bluuebunny/crossref_metadata_2025 huggingface dataset:
The modeling method of machine tool geometry error based on Bryan principle
Authors: Liu Hongwei , Yang Rui
Published: March 2023

The error caused by measurement itself directly affects the accuracy of models. The error caused by the failure to follow the Bryan principle in the process of measuring the volumetric error of the machine tool makes the geometric accuracy of the machine tool after compensation less than the ideal effect. In this paper, it is proposed that the measurement error will be caused by the non coincidence of the measurement point and the tool position point in the measurement of linear axis error. According to Bryan principle, the relationship between the center point of the reflective mirror of the laser interferometer and the tool position point is analyzed. The straightness error produced in the measurement process is introduced into the volumetric error of the machine tool, and the geometric model containing the measurement error is established to improve the modeling accuracy of the machine tool. To prove the effectiveness of compensating measurement errors, an experiment has been conducted on a three-axis vertical machining center. The experimental results show that the geometric accuracy of the machine tool is improved by 23% after the measurement error is compensated.
Challenges and responsibilities in the medication management process in 24/7 group housing services for adults with intellectual disability: Interviews with nurses
Authors: Halmetoja Anne , Teittinen Antti , Laaksonen Raisa
Published: March 2023

Staff in 24/7 group housing services for adults with intellectual disability are responsible for ensuring safe medication management processes and supporting the residents in their health-related issues. Ten interviewed nurses reported several challenges in the medication management process emerging at the staff level, the level of the group home, and the level of the social and healthcare system, and were often related to issues in communication and responsibility. They reported a variety of complex tasks in the medication management process, for which they need a multiple skill set. They also act as healthcare advocates for residents, but healthcare services do not always match residents’ needs. Training for social and healthcare professionals, access to healthcare services and the collaboration of social and healthcare services should be improved to provide the people with intellectual disability the best possible pharmacotherapy and healthcare.
Performing Identity or Performing Relationships? Rethinking Performance Theory in Social Media Studies
Authors: Kaplan Danny
Published: March 2023

Much of the discussion of performance and collective action presupposes a hierarchical performer–audience structure along the lines of Durkheimian public events intended to reaffirm a collective identity. Scholars have generally overlooked an alternative, horizontal formulation of ‘performance of relationships’ in which viewers serve as a third party to the social exchange. While such a performance is central to social media interactions, most studies of performance on social media focus on the presentation of self and the affirmation of personal identity rather than the performance of relationships.

To demonstrate and address this gap, this article provides a typology of four theoretical approaches to performance: performing the self, performing values, performing friendship, and performing complicity. These approaches are placed along two dimensions – an individual versus collective focus and an identity versus relationship focus – and employed in relation to recent studies on social media and collective action. The article suggests that the performance of relationship approach might equally account for societal solidarity, understood not only as a byproduct of identity affirmation but also as a direct consequence of concrete social relationships.
Situating the Atrium: A Cultural Political Economy
Authors: Jones Paul
Published: March 2023

Effectively a double-height or larger void internal to a building, the atrium is a familiar architectural feature the world over. The global popularity of the space in contemporary urban buildings – including hotels, shopping malls, casinos, hospitals, museums, galleries, libraries, schools, office blocks, and universities – is a somewhat puzzling development, and one ripe for sociological analysis.

Cultural political economy (CPE) helps to explain this affinity. Using this perspective guards against reductionisms of various stripes, while rigorously situating the atrium vis-a-vis the production and circulation of material and symbolic surplus value. By facilitating inquiry into how this architectural form stabilises and furthers capitalist arrangements, CPE allows for interrogation of the atrium’s distinctive role in adding momentum and cultural meaning to contemporary urban accumulative strategies.

In particular, the article draws out the atrium space’s paradoxical relationships to (i) the intensification of rentiership in very tall buildings, and (ii) with respect to the demarcation of insider–outsider boundaries underpinning elite consumption. Positioning the atrium as being reflective of attempts to both intensify and embed capitalism in the built environment, key arguments concern the meaningful, experiential and out-of-the ordinary nature of the space, As such, the article contributes to and draws from sociologies of architecture, reconciling the atrium’s materiality and meaning in a way that does not reduce either to the other.
Paediatric kidney stone surgery: state-of-the-art review
Authors: Juliebø-Jones Patrick , Keller Etienne Xavier , Tzelves Lazaros , Beisland Christian , Somani Bhaskar K , Gjengstø Peder , Æsøy Mathias Sørstrand , Ulvik Øyvind
Published: March 2023

While urolithiasis in children is rare, the global incidence is rising, and the volume of minimally invasive surgeries being performed reflects this. There have been many developments in the technology, which have supported the advancement of these interventions. However, innovation of this kind has also resulted in wide-ranging practice patterns and debate regarding how they should be best implemented. This is in addition to the extra challenges faced when treating stone disease in children where the patient population often has a higher number of comorbidities and for example, the need to avoid risk such as ionising exposure is higher. The overall result is a number of challenges and controversies surrounding many facets of paediatric stone surgery such as imaging choice, follow-up and different treatment options, for example, medical expulsive therapy, shockwave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. This article provides an overview of the current status of paediatric stone surgery and discussion on the key topics of debate.
Oligometastatic breast cancer and metastasis-directed treatment: an aggressive multimodal approach to reach the cure
Authors: Merloni Filippo , Palleschi Michela , Casadei Chiara , Romeo Antonino , Curcio Annalisa , Casadei Roberto , Stella Franco , Ercolani Giorgio , Gianni Caterina , Sirico Marianna , Cima Simona , Sarti Samanta , Cecconetto Lorenzo , Di Menna Giandomenico , De Giorgi Ugo
Published: March 2023

Metastatic breast cancer (BC) is considered an incurable disease and is usually treated with palliative intent. However, about 50% of metastatic BCs present with only a few metastatic lesions and are characterized by longer overall survival. These patients, defined as oligometastatic, could benefit from a multimodal approach, which combines systemic therapy with metastasis-directed treatment (stereotactic ablative therapy or surgery). The current definition of oligometastatic seems incomplete since it is based only on imaging findings and does not include biological features, and the majority of relevant data supporting this strategy comes from retrospective or non-randomized studies. However, the chance of reaching long-term complete remission or even a cure has led to the development of randomized trials investigating the impact of combined treatment in oligometastatic BC (OMBC). The SABR-COMET trial, the first randomized study to include BC patients, showed promising results from a combination of stereotactic ablative radiotherapy and systemic therapy. Considering the randomized trial’s results, multidisciplinary teams should be set up to select OMBC patients who could achieve long-term survival with aggressive multimodal treatment.
Established and new horizons in radiotherapy for breast cancer
Authors: Wu Trudy C. , McCloskey Susan A.
Published: March 2023

Modern advances in diagnostics, surgery, systemic therapies, and radiotherapy (RT) have drastically revolutionized treatment strategies for breast cancer. This review outlines current and evolving treatment paradigms for RT in the breast-conserving therapy and post-mastectomy setting. In early-stage breast cancer, there is active investigation in expanding eligibility for omission of RT in women with more biologically favorable tumors and growing options to effectively irradiate less breast tissue and shorten RT treatment courses. For locally advanced breast cancer, we discuss several patient cohorts in which the necessity of post-mastectomy RT (PMRT) is commonly debated. Ongoing efforts to better refine indications for PMRT and evaluate the feasibility of hypofractionated PMRT are being studied. Metastasis-directed therapy with ablative RT is an emerging topic of interest in many cancers, including its role and impact in oligometastatic breast cancer. In this review, we will discuss the rationale for current standard of care and address in greater detail the aforementioned concepts.
Distal humeral corrective osteotomy for treatment of supracondylar fracture malunions in children
Authors: Tarabishi Mohammed M , Almigdad Ahmed K , Ganger Rudolf , Farr Sebastian
Published: March 2023

Purpose:

This study aimed to determine the functional and radiographic outcomes following corrective distal humeral osteotomies for the treatment of supracondylar fracture malunions in children. We hypothesized that such secondary reconstructive procedures could restore a reasonable and near-normal amount of functionality in a large patient cohort at a tertiary referral center.

Methods:

We retrospectively reviewed the clinical and radiological records of 38 children who underwent corrective osteotomy for posttraumatic supracondylar humeral malunion using K-wire fixation. All clinical data were extracted after chart review, including age, sex, dominant side whenever available, follow-up duration, and elbow range of motion preoperatively and at the final visit. Radiographic parameters, including Baumann’s angle, humeroulnar angle, humerocondylar angle, and elbow range of motion were evaluated preoperatively, postoperatively, and at the final visit to identify the surgical correction outcomes.

Results:

The mean age of the patients at fracture was 5.6 (±2.7) years, and the mean age at surgical intervention was 8.6 (±2.6) years. The mean follow-up period of the current series was 28.2 (±31.1) months. Baumann’s angle, humeroulnar angle, and humerocondylar angle were successfully restored to physiological ranges (72.6°, 5.4°, and 36.1°, respectively). Postoperatively, elbow extension improved from -22° (±5.7) to -2.7° (±7.2) versus flexion from 115° (±13.2) to 128.2° (±11.1). Three revision surgeries (8%) were encountered.

Conclusions:

Corrective osteotomy of the distal humerus with K-wire fixation is a reliable method to efficiently correct malunion of the distal humerus in different planes, thereby improving elbow range of motion and appearance.

Level of evidence:

level IV: Retrospective therapeutic study.
Vacuum-Assisted Needle-Free Capillary Blood Sampling
Authors: Hoffman Michael , McKeage James , Ruddy Bryan , Nielsen Poul , Taberner Andrew
Published: March 2023

Background:

Poor glycemic management persists among people practicing insulin therapy in relation to type 1 and 2 diabetes despite a clear relationship with negative health outcomes. Skin penetration by jet injection has recently been shown as a viable method for inducing blood release from fingertips. This study examines the use of vacuum to enhance the volume of blood released and quantifies any dilution of the collected blood.

Methods:

A single-blind crossover study involving 15 participants, each receiving four different interventions, was conducted wherein each participant served as their own control. Each participant experienced fingertip lancing and fingertip jet injection, both with and without applied vacuum. Participants were divided into three equal groups to explore different vacuum pressures.

Results:

This study found that glucose concentration in blood collected under vacuum following jet injection and lancing were equivalent. We found that applying a 40 kPa vacuum following jet injection produced a 35-fold increase in the collected volume. We determined the limited extent to which the injectate dilutes blood collected following jet injection. The mean dilution of blood collected by jet injection was 5.5%. We show that jet injection is as acceptable to patients as lancing, while being equally suited for conducting glucose measurements.

Conclusions:

Vacuum significantly enhances the volume of capillary blood released from the fingertip without any difference in pain. The blood collected by jet injection with vacuum is equivalent to that from lancing for glucose measurement purposes.
Degree of obesity and gastrointestinal adverse reactions influence the weight loss effect of liraglutide in overweight or obese patients with type 2 diabetes
Authors: Zhou Fang , Jiang Lu , Guo Jiamei , Fan Yuting , Pan Qin , Li Tianlian , Sun Xiaoshi , Li Ping
Published: March 2023

Background:

Liraglutide can effectively reduce the weight of patients with type 2 diabetes. Nonetheless, its weight loss effect was highly heterogeneous in different patients in the clinical practice.

Objective:

To identify the factors most associated with the weight loss effect of liraglutide in obese or overweight patients with type 2 diabetes with poorly controlled oral medication in northeast China.

Design:

A prospective study.

Methods:

A prospective study was performed in subjects with type 2 diabetes who were taking oral medication and had a body mass index (BMI) of ⩾24 kg/m2. Liraglutide was administered for at least 12 weeks, while the original hypoglycemic regimen was kept unchanged (Phase I). Later, liraglutide treatment was continued or stopped as necessary or as subjects thought fit in the 13–52 weeks that followed (Phase II), and the potential factors affecting the effect of weight loss of liraglutide were analyzed.

Results:

Of the 127 recruited subjects, 90 had comprehensive follow-up data at week 12. In Phase I, the subjects’ blood sugar levels and weight decreased significantly( P < 0.001). Among all the significant factors, the gastrointestinal adverse reactions score (GARS) was more correlated with BMI change (ΔBMI; r = 0.43) and waist circumference change (ΔWC; r = 0.32) than the baseline BMI (BMI0) and WC (WC0). At week 12, linear regression showed that BMI0 independently affected ΔBMI and ΔWC, whereas WC0 only affected ΔWC. The GARS was significantly associated with ΔBMI and ΔWC, and this association continued until week 52, even after most subjects had discontinued liraglutide treatment.

Conclusion:

The degree of obesity and gastrointestinal adverse reactions were the most promising predictors of weight loss in liraglutide treatment.
Prevalence of low back pain among medical doctors of the teaching hospitals in Karachi, Pakistan: A cross-sectional survey
Authors: Javed Salman , Dawood Muhammad Hamza , Memon Muhammad Waseem , Selod Ibrahim Zahid , Seja Arshi
Published: March 2023

Objective:

Our goal was to deduce the prevalence of low back pain among medical doctors in the teaching hospitals of Karachi, Pakistan, along with its associated variables and the functional disability accompanying it.

Methods:

This cross-sectional study was conducted among medical doctors from Creek General Hospital and United Hospital, affiliated with United Medical and Dental College, Karachi, Pakistan. A sample of 80 participants was included in this study, and a non-probability convenient sampling with randomization was utilized. Using a three-part questionnaire that included the Oswestry Disability Index, all participants were scrutinized for low back pain with its characteristics, associated risk factors, and functional disability.

Results:

Seventy percent of medical doctors included in this study suffered from the problem of low back pain, with 68% experiencing it over the last 3 months to 1 year. Furthermore, 89% and 11% suffered from minimal and moderate disability, respectively, affecting day-to-day and work life. Moreover, this study also found a significantly positive association ( p value < 0.05*) of low back pain with age and work-related characteristics and was more common in those with work experience between 1 and 10 years, >8 working hours, >4 standing hours, and belonging to the surgery and medicine specialties. The association was significantly positive according to the chi-square/Fischer exact test.

Conclusion:

Our study addressed the evidence that low back pain is prevalent among medical doctors in teaching hospitals in Karachi, Pakistan, potentially affecting patient treatment and student education and accentuating the need for further intervention and research among doctors worldwide.
Idiopathic pyostomatitis-pyodermatitis vegetans with nasal obstruction: A case report
Authors: Katz Talia M , Katz Arnon M
Published: March 2023

Pyostomatitis-pyodermatitis vegetans is an uncommon mucocutaneous dermatosis of unknown etiology. It presents as erythematous pustules that coalesce to form exudative vegetating plaques on the oral mucosa and/or skin. Diagnosis is largely based on clinical assessment, although histopathology should be used as supporting evidence. Pyostomatitis-pyodermatitis vegetans is associated with inflammatory bowel disease, liver dysfunction, and others. We report a case of a 48-year-old man who presented with erythematous eroded plaques involving his nares and upper lip. Investigations revealed a dense mixed inflammatory infiltrate and pronounced peripheral eosinophilia. Uniquely, the patient did not have inflammatory bowel disease or any other systemic condition. Systemic corticosteroids were helpful in clearing mucocutaneous lesions; however, this effect was only sustained at high doses. There are few reports of pyostomatitis-pyodermatitis vegetans in the medical literature. This case highlights key aspects of this extremely rare dermatosis, especially in otherwise healthy patients without inflammatory bowel disease.
Warfarin Related Kidney Damage: A Confusing Case of Thrombophlebitis Masquerading as Infection
Authors: Brittanee Samuelson , Matthew Decker , Hannah Scott , Gregory Garrison
Published: March 2023

Anticoagulant-related nephropathy (ARN) is a rare, newly recognized cause of acute kidney injury and significant but underdiagnosed complication of anticoagulation therapy. ARN occurs in patients taking oral anticoagulant therapy most often warfarin or a novel oral anticoagulant (NOAC). It is a potentially devastating disorder with serious renal consequences and increased all-cause mortality. Anticoagulant-related nephropathy presents as an acute kidney injury (AKI) in the setting of a supratherapeutic INR with profuse glomerular hemorrhage seen as renal tubules filled with red cells and red cell casts on renal biopsy. Being that millions of Americans are on warfarin, a thorough understanding and awareness of the clinical presentation, diagnosis, and therapeutic interventions are crucial to protecting the renal function, lowering all-cause mortality and optimizing treatment. Our goal is to provide education on a newly recognized form of AKI and significant but underdiagnosed complication of anticoagulation therapy.
Impact of COVID-19 Pandemic on Treatment and Outcome of Fragility Hip Fractures In Non-COVID Patients: Comparison Between the Lockdown Period, a Historical Series and the “Pandemic Normality” in a Single Institution
Authors: Troiano Elisa , De Sensi Alice Giulia , Zanasi Francesco , Facchini Andrea , De Marco Giulia , Colasanti Giovanni Battista , Mondanelli Nicola , Giannotti Stefano
Published: March 2023

Introduction

The COVID-19 pandemic has affected and is still deeply affecting all aspects of public life. World governments have been forced to enact restrictive measures to stem the contagion which have led to a decrease in the movement of people within national territory and to a redirection of health care resources with a suspension of non-urgent procedures. In Italy, a lockdown was imposed from March 9th to May 3rd, 2020. As a result, a significant reduction in the overall operative volume of orthopedic trauma was expected, but it was not possible to predict a similar trend regarding fragility fractures of the proximal femur in the elderly.

Methods

The aim of this paper was to examine the impact of COVID-19 on the operating volume for trauma surgeries and to determine how the pandemic affected the management of fragility hip fractures (FHFs) in non-COVID patients at a single Institution.

Results

The first result was a statistically significant reduction in the overall operative volume of orthopedic trauma during the period of the first lockdown and an increase in the mean age of patients undergoing surgery, as expected. As regard to the second aim, the incidence of FHFs remained almost unchanged during the periods analysed. The population examined were superimposable in terms of demographics, comorbidities, type of fracture, peri-operative complications, percentage of operations performed within 48 hours from hospitalization and 1-year outcome.

Discussion

Our results are in line with those already present in the Literature.

Conclusions

Our study revealed a significant impact of the restrictive anti-contagion measures on the overall orthopedic surgical volume, but, at the same time, we could affirm that the pandemic did not affect the management of FHFs in non-COVID patients, and their results.
Working Around the Clock: The Association between Shift Work, Sleep Health, and Depressive Symptoms among Midlife Adults
Authors: Frazier Cleothia
Published: March 2023

Shift work is an integral part of living in a 24-hour society. However, shift work can disrupt circadian rhythms, negatively impacting health. Guided by the Stress Process Model (SPM), this study examines the association between shift work and depressive symptoms and investigates whether sleep health (duration, quality, and latency) mediates this relationship among midlife adults. Utilizing data from the National Longitudinal Survey of Youth 1979 cohort ( N = 6,372), findings show that working evening, night, and irregular shifts is associated with increased depressive symptoms. The results also show that part of the association between shift work and depressive symptoms among night and irregular shift workers, is indirect, operating through short sleep during the week and on the weekend. Although shift work can negatively affect mental health, getting more restorative sleep may mitigate part of the harmful mental health consequences of non-standard work schedules.
Millennials’ and Z Generation’s Knowledge on Child Immunization and the Role of Media in the Digital Era in Jabodetabek, Indonesia
Authors: Marta Della Sabrina , Wijaya Ellen
Published: March 2023

Vaccine hesitancy is a threat for global health. Shortly, millennials and Z generation (gen-Z), the digital natives, are responsible for the future of the children. No study was found yet regarding child immunization and the usage of media in Jakarta, Bogor, Depok, Tangerang and Bekasi (Jabodetabek), Indonesia. This study aim to determine factors affecting millennials’ and Z generation’s knowledge about child immunization and the usage of media as the source of health information. Online questionnaire was distributed from 25th September to 20th November 2020 to students and workers in Jabodetabek. Subjects with child and/or <15 or >40 years old are excluded. Analysis was done with SPSS 20. Total of 376 subjects with mean age 18 (15-38) years old were collected. Subject’s varies from high school students (48.4%), university students (46.2%) and workers (1.6%). Total of 357 (94.9%) subjects willing to complete their future child’s immunization. Internet was the primary source of health information for 357 (94.9%) subjects, especially Instagram for 129 (34.3%) subjects. Concluded that subjects’ immunization status affects their willingness to fully vaccinate their future children. Digital media (Instagram) is the primary source of health information. Educational background affects their consideration in trusting online sources
Crossing the Line: Disgust, Dehumanization, and Human Rights Violations
Authors: Rousseau David L. , Gorman Brandon , Baranik Lisa E.
Published: March 2023

What leads Americans to support human rights violations? The authors explore the role of disgust on dehumanization and support for retaliatory human rights violations, including support for torture, targeting noncombatants, and extrajudicial killing. Using a survey experiment, the authors find that American respondents are disgusted with outgroups whose behaviors violate global human rights norms. These feelings of disgust lead respondents to dehumanize these outgroups and support hypothetical human rights violations against past violators as well as noncombatants ostensibly affiliated with them. Although the experimental vignettes also triggered anger and sadness in participants, only disgust reactions consistently produced dehumanization and support for human rights violations against outgroups. The results indicate that global human rights norms delineate not only acceptable behavior toward others but also the boundaries between those deserving and undeserving of human rights protections.
The life and death of the ‘Baron mall’: The shifting politics of urban regeneration in Valparaiso
Authors: Caimanque Rodrigo
Published: March 2023

The waterfront regeneration of Valparaiso in Chile has been the expression of significant institutional efforts aimed at reaching the so-called urban renaissance of the port-city, seeking to overcome the sustained symptoms of urban decay and economic underperformance. Over the years, a locally born idea became a controversial proposal led by the central government: A privately developed commercial project, named Puerto Baron (Baron Port). This article explores spatialized political struggles both underpinning and undermining this project, from institutional and elite interests pushing its realization to social actions triggering its end. In Valparaiso political and economic forces coalesced across different scales in their attempt to materialize a project that transfers globalized spatial imaginaries with tangled territorialized politics that exceed the limits of the city. Although state-led entrepreneurialism sets the waterfront regeneration agenda, interdependencies with networks of elites and local government were key to sustaining the project. In opposition, social movement strategies of scale jumping help to contest and influence the project’s delay. The case highlights the fragile nature of governing coalitions in Valparaiso as a shift in municipal power, which brought an alignment towards grassroots actors, ended the rather flawed regeneration project of Baron Port. The paper shows how unbounded spatial politics become highly permeated by interests at different scales, though still dependent on national centralized actions and definitions.
Evaluation of Virtual Vitreoretinal Surgery Fellowship Interview and Match Experience
Authors: Johnson Gina M. , Tausif Hassan N. , Gill Manjot K.
Published: March 2023

Purpose: To evaluate applicants’ and programs’ experiences during the 2019 and 2020 fellowship application seasons. Methods: An anonymous survey of vitreoretinal surgery fellowship program directors (PDs) (n = 21) and applicants from the 2019 traditional (n = 24) and 2020 virtual (n = 17) match cycles (before and during COVID-19 pandemic, respectively) was conducted. The questions assessed demographics, interview experiences, and overall interview costs. Statistical significance was determined using unpaired and paired 2-sided t tests for applicants and PDs, respectively ( P < .05). Results: In 2020, 17.6% of applicants and 15.8% of PDs strongly agreed that they were able to convey themselves well during the interview compared with 50% and 73.7%, respectively, in 2019 ( P = .002 and P < .001, respectively). In 2020, 5.9% of applicants and 10.5% of PDs strongly agreed that they gained a good understanding of their counterpart compared with 41.7% and 47.4%, respectively, in 2019 ( P < .001 and P = .01, respectively). Regarding cost, 83.3% of applicants and 21.1% of programs spent more than $2000 in 2019, whereas 17.6% of applicants and no program did so in 2020. Conclusions: Although virtual interviews allowed fellowship recruitment to continue during the pandemic, both applicants and PDs expressed uncertainty regarding their abilities to portray themselves and gauge those with whom they interviewed. The benefits of virtual interviews, including decreased cost, increased efficiency, and convenience, must be weighed against these factors.
NIR-triggerable self-assembly multifunctional nanocarriers to enhance the tumor penetration and photothermal therapy efficiency for castration-resistant prostate cancer
Authors: Li Shuqiang , Ma Yan , Ma Chao , Shi Lei , Li Fan , Chang Liansheng
Published: March 2023

Great challenges still remain in the management of patients with castration-resistant prostate cancer (CRPC) based on traditional treatments, and the rapid development of nanotechnology may find a breakthrough. Herein, a novel type of multifunctional self-assembly magnetic nanocarriers (IR780-MNCs) containing iron oxide nanoparticles (Fe3O4 NPs) and IR780 iodide was synthesized by an optimized process. With a hydrodynamic diameter of 122 nm, a surface charge of –28.5 mV and the drug loading efficiency of 89.6%, IR780-MNCs have increased cellular uptake efficiency, long-term stability, ideal photothermal conversion ability and excellent superparamagnetic behavior. The in vitro study indicated that IR780-MNCs have excellent biocompatibility and could induce significant cell apoptosis under the 808 nm laser irradiation. The in vivo study showed that IR780-MNCs highly accumulated at the tumor area could reduce the tumor volume of tumor-bearing mice by 88.5% under the 808 nm laser irradiation, but minimal damage to surrounding normal tissues. Since IR780-MNCs encapsulated a large number of 10 nm homogeneous spherical Fe3O4 NPs, which can be used as T2 contrast agent, the best window for photothermal therapy can be determined through MRI. In conclusion, IR780-MNCs have initially showed excellent antitumor effect and biosafety in the treatment of CRPC. This work provides novel insights into the precise treatment of CRPC by using a safe nanoplatform based on the multifunctional nanocarriers.
Perivascular fat attenuation index measured by coronary computed tomography angiography as a tool for assessment of ischaemia-causing lesions: a case report
Authors: Okamoto Shuichi , Mochizuki Junji , Matsumi Hiroaki , Hashimoto Katsushi , Nikaido Akira , Hata Yoshiki
Published: March 2023

Background

It can be difficult to diagnose coronary artery disease in patients with acute coronary syndrome if coronary angiography does not identify stenosis. Coronary inflammation, which can contribute to the pathogenesis of coronary artery disease and acute coronary syndrome, can be quantified using the perivascular fat attenuation index. Furthermore, the perivascular fat attenuation index is a marker for all-cause mortality, cardiac-related mortality and impaired global coronary flow reserve.

Case presentation

Here we report a case of a patient presenting with symptoms of acute coronary syndrome. The patient had hypokinesis of the lateral-posterior wall of the left ventricle, decreased myocardial perfusion in the posterior wall myocardium and elevated myocardial troponin-T and creatine phosphokinase levels. However, coronary computed tomography angiography did not identify arterial stenosis. The patient did have an increased perivascular fat attenuation index, indicating coronary inflammation. Moreover, the fat attenuation index was higher around the left circumflex artery than around the right coronary artery or left anterior descending artery. Intravascular ultrasonography identified an intramural haematoma, leading to a diagnosis of type 3 spontaneous coronary artery dissection in the left circumflex artery.

Conclusions

Perivascular fat attenuation index may be a useful tool to help identify and localise disease-causing lesions, and to direct further testing to confirm a diagnosis of spontaneous coronary artery dissection in acute coronary syndrome patients without significant arterial stenosis.
Effect of frailty status on mortality risk among Chinese community-dwelling older adults: a prospective cohort study
Authors: Zhao Xinxin , Zhu Rui , Chen Qi , He Jia
Published: March 2023

Background

Frailty is associated with mortality among older adults. We aimed to determine the appropriate time and frailty index (FI) threshold for frailty intervention in Chinese community-dwelling older adults.

Methods

In this prospective cohort study, we used data from the 2011 wave of the Chinese Longitudinal Healthy Longevity Study. Follow-up was performed for seven years from baseline. Using the FI to evaluate frailty and define frailty status, we explored the best time point and FI score for frailty intervention, by comparing the relationships of FI and frailty status with mortality.

Results

From 2011 to 2018, 8642 participants were included and followed-up. A total of 4458 participants died during the study period. After adjusting for variables such as age, sex, marital status, education level, and living conditions, the hazard ratio (HR) of mortality risk based on the FI at baseline was 37.484 (95% confidence interval [CI]: 30.217–46.498; P < 0.001); female sex, living in the city, being married, and living with spouse were found to be protective factors, whereas ageing was a risk factor for frailty. The mortality risk was higher in pre-frail than in frail participants (HR: 3.588, 95% CI: 3.212–4.009, P < 0.001). Piecewise linear regression analysis revealed an FI score threshold of 0.5. When the FI score was > 0.5, the HR of mortality based on the FI was 15.758 (95% CI: 3.656–67.924; P < 0.001); when the FI score was ≤ 0.5, the HR of mortality based on the FI was 48.944 (95% CI: 36.162–66.244; P < 0.001).

Conclusion

Using FI as a continuous variable to predict death is more accurate than frailty status. The advancement of early interventions for mortality risk reduction is more beneficial in pre-frail than in frail patients, and an FI score of 0.5 was found to be the threshold for mortality prediction using the FI.
Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis
Authors: Iqbal Anum , Richardson Charlotte , Iqbal Zain , O’Keefe Hannah , Hanratty Barbara , Matthews Fiona E. , Todd Adam
Published: March 2023

Background

Socioeconomic status (SES) may influence prescribing, concordance and adherence to medication regimens. This review set out to investigate the association between polypharmacy and an individual’s socioeconomic status.

Methods

A systematic review and meta-analyses of observational studies was conducted across four databases. Older people (≥ 55 years) from any healthcare setting and residing location were included. The search was conducted across four databases: Medline (OVID), Web of Science, Embase (OVID) and CINAHL. Observational studies from 1990 that reported polypharmacy according to SES were included. A random-effects model was undertaken comparing those with polypharmacy (≥ 5 medication usage) with no polypharmacy. Unadjusted odds ratios (ORs), 95% confidence intervals (CIs) and standard errors (SE) were calculated for each study.

Results

Fifty-four articles from 13,412 hits screened met the inclusion criteria. The measure of SES used were education (50 studies), income (18 studies), wealth (6 studies), occupation (4 studies), employment (7 studies), social class (5 studies), SES categories (2 studies) and deprivation (1 study). Thirteen studies were excluded from the meta-analysis. Lower SES was associated with higher polypharmacy usage: individuals of lower educational backgrounds displayed 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds. Similar findings were shown for occupation, income, social class, and socioeconomic categories.

Conclusions

There are socioeconomic inequalities in polypharmacy among older people, with people of lower SES significantly having higher odds of polypharmacy. Future work could examine the reasons for these inequalities and explore the interplay between polypharmacy and multimorbidity.
Quantitative muscle MRI displays clinically relevant myostructural abnormalities in long-term ICU-survivors: a case–control study
Authors: Rehmann R. , Enax-Krumova E. , Meyer-Frießem C. H. , Schlaffke L.
Published: March 2023

Background

Long-term data on ICU-survivors reveal persisting sequalae and a reduced quality-of-life even after years. Major complaints are neuromuscular dysfunction due to Intensive care unit acquired weakness (ICUAW). Quantitative MRI (qMRI) protocols can quantify muscle alterations in contrast to standard qualitative MRI-protocols.

Methods

Using qMRI, the aim of this study was to analyse persisting myostructural abnormalities in former ICU patients compared to controls and relate them to clinical assessments. The study was conducted as a cohort/case–control study. Nine former ICU-patients and matched controls were recruited (7 males; 54.8y ± 16.9; controls: 54.3y ± 11.1). MRI scans were performed on a 3T-MRI including a mDTI, T2 mapping and a mDixonquant sequence. Water T2 times, fat-fraction and mean values of the eigenvalue (λ1), mean diffusivity (MD), radial diffusivity (RD) and fractional anisotropy (FA) were obtained for six thigh and seven calf muscles bilaterally. Clinical assessment included strength testing, electrophysiologic studies and a questionnaire on quality-of-life (QoL). Study groups were compared using a multivariate general linear model. qMRI parameters were correlated to clinical assessments and QoL questionnaire using Pearson´s correlation.

Results

qMRI parameters were significantly higher in the patients for fat-fraction (p < 0.001), water T2 time (p < 0.001), FA (p = 0.047), MD (p < 0.001) and RD (p < 0.001). Thighs and calves showed a different pattern with significantly higher water T2 times only in the calves. Correlation analysis showed a significant negative correlation of muscle strength (MRC sum score) with FA and T2-time. The results were related to impairment seen in QoL-questionnaires, clinical testing and electrophysiologic studies.

Conclusion

qMRI parameters show chronic next to active muscle degeneration in ICU survivors even years after ICU therapy with ongoing clinical relevance. Therefore, qMRI opens new doors to characterize and monitor muscle changes of patients with ICUAW. Further, better understanding on the underlying mechanisms of the persisting complaints could contribute the development of personalized rehabilitation programs.
Self-management, care needs and clinical management of primiparous mothers during early labour – a qualitative content analysis
Authors: Mueller Antonia N. , Grylka-Baeschlin Susanne
Published: March 2023

Background

Childbearing women face the problem of managing spontaneous onset of labour without professional support. It is their responsibility to diagnose and react to early labour and subsequently recognise the right time to seek support. Institutional guidelines of clinics aim to admit childbearing women when in established labour. This explains why women in early labour are often advised to stay at home, which can be overwhelming and dissatisfying. This study aims to understand the self- and clinical management of early labour and care needs of first-time mothers during early labour.

Methods

A qualitative approach was used involving four focus group discussions with a total of N = 18 mothers. Included were primiparous women who had given birth at term within the last 6 months and who experienced spontaneous onset of labour. Elective caesarean section or induction of labour were thereby exclusion criteria. The interviews followed a semi-structured, literature-based guide. Content analysis was applied.

Results

Thirteen codes were summarised within three themes: ‘self-management’, ‘care needs’ and ‘professional management’. Various coping strategies and measures such as positive thinking or taking a bath helped women in managing early labour at home. The need for reassurance, professional guidance and pain management led them to seek professional support, which was initially accompanied by a feeling of inhibition. This negative emotion was mostly unjustified since many women felt well cared for and taken seriously in their needs.

Conclusion

Coping strategies and professional care help women going through early labour. Yet, there still exists insecurity about the justified timing in seeking professional support. An individual assessment of the women’s coping resources and their needs is required to promote shared decision making and give high-standard care.
The experience of pregnant women in contexts of vulnerability of prenatal primary nursing care: a descriptive interpretative qualitative study
Authors: Hudon Émilie , Chouinard Maud-Christine , Ellefsen Édith , Beaudin Jérémie , Hudon Catherine
Published: March 2023

Background

Prenatal primary nursing care contributes to improving the health outcomes of mothers and unborn babies. Some pregnant women in contexts of vulnerability experience prenatal nursing care in a positive way, while some do not. A better understanding of factors influencing this experience could help improve prenatal nursing care. The aim of this study was to describe factors influencing the prenatal primary nursing care experience of pregnant women in contexts of vulnerability.

Methods

Thorne’s qualitative interpretative descriptive approach was used. Twenty-four pregnant women in contexts of vulnerability were recruited in local community service centers in Quebec, Canada, using purposive and snowball samplings, to carry out a semi-structured interview. Participants were 16 years old and over, in their second or third trimester, or had given birth in the previous year, and received prenatal nursing care through community health services. Data collection methods included a logbook, sociodemographic questionnaire and semi-structured interview on vulnerable pregnant women’s experience with prenatal primary nursing care. The Qualitative Analysis Guide of Leuven guided the inductive thematic analysis, following a constant comparative iterative process.

Results

The women’s experience was initially influenced by the fulfillment of their needs and expectations. These stem from their previous or current pregnancy experiences, their motivation to receive prenatal care, their family concerns as well as their contexts of vulnerability. From the pregnant women’s perspective, the main factors that influenced their experience were the nurse’s approach, characteristics and interventions that all impact on their relationship with nurses, as well as the prenatal primary care organization, including the modalities of prenatal care (i.e. schedule, setting, duration, number and frequency of meetings), the continuity and the program’s prenatal care services, such as referral to a nutritionist, social worker or other services.

Conclusions

A conceptual framework is proposed to describe relationships among the factors distributed in three dimensions that influence the experience of pregnant women in contexts of vulnerability and to guide nurses in the improvement of prenatal primary care. Considering the complexity of this experience, a person-centered approach is mandatory to promote a positive experience, equity and a better use of services.
A new continuous glucose monitor for the diagnosis of gestational diabetes mellitus: a pilot study
Authors: Di Filippo Daria , Henry Amanda , Bell Chloe , Haynes Sarah , Chang Melissa Han Yiin , Darling Justine , Welsh Alec
Published: March 2023

Background

Gestational Diabetes Mellitus (GDM) incidence and adverse outcomes have increased globally. The validity of the oral glucose tolerance test (OGTT) for GDM diagnosis has long been questioned, with no suitable substitute reported yet. Continuous Glucose Monitoring (CGM) is potentially a more acceptable and comprehensive test. The aim of this study was to assess the Freestyle Libre Pro 2 acceptability as a diagnostic test for GDM, then triangulating its results with OGTT results as well as risk factors and sonographic features of GDM.

Methods

Women wore the CGM device for 7 days at 24–28 weeks, undergoing the OGTT before CGM removal. CGM/OGTT acceptability as well as GDM risk factors evaluation occurred via three online surveys. CGM distribution/variability/time in range parameters, combined in a CGM Score of Variability (CGMSV), were triangulated with OGTT results and a risk-factor-based Total Risk Score (TRS). In a subgroup, GDM ultrasound features (as modified Ultrasound Gestational Diabetes Score – m-UGDS) were also incorporated.

Results

Of 107 women recruited, 87 (81%) were included: 74 (85%) with negative OGTT (NGT) and 13 (15%) positive (GDM). No significant difference was found between NGT and GDM in terms of demographics (apart from family history of diabetes mellitus), CGM parameters and perinatal outcomes. Women considered CGM significantly more acceptable than OGTT (81% versus 27% rating 5/5,p < 0.001).

Of the 55 NGT with triangulation data, 28 were considered ‘true negative’ (TRS concordant with OGTT and CGMSV): of these 4/5 evaluated at ultrasound had m-UGDS below the cut-off. Five women were considered ‘false negative’ (negative OGTT with both TRS and CGMSV above the respective cut-offs). Triangulation identified also six ‘false positive’ women (positive OGTT but TRS and CGM both below the cut-offs). Only one woman for each of the last two categories had m-UGDS evaluated, with discordant results.

Conclusions

CGM represents a more acceptable alternative for GDM diagnosis to the OGTT. CGM triangulation analysis suggests OGTT screening may result in both false positives and negatives. Further research including larger cohorts of patients, and additional triangulation elements (such as GDM biomarkers/outcomes and expanded m-UGDS) is needed to explore CGM potential for GDM diagnosis.