bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploratory Factor Analysis of the Romantic Relationship Stress Scale
Authors: Du Bois Steff , Grotkowski Karolina , Guy Arryn A. , Thomas Erin , Chockalingam Meena , Sher Tamara G.
Published: February 2023

Stress is inherent to romantic relationships. Current relationship scales measure individual stress, relationship conflict, and relationship happiness. However, no known empirically supported scale exists that comprehensively measures romantic relationship stress. We reviewed the extant theory, empirical findings, and measures within the broad category of relationship stress. Using this information, we created the Romantic Relationship Stress Scale (RRSS)—a three-part, 29-item measure. We administered the measure to married individuals ( N = 296) in either a proximal or long-distance relationship, in the context of a larger study. An exploratory factor analysis was performed on RRSS responses, using principal axis factoring with an oblique rotation. A three-factor solution was derived, representing the factors of relational negativity, stressful relationship events, and relational positivity. These factors explained 67.7% of the variance in RRSS responses, and were correlated in the expected directions. The overall scale alpha was 0.93, and subscale alphas ranged from 0.65–0.91. The RRSS demonstrated convergent validity; scores were positively correlated to scores on a widely used measure of individual stress. The RRSS discriminated between those in proximal versus long-distance relationships. Overall, the RRSS appears to be psychometrically sound, and can be considered for use in both research and clinical settings.
Pulmonary Embolism, Mortality, and Medical Complications Following a Total Ankle Replacement: A Systematic Review and Meta-analysis
Authors: Jennison Toby , Taher Suhib , Ukoumunne Obi , Lamb Sallie , Sharpe Ian , Goldberg Andy
Published: February 2023

Background:

There is sparse data on the incidence of thromboembolic and medical complications following total ankle replacements. The aim of this systematic review was to determine the risk of deep vein thrombosis and pulmonary embolism as well as mortality and medical complications following ankle replacements.

Methods:

A systematic review was undertaken using all levels of evidence following PRISMA guidelines. Of the 1657 articles identified, 25 met the inclusion criteria. The inclusion criteria were a primary total ankle replacement with the recording of medical complications and/or thromboembolic events and/or mortality data. Two reviewers independently reviewed all articles. Quantitative methods were used to pool the percentages with complications across studies.

Results:

The pooled percentage with reported symptomatic deep vein thrombosis across 18 studies was 0.07% (95% CI 0.001%-0.59%). The pooled percentage with reported postoperative pulmonary embolism across 8 studies was 0.01% (95% CI 0.001%-0.03%). The pooled postoperative reported mortality was 0.06% (95% CI 0.001%-0.24%). Other medical complications had low incidences.

Conclusion:

Our study indicates rates of reported thromboembolic events of less than 1 in 1000. Notably the level of evidence analyzed was mainly Level III and IV, likely underestimating the true incidence of these events because of recall and medical record limitations, and we had insufficient information on usage of chemoprophylaxis among these patients

Level of Evidence:

Level IV, systematic review based on all levels of evidence including case series.
Risk Factor Analysis of Postoperative Venous Thromboembolism in Patients After Thoracoscopic Lobectomy
Authors: Qiao Junkai , Feng Jiang , Hu Weiwei , Wu Yueming
Published: February 2023

Objective

To analyze independent risk factors for postoperative venous thromboembolism (VTE) in patients after thoracoscopic lobectomy and establish a risk model for predicting thrombosis.

Methods

We selected 135 patients who underwent thoracoscopic lobectomy and assigned them to a VTE group ( n = 31) and a non-VTE group ( n = 104) according to the presence or absence of postoperative VTE. Univariate and multivariate logistic regression models were built to identify independent risk factors for postoperative thrombosis. A nomogram to predict the risk of thrombosis was generated, with the predictive performance of the model being evaluated by plotting calibration curve and the receiver operating characteristic (ROC) curve.

Results

D-dimer on the first postoperative day and Caprini scores were independent high-risk factors for VTE after thoracoscopic lobectomy as revealed by univariate and multivariate logistic regression analyses ( p < .05). The nomogram was evaluated, and the fitting degree of calibration curve indicated good accuracy of the model in predicting thrombosis. The area under the curve (AUC) value was 0.8654, suggesting favorable diagnostic efficacy of the model.

Conclusion

The D-dimer on the first postoperative day and Caprini scores were independent risk factors for VTE after thoracoscopic lobectomy. The nomogram that was generated to predict the risk of thrombosis had good accuracy and diagnostic efficacy, which can guide individual risk assessment and management decisions in clinical practice.
Prominent Staining of MYCN Immunohistochemistry Predicts a Poor Prognosis in MYCN Non-Amplified Neuroblastoma
Authors: Zhao Manli , Gu Weizhong , Liu Fei , Yu Lihua , Shu Yan , Liu Lei , Hu Jiahui , Liu Yang , Tang Hongfeng , Mao Jianhua
Published: February 2023

Background:

MYCN gene amplification is a powerful indicator of poor prognosis of neuroblastoma patients. However, MYCN non-amplified patients still showed heterogeneity in survival outcome. This study aimed to investigate the prognostic role of MYCN immunohistochemistry (IHC) in pre-treatment and post-treatment neuroblastoma tumors.

Methods:

215 untreated neuroblastoma tumors were stained with anti-MYCN antibody by immunohistochemical staining. 22 post-treatment tumors were used to compare MYCN staining with paired pre-treatment samples. Results were analyzed with other prognostic indicators.

Results:

Moderate or strong expression of MYCN was associated with unfavorable survival outcomes ( P < .001). Prominent staining of MYCN IHC was 95% sensitive and 95% specific for the presence of MYCN gene amplification in this study. Ten of 214 (5%) patients showed prominent MYCN staining but MYCN non-amplification, and had a poor prognosis (29.6 ± 16.4%, 5-year overall survival). Most of cases (7/11, 64%) with high or moderate MYCN expression before chemotherapy showed lower expression in their tumors after chemotherapy.

Conclusion:

MYCN protein overexpression was not only a sensitive and specific marker for MYCN gene amplification, but also a marker of poor prognosis in patients without MYCN amplification. However, MYCN protein expression was not always consistent before and after treatment.
Identification of Putative Drug Targets in Highly Resistant Gram-Negative Bacteria; and Drug Discovery Against Glycyl-tRNA Synthetase as a New Target
Authors: Fereshteh Sepideh , Noori Goodarzi Narjes , Kalhor Hourieh , Rahimi Hamzeh , Barzi Seyed Mahmoud , Badmasti Farzad
Published: February 2023

Background:

Gram-negative bacterial infections are on the rise due to the high prevalence of multidrug-resistant bacteria, and efforts must be made to identify novel drug targets and then new antibiotics.

Methods:

In the upstream part, we retrieved the genome sequences of 4 highly resistant Gram-negative bacteria (e.g., Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterobacter cloacae). The core proteins were assessed to find common, cytoplasmic, and essential proteins with no similarity to the human proteome. Novel drug targets were identified using DrugBank, and their sequence conservancy was evaluated. Protein Data Bank files and STRING interaction networks were assessed. Finally, the aminoacylation cavity of glycyl-tRNA synthetase (GlyQ) was virtually screened to identify novel inhibitors using AutoDock Vina and the StreptomeDB library. Ligands with high binding affinity were clustered, and then the pharmacokinetics properties of therapeutic agents were investigated.

Results:

A total of 6 common proteins (e.g., RP-L28, RP-L30, RP-S20, RP-S21, Rnt, and GlyQ) were selected as novel and widespread drug targets against highly resistant Gram-negative superbugs based on different criteria. In the downstream analysis, virtual screening revealed that Rimocidin, Flavofungin, Chaxamycin, 11,11′-O-dimethyl-14′-deethyl-14′-methylelaiophylin, and Platensimycin were promising hit compounds against GlyQ protein. Finally, 11,11′-O-dimethyl-14′-deethyl-14′-methylelaiophylin was identified as the best potential inhibitor of GlyQ protein. This compound showed high absorption capacity in the human intestine.

Conclusion:

The results of this study provide 6 common putative new drug targets against 4 highly resistant and Gram-negative bacteria. Moreover, we presented 5 different hit compounds against GlyQ protein as a novel therapeutic target. However, further in vitro and in vivo studies are needed to explore the bactericidal effects of proposed hit compounds against these superbugs.
Molecular Cloning and AlphaFold Modeling of Thyrotropin (ag-TSH) From the Amazonian Fish Pirarucu (Arapaima gigas)
Authors: Freire Renan Passos , Hernandez-Gonzalez Jorge Enrique , Lima Eliana Rosa , Suzuki Miriam Fussae , Oliveira João Ezequiel de , Torati Lucas Simon , Bartolini Paolo , Soares Carlos Roberto Jorge
Published: February 2023

Arapaima gigas, known as Pirarucu in Brazil, is one of the largest freshwater fish in the world. Some individuals could reach 3 m in length and weight up to 200 kg. Due to extinction risks and its economic value, the species has been a focus for preservation and reproduction studies. Thyrotropin (TSH) is a glycoprotein hormone formed by 2 subunits α and β whose main activity is related to the synthesis of thyroid hormones (THs)—T3 and T4. In this work, we present a combination of bioinformatics tools to identify Arapaima gigas βTSH (ag-βTSH), modeling its molecular structure and express the recombinant heterodimer form in mammalian cells. Using the combination of computational biology, based on genome-related information, in silico molecular cloning and modeling led to confirm results of the ag-βTSH sequence by reverse transcriptase-polymerase chain reaction (RT-PCR) and transient expression in human embryonic kidney (HEK293F) cells. Molecular cloning of ag-βTSH retrieved 146 amino acids with a signal peptide of 21 amino acid residues and 6 disulfide bonds. The sequence has a similarity to 39 fish species, ranging between 43.1% and 81.6%, whose domains are extremely conserved, such as cystine knot motif and N-glycosylation site. The Arapaima gigas thyrotropin (ag-TSH) model, solved by AlphaFold, was used in molecular dynamics simulations with Scleropages formosus receptor, providing similar values of free energy ΔGbind and ΔGPMF in comparison with Homo sapiens model. The recombinant expression in HEK293F cells reached a yield of 25 mg/L, characterized via chromatographic and physical-chemical techniques. This work shows that other Arapaima gigas proteins could be studied in a similar way, using the combination of these techniques, recovering more information from its genome and improving the reproduction and preservation of this prehistoric fish.
Exploring experiences of proculturation in international students during the COVID-19 pandemic
Authors: Correia Daniel , Watkins Maxine
Published: February 2023

This study intends to find what are the experiences of international students semiotically adapting to unfamiliar signs in the United Kingdom before and during the COVID-19 pandemic. Semi-structured interviews were conducted with six international university students to learn about their experiences of adapting to a new country. Data were analysed using thematic analysis. Two themes were classified as dialogical self in interpersonal adaptation and linguistic elements of semiotic adaptation, each with two subthemes. Participants’ experiences of merging self-constructs seem reflective of proculturation theory. The researchers termed ‘language bridges’ to refer to social representations dependent on language-specific signs. Some of the participants’ self-constructs relied on signs not provided by the environment during the COVID-19 pandemic. Overall, proculturation offers insight into the complex psychological and social processes of adapting to unfamiliar signs.
Effect of near-field characteristics on the two-phase distribution of superheated ammonia spray
Authors: Li Shiyan , Li Tie , Wang Ning , Zhou Xinyi , Yi Ping , Chen Run
Published: February 2023

The development of low-carbon or zero-carbon fuel-driven engines has become a key technology to help reduce emissions under the background of carbon neutrality. Ammonia fuel has the advantages of low boiling point and high octane rating, but it also has the disadvantages of high self-ignition temperature and slow combustion speed. Direct injection of liquid ammonia has the potential to reduce greenhouse-gas emissions while maintaining engine power output, especially under high replacement ratio conditions. Meanwhile, liquid ammonia has a lower boiling point than traditional fossil fuels and is more likely to enter superheat state with plenty of bubbles nucleated inside the nozzle. After injection, bubble puffing/micro-explosion occurs inside the jet and thus accelerates the atomization and evaporation process of the spray. In this study, a micro-imaging technique was adopted to investigate the near-field characteristics and the gasification process inside the nozzle. Besides, both Schlieren and diffused backlit imaging techniques were applied to characterize the two-phase distribution evolution. By scanning a wide range of flash-boiling conditions, it is found that 3.5% of gasification ratio and 200.0% of near-field volume increment were achieved respectively inside and outside the nozzle at high fuel temperature conditions. Moreover, the linear increment of the gasification ratio accelerates the two-phase distribution area of ammonia spray exponentially. These results would provide insightful information for two-phase evolution and developing simulation models of ammonia sprays.
Events, narrative and data: why new chronologies or ethically Bayesian approaches should change how we write archaeology
Authors: Griffiths Seren , Carlin Neil , Edwards Ben , Overton Nicholas , Johnston Penny , Thomas Julian
Published: February 2023

In this paper, we discuss how the history of our discipline continues to shape how we think with material culture to produce narratives. We argue that recent developments in scientific dating—in combination with New Materialist and Big Data approaches—offer the potential to produce radical new interpretations. However, we can only achieve this if we adopt ‘ethically Bayesian’ approaches which recognise that some of the most fundamental aspects of our epistemological structures are highly situated, reflecting a Eurocentric, colonial legacy. This legacy is especially important when we study societies that did/do not produce texts—so-called ‘prehistoric’ societies. We suggest that the revolutionary potential of radiocarbon dating on archaeology has not been fully achieved, precisely because chronometric data have not yet been made sufficiently independent from materials-determined narrative structures. We outline the importance of ethically Bayesian approaches as means to challenge this disciplinary inheritance. We argue that we need to describe the richness and specificity of the pasts we bring into being in ways that take better account of the historical processes through which heterogeneous assemblages emerge, rather than to search for preconfigured entities (like ‘the Bronze Age’). Times have changed; we need our approaches to time to catch up.
Effect of telemonitoring on quality of life for patients with chronic obstructive pulmonary disease-A randomized controlled trial
Authors: Køpfli Maria L , Børgesen Sanne , Jensen Michael Skov , Hyldgaard Charlotte , Bell Cathrine , Andersen Frank D
Published: February 2023

Introduction

Patients with chronic obstructive pulmonary disease (COPD) often experience severe physical limitations and psychological distress, which can lead to a deterioration in quality of life (QoL). Telemonitoring (TM) may improve QoL and reduce the number of hospitalizations and readmissions, but results from previous studies have been conflicting. The aim of this study was to assess the effect of TM on QoL in patients with moderate to severe COPD recruited during hospitalization for acute exacerbation (AECOPD).

Methods

We conducted a randomized controlled trial at Silkeborg and Viborg Regional Hospitals in Denmark. Participants were recruited during hospitalization for AECOPD and randomized to a six-month telemonitoring service in addition to standard COPD care or standard COPD care alone. Patients were followed for 24 months. QoL was measured by the Hospital Anxiety and Depression Scale (HADS), and St Georges Respiratory Questionnaire (SGRQ) at 3-, 6-, 12-, and 24-months follow-up. The main outcome was QoL at 6 months.

Results

In total, 101 patients were randomized to the TM intervention and 97 to standard care. The between-group difference in SGRQ at 6 months was −2.0 (−8.5; 4.5), in HADS-Anxiety −0.3 (−2.0; 1.4) and in HADS-depression 0.2 (−1.0; 1.4) corresponding to no significant difference in health-related QoL for patients receiving TM compared to standard care. No difference was seen at 12–24 months follow-up either.

Discussion

TM in addition to standard care did not improve QoL in patients with moderate to severe COPD. Other means of improving management and QoL in severe COPD are urgently needed.
Bridging the Gap Between Research and Practice of Engagement: Toward a Collaborative Human Resource Development
Authors: Fang Bo
Published: February 2023

The Problem

As the discourse around employee engagement has continued to emerge as an interdisciplinary, intercultural, and interprofessional concept, the gap between research and practice of engagement still remains, making collaboration among HRD scholars and practitioners in developing an engaged workforce a huge challenge.

The Solution

To fill the gap between research and practice on engagement, ontological, epistemological, and focal views of various perspectives on engagement are reviewed. Conceptual commonalities and differences in the multiple definitions, theories, and frameworks of employee engagement are also discussed. By exploring the divergence and convergence in the engagement discourse, a common ground for collaborative HRD in developing an engaged workforce is identified. Finally, implications for HRD research and practice are provided.

The Stakeholders

The intended audience for this article is HRD scholars, practitioners, and employers interested in developing an engaged workforce and workplace.
Letter to Editor Regarding “Methylene Blue Staining and Ultrasonic Debridement: A Superior Therapeutic Strategy for Pressure Ulcer Debridement”
Authors: Duan Yu-Ren , Wang Xiao-Bing , Zhang Bao-Lin
Published: February 2023

The treatment of pressure ulcer is of an extreme clinical and social concern. Effective and thorough debridement lays the foundation for favorable wound healing. Recently, a case report confirmed the efficacy of a combined application of methylene blue staining and ultrasonic debridement for pressure ulcer debridement. A 91-year-old male who suffered from severe pressure ulcers for over 6 years eventually obtained a favorable restoration after receiving surgical debridement optimized with methylene blue staining and ultrasonic debridement. We write to learn more about the details of the case. In this letter, we raised some questions involving the identification capability of methylene blue staining among different tissues, the application of methylene blue staining for various wounds, the arrangement of the debridement liquid, and the management strategy after wound closure. We thank the authors for creating a successful paradigm and hope the discussion can make sense for guiding subsequent clinical practice.
TGF-β receptor I inhibitor may restrict the induction of EMT in inflamed intestinal epithelial cells
Authors: Ghorbaninejad Mahsa , Abdollahpour-Alitappeh Meghdad , Shahrokh Shabnam , Fayazzadeh Sara , Asadzadeh-Aghdaei Hamid , Meyfour Anna
Published: February 2023

Despite the extensive body of research, understanding the exact molecular mechanisms governing inflammatory bowel diseases (IBDs) still demands further investigation. Transforming growth factor–β1 (TGF-β1) signaling possesses a multifacial effect on a broad range of context-dependent cellular responses. However, long-term TGF-β1 activity may trigger epithelial–mesenchymal transition (EMT), followed by fibrosis. This study aimed to determine the role of epithelial TGF-β1 signaling in inflammatory bowel disease (IBD) pathogenesis. The expression of TGF-β1 signaling components and EMT-related and epithelial tight junction markers was examined in IBD patients ( n = 60) as well as LPS-induced Caco-2/RAW264.7 co-culture model using quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and immunofluorescence staining. Furthermore, the effect of A83-01, as a TGF-β receptor I (TβRI) inhibitor, on the inflamed epithelial cells was evaluated in vitro. To evaluate the cytotoxic effects of the TβRI inhibitor, a cell viability assay was performed by the MTS method. Considering the activation of canonical and non-canonical TGF-β1 signaling pathways in IBD patients, expression results indicated that administering A83-01 in inflamed Caco-2 cells substantially blocked the expression level of TGF-β1, SMAD4, and PI3K and the phosphorylation of p-SMAD2/3, p-AKT, and p-RPS6 as well as prevented downregulation of LncGAS5 and LncCDKN2B. Further analysis revealed that the inhibition of TGF-β1 signaling in inflamed epithelial cells by the small molecule could suppress the EMT-related markers as well as improve the expression of epithelial adherens and tight junctions. Collectively, these findings indicated that the inhibition of the TGF-β1 signaling could suppress the induction of EMT in inflamed epithelial cells as well as exert a protective effect on preserving tight junction integrity. There is a pressing need to determine the exact cellular mechanisms by which TGF-β1 exerts its effect on IBD pathogenesis.
A cross-sectional study of systemic lupus erythematosus patients complicated with infection
Authors: Yu Hang , Wen Qinwen , Zhang Xiaolu , Wu Xiudi
Published: February 2023

Objectives and Introduction

The purpose of this study was to determine the prevalence and influencing factors of systemic lupus erythematosus (SLE) patients complicated with infection having multi-system involvement and to analyze the influencing factors of early CMV and fungal infection.

Methods

We conducted a cross-sectional study of hospitalized SLE patients complicated with infection. Participants had an average age of 44.80 ± 17.30, with 152 being female (89.94%). Clinical data and laboratory results were collected from medical records. Receiver operating characteristic (ROC) curves were plotted, and sensitivity and specificity were calculated.

Results

Univariate analysis showed that systemic lupus erythematosus disease activity index-2000 (SLEDAI-2k), red blood cell, platelets, hemoglobin, lymphocytes, IgG, IgM, C3, C4, albumin and globulin were significantly associated with SLE patients with infection complicated with multi-system involvement. After multivariable analysis, the following variables remained significant: Hemoglobin, CD4 lymphocyte, IgM and SM ( p < 0.05). ROC curve analysis showed the areas under the curve of Hb, CD4 count, and IgM for the differential diagnosis of SLE with infection complicated with multisystem involvement being 0.646, 0.627, and 0.610. Then, the sensitivities of 73.3%, 53.3%, and 73.3% were observed with the specificities of 54.1%, 69.7%, and 48.6%, respectively.

Conclusions

Our results demonstrated that hemoglobin, CD4 lymphocyte value, IgM and anti SM antibody had significant value in monitoring multi-system involvement in SLE patients complicated with infection. Besides, intrinsic lymphatic count disturbances associated with SLE disease can cause infections by opportunistic pathogens such as fungi.
Who am I and what do I care about? Supporting civic identity development in civic education
Authors: Haduong Paulina , Jeffries Julia , Pao Allison , Webb Willie , Allen Danielle , Kidd David
Published: February 2023

There is increasing urgency to broaden access to inclusive and culturally sustaining K-12 civic education. Civic education can foster young people’s development of their civic identity, which can support a functioning American democracy. Civic education often includes opportunities for learners to develop civic knowledge, skills, and dispositions, but not all learners may see themselves represented in traditional forms of civic education. In this essay, we propose reframing approaches to developing knowledge, skills, and dispositions by focusing on how they can be brought together to support the development of civic identity. First, we describe relevant literature on civic education. We then explain how three aspects of civic education inform learners’ development of a civic identity: personal identity and values, mastery of civic knowledge, and creative capacity for civic action. We close with recommendations for how to support civic identity development in K-12 education.
The making of the citizen in Colombia: Transitional assemblages, civic education, and the long quest for peace
Authors: Romero-Amaya Daniela
Published: February 2023

This article focuses on civic education and the constitution of subjects within a complex landscape of peace and war making in Colombia. Using a genealogical approach to study the manufacturing of citizens, and drawing on a document analysis of policies, curricular guidelines, and teaching resources, this paper evidences an increasing attention to students’ skills, conducts, and interpersonal relations, rather than structural inequality and injustice. Through the examination of the “integral citizen,” I argue that the development of students as skillful civic subjects has become central to the aspiration of building and sustaining peace and democracy. Such citizens are described as individually embodying the virtues and skills of problem-solving, conflict-management, autonomy, and self-regulation of emotions. This research adds to our understanding of the construction of the ideal citizen in conflict-affected settings, and how education policy intersects with larger efforts for meaningful and sustained change.
Can’t catch the beat: Failure to find simple repetition effects in three types of temporal judgements
Authors: Wehrman Jordan , Wearden John H
Published: February 2023

More experience results in better performance, usually. In most tasks, the more chances to learn we have, the better we are at it. This does not always appear to be the case in time perception however. In the current article, we use three different methods to investigate the role of the number of standard example durations presented on performance on three timing tasks: rhythm continuation, deviance detection, and final stimulus duration judgement. In Experiments 1a and 1b, rhythms were produced with the same accuracy whether one, two, three, or four examples of the critical duration were presented. In Experiment 2, participants were required to judge which of four stimuli had a different duration from the other three. This judgement did not depend on which of the four stimuli was the deviant one. In Experiments 3a and 3b, participants were just as accurate at judging the duration of a final stimulus in comparison to the prior stimuli regardless of the number of standards presented prior to the final stimulus. In summary, we never found any systematic effect of the number of standards presented on performance on any of the three timing tasks. In the discussion, we briefly relate these findings to three theories of time perception.
Developing key performance indicators for adult critical care transfer services: Scoping review and Delphi technique
Authors: Haslam Nick , Giouse Aurelien , Dean Jonathon , Abu-Habsa Mamoun , Finney Simon J
Published: February 2023

In 2021 NHS England commissioned regional Adult Critical Care Transfer Services. These services will replace a historically predominant ad hoc approach to adult critical care transfers nationally. It is anticipated that these new formal services will provide a system of robust regional & national governance previously acknowledged to be deficient. As part of this process, it is important that an agreed set of transfer service quality indicators are developed to drive equitable improvement in patient care. We used a Delphi technique to develop a set of key performance indicators through consensus for a recently established London critical care transfer service. We believe this may be the first-time key performance indicators have been developed for adult critical care transfer services using a consensus method. We hope services will consider tracking similar measures to enable benchmarking and drive improvements in patient care.
Nutritional and physical activity issues in frailty syndrome during the COVID-19 pandemic
Authors: Massari Maria Chiara , Bimonte Viviana Maria , Falcioni Lavinia , Moretti Antimo , Baldari Carlo , Iolascon Giovanni , Migliaccio Silvia
Published: February 2023

‘Frailty’ has been described as ‘a state of increased vulnerability of the individual caused by an impairment of homeostasis as a result of endogenous or exogenous stress’. Frail individuals are depicted by a dramatic change in health status following an apparently minor insult and a higher risk of adverse health-related outcomes such as osteoporosis and sarcopenia, falls and disability, and fragility fractures. Frailty is a condition of increasing importance due to the global ageing of the population during the last decades. Central to the pathophysiology of frailty is a mechanism that is partially independent of ageing, but most likely evolves with ageing: the cumulative level of molecular and cellular damage in every subject. Furthermore, an uncorrected nutrition and a sedentary behaviour play a pivotal role in worsening the syndrome. In January 2020, a cluster of a genus of the family Coronaviridae was isolated as the pathogen of the new coronavirus disease (COVID-19). Since then, this infection has spread worldwide causing one of the most dramatic pandemics of the modern era, with more than 500 million confirmed cases all over the world. The clinical spectrum of SARS-CoV-2 severity ranges from asymptomatic conditions to mild symptoms, such as fever, cough, ageusia, anosmia and asthenia, up to most severe conditions, such as acute respiratory distress syndrome (ARDS) and multi-organ failure leading to death. Primary evidence revealed that the elderly frail subjects were more susceptible to the disease in its most intense form and were at greater risk of developing severe COVID-19. Factors contributing to the severity of COVID-19, and the higher mortality rate, are a poor immune system activity and long-standing inflammatory status of the frail subjects compared with the general population. Further recent research also suggested a potential role of sedentary behaviour, metabolic chronic disorders linked to it and uncorrected nutritional status. Thus, the aim of this review was to evaluate the different studies and evidence related to COVID-19 pandemic, both nutritional status and physical activity, and, also, to provide further information on the correct nutritional approach in this peculiar pathological condition.
Systemic lupus erythematosus is associated with increased risk of Parkinson’s disease
Authors: Kim In Young , Eun Yeonghee , Lee Jaejoon , Han Kyungdo , Kim Da Hye , Min Ju-Hong , Cha Hoon-Suk , Koh Eun-Mi , Shin Dong Wook , Kim Hyungjin
Published: February 2023

Background:

A small number of studies have suggested an association between systemic lupus erythematosus (SLE) and Parkinson’s disease (PD).

Objectives:

This study aimed to determine the risk of incident PD among Korean patients with SLE.

Design:

A nationwide retrospective cohort study using the claims database of the National Health Insurance Service of Korea was conducted.

Methods:

Patients above 40 years of age diagnosed with SLE between 2010 and 2015 were included in the study. The primary outcome of the study was incident PD, defined by registration in the rare intractable diseases program for PD and an ICD-10 code of G20. Subjects were followed until PD diagnosis or the end of 2017. We estimated the cumulative incidence of PD among the SLE cohort and compared this to that in a 1:5 age- and sex-matched control group.

Results:

Totals of 11,615 SLE cases and 58,075 matched controls were identified. The cumulative incidence rate of PD was 0.7 per 1000 person-years in the SLE cohort. The crude hazard ratio (HR) of incident PD was 1.71 (95% CI: 1.25–2.36) among the SLE cohort compared to the control group. The HR was 1.59 (95% CI: 1.15–2.20) after adjustment for age, sex, income, and baseline comorbidities.

Conclusion:

This study demonstrated that patients with SLE had an increased risk of incident PD compared to non-SLE controls. Further research is required to determine the mechanism underlying this and to elucidate the precise role of systemic inflammation in the development of PD in patients with SLE.
A 7-year review of medical admission profile for clinical diseases in an intensive care unit of a low-resource setting
Authors: Nwachukwu Cyril Emeka , Nwachukwu Julius , Okpala Boniface Chukwuneme , Nwachukwu Chiugo Anastasia , Oranusi Ifeatu Ogochukwu , Ufoaroh Chinyelu Uchenna , Okpala Augusta Nkiruka , Ofojebe Chukwuemeka Jude , Umeononihu Osita Samuel , Nwajiaku Louis Anayo
Published: February 2023

Objective:

Various patients needing organ or systemic support and close monitoring are routinely managed in the intensive care unit. This includes patients that emanate from various sources, like the trauma unit, emergency department, inpatient wards, and post-anesthesia care unit. Admissions into the intensive care unit due to medical conditions have not been analyzed in our environment to determine the common indications and the outcome. We aimed to determine the pattern of medical admissions and outcomes in the intensive care unit.

Method:

A retrospective study of all patients admitted to the intensive care unit of Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria, from January 1, 2014 to December 31, 2020, with medical diagnosis was conducted. Data were retrieved from the intensive care unit admission and discharge registers and analyzed using the Statistical Package for Social Sciences (SPSS) Version 20 (IBM Corp., Chicago, Illinois, USA).

Results:

Eighty-nine medical patients were admitted, which accounted for 7.63% of the total intensive care unit admissions of 1167 patients during the period, with a preponderance of males (57.3%). The most common medical condition for intensive care unit admission (31.5%) was a cerebrovascular accident. The mean length of stay was found to be 5.13 ± 3.42 days. Mortality following medical intensive care unit admission was 56.18%, which contributed to about 11.4% of the total ICU mortality.

Conclusion:

When compared to all other reasons for admission to a general intensive care unit, medical conditions account for a small percentage. The most frequent illness was a cerebrovascular accident.
BASCULE syndrome: A report of three new cases with various associations
Authors: Bortoluzzi Tessa , Silver Shane
Published: February 2023

Bier anemic spots, cyanosis, and urticaria-like eruption comprise the recently defined BASCULE syndrome. This rare and benign condition has been reported in approximately 15 individuals in the literature. We present three new cases of BASCULE syndrome occurring in adolescents with interesting associations.
Total knee arthroplasty and patelloplasty in a patient with phocomelia caused by thalidomide
Authors: Fahlbusch Hendrik , Ohlmeier Malte , Mau Hans , Ballhause Tobias , Citak Mustafa , Gehrke Thorsten , Korth Moritz
Published: February 2023

The treatment of osteoarthritis in patients with phocomelia with total knee arthroplasty is challenging due to the unusual anatomy and severe deformities. The authors present a case of phocomelia caused by thalidomide with end-stage osteoarthritis and grossly medialized patella. The patient was treated with a cemented constrained non-hinged prosthesis and patelloplasty. Six months later, the patient had complete relief of pain and was able to walk without walking assistance. To our knowledge, total knee replacement in a patient with phocomelia caused by thalidomide has not been described in literature.
Virtual reality distraction, a novel tool for pain alleviation during dressing change following surgical drainage of perianal abscess at Day Treatment Centre
Authors: Zheng Lina , Liu Hailiang
Published: February 2023

Background

The pain induced by postoperative dressing changes adversely influence recovery and quality of life. In this study, we try to evaluate the pain alleviation effect of virtual reality (VR) distraction during postoperative dressing changes of patients who received surgical drainage of perianal abscess.

Methods

This was a prospective, randomized clinical trial. A total of 172 patients with perianal abscess were randomly assigned into control (only analgesics) and VR groups (VR distraction + analgesics). The pain and physiological measurements of all patients were collected before, during, and after the first dressing change following surgery. The difference in pain intensity and physiological parameters measurement between control and VR group was analyzed.

Results

The baseline characteristics of VR and control group were comparable (all P > 0.05). There was no significant difference in mean pain scores prior to and after dressing change between groups (both P > 0.05). Mean pain scores of 5, 10, 15, and 20 min measuring points during the first dressing change were significantly lower in the VR group compared with the control group (all P < 0.05). Pulse rates and oxygen saturation were not significantly different between groups.

Conclusion

VR can be used as an effective adjuvant pain distraction approach for postoperative dressing change.
Formula milk brands marketing on Chinese social media Weibo – a content analysis
Authors: Zhao Jing , Freeman Becky , Guo Ruihua , Li Mu
Published: February 2023

Background

Parents’ feeding practices in the first 2 years of life have profound effects on children's survival, health and development throughout their lives. Decisions on how to feed infants and young children should be based on the best information and evidence, not influenced by commercial interests. China is the largest and fastest-growing market for formula milk products. Social media has emerged as a distinctive marketing avenue that can reach consumers directly. Weibo is one of the most popular Chinese social media platforms. This study examined four of the most popular milk formula brands’ official Weibo accounts: Biotime, Mead Johnson, YiLi-Prokido, and Friso.

Question

What messages posted and what marketing practices and tactics are used by formula milk brands on Weibo.

Methods

We manually downloaded all posts in the four accounts between 1 January and 31 December 2018. Based on previous studies, we developed a marketing practices coding framework and selected ten mutually exclusive categories for coding and analysing the posts.

Findings

Among 2667 original posts analysed, 65% were from three dominant categories: user engagement (939/2667, 35.2%), parenting advice (516/2667, 19.3%), and celebrity endorsement (327/2667, 12.3%). Other categories included making pseudo-health or nutrition claims and portraying breastfeeding as a painful or problematic experience.

Conclusion

Widespread marketing practices and tactics were found in the four examined Weibo accounts of formula milk brands. Monitoring and regulation of formula milk marketing on social media are urgently needed. Social media platforms should also be held accountable for protecting a supportive breastfeeding environment.
Junctures in the time of COVID-19: Topic search and government's framing of COVID-19 response in the Philippines
Authors: Panao Rogelio Alicor L , Rye Ranjit Singh
Published: February 2023

This article argues that, like many in Southeast Asia, the Philippine government's COVID-19 response was marked by policy experimentation and incremental adaptation, having been caught off-guard by the pandemic. Examining 16,281 government press releases related to COVID-19 issued by the Philippine News Agency between February 2020 and April 2021, we find that in its policy narratives the government panders initially to citizen demand, highlighting social amelioration as a pandemic strategy. However, as citizens’ economic anxiety further intensifies, the government's framing of the crisis response becomes pragmatic and turns towards promoting mass inoculation, ostensibly in a bid to convince citizens to choose health over short-term palliative economic measures. The findings nuance policymaking in an illiberal democracy, beyond the conventional populist description of seeking easy solutions or spectacularizing crisis response.
Secondary Outcomes of a Brief Group Alcohol and Risky Sex Intervention for Emerging Adults Experiencing Homelessness
Authors: Pedersen Eric R. , D’Amico Elizabeth J. , Klein David J. , Rodriguez Anthony , Tucker Joan S.
Published: February 2023

AWARE is a four-session group-based motivational enhancement intervention designed to reduce substance use and sexual risk behavior among emerging adults experiencing homelessness. Expanding on promising intervention effects on substance use and risky sex outcomes, this study explored intervention effects on changes in secondary outcomes from baseline to 12 month post-intervention: depression, physical health (general health ratings, physical symptoms), social functioning (satisfaction, quality of friendships), and housing stability. Among the 240 participants with baseline and 12 month follow-up data, we found small effect sizes generally favoring the intervention over usual care for all outcomes. Findings show promise that addressing substance use and risky sexual behavior through interventions in drop-in centers could benefit emerging adults experiencing homelessness in additional areas of their lives. More work is needed to understand how interventions could be tailored to more directly address these outcomes and sustain changes in the long-term.
Impact of Advertising in Creating Brand Equity with Reference to E-Tailers
Authors: Sarika Omkar P.  , Naikwade Shital Sainath
Published: February 2023

As India embraces digitisation, the number of its residents who are comfortable using the internet has grown, creating a fertile environment for the expansion of e-commerce. These webizens are gradually moving away from traditional retail outlets and toward the virtual ones. The rise of services like home delivery and fast returns has contributed greatly to this transition. Since e-commerce is becoming increasingly popular, more and more Indian businesses are entering this industry. As more and more businesses enter the e-commerce space, shoppers have a plethora of options to choose from. The online shopper has the final say in the store they do business with. The content of various e-commerce companies’ websites greatly influences the sites that consumers choose to shop from. Moreover, the rise of digitalisation has proven once again that content is king when it comes to establishing rapport with consumers. There is a greater impact on purchasing decisions when online shopping is supported by factors such as convenience, durability, low perceived risk and a high-quality product’s features and attributes. For marketers, understanding the factors that shape consumers’ decisions requires an understanding of customer behaviour. Thus, innovations in e-commerce and its business model can be liable for change in the purchasing behaviour. Let us examine the results of e-commerce on online purchasing in this article. The purpose of this research is to examine the role of advertising in the development of brands among online merchants.
Online Shopping Dynamics Influencing Customer: Amazon Vs. Alibaba
Authors: Mishra Saniya
Published: February 2023

With the rapid growth of the internet and smart devices, the use of online shopping websites has exploded. People are shifting their preferences from local shopping to online shopping. Online shopping has come up with many new strategies to attract customers, make them loyal and satisfy their needs and wants. The discounts, coupon codes and many other benefits provided in online shopping make the customers loyal and satisfied. People are gravitating toward the e-commerce platform because of the ease, convenience and other advantages of online shopping. This study focuses on the online shopping dynamics influencing customers by analysing two companies, that is, Amazon and Alibaba, using quantitative methods to gather information and identify the factors affecting their buying behaviour. The data for this research has been collected by circulating Google forms on different platforms, and the responses were analysed using ANOVA and percentage analysis test. The research concluded that Amazon aspires to become so strongly rooted in people’s lives that they cannot imagine life without it. Customer loyalty and satisfaction are high, that’s why majority of customers are willing to come back again due to the good services provided by Amazon.
An Explorative Study on Problems and Challenges of Rural Entrepreneurs in Hilly Rural Areas
Authors: Pangriya Ruchita
Published: February 2023

Rural entrepreneurship could be the solution for the problems of poverty, migration, economic disparity, unemployment and underdevelopment associated with rural areas and backward regions. Previous literature on rural entrepreneurship is mostly focused on European countries and on the USA. Some work has been done in Indian settings which is mostly focused on South India, but those results can’t be generalise for hilly districts which have a very tough geographic location. The objective of this study is to find the factors which affect rural entrepreneurship in hilly areas. Qualitative content analysis and thematic analysis were used to serve this purpose. For this study, 15 successful rural entrepreneurs were interviewed from the hilly state of Uttarakhand, India and thematic analysis was performed on their responses. Results revealed various motivating factors for rural youth to become an entrepreneur. The major problems and challenges faced by a rural entrepreneur while starting a new venture were transportation cost, lack of skilled labour, choosing a place for doing business, financial problems, etc. The results of this study might benefit the existing body of knowledge and could serve as a guide for future research in the area of rural entrepreneurship.