bluuebunny/crossref_metadata_2025 huggingface dataset:
HIV retesting among people living with HIV in Lesotho in 2022
Authors: Pogue Spencer D , Saito Suzue , Tlhomola Mphotleng , West Christine A , Asiimwe Fred , Ramphalla Puleng , Poirot Eugenie , Steiner Claire , Greenleaf Abigail R
Published: October 2024

Background

Despite widespread HIV testing in sub-Saharan Africa, regular testing among at-risk populations is crucial for effective prevention. However, reports increasingly indicate retesting among people living with HIV (PLHIV), a group that would not require additional testing since they would already have received a confirmed diagnosis. We describe the demographic characteristics of PLHIV retesters in Lesotho, report the average number of HIV tests post-diagnosis among PLHIV, and share motivations for retesting.

Methods

In August 2022, a nationally representative cohort in Lesotho participated in a cell phone survey about their HIV status and testing history. Study participants were recruited from a face-to-face survey conducted in 2020, Lesotho Population Based HIV Impact Assessment survey.

Results

Of the 1523 participants called, 1111 participants responded (72.9%) and 266 reported living with HIV. We found 18.8% of people living with HIV (PLHIV) reported retesting at least once for HIV, and 58% of PLHIV who reported retesting were likely or very likely to retest for HIV in the coming year. The main reason PLHIV reported retesting was because a health care worker offered the test (61.7%) followed by self-initiated testing to confirm their status (29.1%). Among male PLHIV who had a history of retesting, 92.0% were very likely or likely to retest, compared to only 30.6% of female PLHIV.

Conclusion

We found almost a fifth of PLHIV in Lesotho reported a history of retesting for HIV, and 58% of PLHIV were likely or very likely to retest for HIV in the coming year. Educating providers and men living with HIV could reduce retesting among PLHIV.
From European Roots to Settler Soil: Adapting Foucault’s Biopolitics to Canadian Settler Colonialism
Authors: Swiffen Amy
Published: October 2024

This article examines the applicability of Michel Foucault’s biopolitical theory within the Canadian settler colonial context. Foucault’s concept of biopolitics, which describes the shift from sovereign power to the regulation of life and populations, is grounded in European historical contexts. In contrast, the Canadian settler colonial experience diverges significantly, necessitating a re-examination of biopolitics. The article argues that in Canada, the relationship between sovereignty, population, and territory does not follow the European model described by Foucault. Instead, Crown sovereignty established its control through legal mechanisms that defined ‘Indian’ status, displacing Indigenous territorialities and political structures. By analysing the evolution of ‘Indian’ status within the Indian Act (1985), the article highlights the centrality of law in constructing settler colonial biopolitics. This legal framework was used to manage and assimilate Indigenous populations, reflecting a unique biopolitical strategy aimed at creating a relationship to territory and population. The study contributes to a more specific understanding of biopolitics in settler colonial contexts, emphasizing the distinct role of law in these processes.
Study on the Neuroprotective Mechanism of Salidroside Modified with Polydopamine Nanoparticles in Regulating Notch Pathway by Inhibiting Mir-155 in Stroke Rats
Authors: Liu Song , Lv Xiaomeng , Wang Dong
Published: October 2024

Background and Purpose

Stroke threatens neurological function. Salidroside is widely used to treat neurological diseases such as stroke. Previous studies have shown that miR-155 plays an important regulatory role in the pathogenesis of stroke and that the Notch pathway plays an important role in nervous system development and regeneration.

Methods

PDA NPs-SAL complex was prepared, a stroke rat model was constructed, and the cerebral infarction area of rats was measured. Analyze the changes of PDA NPs-SAL on rat brain tissue and evaluate the neuroprotective effect. Detect the changes in miR-155 and Notch pathway-related proteins in stroke rat models to further understand the role of miR-155 and Notch pathway in the pathogenesis of stroke and their relationship.

Results

Salidroside had certain protective effects on the nerves of stroke rats, and the effect of PDA NPs-SAL was more prominent. At the same time, PDA NPs-SAL promotes the Notch pathway by inhibiting miR-155, thereby exerting a neuroprotective effect on stroke rats.

Conclusion

Under the intervention of PDA NPs-SAL, the neurological function scores of rats were reduced, and the effect of PDA NPs-SAL was more significant. In addition, PDA NPs-SAL inhibited miR-155 and activated the Notch pathway, thereby reducing the water content of rat brain tissue and cerebral infarction area, thereby exerting a neuroprotective effect on stroke rats.
Enhancing Mobile Central Bank Digital Currency Payment Participation Through Creative Communication on Social Media
Authors: Li Chengdong , Tee Lain-Tze , Kew Si-Roei , Abdul-Rahim Ruzita
Published: October 2024

With the development of mobile technology, mobile devices have dramatically changed the way people entertain and pay. Social media platforms are booming, and social media is gradually becoming the main form of entertainment for people. Enterprises and organisations with promotional needs are paying more attention to the high efficiency and high input–output ratio of social media communication. Social media advertising has shown more vitality than traditional advertising. Meanwhile, mobile devices have also changed the way people pay, and mobile payment is gradually becoming popular. China has taken the lead in launching mobile Central Bank Digital Currency (CBDC) payment, a new payment technology, and social media communication also plays an important role in promoting CBDC payment. The purpose of this article is to explore the impact of social media creative communication on mobile CBDC payment participation. A research model suitable for this study was created by integrating privacy concern and elaboration likelihood model theory. A valid response from 300 respondents was obtained through an online self-administered questionnaire. Hypotheses were tested through a two-stage research method of partial least squares structural equation modelling with the method of artificial neural network. The results of the study showed that social media advertisements’ creativity and social media information quality significantly and positively influence users’ social media engagement. Users’ social media engagement significantly and positively influences users’ mobile CBDC payment participation. The study provides valuable practical guidance for managers of mobile CBDC payments to promote mobile CBDC payments through social media.
Cognitive Diversity and Initiative-Taking in Crisis: A Multisource Multilevel Dual-Path Model
Authors: Ikhide Juliet E. , Adedapo Ojo , Moin Muhammad Farrukh
Published: October 2024

Disruptive situations experienced in crises require significant initiative-taking among employees, particularly those in the service sector. Relying on the social information processing theory, this study expounds on how and when team cognitive diversity influences employee initiative-taking through work meaningfulness and perceived subgroup splits during a crisis. Data was collected from 232 hotel employees working within 58 work teams from two sources and in two waves. Results from a multilevel, dual-path parallel mediation data analysis did not support the hypothesized direct relationship between team cognitive diversity and personal initiative-taking or the indirect path through perceived subgroup split. This study’s analysis supported only the indirect path through work meaningfulness. Implications of the findings as well as avenues for further research and theory expansion are discussed.
Mistreatment, Abuse, and Gender-Based Violence During Childbirth: A Longitudinal Analysis of Obstetric Violence in México (2011–2021)
Authors: Frías Sonia M. , Castro Roberto
Published: October 2024

This longitudinal retrospective study of mistreatment, abuse, and gender-based violence during childbirth uses two population representative samples of Mexican women to analyze the incidence of obstetric violence in Mexico from 2011 to 2021. Our assessment is that there are more continuities than changes in the phenomenon and our study does not find evidence to support the claims of increases in obstetric violence during the 2020–2021 COVID-19 pandemic. Conceptually it differentiates between acts of violence, disrespect, and abuse, based on socially constructed gender differences (gender-based violence), and those more generally related to medical authoritarianism and the biomedical model that confers medical professionals a more powerful and higher status relative to that of their patients.
Falls and fractures in men with prostate cancer taking second-generation androgen receptor antagonists: A retrospective chart review
Authors: Dennison Morgan , Holle Lisa
Published: October 2024

Introduction

Second-generation androgen receptor antagonists, including enzalutamide, apalutamide, and darolutamide, are commonly used to treat metastatic and non-metastatic prostate cancer. Although these medications are typically well-tolerated, falls were reported in 4.2–15.6% of patients and fractures in 4.2–11.7% of patients enrolled in the phase III clinical trials evaluating these drugs in prostate cancer. However, post-marketing studies have reported a lower incidence than reported in clinical trials. The objective of this study is to determine the prevalence of falls and fractures in patients with prostate cancer receiving second-generation androgen receptor antagonists at UConn Health and identify potential risk factors associated with falls and fractures in these patients.

Methods

A retrospective chart review involving patients with prostate cancer treated with darolutamide, enzalutamide, or apalutamide from March 1, 2022, to March 31, 2023, at UConn Health Carole & Ray Neag Comprehensive Cancer Center. Data recorded includes basic demographics, history of fall or fracture, presence of metastases, fall risk, history of osteoporosis, prescribed second-generation androgen receptor antagonist, and other comorbidities. Data was evaluated using descriptive statistics.

Results

Twenty-six men were included, all of whom were receiving enzalutamide. At baseline, 96.1% of patients had bone metastases, 15.4% had osteoporosis, 15.4% had osteopenia, and 34.6% had neuropathy. The incidence of falls was 19.2% and the incidence of fractures was 26.9%. The mean length of therapy at time of a fall was 19.44 months (range, 6–31 months). The mean length of therapy at time of a fracture was 19 months (range, 1–33 months). In patients experiencing fall, 100% had arthralgia, 60% had neuropathy, 40% had a gait problem, 40% had hypertension, and 80% of them were at risk of fall. In patients experiencing fracture, 28.6% had osteoporosis, 42.9% had osteopenia, 100% had bone metastases, and 57.1% were on denosumab at time of fracture.

Conclusion

The prevalence of falls and fractures in patients receiving enzalutamide were higher in this retrospective chart review than reported in clinical trials and post-marketing studies. This could be due to the small patient population or the patient's comorbidities such as osteoporosis, bone metastases, or neuropathy. Fall/fracture risk with enzalutamide and other risk factors for fall and fracture should be considered when discussing treatment and developing a monitoring plan.
Transverse energy absorption performance of sandwich tubes with various origami foldcores
Authors: Song Keyao , Liu Han , Ye Haitao , Zhou Xiang
Published: October 2024

Nowadays, composite sandwich tubes are extensively utilized in the civil and aerospace industries due to their superior strength-to-weight mechanical properties. Origami-based core offers a large enhancement of the mechanical properties, yet little study research focuses on the effect of various foldcore configurations on the transverse mechanical properties of sandwich tubes, necessitating the design method for applications. This study introduces an innovative approach by incorporating origami into the composite sandwich core to enhance the transverse energy absorption capacity. The quasi-static transverse mechanical properties of carbon fibre-reinforced polymer (CFRP) sandwich tubes with foldcores are studied under three-point bending-like local compression and transverse structural compression. A systematic geometric design framework and numerical modelling technique are provided. By integrating finite element analysis and experiments, the research investigates the effects of various origami foldcore configurations and geometric parameters on transverse energy absorption capacity. The experiment setup is provided by sandwich tubular specimens with a full-diamond configuration as the foldcore. The cylindrical tubes (foldcore) of the sandwich structures were manufactured using four plies [0°]4 of T700 (T300) woven CFRP with the hot press moulding (vacuum bag using female and male moulds) technique respectively. Then, the parametric study and damage mode analysis of eight different foldcore patterns (axial Miura, circumferential Miura, diamond, Kresling, and their curved-creased counterparts) were studied. The results showed the superior energy absorption performance of the sandwich tube with Miura-pattern foldcore over the origami-pattern counterparts, nested tube, and traditional honeycomb sandwich tube with CFRP or aluminium-made cores. Therefore, the structural parameters optimisation of the Miura pattern tube was carried out by the Response Surface method (RSM) and a design strategy for increasing the energy absorption capacity was found. The findings offer guidance for designing high-specific energy absorption tubular structures for future advanced engineering applications.
Leveraging user-generated content (UGC) in pre-travel behavior: A PLS-SEM and necessary conditions analysis (NCA) approach
Authors: Das Anirban , Kondasani Rama Koteswara Rao , Deb Rupam , Batabyal Debasish
Published: October 2024

Online review reading is almost ritualistic before making any purchases. Building on social cognition theory, uses and gratification theory, and stimulus organism response theory, this study explores user-generated content (UGC) attributes affecting intentions to travel via a mediating variable (destination image). Using partial least squares structural equation modeling (PLS-SEM) analysis and necessary conditions analysis (NCA) on responses ( N = 392) collected online in India, the findings reveal that the perceived novelty of content (PNC) and perceived value of content (PVC) positively influence destination image and behavioral intention. Destination image mediates the relationship between PNC, PVC, and content users’ behavioral intentions. Perceived reliability of content (PRC) positively affects behavioral intention. The findings suggest that adequate PNC, PRC, and PVC levels are necessary to enhance destination image and generate intention to travel. This study contributes to the UGC literature and provides recommendations for stakeholders to improve user experience and enhance destination image perception.
Structural inequality and the protectorate of discrimination law
Authors: Laborde Cécile
Published: October 2024

This article asks whether discrimination law should be symmetrical: whether it should offer the same level of protection to dominant and dominated groups. It articulates a structural inequality theory of the moral foundations of discrimination law and defends it against prominent alternatives, such as the view that discrimination is wrong because it is irrational or disrespectful. The paper then argues that while direct discrimination is symmetrical, indirect discrimination is asymmetrical. It cannot be claimed by those – men, or white persons – who are not at the sharp end of structural inequality. Furthermore, even dominated groups cannot claim to be indirectly discriminated against by just any law that has a disparate impact on them. If the structural inequality view is correct, the protectorate of discrimination law is not as extensive as is commonly assumed.
Exploring Interoceptive Awareness With Adults: Occupational Therapy Practitioner Knowledge, Perception, and Practice Patterns
Authors: Robertson Heidi N. , Camacho Victor Michael , Tsang-Wu Catherine , Provisor Jamie , Gallagher Vera , Pereira Irma J.
Published: October 2024

As the literature states, interoception is important in health and wellness. Disruption of this system can negatively impact occupational performance. We completed a descriptive study to understand how occupational therapy practitioners working with adults address interoceptive awareness. A researcher-developed survey gathered data on knowledge acquisition of interoception and perceived practice patterns related to assessment, intervention, and outcomes. Participants ( N = 44) reported acquiring knowledge of interoception through professional websites, browsing databases, and continuing education as the most common information sources. Client self-report (56.8%) and clinical observation (54.5%) were the most commonly reported assessments. Rehabilitation practitioners ( n = 8) reported no use of formal assessments. Most participants (63.89%) reported interoceptive awareness interventions to be effective. Further research is needed on best practices for interoception assessment and intervention related to occupational performance.
Hospital Network Centralization of Primary Total Joint Arthroplasty Is Associated With Reduced Early Complication Rates But Not Reduced Readmission or Reoperation Rates: A Retrospective Database Study
Authors: Ricciardi Benjamin F. , Ramirez Gabriel , Schloemann Derek T. , Myers Thomas G. , Thirukumaran Caroline P.
Published: October 2024

Background:

Hospital networks centralize primary total joint arthroplasty (TJA) within their existing systems to develop specialized service lines with higher surgical volumes to reduce adverse events. It is not known what role hospital network centralization has had on primary TJA outcomes.

Purpose:

We sought to determine whether the degree of hospital network centralization for primary TJA is associated with (1) 90-day postoperative complication rates, (2) 90-day hospital readmission rates, or (3) 1-year revision rates.

Methods:

We conducted a retrospective database study of Medicare Part A beneficiaries who underwent inpatient primary TJA for osteoarthritis in 2016 and 2017 ( n = 523,142 patients); individual hospital-level characteristics and hospital networks were also identified ( n = 360 unique networks, n = 3339 hospitals). Patients having surgery at a hospital that was not a member of a health care network were excluded ( n = 163,998 patients) because we wanted to examine only the role of network structures on outcomes; this resulted in a cohort of 359,144 patients. Hospital network centralization, which was defined as the percentage of total network cases performed at the highest volume hospital and categorized into quartiles (eg, lowest 25% of networks by concentration, 26%–50% of networks by concentration, etc). Primary outcomes included postoperative 90-day complications, 90-day readmissions, and 1-year revisions. Multivariable logistic and linear regressions evaluated associations of hospital network centralization with outcomes and controlled for relevant patient-level and hospital-level covariates, including hospital network volumes.

Results:

Odds of 90-day complications were lower in the most centralized hospital networks than in least centralized networks (odds ratio [OR] = 0.85; 95% confidence interval [CI]: 0.75, 0.95). Degree of centralization was not associated with readmissions or 1-year revision rates. Non-modifiable patient and individual hospital characteristics appeared to have a greater association with complications, readmissions, and early revision rates than hospital network centralization or volume.

Conclusion:

This retrospective database study found that increased centralization of primary TJA within a hospital network was associated with lower 90-day complication rates but not with 90-day readmission or 1-year revision rates. This suggests that structural changes within hospital networks may be beneficial to reduce early complications in this patient population. In addition, our findings suggest that risk adjustment in assessing non-modifiable patient and hospital risk factors may be important when assessing TJA outcomes.
Mechanisms of Xuefu Zhuyu Tang in the Treatment of Diabetic Erectile Dysfunction in Rats Through the Regulation of Vascular Endothelial Function by CaSR/PLC/PKC and MEK/ERK/RSK Pathways
Authors: Li Xiao , Zhang Mingzhao , Feng Junlong , Wang Jisheng , Wang Kaifeng , Ju Baojun , Wang Xiangyu , Pang Guoming
Published: October 2024

Xuefu zhuyu Tang (XFZYT) is a classic formula used for promoting blood circulation and resolving blood stasis in Traditional Chinese Medicine. Clinical data have indicated that XFZYT plays a significant therapeutic role in diabetes-induced erectile dysfunction (DIED) disease, but the underlying mechanism remains elusive. Male Sprague–Dawley (SD) rats were randomly categorized into normal, model, and treatment groups. The diabetic rat model was established via intraperitoneal injection of streptozotocin. DIED rats were screened using apomorphine, and the number of erections was measured after 8 weeks of XFZYT treatment. Serum nitric oxide (NO) and endothelin-1 levels as well as penile tissue structure alterations were assessed by hematoxylin–eosin staining and electron microscopy. CaSR/PLC/PKC and MEK/ERK/RSK pathway-related proteins in the penile tissue were detected by western blotting (WB) analysis and polymerase chain reaction (PCR). Compared with the blank group, the model group rats showed a significant decrease in weight and erectile function. The pathological damage in the penile tissues of the model rats was indicated by a significantly decreased serum NO level and an increased endothelin-1 content. After treatment with XFZYT, the protein expression of CaSR, PLCβ1, PKCβ, MEK1, ERK1, and RSK1 in the penile tissue was significantly increased. Overall, the treatment group showed significant improvements in the evaluated indexes. In conclusion, this study revealed that XFZYT improves erectile function in diabetic rats, and the underlying mechanism might be linked with the regulation of CaSR/PLC/PKC and related molecules of the MEK/ERK/RSK pathway, which promotes the vascular endothelial diastolic effect.
From Leaky Gut to Leaky Skin: A Clinical Review of Lifestyle Influences on the Microbiome
Authors: Do Nhi Ma
Published: October 2024

The microbiome connects the gut health to the rest of the body’s organs, including the skin. The pathophysiology of intestinal dysbiosis leads to the expression “leaky gut.” Ongoing speculations are aimed at restoring the gut microbiota via modulating lifestyle habits to prevent and potentially reverse autoimmunity. This review finds the connections between gut dysbiosis and skin conditions. It also collects evidence of some lifestyle pillars that influence the gut microbiome including dietary intakes, exercise, sleep, stress, and toxin exposures. It addresses why maintaining a healthy intestinal microbiome is important for the health of all organs in the human host. More people are affected by gut dysbiosis resulting in pro-inflammatory effects on different organs, like the cutaneous tissue, one of the largest epithelial surfaces. It is essential to take care of the gut health because this is where most of the immune system resides. The connection between the intestinal tract with its microbiota and the cutaneous system with its microbiota seems to be mediated by the immune system of the human host. Therefore, this review enhances the understanding of the research on the gut microbiome, its relationship to skin health, and the interplay between the gut and various autoimmune cutaneous conditions.
Research on the distribution structure of 2D piston electro-hydraulic pump based on fluid-structure interaction
Authors: Qiu Xin-Guo , Chen Kui-Ge , Wu Ping , Zheng Ying , Wang Chen , Ji Xing-Jian
Published: October 2024

To address the drawbacks of traditional hydraulic power units, we embedded a 2D piston pump inside the motor rotor, proposing a 2D piston electro-hydraulic pump. The space cam mechanism serves as the primary force-bearing structure during its operation. Excessive wear occurs at the highest point of the space cam when subjected to significant axial forces, which leads to deviations between the motion law of the 2D piston and the theoretical design. Aiming this problem, we conduct research from two perspectives: theoretical analysis and fluid-structure interaction. Firstly, the operational principle of the electro-hydraulic pump is introduced. Then, the contact normal stress of the space cam mechanism is studied, and backflow and chamber pressure overshooting are discussed. Finally, the fluid-structure interaction model of the electro-hydraulic pump is established. Based on the fluid-structure interaction model, the effects of the width and depth angles of the triangular damping groove on the backflow and chamber pressure overshooting are analyzed. The simulation results demonstrate that adding triangular damping grooves can improve the flow field characteristics. With the increase in the width and depth angles, the peak flow of the backflow and chamber pressure overshooting increase, with the depth angle exerting a more pronounced effect.
Does endoscopic carpal tunnel release during distal radial fracture fixation improve outcomes? A randomized controlled trial
Authors: Monteerarat Yuwarat , Sirasittikarn Sawitt , Pimpan Niya , Wejjakul Witchuree , Limthongthang Roongsak , Laohaprasitiporn Panai
Published: October 2024

This study investigated the functional outcome of prophylactic carpal tunnel release during distal radial fracture fixation. A total of 60 patients undergoing anterior locking plate fixation for a distal radial fracture were randomized into two groups: one having prophylactic endoscopic carpal tunnel release and the other serving as a control. Functional outcomes were assessed using the Patient-Reported Wrist Evaluation, Quick Disabilities of the Arm, Shoulder, and Hand, EuroQol 5-Dimension 5-Level questionnaire, Boston Carpal Tunnel Questionnaire, Pain Numerical Rating Scale, grip strength and finger-to-palm distance over a 12-month period. The study found no significant differences in overall functional outcomes or complications between the groups.

Level of evidence: I
Baseline patient demographics for TETRIS: a prospective, noninterventional study to characterize the use of triple therapy for COPD in Germany
Authors: Vogelmeier Claus F. , Beeh Kai-Michael , Kardos Peter , Paulsson Thomas , Rohde Gernot , Watz Henrik , Compton Chris , Mohan Tharishini , Claussen Jing
Published: October 2024

Background:

Evidence on how decisions regarding escalation to triple therapy and de- or re-escalation are taken and the rationale on which these decisions are based is currently limited in Germany.

Objectives:

The TETRIS study aims to elucidate influences on treatment decisions surrounding triple therapy in a real-world practice setting in Germany.

Design:

TETRIS is an ongoing, multicenter, prospective, observational cohort study recruiting patients with chronic obstructive pulmonary disease (COPD) with or without asthma who have already been treated with triple therapy for 2–48 weeks.

Methods:

For better representation of the treatment reality in Germany, patients are recruited from general practitioners and pulmonologists. Data are collected in two parts. Part 1 involves cross-sectional phenotyping of patients at enrollment. Part 2 involves a 2-year longitudinal follow-up period to monitor/document all visits by the patients during the 24-month observation period per routine clinical practice. Here, we report the demographic and baseline characteristics of 1213 eligible patients recruited to part 1 of the study.

Results:

The mean patient age was 66.4 years overall, and 29.3% (356/1213) of patients had no comorbidities. The mean CAT score was 19.4; the number of exacerbations and hospitalizations due to exacerbations in the past 3 years before starting triple therapy was 0.6 and 0.1, respectively. Dual bronchodilation with a long-acting muscarinic antagonist (LAMA) plus a long-acting β-2 agonist (LABA) was the most common therapy for COPD before initiation of triple therapy in 58.3% of patients.

Conclusion:

In this real-world setting in Germany, patients with COPD have a relatively low reported exacerbation rate but high symptom burden, and over 70% are multimorbid. Triple therapy is initiated in patients who are primarily highly symptomatic despite being on LAMA + LABA. Future prospective studies in patients with multimorbidity are warranted to better understand the treatment landscape across the disease spectrum.

Trial registration:

https://clinicaltrials.gov/study/NCT04657211
Cost-Effectiveness Analysis of Molecular Testing for Indeterminate Thyroid Nodules in Nova Scotia
Authors: MacKay Colin , Turner Brooke , Clarke Scott , Wallace Timothy , Rigby Matthew H.
Published: October 2024

Background

The objective of the following retrospective review was to perform a cost-effectiveness analysis of the use of molecular testing of indeterminate thyroid nodules compared to current management practices in Nova Scotia, Canada.

Methods

All cases of cytologically indeterminate thyroid nodules from January 1st, 2014 to December 31st, 2018 were reviewed. All interventions related to an indeterminate thyroid nodule were recorded. Patients were excluded if less than 18 years old if no further information regarding medical management was electronically available beyond the diagnosis of an indeterminate thyroid nodule, history of radiation, or previous thyroid surgery prior to diagnosis of an indeterminate thyroid nodule in the remaining lobe. Microcosting was performed to determine the cost of all relevant interventions including repeat fine needle aspiration biopsy, ultrasound, thyroid surgery(s), and molecular testing. Institution-specific transition state probabilities were calculated and used to build a cost-effectiveness analysis model. Model output was an incremental cost-effectiveness ratio, defined as the ratio of cost difference to effectiveness difference between routine molecular testing and the current management strategy, yielding cost per surgery avoided.

Results

The mean effectiveness of the current management of indeterminate thyroid nodules in Nova Scotia based on the American Thyroid Association guidelines is 64% at a mean cost of $6431, while the simulated mean effectiveness of routine molecular testing is 89% at a mean cost of $8414. Differences in management strategies generated an incremental cost-effectiveness ratio of $7876 per surgery avoided.

Conclusion

Routine molecular testing is the more effective strategy for the appropriate management of indeterminate thyroid nodules; however, it comes at a higher mean cost compared to the current management strategy. As the cost of molecular testing continues to decrease, and the cost of OR resources continues to rise, molecular testing is likely to become the optimal strategy in Nova Scotia.
The impossible and its vicissitudes
Authors: Pohl Lucas
Published: October 2024

In this response, I address the commentaries by Friedrich and Tups and Allahyari on my paper, ‘Geographies of the Impossible’, by engaging with their main arguments, highlighting some key commonalities, and identifying further aspects that could be considered when exploring the impossible in human geography.
The economic divide that isn’t: A comparative study on economic hardship and affective polarisation
Authors: Vanagt Jochem , Russo Luana
Published: October 2024

This article examines the role of economic hardship in contributing to our understanding of the causes of affective polarisation – that is, the animosity between partisan groups. Evidence suggests that a variety of political attitudes and behaviours are influenced by economic hardship, but the relationship between individual economic hardship and affective polarisation has not yet been demonstrated. Thus, the purpose of this study is to investigate whether individuals facing economic insecurities are more affectively polarised. This study leverages two novel surveys, the first conducted in 11 European countries ( N = 12,000), the second in Belgium and the Netherlands ( N = 2174). Both contain individual-level measurements of economic hardship novel to the field of affective polarisation. Whereas the first allows for making generalisable claims across European multiparty systems, the second contains a more thorough operationalisation of the central concepts. The paper finds little to no evidence to support the existence of a link between economic hardship and affective polarisation. Across countries, objective and subjective measures of economic hardship are not linked to affective polarisation, neither when based on employment or financial status. Future research should now examine whether these cross-sectional findings are supported by longitudinal or experimental evidence.
Observational study of the Amaze™ asthma disease management platform
Authors: Alladina Jehan , Moschovis Peter P , Gandhi Hitesh N , Carstens Donna , Bacci Elizabeth D , Cutts Katelyn , Coyne Karin S , Goldsborough Karen , Jiang Dawei , O’Brien Conor , Bernard Kinane T
Published: October 2024

Objective

Asthma is often inadequately controlled, which can result in exacerbations that lead to unplanned healthcare visits. Mobile application (app) use could help manage asthma exacerbations. We implemented the Amaze™ asthma disease management platform in clinical practice and assessed user satisfaction, usage, and usability.

Methods

Adults with asthma and healthcare professionals (HCPs) were enrolled from a community allergy practice ( ClinicalTrials.gov Identifier: NCT04901260) and a large academic hospital ( ClinicalTrials.gov Identifier: NCT04868500). Primary and exploratory outcomes included assessment of platform design, patient app usage, patient-reported daily asthma status, emergency room/urgent care visits, and ease of implementation by HCPs. The system usability scale and a post-clinic visit survey were also administered. HCPs/staff monitored the Amaze dashboard to assess patient needs and completed a post-study survey.

Results

Overall, 159 patients and five HCPs participated in the study. Patients’ mean (SD) age was 38.7 (16.4) years; most were female (78%) and White (78%). Mean patient app usage began at 3.6 days/week but declined to 1.0 day/week by the end of the study. Throughout the study, most daily entries (>69%) reported patient asthma status as “good.” Most patients were satisfied/very satisfied with the app (66%) and reported it helped them during discussions with their HCP (44%). Most patients rated the usability of Amaze as “excellent” (49%) or “good” (30%). Most HCPs (71%) reported that Amaze was “very easy” to implement.

Conclusions

Most patients and HCPs were satisfied with Amaze. The Amaze platform may help patients and HCPs monitor asthma status, which could improve asthma control.
Lay Knowledge and Beliefs Toward Dementia Among the Black African Populations in the UK and Africa: Evidence Synthesis of Qualitative Studies
Authors: Mokwenye Raphael Chinedu
Published: October 2024

Background: The high prevalence of dementia among Black Africans, coupled with their lower engagement with dementia specialist services in the UK, underscores the urgency of understanding lay knowledge and beliefs about dementia in the group. Studies reporting lay knowledge of dementia in the UK tended to conclude that Black Africans lack dementia knowledge, presumably based on biomedical assumptions, without taking into consideration the Black Africans’ lay dementia knowledge and beliefs about dementia. The current study, therefore, investigated the Black African populations’ lay knowledge and beliefs toward dementia in Africa, comparing how this relates to the findings in the UK literature. Methodology: The researcher thoroughly searched electronic databases from September 2017 to October 2022 for qualitative research exploring how Black African populations perceived and experienced dementia, which informed the Black Africans’ dementia knowledge in Africa and the UK. The review included qualitative studies with African populations published in peer-reviewed journals with available abstracts and full text in English. Studies outside the UK and Africa, as well as quantitative research and studies with health practitioners, were excluded. A grounded theory approach informed the thematic analysis. The researcher reported the Black Africans’ lay knowledge and beliefs toward dementia, informed by participants’ experiences and meanings of dementia. Results: Twenty-two studies (n = 22) met the eligibility criteria and were appraised and included in the review. All the UK papers were a multi-modeling of ethnicity in the study. Nine studies (n = 9) were conducted in the UK. Thirteen studies (n = 13) are conducted in Africa, (5 [n = 5] studies from South Africa, 2 [n = 2] from Tanzania, 1 [n = 1] from Congo, 2 [n = 2] from Uganda, 2 [n = 2] from Nigeria, and 1 [n = 1] from Ghana). All the studies were valuable. The researcher identified and developed 4 themes as they emerged from the studies: (i) Dementia witchcraft paradigm, (ii) Dementia older age paradigm, (iii) Dementia disease and illness paradigm, and (iv) Dementia identity paradigm. Discussion/Conclusion: The lay knowledge and beliefs about dementia among Black African populations were foregrounded in sociocultural distinctiveness, and some understanding intersected with biomedical knowledge about dementia. Further empirical study in the UK is essential. Implications for policy and practice: A better understanding of lay knowledge and beliefs about dementia among Black African populations can improve dementia care, providing culturally sensitive and tailored support for Black African communities.
Construction and Validation of a Scale to Measure College EFL Students’ Perceived Teacher Support
Authors: Liang Junjian , Long Zaibo
Published: October 2024

Students’ perceived teacher support (SPTS) is considered crucial to students’ learning. But most existing SPTS scales were developed for the field of general education, and there is a lack of studies that attempt to develop a tailored scale specifically for the context of EFL learning. This study interviewed 86 Chinese college EFL learners and surveyed 1,089 Chinese non-English majors to develop an SPTS scale specifically for the context of college EFL learning in China. Exploratory and confirmatory factor analyses were conducted. The result indicated that SPTS is a tripartite construct consisting of emotional, intellectual, and social support. This study contributes to a better understanding of the unique aspects of language teaching and emphasizes the significance of tailored SPTS scales in different educational settings. The study elucidates the importance of SPTS in college EFL learning, providing guidance for effective teaching practices to enhance students’ learning experience.
Career Adaptability Across Southeast Asia: A Systematic Review
Authors: Asok Kumar Divyashine , Lau Poh Li , Chua Kah Heng , Voon Siok Ping , Lo Yueh Yea
Published: October 2024

Southeast Asia has recently seen a number of developments and transformations that requires one to adjust to as the region’s skill requirements are evolving. For some these new changes brings new opportunities, however, for some greater levels of career adaptability is need to manage these new developments and transformations. The necessity of systematically reviewing articles on career adaptability in Southeast Asian nations is made apparent by this particular instance. A systematic review of career adaptability in Southeast Asia was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. About 22 eligible studies were identified. The findings indicated that the most prevalent groups in career adaptability studies were students, followed by working adults. Antecedents such as role modeling and cultural intelligence were identified. Four categories of predictors were identified such as personal, educational, career behavior, and environmental factor. Two categories were identified for the outcomes of career adaptability, namely, personal and career outcomes. Findings revealed that career adaptability offers several beneficial outcomes such as improved employability skills and life satisfaction. Discussion includes conditions faced in Southeast Asian countries and cultural differences. The dearth of studies within multicultural settings calls for further research in exploring career adaptability, as this broaden cultural understanding and awareness of educational and career behaviors pertaining to one’s career adaptability. This study offers important practical implications and recommendations for career counseling practices and policymakers in Southeast Asia that would potentially benefit students and working adults.
The Effects of Heat Therapy During Immobilization and Rehabilitation on Muscle Atrophy and Strength Loss at Return to Sports in Healthy Humans
Authors: Labidi Mariem , Alhammoud Marine , Mtibaa Khouloud , Ihsan Mohammed , Elhusseiny Rabi , Deldicque Louise , Nader Nelda , Nasir Nada , Papakostas Emmanouil , Olory Bruno , Cruz Flavio , Farooq Mohammed , Sanchez Anthony M.J. , d’Hooghe Pieter , Tourny Claire , Racinais Sebastien
Published: October 2024

Background:

Animal research suggests that repeated heat exposures may stimulate skeletal muscle protein synthesis and downregulate protein degradation.

Hypothesis:

Repeated heat exposures during ankle immobilization and rehabilitation would preserve human muscle strength and mass.

Study Design:

Controlled laboratory study.

Methods:

A total of 20 male participants (age, 33.6 ± 2.8 years; weight, 83.8 ± 9.2 kg; height, 182 ± 6 cm) underwent 4 weeks of supervised training, 2 weeks of single-lower leg immobilization, and 2 weeks of supervised rehabilitation before return to sports (RTS). Participants were split into 2 groups: (1) whole-body heat therapy (HEAT) and (2) sham treatment (SHAM) throughout the immobilization and rehabilitation periods. Measures of muscle strength (isometric and isokinetic), volume (magnetic resonance imaging and ultrasound), and muscle biopsies were obtained preimmobilization, postimmobilization, and at RTS.

Results:

Maximal isometric strength of the plantarflexors was lower at RTS compared with preimmobilization in SHAM ( P = .027) but not HEAT ( P = .301). Isokinetic strength during a fatigue test was higher at RTS compared with preimmobilization in HEAT ( P = .039) but not SHAM ( P = .245). Pennation angle and muscle thickness were lower at postimmobilization compared with preimmobilization only in SHAM ( P≤ .027). Muscle cross-sectional area decreased in soleus and both gastrocnemius medialis and lateralis (all P≤ .035) in SHAM, but only in gastrocnemius medialis in HEAT. There was a large ( d = 0.91) but not significant ( P = .054) decrease in the ratio of phosphorylated/total nuclear factor-kappa B (NFκB) from preimmobilization to postimmobilization in HEAT only. There was an increase in phosphorylated fork head box O proteins (FoxO) only in HEAT ( P = .034), suggesting a decrease in FoxO activity. Caspase 3 expression increased from preimmobilization to postimmobilization in SHAM only ( P = .004).

Conclusion:

These results indicate that using heat therapy throughout immobilization and rehabilitation reduces skeletal muscle atrophy and maintains plantarflexor strength in healthy humans. Moreover, heat therapy may lead to the inactivation of the FoxO and NFκB signaling pathways involved in atrophy.

Clinical Relevance:

Repeated heat exposures should be considered a novel therapeutic intervention to counteract muscle atrophy during immobilization.
Phrasing Crisis Communication: How are Distinct Crisis Response Strategies Put Into Words?
Authors: Fannes Gijs , Claeys An-Sofie , Van Gorp Baldwin
Published: October 2024

This study employs a quantitative content analysis to investigate how reputation-restoring crisis responses (i.e., denial, diminishment, and apology) from organizations and public figures are verbalized. In addition, this study examines if distinct crisis response strategies are systematically associated with particular language categories (i.e., language abstraction, uncertain language, passive voice, and emotional language). By analyzing 179 audiovisual crisis messages (e.g., press conference broadcasts, television interviews, social media videos), this study shows that denials are generally expressed in the most concrete way (i.e., precise numbers), diminish strategies in the most uncertain way (i.e., hedges), and apologies are the most emotionally charged, primarily referring to the emotions of sadness and shame. These findings highlight the significant role of language in crisis communication and help practitioners in the field to become aware of key linguistic features that could influence the effectiveness of a crisis message.
The hepcidin-ferroportin axis modulates liver endothelial cell BMP expression to influence iron homeostasis in mice
Authors: Fisher Allison L. , Phillips Sydney , Wang Chia-Yu , Paulo Joao A. , Xiao Xia , Xu Yang , Moschetta Gillian A. , Xue Yongqiang , Mancias Joseph D. , Babitt Jodie L.
Published: October 2024

The liver hormone hepcidin regulates systemic iron homeostasis to provide enough iron for vital processes while limiting toxicity. Hepcidin acts by degrading its receptor ferroportin (encoded by Slc40a1) to decrease iron export to plasma. Iron controls hepcidin production in part by inducing liver endothelial cells (LECs) to produce bone morphogenetic proteins (BMPs) that activate hepcidin transcription in hepatocytes. Here, we used in vitro and in vivo models to investigate whether ferroportin contributes to LEC intracellular iron content to modulate BMP expression and, thereby, hepcidin. Quantitative proteomics of LECs from mice fed different iron diets demonstrated an inverse relationship between dietary iron and endothelial ferroportin expression. Slc40a1 knockdown primary mouse LECs and endothelial Slc40a1 knockout mice exhibited increased LEC iron and BMP ligand expression. Endothelial Slc40a1 knockout mice also exhibited altered systemic iron homeostasis with decreased serum and total liver iron but preserved erythropoiesis. Although endothelial Slc40a1 knockout mice had similar hepcidin expression to control mice, hepcidin levels were inappropriately high relative to iron levels. Moreover, when iron levels were equalized with iron treatment, hepcidin levels were higher in endothelial Slc40a1 knockout mice than in controls. Finally, LEC ferroportin levels were inversely correlated with hepcidin levels in multiple mouse models, and treatment of hepcidin-deficient mice with mini-hepcidin decreased LEC ferroportin expression. Overall, these data show that LEC ferroportin modulates LEC iron and consequently BMP expression to influence hepcidin production. Furthermore, LEC ferroportin expression is regulated by hepcidin, demonstrating a bidirectional communication between LECs and hepatocytes to orchestrate systemic iron homeostasis.