bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing academic challenges: A quasi-experimental study on the effect of remedial exam strategy for nursing students with low academic performance
Authors: Hassan Eman M. Gaber
Published: August 2023

Background: Universities are responsible for providing education and support to all students, including those who may be underachieving. To fulfill this responsibility, universities need effective strategies to help these students graduate successfully.
Objective: This study aimed to evaluate the effectiveness of a midterm remedial exam strategy in improving the academic performance of nursing students.
Methods: A quasi-experimental design was employed to conduct this research at a private college in Dammam, Saudi Arabia’s eastern region. The study included 306 convenient bachelor nursing students who had failed their midterm exam. Of these, 103 students voluntarily participated in the remedial midterm exam (intervention group) to enhance their midterm scores, while 203 students did not take the remedial exam (control group). Data collection took place in the spring of 2022 by reviewing course files and student records, encompassing formative and summative evaluations across 14 courses. Data analysis involved using SPSS (2023) and Jamovi (version 2.3, 2022) software to conduct paired t-tests, Mann-Whitney, and correlational tests.
Results: The remedial group demonstrated significant differences between their midterm and remedial exam scores. However, only 15.5% of students in the remedial group passed the exam, despite 68% showing improvement. Additionally, there were significant differences between the intervention and control groups in midterm and overall course scores. The control group outperformed the remedial group in the midterm, final exams, and overall course scores (p <0.05).
Conclusion: Remedial exams can be beneficial for students who are close to passing but may not effectively support those who perform poorly. To address this, implementing a comprehensive remedial program or providing ongoing remedial activities throughout the course can offer better support for strongly underperforming students. Additionally, educational institutions can enhance students’ motivation and performance by providing study skills classes and time-management workshops, equipping them with valuable tools for academic success.
Self-care knowledge in patients with intestinal stomas in a selected hospital in the south of Viet Nam: A descriptive cross-sectional study
Authors: Ngo Thi Dung , Hawks Miranda , Nguyen Thi Thanh Truc , Nguyen Thi Ngoc Han , Nguyen Hong Thiep , Mai Nguyen Thanh Truc
Published: August 2023

Background: Intestinal stomas are surgical interventions that have an impact on both physical and psychological health, necessitating patient self-care. Insufficient knowledge regarding peristomal skin care, prevention, and treatment of potential problems can lead to an increase in stoma-related complications.
Objective: This study aimed to assess patients’ knowledge of self-care for intestinal stomas and examine the relationship between background information and self-care knowledge.
Methods: A descriptive cross-sectional study was conducted from December 2021 to December 2022 at the Can Tho University of Medicine and Pharmacy Hospital in Vietnam, involving 74 participants with intestinal stomas. A questionnaire consisting of 24 closed-ended questions was used to evaluate participants' knowledge of self-care for intestinal stomas. Descriptive statistics, Chi-square, and Fisher’s exact tests were employed for data analysis.
Results: The findings revealed that 54.1% of participants had good knowledge of general self-care for intestinal stomas. The distribution of good knowledge among participants was as follows: basic knowledge (66.2%), self-care practice (56.8%), recognizing and managing complications (31.1%), and dietary knowledge (64.8%). Significant relationships were observed between participants’ self-care knowledge and their education level (p = 0.002), marital status (p = 0.017), nurses’ education (p = 0.021), and hospitalization (p = 0.001).
Conclusion: The proportion of participants with good knowledge of self-care for intestinal stomas was relatively low, and it was associated with individuals' education level, marital status, nurses’ education, and hospitalization. This study highlights the need for ongoing development of educational programs on self-care for intestinal stomas. These programs should be tailored to address the specific needs of each patient and aim to improve their self-care knowledge in a meaningful and sustainable manner. By investing in patient education, healthcare professionals, particularly nurses, can assist individuals with intestinal stomas in achieving better outcomes and preventing potential complications.
Securitización sanitaria y control migratorio fronterizo: el Título 42 en la frontera México-Estados Unidos
Authors: Del Monte Madrigal Juan Antonio
Published: August 2023

Title 42 is an old U.S. health policy implemented in the service of immigration control in the wake of the COVID-19 pandemic. This article aims to discuss the argument about the logic behind the migratory containment strategies involved in this provision. From a documentary and bibliographic review of official data and testimonies of migrants expelled under this policy, the effects of this rule are reviewed, especially towards the populations seeking international protection, who were expelled to territories where their lives were in danger. Three ways of understanding are proposed to critically reflect on how a health policy has been implemented as a migratory restriction: the bionecropolitical governance of migrations, the global regime of security and health immunization, and the securitization of borders through constructing external threats.
Recomendación del Editor
Authors: Alvarez Vidigal Evelyn
Published: August 2023

Los conocimientos, prácticas y actitudes relacionadas a la salud bucal de los padres son transmitidas a sus hi-jos, predisponiéndolos a responder de forma positiva o negativa a la adquisición de hábitos saludables.
MODEL PENINGKATAN KOMITMEN ORGANISASI BERBASIS PADA KNOWLEDGE SHARING, LEADERSHIP DAN KOMPENSASI
Authors: Natoil Natoil , Hartarini Yovita Mumpuni , Warsilan Warsilan
Published: August 2023

Penelitian ini ditujukan untuk menguji pengaruh knowledge sharing, leadership dan kompensasi serta dampaknya terhadap  komitmen organisasi. Masalah dalam penelitian  ini adalah bagaimana meningkatkan komitmen organisasi di Koperasi Bina Usaha Karangjati. Dalam penelitian ini populasi yang digunakan adalah seluruh karyawan koperasi yang berjumlah 34 orang. Analisis regressi yang dijalankan dengan perangkat lunak Statistical Package Social Science  (SPSS), digunakan untuk menganalisis data, Hasil analisis menunjukkan bahwa knowlerdge sharing, leadership dan kompensasi berpengaruh signifikan terhadap komitmen organisasi. Temuan empiris tersebut mengindikasikan bahwa knowledge sharing terhadap komitmen organisasi karyawan menunjukkan nilai  t hitung  sebesar 4.239, leadership  menunjukkan nilai  t  hitung  sebesar 3,418 dan kompensasi  menunjukkan nilai  t  hitung  sebesar 4,966 maka berpengaruh signifikan terhadap komitmen organisasi.
The Half-Truth of Western Political Realism: A Buddhist Critique
Authors: Long William
Published: August 2023

Contrary to the assumptions of political realism, Buddhism argues that are fortunes are not separate and at odds and our underlying social disposition is not selfishness. Rather, our underlying ontology is radically interdependent and impermanent and our fundamental nature is altruistic. This paper offers a Buddhist theory of politics and international relations based on this alternative set of assumptions.
Alfabetização científica e tecnológica e a educação em saúde: um estudo sobre a produção científica no cenário brasileiro
Authors: Mistura Claudelí , Félix de Sousa Francisco Jucivânio , Dalla Costa Sibeli Balestrin , Conceição Oliveira Eniz , Silvana Neumann Martins Silvana , Claudio Del Pino José
Published: August 2023

A Alfabetização Científica e Tecnológica (ACT) é uma abordagem de ensino que prepara o estudante para entender princípios básicos de fenômenos do cotidiano de vida. Também prepara o aluno para a capacidade de tomada de decisão em relação à aspectos da adolescência à fase adulta. Trata de questões que se referem à ciência e à tecnologia, tanto em decisões pessoais quanto decisões coletivas e/ou públicas. Nesses termos, o presente estudo tem como objetivo conhecer a produção científica nacional sobre a ACT e sua contribuição para educação em saúde. Para isso, realizou-se um estudo de Revisão Narrativa da Literatura por meio de artigos científicos disponibilizados em periódicos nacionais na Base de Dados Literatura Latino-Americana e do Caribe em Ciências da Saúde e na Biblioteca Virtual de Saúde - Brasil. A busca inicial contemplou 45 publicações relacionadas à ACT e à educação em saúde. Após a aplicação dos critérios de inclusão e exclusão, a amostra foi composta por cinco artigos remanescentes. Com o desenvolvimento deste estudo, foi possível evidenciar a relevância da ACT para a educação em saúde e, consequentemente, para a qualidade de vida dos cidadãos. Assim, ela torna-se imprescindível no ambiente escolar, uma vez que muitos comportamentos e tomada de decisões na fase da adolescência e na fase da vida adulta são reflexos do percurso de vida em que a criança está inserida, tanto no ambiente escolar quanto familiar.
Estratégias de ensino e de aprendizagem para jovens e adultos com deficiência intelectual no Brasil: uma revisão sistemática
Authors: Gueiber Ezequiel , Dos Santos Junior Guataçara , Pedro Lopes Rui , Nasser Matos Simone
Published: August 2023

Este artigo apresenta uma revisão sistemática sobre os trabalhos de teses e dissertações, realizados no Brasil, destinados a jovens e adultos com deficiência intelectual, a fim de fornecer um panorama das pesquisas que abordam as estratégias de ensino e de aprendizagem que contribuem para a formação destes alunos. A busca usou como repositório o Catálogo de Teses e Dissertações da Capes e a Biblioteca Digital Brasileira de Teses e Dissertações, no período de busca de 2010 a 2022. Foram analisados 14 estudos em sua íntegra. Os resultados obtidos evidenciaram que a 78% desses estudos destinaram-se a estratégias aplicadas à aprendizagem em disciplinas, como, Matemática e Língua Portuguesa e, 22% relacionados ao uso ou criação de tecnologias digitais em sua formação. Dessa forma, recomenda-se que novas pesquisas sejam desenvolvidas para favorecer o ensino e a aprendizagem desse público, no que tange aos recursos tecnológicos digitais e a outras áreas do conhecimento.
Tendências da educação inclusiva no ensino de ciências a partir da análise de publicações científicas brasileiras
Authors: De Jesus Beltrão Rafael , Gomes Miranda Ana Carolina
Published: August 2023

Esse trabalho investiga quais são as tendências encontradas nas publicações em periódicos brasileiros que se relacionam com a abordagem ao tema educação inclusiva. Sendo uma pesquisa bibliográfica de cunho predominantemente qualitativo com a finalidade de realizar um  levantamento das perspectivas apresentadas pelos pesquisadores quanto ao tema. Os dados obtidos através dessa pesquisa possibilitaram a análise das principais características da educação inclusiva no ensino de Ciências com a fim de classificar essas características juntamente aos principais resultados obtidos pelas pesquisas relacionadas ao tema educação inclusiva, por meio de uma metodologia fundamentada em quatro estágios, sendo eles: 1) Seleção dos periódicos nacionais para estudo; 2) Coleta dos dados por meio dos artigos que abordam o tema; 3) Triagem a partir da leitura integral dos artigos; 4) Análise dos artigos. Os resultados apresentados foram obtidos através da análise dos artigos a partir da definição dos seguintes critérios: Caracterização; Aspectos Metodológicos; Base Teórica e Resultados. Ao fim desse levantamento foi observado o direcionamento da atenção das pesquisas relacionadas à educação inclusiva no ensino de Ciências para a formação docente, a fim de promover discussão quanto às principais dificuldades na implementação da educação inclusiva e com relação às intervenções em sala de aula, como formas de abordagens direcionadas a contemplar o ensino inclusivo na escola regular, bem como expectativas, desafios e contribuições das pesquisas que abordam esse tema.
Representações do pedagogo no espaço não escolar: relatos de uma experiência na Vara da Infância e Juventude da Comarca de União da Vitória-PR
Authors: Elizete Jankoski Nogatz  , Valeria Aparecida Schena
Published: August 2023

O presente artigo focaliza o trabalho pedagógico em ambientes não escolares, destacando a amplitude do campo de atuação do pedagogo no espaço jurídico. Deste modo, objetiva-se analisar a atuação do pedagogo da Vara da Infância da Juventude da Comarca de União da Vitória-PR. A metodologia adotada foi de abordagem qualitativa, a partir de um estudo exploratório e descritivo, assim como a realização de uma entrevista semiestruturada com duas pedagogas. Os resultados obtidos revelam a importância que o pedagogo assume diante do trabalho no espaço não escolar, em especial na vara da infância e da juventude, em que são tratados assuntos da seara familiar e escolar. Conclui-se que o espaço jurídico oportuniza ao pedagogo o contato com diversos casos e demandas que tratam da vida das crianças e jovens, bem como interferir diretamente no desempenho escolar.
Validation and adaptation of the Russian version colostomy impact score (CIS)
Authors: Khomyakov Evgeniy A. , Pikunov Dmitry Yu. , Mamedli Z. Z. , Karachun A. M. , Kostenko N. V. , Zhilin I. V. , Ignatov I. S. , Medvednikov A. A. , Moskalev A. I. , Khakamov T. Sh. , Skopintsev V. B. , Lukmonov S. N. , Samsonov D. V. , Razuvailova А. G. , Lee Yulia B. , Radostev S. I. , Ayupov R. T. , Malgina N. V. , Achkasov S. I. , Rybakov E. G.
Published: August 2023

BACKGROUND: The number of people with intestinal stomas in Russia reaches 140 thousand people according to the registry of stoma patients. For any outcomes stoma on the anterior abdominal wall has an extremely negative effect on the body image and quality of life of this patient.

AIM: Validation and cultural adaptation of the CIS questionnaire in the Russian Federation.

MATERIALS AND METHODS: The official translation of the CIS questionnaire was performed according to current WHO and EORTC guidelines. The study involved 209 patients from 9 centers (3 national and 6 regional) from different districts of Russia.

RESULTS: The stoma impact on quality-of-life questionnaire showed an inverse negative relationship with the EORTC QLQ-C30 global quality of life scale, physical, role, emotional and social functioning (all p<0,05).

CONCLUSION: The CIS Questionnaire reliably identifies a group of patients with a significant impairment in the quality of life and can be used in Russia.
Open or closed sphincterotomy for treatment of the chronic anal fissure? (systematic review and meta-analysis)
Authors: Goloktionov Nikolay A. , Ponomarenko Aleksey A. , Sagidova K. I. , Lebedeva Ekaterina Yu. , Mudrov A. A. , Zharkov Evgeny E.
Published: August 2023

INTRODUCTION: up to the present time, both open and closed lateral internal sphincterotomy (LIS) are considered by surgeons as fully comparable methods for eliminating the spasm of the internal sphincter in patients with chronic anal fissure. However, each method has a number of advantages and disadvantages. AIM: determination of an effective and safe method of lateral subcutaneous sphincterotomy.

MATERIALS AND METHODS: a systematic overview and meta-analysis of studies, which compare the results of treatment after an open and closed lateral sphincterotomy was performed. The following has been evaluated: the incidence of fissure epithelialization, the postoperative morbidity, the recurrence rate, the incidence of anal incontinence (AI). Statistical processing has been carried out in the Review Manager 5.3 program.

RESULTS: the meta-analysis included 9 studies with the results of treatment of 452 patients after an open lateral sphincterotomy and 443 after a closed one. The groups were comparable in frequency of epithelialization of fissures (OR = 0.87; CI = 0.30; 2.53; p = 0.8), in terms of the number of postoperative complications (OR = 0.52; CI = 0.15; 1.76; p = 0.29), as well as the number of relapses of the disease (OR = 0.5; CI = 0.19; 1.31; p = 0.16). At the same time, the implementation of an open lateral sphincterotomy leads to the development of AI 2.05 times more often than the closed method (OR = 2.05; CI = 1.01; 4.16; p = 0.05).

CONCLUSION: during the treatment of the chronic anal fissure, in order to eliminate the spasm of the internal sphincter, it is advisable to use a closed method, in which the chance of AI is 2.05 times lower.
Comparison of transanal endomicrosurgery and total mesorectumectomy in treatment of early rectal cancer (a systematic literature review and meta-analysis)
Authors: Chernyshov Stanislav V. , Nagudov Marat A. , Shelygin Yuri A. , Maynovskaya Olga A. , Kirgizov Philip I. , Chupina Polina I. , Rybakov Evegeny G.
Published: August 2023

Transanal endomicrosurgery (TEM) presently is the only method for local excision of early rectal cancer with sufficient visualization, possibility for full-wall excision to achieve adequately deep margin of resection for disease staging. Despite the obvious advantage in immediate outcomes of transanal endomicrosurgery over mesorectumectomy, nowadays only in a small number of studies the oncological outcomes were compared. In this regard were performed a systematic review of literature and meta-analysis.

AIM OF THE STUDY: to compare the immediate (frequency of complications, duration of operation and intraoperative blood loss) and long-term (frequency of distant metastases and local recurrences) results of TEM and mesorectumectomy in early rectal cancer.

MATERIALS AND METHODS: literature search was performed according to PRISMA guidelines. Statistical processing of data was performed with use of Review Manager 5.3. Program.

RESULTS: in 4 studies (1 randomized, 2 retrospective, 1 prospective), that were included in meta-analysis the results of treatment of 422 patients were described (240-TEM, 182-mesorectumectomy). The odds-ratio of incidence of postoperative complications after mesorectumectomy was higher for almost 5 times than after TEM (OR 0,21; 95% CI: 0,06 0,74; p = 0,02), as well as the frequency of reoperations in case for complications (OR 0,16; 95% CI: 0,06 0,59; p = 0,02). As well as the overall recurrence rate in TEM group (OR 2,37; 95% CI:1,04 5,39 p = 0,04), the rate of local recurrence (OR 4,61; 95% CI: 1,08 19,6; p = 0,04) was statistically higher than in total mesorectumectomy. At the same time there were no statistically significant difference in incidence of distant metastases (OR 01,0; 95% CI: 0,35 2,84; p = 1,0).

CONCLUSION: transanal endomicrosurgery is the method of choice and is safer than mesorectumectomy. However, oncological outcomes depend on many factors which presence must be taken into account when planning for surgical treatment of early rectal cancer.
Comparative analysis of the effectiveness of the treatment of transsphincter anal fistulas by various methods
Authors: Denisenko E. V. , Denisenko V. L. , Gain Yu. M. , Tsyplakov K. G. , Korobov G. D.
Published: August 2023

AIM: to assess the effectiveness late results of laser technologies in the treatment of anal fistulas compared with traditional methods (excision of the fistula followed by ligature, excision of the fistula followed by restoration of the sphincter).

PATIENTS AND METHODS: a single-center retrospective study included 150 patients. Patients underwent 3 variants of surgical intervention. In the first group (50 patients), the fistula was treated with laser technology. In the 2nd group (50 patients), the fistula was excised followed by seton, in the 3rd group (50 patients), the fistula was excised followed by sphincteroplasty. Quality of life (according to the SF-36 school), as well as differences in the proportion of relapses on the 180th day after the surgery was carried out.

RESULTS: it was revealed that higher indicators of the components of physical health (PH) (F = 11260.72 p < 0.001), as well as mental health (MN) (F = 10459.6 p < 0.001) were detected in the group of patients treated with laser technology. The calculation of significant differences in the observation groups showed that with the number of observations more than the specified one, it is possible to state a decrease in the number of relapses with the laser treatment method by 2.2 times compared with traditional methods.

CONCLUSION: laser technology for anal fistulas is a progressive method that provides a significant reduce of recurrence rate, as well as improving the quality of life of patients in late postoperative period.
COMMENT Eduard V. Denisenko, Valery L. Denisenko, Yury M. Gain, Konstantin G. Tsyplakov, Gennady D. Korobov Comparative analysis of the effectiveness of the treatment of transsphincter anal fistulas by various methods
Authors: Editorial Article
Published: August 2023

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Aerodynamic mitigation of low-rise building with complex roof geometry
Authors: Al-Chalabi Raghdah , Elshaer Ahmed
Published: August 2023

During strong wind events, building roofs are subjected to high wind uplift forces (suctions), which often lead to severe roofing component damage, or even roof total failure, flying debris, and water intrusion, hence, interior damages. Typical roof shapes (e.g., gable and hip) are generally designed using provision codes and standards to accurately estimate peak load impacting the roofs during wind events for design purposes. Complex roof geometry can be efficiently examined using wind tunnel testing and computational modeling to provide quantitative assessment for wind to narrow down the design alternatives and to examine the improvement gained from mitigation techniques. In this study, an isolated low-rise building with a complex roof shape is examined using large eddy simulation (LES) to numerically assess wind load prediction by validating it with wind tunnel results. This study presents two roof modification scenarios using parapets added to roof corners and ridgelines to displace the flow from the separation locations to reduce the wind impact on the roof. The current study aims to 1) evaluate wind load on an isolated low-rise building with complex roof geometry for various angles of attack and 2) mitigate the roof aerodynamically using parapets, added corners, and ridgeline to reduce the wind impact on the roof. The validation shows that both the mean and RMS of the pressure coefficients are in good agreement with the wind tunnel results. The research results suggest that parapets with 500 mm height located at the corner and edges of complex roof geometry can effectively reduce extreme corner suction by 29% and roof uplift by 5.6%.
Diagnostic and prognostic value of autophagy-related key genes in sepsis and potential correlation with immune cell signatures
Authors: Yang Li , Zhou Lin , Li Fangyi , Chen Xiaotong , Li Ting , Zou Zijun , Zhi Yaowei , He Zhijie
Published: August 2023

Background: Autophagy is involved in the pathophysiological process of sepsis. This study was designed to identify autophagy-related key genes in sepsis, analyze their correlation with immune cell signatures, and search for new diagnostic and prognostic biomarkers.

Methods: Whole blood RNA datasets GSE65682, GSE134347, and GSE134358 were downloaded and processed. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were used to identify autophagy-related key genes in sepsis. Then, key genes were analyzed by functional enrichment, protein-protein interaction (PPI), transcription factor (TF)-gene and competing endogenous RNA (ceRNA) network analysis. Subsequently, key genes with diagnostic efficiency and prognostic value were identified by receiver operating characteristic (ROC) curves and survival analysis respectively. The signatures of immune cells were estimated using CIBERSORT algorithm. The correlation between significantly different immune cell signatures and key genes was assessed by correlation analysis. Finally, key genes with both diagnostic and prognostic value were verified by RT-qPCR.

Results: 14 autophagy-related key genes were identified and their TF-gene and ceRNA regulatory networks were constructed. Among the key genes, 11 genes (ATIC, BCL2, EEF2, EIF2AK3, HSPA8, IKBKB, NLRC4, PARP1, PRKCQ, SH3GLB1, and WIPI1) had diagnostic efficiency (AUC > 0.90) and 5 genes (CAPN2, IKBKB, PRKCQ, SH3GLB1 and WIPI1) were associated with survival prognosis (p-value < 0.05). IKBKB, PRKCQ, SH3GLB1 and WIPI1 had both diagnostic and prognostic value, and their expression were verified by RT-qPCR. Analysis of immune cell signatures showed that the abundance of neutrophil, monocyte, M0 macrophage, gamma delta T cell, activated mast cell and M1 macrophage subtypes increased in the sepsis group, while the abundance of resting NK cell, resting memory CD4+ T cell, CD8+ T cell, naive B cell and resting dendritic cell subtypes decreased. Most of the key genes correlated with the predicted frequencies of CD8+ T cells, resting memory CD4+ T cells, M1 macrophages and naive B cells.

Conclusion: We identified autophagy-related key genes with diagnostic and prognostic value in sepsis and discovered associations between key genes and immune cell signatures. This work may provide new directions for the discovery of promising biomarkers for sepsis.
Preferential FGF18/FGFR activity in pseudoglandular versus canalicular stage human lung fibroblasts
Authors: Belgacemi Randa , Cherry Caroline , El Alam Imad , Frauenpreis Andrew , Glass Ian , Bellusci Saverio , Danopoulos Soula , Al Alam Denise
Published: August 2023

Fibroblast growth factor (FGF) signaling is necessary for proper lung branching morphogenesis, alveolarization, and vascular development. Dysregulation of FGF activity has been implicated in various lung diseases. Recently, we showed that FGF18 promotes human lung branching morphogenesis by regulating mesenchymal progenitor cells. However, the underlying mechanisms remain unclear. Thus, we aimed to determine the role of FGF18 and its receptors (FGFR) in regulating mesenchymal cell proliferation, migration, and differentiation from pseudoglandular to canalicular stage. We performed siRNA assays to identify the specific FGFR(s) associated with FGF18-induced biological processes. We found that FGF18 increased proliferation and migration in human fetal lung fibroblasts (HFLF) from both stages. FGFR2/FGFR4 played a significant role in pseudoglandular stage. HFLF proliferation, while FGFR3/FGFR4 were involved in canalicular stage. FGF18 enhanced HFLF migration through FGFR2 and FGFR4 in pseudoglandular and canalicular stage, respectively. Finally, we provide evidence that FGF18 treatment leads to reduced expression of myofibroblast markers (ACTA2 and COL1A1) and increased expression of lipofibroblast markers (ADRP and PPARγ) in both stages HFLF. However, the specific FGF18/FGFR complex involved in this process varies depending on the stage. Our findings suggest that in context of human lung development, FGF18 tends to associate with distinct FGFRs to initiate specific biological processes on mesenchymal cells.
Knowledge, perceptions, and behavioral responses to earthquake early warning in Aotearoa New Zealand
Authors: Vinnell Lauren Jennifer , Tan Marion Lara , Prasanna Raj , Becker Julia Susan
Published: August 2023

Introduction

Aotearoa New Zealand (NZ) experiences frequent earthquakes, with a history of damaging and fatal events, but currently does not have a national, official earthquake early warning (EEW) system. Since April of 2021, Google's Android Earthquake Alert System has operated independently in NZ. While recent work has identified general public support for such a system, it is important to assess public knowledge of EEW as well as typical responses to receiving an alert. The protective actions “Drop, cover, and hold” are recommended and taught in NZ and previous research found strong intentions to undertake these and other protective actions in response to an alert.

Method

However, it is important to explore a range of responses to these novel EEWs, including how much people know about them, what actions they took in response to the warning, and their overall judgment of the system including its usefulness. We undertook surveys following two widely received alerts from the Android Earthquake Alert System to assess public knowledge, perceptions, and responses to these alerts with a total sample size of 3,150.

Results

While most participants who received the alert found it useful, knowledge of both EEW generally and the Android System specifically was low and few participants used the time to protect themselves from shaking.

Discussion

These findings reiterate the importance of education and communication around a warning system, so that the public know how to act when they receive an alert.
Towards a competency-based doctoral curriculum at the University of Zambia: lessons from practice
Authors: Mumba Chisoni , Sichone James Maimbo , Munsaka Sody , Kwenda Geoffrey , Munyeme Musso , Simuunza Martin , Hang’ombe Bernard M. , Phiri Andrew M. , Mutale Wilbroad , Martin Marie H. , Heimburger Douglas C. , Nalubamba King S. , Nchito Wilma , Katowa-Mukwato Patricia , Hondalus Mary , Skjerve Eystein , Muma John Bwalya
Published: August 2023

We describe a collaborative, iterative, and participatory process that we undertook to develop and adopt a competency-based doctoral curriculum framework at the University of Zambia. There needs to be more than the traditional unstructured apprenticeship of PhD training in a knowledge-based economy where PhD graduates are expected to contribute to industry problem-solving. The lack of industry-driven competencies and, to some extent, limited skills possessed by PhD graduates relative to the demands of employers has led to the misclassification of doctoral degrees as mere paper certificates. Further, under traditional PhD training without specific core competencies, it has led to criticisms of such PhD studies as a waste of resources. The calls to rethink doctoral development in broader employment contexts led many countries to redesign their PhD programs. Training has increasingly introduced industrial linkages and industry-defined research projects to increase the attractiveness of doctoral students. Whereas developed countries have made significant reforms towards competency-based PhD training, little or nothing has been done in developing countries, especially in sub-Saharan Africa. This against the demands that Africa needs more than 100,000 PhDs in the next decade to spur economic development. Against this background, the University of Zambia has developed an industry-driven structured competency-based PhD curriculum framework. The framework will guide and support the development of standardized program-specific PhD curricula, delivery, and assessment of competencies at the University of Zambia, ensuring that doctoral students acquire skills and demonstrate core competencies that are transferable and applicable in industry settings. This framework focuses on the development of specific competencies that are necessary for successful PhD completion. The competencies are divided into three main categories: research, teaching, and professional development. Each category is then broken down into ten core competencies from which respective doctoral programs will develop sub-competencies. It is from these core competencies and sub-competencies that learning outcomes, assessment methods, and teaching activities are developed. It is envisioned that this new competency-based doctoral curriculum framework will be a helpful tool in training a cadre of professionals and researchers who benefit the industry and contribute to economic and societal development.
Key features of puberty onset and progression can help distinguish self-limited delayed puberty from congenital hypogonadotrophic hypogonadism
Authors: Aung Yuri , Kokotsis Vasilis , Yin Kyla Ng , Banerjee Kausik , Butler Gary , Dattani Mehul T. , Dimitri Paul , Dunkel Leo , Hughes Claire , McGuigan Michael , Korbonits Márta , Paltoglou George , Sakka Sophia , Shah Pratik , Storr Helen L. , Willemsen Ruben H. , Howard Sasha R.
Published: August 2023

Introduction

Delayed puberty (DP) is a frequent concern for adolescents. The most common underlying aetiology is self-limited DP (SLDP). However, this can be difficult to differentiate from the more severe condition congenital hypogonadotrophic hypogonadism (HH), especially on first presentation of an adolescent patient with DP. This study sought to elucidate phenotypic differences between the two diagnoses, in order to optimise patient management and pubertal development.

Methods

This was a study of a UK DP cohort managed 2015-2023, identified through the NIHR clinical research network. Patients were followed longitudinally until adulthood, with a definite diagnosis made: SLDP if they had spontaneously completed puberty by age 18 years; HH if they had not commenced (complete, cHH), or had commenced but not completed puberty (partial, pHH), by this stage. Phenotypic data pertaining to auxology, Tanner staging, biochemistry, bone age and hormonal treatment at presentation and during puberty were retrospectively analysed.

Results

78 patients were included. 52 (66.7%) patients had SLDP and 26 (33.3%) patients had HH, comprising 17 (65.4%) pHH and 9 (34.6%) cHH patients. Probands were predominantly male (90.4%). Male SLDP patients presented with significantly lower height and weight standard deviation scores than HH patients (height p=0.004, weight p=0.021). 15.4% of SLDP compared to 38.5% of HH patients had classical associated features of HH (micropenis, cryptorchidism, anosmia, etc. p=0.023). 73.1% of patients with SLDP and 43.3% with HH had a family history of DP (p=0.007). Mean first recorded luteinizing hormone (LH) and inhibin B were lower in male patients with HH, particularly in cHH patients, but not discriminatory. There were no significant differences identified in blood concentrations of FSH, testosterone or AMH at presentation, or in bone age delay.

Discussion

Key clinical markers of auxology, associated signs including micropenis, and serum inhibin B may help distinguish between SLDP and HH in patients presenting with pubertal delay, and can be incorporated into clinical assessment to improve diagnostic accuracy for adolescents. However, the distinction between HH, particularly partial HH, and SLDP remains problematic. Further research into an integrated framework or scoring system would be useful in aiding clinician decision-making and optimization of treatment.
Comparative safety of different sodium-glucose transporter 2 inhibitors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized controlled trials
Authors: Li Chun Xing , Liu Li Yan , Zhang Chen Xiao , Geng Xu Hua , Gu Si Meng , Wang Yu Qiao , Liu Hua , Xie Qing , Liang Shuo
Published: August 2023

Backgrounds

The safety of different sodium-glucose transporter 2 (SGLT-2) inhibitors remains uncertain due to the lack of head-to-head comparisons.

Methods

This network meta-analysis (NMA) was performed to compare the safety of nine SGLT-2 inhibitors in patients with type 2 diabetes (T2DM). PubMed, Embase, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched for studies published in English before August 30, 2022. Published and unpublished randomized controlled trials (RCTs) comparing the safety of individual SGLT-2 inhibitors in patients with T2DM were included. A Bayesian NMA with random effects model was applied. Subgroup and sensitivity analyses were performed. The quality of the evidence was evaluated using the Confidence in Network Meta-Analysis framework.

Results

Nine SGLT-2 inhibitors were evaluated in 113 RCTs (12 registries) involving 105,293 adult patients. Reproductive tract infections (RTIs) were reported in 1,967 (4.51%) and 276 (1.01%) patients in the SGLT-2 inhibitor and placebo groups, respectively. Furthermore, pollakiuria was reported in 233 (2.66%) and 45 (0.84%) patients, respectively. Compared to placebo, a significantly higher risk of RTIs was observed with canagliflozin, ertugliflozin, empagliflozin, remogliflozin, dapagliflozin, and sotagliflozin, but not with luseogliflozin and ipragliflozin, regardless of gender. An increased risk of pollakiuria was observed with dapagliflozin [odds ratio (OR) 10.40, 95% confidence interval (CI) 1.60-157.94) and empagliflozin (OR 5.81, 95%CI 1.79-32.97). Remogliflozin (OR 6.45, 95%CI 2.18-27.79) and dapagliflozin (OR 1.33, 95%CI 1.10-1.62) were associated with an increased risk of urinary tract infections (UTIs). Instead, the included SGLT-2 inhibitors had a protective effect against acute kidney injury (AKI). No significant differences were found for hypovolemia, renal impairment or failure, fracture, diabetic ketoacidosis (DKA), amputation, and severe hypoglycemia between the SGLT-2 inhibitor and the placebo groups.

Conclusion

In patients with T2DM, dapagliflozin was associated with an increased risk of RTIs, pollakiuria, and UTIs. Empagliflozin increased the risk of RTIs and pollakiuria. Remogliflozin increased the risk of UTIs. None of the SGLT-2 inhibitors showed a significant difference from the placebo for hypovolemia, renal impairment or failure, fracture, DKA, amputation, and severe hypoglycemia. The findings guide the selection of SGLT-2 inhibitors for patients with T2DM based on the patient’s profiles to maximize safety.

Systematic review registration

https://www.crd.york.ac.uk/prospero, identifier CRD42022334644.
The impact of industrial structure upgrading and digital economy integration on China’s urban carbon emissions
Authors: Jiang Hong , Chen Zhenhuan , Liang Yaowen , Zhao Wencheng , Liu Di , Chen Zhenyu
Published: August 2023

This paper is based on the research hypothesis that the development of the digital economy can enable urban carbon emission reduction. We use the panel data of 275 prefecture-level cities in China from 2011 to 2019, the static panel-data interaction-effect model, and the panel-threshold model to verify the non-linear impact mechanism and heterogeneity of the digital economy in industrial structure upgrading affecting urban carbon emissions. The results demonstrate the following insights. First, due to the heterogeneity of industries, an increase in the proportion of the tertiary industry cannot reduce urban carbon emissions. Second, the digital economy has an inverted U-shaped adjustment effect on the process of industrial structure upgrading, affecting urban carbon emissions. Consequently, the integration and development of the tertiary industry and the digital economy can achieve urban carbon emission reductions. Finally, the digital economy has a double threshold effect on the process of industrial structure upgrading, affecting urban carbon emissions. The carbon-emission-reduction effect of industrial structure upgrading only appears after the scale of the digital economy crosses the first threshold. As the scale of the digital economy continues to increase, the carbon-emission-reduction effect of industrial structures is likely to continue increasing significantly. We recommend that local governments achieve urban carbon reduction by encouraging the development of high-end service industries and strengthening digital infrastructure.
Incorporating electrical impedance tomography to transpulmonary pressure-guided PEEP in severe ARDS with pneumothorax and multiple cavitations: a case report
Authors: Wang Qianling , Su Longxiang , Jiang Jing , Wang Na , He Huaiwu , Long Yun
Published: August 2023

Pneumothorax is a potentially fatal complication in patients with acute respiratory distress syndrome (ARDS), presenting challenges in determining the optimal positive end-expiratory pressure (PEEP) level to prevent atelectasis without exacerbating the pneumothorax. This case report describes the successful application of transpulmonary pressure and electrical impedance tomography (EIT) at the bedside to guide PEEP selection in a patient with ARDS complicated by pneumothorax due to methicillin-resistant Staphylococcus aureus infection. By using minimal PEEP to maintain positive end-expiratory transpulmonary pressure and visualizing lung reopening with EIT, the optimal PEEP level was reaffirmed, even if traditionally considered high. The patient’s condition improved, and successful weaning from the ventilator was achieved, leading to a transfer out of the intensive care unit.

Clinical trial registration: https://clinicaltrials.gov/show/NCT04081142, identifier NCT04081142.
Characteristics of brain activation in high-level football players at different stages of decision-making tasks off the ball: an fMRI study
Authors: Huang Ming-Hao , Lang Jian , Li Ju , Qin Zhe , Cao Ya-Ping
Published: August 2023

Objective

This study aimed to examine the neural mechanisms underlying the decision-making process of off-ball movements among high-level football players and ordinary college students, as well as the effect of long-term skill training on these neural mechanisms using functional magnetic resonance imaging (fMRI).

Methods

The study recruited 20 professional college football players as the expert group (EG) and 20 novice football players with no background in sports-related disciplines as the novice group (NG). The participants performed the motor video observation and button-decision-making tasks, and fMRI data were acquired, pre-processed, and analyzed.

Results

During the decision-making process regarding running without the ball, whole-brain fMRI scans were conducted on both the EG and NG. The analysis of these scans revealed noteworthy disparities in brain activity between the two groups. These disparities were observed during tasks involving motor video observation and button-based decision-making. According to the behavioral data, the EG made more correct decisions than the NG (p < 0.05); however, there was no significant difference in their reaction speed (p > 0.05). During video observation, both the EG and NG exhibited simultaneous activation in the frontoparietal cognitive area, primary somatosensory cortex, visual cortex, and insula. However, there were no significant differences between the two groups in terms of activated brain regions [false discovery rate (FDR) corrected to p < 0.05]. Regarding button-press decisions, the areas of the brain that were commonly activated in both the NG and EG were primarily located in the frontoparietal cognitive area, temporal cortex, and cuneus cortex. Notably, the left superior temporal gyrus, left inferior temporal gyrus, and left middle occipital gyrus exhibited greater activation in the NG compared to those in the EG (FDR corrected to p < 0.05).

Conclusion

This study demonstrated that during motor video observation, the EG’s sports experience and professional knowledge can help them achieve better visual information processing strategies in specific areas of sports. During button decision-making, the EG was more economical, whereas the NG required more brain function activity to process visual information, confirming the “neural efficiency” hypothesis.
Temporal transformer-spatial graph convolutional network: an intelligent classification model for anti N-methyl-D-aspartate receptor encephalitis based on electroencephalogram signal
Authors: Dang Ruochen , Yu Tao , Hu Bingliang , Wang Yuqi , Pan Zhibin , Luo Rong , Wang Quan
Published: August 2023

Encephalitis is a disease typically caused by viral infections or autoimmunity. The most common type of autoimmune encephalitis is anti-N-methyl-D-aspartate receptor (NMDAR) antibody-mediated, known as anti-NMDA receptor encephalitis, which is a rare disease. Specific EEG patterns, including “extreme delta brush” (EDB), have been reported in patients with anti-NMDA receptor encephalitis. The aim of this study was to develop an intelligent diagnostic model for encephalitis based on EEG signals. A total of 131 Participants were selected based on reasonable inclusion criteria and divided into three groups: health control (35 participants), viral encephalitis (58 participants), and anti NMDAR receptor encephalitis (55 participants). Due to the low prevalence of anti-NMDAR receptor encephalitis, it took several years to collect participants’ EEG signals while they were in an awake state. EEG signals were collected and analyzed following the international 10–20 system layout. We proposed a model called Temporal Transformer-Spatial Graph Convolutional Network (TT-SGCN), which consists of a Preprocess Module, a Temporal Transformer Module (TTM), and a Spatial Graph Convolutional Module (SGCM). The raw EEG signal was preprocessed according to traditional procedures, including filtering, averaging, and Independent Component Analysis (ICA) method. The EEG signal was then segmented and transformed using short-time Fourier transform (STFT) to produce concatenated power density (CPD) maps, which served as inputs for the proposed model. TTM extracted the time-frequency features of each channel, and SGCM fused these features using graph convolutional methods based on the location of electrodes. The model was evaluated in two experiments: classification of the three groups and pairwise classification among the three groups. The model was trained using two stages and achieved the performance, with an accuracy of 82.23%, recall of 80.75%, precision of 82.51%, and F1 score of 81.23% in the classification of the three groups. The proposed model has the potential to become an intelligent auxiliary diagnostic tool for encephalitis.
Histochemical mapping of the duration of action of photobiomodulation on cytochrome c oxidase in the rat brain
Authors: Wade Zachary S. , Barrett Douglas W. , Davis Roger E. , Nguyen Adrian , Venkat Sindhu , Gonzalez-Lima F.
Published: August 2023

Introduction

This is the first study mapping the duration of action of in vivo photobiomodulation (PBM) on cytochrome-c-oxidase (CCO). In cellular bioenergetics, CCO is the terminal rate-limiting enzyme in the mitochondrial electron transport chain, which catalyzes oxygen utilization for aerobic energy production. PBM using transcranial infrared laser stimulation (TILS) is a promising intervention for non-invasively modulating CCO in the brain. TILS of the human prefrontal cortex directly causes CCO photo-oxidation, which is associated with increased cerebral oxygenation and improved cognition.

Methods

This experiment aimed to map the duration of action of in vivo PBM on CCO activity in discrete neuroanatomic locations within rat brains up to 4 weeks after a single TILS session (50 s, 1064 nm CW, 250 mW/cm2). Control brains from rats treated with a sham session without TILS (laser off) were compared to brains from TILS-treated rats that were collected 1 day, 2 weeks, or 4 weeks post-TILS. Cryostat sections of the 36 collected brains were processed using quantitative enzyme histochemistry and digitally imaged. Densitometric readings of 28 regions of interest were recorded and converted to CCO activity units of oxygen utilization using calibration standards. Data analysis (ANCOVA) compared each laser-treated group to sham with whole-brain average as a covariate.

Results

The prefrontal infralimbic cortex showed the earliest significant increase in CCO activity between 1-day post-TILS and sham groups, which continued elevated for 2–4 weeks post-TILS. Significant differences in CCO activity between 2-weeks and sham groups were also found in the lateral septum, accumbens core, CA3 of the hippocampus, and the molecular layer of the hippocampus. The medial amygdala showed a significant decrease in CCO activity between 4-weeks and sham. Further analyses showed significant inter-regional CCO activity correlations among the brain regions as the result of TILS, with the most pronounced changes at 4-weeks post-stimulation.

Discussion

The time course of changes in CCO activity and network connectivity suggested that TILS caused different neuroplasticity types of bioenergetic changes at different time scales, depending on brain region and its depth from the cortex. In conclusion, this controlled CCO histochemical study demonstrated a long-lasting duration of action of PBM in the rat brain.