bluuebunny/crossref_metadata_2025 huggingface dataset:
Explaining Police Procedural Justice in a Democracy: An Expanded Internal-External Model
Authors: Kevin Wang Shun-Yung , Sun Ivan Y. , Wu Yuning , Chen Fei-Lin
Published: April 2023

Since procedural justice was proposed, this vein of research has gained much popularity in scholarship, empirical supports, and theoretical advancement. Yet, research on the procedural fairness within police organizations, particularly on the underlying and mediating mechanisms between internal and external procedural justice, remains understudied. Relying on survey data collected from Taiwanese police officers, this study expands the current literature by testing the direct relationships between supervisor, organizational, and social supports and external procedural justice and their indirect connections through supervisor trustworthiness and self-legitimacy. Supervisor and social supports were found to directly boost officers’ commitment to external procedural justice. Perceived organizational support promotes external procedural justice through cultivating officer self-legitimacy. This study concludes by discussing cross-border research and pragmatic implications for police training and management.
A pilot evaluation of the role of a children’s wellbeing practitioner (CWP) in a child and adolescent mental health service (CAMHS)
Authors: Turnbull Michael , Kirk Hayley , Lincoln Michealla , Peacock Sarah , Howey Lynne
Published: April 2023

Background

In 2017, the Children and Young People’s Improving Access to Psychological Therapies (CYP-IAPT) project was extended to deliver low-intensity Cognitive Behavioural Therapy (CBT), delivered by Children’s Wellbeing Practitioners (CWPs), but to date evaluation is sparse.

Aims

To evaluate low-intensity interventions delivered by trainee CWPs for the treatment of anxiety and depression in a child and adolescent mental health service (CAMHS).

Method

The evaluation adopted a quantitative, within-subjects, cross-sectional design. The outcome measures of 98 service users aged 8–17 years were included in the evaluation. Service users were children and young people accessing CAMHS in the North East of England. Outcome measures included the Revised Children’s Anxiety and Depression Scale (RCADS-47) and Goal Based Outcomes (GBOs). Descriptive data relating to the types of interventions used and outcomes following CWP involvement were also explored.

Results

Analysis of pre and post intervention data highlighted significant reduction in symptomatology across all RCADS subscales and composite total scales, and significant goal progress as measures by GBO’s. Effect sizes ranged from moderate to large ( d = 0.75 – 0.90) across all subscales of the RCADS. Large effect sizes were found for depression, total anxiety and total RCADS scores ( d = 0.86, d = 1.12, d = 1.14), and GBOs ( d = −1.33).

Conclusions

Findings support the potential value of low intensity CBT interventions delivered by CWPs in reducing anxiety and depression in this population. Recommendations for the development of the CWP role and CWP services are discussed.
Metrics as the new normal – exploring the evolution of audience metrics as a decision-making tool in Swedish newsrooms 1995-2022
Authors: Tenor Carina
Published: April 2023

This paper explores the implementation process of digital audience metrics as a key strategy in Swedish legacy news production during the last three decades. The historical adoption of metrics in the newsroom is not new but has grown fast (from analogue audience measurements in the 1950s and monthly statistics of unique visitors in the 1990s to a wide range of real-time data). This trend is important because Swedish news organisations have invested heavily in data analytics, which involves integrating metrics-driven journalism into a particularly strong and homogenous tradition of professional autonomy. Based on interviews with key senior managers and supported by the analysis of trade publications, as well as published interviews, the findings reveal three chronologically overlapping periods: the naïve stage of ‘getting online’, the destructive period of ‘social media prominence’, and the end of the ‘paywall hesitation’. This trend has led to a new equilibrium in which audience metrics are perceived as better aligned with the professional values of news selection. More importantly, the industry-wide embrace of metrics as guidance for more relevant and rational news production revolves around two main factors: First, although metrics are tied to organisational targets, they remain under editorial control. Second, the degree of granularity and diversification of metrics allow for wider support of their use for strategic purposes.
Effects of Traditional Chinese Medicine Injections for Anthracyclines-induced Cardiotoxicity: An Overview of Systematic Reviews and Meta-Analyses
Authors: Li Chenchen , Zheng Yuling , Niu Dong , Zhu Ranpei , Yan Xiaoyu , Qu Haoran , Zhang Yaling
Published: April 2023

Introduction:

Traditional Chinese medicine (TCM) injections, as a relatively safe and low-cost treatment, have been widely used in the prevention and treatment of anthracyclines-induced cardiotoxicity in China. However, the quality of the relevant systematic reviews and meta-analyses published in recent years is uneven, so that the effectiveness and safety of TCM injections in preventing and treating anthracyclines-induced cardiotoxicity remain to be discussed. A systematic overview is therefore needed to provide a more advanced evidentiary reference for clinical practice.

Methods:

Eight Chinese and English databases were searched by computer to screen the meta-analyses/systematic reviews on the efficacy of traditional Chinese medicine injections for the prevention and treatment of anthracyclines-induced cardiotoxicity from the database establishment to October 2022. The methodological quality and evidence quality of outcome indicators included in the study were evaluated by AMSTAR 2 tool, PRISMA statement and GRADE classification.

Results:

A total of 7 articles were included in the study. The quality evaluation of AMSTAR 2 showed that 7 studies were extremely low-level; PRISMA stated that the evaluation results showed that the reports of 7 studies were of intermediate quality; The GRADE rating indicated that most of the evidence was of low quality.

Conclusion:

The methodological quality and evidence quality of meta-analysis/system evaluation concerning the prevention and treatment of anthracyclines-induced cardiotoxicity by Chinese medicine are currently low, and the effectiveness of Chinese medicine in the treatment of anthracyclines-induced cardiotoxicity needs more high-quality evidence-based evidence.
Design and Early Evaluation of a Device to Improve the Sharp Count Process in Operating Rooms
Authors: Oliveira Mariana , e Silva Gabriel Delage , Zancul Eduardo
Published: April 2023

Need

Counting surgical sharps in surgeries mitigates the risk of retained surgical items in patients. Current procedures rely on manual counts throughout and at the end of each surgery. The manual count is lengthy, burdensome, and carries the risk of injuries.

Technical solution

This paper presents the design and early evaluation of a technology aid to automatize the sharps’ counting process; it is composed of a shell holding a set of optical sensors that count needles that pass through the shell’s top slot.

Proof of concept

The device was tested with needles originating from 20 surgeries. Users surveyed reported a decrease in counting time and perceived injury risk. The average count error was 4.4%, indicating the need to continue advancing the technology.

Next steps

The counting technology needs to be refined to increase accuracy, and a user guide for the equipment must be prepared. Thereafter, a new set of trials must be performed.

Conclusion

Our work provides a detailed requirements list for developing a technology aid to improve the needle count process and investigates one possible technological route to address this problem.
Digital Health Solutions for Community-Based Control of Diabetes During COVID-19 Pandemic: A Scoping Review of Implementation Outcomes
Authors: Haregu Tilahun , Delobelle Peter , Issaka Ayuba , Shrestha Abha , Panniyammakal Jeemon , Thankappan Kavumpurathu Raman , Parasuraman Ganeshkumar , Schouw Darcelle , Ramalingam Archana , Cao Yingting , Levitt Naomi , Oldenburg Brian
Published: April 2023

Background:

The COVID-19 pandemic has added to the pre-existing challenges of diabetes management in many countries. It has accelerated the wider use of digital health solutions which have tremendous potential to improve health outcomes for people with diabetes. However, little is known about the attributes and the implementation of these solutions.

Objective:

To identify and describe digital health solutions for community-based diabetes management and to highlight their key implementation outcomes.

Methods:

We searched Ovid Medline, CINAHL, Embase, PsycINFO, and Web of Science for relevant articles. A purposive search was also used to identify grey literature. Articles that described digital health solutions that aimed to improve community-based diabetes management were included in this review. We applied a thematic synthesis of evidence to describe the characteristics of digital health solutions, and to summarize their key implementation outcomes.

Results:

We included 15 articles that reported digital health solutions that primarily focused on community-based diabetes management. Nine of the 15 innovations involved were mobile applications and/or web-based platforms, and five were based on social media platforms. The majority of the digital health solutions were used for diabetes education and support. High engagement, utilization, and satisfaction rates with digital health solutions were observed. The use of digital health solutions was also associated with improvement in self-management, taking medication, and reduction in glycated hemoglobin (HbA1c) levels.

Conclusion:

COVID-19 triggered digital health solutions have tremendous potential to improve health outcomes for people with diabetes. Further studies are needed to evaluate the sustainability and scale-up of these solutions.
Influences on Lung Cancer Screening Initiation and Retention in Rural Alabama
Authors: Copeland Amy , Levy Kathy , Hardy Claudia M. , King Jennifer C. , Rigney Maureen
Published: April 2023

Introduction/Objectives:

Despite the introduction of lung cancer screening using low dose computed tomography (LDCT), overall screening rates in the U.S. remain low, with certain populations including Black and rural communities experiencing additional disparities. The primary objective of this study was to understand the facilitators of lung cancer screening initiation and retention in Alabama reported by people at risk from mostly rural, mostly Black populations in Jefferson County—including the urban center of Birmingham—and 6 rural counties: Choctaw, Dallas, Greene, Hale, Marengo, and Sumter.

Methods:

We conducted semi-structured telephone interviews with 58 people who underwent lung cancer screening between December 2019 and January 2022. Participant responses were recorded by the interviewer for analysis. Open-ended responses were coded to identify emergent themes.

Results:

The most reported influences to initiate screening were information or suggestion from a Community Health Advisor (CHAs) or the supervising county coordinator, suggestion from a friend, or consideration of a personal history of smoking. Most participants reported multiple influences. Physicians were not very influential in decisions to initiate screening, but they were extremely influential in participants’ intent to continue screening, both positively and negatively. Knowing the recommended timeline for their annual scans was also a predictor of intention to continue screening. Participants screened during the COVID-19 state of emergency expressed less certainty about dates of next scans and more ambivalence about intention to continue screening.

Conclusions:

This study shows the benefit of using multiple methods to support increased awareness of and interest in lung cancer screening, particularly when educational messaging through CHAs is used. Clear guideline-based messages from healthcare providers about recommended screening is important for increasing retention. COVID-19 related implementation challenges impacted screening recruitment and retention. Future research is warranted to further explore use of CHAs in lung cancer screening.
Workplace Exclusion Impacts on Knowledge-Sharing via Moderation of Digital Media and Organizational Culture
Authors: Luo Shunjun , Huang Yu-Huang , Lee Chiou-Yann , Cai Yuni
Published: April 2023

Technological innovation relies on creating new knowledge and technologies, and the talents who create and share the knowledge are influenced by interpersonal relationships. Therefore, how to use the company’s existing internal resources to solve the issue of interpersonal workplace exclusion and encourage the knowledge-sharing between employees to form a specific cultural dynamism in terms of knowledge sharing, which leads to technological innovations, has become a challenge for enterprises. Through an investigation of the survey conducted in China, this paper aimed to explore the influence mechanism of workplace exclusion on knowledge sharing from resource conservation theory and social exchange theory perspectives. The dual moderation model of this study contained digital media and the dynamics of organizational culture. The research results of this study found that workplace exclusion has a significant negative impact on knowledge sharing while digital media negatively moderates the relationship between workplace exclusion on knowledge sharing. On the other hand, organizational culture dynamics help enhance digital media’s moderating effect on the negative relationship between workplace exclusion and knowledge sharing. This research result indicates that when promoting employees’ knowledge-sharing behavior, the influence of the organizational cultural environment cannot be ignored. With the vibrant dynamics of organizational culture design, the company can promote a free, relaxed and innovative cultural atmosphere, encouraging employees to express their ideas and suggestions freely. That is to say, when employees feel excluded from others and cannot express their views because of being ignored and excluded, the visibility of digital media helps them better express their views and knowledge.
Association Between Contrast Sensitivity and Central Subfield Thickness in Center-Involving Diabetic Macular Edema
Authors: Baldwin Grace , Vingopoulos Filippos , Zeng Rebecca , Wescott Hannah , Bannerman Augustine , Koch Thomas , Wang Kira , Garg Itika , Katz Raviv , Kim Leo A. , Miller John B.
Published: April 2023

Purpose: To evaluate the association between contrast sensitivity (CS) and central subfield thickness (CST) in diabetic macular edema (DME). Methods: This prospectively recruited, cross-sectional study included eyes with DME evaluated from November 2018 to March 2021. CST was measured using spectral-domain optical coherence tomography on the same day as CS testing. Only eyes with center-involving DME (CST >305 µm for women; >320 µm for men) were included. CS was evaluated using the quantitative CS function (qCSF) test. Outcomes included visual acuity (VA) and the following qCSF metrics: area under the log CS function, contrast acuity (CA), and CS thresholds at 1 to 18 cycles per degree (cpd). Pearson correlation and mixed-effects regression analyses were performed. Results: The cohort included 52 eyes of 43 patients. Pearson correlation analysis showed a stronger association between CST and CS thresholds at 6 cpd ( r = −0.422, P = 0.002) than CST and VA ( r = 0.293, P = 0.035). Mixed-effects univariate and multivariate regression analyses showed significant associations between CST and CA (β = −0.001, P = .030), CS at 6 cpd (β = −0.002, P = .008), and CS at 12 cpd (β = −0.001, P = .049) but no significant associations between CST and VA. Among the visual function metrics, the effect size of CST was largest on CS at 6 cpd (βStandardized = −0.37, P = .008). Conclusions: In patients with DME, CS may be more strongly associated with CST than VA. Including CS as an adjunct visual function outcome measure in eyes with DME may prove clinically valuable.
Vision impairment, hearing impairment and functional Limitations of subjective cognitive decline: a population-based study
Authors: Guo Ruirui , Li Xiaotong , Sun Mengzi , Wang Yuxiang , Wang Xuhan , Li Jing , Xie Zechun , Yao Nan , Yang Yixue , Li Bo , Jin Lina
Published: April 2023

Background

The association between sensory impairment including vision impairment (VI), hearing impairment (HI), dual impairment (DI) and the functional limitations of SCD (SCD-related FL) are still unclear in middle-aged and older people.

Methods

162,083 participants from BRFSS in 2019 to 2020 was used in this cross-sectional study. After adjusting the weights, multiple logistic regression was used to study the relationship between sensory impairment and SCD or SCD-related FL. In addition, we performed subgroup analysis on the basis of interaction between sensory impairment and covariates.

Results

Participants who reported sensory impairment were more likely to report SCD or SCD-related FL compared to those without sensory impairment (p < 0.001). The association between dual impairment and SCD-related FL was the strongest, the adjusted odds ratios (aORs) and 95% confidence interval (95% CI) were [HI, 2.88 (2.41, 3.43); VI, 3.15(2.61, 3.81); DI, 6.78(5.43, 8.47)] respectively. In addition, subgroup analysis showed that men with sensory impairment were more likely to report SCD-related FL than women, the aORs and 95% CI were [HI, 3.15(2.48, 3.99) vs2.69(2.09, 3.46); VI,3.67(2.79, 4.83) vs. 2.86(2.22, 3.70); DI, 9.07(6.67, 12.35) vs. 5.03(3.72, 6.81)] respectively. The subject of married with dual impairment had a stronger association with SCD-related FL than unmarried subjects the aOR and 95% CI was [9.58(6.69, 13.71) vs. 5.33(4.14, 6.87)].

Conclusions

Sensory impairment was strongly associated with SCD and SCD-related FL. Individuals with dual impairment had the greatest possibility to reported SCD-related FL, and the association was stronger for men or married subjects than other subjects.
Omadacycline for treatment of acute bacterial infections: a meta-analysis of phase II/III trials
Authors: Lin Fei , He Rong , Yu Bin , Deng Bowen , Ling Baodong , Yuan Mingyong
Published: April 2023

Objective

This study aims to assess the clinical efficacy and safety of omadacycline for the treatment of acute bacterial infections.

Methods

A search of PubMed, Embase, Cochrane Library, and Clinical Trials was conducted up to July 1, 2022. We included only randomized controlled trials (RCTs), in which omadacycline and other antibiotics were evaluated for treating acute bacterial infections in adults. The primary outcomes were clinical response and microbiological response, whereas the secondary outcome was the risk of adverse events (AEs).

Results

A total of seven RCTs involving 2841 patients with acute bacterial infection were included. Overall, our study illustrated that the clinical cure ratio of omadacycline was similar to the comparators in the treatment of acute bacterial infections (OR = 1.18, 95%CI = 0.96, 1.46, I2 = 29%). Omadacycline had a microbiological eradication rate similar to comparators in the treatment of acute bacterial infections (OR = 1.02, 95%CI = 0.81, 1.29, I2 = 42%). No statistical differences were observed between omadacycline and the comparators in terms of infection caused by Staphylococcus aureus (OR = 1.14, 95%CI = 0.80, 1.63, I2 = 0%), methicillin-resistant S. aureus (MRSA, OR = 1.28, 95%CI = 0.73, 2.24, I2 = 0%), methicillin-susceptible S. aureus (MSSA, OR = 1.12, 95%CI = 0.69, 1.81, I2 = 0%), and Enterococcus faecalis (OR = 2.47, 95%CI = 0.36, 16.97, I2 = 7%). A significant difference was found between omadacycline and the comparators for the risk of any AEs and treatment related AEs. The risk of discontinuation of the study drug due to an AEs was lower for omadacycline than for the comparators.

Conclusion

Omadacycline is as good as comparators in terms of efficacy and tolerance in the treatment of acute bacterial infections in adult patients. Thus, omadacycline is an appropriate option for antibiotic therapy in adult patients with acute bacterial infections.
Cost-effectiveness of preimplantation genetic testing for aneuploidy for women with subfertility in China: an economic evaluation using evidence from the CESE-PGS trial
Authors: He Xuan , Wang Xiao , Shen Jiaojie , Wan Bin , Wang Yingpeng , Zhang Zhuolin , Cai Lele , Bao Yuwen , Ding Haixia , Li Xin
Published: April 2023

Background

There are a large number of infertile couples in China, but its treatment is notoriously expensive and not currently covered by insurance. The utility of preimplantation genetic testing for aneuploidy as an adjunct to in vitro fertilization has been debated.

Objective

To investigate the cost-effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) versus conventional technology in in vitro fertilization (IVF) from the perspective of the healthcare system in China.

Methods

Following the exact steps in the IVF protocol, a decision tree model was developed, based on the data from the CESE-PGS trial and using cost scenarios for IVF in China. The scenarios were compared for costs per patient and cost-effectiveness. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to confirm the robustness of the findings.

Main outcome measures

Costs per live birth, Costs per patient, Incremental cost-effectiveness for miscarriage prevention.

Results

The average costs per live birth of PGT-A were estimated as ¥39230.71, which is about 16.8% higher than that of the conventional treatment. Threshold analysis revealed that PGT-A would need to increase the pregnancy rate of 26.24–98.24% or a cost reduction of ¥4649.29 to ¥1350.71 to achieve the same cost-effectiveness. The incremental costs per prevented miscarriage was approximately ¥45600.23. The incremental cost-effectiveness for miscarriage prevention showed that the willingness to pay would be ¥43422.60 for PGT-A to be cost-effective.

Conclusion

The present cost-effectiveness analysis demonstrates that embryo selection with PGT‑A is not suitable for routine applications from the perspective of healthcare providers in China, given the cumulative live birth rate and the high costs of PGT‑A.
Children with autism show differences in the gut DNA virome compared to non-autistic children: a case control study
Authors: Qu Aina , Duan Boyang , Wang Yue , Cui Zhenzhen , Zhang Nuochen , Wu De
Published: April 2023

Background

Several previous studies have identified a potential role that the gut microbiome can play in autism spectrum disorder (ASD) in children, but little is known about how variations in the virome may be involved in ASD. We aimed to understand the changes in the gut DNA virome of children with ASD.

Methods

A case–control study was presented, in which 13 two-children families were observed while considering the age, mode of birth, history of antibiotic use, and vaccination history to minimize the influence of confounding factors. DNA viral metagenomic sequencing was successfully performed on stool samples from 11 children with ASD and 12 healthy non-ASD children. The basic composition and gene function of the participants' fecal DNA virome were detected and analyzed. Finally, the abundance and diversity of the DNA virome of children with ASD and their healthy siblings were compared.

Results

The gut DNA virome in children aged 3–11 years was found to be dominated by the Siphoviridae family of Caudovirales. The proteins encoded by the DNA genes mainly carry out the functions of genetic information transmission and metabolism. Compared the gut DNA virome of ASD and healthy non-ASD children, their abundance of Caudovirales and Petitvirales both showed a significant negative correlation (r = -0.902, P < 0.01), there was no statistically significant difference in the relative abundance of viruses at the order and family levels, and a difference in the relative abundance at the genus level for Skunavirus (Ζ = -2.157, P = 0.031). Viral α diversity was reduced in children with ASD, but α diversity and β diversity did not differ statistically between groups.

Conclusions

This study indicates that elevated Skunavirus abundance and decreased α diversity in the gut DNA virulence group of children with ASD, but no statistically significant difference in the change in alpha and beta diversity. This provides preliminary cumulative information on virological aspects of the relationship between the microbiome and ASD, and should benefit future multi-omics and large sample studies on the gut microbes in children with ASD.
The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey
Authors: Shi Jing , Xiong Lijun , Guo Jun , Yang Yan
Published: April 2023

Aims

This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke.

Methods

We obtained data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model.

Results

We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04–3.81), 2.36 (1.52–3.59), 2.34 (1.44–3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65–0.84), sensitivity was 0.68, and specificity was 0.75.

Conclusion

Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.
Burden of smoking on disease-specific mortality, DALYs, costs: the case of a high-income European country
Authors: Farcher Renato , Syleouni Maria Eleni , Vinci Linda , Mattli Renato
Published: April 2023

Background

Smoking is a major risk factor for chronic diseases causing early death and disability. Smoking prevalence over the past 25 years has remained high in Switzerland. Evidence about the burden of disease and cost of illness attributable to smoking can support tobacco control. The aim of the present paper is to quantify from a societal perspective the mortality, disability-adjusted life years (DALYs), medical costs and productivity losses attributable to smoking in Switzerland in 2017.

Methods

Smoking attributable fractions (SAFs) were calculated based on the prevalence of current and former active smoking in the latest Swiss Health Survey from 2017 and relative risks from the literature. The SAFs were then multiplied with the number of deaths, DALYs, medical costs and productivity losses in the total population.

Results

In the Swiss population in 2017 smoking accounted for 14.4% of all deaths, for 29.2% of the deaths due to smoking-related diseases, 36.0% of the DALYs, 27.8% of the medical costs and 27.9% of productivity losses. Total costs amounted to CHF 5.0 billion which equals CHF 604 per capita per year. The highest disease burden in terms of mortality and DALYs attributable to smoking was observed for lung cancer and chronic obstructive pulmonary disease (COPD), whereas the highest cost of illness in terms of medical costs was observed for coronary heart diseases and lung cancer and in terms of productivity losses for COPD and coronary heart diseases. Sex and age group differences were found.

Conclusions

We provide an estimate of the burden of smoking on disease-specific mortality, DALYs, medical costs and productivity losses in Switzerland that could be prevented through evidence-based tobacco prevention and control policies as well as regular monitoring of tobacco consumption.
Work-related stressors and coping behaviors among leaders in small and medium-sized IT and technological services enterprises
Authors: Dannheim Indra , Buyken Anette E. , Kroke Anja
Published: April 2023

Background

Occupational health interventions for leaders are underrepresented in small and medium-sized enterprises (SMEs). When creating and developing effective occupational health interventions, identification of the specific needs of the target group is regarded as an essential step before planning an intervention. Therefore, the aim of this study was (1) to examine the subjectively experienced work-related stressors of leaders in small and medium-sized IT and technological services enterprises, (2) to explore coping behaviors leaders use to deal with the experienced work-related stressors, (3) to investigate resources supporting the coping process and (4) to identify potentially self-perceived consequences resulting from the experienced stressors.

Methods

Ten semi-structured interviews with leaders in small and medium-sized IT and technological services enterprises were conducted. The interviews were transcribed and analyzed with content-structuring qualitative content analysis in accordance to Kuckartz.

Results

Leaders in small and medium-sized IT and technological services enterprises experience various stressors caused by work organization as well as industry-related stressors and other work-related stressors. To address the experienced stressors, leaders apply problem focused coping behaviors (e.g. performing changes on structural and personal level), emotional focused coping behaviors (e.g. balancing activities, cognitive restructuring) as well as the utilization of social support. Helpful resources for the coping process include organizational, social and personal resources. As a result of the experienced work-related stressors, interviewees stated to experience different health impairments, negative effects on work quality as well as neglect of leisure activities and lack of time for family and friends.

Conclusion

The identified experienced work-related stressors, applied coping behaviors, utilized resources and emerging consequences underpin the urgent need for the development and performance of health-oriented leadership interventions for leaders in small and medium- sized IT and technological services. The results of this study can be used when designing a target-oriented intervention for the examined target group.
Psychometric properties of a standardized protocol of muscle strength assessment by hand-held dynamometry in healthy adults: a reliability study
Authors: Morin Marika , Hébert Luc J. , Perron Marc , Petitclerc Émilie , Lake Shanna-Rose , Duchesne Elise
Published: April 2023

Background

Maximal isometric muscle strength (MIMS) assessment is a key component of physiotherapists’ work. Hand-held dynamometry (HHD) is a simple and quick method to obtain quantified MIMS values that have been shown to be valid, reliable, and more responsive than manual muscle testing. However, the lack of MIMS reference values for several muscle groups in healthy adults with well-known psychometric properties limits the use and the interpretation of these measures obtained with HHD in clinic.

Objective

To determine the intra- and inter-rater reliability, standard error of measurement (SEM) and minimal detectable change (MDC) of MIMS torque values obtained with HHD.

Methods

Intra and Inter-rater Reliability Study. The MIMS torque of 17 muscle groups was assessed by two independent raters at three different times in 30 healthy adults using a standardized HHD protocol using the MEDup™ (Atlas Medic, Québec, Canada). Participants were excluded if they presented any of the following criteria: 1) participation in sport at a competitive level; 2) degenerative or neuromusculoskeletal disease that could affect torque measurements; 3) traumatic experience or disease in the previous years that could affect their muscle function; and 4) use of medication that could impact muscle strength (e.g., muscle relaxants, analgesics, opioids) at the time of the evaluation. Intra- and inter-rater reliability were determined using two-way mixed (intra) and random effects (inter) absolute agreement intraclass correlation coefficients (ICC: 95% confidence interval) models. SEM and MDC were calculated from these data.

Results

Intra- and inter-rater reliability were excellent with ICC (95% confidence interval) varying from 0.90 to 0.99 (0.85–0.99) and 0.89 to 0.99 (0.55–0.995), respectively. Absolute SEM and MDC for intra-rater reliability ranged from 0.14 to 3.20 Nm and 0.38 to 8.87 Nm, respectively, and from 0.17 to 5.80 Nm and 0.47 to 16.06 Nm for inter-rater reliability, respectively.

Conclusions

The excellent reliability obtained in this study suggest that the use of such a standardized HHD protocol is a method of choice for MIMS torque measurements in both clinical and research settings. And the identification of the now known metrological qualities of such a protocol should encourage and promote the optimal use of manual dynamometry.
Empagliflozin-associated postoperative mixed metabolic acidosis. Case report and review of pathogenesis
Authors: Sitina Michal , Lukes Marek , Sramek Vladimir
Published: April 2023

Background

Euglycemic diabetic ketoacidosis associated with SGLT2 inhibitors is a rare, relatively new and potentially fatal clinical entity, characterized by metabolic acidosis with normal or only moderately elevated glycemia. The mechanisms are not fully understood but involve increased ketogenesis and complex renal metabolic dysfunction, resulting in both ketoacidosis and hyperchloremic acidosis. We report a rare case of fatal empagliflozin-associated acidosis with profound hyperchloremia and review its pathogenesis.

Case presentation

A patient with type 2 diabetes mellitus treated with empagliflozin underwent an elective hip replacement surgery. Since day 4 after surgery, he felt generally unwell, leading to cardiac arrest on the day 5. Empagliflozin-associated euglycemic diabetic ketoacidosis with severe hyperchloremic acidosis was identified as the cause of the cardiac arrest.

Conclusions

This unique case documents the possibility of severe SGLT2 inhibitor-associated mixed metabolic acidosis with a predominant hyperchloremic component. Awareness of this possibility and a high index of suspicion are crucial for correct and early diagnosis.
“I stretch them out as long as possible:” U.S. women’s experiences of menstrual product insecurity during the COVID-19 pandemic
Authors: Schmitt Margaret L. , Dimond Katie , Maroko Andrew R. , Phillips-Howard Penelope A. , Gruer Caitlin , Berry Amanda , Nash Denis , Kochhar Shivani , Sommer Marni
Published: April 2023

Background

A growing body of evidence highlights how the COVID-19 pandemic has exacerbated gender inequalities in the US. This resulted in women being more vulnerable to economic insecurity and decreases in their overall well-being. One relevant issue that has been less explored is that of women’s menstrual health experiences, including how inconsistent access to menstrual products may negatively impact their daily lives.

Methods

This qualitative study, conducted from March through May 2021, utilized in-depth interviews that were nested within a national prospective cohort study. The interviews (n = 25) were conducted with a sub-sample of cis-gender women living across the US who had reported challenges accessing products during the first year of the pandemic. The interviews sought to understand the barriers that contributed to experiencing menstrual product insecurity, and related coping mechanisms. Malterud’s ‘systematic text condensation’, an inductive thematic analysis method, was utilized to analyze the qualitative transcripts.

Results

Respondents came from 17 different states across the U.S. Three key themes were identified: financial and physical barriers existed to consistent menstrual product access; a range of coping strategies in response to menstrual product insecurity, including dependence on makeshift and poorer quality materials; and heightened experiences of menstrual-related anxiety and shame, especially regarding the disclosure of their menstruating status to others as a result of inadequate menstrual leak protection.

Conclusions

Addressing menstrual product insecurity is a critical step for ensuring that all people who menstruate can attain their most basic menstrual health needs. Key recommendations for mitigating the impact of menstrual product insecurity require national and state-level policy reform, such as the inclusion of menstrual products in existing safety net basic needs programs, and the reframing of menstrual products as essential items. Improved education and advocacy are needed to combat menstrual stigma.
Fostering formative assessment: teachers’ perception, practice and challenges of implementation in four Sudanese medical schools, a mixed-method study
Authors: Almahal Elaf Abdulla , Osman Abrar Abdalfattah Ahmed , Tahir Mohamed Elnajid , Hamdan Hamdan Zaki , Gaddal Arwa Yahya , Alkhidir Omer Tagelsir Abdall , Gasmalla Hosam Eldeen Elsadig
Published: April 2023

Formative assessment (assessment for learning) enhances learning (especially deep learning) by using feedback as a central tool. However, implementing it properly faces many challenges. We aimed to describe the perception of medical teachers towards FA, their practice, challenges of implementing FA and present applicable solutions. A mixed-method, explanatory approach study was applied by administering a validated questionnaire to 190 medical teachers in four medical schools in Sudan. The obtained results were further studied using the Delphi method. Quantitative analysis revealed that medical teachers perceived their grasping of the concept of FAs and their ability to differentiate formative from summative assessments as very well (83.7%) and (77.4%), respectively. However, in contradiction to the former results, it was noteworthy that (41%) of them mistakenly perceived FA as an approach conducted for purposes of grading and certification. The qualitative study defined the challenges into two main themes: lack of understanding of formative assessment and lack of resources. Medical teachers’ development and resource allocation were the main recommendations. We conclude that there is misunderstanding and malpractice in implementing formative assessment attributed to the lack of understanding of FA as well as the lack of resources. We as well present suggested solutions derived from the perception of the medical teachers in the study and evolved around three approaches: faculty development, managing the curriculum by allocating time and resources for FA, and advocacy among stakeholders.
Development of an assessment tool to measure communication skills among family medicine residents in the context of electronic medical record use
Authors: Antoun Jumana , Saab Bassem , Usta Jinan , Romani Maya , Akl Imad Bou , El Mofti Maha Fathallah , Eter Joudy , AlArab Natally , Itani Hala
Published: April 2023

Background

The introduction of the electronic medical record (EMR) has led to new communication skills that need to be taught and assessed. There is scarce literature on validated instruments measuring electronic-specific communication skills. The aim is to develop an assessment checklist that assesses the general and EMR-specific communication skills and evaluates their content validity and reliability.

Methods

Using the SEGUE theoretical framework for communication skills, the assessment checklist items were developed by the Communication Skills Working Group (CSWG) at the family medicine department using a literature review about the positive and negative aspects of EMR use on physician-patient communication. A group of faculty members rated real resident-patient encounters on two occasions, three weeks apart. Patients were asked to fill out the Communication Assessment Tool (CAT) at the end of the encounter.

Results

A total of 8 residents agreed to participate in the research, with 21 clinical encounters recorded. The average total score was 65.2 ± 6.9 and 48.1 ± 9.5 for the developed scale and the CAT scale, respectively. The scale reliability was good, with a Cronbach alpha of 0.694. The test-retest reliability was 0.873, p < 0.0001. For the total score on the developed checklist, the intraclass correlation coefficient between raters (ICC) was 0.429 [0.030,0.665], p-value of 0.019. The level of agreement between any two raters on the cumulative score of the 5 subsections ranged from 0.506 (interpersonal skills) to 0.969 (end encounter).

Conclusion

This checklist is a reliable and valid instrument that combines basic and EMR-related communication skills.
The Clinical Teaching Fellow role: views of the Heads of Academy in the West Midlands
Authors: Harris Isobel Marion , Greenfield Sheila , Ward Derek J , Sitch Alice J , Parry Jayne
Published: April 2023

Background

Increasingly junior doctors are taking a year out of the traditional training pathway, and some opt to spend a year in a clinical teaching fellow (CTF) post. The CTF post mainly involves delivering hospital-based teaching to undergraduate medical students. In NHS hospital Trusts in the West Midlands, Heads of Academy (HoAs) have oversight of medical education at each Trust and therefore have responsibility for employing and directing the work of CTFs. Currently, only limited literature exists about the CTF role and exploring this from the point of view of different stakeholders in medical education is important in terms of contributing towards development of the role. This study aimed to explore the views of HoAs in the West Midlands region regarding CTFs employed at their Trusts.

Methods

All HoAs at the NHS Trust/teaching hospitals associated with the University of Birmingham were invited to take part in an in-depth interview about CTFs at their Trusts. Interviews were held via Zoom recorded using Zoom’s recording functionality. Interview transcripts were then coded and analysed using thematic analysis.

Results

Seven out of 11 HoAs participated in an interview. Seven themes were identified: CTF duties/Job role, Relationship with students, Benefits of having CTFs, Challenges associated with CTFs, Popularity of the role, What Trust offers CTFs, and Future of the role. Primarily it was felt that having CTFs at their Trust was beneficial in terms of the amount of teaching they provide for medical students. The HoAs were keen to ensure the CTF posts were of maximum benefit to both the post holders and to the Trusts where they were based. The CTF role is one that they felt would continue and develop in the future.

Conclusion

This study has provided the first insight into the CTF role from the point of view of senior doctors with responsibility for delivery of undergraduate medical education. The consistency and reliability of teaching provided by the CTFs was identified as a key benefit of the role. Future work exploring the role from the point of view of post holders themselves would be beneficial to contribute to development of the role.
Identification and validation of cuproptosis related genes and signature markers in bronchopulmonary dysplasia disease using bioinformatics analysis and machine learning
Authors: Jia Mingxuan , Li Jieyi , Zhang Jingying , Wei Ningjing , Yin Yating , Chen Hui , Yan Shixing , Wang Yong
Published: April 2023

Background

Bronchopulmonary Dysplasia (BPD) has a high incidence and affects the health of preterm infants. Cuproptosis is a novel form of cell death, but its mechanism of action in the disease is not yet clear. Machine learning, the latest tool for the analysis of biological samples, is still relatively rarely used for in-depth analysis and prediction of diseases.

Methods and results

First, the differential expression of cuproptosis-related genes (CRGs) in the GSE108754 dataset was extracted and the heat map showed that the expression of NFE2L2 gene was significantly higher in the control group whereas the expression of GLS gene was significantly higher in the treatment group. Chromosome location analysis showed that both the genes were positively correlated and associated with chromosome 2. The results of immune infiltration and immune cell differential analysis showed differences in the four immune cells, significantly in Monocytes cells. Five new pathways were analyzed through two subgroups based on consistent clustering of CRG expression. Weighted correlation network analysis (WGCNA) set the screening condition to the top 25% to obtain the disease signature genes. Four machine learning algorithms: Generalized Linear Models (GLM), Random Forest (RF), Support Vector Machine (SVM), and Extreme Gradient Boosting (XGB) were used to screen the disease signature genes, and the final five marker genes for disease prediction. The models constructed by GLM method were proved to be more accurate in the validation of two datasets, GSE190215 and GSE188944.

Conclusion

We eventually identified two copper death-associated genes, NFE2L2 and GLS. A machine learning model-GLM was constructed to predict the prevalence of BPD disease, and five disease signature genes NFATC3, ERMN, PLA2G4A, MTMR9LP and LOC440700 were identified. These genes that were bioinformatics analyzed could be potential targets for identifying BPD disease and treatment.