bluuebunny/crossref_metadata_2025 huggingface dataset:
Concerns and needs of people with intellectual disabilities and their caregivers during the COVID-19 pandemic in Japan
Authors: Furukawa Sawako , Nawa Nobutoshi , Yamaoka Yui , Fujiwara Takeo
Published: October 2022

Background: People with intellectual disabilities (IDs) and their caregivers face difficulties during the COVID-19 pandemic. However, limited studies have comprehensively investigated their challenges, especially in Japan. We aimed to clarify the concerns and needs of people with IDs and their caregivers during the COVID-19 pandemic in Japan. Method: From March to August 2021, 27 in-depth interviews were conducted with principal caregivers of people with moderate to profound IDs in Japan. We then transcribed the interviews and conducted deductive coding using predetermined codes focused on their daily life difficulties. Inductive coding was used to ensure that no important themes were overlooked. Results: We found four concerns and four needs among people with IDs and their caregivers as significant themes. Conclusions: Our results provide useful information for supporting people with IDs and their caregivers, especially among those who need medical or social care in accordance with the infection control and social-distancing policies.
Civic education in post-conflict societies: The case of Serbia
Authors: Petkovska Sanja
Published: October 2022

Our main goal is to provide a preliminary, descriptive, and thematic overview of civic education courses in Serbia until 2020 from the perspectives of international political sociology, critical pedagogy and critical curriculum studies. After clarifying pertinent conceptual assumptions of curriculum analysis, we review the methodology employed to examine the curriculum. Firstly, our task is to describe how a civic education course in Serbia looks in relevant educational aspects. Secondly, we explore the role civic education plays in postsocialist and post-conflict Serbian society within the educational system and policies, considering transformative processes and reconciliation goals. Among the main findings, we emphasise the inadequacy of the initial phase of implementation of civic education in Serbia. There is insufficient recognition in the broader public regarding the cosmopolitan and social justice values crucial for generating a democratic political culture.
The Twitter factor: How does Twitter impact #Stroke journals and citation rates?
Authors: Sousa João André , Alves Inês Alexandra , Donato Helena , Sargento-Freitas João
Published: October 2022

Background:

Twitter is a social media platform popularly used by health practitioners, a trend that has been followed by medical journals. The impact of Twitter in bibliometrics of stroke-related literature is yet to be determined.

Aims:

We aimed to qualitatively assess the usage of Twitter by stroke journals and study the relationship between Twitter activity and citation rates of stroke articles.

Methods:

We used Journal Citation Reports to identify stroke journals. We collected the 2021 Impact Factor (IF) and the top 50 articles contributing to each journal IF. Relevant metrics were collected through Twitonomy, Altmetric, and Web of Science. The association between Twitter activity and citation rates was tested by a negative binomial regression model adjusted to journal’s IF. A bivariate correlation and a log-linear regression model adjusted to journal’s IF tested the relationship between number of tweets, tweeters, and the number of citations.

Results:

We collected 450 articles across nine stroke-dedicated journals, five of which had a Twitter account. Only 95 (21%) articles had no Twitter mentions. The median number of citations in articles with versus without Twitter activity was 19 (10–39) versus 11(7–17) ( P < 0.001). Twitter activity was associated with higher citation rates controlling for the IF (odds ratio (OR): 2.7, 95% confidence interval (CI) 2.12–3.38, P < 0.001). We found number of tweets to be predicted by the number of citations controlling for the IF (B = 0.33, 95% CI 0.29–0.40, β = 0.54, P < 0.001).

Conclusions:

Tweeted stroke articles tend to have higher citation rates which can be predicted by the number of tweets.
A resilient network recovery framework against cascading failures with deep graph learning
Authors: Zhou Jian , Zheng Weijian , Wang Dali , Coit David W.
Published: October 2022

Because of the increasing importance and dependencies of infrastructure networks and the potential for massive cascading failures in real-world network systems, maintenance optimization to effectively reduce system performance loss caused by diverse disruptions is of significant interest among researchers and practitioners. In this work, a new recovery framework was developed to rapidly identify important system components for maintenance to improve network resilience against cascading failures. This work provides distinct advantages to determine an optimal maintenance priority by combining real-time network structure importance with other maintenance prioritization based on customer preference. This approach adopts structural graph embedding and deep reinforcement learning to extract real-time network topology information (such as minimum vertex cover) to update the maintenance priority during the recovery process. Based on the case studies on synthetic networks and a US airport network, the proposed recovery framework with real-time network topology awareness shows better performance than other maintenance prioritization strategies regarding resilience enhancement. This work improves the understanding of how the changing network structure influences maintenance effects. It also provides insights of the practical usefulness of advanced deep learning on helping optimal maintenance prioritization to effectively reduce the intensity and extent of cascading failures.
A danger to avoid or nothing to worry about? China and the protests in Korea during 2016–2017
Authors: Cho Sunghee
Published: October 2022

“Diffusion-proofing” literature discusses the measures taken by authoritarian regimes to prevent the diffusion of protests from other authoritarian states. What about protests in a neighboring democracy? Do they also fear diffusion due to the proximity, or are they not concerned because of the difference in regime type? This study analyzes Chinese state-run news outlets’ portrayals of Korean protests calling for the president's impeachment from October 2016 to March 2017, based on the frequency and the focus of the reports as well as the descriptions of protests/protesters and the Korean government. The findings indicate that China did not fear the diffusion effect, as shown in their positive descriptions of the protests and protesters in frequent and detailed reports, although they adopted a cautious approach, with reports focusing more on the government side and emphasizing the public's frustration, low government support, and the president's wrongdoing. Overall, China appeared to be less concerned about the diffusion effect due to the regimes’ dissimilarity.
Sexually objectifying work environments and affective commitment in a sample of Italian waitresses: The mediating role of anxiety and job satisfaction
Authors: Cabras Cristina , Sechi Cristina , Mula Silvana
Published: October 2022

Background:

Sexual objectification can assume various forms, from interpersonal to cultural and environmental ones. Previous research has highlighted how working in sexually objectifying environments (SOEs) can lead female workers to experience negative feelings (i.e. anxiety, job dissatisfaction). The study’s main aim was to investigate the relationships between sexually objectifying work environments, job satisfaction, anxiety, and affective commitment.

Design and method:

In this study, we investigated the role of working in sexually objectifying environments (i.e. bars and pubs) in triggering female workers’ (i.e. waitresses) feelings of anxiety and in decreasing their job satisfaction and their affective organizational commitment. Our hypothesis was tested through a mediation model with a sample of ( N = 546) Italian restaurant/bar waitresses.

Results:

The results supported a model in which sexually objectifying environments had a direct effect on job satisfaction and both direct and indirect effects on anxiety. Further, sexually objectifying environments indirectly affected affective commitment through both anxiety and job satisfaction.

Conclusion:

Working in a perceived sexually objectified environment can raise waitresses’ feelings of anxiety and job satisfaction. These feelings, in turn, negatively affect workers’ affective commitment toward their workplace. The limitations and implications of this study were discussed. The main implication concerns the need to implement people’s awareness of the existence of SOEs and the harmful effects they may have on women.
Similarities and differences between SUNCT and SUNA: a cross-sectional, multicentre study of 76 patients in China
Authors: Zhang Shuhua , Cao Ya , Yan Fanhong , Chen Sufen , Gui Wei , Hu Dongmei , Liu Huanxian , Li Hongjin , Yu Rongce , Wei Dan , Wang Xiaolin , Wang Rongfei , Chen Xiaoyan , Zhang Mingjie , Ran Ye , Jia Zhihua , Han Xun , He Mianwang , Liu Jing , Yu Shengyuan , Dong Zhao
Published: October 2022

Background

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) have not been evaluated sufficiently due to limited data, particularly in China.

Methods

Patients with SUNCT or SUNA treated in a tertiary headache centre or seven other headache clinics of China between April 2009 and July 2022 were studied; we compared their demographics and clinical phenotypes.

Results

The 45 patients with SUNCT and 31 patients with SUNA had mean ages at onset of 37.22 ± 14.54 years and 42.45 ± 14.72 years, respectively. The mean ages at diagnosis of SUNCT and SUNA were 41.62 ± 12.70 years and 48.68 ± 13.80 years, respectively (p = 0.024). The correct diagnosis of SUNCT or SUNA was made after an average of 2.5 (0–20.5) years or 3.0 (0–20.7) years, respectively. Both diseases had a female predominance (SUNCT: 1.14:1; SUNA: 2.10:1). The two diseases differed in the most common attack site (temporal area in SUNCT, p = 0.017; parietal area in SUNA, p = 0.002). Qualitative descriptions of the attacks included stabbing pain (44.7%), electric-shock-like pain (36.8%), shooting pain (25.0%), and slashing pain (18.4%). Lacrimation was the most common autonomic symptom in both SUNCT and SUNA patients, while eyelid oedema, ptosis, and miosis were less frequent. Triggers such as cold air and face washing were shared by the two diseases, and they were consistently ipsilateral to the attack site.

Conclusions

In contrast to Western countries, SUNCT and SUNA in China have a greater female predominance and an earlier onset. The shared core phenotype of SUNCT and SUNA, despite their partial differences, suggests that they are the same clinical entity.
Central retinal vein occlusion post ChAdOx1 nCoV-19 vaccination – can it be explained by the two-hit hypothesis?
Authors: Parakh Shweta , Maheshwari Shrey , Das Shrutanjoy , Vaish Hans , Luthra Gaurav , Agrawal Rupesh , Gupta Vishali , Luthra Saurabh
Published: October 2022

Purpose

To report a case of central retinal vein occlusion (CRVO) seven days following the first dose of ChAdOx1 nCoV-19 vaccine and propose a hypothesis for the possible underlying pathogenesis.

Observation

A 31-year-old male presented with CRVO with cystoid macular edema, one week after receiving his first ChAdOx1 nCoV-19 vaccine dose. Apart from mild hyperhomocysteinemia, no major thrombophilic or systemic risk factors were found. Anti-platelet factor 4 antibodies, specific for vaccine-induced immune thrombotic thrombocytopenia, were also negative. However, he tested strongly positive (> 250 U/mL) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG spike antibodies, 2 weeks post the first dose – suggestive of a prior subclinical infection.

Conclusion

COVID-19 is known to be associated with an altered host one-carbon metabolism resulting in hyperhomocysteinemia. We hypothesize that a prior subclinical infection with COVID-19, the first hit, may have led to hyperhomocysteinemia in our patient and vaccination must have been the second hit that triggered the thrombotic event. Further studies, including correlation of thrombotic complications with IgG antibody titres post-vaccination, are essential in order to better understand the pathogenesis of such events.
Shrimp miR-965 transfers tumoricidal mitochondria
Authors: Kim Hyueyun , Choi Ji Ha , Moon Chang Mo , Kang Jihee Lee , Woo Minna , Kim Minsuk
Published: October 2022

Background

Micro RNA of Marsupenaeus japonicas has been known to promote apoptosis of tumor cells. However, the detailed mechanisms are not well understood.

Results

Using tomographic microscope, which can detect the internal structure of cells, we observed breast tumor cells following treatment of the miRNA. Intriguingly, we found that mitochondria migrate to an adjacent tumor cells through a tunneling nanotube. To recapitulate this process, we engineered a microfluidic device through which mitochondria were transferred. We show that this mitochondrial transfer process released endonuclease G (Endo G) into tumor cells, which we referred to herein as unsealed mitochondria. Importantly, Endo G depleted mitochondria alone did not have tumoricidal effects. Moreover, unsealed mitochondria had synergistic apoptotic effects with subtoxic dose of doxorubicin thereby mitigating cardiotoxicity.

Conclusions

Together, we show that the mitochondrial transfer through microfluidics can provide potential novel strategies towards tumor cell death.
BoostMEC: predicting CRISPR-Cas9 cleavage efficiency through boosting models
Authors: Zarate Oscar A. , Yang Yiben , Wang Xiaozhong , Wang Ji-Ping
Published: October 2022

Background

In the CRISPR-Cas9 system, the efficiency of genetic modifications has been found to vary depending on the single guide RNA (sgRNA) used. A variety of sgRNA properties have been found to be predictive of CRISPR cleavage efficiency, including the position-specific sequence composition of sgRNAs, global sgRNA sequence properties, and thermodynamic features. While prevalent existing deep learning-based approaches provide competitive prediction accuracy, a more interpretable model is desirable to help understand how different features may contribute to CRISPR-Cas9 cleavage efficiency.

Results

We propose a gradient boosting approach, utilizing LightGBM to develop an integrated tool, BoostMEC (Boosting Model for Efficient CRISPR), for the prediction of wild-type CRISPR-Cas9 editing efficiency. We benchmark BoostMEC against 10 popular models on 13 external datasets and show its competitive performance.

Conclusions

BoostMEC can provide state-of-the-art predictions of CRISPR-Cas9 cleavage efficiency for sgRNA design and selection. Relying on direct and derived sequence features of sgRNA sequences and based on conventional machine learning, BoostMEC maintains an advantage over other state-of-the-art CRISPR efficiency prediction models that are based on deep learning through its ability to produce more interpretable feature insights and predictions.
Impact of neighbourhood-level socioeconomic status, traditional coronary risk factors, and ancestry on age at myocardial infarction onset: A population-based register study
Authors: Kolden Mathias Øie , Nymo Ståle H. , Øie Erik
Published: October 2022

Background

There is consensus that low socioeconomic status (SES) is associated with an increased risk of acute myocardial infarction (AMI), but the extent to which traditional coronary risk factors and other characteristics of low SES mediate this effect remains uncertain. This study examined AMI patients residing in neighbouring city districts with the same local hospital despite having among the most considerable differences in mean SES in Norway. Our purpose was to assess low SES as a coronary risk factor and examine whether traditional coronary risk factors or ancestry mediate this effect.

Methods

Six hundred six patients (215 and 391 with a low and high neighbourhood-level SES, respectively) admitted to Diakonhjemmet Hospital with non-ST-elevation myocardial infarction (NSTEMI) between 2014 and 2017, entered analysis. Data from the Norwegian Myocardial Infarction Register were used to identify patient characteristics, and the STATA/SE 15.1 software was used to perform the statistical analyses.

Results

Patients from socioeconomically disadvantaged city-districts had a 4.9 years earlier onset of AMI (68.99 vs. 73.89 years; p < 0.001) and a higher prevalence of previous AMI, known diabetes, and current smokers (36% vs. 27%, 25% vs. 12%, and 33% vs. 17%, respectively; all p ≤ 0.05). When only comparing patients with a first time AMI, an even greater difference in the age at AMI onset was found (6.1 yrs; p < 0.001). The difference in age at AMI onset remained statistically significant when adjusting for traditional coronary risk factors (3.28 yrs; 95% confidence interval (CI) 1.11−5.44; p = 0.003), but not when adjusting for presumed non-Northwest-European ancestry (1.81 yrs; 95% CI −0.55 to 4.17; p = 0.132).

Conclusion

This study supports earlier research showing an increased risk of AMI in socioeconomically disadvantaged individuals. In our population, presumed non-Northwest-European ancestry could entirely explain the increased risk, whereas traditional coronary risk factors could only partly explain the increased risk.
Atezolizumab plus nab-paclitaxel for unresectable, locally advanced or metastatic breast cancer: real-world results from a single academic center in Austria
Authors: Deutschmann Christine , Bartsch Rupert , Singer Christian F , Gschwantler-Kaulich Daphne , Seifert Michael , Leser Carmen , Marhold Maximilian , Bago-Horvath Zsuzsanna , Pfeiler Georg
Published: October 2022

Purpose

IMpassion130 led to the approval of atezolizumab plus nab-paclitaxel as first-line treatment for patients with unresectable locally advanced or metastatic triple-negative, PD-L1 immune-cell positive breast cancer (BC) by the European Medicines Agency (EMA). The objective of the present study was to investigate the implementation, safety and efficacy of this combination in the initial phase after approval.

Methods

A retrospective data analysis including all BC patients who received atezolizumab and nab-paclitaxel between 1.1.2019 and 31.10.2020 at the Department of Obstetrics and Gynecology and the Department of Medicine 1, respectively, at the Medical University of Vienna, Austria, was performed. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Maier product-limit method. Owing to the retrospective nature of this study, all statistics must be considered exploratory.

Results

In total 20 patients were included in the study. Median follow-up was 7.1 months (IQR 5.2–9.1). Median PFS was 3.0 months (SE = .24; 95% CI [2.5; 3.5]). Median OS was 8.94 months (SE = 2.34, 95%CI [4.35; 13.53]). No new safety signals were observed.

Conclusion

The present study showed a considerably shorter PFS (3.0 vs. 7.5 months) and OS (8.94 vs. 25.0 months) than IMpassion130 putatively owing to the use of atezolizumab in later treatment lines, more aggressive tumors and a study population with higher morbidity compared to the pivotal trial.
Measurement of hearing impairment among Greenlandic school-children: association between self-reported data and clinical examinations
Authors: Schnohr Christina , Jensen Jakob Schmidt , Skovsen Cecilie Friis , Homøe Preben , Niclasen Birgit , Jensen Ramon Gordon
Published: October 2022

Background

Multiple ear infections is causing hearing impairment among children all over the world and the health and social consequences track into early adolescence and later in life, if not treated. The monitoring of prevalence in a population is important to assess the need for interventions in a population.

Methods

One hundred eighty  five children from 5 to 10th grade from Sisimiut town and the nearby settlements participated in a clinical examination to have ear-examination and pure tone audiometry. Participants filled out a questionnaire at home with their parents before the clinical examination, and hearing impairment was collected as individual self-reports and as audiometric measurements.

Results

A total of 185 children between 9 and 15 years of age (median: 11 years, IQR: 10–13) were included, 60% (n = 111) were girls. 247 (70%) of the 355 available otoscopies were clinically assessed as normal. Cohen’s Kappa coefficient was 0.31. Eighteen children (10%) were found to have hearing impairment. None of the children had hearing aids. Test performance for self-reports were that sensitivity was 56% and specificity was 87%. The predictive value of a positive test was 31%, and the predictive value of a negative test was 95%. 32 children (17%) reported hearing impairment to the extent that they were not able to keep up in school, of which half reported that it had lasted for more than one year. 7 of the 32 children reporting hearing impairment (22%) reported that the extent of their hearing impairment was affecting their classroom experience so they were not able to follow.

Conclusion

Self-reported and clinically screening for hearing impairment are two different concepts. Even though the two concepts are statistically correlated, the correlation coefficients are low. The test performance indicated that self-reported data might be measuring hearing as an experience in a social environment and not directly comparable to pure tone audiometry which examines hearing in controlled testing conditions. Since both measure hearing impairment, they supplement each other in research on impaired hearing, and the choice of measure should relate to the purpose and method of the investigation.
Inverse association between Helicobacter pylori infection and childhood asthma in a physical examination population: a cross-sectional study in Chongqing, China
Authors: Wang Donghai , Chen Yuxia , Ding Yuan , Tu Jinwei
Published: October 2022

Background

Childhood asthma has substantial effects on children's health. It is important to identify factors in early life that influence childhood asthma. Accumulating evidence indicates that Helicobacter pylori may protect against allergic diseases. This study aimed to evaluate the relationship between H. pylori infection and pediatric asthma in Chongqing, China.

Materials and methods

This cross-sectional study included healthy children aged 4–18 years who underwent a 13C urea breath test during medical checkups in 2021. All medical information was extracted from electronic medical records and a big data system. Logistic regression was used to evaluate the association between H. pylori infection and pediatric asthma, and multivariate regression models were adjusted for covariates.

Results

In our study, 2241 participants, including 1240 boys (55.33%) and 1001 girls (44.67%), underwent urea breath testing (average age: 8.67 ± 2.70 years). Among them, 292 (13.03%) were positive for H. pylori and 152 (6.78%) had asthma. The rates of asthma diagnosis in H. pylori-negative and -positive children were 7.23% and 3.77%, respectively (odds ratio = 1.995; 95% confidence interval: 1.003–3.968; P < .05). Furthermore, family history of asthma and the percentage of eosinophils in routine blood examination were associated with childhood asthma; however, the body mass index, platelet count, and serum vitamin D level were not.

Conclusions

We demonstrated a significant inverse association between H. pylori infection and pediatric asthma in Chongqing, China. Further studies are required to determine the causal association and underlying mechanisms to prevent and control childhood asthma.
The processes involved in the establishment of user-provider partnerships in severe psychiatric illnesses: a scoping review
Authors: Boerkoel Aletta , Brommels Mats
Published: October 2022

Purpose

With the rising relevance of person-centred care, initiatives towards user-led decision making and designing of care services have become more frequent. This designing of care services can be done in partnership, but it is unclear how. The aim of this scoping review was to identify for mental health services, what user-provider partnerships are, how they arise in practice and what can facilitate or hinder them.

Methods

A scoping review was conducted to obtain a broad overview of user provider partnerships in severe mental illness. Data was inductively analysed using a conventional content analysis approach, in which meaning was found in the texts.

Results

In total, 1559 titles were screened for the eligibility criteria and the resulting 22 papers found relevant were analysed using conventional content analysis. The identified papers had broad and differing concepts for user-provider partnerships. Papers considered shared decision making and user-involvement as partnerships. Mechanisms such as open communication, organisational top-down support and active participation supported partnerships, but professional identity, power imbalances and stress hindered them. Users can be impeded by their illness, but how to deal with these situations should be formalised through contracts.

Conclusion

The field of research around user-provider partnerships is scattered and lacks consensus on terminology. A power imbalance between a user and a provider is characteristic of partnerships in mental healthcare, which hinders the necessary relationship building allowing partnerships to arise. This power imbalance seems to be closely linked to professional identity, which was found to be difficult to change.
Community networks of sport and physical activity promotion: an analysis of structural properties and conditions of cooperation
Authors: Wolbring Laura , Schmidt Steffen Christian Ekkehard , Niessner Claudia , Woll Alexander , Wäsche Hagen
Published: October 2022

Background:

The importance of intersectoral cooperation networks among community organizations located in people’s immediate environments in addressing population health problems such as physical inactivity has come into focus in recent years. To date, there is limited evidence on how and why such networks emerge. Therefore, the aims of this study were (a) to analyze thestructural propertiesand (b) to identify theconditions of cooperationin interorganizational community networks of sport and physical activity promotion.

Methods:

Survey data on cooperative relationships and organizational attributes of sports and physical activity providers as well as sports administrating organizations in two community networks located in urban districts in southern Germany were collected (Network I: n = 133 organizations; Network II: n = 50 organizations). Two quantitative descriptive procedures – network analysis and stochastic analyses of network modeling (exponential random graphs) – were applied.

Results:

Similar structures and conditions of cooperation were found in the networks (e.g. low density, centralization). The community sports administrations had the most central positions in both networks. Exponential random graph modeling showed that cooperation took place more frequently in triangular structures (closure effect) and revolved around a few central actors (preferential attachment effect). Organizations from different sectors cooperated more often than organizations from the same sector (heterophily effect).

Conclusion:

The study provided valid and robust findings on significant mechanisms and conditions of interorganizational cooperation in community networks focused on sport and physical activity promotion. Based on the results, implications for the development and most efficient governance of these networks can be derived.
A novel surgical technique in transforaminal lumbar interbody fusion by the bone graft delivery device: evaluation of therapeutic effect in patients with minimally invasive spine surgery
Authors: Yang Kai-shun , Chen Chih-Wei , Yau Ru-Bin , Liang Huang-Chien , Ko Ching-Chung , Kuo Jinn-Rung , Chio Chung-Ching , Lim Sher-Wei
Published: October 2022

Background

Transforaminal Lumbar Interbody Fusion (TLIF) is commonly associated with higher complications and longer operative time. This study aims to evaluate the effectiveness, safety, and usability of a novel minimally invasive surgery (MIS) bone graft delivery device.

Methods

73 consecutive patients with lumbar spondylosis, degenerative disc disease, spondylolisthesis, scoliosis or trauma were enrolled in this randomized controlled trial. Group 1 comprised 39 patients treated with the novel MIS bone graft delivery device. Group 2 consisted of 34 patients treated with the conventional system. The primary objective of the study was the assessment of the amount of bone graft delivery using the device. The secondary objectives were the effect of the device on operative time, pain relief, disability improvement, and bone fusion grade.

Results

Bone delivery amount was significantly higher in the MIS device group (6.7 ± 2.9 mL) compared to the conventional group (2.3 ± 0.5 mL), p < 0.001. Regarding the operation time, the MIS device group was associated significantly lower duration than the conventional group (p < 0.001). After a 3-month follow-up, 39.5% of the patients in the MIS device group and 3.5% of the patients in the conventional group were observed to achieve grade I fusion (complete fusion). There was a significant difference in fusion success rates (p < 0.01).

Conclusion

The novel MIS bone graft delivery device was associated with successful bone delivery. Our MIS device provides promising modality with less operative time and higher bone fusion rates than conventional modalities.

Trial Registration This trial was retrospectively registered on ClinicalTrials.gov (Registration date: 11/19/2021; Registration number: NCT05190055).
Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB): results of the longitudinal assessment of bariatric surgery study
Authors: Moradi Marziyeh , Kabir Ali , Khalili Davood , Lakeh Maziar Moradi , Dodaran Masoud Solaymani , Pazouki Abdolreza , Kermansaravi Mohammad , Alibeigi Peyman , Moazenzadeh Hashem , Abdolhosseini Mohammad Reza , Eghbali Foolad , Baradaran Hamid Reza
Published: October 2022

Background

Several studies on various bariatric surgeries involving patients with type 2 diabetes mellitus (T2DM) showed an overall rate of remission of hyperglycemia. However, there is little known about predictive factors on remission after different types of surgeries. The aim of this study was to identify the T2DM remission rate and to determine the effects of preoperative factors characteristics of remission of type 2 diabetes in Iran.

Methods

We conducted a retrospective analysis of 1351 patients with T2DM operated by three different types of surgeries (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB)). Diabetes remission was defined according to the American Diabetes Association (ADA) criteria. Binary logistic regression analyses were employed.

Results

A total of 1351 patients, 675 patients (50.0%) undergoing OAGB, 475 (35.2%) RYGB, and 201 (14.9%) SG. 80.6%, 84.2% of OAGB, 81.7%, 82.6% of RYGB, and 77.1%, 81.5% of SG participants were in T2DM remission after 1 and 3 years, respectively. 1- and 3-year remission were associated with preoperative age, duration of T2DM, FBS and HbA1c, BMI, insulin therapy, and a family history of obesity (p < 0.05).

Conclusion

The remission of T2DM after RYGB, SG, and OAGB surgery is dependent on various preoperative factors. Patients with younger age, shorter duration of T2DM, lower preoperative HbA1c and FBS, higher BMI, who were not on insulin therapy, and not having a family history of obesity were the best candidates to achieve a prolonged diabetes remission.
Association between triglyceride–glucose index and nonalcoholic fatty liver disease in type 2 diabetes mellitus
Authors: Li Wei , Wang Yan , He Feng , Liu Zhuo , Dong Jie , Zhang Yuqi , Li Tianfang , Liu Shengyun , Chen En
Published: October 2022

Background

Lipid and glucose metabolism abnormalities are associated with nonalcoholic fatty liver disease (NAFLD). The triglyceride–glucose (TyG) index is a recently developed indicator that can identify individuals at risk for NAFLD. However, the applicability of the TyG index for identifying NAFLD in patients with type 2 diabetes mellitus (T2DM) is unclear. The aim of this study was to investigate the ability of the TyG index to identify individuals at risk for NAFLD in the T2DM population.

Methods

A total of 2280 participants with T2DM were recruited in this cross-sectional study. The TyG index was calculated, and NAFLD was diagnosed by ultrasonography. Binary logistic regression models were used to evaluate the association of the TyG index, glycemic parameters and lipid parameters with NAFLD.

Results

Logistic regression analysis showed that the TyG index was significantly associated with NAFLD in subjects with T2DM, the odds ratio (OR) were 3.27 (95% confidence interval [CI], 2.03–5.27; P < 0.001) for NAFLD in the highest TyG quartile after adjustment for known confounders. In stratified analysis, an elevated TyG index were more remarkably associated with NAFLD in younger patients (< 65 years; OR, 2.35; 95% CI, 1.83–3.02; P < 0.001), females (OR, 2.69; 95% CI, 1.67–4.32; P < 0.001), patients with BMI < 25 kg/m2 (OR, 2.80; 95% CI, 2.01–3.91; P < 0.0001), and with lower high-density lipoprotein cholesterol (< 1 mmol/L; OR, 2.76; 95% CI, 1.98–3.83; P < 0.001).

Conclusion

The TyG index is significantly associated with NAFLD and shows superior ability for identify NAFLD risk compared with other lipid and glycemic parameters in T2DM.
The oncological and obstetric results of radical trachelectomy as a fertility-sparing therapy in early-stage cervical cancer patients
Authors: Chen Tao , Li Jia , Zhu Yan , Lu An-Wei , Zhou Li , Wang Jian-San , Zhang Ying , Wang Jun-Tao
Published: October 2022

Purpose

This study explored the oncological and obstetric results of radical trachelectomy (RT) in early-stage cervical cancer patients.

Methods

A retrospective analysis was conducted the oncological and obstetric results of 23 patients with early cervical cancer (stages IA2–IB3; International Federation of Gynecology and Obstetrics, 2018) who underwent RT in The Maternal and Child Health Care Hospital of Guiyang, China, from October 2004 to September 2018.

Results

23 patients had cervical tumors of the squamous cell carcinoma histological type. All 23 patients retained reproductive function. The mean follow-up time was 112.87 ± 55.75 (36–199) months. The median tumor size was 2.00 ± 1.35 cm (imperceptible to the eyes 5.00 cm). No recurrence was observed in any of the patient cases. Among the patients with a tumor size > 4 cm (up to 5 cm), three patients who wished to preserve fertility accepted RT following neoadjuvant chemotherapy The pregnancy outcomes were as follows: 8 cases (47.06%) out of 17 cases who attempting pregnancy conceived 12 times.First-trimester abortion and the voluntary abandonment of pregnancy occurred in 4 cases (33.33%), respectively, one patient performed deliberate termination at 24 weeks of gestation. Second-trimester abortion occurred in three cases (25.0%) for chorioamnionitis. Premature delivery at 32 weeks occurred in one case (8.33%).

Conclusion

Radical trachelectomy is a safe and effective treatment for women with early-stage cervical cancer preserving fertility biology. Patients with a cervical tumor sized > 4 cm can be pregnant after neoadjuvant chemotherapy and RT. Accordingly, this treatment is worthy of further exploration.
Enriching operating room based student learning experience: exploration of factors and development of curricular guidelines
Authors: Waseem Talat , Baig Hadia Munir , Yasmeen Rahila , Khan Rehan Ahmad
Published: October 2022

Background

Operating Room (OR) is a high-pressure setting where multiple complex surgical, educational, and administrative facets interplay. Contrary to resident training, the dynamics of undergraduate medical students’ learning process is highly demanding, opportunistic, unstandardized, and suboptimal owing to many reasons. Upon reviewing the existing published literature regarding the medical students’ experience in the OR setting, it was clear that this field is still to date, unstructured, and ambiguous, with many grey areas that need to be worked on. To achieve an optimized and enhanced theatre experience, it is of immense importance to recognize the recurrent themes affecting medical students within this setting and deduce ways to overcome these challenges. This study explores and prioritizes factors influencing OR-based student learning quality and develops guidelines for structured clinical encounters within the OR setting.

Methods

The study involved an extensive literature review and thematic analysis to generate themes and subthemes, which were subjected to a modified Delphi technique where students and teachers participated to identify, debate, and produce a consensus on the relative value of these factors. Finally, expert-validated guidelines were developed for OR curricular designs.

Results

Operating theater-based student learning is multifactorial. Structured learning through optimized course planning, content selection, assessment, and administration are decisive in determining the quality of OR learning experience. The teacher’s interest, attitude, and students’ desire and preparedness to learn play a central role in OR-based student learning, suggesting an enhanced need for adequate faculty training. Similarly, emotional, socio-environmental, and organizational factors can influence students’ learning in a significant way. A new model for undergraduate student learning in OR has been proposed based on these factors and the stakeholders’ interplay. In this model, the teacher’s role is responsible despite OR learning being student- led. Guidelines for the OR curricular designs have been developed.

Conclusion

Structured learning process within the OR setting can lead to optimized lesson planning, content selection, assessment, and administration for a more meaningful and enriched OR learning experience.
Methods of teaching evidence-based practice: a systematic review
Authors: Howard Bethany , Diug Basia , Ilic Dragan
Published: October 2022

Background

To identify the effectiveness of different teaching modalities on student evidence-based practice (EBP) competency.

Methods

Electronic searches were conducted in MEDLINE, Cochrane central register of controlled trials, PsycINFO, CINAHL, ERIC, A + Education and AEI through to November 2021. We included randomised-controlled trials comparing EBP teaching modes on EBP knowledge, skills, attitudes or behaviour in undergraduate and post-graduate health professions education. Risk of bias was determined using the Cochrane risk of bias tool.

Results

Twenty-one studies were included in the review. Overall, no single teaching modality was identified as being superior to others at significantly increasing learner competency in EBP. Changes in learner knowledge, skills, attitudes and behaviour were conflicting, with studies either reporting no change, or a moderate increase in EBP behavioural outcomes when directly compared to another intervention.

Conclusion

Current evidence highlights the lack of a single teaching modality that is superior than others regarding learner competency in EBP, regardless of health professions discipline or graduate status. The poor quality, heterogeneity of interventions and outcome measures limited conclusions. Further research should focus on the development of high-quality studies and use of psychometrically validated tools to further explore the impact of different EBP teaching modalities.
Clinical nursing education during the COVID-19 pandemic: perspectives of students and clinical educators
Authors: Kaveh Omolhoda , Charati Fahimeh Ghasemi , Kamali Mahsa , Mojarrad Fereshteh Araghian
Published: October 2022

Background

The outbreak of the COVID-19 pandemic has thus far disrupted clinical nursing education (CNE) around the world and in Iran; which has encountered numerous challenges to this point for students and clinical educators. Therefore, this qualitative study was conducted to identify the perspectives of nursing students and clinical educators during the COVID-19 pandemic.

Methods

In this qualitative descriptive study, 15 participants, including nursing students and clinical educators, were selected through the purposive sampling method. The data were collected from March to September 2021 in nursing school through in-depth semi-structured interviews, and then analyzed based on the Graneheim and Lundman method.

Results

Two main themes, “CNE in the shadows of threats and opportunities” and “CNE recovery” and five themes (Injured CNE, CNE under fear, Lessons from the COVID-19 crisis, Providing optimal CNE by eradicating COVID-19, and Adapting CNE to existing conditions) were extracted from the data analysis.

Conclusions

The results of this qualitative study demonstrated that the COVID-19 pandemic had led the participants to experience new conditions, also referred to as “combined threats and opportunities”. Based on this, nursing managers and planners are advised to take great steps towards the development and improvement of CNE by considering and applying these results in their plans to overcome the challenge of CNE with effective and useful actions in the COVID-19 pandemic.
Prevalence and factors associated with burnout among nurses in Jeddah: a single-institution cross-sectional study
Authors: Qedair Jumanah T. , Balubaid Renad , Almadani Raghad , Ezzi Suzana , Qumosani Tarteel , Zahid Rania , Alfayea Turki
Published: October 2022

Background

Health care workers, especially nurses, experience significantly elevated levels of emotional and social stressors in the work environment. Therefore, nurses develop high levels of burnout as the stress persists for prolonged periods. The main purpose of this paper is to measure burnout levels amongst nurses and find a relation between burnout levels and demographic factors.

Methods

This descriptive cross-sectional study was held from the 23rd of May till the 6th of September 2021 in King Abdulaziz Medical City of National Guard Health Affairs (KAMC-JD) in Jeddah. Data had been collected voluntarily from the nurses through electronic surveys that included demographic data and the Maslach Burnout Inventory (MBI) that measures three dimensions of burnout which are emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). The association between demographic variables and burnout had been studied using the Fisher Exact test and binary logistic regression.

Results

Out of the 1300 nurses working in KAMC-JD, 250 completed the survey. Burnout had been detected in 112 nurses (44.8%). Out of the 250 nurses, 26.4% were found to be at a high risk of burnout, which means they have high or moderate scores of EE and DP, with low ones in PA. The majority of the participants had high burnout levels in each of burnout components, and 99.6% of them scored high in at least one of the three dimensions. Level of burnout was significantly correlated to certain demographic factors which were the nationality (p-value = 0.01) and working unit (p-value = 0.02). On the other hand, there was no significant association between burnout and age, gender, or marital status.

Conclusion

This study proves that a high percentage of nurses fell victims to burnout with a strong association between certain demographic data namely nationality as well as working unit and burnout levels. Taking into consideration the negative impact of burnout on both nurses and patients, conducting more studies about burnout among nurses, its effect on them, and the risk factors behind it is needed. Early treatment and management are also recommended to avoid the undesirable outcomes.
The pathogenesis of coronavirus-19 disease
Authors: Borczuk Alain C. , Yantiss Rhonda K.
Published: October 2022

Severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) is the causal agent of coronavirus disease-2019 (COVID-19), a systemic illness characterized by variably severe pulmonary symptoms, cardiac conduction abnormalities, diarrhea, and gastrointestinal bleeding, as well as neurologic deficits, renal insufficiency, myalgias, endocrine abnormalities, and other perturbations that reflect widespread microvascular injury and a pro-inflammatory state. The mechanisms underlying the various manifestations of viral infection are incompletely understood but most data suggest that severe COVID-19 results from virus-driven perturbations in the immune system and resultant tissue injury. Aberrant interferon-related responses lead to alterations in cytokine elaboration that deplete resident immune cells while simultaneously recruiting hyperactive macrophages and functionally altered neutrophils, thereby tipping the balance from adaptive immunity to innate immunity. Disproportionate activation of these macrophages and neutrophils further depletes normal activity of B-cells, T-cells, and natural killer (NK) cells. In addition, this pro-inflammatory state stimulates uncontrolled complement activation and development of neutrophil extracellular traps (NETS), both of which promote the coagulation cascade and induce a state of “thrombo-inflammation”. These perturbations have similar manifestations in multiple organ systems, which frequently show pathologic findings related to microvascular injury and thrombosis of large and small vessels. However, the pulmonary findings in patients with severe COVID-19 are generally more pronounced than those of other organs. Not only do they feature inflammatory thromboses and endothelial injury, but much of the parenchymal damage stems from failed maturation of alveolar pneumocytes, interactions between type 2 pneumocytes and non-resident macrophages, and a greater degree of NET formation. The purpose of this review is to discuss the pathogenesis underlying organ damage that can occur in patients with SARS-CoV-2 infection. Understanding these mechanisms of injury is important to development of future therapies for patients with COVID-19, many of which will likely target specific components of the immune system, particularly NET induction, pro-inflammatory cytokines, and subpopulations of immune cells.