Patients With Anterior Cruciate Ligament Injury
Authors: Kerdtho Thanapat , Lertwanich Pisit
Published: November 2023

Background:

The International Knee Documentation Committee Subjective Knee Form (IKDC-SKF) is a knee-specific patient-reported outcome (PRO) measure that is commonly used to evaluate patients with various knee disorders. The Thai version of the IKDC-SKF (Thai IKDC-SKF) was shown to have good validity and reliability; nonetheless, no data regarding its responsiveness are available.

Purpose:

To evaluate the responsiveness of the Thai IKDC-SKF for assessing patients with anterior cruciate ligament (ACL) injury and determine the minimal clinically important difference (MCID) for this PRO measure.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

This prospective study included ACL-injured patients who were scheduled for ACL reconstruction (ACLR) at a single institution. The patients completed the Thai IKDC-SKF at the baseline and the 6-month postoperative follow-up. The global rating of change scale was an anchor question that evaluated patients’ overall perception of a clinical change compared with their preoperative condition. The effect size and standardized response mean were calculated. The MCID was identified with an anchor-based approach by plotting a receiver operating characteristic curve and calculating the value that maximized the Youden index.

Results:

Of 59 enrolled patients, 53 patients (89.8%) completed the preoperative and 6-month postoperative Thai IKDC-SKF. The mean (±SD) age of the participants was 32.3 ± 10.3 years, and 86.8% were men. The mean Thai IKDC-SKF score improved significantly from preoperatively to the 6-month follow-up (from 56.3 ± 14.9 to 70.8 ± 14.1, respectively; P < .001), with an effect size of 0.975 and a standardized response mean of 0.977. A receiver operating characteristic curve was generated to determine the ability of the Thai IKDC-SKF to distinguish between improved patients and unimproved patients, and the area under the curve was 0.80 (95% CI, 0.68-0.92), which was considered excellent. The MCID was 15.5, which yielded a sensitivity and specificity of 0.55 and 1, respectively.

Conclusion:

This study confirmed the responsiveness of the Thai IKDC-SKF for detecting a clinical change in ACL-injured patients after ACLR. The identified MCID of 15.5 can be used to calculate the significant clinical change and sample size in future studies.
The Muted Feelings of a Dalit Woman: A Dalit Feminist Study of Sreeja K. V.’s Labour Room
Authors: James Sinu
Published: November 2023

There is a mainstream glorified image of motherhood. But is this the reality of every mother? An intersectional study of the play Labour Room by Sreeja K. V. is done to get an answer to this question. The play portrays three women from different backgrounds, their journey to motherhood, and their idea of being a mother. A Dalit feminist study of the play, focusing on the character woman three, can be employed to understand that being a mother is not always majestic and is a different experience for every mother. Does a Dalit woman lack motherly feelings, or do their circumstances mute those feelings? Through the character of a woman three, this article attempts to address this question using the theory of intersectionality. The article also tries to shift the focus from the conventional depiction of motherhood.
Evaluating the Correlation Between Various Orthopaedic Foot and Ankle Fellowship Characteristics and Total Industry Payments Through the Open Payments Database
Authors: Anastasio Albert T. , Baumann Anthony N. , Walley Kempland C. , Adams Samuel B.
Published: November 2023

Background:

Since the Physician Payments Sunshine Act in 2010, a substantial body of work has explored the supplemental income received by physicians to understand trends in industry payments and investigate sources of bias. To date, no study has examined how various fellowship characteristics impact industry earning levels at foot and ankle orthopaedic surgery fellowships. The purpose of this study is to examine the various fellowship and faculty-specific variables in correlation with industry earnings in foot and ankle orthopaedic surgery fellowships.

Methods:

This study is a retrospective analysis of foot and ankle orthopaedic surgery fellowships and respective faculty along with various fellowship characteristics in correlation to industry lifetime earning levels as of March 2023. Industry total lifetime earnings represent income directly paid to physicians, is not part of the physician's salary, and does not include any research grants or funding. Lifetime earnings represent all years recorded on the Open Payments Database website (2015-2021).

Results:

There are 165 faculty physicians and 48 programs with complete data out of all foot and ankle orthopaedic surgery fellowship programs in the United States. The mean fellowship H-Index per fellowship was 48.94 ± 38.92, and the mean fellowship lifetime earning was $1 551 791.66 ± $4 136 091.64. There was no significant association between fellowship lifetime earnings and Newsweek ranking of fellowship-affiliated hospitals (P = .906), Doximity ranking of fellowship-affiliated residencies (P = .703), and region of the United States (P = .126). There was a statistically significant increase in total lifetime earnings in programs with 4 fellows as compared to 1 fellow (P = .035).

Conclusion:

There was no statistically significant correlation between a variety of foot and ankle fellowship-specific factors and lifetime industry earnings, aside from increased earnings in programs having 4 fellows. Prestige factors, such as Doximity and Ranked Hospital Newsweek List rank, as well as region of the United States is not associated with industry earnings.

Level of Evidence:

Level III, retrospective cohort study.
Analysis of the trends and cutting-edge developments of research in Tangut studies
Authors: Peng Xiangqian , Mylnikova Julia
Published: November 2023

Tangut studies is a broad discipline, generally consisting of three branches: Tangut language and literature, Tangut archaeology, and Tangut history. There are three new trends in Tangut studies in the new century: the publication of more Tangut written sources and artifacts, the gradual standardization of the interpretation of Tangut texts, and the continuous expansion of the subfields of Tangut historical research. Some issues could potentially hinder the further development of Tangut studies, such as cultivating new scholars in Tangut studies, avoiding the problem of “fragmentation” in research, supplementing the Khara-Khoto material, and the cooperation between Tangut studies and Tibetan studies. Finally, some future work plans are mentioned that cover various aspects, including language and literature, Tangut documents, and historical research.
The influence of household disadvantage on educational achievement inequality in Pakistan: Evidence from Annual Status of Education Report data
Authors: Rind Gul Muhammad , Malik Kamran Hyder
Published: November 2023

Inequity in education is a worldwide concern and there is a growing need to investigate educational achievement inequality in a nuanced and contextual manner. This study aims to elucidate the growing educational achievement inequality within Pakistan by addressing two key questions: What can be revealed about the influence of family socioeconomic condition and household characteristics on children’s disparate educational achievement in Pakistan? And what role do private schools and paid tuition play in exacerbating disparity in learning outcomes? In this study, we applied the concept of Equity in Education, particularly the impartiality approach, to consider disadvantaged conditions among children. We have analyzed the Annual Status of Education Report (ASER) Pakistan household-based survey data ( N = 247,978) conducted in 2021. Our analysis involved both descriptive and logistic regression techniques. Students’ achievement in the local language, arithmetic, and English language served as a dependent variable, while household factors remained a predictable variable. The results revealed that family socioeconomic factors including parents’ education and income, household facilities, and school types have a significant influence on children’s learning achievement and contribute to educational inequality. This study provides further insights for researchers and policymakers to better understand and address educational inequality in its specific context.
Study of the Responsiveness and Minimal Clinically Important Difference of the Trunk Impairment Scale in Patients With Acute Stroke
Authors: Ishiwatari Masahiro , Takahara Tsuyoshi , Hayakawa Masato , Ogawa Akihiro , Kido Satoshi
Published: November 2023

Background:

Trunk function is a prerequisite for functional activity; thus, it is crucial to carry out proper assessments and interventions. However, there is no clear indicator for trunk function evaluation in patients with stroke. To understand the effects of interventions over time, it is important to adopt responsive clinical indicators.

Purpose:

To examine the Trunk Impairment Scale (TIS) (Fujiwara version) in terms of responsiveness and the minimal clinically important difference (MCID).

Methods:

In total, 55 patients who experienced an acute stroke were evaluated on the seventh day of hospitalization and the day before discharge. The responsiveness of the TIS was assessed by the effect size and standardized response mean (SRM). Additionally, an MCID study was conducted to examine the amount of change in TIS scores required to indicate a clinically meaningful change, which was determined by the presence or absence of improvement in the activities of daily living.

Results:

The SRM of the TIS was 1.42. Additionally, the MCID was determined to be 3 points.

Conclusion:

The TIS score improved over time and a 3-point improvement in the TIS score was associated with improvement in the activities of daily living. Thus, this scale’s clinical sensitivity and MCID have been established in patients with stroke.
Elevated rates of dietary generalization in eusocial lineages of the secondarily herbivorous bees
Authors: Wood T. J. , Müller A. , Praz C. , Michez D.
Published: November 2023

Background

Within the Hymenoptera, bees are notable for their relationship with flowering plants, being almost entirely dependent on plant pollen and nectar. Though functionally herbivorous, as a result of their role as pollinators, bees have received comparatively little attention as models for insect herbivory. Bees often display dietary specialization, but quantitative comparison against other herbivorous insects has not previously been conducted.

Results

In the most comprehensive analysis to date for 860 bee species, dietary specialization amounted to 50.1% of studied species collecting pollen from between 1 and 2 botanical families with a relatively long tail of dietary generalists, with 11.1% of species collecting from more than 10 botanical families. This distribution deviated from the truncated Pareto distribution of dietary breadth seen in other herbivorous insect lineages. However, this deviation was predominantly due to eusocial bee lineages, which show a range of dietary breadths that conformed to a normal distribution, while solitary bees show a typical truncated distribution not strongly different from other herbivorous insects. We hypothesize that the relatively low level of dietary specialization in bees as a whole reflects the relaxation of the constraints typically observed in herbivorous insects with a comparatively reduced importance of plant chemistry and comparatively increased importance of phenology and foraging efficiency. The long flight periods of eusocial bees that are necessary to allow overlapping generations both allows and necessitates the use of multiple flowering resources, whereas solitary bees with short flight periods have more limited access to varied resources within a constrained activity period.

Conclusions

Collectively, solitary bees show slightly lower specialization compared to other herbivorous insects, possibly due to their balanced relationship with plants, rather than direct antagonism such as seen in the direct consumption of plant tissues. An additional factor may be the mediocre diversity of bees at low latitudes combined with low levels of dietary specialization, whereas these areas typically display a high rate of specialization by herbivorous insects in general. Though the most important factors structuring dietary specialization in bees appear to differ from many other herbivorous insects, solitary bees show a surprisingly similar overall pattern of dietary specialization.
Transcriptomic monitoring of Douglas-fir heartwood formation
Authors: Delourme Didier , Brémaud Laure , Plazanet Idelette , Pélissier Patrick , Label Philippe , Boizot Nathalie , Breton Christian , Durand Stéphanie , Costa Guy
Published: November 2023

Objectives

Molecular cues linked to heartwood formation open new (complementary) perspectives to genetic breeding programs of Douglas-fir, a tree species largely cultivated in Europe for the natural durability and civil engineering properties of its wood.

Data description

RNAs from a single genotype of Douglas-fir, extracted from three distinct wood zones (outer sapwood, inner sapwood and transition zone) at four vegetative seasons to generate an extensive RNA-seq dataset used to apprehend the in-wood dynamic and seasonality of heartwood formation in this hardwood model species.

Previously published data collected on somatic embryos of the same genotype could be merged with the present dataset to upgrade grade the Douglas-fir reference transcriptome.
Molecular surveillance reveals a potential hotspot of tick-borne disease in Yakeshi City, Inner Mongolia
Authors: Tian Junhua , Liu Jing , Zhao Hongqing , Chen Xiaomin , Geng Xueqin , Lu Miao , Li Kun
Published: November 2023

A molecular surveillance of tick-borne diseases was performed in Hulunbuir City, Inner Mongolia. A total of 149 ticks including three species (Ixodes persulcatus, Haemaphysalis concinna, and Dermacentor silvarum) were collected. As many as 11 tick-borne bacterial pathogens were identified in them. Some of them have high positive rates. For example, Candidatus Rickettsia tarasevichiae was detected with a high prevalence of 72.48%, while Candidatus Lariskella sp. was detected in 31.54% of ticks. For both Rickettsia raoultii and Anaplasma phagocytophilum, two distinct genotypes were identified based on their phylogenetic trees based on 16S rRNA, gltA, and groEL sequences. Remarkable genetic diversity was also observed for 16S and flaB genes of Borreliella garinii, an agent of Lyme disease. Rickettsia heilongjiangensis causing Far-Eastern spotted fever (2.68%, 4/149), Ehrlichia muris causing human ehrlichiosis (4.70%, 7/149), Borrelia miyamotoi causing relapsing fever (2.01%, 3/149), and Borreliella afzelii causing Lyme disease (2.01%, 3/149) were also detected. Additionally, a previously uncharacterized Anaplasma species closely related to Anaplasma ovis was identified. Herein we name it “Candidatus Anaplasma mongolica”. Based on these results, we propose that Yakeshi City might be a potential hotspot of tick-borne diseases.
Pressure-controlled ventilation-volume guaranteed mode improves bronchial mucus transport velocity in patients during laparoscopic surgery for gynecological oncology: a randomized controlled study
Authors: Deng Chao , Xu Tao , Wang Xue-kai , Gu Deng-feng
Published: November 2023

Background

Mechanical ventilation during general anesthesia may impair airway mucosal function. This study aimed to investigate the effect of pressure-controlled ventilation-volume guaranteed (PCV-VG) on bronchial mucus transport velocity (BTV) in patients during laparoscopic surgery for gynecological oncology compared with volume controlled ventilation (VCV).

Methods

66 patients undergoing elective a laparoscopic surgery for gynecological oncology. The patients were randomized into two group receiving either PCV-VG or VCV. a drop of methylene blue was placed on the surface of the airway mucosa under the bronchoscopeand, then the distance the dye movement was measured after 2, 4, and 6 min. Outcomes were assessed at T0 (5 min after endotracheal intubation and before initiation of pneumoperitoneum), T1 and T2 (1 and 2 h after stabilization of pneumoperitoneum respectively). BTV at T0, T1 and T2 was the primary outcome. Secondary outcomes included heart rate (HR), mean arterial pressure (MAP), body temperature, end-tidal CO2 pressure (PETCO2), tidal volume(VT), peak inspiratory pressure (PIP), mean inspiratory pressure (Pmean), respiratory rate (RR), and dynamic compliance (CDyn) at T0, T1, and T2.

Results

64 patients were included in the analysis. The median [interquartile range] BTV was significantly lower in VCV group at T1 and T2 that at T0 (P < 0.05). Furthermore, BTV was slightly reduced in PCV-VG compared with VCV. BTV in PCV-VG was significantly decreased at T2 compared with BTV at T0 (P < 0.05) and slightly decreased at T1 compared with T0(P > 0.05). Compared with the PCV-VG group, BTV in VCV group significantly decreased at T2 (P < 0.05). No participants experienced respiratory complications.

Conclusions

PCV-VG is more suitable for patients undergoing laparoscopic surgery for gynecological oncology than VCV since it can protect mucociliary clearance function.

Trial registration

This trial is registered on https://www.chictr.org.cn/ in Chinese Clinical Trial Registry (ChiCTR.2200064564: Date of registration 11/10/2022).
The efficacy of the treat-repair-treat strategy for severe pulmonary arterial hypertension associated with congenital heart disease: a meta-analysis
Authors: Wang Zhiyuan , Li Xiaobing , Li Mengxuan , Peng Jun , Zhang Huijun
Published: November 2023

Background

This meta-analysis was conducted to evaluate the efficacy of the treat-repair-treat (TRT) strategy in the treatment of severe pulmonary arterial hypertension with congenital heart disease (PAH-CHD).

Methods

PubMed, EMBASE, Cochrane and Web of Science online databases were searched by two independent investigators for studies that used the TRT strategy for PAH-CHD, and the retrieved studies were reviewed by a third investigator. The main outcomes were pulmonary artery pressure (PAP), pulmonary vascular resistance (PVR), 6-minute walk distance (6MWD), and transcutaneous oxygen saturation (SpO2). The changes were compared between follow-up and baseline. Stata version 14.0 was used for data analysis. A random-effects model was selected for meta-analysis. Subgroup analysis and meta-regression were used to find the source of heterogeneity.

Results

A total of 335 patients from 9 single-arm studies were included. Meta-analysis showed significant reductions in PAP and PVR and improvements in 6MWD and SpO2(PAP: SMD -2.73 95% CI -2.97, − 2.50p = < 0.001; PVR: SMD -1.27 95% CI -1.53, − 1.02p = < 0.001; 6MWD: SMD 1.88 95% CI 1.49, 2.27p = < 0.001; SpO2: SMD 3.72 95% CI 3.13, 4.32p = < 0.001). Subgroup analysis showed that younger patients had better efficacy, and the change in SpO2was an indication for patient selection. The combined mortality rate was 5% at follow-up.

Conclusions

In this meta-analysis, we demonstrated that the TRT strategy may have positive effects on haemodynamics and cardiac function in patients with severe PAH-CHD at short-term follow-up. Our analysis suggests that changes in age and SpO2may be related to patient prognosis.

Trial registration

The protocol was registered on the PROSPERO website with the registration number CRD42022366552. The relevant registration information can be obtained from the websitehttps://www.crd.york.ac.uk/prospero/#searchadvanced.
Clinical competence, communication ability and adherence to choosing wisely recommendations for lipid reducing drug use in older adults
Authors: Tamblyn Robyn , Moraga Teresa , Girard Nadyne , Chan Fiona K. I. , Habib Bettina , Boulet John
Published: November 2023

Background

Although lipid-lowering drugs are not recommended for primary prevention in patients 75+, prevalence of use is high and there is unexplained variation in prescribing between physicians. The objective of this study was to determine if physician communication ability and clinical competence are associated with prescribing lipid-lowering drugs for primary and secondary prevention.

Methods

We used a cohort of 4,501 international medical graduates, 161,214 U.S. Medicare patients with hyperlipidemia (primary prevention) and 49,780 patients with a history of cardiovascular disease (secondary prevention) not treated with lipid-lowering therapy who were seen by study physicians in ambulatory care. Clinical competence and communication ability were measured by the ECFMG clinical assessment examination. Physician citizenship, age, gender, specialty and patient characteristics were also measured. The outcome was an incident prescription of lipid-lowering drug, evaluated using multivariable GEE logistic regression models for primary and secondary prevention for patients 75+ and 65-74.

Results

Patients 75+ were less likely than those 65-74 to receive lipid-lowering drugs for primary (OR 0.62, 95% CI 0.59-0.66) and secondary (OR 0.70, 95% CI 0.63-0.78) prevention. For every 20% increase in clinical competence score, the odds of prescribing therapy for primary prevention to patients 75+ increased by 24% (95% CI 1.02-1.5). Communication ability had the opposite effect, reducing the odds of prescribing for primary prevention by 11% per 20% score increase (95% CI 0.8-0.99) for both age groups. Physicians who were citizens of countries with higher proportions of Hispanic (South/Central America) or Asian (Asia/Oceania) people were more likely to prescribe treatment for primary prevention, and internal medicine specialists were more likely to treat for secondary prevention than primary care physicians.

Conclusion

Clinical competence, communication ability and physician citizenship are associated with lipid-lowering drug prescribing for primary prevention in patients aged 75+.
Potential determinants of the quantity and duration of COVID-19 outbreaks in geriatric long-term care facilities
Authors: Evers Janis , Geraedts Max
Published: November 2023

Background

We analyzed potential factors for the number and duration of COVID-19 outbreaks in nursing homes based on routine and structural data.

Methods

All outbreaks during 03/2020-01/2022 in N = 687 of a total of 879 geriatric long-term care facilities (LTCFs) in the Federal State of Hesse, Germany were analyzed using t-tests and logistic regressions in a retrospective cohort study.

Results

Larger LTCFs have more (+ 1.57, p = .009) and longer outbreaks (+ 10.04 days, p > .001). A higher proportion of registered nurses reduces the number (-0.1, p = .036) and duration (-6.02 days, p > .001) of outbreaks. Single-bed rooms provide less duration of outbreaks (-4.5, p = .004). A higher proportion of infected residents (+ 24.26 days, p < .001) and staff (+ 22.98 days, p < .001) prolong outbreaks the most. LTCFs in areas with intermediate population density have an increased risk of prolonged outbreaks (OR: 1.537, p = .036).

Conclusions

To prevent outbreaks and shorten their duration, LTCFs should increase the proportion of registered nurses and single-bed rooms, and control staff infections.
The relationship of pre-pregnancy body mass index with maternal anthropometric indices, weight retention and the baby’s weight and nutrition in the first 6 months post-partum
Authors: Ahmadibeni Ayda , Kashani Parhoon , Hallaj Mohammad Sadegh , Ghanbari Saeed , Javadifar Nahid
Published: November 2023

Purpose

Pre-pregnancy body fat mass is one of the important indicators of the mother's and the infant's health. Therefore, the purpose of this study was to investigate relationship of pre-pregnancy body mass index (PPBMI) with maternal anthropometric indices and weight retention as well as the baby's weight and nutrition in the first 6 months post-partum.

Materials and methods

This is a prospective cohort study including 397 mothers giving birth to healthy babies and referring to health centers in Ahvaz (southwest of Iran) in 2022. The following data were extracted from the participants' electronic record: body mass index (BMI) before or at the beginning of pregnancy, gestational weight gain, and weight at the time of delivery. In addition to demographic information, the following data were also evaluated: maternal anthropometric indices including weight, hip and waist circumference, and conicity index during the first 10 days post-partum, along with the weight and nutrition pattern of the baby 2, 4 and 6 months post-partum.

Results

The mean age of the mothers was 29.96±5.7 years. The frequency of mothers according to BMI classification (i.e., underweight, normal, overweight, and obese) was 4.3%, 38.5%, 37%, and 20.3%, respectively. In this study, PPBMI had a significant relationship with decreasive changes of weight, waist and hip circumferen and conicity index after child birth, 2, 4 and 6 months post-partum (P<0.05) but the mean reduction of these anthropoemetric indices at 6th month postpartum were not related to PPBMI (P>0.05). However, this relationship was not significant when it came to the weight of the baby (P > .05). The lowest reduction in weight, waist and hip circumference and conicity index belonged to overweight mothers but the highest frequency of mothers with excesive gestational weight gain, the lowest frequency of breastfeeding until 6 months and also the lowest values of postpartum weight retention were observed in obese mothers (P<0.05).

Conclusion

According to the findings of this study, the decrease in anthropometric indices up to 6 months after delivery in overweight mothers is less than other BMI groups, but the consequences related to weight and nutrition in infants of obese mothers need special attention. Also, the results re-emphasize the importance of focusing on provision of educational and counseling services to mothers in order to improve their nutrition and weight, especially before pregnancy.