bluuebunny/crossref_metadata_2025_split huggingface dataset:
Institutional ethnography of hemodialysis care: Perspectives of multidisciplinary health care teams in Nepal
Authors: Acharya Devaka Kumari , Nilmanat Kittikorn , Boonyasopun Umaporn 
Published: August 2023

Background: Hemodialysis is the most commonly used renal replacement therapy for end-stage renal disease. The collaborative efforts of multidisciplinary teams comprising nephrologists, nurses, pharmacists, and dietitians play a crucial role in enhancing patient outcomes, improving the quality of care, and reducing treatment costs. However, various factors such as healthcare cost reduction, limited resources, profit-driven systems, organizational structure, and involvement in patient care decisions impact the provision of hemodialysis care by the multidisciplinary teams.
Objective: This study aimed to explore the institutional practices of multidisciplinary teams within a hemodialysis unit.
Methods: This institutional ethnography study was conducted between April 2019 to February 2020 in a hemodialysis unit of a public university hospital in Kathmandu, Nepal. Data were collected through face-to-face interviews with ten nurses (including supervisors and incharge), two nephrologists, two dietitians, two pharmacists, and two technicians. Additionally, 167 hours of observation, two focus groups with nurses, analysis of institutional texts, and field notes were conducted. Participants were purposively selected based on their ability to provide diverse information regarding institutional practices in hemodialysis care. Interviews were recorded and transcribed.
Results: The analyzed data were presented in: 1) the context of hemodialysis care, 2) textual practices: the ruling relations of hemodialysis care (staffing, protocol, job description), 3) hemodialysis decision, and 4) institutional support.
Conclusion: Hemodialysis care provided by multidisciplinary teams is constrained by limited resources, particularly in terms of physical space, dialysis machines, nurses, doctors, and dietitians. The hospital's cost-cutting policies lead to reduced investment in patient care equipment, particularly dialysis machines, which significantly impact the workload of nurses and technicians. Insufficient nurse staffing necessitates the provision of other renal care responsibilities, resulting in increased workload, reduced time available for hemodialysis care, and unfinished tasks. The absence of clear job descriptions for hemodialysis care places an additional burden on nurses, who are often required to fulfill the responsibilities of other healthcare teams. Doctors hold the authority in making care decisions, which are subsequently followed by other team members.
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.
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.
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.
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 &gt; 0.90) and 5 genes (CAPN2, IKBKB, PRKCQ, SH3GLB1 and WIPI1) were associated with survival prognosis (p-value &lt; 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.
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

IntroductionAotearoa 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.MethodHowever, 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.ResultsWhile 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.DiscussionThese 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.
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

IntroductionDelayed 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.MethodsThis 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.Results78 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.DiscussionKey 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.