bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of nanoparticles (Al2O3 and CeO2) blended with biodiesel on combustion, performance, and emissions of a diesel engine
Authors: Lahane Subhash , Deshmukh PW , Sapkal Yogesh
Published: October 2023

The increase in the utilization of fossil fuels in almost all the energy production sector badly impacts the environment because of incomplete combustion. The incomplete combustion of fuels releases soot, unburned hydrocarbon, and greenhouse gas emissions, contributing significantly to climate change. In the current experimental work, the evaluation of the effect of the addition of aluminium oxide (Al2O3) and cerium oxide (CeO2) nanoparticles in Jatropha biodiesel (B20) has been performed on the combustion, performance, and emission characteristics of compression ignition engine. These nanoparticles have been added because they have a large surface area-to-volume ratio. The air-fuel mixture and the evaporation rate are enhanced, leading to improved burning. The increase in brake thermal efficiency has been observed with nanoparticles blended fuel, i.e. (B20 + 30 ppm Al2O3 + 30 ppm CeO2) by 9.354%. In contrast, drop-in oxides of nitrogen, carbon monoxide, HC, and smoke opacity emissions were observed by 24.67%, 33.33%, 23.08%, and 34.01%, respectively, compared with pure biodiesel. Using nanoparticles in Jatropha methyl ester reduces ignition delay, increases combustion duration, and starts earlier combustion, reducing heat release rate, cylinder pressure, and pressure rise rate by 10.53, 1.994, and 3.687%, respectively, as compared to the B20 blend.
Introduction : Améliorer le travail
Authors: Gesualdi-Fecteau Dalia , Lévesque Christian , Murray Gregor , Roby Nicolas
Published: October 2023

Partant du principe que l’amélioration du travail contribue à l’amélioration des sociétés, le défi qu’entend mettre en évidence l’introduction de ce numéro spécial de Transfer: European Review of Labour and Research, consiste à déterminer ce qui rend le travail meilleur, ou pire, et comment il est possible de l’améliorer. Alors que des expériences très variées contribuent à façonner l’avenir de nos économies et de nos communautés, l’un des principaux enjeux consiste à s’engager dans un apprentissage partagé de ces processus afin de stimuler un dialogue entre l’aspiration à un meilleur travail et les conditions susceptibles de entraver ou de faciliter cette amélioration du travail. Cette démarche veut nous inciter à dépasser une conception étroite de la qualité de l’emploi pour adopter un point de vue plus large sur la manière dont les acteurs du monde du travail élaborent des stratégies, innovent et intègrent l’incertitude dans leur quête de solutions durables pour un travail de meilleure qualité. Les principaux thèmes de discussion sont les suivants : pourquoi le travail doit être meilleur (alors qu’il est souvent pire) ; pourquoi un meilleur travail permet-il d’améliorer les sociétés ; comment améliorer le travail ; quel est le rôle des institutions dans cette amélioration du travail ; comment, enfin, les stratégies syndicales sont-elles essentielles dans les processus d’expérimentation destinés à améliorer le travail.
Effectiveness of an LGBTQ+ E-Learning Module for Social Workers: A Randomized Controlled Trial
Authors: Schaub Jason , Keemink Jolie R. , Stander Willem J. , Montgomery Paul
Published: October 2023

Purpose: To evaluate the effectiveness of an e-learning training module for improving children's social workers’ knowledge of, and attitudes toward, LGBTQ+ young people. Methods: A pragmatic randomized, CONSORT-compliant controlled trial to compare an intervention group ( N = 304) with a business-as-usual comparison group ( N = 310). After attrition, the analysis included 188 (intervention) and 278 (comparison) participants. The main outcome measures were the Heteronormative Attitudes and Beliefs Scale and a perceived LGBTQ+ knowledge measure, controlling for several covariates. Results: A significant effect of intervention on both outcome measures, using several rigorous analysis approaches and missing data imputation methods. Participants who undertook the training decreased their heteronormative attitudes and beliefs and increased their perceived LGBTQ+ knowledge compared to business as usual. Conclusion: This study demonstrates the effectiveness of an e-learning training intervention in improving knowledge of, and attitudes toward, LGBTQ+ young people. Implications for research, practice, and policy are outlined.
Liposarcoma Involving Serous Fluid Cavities—A Case Series Illustrating Clinical Implications and the Diagnostic Role of Exfoliative Cytology
Authors: Ng Joanna K. M. , Li Joshua J. X.
Published: October 2023

Introduction: Cytological diagnosis of sarcomas requires detailed cytomorphological assessment and integration of immunocytochemistry and/or molecular testing. The role of exfoliative cytology, as compared to aspiration cytology, is less understood. This case series describes well-differentiated/dedifferentiated liposarcomas in effusions, with cytomorphological features, ancillary test results and clinical outcomes detailed. Methods: A computerized search of the department pathology archives was performed for sarcomatous effusions with histological diagnosis or clinical history of well-differentiated/dedifferentiated liposarcoma. Clinical progress, cytology slides, immunocytochemistry and molecular test results were reviewed. Results: Six patients were identified. In 5 patients with clinical follow up, 4 (80%) were deceased within 5 months of malignant effusion. One patient was alive with 12 years disease-free survival after radical resection with adjuvant radiotherapy. Three patients showed dedifferentiation on histology, and high-grade (dedifferentiated) tumor cells were present in effusion cytology of 2 patients. Two showed well-differentiated components only on biopsy, but high-grade (dedifferentiated) tumor cells were identified in cytology. The high-grade tumor cells displayed marked nuclear irregularity, enlargement, size variation, with macronucleoli and multinucleation. Well-differentiated lipomatous components were demonstrated in 4 patients (66.7%), comprising of multivacuolated lipoblasts and atypical lipocytes. CDK4 and MDM2 immunoreactivity in all 3 cases with cell blocks, and CDK4 and MDM2 amplification in one were successfully demonstrated. Conclusion: Lipomatous and dedifferentiated components can be sampled and cytomorphologically identified on effusion fluids of liposarcomas, with sufficient cellularity for immunocytochemistry and molecular testing. Although generally associated with poor prognosis, long disease-free survival with sarcomatous effusion is possible with radical surgery and adjuvant treatment.
Quality of life in patients with PICC diagnosed with mesothelioma: Results of a multicenter epidemiological survey (LifePICC)
Authors: Bolgeo Tatiana , Di Matteo Roberta , Crivellari Stefania , Gatti Denise , Cassinari Antonella , Riccio Carmela , De Angelis Antonina , Delfanti Sara , Ferrero Elisabetta , Gnani Claudia , Riili Giuseppe , Maconi Antonio
Published: October 2023

Background:

Pleural mesothelioma (PM) is a rare and aggressive cancer. PICC devices are widely used in cancer patients. The aim of the study is to evaluate the quality of life of patients with PICC diagnosed with PM treated at the Hospital of Casale Monferrato and Alessandria (Italy), an area with a high incidence of asbestos-related diseases.

Study design and methods:

Longitudinal prospective observational study with data collection at PICC insertion (T0), after 3 months (T1), 6 months (T2), and 9 months (T3). Participants were aged >18 years, diagnosed with PM, eligible for PICC insertion. Questionnaires used: EORTC QLQ-C30, EORTC QLQ-LC13, and HADS rating scale.

Results:

Twenty-eight patients were enrolled. The mean age was 68.93 years (SD 9.13), mostly male (57.1%). The most frequent cancer stage at diagnosis was III (39.3%), then I (32.1%), and IV (21.4%). 85.7% were treated with chemotherapy, 14.3% also with immunotherapy. 96.4% of patients reported no complications during PICC implantation. The perception of health status and quality of life, measured on a scale of 1–7, was in line with an average score of 5 during the evaluation period. The total anxiety and depression score remained normal for most patients (0–7).

Conclusions:

The PICC management involved a multidisciplinary team with different skills: study findings revealed the key role that dedicated nurses play in PICC placement and ensuring patient problems are promptly addressed. From our study results, PICC placement does not seem to negatively impact the patient’s quality of life.
Putting their money where their mouth is: The gendered dynamics of central party financial transfers to local election candidates
Authors: Currie-Wood Rob , Pruysers Scott
Published: October 2023

Political parties around the world have made widely publicized efforts to improve women’s representation in elected office. While many have investigated these efforts by focusing on gender dynamics during candidate recruitment and selection, party support for women after they are nominated remains somewhat under-analysed. We begin addressing this gap by asking if central party bodies provide women candidates with additional financial support during general election campaigns. Our study leverages population data capturing intraparty financial transfers within three major parties during the 2008 and 2011 Canadian federal elections ( n=1845). The results demonstrate that parties, regardless of ideology, can and do support women candidates with additional campaign funds. However, support from the centre is not always consistent across time or competitive contexts. We conclude that if political parties are sincere in wanting to reduce representational inequities, then consistently providing women candidates with additional financial support is another way of doing so.
The body image experiences of breastfeeding mothers in the UK: A qualitative exploration
Authors: Owen Alison , Cameron Leah , Cassidy Heather , Taylor Jennifer
Published: October 2023

Despite the well-documented benefits of breastfeeding, the UK has one of the lowest breastfeeding rates in the world. One of the areas that has been identified as impacting on a woman’s experience of breastfeeding is body image. The aim of this study was to explore the body image experiences of breastfeeding mothers in the UK. Eighteen female participants were interviewed about their thoughts and feelings around their body image, specifically in relation to their breastfeeding. Three themes were developed following thematic analysis of the data: Breastfeeding as a functional tool, Body confidence and breastfeeding in public and Not feeling like the real me: a loss of identity. Implications of the findings are discussed, with suggestions for health promotion and ideas for encouraging a more positive body image in pregnant and breastfeeding women, with the hope of improving breastfeeding rates and experiences.
Frieda Wunderlich: Feminist research and activism in Berlin
Authors: Golesorkhi Lara-Zuzan , Freeberg Ellen M , Luria Walker Gina
Published: October 2023

In this article, we map the idiosyncratic social research career of Frieda Wunderlich during her years in Berlin (1884–1963). We recover elements of Wunderlich’s unique deployment of social data and her analyses that are emblematic of contributions she made and that have been previously overlooked. We highlight Wunderlich as she lived and worked alongside other women in Berlin who shaped discourse and practice on social protections during a unique moment in the Weimar era. As a scholar and practitioner, Wunderlich helped transform the significance of the relationship between economy and society by insisting on the primacy of humane labor conditions. Our research explores two elements of Wunderlich’s contributions in this context: (1) her efforts to integrate academic social research into public policy and (2) her participation in active, feminist spaces for new policy practices, politics and education. To analyze Wunderlich’s career in Berlin, we refer to three interrelated arenas where she made significant contributions: the German Association of Female Civil Servants of Welfare (1919–1933), the German Democratic Party (1925–1933), the German Academy for Women’s Social and Educational Work (1925–1933). In our exploration of Wunderlich’s scholarship and policy practice within these arenas, we situate her contributions alongside other women including Dorothea Hirschfeld, Hedwig Wachenheim, Cora Berliner, Gertrud Bäumer, Helene Lange, Marianne Weber, Hanna Meuter, Alice Salomon, and Hilde Lion. Recovering and bringing into conversation several figures, we find that theory and praxis concurrently informed Wunderlich’s career, as it did for many of the women around her.
Chemical Exchange Saturation Transfer MRI: What Neuro-Oncology Clinicians Need To Know
Authors: Jabehdar Maralani Pejman , Chan Rachel W. , Lam Wilfred W. , Oakden Wendy , Oglesby Ryan , Lau Angus , Mehrabian Hatef , Heyn Chris , Chan Aimee K.M. , Soliman Hany , Sahgal Arjun , Stanisz Greg J.
Published: October 2023

Chemical exchange saturation transfer (CEST) is a relatively novel magnetic resonance imaging (MRI) technique with an image contrast designed for in vivo measurement of certain endogenous molecules with protons that are exchangeable with water protons, such as amide proton transfer commonly used for neuro-oncology applications. Recent technological advances have made it feasible to implement CEST on clinical grade scanners within practical acquisition times, creating new opportunities to integrate CEST in clinical workflow. In addition, the majority of CEST applications used in neuro-oncology are performed without the use gadolinium-based contrast agents which are another appealing feature of this technique. This review is written for clinicians involved in neuro-oncologic care (nonphysicists) as the target audience explaining what they need to know as CEST makes its way into practice. The purpose of this article is to (1) review the basic physics and technical principles of CEST MRI, and (2) review the practical applications of CEST in neuro-oncology.
Effects of Principled Digitalized Interactive Components on Geometry Computer-Based Assessment in High Schoolers With Learning Difficulties in Mathematics: A Preliminary Investigation
Authors: Liu Changyun , Zhang Dake , Pandolpho Max , Yi Julia
Published: October 2023

This study investigated the effectiveness of four Digitalized Interactive Components (DICs) designed based on cognitive principles to accommodate individual differences among students with learning difficulties in geometry during computer-based assessments. The four DICs were annotations (allowing students to make notes on the screen), pop-up glossary (providing definitions of math terms upon clicking), signaling (displaying corresponding visual information upon clicking verbal information), and rotation (allowing students to rotate shapes). Sixteen high school students with mathematics difficulties participated in the study and were tested with and without the principled DICs. The findings indicate that the principled DICs statistically significantly improved students’ accuracy on the majority of tested problems and increased the average duration engaged in solving geometry problems. Analysis of video data revealed that the pop-up glossary was the most frequently used DIC, followed by signaling, while annotation was the least used.
Origins of the Flint Water Crisis: Uneven Development, Urban Political Ecology, and Racial Capitalism
Authors: Foote Aaron , de Leon Cedric
Published: October 2023

What conditions gave rise to the Flint Water Crisis? Students of contemporary urban disasters tend to advance two claims, increasingly in tandem. First, preexisting racial and class inequalities structure both the impact of disasters on urban communities and the dynamics of resettlement. Second and similarly, neoliberalism (variously theorized as neoliberal urbanism and the growth machine) prefigures urban disasters and underpins an ensuing market-oriented process of redevelopment. While long-standing patterns of inequality and neoliberalization are important contextual factors, by themselves they tend to undertheorize the timing and ecological content of urban crises. In this article, we synthesize the literature on uneven development, urban political ecology, and racial capitalism to advance an alternative hypothesis. Drawing on interviews with Flint residents and Michigan officials, the archival correspondence of government agencies, and ethnographic data, we argue that the Flint Water Crisis was the consequence of an extractivist project of White state and suburban actors to “regionalize” and thereby expropriate the assets and natural resources controlled by the predominantly Black working-class city of Detroit. Specifically, the formation of two regional water authorities required that Flint leave the Detroit Water and Sewer Department for an interim water source, the Flint River, which had been contaminated by decades of automotive toxins.
The Role of Family in Diabetes Management for Mexican American Adults
Authors: Jordan Olivia J. , Benitez Amanda , Burnet Deborah L. , Quinn Michael T. , Baig Arshiya A.
Published: October 2023

Introduction: The purpose of this study was to characterize how family influences diabetes self-management in Mexican American adults. Methods: Data were analyzed from previously collected data that included 34 semi-structured interviews with Hispanic adults with diabetes and six focus groups with 37 adults with diabetes and family members. Themes related to family and diabetes management were identified and analyzed using a modified template approach. Results: Family-related facilitators to T2DM self-management were (1) provides support, (2) provides motivation, and (3) desire to protect family from diabetes. Family-related challenges were (1) lack of support, (2) family responsibilities, and (3) stress related to family. Diabetes education was shared with family members. Family member perspectives on T2DM included (1) not knowing how to help, (2) effect on emotional wellbeing, (3) diabetes affects the whole family, and (4) family provides support. Conclusion: Most participants with T2DM felt supported by family, but many desired more social support and support surrounding dietary changes from family. Many felt family did not understand what living with diabetes meant for them. Most family members wished to learn more about how to help. Future interventions should include family members and teach them supportive strategies to support beneficial diabetes self-management behaviors.
Surgical Management of Swan Neck Deformity Following Mallet Finger Injury: A Review of 25 Patients Over 20 Years
Authors: Rode Matthew M. , Mullen Barbara L. , Zhu Agnes Q. , Helsper Elizabeth A. , Moran Steven L.
Published: October 2023

Introduction:

Swan neck deformity develops as a sequela of chronic mallet finger. Surgical management can include soft tissue reconstruction or distal interphalangeal joint (DIPJ) fusion. Studies examining the incidence and management of posttraumatic swan neck deformity following mallet fracture are limited.

Methods:

A retrospective, single-institution review of patients undergoing surgical management of swan neck deformity following a traumatic mallet finger from 2000 to 2021 was performed. Patients with preexisting rheumatoid arthritis were excluded. Injury, preoperative clinical, and surgical characteristics were recorded along with postoperative outcomes and complications.

Results:

Twenty-five patients were identified who had surgical intervention for swan neck deformity. Sixty-four percent of mallet fingers were chronic. Median time to development of mallet finger was 2 months. Twelve (48%) mallet fingers were Doyle class I, 6 (24%) were class III, and 7 (28%) were class IVB. Forty percent of injuries failed nonoperative splinting trials. Sixteen (64%) underwent primary DIPJ arthrodesis, 8 (32%) underwent DIPJ pinning, and 1 underwent open reduction and internal fixation of mallet fracture. The complication rate was 50% overall, and 33% of surgeries experienced major complications. The overall reoperation rate was 33%. Proximal interphalangeal joint hyperextension improved by 11° on average. Median follow-up was 61.2 months.

Conclusions:

The development of symptomatic swan neck deformity following traumatic mallet finger injury is rare. All patients warrant an attempt at nonsurgical management. Attempts at surgical correction had a high rate of complications, and DIPJ fusion appeared to provide the most reliable solution.
The impact of feedback training on prediction of cancer clinical trial results
Authors: Doussau Adélaïde , Kane Patrick , Peppercorn Jeffrey , Feustel Aden C , Ganeshamoorthy Sylviya , Kekre Natasha , Benjamin Daniel M , Kimmelman Jonathan
Published: October 2023

Introduction

Funders must make difficult decisions about which squared treatments to prioritize for randomized trials. Earlier research suggests that experts have no ability to predict which treatments will vindicate their promise. We tested whether a brief training module could improve experts’ trial predictions.

Methods

We randomized a sample of breast cancer and hematology–oncology experts to the presence or absence of a feedback training module where experts predicted outcomes for five recently completed randomized controlled trials and received feedback on accuracy. Experts then predicted primary outcome attainment for a sample of ongoing randomized controlled trials. Prediction skill was assessed by Brier scores, which measure the average deviation between their predictions and actual outcomes. Secondary outcomes were discrimination (ability to distinguish between positive and non-positive trials) and calibration (higher predictions reflecting higher probability of trials being positive).

Results

A total of 148 experts (46 for breast cancer, 54 for leukemia, and 48 for lymphoma) were randomized between May and December 2017 and included in the analysis (1217 forecasts for 25 trials). Feedback did not improve prediction skill (mean Brier score for control: 0.22, 95% confidence interval = 0.20–0.24 vs feedback arm: 0.21, 95% confidence interval = 0.20–0.23; p = 0.51). Control and feedback arms showed similar discrimination (area under the curve = 0.70 vs 0.73, p = 0.24) and calibration (calibration index = 0.01 vs 0.01, p = 0.81). However, experts in both arms offered predictions that were significantly more accurate than uninformative forecasts of 50% (Brier score = 0.25).

Discussion

A short training module did not improve predictions for cancer trial results. However, expert communities showed unexpected ability to anticipate positive trials. Pre-registration record: https://aspredicted.org/4ka6r.pdf .
Prior experience of variability influences generalisation of unspecified categories
Authors: Hosch Ann-Katrin , Wirtz Philipp , von Helversen Bettina
Published: October 2023

Category variability or diversity is an important factor influencing generalisation. However, expectations of category variability may not only depend on the variability of encountered category members, but may also be shaped by prior experiences with similar categories. In this study, we investigated whether we could influence category generalisation by inducing different category representations in an A/Non-A categorisation task: Participants either learned about a homogeneous category Non-A or a diverse category Non-A during a priming phase. To better understand the transfer process, we varied the nature of the learning phase from implicit transfer to explicit instructions that actively requested participants to use their prior experiences. We found that while with a homogeneous Non-A representation, generalisation of the A and Non-A categories was equal, the generalisation of category Non-A widened after a priming phase with a diverse representation. In a second experiment, we found that the widening of generalisation of category Non-A occurred when the exemplars in this category were themselves diverse (feature-diverse condition) but not when the category contained distinct exemplars (exemplar-diverse condition). These results suggests that categorisation is influenced by previous categorisation experiences possibly altering the representation of a category. Furthermore, the study gives a hint what kind of heterogeneity is needed to observe the commonly reported broader generalisation of diverse categories. The finding has implications not only to understand the influence of prior experiences on category learning, but any cognitive process that hinges on generalisation.
α2-Macroglobulin Promotes Chondrocyte Proliferation and Cartilage Matrix Synthesis via Inducing PCNA
Authors: Guo Hailing , Wang Shaowei , Zhang Yang , Sun Jian , Guo Li , Pang Jian , Zhan Hongsheng
Published: October 2023

Objectives

α2-Macroglobulin (A2M) can prevent cartilage degeneration by blocking many types of cartilage-degrading enzymes, but the mechanism remains to be clarified. This study aimed to test that A2M protects against cartilage degeneration by promoting chondrocyte proliferation and cartilage matrix synthesis via inducing proliferating cell nuclear antigen (PCNA).

Design

The cartilage degeneration of the anterior cruciate ligament transection (ACLT) model was evaluated by Safranin O-fast green staining, and articular cartilage degeneration was graded using the Osteoarthritis Research Society International (OARSI)-modified Mankin criteria. The chondrocyte proliferation was detected by 5-Bromodeoxyuridinc (BrdU), MTT, and Cell Counting Kit-8 (CCK8) methods. The chondrocyte apoptosis was detected by lactate dehydrogenase (LDH) assay and Annexin PI staining with the flow cytometer. The glycosaminoglycan (sGAG) and aggrecan in culture supernatant were measured by enzyme-linked immunosorbent assay (ELISA). Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to analyze the type II collagen and aggrecan mRNA expression. The PCNA protein expression was analyzed by western blot and immunofluorescent staining.

Results

A2M can attenuate cartilage degeneration in ACLT rats. The OARSI scores for cartilage degeneration in the A2M group were lower than those in the phosphate-buffered saline (PBS) group. A2M can promote chondrocyte proliferation and inhibit chondrocyte apoptosis, promote the cartilage matrix synthesis in chondrocytes (type II collagen and aggrecan), and culture supernatant (sGAG and aggrecan). At the same time, it also up-regulated the PCNA protein expression in chondrocytes.

Conclusions

A2M can promote chondrocyte proliferation and cartilage matrix synthesis via inducing PCNA expression.
Cardiogenic shock presenting in myocardial infarction with myocarditis case report: The role of advanced echocardiography parameter
Authors: Alsagaff Mochamad Yusuf , Devi Putu Dwipa Krisna , Budianto Christian Pramudita , Susilo Hendri
Published: October 2023

Myocarditis is distinguished by a wide array of nonspecific symptoms, including chest pain, dyspnea, and palpitations. These symptoms are accompanied by electrocardiographic abnormalities that exhibit similarities to those observed in myocardial infarction. However, the results of coronary angiography frequently, though not consistently, show normal findings. Therefore, the clinical diagnostic procedure often encounters difficulties and is susceptible to the misdiagnosis of myocardial infarction with nonobstructive coronary arteries. The signs of poor cardiac contractility are a common manifestation of myocarditis and can be evaluate with bedside echocardiography. Two-dimensional speckle tracking echocardiography bestows a precise left ventricle (LV) global and regional dysfunction . We present a case of a 40-year-old man with typical chest pain for 8 hours, and dyspnea. He had no significant medical history. This patient was first diagnosed with high lateral ST-elevation myocardial infarction (STEMI) with cardiogenic shock. Angiography examination revealed no significant obstruction of coronary vessels. However, serial left ventricle global longitudinal strain supports the diagnosis of myocarditis. After receiving the treatment for myocarditis, the patient makes a full recovery within 7 days.
COVID-19 Preparedness, Stressors, and Data-Driven Solutions for Healthcare Workers at a Regional Rural-Urban Hospital System: A Longitudinal Total Worker Health® Study
Authors: Jaegers Lisa A. , McAndrew Rose , Cornelius Andrea , Scott Susan D. , Pridgeon Sean , El Ghaziri Mazen , Bello Jennifer K.
Published: October 2023

Background:

During the COVID-19 pandemic in the United States, healthcare workers were devastated by the insufficient preparedness to respond to their patients’ and personal health needs. A gap exists in resources to prevent or reduce acute and long-term healthcare worker mental illnesses resulting from COVID-19 frontline response.

Methods:

We performed an exploratory, mixed methods, longitudinal study of healthcare workers at a regional rural-urban hospital system in the Midwest United States during the COVID-19 response (4 timepoints, 2020). Using the Total Worker Health® (TWH) participatory needs assessment approach, self-identified frontline COVID-19 workers participated in a survey including Health-Related Quality of Life, Impact of Event Scale, and a modified version of the American Nursing Association COVID-19 survey; and a hospital timeline tracked system-level activities.

Findings:

Response rate at Timepoint (T)1 was 21.7% ( N = 39) and of those, 14 (36%) completed all four surveys. From T1 to T4, the rate of COVID-19 patients steadily increased, staff exceeded the threshold for post-traumatic stress disorder at T1 and T4; staff reported not enough rest or sleep 50% of the month, T1-T4. Helpfulness of family support increased but community support decreased, T1-T4. Concerns with performing new tasks increased; the challenges related to lack of protective equipment and negative media decreased. Workers wanted to be involved in decision-making, desired timely communication, and needed adequate physical, environmental, and psychological supports.

Conclusions/Applications for Practice:

Utilization of a TWH® strategy for describing health needs, hospital response, and multi-level staff suggestions to workplace health solutions during the COVID-19 pandemic identified evidence-based health promotion interventions in a hospital system.
Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators
Authors: Park Seungeun , Meischke Hendrika , Lim Sungwon
Published: October 2023

Background:

9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators’ stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours—mandatory and voluntary—and the level of stress symptoms among 9-1-1 telecommunicators.

Methods:

We used secondary data from the surveys of the “Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1” study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level.

Results:

Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 ( SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 ( SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = −0.01, p = .885).

Conclusion/Application to Practice:

Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.
Efficacy of rhBMP-2 and Cellular Bone Matrix in the Revision of Alveolar Bone Grafting
Authors: Harrison Lucas M. , Hallac Rami R. , Seaward James R. , Kane Alex A. , Park Yong Jong
Published: October 2023

Objective:

This study presents a novel approach that utilizes recombinant human bone morphogenic protein 2 (rhBMP-2) and cellular bone matrix (CBM) for revision alveolar bone graft (ABG) in unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) patients following failed autologous ABG.

Methods:

A case series of 14 UCLP and 4 BCLP patients who had failed autologous ABG with revision ABG with rhBMP-2 and CBM. Review of demographics, operative data, Bergland score, and alveolar cleft gap volume was performed.

Results:

Revision ABG had short operative times and low blood loss in both UCLP and BCLP. No postoperative complications were found in either revision group. Repeat ABG surgery was required in one patient. Bergland score improved from 3.86 ± 0.53to 1.21 ± 0.80 in the UCLP group and from 3.75 ± 0.50to 1.00 ± 0.00 in the BCLP group. The cleft volume decreased by 83.62 ± 9.78% in UCLP and by 86.73 ± 13.65% in the BCLP group.

Conclusions:

Revision ABG with rhBMP-2 and CBM is a successful and reliable approach. This method has decreased operative time and no postoperative complications. Most patients achieved clinically successful grafting with canine eruption. Both UCLP and BCLP groups saw a significant decrease in alveolar cleft gap volume.
Mutant PIK3CA is a targetable driver alteration in histiocytic neoplasms
Authors: Durham Benjamin H. , Hershkovitz-Rokah Oshrat , Abdel-Wahab Omar , Yabe Mariko , Chung Young Rock , Itchaki Gilad , Ben-Sasson Maayan , Asher-Guz Vered A. , Groshar David , Doe-Tetteh Seyram A. , Alano Tina , Solit David B. , Shpilberg Ofer , Diamond Eli L. , Mazor Roei D.
Published: October 2023

Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasm characterized by the accumulation of clonal mononuclear phagocyte system cells expressing CD1a and CD207. In the past decade, molecular profiling of LCH as well as other histiocytic neoplasms demonstrated that these diseases are driven by MAPK activating alterations, with somatic BRAFV600E mutations in >50% of patients with LCH, and clinical inhibition of MAPK signaling has demonstrated remarkable clinical efficacy. At the same time, activating alterations in kinase-encoding genes, such as PIK3CA, ALK, RET, and CSF1R, which can activate mitogenic pathways independent from the MAPK pathway, have been reported in a subset of histiocytic neoplasms with anecdotal evidence of successful targeted treatment of histiocytoses harboring driver alterations in RET, ALK, and CSF1R. However, evidence supporting the biological consequences of expression of PIK3CA mutations in hematopoietic cells has been lacking, and whether targeted inhibition of PI3K is clinically efficacious in histiocytic neoplasms is unknown. Here, we provide evidence that activating mutations in PIK3CA can drive histiocytic neoplasms in vivo using a conditional knockin mouse expressing mutant PIK3CAH1047R in monocyte/dendritic cell progenitors. In parallel, we demonstrate successful treatment of PIK3CA-mutated, multisystemic LCH using alpelisib, an inhibitor of the alpha catalytic subunit of PI3K. Alpelisib demonstrated a tolerable safety profile at a dose of 750 mg per week and clinical and metabolic complete remission in a patient with PIK3CA-mutated LCH. These data demonstrate PIK3CA as a targetable noncanonical driver of LCH and underscore the importance of mutational analysis–based personalized treatment in histiocytic neoplasms.
Challenges for quality and utilization of real-world data for diffuse large B-cell lymphoma in REALYSA, a LYSA cohort
Authors: Ghesquières Hervé , Cherblanc Fanny , Belot Aurélien , Micon Sophie , Bouabdallah Krimo K. , Esnault Cyril , Fornecker Luc-Matthieu , Thokagevistk Katia , Bonjour Maxime , Bijou Fontanet , Haioun Corinne , Morineau Nadine , Ysebaert Loïc , Damaj Gandhi , Tessoulin Benoit , Guidez Stéphanie , Morschhauser Franck , Thiéblemont Catherine , Chauchet Adrien , Gressin Rémy , Jardin Fabrice , Fruchart Christophe , Labouré Gaëlle , Fouillet Ludovic , Lionne-Huyghe Pauline , Bonnet Antoine , Lebras Laure , Amorim Sandy , Leyronnas Cécile , Olivier Gaelle , Guieze Romain , Houot Roch , Launay Vincent , Drénou Bernard , Fitoussi Olivier , Detourmignies Laurence , Abraham Julie , Soussain Carole , Lachenal Florence , Pica Gian Matteo , Fogarty Patrick , Cony-Makhoul Pascale , Bernier Adeline , Le Guyader-Peyrou Sandra , Monnereau Alain , Boissard Frédéric , Rossi Cédric , Camus Vincent
Published: October 2023

Real-world data (RWD) are essential to complement clinical trial (CT) data, but major challenges remain, such as data quality. REal world dAta in LYmphoma and Survival in Adults (REALYSA) is a prospective noninterventional multicentric cohort started in 2018 that included patients newly diagnosed with lymphoma in France. Herein is a proof-of-concept analysis on patients with first-line diffuse large B-cell lymphoma (DLBCL) to (1) evaluate the capacity of the cohort to provide robust data through a multistep validation process; (2) assess the consistency of the results; and (3) conduct an exploratory transportability assessment of 2 recent phase 3 CTs (POLARIX and SENIOR). The analysis population comprised 645 patients with DLBCL included before 31 March 2021 who received immunochemotherapy and for whom 3589 queries were generated, resulting in high data completeness (<4% missing data). Median age was 66 years, with mostly advanced-stage disease and high international prognostic index (IPI) score. Treatments were mostly rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine, and prednisone (R-CHOP 75%) and reduced dose R-CHOP (13%). Estimated 1-year event-free survival (EFS) and overall survival rates were 77.9% and 90.0%, respectively (median follow-up, 9.9 months). Regarding transportability, when applying the CT's main inclusion criteria (age, performance status, and IPI), outcomes seemed comparable between patients in REALYSA and standard arms of POLARIX (1-year progression-free survival 79.8% vs 79.8%) and SENIOR (1-year EFS, 64.5% vs 60.0%). With its rigorous data validation process, REALYSA provides high-quality RWD, thus constituting a platform for numerous scientific purposes. The REALYSA study was registered at www.clinicaltrials.gov as #NCT03869619.
Genome-wide association analysis of heifer livability and early first calving in Holstein cattle
Authors: Gao Yahui , Marceau Alexis , Iqbal Victoria , Torres-Vázquez Jose Antonio , Neupane Mahesh , Jiang Jicai , Liu George E. , Ma Li
Published: October 2023

Background

The survival and fertility of heifers are critical factors for the success of dairy farms. The mortality of heifers poses a significant challenge to the management and profitability of the dairy industry. In dairy farming, achieving early first calving of heifers is also essential for optimal productivity and sustainability. Recently, Council on Dairy Cattle Breeding (CDCB) and USDA have developed new evaluations of heifer health and fertility traits. However, the genetic basis of these traits has yet to be thoroughly studied.

Results

Leveraging the extensive U.S dairy genomic database maintained at CDCB, we conducted large-scale GWAS analyses of two heifer traits, livability and early first calving. Despite the large sample size, we found no major QTL for heifer livability. However, we identified a major QTL in the bovine MHC region associated with early first calving. Our GO analysis based on nearby genes detected 91 significant GO terms with a large proportion related to the immune system. This QTL in the MHC region was also confirmed in the analysis of 27 K bull with imputed sequence variants. Since these traits have few major QTL, we evaluated the genome-wide distribution of GWAS signals across different functional genomics categories. For heifer livability, we observed significant enrichment in promotor and enhancer-related regions. For early calving, we found more associations in active TSS, active Elements, and Insulator. We also identified significant enrichment of CDS and conserved variants in the GWAS results of both traits. By linking GWAS results and transcriptome data from the CattleGTEx project via TWAS, we detected four and 23 significant gene-trait association pairs for heifer livability and early calving, respectively. Interestingly, we discovered six genes for early calving in the Bovine MHC region, including two genes in lymph node tissue and one gene each in blood, adipose, hypothalamus, and leukocyte.

Conclusion

Our large-scale GWAS analyses of two heifer traits identified a major QTL in the bovine MHC region for early first calving. Additional functional enrichment and TWAS analyses confirmed the MHC QTL with relevant biological evidence. Our results revealed the complex genetic basis of heifer health and fertility traits and indicated a potential connection between the immune system and reproduction in cattle.
Metagenomic analysis of gut microbiome and resistome of Whooper and Black Swans: a one health perspective
Authors: Fu Yin , Zhang Kaihui , Shan Fa , Li Junqiang , Wang Yilin , Li Xiaoying , Xu Huiyan , Qin Ziyang , Zhang Longxian
Published: October 2023

Background

With the promotion of “One Health,” the health of animals and their impact on the environment have become major concerns recently. Widely distributed in China, the whooper swans (Cygnus cygnus) and black swans (Cygnus atratus) are not only important to the ecological environment, but they may also potentially influence public health security. The metagenomic approach was adopted to uncover the impacts of the gut microbiota of swans on host and public health.

Results

In this study, the intestinal microbiome and resistome of migratory whooper swans and captive-bred black swans were identified. The results revealed similar gut microbes and functional compositions in whooper and black swans. Interestingly, different bacteria and probiotics were enriched by overwintering whooper swans. We also found that Acinetobacter and Escherichia were significantly enriched in early wintering period swans and that clinically important pathogens were more abundant in black swans. Whooper swans and black swans are potential reservoirs of antibiotic resistance genes (ARGs) and novel ARGs, and the abundance of novel ARGs in whooper swans was significantly higher than that in black swans. Metagenomic assembly–based host tracking revealed that most ARG-carrying contigs originated from Proteobacteria (mainly Gammaproteobacteria).

Conclusions

The results revealed spatiotemporal changes in microbiome and resistome in swans, providing a reference for safeguarding public health security and preventing animal epidemics.
Insights into the use of telemedicine in primary care in times of the SARS-CoV-2 pandemic - a cross-sectional analysis based on the international PRICOV-19 study in Austria
Authors: Stummer Florian Odilo , Voggenberger Lisa , Gomez Pellin Maria de la Cruz , van Poel Esther , Willems Sara , Hoffmann Kathryn
Published: October 2023

Background

The SARS-CoV2 pandemic as well as the implementation of public health measures to decrease the spread of the virus re-sparked the call for “virtual” health or “distance” treatments. This paper aimed to assess the use of video consultations, the up-to-dateness of practice websites, and the views of GPs on whether eHealth is a positive aspect for the future of their practices in publicly -funded primary healthcare facilities in Austria.

Methods

The cross-sectional online questionnaire, part of the PRICOV-19 study, was conducted from December 2020 until July 2021. We randomly recruited 176 GP practices across Austria. Descriptive statistics as well as binary logistic regression models were applied to examine the associations between telemedicine use and practice factors.

Results

Compared with before the pandemic (3.8%), 7.6% of publicly funded GP practices have been using video consultations since the pandemic. In line with this, 93.9% of the practices had no increase in video consultation use. Fewer than half (44.3%) had an up-to-date webpage, and 27.8% assumed that the pandemic might have been a positive driver for eHealth in their practices. Positive associations with video consultation use could be found in practices with fewer patients aged 70 years and over than the average and more patients with chronic diseases than the average.

Conclusion

The use of video consultations in general practice and the readiness for other telemedicine approaches are both very low in Austria. Austria has to urgently follow the example of countries with a transparent and comprehensive national digital health strategy that includes video consultation. Without a proper payment system, patient inclusion, and support with regard to administrative and organizational aspects, no substantial change will occur in spite of an increase in need due to the pandemic and changes in the patient population.
General practice nurse trainees’ perspectives on general practice nursing as a career choice: qualitative findings from a vocational training scheme in the United Kingdom (UK)
Authors: Lewis Robin
Published: October 2023

Background

There is a shortage of general practice nurses worldwide to deal with an ever-increasing workload, and the need to attract new staff into general practice nursing is therefore vital. As part of this, a one-year Vocational Training Scheme (VTS) for new to general practice nurses was developed in 2020 by the South Yorkshire Primary Care Workforce and Training Hub.

Methods

The aim of the study was to examine the VTS trainees’ views on general practice nursing as a career. A pragmatic, convenience sample of trainees was recruited. Of the 21 trainees, 17 agreed to take part in the study. Data were collected from the trainees using a series of four regular, timed, online focus groups designed to follow the trainees’ trajectory on the programme over a 12-month period. The data were analysed using framework analysis.

Results

The timed nature of the focus groups meant that the analysis of the data was linked to the trainees’ trajectory over the course of the year. Three themes were generated from the data: ‘pathways into general practice’; ‘learning to be a GPN’; and ‘the future GPN’. In theme one, the trainees talked of the difficulties in accessing general practice as a new graduate, specifically the need for prior experience and how to get it. In the second, the transition to being a general practice nurse was discussed, and the expectation of being able to ‘hit the ground running’ once in post. The new graduate participants were also concerned over the opportunities for clinical supervision and support in the role after the programme. Finally, the participant s expressed concern over future opportunities for professional development and the prospects for a long-term career in general practice.

Conclusion

To address the worldwide workforce ‘crisis’ in general practice nursing, sustainable career pathways are needed to encourage new graduate nurses to consider working in general practice. Starting at university, changing the culture and providing the necessary infrastructure to support ongoing professional development in general practice nursing are key to its success.