bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonsport narratives, fan production, and affective discourse in girls and women eSports fandom: An alternative construction of pro-gaming in China
Authors: Yin Yiyi , Xu Xiaotang
Published: October 2023

This article discusses the cultural practices of girls and women eSports fans and their significance. The paper argues that the cultural performances of girls and women eSports fans challenge the hegemonic masculinity of the eSports sphere by allowing fans to enter the world of eSports affectively. Girls and women eSports fans oppose the patriarchal competitive discourse of “noob is an original sin” from traditional eSports fans and try to open new discourse spaces from the perspectives of romance, homosociality, and cuteness. Through actively participating in tournament spectatorship, social media discussions, and production of fan products, girls and women fans have developed an affective narrative of “generating power with love.” Thus, girls and women girls and women eSports fans have partially transformed the traditional male-dominant eSports fandom and opened new affective spaces for cultural practices for eSports fans.
Complement activation drives antibody-mediated transfusion-related acute lung injury via macrophage trafficking and formation of NETs
Authors: van der Velden Saskia , van Osch Thijs L. J. , Seghier Amina , Bentlage Arthur E. H. , Mok Juk Yee , Geerdes Dionne M. , van Esch Wim J. E. , Pouw Richard B. , Brouwer Mieke C. , Jongerius Ilse , de Haas Masja , Porcelijn Leendert , van der Schoot C. Ellen , Vidarsson Gestur , Kapur Rick
Published: October 2023

Transfusion-related acute lung injury (TRALI) is one of the leading causes of transfusion-related fatalities and, to date, is without available therapies. Here, we investigated the role of the complement system in TRALI. Murine anti–major histocompatibility complex class I antibodies were used in TRALI mouse models, in combination with analyses of plasma samples from patients with TRALI. We found that in vitro complement activation was related to in vivo antibody-mediated TRALI induction, which was correlated with increased macrophage trafficking from the lungs to the blood in a fragment crystallizable region (Fc)-dependent manner and that this was dependent on C5. Human immunoglobulin G 1 variants of the murine TRALI-inducing antibody 34-1-2S, either unable to activate complement and/or bind to Fcγ receptors (FcγRs), revealed an essential role for the complement system, but not for FcγRs, in the onset of 34-1-2S–mediated TRALI in mice. In addition, we found high levels of complement activation in the plasma of patients with TRALI (n = 53), which correlated with elevated neutrophil extracellular trap (NET) markers. In vitro we found that NETs could be formed in a murine, 2-hit model, mimicking TRALI with lipopolysaccharide and C5a stimulation. Collectively, this reveals a critical role of Fc-mediated complement activation in TRALI, with a direct relation to macrophage trafficking from the lungs to the blood and an association with NET formation, suggesting that targeting the complement system may be an attractive therapeutic approach for combating TRALI.
Early complete response as a validated surrogate marker in extranodal marginal zone lymphoma systemic therapy
Authors: Bommier Côme , Zucca Emanuele , Chevret Sylvie , Conconi Annarita , Nowakowski Grzegorz , Maurer Matthew J. , Cerhan James R. , Thieblemont Catherine , Lambert Jérôme
Published: October 2023

Extranodal marginal zone lymphoma (EMZL) has a very indolent course, and the validation of surrogate markers could accelerate novel therapies. Although prognostic markers do exist, no surrogate markers have been validated in EMZL. We hypothesized that time to complete response within 24 months (TTCR24) and complete response (CR) at 24 months (CR24) could be valid surrogate markers of progression-free survival (PFS). The International Extranodal Lymphoma Study Group 19 phase 3 trial showed the advantage of double therapy (rituximab + chlorambucil) over single therapy (rituximab or chlorambucil) on PFS. We used 2 recently published single-trial approaches to assess whether TTCR24 and CR24 were good surrogate markers of 8-year PFS (8y-PFS). Among the 401 patients, 264 (66%) reached a CR in the first 24 months, of which 222 (84%) remained in CR at month 24. The cumulative incidence of CR over time was significantly higher in patients under double therapy (hazard ratio, 1.75; P < .001). The double therapy arm was associated with a higher CR24 rate, a shorter TTCR24, and a longer 8y-PFS. The estimated proportion of treatment effect on 8y-PFS explained by TTCR24 was 95% (95% confidence interval [CI], 0.27-1.87). CR24 was also a strong surrogate marker because it mediated 90% (95% CI, 0.51-2.22) of the treatment effect on PFS and its natural indirect effect was significant throughout the follow-up. We found that TTCR24 predicted 95% and that CR24 mediated 90% of the treatment effect on long-term PFS. Therefore, TTCR24 and CR24 could be used in clinical trials as informative and valid early indicators of treatment effect on PFS. This trial was registered at www.clinicaltrials.gov as #NCT00210353.
Targeting and internalizing PEGylated nanodrugs to enhance the therapeutic efficacy of hematologic malignancies by anti-PEG bispecific antibody (mPEG × CD20)
Authors: Chen Huei-Jen , Cheng Yi-An , Chen Yu-Tung , Li Chia-Ching , Huang Bo-Cheng , Hong Shih-Ting , Chen I.-Ju , Ho Kai-Wen , Chen Chiao-Yun , Chen Fang-Ming , Wang Jaw-Yuan , Roffler Steve R. , Cheng Tian-Lu , Wu Tung-Ho
Published: October 2023

Background

PEGylated nanoparticles (PEG-NPs) are not effective for hematologic malignancies as they lack the enhanced permeability and retention effect (EPR effect). Tumor-targeted PEG-NPs can systemically track lymphoma and actively internalize into cancer cells to enhance therapeutic efficacy. We generated an anti-PEG bispecific antibody (BsAb; mPEG × CD20) which was able to simultaneously bind to methoxy PEG on liposomes and CD20 to form multivalent αCD20-armed liposomes. This αCD20-armed liposome was able to crosslink CD20 on lymphoma cells to enhance cellular internalization and the anti-cancer efficacy of the liposomes to lymphoma. We generated mPEG × CD20 and used this bispecific antibody to modify PEGylated liposomal doxorubicin (PLD) through a one-step formulation.

Results

αCD20-armed PLD (αCD20/PLD) specifically targeted CD20+ Raji cells and enhanced PLD internalization 56-fold after 24 h. αCD20/PLD also increased cytotoxicity to Raji cells by 15.2-fold in comparison with PLD and control mPEG × DNS-modified PLD (αDNS/PLD). mPEG × CD20 significantly enhanced the tumor accumulation 2.8-fold in comparison with mPEG × DNS-conjugated PEGylated liposomal DiD in Raji tumors. Moreover, αCD20/PLD had significantly greater therapeutic efficacy as compared to αDNS/PLD (P < 0.0001) and PLD(P < 0.0001), and αCD20/PLD-treated mice had a 90% survival rate at 100-day post-treatment.

Conclusions

Modification of mPEG × CD20 can confer PLD with CD20 specificity to enhance the internalization and the anti-cancer efficacy of PEG-NPs. This therapeutic strategy can conveniently be used to modify various PEG-NPs with anti-PEG BsAb to overcome the lack of EPR effect of hematologic malignancies and improve therapeutic efficacy.
Emerging roles for diguanylate cyclase during the evolution of soma in dictyostelia
Authors: Kawabe Yoshinori , Du Qingyou , Narita Takaaki B. , Bell Craig , Schilde Christina , Kin Koryu , Schaap Pauline
Published: October 2023

Background

Cyclic di-guanylate (c-di-GMP), synthesized by diguanylate cyclase, is a major second messenger in prokaryotes, where it triggers biofilm formation. The dictyostelid social amoebas acquired diguanylate cyclase (dgcA) by horizontal gene transfer. Dictyostelium discoideum (Ddis) in taxon group 4 uses c-di-GMP as a secreted signal to induce differentiation of stalk cells, the ancestral somatic cell type that supports the propagating spores. We here investigated how this role for c-di-GMP evolved in Dictyostelia by exploring dgcA function in the group 2 species Polysphondylium pallidum (Ppal) and in Polysphondylium violaceum (Pvio), which resides in a small sister clade to group 4.

Results

Similar to Ddis, dgcA is upregulated after aggregation in Ppal and Pvio and predominantly expressed in the anterior region and stalks of emerging fruiting bodies. DgcA null mutants in Ppal and Pvio made fruiting bodies with very long and thin stalks and only few spores and showed delayed aggregation and larger aggregates, respectively. Ddis dgcAˉ cells cannot form stalks at all, but showed no aggregation defects. The long, thin stalks of Ppal and Pvio dgcAˉ mutants were also observed in acaAˉ mutants in these species. AcaA encodes adenylate cyclase A, which mediates the effects of c-di-GMP on stalk induction in Ddis. Other factors that promote stalk formation in Ddis are DIF-1, produced by the polyketide synthase StlB, low ammonia, facilitated by the ammonia transporter AmtC, and high oxygen, detected by the oxygen sensor PhyA (prolyl 4-hydroxylase). We deleted the single stlB, amtC and phyA genes in Pvio wild-type and dgcAˉ cells. Neither of these interventions affected stalk formation in Pvio wild-type and not or very mildly exacerbated the long thin stalk phenotype of Pvio dgcAˉ cells.

Conclusions

The study reveals a novel role for c-di-GMP in aggregation, while the reduced spore number in Pvio and Ppal dgcAˉ is likely an indirect effect, due to depletion of the cell pool by the extended stalk formation. The results indicate that in addition to c-di-GMP, Dictyostelia ancestrally used an as yet unknown factor for induction of stalk formation. The activation of AcaA by c-di-GMP is likely conserved throughout Dictyostelia.
Synergistic antibacterial action of the iron complex and ampicillin against Staphylococcus aureus
Authors: Kosaristanova Ludmila , Rihacek Martin , Sucha Frantiska , Milosavljevic Vedran , Svec Pavel , Dorazilova Jana , Vojtova Lucy , Antal Peter , Kopel Pavel , Patocka Zdenek , Adam Vojtech , Zurek Ludek , Dolezelikova Kristyna
Published: October 2023

Objectives

Resistance to antibiotics among bacteria of clinical importance, including Staphylococcus aureus, is a serious problem worldwide and the search for alternatives is needed. Some metal complexes have antibacterial properties and when combined with antibiotics, they may increase bacterial sensitivity to antimicrobials. In this study, we synthesized the iron complex and tested it in combination with ampicillin (Fe16 + AMP) against S. aureus.

Methods

An iron complex (Fe16) was synthesized and characterized using spectroscopy methods. Confirmation of the synergistic effect between the iron complex (Fe16) and ampicillin (AMP) was performed using ζ–potential, infrared spectra and FICI index calculated from the minimum inhibitory concentration (MIC) from the checkerboard assay. Cytotoxic properties of combination Fe16 + AMP was evaluated on eukaryotic cell line. Impact of combination Fe16 + AMP on chosen genes of S. aureus were performed by Quantitative Real-Time PCR.

Results

The MIC of Fe16 + AMP was significantly lower than that of AMP and Fe16 alone. Furthermore, the infrared spectroscopy revealed the change in the ζ–potential of Fe16 + AMP. We demonstrated the ability of Fe16 + AMP to disrupt the bacterial membrane of S. aureus and that likely allowed for better absorption of AMP. In addition, the change in gene expression of bacterial efflux pumps at the sub-inhibitory concentration of AMP suggests an insufficient import of iron into the bacterial cell. At the same time, Fe16 + AMP did not have any cytotoxic effects on keratinocytes.

Conclusions

Combined Fe16 + AMP therapy demonstrated significant synergistic and antimicrobial effects against S. aureus. This study supports the potential of combination therapy and further research.
Digital measurement and clinical significance of proximal femur in the older people of Inner Mongolia population, China
Authors: Jiawei Li , Kai Zhang , Haiyan Wang , Chao Wu , Yunfeng Zhang , Liangjia Ding , Qinghua Liu , Canran Li , Feng Jin , Xiaohe Li
Published: October 2023

Objective

This study aimed to measure the parameters of the proximal femur in the older people of Inner Mongolia, China and understand the influence of age and gender so as to provide guidance for the design and improvement of prosthesis for total hip arthroplasty.

Methods

A total of 236 patients who underwent CT angiography of lower limbs in the Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University of China were collected. They were divided into 4 groups according to age: < 60 (group A), 60–69 (group B), 70–79 (group C), and > 80 years (group D). Four anatomical parameters, including femoral head diameter (FHD), femoral neck-shaft angle (FNSA), femoral offset (FO), femoral neck anteversion (FNA), were measured by Mimics 21.0. Comparisons were made between age groups of the same gender and between genders in the same age group to analyze the correlation of the 4 parameters of proximal femur with age and gender. In addition, the results of this study were compared with previous studies.

Results

There were no significant differences in FHD and FO between age groups, indicating no correlation with age. FNSA and FNA were no significantly different between group C and group D in the same gender, whereas there were significant differences between other age groups and were negatively correlated with age. There were significant differences in FHD and FO between genders in the same age group, with the males being larger than the females. FNSA and FNA were no significant differences between genders in the same age group.

Conclusions

FNSA and FNA decrease with age. FHD and FO were larger in males than in females in all age groups. Age and gender should be considered in the design of prosthesis.
Effects of rasagiline combined with levodopa and benserazide hydrochloride on motor function and homocysteine and IGF-1 levels in elderly patients with Parkinson’s disease
Authors: Yang Yifan , Gao Feng , Gao Li , Miao Jiaodan
Published: October 2023

Background

During the course of their illness, people with Parkinson’s disease may see changes in their insulin-like growth factor (IGF-1) and serum homocysteine (Hcy) indices. In this study, patients with intermediate to severe Parkinson’s disease were examined for how Resagiline and levodopa and benserazide hydrochloride affected their motor performance, serum levels of homocysteine (Hcy), and insulin-like growth factor (IGF-1).

Methods

From June 2020 to December 2021, a total of 100+ cases of Parkinson’s patients over 60 years old in the middle and late stages of Parkinson’s were seen in the outpatient and inpatient departments of the Third People’s Hospital of Chengdu City and had a detailed observation record, and according to the inclusion criteria, the patients who met the criteria were randomly grouped into a clinical observation group and a control group. The subjects in the control group received only levodopa and benserazide hydrochloride treatment, while the observation group was treated with Resagiline in combination with the clinical control group. The total treatment observation period was 1 year for both groups, and the motor function and serum Hcy and IGF-1 indexes of both groups were compared after the end of treatment.

Results

We randomly and evenly grouped 64 patients who met the requirements of the inclusion criteria into a clinical observation group and a control group, each with 32 patients, from among 168 patients over 60 years of age with detailed observation records in the middle and late stages of Parkinson’s. After the 1-year observation period, we found that the total effective rate after treatment in the clinical observation group (93.75%) and significantly higher than that in the control group (68.75%) (P < 0.05); after 1 year of treatment, the UPDRS score decreased in both groups, and the observation group was significantly lower than the control group (P < 0.05); after treatment, serum Hcy decreased and IGF-1 increased in both groups, and the observation group was higher than the control group mean values (P < 0.05).

Conclusions

In patients with Parkinson’s disease who are in the middle and late stages of the disease, the administration of Resagiline combined with levodopa and benserazide hydrochloride can significantly lower the body’s serum Hcy level, significantly raise IGF-1 levels, and significantly improve motor function in patients with Parkinson’s disease. It can also have significant therapeutic effects.
Dynamic changes in macrophage morphology during the progression of choroidal neovascularization in a laser-induced choroidal neovascularization mouse model
Authors: Xu Nana , Sun Tao , Wang Yulan , Tong Xiaowei , Lu Shiheng , Yang Fan , Wang Jing , Bo Qiyu , Sun Junran , Sun Xiaodong
Published: October 2023

Background

Neovascular age-related macular degeneration (AMD) is responsible for the majority of severe vision loss cases and is mainly caused by choroidal neovascularization (CNV). This condition persists or recurs in a subset of patients and regresses after 5 or more years of anti-vascular endothelial growth factor (VEGF) treatment. The precise mechanisms of CNV continue to be elucidated. According to our previous studies, macrophages play a critical role in CNV. Herein, we aimed to determine the morphological changes in macrophages in CNV to help us understand the dynamic changes.

Methods

Mice were subjected to laser injury to induce CNV, and lesion expansion and macrophage transformation were examined by immunofluorescence and confocal analysis. Several strategies were used to verify the dynamic changes in macrophages. Immunofluorescence and confocal assays were performed on choroidal flat mounts to evaluate the morphology and phenotype of macrophages in different CNV phases, and the results were further verified by western blotting and RT–PCR.

Results

The location of infiltrated macrophages changed after laser injury in the CNV mouse model, and macrophage morphology also dynamically changed. Branching macrophages gradually shifted to become round with the progression of CNV, which was certified to be an M2 phenotypic shift.

Conclusions

Dynamic changes in macrophage morphology were observed during CNV formation, and the round-shaped M2 phenotype could promote neovascularization. In general, the changes in morphology we observed in this study can help us to understand the critical role of macrophages in CNV progression and exploit a potential treatment option for CNV indicated by a shift in macrophage polarity.
Social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples in Aboriginal controlled social housing
Authors: Brown Alison , Haregu Tilahun , Gee Graham , Mensah Fiona , Waters Lea , Brown Stephanie J , Nicholson Jan M , Hegarty Kelsey , Smith Darren , D’Amico Sue , Ritte Rebecca , Paradies Yin , Armstrong Gregory
Published: October 2023

Background

Little is known about the wellbeing and aspirations of Aboriginal and Torres Strait Islander peoples living in social housing. Aboriginal and Torres Strait Islander peoples living in social housing face common social housing challenges of low income, higher incidence of mental health issues and poorer health along with specific challenges due to the impacts of colonisation and its ongoing manifestations in racism and inequity. A greater understanding of social and emotional wellbeing needs and aspirations is essential in informing the provision of appropriate support.

Methods

Surveys of social and emotional wellbeing (SEWB) were completed by 95 Aboriginal people aged 16 years and older living in Aboriginal Housing Victoria social housing in 2021. The survey addressed a range of domains reflecting social and emotional wellbeing, as defined by Aboriginal and Torres Strait Islander peoples.

Results

Most respondents demonstrated a strong sense of identity and connection to family however 26% reported having 6 or more health conditions. Ill health and disability were reported to be employment barriers for almost a third of people (32%). Improving health and wellbeing (78%) was the most cited aspiration. Experiences of racism and ill health influenced engagement with organisations and correspondingly education and employment.

Conclusion

Strong connections to identity, family and culture in Aboriginal peoples living in social housing coexist along with disrupted connections to mind, body and community. Culturally safe and appropriate pathways to community services and facilities can enhance these connections. Research aimed at evaluating the impact of strengths-based interventions that focus on existing strong connections will be important in understanding whether this approach is effective in improving SEWB in this population.

Trial Registration

: This trial was retrospectively registered with the ISRCTN Register on the 12/7/21 with the study ID:ISRCTN33665735.
Factors impacting HIV testing among young sexually active women migrant workers in Vietnamese industrial zones
Authors: Ha Toan , Shi Hui , Givens David , Nguyen Trang , Nguyen Nam
Published: October 2023

Background

Young migrant workers living in low- and middle-income countries often experience barriers and inadequate access to HIV prevention and treatment services. This study examines the prevalence of HIV testing, associated factors, and reasons for obtaining and not obtaining HIV testing among young sexually active women migrant workers in an industrial zone in Hanoi, Vietnam.

Methods

A cross-sectional study was conducted among 512 sexually active young women migrant workers (aged 18 to 29) working in the Thang Long industrial zone in Hanoi, Vietnam. Data was collected via a face-to-face interview from January 2020 to June 2021. Multivariable logistic regression analysis was used to explore factors associated with ever-testing for HIV among sexually active participants.

Results

The study found a low level of HIV testing and high rates of unprotected sex. Among those who reported being sexually active, only 23.7% of participants (n = 126) reported having ever been tested for HIV. Among those who reported never having tested for HIV, 38.2% reported not using condoms during their most recent sexual encounter. Factors associated with engaging in HIV testing included being older (25–29 years), having greater knowledge about HIV, past use of sexual and reproductive health and HIV services, and familiarity with HIV testing locations.

Conclusions

Overall, a low level of HIV testing, high rates of unprotected sex, and low perceived risks regarding HIV among the study participants point to a need to implement targeted HIV interventions that can improve both safe sex practices and perceptions of and knowledge about risky sexual behaviors. Such interventions should use insights from this study to address factors facilitating HIV testing among industrial zones’ women migrant workers.
Barriers and facilitators to palliative care for patients with non-curable cancer in Colombia: perspectives of allied health and social care professionals
Authors: Mendieta Cindy V. , de Vries Esther , Gomez-Neva Maria Elizabeth , Muñoz-Escudero Angela Maria , Calvache Jose Andrés , McConnell Tracey
Published: October 2023

Background

Palliative care aims to improve the quality of life of people with life-limiting illness and their families by addressing physical, psychological, social and spiritual suffering. Allied Health and Social Care Professionals (AHSCP) are key to delivering comprehensive, high quality palliative care. In recent years, Colombia has developed changes in the legal, and regulatory framework for access to palliative care but barriers and facilitators to palliative care for patients with non-curable cancer have not been explored from the perspective of AHSCP.

Method

This study aims to address this knowledge gap in two cities in Colombia: one in a medium-sized city in a rural area (Popayan) and one in a highly urbanized area (Bogota). Two focus groups with AHSCP were conducted using the World Cafe method, and a subsequent thematic analysis was performed to establish the main barriers and facilitators.

Results

A wide range of 18 AHSCPs attended the two World Cafe groups in Popayan and Bogota. As a result of this iterative process, we established five thematic areas: (i) Humanizing care, (ii) Normalizing palliative care: referral at the time of diagnosis, (iii) Misunderstandings related to palliative care, (iv) Barriers within the health system, and (v) Geographic barriers.

Conclusion

This study provided the perspectives of AHSCPs in Colombia in relation to barriers and facilitators in the framework of comprehensive palliative care attention. Participants identified misconceptions about palliative care, which are explained by the lack of inclusion of this area in the educational programs of health professionals and AHSCPs, along with the limited supply and access to palliative care, especially in rural areas.
Assessment of professional identity formation: a transcultural validation of the professional identity essay for brazilian portuguese
Authors: Silveira Gabrielle Leite , Monson Verna , Poço Paula Cristina Eiras , Haydar Ahmed , Brenelli Sigisfredo Luis , Succi Fabiana Moreira Passos , de Menezes Succi Guilherme , de Arruda Martins Milton , Tempski Patrícia Zen
Published: October 2023

Introduction

Professional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese.

Methods

We followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed, we employ manifest content analysis, and the categories of analysis emerged from the participants’ speeches.

Results

Students found the instrument’s questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students’ own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process.

Conclusion

We found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.
‘We work together as a group’: implications of jigsaw cooperative learning
Authors: Jeppu Ashok Kumar , Kumar Kavitha Ashok , Sethi Ahsan
Published: October 2023

Background

Modern clinical practice increasingly relies on collaborative, cooperative and team-based approaches for effective patient care. Recently, Jigsaw cooperative learning has gained attention in medical education. There is a need for studies in Southeast Asian context to establish its effectives in developing various core competencies expected of health professionals such as interpersonal, communication, collaborative, and teamwork skills. This current study explores the impact of using Jigsaw Cooperative Learning on undergraduate medical students.

Method

An explanatory mixed method research design was carried out on first year medical students at a private university in Malaysia. In Phase I, a survey was conducted to explore the effectiveness of jigsaw learning. Descriptive and inferential statistics were calculated using SPSS. In Phase II, a focus group interview was conducted to explore their in-depth experiences. Qualitative data were thematically analysed.

Results

Fifty-seven students participated in the survey and seven students took part in the focus group interview. Quantitative data analysis showed a statistically significant improvement in the student’s individual accountability, promotive interaction, positive interdependence, interpersonal skill, communication skill, teamwork skill, critical thinking and consensus building after jigsaw learning sessions. Qualitative data explained their experiences in-depth.

Conclusion

Jigsaw cooperative learning improves collaboration, communication, cooperation and critical thinking among the undergraduate medical students. Educators should use jigsaw learning methods to encourage effective collaboration and team working. Future studies should explore the effectiveness of the jigsaw cooperative learning technique in promoting interprofessional collaboration in the workplace.
Mediating effects of social support, mental health between stress overload, fatigue and turnover intention among operating theatre nurses
Authors: Xu Jia-Bin , Zheng Qing-Xiang , Jiang Xiu-Min , Zhuo Qing , Nian Jin-Xia , Wang Jie-Ting
Published: October 2023

Background

The high rate of nurses turnover and nursing staff shortage have been an ongoing concern issue and a challenge for global health systems. To explore the turnover intention among operating theatre nurses, and to test the hypothetical model for estimating the effects of stress overload and fatigue between social support, mental health and turnover intention.

Design

a multi-center and cross-sectional online survey.

Methods

This study was conducted from October 2020 to March 2021 comprised 1060 operating theatre nurses from 76 Chinese hospitals. The descriptive analysis, independent sample t test and one-way analysis of variance and Spearman correlation analysis were used to explore the relationships among variables by the SPSS software, and stepwise multiple linear regression analysis was utilized to identify influencing factors of turnover intention and its dimensions among operating theatre nurses. A structural equation model was analyzed by the AMOS software.

Results

Social support, mental health, stress overload and fatigue were important predictors of turnover intention among operating theatre nurses. Besides, stress overload positively affected fatigue, mental health and turnover intention; fatigue negatively affected social support, however, fatigue positively affected mental health; social support negatively affected mental health and turnover intention; mental health positively affected turnover intention. Moreover, social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.

Conclusion

Social support, mental health mediated between stress overload, fatigue and turnover intention among operating theatre nurses.
Nurses’ pain management practices for admitted patients at the Comprehensive specialized hospitals and its associated factors, a multi-center study
Authors: Fekede Legese , Temesgen Worku Animaw , Gedamu Haileyesus , Kindie Selamsew , Bekele Tola Getachew , Abebaw Ambaw , Baymot Aemiro , Difer Mesfin
Published: October 2023

Background

Pain is the most common challenge that most hospitalized patients complain of and is influenced by several patients, nurses, and institutional-related factors. Most studies in Ethiopia on pain were focused on surgical illnesses only.

Objective

To assess nurses’ pain management practice and associated factors for admitted patients at Comprehensive Specialized Hospitals.

Methods and materials

: A multi-center institution-based cross-sectional study was conducted at the five randomly selected Comprehensive Specialized Hospitals of the Amhara region from May 01 to June 01, 2022. A multi-stage sampling method was employed to select a total of 430 nurses and patients for whom the nurses were responsible. Data were collected using standard self-administered, structured, and checklist questionnaires from nurses, patients, and patients’ charts respectively. The modified Bloom’s criteria categorized the overall practice as good, moderate, and poor. Data were checked, coded, and entered into Epi-Data version 4.6 and exported to SPSS version 25. An ordinal logistic regression model was applied, and variables with a p-value < 0.05 with a 95% CI in the multivariable analysis were considered significant.

Results

The study evaluated the pain management practices of 430 nurses and only a quarter had good pain management practices. Those nurses with first degrees and above education level (AOR = 2.282) and who attended in-service training (AOR = 2.465) were found to have significantly higher pain management practice. Expected though patients with painful procedures (AOR = 5.648) and who had severe pain (AOR = 2.573) were receiving better pain management practices from their nurse care provider. Nurses working in the institutions with a pain-free initiative focal person (AOR = 6.339) had higher pain management practices.

Conclusion and recommendation

: Overall, the majority of nurses had poor pain management practices. Higher educational levels, in-service training, and assigning a pain-free focal person had an impact on pain management services. Patients with higher pain levels and painful procedures were getting better attention. Hospital administrations need to provide due attention to the pain management of hospitalized patients by providing in-service training and educational opportunities to improve the capacity of nurses. Patients would be benefited considerably if hospitals focus on assigning focal persons for advocating regular pain management for admitted patients regardless of their pain level.
The operational experience of private owners of small-sized care homes in China: a qualitative study
Authors: Xiuxiang Zhang , Qinghua Xia , Quint Jennifer K. , Morgan Ann D. , McCormack Brendan , Zhang Xiubin
Published: October 2023

Background

Private small-sized care homes (<50 beds)  have proliferated across China, however, until recently little was known about the characteristics of such institutions, and the challenges and the problems faced by their owners. This study aimed to explore the characteristics of small-sized, privately-owned care homes in the People’s Republic of China; and to understand the motivation and challenges faced by their owners.

Methods

This study used an interpretative phenomenological analysis approach of qualitative research. Owners of eight small-sized private care homes located in two cities of Henan Province, China, were interviewed using semi-structured interviews.

Results

Four themes and eight subthemes were identified: 1. Motivation for establishing a care home business; 2. Certification and establishing a legal footing for the business; 3. Operational challenges; 4. Future business development. The study found that the development of privately owned small-sized care homes faced great challenges and critical survival problems due to policies, staffing, and management issues. There is a lack of regulations about the safety and quality of care provided for older people and a lack of legal protections for the owners of small-sized private care homes.

Conclusion

The study suggests that formal regulations and provisions are needed to support these smaller-sized private care homes. Monitoring is also needed to ensure the quality of care. It also suggests that there needs more support by policymakers as well as provision monitoring services to improve quality of care in these care homes. Care regulations and standards are not unique to China so findings from this study can be applied to places where there are similar situations or if there are aged care services still developing.
Sexual workplace violence in the health sector in Saudi Arabia: a cross sectional study
Authors: AlHassan Aseel Khaled , AlSaqat Reem Tarik , Al Sweleh Fahad Saleh
Published: October 2023

Background

Sexual workplace violence occurs worldwide with increasing prevalence, causing psychological and physical injuries. However, only few reports from the Kingdom of Saudi Arabia have investigated the most involved health specialty and its association with other factors, such as working and sociodemographic conditions. The aim of this study was to determine the prevalence of workplace sexual violence over 12 months, from May 2018 to May 2019, circumstances related to the event, and consequences for the perpetrator and survivor and to identify associated factors among all healthcare workers (HCWs) in Saudi Arabia.

Methods

This cross-sectional study included all HCWs registered with the Saudi Commission for Health Specialties who worked for > 1 year in the health sector (government or private) in Saudi Arabia until May 2019. A non-probability convenient sampling technique was used. A modified self-administered questionnaire sent via email was utilized to assess workplace violence. Descriptive statistics were used to report percentages and frequencies, while advanced statistics, such as bivariate analysis, were used to determine associations. Multivariate logistic binary regression analysis was used to assess the combined and individual associations between relevant predictors of exposure of HCWs to recent sexual violence at the workplace.

Results

In total, 7,398 (male, 51.3%; female, 48.7%) HCWs were electively enrolled in the study (mean age 40 ± 8.62 years). Most were non-Saudi (60%). Overall, 3.9% were sexual violence survivors. Approximately 60.7%, 51.4%, 48.3%, and 65.9% of female workers, nurses, Saudi natives, and night shift workers (18:00 to 07:00), respectively, were significantly exposed to sexual violence. Furthermore, approximately 54.8% of those with direct physical contact with patients had a higher rate of exposure to sexual harassment (p = 0.001).

Conclusions

The prevalence of sexual violence is low but remains a risk to HCWs, especially those working night shifts and having direct physical contact with patients. Thus, more support, specific strategies, and policies are needed to reduce the rate of occurrence, protect HCWs, and prevent such events. The underreporting of cases may be skewing the magnitude of the problem; thus, more education and additional research in Saudi Arabia are needed regarding sexual violence experienced by HCWs.
Chronotype is associated with eating behaviors, physical activity and overweight in school-aged children
Authors: Yang Yong , Li Si-Xuan , Zhang Yan , Wang Fei , Jiang Dan-Jie , Wang Si-Jia , Cao Peng , Gong Qing-Hai
Published: October 2023

Background

A later chronotype has been found to be associated with unhealthy habits and diseases, such as an unhealthy diet and metabolic syndrome in adults. Little is known about the association between chronotype, eating habits, physical activity and obesity. Thus, this study aimed to explore the relationships between chronotype, eating behaviors, physical activity, and overweight in Chinese school-aged children.

Methods

Data from this study was based on 952 schoolchildren (10–12 y) from six primary schools that participated in China. Anthropometric measurements of height and body weight were performed. Information about sleeping habits, dietary behaviors, and other lifestyle behaviors was gathered using a self-administered questionnaire. Multiple linear regression analysis or multivariable logistic regression model was performed to assess the associations between chronotype, eating behaviors, physical activity, and overweight.

Results

Nearly 70% (69.9%) of the participants had a self-reported morning chronotype. Multiple linear regression analysis revealed chronotype score was positively associated with physical activities (all P values < 0.001) and sleep duration (all P values < 0.001) and negatively associated with BMI, meal time, eating jet lag and social jet lag (all P values < 0.001). Multivariable logistic regression analysis showed that compared to morning types, non-morning types individuals were more likely to be overweight (OR = 1.593, P value < 0.05), and had more frequent consumption of fast food (OR = 1.616, P value < 0.05), but less frequent consumption of milk (OR = 0.716, P value < 0.05), less time taking part in moderate (OR = 1.356, P value < 0.05) or muscle strengthening (OR = 1.393, 1.877, P value < 0.05) physical activity.

Conclusions

This study indicates that early chronotype children are more active, have healthier dietary habits, get more sleep, have shorter social jet lag, and are less likely to be overweight than non-early chronotype children. Our findings suggest that later chronotype may be a potential indicator in the early detection of overweight, unhealthy eating, and physical inactivity behaviors.

Plain english summary

Chronotype has been found to have an important impact on individual’s health. In the present study, we conducted a cross-sectional study to investigate the association between chronotype, eating behaviors, physical activity, and overweight in school-aged children. The findings showed that children with early chronotype is associated with more active, healthier dietary behaviors, longer sleep duration, short social jet lag, and a lower risk of overweight.
Effects of supplementation with milk protein on glycemic parameters: a GRADE-assessed systematic review and dose–response meta-analysis
Authors: Mohammadi Shooka , Asbaghi Omid , Dolatshahi Sina , Omran Hossein Salehi , Amirani Niusha , Koozehkanani Fatemeh Jahangir , Garmjani Hossein Bagherzadeh , Goudarzi Kian , Ashtary-Larky Damoon
Published: October 2023

Background

It is suggested that supplementation with milk protein (MP) has the potential to ameliorate the glycemic profile; however, the exact impact and certainty of the findings have yet to be evaluated. This systematic review and dose–response meta-analysis of randomized controlled trials (RCTs) assessed the impact of MP supplementation on the glycemic parameters in adults.

Methods

A systematic search was carried out among online databases to determine eligible RCTs published up to November 2022. A random-effects model was performed for the meta-analysis.

Results

A total of 36 RCTs with 1851 participants were included in the pooled analysis. It was displayed that supplementation with MP effectively reduced levels of fasting blood glucose (FBG) (weighted mean difference (WMD): -1.83 mg/dL, 95% CI: -3.28, -0.38; P = 0.013), fasting insulin (WMD: -1.06 uU/mL, 95% CI: -1.76, -0.36; P = 0.003), and homeostasis model assessment of insulin resistance (HOMA-IR) (WMD: -0.27, 95% CI: -0.40, -0.14; P < 0.001) while making no remarkable changes in serum hemoglobin A1c (HbA1c) values (WMD: 0.01%, 95% CI: -0.14, 0.16; P = 0.891). However, there was a significant decline in serum levels of HbA1c among participants with normal baseline body mass index (BMI) based on sub-group analyses. In addition, HOMA-IR values were significantly lower in the MP supplement-treated group than their untreated counterparts in short- and long-term supplementation (≤ 8 and > 8 weeks) with high or moderate doses (≥ 60 or 30–60 g/d) of MP or whey protein (WP). Serum FBG levels were considerably reduced upon short-term administration of a low daily dose of WP (< 30 g). Furthermore, the levels of serum fasting insulin were remarkably decreased during long-term supplementation with high or moderate daily doses of WP.

Conclusion

The findings of this study suggest that supplementation with MP may improve glycemic control in adults by reducing the values of fasting insulin, FBG, and HOMA-IR. Additional trials with longer durations are required to confirm these findings.
A circulating cell-free DNA methylation signature for the detection of hepatocellular carcinoma
Authors: Kim Si-Cho , Kim Da-Won , Cho Eun Ju , Lee Jin-Young , Kim Jiwon , Kwon Chaesun , Kim-Ha Jeongsil , Hong Suk Kyun , Choi YoungRok , Yi Nam-Joon , Lee Kwang-Woong , Suh Kyung-Suk , Kim Won , Kim Woojin , Kim Hyunsoo , Kim Yoon Jun , Yoon Jung-Hwan , Yu Su Jong , Kim Young-Joon
Published: October 2023

To address the shortcomings of current hepatocellular carcinoma (HCC) surveillance tests, we set out to find HCC-specific methylation markers and develop a highly sensitive polymerase chain reaction (PCR)-based method to detect them in circulating cell-free DNA (cfDNA). The analysis of large methylome data revealed that Ring Finger Protein 135 (RNF135) and Lactate Dehydrogenase B (LDHB) are universally applicable HCC methylation markers with no discernible methylation level detected in any other tissue types. These markers were used to develop Methylation Sensitive High-Resolution Analysis (MS-HRM), and their diagnostic accuracy was tested using cfDNA from healthy, at-risk, and HCC patients. The combined MS-HRM RNF135 and LDHB analysis detected 57% of HCC, outperforming the alpha-fetoprotein (AFP) test’s sensitivity of 45% at comparable specificity. Furthermore, when used with the AFP test, the methylation assay can detect 70% of HCC. Our findings suggest that the cfDNA methylation assay could be used for HCC liquid biopsy.
Advanced extracellular vesicle bioinformatic nanomaterials: from enrichment, decoding to clinical diagnostics
Authors: Zhang Yawei , Zhao Liang , Li Yaocheng , Wan Shuangshuang , Yuan Zhiyao , Zu Guangyue , Peng Fei , Ding Xianguang
Published: October 2023

Extracellular vesicles (EVs) are membrane nanoarchitectures generated by cells that carry a variety of biomolecules, including DNA, RNA, proteins and metabolites. These characteristics make them attractive as circulating bioinformatic nanocabinets for liquid biopsy. Recent advances on EV biology and biogenesis demonstrate that EVs serve as highly important cellular surrogates involved in a wide range of diseases, opening up new frontiers for modern diagnostics. However, inefficient methods for EV enrichment, as well as low sensitivity of EV bioinformatic decoding technologies, hinder the use of EV nanocabinet for clinical diagnosis. To overcome these challenges, new EV nanotechnology is being actively developed to promote the clinical translation of EV diagnostics. This article aims to present the emerging enrichment strategies and bioinformatic decoding platforms for EV analysis, and their applications as bioinformatic nanomaterials in clinical settings.