bluuebunny/crossref_metadata_2025 huggingface dataset:
Achievement motivation in civics courses at vocational grammar schools
Authors: Weisseno Georg , Grobshäuser Natalie
Published: April 2023

This article examines achievement motivation in connection with the political knowledge of upper secondary level pupils at german vocational grammar schools. The influence of achievement motivation in civic courses has been scarcely researched so far. In the expectancy-value model, expectations of success are important determinants of action in relation to academic achievements. Pupils’ expectations of success or failure in civics courses have a behaviour-regulating function. They influence pupils’ behaviour when learning about politics. In the cross-sectional survey of 470 pupils, results show lasting effects from an approach motivation (“hope of success”) and an avoidance motivation (“fear of failure”) studied. The data of this study confirmed the influence of achievement motivation in civics courses on the school-related political knowledge. While cultural capital makes no significant difference in the extent of the motivational constructs, a migrant background showed moderate but inconsistent effects and gender had clear negative effects for the girls. In this study, it was shown that based on the theoretical foundation described, the theory of domain-specific competency can be combined with the achievement motivation in Civics.
Clinical Study of a Physician Modified Y-Type Iliac Branch Device (PMYIBD) in the Endovascular Repair of Abdominal Aortic Aneurysms to Preserve the Internal Iliac Artery
Authors: Zhao Zihe , Jin Yi , Fu Dongsheng , Liu Chen , Qiao Tong , Li Xiaoqiang , Gao Xia , Liu Zhao
Published: April 2023

Objectives:

To report the method and curative effect of using a physician modified Y-type iliac branch device (PMYIBD) to preserve the internal iliac artery during the endovascular repair of abdominal aortic aneurysms.

Methods:

From September 2018 to April 2022, 24 patients with abdominal aortic aneurysms or dissecting aneurysms, including 19 true aneurysms and 5 dissecting aneurysms involving the common iliac artery were treated in our department. The average age was (65.3 ± 7.6) years. All patients underwent preoperative evaluation by enhanced computed tomography. Combined with intraoperative angiography, a Y-type stent graft was prepared during surgery to perform endovascular repair of abdominal aortic aneurysms.

Results:

All operations were successfully completed. The average operative duration was (224.8 ± 44.1) minutes. A total of 24 internal iliac arteries were reconstructed. The average follow-up time was (27.1 ± 13.5) months. During the follow-up, there was no expansion of aneurysm cavity, no endoleak or stent displacement, and no death occurred in all patients.

Discussion:

The physician-modified Y-type iliac branched device (PMYIBD) provides an effective method for full-cavity repair. It has a wide range of indications and convenience. According to follow-up results, the early and mid-term had good curative effects; however, the long-term effects require further follow-up.

Conclusion:

The modified Y-type IBD technique is safe and effective for aortic diseases involving internal iliac artery especially with complex anatomy.

Clinical Impact

It is meaningful to preserve the IIA during EVAR. The use of PMYIBD provides a simple and effective method for the total endovascular repair of aortic diseases involving the IIA. Several advantages such as minimal trauma, low mortality, low complication rates and perfect short- and medium-term effects emerge in clinical practice. PMYIBDs are good choices for clinicians before suitable commercial stents are available in markets.
A Review of Hedgehog Signaling in Radioresistant Esophageal Cancer: Potential Treatment Target
Authors: Ma Li , Wang Yu , Chen Peng , Wu Shixiu
Published: April 2023

Esophageal cancer is one of the most lethal malignancies worldwide. For locally advanced diseases, radiotherapy is the main treatment. The survival rates, however, are still appalling, which is partially due to radioresistance. In 6% of cases of esophageal cancer, the Hedgehog pathway is reactivated, and this pathway is crucial for the growth, progression, treatment resistance, and metastasis of esophageal cancer. Here, we conducted a comprehensive review of the current research on Hedgehog pathway in esophageal cancer.
Effect of coronaviruses on blood vessel permeability: potential therapeutic targets
Authors: Machado Nicolle R. , Dias Karina T. , Cortes Bryan F.S. , Rodrigues Stephen F.
Published: April 2023

Coronavirus-induced diseases have afflicted humanity for several decades. This scenario was aggravated by the emergence of the coronavirus disease 2019 (named COVID-19) in Wuhan, China, in December 2019. Since then, COVID-19 has killed millions of people worldwide, probably the most devastating pandemic since HIV/AIDS. This review aimed to bring together important updated aspects related to coronavirus-induced diseases and the enhanced vascular permeability observed mainly in the lungs of affected people. The dysregulated vascular permeability in the lungs is of fundamental importance for coronaviruses-caused morbidity and mortality. Thus, as described in this review, it is a target of new and old drugs.
Predictive privacy: Collective data protection in the context of artificial intelligence and big data
Authors: Mühlhoff Rainer
Published: April 2023

Big data and artificial intelligence pose a new challenge for data protection as these techniques allow predictions to be made about third parties based on the anonymous data of many people. Examples of predicted information include purchasing power, gender, age, health, sexual orientation, ethnicity, etc. The basis for such applications of “predictive analytics” is the comparison between behavioral data (e.g. usage, tracking, or activity data) of the individual in question and the potentially anonymously processed data of many others using machine learning models or simpler statistical methods. The article starts by noting that predictive analytics has a significant potential to be abused, which manifests itself in the form of social inequality, discrimination, and exclusion. These potentials are not regulated by current data protection law in the EU; indeed, the use of anonymized mass data takes place in a largely unregulated space. Under the term “predictive privacy,” a data protection approach is presented that counters the risks of abuse of predictive analytics. A person's predictive privacy is violated when personal information about them is predicted without their knowledge and against their will based on the data of many other people. Predictive privacy is then formulated as a protected good and improvements to data protection with regard to the regulation of predictive analytics are proposed. Finally, the article points out that the goal of data protection in the context of predictive analytics is the regulation of “prediction power,” which is a new manifestation of informational power asymmetry between platform companies and society.
Hands-On(ly) Vlogging: How Turkish Muslim Women Perform “Modesty” and “Piety” in Self-Branding on Their YouTube Cooking Channels
Authors: Bagdogan Seyda
Published: April 2023

Studies examining the self-branding efforts of women producers of online content have proliferated in recent years. Typically focused on the production of content by young, white, and highly educated middle-class women in the West, such scholarship has predominantly conceptualized women’s online self-branding as a function of neo-liberal and postfeminist values centered around notions of “commodified femininity” and “mediated intimacy” along with consumerism and individualism. In contrast, this article examines the sociocultural values underlying the self-branding practices of Turkish Muslim “housewives” from relatively underprivileged backgrounds who have recorded, performed, and monetized their cooking skills and arguably their values on YouTube. Drawing on in-depth interviews with 12 leading Turkish women vloggers, combined with digital ethnographic research into their online profiles and content, my analysis reveals the importance for these vloggers of ensuring their online performances and personae comply with and embody the Islamic values of feminine piety and modesty. By highlighting the importance of social positionality in research on gendered self-branding, my findings problematize dominant conceptualizations of women’s online self-branding as a postfeminist undertaking. In reality, Islamic values are active online, embodied by Turkish Muslim women cooking on YouTube in a way that is empowering for them but also under negotiation through the participatory culture of the Internet.
The Participation Experiences of Chinese Teacher Trainees and Their Finnish Teacher Trainer on an In-Service Teacher Training Program Exported From Finland to China
Authors: Peng (彭素豪) Suhao , Kantelinen Ritva , Räihä Pekka
Published: April 2023

Purpose

This paper aims to examine the participation experiences of a sample of Chinese teacher trainees and their Finnish teacher trainer on an in-service teacher training program exported from Finland to Beijing, China.

Design/Approach/Methods

Six science teachers from Beijing and their Finnish teacher trainer participated in semi-structured interviews. From the ideological perspective of international education, a total of eight semi-structured interviews were analyzed through qualitative content analysis.

Findings

The results show that all interviewees were highly motivated to learn from the Other's education system and culture. Some participants benefited from a broader understanding of the Self's and the Other's education systems, while others did not. The interviewees also described some participation challenges, such as language barriers and practices that adapted learner-centered teaching approaches in Beijing schools. Furthermore, the interviewees mentioned future expectations of more in-depth communication between Finland and China.

Originality/Value

Some recommendations for better training outcomes, improving the quality of participation experiences, and reaching more mutual understandings were discussed at the end of this study.
Depoliticising democracy through discourse: Reading Russia’s descent into autocracy and war with Jacques Rancière’s political theory
Authors: Hjermann Anni Roth
Published: April 2023

This article investigates the role of discourses in processes of deepening authoritarianism and war. By bringing Jacques Rancière’s works on politics and depoliticisation into dialogue with poststructuralist discourse analysis, the article argues that discursive depoliticisation contributes towards authoritarian consolidation and shows how authoritarianism deepens in a co-dependent nexus of domestic and international politics. Focusing in particular on Rancière’s concept of gaps, the article argues that the core mechanism of depoliticisation is to neutralise the gap constitutive of politics proper and that this neutralisation unfolds in discourse, through the logics of archipolitics, parapolitics, metapolitics and ultrapolitics. The article (1) develops a framework for unpacking discursive depoliticisation empirically by conceptualising Rancière’s logics as ideal-typical depoliticising discourses and (2) applies that framework in an analysis of Russian official discourse in recent years (2015–2023). The article thereby explains how discursive constructions have strengthened Russian autocracy: entrenched depoliticising discourses, produced and reinforced in a co-constitutive internal/external sphere, made possible authoritarian consolidation in Russia under Putin and its war on Ukraine. The article puts forward the concept of discursive depoliticisation as a novel perspective on ‘hybrid’ and authoritarian regimes, as well as Russia’s intensified war on Ukraine and full-on autocracy from 2022 onwards.
Militarized urbanism in the cold war era: The resettlement of the refugees in Khan Younis
Authors: Abreek-Zubiedat Fatina
Published: April 2023

The resettlement of Palestinian refugees is often studied through two distinct approaches: the first uses settler colonialism as an analytical framework to explore structural violence and Indigenous transfer, expressed through counterinsurgency and urbicide; the second investigates practices of care and governance and their representations within a universalized discourse of humanitarianism. This article introduces a new approach, exploring historical (post)colonial architectural narratives—rooted in international discourses of humanitarian relief and development aid—to interrogate the complex settler-colonial conditions and practices of Israel’s resettlement of refugees. Such narratives emphasis the materialization of resettlement, in which structural violence is culturally co-produced. The article focuses on the Khan Younis refugee resettlement project in the Gaza Strip (1983-1993), drawing on archival materials and in-depth interviews to offering ‘militarized urbanism’ as a novel description of the violence of resettlement. Situated at the junction between military technologies and cultural practices, ‘militarized urbanism’ represents the transformation of the geopolitics of colonial warfare to the colonization of the everyday, where urban and architectural knowledge are reshaped by security logics in the mediation of conflicting civilian and political agendas.
The cost of coordination can exceed the benefit of collaboration in performing complex tasks
Authors: Straub Vincent J , Tsvetkova Milena , Yasseri Taha
Published: April 2023

Humans and other intelligent agents often rely on collective decision making based on an intuition that groups outperform individuals. However, at present, we lack a complete theoretical understanding of when groups perform better. Here, we examine performance in collective decision making in the context of a real-world citizen science task environment in which individuals with manipulated differences in task-relevant training collaborated. We find 1) dyads gradually improve in performance but do not experience a collective benefit compared to individuals in most situations; 2) the cost of coordination to efficiency and speed that results when switching to a dyadic context after training individually is consistently larger than the leverage of having a partner, even if they are expertly trained in that task; and 3) on the most complex tasks having an additional expert in the dyad who is adequately trained improves accuracy. These findings highlight that the extent of training received by an individual, the complexity of the task at hand, and the desired performance indicator are all critical factors that need to be accounted for when weighing up the benefits of collective decision making.
Ecosystem services research: From golden era to next crossing
Authors: Peng Jian , Xia Pei , Liu Yanxu , Xu Zihan , Zheng Huining , Lan Tianhan , Yu Shuying
Published: April 2023

Ecosystem services has been widely explored in various theoretical or practical studies since its emergence more than 20 years ago. The two big issues in the past golden era of ecosystem services research were: ecosystem services valuing and ecosystem services trade-offs. We analyzed advantages of ecosystem services in promoting the attention that government and the public pay to the natural capital and the management of ecosystem services, together with summarizing the shortcomings. It was found that ecosystem services valuing made the public aware of the importance of natural capital from an economic perspective, while ecosystem services trade-offs highlighted the relationship between various ecosystem services from an ecological perspective, which could be better applied to ecosystem services-based ecosystem management. With an increasing number of papers focusing on ecosystem services flows, it is believed that ecosystem services flows integrating ecology, economy, sociology and geography disciplines will become a new key direction after ecosystem services valuing and trade-offs. To further promote the study of ecosystem services flows that link human and nature within geographical context, we need to focus on the value of ecosystem services flows with payment and benefit accounting, the relationship of ecosystem services flows by trade-off and synergy analysis, and the direction of ecosystem services flows by spatial and temporal assessment. In addition, a more efficient and widely recognized method is also essential for the development of quantifying ecosystem services flow. This study contributes to understanding the development stage of ecosystem services research and highlights the importance of ecosystem services flow research.
Excitatory and inhibitory neuronal signaling in inflammatory and diabetic neuropathic pain
Authors: Breitinger Ulrike , Breitinger Hans-Georg
Published: April 2023

Pain, although unpleasant, is an essential warning mechanism against injury and damage of the organism. An intricate network of specialised sensors and transmission systems contributes to reception, transmission and central sensitization of pain. Here, we briefly introduce some of the main aspects of pain signal transmission, including nociceptors and nociceptive signals, mechanisms of inflammatory and neuropathic pain, and the situation of diabetes-associated neuropathic pain. The role of glia—astrocytes, microglia, satellite glia cells—and their specific channels, transporters and signaling pathways is described. A focus is on the contribution of inhibitory synaptic signaling to nociception and a possible role of glycine receptors in glucose-mediated analgesia and treatment-induced diabetic neuropathy. Inhibitory receptors such as GABAA- and glycine receptors are important contributors to nociceptive signaling; their contribution to altered pain sensation in diabetes may be of clinical relevance, and they could be promising therapeutic targets towards the development of novel analgesics.
Study of the Judder Characteristics of Friction Material for an Automobile Clutch and Test Verification
Authors: Yan Zhengfeng , Li Hangsheng , Lei Hairui , Xie Maoqing , Wang Leigang
Published: April 2023

The friction judder characteristics during clutch engagement have a significant influence on the NVH of a driveline. In this research, the judder characteristics of automobile clutch friction materials and experimental verification are studied. First, considering the stick-slip phenomenon in the clutch engagement process, a detailed 9-degrees-of-freedom (DOF) model including the body, each cylinder of the engine, clutch and friction lining, torsional damper, transmission and other driveline parts is established, and the calculation formula of friction torque in the clutch engagement process is determined. Second, the influence of the friction gradient characteristics on the amplification or attenuation of the automobile friction judder is analyzed, and the corresponding stability analysis and the numerical simulation of different friction gradient values are carried out with MATLAB/Simulink software. Finally, judder bench test equipment and a corresponding damping test program are developed, and the relationship between the friction coefficient gradient characteristics and the system damping is analyzed. After a large number of tests, the evaluation basis of the test is determined. The research results show that the friction lining with negative gradient characteristics of the friction coefficient will have a judder signal. When the friction gradient value is less than −0.005 s/m, the judder signal of the measured clutch cannot be completely attenuated, and the judder phenomenon occurs. When the friction gradient is greater than − 0.005 s/m, the judder signal can be significantly suppressed and the system connection tends to be stable.
Spontaneous hemoperitoneum in the second and third trimester of pregnancy: two uncommon case reports at Tu Du Hospital, in Vietnam and a literature review
Authors: Vuong Anh Dinh Bao , Pham Thanh Hai , Nguyen Xuan Trang , Trinh Ngoc Bich , Nguyen Phuc Nhon , Ho Quang Nhat
Published: April 2023

Background

Spontaneous hemoperitoneum in pregnancy (SHiP) refers to fluid collection in the abdominal cavity with a vague presentation of clinical symptoms. Particularly, SHiP causes a life-threatening condition with the coexistence of intrauterine pregnancy, since this dangerous complication significantly increases the maternal and fetal mortality. Herein, we present two cases of nontraumatic SHiP in the second and third trimester of pregnancy, respectively.

Case presentation

The pregnant woman in case 1 was admitted to our hospital owing to severe paroxysmal shoulder pain along with abdominal pain. Her medical history was remarkably recorded with endometriosis and adenomyosis. At the emergency room, an ultrasound scan revealed a live fetus corresponding to 21 weeks and 3 days and free fluid in the abdominal cavity. She was subsequently diagnosed with SHiP and underwent immediate laparotomy for hemostatic procedures. During the postpartum course, the patient was uneventfully monitored. Unfortunately, the patient delivered on the 4th postoperative day in spite of the initial administration of tocolytic agents and close monitoring. The primigravid woman in case 2 complained of lower abdominal pain and vaginal bleeding. The patient’s history was noted with ovarian tumor removal. At admission, the sonography scan revealed free fluid in the abdominal cavity, a fetus at 34 weeks and 3 days gestational age with bradycardia of 70 bpm, and a laboratory test showed a low hemoglobin level. Thus, exploratory laparotomy and hysterotomy were performed at the same time due to fetal distress. The postpartum course was uneventful. The patient was discharged 5 days later.

Conclusions

In pregnant women with a history of endometriosis, adenomyosis, or ovarian tumor removal, acute abdominal pain combined with the presence of free fluid collection in the intraperitoneal cavity, and a decreased hemoglobin levels should be first assessed as SHiP originating from the spontaneous rupture of abnormal vascular proliferation. Proper management is strongly indicated for an emergent laparotomy to control the active bleeding point, thus increasing the survival rate for both mother and neonate.
Classification of suicidal behavior calls in emergency medical services: a systematic review
Authors: Ramos-Martín Javier , Contreras-Peñalver M. Ángeles , Moreno-Küstner Berta
Published: April 2023

Background

The aim of this systematic review was to examine the classification of calls for suicidal behavior in emergency medical services (EMS).

Methods

A search strategy was carried out in four electronic databases on calls for suicidal behavior in EMS published between 2010 and 2020 in Spanish and English. The outcome variables analyzed were the moment of call classification, the professional assigning the classification, the type of classification, and the suicide codes.

Results

Twenty-five studies were included in the systematic review. The EMS classified the calls at two moments during the service process. In 28% of the studies, classification was performed during the emergency telephone call and in 36% when the professional attended the patient at the scene. The calls were classified by physicians in 40% of the studies and by the telephone operator answering the call in 32% of the studies. In 52% of the studies, classifications were used to categorize the calls, while in 48%, this information was not provided. Eighteen studies (72%) described codes used to classify suicidal behavior calls: a) codes for suicidal behavior and self-injury, and b) codes related to intoxication, poisoning or drug abuse, psychiatric problems, or other methods of harm.

Conclusion

Despite the existence of international disease classifications and standardized suicide identification systems and codes in EMS, there is no consensus on their use, making it difficult to correctly identify calls for suicidal behavior.
Application of sequence semantic and integrated cellular geography approach to study alternative biogenesis of exonic circular RNA
Authors: Kumar Rajnish , Mondal Rajkrishna , Lahiri Tapobrata , Pal Manoj Kumar
Published: April 2023

Background

Concurrent existence of lncRNA and circular RNA at both nucleus and cytosol within a cell at different proportions is well reported. Previous studies showed that circular RNAs are synthesized in nucleus followed by transportation across the nuclear membrane and the export is primarily defined by their length. lncRNAs primarily originated through inefficient splicing and seem to use NXF1 for cytoplasm export. However, it is not clear whether circularization of lncRNA happens only in nucleus or it also occurs in cytoplasm. Studies indicate that circular RNAs arise when the splicing apparatus undergoes a phenomenon of back splicing. Minor spliceosome (U12 type) mediated splicing occurs in cytoplasm and is responsible for the splicing of 0.5% of introns of human cells. Therefore, possibility of cRNA biogenesis mediated by minor spliceosome at cytoplasm cannot be ruled out. Secondly, information on genes transcribing both circular and lncRNAs along with total number of RBP binding sites for both of these RNA types is extractable from databases. This study showed how these apparently unconnected pieces of reports could be put together to build a model for exploring biogenesis of circular RNA.

Results

As a result of this study, a model was built under the premises that, sequences with special semantics were molecular precursors in biogenesis of circular RNA which occurred through catalytic role of some specific RBPs. The model outcome was further strengthened by fulfillment of three logical lemmas which were extracted and assimilated in this work using a novel data analytic approach, Integrated Cellular Geography. Result of the study was found to be in well agreement with proposed model. Furthermore this study also indicated that biogenesis of circular RNA was a post-transcriptional event.

Conclusions

Overall, this study provides a novel systems biology based model under the paradigm of Integrated Cellular Geography which can assimilate independently performed experimental results and data published by global researchers on RNA biology to provide important information on biogenesis of circular RNAs considering lncRNAs as precursor molecule. This study also suggests the possible RBP-mediated circularization of RNA in the cytoplasm through back-splicing using minor spliceosome.
Spatial characteristics of nutrient allocation for Picea crassifolia in soil and plants on the eastern margin of the Qinghai-Tibet Plateau
Authors: Wu Jingjing , Jiao Liang , Qin Huijun , Che Xichen , Zhu Xuli
Published: April 2023

Background

Understanding the stoichiometric characteristics and nutrient allocation strategies of dominant tree species in montane forest systems can provide a basis for decision-making in relation to montane system management. Therefore, according to precipitation and temperature gradients, we selected three typical areas in the Qilian Mountains on the eastern margin of the Qinghai-Tibet Plateau to analyse the spatial relations of plant-soil stoichiometric characteristics and nutrient allocation strategies of plant tissues for Qinghai spruce (Picea crassifolia) along different environmental gradients.

Results

1) The plant and soil stoichiometric characteristics had similar spatial patterns. The C content of plants and soils tended to decrease with increasing latitude, and the N and P contents and the N:P ratio tended to increase with increasing latitude. 2) The stoichiometric characteristics of the plant tissues also interacted with each other and showed synergistic trade-offs. Nutrient allocation in the eastern section of the Qilian Mountains was similar to that in the western section, while more N and P in the plant stems were allocated to maintain plant growth in the relatively arid western Sect. 3) The nutrient allocation strategies in the plant tissues were mainly regulated by soil and climate.

Conclusions

Information on plant-soil stoichiometric characteristics along different gradients can help us better understand the nutrient patterns and dynamics of forest ecosystems under arid and semiarid conditions at a wide geographic scale from the perspective of plant nutrient partitioning.
Adherence to a lifestyle monitoring system in patients with heart disease: protocol for the care-on prospective observational trial
Authors: Goevaerts W. F. , Tenbült - van Limpt N. C. C. W. , Kop W. J. , Birk M. V. , Liu Y. , Brouwers R. W. M. , Lu Y. , Kemps H. M. C.
Published: April 2023

Background

Lifestyle factors such as physical fitness, dietary habits, mental stress, and sleep quality, are strong predictors of the occurrence, clinical course, and overall treatment outcomes of common cardiovascular diseases. However, these lifestyle factors are rarely monitored, nor used in daily clinical practice and personalized cardiac care. Moreover, non-adherence to long-term self-reporting of these lifestyle factors is common. In the present study, we evaluate adherence to a continuous unobtrusive and patient-friendly lifestyle monitoring system using evidence-based assessment tools.

Methods

In a prospective observational trial (N = 100), the project investigates usability of and adherence to a monitoring system for multiple lifestyle factors relevant to cardiovascular disease, i.e., daily physical activity levels, dietary habits, mental stress, smoking, and sleep quality. Patients with coronary artery disease, valvular disease and arrhythmias undergoing an elective intervention are asked to participate. The monitoring system consists of a secured online platform with a custom-built conversational interface—a chatbot—and a wrist-worn wearable medical device. The wrist-worn device collects continuous objective data on physical activity and the chatbot is used to collect self-report data. Participants collect self-reported lifestyle data via the chatbot for a maximum of 4 days every other week; in the same week physiological data are collected for 7 days for 24 h. Data collection starts one week before the intervention and continues until 1-year after discharge. Via a dashboard, patients can observe their lifestyle measures and adherence to self-reporting, set and track personal goals, and share their lifestyle data with practitioners and relatives. The primary outcome of the trial is adherence to using the integrated platform for self-tracking data. The secondary outcomes include system usability, determinants of adherence and the relation between baseline lifestyle behaviour and long-term patient-relevant outcomes.

Discussion

Systematic monitoring during daily life is essential to gain insights into patients’ lifestyle behaviour. In this context, adherence to monitoring systems is critical for cardiologists and other care providers to monitor recovery after a cardiac intervention and to detect clinical deterioration. With this project, we will evaluate patients’ adherence to lifestyle monitoring technology. This work contributes to the understanding of patient-centered data collection and interpretation, to enable personalized care after cardiac interventions in order to ultimately improve patient-relevant outcomes and reduce health care costs.

Trial registration

Netherlands Trial Registry (NTR) NL9861. Registered 6th of November 2021.
Bidirectional screening and testing for TB and COVID-19 among outpatient department attendees: outcome of an initial intervention in Ghana
Authors: Adusi-Poku Yaw , Wagaw Zeleke Alebachew , Frimpong-Mansoh Rita Patricia , Asamoah Isaac Opoku , Sorvor Felix , Afutu Felix Kwami , Sarpong Charity , Amoussou-Gohoungo Luiz Octaviano , Abdulai Farida Ngelba , Ahmedov Sevim
Published: April 2023

Background

Tuberculosis (TB) remains a major public health threat in Ghana. The impact of COVID-19 resulted in a 15% decline of TB case notification in 2020 compared to 2019. To mitigate the impact on TB services, the Ghana National Tuberculosis Programme (NTP) introduced the bidirectional screening and testing for TB and COVID-19 in 2021.

Objective

To evaluate the yield of bidirectional screening and testing for TB and COVID-19 among facility attendees in the Greater Accra region.

Method

We used secondary data obtained from the initial implementation stage of the bidirectional testing for TB and COVID-19 among COVID-19 and/or TB presumed cases in five health facilities in the Greater Accra Region from January to March 2021. To mitigate the impact of COVID-19 on TB services and accelerate TB case detection, the NTP of Ghana introduced bidirectional screening and testing for TB and COVID-19 in Greater Accra Region before scaling up at national level.

Results

A total of 208 presumed TB or COVID-19 cases were identified: 113 were tested for COVID-19 only, and 94 were tested for both TB and COVID-19, 1 was tested for TB only. Among presumed cases tested for COVID-19, 9.7% (95% CI, 5.6-13.7%) were tested positive. Whilst among the total presumed tested for TB, 13.7% (95% CI, 6.8-20.6%) were confirmed to have TB. Among the total 94 presumed cases tested for both TB and COVID-19, 11.7% (95% CI, 5.2-18.2%) were confirmed to have TB and 13.8% (95% CI, 6.9-20.8%) participants were COVID-19 positive and one participant (1.1%) had both COVID-19 and TB.

Conclusion

Bidirectional screening and testing for TB and COVID-19 shows significant potential for improving overall case detection for the two diseases. The bidirectional screening and testing could be applicable to address a similar respiratory epidemic in the future that might have a masking effect on the response to TB disease.
Multimodal ultrasound features of breast cancers: correlation with molecular subtypes
Authors: Zhu Jun-Yan , He Han-Lu , Jiang Xiao-Chun , Bao Hai-Wei , Chen Fen
Published: April 2023

Objectives

To investigate whether multimodal intratumour and peritumour ultrasound features correlate with specific breast cancer molecular subtypes.

Methods

From March to November 2021, a total of 85 patients with histologically proven breast cancer underwent B-mode, real-time elastography (RTE), colour Doppler flow imaging (CDFI) and contrast-enhanced ultrasound (CEUS). The time intensity curve (TIC) of CEUS was obtained, and the peak and time to peak (TTP) were analysed. Chi-square and binary logistic regression were used to analyse the connection between multimodal ultrasound imaging features and breast cancer molecular subtype.

Results

Among 85 breast cancers, the subtypes were as follows: luminal A (36 cases, 42.4%), luminal B (20 cases, 23.5%), human epidermal growth factor receptor-2 positive (HER2+) (16 cases, 18.8%), and triple negative breast cancer (TNBC) (13 cases, 15.3%). Binary logistic regression models showed that RTE (P < 0.001) and CDFI (P = 0.036) were associated with the luminal A cancer subtype (C-index: 0.741), RTE (P = 0.016) and the peak ratio between intratumour and corpus mamma (P = 0.036) were related to the luminal B cancer subtype (C-index: 0.788). The peak ratio between peritumour and intratumour (P = 0.039) was related to the HER2 + cancer subtype (C-index: 0.859), and CDFI (P = 0.002) was associated with the TNBC subtype (C-index: 0.847).

Conclusions

Multimodal ultrasound features could be powerful predictors of specific breast cancer molecular subtypes. The intra- and peritumour CEUS features play assignable roles in separating luminal B and HER2 + breast cancer subtypes.
The epidemiology of multiple primary cancers in Belgium (2004–2017): Incidence, proportion, risk, stage and impact on relative survival estimates
Authors: Macq Gilles , Silversmit Geert , Verdoodt Freija , Van Eycken Liesbet
Published: April 2023

Background

As both life expectancy and cancer survival improve, the incidence of multiple primary cancer has augmented and is expected to further increase. This study describes for the first time the epidemiology of multiple invasive tumours in Belgium.

Methods

This nationwide study, based on all cancers diagnosed between 2004 and 2017 in Belgium, describes the proportion of multiple primary cancer, its evolution over time, the impact of inclusion or exclusion of multiple primary cancer on relative survival estimates, the risk of developing a second primary cancer, and the difference in stage between first and second primary cancer for the same patient.

Results

The proportion of multiple primary cancer increases with age, varies across cancer sites (from 4% for testis cancer to 22.8% for oesophageal cancer), is higher in men than in women, and has linearly increased over time. The inclusion of multiple primary cancer resulted in smaller 5-year relative survival and this impact is more pronounced in cancer sites with high relative survival. Patients with a first primary cancer have an increased risk to develop a new primary cancer compared to the population without a previous cancer history (1.27 and 1.59 times higher in men and women, respectively) and this risk depends on cancer site. Second primary cancers are associated with more advanced stages and more unknown stages than the corresponding first cancer diagnosis.

Conclusions

This study describes multiple primary cancer according to several measures (proportion, standardised incidence ratio for an second primary cancer, impact of multiple primary cancer on relative survival and differences according to stage) for the first time in Belgium. The results are based on data of a population-based cancer registry with a relatively recent onset (2004).
Carbohydrate quality indices and colorectal cancer risk: a case-control study
Authors: Kahrizsangi Masoud Amini , Ebrahimi Zohreh , Shateri Zainab , Mansouri Fatemeh , Zangene Ali , Rajabzadeh-Dehkordi Milad , Nouri Mehran , Rashidkhani Bahram
Published: April 2023

Background

Colorectal cancer (CRC) is the fourth and third most common cancer in Iran and the world, respectively. Carbohydrates can lead to the proliferation of cancer cells, including CRC. The current study aimed to investigate the association between glycemic load (GL), insulin load (IL), glycemic index (GI), insulin index (II), low-carbohydrate diet score (LCDS), and carbohydrate quality index (CQI) with CRC odds.

Methods

The present case-control study was performed on 71 CRC cases and 142 controls in the Hospital Cancer Organization and three general hospitals in Tehran, Iran. We calculated the dietary GI, GL, IL, II, CQI, and LCDS by a validated food frequency questionnaire.

Results

The results indicated that people who were in the highest tertile of the GI had higher odds of CRC compared to the lower tertile (in the adjusted model: odds ratio (OR) = 3.89; 95% confidence interval (CI): 1.71–8.84). On the contrary, people who were in the highest tertile of the CQI and LCDS had significantly lower odds of CRC compared to the lower tertile (in the adjusted model: tertile (T) 2-OR = 0.24; 95% CI: 0.11–0.53 and T3-OR = 0.15; 95% CI: 0.06–0.39 for CQI and T2-OR = 0.33; 95% CI: 0.13–0.79 and T3-OR = 0.28; 95% CI: 0.10–0.82 for LCDS). Also, IL was positively associated with the odds of CRC after adjusting for confounding factors (T2-OR = 2.46; CI: 1.08–5.61 and T3- OR = 2.80; 95% CI: 1.07–7.31). Regarding the GL, only individuals who were in the second tertile had significantly higher odds of CRC compared to the first tertile (OR = 2.42; CI: 1.07–5.47).

Conclusion

According to the findings, it is recommended to use a diet with high-quality carbohydrates and low GI and GL to minimize the odds of developing CRC. People should also be encouraged to have a balanced carbohydrate intake.
“What I wanted to do was build myself back up and prepare”: qualitative findings from the PERCEPT trial of prehabilitation during autologous stem cell transplantation in myeloma
Authors: McCourt Orla , Fisher Abigail , Land Joanne , Ramdharry Gita , Roberts Anna L , Bekris Georgios , Yong Kwee
Published: April 2023

Background

The addition of qualitative methodology to randomised controlled trials evaluating complex interventions allows better understanding of contextualised factors and their potential influence on trial delivery and outcomes, as well as opportunities for feedback on trial participation to improve future trial protocols. This study explored the experiences of participation in cancer rehabilitation research during active cancer treatment. Participants were people living with haematological cancer myeloma, undergoing autologous stem cell transplantation (ASCT) recruited to the PERCEPT myeloma pilot trial.

Methods

A qualitative semi-structured interview study, embedded within a pilot randomised controlled trial of a physiotherapist-led exercise intervention delivered before, during and after ASCT among people living with myeloma. Transcripts were analysed using reflexive thematic analysis.

Results

Interviews from 16 trial participants (n = 8 intervention group; n = 8 control group; mean age 61 years, 56% male) were analysed. Four main themes were identified: (1) “It’s not just beneficial for me, it’s for people after me as well”; (2) Disparities in experience of recovery – expectations, feeling prepared and support; (3) “What I wanted to do was build myself back up and prepare”; (4) Active ingredients – participants’ experience of the trial intervention. Participants reported both altruistic and perceived personal gain as motivators for enrolling in the trial. Disappointment caused by allocation to control arm may have led to participants seeking exercise elsewhere, indicating possible contamination of control condition. Disparities in experience of recovery from transplant were evident with intervention participants reporting greater trajectory of recovery.

Conclusions

The findings from this embedded qualitative study highlight numerous considerations required when designing pilot and efficacy trials of complex interventions. The addition of qualitative investigation offers greater understanding of motivations for participation, intervention mechanisms at play as well as effects of participation that may impact interpretation of quantitative outcomes.

Trial registration

Qualitative findings from a prospectively registered pilot trial (ISRCTN15875290), registered 13/02/2019.
The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis
Authors: Fan Yinyin , Li Nianxing , Zhang Jing , Fu Qiaomei , Qiu Yudong , Chen Yan
Published: April 2023

Background

Pancreaticoduodenectomy (PD) is a complex and traumatic abdominal surgery with a high risk of postoperative complications. Nutritional support, including immunonutrition (IMN) with added glutamine, arginine, and ω-3 polyunsaturated fatty acids, can improve patients’ prognosis by regulating postoperative inflammatory response. However, the effects of IMN on PD patients’ outcomes require further investigation.

Methods

PMC, EMbase, web of science databases were used to search literatures related to IMN and PD. Data such as length of hospital stay, infectious complications, non-infectious complications, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), mortality, systemic inflammatory response syndrome (SIRS) duration, IL-6, and C-reactive protein (CRP) were extracted, and meta-analyses were performed on these data to study their pooled results, heterogeneity, and publication bias.

Results

This meta-analysis involved 10 studies and a total of 572 patients. The results showed that the use of IMN significantly reduced the length of hospital stay for PD patients (MD = -2.31; 95% CI = -4.43, -0.18; P = 0.03) with low heterogeneity. Additionally, the incidence of infectious complications was significantly reduced (MD = 0.42; 95% CI = 0.18, 1.00, P = 0.05), with low heterogeneity after excluding one study. However, there was no significant impact on non-infectious complications, the incidence of POPF and DGE, mortality rates, duration of SIRS, levels of IL-6 and CRP.

Conclusion

The use of IMN has been shown to significantly shorten hospital stays and decrease the frequency of infectious complications in PD patients. Early implementation of IMN is recommended for those undergoing PD. However, further research is needed to fully assess the impact of IMN on PD patients through larger and higher-quality studies.
Facilitating deep learning through preprocessing of optical coherence tomography images
Authors: Li Anfei , Winebrake James P , Kovacs Kyle
Published: April 2023

Background

While deep learning has delivered promising results in the field of ophthalmology, the hurdle to complete a deep learning study is high. In this study, we aim to facilitate small scale model trainings by exploring the role of preprocessing to reduce computational burden and accelerate learning.

Methods

A small subset of a previously published dataset containing optical coherence tomography images of choroidal neovascularization, drusen, diabetic macula edema, and normal macula was modified using Fourier transformation and bandpass filter, producing high frequency images, original images, and low frequency images. Each set of images was trained with the same model, and their performances were compared.

Results

Compared to that with the original image dataset, the model trained with the high frequency image dataset achieved an improved final performance and reached maximum performance much earlier (in fewer epochs). The model trained with low frequency images did not achieve a meaningful performance.

Conclusion

Appropriate preprocessing of training images can accelerate the training process and can potentially facilitate modeling using artificial intelligence when limited by sample size or computational power.
GRADE-ADOLOPMENT of clinical practice guidelines and creation of clinical pathways for the primary care management of chronic respiratory conditions in Pakistan
Authors: Martins Russell Seth , Hussain Hawra , Chaudry Maryam , Rizvi Nashia Ali , Mustafa Mohsin Ali , Ayub Bushra , Aamdani Salima Saleem , Rehman Alina Abdul , Pervez Alina , Nadeem Sarah , Khalid Rameesha , Ali Akbar Shoukat , Shahid Shayan , Zubairi Ali Bin Sarwar , Haider Adil H. , Irfan Muhammad
Published: April 2023

Introduction

In Pakistan, chronic respiratory conditions contribute a large burden of morbidity and mortality. A major reason for this is the lack of availability of local evidence-based clinical practice guidelines (EBCPGs) in Pakistan, particularly at the primary care level. Thus, we developed EBCPGs and created clinical diagnosis and referral pathways for the primary care management of chronic respiratory conditions in Pakistan.

Methods

The source guidelines were selected by two local expert pulmonologists after a thorough literature review on PubMed and Google Scholar from 2010 to December 2021. The source guidelines covered idiopathic pulmonary fibrosis, asthma, chronic obstructive pulmonary disorders, and bronchiectasis. The GRADE-ADOLOPMENT process consists of three key elements: adoption (using recommendations as is or with minor changes), adaptation (effective context-specific changes to recommendations) or additions (including new recommendations to fill a gap in the EBCPG). We employed the GRADE-ADOLOPMENT process to adopt, adapt, adopt with minor changes, or exclude recommendations from a source guideline. Additional recommendations were added to the clinical pathways based on a best-evidence review process.

Results

46 recommendations were excluded mainly due to the unavailability of recommended management in Pakistan and scope beyond the practice of general physicians. Clinical diagnosis and referral pathways were designed for the four chronic respiratory conditions, explicitly delineating the role of primary care practitioners in the diagnosis, basic management, and timely referral of patients. Across the four conditions, 18 recommendations were added (seven for IPF, three for bronchiectasis, four for COPD, and four for asthma).

Conclusion

The widespread use of the newly created EBCPGs and clinical pathways in the primary healthcare system of Pakistan can help alleviate the morbidity and mortality related to chronic respiratory conditions disease in the country.