bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of the use of social media on patients changing dental practice: a web-based questionnaire study
Authors: Freire Yolanda , Sánchez Margarita Gómez , Suárez Ana , Joves Gerardo , Nowak Marlen , Díaz-Flores García Víctor
Published: June 2023

Background

Recent years have seen an increase in the use of social media, by the healthcare sector, including dentistry. Indeed, social media may now be important communication tools for dental practices and patients.

This work analyzes the influence of patient (male and female) use of dental practice social media on their decision to change practice. The results also provide insight into the factors patients considered important when choosing a dental practice.

Methods

This study was approved by the Ethics Committee of the Universidad Europea de Madrid (No. CIPI/22.022). Using a web-based questionnaire, a cross-sectional study was undertaken involving a Spanish population that made use of dental services. The questionnaire consisted of four parts covering provision of informed consent, the collection of sociodemographic data, patient use of dental practice social media, and the factors considered important when changing dental practice.

Results

All participants gave their informed consent regarding inclusion. No compensation was provided for participation. 588 people responded to the questionnaire, of whom 503 were eligible for inclusion. Most respondents were female (312/503; 62%). Most (151/503; 30%) last changed dental practice during the previous 2–5 years. 208/503 (41.4%) indicated that they had visited dental practice social media. 118/503 (23.5%) indicated that they had made use of such the last time they changed dental practice; 102 of these 118 (85.6%) reported their experience to have influenced their decision to change. Respondents who had changed practice in the last 5 years had interacted with dental practice social media more than those who changed over 11 years ago (p < .05), and those who changed practice in the present/past year were more influenced by these media (p < .05). The factor considered most important was 'Facilities and technology'. No gender-based differences were seen for any measured variable (p < .05).

Conclusions

Different factors affect the selection of a new dental practice, but respondents who changed practice in the last few years were more likely to have made use of dental practice social media, which, for some, influenced their final decision to change. Dental practices might do well to consider using social media as communication and marketing tools.
A qualitative study examining the critical differences in the experience of and response to formative feedback by undergraduate medical students in Japan and the UK
Authors: Kozato An , Shikino Kiyoshi , Matsuyama Yasushi , Hayashi Mikio , Kondo Satoshi , Uchida Shun , Stanyon Maham , Ito Shoichi
Published: June 2023

Background

Formative feedback plays a critical role in guiding learners to gain competence, serving as an opportunity for reflection and feedback on their learning progress and needs. Medical education in Japan has historically been dominated by a summative paradigm within assessment, as opposed to countries such as the UK where there are greater opportunities for formative feedback. How this difference affects students’ interaction with feedback has not been studied. We aim to explore the difference in students’ perception of feedback in Japan and the UK.

Methods

The study is designed and analysed with a constructivist grounded theory lens. Medical students in Japan and the UK were interviewed on the topic of formative assessment and feedback they received during clinical placements. We undertook purposeful sampling and concurrent data collection. Data analysis through open and axial coding with iterative discussion among research group members was conducted to develop a theoretical framework.

Results

Japanese students perceived feedback as a model answer provided by tutors which they should not critically question, which contrasted with the views of UK students. Japanese students viewed formative assessment as an opportunity to gauge whether they are achieving the pass mark, while UK students used the experience for reflective learning.

Conclusions

The Japanese student experience of formative assessment and feedback supports the view that medical education and examination systems in Japan are focused on summative assessment, which operates alongside culturally derived social pressures including the expectation to correct mistakes. These findings provide new insights in supporting students to learn from formative feedback in both Japanese and UK contexts.
Associations among leadership, resources, and nurses’ work engagement: findings from the fifth korean Working Conditions Survey
Authors: Kim Eunkyung , Lee Ji Yea , Lee Seung Eun
Published: June 2023

Background

Nurses’ work engagement has received extensive attention due to its positive impacts on individual and organizational outcomes, including patient safety and quality care in healthcare organizations. Although nurse managers’ leadership and a variety of resources have been identified as important factors of nurses’ work engagement, these relationships have not been well understood in Korean nursing contexts. The purpose of this study was to examine the associations among nurse managers’ leadership, resources, and work engagement among Korean nurses after controlling for nurses’ demographic and work-related characteristics.

Methods

This is a cross-sectional study using data from the fifth Korean Working Conditions Survey. Using a sample of 477 registered nurses, we employed hierarchical linear regression analyses. Nurse managers’ leadership, job resources (organizational justice and support from peers), professional resources (employee involvement), and personal resources (meaning of work) were examined as potential predictors of nurses’ work engagement.

Results

We found that nurse managers’ leadership (β = 0.26, 95% confidence interval [CI] = 0.17–0.41) was the strongest predictor of nurses’ work engagement, followed by meaning of work (β = 0.20, 95% CI = 0.07–0.18), organizational justice (β = 0.19, 95% CI = 0.10–0.32), and support from peers (β = 0.14, 95% CI = 0.04–0.23). Employee involvement was not a statistically significant predictor of nurses’ work engagement (β = -0.07, 95% CI = -0.11–0.01).

Conclusions

Our findings suggest that comprehensive approaches are required to promote nurses’ work engagement. Considering that nurse managers’ leadership was the strongest predictor of nurses’ work engagement, nurse managers should demonstrate supportive leadership behaviors such as acknowledging and praising their unit nurses’ work performance. Furthermore, both individual- and organizational-level strategies are necessary for nurses to be engaged at work.
Associations between long-term care-service use and service- or care-need level progression: a nationwide cohort study using the Japanese Long-Term Care Insurance Claims database
Authors: Hasegawa Kohei , Tsukahara Teruomi , Nomiyama Tetsuo
Published: June 2023

Background

The effectiveness of the long-term care service in Japan has been unclear, and most of the relevant studies of this service have been limited to a single region and relatively small samples, necessitating large-scale studies. We examined the associations between long-term care service use and the service/care-need level progression at the national scale in Japan.

Methods

We conducted a nationwide retrospective cohort study using data from the Japanese Long-Term Care Insurance Claims database. Individuals aged ≥ 65 years and newly certified as being at the support-need level 1 or 2 or the care-need level 1 between April 2012 and March 2013 were included. We first conducted 1:1 propensity score matching and then examined the associations between service use and the progression in support-need or care-need levels by using Kaplan–Meier survival curves and log-rank tests.

Results

The final sample consisted of 332,766 individuals. We observed that service use was associated with a faster decline in the support/care-need level, although the differences in the subjects' survival rate diminished; the log-rank test showed significance (p < 0.001). When stratified for urban–rural classifications or regions of Japan, the results were similar to the primary analysis in all of the stratified groups, and no clear regional variations were observed.

Conclusion

We did not observe a clear beneficial effect of receiving long-term care in Japan. Our results suggest that Japan's current long-term care service may not be effective for the recipients of these services. Considering that the system is becoming a financial burden, a re-examination of the service to provide more cost-effective care may be advisable.
Metabolomics analysis of the potential mechanism of Yi-Guan-Jian decoction to reverse bone loss in glucocorticoid-induced osteoporosis
Authors: Yin Mengxing , Zhou Dezhi , Jia Fu , Su Xiaosan , Li Xiufang , Sun Ruifen , Li Junmin
Published: June 2023

Background

Glucocorticoid-induced osteoporosis (GIOP) is a disease in which long-term use of glucocorticoid causes bone loss, deterioration of bone microstructure and fracture. Currently, clinical drugs targeting this disease have certain side effects. There is still a need to find effective drugs with fewer side effects. The theory of traditional Chinese medicine suggests that YGJ has therapeutic effect on GIOP, but it has not been explained. Therefore, this study aims to explore the protective effect of YGJ on GIOP mouse models and elucidate the underlying mechanism through LC–MS-based metabolomics analysis.

Methods

The general condition of 8 week age male C57BL/6J mice was recorded after 8 weeks of treatment with dexamethasone (DEX) and YGJ. Bone-related parameters and bone morphology were determined by Micro-CT. HE staining was used to observe the pathological changes of bone tissue. Serum levels of bone metabolism markers were detected by ELISA. Liver metabolomics analysis was conducted to search for the significant markers of anti-GIOP of YGJ and the metabolic pathway affecting it.

Results

After treatment, YGJ significantly reversed the weight loss caused by DEX; increase the number of bone trabecular in ROI region, significantly improve the bone-related parameters of GIOP mice, and increase the levels of alkaline phosphatase and osteocalcin. In the study of metabolic mechanism, YGJ reversed 24 potential markers in GIOP mice. These included cortisol, 3-hydroxybutyric acid, taurine, esculin and uric acid, which are closely associated with osteoporosis. Topological analysis results showed that YGJ had the most significant effect on taurine and hypotaurine metabolism, with − log10 (P) > 2.0 and Impact > 0.4.

Conclusions

Yi-Guan-Jian decoction can increase bone density and improve bone microstructure by regulating the levels of alkaline phosphatase and osteocalcin and reverse bone loss in GIOP mouse model. The underlying metabolic mechanism may be related to taurine and hypotaurine metabolic pathway.
Preimplantation genetic testing for Aicardi–Goutières syndrome induced by novel compound heterozygous mutations of TREX1: an unaffected live birth
Authors: Xu Huiling , Pu Jiajie , Lin Suiling , Hu Rui , Yao Jilong , Li Xuemei
Published: June 2023

Background

Aicardi–Goutières syndrome (AGS) is a rare, autosomal recessive, hereditary neurodegenerative disorder. It is characterized mainly by early onset progressive encephalopathy, concomitant with an increase in interferon-α levels in the cerebrospinal fluid. Preimplantation genetic testing (PGT) is a procedure that could be used to choose unaffected embryos for transfer after analysis of biopsied cells, which prevents at-risk couples from facing the risk of pregnancy termination.

Methods

Trio-based whole exome sequencing, karyotyping and chromosomal microarray analysis were used to determine the pathogenic mutations for the family. To block the inheritance of the disease, multiple annealing and looping-based amplification cycles was used for whole genome amplification of the biopsied trophectoderm cells. Sanger sequencing and next-generation sequencing (NGS)-based single nucleotide polymorphism (SNP) haplotyping were used to detect the state of the gene mutations. Copy number variation (CNV) analysis was also carried out to prevent embryonic chromosomal abnormalities. Prenatal diagnosis was preformed to verify the PGT outcomes.

Results

A novel compound heterozygous mutation in TREX1 gene was found in the proband causing AGS. A total of 3 blastocysts formed after intracytoplasmic sperm injection were biopsied. After genetic analyses, an embryo harbored a heterozygous mutation in TREX1 and without CNV was transferred. A healthy baby was born at 38th weeks and prenatal diagnosis results confirmed the accuracy of PGT.

Conclusions

In this study, we identified two novel pathogenic mutations in TREX1, which has not been previously reported. Our study extends the mutation spectrum of TREX1 gene and contributes to the molecular diagnosis as well as genetic counseling for AGS. Our results demonstrated that combining NGS-based SNP haplotyping for PGT-M with invasive prenatal diagnosis is an effective approach to block the transmission of AGS and could be applied to prevent other monogenic diseases.
Management of a patient with common variable immunodeficiency and hepatopathy
Authors: Grümme Lea , Schulze-Koops Hendrik
Published: June 2023

Background

Common variable Immunodeficiency (CVID) is a primary immunodeficiency disorder and the most common form of severe antibody deficiency. Both children and adults are affected and clinical manifestations vary widely. Often, CVID manifests with infections, autoimmune phenomena or chronic lung disease, but it also frequently affects the liver. The differential diagnoses of hepatopathies in CVID patients are diverse and the characteristics of CVID patients often make it difficult to determine the correct diagnosis.

Case presentation

We present the case of a 39-year-old patient with CVID and elevated liver enzymes, nausea and unintended weight loss, who was referred to our clinic with the suspected diagnose of autoimmune hepatitis or immunoglobulin-induced hepatopathy. Prior, the patient had undergone an extensive diagnostic work-up including liver biopsy but viral hepatitides had only been investigated serologically – with negative antibody results. We searched for viral nucleic acid by polymerase chain reaction and detected hepatitis E virus-RNA. Antiviral therapy was started and the patient recovered quickly.

Conclusion

Hepatopathies in CVID patients are common with a broad spectrum of possible causes. While treating CVID patients, the distinct diagnostic and therapeutic requirements of the CVID patients should be closely considered and diagnosed by the appropriate measures.
Bath-related headache: a case report
Authors: Chang Thashi
Published: June 2023

Background

Bath-related headache (BRH) is a rare primary headache disorder with only about 50 cases reported from 2000 to 2017 and none since. It is an abrupt onset excruciating headache occurring predominantly in middle-aged Asian women, most commonly following exposure to hot water. This is the first report in a Sri Lankan woman.

Case presentation

A 60-year-old Sri Lankan woman presented with an abrupt onset, severe throbbing holocephalic headache immediately following a hot-water shower. The headache was not associated with photo- or phonophobia, nausea, or vomiting, and she did not report a past history of migraine. However, she had experienced a similar headache 2 years previously precipitated by a hot-water shower. Her neurological examination, blood investigations, and magnetic resonance imaging of brain and intracranial vessels were normal. She was treated with opioid and nonsteroidal antiinflammatory drug analgesics, but the headache resolved only after treatment with nimodipine. The headache did not recur during a follow-up of 2 years since she avoided hot-water showers.

Conclusions

Bath-related headache is a thunderclap primary headache disorder with a benign prognosis, but its recognition requires awareness to differentiate it from subarachnoid hemorrhage. It warrants inclusion in the International Classification of Headache Disorders.
Breast cancer: the first comparative evaluation of oncobiome composition between males and females
Authors: Niccolai Elena , Baldi Simone , Nannini Giulia , Gensini Francesca , Papi Laura , Vezzosi Vania , Bianchi Simonetta , Orzalesi Lorenzo , Ramazzotti Matteo , Amedei Amedeo
Published: June 2023

Background

Emerging evidence suggests that breast microbiota dysbiosis contributes to cancer initiation, progression, prognosis and treatment efficacy. Anyway, available data are referred only to female patients, and studies on males are completely missing. Male breast cancer (MBC) is 70–100 times less frequent, but the mortality rate adjusted to incidence is higher in men than in females. Currently, MBC diagnostic approaches and treatments have generally been extrapolated from the clinical experience gained in women, while few studies focus on characterizing male cancer biology. Taking into account the rising importance of the oncobiome field and the need of MBC targeted studies, we explored the breast cancer oncobiome of male and female patients.

Methods

16S rRNA gene sequencing was performed in 20 tumor and 20 non-pathological adjacent FFPE breast tissues from male and female patients.

Results

We documented, for the first time, the presence of a sexually dimorphic breast-associated microbiota, here defined as “breast microgenderome”. Moreover, the paired analysis of tumor and non-pathological adjacent tissues suggests the presence of a cancer-associated dysbiosis in male patients, with surrounding tissue conserving a healthier microbiome, whereas in female patients, the entire breast tissue is predisposed to cancer development. Finally, the phylum Tenericutes, especially the genera Mesoplasma and Mycobacterium, could to be involved in breast carcinogenesis, in both sexes, deserving further investigation, not only for its role in cancer development but even as potential prognostic biomarker.

Conclusions

Breast microbiota characterization can enhance the understanding of male breast cancer pathogenesis, being useful for detection of new prognostic biomarkers and development of innovative personalized therapies, remarking the relevant gender differences.
Measuring the burden of infodemics with a research toolkit for connecting information exposure, trust, and health behaviours
Authors: Dunn Adam G. , Purnat Tina D. , Ishizumi Atsuyoshi , Nguyen Tim , Briand Sylvie
Published: June 2023

Background

During a public health emergency, accurate and useful information can be drowned out by questions, concerns, information voids, conflicting information, and misinformation. Very few studies connect information exposure and trust to health behaviours, which limits available evidence to inform when and where to act to mitigate the burden of infodemics, especially in low resource settings. This research describes the features of a toolkit that can support studies linking information exposure to health behaviours at the individual level.

Methods

To meet the needs of the research community, we determined the functional and non-functional requirements of a research toolkit that can be used in studies measuring topic-specific information exposure and health behaviours. Most data-driven infodemiology research is designed to characterise content rather than measure associations between information exposure and health behaviours. Studies also tend to be limited to specific social media platforms, are unable to capture the breadth of individual information exposure that occur online and offline, and cannot measure differences in trust by information source or content. Studies are also designed very differently, limiting synthesis of results.

Results

We demonstrate a way to address these requirements via a web-based study platform that includes an app that participants use to record topic-specific information exposure, a browser plugin for tracking access to relevant webpages, questionnaires that can be delivered at any time during a study, and app-based incentives for participation such as visual analytics to compare trust levels with other participants. Other features of the platform include the ability to tailor studies to local contexts, ease of use for participants, and frictionless sharing of de-identified data for aggregating individual participant data in international meta-analyses.

Conclusions

Our proposed solution will be able to capture detailed data about information exposure and health behaviour data, standardise study design while simultaneously supporting localisation, and make it easy to synthesise individual participant data across studies. Future research will need to evaluate the toolkit in realistic scenarios to understand the usability of the toolkit for both participants and investigators.
“It’s not about wanting to be thin or look small, it’s about the way it feels”: an IPA analysis of social and sensory differences in autistic and non-autistic individuals with anorexia and their parents
Authors: Nimbley Emy , Gillespie-Smith Karri , Duffy Fiona , Maloney Ellen , Ballantyne Carrie , Sharpe Helen
Published: June 2023

Background

Despite increasing evidence to support an overlap between autism and anorexia nervosa (AN), underlying mechanisms remain poorly understood. Social and sensory factors have emerged as promising targets in both autism and AN, however there remains scope to compare these differences across autistic and non-autistic experiences of AN. Drawing on dyadic multi-perspectives, this study explored experiences of social and sensory differences in autistic and non-autistic adults and their parents and/or carers.

Methods

Using interpretative phenomenological analysis (IPA), dyadic interviews were conducted with 14 dyads, with seven autistic dyads and seven non-autistic dyads. Data analysis was subjected to a triangulation of interpretations: (1) the participants themselves; (2) a neurotypical researcher; (3) and an Autistic researcher with lived/living experience of AN.

Results

IPA identified three themes in each group, with similarities and differences between autistic and non-autistic dyads. Similar themes were identified regarding the importance of social connectedness and socio-emotional difficulties, as well a common lack of trust in the social and sensory self and body. Autism-specific themes centred on feelings of social ‘defectiveness’, disparities between sensing and expressing certain cues, and lifelong, multi-sensory processing differences. Non-autistic themes reflected social comparisons and inadequacy, and sensitivities to the learning of ideals and behaviour through early experiences.

Conclusions

While similarities were observed across both groups, there appeared to be notable differences in the perceived role and influence of social and sensory differences. These findings may have important implications on the delivery and modification of eating disorder interventions. Specifically, they suggest that while treatment targets may look similar, subtle differences in underlying mechanisms and approaches may be required for Autistic individuals with AN across sensory, emotion and communication-based interventions.
Systematic study of wall painting of the twelfth century from the Christ’s Transfiguration Cathedral of the Mirozhsky Monastery in Pskov (Russia) by complementary physico-chemical methods
Authors: Philippova O. S. , Grebenshchikova A. B. , Dmitriev A. Yu. , Lennik S. G.
Published: June 2023

The unique pre-Mongolian twelfth century wall painting from the Christ's Transfiguration Cathedral of the Mirozhsky Monastery in Pskov (Russia) have been investigated. A little less than 200 XRF spectra were collected in situ by portable spectrometer. Moreover 19 samples were subjected to additional in-depth laboratory analysis by six complimentary physico-chemical methods: neutron activation analysis, Fourier transform infrared spectroscopy, micro-Raman spectroscopy, polished cross-sections, polarized microscopy, and chemical microanalysis. Pigments and plasters from the interior painting, fragments found during archaeological excavations, samples from exterior murals, and sample of salt efflorescence were analyzed. The samples included the author's twelfth century painting as well as late repaintings. The composition of pigments and the number of painting layers were determined. Conclusions about organic binder presence or absence, and the painting technique were drawn. The results obtained will be used for restoration and conservation works.
Three-dimensional analysis of miniscrew position changes during bone-borne expansion in young and late adolescent patients
Authors: Migliorati Marco , De Mari Anna , Annarumma Fabio , Aghazada Hussein , Battista Giovanni , Campobasso Alessandra , Menini Maria , Lo Giudice Antonino , Cevidanes Lucia H. S. , Drago Sara
Published: June 2023

Introduction

Maxillary expansion in patients at the end of their growth relies on the possibility to use miniscrew supported expanders to apply expansion forces directly to the midpalatal suture. Although miniscrews provide a stable anchorage unit, several studies have reported that they do not remain in exactly the same position during treatment. The aim of the present study was to analyze miniscrew position changes after the expansion using bone-borne appliances in late adolescent patients.

Methods

Nineteen patients (13 females, 6 males), with a mean age of 17.81 (SD = 4.66), were treated with a Bone-Borne Expander Device. The appliance was designed with 4 miniscrews: 2 in the anterior palatal area, at the third rugae level; 2 in the posterior area. A CBCT and an intraoral scan were obtained before treatment (T0), and then, a second CBCT was obtained after the expansion (T1). Data on peri-suture bone thickness were collected at T0, then the CBCTs were superimposed, and changes between mini-screws position on T0 and T1 were evaluated, both by linear and angular displacements.

Results

Significant longitudinal differences were found in the distance of the head and the tip of miniscrews measured at the occlusal plane, as well as angular changes. Correlations between displacement measurements and peri-suture bone thickness and height measurements were found as well.

Conclusions

While acting as bone anchor units, miniscrews do not remain in the same position during bone-borne expansion. The amount of displacement was related to peri-sutural total bone height and cortical thickness, especially in the anterior area of the naso-frontal maxillary complex.
Responsible research practices could be more strongly endorsed by Australian university codes of research conduct
Authors: Ong Yi Kai , Double Kay L , Bero Lisa , Diong Joanna
Published: June 2023

Background

This study aimed to investigate how strongly Australian university codes of research conduct endorse responsible research practices.

Methods

Codes of research conduct from 25 Australian universities active in health and medical research were obtained from public websites, and audited against 19 questions to assess how strongly they (1) defined research integrity, research quality, and research misconduct, (2) required research to be approved by an appropriate ethics committee, (3) endorsed 9 responsible research practices, and (4) discouraged 5 questionable research practices.

Results

Overall, a median of 10 (IQR 9 to 12) of 19 practices covered in the questions were mentioned, weakly endorsed, or strongly endorsed. Five to 8 of 9 responsible research practices were mentioned, weakly, or strongly endorsed, and 3 questionable research practices were discouraged. Results are stratified by Group of Eight (n = 8) and other (n = 17) universities. Specifically, (1) 6 (75%) Group of Eight and 11 (65%) other codes of research conduct defined research integrity, 4 (50%) and 8 (47%) defined research quality, and 7 (88%) and 16 (94%) defined research misconduct. (2) All codes required ethics approval for human and animal research. (3) All codes required conflicts of interest to be declared, but there was variability in how strongly other research practices were endorsed. The most commonly endorsed practices were ensuring researcher training in research integrity [8 (100%) and 16 (94%)] and making study data publicly available [6 (75%) and 12 (71%)]. The least commonly endorsed practices were making analysis code publicly available [0 (0%) and 0 (0%)] and registering analysis protocols [0 (0%) and 1 (6%)]. (4) Most codes discouraged fabricating data [5 (63%) and 15 (88%)], selectively deleting or modifying data [5 (63%) and 15 (88%)], and selective reporting of results [3 (38%) and 15 (88%)]. No codes discouraged p-hacking or hypothesising after results are known.

Conclusions

Responsible research practices could be more strongly endorsed by Australian university codes of research conduct. Our findings may not be generalisable to smaller universities, or those not active in health and medical research.
Gender differences in career advancements in Italian universities over the last 20 years
Authors: Falco Vincenzo , Cuntrera Daniele , Attanasio Massimo
Published: June 2023

This article deals with gender differences in Italian universities in the last 20 years in terms of career advancements. Data are taken from the MUR (Ministry of University and Research) archive. In Italy, career advancements are still much easier for men, even if the gender gap has slowly narrowed in the last decades. The novelty of this paper is the analysis through event-history analysis models on the time elapsed to receive a promotion (from assistant to associate professor and from associate to full professor). The event-history analysis applied to career advancements has revealed that women take, on average, about one and a half more years than men to advance, with some differences among fields of study and macroregions. Furthermore, this gender gap is higher in the first years of the career. Two sociological metaphors used in the gender literature, the “leaky pipeline” and the “glass ceiling”, seem to intervene powerfully in the gender gap of Italian universities careers.
Examining voice and choice in online learning
Authors: Henrikson Robin , Baliram Nalline
Published: June 2023

Maximizing student engagement and learning in online courses is critical. The purpose of this study was to determine the nature of how and why graduate-level online students chose learning strategies and how it impacted their perceived levels of engagement. The researchers offered students four strategies for learning content. Qualitative and quantitative data were collected across four quarters. Findings summarized students’ perceptions of their learning and engagement when given a choice on how to engage in the content. Most participants chose asynchronous methods for learning the content, citing time constraints as the primary reason for not choosing synchronous methods of learning. When participants had autonomy to learn content and engage with others in a manner they deemed useful, they better understood the content and remained highly engaged in course activities. Participants who chose to interact with the content asynchronously also remained highly engaged.

Graphical Abstract
Impact of pressure-targeted modes of ventilation on diaphragmatic function as assessed using ultrasonography in critically ill patients with cerebral insult: a randomized clinical trial
Authors: Mosadek Hadeer , Kamel Amr Mohamed EL.-Said , El-Owaidy Raham Hassan Mostafa , Kamal Mohamed Mohamed , Maarouf Mohammed Mahmoud
Published: June 2023

Background

Mechanical ventilation causes diaphragmatic atrophy and reduces diaphragmatic efficiency. Patients with diaphragmatic dysfunction have longer mechanical ventilation durations and intensive care unit stay. There is currently a scarcity of data on the effect of different modes of mechanical ventilation on diaphragmatic function and ultrasound-guided assessment of diaphragmatic efficiency.

Results

Sixty mechanically ventilated patients were randomly divided into four equal groups (15 each): patients were ventilated using either assist control pressure-controlled mode (group A), synchronized intermittent mandatory ventilation pressure-controlled mode (group S), bi-level-positive airway pressure mode (group B) or pressure support ventilation mode (group P). The primary outcome was to assess the diaphragmatic excursion, while the secondary outcomes were to assess the diaphragmatic thickness fraction and the duration of the ICU stay. Patients in the P group had the highest diaphragmatic excursion indicating better diaphragmatic function.

Conclusions

When compared to other pressure-targeted ventilation modes, the pressure support ventilation mode may have the least risk of diaphragmatic dysfunction as preserves diaphragmatic structure and strength.

Trial registration

The clinical trial was retrospectively registered athttp://www.pactr.orgPACTR202112653971335.
Biomechanical considerations for an easily-restricted robot-assisted kinematic alignment: a surgical technique note
Authors: Valpiana Pieralberto , Ghirardelli Stefano , Valtanen Rosa Susanna , Risitano Salvatore , Iannotti Ferdinando , Schaller Christian , Zepeda Karlos , Engl Michael , Indelli Pier Francesco
Published: June 2023

Background

In total knee arthroplasty, the normal kinematics of the knee may not be restored solely based on preoperative gait, fluoroscopic-based, and dynamic radiostereometric analyses.

Surgical technique case presentation

This note introduced a 69-year-old male patient who sustained post-traumatic osteoarthritis of his right knee. He underwent robot-assisted total knee arthroplasty based on anatomical reproduction of knee stability during the swing phase of gait. The kinematic alignment was simply achieved within an easy-to-identified range after preoperative radiographic assessment, intraoperative landmarking and pre-validated osteotomy, and intraoperative range of motion testing.

Conclusions

This novel technique allows personalized and imageless total knee arthroplasty. It provides a preliminary path in reproducing the anatomy alignment, natural collateral ligament laxity, and accurate component placement within safe-to-identified alignment boundaries.
How social support predicts academic achievement among secondary students with special needs: the mediating role of self-esteem
Authors: Saeed Karwan Mustafa , Ahmed Abas Sharif , Rahman Zanyar Maqsud , Sleman Niyan Aziz
Published: June 2023

Background

Students are an essential part and parcel of society, and their mental health, academic achievement, and success are the pillar objectives of a successful educational system. Based on this, students need to be well-equipped to overcome academic difficulties and challenges. Social support and self-esteem are known to play a major role in education and nurture students’ academic achievement. Despite their important attributions, studies however have not examined the joint effects of social support and the mediating role of self-esteem on academic achievement in the context of Kurdistan Region, Iraq. To this end, using a sample of 200 secondary students with special needs (mean age of 14 years) in the city of Halabja, this study tested a structural equation modeling to examine the effect of social support on academic achievement and the potential mediating role of self-esteem between social support and academic achievement. The students with special needs in our sample completed two validated scales to assess their social support and self-esteem and reported their past year’s academic achievement.

Results

The participants in this study scored the highest on significant other (M = 4.46) and the lowest on friends’ support (M = 3.95). With regard to self-esteem, the participants reported the mean score of 3.78, indicating a reasonable level of self-esteem. The results of SEM showed that there is a statistically significant difference (p < 0.05) regarding the effect of family and friends on students’ achievement, while significant other was not found to be statistically significant (p > 0.05). Our SEM results also revealed that the effect of family on students’ self-esteem was found to be statistically significant (p < 0.05), whereas friends and significant other were not statically significant (p > 0.05). Also, SEM findings confirmed that the indirect effects of family and friends on academic achievement were statistically significant (p < 0.05), but significant other did not have any effect, indicating that self-esteem partially mediated the relationship between social support and academic achievement. Last, our analysis also revealed that self-esteem predicted the students’ academic achievement (p < 0.05).

Conclusions

The findings of the study have practical implications for parents, teachers, policy makers, and educators. The study’s implications, limitations, and suggestions for future studies directions are discussed in detail. In so doing, this investigation opens new doors for more future academic contributions in this research area.
Evaluating the role of cytokinesis-block micronucleus assay as a biomarker for oxidative stress-inducing DNA damage in type 2 diabetes mellitus patients
Authors: Vishakh R. , Suchetha Kumari N. , Bhandary Adithi , Shetty Shilpa S. , Bhandary Prajna , Tamizh Selvan G.
Published: June 2023

Background

Type 2 Diabetes Miletus (T2DM) is a common metabolic and lifestyle disorder leading to increased oxidative stress and DNA damage. The present study aims to evaluate the feasibility of utilizing the cytokinesis-block micronucleus assay (CBMN) as a biomarker for assessing the DNA damage induced due to variations in oxidative stress.

Methodology

The study group includes diabetic (n = 50) and non-diabetic (n = 50) subjects. The assays for the diabetes-like fasting blood sugar, postprandial glucose and hemoglobin A1c (HbA1c), lipid profiling, and serum ferritin level along with c-reactive protein (CRP) were applied. Further, the CBMN assay was performed to evaluate the micronuclei present in the lymphocytes of control and T2DM groups.

Results

Significant imbalance in the glycaemic index, dyslipidemia, increased ferritin levels, and CRP levels, with a significant increase of micronucleus frequency, was found in T2DM patients compared with the control group. Results suggest a trend of positive correlation between HbA1c and the micronuclei, indicating the assay’s potential importance as a biomarker for T2DM-induced risk assessment.

Conclusion

From the observed results, it can be suggested that the CBMN assay could be used to assess the risk of oxidative stress-induced DNA damage in high glycaemic index diabetic patients.
Treating negative symptoms of schizophrenia: current approaches and future perspectives
Authors: Howes Oliver , Fusar-Poli Paolo , Osugo Martin
Published: June 2023

Negative symptoms are core symptoms of schizophrenia which are common throughout the course of the illness. We outline their functional impact, before reviewing the latest research and guidelines on their assessment and treatment. Finally, we discuss conceptual issues related to measurement of negative symptoms and approaches to address these.
Intensity at the end of life in pediatric neuro-oncology patients: The case for pediatric palliative care.
Authors: Udemgba Chinwe , Hoehn Karen Sarah , Darlington Wendy Shannon , Palama Brett
Published: June 2023

10021

Background: Although pediatric cancer is rare, it is the leading cause of death by disease after infancy for children and adolescents in the United States. Children exist in the context of a family; hence, excellent care for a child must also include attention to the needs of the family. Palliative care aims to enhance quality-of-life for these children living with life threatening illnesses and their families. Among pediatric cancers, brain tumors have high disease-related mortality rates; therefore, early introduction of palliative care to these patients is critical. This study aims to evaluate the association of palliative care during the terminal admissions of pediatric neuro-oncology patients and intensity of care provided at the end of life. Methods: Pediatric patients with brain tumors were identified using the Pediatric Health Information System (PHIS). Inclusion criteria were age <18, diagnosis of brain tumor as defined by ICD-10 codes, discharged as deceased, and hospital admission between 1/1/2017 and 12/31/2021. Intensity of care measures included: pediatric intensive care unit (PICU) admission, mechanical ventilation, total parenteral nutrition (TPN), and extracorporeal membrane oxygenation (ECMO). Results: 567 patients met the inclusion criteria. 359/567 (63%) patients had an inpatient palliative care consultation during their terminal hospital stay. Patients receiving a palliative care consultation had a lower percentage of PICU admission (64.9 vs 83.2, p=<0.001), mechanical ventilation use (51.0 vs 76.0, p=<0.001), and TPN use (18.1 vs 25.5, p=0.027). There were no significant differences in length of stay (22.07 vs 22.25 days, p=0.181) and ECMO use (0.28% vs 1.92%, p=0.450). Conclusions: Pediatric patients receiving palliative care consultations during their terminal admission received less intense care while having comparable lengths of stay. Palliative care should be offered to all families, even with aggressive goals, to help incorporate quality of life and comfort in the treatment plan and to ensure bereavement support is available if needed. Similar to data in the adult palliative care literature, this data demonstrates reduced resource utilization among pediatric patients receiving palliative care. Palliative care has been shown to be a supportive service that has the potential to improve the quality of life of patients. The first step toward equitable healthcare is to ensure that all children with a potentially terminal cancer diagnosis have access to full supportive services, including palliative care.
Comprehensive genomic profiling and individual therapeutic planning in high-risk/refractory pediatric solid tumors: A single-center real-world study.
Authors: Slaby Ondrej , Pokorna Petra , Pálová Hana , Kyr Michal , Múdry Peter , Sterba Jaroslav
Published: June 2023

10035

Background: Despite major improvements in the survival of pediatric cancer patients that were achieved through the intensification of chemotherapy and the perfection of supportive care in the past decades, treatment outcomes for high-risk, relapsed, and refractory solid cancers remain unsatisfactory. Accelerating the progress of pediatric oncology requires both therapeutic advances and attention to reducing the long-term cytotoxic treatment-related side effects. This could be achieved by targeting specific molecular changes that drive pediatric malignancies. Methods: From September 2016 to August 2020, a total of 192 patients with pediatric high-risk solid tumors successfully underwent comprehensive genomic profiling. Since more than thirty patients had two or more biopsies from recurrent relapses, the total number of samples examined was 295. In the cohort, there were 78 cases of central nervous system tumors, 68 sarcomas, 14 neuroblastomas, 10 lymphomas, and 22 tumors of other histology. Whole-exome sequencing was performed in all patients, fusion gene analysis in 96% of patients, whole-transcriptome profiling in 84% of patients, and CNV analysis in 63% of patients. Results: The diagnostic yield of therapeutically actionable findings was 40%, with single-nucleotide variants and small insertions/deletions being the most common actionable alteration types. In 23% of patients, a clinically relevant gene fusion was identified. The majority of the identified fusions were of diagnostic significance, and 18% of those were therapeutically targetable gene fusions involving BRAF, RAF1, ALK, FGFR1, or NTRK2. Four patients were eligible for immunotherapy based on high tumor mutational burden ( > 10 mut/Mb). Lymphomas and CNS tumors showed the highest rate of patients with therapeutically actionable findings (60% and 56%, respectively), followed by neuroblastomas (36%), sarcomas (25%), and other solid tumors (23%). All results and individual treatment plans were discussed and approved at multidisciplinary molecular tumor boards. Conclusions: Precision medicine in pediatric oncology has rapidly developed over the last decade and resulted in new therapeutic options based on molecular biomarkers and increased our understanding of the complexity of pediatric malignancies. Supported by the Ministry of Health of the Czech Republic, grant nr. NU20-03-00240 and the project National Institute for Cancer Research (Programme EXCELES, ID Project No. LX22NPO5102) - Funded by the European Union - Next Generation EU.
Outcomes of childhood, adolescent, and young adult cancer survivors (CAYACS) with solid organ transplants: A population-based study.
Authors: Gupta Sumit , Lau Cindy , Ng Vicky , Miserachs Mar , Teoh Chia Wei , Solomon Melinda , Nathan Paul C.
Published: June 2023

10056

Background: Organ toxicity requiring solid organ transplant (SOT) is a rare but serious effect of cancer treatment. Given restricted donor organ supply, teams must assess CAYACS requiring SOT in relation to potential recipients with non-malignant indications; decisions are limited by scant long-term outcome data. We compared long-term outcomes for CAYACS requiring SOT with other SOT recipients. Methods: All Ontario, Canada children < 18 years at cancer diagnosed 1986-2021 at pediatric centres, and AYA aged 15-21 diagnosed at adult centres for acute leukemia, lymphoma, sarcoma, or testicular cancer between 1992-2012 were identified using population-based clinical databases. Patients with SOT prior to their primary cancer diagnosis were excluded. SOT was identified through linkage to healthcare databases; patients were matched 1:2 to non-malignant SOT recipients by sex, SOT year and type, and birth year. Post-SOT outcomes including overall survival (OS) and post SOT cancers were compared between CAYACS and SOT controls. Results: Among 16,533 CAYA with cancer, 85 received SOT: 46 liver, 18 kidney, 11 lung, and 10 heart. Among liver recipients, 33 (71.7%) were for primary cancer treatment (e.g. hepatoblastoma) vs. 13 (28.3%) for organ toxicity. Median age at original cancer diagnosis was 4 years [interquartile range (IQR) 1-13] and at SOT was 13 (IQR 3-20). CAYACS with SOT as treatment for long-term toxicity (liver subset plus all renal, lung, heart, N = 52) had a median time from cancer diagnosis to SOT of 9 years (IQR 4-16) and experienced lower 10-year OS from time of SOT [67.7%, 95th confidence interval (95CI) 50.8-79.9] vs. SOT matched controls [86.0% (74.8-92.5); hazard ratio (HR) 3.9; 95CI 1.6-9.7; p = 0.003]. When stratified by SOT type, similar trends were seen but were only statistically significant among lung SOT recipients (Table). The 5-year cumulative incidence of primary cancer relapse from time of SOT among those who received liver SOT for primary cancer therapy was 15.9% (95CI 5.6-30.8). Among CAYACS who require SOT following organ toxicity, 10-year cumulative incidence of second cancers was 8.6%±4.2%; this was similar to the incidence of first cancer among SOT controls (6.4%±2.6%; HR 1.6, 95CI 0.6-4.0; p = 0.34). Conclusions: Though CAYACS requiring SOT have inferior survival compared to other SOT patients, the majority achieve long-term cancer-free survival. These data can inform discussions on the suitability of CAYACS for SOT. [Table: see text]