bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of tranexamic acid on intraoperative blood loss in pediatric osteotomies around the hip: Study protocol for a double-blind randomized placebo-controlled trial
Authors: van Kouswijk Hilde W , Tolk Jaap J , van Bommel Christian PE , Reijman Max , Kempink Dagmar RJ , de Witte Pieter B
Published: October 2023

Background:

Proximal femoral and/or pelvic osteotomies (PFPOs) can be indicated for a multitude of hip pathologies in (often asymptomatic) children, to prevent future hip problems. These procedures can result in significant blood loss. Tranexamic acid (TXA) is an antifibrinolytic agent routinely administered in adult trauma and joint reconstruction surgery to reduce blood loss. TXA is also registered for use in children and reported safe and beneficial for pediatric trauma, cardiac, and spinal surgery. However, for pediatric orthopedics, particularly for PFPOs, the available evidence is limited. Therefore, the current trial will investigate the potential reducing effect of preoperative TXA on intraoperative blood loss in pediatric PFPOs.

Methods:

In this single-center, double-blind, randomized placebo-controlled trial, we aim to include 180 participants aged from 1 to 18 years undergoing PFPOs for any indication at our institution. Participants will be randomized to receive either TXA or placebo (saline) during anesthetic induction. The primary outcome is intraoperative estimated blood loss (mL/kg), which is determined gravimetrically. Secondary outcomes include the percentage of patients with excessive blood loss (>20 mL/kg), procedure time and hospital stay, and postoperative hemoglobin level changes.

Discussion:

This will be the first prospective study investigating the effect of preoperative TXA on intraoperative blood loss in pediatric PFPOs. Its results will help to determine whether it would be advisable to adopt preoperative TXA as a standard medication to minimize blood loss and prevent complications in this vulnerable population.

Trial registration:

EudraCT: 2022-002384-30. Prospectively registered on September 26, 2022.
Personalized Prediction of Change in Fasting Blood Glucose Following Basal Insulin Adjustment in People With Type 2 Diabetes: A Proof-of-Concept Study
Authors: Thomsen Camilla Heisel Nyholm , Kronborg Thomas , Hangaard Stine , Vestergaard Peter , Hejlesen Ole , Jensen Morten Hasselstrøm
Published: October 2023

Aims:

For people with type 2 diabetes treated with basal insulin, suboptimal glycemic control due to clinical inertia is a common issue. Determining the optimal basal insulin dose can be difficult, as it varies between individuals. Thus, insulin titration can be slow and cautious which may lead to treatment fatigue and non-adherence. A model that predicts changes in fasting blood glucose (FBG) after adjusting basal insulin dose may lead to more optimal titration, reducing some of these challenges.

Objective:

To predict the change in FBG following adjustment of basal insulin in people with type 2 diabetes using a machine learning framework.

Methods:

A multiple linear regression model was developed based on 786 adults with type 2 diabetes. Data were divided into training (80%) and testing (20%) sets using a ranking approach. Forward feature selection and fivefold cross-validation were used to select features.

Results:

Participants had a mean age of approximately 59 years, a mean duration of diabetes of 12 years, and a mean HbA1c at screening of 65 mmol/mol (8.1%). Chosen features were FBG at week 2, basal insulin dose adjustment from week 2 to 7, trial site, hemoglobin level, and alkaline phosphatase level. The model achieved a relative absolute error of 0.67, a Pearson correlation coefficient of 0.74, and a coefficient of determination of 0.55.

Conclusions:

A model using FBG, insulin doses, and blood samples can predict a five-week change in FBG after adjusting the basal insulin dose in people with type 2 diabetes. Implementation of such a model can potentially help optimize titration and improve glycemic control.
From the Standpoint of Instructional Designers: Critically Investigating the Coordination of ID Contributions to Collaborative Online Course Development
Authors: Lubin Laura , Reio Thomas G.
Published: October 2023

Instructional Designers (IDs) are talented assets to higher education institutions (HEIs) that have positioned online course development as part of long-term strategic plans. This study investigated the experiences of IDs involved in online course development while working dyadically with faculty members in U.S. HEIs. The study focused on the textually mediated coordination of social working relationships and engagement outcomes on the professional identities of eight ID subjects; analysis of HEI websites and observational field notes were included in the dataset. Five thematic narratives emerged within the analysis: a question of professional (dis)regard, a culture of complex collaborative work, a conversation of representation in HEI governance, a translocal chain of bossy (mis)coordination, and a song of silent, external attributions. These themes provided a platform for disseminating ID lived narratives and perspectives within a relational framework informed by Human Resource Development (HRD), where, in the literature, their experiences can inform and benefit the improved performance of HEIs engaged in online program production and governance.
Response to Lubin and Reio, “From the Standpoint of Instructional Designers: Critically Investigating the Coordination of ID Contributions to Collaborative Online Course Development”
Authors: Carliner Saul
Published: October 2023

This response provides a response to the Lubin and Reio article, Response to Lubin and Reio, “From the Standpoint of Instructional Designers: Critically Investigating the Coordination of ID Contributions to Collaborative Online Course Development.” Specifically, it explores persistent gaps in the literature on the relationships between faculty and of instructional designers when designing asynchronous online courses in higher education: (a) lack of the perspectives of faculty and administrators in the research; (b) a lack of a formal definition of collaboration and, along with that, a consideration of the other roles that instructional designers play in higher education; (c) issues regarding the status of faculty and instructional designers in higher education; and (d) copyright ownership issues and their impact on working relationships. The response argues that, until the research explores these issues, the ability of this line of research to effectively advocate for change in the relationships between faculty and instructional designers is limited.
Long-term use of triple antibiotic-induced black hairy tongue: A case report
Authors: Sun Kin-Weng , Yang Zhi-Cheng
Published: October 2023

Black hairy tongue is a rare condition, characterized by a black discoloration and hair-like structure appearing on the dorsal surface of the tongue. The mechanism of black hairy tongue remains unclear but could be predisposed by multiple factors. We described a case of a 53-year-old Chinese female with a diagnosis of bronchiectasis complicated with Mycobacterium abscessus infection, and a triple antibiotic regimen was prescribed for the infection. One month later, a black hairy tongue appeared. The clinical pharmacist was consulted to investigate the association of medication-related factors by the attending clinician, and the clinical pharmacist identified the potential cause and suggested an appropriate treatment for the black hairy tongue. The black hairy tongue disappeared and did not recur during subsequent treatment.
Clinical remission of feline sino-nasal aspergillosis despite evidence of persistent infection
Authors: Fawsitt Jack , Russell Oliver , Alexander Akash , Peschard Anne-Lorraine , Wong Hannah , Kortum Andre
Published: October 2023

Case summary

Feline sino-nasal aspergillosis is a rare condition with only sparse heterogeneous reports in the literature regarding its treatment. This report describes the presentation, treatment and outcome of a cat with sino-nasal aspergillosis treated by meticulous debridement in combination with topical and systemic azole therapy. Diagnosis was based on MRI, in combination with rhinoscopic assessment and visualisation of fungal plaques, followed by histopathology, fungal culture and panfungal PCR. The cat was treated by debridement of fungal plaques via anterior rhinoscopy and frontal sinusotomy and local instillation of 1% clotrimazole solution, followed by a 4-week course of oral itraconazole. Histopathology confirmed fungal rhinitis and culture identified Aspergillus fumigatus and Aspergillus versicolor. Clinical remission was achieved after treatment; however, evidence of persistent infection was confirmed in the post-mortem examination 8 months after the cat was euthanased for unrelated reasons.

Relevance and novel information

Despite clinical remission, the persistence of fungal infection post mortem highlights the challenges of monitoring the response to treatment and illustrates that the resolution of clinical signs does not necessarily equate with a disease cure.
Integrating digital solutions into national health data systems through public–private collaboration: An early experience of the SPICE platform in Kenya
Authors: Gathecha Gladwell , Ombiro Oren , Shelden Kelly , Stake Anne , Murugami Mary , Mungai Ezra , Odhiambo George , Maree Ephantus , Muthusamy Rajkumar , Marimuthu M , Daniel Duke , Angula Eric , Seshadri Swathi , Nderitu Eric , Onyango Elizabeth , Sitienei Joseph
Published: October 2023

Public–private collaborative efforts to address healthcare challenges in low- and middle-income countries have been the focus of digital initiatives to improve both access and quality of health services. We report the early feasibility, experience, and learnings of migrating healthcare data generated from a proprietary, privately owned cloud-based environment into an on-premises National Health Data Center (NHDC) in compliance with Kenya's data management legislation. In 2018, Medtronic LABS entered into a partnership with the Kenya Ministry of Health and other stakeholders to improve access to quality services and data availability for non-communicable diseases (diabetes and hypertension), anchored on the SPICE digital health platform. Data migration from SPICE to the NHDC necessitated the establishment of multi-stakeholder coordination structures, alignment on system configuration requirements, provisioning of on-premises servers, data replication and monitoring. The data replication process showed consistency in format and content with no evidence of data loss. The monitoring of the server uptime and availability, however, exposed overall downtime of 15% of the total time tracked between April and December 2022 caused by Internet Protocol address configuration issues, power outages, firewall rule changes, and unscheduled system maintenance. Monthly tracked downtime however reduced from a high of 28% in April 2022 to 5% in December 2022. Our early experience shows that data migration from proprietary host environments to public “one-stop-shop” national data warehouses are feasible provided investments are made in the requisite infrastructure, software and human resource capacity to ensure long-term sustainability, maintenance, and scale to match cloud-based data hosting. Further, digital health solutions developed in collaboration with non-state actors can be integrated into national data systems, saving Governments the cost and efforts of building similar tools while leveraging private sector capacity.
Crowdsourcing smartphone data for biomedical research: Ethical and legal questions
Authors: Lang Michael , McKibbin Kyle , Shabani Mahsa , Borry Pascal , Gautrais Vincent , Verbeke Kamiel , Zawati Ma’n H
Published: October 2023

The use of smartphones has greatly increased in the last decade and has revolutionized the way that health data are being collected and shared. Mobile applications leverage the ubiquity and technological sophistication of modern smartphones to record and process a variety of metrics relevant to human health, including behavioral measures, clinical data, and disease symptoms. Information processed by mobile applications may have significant utility for increasing biomedical knowledge, both through conventional research and emerging discovery paradigms such as citizen science. However, the ways in which smartphone-collected data may be used in nontraditional modes of biomedical discovery are not well understood, such as using data to train artificially intelligent algorithms and for product development purposes. This paper argues that the use of mobile health data for algorithm training and product development is (a) likely to become a prominent fixture in medicine, (b) likely to raise significant ethical and legal challenges, and (c) warrants immediate scrutiny by policymakers and scholars. We introduce the concept of “smartphone-crowdsourced medical data,” or SCMD, and set out a broad research agenda for addressing concerns associated with this new and potentially momentous practice. We conclude that SCMD for algorithm training raises a number of ethical and legal issues which require further scholarly attention to ensure that individual interests are protected and that emerging health information sources can be used in ways that maximally, and safely, promote medical innovation.
Leveraging digital technology for social connectedness among adults with chronic conditions: A systematic review
Authors: Wright Pamela J , Raynor Phyllis A , Bowers Dana , Combs Elizabeth M , Corbett Cynthia F , Hardy Hannah , Patel Khushi
Published: October 2023

Purpose

To review the evidence about the impact of digital technology on social connectedness among adults with one or more chronic health conditions.

Methods

PubMed, Embase, Social Sciences, CINAHL, and Compendex were systematically searched for full-text, peer-reviewed empirical evidence published between 2012 and 2023 and reported using the PRISMA flow diagram. Articles were critically appraised applying the Joanna Briggs Institute checklists. Specific data were extracted based on the framework for social identity and technology approaches for health outcomes and then analyzed and synthesized.

Results

Thirty-four studies met study criteria. Evidence showed heterogeneity among research methodology, chronic health conditions, digital technology, and health outcomes. Technology use was influenced by factors such as usability, anonymity, availability, and control. More advanced digital technologies require higher digital literacy and improved accessibility features/modifications. Social support was the most measured aspect of social connectedness. The emotional and informational forms of social support were most reported; instrumental support was the least likely to be delivered. Self-efficacy for using technology was considered in seven articles. Sixteen articles reported health outcomes: 31.2% ( n = 5) described mental health outcomes only, 18.8% ( n = 3) reported physical health outcomes only, 31.2% ( n = 5) detailed both physical and mental health outcomes, whereas 18.8% ( n = 3) denoted well-being or quality-of-life outcomes. Most often, health outcomes were positive, with negative outcomes for selected groups also noted.

Conclusion

Leveraging digital technology to promote social connectedness has the potential to affect positive health outcomes. Further research is needed to better understand the social integration of technology among populations with different contexts and chronic health conditions to enhance and tailor digital interventions.
Factors of regional variations in national cancer screening rates during the COVID-19 pandemic
Authors: Park Jong-Ho , Lim Jihye
Published: October 2023

Objectives

The objective of this study was to analyze factors of regional variation in national cancer screening rate in Korea using regional cancer screening rate data. In addition, during the COVID-19 pandemic in 2020, we tried to identify factors affecting cancer screening rate, including COVID-19 situation in the region.

Methods

Data provided by the National Health Insurance Service Center were used for the national cancer screening rate index data in 2020 in 229 regions. A correlation analysis was conducted to find correlation between national cancer screening rate and variation factors in the national cancer screening rate in the region to be analyzed. In addition, to confirm spatial dependence of the national cancer screening rate among regions, a global spatial autocorrelation (Global Moran's I) analysis was conducted.

Results

In the 2020 COVID-19 situation, variable factors affecting the national cancer screening rate among regions in Korea were the regional number of populations of cumulative COVID-19 confirmed cases, concern of damage caused by COVID-19 infection, income level, the proportion of the population graduating from middle school or lower, the average daily access time to general hospitals by car, and the average daily access time to hospitals and clinics by public transportation or walking.

Conclusions

Results of this study can be used to establish national digital health policies that reflect regional variation factors in situations such as the COVID-19 pandemic. It is believed that they can contribute to policies to promote community health in the future.
Innovating Teaching Practice Through Professional Learning Communities: Determining Knowledge Sharing and Program Value
Authors: Clark Andrew M. , Zhan Monica , Dellinger Justin T. , Semingson Peggy L.
Published: October 2023

The Professional Learning Community (PLC) model has been used to help faculty develop innovative teaching practices and diffuse effective strategies and resources throughout K-12 schools. Yet, whether and how PLCs influence research-focused higher education institutions remain unknown. Drawing on existing research on PLCs and the social network theory, this mixed-methods study investigated how participants shared what they learned during their time in the program to build greater capacity and the perceived benefits and weaknesses of the PLC model. We conducted semi-structured interviews ( n = 8) and a survey ( n = 77) among current PLC fellows and alumni at a large research university. The results based on social network analysis showed that PLC fellows shared knowledge and resources across departments and offices at the university, and these efforts led to additional collaborative research and grant applications. Results also indicate that PLC fellows valued the diversity of the program, developed skills that they used in their courses, gained confidence in their ability to share knowledge and resources, and appreciated the accountability the program provided. Furthermore, respondents rated the program positively and indicated that they were currently using the knowledge and skills gained to further develop innovative teaching practices as well as planning to continue to do so in the future. These findings suggest that the PLC model can be an effective way for universities to empower faculty to develop innovative teaching practices, and, by sharing what they have learned with others, to build capacity for innovative teaching and research practices across the institution.
Teaching AI-Enabled Business Communication in Higher Education: A Practical Framework
Authors: Riapina Natalia
Published: October 2023

This article presents a conceptual framework for integrating AI-enabled business communication in higher education. Drawing on established theories from business communication and educational technology, the framework provides comprehensive guidance for designing engaging learning experiences. It emphasizes the significance of social presence, cognitive load management, and constructivist learning principles. The framework is exemplified through various tasks, including role-playing with AI chatbots, analyzing nonverbal cues, communication simulations, interactive presentation assessments, and collaborative AI-supported projects. Practical considerations for implementation, including technological infrastructure, faculty training, ethics, curriculum integration, and assessment strategies, are discussed. Future directions and implications for business communication education are also explored.
The Use of Digital Telehealth for the Self-Management of Type 2 Diabetes Patients in Hinds County, Mississippi: A Pilot Study
Authors: Onyia Austine U , Berhie Girmay , Cecchetti Alfred , Hines Andre
Published: October 2023

Self-management is crucial for the management of type 2 diabetes. Remote patient monitoring via telehealth may enhance self-management and control of diabetes. A three-arm randomized controlled trial involving 90 participants randomized into two intervention groups and one control group was conducted. The purpose of this study is to test whether the use of a mobile phone-based app, with or without telehealth counseling, could improve HbA1c level, self-management, and health-related quality of life compared with usual care. The two intervention groups received a mobile phone with a self-management app. One intervention group additionally received telehealth counseling delivered by a diabetes specialist nurse for 6 months. All three groups continued to receive the usual care from their provider. The primary outcome is a reduction in HbA1c level. Secondary outcomes are self-management, health-related quality of life, depressive symptoms, and lifestyle changes. Data were analyzed using univariate and multivariate (descriptive, t-test, MANOVA) methods. There was a significant reduction in the HbA1c levels of participants after 3 and 6 months. There was also a significant difference in HbA1c levels between the control and two intervention groups. Pre- and posteducation surveys for intervention group 2 showed an improvement in the understanding of type 2 diabetes risk factors, diabetes, and self-management. Digital telehealth demonstrated considerable potential for reducing blood sugar levels, enhancing self-management, and improving the quality of life of type 2 diabetic patients. The addition of telehealth education and counseling further improved the positive outcomes.
Situational Leadership Role-Play and Debrief: An Exploration of Useful Components and Limitations
Authors: Egan John D.
Published: October 2023

Situational leadership is a popular management training tool, yet scholars criticize the model’s limitations and conflicted empirical support. Management educators are left with a lack of clarity on how to present situational leadership, and this article seeks to address the gap in teaching practice. The experiential role-play activity presented, intended for late-undergraduate and graduate students, provides a basic understanding of situational leadership and its application. The ensuing debrief and discussion explores critical perspectives, limitations, and empirically supported components of the model. Following this experience, students have a complex understanding of situational leadership as they consider thoughtful, cautioned future application. This article also explores recent literature that provides some empirical evidence for using components of situational leadership as well as important leadership concepts highlighted by the model. Management educators could immediately implement this activity and discussion in the classroom.
Tackling Health Inequities: A Unique, Asynchronous Course Designed Through Peer-to-Peer Methods
Authors: Burdzy Alexander , Dai Michelle , Nagubandi Veda , Nguyen My , Marten Carly , Paul-Quinn Jennifer
Published: October 2023

OBJECTIVES

This study investigates the efficacy and feasibility of an asynchronous, peer-to-peer health disparities enrichment course on postbaccalaureate prehealth students’ knowledge, behaviors, and reaction to course materials.

INTRODUCTION

Growing awareness of social inequities has prompted educators of prehealth and medical students to explore student education by addressing systemic healthcare issues. This cross-sectional study assessed reactions, learning, and self-reported behavior changes in students after taking the course “Social Determinants, Disparities, and Preparing for the Future of Healthcare” (SDDH).

METHODS

The curriculum was designed by prehealth postbaccalaureate students for their peers. Course goals were to educate participants on social determinants of health and to build cultural and structural competence in their roles as future healthcare professionals. SDDH is an asynchronous, noncredit-bearing, 5-h online course with 10 modules covering various topics. The Kirkpatrick Model was used to assess the effectiveness of the curriculum, alongside qualitative and quantitative analyses of student performance.

RESULTS

Out of the 102 active students in the prehealth program that accepted the invitation to join, 29 students successfully completed the course (rate of completion = 28%). On average, students expressed positive reactions and attitudes toward the course and experienced an observable increase in knowledge assessment scores upon curriculum completion ( P-value = .0002). Students’ self-reported observations demonstrated sustained behavioral change 3 months after course completion.

CONCLUSION

It is critical to educate prehealth students on health disparities, structural, and cultural competence. A course such as SDDH may help prehealth students build effective communication skills for advocacy and develop an empathetic, patient-centered approach earlier on in their career pursuit. Some barriers to students completing the entire course include its length, uncredited status, and voluntary self-enrollment.
Evaluation of extended depth-of-focus hydrophobic intraocular lens with an optic concept based on combination of high-order aberrations
Authors: Stodulka Pavel , Pracharova Zuzana
Published: October 2023

Background:

Extended depth-of-focus (EDOF) intraocular lenses (IOLs) provide a continuous range of uncorrected vision at different distances.

Objective:

To assess visual acuity, refractive outcomes, and patient satisfaction after cataract surgery using the LuxSmart EDOF IOL (Bausch+Lomb).

Design:

A two-center, prospective observational clinical study.

Methods:

This study includes patients who have undergone bilateral phacoemulsification with bilateral implantation of the LuxSmart EDOF IOL, with the aim of achieving emmetropia. Visual acuity (VA) and subjective refraction were obtained in all patients preoperatively and at 1 week, 1 month, 3 months, and 6 months postoperatively. Subjective measures were obtained using the Catquest-9SF questionnaire and the Patient-Reported Spectacle Independence Questionnaire (PRSIQ). Contrast sensitivity and a glare assessment were undertaken postoperatively. Safety outcomes were additionally assessed.

Results:

Sixty eyes from thirty patients were recruited for this study. The mean spherical equivalent was 1.04 ± 1.67 D preoperatively and −0.30 ± 0.46 D at 6 months. Monocular uncorrected distance VA was 0.57 ± 0.32 (logMAR) preoperatively and 0.09 ± 0.12 (logMAR) at 6 months. Mean 6-month monocular uncorrected VA was 0.11 ± 0.13, 0.12 ± 0.15, and 0.31 ± 0.15 (logMAR) at 80, 66, and 40 cm, respectively. More than 90% of patients were either fairly or very satisfied with their vision. There was one case of suspected vitreomacular traction postoperatively.

Conclusion:

The LuxSmart EDOF IOL offers good refractive, VA, and safety outcomes. The single elongated focal point designed to enhance the DOF shows good results for VA and patient satisfaction.
An Interesting Case of ABCD: A Blocking Complementary Drug
Authors: Birajdar Avinash , Parvathareddy Krishna Mala Konda Reddy , Nagula Praveen , Srinivas Ravi
Published: October 2023

Ginkgo biloba leaf extract is a common herbal supplement globally. It became popular in recent times, due to its stated benefits of improving memory. We report a case of a 66-year-old female having rhythm abnormality secondary to this supplement. She had no cardiac ailment, and the rhythm abnormality resolved on the withdrawal. Every arrhythmia evaluation checklist should include the use of Ginkgo biloba and other supplements.
Making Every Minute Count: Identifying Instructional Opportunities for IEP Goals During Community-Based Work Experiences
Authors: Brenner Hannah R. , Dymond Stacy K.
Published: October 2023

Transition-age students with extensive support needs often participate in community-based work experiences (CBWEs) in preparation for competitive, integrated employment. CBWEs help students gain exposure to different careers, acquire employment skills, and generalize skills learned at school to community settings. Despite their benefits, CBWEs have been known to create scheduling conflicts and decrease school-based instructional time for special educators who must address student goals in academic and functional skill areas. Identifying authentic opportunities to address Individualized Education Program (IEP) goals during students’ CBWEs is one solution that can assist special educators who are faced with such challenges. An existing tool, commonly known as an IEP Matrix, may be particularly useful in helping teachers navigate this process. In this article, we describe how to develop an IEP matrix and assess the feasibility of instruction on IEP goals within CBWEs. We also provide recommendations to consider when identifying and evaluating instructional opportunities.
Is the inverse method more effective than the balance method on learning linear equations? A cross-cultural experimental study between Australia and Malaysia
Authors: Ngu Bing Hiong , Phan Huy P. , Hong Kian Sam , Usop Hasbee
Published: October 2023

We conducted a cross-cultural experimental study, consisting of Australian students ( N = 57) and Malaysian students ( N = 75) on learning to solve one-step and two-step linear equations. Central to our research inquiry is the perceived difference between two instructional methods: the balance method of learning vs. the inverse method of learning. The balance method and the inverse method differ in their use of mathematical operations to solve linear equations (e.g., +4 on both sides, balance operation, vs. –4 becomes +4, inverse operation). According to cognitive load theory, the balance operation imposes twice the level of element interactivity (i.e., interaction between elements) than that of the inverse operation. Our findings, ascertained from univariate analysis of variance (ANOVA) testing, show that for the Australian students, the balance group outperformed the inverse group. Such results do not support our hypothesis and contradict with previous findings, where the inverse group outperformed the balance group in a Malaysian context. No statistically significant difference was found between the two groups of Malaysian students. In line with our hypothesis, the Malaysian students outperformed the Australian students with respect to the inverse method. We attributed the results, in part, to the impact of prior knowledge of the balance method (Australian students) and the inverse method (Malaysian students) upon subsequent learning of linear equations. Nonetheless, given that the differential level of element interactivity favors the inverse method, we advocate the exploration of the potentiality of the inverse method for enhancing the learning of linear equations.
Multiple and regionally specific organisational forms of urban studies?
Authors: Ferenčuhová Slavomíra
Published: October 2023

This short contribution comments on Bas van Heur's article ‘What, where and who is urban studies? On research centres in an unequal world’, a highly original analysis of the state of the art in urban studies complemented by provocative propositions to challenge existing global hierarchies of knowledge production. While I am enthusiastic about this work, I also propose considering in greater detail the interpretational risks associated with van Heur's operationalisation of urban studies as the publication production of multidisciplinary research centres. Specifically, I underline the observation that the article already implicitly contends that the organisational form of multidisciplinary and cross-university urban studies centres may be less likely to emerge in some contexts than in others. Thus, mapping various organisational forms that urban studies take across the world, as well as their history, might usefully complement the project. Yet, the critical question remains – how to do this?
Use of point-of-care ultrasound in a low-resource setting to diagnose Achilles tendon rupture and avulsion fracture of the calcaneal bone
Authors: Habibullah Naheed , Dayo Jamil , Soomar Salman Muhammad , Ali Noman
Published: October 2023

Background

Point-of-care ultrasound (POCUS) is becoming more prevalent in recent years for evaluating patients presenting with musculoskeletal injuries in the emergency department (ED). This imaging modality has been utilized to diagnose soft tissue and bony injuries accurately, obtain appropriate consultation, and perform timely interventional procedures in the ED.

Case presentation

We present the case of a 55-year-old man who presented to the ED with significant left ankle pain following a ground-level fall. His physical examination showed swelling and tenderness around the ankle. POCUS examination aided the rapid and accurate detection of acute Achilles tendon rupture.

Conclusion

This case demonstrates that POCUS is a valuable diagnostic tool in evaluating patients with a suspected Achilles tendon rupture, especially in a resource-limited setting.
Boosting nuclear-targeted photothermal-chemotherapy by NIR-responsive hybrid membrane camouflaged nanotherapeutics
Authors: Xing Xinyue , Zeng Yuying , Zhong Wanqing , Cheng Wendai , Zhou Chengxin , Lu Xiaoxu , Zhong Liyun
Published: October 2023

Background

Engineering nanotherapeutics have been extensively studied for cancer therapy. However, the therapeutic efficacy is still severely restricted by biophysiological barriers and intracellular accumulation. Although the biomimetic nanoparticles have improved the former issue, there is almost no breakthrough in researches of intracellular transport. Herein, we proposed a NIR-responsive nuclear-targeted hybrid membrane biomimetic Prussian blue drug-loading nanotherapeutics (PB@DN@M).

Results

The hybrid membrane coating bestows nanotherapeutics tumor targeting and immune escape ability, thus promoting the tumor enrichment of PB nanotherapeutics. The nuclear targeting function triggered by NIR enhances the cellular internalization and nuclear entry efficiency, resulting in a superadditive effect for boosting photothermal-chemotherapy efficacy. Moreover, taking advantage of non-interference Raman properties of PB, we can track the location and distribution of nanotherapeutics, which is beneficial for guiding precise synchronization of photothermal-chemotherapy. The results revealed that this PB@DN@M presented a remarkable therapeutic efficacy and significantly inhibited the tumor growth up to 87.17%.

Conclusions

Therefore, this spatiotemporal controllable biomimetic nanotherapeutics will provide a new insight and strategy for specific targeted therapy of tumors.
Pathways to lung cancer diagnosis among individuals who did not receive lung cancer screening: a qualitative study
Authors: McCarty Rachel D. , Barnard Mollie E. , Lawson-Michod Katherine A. , Owens Makelle , Green Sarah E. , Derzon Samantha , Karabegovic Lea , Akerley Wallace L. , Watt Melissa H. , Doherty Jennifer A. , Grieshober Laurie
Published: October 2023

Background

Although early detection of lung cancer through screening is associated with better prognosis, most lung cancers are diagnosed among unscreened individuals. We therefore sought to characterize pathways to lung cancer diagnosis among unscreened individuals.

Methods

Participants were individuals with lung cancer who did not undergo asymptomatic lung cancer screening (n = 13) and healthcare providers who may be involved in the pathway to lung cancer diagnosis (n = 13). We conducted semi-structured interviews to identify themes in lung cancer patients’ narratives of their cancer diagnoses and providers’ personal and/or professional experiences of various pathways to lung cancer diagnoses, to identify delays in diagnosis. We audio-recorded, transcribed, and coded interviews in two stages. First, we conducted deductive coding using three time-period intervals from the Models of Pathways to Treatment framework: appraisal, help-seeking, and diagnostic (i.e., excluding pre-treatment). Second, we conducted inductive coding to identify themes within each time-period interval, and classified these themes as either barriers or facilitators to diagnosis. Coding and thematic summarization were completed independently by two separate analysts who discussed for consensus.

Results

Eight of the patient participants had formerly smoked, and five had never smoked. We identified eight barrier/facilitator themes within the three time-period intervals. Within the appraisal interval, the barrier theme was (1) minimization or misattribution of symptoms, and the facilitator theme was (2) acknowledgment of symptoms. Within the help-seeking interval, the barrier theme was (3) hesitancy to seek care, and the facilitator theme was (4) routine care. Within the diagnosis interval, barrier themes were (5) health system challenges, and (6) social determinants of health; and facilitator themes were (7) severe symptoms and known risk factors, and (8) self-advocacy. Many themes were interrelated, including minimization or misattribution of symptoms and hesitancy to seek care, which may collectively contribute to care and imaging delays.

Conclusions

Interventions to reduce hesitancy to seek care may facilitate timely lung cancer diagnoses. More prompt referral to imaging—especially computed tomography (CT)—among symptomatic patients, along with patient self-advocacy for imaging, may reduce delays in diagnosis.
Primary care during COVID-19 pandemic - a survey to establish clinical needs and lessons learned in infectious respiratory diseases in Spain
Authors: Linares Manuel , Larregola Laura Santos , de Yébenes Pilar Galicia García , Galilea Joaquín Santos
Published: October 2023

Background

The COVID-19 pandemic has exposed gaps and areas of need in health care systems. General practitioners (GPs) play a crucial role in the response to COVID-19 and other respiratory infectious diseases (e.g., influenza). Knowing the current flow of these patients and the real needs of GPs is necessary to implement new therapeutic and diagnostic strategies. We sought to learn about the flow of COVID-19 and flu patients in Spanish primary health centers and understand the training needs in both the diagnosis and treatment of these diseases.

Methods

A total of 451 regionally representative GPs completed an online survey between January and February 2022.

Results

Most of the GPs had available infection containment measures (79%) and access to point-of-care (POC) rapid diagnostic testing (81%) in their centers. The availability of on-the-day diagnostic tests for COVID-19 was higher than that for influenza (80% vs. 20%). Most GPs referred 1 of 10 COVID-19 or flu patients with moderate to severe disease to the emergency department (80% and 90%, respectively). Training/knowledge was considered good regarding diagnostic tests and vaccines (85%) but null or low regarding antivirals (60%) and monoclonal antibodies (80%).

Conclusions

This survey identified the conditions of Spanish GPs in terms of the diagnosis and treatment of COVID-19 and flu patients. Respondents’ comments suggested that quite radical system-level adjustments are needed to allow GPs to capitalize on the potential benefits of POC tests for diagnosis, reduction of referrals, and monitoring of these diseases.
Validity of claims-based diagnoses for infectious diseases common among immunocompromised patients in Japan
Authors: Hase Ryota , Suzuki Daisuke , de Luise Cynthia , Chen Haoqian , Nonnenmacher Edward , Higuchi Takakazu , Katayama Kayoko , Kinjo Mitsuyo , Jinno Sadao , Morishima Toshitaka , Sugiyama Naonobu , Tanaka Yoshiya , Setoguchi Soko
Published: October 2023

Background

To validate Japanese claims-based disease-identifying algorithms for herpes zoster (HZ), Mycobacterium tuberculosis (MTB), nontuberculous mycobacteria infections (NTM), and Pneumocystis jirovecii pneumonia (PJP).

Methods

VALIDATE-J, a multicenter, cross-sectional, retrospective study, reviewed the administrative claims data and medical records from two Japanese hospitals. Claims-based algorithms were developed by experts to identify HZ, MTB, NTM, and PJP cases among patients treated 2012–2016. Diagnosis was confirmed with three gold standard definitions; positive predictive values (PPVs) were calculated for prevalent (regardless of baseline disease-free period) and incident (preceded by a 12-month disease-free period for the target conditions) cases.

Results

Of patients identified using claims-based algorithms, a random sample of 377 cases was included: HZ (n = 95 [55 incident cases]); MTB (n = 100 [58]); NTM (n = 82 [50]); and PJP (n = 100 [84]). PPVs ranged from 67.4–70.5% (HZ), 67.0–90.0% (MTB), 18.3–63.4% (NTM), and 20.0–45.0% (PJP) for prevalent cases, and 69.1–70.9% (HZ), 58.6–87.9% (MTB), 10.0–56.0% (NTM), and 22.6–51.2% (PJP) for incident cases, across definitions. Adding treatment to the algorithms increased PPVs for HZ, with a small increase observed for prevalent cases of NTM.

Conclusions

VALIDATE-J demonstrated moderate to high PPVs for disease-identifying algorithms for HZ and MTB using Japanese claims data.
Reviewing the journey to the clinical application of bacteriophages to treat multi-drug-resistant bacteria
Authors: Mboowa Gerald
Published: October 2023

Antimicrobial resistance (AMR) was a leading cause of death globally in 2019. Sadly, COVID-19 has exacerbated AMR, nonetheless, the process of developing new antibiotics remains very challenging. This urgently requires the adoption of alternative approaches to treat multi-drug-resistant bacterial infections. This editorial introduces the ‘Bacteriophages against multi-drug resistant bacteria’ collection launched at BMC Infectious Diseases which highlights progress towards using bacteriophages to tackle AMR.
Urinary exosome proteins PAK6 and EGFR as noninvasive diagnostic biomarkers of diabetic nephropathy
Authors: Li Tao , Liu Tian ci , Liu Na , Li Meng jie , Zhang Man
Published: October 2023

Objective

The actin cytoskeleton plays an essential role in maintaining podocyte functions. However, whether the urinary exosome proteins related to the regulation of the actin cytoskeleton are changed in diabetic nephropathy (DN) is still unknown. This study was to investigate the possibility that related proteins can be applied as diagnostic biomarkers for DN.

Methods

Urinary exosomes were obtained from 144 participants (Discovery phase: n = 72; Validation phase: n = 72) by size exclusion chromatography methods. Proteomic analysis of urinary exosome by LC-MS/MS. Western blot and ELISA were applied to validate the selected urinary exosome proteins. The clinical value of selected urinary exosome proteins was evaluated using correlation and receiver operating characteristic curve analyses.

Results

Fifteen urinary proteins related to the regulation of the actin cytoskeleton were identified in urinary exosomes. Three upregulated proteins were selected, including Serine/threonine-protein kinase PAK6 (PAK6), Epidermal growth factor receptor (EGFR), and SHC-transforming protein 1(SHC1). The expression level of PAK6 and EGFR was negatively correlated with estimated glomerular filtration rate and positively correlated with serum creatinine levels. For diagnosing DN in the discovery phase: the area under curve (AUC) of PAK6 was 0.903, EGFR was 0.842, and the combination of two proteins was 0.912. These better performances were also observed in the validation phase (For PAK6: AUC = 0.829; For EGFR: AUC = 0.797; For PAK6 + EGFR: AUC = 0.897).

Conclusions

Urinary exosome proteins PAK6 and EGFR may be promising and noninvasive biomarkers for diagnosing DN.
RETRACTED ARTICLE: LRPPRC regulates malignant behaviors, protects mitochondrial homeostasis, mitochondrial function in osteosarcoma and derived cancer stem-like cells
Authors: Zhao Ziyi , Sun Yingwei , Tang Jing , Yang Yuting , Xu Xiaochao
Published: October 2023

Background

Leucine-rich pentatricopeptide repeat containing (LRPPRC) is a potential oncogene in multiple tumor types, including lung adenocarcinoma, esophageal squamous cell carcinoma and gastric cancer. LRPPRC exerts its tumor-promoting effects mainly by regulating mitochondrial homeostasis and inducing oxidative stress. However, the exact role and mechanisms by which LRPPRC acts in osteosarcoma and osteosarcoma-derived cancer stem-like cells (CSCs), which potentially critically contribute to recurrence, metastasis and chemoresistance, are still largely unclear.

Methods

LRPPRC level in osteosarcoma cells and CSCs were detected by western blot. Effects of LRPPRC on CSCs were accessed after LRPPRC knockdown by introducing lentivirus containing shRNA targeting to LRPPRC mRNA.

Results

we found that LRPPRC was highly expressed in several osteosarcoma cell lines and that LRPPRC knockdown inhibited malignant behaviors, including proliferation, invasion, colony formation and tumor formation, in MG63 and U2OS cells. Enriched CSCs derived from MG63 and U2OS cells presented upregulated LRPPRC levels compared to parental cells (PCs), and LRPPRC knockdown markedly decreased the sphere-forming capacity. These findings demonstrate that LRPPRC knockdown decreased stemness in CSCs. Consistent with a previous report, LRPPRC knockdown decreased the expression levels of FOXM1 and its downstream target genes, including PRDX3, MnSOD and catalase, which are responsible for scavenging reactive oxygen species (ROS). Expectedly, LRPPRC knockdown increased the accumulation of ROS in osteosarcoma and osteosarcoma-derived CSCs under hypoxic conditions due to the decrease in ROS scavenging proteins. Moreover, LRPPRC knockdown sensitized osteosarcomas and CSCs against carboplatin, a ROS-inducing chemoagent, and promoted apoptosis. Furthermore, LRPPRC knockdown significantly decreased the mitochondrial membrane potential, disturbed mitochondrial homeostasis and led to mitochondrial dysfunction.

Conclusion

Taken together, these findings indicated that LRPPRC exerts critical roles in regulating mitochondrial homeostasis, mitochondrial function and tumorigenesis in osteosarcomas and osteosarcoma-derived CSCs. This suggests that LRPPRC might be a promising therapeutic target for osteosarcomas.