bluuebunny/crossref_metadata_2025 huggingface dataset:
What is the impact of integrated care on the job satisfaction of primary healthcare providers: a systematic review
Authors: Liu Mei , Wang Jian , Lou Jiaxu , Zhao Ruonan , Deng Jiahui , Liu Ziyu
Published: November 2023

Background and objectives

The integration of care influenced the job satisfaction of healthcare professionals, especially affecting primary healthcare providers (PCPs). This study aimed to perform a systematic review to explore the impact of integrated care on the job satisfaction of PCPs on the basis of Herzberg’s two-factor theory.

Methods

This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched 6 electronic databases, including CNKI, WANFANG, PubMed, Web of Science, Cochrane Library, and Embase. Data were retrieved from inception to 19 March 2023. The Mixed Methods Appraisal Tool (MMAT) version 2018 was used to assess the methodological quality of studies for inclusion in the review.

Results

A total of 805 articles were retrieved from databases, of which 29 were included in this review. 2 categories, 9 themes, and 14 sub-themes were derived from the data. 2 categories were identified as intrinsic and extrinsic factors. Intrinsic factors included 4 themes: responsibilities, promotion opportunities, recognition, and a sense of personal achievements and growth. Extrinsic factors included 5 themes: salaries and benefits, organizational policy and administration, interpersonal relationships, working conditions, and work status. To specify some key information under certain themes, we also identify sub-themes, such as the sub-theme “workload”, “work stress”, and “burnout” under the theme “work status”.

Conclusions

Findings suggested that the integration of care had both negative and positive effects on the job satisfaction of PCPs and the effects were different depending on the types of integration. Since PCPs played a vital role in the successful integration of care, their job satisfaction was an important issue that should be carefully considered when implementing the integration of care.
Carbamazepine regulates USP10 through miR-20a-5p to affect the deubiquitination of SKP2 and inhibit osteogenic differentiation
Authors: Wang Huan , Liu Ziye , Niu Dawei , Li Haobo , Han Yaguang , Peng Jinhui , Qian Qirong
Published: November 2023

Background

Antiepileptic drugs (AEDs) harm bone health and are significantly associated with osteoporosis development. In this study, we aimed to explore the mechanisms involved in carbamazepine (CBZ) and microRNA (miR)-20a-5p/ubiquitin-specific peptidase 10 (USP10)/S-phase kinase-associated protein 2 (SKP2) axis in osteoporosis.

Methods

Human bone marrow mesenchymal stem cells (BMSCs) were treated with different concentrations of CBZ. Knocking down or overexpressing miR-20a-5p, USP10, and SKP2 cell lines were constructed. The expressions of miR-20a-5p, USP10, SKP2, runt-related transcription factor 2 (Runx2), Alkaline phosphatase (ALP), Osterix (Osx), osteocalcin (OCN) and Collagen I were detected with western blot (WB) and reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR). Alizarin Red S (ARS) staining was performed to measure calcium deposition. Dual-luciferase assay and RNA immunoprecipitation (RIP) were applied to verify the binding relationship between miR-20a-5p and USP10. USP10 and SKP2 combination was verified by Co-Immunopurification (Co-IP). The stability of the SKP2 protein was verified by Cycloheximide chase assay.

Results

CBZ could reduce cell activity. ALP activity and ARS staining were enhanced in the osteogenic induction (OM) group. The expressions of Runx2, ALP, Osx, OCN and Collagen I were increased. CBZ reduced miR-20a-5p expressions. Verification experiments showed miR-20a-5p could target USP10. USP10 increased SKP2 stability and promoted SKP2 expression. CBZ regulated miR-20a-5p/USP10/SPK2 and inhibited BMSCs osteogenic differentiation.

Conclusions

CBZ regulated USP10 through miR-20a-5p to affect the deubiquitination of SKP2 and inhibit osteogenic differentiation, which provided a new idea for osteoporosis treatment.
Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria
Authors: Musa Jonah , Kocherginsky Masha , Magaji Francis A. , Maryam Ali J. , Asufi Joyce , Nenrot Danjuma , Burdett Kirsten , Katam Neelima , Christian Elizabeth N. , Palanisamy Nisha , Odukoya Olukemi , Silas Olugbenga A. , Abdulkareem Fatimah , Akpa Philip , Badmos Kabir , Imade Godwin E. , Akanmu Alani S. , Gursel Demirkan B. , Zheng Yinan , Joyce Brian T. , Achenbach Chad J. , Sagay Atiene S. , Anorlu Rose , Wei Jian-Jun , Ogunsola Folasade , Murphy Robert L. , Hou Lifang , Simon Melissa A.
Published: November 2023

Introduction

Invasive cervical cancer (ICC) is an HIV-associated cancer that is preventable and precancerous stages including early ICC stages could be detected through screening offering opportunities for treatment and cure. The high incidence in women living with HIV and late presentation often at advanced stages of ICC with limited treatment facilities often result in early mortality. We sought to compare the epidemiologic characteristics and survival differences in HIV status of ICC patients in Nigeria.

Methods

We conducted a cohort study at two federal academic hospital-based research sites in Jos University Teaching Hospital, and Lagos University Teaching Hospital Nigeria, between March 2018 and September 2022. We enrolled women with histologically confirmed ICC with known HIV status, and FIGO staging as part of the United States of America’s National Institutes of Health/National Cancer Institute funded project titled ‘Epigenomic Biomarkers of HIV-Associated Cancers in Nigeria’. The primary outcome was all-cause mortality with assessment of overall survival (OS) and time to death after ICC diagnosis. OS distribution was estimated using the method of Kaplan–Meier and compared between groups using the log-rank test.

Results

A total of 239 women with confirmed ICC were enrolled and included in this analysis, of whom 192 (80.3%) were HIV-negative (HIV−/ICC +), and 47 (19.7%) were HIV-positive (HIV +/ICC +). The HIV +/ICC + patients were younger with median age 46 (IQR: 40–51) years compared to 57 (IQR: 45–66) among HIV−/ICC + (P < 0.001). Squamous cell carcinoma was the commonest histopathologic variant in 80.4% of ICC diagnosis, moderately differentiated tumor grade in 68.1% in both groups. HIV +/ICC + diagnosis was at FIGO advanced stages in 64.9% compared to 47.9% in HIV−/ICC +. The HIV−/ICC + women had better OS compared to HIV +/ICC + participants (p = 0.018), with 12-month OS 84.1% (95%CI 75–90%) and 67.6% (95%CI 42–84%) respectively.

Conclusion

ICC is diagnosed at a relatively young age in women living with HIV, with a significantly lower overall survival probability compared to women without HIV. The trend of presentation and diagnosis at advanced stages in women living with HIV could partly explain the differences in overall survival.
The importance of intraoperative echocardiography in the early detection of mitral regurgitation as a postsurgical sequel of aortic valve replacement: a case report
Authors: Fesharaki Mehrdad Jafari , Akbari Tooba , Bayat Fariba , Ghadirzadeh Erfan , Charkazi Elham
Published: November 2023

Background

Mitral leaflet perforation (MLP) can rarely be a consequence of aortic valve replacement (AVR), resulting in mitral regurgitation (MR). Determining the cause and severity of MLP following AVR is crucial in preventing hemodynamic consequences, such as pulmonary hypertension and biventricular remodeling. However, the diagnosis of this rare complication requires detailed echocardiographic evaluations.

Case presentation

In this paper, we report a 37-year-old Persian male with progressive dyspnea on exertion diagnosed with severe MR caused by anterior MLP following AVR and discuss the importance of intraoperative transesophageal echocardiography (TEE) in the proper and on-time diagnosis of this rare complication.

Conclusion

During AVR procedure, an evaluation with TEE could be beneficial for identifying and treating such condition. Echocardiography is beneficial in providing real-time guidance during surgery, early detection of potential complications, treatment of such complications if present, and prevention of adverse outcomes.
The emerging roles of N6-methyladenosine RNA modifications in thyroid cancer
Authors: Xu Xiaoxin , Zhao Jiayao , Yang Mingyue , Han Lutuo , Yuan Xingxing , Chi Wencheng , Jiang Jiakang
Published: November 2023

Thyroid cancer (TC) is the most predominant malignancy of the endocrine system, with steadily growing occurrence and morbidity worldwide. Although diagnostic and therapeutic methods have been rapidly developed in recent years, the underlying molecular mechanisms in the pathogenesis of TC remain enigmatic. The N6-methyladenosine(m6A) RNA modification is designed to impact RNA metabolism and further gene regulation. This process is intricately regulated by a variety of regulators, such as methylases and demethylases. Aberrant m6A regulators expression is related to the occurrence and development of TC and play an important role in drug resistance. This review comprehensively analyzes the effect of m6A methylation on TC progression and the potential clinical value of m6A regulators as prognostic markers and therapeutic targets in this disease.
Implementing process-genre approach, feedback, and technology in L2 writing in higher education
Authors: Peungcharoenkun Tipaya , Waluyo Budi
Published: November 2023

The process-genre approach, varied feedback types, and technology integration have been shown to improve students' writing skills, but there is little research on how these three variables interact when implemented together in writing instruction. This study applied a quasi-experimental design with a sequential explanatory design to integrate the process-genre approach, teacher and peer oral and written feedback, and an online technology platform into a Thai university's English writing course. The experimental group received interventions, whereas the control group received standard writing instruction with papers and teacher and peer feedback. Writing pre- and post-tests, formative writing assignments, teacher, peer, oral, and written feedback surveys, and semi-structured interviews were the evaluation instruments. Descriptive statistics, the Wilcoxon Signed Rank Test, the Mann–Whitney–Wilcoxon test, Spearman's correlation, and Kendall–Theil regression were used to examine quantitative data. A thematic analysis examined qualitative data. The experimental group scored higher on post-tests than pre-tests, indicating that they valued instructor feedback more than other types of feedback. Task response and lexical resource showed substantial gains, although coherence and cohesion, grammatical range, and accuracy did not. The control group had no significant changes in pre- and post-test scores except for task responsiveness. Written feedback was significantly associated with post-test scores and certain post-test criteria in the experimental group. The findings emphasize the importance of a process-genre approach, constant feedback, and technology to improve students' writing.
Effect of Dioscorea extract on Bax and Bcl-2 gene expression in MCF-7 and HFF cell lines
Authors: Bojar Doulaby Fatemeh , Kavousi Mahsa , Jamshidian Faranak
Published: November 2023

Background

In cancer cells, the balance between proliferation and apoptosis is disturbed. There is a direct relationship between gene expression and the process of apoptosis. The two genes involved in apoptosis are Bax and Bcl-2, and it is now well established that some plant compounds can alter the expression of genes. The aim of this study is to determine the rate of change in the expression of these genes in the cell line MCF-7 treated with Dioscorea extract for 24, 48 and 72 h. For this purpose, the plant extract was prepared by Soxhlet method and diluted in different concentrations. MCF-7 and HFF cell lines were treated in three replicates with different concentrations of the extract at intervals of 24, 48, and 72 h. To evaluate the toxicity of the extract, the MTT assay was performed and the IC50 value was calculated. Both cell types were cultured at IC50 concentration with three treatments and three replicates. RNA extraction, cDNA synthesis and real-time PCR were then performed. Flow cytometry was performed to further confirm apoptosis.

Results

MTT results showed that 72 h treatment with Dioscorea extract in IC50 concentration had the greatest effect on the death of MCF-7 cancer cells, while the cells of the control cell line remained healthy. The results of the study of gene expression changes showed that when treated with the plant extract for 24 h, the increase in Bax gene expression and the decrease in Bcl-2 gene expression were not statistically significant. At 48-h treatment, the decrease in Bcl-2 expression was not statistically significant, whereas the increase in Bax expression, which was 2.1 times, was statistically significant. When treated with the plant extract for 72 h, Bax expression increased 2.72 times and Bcl-2 gene expression decreased 0.67 times. Flow cytometry showed that 72-h treatment with plant extract at a concentration of 438.35 µg/ml was the most effective treatment for MCF-7 cancer cell death.

Conclusions

The expression ratio of Bax gene to Bcl-2 is equal to 4.06, which indicates the induction of more apoptosis by treatment with plant extract.
Biliary atresia with rare associations: a case report
Authors: Sabra Tarek Abdelazeem , Abdelmohsen Sarah Magdy , Abdelazeem Basel
Published: November 2023

Background

It is not often written in medical journals that preduodenal portal vein, biliary atresia, intestinal malrotation, and situs inversus totalis are all related. This is a rare association.

Case reports

A 2-month-old female infant had biliary atresia type III, situs inversus totalis, midgut malrotation, and a preduodenal portal vein. She had been operated on by the Kasai procedure (hepato-portoenterostomy).

Discussion

It is important to carefully look into the relationship between the preduodenal portal vein and biliary atresia because the patient is at risk of injury from this aberrant vein during operative intervention.

Conclusion

The relationship between biliary atresia and other congenital anomalies like preduodenal portal vein, intestinal malrotation, and situs inversus must be taken into consideration to avoid other diverse effects during surgical intervention.
Barriers and facilitators of physical activity, sedentary and sleep behaviours in 3 to 4-year-old children from low-income families: a study protocol
Authors: Dalziell Andrew , Janssen Xanne
Published: November 2023

Background

This study will evaluate the barriers and facilitators that families experience in adhering to the 24-hour movement behaviours guidelines as outlined by World Health Organisation (WHO).

Methods

The study is a mixed-methods study and will recruit between 20 to 30 low-income families with children aged 3- to 4-years living in Scotland. For the quantitative part, children will be asked to wear an Actigraph (GT3X +) accelerometer to measure physical activity, sedentary behaviour, and sleep. Parents/guardians will be asked to keep an activity diary outlining when their child has had to remove the device (i.e., showering, bathing, swimming) and record the child’s screen time each day. Once the data has been analysed, a unique activity profile chart will be sent out to each family illustrating their child’s 24-hour movement behaviours (i.e., time spent active, time spent sedentary and on screens, time spent sleeping). The activity profile will provide a day-by-day output as well as a weekly average for each of the 24-hour movement behaviours. Qualitative data will be collected using the Asynchronous Remote Communities method (ARC). The ARC involves participants completing activities using an online closed Facebook group. Parents/guardians of 3- to 4-year-old children will be asked to engage in group discussion tasks using the private and closed-group online platform (a minimum of 6 and a maximum of 8 families per discussion group). The quantitative data collated from the questionnaire and activity monitor will be presented through descriptive analysis and after the 6-week asynchronous process is complete, qualitative data will be collated and analysed using Braun and Clarke’s reflexive approach to thematic analysis.

Discussion

The data collected will provide an understanding of what barriers and facilitators parent’s/guardians’ experience in relation to adhering to the 24-hour movement behaviour guidelines. This could potentially lead to the design and implementation of support and interventions to help families struggling to adhere to the guidelines.
The effect of depositional environment on sustaining a carbon storage site
Authors: Osunrinde Taiwo O. , Yelisetti Subbarao , Sanchez Veronica
Published: November 2023

One of the most difficult challenges facing planet earth is climate change caused by an increase in the concentration of greenhouse gases. Increased effort is being placed on delineating and characterizing suitable geologic formations that can house these gases. As part of this effort, we studied how the depositional environment would influence the storage of CO2 in the Illinois Basin. Lithofacies of the Mt. Simon Formation within the Illinois Basin were interpreted from the core data available for one of the four wells. The lithofacies interpreted from the core data were correlated with the motifs of the gamma-ray (GR) log in order to synchronize the information. Based on the lithofacies from the core and GR log, the depositional environment was defined. This was further used to establish a stratigraphic correlation across the four wells. Petrophysical analysis was carried out to evaluate the suitability of the rock properties in storing CO2. Structural features such as faults were interpreted on the 3D seismic data to evaluate the sealing capacity of the Mt. Simon Formation. A conceptual model of the depositional environment was developed and integrated with the rock properties using sequential Gaussian simulation. CO2 gas was injected and simulated in the Mt. Simon geologic model to evaluate how the flow would be impacted by the formation's depositional environment over time. Based on the lithofacies interpreted from the geologic core data and GR log, four depositional environments were interpreted — a braided river system, a fluvial deposit, a flood plain/shallow ephemeral environment, and eolian deposits. The structural framework revealed that the lower section of the Mt. Simon Formation is laterally extensive and structurally controlled. This allows CO2 gas to be evenly distributed throughout the formation.
First-Line Pembrolizumab + Chemotherapy Versus Placebo + Chemotherapy for Persistent, Recurrent, or Metastatic Cervical Cancer: Final Overall Survival Results of KEYNOTE-826
Authors: Monk Bradley J. , Colombo Nicoletta , Tewari Krishnansu S. , Dubot Coraline , Caceres M. Valeria , Hasegawa Kosei , Shapira-Frommer Ronnie , Salman Pamela , Yañez Eduardo , Gümüş Mahmut , Olivera Hurtado de Mendoza Mivael , Samouëlian Vanessa , Castonguay Vincent , Arkhipov Alexander , Tekin Cumhur , Li Kan , Keefe Stephen M. , Lorusso Domenica ,   on behalf of the KEYNOTE-826 Investigators
Published: November 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

The phase III, double-blind KEYNOTE-826 trial of pembrolizumab 200 mg or placebo once every 3 weeks for up to 35 cycles plus platinum-based chemotherapy, with or without bevacizumab, showed statistically significant survival benefits with the addition of pembrolizumab for patients with persistent, recurrent, or metastatic cervical cancer (primary data cutoff: May 3, 2021). This article reports the protocol-specified final overall survival (OS) results tested in the PD-L1 combined positive score (CPS) ≥1, all-comer, and CPS ≥10 populations. At the final data cutoff (October 3, 2022), the median study follow-up duration was 39.1 months (range, 32.1-46.5 months). In the PD-L1 CPS ≥1 (N = 548), all-comer (N = 617), and CPS ≥10 (N = 317) populations, median OS with pembrolizumab–chemotherapy versus placebo–chemotherapy was 28.6 months versus 16.5 months (hazard ratio [HR] for death, 0.60 [95% CI, 0.49 to 0.74]), 26.4 months versus 16.8 months (HR, 0.63 [95% CI, 0.52 to 0.77]), and 29.6 months versus 17.4 months (HR, 0.58 [95% CI, 0.44 to 0.78]), respectively. The incidence of grade ≥3 adverse events was 82.4% with pembrolizumab–chemotherapy and 75.4% with placebo–chemotherapy. These results show that pembrolizumab plus chemotherapy, with or without bevacizumab, continued to provide clinically meaningful improvements in OS for patients with persistent, recurrent, or metastatic cervical cancer.
Αρνητικότητα
Authors: Σταθάτου Όλγα
Published: November 2023

Στην εργασία αυτή επιχειρείται η ανασυγκρότηση σε ορισμένες βασικές θέσεις του γερμανού φιλοσόφου Τεόντορ Β. Αντόρνο. Η κεντρική σύλληψη που διέπει το έργο είναι η αρνητικότητα, η μη ταυτότητα, η οποία αποτελεί μια σχέση ανάμεσα στο υποκείμενο και το αντικείμενο, το λόγο και το είναι, την ιστορία και τη φύση που αξιώνει μέσω της ταυτότητας να στραφεί εναντίον της. Στην πρώτη ενότητα της εργασίας γίνεται αναφορά στην κριτική που ασκεί ο Αντόρνο στον Sören Kirkegaard, στον Edmund Husserl και στον Martin Heidegger. Βασική θέση της κριτικής του είναι ότι αυτές οι κορυφαίες φιλοσοφικές κατευθύνσεις δεν εκβάλλουν εν τέλει στην ανάπτυξη της ιστορικής εμπειρίας. Η πρώτη αυτή ενότητα κλείνει με μια αναφορά στον Αριστοτέλη – εδώ ο Αντόρνο θέλει να καταδείξει την σχέση ανάμεσα στην ιδεολογία και τη γνωσιοθεωρία. Η δεύτερη ενότητα της εργασίας αρχίζει με τις θέσεις που αναπτύσσει ο Αντόρνο απέναντι στην εγελιανή διαλεκτική. Ο πυρήνας της κριτικής του εστιάζει στο γεγονός ότι η ταυτότητα που συγκροτείται μέσα από την εγελιανή διαλεκτική έχει πραγματωθεί: ο καταναγκασμός της ταυτότητας δεν είναι μόνο λογικός είναι και πραγματωμένος και συνδέεται με το factum brutum της εμπειρίας. Η αντιφατικότητα που είναι βασική στην εγελιανή διαλεκτική είναι συγκροτητική και για την κοινωνική πραγματικότητα. Στη συνέχεια η εργασία αναφέρεται στο magnum opus του Αντόρνο, την Αρνητική Διαλεκτική και χωρίζεται σε δύο τμήματα. Στο πρώτο τμήμα εξετάζονται ορισμένες κεντρικές θέσεις του Αντόρνο που αφορούν τον αναστοχασμό του συστήματος, τον αναστοχασμό του μη ταυτού και τον αναστοχασμό του υλισμού. Στα πλαίσια αυτά ο Αντόρνο αναπτύσσει τη δική του θεώρηση για μια τροποποιημένη διαλεκτική, η οποία επικεντρώνεται στη διαλεκτική της ταυτότητας, στην κριτική προς τον ιδεαλισμό και στην προτεραιότητα του αντικειμένου. Στο δεύτερο τμήμα αυτής της ενότητας εξετάζονται τα τρία μοντέλα της Αρνητικής Διαλεκτικής, δηλαδή η ελευθερία, η ιστορία και η μεταφυσική. Στο ζήτημα της ελευθερίας είναι σημαντική η στιγμή της παρώθησης (Impuls) που είναι πνευματική και σωματική ταυτόχρονα – στο ζήτημα της ιστορίας είναι σημαντική η ανάδειξη της φυσικής εξάρτησης της ιστορίας και στο ζήτημα της μεταφυσικής είναι σημαντικό το γεγονός ότι έχει συντριβεί η βάση της μεταφυσικής δηλαδή η εμπειρία.Στην τρίτη ενότητα της εργασίας γίνεται αναφορά στο έργο του Τέοντορ Αντόρνο Αισθητική Θεωρία. Ο Αντόρνο θα κάνει κατ’ αρχήν μια κριτική στην ιδεαλιστική αισθητική (κυρίως με βάση τον Κάντ, τον Χέγκελ αλλά και τον Σίλλερ). Κατόπιν θα αναπτύξει το ζήτημα του κοινωνικού χαρακτήρα που έχει (ή που δεν έχει η τέχνη) καθόσον για τον Αντόρνο η τέχνη αποτελεί «την κοινωνική αντίθεση στην κοινωνία». Και τέλος θα αναφερθεί στην modernité προχωρώντας σε μια θερμή συνηγορία προς την avant-garde ενώ ταυτόχρονα αναγνωρίζει και τον ιδεολογικό χαρακτήρα της. Η εργασία κλείνει με μια αναφορά σε δευτερεύουσα βιβλιογραφία στην οποία κυρίως αναπτύσσεται το ερώτημα αν και κατά πόσον ο Αντόρνο υπερβαίνει την εγελιανή διαλεκτική.
Foresight in clinical proteomics: current status, ethical considerations, and future perspectives
Authors: Mundt Filip , Albrechtsen Nicolai J. Wewer , Mann Sebastian Porsdam , Treit Peter , Ghodgaonkar-Steger Medini , O’Flaherty Martina , Raijmakers Reinout , Vizcaíno Juan Antonio , Heck Albert J.R. , Mann Matthias
Published: November 2023

With the advent of robust and high-throughput mass spectrometric technologies and bioinformatics tools to analyze large data sets, proteomics has penetrated broadly into basic and translational life sciences research. More than 95% of FDA-approved drugs currently target proteins, and most diagnostic tests are protein-based. The introduction of proteomics to the clinic, for instance to guide patient stratification and treatment, is already ongoing. Importantly, ethical challenges come with this success, which must also be adequately addressed by the proteomics and medical communities. Consortium members of the H2020 European Union-funded proteomics initiative: European Proteomics Infrastructure Consortium-providing access (EPIC-XS) met at the Core Technologies for Life Sciences (CTLS) conference to discuss the emerging role and implementation of proteomics in the clinic. The discussion, involving leaders in the field, focused on the current status, related challenges, and future efforts required to make proteomics a more mainstream technology for translational and clinical research. Here we report on that discussion and provide an expert update concerning the feasibility of clinical proteomics, the ethical implications of generating and analyzing large-scale proteomics clinical data, and recommendations to ensure both ethical and effective implementation in real-world applications.
Educação 4.0 e Docência em Cursos de Gestão: O que Podemos Aprender com o Designer Educacional?
Authors: Pardim Vanessa Itacaramby , Ximenes Andrea Consolino , Yamamoto Iara , Barbosa Felipe Carvalhal , Viana Adriana Backx Noronha
Published: November 2023

Pensar o processo de ensino e aprendizagem no contexto da Educação 4.0 é um desafio, dada a presença crescente das tecnologias digitais de informação e comunicação (TDICs) nas salas de aula. A questão é que, muitas vezes, os professores se veem compelidos a adotar uma série de tecnologias sem que isso faça parte de um processo estruturado ou frente a inexistência ou ineficiência de programas de aprimoramento continuado que priorizam o aspecto tecnológico, mas não o educacional. Assim, este trabalho traz um relato de experiência sobre o curso Design Educacional Descomplicado, ofertado com o objetivo de auxiliar docentes dos cursos de gestão, na criação, desenvolvimento e avaliação de disciplinas presenciais com o apoio do Moodle. Como resultado, os professores consideraram o curso favorável, envolvente e relevante para a prática, porém sugeriram ajuste no tempo destinado ao desenvolvimento das atividades, por acreditarem ser exíguo tendo em vista a complexidade envolvida. Os fatos apresentados neste relato trazem importantes implicações para aqueles envolvidos no processo de aprimoramento continuado dos docentes, evidenciando que ao incorporar os conhecimentos sobre design educacional, com destaque para o modelo ADDIE, o processo contribuiu para aumentar a confiança na adoção de TDICs, com efeitos positivos sobre a prática docente.
“Larry, O Liquidador”: Um Caso De Ensino à Luz Do Filme ‘Com O Dinheiro Dos Outros’
Authors: Fontes Filho Joaquim Rubens , Baroni Alex Ribeiro Maia
Published: November 2023

Este caso de ensino, baseado no filme ‘Com o dinheiro dos outros’, trata da decisão dos acionistas de uma tradicional empresa frente ao dilema de vender suas ações a um potencial investidor, e assegurar um recurso financeiro, ou tentar revigorar o negócio em um contexto de decadência do mercado. Uma vez que o comprador pretende fechar a empresa e vender seus ativos, a venda das ações detidas pelos empregados e cidadãos da cidade, principais acionistas, representaria a perda de empregos e de importante receita para o orçamento público, mas recusar a oferta de aquisição poderia significar perdas muito maiores a todos. Como os acionistas, particularmente esses grupos mais vinculados à empresa, devem responder à oferta? A situação dispõe o conflito entre questões de governança corporativa de uma empresa que produz fios e cabos em uma pequena cidade do interior dos Estados Unidos.
Diagnostic suspicion bias and machine learning: Breaking the awareness deadlock for sepsis detection
Authors: Prasad Varesh , Aydemir Baturay , Kehoe Iain E. , Kotturesh Chaya , O’Connell Abigail , Biebelberg Brett , Wang Yang , Lynch James C. , Pepino Jeremy A. , Filbin Michael R. , Heldt Thomas , Reisner Andrew T.
Published: November 2023

Many early warning algorithms are downstream of clinical evaluation and diagnostic testing, which means that they may not be useful when clinicians fail to suspect illness and fail to order appropriate tests. Depending on how such algorithms handle missing data, they could even indicate “low risk” simply because the testing data were never ordered. We considered predictive methodologies to identify sepsis at triage, before diagnostic tests are ordered, in a busy Emergency Department (ED). One algorithm used “bland clinical data” (data available at triage for nearly every patient). The second algorithm added three yes/no questions to be answered after the triage interview. Retrospectively, we studied adult patients from a single ED between 2014–16, separated into training (70%) and testing (30%) cohorts, and a final validation cohort of patients from four EDs between 2016–2018. Sepsis was defined per the Rhee criteria. Investigational predictors were demographics and triage vital signs (downloaded from the hospital EMR); past medical history; and the auxiliary queries (answered by chart reviewers who were blinded to all data except the triage note and initial HPI). We developed L2-regularized logistic regression models using a greedy forward feature selection. There were 1164, 499, and 784 patients in the training, testing, and validation cohorts, respectively. The bland clinical data model yielded ROC AUC’s 0.78 (0.76–0.81) and 0.77 (0.73–0.81), for training and testing, respectively, and ranged from 0.74–0.79 in four hospital validation. The second model which included auxiliary queries yielded 0.84 (0.82–0.87) and 0.83 (0.79–0.86), and ranged from 0.78–0.83 in four hospital validation. The first algorithm did not require clinician input but yielded middling performance. The second showed a trend towards superior performance, though required additional user effort. These methods are alternatives to predictive algorithms downstream of clinical evaluation and diagnostic testing. For hospital early warning algorithms, consideration should be given to bias and usability of various methods.
Evaluating the documentation of vital signs following implementation of a new comprehensive newborn monitoring chart in 19 hospitals in Kenya: A time series analysis
Authors: Muinga Naomi , Tuti Timothy , Mwaniki Paul , Gicheha Edith , Paton Chris , Beňová Lenka , English Mike
Published: November 2023

Multi-professional teams care for sick newborns, but nurses are the primary caregivers, making nursing care documentation essential for delivering high-quality care, fostering teamwork, and improving patient outcomes. We report on an evaluation of vital signs documentation following implementation of the comprehensive newborn monitoring chart using interrupted time series analysis and a review of filled charts. We collected post-admission vital signs (Temperature (T), Pulse (P), Respiratory Rate (R) and Oxygen Saturation (S)) documentation frequencies of 43,719 newborns with a length of stay > 48 hours from 19 public hospitals in Kenya between September 2019 and October 2021. The primary outcome was an ordinal categorical variable (no monitoring, monitoring 1 to 3 times, 4 to 7 times and 8 or more times) based on the number of complete sets of TPRS. Descriptive analyses explored documentation of at least one T, P, R and S. The percentage of patients in the no-monitoring category decreased from 68.5% to 43.5% in the post-intervention period for TPRS monitoring. The intervention increased the odds of being in a higher TPRS monitoring category by 4.8 times (p<0.001) and increased the odds of higher monitoring frequency for each vital sign, with S recording the highest odds. Sicker babies were likely to have vital signs documented in a higher monitoring category and being in the NEST360 program increased the odds of frequent vital signs documentation. However, by the end of the intervention period, nearly half of the newborns did not have a single full set of TPRS documented and there was heterogenous hospital performance. A review of 84 charts showed variable documentation, with only one chart being completed as designed. Vital signs documentation fell below standards despite increased documentation odds. More sustained interventions are required to realise the benefits of the chart and hospital-specific performance data may help customise interventions.
The rod synapse in aging wildtype and Dscaml1 mutant mice
Authors: Clemons Mellisa R. , Dimico Ren H. , Black Cailyn , Schlussler Megan K. , Camerino Michael J. , Aldinger-Gibson Kirah , Bartle Amaris , Reynolds Nathan , Eisenbrandt Dylan , Rogers Aspen , Andrianu John , Bruce Bradley , Elliot Arthur , Breazeal Tom , Griffin Hannah , Murphy Molly K. , Fuerst Peter G.
Published: November 2023

The retina is an intricately organized neural tissue built on cone and rod pathways for color and night vision. Genetic mutations that disrupt the proper function of the rod circuit contribute to blinding diseases including retinitis pigmentosa and congenital stationary night blindness (CSNB). Down Syndrome cell adhesion molecule like 1 (Dscaml1) is expressed by rods, rod bipolar cells (RBCs), and sub-populations of amacrine cells, and has been linked to a middle age onset of CSNB in humans. However, how Dscaml1 contributes to this visual deficit remains unexplored. Here, we probed Dscaml1’s role in the maintenance of the rod-to-RBC synapse using a loss of function mouse model. We used immunohistochemistry to investigate the anatomical formation and maintenance of the rod-to-RBC synapse in the young, adult, and aging retina. We generated 3D reconstructions, using serial electron micrographs, of rod spherules and RBCs to measure the number of invaginating neurites, RBC dendritic tip number, and RBC mitochondrial morphology. We find that while rod-to-RBC synapses form and are maintained, similar to wildtype, that there is an increase in the number of invaginating neurites in rod spherules, a reduction in RBC dendritic tips, and reduced mitochondrial volume and complexity in the Dscaml1 mutant retina compared to controls. We also observed precocious sprouting of RBC dendrites into the outer nuclear layer (ONL) of the Dscaml1 mutant retina compared to controls. These results contribute to our knowledge of Dscaml1’s role in rod circuit development and maintenance and give additional insight into possible genetic therapy targets for blinding diseases and disorders like CSNB.
Indexing and partitioning the spatial linear model for large data sets
Authors: Ver Hoef Jay M. , Dumelle Michael , Higham Matt , Peterson Erin E. , Isaak Daniel J.
Published: November 2023

We consider four main goals when fitting spatial linear models: 1) estimating covariance parameters, 2) estimating fixed effects, 3) kriging (making point predictions), and 4) block-kriging (predicting the average value over a region). Each of these goals can present different challenges when analyzing large spatial data sets. Current research uses a variety of methods, including spatial basis functions (reduced rank), covariance tapering, etc, to achieve these goals. However, spatial indexing, which is very similar to composite likelihood, offers some advantages. We develop a simple framework for all four goals listed above by using indexing to create a block covariance structure and nearest-neighbor predictions while maintaining a coherent linear model. We show exact inference for fixed effects under this block covariance construction. Spatial indexing is very fast, and simulations are used to validate methods and compare to another popular method. We study various sample designs for indexing and our simulations showed that indexing leading to spatially compact partitions are best over a range of sample sizes, autocorrelation values, and generating processes. Partitions can be kept small, on the order of 50 samples per partition. We use nearest-neighbors for kriging and block kriging, finding that 50 nearest-neighbors is sufficient. In all cases, confidence intervals for fixed effects, and prediction intervals for (block) kriging, have appropriate coverage. Some advantages of spatial indexing are that it is available for any valid covariance matrix, can take advantage of parallel computing, and easily extends to non-Euclidean topologies, such as stream networks. We use stream networks to show how spatial indexing can achieve all four goals, listed above, for very large data sets, in a matter of minutes, rather than days, for an example data set.
Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19
Authors: Van de Velde Justine , Levecque Katia , Weijters Bert , Laureys Steven
Published: November 2023

While the COVID-19 pandemic challenged the general public’s health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers’ well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day.

Trial registration: ISRCTN ISRCTN61170784 (https://doi.org/10.1186/ISRCTN61170784).
Vibration optimization of spur gear based on GSA-SA algorithm
Authors: Qiu Linyue , Hou Xiangying , Gao Shushen , Li Zhengminqing , Zhu Rupeng
Published: November 2023

To determine the optimal design parameters of spur gear under a specific condition, based on the basic theories of gear dynamics theory, gear meshing principle, tooth contact analysis and load tooth contact analysis, a six-degree-of-freedom vibration analysis model of spur gear pair is established, and a gravitational search-simulated annealing hybrid algorithm (GSA-SA) is used to optimize the gear addendum modification coefficient and profile modification parameters. The vibration response of the spur gear pair is evaluated through the optimization objective function established by the combination of the G1 method and variation coefficient method. The study shows that the optimized design parameters effectively reduce the level of the vibration, which proves the effectiveness of the optimization method, and the simultaneous optimization of the addendum modification coefficient and profile modification parameters of the gear has a better result than only optimizing the addendum modification coefficient or profile modification parameters. This method can be used for gear transmission system vibration optimization design in the automotive industry and shipbuilding.
Liver sinusoidal endothelial cells show reduced scavenger function and downregulation of Fc gamma receptor IIb, yet maintain a preserved fenestration in the Glmpgt/gt mouse model of slowly progressing liver fibrosis
Authors: Antwi Milton Boaheng , Dumitriu Gianina , Simón-Santamaria Jaione , Romano Javier Sánchez , Li Ruomei , Smedsrød Bård , Vik Anders , Eskild Winnie , Sørensen Karen Kristine
Published: November 2023

Liver sinusoidal endothelial cells (LSECs) are fenestrated endothelial cells with a unique, high endocytic clearance capacity for blood-borne waste macromolecules and colloids. This LSEC scavenger function has been insufficiently characterized in liver disease. The Glmpgt/gt mouse lacks expression of a subunit of the MFSD1/GLMP lysosomal membrane protein transporter complex, is born normal, but soon develops chronic, mild hepatocyte injury, leading to slowly progressing periportal liver fibrosis, and splenomegaly. This study examined how LSEC scavenger function and morphology are affected in the Glmpgt/gt model. FITC-labelled formaldehyde-treated serum albumin (FITC-FSA), a model ligand for LSEC scavenger receptors was administered intravenously into Glmpgt/gt mice, aged 4 months (peak of liver inflammation), 9–10 month, and age-matched Glmpwt/wt mice. Organs were harvested for light and electron microscopy, quantitative image analysis of ligand uptake, collagen accumulation, LSEC ultrastructure, and endocytosis receptor expression (also examined by qPCR and western blot). In both age groups, the Glmpgt/gt mice showed multifocal liver injury and fibrosis. The uptake of FITC-FSA in LSECs was significantly reduced in Glmpgt/gt compared to wild-type mice. Expression of LSEC receptors stabilin-1 (Stab1), and mannose receptor (Mcr1) was almost similar in liver of Glmpgt/gt mice and age-matched controls. At the same time, immunostaining revealed differences in the stabilin-1 expression pattern in sinusoids and accumulation of stabilin-1-positive macrophages in Glmpgt/gt liver. FcγRIIb (Fcgr2b), which mediates LSEC endocytosis of soluble immune complexes was widely and significantly downregulated in Glmpgt/gt liver. Despite increased collagen in space of Disse, LSECs of Glmpgt/gt mice showed well-preserved fenestrae organized in sieve plates but the frequency of holes >400 nm in diameter was increased, especially in areas with hepatocyte damage. In both genotypes, FITC-FSA also distributed to endothelial cells of spleen and bone marrow sinusoids, suggesting that these locations may function as possible compensatory sites of clearance of blood-borne scavenger receptor ligands in liver fibrosis.
Factors associated with compliance with Infection Prevention and Control measures during the COVID-19 pandemic among healthcare workers in Kampala City, Uganda
Authors: Limenyande Mitima Jean-Marie , Kobusingye Joyce Owens , Tindyebwa Tonny , Akongo Dorothy , Isunju John Bosco , Musoke David
Published: November 2023

Background

In the context of the COVID-19 pandemic that originated from China in December 2019 and spread around the world, Kampala City witnessed a high number of infections and deaths among healthcare workers (HCWs). This study assessed the level of compliance with Infection Prevention and Control (IPC) measures and its associated factors among HCWs during the COVID-19 pandemic, in Kampala City, Uganda.

Methodology

A cross-sectional study was conducted in Nakawa Division, Kampala City, among 240 HCWs and used multistage sampling in government and private not-for-profit (PNFP) healthcare facilities. The outcome variable was self-reported IPC compliance which was composed of the use of masks, gloves, and hand hygiene. These were assessed using a 4-scale tool: always as recommended, most of the time, occasionally, and rarely. Only HCWs who responded “always as recommended” were considered compliant while the rest were considered non-compliant. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI).

Results

Forty-six (19.2%) respondents were compliant with all the three IPC measures, and this was associated with the presence of a COVID-19 patients’ ward in the healthcare facility (Adjusted Prevalence Ratio, APR: 2.51, 95%CI: 1.24–5.07). Factors associated with the use of masks were being of the Muslim religion (APR: 1.31, CI: 1.05–1.65), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.29, CI: 1.06–1.59). Factors associated with the use of gloves were the age of the HCW, those above 40 years old being less complaint (APR: 0.47, CI: 0.24–0.93), working in the diagnosis department (APR: 2.08, CI: 1.17–3.70), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.73, CI: 1.13–2.64). Factors associated with hand hygiene were working in a health center (HC) IV (PR: 1.7, CI: 1.26–2.30) or a HC II (PR: 1.68, CI: 1.28–2.21).

Conclusion

Considering the elevated risk of disease transmission in health settings, IPC compliance was low; indicating an increased risk of COVID-19 infection among health care workers in Kampala City.
Can a Kathakali (‘story-play’) hold a performance reading?
Authors: Tremblay Richard
Published: November 2023

The reformulation of the world heritage, on the one hand, and the discontinuity of contemporary art on the other congregate at the agency of the performing subject. Yet, the partitioning of synchronicity and diachronicity concur at new cultural sites and conjunctions of ethos to allow discursive stylization, giving ample scope for studying acts of performance in contact. In this perspective, the Kathakali Nāṭyōtpatti (‘birth of theatre’), a new production recently presented at the Kalamandalam Kūttampalam traditional theatre of Kerala, makes performance strategies visible enough to gain insight into the super roles densely packed into the work of art. The article seeks the story maker in the position of the story teller, especially in this presentation on the origins of dance where a young generation of theatre artists are underway to find more or less new paths in understanding what they perform. Judging from the small attendance, a mix of teachers, dance students and members of the local audience who gathered at the opening night of a puttiyakatha (‘new Kathakali story’), some scratching their heads, others peeping into their notes on the play in search of points of reference in the story, a sense of unfamiliarity pervaded the atmosphere at the presentation of Nāṭyōtpatti (‘The Birth of a Theatre/Dance/Music’) in Kerala. To the native audience, a Kathakali performance bearing upon the Nāṭyaśāstra, the Indian holy book on theatre, dance, music and the theatre arts, could be as exotic as a Kathakali Shakespeare. Kathakali has long been associated with the epics and the Pūraṇas. Dealing with the birth of dance through the medium of dance might appear auto-referential. But that gave the theatrical event an overlay to its aesthetic expression. And yet turning to the śāstra to go back to the origins of theatre and dance, the Kathakali dance theatre exposes itself as a mode of representation, and warrants a reflection on its formative years and the ongoing process of transformation involved in its narrative and dramatic devices.