bluuebunny/crossref_metadata_2025 huggingface dataset:
Insights in Practice: Success Stories of Applied Human Factors and Ergonomics
Authors: Lematta Glenn , Branaghan Russel J. , Bruni Sylvain , Dorton Stephen L. , Holder Eric , Patterson Emily S.
Published: October 2024

Practitioners of Human Factors and Ergonomics (HF/E) must frequently adapt to the constraints of organizations, multidisciplinary teams, changing customer requirements, and development lifecycles. Tradeoffs are made in applying techniques and levels of rigor; made to ensure that the highest caliber of HF/E is achieved that is also adoptable and impactful in practice. HF/E professionals, and particularly early career professionals, benefit from positive examples of HF/E practice in a variety of applied settings. In this panel, we will present perspectives and success stories that enable community dialogue about the art of the possible for HF/E in application. Success stories applying HF/E methods and practices at work is a thread deserving of continual discussion to add to the adaptive repertoire of our field and support the next generation of HF/E professionals.
Conyza bonariensis (L.) Impact on Carbohydrate Metabolism and Oxidative Stress in a Type 2 Diabetic Rat Model
Authors: Mustafa Imtiaz , Irfan Shahzad , Hussain Ghulam , Ijaz Muhammad Umar , Ullah Muhammad Irfan , Nisar Jaweria , Maqbool Tahir , Anwar Haseeb
Published: October 2024

This study was conducted to assess the possible antidiabetic potential of Conyza bonariensis by employing in vitro as well as in vivo assessments. The dried plant material was extracted in methanol, ethanol, and water. The in vitro results showed that the ethanolic extract (EthCb) was found to have higher antioxidant and antidiabetic potential as compared with the aqueous (AqCb) and methanolic extracts (MthCb) so it was further evaluated in the in vivo trial using a diabetic rat model. Diabetes was induced in male Wistar rats by administering 5% sucrose in drinking water and a cafeteria diet for 8 weeks, followed by nicotinamide and streptozotocin administration. Subsequently, the diabetic rats were divided into 4 groups (n = 8 each): Positive control (no treatment), standard control (Metformin @ 10 mg/kg bw), treatment 1 ( C. bonariensis ethanolic extract @ 200 mg/kg bw), and treatment 2 ( C. bonariensis ethanolic extract @ 400 mg/kg bw). In addition, there was a negative control group of 8 rats without diabetes induction or treatment. After 21 days of treatment, blood samples were collected from all rats. The serum was evaluated through different means for glucose level, lipid profile, oxidative stress, carbohydrate metabolic enzymes and thyroid hormones. ANOVA was used to evaluate the data statistically. Total oxidant status (TOS) and the serum glucose levels of the streptozotocin-treated rats were reduced significantly ( P ⩽ .05) in Conyza bonariensis treated group. Whereas total antioxidant capacity (TAC) along with enzymes like paraoxonase and arylesterase were increased in Conyza bonariensis treated group. The antihyperlipidemic activity was also observed in Conyza bonariensis treated group Interestingly the subnormal levels of T3 and T4 which were observed in the PC group were also normalized in both treatment groups. This study demonstrated the antidiabetic as well as antioxidant activity of different extracts of Conyza bonariensis.
Multiplying Meanings of Pregnancy Through Personal Accounts of Gestational Trophoblastic Disease
Authors: Ross Emily
Published: October 2024

In cultures where reproduction is highly medicalised, pregnancy is often understood in terms of foetal development and an anticipated baby. This is connected to a wider privileging of the ‘foetal subject’ in these settings, which has had implications for reproductive autonomy. In this article, I disrupt dominant understandings of pregnancy by engaging with qualitative accounts of gestational trophoblastic disease. This rare condition can entail experiences of pregnancy without foetal development, allowing for scholarly attention to the wider biological, affective and relational constituents of this corporeal event. In this article, I pay particular attention to the ‘pregnancy hormone’ human chorionic gonadotropin (hCG), which in the context of gestational trophoblastic disease becomes a biomarker for disease. My research extends feminist science studies perspectives destabilising understandings of maternal and foetal bodies as bounded and distinct entities. The article de-centres foetal development as the most significant consequence of conception and enriches feminist discussions of reproductive politics.
Introducing the symposium: Spinoza on perfectionism and education
Authors: Dahlbeck Johan , Roth Klas
Published: October 2024

This paper introduces the symposium on Spinoza on perfectionism and education. It frames the key issue of Spinoza’s perfectionism in terms of a perennial educational problem and introduces the different contributions to this special issue, where Steven Nadler’s main paper is followed by a series of full paper responses by a group of Spinoza scholars and educational theorists. To round off the special issue, Nadler comments on the responses to his main paper.
Theoretical investigation and experimental validation of wear in conjugate rolling friction pairs of two-dimensional piston pumps
Authors: Lu Chao , Zhou Hongxue , Wang Zhen , Gao Dianrong
Published: October 2024

The two-dimensional piston pump stands as an optimal power component within pump-controlled hydraulic systems due to its utilization of a rolling friction pair. However, the sustained efficiency of the two-dimensional piston pump over prolonged operational periods remains unverified, primarily owing to the insufficient exploration of the wear mechanism inherent to its unique conjugate rolling friction pair. This study combines theoretical investigation and experimental verification to determine that the primary wear trajectory of the conjugate rolling friction pair is concentrated in the region where the roller moves from the low point to the high point of the cam. The wear is most severe at the mid-point of the cam, with a depth of up to 14 μm, which is consistent with the theoretical analysis. Furthermore, experimental observations unveil inconsistencies in the two-point support of the conjugate rolling friction pair, alongside an observed impact of preload force on the wear phenomenon. These findings furnish crucial theoretical underpinnings for the prospective optimization of design strategies in future endeavors.
Heat transfer characteristics in the squeezing flow of casson fluid between circular plates: A comprehensive study
Authors: Mahboobtosi Mehdi , Jalili Bahram , Shateri Amirali , Jalili Payam , Ganji Davood Domiri
Published: October 2024

This research investigates the heat transfer characteristics in the squeezing flow of a non-Newtonian fluid, specifically focusing on the Casson fluid between two parallel circular plates. The research includes the development of nonlinear ordinary differential equations (ODEs), the utilization of conservation laws and similarity transformations, and the subsequent analytical resolution through the application of the Differential Transform Method (DTM) and Akbari-Ganji’s Method (AGM). The investigation explores the influence of various factors on flow characteristics, presenting the results visually and engaging in detailed discussions. The analysis encompasses a comprehensive examination across a range of parameters, including the squeeze number, Casson fluid parameter, Prandtl number, and Eckert number. Notably, the results indicate an acceleration in the rate of motion with respect to both the squeeze number and the Casson fluid parameter. In addition, the skin friction coefficient shows an increasing trend with respect to S, while the influence of [Formula: see text] has the opposite effect. Meanwhile, the Nusselt number decreases as both S and [Formula: see text] increase but exhibits an upward trend with increasing values of PR, Ec, and [Formula: see text]. The findings of this study contribute to the broader understanding of heat transfer in non-Newtonian fluid flows and provide valuable insights for practical applications.
The relationship between post-anastomosis brachial artery flow rate and brachiocephalic arteriovenous fistula access maturity in end-stage kidney disease patients with diabetes mellitus
Authors: Pratama Dedy , Wasisto Octavianus , Kekalih Aria , Suhartono Raden , Muradi Akhmadu , Ferian Muhammad F , Akbar Avicenna
Published: October 2024

Background:

From previous studies, evaluation of post-anastomosis draining-vein volume flow rate with Doppler ultrasound can be a predictor for arteriovenous fistula maturation. Due to the high variation in measurements by the effect of probe pressure in draining vein, measuring volume flow rate based on post-anastomosis feeding-artery may be an early alternative predictor of arteriovenous fistula maturation. This study aims to investigate the correlation of post-creation brachial artery volume flow rate on maturity of brachiocephalic arteriovenous fistula access in patients with end-stage kidney disease with diabetes mellitus.

Methods:

A retrospective cohort study was conducted on end-stage kidney disease patients with diabetes mellitus who underwent brachiocephalic arteriovenous fistula creation at three hospitals from July 2019 to March 2020. Doppler ultrasound examination of the brachial artery and draining vein volume flow rate was conducted at pre-operative, post-creation, 2 weeks, and 6 weeks post-creation. Maturity was evaluated at 6 weeks post-anastomosis.

Results:

A total of 71 subjects met the inclusion and exclusion criteria, with 44 (62%) achieving maturation within 6 weeks. There was a correlation between post-anastomosis brachial artery (p < 0.001) and draining vein volume flow rate (p < 0.001) with arteriovenous fistula maturity after 6 weeks post-operatively. Brachial artery volume flow rate of ⩾350 mL/min can predict AVF maturity with a sensitivity of 95.45% (95% confidence interval = 84.86–98.74) and a specificity of 85.19% (95% confidence interval = 67.52–94.08).

Conclusion:

Post-anastomosis brachial artery flow volume can be a valuable parameter to predict brachiocephalic arteriovenous fistula maturity. It is a potential alternative to draining vein volume flow, which is technically a difficult examination.
Outcomes of dual-mobility trapeziometacarpal arthroplasties: a systematic review
Authors: Maling Lucy , Rooney Aaron
Published: October 2024

This systematic review reports the clinical, patient-reported, radiographic outcomes, complications and survivorship of dual-mobility trapeziometacarpal (TMC) joint arthroplasties including the MAÏA®, Moovis® and Touch® prostheses. Thirteen studies were included and outcomes reported for 1421 such arthroplasties. Overall, improvements in strength, range of motion, pain, function and satisfaction were demonstrated with a complication incidence of 13%. The risk of dislocation was 0.6%. The follow-up period was not long enough to draw conclusions about the long-term survival of the implants. Also, due to the low quality of the evidence, it was not possible to conclude that dual-mobility TMC arthroplasty was superior to trapeziectomy. This review highlights the need for Level I evidence with adequate long-term follow-up for TMC joint arthroplasty.
Twelve-Month Real-World Use of an Advanced Hybrid Closed-Loop System Versus Previous Therapy in a Dutch Center For Specialized Type 1 Diabetes Care
Authors: Dekker Pim , van den Heuvel Tim , Arrieta Arcelia , Castañeda Javier , Mul Dick , Veeze Henk , Cohen Ohad , Aanstoot Henk-Jan
Published: October 2024

Background:

Complexity of glucose regulation in persons with type 1 diabetes (PWDs) necessitates increased automation of insulin delivery (AID). This study aimed to analyze real-world data over 12 months from PWDs who started using the MiniMed 780G (MM780G) advanced hybrid closed-loop (aHCL) AID system at the Diabeter clinic, focusing on glucometrics and clinical outcomes.

Methods:

Persons with type 1 diabetes switching to the MM780G system were included. Clinical data (e.g. HbA1c, previous modality) was collected from Diabeter’s electronic health records and glucometrics (time in range [TIR], time in tight range [TITR], time above range [TAR], time below range [TBR], glucose management indicator [GMI]) from CareLink Personal for a 12-month post-initiation period of the MM780G system. Outcomes were age-stratified, and the MM780G system was compared with previous use of older systems (MM640G and MM670G). Longitudinal changes in glucometrics were also evaluated.

Results:

A total of 481 PWDs were included, with 219 having prior pump/sensor system data and 334 having monthly longitudinal data. After MM780G initiation, HbA1c decreased from 7.6 to 7.1% ( P < .0001) and the percentage of PWDs with HbA1c <7% increased from 30% to 50%. Glucose management indicator and TIR remained stable with mean GMI of 6.9% and TIR >70% over 12 months. Age-stratified analysis showed consistent improvements of glycemic control across all age groups, with older participants achieving better outcomes. Participants using recommended system settings achieved better glycemic outcomes, reaching TIR up to 77% and TTIR up to 55%.

Conclusions:

Use of MM780G system results in significant and sustained glycemic improvements, consistent across age groups and irrespective of previous treatment modalities.
Real-world efficacy of chidamide plus R-CHOP in newly diagnosed double-expressor diffuse large B-cell lymphoma
Authors: Chen Xi , Xie Li , Zhu JunMin , Liang Lijie , Zou Bingwen , Zou Liqun
Published: October 2024

Background:

Approximately 20%–30% of diffuse large B-cell lymphoma (DLBCL) cases are classified as double-expressor lymphoma (DEL), characterized by the co-expression of the MYC and BCL2 proteins. However, the most effective therapeutic strategy for DEL remains unidentified.

Objectives:

To evaluate the efficacy of a novel histone deacetylase inhibitor, chidamide, in combination with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (CR-CHOP) in the treatment of DEL.

Design:

This was a retrospective study.

Methods:

This study included 62 DEL patients from December 2016 to December 2020. All patients were administered a first-line treatment with CR-CHOP. The short-term efficacy, survival status, and adverse reactions in this population were observed, and the prognostic factors were analyzed.

Results:

The median age was 53.9 years (range, 19–77). All patients received a median of six cycles (range, 1–8) of treatment, with 79.0% achieving complete response (CR) and an overall response rate of 88.7%. With a median follow-up of 45.5 months (range, 1–82), the median progression-free survival (PFS) and median overall survival (OS) had not yet been reached. However, the 3-year PFS rate was 71% (95% CI: 61–83), the 3-year OS rate was 87% (95% CI: 79–96), the 5-year PFS rate was 67% (95% CI: 55–80), and the 5-year OS rate was 85% (95% CI: 77–95). Age and autologous stem cell transplantation after CR or partial response were independent prognostic factors for PFS, while various clinical factors were not associated with OS outcomes. The most common grades 3–4 hematologic and nonhematologic toxicity were leukopenia (46.7%) and infection (21%), respectively.

Conclusion:

This long-term follow-up study indicates that CR-CHOP in untreated DLBCL with the DEL phenotype demonstrates high short-term efficacy and safety as well as promising survival outcomes.
AI Privacy in Context: A Comparative Study of Public and Institutional Discourse on Conversational AI Privacy in the US and Chinese Social Media
Authors: Zhang Renwen , Li Han , Chen Anfan , Liu Zihan , Lee Yi-Chieh
Published: October 2024

The proliferation of conversational artificial intelligence (AI) systems, such as chatbots, has sparked widespread privacy concerns. Previous research suggests that privacy perceptions and practices vary across sociocultural contexts. This study examines public and institutional discourses on conversational AI privacy in the United States and China. Semantic network and discourse analyses of privacy-related discussions on Twitter and Weibo reveal divergent patterns. On Twitter, public discourse emphasizes privacy risks and concerns and advocates for systemic changes, while institutional discourse promotes individualistic approaches to privacy protection. Conversely, on Weibo, public discourse is less focused on privacy risks and more on the positive impacts of AI, aligning closely with institutional narratives. These variations are intertwined with the cultural, political, economic, and regulatory contexts of the two countries. Our study underscores the importance of multi-level analysis in comparative privacy research to provide a holistic view of privacy in various contexts.
Comparative Analysis of Food and Nutrition Security in Pakistan: Implications for Sustainable Development Policies
Authors: Hameed Abdul , Ali Tariq Mahmood , Abbasi Mudassar Mushtaq Jawad
Published: October 2024

Food and nutrition security is a critical issue for Pakistan, with over half of the population living in deprivation. Poor nutrition is one of the primary reasons for morbidity and mortality, particularly among children and women. This research compared food and nutrition security in Pakistan by examining three key dimensions: food quantity, quality and economic accessibility using Household Integrated Economic Survey 2015 to 2016 and 2018 to 2019. A study found that dietary intake had decreased by 2% in rural areas and 0.8% in urban areas between 2015 to 2016 and 2018 to 2019. Additionally, 2.1% of households had increased food insecurity during this period, with a greater impact in rural areas. The second most pressing problem of food insecurity is diet quality. Protein deficiency has been observed across the country. A large portion of the population in Sindh, KP, and Balochistan are deprived in micronutrients intake such as calcium, iron, zinc, and vitamins B1, B2, B3, C, and A. The cost of food has also risen due to inflation between 2015 to 2016 and 2018 to 2019, meaning that households have less access to nutritious food. The governments of Sindh, KP, and Balochistan need to do more to combat food insecurity and ensure that rural areas have enough healthy food for low and medium-socioeconomic households. Provincial-level efforts play a crucial role in mitigating the catastrophic loss of life and achieving sustainable development goals, especially the goal of zero hunger.
Engendering Rural Tourism as a Viable Strategy for Poverty Alleviation and Rural Development in the Southern Tourist Circuit of Tanzania
Authors: Haulle Evaristo , Nchimbi Credo Simbert , Ndimbo Gabriel Kanuti
Published: October 2024

This article employs a systematic literature review to present the need to innovate and engender rural tourism as a viable strategy for poverty alleviation in the Southern Tourism Circuit of Tanzania—one of the regions with many rural tourist opportunities that are unexplored and yet to be utilized to transform local peoples’ livelihoods. The study explores why the circuit is underdeveloped in terms of rural tourism as compared to other tourist circuits and maps the existing rural tourism opportunities in the region. The impacts of colonial legacy, limited financial capability, policy issues and poor infrastructure are the main factors for the under-exploitation of tourist resources in the southern circuit. Rural tourism assets such as natural, cultural, agritourism/farm-based, and culinary assets in this circuit still need to be utilized. Innovation and utilization of these rural tourism opportunities could be one of the appropriate strategies to improve residents’ livelihoods. Rural tourism could help to boost individual economies and government revenues and enhance community development. The study highlights the importance of effective collaboration among stakeholders and multisector linkage while putting the local community at the core of rural tourism.
A Corpus-Based Multifactorial Study of Help/help to Alternation in Learners’ Language: From the Perspective of Probabilistic Grammar
Authors: Wang Menglan , Jiang Guiying , Cheng Yan
Published: October 2024

This corpus-based multifactorial study delves deeper into the well-known alternation between bare and full infinitive complements, specifically regarding the help concordances. It extends the line of research to learners’ language productions with a focus on comparing and contrasting the probabilistic grammatical knowledge reflected in the help/ help to choices, which are constrained by a complex network of factors. Regression modeling indicates that constraints such as the horror aequi and certain morphological forms of the verb help are comparatively stable among groups of Chinese English language learners and native English speakers. Therefore, the principle of cognitive complexity and the avoidance strategy fueling infinitive variations are further tested. While the object typology differs in effect strength, it also prompts consideration of cultural influences on the part of Chinese English learners. In addition, two different patterns of interaction effects are explored in each dataset, which implies that learners’ language choice is usage-based, determined by an unconscious assessment of multiple clues that are learned from language input and shaped by language experiences.
What is Known About the Numbers, Experiences  and Outcomes of Young People Transitioning  from Out-of-home  Care in Indonesia?
Authors: Radityaputra Rangga , Mendes Philip , Baidawi Susan
Published: October 2024

Young people transitioning from out-of-home care (OOHC), commonly known as care leavers, are widely recognised internationally as a vulnerable group often subject to disadvantage. Yet, most studies of their pathways and outcomes to date have been completed in affluent Global North countries, and there have been relatively few reports on their experiences in Global South locations where different political, legislative, cultural and religious contexts exist. The particular attention of this article is on the Republic of Indonesia. Previous literature regarding children and young people in OOHC in Indonesia highlighted the poor quality of care within OOHC institutions and their adverse experiences of institutionalisation. In recent years, the Government of Indonesia has encouraged deinstitutionalisation by preventing family separation, promoting family-based alternative care and only utilising residential care as a last resort for child care. Nevertheless, little scholarly attention and studies have been given to researching young people leaving OOHC, who are likely to have poor life outcomes. Utilising existing grey government and non-government literature and reports, this policy briefing critically examines what is known about the numbers, experiences and outcomes of young people transitioning from OOHC in Indonesia.
Democratizing Social Scientists’ Words and Distinctions: Where and Why Moral Reasons Are Decisive
Authors: Abend Gabriel
Published: October 2024

Sitting at your desk, working on your social science paper, you take yourself to be free to use key words and distinctions as you see fit. I argue that these decisions aren’t up to you. Instead, they should be made collectively, by the social science community you’re embedded in, talking to, and contributing to, along with its stakeholders. Such democratic and deliberative processes will be driven by the common good, as opposed to benefiting particular social scientists, schools, research programs, methods, or regions of the world. My book, Words and Distinctions for the Common Good, is an invitation: I invite social science communities to democratically work on how to use their key words and distinctions—and which epistemic and moral goods these uses should help attain.
Preliminary Findings From a Pilot Professional Coaching Program on the Components of Burnout in a Diverse Group of Physician Leaders
Authors: Calderón Vanessa , Mogul Wyman Ashley , Miller Gregg
Published: October 2024

Background

Burnout impacts physicians at alarming rates; physician leaders are not immune. While burnout of physician leaders is associated with decreased leadership efficacy, physician coaching has been associated with reduced burnout.

Objective

This study aimed to assess the effect of a physician-leader specific coaching program on the components of burnout.

Methods

A 10-week Wellness Coaching Program for physician medical directors was conducted and burnout was measured pre and post intervention using the Maslach Burnout Inventory-General Survey (MBI-GS).

Results

All subscales of the MBI-GS trended towards a decrease in the components of burnout with a statistically significant decrease in Cynicism.

Conclusion

Wellness coaching programs have the potential to positively impact the threat of burnout experienced by physician leaders in today’s health care workforce.
“Home out of home”: South Africa, Central Europe, and “dark nostography”
Authors: Kusek Robert
Published: October 2024

The essay provides a comprehensive discussion of South African nostographies which are concerned with the nostographers’ return to their Central European father/motherland. The paper not only explores the poetics of nostographic writing but also attempts to identify specific generic signposts that characterise South African nostos narratives about Central European homecoming. Having analysed – with the support of archival records – several notable examples of second-generation nostographies by South African writers of Central European descent (Gordimer, Zwi, Jacobson), the essay focuses on the first nostos narrative by a second generation South African Pole, i.e. Blood and Silver by Jan Glazewski (2022). The proposed reading of Glazewski’s book pays special attention to the way in which the Polish/Ukrainian “home” to which the author returns partakes in negotiating the “anachronoid” identity of the auto/biographical (homecoming) subject – especially in the context of the subject’s multiple dislocations; and in revealing a new, essentially transnational geography of historical and ideological connections between Central Europe and South Africa. Additionally, the essay argues that Glazewski’s book should be recognised as a specimen of “dark nostography,” i.e. a homecoming narrative in which one’s double home (South African and Central Europe) is acknowledged as a site of trauma, while the homecomer is considered the subject implicated in the past and present forms of injustice and violence.
ECG-based risk factors for adverse cardiopulmonary events and treatment outcomes in COPD
Authors: Wade R. Chad , Martinez Fernando J. , Criner Gerard J. , Tombs Lee , Lipson David A. , Halpin David M.G. , Han MeiLan K. , Singh Dave , Wise Robert A. , Kalhan Ravi , Dransfield Mark T.
Published: October 2024

Background

COPD has high mortality, compounded by comorbid cardiovascular disease. We investigated two ECG markers, Cardiac Infarction Injury Score (CIIS) and P pulmonale, as prognostic tools for adverse cardiopulmonary events in COPD.

Methods

This was apost hocanalysis of the IMPACT trial. Outcomes included odds (odds ratio, 95% confidence intervals) of adverse cardiopulmonary events stratified by CIIS threshold (<20versus≥20) and P pulmonale (baseline). Events included all-cause death, hospitalisation or death, cardiovascular adverse event of special interest, severe COPD exacerbations, and moderate/severe COPD exacerbations. We also assessed the effects of fluticasone furoate/umeclidinium/vilanterolversusfluticasone furoate/vilanterol or umeclidinium/vilanterol based on CIIS and P pulmonale.

Results

We included 9448 patients. Patients with CIIS ≥20 (versusCIIS <20) had greater odds of all-cause death (OR 1.73, 95% CI 1.27–2.37, p<0.001), hospitalisation or death (OR 1.33, 95% CI 1.17–1.50, p<0.001), cardiovascular adverse event of special interest (OR 1.27, 95% CI 1.08–1.48, p<0.005), severe COPD exacerbations (OR 1.41, 95% CI 1.21–1.64, p<0.001) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.13–1.40, p<0.001). Patients with P pulmonale (versuswithout) had greater odds of all-cause death (OR 2.25, 95% CI 1.54–3.29, p<0.001), hospitalisation or death (OR 1.51, 95% CI 1.28–1.79, p<0.001), severe COPD exacerbations (OR 2.00, 95% CI 1.65–2.41, p<0.001) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.08–1.46, p<0.001). A combined model demonstrated that patients with CIIS ≥20 and P pulmonale had increased risk of all-cause death (OR 3.38, 95% CI 1.23–9.30, p=0.019), hospitalisation or death (OR 1.61, 95% CI 1.14–2.22, p=0.004) and rate of severe COPD exacerbations (OR 1.89, 95% CI 1.22–2.91, p=0.004) and moderate/severe COPD exacerbations (OR 1.25, 95% CI 1.00–1.56, p=0.046). The risk of all-cause death and cardiovascular adverse events of special interest was reduced with fluticasone furoate/umeclidinium/vilanterolversusumeclidinium/vilanterol in patients with CIIS ≥20, but not CIIS <20.

Conclusions

These findings suggest the potential clinical relevance of CIIS and P pulmonale as risk indicators for adverse cardiopulmonary events in COPD.
MECOM and the PRDM gene family in uterine endometrial cancer: bioinformatics and experimental insights into pathogenesis and therapeutic potentials
Authors: Lou Meng , Zou Lian , Zhang Liying , Lu Yongquan , Chen Jia , Zong Beige
Published: October 2024

To elucidate the expression profiles, methylation states, and clinicopathological significance of the PRDM gene family, focusing on the MECOM gene's role in uterine endometrial cancer (UCEC) and its molecular interactions with the TGF-beta signaling pathway. Our methodology combined detailed bioinformatics analyses using UALCAN and GEPIA with in vitro assessments in HEC-1-A cells. Techniques included CRISPR-Cas9 for gene editing and various cellular assays (CCK-8, flow cytometry, Transwell) to evaluate the effects of MECOM on cell proliferation, migration, and apoptosis, alongside Western blot analysis for protein regulation in the TGF-beta pathway. MECOM was upregulated in UCEC tissues, influencing tumor cell behavior significantly. Knockout studies demonstrated reduced proliferation and migration and increased apoptosis, while overexpression showed reverse effects. Mechanistically, MECOM modulated critical proteins within the TGF-beta pathway, impacting cell cycle dynamics and apoptotic processes. The PRDM gene family, particularly MECOM, plays a crucial role in the pathogenesis and progression of UCEC, suggesting its utility as a target for novel therapeutic interventions. Our findings offer valuable insights for future research and potential clinical application in managing uterine endometrial cancer.
Wnt/β-catenin signaling pathway: proteins' roles in osteoporosis and cancer diseases and the regulatory effects of natural compounds on osteoporosis
Authors: Wang Xiaohao , Qu Zechao , Zhao Songchuan , luo Lei , Yan Liang
Published: October 2024

Osteoblasts are mainly derived from mesenchymal stem cells in the bone marrow. These stem cells can differentiate into osteoblasts, which have the functions of secreting bone matrix, promoting bone formation, and participating in bone remodeling. The abnormality of osteoblasts can cause a variety of bone-related diseases, including osteoporosis, delayed fracture healing, and skeletal deformities. In recent years, with the side effects caused by the application of PTH drugs, biphosphonate drugs, and calmodulin drugs, people have carried out more in-depth research on the mechanism of osteoblast differentiation, and are actively looking for natural compounds for the treatment of osteoporosis. The Wnt/β-catenin signaling pathway is considered to be one of the important pathways of osteoblast differentiation, and has become an important target for the treatment of osteoporosis. The Wnt/β-catenin signaling pathway, whether its activation is enhanced or its expression is weakened, will cause a variety of diseases including tumors. This review will summarize the effect of Wnt/β-catenin signaling pathway on osteoblast differentiation and the correlation between the related proteins in the pathway and human diseases. At the same time, the latest research progress of natural compounds targeting Wnt/β-catenin signaling pathway against osteoporosis is summarized.
Transactivation of the EGF receptor as a novel desensitization mechanism for G protein-coupled receptors, illustrated by dopamine D2-like and β2 adrenergic receptors
Authors: Kundu Dooti , Min Xiao , Wang Shujie , Peng Lulu , Tian Xinru , Wang Mengling , Kim Kyeong-Man
Published: October 2024

Transactivation of epidermal growth factor receptors (EGFR) provides intricate control over multiple regulatory cellular processes that merge the diversity of G protein-coupled receptors (GPCRs) with the robust signaling capacities of receptor tyrosine kinases. Contrary to the typical assertions, our findings demonstrate that EGFR transactivation contributes to the desensitization of GPCRs. Repeated agonist stimulation of certain GPCRs enhanced EGFR transactivation, triggering a series of cellular events associated with GPCR desensitization. This effect was observed in receptors undergoing desensitization (D3R, K149C-D2R, β2AR) but not in those resistant to desensitization (D2R, C147K-D3R, D4R, β2AR mutants lacking GRK2 or GRK6 phosphorylation sites). The EGFR inhibitor AG1478 prevented both desensitization and the associated cellular events. Similarly, these cellular events were also observed when cells were treated with EGF, but only in GPCRs that undergo desensitization. These findings suggest that EGFR transactivation diversifies pathways involved in ERK activation through the EGFR signaling system and also mediates GPCR desensitization. Alongside the widely accepted steric hindrance model, these findings offer new insights into understanding the mechanisms of GPCR desensitization, which occurs through complex cellular processes.
Statistical methods leveraging the hierarchical structure of adverse events for signal detection in clinical trials: a scoping review of the methodological literature
Authors: de Abreu Nunes Laetitia , Hooper Richard , McGettigan Patricia , Phillips Rachel
Published: October 2024

Background

In randomised controlled trials with efficacy-related primary outcomes, adverse events are collected to monitor potential intervention harms. The analysis of adverse event data is challenging, due to the complex nature of the data and the large number of unprespecified outcomes. This is compounded by a lack of guidance on best analysis approaches, resulting in widespread inadequate practices and the use of overly simplistic methods; leading to sub-optimal exploitation of these rich datasets. To address the complexities of adverse events analysis, statistical methods are proposed that leverage existing structures within the data, for instance by considering groupings of adverse events based on biological or clinical relationships.

Methods

We conducted a methodological scoping review of the literature to identify all existing methods using structures within the data to detect signals for adverse reactions in a trial. Embase, MEDLINE, Scopus and Web of Science databases were systematically searched. We reviewed the analysis approaches of each method, extracted methodological characteristics and constructed a narrative summary of the findings.

Results

We identified 18 different methods from 14 sources. These were categorised as either Bayesian approaches (n=11), which flagged events based on posterior estimates of treatment effects, or error controlling procedures (n=7), which flagged events based on adjusted p-values while controlling for some type of error rate. We identified 5 defining methodological characteristics: the type of outcomes considered (e.g. binary outcomes), the nature of the data (e.g. summary data), the timing of the analysis (e.g. final analysis), the restrictions on the events considered (e.g. rare events) and the grouping systems used.

Conclusions

We found a large number of analysis methods that use the group structures of adverse events. Continuous methodological developments in this area highlight the growing awareness that better practices are needed. The use of more adequate analysis methods could help trialists obtain a better picture of the safety-risk profile of an intervention. The results of this review can be used by statisticians to better understand the current methodological landscape and identify suitable methods for data analysis - although further research is needed to determine which methods are best suited and create adequate recommendations.
The development of early warning scores or alerting systems for the prediction of adverse events in psychiatric patients: a scoping review
Authors: Velasquez Valentina Tamayo , Chang Justine , Waddell Andrea
Published: October 2024

Background

Adverse events in psychiatric settings present ongoing challenges for both patients and staff. Despite advances in psychiatric interventions and treatments, research on early warning scores and tools to predict patient deterioration is limited. This review provides a summary of the few tools that have been developed in a psychiatric setting, comparing machine learning (ML) and nonmachine learning/traditional methodologies. The outcomes of interest include the selected key variables that contribute to adverse events and the performance and validation measures of the predictive models.

Methods

Three databases, Ovid MEDLINE, PsycINFO, and Embase, were searched between February 2023 and April 2023 to identify all relevant studies that included a combination of (and were not limited to) the following search terms: "Early warning," "Alerting tool," and "Psychiatry". Peer-reviewed primary research publications were included without imposing any date restrictions. A total of 1,193 studies were screened. A total of 9 studies met the inclusion and exclusion criteria and were included in this review. The PICOS model, the Joanna Briggs Institute (JBI) Reviewer's Manual, and PRISMA guidelines were applied.

Results

This review identified nine studies that developed predictive models for adverse events in psychiatric settings. Encompassing 41,566 participants across studies that used both ML and non-ML algorithmic approaches, performance metrics, primarily AUC ROC, varied among studies between 0.62 and 0.95. The best performing model that had also been validated was the random forest (RF) ML model, with a score of 0.87 and a high sensitivity of 74% and a specificity of 88%.

Conclusion

Currently, few predictive models have been developed for adverse events and patient deterioration in psychiatric settings. The findings of this review suggest that the use of ML and non-ML algorithms show moderate to good performance in predicting adverse events at the hospitals/units where the tool was developed. Understanding these models and the methodology of the studies is crucial for enhancing patient care as well as staff and patient safety research. Further research on the development and implementation of predictive tools in psychiatry should be carried out to assess the feasibility and efficacy of the tool in psychiatric patients.
The relational institution: an ethnographic study of recovery orientation and relational engagement on a psychiatric rehabilitation ward in London
Authors: Whittle Henry J. , Kiely Ed , Millard Isabel , Jadhav Sushrut , Killaspy Helen
Published: October 2024

Background

In the UK, inpatient psychiatric rehabilitation services for complex psychosis aim to provide recovery-orientated treatment to patients, with the goal of supporting sustained stepdown into community living. The extent to which rehabilitation services uphold this recovery orientation is associated with better outcomes. However, few studies have been able to ascertain what promotes or prevents recovery orientation in inpatient settings.

Methods

We conducted an ethnographic study of treatment on a National Health Service (NHS) psychiatric rehabilitation ward in London over six months during August 2022-February 2023. Data were collected through participant observation and semi-structured interviews with 9 patients and 14 staff members. Fieldnotes and interview transcripts were analysed using situational analysis.

Results

Our analysis highlights the importance of what we term ‘relational engagement’ between staff and patients to nurture and sustain recovery-orientated treatment. This relational engagement was embodied through small acts of genuine human connection grounded in mutual acceptance and affective bonding; close attention to detail that communicated curiosity and respect; and recognition, appreciation, and encouragement of the slow and gradual progress that characterises recovery in complex psychosis. Yet, this relational engagement was often limited or foreclosed by the social environment of the ward and the wider institutional context. Limiting elements included the dominance of hospital logics geared towards high-throughput acute treatment and risk management; the presence of audit culture that led to a level of standardisation curtailing more genuine human connection; and staff demoralisation driven by events on and off the ward, including system-wide crises and more localised conflicts and disturbances. Some of these conflicts involved discrimination, most prominently anti-Black racism and homophobia, reflecting wider structural inequalities that characterise inpatient psychiatric populations and the healthcare workforce.

Conclusion

Relationships, often under-prioritised in mental health services, were a key cornerstone of recovery-orientated treatment on a psychiatric rehabilitation ward. The shaping of therapeutic relationships amounted to an active process of relational engagement, which may be afforded or constrained by complex social elements requiring careful consideration in inpatient psychiatry. These social elements go beyond more surface-level factors such as staff training, knowledge, or attitudes and may require structural and system-level interventions.
Creating a safe space: medical students’ perspectives on using actor simulations for learning communication skills
Authors: Antila Asta Kristiina , Lindblom Sari , Louhiala Pekka , Pyörälä Eeva
Published: October 2024

Background

Communication skills are an essential part of clinical competence that need to be acquired during health professions education. Simulations are extensively used for learning communication skills and have long been integral to medical degree programmes. In this research we use qualitative methodology to explore fourth-year medical students’ experiences in simulations aimed at improving versatile doctor-patient communication, focusing on their learning with trained actors.

Methods

The data comprises reflective writings from 208 fourth-year medical students, gathered after a communication skills course. These students provided informed consent for their writings to be included in the research. We performed an inductive qualitative content analysis on the textual data, with findings presented as themes, supported by categories, codes, and excerpts from raw data to enhance the trustworthiness of the analysis.

Results

We identified eight key themes capturing students’ learning experiences through simulations: practising in a safe learning environment, valuing feedback, gaining new perspectives, finding simulations valuable and enjoyable, boosting confidence and self-knowledge, and viewing simulations as authentic and engaging learning opportunities. Some students offered critical perspectives on simulations. Throughout the course, students learned diverse aspects of patient care, emotional and behavioural communication dynamics, and lessons from medical errors. Some students offered critical perspectives on simulations, and a few indicated they did not learn anything new.

Conclusions

A safe learning environment is vital for encouraging learners to explore, make errors, and absorb feedback to improve their communication with patients. Students predominantly valued the communication skills training with actors and the constructive feedback received and given in the debriefing discussions. However, some students expressed critical views toward simulations. Simulations are not static; they evolve and require continual improvements. Hence, we advocate for the ongoing exploration and enhancement of communication skills learning methods, including simulations, with careful consideration for students’ vulnerability and the importance of psychological safety. Additionally, it is critical to address students’ perceptions that certain clinical teachers prioritise biomedical knowledge over communication skills. Providing tailored training for teachers regarding the learning methods and the desired outcomes of communication courses is essential.
Face and content validity of the EMPOWER-UP questionnaire: a generic measure of empowerment in relational decision-making and problem-solving
Authors: Marqvorsen Emilie Haarslev Schröder , Lund Line , Biener Sigrid Normann , Due-Christensen Mette , Husted Gitte R. , Jørgensen Rikke , Mathiesen Anne Sophie , Olesen Mette Linnet , Petersen Morten Aagaard , Pouwer François , Rasmussen Bodil , Rothmann Mette Juel , Thomsen Thordis , Winkley Kirsty , Zoffmann Vibeke
Published: October 2024

Background

Decision-making and problem-solving processes are powerful activities occurring daily across all healthcare settings. Their empowering potential is seldom fully exploited, and they may even be perceived as disempowering. We developed the EMPOWER-UP questionnaire to enable assessment of healthcare users’ perception of empowerment across health conditions, healthcare settings, and healthcare providers’ professional backgrounds. This article reports the initial development of EMPOWER-UP, including face and content validation.

Methods

Four grounded theories explaining barriers and enablers to empowerment in relational decision-making and problem-solving were reviewed to generate a preliminary item pool, which was subsequently reduced using constant comparison. Preliminary items were evaluated for face and content validity using an expert panel of seven researchers and cognitive interviews in Danish and English with 29 adults diagnosed with diabetes, cancer, or schizophrenia.

Results

A preliminary pool of 139 items was reduced to 46. Independent feedback from expert panel members resulted in further item reduction and modifications supporting content validity and strengthening the potential for generic use. Forty-one preliminary items were evaluated through 29 cognitive interviews, resulting in a 36-item draft questionnaire deemed to have good face and content validity and generic potential.

Conclusions

Face and content validation using an expert panel and cognitive interviews resulted in a 36-item draft questionnaire with a potential for evaluating empowerment in user-provider interactions regardless of health conditions, healthcare settings, and healthcare providers’ professional backgrounds.