bluuebunny/crossref_metadata_2025 huggingface dataset:
Politicizing and humanizing management learning and education with Paulo Freire
Authors: Barros Amon , Bristow Alexandra , Contu Alessia , Wanderley Sergio , Prasad Ajnesh
Published: January 2024

Paulo Freire is widely acknowledged as one of the leading 20th-century philosophers of education. Freire’s ideas have been leveraged by scholars across the social sciences, including in the field of organization studies where it has come to inform extant understandings of management learning and education. While such engagements with Freire have enriched many germane discourses in our field, we have yet to excavate the full potential of his writings. This special issue aims to remedy this oversight by illuminating myriad promising trajectories through which scholars in organization studies can return to Freire’s ideas with the intention of enhancing the future of management learning and education.
Numerical modelling of ventilation strategies for mitigating cough particles transmission and infection risk in hospital isolation rooms
Authors: Korany Hussein Zein , Almhafdy Abdulbasit , AlSaleem Saleem S , Cao Shi-Jie
Published: January 2024

This study used numerical modelling to analyze air velocity, cough particle distribution and infection risks in an isolation room. It investigated air change rates, inlet/outlet vent positioning and assessed various ventilation rates and outlet configurations for reducing infection risks. Quantitative assessments revealed different particle escape timings. In Case 1, smaller particles (2–4  μm) took 8.2 s to escape, while in Case 2, this time extended to 22.7 s. At 48 ACH, there were significant improvements in removing particles of various sizes, particularly those sized 2–4  μm, 16–24  μm and 40–50  μm, reducing the infection risk. The use of the Wells-Riley model highlighted considerable reductions in infection probabilities with higher ACH. Specifically, infection risks were reduced to 5% in Case 1 and 17% in Case 2, underscoring the marked advantage of Case 1 in reducing infection probabilities, particularly for smaller particles. Furthermore, escalated ACH values consistently correlated with decreased infection probabilities across all particle sizes, highlighting the pivotal role of ventilation rates in mitigating infection risks. The study comprehensively investigated the distribution of air velocity, dynamics of cough particles and infection risk associated with different ventilation strategies in isolation rooms.
Metal allergy and neurovascular stenting: A systematic review
Authors: Vaishnav Dhrumil , Essibayi Muhammed Amir , Toma Aureliana , Liriano Genesis , Perkash Raja Sandeep , Stock Ariel , Holland Ryan , Dmytriw Adam A , Wolfe Stacey Q , Al Kasab Sami , Spiotta Alejandro , Haranhalli Neil , Altschul David J
Published: January 2024

Background

Intracranial stents and flow diverters contain significant amounts of metals, notably nickel, which can cause allergic reactions in a considerable portion of the population. These allergic responses may lead to complications like in-stent stenosis (ISS) and TIA/Stroke in patients receiving stents or flow diverters for intracranial aneurysms.

Methods

We conducted a systematic review of studies from inception until July 2023, which reported outcomes of patients with metal allergy undergoing neurovascular stenting. The skin patch test was used to group patients into those with positive, negative, or absent patch test results but with a known history of metal allergy.

Results

Our review included seven studies with a total of 39 patients. Among them, 87% had a history of metal allergy before treatment. Most aneurysms (89%) were in the anterior circulation and the rest (11%) were in the posterior circulation. Skin patch tests were performed in 59% of patients, with 24% showing positive results and 33% negative. Incidental ISS was observed in 18% of patients, and the rate of TIA/Stroke was reported in 21%. The pooled rates of ISS and TIA/Stroke were higher in the first group (43% and 38%) compared to the second (18% and 9%) and third groups (15% and 15%), but these differences were not statistically significant.

Conclusions

The current neurosurgical literature does not provide a conclusive association between metal allergy and increased complications among patients undergoing neurovascular stenting. Further studies are necessary to gain a more comprehensive understanding of this topic.
The effect of temperature on the transfer layer of an aluminium alloy on tool steel and the effect of CrN coating
Authors: Kalin Mitjan , Jerina Jure , Sharma Sandan Kumar , Kovač Janez
Published: January 2024

It is essential to explore temperature's crucial role while unveiling the intricacies of tribological interplay in CrN-coated steel-alloy systems. In the present study, tribological potential of CrN-coated hot-work tool steel was investigated under unidirectional single-pass sliding wear conditions. The sliding wear tests were performed at different temperatures (i.e., 20 °C, 100 °C, 200 °C, 300 °C, 400 °C and 500 °C) for the different sliding distances between 2 mm and 68 mm to explore the effect of temperature on the initiation and evolution of the transfer of an aluminium alloy (EN AW-6060). The effect was studied in terms of the contact area of the aluminium alloy and the volume transferred to the surface of the CrN. In addition, the structure of the wear trace and the equivalent friction coefficient were monitored with respect to the sliding distance and the temperature. The results show the strong dependency of the tribological potential of the CrN coating and the aluminium alloy on the temperature but show insignificant dependency on the sliding distance. When sliding up to 200 °C, the transfer was found to be dependent on the surface roughness of the coating, while strong adhesion led to the aluminium alloy's transfer during sliding at higher temperatures, that is, above 300 °C. At 500 °C, the CrN coating formed a self-protective Cr2O3 oxide that reduced the adhesive transfer of the alloy to the CrN compared to that at 200 °C–300 °C.
Prevalence of Scarpa’s ganglion enhancement on high-resolution MRI imaging
Authors: Siminski Clayton , Benson John C , Carlson Matthew L , Lane John I
Published: January 2024

Background and Purpose

The vestibular ganglion, or Scarpa’s ganglion, is a cluster of afferent vestibular neurons within the internal auditory canal (IAC). There is minimal literature describing enhancement of this region on magnetic resonance imaging (MRI) and its correlation to clinical symptoms. Here, we sought to find the prevalence of enhancement at Scarpa’s ganglion, and determine whether such enhancement correlates with demographics or clinical symptoms.

Materials and Methods

A retrospective review was performed of consecutive patients with an MRI of the IAC between 3/1/2021 and 5/20/2021. Two neuroradiologists independently reviewed for T1 and FLAIR enhancement of the Scarpa’s ganglion on post-contrast fat-saturated T1 and post-contrast FLAIR images. Discrepancies were agreed upon by consensus. Clinical variables (hearing loss, vestibular symptoms, tinnitus, and MRI indication) were gathered from a retrospective chart review.

Results

Eighty-nine patients were included (51 female); the mean age was 58 (range 19–85). The most common MRI indication was hearing loss ( n = 53). FLAIR enhancement was present on the right in 7 patients, on the left in 7 patients, and bilaterally in 6 patients. No enhancement was seen on post-contrast T1 images. There was no statistically significant correlation between consensus FLAIR on at least one side and age ( p = .74), gender ( p = .29), hearing loss ( p = .32), hearing loss side ( p = .39), type of hearing loss ( p = .87), vestibular symptoms ( p = .71), or tinnitus ( p = .81).

Conclusions

Enhancement is present in the minority of patients on post-contrast FLAIR images. If seen, it should be considered an uncommon but not unexpected finding with no clinical significance.
Assessing the financial impact of cancer drug list (CDL) implementation on patients receiving chemotherapy in an ambulatory cancer centre in Singapore
Authors: Lee Darren , Lim Li Qing , Leow Jo Lene , Chew Lita
Published: January 2024

Background

On 1st September 2022, the Cancer Drug List (CDL) was implemented to ensure the long-term affordability of chemotherapy and insurance premiums. This project aimed to determine the financial impact of CDL on out-of-pocket expenses (OOPE), acceptability and financial toxicity (FT) after CDL implementation.

Methods

A cross-sectional study was conducted at National Cancer Center Singapore. We analyzed OOPE before and after implementation of CDL by reviewing billing transactions in Aug-Sept 2022. Acceptability and FT were determined using theoretical framework of acceptability (TFA) and COmprehensive Score for financial Toxicity (COST) tool respectively via survey.

Results

Of the 314 patients finalized bills examined, majority (68.8%) experienced no change in their OOPE, and 69.1% had no OOPE. Most patients (72.6%) were unaware of implementation of CDL. Among patients aware of CDL, majority (61.9%) were accepting, but unsure on how it benefits them. FT was reported as low (mean COST score = 22.4 ± 9.9), and patients ≥65 years old or have at least pre-university education were less likely to experience FT.

Conclusion

Despite best efforts from policymakers, it is challenging to achieve a one-size fits funding or subsidy framework that can cater to the needs of all patients. Some groups of patients would inevitably still experience high OOPE and FT due to their personal or clinical circumstances. Patients can be better empowered to seek financial assistance or resources.
Application of superabsorbent natural polymers in agriculture
Authors: Dingley Cameron , Cass Peter , Adhikari Benu , Daver Fugen
Published: January 2024

To meet global food demand, reduce waste, and minimise environmental impact, the agricultural sector must improve its current practices on soil amendment, fertiliser encapsulation, and seed and crop protection. Super absorbent polymers (SAPs) are a class of polymeric materials that can absorb and retain large quantities of liquids/aqueous solutions compared to their own mass. Typically, SAPs are cross-linked to form three-dimensional hydrophilic networks, commonly known as hydrogels. Although SAPs can be synthesised from both synthetic and naturally sourced materials, for agricultural applications they are generally composed of synthetic polymers, due to their advantageous properties. These include higher water absorption rate and capacity, low cost, availability, durability, and mechanical performance. However, many of these systems utilise polyacrylic acid (PAA) and polyacrylamide (PAM) monomers which may have toxic effects on the nervous and respiratory systems of humans and animals. To ensure sustainable agricultural practices and maintain healthy long-term crop output, synthetic SAP usage must be greatly reduced. This review article aims to investigate alternative natural SAPs for agriculture and critically rationalise their adoption into the industry. Specific applications investigated include (i) soil amendment, (ii) fertiliser encapsulation, (iii) seed coating, and (iv) crop protection.
Gluten-free diet on video platforms: Retrospective infodemiology study
Authors: Ye Chen , Fang Yuehui , Lian Yiyao , He Yuna
Published: January 2024

Background

Video platform is an important approach for individuals to access and adopt health information. Online information on gluten-free diet (GFD) videos remains underinvestigated.

Methods

GFD videos were identified by hashtag-based searching strategy. Videos' basic information, engagement metrics, and content were recorded. Mann-Kendall test was performed to examine time trends of submitting videos and engagement metrics. Video quality was evaluated by the DISCERN instrument and the HONcode.

Results

A total of 822 videos were included in the analysis, with the majority focusing on gluten-free food recipes. The number of videos related to GFD was showing an upward trend. Engagement metrics varied between platforms and video types, with non-recipe videos receiving higher user engagement. The average DISCERN score was 50.20 out of 80 and the average HONcode score was 1.93 out of 8. Videos submitted by health professionals demonstrated better quality compared to those submitted by patients or general users.

Conclusion

There was a rise in the number of videos related to GFD on Chinese video platforms. The overall quality of these videos was poor, most of them were not rigorous enough. Highlighting using social media as a health information source has the potential risk of disseminating one-sided messages and misleading. Efforts should be made to enhance the transparency of advertisements and establish clear guidelines for information sharing on social media platforms.
From Monologue to Dialogue: The Pursuit of Relationship Centered Communication Across a Large, Integrated Healthcare System
Authors: Barden Agnes , Kalman Jill , Gierlinger Sven , Baker Daniel , Giammarinaro Nicole , Rousseau Natalie
Published: January 2024

By listening to the “voice” of patients, Northwell Health, New York's largest healthcare organization, took an evidence-based approach to empowering physicians and advanced care providers. The Relationship Centered Communication course utilizes experiential learning to strengthen patient-centered communication and empathy skills to elicit provider–patient relationships grounded in partnership. This case study highlights (1) The pragmatic cultural journey requiring visionary leadership, strong collaborations, and an evolving educational strategy. (2) Over the course of 6 years, 3300+ providers were educated in this evidence-based communication course. (3) As a result, Northwell's Hospital Consumer Assessment of Healthcare Providers and Systems “Communication with Doctors” domain has increased by 22 percentile rank points, when compared nationally to peers, in addition to other notable patient experience metric improvements within ambulatory medical practice.
“Becoming a Person Who Does Self-Care”: How Health Care Trainees Naturalistically Develop Successful Self-Care Practices
Authors: Campoli Jessica , Cummings Jorden A
Published: January 2024

OBJECTIVES

Self-care is an ethical imperative for health professionals as it can mitigate the adverse effects of stress on professional functioning and health. Yet, there tends to be a lack of self-care among healthcare trainees and an insufficient focus on self-care in medical education. The objective of this study was to develop a grounded theory of how health trainees become successful self-care users.

METHODS

Semi-structured interviews were conducted with 17 students in a variety of healthcare disciplines. Data were analyzed using grounded theory methodology.

RESULTS

Health trainees underwent 4 iterative phases to become successful at self-care: Having a Wake-Up Call, Building Skills, Gaining Confidence, and Building an Identity. Our model also explained why some trainees were unsuccessful at developing self-care practices.

CONCLUSION

We offer the first theory to explain how health trainees develop effective self-care habits. Understanding how self-care practices naturalistically develop has critical implications for developing interventions and curricula: By basing curricula about self-care on knowledge of what works, we have an opportunity to be more successful as educators. Indeed, other researchers have noted a lack of success in self-care and anti-burnout interventions for healthcare professionals. We conclude by discussing implications and recommendations for medical training and curriculum for health professions, including augmenting naturally occurring processes, linking self-care to personalized values, providing opportunities for deliberate practice, focusing on persistence with self-care, and faculty promotion and acceptance of trainee self-care.
Serial adapters? Local government chief officers and the navigation of space and time
Authors: Barnett Neil J , Giovannini Arianna , Griggs Steven
Published: January 2024

This article analyses the everyday practices of ‘doing’ socio-spatial relations, drawing upon a series of in-depth interviews with local authority chief officers from across the UK. It argues that for chief officers ‘thinking spatially’ is played out in and through the practice of leadership on the move as they navigate the multiple spaces and temporalities that constitute the landscape of local government. Such leadership on the move resonates in part with predominant explanations of boundary spanning in studies of public governance. But importantly, boundary spanning suffers, our evidence suggests, from a temporal deficit, a ‘thin’ account of time which fails to address the constitutive function of boundaries and the complex politics of fluidity and fixity that follow. Articulating a ‘thicker’ approach to time, we argue that chief officers experience everyday socio-spatial relations less as boundary spanners and more as serial adaptors, who persistently reproduce sedimented boundaries and perform different modes of governance as they move from one arena to another. Serial adaptation, we conclude, challenges the potential managerialist bias of boundary spanning, in which the quest for harmonisation and unity masks over the irreducible complex reality of fragmentation and political conflict within which chief officers move.
Descriptive before-and-after study of the introduction of a ‘Leave Behind’ take-home naloxone dispensing/distribution program by the ambulance service in Western Australia
Authors: Tohira Hideo , Brits Rudolph , Lenton Simon , Agramunt Seraina , Brink Deon , Naylor Curtis , Belcher Jason , Ball Stephen , Finn Judith
Published: January 2024

Objective

To describe changes observed in case characteristics and patient outcomes before and after ambulance service participation in a ‘Leave Behind’ take-home naloxone (THN) dispensing/distribution program.

Methods

This before-and-after study included emergency ambulance attendances for patients experiencing an opioid overdose one year before 1 October 2021 (pre-participation phase: 1 October 2020–30 September 2021) when St John Western Australia (SJWA) participated in the THN program and those one year after the date (post-participation phase: 1 October 2021–30 September 2022).

Results

There were 945 and 1240 opioid overdoses among 221,451 and 222,480 emergency ambulance attendances in the pre- and post-participation phases (0.43% vs 0.56%, p < 0.001). The number of ambulance attendances for overdose in the post-participation phase was not significantly different from that predicted based on the ambulance attendances in the pre-participation phase. No statistically significant differences in patient age, sex, and geographical location were identified between the two phases. Compared to the pre-participation phase, more patients had naloxone administered prior to ambulance arrival (10.7% vs 15.1%, p = 0.003), and more patients were discharged at the scene (21.2% vs 29.8%, p < 0.001) in the post-participation phase. No difference was found in mortality within one day (3.4% in the pre-participation phase vs 3.5% in the post-participation phase, p = 0.30).

Conclusions

After implementation of a ‘Leave Behind’ take-home naloxone dispensing/distribution program, more patients had naloxone administered prior to ambulance arrival, and the likelihood of discharging a patient at the scene significantly increased without affecting patient survival rates.
Impact of Political Violence on Health: The Case of Academics for Peace in Turkey
Authors: Davas Aslı , Tanık Feride Aksu
Published: January 2024

This study examines the profound impact of political violence and repression on the mental and physical health of Academics for Peace (AfP) in Turkey. The research combines quantitative and qualitative data to explore the interplay between violence, stigmatization, and health outcomes among the affected academics. This study particularly focuses on the aftermath of the State of Emergency in Turkey in 2016, which led to the dismissal of thousands of academics. We employ the World Health Organization's definition of violence to understand the broad nature of violent acts, encompassing power dynamics and systemic repression. The findings highlight the extensive physical and mental health consequences faced by AfP due to political violence. The prevalence of diagnosed mental illness among respondents is notably high, indicating that exposure to trauma, threats, and repression leads to severe mental distress. Anxiety, depression, post-traumatic stress disorder, and musculoskeletal diseases are among the common health issues reported. The research underscores how political violence disrupts psychosocial pillars including safety and security, bonds and networks, justice, roles and identities, and existential meaning, and explores how these disruptions contribute to communal mental health deterioration. It also identifies the impact on well-being of economic losses, uncertainties, and isolation from social and academic networks.
How I treat long-term survivors of childhood acute leukemia
Authors: Saultier Paul , Michel Gérard
Published: January 2024

The population of survivors of childhood leukemia who reach adulthood is growing due to improved therapy. However, survivors are at risk of long-term complications. Comprehensive follow-up programs play a key role in childhood leukemia survivor care. The major determinant of long-term complications is the therapeutic burden accumulated over time. Relapse chemotherapy, central nervous system irradiation, hematopoietic stem cell transplantation, and total body irradiation are associated with greater risk of long-term complications. Other parameters include clinical characteristics such as age and sex as well as environmental, genetic, and socioeconomic factors, which can help stratify the risk of long-term complications and organize follow-up program. Early diagnosis improves the management of several late complications such as anthracycline-related cardiomyopathy, secondary cancers, metabolic syndrome, development defects, and infertility. Total body irradiation is the treatment associated with worse long-term toxicity profile with a wide range of complications. Patients treated with chemotherapy alone are at a lower risk of long-term complications, although the optimal long-term follow-up remains unclear. Novel immunotherapies and targeted therapy are generally associated with a better short-term safety profile but still require careful long-term toxicity monitoring. Advances in understanding genetic susceptibility to long-term complications could enable tailored therapeutic strategies for leukemia treatment and optimized follow-up programs.
CPX-351 exploits the gut microbiota to promote mucosal barrier function, colonization resistance, and immune homeostasis
Authors: Renga Giorgia , Nunzi Emilia , Stincardini Claudia , Pariano Marilena , Puccetti Matteo , Pieraccini Giuseppe , Di Serio Claudia , Fraziano Maurizio , Poerio Noemi , Oikonomou Vasileios , Mosci Paolo , Garaci Enrico , Fianchi Luana , Pagano Livio , Romani Luigina
Published: January 2024

CPX-351, a liposomal combination of cytarabine plus daunorubicin, has been approved for the treatment of adults with newly diagnosed, therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes, because it improves survival and outcome of patients who received hematopoietic stem cell transplant compared with the continuous infusion of cytarabine plus daunorubicin (referred to as “7 + 3” combination). Because gut dysbiosis occurring in patients with AML during induction chemotherapy heavily affects the subsequent phases of therapy, we have assessed whether the superior activity of CPX-351 vs “7 + 3” combination in the real-life setting implicates an action on and by the intestinal microbiota. To this purpose, we have evaluated the impact of CPX-351 and “7 + 3” combination on mucosal barrier function, gut microbial composition and function, and antifungal colonization resistance in preclinical models of intestinal damage in vitro and in vivo and fecal microbiota transplantation. We found that CPX-351, at variance with “7 + 3” combination, protected from gut dysbiosis, mucosal damage, and gut morbidity while increasing antifungal resistance. Mechanistically, the protective effect of CPX-351 occurred through pathways involving both the host and the intestinal microbiota, namely via the activation of the aryl hydrocarbon receptor–interleukin-22 (IL-22)–IL-10 host pathway and the production of immunomodulatory metabolites by anaerobes. This study reveals how the gut microbiota may contribute to the good safety profile, with a low infection-related mortality, of CPX-351 and highlights how a better understanding of the host-microbiota dialogue may contribute to pave the way for precision medicine in AML.
A randomized phase 2 trial of oral vitamin A for graft-versus-host disease in children and young adults
Authors: Khandelwal Pooja , Langenberg Lucille , Luebbering Nathan , Lake Kelly E. , Butcher Abigail , Bota Kylie , Ramos Kristie N. , Taggart Cynthia , Choe Hannah , Vasu Sumithira , Teusink-Cross Ashley , Koo Jane , Wallace Gregory , Romick-Rosendale Lindsey , Watanabe-Chailland Miki , Haslam David B. , Lane Adam , Davies Stella M.
Published: January 2024

Vitamin A plays a key role in the maintenance of gastrointestinal homeostasis and promotes a tolerogenic phenotype in tissue resident macrophages. We conducted a prospective randomized double-blinded placebo-controlled clinical trial in which 80 recipients of hematopoietic stem cell transplantation (HSCT) were randomized 1:1 to receive pretransplant high-dose vitamin A or placebo. A single oral dose of vitamin A of 4000 IU/kg, maximum 250 000 IU was given before conditioning. The primary end point was incidence of acute graft-versus-host disease (GVHD) at day +100. In an intent-to-treat analysis, incidence of acute GVHD was 12.5% in the vitamin A arm and 20% in the placebo arm (P = .5). Incidence of acute gastrointestinal (GI) GVHD was 2.5% in the vitamin A arm (P = .09) and 12.5% in the placebo arm at day +180. Incidence of chronic GVHD was 5% in the vitamin A arm and 15% in the placebo arm (P = .02) at 1 year. In an “as treated” analysis, cumulative incidence of acute GI GVHD at day +180 was 0% and 12.5% in recipients of vitamin A and placebo, respectively (P = .02), and cumulative incidence of chronic GVHD was 2.7% and 15% in recipients of vitamin A and placebo, respectively (P = .01). The only possibly attributable toxicity was asymptomatic grade 3 hyperbilirubinemia in 1 recipient of vitamin A at day +30, which self-resolved. Absolute CCR9+ CD8+ effector memory T cells, reflecting gut T-cell trafficking, were lower in the vitamin A arm at day +30 after HSCT (P = .01). Levels of serum amyloid A-1, a vitamin A transport protein with proinflammatory effects, were lower in the vitamin A arm. The vitamin A arm had lower interleukin-6 (IL-6), IL-8, and suppressor of tumorigenicity 2 levels and likely a more favorable gut microbiome and short chain fatty acids. Pre-HSCT oral vitamin A is inexpensive, has low toxicity, and reduces GVHD. This trial was registered at www.ClinicalTrials.gov as NCT03202849.
The contemporary management of spontaneous pneumothorax in adults
Authors: Shorthose Matthew , Barton Eleanor , Walker Steven
Published: January 2024

Spontaneous pneumothorax is a common presentation, and there has been a recent surge of research into the condition. With the recent publication of the new British Thoracic Society guidelines and the upcoming European Respiratory Society guidelines, we provide a concise up-to-date summary of clinical learning points. In particular we focus on the role of conservative or ambulatory management, as well as treatment options for persistent air leak and guidance for when to refer to thoracic surgeons for the prevention of the recurrence of pneumothorax.

Educational aims

To give up-to-date guidance on the acute management of spontaneous pneumothorax, including the role of conservative or ambulatory management

To discuss the different treatment options for persistent air leak.

To guide physicians on when to refer patients to thoracic surgeons for the prevention of the recurrence of pneumothorax.
The European Respiratory Society led training programme improves self-reported competency and increases the use of thoracic ultrasound
Authors: Pietersen Pia Iben , Konge Lars , Bhatnagar Rahul , Slavicky Marek , Rahman Najib M. , Maskell Nick , Crombag Laurence , Tabin Nathalie , Laursen Christian B. , Nielsen Anders Bo
Published: January 2024

Thoracic ultrasound has become a well-implemented diagnostic tool for assessment and monitoring of patients with respiratory symptoms or disease. However, ultrasound examinations are user dependent and sufficient competencies are needed. The European Respiratory Society (ERS) hosts a structured and evidence-based training programme in thoracic ultrasound. This study aimed to explore and discuss the self-reported activity and self-reported competency of the participants during the ERS course.

Online surveys were sent to the training programme participants before the second part of the course (practical part of the course), and before and 3 months after the third part of the course (final certification exam). A total of 77 participants completed the surveys. The self-reported frequency of thoracic ultrasound examinations increased during the course, and in the final survey more than 90% of the participants used thoracic ultrasound on weekly basis. The self-reported competency (on technical execution of the thoracic ultrasound examination and overall competency) also increased.

The ERS thoracic ultrasound training programme forms the basis of broad theoretical knowledge and sufficient practical skills that seem to lead to behavioural changes, whereby a large proportion of the participants implemented ultrasound in their clinical practice.
Liquid-phase water permeation pathways on outer-bark surfaces of teak (Tectona grandis): a tropical deciduous hardwood
Authors: Matsunaga Hiroyuki , Matsuo Naoko , Nakai Takahisa , Abe Hisashi
Published: January 2024

It has recently been suggested that processes related to water uptake from the tree-stem surface, such as water vapor exchange and rainwater permeation, have implications for forest hydrology. However, few studies have investigated stem surface water uptake itself, and the water permeation pathway has not been elucidated in detail. Based on previous findings that trees with outer bark composed mainly of rhytidome have a high frequency of exfoliation and greater water uptake ability, we hypothesized that exfoliation of the outer bark is the main pathway for water uptake from the outer bark surface to the innermost periderm in these species. We tested this hypothesis in teak, a tropical deciduous hardwood with a high frequency of outer-bark exfoliation. We conducted laboratory experiments using dried bark pieces with different outer-bark shapes to evaluate the rate, amount, and pathway of liquid-phase water permeation of outer-bark surfaces. The rate and amount of water absorption differed markedly among samples. The permeation rate was correlated with the degree of outer-bark exfoliation, and water permeation was observed to begin at exfoliated surfaces. These results support our hypothesis. In addition, the increased water content of bark pieces immediately after the start of the experiment was strongly correlated with the surface roughness of the outer bark, implying that roughness may indicate the water-retention capacity of a given tree species.
Single nucleotide polymorphism SNP19140160 A > C is a potential breeding locus for fast-growth largemouth bass (Micropterus salmoides)
Authors: Hua Jixiang , Zhong Chunyi , Chen Wenhua , Fu Jianjun , Wang Jian , Wang Qingchun , Zhu Geyan , Li Yan , Tao Yifan , Zhang Maoyou , Dong Yalun , Lu Siqi , Liu Wenting , Qiang Jun
Published: January 2024

Background

Largemouth bass (Micropterus salmoides) has significant economic value as a high-yielding fish species in China’s freshwater aquaculture industry. Determining the major genes related to growth traits and identifying molecular markers associated with these traits serve as the foundation for breeding strategies involving gene pyramiding. In this study, we screened restriction-site associated DNA sequencing (RAD-seq) data to identify single nucleotide polymorphism (SNP) loci potentially associated with extreme growth differences between fast-growth and slow-growth groups in the F1 generation of a largemouth bass population.

Results

We subsequently identified associations between these loci and specific candidate genes related to four key growth traits (body weight, body length, body height, and body thickness) based on SNP genotyping. In total, 4,196,486 high-quality SNPs were distributed across 23 chromosomes. Using a population-specific genotype frequency threshold of 0.7, we identified 30 potential SNPs associated with growth traits. Among the 30 SNPs, SNP19140160, SNP9639603, SNP9639605, and SNP23355498 showed significant associations; three of them (SNP9639603, SNP9639605, and SNP23355498) were significantly associated with one trait, body length, in the F1 generation, and one (SNP19140160) was significantly linked with four traits (body weight, height, length, and thickness) in the F1 generation. The markers SNP19140160 and SNP23355498 were located near two growth candidate genes, fam174b and ppip5k1b, respectively, and these candidate genes were closely linked with growth, development, and feeding. The average body weight of the group with four dominant genotypes at these SNP loci in the F1 generation population (703.86 g) was 19.63% higher than that of the group without dominant genotypes at these loci (588.36 g).

Conclusions

Thus, these four markers could be used to construct a population with dominant genotypes at loci related to fast growth. These findings demonstrate how markers can be used to identify genes related to fast growth, and will be useful for molecular marker-assisted selection in the breeding of high-quality largemouth bass.
Incidence and risk of remnant gastric cancer after gastrectomy for gastric cancer: a population-based study from the SEER database
Authors: Yan Shangcheng , Cheng Ming , Peng Wei , Liu Tianhua , Zhang Jingyu , Sheng Mengchao , Ren Rui , Chen Qiang , Gong Wei , Wu Yongyou
Published: January 2024

Background

Gastric cancer (GC) constitutes a major global health problem, of which remnant gastric cancer (RGC) occurs less frequently. The rate of RGCs after gastrectomy for GC is increasing recently due to improved survival and screening, however, their incidence and risk have not been reported in the U.S. population. The objective of this study was to evaluate the incidence and elevated risk of RGC after GC gastrectomy in this population, and to identify the risk factors.

Methods

Patients underwent gastrectomy for first primary GC in 2000–2015 and those who developed RGC were identified from Surveillance, Epidemiology and End Results (SEER) database. Fine-Gray regression was used to estimate the cumulative incidence and to identify risk factors. Standardized incidence ratios (SIRs) were calculated by Poisson regression to compare the risk with the general population.

Results

Among 21,566 patients included in the cohort, 227 developed RGC. The 20-year cumulative incidence of RGC was 1.88%. Multivariate analysis revealed that older age, invasion depth, male sex, marital status, and lower income are independent risk factors for RGC development. SIR was 7.70 overall and > 4.5 in each stratum.

Conclusions

Cumulative incidence and risk for RGCs increased continuously in patients underwent GC gastrectomy. Close and lifelong endoscopy surveillance should be recommended for patients who received GC gastrectomy, especially those with high-risk factors.
Recognition of cognitive dysfunction in hospitalised older patients: a flash mob study
Authors: Visser Fleur C. W. , van Eersel Marlise E. A. , Hempenius Liesbeth , Verwey Nicolaas A. , Band Caterina , van der Bol Jessica M. , Boudestein Kris , van Dijk Suzanne C. , Gobbens Robbert , van der Hooft Cornelis S. , Kamper Adriaan M. , Ruiter Rikje , Sipers Walther , Spoelstra Birgit N. A. , Stoffels Josephine , Stolwijk-Woudstra Dyane J. , van Stralen Karlijn J. , van Strien Astrid M. , Wijngaarden Marjolein A. , Winters Marian , Strijkert Fijanne , van Munster Barbara C.
Published: January 2024

Background

It is important that healthcare professionals recognise cognitive dysfunction in hospitalised older patients in order to address associated care needs, such as enhanced involvement of relatives and extra cognitive and functional support. However, studies analysing medical records suggest that healthcare professionals have low awareness of cognitive dysfunction in hospitalised older patients. In this study, we investigated the prevalence of cognitive dysfunction in hospitalised older patients, the percentage of patients in which cognitive dysfunction was recognised by healthcare professionals, and which variables were associated with recognition.

Methods

A multicentre, nationwide, cross-sectional observational study was conducted on a single day using a flash mob study design in thirteen university and general hospitals in the Netherlands. Cognitive function was assessed in hospitalised patients aged ≥ 65 years old, who were admitted to medical and surgical wards. A Mini-Cog score of < 3 out of 5 indicated cognitive dysfunction. The attending nurses and physicians were asked whether they suspected cognitive dysfunction in their patient. Variables associated with recognition of cognitive dysfunction were assessed using multilevel and multivariable logistic regression analyses.

Results

347 of 757 enrolled patients (46%) showed cognitive dysfunction. Cognitive dysfunction was recognised by attending nurses in 137 of 323 patients (42%) and by physicians in 156 patients (48%). In 135 patients (42%), cognitive dysfunction was not recognised by either the attending nurse or physician. Recognition of cognitive dysfunction was better at a lower Mini-Cog score, with the best recognition in patients with the lowest scores. Patients with a Mini-Cog score < 3 were best recognised in the geriatric department (69% by nurses and 72% by physicians).

Conclusion

Cognitive dysfunction is common in hospitalised older patients and is poorly recognised by healthcare professionals. This study highlights the need to improve recognition of cognitive dysfunction in hospitalised older patients, particularly in individuals with less apparent cognitive dysfunction. The high proportion of older patients with cognitive dysfunction suggests that it may be beneficial to provide care tailored to cognitive dysfunction for all hospitalised older patients.
The association between healthcare expenditures and potentially inappropriate medication use in hospitalized older adults in Ethiopia
Authors: Tesfaye Behailu Terefe , Bosho Dula Dessalegn , Dissassa Gashahun Mekonnen , Tesfaye Mikiyas Gashaw , Yizengaw Mengist Awoke
Published: January 2024

Background

Evidence shows that potentially inappropriate medication (PIM) use in older adults significantly increases the utilization of healthcare resources. PIM is widely prescribed in older adults, however little is known about its association with healthcare resource utilization in Africa, particularly Ethiopia. Therefore, the primary aim of this study was to examine the presence of an association between healthcare expenditure and the frequency of PIM used.

Methods

This observational study was conducted from 06 September 2021 to 30 December 2022. A total of 151 hospitalized older adult patients were included in the study. The data collection format was designed to capture relevant information. STATA V.15.0 was used for analysis. Descriptive statistics and a generalized linear model regression were conducted. Statistical significance was set at a p-value < 0.05. The findings are presented in tables, figures, and text.

Results

The total healthcare expenditure was higher in PIM users (385,368.6 ETB) than in non-PIM users (131,267.7 ETB). The median expenditures for medical supplies (p = 0.025), investigations (p = 0.033), and total healthcare expenditure (p = 0.023) were significantly higher in patients with two and more PIMs than in those with no or one PIM. However, after model adjustment, the total healthcare expenditure was not significantly different across the frequency of PIMs used. Number of medications (adjusted B = 0.068, 95% CI: 0.035, 0.101, p < 0.001) and taking blood and blood-forming organ class of medication (adjusted B = 0.151, 95% CI: 0.005, 0.297, p = 0.042) were associated with higher total healthcare expenditure, whereas the total healthcare expenditure was significantly lower in those patients with diseases of the nervous system (adjusted B = -0.307, 95% CI: -0.502, -0.112, p = 0.002) and respiratory system (adjusted B = -0.196, 95% CI: -0.327, -0.065, p = 0.003).

Conclusion

The total healthcare expenditure is nearly three times higher in PIM users. However, its association with the frequency of PIM use was not statistically significant in the final model. Deprescribing medications after evaluating the benefit-risk ratio may help to reduce the healthcare expenditures of older adult patients. Further similar, adequately powered, comparative study is also warranted to identify the actual effect of PIM use on healthcare expenditures in the local context.
Comprehensive genomic evaluation of advanced and recurrent breast cancer patients for tailored precision treatments
Authors: Ido Mirai , Fujii Kimihito , Mishima Hideyuki , Kubo Akihito , Saito Masayuki , Banno Hirona , Ito Yukie , Goto Manami , Ando Takahito , Mouri Yukako , Kousaka Junko , Imai Tsuneo , Nakano Shogo
Published: January 2024

Aim

The aim of this study was to investigate genetic alterations within breast cancer in the setting of recurrent or de novo stage IV disease.

Patients and methods

: This study included 22 patients with recurrent breast cancer (n = 19) and inoperable de novo stage IV breast cancer (n = 3). For next generation sequencing, FoundationOneCDx (F1CDx) (Foundation Medicine Inc., Cambridge, MA, USA) was performed in 21 patients and FoundationOneLiquid CDx was performed in 1 patient.

Results

Median age was 62.9 years (range, 33.4–82.1). Pathological diagnoses of specimens included invasive ductal carcinoma (n = 19), invasive lobular carcinoma (n = 2), and invasive micropapillary carcinoma (n = 1). F1CDx detected a median of 4.5 variants (range, 1–11). The most commonly altered gene were PIK3CA (n = 9), followed by TP53 (n = 7), MYC (n = 4), PTEN (n = 3), and CDH1 (n = 3). For hormone receptor-positive patients with PIK3CA mutations, hormonal treatment plus a phosphoinositide 3-kinase inhibitor was recommended as the treatment of choice. Patients in the hormone receptor-negative and no human epidermal growth factor receptor 2 expression group had significantly higher tumor mutational burden than patients in the hormone receptor-positive group. A BRCA2 reversion mutation was revealed by F1CDx in a patient with a deleterious germline BRCA2 mutation during poly ADP ribose polymerase inhibitor treatment.

Conclusion

Guidance on tailored precision therapy with consideration of genomic mutations was possible for some patients with information provided by F1CDx. Clinicians should consider using F1CDx at turning points in the course of the disease.
Heparin versus normal saline for the care of peripheral intravenous catheters in pediatrics: a meta-analysis of randomized controlled trials
Authors: Li Ran , Zheng Qiaoqi , Chen Nengyue , Zhao Li
Published: January 2024

Background

It is still controversial for neonates or children to choose normal saline or heparin solution in the care of peripheral intravenous catheters. This meta-analysis aimed to evaluate the effects of heparin versus normal saline for the care of peripheral intravenous catheters in pediatrics, to provide reliable evidence support for clinical care.

Methods

Two authors searched the PubMed, EMbase, Ovid Medline, Cochrane Library, Web of Science, CBM, WanFang Data and China National Knowledge Infrastructure (CNKI) databases for randomized controlled trial (RCT) of heparin versus normal saline for the care of peripheral intravenous catheters in pediatrics until July 16, 2023. The bias of risk tool recommended by Cochrane was used for the quality evaluation of included RCTs. Meta-analysis was carried out by using RevMan 5.4 software.

Results

A total of 22 RCTs involving 3988 peripheral intravenous catheters were finally included. Compare with normal saline, heparin could significantly increase the catheter indwelling time (MD = 9.10, 95%CI:3.30 ~ 14.90). Subgroup analysis indicated that for compare with normal saline, heparin could significantly increase the catheter indwelling time in the neonate (MD = 9.63, 95%CI: 0.38 ~ 18.88) and neonate + children population (MD = 6.22, 95%CI:2.72 ~ 9.73, P < 0.001). Heparin could significantly reduce the incidence of catheter-associated complications (RR = 0.84, 95%CI: 0.70 ~ 0.95). Subgroup analysis indicated that heparin could significantly reduce the incidence of catheter-associated complications in the neonate (RR = 0.70, 95%CI: 0.61 ~ 0.89). There was no publication bias amongst the synthesized outcomes by Egger’s test (all P > 0.05).

Conclusions

Heparin may be worthy of being applicated in the neonate population in terms of prolonged indwelling time and less complications. Limited by the evidence quality, more studies from different area and populations with rigorous design are needed to investigate the role of heparin versus normal saline for the care of peripheral intravenous catheters in pediatrics.
Do girls wash dishes and boys play sports? Gender inequalities in physical activity and in the use of screen-based devices among schoolchildren from urban and rural areas in Brazil
Authors: de Jesus Gilmar Mercês , Dias Lizziane Andrade , Barros Anna Karolina Cerqueira , Araujo Lara Daniele Matos dos Santos , Schrann Mayva Mayana Ferreira
Published: January 2024

Objective

The aim of the study was to analyze gender inequalities in types of physical activity (PA) and in the use of screen-based devices among schoolchildren from both urban and rural areas in Brazil.

Methods

Data from two population-based surveys conducted in 2019 (urban areas: n = 2,479; 52.6% girls; age = 9.2 ± 1.51 years) and 2022 (rural areas: n = 979; 42.6% girls; age = 9.4 ± 1.52 years) were used. PA (active play, nonactive play, home chores, and structured physical activities) and the use of screen-based devices (TV, cellphone, videogame, and computer) were self-reported in a previous-day-recall online questionnaire (Web-CAAFE). Absolute gender inequalities were evaluated and presented as equiplots. Relative gender inequalities were evaluated by the prevalence ratio (PR) and respective 95% confidence intervals (95% CI), which were estimated by Poisson regression, with adjustments for age and BMI z scores.

Results

Girls from urban and rural areas presented a lower prevalence of active play and a higher prevalence of home chores. The prevalence of nonactive play among girls from urban areas was also lower; however, their prevalence of structured physical activities was higher, especially among girls aged seven to nine years. Girls in both urban and rural areas presented a higher prevalence of TV viewing and lower use of video games.

Conclusion

The gender inequalities observed in the types of physical activities and in the use of screen-based devices could be considered potential correlates of the likelihood of girls’ and boys’ compliance with the physical activity guidelines.