bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal associations between childhood maltreatment and sexual motivations in couples: The role of basic psychological needs
Authors: Kotiuga Judith , Bőthe Beáta , Bergeron Sophie , Girouard Alice , Bigras Noémie , Vaillancourt-Morel Marie-Pier
Published: January 2024

Childhood maltreatment (CM) has been consistently associated with negative sexual outcomes in couples. Yet, its link with sexual motivation, which plays a key role in relational and sexual well-being, remains elusive. Based on self-determination theory, sexual motivations encompass intrinsic motivation, extrinsic motivation (i.e., integrated, identified, introjected, and external), and amotivation. This study examined the dyadic longitudinal associations between CM and these six sexual motivations, while considering the satisfaction of basic psychological needs (i.e., autonomy, competence, and relatedness) as potential mediators. Data from 309 cohabitating couples (50.8% cisgender women, M = 32.64 years, SD = 9.59), collected at three time points over 1 year, were analyzed using actor-partner interdependence mediation models. CM was not significantly related to intrinsic motivation. However, overall, a person’s CM was indirectly associated with their own and their partner’s extrinsic motivation (i.e., integrated, identified, introjected, and external) via their own satisfaction of basic psychological needs for autonomy, competence, and relatedness in the romantic relationship. A person’s CM was also indirectly associated with their own amotivation via their own and their partner’s satisfaction for autonomy and relatedness. Findings suggest that catering to basic psychological needs of couples with a CM history may facilitate healthier sexual dynamics through their associations with sexual motivation.
The Effectiveness of a Technical Communication Module for Automobile Manufacturing Students at Vocational Colleges
Authors: Luo Mingdan , DeWitt Dorothy , Alias Norlidah
Published: January 2024

This study employs a one-group pretest and posttest design to assess the written and oral technical communication (TC) skills of students in vocational colleges in China. Fifty-nine 1st-year students in automotive engineering participated in a 3-week implementation of a TC module. To measure learner differences, students took oral and written tests before and after the intervention, respectively. Results showed that the module effectively improved students’ written and oral TC skills. In addition, findings from interviews with participants and English teachers indicated that the TC module is suitable from a pedagogical perspective.
Course Design for Leadership Learning in an Experiential Program
Authors: Penry Tara , Son Eun Hye
Published: January 2024

Background: Leadership development is commonly named as an outcome for experiential learning (EL) programs. Some programs have shown success at inculcating individual leadership traits. However, it is not clear whether there is a relationship between certain kinds of experiential pedagogy and specific leadership concepts or styles, such as industrial and postindustrial leadership and other concepts. Purpose: The researchers identify course-design factors associated with leadership-learning outcomes in an interdisciplinary EL program called Vertically Integrated Projects. Method: From five courses across disciplines, faculty were interviewed and syllabi and student reflections were analyzed for concepts of leadership and course designs. Findings: Students showed the most evidence of leadership learning when at least two of the three factors were present: (i) flexible and cooperative course structures; (ii) conceptual instruction; and (iii) faculty coaching. Leadership practice is distinguished from leadership learning. Implications: Leadership educators recommend conceptual instruction prior to experiential learning; the findings support supplementing that instruction with a flexible, cooperative course design to encourage leadership learning. More research is needed on the relationship between “vertical” experiences, in which advanced students mentor junior students in courses of any size, and leadership development.
The riding comfort improvement by the paralleled semi-active magnetorheological damper and passive inertance suspension from the power perspective
Authors: Hua Yingyu
Published: January 2024

Extensive research demonstrates that a semi-active damper in combination with inerter-based suspension could improve the ride comfort and road-holding performance of vehicles. However, the inherent dynamics of a semi-active damper is always neglected. The underlying mechanism of the controller with inerter in different frequency ranges is not well understood. Accordingly, this paper investigated the quarter-car suspension consisting of the paralleled nonlinear hysteretic semi-active magnetorheological (MR) damper and a passive inerter. To study the influence of different strategies, the clipped optimum controlled- (COC) and the mixed skyhook power-driven damper (SKYPDD) controlled- MR damper with the inerter are both adopted and denoted as COCI and SKYPDI, respectively. The optimal inertance is selected to minimize the sprung acceleration. Since there lacks quantitative method to analyze the working mechanism of semi-active controllers, an innovative power-based criterion was proposed in this paper. The trajectory of the control force and the sprung mass velocity determines the equivalent damping ratio added to the sprung mass and the input power it receives from the unsprung mass. The sprung mass vibration is reduced by decreasing the input power or increasing the damping ratio. Under harmonic excitation, the additional inertance decreases the power input to the sprung mass in the low-frequency range and isolates the sprung mass from the forced vibration at the unsprung resonance. Under the broadband stochastic excitation, SKYPDI and COCI can effectively decrease the input power spectrum and increase the damping ratio spectrum in the dominant sprung mass resonance. A parametric study on varying stiffness ratio demonstrates the semi-active strategy takes effects mainly in the high-stiffness-ratio range where the additional inertance more evidently enhances the damping ratio, especially for COCI. In summary, this paper proposes the power-based criterion for analyzing the working mechanism of semi-active strategies in ride comfort improvement.
Data in the making, political struggle, and epistemic (in)justice: Asian and Asian Americans as early responders to the COVID-19 pandemic in the United States
Authors: Herrenkohl Leslie Rupert , Lee Jiyoung , Wang Everet , Tasker Tammy , Jones Denise , Nkwuzor Paola , Batalon Christopher , Camacho Francisco Parra , Siciliano Peter , Davis Elizabeth A , Barton Angela Calabrese
Published: January 2024

The COVID-19 pandemic exposed the limits of big data to guide decision-making in times of crisis. As people navigated daily life, they were confronted with the reality that data were often not yet material but rather in-the-making. Drawing upon critical and feminist lenses and participatory methodologies, this study investigates the data stories of nine people of Asian descent living in the United States. Findings illustrate how participants navigated within and across time, space, activity, media, epistemology, race, and politics to produce lively data assemblages. These data stories guided social-distancing and mask-wearing weeks before official US policy even as participants lived in constant fear of dehumanizing racist and xenophobic violence. This study advances theorizing about data practices for human knowing and learning with media, racial and epistemic (in)justice, and community action. It also advances participatory research as a site of epistemic resistance and activism.
My Best Alaskan Life: Addressing Adolescent Mental and Reproductive Health in Alaska
Authors: Lessard Lauren , Jessen Cornelia , Buckingham Sara L. , Russell Riley , Morgan S. Abigail , Baker Jennifer
Published: January 2024

Introduction

Since 2020, a multisector research team has coordinated a youth-driven, community-based participatory research project to adapt a reproductive life plan for application in a statewide initiative called My Best Alaskan Life (MBAL). The RLP is adapted for Alaskan youth and is intended to support teens in decision-making processes reflecting cultural priorities, personal goals, and sexual and reproductive health. Background. With 46% of youth in Alaska reporting not having used a condom during their last sexual intercourse and 15% not having used contraception, unintended pregnancy and transmission of STIs will continue. Furthermore, Alaskan youth also cite high rates of hopelessness and suicidality, and research shows that poor mental health among adolescents is correlated with developing and maintaining high-risk sexual behaviors. An intervention focusing on supporting mental wellness and developing personal goals in the context of sexual health decision-making may encourage adolescents to adopt safer sexual health behaviors.

Methods

The MBAL research team completed a statewide pilot assessing the design and implementation of the tool, gathering feedback from over 700 survey responses (youth, ages 14–20); conducted 10 in-depth interviews (adult partners at community organizations and clinics); and hosted two youth-led design review sessions.

Findings

Questionnaire respondents were overwhelmingly positive about the tool (91% “liked or loved” the tool) and its potential applicability in their community (86% cited “very applicable”). Project next steps include incorporating design recommendations, a statewide randomized control trial and ultimately, open source access for all interested parties.
Connecting to Community: Violence Prevention Barriers, Geography, and Preventionist Perceptions of Community Leadership and Opportunities
Authors: Rieger Agnes , Campbell Jeanna , Garthe Rachel
Published: January 2024

Violence is a public health concern, negatively impacting individual and community health and safety. Although violence can be prevented, prevention efforts are complex in part because they require addressing community factors. Despite an increase in funding and support for community violence prevention, relatively little is known about what prevention practice barriers may be related to community factors. This study addressed this gap by surveying a statewide sample of violence preventionists. We explored if coordination and logistical barriers and rural geography are associated with perceptions of two community factors: community opportunities and leadership quality. As part of a statewide assessment of violence and prevention efforts, 130 violence preventionists completed surveys. Results showed that both perceived coordination barriers and rural geography were negatively associated with perceptions of existing community opportunities, representative/influential leadership, and leadership commitment. Perceived logistical barriers were positively associated with perceived leadership commitment. Findings suggest that support reducing community coordination barriers in particular—and to support rural violence prevention work more broadly—is needed.
Andexanet alfa versus non-specific treatments for intracerebral hemorrhage in patients taking factor Xa inhibitors — Individual patient data analysis of ANNEXA-4 and TICH-NOAC
Authors: Siepen Bernhard M , Polymeris Alexandros , Shoamanesh Ashkan , Connolly Stuart , Steiner Thorsten , Poli Sven , Lemmens Robin , Goeldlin Martina B , Müller Madlaine , Branca Mattia , Rauch Janis , Meinel Thomas , Kaesmacher Johannes , Z’Graggen Werner , Arnold Marcel , Fischer Urs , Peters Nils , Engelter Stefan T , Lyrer Philippe , Seiffge David
Published: January 2024

Background:

Data comparing the specific reversal agent andexanet alfa with non-specific treatments in patients with non-traumatic intracerebral hemorrhage (ICH) associated with factor-Xa inhibitor (FXaI) use are scarce.

Aim:

The study aimed to determine the association between the use of andexanet alfa compared with non-specific treatments with the rate of hematoma expansion and thromboembolic complications in patients with FXaI-associated ICH.

Methods:

We performed an individual patient data analysis combining two independent, prospective studies: ANNEXA-4 (180 patients receiving andexanet alfa, NCT02329327) and TICH-NOAC (63 patients receiving tranexamic acid or placebo ± prothrombin complex concentrate, NCT02866838). The primary efficacy outcome was hematoma expansion on follow-up imaging. The primary safety outcome was any thromboembolic complication (ischemic stroke, myocardial infarction, pulmonary embolism, or deep vein thrombosis) at 30 days. We used binary logistic regression models adjusted for baseline hematoma volume, age, calibrated anti-Xa activity, times from last intake of FXaI, and symptom onset to treatment, respectively.

Results:

Among 243 participants included, the median age was 80 (IQR 75–84) years, baseline hematoma volume was 9.1 (IQR 3.4–21) mL and anti-Xa activity 118 (IQR 78–222) ng/mL. Times from last FXaI intake and symptom onset to treatment were 11 (IQR 7–16) and 4.7 (IQR 3.0–7.6) h, respectively. Overall, 50 patients (22%) experienced hematoma expansion (ANNEXA-4: n=24 (14%); TICH-NOAC: n=26 (41%)). After adjusting for pre-specified confounders (baseline hematoma volume, age, calibrated anti-Xa activity, times from last intake of FXaI, and symptom onset to treatment, respectively), treatment with andexanet alfa was independently associated with decreased odds for hematoma expansion (aOR 0.33, 95% CI 0.13–0.80, p = 0.015). Overall, 26 patients (11%) had any thromboembolic complication within 30 days (ANNEXA-4: n=20 (11%); TICH-NOAC: n=6 (10%)). There was no association between any thromboembolic complication and treatment with andexanet alfa (aOR 0.70, 95% CI 0.16–3.12, p = 0.641).

Conclusion:

The use of andexanet alfa compared to any other non-specific treatment strategy was associated with decreased odds for hematoma expansion, without increased odds for thromboembolic complications.
Sleep spindles consolidate declarative memory with tags: A meta-analysis of adult data
Authors: Chen Peiyao , Hao Chao , Ma Ning
Published: January 2024

Tags are attached to salient information during the wake period, which can preferentially determine what information can be consolidated during sleep. Previous studies demonstrated that spindles during non-rapid eye movement (NREM) sleep give priority to strengthening memory representations with tags, indicating a privileged reactivation of tagged information. The current meta-analysis investigated whether and how spindles can capture different tags to consolidate declarative memory. This study searched the Web of Science, Google Scholar, PubMed, PsycINFO, and OATD databases for studies that spindles consolidate declarative memory with tags. A meta-analysis using a random-effects model was performed. Based on 19 datasets from 18 studies (N = 388), spindles had a medium effect on the consolidation of declarative memory with tags ( r = 0.519). In addition, spindles derived from whole-night sleep and nap studies were positively related to the consolidation of memory representations with tags. These findings reveal the shared mechanism that spindles are actively involved in the prefrontal-hippocampus circuits to consolidate memory with tags.
Adenophorae Radix Reduces Fibrosis in a Bleomycin-Induced Pulmonary Fibrosis Mouse Model
Authors: Kim Eui-Joong , Park Jiwon , Yu Chang-Hwan , Park Jae-Woo , Kim Kwan-Il , Jung Hee-Jae , Kim Jang-Hoon , Bu Youngmin , Lee Beom-Joon
Published: January 2024

Background: A screening study investigated the effects of lung-moistening herbal medicines on a bleomycin-induced pulmonary fibrosis mouse model and reported that the efficacy of Adenophorae Radix (ADR) was higher than that of other remedies. Objectives: This study aimed to investigate the antifibrotic efficacy and mechanism of action of ADR in a mouse model of bleomycin-induced pulmonary fibrosis. Materials and Methods: ADR water extract was prepared and orally administered at doses of 30, 100, and 300 mg/kg for 10 days after intratracheal bleomycin instillation. Changes in the body weight and lung histology were assessed. In addition, the quantity of inflammatory cells in the bronchoalveolar lavage fluid (BALF) and the level of transforming growth factor-β and α-smooth muscle actin (α-SMA) were measured. Results: ADR treatment decreased the degree of histological fibrosis based on the Ashcroft score and the number of inflammatory cells in BALF. Moreover, α-SMA level in the lung tissue decreased. ADR at 300 mg/kg resulted in the most significant reduction in the measured indicators. Conclusion: The results indicate that the administration of 300 mg/kg ADR attenuates pulmonary fibrosis in an animal model of idiopathic pulmonary fibrosis; thus, ADR can be considered as a candidate treatment for lung fibrosis.
Uptake of cervical cancer screening and associated factors among human immune virus positive women attending antiretroviral therapy clinic in public health facilities, Northeast Ethiopia, 2022: A cross-sectional study
Authors: Bekalu Yemane Eshetu , Wudu Muluken Amare , Workie Gashu Amare
Published: January 2024

Background:

Although cervical cancer is the most prevalent cancer in women and has a high morbidity, mortality, and low quality of life burden among human immune virus-positive women, there is little evidence of it in northeastern Ethiopia.

Objective:

Sought to determine the magnitude and associated factors of cervical cancer screening among human immune virus-positive women in public health facilities in northeastern Ethiopia.

Methods and material:

A multicentered, institution-based cross-sectional study with 401 participants using the systematic random sampling technique was employed. The data was gathered through personal interviews and chart reviews. The predictors were established via multivariate logistic regression analysis.

Result:

The magnitude of cervical cancer screening was 19.2% (15.7%–22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.

Conclusion:

The magnitude of cervical cancer screening was 19.2% (15.7%–22.9%). Multiparity, bad obstetric history, hearing about cervical cancer, recommendations from medical professionals, duration of antiretroviral therapy >10 years, a family record of cervical cancer, and knowing cervical cancer were revealed to be predictors of testing for cervical cancer.
Superficial white matter integrity in neuromyelitis optica spectrum disorder and multiple sclerosis
Authors: Komnenić Darko , Phillips Owen Robert , Joshi Shantanu H , Chien Claudia , Schmitz-Hübsch Tanja , Asseyer Susanna , Paul Friedemann , Finke Carsten
Published: January 2024

Background

Superficial white matter (SWM) is a particularly vulnerable area of white matter adjacent to cerebral cortex that was shown to be a sensitive marker of disease severity in several neurological and psychiatric disorders, including multiple sclerosis (MS), but has not been studied in neuromyelitis optica spectrum disorder (NMOSD).

Objective

To compare the integrity of SWM between MS patients, NMOSD patients and healthy controls, and explore the correlation of SWM integrity with cognitive performance and overall disability.

Methods

Forty NMOSD patients, 48 MS patients and 52 healthy controls were included in the study. Mean diffusivity (MD) values obtained by diffusion tensor imaging were used as a measure of SWM integrity. Cognitive performance and overall disability were assessed with standardized tests.

Results

Superficial white matter MD was increased in MS patients compared to healthy controls. Higher MD was associated with poorer spatial memory (most prominently in right temporal and right limbic lobe) and poorer information processing speed in MS patients. After adjusting for age, no significant differences of SWM MD were observed between NMOSD patients and healthy controls.

Conclusion

Integrity of SWM is compromised in MS, but not in NMOSD, and can serve as a sensitive marker of disease severity.
Extremely Long-Term Follow-Up of Dr William Glenn's Original Patient Cohort With Superior Cavopulmonary Anastomosis (1958-1990)
Authors: Lee Madonna E. , Amabile Andrea , Geirsson Arnar , Gruber Peter J. , Kopf Gary S.
Published: January 2024

Background

Historically, Dr William Glenn performed the first classic superior cavopulmonary anastomosis in a seven-year-old child at Yale in 1958. By 1990, this operation was performed consecutively in over 90 patients. With over 60 years of follow-up, this is the longest survival record of early Glenn patients from the first 30 years.

Methods

We performed a single center, retrospective evaluation of patients undergoing a Glenn operation. A collected list of surviving patients, previously updated in 1988, included demographics, age at procedure, and underlying diagnosis. Follow-up data were obtained in May 2022 using electronic medical records to determine survival, age of survivors, and age of deceased.

Results

Ninety-five patients underwent the Glenn operation from 1958 to 1990: 58.9% (n  = 56) were male and 41.1% (n = 39) female. Fifteen patients were lost to follow-up, but 12 were alive in 1988. Sixty patients were deceased (68.1%), with an average age of 33.5 ± 18.3(range, 2-78, excluding seven early deaths) years. The oldest patient who passed away was a 78-year-old male with tetralogy of Fallot. Twenty patients remain alive, with an average age of 47.5 (range, 32-66) years. Four patients who are still alive today (20% survivors) are older than 60 years.

Conclusions

Since Dr Glenn's original operation, the technique, timing, and indications have been modified (ie, bidirectional Glenn) to adapt to the current era. By following this initial group of patients, we can approach completion of the survival rates for adult congenital patients who were some of the first pediatric patients to receive this ground-breaking palliative procedure.
High-fidelity (repeat) consensus sequences from short reads using combined read clustering and assembly
Authors: Mann Ludwig , Balasch Kristin , Schmidt Nicola , Heitkam Tony
Published: January 2024

Background

Despite the many cheap and fast ways to generate genomic data, good and exact genome assembly is still a problem, with especially the repeats being vastly underrepresented and often misassembled. As short reads in low coverage are already sufficient to represent the repeat landscape of any given genome, many read cluster algorithms were brought forward that provide repeat identification and classification. But how can trustworthy, reliable and representative repeat consensuses be derived from unassembled genomes?

Results

Here, we combine methods from repeat identification and genome assembly to derive these robust consensuses. We test several use cases, such as (1) consensus building from clustered short reads of non-model genomes, (2) from genome-wide amplification setups, and (3) specific repeat-centred questions, such as the linked vs. unlinked arrangement of ribosomal genes. In all our use cases, the derived consensuses are robust and representative. To evaluate overall performance, we compare our high-fidelity repeat consensuses to RepeatExplorer2-derived contigs and check, if they represent real transposable elements as found in long reads. Our results demonstrate that it is possible to generate useful, reliable and trustworthy consensuses from short reads by a combination from read cluster and genome assembly methods in an automatable way.

Conclusion

We anticipate that our workflow opens the way towards more efficient and less manual repeat characterization and annotation, benefitting all genome studies, but especially those of non-model organisms.
The functional divergence of homologous GPAT9 genes contributes to the erucic acid content of Brassica napus seeds
Authors: Liu Hongbo , Zhu Jinbo , Zhang Bingxin , Li Qingyang , Liu Cui , Huang Qian , Cui Peng
Published: January 2024

Background

The early allopolyploid Brassica napus was a hybrid of two Brassica species, that had undergone a whole genome duplication event followed by genome restructuring, including deletions and small scale duplications. A large number of homologous genes appeared functional divergence during species domestication. Due to the high conservation of de novo glycerolipid biosynthesis, multiple homologues of glycerol-3-phosphate acyltransferases (GPATs) have been found in B. napus. Moreover, the functional variances among these homologous GPAT-encoding genes are unclear.

Results

In this study, four B. napus homologous genes encoding glycerol-3-phosphate acyltransferase 9 (BnaGPAT9) were characterized. Although a bioinformatics analysis indicated high protein sequence similarity, the homologues demonstrated tissue-specific expression patterns and functional divergence. Yeast genetic complementation assays revealed that BnaGPAT9-A1/C1 homologues but not BnaGPAT9-A10/C9 homologues encoded functional GPAT enzymes. Furthermore, a single nucleotide polymorphism of BnaGPAT9-C1 that occurred during the domestication process was associated with enzyme activity and contributed to the fatty acid composition. The seed-specific expression of BnGPAT9-C11124A increased the erucic acid content in the transformant seeds.

Conclusions

This study revealed that BnaGPAT9 gene homologues evolved into functionally divergent forms with important roles in erucic acid biosynthesis.
Single-cell RNA sequencing reveals hub genes of myocardial infarction-associated endothelial cells
Authors: Wang Hao , Dou Liping
Published: January 2024

Background

Myocardial infarction (MI) is a cardiovascular disease that seriously threatens human health. Dysangiogenesis of endothelial cells (ECs) primarily inhibits recovery from MI, but the specific mechanism remains to be further elucidated.

Methods

In this study, the single-cell RNA-sequencing data from both MI and Sham mice were analyzed by the Seurat Package (3.2.2). The number of ECs in MI and Sham groups were compared by PCA and tSNE algorithm. FindMarkers function of Seurat was used to analyze the DEGs between the MI and Sham groups. Then, the ECs was further clustered into 8 sub-clusters for trajectory analysis. The BEAM was used to analyze the branch point 3 and cluster the results. In addition, the DEGs in the microarray data set of MI and Sham mice were cross-linked, and the cross-linked genes were used to construct PPI networks. The key genes with the highest degree were identified and analyzed for functional enrichment. Finally, this study cultured human umbilical vein endothelial cells (HUVECs), established hypoxia models, and interfered with hub gene expression in cells. The impact of hub genes on the migration and tube formation of hypoxic-induced HUVECs were verified by Wound healing assays and tubule formation experiments.

Results

The number and proportion of ECs in the MI group were significantly lower than those in the Sham group. Meantime, 225 DEGs were found in ECs between the MI and Sham groups. Through trajectory analysis, EC4 was found to play an important role in MI. Then, by using BEAM to analyze the branch point 3, and clustering the results, a total of 495 genes were found to be highly expressed in cell Fate2 (mainly EC4). In addition, a total of 194 DEGs were identified in Micro array dataset containing both MI and Sham mice. The hub genes (Timp1 and Fn1) with the highest degree were identified. Inhibiting Timp1 and Fn1 expression promoted the migration and tube formation of HUVECs.

Conclusions

Our data highlighted the non-linear dynamics of ECs in MI, and provided a foothold for analyzing cardiac homeostasis and pro-angiogenesis in MI.
Feasibility and perceptions of a benzodiazepine deprescribing quality improvement initiative for primary care providers in Japan
Authors: Nishimura Masahiro , Teo Alan R. , Mochizuki Takahiro , Fujiwara Naoki , Nakamura Masakazu , Yamashita Daisuke
Published: January 2024

Background

Quality improvement (QI) initiatives in primary care in Japan are rare. One crucial area for QI is the appropriate prescription of benzodiazepines due to the large and growing elderly population in the country.

Objective

This study aimed to determine the feasibility and other perceptions of a Benzodiazepine receptor agonist medications (BZRAs) deprescribing QI initiative for primary care providers (PCPs) in Japanese primary care clinics.

Design

A qualitative study within a QI initiative.

Participants

We recruited 11 semi-public clinics and 13 providers in Japan to participate in a BZRAs deprescribing initiative from 2020 to 2021. After stratifying the clinics according to size, we randomly allocated implementation clinics to either an Audit only or an Audit plus Coaching group.

Interventions

For the Audit, we presented clinics with two BZRAs-related indicators. We provided monthly web-based meetings for the Coaching to support their QI activities.

Approach

After the nine-month initiative, we conducted semi-structured interviews and used content analysis to identify themes. We organized the themes and assessed the key factors of implementation using the Consolidated Framework for Implementation Research (CFIR) framework.

Key results

Audit plus Coaching was perceived as more valuable than Audit only intervention. Participants expressed intellectual curiosity about the QI initiative from resources outside their clinic. However, adopting a team-based QI approach in a small clinic was perceived as challenging, and selecting the indicators was important for meaningful QI.

Conclusion

The small size of the clinic could be a potential barrier, but enhancing academic curiosity may facilitate QI initiatives in primary care in Japan. Further implementation trials are needed to evaluate the possibility of QI with more various indicators and a more extended period of time.
Incidence and predictors of early posttraumatic seizures among patients with moderate or severe traumatic brain injury in Northwest Ethiopia: an institution-based prospective study
Authors: Baye Nega Dagnew , Baye Fikadie Dagnew , Teshome Assefa Agegnehu , Ayenew Atalo Agimas , Mulu Anmut Tilahun , Abebe Endeshaw Chekol , Muche Zelalem Tilahun
Published: January 2024

Background

Early posttraumatic seizure (PTS) is a well-known complication of traumatic brain injury (TBI) that can induce the development of secondary brain injuries, including increased intracranial pressure, brain death, and metabolic crisis which may result in worse outcomes. It is also a well-recognized risk factor for the development of late post-traumatic seizure and epilepsy. This study was aimed to assess the incidence and predictors of PTS among patients with moderate or severe TBI admitted to Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia.

Methods and setting

An institutional-based prospective follow-up study was conducted on 402 patients with TBI admitted to the neurologic unit from June 1, 2022 to January 30, 2023. A systematic sampling technique was employed. The incidence rate of occurrence of early PTS was calculated. Both bivariable and multivariable Cox proportional hazard regression was performed. The strength of the association was measured using adjusted hazard ratios with a 95% confidence interval and p-values < 0.05.

Results

The incidence rate of early PTS was 2.7 per 100 person-days observation. Early PTS was observed in 17.7% of TBI patients. Age 75 and above (AHR = 2.85, 95%CI: 1.58–5.39), severe TBI (AHR = 2.06, 95%CI: 1.03–3.71), epidural hematoma (AHR = 2.4, 95% CI: 1.28–4.57), brain contusion (AHR = 2.6, 95%CI: 1.07–4.09), surgical intervention (AHR = 1.7, 95%CI: 1.03–3.82), posttraumatic amnesia (AHR = 1.99, 95%CI: 1.08–3.48), history of comorbidities (AHR = 1.56, 95%CI: 1.08–3.86), and history of alcohol abuse (AHR = 3.1, 95%CI: 1.89–5.23) were potential predictors of early PTS.

Conclusion

The incidence of early PTS was high. Since, early PTS can worsen secondary brain damage, knowing the predictors helps to provide an effective management plan for patients likely to develop early PTS and improve their outcome.
Initial experience of 3-dimensional exoscope in decompression of massive lumbar disc herniation
Authors: Song Fanglong , Zhou Zhiqiang , Zhou Xiaozhong , Wu Haowei , Shan Bingchen , Zhou Zhentao , Dai Jun , Jiang Fengxian
Published: January 2024

Objectives

To investigate the effect of a three-dimensional (3D) exoscope for decompression of single-segment massive lumbar disc herniation (LDH).

Methods

The study included 56 consecutive patients with single segment massive LDH who underwent decompression assisted by a 3D exoscope from October 2019 to October 2022 at a university hospital. The analysis was based on comparison of perioperative metrics including decompression time, estimated blood loss (EBL) during decompression and postoperative length of stay (PLS); clinical outcomes including assessment using the visual analogue scale (VAS) and the Oswestry disability index (ODI); and incidence of reoperation and complications.

Results

The mean decompression time was 28.35 ± 8.93 min (lumbar interbody fusion (LIF)) and 15.50 ± 5.84 min (fenestration discectomy (LOVE surgery)), the mean EBL during decompression was 42.65 ± 12.42 ml (LIF) and 24.32 ± 8.61 ml (LOVE surgery), and the mean PLS was 4.56 ± 0.82 days (LIF) and 2.00 ± 0.65 days (LOVE surgery). There were no complications such as cerebrospinal fluid leakage, nerve root injury and epidural hematoma. All patients who underwent decompression assisted by a 3D exoscope were followed up for 6 months. At the last follow-up, the VAS and ODI scores were significantly improved from the preoperative period to the last follow-up (P < 0.05).

Conclusions

A 3D exoscope provides a visually detailed, deep and clear surgical field, which makes decompression safer and more effective and reduces short-term complications. A 3D exoscope may be a good assistance tool during decompression for single-segment massive LDH.
Network pharmacology and in vivo evidence of the pharmacological mechanism of geniposide in the treatment of atherosclerosis
Authors: Ma Guiping , Dong Qinqin , Li Feng , Jin Zheng , Pi Jianbin , Wu Wei , Li Junlong
Published: January 2024

Background

Atherosclerosis (AS) is a fundamental pathological state in various cardiovascular diseases. Geniposide, which is the main active component of Gardenia jasminides, is effective against AS. However, the underlying molecular mechanisms remain unclear. Here, we sought to elucidate them.

Methods

The targets of AS and geniposide were collected from online public databases. The potential mechanism of Geniposide in treating AS was predicted by constructing a protein–protein interaction (PPI) network and conducting Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment analyses. Hub proteins and core pathways were verified by molecular docking and in vivo experiments. Moreover, the effect of geniposide on AS was assessed by measuring the atherosclerotic plaque area in the thoracic aorta of mice. ApoE−/− mice were used to establish AS models and randomly divided into different groups. Two different doses of geniposide were administered to the mice. Hematoxylin and eosin (HE) staining was performed to evaluate the effects of geniposide on AS. Oil Red O and Sirius Red staining were used to evaluate plaque stability. The protein expression of key markers involved in the signalling pathways was examined using western blotting and immunofluorescence.

Results

A total of 239 active targets, 3418 AS-related disease targets, and 129 overlapping targets were identified. Hub genes were detected, and molecular docking revealed that geniposide strongly interacted with hub proteins (AKT1, VEGFA, CTNNB1, MMP9, and EGFR). Moreover, 109 signalling pathways, including the Rap1 signalling pathway, were identified using enrichment analysis. The results of in vivo experiments demonstrated that geniposide reduced body weight and blood lipid levels, alleviated the formation of atherosclerotic plaques, enhanced plaque stability, and inhibited inflammation, at least partially, by activating the Rap1/PI3K/Akt signalling pathway in ApoE−/− mice.

Conclusion

Geniposide can alleviate AS and enhance the stability of atherosclerotic plaques by regulating the Rap1/PI3K/Akt signalling pathway.
Status and influencing factors of work stress among nurse managers in western China: a cross-sectional survey study
Authors: Yang Zhuoxin , Huang Huaping , Li Guirong
Published: January 2024

Aims

Due to the nature of their work, nurses are more prone to experiencing psychological consequences than other healthcare workers. However, evidence on the emotional burden of nurse managers in China is limited. Furthermore, perceived organizational support has been approved that can affect mental health outcomes. Therefore, this study aimed to investigate the status quo and influencing factors of nurse managers’ work stress, and their possible relationship with perceived organizational support, which could further provide more countermeasures to safeguard their health.

Methods

A cross-sectional online survey of 21 secondary and tertiary hospitals was conducted in a city in Sichuan province, Southwest China, using a convenience sampling method between October and November 2022. Data were collected using the general information questionnaire, the Chinese version of the Stress Overload Scale (SOS) and the perceived Organizational Support Scale (POSS). SPSS 23.0 was applied to analyze the data.

Results

In total, 380 participants completed the survey. The median scores (interquartile range [IQR]) for SOS and POSS were 60.50 (50.00, 70.75) and 51.00 (44.00, 55.00), respectively. The work stress of the nurse managers was negatively correlated with perceived organizational support (P < 0.01). Multiple linear regression analysis showed that age older than 40 years, from secondary hospitals, working in emergency or pediatric wards, and professional qualification of supervisor nurse or deputy supervisor nurse, and the scores of POSS less than 51 significantly influenced the work stress of the nurse managers.

Conclusions

Our study shows that nurse managers are more prone to work stress, and organizational support can effectively reduce this stress. Governments and hospital administrators should pay more attention to providing comprehensive strategies based on various risk factors to protect and promote psychological health.
Access to quality care after injury in Northern Malawi: results of a household survey
Authors: Whitaker John , Amoah Abena S. , Dube Albert , Rickard Rory , Leather Andrew J. M. , Davies Justine
Published: January 2024

Background

Most injury care research in low-income contexts such as Malawi is facility centric. Community-derived data is needed to better understand actual injury incidence, health system utilisation and barriers to seeking care following injury.

Methods

We administered a household survey to 2200 households in Karonga, Malawi. The primary outcome was injury incidence, with non-fatal injuries classified as major or minor (> 30 or 1–29 disability days respectively). Those seeking medical treatment were asked about time delays to seeking, reaching and receiving care at a facility, where they sought care, and whether they attended a second facility. We performed analysis for associations between injury severity and whether the patient sought care, stayed overnight in a facility, attended a second facility, or received care within 1 or 2 h. The reason for those not seeking care was asked.

Results

Most households (82.7%) completed the survey, with 29.2% reporting an injury. Overall, 611 non-fatal and four fatal injuries were reported from 531 households: an incidence of 6900 per 100,000. Major injuries accounted for 26.6%. Three quarters, 76.1% (465/611), sought medical attention. Almost all, 96.3% (448/465), seeking care attended a primary facility first. Only 29.7% (138/465), attended a second place of care. Only 32.0% (142/444), received care within one hour. A further 19.1% (85/444) received care within 2 h. Major injury was associated with being more likely to have; sought care (94.4% vs 69.8% p < 0.001), stayed overnight at a facility (22.9% vs 15.4% P = 0.047), attended a second place of care (50.3% vs 19.9%, P < 0.001). For those not seeking care the most important reason was the injury not being serious enough for 52.1% (74/142), followed by transport difficulties 13.4% (19/142) and financial costs 5.6% (8/142).

Conclusion

Injuries in Northern Malawi are substantial. Community-derived details are necessary to fully understand injury burden and barriers to seeking and reaching care.
A collaboratively produced model of service design for children and young people with common mental health problems
Authors: Pryjmachuk Steven , Kirk Susan , Fraser Claire , Evans Nicola , Lane Rhiannon , Crooks Jodie , McGowan Rose , Naughton Georgia , Neill Liz , Camacho Elizabeth , Bower Peter , Bee Penny , McDougall Tim
Published: January 2024

Background

Little is known about the effectiveness of, and implementation complexities associated with, service delivery models for children and young people (CYP) experiencing ‘common’ mental health problems such as anxiety, depression, behavioural difficulties and self-harm. This paper outlines how a model for high-quality service design for this population group was developed by identifying available services, their effectiveness, cost-effectiveness and acceptability, and the barriers and enablers to access.

Methods

Sequential, mixed-methods design, combining evidence syntheses (scoping and integrative reviews of the international literature) with primary research (a collective case study in England and Wales). Data from these two elements were collaboratively synthesised in a subsequent model-building phase.

Results

The scoping review yielded a service model typology. The integrative review found effectiveness evidence only for four models: collaborative care (the only service model to also have cost-effectiveness evidence), outreach approaches, brief intervention services and an organisational framework called ‘Availability, Responsiveness and Continuity’. No service model seemed more acceptable than others. Three case study themes were identified: pathways to support; service engagement; and learning and understanding. The model-building phase identified rapid access, learning self-care skills, individualised support, clear information, compassionate and competent staff and aftercare planning as core characteristics of high-quality services. These characteristics were underpinned by four organisational qualities: values that respect confidentiality; engagement and involvement; collaborative relationships; and a learning culture.

Conclusions

A consistent organisational evidence-base for service design and delivery in CYP’s mental health spanning many years appears to have had little impact on service provision in England and Wales. Rather than impose – often inflexible and untested – specific local or national models or frameworks, those commissioning, designing and delivering mental health services for CYP should (re)focus on already known, fundamental components necessary for high-quality services. These fundamental components have been integrated into a collaboratively produced general model of service design for CYP with common mental health problems. While this general model is primarily focused on British service provision, it is broad enough to have utility for international audiences.
Prenatal diagnosis of dent disease type I with a nonsense pathogenic variant in CLCN5: a case study
Authors: Zhu Ruijue , Zhu Mingming , Wang Boye , Chen Enen , Cai Danlei , Yang Yinghong , Liang Yi , Su Chuqi , Wang Ding , Sun Xiaofang , Huang Linhuan , Xie Yingjun
Published: January 2024

Introduction

Dent disease type I is a rare X-linked recessive renal tubular disease resulting from pathogenic variants in the CLCN5 gene. Due to the rarity of Dent disease type I and the diversity of its phenotypes, its clinical diagnosis is complex and poses a challenge to clinicians.

Methods

A foetus and a child from a 36-year-old pregnant woman with a birth history of abnormal children were enrolled in this study. Pregnant women undergo amniocentesis for prenatal diagnosis at the gestational age of 12+ 3 weeks. Chromosomal microarray (CMA) analysis and whole-exome sequencing (WES) were employed to investigate the chromosomal copy number and single gene variants. Literature retrieval and data analysis were performed for genotype and phenotype collection analysis.

Results

No chromosomal abnormalities or CNVs were detected in the entire family through karyotype and familial CMA analyses. WES identified a nonsense pathogenic variant in CLCN5 of the X chromosome, c.1942 C > T (exon 11, NM_000084), which was inherited from his mother, who exhibited regular clinical features.

Conclusion

This study suggests that children with low-molecular-weight proteinuria and hypercalciuria should undergo prompt genetic testing to exclude Dent disease.
Modification of heat-related effects on mortality by air pollution concentration, at small-area level, in the Attica prefecture, Greece
Authors: Zafeiratou Sofia , Samoli Evangelia , Analitis Antonis , Dimakopoulou Konstantina , Giannakopoulos Christos , Varotsos Konstantinos V. , Schneider Alexandra , Stafoggia Massimo , Aunan Kristin , Katsouyanni Klea
Published: January 2024

Background

The independent effects of short-term exposure to increased air temperature and air pollution on mortality are well-documented. There is some evidence indicating that elevated concentrations of air pollutants may lead to increased heat-related mortality, but this evidence is not consistent. Most of these effects have been documented through time-series studies using city-wide data, rather than at a finer spatial level. In our study, we examined the possible modification of the heat effects on total and cause-specific mortality by air pollution at municipality level in the Attica region, Greece, during the warm period of the years 2000 to 2016.

Methods

A municipality-specific over-dispersed Poisson regression model during the warm season (May–September) was used to investigate the heat effects on mortality and their modification by air pollution. We used the two-day average of the daily mean temperature and daily mean PM10, NO2 and 8 hour-max ozone (O3), derived from models, in each municipality as exposures. A bivariate tensor smoother was applied for temperature and each pollutant alternatively, by municipality. Α random-effects meta-analysis was used to obtain pooled estimates of the heat effects at different pollution levels. Heterogeneity of the between-levels differences of the heat effects was evaluated with a Q-test.

Results

A rise in mean temperature from the 75th to the 99th percentile of the municipality-specific temperature distribution resulted in an increase in total mortality of 12.4% (95% Confidence Interval (CI):7.76–17.24) on low PM10 days, and 21.25% (95% CI: 17.83–24.76) on high PM10 days. The increase on mortality was 10.09% (95% CI: − 5.62- 28.41) on low ozone days, and 14.95% (95% CI: 10.79–19.27) on high ozone days. For cause-specific mortality an increasing trend of the heat effects with increasing PM10 and ozone levels was also observed. An inconsistent pattern was observed for the modification of the heat effects by NO2, with higher heat effects estimated in the lower level of the pollutant.

Conclusions

Our results support the evidence of elevated heat effects on mortality at higher levels of PM10 and 8 h max O3. Under climate change, any policy targeted at lowering air pollution levels will yield significant public health benefits.