bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of exacerbators in the US Bronchiectasis and NTM Research Registry: a cross-sectional study
Authors: Lapinel Nicole C. , Choate Radmila , Aksamit Timothy R. , Feliciano Joseph , Winthrop Kevin L. , Schmid Andreas , Fucile Sebastian , Metersky Mark L.
Published: June 2024

Background

Exacerbations of noncystic fibrosis bronchiectasis (bronchiectasis) are associated with reduced health-related quality of life and increased mortality, likelihood of hospitalisation and lung function decline. This study investigated patient clinical characteristics associated with exacerbation frequency.

Methods

A cross-sectional cohort study of patients ≥18 years with bronchiectasis enrolled in the US Bronchiectasis and Nontuberculous Mycobacteria (NTM) Research Registry (BRR) September 2008–March 2020. Patients were stratified by exacerbation frequency in their 2 years before enrolment. Patient demographics, respiratory symptoms, healthcare resource utilisation, microbiology, modified bronchiectasis severity index (mBSI) and select comorbidities were collected at enrolment. Patient characteristics associated with exacerbation frequency were assessed using a negative binomial model.

Results

The study included 2950 patients (mean age 65.6 years; 79.1% female). Frequency of moderate to severe airway obstruction (forced expiratory volume in 1 s (FEV1) % predicted <50%; most recent measure) was 15.9%, 17.8%, and 24.6% in patients with 1, 2, and ≥3 exacerbationsversus8.9% in patients with 0 exacerbations; severe disease (mBSI) was 27.8%, 24.2% and 51.1%versus13.2%; respiratory hospitalisation was 24.5%, 33.0% and 36.5%versus4.1%; andPseudomonas aeruginosainfection was 18.8%, 23.4% and 35.2%versus11.9%. In multivariable model analysis, respiratory hospitalisation, cough, haemoptysis,P. aeruginosa, younger age, lower FEV1% predicted, asthma, and gastro-oesophageal reflux disease were associated with more exacerbations.

Conclusions

These findings demonstrate a high disease burden, including increased respiratory symptoms, healthcare resource utilisation, andP. aeruginosainfection in patients with bronchiectasis and multiple exacerbations.
Global, regional, and national burden and trends of migraine among women of childbearing age from 1990 to 2021: insights from the Global Burden of Disease Study 2021
Authors: Cen Jing , Wang Qian , Cheng Lin , Gao Qian , Wang Hongping , Sun Fengjun
Published: June 2024

Background

Migraine, a neurological disorder with a significant female predilection, is the leading cause of disability-adjusted life years (DALYs) in women of childbearing age (WCBA). There is currently a lack of comprehensive literature analysis on the overall global burden and changing trends of migraines in WCBA.

Methods

This study extracted three main indicators, including prevalence, incidence, and DALYs, related to migraine in WCBA from the Global Burden of Disease(GBD) database from 1990 to 2021. Our study presented point estimates with 95% uncertainty intervals (UIs). It evaluated the changing trends in the burden of migraine in WCBA using the estimated annual percentage change (EAPC) and percentage change.

Results

In 2021, the global prevalence, incidence, and DALYs cases of migraine among WCBA were 493.94 million, 33.33 million, and 18.25 million, respectively, with percentage changes of 48%, 43%, and 47% compared to 1990. Over the past 32 years, global prevalence rates and DALYs rates globally have increased, with an EAPC of 0.03 (95% UI: 0.02 to 0.05) and 0.04 (95% UI: 0.03 to 0.05), while incidence rates have decreased with an EAPC of -0.07 (95% UI: -0.08 to -0.05). Among the 5 Socio-Demographic Index (SDI) regions, in 2021, the middle SDI region recorded the highest cases of prevalence, incidence, and DALYs of migraine among WCBA, estimated at 157.1 million, 10.56 million, and 5.81 million, respectively, approximately one-third of the global total. In terms of age, in 2021, the global incidence cases for the age group 15–19 years were 5942.5 thousand, with an incidence rate per 100,000 population of 1957.02, the highest among all age groups. The total number of migraine cases and incidence rate among WCBA show an increasing trend with age, particularly in the 45–49 age group.

Conclusions

Overall, the burden of migraine among WCBA has significantly increased globally over the past 32 years, particularly within the middle SDI and the 45–49 age group. Research findings emphasize the importance of customized interventions aimed at addressing the issue of migraines in WCBA, thus contributing to the attainment of Sustainable Development Goal 3 set by the World Health Organization.
Highly conductive and durable nanocomposite hard coatings of carbon fiber reinforced thermoplastic composites against lightning strikes
Authors: Parten Clay , Subeshan Balakrishnan , Asmatulu Ramazan
Published: June 2024

The growing use of thermoplastic composites (TPCs) like low-melting polyaryletherketone (LM-PAEK) matrices reinforced with unidirectional carbon fiber (CF) in aircraft structures presents a significant challenge in terms of lightning strikes and electromagnetic interference shielding during aircraft operations. This is due to the weak electrical conductivity of TPC structures, which results in widespread damage when struck by lightning. The repair and maintenance of these extended damaged sites can increase operational costs and loss of flights. Several lightning strike protection (LSP) systems have been developed and implemented to address these concerns. This study evaluated a highly conductive coating with a low filler rate for its effectiveness as an LSP solution for TPCs on exterior aircraft surfaces. The TPC panel without any coatings was first studied. Subsequently, the level of conductivity was increased by incorporating the nanoscale conductive fillers, silver-coated copper (Ag/Cu) nanoflakes, with a silver content of 20 wt.% (Ag20/Cu) and 30 wt.% (Ag30/Cu), correspondingly, into the coating at two loadings of 55 wt.% and 70 wt.% in an epoxy carrier for the surface coatings. The behavior of electrical and surface conductivity was thoroughly examined to understand the impact of Ag/Cu with a high aspect ratio and the effectiveness of the LSP solution. In addition, the spray-coated TPC panels underwent rigorous Zone 2A lightning strike testing using simulated lightning current, in agreement with the industry standard of Society of Automotive Engineers (SAE) Aerospace Recommended Practice (ARP) 5412B. Despite the higher resistance due to the lower conductive coating weight, the TPC panels with Ag30/Cu at loading of 70 wt.% achieved better results than those with Ag30/Cu at loading of 55 wt.%. This is evidenced by the minor structural delamination and CF breakage on the front surface, which proposes a new economic route for a sustainable post-processed LSP system in the aviation industry.
dgfr: an R package to assess sequence diversity of gene families
Authors: Almeida Laila Viana , Reis-Cunha João Luís , Bartholomeu Daniella C.
Published: June 2024

Background

Gene families are groups of homologous genes that often have similar biological functions. These families are formed by gene duplication events throughout evolution, resulting in multiple copies of an ancestral gene. Over time, these copies can acquire mutations and structural variations, resulting in members that may vary in size, motif ordering and sequence. Multigene families have been described in a broad range of organisms, from single-celled bacteria to complex multicellular organisms, and have been linked to an array of phenomena, such as host–pathogen interactions, immune evasion and embryonic development. Despite the importance of gene families, few approaches have been developed for estimating and graphically visualizing their diversity patterns and expression profiles in genome-wide studies.

Results

Here, we introduce an R package named dgfr, which estimates and enables the visualization of sequence divergence within gene families, as well as the visualization of secondary data such as gene expression. The package takes as input a multi-fasta file containing the coding sequences (CDS) or amino acid sequences from a multigene family, performs a pairwise alignment among all sequences, and estimates their distance, which is subjected to dimension reduction, optimal cluster determination, and gene assignment to each cluster. The result is a dataset that allows for the visualization of sequence divergence and expression within the gene family, an approximation of the number of clusters present in the family.

Conclusions

dgfr provides a way to estimate and study the diversity of gene families, as well as visualize the dispersion and secondary profile of the sequences. The dgfr package is available at https://github.com/lailaviana/dgfr under the GPL-3 license.
The influence of climate change on the sesame yield in North Gondar, North Ethiopia: Application Autoregressive Distributed Lag (ARDL) time series model
Authors: Abebe Dagnew Melake , Mengistie Dagne Tesfaye , Mekonen Aychew Alemie
Published: June 2024

Sesame is a major annual oil crop that is grown practically everywhere in tropical and subtropical Asia, as well as Africa, for its very nutritious and tasty seeds. Rising temperatures, droughts, floods, desertification, and weather all have a significant impact on agricultural production, particularly in developing countries like Ethiopia. Therefore, the main objective of this study is to examine the influence of climate change on the sesame yield in North Gondar, North Ethiopia, by using the autoregressive distributed Lag (ARDL) time series model. This study employed climate data from the Bahirdar Agrometeorological Center and secondary data on sesame production from the Ethiopian Statistical Service, spanning 36 years, from 1987 to 2023. Autoregressive Distributed LAG (ARDL) includes diagnostic tests for both short- and long-term autoregressive models. The results for the long-run and short-run elastic coefficients show a significant positive association between temperatures and sesame yield. Sesame yield and rainfall have a significant negative long-run and short-run relationship in North Gondar, North Ethiopia. ARDL results confirm that temperature and rainfall have significant effects on sesame productivity. Temperature had a considerable favorable effect on sesamen production, but rainfall had a negative effect in North Gondar, Ethiopia. Based on the evidence acquired from our study, we made several policy recommendations and suggestions to government officials, policymakers, new technologies, researchers, policy development planners, and other stakeholders in order to develop or implement new technology to halt its production and direct adaptation measures in light of the certainty of global warming and the characteristics of climate-dependent agricultural production.
Left atrial appendage closure in a patient previously implanted with an interatrial shunt device: a case report
Authors: Lin Dawei , Li Mingfei , Weng Zilong , Pan Wenzhi , Zhou Daxin , Ge Junbo
Published: June 2024

Patients with previous interatrial shunt device (IASD) implantation may face greater challenges during future left atrial interventional procedures. Herein, we report the first case of left atrial appendage closure (LAAC) in a patient with previous IASD implantation. The patient successfully underwent LAAC using the LAmbre device without complications.
Determinants of sedentary behavior in community-dwelling older adults with type 2 diabetes based on the behavioral change wheel: a path analysis
Authors: Zhang Xiaoyan , Yang Dan , Luo Jiayin , Meng Meiqi , Chen Sihan , Li Xuejing , Yin Yiyi , Hao Yufang , Sun Chao
Published: June 2024

Background

Sedentary behavior (SB) is deeply ingrained in the daily lives of community-dwelling older adults with type 2 diabetes mellitus (T2DM). However, the specific underlying mechanisms of the determinants associated with SB remain elusive. We aimed to explore the determinants of SB based on the behavior change wheel framework as well as a literature review.

Methods

This cross-sectional study recruited 489 community-dwelling older adults with T2DM in Jinan City, Shandong Province, China. Convenience sampling was used to select participants from relevant communities. This study used the Measure of Older Adults’ Sedentary Time-T2DM, the Abbreviated-Neighborhood Environment Walkability Scale, the Social Support Rating Scale, the Lubben Social Network Scale 6, the Subjective Social Norms Questionnaire for Sedentary Behavior, the Functional Activities Questionnaire, the Numerical Rating Scale, the Short Physical Performance Battery, and the Montreal Cognitive Assessment Text to assess the levels of and the determinants of SB. Descriptive statistical analysis and path analysis were conducted to analyze and interpret the data.

Results

Pain, cognitive function, social isolation, and social support had direct and indirect effects on SB in community-dwelling older adults with T2DM (total effects: β = 0.426, β = -0.171, β = -0.209, and β = -0.128, respectively), and physical function, walking environment, and social function had direct effects on patients’ SB (total effects: β = -0.180, β = -0.163, and β = 0.127, respectively). All the above pathways were statistically significant (P < 0.05). The path analysis showed that the model had acceptable fit indices: RMSEA = 0.014, χ 2/df = 1.100, GFI = 0.999, AGFI = 0.980, NFI = 0.997, RFI = 0.954, IFI = 1.000, TLI = 0.996, CFI = 1.000.

Conclusion

Capability (physical function, pain, and cognitive function), opportunity (social isolation, walking environment, and social support), and motivation (social function) were effective predictors of SB in community-dwelling older adults with T2DM. Deeper knowledge regarding these associations may help healthcare providers design targeted intervention strategies to decrease levels of SB in this specific population.
Short-term culture for rapid identification by mass spectrometry and automated antimicrobial susceptibility testing from positive bottles
Authors: Tian Peng-Peng , Su Shan-Shan , Zhu Li-Sha , Wang Tian , Yang Hui , Du Meng-Yao , Ding Cai-Zhi , Wang Li , Fan Wen , Yi Hua-Wei
Published: June 2024

Background

Early and appropriate antibiotic treatment improves the clinical outcome of patients with sepsis. There is an urgent need for rapid identification (ID) and antimicrobial susceptibility testing (AST) of bacteria that cause bloodstream infection (BSI). Rapid ID and AST can be achieved by short-term incubation on solid medium of positive blood cultures using MALDI-TOF mass spectrometry (MS) and the BD M50 system. The purpose of this study is to evaluate the performance of rapid method compared to traditional method.

Methods

A total of 124 mono-microbial samples were collected. Positive blood culture samples were short-term incubated on blood agar plates and chocolate agar plates for 5 ∼ 7 h, and the rapid ID and AST were achieved through Zybio EXS2000 MS and BD M50 System, respectively.

Results

Compared with the traditional 24 h culture for ID, this rapid method can shorten the cultivation time to 5 ∼ 7 h. Accurate organism ID was achieved in 90.6% of Gram-positive bacteria (GP), 98.5% of Gram-negative bacteria (GN), and 100% of fungi. The AST resulted in the 98.5% essential agreement (EA) and 97.1% category agreements (CA) in NMIC-413, 99.4% EA and 98.9% CA in PMIC-92, 100% both EA and CA in SMIC-2. Besides, this method can be used for 67.2% (264/393) of culture bottles during routine work. The mean turn-around time (TAT) for obtaining final results by conventional method is approximately 72.6 ± 10.5 h, which is nearly 24 h longer than the rapid method.

Conclusions

The newly described method is expected to provide faster and reliable ID and AST results, making it an important tool for rapid management of blood cultures (BCs). In addition, this rapid method can be used to process most positive blood cultures, enabling patients to receive rapid and effective treatment.
Tuberculous ciliary body granuloma initially diagnosed as bullous retinal detachment: a case report
Authors: Zhu Jie , Xu Huirong , Chang Qing , Chen Fang
Published: June 2024

Background

Ocular tuberculosis is a relatively rare extrapulmonary manifestation of tuberculosis. This vision-threatening disease is extremely challenging to diagnose, particularly because it can mimic other diseases. We report a case of tuberculous ciliary body granuloma initially diagnosed as bullous retinal detachment.

Case report

A 52-year-old female presented with bullous retinal detachment in her left eye, and ultrasound biomicroscopy (UBM) verified the presence of a lesion with ciliary body granulomatous inflammation. The T-SPOT was positive, and the purified protein derivative (PPD) test was strongly positive (diameter of 20 mm). Following the administration of oral anti-tuberculosis regimen combined with prednisone, the retina gradually became reattached, the ciliary body granuloma became significantly reduced in size, and the visual acuity of the patient noticeably improved.

Conclusions

Tuberculous ciliary body granulomas can cause bullous exudative retinal detachment and can be diagnosed with UBM. Early and full-course anti-tuberculosis treatment (ATT) combined with corticosteroid therapy can improve the patient prognosis.
“Are we working (too) comfortably?”: a focus group study to understand sedentary behaviour when working at home and identify intervention strategies
Authors: Morton Sarah , Fitzsimons Claire , Sivaramakrishnan Divya , Jepson Ruth , Niven Ailsa
Published: June 2024

Background

The Covid-19 pandemic initiated an enduring shift in working patterns, with many employees now working at home (w@h). This shift has exacerbated existing high levels of occupational sedentary behaviour (SB) in office workers, which is a recognised risk to health and well-being. This study aimed to use the Capability-Opportunity-Motivation-Behaviour (COM-B) model to better understand both employees’ SB, and line managers behaviour to assist employees to reduce SB when w@h, and identify how employees can best be supported to reduce SB.

Methods

Three online focus groups with employees aged 18–40 working in desk-based roles (e.g. administrative / sales / customer services) (n = 21), and three with line managers (n = 21) were conducted. The focus groups facilitated discussion regarding participants’ current behaviour, what impacts it, and what could be done to reduce employee SB when w@h. The focus group data were thematically analysed guided by the COM-B framework to understand influences on behaviour, and to identify promising intervention strategies.

Results

Most participants recognised that w@h had elevated employee occupational SB, and line managers reported the importance of supporting employees to manage their workload, and encouraging and modelling taking breaks. There were multiple influences on both employee and line manager behaviour with capability, opportunity and motivation all perceived as influential, although not equally. For example, a major theme related to the reduced physical opportunities for employees to reduce their SB when w@h, including blurred work-life boundaries. Changes in physical opportunities also made supporting employees challenging for line managers. Additionally, the w@h environment included unique social opportunities that negatively impacted the behaviour of both groups, including an expectation to always be present online, and social norms. A range of strategies for reducing SB when w@h at both individual and organisational level were suggested.

Conclusions

It was evident that SB when w@h is influenced by a range of factors, and therefore multi-component intervention strategies are likely to be most effective in reducing SB. Future intervention research is a priority to evaluate and refine strategies, and inform w@h guidance to protect both the short-term and long-term health consequences of elevated SB for those who continue to w@h.
Thyroid function spectrum in Cushing’s syndrome
Authors: Yu Peng , Yuan Haoyue , Chen Hong , Li Xiaomu
Published: June 2024

Purpose

Thyroid disorders have been reported in hypercortisolism patients. Endogenous Cushing’s syndrome (CS) potentially complicates its metabolic sequelae. We investigated thyroid function in CS patients to determine this relationship.

Methods

In this cross-sectional study, we screened CS patients from 2016 to 2019 at our hospital. Patient demographic, medical history, and laboratory data were collected. Additionally, we performed a meta-analysis to demonstrate the prevalence of thyroid dysfunction in patients with CS.

Results

Among 129 CS patients, 48.6% had triiodothyronine (TT3), 27.9% had thyroxine (TT4), 24.6% had free T3 (FT3), 27.7% had free T4 (FT4), and 6.2% had thyroid-stimulating hormone (TSH) levels below the reference values. Those with clinical CS showed more pronounced thyroid suppression than did those with subclinical CS. Cortisol levels were markedly greater in patients with pituitary hypothyroidism (P < 0.001). Serum cortisol levels throughout the day and post low-dose dexamethasone-suppression test (LDDST) results correlated with thyroid hormone levels, particularly in ACTH-independent CS. Correlations varied by thyroid status; FT3 and TSH were linked to cortisol in euthyroid individuals but not in those with low T3 or central hypothyroidism. TSH levels notably halved from the lowest to highest cortisol tertile post-LDDST. Finally, meta-analysis showed 22.7% (95% CI 12.6%-32.9%) central hypothyroidism in 528 CS patients of nine studies.

Conclusion

Thyroid hormone levels are significantly correlated with cortisol levels and are impaired in patients with CS. However, the physiological adaptation and pathological conditions need further study.
Admission indications, initial diagnoses, Interventions, and patient outcomes within the sole obstetric high-dependency unit in Ethiopia
Authors: Beza Zewdu , Tadesse Roza , Teshome Henok , Tadele Genetu , Siferih Melkamu
Published: June 2024

Background

Obstetric high-dependency care offers holistic care to critically ill obstetric patients while maintaining the potential for early mother-child bonding. Little is known about the obstetric high-dependency unit (HDU) in Ethiopia. Therefore, the objective of the study was to review the admission indications, initial diagnoses, interventions, and patient outcomes in the obstetric high-dependency unit at St.Paul’s Hospital.

Methods

A retrospective observational study was carried out at St. Paul’s Hospital in Addis Ababa, Ethiopia, between September 2021 and September 2022, targeting patients in the obstetric high-dependency unit during pregnancy or with in 42 days of termination or delivery. A checklist was used to compile sociodemographic and clinical data. Epidata-4.2 for data entry and SPSS-26 for data analysis were employed. Chi-square tests yielded significant results at p < 0.05.

Result

Records of 370 obstetric patients were reviewed and analyzed. The study enlisted participants aged 18 to 40, with a mean age of 27.6 ± 5.9. The obstetric high-dependency unit received 3.5% (95% CI, 3.01-4.30) of all obstetric admissions. With the HDU in place, only 0.42% of obstetric patients necessitated adult intensive care unit (ICU) admission. The predominant motive behind HDU admissions (63.2%) was purely for observation. Hypertensive disorders of pregnancy (48.6%) and obstetric hemorrhage (18.9%) were the two top admission diagnoses. Ten pregnant mothers (2.7%) were admitted to HDU: 2 with antepartum hemorrhages, and 8 with cardiac diseases. Maternal mortality and transfer to the ICU were both 1.4 per 100 HDU patients.

Conclusion

Our study found that the most frequent indication for admission to the HDU was just for observational monitoring. Hypertensive disorders of pregnancy and obstetric hemorrhage were the two leading admission diagnoses. Expanding HDUs nationwide is key for mitigating the ICU burden from obstetric admissions. Strategies for early prenatal screening, predicting preeclampsia, and addressing postpartum hemorrhage should be reinforced. Future studies should focus on a broader array of factors affecting fetomaternal outcomes in such a unit.
Perceptions and challenges of online teaching and learning amidst the COVID-19 pandemic in India: a cross-sectional study with dental students and teachers
Authors: Rao Lakshmi Nidhi , Shetty Aditya , Pai Varun , Natarajan Srikant , Baliga Manjeshwar Shrinath , Wahjuningrum Dian Agustin , Shetty Heeresh , Irmaleny Irmaleny , Pawar Ajinkya M.
Published: June 2024

Background

Online education has emerged as a crucial tool for imparting knowledge and skills to students in the twenty-first century, especially in developing nations like India, which previously relied heavily on traditional teaching methods.

Methods

This study delved into the perceptions and challenges experienced by students and teachers in the context of online education during the COVID-19 pandemic. Data were collected from a sample of 491 dental students and 132 teachers utilizing a cross-sectional research design and an online-validated survey questionnaire.

Results

The study’s findings revealed significant insights. Internet accessibility emerged as a major impediment for students, with online instruction proving more effective for theoretical subjects compared to practical ones. Although most teachers expressed comfort with online teaching, they highlighted the absence of classroom interaction as a significant challenge.

Conclusion

This study comprehensively examines the perspectives of both students and teachers regarding online education during the pandemic. The results carry substantial implications for the academic community, underscoring the need to address internet access issues and explore ways to enhance engagement and interaction in online learning environments.
“The genie is out of the bottle”: a qualitative study on the impact of COVID-19 on continuing professional development
Authors: Soklaridis Sophie , Shier Rowen , Zaheer Rabia , Scully Michelle , Williams Betsy , Daniel Sam J. , Sockalingam Sanjeev , Dang Linda , Tremblay Martin
Published: June 2024

Background

The onset of the COVID-19 pandemic catalysed a monumental shift in the field of continuing professional development (CPD). Prior to this, the majority of CPD group-learning activities were offered in-person. However, the pandemic forced the field to quickly pivot towards more novel methods of learning and teaching in view of social distancing regulations. The purpose of this study was to obtain the perspectives of CPD leaders on the impact of the pandemic to elucidate trends, innovations, and potential future directions in the field.

Methods

Semi-structured interviews were conducted between April-September 2022 with 23 CPD leaders from Canada and the USA. Interviews were audio-recorded, transcribed, and de-identified. A thematic analysis approach was used to analyse the data and generate themes.

Results

Participants characterised COVID-19 as compelling widespread change in the field of CPD. From the interviews, researchers generated six themes pertaining to the impact of the pandemic on CPD: (1) necessity is the mother of innovation, (2) the paradox of flexibility and accessibility, (3) we’re not going to unring the bell, (4) reimagining design and delivery, (5) creating an evaluative culture, and (6) a lifeline in times of turmoil.

Conclusion

This qualitative study discusses the impact of the pandemic on the field of CPD and leaders’ vision for the future. Despite innumerable challenges, the pandemic created opportunities to reform design and delivery. Our findings indicate a necessity to maintain an innovative culture to best support learners, to improve the healthcare system, and to prepare for future emergencies.
Assessing attitudes towards biostatistics education among medical students: adaptation and preliminary evaluation of the Chinese version survey of attitudes towards statistics (SATS-36)
Authors: Li Chen , Zhang Yuhai , Qin Weidong , Xia Jielai , Shang Lei , Wang Ling
Published: June 2024

Background

Despite the numerous advantages of mastering biostatistics, medical students generally perceive biostatistics as a difficult and challenging subject and even experience anxiety during the courses. Evidence for the correlation between students’ academic achievements and their attitudes, indicating that attitudes at the beginning of the biostatistics course may affect cognitive competence at the end of the course and subsequently influence student academic performance. However, there are current disagreements regarding the measurement and evaluation of attitudes related to statistics. Thus, there is a need for standard instruments to assess them. This study was conducted to develop a Chinese version of the Survey of Attitudes Toward Statistics (SATS-36) in order to acquire a valid instrument to measure medical students’ attitudes toward biostatistics under Chinese medical educational background.

Methods

The Chinese version SATS-36 was developed through translation and back-translation of the original scale, with subsequent revisions based on expert advice to ensure the most appropriate item content. The local adaption was performed with a cohort of 1709 Chinese-speaking medical undergraduate and graduate students enrolled in biostatistics courses. And then, the reliability, validity and discrimination of the questionnaires were evaluated through correlation coefficient calculation, factor analysis, parallel analysis and other methods.

Results

The Chinese version SATS-36 consisted of 36 items and loaded a five-factor structure by factor analysis, which offered an alternative similar but not equal to that original six-factor structure. The cumulative variance contribution rate was 62.20%, the Cronbach’s α coefficient was 0.908, the Guttman split-half reliability coefficient was 0.905 and the test–retest reliability coefficient was 0.752. Discriminant analysis revealed small to large significant differences in the five attitude subscales.

Conclusions

The Chinese version SATS-36 with good validity and reliability in this study can be used to evaluate the learning framework of Chinese medical students.
Tools for measuring curriculum integration in health professions’ education: a systematic review
Authors: Allouch Soumaya , Ali Raja Mahamade , Al-Wattary Noor , Nomikos Michail , Abu-Hijleh Marwan F.
Published: June 2024

Background

Curriculum integration is an important educational concept widely implemented by various educational institutions, particularly within the healthcare field. Its significance lies in enhancing the preparation of future healthcare professionals. The assessment of these integrated curricula is imperative to guarantee their effectiveness. Consequently, the aim of this systematic review is to delve into existing literature, with the goal of identifying instruments designed to assess the extent of curriculum integration in health professions’ education.

Methods

A comprehensive search was conducted to identify peer-reviewed papers and grey literature describing the development, validation, or use of instruments measuring the degree of integration in a curriculum. Eight databases were searched: PubMed, Scopus, Google Scholar, CINAHL Ultimate, Web of Science, Cochrane, ProQuest Central and EMBASE. Grey literature was also included. Titles, abstracts, and full text screening was conducted. Data extraction was done using a data extraction tool developed by our research team.

Results

The search resulted in the identification of 2094 references. After the removal of duplicates and title and abstract screening, 16 articles were deemed suitable for inclusion in this systematic review. Twenty-two instruments were extracted from these articles. The identified instruments assessed either integration attributes, perceptions about the integrated curriculum characteristics, process and outcomes, or curriculum integration level. Two of the instruments were focused on assessing horizontal integration (Basic Science Curriculum Assessment Instrumentandthe integration characteristic tool).In addition, one instrument was developed to assess integration within a single session only, while other instruments assessed curriculum integration level. Two of the integration instruments (The Session Integration ToolandIntegration Ladder Questionnaire)provided scales for calculating integration levels. Validation of the integration assessment instruments was infrequent, with only 9 of 22 instruments validated for their psychometric properties.

Conclusion

Our findings reveal the existence of diverse instruments designed to assess the extent of curriculum integration within health professions’ curricula. The majority of identified instruments were focused on participants’ perceptions towards the attributes of the integrated curriculum, and a significant number of these tools lacked validation.
Flemish critical care nurses’ experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study
Authors: Billiau Lukas , Bolliger Larissa , clays Els , Eeckloo Kristof , Ketels Margo
Published: June 2024

Background

Critical care nurses (CCNs) around the globe face other health challenges compared to their peers in general hospital nursing. Moreover, the nursing workforce grapples with persistent staffing shortages. In light of these circumstances, developing a sustainable work environment is imperative to retain the current nursing workforce. Consequently, this study aimed to gain insight into the recalled experiences of CCNs in dealing with the physical and psychosocial influences of work-related demands on their health while examining the environments in which they operate. The second aim was to explore the complex social and psychological processes through which CCNs navigate these work-related demands across various CCN wards.

Methods

A qualitative study following Thorne’s interpretive descriptive approach was conducted. From October 2022 to April 2023, six focus groups were organised. Data from a diverse sample of 27 Flemish CCNs engaged in physically demanding roles from three CCN wards were collected. The Qualitative Analysis Guide of Leuven was applied to support the constant comparison process.

Results

Participants reported being exposed to occupational physical activity, emotional, quantitative, and cognitive work-related demands, adverse patient behaviour, and poor working time quality. Exposure to these work-related demands was perceived as harmful, potentially resulting in physical, mental, and psychosomatic strain, as well as an increased turnover intention. In response to these demands, participants employed various strategies for mitigation, including seeking social support, exerting control over their work, utilising appropriate equipment, recognising rewards, and engaging in leisure-time physical activity.

Conclusions

CCNs’ health is challenged by work-related demands that are not entirely covered by the traditional quantitative frameworks used in research on psychologically healthy work. Therefore, future studies should focus on improving such frameworks by exploring the role of psychosocial and organisational factors in more detail. This study has important implications for workplace health promotion with a view on preventing work absenteeism and drop-out in the long run, as it offers strong arguments to promote sufficient risk management strategies, schedule flexibility, uninterrupted off-job recovery time, and positive management, which can prolong the well-being and sustainable careers of the CCN workforce.
Association of the TyG index with prognosis in surgical intensive care patients: data from the MIMIC-IV
Authors: Liu Donghao , Ren Bingkui , Tian Yuqing , Chang Zhigang , Zou Tong
Published: June 2024

Background

The triglyceride–glucose (TyG) index, a tool for assessing insulin resistance, is increasingly recognized for its ability to predict cardiovascular and metabolic risks. However, its relationship with trauma and surgical patient prognosis is understudied. This study investigated the correlation between the TyG index and mortality risk in surgical/trauma ICU patients to identify high-risk individuals and improve prognostic strategies.

Methods

This study identified patients requiring trauma/surgical ICU admission from the Medical Information Mart for Intensive Care (MIMIC-IV) database, and divided them into tertiles based on the TyG index. The outcomes included 28-day mortality and 180-day mortality for short-term and long-term prognosis. The associations between the TyG index and clinical outcomes in patients were elucidated using Cox proportional hazards regression analysis and RCS models.

Results

A total of 2103 patients were enrolled. The 28-day mortality and 180-day mortality rates reached 18% and 24%, respectively. Multivariate Cox proportional hazards analysis revealed that an elevated TyG index was significantly related to 28-day and 180-day mortality after covariates adjusting. An elevated TyG index was significantly associated with 28-day mortality (adjusted hazard ratio, 1.19; 95% confidence interval 1.04–1.37) and 180-day mortality (adjusted hazard ratio, 1.24; 95% confidence interval 1.11–1.39). RCS models revealed that a progressively increasing risk of mortality was related to an elevated TyG index. According to our subgroup analysis, an elevated TyG index is associated with increased risk of 28-day and 180-day mortality in critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases. Additionally, in nondiabetic patients, an elevated TyG index is associated with 180-day mortality.

Conclusion

An increasing risk of mortality was related to an elevated TyG index. In critically ill patients younger than 60 years old, as well as those with concomitant stroke or cardiovascular diseases, an elevated TyG index is associated with adverse short-term and long-term outcomes. Furthermore, in non-diabetic patients, an elevated TyG index is associated with adverse long-term prognosis.
LKB1 biology: assessing the therapeutic relevancy of LKB1 inhibitors
Authors: Trelford Charles B. , Shepherd Trevor G.
Published: June 2024

Liver Kinase B1 (LKB1), encoded by Serine-Threonine Kinase 11 (STK11), is a master kinase that regulates cell migration, polarity, proliferation, and metabolism through downstream adenosine monophosphate-activated protein kinase (AMPK) and AMPK-related kinase signalling. Since genetic screens identified STK11 mutations in Peutz-Jeghers Syndrome, STK11 mutants have been implicated in tumourigenesis labelling it as a tumour suppressor. In support of this, several compounds reduce tumour burden through upregulating LKB1 signalling, and LKB1-AMPK agonists are cytotoxic to tumour cells. However, in certain contexts, its role in cancer is paradoxical as LKB1 promotes tumour cell survival by mediating resistance against metabolic and oxidative stressors. LKB1 deficiency has also enhanced the selectivity and cytotoxicity of several cancer therapies. Taken together, there is a need to develop LKB1-specific pharmacological compounds, but prior to developing LKB1 inhibitors, further work is needed to understand LKB1 activity and regulation. However, investigating LKB1 activity is strenuous as cell/tissue type, mutations to the LKB1 signalling pathway, STE-20-related kinase adaptor protein (STRAD) binding, Mouse protein 25-STRAD binding, splicing variants, nucleocytoplasmic shuttling, post-translational modifications, and kinase conformation impact the functional status of LKB1. For these reasons, guidelines to standardize experimental strategies to study LKB1 activity, associate proteins, spliced isoforms, post-translational modifications, and regulation are of upmost importance to the development of LKB1-specific therapies. Therefore, to assess the therapeutic relevancy of LKB1 inhibitors, this review summarizes the importance of LKB1 in cell physiology, highlights contributors to LKB1 activation, and outlines the benefits and risks associated with targeting LKB1.
Effects of native species richness on reproduction of invasive Bidens pilosa vary with nutrient supply
Authors: Gao Fang-Lei , Roiloa Sergio , Xia Jiangbao , Ren Jiayun , Zou Meiling , Zhao Ximei , Yu Fei-Hai
Published: June 2024

Background

Both increasing native species diversity and reducing nutrient availability can increase the ability of native plant communities to resist alien plant invasions. Furthermore, native species diversity and nutrient availability may interact to influence alien plant invasions. So far, however, little is known about the interactive effect of species diversity and nutrient availability on reproduction of alien invasive plants. We constructed native plant communities with one, four or eight species under low and high nutrient supply and then let them be invaded by the invasive alien plant Bidens pilosa.

Results

At both high and low nutrient supply, increasing native species richness significantly increased aboveground biomass of the native plant community and decreased aboveground biomass and biomass proportion of the invader B. pilosa. Reproductive biomass of B. pilosa decreased significantly with increasing native species richness under high nutrient supply, but this effect was not observed under low nutrient supply. Net biodiversity effect on seed mass of B. pilosa decreased significantly with increasing native species diversity under high nutrient supply, but not under low nutrient supply. This was mainly because the selection effect became dominant with increasing species richness under high nutrient supply.

Conclusions

Our study suggest that native species richness and nutrient supply can interact to influence reproduction of invasive alien plant species and that measures to help maintain a high level of native species richness and to reduce nutrient supply could be useful for efficient invasive plant control.
Understanding the spread of antibiotic resistance in vegetables cultivated with sewage sludge: implications for food safety and human health
Authors: Patra Mrinmoy , Dubey Suresh Kumar
Published: June 2024

The conventional practice of using sewage treatment plant (STP) derived sludge as a fertilizer poses significant negative impacts on agroecosystems. Since sludge has diverse contaminants, including heavy metals (HMs), antibiotics (ABs) and antibiotic resistance genes (ARGs), its application in the agricultural fields contaminates the food and hence causes human health risks via the food chain. The transfer of ABs and ARGs from sludge to soil and then to plants can influence the development of antibiotic resistance (AR) in plant endophytes, and leads to variations in their characteristics. In a pot experiment, vegetable carrot (Daucus carota) and spinach (Spinacia oleracea) were amended with sludge samples from three sewage treatment plants (STPs) with varying treatment capacities and both above and below-ground parts of the plants were analysed for the presence of specific ABs (amoxicillin, azithromycin, chloramphenicol, ciprofloxacin, tetracycline), ARGs (blaCTX-M, blaGES, blaNDM, ermF, qnrS, Sul1), and mobile genetic elements (MGEs) (intl1, IS26). Among the characterized culturable endophytic bacteria (EB), 22 exhibited resistance to various antibiotics (highest against ampicillin, ciprofloxacin, chloramphenicol) and heavy metals (highest against lead, nickel, and chromium). Most importantly, seven multiple antibiotic-resistant endophytic bacteria (MAREB) exhibited resistance to all tested heavy metals (HMs). Additionally, all MAREB tested positive for biofilm production, and a notable proportion (72.72%) of these endophytes displayed mobility, with strong auto-aggregation ranging from 16.67 to 92.61%. The biofilm formation dynamics among these MAREB exhibited a Gaussian distribution pattern, increasing with higher antibiotic concentrations. Notably, five MAREB demonstrated survival at clarithromycin concentrations up to 150 µg ml−1. The study revealed the presence of ABs (µg kg−1) and ARGs (copies kg−1) in all parts of both vegetables, ranging from 2.87 to 314.88 and 1 × 105 to 3.2 × 1010, respectively. MAREB displayed various advantageous features to support plant growth under different stress conditions. Moreover, 51.09% of the identified EBs were reported as both plant and human-associated pathogens, and 9.09% were solely human pathogens. Transfer factor (TF), translocation factor (TLF), and bioconcentration factor (BCF) values were correlated with higher ABs and ARGs abundance in the root and shoot compartments of both vegetables. The risk assessment for ABs and ARGs highlighted children are particularly vulnerable to prolonged adverse health risks from consuming these vegetables. Therefore, this research is imperative for understanding the co-selection mechanisms, the need for improvement of the existing treatment systems in contaminants removal, and the evaluation of the presence of ABs and ARGs in sludge before its application in agricultural fields.
Compendium of 5810 genomes of sheep and goat gut microbiomes provides new insights into the glycan and mucin utilization
Authors: Zhang Ke , He Chong , Wang Lei , Suo Langda , Guo Mengmeng , Guo Jiazhong , Zhang Ting , Xu Yangbin , Lei Yu , Liu Gongwei , Qian Quan , Mao Yunrui , Kalds Peter , Wu Yujiang , Cuoji Awang , Yang Yuxin , Brugger Daniel , Gan Shangquan , Wang Meili , Wang Xiaolong , Zhao Fangqing , Chen Yulin
Published: June 2024

Background

Ruminant gut microbiota are critical in ecological adaptation, evolution, and nutrition utilization because it regulates energy metabolism, promotes nutrient absorption, and improves immune function. To study the functional roles of key gut microbiota in sheep and goats, it is essential to construct reference microbial gene catalogs and high-quality microbial genomes database.

Results

A total of 320 fecal samples were collected from 21 different sheep and goat breeds, originating from 32 distinct farms. Metagenomic deep sequencing and binning assembly were utilized to construct a comprehensive microbial genome information database for the gut microbiota. We successfully generated the largest reference gene catalogs for gut microbiota in sheep and goats, containing over 162 million and 82 million nonredundant predicted genes, respectively, with 49 million shared nonredundant predicted genes and 1138 shared species. We found that the rearing environment has a greater impact on microbial composition and function than the host’s species effect. Through subsequent assembly, we obtained 5810 medium- and high-quality metagenome-assembled genomes (MAGs), out of which 2661 were yet unidentified species. Among these MAGs, we identified 91 bacterial taxa that specifically colonize the sheep gut, which encode polysaccharide utilization loci for glycan and mucin degradation.

Conclusions

By shedding light on the co-symbiotic microbial communities in the gut of small ruminants, our study significantly enhances the understanding of their nutrient degradation and disease susceptibility. Our findings emphasize the vast potential of untapped resources in functional bacterial species within ruminants, further expanding our knowledge of how the ruminant gut microbiota recognizes and processes glycan and mucins.