bluuebunny/crossref_metadata_2025 huggingface dataset:
Calendar Anomalies in Islamic Frontier Markets
Authors: Aslam Faheem , Hunjra Ahmed Imran , Tayachi Tahar , Verhoeven Peter , Mohmand Yasir Tariq
Published: May 2022

This study investigates calendar anomalies in eight Islamic frontier markets. Our sample consists of the daily closing prices of their stock indices for the period of January 2006 to September 2019. The data are categorized with respect to day-of-the-week and month-of-the-year according to both the Gregorian and Islamic calendars. We control for time-varying systematic risk using Morgan Stanley Capital International (MSCI) index as the proxy for the market portfolio and apply Bonferroni correction to reduce the occurrence of false-positive results. We find little support for the proposition that any of the Islamic calendar months generate abnormal returns, bar a slight negative abnormal return during the holy month of Rajab for Kuwait. We find evidence of a small negative Monday effect for the stock markets of Bangladesh and Pakistan and a small positive January effect for the stock market of Morocco. The results support weak-form market efficiency, suggesting that investors in frontier stock markets should not expect to outperform the market on a consistent basis when trading on particular days of the week or months of the year according to the Islamic or Gregorian calendar.
Classification of Urban Spaces: An Attempt to Classify Al-Baha City Urban Spaces Using Carmona’s Classification
Authors: Alzahrani Abdulaziz
Published: May 2022

Due to an increasingly complex mixture of different types of public spaces and their functions in cities, the role of public spaces can be enhanced to serve users under certain circumstances. This paper examines Carmona’s classification of urban spaces in Al-Baha, Saudi Arabia. Carmona introduces a classification that uses aspects of function, perception, and ownership to distinguish between space types. Twenty urban space types are recognized in four groups, representing a variety from clearly public to private space. The classifications of public spaces will be discussed to arrive at classifications for public spaces based on how public spaces are managed. The article builds an understanding of how such classifications relate to how real public spaces are provided today. In this case study, a Geographic Information System (GIS) map is created for Al-Baha Central District and includes the resulting classifications. From the 119 urban spaces selected to represent this study equally distributed across the study area, there are 12 types that public spaces match Carmona’s classification. The classification of urban spaces for this case study revealed the complexity of public spaces’ nature and the difficulty of distinguishing what is public. Public spaces tend to change and develop over time through other uses and activities. However, the classification of public spaces is a valuable tool that policymakers and planners can use to set comprehensive development plan programs and plan open space strategies.
Effects of Resistance Barriers to Service Robots on Alternative Attractiveness and Intention to Use
Authors: Lee Gyutae , Kim Yunsik
Published: May 2022

This study examined the effect of resistance barriers on alternative attractiveness of service robots and intention to use to explain the effect of innovation resistance against such robots on customer behavior. An online survey was conducted with South Korean customers who had used hotel rooms in the past year. This study tested its hypotheses with partial least squares–structural equation modeling. The results indicate that usage barriers related to customers’ familiarity with use and tradition as well as image barriers caused by psychological instability and decreased alternative attractiveness. However, the value and risk barriers based on technological level had no significant effect on alternative attractiveness. The results show that alternative attractiveness increases intention to use; however, alternative attractiveness affected by resistance barriers decreases intention to use. This study broadens the research scope by applying the innovation resistance theory to prior service robot literature with pro-innovation bias. Hospitality managers can refer to these results to design service environments that can lower the resistance barrier against using service robots.
Role Expectations for Nurses and Neuroscientific and Neurotechnological Advancements: A Qualitative Study on the Perceptions of Nurses on Their Roles and Lifelong Learning
Authors: Deloria Rochelle , Wolbring Gregor
Published: May 2022

Nurses can understand and evaluate the impact of neuroscientific and neurotechnological advancements (NNA) from multiple standpoints given their roles as patient liaisons, advocates for their profession and their clients, leaders, and educators as well as their interactions with NNA such including deep brain stimulation and neuroimaging. We conducted semi-structured interviews with Canadian nurses to understand their perspectives on their roles in and outside the workplace, their familiarity with NNA and their ethical, legal, and social implications, their participation in NNA governance discussions and how lifelong learning can be applied to empower their participations in NNA governance discussions. Participants felt that nurses had the potential to meaningfully involve themselves in NNA governance discussions if given a greater opportunity. Participants were not offered lifelong learning surrounding the ethical, legal, and social implications of NNA. It would be fruitful to facilitate and empower nurses as contributors to NNA governance and ethics discussions.
Local Residents’ Attitudes Toward Reopening Inbound Tourism Amid COVID-19: A Study in Vietnam
Authors: Nghiêm-Phú Bình , Phạm Hồng Long
Published: May 2022

This study examined Vietnamese local residents’ attitudes toward the reopening of their country to international tourists amid COVID-19 from March to April 2021. It began with a qualitative analysis of local residents’ opinions ( n = 240) to identify the factors that could affect their attitudes, then continued with a review of the literature to create a theoretical model. Finally, the study implemented a structured survey to collect quantitative data ( n = 412) to confirm the model. The outcomes revealed that “perceived vaccine efficacy” and “xenophobia” were two significant predictors of “attitude toward inbound tourism.” Implications of this study were then discussed.
Through Their Eyes: Gifted Students’ Views on Integrating History of Mathematics Embedded Videos Into Mathematics Classrooms
Authors: Karatas-Aydin Firdevs Iclal , Isiksal-Bostan Mine
Published: May 2022

This study examined gifted students’ views on integrating the history of mathematics embedded videos into mathematics classrooms. The research was conducted with 30 fifth-grade students who were identified as gifted with the WISC-R Intelligent Test Score and aptitude test. Data were collected through students’ video reflection papers after watching the videos on biographies of mathematicians. Content analysis was conducted to analyze data collected with reflection papers. The findings were grouped as history as a tool and history as a goal. Under the title of history as a tool, the students’ reflections were categorized as history as a cognitive tool and history as a motivational tool. As a cognitive tool, students stated that the history of mathematics embedded videos expanded their knowledge of mathematicians’ early work and their occupations. As a motivational tool, the history of mathematics embedded videos helped raise students’ curiosity about mathematicians and their works, and mathematical concepts, increased their motivation for invention, and developed a positive attitude toward mathematics and learning. On the other hand, under the title of history as a goal, the students stated that the history of mathematics embedded videos broaden their knowledge of mathematicians and their contributions, mathematical concepts, and mathematical evolution. Thus, the videos can be used as enrichment activities for gifted elementary students in mathematics classrooms.
Biodegradation behaviors of magnesium(Mg)-based alloy nails in autologous bone grafts: In vivo study in rabbit skulls
Authors: Yanagisawa Yuta , Shimizu Yoshinaka , Mukai Toshiji , Sano Yuya , Odashima Kenji , Ikeo Naoko , Saito Haruka , Yamauchi Kensuke , Takahashi Tetsu , Kumamoto Hiroyuki
Published: May 2022

Objective:

In this study, autologous bone grafts using bone-fixing nails made of magnesium-zinc-calcium ternary alloys were performed using rabbit skulls.

Material and methods:

Two types of nails for bone fixation were prepared: 2.5 mm width, 3 mm length and 2.5 mm width, 2 mm length. A disk-shaped bone with a diameter of 5 mm was resected from the parietal bone and fixed with a 3 mm long nail. As a control group, a 2 mm long nail was driven into the existing bone. The rabbits were sacrificed at 1, 4, 12, and 24 weeks after surgery. The resected samples were observed with micro X-ray CT, and embedded in methyl methacrylate to prepare non-decalcified specimens. The in vivo localization of elements was examined using energy-dispersive X-ray spectroscopy (EDS).

Results:

Micro X-ray CT images of samples showed volume reduction due to degradation in both the bone graft and control groups. No significant difference in the amount of degradation between the two groups was observed, however characteristic degradation processes were observed in each group. The samples stained with alizarin red S showed amorphous areas around the nails, which were considered as corrosion products and contacted directly with the newly formed bones. EDS analysis showed that corrosion products were mainly composed of magnesium and oxygen at an early stage, while calcium and phosphorus were detected on the surface layer during the long-term observation.

Conclusions:

The degradation speed of the magnesium alloy nails varied depending on the shapes of the nails and surrounding tissue conditions. A calcium phosphate layer was formed on the surface of magnesium alloy nails, suggesting that the degradation rate of the nail was slow.
Paying for Work-Family Balance: Assessing the Role of Family-Friendly Job Amenities in Occupational Segregation
Authors: Barcus Miriam
Published: May 2022

Workers in female-dominated occupations earn less, on average, than workers in comparable male-dominated occupations. To explain the gendered occupational wage disparity, com pensating differentials theory focuses on women’s preferences and asserts that women cluster in occupations that pay less in exchange for family-friendly job amenities. On the other hand, the devaluation perspective argues these wage discrepancies are the result of the cultural devaluation of women’s work that leads to both lower wages and a lower likelihood of having job amenities. Using data from the 2017–2018 American Time Use Survey Leave Module, I examine whether workers in female-dominated occupations are indeed more likely to have access to family-friendly job amenities. I focus on workers’ access to three contemporary family-friendly job amenities: paid leave, remote work, and flexible scheduling. I find that workers in female-dominated jobs are no more likely to have access to family-friendly job amenities than workers in male-dominated jobs. Additionally, family-friendly job amenities are associated with higher wages, not the lower wages as compensating differentials posits. These findings suggest that compensating differentials theory cannot explain the clustering of women in lower-paying occupations.
The Community Determinants of Death: Comparing the Macro-Level Predictors of Overdose, Homicide, and Suicide Deaths, 2000 to 2015
Authors: Feldmeyer Ben , Cullen Francis T. , Sun Diana , Kulig Teresa C. , Chouhy Cecilia , Zidar Michael
Published: May 2022

A growing body of research has begun to identify the social and ecological predictors of community overdose rates. However, questions remain about these relationships, and it is unclear whether the predictors of community overdose concentrations mirror those of other fatal social problems, such as homicide and suicide. Drawing on three leading ecological theories of overdose concentrations, the present study provides a longitudinal macro-level analysis of the community “determinants of death” for overdose (overall and by substance type), homicide, and suicide. Specifically, the authors use Centers for Disease Control and Prevention restricted-access mortality data, combined with measures of community social, economic, legal, and health indicators for the period from 2000 to 2015. Findings from time-series models reveal that county concentrations of overdose are linked to multiple theoretically driven factors—including opioid prescription rates, population decline, county health problems, and manufacturing employment—with several key similarities in the determinants of death across overdose, homicide, and suicide.
Endovascular treatment for acute basilar artery occlusion due to different stroke etiologies of large artery atherosclerosis and cardioembolism
Authors: Liu Huihui , Zeng Guoyong , Zeng Hongliang , Yu Yang , Yue Feixue , Ke Yingbing , Yan Zhizhong , Pu Jie , Zhang Jun , Wei Wan , He Dengke , Wu Yupeng , Huang Xianjun , Zhou Peiyang
Published: May 2022

Introduction:

Stroke etiology may affect the prognosis of acute basilar artery occlusion (BAO). This study aimed to estimate the efficacy and safety of endovascular treatment (EVT) in BAO strokes due to the underlying stroke etiologies of large artery atherosclerosis (LAA) and cardioembolism (CE).

Patients and methods:

Patients with LAA and CE subtypes from the registry EVT for Acute Basilar Artery Occlusion Study (BASILAR) were selected for this analysis. We estimated the EVT treatment effect relative to standard medical treatment (SMT) in these patients by using a propensity score approach with inverse probability of treatment weighted estimation. Outcomes included 90-day favorable functional outcomes (modified Rankin scale (mRS) 0–3), functional independence (mRS 0–2), all-cause mortality, and symptomatic intracranial hemorrhage (sICH).

Results:

A total of 744 patients were included in the final analysis. After weighting with inverse probability of treatment estimation, the patients who, based on their characteristics, were treated with EVT rather than SMT, demonstrated higher rates of favorable functional outcomes in both the LAA (29.2% vs 11.7%, adjusted OR with 95% CI: 4.34 [2.15–8.78], p < 0.001) and the CE subtype (36.0% vs 8.1%, adjusted OR with 95% CI: 9.14 [1.96–42.55], p = 0.005). A similar finding was also observed for functional independence. EVT patients also demonstrated lower rates of mortality than SMT. Among EVT patients, no significant difference was observed in mortality or sICH between LAA and CE groups, but LAA patients had lower rates of favorable functional outcome and functional independence (29.2% vs 37% and 24.2% vs 32.9%, respectively), where the latter remained significant after adjustment for imbalances in baseline data ( p = 0.04).

Conclusions:

In acute BAO strokes, both LAA and CE patients who, based on their characteristics, were treated with EVT rather than SMT, demonstrated better outcomes. Among EVT patients, LAA and CE subtypes displayed important baseline and treatment differences, and LAA patients were less likely to achieve functional independence at 3 months, but mortality and sICH were similar between LAA or CE subtypes. These results need to be confirmed in future clinical trials.
Tennison-Randall Repair of Cleft Lip Without Calipers
Authors: Parsa Fereydoun D. , Singh Dylan , Parsa Alan A.
Published: May 2022

Background: Over many years of teaching cleft lip repair, we observed that plastic surgery students often find the principles of skin markings and incisions difficult to conceptualize. The approach described in this report designed and presented as our preferred approach in mitigating this difficulty. Methods: Over a period of 40 years a large number of cleft lips were repaired both in the United States as well as abroad. Both the Millard and Tennison-Randall approaches were utilized by the senior author (FDP). However, skin markings and the use of a template, as reported in this study, were found to communicate the concept and principle of cleft lip repair better than other previously utilized approaches. Results: We found that the students of plastic surgery easily understood and assimilated the principles of cleft lip repair when the initial markings and the execution of incisions were carried out “free-hand” without calipers and with the help of a template. Conclusions: The approach used in this report is proposed as a means of communicating the essential principles of cleft lip repair to students of plastic surgery who are initially exposed to this congenital anomaly.
Latent membrane proteins from EBV differentially target cellular pathways to accelerate MYC-induced lymphomagenesis
Authors: Ikeda Masato , Hayes Cooper K. , Schaller Samantha J. , Longnecker Richard
Published: May 2022

MYC translocations in association with Epstein-Barr virus (EBV) infection are often observed in B-cell lymphomas. A subset of Burkitt lymphoma (BL) expresses EBV latent membrane proteins 1 and 2A (LMP1 and LMP2A) in addition to the typical restricted EBV latent gene expression. EBV-associated diffuse large B-cell lymphoma (DLBCL) typically exhibits latency type II or III and expresses LMP1. Here, we investigate the role of LMP1 in MYC-driven lymphomagenesis in our murine model. λ-MYC mice develop tumors having a “starry sky” appearance and have abnormal p53 expression that is also observed in human BL. LMP2A/λ-MYC double-transgenic mice develop tumors significantly faster than mice only expressing MYC. Similar to LMP2A/λ-MYC mice, LMP1/λ-MYC mice also have accelerated MYC-driven lymphomagenesis. As observed in LMP2A/λ-MYC mice, p27kip1 was degraded in LMP1/λ-MYC pretumor and tumor B cells. Coexpression of LMP1 and LMP2A resulted in the enhancement of B cell proliferation. In contrast to LMP2A, the inhibition of Syk or cyclin-dependant kinase (CDK)4/6 activity did not effectively inhibit LMP1-mediated MYC lymphomagenesis. Also, in contrast to LMP2A, LMP1 did not lessen abnormal p53 expression in λ-MYC tumors. To investigate the significance of LMP1 expression in human BL development, we reanalyzed RNA sequencing (RNA-Seq) data of primary human BL from previous studies. Interestingly, p53 mutations were less observed in LMP1-expressing BL, although they were not significantly changed by EBV infection, indicating LMP1 may lessen p53 mutations in human primary BL. This suggests that LMP1 effects in EBV-associated human BL vary from what we observe in our murine model. Finally, our studies suggest a novel pathogenic role of LMP1 in lymphomagenesis.
Histopathology, pharmacokinetics and estimation of interleukin-6 levels of Moringa oleifera leaves extract-functionalized selenium nanoparticles against rats induced hepatocellular carcinoma
Authors: Ebrahem Eman M. M. , Sayed Galal H. , Gad Gehan N. A. , Anwer Kurls E. , Selim Adli A.
Published: May 2022

Background

Hepatocellular carcinoma (HCC) is one of the most dangerous cancers in all the world. This study focused on prevention and therapy of hepatocellular carcinoma (HCC) usingMoringa oleiferaextract combined with vitamin C and selenium in a nanoplatform (MO/asc.-Se-NPs).

Results

Full characterization of MO/asc.-Se-NPs was performed by using different analytical techniques (TEM, DLS, zeta-sizer), and its antioxidant capacity was measured by DPPH assay. Biodistribution study was performed with the aid of radiolabeling technique using technetium-99m in normal albino mice. HCC was induced in Wister albino rats to evaluate the efficiency of MO/asc.-Se-NPs in the treatment of HCC. The biomarker analysis (ALT, AST and ALB) shows improvement in its values in prevention and treated groups by using MO/asc.-Se NP. The levels of inflammatory marker interleukin 6 (IL6 tissue homogenate) was improved by decreasing its values in these two groups also. Histology section of tissue liver showed alleviation in treated and prevention groups.

Conclusions

In conclusion, MO/asc.-Se-NPs can be used as a potential agent for prevention and treatment of HCC after further preclinical studies.
Re-study of Guangdedendron micrum from the Late Devonian Xinhang forest
Authors: Gao Xue , Liu Le , Qin Min , Zhou Yi , Mao Lei , Wang De-Ming
Published: May 2022

Background

Guangdedendron micrum is the Late Devonian tree lycopsid that made up Xinhang fossil forest in Anhui, China, showing the earliest stigmarian rooting system. Based on new specimens of this lycopsid, the roots bearing rootlets, terminal parts of stems, vegetative leaves and monosporangiate strobili containing megaspores are researched in detail.

Results

The roots with four robust rhizomorphs are largely expanded and approach the size of those of the Late Carboniferous giant tree lycopsids in swampy forests. The rootlets along rhizomorphic axis leave oval to circular scars after abscission. Narrow-fusiform leaf cushions display a leaf scar, vascular bundle and ligule pit. Cylindrical megasporangiate strobili are borne singly, in pairs, or occasionally once-dichotomized. Of each megasporophyll, the pedicel consists of a keel and possibly undeveloped alations, and the long-triangular lamina presents a heel. Megasporangium is sessile and contains multiple Lagenicula megaspores with distinct spines and a large gula.

Conclusions

G. micrum displays large terminal monosporangiate strobili probably adapted to turbulent condition, and its megasporophylls together with multiple Lagenicula-type megaspores hint a possible primitive evolutionary status. These characteristics provide new insights into the evolution of fertile traits of early lycopsids.
Comparison of erector spinae fatigability between female patients with Parkinson’s disease and healthy individuals: a cross sectional pilot study
Authors: Nishimura Yukihide , Tsuboi Hiroyuki , Murata Ken-Ya , Minoshima Yuta , Sato Hideyuki , Umezu Yuichi , Tajima Fumihiro
Published: May 2022

Background

Postural abnormality is one of the main symptoms of Parkinson’s disease (PD). The erector spinae muscles play an important role in maintaining an upright posture, but the fatigability of the erector spinae in patients with PD is unknown. The purpose of this study was to compare the trunk extension maximum voluntary contraction (MVC) and the fatigability of the erector spinae between female patients with PD and healthy volunteers.

Methods

Th participants of this cross-sectional pilot study comprised 19 patients with PD and nine healthy volunteers matched for sex, age, and physical characteristics as a control group. The MVC of all participants was measured, and after sufficient rest, the Sørensen back endurance test was conducted to the point of exhaustion. The muscle activity of the erector spinae during the Sørensen back endurance test was measured using surface electromyography. The median frequency (MF) slope, which is an index of fatigability, was calculated from the recorded surface muscle activity by means of power spectrum analysis using a Fast Fourier transformation.

Results

Nine of the 19 patients with PD were unable to perform the Sørensen back endurance test, and a lower proportion of the PD group were able to perform it compared with the control group. The MVC of those patients with PD who were able to perform the Sørensen back endurance test was lower than that of the control group, and the time for which the pose could be maintained was shorter. There was no significant difference between the MF slope on the left and right side in the PD group, and it was higher on both sides than in the control group.

Conclusion

This is the first study to demonstrate a reduction of maximum muscle strength and great fatigability of the erector spinae in patients with PD. This discovery strongly underlines the need for paraspinal muscle training from an early stage with the aim of preventing the progression of postural abnormality in patients with PD.
Development of a risk assessment scale for perinatal venous thromboembolism in Chinese women using a Delphi-AHP approach
Authors: Zhang Meng , Liu Meixin , Wang Dawei , Wang Yan , Zhang Wenhua , Yang Hanxu , Zhang Junshuang , Li Qiuyi , Guo Zhenqing
Published: May 2022

Background

The treatment and prevention of perinatal venous thromboembolism (VTE) are challenging because of the potential for both fetal and maternal complications.

Methods

This study developed a rapid assessment scale for VTE and evaluate its validity based on Delphi-AHP (Analytic Hierarchy Process) method in China. The research was conducted by literature retrieval and two rounds of Delphi expert consultation. The item pools of the scale were developed and a questionnaire was designed according to literature retrieval published between 2010 and 2020. A survey was conducted among experts from 25 level A hospitals in China, and data of experts’ opinions were collected and analyzed by the Delphi method.

Results

A perinatal VTE risk assessment scale was formed, including 5 first-level items, 20 s-level items and 40 third-level items. The response rates in the two rounds of expert consultation were 97.4% and 98.0%, and the authoritative coefficients were 0.89 and 0.92. The coefficients of variation ranged from 0.04 to 0.28.

Conclusions

The scale is significantly valid and reliable with a high authority and coordination degree, and it can be used to assess the risk of perinatal VTE and initiate appropriate thrombophylactic interventions in China.
Spatial differentiation and determinants of COVID-19 in Indonesia
Authors: Widiawaty Millary Agung , Lam Kuok Choy , Dede Moh , Asnawi Nur Hakimah
Published: May 2022

Background

The spread of the coronavirus disease 2019 (COVID-19) has increasingly agonized daily lives worldwide. As an archipelagic country, Indonesia has various physical and social environments, which implies that each region has a different response to the pandemic. This study aims to analyze the spatial differentiation of COVID-19 in Indonesia and its interactions with socioenvironmental factors.

Methods

The socioenvironmental factors include seven variables, namely, the internet development index, literacy index, average temperature, urban index, poverty rate, population density (PD) and commuter worker (CW) rate. The multiple linear regression (MLR) and geographically weighted regression (GWR) models are used to analyze the impact of the socioenvironmental factors on COVID-19 cases. COVID-19 data is obtained from the Indonesian Ministry of Health until November 30th 2020.

Results

Results show that the COVID-19 cases in Indonesia are concentrated in Java, which is a densely populated area with high urbanization and industrialization. The other provinces with numerous confirmed COVID-19 cases include South Sulawesi, Bali, and North Sumatra. This study shows that the socioenvironmental factors, simultaneously, influence the increasing of confirmed COVID-19 cases in the 34 provinces of Indonesia. Spatial interactions between the variables in the GWR model are relatively better than those between the variables in the MLR model. The highest spatial tendency is observed outside Java, such as in East Nusa Tenggara, West Nusa Tenggara, and Bali.

Conclusion

Priority for mitigation and outbreak management should be high in areas with high PD, urbanized spaces, and CW.
Safe spaces for beneficiaries of a combination HIV prevention intervention for adolescent girls and young women in South Africa: access, feasibility, and acceptability
Authors: Mathews Catherine , Duby Zoe , Bunce Brittany , van Blydenstein Nathanael , Bergh Kate , Ambrose Anthony , Mpungu Fiona , Jonas Kim
Published: May 2022

Background

Safe Spaces are a feature of combination HIV prevention interventions for adolescent girls and young women (AGYW) in South Africa. We investigated whether AGYW at risk for adverse sexual and reproductive health (SRH) outcomes accessed Safe Spaces that were part of an intervention, as well as their feasibility and acceptability.

Methods

In December 2020 to February 2021, as part of a process evaluation of a combination HIV prevention intervention, we randomly sampled 2160 AGYW intervention beneficiaries aged 15–24 years from 6 of the 12 intervention districts. We invited them to participate in a phone survey, with questions about their vulnerability to adverse SRH outcomes, and participation in intervention components including Safe Spaces. We examined factors associated with use of Safe Spaces using bivariate analyses and Pearson’s chi squared tests. We also conducted in-depth interviews with 50 AGYW beneficiaries, 27 intervention implementers, 4 health workers, 7 social workers, and 12 community stakeholders, to explore perceptions and experiences of the intervention. Thematic analysis of the qualitative data was performed.

Results

At least 30 Safe Spaces were established across 6 districts. Five hundred fifteen of two thousand one hundred sixty sampled AGYW participated in the survey of whom 22.6% visited a Safe Space, accessing HIV testing (52.2%), mobile health services (21.2%) and counselling for distress (24.8%) while there. Beneficiaries of lower socioeconomic status (SES) were less likely to have visited a Safe Space, compared with those of higher SES (13.6% versus 25.3%;p < 0.01). Implementers described political, structural and financial challenges in identifying and setting up Safe Spaces that were safe, accessible and adequately-resourced, and challenges with AGYW not utilising them as expected. AGYW shared positive views of Safe Spaces, describing benefits such as access to computers and the internet, support with homework and job and education applications, and a space in which to connect with peers.

Conclusion

AGYW are attracted to Safe Spaces by educational and employment promoting interventions and recreational activities, and many will take up the offer of SRH services while there. The poorest AGYW are more likely to be excluded, therefore, an understanding of the obstacles to, and enablers of their inclusion should inform Safe Space intervention design.
The negative factors influencing the career intention of general practice trainees in eastern China: a qualitative study
Authors: Tang Lei , Yang Huan , Mao Zhuxin , Li Quan , Li Shunping
Published: May 2022

Background

There is an acute shortage of general practitioners (GPs) in China, and GP trainees seem to be less willing to develop their career as a GP. This study aimed to investigate negative factors influencing the career intention of GPs in eastern China from the perspective of trainees taking standardized residency training, as to identify the barriers of GP trainees becoming registered GPs, and to provide a policy-making basis for GP recruitment and retention.

Methods

A qualitative description design by the purposive sample was carried out in two training bases of Jinan and Qingdao in eastern China. Face-to-face, in-depth, semi-structured interviews were conducted, audiotaped, and transcribed using thematic analysis.

Results

Twenty-one trainees participated in this study. Thematic analysis generated five major themes: (1) low social recognition, (2) low professional identity, (3) low remuneration level, (4) imperfect training system, and (5) influence of policy factors.

Conclusions

Our results identified various negative factors influencing the career intentions of trainees. In order to overcome the hurdles and increase the attractiveness of GP, it is recommended that the government and the public should create a supportive environment, which can be beneficial to the construction and development of GP.
Enabling uptake and sustainability of supervision roles by women GPs in Australia: a narrative analysis of interviews
Authors: O’Sullivan B. , Kippen R. , Wearne E. , Wallace G. , Taylor C. , Toukhsati S. R.
Published: May 2022

Background

Worldwide, the proportion of women entering careers in medicine is increasing. To ensure diversity and capacity in the general practice (“GP”) supervision workforce, a greater understanding from the perspective of women GPs engaged in or considering the clinical supervision of trainee doctors is important. This narrative inquiry aims to explore the uptake and sustainability of supervision roles for women GPs in the Australian context.

Methods

Qualitative interviews with Australian women GPs were conducted between July and September 2021. Women GPs were selected to represent a range of demographics, practice contexts, and supervision experience to promote broad perspectives. Narrative analysis drew on participant perspectives, allowing emergent stories to be explored using story arcs based on the characters, settings, problems, actions, and resolutions. These stories were evaluated by a broad research team and a high level of agreement of the final narratives and counter-narratives was achieved.

Results

Of the 25 women who enrolled, 17 completed interviews. Six narratives emerged, including: power and control, pay, time, other life commitments, quality of supervision, and supervisor identity. These represented significant intersecting issues with the potential to impact the uptake and sustainability of supervision by women GPs. Some women GPs reported a lack of agency to make decisions about their role in supervision and were not remunerated for teaching. Uptake and sustainability of supervision was constrained by other life commitments, which could be buffered by team-sharing arrangements and a supportive practice. Although adding a burden of time atop their complex and sensitive consultations, women GPs were committed to being available to registrars and supervising at a high standard. To foster high quality supervision, women GPs were interested in up-skilling resources, building experience and harnessing support networks. Women sensed imposter syndrome when negotiating a supervisor identity, which could be managed by explicitly valuing their contribution.

Conclusion

The findings can inform the development of more specific resources, supports and structures to enable women GPs in Australia to uptake and sustain the supervision of trainee doctors at a level they find both acceptable and rewarding.
Medication dosage calculation among nursing students: does digital technology make a difference? A literature review
Authors: Stake-Nilsson Kerstin , Almstedt Malin , Fransson Göran , Masoumi Davoud , Elm Annika , Toratti-Lindgren Monique , Björkman Annica
Published: May 2022

Background

Patient safety is a major part of nursing care and following patients’ medication orders is considered one of the greatest responsibilities of individual nurses and nursing Failure to make safe drug calculations poses serious risks to patient safety. It is therefore important to strengthen nursing students’ numeracy skills and conceptual abilities during their education. Research suggests that digital technologies play an increasingly important role in promoting nursing students’ knowledge and medication dosage calculation (MDC) skills. The present review aims to identify and critically evaluate research investigating how the use of digital technologies informs the development of nursing students’ MDC skills.

Methods

A systematic literature review was performed within Scopus (Elsevier), Academic Search Elite (Ebsco), Cinahl (Ebsco), ERIC (Ebsco), Web of Science and PubMed. Research papers on MDC using digital technologies were considered for inclusion. Starting from 2843 sources, eighteen research articles met the inclusion criteria.

Results

The results show that use of digital technologies can reduce nursing students’ medication errors. Interestingly, web-based courses were the most commonly used digital technologies aimed at developing nursing students’ MDC skills. However, such courses had limited impacts the development of these skills.

Conclusion

The present review concludes by mapping the current knowledge gaps and making suggestions for further research.
Development and testing of an instrument to measure contextual factors influencing self-care decisions among adults with chronic illness
Authors: Page Shayleigh Dickson , Lee Christopher , Aryal Subhash , Freedland Kenneth , Stromberg Anna , Vellone Ercole , Westland Heleen , Wiebe Douglas J. , Jaarsma Tiny , Riegel Barbara
Published: May 2022

Background

Decisions about how to manage bothersome symptoms of chronic illness are complex and influenced by factors related to the patient, their illness, and their environment. Naturalistic decision-making describes decision-making when conditions are dynamically evolving, and the decision maker may be uncertain because the situation is ambiguous and missing information. Contextual factors, including time stress, the perception of high stakes, and input from others may facilitate or complicate decisions about the self-care of symptoms. There is no valid instrument to measure these contextual factors. The purpose of this study was to develop and test a self-report instrument measuring the contextual factors that influence self-care decisions about symptoms.

Methods

Items were drafted from the literature and refined with patient input. Content validity of the instrument was evaluated using a Delphi survey of expert clinicians and researchers, and cognitive interviews with adults with chronic illness. Psychometric testing included exploratory factor analysis to test dimensionality, item response theory-based approaches for item recalibration, confirmatory factor analysis to generate factor determinacy scores, and evaluation of construct validity.

Results

Ten contextual factors influencing decision-making were identified and multiple items per factor were generated. Items were refined based on cognitive interviews with five adults with chronic illness. After a two round Delphi survey of expert clinicians (n = 12) all items had a content validity index of > 0.78. Five additional adults with chronic illness endorsed the relevance, comprehensiveness, and comprehensibility of the inventory during cognitive interviews. Initial psychometric testing (n = 431) revealed a 6-factor multidimensional structure that was further refined for precision, and high multidimensional reliability (0.864). In construct validity testing, there were modest associations with some scales of the Melbourne Decision Making Questionnaire and the Self-Care of Chronic Illness Inventory.

Conclusion

The Self-Care Decisions Inventory is a 27-item self-report instrument that measures the extent to which contextual factors influence decisions about symptoms of chronic illness. The six scales (external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment) reflect naturalistic decision making, have excellent content validity, and demonstrate high multidimensional reliability. Additional testing of the instrument is needed to evaluate clinical utility.
Natural killer cells: a promising immunotherapy for cancer
Authors: Chu Junfeng , Gao Fengcai , Yan Meimei , Zhao Shuang , Yan Zheng , Shi Bian , Liu Yanyan
Published: May 2022

As a promising alternative platform for cellular immunotherapy, natural killer cells (NK) have recently gained attention as an important type of innate immune regulatory cell. NK cells can rapidly kill multiple adjacent cancer cells through non-MHC-restrictive effects. Although tumors may develop multiple resistance mechanisms to endogenous NK cell attack, in vitro activation, expansion, and genetic modification of NK cells can greatly enhance their anti-tumor activity and give them the ability to overcome drug resistance. Some of these approaches have been translated into clinical applications, and clinical trials of NK cell infusion in patients with hematological malignancies and solid tumors have thus far yielded many encouraging clinical results. CAR-T cells have exhibited great success in treating hematological malignancies, but their drawbacks include high manufacturing costs and potentially fatal toxicity, such as cytokine release syndrome. To overcome these issues, CAR-NK cells were generated through genetic engineering and demonstrated significant clinical responses and lower adverse effects compared with CAR-T cell therapy. In this review, we summarize recent advances in NK cell immunotherapy, focusing on NK cell biology and function, the types of NK cell therapy, and clinical trials and future perspectives on NK cell therapy.
Exhaustion of CAR T cells: potential causes and solutions
Authors: Kouro Taku , Himuro Hidetomo , Sasada Tetsuro
Published: May 2022

Chimeric antigen receptor (CAR) T cell therapy has attracted attention for its promising therapeutic effects on hematological malignancies. However, there are problems such as relapse during long-term follow-up and limited effect on solid tumors with this therapy. Exhaustion, which impairs in vivo persistence and killing activity of CAR T cells, is one of the causes of these issues. Depending on their structure of extracellular portion, some CARs induce tonic signals in the absence of ligand stimulation and induce exhaustion phenotype in CAR T cells. Analysis of these self-activating CARs is expected to provide key information for understanding and resolving CAR T cell exhaustion. In this review, we introduced examples of self-activating CARs and summarized their phenotypes to figure out how CAR T cell exhaustion occurs. Further, we aimed to review promising solutions to the CAR T cell exhaustion that hampers generalized application of CAR T cell therapy.
Respiratory afflictions during hairdressing jobs: case history and clinical evaluation of a large symptomatic case series
Authors: Hiller Julia , Greiner Annette , Drexler Hans
Published: May 2022

Objectives

Respiratory symptoms at work are common among hairdressers. Various working materials, most notably bleaching ingredients such as ammonium persulfate, have been made responsible. The objective of this study is to achieve a better understanding of work-related respiratory symptoms of hairdressers by describing common features in a large affected collective.

Methods

One hundred forty-eight hairdressers with respiratory symptoms at work presenting between 2012 and 2019 were consecutively included in a case series. Anamnestic and diagnostic data including pulmonary function and allergy testing were retrospectively compiled from records and analysed. Additionally, cases were categorised in five groups with respect to occupational causation certainty.

Results

30% of the predominantly female collective had changed jobs or were on longer sick-leave. Besides respiratory symptoms, 10% also reported contact urticaria to blonde dyes. In 60% an obstructive airway disease was confirmed. A specific hypersensitivity reaction to ammonium persulfate was found in 15%. Group 1 with a proven immunological occupational causation showed significantly lower age (p < 0.001) and tenure time (p = 0.001), higher sensitization rates against environmental allergens as well as a higher total IgE (p = 0.015), compared to group 4 (obstructive airway disease, specific occupational causation unlikely).

Conclusions

This case series contributes to a better characterization of work-related respiratory symptoms in hairdressing as one of the largest examined collectives of symptomatic hairdressers. Ammonium persulfate as the most common specific cause showed signs of a type-I-like hypersensitivity reaction with typical risk factors for atopy. Prick testing is recommended in all symptomatic cases. However, a specific occupational causation often cannot be proved.
A mixed-methods study on the association of six-month predominant breastfeeding with socioecological factors and COVID-19 among experienced breastfeeding women in Hong Kong
Authors: Kwan John , Jia Jimsyn , Yip Ka-man , So Hung-kwan , Leung Sophie S. F. , Ip Patrick , Wong Wilfred H. S.
Published: May 2022

Background

In the past decade, various breastfeeding policies were implemented in Hong Kong, including changes in perinatal guidelines in public hospitals, adoption of the Baby-Friendly Hospital Initiative (BFHI), provision of guidelines for the marketing of formula milk, penalisation of discrimination towards breastfeeding, and extension of the statutory maternity leave. Meanwhile, the COVID-19 pandemic brought new challenges and opportunities to breastfeeding practices. Infection control measures in public hospitals included the cancellation of antenatal classes, hospital tours, and postnatal classes; suspension of perinatal visiting periods; and compulsory separation of COVID-19 positive mothers from newborns. In addition, work-from-home policies were widely implemented. This study aimed to identify the associated factors of six-month predominant breastfeeding (PBF), and to evaluate the impact of COVID-19 on breastfeeding practice.

Methods

This study was conducted from 1 March 2021 to 7 April 2021 using a mixed-methods approach. An electronic questionnaire was distributed to members of breastfeeding or parenting groups who have had breastfeeding experience in the past 10 yrs. Logistic and linear regression analyses were conducted to identify factors associated with six-month PBF both in general and during the pandemic period. A qualitative content analysis was conducted using an inductive approach.

Results

The study included 793 participants. Giving birth in a public hospital (OR 2.21; 95% CI 1.46, 3.34) and breastfeeding support from family and friends (OR 1.28; 95% CI 1.05, 1.57) were significantly associated with six-month PBF, even during COVID-19. Factors associated with the self-rated impact of COVID-19 on breastfeeding include working from home, the perceived immunological benefits of breastfeeding, and the wish to avoid breastfeeding or expressing breast milk in public premises. Furthermore, breastfeeding practice in public hospitals was more likely to be affected by the busyness of staff, while private hospitals had worse rooming-in practices and staff who had inadequate breastfeeding knowledge.

Conclusions

Giving birth in a public hospital and having breastfeeding support from family and friends were associated with six-month PBF. Furthermore, COVID-19 in Hong Kong had an overall positive impact on six-month PBF. Further studies should investigate the impact of hospital practices and the COVID-19 pandemic on breastfeeding behaviours.