bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycobacterium avium complex prosthetic joint infection: A systematic review of the literature and pooled analysis
Authors: Kim Seung-Ju , Lee Dong-Woo , Lee Chaeryoung , Kim Jong Hun
Published: October 2023

Background

Mycobacterium avium complex (MAC) prosthetic joint infection (PJI) has been rarely reported.

Methods

This study aimed to investigate the epidemiology and outcomes of MAC PJI. A systematic review of the literature regarding the MAC infection following total joint arthroplasty including hip and knee joint was performed. Multiple databases were searched for published English-written articles up to May 2023. Studies that reported cases of PJI by MAC were reviewed.

Results

A total of 17 patients were identified and analyzed from 11 published studies. All patients presented with joint symptom of pain or swelling prior to the diagnosis and MAC was confirmed by culture. The most of the patients (16/17 patients, 94.1%) were noted to have underlying medical condition(s) that might have affected immunity. Treatment consisted of anti-MAC medication therapy only in two patients and anti-MAC medication therapy plus surgery in 15 patients. Among the patients who underwent surgery, 14 patients (82.3%) had removal of the prosthesis including seven patients who had two-stage surgery to have reimplantation of the prosthesis. No relapse of MAC infection was reported despite of one case of relapse of infection caused by different pyogenic bacteria. The rate of overall mortality was 29.4%, however, identified attributable mortality due to MAC infection was low (5.9%).

Conclusion

PJI by MAC is a rare disease. However, MAC needs to be considered in the differential diagnosis in immunocompromised patients presenting with symptoms of PJI. Two-stage exchange arthroplasty may result in successful treatment outcomes without higher risks of relapse of infection if undertaken in association with appropriate active anti-MAC antibiotic therapy.
“Show Them Who You Are!”: Ritual Combat and Masculine Identities in Ryan Coogler’s Black Panther
Authors: Gearhart Grant
Published: October 2023

Societies have relied on different cultural mechanisms to cultivate appropriate and timely models of heroic masculinity, which have included oral tradition, art, epic poetry, and theatre. In contemporary times, cinema has become one of the primary venues to disseminate masculine archetypes throughout a society’s collective conscious. In certain cases, heroic masculinity can be manifested when characters embrace their valor, courage, and physical prowess for the greater good while eschewing the potentially toxic elements of their personalities and powers. In Ryan Coogler’s 2018 film Black Panther, the dichotomy of toxic masculinity and heroic masculinity plays out through a series of ritual combats. Black Panther applies traditional and historically relevant motifs to show how its superhero addresses the question of toxic versus heroic masculinity; and, in the end the film condemns toxic masculinity by portraying a hero who embodies strength, wisdom, and inclusiveness.
Think tanks and health policy in the United Kingdom: The role of the King’s Fund
Authors: Ham Chris
Published: October 2023

The King’s Fund is a long-established health policy think tank involved in work on evidence-based policy in the United Kingdom. There have been few accounts of how think tanks operate. This essay seeks to partially fill that gap by reviewing the work of the Fund between 2010 and 2018, when the author was its chief executive. The essay outlines the history and status of the Fund, its funding and staffing, and the range of activities undertaken. Examples of policy areas in which the Fund was active and its impact on both policymakers in central government and leaders working in the National Health Service are discussed.
The Mauli Ola Study: A Unique Academic–Community Partnership With MAʻO Organic Farms to Understand and Address Health Inequities Among Native Hawaiians and Other Pacific Islanders in Hawaiʻi
Authors: Maunakea Alika K. , Juarez Ruben , Maunakea-Forth J. Kukui
Published: October 2023

Indigenous peoples, including Native Hawaiians and Pacific Islanders (NHPIs), experience significant cardiometabolic health disparities arising in large part from rapid changes to their diets and food systems. Innovative food sovereignty initiatives led by NHPIs are needed to address these disparities. This article describes a community-based participatory research study that incorporates social and biological measures to examine the impact of an Indigenous-led land-based food sovereignty youth leadership program on health disparities among NHPI youth in Hawaiʻi. Grounded in the Indigenous knowledge that holistic health and wellbeing of people is inseparable from that of the environment and to counter rampant food insecurity in their community of Waiʻanae, Oʻahu, MAʻO Organic Farms developed a Youth Leadership Training (YLT) program that offers education, nutrition, physical activity, and access to health care. The program also engages YLT interns and their social networks in health education and research in the ongoing Mauli Ola study. Preliminary data from this study affirm the need to address the disproportionately high rates of obesity, type 2 diabetes mellitus (T2D), and poor mental health conditions among young NHPIs in the Waiʻanae community, and how the YLT program may provide an effective approach to address this need. Our unique academic-community partnership underscores the importance of social and biomedical research to understand health disparities in the NHPI population, which present novel avenues to enable disease prevention. The outcomes of the Mauli Ola study may serve as a valuable model for health disparities research while leveraging ongoing social programs that support Indigenous food sovereignty.
Enhancing Indigenous Food Sovereignty and Community Health Through the Karuk Agroecosystem Resilience Initiative: We Are Caring for It: xúus nu’éethti
Authors: Sowerwine Jennifer , Mucioki Megan , Sarna-Wojcicki Daniel , McCovey Kathy , Morehead-Hillman Lisa , Hillman Leaf , Lake Frank K. , Preston Vikki , Bourque Shawn
Published: October 2023

Indigenous communities in the United States experience some of the highest rates of food insecurity and diet-related diseases despite an abundance of food assistance programs and other public health interventions. New approaches that center Indigenous perspectives and solutions are emerging and urgently needed to better understand and address these challenges. This Practice Note shares lessons learned from ongoing collaboration between the Karuk Tribe and University of California, Berkeley researchers and other partners to assess and enhance food sovereignty among Tribes and Tribal communities in the Klamath River Basin. Through two participatory research and extension projects, we demonstrate the importance of centering Indigenous knowledge to strengthen research findings and identify more culturally appropriate solutions to community identified food access, health, and ecosystem challenges. Key findings suggest that approaches to food sovereignty and community health must emanate from the community, be approached holistically, reflect community values and priorities, and center Indigenous land stewardship.
Development and pilot validation of a novel disfigurement severity scale for plexiform neurofibromas in children with neurofibromatosis type 1
Authors: John Liny , Singh Gurbani , Dombi Eva , Wolters Pamela L , Martin Staci , Baldwin Andrea , Steinberg Seth M , Bernstein Jessica , Whitcomb Patricia , Pichard Dominique C , Dufek Anne , Gillespie Andy , Heisey Kara , Bornhorst Miriam , Fisher Michael J , Weiss Brian D , Kim AeRang , Widemann Brigitte C , Gross Andrea M
Published: October 2023

Background/Aims

We developed an observer disfigurement severity scale for neurofibroma-related plexiform neurofibromas to assess change in plexiform neurofibroma–related disfigurement and evaluated its feasibility, reliability, and validity.

Methods

Twenty-eight raters, divided into four cohorts based on neurofibromatosis type 1 familiarity and clinical experience, were shown photographs of children in a clinical trial (NCT01362803) at baseline and 1 year on selumetinib treatment for plexiform neurofibromas ( n = 20) and of untreated participants with plexiform neurofibromas ( n = 4). Raters, blinded to treatment and timepoint, completed the 0–10 disfigurement severity score for plexiform neurofibroma on each image (0 = not at all disfigured, 10 = very disfigured). Raters evaluated the ease of completing the scale, and a subset repeated the procedure to assess intra-rater reliability.

Results

Mean baseline disfigurement severity score for plexiform neurofibroma ratings were similar for the selumetinib group (6.23) and controls (6.38). Mean paired differences between pre- and on-treatment ratings was −1.01 (less disfigurement) in the selumetinib group and 0.09 in the control ( p = 0.005). For the disfigurement severity score for plexiform neurofibroma ratings, there was moderate-to-substantial agreement within rater cohorts (weighted kappa range = 0.46–0.66) and agreement between scores of the same raters at repeat sessions ( p > 0.05). In the selumetinib group, change in disfigurement severity score for plexiform neurofibroma ratings was moderately correlated with change in plexiform neurofibroma volume with treatment ( r = 0.60).

Conclusion

This study demonstrates that our observer-rated disfigurement severity score for plexiform neurofibroma was feasible, reliable, and documented improvement in disfigurement in participants with plexiform neurofibroma shrinkage. Prospective studies in larger samples are needed to validate this scale further.
Pushing the boundaries of digital social contact: Experiences of people with disabilities and their social networks during the COVID-19 pandemic
Authors: Bakkum Lianne , Piekema Lotte , Douma Linda , Schuengel Carlo , Sterkenburg Paula , Adam Esmee , Brug Annet ten , Frielink Noud , Embregts Petri , Tharner Anne
Published: October 2023

During the COVID-19 pandemic, many people with intellectual disabilities living in care facilities could not receive visitors. Health authorities suggested the use of digital social contact as an alternative for in-person visits. We examined how people with intellectual disabilities living in care facilities experienced the use of digital social contact with their informal social network throughout 2020. Residents, their relatives, volunteer visitors, direct support staff, and care facility managers ( N = 283) completed an online questionnaire, of whom 35 participated in an interview. Video calling and in-person visits were among the most common forms of staying in touch. Experiences with digital social contact depended on residents’ abilities and support needs, and on preconditions, such as staff availability. The first phases of the pandemic led to experiences of possibilities and benefits of using digital social contact as complementary to in-person contact for people with different levels of intellectual disability, also after the pandemic.
Climate realism: Policy proposals for effective decarbonisation and true sustainability in the EU
Authors: Lilkov Dimitar
Published: October 2023

The EU has put forward a very ambitious policy agenda for decarbonising its economy and limiting the dangerous consequences of climate change. However, parts of its approach have become untenable. This article argues that the current design of the EU’s climate agenda is becoming financially and socially unsustainable. Spiralling fiscal costs, a scarcity of vital energy and resources, and increasing societal strain risk derailing the European Green Deal. The text puts forward a number of centre–right policy proposals for a more realistic European approach to climate change that would deliver true sustainability and take the EU towards climate neutrality.
Empathy and Prosocial Behavior in Adolescent Offenders: The Mediating Role of Rational Decisions
Authors: Cardona-Isaza Arcadio de Jesús , González Barrón Remedios , Montoya-Castilla Inmaculada
Published: October 2023

The study of prosocial behavior, from the cognitive-evolutive approach, has indicated that moral reasoning is the basis of prosocial decisions. Advances in the study of decision-making have shown that there are other factors associated with rational capacity that affect prosocial decision-making. The role of rational decision-making is an aspect that has received little attention from this perspective and could be relevant to explaining prosocial behaviors. This study examines whether rational decision-making is a potential mediator between empathy and prosocial behavior in offenders adolescents. A total of 413 Colombian adolescent offenders aged 14 to 18 years ( Mage = 16.67, SD = 1.05, 17.4% were girls) participated in the study. They belonged to Colombia’s four regions (Antioquia, Caldas, Cundinamarca, and Bogotá, the Capital District). Empathy, decision-making, and prosocial behavior were assessed with self-reports. Confirmatory factor analysis of the scales used, descriptive, correlational, predictive, and mediation analyses were performed. The results indicated positive relationships between the variables empathy, rational decision-making, and prosocial behavior. In the mediation analyses, empathic concern and personal distress were the background variables with the greatest effect on prosocial behavior when mediated by rational decision-making. The results indicate that having greater rational decision-making ability may help adolescent offenders display prosocial behaviors. Results, limitations, and practical implications for adolescent counseling are discussed, and future research suggestions are made.
Does Investment in Green Employee Development Climate Matter for Environmental Commitment and Green Well-Being? A Case Study of a Palm Oil Company in Malaysia
Authors: YinYin Lau Patricia , Park Sunyoung , Hsu Yen-Chen , Lien Bella Ya-Hui , Ho Jo Ann
Published: October 2023

Drawing on social exchange theory and stakeholder responses to corporate social responsibility model, this study aimed to examine if the cross-level impacts of perceived investment in green employee development climate (PIGED) on environmental commitment (EC) and green well-being (GWB) were mediated by green person-job fit and green growth need strength. We collected a total of 412 employees and 80 operating units from a leading palm-oil company in Malaysia. The multilevel regression analysis found the cross-level effects of PIGED on EC and GWB that were partially mediated by green person-job fit and green growth need strength. Due to incomplete understanding of more dynamic relationships at the cross-level analysis, this study contributes a nuanced understanding of psychological mechanism of PIGED and its beneficial values for employees to develop quality of relationships between organizations and employees. Human resource professionals can leverage on PIGED across units at multiple locations to create beneficial values to employees’ jobs and their personal growth desire which can promote EC and GWB.
SpearSim-V2: Synthetic Task Environment for Evaluating Attacker Behaviors
Authors: Mehrabi Elaheh , Xu Tianhao , Rajivan Prashanth
Published: October 2023

Despite extensive research on phishing, a severe lack of work centered on attackers has resulted in a limited understanding of the adversarial behaviors conducive to attack success and failures. This work describes a novel method for conducting controlled laboratory studies of cognitive vulnerabilities that attackers experience during the design and execution phases of spear-phishing attacks. Based on the SpearSim platform, the new simulation environment integrates cognitive agents that model and predict end-user responses to spear-phishing attacks. This advancement to SpearSim allows the generation of real-time, automated, “human-like” responses to simulated spear-phishing attacks. This enables the execution of experiments focused on attackers and attacker behaviors. We describe the proposed simulation framework, provide details about the implemented simulation environment, and present results to evaluate the performance of the simulation environment. Compared to the earlier version of SpearSim involving human end-users, the new approach generates responses at a much faster rate (3 times faster than human end-users) and importantly with less variance in the time to respond. The cognitive agents used in the simulation predicted human responses to phishing and spear-phishing attackers with moderate accuracy (about 60%). Our proposed method intends to provide an effective and robust way to conduct laboratory experiments on spear-phishing attacks and further understand attackers' decision-making processes that could be exploited to thwart future attacks.
Interpersonal and Human-Automation Trust in an Underwater Mine Detection Task
Authors: Barnhart Grace , Knocton Shala , Hunter Aren , Dithurbide Lori , Neyedli Heather
Published: October 2023

In target detection tasks false alarms (i.e., indicating a target is present when it is absent) decrease trust more than misses. Furthermore, human advisors providing advice at the same time as automation, may impact how users trust and subsequently rely on automated aids. This study aimed to understand whether the false alarm rate (FAR) of an automated target recognition aid impacts trust in the automated aid, trust in a human teammate, or operator self-confidence in a dual-advisor target detection task. Participants completed a mine detection task while receiving advice from a human and an automated advisor. The FAR of the automation was manipulated between groups and trust in each type of advisor was measured. Automation FAR did not influence trust in the automation. Low FAR automation was associated with higher trust in a human teammate and increasing self-confidence over the course of the experiment.
Intelligence Analysis Shift Work: Sensemaking Processes, Tensions, and Takeaways
Authors: Kane Aimée A. , Paletz Susannah B. F. , Vahlkamp Sarah H. , Nelson Tammie , Porter Adam , Diep Madeline , Carraway Melissa
Published: October 2023

Intelligence analysts pore over myriad sources to identify key facts, make sense of them, and use that “sensemaking” to inform mission-critical action. Often these operations are conducted 24/7 with analysts working in shifts. To understand these processes in situ, we conducted interviews with seven former and current United States intelligence analysts. We develop theory and advance a descriptive model of shift handover processes in this domain, which takes into account sensemaking, the communication process, and the features of big data. Our qualitative analysis reveals the following tensions analysts face in shift handovers (1) narrowing versus broadening one’s own sensemaking, (2) sensemaking versus encoding for the subsequent analyst, and (3) trusting versus validating the prior analyst’s sensemaking. In addition, we describe several practical takeaways.
Investigating User Preferences for Conversation Design of Voice Assistant Systems using Linguistic Features
Authors: Sargsyan Lilit , Choi Seungju , Kim Sang-Hwan
Published: October 2023

As the use of voice assistant (VA) systems is increasing, conversation design in the system is important for effective human-system interaction. The objective of the study was to investigate the level of user preference for VA outputs in terms of linguistics. Answers of three VA systems for each of the nine questions were collected and categorized for distinctive linguistic factors such as type of theme, thematic progression, number of predications, and ellipsis. The VA answers were evaluated through an online survey. Results show that linguistic factors and features significantly affect user preference for VA outputs. The results imply that the linguistic features need to be considered for designing voice interaction communications as a natural interaction method.
Applying Forces Measured at the Hands to Estimate L5/S1 Compression During Manual Patient Bed-to-Wheelchair Transfers Across Different Levels of Patient Assist
Authors: Banks Jacob J. , Zhou Jie , Riehle Chelsea O. , Wiggermann Neal E.
Published: October 2023

Transferring a patient from a bed to a wheelchair is important for patient well-being. Research has shown that manually performing this task exposes healthcare workers (HCWs) to lower back kinetic demands that can exceed safety standards, necessitating the use of mechanical lift equipment. However, HCWs still commonly perform this task manually, especially for lighter patients who are capable of assisting. Although lower back kinetic demands are presumably dependent upon the patients (in)ability to assist during the transfer, this has not been systematically tested. Therefore, the primary aim of this research was to compare the peak L5/S1 intervertebral joint (IVJ) compressive force demands during a bed-to-wheelchair manual transfer across different levels of simulated patient assist (0%, 18%, and 36% of patient bodyweight). We also compared peak IVJ compressive forces from an approach using external forces directly measured at the hands of the HCW, with an alternative traditional approach that assumed the patient’s mass was fully lifted by the HCW throughout the transfer. Peak L5/S1 IVJ compressive forces were lower ( p < .001) during the 36% than the 0% and 18% bodyweight patient assist conditions when applying the measured forces at the hand. Overall, peak compressive forces were lower ( p < .001) and tended to occur at different phases of the transfer when applying the measured forces at the hand versus assuming all the patient’s mass was being lifted. Our results emphasize the importance of accurately modeling the forces at the hands when estimating in vivo demands. Further, these findings suggest that encouraging the patient to assist during transfers may reduce IVJ forces on HCWs, but for heavier patients even a modest degree of patient assistance is not likely to protect the HCW from elevated spine loads. In most circumstances, lift equipment is warranted.
Redesigning Educational Countermeasures to Increase Virginia Drivers’ Road-Sharing Safety Knowledge
Authors: Proaps Alexandra B. , Still Jeremiah D.
Published: October 2023

The lack of alignment between drivers’ and cyclists’ road-sharing knowledge results in unsafe interactions. To address this issue, educational countermeasures must clearly present and apply evidence-based practices to increase the likelihood that drivers will learn how to share the road safely with cyclists. In this study, we redesigned an existing Virginia road-sharing safety educational handbook to support a series of experiments. The redesign was based on established principles of instructional, organizational, and visual design. Virginia drivers completed a comprehension test after reviewing road-sharing educational material online. Results showed that reviewing the redesigned brochure did not improve global comprehension, law-based knowledge, and procedural knowledge about sharing the road with cyclists. However, the improved design of the educational material enhanced drivers’ declarative knowledge of road-sharing laws and safety. Further research is needed to determine the effectiveness of transferring these design choices to other transportation domains, so policymakers and instructors can effectively prioritize approaches for improving road safety.
A Framework of Vehicle-Human Communication Features at Traffic Intersections to Enhance Trust and Situation Awareness
Authors: Kettle Liam , Herrera Kayla M. G. , Pithayarungsarit Pawinee , Simpson Kassidy L. , Lee Yi-Ching
Published: October 2023

Vehicle manufacturers are advancing their automated driving system (ADS) capabilities with enhanced transparency features. Research supports driving assistants (DA) and augmented reality (AR) displays for conveying the ADS status, actions, and road environment elements. However, providing continuous or irrelevant information degrades driving performance and attitudes towards the ADS. Therefore, the current study sought to create a framework for specific communication features that would enhance drivers’ trust and situation awareness via DA and AR stimuli. Participants watched various driving scenarios and provided their desired communication features to improve trust and situation awareness across modalities. Results identified key themes consistent across events (i.e., current/intended vehicle actions) as well as context-dependent themes such as police presence or pedestrian detection and location. In contrast, auditory cues were identified as redundant across events. These findings can support researchers to focus on relevant information to enhance drivers’ attitudes, awareness, and safety while operating ADS-equipped vehicles.
Shifting Perspectives: A proposed framework for analyzing head-mounted eye-tracking data with dynamic areas of interest and dynamic scenes
Authors: Tzamaras Haroula M. , Wu Hang-Ling , Moore Jason Z. , Miller Scarlett R.
Published: October 2023

Eye-tracking is a valuable research method for understanding human cognition and is readily employed in human factors research, including human factors in healthcare. While wearable mobile eye trackers have become more readily available, there are no existing analysis methods for accurately and efficiently mapping dynamic gaze data on dynamic areas of interest (AOIs), which limits their utility in human factors research. The purpose of this paper was to outline a proposed framework for automating the analysis of dynamic areas of interest by integrating computer vision and machine learning (CVML). The framework is then tested using a use-case of a Central Venous Catheterization trainer with six dynamic AOIs. While the results of the validity trial indicate there is room for improvement in the CVML method proposed, the framework provides direction and guidance for human factors researchers using dynamic AOIs.
What feels light to you? An exploration into supplying simple information through a light bar in a highly automated vehicle
Authors: Scott-Sharoni Sidney T. , Fereydooni Nadia , Walker Bruce N. , Lenneman John K. , Austin Benjamin P. , Yoshida Takeshi
Published: October 2023

As advanced features integrate into vehicle, drivers may feel apprehensive to use them. Providing users information using human-machine interfaces (HMIs) may ease fears; however, in highly automated vehicles, the optimal method of displaying information is unclear. Our study examined how using a light strip to transmit varying degrees of information (none, redundant, or supplemental) impacted trust and acceptance in participants (N = 36) across two drives using self-report and physiological measures. We also analyzed which measures predicted psychological comfort in an exploratory investigation of the largely undefined concept. The results indicated no significant effects suggesting that transmitting information through a light strip and its presence may not impact users. In a regression, only trust significantly explained variance of psychological comfort. Future research would benefit from examining what factors influence psychological comfort. Given our young participant demographic, it is possible future AI users may remain unaffected by additional non-textual HMI displays.
Distributed Supervisory Coordination and Function Allocation Between Multi-Teams in Crewed Space Exploration with Time Delays
Authors: Davis Lacey M. , Caldwell Barrett S.
Published: October 2023

Function allocation and distributed task coordination are complex challenges facing many multi-team systems. These challenges are intensified in the case of human expeditions to and exploration of Mars, due to the impact of one-way light-time communication delays that can exceed 20 minutes. Research to identify, enhance, and support new requirements for task coordination and communication include considerations to mitigate the impact of delays through improved state monitoring and crew coordination and knowledge sharing techniques. Effective coordination for human cislunar and Mars exploration operations, including servicing, assembly, and maintenance activities, require effective and adaptive function and task allocation constrained by available bandwidth and crew member workload capability. The authors describe some of their previous research and ongoing activities, including improvements to time-delayed information and data displays to support mission control and spaceflight crew member situational awareness when conducting both routine operations and real-time responses to emerging anomalies.
Exploring Trust With the AI Incident Database
Authors: Stanley Jeff C. , Dorton Stephen L.
Published: October 2023

Engineering trustworthy artificial intelligence (AI) is important to adoption and appropriate use, but there are challenges to implementing trustworthy AI systems. It is difficult to translate trust studies from the laboratory to the field. It is also difficult to operationalize “trustworthy AI” frameworks and principles to inform the actual development of AI. We address these challenges with an approach based in reported incidents of trust loss “in the wild.” We systematically identified 30 cases of trust loss in the AI Incident Database to gain insight into how and why humans lose trust in AI in various contexts. These factors could be codified into the development cycle in various forms such as checklists and design patterns to manage trust in AI systems and avoid similar incidents in the future. Because it is based in real incidents, this approach offers recommendations that are concrete and actionable for teams addressing real use cases with AI systems.
Predictors of Adopting an Atheistic Worldview: An Analysis of Survey Data Containing a Retrospective Measure of Belief in God
Authors: Scheitle Christopher P. , Corcoran Katie E.
Published: October 2023

Many studies have used retrospective survey measures to examine changes in individuals’ religious affiliation, but studies examining changes to individuals’ core religious beliefs are comparatively rare. This is likely because surveys rarely contain measures of both current and past beliefs. Using data from a probability sample of U.S. adults that includes a measure of individuals’ current and age 16 belief in God, the authors examine the predictors of an individual’s adopting an atheistic worldview. Overall, 6 percent of the sample report moving from a nonatheistic worldview to an atheistic worldview. This rate is higher among those who said they had weaker belief in God at age 16, men, those with higher incomes, and some sexually minoritized groups. This rate is lower among older individuals, political conservatives, and some racially or ethnically minoritized groups. The authors discuss the implications of these findings for the study of nonbelief and the measurement of religious change.
Foot and Ankle Muscle Isometric Strength in Nonrearfoot Compared With Rearfoot Endurance Runners
Authors: Abran Guillaume , Schwartz Cédric , Delvaux François , Aguilaniu Aude , Bornheim Stephen , Croisier Jean-Louis
Published: October 2023

Background:

Transitioning to a forefoot strike pattern can be used to manage running-related knee injuries. However, adopting a nonrearfoot strike induces a higher load on foot and ankle structures than rearfoot strike. Sufficient foot muscle strength is also necessary to prevent excessive longitudinal arch (LA) deformation when running with nonrearfoot strike. The aim of this study was to investigate the potential differences in foot-ankle muscle strength between RF and NRF runners.

Methods:

A cross-sectional study including 40 RF and 40 NRF runners was conducted. The foot posture and the maximal voluntary isometric strength (MVIS) of 6 foot-ankle muscles were measured. The footstrike pattern was determined using a 2-D camera during a self-paced run on a treadmill.

Results:

NRF had higher MVIS for ankle plantar flexor (+12.5%, P = .015), ankle dorsiflexor (+17.7%, P = .01), hallux flexor (+11%, P = .04), and lesser toe flexor (+20.8%, P = .0031). We found a small positive correlation between MVIS of ankle plantar flexor with MVIS of hallux flexor ( r = 0.26; P = .01) and lesser toe flexor ( r = 0.28; P = .01).

Conclusion:

In this cross-sectional study, we found that NRF runners on average have a higher MVIS of hallux and lesser toe flexor compared with RF runners. NRF runners also have a higher MVIS of ankle plantar flexor and dorsiflexor than RF runners. We found only a small correlation between ankle plantar flexor and foot muscle strength.

Level of Evidence:

Level III, case-control study.
Community health workers: essential in ensuring primary health care for equitable universal health coverage, but more knowledge and action is needed
Authors: Hirschhorn Lisa R , Govender Indiran , Zulu Joseph M
Published: October 2023

Community health workers (CHWs) have helped improve access to quality primary health care (PHC). However, knowledge gaps exist in designing and implementing CHW-engaged models needed to ensure quality people-centered PHC. In this collection, we call for papers which bridge this knowledge gap, to build sustainable, resilient and equitable CHW programs.
A case report on Mycobacterium houstonense infection after total hip arthroplasty
Authors: Li ZhiPeng , Yuan ZhaoFeng , Cao HuiLing , Huan DaWei , Qiu Yue , Xia TianWei , Shen JiRong
Published: October 2023

Background

Mycobacterium houstonense is a category of rapidly growing mycobacteria that is gram-positive, acid-fast, polycrystalline, and non-spore-forming. There have been few reports of human infection caused by Mycobacterium houstonense worldwide.

Case presentation

We present a case of chronic periprosthetic joint infection caused by Mycobacterium houstonense in an elderly female patient. The patient developed signs of infection after undergoing total hip arthroplasty. Despite receiving antibiotic treatment and revision surgery, the signs of infection recurred repeatedly. Multiple bacterial cultures during the treatment period were negative. Later, we identified the pathogenic bacteria Mycobacterium houstonense through mNGS testing, isolated the bacteria from the ultrasonically centrifuged fluid of the prosthesis and obtained drug sensitivity results. Finally, we performed a revision surgery and treated the patient with moxifloxacin and clindamycin. After treatment, the patient did not show signs of infection recurrence during 24 months of follow-up.

Conclusion

Through a relevant literature search, we believe that Mycobacterium houstonense may show higher sensitivity to amikacin and quinolone antibiotics. Additionally, clarifying occult infection sources through methods such as gene testing will improve the diagnosis and treatment of periprosthetic joint infection.
Effectiveness and safety of prophylactic abdominal aortic balloon occlusion for patients with type III caesarean scar pregnancy: a prospective cohort study
Authors: Wu Jie , Guo Ruixia , Li Lixin , Chu Danxia , Wang Xinyan
Published: October 2023

Background

Caesarean scar pregnancy (CSP) is a special type of ectopic pregnancy with a high risk of massive haemorrhage. Few studies have focused on the efficacy of prophylactic abdominal aortic balloon occlusion as a minimally invasive method in caesarean section. This study aimed to evaluate the effectiveness and safety of prophylactic abdominal aortic balloon occlusion for patients with type III CSP.

Methods

This was a prospective cohort study. Patients with type III CSP in the First Affiliated Hospital of Zhengzhou University from January 2020 to June 2022 were enrolled. Eligible patients received prophylactic abdominal aortic balloon occlusion (defined as the AABO group) or uterine artery embolization (defined as the UAE group) before laparoscopic surgery. Clinical outcomes included intraoperative blood loss, body surface radiation dose, hospitalization expenses, and time to serum β-hCG normalization, and safety were also assessed.

Results

A total of 68 patients met the criteria for the study, of whom 34 patients were in the AABO group and 34 patients were in the UAE group. The median intraoperative blood loss in the AABO and UAE groups was 17.5 (interquartile ranges [IQR]: 10, 45) and 10 (IQR: 6.25, 20) mL, respectively (P = 0.264). The body surface radiation dose of the AABO group was much lower than that of the UAE group (5.22 ± 0.44 vs. 1441.85 ± 11.59 mGy, P < 0.001). The AABO group also had lower hospitalization expenses than the UAE group (2.42 ± 0.51 vs. 3.42 ± 0.85 *10^5 yuan, P < 0.001). The average time to serum β-hCG normalization in the AABO group was 28.9 ± 3.21 d, which was similar to that in the UAE group (30.3 ± 3.72 d, P = 0.099). In addition, the incidence of adverse events in the AABO group was lower than that in the UAE group (5.9% vs. 58.8%, P < 0.001).

Conclusion

Prophylactic AABO was equally as effective as UAE in patients with type III CSP but was safer than UAE during and after the operation.
Evaluation the validity and reliability of persian short form of the literacy of suicide scale (LOSS): a methodological study in 2022
Authors: Jafari Alireza , Nejatian Mahbobeh , Mokhtari Ali Mohammad , Naddafi Fatemehzahra , Moshki Mahdi
Published: October 2023

Introduction

This research was conducted with the aim of evaluating the validity and reliability of Persian short version of the Literacy of Suicide Scale (LOSS) among the general population.

Methods

This methodological study was conducted to evaluate the validity and reliability of Persian short form of LOSS among the general population, using a sample of 1175 participants in Iran, 2022. Participants were entered to study using method of proportional stratified sampling. The validity of Persian short form of LOSS was checked by four measures of validity: qualitative face validity, qualitative content validity, EFA (exploratory of factor analysis), and CFA (confirmatory factor analysis). The measure of reliability of Persian short form of LOSS was checked by three reliability of McDonald omega coefficient, ICC (Intraclass Correlation Coefficient), and Cronbach’s alpha coefficient.

Results

Based on the findings of EFA, 4 components with eigenvalues > 1 were extracted and these 4 factors were able to explain 57.96% of variance. In EFA section, only 1 question was deleted due to entry into the non -relevant sub –scale. Based on the results of CFA, all items had the factor loading greater than 0.4 and none of the items were removed at this stage. In CFA, based the results of goodness-of-fit indexes for example: χ2/df = 2.077, NFI: 0.957, IFI = 0.977, RMSEA = 0.030, GFI: 0.988, and PGFI = 0.569, the final mode was approved with 11 items and 4 factors. In this study for all items, Cronbach’s alpha coefficient was 0.739, McDonald omega coefficient was 0.753, and ICC was 0.860. Finally, the Persian short form of LOSS was approved with 11 items and four dimensions of signs/ symptoms with 3 questions, the risk factors with 2 questions, treatment/ prevention with 2 questions, and causes/ triggers with 4 questions.

Conclusion

The Persian short form of LOSS with 11 items and four subscales is a valid and reliable scale to survey the suicide literacy status in the general population.
Influencing factors of bone mass abnormalities among postmenopausal women in Tibet, China
Authors: Zhong Huaichang , Zhou Yaxi , Wang Peng , Jia Qundi , Wan Yang , Xiong Hai
Published: October 2023

Background

This study aimed to provide a reference for the prevention and treatment of abnormal bone mass in postmenopausal women by analysing the current situation and influencing factors of bone mass abnormalities in Tibet.

Methods

A total of 229 postmenopausal Tibetan women were randomly selected from six counties by a multistage cluster random sampling method. Multiple logistic regression was utilized to analyse the status and influencing factors of bone mass abnormalities in postmenopausal Tibetan women.

Results

Among 229 postmenopausal Tibetan women, the prevalence of osteopenia and osteoporosis was 54.6% and 9.6%, respectively. Age {odds ratio (OR) = 0.022 [95% confidence interval (CI) = 0.003 ~ 0.163]}, BMI [OR = 441.902 (20.899,9343.717)], altitude [OR = 18.818 (1.391,254.585)], and creatinine (CREA) levels [OR = 0.895 (0.825 ~ 0.971)] were significantly associated with the risk of osteoporosis.

Conclusion

Postmenopausal Tibetan women had high rates of abnormal bone mass. Age, BMI, altitude and CREA levels were associated with osteoporosis. It is suggested that relevant departments should take targeted measures to promote health education on the prevention of osteoporosis in the general population and increase the screening of high-risk groups for osteoporosis to improve the bone health of postmenopausal Tibetan women.
Quality and readability of web-based information on dental caries in Arabic: an infodemiological study
Authors: Aboalshamat Khalid
Published: October 2023

Background

Web-based information on dental caries in Arabic remains poorly understood. This study aimed to assess the quality and readability of web-based information about dental caries in Arabic.

Methods

The first 100 websites in Arabic about dental caries were retrieved from Google and Bing using common terms. The websites were classified and evaluated for quality based on the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN tool, and the presence of the Health on the Net Foundation Code of Conduct (HONcode). Readability was assessed using online readability indexes.

Results

A total of 102 Arabic websites were included. The JAMA benchmark score was low (m = 0.36, SD = 0.56), with 67.7% failing to meet any of the JAMA criteria. The DISCERN total score mean was 37.68 (SD = 7.99), with a majority (67.65%) of moderate quality. None of the websites had the HONcode. Readability was generally good, with 52.94% of websites having a Flesch–Kincaid Grade Level (FKGL) < 7, 91.18% having a Simple Measure of Gobbledygook (SMOG) < 7, and 85.29% having a Flesch reading ease (FRE) score ≥ 80. There was a positive correlation between JAMA and DISCERN scores (p < 0.001). DISCERN scores were positively correlated with the number of words (p < 0.001) and sentences (p = 0.004) on the websites. However, JAMA or DISCERN scores were not correlated with FKGL, SMOG, or FRE scores (p > 0.05).

Conclusions

The quality of Arabic dental caries websites was found to be low, despite their readability. Efforts are needed to introduce more reliable sources for discussing dental caries and treatment options on sites aimed at Arabic populations.
Microlearning and online simulation-based virtual consultation training module for the undergraduate medical curriculum – a preliminary evaluation
Authors: Liew Siaw Cheok , Tan Maw Pin , Breen Emer , Krishnan Kuhan , Sivarajah Inthirani , Raviendran Nivashinie , Aung Thidar , Nimir Amal , Pallath Vinod
Published: October 2023

Background

Virtual consultation is a synchronous mode of telemedicine provided remotely via information and communication technology. The projected growth of digitalization in healthcare delivery, however, necessitates medical student training in virtual consultation (VC) to ensure safe and effective patient care. This study describes the implementation and preliminary evaluation of a competency-based VC training module for undergraduate medical students.

Methods

A newly developed six-week VC module was implemented online through asynchronous microlearning and synchronous simulation-based experiential learning modalities. Clinical students in years 4 and 5 and fresh graduates, who had not started pre-registration house officer or residency programmes, were invited to participate. Training outcomes using checklist-based video-recorded assessments of VC encounters between medical students and simulated patients were compared. Each video was independently assessed by two facilitators trained in VC teaching and assessment, using a direct observed virtual consultation skills checklist derived from established VC competencies. The participants completed course evaluations electronically as additional outcome measures.

Results

Fifty-two clinical phase medical students and alumni completed both the instructional and practical phases of this module. Altogether, 45 (95.7%) students found the module beneficial, and 46 (95.9%) reported increased self-efficacy for conducting VC. In total, 46 (95.9%) students would recommend the course to others. Post-test results showed a significant increase in the students’ abilities to conduct a VC (t-test = 16.33, p < 0.05).

Conclusion

Microlearning and simulation-based sessions were effective instructional delivery modalities for undergraduate medical students in their attainment of VC competencies.
Quest markup for developing FAIR questionnaire modules for epidemiologic studies
Authors: Russ Daniel E. , Gerlanc Nicole M. , Shen Brian , Patel Bhaumik , de González Amy Berrington , Freedman Neal D. , Cusack Julie M. , Gaudet Mia M. , García-Closas Montserrat , Almeida Jonas S.
Published: October 2023

Background

Online questionnaires are commonly used to collect information from participants in epidemiological studies. This requires building questionnaires using machine-readable formats that can be delivered to study participants using web-based technologies such as progressive web applications. However, the paucity of open-source markup standards with support for complex logic make collaborative development of web-based questionnaire modules difficult. This often prevents interoperability and reusability of questionnaire modules across epidemiological studies.

Results

We developed an open-source markup language for presentation of questionnaire content and logic, Quest, within a real-time renderer that enables the user to test logic (e.g., skip patterns) and view the structure of data collection. We provide the Quest markup language, an in-browser markup rendering tool, questionnaire development tool and an example web application that embeds the renderer, developed for The Connect for Cancer Prevention Study.

Conclusion

A markup language can specify both the content and logic of a questionnaire as plain text. Questionnaire markup, such as Quest, can become a standard format for storing questionnaires or sharing questionnaires across the web. Quest is a step towards generation of FAIR data in epidemiological studies by facilitating reusability of questionnaires and data interoperability using open-source tools.