bluuebunny/crossref_metadata_2025 huggingface dataset:
The Monumental Qur’āns of Sultan Shaʿbān
Authors: Laclau Adeline
Published: January 2023

This article focuses on the seven monumental Qur’āns made during the reign of Sultan al-Ashraf Shaʿbān II (r. 1363–1378), considered to be the masterpieces of the Mamluk arts of the book. These are MSS Cairo, Dār al-Kutub al-Miṣriyya Raṣīd 6, 7, 8, 9, 10, 15, and 54. The aim of this study is to deepen our knowledge of the manufacturing system and the context of production of these manuscripts through the examination of paper formats, writing, and illuminations. This analysis allows us to locate these Qur’āns in the overall context of fourteenth-century manuscripts production, but also to reconsider the place of the two illumination workshops involved in their ornamentation, as well as their relationship with Sultan Shaʿbān and his entourage.
Dances at the Palace
Authors: Tessari Silvia
Published: January 2023

The purpose of this article is to comment on three dance-related passages from the Χρονικὴ διήγησις of the Byzantine historian Niketas Choniates (1155 ca.–1217). A linguistic analysis will identify both the precise classical reminiscences used by the author and the medieval reality transfigured through his archaizing linguistic choices. An introduction summarizes some aspects of Constantinopolitan dance in its specific connection with political power.
Enhancing yield of lettuce through irrigation and nitrogen management in a subtropical Inceptisol
Authors: Patra Sanmay Kumar , Sengupta Sudip , Bhattacharya Parijat , Bhattacharyya Kallol
Published: January 2023

To address the dearth of management of lettuce in the Indo-Gangetic plains, field experiment was conducted on a sandy loam Inceptisol for optimizing the irrigation, nitrogen requirement and economics of lettuce for three years. Four irrigation levels (conventional, I1 and irrigation at 0.6, 0.8, 1.0 irrigation water to cumulative pan evaporation (IW/CPE) ratio, as I2, I3 and I4) and three nitrogen management (100% recommended dose of N i.e., RDN as inorganic, N1; 50:50% RDN as inorganic: vermicompost, N2 and 100% RDN as vermicompost, N3) was laid out in thrice replicated split plot design. All the major physiological characteristics like plant height, number of leaves, average head diameter was improved with I4, N2 and their interaction (I4N2). Maximum average head yield (10.6 t ha−1) was obtained with I4 and I3, 10.5 t ha−1 for N2, while I4N2 yielded 11.3 t ha−1. Maximum water productivity (11.8 kg m−3) was obtained under I2N2. A strong non-linear relationship was detected between yield with irrigation water applied (). Higher soil moisture extraction (80.2%) in top 0–30 cm and lower (19.8%) for 30–45 cm depth and maximum leaf dry matter yield, nutrient concentrations and uptake was found with I4N2 and I3N2. The moderate deficit irrigation and optimum nutrient at I3N2 was found best for optimizing yield, higher water productivity, nitrogen economy and monetary returns of lettuce.
An overview on the valid publication and typification of Dryoathyrium chinense and Deparia chinensis (Athyriaceae, Aspleniineae, Polypodiales)
Authors: ZHANG JIAN-HANG , DU CHENG , APPLEQUIST WENDY L. , LIAO SHUAI
Published: January 2023

N/A
The Effect of Social Deprivation on Patient Satisfaction in Otolaryngology Clinics
Authors: Redding Taylor S. , Stephens Andrew R. , Gurgel Richard K.
Published: January 2023

Objectives:

Multiple factors have been associated with lower satisfaction scores. We hypothesize that patients with a more deprived socioeconomic status will have different patient satisfaction scores than patients of higher socioeconomic status.

Methods:

We reviewed Press Ganey satisfaction scores for new, outpatient visits between January 1, 2014, and December 31, 2018. Due to the high ceiling effects of the survey, “satisfaction” was defined as achieving a perfect score of 100. We determined social deprivation using the 2015 Area Deprivation Index (ADI) which serves as a proxy for socioeconomic status derived from zip codes. Patient satisfaction was defined as a binary variable. Univariate and multivariate binary logistic regression analyses were used to identify factors correlated with patient satisfaction.

Results:

There were 3239 unique new patients with completed surveys. Univariate analysis demonstrated decreased odds of achieving satisfaction for both the Total Score and Provider Sub-Score for each decile increase in ADI (OR 0.94; CI = 0.908-0.981; P = .003 and OR 0.94; CI = 0.91-0.98; P = .002 respectively). Multivariate analysis revealed the odds for reporting satisfaction for each decile increase in ADI were 0.96 for Total Score (CI = 0.921-0.998; P = .038) and 0.96 for Provider Sub-Score (CI = 0.92-0.993; P = .019). Patients in the most deprived quartile, compared to the least deprived, were significantly less likely to be satisfied with their care for both Total Score (OR 0.70; CI = 0.564-0.865; P = .001) and Provider Sub-Score (OR 0.69; CI = 0.558-0.852; P = .001).

Conclusions:

Increased social deprivation was an independent predictor of lower patient satisfaction in otolaryngology outpatients using the Press Ganey survey. This non-modifiable outcome should be taken into consideration when evaluating patient satisfaction scores and offers further support to the need of addressing and improving healthcare discrepancies in the field of otolaryngology.

Level of Evidence:

Level 3
Can We Talk? An Exploratory Study of Gender and Network Ties in a Local Government Setting
Authors: DeHart-Davis Leisha , Whetsell Travis A. , Humphrey Nicole
Published: January 2023

We explore the influence of gender and formal organizational status on the formation of discussion ties. Network data, gathered through surveying employees from a municipal organization in the United States, garnered a 92% response rate ( n = 143). Results of exponential random graph modeling indicate women supervisors are more likely to send discussion ties, while women in general are more likely to receive discussion ties. These exploratory results suggest women may be perceived as more approachable for work discussions, but not as supervisors. Finally, the results identified a consistent homophily effect of gender in the discussion network.
Job Satisfaction and the Digital Transformation of the Public Sector: The Mediating Role of Job Autonomy
Authors: Fleischer Julia , Wanckel Camilla
Published: January 2023

Worldwide, governments have introduced novel information and communication technologies (ICTs) for policy formulation and service delivery, radically changing the working environment of government employees. Following the debate on work stress and particularly on technostress, we argue that the use of ICTs triggers “digital overload” that decreases government employees’ job satisfaction via inhibiting their job autonomy. Contrary to prior research, we consider job autonomy as a consequence rather than a determinant of digital overload, because ICT-use accelerates work routines and interruptions and eventually diminishes employees’ freedom to decide how to work. Based on novel survey data from government employees in Germany, Italy, and Norway, our structural equation modeling (SEM) confirms a significant negative effect of digital overload on job autonomy. More importantly, job autonomy partially mediates the negative relationship between digital overload and job satisfaction, pointing to the importance of studying the micro-foundations of ICT-use in the public sector.
Patient satisfaction with therapeutic education in oncology: Antecedents, consequences, and the moderating effect of perceived value
Authors: Labbé-Pinlon Blandine , Lombart Cindy , Berger Virginie , Louis Didier
Published: January 2023

This research aims to deepen our understanding of patients’ satisfaction with therapeutic patient education (TPE) in oncology. The research model proposed was tested, with structural equation modeling, on 207 French breast-cancer patients who participated in a TPE program. The results confirm that post-TPE empowerment and relational proximity to the TPE team are two major antecedents of patient’s satisfaction—and attitude and word-of-mouth toward TPE are two important consequences of this concept of satisfaction. However, the established relationships are moderated by the patients’ profiles (i.e., utilitarin believers, passionate followers, or holistic followers) in terms of the perceived value of their own experience of patient education. These results will enable stakeholders to adapt their TPE promotion strategies to the profiles of the patients. The study will also help to demonstrate and highlight the patient benefits of TPE to various stakeholders and thus will favor access to this personalized care practice, which is essential in the management of chronic diseases, but is still limited in oncology.
The Dynamic Relationship Between Financial Development, Economic Growth, Foreign Direct Investment and Trade Openness: Evidence from South Asian Countries
Authors: Mustafa Ghulam
Published: January 2023

This study examines the nature of the association among financial development, economic growth, foreign direct investment and trade openness in four South Asian countries from the period 1990–2019. The study employed Granger Causality test in Vector Error Correction Model (VECM) framework to find out the dynamic relationship among the variables. Further, variance decomposition analysis (VDA) and impulse response function (IRF) is also applied to determine the relationships among the variables beyond the sample period. The empirical result shows support for growth-led financial development, growth-led foreign direct investment and growth-led trade openness hypothesis for India. For Pakistan, the results suggest growth-led financial development and growth-led foreign direct investment. In the case of Sri Lanka, the results suggest foreign direct investment-led growth and trade openness-led growth hypothesis. The results do not support any kind of causal relationship among the variables in the case of Bangladesh in the short run. Furthermore, no bidirectional causality among the variables was found for all the countries. The findings imply that all four countries should adopt policies to promote further trade liberalization, financial sector development and also need to fast-track reforms to improve the investment climate and attract investments to attain high economic growth in the long run.
Development and Validation of the Adolescent Defending Behaviors Questionnaire Among Chinese Early Adolescents
Authors: Wang Zixuan , Laninga-Wijnen Lydia , Garandeau Claire F. , Liu Junsheng
Published: January 2023

This study aimed to clarify the multidimensionality of defending by developing and validating the Adolescent Defending Behaviors Questionnaire (ADBQ) in a sample of Chinese adolescents. Results of Study 1 ( N = 824, Mage = 11.25) indicated that a five-factor model, comprising (a) assertive defending, (b) aggressive defending, (c) comforting victims, (d) reporting to authority, and (e) tactical defending, yielded a good fit to the data. Study 2 ( N = 1,086, Mage = 11.18) established ADBQ’s reliability (α = .78–.93) and construct validity: the five defending dimensions were differentially associated with cognitive and affective empathy, aggression, sociability, peer preference, and victimization. Together, the results suggest that the ADBQ is a psychometrically valid and reliable instrument for assessing the multidimensionality of defending.
The lived experience of meltdowns for autistic adults
Authors: Lewis Laura Foran , Stevens Kailey
Published: January 2023

Autistic meltdowns have been explored from the perspectives of parents, but there is a paucity of research on the experience of meltdowns from the autistic perspective. Little is known about how adults experience these events. In this descriptive phenomenological study, we conducted online interviews with 32 autistic adults on the experience of having a meltdown. Data were analyzed using Colaizzi’s seven-step method. Six themes emerged from data that captured the essence of meltdowns, including feeling overwhelmed by informational, sensory, social, or emotional stressors; experiencing extreme emotions, such as anger, sadness, and fear; losing logic, including challenges with thinking and memory; grasping for self-control, in which participants felt out of touch with themselves; finding a release for emotions, often described as an “explosion” of external behaviors or self-harm; and minimizing social, emotional, or physical harm by avoiding triggers or self-isolating when possible. Findings highlight the painful and distressing internalized experience of meltdowns beyond behavioral characteristics. Participants shared examples of internal meltdowns, in which external characteristics of meltdowns were camouflaged. Participants also suggested that meltdowns may serve a functional role in regulating emotions and making one’s voice heard. Meltdowns are diverse experiences that hold different meaning to different people.

Lay abstract

There is not a lot known about what it feels like for autistic people to have a meltdown. Past research has focused on what meltdowns are like for parents and what meltdowns look like from the outside without understanding what it is like for the person having the meltdown. We asked 32 autistic adults about what it is like for them to have a meltdown. We asked them to tell us about their thoughts and feelings about having a meltdown. Then, we looked for themes in their responses that summarized the meltdown experience. Our findings showed that meltdowns hold different meaning to different people. During a meltdown, we found that most autistics described feeling overwhelmed by information, senses, and social and emotional stress. They often felt extreme emotions, such as anger, sadness, and fear, and had trouble with thinking and memory during the meltdown. Participants described trying to stay in control of themselves, often feeling like they were not themselves during meltdowns. They described the meltdown as a way of letting go of or releasing the extreme emotions they felt. Participants tried to stay away from things or people that might trigger a meltdown or tried to make sure they were alone if they felt a meltdown may be coming as a way of avoiding harm—including harm to their bodies, their emotions, and their relationships. These findings offer an important look into what it is like for autistic adults to have meltdowns from their own point of view.
The factor structure and measurement invariance of the Autism Spectrum Quotient-28: A cross-cultural comparison between Malaysia and the Netherlands
Authors: Chee Zhong Jian , Scheeren Anke M , De Vries Marieke
Published: January 2023

Despite several psychometric advantages over the 50-item Autism Spectrum Quotient, an instrument used to measure autistic traits, the abridged AQ-28 and its cross-cultural validity have not been examined as extensively. Therefore, this study aimed to examine the factor structure and measurement invariance of the AQ-28 in 818 Dutch ( Mage = 37.4, 581 females, 233 males, 4 others) and 437 Malaysian ( Mage = 23.0, 328 females, 99 males, 10 others) participants from the general population. The hierarchical structure of the AQ-28 showed fair and good fit in Malaysia and in the Netherlands, respectively. A multi-group invariance analysis supported that the AQ-28 is cross-culturally invariant. Malaysians ( M = 68.63, SD = 8.33) scored significantly higher than Dutch participants ( M = 51.48, SD = 10.30) on the AQ-28 while gender was controlled for. While the measurement invariance suggests that the AQ-28 functions similarly in Malaysia and the Netherlands in terms of structure, exploratory analyses showed 11 items with differential item functioning. Hence, while the AQ-28 possesses a stable factor structure and appears to measure the same latent traits in Malaysia and the Netherlands, some items potentially display cultural bias which, in turn, might explain the differences in AQ scores.

Lay abstract

The AQ-28 is a questionnaire measuring autistic traits, that is, traits that are related to Autism Spectrum Conditions, but its reliability in other cultures has not been thoroughly evaluated. We, therefore, tested whether the properties of the AQ-28 are comparable between two countries with different cultures, Malaysia and the Netherlands. A total of 437 Malaysian and 818 Dutch participants completed the AQ-28 online. We measured whether the AQ-28 measures autistic traits similarly in Malaysia and the Netherlands. The AQ-28 measures autistic traits similarly, and the reliability was acceptable and good in the general population of Malaysia and the Netherlands, respectively. However, Malaysians scored higher than Dutch participants. Moreover, 11 AQ-28 items showed cultural bias, indicating that these items are answered/interpreted differently in Malaysia and the Netherlands. Cross-cultural differences in interpreting, reporting, and/or expressing autistic traits highlighted in this study could potentially explain why some items are culturally biased and why Malaysians score higher on these items. The findings of this work imply that cutoff scores derived from one culture should not be generalised to another culture. Moreover, the findings are informative for future development of culturally neutral or appropriate screening and diagnostic tools for autism.
Health assessment framework of marine engines enabled by digital twins
Authors: Tsitsilonis Konstantinos - Marios , Theotokatos Gerasimos , Patil Chaitanya , Coraddu Andrea
Published: January 2023

The advancements in digital twins when combined with the use of the machine learning tools can facilitate the effective health assessment and diagnostics of safety critical systems. This study aims at developing a framework to address the health assessment of marine engines utilising digital twins based on first-principles. This framework follows four distinct stages, with the former two including the marine engine digital-twin set up by customising the required thermodynamic models, as well as its calibration using tests trials data representing the engine healthy conditions. In the third stage, measurements from actual operating conditions are corrected and subsequently employed to develop the digital twin representing the prevailing conditions. The fourth stage deals with the engine health assessment by assessing health metrics derived from the developed digital twins. This framework is demonstrated in a case study of a large marine four-stroke nine-cylinder propulsion engine. The results demonstrate that three cylinders are identified to be underperforming leading to an average increase of the engine Brake Specific Fuel Consumption (BSFC) by 2.1%, whereas an average decreases of 6.8% in Indicated Mean Effective Pressure (IMEP) and 6.1% in the Exhaust Gas Temperature (EGT) are exhibited for the underperforming cylinders across the entire operating envelope. The developed digital twins facilitate the effective mapping of the engine performance for the entire operating envelope under several health conditions, providing enhanced insights for the current engine health status. The advantages of the proposed framework include the use of easily obtained data, and its application to several engine types including two and four-stroke engines for both propulsion and auxiliary use.
Comparison and validation of neural network models to estimate LED spectral power distribution
Authors: Lokesh J , Padmasali AN , Mahesha MG , Kini SG
Published: January 2023

The spectral power distribution (SPD) is the true fingerprint of a light source and is mainly dependent on electrical and thermal loading. Both the photometric and colorimetric quantities are originally extracted from SPD. Therefore, the dynamic prediction of SPD for LED has become an important aspect to evaluate the performance of LED during its time of operation. Generally, the statistical models are used to predict SPD. However, the statistical model with more than two input makes the system complex and time demanding. Artificial Neural Network (ANN) models, on the other hand, can help with this problem. The major goal of this research is to improve the utility of ANN in lighting applications. This is demonstrated by various neural network (NN) structures referred as models 1, 2 and 3 with combinations of varied neurons and hidden layers (HLs) to forecast SPD for various electrical and thermal stress levels at zero hours. The results are compared and based on absolute prediction error (APE) set to 5%, model 1 is considered as the best model for the SPD prediction. In addition, the time-based SPD prediction with model 1 is investigated using temperature, wavelength and time as input parameters for the LED luminaire and is validated.
Video-Conference-Based Graphomotor Examination for Children: A Validation Study
Authors: Sinvani Rachel-Tzofia , Gilboa Yafit
Published: January 2023

Background:

Telehealth can assist with providing accessible pediatric occupational therapy services.

Objectives:

This study aimed to investigate the acceptability, inter-rater reliability, and concurrent validity of the Gilboa Functional Test (GIFT) as a video-conference-based graphomotor examination for children (GIFT-Online).

Methodology:

A community-based sample of 157 children aged 3 to 7 years was screened using the GIFT-Online.

Findings:

Inter-rater reliability was excellent ( r = 0.97; p < .001; n = 40). In addition, significant correlations were found between the total GIFT-Online scores and the Developmental Coordination Disorder Questionnaire 2007 (DCDQ’07), the Little DCDQ (LDCDQ) ( r = 0.29, p < .001; n = 157), and the Drawing Proficiency Screening Questionnaire (DPSQ) ( r = −0.35, p < .001; n = 157); demonstrating construct and concurrent validity. The online assessment was well received by parents and children.

Conclusions:

The GIFT-Online was found to be an acceptable method of assessing graphomotor performance. Our results support the validity and reliability of the GIFT-Online as a screening tool administered remotely, thereby overcoming physical distancing and travel restrictions.
Ethics governance in Scottish universities: how can we do better? A qualitative study
Authors: Dove Edward S , Douglas Cristina
Published: January 2023

While ethical norms for conducting academic research in the United Kingdom are relatively clear, there is little empirical understanding of how university research ethics committees (RECs) themselves operate and whether they are seen to operate well. In this article, we offer insights from a project focused on the Scottish university context. We deployed a three-sided qualitative approach: (i) document analysis; (ii) interviews with REC members, administrators, and managers; and (iii) direct observation of REC meetings. We found that RECs have diverse operation and vary in terms of what members understand to be the remit of their REC and what should constitute the content of ethics review. Overall, though, most participants perceive university RECs as operating well. When asked what they consider to be areas for further improvement, most commented on: implementation of an online system; more experience with how to evaluate various kinds of research projects; best practice exchange and training opportunities; more accurate reflection of the REC role as part of the university’s workload allocation model; and greater recognition of the importance of research ethics governance in the university’s research environment, and, for the members themselves, their career advancement. Based on our findings and subsequent discussions during an end-of-project roundtable with stakeholders, we propose a model of collaboration that can address some of the identified areas that could benefit from further improvement. This model would facilitate a heightened awareness of the importance of supporting REC members in their own effort in assisting students and staff alike in undertaking as ethically robust research as possible.
In search of a ‘pan-European value set’; application for EQ-5D-3L
Authors: Sajjad Ayesha , Versteegh Matthijs M. , Santi Irene , Busschbach Jan , Simon Judit , Roijen Leona Hakkaart-van
Published: January 2023

Objectives

Country-specific value sets for the EQ-5D are available which reflect preferences for health states elicited from the general population. This allows the transformation of responses on EQ-5D to health state utility values. Only twelve European countries possess country-specific value sets and no value set reflecting the preferences of Europe exists. We aim to estimate a ‘pan-European’ value set for the EQ-5D-3L, reflecting the preferences for health states of the European population that could help to evaluate health care from the perspective of the European decision-maker.

Methods

We systematically assessed and compared the methodologies of available EQ-5D-3L time trade-off (TTO) value sets from twelve European countries: Denmark, France, Germany, Hungary, Italy, Netherlands, Poland, Portugal, Romania, Slovenia, Spain and UK. Using their published coefficients, a dataset with utility values for all 243 health states was simulated. Different modelling techniques and model specifications including interaction terms were tested. Model selection was based on goodness-of-fit criteria. We also explored results with application of population size weights.

Results

Methodological, procedural and analytical characteristics of the included EQ-5D-3L valuation studies were quite comparable. An OLS based model was the preferred model to represent European preferences. Weighting with population size made little difference.

Conclusions

EQ-5D-3L valuation studies were considered of sufficient comparability to form the basis for a new ‘pan-European’ value set. The method used allows for an easy update when new national value sets become available.
Longitudinal trajectories of depressive symptoms: the role of multimorbidity, mobility and subjective memory
Authors: Ji Yiman , Feng Yiping , Wu Sijia , Wu Yutong , Wang Jiongjiong , Zhao Xiangjuan , Liu Yunxia
Published: January 2023

Background

The high prevalence of depression among older people in China places a heavy burden on the health system. Multimorbidity, mobility limitation and subjective memory impairment are found to be risk indicators for depression. However, most studies on this topic focused on depression at a single point in time, ignoring the dynamic changes in depressive symptoms and the relationship between the trajectories and these three conditions. Therefore, we aimed to identify distinct trajectories of depressive symptoms in older people and investigate their associations with multimorbidity, mobility limitation and subjective memory impairment.

Methods

Data was drawn from China Health and Retirement Longitudinal Study conducted during 2011–2018. A total of 5196 participants who completed 4 visits, conducted every 2–3 years were included in this study. Group-based trajectory modeling was conducted to identify distinct trajectories of depressive symptoms z-scores. Multinomial logistic regression was used to investigate the relationships.

Results

Four distinct trajectories of depressive symptoms z-scores were identified, labeled as persistently low symptoms (68.69%, n = 3569), increasing symptoms (12.14%, n = 631), decreasing symptoms (14.05%, n = 730) and persistently high symptoms (5.12%, n = 266). Participants with multimorbidity had unfavorable trajectories of depressive symptoms compared with those without multimorbidity, with adjusted odds ratios (95% CIs) of 1.40 (1.15, 1.70), 1.59 (1.33, 1.90) and 2.19 (1.65, 2.90) for the increasing symptoms, decreasing symptoms and persistently high symptoms, respectively. We also observed a similar trend among participants with mobility limitations. Compared with participants who had poor subjective memory, participants with excellent/very good/good subjective memory had a lower risk of developing unfavorable trajectories of depressive symptoms. The adjusted odds ratios (95% CIs) of the increasing symptoms, decreasing symptoms and persistently high symptoms were 0.54 (0.40, 0.72), 0.50 (0.38, 0.65) and 0.48 (0.31, 0.73), respectively.

Conclusions

Multimorbidity, mobility limitation and subjective memory impairment were found to be potential risk factors for unfavorable depression trajectories.
Low influenza vaccine uptake by healthcare workers caring for the elderly in South African old age homes and primary healthcare facilities
Authors: Sibanda Mncengeli , Meyer Johanna C. , Godman Brian , Burnett Rosemary J.
Published: January 2023

Background

The elderly bear the highest burden of South Africa’s estimated annual > 10 million influenza cases and > 11,000 influenza-related deaths. Unvaccinated healthcare workers (HCWs) are at high occupational risk of contracting influenza, and may transmit influenza to elderly patients in their care. Thus, the South African National Department of Health recommends that HCWs receive annual influenza vaccination. This study aimed to determine influenza vaccination coverage among HCWs; identify reasons for their vaccination status; and investigate if HCWs recommend vaccination to their elderly patients.

Methods

A descriptive study was conducted in 18 community health centres and 44 private sector and non-governmental organisation managed old age homes across South Africa, using a self-administered structured questionnaire, which was distributed to 360 HCWs present on the day of data collection. Data were captured using Microsoft Excel® and imported to Epi Info™ 7 (Centers for Disease Control and Prevention, USA) for descriptive statistical analysis. Ethics approval (SMUREC/P/36/2018: PG) and permission to conduct the study at the facilities were obtained. All participants provided informed consent.

Results

The response rate was 76.7% (276/360). Most participants were female (90.9% [251/276]), nursing professionals (81.2% [224/276]) with a mean age of 41.1 ± 11.7 years. Although 62.7% of participants indicated having ever received at least one dose of the influenza vaccine, influenza vaccine uptake for 2017 and 2018 was 24.36% (41/276) and 33.3% (92/276) respectively. The main reasons given for never being vaccinated against influenza were related to the unavailability of the vaccine (70.9%) and vaccine hesitancy (27.2%). Most participants (67.8% [187/276]) recommended vaccines to elderly patients in their care.

Conclusion

The main reasons behind low influenza vaccine uptake by HCWs in South Africa who care for the elderly were related to unavailability of the vaccine and vaccine hesitancy. Strategies to educate HCWs on the importance of influenza vaccination, while concurrently increasing sustained and easy access to the vaccine by HCWs are needed to preserve public health.
Modulatory activity of testosterone on growth pattern and IGF-1 levels in vanishing testis syndrome: a case report during 15 years of follow-up
Authors: Franco Marta , Khorrami Chokami Keyvan , Albertelli Manuela , Teti Claudia , Cocchiara Francesco , Gatto Federico , Trombetta Carlo , Ferone Diego , Boschetti Mara
Published: January 2023

Background

The vanishing testis syndrome (VTS), is a 46, XY disorder of sex development (46, XY DSD) and is characterized by the absence of testis in a 46, XY subject with male genitalia, gonadal dysgenesis and consequent hypergonadotropic hypogonadism.

Case presentation

A young man affected by VTS has been followed up for more than 15-year in our center. The patient received different testosterone formulations, which modulated his IGF-1 levels and height velocity, depending on different stimulatory effects, mimicking pubertal spurt until achieving a final height in line with his genetic target.

Exogenous testosterone, activating GH/IGF-1 system, can directly influence growth pattern. With this particular case report we demonstrate that an accurate monitoring of patients with VTS, as well as a perfect reproduction of testosterone secretion during pubertal spurt, can guarantee a normal growth and development and, consequently, a high level of quality of life in adulthood.

Conclusion

Testosterone levels act an important role during pubertal spurt in modulating the GH/IGF-1 axis, besides its well-known impact in sexual development.

Very little amount of exogenous testosterone can stimulate IGF-1 secretion and provide to growth velocity the drive that characterizes the initial phases of the growth spurt.
Burnout and quality of life in nursing staff during the COVID-19 pandemic
Authors: Meneguin Silmara , Ignácio Isabelle , Pollo Camila Fernandes , Honório Heitor Marques , Patini Mayara Salles Gasparini , de Oliveira Cesar
Published: January 2023

Objective

To investigate the association between burnout and quality of life among nursing staff at intensive care units during the new coronavirus pandemic and identify the influence of sociodemographic variables.

Methods

A cross-sectional study was conducted with 109 nursing staff members at intensive care units of a public hospital in Brazil. Data collection involved the administration of a sociodemographic questionnaire as well as the WHOQOL-Bref and Oldenburg Burnout Inventory.

Results

The participants presented a high state of burnout and a low score in the physical domain of the quality-of-life instrument. Men (p = 0.037), income (p = 0.011) and burnout (p < 0.001) independently influenced quality-of-life (p < 0.01). Age, being a nursing technician and working at two hospitals exerted an influence on burnout status (p < 0.05). A negative association was found between quality of life and burnout (p < 0.01).

Conclusion

Our findings showed that burnout due to occupational circumstances affected negatively the quality of life perceptions of nursing staff working at intensive care units during the COVID-19 pandemic.
Surgeons’ involvement in COVID-19 treatment: a practice by a regional core hospital in Japan to avoid physician burnout
Authors: Matsui Yugo , Yao Siyuan , Kumode Takashi , Tanino Keisuke , Mizuno Ryosuke , Ogoshi Yusuke , Honma Shusaku , Murakami Teppei , Kan Takatsugu , Nakajima Sanae , Harada Takehisa , Oh Koji , Nakamura Takehiro , Konishi Hiroki , Arii Shigeki
Published: January 2023

Background

To prevent task accumulation on certain divisions, our institution developed a unique system of allocating inpatient treatment of COVID-19 patients to doctors who were not specialized in respiratory infections. The objective of this study was to investigate whether surgeons can be involved in the COVID-19 inpatient treatment without negatively affecting patient outcome, and how such involvement can affect the wellbeing of surgeons.

Methods

There were 300 patients diagnosed with COVID-19 and hospitalized from January to June 2021, and 160 of them were treated by the redeployed doctors. They were divided into 3 groups based on the affiliation of the treating doctor. Patient characteristics and outcomes were compared between the groups. In addition, the impact of COVID-19 duty on participating surgeons was investigated from multiple perspectives, and a postduty survey was conducted.

Results

There were 43 patients assigned to the Department of Surgery. There were no differences in the backgrounds and outcomes of patients compared with other groups. The surgeon’s overtime hours were significantly longer during the duty period, despite no change in the number of operations and the complication rate. The questionnaire revealed that there was a certain amount of mental and physical burden from the COVID-19 duty.

Conclusion

Surgeons can take part in inpatient COVID-19 treatment without affecting patient outcome. However, as such duty could negatively affect the surgeons’ physical and mental wellbeing, further effort is needed to maintain the balance of fulfilling individual and institutional needs.
The localization of Toll and Imd pathway and complement system components and their response to Vibrio infection in the nemertean Lineus ruber
Authors: Orús-Alcalde Andrea , Børve Aina , Hejnol Andreas
Published: January 2023

Background

Innate immunity is the first line of defense against pathogens. In animals, the Toll pathway, the Imd pathway, the complement system, and lectins are well-known mechanisms involved in innate immunity. Although these pathways and systems are well understood in vertebrates and arthropods, they are understudied in other invertebrates.

Results

To shed light on immunity in the nemertean Lineus ruber, we performed a transcriptomic survey and identified the main components of the Toll pathway (e.g., myD88, dorsal/dif/NFκB-p65), the Imd pathway (e.g., imd, relish/NFκB-p105/100), the complement system (e.g., C3, cfb), and some lectins (FreD-Cs and C-lectins). In situ hybridization showed that TLRβ1, TLRβ2, and imd are expressed in the nervous system; the complement gene C3-1 is expressed in the gut; and the lectins are expressed in the nervous system, the blood, and the gut. To reveal their potential role in defense mechanisms, we performed immune challenge experiments, in which Lineus ruber specimens were exposed to the gram-negative bacteria Vibrio diazotrophicus. Our results show the upregulation of specific components of the Toll pathway (TLRα3, TLRβ1, and TLRβ2), the complement system (C3-1), and lectins (c-lectin2 and fred-c5).

Conclusions

Therefore, similarly to what occurs in other invertebrates, our study shows that components of the Toll pathway, the complement system, and lectins are involved in the immune response in the nemertean Lineus ruber. The presence of these pathways and systems in Lineus ruber, but also in other spiralians; in ecdysozoans; and in deuterostomes suggests that these pathways and systems were involved in the immune response in the stem species of Bilateria.
Purification, Characterization and anticancer activity of L-methionine γ-lyase from thermo-tolerant Aspergillus fumigatus
Authors: Hendy Mahmoud H. , Hashem Amr H. , Suleiman Waleed B. , Sultan Mahmoud H. , Abdelraof Mohamed
Published: January 2023

Purification of L-methionine γ-lyase (MGL) from A. fumigatus was sequentially conducted using heat treatment and gel filtration, resulting in 3.04 of purification fold and 73.9% of enzymatic recovery. The molecular mass of the purified MGL was approximately apparent at 46 KDa based on SDS-PAGE analysis. The enzymatic biochemical properties showed a maximum activity at pH 7 and exhibited plausible stability within pH range 5.0–7.5; meanwhile the highest catalytic activity of MGL was observed at 30–40 °C and the enzymatic stability was noted up to 40 °C. The enzyme molecule was significantly inhibited in the presence of Cu2+, Cd2+, Li2+, Mn2+, Hg2+, sodium azide, iodoacetate, and mercaptoethanol. Moreover, MGL displayed a maximum activity toward the following substrates, L-methionine < DL-methionine < Ethionine < Cysteine. Kinetic studies of MGL for L-methioninase showed catalytic activity at 20.608 mM and 12.34568 µM.min−1. Furthermore, MGL exhibited anticancer activity against cancerous cell lines, where IC50 were 243 ± 4.87 µg/ml (0.486 U/ml), and 726 ± 29.31 µg/ml (1.452 U/ml) against Hep-G2, and HCT116 respectively. In conclusion, A. fumigatus MGL had good catalytic properties along with significantly anticancer activity at low concentration which makes it a probably candidate to apply in the enzymotherapy field.
Analysis of influencing factors of perioperative myasthenic crisis in 387 myasthenia gravis patients without thymoma in a single center
Authors: Jiao Peng , Wu Fanjuan , Liu Yuxing , Wu Jiangyu , Sun Yaoguang , Tian Wenxin , Yu Hanbo , Huang Chuan , Li Donghang , Wu Qingjun , Ma Chao , Tong Hongfeng
Published: January 2023

Objective

To study the influencing factors of myasthenic crisis in non-thymoma myasthenia gravis (MG) patients during perioperative period.

Methods

We retrospectively analyzed a total of 387 non-thymoma MG patients who underwent extended thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from February 2011 to December 2021, recorded ASA score, Osserman classification, preoperative course, pyridostigmine dosage, operation method, operation time, and intraoperative blood loss, then analyzed the factors associated with postoperative myasthenic crisis by univariate and multivariate logistic regression.

Results

Osserman classification IIB + III + IV (P < 0.001), history of myasthenic crisis (P = 0.013), pyridostigmine dosage greater than 240 (P < 0.001), ASA score 2 and 3 (P = 0.001) are independent risk factors for myasthenic crisis.

Conclusion

Patients with poor Osserman classification, history of myasthenic crisis before surgery, larger preoperative dosage of pyridostigmine, and higher ASA scores should be highly alert to the occurrence of postoperative myasthenic crisis.
Management of pneumothorax with 8.3-French Pigtail Catheter: description of the ultrasound-guided technique and case series
Authors: Ramírez-Giraldo Camilo , Rey-Chaves Carlos Eduardo , Rodriguez Lima David Rene
Published: January 2023

Spontaneous and traumatic pneumothorax are most often treated with chest tube (CT) thoracostomy. However, it appears that small-bore drainage systems have similar success rates with lower complications, pain, and discomfort for the patient. We present the description of the ultrasound-guided technique for pneumothorax drainage with an 8.3-French pigtail catheter (PC) in a case series of 10 patients.
Therapeutic and adverse effects of adrenaline on patients who suffer out-of-hospital cardiac arrest: a systematic review and meta-analysis
Authors: Zhong Hong , Yin Zhaohui , Kou Bojin , Shen Pei , He Guoli , Huang Tingting , Liang Jing , Huang Shan , Huang Jiaming , Zhou Manhong , Deng Renli
Published: January 2023

Objective

The efficacy and safety of epinephrine in patients with out-of-hospital cardiac arrest (OHCA) remains controversial. The meta-analysis was used to comprehensively appraise the influence of epinephrine in OHCA patients.

Methods

We searched all randomized controlled and cohort studies published by PubMed, EMBASE, and Cochrane Library from the inception to August 2022 on the prognostic impact of epinephrine on patients with OHCA. Survival to discharge was the primary outcome, while the return of spontaneous circulation (ROSC) and favorable neurological outcome were secondary outcomes.

Results

The meta-analysis included 18 studies involving 863,952 patients. OHCA patients with adrenaline had an observably improved chance of ROSC (RR 2.81; 95% CI 2.21–3.57; P = 0.001) in randomized controlled studies, but the difference in survival to discharge (RR 1.27; 95% CI 0.58–2.78; P = 0.55) and favorable neurological outcomes (RR 1.21; 95% CI 0.90–1.62; P = 0.21) between the two groups was not statistically significant. In cohort studies, the rate of ROSC (RR 1.62; 95% CI 1.14–2.30; P = 0.007) increased significantly with the adrenaline group, while survival to discharge (RR 0.73; 95% CI 0.55–0.98; P = 0.03) and favorable cerebral function (RR 0.42; 95% CI 0.30–0.58; P = 0.001) were lower than the non-adrenaline group.

Conclusion

We found that both the randomized controlled trials (RCTs) and cohort studies showed that adrenaline increased ROSC in OHCA patients. However, they were unable to agree on a long-term prognosis. The cohort studies showed that adrenaline had an adverse effect on the long-term prognosis of OHCA patients (discharge survival rate and good neurological prognosis), but adrenaline had no adverse effect in the RCTs. In addition to the differences in research methods, there are also some potential confounding factors in the included studies. Therefore, more high-quality studies are needed to fully confirm the effect of adrenaline on the long-term results of OHCA.
CTP synthase 2 predicts inferior survival and mediates DNA damage response via interacting with BRCA1 in chronic lymphocytic leukemia
Authors: Hu Xinting , Han Yang , Liu Jiarui , Wang Hua , Tian Zheng , Zhang Xin , Zhang Ya , Wang Xin
Published: January 2023

Background

Cytidine triphosphate synthase 2 (CTPS2) is an essential metabolic enzyme that catalyzes the biosynthesis of CTP. CTP synthases contribute to lymphocytes proliferation and tumorigenesis, but the role of CTPS2 in chronic lymphocytic leukemia (CLL) remains undefined.

Methods

In silico analysis was performed to quantified the expression and clinical analysis of CTPS2 and BRCA1. The expression was then validated on the internal sets. Loss-and gain-of-function assays were conducted to investigate the physiological phenotypes in CLL. RNA-seq was employed to probe the molecular mechanism of CTPS2.

Results

Herein, significant elevated expression of CTPS2 was observed in CLL patients compared to normal CD19 + B cells, which was verified in three independent cohorts. Furthermore, overexpression of CTPS2 was closely associated with undesired prognostic indicators, including unmutated IGHV status and chromosome 11q23 deletion. Additionally, elevated CTPS2 expression predicted adverse overall survival and treatment-free survival with independent prognostic significance. Downregulation of CTPS2 in CLL cells exhibited attenuated cell proliferation, arrested G2/M cell cycle and increased apoptosis. The addition of CTP or glutamine could reverse the above effects. Since RNA-seq showed the enrichment in DNA damage and response signaling, we subsequently found that silence of CTPS2 remarkably elevated DNA damage and decreased DNA repair. It was demonstrated that CTPS2 mediated DNA damage response via interacting with Breast Cancer 1 (BRCA1) protein in CLL through CoIP assays and rescued experiments.

Conclusions

Collectively, our study generated the novel findings that CTPS2 promoted CLL progression via DNA damage response and repair pathway. Targeting nucleotide metabolism potentially became an attractive strategy for treatment against CLL.
PRC2 disruption in cerebellar progenitors produces cerebellar hypoplasia and aberrant myoid differentiation without blocking medulloblastoma growth
Authors: Cleveland Abigail H. , Malawsky Daniel , Churiwal Mehal , Rodriguez Claudia , Reed Frances , Schniederjan Matthew , Velazquez Vega Jose E. , Davis Ian , Gershon Timothy R.
Published: January 2023

We show that Polycomb Repressive Complex-2 (PRC2) components EED and EZH2 maintain neural identity in cerebellar granule neuron progenitors (CGNPs) and SHH-driven medulloblastoma, a cancer of CGNPs. Proliferating CGNPs and medulloblastoma cells inherit neural fate commitment through epigenetic mechanisms. The PRC2 is an epigenetic regulator that has been proposed as a therapeutic target in medulloblastoma. To define PRC2 function in cerebellar development and medulloblastoma, we conditionally deleted PRC2 components Eed or Ezh2 in CGNPs and analyzed medulloblastomas induced in Eed-deleted and Ezh2-deleted CGNPs by expressing SmoM2, an oncogenic allele of Smo. Eed deletion destabilized the PRC2, depleting EED and EZH2 proteins, while Ezh2 deletion did not deplete EED. Eed-deleted cerebella were hypoplastic, with reduced proliferation, increased apoptosis, and inappropriate muscle-like differentiation. Ezh2-deleted cerebella showed similar, milder phenotypes, with fewer muscle-like cells and without reduced growth. Eed-deleted and Ezh2-deleted medulloblastomas both demonstrated myoid differentiation and progressed more rapidly than PRC2-intact controls. The PRC2 thus maintains neural commitment in CGNPs and medulloblastoma, but is not required for SHH medulloblastoma progression. Our data define a role for the PRC2 in preventing inappropriate, non-neural fates during postnatal neurogenesis, and caution that targeting the PRC2 in SHH medulloblastoma may not produce durable therapeutic effects.