bluuebunny/crossref_metadata_2025 huggingface dataset:
Pityriasis rosea
Authors: Shah Murwareed , Adeel Sariya
Published: October 2024

Pityriasis rosea is a benign self-limiting rash, usually lasting 6 to 8 weeks. In classic pityriasis rosea a ‘herald patch’ is the initial finding, a large oval patch usually found on the torso. Smaller, scaly oval pink eruptions follow after 1 to 2 weeks on the chest, back and limbs, and can resemble a Christmas tree pattern on the back. It is seen more commonly in women, with a higher incidence in pregnancy, and has an estimated prevalence of around 1.3%. The rash usually heals without scarring and often no treatment is required. Symptomatic treatment is used occasionally to alleviate pruritus. This article will explore different presentations of pityriasis rosea, how to make a diagnosis and the main management options.
Efficacy and safety of perioperative, neoadjuvant, or adjuvant immunotherapy alone or in combination with chemotherapy in early-stage non-small cell lung cancer: a systematic review and meta-analysis of randomized clinical trials
Authors: Meng Yunchang , Zhang Qingfeng , Wu Ranpu , Li Huijuan , Wang Zhaofeng , Yao Yang , Li Xinjing , Chen Zhangxuan , Gong Yanzhuo , Liu Hongbing
Published: October 2024

Background:

Neoadjuvant (NE), adjuvant (AD), and perioperative (PE) immunotherapies have gained validation in early-stage non-small cell lung cancer (NSCLC) trials. However, a comprehensive assessment of their comparative efficacy and safety is lacking.

Objectives:

To compare the efficacy and safety of NE, AD, and PE immunotherapies in early-stage NSCLC.

Design:

A systematic review and network meta-analysis using a Bayesian framework.

Data sources and methods:

We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) of immune checkpoint inhibitors plus chemotherapy (CT) for early-stage NSCLC. Hazard ratios (HRs) and odds ratios (ORs) for binary endpoints with 95% confidence intervals (CIs) were calculated.

Results:

We included 10 RCTs involving 5569 NSCLC patients, categorized as NE, PE, or AD immunotherapy. Indirect comparisons highlighted differences in efficacy between PE and AD immunotherapy, specifically in event-free survival (EFS)/disease-free survival (DFS) (HR = 0.72, 95% CI: 0.53–0.96). NE/PE immunotherapies improved pathologic complete response (pCR) (OR = 7.56, 95% CI: 5.24–10.92), major pathologic response (MPR) (OR = 5.46, 95% CI: 3.97–7.51), and EFS (HR = 0.58, 95% CI: 0.52–0.65), while AD immunotherapy enhanced DFS (HR = 0.78, 95% CI: 0.69–0.90). Overall survival (OS) benefits were seen only with PE immunotherapy (HR = 0.66, 95% CI: 0.55–0.81). PE treatment improved EFS across various subgroups (PD-L1 < 1%, IIIB, squamous, female, without MPR/pCR, epidermal growth factor receptor (EGFR) mutant-negative), except EGFR mutant-positive NSCLC (HR = 0.54, 95% CI: 0.21–1.43). AD (OR = 1.81, 95% CI: 1.20–2.73) and PE (OR = 1.28, 95% CI: 1.10–1.50) immunotherapies were associated with higher grade ⩾3 adverse events.

Conclusion:

In the three treatment modalities, PE immunotherapy appears to be more effective than AD immunotherapy, with PE showing significant advantages in certain subgroups that NE does not. NE and PE immunotherapy significantly improved pCR, MPR, and EFS, while AD immunotherapy significantly improved DFS in NSCLC patients compared to the control group. However, only PE immunotherapy significantly improved OS. Differences in efficacy between NE and PE across the entire population of resectable NSCLC remain to be explored in additional studies.
Synthesis of M + 4 Stable Isotopomers of Ergometrine and Ergometrinine
Authors: Braun Birgit , Köppen Robert , Wedler Christine , Theil Fritz
Published: October 2024

The priority ergot alkaloids ergometrine and ergometrinine are highly toxic mycotoxins naturally occurring in different types of grains (i.e. rye, wheat, rice), as well as grain-based foods and, therefore, have gained increasing importance for food safety over the last years. The application of HPLC-MS/MS for the analysis of ergot alkaloids in food presupposes the availability of isotopically labelled internal standards. Thus, a multistep synthesis was developed for ergometrine-( N-13CD3) and its epimer ergometrinine-( N-13CD3) with a mass shift of four units compared with the parent compounds. The synthesis is based on the preparation of stable isotope labelled lysergic acid that was coupled with ( S)-alaninol. The chemical synthesis of both compounds has been achieved in six steps with an overall yield of 1 % (ergometrine-( N-13CD3)) and 0.6 % (ergometrinine-( N-13CD3)), respectively. Structural identification was performed by MS analysis as well as 1H and 13C NMR.
Investigation of the Active Ingredients and Mechanism of Action of YGZ223 in the Treatment of Senile Pruritus Using Network Pharmacology and UPLC-MS
Authors: Shu Xiankui , Ye Ling , Han Shiqi , Liang Lu , Song Hancheng , Xue Shuang , Zhao Yilang , Ling Sa , Liu Bo
Published: October 2024

Background/Objective: Senile pruritus (SP) is a prevalent disease that occurs in elderly individuals over the age of 60 and is characterized by the primary symptom of pruritus. The disease's pathogenesis is complex, and clinical practice mainly uses symptomatic treatment drugs. YGZ223 is a traditional Chinese medicine currently in clinical trials for treatment of SP. However, its chemical composition and pharmacological mechanism remain unclear. The purpose of this inquiry is to investigate the workings of YGZ223 in managing SP using network pharmacology, UPLC-MS, and molecular docking. Materials and Method: This investigation employs network pharmacology to anticipate the mode of operation of YGZ223 in alleviating SP, and UPLC-MS is applied to identify the chemical constituents. Molecular docking provides the binding strengths between principal constituents and targets, while animal experiments are performed to validate the antipruritic activity of YGZ223. Results: The compound prescription for SP contains formononetin and erysodienone as effective ingredients. These ingredients have the potential to impact pathways related to cancer, endocrine resistance, and the PI3K/AKT signaling pathway by regulating targets such as AKT1, EGFR, and mTOR. Formononetin and erysodienone have a considerable binding capacity with various targets, the former displaying the strongest binding with AKT1. Animal test results show that the YGZ223 group can significantly reduce the number of tickles in mice compared to the 4-Aminopyridine induced model group, and has a good anti-itch effect. Conclusion: This study demonstrates that YGZ223 has potential anti-SP activity due to multiple constituents, targets, and pathways, and thus lays the groundwork for development of novel therapeutic approaches for SP.
Effects of Parallax and Distortion in Total Ankle Arthroplasty
Authors: Brown Joseph R. , Hill Zachary P. , Groeschl Ross , Steginsky Brian , Mendicino Robert W.
Published: October 2024

Background

Surgeons rely on intraoperative fluoroscopy to assist in placement of implant components during total ankle arthroplasty (TAA). Parallax alters the direction of an object when viewed from two different points, resulting in image distortion. The purpose of this study was to evaluate parallax/distortion in intraoperative fluoroscopic images during TAA.

Methods

A retrospective review of all TAAs performed by two surgeons (R.W.M. and B.S.) from August 2019 to April 2023 were reviewed. Intraoperative fluoroscopic anteroposterior (AP) ankle views were evaluated for any obvious parallax image distortion. Cases with obvious parallax distortion were included for angular evaluation of AP intraoperative fluoroscopic and first postoperative plain films. The tibia was marked at 2-centimeter intervals to create zones from the proximal stem of the implant. The anatomical axis of the tibia (AAT) was drawn at the mid-diaphysis. The anatomic lateral distal tibial angle (aLDTA) and anatomic axis deviation (AAD) were measured for each zone.

Results

A total of 22 TAAs were performed during the study period. Four cases were excluded due to inadequate imaging, leaving a total of 18 TAAs for review. We found 6 of 18 (33.3%) cases had obvious parallax distortion. We found the average aLDTA was 90.9° (84°-101°). At the most proximal tibial zone, the average aLDTA was 94° (91°-101°). We found the average AAD was 4.7 (0.5-17.2) mm. The AAD ranged from 0.5 to 17.2 mm lateral to 0.8 to 8.2 mm medial. Postoperative plain film radiographs displayed a normal aLDTA and an AAT centered within the ankle joint.

Conclusion

Parallax can distort the appearance of the tibia on fluoroscopic images. Deviation from the normal aLDTA and anatomical axis should be anticipated. Surgeons should be aware of the potential impact of parallax and ways to mitigate these effects.
Pressure and cold pain threshold reference values in a pain-free older adult population
Authors: Waller R , Brown E , Lim J , Nadarajah R , Reardon E , Mikhailov A , Straker L , Beales D
Published: October 2024

Background

More sex-specific pain sensitivity normative values from population-based cohorts in pain-free older adults are required. The aims of this study were (1) to provide sex- and age-specific normative values of pressure and cold pain thresholds in older pain-free adults and (2) to examine the association of potential correlates of pain sensitivity with pain threshold values.

Methods

This study investigated sex-specific pressure (lumbar spine, tibialis anterior, neck and dorsal wrist) and cold (dorsal wrist) pain threshold estimates for older pain-free adults aged 41–70 years. This cross-sectional study used participants ( n = 212) from the Raine Study Gen1-26 year follow-up. The association of pain thresholds, with correlates including sex, test site, ethnicity, waist-hip ratio, smoking status, health-related quality of life, depression, anxiety and stress symptoms, sleep quality, socioeconomic status and physical activity levels, was examined.

Results

Values for pressure and cold pain thresholds for older pain-free adults are provided, grouped by vicennium, sex and test site (pressure). Statistically significant independent correlates of increased pressure pain sensitivity were test site, ethnicity and sex. Only lower waist/hip ratio was a statistically significant, independent correlate of increased cold pain sensitivity.

Conclusions

This study provides robust sex- and age-specific normative values for pressure pain threshold and cold pain threshold for an older adult pain-free population. Combined with existing values, these data provide an important resource in assisting interpretation of pain sensitivity in clinical pain disorders and provide insights into the complex association of pain sensitivity with correlates that can be used in research.
Integrating tabular data through image conversion for enhanced diagnosis: A novel intelligent decision support system for stratifying obstructive sleep apnoea patients using convolutional neural networks
Authors: Casal-Guisande Manuel , Fernández-Villar Alberto , Mosteiro-Añón Mar , Comesaña-Campos Alberto , Cerqueiro-Pequeño Jorge , Torres-Durán María
Published: October 2024

Objective

High-dimensional databases make it difficult to apply traditional learning algorithms to biomedical applications. Recent developments in computer technology have introduced deep learning (DL) as a potential solution to these difficulties. This study presents a novel intelligent decision support system based on a novel interpretation of data formalisation from tabular data in DL techniques. Once defined, it is used to diagnose the severity of obstructive sleep apnoea, distinguishing between moderate to severe and mild/no cases.

Methods

The study uses a complete database extract from electronic health records of 2472 patients, including anthropometric data, habits, medications, comorbidities, and patient-reported symptoms. The novelty of this methodology lies in the initial processing of the patients’ data, which is formalised into images. These images are then used as input to train a convolutional neural network (CNN), which acts as the inference engine of the system.

Results

The initial tests of the system were performed on a set of 247 samples from the Pulmonary Department of the Álvaro Cunqueiro Hospital in Vigo (Galicia, Spain), with an AUC value of ≈ 0.8.

Conclusions

This study demonstrates the benefits of an intelligent decision support system based on a novel data formalisation approach that allows the use of advanced DL techniques starting from tabular data. In this way, the ability of CNNs to recognise complex patterns using visual elements such as gradients and contrasts can be exploited. This approach effectively addresses the challenges of analysing large amounts of tabular data and reduces common problems such as bias and variance, resulting in improved diagnostic accuracy.
Are multiple coders needed for cause of death assignment: results from telephonic verbal autopsy interviews conducted in 2021 in South Africa
Authors: Neethling Ian , Morof Diane , Glass Tracy , Kallis Natasha , Rao Chalapati , Bradshaw Debbie , Groenewald Pam
Published: October 2024

Introduction

Verbal autopsy (VA) methods have emerged to estimate causes of death in populations lacking robust civil registration and vital statistics (CRVS) systems. Despite World Health Organization endorsement of routine VA use, cost and efficiency concerns persist. Telephonic verbal autopsies (teleVAs) can reduce cost. Physician coding offers a valuable approach, but the expertise required makes it resource-intensive, often involving multiple coders for consensus.

Objective

To assess inter-coder agreement for cause of death (CoD) in South African teleVAs using Kappa statistics, evaluating if agreement surpasses a 0.8 cut-off (very high) potentially allowing single coders.

Methods

A cross-sectional study employed telephonic VA interviews on non-facility deaths in Cape Town (December 2020–September 2021). Trained fieldworkers administered a standard VA questionnaire. Each case's VA responses were reviewed independently by two physicians, medically certifying the CoD. A panel was used to solve disagreements. Cohen’s kappa-statistic ( k-statistic) tested agreement levels.

Results

Decedents were aged between 18 and 98 years. In total, 228 teleVAs (16.6% response rate) were conducted. Physician coding agreement was good overall ( k-statistic: 0.63). Diabetes mellitus (47%) and other non-communicable disease (42%) had initial agreement between physician coders in less than 50% of cases in comparison to consensus totals. COVID-19 (89%) and acute cardiac disease (83%) showed initial agreement in more than 80% of cases compared to consensus totals. A chi-square test revealed a significant difference in the number of causes listed on death notification forms for cases with and without agreement in Part 1 (χ2 = 14.71, p < 0.01), but not in Part 2 (χ2 = 4.97, p = 0.17).

Conclusion

CoD agreement might not be high enough to infer that single coders can be used instead of multiple coders. Challenges with co-morbidities and specific CoDs with multiple sequelae highlight the need for further research and refinement of VA methodologies for reliable CoD determination in routine practice.
Registered nurses' experiences of non-nurses being involved in nursing care to hospitalised patients – A focus group study
Authors: Enggaard Helle , Laugesen Britt , Kusk Kathrine Hoffmann , Bundgaard Karin , Haslund-Thomsen Helle , Jacobsen Sara , Voldbjerg Siri Lygum , Lerbæk Birgitte
Published: October 2024

The aim of this study was to explore registered nurses’ experiences of non-nurses being involved in nursing care of hospitalised patients at a Danish university hospital. A total of 16 registered nurses from 12 different inpatient wards where non-nurses were employed (employees without a nursing education) participated in five focus groups. The data were examined using thematic analysis. This article followed the COREQ guidelines. Three themes were generated: (1) balancing support: RNs’ experiences with non-nurses in indirect and direct nursing care; (2) managing complexity: RNs’ experiences with delegating nursing care to non-nurses; and (3) navigating responsibility: RNs’ experiences with coordinating patient care amidst non-nurse involvement. Replacing registered nurses with non-nurses makes delivery of nursing care complex. On the one hand, involving non-nurses in the delivery of indirect nursing care eases nurses’ workloads and releases time to spend with patients. Furthermore, quality of care can be improved if the competencies of the non-nurses’ match patients’ care needs. On the other hand, the involvement of non-nurses in direct nursing care complicates nurses’ delegation practice and causes uncertainty about their nursing role.
Influence of Age on Outcome Following Rib Fractures – A Case-Control Analysis
Authors: Ziegenhain Franziska , Mittlmeier Anne S. , Pape Hans-Christoph , Neuhaus Valentin , Canal Claudio
Published: October 2024

Background

Thoracic injuries are a very common entity throughout all age groups. With rising numbers of geriatric patients, characteristics of this patient group need to be better defined. The aim of this study was to investigate the impact of age on the outcome of thoracic trauma. In this project we provide a stratification of differentiated age groups regarding outcome parameter on rib fractures.

Methods

The study employed a retrospective design using data from patients who sustained thoracic trauma and received treatment at a level I trauma center over a 5-year period. Patients with the same pattern of injury and gender but different age (above and below 70 years) were matched.

Results

The mean age of the study population was 57 ± 19 years, 69% were male, 54% of patients had preexisting comorbidities. Hemothorax was present in 109 (16%), pneumothorax in 204 (31%) and lung contusions in 136 patients (21%). The overall complication rate was 36%, with a mortality rate of 10%. The matched pair analysis of 70 pairs revealed a higher prevalence of comorbidities in the older age group. They had significantly fewer pulmonary contusions and pneumothoraces than the younger patients and a shorter length of stay. However, the older age group had a significantly higher mortality rate.

Conclusions

Geriatric patients with rib fractures exhibit different patterns of intrathoracic injuries compared to their younger counterparts. Although numeric age may not be the most accurate predictor of adverse outcome, we found that higher age was associated with a clear trend towards an increased mortality rate. Our findings build a basis for further research to evaluate the outcome of age for instance with the tool of a rib fracture scoring system within stratified age groups in order to identify patients at major risk.
A Unique Presentation of Bacterial Group G Streptococcus Myopericarditis
Authors: Ozgur Sacide S. , Ansari Nida , Alcantara Alan , Vidreiro Angela Pais , Rahman Ryan , Shamoon Yezin , Elkattawy Sherif , Abboud Rachel , Doshi Rajkumar , Shamoon Fayez
Published: October 2024

Perimyocarditis and myopericarditis are inflammatory conditions of the pericardium and myocardium, often of idiopathic or infectious etiology, with viral infections being the most common. Nonrheumatic streptococcal myopericarditis (NSM) is a rare condition that can mimic acute myocardial infarction. This case report presents a 22-year-old male with no prior medical history who developed NSM following a streptococcal pharyngitis infection. The patient presented with pleuritic chest pain, tightness, and decreased exercise tolerance. Laboratory studies revealed elevated troponin levels and positive Streptococcus G antigen. Treatment included ampicillin-sulbactam, colchicine, ibuprofen, and dexamethasone. The patient’s symptoms resolved, and he was discharged with amoxicillin-clavulanate, colchicine, and ibuprofen.
Fulminant Meningitis: A Rare Case of HSV-2 and Cryptococcal Co-Infection in a Patient With AIDS
Authors: Bathobakae Lefika , Mohtadi Malina , Kim Chanhee , Ruff Trevor , Bashir Rammy , Ekin Utku , Philip Simi , Upadhyay Shivanck
Published: October 2024

Cryptococcal meningitis (CM) is a severe and often fatal infection of the central nervous system that is caused by Cryptococcus spp. Cryptococcal meningitis mainly affects immunocompromised individuals such as those with AIDS, organ transplantation recipients, and those with conditions requiring prolonged immunosuppressive therapy. Infection typically begins with the inhalation of cryptococcal spores, often from bird droppings, which can remain dormant in the lungs and lymph nodes before disseminating to the central nervous system. Signs and symptoms include headache, nausea, and cognitive impairment, which can progress to severe neurological complications if not promptly treated. Even in the era of antifungal and antiretroviral therapies, CM remains a public health challenge with substantial morbidity and mortality. Although rare, sporadic cases of cryptococcal neoformans/gattii coinfection with Mycobacterium tuberculosis, Streptococcus pneumoniae, and Treponema pallidum have been reported in the literature. Herein, we describe an extremely rare case of fulminant meningitis due to herpes simplex virus (HSV)-2 and Cryptococcal neoformans coinfection. Our patient also had cryptococcemia, which is known to increase acute mortality rates in patients with CM.
Health Workers’ Perception on Fall Risk Prevention: A Photovoice Method
Authors: Dewi Arlina , Meisari Winda Azmi , Almanfaluthi Muhammad Luthfi , Ambarwati Dwi , Dewi Rachmawati , Handini Diny Rachma Putri , Sutrisno Sutrisno , Dewi Trisna Setya
Published: October 2024

Health workers’ awareness can affect hospital fall prevention success. Enhancing awareness can be achieved by exploring their perspectives on the phenomenon. This study aims to explore health workers’ perceptions regarding fall risk prevention in hospitals. This study employed qualitative methods using photovoice. The participants were 20 health workers. The data collection was done within several steps, such as (1) The photographs of fall prevention were collected at 5 different hospitals within 3 months; (2) 20 photos were selected to be shown in the photo exhibition; (3) Participants were asked to reflect on the meaning of the photographs during photo exhibition, individually through Google Form and interview using SHOWED guidelines. This study identified 4 themes, including (1) the importance of fall risk identification, including environmental and physiological identification and the use of the appropriate assessment instrument based on age range; (2) the role of family and patient education, but does not guarantee that those who are educated have better attention; (3) involvement of nonhealthcare workers, such as security guide's contribution to identify patients; (4) application of fall protection and signs is crucial stuff to be applied in an appropriate way to prevent patients from falls. Health workers encountered both positive and negative aspects related to fall prevention strategies in hospital settings. Health workers’ perspectives can be considered by stakeholders to help improve hospital fall prevention regulations.
The Relationship Between Nurses’ Psychological Well-Being and Their Work Productivity Loss: A Descriptive Correlational Study
Authors: Hussein Azza Hassan Mohamed , Abou Hashish Ebtsam Aly , Younes Boshra Mostafa
Published: October 2024

Introduction

Nurses play a vital role in ensuring effective patient care delivery and organizational productivity. Hence, it becomes imperative to prioritize their psychological well-being and explore how its impairment may be associated with their productivity loss.

Aims

The study aims to investigate the relationship between nurses’ psychological well-being and their work productivity loss by examining how nurses self-reported their own psychological well-being and work productivity loss.

Methods

A descriptive correlational design was conducted at an Egyptian university hospital. A convenience sample of 400 nurses completed two tools: (a) Outcome Questionnaire-45 was used to assess the psychological well-being of nurses and (b) the Work Productivity and Activity Impairment – General Health Questionnaire was used to measure nurses’ work productivity.

Results

Among the 400 surveyed nurses, 66.7% reported overall poor psychological well-being. Regarding work productivity loss, 22.8% of nurses missed an average of 974.81 work hours due to absenteeism, and 62.0% lost an average of 10,630 work hours due to presenteeism. Additionally, 75.5% experienced impaired daily living activities. Approximately 13.4% of total working hours were missed due to health problems or psychological distress. Regression analysis revealed that poor psychological well-being significantly predicts work productivity loss, accounting for 2.0% of absenteeism, 11.0% of presenteeism, 17.0% of daily activity impairment, and 9.0% of overall productivity loss, with the model being significant ( p < 0.01).

Conclusion

Nurses often experience poor psychological well-being and distress that hinder their daily activities and cause work productivity loss. Therefore, hospital management should prioritize improving nurses’ physical and mental health and bolstering their self-efficacy and resilience to minimize the effects of symptom distress on productivity. Investing in nurses’ well-being through managerial caring, organizational support, and fostering a supportive work environment are vital strategies for promoting quality patient care and enhancing their work productivity.
Risk of Severe Early Childhood Caries over Time in Low-Income Preschoolers
Authors: Chou Y.C. , Cheng F.S. , Weng S.H. , Hu H.Y.
Published: October 2024

Introduction:

Early childhood caries (ECC), and the progression to severe ECC (S-ECC), is a serious oral health issue, leading to acute pain, sepsis, tooth loss, and compromised quality of life. Although the association between sociodemographic factors and ECC has been widely discussed, it remains unclear whether the same association exists between inequality and S-ECC.

Objectives:

To investigate the impact of low income on the oral health of preschool children and explore any additional risk factors for developing ECC and S-ECC during follow-up.

Methods:

The study used Taipei Child Development Screening Program data from 2014 to 2019. It included children aged 3 to 5 y who had more than 2 oral exams and completed baseline oral health questionnaires. Low-income children were matched 1:4 with controls by age and gender. Evaluation of ECC and S-ECC used the dmft index during follow-up exams. Generalized estimating equations (GEEs) assessed the impact of household income on ECC and S-ECC risk over time.

Results:

Of the 895 participants, 179 were from low-income households. We revealed a significantly higher risk of developing S-ECC (adjusted odds ratio [aOR] 1.99; 95% confidence interval [CI] 1.25–3.17) in children from low-income households, with no significantly increased of risk of developing ECC. Children who consumed sugary beverages >4 times per week showed elevated risks of developing both ECC (aOR 1.77; 95% CI 1.07–2.94) and S-ECC (aOR 1.89; 95% CI 1.13–3.17). Protective factors included children with mothers with a college education (S-ECC: aOR 0.50; 95% CI 0.32–0.79).

Conclusion:

Children from low-income households have a significant risk of developing S-ECC compared with children from non–low-income households during follow-up. Factors contributing to this risk include lower maternal education, poor maternal oral health, and increased consumption of sugar-sweetened beverages. Policymakers should develop health measures to reduce the prevalence of ECC and S-ECC in children from low-income households whose mothers have lower educational levels and poor oral health.

Knowledge Transfer Statement:

The results of this study highlight the significant S-ECC risk among preschool children from low-income households in Taipei, with other risk factors including higher consumption of sugar-sweetened beverages, lower maternal education, and poor maternal oral health. Policymakers can use our findings to develop targeted policy and behavioral interventions to reduce S-ECC in vulnerable populations.
Feasibility of Easy to Use and Inexpensive Three-Dimensional Printed Educational Model of Temporal Bone: Practiced Without Drilling
Authors: Lee Sang-Youp , Jeong Baren , Lee Whal , Park Moo Kyun
Published: October 2024

OBJECTIVE

Three-dimensional (3D) printed temporal bone model draws great attention as a promising alternative for conventional cadaveric model in education of otologic surgery. However, its high price and requirement for specialized tools hinder widespread use. We devised a simple educational model based on lattice structure to overcome these problems and compared it with a commercial model.

METHODS

We converted high-resolution temporal bone computed tomography images into stereolithography format, and printed it using the G005 3D printing system from CUBICON©. In this process, the part to be drilled out was made of lattice structure. We evaluated the model by a questionnaire prepared in advance, and compared the results with those of a commercial model.

RESULTS

We created an educational 3D printed temporal bone lattice model one-tenth the cost of commercial temporal bone. Our model reproduced the important structures of the temporal bone, produced less dust, and had similar strength and grinding sensation compared to the commercial model. The surface texture and reproducibility were comparable to the commercial model. Although most of structures were remodeled more elaborately in the commercial model than our model, our model demonstrated significant potential as a cost-effective educational tool for medical students and residents.

CONCLUSION

3D printed temporal bone lattice model has potential for widespread use due to low cost and easy accessibility. Further improvements in the fine structures of the temporal bone are necessary to enhance its utility as an educational model.
Abolition-democracy and the future of climate change
Authors: Miyake Keith K.
Published: October 2024

The world is already in climate “crisis” mode. Fossil fuels are the largest driver of climate change, and eliminating their use is an important step toward addressing the future of climate change. Yet, I argue that eliminating fossil fuel use alone is insufficient to address the crises not only of climate change, but the uneven effects of climate change and fossil fuel racial capitalism as they play out across the world. Building on the work of W.E.B. Du Bois in thinking through the establishment of abolition democracy in the post-emancipation project of Black Reconstruction, this article offers a conceptual analysis of why and to what end such a framework is essential to building a radically democratic society rooted in liberation for all. The article looks toward an abolitionist energy democracy, where abolition democracy offers guiding principles for developing theory and organizing praxis. Using a case study of the People Power Solar Cooperative in Oakland, California, USA, the article considers how people are working to dismantle fossil fuel racial capitalism through the simultaneous building up of new institutions and infrastructures in the spirit of abolition democracy. This article thus considers a notion of abolition democracy rooted in not just the elimination of a system of dominance, but the simultaneous remaking of new systems as an important way of thinking about fighting for social and ecological change.
Introducing the KRA System at the Softech Semiconductors
Authors: Mukul Kumar , Padmaja V. , Jagadeeswari Itam Urmila , B Megha
Published: October 2024

A systematic and continuous performance assessment method alongwith timely and constructive feedback on employee contribution is crucial to human resources functions, driving organizational growth and development. An effective performance management system significantly enhances clarity on goal setting and accountability, leading to improved individual and team performance - which is crucial for a company like Softech which was evolving out of its ‘startup’ days. It helps align employee contributions with the organizational goals. Clear articulation of key performance indicators (KPIs) and key result areas (KRAs) plays a vital role in managing talents. This case study examines the HR challenges faced by Softech Semiconductor, a leading technology service provider with eight branches in India, and plans for global expansion. Despite its success in the semiconductor space in India, Softech struggles with talent management, retention, and reliance on conventional HR processes. To overcome these challenges, Mr Vikas Patil, a visionary leader and the founder of Softech, in association with his HR team and external organizational development experts, implemented a new talent strategy, focusing on introducing KRAs to enhance clarity, accountability, and alignment with the company’s vision and mission. The case study highlights the challenges, interventions, and outcomes, offering valuable insights for HR leaders looking to modernize talent management in technology-driven industries. The case captures the growth challenges related to people management and leadership styles when a startup firm scales up and strives to transform into an established organization.
INTRINSIC TEAR STRENGTHS AND THEIR CORRELATION WITH PROPERTIES OF POLYMERS MADE USING INSITE TECHNOLOGY
Authors: Plumley T. A. , Sehanobish K. , Patel R. M. , Lai S. Y. , Chum S. P. , Knight G. W.
Published: October 2024

The intrinsic tear strengths have been measured for polymers made with INSITE* Technology, also called constrained geometry catalyst technology (CGCT), and having a wide range of physical properties. The intrinsic tear strengths allow the molecular contribution to tear strength to be determined since the samples have essentially isotropic orientation. Correlations have been obtained between intrinsic tear strengths and the physical and mechanical properties of these polymers.
STRUCTURE-PROPERTY RELATIONSHIPS OF ETHYLENE/1 -OCTENE AND ETHYLENE/1-BUTENE COPOLYMERS MADE USING INSITE TECHNOLOGY
Authors: Kale L. T. , Plumley T. A. , Patel R. M. , Redwine O. D. , Jain P.
Published: October 2024

The structure-property relationships of homogeneous ethylene/1-butene copolymers made using INSITE * Technology-also called constrained geometry catalyst technology (CGCT)-are explored and compared with Dow’s current AFFINITY * polyolefin elastomers, which are ethylene/1-octene copolymers. The well defined molecular architecture of these copolymers allows one to explore the comonomer effect with greater precision. The preformance of ethylene/butene and ethylene/octene copolymers with densities of 0.91 and 0.92 g/cc are emphasized.

Ethylene/1-octene copolymers produced by CGCT have improved tear, impact and tensile properties, relative to ethylene/1-butene copolymers produced by CGCT. These improved physical properties were observed in both compression molded plaques and blown film samples. This study confirms the general trend of improved physical properties with increasing α-olefin branch length.
Continuous digital cough monitoring during 6-month pulmonary tuberculosis treatment
Authors: Raberahona Mihaja , Zimmer Alexandra , Rakotoarivelo Rivonirina Andry , Randrianarisoa Patrick Andriniaina , Rambeloson Garcia , Rakotomijoro Etienne , Andry Christophe Elody , Razafindrakoto Haingonirina Anique , Andriantahiana Dera , Randria Mamy Jean de Dieu , Rakotosamimanana Niaina , Grandjean Lapierre Simon
Published: October 2024

Introduction

The recent advances in digital and wearable technologies with artificial intelligence (AI) enable the use of continuous cough monitoring (CCM) to objectively monitor symptoms as surrogate markers of treatment efficacy in pulmonary tuberculosis (PTB). The objectives of this study are to describe the evolution of cough during PTB treatment in adult and to assess the feasibility of community-based CCM.

Methods

We prospectively enrolled PTB adult participants upon treatment initiation. Participants’ coughs were continuously monitored during 6 months with a smartphone loaded with an app able to detect cough by using an AI algorithm.

Results

Twenty-two participants were included. The median age was 28.5 (IQR: 22–42) and 62% were male. The median cough per hour (medCPH) was 11.0 (IQR: 7.0–27.0) at week 1. By the end of the intensive phase of PTB treatment at week 8, the medCPH was 3.5 (IQR: 1.5–7.0), which was significantly lower than the medCPH at week 1 (p=0.002). At week 26 (end of treatment), the medCPH was 1.0 (IQR: 1.0–2.5). The adherence to CCM was high during the first 13 weeks of PTB treatment and then waned over time. The adherence was similar during daytime and nighttime.

Conclusion

Cough counts rapidly drop during the intensive phase of PTB treatment and then slowly decrease to a low baseline level by the end of the treatment. Community-based CCM using digital technology is feasible in low resource settings but requires evaluation of alternative approaches to overcome adherence issues and technical limitations (mobile internet and electricity availability).
Clinical characteristics of obstructive sleep apnea patients with residual sleepiness
Authors: Feng Xujun , Zhang Ye , Shi Yuan , Ren Rong , Lei Fei , Vitiello Micheal V. , Tang Xiangdong
Published: October 2024

Objective

This meta-analysis examines the clinical characteristics of CPAP-treated obstructive sleep apnea (OSA) patients with residual excessive sleepiness (RES).

Method

We conducted a search for articles published from inception to March 16, 2024, in PubMed, Embase, Cochrane Library, and Web of Science. Seven studies were included in this meta-analysis.

Results

The meta-analysis revealed that continuous positive airway pressure (CPAP)-treated OSA patients with RES were characterized by higher Epworth Sleepiness Scale and Depression Scale scores, lower body mass index (BMI) and apnea-hypopnea index (AHI) before CPAP treatment. RES patients also exhibit poorer CPAP adherence. Being female was also associated with RES.

Conclusion

Being female, having lower BMI and AHI, and more severe daytime sleepiness and depressive symptoms before CPAP treatment, and lower CPAP adherence were characteristics of OSA patients with RES. These factors may prove helpful in identifying CPAP-treated OSA patients who may need additional treatment to minimize RES.
Exploring GP and patient attitudes towards the use and deprescribing of dietary supplements: a survey study in Switzerland
Authors: Lüthold Renata Vidonscky , Rozsnyai Zsofia , Weir Kristie Rebecca , Streit Sven , Jungo Katharina Tabea
Published: October 2024

Background

Dietary supplements are commonly used by older adults, but their inappropriate use may lead to adverse events. To optimise medication use, general practitioners (GPs) ideally are aware of all substances that patients use, including supplements. This cross-sectional study explored the use of dietary supplements by older patients with polypharmacy, the rate at which they disclosed this use to their GPs, and compared patients’ and GPs’ attitudes towards discontinuing dietary supplements.

Methods

Ten GPs in Swiss primary care recruited five to ten of their older patients taking ≥ 5 regular medications. Both GPs and their patients completed a survey on patients’ use of dietary supplements and attitudes towards deprescribing those. We described and compared their responses. We assessed the association of supplement disclosure with patient characteristics using multilevel logistic regression analysis.

Results

Three out of ten GPs (30%) were female, and GPs’ average age was 52 years (SD = 8). 45% of patients were female (29/65). Most patients (n = 45, 70%) were taking ≥ 1 supplement. On average, patients reported to be using three supplements (SD = 2). In 60% (n = 39) of patients, GPs were unaware of ≥ 1 supplement used. We did not find evidence for an association between supplement disclosure to GPs and patient characteristics. Only 8% (n = 5) of patients and 60% (n = 6) of GPs reported ≥ 1 supplement they would be willing to deprescribe and none of the supplements reported by GPs and patients to deprescribe matched.

Conclusion

Swiss GPs were unaware of many dietary supplements used by their older patients, which may affect medication optimisation efforts.
Efficacy of the Mediterranean diet in treating metabolic dysfunction-associated steatotic liver disease (MASLD) in children and adolescents: a systematic review and meta-analysis
Authors: Jamil Asma , Chivese Tawanda , Elshaikh Usra , Sendall Marguerite
Published: October 2024

Background

There are limited treatment options for metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic Fatty Liver Disease (MASLD) in children and adolescents.

Aim

To evaluate the effectiveness of the Mediterranean diet in improving liver function in children and adolescents with MASLD.

Methods

In this systematic review and meta-analysis, we searched PubMed, Scopus, Embase, CINAHL, and Cochrane CENTRAL for interventional studies investigating the effect of Mediterranean diet on MASLD in children and adolescents. The primary outcome was a change in liver function measured using these liver enzymes; Alanine Transaminase (ALT), Aspartate Transaminase (AST) and Gamma-glutamyl transferase (GGT). The secondary outcomes were lipid profile, body weight, and insulin resistance. The risk of bias was assessed using the MASTER scale. Bias-adjusted inverse variance heterogeneity models were used to synthesize overall weighted mean differences for the treatment effect (WMD) and their 95% confidence intervals. Heterogeneity and publication bias were evaluated using the I2 statistics, Tau-squared and Doi plots, respectively.

Result

Out of 5915 study records identified from database searches, five studies with 308 participants, two randomized controlled trials, and three quasi-experimental studies, met the inclusion criteria. In overall synthesis, the Mediterranean diet was associated with moderate improvements in liver function as shown by reductions in the liver enzymes [ALT - WMD − 10.85 U/L, 95% CI -20.03 to -1.68, I2 = 42, T2 = 38.8, AST - WMD − 9.26 U/L, 95% CI -17.14 to -1.38, I2 = 70.7, T2 = 42.7, and GGT - WMD − 1.99 95% CI -5.09 to 1.11)], but changes in body weight, lipid profile and insulin resistance were small and insignificant.

Conclusion

The Mediterranean diet may improve liver function in children with MASLD. More randomized controlled trials are needed to develop high-certainty evidence on these findings.

Registration

This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) CRD42023426939. 31/05/2023.
Uncovering the role of traditional Chinese medicine in immune-metabolic balance of gastritis from the perspective of Cold and Hot: Jin Hong Tablets as a case study
Authors: Wang Boyang , Xiao Lihao , Chen Pan , Zhang Tingyu , Zhang Peng , Cao Liang , Zhou Ziyi , Cheng Haibo , Zhang Tong , Li Shao
Published: October 2024

Chronic gastritis (CG) is a common inflammatory disease of chronic inflammatory lesion of gastric mucosa and in the diagnosis of gastritis in traditional Chinese medicine (TCM), CG can be classified into Cold ZHENG (syndrome in TCM) and Hot ZHENG. However, the molecular features of Cold/Hot ZHENG in CG and the mechanism of Cold/Hot herbs in formulae for CG remained unclear. In this study, we collected a transcriptomics data including 35 patients of Cold/Hot ZHENG CG and 3 scRNA-seq CG samples. And 25 formulae for CG and 89 herbs recorded in these formulae were also collected. We conduct a comprehensive analysis based on the combination of transcriptomics datasets and machine learning algorithms, to discover biomarkers for Cold/Hot ZHENG CG. Then the target profiles of the collected formulae and Cold/Hot herbs were predicted to uncover the features and biomarkers of them against Cold/Hot ZHENG CG. These biomarkers suggest that Hot ZHENG CG might be characterized by over-inflammation and exuberant metabolism, and Cold ZHENG CG showed a trend of suppression in immune regulation and energy metabolism. Biomarkers and specific pathways of Hot herbs tend to regulate immune responses and energy metabolism, while those of Cold herbs are more likely to participate in anti-inflammatory effects. Finally, the findings were verified based on public transcriptomics datasets, as well as transcriptomics and ELISA detection, taking Jin Hong tablets as a case study. Biomarkers like leptin and IL-6 together with proportions of immune cells showed significant changes after the intervention. These findings might reflect the mechanism and build a bridge between macro and micro views of Cold/Hot ZHENG as well as Cold/Hot herbs.

Graphical abstract
The apple does not fall far: stable predictive relationships between parents’ ratings of their own and their children’s self-regulatory abilities
Authors: Kneidinger Johanna , García Alanis José C. , Steinmayr Ricarda , Schneider Silvia , Christiansen Hanna
Published: October 2024

Having control over your own behavior and impulses is a critical skill that influences children’s academic, social, and emotional development. This study investigates the stability and predictive relationships between parents’ ratings of their own and their children’s executive function and delay aversion. Using data from approximately 1700 families collected during the COVID-19 pandemic, we employed hierarchical structural equation models and cross-lagged panel models to analyze the temporal stability and directional influences of executive function and delay aversion assessments.

Our analysis revealed a substantial latent correlation (r = 0.48, p < 0.001) between parents’ and children’s executive function problems, indicating a shared variance of approximately 23%. Significant cross-lagged effects were found, with parental executive functions at T1 predicting child executive functions at T2 (β = 0.16, p = 0.005). For delay aversion, we found a latent correlation of r = 0.53 (p < 0.001) and significant within-timepoint and temporal stability, but no cross-lagged effects.

These findings suggest that higher levels of executive function problems reported by parents at T1 correspond to an increased perception of similar problems in their children at T2. This highlights the importance of parental self-perception in assessing children’s abilities. Our results highlight the importance of incorporating family dynamics into interventions targeting executive function difficulties and delay aversion in children, and understanding this interplay enables the development of more effective, individualized approaches to support positive developmental outcomes.