bluuebunny/crossref_metadata_2025 huggingface dataset:
Critical Reading Skills in English of Incoming Grade 10 Learners: An Analysis and Interpretation
Authors: Tan Helen Suelto
Published: November 2023

Critical reading encourages students to think more deeply and actively to understand a reading material. It is a manner of broadening one's mind and enhancing their thought process. The study analysed the critical reading skills of Grade 9 students and assessed the difficulties they encountered to shed light and provide valuable solutions in the successful development and improvement of the students critical reading skills. The study utilized a qualitative research design involving Grade 9 learners and English teachers who are employed in a public high school in the Philippines. Data were gathered through the use of semi-structured survey questionnaires, both for Grade 9 learners and teachers. In this study, the researcher used a purposive sampling technique to select the three Grade 9 students, and three English teachers who became part of the study. The findings revealed that students' perception of their reading ability is below average. The majority of the respondents have poor reading skills. In addition to these, students have limited vocabulary and often disassociate themselves to reading. The different strategies used in motivating students to read were presented. The majority of the teacher respondents stated that critical reading skills are part of higher-order thinking skills. Moreover, a shortage in teaching facilities and resources in the classroom are the major factors why students have poor reading ability. Findings revealed that the majority of the teacher respondents claimed that improving critical reading skills of the students can also enhance their reading comprehension skills.
School Leaders’ Ethnographic Reflections: Lessons for Bridging Through the Post-Pandemic Era
Authors: Caño Sheena Aguilar , Lamela Renee , Alcantara Jessica M.
Published: November 2023

In the context of the evolving educational landscape, school leaders hold a pivotal position in ensuring quality education in the post-pandemic. To explore this phenomenon, the researcher employed ethnographic method and thematic analysis to interpret the reflections of secondary school leaders in Masbate province. Key themes and cultural patterns emerged from the data analysis. Along with curriculum and learning, the key theme is the implementation of diverse learning modalities and strategies to address the challenges brought by the pandemic. Health protocols and guidelines were observed. Adaptability within the education sector aligns with the values of Filipino. Further, leadership and governance, such as leadership practices that encompass modeling behavior, investing in teacher potential, and supporting teachers’ initiatives and collaboration, are the cultural patterns. Moreover, continuous improvement highlights the significance of ongoing projects, particularly those who struggle with literacy and numeracy. Passion for crafting projects, data analysis, and technology in forming project designs and enhancing students’ performance is also needed. The strong commitment came out as a cultural pattern. Lastly, with managing resources, prioritize resources for the teaching and learning process, provide opportunities for professional development, allocate financial resources to priority areas, and manage human resources equitably. Flexibility in adapting to changing circumstances while emphasizing accountability and transparency.

Hence, a resilient-collaborative leadership model was crafted to support the existing situation of education in the post-pandemic. However, further studies are encouraged about this phenomenon.
Aplikasi Termodinamika pada Industri Kimia
Authors: Supriyono Supriyono
Published: November 2023

Buku Aplikasi Termodinamika pada Industri Kimia berisi tentang teori yang telah diringkas disertai gambar dan persamaan-persamaan yang digunakan. Buku ini membahas tentang aplikasi rumus termodinamika pada alat-alat industri kimia yang umum dijumpai antara lain aliran fluida pada pipa lurus, nozzle, throttle, pompa, ekspander, kompresor, sistem pembangkit listrik, sistem regeneratif pada pembangkit listrik, turbin gas, mesin pembakaran internal (Otto Engine), mesin pembakaran diesel, sistem pendingin, tangki pencampur cair-cair, tangki pencampur gas-gas, dan tanur pembakaran. Buku ini juga dilengkapi dengan contoh kasus dan pembahasannya berdasarkan data penelitian dan referensi ilmiah lainnya. Pada setiap akhir bab buku ini dilengkapi dengan latihan soal. Setiap contoh soal yang diberikan disertai dengan langkah-langkah penyelesaiannya sehingga akan lebih mudah untuk dipahami. Metode matematis yang disajikan kemudian diaplikasikan untuk menyelesaikan persoalan-persoalan termodinamika pada kasus di industri kimia. Dalam bagian ini, kasus-kasus serta penyelesaiannya dibahas secara detail. Tersusunnya buku ini diharapkan dapat memberikan referensi buku ajar berbahasa Indonesia yang mudah dipahami bagi mahasiswa tentang penyelesaian permasalahan termodinamika pada industri kimia serta juga dapat digunakan sebagai rujukan untuk dosen pengajar mata kuliah matematika teknik kimia agar lebih terarah penyampaian materi, tetapi tetap komprehensif.
Rich Nation, Liberal International: Ideology and Action in Japanese Foreign Aid Policy
Authors: Atkinson Joel
Published: November 2023

Characterizations of foreign aid donors neglect the overarching importance of ideas in determining policy. This article explores Japan’s ideological criteria for foreign aid decision-making, differentiated both between goals and the instruments to achieve them, as well as between ideas in the specific foreground and the general background. Japan continues to operate with a recognizable postwar ideology, which synthesized aspects of an earlier militarist and economic nationalism paradigm with liberal internationalism. In recent years, the perception of a growing threat from China and other changes have catalyzed a shift in Japan’s ODA toward greater securitization and liberal value-orientation; however, aid policy still remains situated within this “Rich Nation, Liberal International” paradigm.
Regional Abyssal Vorticity Balance in the Northeast South China Sea: External and Internal Dynamics of Abyssal Circulation
Authors: Zheng Hua , Zhu Xiao-Hua , Wang Min , Chen Juntian , Nan Feng , Yu Fei
Published: November 2023

Abyssal vorticity balance in the northeast South China Sea was assessed for over a year based on observations from 28 current- and pressure-recording inverted echo sounders distributed west of the Luzon Strait. The regional first-order balance was dominated by the planetary vorticity flux and bottom pressure torque, which reflect the external and internal dynamics of abyssal circulation. Vertical motion considerably contributed to the planetary vorticity flux, whereas the contribution of horizontal motion was negligible. Positive and negative planetary vorticity fluxes dominate the areas along the eastern and western boundaries, indicating upward and downward vertical transport, respectively. The opposite planetary vorticity fluxes in the different areas were accompanied by different current patterns; regional anticyclonic and cyclonic characteristics appeared near the western and eastern boundaries, respectively, owing to the deep topography as the abyssal current followed the boundary. The planetary vorticity flux near the eastern boundary was substantial in spring and autumn; in contrast, along the western boundary it was enhanced only in spring. Deep eddies played important roles in planetary vorticity flux and regional vorticity balance. The results of this study reveal the formation dynamics of abyssal circulation in the South China Sea as well as its spatiotemporal distributions, providing a more detailed description of abyssal circulation.

Significance Statement

The deep South China Sea (SCS) is a nearly enclosed basin characterized by cyclonic abyssal circulation. Based on the observations from 28 current- and pressure-recording inverted echo sounders distributed west of the Luzon Strait, the vorticity balance in the deep SCS was clarified. The planetary vorticity flux and bottom pressure torque maintain a first-order balance of vorticity, which acts as the external and internal dynamics of the abyssal circulation. The study describes the temporal variability and spatial distribution of vorticity terms in the deep ocean west of the Luzon Strait, which may contribute to a more detailed understanding of abyssal circulation formation and its evolution.
Assessment of Medical Education on Transgender Health: A Scoping Literature Review
Authors: Dubin Samuel , Kutscher Eric , Nolan Ian , Levitt Nathan , Cook Tiffany E. , Greene Richard E.
Published: November 2023

Little is known about how physician learners are assessed following educational interventions about providing gender-affirming care to transgender and gender diverse (TGD) people. The inclusion of learner assessments with educational interventions is essential to understand and measure health professionals' knowledge and skills. We seek to describe how the medical literature has approached the assessment of learners following educational interventions about TGD health. A scoping literature review was done. The guiding research question was “What are the current learner-assessment practices in medical education pedagogy about TGD health?” A total of 270 manuscripts were reviewed. 17 manuscripts were included for data extraction. Miller’s pyramid was used to categorize results. 15 used pre- and post-intervention knowledge questionaries to assess learners. Six used simulated patient encounters to assess learners. Most assessments of TGD knowledge and skills among physician learners are pre- and post-surveys. There is sparse literature on higher level assessment following educational interventions that demonstrate learner skills, behaviors, or impact on patient outcomes. Discrete, one-time interventions that are lecture or workshop-based have yet to rigorously assess learners’ ability to provide clinical care to TGD patients that is both culturally humble and clinically astute.
Cupid stealing visual attention - the restoration of Vermeer’s “Girl Reading a Letter at an Open Window” altered viewing behavior
Authors: Hayn-Leichsenring Gregor U. , Rottleb Dana G.
Published: November 2023

A major restoration of Vermeer's “Girl Reading a Letter at an Open Window” revealed a painting of cupid on the back wall that had been overpainted. The uncovering of this painting within a painting changed the composition of the artwork. We performed an eye tracking study on digital representations of the painting to investigate how the restoration altered the way people perceive this artwork. We show that the painting of cupid draws visual attention from the letter and that viewing behavior depends on knowledge of the other version of the painting. Moreover, lay people prefer the version without cupid.
Acceptance of electronic medical records and associated factor among physicians working in University of Gondar comprehensive specialized hospital: A cross-sectional study
Authors: Kasaye Mulugeta Desalegn , Mengestie Nebyu Demeke , Beyene Sara , Kebede Natnael , Ngusie Habtamu Setegn , Kalayou Mulugeta Hayelom
Published: November 2023

Objective

Electronic Medical Records (EMRs) are digitalized medical record systems that collect, store, and display patient data. It is individual patient clinical information electronically gathered and made instantly available to all physicians in the healthcare chain, assisting in the delivery of coherent and consistent care. However, the acceptance of the electronic medical record status of physicians in Ethiopia is limitedly known due to knowledge, attitude, and computer skill gaps. This study aims to assess the acceptance of electronic medical records and associated factors among physicians working in Ethiopia.

Methods

A cross-sectional study was conducted among physicians working in Gondar Comprehensive Specialized Hospital. A total of 205 physicians were included. Data were collected through a self-administered structured questionnaire. Descriptive and Logistic regression were conducted.

Result

A one hundred ninety-eight participants returned the questionnaire from the total yielding a response rate of 96.6%. The proportion of those who have good acceptance for EMR was 72.2% and about 48.5%, 78.3%, and 59.6%, were sufficient computer skills, Good knowledge, and a favorable attitude toward EMR respectively. Age ≤ 30 years (AOR =  0.13 (0.02, 0.57), working experience AOR = 0.15 (0.04, 0.54), working department AOR = 0.09 (0.01, 0.90), good computer skills AOR = 8.42 (6.45, 16.02), Good knowledge AOR = 5.21 (1.22, 12.28), and favorable attitude AOR = 15.24 (12.06, 25.94) were significantly associated towards EMR acceptance.

Conclusion

Generally, in this study, physicians’ acceptance of electronic medical records was good. Age, year of experience, working department, good computer skills, good knowledge, and favorable attitude were significantly associated with physicians’ acceptance of the electronic medical record. Improving computer skills, enhancing positive attitudes, and increasing the knowledge of the health care professionals are vital interventions to enhance and improve the acceptance of EMR system in the study area
Safety evaluations of alternansucrase enzyme expressed in Escherichia coli shows no adverse effects invivo and invitro
Authors: Rathi Ankit , Chandan Harshada , Vira Chaitali , Pore Mukul P
Published: November 2023

Background

Alternansucrase is a glucansucrase enzyme that mainly functions in synthesis of glucan-like polysaccharides and can be used for production of novel oligosaccharides and polysaccharides having low glycemic index and prebiotics properties which makes them ideal candidates as dietary fibers and food. From a regulatory perspective, it is necessary to prove the safety of alternansucrase before it can be used in any application as it is a novel enzyme and has not been historically used in food processing.

Objectives

Alternansucrase obtained from Escherichia coli was subjected to toxicological tests to determine its safety for use in various industrial applications.

Design

Toxicity studies were conducted at acute oral and repeated sub-chronic (14 days and 90 days) levels in rats following the OECD guidelines. The genotoxicity studies were conducted using the bacterial reverse mutation test as well as in vitro mammalian cell micronucleus test as per the OECD guidelines.

Results

Alternansucrase did not induce any clinical abnormalities or mortality in rats at the dose level of 2000 mg/kg of body weight in the acute oral toxicity test. A 90-day sub chronic repeated dose oral toxicity study with alternansucrase at and up to dose of 1000 mg TOS/kg of body weight did not show any treatment-related significant toxicological effects on body weight, food consumption, organ weights, hematological and clinical chemistry, or histopathology parameters. Alternansucrase was found to be non-mutagenic up to 5000 µg TOS/plate concentration in the bacterial reverse mutation test. Alternansucrase was determined to be non-clastogenic and non-aneugenic up to the test concentration of 1250 µg TOS/mL during the in vitro mammalian cell micronucleus test.

Conclusion

The lethal dose (LD50) based on this study is greater than 2000 mg/kg body weight, which falls into the category 5 criteria of Globally Harmonized System (GHS). No-Observed-Adverse-Effect-Level (NOAEL) was concluded to be greater than 1000 mg TOS/kg per day. The studies taken together substantiate the safety of alternansucrase enzyme in various food and associated industries. The present study paves a future for safe use of alternansucrase in varied industrial applications.
The Sonographic Detection of an Obstructive Pelvic Lymphocele
Authors: Benjamin Evan , Siegelbaum Robert
Published: November 2023

Pelvic lymphoceles are collections of leaked lymphatic fluid which can be postsurgical complications. These are most prevalent following a radical prostatectomy with simultaneous pelvic node dissection to address prostate cancer. Although a common occurrence after this type of procedure, a small percentage may cause significant complications, including deep vein thrombosis. This case study demonstrated an obstructive pelvic lymphocele that was incidentally detected with sonography, during a lower extremity venous Doppler examination.
Leaf phenotypic variation and its response to environmental factors in natural populations of Eucommia ulmoides
Authors: Gong Huimin , Yang Min , Wang Chaochun , Tian Chunlian
Published: November 2023

Background

Eucommia ulmoides leaves have high medicinal and economic value as a dual-purpose substance for medicine and food. Employing leaves from 13 natural populations of Eucommia ulmoides as research objects, this study reveals the variation patterns of intra-specific and inter-specific trait variation and explores the response of leaf characteristics to geographical and climatic changes, aiming to provide a scientific basis for the efficient utilization of leaf resources and the breeding of superior varieties.

Results

Descriptive statistical analysis and nested analysis of variance showed significant differences in 11 leaf traits of Eucommia ulmoides inter-populations and intra-populations, with an average coefficient of variation of 17.45%. The coefficient of variation for average leaf phenotypic traits is 20.77%, and the leaf phenotypic variation is mainly from the variation intra-populations. Principal component analysis reveals that the cumulative contribution rate of the top three principal components which mainly contributed to the phenotypic variation of Eucommia ulmoides leaves reached 74.98%, which could be sorted into size traits (34.57%), color traits (25.82%) and shape traits (14.58%). In addition, correlation analysis expresses there is a specific co-variation pattern among leaf traits, with a strong connection between shape, size, and color traits. Geographic and climatic distances are significantly correlated, and mantel test and correlation analysis indicate that leaf traits of Eucommia ulmoides are mainly influenced by altitude. With the increase of altitude, the leaves become smaller. Partial correlation analysis shows that after controlling climate factors, the correlation between some characters and geographical factors disappears significantly. Temperature and precipitation have a great influence on the variation of leaf phenotypic traits, and the larger the leaves are in areas with high temperature and heavy rainfall.

Conclusions

These findings contribute to a further understanding of the leaf morphological characteristics of Eucommia ulmoides and the extent to which the environment influences leaf trait variation. They can provide a scientific basis for the protection and application of Eucommia ulmoides leaf resources in the future.
The effects of walking aids on shoulder joint kinematics in older persons: an initial study
Authors: Yang Jiemeng , Mo Zhongjun , Zhang Yanyu , Ji Run , Tao Chunjing , Fan Yubo
Published: November 2023

Background

Many older persons with degenerative physical functions use walking aids to improve their ambulation ability. The aim of this study was to investigate the effects of walking aids with different configurations on shoulder joint motion in older persons.

Methods

The 3D motion capture system VICON was applied to collect data on gait parameters and shoulder motion characteristics of 6 older persons walking either independently or with the assistance of a footed walking frame and a wheeled walking frame. The different effects of walking aids on gait parameters and the shoulder joint motion of older individuals were quantitatively analyzed.

Results

The gait parameters of the older individuals changed significantly when they used walking frames to assist walking. Compared to independent walking, the range of motion of the shoulder joint was reduced by 79.92% in flexion when walking with a wheeled walking frame. Meanwhile, the range of motion in flexion, extension, and external rotation increased by 76.04%, 85.55%, and 110.99%, respectively, when walking with a footed walking frame.

Conclusion

The motion characteristics of shoulder joints in older persons were significantly affected by using different walking aids. These changes in shoulder joint motion characteristics will lead to potential diseases related to the shoulder musculoskeletal system. These findings are beneficial to determine a walking aid for older people.
Epstein-Barr virus reactivation is not causative for post-COVID-19-syndrome in individuals with asymptomatic or mild SARS-CoV-2 disease course
Authors: Hoeggerl Alexandra Domnica , Nunhofer Verena , Lauth Wanda , Badstuber Natalie , Held Nina , Zimmermann Georg , Grabmer Christoph , Weidner Lisa , Jungbauer Christof , Lindlbauer Nadja , Neureiter Heidrun , Ortner Tuulia , Flamm Maria , Osterbrink Jürgen , Rohde Eva , Laner-Plamberger Sandra
Published: November 2023

Purpose

Post-COVID-19-Syndrome (PCS) frequently occurs after an infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, the understanding of causative mechanisms is still limited. Aim of this study was to determine the PCS rate among SARS-CoV-2 seropositive blood donors as representatives of supposedly healthy adults, who had experienced an asymptomatic or mild COVID-19 disease course, and to examine whether Epstein-Barr virus (EBV) is reactivated in individuals reporting PCS.

Methods

The PCS rate was determined using questionnaires that included questions about infection and persistent symptoms. Pre-pandemic blood samples and samples collected at regular, pre-defined times after a SARS-CoV-2 infection were analysed for neopterin, a marker for antiviral immune responses, by an enzyme-linked immunosorbent assay (ELISA). Additionally, we determined the rate of SARS-CoV-2 anti-N total antibodies using an electrochemiluminescence immunoassay (ECLIA). Furthermore, quantitative real-time polymerase chain reaction (qPCR) to detect EBV DNA and ECLIA screening for EBV viral capsid-antigen (VCA) IgM, IgG and EBV nuclear antigen 1 (EBNA) IgG were performed.

Results

Our data reveal that 18% of all infections result in PCS, with symptoms lasting for up to one year. In individuals reporting PCS, no elevated levels of neopterin were detected, indicating no persisting pro-inflammatory, antiviral immune response. SARS-CoV-2 antibody levels were declining in all participants in comparable manner over time, pointing to a successful virus clearance. In individuals with PCS, no EBV DNA could be detected. Furthermore, no differences in EBV specific antibody levels could be shown in PCS groups compared to non-PCS groups.

Conclusion

Our data suggest that PCS in per se healthy, immunocompetent adults cannot be ascribed to a reactivation of EBV.
ESCO2 promotes hypopharyngeal carcinoma progression in a STAT1-dependent manner
Authors: Hu Juan , Yan Jing , Chen Yijie , Li Xiaohui , Yang Liu , Di Haiyu , Zhang Huihui , Shi Yewen , Zhao Junjie , Shi Yanxia , Xu Yinglong , Ren Xiaoyong , Wang Zhenghui
Published: November 2023

Background

The establishment of sister chromatid cohesion N-acetyltransferase 2 (ESCO2) is involved in the development of multiple malignancies. However, its role in hypopharyngeal carcinoma (HPC) progression remains uncharacterized.

Methods

This study employed bioinformatics to determine the ESCO2 expression in head and neck squamous cell carcinoma (HNSC) and normal tissues. In vitro cell proliferation, migration, apoptosis, and/or cell cycle distribution assays were used to determine the function of ESCO2 and its relationship with STAT1. Xenograft models were established in nude mice to determine ESCO2 in HPC growth in vivo. Co-immunoprecipitation/mass spectrometry (Co-IP/MS) was conducted to identify the potential ESCO2 binding partners.

Results

We found that ESCO2 expression was elevated in HNSC tissues, and ESCO2 depletion suppressed tumor cell migration in vitro and inhibited tumor growth in vitro and in vivo. Co-IP/MS and immunoblotting assays revealed the interaction between ESCO2 and STAT1 in HPC cells. STAT1-overexpression compromised ESCO2-mediated suppressive effects on HPC cell proliferation, viability, and migration.

Conclusions

These findings suggest that ESCO2 is crucial in promoting HPC malignant progression through the STAT1 pathway and provides novel therapeutic targets for HPC treatment.
Influence of bone density on stability in TBW
Authors: Bischoff Fabian R. , Tille Eric , Beyer Franziska , Bota Olimpiu , Biewener Achim , Nowotny Jörg
Published: November 2023

Osteoporosis is a common disease that leads to a reduction in bone density and increases the risk of fractures. Stable surgical treatment is particularly important for these fractures. The aim of this study was to examine the influence of bone density in the area of ​​the proximal ulna on the failure of the fixation technique of K-wires in tension band wiring (TBW). We provided 10 ulna specimens with TBW and biomechanically examined the pull-out strength of bi- and tricortical K-wires. Bone density measurement was performed using qCT. In the paired t-test, the tricortical group showed a significantly higher pull-out strength in relation to bone density than the bicortical group (p = 0.001). Furthermore, the Pearson correlation showed a high influence of bone density on pull-out strength in the tricortical group (r = 0.544), but without significance (p = 0.100).

Our work shows that bone density has a direct effect on the pull-out strength of K-wires in TBW. TBW should therefore be used as osteosynthesis technique, especially in young patients with non-osteoporotic bones. In the case of osteoporotic fractures, alternative procedures should be preferred.
Supplementary orthopaedic screening for children and adolescents to prevent permanent skeletal deformities – protocol for the “OrthoKids” study
Authors: Scheckel B. , Naumann M. , Simic D. , Stock S. , Loose O. , Breig M. , Albrecht K. , Braun K. , Kucher R. , Deininger S. , Schmid L. , John M. , Grohnert A. , Giertz C. , Wirth T.
Published: November 2023

Background

Skeletal deformities (SD) in children and adolescents can lead to arthritic conditions, impairment of quality of life, and high treatment costs in the long term. However, comprehensive data on the prevalence of SDs in children and adolescents are limited and it remains therefore unclear whether there is a healthcare gap. “OrthoKids” is a project that addresses this evidence gap by implementing an orthopaedic screening for children and adolescents that supplements existing detection examinations within statutory standard care in Germany.

Objective

To detect SDs so that they can be treated as needed at an early stage.

Methods

The implementation of the supplementary orthopaedic screening will be evaluated through an exploratory cohort study that is set up in the German state Baden-Wuerttemberg. 20,000 children and adolescents aged 10 to 14 years will be recruited as a prospective cohort. A retrospective control cohort will be formed based on claims data provided by two cooperating statutory health insurances (SHIs). Participating children and adolescents receive a one-time orthopaedic screening. If at least one SD is diagnosed, treatment will be provided as part of the statutory standard care. Within the scope of the project, a follow-up examination will be performed after one year. An IT-platform will complement the study. The primary outcome measure is the point prevalence of scoliosis, genu varum/valgum, hip dysplasia, and flat feet. Secondary outcome measures are (i) the point prevalence of further less common SDs, (ii) health-related quality of life (HRQoL), (iii) sports ability based on activity (physical/athletic), physical constraints, and (sports) injuries, as well as (iv) monetary consequences of the orthopaedic screenings’ implementation. Implementation determinants will be evaluated, too.

Discussion

If the supplementary orthopaedic screening proves to be viable, it could be considered as a supplementary examination for children and adolescents within the frame of SHI in Germany. This could relieve the burden of disease among children and adolescents with SDs. In addition, it could disburden SHIs in the medium to long term.

Trial registration

The OrthoKids study was registered in the German Clinical Trials Registry (Deutsches Register Klinischer Studien (DRKS)) on 26th July 2022 under the number 00029057.
Nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure: a context-based study
Authors: Akbarian-Rokni Mostafa , Mardani-Hamooleh Marjan , Abbasi Mohammad , Seyedfatemi Naima , Pezaro Sally
Published: November 2023

Background

High quality end-of-life care is essential. Yet for those experiencing heart failure, the provision of high-quality end- of -life care can be challenging. The aim of this study was to explore Iranian nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure.

Methods

Conventional content analysis was used to analyze qualitative data collected from nurses (n = 33) using semi-structured and individual interviews. Participants were aged between 29 and 51 years. The majority of participants were women (n = 20). Most had a bachelor’s degree (n = 24), and work experience of between 7 and 18 years.

Results

Nurses challenges in providing end-of-life care to those with heart failure included (1) adverse consequences relating to compassion fatigue and continued futility in care and (2) lack of palliative care services with regards to a lack of specialists, lack of support from health systems, and poor teamwork.

Conclusions

This is the first qualitative study to explore Iranian nurses’ challenges in providing end-of-life care to those with heart failure. Investment is required in education and research in this area. Particular attention must be paid to prevention of compassion fatigue. Law changes would enable the delivery of higher-quality palliative care in this context overall.
Healthcare workers safety in the COVID-19 era: the impact of pre-pandemic personal protective equipment (PPE) training in Pakistan
Authors: Haq Zia Ul , Sher Zarghona Fazal , Khattak Farhad Ali , Zala  , Hakim Muhammad , Ullah Naeem , Rahim Abid , Hussain Umar , Afaq Saima
Published: November 2023

Background

The COVID-19 pandemic has revealed vulnerabilities in healthcare systems worldwide, emphasizing the importance of healthcare worker safety through adequate utilization of personal protective equipment (PPE). This study aims to assess the impact of pre-pandemic PPE training on the practices and other associated factors among frontline healthcare workers during the COVID-19 pandemic in Pakistan and provide insights into the implications of such training programs for future initiatives.

Methods

A cross-sectional study from May 9th to June 5th, 2020 was conducted among the frontline healthcare workers against COVID-19 in Pakistan, utilizing an online structured questionnaire shared via WhatsApp and Facebook by using purposive sampling. Statistical analyses, including chi-square tests for proportion and logistic regression for the association while multi-logistic regression for potential confounders, were performed using SPSS version 22.

Results

A total of 453 healthcare staff participated, with 68.9% (n = 312) reporting no prior PPE training and 31.1% (n = 141) having received training. Significant associations were found between prior training and healthcare group distribution (p = 0.006), with doctors exhibiting the highest proportion of training 82 (37.61%), followed by nurses 50 (27.32%) and paramedics 9 (17.31%). Those who didn’t receive any prior training in PPEs showed a higher perceived professional risk of 216 (69.23%) compared to those who received prior PPE training 96 (30.77%, p-value 0.005). Similarly, a higher frequency 137 (63.72%) of Perceived Personal risk was observed in those who didn’t receive training, labeled as “high risk” compared to those who were trained 78 (36.28%, P value 0.02). Multi-logistic regression analysis identified paramedics as 0.26 times less likely to have received prior PPE training (Adjusted OR 0.26, 95% CI 0.10–0.65, p = 0.01) compared to medical doctors. Healthcare workers in tertiary care hospitals were 0.46 times less likely to undergo PPE training (Adjusted OR 0.46, 95% CI 0.25–0.87,p = 0.01) compared to those working at COVID-19 facilities/hospitals/quarantine centers. Likewise, individuals who doffed disposable gowns [Adjusted OR 3.86, (95% CI, 1.23–12.08, p = 0.02] were 3.86 times more interested in getting prior training in PPE compared to those who don’t have skills to wear them.

Conclusion

Our findings highlight that healthcare levels, type of healthcare, and doffing skills are important predictors of whether healthcare workers have taken prior training in PPE. These findings imply developing effective training programs for healthcare workers to ensure safety while providing care during pandemics like COVID-19.
Standardizing post-cardiac arrest care across rural–urban settings – qualitative findings on proposed post-cardiac arrest learning community intervention
Authors: May Teresa L , Siladi Skye , Daley Alison L , Riker Richard , Zanichkowsky Rita , Burla Michael , Swan Erica , Talbot Jean A
Published: November 2023

Background

Standardization of post-cardiac arrest care between emergency department arrival and intensive care unit admission can be challenging, particularly for rural centers, which can experience significant delays in interfacility transfer. One approach to addressing this issue is to form a post-cardiac arrest learning community (P-CALC) consisting of emergency department (ED) and intensive care unit (ICU) physicians and nurses who use data, shared resources, and collaboration to improve post-cardiac arrest care. MaineHealth, the largest regional health system in Maine, launched its P-CALC in 2022.

Objective

To explore P-CALC participants’ perspectives on current post-cardiac arrest care, attitudes toward implementing a P-CALC intervention, perceived barriers and facilitators to intervention implementation, and implementation strategies.

Methods

We conducted semi-structured, individual, qualitative interviews with 16 staff from seven system EDs spanning the rural–urban spectrum. Directed content analysis was used to discern key themes in transcribed interviews.

Results

Participants highlighted site- and system-level factors influencing current post-cardiac arrest care. They expressed both positive attitudes and concerns about the P-CALC intervention. Multiple facilitators and barriers were identified in regard to the intervention implementation. Five proposed implementation strategies emerged as important factors to move the intervention forward.

Conclusions

Implementation of a P-CALC intervention to effect system-wide improvements in post-cardiac arrest care is complex. Understanding providers’ perspectives on current care practices, feasibility of quality improvement, and potential intervention impacts is essential for program development.
Leveraging transcriptomics to develop bronchopulmonary dysplasia endotypes: a concept paper
Authors: Moreira Alvaro G. , Arora Tanima , Arya Shreyas , Winter Caitlyn , Valadie Charles T. , Kwinta Przemko
Published: November 2023

Impact

Bronchopulmonary dysplasia has multiple definitions that are currently based on phenotypic characteristics. Using an unsupervised machine learning approach, we created BPD subclasses (e.g., endotypes) by clustering whole microarray data. T helper 17 cell differentiation was the most significant pathway differentiating the BPD endotypes.

Introduction

Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Discovery of BPD endotypes in an unbiased format, derived from the peripheral blood transcriptome, may uncover patterns underpinning this complex lung disease.

Methods

An unsupervised agglomerative hierarchical clustering approach applied to genome-wide expression of profiling from 62 children at day of life five was used to identify BPD endotypes. To identify which genes were differentially expressed across the BPD endotypes, we formulated a linear model based on least-squares minimization with empirical Bayes statistics.

Results

Four BPD endotypes (A, B,C,D) were identified using 7,319 differentially expressed genes. Across BPD endotypes, 5,850 genes had a p value < 0.05 after multiple comparison testing. Endotype A consisted of neonates with a higher gestational age and birthweight. Endotypes B-D included neonates between 25 and 26 weeks and a birthweight range of 640 to 940 g. Endotype D appeared to have a protective role against BPD compared to Endotypes B and C (36% vs. 62% vs. 60%, respectively). The most significant pathway focused on T helper 17 cell differentiation.

Conclusion

Bioinformatic analyses can help identify BPD endotypes that associate with clinical definitions of BPD.
Efficacy and nephrotoxicity of polymyxin B in elderly patients with carbapenem resistant bacterial infection
Authors: Xia G. L. , Xu X. , You X. B. , Wang X. , Feng D. D. , Lei S. , Jiang R. L.
Published: November 2023

Background

To study the efficacy and nephrotoxicity of polymyxin B in the treatment of elderly patients with carbapenem-resistant organism (CRO) infection.

Methods

The clinical and microbiological data of patients with CRO-infected sepsis treated with polymyxin B were retrospectively analyzed. The effective rate, bacterial clearance, incidence and recovery rate of acute renal injury (AKI) and prognosis-related indicators in AKI at different stages were compared.

Results

The effective rate of 215 elderly patients with CRO infection treated with polymyxin was 50.7%. The total bacterial clearance rate was 44.2%, the total incidence of AKI was 37.2%, the recovery rate of AKI was 35%, and the incidence range of polymyxin B-related AKI was 10.2–37.2%. Logistic multivariate regression analysis showed that the predictors of AKI in elderly patients were high APACHE II score, long duration of polymyxin, chronic renal insufficiency and ineffective outcome; the ROC curve showed that the cutoff value for predicting AKI was a serum creatinine concentration of 73 mmol/L before polymyxin B use, and the AUC was 0.931.

Conclusions

Rational use of polymyxin B is safe and effective in elderly patients with CRO infection, and its effective outcome can improve the recovery rate of AKI.
Mannose-doped metal-organic frameworks induce tumor cell pyroptosis via the PERK pathway
Authors: Jin Nianqiang , Wang Binhang , Liu Xinyao , Yin Chengcheng , Li Xing , Wang Zilin , Chen Xi , Liu Yunling , Bu Wenhuan , Sun Hongchen
Published: November 2023

Background

The implementation of pyroptosis exhibits significant potential as a tactic to enhance tumor immune microenvironments. Previous applications of pyroptosis inducers have encountered various limitations, such as the development of drug resistance, manifestation of toxic side effects, and a deficiency in targeting capabilities. As a result, there is a growing demand for tumor therapeutic molecules that can overcome these obstacles. Therefore, the objective of this study is to develop a multifunctional nanospheres that addresses these challenges by enabling high-precision targeting of tumor cells and inducing effective pyroptosis.

Results

We prepared a mannose-modified MOF called mannose-doped Fe3O4@NH2-MIL-100 (M-FNM). M-FNM could enter CAL27 cells through MR-mediated endocytosis, which caused in a significant increase in the level of intracellular ROS. This increase subsequently triggered ER stress and activated the PERK-eIF2α-ATF4-CHOP signaling pathway. CHOP then mediated the downstream cascade of Caspase-1, inducing pyroptosis. In in vivo experiments, M-FNM demonstrated excellent targeting ability and exhibited anti-tumor effects. Additionally, M-FNM reshaped the immune microenvironment by promoting the infiltration of anti-tumor immune cells, primarily T lymphocytes.

Conclusions

M-FNM significantly decreased tumor growth. This novel approach to induce pyroptosis in tumor cells using M-FNM may offer new avenues for the development of effective immunotherapies against cancer.
Clinical characteristics and prognostic factors for primary pediatric and adolescent Non-Hodgkin Lymphomas of the gastrointestinal tract: a population-based study
Authors: Wu Peng , Zhu Dongsheng , Lou Yi , Wang Xinxin
Published: November 2023

Purpose

To investigate the clinical features and survival outcomes of primary gastrointestinal non-Hodgkin lymphomas (PGINHL) in pediatric and adolescent population, we conducted a population-based cohort study.

Methods

All pediatric and adolescent patients with PGINHL diagnosed between 2000 and 2019 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplane-Meier estimations were used to generate survival curves based on various criteria. To compare survival curves, the log-rank test was applied. A multivariate Cox proportional hazards model was developed to investigate the effect of each component on overall survival.

Results

A total of 334 pediatric and adolescent with PGINHL patients were identified. The median age at diagnosis was 12 years (range 1.0–19 years). Tumors were most commonly found in the small bowel (47.3%), followed by the large bowel (42.8%) and the stomach (9.9%). Overall, the most common histological subtype was Burkitt lymphoma (56.9%), followed by diffuse large B-cell lymphoma (DLBCL) (27.8%). Overall survival rates for all patients were 92.2% at 5- year and 91.6% at 10- year, respectively. The Cox proportional hazard regression revealed that only chemotherapy was an important independent predictor in this model. Patients with chemotherapy have a higher survival rate than those without.

Conclusions

Our study revealed that only chemotherapy was found to be the most important predictor of the OS in pediatric and adolescent PGINHL, providing critical information for therapeutic care.
Ethnobotanical study of traditional forage plants in the Gansu–Ningxia–Inner Mongolia junction zone: conservation and sustainable utilization for animal husbandry
Authors: Xie Jian , Liu Xiaoqi , Luo Mingxia , Liu Fusong , Liu Sha , Zhao Yongxia , Zhang Xingsheng , Zhao Wenji , Wu Faming
Published: November 2023

Introduction

This study aims to safeguard the ethnobotanical knowledge pertaining to traditional forage plants within the ethnically diverse Gansu–Ningxia–Inner Mongolia junction zone. It seeks to establish a foundation for the sustainable utilization of these traditional resources for animal husbandry.

Methods

A combination of literature research, village interviews, participatory observation, and ethnobotanical quantitative evaluation methods was employed to investigate and study the traditional knowledge of wild forage plants used by local residents in the study area.

Results

Local residents provided information on 73 forage plants, which were identified as 116 distinct wild forage plant species. These plants belong to 22 families and play an active role in the lives of the local inhabitants. Notably, the families Poaceae, Fabaceae, and Asteraceae are prominent, comprising the most abundant and widely utilized wild forage plants. Bing Cao (collectively referring to plants of the Agropyron, Leymus, and Psammochloa), Suo Cao (collectively referring to plants of the genus Stipa), and Ku Cai (encompassing Lactuca tatarica (L.) C.A.Mey. and Ixeris polycephala Cass.) emerge as the most representative and vital wild forage plants for animal husbandry. Additionally, plants within the Astragalus (referred to collectively as NiaoZi by local residents) in the Fabaceae family, as well as plants from the Amaranthaceae family, exhibit notable significance.

Conclusion

Animal husbandry assumes a pivotal role in the local agricultural economy, and the 116 wild forage plants investigated hold substantial importance in its development. Among these, 59 and 103 plant resources display high developmental potential, making them prospective candidates for high-quality cultivated forage grasses. Additionally, extensive grazing practices have resulted in significant ecological degradation within this already fragile ecosystem. The cultivation of forage grasses and the practice of pen-based animal husbandry may emerge as crucial strategies for sustainable development in this area.
Dissecting the autism-associated 16p11.2 locus identifies multiple drivers in neuroanatomical phenotypes and unveils a male-specific role for the major vault protein
Authors: Kretz Perrine F. , Wagner Christel , Mikhaleva Anna , Montillot Charlotte , Hugel Sylvain , Morella Ilaria , Kannan Meghna , Fischer Marie-Christine , Milhau Maxence , Yalcin Ipek , Brambilla Riccardo , Selloum Mohammed , Herault Yann , Reymond Alexandre , Collins Stephan C. , Yalcin Binnaz
Published: November 2023

Background

Using mouse genetic studies and systematic assessments of brain neuroanatomical phenotypes, we set out to identify which of the 30 genes causes brain defects at the autism-associated 16p11.2 locus.

Results

We show that multiple genes mapping to this region interact to regulate brain anatomy, with female mice exhibiting far fewer brain neuroanatomical phenotypes. In male mice, among the 13 genes associated with neuroanatomical defects (Mvp, Ppp4c, Zg16, Taok2, Slx1b, Maz, Fam57b, Bola2, Tbx6, Qprt, Spn, Hirip3, and Doc2a), Mvp is the top driver implicated in phenotypes pertaining to brain, cortex, hippocampus, ventricles, and corpus callosum sizes. The major vault protein (MVP), the main component of the vault organelle, is a conserved protein found in eukaryotic cells, yet its function is not understood. Here, we find MVP expression highly specific to the limbic system and show that Mvp regulates neuronal morphology, postnatally and specifically in males. We also recapitulate a previously reported genetic interaction and show that Mvp+/−;Mapk3+/− mice exhibit behavioral deficits, notably decreased anxiety-like traits detected in the elevated plus maze and open field paradigms.

Conclusions

Our study highlights multiple gene drivers in neuroanatomical phenotypes, interacting with each other through complex relationships. It also provides the first evidence for the involvement of the major vault protein in the regulation of brain size and neuroanatomy, specifically in male mice.