bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Arthroscopy-Assisted Reduction Internal Fixation versus Open Reduction Internal of Tibial Plateau Fracture Management: A Systematic Review of Case Control Studies
Authors: Mahardika Yudi , Wien Aryana I Gusti Ngurah
Published: October 2024

Background:

Tibial plateau fractures are complex injuries that demand meticulous surgical techniques to achieve anatomical reduction and stable fixation. Both ARIF and ORIF have been utilized for fracture management, each with its advantages and limitations. ARIF offers the potential for enhanced visualization, accurate reduction, and minimally invasive approaches. This review aims to assess the available evidence to determine whether ARIF offers superior outcomes compared to ORIF in tibial plateau fracture management.

Method:

A systematic search of relevant databases was conducted to identify case control studies comparing ARIF and ORIF for tibial plateau fractures. Inclusion criteria encompassed studies reporting KSS as an outcome measure. Quality assessment and data extraction were performed independently by two reviewers.

Result:

The systematic review identified a total of four case-control studies meeting the inclusion criteria with total of 261 patients with tibial plateau fractures. The sample sizes varied across the studies, with the smallest study including 40 patients and the largest study including 317 patients. The outcomes were assessed using various scoring systems, including IKDC scores, Lysholm scores, and KSS scores. The results consistently showed that ARIF had higher scores compared to ORIF, indicating better functional outcomes.

Conclusion:

ARIF holds promise as a superior technique compared to ORIF for managing tibial plateau fractures. ARIF offers enhanced visualization, more accurate reduction, and potentially faster postoperative recovery. However, individual patient and fracture characteristics must still be considered when determining the optimal surgical approach. Further high-quality prospective studies and long-term follow-up are warranted to confirm these findings and establish the broader applicability of ARIF in diverse tibial plateau fracture scenarios.
Patellar-shaped Osteochondromatosis in Young Adults: A Rare Case
Authors: Christian Dachi Felix Norman , Utoyo Ghuna Arioharjo , Budi Irawan M. Naseh Sajadi
Published: October 2024

Introduction:

Synovial chondromatosis is a rare, benign condition that affects the synovial lining of joints, bursae, and synovial sheaths. It commonly occurs in larger joints and presents as a metaplastic disorder affecting a single joint. This case report focuses on an unusual occurrence of synovial chondromatosis in young adults, specifically with a patellar-shaped presentation.

Case Presentation:

A 23-year-old male patient presented with a two-year history of right knee pain and the presence of a gradually enlarging lump. The lump, currently the size of a pingpong ball, has limited the patient's range of motion in his knee joint. An MRI scan revealed a solid mass in the hoffa's fat pad on the right knee joint suggestive of extraskeletal ossifying chondroma, as well as minimal fluid accumulation in the knee joint. The mass located in front of anterior meniscus and posterior of patellar tendon, it makes the pattelar tendon redundant and patellar alta (Insall-Salvati ratio 0.88), so we performed wide excision patellar tendon augmentation with tape (ultra high molecular weight polyethylene based) and imbrication of MPFL. Histopathological analysis confirmed osteochondromatosis measuring 6.5x5x3.5cm, resembling the shape of a patella. Post-operation x-ray examination showed no signs of ossification in the hoffa's fat area or any narrowing or sclerosis in knee joints. Furthermore, there were no visible fracture/dislocation lines or indications for osteomyelitis. The patient is now free from pain and can move without any limitations in range of motion.

Discussion:

Synovial Chondromatosis with pattelar-like shape mass is uncommon benign tumor that rarely affects young adults. Effective surgical treatments such as wide excision and patellar tendon augmentation using UHMWPE tape with imbrication of the medial patellofemoral ligament have demonstrated favorable outcomes for cases of osteochondromatosis that have reached a significant size and are impacting adjacent tendons.
Haglund’s Deformity, Retrocalcaneal Bursitis, and Achilles Tendinopathy (Haglund’s Syndrome) Treated with Arthroscopic Calcaneoplasty, Synovectomy and PRP Injection Outcome Score: A Case Report
Authors: Haryono Handy , Lim Evan
Published: October 2024

Introduction:

Haglund’s deformity is an abnormal bony enlargement of posterosuperior part of calcaneus at the attachment of achilles tendon which often leads to retrocalcaneal bursitis and insertional achilles tendinopathy (Haglund’s syndrome) causing back heel pain. Arthroscopic calcaneoplasty, synovectomy and PRP injection should be considered as minimally invasive treatment option with speedy recovery.

Case Report:

A 57 years old woman came with pain and lump at posterior site of left ankle more than right ankle since 6 months before that didn’t respond conservatively. Pain was felt with pressure on left ankle with edema. AOFAS Ankle-Hindfoot score was 65%. X-Ray and MRI showed Haglund’s deformity with achilles tendon impingement. The patient was diagnosed with Haglund’s deformity, retrocalcaneal bursitis and achilles tendinopathy. Arthroscopic calcaneoplasty, synovectomy and PRP injection was then conducted. One week after operation, pain decreased and she could do daily activities better with AOFAS Ankle-Hindfoot score increased to 87%. Two weeks after operation, pain was still felt but seldom with AOFAS Ankle-Hindfoot score remain at 87%.

Result and Discussion:

Haglund’s syndrome is mostly idiopathic with several factors suggested. Clinical features are back heel pain, swelling, bump on posterior heel and inflammation signs. Dorsiflexion causes pain of the ankle. Lateral radiographic can show bony prominence at posterosuperior of calcaneus, calcaneal spur and bone formation at achilles tendon insertion. MRI can additionally show synovitis, retrocalcaneal bursitis and achilles tendinopathy. Conservative treatment is often used to treat Haglund’s syndrome, if it doesn’t respond well then surgical treatment is required. Arthroscopic calcaneoplasty with synovectomy has better outcome compared to open surgery. PRP injection can be added to enhance achilles tendinopathy healing. The AOFAS Ankle-Hindfoot score used is a standardized evaluation which combine subjective and objective information from the patient and the physician, in which a healthy ankle scored 100. In this case, the AOFAS Ankle-Hindfoot score increased significantly from 65% pre-operative to 87% post-operative which shows better functional outcome.

Conclusion:

Treatment of Haglund’s deformity, retrocalcaneal bursitis and achilles tendinopathy with arthroscopic calcaneoplasty, synovectomy and PRP injection should be considered to produce good functional outcome based on AOFAS Ankle-Hindfoot score..
Psychometric properties analysis of Indonesian IKDC scale for managing patients with ACL injury
Authors: Deviandri R , van der Veen HC , Lubis AMT , Postma MJ , van den Akker-Scheek I
Published: October 2024

Introduction:

The most-used questionnaire in clinical research for these patients is the International Knee Documentation Committee (IKDC) Subjective Knee Form, as its psychometric properties are considered excellent.

Objectives:

To assess the validity, reliability, and responsiveness of the Indonesian version of IKDC for use in the Indonesian-speaking ACL population.

Material & Methods:

After a forward-and-backward translation procedure and cross-cultural adaptation, validity, reliability, and responsiveness were investigated. The responses of 106 ACL injury patients on three questionnaires – the Indonesian-IKDC (I-IKDC), Short Form–36, and Kujala scores – were used. Following COSMIN guidelines, construct validity, test-retest reliability, internal consistency, floor and ceiling effects, measurement error, and responsiveness were determined. The Bland and Altman method was used to explore absolute agreement.

Results:

Construct validity can be considered good, as all predefined hypotheses on correlations between the I-IKDC and other scores were confirmed. Reliability proved excellent, with a high test-retest correlation (ICC=0.99). Bland and Altman analyses showed no systematic bias between test and retest. Internal consistency was good (Cronbach α .90). There were no floor or ceiling effects. Standard error of measurement (SEM) was 2.1, minimal detectable change at the individual level (MDCind) 5.8 and at the group level (MDCgrp) 0.7. Responsiveness was considered good.

Conclusion:

The I-IKDC appears to be a good evaluation instrument for Indonesian patients with anterior cruciate ligament injuries.
Psychometric properties analysis of Indonesian Lysholm and Tegner scales regarding COSMIN guidelines
Authors: Deviandri R , van der Veen HC , Lubis AMT , Postma MJ , van den Akker-Scheek I
Published: October 2024

Introduction:

The Lysholm knee score and Tegner activity scale are frequently used patient-reported outcome measures (PROMs) in patients with anterior cruciate ligament (ACL) injury because of their excellent psychometric properties.

Objectives:

To assess the validity, reliability, and responsiveness of the Indonesian version of Lysholm and Tegner scales for use in the Indonesian-speaking ACL population.

Material & Methods:

After a forward-and-backward translation procedure and cross-cultural adaptation, validity, reliability, and responsiveness were investigated. The responses of 106 ACL injury patients on four questionnaires – Indonesian Lysholm knee score (I-LK), Indonesian Tegner scale (I-TS), Short Form–36, and Kujala scores – were used. Following COSMIN guidelines, construct validity, test-retest reliability, internal consistency, floor and ceiling effects, measurement error, and responsiveness were determined. The Bland and Altman method was used to explore absolute agreement.

Results:

Construct validity is good, as more than 75% of the predefined hypotheses on correlations between I-LK, I-TS and other scores were confirmed. Reliability proved excellent, with a high test-retest correlation for both questionnaires (ICC = 0.99). Bland and Altman analyses showed no systematic bias between test and retest. Internal consistency of I-LK was good (Cronbach alpha = .73). For I-LK and I-TS, respectively, floor and ceiling effects were less than 15% (floor 0%, 4.7%; ceiling 12.3%, 3.8%); standard error of measurement (SEM) 1.8 and 0.9; minimal detectable change at the individual level (MDCind) 5.1 and 0.6, and at the group level (MDCgrp) 2.4 and 0.5. Responsiveness was considered good, especially at the group level.

Conclusion:

The I-LK and I-TS appears to be a good evaluation instrument for Indonesian patients with anterior cruciate ligament injuries.
Progression of Osteoarthritis After Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review of Randomized Controlled Trial
Authors: Hasan Jafri , Tanaya Hutami Wintang Dayinta
Published: October 2024

Introduction:

Recently, anterior cruciate ligament (ACL) reconstruction procedures are frequently performed both single-bundle (SB) and double-bundle (DB) techniques. Following anterior cruciate ligament (ACL) injury, the knee suffers from a high incidence of osteoarthritis (OA), which has been decreased by ACL reconstruction using DB and SB techniques. However, there is debate regarding the extent to which the DB and SB techniques work at preventing the progression of OA after an ACL reconstruction.

Methods:

The databases, which included Scopus, Embase, and PubMed, were searched up. A Randomized Controlled Trial (RCT) comparing SB and DB ACL reconstruction and reporting the clinical outcomes for OA progression was included in the study. Only studies with a minimum of two years of follow-up and a ten-year time frame were included.

Result:

The evaluation was conducted on seven RCTs that satisfied the eligibility requirements. Overall, the studies indicate that there was no statistically significant difference in the rate of radiological OA progression between the DB group and the SB group.

Conclusion:

When it came to OA changes in ACL reconstruction, the DB technique was not better than the SB technique. This necessitates further research with longer follow-up periods, a larger sample size, and improved study designs.
Neglected Achilles Tendon Rupture Repair with Gastrosoleus Turn Down Flap: A Case Report
Authors: Hasan Jafri , Tanaya Hutami Wintang Dayinta
Published: October 2024

Introduction:

The most prevalent tendon rupture in the lower extremities is an achilles tendon rupture. Adults in their third to fifth decades of life are the ones who sustain the injury most frequently. The optimal method for treating these ruptures is not generally agreed upon in the literature. The objective of this study was to evaluate the functional outcomes of the gastrosoleus turn down flap method used to repair the neglected achilles tendon rupture.

Methods:

A 58-year-old woman who has had difficulty in walking for 6 months after slipping on the floor. The modified Lindholm method, with a turn-down of the gastrosoleus flap, was used to repair the neglected achilles tendon rupture. The patient was positioned prone, and a posterior incision was used to access the ruptured tendon. There was a complete rupture of the achilles tendon along with some fibrous tissue. The torn ends were cut into fresh tissue, and the scar tissue that had formed between the torn proximal and distal ends was resected. The gap was 10 cm. The repair was then reinforced using a 12-cm-long and 2-cm-wide segment of gastrosoleus fascia that was trimmed sharply by horizontal incision and divided into two layers, and it was then rotated 180 degrees upside down. The flap was then pulled gently but steadily in the distal direction until it bridged the gap and connected with the distal tendon. The Krackow technique was then used to suture the flap to the end of the distal stump. The tension was roughly adjusted so that the foot would be in an equinus posture with normal gravity.

Results:

At 6 weeks after the operation, the patient is able to walk and perform regular daily activities. No recurrent rupture and further complications were reported.

Conclusion:

According to this study, the gastrosoleus turn down flap method for neglected achilles tendon rupture repair provides a functional outcome that is satisfactory.
Processing of Visual Speech Cues in Speech-in-Noise Comprehension Depends on Working Memory Capacity and Enhances Neural Speech Tracking in Older Adults With Hearing Impairment
Authors: Frei Vanessa , Schmitt Raffael , Meyer Martin , Giroud Nathalie
Published: October 2024

Comprehending speech in noise (SiN) poses a challenge for older hearing-impaired listeners, requiring auditory and working memory resources. Visual speech cues provide additional sensory information supporting speech understanding, while the extent of such visual benefit is characterized by large variability, which might be accounted for by individual differences in working memory capacity (WMC). In the current study, we investigated behavioral and neurofunctional (i.e., neural speech tracking) correlates of auditory and audio-visual speech comprehension in babble noise and the associations with WMC. Healthy older adults with hearing impairment quantified by pure-tone hearing loss (threshold average: 31.85–57 dB, N = 67) listened to sentences in babble noise in audio-only, visual-only and audio-visual speech modality and performed a pattern matching and a comprehension task, while electroencephalography (EEG) was recorded. Behaviorally, no significant difference in task performance was observed across modalities. However, we did find a significant association between individual working memory capacity and task performance, suggesting a more complex interplay between audio-visual speech cues, working memory capacity and real-world listening tasks. Furthermore, we found that the visual speech presentation was accompanied by increased cortical tracking of the speech envelope, particularly in a right-hemispheric auditory topographical cluster. Post-hoc, we investigated the potential relationships between the behavioral performance and neural speech tracking but were not able to establish a significant association. Overall, our results show an increase in neurofunctional correlates of speech associated with congruent visual speech cues, specifically in a right auditory cluster, suggesting multisensory integration.
Psychiatric Labels and Status: Exploring Variations by Gender, Diagnosis, and Participant Attributes
Authors: Kroska Amy , Harkness Sarah K. , Mattingly Kelsey N. , Lovera Mollie A.
Published: October 2024

Many studies suggest that people discriminate against individuals with a mental illness. Despite these generally robust patterns, however, variability in the results from laboratory experiments examining competence-based discrimination leaves questions about the specific diagnoses that elicit the discrimination and gender differences in the discriminatory behavior. Therefore, we revisit this question with a design aimed at clarifying some of the ambiguities. We examine the effects of two diagnoses (schizophrenia and depression) and a nonpsychiatric health problem (the need for leg surgery). As with other laboratory studies, we examine if and how a teammate’s psychiatric diagnosis affects participants’ willingness to accept the teammate’s problem-solving suggestions in a two-person task group. But we go beyond the previous studies by crossing the teammate gender with participant gender and by exploring the robustness in our results by examining the moderating role of numerous participant attributes (e.g., education, social desirability, parents’ education, age, political liberalism, three gender ideology scales, trust in others). We find that participants discriminate against teammates with both types of psychiatric diagnoses but not against teammates with the nonpsychiatric health problem and that this pattern is highly robust: The processes are almost entirely unrelated to teammate gender and participant attributes, including participant gender. Together, these results suggest that both schizophrenia and depression elicit competence-based discrimination, that these processes differ very little by participants’ demographic and attitudinal attributes, and that the status beliefs underlying this discrimination may be fairly uniform.
Mismatch between flood risk and insurance protection: A county-level analysis in the contiguous United States
Authors: Xue Yang , Fu Xinyu , Li Chaosu
Published: October 2024

Flood insurance plays a pivotal role in disaster management, providing the financial safety net for individuals and communities at risk. However, flood insurance penetration may not align with the actual flood risk over space. Using the National Risk Index and the National Flood Insurance Program (NFIP) Datasets, this study examines the county-level mismatch between flood risk and insurance protection across the contiguous United States, with an emphasis on both coastal and riverine flooding. Our findings indicate that, while a very limited number of high-risk counties are underinsured for coastal flooding, several high-risk counties experienced inadequate insurance protection for riverine flooding. These findings underscore the need for targeted policy interventions to improve flood risk awareness and insurance access in vulnerable areas facing the increasing impacts of climate change.
Skill-based Employment Opportunities Versus Youth Aspirations in Logistics Sector in Hyderabad: Findings of a Market Study
Authors: Thumakunta Navin
Published: October 2024

Skill-based training leading to youth employment has been accepted as an important means for addressing youth unemployment. The skill-based policies of the last one and half decades have emphasised the same. Logistics sector is a growing sector with the potential to create employment. This study delves into the current employment patterns in the logistics sector in Hyderabad, the potential for future employment, the state of the training ecosystem available for promoting youth employment and the youth aspirations for employment in the logistics sector. The study indicates that while there remains potential for youth employment in the logistics sector, there is low awareness as well as aspiration to join the logistics workforce. The tendency to associate low social prestige with the logistics sector remains a factor.
Constipation as a possible predictor of poor treatment response in chronic migraine: A retrospective study of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies and the impact of switching
Authors: Uzun Sena , Frejvall Ulf , Petersson Per , Sahin Gürdal
Published: October 2024

Background

There is a growing awareness of constipation being a side effect of anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies (mAbs). This study aims to assess constipation as a side effect and explore its potential role as a predictor of treatment response in chronic migraine (CM) patients treated with anti-CGRP mAbs.

Methods

We conducted a retrospective analysis of patients with CM treated with anti-CGRP mAbs between January 2019 and December 2022 at a single center. Data on patient demographics, migraine characteristics, and constipation were reviewed.

Results

Among 317 patients, 192 received erenumab, 94 received fremanezumab, and 31 received galcanezumab. Constipation was significantly more common with erenumab (51.5%) compared to fremanezumab (4.2%) and galcanezumab (12.9%). Among erenumab patients, 24.4% switched due to constipation, while 19.2% switched due to lack/loss of effectiveness. Patients who switched treatment experienced milder symptoms ( p < 0.0001) without compromising effectiveness, even when switching due to lack/loss of effectiveness ( p = 0.0068). Importantly, severe constipation rates were higher in non-responders ( p = 0.036).

Conclusion

Constipation is a notable side effect of anti-CGRP mAbs, particularly with erenumab in CM. Side effect monitoring is consequently crucial. Our findings suggest a potential link between poor treatment response and constipation, warranting further research into the underlying mechanisms.
Effect of micro-electrical discharge drilling parameters on machining responses during machining of Al/(SiC/ZrO2/NiTi)-MMC
Authors: Maurya Saurabh Kumar , Susheel Chander Kant , Manna Alakesh
Published: October 2024

The use of metal matrix composites is increasing gradually in numerous industrial applications. As a result of increased demand, accurate and precise machining of the composites in microdomains become important. Micro-electrical discharge drilling can be effectively applied for machining micro-holes in hybrid composites. The effect of micro-drilling process parameters such as pulse-on-time, pulse-off-time, peak current, tool rotation and electrode polarity on the material removal rate (MRR), radial overcut (RO) and tool wear rate (TWR) has been identified. Results reveal that the MRR, RO and TWR increase as the peak current, pulse-on-time and tool rotation increase. A copper tool with positive polarity provided better results when compared to the other combinations. Although MRR was reduced by 11.22%, RO and TWR were improved by 14.51% and 59.52%, respectively, in a grey relational analysis-based optimal parametric setting. Scanning electrode microscopic (SEM) images of the machined surface demonstrate that the machined holes have high circularity, less surface damage and negligible recast layer at the optimal setting.
Soft Tissue Sarcoma: Experience  in a Tertiary Referral Center
Authors: Lahiri Anupam , Rohela Himanshu , Jain Prakhar , Batra Ullas , Chufal Kundan Singh , Goel Sneha , Negi Ritu
Published: October 2024

Introduction

This retrospective study investigates the clinical features, survival outcomes, and treatment-related results of patients with soft tissue sarcoma (STS) at a tertiary referral center in India. STSs are rare malignant tumors comprising over 50 subtypes, representing approximately 1% of adult and 15% of pediatric neoplasms.

Materials and Methods

We reviewed 91 patients with STS diagnosed in the Rajiv Gandhi Cancer Institute and Research Center, India, from 2020 to 2023. Data were collected on demographics, disease characteristics, and treatment outcomes. Statistical analyses were performed with survival rates estimated via the Kaplan–Meier method. Prognostic factors were evaluated through univariate and multivariate analyses using log-rank and Cox regression models.

Results

The study cohort included slightly more males (64.8%) than females, with 51.6% of patients under 50 years. Most tumors were over 5 cm (70.3%) and classified as Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade 3 (62.6%). Local recurrence occurred in 7.7% of cases, and distant recurrence occurred in 24.2%. The 3-year overall survival rate was 60.5%, with a 3-year disease-free survival rate of 58%. Significant prognostic factors for better outcomes included smaller tumor size (≤5 cm), margin status (≥1 cm), lower necrosis, lower intraoperative blood loss (<100 ml), and administration of adjuvant chemotherapy. Multivariate analysis showed only intraoperative blood loss to be significant.

Conclusion

This study highlights the necessity of multidisciplinary care in STS management. Achieving wide surgical margins with minimal blood loss followed by multimodality treatment is crucial. Future prospective trials with larger, diverse cohorts are essential to validate these findings and optimize STS treatment strategies.
Ethyl Acetate Extract from Romdoul (Sphaerocoryne affinis) Fruit Induced Apoptosis in Human Promyelocytic Leukemia Cells
Authors: Hoai Nga Nguyen Thi , Long Tran Thanh , Ngoc Truong Thi Bich , Nguyen Nguyen Hoang Khoi , Thao Dang Thi Phuong , Trinh Nguyen Thi My
Published: October 2024

Background

Romdoul ( Sphaerocoryne affinis) is a flowering plant of the Annonaceae family and has been used customarily in folk medicine. The bioactivities of this plant, especially the anti-cancer effect, however, remain surprisingly few.

Objective

this study aimed to elucidate the anti-leukemic effect of romdoul fruit extracts and their underlining mechanisms.

Methods

The extracts were prepared from fresh fruits and the phytochemical contents were evaluated by biochemical assays and HPLC method. The promising extract was identified via the inhibition of HL60 as well as normal NIH-3T3 cell densities utilizing MTT assay. The underline mechanism of the extract’s effect was studied by accessing the treated HL60 cell population overtime (via MTT assay). The morphology of abnormal cells was examined by bright-field microscopic imaging. Hallmarks of apoptosis including nucleus characteristics and caspase 3 activation were analyzed by fluorescence imaging. The underline mechanisms of apoptosis and proliferation inhibition were accessed via RT-qPCR examination of involved genes.

Results

Our findings showed that the ethyl acetate extract of romdoul fruit (SA-EA) was found to be an exceptional anti-leukemic candidate (IC50 was as low as 4.11 μg/mL). More interestingly, the treated HL60 cells expressed nuclear fragmentation and caspase 3 activation, indicating the effect could follow an apoptotic mechanism. Importantly, the transcription assessment of apoptotic and proliferative genes suggested that SA-EA might suppress the growth of HL60 cells and induce p21-dependent apoptotic pathway.

Conclusion

This study demonstrated one of the first scientific evidence for the anti-cancer activity of Sphaerocoryne affinis fruit-derived extract. Thus, our findings exhibited a novel and promising anti-leukemic candidate for future studies.
Examining Cultural Identity in Secondary Music Classrooms: Perceptions of Teachers and Students
Authors: Song Christopher
Published: October 2024

The purpose of this study was to explore the perceptions of secondary-level music teachers and students when teachers implemented cultural identity affirming activities for their culturally diverse students. The method of this qualitative study was a phenomenological interview design. Teachers ( n = 2) and students ( n = 6) were selected from a racially diverse suburban area in the southern United States. Participants recounted their past and present musical and cultural backgrounds to provide insight into how these identities are represented in their music classrooms. Data were collected an in-depth interview series where “meaning-making” was studied through recounting the lived human experience. Interview transcripts were analyzed to understand how participants aimed to respect cultural identities in the music classroom, while also identifying any power imbalances that could hinder these efforts. Findings revealed that teachers’ own cultural background affected their pedagogical decisions and how they provided culturally responsive music experiences for their students. Students shared the kinds of musical experiences they expected in their music classroom and how their cultural identities were being acknowledged in their music experiences. Students recognized culturally responsive environments when student input in programmed music was respected, community was built through acknowledgment of each other’s cultures, and when open discussion about one another’s cultures occurred.
Long-term 3-year follow-up of mosunetuzumab in relapsed or refractory follicular lymphoma after ≥2 prior therapies
Authors: Sehn Laurie H. , Bartlett Nancy L. , Matasar Matthew J. , Schuster Stephen J. , Assouline Sarit E. , Giri Pratyush , Kuruvilla John , Shadman Mazyar , Cheah Chan Yoon , Dietrich Sascha , Fay Keith , Ku Matthew , Nastoupil Loretta J. , Wei Michael C. , Yin Shen , To Iris , Kaufman Derrick , Kwan Antonia , Penuel Elicia , Bolen Christopher R. , Budde Lihua E.
Published: October 2024

Mosunetuzumab, a CD20×CD3 T-cell engaging bispecific antibody, redirects T cells to eliminate malignant B cells. We present updated efficacy and safety data of a pivotal phase 1/2 study after a median follow-up of 37.4 months in 90 patients with relapsed/refractory (R/R) follicular lymphoma (FL) and ≥2 prior lines of therapy treated with fixed-duration mosunetuzumab. Investigator-assessed complete response (CR) rate and objective response rate were 60.0% (95% confidence interval [CI], 49.1-70.2) and 77.8% (95% CI, 67.8-85.9), respectively. Among 70 responders, median duration of response was 35.9 months (95% CI, 20.7 to not estimable [NE]). Among 54 patients who achieved CR, 49 remained in CR at the end of treatment; median duration of CR was not reached (NR; 95% CI, 33.0 to NE); Kaplan-Meier-estimated 30-month remission rate was 72.4% (95% CI, 59.2-85.6). Estimated 36-month overall survival (OS) rate was 82.4% (95% CI, 73.8-91.0); median OS was NR (95% CI, NE to NE). Median progression-free survival was 24.0 months (95% CI, 12.0 to NE). Median time to CD19+ B-cell recovery was 18.4 months (95% CI, 12.8-25.0) after 8 cycles of mosunetuzumab treatment. No new cytokine release syndrome events or fatal, serious, or grade ≥3 adverse events were reported. With extended follow-up, mosunetuzumab demonstrated high response rates, durable remissions, and manageable safety with no long-term concerns. This supports outpatient mosunetuzumab administration as an off-the-shelf, fixed-duration, safe, and effective treatment for patients with R/R FL, including those with high-risk disease. This trial was registered at www.clinicaltrials.gov as #NCT02500407.
Compressive Mechanical and Heat Conduction Properties of AlSi10Mg Gradient Metamaterials Fabricated via Laser Powder Bed Fusion
Authors: Sun Qidong , Zhi Geng , Zhou Sheng , Tao Ran , Qi Junfeng
Published: October 2024

Metamaterials are defined as artificially designed micro-architectures with unusual physical properties, including optical, electromagnetic, mechanical, and thermal characteristics. This study investigates the compressive mechanical and heat transfer properties of AlSi10Mg gradient metamaterials fabricated by Laser Powder Bed Fusion (LPBF). The morphology of the AlSi10Mg metamaterials was examined using an ultrahigh-resolution microscope. Quasi-static uniaxial compression tests were conducted at room temperature, with deformation behavior captured through camera recordings. The findings indicate that the proposed gradient metamaterial exhibits superior compressive strength properties and energy absorption capacity. The Gradient-SplitP structure demonstrated better compressive performance compared to other strut-based structures, including Gradient-Gyroid and Gradient-Lidinoid structures. With an apparent density of 0.796, the Gradient-SplitP structure exhibited an outstanding energy absorption capacity, reaching an impressive 23.57 MJ/m3. In addition, heat conductivity tests were performed to assess the thermal resistance of these structures with different cell configurations. The gradient metamaterials exhibited higher thermal resistance and lower thermal conductivity. Consequently, the designed gradient metamaterials can be considered valuable in various applications, such as thermal management, load-bearing, and energy absorption components.
LLpowershap: logistic loss-based automated Shapley values feature selection method
Authors: Madakkatel Iqbal , Hyppönen Elina
Published: October 2024

Background

Shapley values have been used extensively in machine learning, not only to explain black box machine learning models, but among other tasks, also to conduct model debugging, sensitivity and fairness analyses and to select important features for robust modelling and for further follow-up analyses. Shapley values satisfy certain axioms that promote fairness in distributing contributions of features toward prediction or reducing error, after accounting for non-linear relationships and interactions when complex machine learning models are employed. Recently, feature selection methods using predictive Shapley values and p-values have been introduced, including powershap.

Methods

We present a novel feature selection method, LLpowershap, that takes forward these recent advances by employing loss-based Shapley values to identify informative features with minimal noise among the selected sets of features. We also enhance the calculation of p-values and power to identify informative features and to estimate number of iterations of model development and testing.

Results

Our simulation results show that LLpowershap not only identifies higher number of informative features but outputs fewer noise features compared to other state-of-the-art feature selection methods. Benchmarking results on four real-world datasets demonstrate higher or comparable predictive performance of LLpowershap compared to other Shapley based wrapper methods, or filter methods. LLpowershap is also ranked the best in mean ranking among the seven feature selection methods tested on the benchmark datasets.

Conclusion

Our results demonstrate that LLpowershap is a viable wrapper feature selection method that can be used for feature selection in large biomedical datasets and other settings.
Successful ability to stay at home - an interview study exploring multiple diagnosed older persons and their relatives’ experiences
Authors: Gustafsson Lena-Karin , Bondesson Anna , Pettersson Tina , Östlund Gunnel
Published: October 2024

Background

Society places increased demands on regions and municipalities to jointly carry out activities for multi-diagnosed older persons with extensive coordination needs. Interprofessional collaboration is reported as an important success factor for the overall health care of this group of patients. This project focuses on older persons with multiple diagnoses and their relatives’ own experiences of what is most important for safety and security in their homes. The aim of the study was: to illuminate the meaning of success for the ability to stay at home as experienced by older persons with multiple diagnoses and their relatives.

Methods

The project had a descriptive explorative design with a phenomenological hermeneutic approach based on analysis of 14 in-depth interviews with older people and their relatives.

Findings

Own resources were identified such as belief in the future, spiritual belief, social network, having loved ones and pets. Technical aids were seen as helpful resources, working as indoor and outdoor security safeguards. These resources included having good telephone contact with social and professional networks as well as other forms of personal equipment such as a personal alarm. The professional network was a resource, acting as support when the patient’s own abilities were not sufficient. Finally, having personnel who had the time and interest to listen was seen as crucial to experience safety.

Conclusions

The main reason for being able to continue homecare was the person’s self-care system, their personal, social, and technical resources. Professional care development should anchor team work to the patient’s own system of self and informal care.
A conceptual health state diagram for modelling the transmission of a (re)emerging infectious respiratory disease in a human population
Authors: Avramov Marc , Gabriele-Rivet Vanessa , Milwid Rachael M. , Ng Victoria , Ogden Nicholas H. , Hongoh Valerie
Published: October 2024

Mathematical modelling of (re)emerging infectious respiratory diseases among humans poses multiple challenges for modellers, which can arise as a result of limited data and surveillance, uncertainty in the natural history of the disease, as well as public health and individual responses to outbreaks. Here, we propose a COVID-19-inspired health state diagram (HSD) to serve as a foundational framework for conceptualising the modelling process for (re)emerging respiratory diseases, and public health responses, in the early stages of their emergence. The HSD aims to serve as a starting point for reflection on the structure and parameterisation of a transmission model to assess the impact of the (re)emerging disease and the capacity of public health interventions to control transmission. We also explore the adaptability of the HSD to different (re)emerging diseases using the characteristics of three respiratory diseases of historical public health importance. We outline key questions to contemplate when applying and adapting this HSD to (re)emerging infectious diseases and provide reflections on adapting the framework for public health-related interventions.
Longitudinal assessment of the impact of prevalent diabetes on hospital admissions and mortality in the general population: a prospective population-based study with 19 years of follow-up
Authors: Johansson Madeleine , Åkesson Anna , Nilsson Peter M. , Melander Olle
Published: October 2024

Background

Hospitalization indicates the presence of severe disease and constitutes a leading cost in health care. We aimed to prospectively assess if prevalent diabetes mellitus contributes to excess all-cause and cause-specific hospital admissions and mortality at the population level.

Methods

We used a Swedish prospective population-based cohort, including 25,642 individuals of whom 4.2% had prevalent diabetes at baseline (mean age 61.2 ± 6.8 years, age range 44.8–73.4 years). We compared the number of hospitalizations and mortality classified according to the main chapters of the 10th revision of the International Classification of Diseases (ICD-10) during follow-up using nationwide inpatient registries, comparing individuals with and without prevalent diabetes, using multivariate adjusted negative binomial regression (incidence rate ratio, IRR) and Cox regression, respectively.

Results

During a median follow-up of 19 years, 18,904 subjects were hospitalized at least once [median 3 (IQR 2–6)] and 6767 (26.4%) individuals died. Overall, subjects with diabetes were hospitalized (IRR 1.83, p < 0.001) more often, and had a higher incidence rate of hospital admissions due to endocrine diseases (IRR 14.6, p < 0.001), dermatological diseases (IRR 3.7, p < 0.001), injuries and poisoning (IRR 2.7, p < 0.001), infectious diseases (IRR 2.5, p < 0.001), psychiatric diseases (IRR 2.0, p < 0.001), but also cardiovascular, hematological, genitourinary, neurologic and respiratory diseases compared with non-diabetic individuals. No difference was observed for hospital admissions due to cancer or musculoskeletal disorders. All-cause mortality was higher (HR 1.77, p < 0.001) in individuals with diabetes, with disease-specific mortality being significant only for cardiovascular and endocrine disease-related death.

Conclusions

At the population level, prevalent diabetes increased the hospitalization burden longitudinally due to diseases of most of the ICD-10 main chapters, except for cancer and musculoskeletal disorders. These novel findings challenge the current view on the spectrum of prevalent diabetes-related conditions and may have implications for screening and treatment strategies in diabetes.

Permission of graphical illustrations

Source: Pixabay.com. No permission or acknowledgement is required.
Comparative evaluation of surface roughness and bacterial adhesion on two bioactive cements: an in-vitro study
Authors: Dey Pallabi , Suprabha Baranya Shrikrishna , Suman Ethel , Natarajan Srikant , Shenoy Ramya , Rao Arathi
Published: October 2024

Background

Dental restorative materials are recognized as artificial niches that facilitate the adherence and accumulation of oral microorganisms. To mitigate oral diseases and extend the lifespan of restorations, it is advantageous to use dental materials that exhibit low susceptibility to bacterial adhesion.

Objective

To evaluate and compare bacterial adhesion on two bioactive restorative materials, a glass hybrid restorative, and an alkasite with a nanohybrid resin composite as a positive control. The secondary objectives were to compare the surface roughness (SR) of the materials and determine the correlation between the bacterial adhesion and the SR.

Materials and methods

The samples consisted of 33 polished discs of each material: Group A: Tetric® N-Ceram (nanohybrid resin composite), Group B: Equia Forte™ HT Fil (glass hybrid restorative) and Group C: Cention N® (alkasite). Streptococcus mutans cultures were inoculated and after 24-hours of incubation, bacterial adhesion was measured by measuring optical density (OD) and number of colony forming units (CFUs). After 96-hours incubation, the bacterial cell count was determined using scanning electron microscopy (SEM). SR was assessed using surface profilometer.

Results

Alkasite had significantly lower OD and CFUs (p < 0.001 and p = 0.015 respectively). According to the SEM analysis, the glass hybrid restorative had lower mean bacterial cell count with no significant difference between the groups. The nanohybrid composite had the smoothest surface that was significantly lower than the alkasite and glass hybrid restorative (p = 0.002). None of the groups demonstrated a correlation between bacterial adhesion and SR.

Conclusion

Alkasite impedes bacterial adhesion better than the glass hybrid restorative and nanohybrid composite, while smoother surfaces are achieved with the nanohybrid composite.
Registrars as teachers: a qualitative study exploring the experiences of Australian general practice registrars in teaching roles
Authors: Fisher Katie , Patsan Irena , Klein Linda , Turner Alexandria , Runciman Dave , Fielding Alison , Tran Michael , Pond Dimity , Guppy Michelle , Starling Chris , D’Amore Angelo , Davey Andrew , Magin Parker
Published: October 2024

Background

GP registrars (specialist vocational trainees in general practice) are interested in teaching, and there are considerable benefits to teaching during training. There are, however, significant barriers for registrars as teachers, including inadequate funding, time pressures, and limited teacher training. Current evidence does not include medical educator (ME) perspectives or compare teaching settings (e.g. university vs. in-practice). Further evidence is needed to inform programs supporting registrar teaching roles.

This project aimed to explore the experiences of Australian GP registrars as teachers in different contexts and from multiple stakeholder perspectives.

Methods

A qualitative study with GP registrars, GP supervisors, MEs, and medical students was conducted. Participants were registrars and new (within 12 months) Fellows with teaching experience during training, supervisors who supervised a registrar in the preceding 12 months, Royal Australian College of General Practitioner MEs, and medical students with experiences of being taught by registrars. Recruitment was open to participants nationwide and sampling was purposive, aiming for a maximum variation sample. Data collection was performed via videoconference and analysed using reflexive thematic analysis.

Findings

Interviews were conducted with 15 registrars, 10 supervisors, and one ME. Two focus groups involved four MEs and five medical students respectively. Registrar participants taught in a variety of settings, including in-practice, universities, hospitals, and at educational workshop days. Three had experience in GP academic posts and one as a registrar ME. There were four major themes. 1) Near-peer teaching by registrars is valuable - both for medical students and registrars. 2) Teaching makes you a better GP - participants noted the transferability of teaching skills to clinical practice. 3) The importance of the teaching context
– this was identified as an important determinant for registrars in teaching roles. 4) Registrar teaching strengthens the GP workforce – participants noted that teaching could elevate general practice as a specialty and increase interest in GP training.

Conclusions

Study participants saw teaching as a core skill for GPs, with transferability to their clinical practice. Registrar participants wanted greater promotion and support for teaching opportunities that counted towards attainment of Fellowship. These findings have implications for teaching practices, MEs, universities, and training providers.