bluuebunny/crossref_metadata_2025 huggingface dataset:
Listening to students: Beliefs and attitudes about active learning and effective lecture-style courses
Authors: Johnson David C , Coulter-Kern Marcie
Published: May 2024

Research shows that active-learning methods (e.g. discussion) are often superior to passive methods (e.g. lecture) with respect to learning outcomes. However, students sometimes report preferring and learning more in lecture-style classes compared to those in which they play an active role. These and related findings suggest students may lack awareness about the relative effectiveness of passive versus active teaching methods on their own learning. Here, we used a mixed methods approach to assess college students’ beliefs, attitudes, and feelings about lecture-style courses ( n = 246). One primary goal was to assess if, and to what extent, students would express an unprompted desire for interaction in lecture-style classes when reflecting, in an open-ended format, upon their real-world educational experiences. Respondents reported that the majority of their classes were lecture style, in accordance with previous research, and noted that they view lecture as a mostly effective form of pedagogy. While respondents described high-level knowledge and compelling delivery of the subject matter, effective class design and use of technology, and good stagecraft on behalf of the instructor as important aspects of effective lecture-style teaching, a substantial proportion of students mentioned interaction as the most important component of an effective lecture style class, suggesting that student preferences for passive classrooms is far from universal. Implications of these findings are discussed.
Interpretable domain adaptation transformer: a transfer learning method for fault diagnosis of rotating machinery
Authors: Liu Dongdong , Cui Lingli , Wang Gang , Cheng Weidong
Published: May 2024

Domain adaptation-based transfer learning methods have been widely investigated in fault diagnosis of rotating machinery, but their basic convolution or recurrent structure is subject to poor global feature representation ability, which hinders the learning of domain-irrelevant modulation information. In addition, the “black box” nature of deep learning models limits their applications in high risk-sensitive scenarios. In this paper, an interpretable domain adaptation transformer (IDAT) is proposed for the transferable fault diagnosis of rotating machinery. First, a multi-layer domain adaptation transformer framework is proposed, which can capture the global information that is crucial for learning the modulation information of different domains, and meanwhile reduce the feature distribution discrepancy. Second, an ensemble attention weight is applied to enable the transfer learning framework to be interpretable, which is implemented by averaging the integral values of the multi-head attention maps along the key direction. In addition, the raw vibration signals are embedded as the input of the model, which provides an end-to-end fault diagnosis. The proposed IDAT is tested by various cross-condition and cross-machine bearing fault diagnosis tasks, and results confirm the advantages of the method.
The Initial Results of Physician-Modified Fenestrated-Branched Endovascular Repairs of the Aortic Arch and Lessons Learned From the First 21 Cases
Authors: DiBartolomeo Alexander D. , Kazerounim Kayvan , Fleischman Fernando , Han Sukgu M.
Published: May 2024

Introduction:

Physician-modified fenestrated-branched endovascular aortic repair (PM-FBEVAR) for the aortic arch provides a minimally invasive treatment option for patients who are too high-risk for open repair. Improvements in technique are gained with ongoing experience with these complex repairs. This study aims to describe outcomes of arch PM-FBEVAR and technical lessons.

Materials and Methods:

A retrospective review of consecutive patients who underwent PM-FBEVAR with zone 0 proximal sealing at a single institution between January 2019 and July 2023 was performed. Cases completed using initial techniques (early technique) were compared with cases using the current techniques (current technique). Modification technique changed to include a self-orienting spine trigger wire and anatomically specific fenestrations or inner branches in the current group. The primary outcome was in-hospital mortality. Secondary outcomes included technical success and 30 day stroke.

Results:

A total of 21 patients underwent arch PM-FBEVAR, with 7 in the early group and 14 in the current group. Severe comorbidities were present in both groups including chronic obstructive pulmonary disease (COPD) (43% vs 36%), prior open ascending aortic repair (57% vs 43%), and prior stroke (86% vs 21%), respectively. Technical success was the same (86% vs 86%, p=1.0). Fluoroscopy time (56 vs 24 min, p=0.012) and in-hospital death (43% vs 0%, p=0.026) were significantly lower in the current group. A 30 day stroke rate (29% vs 7%, p=0.247) was non-significantly decreased in the current group. All-cause mortality was 100% vs 7% during median follow-up of 8 and 6 months (p<0.001). Three deaths in the early group were related to their aortic arch repair including aortic rupture during endograft advancement and 2 postoperative strokes.

Conclusion:

There is a significant learning curve associated with aortic arch PM-FBEVAR. This study suggests that gained experience, use of the spine trigger wire technique, and precise creation of fenestrations or inner branches can lead to a shorter procedure time and lower complications.

Clinical Impact

Physician modified fenestrated branched endografting is feasible for the aortic arch. The high rate of stroke and perioperative mortality was reduced with incorporation of self-orienting spine trigger wire and anatomically specific inner branch creation.
Vascular Abnormality in TSC: Leaky Plumbing Is a Problem, but not THE Problem
Authors: Lillis Kyle P.
Published: May 2024

[Box: see text]
Assessing Muscular Pain and Ergonomics Among Robotic Surgeons in China: A Validation
Authors: Saikali Shady , Patel Ela , Mascarenhas Anya , Jaber Abdelrahman , Gamal Ahmad , Moschovas Marcio Covas , Cui Liang , Li Xuesong , Patel Vipul
Published: May 2024

Introduction

Robotic surgery has transformed minimally invasive procedures, offering precision and efficiency. However, the ergonomic aspects of robotic consoles and their impact on surgeon health remain understudied. This review investigates the burden of ergonomics and muscle fatigue among robotic surgeons in China, comparing the findings to a multinational study.

Methodology

A literature review identified themes related to physical discomfort in robotic surgery. A questionnaire was administered to Chinese robotic surgeons, yielding 40 responses. The study assessed demographic characteristics, surgeon experience, ergonomic practices, reported discomfort, and pain-relief mechanisms.

Results

The study revealed that most surgeons experienced shoulder and neck pain, with mixed opinions on whether robotic surgery was the primary cause. Stretching exercises were commonly used for pain relief. Surgeons believed that case volume and surgery duration contributed to discomfort. Comparisons with a multinational study suggested potential demographic and experience-related differences.

Conclusion

While the study has limitations, including a small sample size and potential translation issues, it underscores the importance of addressing ergonomic concerns and providing proper training to robotic surgeons to ensure their well-being and longevity in the field. Further research with larger cohorts and platform-specific analyses is warranted.
Radiocarpal and midcarpal kinematics in scapholunate instability: a four-dimensional CT study in vivo
Authors: Amarasooriya Melanie , Al Dirini Rami , Bryant Kimberley , Ian Bain Gregory
Published: May 2024

The distribution of motion between the radiocarpal and midcarpal joints in scapholunate instability is poorly understood. This has potential implications in predicting degenerative changes and in selecting salvage procedures. We studied 19 healthy wrists and 19 wrists with scapholunate instability using dynamic computed tomography during wrist extension to flexion and ulnar to radial deviation. Radiocarpal and midcarpal kinematics of the scaphoid and the lunate were computed. In scapholunate instability, in the radial column, there was increased motion in the radiocarpal joint when the wrist was radially deviating beyond 10° or moving from 70° to 40° extension. In both groups, the capitolunate joint was the dominant articulation in the central column. In scapholunate instability, there was significantly more capitolunate motion during 70° to 30° extension. These changes may predict the development of radioscaphoid arthritis and enable identifying a kinematically abnormal wrist. The motion distribution in scapholunate instability was abnormal beyond 10° of radial deviation and between 70° and 40° of wrist extension.

Level of evidence: III
Effect of Alaska pollock-gelatin sheet on repair strength and regeneration of nerve
Authors: Tsujisaka Ryosuke , Suzuki Taku , Shibata Shinsuke , Iwamoto Takuji , Taguchi Tetsushi , Nakamura Masaya
Published: May 2024

The aim of the study was to investigate the repair strength and the biocompatibility of Alaska pollock-derived gelatin (ApGltn) sheet for nerve repair. Cadaveric digital nerves were repaired with double suture, single suture + ApGltn sheet, single suture + fibrin glue, single suture, ApGltn sheet and fibrin. Maximum failure loads were measured (20 nerves each). Rat sciatic nerves were repaired with double suture, single suture + ApGltn sheet, single suture, ApGltn sheet, fibrin glue and resection (10 nerves each). Macroscopic appearance, muscle weight and histopathological findings were examined 8 weeks postoperatively. The mean failure load of ApGltn sheet (0.39 N) was significantly higher than that of a fibrin (0.05 N), and that of single suture + ApGltn sheet (1.32 N) was significantly higher than that of a single suture alone (0.97 N). Functional and histological assessments showed similar nerve recovery among the suture, ApGltn and fibrin groups. ApGltn sheet has potential for clinical application as an alternative to fibrin.
A modified partial wedge-shaped metaphyseal ulnar osteotomy for the treatment of ulnar impaction syndrome with reverse oblique sigmoid notch
Authors: Liu Yuchen , Li Xiucun , Su Xiangmeng , Yin Huawei , Xu Wendong , Shen Yundong
Published: May 2024

We describe a modified metaphyseal ulnar osteotomy to treat ulnar impaction syndrome with a reverse oblique sigmoid notch. Based on a computational analysis of radiographs, a modified wedge metaphyseal ulnar osteotomy was devised with its apex positioned at the ulnar styloid base to avoid impaction between the sigmoid notch and ulnar head. Subsequently, nine patients with ulnar impaction syndrome and a reverse oblique sigmoid notch underwent this operation, combined with arthroscopic exploration and transosseous triangular fibrocartilage complex repair. The mean follow-up was 14 months. All patients achieved bone union within 5 weeks, with no degenerative changes being observed during the follow-up assessments. The final follow-up assessments revealed decreases in ulnar variance and in the scores for Visual Analogue Scale, Quick Disabilities of the Arm, Shoulder and Hand questionnaire and the Patient-Rated Wrist Evaluation. All patients achieved excellent or good grades on the Modified Mayo Wrist Score. This technique is effective in treating the ulnar impaction syndrome with a reverse oblique sigmoid notch.

Level of evidence: IV
Myricetin reduces neutrophil extracellular trap release in a rat model of rheumatoid arthritis, which is associated with a decrease in disease severity
Authors: Shu Yiqin , Yang Rui , Wen Huijie , Dong Qiannan , Chen Zhiqi , Xiang Yang , Wu Hao
Published: May 2024

Rheumatoid arthritis (RA) is a chronic disease characterized by joint inflammation and severe disability. However, there is a lack of safe and effective drugs for treating RA. In our previous study, we discovered that myricetin (MC) and celecoxib have a synergistic effect in the treatment of RA. We conducted in vitro and in vivo experiments to further investigate the effects and mechanisms of action of MC. Our findings demonstrated that MC treatment effectively reduced the release of neutrophil extracellular traps (NETs) and alleviated the inflammatory response in RA. Mechanistic studies showed that MC prevents the entry of PADI4 and MPO into the cell nucleus, thereby protecting DNA from decondensation. In a rat arthritis model, MC improved histological changes in ankle joints and suppressed NET-related signaling factors. In conclusion, MC protects the ankle joints against arthritis by inhibiting MPO and PADI4, thereby reducing NET release. The pharmacological mechanism of MC in RA involves the inhibition of NET release.
Accessing peripartum care in an internal medicine clinic: Barriers, interventions, and racial disparities
Authors: Malani Kanika , Arbaugh Sarah , Bilodeau Courtney
Published: May 2024

Objective

This study evaluates obstacles peripartum patients with additional medical needs face and services that would be helpful in obtaining this care.

Study Design

A survey was administered to 226 patients at a clinic specializing in internal medicine care for peripartum patients. Data was analyzed through descriptive statistics and linear regression.

Results

The three most reported barriers that interfered with attending medical appointments included the inability to leave work (41%), being too busy (33%), and lack of childcare (29%). Hispanic and Black patients reported more barriers to care as compared to White patients. The three most reported interventions that would be helpful in attending appointments were more virtual appointment options (38%), increased insurance coverage (31%), and provision of childcare (30%). Interventions were widely rated as helpful regardless of barriers faced and race reported.

Conclusions

Targeted interventions are needed to enhance access to peripartum care, especially for patients from marginalized racial and ethnic populations.
Far Infrared/Terahertz Spectroscopy as a Complementary Method for the Analysis of the Spectral Features of Thymol and Carvacrol Structural Isomers
Authors: Lepodise L. M. , Billy R. , Tsenang M. , Pheko-Ofitlhile T.
Published: May 2024

Objective: The conventional method for the characterization of volatile compounds has been mostly limited to the use of gas chromatography. This work offers an alternative method to address the limitations that might be encountered with the use of the gas chromatography method. Furthermore, this work addresses the scarcity of the analysis of these materials in the far infrared/terahertz region as previous studies have been focused mainly on the mid-infrared region. Methods: The far infrared/terahertz spectra of carvacrol and thymol were analyzed using the Fourier transform infrared (FTIR) and gas chromatography-mass spectroscopy (GC-MS). Density function theory (DFT) calculations were employed for the interpretation of the FTIR experimental spectra. Results: Thymol and carvacrol spectra were characterized by distinct absorption bands in the 200-600 cm−1 (6-18 THz). There were appearances of bands at similar energies for these isomers. These bands appeared at 320.7 cm−1 (9.6 THz), 439.2 cm−1 (13.2 THz), 525.2 cm−1 (15.8 THz), and 586.8 cm−1 (17.6 THz) for thymol and at 313.6 cm−1 (9.4 THz), 419.8 cm−1 (12.6 THz), 521.2 cm−1 (15.7 THz), and 566.9 cm−1 (17.0 THz) for carvacrol. Despite these similarities, there were also significant differences in the spectra of these materials. The theoretical peak frequencies were in agreement with the experimental absorption band frequencies. Two seemingly common absorption bands were observed in the spectra of thymol and carvacrol. However, peak assignments revealed that these bands have different vibrational modes. The GC-MS results show that the retention time of thymol and carvacrol are very close at 18.5 and 18.8 respectively. Conclusion: This work underscores the ability of far infrared/terahertz waves in identifying materials with similar structural features. Furthermore, it supplements the limited studies of these isomers in the far infrared/terahertz region. The GC-MS results emphasize the need for a complementary method that can improve the characterization of these materials.
Metabolizing the Challenges to Partnership: Partner Learning in a University-District Partnership for Leadership Preparation
Authors: Goldstein Jennifer , Lozano Maritza , Panero Nell Scharff
Published: May 2024

We describe the contours of one leadership preparation partnership between a university and urban high school district, to demonstrate the affordances that have allowed the partnership to process and weather challenges. Critically, we describe the actual work of collaboration, presenting one extended example of learning-in-action. As such, the article addresses an existing gap in the literature on research practice partnerships, namely how partners can address widespread challenges. Findings suggest that the boundary practice of co-teaching and a “boundary stance” of ontological humility have been critical affordances toward partner and partnership learning.
Effective enforcement of the EU framework on the posting of workers: Empirical evidence
Authors: Lasek-Markey Marta
Published: May 2024

This article addresses the issue of effective enforcement of EU labour law by looking at the case study of the enforcement of the EU framework on the posting of workers. While recent years have seen a revival of Social Europe in the form of the European Pillar of Social Rights, scholars have also expressed concern over the effectiveness in practice of transnational labour law, and EU labour law in particular. Rasnača (2022) argues that ineffective enforcement creates a ‘justice gap’ between formal rights on paper and access to these rights in practice. One example of an area of EU labour law plagued by enforcement issues is the posting of workers. It is a peculiar type of intra-EU labour mobility, where posted workers, despite often being EU citizens, cannot benefit from the protection afforded by the EU's fundamental principle of the free movement of workers. As the original Directive 96/71/EC on the posting of workers proved manifestly inadequate to safeguard the rights of posted workers, the EU enacted Directive 2014/67 to improve the framework's enforcement. This article offers an evaluation of the Enforcement Directive based on data collected from 29 qualitative interviews. The effectiveness of the Enforcement Directive will be assessed based on the theoretical framework of precarious work. It will be argued that while the Enforcement Directive has contributed to narrowing the justice gap, posted workers continue to be exposed to precarity.
Violent abduction of Yemenite Jewish children in Israel: A historical study on the intergenerational dynamics of oppression and resistance
Authors: Liebel Manfred
Published: May 2024

In the founding years of the State of Israel, numerous Jewish children who immigrated to Israel with their parents from Arab countries, especially Yemen, were removed and disappeared. Some of these children were adopted by people in Europe and the USA, while others remained missing. The article reconstructs the efforts to clarify the fate of these children. The disappearance of the children is analysed in the context of the Zionist founding myth and the colonial genesis of the State of Israel and interpreted as an early form of bio-politics with racist connotations. Particular attention is paid to the traumatic consequences of this practice for the people affected and the psycho-structure of Israeli society. Finally, the question is posed as to how today’s young generation of descendants of immigrants is coming to terms with the history of their ancestors and what consequences this could have for the future identity of Israeli society and its positioning between ‘Occident’ and ‘Orient’.
Atropine sulfate as a continuous intravenous infusion for the treatment of organophosphate toxicity in a cat
Authors: Baker Edward , Southern Carl , Martinez Jennifer
Published: May 2024

Case summary

A 1-year-old male neutered domestic shorthair cat presented on an emergency basis with clinical signs suspected to be secondary to organophosphate (OP) toxicity. The control of clinical abnormalities (bradycardia, obtundation, tachypnea, anorexia) was achieved using high-dose continuous rate intravenous infusion (CRI) of atropine sulfate (maximum rate 0.1 mg/kg/h). After 5 days of hospitalization, the patient made a full clinical recovery without the development of atropine toxicity, intermediate syndrome or delayed polyneuropathy at 4 weeks after discharge.

Relevance and novel information

Treatment of OP toxicity in cats is sparsely reported in veterinary literature. Current standards of treatment and published protocols recommend the use of atropine sulfate as intermittent boluses for the treatment of muscarinic signs of toxicity; however, there is a paucity of information regarding the safety and efficacy of atropine sulfate as a CRI for severe toxicosis as described in humans. This report includes the first published case using such a treatment protocol in a cat.
UK homecare providers’ views about, and experiences of, digitalisation: A national survey
Authors: Healey Jan , Davey Vanessa , Liddle Jennifer , O’Rourke Gareth , Hanratty Barbara , Beresford Bryony
Published: May 2024

Objective

Using digital systems to support the management and delivery of social care is a priority for UK governments. This study explored progress towards, and experiences of, digitalisation in the homecare sector and providers’ views on contributing client data to a national policy/research dataset.

Methods

Over 150 UK homecare providers completed an on-line survey (October–December 2022). The survey was hosted on Qualtrics and comprised fixed- and free-text response questions. The recruited sample aligned with the profile of UK homecare providers in terms of use of digital systems, organisation type and size.

Results

Almost all respondents (95.5%) were using digital systems, in part or exclusively, to support care delivery. However, many (42.7%) reported a desire to further digitalise or a dissatisfaction with existing systems. Findings highlight the time and work involved in choosing a a software system, with the decision regarded as relatively high risk. Over 50 different software systems were being used across the sample. Most respondents (72.5%) supported the creation of a national dataset on homecare users. However, support and recompense are likely to needed to secure buy-in from what is a predominantly private sector context.

Conclusions

Findings suggest a complex and changing situation, with numerous different digital systems being used and the sector at different stages of digitalisation. The high-pressure, low margin context of UK homecare appeared to be exerting an influence on progress towards digitalisation. Evaluations of government strategies to stimulate and support digitalisation in this diverse and predominantly private sector context will be valuable.
Surgical Protocol for Partial Heart Transplantation in Growing Piglets
Authors: Medina Cathlyn K. , Aykut Berk , Kang Lillian , McVadon Deani , Overbey Douglas M. , Helke Kristi L. , Taylor Carolyn L. , Fitzgerald David C. , Hassid Marc , Braxton Alicia M. , Miller Stephen G. , Mealer Corey , Ho Chak-Sum , Whitworth Kristin M. , Prather Randall S. , Moya-Mendez Mary E. , Jeffs Sydney , Parker Lauren E. , Turek Joseph W. , Rajab Taufiek Konrad
Published: May 2024

Partial heart transplantation is a new approach to deliver growing heart valve implants. Partial heart transplants differ from heart transplants because only the part of the heart containing the necessary heart valve is transplanted. This allows partial heart transplants to grow, similar to the valves in heart transplants. However, the transplant biology of partial heart transplantation remains unexplored. This is a critical barrier to progress of the field. Without knowledge about the specific transplant biology of partial heart transplantation, children with partial heart transplants are empirically treated like children with heart transplants because the valves in heart transplants are known to grow. In order to progress the field, an animal model for partial heart transplantation is necessary. Here, we contribute our surgical protocol for partial heart transplantation in growing piglets. All aspects of partial heart transplantation, including the donor procedure, the recipient procedure, and recipient perioperative care are described in detail. There are important nuances in the conduct of virtually all aspects of open heart surgery that differs in piglets from humans. Our surgical protocol, which is based on our experience with 34 piglets, will allow other investigators to leverage our experience to seek fundamental knowledge about the nature of partial heart transplants. This is significant because the partial heart transplant model in piglets is complex and very resource intensive.
The Development and Validation of an Intercultural Communicative Competence Scale for Students
Authors: Ertay Zehra , Gilanlioglu Ilkay
Published: May 2024

Intercultural Communicative Competence (ICC) plays a significant role in learning a foreign language. Therefore, it is important to measure the ICC level of language learners before taking actions to improve the educational process. The present study aimed at developing an ICC Scale to measure the perceived ICC level of Academic English students studying in the Foreign Language Division of an international university. The participants of the study consisted of 325 first year students in their second semester in the 2021 to 2022 academic year enrolled in 48 English-medium instructed (EMI) departments. In order to produce a reliable and valid ICC Scale, statistical data were analyzed through software programs. Further, the Exploratory Factor Analysis generated an 18-item Intercultural Communicative Competence (ICC) Scale with four factors, namely knowledge, awareness, attitude, and skills. Additionally, the Confirmatory Factor Analysis results confirmed and validated the four factors. Consequently, the ICC Scale was found to be highly reliable in measuring the perceived ICC level of students and had a high internal consistency. The newly designed ICC Scale proves to be a useful instrument for measuring the perceived ICC level of language learners.
Heavy Study Investment in Indonesian College Students: Do Studyholism and Study Engagement Predict Academic Resilience?
Authors: Nugraha M. Fadli , Loscalzo Yura
Published: May 2024

Studyholism (SH) is a new potential clinical condition introduced in 2017 by Loscalzo and Giannini to refer to problematic overstudying, specifying that it might be associated with either high or low Study Engagement (SE). We aimed to analyze SH and SE’s predictive role on academic resilience. We gathered 609 Indonesian youths, and we performed a path analysis model. Among the main findings, SH predicts a lack of academic resilience, while SE predicts higher academic resilience. However, SH and SE do not predict time spent studying, and GPA is negatively (although weakly) predicted by SH only. Hence, we provided support for the critical role of SH and SE in predicting students’ academic success and for implementing preventive and clinical interventions to reduce SH and foster SE, given their impact on academic resilience, which, in turn, influences students’ well-being and academic success. Finally, we recommend future research on Studyholism in non-Western countries.
A Mixed Methods Investigation of Mobile-Based Language Learning on EFL Students’ Listening, Speaking, Foreign Language Enjoyment, and Anxiety
Authors: Bai Yun
Published: May 2024

This mixed-methods study examined the effectiveness of Rosetta Stone, a mobile-based language learning application, on Chinese EFL students’ listening, speaking, foreign language enjoyment (FLE), and foreign language anxiety (FLA). Two groups of intermediate Chinese EFL students from a language institute, with 33 students in the control group and 36 in the experimental group, were recruited as the participants. The treatment lasted for 3 months, with the experimental group using Rosetta Stone in addition to in-class instruction whereas the control group received only the regular in-class instruction. Data collection involved administering IELTS module tests of speaking and listening, FLE and FLA scales, as well as semi-structured interviews. ANCOVA, paired samples test, and content analysis were used for the data analysis of the quantitative and qualitative data. The results indicate that the experimental group showed significant improvements in their listening, speaking, FLE, and reduced FLA more than the control group. The results of the qualitative data indicated that the students had positive attitudes toward mobile-based language learning. The qualitative findings provided further support to the quantitative results and highlighted the convenience, flexibility, and engaging nature of the application. The outcomes stressed the potential benefits of using mobile-based language learning tools like Rosetta Stone as an effective supplementary method for improving EFL learning outcomes and promoting positive affective variables.
Self-Disclosure on Social Media: Do Personality Traits Matter?
Authors: Alwahaishi Saleh , Al-Ahmadi Mohammad Saad , Ali Zulqurnain , Al-Jabri Ibrahim
Published: May 2024

The aim of this study is to integrate the privacy calculus theory with the Big Five Personality Traits Theory and to investigate the direct and moderating effects of the Big Five personality traits (openness, neuroticism, agreeableness, extraversion, and conscientiousness) on the relationship between the privacy calculus structural factors (Perceived Risk and Perceived Benefits) and disclosure of personal information on social network sites. A survey was conducted to collect data from 379 social network sites users. The sample is composed of 225 females and 154 males. The survey was designed in Qualtrics and distributed on WhatsApp using the snowball sampling technique. The measurements of the research model and the hypotheses related to the direct and moderating effects were tested using SmartPLS software. We found that perceived risk was a strong inhibitor, while perceived benefit was a strong facilitator for the disclosure of personal information. In contrast to our expectation, we found no indication that the Big Five personality traits moderate the disclosure of personal information. However, agreeableness had a positive direct effect on information disclosure. These results have implications for privacy policy makers in organizations in modifying policies and strategies for users based on their unique personality traits.
Reducing Employee Turnover in the Hospitality Industry Through the Use of Job Design Optimization
Authors: Zirbes Emily
Published: May 2024

This case study follows an employee who after working for the Quad City Golden Hotel (QCG) for several years, ultimately handed in her resignation after complaining the demands of her new position were overwhelming and offered little to no support. Like many before her, the resignation was disregarded as a typical characteristic of the dynamic employment turnover in the hospitality industry. Through the use of a job design optimization tool (JDOT), this case study explores how a balanced job design can ensure employees are provided with the most efficient tools to complete their jobs effectively. This method of strategic design can, in turn, also lead to a reduction in turnover as employees begin to feel more supported in the workplace and equipped to do their jobs.
Experiences of Residents and Fellows at Mayo Clinic After the Rapid Implementation of Telemedicine During the COVID-19 Pandemic
Authors: Clapp Adrianna D.M. , Punj Mantavya , Farford Bryan , TerKonda Sarvam P. , Presutti R. John , Hattery Wendy M. , Leak Michelle A. , Austin Matthew K. , Keith Joshua J.
Published: May 2024

OBJECTIVE

The COVID-19 pandemic led to many changes across medical organizations and graduate medical education programs nationwide including the rapid implementation of telemedicine as a modality for delivering health care. The purpose of this study was to investigate the telemedicine experiences of residents and fellows with their self-reported level of preparedness, impact on their education including precepting, skill development, and patient-physician relationships, and perceptions of telehealth platforms and curricula in the future.

METHODS

A total of 365 Mayo Clinic residents and fellows across three sites (Florida, Arizona, and Minnesota) were identified as trainees who conducted at least one telemedicine encounter from January 1, 2020 to June 30, 2020 and were sent an electronic survey by e-mail.

RESULTS

There was a total of 103 completed surveys across various specialties with 58.3% female respondents, 63.1% residents, 35.0% fellows and 77.7% of respondents who attended medical school in the United States. Most trainees reported having very little to no exposure to telemedicine in their medical careers before the pandemic. The majority were satisfied with their first telemedicine encounter and found precepting comparable to in-person visits. The trainees in this study had a favorable view with 98.1% believing telemedicine will play a more prevalent role in the future and most agreed this should be included in medical school and residency training.

CONCLUSION

Our survey found that after the implementation of telemedicine during the COVID-19 pandemic, the experiences of trainees at a multi-site academic center were overall positive. More research is needed on the perceptions of skill development (physical exam and history taking) during a telemedicine encounter and outlining an optimal telemedicine curriculum that can improve confidence in trainees.
Artificial intelligence to predict individualized outcome of acute ischemic stroke patients: The SIBILLA project
Authors: Caliandro Pietro , Lenkowicz Jacopo , Reale Giuseppe , Scaringi Simone , Zauli Aurelia , Uccheddu Christian , Fabiole-Nicoletto Simone , Patarnello Stefano , Damiani Andrea , Tagliaferri Luca , Valente Iacopo , Moci Marco , Monforte Mauro , Valentini Vincenzo , Calabresi Paolo
Published: May 2024

Introduction:

Formulating reliable prognosis for ischemic stroke patients remains a challenging task. We aimed to develop an artificial intelligence model able to formulate in the first 24 h after stroke an individualized prognosis in terms of NIHSS.

Patients and methods:

Seven hundred ninety four acute ischemic stroke patients were divided into a training (597) and testing (197) cohort. Clinical and instrumental data were collected in the first 24 h. We evaluated the performance of four machine-learning models (Random Forest, K-Nearest Neighbors, Support Vector Machine, XGBoost) in predicting NIHSS at discharge both in terms of variation between discharge and admission (regressor approach) and in terms of severity class namely NIHSS 0–5, 6–10, 11–20, >20 (classifier approach). We used Shapley Additive exPlanations values to weight features impact on predictions.

Results:

XGBoost emerged as the best performing model. The classifier and regressor approaches perform similarly in terms of accuracy (80% vs 75%) and f1-score (79% vs 77%) respectively. However, the regressor has higher precision (85% vs 68%) in predicting prognosis of very severe stroke patients (NIHSS > 20). NIHSS at admission and 24 hours, GCS at 24 hours, heart rate, acute ischemic lesion on CT-scan and TICI score were the most impacting features on the prediction.

Discussion:

Our approach, which employs an artificial intelligence based-tool, inherently able to continuously learn and improve its performance, could improve care pathway and support stroke physicians in the communication with patients and caregivers.

Conclusion:

XGBoost reliably predicts individualized outcome in terms of NIHSS at discharge in the first 24 hours after stroke.
A Combination of Curcumin and Lactobacillus rhamnosus GG Inhibits Viability and Induces Apoptosis in SCC-9 Human Oral Squamous Cell Carcinoma Cells
Authors: Udompatanakorn Chatchaphan , Ratthawongjirakul Panan
Published: May 2024

The aim of this study was to evaluate the effect of curcumin combined with Lactobacillus rhamnosus GG cell-free supernatant (LGG CFS) on the proliferation and induction of apoptosis in SCC-9 oral squamous cell carcinoma (OSCC) cells. Curcumin (40 µg/ml) and 25% v/v LGG CFS (108 CFU/ml), both alone and in a combination regimen, significantly decreased the viability of SCC-9 cells and normal human gingival fibroblast (HGF) cells. Interestingly, the combination of low doses of curcumin (5 µg/ml) and 25% v/v LGG CFS (106 CFU/ml) had no effect on the HGF cells but significantly inhibited the viability of SCC-9 cells (p < 0.05). Flow cytometric analysis revealed that SCC-9 cells treated with the combination of low-dose curcumin and low-dose LGG CFS had a higher apoptotic rate than the cells in the control group and the single treatment groups ( p < 0.05). The combined treatment also significantly increased the Bax/Bcl2 mRNA and protein expression in SCC-9 cells ( p < 0.05) but not in HGF cells, indicating the underlying mechanism of the combination regimen. There was no significant difference in caspase-3 protein expression or the Bcl-xL/Bak and Mcl-1/Bak ratios between the treatment and control groups in both cell lines. These findings suggested that the coadministration of curcumin and LGG could exhibit anticancer effects in SCC-9 cells without causing toxicity to normal fibroblast cells.
Multimorbidity and acute infectious diseases in urban and semi-urban settings in Peru: A mixed-methods study
Authors: Anza-Ramirez Cecilia , Najarro Lizzete , Bernabé-Ortiz Antonio , Diez-Canseco Francisco , Fottrell Edward , Abubakar Ibrahim , Hernández-Vásquez Akram , Carrillo-Larco Rodrigo M. , Hurst John R. , Miranda Juan Jaime
Published: May 2024

Background

The co-occurrence of chronic diseases and acute infectious events exacerbates disability and diminishes quality of life, yet research in Low- and Middle-Income countries is scarce. We aimed to investigate the relationship between infectious events and multimorbidity in resource-constrained settings.

Methods

We conducted a sequential mixed-method study in Lima and Tumbes, Peru, with participants having multimorbidity from the CRONICAS Cohort Study. They completed a questionnaire on the occurrence, treatment, and health-seeking behaviour related to acute infectious events. Qualitative interviews explored the perceptions and links between multimorbidity and acute infectious events for a subgroup of participants.

Findings

Among individuals with multimorbidity, low awareness of chronic conditions and poor medication adherence. The cumulative incidence for respiratory and gastrointestinal infections, the most reported acute conditions, was 2.0 [95%CI: 1.8–2.2] and 1.6 [1.2–1.9] events per person per year, respectively. Individuals with cancer (6.4 [1.6–11.2] events per person per year) or gastrointestinal reflux (7.2 [4.4–10.1] events per person per year) reported higher cumulative incidence of infectious events than others, such as those with cardiovascular and metabolic conditions (5.2 [4.6–5.8] events per person per year). Those with three or more chronic conditions had a slightly higher cumulative incidence compared with individuals with two conditions (5.7 [4.4–7.0] vs 5.0 [4.4–5.6] events per person per year). Around 40% of individuals with multimorbidity sought healthcare assistance, while others chose drugstores or didn't seek help. Our qualitative analysis showed diverse perceptions among participants regarding the connections between chronic and acute conditions. Those who recognized a connection emphasized the challenges in managing these interactions.

Interpretation

Our study advances understanding of multimorbidity challenges in resource-limited settings, highlighting the impact of acute infections on patients' existing multimorbidity burden.
To mask or not to mask: The role of concealment behavior, stigma experience, and community connectedness in autistic people's mental health
Authors: Khudiakova Valeria , Le Forestier Joel M. , Chasteen Alison L.
Published: May 2024

Psychological theory and results from previous empirical studies paradoxically suggest that concealing and revealing one's autism can each result in reduced mental well-being. On one hand, autistic people who reveal their autistic identity experience considerable anti-autism stigma, which can lead to worse mental health outcomes compared to autistic people who conceal their autistic identity. On the other hand, autistic people who conceal their autistic identity are not afforded the benefits of autistic community connectedness, potentially undermining mental health outcomes compared to autistic people who reveal their autistic identity. The present study explores the relationships between autism concealment behaviors, autistic community connectedness, stigma experience, and mental well-being in autistic people. In an analytic sample of 409 autistic people, we found that concealing one's autistic identity was related to worse depressive symptoms, and that this relationship was related to experiencing greater stigma, and not to differences in community connectedness. These findings reinforce the need for combatting stigma against autistic people.

Lay Abstract

Many autistic people try to hide their autistic traits or appear more in line with typical social norms through changing their behavior, even when it is uncomfortable, which is known as camouflaging. Previous studies have shown that autistic people often attribute mental health difficulties, such as anxiety and depression, to concealing their autism through camouflaging. In part, this might be because concealing one's autism is related the loss of a sense of community with other autistic people, which is a protective factor for autistic people's mental health. However, allowing one's autistic identity to be public by forgoing camouflaging can make autistic people more likely to face judgement, stigmatization, and unfair treatment due to society's negative view of autism, which can also lead to poor mental health. Autistic people may thus be in a double bind between engaging in camouflaging but possibly experiencing related mental health difficulties and camouflaging less but encountering more stigmatization. In this study, we explored what contributes to this seemingly contradictory relationship between autism concealment and depressive symptoms. We collected data from 409 autistic people in an online survey. The results showed that participants who concealed their autism more were more likely to show depressive symptoms. This increase in depression symptoms was explained by experiencing stigma rather than feeling connected to the autistic community. These findings suggest negative effects of camouflaging and stigma on autistic people's mental health and support the call for increased autism acceptance.
Unmet healthcare needs in Southeastern Europe: a systematic review
Authors: Maslyankov Ivan
Published: May 2024

Objectives:

This study sought to systematically review the existing literature on self-reported unmet healthcare needs in Southeastern Europe.

Methods:

A systematic literature review of quantitative evidence in English and Bulgarian was performed in July 2023 using the following databases: Medline, Embase and EconLit. Publications were only included if they used self-reported unmet healthcare needs as an indicator of access to healthcare, concerned people living in Albania, Bosnia and Herzegovina, Bulgaria, Greece, Kosovo, Montenegro, Serbia, North Macedonia or Romania and if they were published after 2003. Quality assessment of the included publications was performed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

Results:

Twenty-three publications of varying quality were included in the review. Significantly more evidence was available for Greece, Bulgaria and Romania than for the rest of the region. Data collected through Pan-European surveys were commonly used, but almost half of the studies were only descriptive. Generally, the prevalence of unmet healthcare needs has decreased over the years. Unmet healthcare needs were higher among people of lower socioeconomic and educational status, ethnic minorities and migrants and high cost was consistently identified as the primary barrier to accessing healthcare.

Conclusion:

Unmet healthcare needs are more prevalent among already disadvantaged societal groups. A trend of a declining prevalence of unmet needs has been observed, but it is more notable in the more socioeconomically developed countries. Improving financial protection should be a priority for the healthcare systems.
Static Ultrasonographic Assessment for Central Venous Catheterization Reduces Catheter Dysfunction in the Emergency Department
Authors: Çebişli Ali , Dişel Nezihat Rana , Taşkın Ömer , Açıkalın Akpınar Ayça , Sebe Ahmet
Published: May 2024

Objective:

This study aimed to investigate the effect of a static ultrasonographic (US) examination of the central venous structures before central venous catheterization (CVC) and the success of the procedure.

Materials and Methods:

In this prospective study, patients who underwent CVC, in an emergency department (ED), were divided into two groups: patients who underwent CVC using the anatomical landmark technique (n = 34) and patients who underwent CVC using a static US examination (n = 33). The procedure times, success rates, and number of catheters used were compared.

Results:

A total of 67 patients who underwent CVC were included in the study. Compared with the anatomical landmark technique, the static US examination had a higher procedural success rate ( P = .001), fewer total interventions ( P = .001), and fewer postprocedural catheter dysfunctions ( P = .048). While there was no difference in the duration of the CVC between groups ( P = .222), the total time spent was longer using a static US examination ( P = .022).

Conclusion:

The static US examination was a practical, easy-to-apply method that could be used for CVC placement in an ED. This study demonstrated sonography had a high success rate in CVC procedures and contributed to a reduction in the number of interventions and catheters used.