bluuebunny/crossref_metadata_2025 huggingface dataset:
Photos Sculpt the Stories of Youth: Using Photovoice to Holistically Capture the Lived Experiences and Pain of Youth Who Underwent Spinal Fusion Surgery
Authors: Noyek Samantha , Newman Gillian , Jordan Abbie , Birnie Kathryn A. , Noel Melanie
Published: February 2024

Spinal fusion surgery is one of the most common major surgical procedures in youth. Adolescent idiopathic scoliosis (AIS) is the most frequent reason for corrective spinal fusion. AIS (∼25%–47% of cases) and spinal fusion surgeries are associated with pain, including the development of new onset chronic pain for up to 15% of youth. This research used photovoice approaches to explore the journeys of youth from before, during, and after spinal fusion surgery, to demonstrate their experiences both of and beyond pain. Twenty participants were recruited from a previous study conducted by the senior author’s lab. Participants captured photos/videos in their daily life (Phase 1); collected previously taken photos/videos from before/during/after their surgery (Phase 2); and participated in individual interviews to reflexively discuss the meaning behind photos/videos (Phase 3). Before interviews, a questionnaire was administered to assess pain characteristics. Nineteen girls/women with scoliosis and one boy/man with kyphosis (12–19 years old, M age = 16 years) participated; they identified as white (80%), other (15%), and Southeast Asian (5%). The researchers used a reflexive thematic analysis approach, which generated five themes: (1) body aesthetic versus machine; (2) expectations and anticipation of surgery/outcomes; (3) desire of normalcy and freedom; (4) navigating a hoped-for positive surgery experience; and (5) the journey sculpts identity formation and sense of self. Findings support youth advocacy, underscoring the need to validate youth concerns and inform healthcare professionals of the importance of individualized care. Youth perspectives highlighted opportunities for optimizing surgery/healthcare experiences and the psychosocial impacts of scoliosis on body image and appearance.
Investigating Variations in Medicine Approvals for Attention-Deficit/Hyperactivity Disorder: A Cross-Country Document Analysis Comparing Drug Labeling
Authors: Tanana Laila , Latif Asam , Nishtala Prasad S , Chen Timothy F
Published: February 2024

Objective:

This study aimed to compare the approval of medicines for attention deficit/hyperactivity disorder (ADHD) for pediatric patients across five countries.

Method:

A document analysis was completed, using the drug labeling for ADHD medicines from five countries; United Kingdom, Australia, New Zealand, Canada and United States (US). Comparisons of available formulations and approval information for ADHD medicine use in pediatric patients were made.

Results:

The US had the highest number of approved medicines and medicine forms across the studied countries (29 medicine forms for 10 approved medicines). Approved age and dosage variations across countries and missing dosage information were identified in several drug labeling.

Conclusions:

The discrepancies in approval information in ADHD medicine drug labeling and differing availability of medicine formulations across countries suggest variations in the management of ADHD across countries. The update of drug labeling and further research into reasons for variability and impact on practice are needed.
Metagenomic Analysis Reveals Difference of Gut Microbiota in ADHD
Authors: Wang Ning , Wang Haibin , Bai Yu , Zhao Yilu , Zheng Xiangyu , Gao Xuping , Zhang Zifeng , Yang Li
Published: February 2024

Objective:

Although ADHD is highly heritable, some environmental factors contribute to its development. Given the growing evidence that gut microbiota was involved in psychiatric disorders, we aimed to identify the characteristic composition of the gut microbiota in ADHD.

Methods:

We recruited 47 medication-naive children and adolescents with ADHD, and 60 healthy controls (HCs). We used shotgun metagenomics to measure the structure of the gut microbiota and analyzed the difference in bacterial taxa between ADHD and HCs.

Results:

Significant differences were found between the ADHD and HC groups in both alpha diversity indices (Simpson index, p = .025 and Shannon index, p = .049) and beta diversity indices (Euclidean distance, Bray-Curtis distance, and JSD distance, p < 2.2e-16). Nine representative species best explain the difference.

Conclusion:

Patients with ADHD showed significant differences in the composition of the gut microbiota compared with HCs. These results may help identify potential biomarkers of ADHD.
Adherence to Iron and Folic Acid Supplementation Among Pregnant Women From Northern Ghana
Authors: Seidu Haruna , Gaa Patience Kanyiri , Mogre Victor
Published: February 2024

Iron and folic Acid (IFA) supplementation is an effective intervention for reducing the incidence of anaemia during pregnancy. The WHO recommends at least 6 months intake of IFA to pregnant women. However, in Ghana some women experience challenges with adhering to IFA supplementation. The main objective of the study was to assess the level of adherence to iron and folic acid supplementation and its associated factors among pregnant women in a peri-urban municipality in Northern Ghana. A cross-sectional study was conducted from March to December 2021 among 400 pregnant women who attended ANC in Sagnarigu municipality in Ghana and were selected through a 3-stage random sampling technique. A structured questionnaire was used to collect data. The data were analysed using descriptive statistics, univariate and binary logistic regression statistical tools. Self-reported level of adherence to iron and folic acid supplementation was 84.5%. Knowledge of iron and folic acid supplementation (AOR = 0.08: 021, 0.343) was associated with adherence. Three other factors: time of first antenatal visit (AOR = 0.32: 0.153, 0.649) having history of anaemia [AOR = 2.67: 1.373, 5.201] having side effects of IFA [AOR = 3.70, CI: (1.756, 7.793)], and having knowledge of management of side effects of iron and folic acid supplementation (AOR = 0.08: 021, 0.343) were found to be significantly associated with adherence. Adherence to iron and folic supplementation among the pregnant women was generally frequent. Strategies to increase iron and folic acid supplementation adherence among pregnant women could focus on encouraging pregnant women to have early ANC visits and educating them on how to manage side effects.
Real-World Experience of Vitiligo Patients: A Retrospective Chart Review
Authors: Obeng-Asumeng Chelsea , Rodriguez-Bolanos Fabian , Gooderham Melinda
Published: February 2024

Background:

Vitiligo is a common depigmenting skin disorder with an estimated prevalence of 0.5% to 2% worldwide.

Objective:

We conducted a study to characterize the presentation of vitiligo in community dermatology clinic setting in Ontario, Canada.

Methods:

A retrospective cross-sectional study was performed through an electronic chart review at a community dermatology clinic with 2 sites in Ontario, Canada.

Results:

We found a male to female ratio of 1:1.3. The average age at the time of assessment was 40.8 years (ranging from 7 to 75 years). Sixteen percent of the patients were children (less than 18 years of age). Hands were the most common location for vitiligo (55.8%).

Conclusions:

Our findings are in keeping with previously described epidemiologic data. To our knowledge, this is the first Canadian study looking at the population in a community setting.
Solving puzzles, playing games: The potential and pitfalls of entertainment education in teaching about sexuality
Authors: Naezer Marijke , Krebbekx Willemijn
Published: February 2024

This paper explores the potential of entertainment education (EE) in teaching about sexuality, especially in terms of (1) addressing gaps and instigating an approach that is more (2) youth-centred and (3) norm-critical than conventional sex education. Based on the analysis of five projects in the Netherlands (escape room, educational theatre performance, interactive website, offline game, VR production), we argue that these methods attend to often-overlooked themes. Moreover, they allow for higher levels of student activity and student responsibility: elements of a youth-centred approach. Yet, EE-initiatives are not by themselves more norm-critical, and we observed inequality practices such as heteronormativity and victim-blaming. In our conclusion, we define crucial conditions for realising the potential of EE in teaching about sexuality.
Self-compassion and self-coldness and their relationship with psychological distress and subjective well-being among community-based Hazaras in Australia
Authors: Wilson Clare , Misajon RoseAnne , Brooker Joanne
Published: February 2024

Hazaras are a newly emerging community in Australia and limited research has explored their mental health. The first aim of this study was to explore levels of psychological distress and subjective well-being reported by Hazaras in Australia, and whether scores on psychosocial variables (self-compassion, self-coldness, acculturation, resilience, spirituality), psychological distress and domains of subjective well-being differed by sociodemographic groups. The second aim had two parts: (a) to examine bivariate relationships between the psychosocial variables, psychological distress and subjective well-being; and (b) to examine whether the psychosocial predictor variables independently contributed to subjective well-being and psychological distress when controlling for sociodemographic characteristics. Seventy-two Hazaras (58 men and 14 women), with a mean age of 28.82 years ( SD = 8.84) and average length of time residing in Australia of 10.17 years ( SD = 4.11), completed an online survey. There were sociodemographic differences in relation to key variables of interest; for example, participants who did not have family members in Australia reported lower levels of global life satisfaction. Moderate negative relationships were found between self-compassion and psychological distress and between self-coldness and subjective well-being. Self-coldness, self-compassion, resilience and acculturation contributed uniquely to psychological distress and subjective well-being when controlling for sociodemographic variables. Although migration programmes that provide permanent residency and allow family members to join refugees in Australia are limited, they appear important. Many of the difficulties facing Hazaras are ongoing, external and beyond their control (e.g. visa status); however, there is a possibility that self-compassion can play a role as a protective factor.
Sexism and misogyny as traits of police culture: Problems, red flags and solutions
Authors: Turner Allison
Published: February 2024

The aim of this article is to utilise pre-existing literature to explore the problems of misogyny and sexism currently found to be operating within the police service, and to provide recommendations around reform. This article analyses problems associated with sexism and misogyny at a time of media scrutiny following the Baroness Casey Review of the Metropolitan Police culture, which identifies these concepts as an institutional problem that can impact upon female police officers and women in general. The article begins by highlighting the importance of understanding the differences between sexism and misogyny and then reviews potential strategies towards police reform. These changes include a review of policy and law, use of education, leadership changes, reform to the Police Complaints and Discipline system, male peer support and more-effective whistleblowing processes. The article concludes by establishing that all strategies are worthy of consideration to reform a negative police culture. It also acknowledges that failures to respond to the challenges of dealing with misogyny and sexism effectively, will result in the strengthening of a police culture that continues to damage the police’s reputation and public trust and which will consequently affect all who are victim and witness to this behaviour.
Quadrotor control in complex manoeuvres using a hybrid backstepping and feedback linearisation control strategy
Authors: Keymasi-Khalaji Ali , Saadat Iman
Published: February 2024

In this article, a novel control algorithm called the combined backstepping and feedback linearisation method, along with an uncertainty estimator, is presented for quadrotors. The objective is to develop a robust control algorithm capable of handling various flight conditions, compensating for uncertainties and disturbances, and effectively controlling high-speed manoeuvres. To accomplish this, the quadrotor dynamics model is first derived using the Newton–Euler method. Subsequently, a backstepping control algorithm is designed for the quadrotor's internal control layer, followed by the application of the feedback linearisation method to the external control layer. An estimator is also designed to mitigate the effects of disturbances and uncertainties. A comparison is made between the proposed combined backstepping and feedback linearisation algorithm and the backstepping method, revealing that the combined backstepping and feedback linearisation algorithm outperforms the backstepping method across different aspects. Notably, the combined backstepping and feedback linearisation algorithm achieves faster trajectory tracking and demonstrates fewer steady-state errors. Additionally, the integration of the uncertainty estimator into the combined backstepping and feedback linearisation algorithm effectively mitigates the detrimental effects of disturbances and uncertainties. Comparative results for tracking control are presented to evaluate the performance of the proposed algorithm across various scenarios and case studies.
Integrating joint latent class mixed models and Bayesian network for uncovering clinical subgroups of COVID-19 patients
Authors: Cugnata Federica , Brombin Chiara , Cippà Pietro E. , Ceschi Alessandro , Ferrari Paolo , Di Serio Clelia
Published: February 2024

When modelling the dynamics of biomarkers in biomedical studies, it is essential to identify homogeneous clusters of patients and analyse them from a precision medicine perspective. This need has emerged as crucial and urgent during the COVID-19 pandemic: early understanding of symptoms and patient heterogeneity has significant implications for prevention, early diagnosis, effective management, and treatment. Additionally, biomarker progression may be associated with clinically relevant time-toevent data. Therefore, statistical models are necessary to gain insight into complex disease mechanisms by properly accounting for unobservable heterogeneity in patients while jointly modelling longitudinal and time-to-event data. In this study, we leverage the key features of Latent Class modelling and Bayesian Network approaches and propose a unified framework to (a) uncover homogeneous subgroups of patients concerning their longitudinal and survival data and (b) describe patient subgroups within a multivariate framework.
Incorporating Trauma-Informed Care Strategies Into the Assessment of and Intervention for Food Selectivity: A Pilot Investigation
Authors: Gover Holly C. , Rajaraman Adithyan , Weiss Tara
Published: February 2024

Autistic children are at an increased risk for both (a) exhibiting problematic eating behaviors such as food selectivity and (b) experiencing potentially traumatic events and correlated posttraumatic stress symptoms. Not only could a history of trauma directly influence the development of food selectivity but may also negatively impact the efficacy and social validity of existing evidence-based interventions. There is currently very little published research on interventions for food selectivity that incorporate commitments and strategies of trauma-informed care. In the current study, we sought to apply a trauma-informed approach to address the food selectivity of an autistic adolescent. Via a combination of single-subject experimental designs, we demonstrated that an intervention package inclusive of multiple trauma-informed care strategies directly contributed to increases in consumption of nonpreferred foods. We describe multiple ways in which we recruited and obtained social validation from the adolescent during his participation. Implications for practitioners and future research are discussed.
Influence of particle size and aggregates on translucent alumina ceramics fabricated by gelcasting
Authors: Di Zhengxian , Li Ting , Jin Dongliang , Huang Guowei , Fan Hengzhong , Hu Litian , Zhang Yongsheng
Published: February 2024

Three types of alumina powders and a polymer electrolyte Isobam system were used to fabricate translucent alumina ceramics via gelcasting, and each powder had the highest attainable solid loading. The effects of alumina particle size on slurry dispersion, microstructures and properties of green bodies and ceramics were investigated. All of the high-solid loading slurries contained strong aggregates, which could bridge with each other to form weak agglomerates. The smaller the initial particle size was, the more the contained particle number per aggregate. In addition, the smaller the aggregate size was, the lower the sintering activation energy of the ceramic and, finally, the higher the relative density. The initial particle size of the powder may not be the critical factor determining ceramic sintering, but the aggregate size and effective volume fraction of the aggregates may be the critical factors. Finally, the in-line transmittance of the ceramic with a higher density reached 22% at a wavelength of 650 nm and a thickness of 0.8 mm.
Narrating Anger Appropriately: Implications for Narrative Form and Successful Coping
Authors: Habermas Tilmann , Bongard Stephan
Published: February 2024

We propose that emotion psychology would significantly gain from including narrative(s) and the conversational negotiation of appropriateness. Using the example of anger, we argue that narrators need to construct plausible narratives of emotional events to achieve validating responses by listeners. We argue first that narrators attempt to demonstrate that the appraisal conditions for their emotion are given so that the emotion fits the narrated events. Second, we argue that this in turn explains why narratives of specific emotions exhibit specific forms. Third, we argue that coping with emotional experiences is helped by narrating such that the fittingness of emotions is demonstrated. We conclude that narrative plays an important role for identifying, processing, communicating, and eliciting emotions.
Current role of intraoperative cell salvage techniques in the management of renal tumors with level III and IV inferior vena cava thrombus extension
Authors: Surcel Cristian , Dotzauer Robert , Mirvald Cristian , Popa Calin , Olariu Cosmin , Baston Catalin , Harza Mihai , Gangu Constantin , Tsaur Igor , Sinescu Ioanel
Published: February 2024

Background:

En bloc removal of the kidney with tumor thrombus excision in a multidisciplinary team remains the standard treatment for renal cell carcinoma (RCC) with tumor thrombus extension. In order to minimize the hemodynamic impact of the surgical blood loss, intraoperative cell salvage (IOCS) techniques can decrease the need for allogeneic blood and prevent blood transfusion related complications.

Objective:

In this article, we evaluated the safety of IOCS during radical nephrectomy with inferior vena cava thrombectomy under cardiopulmonary bypass with or without deep hypothermic circulatory arrest.

Design and method:

In this retrospective comparative multicenter analysis, clinical characteristics of 27 consecutive patients who underwent surgery with or without IOCS between 2012 and 2022 in three referral care units were collected into a database. The need for an allogenic blood transfusion (ABT) was also recorded, defined as any transfusion that occurred either intraoperatively or during the hospital stay.

Results:

The need for ABT in the cell saver arm was significantly smaller due to the reinfusion of rescued blood ( p < 0.015). In multivariate analysis, no cell saver usage was an independent predictor for complications ⩾3 Clavien 3a [odds ratio (OR) 18.71, 95% CI 1.056–331.703, p = 0.046]. No usage of IOCS was an independent predictor for a lower risk of death (OR 0.277, 95% CI 0.062–0.825, p = 0.024). During follow-up, patients who received salvaged blood did not experience an increased risk for developing local recurrence or distant metastases.

Conclusion:

Transfusion of autologous blood is safe and can be using during nephrectomy and thrombectomy for advanced RCC.
South Korean University Lecturers’ Opinions About Initial Teacher Education in Gifted Education
Authors: Woo Heejin , Cumming Therese M. , O’Neill Susan C.
Published: February 2024

Despite the importance of initial teacher training, no primary education courses in South Korean universities provide a compulsory course in gifted education and elective courses are limited. Individual in-depth interviews with seven lecturers of gifted education courses were conducted to elicit their opinions about initial teacher education in gifted education. The lecturer interviewees suggested that there should be more of an emphasis on gifted education in initial teacher education programs. They also emphasized the importance of practical teaching experience with gifted students. The expansion of initial teacher education in gifted education in South Korea has the potential to improve preservice teachers’ understanding gifted students, ultimately improving the outcomes of this population.
Therapeutic potential of luteolin-loaded poly(lactic-co-glycolic acid)/modified magnesium hydroxide microsphere in functional thermosensitive hydrogel for treating neuropathic pain
Authors: Park So-Yeon , Jung Joon Hyuk , Kim Da-Seul , Lee Jun-Kyu , Song Byeong Gwan , Shin Hae Eun , Jung Ji-Won , Baek Seung-Woon , You Seungkwon , Han Inbo , Han Dong Keun
Published: February 2024

Neuropathic pain (NP) is a debilitating condition stemming from damage to the somatosensory system frequently caused by nerve injuries or lesions. While existing treatments are widely employed, they often lead to side effects and lack specificity. This study aimed to alleviate NP by developing an innovative sustained-release thermosensitive hydrogel system. The system incorporates hyaluronic acid (HA)/Pluronic F127 injectable hydrogel and bupivacaine (Bup, B) in combination with poly(lactic-co-glycolic acid; PLGA)/modified magnesium hydroxide (MH)/luteolin (Lut; PML) microspheres (PML@B/Gel). The PML@B/Gel was designed for localized and prolonged co-delivery of Bup and Lut as an anesthetic and anti-inflammatory agent, respectively. Our studies demonstrated that PML@B/Gel had exceptional biocompatibility, anti-inflammatory, and antioxidant properties. In addition, it exhibited efficient pain relief in in vitro cellular assays. Moreover, this functional hydrogel showed substantial sustained drug release while diminishing microglial activation. Consequently, it effectively mitigated mechanical allodynia and thermal hyperalgesia in in vivo rat models of chronic constriction injury (CCI). Based on our research findings, PML@B/Gel emerges as a promising therapeutic approach for the protracted treatment of NP.
(Pragmatic) collaboration for progress or threat to autonomy? African news discourses about Chinese technology in Nigeria and Ghana
Authors: Nguyen Dennis , Wang Bei , Mutsvairo Bruce
Published: February 2024

This study explores how African news media frame China’s role in digital technology. China’s engagement in Africa is portrayed as an ambiguous trend by Western media, which point to risks of Chinese influence. Themes of exploitation and support for autocratic regimes are common in media narratives about Chinese-African collaborations. Yet claims that China pursues a neo-colonial project in Africa seem exaggerated. While Chinese geopolitical ambitions drive its foreign policy decisions, African actors often appear absent from these discussions. African perceptions and assessments of China are nuanced, indicating a complex relationship. They point to benefits and risks with China as an economic, political, and cultural partner. It is crucial to analyze local contexts where stakeholders “get to speak” about China and technology, offering interpretative frameworks and engaging with opposing perspectives. News media are vital sites where technology narratives are conceived and circulated. The present study analyses Nigerian and Ghanaian news media as examples. Both countries share a complex history of development collaboration with China. Using a news framing approach linked to sociotechnical imageries, the study focuses on how African media discourses give meaning to digital technology and assess it in relation to foreign partners, including geopolitical implications in the Global South.
Treatment patterns and characteristics of patients with migraine: results from a retrospective database study in Japan
Authors: Takizawa Tsubasa , Kitano Takahiro , Iijima Masahiro , Togo Kanae , Yonemoto Naohiro
Published: February 2024

Background

Clinical characteristics and treatment practice of patients with migraine in Japan in real-world setting have not been fully investigated. We conducted a retrospective cohort study using claims database to understand the clinical practice of migraine in recent years and to characterize patients potentially not managed well by current treatment options.

Methods

Our study used data from the large claims database maintained by JMDC Inc. Patients with diagnosis of headache or migraine between January 1, 2018, and July 31, 2022, were defined as the headache cohort, and those with migraine diagnosis and prescription of migraine treatments among the headache cohort were included in the migraine cohort. In the headache cohort, characteristics of medical facilities and status of imaging tests to distinguish secondary headache were examined. Treatment patterns and characteristics of patients potentially not managed well by acute/preventive treatment were described in migraine cohort.

Results

In the headache cohort, 989,514 patients were included with 57.0% females and mean age of 40.3 years; 77.0% patients visited clinics (with ≤ 19 bed capacities) for their primary diagnosis, and 30.3% patients underwent imaging tests (computed tomography and/or magnetic resonance imaging). In the migraine cohort, 165,339 patients were included with 65.0% females and mean age of 38.8 years. In the migraine cohort, 95.6% received acute treatment while 20.8% received preventive treatment. Acetaminophen/non-steroidal anti-inflammatory drugs were most common (54.8%) as the initial prescription for migraine treatment followed by triptan (51.4%). First treatment prescription included preventive treatment in 15.6%, while the proportion increased to 82.2% in the fourth treatment prescription. Among patients with more than 12 months of follow-up, 3.7% had prescription patterns suggestive of risk of medication-overuse headache, and these patients were characterized by a higher percentage of females and a higher prevalence of comorbidities.

Conclusions

This study revealed that approximately one-fifth of the patients with migraine visiting medical facilities use preventive drugs. The presence of potential patients at risk of medication-overuse headache and the role of clinics in migraine treatment were also described.
Offspring of women with hyperemesis gravidarum are more likely to have cardiovascular abnormalities
Authors: Fan Jiao , Yin Minghong
Published: February 2024

Background

Hyperemesis gravidarum (HG) is a severe form of pregnancy-related nausea and vomiting affecting 0.3–2.3% of pregnancies, which can lead to fluid, electrolyte, and acid–base imbalances, nutritional deficiencies, and weight loss, and is usually severe enough to require hospitalization. Abnormally elevated urinary ketones are commonly seen in patients with HG, and ketone bodies are free to pass through the placenta, and maternal hyperketonemia, with or without acidosis, is associated with an increased rate of stillbirth, an increased incidence of congenital anomalies, and impaired neurophysiologic development of the infant. This study investigates the obstetric outcomes of patients with HG and whether HG increases the incidence of cardiovascular disease in the offspring.

Methods

This study included 1020 pregnant women who were hospitalized in our hospital for HG and ultimately delivered in our hospital as well as pregnant women without HG in early gestation and delivered in our hospital from January 2019-January 2020, and we collected and followed up the clinical information of the pregnant women and their offspring.

Results

Pregnant women with HG were more likely to have severe urinary ketones, the rate of early miscarriage and mid-term miscarriage was significantly higher in women with HG compared to pregnant women without HG. Fetal and neonatal head and abdominal circumferences were smaller in HG group than in control group.

Neonatal birth weight and length were also lower in the HG group and cardiovascular anomalies were more likely to occur in the offspring of women with HG when all births were followed up for 3 years.

Conclusions

HG may cause poor obstetric outcomes and was associated with the development of cardiovascular disease in the offspring of women with HG.
Retrospective, single-center analysis of autoimmune hepatitis in Jordanian children: clinical features, treatments, and outcomes
Authors: Altamimi Eyad , Al Omari Dana , Obeidat Hanadi , Barham Kamleh
Published: February 2024

Objectives

This study describes clinical, biochemical, and histological features and long-term outcomes in pediatric patients diagnosed with autoimmune hepatitis (AIH) at King Abdullah University Hospital, Jordan.

Design

Retrospective, single-center study.

Setting

King Abdullah University Hospital, Jordan.

Participants

Inclusion of all pediatric patients with AIH diagnosed at our hospital from 2015 to 2023. Exclusion criteria was patients aged over 18 at time of diagnosis and those diagnosed elsewhere.

Outcome measures

Understanding clinical, biochemical, and histological AIH features in children, evaluating treatment responses, and reporting short- and long-term complications, including mortality.

Results

Sixteen pediatric cases were diagnosed, with an average age of 9.84 ± 4.13 years. Females comprised 75% of patients, and 31.3% presented with acute liver failure. Jaundice was the most common symptom, and hepatosplenomegaly was observed in 18% of cases. Most patients had elevated transaminase levels, along with positive anti-smooth muscle antibody (ASMA) and antinuclear antibodies (ANA). Common hematological abnormalities included anemia (56.3%) and thrombocytopenia (37.5%). All patients underwent liver biopsy, with interface hepatitis present in 81.3% of cases. Treatment mainly involved prednisone and azathioprine. Three patients died, one discontinued therapy, two patients were lost to follow-up, and 10 remained on treatment.

Conclusion

Autoimmune hepatitis affects Jordanian children, primarily female children. Jaundice is the most common presenting symptoms. Only Type I AIH occurred in our cohort. Although of good response to conventional treatment with steroids and immunosuppression, mortality reached 18.8%.
Differentiation of the body build and posture in the population of people with intellectual disabilities and Down Syndrome: a systematic review
Authors: Gaweł Eliza , Celebańska Diana , Zwierzchowska Anna
Published: February 2024

Background

The aim of the study was to identify the variables of the internal compensatory mechanisms that differentiate the body build and posture of people with Down syndrome (DS) from the intellectual disability (ID) population. It was assumed that gaining knowledge in the abovementioned aspect will allow for a better understanding of the limitation of the kinesthetic abilities of people with ID and DS and simultaneously enable to optimize the process of planning and interventions to improve physical activity in this population with the adequate use of theirs strengths in the biomechanical and morphofunctional systems.

Methods

The methodology of this systematic review was developed according to the PRISMA guidelines. A search of PubMed, EBSCO, Scopus databases was conducted to identify all studies on DS/ID and the body build and posture from 2003 to 2023.

Results

395 articles were assessed to determine eligibility, while 22 studies met the inclusion criteria and were subjected to detailed analysis and assessment of their methodological quality. The differentiation of the body build and posture in DS population can be induced by both internal and external compensatory mechanisms. It is difficult to confirm the direct effect of the intrinsic variables that impact the body build and posture in the ID population, excluding people with DS.

Conclusions

Compared to other ID, the intrinsic differences in the body build and posture in DS individuals were induced by gender, age, and level of ID. The tendency for diversity between DS and other ID populations in body build and posture may be determined by the presence of the third copy of chromosome 21 in DS group. Internal compensatory processes may be induced mainly by abnormalities in the structure of the cervical vertebrae and feet. IQ should not be used as the only variable that identifies the population of people with ID.
Instrumentation failure following pediatric spine deformity growth-sparing surgery using traditional growing rods or vertical expandable prosthetic titanium ribs
Authors: Yokogawa Noriaki , Demura Satoru , Ohara Tetsuya , Tauchi Ryoji , Takimura Kosuke , Yanagida Haruhisa , Yamaguchi Toru , Watanabe Kota , Suzuki Satoshi , Uno Koki , Suzuki Teppei , Watanabe Kei , Kotani Toshiaki , Nakayama Keita , Oku Norihiro , Taniguchi Yuki , Murakami Hideki , Yamamoto Takuya , Kawamura Ichiro , Takeshita Katsushi , Sugawara Ryo , Kikkawa Ichiro , Kawakami Noriaki
Published: February 2024

Background

Instrumentation failure (IF) is a major complication associated with growth-sparing surgery for pediatric spinal deformities; however, studies focusing on IF following each surgical procedure are lacking. We aimed to evaluate the incidence, timing, and rates of unplanned return to the operating room (UPROR) associated with IF following each surgical procedure in growth-sparing surgeries using traditional growing rods (TGRs) and vertical expandable prosthetic titanium ribs (VEPTRs).

Methods

We reviewed 1,139 surgical procedures documented in a Japanese multicenter database from 2015 to 2017. Of these, 544 TGR and 455 VEPTR procedures were included for evaluation on a per-surgery basis. IF was defined as the occurrence of an implant-related complication requiring revision surgery.

Results

The surgery-based incidences of IF requiring revision surgery in the TGR and VEPTR groups were 4.3% and 4.0%, respectively, with no significant intergroup difference. Remarkably, there was a negative correlation between IF incidence per surgical procedure and the number of lengthening surgeries in both groups. In addition, rod breakage in the TGR group and anchor-related complications in the VEPTR group tended to occur relatively early in the treatment course. The surgery-based rates of UPROR due to IF in the TGR and VEPTR groups were 2.0% and 1.5%, respectively, showing no statistically significant difference.

Conclusions

We found that IF, such as anchor related-complications and rod breakage, occurs more frequently earlier in the course of lengthening surgeries. This finding may help in patient counseling and highlights the importance of close postoperative follow-up to detect IF and improve outcomes.
Lipoxin A4 levels predict site-specific clinical improvements post scaling and root planing and correlate negatively with periodontal pathogens in severe periodontitis
Authors: Ma Rui , Liu Yiying , Xu Yi , Duan Dingyu
Published: February 2024

Background

Serving as a stop signal of inflammation, the role of lipoxin A4 (LXA4) in periodontitis remains to be clarified. This study is aimed to examine the changes in LXA4 levels in gingival crevicular fluid (GCF) after scaling and root planing (SRP) and to determine the relationship between LXA4 levels and treatment outcomes and periodontal pathogens in severe periodontitis.

Methods

A total of 74 GCF samples were collected from 21 severe periodontitis participants at the deepest affected sites. These sites were re-sampled at 1, 3, and 6 months after SRP. Besides, GCF samples were also collected from 25 periodontally healthy participants. Clinical parameters including probing depth (PD) and clinical attachment level (CAL) in periodontitis group were recorded. LXA4 levels and periodontal pathogens in the GCF were analyzed by ELISA and PCR, respectively. Correlations between GCF LXA4 levels and treatment effect and periodontal pathogens were assessed.

Results

LXA4 levels in GCF significantly increased after SRP (p < 0.05), but remained lower than those observed in healthy individuals (p < 0.05). Sites with lower baseline LXA4 concentrations were more likely to experience greater improvements in PD at 6 months post-SRP (area under the curve [AUC] = 0.792), and the improvements were positively correlated with the increase of LXA4 at these sites post-treatment (p < 0.05). Furthermore, more elevated LXA4 levels were observed in sites that became negative for Prevotella intermedia or Tannerella forsythia after SRP.

Conclusion

Baseline LXA4 in GCF has the potential to predict the site-specific response of severe periodontal lesions to SRP. The increase of LXA4 levels after treatment was positively correlated with clinical improvements and negatively correlated with the presence of Prevotella intermedia or Tannerella forsythia.
The effectiveness of aesthetic care training on nurses’ perceptions of end-of-life care in patients with cancer: a quasi-experimental study
Authors: Shahmohammadi Sina , Mangolian shahrbabaki Parvin , Radmehr Maryam , Shahraki Sedigheh Khodabandeh
Published: February 2024

Background

Supportive end-of-life care plays a significant role for patients with cancer. Significantly, art and aesthetics in nursing are regarded as key components of nursing practice. They may contribute to supportive end-of-life care that nurses provide for patients with cancer. Therefore, this study aimed to examine the effectiveness of aesthetic care training on nurses’ perceptions of end-of-life care in patients with cancer.

Methods

A quasi-experimental study was conducted with two groups of nurses working in the oncology wards of two hospitals in Kerman, Iran. A sample consisting of 100 nurses was selected by census and randomly assigned to an experimental group (n = 49) and a control group (n = 51). The experimental group received educational workshops on aesthetic care over four weekly-held 90-minute sessions. Both groups completed the Oncology Nurses’ Perceptions of End-Of-Life Care (ONPEoLC) Scale before, immediately after, and one month after the intervention. The data were analyzed with SPSS software version 21 using t-test, Chi-square, and repeated measures ANOVA. The significance level was set to p < 0.05.

Results

The mean baseline scores on the ONPEoLC Scale were 163.08 ± 13.58 in the experimental group and 163.27 ± 14.57 in the control group. There was no statistically significant difference between the two groups (P > 0.05). Post-intervention mean scores in the experimental and control groups were 187.1 ± 18.22 and 159.11 ± 22.11, respectively, indicating a statistically significant difference between the two groups (P < 0.001). One month after the intervention, the experimental and control groups’ mean scores were 190.89 ± 11.13 and 165.80 ± 11.69, respectively, with a significant difference between the groups (P = 0.001).

Conclusion

Based on the results of the present study, designing aesthetic care educational programs is an effective way to improve nurses’ understanding of end-of-life care. Therefore, it is recommended that nursing faculties and educational policymakers utilize aesthetic care training to improve the nurses’ perceptions of end-of-life care.
Choice of refractive surgery types for myopia assisted by machine learning based on doctors’ surgical selection data
Authors: Li Jiajing , Dai Yuanyuan , Mu Zhicheng , Wang Zhonghai , Meng Juan , Meng Tao , Wang Jimin
Published: February 2024

In recent years, corneal refractive surgery has been widely used in clinics as an effective means to restore vision and improve the quality of life. When choosing myopia-refractive surgery, it is necessary to comprehensively consider the differences in equipment and technology as well as the specificity of individual patients, which heavily depend on the experience of ophthalmologists. In our study, we took advantage of machine learning to learn about the experience of ophthalmologists in decision-making and assist them in the choice of corneal refractive surgery in a new case. Our study was based on the clinical data of 7,081 patients who underwent corneal refractive surgery between 2000 and 2017 at the Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences. Due to the long data period, there were data losses and errors in this dataset. First, we cleaned the data and deleted the samples of key data loss. Then, patients were divided into three groups according to the type of surgery, after which we used SMOTE technology to eliminate imbalance between groups. Six statistical machine learning models, including NBM, RF, AdaBoost, XGBoost, BP neural network, and DBN were selected, and a ten-fold cross-validation and grid search were used to determine the optimal hyperparameters for better performance. When tested on the dataset, the multi-class RF model showed the best performance, with agreement with ophthalmologist decisions as high as 0.8775 and Macro F1 as high as 0.8019. Furthermore, the results of the feature importance analysis based on the SHAP technique were consistent with an ophthalmologist’s practical experience. Our research will assist ophthalmologists in choosing appropriate types of refractive surgery and will have beneficial clinical effects.
Enolase of Streptococcus suis serotype 2 promotes biomolecular condensation of ribosomal protein SA for HBMECs apoptosis
Authors: Jiang Hexiang , Sun Yi , Li Fengyang , Yu Xibing , Lei Siyu , Du Sulan , Wu Tong , Jiang Xuan , Zhu Junhui , Wang Jun , Ji Yalu , Li Na , Feng Xin , Gu Jingmin , Han Wenyu , Zeng Lei , Lei Liancheng
Published: February 2024

Background

Ribosomal protein SA (RPSA) of human brain microvascular endothelial cells (HBMECs) can transfer from the cytosol to the cell surface and act as a receptor for some pathogens, including Streptococcus suis serotype 2 (SS2), a zoonotic pathogen causing meningitis in pigs and humans. We previously reported that SS2 virulence factor enolase (ENO) binds to RPSA on the cell surface of HBMECs and induces apoptosis. However, the mechanism that activates RPSA translocation to the cell surface and induces ENO-mediated HBMEC apoptosis is unclear.

Results

Here, we show that RPSA localization and condensation on the host cell surface depend on its internally disordered region (IDR). ENO binds to the IDR of RPSA and promotes its interaction with RPSA and vimentin (VIM), which is significantly suppressed after 1,6-Hexanediol (1,6-Hex, a widely used tool to disrupt phase separation) treatment, indicating that ENO incorporation and thus the concentration of RPSA/VIM complexes via co-condensation. Furthermore, increasing intracellular calcium ions (Ca2+) in response to SS2 infection further facilitates the liquid-like condensation of RPSA and aggravates ENO-induced HBMEC cell apoptosis.

Conclusions

Together, our study provides a previously underappreciated molecular mechanism illuminating that ENO-induced RPSA condensation activates the migration of RPSA to the bacterial cell surface and stimulates SS2-infected HBMEC death and, potentially, disease progression. This study offers a fresh avenue for investigation into the mechanism by which other harmful bacteria infect hosts via cell surfaces’ RPSA.
Cardiorenal effectiveness of empagliflozin vs. glucagon-like peptide-1 receptor agonists: final-year results from the EMPRISE study
Authors: Htoo Phyo T. , Tesfaye Helen , Schneeweiss Sebastian , Wexler Deborah J. , Everett Brendan M. , Glynn Robert J. , Schmedt Niklas , Koeneman Lisette , Déruaz-Luyet Anouk , Paik Julie M. , Patorno Elisabetta
Published: February 2024

Background

No randomized clinical trials have directly compared the cardiorenal effectiveness of empagliflozin and GLP-1RA agents with demonstrated cardioprotective effects in patients with a broad spectrum of cardiovascular risk. We reported the final-year results of the EMPRISE study, a monitoring program designed to evaluate the cardiorenal effectiveness of empagliflozin across broad patient subgroups.

Methods

We identified patients ≥ 18 years old with type 2 diabetes who initiated empagliflozin or GLP-1RA from 2014 to 2019 using US Medicare and commercial claims databases. After 1:1 propensity score matching using 143 baseline characteristics, we evaluated risks of outcomes including myocardial infarction (MI) or stroke, hospitalization for heart failure (HHF), major adverse cardiovascular events (MACE – MI, stroke, or cardiovascular mortality), a composite of HHF or cardiovascular mortality, and progression to end-stage kidney disease (ESKD) (in patients with chronic kidney disease stages 3–4). We estimated hazard ratios (HR) and rate differences (RD) per 1,000 person-years, overall and within subgroups of age, sex, baseline atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF).

Results

We identified 141,541 matched pairs. Compared with GLP-1RA, empagliflozin was associated with similar risks of MI or stroke [HR: 0.99 (0.92, 1.07); RD: -0.23 (-1.25, 0.79)], and lower risks of HHF [HR: 0.50 (0.44, 0.56); RD: -2.28 (-2.98, -1.59)], MACE [HR: 0.90 (0.82, 0.99); RD: -2.54 (-4.76, -0.32)], cardiovascular mortality or HHF [HR: 0.77 (0.69, 0.86); RD: -4.11 (-5.95, -2.29)], and ESKD [0.75 (0.60, 0.94); RD: -6.77 (-11.97, -1.61)]. Absolute risk reductions were larger in older patients and in those with baseline ASCVD/HF. They did not differ by sex.

Conclusions

The cardiovascular benefits of empagliflozin vs. cardioprotective GLP-1RA agents were larger in older patients and in patients with history of ASCVD or HF, while they did not differ by sex. In patients with advanced CKD, empagliflozin was associated with risk reductions of progression to ESKD.