bluuebunny/crossref_metadata_2025 huggingface dataset:
Law and Cartoons: The Use of New Interactive Approach in Educating at Law Departments
Authors: Abezin Denis , Anisimov Aleksey , Melikhov Alexander
Published: May 2024

The praxis article is devoted to the study of educational cartoon as an interactive method of teaching legal disciplines. The purpose of the article is to argue the usefulness of this methodology for the educational process (e.g., the development of critical thinking, increasing the activity of students when discussing educational tasks on the basis of cartoons, clarification of complex terms), to improve the image of the university (use of educational cartoons in universities during the week of the Faculty of Law), and explain how we assessed the effectiveness of this methodology through quantitative and qualitative methods. While it is a new approach in Russian Law schools, we draw attention to the universality of this methodology; as educational cartoons can be used in schools and across different university departments, and to the specificity of modeling of educational tasks in law, by providing specific examples of such educational tasks. We propose three variants of development of educational cartoons for the educational process at law faculties: placing an order for special production of educational cartoons; use of fragments of already existing cartoons; creation by the teacher of oral tasks on the motives of national fairy tales. The results of our research substantiate that the greatest effect of the proposed methodology can give only in the case of using for the preparation of educational cartoons national content, which is closest to the culture and mentality of students of a particular university.
The Pharmacological Effects and Potential Applications of Limonene From Citrus Plants: A Review
Authors: Chen Xian-fang , Ding Yan-yan , Guan Hao-ru , Zhou Chuan-jie , He Xinglishang , Shao Ya-ting , Wang Yi-bin , Wang Ning , Li Bo , Lv Gui-yuan , Chen Su-hong
Published: May 2024

The citrus plant is the general term for Citrus, Fortunella, and Poncirus, which includes oranges, tangerines, lemons, grapefruits, and citrons. Not only does it contain a variety of delicious fruits, but it is also an important part of traditional Chinese medicine. Citrus plant peels are rich in essential oils, the primary active component of which is limonene. Modern pharmacological research has revealed that limonene has many pharmacological effects, including antibacterial, anticancer, analgesic, immune regulation, neuroprotection, antioxidant, anti-inflammatory properties, and the treatment of metabolic diseases. It finds widespread application in a variety of industries, including cosmetics, food, personal care, medicine, pesticides, and others. This article reviews the pharmacological effects of limonene from citrus plants to build a scientific basis for future limonene research and application and also to lay the groundwork for developing functional foods for the prevention and management of linked disorders.
Retracing the rabbit's path: Effects of altering the second flash position in the visual saltation illusion
Authors: Manaligod de Jesus Sheryl Anne , Ito Hiroyuki , Kanematsu Tama
Published: May 2024

Two dots shown in quick succession at one point and a third at a distance on the same linear path creates an illusion of intervening flashes on a visual field, a phenomenon known as the reduced visual rabbit illusion or visual saltation illusion. This study presents this illusion in a novel way by altering the position of the second flash, which has been typically presented only in the same position as the first flash. A series of experiments were conducted to observe whether saltation would occur if the second flash was presented in the same position as the third flash, out of sequential order relative to the first and last flash, or out of linear alignment at the midpoint between the first and the last flash. When all three flashes were presented in quick succession, participants misperceived the second flash to occur close to the midpoint between the first and last flash. Saltation was achieved in all three novel conditions, hinting a particular neurological process may be responsible for shared outcomes.
The trustification of AI. Disclosing the bridging pillars that tie trust and AI together
Authors: Bareis Jascha
Published: May 2024

Trustworthy artificial intelligence (TAI) is trending high on the political agenda. However, what is actually implied when talking about TAI, and why it is so difficult to achieve, remains insufficiently understood by both academic discourse and current AI policy frameworks. This paper offers an analytical scheme with four different dimensions that constitute TAI: a) A user perspective of AI as a quasi-other; b) AI's embedding in a network of actors from programmers to platform gatekeepers; c) The regulatory role of governance in bridging trust insecurities and deciding on AI value trade-offs; and d) The role of narratives and rhetoric in mediating AI and its conflictual governance processes. It is through the analytical scheme that overlooked aspects and missed regulatory demands around TAI are revealed and can be tackled. Conceptually, this work is situated in disciplinary transgression, dictated by the complexity of the phenomenon of TAI. The paper borrows from multiple inspirations such as phenomenology to reveal AI as a quasi-other we (dis-)trust; Science & Technology Studies (STS) to deconstruct AI's social and rhetorical embedding; as well as political science for pinpointing hegemonial conflicts within regulatory bargaining.
Test–retest reliability and agreement of remote home-based functional capacity self-administered assessments in community-dwelling, socially isolated older adults
Authors: Villar Rodrigo , Beltrame Thomas , Ferreira dos Santos Gabriela , Zago Anderson Saranz , Bocalini Danilo Sales , Pontes Júnior Francisco Luciano
Published: May 2024

Objectives

To determine the test–retest reliability and agreement of home-based functional capacity self-administered assessments in socially isolated older adults.

Methods

Fourteen community-dwelling older adults (eight females, 67.9 ± 7.7 years) volunteered for this study. Before testing, participants were screened online for eligibility and received instructional videos explaining test set-up and execution. Participants underwent the 30-second sit-to-standing test, gait speed tests at the usual pace, and timed-up-and-go tests administered 4 weeks apart. For the 30-second sit-to-standing protocol, participants were instructed to repeatedly sit and stand from a chair (with a height of ∼ 43 cm and without armrests) for 30 s, with the number of repetitions recorded. In the gait speed test protocol, participants were instructed to walk at their usual and comfortable pace, with the time taken recorded (seconds). In the timed-up-and-go, participants stood up from a chair, walked as fast as possible for 3 m, circled a marked point, and returned to the chair to sit down, completing the test, with the score recorded (seconds). A trained researcher conducted the scoring virtually via synchronous video.

Results

30-second sit-to-standing, gait speed test, and timed-up-and-go showed excellent mean coefficient of variation values (2.0–4.9), small standard error of measurement (0.08–1.27), excellent intraclass coefficient (0.97–0.99), very strong correlations (0.97–0.99) and good agreement between the two days of testing.

Conclusion

Self-administered functional capacity tests performed by older adults at home were reliable with good agreement. Healthcare professionals and older adults should take advantage of simple remote self-administered assessments performed at home to evaluate older adults’ health status.
Evaluating the performance of an AI-powered VBAC prediction system within a decision-aid birth choice platform for shared decision-making
Authors: Yang Cherng Chia , Wang Ching Fu , Lin Wei Ming , Chen Shu Wen , Hu Hsiang Wei
Published: May 2024

Background

Vaginal birth after cesarean (VBAC) is generally regarded as a safe and viable birthing option for most women with prior cesarean delivery. Nonetheless, concerns about heightened risks of adverse maternal and perinatal outcomes have often dissuaded women from considering VBAC. This study aimed to assess the performance of an artificial intelligence (AI)-powered VBAC prediction system integrated into a decision-aid birth choice platform for shared decision-making (SDM).

Materials and Methods

Employing a retrospective design, we collected medical records from a regional hospital in northern Taiwan from January 2019 to May 2023. To explore a suitable model for tabular data, we compared two prevailing modeling approaches: tree-based models and logistic regression models. We subjected the tree-based algorithm, CatBoost, to binary classification.

Results

Forty pregnant women with 347 records were included. The CatBoost model demonstrated a robust performance, boasting an accuracy rate of 0.91 (95% confidence interval (CI): 0.86–0.94) and an area under the curve of 0.89 (95% CI: 0.86–0.93), surpassing both regression models and other boosting techniques. CatBoost captured the data characteristics on the significant impact of gravidity and the positive influence of previous vaginal birth, reinforcing established clinical guidelines, as substantiated by the SHapley Additive exPlanations analysis.

Conclusion

Using AI techniques offers a more accurate assessment of VBAC risks, boosting women’s confidence in selecting VBAC as a viable birthing option. The seamless integration of AI prediction systems with SDM platforms holds a promising potential for enhancing the effectiveness of clinical applications in the domain of women's healthcare.
A Clinician’s Guide to the Implementation of Point-of-Care Ultrasound (POCUS) in the Outpatient Practice
Authors: Overgaard Joshua , Thilagar Bright P. , Bhuiyan Mohammed Nadir
Published: May 2024

Point-of-care ultrasound (POCUS) is a valuable clinical tool used at the patient bedside to rapidly assess a wide variety of symptoms and problems which would otherwise take hours or even days. Though it has become the standard of care in Emergency Medicine and is becoming so in hospital internal medicine, less uptake has been appreciated in the outpatient setting despite reported interest from clinicians practicing there. A number of common barriers have been cited to explain this gap in use, which usually include access to equipment, mentorship, and time. In this review we present a proposed framework for clinicians who have an interest in implementing POCUS in their outpatient practice which we hope can mitigate some of these barriers and provide a more streamlined pathway to their desired goals.
Demands and Resources  of Working from Home: From Pandemic to Economic Crisis
Authors: Naotunna N. P. G. S. I. , Adikaram Arosha S.
Published: May 2024

Situated in the backdrop of Sri Lanka, this article delves into the challenges hindering work from home (WFH) for employees and explores how organisations have navigated these hurdles during the ever-evolving stages of the COVID-19 pandemic and subsequent economic turmoil. Employing a qualitative approach, 77 in-depth, semi-structured interviews were carried out with 46 individuals—comprising 20 employees and 26 human resources practitioners (HRPs). Some participants were interviewed multiple times, offering insights into various phases of the study. Through the lens of the job demands and resources (JD-R) framework, our analysis uncovered four key job demands impeding remote work and identified resources that have empowered employees to navigate and alleviate these challenges: (a) adjustment demands and resources, (b) work demands and resources, (c) family demands and resources, and (d) emotional demands and resources. Despite persistent challenges across stages, their manifestations were unique. Even after two years of widespread WFH practice and extensive use of resources, WFH demands endure in diverse ways. In conclusion, our findings underscore numerous resources available to HRPs, offering valuable insights to address WFH demands and fortify the success and sustainability of WFH practices.
Usefulness of Current Patient-Reported Outcome Scales for ACL Injury: A Mixed-Methods Evaluation of Stakeholder-Perceived Utility of Specific Constructs and Items Across the Rehabilitation Timeline
Authors: Petushek Erich J. , Diekfuss Jed A. , Lamplot Joseph D. , Mørtvedt Anne-Inger , Hoey Lauren C. , Heo Kevin , Petit Camryn B. , Barber Foss Kim D. , Warren Shayla M. , Slutsky-Ganesh Alexis B. , Kenyon Charles D. , McPherson April L. , Biller Michael E. , Newsome Michael , Jennings Brian , Xerogeanes John W. , Myer Gregory D.
Published: May 2024

Background:

Numerous patient-reported outcome measures (PROMs) have been used in patients with anterior cruciate ligament reconstruction (ACLR), often with overlapping constructs of interest and limited content validity. Inefficient scale application increases burden and diminishes overall usefulness for both the patient and practitioner.

Purpose:

To isolate specific PROM items across a diverse set of constructs that patients and practitioners perceive as having the greatest value at various stages of recovery and return to sport (RTS) in patients after ACLR.

Study Design:

Cross-sectional study.

Methods:

A combined 77 stakeholders participated in this 2-phase mixed-methods investigation. In phase 1, a total of 27 patients and 21 practitioners selected individual PROM items from various constructs that had the greatest utility or importance. In phase 2, the highest rated items were further tested in a head-to-head comparison with 29 stakeholders who attended the 2022 ACL Injury Research Retreat. In addition to the utility assessment, practitioners answered other questions related to importance and timing of PROM assessments.

Results:

In phase 1, both patients and practitioners shared the same top item in 6 of the 8 (75%) constructs assessed. In phase 2, the construct of psychological burden was rated as “extremely important” by 59% of respondents, followed by physical function (54%), symptoms (35%), and donor site issues (10%). The PROM items of confidence, perceived likelihood of reinjury, and difficulty stopping quickly were rated by a respective 93%, 89%, and 86% of the sample as either “very useful” or “extremely useful.” All constructs except donor site issues were rated by most stakeholders to be absolutely necessary to evaluate treatment progress and RTS readiness at the 6-month postoperative time and at RTS.

Conclusion:

Overall, psychological burden, with specific items related to confidence and reinjury likelihood, were rated as most important and useful by both patients and practitioners. The second most important and useful PROM item was related to higher intensity function (eg, decelerating or jumping/landing activities during sports).
Psychological Well-Being of Nurses with One to Five Years of Clinical Experience
Authors: Yi Eunhye , Lee Sunhee
Published: May 2024

Introduction

Nurses are required to fulfill many roles, including expertise, communication, and leadership and are psychologically vulnerable due to lack of manpower, emotional labor, and shift work. Among them, it is necessary to understand the psychological well-being of new nurses and junior nurses who have a high early resignation rate.

Objective

The purpose of this study was to investigate psychological well-being of nurses and compare psychological well-being of nurses from the first to the fifth years of clinical experience.

Methods

Cross-sectional comparative design and purposive sampling method were used. Data were collected from 148 nurses with one to five years of experience working in tertiary care general hospitals. On November 11, 2021, an online link for the structured questionnaire was sent to the group social networking service accounts for nurses. Psychological well-being was assessed using a Korean version of the Scales of Psychological Well-being including autonomy, environmental mastery, personal growth, positive relations with others, purpose in life, and self-acceptance.

Results

The average psychological well-being of nurses was 194.11, with significant differences depending on years of clinical experience ( p = .006, F = 3.82) and satisfaction with nursing ( p < .001, F = 13.12). It was lowest at 180.08 in the first year, gradually improving, but falling again from the fourth year. Among five subfactors except positive relations with others ( p = .389), psychological well-being was related to clinical experiences years using satisfaction with nursing and religion as covariates.

Conclusions

This study that compared psychological well-being from the first to the fifth year according to clinical experience revealed the need for optimized intervention for each year. Nursing managers can improve the psychological well-being of nurses through active and appropriate intervention according to the passage of nursing experience.
Challenges and Counteracting Strategies Including Optimum Health Service Practices for Frontline Nurses During the Mpox Outbreak and Futuristic Vision
Authors: Ahmed Sirwan Khalid , Dabou Eman A. , Ibrahim Fatma M. , Mohammed Mona G. , Chandran Deepak , Basit Jawad , Chakraborty Sandip , Emran Talha Bin , Islam Md. Rabiul , Dhama Kuldeep
Published: May 2024

Introduction

Monkeypox (mpox) is an evolving infectious disease caused by the monkeypox virus (MPXV). On July 23, 2022, the WHO declared the recent mpox outbreaks a public health emergency of international concern (PHEIC), which terminated on May 11, 2023. As of July 11, 2023, 88,288 confirmed cases and 149 deaths have been reported from 112 countries and territories. Currently, mpox is not a PHEIC, as the outbreak and its impacts are nearly over. Nurses played significant roles during the mpox 2022 outbreak as frontline workers.

Purpose

In light of the impending mpox global outbreak in 2022, this brief report provides an update on the enormous difficulties faced by frontline nurses while playing a crucial role in handling the mpox outbreak and some potential solutions to these difficulties. The methodological framework employed in this narrative brief report involves conducting a comprehensive analysis and synthesis of relevant literature and hypothetical scenarios. The aim is to put forth practical strategies that can effectively tackle the difficulties encountered by frontline nurses in the context of the mpox outbreak. Additionally, the report seeks to envision a healthcare system that is more resilient in the face of future challenges.

Conclusion

It is important to understand the challenges the nurses face from their perspective. As frontline health care workers, the various health issues of nurses and their concerns must be taken care of appropriately by adopting optimum health service practices, adequate safety measures, recommended precautionary measures, and boosting them mentally while handling mpox patients. Counseling and the arrangement of workshops are required. Appropriate care should be taken to address the various health issues concerning nurses by adopting health service practices at optimum levels. Side by side, recommended safety and precautionary measures should be followed.
Natural language acquisition and gestalt language processing: A critical analysis of their application to autism and speech language therapy
Authors: Hutchins Tiffany L , Knox Sophie E , Fletcher E Cheryl
Published: May 2024

Background and Aim

Recently, there has been a lot of interest surrounding the term gestalt language processor (GLP) which is associated with Natural Language Acquisition (NLA): a protocol intended to support the language development of autistic people. In NLA, delayed echolalia is presumed raw source material that GLPs use to acquire language in a stage-like progression from delayed echolalia to spontaneous speech. The aim of this article is to evaluate NLA in light of relevant literatures to allow scrutiny of NLA claims.

Main contributions

First, we review the notion of gestalt language and situate it in the broader literature on language styles to update understanding of its significance. We then review the links from gestalt language processing to autism and identify definitional and conceptual problems and clarify the construct ‘episodic memory’. We discuss the ‘raw material view of delayed echolalia’ and identify theoretical and empirical shortcomings. Finally, we review Blanc’s language stages and their accompanying assessment and language support recommendations and challenge their validity.

Conclusions & Implications

The term ‘gestalt language processor’ is definitionally and conceptually troubled, the assertion that autistic people are GLPs is misleading and unhelpful, and evidence is lacking that GLP represents a legitimate clinical entity. The theoretical basis of NLA lacks empirical support. NLA stages are implausible and their accompanying assessment and support recommendations lack justification. We recommend the use of alternate, individualized, theoretically-sound, evidence-based, neurodiversity-affirming supports that are sensitive and responsive to the heterogeneity that defines autism.
B. R. Ambedkar as a Humanistic Economist
Authors: Laxman Manjula
Published: May 2024

B. R. Ambedkar was a prominent humanistic philosopher in India in the twentieth century. He was a humanistic economist, anthropologist, lawyer, social reformer and political leader who played a pivotal role in making modern India. As a humanistic economist who pioneered analysing economic development challenges, he focused on human dignity, liberty and justice to achieve inclusive development in India. He found that economic inequality, poverty and exploitation resulted from social inequality and employed plural and normative economic analysis methods to establish justice in practice in the Indian economy and even society. He believed that through social, economic and political institutional reforms, an equitable society could be achieved. He was against capitalism and the centralization of economic power; he promoted the egalitarian state and alternative economies. He believed that without democratic institutions, distributive justice could not be achieved, which is the source of human well-being and the flourishment of human lives.
Algorithmic narrativity: Literary experiments that drive technology
Authors: Rettberg Scott , Rettberg Jill Walker
Published: May 2024

This paper extends Raymond Williams’ insights on technology and society by asserting that not only scientific, social, and economic conditions but also aesthetic factors are crucial for technological adoption. The concept of ‘algorithmic narrativity’ is introduced to describe the combination of the human ability to understand experience through narrative with the power of the computer to process and generate data. Using examples ranging from the exhibition of John Clark's Latin Verse Machine in 1845 through generative poetry in the early 1950s to today's generative AI, the authors argue that aesthetic innovation precedes and is necessary to technological advances.
Rapid tumor DNA analysis of cerebrospinal fluid accelerates treatment of central nervous system lymphoma
Authors: Gupta Mihir , Bradley Joseph D. , Massaad Elie , Burns Evan J. , Georgantas N. Zeke , Maron Garrett E. , Batten Julie M. , Gallagher Aidan , Thierauf Julia , Nayyar Naema , Gordon Amanda , Jones SooAe S. , Pisapia Michelle , Sun Ying , Jones Pamela S. , Barker Fred G. , Curry William T. , Gupta Rajiv , Romero Javier M. , Wang Nancy , Brastianos Priscilla K. , Martinez-Lage Maria , Tateishi Kensuke , Forst Deborah A. , Nahed Brian V. , Batchelor Tracy T. , Ritterhouse Lauren L. , Iser Florian , Kessler Tobias , Jordan Justin T. , Dietrich Jorg , Meyerson Matthew , Cahill Daniel P. , Lennerz Jochen K. , Carter Bob S. , Shankar Ganesh M.
Published: May 2024

Delays and risks associated with neurosurgical biopsies preclude timely diagnosis and treatment of central nervous system (CNS) lymphoma and other CNS neoplasms. We prospectively integrated targeted rapid genotyping of cerebrospinal fluid (CSF) into the evaluation of 70 patients with CNS lesions of unknown cause. Participants underwent genotyping of CSF-derived DNA using a quantitative polymerase chain reaction–based approach for parallel detection of single-nucleotide variants in the MYD88, TERT promoter, IDH1, IDH2, BRAF, and H3F3A genes within 80 minutes of sample acquisition. Canonical mutations were detected in 42% of patients with neoplasms, including cases of primary and secondary CNS lymphoma, glioblastoma, IDH-mutant brainstem glioma, and H3K27M-mutant diffuse midline glioma. Genotyping results eliminated the need for surgical biopsies in 7 of 33 cases (21.2%) of newly diagnosed neoplasms, resulting in significantly accelerated initiation of disease-directed treatment (median, 3 vs 12 days; P = .027). This assay was then implemented in a Clinical Laboratory Improvement Amendments environment, with 2-day median turnaround for diagnosis of CNS lymphoma from 66 patients across 4 clinical sites. Our study prospectively demonstrates that targeted rapid CSF genotyping influences oncologic management for suspected CNS tumors.
Absolute lymphocyte count after BCMA CAR-T therapy is a predictor of response and outcomes in relapsed multiple myeloma
Authors: Mejia Saldarriaga Mateo , Pan Darren , Unkenholz Caitlin , Mouhieddine Tarek H. , Velez-Hernandez Juan Esteban , Engles Katherine , Fein Joshua A. , Monge Jorge , Rosenbaum Cara , Pearse Roger , Jayabalan David , Gordillo Christian , Chan Hei Ton , Yamshon Samuel , Thibaud Santiago , Mapara Markus , Inghirami Giorgio , Lentzsch Suzanne , Reshef Ran , Rossi Adriana , Parekh Samir , Jagannath Sundar , Richard Shambavi , Niesvizky Ruben , Bustoros Mark
Published: May 2024

B-cell maturation antigen (BCMA)–targeting chimeric antigen receptor T cells (CAR-Ts) used in multiple myeloma (MM) are rapidly becoming a mainstay in the treatment of relapsed/refractory (R/R) disease, and CAR-T expansion after infusion has been shown to inform depth and duration of response (DoR), but measuring this process remains investigational. This multicenter study describes the kinetics and prognostic impact of absolute lymphocyte count (ALC) in the first 15 days after CAR-T infusion in 156 patients with relapsed MM treated with the BCMA-targeting agents ciltacabtagene autoleucel and idecabtagene vicleucel. Patients with higher maximum ALC (ALCmax) had better depth of response, progression-free survival (PFS), and DoR. Patients with ALCmax >1.0 × 103/μL had a superior PFS (30.5 months vs 6 months; P < .001) compared with those with ≤1.0 × 103/μL, whereas patients with ALCmax ≤0.5 × 103/μL represent a high-risk group with early disease progression and short PFS (hazard ratio, 3.4; 95% confidence interval, 2-5.8; P < .001). In multivariate analysis, ALCmax >1.0 × 103/μL and nonparaskeletal extramedullary disease were the only independent predictors of PFS and DoR after accounting for international staging systemic staging, age, CAR-T product, high-risk cytogenetics, and the number of previous lines. Moreover, our flow cytometry data suggest that ALC is a surrogate for BCMA CAR-T expansion and can be used as an accessible prognostic marker. We report, to our knowledge, for the first time the association of ALC after BCMA CAR-T infusion with clinical outcomes and its utility in predicting response in patients with R/R MM.
Costs and impact of disease in adults with sickle cell disease: a pilot study
Authors: Lanzkron Sophie , Crook Nicole , Wu Joanne , Hussain Sarah , Curtis Randall G. , Robertson Derek , Baker Judith R. , Nugent Diane , Soni Amit , Roberts Jonathan C. , Ullman Megan M. , Kanter Julie , Nichol Michael B.
Published: May 2024

We assessed the feasibility to estimate illness burden in adults with SCD, investigated factors associated with health-related quality of life (HRQoL), and estimated societal burden. We recruited 32 participants and collected data on fatigue, HRQoL, and work productivity and activity impairment via patient survey. Health care utilization was abstracted for the 12 months before enrollment using medical chart review. Mean age was 36.7 years; 84.4% of participants had hemoglobin SS or Sβthal0 disease, and 81.3% reported chronic pain (experiencing pain on ≥3 days per week in the past 6 months). Mean EQ-5D-3L visual analogue scale score was 63.4 and the index score was 0.79. The mean fatigue score was 57.9. Higher fatigue score was correlated with lower EQ-5D index score (correlation coefficient r = −0.35; P = .049) and Adult Sickle Cell Quality of Life Measurement Information System (ASCQ-Me) scores, including pain (r = −0.47; P = .006), sleep (r = −0.38; P = .03), and emotion scores (r = −0.79; P < .0001). The number of hospitalizations was negatively correlated with HRQoL (all P < .05). Patients who reported chronic pain had significantly lower mean ASCQ-Me sleep scores (48.3 vs 57.1; P = .04) and EQ-5D index scores (0.72 vs 0.89; P = .002) than those without chronic pain. Mean estimated annual per person costs were $51 779 (median, $36 366) for total costs, $7619 ($0) for indirect costs (estimated from lost earnings of participants), and $44 160 ($31 873) for medical costs. Fatigue, SCD complications, hospitalization, and chronic pain negatively affected HRQoL. This sample experienced a high economic burden, largely from outpatient doctor visits.
Proteomic snapshot of saliva samples predicts new pathways implicated in SARS-CoV-2 pathogenesis
Authors: Moreno Elena , Ciordia Sergio , Fátima Santos Milhano , Jiménez Daniel , Martínez-Sanz Javier , Vizcarra Pilar , Ron Raquel , Sánchez-Conde Matilde , Bargiela Rafael , Sanchez-Carrillo Sergio , Moreno Santiago , Corrales Fernando , Ferrer Manuel , Serrano-Villar Sergio
Published: May 2024

Background

Information on the microbiome's human pathways and active members that can affect SARS-CoV-2 susceptibility and pathogenesis in the salivary proteome is very scarce. Here, we studied a unique collection of samples harvested from April to June 2020 from unvaccinated patients.

Methods

We compared 10 infected and hospitalized patients with severe (n = 5) and moderate (n = 5) coronavirus disease (COVID-19) with 10 uninfected individuals, including non-COVID-19 but susceptible individuals (n = 5) and non-COVID-19 and nonsusceptible healthcare workers with repeated high-risk exposures (n = 5).

Results

By performing high-throughput proteomic profiling in saliva samples, we detected 226 unique differentially expressed (DE) human proteins between groups (q-value ≤ 0.05) out of 3376 unambiguously identified proteins (false discovery rate ≤ 1%). Major differences were observed between the non-COVID-19 and nonsusceptible groups. Bioinformatics analysis of DE proteins revealed human proteomic signatures related to inflammatory responses, central cellular processes, and antiviral activity associated with the saliva of SARS-CoV-2-infected patients (p-value ≤ 0.0004). Discriminatory biomarker signatures from human saliva include cystatins, protective molecules present in the oral cavity, calprotectins, involved in cell cycle progression, and histones, related to nucleosome functions. The expression levels of two human proteins related to protein transport in the cytoplasm, DYNC1 (p-value, 0.0021) and MAPRE1 (p-value, 0.047), correlated with angiotensin-converting enzyme 2 (ACE2) plasma activity. Finally, the proteomes of microorganisms present in the saliva samples showed 4 main microbial functional features related to ribosome functioning that were overrepresented in the infected group.

Conclusion

Our study explores potential candidates involved in pathways implicated in SARS-CoV-2 susceptibility, although further studies in larger cohorts will be necessary.

Graphical Abstract
Reconstruction of the pollution history of the Urft reservoir: an organic-geochemical investigation
Authors: Schwanen Christina A. , Stauch Georg , Schulte Philipp , Schwarzbauer Jan
Published: May 2024

Background

The reconstruction of the pollution history using aquatic sedimentary archives is of major relevance not only for the present and past, but also for future actions. The extent and influence of past anthropogenic emissions can be correlated with site-specific (e.g., industrial) developments as well as political actions, regulations, and initiatives. Finally, the need for further restrictions, specific monitoring or other countermeasures can be defined. Accordingly, within the scope of this study, a drilling core of subaquatic sediment was comprehensively analyzed to reconstruct the pollution history of the Urft reservoir and to understand the linkage between introduction, fate, and behavior of different organic pollutants.

Results

The Urft reservoir is well suitable for pollution reconstruction as the investigated interval covered a period of nearly 60 years of undisturbed sedimentation of fine-grained material. Additionally, specific input factors and their development (e.g., in industrial production) could be easily correlated with the emission profile detected for the reservoir. Overall, quantitative data of more than 60 lipophilic organic compounds were obtained and traced back to urban and industrial emissions. Concentrations were mainly in the range of ng/gTOC–µg/gTOC showing a decreasing tendency toward the surface and, thus, the effectiveness of political regulations. In addition, a clear maximum was detected for almost all substances at the end of the 1970s/beginning of the 1980s, probably related to an exceptional event such as a flood or a malfunction affecting wastewater-related compounds of both urban and industrial origin.

Conclusions

Based on the organic-geochemical investigation and the associated dating, it was possible to reconstruct the pollution history of the Urft catchment in the northern Eifel mountains. Overall, organic indicators have proven to be very useful to obtain information on distribution patterns and the influence of industrial as well as governmental actions. For instance, catchment-specific developments such as the closure of ironworks were recognizable in the identified emission patterns. Generally, in the last 50 years, the pollution of the reservoir sediment has decreased clearly showing the efficiency of increasing environmental awareness and corresponding regulations.
A qualitative study of the experiences of insulin use by older people with type 2 diabetes mellitus
Authors: Langerman Chaya , Forbes Angus , Robert Glenn
Published: May 2024

Background

There is a rising prevalence of type 2 diabetes among older people. This population also suffers from co-morbidity and a greater number of diabetes related complications, such as visual and cognitive impairment, which can potentially affect their ability to manage insulin regimens. Understanding the experiences of older people when they transition to insulin will help the development of healthcare interventions to enhance their diabetes outcomes, overall health and quality of life.

Aims

The aims of this exploratory study were to (1) understand the experiences of older people with type 2 diabetes in relation to insulin treatment initiation and management and (2) use this understanding to consider how the insulin management support provided to older people by healthcare providers could be more tailored to their needs.

Method

A qualitative study using semi structured (remote) interviews with older people with diabetes (n = 10) and caregivers (n = 4) from the UK. Interviews were audio recorded and transcribed, and framework analysis was used to analyse the data.

Results

Three main themes, along with six subthemes, were generated from the study data. Participants generally felt at ease with insulin administration following training, yet some reported feelings of failure at transitioning to insulin use. Participants were also frustrated at what they perceived were insufficient resources for effective self-management, coupled with a lack of professional interest in optimising their health as older people. Some also expressed dissatisfaction regarding the brevity of their consultations, inconsistent information from different healthcare professionals and poor treatment coordination between primary and secondary care.

Conclusion

Overall, the study emphasised that older people need better support, education and resources to help manage their insulin use. Healthcare professionals should be encouraged to adopt a more individualised approach to supporting older people that acknowledges their prior knowledge, physical and psychological capabilities and motivation for diabetes self-management. In addition, better communication between different services and greater access to specialist support is clearly needed for this older population.

Practice implications

An integrated care pathway for insulin use in older people could be considered. This would include an assessment of the older person’s needs and capacity on their initiation to insulin; targeted education and training in self-management; timely access to appropriate emotional and peer support resources; care plans developed collaboratively with patients; and individualised glucose targets that recognise the needs and preferences of the older person.
Sustainable solutions to barriers of point-of-care diagnostic testing services in health facilities without laboratories in the Bono Region, Ghana: a qualitative study
Authors: Ansu-Mensah Monica , Bawontuo Vitalis , Kuupiel Desmond , Ginindza Themba G.
Published: May 2024

Background

A sustainable point-of-care (POC) diagnostic testing implementation in low-resourced facilities enhances quick diagnostic investigation and halts unnecessary referrals. This study identified the barriers impeding the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana; as well as explored potential solutions that could enhance the accessibility and effectiveness of POC diagnostic testing, ultimately improving the quality of healthcare delivery.

Methods

A total of twenty-eight participants were purposively selected from health facilities in low-resourced settings in the Bono Region for a descriptive qualitative study. Of the twenty-eight participants, seventeen including ten healthcare providers from CHPS facilities, six district health depot managers, and one regional depot manager were engaged in in-depth interviews. Additional eleven including nine healthcare providers and two district depot managers were also engaged in focus group discussions. NVivo version 12 software was employed for condensation, labelling, and grouping of themes. Data was analysed narratively.

Results

Work overloads, limited POC testing services, stock-outs of POC tests at the facilities, and supply-related challenges of POC test kits were identified as major barriers to POC testing services. To solve these barriers, adequate funding, an effective delivery system, stakeholders’ engagement and advocacy, and in-service and refresher training courses were suggested as potential solutions to POC diagnostic testing services implementation by the stakeholders.

Conclusions

This study’s findings emphasize the need to address the barriers hindering the implementation of POC diagnostic testing in health facilities without laboratories in the Bono Region of Ghana. The suggested solutions provide a roadmap for improving the accessibility and effectiveness of POC testing, which has the potential to enhance the quality of healthcare delivery, reduce unnecessary referrals, and ultimately improve patient health outcomes in underserved settings.
Investigating the association between medication regimen complexity, medication adherence and treatment satisfaction among Malaysian older adult patients: a cross-sectional study
Authors: Al Haqimy Mohammad Yunus Mohammad Adam , Akkawi Muhammad Eid , Fata Nahas Abdul Rahman
Published: May 2024

Background

The prevalence of medication nonadherence among Malaysian older adults is approximately 60%. However, there is a lack of studies assessing the factors associated with medication nonadherence among this population. This research aims to explore the association between medication regimen complexity (MRC), treatment satisfaction and medication adherence among Malaysian older adults.

Method

A cross-sectional study was conducted in outpatient clinics of a teaching hospital in Pahang, Malaysia, between April 2023 and September 2023. MRC Index (MRCI), Treatment Satisfaction for Medication version II (TSQM v.II), and the Malaysian Medication Adherence Assessment Tool (MyMAAT) were used. Multivariate linear and logistic regression models were performed to test the factors affecting treatment satisfaction and medication adherence. Mediator analysis was implemented to assess the mediating role of treatment satisfaction.

Result

The study involved 429 Malaysian older adult patients, with a prevalence of nonadherence of 51.0% (n = 219) and an MRCI mean score of 17.37 (SD = 7.07). The mean overall treatment satisfaction score was 73.91 (SD = 15.23). Multivariate logistic regression analysis expressed four significant predictors associated with nonadherence: MRC (AOR = 1.179, p = 0.002), overall treatment satisfaction (AOR = 0.847, p < 0.001), partially self-managed medication (AOR = 2.675, p = 0.011) and fully managed medication by family members/caregivers (AOR = 8.436, p = 0.004). Multivariate linear regression shows three predictors of treatment satisfaction: MRC (β = -1.395, p < 0.001), Charlson Comorbidity Index (CCI) (β = -0.746, p = 0.009) and self-managed medication (β = 5.554, p = 0.006). Mediator analysis indicated that treatment satisfaction partially mediated the association between MRC and nonadherence.

Conclusion

Nonadherence was quite prevalent among Malaysian older outpatients and was associated with regimen complexity, treatment satisfaction and patient dependence on others to manage their medications. Future studies should focus on interventions to control the factors that negatively affect patients’ medication adherence.
Plasma proenkephalin and neutrophil gelatinase-associated lipocalin predict mortality in ICU patients with acute kidney injury
Authors: Zhang Mengqin , Yang Yang , Zhu Luqi , Cui Ke , Zhang Sheng , Xu Yinghe , Jiang Yongpo
Published: May 2024

Background

Acute kidney injury (AKI) is a common complication in patients admitted to intensive care unit (ICU) and mortality rates for this condition are high. To reduce the high incidence of short-term mortality, reliable prognostic indicators are required to facilitate early diagnosis and treatment of AKI. We assessed the ability of plasma proenkephalin (p‑PENK) and plasma neutrophil gelatinase-associated lipocalin (p‑NGAL) to predict 28-day mortality in AKI patients in intensive care.

Methods

This prospective study, carried out between January 2019 and December 2019, comprised 150 patients (100 male) diagnosed with AKI after excluding 20 patients discharged within 24 h and those with missing hospitalization data. Blood samples were collected to determine admission p-PENK and p-NGAL levels. The study outcome was 28‑day mortality.

Results

The mean patient age was 68 years (female, 33%). The average P‑PENK and p‑NGAL levels were 0.24 ng/µL and 223.70 ng/mL, respectively. P‑PENK levels >0.36 ng/µL and p‑NGAL levels >230.30 ng/mL were used as critical values to reliably indicate 28‑day mortality for patients with AKI (adjusted hazard ratios 0.785 [95% confidence interval 0.706–0.865, P<0.001] and 0.700 [95% confidence interval 0.611–0.789, P<0.001], respectively). This association was significant for mortality in patients in intensive care with AKI. Baseline p-PENK (0.36 ng/µL) and p-NGAL (230.30 ng/mL) levels and their respective cut-off values showed clinical value in predicting 28-day mortality.

Conclusion

Serum PENK and NGAL levels, when used in conjunction, improved the accuracy of predicting 28-day mortality in patients with AKI while retaining sensitivity and specificity.
Educational level and gender are associated with emotional well-being in a cohort of Dutch dialysis patients
Authors: Bakker Wisanne M. , Theunissen Maurice , Öztürk Elife , Litjens Elisabeth , Courtens Annemie , van den Beuken- van Everdingen Marieke H. J. , Hemmelder Marc H.
Published: May 2024

Background

Patients undergoing dialysis have an impaired health-related quality of life (HRQOL). There are conflicting data from small series on whether patient-related factors such as educational level have an impact on experienced HRQOL. The aim of this study was to investigate the association between educational level and HRQOL in dialysis patients.

Methods

In a single-center retrospective cross-sectional study HRQOL was measured using the Kidney Disease Quality of Life Short Form-36 (KDQOL-SF36) in prevalent chronic dialysis patients. Educational level was categorized into low, intermediate and high subgroups. Univariate and multivariate regression analyses were performed to assess the effects of age, gender, ethnicity, and dialysis vintage on the association between HRQOL and educational level.

Results

One hundred twenty-nine chronic dialysis patients were included. Patients with an intermediate educational level had significantly higher odds of a higher emotional well-being than patients with a low educational level 4.37 (1.-89–10.13).

A similar trend was found for a high educational level (OR 4.13 (1.04–16.42), p = 0.044) The odds for women compared to men were 2.83 (1.32–6.06) for better general health and 2.59 (1.15–5,84) for emotional well-being. There was no interaction between gender and educational level for both subdomains. Each year of increasing age significantly decreased physical functioning (OR 0.94 (0.91–0.97)).

Conclusions

Educational level and sex were associated with emotional well-being, since patients with intermediate and high educational level and females had better emotional well-being in comparison to patients with low educational level and males. Physical functioning decreased with increasing age.
Extracellular vesicle biomarkers in circulation for colorectal cancer detection: a systematic review and meta-analysis
Authors: Shi Xianquan , Zhao Xinyu , Xue Jinru , Jia Erna
Published: May 2024

We provided an overview which evaluated the diagnostic performance of circulation EV biomarkers for CRC from PubMed, Medline, and Web of Science until 21 August 2022.Weidentified 48 studies that involved 7727 participants and evaluated 162 plasma/serum individual EV biomarkers including 117 RNAs and 45 proteins, as well as 45 EV biomarker panels for CRC detection. 12 studies evaluated the diagnostic performance of EV biomarkers for early CRC. The summarized sensitivity, specificity, and AUC value of individual EV RNAs and EV RNA panels were 76%, 75%, 0.87 and 82%, 79% and 0.90, respectively. Meanwhile, those of individual EV proteins and EV protein panels were 85%, 84%, 0.92 and 87%, 83%, 0.92, respectively. These results indicated that EV biomarker panels revealed superior diagnostic performance than the corresponding individual biomarkers. In early CRC, EV biomarkers showed available diagnostic value with the sensitivity, specificity, and AUC value of 80%, 75%, and 0.89.In subgroup analyses, EV miRNAs and LncRNAs held similar diagnostic value with the sensitivity, specificity and AUC value of 75%, 78%, 0.90 and 79%, 72%, 0.83, which was highly consistent with the whole EV RNAs. Significantly, the diagnostic values of EV miRNAs in plasma were marginally higher than those based on serum. In detail, the sensitivity, specificity, and AUC values were 79%, 81%, and 0.92 in plasma, as well as 74%, 77%, and 0.88 in serum, respectively. Therefore, circulation EV biomarkers could be considered as a promising biomarker for the early detection of CRC.