bluuebunny/crossref_metadata_2025 huggingface dataset:
Ambassadors of ideology: A conceptualization and computational investigation of far-right influencers, their networking structures, and communication practices
Authors: Rothut Sophia , Schulze Heidi , Hohner Julian , Rieger Diana
Published: June 2023

Increasingly, influencers are employed to market not only products but also ideas and beliefs. The far right has recognized the strategic potential of influencer communication to tap into new target groups and mobilize supporters. This paper provides insights into the little-explored field of far-right influencers. We conceptualize them as individual actors characterized by far-right ideology, positioned as political influencers, actively advocating for their ideological aims. Employing a multi-layered computational approach to explore communication practices and networking structures of 243 German-speaking far-right influencers on Telegram, we derive a typology and observe the emergence of a functionally differentiated influencer collective. In this collective, each community has specific functions and characteristics that emphasize different ideological aspects, mobilization modes, and influencer practices. Despite the decentralized organization, we find high efficiency in information dissemination. The results corroborate the assumed potential of far-right influencers as disseminators of ideological content who can be particularly persuasive through their role as parasocial opinion leaders.
Exploring the flexural and impact properties of pure flax/epoxy and Kevlar/flax/epoxy composites through experimental and numerical analysis
Authors: Hadj-Djilani Abdelhadi , Kioua Abderraouf , Zitoune Redouane , Toubal Lotfi , Bougherara Habiba
Published: June 2023

Hybrid composites offer a viable alternative to conventional composites in terms of reduced cost and environmental impact. This study investigated the effect of hybridizing flax with Kevlar on the flexural and impact properties of Kevlar/flax/epoxy composites using three-point bending, drop-weight, and Charpy impact tests. The tested specimens were made of unidirectional flax fibers (F) and woven Kevlar fibers (K) in four configurations: unidirectional flax/epoxy [016F] (UFE), angle-ply flax/epoxy [±454F]S (AFE), woven Kevlar/unidirectional flax/epoxy [0–902K/06F]S (UKFE), and woven Kevlar/angle-ply flax/epoxy [0–902K/±453F]S (AKFE). The three-point bending test results showed that the ultimate strength and the flexural modulus of the UKFE increased by 15% compared to pure UFE and by more than threefold for AKFE compared to AFE laminates. Additionally, the results of the drop-weight test revealed a significant increase in the impact force by 30% for both unidirectional and angle-ply laminate configurations. Similarly, Charpy test results indicated a 60% improvement in the impact energies of the flax laminates. The predictions of the proposed finite element model agreed very well with the experimental results. These findings demonstrate the effectiveness of hybridizing two layers of Kevlar onto flax/epoxy composites in enhancing the composite's impact and flexural properties.
Native and compactly folded in-solution conformers of pepsin are revealed and distinguished by mass spectrometric ITEM-TWO analyses of gas-phase pepstatin A – pepsin complex binding strength differences
Authors: Koy Cornelia , Glocker Ursula M , Danquah Bright D , Glocker Michael O
Published: June 2023

Pepsin, because of its optimal activity at low acidic pH, has gained importance in mass spectrometric proteome research as a readily available and easy-to-handle protease. Pepsin has also been study object of protein higher-order structure analyses, but questions about how to best investigate pepsin in-solution conformers still remain. We first determined dependencies of pepsin ion charge structures on solvent pH which indicated the in-solution existence of (a) natively folded pepsin (N) which by nanoESI-MS analysis gave rise to a narrow charge state distribution with an 11-fold protonated most intense ion signal, (b) unfolded pepsin (U) with a rather broad ion charge state distribution whose highest ion signal carried 25 protons, and (c) a compactly folded pepsin conformer (C) with a narrow charge structure and a 12-fold protonated ion signal in the center of its charge state envelope. Because pepsin is a protease, unfolded pepsin became its own substrate in solution at pH 6.6 since at this pH some portion of pepsin maintained a compact/native fold which displayed enzymatic activity. Subsequent mass spectrometric ITEM-TWO analyses of pepstatin A – pepsin complex dissociation reactions in the gas phase confirmed a very strong binding of pepstatin A by natively folded pepsin (N). ITEM-TWO further revealed the existence of two compactly folded in-solution pepsin conformers (Ca and Cb) which also were able to bind pepstatin A. Binding strengths of the respective compactly folded pepsin conformer-containing complexes could be determined and apparent gas phase complex dissociation constants and reaction enthalpies differentiated these from each other and from the pepstatin A – pepsin complex which had been formed from natively folded pepsin. Thus, ITEM-TWO turned out to be well suited to pinpoint in-solution pepsin conformers by interrogating quantitative traits of pepstatin A – pepsin complexes in the gas phase.
The Educational Costs of Chrono-Curriculum and Academic Chrono-Politics on the Schooling of Disabled College Students in Kenya
Authors: Ressa Theodoto
Published: June 2023

A college education is vital because it exposes students to worldwide experiences fundamental for productive citizenship. However, it is elusive to most disabled citizens because of the clash of school time and disability and colleges’ obsession with efficiency. Guided by the historical, biological, and social construction of disability as a human flaw, this qualitative study contextualizes the findings within the frame of crip time, chrono-curriculum, and academic chrono-politics to reveal that disability is the basis of academic oppression and, therefore, the disempowerment of disabled college learners in Kenya. Education costs manifest in individual impairment/disability, lack of accommodations, inaccessible infrastructure, lost time, defensive unsupportive faculty and administrators, mythologies of disability, and poverty and insecurity. Since universities’ ableist chrono-curriculum and academic chrono-politics are educationally `costly to disabled students, the reformation of universities is needed to foster faculty disability awareness and commitment to disability rights and empowerment of disabled students.
On Learning Interbeing
Authors: Potts Monique , Le Hunte Bem , Ross Katie
Published: June 2023

The experience of interbeing – or a deep, authentic feeling of the continuum between our inner-selves, each other and the natural world – gives a profound sense of interconnectedness. Teachings of interbeing have roots in ancient knowledges yet offer insight into how we might respond collectively and purposefully to the challenges of today. It is also proposed as a core meta-competency contributing to resilience and wellbeing for young people, creating a sense of unity in response to fragmented and technologically mediated environments. This article explores what learning activities and environments support experiences of interbeing and how these might be integrated into secondary school education, focusing on transformative, place-based learning. We present findings from participatory action research in an Australian secondary school undertaken as a pilot program focused on building resilience and wellbeing for students – and contribute ideas for transformative learning practices that support resilience in the face of uncertain futures.
Outcomes of mechanical thrombectomy at a single-centre tertiary level public healthcare hospital in South Africa
Authors: Kiriinya Martin Muthinja , Bateman Kathleen , Qureshi Aamir , Feuvre David Le , Taylor Allan
Published: June 2023

Introduction

Mechanical thrombectomy (MT) is standard of care for acute ischaemic stroke from large vessel occlusion following randomised controlled trials performed largely in high-income countries. Limited data exists on its effectiveness in the setting of low-and-middle-income countries. We aimed to evaluate the safety and efficacy of MT in a tertiary level public hospital in Cape Town, South Africa.

Methods

Patients with acute ischaemic stroke presenting consecutively to Groote Schuur Hospital between 1 January 2018 to 1 January 2022 with proximal intracranial occlusion in the anterior circulation treated with MT within 6 h from onset using computed tomography (CT) and CT angiography imaging-based protocols were evaluated. Demographic, clinical, radiological and procedural data were obtained from the stroke unit database. Recanalisation was evaluated post-procedure by modified Treatment in Cerebral Infarction score (mTICI). Functional independence (modified Rankin scores 0–2) and mortality at 90 days were also assessed.

Results

Thrombectomies were performed in 84 patients during the study period. The median age was 56 years (interquartile range, IQR) and 51% of participants were female. Median National Institute of Health Stroke Score was 18 and median baseline Alberta Stroke Programme Early CT score was 8. Bridging thrombolysis was given to 65% of participants. Median time from symptom onset to reperfusion was 339 min (IQR). Successful recanalisation (mTICI 2b/3) was obtained in 62%. At 90 days, 34% of participants gained functional independence and mortality was 34%.

Conclusion

This study demonstrated similar rates of recanalisation and functional independence to that seen in trials in high-income countries using basic imaging despite a higher mortality and longer median time to reperfusion. This data supports the effectiveness of MT in a tertiary level public hospital in South Africa despite the challenges of providing emergent stroke care in a resource-constrained setting.
Upper extremity soft tissue stiffness measured with shear wave elastography: A between-day reliability study
Authors: Day Joseph M , Merriman Harold
Published: June 2023

Background

Imbalances in soft tissue stiffness (STS) of the pectoralis and common wrist extensors (CWEs) can adversely alter upper extremity function. Shear wave elastography (SWE) has the capacity to provide precise, repeatable, objective data on STS. The purpose of this study was to determine the between-day intrarater reliability for the pectoralis and CWE tendon stiffness as measured by SWE.

Methods

STS measured by the shear wave modulus (kilopascals (kPa)) was captured bilaterally on the pectoralis major, pectoralis minor, and CWE tendon using 2D SWE ultrasound imaging (GE Logiq S8, 9 L transducer) on two separate days. Within examiner intraclass correlation coefficients (ICC (3, 3)) with 95% confidence intervals, standard error of the measure, and minimal detectable changes were calculated.

Results

The investigators recruited 10 healthy participants (mean age = 23.50  ±  1.43). Between day intrarater reliability values were obtained for the dominant pectoralis major ICC  =  0.70 (−0.15, −0.93), nondominant pectoralis major ICC  =  0.63 (−0.30, −0.91), dominant pectoralis minor ICC  = 0 .72(−0.04, −0.93), nondominant pectoralis minor ICC  = 0.75(0.08, −0.94), dominant CWE tendon ICC  =  0.75(−0.08, −0.94), and nondominant CWE tendon ICC  =  0.75(−0.12, −0.94).

Discussion

Our data demonstrate acceptable reliability but future studies should include methods that control for variables known to effect STS.
Below- versus above-elbow cast treatment of displaced distal forearm fractures in children: A systematic review and meta-analysis of randomized controlled trials
Authors: Alzobi Osama Z , Hantouly Ashraf T , Kenawey Mohamed , Ibrahim Talal
Published: June 2023

Objectives:

Distal forearm fractures are the most common pediatric fractures. This study aimed to investigate the effectiveness of below-elbow cast treatment for displaced distal forearm fractures in children compared to above-elbow cast through meta-analysis of randomized controlled trials.

Methods:

Several databases from January 1, 2000 until October 1, 2021 were searched for randomized controlled trials that assessed below versus above-elbow cast treatment of displaced distal forearm fractures in pediatric patients. The main meta-analysis comparison was based on the relative risk of loss of fracture reduction between children undergoing below versus above-elbow cast treatment. Other outcome measures including re-manipulation and cast-related complications were also investigated.

Results:

Nine studies were eligible of the 156 articles identified, with a total of 1049 children. Analysis was undertaken for all included studies with a sensitivity analysis conducted for studies with high quality. In the sensitivity analysis, the relative risks of loss of fracture reduction (relative risk = 0.6, 95% confidence interval = 0.38, 0.96) and re-manipulation (relative risk = 0.3, 95% confidence interval = 0.19, 0.48) between the below and above-elbow cast groups were in favor of below-elbow cast and statistically significant. Cast-related complications were in favor of below-elbow cast but did not attain statistical significance (relative risk = 0.45, 95% confidence interval = 0.05, 3.99). Loss of fracture reduction was noted in 28.9% of patients treated with above-elbow cast and 21.5% in below-elbow cast. Re-manipulation was attempted in 48.1% versus 53.8% of children who lost fracture reduction in the below-elbow cast and above-elbow cast groups, respectively.

Conclusion:

Below-elbow cast treatment was favored, with statistical significance, in terms of loss of fracture reduction and re-manipulation, and was not associated with a higher risk of cast-related complications. The accumulative evidence currently does not support above-elbow cast treatment and below-elbow cast treatment should be the mainstay for displaced distal forearm fractures in children.

Level of evidence:

Level I, meta-analysis of therapeutic level I studies.
Extending the cultural-economic model of public relations through Bourdieu’s theoretical lens to inform public diplomacy efforts
Authors: Ertem-Eray Tugce
Published: June 2023

Several scholars have addressed the convergence of public relations and public diplomacy theories, and many have argued that public diplomacy needs to move beyond normative theories of communication. Yet little scholarly work has been done to date. To fill this gap, this study explores how critical and postmodern theoretical approaches can inform public diplomacy practice by extending the cultural–economic model (CEM) of public relations through Pierre Bourdieu’s theory of practice. Based on interviews with organizational members of Sister Cities International (SCI), this study suggests that critical–cultural and postmodern perspectives can inform SCI’s public diplomacy efforts by considering larger structural factors in tension with agency. Thus, this study contributes to both the development of robust international public relations theory and theory building in the public diplomacy field. Findings indicate that drawing on Bourdieu’s Theory of Practice (1997), social capital contributes to the notion of institutionalized relationships, such as family or resources, that individuals acquire through group memberships as found in articulations within the CEM. Additionally, although the CEM explains the connection between culture and power in creating meaning, Bourdieu’s notion of cultural capital makes explicit a focus on education, which is a significant focus of many public diplomacy efforts. Therefore, the term cultural capital provides additional insight into the model to inform public diplomacy efforts. Thus, this study extends the CEM through Pierre Bourdieu’s theory of practice by indicating the role of social capital and cultural capital in SCI’s public diplomacy efforts.
Untargeted metabolomics characterization of the resectable pancreatic ductal adenocarcinoma
Authors: Cao Ying-Ying , Guo Kai , Zhao Rui , Li Yuan , Lv Xiao-Jing , Lu Zi-Peng , Tian Lei , Ren Shuai , Wang Zhong-Qiu
Published: June 2023

Background

Diagnosis of pancreatic ductal adenocarcinoma (PDAC) is difficult due to the lack of specific symptoms and screening methods. Only less than 10% of PDAC patients are candidates for surgery at the time of diagnosis. Thus, there is a great global unmet need for valuable biomarkers that could improve the opportunity to detect PDAC at the resectable stage. This study aimed to develop a potential biomarker model for the detection of resectable PDAC by tissue and serum metabolomics.

Methods

Ultra-high-performance liquid chromatography and quadrupole time-of-flight mass spectrometry (UHPLC-QTOF-MS/MS) was performed for metabolome quantification in 98 serum samples (49 PDAC patients and 49 healthy controls (HCs)) and 20 pairs of matched pancreatic cancer tissues (PCTs) and adjacent noncancerous tissues (ANTs) from PDAC patients. Univariate and multivariate analyses were used to profile the differential metabolites between PDAC and HC.

Results

A total of 12 differential metabolites were present in both serum and tissue samples of PDAC. Among them, a total of eight differential metabolites showed the same expressional levels, including four upregulated and four downregulated metabolites. Finally, a panel of three metabolites including 16-hydroxypalmitic acid, phenylalanine, and norleucine was constructed by logistic regression analysis. Notably, the panel was capable of distinguishing resectable PDAC from HC with an AUC value of 0.942. Additionally, a multimarker model based on the 3-metabolites-based panel and CA19-9 showed a better performance than the metabolites panel or CA19-9 alone (AUC: 0.968 vs. 0.942, 0.850).

Conclusions

Taken together, the resectable early-stage PDAC has unique metabolic features in serum and tissue samples. The defined panel of three metabolites has the potential value for early screening of PDAC at the resectable stage.
Physiologic Repair of Congenitally Corrected Transposition of the Great Arteries in a Criss-Cross Heart
Authors: Castillo-Romero César , Cárdenas-González Julio C , Espinosa-Guerra Kenia K , Patrón-Chi Sergio A , Ortega-Zhindón Diego B , Cervantes-Salazar Jorge L
Published: June 2023

Congenitally corrected transposition of great arteries is an uncommon congenital heart disease characterized by discordance at both the atrioventricular and ventriculoarterial connections. A rare subgroup of patients with congenitally corrected transposition of the great arteries also has a criss-cross heart. The morphology of these patients represents a diagnostic challenge that requires critical analysis to perform a satisfactory surgical procedure. We present a case of a 12-year-old patient with the above mentioned anatomy who underwent physiologic repair.
Diaphragm dome height on chest radiography as a predictor of dynamic lung hyperinflation in COPD
Authors: Shiraishi Masashi , Higashimoto Yuji , Sugiya Ryuji , Mizusawa Hiroki , Takeda Yu , Noguchi Masaya , Nishiyama Osamu , Yamazaki Ryo , Kudo Shintarou , Kimura Tamotsu , Tohda Yuji , Matsumoto Hisako
Published: June 2023

Background and objective

Dynamic lung hyperinflation (DLH) can play a central role in exertional dyspnoea in patients with COPD. Chest radiography is the basic tool for assessing static lung hyperinflation in COPD. However, the predictive capacity of DLH using chest radiography remains unknown. This study was conducted to determine whether DLH can be predicted by measuring the height of the right diaphragm (dome height) on chest radiography.

Methods

This single-centre, retrospective cohort study included patients with stable COPD with pulmonary function test, cardiopulmonary exercise test, constant load test and pulmonary images. They were divided into two groups according to the median of changes of inspiratory capacity (ΔIC=IC lowest − IC at rest). The right diaphragm dome height and lung height were measured on plain chest radiography.

Results

Of the 48 patients included, 24 were classified as having higher DLH (ΔIC ≤−0.59 L from rest; −0.59 L, median of all) and 24 as having lower DLH. Dome height correlated with ΔIC (r=0.66, p<0.001). Multivariate analysis revealed that dome height was associated with higher DLH independent of % low attenuation area on chest computed tomography and forced expiratory volume in 1 s (FEV1) % predicted. Furthermore, the area under the receiver operating characteristic curve of dome height to predict higher DLH was 0.86, with sensitivity and specificity of 83% and 75%, respectively, at a cut-off of 20.5 mm. Lung height was unrelated to ΔIC.

Conclusion

Diaphragm dome height on chest radiography may adequately predict higher DLH in patients with COPD.
Evaluating the impact of cash transfers on tuberculosis (ExaCT TB): a stepped wedge cluster randomised controlled trial
Authors: Shete Priya B. , Kadota Jillian L. , Nanyunja Grace , Namale Catherine , Nalugwa Talemwa , Oyuku Denis , Turyahabwe Stavia , Kiwanuka Noah , Cattamanchi Adithya , Katamba Achilles
Published: June 2023

Background

Mitigating financial barriers to tuberculosis (TB) diagnosis and treatment is a core priority of the global TB agenda. We evaluated the impact of a cash transfer intervention on completion of TB testing and treatment initiation in Uganda.

Methods

We conducted a pragmatic complete stepped wedge randomised trial of a one-time unconditional cash transfer at 10 health centres between September 2019 and March 2020. People referred for sputum-based TB testing were enrolled to receive UGX 20 000 (∼USD 5.39) upon sputum submission. The primary outcome was the number initiating treatment for micro-bacteriologically confirmed TB within 2 weeks of initial evaluation. The primary analysis included cluster-level intent-to-treat and per-protocol analyses using negative binomial regression.

Results

4288 people were eligible. The number diagnosed with TB initiating treatment was higher in the intervention periodversusthe pre-intervention period (adjusted rate ratio (aRR)=1.34) with a 95% CI of 0.62–2.91 (p=0.46), indicating a wide range of plausible true intervention effects. More were referred for TB testing (aRR=2.60, 95% CI 1.86–3.62; p<0.001) and completed TB testing (aRR=3.22, 95% CI 1.37–7.60; p=0.007) per National Guidelines. Results were similar but attenuated in per-protocol analyses. Surveys revealed that while the cash transfer supported testing completion, it was insufficient to address long-term underlying social/economic barriers.

Interpretation

While it is uncertain whether a single unconditional cash transfer increased the number of people diagnosed and treated for TB, it did support higher completion of diagnostic evaluation in a programmatic setting. A one-time cash transfer may offset some but not all of the social/economic barriers to improving TB diagnosis outcomes.
Transthyretin derived amyloid deposits in the atrium and the aortic valve: insights from multimodality evaluations and mid-term follow up
Authors: Okada Atsushi , Kakuta Takashi , Tadokoro Naoki , Tateishi Emi , Morita Yoshiaki , Kitai Takeshi , Amaki Makoto , Kanzaki Hideaki , Ohta-Ogo Keiko , Ikeda Yoshihiko , Fukushima Satsuki , Fujita Tomoyuki , Kusano Kengo , Noguchi Teruo , Izumi Chisato
Published: June 2023

Background

Recent studies have reported atrial involvement and coexistence of aortic stenosis in transthyretin (ATTR) cardiac amyloidosis (CA). However, pathological reports of extraventricular ATTR amyloid deposits in atrial structures or heart valves are limited, and the clinical implications of ATTR amyloid deposits outside the ventricles are not fully elucidated.

Case presentation

We report 3 cases of extraventricular ATTR amyloid deposits confirmed in surgically resected aortic valves and left atrial structures, all of which were unlikely to have significant ATTR amyloidosis infiltrating the ventricles as determined by multimodality evaluation including 99mtechnetium-pyrophosphate scintigraphy, cardiac magnetic resonance, endomyocardial biopsy and their mid-term clinical course up to 5 years. These findings suggested that these were extraventricular ATTR amyloid deposits localized in the aortic valve and the left atrium.

Conclusions

While long-term observation is required to fully clarify whether these extraventricular ATTR amyloid deposits are truly localized outside the ventricles or are early stages of ATTR-CA infiltrating the ventricles, our 3 cases with multimodality evaluations and mid-term follow up suggest the existence of extraventricular ATTR amyloid deposits localized in the aortic valve and left atrial structures.
Combined exercise and nutrition intervention for older women with spinal sarcopenia: an open-label single-arm trial
Authors: Kim Seungcheol , Park Jinhee , Kim Dong Hyun , Sun Jiyu , Lee Sang Yoon
Published: June 2023

Purpose

Spinal sarcopenia is a multifactorial disorder associated with atrophy and fatty changes in paraspinal muscles. Interventional studies for spinal sarcopenia are limited. We aimed to evaluate the effectiveness of a combined exercise and nutrition intervention for the treatment of spinal sarcopenia.

Methods

35 community-dwelling older women diagnosed with spinal sarcopenia in a previous cohort study were included. The 12-week combined intervention consisted of back extensor strengthening exercises and protein supplementation. The following outcomes were measured at baseline (week 0), after the intervention (week 12), and follow-up (week 24): conventional variables of sarcopenia (appendicular skeletal muscle mass, handgrip strength, 6-meter gait speed, and short physical performance battery); lumbar extensor muscle mass; lumbar extensor muscle volume and signal intensity; back extensor isokinetic strength; and back performance scale. We used the intention-to-treat analysis method, and repeated measures analysis of variance was used to analyze the data.

Results

Of the total 35 potential participants, 26 older women participated in the study (mean age 72.5 ± 4.0 years old). After 12 weeks of combined exercise and nutrition intervention, there were no changes in the appendicular skeletal muscle mass, lumbar extensor muscle mass, volume, or signal intensity. Handgrip strength and back extensor isokinetic strength did not change significantly. Short physical performance battery significantly increased (P = 0.042) from 11.46 ± 0.86 to 11.77 ± 0.53 at week 12 and 11.82 ± 0.40 at week 24. The back performance scale sum score also significantly improved (P = 0.034) from 2.68 ± 1.81 to 1.95 ± 1.21 at week 12 and 2.09 ± 1.34 at week 24.

Conclusion

The combined exercise and nutrition intervention for community-dwelling older women with spinal sarcopenia could be feasible and helpful in improving the physical performance as well as back performance.
Real-time risk ranking of emerging epidemics based on optimized moving average prediction limit—taking the COVID-19 pandemic as an example
Authors: Wang Zhongliang , Liu Bin , Luan Jie , Lu Shanshan , Zhang Zhijie , Ba Jianbo
Published: June 2023

Background

Mathematical models to forecast the risk trend of the COVID-19 pandemic timely are of great significance to control the pandemic, but the requirement of manual operation and many parameters hinders their efficiency and value for application. This study aimed to establish a convenient and prompt one for monitoring emerging infectious diseases online and achieving risk assessment in real time.

Methods

The Optimized Moving Average Prediction Limit (Op-MAPL) algorithm model analysed real-time COVID-19 data online and was validated using the data of the Delta variant in India and the Omicron in the United States. Then, the model was utilized to determine the infection risk level of the Omicron in Shanghai and Beijing.

Results

The Op-MAPL model can predict the epidemic peak accurately. The daily risk ranking was stable and predictive, with an average accuracy of 87.85% within next 7 days. Early warning signals were issued for Shanghai and Beijing on February 28 and April 23, 2022, respectively. The two cities were rated as medium–high risk or above from March 27 to April 20 and from April 24 to May 5, indicating that the pandemic had entered a period of rapid increase. After April 21 and May 26, the risk level was downgraded to medium and became stable by the algorithm, indicating that the pandemic had been controlled well and mitigated gradually.

Conclusions

The Op-MAPL relies on nothing but an indicator to assess the risk level of the COVID-19 pandemic with different data sources and granularities. This forward-looking method realizes real-time monitoring and early warning effectively to provide a valuable reference to prevent and control infectious diseases.
Obesity and risk of hearing loss in the middle-aged and elderly: a national cohort of Chinese adults
Authors: Zhang Chen , Wang Weiwei , Chang Xiaotian , Zhan Siyan , Wang Shengfeng , Feng Lei , Song Yongfeng
Published: June 2023

Background

The relationship between obesity and hearing loss among the middle-aged and older population remained unclear. Moreover, few studies have focused on the impact of gender on this association.

Methods

This cohort study extracted the data from the China Health and Retirement Longitudinal Study, a national survey of adults aged 45 years or over. Waist circumference was categorized into three groups: normal, pre-central obesity, and central obesity. We classified BMI into four categories: underweight, normal weight, overweight, and obese. The primary endpoint was the incidence of self-reported hearing loss.

Results

Of the 14,237 participants, 1972 incidents of hearing loss were identified during a median 6.9 years of follow-up. The cumulative incidence of hearing loss was 13.9% (95% CI 13.3% -14.4%). Our study showed that central obesity was significantly associated with hearing loss (HR 0.84, 95%CI 0.75–0.94), and this relationship was more prominent in males (HR 0.76, 95%CI 0.63–0.91). Among male participants, the underweight group was at the highest risk of hearing loss (HR 1.39, 95%CI 1.08–1.79). Compared with the normal weight group, the adjusted HR for hearing loss in the obese groups was 0.69 (95%CI 0.51–0.94) among men. Among female participants, only the overweight group had a lower risk of hearing loss than the normal weight group (HR 0.83, 95%CI 0.71–0.96).

Conclusions

Being overweight and obese were significantly associated with a decreased risk of hearing loss, whereas being underweight was associated with an increased risk of hearing loss.
Acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana
Authors: Appiah Evans Osei , Oti-Boadi Ezekiel , Appiah Stella , Bakkari Mohammed Ali , Menka Manuela Akosua , Awuah Dorothy Baffour , Kontoh Samuel , Menlah Awube , Garti Isabella , Boateng Susana Agyekum
Published: June 2023

Background

Almost all cases of cervical and anal cancer have been linked to the human papillomavirus (HPV). However, in addition to women who develop HPV-related cervical cancer, both men and women can also develop cancers of the anus, oral cavity, and oropharynx that are attributed to HPV. However, literature on HPV vaccination among boys globally, in Africa, and most especially in Ghana is scarce. Thus, the main objective of this study was to explore the acceptance of HPV vaccination in boys among mothers from selected churches in Accra, Ghana.

Methods

In this study, a qualitative exploratory design was utilized to enlist 30 mothers who have male children aged between 9 and 12 years from the Greater Accra Region of Ghana. The recruitment of participants was carried out using a purposive sampling technique, and they were subsequently interviewed in-depth in a face-to-face setting, with the entire conversation being recorded for reference. After transcription, the recorded data were analyzed through content analysis.

Findings

Upon analyzing the data, two (2) primary themes and 11 sub-themes emerged. The research showed that although the majority of the mothers were unaware of HPV in boys, they perceived it as a positive initiative and expressed a willingness to allow their sons to receive the vaccine. However, some participants mentioned certain factors that they believed could hinder the acceptance of HPV vaccination in boys among mothers. These included concerns about injection-related pain, high cost, and fears that the vaccine could make men immoral or infertile.

Conclusion

The study revealed poor awareness of HPV vaccination in boys among mothers, and hence, suggested the need to increase the awareness on HPV vaccination in boys among mothers as well as the public to increase its acceptance.
Clinical analysis of successful insertion of orthodontic mini-implants in infrazygomatic crest
Authors: He Yinxue , Liu Jinan , Huang Rui , Chen Xing , Jia Xueting , Zeng Na , Fan Xiaochuan , Huang Xiaofeng
Published: June 2023

Background

The insertion positions of mini-implant in infrazygomatic crest has been reported, but due to the anatomical variation, the precise location of this site is not clear yet. This study used cone-beam computed tomography (CBCT) to analyze the position and angle of mini-implants successfully inserted in the infrazygomatic crest, with the goal of providing reference data for clinical practice.

Methods

CBCT was used to image 40 mini-implants and their surrounding tissues in adult orthodontic patients who successfully underwent mini-implant insertion in the infrazygomatic crest. The insertion positions and angles of mini-implants were measured, and the thicknesses of buccal and palatal bone adjacent to the mini-implants were also recorded. Then, we proposed the position and implantation angle for infrazygomatic crest insertion. According to the position and angle, the cortical bone thickness and distance to the root of another 54 randomly selected infrazygomatic crests were recorded to verify its feasibility.

Results

In the coordinate system, the implantation position of the 40 successful mini-implants was (-0.4 ± 2, 8.2 ± 2.5) and the implantation angle between the long axis of the mini-implant and horizontal reference plane was 56.4° ± 7.7°. The bone thicknesses on buccal and palatal sides of infrazygomatic crest adjacent to mini-implants were 4.1 ± 2.5 mm and 7.2 ± 3.2 mm, respectively, and the cortical bone thickness was 2.4 ± 0.6 mm. Among 54 infrazygomatic crests, 75.9% of them met the safety and stability requirements. When the implantation height was increased by 1, 2, and 3 mm, the proportions of implants that met requirements for success were 81.5%, 90.7%, and 94.4%, respectively. But, the proportions of eligible implants were limited at implantation angle increases of 5° and 10°.

Conclusions

Using the long axis of the maxillary first permanent molar (U6) as the vertical reference line, mini-implants could be safely inserted in the infrazygomatic crest at a distal distance of 0.4 mm and height of 8.2 mm from the central cementum-enamel junction of U6, with an implantation angle of 56.4°. The success rate increased when the implant height increased, but the proportion of eligible implantation was limited with the increase of implantation angle.
Impacts of COVID-19 on family violence in Thailand: prevalence and influencing factors
Authors: Napa Wilai , Neelapaichit Nareemarn , Kongsakon Ronachai , Chotivitayataragorn Somporn , Udomsubpayakul Umaporn
Published: June 2023

Background

The COVID-19 pandemic drastically affected societies globally, prompting rising unemployment, insufficient household incomes, and stress and undermining women's and children's health within families. This study examined family violence and identified influencing factors during the COVID-19 pandemic in Thailand.

Methods

A mixed-method design was used, entailing a questionnaire followed by focus group interviews. A cross-sectional survey was administered to investigate family violence among 1285 female respondents aged 15 years and above who were recruited through stratified sampling. The Cronbach alpha and and inter-raters Kappa coefficient values for the questionnaire were 0.67 and 1.00, respectively. In addition, a descriptive qualitative instrument was employed to analyze the data sets from four focus group interviews held with 32 staff members from agencies that deal with family violence. The researchers jointly developed the focus group questions, which focused on the impacts of the COVID-19 pandemic on family violence. They independently analyzed data using content analysis.

Results

The majority of the study participants were aged above 45 years (>50%), married (61.1%), lived in single-family settings (52.5%), had lost their jobs (64.4%), and had economic constraints that were moderate (37.8%) to severe (40.6%). The prevalence of family violence, which was primarily physical, was 42.2%. Family income, stress, and substance abuse were the main factors associated with family violence. These findings were correlated with those from the qualitative interviews.

Conclusions

The COVID-19 pandemic had indirect impacts through family violence. Women were subjected to family violence behaviors, which were associated with household income, economic status, stress, and substance abuse. These behaviors included psychological and physical violence, as well as sexual abuse. Future interventions should focus on financial support and stress reduction.
‘A role model is like a mosaic’: reimagining URiM students’ role models in medical school
Authors: Spaans Isabella , de Kleijn Renske , Seeleman Conny , Dilaver Gönül
Published: June 2023

Background

Role modelling is a widely acknowledged element of medical education and it is associated with a range of beneficial outcomes for medical students, such as contributing to professional identity development and a sense of belonging. However, for students who are racially and ethnically underrepresented in medicine (URiM), identification with clinical role models may not be self-evident, as they have no shared ethnic background as a basis for social comparison. This study aims to learn more about the role models of URiM students during medical school and about the added value of representative role models.

Methods

In this qualitative study we used a concept-guided approach to explore URiM alumni’s experiences with role models during medical school. We conducted semi-structured interviews with ten URiM alumni about their perception of role models, who their own role models were during medical school and why they considered these figures as role models. Sensitizing concepts guided the topic list, interview questions and finally served as deductive codes in the first round of coding.

Results

The participants needed time to think about what a role model is and who their own role models are. Having role models was not self-evident as they had never thought about it before, and participants appeared hesitant and uncomfortable discussing representative role models. Eventually, all participants identified not one, but multiple people as their role model. These role models served different functions: role models from outside medical school, such as parents, motivated them to work hard. Clinical role models were fewer and functioned primarily as examples of professional behaviour. The participants experienced a lack of representation rather than a lack of role models.

Conclusions

This study presents us with three ways to reimagine role models in medical education. First, asculturally embedded: having a role model is not as self-evident as it appears in existing role model literature, which is largely based on research conducted in the U.S. Second, ascognitive constructs: the participants engaged in selective imitation, where they did not have one archetypical clinical role model, but rather approach role models as a mosaic of elements from different people. Third, role models carry not only a behavioural but also asymbolical value, the latter of which is particularly important for URiM students because it relies heavier on social comparison.
Drivers and constraints to environmental sustainability in UK-based biobanking: balancing resource efficiency and future value
Authors: Samuel Gabrielle , Sims Jessica M
Published: June 2023

Background

Biobanks are a key aspect of healthcare research; they enable access to a wide range of heterogenous samples and data, as well as saving individual researchers time and funds on the collection, storage and/or curation of such resources. However, biobanks are also associated with impacts associated with a depletion of natural resources (energy, water etc.) production of toxic chemicals during manufacturing of laboratory equipment, and effects on biodiversity. We wanted to better understand the biobanking sector in the UK as a first step to assessing the environmental impacts of UK biobanking.

Methods

We explored the sample storage infrastructure and environmental sustainability practices at a number of UK biobanks through a mixed methods quantitative and qualitative approach, including information gathering on an online platform, and eight in-depth interviews.

Results

Environmental sustainability was deprioritised behind biobanks’ financial sustainability practices. Nevertheless, both often aligned in practice. However, there was a tendency towards underutilisation of stored samples, the avoidance of centralisation, and providing accessibility to biosamples, and this conflicted with valuing sustainability goals. This related to notions of individualised and competitive biobanking culture. Furthermore, the study raised how value attachments to biosamples overshadows needs for both financial and environmental sustainability concerns.

Conclusions

We need to move away from individualised and competitive biobanking cultures towards a realisation that the health of the publics and patients should be first and foremost. We need to ensure the use of biosamples, ahead of their storage (‘smart attachments’), align with environmental sustainability goals and participants’ donation wishes for biosample use.
Facilitating implementation of primary care mental health over time and across organizational contexts: a qualitative study of role and process
Authors: Ritchie Mona J. , Parker Louise E. , Kirchner JoAnn E.
Published: June 2023

Background

Healthcare organizations have increasingly utilized facilitation to improve implementation of evidence-based practices and programs (e.g., primary care mental health integration). Facilitation is both a role, related to the purpose of facilitation, and a process, i.e., how a facilitator operationalizes the role. Scholars continue to call for a better understanding of this implementation strategy. Although facilitation is described as dynamic, activities are often framed within the context of a staged process. We explored two understudied characteristics of implementation facilitation: 1) how facilitation activities change over time and in response to context, and 2) how facilitators operationalize their role when the purpose of facilitation is both task-focused (i.e., to support implementation) and holistic (i.e., to build capacity for future implementation efforts).

Methods

We conducted individual monthly debriefings over thirty months with facilitators who were supporting PCMHI implementation in two VA networks. We developed a list of facilitation activities based on a literature review and debriefing notes and conducted a content analysis of debriefing notes by coding what activities occurred and their intensity by quarter. We also coded whether facilitators were “doing” these activities for sites or “enabling” sites to perform them.

Results

Implementation facilitation activities did not occur according to a defined series of ordered steps but in response to specific organizational contexts through a non-linear and incremental process. Amount and types of activities varied between the networks. Concordant with facilitators’ planned role, the focus of some facilitation activities was primarily on doing them for the sites and others on enabling sites to do for themselves; a number of activities did not fit into one category and varied across networks.

Conclusions

Findings indicate that facilitation is a dynamic and fluid process, with facilitation activities, as well as their timing and intensity, occurring in response to specific organizational contexts. Understanding this process can help those planning and applying implementation facilitation to make conscious choices about the facilitation role and the activities that facilitators can use to operationalize this role. Additionally, this work provides the foundation from which future studies can identify potential mechanisms of action through which facilitation activities enhance implementation uptake.
Ovarian response and conception rate in Boran and Boran*Holstein cows treated by Gonadotrophin-realizing hormone and ProstaglandinF2α with and without exogenous progesterone
Authors: Ayanie Tilaye Demissie , Wassie Alebachew Tilahun , Kebede Ebisa Merga , Mekonnen Tefera Yilma , Geleto Tamrat Degefa , Biru Alemayehu Lemma
Published: June 2023

Background

Difference in breed, nutrition status and climate in which animals are managed result in differences in response to reproductive hormones. Fertility rate to artificial insemination is very low in Ethiopian Boran and Boran*Holstein crosses. This partly maybe due to adopting estrus and/or ovulation synchronization developed for temperate taurine cattle. Experimental study was conducted to evaluate ovarian response to combinations of Gonadotrophin-Realizing Hormone agonist (gonadorelin) and ProstaglandinF2α (PGF2α) with or without progesterone (Controlled Internal Drug Release/CIDR), and conception rate to timed AI. Postpartum native Ethiopian Boran (n = 60) and Boran*Holstein cross (n = 66) cows were randomly assigned to four treatment groups as Ovsynch (gonadorelin on day of start, PGF2α seven days later, 2nd gonadorelin at 48 h of PGF2α and insemination at 19 h of the 2nd gonadorelin); CIDR + Ovsynch (same as Ovsynch but CIDR device was inserted into vagina for 7 days); Cosynch (same as Ovsynch but insemination was made at the 2nd gonadorelin) and CIDR + Cosynch (same as Cosynch but CIDR was inserted for 7 days).

Result

There was no difference (P > 0.05) in ovulation rate to day 9 gonadorelin (88.33% in Boran; 78.79% in Boran*Holstein) and interval from day 9 gonadorelin to ovulation (36.5 ± 1.13 h in Boran and 36.057 ± 1.11 h in Boran*Holstein). Dominant follicle immediate to ovulation (14.95 ± 0.19 mm Vs 19.12 ± 0.49 mm) and corpus luteum size (16.31 ± 0.33 mm Vs 20.28 ± 0.43 mm ) respectively were smaller (P < 0.05) in Boran than Boran*Holstein. Plasma progesterone concentration at PGF2α was higher (P < 0.05) in Boran (11.91 ± 0.74ng/mL) than Boran*Holstein (6.13 ± 0.27ng/mL) but luteolysis rate was lower (P < 0.05) in Boran (87.9%) than Boran-Holstein (96.9%). Cows with CIDR had higher conception rate than cows without CIDR (72.00% Vs 39.02% in Boran*Holstein and 74.07%, Vs 51.52% in Boran respectively). Insemination at 19 h of gonadorelin administration resulted in higher conception rate (78.6% for Boran; 71.43% for Boran*Holstein) than insemination at gonadorelin (69.29% for Boran; 66.67% for Boran*Holstein).

Conclusion

Boran cows have smaller preovulatory follicles, smaller corpus luteum, large amount of progesterone and lower rate of luteolysis to PGF2α compared to Boran*Holstein. The CL of Boran cattle seems les reactive to PGF2α than Boran*Holstein CL. CIDR significantly improved conception rate in Boran and Boran*Holstein cows.