bluuebunny/crossref_metadata_2025 huggingface dataset:
Obstructed Descending Colon Mass Presented With Bochdalek Hernia: A Case Report
Authors: Eslamian Mohammad , Goharian Maryam , Ghasempour Dabaghi Ghazal , Rabiee Rad Mehrdad
Published: February 2023

The adult Bochdalek hernia is one of the right-sided diaphragmatic hernias that less than 30 cases reported until now. Here, we report a 64-year-old female patient who presented with dyspnea, abdominal pain, and nausea. Primary imaging showed a right-sided diaphragmatic hernia that contained the liver and right colon. At first, the patient underwent a right posterior thoracotomy, and the diaphragmatic defect was repaired. After 2 days, abdominal peritonitis happened then a midline laparotomy was performed. Finally, it was clear that the main problem was the obstructed and perforated descending colon mass that was presented with Bockdalek hernia. Unfortunately, the patient passed away 2 days after the operation. It should be considered that an increase in intra-abdominal pressure like the presence of obstructed colon mass can cause this rare hernia and It is important to determine the reason for the presentation of the symptomatic Bochdalek hernia in adult patients.
Learning to manage as learning to fail: The lessons of running
Authors: Warhurst Russell , Black Kate
Published: February 2023

Management learning aims to ensure managerial success and while failure is acknowledged, learners are encouraged to adopt a growth mindset and to bounce back from failure. However, the complexity of contemporary managerial work and the degradation of the managerial labour process mean that managers increasingly experience failures. Managers therefore need to learn not merely from failure but to learn to tolerate failure, that is, to fail well. The article differentiates types of failures and focuses on intractable failures that leave managers feeling inadequate and that corrode their sense-of-self. Therefore, an affective and embodied identity-based understanding of managerial failure is developed and an empirical case study of managers who engage in the most popular managerial sporting activity, running, is used to theorise the process of learning to fail-well. The mixed-methods empirical study using artefact elicitation participant data and autoethnographic authorial data is detailed and suggestions for more reflexive managerial education are advanced.
Effectiveness of written corrective feedback in developing L2 accuracy: A Bayesian meta-analysis
Authors: Brown Dan , Liu Qiandi , Norouzian Reza
Published: February 2023

Corrective feedback on second language (L2) writing has remained one of the most heavily studied areas in applied linguistics, yet clear guidance for practitioners about how to provide it most effectively remains limited. Previous studies have meta-analysed written corrective feedback (WCF) research revealing conflicting findings in how WCF affects development in L2 writers’ accuracy over time. This study provides a needed update in light of a recent increase in (quasi)experimental WCF studies. It features several methodological advances by introducing a Bayesian approach to conducting a meta-analysis, which provides a more valid picture of the generalizable effects. The analysis allows distinction – for the first time at a meta-analytic level – between short-, medium-, and long-term effects of WCF. Results aggregate data from an initial 52 primary studies that utilized control groups revealing robust evidence of the durability of moderate effectiveness of WCF over time and deeper insight into the relative effectiveness of various types of WCF (e.g. direct, indirect, metalinguistic – all yielding similar effect sizes) across research contexts, writing task types, target error types, and instructional characteristics. We conclude with recommendations to help continue methodological advances in this domain.
A systematic review of proficiency assessment methods in bilingualism research
Authors: Olson Daniel J.
Published: February 2023

Aims and objectives:

Proficiency assessment is a key methodological consideration in the field of bilingualism, and previous reviews have highlighted significant variability in both the use and type of assessment methods. Yet, previous reviews of proficiency assessment methods in bilingualism have failed to consider key study characteristics (e.g., methodology and subfield) that may impact the choice of proficiency assessment method. This paper provides an updated systematic review of proficiency assessment methods in the field of bilingualism, analyzing trends within different methodological approaches and linguistic subfields.

Design/methodology/approach:

A systematic review was conducted, examining recent research articles in the field of bilingualism, broadly defined. A total of 17 journals (of 100) and 140 empirical research articles (of 478) with bilingual participants fit the relevant inclusionary criteria.

Data and analysis:

Studies were coded for several characteristics, including methodology (e.g., quantitative vs qualitative), linguistic subfield (e.g., psycholinguistics), and the method of proficiency assessment (e.g., standardized testing, self-reporting).

Findings/conclusions:

Analyses revealed a number of different methods of proficiency assessment currently used in bilingualism research. However, different trends were found by methodology type and linguistic subfield. Broadly, the results revealed greater use of proficiency assessments in quantitative research than qualitative research. Moreover, while there was significant variability in all of the subfields examined, several within-subfield trends were identified.

Originality:

This study provides an update to previous findings, establishing current proficiency assessment practices in bilingualism research. In addition, acknowledging the unique needs of different types of research, this study is the first to examine trends within different methodological approaches (i.e., quantitative vs qualitative) and subfields of bilingualism (e.g., psycholinguistics, sociolinguistics).

Significance/implications:

The notable variability in proficiency assessment methods within different subfields suggests a greater need for subfield-specific norms to facilitate comparative analysis. Several key considerations are given for the selection of proficiency assessment methods in bilingualism research.
When meat-eaters expect vegan food to taste bad: Veganism as a symbolic threat
Authors: Rosenfeld Daniel L. , Rothgerber Hank , Tomiyama A. Janet
Published: February 2023

People who eat meat generally expect vegan food to taste bad. We theorize that this expectation stems in part from the perception that veganism is symbolically threatening; devaluing vegan food may enable meat-eaters to defend in-group values and defuse symbolic threat. We conducted four studies (total N = 1,563) on meat-eaters residing in the US. In Studies 1a and 1b, participants who most strongly endorsed carnism—the ideology that humans have a right to eat animals and their byproducts as food—were most likely to expect vegan food to taste bad. In Study 2, perceptions of veganism as symbolically threatening explained the relationship between carnism and taste expectations. In Study 3, experimentally increasing the salience of symbolic threat worsened taste expectations. Attachment to dominant group values and perceptions of intergroup threat may be barriers to the acceptance of veganism.
‘Everything turned upside down’: A thematic analysis of adolescents’ experiences of everyday life during COVID-19 restrictions
Authors: Stänicke Line Indrevoll , Kurseth Pauline Olin , Bekkhus Mona
Published: February 2023

Background:

At the beginning of the COVID-19 pandemic, people were encouraged to practice social distancing, and schools and leisure venues closed.

Aims:

We aimed to explore the everyday experiences of Norwegian adolescents during COVID-19 restrictions, when in-person contact with peers was severely limited.

Methods:

A total of 622 high-school students (16–18 years of age) replied to an online survey containing open-ended questions about the changes they experienced in everyday life during the first three months of the pandemic.

Results:

Reflexive thematic analysis resulted in four themes: (a) ‘Everyday life turned upside down – everything is on hold’; (b) ‘Alone with my thoughts – new concerns’; (c) ‘A loss of social life – a fear of wasting important time’; and (d) ‘Gratitude – new perspectives in life’. The results are discussed according to mental-health concerns and psychological developmental challenges during adolescence, such as social exploration of roles with peers, autonomy and identity formation during a crisis.

Conclusions:

The results underline individual variations and positive experiences among adolescents during the COVID-19 pandemic, despite social restrictions. Still, the lack of in-person contact with friends is related to an increased experience of loneliness and mental-health concerns for many adolescents.
Advocating for a dementia-inclusive visual communication
Authors: Ang Pei Soo , Yeo Siang Lee , Koran Leela
Published: February 2023

Introduction

This study examines the underlying visual communication strategies found in existing images of dementia in the public domain. By delineating how experiences of dementia are visualized and their consequent social interpretations, we aim to inform and advocate for a dementia-inclusive visual communication, that is, visual depictions that cultivate and represent a dementia-inclusive society.

Methods

The visuals were analyzed by employing the Visual Discourses of Disability (ViDD) framework that juxtaposes the “ perspectivizing-personizing” cline with the “ enabling-disabling” continuum . The data studied comprise a total of 432 images sourced from three domains, namely (1) The Star, a Malaysian mainstream English newspaper (2012–2021); (2) Alzheimer’s Disease Foundation Malaysia (ADFM) website (2019–2021); and (3) the Ministry of Health Malaysia (2019–2021) website. Findings from the visual analyses were corroborated by four representatives of ADFM in a group interview.

Results

There is a predominance of stigmatized images, constructing dementia as a loss and deficit, thus depicting individuals in distanced suffering. Generic representations of people through stock images, a unique focus on the hands, representations of brain degeneration through abstractions and missing puzzle pieces are also prevalent. Despite these, the interview data confirmed that the perspectivizing aspect may be necessary to educate the public on what dementia entails. While personizing images that depict personhood and actual persons living with dementia are ideal, the use of stock images may be necessary if there is a need to maintain confidentiality and observe sensitivities. Similarly, images with positive emotions are encouraged but disabling ones are equally important to reflect reality and inculcate empathy.

Conclusion

When capturing, selecting and publishing images of dementia, organizations should deliberate on different visual elements which evoke empowerment, advocacy, handicapping and othering implications as outlined in the ViDD framework. Any decision should only be made after considering the purposes of publications and implications such images have on the intended audiences.
A diagnostic framework with a novel simulation data augmentation method for rail damages based on transfer learning
Authors: Xie Jingsong , Guo Zhibin , Wang Tiantian , Yang Jinsong
Published: February 2023

The ultrasonic guide wave (UGW) has good application prospects in steel rail damage diagnosis, but the features of the rail damage implied in the UGW are complex. Deep learning enables an end-to-end approach to fault diagnosis. Nevertheless, a large amount of diversity data is needed for training, whereas the ultrasonic wave guide signals of simulation and repeated experiments lack diversity. Therefore, in this paper, a diagnostic framework based on simulation and transfer learning for rail damage is developed to tackle the problems mentioned above. The proposed framework is based on deep learning with a simulation pretraining strategy to build convolutional neural network (CNN) models through parameter fine-tuning for damage diagnosis. Specifically, for the problem that the simulation data lacks diversity, a damage mechanism-based data diversity augmentation method is proposed; this obtains the diagnostic high-value simulation data including supporting features, and expanded the diversity of the simulation data. Adopting the proposed method of data augmentation and transfer learning (TL), a diagnostic model for rail damage utilizing augmented UGW signals is constructed. The finite element simulation data of UGW with damages at different locations and depths of rails are augmented to achieve the pretraining of CNN models, and the model transfer is performed with the experimental data of rails. Ultimately, through comparative studies it can be concluded that (1) The TL diagnostic framework makes full use of the finite element simulation data to realize the model pretraining. (2) The proposed data augmentation method realizes the diversity expansion of simulation data containing supporting features and ensures the efficient application of simulation data in model pretraining.
Continuous monitoring with a permanently installed high-resolution ultrasonic phased array
Authors: Sun Xiaoyu , Croxford Anthony J , Drinkwater Bruce W
Published: February 2023

High-resolution defect detection is an integral part of non-destructive testing (NDT). Ultrasonic array transducers have been developed to respond to this need and provide high-resolution images for such applications. At present, high-resolution imaging is achieved by ultrasonic array design, such as enhanced transducer materials, and optimised element geometry to fulfil inspection requirements and miniaturise imaging artefacts, etc. This paper presents a novel ultrasonic array and controller system design strategy that can miniaturise the array and reduce manufacturing cost of the entire array system. This then enables the permanent or semi-permanent installation of arrays onto structures and long-term continuous structural health monitoring (SHM). The array geometry is designed as a compromise between the required imaging performance for the desired application and the fabrication cost for permanent installation. A prototype array transducer is constructed from piezoceramic elements bonded to a flexible printed circuit (FPC) substrate and then permanently installed on example structures to demonstrate long-term monitoring. Improved long-term sensitivity to defect growth is achieved by applying a compensation strategy for velocity and phase changes with temperature. Results show that a 5 MHz, 18-element prototype array can detect changes as small as 0.1 mm in the diameter of a side-drilled hole (SDH) defect after 3 months of continuous monitoring.
Listening to mothers’ voices of children’s play challenges and changes during social distancing
Authors: Dewhirst Courtney Beers , Casey Erin
Published: February 2023

This study explores how mothers in the US described challenges to their children’s (ages birth to eight) play experiences at home during social distancing due to the COVID-19 virus. Understanding their lived experiences is valuable because it will add insight into the effects of this unique time period on the critical role parent-child interactions play in children’s physical, social, and emotional well-being. Using a phenomenological design, interviews with 14 mothers revealed a common experience in which play efforts were altered at times due to challenges related to social distancing and COVID-19. Four themes described these challenges: Lack of Parent Resources and Support, Work and Child Care Balance, Children’s Struggles with Social Isolation, and Children’s Uncertainty Regarding COVID-19. Mothers believed it was their responsibility to keep their children engaged in play as part of their childcare duties. They struggled to balance work and childcare, did not always enjoy playing with their children, and desired alone time to recover during this challenging time. They sought to best meet their children’s needs but had to make allowances to their parenting practices and play attitudes. The authors discuss how more intensive parenting philosophies could be difficult to sustain when society does not operate as usual.
Quality early childhood education and care in a time of COVID-19
Authors: Tregenza Sasha , Campbell-Barr Verity
Published: February 2023

Contextual approaches to high quality Early Childhood Education and Care (ECEC) seek to capture the complexity of children’s lives, developing pedagogical approaches that are responsive to children’s needs and interests. In 2020, the COVID-19 pandemic provided a complex layer to the question of what constitutes quality ECEC. A mixed methods appreciative inquiry of educators’ and parents’ views of quality in one ECEC setting in England, became an unexpected ethnographic exploration of quality ECEC in the time of a global pandemic. The findings indicate how features of quality, such as offering a range of learning environments and structuring the pedagogic environment to offer free-flowing play, had to be adapted to prevent the spread of COVID-19. The focus on quality shifted, prioritising the health and safety of families and staff, over the quality and variety of the curriculum. Greater emphasis was also placed on children’s social and emotional well-being to support their ability to understand and manage the changes to routines in response to the pandemic. The findings demonstrate that the early years workforce remains central to understanding and supporting quality, concluding that quality ECEC is shaped by adaptability – adapting to the needs of children, families, staff, and the unprecedented context of COVID-19. The focus on adaptability seeks to highlight how educators frequently respond to unique contexts in juggling concepts of quality ECEC. Consequently, a recommendation is made for future educator training to consider the importance of adaptability, in providing a useful framework for reimaging quality ECEC post COVID-19.
Diversity Officer Development Programs: A New Approach to Cultivating High Performing Chief Diversity Officers
Authors: Bohonos Jeremy W.
Published: February 2023

Problem

Increasing numbers of organizations are creating new Chief Diversity Officer positions, and because these roles are relatively new to the corporate landscape, industry lacks established methods for developing employees to excel in these roles.

Solution

Diversity Officer Development Programs (DODPs) are proposed as a method for organizations to ensure they are developing a robust pipeline of diversity specialists who can move into CDO roles as well as other top leadership positions.

Stakeholders

Organizations and HRD scholars who are committed to advancing diversity, equity, inclusion, and social justice in the workplace.
Low-Dose Radiation Reduces Doxorubicin-Induced Myocardial Injury Through Mitochondrial Pathways
Authors: Zhao Di , Jiang Xin , Meng Xinxin , Liu Dandan , Du Yanwei , Zhao Lijing , Jiang Hongyu
Published: February 2023

The use of doxorubicin (DOX) as an anthraquinone antineoplastic agent is limited due to its cardiotoxicity. Our previous study suggested that low-dose radiation (LDR) could mitigate the cardiotoxicity induced by DOX via suppressing oxidative stress and cell apoptosis. However, the molecular targets and protective mechanism of LDR are not understood. In the present study, we sought to investigate the mechanisms underlying LDR’s cardioprotection. Balb/c mice were randomly divided into four groups: Control group (no treatment), DOX group, LDR group (75 mGy), and LDR-72 h-DOX group (LDR pretreatment followed by intraperitoneal injection of DOX). Electron microscopy, PCR, and Western blot analyses indicated that LDR pretreatment mitigated changes in mitochondrial morphology caused by DOX, upregulated activity of mitochondrial complexes, and restored ATP levels in cardiomyocytes that were decreased by DOX. Whole genome microarray and PCR analyses showed that mitochondrial-related genes were altered by LDR pretreatment. Thus, our study showed that LDR can protect cardiomyocytes against DOX through improving mitochondrial function and increasing ATP production. This research could inform DOX chemotherapy strategies and provide new insight into the molecule mechanisms underlying the cardioprotective effects of LDR.
A study on spot welding quality judgment of stainless steel plate based on semi-supervised conditional generation adversarial network
Authors: Wang Bing
Published: February 2023

During RSW, the number of qualified samples is much more than the unqualified ones, forming an unbalanced set, thus affecting the training effect of the model, meanwhile, most samples are unlabeled, and if all the joints are marked, it is more expensive. Based on this, a method of spot welding quality judgment of stainless steel plate based on semi-supervised conditional generation adversarial network is proposed. Firstly, labels are added to the noise to generate labeled data and unlabeled data, which are mixed in a certain proportion to ensure the diversity of generated data. Then, the real data is divided into two parts, in which the unlabeled part plays a game with the generated data to generate samples as close to the real as possible, meanwhile, the data with true discriminant results and labeled data are input into the autoencoder to obtain the feature vectors set of different states. Finally, the training parameters and test samples are input into the classifier to obtain the judgment results. The proposed method was applied to application case, and the results showed that it not only had a good fitting effect, but also had a high classification accuracy. Consequently, the method proposed was effective.
The role of language in mental health during the transition from primary to secondary education
Authors: Jelen Maria Barbara , Griffiths Sarah Louise , Lucas Laura , Saul Jo , Norbury Courtenay F
Published: February 2023

We report a preregistered analysis to test whether children meeting diagnostic criteria for language disorder (LD) have higher self-reported and/or parent-reported mental health symptoms during the transition from primary to secondary education. Data are from a UK-based longitudinal cohort study, The Surrey Communication and Language in Education Study (SCALES). SCALES oversampled children at risk of LD at school entry. Language was measured using a battery of standardised assessments in Year 1 (age 5–6 years, n = 529), and mental health symptoms were measured using self and parent report in Year 6 (age 10–11 years, n = 384) and Year 8 (age 12–13 years, n = 246). Social experiences were also measured using self-report measures in Year 6. Mental health symptoms were stable during the transition from primary to secondary school. Symptom rates did not differ between children with and without LD based on self-report, but children with LD had higher parent-reported mental health symptoms than their peers with typical language. Similarly, early language was negatively associated with parent-reported but not self-reported mental health symptoms. Early language was associated with fewer child-reported positive social experiences in Year 6, but social experiences did not mediate the association between language and mental health. We found poor agreement between parent and self-reported child mental health symptoms across language groups. Future studies should aim to determine sources of disagreement between parent and child report, particularly for children with communication difficulties who may struggle to accurately self-report mental health symptoms.
Dementia in people with Down syndrome
Authors: Lewis Fergus , Hinson-Raven Michaela , Saraswat Charvi , Cruden-Smith Leola , Blunstone Rosy , Bonnici-Mallia Anne M.
Published: February 2023

Down syndrome (trisomy 21) is one of the most common causes of intellectual disability. It is associated with characteristic physical features and multiple comorbidities, due to the process of accelerated ageing. Improved recognition and access to healthcare in recent decades has dramatically increased life expectancy. However, as a result, people with the syndrome are more at risk of developing conditions associated with ageing, significantly Alzheimer’s dementia. The diagnosis of dementia remains a challenge in the context of intellectual disability, leading to delayed diagnosis and poor outcomes. The importance of recognising early signs is a key to improving management and prognosis.
Wireless sensor network security: A recent review based on state-of-the-art works
Authors: Faris Mohammed , Mahmud Mohd Nazri , Salleh Mohd Fadzli Mohd , Alnoor Alhamzah
Published: February 2023

Wireless sensor networks (WSNs) are a major part of the telecommunications sector. WSN is applied in many aspects, including surveillance battlefields, patient medical monitoring, building automation, traffic control, environmental monitoring, and building intrusion monitoring. The WSN is made up of a vast number of sensor nodes, which are interconnected through a network. However, despite the growing usage of applications that rely on WSNs, they continue to suffer from restrictions, such as security issues and limited characteristics due to low memory and calculation power. Security issues lead to a lack of communication between sensors, wasting more energy. The need for efficient solutions has increased, especially with the rise of the Internet of Things, which relies on the effectiveness of WSNs. This review focuses on security issues by reviewing and addressing diverse types of WSN assaults that happened on each layer of the WSN that were published in security issues in the previous 3 years. As a consequence, this paper gives a taxonomy of security threats for each layer and different algorithmic solutions that numerous researchers who seek to counter this attack have explored. This study also presents a framework for constructing an intrusion detection system in the WSN by emphasising the drawbacks of each approach suggested by researchers to defend against specific forms of assault. In order to diminish the impact of this attack, this summary shows which attacks the majority of researchers have dealt with as well as which ones they have not yet addressed in their academic work.
Principle of proportionality as a threat to criminal-law-related fundamental rights
Authors: Śliwiński Emil
Published: February 2023

The article argues that the principle of proportionality—a legal tool widely used for balancing competing rights—can be perceived as a threat to criminal-law-related fundamental rights, i.e. mainly the nullum crimen sine lege and ne bis in idem principles. A case study is carried out, of A and B v Norway, Tsonyo Tsonev v Bulgaria (no 4) and Saquetti Iglesias v Spain ECtHR judgments, as well as P16-2021-001 ECtHR advisory opinion and Menci CJEU ruling, heavily relying on the rule-principle distinction (as presented by Ronald Dworkin and Robert Alexy). The conclusion stemming from the study can be described as follows: in some instances ‘inserting’ proportionality into the content of fundamental rights might be inappropriate, i.e. dogmatically flawed and detrimental to the effective protection of these rights.
English and Spanish Adjectives That Describe the Japanese Concept of Kawaii
Authors: Nittono Hiroshi , Saito Hatsune , Ihara Namiha , Fenocchio Dante Nicolas , Andreau Jorge Mario
Published: February 2023

The word “kawaii” is ubiquitous in contemporary Japan and has spread to the rest of the world with the dissemination of Japanese pop culture. Although the word is conventionally translated in English as “cute,” its meaning is more nuanced than “cute,” and it is used for a wider variety of objects. The primary aim of this study was to determine if Spanish has an equivalent to the word “kawaii”; additionally, similarities and differences across Japanese, English, and Spanish were explored. An internet survey was conducted in which respondents from Japan ( n = 486), the United States ( n = 365), and Argentina ( n = 303) were presented with various photographic images that were often described as “kawaii” in Japanese and asked to write three adjectives to describe the images. They were also instructed to rate their affective states when looking at each image in the valence and arousal dimensions. The results showed that babyish objects (e.g., human, animal, and toy) were most frequently defined as “kawaii” in Japanese, “cute” in English, and “tierno” in Spanish. The average frequency at which these words were used as primary adjectives was higher for “kawaii” (57.5%) than for “cute” (26.8%) or “tierno” (22.4%). All of these images were associated with positive and moderately-aroused affective states similarly across all three countries. The present study demonstrates that the adjectives “kawaii,” “cute,” and “tierno” can be used almost equivalently for describing babies and pets, but that the Japanese adjective “kawaii” encompasses wider categories than the other two words.
The Impact of Gender on the Postoperative Consumption of Intensive and Intermediate Care Resources
Authors: Weissman Charles
Published: February 2023

Gender disparities when delivering healthcare are attributed to gender bias and gender-related pathophysiology. We examined the interaction of gender with the provision of postoperative intensive and intermediate care. Specifically whether for major surgeries, co-morbidities and lengths-of-surgery, women receive intensive and intermediate care as often as men. A two-phase prospective study performed in an Israeli university medical center explored utilization of postoperative intensive/intermediate care. Phase 1 examined gender differences in a broad range of postoperative intensive and intermediate patients. Phase 2 examined consecutive patients undergoing major abdominal and vascular surgeries to ascertain whether for similar surgeries and co-morbidities, women were as likely as men to receive intensive/intermediate care. Phase 1 ( n = 1883)—Proportionately more males were admitted to intensive/intermediate areas because they more often were trauma victims or had pre-existing ischemic heart disease. Female admissions were notable for obstetrical emergencies and post-meningioma excisions. Phase 2 ( n = 796)—The proportion of males and females receiving intensive/intermediate care did not differ after specific surgeries, for example, hepatectomy, carotid endarterectomy. However, among patients with underlying ischemic heart disease men, more often than women (15% vs. 21%, p < 0.05), received intensive care after elective surgery. Although pathophysiologic differences resulted in more men than women, receiving postoperative intensive/intermediate care, gender bias might also be operative. These observations highlight the importance of considering the influence of gender when choosing a postoperative care location to insure that gender differences in the levels of care are due to pathophysiology and not gender bias.
The definition of a community paramedic: An international consensus
Authors: Shannon Brendan , Baldry Sascha , O’Meara Peter , Foster Nicole , Martin Angela , Cook Matthew , Stewart Karen , Miles Alecka
Published: February 2023

Community paramedicine is a globally evolving model of care where paramedics provide community-based, preventative and primary healthcare services. With increased global interest and adaptation of the community paramedicine model, there is a lack of a clear definition of the role of a community paramedic. This study sought to come to an international consensus on the definition of a community paramedic. A four-phase Delphi methodology was utilised to achieve a global consensus on the definition of a community paramedic. A systematic approach to expert identification was performed and reported in line with the Conducting and REporting of DElphi Studies standard. A total of 94 community paramedicine experts were identified and 76 experts consented to involvement in this Delphi. Response rate ranged from 81.6% (Phase 1) to 63.1% (Phase 2). Participants expressed the importance of community paramedic definition having components attributed to primary health care, health promotion, chronic disease management and advanced clinical assessment. Participants expressed that these are essential components of the community paramedic skill set, which distinguishes the role from other frontline paramedics. A final consensus with 91% agreement on the definition of a community paramedic was achieved. The four-phase Delphi achieved consensus on the definition of a community paramedic as follows: A community paramedic provides person-centred care in a diverse range of settings that address the needs of the community. Their practice may include the provision of primary health care, health promotion, disease management, clinical assessment and needs-based interventions. They should be integrated with interdisciplinary healthcare teams which aim to improve patient outcomes through education, advocacy and health system navigation. The adoption of the global consensus on the definition of a community paramedic will enhance efforts to promote the value of this specialist role, enabling a better understanding of how a community paramedic contributes to the wider healthcare system.

[Media: see text]
Paramedic perspectives on sex and gender equity in prehospital electrocardiogram acquisition
Authors: Hussain Aman , McDonald Neil , Little Nicola , Weldon Erin
Published: February 2023

Acute coronary syndrome (ACS) makes up a substantial healthcare burden. Previous research has demonstrated that women fare worse than men across a range of hospital-based ACS processes and outcomes. In the prehospital setting, the 12-lead electrocardiogram (ECG) can identify critical ACS cases and speed access to definitive treatment. However, studies on rates of ECG acquisition among patients at risk of ACS in the prehospital setting have shown that women receive the test less frequently than men. The purpose of this study was to investigate the reasons for observed gender differences in rates of ECG acquisition in the prehospital setting. This is a cross-sectional study of paramedics in an urban emergency medical service agency. An experienced qualitative researcher conducted 26 semi-structured interviews. Using a subjectivist inductive approach, the study team analyzed interview transcripts following the six-step process described by Braun and Clarke (2006). Qualitative rigor was maintained through consistent review, discussion, and revision at each stage. Four themes were identified among diverse views around the 12-lead acquisition. (1) Safety (feelings of physical comfort and psychological safety related to administering a 12-lead). (2) Knowledge (subject-matter knowledge involving the protocols and procedures as well as self-knowledge of participants’ own practice). (3) Training and learning (perceptions of foundational training and on-the-job learning, and how those have influenced their perceptions of how to care for patients experiencing ACS). (4) Professionalism (perceptions of behavior and attitudes and how they influence patient care). These four interrelated themes were integrated to represent a model of prehospital cardiac care. This study addressed a gap in the literature by documenting prehospital providers’ attitudes and beliefs around cardiac care. The resulting model of prehospital cardiac care offers both a template for evaluating the equity of current treatment and a road map for improvement.
The Effectiveness of a Patient’s Bedside Ultrasonography in Diagnosing a Pulmonary Embolism, in the Emergency Department
Authors: Taşkın Ömer , Kekeç Zeynep , Belli Fuat , Tuğcan Mustafa Oğuz
Published: February 2023

Objective:

The research aim was to analyze the function of focused cardiac ultrasonography (FoCUS) in diagnosing a pulmonary embolism (PE) and contributing to the practice of emergency medicine and expediting the treatment of PE.

Materials and Methods:

In this prospective and observational study, Wells scores were calculated on those patients who presented to the emergency department over the last 2 years and were evaluated with a preliminary diagnosis of PE, as well as the biochemical values and imaging techniques. In all cases, FoCUS was used as the diagnostic tool.

Results:

A PE was detected in 38 (63.3%) of 60 patients. According to Wells score, it was determined that 5 (8.3%) patients had low-risk, 41 (68.3%) had medium-risk, and 14 (23.3%) had high-risk Wells score. There was a statistically significant correlation between the existence of PE and the findings of FoCUS in patients with right ventricular dilatation ( P < .001). According to Wells score, moderate-risk individuals with PE were more likely to exhibit right ventricular dilatation ( P = .003).

Conclusion:

The FoCUS results either alone or in conjunction with the Wells score, reviewed in the diagnosis of PE, effectively indicated and directed the diagnosis and treatment of patients admitted to this particular emergency department.
A Ruptured Inferior Pancreaticoduodenal Artery Aneurysm Detected With Ultrasonography: A Case Report
Authors: Fujioka Masayuki , Yabunaka Koichi , Miyazaki Minoru , Saga Toshihiko
Published: February 2023

Pancreaticoduodenal artery aneurysm (PDAA) is a rare disease that is recognized as an intra-abdominal hemorrhage differential diagnosis. This case study reports on a ruptured PDAA case in which ultrasonography (US) proved useful for the initial diagnosis. A 60-year-old man presented to the emergency department with pain in the epigastrium and back. An abdominal US performed at presentation suggested a PDAA and intraperitoneal hemorrhage/retroperitoneal hematoma. In addition, a contrast-enhanced computed tomogram (CT) revealed a hematoma extending from the upper abdomen to the pelvic floor and an aneurysmal pancreaticoduodenal artery arcade dilatation. Furthermore, emergency abdominal angiography findings revealed bleeding from a posterior-inferior PDAA, and coil embolization was performed. Postoperative progress was good, and the postoperative CT at 7 days showed no rebleeding signs and/or enlargement or new PDAA development. Therefore, the patient was discharged from the hospital 14 days after embolization.
Lacticaseibacillus casei T1 attenuates Helicobacter pylori-induced inflammation and gut microbiota disorders in mice
Authors: Yu Zhihao , Cao Mei , Peng Jingshan , Wu Daoyan , Li Shu , Wu Chengmeng , Qing Liting , Zhang Andong , Wang Wenjie , Huang Min , Zhao Jian
Published: February 2023

Probiotics are defined as live microbial food elements that are beneficial to human health. Lacticaseibacillus casei T1 was considered to have potential as a bioactive ingredient in functional foods, which was isolated from kurut. Previous research by our group proved that L. casei T1 could prevent inflammatory responses caused by Helicobacter pylori. This study aimed to investigate whether treatment with L. casei T1 resulted in a suppressive effect on H. pylori-induced oxidative stress and inflammatory responses. The results showed that treatment with L. casei T1 could relieve H. pylori-induced overexpression of inflammatory cytokines in GES-1 cells. Experiments in animals suggested that taking long-term L. casei T1 could reduce oxidative stress and inflammatory cytokines and improve H. pylori-induced gastric mucosal damage. Furthermore, taking L. casei T1 could increase the relative abundance of beneficial intestinal bacterium (Lachnospiraceae and Odoribacter) of H. pylori-infected mice and help in maintaining the balance of intestinal microflora.

Collectively, L. casei T1 had certain degrees of therapeutic effect against H. pylori. In the future, it combined with antibiotics for H. pylori eradication deserves further study.
Trans-Zeatin induce regulation the biosynthesis of 2-acetyl-1-pyrroline in fragrant rice (Oryza sativa L.) seedlings
Authors: Xing Pipeng , Luo Haowen , He Zhenzhen , He Longxin , Zhao Hua , Tang Xiangru , Duan Meiyang
Published: February 2023

Background

In plants, cytokinin is activated into trans-zeatin to fight abiotic stresses. However, the mechanism of the effect of trans-zeatin on 2-acetyl-1-pyrroline (2-AP) biosynthesis in fragrant rice has yet to be studied. The present study was conducted to explore the effects of exogenous trans-zeatin on enzymes activities, genes expression, and precursors involved in 2-AP biosynthesis and 2-AP contents as well as the seedling quality of a fragrant rice cultivar viz., Meixiangzhan2. Four concentrations of trans-zeatin solutions at 20, 40, and 80 μmol L− 1 (ZT1, ZT2, and ZT3) were sprayed onto rice seedlings.

Results

Compared to the control, trans-zeatin treatments showed significantly higher 2-AP contents of fragrant rice seedlings. Increased plant height and stem width were observed due to trans-zeatin treatments. The trans-zeatin application increased 1-pyrroline, methylglyoxal, proline, and P5C contents, enhanced P5CS and OAT activities, and reduced glutamic acid contents. In addition, expressions of ProDH, P5CS2, and DAO4 were comparatively higher under trans-zeatin treatments than CK in fragrant rice seedlings.

Conclusions

Overall, up-regulation of P5C, 1-pyrroline, and proline and down-regulation of glutamic acid under appropriate trans-zeatin concentrations (20 and 40 μmol L− 1) resulted in enhanced 2-AP biosynthesis in fragrant rice seedlings and 20–40 μmol L− 1 was considered as the suggested concentrations of trans-zeatin application in fragrant rice seedling.
One-year outcomes of catheter ablation for atrial fibrillation in young patients
Authors: Tseng Andrew S. , Patel Harsh P. , Kumar Ashish , Jani Chinmay , Patel Kirtenkumar , Jaswaney Rahul , Thakkar Samarthkumar , Kowlgi Narayan G. , Dani Sourbha S. , Arora Shilpkumar , Mulpuru Siva K. , Madhavan Malini , Killu Ammar M. , Cha Yong-mei , DeSimone Christopher V. , Deshmukh Abhishek
Published: February 2023

Background

Atrial fibrillation (AF) is relatively less frequent in younger patients (age < 50). Recently, studies have suggested that early restoration of sinus rhythm may lead to improved outcomes compared with rate control, however the efficacy of catheter ablation for AF in young is scarce.

Methods

We included all hospitalized patients between 18 and 50 years with a diagnosis of AF from the Nationwide Readmission Database 2016–2017 from the Healthcare Cost and Utilization Project. Demographic and comorbidity data were collected and analyzed. Outcomes assessed included one-year AF readmission rates, all-cause readmission, ischemic stroke, and all-cause mortality. Subgroup analyses were performed for all demographic and comorbidity variables.

Results

Overall, 52,598 patients (medium age 44, interquartile range 38–48, female 25.7%) were included in the study, including 2,146 (4.0%) who underwent catheter ablation for AF. Patients who underwent catheter ablation had a significantly lower rate of readmission for AF or any cause at one year (adjusted hazard ratios (HR) of 0.52 [95% confidence interval (CI): 0.43–0.63] and HR of 0.81 [95% CI: 0.72–0.89], respectively). There was no difference in 1-year readmission for stroke or all-cause mortality between the two groups. Subgroup analyses showed a consistent reduction in the risk of AF readmission among major demographic and comorbidity subgroups.

Conclusion

Catheter ablation in young patients with AF was associated with a reduction in 1-year AF related and all-cause readmissions. These data merit further prospective investigation for validation, through dedicated registries and multicenter collaborations to include young AF from diverse population.
Surgical volume and outcomes of surgical ablation for atrial fibrillation: a nationwide population-based cohort study
Authors: Chang Feng-Cheng , Huang Yu-Tung , Wu Victor Chien-Chia , Tu Hui-Tzu , Lin Chia-Pin , Yeh Jih-Kai , Cheng Yu-Ting , Chang Shang-Hung , Chu Pao-Hsien , Chou An-Hsun , Chen Shao-Wei
Published: February 2023

Background

Atrial fibrillation is the most common cardiac arrythmia and causes many complications. Sinus rhythm restoration could reduce late mortality of atrial fibrillation patients. The Maze procedure is the gold standard for surgical ablation of atrial fibrillation. Higher surgical volume has been documented with favorable outcomes of various cardiac procedures such as mitral valve surgery and aortic valve replacement. We aimed to determine the volume–outcome relationship (i.e., association between surgical volume and outcomes) for the concomitant Maze procedure during major cardiac surgeries.

Methods

This nationwide population-based cohort study retrieved data from the Taiwan National Health Insurance Research Database. Adult patients undergoing concomitant Maze procedures during 2010–2017 were identified; consequently, 2666 patients were classified into four subgroups based on hospital cumulative surgery volumes. In-hospital outcomes and late outcomes during follow-up were analyzed. Logistic regression and Cox proportional hazards model were used to analyze the volume–outcome relationship.

Results

Patients undergoing Maze procedures at lower-volume hospitals tended to be frailer and had higher comorbidity scores. Patients in the highest-volume hospitals had a lower risk of in-hospital mortality than those in the lowest-volume hospitals [adjusted odds ratio, 0.30; 95% confidence interval (CI), 0.15–0.61; P < 0.001]. Patients in the highest-volume hospitals had lower rates of late mortality than those in the lowest-volume hospitals, including all-cause mortality [adjusted hazard ratio (aHR) 0.53; 95% CI 0.40–0.68; P < 0.001] and all-cause mortality after discharge (aHR 0.60; 95% CI 0.44–0.80; P < 0.001).

Conclusions

A positive hospital volume–outcome relationship for concomitant Maze procedures was demonstrated for in-hospital and late follow-up mortality. The consequence may be attributed to physician skill/experience, experienced multidisciplinary teams, and comprehensive care processes. We suggest referring patients with frailty or those requiring complicated cardiac surgeries to high-volume hospitals to improve clinical outcomes.

Trial registration: the institutional review board of Chang Gung Memorial Hospital approved all data usage and the study protocol (registration number: 202100151B0C502).