bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward a MALDI in-source decay (ISD) method for top-down analysis of protein footprinting
Authors: Jiang Ruidong , Rempel Don L , Gross Michael L
Published: September 2023

Irreversible protein footprinting is a mass spectrometry–based approach in which solvent-accessible sites of a protein are modified to assess high-order protein structure. Structural insights can be gained by determining the position and extents of modification. The usual approach to obtain the “footprint” is to analyze the protein through bottom-up LC-MS/MS. In this approach, the proteins are digested to yield a mixture of peptides that are then separated by LC before locating the modification sites by MS/MS. This process consumes substantial amounts of time and is difficult to accelerate for applications that require quick and high-throughput analysis. Here, we describe employing matrix-assisted laser desorption/ionization (MALDI) in-source decay (ISD) to analyze a footprinted small test protein (ubiquitin) via a top-down approach. Matrix-assisted laser desorption/ionization is easily adapted for high-throughput analysis, and top-down strategies can avoid lengthy proteolysis and LC separation. We optimized the method with model peptides and then demonstrated its feasibility on ubiquitin submitted to two types of footprinting. We found that MALDI ISD can produce a comprehensive set of fragment ions for small proteins, affording footprinting information in a fast manner and giving results that agree with the established methods, and serve as a rough measure of protein solvent accessibility. To assist in the implementation of the MALDI approach, we developed a method of processing top-down ISD data.
Scale-dependent complexity in administrative units and implications for data-driven decision-making models
Authors: Søder Peter Højrup
Published: September 2023

Through analysis and discussion of basic systemic properties of a rural municipality, this paper explores how aggregating data in planning and land use modeling can potentially obscure intricate real-world behavior. Complexity theory is applied as a theoretical framework for explaining this hypothesis. Thus, the aim of this study is to address the author’s desire to understand systemic complexity when designing a data-driven decision-making model for rural planning. The novelty of this approach is two-fold: one, most studies on scalability issues in planning addresses spatial complexity, more so than systemic complexity within the complex system that the very act of planning strives to dictate. Two, although delimited to the scope of the study, the accessibility to and use of complete and valid socio-demographic data enables a rarely demonstrated accurate representation of an entire population. It is ultimately observed that on the disaggregated municipal level, systemic dispersion increases parallelly with population size, a correlation that is significantly influenced by gender ratio in any given parish – a characteristic that was not visible at the aggregated municipal level. In addition to advancing the understanding and placement of complexity science within spatial data science, these insights will make it easier to assess the generalizability of any given administrative unit by quantifying basic complexity attributes; in this case based on the correlation dispersion caused by the fragmentation of a municipality into its comprising parishes.
Insights From the FDA’s MAUDE Database Regarding the Real-World Safety of Jetstream Atherectomy for Peripheral Arterial Disease
Authors: Min Adam , Alkhalifa Fahd , Ahrari Aida , Healy Gerard , Jaberi Arash , Tan Kong Teng , Mafeld Sebastian
Published: September 2023

Introduction:

Rotational atherectomy has shown promise as an adjunctive therapy to percutaneous transluminal angioplasty (PTA) and stenting for the treatment of peripheral arterial disease (PAD). However, published data regarding the safety of these devices are limited. The Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database collects reports of adverse event for medical devices. We present 3 years of MAUDE adverse events data for the Jetstream Atherectomy System (Boston Scientific) for the treatment of PAD.

Materials and Methods:

We searched MAUDE from January 1, 2019 to December 31, 2021. Duplicate reports and those with insufficient information were excluded, leaving a total of 500 reports for analysis. Adverse events were categorized as either patient complication, device malfunction, or both. Adverse events were classified using the Cardiovascular and Interventional Radiological Society of Europe’s (CIRSE) classification system for adverse events.

Results:

The most common patient complications were embolism (22; 4.4%), dissection (17; 3.4%), vessel perforation (12; 2.4%), and device fracture in the patient (6; 1.2%). The most common modes of device failure were entrapment of the device on the guidewire (134; 27%), loss of blade rotation (116; 23%), loss of aspiration (99; 20%), and mechanical damage (57; 11%). As per the CIRSE adverse events classification, most events had no post-procedural sequelae (475; 95%), followed by those requiring prolonged observation (14; 2.8%), and post-procedural therapy without long-term sequelae (10; 2.0%). One hundred six devices (21%) were returned for manufacturer analysis.

Conclusion:

We highlight important adverse events encountered in real-world practice with the Jetstream Atherectomy System. This analysis provides further understanding of the safety profile and modes of failure of Jetstream, and could help guide improvements in product design and manufacturer-user training. There is greater need for root-cause analysis that can aided by returning devices to the manufacturer.

Clinical Impact

We highlight important adverse events encountered in real-world practice with the Jetstream Atherectomy System. The MAUDE database is useful for capturing and characterizing modes of device failure/malfunction not typically described in conventional clinical studies. This may provide valuable information to help guide improvements in product design and manufacturer-user training. This information could also potentially be useful in helping establish manufacturer and product liability in the setting of medicolegal claims. We hope that by contributing to the growing understanding of the safety profile of the Jetstream Atherectomy System, our study may help physicians and patients come to more informed decisions regarding treatment options for PAD.
Neuroplastic Changes Associated With Hybrid Exercise-Cognitive Training in Stroke Survivors With Mild Cognitive Decline: A Randomized Controlled Trial
Authors: Yeh Ting-Ting , Chang Ku-Chou , Wang Jiun-Jie , Lin Wei-Che , Wu Ching-Yi
Published: September 2023

Background

Exercise and cognitive training have been shown to induce neuroplastic changes and modulate cognitive function following stroke. However, it remains unclear whether hybridized exercise-cognitive training facilitates cortical activity and further influences cognitive function after stroke.

Objective

The study aimed to investigate the effects of 2 hybridized exercise-cognitive trainings on neuroplastic changes and behavioral outcomes in stroke survivors with mild cognitive decline.

Methods

This study was a single-blind randomized controlled trial. Stroke survivors were randomly assigned to 1 of 3 groups: (1) sequential exercise-cognitive training (SEQ), (2) dual-task exercise-cognitive training (DUAL), or (3) control group (CON). All groups underwent training 60 min per day, 3 days per week, for a total of 12 weeks. The primary outcome was the resting-state (RS) functional connectivity (FC) in functional magnetic resonance imaging. Secondary behavioral outcomes included cognitive and physical functions.

Results

After 12 weeks of training, patients in the SEQ group (n = 21) exhibited increased RS FC between the left occipital lobe and posterior cingulate gyrus with right parietal lobe, compared to the DUAL (n = 22) and CON (n = 20) groups. Additionally, patients in the DUAL group showed increased FC of the left temporal lobe. However, changes in behavioral outcome measures were non-significant among the 3 groups (all P’s > .05).

Conclusions

This study highlights the distinct neuroplastic mechanisms associated with 2 types of exercise-cognitive hybridized trainings. The pre-post functional magnetic resonance imaging measurements illustrated the time course of neural mechanisms for cognitive recovery in stroke survivors following different exercise-cognitive training approaches. Trial registration. NCT03230253.
How Well Do Studies of Mesenchymal Stem Cell Intervention and Knee Osteoarthritis Adhere to the Minimum Information for Studies Evaluating Biologics Guidelines? A Systematic Review of Randomized Controlled Trials
Authors: Abed Varag , Jacobs Cale , Skinner Matthew , Owens Mitchell , Keshishi Dro , Stone Austin V.
Published: September 2023

Background:

The Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) guidelines for mesenchymal stem cell (MSC) research, published in 2017, contain a suggested checklist for reporting items in manuscripts involving MSCs.

Purpose:

We sought to determine how well randomized controlled trials (RCTs) on MSC intervention for knee osteoarthritis (OA) adhered to the MIBO guidelines.

Methods:

A comprehensive literature search was performed in the PubMed/MEDLINE and Web of Science databases. Inclusion criteria included English-only RCTs that assessed MSC intervention for knee OA published between 2018 and 2022. Metrics were extracted, including year of publication, study design, first author name, journal name, patient demographics, and MIBO checklist criteria.

Results:

In 27 RCTs analyzed, 1006 patients were included, with a weighted male percentage of 41.8% and weighted mean age of 60.5 ± 7.2 years. On average, 70.5% (range, 30.2%–90.6%) of the modified 53-point MIBO checklist elements were reported per article. Seven (25.9%) articles had adherence rates of 80% or more, 13 (48.1%) had rates between 60% and 79.9%, and 7 (25.9%) had rates of 59.9% or less. The MIBO “intervention” category had the greatest adherence (100%), while the other categories had more variability. Six (50.0%) categories had an adherence level of 80% or more, 3 (25.0%) had adherence levels of 60% to 79.9%, and 3 (25.0%) had an adherence level of 59.9% or less.

Conclusion:

The overall mean adherence to MIBO guidelines of RCTs on MSC intervention for knee OA was 70.5%. Authors should better integrate the MIBO guidelines into their methodology to improve transparency, reproducibility, and reporting.
Application of steel fiber concrete in small box girder under vehicle explosion load
Authors: Wang YuJie , Chen YaQin , Wang Jun , Iqbal Shahid
Published: September 2023

In recent years, the exceptional performance of steel fiber-reinforced concrete in blast and impact resistance has garnered widespread recognition, sparking considerable interest in its practical application in small box girders. To this end, nine groups of Trinitrotoluene (TNT) explosion simulation experiments were designed with the equivalent magnitudes matching those of actual automobile explosions to evaluate the anti-explosion and anti-penetration capabilities of steel fiber-reinforced concrete and ordinary concrete using the Arbitrary Lagrangian-Eulerian (ALE) method and the Smoothed Particle Hydrodynamics-ALE method. The aim was to explore the application prospects of steel fiber-reinforced concrete in small box girders. The research results demonstrate that with increasing TNT equivalent, the leading cause of breach to concrete slabs changes from spalling to cratering. The penetration resistance of steel fiber-reinforced concrete slabs is superior to its blast resistance. However, when the explosive force is larger than the sedan, the anti-explosion effect of steel fiber-reinforced concrete slabs becomes negligible. Moreover, under typical automobile explosion loads, the addition of 2% steel fibers can reduce spalling by up to 23% and cratering by up to 13% and can decrease the area of penetration damage by up to 47%. In designing blast-resistant structures, steel fiber-reinforced concrete is not recommended to enhance the blast resistance of bridges when the TNT equivalent exceeds 500 kg.
Ultrasound and computed tomography findings of hepatic portal venous gas associated with acute appendicitis in a paediatric patient: A case report
Authors: Furuta Takashi , Fujiwara Mayu , Motonaga Takahiro , Matsufuji Hironori , Tateishi Hiroshi , Nakada Soichi , Kanagawa Tsutomu , Uchida Masashi
Published: September 2023

Introduction:

Hepatic portal venous gas is a rare and life-threatening condition characterised by the presence of gas in the portal vein. Hepatic portal venous gas is frequently associated with intestinal ischaemia and necrosis. We present the case of a paediatric patient with acute appendicitis with hepatic portal venous gas detected using ultrasonography.

Case report:

A 5-year-old boy was admitted to our hospital with a respiratory tract infection. The boy started vomiting on day 2 of hospitalisation. He did not complain of any symptoms due to developmental retardation. We performed bedside point-of-care ultrasound, which detected hepatic portal venous gas, although the appendix could not be detected due to an acoustic shadow associated with bowel gas. Contrast-enhanced computed tomography revealed perforated appendicitis and pneumatosis intestinalis associated with paralytic ileus. An emergency laparoscopic appendectomy was performed. He was discharged on day 25 of hospitalisation after antibiotic therapy.

Discussion:

The present case suggests that the mechanism of hepatic portal venous gas was paralytic ileus, which caused gas-forming bacterial proliferation. The gas produced by bacteria and/or the gas-forming bacteria entered the bowel wall, which caused pneumatosis intestinalis. The bubbles in the intestinal wall floated in the portal system and were detected as hepatic portal venous gas. Perforated appendicitis and paralytic ileus seemed to be caused by a delayed diagnosis of appendicitis. The point-of-care ultrasound examination was useful for detecting hepatic portal venous gas and for helping establish the diagnosis of appendicitis.

Conclusion:

Hepatic portal venous gas is a rare finding associated with appendicitis in children. In addition, point-of-care ultrasound is useful for detecting hepatic portal venous gas in paediatric patients.
Social Preferences Toward Humans and Machines: A Systematic Experiment on the Role of Machine Payoffs
Authors: von Schenk Alicia , Klockmann Victor , Köbis Nils
Published: September 2023

There is growing interest in the field of cooperative artificial intelligence (AI), that is, settings in which humans and machines cooperate. By now, more than 160 studies from various disciplines have reported on how people cooperate with machines in behavioral experiments. Our systematic review of the experimental instructions reveals that the implementation of the machine payoffs and the information participants receive about them differ drastically across these studies. In an online experiment ( N = 1,198), we compare how these different payoff implementations shape people’s revealed social preferences toward machines. When matched with machine partners, people reveal substantially stronger social preferences and reciprocity when they know that a human beneficiary receives the machine payoffs than when they know that no such “human behind the machine” exists. When participants are not informed about machine payoffs, we found weak social preferences toward machines. Comparing survey answers with those from a follow-up study ( N = 150), we conclude that people form their beliefs about machine payoffs in a self-serving way. Thus, our results suggest that the extent to which humans cooperate with machines depends on the implementation and information about the machine’s earnings.
Targeted partial arthroscopic trapeziectomy with temporary distraction: a retrospective study with 5-year follow-up
Authors: de Villeneuve Bargemon Jean-Baptiste , Lupon Elise , Soudé Guillaume , Jaloux Charlotte , Levet Paul , Levadoux Michel
Published: September 2023

Targeted partial arthroscopic trapeziectomy with temporary distraction is a minimally invasive treatment for trapeziometacarpal osteoarthritis. We performed a retrospective single centre study from March 2011 to May 2022 and included patients with at least 5 years of follow-up. A failure was defined as a patient requiring a second procedure. Of the 28 patients with at least 5 years of follow-up, 23 were reviewed. Five of the 23 patients underwent revision surgery with a 5-year survival rate of 78%. There was a significant improvement in pain and the Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score. There were three postoperative complications, one with complex regional pain syndrome, and two with hyperesthesia in the distribution of the sensory branch of the radial nerve. Targeted partial arthroscopic trapeziectomy with temporary distraction is a feasible temporary solution for early stage trapeziometacarpal joint osteoarthritis. However, there remains a 20% risk of failure.

Level of evidence: IV
Heterotopic respiratory mucosa as a potential source of ectopic Sonic hedgehog (SHH) in the development of complex radial polydactyly and ulnar dimelia
Authors: Habenicht Rolf , Mann Max , Huelsemann Wiebke , Pira Charmaine U. , Oberg Kerby C.
Published: September 2023

We report eight cases of complex radial polydactyly and/or ulnar dimelia each with a fistulous lesion of heterotopic respiratory mucosa in radial-anterior skin ranging from shoulder to wrist. Although speculative, the coincidence of these rare conditions suggests a mechanistic relationship.
Technology and digital transformation for the structural reform of the sports industry: Building the roadmap
Authors: Magaz-González Ana María , García-Tascón Marta , Sahelices-Pinto César , Gallardo Ana María , Guevara Pérez Juan Carlos
Published: September 2023

The COVID-19 pandemic in 2020, has accelerated technological immersion into society, economy and public administrations. The sports organisations are no strangers to this digitisation and must carry out their own digital transformation. However, investment in digital technology must be preceded by a diagnosis of the technological needs of each sports entity. Said mapping will help organisations know the most appropriate technological tools for their core businesses so they can properly design their digital transformation strategies. The objectives of this study were to design and create a tool to understand the digital structure of Spanish sports. The result has been the configuration of an instrument that includes the description of different technologies and different digital competencies specific to the sports industry, and which allows individuals to know the use, importance, perceived difficulty of use and economic accessibility of available technologies, as well as the degree of developed competency in the different sports organisations. It is concluded that the creation and application of a consultation instrument on digitalisation is the first and necessary step to carry out relevant, in-depth, valid and replicable research, which allows information to be gathered on the digitalisation needs of sports organisations to design their digital transformation roadmap and that the aids for digital transformation is distributed efficiently.
Effect of citric acid on the properties of thermoplastic bitter cassava starch plasticized with isosorbide
Authors: Arfiathi Arfiathi , Sumirat Riska , Syamani Firda Aulya , Lubis Muhammad Adly Rahandi , Filianty Fitry , Nurhamiyah Yeyen
Published: September 2023

The rising concern of environmental issues from the non-degradable conventional polymers is triggering the development of sustainable and renewable polymers. Thermoplastic starch (TPS) has been known to have huge potential to substitute conventional synthetic polymers. A thermoplastic starch was prepared using a non-food bitter cassava starch with isosorbide as plasticizer. To improve the dispersion and interfacial affinity of thermoplastic starch and boost the compatibility between starch and isosorbide, citric acid (CA) was used as an additive. The influence of citric acid to the TPS was then investigated. The result shows that citric acid improved tensile strength from 8.68 MPa to 11.98 MPa. The addition of citric acid at a concentration of 1 – 10 wt % can increase glass transition temperature (Tg) from 48.81°C to 63.89°C and storage modulus at 25°C from 1.20 GPa to 3.47 GPa. Two degradation temperatures (Td) were detected which are Td1onset value was decrease from 83.32°C down to 79.78°C while Td2onset value was decrease from 275.29°C down to 247.17°C and Td2max from 311.12°C to 295.06°C.
Technology enabled entrepreneurship: Ekshop and rural women in Bangladesh
Authors: Sadrul Huda Syed Sirrul Mowla , Akter Sayma , Safder Ayesha
Published: September 2023

This case discusses Ekshop and its functionalities. It focuses on how Ekshop has become a platform on which people nationwide in Bangladesh get access to the internet. The core focus of Ekshop is to encourage rural women to become entrepreneurs and earn on their own. This case also highlights how Ekshop encourages women empowerment in the rural area. Additionally, it also covers the technology that Ekshop uses as well as the potential challenges. We have used primary and secondary data to carry out the research. The findings of this research indicate how technology and innovation help rural people, in particular women, to become more digitalized. It could be a great resource for future research to understand rural economic progress. Overall, the case discusses how Ekshop has helped rural women find additional support and how this platform promotes women’s empowerment in rural regions.
Effectiveness, safety and patients’ perceptions of an immersive virtual reality–based exercise system for poststroke upper limb motor rehabilitation: A proof-of-concept and feasibility randomized controlled trial
Authors: Chen Jiayin , Or Calvin Kalun , Li Zhixian , Yeung Eric Hiu Kwong , Zhou Yong , Hao Tiantian
Published: September 2023

Objective

This study aimed to examine the effectiveness, safety and patients’ perceptions of an immersive virtual reality (VR)–based exercise system for poststroke upper limb rehabilitation.

Methods

A proof-of-concept, 2-week randomized controlled trial was conducted. Fifty stroke patients were randomly assigned to either use the immersive VR-based exercise system to perform upper limb exercises for 2 weeks (intervention) or play commercial games (control). Effectiveness, safety and patients’ perceptions of the exercise system were assessed at baseline and at 1- and 2-week follow-ups.

Results

Intention-to-treat analysis revealed that after 2 weeks, statistically significant improvements in shoulder flexion active range of motion (AROM), shoulder abduction AROM, perceived upper limb motor function and quality of life (QoL) were observed in one or both groups, but not between the groups. Per-protocol analysis showed that after 2 weeks: (i) statistically significant improvement in shoulder abduction AROM was obtained in the intervention group, and the difference in the mean changes between the groups was statistically significant; (ii) statistically significant improvements in coordination/speed (Fugl–Meyer Assessment for Upper Extremity), shoulder flexion AROM, perceived upper limb motor function and QoL were obtained in one or both groups, but not between the groups.

Conclusions

The immersive VR-based exercise system is a potentially effective, safe and acceptable approach for supporting poststroke motor rehabilitation. These findings can serve as a basis for larger-scale studies on the application of VR for poststroke exercises.
Technology-assisted behavioral intervention to encourage prehabilitation in frail older adults undergoing surgery: Development and design of the BeFitMe™ Apple Watch app
Authors: Kerstiens Savanna , Bender Edward M. , Rizzo Michael G. , Landi Andrea , Gleason Lauren J. , Huisingh-Scheetz Megan , Rubin Daniel , Ferguson Mark , Madariaga Maria Lucia L.
Published: September 2023

Objective

Increasing the physical activity of frail, older patients before surgery through prehabilitation (prehab) can hasten return to autonomy and reduce complications postoperatively. However, prehab participation is low in the clinical setting. In this study, we re-design an existing prehab smartphone application (BeFitMe™) using a novel standalone Apple Watch platform to increase accessibility and usability for vulnerable patients.

Methods

Design Science Research Methodology was used to (1) develop an approach to clinical research using standalone Apple Watches, (2) re-design BeFitMe™ for the Apple Watch platform, and (3) incorporate user feedback into app design. In phase 3, beta and user testers gave feedback via a follow-up phone call. Exercise data was extracted from the watch after testing. Descriptive statistics were used to summarize accessibility and usability.

Results

BeFitMe™ was redesigned for the Apple Watch with full functionality without requiring patients to have an iPhone or internet connectivity and the ability to passively collect exercise data without patient interaction. Three study staff participated in beta testing over 3 weeks. Six randomly chosen thoracic surgery patients participated in user testing over 12 weeks. Feedback from beta and user testers was addressed with updated software (versions 1.0–1.10), improved interface and notification schemes, and the development of educational materials used during enrollment. The majority of users (5/6, 83%) participated by responding to at least one notification and data was able to be collected for 54/82 (68%) of the days users had the watches. The amount of data collected in BeFitMe™ Watch app increased from 2/11 (16%) days with the first patient tester to 13/13 (100%) days with the final patient tester.

Conclusions

The BeFitMe™ Watch app is accessible and usable. The BeFitMe™ Watch app may help older patients, particularly those from vulnerable backgrounds with fewer resources, participate in prehab prior to surgery.
The evolution and predicament of modern social technicalization
Authors: Song Jie
Published: September 2023

Social technicalization refers to the construction and operation of society in accordance with the principles of technology. The stage of modern social technicalization was spawned after the Industrial Revolution and has mainly been manifested in two aspects: the heavy reliance of the operation of society on technology, and the increasing rationality of social technology. Modern society has undergone four stages of development driven by natural and social technologies: the initial stage, the institutionalised stage, the era of globalisation and the era of intelligence. The standardisation of social technology into natural technology, the comprehensive shaping of the human perspective and the promotion of social technicalization to attain social modernisation highlight the rationality and progressiveness of the technicalization of modern society. However, the rise of technological rationality also poses the dilemma of the one-sided human pursuit of efficiency, which has deepened the conflict between technology and culture and has exacerbated the imbalance between the development of social technology and natural technology. This needs to be examined dialectically.
Tip-to-apex distance does not predict fixation failure regardless of reduction quality in intra-capsular neck of femur fractures treated with femoral neck system
Authors: Leung Hiu Yan , Wong Janus Siu Him , Fang Christian , Tsoi Calvin
Published: September 2023

Femoral neck system (FNS) is a novel fixed-angle gliding device combining a sliding bolt and an anti-rotational screw to treat femoral neck fractures. It was proven to have comparable biomechanical strength to sliding hip screws. Tip-to-apex distance (TAD) is an established assessment for fixation quality in sliding hip screws. The purpose of our study was to evaluate whether TAD can be used in FNS implant to predict fixation failure. Seventy-six patients receiving FNS fixation for intra-capsular hip fracture were included. TAD was measured from post-operative radiographs and clinical outcomes were collected with a mean follow-up of 14.1 months. The mean TAD for patients who experienced fixation failure was 20.7 mm, versus 19.7 mm for those who did not ( p = 0.395). Subgroup analysis among fractures with good reduction quality, defined as no varus angulation, less than 5 degrees of retroversion, and less than 4 mm cortical translation, did not demonstrate statistically significant difference in the mean TAD between failure and non-failure group (20.7 mm vs 19.5 mm, p = 0.68). We conclude that in our study of modest sample size, there was not demonstrable association between TAD and fixation failure in intra-capsular neck of femur patients treated with FNS.
The Interplay of Job Demands–Resources: Experiences of Public Health Inspectors of Sri Lanka During the First and Second Waves of the COVID-19 Pandemic
Authors: Wanninayake S.D.K. , Razik Ruwaiha
Published: September 2023

The COVID-19 pandemic posed unprecedented challenges to healthcare employees worldwide. As part of combatting the disease, they were often confronted with numerous physical and psychological job demands. Studies have explored the experiences of and responses to a COVID-19-related job demand–resource (JD-R) interplay of Western hospital-based healthcare staff. However, whether community-based, non-clinical healthcare workers experienced and responded to the COVID-19-related JD-R interplay similarly to hospital-based clinical healthcare employees is severely under-researched. This article explores how Sri Lanka’s public health inspectors (PHIs), a group of community-based, non-clinical healthcare workers experienced and responded to the COVID-19-related JD-R interplay. Using 18 in-depth interviews, this study found that PHIs were confronted with COVID-19-specific physical and psychological job demands including work pressure, workload, ambiguities in authority and job responsibilities, fear of contracting and passing on the disease to family members and social rejection which they managed with limited training, minimal rewards and less recognition. This JD-R incompatibility led to stress, exhaustion and coping inflexibility to which PHIs responded through approach and avoidance coping. While most coping strategies enabled PHIs to ease their stress and exhaustion, there were others that exacerbated the feelings of burnout.
Comparison of ACL and Anterolateral Ligament Reconstruction With Isolated ACL Reconstruction Using Hamstring Autograft: Outcomes in Young Female Patients With High-Grade Pivot Shift
Authors: Lee Dhong Won , Lee Dong Hwan , Cho Seung Ik , Yang Sang Jin , Kim Woo Jong , Lee Joon Kyu , Kim Jin Goo
Published: September 2023

Background:

Inferior return to sports (RTS) and functional outcomes have been reported in women after anterior cruciate ligament reconstruction (ACLR).

Purpose/Hypothesis:

The purpose was to evaluate the results of combined ACLR and anterolateral ligament reconstruction (ALLR) in young women with a high-grade pivot shift (grade ≥2). It was hypothesized that combined ACLR and ALLR would result in better RTS and rotational stability than isolated ACLR.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Two groups were retrospectively evaluated and compared. Group I (n = 39; mean age, 31.1 ± 5.7 years) underwent isolated ACLR using hamstring autografts; group C (n = 39; mean age, 30.4 ± 6.1 years) underwent combined ACLR and ALLR. Subjective outcome measures included the International Knee Documentation Committee subjective form, Lysholm, Tegner, and ACL–Return to Sport after Injury (ACL-RSI). Objective tests included a KT-2000 arthrometer stress test, a pivot-shift test, an isokinetic strength test, a Y-balance test, and a single-leg hop test. A postoperative questionnaire was administered to determine the rates and types of RTS, quality of sports performance, and reinjury and satisfaction rates. Subjective scores and clinical tests were performed at 2 years. Magnetic resonance imaging and second-look arthroscopy were conducted during the 1- and 2-year follow-ups, respectively.

Results:

The mean follow-up for groups I and C were 30.4 ± 3.9 and 29.3 ± 3.5 months, respectively ( P = .194). Patients in group C had better anteroposterior ( P = .001) and rotational ( P = .005) stability and higher ACL-RSI scores ( P = .025) than those in group I. Group C had higher composite and posteromedial reach scores on the Y-balance test than group I ( P = .014 and P = .010, respectively). A total of 26 (66.7%) patients in group C and 17 (43.6%) in group I returned to their prior level of sports ( P = .040). Rerupture of the ACL graft and contralateral ACL rupture occurred in 2 (5.1%) and 2 (5.1%) patients in group I, respectively, compared with no rerupture or contralateral ACL rupture in group C.

Conclusion:

Combined ACLR and ALLR in young women with a high-grade pivot shift was associated with better knee stability parameters, dynamic postural stability, and psychological readiness to RTS than isolated ACLR.
Transportation and urban spatial structure: Evidence from Paris
Authors: Salov Anton , Semerikova Elena
Published: September 2023

This paper analyses the role of railroad development in employment subcentre formation in the Paris metropolitan area between 1968 and 2018. Over half a century, approximately 1.5 million new jobs were created; however, their spatial distribution across the Île-de-France region was uneven. Paris intramuros has lost 123,000 jobs for the 50-year period, while the Grande Couronne (outer periphery) accounted for 2/3 of employment growth. These dramatic changes in the geography of employment in the Paris metropolitan region were coupled with cardinal alterations in railroad transportation, whose network has expanded and whose branches have been intertwined in order to improve population mobility and, to some extent, decentralise the capital area in favour of the development of peripheral territories. The construction of the Réseau Express Régional (RER) on the basis of 19th century railroads together with formation of the Transilien network were stepping stones towards today’s efficient rapid transit system. Our investigation, using McMillen (2001) method to identify subcentres as well as the IV approach to determine the role of railway transport development in local employment growth and the evolution of urban spatial structures, corroborates the decisive role of RER in fostering employment and in the emergence of employment subcentres. Specifically, the proximity to a railway station boosts employment in the commune. For RER stations, this effect is more substantial and heterogeneous across space, being of greater magnitude for municipalities more distant from the CBD. Furthermore, the presence of a railway station in a commune increases its probability of being a (part of) subcentre from 19.3% to 41.3% depending on the period. Moreover, this effect is of greater magnitude for the presence of a RER station in a municipality (53.2%–76.1%). Interestingly, we cannot confirm that the influence of a railway station on subcentre formation spills over the edge of the commune where it is located.
Insights Into Patients Questions Over Bunion Treatments: A Google Study
Authors: Phelps Cole R. , Shepard Samuel , Hughes Griffin , Gurule Jon , Scott Jared , Raszewski Jesse , Hatic Safet , Hawkins Bryan , Vassar Matt
Published: September 2023

Background:

Approximately 1 in 4 adults will develop hallux valgus (HV). Up to 80% of adult Internet users reference online sources for health-related information. Overall, with the high prevalence of HV combined with the numerous treatment options, we believe patients are likely turning to Internet search engines for questions relevant to HV. Using Google’s people also ask (PAA) or frequently asked questions (FAQs) feature, we sought to classify these questions, categorize the sources, as well as assess their levels of quality and transparency.

Methods:

On October 9, 2022, we searched Google using these 4 phrases: “hallux valgus treatment,” “hallux valgus surgery,” “bunion treatment,” and “bunion surgery.” The FAQs were classified in accordance with the Rothwell Classification schema and each source was categorized. Lastly, transparency and quality of the sources’ information were evaluated with the Journal of the American Medical Association’s (JAMA) Benchmark tool and Brief DISCERN, respectively.

Results:

Once duplicates and FAQs unrelated to HV were removed, our search returned 299 unique FAQs. The most common question in our sample was related to the evaluation of treatment options (79/299, 26.4%). The most common source type was medical practices (158/299, 52.8%). Nearly two-thirds of the answer sources (184/299; 61.5%) were lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4) = 54.49 ( P < .001), with medical practices averaging the worst score (12.1/30).

Conclusion:

Patients seeking online information concerning treatment options for HV search for questions pertaining to the evaluation of treatment options. The source type encountered most by patients is medical practices; these were found to have both poor transparency and poor quality. Publishing basic information such as the date of publication, authors or reviewers, and references would greatly improve the transparency and quality of online information regarding HV treatment.

Level of Evidence:

Level V, mechanism-based reasoning.
Anytime, anywhere: Understanding random breath testing deployments at the local level
Authors: Green Darren
Published: September 2023

The impact of random breath testing (RBT) on alcohol-related traffic crashes has been the subject of numerous studies over the past 30 years. The existing body of research clearly identifies the positive impact of RBT programmes around the world. However, very little is known about when and where RBT is deployed locally to achieve the desired outcomes. By understanding how RBT is being deployed in space and time opportunities may be identified to improve current practices. To start addressing this gap, the current paper characterises the location and timing of RBT within a Queensland Police District. Results identify RBT is more likely to be conducted within specific locations, on particular days and at particular times. These outcomes provide a level of clarity over the operationalisation of RBT, offering opportunities to explore how this strategy could be varied to try and improve road safety outcomes, for example, increasing the diversity of RBT locations or evening out the number of tests conducted each day of the week to increase the perceived certainty of sanctions. The results also have implications for future research. Of interest would be the impact of RBT predictability on perceptions of avoidance. The repeat police presence also provides an opportunity for future research to explore a potential diffusion of benefit, crime reduction. These implications are discussed, within the context of the extant literature, to guide future research aiming to maximise the efficacy and efficiency of RBT programmes.
Reconceptualising organised (cyber)crime: The case of ransomware
Authors: Whelan Chad , Bright David , Martin James
Published: September 2023

The concept of organised cybercrime has been the subject of much debate over the last decade. Many researchers who have applied scholarly definitions of organised crime to cyber-criminal groups have concluded that such groups are not “organised criminal groups” and do not engage in “organised crime”. This paper adopts a different perspective to argue that certain cyber-criminal groups involved in ransomware can and should be considered organised crime if a more contemporary and flexible framework for conceptualising organised crime is adopted. We make this argument using three primary domains of organised crime first described by von Lampe: criminal activities, offender social structures, and extra-legal governance. We narrow in on the concepts of violence and extra-legal governance in particular as they have been interpreted to hold significant differences for criminal groups operating in physical and digital domains. The paper argues that it is time to move on from criminological debates regarding whether organised cybercrime can exist to focus on the many rich questions that researchers can take from organised crime scholarship and apply to cyber-criminal groups. We put forward a reconceptualisation of organised cybercrime towards this end.
Provision of bystander CPR for out-of-hospital cardiac arrest in the Middle East: a retrospective gender-based analysis
Authors: Awad Emad , Alinier Guillaume , Farhat Hassan , Rumbolt Niki , Azizurrahman Adnaan , Mortada Buthaina , Shami Rakan
Published: September 2023

Background

Previous studies conducted in North America, Europe, and East Asia (Liu et al., EClinicalMedicine 44:101293, 2022; Matsui et al., JAMA Netw Open 2:e195111, 2019; Awad et al., J Am Coll Emerg Physicians Open 4:e12957, 2023; Yoon et al., Prehosp Emerg Care :1–7, 2022) reported gender disparities in the provision of bystander CPR for patients with out-of-hospital cardiac arrest (OHCA). However, it remains unknown whether similar disparities exist in the Middle Eastern and Gulf regions. The primary objective of this study is to evaluate gender differences in the provision of bystander CPR for patients with OHCA in Qatar.

Methods

Retrospective analysis of data obtained from Hamad Medical Corporation OHCA registry in the State of Qatar (2016–2022). We included adults with non-traumatic and EMS-attended OHCA. We used multilevel logistic regression to examine the association between gender and provision of bystander CPR.

Results

In total, 4283 patients were included. Of those, 3414 (79.7%) were males, 1639 (38.3%) arrested in public locations, and 1463 (34.2%) received bystander CPR. Unadjusted comparisons showed that females were significantly older than males (mean age: 62.2 vs. 52.7). Females had a lower proportion of OHCA occurring in public locations (15.1% vs. 44.2%) and a lower proportion of shockable rhythm (11.9 vs. 27.5%). Regarding the outcome variable (provision of bystander CPR), the unadjusted analysis showed that the proportion of females who received bystander CPR was lower than that of males (29.2% vs. 35.4%, p < 0.001). However, after adjustment, we found no significant difference in provision of bystander CPR by gender (adjusted OR female vs. male 0.99, 95% CI 0.84–1.20, p = 0.97). In the subgroup who arrested in public locations, the analysis revealed females had greater odds of receiving bystander CPR (adjusted OR female vs. male 1.47, 95% CI 1.10–1.82, p = 0.04).

Conclusions

Overall, bystander CPR was less common in female gender; after adjustment for other covariates, including arrest location, we found no significant gender differences in provision of bystander CPR. We also observed that females were found to have a lower incidence of cardiac arrest in public locations. Nevertheless, if females were to experience cardiac arrest in a public location, they would be more likely to receive CPR. Further research is required to explain the observed differences in provision of bystander CPR.
Screening Tool Risk Score Assessment in the Emergency Department for Geriatric (S-TRIAGE) in 28-day mortality
Authors: Supatanakij Praphaphorn , Imok Kanruethai , Suttapanit Karn
Published: September 2023

Background

The number of older adults with a high risk of frailty and severe illness continues to increase. Moreover, physiological change and multiple comorbidities are challenging to triage in geriatrics. Therefore, we aimed to evaluate variables to predict 28-day mortality and develop a screening tool to predict mortality and lifesaving intervention among geriatric patients in the emergency department (ED).

Methods

This study was a retrospective, single-center, observational study at the ED of Ramathibodi Hospital, Bangkok. Patients aged ≥ 65 years who visited the ED between January 2018 and December 2019 were enrolled. In the development cohort, univariable logistic regression was used to identify predictors of 28-day mortality in older patients. A predictive model for mortality and the need for lifesaving intervention was developed by multivariable logistic regression. In addition, the score was validated with internal validation and compared between development and validation set by chi-square.

Results

We enrolled 1393 patients. In the development cohort, among these 1002 patients, 103 (10.3%) of whom died within 28 days. Malignancy, shock index (SI), systolic blood pressure (SBP) < 100 mmHg, and altered mentation were independent risk factors of 28-day mortality. We developed new screening tools named the S-TRIAGE score, which has the respiratory rate (< 11, > 22 breaths/min), the ratio of pulse oximetric saturation to the fraction of inspired oxygen (< 420, 420–450), SI (> 1, 0.6–0.99), SBP < 100 mmHg, body temperature (< 36, > 37.5 °C), and mental change. The area under a receiver operating characteristic (ROC) curve of the S-TRIAGE score in the validation cohort was 0.826 [95% confidence interval (95%CI) 0.773–0.879] in predicting mortality and lifesaving intervention, and the clinical score classified patients into five groups.

Conclusion

This study showed malignancy, hypotension, increased SI, and mental status change were predictive factors for 28-day mortality in older adults in the ED. The screening tool risk score for geriatrics used in this study is potentially a good predictor of mortality and lifesaving intervention in high-risk older patients in the ED.
Do patients referred to emergency departments after being assessed in primary care differ from other ED patients? Retrospective analysis of a random sample from two German metropolitan EDs
Authors: Umgelter Andreas , Faust Markus , Wenske Slatomir , Umgelter Katrin , Schmid Roland M. , Walter Georg
Published: September 2023

Background

To assess differences between patients referred to emergency departments by a primary care physician (PCP) and those presenting directly and the impact of referral on the likelihood of admission.

Design of study

Retrospective cohort study.

Setting

EDs of two nonacademic general hospitals in a German metropolitan region.

Participants

Random sample of 1500 patients out of 80,845 presentations during the year 2019.

Results

Age was 55.8 ± 22.9 years, and 51.4% was female. A total of 34.7% presented by emergency medical services (EMS), and 47.7% were walk-ins. One-hundred seventy-four (11.9%) patients were referred by PCPs. Referrals were older (62.4 ± 20.1 vs 55.0 ± 23.1 years,p < .001) and had a higher Charlson Comorbidity Index (CCI) (3 (1–5) vs 2 (0–4);p < .001). Referrals received more ultrasound examinations independently from their admission status (27.6% vs 15.7%;p < .001) and more CT and laboratory investigations. There were no differences in sex, Manchester Triage System (MTS) category, or pain-scale values. Referrals presented by EMS less often (9.2% vs 38.5%;p < .001). Admission rates were 62.6% in referrals and 37.1% in non-referrals (p < .001). Referral (OR3.976 95%CI: 2.595–6.091), parenteral medication in ED (OR2.674 (1.976–3.619)), higher MTS category (1.725 (1.421–2.093)), transport by EMS (1.623 (1.212–2.172)), abnormal vital parameters (1.367 (0.953–1.960)), higher CCI (1.268 (1.196–1.344)), and trauma (1.268 (1.196–1.344)) were positively associated with admission in multivariable analysis, whereas ultrasound in ED (0.450 (0.308–0.658)) and being a nursing home resident (0.444 (0.270–0.728)) were negatively associated.

Conclusion

Referred patients were more often admitted. They received more laboratory investigations, ultrasound examinations, and computed tomographies. Difficult decisions regarding the necessity of admission requiring typical resources of EDs may be a reason for PCP referrals.