bluuebunny/crossref_metadata_2025 huggingface dataset:
Marketing Competence and Institutional Trust in Business
Authors: Janani Saeed , Wiles Michael A. , Mishra Saurabh
Published: June 2022

Trust in institutions can have important benefits for a country’s overall well-being. However, research on the specific factors that engender institutional trust in business remains limited. To this end, the authors conduct two studies to examine the impact of marketing competence on institutional trust in business. First, they compile a data set of trust in business perceptions among the general public from 26 countries from 2011–2017. Drawing on institutional theory and the capabilities-based view, the authors examine the effect of country-level business competence in marketing on a country’s level of institutional trust in business. Country-level panel data analysis indicates that the level of marketing competence of a country's businesses positively impacts public trust in business in the country. Results also indicate that this effect strengthens when confidence in government is low. Second, an experiment explores the mediating pathways by which marketing competence fosters this effect on public trust in business. Together, these findings provide new insight into the concept of institutional trust in business and showcase the role of marketing in creating such trust.
The Temporal Politics of Placenta Epigenetics: Bodies, Environments and Time
Authors: Lappé Martine , Hein Robbin Jeffries
Published: June 2022

This article builds on feminist scholarship on new biologies and the body to describe the temporal politics of epigenetic research related to the human placenta. Drawing on interviews with scientists and observations at conferences and in laboratories, we argue that epigenetic research simultaneously positions placenta tissue as a way back into maternal and fetal bodies following birth, as a lens onto children’s future well-being, and as a bankable resource for ongoing research. Our findings reflect how developmental models of health have helped recast the placenta as an agential organ that is uniquely responsive to environments during pregnancy and capable of embodying biological evidence about the effects of in utero experiences after birth. We develop the concept of ‘recursive embodiment’ to describe how placenta epigenetics is reimagining relationships between bodies and environments across developmental, epigenetic, and generational time, and the impacts this has for experiences of pregnancy and responsibilities related to children’s health.
Decision-making among adolescents prescribed antipsychotic medications: Interviews to gain perspectives of youth without psychosis or mania
Authors: Evers Sarah , Hsu Clarissa , Gray Marlaine F , Chisolm Deena J , Dolcé Millie , Autio Kirsti , Thompson Ella E , Ervin Emma , Quintana LeeAnn M , Beck Arne , Hansell Laurel , Penfold Rob
Published: June 2022

Objectives: This study aimed to understand the experiences of youth who had been prescribed antipsychotics but did not have psychosis, mania, autism spectrum disorder, or developmental disability. Methods: Twenty-three qualitative telephone interviews were conducted with youth aged 11–18 who had been prescribed an antipsychotic medication but did not have a diagnosis of psychotic disorder, bipolar disorder, autism spectrum disorder, or developmental disability. Participants were recruited from four U.S. healthcare systems participating in the pragmatic trial Safer Use of Antipsychotics in Youth (SUAY). Interviews were recorded, transcribed and analyzed using template analysis techniques. Results: Prior to initiating an antipsychotic medication, most participants experienced behavioral health crises; many felt that they had no options other than to start the medication. Other core themes included: (1) antipsychotics had both positive psychosocial outcomes, such as improvement of family life, and adverse effects, such as drowsiness or weight gain, (2) antipsychotics were only one part of a broader treatment plan, (3) efforts were made to maximize benefits and minimize side effects through careful titration, (4) feedback from friends and family was important in the decision to continue. Conclusions: The findings provide valuable insights into how to engage youth in conversations around the use of antipsychotics.
“You enjoy being a second class citizen”: Unicorn dynamics and identity negotiation on subreddit r/polyamory
Authors: Johnston Sally W
Published: June 2022

Recent attention to the non-monogamous identity known as the “unicorn” has increased the visibility of a poorly understood sexual minority. Conflicting definitions in popular media, heightened social stigma, and reports of inequitable, and even abusive, relationship dynamics justify attention to unicorns. With very few academic studies to date on unicorn identity, an exploratory study was conducted to address a gap in sexuality research. Discourse analysis of an online polyamorous community offered a definition of unicorns and revealed that those interested in unicorn dynamics are treated as an “out-group” in polyamorous spaces. Further, evidence of community gatekeeping revealed that unicorns threaten polyamorous identity security and trigger identity negotiations that may be impeding queer feminist efforts to undo relational and sexual hierarchies.
Experiment and phase-field simulation of uniaxial compression of ultra-high-performance concrete with coarse aggregate
Authors: Zhao Bing , Xu Yaxing , Peng Hui , Pan Jun , Li Taofeng , Zhang Zhenhao , Peng Xulong
Published: June 2022

Ultra-high-performance concrete with coarse aggregate (UHPC-CA) is a newly developed material. To explore the influence of aggregate volume fraction and maximum aggregate particle size on the compressive strength of UHPC-CA, a batch of UHPC-CA numerical samples as well as some experiments is carried out. The phase-field method is introduced to simulate the uniaxial compressive strength, and the simulation results show good agreement with experimental results. Both the simulation results and experiment results show that the compressive strength decreases with the aggregate volume fraction and increases with the maximum aggregate particle size. A size effect model of UHPC-CA is established by using its aggregate volume fraction and the maximum aggregate particle size.
Seismic design and numerical assessment of shape memory alloy-restrained rocking precast concrete bridge columns
Authors: Akbarnezhad Miles , Salehi Mohammad , DesRoches Reginald
Published: June 2022

This paper introduces a class of shape memory alloy (SMA)-restrained rocking (SRR) bridge columns and numerically evaluates their response under lateral loading. SRR columns are low-damage precast concrete columns that are connected to their adjacent substructure components through two series of unbonded links, namely, SMA links and energy dissipation (ED) links. The SMA links, which are prestressed and made of superelastic Nitinol, provide the rocking joints with self-centering and dissipate a moderate amount of energy. The ED links, which are made of mild steel and are replaceable, supplement the hysteretic energy dissipation provided by the SMA links. The rocking joints are protected against concrete damage via steel jacketing and end steel plates. Following the introduction of three SRR column design variations, a displacement-based procedure is proposed for their effective seismic design. Nonlinear 3D finite element models are then developed to investigate the performance of the proposed columns under monotonic and cyclic lateral loading. Finally, a parametric study is conducted to examine the effective ranges of two major design parameters of SRR columns. The findings illustrate that the proposed SRR columns are capable of meeting their targeted performance objectives, i.e., avoiding damage under the displacement demands induced by a 2475-year seismic event, as well as providing significant self-centering and hysteretic damping.
Ffowcs Williams – Hawkings analogy for near-field acoustic sources analysis
Authors: Karakulev Alexander , Kozubskaya Tatiana , Plaksin Gleb , Sofronov Ivan
Published: June 2022

The paper expands the scope of applying the Ffowcs Williams – Hawkings integration method. We propose using the acoustic field generated from time-dependent data stored on the FW-H control surface as the same common field for computational acoustic beamforming and dynamic mode decomposition methods to analyze the aerodynamic noise sources. We exemplify that it leads to obtaining mutually consistent and complementary information for reliable prediction of acoustic sources characteristics in the process of inverting data produced by a CFD simulation. Moreover, as the results of applying computational acoustic beamforming and dynamic mode decomposition methods depend on many geometric and algorithmic inputs, the proposed approach makes it possible to use various sets of the latter for a comprehensive analysis of obtained inversions and to form the final answer by an averaging procedure. We illustrate this by taking advantage of fast generating the examined acoustic field snapshots in any required region by the FW-H integration method for the recently developed new inverse computational acoustic beamforming algorithm and the standard dynamic mode decomposition method when carrying out a sensitivity study of the predicted acoustic source. The capabilities of the developed approach are demonstrated on the data of CFD scale-resolving simulation of turbulent flow over the 30P30N high-lift configuration.
Are Shifts in Same-Sex Marriage Attitudes Associated With Declines in Religious Behavior and Affiliation?
Authors: Djupe Paul A. , Neiheisel Jacob
Published: June 2022

The anti-LGBTQ politics of the Religious Right has been implicated as one of the critical forces promoting the rise of disaffiliation from religion. The association seems plain given the rapid rise of the nones among younger cohorts of Americans – a group which also holds the most pro-LGBTQ attitudes. However, little work actually tests the link between shifting attitudes on same-sex marriage and declining religious behavior and affiliation. Drawing on the Portraits of American Life Panel study with waves in 2006 and 2012, we use appropriate measures to document the religious effects of changing views on same-sex marriage. We find that while shifting views did have a negative effect on church attendance and affiliation, these effects were not limited to shifts toward support for same-sex marriage and were not limited to liberals.
Low Fat-Free Mass Index Measured by Bioelectrical Impedance Analysis Correlates With Hematologic Adverse Events in Early-Stage Breast Cancer Patients Receiving Chemotherapy: A Prospective Observational Cohort Study
Authors: Thanestada Jirawat , Srinonprasert Varalak , Nimmannit Akarin , Korphaisarn Krittiya , Pramyothin Pornpoj , Akewanlop Charuwan
Published: June 2022

Background: Low muscle mass is associated with worse cancer treatment outcomes. Although dual-energy X-ray absorptiometry or computerized tomography-based analysis have both been widely studied in this clinical setting, studies in the use of bioelectrical impedance analysis (BIA) remain limited. The aim of this prospective study was to investigate for association between body composition estimated by BIA and hematologic adverse events in early-stage breast cancer patients receiving chemotherapy. Methods: A total of 144 female patients were enrolled. Before the first cycle of chemotherapy, body weight and fat-free mass were measured by a BIA device and then those values were converted into body mass index and fat-free mass index. Association between fat-free mass index and composite adverse events (CAEs), including grade 4 neutropenia, febrile neutropenia, or relative dose intensity <85%, was explored. Results: CAEs occurred in 85 patients (59%), and point biserial correlation showed an inverse correlation between the fat-free mass index and CAE. No included patients were sarcopenic (fat-free mass index <11.4 kg/m2). Receiver operating characteristic curve analysis revealed <14.85 kg/m2 as the cutoff value indicating a low fat-free mass index. Using this cutoff, 85 patients were classified as having a low fat-free mass index, and 62 of those patients (72.9%) had CAE (relative risk: 1.86, P < .001). After adjusting for other factors, a low fat-free mass index was found to be independently associated with a high CAE (adjusted odds ratio: 4.562, 95% CI: 2.162-9.627, P < .001). Conclusion: Low fat-free mass index is an independent predictor of increased risk of hematologic adverse events in early-stage breast cancer patients receiving chemotherapy. Estimation of fat-free mass index by BIA may identify at-risk patients so that interventions can be considered to improve treatment outcomes.
Autonomy as a Teammate: Evaluation of Teammate-Likeness
Authors: Tokadlı Güliz , Dorneich Michael C.
Published: June 2022

What makes an autonomous system a teammate? The paper presents an evaluation of factors that can encourage a human perceive an autonomous system as a teammate rather than a tool. Increased perception of teammate-likeness more closely matches the human’s expectations of a teammate’s behavior, benefiting coordination and cooperation. Previous work with commercial pilots suggested that autonomous systems should provide visible cues of actions situated in the work environment. These results motivated the present study to investigate the impact of feedback modality on the teammate-likeness of an autonomous system under low (sequential events) and high (concurrent events) task loads. A Cognitive Assistant (CA) was developed as an autonomous teammate to support a (simulated) Mars mission. With centralized feedback, an autonomous teammate provided verbal and written information on a dedicated display. With distributed feedback, the autonomous teammate provided visible cues of actions in the environment in addition to centralized feedback. Perception of teammate-likeness increased with distributed feedback due to increased awareness of the CA’s actions, especially under low task load. In high task load, teamwork performance was higher with distributed feedback when compared to centralized feedback, where in low task load there was no difference in teamwork performance between feedback modalities.
Basilar artery occlusion: A review of clinicoradiologic features, treatment selection, and endovascular techniques
Authors: Ahmed Rashid A , Dmytriw Adam A , Patel Aman B , Stapleton Christopher J , Vranic Justin E , Rabinov James D , Leslie-Mazwi Thabele M , Rost Natalia S , Hirsch Joshua A , Regenhardt Robert W
Published: June 2022

Basilar artery occlusion (BAO) is an infrequent but often fatal subtype of stroke. Predicting outcomes and selecting patients for endovascular therapy (EVT) remains challenging. Advances in neuroimaging and the development of prognostic scoring systems have augmented clinical decision-making over time. Recent randomized trials, BEST (Basilar Artery Occlusion Endovascular Intervention vs. Standard Medical Treatment), BASICS (Basilar Artery International Cooperation Study), BAOCHE (Basilar Artery Occlusion CHinese Endovascular Trial) and ATTENTION (Endovascular Treatment for Acute Basilar Artery Occlusion), compared EVT and medical management for patients with BAO. These trials yielded mixed results. The former two suggested unclear benefit while the latter two supported a benefit of EVT. While all had limitations, most providers agree caution should be exercised when excluding patients from EVT who may stand to benefit. Further studies are therefore needed to determine the effectiveness, safety, selection criteria, and optimal technical approach for EVT among patients with BAO. Hyperacute-phase advanced imaging can offer several benefits to aid decision making. It is reasonable to exclude patients with low National Institutes of Health Stroke Scale (NIHSS), large imaging-proven cores, and evidence of perforator occlusion by branch atheromatous disease. Herein, we review the clinical presentation, imaging work-up, treatments, and clinical outcomes for BAO, while highlighting knowledge gaps in treatment selection and technique.
Predictors of substitution to generic drugs and physicians’ perceived exclusivity of substitution: A cross sectional survey among physicians
Authors: Hatem Georges , Navasardyan Nare , Lahoud Elsa , Awada Sanaa , Itani Rana , Ajrouche Roula , Goossens Mathijs
Published: June 2022

The use of generic medicines facilitate access to treatment and reduce the overall health cost. Policies promoting generic substitution take into account many components such as quality and efficacy considering health stakeholders including physicians and pharmacists and identifying factors impacting generics prescription. The current study aimed to assess the association between the perception of physicians towards generics with their sex and age and their willingness to switch to generics after initial treatment. Furthermore, it aimed to evaluate the predictors for switching brands to generics after initial treatment and perceiving the exclusivity to perform this substitution. Prescription of generics to lower medical cost was more common among younger physicians compared to those 50 years and older. Interestingly, physicians aged 40 and above were more prone to prescribe generics to patients without medical coverage, while compared to physicians younger than 30 years of age. Age was significantly associated with switching initial treatment to generics, which was 2.46 times higher for physicians older than 50 years compared to those younger than 30 years. In addition, physicians practicing more than 20 years were about 1,5 times more accepting the substitution by pharmacists after initial treatment by brand while compared to physicians practicing for less than 10 years. Strategies to increase generic substitution and promoting its acceptance among physicians should take into consideration the different significant predictors. However, Further research is required to explore more factors, predicting prescription of generics in Lebanon, such as visits by medical representatives, regulations of the hospital that the physician is practicing, which are also proven to have high influence on the prescription practice of generics.
A scoping review of clusters of multiple long-term conditions in people with intellectual disabilities and factors impacting on outcomes for this patient group
Authors: Mann Claire , Jun Gyuchan T , Tyrer Freya , Kiani Reza , Lewin Gemma , Gangadharan Satheesh K
Published: June 2022

People with intellectual disabilities (ID) are vulnerable to multiple long-term conditions (MLTC). However, in the UK, there are no individual strategies tailored for them. This study synthesised evidence on prevalence of MLTC in people with ID alongside risk factors, outcomes and preventative strategies. The scoping review used the tool Abstrackr to search retrieved articles from three bibliographic databases. Of 933 articles initially screened and further identified, 20 papers met our inclusion criteria. Our findings revealed significant data on prevalence of MLTC in people with ID across the studies, but very limited data on clusters or patterns of co-occurrence in this population. The majority of papers explored risk factors and strategies for prevention of MLTC, but far fewer compared outcomes by MLTC. The identified gaps in the literature indicate the need for further research to identify clusters of MLTC and tailored prevention strategies to reduce poor outcomes in this population.
Sleep Apnea and Postoperative Medical Complications and Health Care Expenditures Following Open Reduction and Internal Fixation of Bimalleolar Ankle Fractures
Authors: Thamer Semran B. , Lam Aaron W. , Golub Ivan J. , Magruder Matthew L. , Vakharia Rushabh M. , Aiyer Amiethab A. , Abdelgawad Amr A.
Published: June 2022

Introduction

Sleep Apnea (SA) is a common sleep disorder that increases postoperative morbidity. There is limited research on how SA influences outcomes following operative fixation of ankle fractures. Therefore, the aim of this study was to determine whether patients who undergo surgical fixation for bimalleolar ankle fractures have higher rates of medical complications and health care expenditures.

Methods

A retrospective review from January 1, 2005 to March 31, 2014 was conducted using the parts A and B Medicare Data from PearlDiver database. Patients with and without SA on the day of the primary open reduction and internal fixation (ORIF) of their bimalleolar ankle fractures were queried using the International Classification of Diseases, Ninth Revision codes. Welch’s t-tests were used to compare costs of care. A multivariate binomial logistic regression model was used to calculate the odds ratio (OR) of adverse events. A P-value <.001 was considered statistically significant.

Results

There were 20 560 patients (SA = 3150; comparison cohort = 17 410) who underwent ORIF for bimalleolar ankle fractures during the study period. Sleep apnea patients were found to have significantly higher rates and odds of 90-day medical complications (21.42% vs 7.47%, OR: 3.11, P < .0001) and 90-day costs of care ($7213.12 vs $5415.79, P < .0001).

Conclusion

This research demonstrates an increased risk of postoperative medical complications and health care costs among patients with SA undergoing ORIF for bimalleolar ankle fractures.

Level of Evidence

Therapeutic, Level IV: Retrospective
Changes in Ecosystem Service Values in Response to the Planting of Eucalyptus and Acacia Species in the Gilgel Abay Watershed, Northwest Ethiopia
Authors: Debie Ermias , Anteneh Mesfin
Published: June 2022

Plantation of Eucalyptus and Acacia species emerges as a promising alternative in the tropics in a scenario of high demand for provisional and regulating ecosystem services. The research aimed to characterize the spatiotemporal dynamics of ecosystem service values in response to planting practices of Eucalyptus and Acacia species in the Gilgel Abay watershed, Northwest Ethiopia. The threshold values of NDVI were employed to classify land-use/covers using cloud-free satellite imagery data in 1984, 1998, 2013, and 2021. The benefit transfer method of modified value coefficient was used to estimate ecosystem service values (ESVs) of the study watershed. Total ESV decreased from 1984 to 1998 due to the expansion of cultivated land at the expense of natural forests, shrubs, and grasslands. As food production increased, performance levels of climate regulation, erosion control, and nutrient cycle declined. In contrast, the service values of erosion control, climate regulation, and nutrient cycles were the major contributors to the overall increase in ESV from 1998 to 2021. This was caused by expanding Acacia and Eucalyptus species plantation at the expense of cultivated land in the watershed. The research revealed a trade-off relationship between provisional and other ecosystem services, such as regulating and supporting ecosystem service values in response to land-use system transformation. As a result, it is suggested that synergistic interactions between regulating, provisional, and supporting ecosystem service values be developed by merging plantation and cultivated land. Maintaining the right proportions of degraded plantations, protected natural forests, farmlands, and wetland ecosystems can be the most effective way to provide optimal multiple ecosystem services.
System quality, technology acceptance model and theory of planned behaviour models: Agents for adopting blended learning tools
Authors: Ohanu Ifeanyi B , Shodipe Taiwo O , Ohanu Chinenye M-G , Anene-Okeakwa Josephine E
Published: June 2022

There are declines in learning outcomes despite teacher’s efforts to attain the lesson goals and objectives. The application of technology in education paved way for constructive teaching and learning, which made the evaluative processes convenient. Hence, this study investigated system quality, technology acceptance model and theory of planned behaviour models as an agent to adopt blended learning tools. The sample used for the study was 1200 students from seven public higher institutions in Lagos State using a stratified sampling technique to select the students from their respective colleges. A seven-point Likert scale was used to collect data from the selected samples. SmartPLS3 was used to analyze the data using the bootstrapping method. It was found that system quality influences the perceived ease of use, perceived usefulness, attitude, subjective norms, perceived behavioural control towards intentions to use and culminated into actual usage of blended learning. Also, there is a strong mediating influence of system quality and the antecedents of technology acceptance model as against the theory of planned behaviour towards the actual usage of blended learning. Therefore, education institutions will have to create enabling classroom environment and quality blended learning tools which gives the facilitators the privilege to interact well with the learners and the subject matter without abrupt alteration of the lesson processes/procedures.
Impact of the Covid-19 pandemic on perceptions and behaviors of university students in Tunisia
Authors: Erragcha Nozha , Babay Hanène , Bchir Souheil , Saidi Salma
Published: June 2022

This research investigates student’s perceptions around their online learning experience during the sanitary confinement period. It tests the impact of social presence on the performance of learners through an integrator model that includes direct, mediating and moderating relationships. This research uses the method of structural equations (AMOS 21) and the macro Spss for the test of mediating and moderating effects. The model is tested on a sample of 234 students interviewed through a self-administered questionnaire. The results of this study showed that social presence influences positively collaborative learning, learner satisfaction and engagement. Satisfaction and engagement play a mediating role between collaborative learning and academic performance. Finally, the results proved the moderating role of selfefficacy on the relationship between satisfaction-performance and engagement-performance has been invalidated. From where, it is recommended that teachers design their learning modules based on collaborative activities and using interactive social media tools to enhance the e-learning experience.
Phalangeal autologous bone graft for flail digit subluxation: A case report
Authors: Uddin Akram , Bramall John , Santos Derek
Published: June 2022

A 70-year-old patient was referred for a surgical opinion with a flail digit. Flail digit occurs as a result of over resection to the head of the proximal phalanx beyond the surgical neck and proximally into the shaft. The patient was complaining of a symptomatic right fourth digit (pain 7/10 on a Visual Analogue Scale) that had previously undergone two failed hammer toe surgeries resulting in symptomatic plantar hyperkeratosis with no history of ulceration or infection. The patient was surgically managed with autologous bone graft harvested from an adjacent digit biphalangic phalanx. Six months postoperative, the patient presented asymptomatic. Anatomical alignment, digital stabilisation and function were achieved. Full autologous graft consolidation was confirmed radiographically. Favourable patient-reported outcomes using the Manchester–Oxford Foot Questionnaire showed improvement in all domains. Currently, there is no published case study or description utilising our surgical technique to treat flail digit deformity.
Efficacy and Safety of Posterior Long-Segment Fixation Versus Posterior Short-Segment Fixation for Kummell Disease: A Meta-Analysis
Authors: Yu Yikang , Zeng Hanbing , Guo Enpin , Tang Binbin , Fang Yuan , Wu Lianguo , Xu Chao , Peng Yi , Zhang Bin , Liu Zhen
Published: June 2022

Purpose

Posterior short-segment fixation (SSF) and long-segment fixation (LSF) are two methods for the treatment of Kummell disease, but the safety and effectiveness of these two surgical methods still lack adequate medical evidence. This study aimed to evaluate the two methods.

Methods

Database searches for randomized controlled trials, case-control studies, and cohort studies of posterior SSF and posterior LSF in the treatment of Kummell disease were performed. After the document quality was evaluated with the Newcastle-Ottawa Quality Assessment Scale, a meta-analysis was carried out.

Results

Meta-analysis revealed that the operation time and intraoperative blood loss in the LSF group were higher than those in the SSF group [MD = −18.17, 95% CI (−30.31, −6.03), z = 2.93, P = .003; MD = −82.07, 95% CI (−106.91, −57.24], z = 6.48, P < .00001). The postoperative last follow-up local kyphosis angle in the SSF group was greater than that in the LSF group (MD = 3.18, 95% CI [.56, 5.81], z = 2.38, P = .02), and there were no significant differences in perioperative complications, bone cement leakage rate, incidence of adverse events during follow-up, postoperative follow-up visual analog scale, postoperative Oswestry dysfunction index, and postoperative immediate local kyphosis angle between the two groups ( P > .05).

Conclusion

SSF and LSF are effective and safe for the treatment of Kummell disease. SSF can reduce the operation time and intraoperative bleeding; LSF can better maintain the long-term stability of kyphosis. The methods should be evaluated by clinicians according to the individual situation of the patients.
Cross-Sectional Association and Influencing Factors of Job Satisfaction and Burnout Among Nurses in Macao
Authors: Leong Kinfong , Fong Pedro , Kuok Chiufai , Meng Lirong
Published: June 2022

The factors affecting nursing job satisfaction and burnout have been widely studied, but the research results vary in nations with different cultures and organization schemes. The healthcare system of Macao is unique, which tends to be a combination of that of Chinese and Portuguese. This study aimed to assess the factors influencing job satisfaction and burnout and to investigate their associations with demographic characteristics. This descriptive cross-sectional study was conducted among 345 randomly selected nurses registered with the Health Bureau of Macao Special Administrative Region who agreed to participate in this study voluntarily. This study employed two questionnaires using eight subscales (28 items) and five subscales (49 items) to describe job satisfaction and burnout, respectively. The demographic variables of age, highest education level, monthly income, type of working organization, and role were associated with job satisfaction. Whereas marital status was the only demographic variable associated with burnout. Professional development opportunities and childcare support were the main reasons for job dissatisfaction and coping strategies was the major issue for burnout. No significant correlation was found between job satisfaction and burnout. Health organizations may provide solutions focusing on these factors to enhance the job satisfaction of nurses and reduce burnout.
Reflective Journaling to Assure Learning in the Affective Domain
Authors: Deepa R. , Mansurali A.
Published: June 2022

The case presents reflective journaling as an effective tool to assess higher-order learning outcomes. There are two predominant approaches to learning namely surface and deep learning. Surface learning stops with the acquisition, remembering, reproducing and using the knowledge whereas deep learning culminates in development or change by enabling the learner to evaluate and create. The case describes a challenge encountered in the course ‘Emotional Intelligence for Managers’, which is a part of the Master of Business Administration programme in a leading business school in South India. In this course, learning happens in the affective domain and should culminate in a change in attitude or behaviour of the learner, who in turn should be capable of applying the learning to different situations. Standardized assessment components such as quizzes, viva and written tests cannot be used to assess this higher conception of learning and, hence, the instructor chose journal writing to assure learning and attainment of higher-order learning outcomes. Journal writing is a process in which learners record events, their responses to those events, and their reflections on the responses. This facilitates critical thinking and motivates deep learning. The case demonstrates the use of reflective journaling as a tool to assess learning in the affective domain and also shares evidence of the positive outcomes of reflective journaling. The case also serves as a blueprint to foster and assess deep learning in the classrooms.
Endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without Helicobacter pylori infection: a retrospective observational study
Authors: Iwamuro Masaya , Kusumoto Chiaki , Nakagawa Masahiro , Matsueda Kazuhiro , Kobayashi Sayo , Yoshioka Masao , Inaba Tomoki , Toyokawa Tatsuya , Sakaguchi Chihiro , Tanaka Shouichi , Tanaka Takehiro , Okada Hiroyuki
Published: June 2022

Background

The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type have not been fully investigated in relation to Helicobacter pylori infection status. We compared the morphology, color, and location of these lesions between patients with and without H. pylori infection.

Methods

We retrospectively enrolled 165 patients (180 lesions) from 10 institutions. We divided the patients into the (i) Hp group (patients with current H. pylori infection [active gastritis, n = 13] and those with past infection [inactive gastritis, n = 76]) and (ii) uninfected group (H. pylori-uninfected patients, n = 52). We compared the clinical and endoscopic features of the two groups. We also performed an analysis between (i) lesions with atrophy of the surrounding gastric mucosa (atrophy group) and (ii) lesions without atrophy of the surrounding gastric mucosa (non-atrophy group).

Results

The average age was older in the Hp group than in the uninfected group (68.1 ± 8.1 vs. 63.4 ± 8.7 years, p < 0.01). Although the difference was not statistically significant (p = 0.09), multiple lesions were observed in 9 of 89 patients (10.1%) in the Hp group and in only 1 of 52 patients (1.9%) in the uninfected group. Meanwhile, significant differences were observed in the prevalence of lesions located in the gastric fornix or cardia (uninfected group: 67.3% vs. Hp group: 38.0%, p < 0.01), with an elevated morphology (80.0% vs. 56.0%, p < 0.01), with a subepithelial-like appearance (78.2% vs. 42.0%, p < 0.01), and with a color similar to that of the peripheral mucosa (43.6% vs. 25.0%, p = 0.02). The male-to-female ratio, lesion size, and presence or absence of vascular dilatation or black pigmentation on the surface were not different between the two groups. In the analysis comparing lesions with and without mucosal atrophy, the prevalence of multiple lesions was significantly higher (p = 0.02) in the atrophy group (5/25 patients, 20.0%) than in the non-atrophy group (7/141 patients, 5.0%).

Conclusions

The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without H. pylori infection.
Exploring patient experiences and acceptability of group vs. individual acupuncture for Cancer-related pain: a qualitative study
Authors: Oberoi Devesh , Reed Erica N. , Piedalue Katherine-Ann , Landmann Jessa , Carlson Linda E.
Published: June 2022

Background

Individual acupuncture (AP) is a safe and effective treatment for cancer-related pain and other symptoms in cancer survivors. However, access to individual AP is limited, and costs can be prohibitive. Group AP could be a more cost-effective alternative as it is less expensive and non-inferior to individual AP for pain relief. Despite growing evidence in favour of group AP, patient acceptability and experience of group AP in cancer patients is relatively unknown. This exploratory study sought to compare patient experiences and acceptability of group versus individual AP in cancer patients.

Methods

Semi-structured, open-ended, in-depth interviews were conducted in a subset of 11 cancer patients enrolled in a randomized non-inferiority trial of group vs. individual AP for cancer pain. Participants for this study were recruited via purposive sampling, aiming for diversity in age, sex, education, employment, cancer types, and treatment arms. Data was analyzed using inductive thematic analysis.

Results

Two major themes were identified: a) overall experience of AP treatment b) value of AP. Participants across both treatment arms acknowledged improvement in pain, quality of sleep, mood and fatigue. Participants in the group AP arm reported a significant increase in perceived social support, while participants in the individual arm valued privacy and one-on-one interaction with the acupuncturist. Although some participants in the group arm had privacy-related concerns before the commencement of the program, these concerns waned after a few AP sessions. Participants across both the treatment arms reported cordial clinician-patient relationship with the acupuncturist. Willingness to pursue AP treatment in the future was comparable across both the treatment arms and was limited by out-of-pocket costs.

Conclusion

Patient acceptability and experience of treatment in group AP was on par with individual AP. Group AP may further augment perceived social support among patients and privacy concerns, if any, subside after a few sessions.

Trial registration

ClinicalTrials.gov (NCT03641222). Registered 10 July 2018 - Retrospectively registered.
RETRACTED ARTICLE: Suppression of NF-κB signaling by ECN in an arthritic model of inflammation
Authors: Khan Amna , Zhang Li , Li Chang Hu , Khan Ashraf Ullah , Shal Bushra , Khan Adnan , Ahmad Sajjad , Din Fakhar ud , rehman Zia ur , Wang Feng , Khan Salman
Published: June 2022

Background

The 7β-(3-ethyl-cis-crotonoyloxy)-1α-(2-methylbutyryloxy)-3,14-dehydro-Z-notonipetranone (ECN), a sesquiterpenoid isolated from the Tussilago farfara Linneaus (Asteraceae), was evaluated against acute Carrageenan and chronic complete Freund’s adjuvant (CFA)-induced arthritis in mice.

Methods

Acute and chronic arthritis were induced by administering Carrageenan and CFA to the intraplantar surface of the mouse paw. Edema, mechanical allodynia, mechanical hyperalgesia, and thermal hyperalgesia were assessed in the paw. Similarly, histological and immunohistological parameters were assessed following arthritis induced by CFA. Antioxidants, inflammatory cytokines, and oxidative stress markers were also studied in all the treated groups.

Results

The ECN treatment significantly attenuated edema in the paw and elevated the nocifensive threshold following induction of this inflammatory model. Furthermore, ECN treatment markedly improved the arthritis index and distress symptoms, while attenuating the CFA-induced edema in the paw. ECN treatment also improved the histological parameters in the paw tissue compared to the control. At the same time, there was a significant reduction in edema and erosion in the ECN-treated group, as measured by radiographic analysis. Using the Comet’s assay, we showed that ECN treatment protected the DNA from chronic CFA-induced arthritis. Immunohistochemistry analysis showed a marked decrease in the expression level of p-JNK (phosphorylated C-Jun N-terminal kinase), NF-κB (Nuclear factor-kappa B), COX-2 (Cyclooxygenase-2), and TNF-α (Tumour necrosis factor-alpha) compared to the CFA-treated group. Biophysical analysis involving molecular docking, molecular dynamics simulations, and binding free energies of ECN were performed to explore the underlying mechanism.

Conclusion

ECN exhibited significant anti-inflammatory and anti-arthritic activity against Carrageenan and CFA-induced models.
Plasma neurofilament light and its association with all-cause mortality risk among urban middle-aged men and women
Authors: Beydoun May A. , Noren Hooten Nicole , Weiss Jordan , Beydoun Hind A. , Hossain Sharmin , Evans Michele K. , Zonderman Alan B.
Published: June 2022

Background

Neurofilament light chain (NfL) is released into the blood during neuronal damage. NfL is linked to mortality in neurological disorders, remaining unexplored in population studies. We investigated whether initial (v1) and annualized change (δ) in plasma NfL can predict all-cause mortality in middle-aged dementia-free urban adults.

Methods

Longitudinal data were from 694 participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span study (HANDLS, mean agev1: 47.8 years, 42% male, 55.8% African American). Plasma NfL was measured prospectively at three visits. Analyses included Cox proportional hazards models for all-cause mortality risk and 4-way decomposition testing for interaction and mediation.

Results

Unlike men, women exhibited a direct association between δNfL (above vs. below median) and all-cause mortality risk in both the minimally (HR = 3.91, 95% CI 1.10–13.9, p = 0.036) and fully adjusted models (HR = 4.92, 95% CI 1.26–19.2, p = 0.022), and for δNfL (per unit increase) in the full model (HR = 1.65, 95% CI 1.04–2.61, p = 0.034). In both models, and among women, 1 standard deviation of NfLv1 was associated with an increased all-cause mortality risk (reduced model: HR = 2.01, 95% CI 1.24–3.25, p = 0.005; full model: HR = 1.75, 95% CI 1.02–2.98, p = 0.041). Only few interactions were detected for cardio-metabolic risk factors. Notably, NfLv1 was shown to be a better prognostic indicator at normal hsCRP values among women, while HbA1c and δNfL interacted synergistically to determine mortality risk, overall.

Conclusions

These findings indicate that plasma NfL levels at baseline and over time can predict all-cause mortality in women and interacts with hsCRP and HbA1c to predict that risk.
Alert sign and symptoms for the early diagnosis of pulmonary tuberculosis: analysis of patients followed by a tertiary pediatric hospital
Authors: Farina Elisa , D’Amore Carmen , Lancella Laura , Boccuzzi Elena , Ciofi degli Atti Marta Luisa , Reale Antonino , Rossi Paolo , Villani Alberto , Raponi Massimiliano , Raucci Umberto
Published: June 2022

Background

Intercepting earlier suspected TB (Tuberculosis) cases clinically is necessary to reduce TB incidence, so we described signs and symptoms of retrospective cases of pulmonary TB and tried to evaluate which could be early warning signs.

Methods

We conducted a retrospective descriptive study of pulmonary TB cases in children in years 2005–2017; in years 2018–2020 we conducted a cohort prospective study enrolling patients < 18 years accessed to Emergency Department (ED) with signs/symptoms suggestive of pulmonary TB.

Results

In the retrospective analysis, 226 patients with pulmonary TB were studied. The most frequently described items were contact history (53.5%) and having parents from countries at risk (60.2%). Cough was referred in 49.5% of patients at onset, fever in 46%; these symptoms were persistent (lasting ≥ 10 days) in about 20%. Lymphadenopathy is described in 15.9%. The prospective study enrolled 85 patients of whom 14 (16.5%) were confirmed to be TB patients and 71 (83.5%) were non-TB cases. Lymphadenopathy and contact history were the most correlated variables. Fever and cough lasting ≥ 10 days were less frequently described in TB cases compared to non-TB patients (p < 0.05).

Conclusions

In low TB endemic countries, pulmonary TB at onset is characterized by different symptoms, i.e. persistent fever and cough are less described, while more relevant are contact history and lymphadenopathy. It was not possible to create a score because signs/symptoms usually suggestive of pulmonary TB (considered in the questionnaire) were not significant risk factors in our reality, a low TB country.
Clinical characteristics and genetic testing outcome of suspected hereditary peripheral nerve sheath tumours in a tertiary cancer institution in Singapore
Authors: Loh Jerold , Ong Pei Yi , Goh Denise Li Meng , Puhaindran Mark E. , Vellayappan Balamurugan A. , Ow Samuel Guan Wei , Chan Gloria , Lee Soo-Chin
Published: June 2022

Background

Peripheral Nerve Sheath Tumors (PNST) are a diverse group of mostly benign tumours uncommon in the general population. About 5–10% of PNSTs are hereditary, predominantly arising from germline variants in NF1, NF2, SMARCB1, or LZTR1 gene.

Methods

We reviewed the clinical characteristics and genetic testing results of patients referred to the NCIS Adult Cancer Genetics Clinic for suspected hereditary PNST.

Results

3,001 patients suspected to have various hereditary cancer syndromes were evaluated between year 2000 to March 2021. 13 (0.4%) were clinically diagnosed to have hereditary PNSTs. The majority were male (54%), with a median age at presentation to the genetics clinic of 29 years (range 19–48). 11/13 (85%) patients had multiple PNSTs, 12/13 (92%) had young onset PNSTs, 5/13 (38.5%) had personal and family history of PNST. 11/13 patients (85%) had clinical features of neurofibromatosis type 1 (NF1) including one patient who also fulfilled clinical criteria of neurofibromatosis type 2 (NF2); 2/13 (14%) had multiple schwannomas. Four patients underwent multi-gene panel testing, including one patient with clinical NF1, one patient who met both clinical NF1 and NF2 criteria, and two patients with multiple schwannomas. The patient with clinical features of NF1 was heterozygous for a pathogenic c. 2033dup variant in the NF1 gene. The patient with both NF1/NF2 features was heterozygous for a novel c.732 T > A nonsense variant in the NF2 gene. The two patients with multiple schwannomas were heterozygous for a pathogenic/likely pathogenic variant in the LZTR1 gene and are the first LZTR1-positive schwannomatosis patients reported in Asia.

Conclusion

Hereditary PNSTs are rare referrals to an adult cancer genetics clinic. NF1 is the most common PNST seen. LZTR1 variants may be the underlying cause in Asian patients with multiple schwannomatosis.