bluuebunny/crossref_metadata_2025 huggingface dataset:
Blurred lines: Ethical challenges related to autonomy in home-based care
Authors: Hertzberg Cecilie Knagenhjelm , Heggestad Anne Kari Tolo , Magelssen Morten
Published: December 2023

Background

Home-based care workers mainly work alone in the patient’s home. They encounter a diverse patient population with complex health issues. This inevitably leads to several ethical challenges.

Aim

The aim is to gain insight into ethical challenges related to patient autonomy in home-based care and how home-based care staff handle such challenges.

Research design

The study is based on a 9-month fieldwork, including participant observation and interviews in home-based care. Data were analysed with a thematic analysis approach.

Participants and research context

The study took place within home-based care in three municipalities in Eastern Norway, with six staff members as key informants.

Ethical considerations

The Norwegian Agency for Shared Services in Education and Research evaluated the study. All participants were competent to consent and signed an informed consent form.

Findings

A main challenge was that staff found it difficult to respect the patient’s autonomy while at the same time practicing appropriate care. We found two main themes: Autonomy and risk in tension; and strategies to balance autonomy and risk. These were explicated in four sub-themes: Refusing and resisting care; when choosing to live at home becomes risky; sweet-talking and coaxing; and building trust over time. Staff’s threshold for considering the use of coercion appeared to be high.

Conclusions

Arguably, home-based care staff need improved knowledge of coercion and the legislation regulating it. There is also a need for arenas for ethics reflection and building of competence in balancing ethical values in recurrent ethical problems.
Olecranon fractures: A biomechanical comparison of three tension band wiring fixation methods on bone models
Authors: Calisal Emre , Uğur Levent
Published: December 2023

Purpose

This study aimed to compare the biomechanical pull-out strength of the three different tension band wiring (TBW) methods employed to fix transverse olecranon fractures on bone models.

Methods

Three different fixation models were created in groups of seven synthetic olecranon fractured bone models. The first technique was fixed the olecranon with the traditional TBW method. The second technique was fixed the olecranon with a large intramedullary screw TBW method. The third technique was fixed the olecranon with the double-screw TBW method. The pull-out force needed for the failure of each specimen under the tensile test device was evaluated, and the results were recorded.

Results

We found that the lowest average pull out strength was 55.10 N (range: 35.87–65.85 ± 10.17) in the traditional TBW method, the highest pull out strength was 84.28 N (range: 63.67–117 ± 18.87) in the double-screw TBW method. The pull out strength was 70.80 N (range: 52.60–80.95 ± 10.18) in the intramedullary screw TBW method. In terms of ultimate failure loads, there was no significant difference between the intramedullary screw TBW and the double-screw TBW ( p > .05) while there was a significant difference between the traditional TBW and the other two methods ( p < .05).

Conclusion

The use of screw(s) shows higher biomechanical stability than K-wires in the TBW method. Double-screws fixation gives similar results in terms of the biomechanical load to failure compared to a large intramedullary screw fixation. Both screw methods can be used as stable constructs in clinical practice.

Level of Evidence

III, biomechanical trial.
A Comprehensive Bibliometric Analysis of Live Streaming Commerce: Mapping the Research Landscape
Authors: Mai Xiaojun , Sheikh Ahmad Fauziah , Xu Jiayi
Published: December 2023

Livestreaming commerce (LSC) has transformed the retail business model, introducing it as an integral channel of distribution in social commerce. Numerous existing contemporary research literature highlights the absence of LSC-underpinning theories. The paramount aim of the present study is to furnish a comprehensive reference for forthcoming analyses by conducting an all-encompassing meta-review of the literature. The present study adopted VOSviewer software package to conduct a bibliometric analysis of 75 articles in domain. The conducted comprehensive literature analysis reveals current LSC research segments, classifying significant discoveries into three broad areas of specialization: streamer-focused research, consumer-focused research, and platform-focused research. These subdomains contribute to the existing knowledge base by identifying underpinnings theory, methodologies, and eight core themes that have emerged: behavior, credibility, trust, adoption, costs, information dissemination, purchase intention and knowledge acquisition. A comprehensive study is a valuable tool for pinpointing pivotal research areas that have been extensively examined while establishing a strong foundation for detecting potential obstacles and emerging patterns that could influence forthcoming investigations. This study aims to fill the gap by conducting a comprehensive review of this emerging phenomenon. This study categorizes key findings into three specialization and identifies underpinnings theory, and methodologies for each subdomain. By exploring key themes in the field, this study sheds light on important areas for future research in LSC.
The Moderating Role of Teacher Collegiality in the Relationship Between Instructional Leadership and Teacher Self-Efficacy
Authors: Chen Shuangye , Rong Jiani
Published: December 2023

This study elucidates the relationship between instructional leadership and teacher self-efficacy by identifying the moderating role of teacher collegiality. Survey data were collected from 1,498 teachers at 53 middle schools in Henan, China. Findings indicate that instructional leadership has a positive impact on teacher self-efficacy. More importantly, teacher collegiality was found to moderate the relationship between principal instructional leadership and teacher self-efficacy. More specifically, when there was a high level of teacher collegiality, instructional leadership positively predicted teacher self-efficacy; however, when there was a low level of teacher collegiality, instructional leadership barely predicted teacher self-efficacy. In addition to elaborating on the relationship between principal instructional leadership and teacher self-efficacy, this study underscores the importance of teacher collegiality in promoting the effectiveness of instructional leadership.
Should I Return or Not?
Authors: Manzoor Mahak , Siddiqui Saif
Published: December 2023

Jammu and Kashmir, famous for its picturesque beauty, is one of the most attractive and welcoming tourist hubs in India. The tourism industry contributes significantly to Jammu and Kashmir’s GDP. In addition to its scenic beauty, this union territory is rebranding itself with adventure, horticulture, cultural, eco, film, rural, spiritual and golf tourism. Following an uncertain business environment, new policies are being framed which may enhance investments. The government has taken several initiatives to develop an ambience and new favourable infrastructure simultaneously. Now the challenge is to determine if an individual (here Mrs Fatima Wani, a Canada-based entrepreneur) should invest in the hotel industry of this union territory. Since she inherited an ancestral property recently, can she now consider taking up this venture as the laws and environment are favourable to her?
Comparative genomics analysis and characterization of Shiga toxin-producing Escherichia coli O157:H7 strains reveal virulence genes, resistance genes, prophages and plasmids
Authors: Naidoo Natalie , Zishiri Oliver T.
Published: December 2023

Escherichia coli O157:H7 is a foodborne pathogen that has been linked to global disease outbreaks. These diseases include hemorrhagic colitis and hemolytic uremic syndrome. It is vital to know the features that make this strain pathogenic to understand the development of disease outbreaks. In the current study, a comparative genomic analysis was carried out to determine the presence of structural and functional features of O157:H7 strains obtained from 115 National Center for Biotechnology Information database. These strains of interest were analysed in the following programs: BLAST Ring Image Generator, PlasmidFinder, ResFinder, VirulenceFinder, IslandViewer 4 and PHASTER. Five strains (ECP19–198, ECP19–798, F7508, F8952, H2495) demonstrated a great homology with Sakai because of a few regions missing. Five resistant genes were identified, however, Macrolide-associated resistance gene mdf(A) was commonly found in all genomes. Majority of the strains (97%) were positive for 15 of the virulent genes (espA, espB, espF, espJ, gad, chuA, eae, iss, nleA, nleB, nleC, ompT, tccP, terC and tir). The plasmid analysis demonstrated that the IncF group was the most prevalent in the strains analysed. The prophage and genomic island analysis showed a distribution of bacteriophages and genomic islands respectively. The results indicated that structural and functional features of the many O157:H7 strains differ and may be a result of obtaining mobile genetic elements via horizontal gene transfer. Understanding the evolution of O157:H7 strains pathogenicity in terms of their structural and functional features will enable the development of detection and control of transmission strategies.
Regulatory effect of bacterial melanin on the isoforms of new superoxide-producing associates from rat tissues in rotenone-induced Parkinson’s disease
Authors: Danielyan Margarita , Nebogova Kristina , Simonyan Ruzan , Hovsepyan Anichka , Avetisyan Zubeida , Simonyan Karen , Simonyan Gegham , Khachatryan Vahagn , Karapetyan Kristine
Published: December 2023

According to recent research, selective neuronal vulnerability in Parkinson’s disease (PD) results from several phenotypic traits, including calcium-dependent, feed-forward control of mitochondrial respiration leading to elevated reactive oxygen species and cytosolic calcium concentration, an extensive axonal arbor, and a reactive neurotransmitter. Therefore, antioxidant therapy is a promising direction in the treatment of PD. In vitro studies have indicated the survival-promoting activity of bacterial melanin (BM) on midbrain dopaminergic neuron cultures. It has been established that BM has a number of protective and anti-inflammatory properties, so there is a high probability of a protective effect of BM in the early stages of PD. In this study, PD was induced through the unilateral intracerebral administration of rotenone followed by bacterial melanin. Tissues (brain, lungs, and small intestine) from the observed groups underwent isolation and purification to extract isoforms of new thermostable superoxide (О2−)-producing associates between NADPH-containing lipoprotein (NLP) and NADPH oxidase-Nox (NLP-Nox). The optical absorption spectral characteristics, specific amounts, stationary concentration of the produced О2−, and the content of NADPH in the observed associates were determined. The optical absorption spectra of the NLP-Nox isoforms in the visible and UV regions in the experimental groups did not differ from those of the control group. However, compared with the control group, the specific content of the total fractions of NLP-Nox isoforms associated with PD groups was higher, especially in the small intestine. These findings suggest that the described changes may represent a novel mechanism for rotenone-induced PD. Furthermore, bacterial melanin demonstrated antioxidant properties and regulated membrane formation in the brain, lung, and small intestine. This regulation occurred by inhibiting the release of new membrane-bound formations (NLP-Nox associates) from these membranes while simultaneously regulating the steady-state concentration of the formed О2−.
Comparative physiological and transcriptomic analysis of two salt-tolerant soybean germplasms response to low phosphorus stress: role of phosphorus uptake and antioxidant capacity
Authors: Zhou Xiu-Wen , Yao Xing-Dong , He De-Xin , Sun He-Xiang , Xie Fu-Ti
Published: December 2023

Background

Phosphorus (P) and salt stress are common abiotic stressors that limit crop growth and development, but the response mechanism of soybean to low phosphorus (LP) and salt (S) combined stress remains unclear.

Results

In this study, two soybean germplasms with similar salt tolerance but contrasting P-efficiency, A74 (salt-tolerant and P-efficient) and A6 (salt-tolerant and P-inefficient), were selected as materials. By combining physiochemical and transcriptional analysis, we aimed to elucidate the mechanism by which soybean maintains high P-efficiency under salt stress. In total, 14,075 differentially expressed genes were identified through pairwise comparison. PageMan analysis subsequently revealed several significantly enriched categories in the LP vs. control (CK) or low phosphorus + salt (LPS) vs. S comparative combination when compared to A6, in the case of A74. These categories included genes involved in mitochondrial electron transport, secondary metabolism, stress, misc, transcription factors and transport. Additionally, weighted correlation network analysis identified two modules that were highly correlated with acid phosphatase and antioxidant enzyme activity. Citrate synthase gene (CS), acyl-coenzyme A oxidase4 gene (ACX), cytokinin dehydrogenase 7 gene (CKXs), and two-component response regulator ARR2 gene (ARR2) were identified as the most central hub genes in these two modules.

Conclusion

In summary, we have pinpointed the gene categories responsible for the LP response variations between the two salt-tolerant germplasms, which are mainly related to antioxidant, and P uptake process. Further, the discovery of the hub genes layed the foundation for further exploration of the molecular mechanism of salt-tolerant and P-efficient in soybean.
A qualitative study of perspectives on the acceptability and feasibility of “virtual home visits” for asthma
Authors: Crocker Mary E. , Stout James W.
Published: December 2023

Background

Asthma home-visit programs delivered by community health workers (CHWs) are an effective way to improve asthma outcomes and cost of care, through performing home environmental inspections, delivering education and hands-on demonstrations, and providing personalized behavior change support. During the COVID-19 pandemic, many in-person asthma CHW programs have been adapted to be delivered virtually, but it is unclear whether this is acceptable or feasible for clients with asthma. This qualitative study sought to identify perspectives of prior clients of the Public Health–Seattle & King County Asthma Program on acceptability and feasibility of a hypothetical virtual asthma program.

Methods

We performed semi-structured interviews with participants speaking English, Spanish, and Somali. An a priori codebook was developed based on the Theoretical Framework of Acceptability and was revised iteratively during coding. Intra-rater reliability was established, and thematic analysis was used to determine major themes.

Results

A total of 19 individuals participated (9 speaking English, 8 Spanish, and 2 Somali). Krippendorf’s alpha was 0.848, indicating high intra-rater reliability. Our results demonstrated that many participants felt positively about the prospect of completing the program virtually, but they also expected a variety of challenges, the most important of which were lack of engagement with the CHW and lack of confidence in the accuracy of a virtual home inspection. Participants also varied widely in their comfort level with videoconferencing platforms and their access to adequate internet connectivity.

Conclusions

Acceptability and feasibility of virtual programming varies widely between participants, indicating that there may be no “one-size-fits-all” approach. We present several recommendations for adapting in-person asthma home visit programs to a virtual format, including considering a hybrid approach to delivery, making concerted efforts to build rapport when using videoconferencing, and deliberately evaluating the effectiveness of new adaptations, especially if a virtual environmental assessment is attempted.
Topical Chinese patent medicines for chronic musculoskeletal pain: systematic review and trial sequential analysis
Authors: Tang Kaiqiang , Sun Jigao , Dong Yawei , Zheng Zelu , Wang Rongtian , Lin Na , Chen Weiheng
Published: December 2023

Purpose

Chronic musculoskeletal pain (CMP) is defined as persistent or recurrent pain that occurs in the joints, musculo-soft tissue, spine or bones for more than three months and is not completely curable. Although topical Chinese patent medicine (CPM) is the most extensively utilized medication in Asia and is widely used for pain management, its efficacy remains controversial. This article presents a systematic review of clinical studies on the therapeutic properties of topical CPM for CMP patients to better inform clinical decision-making and provide additional and safer treatment options for patients with CMP.

Method

We performed a comprehensive search on PubMed, Cochrane Library, web of science and Chinese databases (CNKI and WanFang data) from 2010 to 2022. In all the studies, knee osteoarthritis, cervical spondylosis, low back pain, and periarthritis of shoulder met the International Pain Association definition of chronic musculoskeletal pain. We included only randomized controlled trials (RCTs) using topical CPM primarily for chronic musculoskeletal pain in adults. To determine the effect of topical CPM on clinical symptoms, we extracted the Visual Analog Scale (VAS, range 0–10) and the Western Ontario and McMaster Universities Arthritis Index pain scores (WOMAC pain, range 0–20), in which the lower the score, the better the results. We also accepted the comprehensive outcome criteria developed by the Chinese National Institute of Rheumatology as an endpoint (total effectiveness rate, range 0–100%, higher score = better outcome), which assesses the overall pain, physical function and wellness. Finally, trial sequential analysis of VAS pain score and total effectiveness rate was performed using TSA software.

Results

Twenty-six randomized controlled trials (n = 3180 participants) compared topical CPM with oral Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (n = 15), topical NSAIDs (n = 9), physiotherapy (n = 5), exercise therapy (n = 4), and intra-articular Sodium hyaluronate injection (n = 2). Sixteen studies found that topical CPM was statistically significant in improving CMP pain (measured by VAS pain and Womac pain scores)(p < 0.05), and 12 studies found topical CPMs to be more clinically effective (assessed by ≥ 30% reduction in symptom severity) in treating patients with CMP (p < 0.05). Trial sequential analysis indicates that the current available evidence is robust, and further studies cannot reverse this result. In most of the studies, randomisation, allocation concealment and blinding were not sufficiently described, and no placebo-controlled trials were identified.

Conclusion

Most studies showed superior analgesic effects of topical CPM over various control treatments, suggesting that topical CPM may be effective for CMP and is an additional, safe and reasonable treatment option. These reported benefits should be validated in higher-quality RCTs.
Pediatric Endocrinology Milestones 2.0—guide to their implementation
Authors: Tillotson Cara V. , Becetti Imen , Hwu Katherine , Page Laura , Krishnan Sowmya , Stafford Dianne , Stanley Takara , Vuguin Patricia , Barker Jennifer M.
Published: December 2023

The Milestones were initiated by the Accreditation Council for Graduate Medical Education (ACGME) to provide a framework for monitoring a trainee’s progression throughout residency/fellowship. The Milestones describe stepwise skill progression through six core domains of clinical competency: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-based Learning and Improvement, Professionalism, and Systems-based Practice. Since their introduction in 2013, several barriers to implementation have emerged. Thus, the ACGME launched the Milestones 2.0 project to develop updated specialty-specific milestones. The Pediatric Endocrinology Milestones 2.0 project aimed to improve upon Milestones 1.0 by addressing common limitations, providing resources for faculty to easily incorporate milestones into their assessment of trainees, and adding sub-competencies in health disparities, patient safety, and physician well-being.

This paper reviews the development of the Pediatric Endocrinology Milestones 2.0 including the major changes from Milestones 1.0, development of the Supplemental Guide, and how Milestones 2.0 can be applied at the program level. Although use of the Milestones are required only for ACGME programs, the tools provided in Milestones 2.0 are applicable to fellowship programs worldwide.
Effects of mind mapping based on standardized patient program in patient education among postgraduate nursing students in clinical setting
Authors: Wang Lianhong , Wang Yousha , Wang Xueting , Xue Caixiu
Published: December 2023

Background

Patient education as an important process of postgraduate nursing education, however in previous studies there was limited study focus on the improvement of nursing students’ patient education in clinical practice.This study examined the effects of a mind mapping based on standardized patient program in the patient education knowledge and communication competence of postgraduate nursing students in clinical setting.

Methods

The present quasi-experimental study was performed in 2022 on 74 postgraduate nursing students who had taken clinical practice courses at affiliated hospital of Zunyi Medical University. Students were underwent two weeks of mind mapping based on standardized patient program. The outcome measures were patient education knowledge and communication competence evaluated were by the self-designed questionnaire consisting of 6 questions based on the Likert scale and nurse-patient communication competency rating scale respectively, self-efficacy was evaluated by the general self-efficacy scale, and patients’ satisfaction were measured using a self-designed question. Data collection was conducted before and after intervention. Data analysis was performed using SPSS 19.0 software, and descriptive statistics and inferential statistics were performed.

Results

Significant improvements in patient education knowledge, patient education communication competence, and self-efficacy (all P = 0.000)were observed after intervention. Improvements were also seen in measures of patients’ satisfaction; 12/74 (16.22%) patients reported satisfied at baseline but only 53/74 (71.62%) at the end of intervention.

Conclusions

A web-based mind maps integrated with standardized patient program could improve patient education knowledge, communication competence,and self-efficacy of postgraduate nursing students in clinical setting.
Patient perspectives of diabetes care in primary care networks in Singapore: a mixed-methods study
Authors: Goh Lay Hoon , Szücs Anna , Siah Chiew Jiat Rosalind , Lazarus Monica A , Tai E Shyong , Valderas Jose M , Young Doris Yee Ling
Published: December 2023

Background

Type 2 diabetes (T2D) remains an important chronic condition worldwide requiring integrated patient-centred care as advocated by the Chronic Care Model (CCM). The Primary Care Networks (PCNs) in Singapore organise general practitioners (GPs) with nurses and care coordinators to deliver team-based care for patients with chronic conditions. This study examined the quality of care in the PCNs as defined by the CCM from the patients’ perspective.

Methods

This study followed a cross-sectional convergent mixed-method design with T2D patients across three PCN types (GP-led, Group, and Cluster). The Patient Assessment of Chronic Illness Care (PACIC, range 1-5) was completed by a convenience sample of 343 patients. Multivariate linear regression was performed to estimate the associations between patient and service characteristics and PACIC summary score. Twenty-four participants were purposively recruited for interviews on the experienced care until thematic saturation was reached. Quantitative and qualitative data were collected concurrently and independently. Integration occurred during study design and data analysis using the CCM as guidance. Quantitative and qualitative results were compared side-by-side in a joint comparison table to develop key concepts supported by themes, subthemes, and patients’ quotes.

Results

The PACIC mean summary score of 3.21 for 343 patients evidenced that some have received CCM consistent care in the PCNs. Being younger and spending more time with the GP were associated with higher PACIC summary scores. PACIC summary scores did not differ across PCN types. The 24 patients interviewed in the qualitative study reported receiving team-based care, nurse services, good continuity of care, as well as patient-centred care, convenient access, and affordable care. Key concepts showed that integrated care consistent with the CCM was sometimes received by patients in the PCNs. Patient activation, delivery system design/decision support, goal setting/tailoring, and problem-solving/contextual counselling were sometimes received by patients, while follow-up/coordination was generally not received.

Conclusions

Patients with T2D from the Singapore Primary Care Networks received integrated care consistent with the Chronic Care Model, particularly in patient activation, delivery system design/decision support, goal setting/tailoring, and problem-solving/contextual counselling. Follow-up/coordination needed improvement to ensure higher quality of diabetes care.
Identifying disease-related microbes based on multi-scale variational graph autoencoder embedding Wasserstein distance
Authors: Zhu Huan , Hao Hongxia , Yu Liang
Published: December 2023

Background

Enormous clinical and biomedical researches have demonstrated that microbes are crucial to human health. Identifying associations between microbes and diseases can not only reveal potential disease mechanisms, but also facilitate early diagnosis and promote precision medicine. Due to the data perturbation and unsatisfactory latent representation, there is a significant room for improvement.

Results

In this work, we proposed a novel framework, Multi-scale Variational Graph AutoEncoder embedding Wasserstein distance (MVGAEW) to predict disease-related microbes, which had the ability to resist data perturbation and effectively generate latent representations for both microbes and diseases from the perspective of distribution. First, we calculated multiple similarities and integrated them through similarity network confusion. Subsequently, we obtained node latent representations by improved variational graph autoencoder. Ultimately, XGBoost classifier was employed to predict potential disease-related microbes. We also introduced multi-order node embedding reconstruction to enhance the representation capacity. We also performed ablation studies to evaluate the contribution of each section of our model. Moreover, we conducted experiments on common drugs and case studies, including Alzheimer’s disease, Crohn’s disease, and colorectal neoplasms, to validate the effectiveness of our framework.

Conclusions

Significantly, our model exceeded other currently state-of-the-art methods, exhibiting a great improvement on the HMDAD database.
Retraction Note: Valproic acid attenuates intercellular adhesion molecule-1 and E-selectin through a chemokine ligand 5 dependent mechanism and subarachnoid hemorrhage induced vasospasm in a rat model
Authors: Chang Chih-Zen , Wu Shu-Chuan , Lin Chih-Lung , Kwan Aij-Lie
Published: December 2023

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12950-015-0074-3.
Clinical characteristics and prognosis of childhood-onset lupus mesenteric vasculitis as the initial presentation—a case–control study
Authors: Zhu Jia , Lai Jianming , Liu Xiaohui , Zhao Xue , Tao Ran , Kang Min , Huang Xiaolan , Wang Li , Wu Fengqi , Pan Xiaoping , Su Gaixiu
Published: December 2023

Background

Lupus mesenteric vasculitis (LMV) as initial presentation is rare, especially in childhood-onset systemic lupus erythematosus (cSLE). It is a critical complication of lupus. At present, the research on cSLE with LMV as the initial presentation is few. The aim of this study was to analyze the clinical characteristics and prognosis of cSLE with LMV in the Chinese population, compared with non-LMV cSLE.

Methods

A retrospective case-controlled study was conducted on 55 cSLE patients between July 2018 and July 2021. The clinical data, laboratory findings, imaging, treatment, and follow-up data were collected and compared between the two groups of cSLE with LMV and non-LMV. Non-LMV cSLE patients were matched according to the age and sex of LMV patients.

Results

A total of 11 cSLE patients with LMV as the LMV group and 44 cSLE patients without LMV as the non-LMV group were included. The average age of onset was 12.55 ± 1.57 years old, the male-to-female ratio was 2:9, and high disease activity was observed in the LMV group. Abdominal pain was most common in LMV. Compared with the non-LMV, the percentage of abdominal pain, vomiting, abdominal distension, and diarrhea was higher, and gastrointestinal tract, serous cavity, kidney, and lung damage were higher in the LMV group (P < 0.05). In abdominal-enhanced CT, the percentage of intestinal wall thickening, peritoneal effusion, mesenteric vascular enhancement, hydronephrosis with ureteral dilatation, intestinal congestion, and gastric mucosa thickening in the LMV group were higher than those in the non-LMV group (P < 0.05). The percentage of receiving methylprednisolone pulse combined with cyclophosphamide pulse therapy in LMV was higher than in non-LMV. The clinical symptoms disappeared quickly, and there were no deaths in the LMV group. Compared with the non-LMV group, the 24-h urinary protein was higher, the complement C3 was lower, and the disease activity was higher in the LMV group (P < 0.05).

Conclusions

LMV often occurs in 12 ~ 13-year-old girls with high disease activity of cSLE. Abdominal pain is the most common and more susceptible to damage to the kidney, serous cavity, and lung in cSLE with LMV. Methylprednisolone pulse combined with CTX pulse therapy is effective. After the treatment above, cSLE with LMV has a good prognosis, but the overall recovery is worse than non-LMV patients.
Recommended characteristics and processes for writing lay summaries of healthcare evidence: a co-created scoping review and consultation exercise
Authors: Zarshenas Sareh , Mosel JoAnne , Chui Adora , Seaton Samantha , Singh Hardeep , Moroz Sandra , Khan Tayaba , Logan Sherrie , Colquhoun Heather
Published: December 2023

Background

Lay summaries (LSs) of scientific evidence are critical to sharing research with non-specialist audiences. This scoping review with a consultation exercise aimed to (1) Describe features of the available LS resources; (2) Summarize recommended LS characteristics and content; (3) Outline recommended processes to write a LS; and (4) Obtain stakeholder perspectives on LS characteristics and writing processes.

Methods

This project was a patient and public partner (PPP)-initiated topic co-led by a PPP and a researcher. The team was supported by three additional PPPs and four researchers. A search of peer-reviewed (Ovid MEDLINE, Scopus, Embase, Cochrane libraries, CINAHL, PsycINFO, ERIC and PubMed data bases) and grey literature was conducted using the Joanna Briggs Institute Methodological Guidance for Scoping Reviews to include any resource that described LS characteristics and writing processes. Two reviewers screened and extracted all resources. Resource descriptions and characteristics were organized by frequency, and processes were inductively analyzed. Nine patient and public partners and researchers participated in three consultation exercise sessions to contextualize the review findings.

Results

Of the identified 80 resources, 99% described characteristics of a LS and 13% described processes for writing a LS. About half (51%) of the resources were published in the last two years. The most recommended characteristics were to avoid jargon (78%) and long or complex sentences (60%). The most frequently suggested LS content to include was study findings (79%). The key steps in writing a LS were doing pre-work, preparing for the target audience, writing, reviewing, finalizing, and disseminating knowledge. Consultation exercise participants prioritized some LS characteristics differently compared to the literature and found many characteristics oversimplistic. Consultation exercise participants generally supported the writing processes found in the literature but suggested some refinements.

Conclusions

Writing LSs is potentially a growing area, however, efforts are needed to enhance our understanding of important LS characteristics, create resources with and for PPPs, and develop optimal writing processes.
Extracting Bayesian networks from multiple copies of a quantum system
Authors: Micadei Kaonan , Landi Gabriel T. , Lutz Eric
Published: December 2023

Despite their theoretical importance, dynamic Bayesian networks associated with quantum processes are currently not accessible experimentally. We here describe a general scheme to determine the multi-time path probability of a Bayesian network based on local measurements on independent copies of a composite quantum system combined with postselection. We further show that this protocol corresponds to a nonprojective measurement. It thus allows the investigation of the multi-time properties of a given local observable while fully preserving all its quantum features.
Temporomandibular Disorders Treatments and Its Effects on Headaches
Authors: Streck Julia Niero Zanatta , Cruz Mateus Vinicius Barbosa , Candido Ana Claudia Rodrigues , Colonetti Tamy , Ceretta Renan
Published: December 2023

Objective: temporomandibular Disorders (TMD) are the most common causes of chronic orofacial pain and, along with primary headaches, are considered Chronic Overlapping Pain Conditions (COPCs). The aim of this study is to evaluate TMD treatment effects in individuals with comorbid headaches. Methods: a systematic review was conducted over a search in the database up to October 2020. Selected studies were randomized clinical trials with individuals diagnosed with TMD and comorbid headaches compared to a control group after treatments for TMD. All included studies were evaluated for their methodological quality through the Cochrane Collaboration tool for assessing the risk of bias. Results: seven studies fulfilled the inclusion criteria and were applied in the review, with a total of 432 participants. Four studies were included in a meta-analysis. There was no significative mean difference in the frequency of headache after TMD treatment, nor for a reduction in pain, after TMD intervention for less than 12 weeks. Although for an individual with a TMD intervention period higher than 12 weeks, there was a significant reduction in pain. Conclusion: there is moderate evidence that painful TMD therapies for 12 weeks or higher reduce headache intensity in individuals with painful TMD and headaches. Simultaneous management of TMD and headache must be prioritized for more effective results on both conditions.
ESTUDO DE CASO SOBRE O ECOSSISTEMA DE INOVAÇÃO DA REGIÃO DO ALTO PARAOPEBA/MG
Authors: Ribeiro Juliane de Almeida , Dias Iara Monteiro , Barros Francis Marcean Resende , Leite Gérber Lúcio
Published: December 2023

Objetivo: analisar o desenvolvimento, as limitações, os desafios e as oportunidades do ecossistema de inovação da região do Alto Paraopeba.
Método: foram realizadas entrevistas semiestruturadas com representantes das áreas universitárias, governamentais e empresariais dos atores que fazem parte do ecossistema de inovação regional. Os dados foram analisados por meio de análise de conteúdo.
Resultado: os resultados apresentam o grande potencial e impacto que o ecossistema tem para oferecer à região, mas, por ainda estar em fase de maturidade inicial, é necessário um melhor planejamento estratégico de ações que visem ao engajamento dos atores que o compõem.
Conclusão: a pesquisa recomenda estudos futuros a fim de mensurar os estágios de desenvolvimento do ecossistema nos próximos anos. Além disso, ela contribui com conhecimentos e olhares sobre o desafiador trabalho de integração e orquestração de atores em um ecossistema de inovação.
Association of high pre-pregnancy body mass index with adverse maternal and perinatal outcomes
Authors: Liaqat Nazia , Qudsia Qazi  , Fauzia Afridi  , Saima Khattak
Published: December 2023

Background & Objectives: Obesity is an epidemic of the 21st century with its rates doubling in both developed and developing countries. It raises concerns for both maternal and fetal well-being and needs altered care throughout pregnancy and in postnatal period. Raised BMI prior to conception is associated with adverse feto-maternal outcomes. Limited data is available about its association with adverse maternofetal outcome in this region of the world. Our objective was to find out association of high pre-pregnancy BMI with adverse maternal and perinatal outcomes.

Methods: This cohort study of 390 patients was conducted in Gynae department of Lady Reading Hospital Peshawar. Study duration was from June 2021 to March 2022. Patients enrolled in third trimester of gestation (≥ 37 weeks) were divided into two groups based on BMI i.e., Group-A with BMI <25 and Group-B with BMI ≥25. Both groups were followed until their delivery and discharge.

Results: The mean age of 390 women was 28.2 ± 4.8 years. There was statistically significant association between raised pre pregnancy BMI and maternal risks like postpartum hemorrhage (p-0.0001), genital tract (p-0.0002) and perineal trauma (p-0.04). Neonatal risks significantly associated with high pre-pregnancy BMI were macrosomia (p-0.0001), and one minute APGAR score of < 8/10(p- 0.01). Both groups had no statistically significant difference for different modes of delivery i.e normal vaginal/ instrumental delivery and cesarean section (P-value 0.9).

Conclusion: Maternal pre-conception BMI of ≥ 25 leads to poor maternal and perinatal outcomes.

doi: https://doi.org/10.12669/pjms.40.3.7317

How to cite this: Qazi Q, Liaqat N, Afridi F, Khattak S. Association of high pre-pregnancy body mass index with adverse maternal and perinatal outcomes. Pak J Med Sci. 2024;40(3):---------. doi: https://doi.org/10.12669/pjms.40.3.7317

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effect of diastolic dysfunction on outcomes of patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
Authors: Καμπακτσής Πολύδωρος
Published: December 2023

Υπόβαθρο και στόχοι: Προηγούμενες μελέτες έχουν δείξει πως η διαστολική δυσλειτουργία (DD) αριστερής κοιλίας μπορεί να σχετίζεται με χειρότερη έκβαση μετά από αντικατάσταση αορτικής βαλβίδας. Μελέτες σε διακαθετηριακή αντικατάσταση αορτικής βαλβίδας (TAVR) είναι περιορισμένες, δεν έχουν λάβει υπόψιν την επασβεστοποίηση μιτροειδούς δακτυλίου (MAC), η οποία περιορίζει τη χρήση Doppler στο μιτροειδή δακτύλιο και δεν έχουν λάβει υπόψιν την πνευμονική υπέρταση. Πραγματοιποιήσαμε μια μονοκεντρική μελέτη για να κατανοήσουμε καλύτερα το ρόλο της DD στην έκβαση ασθενών που υπόκεινται σε TAVR. Μεθοδολογία: Μετά το αποκλεισμό ασθενών με κολπική μαρμαρυγή, σημαντική στένωση μιτροειδούς και αντικατάσταση μιτροειδούς, 359 συνεχόμενοι ασθενείς που υποβλήθηκαν σε TAVR συμπεριλήφθησαν. Μετρίου-με-σοβαρού βαθμού MAC ήταν παρούσα σε 58% των ασθενών. Ταξινομήσαμε τους ασθενείς σε σοβαρού και μη σοβαρου βαθμού DD με βάση την διαστολική πίεση της αριστερής κοιλίας. Το πρωτογενές μέτρο έκβασης ήταν η ολική θνησιμότητα ή η επανεισαγωγή λόγω καρδιακής ανεπάρκειας. Πραγματοποιήσαμε δευτερογενής ανάλυση για να ερευνήσουμε το ρόλο της DD σε ασθενείς που αναπτύσσουν παραβαλβιδική διαφυγή (PVL). Αποτελέσματα: Σε μέσο χρόνο παρακολούθησης 13 μηνών, η σοβαρή DD σχετίστηκε με αυξημένο κίνδυνο του πρωτογενούς μέτρου έκβασης (HR 2.02 (1.23-3.30), p=0.005). Εντούτοις, η συσχέτιση αυτήν δεν διατηρήθηκε σε ανάλυση propensity score, η οποία έλαβε υπόψιν την πνευμονική υπέρταση. Σε πολυπαραγοντική ανάλυση, STS σκορ ήταν η μοναδική μεταβλητή που πρόβλεψε το πρωτογενές μέτρο έκβασης (HR 1.1 (1.05-1.15), p<0.001). Ασθενείς με σοβαρού βαθμού DD που ανέπτυξαν ακόμα και ήπια PVL μετά από TAVR είχαν αυξημένο και ανεξάρτητο κίνδυνο για αυξημένη θνησιμότητα (HR 3.89, CI 1.76–8.6, p=0.001). Συμπερασμα: Η σοβαρού βαθμού DD σχετίστηκε με αυξημένο κίνδυνο ολικής θνησιμότητας ή επανεισαγωγής για καρδιακή ανεπάρκεια, αλλά όχι ανεξάρτητα της πνευμονικής υπέρτασης ή άλλων προβλεπτικών παραγόντων. Η σοβαρή DD ειναι πιθανώς ιδιαίτερα βλαβερή σε ασθενείς που αναπτύσσουν PVL μέσω οξείας υπερφόρτωσης όγκου της αριστερής κοιλίας
Οι δημόσιες συμβάσεις έργων και υπηρεσιών στην Ελλάδα υπό το καθεστώς των οδηγιών 2004/17/ΕΚ και 2004/18/ΕΚ από την σκοπιά της κοινωνιολογίας του δικαίου και του δικαίου και οικονομικών
Authors: Παναγιωτίδου Ελισάβετ
Published: December 2023

Η παρούσα διατριβή παρουσιάζει το παλαιότερο και το νεότερο νομικό πλαίσιο των δημόσιων συμβάσεων μέσα από το πρίσμα του Δικαίου και Οικονομικών (ΔκΟ) και της Κοινωνιολογίας του Δικαίου. Η προσέγγιση αυτή έχει στόχο να καταδείξει την σημαντική θέση που κατέχουν οι δημόσιες συμβάσεις στην κάθε κοινωνία και πώς επηρεάζεται το επίπεδο διαβίωσης των πολιτών. Η οικονομική σημασία των δημόσιων συμβάσεων σε ευρωπαϊκό, αλλά και σε εθνικό επίπεδο είναι αδιαμφισβήτητη. Εξίσου όμως σημαντικό είναι και το κοινωνικό τους αποτύπωμα, το οποίο προσπάθησε να σκιαγραφήσει η διατριβή αυτή. Στο πρώτο κεφάλαιο παρουσιάζονται βασικοί όροι των δημόσιων συμβάσεων, οι διαδικασίες ανάθεσης και το νομικό πλαίσιο όπως έχει διαμορφωθεί μέχρι και σήμερα. Η εισαγωγή αυτή είναι απαραίτητη, προκειμένου να προχωρήσουμε στην οικονομική και κοινωνιολογική ανάλυση των δημόσιων συμβάσεων. Το δεύτερο κεφάλαιο αποτελεί την κοινωνιολογική ανάλυση των δημόσιων συμβάσεων. Στην ενότητα αυτή, παρουσιάζονται οι κοινωνιολογικοί δείκτες που σχετίζονται άμεσα με τη λειτουργία των δημόσιων συμβάσεων, όπως είναι η απασχόληση, η διαφάνεια και η προστασία του καταναλωτή. Επιπλέον, αναπτύσσονται θεωρίες δικαίου και κοινωνίας, ενώ ιδιαίτερη έμφαση δίνεται στην καινοτομία και σε νέες μορφές δημόσιων συμβάσεων, όπως είναι οι πράσινες δημόσιες συμβάσεις (ΠΔΣ). Στο τρίτο κεφάλαιο, οι δημόσιες συμβάσεις προσεγγίζονται από την πλευρά της οικονομικής ανάλυσης του δικαίου. Στο σημείο αυτό, εξειδικεύεται ο αμιγώς οικονομικός χαρακτήρας της κάθε δημόσιας σύμβασης, τον οποίο συναντούμε σε όλα τα στάδια ανάθεσης. Παρουσιάζεται η πιο ειδική περίπτωση δημόσιων συμβάσεων, οι Συμπράξεις Δημόσιου και Ιδιωτικού Τομέα (ΣΔΙΤ), όπως και το φαινόμενο της διαφθοράς, που ταλανίζει την ελληνική κοινωνία, αναπόσπαστο μέρος της οποίας αποτελούν οι δημόσιες συμβάσεις. Στο τελικό τμήμα της διατριβής, παρουσιάζονται τα συμπεράσματα για την υφιστάμενη κατάσταση στις δημόσιες συμβάσεις στην Ελλάδα σε σχέση με τις άλλες χώρες της Ευρωπαϊκής Ένωσης. Στη συνέχεια, γίνονται προτάσεις ενδυνάμωσης της αποτελεσματικότητας των δημόσιων συμβάσεων, οι οποίες μπορούν να αξιοποιηθούν, εφόσον αποδεχθούμε τις δημόσιες συμβάσεις ως ένα ζωντανό, αλληλεπιδρόν κομμάτι της κοινωνίας μας.
Reflections on the ethical challenges of individual psychological intervention
Authors: Paluchowski Władysław Jacek
Published: December 2023

Tekst przedstawia refleksje na temat pomagania w psychologii oraz wybranych dylematów etycznych, które mu towarzyszą: paternalizmu i dyrektywności. Interwencje psychologiczne opierają się na jawnej zgodzie na naruszanie praw jednostki, co jest konsekwencją asymetrii położenia oraz kompetencji i odpowiedzialności uczestników. Relacja pomagania jest zbudowana na osobistym zaufaniu i praktyce opartej na wynikach badań empirycznych. Zmiany w rozumieniu relacji pomiędzy pomagającym a klientem/pacjentem skutkują m. in. stworzeniem lepszego modelu komunikacji. Pułapką i zagrożeniem dla interwencji psychologicznej jest wątpliwość, czyja definicja dobra zostanie przyjęta jako kryterium jego oceny. Dialogowanie na temat rozwiązania problemu klienta/pacjenta wydaje się najlepszym i bezpiecznym antidotum na potencjalne zagrożenie.
EXAMINATION OF ETHICAL AND PROFESSIONAL CONDUCT OF LEBANESE EXTERNAL AUDITORS
Authors: Abrach Dalia , Feghali Khalil
Published: December 2023

This article proposes to analyze the ethical reasoning of Lebanese external auditors with regard to the extent of their compliance with the code of professional conduct. As part of a positivist epistemological format, a quantitative methodology was employed. The data were collected using semi-directive survey that was sent to 250 Lebanese external auditors. The final sample consisted of 207 Lebanese external auditors for which we used correlation and logistic regression. The results reveal that because of an economic dependance on their clients, Lebanese external auditors demonstrate an inability to remain independent. This limits compliance with the code of professional conduct and thus negatively affects the quality of audit work. This study adds to the sparse literature found in developing countries that highlight the behavior of Lebanese external auditors with respect to professional conduct, which has always been considered sensitive and complex.
BEHAVIORAL BIASES AND PORTFOLIO STRATEGIES: ANALYZING THE IMPACT ON INVESTOR DECISION MAKING IN THE NEPALESE STOCK MARKET
Authors: Nepal Bidush , Gyawali Mira
Published: December 2023

Our paper explored the impact of demographic variables on the manifestation of behavioral biases among Nepalese portfolio investors as they make investment decisions. Our research analyzed the relationship between age, gender, and experience, and five common biases such as overconfidence, anchoring, herding, loss aversion, and hindsight. Our survey of 132 investors revealed that demographic factors play a role in the presence of these biases, with female investors exhibiting higher overconfidence and anchoring biases, while male investors displayed loss aversion, herding, and hindsight biases. Younger investors were found to be more overconfident and prone to loss aversion, whereas more experienced investor demonstrated greater overconfidence in their analysis skills. This paper provides crucial insight into the importance of considering demographic factors in addressing investment decision-making biases. It’s worth noting that the responses and sample location may not be fully representative.
A REVIEW OF STOCK MARKET IMPACT OF ENVIRONMENTAL CATACLYSMS AND LESSONS FOR INVESTORS
Authors: Ngwakwe Collins C
Published: December 2023

The objective of this paper is to present a review analysis of stock market impact of environmental disaster with the factors that orchestrate the impact, and to offer a novel framework for investors and managers. The paper applied an in-depth empirical review and synthesis method. Findings from the review and synthesis of empirical literature provide strong evidence that environmental disasters have diverse effects on the stock markets with majority of the literature reporting adverse effects on the stock markets. Additionally, findings are more preponderant on short run impact than on long run effects. Findings also show that environmental disasters may offer unique arbitrage opportunities for short-selling investors. The paper concludes by highlighting the capacity of environmental finance as one of the catalysts to bolster corporate adaptive capacity to environmental disaster. Furthermore, the degree of environmental disaster impact on stock market may depend on factors such as the type of environmental disaster, geographical location of environmental disaster, economic sector, stage of economic development, length of disaster and intensity of disaster. Accordingly, the paper develops a framework, which is recommended as a model for further research agenda on environmental disaster effect on stock markets.