bluuebunny/crossref_metadata_2025_split huggingface dataset:
Two undesirable complications of a blowhole colostomy in left-sided colonic obstruction
Authors: van de Laar Bart Cornelis Theodorus , de Jong Gabrielle Mirjam 
Published: November 2022

Two patients with an acute left-sided colonic obstruction had a successful decompression after construction of a blowhole transverse colostomy as a bridge to surgery. However, they presented with two rather unknown stoma-related complications during this bridging period. Patient A had a stomal prolapse with additional skin problems.Patient B complained of abdominal discomfort during follow-up. The blowhole colostomy appeared to be stenotic. Stoma dilation and irrigation was initiated to prevent complete closure.Definite resection of the left-sided obstruction and reversal of both blowhole colostomies was successful, and the patients recovered without further complications.We hypothesise that incision size may be related to prolapse and stenosis rates and that eversion of the mucosa of the blowhole may reduce the risk of stomal stenosis.
Prevalence and determinants of insomnia among patients living with asthma in Northwest Ethiopian University specialised hospitals: Multicentre cross-sectional study
Authors: Belachew Eyayaw Ashete , Sendekie Ashenafi Kibret , Ayele Emneteab Mesfin , Netere Adeladlew Kassie 
Published: November 2022

ObjectiveThe study was aimed to determine the prevalence and contributing factors of insomnia among patients with bronchial asthma.DesignA multicentre cross-sectional survey was used.SettingThis study was carried out from January to March 2022 in three university comprehensive specialised hospitals in Northwest Ethiopia.Participants422 patients with bronchial asthma were approached of which 93.8% completed the survey.OutcomesThe degree of asthma control and the severity of insomnia were evaluated using the Asthma Control Test and Insomnia Severity Index (ISI), respectively. The characteristics of the participants were presented, arranged and summarised using descriptive statistical analysis, and correlations between predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05.ResultsParticipants’ ages ranged from 33.6 to 65.2 years on average. Just under three-fourths (71.4%) of the participants had at least one episode of insomnia as per the ISI measurement (score ≥10). The odds of insomnia episodes were about 5.4 and 1.93 times higher in patients with uncontrolled asthma and partially controlled asthma status, with adjusted OR (AOR)=5.4 (95% CI 4.4 to 6.79, p<0.001) and AOR=1.93 (95% CI 1.21 to 4.11, p<0.001), respectively.ConclusionInsomnia episodes were substantially higher in bronchial patients with asthma. Insomnia is accompanied by asthma severity, and uncontrolled asthma and partially controlled asthma status are the two most determining factors for experiencing sleep disturbance. Furthermore, a prospective follow-up study must determine the real association found between insomnia and asthma control.
Why might medical student empathy change throughout medical school? Protocol for a systematic review and thematic synthesis of qualitative studies
Authors: Howick Jeremy , Ahmed Ahmed , Dudko Maya , Feng Shi Nan , Nockels Keith , Alluri Namitha , Winter Rachel , Holland Richard 
Published: November 2022

IntroductionSeveral studies suggest that medical student empathy declines throughout medical school. However, no studies have systematically investigated why. The objective of our proposed review is to conduct a systematic review and thematic synthesis of qualitative studies investigating the reasons empathy may change throughout medical school.Methods and analysisThis systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We have searched MEDLINE, Scopus, CINAHL, ERIC and APA PsycINFO for relevant studies. We will also search reference lists of included studies and contact experts to identify additional studies. We will include any qualitative study investigating the reasons why empathy changes throughout medical school. We will use the Joanna Briggs Institute tool to evaluate the risk of bias in the included studies. We will use thematic analysis to synthesise our results. For all included studies, we will summarise the main characteristics including the number of participants, medical school year, country and gender. In our discussion, we will summarise the limitations of the evidence (including the risk of bias and inconsistency), and provide a general interpretation of the results and important implications.Ethics and disseminationThis study will not require ethical approval since no original data will be collected. The results of this review will be published through peer-reviewed publications and conference presentations. Additionally, this review will inform changes to the enhanced empathy curriculum at the Leicester Medical School.
The FCC-ee vacuum system, from conceptual to prototyping
Authors: Kersevan Roberto 
Published: November 2022

AbstractThe FCC-ee is a very challenging accelerator project from the point of view of vacuum. Apart from the sheer size of the machine, a twin-ring of 100 km circumference, the vacuum system design must be capable of dealing with the low-energy 45.6 GeV, high-current version of the machine (the Z-pole) as well as the higher energy, lower current versions. The main difficulty is related to the very much different synchrotron radiation (SR) spectra of the Z-pole vs the other energies, in particular the ttbar at 182.5 GeV. The critical energy of the SR spectrum of the Z-pole is 19.5 keV, while the ttbar exceeds 1.2 MeV. It is particularly challenging in terms of shielding the beryllium chamber in the detectors, for the Machine Detector Interface (MDI) area. We discuss the evolution of the vacuum system design for the arc sections, and some new ideas on NEG-coating, SR absorbers, and pumping system, with the aim to build prototypes soon, in the framework of the FCC Innovation Study program. The design of the vacuum hardware depends on the choices made for the magnets, and the required shielding from high-energy radiation generated by the circulating beam interacting with the residual gas and the interaction of the intense SR fans with the photon. There is also an important collaboration with the engineering integration of the vacuum system in the tunnel, particularly considering the full-energy booster injector, which is not detailed here. We also briefly describe the raytracing montecarlo modelling efforts carried out in the MDI area, and its pumping configuration.
Different Interventions for COVID-19 Primary and Booster Vaccination? Effects of Psychological Factors and Health Policies on Vaccine Uptake
Authors: Sprengholz Philipp , Henkel Luca , Böhm Robert , Betsch Cornelia 
Published: November 2022

Background Mitigation of the COVID-19 pandemic requires continued uptake of SARS-CoV-2 vaccines. To increase vaccination intention and uptake, key determinants of primary and booster vaccination need to be understood and potential effects of vaccination policies examined. Design Using experimental data collected in Germany in February 2022 ( N = 2,701), this study investigated 1) predictors of primary and booster vaccination and 2) potential effects of policies combining vaccination mandates and monetary incentives. Results Compared with unvaccinated participants, those with primary vaccination were less complacent, more often understood the collective protection afforded by vaccination, and less often endorsed conspiracy-based misinformation. Compared with participants with primary vaccination, boosted individuals were even less complacent, exhibited fewer conspiracy-based beliefs, perceived fewer constraints by prioritizing vaccination over other things, and more often favored compliance with official vaccination recommendations. Support for and reactance about vaccination mandates depended on vaccination status rather than policy characteristics, regardless of mandate type or incentives (up to 500 EUR). While unvaccinated individuals rejected policy provisions and declined vaccination, boosted individuals indicated mid-level support for mandates and showed high vaccination intention. Among vaccinated individuals, higher incentives of up to 2,000 EUR had a considerable positive effect on the willingness to get boosted, especially in the absence of a mandate. Conclusions While mandates may be needed to increase primary vaccination, our results indicate that financial incentives could be an alternative to promote booster uptake. However, combining both measures for the same target group seems inadvisable in most cases. Highlights Unvaccinated individuals and people with primary and booster vaccinations differ on psychological dimensions, calling for tailored immunization campaigns. Vaccination intentions depend on vaccination status rather than on mandatory or incentivizing policies. Incentives are unlikely to persuade unvaccinated individuals but may increase booster uptake. Positive effects of incentives decrease when vaccination is mandatory, advising against combination.
Hemoadsorption as part of a multimodal therapy concept to treat Capnocytophaga sepsis with thrombocytopenia and multiple organ failure
Authors: Kreutz Julian , Choukeir Maryana , Chatzis Georgios , Schieffer Bernhard , Markus Birgit 
Published: November 2022

Background: Capnocytophaga, a bacteria native to the oral flora of canines, in rare cases can lead to severe infections resulting in septic shock, respiratory tract infection, and multiple organ failure. In case of trauma following animal bites with rapidly progressing clinical courses, also adjunctive therapeutic measures such as extracorporeal blood purification therapies might be beneficial. Case presentation: We report on a 68-year-old male who was hospitalized with fever, oliguria and repeated vomiting after suffering a minor bite by his dog. On admission, he was diagnosed with sepsis. In addition, his coagulation status was markedly deranged resulting in the administration of mass transfusions to stabilize his coagulative status. Following detection of Capnocytophaga canimorsus, anti-infective therapy was initiated. In the context of a progressive respiratory deterioration and an increasing vigilance disorder, he had to be intubated. Due to development of renal failure, dialysis was started in conjunction with CytoSorb hemoadsorption therapy to control the hyperinflammatory condition. All of the applied therapeutic measures led to a rapid clinical stabilization, a control of the hyperinflammatory situation, and an improvement in his neurological status. The therapy was well tolerated with no complications encountered. Conclusions: This case supports the clinical recognition of severe Capnocytophaga infection that can lead to critical conditions even in immunocompetent patients. Combined broad spectrum antibiotic therapy, mass transfusions, CRRT, and CytoSorb hemoadsorption therapy resulted in a control of the critical situation. However, further research is needed to fully elucidate the role of hemoadsorption in this rare but life-threatening setting.
Intravesical Botulinum toxin-A injection in pediatric overactive neurogenic bladder with Detrusor overactivity: Radiologic and clinical outcomes
Authors: Sharifiaghdas Farzaneh , Narouie Behzad , Rostaminejad Niloofar , Hamidi Madani Mohammad , Manteghi Mohammadjavad , Rouientan Hamidreza , Ahmadzade Mohadese , Dadpour Mehdi 
Published: November 2022

Objective: The neurogenic bladder is one of the most serious and painful disorders seen in pediatric urology clinics. The upper urinary tract can be impaired by increased bladder pressure. Botulinum toxin-A (BTX-A) is one of the new therapeutic interventions for this disease. Thus, this research was designed to determine the clinical as well as radiological outcomes intravesical BTX-A injections in patients with overactive neurogenic bladder with Detrusor over activity. Patients and methods: From March 2012 to March 2019, this cohort study was conducted at Shahid Labbafinejad hospital in Tehran, Iran. Thirty-five pediatric patients with a neurogenic bladder and Detrusor overactivity who fulfilled the eligibility criteria received BTX-A injections. Demographic data, including spinal cord lesions or congenital malformations, upper and lower urinary tract nuclear scans, evidence of vesicoureteral reflux (VUR) and its severity, and hydronephrosis and 72 h voiding diary before and after intervention were all recorded. Results: The mean ± standard deviation age of participants was 9.47 ± 4.61 years. After injection, nocturia and urination frequency as general symptoms of the overactive neurogenic bladder improved ( p < 0.05). Also, the severity of hydronephrosis was decreased in 33% of patients following injection. In our study, 32 out of 35 patients had vesicoureteral reflux. Of those, there was complete resolution and downgrading of VUR in 17 (53.12%) and 13 (40.62%) respectively. Conclusion: In the evaluation of voiding cystourethrography (VCUG) before and after the injection, downgrading of VUR was seen in 53% of the cases. In the 99mTc-DMSA nuclear scan before and after the injection, the appearance of a new parenchymal scar and uptake reduction was not observed, which indicates the cessation of scar formation in all patients. Although Enuresis, Urgency, Frequency, Nocturia, and UUI significantly improved after injection.
Numerical analysis of aerodynamic characteristics of multi-pod hyperloop system
Authors: Mirza Muhammad Omer , Ali Zaib 
Published: November 2022

The Hyperloop system is a new and innovative mode of transportation in which high-speed pods move through near-vacuum tubes. The multi-pod Hyperloop Systems are essential for increased transportation capacity. In this study, a multi-pod Hyperloop System was analyzed using numerical simulations at different values of the distance between the pods (i.e., 2 L–3.5 L). The pressure and velocity flow fields and the aerodynamic characteristics of the pods were analyzed for four different flow speeds, that is, 100, 200, 300, and 400 m/s, using unsteady compressible flow conditions. The simulation results indicated that the pressure waves generated across the pods play a significant role in the determination of the aerodynamic characteristics of the pods. Increasing the distance between the pods results in the delay of the pressure wave interaction. The aerodynamic drag increases on the first pod with the increase in the distance between the pods due to an increase in the pressure gradient. In contrast, the aerodynamic drag decreases across the second pod with the increase in the distance between them. So, the distance between the pods is a critical factor that should be considered when designing the Hyperloop System with more than one pod.
The Experiences and Needs of Hospice Care Nurses Facing Burnout: A Scoping Review
Authors: Yu Jiaxiang , Soh Kim Lam , He Liping , Wang Pengpeng , Soh Kim Geok , Cao Yingjuan 
Published: November 2022

Aim Explore the existing literature on the experience and needs of palliative nurses facing job burnout. Background On a global scale, with the increase of aging, the number of people in need of palliative care has increased significantly, which has a huge impact on the professional pressure of palliative nurses. Existing literature focuses on examining palliative care from the perspective of patients, but palliative nurses also face the threats to physical and mental health caused by job burnout. Evaluation A systematic literature search has been carried out in the following databases as of October 2021:PubMed, EMBASE, CINAHL, Web of Science, and Scopus. The Cochrane Library and Joanna Briggs Institute Library were also searched to confirm if there are any available systematic reviews on the subject. Manually searched the reference list of included papers. Key issues Seventeen studies were included in this review. Five key issues in the palliative care nurse’s experience: (1) psychological harm, (2) physical symptoms, (3) negative emotions, (4) Burnout caused by communication barriers, and (5) Lack of experience. Two key issues in the needs of palliative care nurses: (1) social support, and (2) training and education. Conclusion The pressure of facing death for a long time and controlling the symptoms of patients has a very important impact on the mental and physical health of palliative nurses. Nursing staff have needed to be satisfied, and it is essential to provide support and help relieve the pressure on palliative nurses.
Fostering Leader Feedback Seeking at the Workplace: The Role of HRD Practice
Authors: Carvalho Sheldon , Kurian Prasad Oommen , Carvalho Charles , Carvalho Fallan Kirby 
Published: November 2022

The Problem. Scholars in the feedback-seeking domain have predominantly focused on employee feedback seeking. However, there is less known about feedback seeking when the leader is the seeker of feedback. This is unfortunate because in dynamic and uncertain environments, as presented by the COVID-19 crisis, leaders will need to seek feedback from others to develop a holistic view of the emerging situation and respond in a timely manner. The Solution. The authors make a case for leader feedback seeking by identifying its four potential benefits for leaders themselves and organizations. Subsequently, they discuss four human resource development practices that can promote leader feedback-seeking behavior within organizations. The Stakeholders. This article will benefit organizations that seek to encourage their leadership talent to seek feedback at work.
Physical and flammability properties of treated sugar palm fibre reinforced polylactic acid composites
Authors: Sherwani Shah Faisal Khan , Salit Mohd Sapuan Bin , Zainudin Edi Syams bin , Leman Zulkiflle , Khalina Abdan 
Published: November 2022

The aim of this study is to determine the physical properties and flammability of a composite of polylactic acid (PLA) reinforced with chemically treated sugar palm fibre (SPF). Seven different SPF parameters have been evaluated: untreated, alkaline treatment with three alkaline solution concentrations of 4, 5 and 6% and 50 mL of benzoyl chloride treated SPFs at three different soaking times (10, 15 and 20 min). 30 wt.% of SPF reinforced with 70 wt.% PLA composites have been prepared by using a Brabender plastograph mixer and compression moulding. The 6% alkaline treated SPF/PLA composites resulted in the lowest water absorption and thickness swelling of 7.09% and 4.69%, respectively. These composites reached the lowest ‘maximum equilibrium sorption’ value [Formula: see text] of 5.94%. Benzoyl chloride treated SPF/PLA composites (for 15 min soaking) exhibited the highest density of 1.34 g/cm3 and void content had reduced from 14% to 0.7%. The flammability of the c omposites is characterised by the horizontal UL-94 and vertical UL-94V burning test. Through the flammability test, the outcomes reveal that treated SPF/PLA composites are highly fire-resistant, except for 6% alkaline treated SPF/PLA composites. Morphologies of the composites have been analysed using the scanning electron microscopy. The results revealed that the maximum surface roughness and fewer voids were accomplished after 6% alkaline treatment of SPF. The novel treated SPF/PLA composites are appropriate for the application of automobile components.
San-Zhong-Kui-Jian-Tang Exerts Antitumor Effects Associated With Decreased Cell Proliferation and Metastasis by Targeting ERK and the Epithelial–Mesenchymal Transition Pathway in Oral Cavity Squamous Cell Carcinoma
Authors: Hsu Pei-Yu , Chen Jiun-Liang , Kuo Shun-Li , Wang Wan-Ling , Jan Fei-Wen , Yang Sien-Hung , Yang Chia-Yu 
Published: November 2022

Background: Oral squamous cell carcinoma (OSCC) is an aggressive cancer whose 5-year survival rate remains poor. San-Zhong-Kui-Jian-Tang (SZKJT), a Chinese herbal formula, has long been used in clinical practice as adjuvant therapy in cancers. However, its therapeutic effects and molecular mechanisms in OSCC remain unclear. Methods: We investigated the potential therapeutic effects and molecular mechanism of SZKJT in OSCC in tumor cell lines and in tumor xenograft mice and evaluated combined SZKJT and cisplatin treatment efficacy. In vitro-cultured OSCC cells were administered SZKJT at different doses or SZKJT plus cisplatin, and cell proliferation, colony formation assays, and cell cycle analysis were used to assess the effects on cancer cell proliferation and apoptosis. We also analyzed the effects of SZKJT on oral cancer cell line migration, the regulation of mitogen-activated protein kinase (MAPK) signaling, and epithelial-mesenchymal transition (EMT)-associated genes. The antitumor effects of SZKJT plus cisplatin were also tested in vivo using a tumor-bearing NOD/SCID mice model. Results: The results showed that SZKJT effectively inhibited OSCC cell proliferation, induced cell cycle S phase arrest, and induced cell apoptosis. SZKJT also inhibited cell migration by modulating the MAPK signaling and epithelial-mesenchymal transition (EMT) pathway. Further exploration suggested that SZKJT affects OSCC by modulating ERK pathway; downregulating vimentin, fibronectin, and Oct-4; and upregulating E-cadherin. In vivo, SZKJT significantly inhibited tumor growth, and SZKJT and cisplatin exerted synergistic antitumor effects in model animals. Conclusions: SZKJT exerts antitumor effects in OSCC cells. Additionally, SZKJT and cisplatin exhibit synergy in OSCC treatment. These findings support the clinical usage of Chinese herbal formulas as adjuvant therapy with chemotherapy in cancer treatment.
A randomised pilot feasibility study of eye movement desensitisation and reprocessing recent traumatic episode protocol, to improve psychological recovery following intensive care admission for COVID-19
Authors: Bates Andrew , Golding Hannah , Rushbrook Sophie , Shapiro Elan , Pattison Natalie , Baldwin David S , Grocott Michael P W , Cusack Rebecca 
Published: November 2022

Background: Approximately 50% of intensive care survivors experience persistent psychological symptoms. Eye-movement desensitisation and reprocessing (EMDR) is a widely recommended trauma-focussed psychological therapy, which has not been investigated systematically in a cohort of intensive care survivors: We therefore conducted a randomised pilot feasibility study of EMDR, using the Recent Traumatic Episode Protocol (R-TEP), to prevent psychological distress in intensive care survivors. Findings will determine whether it would be possible to conduct a fully-powered clinical effectiveness trial and inform trial design. Method: We aimed to recruit 26 patients who had been admitted to intensive care for over 24 h with COVID-19 infection. Consenting participants were randomised (1:1) to receive either usual care plus remotely delivered EMDR R-TEP or usual care alone (controls). The primary outcome was feasibility. We also report factors related to safety and symptom changes in post-traumatic stress disorder, (PTSD) anxiety and depression. Results: We approached 51 eligible patients, with 26 (51%) providing consent. Intervention adherence (sessions offered/sessions completed) was 83%, and 23/26 participants completed all study procedures. There were no attributable adverse events. Between baseline and 6-month follow-up, mean change in PTSD score was −8 (SD = 10.5) in the intervention group versus +0.75 (SD = 15.2) in controls ( p = 0.126). There were no significant changes to anxiety or depression. Conclusion: Remotely delivered EMDR R-TEP met pre-determined feasibility and safety objectives. Whilst we achieved group separation in PTSD symptom change, we have identified a number of protocol refinements that would improve the design of a fully powered, multi-centre randomised controlled trial, consistent with currently recommended rehabilitation clinical pathways. Trial registration: ClinicalTrials.gov: NCT04455360.