bluuebunny/crossref_metadata_2025 huggingface dataset:
“You kind of blame it on the alcohol, but. . .”: A discourse analysis of alcohol use and sexual consent among young men in Vancouver, Canada
Authors: Goodyear Trevor , Oliffe John L , Kia Hannah , Jenkins Emily K , Knight Rod
Published: December 2023

There is growing awareness about issues of sexual consent, especially in autonomy-compromising or “non-ideal” contexts, including sex involving alcohol. Understanding the conditions needed for consensual sex to occur in this emergent milieu is critically important, especially for young men (ages 18–30 years) who normatively combine drinking alcohol with sex and are most often perpetrators of sexual violence. This study offers a discourse analysis of young men’s alcohol use and sexual consent. Data are drawn from qualitative interviews with 76 young men (including gay, bisexual, queer, and straight men) in Vancouver, Canada, from 2018 to 2021. Informed by Kukla’s non-ideal theory of sexual consent and critical and inclusive masculinities, this analysis identified three discursive frames: careful connections, watering it down, and blurred lines. In careful connections young men discussed their efforts to actively promote sexual and decisional autonomy for themselves and their sexual partners when drinking. Yet, in watering it down young men invoked discourses of disinhibition, deflection, and denial to normalize alcohol use as being somewhat excusatory for sexual violence, downplaying the role and responsibility of men. Lastly, men operationalized blurred lines through a continuum of consent and of “meeting (masculine) expectations” when discussing sexual violence and victimization while intoxicated. Together, these discursive frames provide insights into the gendered nature of sexual violence and the extent to which idealized notions of sexual consent play out in the everyday lives of young men who use alcohol with sex. Findings hold philosophical and pragmatic implications for contemporary efforts to scaffold sexual consent.
Particle swarm optimized fuzzy proportional-integral-derivative controller-based transverse leaf spring active suspension for vibration control
Authors: Zhang Junhong , Long Feiqi , Lin Jiewei , Zhu Xiaolong
Published: December 2023

The transverse leaf spring (TLS) suspensions are a promising option for van vehicles due to their high load-carrying capacity and excellent handling stability. However, its ride comfort remains a major challenge. This paper investigates and compares the effects of semi-active and active control strategies to enhance the ride comfort of TLS suspensions. Firstly, a four-degree-of-freedom (4-DOF) half-car model and a multi-body dynamics (MBD) model of the TLS suspensions are established. The MBD model has higher accuracy and can describe the medium and high frequency characteristics of the TLS suspensions, such as the suspension offset frequency and the frequency response function of the body vertical acceleration (BVA). Therefore, based on the MBD half-car model with TLS suspensions, this paper proposes an optimal fuzzy PID active control strategy considering the left and right suspension coupling. The optimization objectives are the BVA, the left and right suspensions dynamic deflection, and the left and right wheels dynamic displacement. The integral absolute error is used as the evaluation criterion. The left and right fuzzy PID controllers’ parameters are obtained through particle swarm optimization. Simulation results demonstrate that the particle swarm optimization fuzzy PID active control strategy effectively controls the low-frequency vibration of the TLS suspensions and suppresses the medium- and high-frequency vibration characteristics compared with the traditional skyhook semi-active control strategy. This technology provides a reference for improving the ride comfort of the TLS suspensions.
The journalism-audience relationship in the digital age: A theoretical literature review
Authors: Uth Bernadette , Stehle Helena , Wilhelm Claudia , Detel Hanne , Podschuweit Nicole
Published: December 2023

The journalism-audience relationship is a key research topic within communication and journalism studies. Digitalization, which has transformed the relationship, has made it even more relevant to both journalism practice and research. There is a large body of literature that examines how the relationship between journalism and its audience has changed, what the mutual expectations are, and how the audience can actively participate in journalism. However, profound theoretical conceptualizations of the journalism-audience relationship are scarce, especially in relation to a digital media environment. Based on a systematic theoretical review, we compare different theoretical conceptualizations of the journalism-audience relationship in the digital age that are currently in use, and how they can be characterized and classified. Our analysis identifies six main theoretical approaches: (1) discursive, (2) expectation-based, (3) network-oriented, (4) technological, (5) parasocial, and (6) strategic-organizational conceptualizations. The literature review provides insights into how the multifaceted relationship between journalism and its audience is captured and described, and raises important questions for future research.
What Do Practitioners Want from Research? Exploring Ugandan and American Development Practitioners’ Interest in Research
Authors: Fischer-Mackey Julia
Published: December 2023

Are development practitioners interested in research? If so, what kinds of research interest them, and for what purposes? Is the research they have access to meeting their needs for program design and management? These questions are central to understanding why research is used (or not), yet they are often overlooked by efforts to promote development research use. I interviewed practitioners in Washington, DC and Uganda to explore how they relate to research, and I identified six types of interest in research. Understanding practitioners’ diverse interests in research, and better aligning research agendas and knowledge mobilization efforts with them, may lead to more research use and more informed development practices.
Interpreting a virtual reconstruction from different levels of detail: 3D modeling approaches combined with a phenomenological exploratory study
Authors: Vilela João Paulo , Lopes Ricardo , Lima Fernando
Published: December 2023

Despite offering new possibilities for the education, interpretation, preservation, and management of cultural assets, virtual heritage still demands more consistent theoretical-practical debates. Under the scope of developing historical buildings' virtual models, the level of detail (LOD) is defined as a parameter that directly affects workflows, requiring time, investments, and specialized professionals. This work investigates how different LOD configurations influence the construction and interpretation of three-dimensional models of historic buildings. To this end, five 3D models with different LODs of a historic building in Brazil were set in an exploratory study that addressed users' perceptions when experimenting with them from a phenomenological perspective. The goal was to identify which elements and LOD configurations of the model were preponderant. The experiment was performed through an online workshop, where first-year architecture students could virtually experience the 3D models created, comparing them to a movie of the existing building. Participants were divided into five groups, one for each proposed LOD, and described their experiences through reports that were then analyzed, considering a list of themes emerging from their speeches. The findings underwent statistical analysis to understand how different themes and videos were linked. The experiment findings showed that (1) the 3D models with higher LODs led to more comprehensive comments on the architecture of the building and (2) elements such as the building's surroundings, the humanization of the scenery, and the temporal depth of the 3D models should be considered in the virtual reconstruction process.
Renoprotective effects of combination treatment with sodium-glucose cotransporter inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes mellitus according to preceding medication
Authors: Kobayashi Kazuo , Toyoda Masao , Tone Atsuhito , Kawanami Daiji , Suzuki Daisuke , Tsuriya Daisuke , Machimura Hideo , Shimura Hidetoshi , Takeda Hiroshi , Yokomizo Hisashi , Takeshita Kei , Chin Keiichi , Kanasaki Keizo , Miyauchi Masaaki , Saburi Masuo , Morita Miwa , Yomota Miwako , Kimura Moritsugu , Hatori Nobuo , Nakajima Shinichi , Ito Shun , Tsukamoto Shunichiro , Murata Takashi , Matsushita Takaya , Furuki Takayuki , Hashimoto Takuya , Umezono Tomoya , Muta Yoshimi , Takashi Yuichi , Tamura Kouichi
Published: December 2023

Aims

Combination therapy with sodium-glucose cotransporter inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP1Ras) is now of interest in clinical practice. The present study evaluated the effects of the preceding drug type on the renal outcome in clinical practice.

Methods

We retrospectively extracted type 2 diabetes mellitus patients who had received both SGLT2i and GLP1Ra treatment for at least 1 year. A total of 331 patients in the GLP1Ra-preceding group and 312 patients in the SGLT2i-preceding group were ultimately analyzed. Either progression of the albuminuria status and/or a ≥30% decrease in the eGFR was set as the primary renal composite outcome. The analysis using propensity score with inverse probability weighting was performed for the outcome.

Results

The incidences of the renal composite outcome in the SGLT2i- and GLP1Ra-preceding groups were 28% and 25%, respectively, with an odds ratio [95% confidence interval] of 1.14 [0.75, 1.73] ( p = .54). A logistic regression analysis showed that the mean arterial pressure (MAP) at baseline, the logarithmic value of the urine albumin-to-creatinine ratio at baseline, and the change in MAP were independent factors influencing the renal composite outcome.

Conclusion

With combination therapy of SGLT2i and GLP1Ra, the preceding drug did not affect the renal outcome.
How College Students React to COVID Vaccine PSAs: An Experimental Investigation
Authors: Fridkin Kim , Horsting Trudy , Brown Anastasia L. , Williams Alexandra M.
Published: December 2023

We explore how political and psychological factors condition the effectiveness of PSAs promoting COVID-19 vaccines. Targeting college students, we utilize a pretest-posttest experiment to examine how different PSAs (emotional, informational, and humorous) influence students’ emotional reactions and assessments of the PSAs. Further, we assess whether the PSAs are able to influence learning and persuasion. We find certain PSAs are more effective at changing people’s attitudes about the COVID-19 vaccine and the impact of these messages depends on people’s political and psychological predispositions. The informational PSA produces learning, regardless of students’ receptivity to pro-vaccine messaging. However, the humorous and emotional PSAs encourages learning only for those who are already receptive to the vaccine. These findings have implications for future public health campaigns aimed at college students, suggesting PSA campaigns developed to battle new health crises should be launched quickly before people develop strong attitudes about the emerging crisis.
Effectiveness of Specific Single-Use Incisional Negative Pressure Wound Therapy (PICO System) After Major Lower Extremity Amputation
Authors: Takahashi Hiroshi , Takeda Shinsuke , Tanaka Yoshihiro , Shibata Ryutaro , Ito Hiroki , Kurahashi Shingo , Mitsuya So , Murakami Hideki
Published: December 2023

Lower extremity amputation (LEA), particularly in patients with diabetes or peripheral vascular disease, often results in complications such as surgical site infections (SSIs) and wound dehiscence. This study examined whether utilizing the portable and user-friendly PICO system (Smith and Nephew Medical Ltd, Hull, UK) as incisional negative-pressure wound therapy can reduce post-LEA complications. This study was conducted at a Japanese tertiary medical center and involved a retrospective analysis of LEA cases (n = 32) between January 2021 and December 2022. The PICO dressing group (n = 16) was compared to the conventional dressing group (n = 16) for post-LEA wound management. The primary outcome was the incidence of postoperative wound complications, including SSI and wound dehiscence, within 15 days of LEA. Superficial/deep SSI and wound dehiscence occurred less frequently in the PICO dressing group than in the conventional dressing group (12.5% vs 43.8%; p = .054). There were no cases of deep SSIs in the PICO dressing group. Although this study has limitations owing to its retrospective design and small sample size, the results suggest the potential of the PICO system for improving outcomes in post-LEA wound management.
Accounting For the Limited Success of #MeToo in the Popular Music and Stand-Up Comedy Industries
Authors: Worden Chris , Gjika Anna
Published: December 2023

Despite several high-profile cases and years of #MeToo activism, a lack of systemic change and consistent consequences for many alleged offenders has led journalists and fans to wonder when the popular music and stand-up comedy industries will truly have their ‘MeToo moment.’ In this article, we explain that this moment has already arrived, but has produced inconsistent results in these industries due to the unique cultural and structural obstacles they share, and which frustrate civil sphere actors’ attempts at civil repair. Our analysis draws on Jeffrey C. Alexander’s (2018, 2019) theory of societalization – the process by which institutional crises come to be seen as social problems that demand the intervention of civil sphere actors. We argue that where #MeToo and the popular music and stand-up comedy industries are concerned, the process of societalization has been (and will likely continue to be) ‘blocked’ or ‘stalled’ (Alexander, 2018, 2019). We suggest that the potential for societalization is reduced due to a combination of the arts sphere’s anti-civil values and weak institutionalization in the popular music and stand-up comedy industries.
Development of a Scale to Measure the Parental Competency of Science-Gifted Students in South Korea
Authors: Kim Dongsim , Ryoo Dahyeon , Lee Myunghwa
Published: December 2023

This study aimed to develop and validate a scale of parental competency of science-gifted students in South Korea. The parental competency of science-gifted students is constructed in three dimensions (Learner, Fosterer, Scientist) from the literature review. We in-depth-interviewed science-gifted students and parents to discover the competency behavior indicators. To confirm the content validity, 15 experts in Korea conducted a Delphi method. We were determined lifelong learning, information utilization as the sub-elements of learner, partnership, parenting attitude, empathy of fosterer, and science capability, responsibility in science, and career preparation of scientist. As a result, we developed the initial instrument with 45 items. To validate the instrument, we carried out an online survey with 512 parents. Finally, 23 items of the measurement instrument for parental competency underwent development with three dimensions and eight sub-dimensions. This study provides a reliable instrument for parental competency and contributes to its enhancement for science-gifted students.
A case report and literature review of iatrogenic copper deficiency myeloneuropathy due to zinc treatment in patients with Wilson’s disease
Authors: Pawa Chloe , Ang Kexin , Chiew Yi Rong
Published: December 2023

Iatrogenic copper deficiency is rare in patients with Wilson’s disease. We present a case of iatrogenic copper deficiency myeloneuropathy secondary to zinc treatment for Wilson’s disease and compare the patient’s clinical features with existing cases. Our study highlights the importance of recognizing subtle clinical manifestations and counselling patients receiving copper-reducing treatment to watch for symptoms of myeloneuropathy. Early biochemical testing, including serum copper, caeruloplasmin and zinc levels, as well as magnetic resonance imaging of the spine and electrophysiological studies, may be helpful in diagnosing copper deficiency-related myeloneuropathy due to zinc treatment. Early detection and treatment of copper deficiency may lead to good recovery of neurological symptoms.
Patient and Clinician Experiences With the Combination of Virtual and In-Person Chronic Kidney Disease Care Since the COVID-19 Pandemic
Authors: Bevilacqua Micheli , Melnyk Yuriy , Chiu Helen , Williams Janet , Watson Paul , Lee Brenda , Dhariwal Palvir , McGuire Marlee , Wei Julie , Chohan Robin , Logie Anne , Fryer Michele , Stoll Dominik , Levin Adeera
Published: December 2023

Background:

Following onset of the COVID-19 pandemic, chronic kidney disease (CKD) clinics in BC shifted from established methods of mostly in-person care delivery to virtual care (VC) and thereafter a hybrid of the two.

Objectives:

To determine strengths, weaknesses, quality-of-care delivery, and key considerations associated with VC usage to inform optimal way(s) of integrating virtual and traditional methods of care delivery in multidisciplinary kidney clinics.

Design:

Qualitative evaluation.

Setting:

British Columbia, Canada.

Participants:

Patients and health care providers associated with multidisciplinary kidney care clinics.

Methods:

Development and delivery of semi-structured interviews of patients and health care providers.

Results:

11 patients and/or caregivers and 12 health care providers participated in the interviews. Participants reported mixed experiences with VC usage. All participants foresaw a future where both VC and in-person care was offered. A reported benefit of VC was convenience for patients. Challenges identified with VC included difficulty establishing new therapeutic relationships, and variable of abilities of both patients and health care providers to engage and communicate in a virtual format. Participants noted a preference for in-person care for more complex situations. Four themes were identified as considerations when selecting between in-person and VC: person’s nonmedical context, support available, clinical parameters and tasks to be completed, and clinic operations. Participants indicated that visit modality selection is an individualized and ongoing process involving the patient and their preferences which may change over time. Health care provider participants noted that new workflow challenges were created when using both VC and in-person care in the same clinic session.

Limitations:

Limited sample size in the setting of one-on-one interviews and use of convenience sampling which may result in missing perspectives, including those already facing challenges accessing care who could potentially be most disadvantaged by implementation of VC.

Conclusions:

A list of key considerations, aligned with quality care delivery was identified for health care providers and programs to consider as they continue to utilize VC and refine how best to use different visit modalities in different patient and clinical situations. Further work will be needed to validate these findings and evaluate clinical outcomes with the combination of virtual and traditional modes of care delivery.

Trial registration:

Not registered.
Outcomes of Lateral Meniscal Oblique Radial Tear Repair Compared With Intact Meniscus After ACL Reconstruction: A Cohort Study
Authors: Therrien Erik , Langhans Mark T. , Lamba Abhinav , Daniel Adam V. , Stuart Michael J. , Levy Bruce A. , Smith Patrick A. , Krych Aaron J.
Published: December 2023

Background:

Recently, the posterior horn lateral meniscal oblique radial tear (LMORT) was identified in 12% of acute anterior cruciate ligament (ACL) injuries. However, patient-reported outcomes for repair of this relatively common tear have not been reported.

Purpose:

To determine the minimum 2-year functional outcomes after LMORT repair at the time of ACL reconstruction (ACLR) compared to a matched cohort of patients who underwent isolated ACLR (iACLR).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 100 patients (mean age at surgery, 21 years; range, 13-45 years) who underwent primary ACLR between 2010 and 2018. The mean follow-up period was 4.1 ± 2.0 years (range, 2.0-9.2 years). A total of 50 patients with surgically repaired LMORT type 3 or type 4 lesions, defined as partial or complete tears >10 mm from the root (LMORT group) were matched 1:1 based on age, date of surgery, and graft choice with 50 patients who underwent iACLR (iACLR group). The postoperative outcomes were compared between groups using the International Knee Documentation Committee subjective score (sIKDC) and the Tegner activity scale. An updated medical history was obtained via the electronic medical record to determine any subsequent complications and reoperations.

Results:

There was 1 ACL graft failure in each group as well as 5 (10%) reoperations per group. None of the patients in the LMORT group necessitated a lateral meniscal revision repair or partial meniscectomy. The LMORT and iACLR groups reported comparable sIKDC scores (92.5 ± 6.8 vs 91.9 ± 8.2, respectively; P = .712) as well as Tegner scores (6.7 ± 1.8 vs 6.6 ± 1.8, respectively; P = .910) at final follow-up. No failures of the LMORT repairs were reported.

Conclusion:

The study findings demonstrated that reoperations, graft failure rates, patient-reported outcomes, and patient activity levels at ≥2 years after type 3 and 4 LMORT repairs at the time of ACLR compared favorably with those of a matched cohort of patients who underwent iACLR with intact meniscus.
Hematopoietic and eosinophil-specific LNK(SH2B3) deficiency promotes eosinophilia and arterial thrombosis
Authors: Dou Huijuan , Wang Ranran , Tavallaie Mojdeh , Xiao Tong , Olszewska Malgorzata , Papapetrou Eirini P. , Tall Alan R. , Wang Nan
Published: December 2023

Increased eosinophil counts are associated with cardiovascular disease and may be an independent predictor of major cardiovascular events. However, the causality and underlying mechanisms are poorly understood. Genome-wide association studies have shown an association of a common LNK variant (R262W, T allele) with eosinophilia and atherothrombotic disorders. LNK(TT) reduces LNK function, and Lnk-deficient mice display accelerated atherosclerosis and thrombosis. This study was undertaken to assess the role of eosinophils in arterial thrombosis in mice with hematopoietic Lnk deficiency. Hematopoietic Lnk deficiency increased circulating and activated eosinophils, JAK/STAT signaling in eosinophils, and carotid arterial thrombosis with increased eosinophil abundance and extracellular trap formation (EETosis) in thrombi. Depletion of eosinophils by anti–Siglec-F antibody or by the ΔdbIGata1 mutation eliminated eosinophils in thrombi and markedly reduced thrombosis in mice with hematopoietic Lnk deficiency but not in control mice. Eosinophil depletion reduced neutrophil abundance and NETosis in thrombi without altering circulating neutrophil counts. To assess the role of Lnk specifically in eosinophils, we crossed Lnkf/f mice with eoCre mice. LnkΔeos mice displayed isolated eosinophilia, increased eosinophil activation, and accelerated arterial thrombosis associated with increased EETosis and NETosis in thrombi. DNase I infusion abolished EETs and neutrophil extracellular traps (NETs) in thrombi and reversed the accelerated thrombosis. Human induced pluripotent stem cell–derived LNK(TT) eosinophils showed increased activation and EETosis relative to isogenic LNK(CC) eosinophils, demonstrating human relevance. These studies show a direct link between eosinophilia, EETosis, and atherothrombosis in hematopoietic Lnk deficiency and an essential role of eosinophil LNK in suppression of arterial thrombosis.
Identification and surveillance of rare relapse-initiating stem cells during complete remission after transplantation
Authors: Dimitriou Marios , Mortera-Blanco Teresa , Tobiasson Magnus , Mazzi Stefania , Lehander Madeleine , Högstrand Kari , Karimi Mohsen , Walldin Gunilla , Jansson Monika , Vonlanthen Sofie , Ljungman Per , Langemeijer Saskia , Yoshizato Tetsuichi , Hellström-Lindberg Eva , Woll Petter S. , Jacobsen Sten Eirik W.
Published: December 2023

Relapse after complete remission (CR) remains the main cause of mortality after allogeneic stem cell transplantation for hematological malignancies and, therefore, improved biomarkers for early prediction of relapse remains a critical goal toward development and assessment of preemptive relapse treatment. Because the significance of cancer stem cells as a source of relapses remains unclear, we investigated whether mutational screening for persistence of rare cancer stem cells would enhance measurable residual disease (MRD) and early relapse prediction after transplantation. In a retrospective study of patients who relapsed and patients who achieved continuous-CR with myelodysplastic syndromes and related myeloid malignancies, combined flow cytometric cell sorting and mutational screening for persistence of rare relapse-initiating stem cells was performed in the bone marrow at multiple CR time points after transplantation. In 25 CR samples from 15 patients that later relapsed, only 9 samples were MRD-positive in mononuclear cells (MNCs) whereas flowcytometric-sorted hematopoietic stem and progenitor cells (HSPCs) were MRD-positive in all samples, and always with a higher variant allele frequency than in MNCs (mean, 97-fold). MRD-positivity in HSPCs preceded MNCs in multiple sequential samples, in some cases preceding relapse by >2 years. In contrast, in 13 patients in long-term continuous-CR, HSPCs remained MRD-negative. Enhanced MRD sensitivity was also observed in total CD34+ cells, but HSPCs were always more clonally involved (mean, 8-fold). In conclusion, identification of relapse-initiating cancer stem cells and mutational MRD screening for their persistence consistently enhances MRD sensitivity and earlier prediction of relapse after allogeneic stem cell transplantation.
Performance analysis of conventional and AI-based variant callers using short and long reads
Authors: Abdelwahab Omar , Belzile François , Torkamaneh Davoud
Published: December 2023

Background

The accurate detection of variants is essential for genomics-based studies. Currently, there are various tools designed to detect genomic variants, however, it has always been a challenge to decide which tool to use, especially when various major genome projects have chosen to use different tools. Thus far, most of the existing tools were mainly developed to work on short-read data (i.e., Illumina); however, other sequencing technologies (e.g. PacBio, and Oxford Nanopore) have recently shown that they can also be used for variant calling. In addition, with the emergence of artificial intelligence (AI)-based variant calling tools, there is a pressing need to compare these tools in terms of efficiency, accuracy, computational power, and ease of use.

Results

In this study, we evaluated five of the most widely used conventional and AI-based variant calling tools (BCFTools, GATK4, Platypus, DNAscope, and DeepVariant) in terms of accuracy and computational cost using both short-read and long-read data derived from three different sequencing technologies (Illumina, PacBio HiFi, and ONT) for the same set of samples from the Genome In A Bottle project. The analysis showed that AI-based variant calling tools supersede conventional ones for calling SNVs and INDELs using both long and short reads in most aspects. In addition, we demonstrate the advantages and drawbacks of each tool while ranking them in each aspect of these comparisons.

Conclusion

This study provides best practices for variant calling using AI-based and conventional variant callers with different types of sequencing data.
Management of type 1 gastric neuroendocrine tumors: an 11-year retrospective single-center study
Authors: Chen Ying-Ying , Guo Wen-Juan , Shi Yan-Fen , Su Fei , Yu Fu-Huan , Chen Ru-Ao , Wang Chao , Liu Ji-Xi , Luo Jie , Tan Huang-Ying
Published: December 2023

Background

Type 1 gastric neuroendocrine tumors (NETs) are relatively rare to the extent that some physicians have little experience in diagnosing and treating them. The purpose of this study was to increase the understanding of the disease by analyzing and summarizing the management and prognoses of patients with type 1 gastric NETs at our center.

Methods

The data of 229 patients (59.4% female) with type 1 gastric NETs who were treated at our center during 2011–2022 were retrospectively analyzed.

Results

The average patient age was 50.5 ± 10.8 years. Multiple tumors affected 72.5% of the patients; 66.4% of the tumors were < 1 cm, 69.4% were NET G1, and 2.2% were stage III-IV. A total of 76.9% of the patients had received endoscopic management, 60.7% had received traditional Chinese medicine treatment, 10.5% received somatostatin analogues treatment, and 6.6% underwent surgical resection. Seventy patients (41.2%) experienced the first recurrence after a median follow-up of 31 months (range: 2-122 months), and the median recurrence-free time was 43 months. The 1-, 2-, and 3-year cumulative recurrence-free survival rates were 71.8%, 56.8%, and 50.3%, respectively. During a median follow-up of 39 months (range: 2-132 months), one patient had bilateral pulmonary metastasis, and no disease-related deaths were observed.

Conclusion

Type 1 gastric NETs have a high recurrence rate and a long disease course, underscoring the importance of long-term and comprehensive management.
Prevalence and feasibility of assessing the frailty phenotype among hemodialysis patients in a dialysis unit
Authors: Wadhwa Anuradha , Balbale Salva N. , Palleti Sujith K. , Samra Manpreet , Lopez-Soler Reynold I. , Stroupe Kevin T. , Markossian Talar W. , Huisingh-Scheetz Megan
Published: December 2023

Background

Frailty increases risk of morbidity and mortality in hemodialysis patients. Frailty assessments could trigger risk reduction interventions if broadly adopted in clinical practice. We aimed to assess the clinical feasibility of frailty assessment among Veteran hemodialysis patients.

Methods

Hemodialysis patients’ ≥50 years were recruited from a single dialysis unit between 9/1/2021 and 3/31/2022.Patients who consented underwent a frailty phenotype assessment by clinical staff. Five criteria were assessed: unintentional weight loss, low grip strength, self-reported exhaustion, slow gait speed, and low physical activity. Participants were classified as frail (3–5 points), pre-frail (1–2 points) or non-frail (0 points). Feasibility was determined by the number of eligible participants completing the assessment.

Results

Among 82 unique dialysis patients, 45 (52%) completed the assessment, 13 (16%) refused, 18 (23%) were not offered the assessment due to death, transfers, or switch to transplant or peritoneal dialysis, and 6 patients were excluded because they did not meet mobility criteria. Among assessed patients, 40(88%) patients were identified as pre-frail (46.6%) or frail (42.2%). Low grip strength was most common (90%). Those who refused were more likely to have peripheral vascular disease (p = 0.001), low albumin (p = 0.0187), low sodium (p = 0.0422), and ineligible for kidney transplant (p = 0.005).

Conclusions

Just over half of eligible hemodialysis patients completed the frailty assessment suggesting difficulty with broad clinical adoption expectations. Among those assessed, frailty and pre-frailty prevalence was high. Given patients who were not tested were clinically high risk, our reported prevalence likely underestimates true frailty prevalence. Providing frailty reduction interventions to all hemodialysis patients could have high impact for this group.
Development and validation of a nomogram for predicting overall survival in patients with early-onset endometrial cancer
Authors: Zhang Meng , Li Ruiping , Zhang Jiaxi , Wang Yunyun , Wang Yunlu , Guo Yuzhen
Published: December 2023

Background

This study aimed to investigate the differences in the clinicopathological characteristics of younger and older patients with endometrial cancer (EC) and develop a nomogram to assess the prognosis of early onset EC in terms of overall survival.

Methods

Patients diagnosed with EC from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 were selected. Clinicopathological characteristics were compared between younger and older patients, and survival analysis was performed for both groups. Prognostic factors affecting overall survival in young patients with EC were identified using Cox regression. A nomogram was created and internal validation was performed using the consistency index, decision curve analysis, receiver operating characteristic curves, and calibration curves. External validation used data from 70 patients with early onset EC. Finally, Kaplan-Meier curves were plotted to compare survival outcomes across the risk subgroups.

Results

A total of 1042 young patients and 12,991 older patients were included in this study. Younger patients were divided into training (732) and validation (310) cohorts in a 7:3 ratio. Cox regression analysis identified age, tumorsize, grade, FIGO stage(International Federation of Gynecology and Obstetrics) and surgery as independent risk factors for overall survival, and a nomogram was constructed based on these factors. Internal and external validations demonstrated the good predictive power of the nomogram. In particular, the C-index for the overall survival nomogram was 0.832 [95% confidence interval (0.797–0.844)] in the training cohort and 0.839 (0.810–0.868) in the internal validation cohort. The differences in the Kaplan-Meier curves between the different risk subgroups were statistically significant.

Conclusions

In this study, a nomogram for predicting overall survival of patients with early onset endometrial cancer based on the SEER database was developed to help assess the prognosis of patients and guide clinical treatment.
Investment case for small and sick newborn care in Tanzania: systematic analyses
Authors: Kamuyu Rosemary , Tarus Alice , Bundala Felix , Msemo Georgina , Shamba Donat , Paul Catherine , Tillya Robert , Murless-Collins Sarah , Oden Maria , Richards-Kortum Rebecca , Powell-Jackson Timothy , Kumar Meghan Bruce , Salim Nahya , Lawn Joy E
Published: December 2023

Background

Small and sick newborn care (SSNC) is critical for national neonatal mortality reduction targets by 2030. Investment cases could inform implementation planning and enable coordinated resource mobilisation. We outline development of an investment case for Tanzania to estimate additional financing for scaling up SSNC to 80% of districts as part of health sector strategies to meet the country’s targets.

Methods

We followed five steps: (1) reviewed national targets, policies and guidelines; (2) modelled potential health benefits by increased coverage of SSNC using the Lives Saved Tool; (3) estimated setup and running costs using the Neonatal Device Planning and Costing Tool, applying two scenarios: (A) all new neonatal units and devices with optimal staffing, and (B) half new and half modifying, upgrading, or adding resources to existing neonatal units; (4) calculated budget impact and return on investment (ROI) and (5) identified potential financing opportunities.

Results

Neonatal mortality rate was forecast to fall from 20 to 13 per 1000 live births with scale-up of SSNC, superseding the government 2025 target of 15, and close to the 2030 Sustainable Development Goal 3.2 target of <12. At 85% endline coverage, estimated cumulative lives saved were 36,600 by 2025 and 80,000 by 2030. Total incremental costs were estimated at US$166 million for scenario A (US$112 million set up and US$54 million for running costs) and US$90 million for scenario B (US$65 million setup and US$25 million for running costs). Setup costs were driven by infrastructure (83%) and running costs by human resources (60%). Cost per capita was US$0.93 and the ROI is estimated to be between US$8–12 for every dollar invested.

Conclusions

ROI for SSNC is higher compared to other health investments, noting many deaths averted followed by full lifespan. This is conservative since disability averted is not included. Budget impact analysis estimated a required 2.3% increase in total government health expenditure per capita from US$40.62 in 2020, which is considered affordable, and the government has already allocated additional funding. Our proposed five-step SSNC investment case has potential for other countries wanting to accelerate progress.
A service evaluation of passive remote monitoring technology for patients in a high-secure forensic psychiatric hospital: a qualitative study
Authors: Dewa Lindsay H. , Broyd Josephine , Hira Rita , Dudley Alison , Hafferty Jonathan D. , Bates Robert , Aylin Paul
Published: December 2023

Background

Technology has the potential to remotely monitor patient safety in real-time that helps staff and without disturbing the patient. However, staff and patients’ perspectives on using passive remote monitoring within an inpatient setting is lacking. The study aim was to explore stakeholders’ perspectives about using Oxehealth passive monitoring technology within a high-secure forensic psychiatric hospital in the UK as part of a wider mixed-methods service evaluation.

Methods

Semi-structured interviews were conducted with staff and patients with experience of using Oxehealth technology face-to-face within a private room in Broadmoor Hospital. We applied thematic analysis to the data of each participant group separately. Themes and sub-themes were integrated, finalised, and presented in a thematic map. Design, management, and analysis was meaningfully informed by both staff and patients.

Results

Twenty-four participants were interviewed (n = 12 staff, n = 12 patients). There were seven main themes: detecting deterioration and improving health and safety, “big brother syndrome”, privacy and dignity, knowledge and understanding, acceptance, barriers to use and practice issues and future changes needed. Oxehealth technology was considered acceptable to both staff and patients if the technology was used to detect deterioration and improve patient’s safety providing patient’s privacy was not invaded. However, overall acceptance was lower when knowledge and understanding of the technology and its camera was limited. Most patients could not understand why both physical checks through bedroom windows, and Oxehealth was needed to monitor patients, whilst staff felt Oxehealth should not replace physical checks of patients as reassures staff on patient safety.

Conclusions

Oxehealth technology is considered viable and acceptable by most staff and patients but there is still some concern about its possible intrusive nature. However, more support and education for new patients and staff to better understand how Oxehealth works in the short- and long-term could be introduced to further improve acceptability. A feasibility study or pilot trial to compare the impact of Oxehealth with and without physical checks may be needed.
Efficacy of rotator cuff suture and arthroscopic 360° capsular release in patients with rotator cuff tear with limited shoulder movement
Authors: Zuo Jianwei , Chen Chen , Guo Jiang , Lin Jianjing , You Tian , Chen Peng , Li Canfeng , Li Wei
Published: December 2023

Background

To determine the clinical efficacy of rotator cuff suture and arthroscopic 360° capsular release in patients with rotator cuff tendinopathy to improve the Constant-Murley and Visual Analogue Scale (VAS) scores, and shoulder flexion.

Methods

Fifty-one patients with full-thickness rotator cuff tears and limited shoulder movement who were admitted to our hospital from October 2017 to October 2020 were selected; all patients were treated with arthroscopic rotator cuff suture and 360° capsular release. The Constant-Murley score, VAS score, and shoulder flexion angle were used to evaluate shoulder joint function before and during follow-up. Rotator cuff healing was assessed by MRI with the Sugaya classification.

Results

After treatment, the Constant-Murley score (58.98 ± 9.84) was significantly improved compared with pre-treatment (29.33 ± 9.71), the VAS score (1.23 ± 0.87) was significantly lower than pre-treatment (7.54 ± 1.22), and the shoulder flexion angle (142.67 ± 8.59°) was significantly improved compared with pre-treatment (51.50 ± 2.10°); the difference was statistically significant (P < 0.05).

Conclusions

Arthroscopic rotator cuff suture and simultaneous 360° capsular release have a significant effect on the treatment of rotator cuff tear with limited shoulder movement.
Exploring knowledge, attitudes, and practices towards artificial intelligence among health professions’ students in Jordan
Authors: Al-Qerem Walid , Eberhardt Judith , Jarab Anan , Al Bawab Abdel Qader , Hammad Alaa , Alasmari Fawaz , Alazab Badi’ah , Husein Daoud Abu , Alazab Jumana , Al-Beool Saed
Published: December 2023

Introduction

The integration of Artificial Intelligence (AI) in medical education and practice is a significant development. This study examined the Knowledge, Attitudes, and Practices (KAP) of health professions’ students in Jordan concerning AI, providing insights into their preparedness and perceptions.

Methods

An online questionnaire was distributed to 483 Jordanian health professions’ students via social media. Demographic data, AI-related KAP, and barriers were collected. Quantile regression models analyzed associations between variables and KAP scores.

Results

Moderate AI knowledge was observed among participants, with specific understanding of data requirements and barriers. Attitudes varied, combining skepticism about AI replacing human teachers with recognition of its value. While AI tools were used for specific tasks, broader integration in medical education and practice was limited. Barriers included lack of knowledge, access, time constraints, and curriculum gaps.

Conclusions

This study highlights the need to enhance medical education with AI topics and address barriers. Students need to be better prepared for AI integration, in order to enable medical education to harness AI’s potential for improved patient care and training.
Surgical outcomes and risk factors for surgical complications after en bloc resection following reconstruction with 3D-printed artificial vertebral body for thoracolumbar tumors
Authors: Hu Jinxin , Song Guohui , Chen Hongmin , Xu Huaiyuan , Wang Anqi , Wang Xiangqin , Hou Bingbing , Lu Jinchang , Tang Qinglian , Wang Jin , Zhu Xiaojun
Published: December 2023

Background

The outcomes of patients with tumors of the thoracolumbar spine treated with en bloc resection (EBR) using three-dimensional (3D)-printed endoprostheses are underreported.

Methods

We retrospectively evaluated patients with thoracolumbar tumors who underwent surgery at our institution. Logistic regression analysis was performed to identify the potential risk factors for surgical complications. Nomograms to predict complications were constructed and validated.

Results

A total of 53 patients with spinal tumors underwent EBR at our hospital; of these, 2 were lost to follow-up, 45 underwent total en bloc spondylectomy, and 6 were treated with sagittal en bloc spondylectomy. The anterior reconstruction materials included a customized 3D-printed artificial vertebral body (AVB) in 10 cases and an off-the-shelf 3D-printed AVB in 41 cases, and prosthesis mismatch occurred in 2 patients reconstructed with the off-the-shelf 3D-printed AVB. The median follow-up period was 21 months (range, 7–57 months). Three patients experienced local recurrence, and 5 patients died at the final follow-up. A total of 50 perioperative complications were encountered in 29 patients, including 25 major and 25 minor complications. Instrumentation failure occurred in 1 patient, and no prosthesis subsidence was observed. Using a combined surgical approach was a dependent predictor of overall complications, while Karnofsky performance status score, lumbar spine lesion, and intraoperative blood loss ≥ 2000 mL were predictors of major complications. Nomograms for the overall and major complications were constructed using these factors, with C-indices of 0.850 and 0.891, respectively.

Conclusions

EBR is essential for the management of thoracolumbar tumors; however, EBR has a steep learning curve and a high complication rate. A 3D-printed AVB is an effective and feasible reconstruction option for patients treated with EBR.
An overview of the role of Niemann-pick C1 (NPC1) in viral infections and inhibition of viral infections through NPC1 inhibitor
Authors: Ahmad Irfan , Fatemi Seyede Narges , Ghaheri Mohammad , Rezvani Ali , Khezri Dorsa Azizi , Natami Mohammad , Yasamineh Saman , Gholizadeh Omid , Bahmanyar Zahra
Published: December 2023

Viruses communicate with their hosts through interactions with proteins, lipids, and carbohydrate moieties on the plasma membrane (PM), often resulting in viral absorption via receptor-mediated endocytosis. Many viruses cannot multiply unless the host’s cholesterol level remains steady. The large endo/lysosomal membrane protein (MP) Niemann-Pick C1 (NPC1), which is involved in cellular cholesterol transport, is a crucial intracellular receptor for viral infection. NPC1 is a ubiquitous housekeeping protein essential for the controlled cholesterol efflux from lysosomes. Its human absence results in Niemann-Pick type C disease, a deadly lysosomal storage disorder. NPC1 is a crucial viral receptor and an essential host component for filovirus entrance, infection, and pathogenesis. For filovirus entrance, NPC1’s cellular function is unnecessary. Furthermore, blocking NPC1 limits the entry and replication of the African swine fever virus by disrupting cholesterol homeostasis. Cell entrance of quasi-enveloped variants of hepatitis A virus and hepatitis E virus has also been linked to NPC1. By controlling cholesterol levels, NPC1 is also necessary for the effective release of reovirus cores into the cytoplasm. Drugs that limit NPC1’s activity are effective against several viruses, including SARS-CoV and Type I Feline Coronavirus (F-CoV). These findings reveal NPC1 as a potential therapeutic target for treating viral illnesses and demonstrate its significance for several viral infections. This article provides a synopsis of NPC1’s function in viral infections and a review of NPC1 inhibitors that may be used to counteract viral infections.

Graphical Abstract