bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethical human participant research in Central Asia: a quantitative analysis of attitudes and practices among social science researchers based in the region
Authors: Berekeyeva Aipara , Sharplin Elaine , Courtney Matthew , Sagitova Roza
Published: October 2023

Central Asian researchers are underrepresented in the global research production in social sciences, resulting in a limited Central Asian perspective on many social issues. To stimulate the production of local knowledge, it is important to develop strong research cultures, including knowledge of ethical practices in research with human participants. There is currently scarce evidence about research ethics regulations used by social science researchers working in the Central Asian region. This article reports findings from an online survey conducted in Kazakhstan, Kyrgyzstan, and Uzbekistan ( n = 296) from October 2021 to January 2022. Focusing on three Central Asian countries, this article addresses the following research questions: What are the attitudes and practices of social science researchers based in Central Asia toward research ethics regulations and research ethics committees (RECs)? Is research ethics training associated with improved attitudes and practices in relation to research ethics among social scientists based in Central Asia? Is research experience associated with improved attitudes and practices in relation to research ethics among social scientists based in Central Asia? Regression analyses results demonstrate that locally based social scientists with prior research ethics training implement ethical procedures in their empirical research practice more often compared to researchers without any prior research ethics training. The preliminary findings indicate that research ethics training is positively associated with Central Asia-based social science researchers’ engagement in ethical research, thus potentially increasing the amount and quality of empirical social science research produced in the region.
Restoration of positive self-image: Ideological circles in the mediatization of government-migrant worker relations during Covid 19
Authors: Lazar Michelle M , Tham Aaron , Wang Wesley
Published: October 2023

This article focuses on migrant workers (MWs) during Covid-19 in Singapore. A second wave of Covid-19 transmissions in MW dormitories in 2020 had cast a spotlight on this vulnerable population, amidst inter/national criticisms of the national government for oversight. From a critical discourse studies perspective, we examine how the national newspaper attempted to restore a positive self-image of the Singapore government, through the discursive mobilization of ‘ideological circles’. These ideological circles involve, variously, positive and negative discursive presentational strategies of the Singapore government, its MWs, selected regional governments, and their MWs. The study unpacks the ideological mechanisms at work in the restoration of the government’s reputation as well as examines the implications for MWs in Singapore as perpetual ‘others’.
Mobile-based program improves healthy eating of ulcerative colitis patients: A pilot study
Authors: Tu Wenjing , Yan Shuxia , Yin Tingting , Zhang Sumin , Xu Wenjing , Zhang Ping , Xu Guihua
Published: October 2023

Background

Dietary management plays a crucial role in the treatment of patients with ulcerative colitis (UC). While various e-services provide dietary advice, the long-term dietary management requires continuous monitoring and dynamic adjustment to accommodate the evolving nature of the disease and meet the patients’ nutritional needs. Consequently, the development of a novel dietary management tool that incorporates diet tracking, personalized nutritional feedback, and evidence-based advice becomes imperative. This study aims to address this need by developing a WeChat applet called “HealthyGut” specifically designed for the dietary management of UC patients, and evaluate its feasibility, acceptability, and preliminary efficacy.

Methods

A total of 134 UC patients were equally allocated into the intervention group (receiving a 12-week mobile-based dietary management via HealthyGut) and control group (receiving a paper-based food diary and routine advice). The feasibility outcomes were recruitment, retention, engagement, satisfaction, and acceptability in the intervention group. Dietary intakes were effective outcomes.

Results

Both groups had satisfactory retention rates (89.6% and 77.6%, respectively). The System Usability Scale in the intervention group yielded “good usability” with a mean score of 79.63 (SD 7.39), and all participants reported good user experiences and perceived benefits after using HealthyGut. At week 12, intervention responders reported significantly higher daily energy intake than control group (Z = −3.089, p = 0.002).

Conclusions and Implications

The results display that HealthyGut as a dietary management tool is feasible and accepted by UC patients, and it may help them make healthier food choices. Larger sample studies should be considered in the future.
Ethical considerations in implementing AI for mortality prediction in the emergency department: Linking theory and practice
Authors: Petersson Lena , Vincent Kalista , Svedberg Petra , Nygren Jens M , Larsson Ingrid
Published: October 2023

Background

Artificial intelligence (AI) is predicted to be a solution for improving healthcare, increasing efficiency, and saving time and recourses. A lack of ethical principles for the use of AI in practice has been highlighted by several stakeholders due to the recent attention given to it. Research has shown an urgent need for more knowledge regarding the ethical implications of AI applications in healthcare. However, fundamental ethical principles may not be sufficient to describe ethical concerns associated with implementing AI applications.

Objective

The aim of this study is twofold, (1) to use the implementation of AI applications to predict patient mortality in emergency departments as a setting to explore healthcare professionals’ perspectives on ethical issues in relation to ethical principles and (2) to develop a model to guide ethical considerations in AI implementation in healthcare based on ethical theory.

Methods

Semi-structured interviews were conducted with 18 participants. The abductive approach used to analyze the empirical data consisted of four steps alternating between inductive and deductive analyses.

Results

Our findings provide an ethical model demonstrating the need to address six ethical principles (autonomy, beneficence, non-maleficence, justice, explicability, and professional governance) in relation to ethical theories defined as virtue, deontology, and consequentialism when AI applications are to be implemented in clinical practice.

Conclusions

Ethical aspects of AI applications are broader than the prima facie principles of medical ethics and the principle of explicability. Ethical aspects thus need to be viewed from a broader perspective to cover different situations that healthcare professionals, in general, and physicians, in particular, may face when using AI applications in clinical practice.
Tolerability of subcutaneous ofatumumab with long-term exposure in relapsing multiple sclerosis
Authors: Kramer John , Linker Ralf , Paling David , Czaplinski Adam , Hoffmann Olaf , Yong V Wee , Barker Noreen , Ross Amy Perrin , Lucassen Elisabeth , Gufran Mohammad , Hu Xixi , Zielman Ronald , Seifer Gustavo , Vermersch Patrick
Published: October 2023

Background

Ofatumumab is approved for treating relapsing multiple sclerosis (RMS). Examining tolerability will enable understanding of its risk–benefit profile.

Objective

Report the tolerability profile of ofatumumab in RMS during treatment of up to 4 years and the effect of pre-medication.

Methods

Cumulative data from the overall safety population included patients taking continuous ofatumumab or being newly switched from teriflunomide. Injection-related reactions (IRRs) by incidence and severity, and post-marketing surveillance data, with an exposure of 18,530 patient-years, were analyzed.

Results

Systemic IRRs affected 24.7% of patients (487/1969) in the overall safety population; most (99.2% [483/487]) were mild (333/487) to moderate (150/487) in Common Terminology Criteria for Adverse Events severity; most systemic IRRs occurred after first injection. Local-site IRRs affected 11.8% (233/1969) and most (99.6% [232/233]) were mild/moderate. Incidence and severity of systemic and localized IRRs were similar between continuous and newly switched patients across repeated injections. Systemic IRR incidence and severity were not substantially affected by steroidal or non-steroidal pre-medication. Post-marketing surveillance identified no new tolerability issues.

Conclusion

Ofatumumab is well tolerated, displays a consistent safety profile during continuous use or after switching from teriflunomide and does not require pre-medication. This enables home management of RMS with a high-efficacy treatment.
The influence of methylphenidate on auditory brainstem response patients with attention deficit hyperactivity disorder; an exploratory study
Authors: Claesdotter-Knutsson Emma , Källstrand Johan , Niklasson Katalin , Andersson Mitchell , Lindvall Magnus
Published: October 2023

Background:

Attention-deficit hyperactivity disorder (ADHD), characterized by periods of inattention, overactivity, and impulsiveness, is the most prevalent neurodevelopmental disorder among children. Auditory Brainstem Response (ABR) is a technique in which clickshaped sounds elicit potentials that are recorded from electrodes placed on a patient’s skull. Extant research indicates that ABR is frequently affected in neurodevelopmental disorders such as ADHD. Methylphenidate (MPH), a psychostimulant, is often prescribed to children with ADHD as a first-line pharmacological treatment. The aim of this study was to explore the effects of Methylphenidate treatment on previously observed amplitude alterations in the ABR of patients with ADHD.

Methods:

We recruited 32 drug-naïve children and adolescents (19 males and 13 females; mean age 11 years) diagnosed with ADHD and 35 health controls (15 males and 20 females; mean age 12 years). The ADHD group was treated with Methylphenidate, and ABR was recorded before treatment and at a steady state of medical treatment.

Results:

Medicated ADHD patients exhibited increased activity in the right side ABR in Wave VI.

Conclusions:

A significant increase in activity was found in a part of the ABR thought to correspond to the thalamic area in medicated ADHD patients compared to the same area of non-medicated ADHD patients. The results add to the growing body of research suggesting that specific ABR peaks correlate to certain psychiatric symptoms.
Assessment of Coracoclavicular Ligament Healing on MRI After Arthroscopic TightRope Fixation for Acute Acromioclavicular Joint Dislocation
Authors: Elhalawany Mohamed Fathy , Abdalla Usama Gaber , Shwitter Lotfy , ElAttar Mohammed Said , Fahmy Fahmy Samir
Published: October 2023

Background:

Arthroscopic-assisted fixation of acute high-grade acromioclavicular (AC) joint dislocation has gained popularity in the last decade. Coracoclavicular (CC) fixation using the TightRope device is a less invasive technique.

Purpose:

To investigate CC ligament healing and functional outcomes after arthroscopic fixation using the TightRope device for acute AC joint disruption.

Study Design:

Case series; Level of evidence, 4.

Methods:

The study retrospectively analyzed the data of patients admitted for arthroscopic surgical treatment of acute AC joint injury using a single TightRope device. The data collection commenced in October 2021. The Constant-Murley (CM) score and University of California, Los Angeles (UCLA) shoulder score were used for functional evaluation. The CC distance (CCD) was measured on plain radiographs, whereas healing of the CC ligament was evaluated on magnetic resonance imaging (MRI). Statistical analyses were conducted with the Mann-Whitney U test, independent t test, or paired t test, as appropriate.

Results:

The analysis included 33 patients with a mean age of 37.7 years (range, 24-49 years) and a minimum follow-up of 24 months. Significant preoperative to postoperative increases were noted in both the CM and UCLA scores (from 34.1 ± 7.6 to 93.3 ± 3.6 and from 8.7 ± 2.1 to 32.9 ± 1.7, respectively; P < .0001 for both). The CCD decreased from 21.8 ± 3.02 mm preoperatively to 10.6 ± 1.2 mm postoperatively ( P < .0001). All patients displayed CC ligament healing on MRI. Two patients with superficial infection and 1 case of partial reduction loss were confirmed at the end of this study.

Conclusion:

The arthroscopic TightRope technique was found to be a reliable and less invasive method of fixation for acute AC joint disruptions. The CC ligament healed adequately based on MRI evaluation, and the patients regained their preinjury activities, with favorable functional outcomes and minor comorbidities.
Comparable Injury to the Indirect Head of the Rectus Femoris During Interportal and Periportal Capsulotomy: A Cadaveric Study
Authors: Patel Urvi J. , Anderson Devon E. , Yen Yi-Meng , Giordano Brian D.
Published: October 2023

Background:

There is concern for maintaining the integrity of the reflected head of the rectus femoris during arthroscopic hip joint access. Because of the proximity to the indirect head of the rectus femoris (IHRF), capsulotomy technique and capsular closure during routine hip arthroscopy may play a role in postoperative tendinitis.

Purpose:

To quantify the extent of injury sustained to the IHRF during interportal versus periportal capsulotomy for routine arthroscopic hip joint access.

Study Design:

Controlled laboratory study.

Methods:

A cadaveric study was conducted using 20 fresh-frozen cadaveric hips, in which hip joint access through a periportal capsulotomy (n = 10) or interportal capsulotomy (n = 10) was performed. Capsular closure followed by a layered dissection to the capsuloligamentous complex of the hip joint was then performed to localize the IHRF. Suture proximity to the tendon, tendon disruption, and the IHRF footprint was documented to the nearest 0.01 mm using digital calipers. Statistical analysis was performed using unpaired Student t tests.

Results:

The mean capsulotomy length for the interportal specimens was 19.27 ± 3.25 mm, and the mean medial and lateral capsulotomy length for the periportal specimens was 4.47 ± 1.60 and 4.26 ± 0.89 mm, respectively. There was violation of the tendon in 3 of 10 interportal specimens and 4 of 10 periportal specimens. There was no significant difference in the closest suture measured to the IHRF for specimens with versus without tendon violation, for either interportal or periportal capsulotomy.

Conclusion:

We found comparable outcomes with regard to violation of the IHRF between interportal and periportal capsulotomy, with no significant difference in suture proximity to the IHRF in specimens with or without tendon violation. There remains no consensus on the ideal method by which to avoid iatrogenic damage to the IHRF.

Clinical Relevance:

Our findings provide insight that may lead to future advances in surgical care, such that protection of the tendon during routine hip arthroscopy may allow for improved postoperative rehabilitation and strength.
Susceptibility to Steady Noise Largely Explains Susceptibility to Dynamic Maskers in Cochlear Implant Users, but not in Normal-Hearing Listeners
Authors: Chen Biao , Shi Ying , Kong Ying , Chen Jingyuan , Zhang Lifang , Li Yongxin , Galvin John J. , Fu Qian-Jie
Published: October 2023

Different from normal-hearing (NH) listeners, speech recognition thresholds (SRTs) in cochlear implant (CI) users are typically poorer with dynamic maskers than with speech-spectrum noise (SSN). The effectiveness of different masker types may depend on their acoustic and linguistic characteristics. The goal of the present study was to evaluate the effectiveness of different masker types with varying acoustic and linguistic properties in CI and NH listeners. SRTs were measured with nine maskers, including SSN, dynamic nonspeech maskers, and speech maskers with or without lexical content. Results showed that CI users performed significantly poorer than NH listeners with all maskers. NH listeners were much more sensitive to masker type than were CI users. Relative to SSN, NH listeners experienced significant masking release for most maskers, which could be well explained by the glimpse proportion, especially for maskers containing similar cues related to fundamental frequency or lexical content. In contrast, CI users generally experienced negative masking release. There was significant intercorrelation among the maskers for CI users’ SRTs but much less so for NH listeners’ SRTs. Principal component analysis showed that one factor explained 72% of the variance in CI users’ SRTs but only 55% in NH listeners’ SRTs across all maskers. Taken together, the results suggest that SRTs in SSN largely accounted for the variability in CI users’ SRTs with dynamic maskers. Different from NH listeners, CI users appear to be more susceptible to energetic masking and do not experience a release from masking with dynamic envelopes or speech maskers.
Predictors of illiberalism in Romania: A case study during the Russian invasion in Ukraine
Authors: Bârgăoanu Alina , Durach Flavia , Ştefăniţă Oana
Published: October 2023

Illiberalism emphasizes traditional values and national sovereignty over liberal democratic ideals, which can lead to the erosion of democratic norms and institutions. Against this background, the paper investigates the relationship between illiberalism and various political and social factors in Romania, taking into account a particular context (the Russian invasion in Ukraine). Romania has experienced a rise in illiberal attitudes and the spread of populist and nationalist rhetoric, which is particularly concerning given its strategic location as a member of the European Union and NATO, and its proximity to the ongoing conflict in Ukraine. This study aims to investigate the associations between various attitudes, news consumption habits, and perceived exposure to misinformation, and how these factors relate to levels of illiberalism in Romanian society. Given the increasing prominence of illiberal and populist ideologies globally, a nuanced understanding of these relationships is critical. The study employs a quantitative approach, leveraging an online survey to collect data from a sample of 1000 Romanian citizens. Soft quotas were used to ensure a diverse representation across age, gender, and education levels. Data collection was carried out by Dynata, a globally recognized market research firm, between March 1–9, 2022. Our analysis, informed by multiple regression models, uncovers complex relationships between trust in institutions, attitudes towards Russia and Ukraine, news consumption habits, perceived misinformation, and demographic factors in shaping illiberal perspectives. By providing a comprehensive understanding of the contributing factors, this study aims to inform public discourse and policy-making processes on how to address illiberal tendencies in society.
Critical Care Nursing in a Resource-Constrained Setting: A Qualitative Study of Critical Care Nurses’ Experiences Caring for Patients on Mechanical Ventilation
Authors: Mukuve Paulus , Nuuyoma Vistolina
Published: October 2023

Introduction

Managing a patient on mechanical ventilation is a vital aspect of clinical scope in intensive and critical care units. In addition, it is a highly technical, intricate, dynamic task requiring extensive knowledge and skills. Little is known about critical care nurses’ experiences caring for patients on mechanical ventilation in contexts where resources are constrained, creating an empirical gap in the available body of knowledge.

Objective

This study explored critical care nurses’ experiences caring for patients on mechanical ventilators at an intermediate hospital in northeastern Namibia.

Method

The study followed qualitative descriptive and explorative designs. The purposive sample included 13 critical care nurses who had cared for patients on mechanical ventilation for more than 6 months. Data were collected via individual unstructured interviews and analyzed using a reflexive thematic analysis approach.

Results

Four themes and eight subthemes emerged. Varied personal feelings, such as feeling proud, competent, exhausted, traumatized, overwhelmed, and concerns for patients’ well-being were experienced by critical care nurses. Participants described learning from colleagues in the unit and expressed concerns about not having postbasic training in critical care nursing. Negative experiences included concerns about community members’ misconceptions about critical care units and mechanical ventilators, and challenges with resources, personnel, and admission procedures.

Conclusion

Critical care nurses in resource-constrained settings have positive and negative experiences caring for patients on mechanical ventilators. The findings have implications for the development of support systems for critical care nurses, including induction programs, competence enhancement, psychological support, the development of guiding documents for admission, patient preparation and sensitization of community members. There is a need for this study to be replicated in other resource-constrained contexts where specialized critical care nurses are available.
Sociodemographic and Maternal Determinants of Postnatal Care Utilization: A Cross-Sectional Study
Authors: Asumah Mubarick Nungbaso , Abubakari Abdulai , Abdulai Abdul Malik , Nukpezah Ruth Nimota , Adomako-Boateng Fred , Faridu Abdul-Wadudu , Kubio Chrysantus , Padhi Bijaya Kumar , Kabir Russell
Published: October 2023

Introduction

Postnatal care (PNC) is critical for the newborn and the mother, as it offers the opportunity to examine the mother and child to ensure early and timely intervention of any obstetric anomalies that might have gone unnoticed during delivery. However, there is a lack of data on PNC utilization and associated determinants in Ghana. Meanwhile, it is suspected that the PNC service should be more patronized by mothers, particularly within the first 2 days after delivery; therefore, investigating PNC utilization and associated factors could inform policies to enhance PNC uptake.

Objective

The objective is to determine the level of utilization of PNC service and associated factors in the Savannah region of Ghana.

Methods

The study used a facility-based analytical cross-sectional study design. The study was carried out in 311 postnatal mothers using consecutive sampling. Data collection was carried out using a questionnaire. Univariate and multiple logistic regression was performed to establish the determinants of PNC. Variables/variable categories with P < .05 were significantly associated with PNC. The significance level is anchored at P < .05.

Results

The study showed that almost all respondents (98.7%) have heard about PNC services through health workers (39.7%), media (13.0%), and friends and relatives (47.2%). Most of the respondents (88.7%) have used PNC services within 48 h. Mothers aged 25–39 years were about seven times more likely to utilize PNC compared to those who were less than 25 years old (AOR [adjusted odds ratio] = 7.41, 95% CI [confidence interval]: 1.98–7.71); mothers with high school education (SHS) and above were also approximately four times more likely to use PNC compared to those who had no formal education (AOR = 3.65, 95% CI 1.97–13.66). In the same vein, married mothers were 10 times more likely to use PNC compared to those who are single mothers (AOR = 10.34, 95% CI: 3.69–28.97), whereas mothers who had at least four antenatal care (ANC) visits during pregnancy were approximately seven times more likely to use PNC compared to those who had less than four ANC visits (AOR = 6.92, 95% CI: 1.46–32.78). Reasons for not attending PNC include waiting time (40.5%), health workers’ attitude (32.4%), being attended by a student (16.2%), being busy (27.0%), inadequate information on PNC (24.3%), and no family support (18.9%).

Conclusion

All mothers knew about the PNC services, with a higher proportion patronizing the services. The increasing age, the level of mothers, marital status, and participation in ANC were significant determinants of the use of PNC. More education during ANC on the importance of PNC service is required to achieve universal coverage of PNC.
Modeling as Visioning: Exploring the Impact of Criminal Justice Reform on Health of Populations with Substance Use Disorders
Authors: Martin Natasha K. , Beletsky Leo , Linas Benjamin P. , Bayoumi Ahmed , Pollack Harold , Larney Sarah
Published: October 2023

In the context of historic reckoning with the role of the criminal-legal system as a structural driver of health harms, there is mounting evidence that punitive drug policies have failed to prevent problematic drug use while fueling societal harms. In this explainer article, we discuss how simulation modeling provides a methodological framework to explore the potential outcomes (beneficial and harmful) of various drug policy alternatives, from incremental to radical. We discuss potential simulation modeling opportunities while calling for a more active role of simulation modeling in visioning and operationalizing transformative change.

Highlights

This article discusses opportunities for simulation modeling in projecting health and economic impacts (beneficial and harmful) of drug-related criminal justice reforms. We call on modelers to explore radical interventions to reduce drug-related harm and model grand alternative futures in addition to more probable scenarios, with a goal of opening up policy discourse to these options.
Various Types of Wounds That Diabetic Patients Can Develop: A Narrative Review
Authors: Jais Suriadi
Published: October 2023

Diabetic foot complications represent a substantial health burden and are the foremost cause of hospitalization in patients with diabetes. Diabetes mellitus (DM) is known to cause several other problems. Diabetes is rapidly becoming the leading cause of illness and death worldwide. Diabetic foot ulcers (DFU) are one of the most painful complications of diabetes. These complications cause problems in blood vessels, nerves, and other organs throughout the body. DFU pathophysiology is attributed to a triad of neuropathies, trauma with secondary infection, and arterial occlusive disease. This review aims to identify the types of wounds that diabetics can develop. Owing to the complexity of their disease pathology, diabetics are susceptible to a variety of wounds, such as diabetic ulcers due to trauma (DUDT); neuropathic, ischemic, neuroischemic, arterial, venous, and mixed wounds; and diabetic bullae, furuncles, cellulitis, and carbuncles. Therefore, it is essential for healthcare providers to recognize the specific classification of a diabetic wound based on its distinctive attributes to provide appropriate wound care and therapeutic interventions. In the context of individuals with diabetes, it is of paramount significance to precisely identify the types of wounds during the initial evaluation to provide appropriate care and treatment, thereby enhancing the probability of favorable outcomes.
Extracorporeal Shockwave Therapy Improves Outcomes Following Secondary Alveolar Bone Grafting
Authors: Coombs Demetrius M. , Patel Viren , Kochenour Nicholas , Patel Niyant , Murthy Ananth S.
Published: October 2023

Background:

Recent studies have reported that extracorporeal shock wave therapy (ESWT) enhances bone formation during mandibular distraction osteogenesis. This study seeks to investigate the clinical outcomes in children undergoing ESWT alongside secondary alveolar bone grafting procedures at our institution.

Methods:

Retrospective review of all children that underwent secondary alveolar cleft bone grafting with adjunctive ESWT between 2019 and 2021. Variables including age, gender, cleft type, cleft width, pre-operative cleft dentition, volume of bone graft placed intraoperatively, ESWT settings, pain medication utilization, length of stay (LOS), follow-up, cone beam computed tomography (CBCT) data, and complications were recorded.

Results:

Twenty patients met inclusion criteria. Median age at surgery was 9 years (range 8-16). Four (20%) patients were female; 16 (80%) were male. Eight (40%) patients had bilateral alveolar clefts; 12 (60%) had unilateral clefts. All (100%) patients were discharged on the day of surgery. Twelve (60%) patients required a median of 1.3 oxycodone doses post-operatively (range 0-6.5). All patients received ESWT treatments intra and post-operatively. All patients demonstrated an increase in bone graft volume visualized on CBCT: median increase of 6.8% (range 1.3%-35.7%) between 106.5 days (17.5% of ideal visualized, range 5%-42%) and 245.5 days (27.9% of ideal, range 8%-55.7%). Three (15%) patients experienced minor complications.

Conclusions:

Initial outcomes suggest that ESWT may expedite visualization of bone consolidation and facilitate recovery without increasing complications. ESWT could further represent an opportunity to improve care in craniofacial surgery. Pertinent considerations, the role of standardized assessment protocols, and future directions will be reviewed.
Colleagues or Friends? Comparing Communication and Advice Networks for Building Information Modeling (BIM) Implementation in Construction Projects
Authors: Cao Dongping , Shao Shiting
Published: October 2023

We examine how formal task-oriented communication and informal knowledge-oriented advice networks for building information modeling (BIM) implementation in construction projects exhibit different macrostructural characteristics and microformation mechanisms. The results show that while the two networks have some shared connections, individuals are more densely connected and centrally embedded within triads in the communication network than in the advice network. The results further show that the formation of these networks is differently driven by BIM implementation behaviors and individual demographic characteristics, suggesting that managers need to contingently design measures to facilitate task coordination and knowledge exchange for innovation implementation among heterogeneous participants in temporary projects.
Similar proteome expression profiles of the aggregated lymphoid nodules area and Peyer’s patches in Bactrian camel
Authors: Cheng Yujiao , Ren Yan , Wang Wenhui , Zhang Wangdong
Published: October 2023

Background

The presence of Aggregated Lymphoid Nodules Area (ALNA) is a notable anatomical characteristic observed in the abomasum of Bactrian camels. This area is comprised of two separate regions, namely the Reticular Mucosal Folds Region (RMFR) and the Longitudinal Mucosal Folds Region (LMFR). The histological properties of ALNA exhibit significant similarities to those of Peyer’s patches (PPs) found in the gastrointestinal system. The functional characteristics of ALNA were examined in relation to mucosal immunity in the gastrointestinal system.

Results

We used iTRAQ-based proteomic analysis on twelve Bactrian camels to measure the amount of proteins expressed in ALNA. In the experiment, we sampled the RMFR and LMFR separately from the ALNA and compared their proteomic quantification results with samples from the PPs. A total of 1253 proteins were identified, among which 39 differentially expressed proteins (DEPs) were found between RMFR and PPs, 33 DEPs were found between LMFR and PPs, and 22 DEPs were found between LMFR and RMFR. The proteins FLNA, MYH11, and HSPB1 were chosen for validation using the enzyme-linked immunosorbent assay (ELISA), and the observed expression profiles were found to be in agreement with the results obtained from the iTRAQ study. The InnateDB database was utilized to get data pertaining to immune-associated proteins in ALNA. It was observed that a significant proportion, specifically 76.6%, of these proteins were found to be associated with the same orthogroups as human immune-related genes. These proteins are acknowledged to be associated with a diverse range of functions, encompassing the uptake, processing and presentation of antigens, activation of lymphocytes, the signaling pathways of T-cell and B-cell receptors, and the control of actin polymerization.

Conclusions

The experimental results suggest that there are parallels in the immune-related proteins found in ALNA and PPs. Although there are variations in the structures of LMFR and RMFR, the proteins produced in both structures exhibit a high degree of similarity and perform comparable functions in the context of mucosal immune responses.
COVID-19 risks in private equity nursing homes in Hesse, Germany – a retrospective cohort study
Authors: Evers Janis , Geraedts Max
Published: October 2023

Background

Private-equity-owned nursing homes (PENH) represent the strongest form of profit orientation in the nursing care market. Private equity firms aim to increase the profitability of nursing care facilities, which often leads to cost-cutting measures and the use of less qualified staff. Our study aims to fill the existing knowledge gap by examining the association between private equity ownership and COVID-19 related infections and deaths among residents and staff during the COVID-19 pandemic.

Methods

We analyzed outbreak and mortality data for the period from 20/03/2020 to 05/01/2022 from 32 long-term care facilities in the Federal State of Hesse, Germany, which included 16 PENH that were propensity score matched on regional population density and number of beds with 16 non-PENH. We used logistic regression to determine the odds ratios (OR) for above-median values for the independent variables of PENH-status, number of beds, proportion of single rooms, registered nurses' ratio, and copayments.

Results

PENH had substantially fewer outbreaks in number, but longer and larger outbreaks among nursing home residents, as well as a markedly increased proportion of deceased residents. The odds of the outcome "infections & deaths" were 5.38 (p <. 05) times higher among PENH compared to non-PENH.

Conclusions

The study indicates a need for further research into the quality of care in PENH to inform evidence-based policy decisions, given the higher infection and death rates. Improved documentation and public visibility of PENH is also recommended, in line with existing practices for for-profit and non-profit nursing homes in Germany. Given our findings, regulatory bodies should closely observe PENH operational practices.
The associations of gestational weight gain and midpregnancy lipid levels with placental size and placental-to-birth weight ratio: findings from a chinese birth cohort study
Authors: Zhang Kangdi , Jia Xiaomin , Yu Wenjie , Cheng Xin , Li Yingqing , Wang Xinqiang , Wang Jie , Li Zhenhua , Mao Yicheng , Zhao Jiawen , Li Tao , Chen Maolin , Gao Guopeng , Hu Chengyang , Yan Shuangqin , Zhang Xiujun
Published: October 2023

Background

The placenta serves as the sole maternal organ responsible for transmitting nutrients to the fetus, playing a crucial role in supporting standard fetal growth and development. To date, only a small number of studies have investigated the impact of maternal gestational weight gain and lipid concentrations on placental development. This study aimed to explore the influence of weight gain during pregnancy and lipid levels in the second trimester on placental weight, volume, and the placental weight ratio.

Methods

This birth cohort study encompassed 1,358 mother-child pairs. Placental data for each participant was gathered immediately post-delivery, and the study incorporated data on gestational weight gain throughout pregnancy and lipid profiles from the mid-trimester. A linear regression model was employed to assess the correlations between gestational weight gain, mid-trimester lipid levels, and metrics such as placental weight, placental volume, and the placental-to-birth weight ratio (PFR).

Results

In the study groups of pre-pregnancy underweight, normal weight, and overweight, the placental weight increased by 4.93 g (95% CI: 1.04–8.81), 2.52 g (95% CI: 1.04–3.99), and 3.30 g (95% CI: 0.38–6.22) per 1 kg of gestational weight gain, respectively. Within the pre-pregnancy underweight and normal weight groups, the placental volume increased by 6.79 cm^3 (95% CI: 3.43–10.15) and 2.85 cm^3 (95% CI: 1.31–4.39) per 1 kg of gestational weight gain, respectively. Additionally, placental weight exhibited a positive correlation with triglyceride (TG) levels (β = 9.81, 95% CI: 3.28–16.34) and a negative correlation with high-density lipoprotein (HDL-C) levels (β = − 46.30, 95% CI: − 69.49 to − 23.11). Placental volume also showed a positive association with TG levels (β = 14.54, 95% CI: 7.69–21.39). Conversely, PFR demonstrated a negative correlation with increasing HDL-C levels (β = − 0.89, 95% CI: − 1.50 to − 0.27).

Conclusions

Gestational weight gain was significantly correlated with both placental weight and volume. This association was especially pronounced in women who, prior to pregnancy, were underweight or of normal weight. Additionally, TG and HDL-C levels during the mid-trimester were linked to placental development.
Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis
Authors: Lv Jiamin , Xu Li , Mao Shuhui
Published: October 2023

Background

A meta-analysis has compared the pregnancy outcomes between women with and without RA, while the effect of disease severity on pregnancy outcomes within women with RA has not been explored. Therefore, we performed a systematic review and meta-analysis to assess the association between disease activity of RA and pregnancy outcomes.

Methods

Four English databases (Pubmed, Embase, Cochrane Library, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure [CNKI], VIP, and Wan Fang) was searched for eligible studies up to August 13, 2023. Cochran’s Q test and the I2 statistic were used to assess the heterogeneity of the included studies. The odds ratio (OR) (for counting data) and weighted mean difference (WMD) (for measurement data) were calculated with 95% confidence intervals (95%CIs) using random-effect model (I2 ≥ 50%) or fixed-effect model (I2 < 50%). Subgroup analysis based on study design and regions was used to explore the sources of heterogeneity. Sensitivity analysis was performed for all outcomes and the publication bias was assessed using Begg’s test.

Results

A total of 41 eligible articles were finally included. RA women had higher odds to suffer from preeclampsia, gestational diabetes, spontaneous abortion, and cesarean delivery (all P < 0.05). The infants born from RA mother showed the higher risk of stillbirth, SGA, LBW, congenital abnormalities, diabetes type 1, and asthma (all P < 0.05). The high disease activity of RA was significantly associated with the higher risk of cesarean delivery (OR: 2.29, 95%CI: 1.02–5.15) and premature delivery (OR: 5.61, 95%CI: 2.20–14.30).

Conclusions

High disease activity of RA was associated with the high risk of adverse pregnancy outcomes, suggesting that it was important to control disease for RA women with high disease activity who prepared for pregnancy.
Role of multi-strain probiotics in preventing severity and frequency of recurrent respiratory tract infections in children
Authors: Khan Laghari Imran , Nawaz Tahira , Mustafa Sultan , Jamali Abid Ali , Fatima Sanober
Published: October 2023

Background

Respiratory tract infections are among the most common infections in the pediatric population throughout the globe. Globally around 20% of all deaths in children below 5 years of age are secondary to acute respiratory infections, mostly pneumonia. Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host. Their mechanism in preventing respiratory tract infections is not known but it is thought that probiotics act by modulating the immune system. This study was conducted to find out whether using probiotics is effective in decreasing the severity and frequency of recurrent respiratory tract infections or not.

Methods

A Quasi-experimental study was conducted at the Pediatric Medicine Department of Abbassi Shaheed Hospital Karachi during 2021–2022. The study was approved by the institutional ethical review committee i.e. advanced studies and research board (ASRB). The sampling technique was non-probability consecutive sampling and the sample size was 70 patients with recurrent respiratory tract infections, aged six months to 12 years of age. All enrolled children were given probiotics containing Bifidobacterium, Lactobacillus Acidophilus for two weeks. Data were analyzed by using SPSS version 22. A p-value of < 0.05 was considered statistically significant.

Results

Out of 70 children with recurrent respiratory tract infections, 39 (55.71%) were male and 31 (44.29%) female. Around 75% of the children were below five years of age. The most common presenting complaint was fever (72.86%), followed by cough (68.57%), wheezes (45.71%) and nasal discharge/sneezing (32.86%), respectively. The most common RRTI was infectious rhinitis (30% of the cases), otitis media (24%) and pharyngitis/tonsillitis (21%). After giving probiotics for two weeks most significant decrease was found in recurrent infectious rhinitis (p-value 0.02), recurrent otitis media (p-value 0.03) and recurrent bronchiolitis (p-value 0.05) over the next six months.

Conclusion

The results of our study indicate that the administration of probiotics reduces recurrent respiratory tract infections among children. This six months trial has demonstrated that there was a significant decline in respiratory symptoms among study participants. This study also observed a significant decrease in respiratory diseases during the follow-up.
Lifestyle risk factors of self-reported fibromyalgia in the Norwegian Women and Cancer (NOWAC) study
Authors: Benebo Faith Owunari , Lukic Marko , Jakobsen Monika Dybdahl , Braaten Tonje Bjørndal
Published: October 2023

Background

While the aetiology of fibromyalgia syndrome (FM) remains unknown, lifestyle factors have been linked to the disorder. However, there are few studies on the association between lifestyle factors and FM, thus we examine the risk of self-reported fibromyalgia given selected lifestyle factors.

Methods

We used data from 75,485 participants in the Norwegian Women and Cancer study. Information on FM and the lifestyle factors body mass index (BMI), physical activity level, smoking status/intensity, and alcohol consumption were obtained from baseline and follow-up questionnaires. We used Cox proportional hazards model to calculate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

After a median follow-up time of 10 years, we observed 2,248 cases of self-reported fibromyalgia. Overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥ 30 kg/m2) women had a relative risk of 1.34 (95% CI 1.21–1.47) and 1.62 (95% CI 1.41–1.87), respectively, compared to women with normal weight (BMI 18.5–24.9 kg/m2). Very low physical activity level (1–2) was associated with a 31% higher risk of self-reported fibromyalgia (HR 1.31, 95% CI 1.09–1.57) when compared to moderate physical activity level (5–6). There was a strong dose-response relationship between smoking status/intensity and self-reported fibromyalgia (p for trend < 0.001). Compared with moderate alcohol consumption (4.0–10 g/day), the risk of self-reported FM was 72% (HR 1.72; 95% CI 1.45–2.03) higher among teetotallers, and 38% (HR 1.38, 95% CI 1.23–1.54) higher among those with low consumption (0.1–3.9 g/day).

Conclusions

Overweight and obesity, very low physical activity level, smoking, and alcohol consumption were associated with an increased risk of self-reported FM.
Inclusion of person-centred care in UK postgraduate medical education curricula: Interviews and documentary analysis
Authors: Moore Heather L. , Watson Rose , Farnworth Allison , Giles Karen , Tomson David , Thomson Richard G.
Published: October 2023

Background

Person-centred care (PCC) involves placing people at the centre of their healthcare decision making to ensure it meets their needs, values, and personal circumstances. Increasingly, PCC is promoted in healthcare policy and guidance, but little is known about how this is embedded in postgraduate medical training. The aim of this research was to understand how PCC is embedded in UK postgraduate medical training and explore factors influencing inclusion of PCC in curricula content.

Methods

To explore this, we interviewed senior professionals with key roles in the curricula from four UK Royal Colleges (Psychiatrists; Physicians; Surgeons; and GPs) and used framework analysis on interviews and relevant curricula documents to identify themes.

Results

Legislation and professional/educational guidance influenced inclusion. PCC definitions and terminology differed and placement within curricula was variable. Royal Colleges defined the curriculum and provided training to ensure competence, but local deaneries independently implemented the curriculum. Trainer engagement was greater than trainee buy in. Quality assurance focused on feedback from trainers and trainees rather than patients, and patient and public involvement in curriculum development, teaching, and assessment was limited.

Conclusions

There is a need for cross-organisation collaboration to develop a PCC competence framework that defines the skills and level of competence required at different points in training, with clarity around the differences between undergraduate and postgraduate requirements. Greater auditing and quality assurance of programme delivery would help identify successful practices to share within and across Royal Colleges, while still maintaining the flexibility of local provision. Engagement with patients and the public in this work can only strengthen provision.