bluuebunny/crossref_metadata_2025_split huggingface dataset:
The perceived impact of physician shortages on human resource strategies in German hospitals – a resource dependency perspective
Authors: Schnack Helge , Uthoff Sarah Anna Katharina , Ansmann Lena 
Published: September 2022

PurposeLike other European countries, Germany is facing regional physician shortages, which have several consequences on patient care. This study analyzes how hospitals perceive physician shortages and which strategies they adopt to address them. As a theoretical framework, the resource dependency theory is chosen.Design/methodology/approachThe authors conducted 20 semi-structured expert interviews with human resource officers, human resource directors, and executive directors from hospitals in the northwest of Germany. Hospitals of different ownership types, of varying sizes and from rural and urban locations were included in the sample. The interviews were analyzed by using qualitative content analysis.FindingsThe interviewees reported that human resource departments in hospitals expand their recruiting activities and no longer rely on one single recruiting instrument. In addition, they try to adapt their retaining measures to physicians' needs and offer a broad range of employment benefits (e.g. childcare) to increase attractiveness. The study also reveals that interviewees from small and rural hospitals report more difficulties with attracting new staff and therefore focus on recruiting physicians from abroad.Practical implicationsSince the staffing situation in German hospitals will not change in the short term, the study provides suggestions for hospital managers and health policy decision-makers in dealing with physician shortages.Originality/valueThis study uses the resource dependency theory to explain hospitals' strategies for dealing with healthcare staff shortages for the first time.
Analyzing the law qualitatively
Authors: Mitchell Matthew 
Published: September 2022

PurposeThis article develops a methodological framework to support qualitative analyses of legal texts. Scholars across the social sciences and humanities use qualitative methods to study legal phenomena but often overlook formal legal texts as productive sites for analysis. Moreover, when qualitative researchers do analyze legal texts, they rarely discuss the methodological underpinnings that support their approach. A thorough consideration of the methodological underpinnings of qualitative approaches to legal analysis is therefore warranted.Design/methodology/approachBy bringing critical legal theory into conversation with qualitative methodology, this article outlines a set of key principles to inform qualitative approaches to reading the law.FindingsTo construct this methodological framework, this article first distinguishes between qualitative approaches to textual analysis and the doctrinal approaches undertaken in legal practice and formal legal scholarship. It then considers how this qualitative approach might be applied to one particular genre of legal text: namely, judicial opinions, otherwise known as reasons for judgment. In doing so, it argues that robust qualitative analyses of legal texts must consider the unique characteristics of those texts, such as their distinct form, voice, rhetorical structure, and performative capabilities.Originality/valueThe methodological framework outlined here should encourage qualitative researchers to approach legal texts more readily and challenge the hegemony of doctrinal approaches to legal interpretation in social science research.
Triggering a patient-driven service innovation to foster the service ecosystem well-being: a case study
Authors: Megaro Antonietta , Carrubbo Luca , Polese Francesco , Sirianni Carlo Alessandro 
Published: September 2022

PurposeThe aim of this paper is to understand if service innovation (Helkkula et al., 2018), based on artificial intelligence (AI) systems, may guarantee healthcare service ecosystem (H-SES) well-being (Frow et al., 2019; Beirão et al., 2017), taking into account that many doubts relieved in terms of transparency may compromise the patients' perceived quality of health services provided through AI systems.Design/methodology/approachA literature review on service innovation, detected in terms of value co-creation, and service ecosystem, investigated in terms of well-being, is drawn. To analyze the implications of service innovation on a H-SES well-being, through the technology acceptance degree and predisposition to use by actors, a case study based on TAM-model 3 determinants as categories is carried out.FindingsAI-based service innovation archetypes in healthcare may be considered as antecedents of the service ecosystem well-being conditions as long as they enable actors to co-create value. To make it possible, a patient-driven service innovation is necessary in order to mitigate the risks of its inactivity due to fears in terms of transparency.Originality/valueService innovation and service ecosystem well-being may be studied in an integrated way, with a multidisciplinary approach, and are linked by value co-creation, because only thanks a patient-driven service innovation is possible to foster service ecosystem well-being in healthcare.
Volatile fingerprints of different parts of Chongming saffron (Crocus sativus) flowers by headspace‐gas chromatography‐ion mobility spectrometry and in vitro bioactive properties of the saffron tepals
Authors: Yao Lingyun , Guo Shuangfei , Wang Huatian , Feng Tao , Sun Min , Song Shiqing , Hou Feina 
Published: September 2022

AbstractIn this work, the volatile fingerprints of different parts of Chongming saffron flowers (stigmas, stamens, and tepals) were analyzed and compared for the first time by headspace‐gas chromatography‐ion mobility spectrometry. Three different parts of saffron flowers could be clearly distinguished using principal component analysis based on signal intensity data of gas chromatography‐ion mobility spectrometry. Therefore, gas chromatography‐ion mobility spectrometry coupled with principal component analysis method could be employed as a new method for authentication and quality control of saffron for the reason of frequent addition with stamens and/or tepals as adulterants in saffron. Moreover, the bioactive composition (total flavonoids, total phenolics, and total anthocyanins) and bioactive properties of saffron tepals were evaluated. The results indicated that aqueous, ethanol, and ethyl acetate extracts of saffron tepals exhibited good radical scavenging (2,2‐Diphenyl‐1‐picrylhydrazyl, ABTS, and OH) and enzyme (α‐amylase/α‐glucosidase) inhibition activities, which probably were attributed to the bioactive components contained in the extracts. This approach would provide the important information for monitoring the quality of saffron as well as exploring the utilization of saffron tepals in functional food technology.Practical ApplicationThis study demonstrated that the HS‐GC‐IMS method might be used as a new strategy for quality control of saffron, and the saffron tepals were rich source of bioactive components that could be used in health‐promoting products.
Biocontrol: Endophytic bacteria could be crucial to fight soft rot disease in the rare medicinal herb, Anoectochilus roxburghii
Authors: Xing Bingcong , Zheng Ying , Zhang Man , Liu Xinting , Li Lihong , Mou Chenhao , Wu Qichao , Guo Haipeng , Shao Qingsong 
Published: September 2022

AbstractMicrobial destabilization induced by pathogen infection has severely affected plant quality and output, such as Anoectochilus roxburghii, an economically important herb. Soft rot is the main disease that occurs during A. roxburghii culturing. However, the key members of pathogens and their interplay with non‐detrimental microorganisms in diseased plants remain largely unsolved. Here, by utilizing a molecular ecological network approach, the interactions within bacterial communities in endophytic compartments and the surrounding soils during soft rot infection were investigated. Significant differences in bacterial diversity and community composition between healthy and diseased plants were observed, indicating that the endophytic communities were strongly influenced by pathogen invasion. Endophytic stem communities of the diseased plants were primarily derived from roots and the root endophytes were largely derived from rhizosphere soils, which depicts a possible pathogen migration image from soils to roots and finally the stems. Furthermore, interactions among microbial members indicated that pathogen invasion might be aided by positively correlated native microbial members, such as Enterobacter and Microbacterium, who may assist in colonization and multiplication through a mutualistic relationship in roots during the pathogen infection process. Our findings will help open new avenues for developing more accurate strategies for biological control of A. roxburghii bacterial soft rot disease.
Salinomycin biosynthesis reversely regulates the β‐oxidation pathway in Streptomyces albus by carrying a 3‐hydroxyacyl‐CoA dehydrogenase gene in its biosynthetic gene cluster
Authors: Wei Jiaxiu , Chen Binbin , Dong Jianxin , Wang Xueyu , Li Yongquan , Liu Yingchun , Guan Wenjun 
Published: September 2022

AbstractStreptomyces is well known for synthesis of many biologically active secondary metabolites, such as polyketides and non‐ribosomal peptides. Understanding the coupling mechanisms of primary and secondary metabolism can help develop strategies to improve secondary metabolite production in Streptomyces. In this work, Streptomyces albus ZD11, an oil‐preferring industrial Streptomyces strain, was proved to have a remarkable capability to generate abundant acyl‐CoA precursors for salinomycin biosynthesis with the aid of its enhanced β‐oxidation pathway. It was found that the salinomycin biosynthetic gene cluster contains a predicted 3‐hydroxyacyl‐CoA dehydrogenase (FadB3), which is the third enzyme of β‐oxidation cycle. Deletion of fadB3 significantly reduced the production of salinomycin. A variety of experimental evidences showed that FadB3 was mainly involved in the β‐oxidation pathway rather than ethylmalonyl‐CoA biosynthesis and played a very important role in regulating the rate of β‐oxidation in S. albus ZD11. Our findings elucidate an interesting coupling mechanism by which a PKS biosynthetic gene cluster could regulate the β‐oxidation pathway by carrying β‐oxidation genes, enabling Streptomyces to efficiently synthesize target polyketides and economically utilize environmental nutrients.
Myeloid cell‐specific mutation of Spi1 selectively reduces M2‐biased macrophage numbers in skeletal muscle, reduces age‐related muscle fibrosis and prevents sarcopenia
Authors: Wang Ying , Welc Steven S. , Wehling‐Henricks Michelle , Kong Ying , Thomas Connor , Montecino‐Rodriguez Enca , Dorshkind Kenneth , Tidball James G. 
Published: September 2022

AbstractIntramuscular macrophages play key regulatory roles in determining the response of skeletal muscle to injury and disease. Recent investigations showed that the numbers and phenotype of intramuscular macrophages change during aging, suggesting that those changes could influence the aging process. We tested that hypothesis by generating a mouse model that harbors a myeloid cell‐specific mutation of Spi1, which is a transcription factor that is essential for myeloid cell development. The mutation reduced the numbers of macrophages biased to the CD163+/CD206+ M2 phenotype in muscles of aging mice without affecting the numbers of CD68‐expressing macrophages and reduced the expression of transcripts associated with the M2‐biased phenotype. The mutation did not affect the colony‐forming ability or the frequency of specific subpopulations of bone marrow hematopoietic cells and did not affect myeloid/lymphoid cell ratios in peripheral blood leukocyte populations. Cellularity of most myeloid lineage cells was not influenced by the mutation. The Spi1 mutation in bone marrow‐derived macrophages in vitro also did not affect expression of transcripts that indicate the M2‐biased phenotype. Thus, myeloid cell‐targeted mutation of Spi1 influences macrophage phenotype in muscle but did not affect earlier stages of differentiation of cells in the macrophage lineage. The mutation reduced age‐related muscle fibrosis, which is consistent with the reduction of M2‐biased macrophages, and reduced expression of the pro‐fibrotic enzyme arginase. Most importantly, the mutation prevented sarcopenia. Together, our observations indicate that intramuscular, M2‐biased macrophages play significant roles in promoting detrimental, age‐related changes in muscle.
A qualitative analysis of adding kindness into the ISBAR handover tool
Authors: de Senneville Lizzie Liew , Brewin Andrew , Thomas Alarna , Calvert Katrina 
Published: September 2022

BackgroundThe COVID pandemic has highlighted the stresses experienced by our medical workforce, with worldwide publications attesting to high rates of depression, anxiety and burnout, particularly in junior doctors. Many studies focus on reporting on the prevalence of mental health issues, but not many report on interventional strategies. One of the most stressful interactions in the day of a junior doctor is the medical handover. The incorporation of kindness into clinical handover has coined the term ‘KISBAR’ to underline the importance of delivering handover in a kind manner.AimThe aim is to analyse the efficacy of a novel intervention by introducing an emotional support representative to participate in the morning labour ward handover.MethodsWe undertook an ethnographic constructivist qualitative research project in a tertiary hospital in Perth, Western Australia, using focus groups to explore the views of junior medical staff on the KISBAR handover tool in the specific context of labour ward handover. Fifty per cent of the total junior doctors from the hospital participated in this study.ResultsFour dominant themes arose from analysis of the focus group discussions: (i) inherent stress experienced by junior doctors during the labour ward handover process, (ii) support strategies for junior doctors during labour ward handover; (iii) role modelling and the hidden curriculum aspects of communication from senior doctors at labour ward handover; and (iv) benefit of having an emotional support person present for labour ward handover.ConclusionOur study confirmed the benefit of having an emotional support person present at labour ward handover: improved perception of safety and an environment that junior doctors found to be supportive. This is a novel and reproducible interventional strategy which is applicable to various obstetric units around Australia.
Ferroptosis is involved in corpus cavernosum smooth muscle cells impairment in diabetes mellitus‐induced erectile dysfunction
Authors: Xu Wenchao , Sun Taotao , Wang Jiaxin , Wang Tao , Wang Shaogang , Liu Jihong , Liu Kang , Li Hao 
Published: September 2022

AbstractBackgroundsErectile dysfunction (ED) is a common andrological disorder that tends to afflict diabetic patients, among others. Pharmacological therapy of diabetes mellitus‐induced ED (DMED) is ineffective, as it is linked with smooth muscle cell loss in the corpus cavernosum. Ferroptosis is a recently identified kind of cell death evoked by lipid peroxidation, and it is connected with a number of diabetic complications.ObjectivesTo investigate the role of ferroptosis in DMED.Materials and methodsWe established the rat model of DMED and conducted a combined analysis of RNA sequencing (RNA‐seq) and Gene Expression Omnibus (GEO) data to identify differentially expressed genes (DEGs). Next, DMED disease targets were determined by cross‐referencing DEGs and DMED‐related genes in the DisGeNET, GenCLiP3, and GeneCards databases. Additionally, these targets were analyzed using “clusterProfiler” in R utilizing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations. Immunohistochemistry (IHC) staining of rat penile tissues was used to validate several targets. Notably, the Cell Counting Kit‐8 assay, Western blotting, oxidative stress (OS) level, and iron concentration were tested in corpus cavernosum smooth muscle cells (CCSMCs) stimulated with high glucose (HG), and treated with Ferrostatin‐1 (Fer‐1).ResultsSixty‐nine disease targets of DMED were identified. According to KEGG analysis, these targets were primarily enriched in the ferroptosis pathway. Additionally, IHC results revealed that the expression of GPX4, SLC7A11, and ACSL4 was deregulated in the DMED group compared to the control group. Significantly, HG decreased cell viability and increased OS and iron levels in CCSMCs, which could be reversed by Fer‐1 treatment.Discussion and conclusionOur study revealed that ferroptosis may indeed exist in DMED. GPX4, SLC7A11, and ACSL4 all have a role in controlling the viability of CCSMCs, making them potential therapeutic targets.
In it together?: Exploring solidarity with frontline workers in the United Kingdom and Ireland during COVID‐19
Authors: Kinsella Elaine L. , Muldoon Orla T. , Lemon Sarah , Stonebridge Natasha , Hughes Samantha , Sumner Rachel C. 
Published: September 2022

AbstractThe phrase ‘in it together’ has been used liberally since the outbreak of COVID‐19, but the extent that frontline workers felt ‘in it together’ is not well understood. Here, we consider the factors that built (or eroded) solidarity while working through the pandemic, and how frontline workers navigated their lives through periods of disconnection. Semi‐structured interviews with 21 frontline workers, across all sectors, were conducted in the United Kingdom and Ireland. The qualitative data were analysed systematically using reflexive thematic analysis. The three themes identified in the data were: (1) Solidarity as central to frontline experiences; (2) Leadership as absent, shallow and divisive: highlighting ‘us‐them’ distinctions and (3) The rise of ‘us’ and ‘we’ among colleagues. Our research offers insights into how frontline workers make sense of their experiences of solidarity and discordance during the first year of the COVID‐19 pandemic, with relevance for government and organizational policy‐makers shaping future conditions for frontline workers.
Provenance of Oligocene lithic and quartz arenites of the East Carpathians: Understanding sediment routing systems on compressional basin margins
Authors: Roban Relu D. , Ducea Mihai N. , Mihalcea Vlad I. , Munteanu Ioan , Barbu Victor , Melinte‐Dobrinescu Mihaela C. , Olariu Cornel , Vlăsceanu Mihai 
Published: September 2022

AbstractWe present new sedimentological, petrographical, palaeontological and detrital zircon U–Pb data on late Oligocene–early Miocene sedimentary rocks of the thin‐skinned thrust belt of East Carpathians. These data were acquired to reconstruct the sedimentary routing system for two compositionally different turbidite fans made of the regionally extensive Kliwa and Fusaru formations. On the eastern margin of the Moldavides foreland basin, large low‐gradient river systems draining the East European Platform provided well‐sorted quartz‐rich sand forming deltas on wide shallow shelves and thick Kliwa submarine fans. Due to the westward subduction of a thinned continental plate, the western basin margin was characterized by short, steep‐gradient routing systems where sediment transport to deep water was mainly through hyperpycnal flows. The Getic and Bucovinian nappes of the East Carpathians and the exhumed Cretaceous–Early Palaeogene orogenic wedge fed Fusaru fans with poorly sorted lithic sand. The Fusaru fans trend northwards in the foredeep basin having an elongate depocentre, interfingering and then overlapping on the distal part of the Kliwa depositional system due to the eastward advance of the Carpathian fold‐and‐thrust belt. A smaller sediment input is supplied by southern continental areas (i.e. Moesian Platform, North Dobrogea and potentially the Balkans). In general, the sandstone interfingering between distinct basin floor fan systems is less well documented because the facies would be similar and there are not many systems that have a distinct sediment provenance like Kliwa and Fusaru systems. This case study improves the understanding of regional palaeogeography and sedimentary routing systems and provides observations relevant here or elsewhere on the interfingering turbidite fan systems.
Revision of endoscopic sinus surgery in adults: A population‐based study in Taiwan
Authors: Kang Kun‐Tai , Lee Chia‐Hsuan , Hsu Wei‐Chung , Ko Jenq‐Yuh , Yeh Te‐Huei 
Published: September 2022

AbstractObjectiveThis study aimed to elucidate the revision rate, time to revision, and factors associated with revision of endoscopic sinus surgery (ESS) in Taiwan.DesignRetrospective study.SettingPopulation‐based analysis.ParticipantWe identified all in‐hospital patients, aged >20 years, who underwent ESS between 2000 and 2008 from the Taiwan National Health Insurance Research Database, and followed up with them until 2018.Main outcome measuresFactors associated with revision surgery were analyzed using multivariable Cox proportional hazard model.ResultsOverall, 66 592 patients were identified (mean age, 46.3 years; 62% males). The revision rate was 14.5% (9644/66 592) and time to revision surgery was 5.9 years. Multivariable Cox proportional hazard model showed that young age, male gender (hazard ratio [HR] = 1.18; 95% confidence interval [CI], 1.13–1.23), having nasal polyposis (HR = 1.17; 95% CI, 1.12–1.22), having allergic rhinitis (HR = 1.08; 95% CI, 1.04–1.13), having asthma (HR = 1.26; 95% CI, 1.14–1.39), and surgical time of >4 h (HR = 1.11; 95% CI, 1.06–1.16) were associated with increased risk of revision surgery. Concurrent septal surgery (HR = 0.81; 95% CI, 0.76–0.87), turbinate surgery (HR = 0.91; 95% CI, 0.85–0.97), or septal and turbinate surgery (HR = 0.68; 95% CI, 0.64–0.73) were associated with decreased risks of revision surgery.ConclusionIn Taiwan, risk factors for revision ESS are young age, male gender, having nasal polyposis, having allergic rhinitis, having asthma, and long surgical times. Concurrent septal or turbinate surgery decreases the risk of revision.
Quality of life and patient reported symptoms after colorectal cancer in a Swedish population
Authors: Sjövall Annika , Lagergren Pernilla , Johar Asif , Buchli Christian 
Published: September 2022

AbstractAimA proportion of patients treated for colorectal cancer have impaired quality of life (QoL) but it is uncertain if the level of QoL differs from the corresponding background population. This population‐based cohort study aimed to evaluate health‐related QoL in colorectal cancer patients and compare their QoL with that of a Swedish reference population.MethodsPatients who underwent surgery for colorectal cancer Stages I–III in the Stockholm–Gotland region in 2013–2015 received the European Organization for Research and Treatment of Cancer (EORTC) QLQ‐C30 and the QLQ‐CR29 questionnaires and the low anterior resection syndrome score, 1 year after surgery. Patient and tumour data were collected from the Swedish Colorectal Cancer Registry. The patient cohort was matched to a Swedish reference population regarding EORTC QLQ‐C30. Global QoL was compared to the reference population and a patient group with impaired QoL was defined. Detailed patient‐reported outcomes were analysed in relation to global QoL in the patient cohort.ResultsA total of 925 patients returned the questionnaires and 358 patients (38.70%) reported a clinically relevant impaired global QoL compared to the reference population. Patients with impaired QoL reported clinically relevant and statistically significantly more complaints regarding bowel habits, pain and anxiety. After adjustment for sex, age and stoma, anxiety was the strongest predictor for impaired QoL, with OR 6.797 (95% CI 4.677–9.879).ConclusionA substantial proportion of patients treated for colorectal cancer have impaired global QoL. This impairment is strongly associated with several physical symptoms and anxiety.