bluuebunny/crossref_metadata_2025 huggingface dataset:
Delayed Cortical Responses During Reactive Balance After Stroke Associated With Slower Kinetics and Clinical Balance Dysfunction
Authors: Palmer Jacqueline A. , Payne Aiden M. , Mirdamadi Jasmine L. , Ting Lena H. , Borich Michael R.
Published: September 2024

Background

Slowed balance and mobility after stroke have been well-characterized. Yet the effects of unilateral cortical lesions on whole-body neuromechanical control is poorly understood, despite increased reliance on cortical resources for balance and mobility with aging. Objective. We tested whether individuals post stroke show impaired cortical responses evoked during reactive balance, and the effect of asymmetrical interlimb contributions to balance recovery and the evoked cortical response.

Methods

Using electroencephalography, we assessed cortical N1 responses evoked over fronto-midline regions (Cz) during backward support-surface perturbations loading both legs and posterior-lateral directions that preferentially load the paretic or nonparetic leg in individuals’ post-stroke and age-matched controls. We tested relationships between cortical responses and clinical balance/mobility function, as well as to center of pressure (CoP) rate of rise (RoR) during balance recovery.

Results

Cortical N1 responses were smaller and delayed after stroke ( P < .047), regardless of perturbation condition. In contrast to controls, slower cortical response latencies associated with lower clinical function in stroke (Mini Balance Evaluation Systems Test: r = −.61, P = .007; Timed-Up-and-Go: r = .53, P = .024; walking speed: r = −.46, P = .055). Paretic-loaded balance recovery revealed slower CoP RoR ( P = .012) that was associated with delayed cortical response latencies ( r = −.70, P = .003); these relationships were not present during bilateral and nonparetic-loaded conditions, nor in the older adults control group.

Conclusions

Individuals after stroke may be limited in their balance ability by the slowed speed of their cortical responses to destabilization. In particular, paretic leg loading may reveal cortical response impairments that reflect reduced paretic motor capacity.
Public Perspectives on Consent for and Governance of Biobanking in Japan
Authors: Oikawa Masanori , Takimoto Yoshiyuki
Published: September 2024

Through strengthened biobank governance, broad consent has been widely accepted as a means to replace donors’ discretion based on the information of individual research protocols. Trust and other ethical and social notions, such as reciprocity and solidarity, are key concepts that support biobank governance. The types of allowed broad consent are several; however, they remain unclear, and whether these ethical and social notions are associated with public attitudes toward the consent model is not fully understood. This quantitative study examined two hypotheses: narrower and limited broad consent are more accepted by the public, and acceptance rates for broad consent increase with established measures related to biobank governance. This analysis supported both hypotheses, implying that the limited type of broad consent should be considered an important option, and that a specific type of governance is critical in promoting trust, reciprocity, and solidarity between biobanks and the public.
Memory benefits of daily-living-related contextual cueing for individuals with subjective cognitive decline and mild cognitive impairment
Authors: Liu Chien-hsiou , Li Kuan-yi , Liao Wan-wen , Chuang I-ching , Huang Yan-hua , Wu Ching-yi
Published: September 2024

Objective

We aimed to assess how daily-living-related contextual cueing (DLCC) affects memory performance in three groups: healthy older adults (HA), those with subjective cognitive decline (SCD), and mild cognitive impairment (MCI), while accounting for age and education.

Methods

After gathering demographic information, participants underwent neuropsychological assessments including the Montreal Cognitive Assessment (MoCA), Everyday Cognition Scale (ECog-12), Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and Trail Making Test (TMT) to establish baseline characteristics. Participants were categorized into HA ( N = 47), SCD ( N = 54), and MCI ( N = 43) groups based on MoCA and ECog-12 scores. Memory performance was evaluated through two components of the Contextual Memory Test (CMT): one with non-contextual cues and the other with daily-living-related contextual cues.

Results

Interaction effects between contextual cueing and group for immediate recall ( p < .001), delayed recall ( p < .001), and total recall ( p < .001) were found. All recall scores were lower in the MCI group than in the other two groups in the contextual cueing, not non-contextual. The post-hoc results revealed that scores on immediate recall, delayed recall, and total recall were lower in the MCI group than in the other two groups in the contextual cueing condition but not in the non-contextual cueing one.

Conclusions

Daily-living-related contextual cueing benefited HA, SCD, and younger-adult MCI groups more than older-adult MCI group, particularly enhancing delayed and total memory performance.
Arterial spin labeling detects trapped labeled spins in flow-diverted aneurysms and it reflects intra-aneurysmal flow stasis
Authors: Oki Tatsuya , Tsuji Atsushi , Ishida Shota , Matsubayashi Jun , Yoshida Kazumichi , Watanabe Yoshiyuki
Published: September 2024

Background

This study evaluated arterial spin labeling (ASL) imaging findings in flow-diverted aneurysms (FD-ANs).

Methods

Twenty-one patients with internal carotid artery aneurysms treated with flow-diverter stent (FDS) were included. Time-of-flight magnetic resonance angiography (TOF-MRA) and ASL were performed before and after follow-up digital subtraction angiography (DSA) on the day, 6 months, and/or 1 year after treatment. Two radiologists rated the clarity of the depiction of FD-ANs for MRA on a 3-point scale and the ASL signal intensity of the aneurysm as negative or positive. A neurosurgeon assessed DSA findings using the O’Kelly–Marotta (OKM) grading scale, categorizing them into filling and stasis grades. The 23 examinations were classified according to the OKM grading scale, and the proportion of ASL-positive cases and the proportion of cases with MRA scores of 1–2 (detectable) were calculated for each grade. The relationship between the OKM grading scale and ASL positivity or MRA detectable was examined using Fisher's exact test.

Results

Of seven examinations where the statis grade was 1 or 2, no examinations showed ASL positivity. However, among the 16 examinations in which the stasis grade was 3, 9 examinations showed ASL positivity. A significant association was observed between stasis grade and ASL positivity ( p = 0.035). In contrast, no significant relationship was observed between the OKM grading scale and the MRA 3-point scale.

Conclusion

High-signal ASL in FD-ANs could reflect stasis within the aneurysm; therefore, noninvasive ASL can indicate reduction in intra-aneurysmal blood flow after treatment and reperfusion during posttreatment observation.
pRESET thrombectomy device outcomes in patients with acute ischemic stroke: A systematic review and meta-analysis
Authors: Hamouda Abdelrahman M , Cwajna Mark , Kobeissi Hassan , Kendall Nicholas , Elgazzar Tasnim , Ghozy Sherief , Brinjikji Waleed , Kallmes David F
Published: September 2024

Background

Many devices are used to perform mechanical thrombectomy in the setting of large vessel occlusion acute ischemic stroke. We sought to evaluate the efficacy and safety of pRESET stent-retriever systems.

Methods

We conducted a comprehensive systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies up to March 2024 were retrieved from PubMed, Scopus, Web of Science, and Embase databases.

Results

A total of 8 papers met the inclusion/exclusion criteria comprising a total of 1140 participants (average age 72.4 ± 11.9, female percentage (50%). Preintervention intravenous thrombolysis was utilized in 46.5% (range 32.9–65.4) of patients, with a median National Institute of Health Stroke Scale at presentation of 15 (range 0–38). The middle cerebral artery was the most commonly affected artery, with a prevalence of 76.4% (range 62.8–100). The pRESET stent-retriever systems demonstrated a first-passing effect rate of 53.4% [95% confidence interval [CI] 44.8; 61.7] and a final thrombolysis in cerebral infarction 2b-3 grade rate of 90.41% [95% CI 82.13; 95.08]. Ninety-day modified Rankin Scale (0–2) rate was 42.2% [95% CI 27.6; 58.4], and 90-day mortality rate was 15.1% [95% CI 9.8; 22.6]. Postintervention hemorrhage occurred at a rate of 28.6% [CI 17.2; 43.6].

Conclusion

Our systematic review and meta-analysis describes the efficacy of the pRESET stent retriever system in managing acute ischemic stroke patients. The pRESET device was found to have a similar safety and efficacy profile to other mechanical thrombectomy devices currently in use.
A Mixed Methods, Cluster-Randomised Study Protocol to Design and Test WhatsApp Group-Based HIV Microlearning for Rural South African Healthcare Workers
Authors: Chisholm Briony Sue , Blockman Marc , Orrell Catherine Jane
Published: September 2024

Treatment of HIV in South Africa is informed by national guidelines, which are regularly updated. Ongoing training of healthcare workers is vital for optimal patient care, but is challenging, due to human, financial and infrastructural constraints. There is a need for innovative solutions to meet training and support needs. With 93.2% of South African adults using WhatsApp, it is an ideal platform for training, even in the most remote clinics. The primary aim of the study is to design, test and evaluate the effect of WhatsApp group-based HIV training on nurses’ and community health workers’ knowledge. The secondary aims are to assess uptake, acceptability, and feasibility of the intervention; and to explore and describe the changes in prescribing, comparing the intervention group to the control group. A pragmatic, mixed-methods, parallel-group cluster-randomised study design will be used. This paper details the design – and rationale behind it – of the study. A critical realist stance was chosen, with outcomes measured using questionnaires, pre- and post-intervention; WhatsApp group interaction; focus groups; and folder reviews. Inferential analysis will be conducted using Stata, descriptive analysis using Excel™ and qualitative data using template analysis with NVivo™. Rigor of the study will be ensured using relevant points from the CASP and COREQ checklists, considering the study’s theoretical underpinning, design and aims. Reporting will be guided by the CONSORT and SRQR guidelines.
Acute postoperative complications after spine deformity correction in patients with Down syndrome
Authors: Bonnyman Claire W , Klinkerman Lydia N , Ramo Brandon A , Johnson Megan E
Published: September 2024

Introduction:

Down syndrome, or trisomy 21, is the most diagnosed chromosomal abnormality and is associated with multiple orthopedic concerns, including scoliosis. We sought to examine the surgical treatment of scoliosis associated with Down syndrome with an emphasis on specific complications in this population.

Methods:

A retrospective review of 13 patients with Down syndrome who underwent surgical intervention for spinal deformity between 2000 and 2018 were identified. Postoperative complications were classified using the modified Clavien-Dindo-Sink system. Perioperative and final follow-up radiographic data were analyzed.

Results:

The mean age at surgery was 14.2 years (11–19) with a mean follow-up of 3.6 years (0.4–6.2) at the time of data collection. Seven (54%) patients had postoperative complications, all related to wound healing. Three patients (23%) had major complications (Clavien-Dindo-Sink grade ≥3). These included one deep surgical site infection, one hematoma, and one seroma, all requiring surgical drainage. Four additional patients (31%) had minor complications (Clavien-Dindo-Sink grade ≤2).

Discussion:

Surgical intervention for scoliosis in patients with Down syndrome is associated with high complication rates despite the use of more modern surgical techniques and implant types. Complications in this cohort primarily involved wound healing, whereas previous studies described high rates of postoperative implant failure, pseudoarthrosis, and significant curve progression, which were not experienced by the patients in this study. Although the etiology of wound-related complications is unknown, awareness of this risk may help surgeons optimize surgical technique, postoperative monitoring, and preoperative counseling of families.

Level of Evidence:

IV—single-institution retrospective case series.
Unraveling a Political Technology: Free, Prior, and Informed Consent in Peruvian Oil and Mining Sectors
Authors: Merino Roger
Published: September 2024

The worldwide dissemination of the right to free, prior, and informed consent (FPIC) has fostered discussions about its significance for removing the social exclusion of indigenous peoples. Most studies address problems in the regulation and implementation of FPIC, but less attention is paid to how the strengths and weaknesses of indigenous organizations and their different political engagements influence FPIC processes and outcomes. Based on the analysis of consultation agreements in the mining and oil sectors in Peru (2011–2022) and the evaluation of two case studies, this article explains how FPIC might be a tool for indigenous politics and state governance.
The efficacy and safety of third-party umbilical blood/umbilical cord mesenchymal stem cell assisted related haploid hematopoietic stem cell transplantation in pediatric patients with acute leukemia: an observational study
Authors: Liu Chang , Liu Minyuan , Liu Xin , Li Bohan , Gao Li , Wu Shuiyan , Ji Qi , Zhang Zhiqi , Zhang Senlin , Xiao Peifang , Lu Jun , Li Jie , Hu Shaoyan
Published: September 2024

Background:

There is limited data on third-party umbilical cord blood (UCB) or mesenchymal stem cell (MSC) transplantation-assisted haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in pediatric patients.

Objective:

To evaluate the efficacy and safety of UCB and MSC transplantation-assisted haplo-HSCT in pediatric patients with acute leukemia (AL).

Design:

Observational study.

Methods:

Clinical data of 152 children with AL undergoing haplo-HSCT at the Children’s Hospital of Soochow University between January 2020 and June 2022 were collected. The patients were divided into the haplo-HSCT + UCB group ( n = 76), haplo-HSCT + MSC group ( n = 31), and haplo-HSCT group ( n = 45). Hematopoietic reconstruction time, complications within 30 days after transplantation, and survival and recurrence at 3 years after transplantation were compared among the groups.

Results:

Multivariate analysis revealed that haplo-HSCT with MSC and human leukocyte antigen (HLA) matching ⩾6/10 were independent factors reducing engraftment syndrome (ES) incidence. There were no significant differences among the groups in the hematopoietic reconstruction time or incidence of complications within 30 days after transplantation ( p > 0.05). Overall survival, relapse-free survival, cumulative incidence of relapse, cumulative incidence of hematological relapse, and 3-year transplant-related mortality were not significantly different ( p > 0.05). The incidence of adverse reactions in the haplo-HSCT + UCB group was 97.3% within 4 h after UCB infusion, with a particularly high occurrence rate of 94.7% for hypertension. No transfusion-related adverse reactions occurred after the transfusion of umbilical cord MSC in the haplo-HSCT + MSC group.

Conclusion:

MSC-assisted haplo-HSCT can reduce ES incidence after transplantation in pediatric patients with AL. UCB infusion is associated with a high incidence of reversible hypertension. However, no adverse reactions were observed in umbilical cord MSC transfusion.
Management of isolated native tricuspid valve infective endocarditis by a multidisciplinary program: a single-center retrospective cohort study
Authors: Collis Bennett , Alnabelsi Talal , Hall Evan , Cao Chloe , Johnson Meredith , Gurley John , Strnad Luke , Reda Hassan , London Tessa , Ogburn Erinn , Sekela Michael , Stoner Bobbi Jo , El-Dalati Sami
Published: September 2024

Background:

Isolated native tricuspid valve infective endocarditis remains a challenging disease to treat given the large number of patients with substance use disorder. There is limited data on the optimal treatment strategy and the impact of a multidisciplinary endocarditis program on outcomes for this population.

Objectives:

To assess the clinical outcomes associated with management of native tricuspid valve infective endocarditis by a multidisciplinary team.

Design:

Single-center, retrospective cohort study.

Methods:

Patient cases were identified from the registry of the institutional multidisciplinary endocarditis team. Patients with left-sided endocarditis, multivalvular endocarditis, prosthetic tricuspid valves and cardiac implantable electronic devices were excluded.

Results:

Between September 7th, 2021 and February 1st, 2024 72 consecutive patients with isolated native tricuspid valve infective endocarditis were identified. Sixty-six (91.7%) patients were managed medically. Five patients underwent percutaneous mechanical aspiration of tricuspid valve vegetations and one patient underwent tricuspid valve replacement during the index hospitalization. In-hospital mortality was 1.4% and 90-day mortality was 2.8%. Nineteen (26.4%) patients discharged before medically advised and 25% were re-admitted within 30 days. Ten (13.9%) patients underwent elective tricuspid valve replacements after outpatient follow-up.

Conclusion:

Among 72 patients with isolated native tricuspid valve infective endocarditis managed by a multidisciplinary endocarditis program over a 2.5-year period, in-hospital, 90-day mortality and 1-year mortality were very low despite low rates of percutaneous mechanical aspiration and tricuspid valve surgery. Multidisciplinary follow-up can lead to elective tricuspid valve surgery in a delayed fashion.
Multiple fractures of the femur: Case report, literature review, and proposal for a shared algorithm of treatment
Authors: Sessa Pasquale , Galluzzo Michele , Leone Edoardo , Antonio Maria Schirò , Giannicola Giuseppe
Published: September 2024

Multiple fractures of the femur, defined for the purposes of this study as the association of three or more non-contiguous fractures on the same bone segment, is an exceedingly rare condition with an unknown incidence in the literature. A limited number of studies, mainly consisting of case reports or small case series, have addressed this topic, and no shared consensus or guidelines exist on what the ideal timing and sequence of multiple fracture fixation is. The present paper reports the clinical case of a 36 years old man who sustained a blunt chest injury, a non-concussive head injury, a displaced intracapsular fracture of the left femur (AO 31B2), a left diaphyseal multifragmentary fracture (AO 32B3), a supradiacondylar fracture of the distal end of the left femur (AO 33C1.1), a Hoffa fracture of the lateral left femoral condyle (AO 33B3.2 f), and a multifragmentary fracture of the left patella with bone loss (AO 34C3) due to a vehicular high-energy trauma. The patient was surgically treated by open reduction and internal fixation according to a proposed algorithm of treatment and reported excellent clinical and radiological outcomes at 32 months follow-up. The primary aim of this study is to describe our experience in the treatment of such complex fractures, by presenting our clinical and radiological results, and to propose a treatment algorithm. The secondary aim is to provide a comprehensive review of the literature on this topic.
Food accessibility: A lived experience perspective of college students living away from parents’ home
Authors: Garcia Karine , Rodhain Angelique , Gourmelen Andrea , Masson Josselin
Published: September 2024

This article aims to examine food accessibility for college students who moved away from their parents’ home, focusing on both objective and perceived perspectives. It considers all the food options surrounding them in the city where they lived for their studies. Using a qualitative methodology based on interviews with 24 students living away from their parents’ home, local stakeholders, heads of university organizations, and field observations, this research shows a gap between objective accessibility (OA) and perceived accessibility (PA) of the supply of food shops, whereas a greater convergence is observed for offers of meals taken away from home. The results show that food options that are available close to where college students live (study, home, commute) are not often included in their set of consideration. Furthermore, they experience conflicts between the three dimensions of PA (price, distance, and cognitive). College students react to these conflicts with different coping strategies depending on their level of food and urban literacy. To improve food accessibility, it is necessary to adopt an integrated approach according to the types of literacy.
Smartwatch measurement of blood oxygen saturation for predicting acute mountain sickness: Diagnostic accuracy and reliability
Authors: Zeng Zhengyang , Li Lili , Hu Li’ao , Wang Kang , Li Lun
Published: September 2024

Objective

This study aims to assess the accuracy and stability of smartwatches in predicting acute mountain sickness (AMS).

Methods

In locations exceeding an altitude of 2500 m, a cohort of 42 subjects had their Lake Louise AMS self-assessment score, blood oxygen saturation (SpO2), heart rate, and perfusion index measured using smartwatches, with the data seamlessly conveyed to the Huawei Cloud.

Results

A significant decrease in SpO2 was observed in individuals positive for AMS compared to those negative ( p < 0.05), with the mild AMS group exhibiting significantly lower SpO2 levels than the non-AMS group ( p < 0.05). Furthermore, SpO2 emerged as a significant, independent predictor of AMS [ β=−0.086, p < 0.01, OR (95% CI) = 0.92 (0.87–0.97)], indicating that each unit increase in SpO2 decreases the probability of AMS occurrence by 8.6%.

Conclusion

The Huawei smartwatches have demonstrated efficacy in diagnosing and foretelling AMS at elevations exceeding 4000 m, showcasing significant reliability and high precision in SpO2 measurement.
Physician Communication Behaviors on Patient Satisfaction in Primary Care Medical Settings in Bangladesh
Authors: Zakaria Muhammad , Mazumder Subarna , Faisal Hasan Mahmud , Zannat Rubaiya , Haque Md Rejaul , Afrin Tanjina , Cheng Feng , Xu Junfang
Published: September 2024

Objectives:

This study aims at exploring the effects of physicians’ communication behaviors on patients’ satisfaction in primary care medical consultations in Chattogram, Bangladesh. The study used a quantitative research approach designed with a cross-sectional survey.

Methods:

Data were collected using post-consultation and facilitator administered questionnaire from the patients who visited the physician for medical consultation in different hospitals and clinics in Chattogram city. Seven hundred patients were included as the study participants. A hierarchical linear regression analysis was performed to examine the factors contributing to the outcome variables.

Results:

A statistically significant difference ( P < .001) appeared regarding patients’ perception of adequate consultation, physicians’ nonverbal behavior, inhibiting behavior and patients’ participating behavior in private and public settings. However, R2 value shows that physicians’ patient-centered behaviors appeared as the stronger predictors of patient satisfaction toward medical interviews, followed by socioeconomic variables of patients and physicians and patients’ participation during the consultation. Presence of a third person with patients during consultation (β = −.05, P = .040), physicians’ private setting of consultation (β = .16, P < .001), physicians’ seniority (β = .05, P = .042), patients’ participating behavior during consultation (β = .20, P < .001), physicians’ nonverbal behavior (β = .10, P < .001), physicians’ inhibiting behavior (β = −.39, P < .001), and physicians’ facilitating behavior with patients (β = .32, P < .001) were reported as the influencing factors of patients’ satisfaction with medical consultation.

Conclusion:

This study suggests the profound impact of physicians’ patient-centered communication behaviors on patient satisfaction in primary care settings, overshadowing even socioeconomic factors and patient participation.
Assessing the Implementation Success of Strategic Information Systems Planning (SISP) in Ghanaian Organizations
Authors: Owusu Acheampong
Published: September 2024

The purpose of this study is to assess the implementation success of strategic information systems planning (SISP) in Ghanaian organizations. The study adopted the qualitative approach and interviewed 20 managers from large organizations in diverse sectors and used content analysis in analyzing the data. The results indicate that the success of SISP depends largely on the Alignment of an organization’s Business Strategy to its IT Strategy, the Awareness of Top Management to utilize SISP in strategic planning, the Cooperation of all the functional units/levels of management in utilizing IS in their operations and the Capabilities of the employees in the firm. Findings further suggest that the available resources of the firms also play a key role in the SISP implementation Success. The study, therefore, concludes that adequate resources in terms of highly skilled manpower, financial resources, and financial commitment must be made available always to ensure SISP implementation success. In addition, policies should be formulated around these factors to ensure SISP implementation success for organizations that embark on SISP implementation.
Spiral Forward: A Knowledge Management Perspective of Chinese Post-merger Autonomy Integration
Authors: Yang Yanan
Published: September 2024

Chinese multinational enterprises (CMNEs) are increasingly initiating risky mergers and acquisitions (M&As) in developed markets to obtain strategic assets, which necessitates long-term integration that often takes years. Drawing on knowledge management literature, this study explores CMNEs’ dynamic post-merger integration (PMI) changes, the role of knowledge, and coevolutionary relationships. Based on 41 conversations concerning five Chinese acquisitions in Germany, this study develops a spiral-forward framework, determining that CMNEs’ PMI changes proceed through three phases of access, adjustment, and growth, moving from autonomy to systemic integration to business integration in a forward spiral with evolving knowledge needs. The efficiency of previous integration and knowledge needs has an influence in the following periods’ degree of integration via balanced integration, over-integration, or delayed integration. This study stresses the crucial role of knowledge types and knowledge processes in CMNEs’ PMI changes, offering a valuable framework for understanding CMNEs’ PMI dynamics and the role of knowledge management.
Proactive Personality and Academic Performance Among Undergraduate Students: The Mediating Role of Psychological Capital
Authors: Ng Lee-Peng , Choong Yuen-Onn , Kuar Lok-Sin , Teoh Sok-Yee
Published: September 2024

The main aim of this study is to examine the mediating effect of psychological capital (PsyCap) on the relationship between proactive personality and academic performance among undergraduates. A quantitative approach with a cross-sectional study was employed. The sample consisted of 390 undergraduate students from Malaysian private universities. Partial Least Square-Structural Equation Modeling was used to confirm the proposed research model and test the hypotheses. Results revealed that proactive personality explained a significant proportion of the variance in PsyCap. Further, PsyCap partially mediated the relationship between proactive personality and academic performance. This study concluded that PsyCap could serve as personal resource to improve students’ academic performance. The findings of this study offer valuable theoretical and practical implications. The university’s management and academic staff need to work together to design effective training interventions and activities that can promote undergraduates’ proactive personality and PsyCap.
The Moderating Effect of Social Networks on Health-Promoting Behaviors Among Korean Older Adults
Authors: Shin Hyewon , Dudley William N. , Hong Minjoo , De Gagne Jennie C.
Published: September 2024

This study is a secondary analysis of data collected in a previous study that consisted of 354 older adults, including 226 living in South Korea and 128 South Korean immigrants living in the United States. The aim of this study was to identify the moderating effects of social networks on health-promoting behaviors among Korean older adults with chronic illnesses. Using moderated mediation analyses, we found that the interaction effect between U.S. residency, the number of chronic illnesses, age, and education level accounted for 25% of the social networks. Our findings highlight the importance of social networks in promoting health behaviors and the need to strengthen social networks to improve the health of Korean older adults with chronic illnesses living in the United States. These results also emphasize the need for distinct approaches to health promotion, as health-promoting behaviors vary based on the number of chronic illnesses and country of residence.
AO Spine-DGOU Osteoporotic Fracture Classification System: Internal Validation by the AO Spine Knowledge Forum Trauma
Authors: Scherer Julian , Joaquim Andrei , Vaccaro Alex , Kanna Rishi , El-Sharkawi Mohammad , Takahata Masahiko , Aly Mohamed M. , Camino-Willhuber Gaston , Spiegl Ulrich , Oner Cumhur , Canseco Jose A. , Yurac Ratko , Benneker Lorin Michael , Popescu Eugen Cezar , Bransford Richard , Chhabra Harvinder Singh , Kandziora Frank , Neva Marko H. , Schnake Klaus John
Published: September 2024

Study Design

Cross-sectional survey.

Objectives

Injury classifications are important tools to identify fracture patterns, guide treatment-decisions and aid to identify optimal treatment plans. The AO Spine-DGOU Osteoporotic Fracture (OF) classification system was developed, and the aim of this study was to assess the reliability of this new classification system.

Methods

23 Members of the AO Spine Knowledge Forum Trauma participated in the validation process. Participants were asked to rate 33 cases according to the OF classification at 2 time points, 4 weeks apart (assessment 1 and 2). The kappa statistic (κ) was calculated to assess inter-observer reliability and intra-rater reproducibility. The gold master key for each case was determined by approval of at least 5 out of 7 members of the DGOU.

Results

A total of 1386 ratings (21 raters) were performed. The overall inter-rater agreement was moderate with a combined kappa statistic for the OF classification of 0.496 in assessment 1 and 0.482 in assessment 2. The combined percentage of correct ratings (compared to gold-standard) in assessment 1 was 71.4% and 67.4% in assessment 2. The average intra-rater reproducibility was substantial (κ = 0.74, median 0.76, range 0.55 to 1.00, SD 0.13) for the assessed fracture types.

Conclusions

The assessed overall inter-rater reliability was moderate and substantial in some instances. The average intra-rater reproducibility is substantial. It seems that appropriate training of the classification system can enhance inter- and intra-rater reliability.
Assessing the Impact of Psychological Readiness on Performance and Symmetry in Functional Testing After ACL Reconstruction in Pediatric and Adolescent Patients
Authors: Mercurio Angela M. , Scott Elizabeth J. , Sugimoto Dai , Christino Melissa A. , Coene Ryan P. , Gossman Emma C. , Cook Danielle L. , Kocher Mininder S. , Kramer Dennis E. , Yen Yi-Meng , Micheli Lyle J. , Milewski Matthew D.
Published: September 2024

Background:

Readiness for return to sports involves both physical and psychological aspects of recovery; however, the relationship between psychological and physical variables after anterior cruciate ligament (ACL) reconstruction (ACLR) is poorly understood.

Hypothesis:

ACLR patients with a higher psychological readiness would demonstrate better functional testing results at 6 months.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Participants were evaluated at 6 months after ACLR with various patient-reported outcome metrics: Hospital for Special Surgery Pediatric Functional Activity Brief Scale, pediatric or adult International Knee Documentation Committee Questionnaire (IKDC), Patient-Reported Outcomes Measurement Information System (PROMIS) - Psychological Stress Experience and ACL - Return to Sport After Injury (ACL-RSI) scale. Functional testing included quadriceps, hamstrings, and gluteal strength testing; Y-balance test; single-leg single hop, crossover hop, and triple hop tests; and timed 6-m hop test. Pearson correlation coefficient and multivariable regression were used to determine associations between the limb symmetry index (LSI) on functional testing and patient-reported outcomes. Those with LSI deficits <20% (better performance) were compared with those with deficits >20% (worse performance).

Results:

A total of 229 participants (89 male, 140 female) with a median age of 17 years (range, 10.3-30.6 years) were enrolled. IKDC had a moderate negative correlation with PROMIS - Psychological Stress Experience ( r = -0.39; 95% CI = -0.49, -0.27; P < .001) and a moderate positive correlation with ACL-RSI ( r = 0.55; 95% CI = 0.46, 0.64; P < .001). A total of 151 patients completed functional testing. ACL-RSI demonstrated a positive correlation with single-hop LSI ( r = 0.21; 95% CI = 0.05, 0.35; P = .01) and timed 6-m hop ( r = 0.28; 95% CI, 0.42; P = .001). When adjusting for sex, age, and graft type, patients who had <20% deficit on the single-hop test scored 16.6 points higher on ACL-RSI ( P = .001), and those with <20% deficit on crossover hop testing scored a mean 13.9 points higher on ACL-RSI ( P = .04)

Conclusion:

Higher psychological readiness for return to sport was associated with better performance and greater symmetry on hop testing 6 months after ACLR, suggesting a potential link between physical and psychological recovery.
Depression and Plasma pTau181 Levels Are Associated with Frailty Status in Hispanic Community-Dwelling Older Women
Authors: Rangel Giselle A. , Tratner Adam E. , Oviedo Diana C. , Villarreal Alcibiades E. , Carreira Maria B. , Rodriguez-Araña Sofia , Flores Millender Eugenia , Xavier Hall Casey , Wong Frank Y. , O’Bryant Sid , Britton Gabrielle B.
Published: September 2024

The population of Hispanic older adults is growing along with the burden of chronic diseases. This cross-sectional study aims to assess the factors associated with frailty among community-dwelling Hispanic women aged ≥60 years ( n = 357) enrolled in the Panama Aging Research Initiative—Health Disparities study of cognitive-functional health of older persons in Panama. Cognitive function was assessed with a neuropsychological test battery. Depression was measured with the Geriatric Depression Scale. Frailty was defined using the Fried criteria and participants were classified as non-frail, pre-frail or frail. A subsample ( n = 281) provided fasting blood samples for quantification of protein biomarkers. Associations were examined using hierarchical multiple linear regressions. 59.4% and 9.0% of participants ( M = 69.2 years, SD = 6.3) were pre-frail and frail, respectively. Having more depression (β = .28, p < .001) was significantly associated with frailty, even after covariate adjustment. Cognitive function was not associated with frailty. Higher pTau181 levels were associated with increased frailty (β = .13, p = .039), whereas higher α2M levels were associated with decreased frailty (β = −.16, p = .004). These findings advance the search for health indicators and biomarkers of frailty and warrant further studies to decrease the burden of frailty among older Hispanic women.
Parental Attitudes and Hesitancy About COVID-19 Vaccination Versus Routine Childhood Vaccination in a Selected Hospital in the United Arab Emirates: A Cross-Sectional Study
Authors: Selvam Vijayalakshmi , Hanson Victoria Funmilayo , Pitre Sneha
Published: September 2024

Background

A complex interplay of social and political influences, cultural and religious beliefs, the availability and interpretation of health and scientific information, individual and population experiences with health systems, and government policies contributes to the anxiety about vaccines and their programs that results in vaccine hesitancy. Vaccine hesitancy is becoming a serious threat to vaccination programs; in 2019, the World Health Organization (WHO) listed it as one of the top ten global health threats. The negative impacts of antivaccination movements are blamed for the major portion of the global resistance to vaccination.

Objective

To evaluate and compare parental attitudes and reluctance regarding routine childhood vaccinations versus COVID-19 vaccines among children in the United Arab Emirates (UAE).

Methods

A study of 102 parents with children admitted to SAQR Hospital in Ras Al Khaimah, UAE, was conducted using a convenience sample approach in a descriptive cross-sectional study. One-on-one interviews were conducted to gather data using the standardized Vaccine Hesitancy Scale (VHS) questionnaire developed by the WHO. Statistical Package for Social Sciences version 25 was used for data analysis.

Results

Vaccine-hesitant respondents are also highly resistant to the required proof of vaccination. A statistically significant difference ( P = .000) was observed between parental reluctance to receive the COVID-19 vaccination and routine childhood vaccination. Parental knowledge of the COVID-19 vaccine hesitancy ( P = .001) and confidence ( P = .000) showed a statistically significant correlation. No significant correlation was observed with sociodemographic factors.

Conclusion

The impact of vaccine hesitancy on herd immunity, social, psychological, and public health strategies to combat vaccine hesitancy was observed in this study with various challenges to overcome in COVID-19 vaccination campaigns. Expanding access to and acceptance of vaccines among parents in low- and middle-income nations, as well as raising vaccination rates among those who express a lack of confidence in vaccines.
Knowledge, Attitudes, and Awareness of Food and Drug Interactions (FDI) Among Nurses on General Medical Wards: A Cross-Sectional Study
Authors: Elajez Reem , Alkhawaja Raja , Kehyayan Vahe , Shukaili Khadija AL , Swallmeh Esmat
Published: September 2024

Background

Food and nutritional supplements can interact with medication and cause drug interaction. Registered nurses play an essential role in patients’ safety related to drug interaction.

Objective

Explore nurses’ knowledge, attitudes, and awareness regarding food–drug interactions (FDIs).

Method

A cross-sectional survey was conducted among nurses working in the general medical wards at Hamad General Hospital (HGH) in Qatar. The survey questionnaire comprised 50 multiple-choice questions, encompassing three key sections: (a) demographic details, (b) assessment of FDIs knowledge, and (c) exploration of beliefs, attitudes, and practices concerning FDIs.

Results

A total of 227 surveys were collected. Nurses’ average score for FDI knowledge across all responses was 20 out of 34 (IQR 16–25). Notably, there were no statistically significant differences in average scores based on respondents’ demographic subgroups. While nurses displayed a high level of knowledge (over 90%) regarding the timing of food and drug intake for proton pump inhibitors, nonsteroidal anti-inflammatory drugs, and thyroid hormones, they exhibited limited awareness of the possible FDIs related to carvedilol and furosemide. Approximately half of the participating nurses (56.4%) rated their FDI knowledge as satisfactory. However, only 42.3% claimed to be always educating patients about FDIs in their daily practice. Two-thirds (67.4%) of respondents believed educating patients about FDIs should primarily fall under the responsibility of pharmacists.

Conclusion

This study highlights the nurses’ knowledge, attitudes, and beliefs of FDIs. Prompt intervention is required to enhance the nurse's awareness and knowledge in this domain which may impact patient care and drug safety.
Health Professionals’ Knowledge, Perceptions, and Attitudes Toward Baby-Led Weaning: Scoping Review
Authors: Sarreira–de-Oliveira P. , Fernandes S. , Ramalho R. , Loureiro F.
Published: September 2024

Introduction

Baby-led weaning (BLW) is a growing method for parents to introduce food to their kids. As advisers who affect the decisions of parents, health practitioners have significant obligations in this regard.

Objective

We aim to identify existing literature on the knowledge, perceptions, and attitudes of health professionals toward BLW.

Methods

We carried out a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. After registering with Open Science Framework, published articles were retrieved from EBSCOhost, PubMed, SciELO, ScienceDirect, Open Grey, and the Portuguese Scientific Open Access Repository. Primary studies with full-text availability in English, Spanish, or Portuguese, and no data publication limitations were included.

Results

The final sample included seven publications conducted in five countries published between 2012 and 2022. Only one study employed a hybrid methodology showing incongruent practices in parents/health professionals on BLW, whereas most studies employed a quantitative approach. Regarding BLW, it is recognized that there is a dearth of evidence, consensus, and advice.

Conclusion

Despite benefits, health professionals hesitate to recommend BLW due to insufficient study and safety concerns, warranting more research. Hence, our scoping review demonstrated that BLW is a scientifically under-researched subject, indicating a significant research gap that must be filled in the future.
Marital Status and Deaths from Alcohol, Drug Overdose, and Suicide in the United States: 2000–2021
Authors: Ruan Hangqing , Gao Melody Ge , Xiong Yajie , Cohen Philip N.
Published: September 2024

This article is the first to explore variations in alcohol, drug overdose, and suicide deaths in the United States by marital status before and after the outbreak of COVID-19 pandemic. Using the Multiple Cause-of-Death file and the American Community Survey (2000–2021), we found the nonmarried exhibit mortality rates 2 to 3 times higher in alcohol and suicide deaths and 4 to 5 times higher in drug-related deaths compared to the married population, net of education. This magnitude of marriage advantage is comparable to educational differences in these deaths. The marriage advantages are more pronounced for males than females (except in suicide, where gender differences are minor) and for White individuals compared to Black and Hispanic individuals. Furthermore, the marriage advantage widened substantially during the COVID-19 pandemic. We advocate for viewing these deaths not only through an economic lens but also as manifestations of “social pathology,” urging consideration within broader societal shifts.
Understandings of Culture: A European Bottom-up Study Using Structural Topic Modeling
Authors: Sirkka Ossi , Walo Simon , Purhonen Semi , Verboord Marc , Janssen Susanne , Bonnet Philippe
Published: September 2024

This exploratory study renders it an open empirical question how ordinary people understand the meaning of culture and what are its sociopolitical implications. Using original survey data from over 11,000 respondents across nine European countries, the study focuses on an open-ended question where the respondents defined the meaning of “culture” in their own words. The open-ended answers are scrutinized by structural topic modeling, which allows for identifying relatively coherent clusters of understandings of culture and their relationships. In addition to examining how these understandings vary across national contexts, the study investigates their variation according to major sociodemographic divisions and sociopolitical and cultural factors in and across the nine European societies through regression methods. The results underscore substantial national variation and social stratification of the understandings of culture and the potential of computational text analysis in open-ended survey research.
Systemic sclerosis and acute heart failure in prosthetic heart valve patients: A retrospective analysis
Authors: Khattar Georges , Wei Chapman , Davis Alanna , Saliba Fares , Aoun Laurence , Mourad Omar , Achkar Michel Al , Rosenberg Angela , Grovu Radu , Bradu Stefan , El-Sayegh Suzanne , Mustafa Ahmad
Published: September 2024

Background:

Acute heart failure in patients with prosthetic heart valves is a complex problem with clinical and therapeutic challenges. Systemic sclerosis is a chronic autoimmune disease frequently associated with valvular abnormalities. The association between systemic sclerosis and acute heart failure in patients with prosthetic heart valves remains understudied.

Methods:

Prosthetic valve patients were extracted from the National Inpatient Sample Database. Baseline patient demographics, comorbidities, and known acute heart failure risk factors were collected from the database using International Classification of Diseases, 10th Revision codes. Patients were subsequently stratified by the diagnosis of systemic sclerosis. The primary outcome was acute heart failure. while secondary outcome included pulmonary outcomes. Univariate and multivariate logistic regression analyses were performed. 1:1 matching was performed to verify our findings.

Results:

Among 188,615 patients, 235 patients had systemic sclerosis. Systemic sclerosis patients had higher rates of acute heart failure relative to non-systemic sclerosis patients (28.5% vs 22.6%). On multivariate analysis, systemic sclerosis was associated with increased acute heart failure (adjusted OR: 1.38 (1.02–1.85), p = 0.036). After matching, systemic sclerosis was still associated with an increased incidence of acute heart failure (OR: 1.94 (1.25–3.03), p = 0.003). On subgroup analysis, patients with CREST syndrome did not show significantly increased acute heart failure (OR: 1.44 (0.84–2.47), p = 0.184). Patients with systemic sclerosis also showed a significantly higher rate of acute respiratory failure compared to non-systemic sclerosis patients (20.9% vs 13.7%, p = 0.001).

Conclusion:

Systemic sclerosis may increase the risk for acute heart failure in patients with prosthetic valves. Closer monitoring for heart failure symptoms should be considered in systemic sclerosis patients with prosthetic valves.
Reply to commentaries
Authors: Toal Gerard
Published: September 2024

The commentaries on my essay reveal the culture of debate on the Russia-Ukraine war. They also provide some evidence for the argument I sought to make. In this response I contextualize the original essay, sharpen its political implications, and engaging the commentaries. I conclude by addressing Ukraine’s seizure of Russian territory which reveals a shifting attitude toward negotiations and territory.