bluuebunny/crossref_metadata_2025 huggingface dataset:
Localizing epileptogenic network from SEEG using non-linear correlation, mutual information and graph theory analysis
Authors: Devisetty Rohith , Amsitha MB , Jyothirmai Sasi , Ajai Remya , Pillai Ashok , Kumar Anand , Gopinath Siby , Parasuram Harilal
Published: November 2022

The key challenge in epilepsy surgery is precise localization and removal of the epileptogenic zone (EZ) from the brain. Localization of the epileptogenic network by visual analysis of intracranial EEG is extremely difficult. In this retrospective study, we used interictal connectivity and graph theory analysis on intracranial EEG to better delineate the epileptogenic zone. Patients who underwent surgery for drug-refractory mesial temporal and neocortical epilepsy were included. Computational measures, such as h2 nonlinear correlation and mutual information, were used to estimate the interdependency of intracranial EEGs. We observed that the Out-Degree, Out-Strength, and Betweenness centrality (graph properties) were the best predictors of EZ. From the results, we also found that graph properties with a normalized value above 0.75 were found to be a useful measure to localize the EZ with a sensitivity of 87.88 and a specificity of 87.13. Our results also validate that frequently occurring types of interictal fast discharges (IFD) with connectivity measures and graph properties can better localize the EZ. We foresee graph theory analysis of interictal intracranial EEG data can help precise localization of EZ for cortical resection as well as in minimally invasive radiofrequency ablation of epileptogenic hubs. Further, prospective validation is required for clinical use.
‘Stylistics will never become boring’: An interview with Paul Simpson
Authors: Sorlin Sandrine
Published: November 2022

Paul Simpson got his PhD from the University of Ulster in 1984 and took up a post at the University of Nottingham the same year. He has since worked at Queen’s University Belfast and Liverpool University, and is currently at the latter institution. He was editor of Language and Literature from 2004 to 2009 after having been assistant editor. In this interview he recalls the influences that got him into stylistics and how he came to find a place for himself in the field. He explains why the international Poetics and Linguistics Association (PALA) is an essential outlet for like-minded individuals who may be in different ‘pockets’ around the world. He talks about his early interest in sociolinguistics and language variation and what fascinates him about language – the things that are usually dismissed by mainstream linguistics as too messy, problematic or slippery. The creativity of language and the pragmatic ways in which ‘language routines’ are subverted are at the heart of what interests him as a stylistician. This brings him to come back to the absurdity of speaking of ‘literary language’ as a separate genre. He comments on his time as editor of Language and Literature, the satisfactions and challenges of the work, the place of the journal in the editorial market and ventures a definition of the broad church of stylistics. Lastly he mentions how stylistics is picking up on new things all the time, going with the tide of new media and approaches, while keeping its momentum at all times and even ‘decolonizing’ itself in the process.
The association between late-onset keratitis in congenital cytomegalovirus infection: A nationwide population-based cohort study
Authors: Chien Hsiang-Wen , Lee Chia-Yi , Huang Jing-Yang , Chen Hung-Chi , Wang Kai , Yang Shun-Fa
Published: November 2022

Aim

To estimate the relationship between congenital cytomegalovirus (CMV) infection and late-onset keratitis via use of the National Health Insurance Research Database (NHIRD) of Taiwan.

Methods

We yielded this retrospective cohort study and subjects with congenital CMV infection, which according to the diagnostic codes and laboratory exam, were selected as our study group that diagnosed with congenital CMV infection. Each participant in the study group was matched to four individuals without the non-congenital CMV infection by propensity-score matching (PSM) process and the latter served as the control group. The main outcome is the late-onset keratitis that occurs one year after the congenital CMV infection diagnosis. We applied Cox proportional hazard regression to produce the adjusted hazard ratio (HR) and corresponding 95% confidence interval (CI) of late-onset keratitis between two groups.

Results

There were 426 (7.4%) and 1,516 (6.5%) events of keratitis in the study and control groups. The study group revealed significantly higher ratio of late-onset keratitis than control group after adjusting many confounders (adjusted HR: 1.14, 95% CI: 1.02–1.27), and the cumulative probability of keratitis in the study group was also higher than control group. For the subgroup analysis, the existence of severe congenital CMV infection was significantly correlated to the late-onset keratitis in individuals with congenital CMV infection (adjusted HR: 1.48, 95% CI: 1.01–2.70; P < 0.05).

Conclusion

The congenital CMV infection is related to higher rate of late-onset keratitis, especially for those with severe form.
A year and a half into the pandemic in Mexico: evidence of differences in COVID-19 mortality between Indigenous and non-Indigenous populations continues to accumulate
Authors: Novak Beatriz , Hernández Flores José Alvaro
Published: November 2022

Among the groups most vulnerable to COVID-19 are Indigenous populations around the world, and in particular, the Mexican Indigenous population. We used public data made available by the General Directorate of Epidemiology of the Mexican Ministry of Health to compare the risk of COVID-19 mortality among the Indigenous and non-Indigenous Mexican population one and a half years into the pandemic. The analytical sample comprises 3,545,952 Mexicans who were diagnosed as infected with severe acute respiratory syndrome coronavirus-2 between March 18, 2020, and September 16, 2021, of which 1.0% (36,195) are Indigenous. Based on parametric survival models, our results show that the risk of death among Indigenous individuals is 52% higher than that of their non-Indigenous counterparts, regardless of age, sex, area of residence, health service, number of chronic diseases, and obesity status. These results suggest that certain structural conditions of the Mexican Indigenous population increase their vulnerability to the pandemic.
Perception and Experience of Youth About Youths Sexual and Reproductive Health Services in Western Ethiopia: A Community-Based Cross Sectional Study
Authors: Tilahun Temesgen , Tesfaye Bekuma Tariku , Getachew Motuma , Oljira Rut , Seme Assefa
Published: November 2022

Objectives:

The use of youth sexual and reproductive health (YSRH) services is low in poor nations like Ethiopia. This puts individuals at risk for a variety of sexual and reproductive health issues. Thus, the goal of this study is to evaluate how young people in East Wollega, Western Ethiopia, perceive and use YSRH services.

Methods:

A community-based cross-sectional quantitative study mixed with a qualitative inquiry was conducted among 771 participants from February 1 to 28, 2020. Data were collected through face-to-face interviews using pretested structured questionnaires adopted from reviewed works of literature on YSRH services. Data were entered using Epi Info version 7.0 and analyzed by SPSS version 20. The qualitative data was collected using interview guides and checklists. These data were analyzed using a thematic framework approach.

Results:

In this study, 48.2% of teens felt that the YSRH service units’ location within the medical facilities was inconvenient and difficult to access. More than half, 71.3% of participants, concurred that the health providers offer services that are technically sound. The confidentiality of information is disputed by 18% of participants at YSRH service locations. The limited awareness and use of YSRH services was investigated. Because of their fear of embarrassment, lack of privacy, the providers’ attitudes and workload, and the service unit’s awkward location, the adolescents believe they lack the confidence to use YSRH services.

Conclusion:

Due to low awareness, providers’ attitudes, and characteristics specific to health facilities, such as poorly placed service sites inside such facilities, a lack of services offered there, and a terrible work environment, youth had a negative opinion of YSRH services. Therefore, it is advised that families, local authorities, the medical field, the educational field, and the media all collaborate to alter public opinions of juveniles by utilizing youth-friendly strategies. The authors advise health facilities to respect young people’s privacy, alter health workers’ attitudes, let them use the services, remove obstacles to payment, designate enough health workers for both working and non-working hours, and reorganize the services.
Pregnancy and neuromyelitis optica spectrum disorders: 2022 recommendations from the French Multiple Sclerosis Society
Authors: Vukusic Sandra , Marignier Romain , Ciron Jonathan , Bourre Bertrand , Cohen Mikael , Deschamps Romain , Guillaume Maxime , Kremer Laurent , Pique Julie , Carra-Dalliere Clarisse , Michel Laure , Leray Emmanuelle , Guennoc Anne-Marie , Laplaud David , Androdias Géraldine , Bensa Caroline , Bigaut Kevin , Biotti Damien , Branger Pierre , Casez Olivier , Daval Elodie , Donze Cécile , Dubessy Anne-Laure , Dulau Cécile , Durand-Dubief Françoise , Hebant Benjamin , Kwiatkowski Arnaud , Lannoy Julien , Maarouf Adil , Manchon Eric , Mathey Guillaume , Moisset Xavier , Montcuquet Alexis , Roux Thomas , Maillart Elisabeth , Lebrun-Frenay Christine
Published: November 2022

Background:

In 2020, the French Multiple Sclerosis (MS) Society (SFSEP) decided to develop a national evidence-based consensus on pregnancy in MS. As neuromyelitis optica spectrum disorders (NMOSD) shares a series of commonalities with MS, but also some significant differences, specific recommendations had to be developed.

Objectives:

To establish recommendations on pregnancy in women with NMOSD.

Methods:

The French Group for Recommendations in Multiple Sclerosis (France4MS) reviewed PubMed and universities databases (January 1975 through June 2021). The RAND/UCLA appropriateness method, which was developed to synthesise the scientific literature and expert opinions on health care topics, was used to reach a formal agreement. Fifty-six MS experts worked on the full-text review and initial wording of recommendations. A sub-group of nine NMOSD experts was dedicated to analysing available data on NMOSD. A group of 62 multidisciplinary healthcare specialists validated the final proposal of summarised evidence.

Results:

A strong agreement was reached for all 66 proposed recommendations. They cover diverse topics, such as pregnancy planning, follow-up during pregnancy and postpartum, delivery routes, loco-regional analgesia or anaesthesia, prevention of postpartum relapses, breastfeeding, vaccinations, reproductive assistance, management of relapses, and disease-modifying treatments.

Conclusion:

Physicians and patients should be aware of the new and specific evidence-based recommendations of the French MS Society for pregnancy in women with NMOSD. They should help harmonise counselling and treatment practise, allowing for better individualised choices.
Dementia ECHO: Evaluation of a telementoring programme to increase dementia knowledge and skills in First Nations-led health services
Authors: Haydon Helen M , Caffery Liam J , Snoswell Centaine L , Thomas Emma E , Wright Roderick , Doolan Rachel , Garner Lisa , Aitken Phil , Smith Anthony C
Published: November 2022

Introduction

High rates of dementia among Australian First Nations’ peoples have resulted in an increased demand for dementia knowledge and skills among the primary health care professionals in these communities. The Dementia Extension for Community Healthcare Outcomes (ECHO) program aims to be a culturally safe way of increasing local health workforce capacity by facilitating dementia knowledge, skills and confidence among primary care professionals in First Nations community settings. Dementia ECHO is based on the international evidence-based telementoring programme, Project Extension for Community Healthcare Outcomes. Every Dementia ECHO session is delivered by videoconference and comprises a specialist-led presentation and a case discussion from a primary care health service participant. The aims of this study were to assess the uptake and reach of Dementia ECHO; examine the perceived importance of dementia care and dementia education among Aboriginal and Torres Strait Islander Community Controlled Health Service staff; and evaluate the potential impact of Dementia ECHO on health service staff pertaining to dementia knowledge, confidence to provide dementia care and professional isolation.

Method

Dementia ECHO service activity data maintained by the programme providers was reviewed to determine uptake and reach. A pre-implementation survey examined Aboriginal and Torres Strait Islander Community Controlled Health Service staff perspectives on the importance of dementia education and the priority of a range of health issues. After each Dementia ECHO session, a brief online survey gathered quantitative and qualitative data regarding the potential impact of the session.

Results

Of 30 completed pre-implementation surveys, all staff rated dementia education as either very important or important. Salient themes highlighting why it is important are presented. When asked to rank six different health priorities, dementia ( n = 10) and chronic disease ( n = 10) were placed as the top priority. The brief post-session feedback provided 44 complete survey responses demonstrating: perceived improvement in dementia knowledge and skills (88.4%); increased confidence to provide dementia care (83%); and a reduction in professional isolation (88%).

Conclusion

Dementia ECHO addresses a gap in dementia education that is much needed in health professionals with increasing numbers of First Nations people living with dementia. This current study shows that attending an evidence-based telementoring programme, such as Dementia ECHO, can increase dementia knowledge and confidence to care for someone living with dementia and their families.
Exploring public opinion about telehealth during COVID-19 by social media analytics
Authors: Pool Javad , Namvar Morteza , Akhlaghpour Saeed , Fatehi Farhad
Published: November 2022

While COVID-19 catalyzed the acceptance and use of telehealth, our understanding of how it is perceived by multi-stakeholders such as patients, clinicians, and health authorities is limited. Drawing on social media analytics, this research examines social media discourses and users’ opinions about telehealth during the COVID-19 pandemic. It applies natural language processing and deep learning to explore word of mouth on telehealth with a contextualized focus on the COVID-19 pandemic. We conducted topic modeling, sentiment analysis, and emotion analysis (fearful, happy, sad, surprised, and angry emotions). The topic modeling analysis led to the identification of 18 topics, representing 6 themes of digital health service delivery, pandemic response, communication and promotion, government action, health service domains (e.g. mental health, cancer, aged care), as well as pharma and drug. The sentiment analysis revealed that while most opinions expressed in tweets were positive, the public expressed mostly negative opinions about certain aspects of COVID-19 such as lockdowns and cyberattacks. Emotion analysis of tweets showed a dominant pattern of fearful and sad emotions in particular topics. The results of this study that inductively emerged from our social media analysis can aid public health authorities and health professionals to address the concerns of telehealth users and improve their experiences.
“I didn’t do it!”: Lived experiences of suicide attempts made without perceived intent or volition
Authors: Savani Shahnaz , Gearing Robin E.
Published: November 2022

Suicide is considered to be a conscious and intentional act that is carried out within a social and cultural context. This study examines the unique phenomenon of a cluster of suicide attempts conducted without perceived intent, ideation, plan, volition, or agency in a remote province in Central Asia. This study investigated the lived experiences of individuals who made such unintended suicide attempts and examined the differences between these experiences and those of individuals who made their suicide attempt with intent and agency. The authors conducted a secondary analysis of qualitative data originally collected for a prior grounded theory study. The present study examined a specific and unique set of participant experiences related to suicide attempts made without agency. Results found that instances of suicide attempts made without perceived intent by participants included themes of impulsivity, not knowing what happened, feeling out of control, attributing these experiences to the supernatural, and being fearful of such events occurring again. Clinical practice may need to be adapted to address experiences of such unique suicide attempt experiences. In addition, further research is warranted to understand and examine the phenomenon of suicide attempts carried out without perceived intent, ideation, plan, volition, or agency.
Forcibly displaced persons and mental health: A survey of the experiences of Europe-wide psychiatry trainees during their training
Authors: Frankova Iryna , Scheeres Karl , Menculini Giulia , Cikrikcili Uğur , Matei Ioan-Costin , Fellinger Matthäus , Riboldi Ilaria , Uzer-Kremers Laura , Küey Levent
Published: November 2022

Many European countries have seen increasing refugee populations and asylum applications over the past decade. Forcibly displaced persons (FDPs) are known to be at higher risk of developing mental disorders and are in need of specific care. Thus, specific training for mental health professionals is recommended by international health organizations. The aim of this exploratory study was to assess the experience of clinical work with FDPs among psychiatric trainees in Europe and Central Asia as well as their interest and specific training received on this topic. An online questionnaire was designed by the Psychiatry Across Borders working group of the European Federation of Psychiatric Trainees (EFPT) and was distributed via email through local networks among European trainees from 47 countries between March 2017 and April 2019. Answers of 342 psychiatric trainees from 15 countries were included in the survey analysis. A majority of trainees (71%) had had contact with FDPs in the last year of their clinical work. Although three-quarters expressed a strong interest in the mental health of FDPs, only 35% felt confident in assessing and treating them. Specific training was provided to 25% of trainees; of this subset, only a quarter felt this training prepared them adequately. Skills training on transcultural competencies, post-traumatic stress disorder, and trauma management was regarded as essential to caring for refugees with confidence. Although psychiatric trainees are motivated to improve their skills in treating FDPs, a lack of adequate specific training has been identified. The development of practical skills training is essential. International online training courses could help meet this pressing need.
OBGYNs of TikTok and the role of misinformation in diffractive knowledge production
Authors: Southerton Clare , Clark Marianne
Published: November 2022

Health misinformation on social media has largely been examined from a harms-focused perspective, with scholars seeking to identify what impacts misinformation has on public health and a popular focus on removing it from platforms. The act of debunking is one response wherein misinformation is corrected with knowledge from scientific sources. To date, little research exists examining how experts and the public engage with misinformation beyond a focus on harm. Using Karen Barad's concept of diffraction, we examine the iterative relationships between misinformation, obstetrician-gynaecologists (OBGYNs) and the educational content they generate on the short-form video platform TikTok. Though misinformation and debunking content have been seen as oppositional, they are brought into productive dialogue with one another using diffractive techniques and platform affordances. We conclude that through the educational content created by the OBGYNs of TikTok, misinformation becomes diffractively integrated into debunking content and is generative of new knowledge, rather than cleansed away.
Personalisation in Journalism: Ethical insights and blindspots in Finnish legacy media
Authors: Rydenfelt Henrik , Haapanen Lauri , Haapoja Jesse , Lehtiniemi Tuukka
Published: November 2022

The algorithmic personalisation and recommendation of media content has resulted in considerable discussion on related ethical, epistemic and societal concerns. While technologies of personalisation are widely employed by social media platforms, they are currently also being instituted in journalistic media. The objective of this study is to explore how concerns about algorithms are articulated and addressed when technologies of personalisation meet with long-standing journalistic values, norms and publicist missions. It first distinguishes five normative concerns related to personalisation: autonomy, opacity, privacy, selective exposure and discrimination. It then traces the ways that these issues are navigated in the context of journalistic media in Finland where the implications of algorithmic media technologies have received considerable attention. The results indicate that personalisation challenges traditional notions of journalism, including those of choosing what is important and relevant and providing the same content to everyone. However, aspects of personalisation also have a long history within journalistic practices, and new technologies of personalisation are being adapted to accord with journalistic norms and aims. Based on these results, ethical blindspots concerning privacy and discrimination are also identified.
“Young Women My Age Really Need Boosts Like This”: Exploring Improv as a Facilitator of Wellness Among Young Women of Color
Authors: Begun Stephanie , Bautista Cam , Mayorga Brigette , Cooke Krysta
Published: November 2022

This project qualitatively examined the potential of scenic improvisation (“improv”) for engaging young women of color as a possible means of promoting and enhancing health and wellness outcomes in this often-overlooked population. Seven young women of color (ages 15–18), accessing virtual after-school programming, participated in a three-session professionally facilitated improv workshop series. Participants provided insights through in-depth pre- and postproject qualitative interviews about their experiences. Participants indicated that improv boosted their self-esteem and strengthened their social connections. Participants were enthusiastic about accessing further improv opportunities, noting that improv should be embedded into other youth-serving programs and health-promotion efforts, as such approaches were deemed as particularly needed among young women of color. Inclusion of improv activities in intervention and prevention efforts would benefit from additional exploration as ways by which health and wellness programs and supports might be innovated and tailored to the specific needs and preferences of young women of color.
Heat release and wear comfort characteristics of the ceramic imbedded fabrics for cold weather protective clothing
Authors: Kim HyunAh
Published: November 2022

This paper examined the heat release and wear comfort characteristics of clothing made of aluminium oxide (Al2O3)/graphite imbedded yarn fabrics for cold weather protective clothing. The wear comfort of the clothing was compared and discussed in terms of the moisture vapor resistance of the fabric, which was verified by far-infrared and light heat emission experiments. The maximum surface temperature of the Al2O3/graphite-imbedded sheath/core yarn fabric was 3.4°C higher than that of the regular one, which was attributed to heat release by the far-infrared radiation emitted from the Al2O3/graphite imbedded in the yarns. The moisture vapor resistance of the Al2O3/graphite-imbedded sheath/core yarn clothing, as measured by a sweating thermal manikin test, was 3.6% lower than that of the regular PET one. In addition, the clothing microclimate temperature of the Al2O3/graphite sheath/core yarn fabric measured by wearer trials was approximately 1°C higher than that of the regular PET fabric, which revealed the superior thermal insulation of the Al2O3/graphite sheath/core yarn clothing compared to the regular PET one. Finally, the superior breathability with thermal insulation of the Al2O3/graphite-imbedded sheath/core yarn fabric were revealed due to its good heat release and storage properties, which support the possible applications for cold weather protective clothing.
Stab-resistance improvement of short carbon fiber reinforced UHMWPE knitted composites with plasma/oxidation treatment
Authors: Liu Qing , Wang Lanlan , Luo Qin , Sun Zhaoling , He Haijun , Chen Chaoyu , Ma Pibo
Published: November 2022

Two modification methods, including low temperature plasma treatment and HNO3 oxidation, used to modify double-layer knitted fabric (DLKF) with UHMWPE yarn and CFs respectively. Contact angle, Fourier transform infrared spectroscopy (FTIR), Scanning electron microscopy (SEM) are used to evaluate the modification effect of the fabric or CFs. Epoxy resin (ER) is used as adhesive to prepare composite, and the effect of modification on the stab resistance is further studied through the test of stab resistance. In addition, the damage mechanism of DLKF and R-DLKF are analyzed. The results showed that the plasma treatment has a great effect on the modification of DLKF. After 15–20min of modification, the stab resistance of the composite is the best. The peak load and energy can be increased by about 19.1% and 23.1%. HNO3 oxidation has a great effect on the modification of CFs, the stab-resistance of CFs reinforced DLKF (R-DLKF) can be improved by about 17.3% after being treated with 60% HNO3 for 24h. DLKF fails mainly due to the stretching and cutting action of the yarn. Fabric as matrix can prevent crack propagation further, and the shear force, yarn cutting and pullout action within the composite is the key to improve the stab resistance. This work opens up the possibilities for the industrial production of personal protection products and devices, which is expected to provides a reference for the modification of fabrics and fibers in the production of composite.
Trigger Thumb in Pediatric Patients: A 20-Year Update
Authors: Ray Shea B. , Gibbs Christopher M. , Fowler John R.
Published: November 2022

Background:

The study purpose was to analyze the characteristics of patients presenting for evaluation of pediatric trigger thumb over a 20-year period and to determine what factors were associated with operative versus nonoperative management.

Methods:

All patients evaluated for a pediatric trigger thumb by 1 of 2 hand surgeons at our institution between January 1, 2000, and August 31, 2021, were retrospectively reviewed. Data were collected, including patient demographics, laterality, patient age and stage of triggering at presentation, treatment recommendations, age at surgery (if performed), and complications. Comparison was made based on age group (<2 years, 2-5 years, and >5 years). Subgroup analysis was performed for patients who had alternative treatments recommended prior to surgery.

Results:

A total of 381 patients (468 thumbs) were identified. The average age at presentation was 3.1 years, 76% were stage IV locked trigger thumbs, and 78% underwent surgery. Patients below 2 years were more likely to have bilateral involvement and have nonoperative management recommended prior to surgery. Those below 5 years were more likely to present with stage IV triggering. Patients who presented with a stage IV trigger thumb and had an initial alternative treatment were more likely to go on to have surgery. The total complication rate was 5.3%.

Conclusions:

These findings are helpful in counseling families and better understanding this patient population. We recommend early surgical intervention, rather than observation or splinting, for patients with stage IV trigger thumbs who can safely undergo anesthesia.
Thrombectomy of a distal occlusion of the middle cerebral artery (M3-segment) using the controlled mini-pinning technique
Authors: Sporns Peter B , Fischer Urs , Psychogios Marios Nikos
Published: November 2022

Mechanical thrombectomy for distal, medium vessel occlusions is gaining importance and increasingly performed. However, there is an ongoing debate on selection criteria for thrombectomy and the best techniques for fast and effective complete reperfusion. Here, we present a case where we use a combination of a stent retriever and aspration catheter for a distal middle cerebral artery occlusion (M3-segment). The aspiration catheter was advanced over the wire of the stent-retriever after deployment – but not using a blind exchange with the mini-pinning technique as previously described. Instead, a new extension wire to the stent retriever was used to advance the aspiration catheter safely. This technique can be important in the near future as distal occlusions will be treated more regularly and trials randomizing patients with distal occlusions such as the Distal trial are underway.
Antagonism of m3 Alleviates Type 2 Inflammation in Allergic Rhinitis Mice
Authors: Chen Yu , Huang Aijie , Tan Guolin , Liu Honghui
Published: November 2022

Background

Type 2 immune cells play a pivotal role in allergic rhinitis (AR). Increasing evidence shows that inhibition of cholinergic nerve activity decreases the severity of airway diseases including asthma and AR. However, the role of the cholinergic receptor muscarinic 3 (m3) in type 2 inflammation in AR is unknown.

Objective

We aimed to investigate the effect of m3 on the type 2 immune response, including both T helper 2 (Th2)-mediated and type 2 innate lymphocyte (ILC2)-mediated inflammation, in AR.

Methods

Peripheral blood mononuclear cells (PBMCs) from human were cultured in vitro. Treatment with the m3 antagonist 1,1-dimethyl-4-diphenylacetoxypiperidinium iodide (4-DAMP) was used. The percentages of Th2 and ILC2 cells in PBMCs were evaluated by flow cytometry. AR mouse models were established by house dust mite (HDM) sensitization, and treated with tiotropium intranasally. The expression of Th2 cytokines, ILC2 cytokines and related factors in the nasal mucosa was assessed by immunohistochemistry and quantitative real-time polymerase chain reaction. Serum HDM-specific immunoglobulin E (sIgE) level was detected by enzyme-linked immunosorbent assay.

Results

Both Th2 and ILC2 percentages in PBMCs were decreased after 4-DAMP treatment. Similarly, the levels of Th2 cytokines (interleukin 4 [IL-4] and IL-13) and ILC2 cytokines and related factors (IL-25, IL-33, GATA3 and RORα) were significantly decreased in the nasal mucosa of AR mice after tiotropium treatment. Furthermore, tiotropium treatment decreased the nasal symptom score, the serum sIgE level and eosinophil infiltration in AR mice. In addition, tiotropium decreased phospholipase Cγ1 (PLCγ1), PLCγ2, nuclear factor of activated T cell 1 (NFATc1), and NFATc2 mRNA levels in AR mice.

Conclusion

Antagonism of m3 alleviated type 2 inflammation in the nasal mucosa of AR mice.
Characteristics of pediatric emergency patients in a Turkish tertiary-level hospital: A 1-year cross-sectional study
Authors: Yüksel Ayfer
Published: November 2022

Objectives:

Overcrowding in pediatric emergency departments negatively affects the quality of care. Investigating the characteristics of the patients admitted to PEDs will provide valuable information to increase the satisfaction of patients and healthcare staff. This research aimed to investigate the characteristics of pediatric emergency patients in a foundation university hospital in Ankara.

Methods:

This is a retrospective, descriptive, single-center, cross-sectional study, which was conducted with 6550 patients who were admitted to the pediatric emergency department of a foundation university hospital in Ankara, and got diagnosed with one of the 15 most common diseases between 1 August 2017 and 31 July 2018. The associations between the demographics and clinical features of the patients and their diagnoses were evaluated. For comparisons, frequencies, percentages, crosstabs, and chi-square tests were used.

Results:

While none of the patients had a red triage level, 19% had a yellow triage level, and 81% had a green triage level. The three most common diagnoses were fever of unknown origin, cough, and nausea and vomiting. Despite the 0–28 days of age group having the lowest admission rate of 5%, they had the highest usage rate of yellow triage level (66.5%). However, it was the opposite for the 19 months to 5 years of age group with the highest rate of admissions of 49% and the lowest usage rate of yellow triage level (12.8%).

Conclusion:

The reasons for admitting to pediatric emergency department differ according to some contextual variables. Being aware of the current situation is the first step in planning for better pediatric emergency service.
Drug–drug interactions among hospitalized elderly in patients at medical wards of Northwest Ethiopia’s Comprehensive Specialized Hospitals: A multicenter observational study
Authors: Dagnew Samuel Berihun , Tadesse Tesfaye Yimer , Zeleke Mulugeta Molla , Yiblet Tesfagegn Gobezie , Addis Getu Tesfaw , Mekonnen Gashaw Binega , Agegnew Wondm Samuel , Negash Erkihun Assefa
Published: November 2022

Objective:

Drug–drug interactions are of major concern due to links to untoward drug effects, hospitalizations, and serious health impacts. Elderly patients are more predisposed to drug interactions than younger patients. The present study aimed to find out the prevalence of drug–drug interactions at North West Ethiopian compressive specialized hospitals’ Internal Medicine wards.

Methods:

From 30 April to 30 July 2021 GC, a multicenter prospective observational study was conducted at north Ethiopian specialized hospitals. Data was collected by using a structured questionnaire adapted from different literature and medical records at the North West Ethiopian Comprehensive Specialized Hospitals’ Internal Medicine wards during the study period. Thereafter checked the completeness of the collected data was checked drug–drug interactions by using Medscape. Epi data version 4.6.2 software was used as data clearance and STATA version 14.1 was used for further data analysis.

Result:

A total of 389 subjects participated in the study of which more than half (55.53%) of them were female with a mean (SD) age of 68.9 ± 7.46 years. A total of 641 drug–drug interactions were detected in this investigation of which, 225(35.1%) were major, 299(46.6%) were significant interactions, and 117(18.3%) were minor interactions. Hospital stay (AOR = 5.95 CI: 3.49–10.12), retire (AOR = 6.71 CI: 1.26–35.78), 5–9 drugs (AOR = 5.30 CI: 2.91–9.67) and more than 10 drugs (AOR = 8.03 CI: 2.47–26.07) were important risk factors for drug–drug interactions.

Conclusion:

The findings of this study suggest that drug–drug interactions were high among hospitalized elderly patients. The presence of polypharmacy, to be retired, and hospital stayed were all found to be strongly linked with drug–drug interactions.
Spontaneous omental infarction: A rare case of acute abdomen
Authors: Subasinghe Duminda , Jayasinghe Ravindri , Ranaweera Gayani , Kodithuwakku Uditha
Published: November 2022

Omental infarction is a rare but a sinister cause of acute abdomen. Preoperative diagnosis is challenging due to its rare nature. It poses nonspecific abdominal signs that can be easily mistaken with other more common intra-abdominal pathologies. We report a case of a 37-year-old male patient presented with right lower quadrant abdominal pain with an elevation of inflammatory markers. His cross-sectional imaging did not a reveal specific diagnosis; therefore, a diagnostic laparoscopy was performed which revealed a non-inflamed appendix and an inflammatory mass formed by the ischemic omentum attached to the ascending colon. Diagnostic laparoscopy and subsequent laparotomy revealed spontaneous omental infarction. The histology of the resected specimen was in keeping with the omental necrosis. This case reflects the importance of considering omental infarction in patients presenting with abdominal pain and raised inflammatory markers. He made an uneventful recovery following surgery.
Care providers’ experiences with and attitudes towards virtual antenatal care: Findings from a qualitative study in British Columbia
Authors: Kornelsen Jude , Nowaczek Daria , Johnson Robin , Mattei Mona , Moola Shiraz
Published: November 2022

Background

Virtual care has emerged as an adjunctive response to challenges in rural health care, including maternity care, and use has accelerated during the coronavirus disease 2019 (COVID-19) pandemic. This gives rise to the need for a strategic plan for post-COVID-19 virtual maternity care in rural communities. To date, no provincial initiative has focused on understanding and documenting the needs of maternity care practitioners to provide virtual care.

Methods

Qualitative study, including virtual interviews and focus groups with rural primary maternity care providers and urban and rural specialists on perceptions of the utility of virtual maternity care pre- and post-COVID-19, and benefits and barriers of virtual care. Data were thematically analysed.

Results

In total, 82 health care providers participated in the study. Health care provider responses fell into three categories: Attributes of virtual care, barriers to virtual care and system interventions needed to optimize the provision of virtual perinatal care. Participants expressed a desire for use of virtual communication tools post-COVID-19, continued ability to use fee codes for virtual care and a need for more secure texting options. The benefits of tripartite consultations were noted by many participants; impacts of the transition to virtual care included additional workload and interrupted workflow. Concerns over the lack of physical examinations and challenges in building relationships with patients when providing virtual care were frequently noted.

Conclusion

Adapting the current implementation of virtual maternity care in British Columbia may be enhanced through several provider- and evidence-derived strategies, many of which are currently underway in BC. The results from this provincial survey will be used to focus further discussion on the characteristics of an optimal system to meet patient and provider needs within a rural context.
Motivation in Instrumental Music Instruction Before and During the Remote Learning Phase Due to COVID-19 Crisis
Authors: Wieser Martin , Müller Florian H.
Published: November 2022

This study, which is based on self-determination theory, compares the motivation and satisfaction of basic psychological needs of music students in instrumental lessons before and after the COVID-19-induced transition to online teaching and learning. We investigated whether, in addition to the satisfaction of students’ basic needs, teachers’ enthusiasm, experience with online teaching, and age can explain motivation in online lessons. Two independent groups of music students were surveyed: one group before (n  =  856; Mage  =  16.4, SD  =  14.1) and the other group after the shift to enforced distance learning (n  =  640; Mage  =  16.7, SD  =  13.8). The main findings are that intrinsic motivation in online learning was significantly lower, and controlled forms of motivation higher than before enforced distance learning. Furthermore, satisfaction of basic needs for autonomy, competence, and relatedness, which are essential for autonomous motivation, were lower in online learning. Regression analyses showed that 39% of the variance of intrinsic motivation for online learning could be explained by social relatedness, perceived teacher’s enthusiasm for teaching, and age.
Qualitative Exploration of Geospatially Identified Bright Spots and Priority Areas to Improve Diabetes Management
Authors: Banerjee Elaine Seaton , Hansen Susan E. , Burgess Nicole , Shaak Kyle , Johnson Melanie , Kieber-Emmons Autumn
Published: November 2022

Background:

Type 2 diabetes (T2DM) results in significant morbidity and mortality and is associated with disparities in prevalence, treatment, and outcomes. GIS can identify geographically based disparities. In the focused Rapid Assessment Process (fRAP)—a novel mixed-method study design—GIS is combined with qualitative inquiry to inform practice interventions and policy changes.

Methods:

Using fRAP, areas with poor T2DM outcomes (priority areas) as well as areas with positive T2DM outcomes (bright spots) were identified, focus groups were conducted, and responses analyzed for intervention opportunities. Focus group participants were English- and Spanish-speaking patients with T2DM living in one of the identified areas. Qualitative analysis consisted of initial coding with a priori themes from the focus group question guide, followed by identification of emergent themes within each defined category.

Results:

The a priori categories included Facilitators, Barriers, Strategies, and Impact of Diabetes Diagnosis. Emerging recurrent themes were Interactions with Medical Professionals, Medications, Lifestyle Management, Family Motivators and Support, Self-Efficacy, and Social Needs and Community Resources.

Conclusions:

Thematic results from focus groups can be used by practices to improve T2DM care through educating patients about chronic disease and nutrition, connecting them to diabetes-specific services, learning how diabetes fits in the context of patient lives, and eliciting patient values and motivations to improve diabetes self-management. Findings also may be used by health care professionals to inform community-based advocacy efforts, interventions, and future research.
Effect of Progressive Muscle Relaxation Exercise on Anxiety Among Male Nursing Students Undergoing Maternity Clinical Training
Authors: Toqan Dalia , Malak Malakeh Z. , Ayed Ahmad , Fashafsheh Imad , Salameh Basma , Sarhan Adnan Lutfi , Azizeh Saed , Batran Ahmad
Published: November 2022

Introduction

Student in a maternity nursing program must be engaged in practical training and they must be well prepared and directed along the way to becoming qualified professionals.

Objective

The study aimed to investigate the effect of progressive muscle relaxation exercise on anxiety among male nursing students undergoing maternity clinical training.

Methods

A quasi-experimental, pre-post study was conducted on nursing at Arab American University Palestine. The sample of the study consisted of 48 male nursing students enrolled in the maternity nursing course. They were selected through convenience sampling. This study was conducted on one group of male nursing students that received Jacobson's progressive muscle relaxation exercise for five consecutive days per week. The S-anxiety scale (STAI Form Y-1) was applied to collect data before and after the intervention.

Results

The magnitude of anxiety reduction after the progressive muscle relaxation exercise was greater than before ( t (47) = 21.2, p < .05).

Conclusion

The current study's findings indicated the influence of progressive muscle relaxation on maternity clinical setting anxiety reduction among male nursing students.
The business of saving cheetahs: Cheetah ecology and the diverse politics at work in human wildlife conflict (HWC) interventions in Namibia
Authors: Brandon Suzanne
Published: November 2022

This paper is concerned with the intersection of cheetah ecology, human wildlife conflict (HWC), settler colonialism, and private land ownership in Namibia. Cheetahs’ ecological adaptation(s) in Namibia point to the need for a fuller picture of the permutations of conservation and conservation NGOs in Africa. In the case of Namibia, cheetahs’ ecological adaptations to interspecies threats have shaped their territory to be primarily on private commercial farms where they cause HWC. While cheetahs cause HWC on commercial farms and farming communities in Namibia writ large, HWC itself is not the conflict discussed in this research. Rather, HWC is the catalyst for what this paper will analyze to be a conflict between two private sector industries—commercial farming and cheetah conservation. After thirteen months of ethnographic fieldwork in Namibia, this case study suggested diverse politics are at work within the NGOs conservation intervention policies at global, national, and local scales. This research identified a theoretical and conceptual fissure which led to an anomaly in the field of political ecology. This paper will argue HWC is an organizing structure in the business of saving cheetahs. The NGOs studied in Namibia are a service-based industry. They invest in both tangible and intangible conservation services rather than market-based participatory approaches, ecosystem services, and/or economic development. This is illustrative of a shift from market-based conservation to a service-based approach and calls for widening the political ecology lens to account for other cases of NGOs’ on-the-ground conservation business practices in Africa.
How I treat thrombotic microangiopathy in the era of rapid genomics
Authors: Doreille Alice , Rafat Cédric , Rondeau Eric , Mesnard Laurent
Published: November 2022

Thrombotic microangiopathy (TMA) encompasses various genetically-driven diseases. The emergence of ultrafast genomic sequencing has recently opened up new avenues of research for genetic investigations in the setting of intensive care units. TMA is likely to be a suitable focus for fast-track genomic sequencing. By establishing an expeditious molecular diagnosis of patients with the complement-dependent hemolytic uremic syndrome, fast-track genomic sequencing allows for the timely implementation or withdrawal of anti-C5 treatment while averting unnecessary, costly, and potentially harmful therapy in patients testing negative for the syndrome. Furthermore, genomics has the potential to reshape the taxonomic classification of TMA owing to comprehensive genomic analysis. The most significant results from such analysis can be categorized as (1) new descriptions of genetic diseases previously not recognized as associated with TMA and (2) an enrichment of the phenotypic spectrum of diseases traditionally related to TMA. The latter draws on the concept of retrophenotyping, wherein genomic investigation precedes full clinical description. By taking precedence over a phenotypic approach, an unbiased genomic-focused analysis maximizes the chances of discovering new descriptions of a given variant. Presented here are 4 cases of TMA which highlight these issues and substantiate the promise of fast-track genomic sequencing.