bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergent Properties of Organizational Sensemaking Systems: A Grounded Theory Assessment of The HITEC Project
Authors: Hughes James Michael , Henning Robert A. , Robertson Michelle M.
Published: October 2023

The process of organizational sensemaking initially attracted empirical attention as a tool for retrospectively assessing organizational decision-making during critical incidents (Weick, 1988, 1993). However, recent advancements in multilevel theory design have created an opportunity to re-envision organizational sensemaking not only as an individual and retrospective process but as a broader macro-cognitive and multilevel organizational system. The identification and intentional design of organizational sensemaking systems can potentially facilitate present and future decision-making processes and organizational change management. Using the organizational sensemaking systems paradigm proposed by Hughes, et al. (2022), this study builds on the inductive assessment of a significant organizational change effort to extract novel theoretical propositions of the emergent properties of organizational sensemaking systems. Results include the identification of properties of organizational sensemaking systems and a series of theoretical propositions about the nature of sensemaking emergence. The potential implications for change management practice and future empirical work are discussed.
Bimodal Trust: High and Low Trust in Vehicle Automation Influence Response to Automation Errors
Authors: Kamaraj Amudha V. , Lee Joonbum , Parker Jah’inaya , Domeyer Joshua E. , Liu Shu-Yuan , Lee John D.
Published: October 2023

Extended exposure to reliable automation may lead to overreliance as evidenced by poor responses to auto-mation errors. Individual differences in trust may also influence responses. We investigated how these factors affect response to automation errors in a driving simulator study comprised of stop-controlled and uncon-trolled intersections. Drivers experienced reliable vehicle automation during six drives where they indicated if they felt the automation was going too slow or too fast by pressing the accelerator or brake pedal. Engage-ment via pedal presses did not affect the automation but offered an objective measure of trust in automation. In the final drive, an error occurred where the vehicle failed to stop at a stop-controlled intersection. Drivers’ response to the error was inferred from brake presses. Mixture models showed bimodal response times and revealed that drivers with high trust were less likely to respond to automation errors than drivers with low trust.
Limning Auditing Indian Auditors
Authors: Deb Rajat
Published: October 2023

The boom of regulatory agencies is a common global phenomenon, and its basics are deeply rooted in national settings, leading to the setting up of specific regulators. Theoretically, auditors must demonstrate their professional prowess, skepticism, and analytical procedure, and effectively communicate audit outcomes to the stakeholders. Interestingly, the Indian audit profession is at its crossroads: constrained by scams and multiple regulators. Reform initiatives in the wake of corporate shenanigans compelled the creation of the National Financial Reporting Authority (NFRA) under Section 132 of the Companies Act, 2013. However, the accounting profession regulator, the Institute of Chartered Accountants of India (ICAI), alleges penetration of the former in its regulatory jurisdiction. Against this backdrop, adopting a descriptive approach, the current study attempts to unearth the factors leading to such face-offs for offering an amicable solution. The study concludes that the ICAI’s objections to treating the NFRA as a “super-regulator” cannot be supported. Consequently, the observation of the Committee on Experts constituted by the Supreme Court. Vesting investigating power in the NFRA could be a game changer in regulating auditors, audit firms, and audit networks. In light of the findings, the auditors could motivate to improve the audit quality substantially.
The potent analgesia of intrathecal 2R, 6R-HNK via TRPA1 inhibition in LF-PENS-induced chronic primary pain model
Authors: Liu An-Ran , Lin Zhen-Jia , Wei Ming , Tang Yuan , Zhang Hui , Peng Xiang-Ge , Li Ying , Zheng Yu-Fan , Tan Zhi , Zhou Li-Jun , Feng Xia
Published: October 2023

Background

Chronic primary pain (CPP) is an intractable pain of unknown cause with significant emotional distress and/or dysfunction that is a leading factor of disability globally. The lack of a suitable animal model that mimic CPP in humans has frustrated efforts to curb disease progression. 2R, 6R-hydroxynorketamine (2R, 6R-HNK) is the major antidepressant metabolite of ketamine and also exerts antinociceptive action. However, the analgesic mechanism and whether it is effective for CPP are still unknown.

Methods

Based on nociplastic pain is evoked by long-term potentiation (LTP)-inducible high- or low-frequency electrical stimulation (HFS/LFS), we wanted to develop a novel CPP mouse model with mood and cognitive comorbidities by noninvasive low-frequency percutaneous electrical nerve stimulation (LF-PENS). Single/repeated 2R, 6R-HNK or other drug was intraperitoneally (i.p.) or intrathecally (i.t.) injected into naïve or CPP mice to investigate their analgesic effect in CPP model. A variety of behavioral tests were used to detect the changes in pain, mood and memory. Immunofluorescent staining, western blot, reverse transcription-quantitative real-time polymerase chain reaction (RT-qPCR) and calcium imaging of in cultured dorsal root ganglia (DRG) neurons by Fluo-8-AM were used to elucidate the role and mechanisms of 2R, 6R-HNK in vivo or in vitro.

Results

Intrathecal 2R, 6R-HNK, rather than intraperitoneal 2R, 6R-HNK or intrathecal S-Ketamine, successfully mitigated HFS-induced pain. Importantly, intrathecal 2R, 6R-HNK displayed effective relief of bilateral pain hypersensitivity and depressive and cognitive comorbidities in a dose-dependent manner in LF-PENS-induced CPP model. Mechanically, 2R, 6R-HNK markedly attenuated neuronal hyperexcitability and the upregulation of calcitonin gene-related peptide (CGRP), transient receptor potential ankyrin 1 (TRPA1) or vanilloid-1 (TRPV1), and vesicular glutamate transporter-2 (VGLUT2) in peripheral nociceptive pathway. In addition, 2R, 6R-HNK suppressed calcium responses and CGRP overexpression in cultured DRG neurons elicited by the agonists of TRPA1 or/and TRPV1. Strikingly, the inhibitory effects of 2R, 6R-HNK on these pain-related molecules and mechanical allodynia were substantially occluded by TRPA1 antagonist menthol.

Conclusions

In the newly designed CPP model, our findings highlighted the potential utility of intrathecal 2R, 6R-HNK for preventing and therapeutic modality of CPP. TRPA1-mediated uprgulation of CGRP and neuronal hyperexcitability in nociceptive pathways may undertake both unique characteristics and solving process of CPP.
Exploring the biosynthetic gene clusters in Brevibacterium: a comparative genomic analysis of diversity and distribution
Authors: Cumsille Andrés , Serna-Cardona Néstor , González Valentina , Claverías Fernanda , Undabarrena Agustina , Molina Vania , Salvà-Serra Francisco , Moore Edward R.B. , Cámara Beatriz
Published: October 2023

Exploring Brevibacterium strains from various ecosystems may lead to the discovery of new antibiotic-producing strains. Brevibacterium sp. H-BE7, a strain isolated from marine sediments from Northern Patagonia, Chile, had its genome sequenced to study the biosynthetic potential to produce novel natural products within the Brevibacterium genus. The genome sequences of 98 Brevibacterium strains, including strain H-BE7, were selected for a genomic analysis. A phylogenomic cladogram was generated, which divided the Brevibacterium strains into four major clades. A total of 25 strains are potentially unique new species according to Average Nucleotide Identity (ANIb) values. These strains were isolated from various environments, emphasizing the importance of exploring diverse ecosystems to discover the full diversity of Brevibacterium. Pangenome analysis of Brevibacterium strains revealed that only 2.5% of gene clusters are included within the core genome, and most gene clusters occur either as singletons or as cloud genes present in less than ten strains. Brevibacterium strains from various phylogenomic clades exhibit diverse BGCs. Specific groups of BGCs show clade-specific distribution patterns, such as siderophore BGCs and carotenoid-related BGCs. A group of clade IV-A Brevibacterium strains possess a clade-specific Polyketide synthase (PKS) BGCs that connects with phenazine-related BGCs. Within the PKS BGC, five genes, including the biosynthetic PKS gene, participate in the mevalonate pathway and exhibit similarities with the phenazine A BGC. However, additional core biosynthetic phenazine genes were exclusively discovered in nine Brevibacterium strains, primarily isolated from cheese. Evaluating the antibacterial activity of strain H-BE7, it exhibited antimicrobial activity against Salmonella enterica and Listeria monocytogenes. Chemical dereplication identified bioactive compounds, such as 1-methoxyphenazine in the crude extracts of strain H-BE7, which could be responsible of the observed antibacterial activity. While strain H-BE7 lacks the core phenazine biosynthetic genes, it produces 1-methoxyphenazine, indicating the presence of an unknown biosynthetic pathway for this compound. This suggests the existence of alternative biosynthetic pathways or promiscuous enzymes within H-BE7’s genome.
A comparison of four dementia palliative care services using the RE-AIM framework
Authors: Fox Siobhan , Drennan Jonathan , Guerin Suzanne , Kernohan W. George , Murphy Aileen , O’Connor Niamh , Rukundo Aphie , Timmons Suzanne
Published: October 2023

Background

Living with a life-limiting illness, people with dementia benefit from palliative care which considers the holistic needs of the person and their family. However, little is known about how palliative care may be best provided to people living with dementia at home in the community. We examined four exemplary dementia palliative care services for people with dementia in the community, to see what activities they were providing, what were the commonalities and differences, and what lessons could be learned.

Methods

A long-list of dementia palliative care services in Ireland, Northern Ireland, England, Scotland, and Wales, was identified through a survey, and four exemplar services were chosen based on criteria including: in operation >six months; provides identifiable activities; availability of routinely collected service data; not exclusively for people with dementia in final hours or days of life. Mixed-methods of data collection included interviews, focus-groups and surveys with service staff, surveys of service users, and routinely collected service data. The RE-AIM framework was used to describe and understand the sample of dementia palliative care services.

Results

The four services had varied organisational structures and were led by different disciplines. However, they all provided common core activities including holistic and person-centred care, early advance care planning with service user involvement, carer support, integrated healthcare services, continuity of care, 24/7 support, bereavement support. All had needs-based referral criteria, accepting any age or dementia sub-type. All supported people with dementia to remain living at home and to have a comfortable, dignified death in their preferred place.

Conclusions

An effective dementia palliative care service may take different forms. Whether the service is dementia-led or Specialist Palliative Care-led, efficacy is associated with providing a range of key activities and implementing them effectively. The data collected strongly suggests the benefits of the dementia palliative care services to a person with dementia and their families and offers valuable insight into the key factors for the establishment and successful running of such services.
Analysis and prediction of older adult sports participation in South Korea using artificial neural networks and logistic regression models
Authors: Byun Hyun , Jeon Sangwan , Yi Eun Surk
Published: October 2023

Background

Korea’s aging population and the lack of older adult participation in sports are increasing medical expenses.

Aims

This study aimed to segment older adult sports participants based on their demographic characteristics and exercise practice behavior and applied artificial neural network and logistic regression models to these segments to best predict the effect of medical cost reduction. It presents strategies for older adult sports participation.

Methods

A sample comprising data on 1,770 older adults aged 50 years and above was drawn from the 2019 National Sports Survey. The data were analyzed through frequency analysis, hierarchical and K-means clustering, artificial neural network, logistic regression, cross-tabulation analyses, and one-way ANOVA using SPSS 23 and Modeler 14.2.

Results

The participants were divided into five clusters. The artificial neural network and logistic analysis models showed that the cluster comprising married women in their 60s who participated in active exercise had the highest possibility of reducing medical expenses.

Discussion

Targeting women in their 60s who actively participate in sports, the government should expand the supply of local gymnasiums, community centers, and sports programs. If local gymnasiums and community centers run sports programs and appoint appropriate sports instructors, the most effective medical cost reduction effect can be obtained.

Conclusions

This study contributes to the field by providing insights into the specific demographic segments to focus on for measures to reduce medical costs through sports participation.
Hepatitis C virus prevalence among men who have sex with men: a cross-sectional study in 12 Brazilian cities
Authors: Silva Vanessa C. M. , Kerr Lígia R. F. S. , Kendall Carl , Mota Rosa S. , Guimarães Mark Drew C. , Leal Andréa F. , Merchan-Hamann Edgar , Dourado Inês , Veras Maria Amélia , de Brito Ana Maria , Pontes Alexandre K. , Macena Raimunda H. M. , Knauth Daniela , Lima Luana N. G. C. , Cavalcante Socorro , Camillo Ana Cláudia , Díaz-Bermudez Ximena P. , Oliveira Lisangela C. , Magno Laio , Lemos Marcílio F. , Compri Adriana P. , Motta-Castro Ana Rita C. , Moreira Regina C.
Published: October 2023

Background

Despite the preventive policies adopted, reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) has been limited. The risk of hepatitis C virus (HCV) infection has increased among the most vulnerable population groups, including MSM. The aim of this study was to estimate the prevalence of HCV infection and to assess risky practices among MSM from 12 Brazilian cities.

Methods

This study was carried out from June to December 2016 using respondent driven sampling (RDS). Participants completed a self-administered questionnaire to collect behavioral, socioeconomic, and demographic variables. In addition, the rapid diagnostic test (RDT) for HCV was offered. Positive results were sent to Instituto Adolfo Lutz for confirmation.

Results

A total of 4,176 participants were recruited and 23 samples were sent for confirmation. Of these, 16 were confirmed, resulting in a prevalence of 0.7% (95% CI: 0.3%—1.7%). The Southeast region showed a prevalence of 0.9% (95% CI: 0.3—2.6), followed by the South region, with 0.6% (95% CI: 0.2—2.1). The Northeast region had a prevalence of 0.3% (95% CI: 0.1—1.0) and the Midwest 0.1% (95% CI: 0.0—0.7). No positive cases were found in the North. Single men aged 40 years or older were the majority of participants exposed to HCV. High levels of alcohol consumption, illicit drug use, irregular condom use, in addition to infection with other STIs, were associated with exposure to HCV.

Conclusions

STIs continue to be important health problems in Brazil and globally. Many STIs are inapparent for many years until they bring more serious consequences. Extra investment in HCV is also warranted, given that it can be eliminated. Relying solely on clinical data to provide information about inapparent infection, especially in stigmatized populations, will make that goal more difficult to achieve. Surveillance studies, such as the one reported here need to be repeated over time to demonstrate trends and to provide information for evaluation, program and policies. Investments in the most vulnerable populations are critical to achieve the World Health Organization global health goals including the elimination of viral hepatitis by 2030.
Weakly supervised video-based cardiac detection for hypertensive cardiomyopathy
Authors: Chen Jiyun , Zhang Xijun , Yuan Jianjun , Shao Renjie , Gan Conggui , Ji Qiang , Luo Wei , Pang Zhi-Feng , Zhu Haohui
Published: October 2023

Introduction

Parameters, such as left ventricular ejection fraction, peak strain dispersion, global longitudinal strain, etc. are influential and clinically interpretable for detection of cardiac disease, while manual detection requires laborious steps and expertise. In this study, we evaluated a video-based deep learning method that merely depends on echocardiographic videos from four apical chamber views of hypertensive cardiomyopathy detection.

Methods

One hundred eighty-five hypertensive cardiomyopathy (HTCM) patients and 112 healthy normal controls (N) were enrolled in this diagnostic study. We collected 297 de-identified subjects’ echo videos for training and testing of an end-to-end video-based pipeline of snippet proposal, snippet feature extraction by a three-dimensional (3-D) convolutional neural network (CNN), a weakly-supervised temporally correlated feature ensemble, and a final classification module. The snippet proposal step requires a preliminarily trained end-systole and end-diastole timing detection model to produce snippets that begin at end-diastole, and involve contraction and dilatation for a complete cardiac cycle. A domain adversarial neural network was introduced to systematically address the appearance variability of echo videos in terms of noise, blur, transducer depth, contrast, etc. to improve the generalization of deep learning algorithms. In contrast to previous image-based cardiac disease detection architectures, video-based approaches integrate spatial and temporal information better with a more powerful 3D convolutional operator.

Results

Our proposed model achieved accuracy (ACC) of 92%, area under receiver operating characteristic (ROC) curve (AUC) of 0.90, sensitivity(SEN) of 97%, and specificity (SPE) of 84% with respect to subjects for hypertensive cardiomyopathy detection in the test data set, and outperformed the corresponding 3D CNN (vanilla I3D: ACC (0.90), AUC (0.89), SEN (0.94), and SPE (0.84)). On the whole, the video-based methods remarkably appeared superior to the image-based methods, while few evaluation metrics of image-based methods exhibited to be more compelling (sensitivity of 93% and negative predictive value of 100% for the image-based methods (ES/ED and random)).

Conclusion

The results supported the possibility of using end-to-end video-based deep learning method for the automated diagnosis of hypertensive cardiomyopathy in the field of echocardiography to augment and assist clinicians.

Trial registration

Current Controlled Trials ChiCTR1900025325, Aug, 24, 2019. Retrospectively registered.
Transforming Parkinson's Care in Africa (TraPCAf): protocol for a multimethodology National Institute for Health and Care Research Global Health Research Group project
Authors: Walker R. , Fothergill-Misbah N. , Kariuki S. , Ojo O. , Cilia R. , Dekker M. C. J. , Agabi O. , Akpalu A. , Amod F. , Breckons M. , Cham M. , Del Din S. , Dotchin C. , Guggsa S. , Kwasa J. , Mushi D. , Nwaokorie F. O. , Park T. , Rochester L. , Rogathi J. , Sarfo F. S. , Shalash A. , Ternent L. , Urasa S. , Okubadejo N.
Published: October 2023

Background

Parkinson’s disease (PD) is the second most common neurodegenerative disorder and, according to the Global Burden of Disease estimates in 2015, was the fastest growing neurological disorder globally with respect to associated prevalence, disability, and deaths. Information regarding the awareness, diagnosis, phenotypic characteristics, epidemiology, prevalence, risk factors, treatment, economic impact and lived experiences of people with PD from the African perspective is relatively sparse in contrast to the developed world, and much remains to be learned from, and about, the continent.

Methods

Transforming Parkinson’s Care in Africa (TraPCAf) is a multi-faceted, mixed-methods, multi-national research grant. The study design includes multiple sub-studies, combining observational (qualitative and quantitative) approaches for the epidemiological, clinical, risk factor and lived experience components, as appropriate, and interventional methods (clinical trial component). The aim of TraPCAf is to describe and gain a better understanding of the current situation of PD in Africa. The countries included in this National Institute for Health and Care Research (NIHR) Global Health Research Group (Egypt, Ethiopia, Ghana, Kenya, Nigeria, South Africa and Tanzania) represent diverse African geographies and genetic profiles, with differing resources, healthcare systems, health and social protection schemes, and policies. The research team is composed of experts in the field with vast experience in PD, jointly led by a UK-based and Africa-based investigator.

Discussion

Despite the increasing prevalence of PD globally, robust data on the disease from Africa are lacking. Existing data point towards the poor awareness of PD and other neurological disorders on the continent and subsequent challenges with stigma, and limited access to affordable services and medication. This multi-site study will be the first of its kind in Africa. The data collected across the proposed sub-studies will provide novel and conclusive insights into the situation of PD. The selected country sites will allow for useful comparisons and make results relevant to other low- and middle-income countries. This grant is timely, as global recognition of PD and the public health challenge it poses builds. The work will contribute to broader initiatives, including the World Health Organization’s Intersectoral global action plan on epilepsy and other neurological disorders.

Trial registration

https://doi.org/10.1186/ISRCTN77014546.
Early fever in patients with primary intracerebral hemorrhage is associated with worse long-term functional outcomes: a prospective study
Authors: Tseng Wen-Che , Chiu Yi-Hsiang , Chen Yun-Chang , Chen Hsin-Shui , Hsiao Ming-Yen
Published: October 2023

Background

Primary intracerebral hemorrhage (ICH) accounts for 85% of ICH cases and is associated with high morbidity and mortality rates. Fever can cause secondary injury after ICH; however, relevant studies have reported inconsistent results regarding the effects of fever on functional outcomes after ICH. This study examined the effects of early fever on the prognosis of ICH, particularly on long-term functional outcomes.

Methods

This prospective study recruited patients with primary ICH at a tertiary medical center between 2019 and 2021. Early fever was defined as a tympanic body temperature of ≥ 38 °C upon admission. Barthel Index (BI) and modified Rankin scale (mRS) were examined at 1 year after ICH. A BI of ≤ 60 or mRS of ≥ 4 was considered as indicating severe disability.

Results

We included 100 patients, and early fever was significantly associated with less functional independence at 1 year post-ICH, as determined using the mRS (p = 0.048; odds ratio [OR] = 0.23), and with severe functional dependency at 1 year post-ICH, as determined using the BI (p = 0.043; OR = 3) and mRS (p = 0.045; OR = 3). In addition, patients with early fever had a longer length of hospital stay (p = 0.002; 95% confidence interval = 21.80–95.91).

Conclusions

Fever is common among patients with primary ICH. Our data indicate a significant association between early fever and worse functional outcomes in ICH survivors at 1 year after ICH. Additionally, patients with early fever had a significantly longer length of hospital stay after ICH.
Association between neutrophil-to-albumin ratio and long-term mortality of aneurysmal subarachnoid hemorrhage
Authors: Zhang Renjie , Zhang Yu , Liu Zheran , Pei Yiyan , He Yan , Yu Jiayi , You Chao , Ma Lu , Fang Fang
Published: October 2023

Objective

The prognosis of aneurysmal subarachnoid hemorrhage (aSAH) survivors is concerning. The goal of this study was to investigate and demonstrate the relationship between the neutrophil-to-albumin ratio (NAR) and long-term mortality of aSAH survivors.

Methods

A retrospective observational cohort study was conducted at Sichuan University West China Hospital between January 2009 and June 2019. The investigation of relationship between NAR and long-term mortality was conducted using univariable and multivariable Cox regression models. To demonstrate the predictive performance of different biomarkers over time, time-dependent receiver operating characteristic curve (ROC) analysis and decision curve analysis (DCA) were created.

Results

In total, 3173 aSAH patients were included in this study. There was a strong and continuous relationship between NAR levels and long-term mortality (HR 3.23 95% CI 2.75–3.79, p < 0.001). After adjustment, the result was still significant (adjusted HR 1.78 95% CI 1.49–2.12). Compared with patients with the lowest quartile (< 0.15) of NAR levels, the risk of long-term mortality in the other groups was higher (0.15–0.20: adjusted HR 1.30 95% CI 0.97–1.73; 0.20–0.28: adjusted HR 1.37 95% CI 1.03–1.82; >0.28: adjusted HR 1.74 95% CI 1.30–2.32). Results in survivors were found to be still robust. Moreover, out of all the inflammatory markers studied, NAR demonstrated the highest correlation with long-term mortality.

Conclusions

A high level of NAR was associated with increased long-term mortality among patients with aSAH. NAR was a promising inflammatory marker for long-term mortality of aSAH.
Effect of chemotherapy alone or combined with immunotherapy for locally advanced or metastatic genitourinary small cell carcinoma: a real-world retrospective study
Authors: Huang Riqing , Chen Meiting , Li Haifeng , An Xin , Xue Cong , Hu Anqi , Shu Ditian , Yang Wei , Zhou Fangjian , Sui Dan , Yao Kai , Li Yonghong , Wu Zhiming , Li Zhiyong , Liu Zhuowei , Shi Yanxia
Published: October 2023

Background

Genitourinary small cell carcinoma is rare, and has a poor prognosis. However, effective treatment options for this disease are limited. We present a study to assess the efficacy of chemotherapy alone or combined with immunotherapy for locally advanced or metastatic genitourinary small cell carcinoma (GSCC).

Methods

We performed a retrospective analysis of patients with locally advanced or metastatic GSCC from Jan 2013 to September 2022 at Sun Yat-sen University Cancer Center. The survival and safety profiles were analyzed.

Results

Forty-two GSCC patients were enrolled, which included 20 with chemotherapy plus immunotherapy and 22 with chemotherapy alone. The median follow-up time was 15.13 months (95% CI, 8.84–21.42). The addition of immunotherapy to chemotherapy demonstrated no significant difference in median progression-free survival (p = 0.37). However, the median overall survival (OS) was 22.97 and 14.03 months with immunotherapy plus chemotherapy and chemotherapy alone, respectively (HR = 0.69, 95%CI 0.08–0.55, p = 0.017). Two patients with immunotherapy plus chemotherapy achieved clinical complete remission. The overall response rate for patients receiving chemotherapy combined with immunotherapy was 65%, which was higher in comparison to those treated with chemotherapy alone (50%). Univariate and multivariate analyses demonstrated that chemotherapy combined with immunotherapy independently achieved favorable OS. Four patients experienced immunotherapy-related adverse events, with one developing grade 3 hypothyroidism.

Conclusions

Among patients with locally advanced or metastatic GSCC, immunotherapy combined with chemotherapy might be thought of as a potentially effective treatment option for patients with GSCC.
Using immunovascular characteristics to predict very early recurrence and prognosis of resectable intrahepatic cholangiocarcinoma
Authors: Xu Ying , Li Zhuo , Zhou Yanzhao , Yang Yi , Ouyang Jingzhong , Li Lu , Huang Zhen , Ye Feng , Ying Jianming , Zhao Hong , Zhou Jinxue , Zhao Xinming
Published: October 2023

Objective

To predict the very early recurrence (VER) of patients with intrahepatic cholangiocarcinoma (ICC) based on TLSs and MVI status, and further perform prognosis stratifications.

Methods

A total of 160, 51 ICC patients from two institutions between May 2012 and July 2022 were retrospectively included as training, external validation cohort. Clinical, radiological and pathological variables were evaluated and collected. Univariate and multivariate analysis were applied to select the significant factors related to VER of ICC. The factors selected were combined to perform stratification of overall survival (OS) using the Kaplan-Meier method with the log-rank test.

Results

Overall, 39 patients (24.4%) had VER, whereas 121 (75.6%) did not (non-VER group). In the training cohort, the median OS was 40.5 months (95% CIs: 33.2–47.7 months). The VER group showed significantly worse OS than the non-VER group (median OS: 14.8, 95% CI:11.6–18.0 months vs. 53.4, 34.3–72.6 months; p<0.001), and it was confirmed in the validation cohort (median OS: 22.1, 95% CI: 8.8–35.4 months vs. 40.1, 21.2–59.0 months; p = 0.003). According to the univariate analysis, four variables were significantly different between the VER group and non-VER group (TLSs status, p = 0.028; differentiation, p = 0.023; MVI status, p = 0.012; diameter, p = 0.028). According to the multivariate analysis, MVI-positive status was independently associated with a higher probability of VER (odds ratio [OR], 2.5; 95% CIs,1.16–5.18; p = 0.018), whereas intra-tumoral TLSs-positive status was associated with lower odds of VER (OR, 0.43; 95% CIs, 0.19–0.97; p = 0.041). Based on the TLSs and MVI status, patients of ICC were categorized into four groups: TLSs-positive and MVI-negative (TP/MN); TLSs-negative and MVI-negative (TN/MN); TLSs-positive and MVI-positive (TP/MP), TLSs-negative and MVI-positive groups (TN/MP). In the training cohort, the four groups could be correlated with OS significantly (p<0.001), and it was confirmed in the validation cohort (p<0.001).

Conclusion

Intra-tumoral TLSs and MVI status are independent predictive factors of VER after surgery, based on which immunovascular stratifications are constructed and associated with OS significantly of resectable intrahepatic cholangiocarcinoma.
Screening and determinant of suspected developmental delays among Egyptian preschool-aged children: a cross-sectional national community-based study
Authors: Metwally Ammal M. , Abdallah Ali M. , El-Din Ebtissam M. Salah , Zeid Dina Abu , Khadr Zeinab , Elshaarawy Ghada A. , Elkhatib Alshaimaa A. , Elsaied Amal , Ashaat Engy A. , Elghareeb Nahed A. , Abdou Mohamed H. , Fathy Asmaa M. , Eldeeb Sherif E. , AbdAllah Mohamed , Soliman Muhammed Al-tohamy , El Banna Rokia AbdElshafy S. , Hassanein Abdelrahman K. , Rabah Thanaa M. , Abdelrahman Mohamed , Sallam Sara F.
Published: October 2023

Background

Early childhood life is critical for optimal development and is the foundation of future well-being. Genetic, sociocultural, and environmental factors are important determinants of child development.

Aim

The objectives were to screen for suspected developmental delays (DDs) among Egyptian preschool children, and to explore the determinants of these delays based on sociodemographic, epidemiological, maternal, and child perinatal risk factors.

Methods

A national Egyptian cross-sectional developmental screening of a representative sample of preschool children (21,316 children) aged 12 to 71 months. The Revised Denver Prescreening Developmental Questionnaire (R-PDQ) followed by the Denver Developmental Screening Test, 2ndedition (DDST) was used.

Results

Each screened child manifested at least one of six developmental categories. Either typical development, gross motor delay (GM), fine motor adaptive delay (FMA), Language delay (L), Personal-social delay (PS), or multiple DDs. The prevalence of preschool children with at least one DD was 6.4%, while 4.5% had multiple DDs. Developmental language delay was the most prevalent, affecting 4.2% of children. The least affected domain was GM (1.9% of children). Boys were more likely to have DD than girls. Children in urban communities were more likely to have at least one DD than those in rural areas (OR = 1.28, 95%CI: 1.14–1.42), and children of middle social class than of low or high social class (OR = 1.49, 95%CI: 1.30–1.70 & OR = 1.40, 95%CI: 1.23–1.59 respectively). The strong perinatal predictors for at least one DD were children with a history of postnatal convulsions (OR = 2.68, 95%CI: 1.97–3.64), low birth weight (OR = 2.06, 95%CI: 1.69–2.52), or history of postnatal cyanosis (OR = 1.77, 95%CI: 1.26–2.49) and mothers had any health problem during pregnancy (OR = 1.73, 95%CI: 1.44–2.07). Higher paternal and maternal education decreased the odds of having any DD by 43% (OR = 0.57, 95% CI: 0.47–0.68) and 31% (OR = 0.69, 95%CI: 0.58–0.82) respectively.

Conclusion

This study demonstrates a considerable attempt to assess the types and the prevalence of DD among preschool children in Egypt. Perinatal factors are among the most common determinants of DD in preschool children and the majority could be preventable risk factors.
The “GU-GU-RU” project to eliminate discrimination related to the health effects of the Fukushima nuclear accident
Authors: Amir Isamu , Eguchi Yuichiro , Saotome Kousaku , Ogawa Soichiro , Kojima Yoshiyuki , Tamaki Tomoaki , Tsubokura Masaharu
Published: October 2023

Background

Although 12 years have passed since Great East Japan Earthquake and following Fukushima nuclear accident, approximately 40% of Japanese citizen still believe that the current radiation exposure in Fukushima residents will likely/ very likely to cause genetic effects of radiation. This incorrect understanding could continue unexpected discrimination and prejudice towards those from Fukushima now and in the future. In order to provide updated knowledge and eliminate rumors related to radiation, Japanese Ministry of the Environment has launched “GU-GU-RU” project in 2021 with consisting of five sections.

Objective

(1) To discuss the objectives and effects of the “GU-GU-RU” project (results after the first year), (2) to present administrative measures that may be effective in the long-term to prevent unjustified discrimination and prejudice, and (3) to eliminate rumors in the event of future large-scale disasters, including radiation disasters.

Methods

We showed the contents of each sections carried out under the project and observed the result of first-year activities in each section.

Results

Among the programs, the “Radiation College” has steadily produced positive results, with nearly 1,300 students participating and 50 students sharing their thoughts and ideas. In addition, the project has adopted strategies such as creating and broadcasting a TV program and collaborations with manga, which are expected to have a significant impact on society.

Conclusions

Compared to previous efforts on disseminating information related to health effect of radiation exposure, the “GU-GU-RU” project has taken a different approach in providing primary data of radiation and its health effects, which could become a better understanding of health effects of radiation for the general public, in order to eliminate rumors that may lead unjustified discrimination and prejudice.
The multicultural conceptualisation of well-being
Authors: Adedeji Adekunle , Olonisakin Tosin Tunrayo , Buchcik Johanna , Metzner Franka , Tsabedze Wandile , Boehnke Klaus , Idemudia Erhabor S.
Published: October 2023

Background

Exploring and understanding indicators of better life outcomes have remained popular among social and health researchers. However, the subjective approach to measuring well-being has raised questions on the appropriateness of standard measures of well-being in multicultural settings. The current study examines generalised well-being and its dependence on the implicit understanding of individual culture and circumstances.

Methods

A mixed-method approach with a cross-sectional design and focus group discussions was adopted. Fifteen focus group discussions with 66 participants were conducted in four provinces of South Africa. Descriptive statistics, correlations, regression analysis and analysis of variance were computed for quantitative data. The focus group discussions were analysed using a content analysis approach. The recorded focus group discussions were transcribed using the intelligent verbatim technique. Data analysis was done stepwise using open, axial, and selective coding techniques.

Results

Quantitative analysis showed a strong and significant association between quality of life and income and a moderate association with educational attainment. The open coding technique for qualitative data confirmed 11 different subconstructs of well-being, mentioned 403 times during the 15 focus group discussions. Furthermore, well-being indicators varied based on participants’ racial identity.

Conclusions

The findings confirm personal circumstance and culture as significant for interpreting results from well-being research. Furthermore, it supports Maslow’s Hierarchy of Needs, highlighting the movement from deficiency needs to growth needs after deficiency needs are met. Research must adopt a more sociological approach to improve the accuracy and implementibility of findings when using standardised measures of well-being.
Open reduction and internal fixation of irreducible displaced femoral neck fracture with femoral Neck System: a preliminary study
Authors: Liang Chengzhi , Cao Yuan , Lin Zhihao , Liu Guoming , Zhang Chengdong , Hu Yanling
Published: October 2023

Background

Most displaced femoral neck fractures can achieve satisfactory anatomical reduction by closed reduction, but there are still some that cannot reset satisfactorily after closed reduction, and open reduction are required. Such fractures that cannot be repositioned successfully by closed reduction are called irreducible displaced femoral neck fractures in this study. The objective of our study was to evaluate the efficacy of direct anterior incision with the Femoral Neck System in the treatment of irreducible displaced femoral fractures.

Methods

A total of 16 young and middle-aged patients with irreducible displaced femoral neck fractures involving Garden type III and IV were treated using Femoral Neck System fixation by open reduction through Direct Anterior Approach between January 2020 to September 2021. Functional outcomes and postoperative complications were assessed during follow-up. Clinical outcomes were evaluated by the Hip Harris score. The postoperative reduction was evaluated by the Garden Index. Observe postoperative complications.

Results

All patients were followed up with a mean follow-up time of 21.1(12–30) months, and according to radiological results, all patients achieved fracture healing, with a mean healing time of 4.25 months. All 16 patients received grade Garden I and II reductions, and there was no significant difference in the anteroposterior Garden reduction index between the first day after surgery (166.13 ± 5.61) and the 12th month after surgery(164.94 ± 4.49) (P>0.05) and no significant difference in lateral Garden index between the first day after surgery(171.06 ± 4.46) and the 12th month after surgery(169.38 ± 3.98) (P<0.05). According to the Hip Harris score scale, 13 patients received excellent and 3 patients received good. The postoperative Hip Harris Score(17.19 ± 4.8) was significantly higher than the preoperative score(92.19 ± 3.4), and the difference was statistically significant (P < 0.05). No or mild femoral neck shortness occurred in 12 (75%) patients, moderate shortening occurred in 3 (18.75%) patients, and severe shortening occurred in 1 (6.25%) patient. None of the patients experienced femoral head necrosis, fracture nonunion, or incision infection. One patient developed deep venous thrombosis of the lower extremity.

Conclusions

The Direct Anterior Approach combined with Femoral Neck System is an excellent treatment for irreducible displaced femoral neck fracture and achieved good functional outcomes and anatomical reduction with low complications.
Color behavior of composite resin enhanced with different shapes of new antimicrobial polymer coated nanoparticles
Authors: Naguib Ghada , Mously Hisham , Magdy Walaa , Binmahfooz Abdulelah , Qutub Osama , Hajjaj Maher , Hamed Mohamed Tharwat
Published: October 2023

Background

Zein-coated magnesium oxide nanoparticles (zMgO NPs) demonstrate a potent antimicrobial effect, endorsing it as a compelling additive to dental materials formulations for oral health care advances. However, currently there is no data on the imprint of zMgO NPs on the color permanence of dental composites. The objective of this study is to evaluate the color stability of different types of composite enhanced with antimicrobial zein-coated magnesium oxide nanoparticles (zMgO NPs) of different shapes before and after thermocycling.

Methods

Two hundred composite samples were divided into four groups: Gp1: Tetric N-Flow with zMgO nanowires, Gp2: Tetric N-Flow with zMgO nanospheres, Gp3: Tetric N-Ceram with zMgO nanowires; Gp4: Tetric N-Ceram with zMgO nanospheres. Each group was subdivided into 5 subgroups (n = 10) with concentrations of zMgO NPs 0%, 0.3%, 0.5%, 1% and 2%. The characterization of the modified composite containing the zMgO was done via X-ray Diffraction, Field Emission Scanning Electron Microscopy (FESEM), and Fourier Transform Infrared Spectroscopy (FTIR). Colorimetric evaluation was performed through spectrophotometry with a white background. Samples underwent color assessment using a spectrophotometer, followed by thermocycling, and then another color assessment.

Results

FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. However, the XRD spectra exhibited an amorphous pattern in the composite enhanced with zMgO NPs. There was no compelling discrepancy in color variation ΔE among the different groups before and after thermocycling (p > 0.05). A statistically notable variation in ΔL was found amid the control and N-Flow and N-Ceram with 2% zMgO nanospheres before and after thermocycling respectively (p < 0.05). While after thermocycling, there was a statistically significant difference in Δa in N-Flow and N-Ceram wires amid the control and the different groups (p < 0.05). Additionally, after thermocycling there was a statistically significant difference in Δb in N-Flow and N-Ceram wires between the control and the different groups (p < 0.05). The Tukey test exhibited no variation among the groups with different zMgO concentrations (p > 0.05).

Conclusion

Enhancing N-Flow and N-Ceram composite with antimicrobial zMgO nanowires and nanospheres did not alter the total color stability of the materials before and after thermocycling.
Estimated indirect costs of haemodialysis versus peritoneal dialysis from a patients’ perspective at an Academic Hospital in Pretoria, South Africa
Authors: Moalosi Kotulo , Sibanda Mncengeli , Kurdi Amanj , Godman Brian , Matlala Moliehi
Published: October 2023

In South Africa (SA), patients with kidney failure can be on either haemodialysis (HD), which is performed by a healthcare professional in a hospital thrice weekly; or peritoneal dialysis (PD), which can performed daily at home. There needs to be more studies within the South African healthcare sector on the cost of kidney failure and especially the indirect costs associated with patients being on dialysis to provide future guidance. This study aimed to determine and compare the indirect costs associated with HD and PD from the patients’ perspective at an Academic Hospital in Pretoria. The study used a cross-sectional prospective quantitative study design. The researcher used face-to-face interviews to collect data and the human capital approach to calculate productivity losses. The study population included all patients over 18 receiving HD or PD for over three months; 54 patients participated (28 on HD and 26 on PD). The study lasted seven months, from September 2020 to March 2021. Haemodialysis patients incurred greater productivity losses per annum ($8127.55) compared to PD (R$3365.34); the difference was statistically significant with a P-value of p < 0.001. More HD (96.4%) patients were unemployed than (76.9%) PD patients.
‘Making every contact count’ with patients with musculoskeletal conditions: a qualitative exploration of acceptability to physiotherapists
Authors: Parchment Amelia , Lawrence Wendy , Rahman Em , Townsend Nick , Wainwright Elaine , Wainwright David
Published: October 2023

Aim

To qualitatively explore physiotherapists’ experiences and acceptability of implementing ‘Making Every Contact Count Healthy Conversation Skills’ (MECC HCS) in routine practice with patients with musculoskeletal (MSK) conditions.

Methods

This article reports the second phase of a mixed method, sequential explanatory study. Physiotherapists trained in and delivering MECC HCS in their practice were invited to take part in semi-structured interviews. We hoped to develop a rich, in-depth understanding of their use and perceptions of the brief intervention and to contextualise findings from the first phase of the study. Qualitative data were analysed using Reflexive Thematic Analysis.

Results

Physiotherapists valued MECC HCS as being integral to their practice, promoting a person-centred approach to supporting behaviour change and enhancing self-management in patients with MSK conditions and pain. It was believed that this brief intervention could reduce workload pressure for physiotherapists and have significant wider benefits for health services. Time limitations associated with appointments did, however, pose as a challenge to MECC HCS delivery, and it was felt that more organisational-level support was needed to sustain it.

Conclusions

These findings support our quantitative data, collected in the first phase of this study. MECC HCS is a highly acceptable brief intervention that can be delivered in physiotherapy care to support behaviour change in patients with MSK conditions. Future roll-out may be optimised within organisations by providing regular refresher training and adopting a MECC champion.