bluuebunny/crossref_metadata_2025 huggingface dataset:
Model-Based Approaches to Investigating Mismatch Responses in Schizophrenia
Authors: Gütlin Dirk C. , McDermott Hannah H. , Grundei Miro , Auksztulewicz Ryszard
Published: May 2024

Alterations of mismatch responses (ie, neural activity evoked by unexpected stimuli) are often considered a potential biomarker of schizophrenia. Going beyond establishing the type of observed alterations found in diagnosed patients and related cohorts, computational methods can yield valuable insights into the underlying disruptions of neural mechanisms and cognitive function. Here, we adopt a typology of model-based approaches from computational cognitive neuroscience, providing an overview of the study of mismatch responses and their alterations in schizophrenia from four complementary perspectives: (a) connectivity models, (b) decoding models, (c) neural network models, and (d) cognitive models. Connectivity models aim at inferring the effective connectivity patterns between brain regions that may underlie mismatch responses measured at the sensor level. Decoding models use multivariate spatiotemporal mismatch response patterns to infer the type of sensory violations or to classify participants based on their diagnosis. Neural network models such as deep convolutional neural networks can be used for improved classification performance as well as for a systematic study of various aspects of empirical data. Finally, cognitive models quantify mismatch responses in terms of signaling and updating perceptual predictions over time. In addition to describing the available methodology and reviewing the results of recent computational psychiatry studies, we offer suggestions for future work applying model-based techniques to advance the study of mismatch responses in schizophrenia.
“The Devil in the Mirror: Projections of Desire from Folk Tales to Witcher 3: The Wild Hunt”
Authors: Özgü Can
Published: May 2024

Dealing with the Devil is one of most prominent cultural motifs across the history of recorded folk tales. From ancient folk tales to contemporary cultural products, the Devil has appeared as an illicitly desirable being. The focal point of dealing with the Devil is that it is instigated by a pre-existent desire to exceed one's capacity determined by their temporal circumstances. In the Christian narrative tradition, a deal with the devil occurs over a Manichean undercurrent and ends in the condemnation of the participant or in the devil's humiliation. Pantheistic traditions discombobulate this contract by virtue of the nonexistence of Manichean binaries. This study aims to analyze the prevalence of desire in the deal with the devil motif throughout various tales and how the video game Witcher 3: The Wild Hunt (2015) complicates notions that are often taken for granted in Christian folk tales through its core narrative design.
Lifestyle Intervention Improves Parasympathetic Activity in Hypertrophic Cardiomyopathy
Authors: Alyahya Alaa I. , Charman Sarah J. , Okwose Nduka C. , Fuller Amy S. , Eggett Christopher , Luke Peter , Bailey Kristian , MacGowan Guy A. , Jakovljevic Djordje G.
Published: May 2024

Background A limited number of studies have investigated the effects of lifestyle interventions in hypertrophic cardiomyopathy (HCM). This study evaluated the effect of a novel lifestyle intervention incorporating physical activity (PA) and dietary nitrate supplementation on heart rate variability (HRV) and haemodynamic measures in HCM.

Methods

Twenty-eight individuals with HCM were randomised into either the intervention or control group. Frequency-domain HRV measures including low frequency power (LF), high frequency power (HF) and LF/HF were recorded at rest using bioimpedance. Non-invasive haemodynamic variables were recorded at rest using bioreactance. Participants in the intervention group consumed 6 mmol of nitrate daily (concentrated beetroot juice) and were instructed to increase and maintain daily PA by ≥ 2000 steps/day above baseline for 16 weeks. Control group participants retained their usual lifestyle and monitored daily step counts.

Results

There was a significant increase in post-intervention HF power (7.54 ± 2.14 vs 8.78 ± 1.60 ms2, P < .01) and LF power (6.89 ± 2.33 vs 8.17 ± 1.55, P < .01) in the intervention but not in the control group. Resting mean arterial blood pressure (MABP) in the intervention group significantly reduced at follow-up (108 ± 6 vs 102 ± 7 mmHg, P < .01).

Conclusions

A novel lifestyle intervention including PA and dietary nitrate supplementation enhanced parasympathetic activity and resting MABP in HCM.
Experimental comparison of first-pass effect between direct thromboaspiration and combined thrombectomy in the setting of distal basilar occlusion
Authors: Seiffert Reza , Brina Olivier , Reymond Philippe , Hofmeister Jeremy , Bernava Gianmarco , Rosi Andrea , Michels Lars , Kulcsar Zsolt , Lovblad Karl-Olof , Machi Paolo
Published: May 2024

Background

Studies investigating endovascular therapy in vertebro-basilar stroke have led to controversial results in the past, but recent randomized trials seem to show an effectiveness superiority of endovascular therapy versus best medical treatment. However, uncertainty remains concerning many aspects of thrombectomy in acute basilar artery occlusion, notably technical considerations. This study compared the first-pass effect of direct thromboaspiration and combined thrombectomy in the setting of distal basilar occlusion.

Methods

An in-vitro experimental set-up was used, consisting of a vascular phantom model and thrombus analogs of different consistencies to mimic human clots. Thrombus analogs were injected into the model through the vertebral artery and flowed to the basilar distal third to mimic a distal basilar occlusion. Ten procedures were performed for each thrombus analog stiffness and technique (direct thromboaspiration versus combined thrombectomy).

Results

Direct thromboaspiration showed an overall first-pass effect rate of 83.3% (25/30) and was particularly effective for ultra-soft and soft clot analogs, but decreased for hard clot analogs. Combined thrombectomy had an overall first-pass effect rate of 56.7% (17/30). The effect rate for ultra-soft and soft clot analogs was 60% and 50% for hard clot analogs. In the softer clot analogs, the stent-retriever device used for the combined thrombectomies tended to deviate the clot analog from a co-axial trajectory with the aspiration catheter.

Conclusions

In the context of distal basilar occlusion, our in-vitro results showed that higher first-pass effect rates were achieved with direct thromboaspiration compared to combined thrombectomy in all types of thrombus analogs.
Quantification of steal flow on Doppler ultrasound in patients with arteriovenous graft for hemodialysis
Authors: Kang Kyoungin , Lee Jung Ho , Hwang Hong Pil , Kaliannagounder Vignesh Krishnamoorthi , Park Chan Hee , Kwak Hyo Sung
Published: May 2024

Purpose

Arteriovenous fistula (AVF) is the preferred treatment for long-term hemodialysis patients to allow reliable vascular access. Arteriovenous graft (AVG) is monitored using Doppler sonography to check a vessel’s condition and predict complications such as steal syndrome. In this study, we developed an analysis algorithm and method to quantify steal syndrome using Doppler sonography.

Methods

Doppler sonography was used to determine the pattern of anterograde and retrograde flow. The ratio of blood volumes was calculated with a vision analysis software. First, performance of the developed algorithm was validated by comparing it with commercial Doppler sonography data. Doppler sonography was performed for an artificial vessel to analyze the steal flow.

Results

A total of 58 patients with steal flow were enrolled in this study. Of these patients, 23 did not have a difference in fingertip temperature between both sides. The median difference in temperature of 35 patients was 0.8°C (range, 0.3−1.9°C). The ratio of retrograde flow volume/antegrade flow volume in patients with the presence of temperature difference was significantly higher compared to that in patients without the temperature difference ( p < .001). The ROC curve for the difference in flow volume had an AUC of 0.770. The optimal cutoff of difference in the flow volume between the two groups was 0.24 (sensitivity of 91.4 % and specificity of 52.2%). The flow volume difference was significantly positively correlated to temperature difference (r = 0.487, p < .003).

Conclusion

Our algorithm could measure steal flow volume of a bidirectional waveform by antegrade arterial flow and retrograde reversal flow.
LogMyScan: A pilot evaluation study of a mobile phone–based ultrasound logbook application
Authors: Jarman Robert David , Anderson David , Richards Simon , Davison Tyrone , Fenton Siobhan , Batterham Alan , Ryan Cormac , Cosson Philip
Published: May 2024

Introduction:

We developed a mobile phone logbook application called LogMyScan. The study objectives were to evaluate a number of domains as per the technology acceptance model.

Methods:

A prospective pilot cohort study was conducted using a version of LogMyScan and reported according to Statement on Reporting of Evaluation studies in Health Informatics. Prospective participants were directed to a website which provided information and links. Participants were recruited via email distribution lists and social media. A task list was provided, which included entering simulated scan data and navigating the application, prior to completing a questionnaire. Questions were aligned to technology acceptance model domains, and Cronbach’s alpha was calculated to assess reliability.

Results:

There were 49 participants and 7 were unable to complete the image upload and editing step. Levels of agreement for usability, educational and governance/security aspects were generally good. The desirability of existing and proposed features was high for images and video clip handling, feedback and reflection and less for motivational notifications and benchmarking. Comments identified some limitations and issues on the Android platform. Cronbach’s alpha demonstrated good to excellent reliability: 0.87 (95% confidence interval, 0.79–0.91) for usability, educational and governance/security and 0.86 (95% confidence interval, 0.78–0.91) for desirability of existing and proposed features.

Conclusion:

There was generally high perceived ease of use, usefulness, attitude towards use and behavioural intention to use LogMyScan. Further research is needed to evaluate LogMyScan for future iterations, allowing recruitment of a larger number of participants and evaluating user expectations prior to using, and at timed intervals after using.
Experimental evidence for a semantic typology of emoji: Inferences of co-, pro-, and post-text emoji
Authors: Tieu Lyn , Qiu Jimmy L , Puvipalan Vaishnavy , Pasternak Robert
Published: May 2024

Emoji symbols are widely used in online communication, particularly in instant messaging and on social media platforms. Existing research draws comparisons between the functions of emoji and those of gestures, with recent work extending a proposed typology of gestures to emoji, arguing that different emoji types can be distinguished by their placement within the modified text and by their semantic contribution (the linguistic inferences that they give rise to). In this paper, we present four experiments designed to test the predictions of this extended typology, the results of which suggest that emoji symbols indeed trigger the hypothesised linguistic inferences. The findings provide support for a semantic typology of emoji and contribute further evidence of the parallels between gesture and emoji.
Associated demographic factors for the recurrence and prognosis of stroke patients within a multiethnic Asian population
Authors: Lee Keng Siang , Siow Isabel , Riandini Tessa , Narasimhalu Kaavya , Tan Kelvin Bryan , De Silva Deidre Anne
Published: May 2024

Objective:

There is a paucity of studies investigating the outcomes among Asian stroke patients. Identifying subgroups of stroke patients at risk of poorer outcomes could identify patients who would benefit from targeted interventions. Therefore, the aim of this study was to identify which ischemic stroke patients at high risk of recurrent events and mortality.

Methods:

This cohort study adhered to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines. We obtained data from the Singapore Stroke Registry (SSR) from 2005 to 2016 and cross referenced to the Death Registry and the Myocardial Infarction Registry. Outcome measures included recurrent stroke, acute myocardial infarction (AMI), and all-cause and stroke-related deaths. Multivariable Cox proportional hazards regression models were performed to determine risk factors for recurrent stroke, AMI, and all-cause and stroke-related deaths.

Results:

A total of 64,915 patients (6705 young, and 58,210 older) were included in our analysis. Older stroke patients were found to have an increased risk of recurrent stroke (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.12–1.30), AMI (HR = 1.73, 95% CI = 1.54–1.95), all-cause death (HR = 2.49, 95% CI = 2.34–2.64), and stroke-related death (HR = 176, 95% CI = 1.61–1.92). Among young stroke patients, males were at increased risk for recurrent stroke (HR = 1.18, 95% CI = 1.01–1.39) and AMI (HR = 1.41, 95% CI = 1.08–1.83), but at reduced risk for all-cause (HR = 0.78, 95% CI = 0.69–0.89) and stroke-related deaths (HR = 0.79, 95% CI = 0.67–0.94). Ethnicity appeared to influence outcomes, with Malay patients at increased risk of recurrent stroke (HR = 1.37, 95% CI = 1.14–1.65), AMI (HR = 2.45, 95% CI = 1.87–3.22), and all-cause (HR = 1.43, 95% CI = 1.24–1.66) and stroke-related deaths (HR = 1.34, 95% CI = 1.09–1.64). Indian patients were also at increased risk of AMI (HR = 1.96, 95% CI = 1.41–2.72). Similar findings were seen among the older stroke patients.

Conclusion:

This study found that older stroke patients are at risk of poorer outcomes. Within the young stroke population specifically, males were predisposed to recurrent stroke and AMI but were protected against all-cause and stroke-related deaths. Males were also at reduced risk of all-cause and stroke-related deaths in the older stroke population. In addition, Malay and Indian patients experience poorer outcomes after first stroke. Further optimization of risk factors targeting these high-priority populations are needed to achieve high-quality care.
An appetite to win: Disordered eating behaviours amongst competitive cyclists
Authors: Roberts Charlie Jon , Hurst Howard Thomas , Keay Nicola , Hamer Jennifer , Sims Stacy , Schofield Katherine L , Hardwicke Jack
Published: May 2024

Competitive cyclists may be vulnerable to disordered eating (DE) and eating disorders (ED) due to perceived body composition optimisation and external influences within cycling culture and from stakeholders. Therefore, this study aimed to assess DE and ED risk in competitive cyclists using the Eating Attitudes Test (EAT-26), explore differences in responses based on sex, discipline and level of competition, and to gain insights into contributing factors towards DE via open-ended survey questions. In total, 203 participants completed a mixed-method questionnaire. Eating disorders were reported by 5.7% ( n = 11) of participants, with three being historic cases. The median (inter-quartile range) EAT-26 score was 8 (12) of a total possible score of 78. Disordered eating risk was observed in 16.7% of participants due to an EAT-26 score ≥20. Female participants had significantly higher scores than male participants (12.5 ± 17.5 vs. 6.5 ± 10.0; p = .004). There was no significant difference between road cyclists and off-road cyclists (7.0 ± 13.25 vs. 8.0 ± 10.5; p = .683). There was a significant difference in scores between novice/club/regional and national/elite/professional cyclists (6.0 ± 11.25 vs. 10.5 ± 12.0; p = .007). Thematic analysis of open-text responses found that the social environment of competitive cycling contributed towards DE behaviours and body image issues. These findings indicate competitive cyclists do appear to be an ‘at risk’ population for DE/ED. Therefore, there is need for stakeholders to enhance nutritional services, nutrition education and create supportive athlete environments.
Multidisciplinary strategies to treat painful mononeuropathies in the upper extremity: from lab to bedside
Authors: Rijsdijk Mienke , Tuffaha Sami , Coert J. Henk
Published: May 2024

Neuropathic pain in the upper extremity is a serious problem, commonly involving relatively young patients. The pain causes loss of function and productivity, changes a patient’s lifestyle and can progress into a chronic pain syndrome with secondary psychosocial co-morbidities. Treating patients with a painful mononeuropathy remains challenging, with a monodisciplinary approach often having limited treatment efficacy. This narrative review discusses how to deal with this challenge in the treatment of patients with peripheral nerve injury pain, addressing the four important pillars: (1) diagnosing a painful mononeuropathy; (2) clinical pain phenotyping; (3) personalized pain treatment; and (4) using a multidisciplinary team approach.
Subcapital realignment osteotomy for the treatment of moderate and severe slipped upper femoral epiphysis: A retrospective study of 123 hips in a tertiary center
Authors: Winson Daniel MG , Cundy William J , Roser Megan JN , Carty Christopher P , Maine Sheanna , Donald Geoffrey
Published: May 2024

Background:

The surgical treatment of moderate and severe slipped capital femoral epiphysis is controversial. Treatment ranges from pinning in situ to open dislocation and reduction of the slipped epiphysis. The modified Dunn procedure has been associated with variable avascular necrosis with rates, ranging between 0% and 67%. The aim of this study was to evaluate the outcomes and complications of patients who have undergone a subcapital realignment osteotomy (SCRO) in our center.

Methods:

A retrospective longitudinal study of the osteotomies performed between 2009 and 2019 in a tertiary referral center for Pediatric Orthopedics in Queensland, Australia. Patient demographics, stability, and severity of slip and surgical outcomes were collected.

Results:

A total of 123 procedures were performed on 116 patients. The mean age was 12.4 years, 65 (56%) patients were male and the mean posterior sloping angle was 60.10 with 93 (75%) being severe slips. There were 51 (41.5%) Loder’s stable and 72 (58%) unstable slipped capital femoral epiphysis. Our overall avascular necrosis rate following SCRO was 17.8%. Time between surgery and diagnosis did not have an effect on avascular necrosis.

Conclusion:

The subcapital realignment osteotomy remains a controversial and complex procedure for the management of moderate and severe slipped capital femoral epiphysis. We found that our cohort demonstrated an avascular necrosis rate in keeping with the existing literature. This indicates that when performed in a high-volume center with experienced surgical staff, it can be an effective treatment option for these patients.

Level of evidence:

Level IV
The Impact of Changing Antithrombotic Management in Patients With Atrial Fibrillation and Ischemic Cerebrovascular Events Despite Anticoagulation
Authors: Harahsheh Ehab , Elshaigi Omer , Alhayek Nour , Buckner Skye A. , Quillen Jaxon K. , O’Carroll Cumara B. , Dumitrascu Oana M.
Published: May 2024

Background

Patients with atrial fibrillation (AF) are at increased risk of ischemic cerebrovascular events despite anticoagulants (AC). We aim to evaluate whether changing AC or adding antiplatelet therapy to anticoagulants (AP + AC) in patients with AF presenting with acute ischemic stroke (AIS) or transient ischemic attack (TIA) despite AC, decreases the risk of recurrent AIS/TIA compared to patients continued on same AC regimen.

Methods

Patients with AF on AC presenting with AIS or TIA at our center between 2011- 2021 were included. Data on Demographics, index event, antithrombotic therapy before and after index event, recurrent AIS/TIA, or major bleeding events (MBE) were extracted. Cox proportional hazards models were used to compare outcomes between AC unchange vs AC change, and AP + AC vs AC only groups.

Results

One hundred eighty-five patients were included (mean age 78.3 years; 62% males, median follow-up 9 months (IQR 1-34)). Seventeen patients (9%) had AC change, 100 (54%) received AP + AC, 39 (21%) had recurrent AIS/TIA, and 27 (15%) had MBE following index event. No difference was observed between AC unchange vs AC change and AP + AC vs AC only groups regarding recurrent AIS/TIA (HR 1.72 [.65-4.57], P = .27 and HR 1.02 [.53- 1.98], P = .95, respectively) or MBE (HR .85 [.19-3.67], P = .83 and HR 1.49 [.67-3.33)], P = .33, respectively). Fourteen vascular neurologists treated this cohort and 9(64%) implemented AC changes.

Conclusion

In this single center retrospective study of 185 patients with AF and AIS/TIA despite AC, changing AC or adding AP agents did not decrease the risk of ischemic cerebrovascular events.
Bringing in the asset economy
Authors: Dörry Sabine
Published: May 2024

This commentary on the ‘urban state venturism’, highlighting the state's pivotal role in driving large-scale urban investments, offers a nuanced reading with areas for a sympathetic critique. I advocate for a redefined starting point of analysis that centres on the emerging asset economy model. This prompts a consequential distinction between asset-based and commodity-based value/wealth creation, particularly in the context of public venture capital investments, which necessitates further empirical scrutiny. However, there is a risk that current and proposed future research falls into the ‘endogeneity trap’, underscoring the need to reinvigorate practice-oriented research to capture the evolving new modes of urban entrepreneurialism.
Myasthenia gravis and pregnancy: Lessons learned from a complex a case report
Authors: Benlghazi Abdelhamid , Messaoudi Hamza , Belouad Moad , Bouhtouri Yassine , Benali Saad , Rachid Ait Bouhou , El Mangoub Fatima , Elhassani Moulay Mehdi , Kouach Jaouad
Published: May 2024

Myasthenia gravis primarily affects young adults, with a higher incidence in women, particularly between the ages of 20 and 30. When a young woman with myasthenia gravis contemplates pregnancy, healthcare providers must consider the potential implications. The interplay between hormonal factors and changes in the immune system establishes a complex relationship between myasthenia gravis and pregnancy. On one hand, pregnancy can alter the course of the disease, while on the other hand, the disease can impact the progression of the pregnancy and the well-being of the fetus. In this case report, we present the case of a 28-year-old woman suffering from myasthenia gravis who had undergone a thymectomy 5 years ago and was being treated with an acetylcholinesterase inhibitor. After a planned conception, the patient presented a relapse of her disease during the third trimester of pregnancy, with the onset of severe hydramnios. This observation highlights a specific case of decompensation of myasthenia gravis during pregnancy, associated with the presence of severe hydramnios. Subsequently, we delve into the existing literature to examine the reciprocal influence between myasthenia gravis and pregnancy, as well as the effects of anti-myasthenic treatments on pregnancy outcomes.
Choledochoduodenostomy combined with Billroth II procedure for extrahepatic biliary obstruction and duodenal perforation in a cat
Authors: Tomura Shintaro , Iwata Taisuke , Sugimoto Taichi , Nakashima Ko , Kojima Kazuhiro , Uchida Kazuyuki , Fujita Atsushi
Published: May 2024

Case summary

A 5-year-old neutered Somali cat presented with a 2-week history of icterus. Diagnostic imaging revealed extrahepatic biliary obstruction (EHBO) due to a common bile duct (CBD) mass. During exploratory laparotomy, a duodenal perforation was discovered incidentally. Choledochoduodenostomy combined with the Billroth II procedure was performed after resection of the CBD mass and the proximal duodenum to treat the EHBO and duodenal perforation. Based on histological and immunohistochemical findings, the CBD mass was diagnosed as a neuroendocrine carcinoma with gastrin-producing cell differentiation. The cat recovered almost uneventfully and was discharged 11 days after surgery. The cat survived for nearly 100 days without recurrence of EHBO or duodenal perforation; however, intermittent vomiting and weight loss persisted despite supportive medications.

Relevance and novel information

To the best of our knowledge, there is no detailed report on the application of choledochoduodenostomy combined with the Billroth II procedure in cats, as we used to treat the EHBO and duodenal perforation in the present case. As serum gastrin concentrations were elevated on the first day of hospitalisation, the CBD mass was diagnosed as a neuroendocrine carcinoma with gastrin-producing cell differentiation, which seemed to have caused not only EHBO but also duodenal perforation (Zollinger–Ellison syndrome). The cat survived for almost 100 days without any perioperative complications. However, this combined procedure might be considered as only a salvage option and not as a definitive treatment option in cats requiring simultaneous biliary and gastrointestinal reconstruction because postoperative supportive care could not improve the cat’s condition or maintain its quality of life.
An innovative technological infrastructure for managing SARS-CoV-2 data across different cohorts in compliance with General Data Protection Regulation
Authors: Dellacasa Chiara , Ortali Maurizio , Rossi Elisa , Abu Attieh Hammam , Osmo Thomas , Puskaric Miroslav , Rinaldi Eugenia , Prasser Fabian , Stellmach Caroline , Cataudella Salvatore , Agarwal Bhaskar , Mata Naranjo Juan , Scipione Gabriella
Published: May 2024

Background

The ORCHESTRA project, funded by the European Commission, aims to create a pan-European cohort built on existing and new large-scale population cohorts to help rapidly advance the knowledge related to the prevention of the SARS-CoV-2 infection and the management of COVID-19 and its long-term sequelae. The integration and analysis of the very heterogeneous health data pose the challenge of building an innovative technological infrastructure as the foundation of a dedicated framework for data management that should address the regulatory requirements such as the General Data Protection Regulation (GDPR).

Methods

The three participating Supercomputing European Centres (CINECA - Italy, CINES - France and HLRS - Germany) designed and deployed a dedicated infrastructure to fulfil the functional requirements for data management to ensure sensitive biomedical data confidentiality/privacy, integrity, and security. Besides the technological issues, many methodological aspects have been considered: Berlin Institute of Health (BIH), Charité provided its expertise both for data protection, information security, and data harmonisation/standardisation.

Results

The resulting infrastructure is based on a multi-layer approach that integrates several security measures to ensure data protection. A centralised Data Collection Platform has been established in the Italian National Hub while, for the use cases in which data sharing is not possible due to privacy restrictions, a distributed approach for Federated Analysis has been considered. A Data Portal is available as a centralised point of access for non-sensitive data and results, according to findability, accessibility, interoperability, and reusability (FAIR) data principles. This technological infrastructure has been used to support significative data exchange between population cohorts and to publish important scientific results related to SARS-CoV-2.

Conclusions

Considering the increasing demand for data usage in accordance with the requirements of the GDPR regulations, the experience gained in the project and the infrastructure released for the ORCHESTRA project can act as a model to manage future public health threats. Other projects could benefit from the results achieved by ORCHESTRA by building upon the available standardisation of variables, design of the architecture, and process used for GDPR compliance.
Telestroke network to robotic telestroke network: How to upgrade regional stroke care to include remote robotics?
Authors: Charbonnier Guillaume , Consoli Arturo , Bonnet Louise , Biondi Alessandra , Vuillier Fabrice , Rabenorosoa Kanty , Mendes Pereira Vitor , Moulin Thierry
Published: May 2024

Objective

Selected patients with large vessel occlusion (LVO) strokes can benefit from endovascular therapy (EVT). However, the effectiveness of EVT is largely dependent on how quickly the patient receives treatment. Recent technological developments have led to the first neurointerventional treatments using robotic assistance, opening up the possibility of performing remote stroke interventions. Existing telestroke networks provide acute stroke care, including remote administration of intravenous thrombolysis (IVT). Therefore, the introduction of remote EVT in distant stroke centers requires an adaptation of the existing telestroke networks. The aim of this work was to propose a framework for centers that are potential candidates for telerobotics according to the resources currently available in these centers.

Methods

In this paper, we highlight the future challenges for including remote robotics in telestroke networks. A literature review provides potential solutions.

Results

Existing telestroke networks need to determine which centers to prioritize for remote robotic technologies based on objective criteria and cost-effectiveness analysis. Organizational challenges include regional coordination and specific protocols. Technological challenges mainly concern telecommunication networks.

Conclusions

Specific adaptations will be necessary if regional telestroke networks are to include remote robotics. Some of these can already be put in place, which could greatly help the future implementation of the technology.
“Interrogating ‘Chinese imperialism’: Multi-polarity, inter-imperialist rivalry, and the New Cold War with China”
Authors: Davis Stuart
Published: May 2024

This article serves as an introduction to the special issue “China and the Global South: Interrogating Imperialist Ambitions.” It begins the issue by laying out the major theoretical positions developed in recent years regarding so-called “Chinese imperialism” and highlights the framing effects of the US-propagated New Cold War with China on how nations in the Global South interact with both China and the US. Finally, it briefly introduces the five articles that make up the special issue.
Advanced Imaging Guidance for Ductus Venosus Stenting in Obstructed Total Anomalous Pulmonary Venous Return
Authors: Mejia Ernesto , Morgan Gareth J. , Stone Matthew , Shorofsky Michael J. , Jaggers James , Zablah Jenny E.
Published: May 2024

Obstructed infracardiac total anomalous pulmonary venous return is nearly always a surgical emergency in which infants present in severe cardiopulmonary distress. Ductal venosus stenting can provide a temporizing option for premature, low birth weight infants with high risk for surgical complications. In challenging anatomic cases, virtual reality, 3D-printed models, and fusion image guidance can aid in procedural planning and provide support for successful intervention.
Explaining Enterprise Litigation Success with fsQCA: The Role of Local Economic Environment, Policy Preferences, Case Complexity, and Party Capability
Authors: Zhang Shilin , Yu Guilan , Qu Yong , Chen Lifang
Published: May 2024

Since the initiation of reforms and the opening-up policy in China, enterprises have played a pivotal role as a key pillar of local economic growth. Within the context of harmonious labor relations, the effective means of assisting enterprises in safeguarding their particular interests during labor disputes remains unresolved. Fuzzy-set qualitative comparative analysis (fsQCA) is able to capture a higher degree of complexity by testing theory-based conditions and environmental effects rather than focusing on a single effect of a single variable. Therefore, coming from a new institutionalist perspective, this study employed fsQCA to explore the causal relationships among factors including local economic environment, policy preferences, case complexity, party capability, and enterprise litigation success. Analyzing data from 28,685 labor dispute cases from Guangdong Province between 2015 and 2019, and utilizing enterprise data from the China Economic Information Network and the National Enterprise Credit Information Publicity System, we found that: (1) it is difficult for enterprises to succeed substantially in a single-antecedent condition; (2) There are four pathways to forming high enterprise victory, each involving different configurations of eight conditions; and (3) Judicial preference, employee legal representative, and enterprise legal representative are central elements in all aforementioned pathways, even if they are not necessary conditions for the success of high enterprises. The research results enrich our understanding of the current style of institutionalism, providing a valuable reference point for effectively improving the legal success of enterprises and improving the harmonious development of labor relations, with far-reaching implications for the further study of the judicial protection of enterprise rights under the socialist system.
Can Social Media Use Be More Health-Promoting? Description and Pilot Evaluation of a School-Based Program to Increase Awareness and Reflection on the Use of Social Media
Authors: Andersen Amanda Iselin Olesen , Finserås Turi Reiten , Hjetland Gunnhild Johnsen , Bøe Tormod , Sivertsen Børge , Colman Ian , Hella Randi Træland , Skogen Jens Christoffer
Published: May 2024

Social media plays a significant role in adolescents’ lives, with both positive and negative effects. Implementing interventions to mitigate the negative aspects and enhance the positive ones could improve adolescents’ well-being. Unfortunately, there is a scarcity of evidence-based interventions available. To fill this gap, we have developed a school-based program based on combining evidence-based and consensus-based approaches, incorporating input from adolescents, school personnel, researchers, and municipal advisers. This paper describes the program’s content and principles, and presents the results from a pilot evaluation, which assesses feedback from pupils and teachers, thereby informing potential enhancements and the program’s overall significance. The intervention description encompasses theoretical perspectives, behavior change techniques, and procedural details. Pupils ( n = 266; 16+ years) evaluated the program concerning satisfaction, relevance, importance, and usefulness through a questionnaire. Additionally, exploratory focus group interviews were conducted with seven teachers and eleven pupils to gather their perspectives on the program’s relevance, impact, and potential changes to the theme-based teaching. Results from the pilot showed an average score of 7.3/10 for overall satisfaction with the program. Sub-questions assessing perceived relevance, engagement, and usefulness averaged between 6.7 and 7.5. Gender differences were observed, with boys tending to rate the program lower than girls. In focus group interviews, the pupils expressed increasing awareness of their own and others’ social media use, that the topic was important and exciting, and that the program generally worked well. The pupils’ evaluation indicates the need for this kind of program described in this study.
Social Media News as a Predictor of Sports Gambling Salience, Attitudes, and Behaviors in the United States
Authors: Holbert R. Lance , Holbert Leland G.
Published: May 2024

Gambling has become a more prominent aspect of American sports culture after the 2018 United States Supreme Court decision offered in Murphy v National Collegiate Athletic Association that rendered the Professional and Amateur Sports Protection Act (PASPA) unconstitutional. A secondary analysis of 2022 PEW American Trends Panel (ATP) data ( N = 3900) explores social media news exposure and satisfaction as predictors of the salience of, attitudes toward, and behavioral engagement with sports gambling. Social media news exposure and satisfaction do not predict individual-level salience of the expanded legalization of sports betting. However, social media news exposure and an individual’s satisfaction with news content on X, Facebook, and YouTube positively predict feelings that sports betting is good for society and sports culture. Social media news exposure positively predicts sports gambling behaviors. A broader media effects research agenda pertaining to sports gambling is outlined based on these findings.
Differently Imagined: Minorities and Majoritarian Politics in India
Authors: Ranjan Amit
Published: May 2024

The rise of the BJP is usually credited for the shift towards the Hindutva politics in India, but other political parties are also not immune to using confession for electoral purposes. This article discusses how, despite living together for years, a large number of Hindus differently imagine the citizens belonging to the minority religious communities and vice versa. The article then examines the political events of the 1980s and analyses how they are linked with the contemporary social and political developments in India.
A Longer Life or a Quality Death? A Discrete Choice Experiment to Estimate the Relative Importance of Different Aspects of End-of-Life Care in the United Kingdom
Authors: Skedgel Chris , Mott David John , Elayan Saif , Cramb Angela
Published: May 2024

Background. Advocates argue that end-of-life (EOL) care is systematically disadvantaged by the quality-adjusted life-year (QALY) framework. By definition, EOL care is short duration and not primarily intended to extend survival; therefore, it may be inappropriate to value a time element. The QALY also neglects nonhealth dimensions such as dignity, control, and family relations, which may be more important at EOL. Together, these suggest the QALY may be a flawed measure of the value of EOL care. To test these arguments, we administered a stated preference survey in a UK-representative public sample. Methods. We designed a discrete choice experiment (DCE) to understand public preferences over different EOL scenarios, focusing on the relative importance of survival, conventional health dimensions (especially physical symptoms and anxiety), and nonhealth dimensions such as family relations, dignity, and sense of control. We used latent class analysis to understand preference heterogeneity. Results. A 4-class latent class multinomial logit model had the best fit and illustrated important heterogeneity. A small class of respondents strongly prioritized survival, whereas most respondents gave relatively little weight to survival and, generally speaking, prioritized nonhealth aspects. Conclusions. This DCE illustrates important heterogeneity in preferences within UK respondents. Despite some preferences for core elements of the QALY, we suggest that most respondents favored what has been called “a good death” over maximizing survival and find that respondents tended to prioritize nonhealth over conventional health aspects of quality. Together, this appears to support arguments that the QALY is a poor measure of the value of EOL care. We recommend moving away from health-related quality of life and toward a more holistic perspective on well-being in assessing EOL and other interventions.

Highlights

Advocates argue that some interventions, including but not limited to end-of-life (EOL) care, are valued by patients and the public but are systematically disadvantaged by the quality-adjusted life-year (QALY) framework, leading to an unfair and inefficient allocation of health care resources. Using a discrete choice experiment, we find some support for this argument. Only a small proportion of public respondents prioritized survival in EOL scenarios, and most prioritized nonhealth aspects such as dignity and family relations. Together, these results suggest that the QALY may be a poor measure of the value of EOL care, as it neglects nonhealth aspects of quality and well-being that appear to be important to people in hypothetical EOL scenarios.
Enhanced sensitivity to pitch perception and its possible relation to language acquisition in autism
Authors: Hisaizumi Megumi , Tantam Digby
Published: May 2024

Background and aims

Fascinations for or aversions to particular sounds are a familiar feature of autism, as is an ability to reproduce another person's utterances, precisely copying the other person's prosody as well as their words. Such observations seem to indicate not only that autistic people can pay close attention to what they hear, but also that they have the ability to perceive the finer details of auditory stimuli. This is consistent with the previously reported consensus that absolute pitch is more common in autistic individuals than in neurotypicals. We take this to suggest that autistic people have perception that allows them to pay attention to fine details. It is important to establish whether or not this is so as autism is often presented as a deficit rather than a difference. We therefore undertook a narrative literature review of studies of auditory perception, in autistic and nonautistic individuals, focussing on any differences in processing linguistic and nonlinguistic sounds.

Main contributions

We find persuasive evidence that nonlinguistic auditory perception in autistic children differs from that of nonautistic children. This is supported by the additional finding of a higher prevalence of absolute pitch and enhanced pitch discriminating abilities in autistic children compared to neurotypical children. Such abilities appear to stem from atypical perception, which is biased toward local-level information necessary for processing pitch and other prosodic features. Enhanced pitch discriminating abilities tend to be found in autistic individuals with a history of language delay, suggesting possible reciprocity. Research on various aspects of language development in autism also supports the hypothesis that atypical pitch perception may be accountable for observed differences in language development in autism.

Conclusions

The results of our review of previously published studies are consistent with the hypothesis that auditory perception, and particularly pitch perception, in autism are different from the norm but not always impaired. Detail-oriented pitch perception may be an advantage given the right environment. We speculate that unusually heightened sensitivity to pitch differences may be at the cost of the normal development of the perception of the sounds that contribute most to early language development.

Implications

The acquisition of speech and language may be a process that normally involves an enhanced perception of speech sounds at the expense of the processing of nonlinguistic sounds, but autistic children may not give speech sounds this same priority.
Prehospital stroke diagnostics using three different simulation methods: A pragmatic pilot study
Authors: Christensen Emma , Fagerheim Bugge Helge , Hagemo Jostein , Larsen Karianne , Harring Astrid KV , Gleditsch Jostein , Ibsen Jørgen , Guterud Mona , Sandset Else Charlotte , Hov Maren Ranhoff
Published: May 2024

Introduction:

The optimal pathway for ultra-early diagnostics and treatment in patients with acute stroke remains uncertain. The aim of this study was to investigate how three different methods of simulated, rural prehospital computed tomography (CT) affected the time to prehospital treatment decision in acute stroke.

Materials and Methods:

In this pragmatic, simulation, pilot study of prehospital CT we investigated a conventional ambulance with transport to a standard care rural stationary CT machine managed by paramedics, a Mobile Stroke Unit (MSU), and a helicopter with a simulated CT machine. Each modality completed 20 real-life dispatches combined with simulation of predetermined animated patient cases with acute stroke symptoms and CT images. The primary endpoint of the study was the time from alarm to treatment decision.

Results:

Median time from alarm to the treatment decision differed significantly between the three groups ( p = 0.0005), with 38 min for rural CT, 33 min for the MSU, and 30 min for the helicopter. There was no difference in time when comparing rural CT with MSU, nor when comparing the MSU with the helicopter. There was a difference in time to treatment decision between the rural CT and the helicopter ( p < 0.0001). The helicopter had significantly lower estimated time from treatment decision to hospital ( p = 0.001).

Disscussion/Conclusion:

Prehospital CT can be organized in several ways depending on geography, resources and need. Further research on paramedic run rural CT, MSU in rural areas, and helicopter CT is needed to find the optimal strategy.
New models for prediction of postoperative pulmonary complications in lung resection candidates
Authors: Svoboda Michal , Cundrle Ivan , Plutinsky Marek , Homolka Pavel , Mitas Ladislav , Chovanec Zdenek , Olson Lyle J. , Brat Kristian
Published: May 2024

Introduction

In recent years, ventilatory efficiency (minute ventilation (V′E)/carbon dioxide production (V′CO2) slope) and partial pressure of end-tidal carbon dioxide (PETCO2) have emerged as independent predictors of postoperative pulmonary complications (PPC). Single parameters may give only partial information regarding periprocedural hazards. Accordingly, our aim was to create prediction models with improved ability to stratify PPC risk in patients scheduled for elective lung resection surgery.

Methods

Thispost hocanalysis was comprised of consecutive lung resection candidates from two prior prospective trials. All individuals completed pulmonary function tests and cardiopulmonary exercise testing (CPET). Logistic regression analyses were used for identification of risk factors for PPC that were entered into the final risk prediction models. Two risk models were developed; the first used restPETCO2(for patients with no available CPET data), the second usedV′E/V′CO2slope (for patients with available CPET data). Receiver operating characteristic analysis with the De-Long test and area under the curve (AUC) were used for comparison of models.

Results

The dataset from 423 patients was randomly split into the derivation (n=310) and validation (n=113) cohorts. Two final models were developed, both including sex, thoracotomy, “atypical” resection and forced expiratory volume in 1 s/forced vital capacity ratio as risk factors. In addition, the first model also included restPETCO2, while the second model usedV′E/V′CO2slope from CPET. AUCs of risk scores were 0.795 (95% CI: 0.739–0.851) and 0.793 (95% CI: 0.737–0.849); both p<0.001. No differences in AUCs were found between the derivation and validation cohorts.

Conclusions

We created two multicomponental models for PPC risk prediction, both having excellent predictive properties.