bluuebunny/crossref_metadata_2025 huggingface dataset:
Process evaluation of a Central Australian Aboriginal cultural awareness training program (2015–2020) for health professionals and students
Authors: Rissel Chris , Wilson Annabelle , Richards Barbara , Ryder Courtney , Bower Madeleine
Published: January 2023

Most Central Australian health service users are Aboriginal peoples. It is important that health professionals have cultural awareness related to the specific Aboriginal peoples they are working with and how cultural norms might impact upon their healthcare. This process evaluation reports how participants perceived the relevance of the Alice Springs Aboriginal cultural awareness training program and their attainment of course objectives, and it explores the qualitative feedback of participants.
A mixed methods approach was used to analyse previously collected data (2015–2020). Standard anonymous evaluation forms were used to collect quantitative data on perceived achievement of course objectives and the relevance of the program to participants as well as responses to open-ended questions. Quantitative data were summarised, and then, qualitative data were analysed through inductive thematic analysis, followed by content analysis.
Over 6 years, 2,081 people participated in the same cultural awareness program, which ran 133 times, with nearly all participants completing an evaluation form (97%). A high proportion of respondents reported that the program was relevant to their individual practice/workplace (consistently above 87%). Similarly, program objectives were reported as having been met (above 79% for each objective), and qualitative feedback was consistently positive. Many respondents learnt new information about the negative effects of colonisation on Aboriginal peoples and how this continues to affect current health. Learning about Aboriginal cultures, kinship relationships and systems, and communication styles was highly appreciated and identified as directly relevant to participants’ work practices.
The very high ratings of relevance and achievement of program objectives, plus highly positive feedback, suggests the program is meeting an important cultural awareness need in Central Australia.
The transformation of a student-led health clinic in rural Australia from a face-to-face service to a telehealth model: Evaluation of student and client experiences during a COVID 19 driven transition
Authors: Walker Clara , Forbes Roma , Osborn Dayle , Lewis Peter A , Cottrell Neil , Peek Sam , Argus Geoff
Published: January 2023

Introduction: The COVID-19 pandemic has necessitated the rapid transition of many face-to-face health services to alternate modes of service delivery. The objective of this study was to explore the benefits, challenges and perceived quality of a telehealth service delivery model from the perspective of clients and students. Further, students’ perceptions relating to the quality of the educational experience were also explored. 
Methods: The study was set in a student-led interprofessional health and wellness clinic in rural Queensland, Australia. A qualitative case study design was used, including semi-structured student interviews and client open-response survey data. Participants were nursing and allied health students who completed a student-led interprofessional clinic placement and adults with low to rising risk of chronic disease who attended the clinic for telehealth delivered services.
Results: Themes identified following analysis included: new or adapted skills needed for success; challenges, limitations and the need for resources, training and support; quality interprofessional education experiences can be achieved in telehealth; coming away with a new set of skills; the important role of the client for success; and benefits and disadvantages of telehealth for clients.
Conclusions: The findings support that telehealth-based service-learning models are a feasible way to deliver health and wellness services from the perspective of students and clients and provide students with important skills for rural health service delivery.
Problematising voice in qualitative health professional education research
Authors: Ajjawi Rola
Published: January 2023

Qualitative research is inherently relational, thus paying attention to subjectivities is important. As researchers, we are fundamentally entangled in the research through the decisions we make about design, the rapport and shaping of interviews to construct the data and the lenses we bring to interpretation and sense making. This is a multivoiced project, including at the very minimum, the researcher(s)’ voice and those of the participants. And yet we see several practices that either elide our role in the research and/or labour under the misapprehension that only the participants’ voice matters. This paper unpacks common practices that misrepresent the multivoicedness of qualitative research and presents strategies that acknowledge and work with the complexities of representing voice in research. E.B. White aptly said, “I have yet to see a piece of writing, political or non-political, that does not have a slant. All writing slants the way a writer leans, and no man is born perpendicular.”
Supporting Pacific clinicians’ medical education practice change through faculty development: A qualitative case study
Authors: Kado Sinead Katherine , Lindemann Iris , Brand Gabrielle
Published: January 2023

Introduction: In the Pacific region, there is a growing need to support medical education and supervision. Following a faculty development initiative, we pondered a question: To what extent and how do Pacific clinicians change their educational practice in a low-resource setting? Current medical education literature advocates exploring educational change in different contexts. Therefore, we aimed to expand current understandings of educational change and provide recommendations for enhancing faculty development in low-resource settings by exploring if and how clinicians in Fiji translated knowledge learnt during faculty development to their educational practice.
Methods: Utilising a qualitative case study approach, we recruited nine clinicians through purposeful sampling. Data collection occurred over 3 months through reflective journals, interviews, lesson plans and videos of teaching. All data were subjected to thematic analysis.
Results: Six themes represented the Pacific clinicians’ educational journey: 1) perception of faculty development, 2) reflecting on and evolving educational philosophy, 3) adapting and changing practice, 4) clinicians’ perception of student responses to their teaching, 5) inhibitors to change and 6) enablers of change.
Conclusions: We further conceptualised the themes into an educational change model. Our results, together with the international literature, guided key recommendations for medical education faculty development in low-resource settings. The key recommendations included considering cultural organisational influences, clinicians’ prior educational experiences and local enablers and barriers to changing educational practice when developing relevant faculty development programs. Furthermore, clinicians in low-resource settings, such as the Pacific, require support through mentorship, flexible learning, feedback, developing communities of practice and the promotion of reflective practice to facilitate sustainable educational change.
Experience of volunteer medical students assisting in the healthcare worker influenza vaccine program at a tertiary hospital during the COVID-19 pandemic
Authors: Fahey Kieren Patrick , Clucas Luisa , Elia Sonja , Uahwatanasakul Wonie , Cobbledick Annie , Addlem Lynne , Crawford Nigel
Published: January 2023

Introduction: For a more rapid rollout of staff influenza vaccination, medical student assistance with a vaccination program was sought during a time when the healthcare workforce was facing unprecedented pressures. This study explored the experience of both the students and supervising nursing staff involved.
Innovation: Volunteer medical students were recruited to assist nurse immunisers in a staff influenza vaccination program. The education of medical students involved three components: an online educational session, written and video resources and direct supervision by trained nursing staff.
Evaluation and outcomes: Qualitative data was collected from online surveys completed by medical students and structured interviews conducted with students and supervising nursing staff. The interviews underwent thematic analysis. Seventy-four percent (17/23) of medical students completed the survey. Three students and two supervising nurses completed interviews. Ninety-four percent of students strongly agreed they were confident in performing intramuscular injections after participating in the program compared with only 12% prior to participation. The interviews identified that medical students were motivated by gaining clinical experience, feeling useful during the pandemic and an altruistic desire to assist the healthcare workforce. Nursing staff displayed some initial hesitation working with medical students, which was alleviated after their competence was demonstrated.
What’s next? Clinical opportunities that allow medical students to learn or refine skills, whilst also assisting in areas of need, serve a dual purpose in the setting of the pandemic. This program highlights the benefits to students of participating in a staff vaccination program and provides evidence for their involvement in the ongoing rollout of the COVID-19 vaccine in Australia.
Deep ocean long range underwater navigation with ocean circulation model corrections
Authors: Mikhalevsky Peter N. , Gopalakrishnan Ganesh , Cornuelle Bruce D.
Published: January 2023

An underwater navigation algorithm that provides a “cold start” (CSA) geographic position, geo-position, underwater while submerged using travel times measured from a constellation of acoustic sources is described in Mikhalevsky, Sperry, Woolfe, Dzieciuch, and Worcester [J. Acoust. Soc. Am. 147(4), 2365 – 2382 (2020)]. The CSA geo-position is used as the receive position in the ocean for acoustic modeling runs using an ocean general circulation model (GCM). A different geo-position is calculated using adjusted ranges from the travel time offsets between the data and modeled arrival times for each source. Because the CSA geo-position is close to the true position, the source to CSA position propagation model path and the source to true vehicle position data path of the acoustic arrivals are nearly coincident, enabling accurate measurement of travel time offsets. The cold start with model (CSAM) processing reduced the CSA geo-position errors from a mean of 58 to 25 m. A simulation is developed to estimate CSA and CSAM performances as a function of group speed variability between the source paths. The CSAM geolocation accuracy can be calculated from and is controlled by the accuracy of the GCM.
North Atlantic surface ocean warming and salinization in response to middle Eocene greenhouse warming
Authors: van der Ploeg Robin , Cramwinckel Margot J. , Kocken Ilja J. , Leutert Thomas J. , Bohaty Steven M. , Fokkema Chris D. , Hull Pincelli M. , Meckler A. Nele , Middelburg Jack J. , Müller Inigo A. , Penman Donald E. , Peterse Francien , Reichart Gert-Jan , Sexton Philip F. , Vahlenkamp Maximilian , De Vleeschouwer David , Wilson Paul A. , Ziegler Martin , Sluijs Appy
Published: January 2023

Quantitative reconstructions of hydrological change during ancient greenhouse warming events provide valuable insight into warmer-than-modern hydrological cycles but are limited by paleoclimate proxy uncertainties. We present sea surface temperature (SST) records and seawater oxygen isotope (δ
18
O
sw
) estimates for the Middle Eocene Climatic Optimum (MECO), using coupled carbonate clumped isotope (Δ
47
) and oxygen isotope (δ
18
O
c
) data of well-preserved planktonic foraminifera from the North Atlantic Newfoundland Drifts. These indicate a transient ~3°C warming across the MECO, with absolute temperatures generally in accordance with trace element (Mg/Ca)–based SSTs but lower than biomarker-based SSTs for the same interval. We find a transient ~0.5‰ shift toward higher δ
18
O
sw
, which implies increased salinity in the North Atlantic subtropical gyre and potentially a poleward expansion of its northern boundary in response to greenhouse warming. These observations provide constraints on dynamic ocean response to warming events, which are consistent with theory and model simulations predicting an enhanced hydrological cycle under global warming.
Quantum vortex formation in the “rotating bucket” experiment with polariton condensates
Authors: Gnusov Ivan , Harrison Stella , Alyatkin Sergey , Sitnik Kirill , Töpfer Julian , Sigurdsson Helgi , Lagoudakis Pavlos
Published: January 2023

The appearance of quantized vortices in the classical “rotating bucket” experiments of liquid helium and ultracold dilute gases provides the means for fundamental and comparative studies of different superfluids. Here, we realize the rotating bucket experiment for optically trapped quantum fluid of light based on exciton-polariton Bose-Einstein condensate in semiconductor microcavity. We use the beating note of two frequency-stabilized single-mode lasers to generate an asymmetric time-periodic rotating, nonresonant excitation profile that both injects and stirs the condensate through its interaction with a background exciton reservoir. The pump-induced external rotation of the condensate results in the appearance of a corotating quantized vortex. We investigate the rotation frequency dependence and reveal the range of stirring frequencies (from 1 to 4 GHz) that favors quantized vortex formation. We describe the phenomenology using the generalized Gross-Pitaevskii equation. Our results enable the study of polariton superfluidity on a par with other superfluids, as well as deterministic, all-optical control over structured nonlinear light.
Biological therapies need definitive randomized controlled clinical trials
Authors: Califf Robert M. , Marks Peter W.
Published: January 2023

Adequate and well-controlled clinical trials remain critical tools for helping to bring benefit to patients in medical need.
Characterization of Escherichia coli and Other Enterobacterales Resistant to Extended-Spectrum Cephalosporins Isolated from Dairy Manure in Ontario, Canada
Authors: Anderson Rebecca E.V. , Chalmers Gabhan , Murray Roger , Mataseje Laura , Pearl David L. , Mulvey Michael , Topp Edward , Boerlin Patrick
Published: January 2023

The increase in antimicrobial resistance is of concern for human and animal health, especially when resistance is conferred to extended-spectrum cephalosporins, which are used to treat serious infections in both human and veterinary medicine. Bacteria carrying extended-spectrum cephalosporin resistance genes, including
bla
CTX-M
and
bla
CMY
, are frequently found in dairy manure.
In Search of a Mechanistic Link between Chlamydia trachomatis-Induced Cellular Pathophysiology and Oncogenesis
Authors: Steiert Brianna , Faris Robert , Weber Mary M.
Published: January 2023

Centrosome duplication and cell cycle progression are essential cellular processes that must be tightly controlled to ensure cellular integrity. Despite their complex regulatory mechanisms, microbial pathogens have evolved sophisticated strategies to co-opt these processes to promote infection.
Draft Genome Sequence of a Putatively Antibiotic-Resistant Escherichia coli Strain Isolated from Calf Intestine in Boyacá, Colombia
Authors: Torres Caycedo Maria Inés , Rodríguez López Javier , Pérez Pulido Rubén , Lucas Rosario , Galvez Antonio , Grande Burgos Maria José
Published: January 2023

A draft genome of the putatively antibiotic-resistant
Escherichia coli
strain ANGUJ1, which was isolated from calf intestine from Boyacá, Colombia, is reported. The genome possessed genetic determinants for antibiotic resistance and multicompound resistance efflux pumps.
In silico
prediction analysis suggests phenotypic resistance to six classes of antibiotics plus aldehyde and peroxide.
Mutation of Phenylalanine 23 of Newcastle Disease Virus Matrix Protein Inhibits Virus Release by Disrupting the Interaction between the FPIV L-Domain and Charged Multivesicular Body Protein 4B
Authors: Pei Yu , Xue Jia , Teng Qingyuan , Feng Delan , Huang Min , Liang Rong , Li Xiao , Zhao Ye , Zhao Jing , Zhang Guozhong
Published: January 2023

Multiple viruses utilize a conserved motif, termed the L-domain, to act as a cellular adaptor for recruiting host ESCRT machinery to their budding site. Despite the FPIV type L-domain having been identified in some paramyxoviruses 2 decades ago, its function in virus life cycles and its method of recruiting the ESCRT machinery are poorly understood.
mRNA Vaccine Mitigates SARS-CoV-2 Infections and COVID-19
Authors: Kackos Christina M. , Surman Sherri L. , Jones Bart G. , Sealy Robert E. , Jeevan Trushar , Davitt Christopher J. H. , Pustylnikov Sergei , Darling Tamarand L. , Boon Adrianus C. M. , Hurwitz Julia L. , Samsa Marcelo M. , Webby Richard J.
Published: January 2023

SARS-CoV-2 continues to disrupt everyday life and cause excess morbidity and mortality worldwide. Vaccination has been key to quelling the impact of this respiratory pathogen, and mRNA vaccines have led the charge on this front.
Specific Plasma MicroRNA Signatures Underlying the Clinical Outcomes of Hepatitis E Virus Infection
Authors: Costafreda Maria I. , Sauleda Silvia , Riveiro-Barciela Mar , Rico Angie , Llorens-Revull Meritxell , Guix Susana , Pintó Rosa M. , Bosch Albert , Rodríguez-Frías Francisco , Rando Ariadna , Piron Maria , Bes Marta
Published: January 2023

There is increasing evidence that viruses dysregulate the expression and/or secretion of microRNAs to promote viral replication, immune evasion, and pathogenesis. In this study, we evaluated the change in microRNA abundance in patients with acute or chronic HEV infection and asymptomatic HEV-infected blood donors.
Supplemental Material: New insights into the age and origin of two small Cretaceous seamount chains proximal to the Northwestern Hawaiian Ridge
Authors: Sotomayor A. , Balbas A. , al. et
Published: January 2023

Includes raw data for 40Ar/39Ar age determinations and metadata related to sample collection.  
Splenic abscess caused byCutibacterium acnesin a patient with multiple tooth extractions
Authors: Walsh Madalyn , Wasko Nicholas , Simms Andrew Joseph , Hodges Jacob
Published: January 2023

A woman in her 40s with a history of dental abscess presenting with a 3-month history of nightly fevers, malaise, fatigue and acutely worsening left flank pain was found to have a splenic abscess replacing almost the entire splenic parenchyma on abdominal CT. Abscess aspirate showed Gram-positive rods, and both aerobic and anaerobic cultures grewCutibacterium acnes(previously Propionibacterium acnes), a common member of the skin microbiome. Prior case reports ofC. acnessplenic abscess all involved parental inoculation via needle use. However, in the context of no percutaneous needle exposure and multiple tooth extractions immediately preceding her symptoms, the most likely source of her infection is oral flora with haematogenous or lymphatic spread to the spleen.
CMV proctitis: a rare disease presentation in a young and immunocompetent man
Authors: Balian Steve , Humm Meredith , Haddad Nicholas
Published: January 2023

A young adult man presented to an outlying emergency department with a sore throat, fever and chills. Upon failure of symptomatic management and a course of amoxicillin, he developed rectal pain and loose stools. Despite outpatient doxycycline treatment for presumed chlamydial proctitis, he developed worsening rectal pain and bloody stools. Results on abdominal and pelvic CT were consistent with proctitis. His symptoms worsened despite added metronidazole for bacterial proctitis. Workup revealed an elevated erythrocyte sedimentation rate, C reactive protein and calprotectin, suggestive of a diagnosis of inflammatory bowel disease (IBD). A colonoscopy revealed proximal tightness of the rectum, and pathology reported features suggestive of IBD. He was treated with prednisone and mesalamine. However, immunostaining positive for cytomegalovirus (CMV) confirmed a diagnosis of tissue-invasive CMV proctitis. This was further supported by serological testing for CMV consistent with a diagnosis of CMV proctitis preceded by a primary CMV infection of the pharynx.
Impact of Tourette’s syndrome tics on healing following dental trauma
Authors: Budhdeo Rakhee , Kabban Marielle , Vaidyanathan Mina
Published: January 2023

The following case report outlines the impact of motor tics linked to Tourette’s syndrome on dental development and healing following a dental injury to a maxillary central incisor. Emergency care and splinting of a mobile extruded maxillary left central incisor tooth was carried out at the local dentist on the same day as the dental trauma. A subsequent referral was made to the paediatric dental department for continued mobility of the maxillary central incisor on splint removal approximately 2 weeks later. A clinical and radiographic examination revealed shortened root length and apical root blunting associated with both maxillary anterior teeth. Further questioning revealed the likely cause of this to be related to the clenching and biting oral tics which the patient has experienced over the past 4 years. A removable splint has been fabricated for night-time wear and a mouthgaurd has been recommended for use during contact sports. Regular reviews will be conducted using a shared care approach between the patient’s local dentist and the paediatric dental department.
Impact of cognitive impairment on clinical outcomes in elderly patients with atrial fibrillation: ANAFIE Registry
Authors: Nagata Ken , Inoue Hiroshi , Yamashita Takeshi , Akao Masaharu , Atarashi Hirotsugu , Ikeda Takanori , Koretsune Yukihiro , Okumura Ken , Shimizu Wataru , Suzuki Shinya , Tsutsui Hiroyuki , Toyoda Kazunori , Hirayama Atsushi , Yamaguchi Takenori , Teramukai Satoshi , Kimura Tetsuya , Morishima Yoshiyuki , Takita Atsushi , Yasaka Masahiro
Published: January 2023

Background

This subcohort study of All Nippon AF In the Elderly (ANAFIE) Registry based on 33 275 elderly patients (aged ≥75 years) with non-valvular atrial fibrillation (NVAF) investigated the relationship between cognitive function and 2-year clinical outcomes.

Methods

A total of 2963 (mean age, 81.4 years) patients participated in this subcohort study and were classified as having normal cognition (Mini-Mental State Examination (MMSE) score ≥24/30) or cognitive impairment (score ≤23/30) at baseline. Patients with a decrease of >2 points after 24 months were classified as having cognitive decline.

Results

At baseline, 586 (19.8%) patients had cognitive impairment. These patients tended to be older and had poorer general conditions than patients with normal cognition. The 2-year probability of stroke/systemic embolic events (SEEs), major bleeding and intracranial haemorrhage was numerically higher; those of cardiovascular death, all-cause death and net clinical outcome (composite of stroke/SEE, major bleeding and all-cause death) were significantly higher (all p<0.001) in patients with cognitive impairment versus normal cognition. In multivariate analysis, the risks of cardiovascular death (p=0.021), all-cause death (p<0.001) and net clinical outcome (p<0.001) were higher in patients with cognitive impairment versus those with normal cognition. After 24 months, 642 of 1915 (33.5%) patients with repeated MMSE determination had cognitive decline. Educational background <9 years, older age and concomitant cerebrovascular disorders were significant risk factors of cognitive decline at the 2-year follow-up.

Conclusions

Elderly patients with NVAF with cognitive impairment have a higher mortality risk than those with normal cognition. Several significant risk factors of cognitive decline were identified at 2-year follow-up.

Trial registration number

UMIN000024006 (http://www.umin.ac.jp/).
Decreased capsaicin cough reflex sensitivity predicts hospitalisation due to COPD
Authors: Kanemitsu Yoshihiro , Kurokawa Ryota , Akamatsu Taisuke , Fukumitsu Kensuke , Fukuda Satoshi , Ito Yutaka , Takeda Norihisa , Nishiyama Hirono , Ito Keima , Tajiri Tomoko , Mori Yuta , Uemura Takehiro , Ohkubo Hirotsugu , Takemura Masaya , Maeno Ken , Oguri Tetsuya , Shirai Toshihiro , Niimi Akio
Published: January 2023

Introduction

Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised due to severe acute exacerbation (AE) or community-acquired pneumonia (CAP). Previous studies revealed the association of cough reflex sensitivity with the pathophysiology of COPD and pneumonia. We hypothesised that cough reflex sensitivity may be associated with severe AE or CAP requiring hospitalisation in patients with COPD.

Methods

We prospectively recruited 68 patients with COPD between June 2018 and January 2020. Patient characteristics, lung and cardiac functions, and biomarkers, including capsaicin cough reflex sensitivity and blood eosinophil count, were evaluated at enrolment. All participants were monitored for AE or CAP requiring hospitalisation for 12 months. We determined the risk factors and ORs for hospitalisation in patients with COPD using a multivariate analysis.

Results

Eight patients experienced AE (n=3) or CAP (n=5) and required hospitalisation during follow-up. Patients in the hospitalisation+ group had higher modified Medical Research Council scores and blood eosinophil counts (≥300 µL) than those in the hospitalisation− group. Capsaicin cough reflex sensitivity tended to decrease in the hospitalisation+ group compared with that in the hospitalisation− group. Multivariate analysis revealed that a decreased capsaicin cough reflex and high eosinophil count (≥300 µL) were predictive risk factors for future hospitalisation due to AE-COPD or CAP.

Conclusion

In addition to eosinophils, decreased capsaicin cough reflex sensitivity was associated with hospitalisation due to AE-COPD or CAP. Capsaicin cough reflex sensitivity in patients with COPD may play a role in the prevention of severe AE or pneumonia requiring hospitalisation.

Trial registration number

UMIN000032497.
Primary salivary duct carcinoma of the lung: clinicopathological features, diagnosis and practical challenges
Authors: Li Shaoling , Hou Likun , Huang Yan , Wu Wei , Wu Chunyan , Zhang Liping
Published: January 2023

Aims

To investigate the clinicopathological features, molecular characteristics and diagnostic criteria of primary salivary duct carcinoma of the lung (LSDC).

Methods

We analysed the clinicopathological and molecular features of five cases of LSDC retrieved from the archives of Shanghai Pulmonary Hospital from 2020 to 2022, and reviewed the relevant literature.

Results

All patients were men, with an average age of 66 years (age range: 49–79 years), and all lesions were central masses with a mean maximum diameter of 42.6 mm (range: 16–70 mm). Morphologically, LSDC comprised of intraductal and invasive components. Both the intraductal and invasive components of LSDC can exhibit papillary, micropapillary, cribriform, tubule structures and solid proliferation. The intraductal component can exhibit Roman bridge structures, which were usually accompanied by central comedo-like necrosis. Immunohistochemically, LSDCs consistently expressed cytokeratin (CK)7 (5 of 5) and showed variable positivity of androgen receptor (AR) (5 of 5) focally or diffusely; additionally, the tumour cells expressed human epidermal growth factor receptor 2 (HER2) (3+, n=3; 2+, n=2), GATA-binding protein 3 (3 of 5), and gross cystic disease fluid protein-15 (1 of 5), and all of which were negative for thyroid transcription factor-1, napsin A, p40, CK5/6 and p63. The residual basal/myoepithelial cells surrounding the in situ carcinoma expressed p40, CK5/6 and p63. TP53 mutation and HER2 gene amplification (3 of 5) were the most frequent genetic alterations in LSDC. All patients who underwent surgical lobectomies were alive without recurrence or metastasis.

Conclusions

LSDC is a highly rare malignant tumour. The distinctive architecture of in situ carcinoma and tumour cells expressing AR can provide diagnostic indications for LSDC.
Effectiveness of an outpatient rehabilitation programme in patients with neuralgic amyotrophy and scapular dyskinesia: a randomised controlled trial
Authors: Janssen Renske M J , Lustenhouwer Renee , Cup Edith H C , van Alfen Nens , Ijspeert Jos , Helmich Rick C , Cameron Ian G M , Geurts Alexander C H , van Engelen Baziel G M , Graff Maud J L , Groothuis Jan T
Published: January 2023

Background

Neuralgic amyotrophy (NA) is an acute inflammation of nerves within the brachial plexus territory leading to severe pain and multifocal paresis resulting in >60% of patients having residual complaints and functional limitations correlated with scapular dyskinesia. Our primary aim was to compare the effects of multidisciplinary rehabilitation (MR), focused on motor relearning to improve scapular dyskinesia and self-management strategies for reducing pain and fatigue, with usual care (UC) on shoulder, arm and hand functional capability in patients with NA.

Methods

In a non-blinded randomised controlled trial (RCT), patients with NA (aged≥18 years, scapular dyskinesia, >8 weeks after onset) were randomised to either an MR or an UC group. MR consisted of a diagnostic multidisciplinary consultation and eight sessions of physical and occupational therapy. Primary outcome was functional capability of the shoulder, arm and hand assessed with the Shoulder Rating Questionnaire–Dutch Language Version (SRQ-DLV).

Results

We included 47 patients with NA; due to drop-out, there were 22 participants in MR and 15 in UC for primary analysis. The mean group difference adjusted for sex, age and SRQ-DLV baseline score was 8.60 (95%CI: 0.26 to 16.94, p=0.044). The proportion attaining a minimal clinically relevant SRQ-DLV improvement (≥12) was larger for the MR group (59%) than the UC group (33%) with a number needed to treat of 4.

Conclusion

This RCT shows that an MR programme focused on motor relearning to improve scapular dyskinesia, combined with self-management strategies for reducing pain and fatigue, shows more beneficial effects on shoulder, arm and hand functional capability than UC in patients with NA.

Trial registration number

NCT03441347.
Narrative and its discontents
Authors: Morrison Alastair
Published: January 2023

This review considers recent challenges to, and changes within, narrative medicine as a paradigm for humanities-based medical education. It suggests that, while narrative medicine has often been criticised for emphasising narrative at the expense of other dimensions of human experience, newer criticism has focused more on its relationship with other areas of medical knowledge. In different ways, recent work has shown greater interest in taking in humanities perspectives on their own terms, rather than (this is the charge against narrative medicine) instrumentalising them as diagnostic tools. The review concludes by considering how these criticisms might make their way into the institutional realities of medical education, as well as what they might learn from narrative medicine’s success.
Health check-ups as interventions for work disability management: supervisors and occupational healthcare follow the recommendations to a great extent
Authors: Kuronen Jarmo , Winell Klas , Kopra Juho , Räsänen Kimmo
Published: January 2023

Objectives

Work disability management is a problem globally. This study was designed to find out whether the initiation, process and outcome of health check-ups (HCUs) follow the national legislation and whether supervisors and occupational healthcare (OHC) units act according to the legislation-based recommendations.

Methods

Data of 1092 employees with reduced work ability were collected during 2013–2018 in 15 OHC units across Finland. Nine reasons for HCUs, eight process activities and three recommendations were analysed. Cross-tabulation and multinomial logistic regression analysis were used in the analyses.

Results

Employees themselves initiated an HCU for early support more often (OR with 95% CI 2.37; 1.04 to 5.40) compared with supervisors. Personnel in OHC units initiated an HCU in musculoskeletal disorders more often (OR 1.58; 95% CI 1.05 to 2.37) and in mental disorders less often (OR 0.52; 95% CI 0.35 to 0.76) compared with supervisors. These findings were reflected in the recommendations after the HCU, where rehabilitation was recommended for employees with musculoskeletal disorders more often than for employees with mental disorders (ORs 5.48; 95% CI 1.91 to 15.67 and 1.59; 95% CI 0.74 to 3.43, respectively).

Conclusion

Supervisors and OHC units followed the recommendations for management of work disability to a great extent. Employees were active in looking for help early when they had problems with work ability. This positive finding should be promoted even more. OHC units did not initiate HCUs or recommend rehabilitation in mental disorders as actively as they did in musculoskeletal disorders. Support of employees with mental disorders should be improved and studied more.

Registration of the study

The study protocol was approved and registered on 22 September 2017 by the Doctoral Program of Health Sciences, Faculty of Medicine, University of Eastern Finland, registration no. 189067.
Raising the bar on fibrinogen: a retrospective assessment of critical hypofibrinogenemia in severely injured trauma patients
Authors: Richards Justin , Fedeles Benjamin T , Chow Jonathan H , Scalea Thomas , Kozar Rosemary
Published: January 2023

Objectives

Fibrinogen depletion may occur at higher levels than historically referenced. We evaluated hypofibrinogenemia and associated mortality and multiple organ failure (MOF) after severe injury.

Methods

Retrospective investigation including 417 adult patients with Injury Severity Score (ISS) >15. Demographics and injury characteristics were collected. Fibrinogen within 30 minutes of admission was described: <150 mg/dL, 150 mg/dL to 200 mg/dL and >200 mg/dL. Primary outcome: 28-day mortality. Secondary outcomes: 28-day MOF and blood product transfusion. Multivariable logistic regression model evaluated association of fibrinogen categories on risk of death, after controlling for confounding variables. Results presented as OR and 95% CIs.

Results

Fibrinogen <150 mg/dL: 4.8%, 150 mg/dL to 200 mg/dL: 18.2%, >200 mg/dL: 77.0%. 28-day mortality: 15.6%. Patients with <150 mg/dL fibrinogen had over fourfold increased 28-day mortality risk (OR: 4.9, 95% CI 1.53 to 15.7) after adjusting for age, ISS and admission Glasgow Coma Scale. Patients with lower fibrinogen were more likely to develop MOF (p=0.04) and receive larger red blood cell transfusion volumes at 3 hours and 24 hours (p<0.01).

Conclusions

Fibrinogen <150 mg/dL is significantly associated with increased 28-day mortality. Patients with fibrinogen <150 mg/dL were more likely to develop MOF and required increased administration of blood products. The optimal threshold for critically low fibrinogen, the association with MOF and subsequent fibrinogen replacement requires further investigation.

Level of evidence

Level III
Demographic analyses reveal differential biological vulnerability in four Southwestern Atlantic skates
Authors: Cortés Federico , Colonello Jorge H. , Sammarone Marina , Zavatteri Anabela , Hozbor Natalia M.
Published: January 2023

More than 33 skate species have been registered in the Southwestern Atlantic Ocean (SAO) 34°S, where hotspots of the endemic threatened marine chondrichthyans with high scientific and conservation priorities have been detected. The lack of species-specific landing data highlights the importance of biological data-based methods to determine the vulnerability and productivity of skate species. In this work, we estimated the demographic parameters for the skates Atlantoraja castelnaui, Rioraja agassizi, Sympterygia bonapartii, and Zearaja brevicaudata in SAO, by implementing Leslie matrix models. The finite rate of population growth ( ʎ) for the four skate's species ranged from 1.036 ( Z. brevicaudata) to 1.196 ( R. agassizi). Elasticity analyses and the performance of different harvest strategies show that reducing juvenile catches appears to be one of the most effective management actions for these species since they result in higher survivorship of age classes with more influence in λ. Differences in the biological productivity of the skates suggest that, to achieve sustainable exploitation of skates, the commitment of all stakeholders to improve species-level information is necessary.
Ovule abortion and seed set of field pea (Pisum sativum L.) grown under high temperature
Authors: Osorio Evelyn , Davis Arthur R. , Warkentin Thomas D. , Bueckert Rosalind A.
Published: January 2023

In pea, high temperatures during reproductive development lead to severe yield loss. Although the ovule is the seed precursor, studies elucidating the effect of heat on this plant structure are scarce. We investigated the impact of heat in the field and growth chamber on ovules 4 days after the open flower (4DOF) stage. Objectives were to identify associations between ovaries and plant performance, and to evaluate seed set and ovule abortion of heat-treated plants for six cultivars from a diverse range of seed-to-ovule ratios. In the field, plants were seeded at early (control, [early seeded pea, ESP]) and late (stress plant [late seeded pea, LSP]) periods in the season. In growth chambers, plants were exposed to heat (35/18 °C) at early flowering for 4 days and then evaluated at maturity. Stressed plants (LSP) displayed twice as many aborted ovules than ESP during early embryo growth (pro-embryo to globular stage) in synchrony with reduced ovaries, ovules, and embryo sac size. Cultivars with reduced ovary size at 4DOF were related to a high number of reproductive nodes and pods in LSP ( r = −0.44 to −0.48). Similarly, under growth chamber conditions, heat caused seed reduction by increasing the abortion of immature ovules (early embryonic stages) at various reproductive nodes. Collectively, our results indicated that pea seed loss from heat in the field is largely due to early embryo abortion, a novel finding, rather than disruption of pre-fertilization events. Compensatory effects on plant performance infer plant resource adjustment. Our findings contribute to the assessment and selection of high-yielding pea cultivars for future warming seasons.
Constant-roll inflation field with Tsallis entopic proposal
Authors: Keskin A. I. , Kurt K.
Published: January 2023

In this work, we investigate the high-energy era of the universe from the constant-roll condition perspective by taking the Friedmann equation, which is modified by a non-additive Tsallis entropic proposal. In the framework of the observational data, we determine the constant-roll parameter. Under the fixed field condition of the constant-roll parameter, for the wide range of the power-term of the chaotic potentials, $$\sim \phi ^{n}$$

∼

ϕ
n

, which involves some string-chaotic potential models, $$n=\frac{2}{3}$$

n
=

2
3

, $$n=\frac{4}{5}$$

n
=

4
5

, the non-additive (nonextensive) Tsallis parameter is analyzed graphically. The resulting analysis shows that, in addition to a quasi-de Sitter phase, any value of the range $$0.5<n<1.2$$

0.5
<
n
<
1.2

points to a dynamical form of the dark energy (quintessence) in the early universe. It implies that n values in the range may be included in string-chaotic potential models. The non-additive Tsallis parameter provides this with the help of its negative values in the constant-roll field.
The deformation of the icosahedral gold 13-atom cluster
Authors: Ren Shi-Wei
Published: January 2023

As a building block, the icosahedral gold 13-atom cluster has attracted much attention for many years. In this paper, the tensile and compressive deformation of the icosahedral gold 13-atom cluster are investigated and some interesting results different from bulks and nanowires are obtained. It is found that the elastic strain limits of the cluster are much larger than those of the gold bulks and the nanowires. Within the elastic strain limit, the loading force–strain relationship is not linear. And the stiffness coefficient decreases with increasing strain under the tensile loading, and increases with increasing strain under the compressive loading. Under the influence of temperature, the loading force and the stiffness coefficient decrease with the increasing temperature at the same strain. The elastic strain limit and the break-up strain are also reduced as the temperature rises. Although the bulks and nanowires cannot return to their original configurations when they are in a plastic state, however, the calculation shows that the cluster can return spontaneously to its original icosahedral structure even if the cluster has been at plastic deformation when the loading is released above a certain temperature. A monatomic chain is formed when the cluster is close to rupture. The interatomic distance and the tensile force for the monatomic chain are consistent with the experimental data.
Defining a critical temperature of a crossover from BEC to the normal phase
Authors: Rakhimov Abdulla , Khudoyberdiev Asliddin , Narzikulov Zabardast , Tanatar Bilal
Published: January 2023

We address the problem of identifying the critical temperature in a crossover from the Bose–Einstein condensed (BEC) phase to the normal phase. For this purpose we study the temperature dependence of magnetization of spin-gapped quantum magnets described by BEC of triplons. We have calculated the heat capacity [Formula: see text] at constant field and fluctuations in magnetization in a spin-gapped quantum magnet using the Hartree–Fock–Bogouliubov approximation and found optimized parameters of the Hamiltonian of triplon gas. In the region of phase transition, the heat capacity [Formula: see text] is smeared out due to the Dzyaloshinsky–Moriya (DM) interaction. The sharp maximum of the fluctuations in the magnetization is identified as the critical temperature of the crossover.
A Hybrid Approximation Method for Integer-Order Approximate Realization of Fractional-Order Derivative Operators
Authors: Köseoğlu Murat
Published: January 2023

The use of fractional-order (FO) calculus for the solution of different problems in many fields has increased recently. However, the usage of FO system models in practice brings some difficulties. The FO operator, fractance device, is usually realized via several integer-order approximation methods, which have pros and cons in the aspect of operation frequency, time response and stability region. These methods may not meet all performance expectations. In this regard, author proposes an efficient hybrid integer-order approximation method for FO derivative operator without causing any additional difficulty in realization. The proposed method combines Matsuda and modified stability boundary locus (M-SBL) approximation methods. The advantage of each method is combined in a single hybrid function by considering root mean square error (RMSE) rates for step response. The performance of hybrid transfer function is analyzed in comparison with Matsuda, Oustaloup, continued fraction expansion (CFE) and M-SBL transfer functions for both frequency and time response. Analog realization of the proposed model is performed experimentally via partial fraction expansion method. Analog design is verified via both Multisim simulations and experimental results. The improvements due to the hybrid behavior and the consistency of experimental results with theoretical and simulation results demonstrate the practicality and usefulness of the hybrid model.
The virtual element method for the 3D resistive magnetohydrodynamic model
Authors: Beirão da Veiga Lourenço , Dassi Franco , Manzini Gianmarci , Mascotto Lorenzo
Published: January 2023

We present a four-field virtual element discretization for the time-dependent resistive magnetohydrodynamics equations in three space dimensions, focusing on the semi-discrete formulation. The proposed method employs general polyhedral meshes and guarantees velocity and magnetic fields that are divergence free up to machine precision. We provide a full convergence analysis under suitable regularity assumptions, which is validated by some numerical tests.
Energy Efficient Secure-Trust-Based Ring Cluster Routing in Wireless Sensor Network
Authors: Sumesh J. J. , Maheswaran C. P.
Published: January 2023

Typically, wireless sensor networks (WSNs) are used to monitor as well as detect different kinds of objects in realistic monitoring, where security remains as a major confront. Estimation of node trust is established to be an effectual way of enhancing the security, thus aiding in nodes collaboration and decision-making in wireless and wired networks. Nevertheless, conventional methods of trust management generally highlight on trust modeling and fail to notice the overhead issues. In this paper, a security aware ring cluster routing technique is introduced. The routing is undergone based on the multi-objectives including trust (security) parameters, energy, and distance. Here, the trust parameters include both the direct trust evaluation and indirect trust evaluation. Thereby, the lifetime of the network gets maximized even with secured manner. An innovative Self-Adaptive Deer Hunting Optimization (SA-DHO) is presented in this study because the optimization plays a significant role in selecting the neighbors as ring nodes. Finally, the superiority of the suggested approach is demonstrated in relation to various measures.
Calibrating the classifier for protein family prediction with protein sequence using machine learning techniques: An empirical investigation
Authors: Idhaya T. , Suruliandi A. , Calitoiu Dragos , Raja S. P.
Published: January 2023

A gene is a basic unit of congenital traits and a sequence of nucleotides in deoxyribonucleic acid that encrypts protein synthesis. Proteins are made up of amino acid residue and are classified for use in protein-related research, which includes identifying changes in genes, finding associations with diseases and phenotypes, and identifying potential drug targets. To this end, proteins are studied and classified, based on the family. For family prediction, however, a computational rather than an experimental approach is introduced, owing to the time involved in the latter process. Computational approaches to protein family prediction involve two important processes, feature selection and classification. Existing approaches to protein family prediction are alignment-based and alignment-free. The drawback of the former is that it searches for protein signatures by aligning every available sequence. Consequently, the latter alignment-free approach is taken for study, given that it only needs sequence-based features to predict the protein family and is far more efficient than the former. Nevertheless, the sequence-based characteristics taken for study have additional features to offer. There is, thus, a need to select the best features of all. When comes to classification still there is no perfection in classifying the protein. So, a comparison of different approaches is done to find the best feature selection technique and classification technique for protein family prediction. From the study, the feature subset selected provides the best classification accuracy of 96% for filter-based feature selection technique and the random forest classifier.