bluuebunny/crossref_metadata_2025 huggingface dataset:
Rebuttal to Comments of Target Article: Introductory Psychology: Embracing the Complexities and Controversies
Authors: Bartels Jared M.
Published: September 2023

In the target article I argued, based on a review of studies published on psychology textbook misrepresentations, that liberal or left-wing bias influences the presentation of politically relevant topics in the texts. Some responses to the target article provided helpful context in terms of better understanding the political backdrop against which psychological science is dispensed in psychology textbooks and courses. Questions were also raised about the sufficiency of the evidence and conclusions drawn. Lastly, several authors recommended changes to introductory psychology, most of which would reduce bias and indoctrination. In the rebuttal, I address several questions and concerns raised and review additional research in the process. While this research is further evidence of indoctrination, I will highlight how authors have been able to effectively navigate controversial topics.
Investigation of structural parameters of acoustic panels produced from post-industrial textile wastes containing different raw materials
Authors: Yalcin-Enis Ipek , Sezgin Hande
Published: September 2023

Although noise pollution appears to be a minor issue, it worsens as a result of urbanization and population growth. Unwanted noises have a wide range of negative effects, including anxiety, hostility, high blood pressure, tinnitus, hearing loss, and sleep difficulties. The researchers are compelled to conduct a creative search in order to uncover future environmental solutions due to the noise problem, which is becoming each day worse. Moreover, the textile sector, which is growing day by day, generates huge amounts of waste with the effect of fast fashion trend. The objective of this study is to develop ecofriendly acoustic panels utilizing recycled textile waste and thermoplastic polypropylene (PP) fibers. Within the scope of the study, waste fabrics made of viscose, lyocell, flax, cotton, and polyester are shredded into fibers, and sandwich panels including waste fibers bonded together with PP fibers are generated using the hot press technique. In addition to the use of natural and synthetic fibers, the effects of surface shape (perforated-imperforated) and layer thickness (5 mm and 10 mm) on acoustic performance are examined. The results of the sound absorption and sound transmission loss tests reveal that the acoustic properties of the samples improve as the sample thickness increases, but the perforation process does not have the desired favorable impact on samples of the same thickness. Additionally, the outcomes demonstrate that around 2000 Hz, natural and regenerated fibers with high cellulose content had the best sound absorption coefficients around 0.60. The findings indicate that these eco-friendly panels can be used to reduce unwanted noise in open offices, co-working spaces, and meeting rooms.
Introduction: Reconsidering Paratext as a Received Concept
Authors: Galey Alan
Published: September 2023

It is now 40 years since Gérard Genette's work introduced the term paratexts into literary studies, giving a unifying name to the many kinds of texts that serve as thresholds to other texts. The term and concept have migrated into the study of several other media forms, including video game studies, thanks principally to Mia Consalvo in Cheating: Gaining Advantage in Video Games (2007) and Steven Jones in The Meaning of Video Games: Gaming and Textual Strategies (2008). The term's meaning expanded in the process, which has been the subject of much debate since then. Over a decade later, the timing seems apt to take stock of the concept of paratextuality and consider new ways of adapting it. This introduction to a special issue titled “Video Games and Paratextuality” reconsiders Genette's reception in video game studies, and introduces a set of articles that together look beyond Genette.
ASPECTS evolution after endovascular successful reperfusion in the early and extended time window
Authors: Anadani Mohammad , Finitsis Stephanos , Pop Raoul , Darcourt Jean , Clarençon Frédéric , Richard Sébastien , de Havenon Adam , Liebeskind David , Marnat Gaultier , Bourcier Romain , Sibon Igor , Dargazanli Cyril , Arquizan Caroline , Blanc Raphaël , Lapergue Bertrand , Consoli Arturo , Eugène François , Vannier Stéphane , Caroff Jildaz , Denier Christian , Boulanger Marion , Gauberti Maxime , Saleme Suzana , Macian Francisco , Rosso Charlotte , Turc Guillaume , Ozkul-Wermester Ozlem , Papagiannaki Chrysanthi , Olivot Jean-Marc , Le Bras Anthony , Evain Sarah , Wolff Valérie , Timsit Serge , Gentric Jean-Christophe , Bourdain Frédéric , Veunac Louis , Maïer Benjamin , Ben Hassen Wagih , Gory Benjamin ,   On behalf of the ETIS Registry Investigators
Published: September 2023

Background

The Alberta Stroke Program Early CT scan Score (ASPECTS) is a reliable imaging biomarker of infarct extent on admission but the value of 24-hour ASPECTS evolution in day-to-day practice is not well studied, especially after successful reperfusion. We aimed to assess the association between ASPECTS evolution after successful reperfusion with functional and safety outcomes, as well as to identify the predictors of ASPECTS evolution.

Methods

We used data from an ongoing prospective multicenter registry. Stroke patients with anterior circulation large vessel occlusion treated with endovascular therapy (EVT) and achieved successful reperfusion (modified thrombolysis in cerebral ischemia (mTICI) 2b-3) were included. ASPECTS evolution was defined as one or more point decrease in ASPECTS at 24 hours.

Results

A total of 2366 patients were enrolled. In a fully adjusted model, ASPECTS evolution was associated with lower odds of favorable outcome (modified Rankin Scale (mRS) score 0-2) at 90 days (adjusted odds ratio (aOR) = 0.46; 95% confidence interval (CI) = 0.37–0.57). In addition, ASPECTS evolution was a predictor of excellent outcome (90-day mRS 0-1) (aOR = 0.52; 95% CI = 0.49–0.57), early neurological improvement (aOR = 0.42; 95% CI = 0.35–0.51), and parenchymal hemorrhage (aOR = 2.64; 95% CI, 2.03–3.44). Stroke severity, admission ASPECTS, total number of passes, complete reperfusion (mTICI 3 vs. mTICI 2b-2c) and good collaterals emerged as predictors of ASPECTS evolution.

Conclusion

ASPECTS evolution is a strong predictor of functional and safety outcomes after successful endovascular therapy. Higher number of EVT attempts and incomplete reperfusion are associated with ASPECTS evolution at day 1.
Safety and efficacy of the fourth-generation Acandis Acclino flex plus stent for the treatment of complex intracranial aneurysms
Authors: Goertz Lukas , Zopfs David , Pennig Lenhard , Zaeske Charlotte , Timmer Marco , Laukamp Kai R , Schönfeld Michael , Schlamann Marc , Kabbasch Christoph
Published: September 2023

Objective

The low-profile Acandis Acclino flex plus (AFP) is a fourth-generation laser-cut microstent with a flexible structure designed for the treatment of a wide variety of aneurysms. We report our single-center experience with this device in the treatment of complex aneurysms.

Methods

Twenty-eight patients were treated with the Acclino flex plus for 28 aneurysms. Aneurysm characteristics, technical success, complications, clinical outcome, and angiographic results were retrospectively analyzed.

Results

The cohort included 8 unruptured untreated aneurysms, 9 unruptured recurrent aneurysms, and 12 ruptured aneurysms with aneurysm diameters ranging from 3 to 23 mm. The anterior communicating artery was the most common location (52%). Stent deployment was successful in 28 cases (97%) with an average of 1.3 stents per aneurysm. The overall procedural complication rate was 17%, including 2 (6.8%) major clinical events (one ischaemic stroke and one aneurysm perforation) and one (3.4%) minor clinical event (one seizure). Angiographic results of 23 aneurysms at a mean of 6 months were complete occlusion in 74%, neck remnants in 13% and aneurysm remnants in 13%. Three patients were retreated.

Conclusions

Given the complexity of the aneurysms, the use of the Acclino flex plus was feasible and associated with a favourable safety and efficacy profile. Further studies are needed to evaluate Acclino flex plus in other aneurysm subsets and to define its role in endovascular aneurysm treatment.
Beliefs and misconceptions about hypertension disease: A qualitative study among patients in a peri-urban community in Ghana
Authors: Otemah Jemima , Ohene Lillian Akorfa , Kyei Josephine , Owusu-Darkwa Irene
Published: September 2023

Objective

This study aims to explore beliefs and perceptions about hypertension among patients living with hypertension in a local district in the Eastern region of Ghana.

Methods

A descriptive qualitative approach was adopted, and the Health Belief Model was used to guide the data collection, analysis, and organization of the study findings. Overall, seventeen participants were interviewed. In-depth interviews were conducted using a semistructured interview guide. Participants were conveniently selected from a district local Government Hospital. Data gathered were transcribed verbatim and analyzed using thematic analysis.

Results

Almost all the participants acknowledged hypertension as a severe but chronic illness that can cause sudden death. They also identified that lifestyle practices and individual attitudes were associated with the hypertension condition's causes, management, and control. The findings revealed several unscientific misconceptions and beliefs about hypertension, which could influence their disease management and control decisions.

Discussion

Patients’ decisions on alternative treatment for hypertension are primarily based on beliefs and misconceptions based on the information they receive from unregulated media and peers. The prevention and control of hypertension should focus on behavior and lifestyle modification which needs reinforcement through health education and promotion.
The Effect of Insulin Degludec Versus Insulin Glargine U100 on Glucose Metrics Recorded During Continuous Glucose Monitoring in People With Type 1 Diabetes and Recurrent Nocturnal Severe Hypoglycemia
Authors: Brøsen Julie Maria Bøggild , Agesen Rikke Mette , Alibegovic Amra Ciric , Andersen Henrik Ullits , Beck-Nielsen Henning , Gustenhoff Peter , Hansen Troels Krarup , Hedetoft Christoffer , Jensen Tonny Joran , Juhl Claus Bogh , Stolberg Charlotte Røn , Lerche Susanne Søgaard , Nørgaard Kirsten , Parving Hans-Henrik , Tarnow Lise , Thorsteinsson Birger , Pedersen-Bjergaard Ulrik
Published: September 2023

Aim:

Comparing continuous glucose monitoring (CGM)-recorded metrics during treatment with insulin degludec (IDeg) versus insulin glargine U100 (IGlar-100) in people with type 1 diabetes (T1D) and recurrent nocturnal severe hypoglycemia.

Materials and methods:

This is a multicenter, two-year, randomized, crossover trial, including 149 adults with T1D and minimum one episode of nocturnal severe hypoglycemia within the last two years. Participants were randomized 1:1 to treatment with IDeg or IGlar-100 and given the option of six days of blinded CGM twice during each treatment. CGM traces were reviewed for the percentage of time-within-target glucose range (TIR), time-below-range (TBR), time-above-range (TAR), and coefficient of variation (CV).

Results:

Seventy-four participants were included in the analysis. Differences between treatments were greatest during the night (23:00-06:59). Treatment with IGlar-100 resulted in 54.0% vs 49.0% with IDeg TIR (70-180 mg/dL) (estimated treatment difference [ETD]: –4.6%, 95% confidence interval [CI]: –9.1, –0.0, P = .049). TBR was lower with IDeg at level 1 (54-69 mg/dL) (ETD: –1.7% [95% CI: –2.9, –0.5], P < .05) and level 2 (<54 mg/dL) (ETD: –1.3% [95% CI: –2.1, –0.5], P = .001). TAR was higher with IDeg compared with IGlar-100 at level 1 (181-250 mg/dL) (ETD: 4.0% [95% CI: 0.8, 7.3], P < .05) and level 2 (> 250 mg/dL) (ETD: 4.0% [95% CI: 0.8, 7.2], P < .05). The mean CV was lower with IDeg than that with IGlar-100 (ETD: –3.4% [95% CI: –5.6, –1.2], P < .05).

Conclusion:

For people with T1D suffering from recurrent nocturnal severe hypoglycemia, treatment with IDeg, compared with IGlar-100, results in a lower TBR and CV during the night at the expense of more TAR.
Genetic Relationship Between Founders of a Threatened Freshwater Turtle in a Mexican Wildlife Management Unit. A Conservation Strategy
Authors: Gallardo-Alvarez Manuel Ignacio , Lesher-Gordillo Julia María , Machkour-M’Rabet Salima , Zenteno-Ruíz Claudia Elena , Olivera-Gómez León David , Recino-Reyes Elsi Beatriz , Montejo-Méndez Heidi Beatriz , Gómez-Carrasco Guadalupe , Hernández-Marín Aminta , Valdés-Marín Alejandra
Published: September 2023

Management Units for Wildlife Conservation (UMAs according to its Spanish acronym), are used for the ex-situ reproduction of freshwater turtles. These areas, often administered by local communities, are dedicated to conservation and sustainable management. The critically endangered freshwater turtle Dermatemys mawii has been successfully reproduced in several UMAs; however, no genetic management plan has been developed to maintain offspring genetic variability. Therefore, this study aims to determine the kinship relationship and homozygosity through the loci index of founder individuals in three UMAs devoted to the reproduction of D. mawii for the establishment of breeding groups. We collected skin samples of D. mawii in 2017 from 117 founder individuals from three UMAs located in the state of Tabasco, southeast Mexico. Ten specific D. mawii microsatellite markers were used for genotyping the founder individuals. We estimated the pedigree relationship between founders and proposed the formation of three breeding groups to optimize the use of related and non-related individuals to meet UMA-specific objectives and evaluated the genetic diversity retention of the breeding groups. The breeding groups were integrated as follows: 1) conservation breeding group consisting of 16 unrelated females and 7 unrelated males that presented a lower level of homozygosity (< 0.4); 2) research breeding group consisting of 45 females and 16 males that were unrelated or presented a half-sibling relationship and with a medium level of homozygosity (<0.6); and 3) a sustainable breeding group comprising 29 females and 4 males that were not necessarily unrelated and with a high level of homozygosity (> 0.6). Genetic diversity retention (Ho, He) was highest for the conservation breeder group and research breeder group. UMAs can create 3 breeding groups with different objectives: 1) species conservation, 2) research, and 3) sustainable use of species. All breeding groups can retain genetic diversity. Our proposal can enrich conservation actions and sustainable use for D. mawii at both national and international levels, specifically within the Mesoamerican corridor.
Working time and autonomy: Lessons for the new ways of working
Authors: Huybrechts Sara
Published: September 2023

This article critically examines the relationship between autonomy and working time, with a focus on the new challenges in the world of work and explores whether traditional approaches can address new challenges. By comparing the situation of autonomous workers to known contexts, valuable lessons emerge. Autonomous work in this contribution is approached as work under subordination with at least one of three characteristics, namely, time independency, place independency (understood as autonomy in respect of hours and place of work) and autonomy in the performance of the work. The discussion covers issues such as the concept of working time, reconciling constant connectivity with rest periods, the scope of the Working Time Directive and the derogation of Article 17(1), as well as the obligation to measure working time. Comparative examples from Belgium, France, Finland and Italy provide useful and tangible insights into the application of the Working Time Directive. The article concludes that while old insights alone cannot address the specific issues faced by autonomous workers, they can guide the identification of suitable rules and regulations.
The kinetic Orbison illusion
Authors: Matsunaga Hikari , Ito Hiroyuki , Kanematsu Tama
Published: September 2023

In the typical Orbison illusion, the sides of a square placed on concentric circles appear to be bending toward the center of the circles. We report a motion version of the Orbison illusion (namely, the kinetic Orbison illusion). When a dot moves along a square trajectory against a background of concentric circles, the sides of the trajectory appear to bend toward the center and the corners appear to be sharpened. In the present study, observers adjusted the shape of a comparison stimulus to the shape of the perceived trajectory by bending the sides. The amount of illusion was operationally defined as the largest discrepancy between the square and adjusted shape in the comparison stimulus. It was found that the illusory bending was more than twice the static Orbison illusion and reached a maximum of 7.3% of the length of one side. Experiments including a comparison between fixation and pursuit conditions revealed that the main cause of the kinetic illusion was not motion streaks of the dot crossing background circles. We propose an alternative hypothesis based on induced motion generated by background circle motion, the direction of which is misperceived owing to the aperture problem.
Development of a food handling practices assessment tool based on the Sri Lanka food regulations
Authors: Hirimuthugoda Lasantha Krishan , De Silva Padmal , Abeykoon Palitha , Tunio Sameer Altaf , Madarasinghe Hasadari Pamoda
Published: September 2023

Objectives:

Neither the current assessment tool of Sri Lanka for food establishments is based on prevailing Food Regulations 2011 nor did its focus cover serious adaptions for precautions upon prevention of the diseases. The study aims to develop a food handling practices assessment tool based on the Sri Lanka Food Regulations 2011 and to assess food handling practices using a developed tool in the Regional Director of Health Services area, Kalutara.

Methods:

The study consisted of developing food establishments’ assessment tool (FEAT) in accordance with Food (Hygiene-1742/26) Regulations of Sri Lanka 2011 and assessing the food establishments using the developed tool in the Regional Director of Health Services area, Kalutara, Sri Lanka. The development of FEAT was carried out to mark inspection scores for food establishments conforming to Food Regulations, others reviewed international food safety protocols and agreements following key informant interviews and focus group discussions. Fully developed FEAT was transferred to a mobile application for ease of use, and assessments were conducted among 421 food establishments in three Medical Officer of Health areas.

Results:

FEAT contained 11 domains including 75 items with more than 100 assessment points including a guide to conducting an assessment of food handling, compared to the current version of the assessment tool in Sri Lanka. The majority of participants included in the qualitative assessment agreed to include a 1–5 scoring scale to report hygiene levels and to use hygiene regulation to develop FEAT as a legal basis. The highest percentage of food establishments (69.4%) in the “Good” category were in the Bandaragama Medical Officer of Health Area and the highest percentage of food establishments (54.5%) in the “very poor” category were in the Walallawita Medical Officer of Health Area. Food establishments taking precautionary measures, which are not assessed in the current tool, were good, but maintenance of processing area and installation of overhead structures and fitting were poor in food establishments in all three Medical Officer of Health Areas.

Conclusions:

The novel food assessment tool FEAT is a completely valid instrument for food establishments. It is designed for easy administration and supports reliable assessments. Overall food handling practices of food establishments in the Kalutara Regional Director of Health Services area following assessment with FEAT were in the “satisfactory” category.
Wikidata as Semantic Infrastructure: Knowledge Representation, Data Labor, and Truth in a More-Than-Technical Project
Authors: Ford Heather , Iliadis Andrew
Published: September 2023

Wikidata is a knowledge base (i.e., a database of facts) project of the Wikimedia Foundation and a sister project to Wikipedia that contains billions of facts that anyone can edit. Platform companies, such as Amazon, Google, and Microsoft use Wikidata to retrieve and transmit facts across the internet, while researchers rely on Wikidata as a data source for facts. Various Wikipedia researchers have commended Wikidata for its collaborative nature and liberatory potential, yet less attention has been paid to the social and political implications of Wikidata. This article aims to advance work in this context by introducing the concept of semantic infrastructure and outlining how Wikidata’s role as semantic infrastructure is the primary vehicle by which Wikipedia has become infrastructural for digital platforms. We develop two key themes that build on questions of power that arise in infrastructure studies and apply to Wikidata: knowledge representation and data labor. We argue that considering these issues about Wikidata helps contextualize such infrastructural technologies within existing media and communication studies debates and highlights the contingencies upon which their outcomes depend.
HIV Testing and HIV Positivity Among People Who Inject Drugs (PWIDs) With and Without History of High-Risk Behaviors: Findings From a Respondent-Driven Sampling (RDS) Survey in Southern Thailand
Authors: Talek Muhammadfahmee , Saingam Darika , Wichaidit Wit
Published: September 2023

People who inject drugs (PWIDs) may engage in other behaviors with high risk of HIV transmission to various extents. However, data are scarce regarding differences in HIV testing and HIV positivity among PWIDs with and without high-risk behaviors. Such data can help inform stakeholders with regard to program prioritization. The objective of this study was to assess the extent that lifetime and past-year histories of HIV tests and HIV positivity varied by history of high-risk behaviors among PWIDs. We conducted a cross-sectional study with respondent-driven sampling (RDS) in the deep south provinces of Thailand during late 2019 thru early 2020. Data collection was done using structured questionnaire with face-to-face interviews. We analyzed data using descriptive statistics and multivariate logistic regression analyses. A total of 283 PWIDs gave verbal informed consent, and 282 PWIDs participated in the interview ( n = 282 PWIDs). Approximately 44.6% of the participants never had an HIV test. Participants with history of high-risk behaviors had significantly higher odds of lifetime HIV testing than participants with no history of high-risk behaviors (Adjusted OR = 2.94; 95% CI [1.11, 7.78]). Among participants with lifetime history of HIV tests, those with history of high-risk behaviors had significantly higher odds of being HIV-positive than those with no history of high-risk behaviors (Adjusted OR = 2.44; 95% CI [0.73, 8.17]). Stakeholders should consider encouraging those without history of high-risk behaviors not to be complacent about HIV testing, and ensure that those with high-risk behaviors have full access to HIV care when they test positive.
Development of an integrative empowerment model to care for patients with schizophrenia disorder
Authors: Indah Iswanti Dwi , Nursalam Nursalam , Fitryasari Rizki , Kusuma Dewi Rian
Published: September 2023

Background:

The main factor that causes a family the inability to care for patients with schizophrenia disorder is inadequate family-centered empowerment. Nevertheless, the family-integrated empowerment model has not been developed yet. This study aims to develop a integrative empowerment model to care for patients with schizophrenia disorder.

Design and methods:

The mixed methods research design was divided into two stages. The first stage used a cross-sectional method with a questionnaire to 135 families who cared for patients with schizophrenia disorder using purposive sampling. Data analysis was obtained using Partial Least Squares (PLS). The second stage is a focused group discussion (FGD) conducted with six families, seven health workers, and six social workers, and discussions with two experts for model development.

Results:

The integrative empowerment-based family empowerment model is developed from Outside-in empowerment (path coefficient = 0.309; t = 3.292) and Inside-out empowerment (path coefficient = 0.478; t = 4.850). Family factors is the most potent variable in shaping Inside-out empowerment (path coefficient = 0.217; t = 2.309). Moreover, re-meaning of caregiving is the strongest indicator that builds the Inside-out empowerment variable ( t = 42.643). The value of Q2 is 0.433 indicates that this model can be generalized, since 61% of family ability to provide care for schizophrenia patients.

Conclusions:

Re-meaning of caregiving is the most potent indicator in shaping Inside-out empowerment, which is the strongest factor forming this model. Nurses assist families to be able to find activities that can generate positive meaning when caring for patients with schizophrenia disorder.
Opportunities for Patient Participation in Perioperative Malnutrition Care: A Qualitative Study
Authors: Berg Gerda van den , Schueren Marian de van der , Vermeulen Hester , Huisman-de Waal Getty
Published: September 2023

Introduction

In the perioperative period of hospitalization, barriers to food intake are common due to special nutritional needs, compromised nutritional status, and metabolic stress. Good nutritional care call for an interdisciplinary approach. And patients themselves may also play an essential role in managing nutritional care.

Objective

This study aimed to explore how patients with malnutrition experience nutritional care, their perspectives on patient participation, and their own role in malnutrition care in the perioperative period of hospitalization.

Methods

A qualitative study was conducted using an interpretive phenomenological approach. To follow patients’ experiences, in-depth longitudinal interviews were undertaken before, during, and after hospitalization. Interview transcripts were analyzed thematically using open, axial, and selective coding and interpreted in an iterative process.

Results

Fifty-six interviews were undertaken with 26 patients with malnutrition scheduled for surgery and during the perioperative period of hospitalization. Four themes were identified: (1) unawareness and stigmata about being malnourished, (2) feasibility of optimal nutritional care, (3) needs and expectations for self-management, and (4) barriers and facilitators of taking own responsibilities in nutritional care.

Conclusion

Awareness and responsiveness to patients’ perspectives, motivation, and compliance are prerequisites for patient participation in malnutrition care. This requires good communication between healthcare professionals and patients in all phases of hospitalization.
Structural Relationships Between Cognitive Function, Depressive Symptoms, Self-Care Confidence, and Maintenance in Patients With Heart Failure
Authors: Kim JinShil , Hwang Seon Young , Kim Sun Hwa , Shim Jae Lan
Published: September 2023

Introduction

In order to promote self-care maintenance behavior in patients with heart failure (HF), it is necessary to identify the direct and indirect effects of major latent variables.

Objective

This study aimed to identify structural relationships between different domains of cognitive function, depression and self-care confidence, and self-care maintenance.

Methods

This descriptive study involved a secondary analysis using data of 201 patients with HF from two observational studies in three hospitals in Korea. The structural equation model using AMOS version 24.0 was constructed to assess the relationships among the variables. The Seoul Neuropsychological Screening Battery was used to assess global cognition, immediate/delayed memory, and executive function, and the Self-Care of HF Index v.6.2. was used for self-care confidence and maintenance.

Results

Self-care maintenance was affected by memory function with a significant direct effect (β=.43, p = .006), as well as self-care confidence (β=.70, p < .001). Memory function and global function indirectly affected self-care maintenance through self-care confidence (β = −.37, p = .002; β = .14, p = .030). Depressive symptoms also had an indirect effect through self-care confidence on self-care maintenance (β = −.21, p = .005).

Conclusion

This study confirmed that it is important to increase self-care confidence through supportive care and to maintain memory function for maintaining self-care in the chronic course of HF patients. In particular, this study suggests that it is necessary to perform periodic memory check-ups for chronic HF patients on an outpatient basis, and counseling and education are needed to improve memory and increase confidence in self-care.
Professional Identity Formation, Professionalism, Leadership and Resilience (PILLAR) in Medical Students: Methodology and Early Results
Authors: Ryan Aine , Hickey Anne , Harkin Denis , Boland Fiona , Collins Mary E. , Doyle Frank
Published: September 2023

Objectives

The fundamental role of medical education is the transformation of students to doctors, through a process of education and professional identity formation (PIF), which can be informed by several educational, behavioural and emotional factors. PIF has been deemed to be of equal importance to the acquisition of clinical knowledge and skills and includes constructs such as professionalism, leadership and resilience. We aimed to assess professional identity formation, professionalism, leadership and resilience (PILLAR) in the junior years of medical school in the 2020/2021 academic year and illustrate the potential role of quantitative assessment to demonstrate progression in these areas. In this research, we provide the methods and baseline results for the PILLAR study.

Methods

We implemented a compulsory assessment in pre-clinical years of graduate entry and direct entry medicine at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Validated scales were used to assess students’ PILLAR. Descriptive and univariable statistical techniques were used to compare student scores between respective years.

Results

A total of 1311 students (92% response rate) provided their consent for research. For the psychometric scales, there were no evident trends among the years on these assessment measures. Results indicated significant differences in all measures, however, these did not correspond to ascending years of seniority.

Conclusion

The PILLAR methodology provides important information on the challenges of quantitatively assessing medical students in the four key areas of PIF, professionalism, leadership, and resilience. Our cross-sectional results point to cohort effects, without the expected progression per year in the cross-sectional data, or suggest that the chosen quantitative measures may be problematic for these constructs in pre-clinical students. Therefore, while we believe that PILLAR has potential as a progress test for these constructs, this will only truly be elucidated by repeated measures of each cohort over time.
Values in college mathematics learning: Student teachers’ preference
Authors: Kyeremeh Patrick , Dorwu Esenam
Published: September 2023

This study explored what Ghanaian student teachers value in college mathematics learning. A cross-sectional survey involving 180 student teachers from College of Education in Ghana was conducted using the What I Find Important (WIFI) in mathematics learning questionnaire. The study employed principal component analysis with Oblimin rotation and one-way multivariate analysis of variance in analyzing the data gathered. Among the findings, it was found that student teachers value exploration, connections, understanding, and fluency in their study of college mathematics. Also, the findings of the study revealed a statistically significant difference in what student teachers value in college mathematics learning across college class levels. To facilitate a clearer understanding of valuing in the colleges of education in Ghana, it is considered important to establish through research the values of teacher educators regarding college mathematics learning and teaching, and how these values reflect what student teachers value and those values espoused in the new 4-year Bachelor of Education (B.Ed.) curriculum in Ghana.
The role of vaccination in COPD: influenza, SARS-CoV-2, pneumococcus, pertussis, RSV and varicella zoster virus
Authors: Simon Susanne , Joean Oana , Welte Tobias , Rademacher Jessica
Published: September 2023

Exacerbations of COPD are associated with worsening of the airflow obstruction, hospitalisation, reduced quality of life, disease progression and death. At least 70% of COPD exacerbations are infectious in origin, with respiratory viruses identified in approximately 30% of cases. Despite long-standing recommendations to vaccinate patients with COPD, vaccination rates remain suboptimal in this population.

Streptococcus pneumoniaeis one of the leading morbidity and mortality causes of lower respiratory tract infections. The Food and Drug Administration recently approved pneumococcal conjugate vaccines that showed strong immunogenicity against all 20 included serotypes. Influenza is the second most common virus linked to severe acute exacerbations of COPD. The variable vaccine efficacy across virus subtypes and the impaired immune response are significant drawbacks in the influenza vaccination strategy. High-dose and adjuvant vaccines are new approaches to tackle these problems. Respiratory syncytial virus is another virus known to cause acute exacerbations of COPD. The vaccine candidate RSVPreF3 is the first authorised for the prevention of RSV in adults ≥60 years and might help to reduce acute exacerbations of COPD. The 2023 Global Initiative for Chronic Lung Disease report recommends zoster vaccination to protect against shingles for people with COPD over 50 years.
Effects of continuous positive airway pressure therapy on glucose metabolism in patients with obstructive sleep apnoea and type 2 diabetes: a systematic review and meta-analysis
Authors: Herth Jonas , Sievi Noriane Adriana , Schmidt Felix , Kohler Malcolm
Published: September 2023

Obstructive sleep apnoea is a highly prevalent chronic disorder and has been shown to be associated with disturbed glucose metabolism and type 2 diabetes. However, the evidence from individual clinical trials on the effect of continuous positive airway pressure (CPAP) treatment on glycaemic control in patients with co-existing obstructive sleep apnoea and type 2 diabetes remains controversial. A systematic review of randomised controlled trials assessing the effect of CPAP on glycaemic control in patients with obstructive sleep apnoea and type 2 diabetes was conducted using the databases MEDLINE, Embase, Cochrane and Scopus up to December 2022. Meta-analysis using a random-effect model was performed for outcomes that were reported in at least two randomised controlled trials. From 3031 records screened, 11 RCTs with a total of 964 patients were included for analysis. CPAP treatment led to a significant reduction in haemoglobin A1c (HbA1c) (mean difference −0.24%, 95% CI −0.43– −0.06%, p=0.001) compared to inactive control groups. Meta-regression showed a significant association between reduction in HbA1c and hours of nightly CPAP usage. CPAP therapy seems to significantly improve HbA1c and thus long-term glycaemic control in patients with type 2 diabetes and obstructive sleep apnoea. The amount of improvement is dependent on the hours of usage of CPAP and thus optimal adherence to CPAP should be a primary goal in these patients.
Comparative transcriptomes reveal geographic differences in the ability of the liver of plateau zokors (Eospalax baileyi) to respond and adapt to toxic plants
Authors: Tan Yuchen , Wang Yanli , Liu Qianqian , Wang Zhicheng , Shi Shangli , Su Junhu
Published: September 2023

Background

Environmental changes are expected to intensify in the future. The invasion of toxic plants under environmental changes may change herbivore feeding environments. Herbivores living long-term in toxic plant-feeding environments will inevitably ingest plant secondary metabolites (PSMs), and under different feeding environments are likely to have unique protection mechanisms that support improved adaptation to PSMs in their habitat. We aimed to compare different subterranean herbivore population responses and adaptations to toxic plants to unveil their feeding challenges.

Results

Here, we investigated the adaptive capacity of the liver in two geographically separated populations of plateau zokors (Eospalax baileyi) before and after exposure to the toxic plant Stellera chamaejasme (SC), at the organ, biochemical, and transcriptomic levels. The results showed no significant liver granules or inflammatory reactions in the Tianzhu (TZ) population after the SC treatment. The transaminase level in the TZ population was significantly lower than that in the Luqu population. Transcriptome analysis revealed that the TZ population exhibited interactions with other detoxification metabolic pathways by oxytocin pathway-associated genes, including diacylglycerol lipase alpha (Dagla), calcium/calmodulin dependent protein kinase II Alpha (Camk2a), and CD38 molecule (Cd38). The phase II process of liver drug metabolism increased to promote the rate of metabolism. We found that alternative splicing (AS) and the expression of the cyclin D (Ccnd1) gene interact—a TZ population hallmark—reduced liver inflammatory responses.

Conclusion

Our study supports the detoxification limitation hypothesis that differences in liver detoxification metabolism gene expression and AS are potential factors in herbivore adaptation to PSMs and may be a strategy of different herbivore populations to improve toxic plant adaptability.
Trends in output of hypertension management and associated factors in primary care facilities: a latent trajectory analysis in China from 2009 to 2017
Authors: Duan Lei , Zhang Liang , Zhang Xiang , Lu Shan
Published: September 2023

Background

The prevalence of hypertension is high (25.2% in 2012) and there were a large number of patients with hypertension (more than 200 million) in China. Township health centres in rural areas and community health centres in urban areas are responsible for hypertension management. This study aims to identify trends in hypertension management output and related facility-level, geographical and economic factors in primary care facilities and to assess the effect of the national project of basic public health services in China from 2009 to 2017.

Methods

A cross-sectional survey (2018) was combined with retrospective data collection (2009–2017) from 685 primary care facilities in six provinces in China. The hypertension management output was indicated by the number of patients with hypertension under management per 10,000 population. Latent class growth analysis and group-based trajectory models were applied to classify trajectories and determine associations with facility-level, geographic and economic characteristics.

Results

The trend in the output increased rapidly from 2009 to 2012 with an average growth rate of 54.58% and slowed down from 2012 to 2017 (growth rate of 5.94%). Five trajectories of the output were identified and labelled according to baseline status and increase rates: low-gradually increasing (16.9%), middle-slightly increasing (16.2%), low-sharply increasing (7.9%), middle-sharply increasing (34.2%) and persistently high (24.9%). The time-stable characteristics, including region (eastern, central or western), district (urban or rural), landform, were associated with hypertension management output of the facilities. Number of public health physicians was a significant time-dependent characteristic influencing management output.

Conclusions

Five latent trajectories of hypertension management output were identified. The output was still at a low level compared with the prevalence of hypertension. Hypertension screening in young people need to be emphasized. Facilities are recommended to establish good relationships with residents for better hypertension management outcomes especially in urban areas.
Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial
Authors: Gigonzac Mathilde , Terrier Philippe
Published: September 2023

Context

Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls.

Rationale

Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls.

Objective

The aim is to assess the efficacy of an arm-in-arm gait-training program in older people.

Design

The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial.

Participants

We will enroll 66 dyads of older people and their younger “gait instructors”. The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry.

Intervention

Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks.

Outcomes

The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 – week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training.

Expected results

Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors.

Trial registration

ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
Prevalence and risk factors of tuberculosis among people living with HIV/AIDS in China: a systematic review and meta-analysis
Authors: Qi Cong-Cong , Xu Li-Ran , Zhao Chang-Jia , Zhang Hai-Yan , Li Qing-Ya , Liu Mei-Jun , Zhang Ye-Xuan , Tang Zhou , Ma Xiu-Xia
Published: September 2023

Objective

To estimate the prevalence and risk factors associated with tuberculosis (TB) among people living with human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) in China.

Methods

A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. After the literature was screened based on the inclusion and exclusion criteria, STATA® version 17.0 software was used for the meta-analysis. The heterogeneity among study data was assessed using I2 statistics. Subgroup analysis and meta-regressions were performed to further explore the source of heterogeneity.

Results

A total of 5241 studies were retrieved. Of these, 44 studies were found to be eligible. The pooled prevalence of HIV/TB co-infection was 6.0%. The risk factors for HIV/TB co-infection included a low CD4+ T cell count, smoking, intravenous drug use and several other sociodemographic and clinical factors. Bacillus Calmette–Guérin (BCG) vaccination history was a protective factor.

Conclusion

A high prevalence of TB was observed among people living with HIV/AIDS in China. Low CD4+ T cell count, smoking, and intravenous drug use were the primary risk factors for HIV/TB co-infection, whereas BCG vaccination history was a protective factor. Checking for TB should be prioritized in HIV screening and healthcare access.

Systematic review registration

Registered on PROSPERO, Identifier: CRD42022297754.
Current evidence for J147 as a potential therapeutic agent in nervous system disease: a narrative review
Authors: Qiu Fang , Wang Yanmei , Du Yunbo , Zeng Changchun , Liu Yuqiang , Pan Haobo , Ke Changneng
Published: September 2023

Curcumin has anti-inflammatory, antioxidant, and anticancer effects and is used to treat diseases such as dermatological diseases, infection, stress, depression, and anxiety. J147, an analogue of curcumin, is designed and synthesized with better stability and bioavailability. Accumulating evidence demonstrates the potential role of J147 in the prevention and treatment of Alzheimer’s disease, diabetic neuropathy, ischemic stroke, depression, anxiety, and fatty liver disease. In this narrative review, we summarized the background and biochemical properties of J147 and discussed the role and mechanism of J147 in different diseases. Overall, the mechanical attributes of J147 connote it as a potential target for the prevention and treatment of neurological diseases.