bluuebunny/crossref_metadata_2025 huggingface dataset:
On preventive maintenance of k-out-of-n systems subject to fatal shocks
Authors: Ashrafi Somayeh , Asadi Majid , Rostami Razieh
Published: January 2023

In this paper, we investigate optimal age-based preventive maintenance (PM) policies for an ( n- k + 1)-out-of- n system whose components are exposed to fatal shocks that arrive from various sources. We consider two different scenarios for the system failure. In the first one, it is assumed that the shock process is of the type of Marshall-Olkin where each shock affects one component of the system and puts it down, and one shock affects all components and destroys all of them. In the second scenario, it is assumed that the system is subject to an extended type of Marshall-Olkin shock process where the shocks arriving at random times may cause the breakdown of 1, 2, …, or n components. Under each scenario for the components failure, we investigate an optimal age-based PM model for the system by imposing the related cost function. Then, in each case, we explore the optimal PM time that minimizes the mean cost per unit of time. Some numerical results are presented to illustrate the applications of the proposed models.
Condition-based maintenance optimization for deteriorating systems considering performance-based contracting and destructive inspections
Authors: Zhang Yujie , Wang Yukun , Li Xiaopeng , Liu Yiliu , Gao Weizheng
Published: January 2023

As a novel contracting approach, the performance-based contracting (PBC) utilizes defined performance goals and structured incentives to improve the system availability and reduce the cost by tying the compensation to the service supplier to the system performance outcome. In this paper, two new CBM optimization models within the PBC framework are proposed considering the impacts of destructive inspections on the system degradation behavior. The average maintenance cost rate and the system availability within the contract horizon are estimated. Under the inspection-based replacement scheme, the objectives are to maximize the expected profit rate to the supplier and/or the resulting system average availability. A solution procedure based on the non-dominated sorting genetic algorithm (NSGA-II) combining with the weighted sum method (WSM) is introduced to derive the optimal CBM policies. Numerical examples and sensitivity analysis are conducted to examine the applicability of the proposed models.
Chemical constituents, viable micro-organism and malignant cell content in ultrasonic scalpel plume: A literature review
Authors: Steel Ben J , Horridge Catherine , Awni Sarah , Adams James R
Published: January 2023

Purpose:

To identify all published data on the chemical, micro-organism and malignant cell contents of ultrasonic scalpel plume, if any, and on any clinical implications of the contents on patients and operating staff.

Methods:

Searches were conducted aiming to identify all published evidence on the chemical constituents, presence/absence of viable micro-organisms and malignant cells in ultrasonic scalpel plume. Attempts were made to source unpublished industry data.

Results:

There is evidence from human and in vitro studies of the presence of a range of harmful, and some human carcinogenic, chemicals within ultrasonic plume, mostly at very low concentrations. Any clinical relevance of this has not been studied. There is evidence from experimental studies of the presence of hepatitis virus, human coronavirus and human papillomavirus material within ultrasonic plume. Any clinical effect of this has not been studied. There is conflicting evidence from combined in vitro and mouse model studies of the presence of viable malignant cells within ultrasonic plume. Any clinical relevance of this has also not been studied.

Conclusion:

Overall, relatively little research into the plume has been published, and further study is required to more clearly delineate any potential risk to patients, surgeons and other theatre staff. Current safety recommendations are discussed.
The role of switch maintenance therapy in urothelial cancers
Authors: Yu Eun-mi , Mudireddy Mythri , Biswas Rakesh , Aragon-Ching Jeanny B.
Published: January 2023

Maintenance therapy with immune checkpoint inhibitors (ICIs) has changed the treatment paradigm of metastatic urothelial carcinoma (mUC). The JAVELIN Bladder 100 trial established avelumab, one of several ICIs in use today, as a life-prolonging maintenance therapy for patients with advanced urothelial carcinoma. Platinum-based chemotherapy is most often used in the first-line treatment of mUC, and while response rates approach about 50%, disease control is usually short-lived upon completion of the standard three to six cycles of chemotherapy. Much progress has been made in recent years in the second-line space and beyond with the use of ICIs, antibody-drug conjugates (ADCs), and tyrosine kinase inhibitors (TKIs) in eligible patients at the time of disease progression post-platinum-based chemotherapy. However, many patients with progressive mUC after first-line chemotherapy suffer from rapid progression of disease, treatment toxicity with subsequent lines of therapy, and a limited life expectancy. Until the results of the JAVELIN Bladder 100 trial were presented in 2020, there were no maintenance strategies proven to be beneficial over best supportive care after disease control is achieved with first-line platinum-based chemotherapy. To date, standard of care frontline treatment of metastatic urothelial cancer remains to be four to six cycles of platinum-based chemotherapy followed by maintenance avelumab. This review summarizes the current evidence available on maintenance therapies in mUC, as well as several highly anticipated clinical trials that we hope will result in further progress in the management of this aggressive cancer and improve patient outcomes.
Apoyo organizacional percibido y comportamientos de empoderamiento en mujeres supervivientes de cáncer de mama reincorporadas laboralmente
Authors: Vásquez-Trespalacios Elsa María , Gómez-Jaramillo Valentina , Palacio-Orozco Susana , Atehortua-Salazar Sara
Published: January 2023

Objetivo:

evaluar el apoyo organizacional percibido y los comportamientos de empoderamiento en mujeres sobrevivientes de cáncer de mama, activas laboralmente, en un centro de referencia oncológico.

Métodos:

estudio descriptivo en el que se recolectaron datos sobre las características sociodemográficas, laborales, clínicas, las secuelas del tratamiento, los comportamientos de empoderamiento y la percepción del apoyo organizacional.

Resultados:

Cerca del 90% de las mujeres conservó el trabajo anterior al diagnóstico. El 69% reportó que sus ingresos se mantuvieron iguales. La mayoría de las mujeres participantes percibieron bajo apoyo organizacional, y este cambia según la presencia de algunas secuelas del tratamiento. El 49.6% de las participantes había adoptado totalmente comportamientos de empoderamiento que varían significativamente de acuerdo con la edad, la presencia de secuelas, el apoyo organizacional percibido y el tiempo de retorno al trabajo.

Conclusión:

Las secuelas del tratamiento tienen influencia sobre el apoyo organizacional percibido y la adopción de comportamientos de empoderamiento.
Two New Nitrogen-Containing Glycosides From Stixis scandens
Authors: Thi Yen Tran , Tam Nguyen Thanh , Thanh Thi Kim Nguyen , Ngoc Binh Vo , Thao Kim Nu Nguyen , Quoc Anh Ngo
Published: January 2023

Phytochemical investigation of a methanol extract of Stixis scandens stems and leaves led to the isolation of 3 nitrogen-containing compounds (1-3) and 6 phenolics (4-9), which included 2 new glycosides, one a phenolic amide glucoside, scandemide (1), and the other an indole alkaloid glycoside, stixilenin (2). Their structures were elucidated by spectroscopic (1D- and 2D-NMR) and spectrometric (HR-ESI-MS) analyses, and acid hydrolysis. The isolated compounds were evaluated for their inhibitory effects on nitric oxide production in lipopolysaccharide-induced RAW264.7 cells.
School as Soil: Pedagogies of Care for Alternative Future Imaginaries
Authors: Albuquerque Paula , Pischetola Magda
Published: January 2023

In the majority of Brazilian public schools, poverty and social injustice prevail. Most students come from disadvantaged realities, and their future seems to be already defined by a lack of social mobility, exclusion from civil rights, and violence—a situation that has worsened with the global pandemic. Rooted in ethnographic research in public schools in the municipality of Rio de Janeiro, this paper explores the role of pedagogies of care in creating alternative, possible, and preferable narratives about the future of these students. By using the metaphor of “school as soil”, the study identifies care in four dimensions: time, heterogeneity, mattering, and fertility. It draws on 12 semi-structured interviews with teachers from eight different public schools that were part of a larger doctoral project. By researching school as soil, we examine how pedagogies of care encourage teachers’ speculation about preferable imaginaries for the future of their students. Results show that despite precarious resources and scarce institutional support, pedagogies of care appear in multiple reported situations, aiming to inspire learning processes, give voice and agency to the socially marginalized, and allow for ways of thinking that offer alternatives to the seemingly ubiquitous oppressive relations.
How to translate and implement the current science of gene therapy into haemophilia care?
Authors: Hermans Cedric , Gruel Yves , Frenzel Laurent , Krumb Evelien
Published: January 2023

Gene-based therapy opens an entirely new paradigm in managing people with haemophilia (PWH), offering them the possibility of a functional cure by enabling continuous expression of factor VIII (FVIII) or factor IX (FIX) after transfer of a functional gene designed to replace the PWH’s own defective gene. In recent years, significant advances in gene therapy have been made, resulting in clotting factor activity attaining near-normal levels, as reflected by ‘zero bleeding rates’ in previously severely inflicted patients following a single administration of adeno-associated viral (AAV) vectors. While this new approach represents a major advancement, there are still several issues that must be resolved before applying this technology in clinical practice. First, awareness, communication, and education about the therapeutic potential and modalities of gene therapy must be further strengthened. To this end, objective, unbiased, transparent, and regularly updated information must be shared, in an appropriate way and understandable language with the support of patients’ organizations. Second, healthcare providers should adopt a patient-centred approach, as the ‘one size fits all’ approach is inappropriate when considering gene therapy. Instead, a holistic patient view taking into account their physical and mental dimensions, along with unexpressed expectations and preferences, is mandatory. Third, the consent procedure must be improved, ensuring that patients’ interests are maximally protected. Finally, gene therapy is likely to be first delivered in a few centres, with the highest expertise and experience in this domain. Thus, patients should be managed based on a hub-and-spoke model, taking into account that the key to gene therapy’s success lies in an optimal communication and collaboration both within and between haemophilia centres sharing their experiences in the frame of international registries. This review describes recent progress and explains outstanding hurdles that must be tackled to ease the implementation of this paradigm-changing new therapy.
Antihuman T lymphocyte porcine immunoglobulin combined with cyclosporine as first-line immunosuppressive therapy for severe aplastic anemia in China: a large single-center, 10-year retrospective study
Authors: Yang Wenrui , Liu Xu , Zhao Xin , Zhang Li , Peng Guangxin , Ye Lei , Zhou Kang , Li Yuan , Li Jianping , Fan Huihui , Yang Yang , Xiong Youzhen , Jing Liping , Zhang Fengkui
Published: January 2023

Background:

Antihuman T lymphocyte porcine immunoglobulin (p-ATG) has been the most common ATG preparation in immunosuppressive therapy (IST) in Chinese patients with severe aplastic anemia (SAA) since 2009.

Objectives:

This study aimed to evaluate the early hematologic response and long-term outcomes of a large cohort of patients with SAA who received p-ATG plus cyclosporine (CsA) as first-line therapy from 2010 to 2019.

Design:

This is a single-center retrospective study of medical records.

Methods:

We analyzed the data of 1023 consecutive patients with acquired aplastic anemia (AA) who underwent p-ATG combined with CsA as a first-line IST treatment from 2010 to 2019 at our department.

Results:

The median age of the patients was 24 (4–75) years, and the median follow-up time was 57.2 months (3 days–137.5 months). There was an early mortality rate of 2.8% with a median death time of 0.9 months (3 days–2.9 months). The overall response rates were 40.6% and 56.1% at 3 and 6 months, respectively. The 5-year cumulative incidences of relapse and clonal evolution were 9.0% [95% confidence interval (CI) = 4.2–16.0%] and 4.5% (95% CI = 1.4–10.6%), respectively. The 5-year overall survival (OS) and event-free survival rates were 83.7% (95% CI = 81.1–86.0%) and 50.4% (95% CI = 47.1–53.5%), respectively.

Conclusion:

p-ATG combined with CsA for the treatment of AA is effective and safe, and p-ATG can be used as an alternative ATG preparation for the standard IST regimen in areas in which h-ATG is not available.
Genetic lesions and targeted therapy in Hodgkin lymphoma
Authors: Li Zhe , Mu Wei , Xiao Min
Published: January 2023

Hodgkin lymphoma is a special type of lymphoma in which tumor cells frequently undergo multiple genetic lesions that are associated with accompanying pathway abnormalities. These pathway abnormalities are dominated by active signaling pathways, such as the JAK-STAT (Janus kinase–signal transducer and activator of transcription) pathway and the NFκB (nuclear factor kappa-B) pathway, which usually result in hyperactive survival signaling. Targeted therapies often play an important role in hematologic malignancies, such as CAR-T therapy (chimeric antigen receptor T-cell immunotherapy) targeting CD19 and CD22 in diffuse large B-cell lymphoma, while in Hodgkin lymphoma, the main targets of targeted therapies are CD30 molecules and PD1 molecules. Drugs targeting other molecules are also under investigation. This review summarizes the actionable genetic lesions, current treatment options, clinical trials for Hodgkin lymphoma and the potential value of those genetic lesions in clinical applications.
Short-circuiting biology: Digital phenotypes, digital biomarkers, and shifting gazes in psychiatry
Authors: Mulinari Shai
Published: January 2023

Digital phenotyping is a rapidly growing research field promising to transform how psychiatry measures, classifies, predicts, and explains human behavior. This article advances the social-scientific examination of digital phenotyping's epistemology and knowledge claims. Drawing on the notion of a “neuromolecular gaze” in psychiatry since the 1960s, it suggests that digital phenotyping concerns a new psychiatric gaze—the “digital gaze.” Rather than privileging neuromolecular explanations, the digital gaze privileges the “deep” physiological, behavioral, and social “truths” afforded by digital technologies and big data. The article interrogates two concepts directing the digital gaze: “digital phenotype” and “digital biomarkers.” Both concepts make explicit an epistemic link between “the digital” and “the biological.” The article examines the soundness and construction of this link to, first, offer a “reality check” of digital phenotyping's claims and, second, more clearly delineate and demarcate the digital gaze. It argues there is evidence of significant mis- and overstatements about digital phenotyping's basis in biology, including in much-hyped psychiatric digital biomarker research. Rather than driving the biologization of digital traces, as some have suggested, digital mental health phenotyping so far seems mainly concerned with physiological, behavioral, and social processes that can be surveilled by means of digital devices.
A New Perspective to Longstanding Challenges with Outpatient Hyperkalemia: A Narrative Review
Authors: Chiu Michael , Garg Amit X. , Moist Louise , Jain Arsh K.
Published: January 2023

Purpose of Review:

Outpatient hyperkalemia is a common problem with potentially deadly consequences. Potassium level thresholds to treat outpatient hyperkalemia are unstandardized and variable, leaving health care providers to rely on their own clinical judgment. This narrative review highlights the challenges of outpatient hyperkalemia management and includes recommendations for future studies that may standardize treatment, improve patient outcomes, and optimize health care utilization.

Sources of Information:

PubMed, Google Scholar, and the reference lists of identified articles were used to include English, peer-reviewed studies and guidelines for this review.

Methods:

This narrative review examines outpatient hyperkalemia from both a laboratory and clinical perspective. In addition to peer-reviewed literature, guidelines and expert consensus statements were included to highlight the inconsistencies and paucity of evidence that health care providers rely on to make clinical decisions.

Key Findings:

There are multiple reasons why outpatient hyperkalemia management is both challenging and sub-optimal. Clinicians must discern if the potassium level result is accurate and, if so, does the result warrant referral to the emergency department. Factitious hyperkalemia, or falsely elevated potassium level results due to analytical errors, occurs frequently, but there are no ways to identify it other than for hemolyzed samples. Additionally, guidelines and expert panels are inconsistent on the thresholds for treatment and the management of hyperkalemia. Finally, there are inconsistencies between laboratories as to when and how providers are notified of results, and the suggested thresholds for urgent management. A study that integrates the expertise of clinical biochemists and clinicians is needed to inform evidence-based guidelines for the management of outpatient hyperkalemia.

Limitations:

This was a comprehensive review of what is known and what still needs to be understood for the management of outpatient hyperkalemia. A formal tool to assess the quality of the included studies was not used and selection bias may have occurred.
The Influence of Parent–Child Relationships on Musical Activity in the Family: Findings from a Longitudinal Panel Study
Authors: Kreutz Gunter , Feldhaus Michael
Published: January 2023

Singing and playing musical instruments is seen as beneficial for parent–child relationships. Using longitudinal data from the German Panel Analysis of Intimate Relationships and Family Dynamics (Pairfam) we investigate the role of specific facets of parent–child relationships as predictors of family musical activity, namely Intimacy, that is, the degree of mutual sharing of thoughts and feelings, Admiration, that is, positive affirmative attitudes, and Prosocial Behavior, that is, showing empathy and consideration for others. Study 1 included responses from a total of N = 1,339 parents (71% mothers) and N = 1,783 children (52% male), and Study 2 differentiates between specific subsamples of parent–child relations. Data were submitted to a series of regression models. Study 1 showed that higher values of Intimacy were associated with greater music activities for both parent and child even when general levels of music activities decreased over time. Study 2 addressed cases in which mothers and fathers independently assessed the same child. The results showed similar patterns of association for both parents and children across studies. In addition, mothers perceived higher levels of family music activities than did fathers. Finally, high levels of Intimacy were associated with increased family music activity against the general trend of decline. Taken together, a strong and consistent pattern of a positive relationship between, on the one hand, mutual parent–child perceptions of trust and confidence, that is, Intimacy, and on the other hand, music activity, was found. These results confirm and extend earlier work to suggest a certain role of the quality of family relationships in pursuing musical activities from childhood to adolescence.
Students as Co-Creators: Bringing Culturally Responsive Teaching into a Doctoral Course for International Students in China
Authors: Androsov Alexey , Zhang BaoHui
Published: January 2023

The influx of international students pursuing academic degrees in China in recent years has posed several challenges for educators who must cope with cultural and linguistic plurality. This qualitative dominant mixed-methods study explores how the engagement through partnership builds on and caters to cultural diversity. For one semester, seven international doctoral students of a course Frontiers of the Learning Sciences took on the role of course co-creators and discussion leaders. Classroom videos, student surveys, interviews, weekly reflection journals, and social media chatlogs were collected and analyzed. Results showed that engaging students as course co-creators was responsive to cultural diversity. Three interrelated factors emerged that defined the effectiveness of students’ engagement within multicultural settings: language proficiency, academic ability, and personal attitude to the differences. Moreover, the study revealed four interconnected factors (time, challenge, competency, support) that should be considered in designing effective culturally responsive learning environments for international doctoral students.
Foot and Ankle Disorders in Nurses Exposed to Prolonged Standing Environments: A Scoping Review
Authors: Bernardes Rafael A. , Caldeira Sílvia , Parreira Pedro , Sousa Liliana B. , Apóstolo João , Almeida Inês F. , Santos-Costa Paulo , Stolt Minna , Guardado Cruz Arménio
Published: January 2023

Background:

Prolonged standing environments constitute an occupational risk factor for nurses, particularly for developing foot and ankle disorders. The definitions and potential relationship to hours spent walking or standing are poorly understood. This scoping review aimed to synthesize the main disorders found on nurses’ ankles and feet, their prevalence, the influence of hours spent walking or standing, and gender differences.

Methods:

This review followed a previously published protocol. Primary and secondary studies were retrieved from relevant databases from December 2020 to March 2021. Potential articles were collated to Mendeley, and two independent reviewers assessed the title and abstracts. Studies meeting inclusion criteria were included. Two researchers retrieved and reviewed the full text of these studies independently. A predetermined extraction tool was used to retrieve relevant data, summarized in a tabular and narrative format.

Findings:

The most common disorder was pain, followed by numbness, burning feet, bunions, structural deformities, and calluses. Prevalence differed among studies, depending on settings and specific local policies. Discussion: Various foot and ankle disorders and related variables have been found, with clear gaps that may be addressed in the future.

Conclusion/Applications to Practice::

Few studies have focused on nurses’ foot and ankle disorders. Mapping signs and symptoms may contribute to the future development of preventive interventions for nurses’ workplaces.
Opportunities and Challenges for Critical Reporting at the Olympics: Journalists’ Perspectives From Tokyo 2020
Authors: Robertson Cerianne
Published: January 2023

How Olympics reporters understand the Games and their role within them has implications for what and how they report. At stake in journalists’ storytelling choices are the representations of the Olympics themselves as well as representations of the host city and country — representations that can serve to bolster powerful institutions and dominant ideologies, or to challenge them and open new opportunities for change. Despite the importance of journalists to the production of the Olympic spectacle, there has been relatively little research that examines how Olympics reporters think about what it means to report on the Games. This paper explores what journalists’ perspectives and experiences can reveal about the opportunities and challenges for reporting from a “critical stance” at the Games. I highlight three key themes from interviews with journalists who reported on Tokyo 2020 for influential English-language publications: the role of awe in Olympics reporting; impressions of what readers want; and the role of reporters’ experiences at past Olympic Games. I suggest that at Tokyo 2020 there were more opportunities for critical reporting that portrayed Olympics problems as exceptional, rather than structural, although the space for structural critique may be growing.
Correlation between presence of traumatic disco-ligamentous injuries as an MRI finding with the results of management of thoracolumbar and lumbar injuries
Authors: Aly Tarek
Published: January 2023

Introduction: Radiographic study plays an important role in diagnosis of acute vertebral injuries and helps in proper management of those patients. Magnetic resonance imaging (MRI) is the modality of choice for evaluation of ligamentous and other soft tissue structures, disc, spinal cord and occult osseous injuries. Due to high cost, it is necessary to detect the best use of this technique in the evaluation of thoracolumbar spinal injuries. The purpose of this study was to evaluate the importance of MRI as indicators for vertebral ligamentous injuries and intervertebral disc injuries or herniation in management of thoracolumbar and lumbar fractures. Methods: Retrospective study using radiological measurements. Seventy-two patients with thoracolumbar and lumbar fractures were included. Radiographic parameters detected were percentage of compression, kyphosis angle, vertebral translation and scoliosis angle. Computed tomography was used to detect the degree of spinal canal narrowing, MRI was used to evaluate the condition of posterior ligamentous complex and intervertebral disc injury or herniation. American Spinal Injury Association score was recorded. Results: There were 83% AO spine type A, 6% AO spine type B and 11% AO spine type C. Correlation between fracture type and neurological status with the posterior ligamentous complex injury was found to be significant: ( P = 0.0143 and P = 0.0344, respectively). Degree of vertebral body compression, kyphosis and scoliosis angles, vertebral body translation and spinal canal narrowing were found to be insignificant in correlation with posterior ligamentous complex injuries. Correlation of the above-mentioned parameters with disc injury or herniation was found to be insignificant except for kyphotic angle that was found to be significant in correlation with posttraumatic disc herniation ( P = 0.0219). Conclusion: MRI finding is of great value in management plan of thoracolumbar and lumbar fractures. Injury of posterior ligamentous complex is significantly correlated with fracture severity and the neurological function. But the intervertebral disc injury or herniation was not correlated to them except that the disc herniation was significantly correlated to kyphosis angle.
Review of Reliable and Valid Noninvasive Tools for the Diagnosis of Chronic Exertional Compartment Syndrome
Authors: der Kraats Annick M. van , Winkes Michiel , Janzing Heinrich M.J. , Eijkelenboom Rob P.R. , de Koning Marleen T.G.
Published: January 2023

Background:

Currently, invasive dynamic intracompartmental pressure (ICP) measurements are considered the gold standard for diagnosis of chronic exertional compartment syndrome (CECS). During recent years, different noninvasive imaging modalities have been presented as a possible replacement for ICP measurement.

Purpose:

To provide an overview of the current state of evidence and possibilities regarding noninvasive diagnostic methods for CECS.

Study Design:

Scoping review; Level of evidence, 4.

Methods:

The PubMed (MEDLINE) and Embase databases were searched using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Full-text articles were included if they reported on noninvasive diagnostic methods for CECS, included ≥5 patients with CECS, and were published between 1994 and 2022. Articles not written in English were excluded. Systematic reviews, letters to the editor, and case reports were not eligible for inclusion. Out of 961 articles identified in the initial search, 25 studies (N = 1257 participants) were included. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies–Comparative (QUADAS-C) tool for comparative studies and the QUADAS-2 tool for noncomparative studies. Narrative synthesis was used to present results.

Results:

The level of evidence for the 25 studies ranged from 2 to 4. Four studies were classified as having a low risk of bias, 21 studies were classified as being at risk of bias. The following noninvasive diagnostic tools for CECS were reported: magnetic resonance imaging/diffusion tensor imaging (n = 8), near-infrared spectroscopy (n = 6), electromyography (n = 4), single-photon emission computed tomography (n = 5), ultrasound (n = 2), myotonometry (n=1) and predictive clinical model (n = 1). There was insufficient evidence in the literature to support the use of any of these noninvasive diagnostic tools as a gold standard for CECS.

Conclusion:

Despite the need to replace the controversial use of ICP for the diagnosis of CECS, our review indicated a lack of validity on all discussed noninvasive diagnostic tools as a replacement.
Developing and Testing Digital Ethical Reflection in Long-Term Care: Nurses’ Experiences
Authors: Jakobsen Lena , Olsen Rose Mari , Brinchmann Berit Støre , Devik Siri Andreassen
Published: January 2023

Introduction

Nurses working in municipal long-term care face ethical challenges that can lead to moral distress and discomfort for the nurse and affect the quality of patient care. Tools and methods that contribute to increased ethical awareness and support for nurses dealing with moral issues are lacking. Technological innovations may be suitable for ethics work, but little research has been conducted on how such solutions could be designed or their potential benefit. Therefore, this study contributes knowledge about the development and testing of a digital tool for ethics support among nurses.

Objective

To investigate how digital ethical reflection can support ethics work among nurses working in long-term care.

Methods

A digital ethical reflection tool was designed and tested in nursing homes and home nursing care in collaboration with two Norwegian municipalities. The study used sequential explanatory mixed-methods design. Over a 6-week period, at the end of each shift, nurses digitally reported the ethical challenges they had experienced. Their responses and experiences were described using descriptive statistics. Additionally, focus group interviews were conducted and analyzed using reflexive thematic analysis (TA).

Results

During the study period, 17 nurses reported a total of 223 registrations, with 24.8% stating that they had been in an ethically difficult situation. The digital reporting was perceived as practically applicable and helped to increase nurses’ awareness of morally charged situations. The value of the registrations was found to depend on manager participation and the application of the obtained information. The participating nurses become aware that they lacked an arena for meaningful dialogue with and recognition from their manager.

Conclusions

Information obtained through digital reflection can form the basis for ethical reflections at the departmental level. Digital reflection has the potential to become a tool for managers in their support for employees facing ethical challenges when providing long-term care.
Strengths and weaknesses of the incident reporting system: An Italian experience
Authors: Benevento Marcello , Nicolì Simona , Mandarelli Gabriele , Ferorelli Davide , Cicolini Giancarlo , Marrone Maricla , Dell’Erba Alessandro , Solarino Biagio
Published: January 2023

One of the cornerstones for enhancing the patient safety culture is the incident reporting system (IRS). It is a process for detecting, reporting, collecting, and summarizing adverse events (AEs) and near-misses in healthcare, and so it represents a vital tool for clinical risk management. We analyzed the 5-year experience of a third-level hospital's IRSs, showing its trends and highlighting its main strengths and weaknesses. Patients’ falls and physical or verbal aggression toward the providers or between patients are the most reported events. Underreporting is the main limitation of the system, especially among nurses. Visible actions, forceful analysis of the reports, operators’ education, no-blame culture promotion, and organizational adjustments may improve operators’ adherence to IRS. Providers do not willingly inform patients’ relatives about fatal incidents. Despite that, the IRS is far from its potential, and the number of data collected has increased.
Digital note-taking: An effective self-regulation tool in increasing academic achievement of Filipino students in a business mathematics online learning course
Authors: Calamlam Jose Mari M.
Published: January 2023

Online learning is a relatively new but emerging approach in Philippine education. The approach's rise in popularity warrants an emphasis on self-regulated learning (SRL). Hence, the current study aimed to propose and assess an intervention using a digital note-taking application as an SRL tool for Business Math. Data collection included the administration of a pre-test and a post-test and weekly ratings of digital notebook usage. Two-way ANCOVA results suggest that skillful self-regulators consistently achieved more than naïve self-regulators. Hierarchal regression analysis results imply that learners with better digital notebooks are likelier to achieve more in the course. These results demonstrate the effectiveness of the SRL intervention used in the study. Furthermore, repeated measures of ANOVA results suggest that different groups of learners use their SRL tools differently. Despite the effect of SRL tools on achievement, higher achievers are not certainly better self-regulators than lower achievers.
Seismic resilience of typical code-conforming RC moment frame buildings in Canada
Authors: Badal Prakash S , Tesfamariam Solomon
Published: January 2023

This article examines the baseline resilience of reinforced concrete (RC) moment frame buildings conforming to the seismic design standards of Canada. Metrics for robustness, rapidity, and resilience are evaluated to capture the system’s reliability, speed of recovery, and socioeconomic impacts. Buildings of different heights are evaluated using nonlinear time-history analyses. Six damage states are defined as disjoint branches of an event tree depending on the building’s path to recovery. For a scenario earthquake of magnitude 7.3 magnitude at a distance of 30 km from Vancouver, the housing occupancy recovery trajectory is developed. Monte Carlo simulations are used to propagate uncertainty from seismic hazards to the building response to the lead time required for recovery. Buildings are found to maintain 50%–65% of their pre-event housing occupancy in the immediate aftermath. The housing occupancy is restored to 90% within 2–4 months, with a shorter recovery period for low-rise buildings, whereas the system resilience level requires 6 months to 1 year for restoration to 90%. Empirical data from the Loma Prieta (1989) and Northridge (1994) earthquakes are used to compare analytically predicted repair times. The findings from this article will facilitate the shift to resilience-based design in Canada.
Characterization and distribution of clay minerals in the soils of Fildes Peninsula and Ardley Island (King George Island, Maritime Antarctica)
Authors: Pelayo Marta , Schmid Thomas , Díaz-Puente Francisco Javier , López-Martínez Jerónimo
Published: January 2023

The environmental conditions in Maritime Antarctica are more favorable to soil development than in continental areas, which is reflected in the content and type of clay minerals present. In this context, soil clay minerals of Fildes Peninsula, South Shetland Islands were studied with the aim of relating them to periglacial and paraglacial processes as possible indicators of initial pedogenic processes. In this work, textural, mineralogical and crystallochemical characterization of clay minerals as well as chemical and physical soil analyses were carried out. The soil samples represented various surface cover types present on Fildes Peninsula. All samples were composed mainly of clay minerals, plagioclase, quartz and minor zeolites and pyroxene. The clay mineral content was very variable and reached up to 63% w/w. The clay minerals present are mainly smectite, vermiculite, chlorite and minor kaolinite, mica, corrensite and interstratified illite–smectite, with smectite and vermiculite dominating in almost all of the samples. The primary minerals display chemical alteration, and smectite formed by alteration of plagioclase. The clay mineral types were related to the parent material, which was affected by low-grade metamorphism and hydrothermal alteration that transformed biotite and chlorite into vermiculite via interstratified chlorite–vermiculite. Furthermore, this process and/or ongoing surface weathering transformed vermiculite into smectite. The genetic relationship observed between vermiculite and smectite suggests progressive alteration and transformation into a phase with intermediate composition between vermiculite and smectite. Therefore, vermiculite could be at least in part the smectite precursor. Samples closer to the current Collins Glacier front are composed mainly of vermiculite, with the greatest chemical variation occurring where the soils were developed from a mixture of initially glacially transported volcanic rocks through periglacial and fluvial processes. The clay minerals from the centre and south of Fildes Peninsula are mixtures of montmorillonite and vermiculite, as well as of chlorite and corrensite in various proportions. The clay minerals in soils developed on the west coast are a mixture of Fe-rich montmorillonite and vermiculite.
Resistance exercise promotes the resolution and recanalization of deep venous thrombosis in a mouse model via SIRT1 upregulation
Authors: Wu Caijiao , Li Xiaorong , Zhao Huihan , Ling Ying , Ying Yanping , He Yu , Zhang Shaohan , Liang Shijing , Wei Jiani , Gan Xiao
Published: January 2023

Background

Early exercise for acute deep venous thrombosis (DVT) improves the patient’s symptoms and does not increase the risk of pulmonary embolism. However, information about its effect on thrombus resolution is limited. The aim of this study was to investigate the role of resistance exercise (RE) in thrombus resolution and recanalization and determine its underlying mechanisms. 

Methods

Ninety-six C57BL/6 J mice were randomly divided into four groups: Control group (C, n = 24); DVT group (D, n = 24); RE + DVT group (ED, n = 24); and inhibitor + RE + DVT group (IED, n = 24). A DVT model was induced by stenosis of the inferior vena cava (IVC). After undergoing IVC ultrasound within 24 h post-operation to confirm DVT formation, mice without thrombosis were excluded. Other mice were sacrificed and specimens were obtained 14 or 28 days after operation. Thrombus-containing IVC was weighed, and the thrombus area and recanalization rate were calculated using HE staining. Masson’s trichrome staining was used to analyze the collagen content. RT-PCR and ELISA were performed to examine IL-6, TNF-α, IL-10, and VEGF expression levels. SIRT1 expression was assessed using immunohistochemistry staining and RT-PCR. VEGF-A protein expression and CD-31-positive microvascular density (MVD) in the thrombus were observed using immunohistochemistry. 

Results

RE did not increase the incidence of pulmonary embolism. It reduced the weight and size of the thrombus and the collagen content. Conversely, it increased the recanalization rate. It also decreased the levels of the pro-inflammatory factors IL-6 and TNF-α and increased the expression levels of the anti-inflammatory factor IL-10. RE enhanced VEGF and SIRT1 expression levels and increased the MVD in the thrombosis area. After EX527 (SIRT1 inhibitor) was applied, the positive effects of exercise were suppressed.

Conclusions

RE can inhibit inflammatory responses, reduce collagen deposition, and increase angiogenesis in DVT mice, thereby promoting thrombus resolution and recanalization. Its underlying mechanism may be associated with the upregulation of SIRT1 expression.
Not only COVID-19 disease impacts ambulance emergency demands but also lockdowns and quarantines
Authors: Vuilleumier Séverine , Spichiger Thierry , Dénéréaz Sandrine , Fiorentino Assunta
Published: January 2023

Background

The pandemic has impacted both patients infected by the SARS-CoV-2 virus and patients who seek emergency assistance due to other health issues. Changes in emergency demands are expected to have occurred during the pandemic, the objective of this investigation is to characterize the changes in ambulance emergency demands during the first year of the COVID-19 pandemic in the Vaud State of Switzerland. The goal of this research is to identify the collateral effects of the COVID-19 pandemic on emergency demands. To do so, this study quantifies the differences in health issues, level of severity, and patients’ sociodemographic characteristics (age, location, gender) prior to and during the outbreak.

Method

This is a retrospective, descriptive and comparative statistical analysis of all ambulance emergency missions from 2018 to 2020 (n = 107,150) in the State of Vaud in Switzerland. Variables analyzed were the number of ambulance missions, patient age and gender, health issues, severity (NACA scores), number of non-transports, mission times and locations. Variables were compared between prepandemic and pandemic situations across years and months. Comparative analysis used bivariate analysis, χ2 test, Student’s t test, and Mann‒Whitney U test.

Results

The pandemic has had two major impacts on the population’s emergency demands. The first appears to be due to COVID-19, with an increase in respiratory distress cases that doubled in November 2020. The second relates to the implementation of lockdown and quarantine measures for the population and the closures of restaurants and bars. These might explain the decrease in both the number of traumas and intoxications, reaching more than 25% and 28%, respectively. An increase in prehospital emergency demands by the older population, which accounted for 53% of all demands in 2020, is measured.

Conclusion

Collateral effects occurred during 2020 and were not only due to the pandemic but also due to protective measures deployed relative to the population. This work suggests that more targeted reflections and interventions concerning the most vulnerable group, the population of people 65 and older, should be of high priority. Gaining generalizable knowledge from the COVID-19 pandemic in prehospital settings is critical for the management of future pandemics or other unexpected disasters.
Serotype distribution and antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates among adult and elderly population before and after introduction of pneumococcal conjugate vaccine in Casablanca, Morocco
Authors: Nzoyikorera Néhémie , Diawara Idrissa , Katfy Mostafa , Katfy Khalid , Maaloum Fakhreddine , Nyandwi Joseph , Belabbes Houria , Elmdaghri Naima , Zerouali Khalid
Published: January 2023

Background

Streptococcus pneumoniae (S. pneumoniae), remains a major cause of mortality and morbidity worldwide. The objective of this study was to determine the trends of invasive pneumococcal diseases (IPD) in adult and elderly population in Casablanca (Morocco) before and after introduction of pneumococcal conjugate vaccine (PCV) by determining the distribution of pneumococcal serotypes and antibiotic resistance profile of isolated strains.

Method

The proposed study is a retrospective laboratory-based surveillance of IPD in hospitalized adult (15–59 years old) and elderly (≥ 60 years old) patients in Ibn Rochd University Hospital Centre from 2007 to 2019 (13 years). All the 250 non-duplicate clinical invasive isolates from adult and elderly patients, confirmed as S. pneumoniae according to the laboratory standard identification procedures, are included in this study.

Results

A significant decrease of the overall incidence in IPD was observed only in adults from 0.71 to 0.54/100000 populations (P  =  0.02) and to 0.47/100000 populations (P  =  0.0137) in the early and mature post-vaccine period respectively compared to the pre-vaccine period. Our results also showed a significant reduction in the overall prevalence of vaccine serotypes from 28.17 to 6.90% (P  =  0.0021) for the PCV-10 serotypes, and from 46.48 to 25.86% (P  =  0.0164) for the PCV-13 serotypes only in the mature post-vaccine period (2015–2019). In parallel, the rate of non-vaccine serotypes did not significantly change in the early post-vaccine period (2011–2014) while it increased considerably from 54 to 74.14% (P  =  0.0189) during the mature post-vaccine period. The rate of penicillin non-susceptible pneumococcal isolates decreased significantly from 23.94 to 8.77% (P  =  0.02) in adult patients, and the rate of cotrimoxazole non-susceptible pneumococcal isolates significantly decreased from 29.58 to 8.77% in the early post-vaccine period (P  =  0.003) and to 7.24% in the mature post-vaccine period (P  =  0.0007).

Conclusion

Although childhood vaccination has considerably reduced the incidence of IPD in adult population through the herd effect, IPD remain a real public health problem due to the alarming increase in non-vaccine serotypes (NVS) and the lack of herd effect among elderly population. The rate of antibiotic resistance was relatively low. Nevertheless, resistance constitutes a serious problem to the therapeutic arsenal due to the known capacity for genetic dissemination in the pneumococcus.