bluuebunny/crossref_metadata_2025 huggingface dataset:
Portable Touchscreen Assessment of Motor Skill: A Registered Report of the Reliability and Validity of EDNA MoTap
Authors: McGuckian Thomas B. , Laracas Jade , Roseboom Nadine , Eichler Sophie , Kardas Szymon , Piantella Stefan , Cole Michael H. , Eldridge Ross , Duckworth Jonathan , Steenbergen Bert , Green Dido , Wilson Peter H.
Published: July 2024

Portable and flexible administration of manual dexterity assessments is necessary to monitor recovery from brain injury and the effects of interventions across clinic and home settings, especially when in-person testing is not possible or convenient. This paper aims to assess the concurrent validity and test–retest reliability of a new suite of touchscreen-based manual dexterity tests (called EDNA™ MoTap) that are designed for portable and efficient administration. A minimum sample of 49 healthy young adults will be conveniently recruited. The EDNA™ MoTap tasks will be assessed for concurrent validity against standardized tools (the Box and Block Test [BBT] and the Purdue Pegboard Test) and for test–retest reliability over a 1- to 2-week interval. Correlation coefficients of r > .6 will indicate acceptable validity, and intraclass correlation coefficient (ICC) values > .75 will indicate acceptable reliability for healthy adults. The sample were primarily right-handed (91%) adults aged 19 and 34 years ( M = 24.93, SD = 4.21, 50% female). The MoTap tasks did not demonstrate acceptable validity, with tasks showing weak-to-moderate associations with the criterion assessments. Some outcomes demonstrated acceptable test–retest reliability; however, this was not consistent. Touchscreen-based assessments of dexterity remain relevant; however, there is a need for further development of the EDNA™ MoTap task administration.
The Impact of Data Suppression Rules on Data Access and Re-Identification Risk in Adoption and Foster Care Analysis and Reporting System Annual Files
Authors: Eiermann Martin
Published: July 2024

One of the most widely used data sources for research on foster care and adoption is the Adoption and Foster Care Analysis and Reporting System (AFCARS). County identifiers in AFCARS are suppressed for all counties with fewer than 1000 cases to prevent the re-identification of vulnerable children, but this also impacts researchers’ ability to study smaller communities and analyze how local environments may affect out-of-home placements. This study uses non-public AFCARS datasets to assess, for the first time, how data suppression rules impact data access and re-identification risk. It compares the long-standing 1000-case threshold against a wide range of potential alternatives and finds substantial data access gains coupled with moderate risk increases for thresholds between 400 and 700. Adopting a 700-case threshold leads to a 50% increase in the number of identifiable counties while also keeping the percentage of fostered children who face an elevated risk of re-identification below 1%. Making data from a substantial number of rural counties available to researchers requires much larger threshold changes, which in turn increases re-identification risks.
Iron and cardiovascular health: A review
Authors: Othon-Martínez Diana , Fernandez-Betances Osiris A. , Málaga-Espinoza Bárbara X. , Torres-Perez Maria E. , Cobos Everardo , Gutierrez-Martinez Cesar
Published: July 2024

Iron is an essential element for the biological processes of living organisms, including the production of crucial oxygen-carrying proteins, formation of heme enzymes, and playing roles in electron transfer and oxidation–reduction reactions. It plays a significant role in various cardiovascular functions, including bioenergetics, electrical activity, and programmed cell death. Minor deficiencies of iron have been found to have negative impact on cardiovascular function in patients with heart failure (HF). The contractility of human cardiomyocytes is impaired by iron deficiency (ID), which results in reduced mitochondrial function and lower energy production, ultimately leading to cardiac function impairment, contributing to significant morbidity and mortality in patients with HF. This review discusses iron homeostasis within the human body, as well as ID pathophysiology and its role in HF. Focusing on therapeutic approaches including iron supplementation and/or repletion in patients with ID and HF, comparing results from recent clinical trials. Intravenous (IV) iron therapy has shown promising results in treating ID in HF patients. Large, randomized trials and meta-analysis, like Ferinject Assessment in patients with ID and chronic HF, AFFIRM-AHF, IRONMAN, and HEART-FID have demonstrated the efficacy of IV iron supplementation with IV ferric carboxymaltose or IV ferric derisomaltose in reducing hospitalizations and improving quality of life in patients with Heart Failure with reduced ejection fraction (HFrEF), New York Heart Association (NYHA) II–III. However, survival and mortality have demonstrated no improvement during acute exacerbations of HF or in outpatient management. The potential benefits of IV iron across the entire HF spectrum and its interaction with other HF therapies remain areas of interest for further research.
Effect of VDR and TLR2 gene variants on the clinical course of patients with COVID-19 disease
Authors: Kuruca Nilufer , Atilla Aynur , Kaya Muhammed Taha , Gokmen Sedat , Nursal Ayse Feyda , Kilic Ozgur , Kuruoglu Tuba , Temocin Fatih , Guvenc Tolga , Yigit Serbulent , Guvenc Dilek
Published: July 2024

The coronavirus disease 2019 (COVID-19) pandemic, which has caused a major global health crisis, primarily targets the upper and lower respiratory tract. But infected individuals may experience different clinical symptoms, ranging from asymptomatic to critical. The vitamin D receptor (VDR) and Toll-like receptor 2 (TLR2) polymorphisms play a role in the immune response. This study aimed to evaluate the effect of VDR Bsml (rs1544410) and TLR2 23bp indel variants on the clinical status of Turkish patients with COVID-19 disease. A total of 312 people, including 106 intensive care unit (ICU) patients, 103 symptomatic hospitalized patients, and 103 healthy controls, were included in the study. The VDR BsmI and TLR2 23bp indel were genotyped using polymerase chain reaction and/or restriction fragment length fraction methods. The VDR BsmI b/b genotype and b allele were higher in symptomatic patients compared to the healthy control group ( p  = 0.035). The VDR BsmI B/B and B/b genotype distribution did not differ between ICU patients and both symptomatic patients and controls ( p  > 0.05). We found that B/B:B/b+b/b and B/B+B/b:b/b were significantly different in symptomatic patients compared to controls ( p = 0.033 and p = 0.041, respectively). The VDR BsmI b/b genotype distribution was found to be lower in deceased patients than in living patients ( p = 0.023). There was no significant difference between the groups in terms of TLR2 23bp indel genotype and allele distribution ( p > 0.05). Our study results suggest that the VDR BsmI b allele may have a role in COVID-19 patients with symptomatic findings. These data need to be repeated in different ethnic and larger sample groups.
Glucagon-like peptide-1 receptor agonist therapy effects on glycemic control and weight in a primary care clinic population
Authors: Palecek Eric J. , Kimzey Margaret M. , Zhang Jingwen , Marsden Justin , Bays Chloe , Moran William P. , Mauldin Patrick D. , Schreiner Andrew D.
Published: July 2024

Glucagon-like peptide-1 receptor agonist (GLP-1a) medications have been shown in randomized controlled trials (RCTs) to have consistent and impressive effectiveness in lowering hemoglobin A1c (HbA1c) and weight, but limited data exist on the efficacy of GLP-1a medications in clinical practice. We studied the association between GLP-1a therapy and changes in weight and HbA1c in a real-world patient population. In this retrospective cohort study of patients seen in a primary care clinic between 2012 and 2021, we examined the change in weight and HbA1c over 12 months in a cohort of patients with at least one prescription for a GLP-1a. Within this cohort, treatment was defined as having ≥2 GLP-1a prescriptions at a therapeutic dosage separated by ≥10 months. The cohort included 693 patients of whom 393 (57%) were treated with GLP-1a therapy. The treatment group had a mean change in body mass index (BMI) of −0.83 kg/m2 (±2.88) compared to −0.70 kg/m2 (±2.99) in the without GLP-1a group (p = 0.57). Treated patients had a mean change in HbA1c of −1.00% (±2.07) compared to −0.83% (±1.92) in the without GLP-1a group (p = 0.27). For treated and without GLP-1a patients, respectively, the proportion of patients with a decrease in BMI was 65 versus 64% (p = 0.86), and the proportion with a decrease in HbA1c was 73 versus 69% (p = 0.28). In clinical practice, GLP-1a therapy was associated with more modest reductions in weight and HbA1c than shown in prior RCTs. As GLP-1a use continues to expand throughout primary care, the real-world impact of this pharmacotherapy will require further evaluation.
Identification of an Allele-Specific Transcription Factor Binding Interaction that May Regulate PLA2G2A Gene Expression
Authors: Hara Aki , Lu Eric , Johnstone Laurel , Wei Michelle , Sun Shudong , Hallmark Brian , Watkins Joseph C , Zhang Hao Helen , Yao Guang , Chilton Floyd H
Published: July 2024

The secreted phospholipase A2 (sPLA2) isoform, sPLA2-IIA, has been implicated in a variety of diseases and conditions, including bacteremia, cardiovascular disease, COVID-19, sepsis, adult respiratory distress syndrome, and certain cancers. Given its significant role in these conditions, understanding the regulatory mechanisms impacting its levels is crucial. Genome-wide association studies (GWAS) have identified several single nucleotide polymorphisms (SNPs), including rs11573156, that are associated with circulating levels of sPLA2-IIA. The work in the manuscript leveraged 4 publicly available datasets to investigate the mechanism by which rs11573156 influences sPLA2-IIA levels via bioinformatics and modeling analysis. Through genotype-tissue expression (GTEx), 234 expression quantitative trait loci (eQTLs) were identified for the gene that encodes for sPLA2-IIA, PLA2G2A. SNP2TFBS was used to ascertain the binding affinities between transcription factors (TFs) to both the reference and alternative alleles of identified eQTL SNPs. Subsequently, candidate TF-SNP interactions were cross-referenced with the ChIP-seq results in matched tissues from ENCODE. SP1-rs11573156 emerged as the significant TF-SNP pair in the liver. Further analysis revealed that the upregulation of PLA2G2A transcript levels through the rs11573156 variant was likely affected by tissue SP1 protein levels. Using an ordinary differential equation based on Michaelis-Menten kinetic assumptions, we modeled the dependence of PLA2G2A transcription on SP1 protein levels, incorporating the SNP influence. Collectively, our analysis strongly suggests that the difference in the binding dynamics of SP1 to different rs11573156 alleles may underlie the allele-specific PLA2G2A expression in different tissues, a mechanistic model that awaits future direct experimental validation. This mechanism likely contributes to the variation in circulating sPLA2-IIA protein levels in the human population, with implications for a wide range of human diseases.
Determinants of Hemoglobin Among Pregnant Women at Agro-Pastoralist Communities in South Omo Zone, Ethiopia: Community Based Cross-Sectional Study, Nutrition Experience from Movable Community
Authors: Alemu Tsegaye , Nkosi Zerish Zethu , Yakob Tigist
Published: July 2024

Background:

Low hemoglobin level is the most common public health problem during pregnancy in developing countries including Ethiopia, which is affecting both mother and fetus. However, the determinants of anemia among pregnant women are not well studied.

Objective:

To assess the determinates of hemoglobin among pregnant women in rural agro-pastoralist communities in the South Omo zone, Ethiopia

Method:

Community-based cross-sectional study was done in rural agro-pastoralist communities. A multistage stratified sampling technique was used to select 526 pregnant women. Data were collected by using structured questionnaires. Hemoglobin level was measured by using HemoCue ® Hb301. Data were analyzed by using a statistical package for the social science version 26. Descriptive (Mean, standard deviation, frequency, range), bivariate and multivariate analysis was carried out to check the association between lower hemoglobin levels and independent variables. The output is presented in tables and figures.

Result:

The mean (±SD) of hemoglobin concentration was 11.8 ± 1.7. The overall prevalence of anemia was 39.9% [95% CI: 35.5, 44.4], 19.4% (95% CI: 16.0, 23.2) was mild, 19.6% (95% CI: 16.27, 2.5) was moderate and 0.9% (95% CI: 0.25, 2.25) was severe anemia. Not taking IFA (AOR = 5.7(3.3, 9.8)), severe under nutrition (AOR = 8.9(2.1, 37.3)), no fish food (AOR = 2.4(1.3, 4.5)), drinking coffee (AOR = 1.6(1.0, 2.6)), moderate food insecurity (AOR = 2.5(1.4, 4.6)), and no malaria infection (AOR = 0.6(0.4, 0.9)) were statistically significant with anemia.

Conclusion:

The anaemia is a public health problem in this study area. Therefore, nutrition education and counselling to enhance iron supplementation, dietary diversity and a flesh diets are very essential to enhance haemoglobin levels.
From loss to recovery: Spin-outs and parents’ innovation
Authors: Chila Vilma , Devarakonda Shivaram , Martin Xavier
Published: July 2024

Spin-outs (new ventures founded by ex-employees) have received attention partly due to the potential negative implications they present to the incumbents from which they originate (i.e. parents). Spin-outs can threaten parents not only because of the increased future competition but also because of the immediate disruptions to their knowledge bases. These negative implications rest on the notion that parents are mere bystanders. We depart from this bystander notion by considering parents’ adaptations to disruptions caused by spin-outs. Specifically, we investigate both the effects of spin-outs on parents’ innovation and the factors that motivate and enable parents to cope with the knowledge gaps arising from spin-outs. We demonstrate that although spin-outs dent parents’ innovation output in the knowledge areas affected by spin-outs, such decline is non-enduring. We also argue and demonstrate that the importance of knowledge areas affected by spin-outs as well as the availability of human capital—internal and newly hired—drive the recovery of parents’ innovation output. We contribute to the literature by refining the theoretical and empirical understanding of the factors shaping parents’ adaptation and creative reconstruction in the aftermath of spin-outs.
Image-Based Sexual Abuse Perpetration: A Scoping Review
Authors: Henry Nicola , Beard Gemma
Published: July 2024

Image-based sexual abuse (IBSA) refers to the nonconsensual creating, taking, or sharing of intimate images, including threatening to share images. It can also include coercing someone into sharing intimate images, or sending unwanted intimate images. In recent years, there has been growing attention to the nature, scope, and impacts of IBSA, but comparatively little attention has been paid to the perpetration of these harms. This scoping review consolidates and synthesizes the existing knowledge on the perpetration of IBSA against adults. The review involved a systematic search of scholarly and gray literature across select databases. In total, 26 studies met the inclusion criteria. Studies were included if they were published in English between 2013 and 2023 and reported on findings of a sample of adults over the age of 16 who admitted IBSA perpetration behaviors. The review found that prevalence of subtypes of IBSA varied significantly across the studies. There was consensus that adults who engage in IBSA perpetration are more likely to be men, younger adults, and LGBTIQ+. Motivations were multifaceted, but tended to relate to social rewards, power dynamics, sexual gratification, and retaliatory impulses. Dark Tetrad traits were found to be positively associated with IBSA perpetration. The research also indicates on overlap between victimization and perpetration, as well as an association with other offending behaviors, such as intimate partner violence. Prevention interventions should be focused on changing the opportunities, affordances, and infrastructures for offending, as well as addressing problematic societal attitudes and norms, with early interventions focused on building resilience and self-esteem, and promoting healthy behaviors and respectful relationships.
Effect of membrane morphology on the thermo-physiological comfort of outdoor clothing
Authors: Knížek Roman , Tunák Maroš , Tunáková Veronika , Honzíková Petra
Published: July 2024

This article examines the effect of membrane type and its morphology on the chosen thermo-physiological properties of the middle layer of outdoor clothing. In total four different membranes were selected for the production and analysis of three-layer laminates, which could replace the second and third layers of layered clothing for sports/outdoor purposes. As an outer and lining material a polyester knitted fabric with fleece was chosen, whereas the lamination technology was used to join the individual layers. Chosen properties affecting the thermo-physiological comfort of the laminates were evaluated, to be able to select a membrane that, in combination with the outer and inner layer, enabled the use of laminate as an upper clothing layer – a jacket, thereby replacing the necessity of using a second clothing layer. The following properties were chosen as crucial: thermal resistance, air permeability, vapor permeability (water vapor penetration), and hydrostatic pressure resistance. The utility value methodology was used to evaluate individual fleece-based laminates. For the completeness of this study, two types of commercially available three-layer laminates containing soft-shell fabric as the top layer were incorporated for comparison.
Needle Arthroscopy Versus Conventional Arthroscopy in the Evaluation of Carpal Pathology: A Comparative Study
Authors: Moses Michael J. , Lorentz Nathan A. , Azad Ali , Paksima Nader
Published: July 2024

Background:

The needle scope is a less invasive intervention to evaluate carpal pathology. We hypothesize that there is no difference in the evaluation and diagnostic capability of the needle scope versus the conventional wrist arthroscope.

Methods:

Twenty patients indicated for wrist arthroscopy were prospectively enrolled. Prior to insertion of the 2.7-mm arthroscope, the needle scope evaluated for synovitis; cartilage damage (location and modified Outerbridge classification); integrity of the volar, scapholunate (SL), and lunotriquetral ligaments; and the triangular fibrocartilage complex (TFCC). Following needle scope evaluation, the surgeon completed a survey regarding the visualization and diagnosis. The 2.7-mm arthroscope was then inserted, and the surgeon completed the second portion of the survey. Statistical analysis was then completed to determine statistical significance.

Results:

Twelve patients were female (60%), and the mean age was 39.8 years (±11.8 years). Eleven patients underwent arthroscopy for TFCC pathology, 4 patients for SL tearing, and 5 patients for extensive synovitis. There was no difference between the needle scope and wrist arthroscopy diagnosis. There was no difference between radiocarpal and midcarpal visualization. Surgeon-rated ease of use and diagnostic confidence were the same between two groups. The needle scope was better able to visualize the scapho-trapezium-trapezoid and carpometacarpal joints; however, the image was of marginally decreased quality.

Conclusion:

In this study, there was no difference between radiocarpal or midcarpal visualization and surgeon-rated ease of use, while diagnostic confidence was the same between two groups.

Level of Evidence:

II (prospective cohort study)—Diagnostic
Telemedicine ultrasound in intensive care unit: A pilot diagnostic accuracy study
Authors: König Klever Emanuele , Silva Gabriela de Oliveira Laguna , da Silva Mariana Motta Dias , da Rocha Jacqueline Castro , da Silva Márcio Gustavo Santanna , Chagas Maria Eulália Vinadé , de Amorim Jerusa da Rosa , Pires Aristóteles de Almeida , Cunha Birriel Daniella , Constant Hilda Maria Rodrigues Moleda , Moreira Taís de Campos , Cabral Felipe Cezar
Published: July 2024

Introduction:

Digital health is an opportune way of facilitating the implementation of point-of-care ultrasound (POCUS) in intensive care units (ICUs) of the Brazilian Unified Health System (SUS) through remote tele-mentored ultrasound (RTMUS). Therefore, this pilot diagnostic accuracy study aims to evaluate the sensitivity and specificity of RTMUS, using POCUS as the gold standard for the diagnosis of pulmonary oedema. As a secondary objective, these metrics will be assessed for pneumonia, chronic obstructive pulmonary disease (COPD), pneumothorax, pulmonary embolism, and cardiac tamponade.

Methods:

The study was conducted in three adult ICUs, monitored by the TeleUTI project, and included 23 patients who underwent POCUS carried out by an ICU medical professional and RTMUS carried out by a tele-intensivist from the institution that proposed the project.

Results:

The accuracy in diagnosing pulmonary oedema was 71.43%, COPD 89.96%, and for pneumonia, the results showed an accuracy of 65.22%. Analyses demonstrated that RTMUS has the same capability as POCUS for detecting true positive cases of pulmonary oedema, the same results of true negative cases for COPD, and a limitation in performance for pneumonia.

Conclusions:

For COPD and pulmonary oedema, remote examination can support healthcare teams, suggesting that RTMUS has the potential to be a substitute for POCUS. We emphasise that the results should be interpreted within the context of the study, which is considered small and should be validated on a larger scale to consolidate the conclusions.
Ethical and informative trials: How the COVID-19 experience can help to improve clinical trial design
Authors: Law Emma , Smith Isabel
Published: July 2024

During the COVID-19 pandemic, the race to find an effective vaccine or treatment saw an ‘extraordinary number’ of clinical trials being conducted. While there were some key success stories, not all trials produced results that informed patient care. There was a significant amount of waste in clinical research during the pandemic which is said to have hampered an evidence-based response. Conducting trials which could have been predicted to fail to answer the research question (e.g. because they are not large enough to provide a definitive result) is not only a waste of resources but also a breach of research participants’ trust and a violation of research ethics.

The issues seen in COVID-19 clinical trials are symptomatic of a wider trial design crisis where many trials do not provide informative results. This paper examines the roles of key stakeholders in delivering ethical and informative trials and whether guidance published by ‘The Good Clinical Trials Collaborative’ could be used to align key stakeholder groups and enable a joined-up approach to improve clinical trial design.
The role of articulatory rehearsal in short-term false memories during ageing
Authors: Piroelle Magaux , Guette Christelle , Abadie Marlène
Published: July 2024

Recent studies have shown that articulatory rehearsal prevents false memories in working memory tasks in young adults. During ageing, a substantial increase in false memories has been documented in numerous studies. The aim of this study was to investigate the role of rehearsal in the increase of false memories with age. In two experiments, we manipulated the opportunity to use rehearsal in a Brown–Peterson task in which younger ( n = 80) and older ( n = 70) adults maintained semantically related word lists and reported their maintenance strategies. Both experiments showed that reducing the opportunity to use rehearsal increased false memories and decreased correct recall in both groups. Furthermore, older adults made more false memories and less correct recall than younger adults, and these effects were partially mediated by the number of times participants reported using rehearsal (Experiment 2). These findings suggest that age-related differences in rehearsal use explain differences in working memory task performance.
Association of first-line thrombectomy technique and outcome in late-window large vessel occlusion strokes: A post hoc analysis of the MR CLEAN-LATE trial
Authors: Knapen Robrecht RMM , Olthuis Susanne GH , van Es Adriaan CGM , Emmer Bart J , Schonewille Wouter J , van der Leij Christiaan , van Zwam Wim H , van Oostenbrugge Robert J
Published: July 2024

Background:

This study aimed to compare direct aspiration, stent retriever, and the combined thrombectomy technique on clinical, safety, and technical outcomes in late-window stroke patients included in the MR CLEAN-LATE trial.

Methods:

This post hoc analysis of the MR CLEAN-LATE trial included patients treated with direct aspiration, stent retriever, or combined thrombectomy technique as first-line approach. Primary outcome was the modified Rankin Scale (mRS) score at 90 days follow-up, and compared between the three groups with ordinal logistic regression analysis. Secondary outcomes included mortality at 90 days, total technique switches, procedure time, recanalization rate measured with the expanded thrombolysis in cerebral infarction (eTICI) score, and symptomatic intracranial hemorrhage (sICH). Predefined variables were used for adjustments.

Results:

In the MR CLEAN-LATE trial, 258 patients underwent endovascular treatment and 232 were included in our analyses. The mRS at 90 days did not differ (stent retriever vs. direct aspiration: adjusted common odds ratio (acOR) = 1.35, 95% confidence interval (CI) = 0.73 to 2.50; stent retriever vs. combined: acOR = 1.13, 95% CI = 0.64 to 2.00; direct aspiration vs. combined: acOR = 1.19, 95% CI = 0.64 to 2.21). Direct aspiration thrombectomy was accompanied with more switches to another technique compared to the stent retriever (adjusted odds ratio (aOR) = 6.50, 95% CI = 2.52 to 16.8) or combined group (aOR = 4.67, 95% CI = 1.80 to 12.1) and with higher sICH rates compared to the combined technique (13% vs. 2.5%; aOR = 8.19, 95% CI = 1.49 to 45.1). Mortality, procedure time, and eTICI did not differ.

Conclusion:

Stent retriever, direct aspiration, or the combined thrombectomy technique as first-line approach showed no differences in clinical outcome in late-window stroke patients. Direct aspiration was accompanied with higher sICH rates and more switcher to another technique compared to the combined group.
Differences Between Glycated Hemoglobin and Glucose Management Indicator in Real-Time and Intermittent Scanning Continuous Glucose Monitoring in Adults With Type 1 Diabetes
Authors: Yoo Jee Hee , Moon Sun Joon , Park Cheol-Young , Kim Jae Hyeon
Published: July 2024

Background:

This study demonstrates the difference between glucose management indicator (GMI) and glycated hemoglobin (HbA1c) according to sensor mean glucose and HbA1c status using 2 continuous glucose monitoring (CGM) sensors in people with type 1 diabetes.

Methods:

A total of 275 subjects (117 Dexcom G6 [G6] and 158 FreeStyle Libre 1 [FL]) with type 1 diabetes was included. The G6 and FL sensors were used, respectively, over 90 days to analyze 682 and 515 glycemic profiles that coincide with HbA1c.

Results:

The mean HbA1c was 6.6% in Dexcom G6 and 7.2% in FL profiles. In G6 profiles, GMI was significantly higher than HbA1c irrespective of mean glucose (all P < .001, mean difference: 0.58% ± 0.49%). The GMI was significantly higher than the given HbA1c when HbA1c was below 8.0% (all P < .001). The discordance was the highest at 0.9% for lower HbA1c values (5.0%-5.9%). The proportion of discordance >0.5% improved from 60.1% to 30.9% when using the revised GMI equation in G6 profiles. In FL profile, the overall mean difference between GMI and HbA1c was 0 ( P = .966). The GMI was significantly lower by 0.9% than HbA1c of 9.0% to 9.9% and higher by 0.5% in HbA1c of 5.0% to 5.9% (all P < .001).

Conclusions:

The GMI is overestimated in G6 users, particularly those with well-controlled diabetes, but the GMI and HbA1c discordance improved with a revised equation from the observed data. The FL profile showed greater discordance for lower HbA1c levels or higher HbA1c levels.
Acute on chronic pancreatitis affecting the ectopic pancreas located in the jejunal mesentery: A case report
Authors: Okamura Kazuya , Ishibashi Emi , Araki Kazumi , Kanasaki Yoshiko , Kodama Koji , Kanazawa Akiyoshi , Onuma Hideyuki
Published: July 2024

Ectopic pancreas within the mesentery is rare. In this case report, a 61-year-old man with an ectopic pancreas within the jejunal mesentery for over 20 years developed chronic pancreatitis that progressed to acute exacerbation. Our computed tomography (CT) performed for acute abdomen assessment suggested acute appendicitis or Meckel’s diverticulitis. However, a CT scan taken 20 years ago revealed a structure indicative of an ectopic pancreas in the mesentery, and further imaging findings taken 10 and 4 years ago confirmed progression to chronic pancreatitis. Furthermore, we found a pancreatic stone confined in the luminal structure that corresponded to the main pancreatic duct; this stone eventually caused acute exacerbation. In summary, we report a case of mesenteric ectopic pancreas that showed typical findings of progression and acute exacerbation of chronic pancreatitis on CT.
Screening for Autism Spectrum Disorder in Young Children: Still Not Enough Evidence
Authors: Grigore Bogdan , Peters Jaime , Williams Jessica , Russell Ginny , Coles Paula , Visintin Cristina , Rogers Morwenna , Hayward Robert , Zhelev Zhivko , Logan Stuart , Hyde Christopher
Published: July 2024

Background:

Early detection of autism spectrum disorder (ASD) has the potential to significantly reduce the impact of the condition, however previous reviews have found little evidence to support screening programs for ASD in young children.

Methods:

We conducted a review with the aim of updating evidence on 3 aspects: (a) diagnostic stability of ASD in young children; (b) accuracy of ASD screening tools in young children; and (c) the benefits of early interventions in screen-detected young children with ASD.

Results:

A total of 33 studies were included in our review. Five studies looking at diagnostic stability reported estimates ranging from 71.9% to 100%, however the majority only included a follow-up of 24 months and all studies raised concerns regarding the risk of bias due particularly to lack of blinding, sample size, and patient flow. A total of 25 studies, reported in 26 articles, were identified that reported accuracy data on 11 screening tools. Most of the reports were concerned with versions of M-CHAT, reporting sensitivity estimates from 0.67 to 1.0; however, many of these were deemed to be of high risk of bias due to lack of blinding and follow-up. Four studies reported on early interventions in screen-detected children; however, the majority did not find significant improvements on the relevant outcomes.

Conclusions:

Overall, the evidence on screening for ASD in young children captured by this review is not conclusive regarding the 3 aspects of screening in this population. Future studies should attempt to ensure blinded diagnostic assessments, include longer follow-up periods and limit attrition.
A Transtheoretical Model-Based Online Intervention to Improve Medication Adherence for Chinese Adults Newly Diagnosed With Type 2 Diabetes: A Mixed-Method Study
Authors: Zhang Baolu , Kalampakorn Surintorn , Powwattana Arpaporn , Sillabutra Jutatip , Liu Gang
Published: July 2024

Background:

Type 2 diabetes mellitus (T2DM) is increasing in China, with medication non-adherence being a significant contributor to uncontrolled T2DM. The Transtheoretical Model (TTM) has shown effectiveness in chronic disease management, but few studies have applied it in online interventions for T2DM medication adherence.

Aim:

The study aimed to develop and investigate the effects of a TTM-based online health education program on promoting positive stage of change (SOC) movement, improving self-efficacy and medication adherence, as well as reducing HbA1c levels in newly diagnosed patients with T2DM.

Methods:

This sequential mixed-method study was conducted from April 2023 to March 2024. Using the TTM framework, the study initially explored 32 participants’ experiences with hypoglycemic medications, health information acquisition, and perspectives on online programs. Then, a quasi-experimental study design was conducted. Two communities were randomly assigned as the intervention (n = 91) and comparison (n = 98) groups, with 189 newly diagnosed middle-aged T2DM patients from various SOC. The intervention group received short videos health education and participated in WeChat group discussions, compared with usual care in the comparison group. Data were collected at baseline, 3-month, and 6-month follow-ups.

Results:

The intervention group was more likely to achieve positive SOC movement ( P < .001, Adj OR = 13.69 95% CI = 6.76-27.71) compared to the comparison group. The intervention group also had significantly higher mean CDMSS-11 and MMAS-8 scores at 6 months ( P = .03 and <.001, respectively) and more likely to achieve clinically significant glycated Hemoglobin (HbA1c) change at 3 months ( P < .001, Adj OR = 3.91, 95% CI = 1.77-8.63) and at 6 months ( P < .001, Adj OR = 5.62, 95% CI = 2.70-11.69) compared to the comparison group.

Conclusion:

These findings support that applying the TTM to develop an online program could promote behavior change, improve self-efficacy and medication adherence, and could lead to better glycemic control in newly diagnosed T2DM patients.
Communication Strategies, Difficulties, and Speaking Tasks in Foreign Language Learning
Authors: Chou Mu-Hsuan
Published: July 2024

This study explored the communication strategies of college students majoring in one of five modern foreign languages (i.e., English, French, German, Japanese, and Spanish) and their relation to communication confidence. It also explored the association between their strategy use and the difficulty regarding the speaking components, and students’ feedback on pedagogical tasks to improve their speaking ability. A questionnaire survey of communication strategy was distributed to 538 college students in Taiwan, and semi-structured interviews were conducted with 20 students. The results showed that there was a statistically significant difference between the majored language and the use of communication strategies. Specifically, a one-way between-groups MANOVA revealed that the participants adopted the message reduction/alteration and fluency-oriented strategies frequently and equally, regardless of the language they studied. English and Spanish learners employed social affective, phonological awareness, and negotiation for meaning while speaking strategies more frequently than German learners. Students who reported difficulties in fluency, lexical resources, grammatical accuracy, and pronunciation while speaking the major language employed social affective strategies less frequently. Finally, students’ preferences for particular tasks reflected the speaking components they wished to foster. It is concluded that lexical and grammatical knowledge should be emphasized first to build communication confidence and strengthen fluency.
Does Artificial Intelligence Improve Export Technical Complexity Upgrade of Manufacturing Enterprises? Evidence from China
Authors: Lin Changqing , Xiao Shengpeng , Tang Pingjuan
Published: July 2024

Export technical complexity is an effective indicator to measure the upgrading of a country’s trade structure and high-quality development of trade. This study examines the impact of artificial intelligence on the export technical complexity upgrading of Chinese manufacturing enterprises at the enterprise and industry levels. It analyses matched data from the China Customs and Chinese Industrial Enterprises databases from 2000 to 2015. The results show that artificial intelligence promotes the upgrading of export technical complexity in Chinese manufacturing enterprises. The impact of artificial intelligence on upgrading export technical complexity is dynamic, showing an “inverted U-shape.” Heterogeneity test results indicate that artificial intelligence has a greater effect on export technical complexity upgrading if it features high-tech complexity, or the enterprises are local or in the eastern region of China. The mechanism results indicate that artificial intelligence significantly promotes labor productivity and innovation to upgrade China’s manufacturing enterprises’ export technical complexity. Finally, industry-level analysis shows that the application intensity of artificial intelligence substantially affects the average export technical complexity upgrades of Chinese manufacturing enterprises through spillover effects and resource reallocation effects. These findings promote upgrading export technical complexity at the enterprise and industry levels.
Impact of COVID-19 on Healthcare Professionals at a Midwestern Quaternary Academic Urban Health Center
Authors: Sledge Jennifer A. , Prentice Donna , Arroyo Cassandra
Published: July 2024

Background:

Prior pandemic research has focused on physicians and nurses who provide direct patient care. Literature on the experiences of nonnurse/physician clinicians and nonclinical health care professionals is sparse.

Methods:

An observational, cross-sectional study was conducted over threetime points to examine the impact of COVID-19 on clinical and nonclinical healthcare professionals ( n = 464).

Findings:

There were no significant differences in distress across survey waves, except for anger ( p = .046). No significant differences in distress scores were found between job types. Multiple linear regression results varied. Both the threat and interrupted plans scores were significant predictors of distress. Resources available to healthcare providers (HCPs) were underutilized in all three waves.

Conclusions:

Healthcare professionals’ distress increases with exposure. Integrating self-care resources for staff may mitigate the impact and maintain a healthy work environment.

Application to practice:

Occupational health providers should incorporate these findings when developing opportunities to address the needs of health care professionals in the workplace.
Shape and Size of the Annulus Fibrosus Excision Alters the Biomechanics of the Intervertebral Disc
Authors: Nie Mao-dan , Huang Ze-bin , Cheng Rong-shan , Zhang Qiang , Zhang Ji-ping , Fu Ling-Jie , Cheng Cheng-Kung
Published: July 2024

Study Design

Biomechanical testings and finite element analysis.

Objectives

This study aims to investigate how annulus fibrosus (AF) incision size (RIS, Ratio of incision width to AF height) and shape affect intervertebral disc (IVD) biomechanics.

Methods

A validated finite element model of lumbar spines simulated various incisions in the middle-right posterior region of the AF, with different sizes and shapes. Simulations included axial compression, flexion, extension, bending, and rotation. Parameters assessed included stability, re-herniation, and IVD degeneration by analyzing stress, height, Intradiscal pressure (IDP), and the range of motion (ROM).

Results

Incision increased AF stress and ROM under 3 Nm moment, with values rising as RIS increased. RIS exceeding 40% resulted in a 20% AF stress increase during compression and extension, while RIS over 50% led to over 20% AF stress increase during other motions. Incision stress also increased with higher RIS, particularly surpassing 50% RIS. IDP rose across all incision shapes. Endplate stress increased (9.9%-48.9%) with larger incisions, with average increases of 12.8%, 12.7%, 30.5%, and 22.8% for circular, oval, square, and rectangular incisions. Compression and rotation minimally affected NP pressure (<15%), while flexion (19.8%-38.8%) and bending (18.5%-43.9%) had a more pronounced effect. ROM increased with RIS (20.0% ∼ 77.4%), especially with an incision RIS exceeding 40%.

Conclusions

AF injury elevates AF stress, reduces spine stability, heightens degeneration risk with increasing RIS. Reherniation risk rises when RIS exceeds 40%. Circular or oval incisions maintain spine biomechanics better than square or rectangular ones.
Unequal Exposure to Occupational Stress across the Life Course: The Intersection of Race/Ethnicity and Gender
Authors: Sheftel Mara Getz , Goldman Noreen , Pebley Anne R. , Pratt Boriana , Park Sung S.
Published: July 2024

Work, a segregated social context in the United States, may be an important source of differential exposure to stress by race/ethnicity, but existing research does not systematically describe variation in exposure to occupational stress by race/ethnicity. Using work history data from the U.S. Health and Retirement Study and occupational-level measures from the Bureau of Labor Statistics and the Occupational Information Network, the authors document the extent to which the race/ethnicity and gender composition of occupational categories varies by level of occupational strain and how life-course exposure to occupational strain differs by race/ethnicity and gender. Black and Latino workers are overrepresented in high-strain jobs at many ages, compared with other groups. Exposure to job strain across working ages shows more variation in exposure by gender and race/ethnicity groups than static measures. These findings point to potential bias in research using a single, cross-sectional measure of job stress.
What’s Art Got to Do With It? Using Visual Thinking Strategies to Develop Critical Thinking Skills
Authors: Dawson Christine M. , Salmon Jessica Rae
Published: July 2024

Visual Thinking Strategies (VTS) is an experiential exercise readily adapted to the management classroom. Through this exercise, instructors use a structured process to help students develop and apply critical thinking skills, with a focus on clearly articulating a concept, explaining their reasoning and use of evidence to inform their claim, interrogating assumptions, and exploring a range of perspectives. The exercise involves guiding students to interpret first visual artwork and then other texts through the use of guiding questions and specific facilitation strategies, followed by a practice and a debriefing. Additional adaptations discussed in the appendix, such as using VTS with graphic organizers from a course text, the landing page of a multinational company website, a SWOT analysis, or quantitative datasets, are a testament to the versatility and flexibility of this strategy in building students’ critical thinking skills across management contexts.
Insights from the 2021 OECD Trust Survey: How people evaluate the trustworthiness of government institutions & implications for policymakers
Authors: Prats Mariana , Phillips Emma , Smid Sina
Published: July 2024

The inaugural OECD Survey on the Drivers of Trust in Public Institutions asked respondents in 22 OECD countries to evaluate the trustworthiness of national and local governments and other public institutions as well as to report their perceptions and experiences with various public governance–related drivers of trust (factors likely to affect trust) in those institutions. The main drivers include the government’s competence (as indicated by its reliability and responsiveness) and government values, including integrity, openness, and fairness. The article highlights the key findings of the survey and of analyses exploring the impact of various drivers on trust. The results underscore that people are relatively satisfied with delivery of public services and governments’ reliability, but it is crucial to enhance citizens’ perceptions of governments’ responsiveness and their perceived ability to influence public decision-making. The article also addresses the policy implications of the research and describes ways some countries have already used the country-specific findings as a guide to developing policies for reinforcing their citizens’ trust.
Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial
Authors: Law Zhe Kang , Menon Chaamanti Sivakumar , Woodhouse Lisa J , Appleton Jason Philip , Al-Shahi Salman Rustam , Robinson Thompson , Werring David , Roffe Christine , Dineen Robert A , Bath Philip Michael , Sprigg Nikola
Published: July 2024

Introduction:

The Tranexamic acid for IntraCerebral Haemorrhage-2 (TICH-2) trial reported no significant improvement in death and dependency at day 90 despite reductions in haematoma expansion, early neurological deterioration and early death. However, significant recovery after stroke, particularly intracerebral haemorrhage (ICH), may take more than 3 months. Here we report the participant outcomes at 1 year after stroke.

Patients and methods:

TICH-2 was a prospective randomised controlled trial that tested the efficacy and safety of tranexamic acid in spontaneous ICH when given within 8 h of onset. Patients with ICH on anticoagulation were excluded. Centralised blinded telephone follow up was performed for patients from the United Kingdom at 1 year. The primary outcome was modified Rankin Scale at 1 year. Secondary outcomes included Barthel index, Telephone Interview Cognitive Status-modified, EuroQoL-5D and Zung Depression Scale. This was a prespecified secondary analysis of the TICH-2 trial.

Results:

About 2325 patients were recruited into the trial (age 68.9 ± 13.8 years; 1301 male, 56%). About 1910 participants (82.2%) were eligible for day 365 follow up. 57 patients (3.0%) were lost to follow up. Tranexamic acid did not reduce the risk of poor functional outcome at 1 year (adjusted OR 0.91 95% CI 0.77–1.09; p = 0.302). However, Cox proportional hazard analysis revealed significant survival benefit in the tranexamic acid group (adjusted HR 0.83, 95% CI 0.70–0.99; p = 0.038).

Conclusion:

There was no difference in functional outcome at 1 year after ICH. Tranexamic acid may reduce mortality at 1 year without an increase in severely dependent survivors. But this should be interpreted with caution as this is a result of secondary analysis in a neutral trial.
Genome-wide association study of trace elements in maize kernels
Authors: Chen Weiwei , Li Xuhui , Zhang Xiangbo , Chachar Zaid , Lu Chuanli , Qi Yongwen , Chang Hailong , Wang Qinnan
Published: July 2024

Maize (Zea mays L.), a staple food and significant economic crop, is enriched with riboflavin, micronutrients and other compounds that are beneficial for human health. As emphasis on the nutritional quality of crops increases maize research has expanded to focus on both yield and quality. This study exploreed the genetic factors influencing micronutrient levels in maize kernels through a comprehensive genome-wide association study (GWAS). We utilized a diverse panel of 244 inbred maize lines and approximately 3 million single nucleotide polymorphisms (SNPs) to investigate the accumulation of essential and trace elements including cadmium (Cd), cobalt (Co), copper (Cu), nickel (Ni), selenium (Se) and zinc (Zn). Our analysis identified 842 quantitative trait loci (QTLs), with 12 QTLs shared across multiple elements and pinpointed 524 potential genes within a 100 kb radius of these QTLs. Notably ZmHMA3 has emerged as a key candidate gene previously reported to influence the Cd accumulation. We highlighted ten pivotal genes associated with trace element transport including those encoding heavy metal ATPases, MYB transcription factors, ABC transporters and other crucial proteins involved in metal handling. Additionally, haplotype analysis revealed that eight inbred linesaccumulated relatively high levels of beneficial elements while harmful elements were minimized. These findings elucidate the genetic mechanisms underlying trace element accumulation in maize kernels and provide a foundation for the breeding of nutritionally enhanced maize varieties.