bluuebunny/crossref_metadata_2025 huggingface dataset:
3-Year Outcomes for Degenerative Mitral Regurgitation Repair in a Medicare Population
Authors: Thourani Vinod H. , James Edelman J. , Murphy Shannon M. E. , Vemulapalli Sreekanth , Moore Matt , Gammie James S. , Nguyen Tom C.
Published: May 2024

Objective:

Mitral valve repair (MVr) has become the standard therapy for degenerative mitral regurgitation (DMR), but real-world late mortality, reintervention, and readmission data are lacking. This study estimates MVr outcomes for DMR to 3 years in the Medicare fee-for-service population.

Methods:

There were 4,219 DMR patients older than 65 years undergoing MVr within the Medicare 100% standard analytic file from October 2015 to December 2018 who were evaluated. Outcomes were analyzed for isolated MVr patients ( n = 2,433) and patients undergoing MVr with certain concomitant procedures: MVr + tricuspid valve surgery (TVS; n = 619), MVr + cardiac ablation (CA; n = 540), and MVr + left atrial appendage closure ( n = 627). Outcomes over a 3-year period included all-cause mortality, reintervention, rehospitalization, and common complications. All outcomes were modeled with adjustments for patient demographics and comorbid conditions.

Results:

The average age for all patients was 71.9 ± 5.2 years. Adjusted all-cause mortality and MV reintervention (surgery or transcatheter) at 3 years for the primary cohort of isolated MVr was 3.5% and 1.6%, respectively. Directionally higher mortality at 3 years was observed in patients with concomitant TVS or CA. All-cause readmission and cardiac readmission for isolated MVr was 37.0% and 14.1%, with the highest rates for those with concomitant TVS or CA. Acute kidney injury and stroke/transient ischemic attack were the most common adverse events over 3 years for all patients.

Conclusions:

The 3-year mortality and reintervention rates in Medicare patients undergoing degenerative MVr are low. Those undergoing concomitant TVS or CA had directionally higher mortality and cardiac readmission rates. These results help refine outcome benchmarks as new transcatheter MVr procedures continue to emerge.
Biomarkers in inflammatory bowel disease: a practical guide
Authors: Clough Jennie , Colwill Michael , Poullis Andrew , Pollok Richard , Patel Kamal , Honap Sailish
Published: May 2024

Inflammatory bowel disease (IBD), comprising ulcerative colitis (UC) and Crohn’s disease (CD), is a costly condition in terms of morbidity and healthcare utilization, with an increasing prevalence now approaching 1% in the Western world. Endoscopic assessment of IBD remains the gold standard for diagnosis, evaluation of treatment response and determination of post-operative recurrence, but is expensive and invasive. Biomarkers can facilitate non-invasive disease assessment, with C-reactive protein and faecal calprotectin as the most widely available biomarkers in current clinical practice. This narrative review summarizes the evidence for their use in both UC and CD and offers practical guidance for healthcare providers taking into account the limitations of biomarker interpretation. We present evidence for the future use of novel biomarkers in IBD and discuss how biomarker discovery could deliver the goal of precision medicine in IBD.
Intra-Party Rules: Rebuilding the Chinese Communist Party’s Political Ecology
Authors: Mittelstaedt Jean Christopher
Published: May 2024

This article offers an in-depth analysis of intra-party rules development within the Chinese Communist Party (CCP) since the Eighteenth Party Congress in 2012. Through examining fifty-three major intra-party rules, leaders’ speeches, media articles, and 9,412 punishment verdicts, the study uncovers a three-stage process aimed at revitalising the CCP and constructing a “political ecology.” The analysis identifies three stages of intra-party rules development, characterised by nascent attempts to define political–moral and organisational norms, the tension between expansion and centralisation from 2016 onwards, and a period of deepening and advancement coupled with increasing arbitrariness in enforcement. This investigation enriches our comprehension of the intricate interplay between organisation, morality, and punishment within the CCP under Xi Jinping, shedding light on broader ramifications for China's societal structure, governance, and foreign policy approach.
Chemical Constituents From the Leaves of Grewia bulot Gagn. and Their Cytotoxic Activity
Authors: Pham Ty Viet , Ho Duc Viet , Ngo Y Duy , Dang Nhan Thanh Thi , Le Thang Quoc , The Son Ninh , Le Anh Tuan , Nguyen Bao Chi
Published: May 2024

Objective: The ultimate objective of this study was to isolate bioactive compounds from Grewia bulot Gagn. leaves and evaluate their cytotoxicity against a panel of human cancer cell lines. Methods: Compounds were isolated by column chromatography, whereas their chemical structures were elucidated by NMR spectroscopic data, and literature comparison. The cytotoxic activity of the isolated compounds was assessed using SRB assay against 4 cancer cell lines, including MCF-7 (human breast carcinoma), Hep-G2 (human hepatocellular carcinoma), KB (human carcinoma in the mouth), and SK-LU-1 (human lung carcinoma). Results: From the n-hexane extract, 4 compounds were isolated and identified as taraxerol (1), 3-( E)-coumaroyltaraxerol (2), 3-( Z)-coumaroyltaraxerol (3), and lupeol (4). Additionally, 6 compounds were isolated from the ethyl acetate extract and identified as daucosterol (5), trans-tiliroside (6), inugalactolipid A (7), (3 S,5 R,6 S,7 E,9 R)-7-megastigmene-3,6,9-triol (8), biphenyl-3,3′,4,4′-tetrol (9), and smiglabrone B (10). Among these isolates, only compound 9 exhibited moderate cytotoxic activity against all tested cancer cell lines with the IC50 values ranging from 31.67 to 63.15 µM. Conclusion: All these compounds have been detected from G bulot for the first time, biphenyl-3,3′,4,4′-tetrol (9) emerged as a promising candidate for cancer drug development. This study contributes to the growing body of knowledge regarding natural compounds with anticancer properties.
Two Miniplates Versus Three Dimensional Plate in Management of Mandibular Condylar Fractures: A Systematic Review and Meta-Analysis
Authors: Kuna Santhosh Kumar , Jain Anuj , Kuna Vishala
Published: May 2024

Study Design

Systematic Review and Meta-analysis.

Objective

This systematic review and meta-analysis aimed to compare the efficacy of 2 miniplates vs a three-dimensional plate in the management of mandibular condylar fractures. The primary objective was to assess key parameters, including intraoperative time, maximum mouth opening, complications, and functional outcomes, to determine potential differences between the 2 fixation methods.

Methods

A comprehensive literature search was conducted to identify relevant studies. Inclusion criteria were applied, and the selected studies underwent systematic review. The key parameters were extracted and subjected to meta-analysis to quantify and compare the outcomes associated with the use of 2 miniplates and three-dimensional plates. The methodologies of the included studies were critically evaluated to address potential biases and confounding factors.

Results

The meta-analysis results indicated that there were no statistically significant differences between the 2 fixation methods in terms of intraoperative time, maximum mouth opening, complications, and functional outcomes. However, concerns were raised regarding the high risk of bias, confounding factors, and considerable heterogeneity observed across the reviewed studies.

Conclusions

The findings suggest that both 2 miniplates and three-dimensional plates are viable options for the management of mandibular condylar fractures. Despite the lack of statistical significance in the observed differences, the study highlights the need for further prospective research with enhanced methodologies, standardized protocols, larger sample sizes, and reduced bias to refine our understanding and potentially influence clinical management protocols.
Evaluating the efficacy of a modified mindfulness program in enhancing psychosocial wellbeing and cognitive functions of community dwelling older adults
Authors: Foo Samuel Dun Hai , Tham Leanne Li Yan , Tay Kirsten Anne Yu En , Koo Isabel Yi Xuan , Ong Jin En , Chee Chew Sim
Published: May 2024

Objective

To assess the effects of a modified Mindfulness for Senior Wellbeing (MSW) program on older adults’ psychosocial wellbeing (flourishing, sleep quality, self-transcendence, purpose and meaning) and cognitive functions (working memory, episodic memory, speed of processing, cognitive flexibility).

Methods

Twenty-eight community dwelling older adults were recruited to participate in the 5-week mindfulness training out of which nineteen (mean age = 69.7 years) who met the training requirements were included in the data analysis. Due to practical limitations, a single-group pre–post study design was adopted. Participants completed the outcome measures before and after the training program.

Results

Participants experienced significant improvements in their levels of mindfulness, sleep quality, and some aspects of cognitive functions (working memory, episodic memory, cognitive flexibility), and reduced worrying thoughts related to a financial subscale of flourishing. Other outcome measures showed slight improvements albeit not statistically significant.

Conclusion

Taken together, these preliminary findings shed light on the feasibility and potential of the locally tailored mindfulness program to bring about positive benefits to the older adults.
Simoctocog alfa (Nuwiq®) in children: early steps in life’s journey for people with severe hemophilia A
Authors: Klukowska Anna , Sidonio Robert F. , Young Guy , Mancuso Maria Elisa , Álvarez-Román María Teresa , Bhatnagar Neha , Jansen Martina , Knaub Sigurd
Published: May 2024

People with severe hemophilia A usually experience their first bleed early in life. In children with severe hemophilia A, primary prophylaxis is recommended to prevent recurrent and potentially life-threatening bleeds that significantly impact day-to-day life. Factor VIII (FVIII) prophylaxis is well-established in children and has been shown to reduce the development of hemophilic arthropathy. However, a major challenge of FVIII therapy is the development of neutralizing anti-FVIII antibodies (FVIII inhibitors). Simoctocog alfa (Nuwiq®) is a human cell line-derived recombinant FVIII (rFVIII) whose immunogenicity, efficacy, and safety have been studied in 167 children with severe hemophilia A across two prospective clinical trials and their long-term extensions. In 105 previously untreated children, the inhibitor rate of 16.2% for high-titer inhibitors (26.7% for all inhibitors) was lower than published rates for hamster cell line-derived rFVIII products. There was no inhibitor development in previously untreated children with non-null F8 mutations and in previously treated children. In a case series of 10 inhibitor patients, 8 (80%) underwent successful immune tolerance induction with simoctocog alfa with a median time to undetectable inhibitor of 3.5 months. In an analysis of 96 children who enrolled in the extension studies and received long-term simoctocog alfa prophylaxis for up to 5 years, median spontaneous, joint, and total annualized bleeding rates were 0.3, 0.4, and 1.8, respectively. No thromboembolisms were reported in any of the 167 children, and there were no treatment-related deaths. Optimal care of children should consider several factors, including minimization of inhibitor development risk, maintaining tolerance to FVIII, highly effective bleed prevention and treatment, safety, and impact on long-term outcomes such as bone and joint health. In this context we review the pediatric clinical data and ongoing studies with simoctocog alfa.
Development of a fast-running method for prediction of blast propagation in partially confined spaces
Authors: Yeo Hwee Kiat , Tan Swee Hong
Published: May 2024

In this contribution, a series of findings from Computational Fluid Dynamics (CFD) simulations of blast propagation within fully confined spaces are presented. These numerical works have been carried out as part of an ongoing in-house development towards a fast-running method to predict overpressures and impulses arising from detonations within the various configurations of carparks in Singapore. In land-scarce cities like Singapore, carparks are typically located within the same structural footprints and are integrated with other functions of the building to facilitate convenient access. Design of carparks are required to meet statutory provisions with regards to the layout, headroom clearance and safety. To this end, the present research study has adopted a three-stage approach. First, different representative configurations of carparks are determined by making reference to and rationalising based on the prevailing statutory provisions in Singapore. This is then followed by a series of parametric CFD simulations to obtain essential numerical data in order to characterise the blast propagation within the respective partially confined spaces. Finally, several regression models are employed to derive relationships between the critical parameters and the blast data, with the aim of achieving a fast-running predictive method. This paper seeks to provide detailed descriptions of the first and the second stages, as well as to present the comparisons of numerically converged solutions, which are obtained from preliminary CFD simulations using two mesh sizes, against semi-analytical solutions which are calculated based on guidance from UFC 3-340-02 for fully confined detonation as initial reference cases.
Trichohepatoenteric syndrome and cytomegalovirus infection: Case report and literature summary
Authors: Zhu Yumo , Cao Yanyan , Ma Li , Fan Lili , Pu Weicong , Xia Yaofang
Published: May 2024

Trichohepatoenteric syndrome is a rare autosomal recessive genetic disease caused by TTC37 (also known as SKIC3) or SKIV2L gene variant. We present a severely affected 2-month-old male infant with recurrent fever and unexplained diarrhea. Additionally, clinical data of 11 patients with trichohepatoenteric syndrome in China from 1 to 60 days of onset was presented. The infant’s condition was not substantially relieved after cefotaxime sulbactam and meropenem treatment. Whole-exome sequencing revealed compound heterozygous variants (c.1708C>T and c.3342-9T>G) in TTC37 of the child whose parents were heterozygous carriers of the corresponding locus. The c.3342-9T>G variant originated from his mother and was reported for the first time. Combined with the clinical manifestations, the infant was diagnosed with trichohepatoenteric syndrome and treated with ganciclovir antiviral, intravenous nutritional support, and liver function protection. The infant was discharged with no fever and high stool frequency, but his condition improved. Therefore, trichohepatoenteric syndrome should be considered for recurrent fever and unexplained diarrhea.
Improvements in sleep problems and their associations with mental health symptoms: A study of children and adolescents participating in a digital mental health intervention
Authors: Lawrence-Sidebottom Darian , Huffman Landry Goodgame , Beam Aislinn , Parikh Amit , Guerra Rachael , Roots Monika , Huberty Jennifer
Published: May 2024

Objective

A growing number of youth are utilizing digital mental health interventions (DMHIs) for treatment of mental health problems such as anxiety, depression, and ADHD. Although these mental health symptoms are closely related to sleep problems, it is unknown whether nonsleep DMHIs indirectly confer improvements in sleep. Using retrospective data, the current study assesses (1) whether youth sleep problems improve over participation in a nonsleep DMHI, and (2) whether mental health symptom severity and improvement are correlated with sleep problem severity over time.

Methods

Sleep problems and mental health symptoms were assessed every 30 days among children (ages 5–12) and adolescents (ages 13–17) participating in a pediatric digital mental health intervention (DMHI; N = 1219).

Results

Children and adolescents with elevated sleep problems (39.3%; n = 479) were older (P < .001), more predominantly female (P < .001), and more likely to have elevated anxiety (P < .001), depressive (P < .001) and inattention symptoms (P = .001), as compared to those with nonelevated sleep problems (60.7%; n = 740). From the baseline to last assessment, 77.3% (n = 269) of members with elevated sleep problems exhibited improvements, with sleep problems decreasing significantly over each month in care (P < .001). Members with improvements in anxiety, depressive, and/or ADHD symptoms had larger improvements in sleep over time compared to their peers with no improvement in their mental health symptoms (Months in care*Change type: P < .001 for all).

Conclusions

Our results provide preliminary evidence that participation in a pediatric DMHI is associated with improvements in sleep problems, even when youth are not being treated directly for sleep problems. These findings highlight a valuable secondary benefit of participating in mental health care within pediatric DMHIs and warrant further experimental research.
Assessing the Impact of the COVID-19 Pandemic on Graduate Learning Experiences in Higher Education: Insights and Recommendations
Authors: Zhang Linfeng , Li Qingyun , Duffy Peter , Zhang Zhongyang , Xu Junyi , Cai Jingming
Published: May 2024

The COVID-19 pandemic has left a profound impact on higher education, prompting the need to assess its effects and provide guidance for future pandemics or disasters. While previous research has often focused on individual courses and short-term consequences, there is a limited understanding of the broader college experience. This study conducts a comparative analysis of graduate performance throughout different phases of the COVID-19 pandemic, utilizing a Graduate Learning Experience questionnaire with a five-point Likert scale. Scores for graduate attribute items were collected and compared across three distinct phases: pre-pandemic, pandemic era, and post-pandemic. The results reveal significant shifts in the student learning experience during these timeframes, with notable differences between on-campus and off-campus learners concerning their learning environments. The study also examines the reasons behind these variations, particularly among students living in on-campus hostels versus those off-campus. Additionally, it assesses the university’s response to the pandemic’s adverse effects and evaluates the effectiveness of these response measures. These findings offer valuable insights into the factors influencing graduate attributes in the context of online learning, with a specific focus on Hong Kong. They also provide policy recommendations for shaping the future of higher education in the aftermath of pandemics or disasters. Furthermore, these results can serve as a guiding framework for addressing similar challenges in other regions dealing with post-disaster recovery.
Does Women’s Empowerment Matter for Household Food Security? Evidence From Northern Ghana
Authors: Essilfie Gloria , Sebu Joshua , Baako-Amponsah Josephine
Published: May 2024

The study seeks to analyze the effect of women’s empowerment on household food security in northern Ghana. Employing Random Effect and Generalized Estimating Equations on the two rounds of Feed the Future dataset, 2012 and 2015, the study measured women empowerment as the comparative years of schooling and decision making by women. Multivariate Decomposition was used to explain whether variations in food insecurity between gendered household types are due to differences in explained and/or unexplained variations. The study showed significant differences in food insecurity levels between male and female headed households. The finding revealed that improving women decision making at the household level will reduce food insecurity by 45%. The study therefore recommends that Ministry of Gender, Children and Social protection should educate male partners on the need for women’s decision making and also ensure the establishment of social groups for women.
Linking Paternalistic Leadership to Employee Inauthentic Behavior: The Role of Psychological Strain Process
Authors: Liang Huai-Liang
Published: May 2024

This study examined the effect of paternalistic leadership on follower fake behavior and compared the effect of authoritarian leadership with that of benevolent leadership and moral leadership on the facades of conformity. The study suggested that leader authoritarianism resulted in high levels of employee facades of conformity, whereas both leader benevolence and leader morality produced low levels of employee facades of conformity. This study used 253 participants from a large Taiwanese company. The findings of the study showed a positive effect of authoritarian leadership on facades of conformity, whereas there was a negative relationship between benevolent leadership and facades of conformity and a negative relationship between moral leadership and facades of conformity. Psychological strain mediated the relationship between the three types of paternalistic leadership and facades of conformity. Implications and directions for future study are discussed.
Transportation Experiences of College Students With Intellectual and Developmental Disabilities: A Photovoice Study
Authors: Smith Hill Rebecca B. , Plotner Anthony J. , Peak Hannah J.
Published: May 2024

Transition-age adults with disabilities largely desire the same community employment and community participation outcomes as young adults without disabilities. One common barrier to the manifestation of these desires is the lack of reliable and accessible transportation in their communities. This study used the participatory action research method of photovoice to investigate the experiences of college students with intellectual and developmental disabilities (IDDs) accessing various transportation options within their community. Utilizing a critical constructivist theoretical framework, researchers worked with participants to co-construct situated knowledge. The overall aim of this study was to contribute to the extant literature on transportation barriers and facilitators for this population and to give emerging adults enrolled in an inclusive postsecondary education program an opportunity to share their lived experiences and raise critical consciousness related to their transportation experiences. Limitations and implications for future research, and practice are included.
Emerging Adult Mental Health Resource Access, Use, and Sufficiency During COVID-19
Authors: Maly Ellie G. , Grower Petal L. , Graham-Bermann Sandra A.
Published: May 2024

Purpose While Emerging Adults (EAs) report the highest rates of psychopathology, age-related barriers to access and use of mental health resources (MHR) leave many EAs to struggle. Contextualized within the COVID-19 pandemic, the present study explores factors related to EAs’ perceptions of access, use, and sufficiency of MHR. Method Four hundred twenty-three EAs enrolled in post-secondary education at the onset of the pandemic were recruited for an online survey. An age-related COVID questionnaire and multiple empirically validated measures were used to assess mental health status and MHR use throughout the pandemic. Results Those who reported Reduced or Eliminated Access to MHR during the pandemic were likely to have experienced at least one Change in Residence. Reduced or Eliminated Access to MHR and higher levels of depression accounted for the greatest variance in MHR Sufficiency. Conclusion This study underscores the importance of efforts to expand access to MHR amongst EAs.
Team Presentation Theory II: Q&A Management
Authors: Usera Daniel , Fuller Alex
Published: May 2024

Effective Q&A management in team presentations is a crucial yet often neglected aspect in academic discourse. Building upon Usera and Fuller’s previous work, this article explores the intricacies of Q&A management for teams. It outlines three key challenges teams face in managing Q&A, introduces two common components (isolated and embedded Q&A) with strategic insights, and proposes techniques for anticipating and responding to questions. By aligning Q&A strategies with the five team presentation formats identified by Usera and Fuller, this article offers a comprehensive framework for enhancing team presentations, with implications for educators, practitioners, and researchers in public speaking.
Effectiveness of Trans-Theoretical Model-Based Health Education Intervention in the Promotion of Lifestyle Changes among Adults with Metabolic Syndrome: A Randomized Controlled Trial
Authors: Okube Okubatsion Tekeste , Kimani Samuel T.
Published: May 2024

Background

Evidence revealed that, 60% of deaths in the underdeveloped nations are linked to adoption of unhealthy lifestyles. The Trans-theoretical Model (TTM) has been considered a useful interventional approach in smoking cessation, drug addiction and weight control. However, its effectiveness in improving changes in dietary pattern, physical activity and alcohol consumption has not been reported.

Purpose

The study aimed at evaluating the effectiveness of the TTM-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome.

Methods

This was an experimental design where 352 participants with metabolic syndrome were allocated to intervention and control groups. The participants were randomly assigned to receive either standard CVD care or a TTM stage-based lifestyle modification intervention for 12-months. Lifestyle patterns were assessed at baseline and endpoint. The mean difference of the subtotal TTM concept scores between pre and post intervention was evaluated using paired t-test. The chi-square test of independence was used to detect between group differences in the categorical data.

Results

Most of the participants were in the pre-action stage of change for their dietary intake patterns and physical activity habits at the baseline assessment with no difference between the groups. The intervention group's total level of change toward adopting a healthy lifestyle was markedly ( p < 0.001) improved than the control group at the endpoint. The mean scores for the intervention group's stage of change, self-efficacy, and pros and cons of decisional balance all improved significantly ( p < 0.001) from the baseline. The mean scores for the control group's pros and cons of decisional balance and stage of change also considerably ( p < 0.05) improved from baseline to the endpoint.

Conclusion

The TTM- based health education intervention was effective in improving the participants’ lifestyles that includes diet and physical activity. Health care providers, particularly nurses should implement TTM staged-matched educational intervention for individuals who are at risk for cardiovascular diseases.
Using Reflective Practice to Enhance Student Professionalism
Authors: Pestka Brandy
Published: May 2024

Reflective practice, critically reflecting on one's actions or attitudes to engage in the process of continuous adaptation and learning, has proven to be an effective strategy for improved patient care. Additionally, literature supports applying reflective practice for professional growth in medical providers. When contemplating professionalism training in physician assistant (PA) education, it is important to consider how to obtain buy-in from students. One way to do this is to link professionalism to the students’ future career as a PA. The School of Physician Assistant Studies at Pacific University (the Program) created an Online Orientation Reflective Practice Assignment that was implemented during online orientation. Students were prompted to use reflective practice to create detailed “plans for success.” The goal of this assignment was to reduce common professionalism missteps students often experienced. Data regarding the number of professionalism encounters per cohort, broken down into occurrences by curricular phase (didactic vs clinical), was tracked and collated using Microsoft® Excel®. The data was analyzed to determine trends. Implementation of the Online Reflective Practice Assignment for all PA students at the beginning of their education has increased student awareness of the Program's, and the profession's, expectations regarding professionalism and accountability. Thus far, the resulting number of professionalism missteps have not decreased year-over-year. We hypothesize that this is due to the difficulty meeting increased administrative expectations and burdens put on students during the pandemic. Students’ use of reflective practice to review what went wrong and to create plans to avoid missteps in the future allows them to focus on productive next steps in building their professional identity. Implementation of the Online Orientation Reflective Practice Assignment has better prepared students for the expectations of the PA profession and provided them with a solid foundation to build their professional identity throughout their education and into their careers.
Negotiating the border: Contending with constraints and creating opportunity from Venezuela to Peru
Authors: Aufseeser Dena
Published: May 2024

Utilizing a feminist geopolitical lens, this article examines the accounts of 18 Venezuelans who migrated from Venezuela since 2015. I make two main arguments. First, I expand accounts that focus on restrictive mobility regimes in countries receiving migrants to also look at how governments such as Venezuela’s, along with their accompanying border management strategies, limit Venezuelans’ mobility. Many scholars argue that the regulation of borders extends beyond physical territorial boundaries. Here, I show the diverse ways in which Venezuelan government actions impose border constraints both within Venezuela and beyond. Second, recent studies examine migrant management as resulting from an assemblage of different actors and practices, including humanitarian organizations, travel agencies and others. I add to this literature to suggest that acts of solidarity and support from fellow travelers, local individuals who are not part of any formal group, and social media accounts should also be considered part of migrant regimes, shaping border permeability. Policies are reworked through embodied encounters between migrants and a range of other actors in spaces as varied as buses, border checkpoints and food lines, and speak to the importance of multi-scalar accounts to understand migration experiences.
The eviction room: How Carolina Maria de Jesus can help us analyze migration, segregation, and the politics of citizenship in the city
Authors: Zacca Thomaz Diana
Published: May 2024

In this paper, I propose the “eviction room” as an analytical frame for the linked struggles of citizens and noncitizens living at the urban margins. The metaphor of the eviction room was coined by Carolina Maria de Jesus, a late Black Brazilian writer and favela dweller. De Jesus sees the city as a house: the city center is its luxurious living room; the favela, its eviction room, a precarious space to which the racialized urban poor are pushed like disposable objects. Expanding on this metaphor, we can think of those segregated and stigmatized in a city’s eviction rooms as not only physically but also politically cast out. Regardless of their legal citizenship status, eviction room dwellers are constructed as the immanent others of the “good citizens” inhabiting the city’s living rooms. Segregated in space, their presence is transient in time given their “evictability.” While the frame of the eviction room can help us make sense of the urban marginalization of both citizens and noncitizens, it assumes neither their social homogeneity nor a united “politics of the evicted.” I expand on possible strategies within such politics, as well as on the spatial and temporal dimensions of the city as a house with an ever-shifting plan. The eviction room advances a research agenda centered on migration, residential segregation, and the politics of citizenship relevant to urban contexts across the global south and north.
Open-Globe Injury With Globe Penetration Leading to Complex Retinal Detachment After Intraoral Anesthetic Injection
Authors: Trejo Corona Stephanie , Parvus Matthew N. , Fan Kenneth C. , Patel Sagar B. , Lane R. Gary , Flynn Harry W. , Wykoff Charles C.
Published: May 2024

Purpose: To report a case of a suspected open-globe injury and globe penetration complicated by a rhegmatogenous retinal detachment (RRD) after administration of intraoral anesthetic injections during an endodontic procedure. Methods: A retrospective chart review was performed. Results: A 34-year-old woman presented with acute onset of flashes, floaters, and a curtain-like shadow across her field of vision. Four days previously, she had multiple left-sided anesthetic injections during an endodontic procedure. The visual acuity (VA) in the left eye was 20/25. Ophthalmoscopy showed a suspected globe-penetration site inferiorly, associated multilayered hemorrhages, and adjacent subretinal fluid. Laser demarcation of the inferior RRD was performed at sequential clinical visits. Through 8 months, the multilayered hemorrhages improved while proliferative vitreoretinopathy–associated tissue formation over the posterior pole caused macular distortion and mild visual deterioration. The VA in the left eye was 20/40 at the last follow-up. Conclusions: Iatrogenic globe penetration during intraoral anesthesia delivery associated with an endodontic procedure may result in globe injury.
Bridge-Enhanced Anterior Cruciate Ligament Restoration: Surgical Technique
Authors: Bond Elizabeth , Wu Kevin A. , Mills Frederic Baker , O’Donnell Ryan , Cochran Grant , Lau Brian C.
Published: May 2024

Background:

Anterior cruciate ligament (ACL) repair has historically had poor outcomes and fell out of favor in the 1980s with the majority of surgeons opting to do an ACL reconstruction instead due to the high failure rate. The Bridge-Enhanced ACL Restoration or BEAR technique utilizes a de-cellularized, bovine-derived, type I collagen implant to aid in the ACL repair. The device is implanted to augment the healing of the ACL.

Indications:

The BEAR technique is indicated to augment ACL repair in cases of complete rupture where there is a residual tibial stump of sufficient length and good tissue quality.

Results:

In our experience to date, patients undergoing an ACL repair with BEAR recover range of motion quickly and have less quadriceps atrophy and less postoperative swelling than those undergoing ACL reconstruction requiring autograft harvest. We will continue to follow up our patient cohort to assess for re-rupture rate as they return to sport.

Conclusion:

The BEAR technique is a promising development that enables ACL repair as an alternative option to reconstruction. This article describes our approach including tips and tricks to successfully perform this procedure.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.
Changes in fatigue symptoms following an exercise-based rehabilitation programme for patients with long COVID
Authors: Daynes Enya , Baldwin Molly M. , Annals Matthew , Gardiner Nikki , Chaplin Emma , Ward Sarah , Greening Neil J. , Evans Rachael A. , Singh Sally J.
Published: May 2024

Background

There is evidence to support COVID-19 rehabilitation programmes improving persistent COVID-19 symptoms; however, there is concern that therapies that include an exercise component may increase fatigue and post-exertional symptom exacerbation (PESE). The objectives of the present study were to determine the effect of a 6-week COVID-19 rehabilitation programme on fatigue and PESE in individuals with ongoing COVID-19 symptoms.

Methods

After a routine medical assessment, individuals with persistent COVID-19 symptoms were enrolled on a 6-week COVID-19 specific rehabilitation programme. The programme included symptom-titrated exercise, education and self-management advice. Fatigue was assessed pre- and post-programme using the Functional Assessment Chronic Illness Therapy Fatigue questionnaire (FACIT). Exercise capacity (Incremental and Endurance Shuttle Walking Test (ISWT and ESWT)) and PESE (DePaul Symptom Questionnaire (DSQ)) were also assessed pre- and post-programme. Composite scores were calculated for the frequency and severity domains of the DSQ.

Results

148 patients (median (IQR) age 59 (49–72) years, 82 (55%) female, 81 (54%) hospitalised) completed the COVID-19 rehabilitation programme. FACIT score was reduced pre- to post-programme by a mean (CI) change of −5 (−7– −4); p<0.01. Exercise capacity increased by 82 (65–99) m for the ISWT and 398 (333–462) s for the ESWT (n=148). PESE was assessed in 44 patients. The DSQ frequency and severity composite score improved by 20 (13–28) and 19 (13–26) points, respectively (p<0.01, n=44).

Conclusion

These data demonstrate the potential benefits of a COVID-19 rehabilitation programme in improving fatigue, exercise capacity and symptom exacerbation in those with persistent COVID-19 symptoms.
What every clinician should know about inflammation in COPD
Authors: Wechsler Michael E. , Wells J. Michael
Published: May 2024

Inflammation drives COPD pathogenesis and exacerbations. Although the conceptual framework and major players in the inflammatory milieu of COPD have been long established, the nuances of cellular interactions and the etiological differences that create heterogeneity in inflammatory profiles and treatment response continue to be revealed. This wealth of data and understanding is not only a boon to the researcher but also provides guidance to the clinician, moving the field closer to precision medicine. It is through this lens that this review seeks to describe the inflammatory processes at play in COPD, relating inflammation to pathological and functional changes, identifying patient-specific and disease-related factors that may influence clinical observations, and providing current insights on existing and emerging anti-inflammatory treatments and treatment targets, including biological therapies and phosphodiesterase (PDE) inhibitors.
AERIFY-1/2: two phase 3, randomised, controlled trials of itepekimab in former smokers with moderate-to-severe COPD
Authors: Rabe Klaus F. , Martinez Fernando J. , Bhatt Surya P. , Kawayama Tomotaka , Cosio Borja G. , Mroz Robert M. , Boomsma Maarten M. , Goulaouic Helene , Nivens Michael C. , Djandji Michel , Soler Xavier , Liu Ying , Kosloski Matthew P. , Xu Christine R. , Amin Nikhil , Staudinger Heribert , Lederer David J. , Abdulai Raolat M.
Published: May 2024

Background

Accumulating data implicate interleukin (IL)-33, a proinflammatory cytokine released locally upon epithelial cell damage, in the pathogenesis of COPD. In a phase 2 study, itepekimab, a human monoclonal antibody against IL-33, reduced exacerbations and improved lung function in a subgroup analysis of former smokers with COPD with an acceptable safety profile.

Methods

The study designs of AERIFY-1 and AERIFY-2 are described in this article.

Discussion

The primary objective of AERIFY-1/2 (NCT04701983/NCT04751487), two phase 3 randomised, double-blind, placebo-controlled trials, is to assess the efficacy and safety of itepekimabversusplacebo in a population of former smokers with moderate-to-severe COPD over up to 52 weeks. An additional secondary population of current smokers are being enrolled in AERIFY-2. These two studies will enrol patients (aged 40–85 years) with COPD and chronic bronchitis who had ≥2 moderate or ≥ 1 severe exacerbations within the previous year despite standard-of-care triple or double background therapy. All participants are required to have ≥10-pack-year smoking history, and ≥6 months since smoking cessation for former smokers. The primary end-point is the annualised rate of moderate or severe acute exacerbation of COPD. Secondary end-points include change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 s, and annualised frequency of severe exacerbations. Symptomatic end-points include Evaluating Respiratory Symptoms in COPD and St. George's Respiratory Questionnaire, safety and anti-drug antibody responses.
RLS-0071, a novel anti-inflammatory agent, significantly reduced inflammatory biomarkers in a randomised human evaluation of mechanisms and safety study
Authors: Cunnion Kenji , Goss Jessica , Hair Pamela , Dell Linda , Roberson Destrey , Thienel Ulrich , Müller Meike , Carstensen-Aurèche Saskia , Badorrek Philipp , Holz Olaf , Hohlfeld Jens M.
Published: May 2024

Background

This study was a randomised, double-blind, placebo-controlled study intended to establish the translatability of the RLS-0071 mechanisms of action from animal disease models to humans by inhibiting neutrophil-mediated inflammation at the tissue level and major inflammatory biomarkers. We hypothesised that RLS-0071 inhibits a temporary neutrophil-mediated inflammation in the lungs induced by inhalation of low-dose lipopolysaccharide (LPS) in healthy participants.

Methods

Participants were randomised to one of three arms to receive inhaled LPS followed by three doses of either low-dose (10 mg·kg−1) or high-dose (120 mg·kg−1loading dose followed by two doses of 40 mg·kg−1) RLS-0071i.v.or placebo (saline) every 8 h. Biomarkers evaluating inflammatory responses, with absolute neutrophil counts in induced sputum as the primary end-point, were collected before and at 6 and 24 h after LPS challenge.

Results

Active treatment with RLS-0071 showed a similar safety profile to participants receiving placebo. RLS-0071 significantly decreased the numbers of neutrophils in sputum at 6 h post LPS by approximately half (p=0.04). Neutrophil effectors myeloperoxidase, neutrophil elastase and interleukin-1β in sputum were also significantly decreased at 6 h for RLS-0071 compared with placebo. Several biomarkers showed trends suggesting sustained decreases for RLS-0071versusplacebo at 24 h.

Conclusion

This clinical trial demonstrated that RLS-0071 was safe and well tolerated and modulated neutrophil-mediated inflammation in humans after inhaled LPS challenge, consistent with results from prior animal model studies.
Pulmonary perfusion defects or residual vascular obstruction and persistent symptoms after pulmonary embolism: a systematic review and meta-analysis
Authors: Cimini Ludovica Anna , Luijten Dieuwke , Barco Stefano , Ghanima Waleed , Jervan Øyvind , Kahn Susan R. , Konstantinides Stavros , Lachant Daniel , Nakano Yoshihisa , Ninaber Maarten , van Es Josien , van Mens Thijs , Vonk Noordegraaf Anton , Becattini Cecilia , Klok Frederikus A.
Published: May 2024

Introduction:

Up to 50% of pulmonary embolism (PE) patients have perfusion defects or residual vascular obstruction during follow-up despite adequate anticoagulant treatment, and a similar percentage experience chronic functional limitations and/or dyspnoea post-PE. We aimed to evaluate the association between pulmonary perfusion defects or residual vascular obstruction and functional recovery after PE.

Methods:

We performed a systematic review and meta-analysis including studies assessing both the presence of perfusion defects or residual vascular obstruction and functional recovery (i.e.persistent symptoms, quality of life, exercise endurance). An odds ratio was pooled for perfusion defects or residual vascular obstruction and persistent symptoms using a random-effect model.

Results:

12 studies were included totalling 1888 PE patients; at a median of 6 months after PE (range 2–72 months), 34% had perfusion defects or residual vascular obstruction and 37% reported persistent symptoms. Among patients with perfusion defects or residual vascular obstruction, 48% (95% CI 37–60%, I2=82%) remained symptomatic during follow-up, compared to 34% (95% CI 20–51%, I2=96%) of patients without such defects. Presence of perfusion defects or residual vascular obstruction was associated with persistent symptoms (OR 2.15, 95% CI 1.66–2.78; I2=0%, τ=0). Notably, there was no association between these defects and quality of life or cardiopulmonary exercise test parameters.

Conclusion:

While the odds of having persistent symptoms was higher in patients with perfusion defects or residual vascular obstruction after acute PE, a significant proportion of these patients reported no limitations. A possible causality between perfusion defects or residual vascular obstruction and residual functional limitation therefore remains to be proven.
Effect of radius-dependent diffusion behavior of various gold nanoparticles on photothermal therapy
Authors: Kim Donghyuk , Kim Hyunjung
Published: May 2024

Among the various anti-cancer treatments, photothermal therapy (PTT) is gaining traction as it is a non-invasive treatment. PTT is a treatment technique involving the use of a laser to raise the temperature of the target tumor until it dies. In this study, the effects of PTT under various conditions of squamous cell carcinoma (SCC) occurring in the skin were numerically analyzed and optimized. Gold nanoparticles (AuNPs) with different radii were injected into the center of the SCC. Subsequently, the diffusion behavior of the AuNPs was analyzed to calculate the distribution area of the AuNPs that changed over time. Furthermore, at each elapsed time point after injection, the temperature distribution in the tissue was calculated, as treatment was performed using varying laser intensities. The diffusion coefficient of AuNPs was calculated using the Stokes–Einstein equation, and diffusion behavior of AuNPs in biological tissues was analyzed using the convection–diffusion equation. Additionally, temperature distribution was analyzed using the Pennes bioheat equation. The effect of PTT under each condition was quantitatively analyzed using apoptotic variables. As a result, As the radius of AuNPs increased, the optimal treatment start time was derived as 2 h, 8 h, 8 h, and 12 h, respectively, and the laser intensity at that time was derived as 0.44 W, 0.46 W, 0.42 W, and 0.42 W, respectively. The study findings will provide reference for the optimization of the efficacy of PTT.
Biclustering analysis on tree-shaped time-series single cell gene expression data of Caenorhabditis elegans
Authors: Guan Qi , Yan Xianzhong , Wu Yida , Zhou Da , Hu Jie
Published: May 2024

Background

In recent years, gene clustering analysis has become a widely used tool for studying gene functions, efficiently categorizing genes with similar expression patterns to aid in identifying gene functions. Caenorhabditis elegans is commonly used in embryonic research due to its consistent cell lineage from fertilized egg to adulthood. Biologists use 4D confocal imaging to observe gene expression dynamics at the single-cell level. However, on one hand, the observed tree-shaped time-series datasets have characteristics such as non-pairwise data points between different individuals. On the other hand, the influence of cell type heterogeneity should also be considered during clustering, aiming to obtain more biologically significant clustering results.

Results

A biclustering model is proposed for tree-shaped single-cell gene expression data of Caenorhabditis elegans. Detailedly, a tree-shaped piecewise polynomial function is first employed to fit non-pairwise gene expression time series data. Then, four factors are considered in the objective function, including Pearson correlation coefficients capturing gene correlations, p-values from the Kolmogorov-Smirnov test measuring the similarity between cells, as well as gene expression size and bicluster overlapping size. After that, Genetic Algorithm is utilized to optimize the function.

Conclusion

The results on the small-scale dataset analysis validate the feasibility and effectiveness of our model and are superior to existing classical biclustering models. Besides, gene enrichment analysis is employed to assess the results on the complete real dataset analysis, confirming that the discovered biclustering results hold significant biological relevance.