bluuebunny/crossref_metadata_2025 huggingface dataset:
High realistic aspirations – Do normative pressures overthrow rational calculations? Applying the model of frame selection to the educational aspirations of immigrant and majority students in Germany
Authors: Schmaus Miriam , Olczyk Melanie , Neumeyer Sebastian , Will Gisela
Published: November 2023

Educational aspirations are of interest to scholars in several disciplines. They can affect multiple aspects of educational success and have been shown to differ between major social groups. Explanations for educational aspirations typically link to two main models of aspiration formation: the Wisconsin model (WM) and rational choice theory (RCT). Whereas the WM highlights significant others’ educational norms, RCT cites cost-benefit calculations to explain how aspirations are formed. As it is still unclear how the two approaches interrelate, we apply a third model, namely the model of frame selection (MFS), which allows the integration of both WM and RCT arguments. In short, it suggests that the importance of others’ educational norms moderates the relevance of own cost-benefit calculations. We assume that considering this interrelation is fruitful when explaining aspirations in general, and specifically when explaining immigrant students’ aspirations, who often perceive high educational obligations by their parents. Using data from the German National Educational Panel Study (NEPS), we test prognoses derived from the three theoretical models for their relevance when explaining the aspirations of Turkish and German students. Results indicate that the processes suggested by both WM and RCT shape aspirations. Consistent with the MFS, these processes also interrelate in that parents’ educational norms reduce the relevance of students’ own cost-benefit calculations. This interrelation does not only apply to Turkish students but holds for all students in the sample.
Stories of Hope: Young People’s Personal Narratives About ADHD Put Into Context of Positive Aspects
Authors: Grønneberg Siv Vea , Engebretsen Eivind , Løkkeberg Stine Torp
Published: November 2023

There is a growing acceptance that ADHD is a multi-dimensional disorder in which not all symptoms are associated with deficits or functional impairments. This article contributes to research on the positive aspects of the diagnosis, specifically understanding the positive aspects of living with ADHD. The empirical data was based on individual interviews and self-narratives of 10 young adults with ADHD. Narrative analysis was implemented when investigating their stories. The findings showed that challenges with the diagnosis were not necessarily stably occupied, and for some, the diagnosis was thought of as a benefit and something they would not have been without. Four stories highlighted particularly the context of positive aspects: (1) insight and strategies, (2) targeted efforts, (3) balanced energy, and (4) social skills. These aspects were correlated to both the individual’s strengths as well as the strengths and support that could be related to their societal and cultural environment.
EBEI: A new index of eye bank efficiency
Authors: Aiello Francesco , Gallo Afflitto Gabriele , Ceccarelli Francesca , Cesareo Massimo , Griffoni Carlo , Ponzin Diego , Nucci Carlo
Published: November 2023

Purpose

To describe a new proxy of the Eye Bank (EB) activity named “Eye Bank Efficiency Index” (EBEI), calculated as the ratio between the number of corneal tissues distributed by an EB within a certain time period, and the difference between the number of procured and discarded tissues.

Methods

To demonstrate the effectiveness of the new metric as compared to traditional statistics, an analysis was conducted using data from the largest Italian Eye Bank (Fondazione Banca degli Occhi del Veneto Venice, Italy). Collected data included: the number of corneas retrieved, the number of discarded grafts, and the number of distributed tissues. The analysis focused on three defined timeframes: January to December, March to May (the “Italian Lockdown period”), and June to December (the “Italian post-lockdown period”).

Results

In 2020, the annual variation of the EBEI showed a significant increase of up to 3.4% compared to the previous year (0.986 in 2019; 1.020 in 2020), but then gradually decreased to 0.993 in 2022. However, during the months of lockdown in 2020, there was a significant decline of −13.8% in the EBEI compared to the same period in the previous year. The variation in the EBEI during the post-lockdown months was minimal in 2020 and 2021, with the lowest EBEI value of 0.976 being reached in 2022 (−7.8% compared to 2019).

Conclusion

The EBEI is a simple and reliable new measure of the EB activity. Its widespread adoption could ensure a more accurate and reliable analysis of EB data for academic, political, and economic purposes.
Assessing progress in managing and improving quality in nascent integrated care systems in England
Authors: Lalani Mirza , Sugavanam Priya , Caiels James , Crocker Helen , Gunn Sarah , Hay Harriet , Hogan Helen , Page Bethan , Peters Michele , Fitzpatrick Ray
Published: November 2023

Objectives

In 2022, England embarked on an ambitious reorganisation to produce an integrated health and care system, intended also to maximise population health. The newly created integrated care systems (ICSs) aim to improve quality of care, by achieving the best outcomes for individuals and populations through the provision of evidence-based services. An emerging approach for managing quality in organisations is the Quality Management System (QMS) framework. Using the framework, this study assessed how ICSs are managing and improving quality.

Methods

Four ICSs were purposively sampled, with the data collected between November 2021 and May 2022. Semi-structured interviews with system leaders ( n=60) from health and social care, public health and local representatives were held. We also observed key ICS meetings and reviewed relevant documents. A thematic framework approach based on the QMS framework was used to analyse the data.

Results

The ICSs placed an emphasis on population health, reducing inequity and improving access. This represents a shift in focus from the traditional clinical approach to quality. There were tensions between quality assurance and improvement, with concerns that a narrow focus on assurance would impede ICSs from addressing broader quality issues, such as tackling inequalities and unwarranted variation in care and outcomes. Partnerships, a key enabler for integration, was seen as integral to achieving improvements in quality. Overall, the ICSs expressed concerns that any progress made in quality development and in improving population health would be tempered by unprecedented system pressures.

Conclusion

It is unclear whether ICSs can achieve their ambition. As they move away from an assurance-dominated model of quality to one that emphasises openness, learning and improvement, they must simultaneously build the digital infrastructure, staff expertise and culture to support such a shift.
Down the (digital) rabbit hole: Mapping and decolonizing Safavid women's imagery in digital museums
Authors: Rahbari Ladan
Published: November 2023

In this article, I trace Safavid paintings depicting women's imagery online and explore the possibility of digitally mapping Safavid (1501–1736) paintings featuring women on publicly accessible platforms. Along with the practice of online mapping that led me to digital museums, I investigated the descriptions presented on three digitized paintings on different platforms to address the questions, “Where and how can Safavid paintings be digitally encountered” and “In light of the theoretical developments in the scholarship on pre-modern discourses of Safavid gender and sexuality, how do the descriptions of Safavid paintings reflect gender discourses online?” By following Safavid paintings of women online and probing the textual descriptions attached to them, and using netnographic research methods to document my experience and encounter with the digitized Safavid paintings, I explore whether the online descriptions accompanying the images could contribute to the making of decolonial knowledge about non-Western gender discourses.
The Social Structures of Sleep: Effects of Work-Related and Family Constraints on Sleep Duration and Regularity Among French Workers
Authors: Rauch Capucine
Published: November 2023

Previous research shows that sleep time is shaped by family constraints and paid work organisation. However, the impact of both work and family on sleep routines is relatively unknown. Using the 2009–2010 French Time Use Survey, this article examines how workers’ sleep routines are affected by paid work and family situation, and emphasises the social significance of sleep patterns. Paid work and family situation both structure the duration and regularity of sleep. Paid work reduces sleep time and has a disruptive effect on sleep routines, but to different degrees depending on socio-occupational category and work schedule. Having a small child has a negative effect on sleep on any given day, but works in favour of a regular sleep routine, as well as the tendency for spouses to synchronise. However, the regulating effect of family life accentuates the disruptive effect of paid work for the most atypical work schedules.
Dynamic rollover-safety index-based tilt optimisation encompassing road configurations for narrow three-wheelers: Balancing energy efficiency and ride comfort
Authors: Dandiwala Ankitkumar , Chakraborty Basab , Chakravarty Debashish
Published: November 2023

The active tilt-controlled narrow three-wheelers (3Ws) equipped with a closed cabin aim to offer a comfortable driving experience comparable to four-wheelers while maintaining the manoeuvrability of two-wheelers without compromising on speed. Based on this concept, this study explores a tilt control strategy for narrow 3Ws. While previous research has established a steady-state tilt angle considering a zero-track width, this study incorporates track width due to the multi-wheel axle configuration. This novel approach not only withstands unbalanced lateral acceleration but also saves significant tilting torque. Unnecessary tilting is minimised by introducing a tilt actuation system (TAS) based on a unique dynamic rollover index. Central to the original contribution is the stability margin (SM), a dynamic rollover-safety index considering longitudinal and lateral dynamics, surpassing the traditional rollover index load transfer ratio, particularly for delta 3Ws. This work proposes a desired SM threshold-dependent steady-state tilt angle, activating TAS only when necessary. This pioneering method optimises the desired SM threshold using goal programming. Additionally, this research addresses a critical oversight in previous studies by accounting for the influence of road slopes, ensuring consistent stability across diverse road conditions. It is crucial to note that the proposed rollover index-based tilting approach markedly outperforms the conventional methods, reinforcing its originality and potential for future vehicular design.
Morphological composition assessment of kinetic façade designs via AHP and TOPSIS methods based on façade components and design inputs
Authors: Engin Abdul Samet , Dincer Ahmet Emre
Published: November 2023

The study examines kinetic façade design components and inputs through literature. Factors affecting the kinetic façade composition are generalized with a compositional perspective. Compositional framework elements are distinguished as morphological and system aspects. These aspects are assessed with widely known examples in the relational dimension to reveal interactions between components and inputs. The relational assessments provide a base to build a morphological evaluation via AHP-TOPSIS. The method is applied to a parametric model. The values from the calculation can represent the complexity/uniformity of design alternatives. The most remarkable points of the method are that it can be reconstructed contextually with various sets of components for distinct subjects and its integration ability to any evaluation method as an external approach.
A Challenge to Orthodoxy in Psychology: Thomas Sowell and Social Justice
Authors: O’Donohue William , Silander Nina C. , Frisby Craig L. , Fisher Jane E.
Published: November 2023

Psychologists address social-justice problems in their research and applied work, and their scholarly efforts have been influenced by assumptions, constructs, and hypotheses from the political left. Recently, some psychologists have called for increased intellectual and political diversity in psychology, particularly as such diversity may lead to improved problem-solving. As an attempt to increase intellectual diversity in psychology, we review here the scholarship of Thomas Sowell. His work represents a rich source of hypotheses for psychologists’ future research. We focus on his views on the importance of freedom; the extent to which reforms can reduce freedom; the importance of free markets to human flourishing; the role of free markets in producing costs for discrimination; the way spontaneously ordered systems can contain knowledge that can be overlooked in reforms; and the importance of culture and cultural capital. We will also discuss Sowell’s more thoroughgoing economic analyses of problems and solutions and his analyses of contingencies operating on politicians and reformers, as well as his views on conflicts in fundamental visions about human nature and the pivotal role of improvements in minority education.
Diabetic kidney disease
Authors: Mishra Dr Apurva , Watson Dr Wendy
Published: November 2023

Diabetes is the leading cause of chronic kidney disease and end stage renal disease (ESRD) globally. Diabetic kidney disease, previously known as diabetic nephropathy, is a general term used for deterioration of kidney function in patients with diabetes. It is important to diagnose and manage diabetic kidney disease early, so as to reduce the incidence of ESRD and the cardiovascular complications of diabetes. This article looks at the epidemiology, presentation and management of diabetic kidney disease.
Safety and Efficacy of Tranexamic Acid in Total Ankle Arthroplasty
Authors: Ghobrial Philip G. , Eikani Carlo K. , Schmitt Daniel R. , Brown Nicholas M. , Pinzur Michael S. , Schiff Adam P.
Published: November 2023

Tranexamic acid has been shown to significantly reduce blood loss in patients undergoing total knee arthroplasty and total hip arthroplasty. However, there is a paucity of data regarding its safety and efficacy in total ankle arthroplasty. The purpose of this study was to determine whether tranexamic acid use in patients with total ankle arthroplasty affects blood loss or overall complication rate. A retrospective chart review was conducted for 64 patients who underwent total ankle arthroplasty with (n = 32) and without (n = 32) intraoperative tranexamic acid from 2014 to 2023 at a single academic medical center. Recorded blood loss, pre-to-postoperative hemoglobin changes, hidden blood loss, and complication rates were recorded and compared. There was no statistically significant difference in recorded blood loss, total calculated blood loss, pre-to-postoperative hemoglobin difference, hidden blood loss, or overall complications between the groups (all, P > .05). A lower rate of wound complications was observed in the tranexamic acid group, but the difference between each group was not statistically significant (P > .05). Tranexamic acid did not decrease blood loss during total ankle arthroplasty, as measured in our study. Tranexamic acid was not associated with any increase in overall complications. Based on our findings, tranexamic acid may be a safe intervention in total ankle arthroplasty, but further studies are needed to better elucidate its clinical impact.

Level of Evidence: Level 3
Multiparty relationships in platform work: Cross-European case law developments and points of departure for (supranational) regulation
Authors: Hiessl Christina
Published: November 2023

Multiparty constellations are on the rise in the labour market, and they can make the classification of contractual relationships exceedingly difficult. Recent case law on platform work provides an insight into the various problems resulting from this development. The article provides an overview of cases in which courts and/or administrative bodies across Europe were called upon to rule on platform workers’ rights in cases that involved relevant multi-party constellations. It establishes a typology of the different actors that have figured as defendants in cases on platform workers’ rights and explores the consequences for both procedural and material aspects. On the basis of these insights from case law, as well as a brief review of the European Parliament's suggestion of regulating subcontractor liability in the proposed directive on platform work, a number of regulatory implications are identified.
From “Extensive” to “Connotative” Development: Modernization of Chinese-Style Education
Authors: Yang (杨九诠) Jiuquan
Published: November 2023

Highlights

The transformation of China's education reform from extensive to connotative development involved a shift from characteristically exogenous and late development to endogenous and spontaneous development. The mechanism behind the shift from rationalism to universalism has resulted in tension between extension and intension in the process of modernization. Reflexive modernity has always existed in historical experience and situations, strengthening the appeal of intension to the right of defining. In terms of the scale effect, the expansion of higher education enrollment made historically significant contributions to the modernization of education in China; however, it also had several disadvantages. China's educational modernization invariably requires solving the problem of large-class teaching and promoting small-class teaching in the process of shifting from extensive to connotative development.
Leading a post-pandemic workforce: Understanding employees’ changing work ethic
Authors: Arciniega Luis M , Woehr David J , González Luis
Published: November 2023

A recent cross-cultural study suggests employees may be classified, based on their scores on a measure of work ethic, into three profiles labeled as “live to work,” “work to live,” and “work as a necessary evil.” The present study assesses whether these profiles were stable before and after an extended lockdown that forced employees to work from home for 2 years because of the COVID-19 pandemic. To assess our core research question, we conducted a longitudinal study with employees of a company in the financial sector, collecting data in two waves: February 2020 ( n = 692) and June 2022 ( n = 598). Tests of profile similarity indicated a robust structural and configural equivalence of the profiles before and after the lockdown. As expected, the prolonged pandemic-based lockdown had a significant effect on the proportion of individuals in each profile. Implications for leading and managing in a post-pandemic workforce are presented and discussed.

JEL CLASSIFICATION: M12
Grass versus trees: A proxy debate for deeper anxieties about competing stream worlds
Authors: Gottschalk Druschke Caroline , Booth Eric G. , Lave Rebecca , Widell Sydney , Lundberg Emma , Sellers Ben , Stork Paige
Published: November 2023

Stream restoration has become an increasingly important focus in southwestern Wisconsin's Driftless Area, an unglaciated, hilly pocket of the Upper Mississippi River Basin rich in groundwater-driven coldwater streams, recreationally important trout species, and agricultural communities. Climate change is driving a major increase in precipitation and flooding across this rural and often under-resourced region, effects complicated by the ongoing legacies of white settlement and the changes it wrought to area streams, including the burial of floodplains in sediment displaced off area hillslopes. As managers work to consider how to “restore” Driftless streams, riparian vegetation—grass versus trees—has become a central and surprisingly controversial node. Current stream restoration practice typically includes the removal of riparian trees, though that practice has come under increasing criticism. Grounded in more than 5 years of qualitative and biophysical fieldwork in the region, we build from interviews gathered with 18 Driftless Area stream restoration managers from 2018 to 2020 to point to the ways that managers leverage arguments about erosion, flooding, habitat, and angler access, among other things, in service of grass and trees. Indexing the surface flows and underflows of this restoration debate, we introduce the rhetorical concept of the proxy debate to argue that debates about grass versus trees are tethered to competing perspectives on scale, temporality, and dynamism, surficial distractions from much deeper anxieties about what a stream is and should be. We turn to the ways that these distractions serve to further distance the stream restoration enterprise from acknowledging the ongoing human and hydrologic legacies of settler colonialism, and we close by suggesting that careful attention to rhetorical power—both to what arguments say and do, and to what they elide—offers a tentative first step toward restoring lands and relations by questioning what is taken for granted and what lies beneath.
Bayesian analysis of ground motion models using chimney fragility curves: 2021, 5.9-Mw Woods Point intraplate earthquake, Victoria, Australia
Authors: La Greca James , Quigley Mark , Vaculik Jaroslav , Rayner Peter , Allen Trevor
Published: November 2023

The 22 September 2021 (AEST) MW 5.9 Woods Point earthquake occurred in an intraplate setting (southeast Australia) approximately 130 km East Northeast of the central business district of Melbourne (pop. ∼5.15 million). A lack of seismic instrumentation and a low population density in the epicentral region resulted in a dearth of near-source instrumental and “felt” report intensity data, limiting evaluation of the near-source performance of ground motion models (GMMs). To address this challenge, we first surveyed unreinforced masonry chimneys following the earthquake to establish damage states and develop fragility curves. Using Bayesian inference, and including pre-earthquake GMM weightings as Bayesian priors, we evaluate the relative performance of GMMs in predicting chimney observations for different fragility functions and seismic velocity profiles. At the most likely VS30 (760 m/s), the best performing models are AB06, A12, and CY08SWISS. GMMs that were preferentially selected for utility in the Australian National Seismic Hazard Model (NSHA18) prior to the Woods Point earthquake outperform other GMMs. The recently developed NGA-East GMM performs relatively well in the more distal region (e.g. >50 km) but is among the poorest performing GMMs in the near-source region across the range of VS30. Our new method of combining analysis of engineered features (chimneys) with Bayesian inference to evaluate the near-source performance of GMMs may have applicability in diverse settings worldwide, particularly in areas of sparse seismic instrumentation.
Well-Dispersed Graphene Enhanced Lithium Complex Grease Toward High-Efficient Lubrication
Authors: Lin Kaiyue , Zhao Zhuang , Li Yuting , Zeng Zihan , Wei Xiaofeng , Fan Xiaoqiang , Zhu Minhao
Published: November 2023

Graphene as a lubricating additive holds great potential for industrial lubrication. However, its poor dispersity and compatibility with base oils and grease hinder maximizing performance. Here, the influence of graphene dispersion on the thickening effect and lubrication function is considered. A well-dispersed lubricant additive was obtained via trihexyl tetradecyl phosphonium bis(2-ethylhexyl) phosphate modified graphene ([P66614][DEHP]-G). Then lithium complex grease was prepared by saponification with 12-OH stearic acid, sebacic acid, and lithium hydroxide, using polyalphaolefin (PAO20) as base oil and the modified-graphene as lubricating additive, with the original graphene as a comparison. The physicochemical properties and lubrication performance of the as-prepared greases were evaluated in detail. The results show that the as-prepared greases have high dropping point and colloidal stability. Furthermore, modified-graphene lithium complex grease offered the best friction reduction and anti-wear abilities, manifesting the reduction of friction coefficient and wear volume up to 18.84% and 67.34%, respectively. With base oil overflow and afflux, well-dispersed [P66614][DEHP]-G was readily adsorbed to the worn surfaces, resulting in the formation of a continuous and dense graphene deposition film. The synergy of deposited graphene-film, spilled oil, and adhesive grease greatly improves the lubrication function of grease. This research paves the way for modulating high-performance lithium complex grease to reduce the friction and wear of movable machinery.
Bernese periacetabular osteotomy (PAO): from its local inception to its worldwide adoption
Authors: Ganz Reinhold , Leunig Michael
Published: November 2023

The development of the Bernese periacetabular osteotomy (PAO) is based on a structured approach starting with an analysis of the preexisting procedures to improve the coverage of the femoral head and was followed by a list of additional goals and improvements. Cadaveric dissections with a detailed description of the vascular supply of acetabulum and periacetabular bone set the stage for an intrapelvic approach, which offered the largest acetabular correction possible combined with safe intracapsular access. The final composition of osteotomies required the development of several instruments and cutting devices before the feasibility could be tested on a series of cadaveric hips.

While the sequence of the osteotomies remained largely unchanged over time (except for the pubic and ischial osteotomies), several propositions for an easier/less invasive approach have been discussed; some made it into standard practice. Efforts were undertaken to optimize the learning curve and minimize failures using video-clips, hands-on courses, fellowships, publications, and ongoing mentoring programs. In retrospect, with almost 40 years of experience, such efforts have promoted a worldwide adoption of the Bernese periacetabular osteotomy.
3-D chromatin conformation, accessibility, and gene expression profiling of triple-negative breast cancer
Authors: Llinàs-Arias Pere , Ensenyat-Méndez Miquel , Orozco Javier I. J. , Íñiguez-Muñoz Sandra , Valdez Betsy , Wang Chuan , Mezger Anja , Choi Eunkyoung , Tran Yan Zhou , Yao Liqun , Bonath Franziska , Olsen Remi-André , Ormestad Mattias , Esteller Manel , Lupien Mathieu , Marzese Diego M.
Published: November 2023

Objectives

Triple-negative breast cancer (TNBC) is a highly aggressive breast cancer subtype with limited treatment options. Unlike other breast cancer subtypes, the scarcity of specific therapies and greater frequencies of distant metastases contribute to its aggressiveness. We aimed to find epigenetic changes that aid in the understanding of the dissemination process of these cancers.

Data description

Using CRISPR/Cas9, our experimental approach led us to identify and disrupt an insulator element, IE8, whose activity seemed relevant for cell invasion. The experiments were performed in two well-established TNBC cellular models, the MDA-MB-231 and the MDA-MB-436. To gain insights into the underlying molecular mechanisms of TNBC invasion ability, we generated and characterized high-resolution chromatin interaction (Hi-C) and chromatin accessibility (ATAC-seq) maps in both cell models and complemented these datasets with gene expression profiling (RNA-seq) in MDA-MB-231, the cell line that showed more significant changes in chromatin accessibility. Altogether, our data provide a comprehensive resource for understanding the spatial organization of the genome in TNBC cells, which may contribute to accelerating the discovery of TNBC-specific alterations triggering advances for this devastating disease.
The molecular architecture of a complex social behavior: gregarious song
Authors: Stevenson Tyler J.
Published: November 2023

The medial preoptic area (mPOA) regulates the probability and intensity of singing behavior in birds. Polzin and colleagues examined the molecular changes in the mPOA that were associated with gregarious song in European starlings (Sturnus vulgaris). High-throughput transcriptome analyses identified glutamate and dopamine pathways were highly enriched with gregarious song.
Nurse practitioner led implementation of huddles for staff in long term care homes during the COVID-19 pandemic
Authors: McGilton Katherine S , Krassikova Alexandra , Wills Aria , Bethell Jennifer , Boscart Veronique , Escrig-Pinol Astrid , Iaboni Andrea , Vellani Shirin , Maxwell Colleen , Keatings Margaret , Stewart Steven C. , Sidani Souraya
Published: November 2023

Background

Staff working in long-term care (LTC) homes during COVID-19 frequently reported a lack of communication, collaboration, and teamwork, all of which are associated with staff dissatisfaction, health concerns, lack of support and moral distress. Our study introduced regular huddles to support LTC staff during COVID-19, led by a Nurse Practitioner (NP). The objectives were to evaluate the process of huddle implementation and to examine differences in outcomes between categories of staff (direct care staff, allied care and support staff, and management) who attended huddles and those who did not.

Methods

All staff and management at one LTC home (< 150 beds) in Ontario, Canada were included in this pre-experimental design study. The process evaluation used a huddle observation tool and focused on the dose (duration, frequency) and fidelity (NP’s adherence to the huddle guide) of implementation. The staff attending and non-attending huddles were compared on outcomes measured at post-test: job satisfaction, physical and mental health, perception of support received, and levels of moral distress. The outcomes were assessed with validated measures and compared between categories of staff using Bayesian models.

Results

A total of 42 staff enrolled in the study (20 attending and 22 non-attending huddles). Forty-eight huddles were implemented by the NP over 15 weeks and lasted 15 min on average. Huddles were most commonly attended by direct care staff, followed by allied care/support, and management staff. All huddles adhered to the huddle guide as designed by the research team. Topics most often addressed during the huddles were related to resident care (46%) and staff well-being (34%). Differences were found between staff attending and non-attending huddles: direct care staff attending huddles reported lower levels of overall moral distress, and allied care and support staff attending huddles perceived higher levels of support from the NP.

Conclusions

NP-led huddles in LTC homes may positively influence staff outcomes. The process evaluation provided some understanding of why the huddles may have been beneficial: the NP addressed resident care issues which were important to staff, encouraged a collaborative approach to solving issues on the unit, and discussed their well-being.

Trial registration number

NCT05387213, registered on 24/05/2022.
Real-world treatment patterns of OTX-101 ophthalmic solution, cyclosporine ophthalmic emulsion, and lifitegrast ophthalmic solution in patients with dry eye disease: a retrospective analysis
Authors: Karpecki Paul , Barghout Victoria , Schenkel Brad , Huynh Lynn , Khanal Anamika , Mitchell Brittany , Yenikomshian Mihran , Zanardo Enrico , Matossian Cynthia
Published: November 2023

Background

Dry eye disease (DED) is a disorder characterized by loss of tear film homeostasis that causes ocular surface inflammation and damage. The incidence of DED increases with age. Cyclosporine ophthalmic solution 0.09% (CEQUA®; OTX-101), cyclosporine ophthalmic emulsion 0.05% (Restasis®; CsA), and lifitegrast ophthalmic solution 5% (Xiidra®; LFT) are anti-inflammatory agents indicated for DED. This analysis compared treatment patterns in patients with DED receiving OTX-101, CsA, or LFT.

Methods

This real-world, retrospective, longitudinal cohort study utilized Symphony Health Integrated Dataverse claims from July 2019 to June 2021. The dataset included all patients with OTX-101 claims and patients with CsA or LFT claims randomly selected 2:1 to OTX-101. Patients were sorted into 3 cohorts based on index treatment. Index date was that of first treatment claim, and follow-up period was from index date to end of clinical activity or data availability. Time to treatment discontinuation (TTD), probability of discontinuation, and treatment persistence were assessed for OTX-101 vs. CsA, then OTX-101 vs. LFT. Subgroup analysis was performed based on age and prior DED treatment. Kaplan-Meier analysis and log-rank test were used to examine TTD. A logistic model evaluated association between index treatment and discontinuation. Unadjusted and adjusted odds ratios, 95% confidence intervals, and P-values were reported, with statistically significant associations based on P-values < 0.05.

Results

Overall, 7102 patients (OTX-101 n = 1846; CsA n = 2248; LFT n = 3008) were eligible. Median TTD was 354 days for patients receiving OTX-101 vs. 241 days for CsA and 269 days for LFT. Log-rank test indicated TTD was significantly longer for patients on OTX-101 vs. CsA (P = 0.033). Patients on CsA were 35% more likely to discontinue treatment than patients on OTX-101; OTX-101 and LFT groups had similar discontinuation rates. After 360 days, 49.8% of patients receiving OTX-101 remained on treatment vs. 39.4% of patients on CsA (P = 0.036) and 44.0% of patients on LFT (P = 0.854).

Conclusions

Patients receiving OTX-101 remained on treatment significantly longer and were significantly less likely to discontinue treatment than patients on CsA. Older patients remained on OTX-101 significantly longer than CsA. These findings highlight treatment pattern differences in patients with DED receiving these anti-inflammatory agents.
Knowledge, psychological impacts, and protective behaviours during the first wave of the COVID-19 pandemic among Chinese residents in Canada with dependent school-age children: a cross-sectional online study
Authors: Kong Yujia , Shaver Lance Garrett , Shi Fuyan , Yang Lixia , Zhang Weiguo , Wei Xiaoling , Zhang Eleen , Ozbek Sara , Effiong Andem , Wang Peizhong Peter
Published: November 2023

Background

The purpose of this study was to describe the knowledge, protective behaviours, and psychological impact of COVID-19 on Chinese residents in Canada, as the emotional and behavioural impacts of the pandemic have not been intensively studied amongst these populations. It was important to determine whether having dependent school-age children (DSAC) aged 16 or under was associated with adverse psychological impacts amongst the Chinese residents living in the country.

Methods

In April 2020, 757 eligible participants were recruited through a snowball sampling to complete an online survey related to the COVID-19 pandemic. Psychological, behavioural, and sociodemographic variables were collected and first analyzed using descriptive and univariate statistics. Multiple logistic regression analyses were performed to further confirm the observed significant associations in bivariate analyses for selected psychological outcome variables.

Results

Seven hundred forty-two participants who responded to the “dependent school-age children” question were included in the analysis. Most of them identified as females (65.8%) and 77.2% included receiving a university degree or higher. There were no significant differences in COVID-19 knowledge between those living with or without DSAC. However, participants with DSAC were more likely to perceive themselves as being at greater risk of contracting COVID-19 (p = .023); therefore, having a higher chance of adopting protective behaviours (e.g., hand washing, sanitizing frequently or disinfecting work and living spaces (p < .05), elevated risks of depression (p = .007), and stress (p = .010), compared to those without DSAC.

Conclusions

Predominantly, the Chinese residents in Canada with dependent school-age children were more likely to report the negative psychological impacts of the pandemic. These findings warrant further investigations that may contribute to informing key stakeholders about the identification and implementation of policies and interventions to support the needs of parents with young children, during and after the pandemic.
Investigation on the association between serum lipid levels and periodontitis: a bidirectional Mendelian randomization analysis
Authors: Chen Zhihong , Song Jukun , Tang Liszen
Published: November 2023

Objective

Several research has considered the potential correlation between periodontitis and serum lipids. However, serum lipid profiles correlation with periodontitis remains largely unknown. The investigation objective was to examine periodontitis correlation with serum lipid levels using a bidirectional Mendelian randomization (MR) analysis.

Methods

The study employed a bidirectional MR analysis with two samples, utilizing a freely accessible genome-wide association study (GWAS). Furthermore, the primary analysis employed the inverse variance weighted (IVW) method. To determine whether the lipid profiles were associated with periodontitis, a variety of sensitivity analyses (including MR-Egger regression, MR-PRESSO, and weighted median), as well as multivariable MR, were employed.

Results

MR analysis performed by IVW did not reveal any relationship between periodontitis and low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), or total cholesterol (TC). It was also found that LDL, HDL, TG, and TC were not associated to periodontitis. Furthermore, the MR estimations exhibited consistency with other MR sensitivity and multivariate MR (MVMR) analyses. These results show that the correlation between serum lipid levels and periodontitis could not be established.

Conclusion

The finding indicates a negligible link between periodontitis and serum lipid levels were identified, despite previous observational studies reporting a link between periodontitis and serum lipid levels.
Translation and cultural adaptation of the Greek integrated palliative care outcome scale (IPOS): challenges in a six-phase process
Authors: Anagnostou Despina , Katsaragakis Stylianos , Panagiotou Irene , Patiraki Elisabeth , Tserkezoglou Aliki
Published: November 2023

Aim

To translate and culturally adapt IPOS to the Greek population.

Methods

A four phases- sequential study, which included verification of conceptual equivalence, double forward- backward translations and conceptual cognitive debriefing. Focus group interviews used ‘think aloud’ and ‘verbal probing’ techniques. Interviews were audio-recorded, transcribed verbatim and thematically analyzed using predefined categories. Purposely sampled from two oncology and palliative care units in Athens.

Results

The Integrated Palliative Care Outcome Scale was well accepted by both patients and health professionals. Overall comprehension and acceptability of the scale were good. The comprehension and judgement challenges identified in the pre-final version were successfully resolved in the cognitive interviewing phase. Five out of the seventeen translated items of the scale were modified after cognitive debriefing. Comprehension difficulties were identified with specific terms (e.g., energy/feeling depressed) and with some answer options. Severity of symptoms and not their impact was a common difficulty. A judgement challenge was reported in relation to 7-days recall and fluctuation of symptoms. Layout concerns in relation to length of questions were also stated. All questions were considered important and none as inappropriate.

Conclusion

This study demonstrated face and content validity and acceptability of the Integrated Palliative Care Outcome Scale in the Greek context. Cognitive Interviewing proved valuable in refining concepts within the specific cultural context.

Clinical implications

The IPOS outcome measure tool is now being used routinely in a palliative care service in Athens and is currently used to evaluate service outcomes.
Neurophobia among medical students and resident trainees in a tertiary comprehensive hospital in China
Authors: Han Fei , Zhang Yao , Wang Ping , Wu Dong , Zhou Li-Xin , Ni Jun
Published: November 2023

Abstracts

Background

Medical students and residents have been revealed to have extraordinary difficulties in managing patients with neurological complaints. However, specific information on Chinese trainees is scarce. Herein, we aimed to uncover the presence of, contributing factors for, and potential solutions to neurophobia among medical students and resident trainees in China.

Methods

Questionnaires were administered to the medical students of Peking Union Medical College and residents of the Internal Medicine Residency Training Program at Peking Union Medical College Hospital. We asked about perceived difficulty, knowledge, interest, and confidence in neurology in contrast to six other specialties. The reasons why neurology is regarded as difficult and approaches for improving neurological teaching have been appraised.

Results

A total of 351 surveys were completed by 218 medical students and 133 residents. The response rate exceeded 70% in both groups. The prevalence of neurophobia was 66.1% and 58.6% among medical students and residents, respectively. Respondents declared that greater difficulty was observed in neurology than in other specialties, and the management of patients with neurological problems was the least comfortable (p < 0.0001). Neurophobia has various perceived causes, and neuroanatomy is regarded as the most important contributor. Nearly 80% of medical students felt that improvements in neurology teaching could be achieved through further integration of preclinical and clinical neurological teaching.

Conclusions

The findings of the first survey on neurophobia in China are in accordance with those of previous studies. Neurophobia is highly prevalent in Chinese medical students and residents. Strategies to improve teaching, including enhanced integration of teaching and more online resources, are needed to prevent neurophobia.
Knowledge and practices of private pharmacy auxiliaries on malaria in Abidjan, Côte d’Ivoire
Authors: Bedia-Tanoh Valérie A. , Angora Étienne K. , Miezan Sebastien A. J. , Koné-Bravo Estelle D. M. , Konaté-Touré Abibatou , Bosson-Vanga Henriette , Kassi Fulgence K. , Kiki-Barro Pulchérie C. M. , Djohan Vincent , Menan Hervé E. I. , Yavo William
Published: November 2023

Background

The emergence of resistance to artemisinin derivatives in Southeast Asia constitutes a serious threat for other malaria endemic areas, particularly in Côte d’Ivoire. To delay this resistance, the application of the control measures recommended by the National Malaria Control Programme (NMCP) for a correct management, in the private pharmacies, is a necessity. The purpose of this study was, therefore, to assess the level of knowledge and practices of private pharmacy auxiliary in Abidjan about the management of malaria.

Methods

A descriptive cross-sectional study was conducted from April to November 2015. It included auxiliaries of private pharmacies in Abidjan. Data collection material was a structured an open pretested questionnaire. Data analysis was carried out using Package for Social Science (SPSS) software version 21.1. Chi square test was used to compare proportions for a significance threshold of 0.05 for the p value.

Results

A total, 447 auxiliaries from 163 private pharmacies were interviewed. It was noted that the auxiliaries had a good knowledge of clinical signs of uncomplicated malaria (99.1%), biological examinations (54.6% for the thick film and 40.7% for rapid diagnostic tests (RDTs) and anti-malarial drugs (99.3% for artemether + lumefantrine, AL). The strategies of vector control (long-lasting insecticide-treated mosquito nets (LLITNs, Repellent ointments, cleaning gutters, elimination of larvae breeding site and intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) in pregnant women were also known by the auxiliaries, respectively 99.8% and 77.4%. However, the malaria pathogen (25.1%) and the NMCP recommendations (e.g. use of AL or AS + AQ as first-line treatment for uncomplicated malaria and IPTp-SP in pregnant women) were not well known by the auxiliaries (28.2% and 26.9% for uncomplicated and severe malaria). Concerning the practices of the auxiliaries, 91.1% offered anti-malarial drugs to patients without a prescription and 47.3% mentioned incorrect dosages. The combination artemether + lumefantrine was the most recommended (91.3%). The delivery of anti-malarial drugs was rarely accompanied by advice on malaria prevention, neither was it carried out on the result of an RDT.

Conclusion

The epidemiology and the NMCP recommendations for the diagnostic and therapeutic management of malaria, are not well known to auxiliaries, which may have implications for their practices. These results show the need to sensitize and train private pharmacy auxiliaries, and also to involve them in NMCP activities.
Recent advancements in nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma, review and update
Authors: Baghban Roghayyeh , Talebnejad Mohammad Reza , Meshksar Aidin , Heydari Mojtaba , Khalili Mohammad Reza
Published: November 2023

Despite the existence of numerous eye drops in the market, most of them are not sufficiently effective because of quick clearance and the barriers within the eye. To increase the delivery of the drugs to the eye, various new formulations have been explored in recent decades. These formulations aim to enhance drug retention and penetration, while enabling sustained drug release over extended periods. One such innovative approach is the utilization of contact lenses, which were originally designed for cosmetic purposes and vision correction. Contact lenses have appeared as a promising formulation for ocular drug delivery, as they can increase the bioavailability of drugs in the eye and diminish unwanted side effects. They are specifically appropriate for treating chronic eye conditions, making them an area of interest for researchers in the field of ophthalmology. This review outlines the promising potential of nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma. It classifies therapeutic approaches based on nanomaterial type, summarizes diagnostic advances, discusses improvement of contact lenses properties, covers marketing perspectives, and acknowledges the challenges of these innovative contact lenses for glaucoma management.