bluuebunny/crossref_metadata_2025 huggingface dataset:
Encountering disability in music: Exploring perceptions on inclusive music education in higher music education
Authors: Bremmer Melissa
Published: May 2023

This research study evaluated an Artist-in-Residence-project (AIR-project) at the Conservatory of Amsterdam, focusing on inclusive music education. For this project, the Conservatory invited the organization Drake Music Scotland to work with its students. The project’s aim was to provide students with practical skills regarding music technology, to discuss the social model of disability, and to play in an inclusive music ensemble with a musician with a severe physical disability. The perceived learning experiences of students, the experienced value of the project, and recommendations for its improvement were explored through online questionnaires with the students and online semistructured interviews with the AIR-project leader, the musician with a disability, and the two workshop leaders of Drake Music Scotland. Findings suggest that alongside learning practical skills regarding music technology, students changed or broadened their perceptions about people with disabilities and inclusive music-making in positive ways. Furthermore, participants valued that the project created a space in which “taking enough time” and “belonging” could be experienced; these values are important in inclusive music environments as they can empower musicians with disabilities. The main recommendation for similar projects was that students wanted to gain hands-on experience in inclusive music education.
Examining the empathic voice teacher
Authors: Fletcher Heather , Davidson Jane W , Krause Amanda E
Published: May 2023

Empathy enables successful communication and connection between teachers and their students, yet few studies have investigated its specific use in teaching singing. Addressing this gap, we interviewed voice teachers to discover how they articulate their pedagogy in terms of empathic practices and observed one-to-one lessons for evidence of the same. A sample of 27 classical and music theater voice teachers in Australia (70% females, 30% males), aged 35 to 75 years old ( M = 55) were interviewed. Of this cohort, seven teachers were observed in their one-to-one teaching practices. Interviews and observations were analyzed using Interpretative Phenomenological Analysis. Results indicated that voice teachers tailor their practices to the needs of students and demonstrate characteristics of teacher empathy identified in previous literature: effective communication, positive relationships, care, welcoming learning environment, trust, morality, and listening. Empathic teaching facilitates an individualized approach in which singing students are supported and motivated in their own autonomous learning environment. These findings have implications for voice pedagogy that features the use of empathy to benefit future students.
Hope, quality of life, and psychological distress in patients on peritoneal dialysis: A cross-sectional study
Authors: Shek Nam Ng Marques , Kwok Wei So Winnie , Chow Choi Kai , Chen Jieling , Sze Ho Wong Sunny , Hui Yun Ho , Kin Hung Chan Andex , Hau Sim Ho Eva , Wing Han Chan Carmen
Published: May 2023

Hope is a goal-directed thought that reflects the sense of control over uncertainties and can promote adjustment to chronic illness. This study aimed to assess the level of hope among patients on peritoneal dialysis and evaluate the association of hope with health-related quality of life and psychological distress. This cross-sectional study included 134 Chinese patients receiving peritoneal dialysis in Hong Kong. Patients’ level of hope was assessed using the Adult Trait Hope Scale. Participants who were employed, had a higher income, and received automated peritoneal dialysis reported a higher hope score. Hope was found to have significant correlations with age and social support. A higher hope score was associated with better mental well-being and less severe depressive symptoms. Specific relationships between agency/pathway thinking and these outcomes were identified. The patient subgroups at risk for losing hope need to be identified and received early interventions to prevent adverse outcomes.
Paralympic cripvertising: On the gendered self-representations of Paralympic athletes on social media
Authors: Pullen Emma , Mora Laura , Silk Michael
Published: May 2023

Paralympic athletes are increasingly using social media platforms such as Instagram and TikTok to self-represent and engage audiences in disability counter narratives that resist dominant disability stereotypes. This is particularly the case at the intersection of gender and sexuality where social media is being harnessed to visibly reclaim gendered and sexualised disabled identities in new and diverse ways. In this article, we advance scholarship on female Paralympic athletes’ self-representational practices through an intersectional visual media analysis of the most popular female British Paralympic athlete Instagram pages. We capture a particular trend in Paralympic athletes’ self-representational practices, termed cripvertising, that intersects with gendered heteronormative scripts centred on neoliberal ableism, kinship normativity and consumption (‘branding’) capabilities. We discuss the contradictions and complexities of Paralympians self-representations and their role in relation to the subversive, pedagogical and emancipatory potential for shaping new disability media narratives, disabled (online) normativity and representational politics.
Campaigning Through Cable: Examining the Relationship Between Cable News Appearances and House Candidate Fundraising
Authors: Benson Seth , Limbocker Scott
Published: May 2023

Appearances of elected officials on cable news have become a regular feature of American politics. Do candidates going on cable news see a subsequent bump in fundraising? We evaluate all television appearances for every major party candidate running for the House from 2009–2020 on CNN, MSNBC, and Fox News. We match these with FEC records of every individual campaign contribution made during the same period. We find evidence that candidates who appear on cable news do see a spike in fundraising on the day of the appearance. We find incumbents raise more money from in-state donors while nonincumbents see a bump from out-of-state donors. Also, this money comes more from appearances in primetime slots, not daytime appearances. Given that candidates see a bump in fundraising for TV appearances, it remains likely that this facet of American politics will persist.
The Nurse Licensure Compact's Effect on Telemedicine Usage
Authors: Norris Conor , Nandy Protik
Published: May 2023

As a result of a shortage of primary care physicians, considerable portion of patients in the US have difficulty accessing primary care. Telemedicine allows healthcare professionals to reach patients in shortage areas, but state-based occupational licensing laws make interstate practice difficult. The Nurse Licensure Compact (NLC) was designed to improve interstate practice for Registered Nurses (RNs), including telemedicine. Our preliminary analysis does not find evidence that the NLC is able to significantly increase telemedicine usage from out-of-state providers. Policymakers cannot rely on just the NLC to encourage the adoption of telemedicine; other regulations currently limit its adoption.
Leveraging identity and access management technology to accelerate emergency COVID-19 vaccine delivery
Authors: Gellert George A.
Published: May 2023

COVID-19-related vaccine demand and delivery volume challenged delivery organizations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats, and accurately identify/authenticate clinician identity for patients remained unchanged. Deployment of identity access and management (IAM) and single sign-on (SSO) can accelerate operationalization of a vaccine delivery center when urgently needed in a crisis. Innovative application of existing IAM/SSO technology, combined with an identity governance solution, greatly accelerated vaccine delivery. Secure access enabled by IAM technology facilitated a rapid expansion (25 minutes) where 500 new vaccine delivery personnel were identified and authenticated during a period of high pandemic incidence. Existing digital identity solutions enabled a vaccine delivery organization to accelerate secure IAM of clinical staff during the peak of the COVID-19 pandemic. Existing IAM investments and capabilities that are widely implemented in nations with mature health information technology systems can greatly accelerate standing up emergent vaccine delivery capabilities and sites in the midst of a public health crisis.
Genomic analysis of 61 Chlamydia psittaci strains reveals extensive divergence associated with host preference
Authors: Sachse Konrad , Hölzer Martin , Vorimore Fabien , Barf Lisa-Marie , Sachse Carsten , Laroucau Karine , Marz Manja , Lamkiewicz Kevin
Published: May 2023

Background

Chlamydia (C.) psittaci, the causative agent of avian chlamydiosis and human psittacosis, is a genetically heterogeneous species. Its broad host range includes parrots and many other birds, but occasionally also humans (via zoonotic transmission), ruminants, horses, swine and rodents. To assess whether there are genetic markers associated with host tropism we comparatively analyzed whole-genome sequences of 61 C. psittaci strains, 47 of which carrying a 7.6-kbp plasmid.

Results

Following clean-up, reassembly and polishing of poorly assembled genomes from public databases, phylogenetic analyses using C. psittaci whole-genome sequence alignment revealed four major clades within this species. Clade 1 represents the most recent lineage comprising 40/61 strains and contains 9/10 of the psittacine strains, including type strain 6BC, and 10/13 of human isolates. Strains from different non-psittacine hosts clustered in Clades 2– 4. We found that clade membership correlates with typing schemes based on SNP types, ompA genotypes, multilocus sequence types as well as plasticity zone (PZ) structure and host preference. Genome analysis also revealed that i) sequence variation in the major outer membrane porin MOMP can result in 3D structural changes of immunogenic domains, ii) past host change of Clade 3 and 4 strains could be associated with loss of MAC/perforin in the PZ, rather than the large cytotoxin, iii) the distinct phylogeny of atypical strains (Clades 3 and 4) is also reflected in their repertoire of inclusion proteins (Inc family) and polymorphic membrane proteins (Pmps).

Conclusions

Our study identified a number of genomic features that can be correlated with the phylogeny and host preference of C. psittaci strains. Our data show that intra-species genomic divergence is associated with past host change and includes deletions in the plasticity zone, structural variations in immunogenic domains and distinct repertoires of virulence factors.
ssDNA is not superior to dsDNA as long HDR donors for CRISPR-mediated endogenous gene tagging in human diploid RPE1 and HCT116 cells
Authors: Mabuchi Akira , Hata Shoji , Genova Mariya , Tei Chiharu , Ito Kei K. , Hirota Masayasu , Komori Takuma , Fukuyama Masamitsu , Chinen Takumi , Toyoda Atsushi , Kitagawa Daiju
Published: May 2023

Background

Recent advances in CRISPR technology have enabled us to perform gene knock-in in various species and cell lines. CRISPR-mediated knock-in requires donor DNA which serves as a template for homology-directed repair (HDR). For knock-in of short sequences or base substitutions, ssDNA donors are frequently used among various other forms of HDR donors, such as linear dsDNA. However, partly due to the complexity of long ssDNA preparation, it remains unclear whether ssDNA is the optimal type of HDR donors for insertion of long transgenes such as fluorescent reporters in human cells.

Results

In this study, we established a nuclease-based simple method for the preparation of long ssDNA with high yield and purity, and comprehensively compared the performance of ssDNA and dsDNA donors with 90 bases of homology arms for endogenous gene tagging with long transgenes in human diploid RPE1 and HCT116 cells. Quantification using flow cytometry revealed lower efficiency of endogenous fluorescent tagging with ssDNA donors than with dsDNA. By analyzing knock-in outcomes using long-read amplicon sequencing and a classification framework, a variety of mis-integration events were detected regardless of the donor type. Importantly, the ratio of precise insertion was lower with ssDNA donors than with dsDNA. Moreover, in off-target integration analyses using donors without homology arms, ssDNA and dsDNA were comparably prone to non-homologous integration.

Conclusions

These results indicate that ssDNA is not superior to dsDNA as long HDR donors with relatively short homology arms for gene knock-in in human RPE1 and HCT116 cells.
Facilitators and barriers to collaboration between pre-hospital emergency and emergency department in traffic accidents: a qualitative study
Authors: Jamshidi Hasan , Jazani Reza Khani , Khani Jeihooni Ali , Alibabaei Ahmad , Alamdari Shahram , Kalyani Majid Najafi
Published: May 2023

Background

Death caused by traffic accidents is one of the major problems of health systems in low- and middle-income countries. Rapid handover of the traffic accident victims and proper collaboration between the pre-hospital and emergency departments (EDs) play a critical role in improving the treatment process and decreasing the number of accidental deaths. Considering the importance of the collaboration between pre-hospital and emergency departments, this study was designed to investigate the facilitators and barriers of collaboration between pre-hospital and emergency departments in traffic accidents.

Method

This research is a qualitative study using content analysis. In order to collect data, semi-structured interviews were used. Seventeen subjects (including pre-hospital and emergency department personnel, emergency medicine specialists, and hospital managers) were selected through purposive sampling and were interviewed. After transcribing and reviewing interviews, data analysis was performed with the qualitative content analysis approach.

Results

The participants consisted of 17 individuals (15 persons in pre-hospital and emergency departments with at least three years of work experience, one emergency medicine specialist and one hospital manager) who were selected by purposive sampling. The interviews were analyzed and three main categories and seven sub-categories were extracted. The main categories included “individual capabilities”, “development of mutual understanding”, and “infrastructures and processes”.

Discussion

Proper and practical planning and policymaking to strengthen facilitators and eliminate barriers to collaborate between pre-hospital and emergency departments are key points in promoting collaboration between these two important sectors of health system and reducing the traffic accident casualties in Iran.
“Echoes of a dark past” is a history of maternal childhood maltreatment a perinatal risk factor for pregnancy and postpartum trauma experiences? A longitudinal study
Authors: Mackle Tracey , Colodro-Conde Lucía , de Dassel Therese , Braun Anastasia , Pope Adele , Bennett Elizabeth , Kothari Alka , Bruxner George , Medland Sarah E. , Patterson Sue
Published: May 2023

Background

Although associations between maternal exposure to adverse childhood experiences (ACEs) and perinatal anxiety and depression are established, there is a paucity of information about the associations between ACEs and perinatal trauma and perinatal post-traumatic stress outcomes. For the purposes of this article, perinatal trauma is defined as a very frightening or distressing event that may result in psychological harm. The event must have been related to conception, pregnancy, birth, and up to 12 months postpartum.

Methods

Women recruited at an antenatal appointment (n = 262) were invited to complete online surveys at two-time points; mid-pregnancy and eight weeks after the estimated date of delivery. The ACE Q 10-item self-reporting tool and a perinatal trauma screen related to the current and/or a previous perinatal period were completed. If the perinatal trauma screen was positive at either time point in the study, women were invited to complete a questionnaire examining symptoms of perinatal post-traumatic stress disorder and, if consenting, a clinical interview where the Post-traumatic Symptoms Scale was administered.

Results

Sixty women (22.9%) reported four or more ACEs. These women were almost four times more likely to endorse perinatal trauma, when compared with those who either did not report ACEs (OR = 3.6, CI 95% 1.74 – 7.36, p < 0.001) or had less than four ACEs (OR = 3.9, CI 95% 2.037.55, p < 0.001). A 6–sevenfold increase in perinatal trauma was seen amongst women who reported having at least one ACE related to abuse (OR = 6.23, CI 95% 3.32–11.63, p < 0.001) or neglect (OR = 6.94, CI 95% 2.95–16.33, p < 0.001). The severity of perinatal-PTSD symptoms for those with perinatal trauma in pregnancy was significantly higher in those women exposed to at least one ACE related to abuse.

Conclusions

Awareness of maternal exposure to childhood adversity/maltreatment is critical to providing trauma-informed approaches in the perinatal setting. Our study suggests that routine screening for ACEs in pregnancy adds clinical value. This adds to previous research confirming the relationship between ACEs and mental health complexities and suggests that ACEs influence perinatal mental health outcomes.
Refractive surprise of irregular astigmatism following cataract surgery in two patients with neglected subclinical corneal ectasia: two case reports
Authors: Chen Leran , Chen Xiaoyong , Li Fanshu , Liu Ziyuan
Published: May 2023

Background

Corneal ectatic diseases are a group of corneal disorder characterized by the steepening and thinning of the cornea. Older people are not a high-risk population for corneal ectatic diseases; due to the lack of typical preoperative topographic manifestations, there is a high possibility that corneal ectasia is undetected.

Case presentation

Two patients with subclinical corneal ectasia and senile cataracts presented with irregular astigmatism after steep-axis incision during cataract surgery. The two cases presented in this case report are rare because both patients experienced tremendous changes in astigmatism after cataract surgery.

Conclusion

This case report may shed some light on astigmatism-correcting steep-axis incisions in cataract surgeries.
Maternal distress and parenting during COVID-19: differential effects related to pre-pandemic distress?
Authors: Low Ann , Yu Yue , Sim Lit Wee , Bureau Jean Francois , Tan Ngiap Chuan , Chen Helen , Yang Yang , Cheon Bobby , Lee Kerry , Bakermans-Kranenburg Marian , Tsotsi Stella , Rifkin-Graboi Anne
Published: May 2023

Background

Distinguishing whether and how pre-existing characteristics impact maternal responses to adversity is difficult: Does prior well-being decrease the likelihood of encountering stressful experiences? Does it protect against adversity’s negative effects? We examine whether the interaction between relatively uniformly experienced adversity (due to COVID-19 experience) and individual variation in pre-existing (i.e., pre-pandemic onset) distress predicted mothers’ pandemic levels of distress and insensitive caregiving within a country reporting low COVID-19 death rates, and strict nationwide regulations.

Method

Fifty-one Singaporean mothers and their preschool-aged children provided data across two waves. Pre- pandemic onset maternal distress (i.e., psychological distress, anxiety, and parenting stress) was captured via self-reports and maternal sensitivity was coded from videos. Measures were repeated after the pandemic’s onset along with questionnaires concerning perceived COVID-19 adversity (e.g., COVID-19’s impact upon stress caring for children, housework, job demands, etc.) and pandemic-related objective experiences (e.g., income, COVID-19 diagnoses, etc.). Regression analyses (SPSS v28) considered pre-pandemic onset maternal distress, COVID-19 stress, and their interaction upon post-pandemic onset maternal distress. Models were re-run with appropriate covariates (e.g., objective experience) when significant findings were observed. To rule out alternative models, follow up analyses (PROCESS Model) considered whether COVID-19 stress mediated pre- and post-pandemic onset associations. Models involving maternal sensitivity followed a similar data analytic plan.

Results

Pre-pandemic maternal distress moderated the association between COVID-19 perceived stress and pandemic levels of maternal distress (β = 0.22, p < 0.01) but not pandemic assessed maternal sensitivity. Perceived COVID-19 stress significantly contributed to post-pandemic onset maternal distress for mothers with pre-pandemic onset distress scores above (β = 0.30, p = 0.05), but not below (β = 0.25, p = 0.24), the median. Objective COVID-19 adversity did not account for findings. Post-hoc analyses did not suggest mediation via COVID-19 stress from pre-pandemic to pandemic maternal distress.

Conclusions

Pre-existing risk may interact with subsequent perceptions of adversity to impact well-being. In combination with existing research, this small study suggests prevention programs should focus upon managing concurrent mental health and may highlight the importance of enhanced screening and proactive coping programs for people entering high stress fields and/or phases of life.
Sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China: the mediating role of entrapment and defeat
Authors: Liu Yujie , Ge Xin , Zhang Jinxin , Xu Lulu , Hu Fan , Wang Suping , Liu Jialin , Yang Xiaodong , Shi Dake , Cai Yong
Published: May 2023

Background

The COVID-19 pandemic increases the risk of psychological problems, especially for the infected population. Sleep disturbance and feelings of defeat and entrapment are well-documented risk factors of anxiety symptoms. Exploring the psychological mechanism of the development of anxiety symptoms is essential for effective prevention. This study aimed to examine the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms among asymptomatic COVID-19 carriers in Shanghai, China.

Methods

A cross-sectional study was conducted from March to April, 2022. Participants were 1,283 asymptomatic COVID-19 carriers enrolled from the Ruijin Jiahe Fangcang Shelter Hospital, Shanghai (59.6% male; mean age = 39.6 years). Questionnaire measures of sleep disturbance, entrapment, defeat, anxiety symptoms, and background characteristics were obtained. A mediation model was constructed to test the mediating effects of entrapment and defeat in the association between sleep disturbance and anxiety symptoms.

Results

The prevalence rates of sleep disturbance and anxiety symptoms were 34.3% and 18.8%. Sleep disturbance was positively associated with anxiety symptoms (OR [95%CI] = 5.013 [3.721–6.753]). The relationship between sleep disturbance and anxiety symptoms (total effect: Std. Estimate = 0.509) was partially mediated by entrapment (indirect effect: Std. Estimate = 0.129) and defeat (indirect effect: Std. Estimate = 0.126). The mediating effect of entrapment and defeat accounted for 50.3% of the association between sleep disturbance and anxiety symptoms.

Conclusion

Sleep disturbance and anxiety symptoms were prevalent among asymptomatic COVID-19 carriers. Entrapment and defeat mediate the association between sleep disturbance and anxiety symptoms. More attention is needed to monitoring sleep conditions and feelings of defeat and entrapment to reduce the risk of anxiety.
Engaging transgender women in HIV research in South Africa
Authors: van der Merwe L. Leigh Ann , Cloete Allanise , Savva Helen , Skinner Donald , November Gita , Fisher Zsa-Zsa
Published: May 2023

The Botshelo Ba Trans study was the first HIV bio-behavioral survey conducted with transgender women in South Africa. Engaging research with marginalized communities requires clear points of entry, reference points for understanding the internal culture, and establishing trust and understanding. The community-based participatory research approach guided the development and implementation of this study. We conducted a rapid qualitative and pre-surveillance formative assessment between August 2017 to January 2018 and a bio-behavioral survey between July 2018 and March 2019. At the start, a Steering Committee, comprising primarily of transgender women, was established and subsequently provided substantial input into the mixed methods study conducted in Buffalo City, Cape Town, and Johannesburg. Key to the study's success was building trust and establishing ownership of the survey by transgender women recognized as expert knowledge holders. Thus, a community-based participatory research-informed approach enhanced the validity of the data and ensured that we addressed relevant issues.
An unusual cause of adrenal insufficiency with elevation of 17-hydroxyprogesterone: case report
Authors: Teti Claudia , Bezante Giampaolo , Gatto Federico , Khorrami Chokami Keyvan , Albertelli Manuela , Falchi Marco , Bovio Giulio , Nati Sandro Teresio , Ferone Diego , Boschetti Mara
Published: May 2023

Background

We present an intriguing case of primary adrenal lymphoma, with associated primary adrenal insufficiency (PAI), in a patient presenting a transitory partial 21-hydroxylase deficiency during the active phase of the adrenal disease.

Case presentation

An 85-years old woman was referred because of worsening asthenia, lumbar pain, generalized myalgia and arthralgia. During investigations a computed tomography (CT) scan evidenced two large bilateral adrenal masses, highly suspicious for primary adrenal tumor. The hormonal assessment revealed very low levels of morning plasma cortisol and 24-h urinary cortisol, elevated ACTH levels with low plasma concentration of aldosterone, pointing to the diagnosis of PAI. After diagnosis of PAI our patient started glucocorticoid and mineralcorticoid replacement therapy with clinical benefit. In order to further characterize the adrenal lesions, adrenal biopsy, was performed. The histology revealed a high grade non-Hodgkin lymphoma with an immunophenotype consistent with intermediate aspects between diffuse large B-cell and Burkitt lymphoma, with a high proliferation index (KI-67 > 90%). The patient received chemotherapy with epirubicin, vincristine, cyclophosphamide, and rituximab, associated with methylprednisolone that resulted in a complete clinical and radiological remission within one year. After 2 years from the diagnosis and a total of 6 cycles of rituximab, the patient was in good clinical condition and was taking only the replacement therapy for PAI. The patient initially presented also a slight increase of 17-hydroxyprogesterone (17-OHP) for age that normalize after resolution of lymphoproliferative disease.

Conclusions

In the presence of bilateral adrenal disease and/or in the presence of signs and symptoms of PAI clinicians must exclude the presence of PAL. The evidence of elevated ACTH-stimulated 17-OHP levels also in patients with other adrenal masses, together with the detection of elevated basal 17-OHP levels in our patient make it more plausible, in our view, an effect of the lesion on the “healthy” adrenal tissue residue than a direct secretory activity by the adrenal tumor.
The nonlinear correlation between alanine aminotransferase to high-density lipoprotein cholesterol ratio and the risk of diabetes: a historical Japanese cohort study
Authors: Cao Changchun , Hu Haofei , Han Yong , Yuan Shuting , Zheng Xiaodan , Zhang Xiaohua , Zan Yibing , Wang Yulong , He Yongcheng
Published: May 2023

Background

Low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of alanine aminotransferase (ALT) are related to insulin resistance, metabolic syndrome, and diabetes mellitus (DM). However, evidence on the connection between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and diabetes mellitus (DM) risk was limited. The study aimed to investigate the relationship between baseline ALT/HDL-C ratio and DM among Japanese individuals.

Methods

This second analysis was based on a cohort study using open-source data. Data from 15,342 individuals who participated in the medical examination program were recorded at Murakami Memorial Hospital in Japan between 2004 and 2015. Smooth curve fitting, subgroup analysis, Cox proportional-hazards regression, and a series of sensitivity analyses were conducted to examine the relationship between ALT/HDL-C ratio and incident diabetes. The ability of the ALT/HDL-C ratio to predict diabetes was evaluated using a receiver operating characteristic curve analysis.

Results

After controlling for confounding covariates, the ALT/HDL-C ratio was found to be positively correlated to the DM risk in Japanese adults (HR: 1.01, 95%CI: 1.00–1.02, P = 0.049). This study also found a stable relationship between ALT/HDL-C ratio and diabetes after employing a series of sensitivity analyses. Additionally, there was a non-linear association between the ALT/HDL-C ratio and incident diabetes, and the ALT/HDL-C ratio inflection point was 30.12. When the ALT/HDL-C ratio was below 30.12, the present study discovered a significant positive association between the ALT/HDL-C ratio and incident diabetes (HR: 1.04, 95%CI: 1.02–1.06, P = 0.001). Furthermore, among liver enzymes, blood lipids, and anthropometric indicators, the ALT/HDL-C ratio best predicts DM (AUC = 0.75, 95%CI: 0.73–0.78).

Conclusion

Increased ALT/HDL-C ratio levels at baseline correlated to incident DM. The relationship between ALT/HDL-C ratio and incident DM was also non-linear. When the ALT/HDL-C ratio is below 30.12, there is a statistically significant positive correlation between the ALT/HDL-C ratio and incident DM.
Organ donation after euthanasia starting with anesthesia at home is legal in The Netherlands, Belgium, Canada and Spain
Authors: Mulder Johannes , Sonneveld Hans
Published: May 2023

We would like to respond to the article “Organ donation after euthanasia starting at home in a patient with multiple system atrophy Tajaâte et al., [2021] 22:120” on organ donation after euthanasia from home [ODEH]. Although we welcome the performance of ODEH, we would like to make some critical comments regarding the article, both in relation to factual inaccuracies and in terms of the vision expressed on this subject. In this letter we stress the protection of autonomy of vulnerable euthanasia patients, we contradict the assumption of illegality, we question if the anesthesia method utilized is optimal and correct a mistake in regard to an article to which is referred of ourselves.
Reply to reaction on ‘Organ donation after euthanasia starting at home in a patient with multiple system atrophy – case report’
Authors: Tajaâte Najat , van Dijk Nathalie , Pragt Elien , Shaw David , Kempener-Deguelle A , Jongh Wim de , Bollen Jan , van Mook Walther
Published: May 2023

We would like to respond to the comment we received from our colleagues on our case report about organ donation after euthanasia starting at home. We reply to their statements on medical and legal aspects, and provide more information on our view of informed consent.
The impact of the COVID-19 pandemic on the health and working conditions of nurses and its implications for policies: a cross-sectional study in Slovakia
Authors: Putekova Silvia , Martinkova Jana , Urickova Alena , Kober Lukas , Reichertova Stanislava , Plancikova Dominika , Majdan Marek
Published: May 2023

Background

Increased workload and of the health workforce (HW) strained the capacity to maintain essential health services (EHS) during the Coronavirus Disease 2019 (COVID-19) pandemic, while putting them at increased risk of COVID-19 and other consequences to their health. The aim of this study was to assess the impact of COVID-19 on the health, wellbeing, and working conditions of nurses in Slovakia and to identify gaps in policies to be addressed to increase preparedness of the HW for future emergencies.

Methods

A nation-wide cross-sectional study was conducted among nurses during November–December 2021, referring to the period of January 2021 to November 2021. To assess the differences between impact on HW on various levels of care, respondents were grouped by type of facility: hospital-COVID-19 wards; Hospital–non-covid ward; Outpatient or ER; Other care facilities.

Results

1170 nurses participated, about 1/3 of them tested positive for COVID-19 by November 2021, mostly developing mild disease. Almost 2/3 reported long-covid symptoms and about 13% reported that they do not plan to get vaccinated against COVID-19. The median of the score of the impact of workload on health was 2.8 (56% of the maximum 5), the median score of mental health-wellbeing was 1.9 (63% of a maximum of 3). The studied impacts in all domains were highest in nurses working in COVID-19 hospital wards. Significant disruptions of health care were reported, with relatively high use of telemedicine to mitigate them. Overall, about 70% of the respondents thought of leaving their job, mostly due to working stress or inadequate pay.

Conclusions

Our study showed that the COVID-19 pandemic poses a substantial burden on the health, wellbeing and working conditions of nurses in Slovakia and that a large proportion of nurses considered leaving their jobs because of work overload or low salaries. Human resource strategies should be adopted to attract, retain and continuously invest in HW development including in emergency preparedness and response. Such an approach may improve the resilience and preparedness of the health system in Slovakia for future emergencies.
Perioperative and oncologic outcomes of transperitoneal versus retroperitoneal laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma: a systematic review and pooled analysis of comparative outcomes
Authors: Zhu Ping-yu , Wang Li , Li Kun-peng , Yin Shan , Chen Xiao-bin
Published: May 2023

Background

The debate on whether to choose a transperitoneal (TP) or retroperitoneal (RP) approach for treating upper urinary tract urothelial carcinoma (UTUC) with laparoscopic surgery has been drawing attention. This study aimed to systematically review and meta-analyze the existing evidence regarding oncologic and perioperative outcomes of transperitoneal laparoscopic radical nephroureterectomy (TLNU) and retroperitoneal laparoscopic radical nephroureterectomy (RLNU) in managing UTUC.

Methods

A comprehensive literature search was conducted using PubMed, Scopus, Embase, and Google Scholar for identifying randomized controlled trials (RCTs) and observational studies that evaluated the outcomes of TLNU and RLNU for UTUC. Continuous variables were represented by weighted mean difference (WMD) and standard mean difference (SMD), while binary variables were represented by odds ratio (OR), with 95% confidence intervals (CIs). The quality was assessed using the Newcastle–Ottawa scale. A sensitivity analysis was performed to evaluate the robustness of the estimates.

Result

Six observational studies were incorporated into this meta-analysis. The overall TLNU was associated with significantly shorter operating time (WMD − 19.85; 95% CI − 38.03 to − 1.68;P = 0.03); longer recovery time of intestinal function (SMD 0.46; 95% CI 0.08 to 0.84;P = 0.02). However, the terms of estimated blood loss (WMD − 5.72; 95% CI − 19.6 to − 8.15;P = 0.42); length of stay (WMD − 0.35; 95% CI − 1.61 to 0.91;P = 0.59), visual analog pain scale (WMD − 0.38; 95% CI − 0.99 to 0.84;P = 0.22); drainage duration (WMD − 0.22; 95% CI − 0.61 to 0.17;P = 0.26); overall complication rates (OR 1.24; 95% CI 0.58 to 2.63;P = 0.58); local recurrence rate (OR 0.6; 95% CI 0.3 to 1.21;P = 0.16); distant metastasis (OR 0.94; 95% CI 0.04 to 20.77;P = 0.97); 1-year overall survival (OS) (OR 0.45; 95% CI 0.1 to 2.01;P = 0.3) showed no difference between TLNU and RLUN.

Conclusion

TLNU provides similar surgical outcomes and oncologic results compared to RLUN; however, TLNU has a shorter procedure time and prolonged intestinal function recovery time. Due to the heterogeneity among the studies, randomized clinical trials with follow-ups in the long term are required to obtain more definite results.

Trial registration

www.crd.york.ac.uk/prospero/, identifier CRD42023388554.
Vitamin D receptor (VDR) on the cell membrane of mouse macrophages participates in the formation of lipopolysaccharide tolerance: mVDR is related to the effect of artesunate to reverse LPS tolerance
Authors: Zhang Yu , Zhou Jun , Hua Ling , Li Pan , Wu Jiaqi , Shang Shenglan , Deng Fei , Luo Jing , Liao Mengling , Wang Nuoyan , Pan Xichun , Yuan Yue , Zheng Yue , Lu Yonglin , Huang Yasi , Zheng Jiang , Liu Xin , Li Xiaoli , Zhou Hong
Published: May 2023

It is unclear whether membrane vitamin D receptor (mVDR) exists on the macrophage membrane or whether mVDR is associated with lipopolysaccharide (LPS) tolerance. Herein, we report that interfering with caveolae and caveolae-dependent lipid rafts inhibited the formation of LPS tolerance. VDR was detected as co-localized with membrane molecular markers. VDR was detected on the cell membrane and its level was higher in LPS-tolerant cells than that in only LPS treatment cells. Anti-VDR antibodies could abolish the effect of artesunate (AS) to reverse LPS tolerance, and the wild-type peptides (H397 and H305) of VDR, but not the mutant peptide (H397D and H305A), led to the loss of AS’s effect. AS decreased the mVDR level in LPS-tolerant cells. In vivo, AS significantly reduced VDR level in the lung tissue of LPS-tolerant mice. In summary, mVDR exists on the cell membrane of macrophages and is closely associated with the formation of LPS tolerance and the effects of AS.
Discovery of CLEC2B as a diagnostic biomarker and screening of celastrol as a candidate drug for psoriatic arthritis through bioinformatics analysis
Authors: Niu Min , Yuan Jingman , Yan Meixi , Yang Ge , Yan Ziyi , Yang Xichao
Published: May 2023

Background

Psoriatic arthritis (PSA) is a chronic, immune-mediated inflammatory joint disease that is liked to mortality due to cardiovascular disease. Diagnostic markers and effective therapeutic options for PSA remain limited due to the lack of understanding of the pathogenesis. We aimed to identify potential diagnostic markers and screen the therapeutic compounds for PSA based on bioinformatics analysis.

Methods

Differentially expressed genes (DEGs) of PSA were identified from the GSE61281 dataset. WGCNA was used to identify PSA-related modules and prognostic biomarkers. Clinical samples were collected to validate the expression of the diagnostic gene. These DEGs were subjected to the CMap database for the identification of therapeutic candidates for PSA. Potential pathways and targets for drug candidates to treat PSA were predicted using Network Pharmacology. Molecular docking techniques were used to validate key targets.

Results

CLEC2B was identified as a diagnostic marker for PSA patients (AUC > 0.8) and was significantly upregulated in blood samples. In addition, celastrol was identified as a candidate drug for PSA. Subsequently, the network pharmacology approach identified four core targets (IL6, TNF, GAPDH, and AKT1) of celastrol and revealed that celastrol could treat PSA by modulating inflammatory-related pathways. Finally, molecular docking demonstrated stable binding of celastrol to four core targets in the treatment of PSA. Animal experiments indicated celastrol alleviated inflammatory response in the mannan-induced PSA.

Conclusion

CLEC2B was a diagnostic marker for PSA patients. Celastrol was identified as a potential therapeutic drug for PSA via regulating immunity and inflammation.
A multi-center, randomized, parallel-group study to compare the efficacy of enhanced cognitive behavior therapy (CBT-E) with treatment as usual (TAU) for anorexia nervosa: study protocol
Authors: Nohara Nobuhiro , Yamanaka Yukari , Matsuoka Mikiko , Yamazaki Tadahiro , Kawai Keisuke , Takakura Shu , Sudo Nobuyuki , Ando Tetsuya , Matsuyama Yutaka , Byrne Susan , Dalle Grave Riccardo , Cooper Zafra , Yoshiuchi Kazuhiro
Published: May 2023

Background

The superiority of Enhanced Cognitive Behavior Therapy (CBT-E) with regard to weight gain and improvement of psychopathology of eating disorders for patients with anorexia nervosa (AN) over other psychotherapies and treatment as usual (TAU) has not been demonstrated in randomized controlled trials (RCTs). However, a previous RCT showed that patients with AN whose baseline body mass index (BMI) was less than 17.5 kg/m2 gained more weight when treated with CBT-E than with other psychotherapies. The aim of the study is to compare the efficacy of CBT-E and TAU for patients with AN. It was hypothesized that CBT-E would be superior to TAU, at least in terms of weight gain, as most patients with AN are likely to have a BMI lower than 17.5 kg/m2.

Methods/design

A randomized parallel-group multicenter trial will be conducted in three teaching hospitals in Japan between January 2023 and March 2026. Patients with DSM-5 AN, aged 16 years and older, with a BMI equal to or above 14.0 and below 18.5 will be eligible to participate. 56 patients will be randomly and evenly assigned to two intervention groups (CBT-E and TAU). Those assigned to CBT-E will be offered 25–40 sessions in accordance with their initial BMI. Patients assigned to TAU will have at least one session every 2 weeks, with the number of sessions and treatment period not fixed in advance. The primary outcome is BMI at 40 weeks after treatment initiation. The secondary outcomes are the results from the Japanese version of the Eating Disorder Examination Questionnaire and Clinical Impairment Assessment questionnaire to measure eating disorder psychopathology and psychological impairment. The follow-up assessment will be performed 6 months after the 40-week assessment.

Discussion

This multi-center randomized controlled study will probably evaluate the efficacy of CBT-E compared with TAU for patients with more severe AN than in previous studies since Japanese patients are likely to have a lower BMI than those in Western countries. While it may be difficult to generalize the results of a study conducted in Japan, it would be valuable to clarify the efficacy of CBT-E as a treatment package.

Trial registration

UMIN, UMIN000048847. Registered 12 Sep 2022.
Low electric field induction in BaTiO3-epoxy nanocomposites
Authors: Mishra Raghvendra Kumar , Li Danning , Chianella Iva , Goel Saurav , Lotfian Saeid , Yazdani Nezhad Hamed
Published: May 2023

Epoxy is widely used material, but epoxy has limitations in terms of brittleness in failure, and thus researchers explore toughening and strengthening options such as adding a second phase or using electromagnetic fields to tailor toughness and strength, on demand and nearly instantaneously. Such approach falls into the category of active toughening but has not been extensively investigated. In this research, Si-BaTiO3 nanoparticles were used to modify the electro-mechanical properties of a high-performance aerospace-grade epoxy so as to study its response to electric fields, specifically low field strengths. To promote uniform dispersion and distribution, the Si-BaTiO3 nanoparticles were functionalised with silane coupling agents and mixed in the epoxy Araldite LY1564 at different content loads (1, 5, 10 wt%), which was then associated with its curing agent Aradur 3487. Real-time measurements were conducted using Raman spectroscopy while applying electric fields to the nanocomposite specimens. The Raman data showed a consistent trend of increasing intensity and peak broadening under the increasing electric field strength and Si-BaTiO3 contents. This was attributed to the BaTiO3 particles’ dipolar displacement in the high-content nanocomposites (i.e., 5 wt% and 10 wt%). The study offers valuable insights on how electric field stimulation can actively enhance the mechanical properties in epoxy composites, specifically in relatively low fields and thin, high-aspect-ratio composite layers which would require in-situ mechanical testing equipped with electric field application, an ongoing investigation of the current research.
Assessment of GNSS zenith tropospheric delay responses to atmospheric variables derived from ERA5 data over Nigeria
Authors: Nzelibe Ifechukwu Ugochukwu , Tata Herbert , Idowu Timothy Oluwadare
Published: May 2023

Tropospheric delay is a major error caused by atmospheric refraction in Global Navigation Satellite System (GNSS) positioning. The study evaluates the potential of the European Centre for Medium-range Weather Forecast (ECMWF) Reanalysis 5 (ERA5) atmospheric variables in estimating the Zenith Tropospheric Delay (ZTD). Linear regression models (LRM) are applied to estimate ZTD with the ERA5 atmospheric variables. The ZTD are also estimated using standard ZTD models based on ERA5 and Global Pressure and Temperature 3 (GPT3) atmospheric variables. These ZTD estimates are evaluated using the data collected from the permanent GNSS continuously operating reference stations in the Nigerian region. The results reveal that the Zenith Hydrostatic Delay (ZHD) from the LRM and the Saastamoinien model using ERA5 surface pressure are of identical accuracy, having a Root Mean Square (RMS) error of 2.3 mm while the GPT3-ZHD has an RMS of 3.4 mm. For the Zenith Wet Delay (ZWD) component, the best estimates are derived using ERA5 Precipitable Water Vapour (PWV). These include the ZWD derived by the LRM having an average RMS of 20.9 mm and Bevis equation having RMS of 21.1 mm and 21.0 mm for global and local weighted mean temperatures, respectively. The evaluation of GPT3-ZWD estimates gives RMS of 45.8 mm. This study has provided a valuable insight into the application of ERA5 data for ZTD estimation. In line with the findings of the study, the ERA5 atmospheric variables are recommended for improving the accuracy in ZTD estimation, required for GNSS positioning.
Optical spatiotemporal vortices
Authors: Wan Chenhao , Chong Andy , Zhan Qiwen
Published: May 2023

Spatiotemporal vortices of light, featuring transverse orbital angular momentum (OAM) and energy circulation in the spatiotemporal domain, have received increasing attention recently. The experimental realization of the controllable generation of spatiotemporal vortices triggers a series of research in this field. This review article covers the latest developments of spatiotemporal vortices of light ranging from theoretical physics, experimental generation schemes, and characterization methods, to applications and future perspectives. This new degree of freedom in photonic OAM endowed by spatiotemporal vortices paves the way to the discovery of novel physical mechanisms and photonic applications in light science.