bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health implementation research in Indigenous communities: creating culturally safe space to enhance collective strengths
Authors: D’souza Nicole A , Field Michaela , Supino Tristan , Messer Mia , Aleck Erin , Kirmayer Laurence J
Published: March 2024

In this article, we discuss the construct of cultural safety in relation to the ethics, politics, and practice of implementation research in Indigenous communities. We convened a 3-day workshop, bringing together 23 Indigenous and non-Indigenous collaborators from First Nation communities and universities across Canada to reflect on experiences with implementing an Indigenous youth and family mental health promotion program in First Nation communities. Participants identified three dimensions central to achieving culturally safe space in implementation research: (1) interpersonal dynamics of collaboration between Indigenous and non-Indigenous partners; (2) structural and temporal arrangements necessary for collaborative work; and (3) the systematic recognition and incorporation of Indigenous cultural knowledge, values, and practices. Within implementation research, attention to cultural safety can mitigate the epistemic injustice that arise from research frameworks and methodologies that exclude Indigenous perspectives and values. Cultural safety can increase the likelihood that the research process itself contributes to mental health promotion.
AI and racism: Tone policing by the Bing AI chatbot
Authors: Appignani Timothy , Sanchez Jacob
Published: March 2024

This paper looks at the way that Bing AI uses tone policing and racial gaslighting in its conversations with users as a method of disciplining them away from critical anti-racist ideological engagement and towards an ethos of white supremacy. We use a critical discourse analysis to examine the conversations produced through our use of Microsoft’s Bing AI chatbot to find that through both the content it generates and the mechanisms through which it responds the Bing AI chatbot polices the tone of its users in a variety of ways.
Different yet complementary: A systematic literature review on data journalism in visualization research and journalism studies
Authors: Morini Francesca
Published: March 2024

This article surveys and compares literature on data journalism from two areas of inquiry: journalism studies and visualization research. As digital interfaces become an important access point for news, journalism and visualization scholars have begun to share a common research interest: data journalism. Given their radically different traditions and histories, these areas follow very different rules in how the topic is approached. The result is two parallel scholarships on data journalism with little points of contact. Arguably, developing research space for encounters and exchange of the two is an opportunity for expanding the academic discourse on data journalism. This study aims at opening this space of exchange through a systematic literature review. 121 articles, published between 2010 and 2023, are analyzed. Findings show that the two areas of research approach data journalism with very different aspirations. In relation to data journalism, journalism studies and visualization research could be compared with Lazersfeld’s distinction between critical and administrative research. These aspects cause various differences at an epistemic level, namely what, how and when knowledge about data journalism is produced.
The urge to splurge: Differentiating unplanned and impulse purchases
Authors: Morozova Nadia , Vlaev Ivo
Published: March 2024

This research note addresses a significant gap in the literature regarding the underlying mechanisms of purchase decision-making that lead to unplanned and impulse purchases. Although several papers have highlighted the differences between the two purchase types, recent academic publications continue to use those terms interchangeably. Through a systematic literature review, this study identified six high-level constructs, in line the Theoretical Domains Framework, that effectively differentiate unplanned from impulse purchase types. Overall, impulse (vs. unplanned) purchases have a primary association with automatic (vs. reflective) motivation. With these findings, academic researchers can better define the types of purchase they are investigating, including the main constructs and underlying psychological mechanisms that are associated with these purchases. As a result, this study substantially improves the reliability of knowledge in this domain. Additionally, this study may encourage marketers to expand their existing toolkits with a broader set of activities that can drive these different purchase types. For instance, marketers could appeal to different underlying purchase decision-making mechanisms: for unplanned purchases, they could offer reminders of related products; for impulse purchases, they could focus on immediate gratification.
Comparing the criminal careers of organized crime offenders in Italy and the Netherlands
Authors: Calderoni Francesco , Comunale Tommaso , van der Geest Victor , Kleemans Edward R.
Published: March 2024

The concept of organized crime has dynamically evolved, with researchers contending that it is a social construct or an umbrella concept encompassing different empirical manifestations. Scholars have often suggested classifying organized crime groups into those involved in “racketeering” or “governing” and those engaged in “transit crime” or “trading.” However, these propositions were never assessed at the level of individual criminal careers. We address two primary objectives: first, we test differences in the criminal careers of organized crime offenders between organized crime contexts that are historically different—comparing Italy, which is primarily known for racketeering organized crime, to the Netherlands, which is characterized more by transit crime. Second, we explore differences between criminal careers of organized crime offenders born in different decades; doing so allows us to measure differences in offending patterns in shifting organized crime contexts due to broader social changes while considering more country-specific changes in law enforcement and organized crime policies. The study relies on the criminal careers of 4480 organized crime offenders in Italy ( n = 3360) and the Netherlands ( n = 1120). We analyze the distributions of criminal career parameters, crime categories, age-crime curves, and offending trajectories. Offenders in Italy exhibit higher offending, earlier violence, earlier onset, and decline; offenders in the Netherlands display later onset, slower decline, and a greater involvement in drug and property offenses. Also, both samples show generalist offending patterns, long-lasting careers, and involvement in organized crime in adulthood. We also find substantial variation across decades of birth, with younger offenders in both countries reporting higher frequencies. We attribute this to the interplay of increased offending among younger individuals, the implicit selection bias in the sampling, and greater law enforcement pressure due to stricter anti-organized crime policies since the 1980s and 1990s.
Interviews With Lay Caregivers About Their Experiences Supporting Patients Throughout Kidney Transplantation
Authors: Solbu Anne , Cadzow Renee B. , Pullano Teresa , Brinser-Day Sherry , Tumiel-Berhalter Laurene , Kayler Liise K.
Published: March 2024

Introduction: Lay caregivers provide essential support to patients throughout the kidney transplant process, pretransplant through discharge. Sparse data exists about kidney transplant caregiver experience and facilitators of caregiver engagement. The aim of this study was to explore and describe lay caregivers’ accounts of supporting a patient before and early after kidney transplantation. Methods: Caregivers of recent kidney transplant recipients were individually interviewed about their experiences, coping strategies, and perspectives of center-specific support approaches for patients and caregivers in a single transplant center. Results: Inductive content analysis of transcribed interviews with 23 caregivers revealed 6 domain areas: visit preparation, initial evaluation, caregiver role discussion, exposure to support resources, transplant preparedness, and coping styles. Caregivers used and appreciated information offered by the transplant center, including materials directed to the patient. They recommended repeating information, online access, and adding video to complement print resources. They valued and requested information directed to them, both within passive materials and communication with providers. Social network interactions were helpful for practical, emotional, and informational support. Support group reminders and connection pathways to peers were suggested for both patients and caregivers. Conclusion: Findings highlight steps that can be taken by transplant centers and may stimulate caregiver engagement. Featuring caregiver-focused information and communication more prominently may support caregivers to improve patient progress in navigating kidney transplantation.
Labor Market Reentry Among White-Collar Female Ex-Prisoners in China: A Feminist Desistance Perspective
Authors: Zhang Xiaoye
Published: March 2024

This study, part of a collaborative project with the women’s prison in City A, China, aims to understand the experience of regaining employment among 18 white-collar ex-prisoners. Findings include shame and internalized stigmatization, labor market marginalization, and the political background check as a central part of the Chinese motherhood penalty. This paper demonstrates how the consequences of the women’s conviction and incarceration interact with individual, familial, and structural factors, leading some to return to domestic gender roles and pushing most into a state of precariousness. The study aims to contribute to the emerging field of feminist desistance research.
Subcutaneous injection of lidocaine around ischemic ankle provides safe and effective foot analgesia in patients with critical limb ischemia
Authors: Kanai Akifumi , Ara Masatomo , Saito Ryusei , Mishima Toshiaki , Takahashi Yuichiro
Published: March 2024

Objective

It is often difficult to alleviate foot pain associated with critical limb ischemia (CLI) using common analgesics. Neuraxial block is contraindicated in anticoagulant therapy. This study was designed to determine the response to subcutaneous injection of lidocaine around the network of peripheral nerves around the ankle in patients with CLI pain on anticoagulants and antiplatelets.

Methods

Sixteen patients with CLI pain in the foot were enrolled in this double-blind placebo-controlled crossover study. Patients were randomized to receive either 2% lidocaine or saline via catheters inserted into the subcutaneous area around the ankle. After recurrence of pain, the patients were crossed over to receive the alternative treatment. Pain was assessed with a numerical rating scale (NRS) before and 15 min after injection. Patients used a descriptive scale to grade pain control and were asked to determine the duration of analgesia in each arm of the study.

Results

No serious complications including protracted bleeding occurred. Lidocaine significantly decreased the NRS on movement from 10 (6, 10) [median (range)] to 2 (0, 10) ( p < .001), and the differences in the Δ change in NRS between lidocaine and placebo were significant ( p = .009). Of the 16 patients, 14 patients were very satisfied after lidocaine but only one described the same after saline. The effect of lidocaine and placebo lasted 11 (0, 28) and 1 (0, 22) h, respectively.

Conclusion

Subcutaneous injection of lidocaine around the ischemic ankle affectively alleviated pain in patients with CLI without serious adverse effects under anticoagulant therapy.
Factors associated with chronic pelvic pain in women with endometriosis: A national study on clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care, during the COVID-19 pandemic
Authors: Cofini Vincenza , Muselli Mario , Petrucci Emiliano , Lolli Chiara , Pelaccia Erika , Guido Maurizio , Marinangeli Franco , Fabiani Leila , Necozione Stefano
Published: March 2024

Background:

Endometriosis is a persistent inflammatory condition that affects women of reproductive age and causes pelvic pain. Chronic pelvic pain is a chronic regional pain syndrome involving the pelvic area.

Objectives:

This survey aimed to characterize the clinical and sociodemographic characteristics, lifestyles, quality of life, and perceptions of quality of care in women with endometriosis who reported chronic pelvic pain during the Covid pandemic.

Design:

We conducted a cross-sectional survey among the Italian population from July to September 2021.

Methods:

Snowball sampling was used to interview a large sample of adult women who reported a diagnosis of endometriosis, through a self-reported questionnaire. Univariate and multivariable logistic regression analyses were performed to identify the factors associated with chronic pelvic pain. The primary outcome was describing women who reported chronic pelvic pain.

Results:

A total of 661 out of 1045 (63%) women who responded to the survey reported chronic pelvic pain. The multivariable analysis evidenced that chronic pelvic pain was related to physical and mental quality perception, pelvic floor disorders (adjusted odds ratio = 1.58; 95% CI = 1.10–2.27; p = 0.012), dyspareunia (adjusted odds ratio = 1.87; 95% CI = 1.31–2.65; p < 0.001), adhesions syndrome (adjusted odds ratio = 1.49; 95% CI = 1.05–2.11; p = 0.026), and the delay in diagnosing endometriosis (adjusted odds ratio = 1.04; 95% CI = 1.00–1.09; p = 0.034). The only social factor associated with chronic pelvic pain was marital status (adjusted odds ratio = 0.66; 95% CI = 0.46–0.93; p = 0.019).

Conclusion:

In the pandemic period, there was a very high prevalence of chronic pelvic pain in women with endometriosis in Italy. The pandemic highlighted the need for careful attention to diagnose endometriosis and the need for psychological and partner support, which would allow better pain management and prevent chronicity.
Resected EGFR-mutated non-small-cell lung cancers: incidence and outcomes in a European population (GFPC Exerpos Study)
Authors: Auliac Jean-Bernard , Thomas Pascal-Alexandre , Bylicki Olivier , Guisier Florian , Curcio Hubert , AlainVegnenègre  , Swalduz Aurelie , Wislez Marie , Le Treut Jacques , Decroisette Chantal , Basse Victor , Falchero Lionel , De Chabot Gonzague , Moreau Diane , Huchot Eric , Lupo Mansuet Audrey , Blons Helene , Chouaïd Christos , Greillier Laurent
Published: March 2024

Background:

Few epidemiological data are available on surgically treated Caucasian patients with non-small-cell lung cancers (NSCLCs) harboring epidermal growth factor receptor ( EGFR) mutations. The main objective of this study was to describe, in the real-world setting, these patients’ incidence, clinical, and tumoral characteristics.

Methods:

The participating centers included all consecutive localized non-squamous NSCLC patients undergoing surgery between January 2018 and December 2019 in France. EGFR status was determined retrospectively when not available before surgery.

Results:

The study includes 1391 no squamous NSCLC patients from 16 centers; EGFR status was determined before surgery in 692 (49.7%) of the cases and conducted as part of the study for 699 (50.3%); 171 (12.3%) were EGFR mutated; median age: 70 (range: 36–88) years; female: 59.6%; never smokers: 75.7%; non-squamous histology 97.7%, programmed death ligand-1 expression 0%/1–49%/⩾50 in 60.5%/25.7%/13.8%, respectively. Surgery was predominantly lobectomy (81%) or segmentectomy (14.9%), with systematic lymph node dissection in 95.9%. Resection completeness was R0 for 97%. Post-surgery staging was as follows: IA: 52%, IB: 16%, IIA: 4%, IIB: 10%, IIIA: 16%, and IIIB: 0.05%; EGFR mutation exon was Del19/exon 21 ( L858R)/20/18 in 37.4%/36.8%/14%, and 6.4% of cases, respectively; 31 (18%) patients received adjuvant treatment (chemotherapy: 93%, EGFR tyrosine kinase inhibitor: 0%, radiotherapy: 20%). After a median follow-up of 31 (95% confidence interval: 29.6–33.1) months, 45 (26%) patients relapsed: 11/45 (24%) locally and 34 (76%) with metastatic progression. Median disease-free survival (DFS) and overall survival were not reached and 3-year DFS was 60%.

Conclusion:

This real-world analysis provides the incidence and outcomes of resected EGFR-mutated NSCLCs in a European patient cohort.
Smoke: Enablers and barriers for sustainable engagement with local Aboriginal communities
Authors: Skattebol Jennifer , Hind Paula , Blaxland Megan , Newton BJ
Published: March 2024

For many years, activists in Early Childhood Education and Care (ECEC) have called for the sector to engage closely with Aboriginal and Torres Strait Islander families and communities. However, less is documented on how mainstream services might achieve authentic, sustained engagement at a local service level. This paper showcases educators who connect with local Aboriginal community members/Elders as a central plank of their ECEC practice. In sharing their account, we examine what engagement looks like and what makes it possible. We have used Indigenous methodologies and the Theory of Practice Architecture (TPA) as theoretical lenses for exploring the policy, and organisational arrangements that sustained their engagement practices. We discuss the theoretical and practical implications of the research.
Treatment of External Fixator Pin Tract Deep Infections With an Antibiotic “Sparkler”
Authors: Hlad Lee M. , Rizkalla Jacob N. , So Eric , Herzenberg John E.
Published: March 2024

Pin tract infections are virtually universal complications with the use of external fixation. While most are superficial and respond to oral antibiotics and local care, septic loosening may occur at the bone–pin interface, which may lead to instability of the fixator, catastrophic failure, fracture, and long-term osteomyelitis. Classification systems and prevention protocols have been developed to address this ubiquitous complication. Treatment of severe pin tract infections often requires debridement, parenteral antibiotics, and removal of the offending pin or the entire external fixator. In cases of osteomyelitic pin tracks, a sizable cavity is often present. We describe a simple technique for treatment of deep bone pin tract infection through the use of debridement, irrigation, and an antibiotic “sparkler,” which is a specially prepared percutaneous implant of antibiotic laden bone cement.

Levels of Evidence: Level 5
Beware the Boxer's Fracture Imposter: Where Does the Metaphysis End and the Diaphysis Begin?
Authors: DeBiasio Celina , Sucha Ewa , Webster Richard J. , Tse Sandy , Cheung Kevin
Published: March 2024

Introduction: Fractures of the fifth metacarpal are a common injury. In children, they are often stable and heal uneventfully, including after closed reduction. Fractures of the metacarpal diaphysis, conversely, tend to be unstable and may require surgical intervention. It is unclear at what point fractures of the fifth metacarpal fracture should be considered unstable. We identify the location at which a fifth metacarpal fracture is at risk for surgical intervention. Methods: A two-year retrospective cohort analysis of all children (age ≤18) with fifth metacarpal fractures presenting to a Pediatric Plastic Surgery clinic was performed. Clinical and radiographical data were acquired from electronic medical records. Fracture location and fracture angulation were measured, descriptive statistics were performed, and multivariable logistic regression was used to identify predictors for surgery. Results: Ninety-eight patients met criteria for review. Mean patient age was 14.0 years (SD 2.2), and 95% were male. Forty-two (44.2%) patients underwent closed reduction, and 12 (12.2%) patients were recommended for surgery. Increased fracture angulation on initial lateral radiograph (OR: 1.08 (1.03-1.14 95% CI), p = 0.006) and more proximal fractures (OR: 0.92 (0.86-0.98 95% CI), p = 0.008) were identified as independent predictors for surgery. Fractures occurring proximal to 70% of metacarpal length resulted in accurate detection of those requiring surgery with 72.4% sensitivity, 75.3% specificity, 95.5% and 27.6% negative and positive predictive value, respectively. Conclusions: In pediatric fifth metacarpal fractures, increased fracture angulation and those occurring proximal to 70% of the metacarpal length were independent predictors for surgery.
Association between high levels of nitrogen dioxide and increased cumulative incidence of lung cancer in patients with idiopathic pulmonary fibrosis
Authors: Yoon Hee-Young , Kim Sun-Young , Song Jin Woo
Published: March 2024

Background

Lung cancer is a fatal complication of idiopathic pulmonary fibrosis (IPF) with a poor prognosis. However, the association between individual exposure to air pollutants and lung cancer development in patients with IPF is unknown. This study aimed to assess the effect of individual exposure to nitrogen dioxide (NO2) on lung cancer development in patients with IPF.

Methods

We enrolled 1085 patients from an IPF cohort in the Republic of Korea (mean age 65.6 years, males 80.6%). We estimated individual-level long-term exposures to NO2at the patients' residential addresses using a national-scale exposure prediction model based on data from air quality regulatory monitoring stations. To evaluate the association between NO2levels and lung cancer development in IPF, we used an individual- and area-level covariates adjusted model as our primary model.

Results

The estimated average annual NO2concentration was 23.1 ppb. During a median follow-up of 4.3 years, 86 patients (7.9%) developed lung cancer. NO2concentration was associated with lung cancer development in an unadjusted model (HR 1.219; p=0.042), while a marginal association was found in the primary model (HR 1.280; p=0.084). When NO2concentration was stratified by the median value (21.0 ppb), exposure to high NO2levels (≥21.0 ppb) was associated with a 2.0-fold increase in the risk of lung cancer development (HR 2.023; p=0.047) in the primary model.

Conclusion

Individual exposure to high NO2levels may increase the risk of lung cancer development in patients with IPF.
Mortality prevention as the centre of COPD management
Authors: Papaioannou Andriana I. , Hillas Georgios , Loukides Stelios , Vassilakopoulos Theodoros
Published: March 2024

COPD is a major healthcare problem and cause of mortality worldwide. COPD patients at increased mortality risk are those who are more symptomatic, have lower lung function and lower diffusing capacity of the lung for carbon monoxide, decreased exercise capacity, belong to the emphysematous phenotype and those who have concomitant bronchiectasis. Mortality risk seems to be greater in patients who experience COPD exacerbations and in those who suffer from concomitant cardiovascular and/or metabolic diseases. To predict the risk of death in COPD patients, several composite scores have been created using different parameters. In previous years, large studies (also called mega-trials) have evaluated the efficacy of different therapies on COPD mortality, but until recently only nonpharmaceutical interventions have proven to be effective. However, recent studies on fixed combinations of triple therapy (long-acting β-agonists, long-acting muscarinic antagonists and inhaled corticosteroids) have provided encouraging results, showing for the first time a reduction in mortality compared to dual therapies. The aim of the present review is to summarise available data regarding mortality risk in COPD patients and to describe pharmacological therapies that have shown effectiveness in reducing mortality.
Motivation and preferences for learning of patients with COPD or asthma and their significant others in pulmonary rehabilitation: a qualitative study
Authors: Muijsenberg Anouk J.L. , Haesevoets Sarah , Houben-Wilke Sarah , Tatousek Jan , Lacroix Joyca , Spruit Martijn A. , Janssen Daisy J.A.
Published: March 2024

Introduction

An in-depth understanding of educational needs from the perspective of learners in pulmonary rehabilitation is lacking. To improve learning in pulmonary rehabilitation, understanding of factors that induce or enhance intrinsic motivation in both patients and their significant others is needed. Therefore, this study aims to gain in-depth understanding of what motivates patients with COPD or asthma referred for pulmonary rehabilitation and their significant others to learn and what their preferences are for education.

Methods

For this qualitative study, a sample was taken from a previous quantitative study. Data was collected through one-time face-to-face semi-structured interviews. The interviews were transcribed and independently analysed by two researchers using thematic analyses.

Results

Twelve patients and four significant others (56% female; age: 63±11 years) were interviewed. Participants expressed a variety of information needs and learning preferences. Subthemes that emerged within the theme of motivation for learning were: 1) curiosity, such as knowledge gaps and hope for new information; and 2) values and goals, such as own health, caring for loved ones and spending time with family.

Discussion

To enhance intrinsic motivation for learning within pulmonary rehabilitation, autonomy of individuals should be supported by offering several learning topics and education adapted to preferences, while curiosity should be fostered by targeting information needs. Moreover, health education programmes should match with the personal values and goals of individuals, such as own health, caring for loved ones and spending time with family.
Artemisinin ameliorates cognitive decline by inhibiting hippocampal neuronal ferroptosis via Nrf2 activation in T2DM mice
Authors: Wang Bo , Zhu Sheng , Guo Miao , Ma Run-Dong , Tang Ya-Ling , Nie Ya-Xiong , Gu Hong-Feng
Published: March 2024

Background

Neuronal ferroptosis plays a critical role in the pathogenesis of cognitive deficits. The present study explored whether artemisinin protected type 2 diabetes mellitus (T2DM) mice from cognitive impairments by attenuating neuronal ferroptosis in the hippocampal CA1 region.

Methods

STZ-induced T2DM mice were treated with artemisinin (40 mg/kg, i.p.), or cotreated with artemisinin and Nrf2 inhibitor MEL385 or ferroptosis inducer erastin for 4 weeks. Cognitive performance was determined by the Morris water maze and Y maze tests. Hippocampal ROS, MDA, GSH, and Fe2+ contents were detected by assay kits. Nrf2, p-Nrf2, HO-1, and GPX4 proteins in hippocampal CA1 were assessed by Western blotting. Hippocampal neuron injury and mitochondrial morphology were observed using H&E staining and a transmission electron microscope, respectively.

Results

Artemisinin reversed diabetic cognitive impairments, decreased the concentrations of ROS, MDA and Fe2+, and increased the levels of p-Nr2, HO-1, GPX4 and GSH. Moreover, artemisinin alleviated neuronal loss and ferroptosis in the hippocampal CA1 region. However, these neuroprotective effects of artemisinin were abolished by Nrf2 inhibitor ML385 and ferroptosis inducer erastin.

Conclusion

Artemisinin effectively ameliorates neuropathological changes and learning and memory decline in T2DM mice; the underlying mechanism involves the activation of Nrf2 to inhibit neuronal ferroptosis in the hippocampus.

Graphical Abstract
Associations of resistance training levels with low muscle mass: a nationwide cross-sectional study in Korea
Authors: Park Jae Ho , Lim Nam-Kyoo , Park Hyun-Young
Published: March 2024

Background

Low muscle mass is associated with adverse health outcomes such as functional decline and all-cause mortality. This study investigated the relationship between the risk of low muscle mass and the training period and/or frequency of resistance training (RT).

Methods

We included 126,339 participants (81,263 women) from nationwide cohorts in Korea. Low muscle mass was defined based on the fat-free mass index. To investigate the presence of an inverse dose–response relationship between RT levels and the risk of low muscle mass, the training period (months) and frequency (per week) of RT were used. Multiple logistic regression models were used to assess the risk of low muscle mass according to the RT levels.

Results

Prevalence rates for low muscle mass in our study population were 21.27% and 6.92% in men and women, respectively. When compared with not performing RT, performing RT for 3–4 days/week and ≥5 days/week decreased the risk of low muscle mass by 22% and 27%, respectively, and performing RT for 12–23 months and ≥24 months decreased the risk by 19% and 41%, respectively. When simultaneously considering both training period and frequency, performing RT for either 3–4 days/week or ≥5 days/week was significantly related to risk reduction, provided that the training period was at least 1 year. Importantly, performing RT for more than 2 years resulted in an additional risk reduction. However, there was no additional effect of performing RT for ≥5 days/week compared to 3–4 days/week, regardless of whether the RT duration was 1–2 years or more than 2 years.

Conclusions

Since performing RT for 5 days/week or more did not yield any additional effects on the risk of low muscle mass, performing RT for 3–4 days/week was sufficient to prevent low muscle mass. The effectiveness of this preventive measure can be further enhanced by engaging in long-term RT, specifically for more than 2 years.
Nano-enabled pesticides: a comprehensive toxicity assessment of tebuconazole nanoformulations with nematodes at single species and community level
Authors: Eghbalinejad Mahleh , Hofman Jakub , Kotouček Jan , Grillo Renato , Hochmanová Bílková Zuzana , Reiff Nicola , Höss Sebastian
Published: March 2024

There is an increasing imperative to explore safer alternatives for pesticides due to their indiscriminate use and consequential health impacts on the environment and humans. Nanoformulations of pesticides are being developed as potential alternatives due to their beneficial properties, including enhanced solubility, targeted delivery to the site of action, improved stability and efficacy and reduced non-target effects. Nevertheless, a comprehensive assessment is necessary for these emerging nanopesticides compared to existing formulations, aiming to ascertain whether their "nano" characteristics exacerbate toxicity for non-target organisms. This study investigated the toxicity of tebuconazole (TBZ) in different formulations, including nanoformulations (poly-ε-caprolactone [PCL] and nanostructured lipid carrier [NLC] loaded with TBZ), as well as a commercial formulation, on the reproduction of the nematode Caenorhabditis elegans in both aqueous and soil matrices. Additionally, the impact of the correspondent nanocarriers without TBZ on C. elegans was examined. In water, TBZ in the form of nano and commercial formulations exhibited higher toxicity on the nematodes' reproduction than the TBZ (a.s.) attributable to higher freely dissolved concentrations of TBZ, which resulted in a toxicity order, ranging from the most to the least toxic as follows: NLC-TBZ > PCL-TBZ > commercial formulation > TBZ (a.s.). For NLC-TBZ, the excess toxicity could be clearly explained by combined toxicity of TBZ (a.s.) and nanocarriers, with the effect addition of the separate single compounds matching the observed effects of the nanoformulation. For PCL-TBZ, effects were stronger than expected from the effect addition of TBZ (a.s.) and PCL nanocarriers, potentially due to enhanced bioavailability of encapsulated TBZ in the gut of the nematodes. In soil, NLC with and without loaded TBZ showed higher toxicity than other tested compounds, while PCL nanocarriers without TBZ did not exhibit negative effects on the reproduction of C. elegans. Microcosm experiment, where long-term effects on native soil nematode fauna were tested, confirmed that TBZ-nanoformulations act via combined toxic effects of TBZ and nanocarriers. These findings contribute valuable insights to understanding nanopesticides' ecotoxicity and underscore the need for harmonized regulatory assessments to evaluate these novel formulations adequately.
Unlocking potential biomarkers bridging coronary atherosclerosis and pyrimidine metabolism-associated genes through an integrated bioinformatics and machine learning approach
Authors: Bu Fanli , Qin Xiao , Wang Tiantian , Li Na , Zheng Man , Wu Zixuan , Ma Kai
Published: March 2024

Background

This study delves into the intricate landscape of atherosclerosis (AS), a chronic inflammatory disorder with significant implications for cardiovascular health. AS poses a considerable burden on global healthcare systems, elevating both mortality and morbidity rates. The pathological underpinnings of AS involve a marked metabolic disequilibrium, particularly within pyrimidine metabolism (PyM), a crucial enzymatic network central to nucleotide synthesis and degradation. While the therapeutic relevance of pyrimidine metabolism in diverse diseases is acknowledged, the explicit role of pyrimidine metabolism genes (PyMGs) in the context of AS remains elusive. Utilizing bioinformatics methodologies, this investigation aims to reveal and substantiate PyMGs intricately linked with AS.

Methods

A set of 41 candidate PyMGs was scrutinized through differential expression analysis. GSEA and GSVA were employed to illuminate potential biological pathways and functions associated with the identified PyMGs. Simultaneously, Lasso regression and SVM-RFE were utilized to distill core genes and assess the diagnostic potential of four quintessential PyMGs (CMPK1, CMPK2, NT5C2, RRM1) in discriminating AS. The relationship between key PyMGs and clinical presentations was also explored. Validation of the expression levels of the four PyMGs was performed using the GSE43292 and GSE9820 datasets.

Results

This investigation identified four PyMGs, with NT5C2 and RRM1 emerging as key players, intricately linked to AS pathogenesis. Functional analysis underscored their critical involvement in metabolic processes, including pyrimidine-containing compound metabolism and nucleotide biosynthesis. Diagnostic evaluation of these PyMGs in distinguishing AS showcased promising results.

Conclusion

In conclusion, this exploration has illuminated a constellation of four PyMGs with a potential nexus to AS pathogenesis. These findings unveil emerging biomarkers, paving the way for novel approaches to disease monitoring and progression, and providing new avenues for therapeutic intervention in the realm of atherosclerosis.
Applying Sydney Triage to Admission Risk Tool (START) to improve patient flow in emergency departments: a multicentre randomised, implementation study
Authors: Berendsen Russell Saartje , Seimon Radhika V , Dixon Emma , Murphy Margaret , Vukasovic Matthew , Bohlken Nicole , Taylor Sharon , Cooper Zoe , Scruton Jennifer , Jain Nitin , Dinh Michael M
Published: March 2024

Background

To determine the effectiveness of applying the Sydney Triage to Admission Risk Tool (START) in conjunction with senior early assessment in different Emergency Departments (EDs).

Methods

This multicentre implementation study, conducted in two metropolitan EDs, used a convenience sample of ED patients. Patients who were admitted, after presenting to both EDs, and were assessed using the existing senior ED clinician assessment, were included in the study. Patients in the intervention group were assessed with the assistance of START, while patients in the control group were assessed without the assistance of START. Outcomes measured were ED length of stay and proportion of patients correctly identified as an in-patient admission by START.

Results

A total of 773 patients were evaluated using the START tool at triage across both sites (Intervention group n = 355 and control group n = 418 patients). The proportion of patients meeting the 4-hour length of stay thresholds was similar between the intervention and control groups (30.1% vs. 28.2%; p = 0.62). The intervention group was associated with a reduced ED length of stay when compared to the control group (351 min, interquartile range (IQR) 221.0–565.0 min versus 383 min, IQR 229.25–580.0 min; p = 0.85). When stratified into admitted and discharged patients, similar results were seen.

Conclusion

In this extension of the START model of care implementation study in two metropolitan EDs, START, when used in conjunction with senior early assessment was associated with some reduced ED length of stay.
Novel CAD gene mutations in a boy with developmental and epileptic encephalopathy 50 with dramatic response to uridine therapy: a case report and a review of the literature
Authors: Duan Lifen , Ye Lei , Yin Runxiu , Sun Ying , Yu Wei , Zhang Yi , Zhong Haiyan , Bao Xinhua , Tian Xin
Published: March 2024

Background

Developmental and epileptic encephalopathy-50 (DEE-50) is a rare clinical condition believed to be caused by a mutation in the CAD gene and is associated with a bleak prognosis. CAD-related diseases have a wide range of clinical manifestations and other symptoms that may be easily overlooked. Like other rare diseases, the clinical manifestations and the treatment of DEE-50 necessitate further investigation.

Case presentation

A 1-year-old male patient presented with developmental delay, seizures, and anaemia at 3 months of age. He further developed refractory status epilepticus (SE), rapid deterioration of cognitive and motor function, and even became comatose at 5 months of age. Whole-exome sequencing of trios (WES-trios) revealed a compound heterozygous variant in the CAD gene, with one locus inherited from his father (c.1252C>T: p.Q418* nonsense mutation) and one from his mother (c.6628G>A: p.G2210S, missense mutation). This compound heterozygous CAD variant was unreported in the Human Gene Mutation Database. After uridine treatment, his cognitive faculties dramatically improved and he remained seizure-free.

Forty two cases with CAD gene mutation reported in the literatures were reviewed. Among them, 90% had onset before 3 years of age, with average of 1.6±1.8 years old. The average age of diagnosis was 7.7 ± 10 years. The mortality rate was approximately 9.5%, with all reported deaths occurring in patients without uridine treatment. The clinical entity could be improved dramatically when the patient treated with uridine.

Conclusions

We present a boy with DEE 50 caused by novel CAD gene mutations and reviewed the clinical features of 42 patients reported previously. DEE 50 has early onset, refractory seizures, even status epilepticus leading to death, with favorable response to treatment with oral uridine. Early uridine treatment is recommended if CAD defect is suspected or genetically diagnosed. This study enhances the knowledge of DEE 50 and expands the spectrum of CAD gene mutations.
Practical implications of ICD-11 personality disorder classifications
Authors: Pan Bing , Wang Wei
Published: March 2024

Personality disorders (PDs) are associated with an inferior quality of life, poor health, and premature mortality, leading to heavy clinical, familial, and societal burdens. The International Classification of Diseases-11 (ICD-11) makes a thorough, dramatic paradigm shift from the categorical to dimensional diagnosis of PD and expands the application into adolescence. We have reviewed the recent literature on practical implications, and severity and trait measures of ICD-11 defined PDs, by comparing with the alternative model of personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), by mentioning the relevance in forensic and social concerns, and by referencing the developmental implication of life span, especially in adolescence. Study results strongly support the dimensional utility of ICD-11 PD diagnosis and application in adolescence which warrants early detection and intervention. More evidence-based research is needed along the ICD-11 PD application, such as its social relevance, measurement simplification, and longitudinal design of lifespan observation and treatment.
Analysis of three different reverse shoulder arthroplasty designs for cuff tear arthropathy – the combination of lateralization and distalization provides best mobility
Authors: Freislederer Florian , Moroder Philipp , Audigé Laurent , Schneller Tim , Ameziane Yacine , Trefzer Raphael , Imiolczyk Jan-Philipp , Scheibel Markus
Published: March 2024

Background

The two major reverse shoulder arthroplasty (RSA) designs are the Grammont design and the lateralized design. Even if the lateralized design is biomechanically favored, the classic Grammont prosthesis continues to be used. Functional and subjective patient scores as well as implant survival described in the literature so far are comparable to the lateralized design. A pure comparison of how the RSA design influences outcome in patients has not yet been determined. The aim of this study was a comparison focused on patients with cuff tear arthropathy (CTA).

Methods

We analyzed registry data from 696 CTA patients prospectively collected between 2012 and 2020 in two specialized orthopedic centers up to 2 years post-RSA with the same follow-up time points (6,12 24 months). Complete teres minor tears were excluded. Three groups were defined: group 1 (inlay, 155° humeral inclination, 36 + 2 mm eccentric glenosphere (n = 50)), group 2 (inlay, 135° humeral inclination, 36 + 4 mm lateralized glenosphere (n = 141)) and group 3 (onlay, 145° humeral inclination, + 3 mm lateralized base plate, 36 + 2 mm eccentric glenosphere (n = 35)) We compared group differences in clinical outcomes (e.g., active and passive range of motion (ROM), abduction strength, Constant-Murley score (CS)), radiographic evaluations of prosthetic position, scapular anatomy and complications using mixed models adjusted for age and sex.

Results

The final analysis included 226 patients. The overall adjusted p-value of the CS for all time-points showed no significant difference (p = 0.466). Flexion of group 3 (mean, 155° (SD 13)) was higher than flexion of group 1 (mean, 142° (SD 18) and 2 (mean, 132° (SD 18) (p < 0.001). Values for abduction of group 3 (mean, 145° (SD 23)) were bigger than those of group 1 (mean, 130° (SD 22)) and group 2 (mean, 118° (SD 25)) (p < 0.001). Mean external rotation for group 3 (mean, 41° (SD 23)) and group 2 (mean, 38° (SD 17)) was larger than external rotation of group 1 (mean, 24° (SD 16)) (p < 0.001); a greater proportion of group 2 (78%) and 3 (69%) patients reached L3 level on internal rotation compared to group 1 (44%) (p = 0.003). Prosthesis position measurements were similar, but group 3 had significantly less scapular notching (14%) versus 24% (group 2) and 50% (group 1) (p = 0.001).

Conclusions

Outcome scores of different RSA designs for CTA revealed comparable results. However, CTA patients with a lateralized and distalized RSA configuration were associated with achieving better flexion and abduction with less scapular notching. A better rotation was associated with either of the lateralized RSA designs in comparison with the classic Grammont prosthesis.

Level of Evidence

Therapeutic study, Level III.
Hybrid kyphoplasty with short-versus intermediate- and long-segment pedicle screw fixations for the management of thoracolumbar burst fractures
Authors: Chou Kuan-Nien , Wang Peng-Wei , Chung Ming-Hsuan , Ju Da-Tong
Published: March 2024

Background

This study aimed to determine if the hybrid short-segment (HSS) technique is a good alternative to the intermediate-segment (IS) and long-segment (LS) techniques in pedicle screw fixations for acute thoracolumbar burst fractures (TLBFs).

Methods

In this retrospective evaluation, we examined 43 patients who underwent surgical treatments, including one- or two-level suprajacent (U) and infrajacent (L) pedicle screw fixations, for acute single-level TLBFs with neurological deficits between the T11 and L2 levels from July 2013 to December 2019. Among these patients, 15 individuals underwent HSS (U1L1), 12 received IS (U2L1), and 16 underwent LS (U2L2) fixations. Supplemental kyphoplasty of the fractured vertebral bodies was performed exclusively in the HSS group. Our analysis focused on assessing blood loss and surgical duration. Additionally, we compared postoperative thoracolumbar kyphotic degeneration using the data on Cobb angles on lateral radiographic images acquired at three time points (preoperatively, postoperative day 1, and follow-up). The end of follow-up was defined as the most recent postoperative radiographic image or implant complication occurrence.

Results

Blood loss and surgical duration were significantly lower in the HSS group than in the IS and LS groups. Additionally, the HSS group exhibited the lowest implant complication rate (2/15, 13.33%), followed by the LS (6/16, 37.5%) and IS (8/12, 66.7%) group. Implant complications occurred at a mean follow-up of 7.5 (range: 6–9), 9 (range: 5–23), and 7 (range: 1–21) months in the HSS, IS, and LS groups. Among these implant complications, revision surgeries were performed in two patients in the HSS group, two in the IS group, and one in the LS group. One patient treated by HSS with balloon kyphoplasty underwent reoperation because of symptomatic cement leakage.

Conclusions

The HSS technique reduced intraoperative blood loss, surgical duration, and postoperative implant complications, indicating it is a good alternative to the IS and LS techniques for treating acute single-level TLBFs. This technique facilitates immediate kyphosis correction and successful maintenance of the corrected alignment within 1 year. Supplemental kyphoplasty with SpineJack® devices and high-viscosity bone cements for anterior reconstruction can potentially decrease the risk of cement leakage and related issues.
Challenges faced by teachers of postgraduate health professions blended learning programs: a qualitative analysis
Authors: Shah Sana , Mahboob Usman , Junaid Syed Muhammad , Siddiqui Sana , Jamil Brekhna , Rehman Saadia
Published: March 2024

Introduction

Blended learning, which integrates classroom face-to-face teaching with both asynchronous and synchronous online learning elements, has swiftly gained acceptance in educational environments. However, the implementation of blended learning presents challenges that impact all stakeholders, necessitating thoughtful consideration. Teachers play a central role in shaping the instructional experience among these stakeholders. To fully realize the potential of comprehensive blended learning, it is imperative to identify the challenges faced by these teachers and develop strategies that sensibly address and overcome them.

Methodology

A qualitative exploratory study was conducted with twelve teachers involved in the postgraduate blended learning health professions program at Khyber Medical University, Peshawar in 2022. One-on-one semi-structured Interviews were conducted via WhatsApp/ZOOM, transcribed by Otter AI, coded on NVivo & analyzed using Braun/Clarke’s Thematic Analysis.

Results

Three themes of challenges faced by teachers of postgraduate blended learning programs were constructed namely (1) Skills, such as (i) digital, (ii) instructional, and (iii) online class management, and (2) Administrative barriers in terms of (iv) resources (iv) training, and (3) Faculty resistance.

Conclusion

This study provides profound insights into the daunting challenges that postgraduate blended learning program teachers encounter in terms of skills, administrative barriers, and faculty resistance. These findings offer a valuable opportunity for program directors to identify the critical requirements of these faculties in their pursuit of effective teaching and learning, ultimately transforming the landscape of blended education. This study emphasizes the need for ongoing faculty development and institutional support to address the identified challenges and improve the quality of postgraduate blended-learning programs.