bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis of a Rare Flexor Tendon Entrapment Using 3D CT Imaging Techniques
Authors: Sendek Gabriela , Englar Kevin , Huang Brady K. , Hinchcliff Katharine M.
Published: July 2023

Flexor tendon entrapments as a result of fractures or dislocations in the upper extremity are rare. Diagnosis by clinical examination is not always possible, and imaging such as magnetic resonance imaging and ultrasound is often obtained. These modalities have the disadvantages of reduced sensitivity or increased cost and time, respectively. We present a unique case of a triquetral fracture and pisiform dislocation causing index finger flexor digitorum profundus (FDP-I) entrapment that was diagnosed preoperatively with computed tomography (CT) imaging with 3-dimensional (3D) volume rendering. A 30-year-old man presented in delayed fashion 4 weeks after a dune buggy accident. Among other injuries noted on examination, his index finger was held in flexion and unable to be passively extended. The CT source images showed dislocation and interposition of the FDP-I tendon within a fracture-dislocation of the triquetrum and pisiform. Postprocessed 3D volume renderings obtained from the CT source images confirmed this finding. The patient underwent operative intervention, where FDP-I entrapment between the triquetral fracture fragments and the dislocated pisiform was confirmed and released. Practitioners should be aware of this injury pattern and evolving advanced CT techniques which may be used to aid in soft-tissue diagnoses and obviate the need for additional advanced imaging.
Animating for Interactivity: The Walk Cycles of Prince of Persia (1989) and Ninja Gaiden (1988)
Authors: Fong Byron
Published: July 2023

This article uses the walk cycle to simultaneously place movement in video games within the history of animation, and to show how the walk cycle has been adapted for the video game medium. Dating back to the pre-cinematic toys of the 19th century, the walk cycle is an animation technique that depicts a character’s walking animation as a self-contained, reusable loop. Video games import this technique into a new context with different affordances. A comparative analysis of the video games Prince of Persia (1989) and Ninja Gaiden (1988) explores different methods of implementing the walk cycle and reveals a trade-off between verisimilitude of movement and responsiveness to user input. Prince of Persia’s walk cycle, inspired by full cel animation, foregrounds fluid movement, while Ninja Gaiden utilizes limited animation techniques to prioritize responsiveness. Thus, this article argues that interactivity becomes a site of tension between movement and responsiveness, with video games drawing on older forms of animation to negotiate this tension.
Animation of Experiment: The Science Education Film and Useful Animation in China
Authors: Zhuang Muyang
Published: July 2023

From the early 1950s to the mid-1990s, the People’s Republic of China (PRC) produced numerous science education films. Many utilized animated effects, such as illustrations, maps and cartoons, to promote the reception of scientific knowledge and ideological messages by audiences. Current scholarship on Chinese animation history stresses films made by the Shanghai Animation Film Studio, neglecting animation created by filmmakers in science education film studios. In this article, the author argues that the history of useful animation in science education films provides a different approach to understanding Chinese animation as the animation of experiment. Animation functioned as scenes of experiment that enabled science education films to deliver messages of knowledge; they also inspired amateur experiment with animated filmmaking and experimental animation practices in the post-socialist era. This article analyses animation for science education films, amateur animation practices and experimental works inspired by, or that benefited from, science education filmmaking. It will enrich the scholarship on Chinese animation and shed new light on the history of Chinese animation and film culture in the PRC.
We care but we’re not carers: perceptions and experiences of social prescribing in a UK national community organisation
Authors: Porter B , Wood C , Belderson P , Manning C , Meadows R , Sanderson K , Hanson S
Published: July 2023

Aims:

(1) To explore how social prescribing referrals impact experiences of existing members of a voluntary and community-based organisation and (2) to describe the processes and relationships associated with joining community and voluntary organisations.

Methods:

Online survey and qualitative interviews with members of Men’s Sheds, a global volunteer-led initiative to address loneliness and social isolation in men. 93 self-selecting Shed members (average age 67 years, 93% male) from across England and Scotland took part in the survey about demographics, joining the Shed, and free-text questions about experiences in the Shed. From the survey participants, 21 Shed members were purposively sampled and interviewed to explore the impact of social prescribing and referrals on the Sheds.

Results:

Participating in the Men’s Shed was often associated with a significant change in personal circumstances, and Sheds provided a unique social support space, particularly valuable for men. Key factors around experiences of social prescribing and referral mechanisms were identified. We developed three themes: the experience of joining a Shed, success factors and risks of social prescribing, and ‘we care but we’re not carers’.

Conclusions:

The results show that Men’s Sheds are a caring organisation, but their members are not trained as professional carers, and men come to the Shed for their own personal reasons. They are concerned about the potential additional responsibilities associated with formal referrals. They encourage the development of relationships and local-level understanding of the essence of Sheds to enable social prescribing. As models of social prescribing grow nationally and internationally, collaboratively working with voluntary and community organisations to develop a mutually beneficial approach is essential for the effectiveness and sustainability of social prescribing in community health.
How Feeling Understood Predicts Trust and Willingness to Forgive in the Midst of Violent Intergroup Conflict: Longitudinal Evidence From Ukraine
Authors: Brik Tymofii , Livingstone Andrew G. , Chayinska Maria , Bliznyuk Evgeniya
Published: July 2023

How can intergroup trust and forgiveness be fostered in the face of violent, large-scale intergroup conflict? We addressed this challenge by testing the role of intergroup felt understanding—the extent to which outgroup members are perceived to understand ingroup perspectives—in predicting Ukrainian nationals’ inclinations to trust and forgive Russians for the conflict that has affected Ukraine since 2014. We did so using representative longitudinal data ( N = 743; three time points) collected 6 months before Russia’s full-scale invasion. Pre-registered analysis of dynamic mediation models confirmed that increases over time in felt understanding predicted increases over time in perceived positive regard, which in turn predicted increased outgroup trust and forgiveness over time. A mini-multiverse analysis indicated that this pattern was also largely robust to varying time point specifications. The findings provide further evidence that the feeling of being understood may be a key psychological factor that enables reconciliation.
The problem with annotation. Human labour and outsourcing between France and Madagascar
Authors: Le Ludec Clément , Cornet Maxime , Casilli Antonio A
Published: July 2023

Artificial intelligence advancements have reignited job displacement debates that focus on how the use of artificial intelligence affects labour, without considering how the production of this technology influences labour division. The generalisation of machine learning has created an increased demand for outsourced data workers. Outsourcing companies and crowdwork platforms are both used to generate, annotate, and enrich data. This data tasks are performed by workers from low-income countries, who often earn poverty wages. As with traditional outsourcing, workers must integrate complex multinational subcontracting networks. In this article, we examine how France outsources artificial intelligence-related tasks to workers in the African island nation of Madagascar. For our study, we interviewed 26 data workers, eight employees of French start-ups, and conducted secondary research on two artificial intelligence systems – a canteen checkout terminal and an algorithm to detect shoplifters in stores. The data collected allowed us to reconstruct an end-to-end artificial intelligence production value chain, revealing the need for data classification and artificial intelligence problematisation. Commercial artificial intelligence, therefore, does not displace employment by automating service jobs. Rather, by delocalising labour into the Global South, it lengthens the externalisation chain.
External Knowledge Acquisition and Green Innovation in Chinese Firms: Unveiling the Impact of Green Dynamic Capabilities
Authors: Guo Ying
Published: July 2023

Within the context of low-carbon development and drawing on the resource-based and dynamic capability theories, this paper provides a conceptual model of the relationship between external knowledge acquisition, green dynamic capability and corporate green innovation. Then, using 416 samples of firms in China collected from January 2018 to September 2018, the model was tested using the hierarchical regression analyses. The empirical results show that external technical knowledge acquisition and market knowledge acquisition have a positive influence on corporate green innovation. Additionally, the results show that green integration capability and green dynamic configuration capability positively moderate the relationship between technical knowledge acquisition and green innovation. The results also show that green learning capability, green integration capability and green dynamic configuration capability positively moderate the relationship between market knowledge acquisition and green innovation. This study supports the resource-based view, enriches the application of external knowledge acquisition in sustainable development, and extends the theory of green dynamic capability from causal prediction to situational factors. This paper provides theoretical support and practical guidance for firms seeking to effectively conduct open innovation, implement green innovation, and realize low-carbon development.
Configuration of Network Embedding and Financing Capability: Research on the Growth Path of Small and Medium-Sized Sports Enterprises Under the Heterogeneity of the Business Environment
Authors: Chenxi Wang , Haijie Li
Published: July 2023

Small and medium-sized sports enterprises are an important part of China’s sports industry market innovation, it provides a steady stream of motivation for improving the technological innovation capabilities and high-quality development of the sports industry. However, the problem of difficulty in financing and expensive financing is still the key to hindering the innovation and development of small and medium-sized enterprises. Limited by theoretical perspective and research methods, previous studies are difficult to guide small and medium-sized sports enterprises to achieve health and high-quality development. In order to promote the high-quality development of small and medium-sized sports enterprises, the research constructs the theoretical framework of network embeddedness-financing capability-enterprise performance, and uses fuzzy set Qualitative Comparative Analysis to explain the impact of network embeddedness and financing capability configuration on the performance under the concept of resource dependence and the heterogeneity of urban business environment. The results show that the enterprise should choose a suitable development model based on their own characteristics and the business environment they are located. The role of the business environment is crucial to the development of the enterprise. In the low business environment, the government should provide sufficient public services for them, and accelerate the transformation of high-quality development landing mode from cultivating enterprise network embedding and financing capability by enterprises to co-developing includes cities, financial industries and enterprises.
The Next Generation of Clinical-Psychological Science: Moving Toward Anti-Racism
Authors: Rodriguez-Seijas Craig , McClendon Juliette , Wendt Dennis C. , Novacek Derek M. , Ebalu Tracie , Hallion Lauren S. , Hassan Nima Y. , Huson Kelsey , Spielmans Glen I. , Folk Johanna B. , Khazem Lauren R. , Neblett Enrique W. , Cunningham Tony J. , Hampton-Anderson Joya , Steinman Shari A. , Hamilton Jessica L. , Mekawi Yara
Published: July 2023

The field of clinical-psychological science exists in a broader field of psychology that is increasingly acknowledged as embedded in racist and white-supremacist history. In the production of clinical-psychological science, the clinical science model predominates as one of the most influential scientific voices that emphasizes the value of rigorous scientific theory, training, and praxis. We highlight some of the ways in which the clinical science model has neglected anti-racism. By examining the idiosyncratic development of the clinical science model in clinical-psychological science, we outline how its failure to contend with systemic racism in the field propagates a racist subdiscipline. Our hope is that by enacting difficult self-reflection, we invite other stakeholders in our field to think more critically about how systemic racism and white supremacy pervade our structures and institutions and to begin making more concrete changes that move the clinical-psychological-science field toward explicit anti-racism.
Entrepreneurial Intentions: What Is Known, Unknown, and Lacking? A Unifying Review and New Pathways for Potential Research
Authors: Katoch Rupinder , Rana Avinash , Singh Mohinder
Published: July 2023

This research provides a bibliometric account of the research on Entrepreneurial Intention (EI) from the “Scopus” database. Based on 1,345 articles published during a period of 28 years (i.e., 1993–2021), the study analyzes the conceptual structure of the work on EI. The study finds prospective synergies and interactions, thereby classifying the scientific literature into various clusters that address similar problems and share common themes. The development of imminent research streams built on quantitative and qualitative content analyses of the clustered publications highlighting previously overlooked idiosyncrasies of EI and their role across multiple levels of analysis and varied contexts can be considered as an accomplishment of this review. The study furthermore proposes a framework for the conceptualization of novel models for future exploration of EI. However, the research suggests some pathways to develop and empirically test statistical models emerging from the flow of scientific inquiry. The study urges researchers to use the case study method to evaluate EI. This study will help both pioneer and veteran EI researchers and other stakeholders benefit, who also intend to explore new directions for future investigations offering integration and synchronization with other fields of research.
Causal Stories and Problem Definitions: How Policymakers and Superintendents Frame School Turnaround
Authors: Torres A. Chris
Published: July 2023

This study uses framing theory and the concept of causal stories to examine beliefs about causes and solutions to improving chronically low-performing schools in response to Michigan’s school turnaround policy. Across cases, policymakers and district leaders assigned most responsibility to poor leadership, poverty, and chronic educator turnover as primary causes of problems leading to turnaround identification. These causal stories were most often framed as side effects of policy or practice rather than as intentional actions. However, a notable subset assigned blame more directly to intentional policy action (or inaction) that would help districts counteract the effects of concentrated poverty, such as weighted funding. In terms of solutions, most leaders believed that improved funding was necessary to strengthen and stabilize the workforce and meet the nonacademic needs of children—for instance, attending to the deleterious effects of poverty through wraparound services or efforts to address trauma.
Appreciative Inquiry Utilizing Online Platforms
Authors: Van Dellen Stephanie A.
Published: July 2023

This experiential exercise teaches students what constitutes Appreciative Inquiry and how it is different from other feedback models, along with giving students the opportunity to apply their knowledge. Students practice giving Appreciative Inquiry to their peers’ presentations through the use of an online platform that allows for written words along with memes, GIFs, and photos to express their feedback. The activity is suitable for face-to-face undergraduate and graduate-level organizational behavior and management classes who have at least one, ideally two teams-based presentations, and are looking to provide strengths-based, positive feedback to produce high-performing teams. Information is presented about how to set up, run, and debrief this activity to meet learning objectives.
Radiographic Measurements of the Foot and Ankle After Ankle Arthrodesis
Authors: Boivin Jordan , Traynor Christopher , Stehlik Kevin , Jastifer James
Published: July 2023

Background:

Ankle arthrodesis is an established treatment for ankle arthritis. For patients with ankle arthritis, the position of the talus during ankle arthrodesis may affect the radiographic parameters of the foot. The purpose of this study is to assess the radiographic relationship between talar alignment and the longitudinal arch of the foot before and after ankle arthrodesis.

Methods:

We retrospectively reviewed a single-surgeon series of 30 patients who had undergone ankle arthrodesis. Measured parameters included the lateral tibiotalar angle (LTTA), lateral talometatarsal angle (LTMA), lateral talocalcaneal angle (LTCA), cuneiform height (CH), and calcaneal pitch (CP). Additional data collected included demographics, fusion construct type, and visual analog scale (VAS) measurements.

Results:

LTTA was increased from 68.2 ± 7.4 degrees preoperatively to 75.0 ± 6.4 degrees postoperatively ( P = .001), LTMA increased from −2.0 ± 10.7 degrees to 4.0 ± 10.1 degrees ( P < .001), CH increased from 20.1 ± 7.5 mm to 26.1 ± 8.4 mm ( P < .001), LTCA and CP had no statistically significant change. VAS score decreased from 5.7 ± 2.7 to 1.3 ± 1.9 ( P < .001).

Conclusion:

Correcting the talar alignment in the sagittal plane during ankle arthrodesis improved the radiographic parameters of the foot, contributing to restoration of the longitudinal arch. The clinical significance of these findings is that in patients undergoing ankle arthrodesis, the surgeon should be aware that the alignment of the foot will be altered at the time of ankle arthrodesis and should be considered in preoperative planning. Further research is needed to determine the effect of ankle arthrodesis in patients determined to have pes planus preoperatively.

Level of Evidence:

Level III, retrospective cohort study.
Republication of “A Biomechanical Comparison of Limited Open Versus Krackow Repair for Achilles Tendon Rupture”
Authors: Dekker Robert G. , Qin Charles , Lawton Cort , Muriuki Muturi G. , Havey Robert M. , Alshouli Mohammed , Patwardhan Avinash G. , Kadakia Anish
Published: July 2023

Background:

Soft tissue complications after Achilles tendon repair has led to increased interest in less invasive techniques. Various limited open techniques have gained popularity as an alternative to open operative repair. The purpose of this study was to biomechanically compare an open Krackow and limited open repair for Achilles tendon rupture. We hypothesized that there would be no statistical difference in load to failure, work to failure, and initial linear stiffness.

Methods:

A simulated Achilles tendon rupture was created 4 cm proximal to its insertion in 18 fresh-frozen cadaveric below-knee lower limbs. Specimens were randomized to open or limited open PARS Achilles Jig System repair. Repairs were loaded to failure at a rate of 25.4 mm/s to reflect loading during normal ankle range of motion. Load to failure, work to failure, and initial linear stiffness were compared between the 2 repair types.

Results:

The average load to failure (353.8 ± 88.8 N vs 313.3 ± 99.9 N; P = .38) and work to failure (6.4 ± 2.3 J vs 6.3 ± 3.5 J; P = .904) were not statistically different for Krackow and PARS repair, respectively. Mean initial linear stiffness of the Krackow repair (17.8 ± 5.4 N/mm) was significantly greater than PARS repair (11.8 ± 2.5 N/mm) ( P = .011).

Conclusion:

No significant difference in repair strength was seen, but higher initial linear stiffness for Krackow repair suggests superior resistance to gap formation, which may occur during postoperative rehabilitation. With equal repair strength, but less soft tissue devitalization, the PARS may be a favorable option for patients with risk factors for soft tissue complications.
Republication of “Current Concepts Review: Hallux Rigidus”
Authors: Anderson Michael R. , Ho Bryant S. , Baumhauer Judith F.
Published: July 2023

Arthritis of the first metatarsophalangeal (MTP) joint, hallux rigid, is a common and disabling source of foot pain in the adult population. Hallux rigidus is characterized by diseased cartilage and large, periarticular osteophytes that result in a stiff, painful joint. Activity modification, sensible shoes, orthotics, anti-inflammatory medications and occasional intra-articular steroid injections can be attempted to alleviate the discomfort associated with hallux rigidus. A number of surgical options exist for the treatment of recalcitrant hallux rigidus. Cheilectomy is a useful treatment for dorsal impingement pain seen in mild hallux rigidus. A new polyvinyl alcohol hemi-arthroplasty implant has shown promising early and midterm results in the treatment of advanced hallux rigidus; however, arthrodesis of the first MTP joint remains the gold standard treatment for advanced hallux rigidus because of unpredictable outcomes after early-generation joint replacement implants.
Prevalence of choroidal nevi in patients with central serous chorioretinopathy
Authors: Maltsev Dmitrii S. , Kulikov Alexey N. , Vasiliev Alexander S. , Shapovalova Ekaterina D. , Chhablani Jay
Published: July 2023

Background:

A number of articles report the association of polypoidal lesions and choroidal nevi; however, the relationship between choroidal nevi and pachychoroidal disorders has not been studied.

Objectives:

To study the prevalence of choroidal nevi in central serous chorioretinopathy (CSCR) patients and to elucidate potential differences in the clinical characteristics of CSCR in patients with and without choroidal nevi.

Design:

Case-control study.

Methods:

This study included a retrospective analysis of medical records and multimodal imaging data of CSCR patients and a prospective evaluation of the prevalence of the choroidal nevi in age- and sex-matched healthy controls. All participants received comprehensive ophthalmic examination and multimodal imaging including infrared scanning laser ophthalmoscopy in dark-field mode to detect choroidal nevi in the central 40° × 60° region.

Results:

A total of 199 CSCR patients (160 males and 39 females, 47.9 ± 9.4 years) and 184 age-matched healthy individuals (139 males and 45 females, 44.8 ± 12.5 years) were included. Choroidal nevi were detected in 24 (12.1%) CSCR patients and 10 (5.4%) healthy controls ( p = 0.01). CSCR patients with choroidal nevi had statistically significantly higher subfoveal choroidal thickness, lower best-corrected visual acuity, and lower central retinal thickness ( p < 0.05) than CSCR patients without choroidal nevi. The odds ratio for the presence of chronic CSCR in patients with choroidal nevi was 27.0 (95% CI: 3.1–231.9, p = 0.003).

Conclusion:

The prevalence of choroidal nevi among patients with CSCR is higher than in age- and sex-matched healthy population. Choroidal nevi may be associated with chronic CSCR.
Selection for social genetic effects in purebred pigs improves behaviour and handling of their crossbred progeny
Authors: Nielsen Bjarne , Horndrup Lizette Vestergaard , Turner Simon P. , Christensen Ole Fredslund , Nielsen Hanne Marie , Ask Birgitte
Published: July 2023

Background

In commercial pig production, reduction of harmful social behavioural traits, such as ear manipulation and tail biting, is of major interest. Moreover, farmers prefer animals that are easy to handle. The aim of this experiment was to determine whether selection on social breeding values (SBV) for growth rate in purebred pigs affects behaviour in a weighing crate, lesions from ear manipulation, and tail biting of their crossbred progeny. Data were collected on crossbred F1 pigs allocated to 274 pens, which were progeny of purebred Landrace sows and Yorkshire boars from a DanBred nucleus herd.

Results

Behaviour in the weighing crate scored on a three-level scale showed that groups of pigs with high SBV for growth rate were significantly calmer than groups of pigs with low SBV (P < 0.027). When the mean SBV in the group increased by 1 unit, the proportion of pigs that obtained a calmer score level was increased by 14%. A significant (p = 0.04), favourable effect of SBV was found on both the number of pigs with ear lesions in the group and the mean number of ear lesions per pig. For a 1 unit increase in mean SBV, the mean number of lesions per pig decreased by 0.06 from a mean of 0.98. Individual severity of ear lesions conditional upon the number of ear lesions was also significantly affected (p = 0.05) by the mean SBV in the group. In groups for which the mean SBV increased by 1 unit, the proportion of pigs that were observed with a lower severity score was increased by 20% on a three-level scale. Most pigs received no tail biting injuries and no effect of SBV was observed on the tail injury score.

Conclusions

After 7 weeks in the finisher unit, crossbred progeny with high SBV were calmer in the weighing crate and had fewer ear lesions. These results indicate that selection of purebred parents for SBV for growth rate will increase welfare in their crossbred progeny by decreasing the number of ear lesions and making them easier to handle.
Systemic review of age brackets in pediatric emergency medicine literature and the development of a universal age classification for pediatric emergency patients - the Munich Age Classification System (MACS)
Authors: Althammer Alexander , Prückner Stephan , Gehring Geogr Christian , Lieftüchter Victoria , Trentzsch Heiko , Hoffmann Florian
Published: July 2023

Currently arbitrary, inconsistent and non-evidence-based age cutoffs are used in the literature to classify pediatric emergencies. None of these classifications have valid medical rationale. This leads to confusion and poor comparability of the different study results. To clarify this problem, this paper presents a systematic review of the commonly used age limits from 115 relevant articles. In the literature search 6226 articles were screened. To be included, the articles had to address the following three topics: “health services research in emergency medicine”, “pediatrics” and “age as a differentiator”. Physiologic and anatomic principles with reference to emergency medicine were used to solve the problem to create a medically based age classification for the first time.

The Munich Age Classification System (MACS) presented in this paper is thus consistent with previous literature and is based on medical evidence. In the future, MAC should lead to ensure that a uniform classification is used. This will allow a better comparability of study results and enable meta-analyses across studies.
Factors influencing the prevalence of cervical cancer screening in Malaysia: a nationwide survey
Authors: Chan Yee Mang , Ismail Muhd Zulfadli Hafiz , Khaw Wan-Fei
Published: July 2023

Background

In 2020, cervical cancer ranked fourth in terms of both frequency of diagnosis and the leading cause of cancer-related deaths among women globally. Among Malaysian women, it was the third most prevalent form of cancer. Published data on nationally representative cervical cancer screening in Malaysia have been limited. Therefore, this study aimed to determine the prevalence of receiving a Pap smear test in the past three years, its relationship with socio-demographic factors and physical activity.

Methods

Using a subset of survey data from the National Health and Morbidity Survey (NHMS) 2019, a secondary data analysis was performed. Trained research assistants collected data through face-to-face method using a mobile tablet questionnaire system application. Logistic regression analysis was performed to examine the relationship between sociodemographic factors, physical activity, and cervical cancer screening. The analyses were conducted using STATA version 14 (Stata Corp, College Station, Texas, USA), accounting for sample weighs and complex sampling design.

Results

The analysis included 5,650 female respondents, representing an estimated 10.3 million Malaysian female adults aged 18 and above. Overall, 35.2% (95%CI 33.2, 37.4) respondents had a Pap smear test within the past three years. Respondents who were physically active were 1.41 times more likely to have a Pap smear test. Similarly, respondents aged 35–59 (OR 1.84; 95%CI 1.46, 2.34) and those living in rural localities (OR 1.38; 95%CI 1.13, 1.70) had higher odds of receiving a Pap smear test. Compared to married respondents, single respondents (OR 0.04; 95%CI 0.02, 0.07) and widowed/divorcee respondents (OR 0.72; 95%CI 0.56, 0.82) were less likely to receive a Pap smear test. Educated respondents were more likely to have had a Pap smear test.

Conclusions

The overall prevalence of cervical cancer screening in Malaysia remains low (35.2%). Efforts should be made to strengthen health promotion programs and policies in increasing awareness on the significance of cervical cancer screening. These initiatives should specifically target younger women, single women, and widowed/divorced individuals. The higher cervical screening uptake among rural women should be studied further, and the enabling factors in the rural setup should be emulated in urban areas whenever possible.
Prescription patterns and compliance with World Health Organization recommendations for the management of uncomplicated and severe malaria: A prospective, real-world study in sub-Saharan Africa
Authors: Baraka Vito , Nhama Abel , Aide Pedro , Bassat Quique , David Agatha , Gesase Samwel , Gwasupika Jonathan , Hachizovu Sebastian , Makenga Geofrey , Ntizimira Christian Ruchaho , Obunge Orikomaba , Tshefu Kitoto Antoinette , Cousin Marc , Otsyula Nekoye , Pathan Rashidkhan , Risterucci Céline , Su Guoqin , Manyando Christine
Published: July 2023

Background

This study aimed to evaluate the gap between guidelines and local clinical practice for diagnosis and treatment of uncomplicated and severe malaria, the patient characteristics, diagnostic approach, treatment, and compliance to standard guideline recommendations.

Methods

This was a multicentre, observational study conducted between October 2020 and March 2021 in which patients of all ages with symptoms suggestive of malaria and who visited a healthcare facility were prospectively enrolled in six countries in sub-Saharan Africa (The Democratic Republic of the Congo, Mozambique, Nigeria, Rwanda, The United Republic of Tanzania, and Zambia).

Results

Of 1001 enrolled patients, 735 (73.4%) patients had confirmed malaria (based on overall judgment by investigator) at baseline (uncomplicated malaria: 598 [81.4%] and severe malaria: 137 [18.6%]). Of the confirmed malaria patients, 533 (72.5%) were administered a malaria rapid diagnostic test. The median age of patients was 11 years (range: 2 weeks–91 years) with more patients coming from rural (44.9%) than urban (30.6%) or suburban areas (24.5%). At the community level, 57.8% of patients sought advice or received treatment for malaria and 56.9% of patients took one or more drugs for their illness before coming to the study site. In terms of early access to care, 44.1% of patients came to the study site for initial visit ≥ 48 h after symptom onset. In patients with uncomplicated malaria, the most prescribed treatments were artemisinin-based combination therapy (ACT; n = 564 [94.3%]), primarily using artemether-lumefantrine (82.3%), in line with the World Health Organization (WHO) treatment guidelines. In addition, these patients received antipyretics (85.6%) and antibiotics (42.0%). However, in those with severe malaria, only 66 (48.2%) patients received parenteral treatment followed by oral ACT as per WHO guidelines, whereas 62 (45.3%) received parenteral treatment only. After receiving ambulatory care, 88.6% of patients with uncomplicated malaria were discharged and 83.2% of patients with severe malaria were discharged after hospitalization. One patient with uncomplicated malaria having multiple co-morbidities and three patients with severe malaria died.

Conclusions

The findings of this study suggest that the prescribed treatment in most patients with uncomplicated malaria, but not of those with severe malaria, was in alignment with the WHO recommended guidelines.
The confidante method to measure abortion: implementing a standardized comparative analysis approach across seven contexts
Authors: Owolabi Onikepe O. , Giorgio Margaret , Leong Ellie , Sully Elizabeth
Published: July 2023

Background

Obtaining representative abortion incidence estimates is challenging in restrictive contexts. While the confidante method has been increasingly used to collect this data in such settings, there are several biases commonly associated with this method. Further, there are significant variations in how researchers have implemented the method and assessed/adjusted for potential biases, limiting the comparability and interpretation of existing estimates. This study presents a standardized approach to analyzing confidante method data, generates comparable abortion incidence estimates from previously published studies and recommends standards for reporting bias assessments and adjustments for future confidante method studies.

Methods

We used data from previous applications of the confidante method in Côte d’Ivoire, Ethiopia, Ghana, Java (Indonesia), Nigeria, Uganda, and Rajasthan (India). We estimated one-year induced abortion incidence rates for confidantes in each context, attempting to adjust for selection, reporting and transmission bias in a standardized manner.

Findings

In each setting, majority of the foundational confidante method assumptions were violated. Adjusting for transmission bias using self-reported abortions consistently yielded the highest incidence estimates compared with other published approaches. Differences in analytic decisions and bias assessments resulted in the incidence estimates from our standardized analysis varying widely from originally published rates.

Interpretation

We recommend that future studies clearly state which biases were assessed, if associated assumptions were violated, and how violations were adjusted for. This will improve the utility of confidante method estimates for national-level decision making and as inputs for global or regional model-based estimates of abortion.
Integration of single-cell regulon atlas and multi-omics data for prognostic stratification and personalized treatment prediction in human lung adenocarcinoma
Authors: Xiong Yi , Zhang Yihao , Liu Na , Li Yueshuo , Liu Hongwei , Yang Qi , Chen Yu , Xia Zhizhi , Chen Xin , Wanggou Siyi , Li Xuejun
Published: July 2023

Transcriptional programs are often dysregulated in cancers. A comprehensive investigation of potential regulons is critical to the understanding of tumorigeneses. We first constructed the regulatory networks from single-cell RNA sequencing data in human lung adenocarcinoma (LUAD). We next introduce LPRI (Lung Cancer Prognostic Regulon Index), a precision oncology framework to identify new biomarkers associated with prognosis by leveraging the single cell regulon atlas and bulk RNA sequencing or microarray datasets. We confirmed that LPRI could be a robust biomarker to guide prognosis stratification across lung adenocarcinoma cohorts. Finally, a multi-omics data analysis to characterize molecular alterations associated with LPRI was performed from The Cancer Genome Atlas (TCGA) dataset. Our study provides a comprehensive chart of regulons in LUAD. Additionally, LPRI will be used to help prognostic prediction and developing personalized treatment for future studies.
Relation between interleukin-6 concentrations and oxidative status of HIV infected patients with /or at risk of Kaposi disease in Yaounde
Authors: Voufo Roger Ahouga , Kouotou Armand Emmanuel , Tatah Nchinda Jones , TeTo Georges , Gueguim Cédric , Ngondé Chantal Marie Essome , Njiguet Tepa Armand Gabin , Gabin Arnaud , Amazia Falmata , Yembeau Natacha Lena , Kouanfack Charles , Anatole Pieme Constant
Published: July 2023

Objective

To investigate the relation between interleukin-6 concentration and oxidative status of HIV infected patients with or at risk of Kaposi’s disease in Yaoundé.

Methods

We conducted a two-months cross-sectional study on 87 consenting HIV infected patients followed at the Day Hospital of the Yaoundé Central Hospital. Serum/plasma obtained after centrifugation of blood collected in dry/EDTA tubes was used for the determination of Human Herpes Virus-8 antigen (HHV-8) and Interleukin-6 (IL-6) by the ELISA technique, and that of oxidative stress markers: Malondialdehyde (MDA) reduced Glutathione (GSH) and total antioxidant capacity by spectrophotometry.

Results

Subjects belonging to the [40–50[year-old age group were mainly represented in our study population with 43.7%. The average age was 44.6 ± 10.4 years with extremes ranging from 26 to 72 years. The sex ratio was 0.24. Our population was mainly represented by people infected with HIV type I (90.8%) and 3.4% had developed clinical signs of Kaposi’s disease. The prevalence of the HHV-8 antigen was 57.5%. Immune and oxidative parameters did not vary with age, sex and therapeutic line. We noted a significant increase in IL-6 concentrations in patients positive to the HHV-8 antigen for IL-6 concentrations < 37 (P = 0.005; CI= [0.40; 0.59]. MDA and GSH concentrations increased significantly with the HHV-8 infection (P < 0.0001; CI= [0.40; 0.59] and P < 0.0001; CI= [13.30;21.45], respectively). Total antioxidant capacity (FRAP) decreased significantly with HHV-8 infection (P = 0.004; CI= [-69.18; -13.78]). We noted a significant increase in MDA concentrations in patients taking their ARVs irregularly, (P < 0.0001).

Conclusion

Our study showed a weak positive correlation between IL-6 and MDA, a strong negative correlation between FRAP and MDA and a strong positive correlation between MDA and GSH highlighting the association of these few markers of oxidative stress and Il-6 to the risk of Kaposi’s disease.
Gaps in the evidence underpinning high-risk medical devices in Europe at market entry, and potential solutions
Authors: Hulstaert Frank , Pouppez Céline , Primus-de Jong Célia , Harkin Kathleen , Neyt Mattias
Published: July 2023

Aim

To determine the level of evidence for innovative high-risk medical devices at market entry.

Methods

We reviewed all Belgian healthcare payer (RIZIV-INAMI) assessor reports on novel implants or invasive medical devices (n = 18, Class IIb-III) available between 2018 to mid-2019 on applications submitted for inclusion on their reimbursement list. We also conducted a review of the literature on evidence gaps and an analysis of relevant legal and ethical frameworks within the European context.

Findings

Conformity assessment of medical devices is based on performance, safety, and an acceptable risk-benefit balance. Information submitted for obtaining CE marking is confidential and legally protected, limiting access to clinical evidence. Seven out of the 18 RIZIV-INAMI assessor reports (39%) included a randomized controlled trial (RCT) using the novel device, whilst 2 applications (11%) referred to an RCT that used a different device. The population included was inappropriate or unclear for 3 devices (17%). Only half of the applications presented evidence on quality of life or functioning and 2 (11%) presented overall survival data. Four applications (22%) included no data beyond twelve months. The findings from the literature demonstrated similar problems with the study design and the clinical evidence.

Discussion and conclusions

CE marking does not indicate that a device is effective, only that it complies with the law. The lack of transparency hampers evidence-based decision making. Despite greater emphasis on clinical benefit for the patient, the provisions of the European Medical Device Regulation (MDR) are not yet fully aligned with international ethical standards for clinical research. The MDR fails to address key issues, such as the lack of access to data submitted for CE marking and a failure to require evidence of clinical effectiveness. Indeed, a first report shows no improvement in the clinical evidence for implantable devices generated under the MDR. Thus, patients may continue to be exposed to ineffective or unsafe novel devices. The Health Technology Assessment Regulation plans for Joint Scientific Consultations for specific high-risk devices before companies begin their pivotal clinical investigations. The demanded comparative evidence should facilitate payer decisions. Nevertheless, there is also a need for legislation requiring comparative RCTs assessing patient-relevant outcomes for high-risk devices to ensure implementation, including development and implementation of common specifications for study designs.
Non-viral gene delivery to human mesenchymal stem cells: a practical guide towards cell engineering
Authors: Carballo-Pedrares Natalia , Ponti Federica , Lopez-Seijas Junquera , Miranda-Balbuena Diego , Bono Nina , Candiani Gabriele , Rey-Rico Ana
Published: July 2023

In recent decades, human mesenchymal stem cells (hMSCs) have gained momentum in the field of cell therapy for treating cartilage and bone injuries. Despite the tri-lineage multipotency, proliferative properties, and potent immunomodulatory effects of hMSCs, their clinical potential is hindered by donor variations, limiting their use in medical settings. To address this challenge, gene delivery technologies have emerged as a promising approach to modulate the phenotype and commitment of hMSCs towards specific cell lineages, thereby enhancing osteochondral repair strategies. This review provides a comprehensive overview of current non-viral gene delivery approaches used to engineer MSCs, highlighting key factors such as the choice of nucleic acid or delivery vector, transfection strategies, and experimental parameters. Additionally, it outlines various protocols and methods for qualitative and quantitative evaluation of their therapeutic potential as a delivery system in osteochondral regenerative applications. In summary, this technical review offers a practical guide for optimizing non-viral systems in osteochondral regenerative approaches.

Graphical Abstract

hMSCs constitute a key target population for gene therapy techniques. Nevertheless, there is a long way to go for their translation into clinical treatments. In this review, we remind the most relevant transfection conditions to be optimized, such as the type of nucleic acid or delivery vector, the transfection strategy, and the experimental parameters to accurately evaluate a delivery system. This survey provides a practical guide to optimizing non-viral systems for osteochondral regenerative approaches.
Parental support for physical activity and children’s physical activities: a cross-sectional study
Authors: Hosokawa Rikuya , Fujimoto Megumi , Katsura Toshiki
Published: July 2023

Background

Physical activity (PA) in school-aged children is imperative for physical and mental development. However, there has been reduced PA among children in recent years owing to environmental changes, resulting in declining physical strength and athletic ability. Although parents’ and children’s PA has been found to be correlated, the specific parental caregiving attitudes associated with children’s actual levels of PA during school-age years remain unknown. Therefore, this study aimed to examine the relationship between parental support for PA and children’s levels of PA.

Methods

In 2017, a self-reported questionnaire survey was administered to 1,515 third-grade students (8–9 years old) and their caregivers in Nagoya, Aichi, a major metropolitan area in Japan. The main items surveyed included the attitudes of children and parents towards PA and the children’s actual PA level. Multiple regression analysis was conducted with parental involvement related to PA as the explanatory variable and children’s PA as the objective variable.

Results

In total, 717 children with valid responses were included in the analysis. The mean age of the children was 9.08 ± 0.33 years; 366 (51.0%) were boys, and 351 (49.0%) were girls. For moderate-to-vigorous and vigorous PA, PA levels tended to be significantly higher in children whose parents provided logistic support such as enrolling their children in a sports club. However, for moderate PA and walking, PA levels tended to be significantly higher in children whose parents used community resources. Modeling and limiting sedentary activities were not associated with children’s PA.

Conclusions

The results of this study suggest that direct parental assistance for PA such as logistic support encourages children to engage in moderate-to-vigorous PA; in addition, parental use of community resources may encourage children to engage in moderate and light PA such as walking. Conversely, indirect and negative involvement such as modeling and limiting sedentary activities were not associated with children’s PA. Therefore, logistic support may need to be strengthened to encourage moderate-to-vigorous and vigorous PA, which is important for children’s health.
User authentication and access control to blockchain-based forensic log data
Authors: Islam Md. Ezazul , Islam Md. Rafiqul , Chetty Madhu , Lim Suryani , Chadhar Mehmood
Published: July 2023

For dispute resolution in daily life, tamper-proof data storage and retrieval of log data are important with the incorporation of trustworthy access control for the related users and devices, while giving access to confidential data to the relevant users and maintaining data persistency are two major challenges in information security. This research uses blockchain data structure to maintain data persistency. On the other hand, we propose protocols for the authentication of users (persons and devices) to edge server and edge server to main server. Our proposed framework also provides access to forensic users according to their relevant roles and privilege attributes. For the access control of forensic users, a hybrid attribute and role-based access control (ARBAC) module added with the framework. The proposed framework is composed of an immutable blockchain-based data storage with endpoint authentication and attribute role-based user access control system. We simulate authentication protocols of the framework in AVISPA. Our result analysis shows that several security issues can efficiently be dealt with by the proposed framework.