bluuebunny/crossref_metadata_2025 huggingface dataset:
Progressive Ulnar Neuropathy Following a Presumed Catfish Sting
Authors: Checkley Taylor , Cole Madeline , Shoja Mohammadali M. , Schwartz Gary
Published: September 2024

Catfish are a highly diverse group of fish comprising more than 3500 species found in both freshwater and marine ecosystems. Upon handling, they can inflict a sting, with certain species capable of inducing significant pain and injury to the affected extremity. The prevalence of aquatic activities, such as fishing by line or manual capture (“noodling”), increases the likelihood of catfish stings, making prompt identification and treatment an important aspect of managing such encounters. A case of a presumed catfish spine injury during noodling in Tallahassee, Florida, is presented. The pectoral fin penetrated the volar aspect of the patient's right hand resulting in immediate pain and numbness. Over the course of 2 weeks, the patient developed distal ulnar neuropathy with conduction block at the wrist level. Surgical exploration revealed the ulnar nerve to be grossly intact, but the area surrounding the terminal division point of the ulnar nerve in the hand displayed infiltration by fibrous tissue that entrapped the nerve and its branches. Following surgical release of the ulnar nerve and its terminal branches from the fibrous tissue, complete resolution of distal ulnar neuropathy was achieved. In this patient's case, the absence of foreign bodies and the lack of visible nerve damage suggest that the injury to the patient's hand was largely attributable to toxin-mediated proinflammatory response and fibrosis.
Study on the abrasion process and mechanism of rubber subjected to tipped cone scratching
Authors: Tian Yuxin , Wang Congwen , Xiao Chi , Zhao Chong , Dai Yujing , Huan Yong
Published: September 2024

The abrasion resistance of rubber is one of the important indicators of rubber, which significantly affects the durability and reliability of rubber products. To explore the abrasion resistance of rubber, this article uses the classic rubber-tipped cone model as the research object, and analyzes the rubber abrasion mechanism through experiments and numerical methods. To this end, a rubber abrasion experiment machine was first researched and developed, and the rubber abrasion process was analyzed through scratching experiments. Subsequently, the mechanical constitutive parameters of rubber were obtained through tensile experiments. Based on the finite element method, a rubber-tipped cone model was established and the fundamental reasons for rubber abrasion were analyzed. Finally, the effects of tipped cone taper, load, and speed on rubber abrasion were analyzed. The research results of this paper explain the rubber abrasion mechanism and provide theoretical references for improving the durability and reliability of rubber products.
Feasibility and desirability of a realist CMOC database: Lessons learned
Authors: Renmans Dimitri , Westhorp Gill , Astbury Brad , Belrhiti Zakaria , Hardwick Rebecca , Leeuw Frans , Maidment Ian , Williams Emma
Published: September 2024

Central to realist evaluation is its focus on underlying generative mechanisms that cause outcomes in particular contexts, often presented as context–mechanism–outcome configurations. The first author brought together 22 realist evaluation experts in a Delphi technique-inspired exercise to explore the potential of creating a database from context–mechanism–outcome configurations identified in the empirical literature, to enhance learning about what context–mechanism–outcome configurations are and to further the cumulation of knowledge. The exercise, and the comments it evoked, showed why developing such a database is not straightforward and the views on its desirability and utility are mixed. The main reasons are the lack of common concepts to organize the database and the problem of the triple hermeneutic, different uses and non-uses of the context–mechanism–outcome configuration heuristic, and different perceptions of the quality of a context–mechanism–outcome configuration. The discussion points raised in this exercise offer valuable insights into realist reasoning and highlight interesting avenues for further research and debate.
Comparison of Instructions to Authors and Reporting of Ethics Components in Selected African Biomedical Journals: 2008 and 2017
Authors: Dipeolu Isaac O. , Wassenaar Douglas R.
Published: September 2024

Journal editors instruct authors to describe human participant protections in original research reports. However, little is known about African biomedical journal authors’ adherence to such journal editors’ instructions. This study investigated changes in editors’ instructions to authors and authors’ reporting of research ethics information in selected African biomedical journals between 2008 and 2017. Twelve selected journal websites and online articles were reviewed in Eastern, Southern, and Western African [ESWA] countries. A pre-tested schema and a checklist were used to collect data from journal websites and articles published in 2008 and 2017, and the data were analysed using descriptive and inferential statistics. Half of the journals requested prospective authors to disclose ethics approval and related issues in their manuscripts between 2008 and 2017. There was a significant increase in instructions to authors regarding information on the protection of research participants within this period; more authors complied with these requirements in 2017 than in 2007.
Multi-objective optimization of series-parallel system with mixed subsystems failure dependencies using NSGA-II and MOHH
Authors: Mellal Mohamed Arezki
Published: September 2024

In complex systems, failure dependencies play a crucial role in determining their overall performance. This paper explores the multi-objective optimization of series-parallel systems with mixed failure dependencies. By optimizing system cost and availability, the study aims to identify the most efficient redundancy and repair strategies. Two optimization algorithms, the non-dominated sorting genetic algorithm II (NSGA-II) and a novel multi-objective algorithm named the multi-objective hoopoe heuristic (MOHH), are utilized alongside constraint handling techniques to produce Pareto fronts. These fronts illustrate the trade-offs between cost and availability. Additionally, a fuzzy decision method is utilized to determine the best compromise solutions from each optimization technique. Comparing the results, NSGA-II consistently outperforms MOHH in providing better compromise solutions across five independent runs. However, MOHH demonstrates a better standard deviation in its performance.
Examining the instructional process of citizenship education in Ethiopia: The case of secondary schools in the Amhara state
Authors: Worku Mulugeta Yayeh
Published: September 2024

This study aimed to examine the instructional process of citizenship education in secondary schools in the Amhara state of Ethiopia. To that end, a mixed-method research approach with a concurrent triangulation design was employed. A total of 107 citizenship education teachers and 480 students were selected from 24 secondary schools. Questionnaires, semi-structured interviews, and classroom observations were used as data gathering methods. The results of the study revealed that the status of classroom instructional methods in citizenship education was low. Instead of using a variety of specific instructional methods advocated by prominent scholars of the field, teachers were using traditional teacher-centered methods that were less appropriate to engage students in the teaching-learning process. Whole-school events were also found at their lowest stage. Many of the school-wide opportunities were not widely practiced in relation to citizenship education. The same was true for service-learning. The status of this instructional approach was not only extremely low, but its pedagogical significance was also not well understood by citizenship education teachers. Hence, areas of intervention that could improve the instructional process of secondary school citizenship education are indicated.
Criteria for assessing evidence for biomarker-targeted therapies in rare cancers—an extrapolation framework
Authors: Cho Doah , Lord Sarah J. , Ward Robyn , IJzerman Maarten , Mitchell Andrew , Thomas David M. , Cheyne Saskia , Martin Andrew , Morton Rachael L. , Simes John , Lee Chee Khoon
Published: September 2024

Background:

Advances in targeted therapy development and tumor sequencing technology are reclassifying cancers into smaller biomarker-defined diseases. Randomized controlled trials (RCTs) are often impractical in rare diseases, leading to calls for single-arm studies to be sufficient to inform clinical practice based on a strong biological rationale. However, without RCTs, favorable outcomes are often attributed to therapy but may be due to a more indolent disease course or other biases. When the clinical benefit of targeted therapy in a common cancer is established in RCTs, this benefit may extend to rarer cancers sharing the same biomarker. However, careful consideration of the appropriateness of extending the existing trial evidence beyond specific cancer types is required. A framework for extrapolating evidence for biomarker-targeted therapies to rare cancers is needed to support transparent decision-making.

Objectives:

To construct a framework outlining the breadth of criteria essential for extrapolating evidence for a biomarker-targeted therapy generated from RCTs in common cancers to different rare cancers sharing the same biomarker.

Design:

A series of questions articulating essential criteria for extrapolation.

Methods:

The framework was developed from the core topics for extrapolation identified from a previous scoping review of methodological guidance. Principles for extrapolation outlined in guidance documents from the European Medicines Agency, the US Food and Drug Administration, and Australia’s Medical Services Advisory Committee were incorporated.

Results:

We propose a framework for assessing key assumptions of similarity of the disease and treatment outcomes between the common and rare cancer for five essential components: prognosis of the biomarker-defined cancer, biomarker test analytical validity, biomarker actionability, treatment efficacy, and safety. Knowledge gaps identified can be used to prioritize future studies.

Conclusion:

This framework will allow systematic assessment, standardize regulatory, reimbursement and clinical decision-making, and facilitate transparent discussions between key stakeholders in drug assessment for rare biomarker-defined cancers.
Antithrombotic utilization, adverse events, and associations with treatment outcomes in multiple myeloma: pooled analysis of three clinical trials
Authors: Almansour Sara A. , Alqudah Mohammad A. Y. , Abuhelwa Ziad , Al-Shamsi Humaid O. , Alhuraiji Ahmad , Semreen Mohammad H. , Bustanji Yasser , Alzoubi Karem H. , Modi Natansh D. , Mckinnon Ross A. , Sorich Michael J. , Hopkins Ashley M. , Abuhelwa Ahmad Y.
Published: September 2024

Background:

Patients with multiple myeloma (MM) are at risk of venous thromboembolism (VTE), worsened by immunomodulatory drugs. Although antithrombotics are recommended for prophylaxis, existing guidelines are suboptimal and treatment outcomes remain unclear.

Objectives:

This study aimed to investigate adverse events, antithrombotic utilization, and their associations with survival outcomes in patients with MM initiating multi-drug immunomodulatory combinations.

Design:

A posthoc analysis of individual-participant level data (IPD).

Methods:

IPD from three daratumumab clinical trials (MAIA, POLLUX, and CASTOR) were pooled. Adverse events incidence and antithrombotic utilization were assessed. Logistic and Cox regression were utilized to examine associations between antithrombotics use with adverse events and survival outcomes at the baseline and 6-month landmark.

Results:

Among 1804 patients, VTE occurred in 10%, bleeding in 14%, ischemic heart disease in 4%, and stroke in 2%. Patients with these adverse events demonstrated elevated rates of any grade ⩾3 events. Antiplatelet (primarily aspirin) and anticoagulant (primarily LMWH and direct oral anticoagulants) prescriptions have seen an increase from baseline (25% and 14%, respectively) to 6 months (35% and 31%). The primary indication for their use was prophylaxis. Anticoagulant use within 6 months was associated with reduced VTE (OR (95% CI) = 0.45 (0.26–0.77), p = 0.004), while antiplatelet use showed no associations with any evaluated adverse events. Antithrombotics and survival outcomes had no significant associations.

Conclusion:

This study underscores the complexities of antithrombotic therapy and adverse events in MM and highlights the need for vigilant and proactive management due to increased grade ⩾3 adverse events. While anticoagulant use was associated with reduced VTE risk, further research is needed to optimize thromboprophylaxis guidelines and explore antithrombotic efficacy and safety in patients with MM.

Trial registration:

MAIA (NCT02252172), POLLUX (NCT02076009), CASTOR (NCT02136134).
YOLOv7-based automated detection platform for scalp lesions
Authors: Nguyen Hung Viet , Byeon Haewon
Published: September 2024

Objective

In dermatological research, the focus on scalp and skin health has intensified, particularly regarding prevalent conditions like dandruff and erythema. This study aimed to utilize YOLOv7 model to develop an automated detection web-based system for these specific scalp lesions.

Methods

Utilizing a dataset of 2200 clinical images, the model's accuracy and robustness were assessed. The raw images were initially preprocessed by the Roboflow tool. We then trained and evaluated the YOLOv7 model, comparing its performance with several baseline models including YOLOv5, YOLOF, and the single-shot detector. Finally, the proposed model was integrated into a flask API-based web application using the flask-ngrok library.

Results

The YOLOv7 demonstrated exceptional performance, attaining a mean average precision of 98.6%, with precision and recall rates of 98.6% and 97.2%, respectively. When benchmarked against baseline models, the YOLOv7 demonstrated enhanced performance metrics both during the training phase and the testing process on unseen data.

Conclusions

This study not only validates the potential of YOLOv7 for scalp lesion diagnostic applications but also brings the integration of sophisticated AI models into practical healthcare solutions.
Development of a Soft Tissue Knee Clinical Decision-Making Tool for Patients Presenting to Primary Point-of-Care Providers in Alberta, Canada
Authors: Eubank Breda H. F. , Takahashi Tim , Shields Ryan , Martyn Jason , Zhao Rachel Xurong , Lackey Sebastian W. , Slomp Mel , Werle Jason R. , Robert Jill , Hui Catherine
Published: September 2024

Several barriers exist in Alberta, Canada to providing accurate and accessible diagnoses for patients presenting with acute knee injuries and chronic knee problems. In efforts to improve quality of care for these patients, an evidence-informed clinical decision-making tool was developed. Forty-five expert panelists were purposively chosen to represent stakeholder groups, various expertise, and each of Alberta Health Services’ 5 geographical health regions. A systematic rapid review and modified Delphi approach were executed with the intention of developing standardized clinical decision-making processes for acute knee injuries, atraumatic/overuse conditions, knee arthritis, and degenerative meniscus. Standardized criteria for screening, history-taking, physical examination, diagnostic imaging, timelines, and treatment were developed. This tool standardizes and optimizes assessment and diagnosis of acute knee injuries and chronic knee problems in Alberta. This project was a highly collaborative, province-wide effort led by Alberta Health Services’ Bone and Joint Health Strategic Clinical Network (BJH SCN) and the Alberta Bone and Joint Health Institute (ABJHI).
Understanding Childhood Victimization Experiences and Mental Health Outcomes in a Sample of Prison Inmates in Northern Chile
Authors: Pinto-Cortez Cristián , Portilla-Saavedra Diego , Ferrer-Urbina Rodrigo , Diaz-Faes Diego Arias , Suárez-Soto Elizabeth , Rojas Marjorie , Carvajal Javiera , Zamora Alvaro
Published: September 2024

Prior research has shown a link between childhood victimization and adverse mental health effects in incarcerated individuals. However, these studies have generally focused on physical abuse or sexual abuse and have been conducted in developed countries. Based on this background, the present study aimed to explore the associations between different forms of childhood victimization and psychological distress in a sample of individuals deprived of liberty in northern Chile. Data from 229 participants in a high-security prison were analyzed, incorporating six victimization modules including conventional crimes, caregiver victimization, peer victimization, sexual victimization, and indirect victimization. Correlation analyses and hierarchical regression revealed associations between different victimization forms and psychological distress. Notably, gender, caregiver victimization, and sexual victimization emerged as the key predictors of mental health issues in this population. Considering that many of these individuals may have been exposed to experiences of victimization in their childhood, it becomes crucial to prioritize their mental well-being as part of their rehabilitation process. It is necessary to continue deepening the understanding of these phenomena through studies considering the high prevalence of mental health problems among individuals in correctional systems.
Gender Diversity Among Young Adolescents: Are Gender Attitudes, Sexual Orientation, Gender Roles, Gender Identity and Sex Assigned at Birth Associated With Liking to Become a Wo/Man and the Body Image of Young Adolescents in Belgium?
Authors: De Meyer Sara , Degomme Olivier , Michielsen Kristien
Published: September 2024

This study aims to understand how gender diversity and gender attitudes are linked to the sexual well-being of young adolescents. Data was collected among 561 adolescents in secondary schools in Flanders and binary logistic regressions were performed. Gender diversity was conceptualized as gender identity, gender expression, sex assigned at birth, sexual orientation and personal gender attitudes. Whereas “like to become a wo/man” and body image were used as measures for sexual well-being. Age and migration were added as covariates.The data illustrates that gender diversity is present among young adolescents and that it can be linked to young adolescent’s body image and liking to become a wo/man. In addition, it shows how diverse sets of gender attitudes are differently associated with sexual well-being outcomes. The findings also suggest the internalization of patriarchal and heterosexual societal norms by the respondents. The results indicate an association between on the one hand gender diversity and gender attitudes and on the other hand adolescent sexual well-being. Furthermore, it suggests that gender transformative research and programs that aim to improve adolescent sexual health and well-being should carefully choose their gender focus and invest in improving gender equity beyond the individual level. Additional research is needed to investigate the association between gender diversity and adolescent sexual wellbeing among diverse sexual well-being conceptualizations and specific groups (gender, ethnic, and others) of young adolescents.
“The Walls Had Been Built”: A Qualitative Study of Canadian Adolescent Perspectives on Mental Health During the COVID-19 Pandemic
Authors: Taylor Mischa , Dimitropoulos Gina , Scott Shannon D. , Ben-David Shelly , Hilario Carla
Published: September 2024

Public health measures (PHMs) implemented during the COVID-19 pandemic introduced sudden changes to adolescents’ everyday routines and required adolescents to repeatedly adapt their routines at a critical developmental stage. While meant to protect physical health, the PHMs destabilized mental health. Using a youth-engaged approach and interpretive description, this study explored adolescents’ perspectives on their mental health in relation to the COVID-19 pandemic-related PHMs in Canada from March 2020 to the time of data collection in March 2022. Four Youth Research Collaborators contributed an adolescent lens to informing study activities, and a total of 33 high-school aged adolescents ages 14 to 19 completed individual interviews. Findings suggest an overarching concept of a “timeline” through which adolescents described their experiences. Most adolescents described their mental health as worsening during the initial lockdown, although some adolescents experienced positive mental health outcomes. Several adolescents felt their mental health had not recovered after the PHMs were fully lifted. This study contributes young Canadians’ unique voices to the literature on the pandemic-related PHMs and adolescent mental health. It is essential that the impacts of the pandemic on adolescent mental health continue to be a focus of research and programming to better understand and address its ongoing effects.
US–Afghanistan Relations Post-withdrawal: Is There a Future?
Authors: Shahnan Zabih Ullah , Hussain Ejaz
Published: September 2024

Since the Taliban’s takeover of Afghanistan in 2021, no country, including the United States (US), has yet recognised the former. The US has consistently urged the regime to comply with the Doha agreement that emphasised an inclusive government. Moreover, the Biden administration has repeatedly asked the regime to respect human rights and allow girls education and employment, but in vain. What explains the divergences in US–Afghanistan relations post-withdrawal? What is the trajectory of the US–Taliban ties in the current context? Above all, is there any possibility of the US recognition of the Taliban regime in the foreseeable future? Based on primary data, it is posited that the relations between the US and the Taliban-controlled Afghanistan are divergent and currently antagonistic due to the Taliban’s non-compliance with the Doha agreement. Futuristically, the study explores three scenarios to predict US–Afghanistan relations. First, there is a likelihood of US–Afghanistan rapprochement if the Taliban do the US bidding. Second, in cases of non-compliance, the US would get tough on the regime in terms of further sanctions. However, the Taliban would consolidate (informal) ties with China, Russia and other regional countries, including Pakistan. Third, the US has the military capabilities to do regime change in Afghanistan in case of another 9/11-type incident in the US.
Facilitators of and Barriers to Effective Preceptorships for Pre-licensure Nursing Students: What Nursing Faculty Need to Know
Authors: Davis Suja P.
Published: September 2024

Introduction

Preceptorships offer prelicensure nursing students the opportunity to meet their clinical objectives by working one-on-one with a registered nurse (RN). Although preceptorships can be provided for any clinical course, most prelicensure nursing programs offer them during the final semester. Preceptorships provide a bridge between academic study and the real world of nursing. By acting as a teacher, role model, evaluator, and person who can help a student to socialize with the profession, a preceptor can reduce the reality shock experienced by new nurses and provide them with realistic expectations about the nursing profession. The recent nursing shortage has inadvertently led to a preceptor shortage and forced the nursing leadership to become dependent on available RNs, including those without preceptor training or experience.

Purpose

This practice update paper aimed to address the facilitators and barriers associated with preceptorships for prelicensure nursing students and discuss the proposed solutions for effective clinical preceptorship based on evidence and the author's personal reflections.

Conclusion

The major facilitators were the discussion of nursing program expectations, the selection of teaching strategies with real-world examples, the creation of a structured weekly plan to promote learning, and the consideration of alternative teaching approaches. The major barriers were preceptors' dual responsibilities to students and patients, challenging students, and the lack of experienced preceptors. The proposed solutions included obtaining support from the nursing leadership team to ensure that the preceptor had a balanced workload, developing the emotional competence of the preceptor, addressing challenging students through a three-way conference with the student, the preceptor, and the clinical faculty and a written plan to ensure student progress, having the nursing leadership conduct periodic assessments of the preceptor pool, and ensuring that appropriate training was offered to candidates who were willing to become preceptors.
Patients’ Preferences for Antiretroviral Therapy Service in Northwest Ethiopia: A Discrete Choice Experiment
Authors: Belay Yihalem Abebe , Yitayal Mezgebu , Atnafu Asmamaw , Taye Fitalew Agimass
Published: September 2024

Objective. We aim to evaluate patients’ preferences for antiretroviral therapy (ART) to enhance shared decision making in clinical practice in Northwest Ethiopia. Methods. A discrete choice experiment approach was used among adult patients from 36 randomly selected public health facilities from February 6, 2023, to March 29, 2023. A literature review, qualitative work, ranking and rating surveys, and expert consultation were used to identify the attributes. Location, provider, frequency of visit, appointment modality, refill time, and cost of visit were the 6 ART service features chosen. Participants were given the option of choosing between 2 hypothetical differentiated ART delivery models. Mixed logit and latent class analysis were used. Results: Four hundred fifty-six patients completed the choice task. Respondents preferred to receive ART refills alone at health facilities by health care workers without having to have frequent visits and with reduced cost of visit. Overall, the participants valued the cost of the visit the most while they valued the timing of ART refill the least. Participants were willing to pay only for the attributes of frequency of visit and medication refill time. The latent class model with 3 classes provided the best model fit. Location, cost, and frequency were the most important attributes in class 1, class 2, and class 3, respectively. Income and marital status significantly predicted class membership. Conclusions. Respondents preferred to receive refills at health facilities, less frequent visits, individual appointments, service provision by health care workers, and reduced cost of visit. The cost attribute had the greatest impact on the choice of patients. Health care workers should consider the preferences of patients while providing ART services to meet patients’ expectations and choices.

Highlights

A discrete choice experiment was used to elicit patient preferences. People living with HIV preferred receiving medication refills at health facilities, less frequent visits, individual appointments, service delivery by health care workers, and lower visit costs. Health care workers should consider the preferences of patients while providing ART service to meet their expectations and choices. Scaling up differentiated HIV treatment services is crucial for patient-centered care.
First Years Away From Home: Predictors of Engagement in a Self-Directed Prevention Handbook for Caregivers of Transitioning College Students
Authors: Cooper Brittany Rhoades , Skinner Martie L. , Haggerty Kevin P. , Hill Clara M. , Jenkins Garrett J. , Bumpus Matthew F. , Hill Laura G.
Published: September 2024

Caregiver and teen engagement in prevention programs is critical for positive outcomes, but barriers may reduce participation for those who may benefit most. Self-directed programs can reduce some barriers, but little research exists on predictors of engagement in these programs, especially those aimed at college-age youth and their caregivers. This paper describes engagement in a self-administered, paper handbook-based preventive intervention for students leaving home for their first year of college. Data are from the First Years Away from Home randomized controlled trial study. We measured four engagement outcomes: caregiver-reported initiation, caregiver- and student-reported dose, and caregiver-reported student engagement. Aim 1 was to describe caregiver and student engagement in the intervention; Aim 2 was to examine four categories of engagement predictors measured at baseline: sociodemographic, student, and caregiver factors, and caregiver–student relationship quality. Caregivers and students reported engaging with intervention materials, with 80% of caregivers and 77% of students reporting some handbook use. Most caregivers reported students as moderately to highly engaged. Some positive predictors of engagement outcomes included a positive caregiver–student relationship, greater student well-being, and caregiver disapproval of substance use. However, some were less engaged: risk factors for lower engagement included minoritized ethnicity status, student substance use, first-generation college student status, and students with poorer well-being and less positive relationships with their caregiver. Future work should examine ways to better engage families of students who may be entering college with higher levels of risk when creating and implementing interventions aimed at this developmental period.
Actions speak louder than words: An exploration of the role of shared activities in mentoring.
Authors: Dallos Rudi , Myhill Craig
Published: September 2024

The paper explores the experience of mentoring for a group of 18 disadvantaged young people taking part in the PromiseWorks mentoring programme in the Southwest of the UK. It builds on previous studies which showed that the young people in the scheme found mentoring to be valuable in building a positive relationship of trust, mutual understanding and safety. Also, the young people had stated that ‘actions speak louder than words’, namely, that engaging in mutually rewarding shared activities was an important way that this sense of trust had developed. This study aimed to explore this finding further through shared interviews with 18 pairs of mentors and mentees examining the nature of the activities they had engaged in, participants’ views and how this had contributed to the development of their relationship. The findings indicated that they had engaged in a very wide range of shared activities and that these were experienced as having a variety of benefits. They were seen as a source of mutual pleasure, relief from the troubled lives of the young people, helping to gain a state of calmness and fostering abilities to think. The activities were also seen as important in distinguishing the mentoring relationship from relationships with professionals, such as with teachers, counsellors and social workers. An important overall finding was that shared activities could generate a sense of calm for the young people which could make it more possible for them to express and reflect on their circumstances. Talking and reflection emerging spontaneously rather than being felt as an expectation, as in counselling was seen as helpful.
Can Blockchain Manage Trust in Organizations?
Authors: Cremer David De , Pang Yan
Published: September 2024

David De Cremer and Yan Pang illuminate both the limitations and the potential of blockchain technology as the new currency of trust in organizational life. They have found that building trust within organizations requires leaving room for vulnerability, which makes blockchain unsuitable. For building trust between organizations, however, blockchain technology shows more promise because it acts as a regulatory middleman.
Wolbachia strain diversity in a complex group of sympatric cryptic parasitoid wasp species
Authors: Valerio Federica , Martel Cornelia , Stefanescu Constanti , van Nouhuys Saskya , Kankare Maaria , Duplouy Anne
Published: September 2024

Background

Maternally-inherited symbionts can induce pre-mating and/or post-mating reproductive isolation between sympatric host lineages, and speciation, by modifying host reproductive phenotypes. The large parasitoid wasp genus Cotesia (Braconidae) includes a diversity of cryptic species, each specialized in parasitizing one to few related Lepidoptera host species. Here, we characterized the infection status of an assemblage of 21 Cotesia species from 15 countries by several microbial symbionts, as a first step toward investigating whether symbionts may provide a barrier to gene flow between these parasitoid host lineages.

Results

The symbiotic microbes Arsenophonus, Cardinium, Microsporidium and Spiroplasma were not detected in the Cotesia wasps. However, the endosymbiotic bacterium Wolbachia was present in at least eight Cotesia species, and hence we concentrated on it upon screening additional DNA extracts and SRAs from NCBI. Some of the closely related Cotesia species carry similar Wolbachia strains, but most Wolbachia strains showed patterns of horizontal transfer between phylogenetically distant host lineages.

Conclusions

The lack of co-phylogenetic signal between Wolbachia and Cotesia suggests that the symbiont and hosts have not coevolved to an extent that would drive species divergence between the Cotesia host lineages. However, as the most common facultative symbiont of Cotesia species, Wolbachia may still function as a key-player in the biology of the parasitoid wasps. Its precise role in the evolution of this complex clade of cryptic species remains to be experimentally investigated.
The effectiveness and outcomes of epidural analgesia in patients undergoing open liver resection: a propensity score matching analysis
Authors: Pianngarn Isarapong , Lapisatepun Worakitti , Kulpanun Maytinee , Chotirosniramit Anon , Junrungsee Sunhawit , Lapisatepun Warangkana
Published: September 2024

Background

Open liver resection necessitates a substantial upper abdominal inverted-L incision, resulting in severe pain and compromising patient recovery. Despite the efficacy of epidural analgesia in providing adequate postoperative analgesia, the potential epidural-related adverse effects should be carefully considered. This study aims to compare the efficacy and safety of continuous epidural analgesia and intravenous analgesia in open liver resection.

Methods

A retrospective study was conducted, collecting data from patients who underwent open liver resection between 2007 and 2017. Propensity score matching was implemented to mitigate confounding variables, with patients being matched in a 1:1 ratio based on propensity scores. The primary outcome was the comparison of postoperative morphine consumption at 24, 48, and 72 hours between the two groups. Secondary outcomes included pain scores, postoperative outcomes, and epidural-related adverse effects.

Results

A total of 612 patients were included, and after matching, there were 204 patients in each group. Opioid consumption at 24, 48, and 72 hours postoperatively was statistically lower in the epidural analgesia group compared to the intravenous analgesia group (p < 0.001). However, there was no significant difference in pain scores (p = 0.422). Additionally, perioperative hypotension requiring treatment, as well as nausea and vomiting, were significantly higher in the epidural analgesia group compared to the intravenous analgesia group (p < 0.001).

Conclusions

Epidural analgesia is superior to intravenous morphine in terms of reducing postoperative opioid consumption within the initial 72 h after open liver resection. Nevertheless, perioperative hypotension, which necessitates management, should be approached with consideration and vigilance.

Trial registration

The study was registered in the Clinical Trials Registry at www.clinicaltrials.gov/, NCT number: NCT06301932.
Clinical outcome of ampicillin or ampicillin/sulbactam versus glycopeptides in ampicillin-susceptible Enterococcus faecalis/faecium bacteremia: a 10-year retrospective cohort study
Authors: Seong Yeol Jung , Song Je Eun , Lee Eugene , Kim Eun Jin , Heo Jung Yeon , Choi Young Hwa , Kim Yong Chan
Published: September 2024

Background

Glycopeptides for ampicillin-susceptible Enterococcus faecalis/faecium bacteremia are readily prescribed depending on the severity of the condition. However, there is limited data on the outcomes of glycopeptide use compared to ampicillin-containing regimens for ampicillin-susceptible E. faecalis/faecium bacteremia. From an antibiotic stewardship perspective, it is important to determine whether the use of glycopeptides is associated with improved clinical outcomes in patients with ampicillin-susceptible E. faecalis/faecium bacteremia.

Methods

This retrospective cohort study was conducted at a university-affiliated hospital between January 2010 and September 2019. We collected data from patients with positive blood cultures for Enterococcus species isolates. The clinical data of patients who received ampicillin-containing regimens or glycopeptides as definitive therapy for ampicillin-susceptible E. faecalis/faecium bacteremia were reviewed. Multivariate logistic regression analysis was performed to identify risk factors for 28-day mortality.

Results

Ampicillin-susceptible E. faecalis/faecium accounted for 41.2% (557/1,353) of enterococcal bacteremia cases during the study period. A total of 127 patients who received ampicillin-containing regimens (N = 56) or glycopeptides (N = 71) as definitive therapy were included in the analysis. The 28-day mortality rate was higher in patients treated with glycopeptides (19.7%) than in those treated with ampicillin-containing regimens (3.6%) (p = 0.006). However, in the multivariate model, antibiotic choice was not an independent predictor of 28-day mortality (adjusted OR, 3.7; 95% CI, 0.6–23.6).

Conclusions

Glycopeptide use was not associated with improved mortality in patients with ampicillin-susceptible E. faecalis/faecium bacteremia. This study provides insights to reduce the inappropriate use of glycopeptides in ampicillin-susceptible E. faecalis/faecium bacteremia treatment and promote antimicrobial stewardship.
Association between nighttime sleep duration, nap time, and mild cognitive impairment in Chinese older adults: a cross-sectional study
Authors: Song Yanliqing , Liu Haoqiang , Gu KeNan , Liu Yue
Published: September 2024

Objective

This study aims to investigate the relationship between midday nap time, nighttime sleep duration, and mild cognitive impairment (MCI) in Chinese older adults and determine the recommended sleep duration to provide a scientific basis for preventing and managing MCI in this population.

Methods

Utilizing the 2020 China Health and Retirement Longitudinal Study database, the demographic data, health status, and lifestyle information of the study participants were collected. A total of 5,314 valid samples were included in the analysis. Logistic regression and restricted cubic spline plots were employed to explore the relationship between sleep patterns and MCI.

Results

In the cross-sectional analysis, a linear relationship was observed between midday nap duration and MCI among Chinese elderly. The probability of MCI was lowest among those who napped for less than 30 min at noon. Compared with individuals who napped for30-90 min, those who did not nap were more likely to have MCI (OR = 1.30, 95% CI: 1.05–1.60). Older adults with napping duration < 30 min (OR = 0.73, 95% CI:0.56–0.95) also exhibited lower probability of MCI when compared those without napping habit, Nighttime sleep duration exhibited a U-shaped relationship with MCI. Individuals with less than approximately 6 h of nighttime sleep showed a gradual decrease in the probability of MCI with increasing sleep duration, whereas those with more than 7.5 h demonstrated an increase in the probability of MCI with longer sleep duration. Older adults who slept less than 6 h at night (OR = 1.22, 95% CI: 1.01 ~ 1.46) or more than 8 h (OR = 1.78, 95% CI: 1.35–2.33) were more likely to develop MCI compared with those who slept 6 to 8 h.

Conclusion

After controlling for potential confounding variables, both nighttime sleep duration and midday nap duration exhibited a nonlinear “U”-shaped relationship with MCI among the elderly. The probability of depression was lower with a nap duration of approximately 60 min, and the optimal nighttime sleep duration was 6–8 h, with around 7 h providing the greatest cognitive benefits.
Does combining numerous data types in multi-omics data improve or hinder performance in survival prediction? Insights from a large-scale benchmark study
Authors: Li Yingxia , Herold Tobias , Mansmann Ulrich , Hornung Roman
Published: September 2024

Background

Predictive modeling based on multi-omics data, which incorporates several types of omics data for the same patients, has shown potential to outperform single-omics predictive modeling. Most research in this domain focuses on incorporating numerous data types, despite the complexity and cost of acquiring them. The prevailing assumption is that increasing the number of data types necessarily improves predictive performance. However, the integration of less informative or redundant data types could potentially hinder this performance. Therefore, identifying the most effective combinations of omics data types that enhance predictive performance is critical for cost-effective and accurate predictions.

Methods

In this study, we systematically evaluated the predictive performance of all 31 possible combinations including at least one of five genomic data types (mRNA, miRNA, methylation, DNAseq, and copy number variation) using 14 cancer datasets with right-censored survival outcomes, publicly available from the TCGA database. We employed various prediction methods and up-weighted clinical data in every model to leverage their predictive importance. Harrell’s C-index and the integrated Brier Score were used as performance measures. To assess the robustness of our findings, we performed a bootstrap analysis at the level of the included datasets. Statistical testing was conducted for key results, limiting the number of tests to ensure a low risk of false positives.

Results

Contrary to expectations, we found that using only mRNA data or a combination of mRNA and miRNA data was sufficient for most cancer types. For some cancer types, the additional inclusion of methylation data led to improved prediction results. Far from enhancing performance, the introduction of more data types most often resulted in a decline in performance, which varied between the two performance measures.

Conclusions

Our findings challenge the prevailing notion that combining multiple omics data types in multi-omics survival prediction improves predictive performance. Thus, the widespread approach in multi-omics prediction of incorporating as many data types as possible should be reconsidered to avoid suboptimal prediction results and unnecessary expenditure.
Past trends and future projections of palliative care needs in Chile: analysis of routinely available death registry and population data
Authors: Leniz Javiera , Domínguez Angélica , Bone Anna E. , Etkind Simon , Perez-Cruz Pedro E. , Sleeman Katherine E.
Published: September 2024

Background

The number of people with palliative care needs is projected to increase globally. Chile has recently introduced legislation for universal access to palliative care services for patients with severe and terminal illnesses, including non-cancer conditions. We aimed to estimate the number of people affected by serious health-related suffering and need for palliative care in Chile to 2050.

Methods

We used data on all deaths registered in Chile between 1997-2019 and population estimates for 1997–2050. We used Poisson regression to model past trends in causes of death adjusted by age, sex and population estimates, to project the number of deaths for each cause from 2021 to 2050. We applied the Lancet Commission on Palliative Care and Pain Relief weights to these projections to identify decedents and non-decedents with palliative care needs.

Results

Population palliative care needs in Chile are projected to increase from 117 (95% CI 114 to 120) thousand people in 2021 to 209 (95% CI 198 to 223) thousand people in 2050, a 79% increase (IRR 1.79; 95% CI 1.78–1.80). This increase will be driven by non-cancer conditions, particularly dementia (IRR 2.9, 95% CI 2.85–2.95) and cardiovascular conditions (IRR 1.86, 95% CI 1.83–1.89). By 2050, 50% of those estimated to need palliative care will be non-decedents (not expected to die within a year).

Conclusions

Chile will experience a large increase in palliative care needs, particularly for people with dementia and other non-cancer conditions. Improved availability of high-quality services, expanded clinician training and new sustainable models of care are urgently required to ensure universal access to palliative care.
Targeting NLRP3 inhibits AML progression by inducing PERK/eIF2-mediated apoptosis
Authors: Luciano Michela , Sieberer Helene , Krenn Peter W. , Dang Hieu-Hoa , Vetter Julia , Neuper Theresa , Amend Diana , Blöchl Constantin , Weichenberger Christian X. , Eglseer Anna , Unger Michael S. , Andosch Ancuela , Steiner Philip , Neureiter Daniel , Bauer Renate , Hummer Laura , Tesanovic Suzana , Binder Stephanie , Elmer Dominik P. , Strandt Helen , Schaller Susanne , Strunk Dirk , Pleyer Lisa , Greil Richard , Winkler Stephan , Hartmann Tanja N. , Schmidt-Arras Dirk , Huber Christian G. , Aberger Fritz , Horejs-Hoeck Jutta
Published: September 2024

Background

Acute myeloid leukemia (AML) is characterized by the abnormal proliferation of myeloid precursor cells and presents significant challenges in treatment due to its heterogeneity. Recently, the NLRP3 inflammasome has emerged as a potential contributor to AML pathogenesis, although its precise mechanisms remain poorly understood.

Methods

Public genome datasets were utilized to evaluate the expression of NLRP3 inflammasome-related genes (IL-1β, IL-18, ASC, and NLRP3) in AML patients compared to healthy individuals. CRISPR/Cas9 technology was employed to generate NLRP3-deficient MOLM-13 AML cells, followed by comprehensive characterization using real-time PCR, western blotting, FACS analysis, and transmission electron and immunofluorescence microscopy. Proteomic analyses were conducted to identify NLRP3-dependent alterations in protein levels, with a focus on the eIF2 kinase PERK-mediated signaling pathways. Additionally, in vivo studies were performed using a leukemic mouse model to elucidate the pathogenic role of NLRP3 in AML.

Results

Elevated expression of NLRP3 was significantly associated with diminished overall survival in AML patients. Genetic deletion, pharmacological inhibition and silencing by RNA interference of NLRP3 led to decreased AML cell survival through the induction of apoptosis. Proteomic analyses uncovered NLRP3-dependent alterations in protein translation, characterized by enhanced eIF2α phosphorylation in NLRP3-deficient AML cells. Moreover, inhibition of PERK-mediated eIF2α phosphorylation reduced apoptosis by downregulating pro-apoptotic Bcl-2 family members. In vivo studies demonstrated reduced leukemic burden in mice engrafted with NLRP3 knockout AML cells, as evidenced by alleviated leukemic symptoms.

Conclusion

Our findings elucidate the involvement of the NLRP3/PERK/eIF2 axis as a novel driver of AML cell survival. Targeting NLRP3-induced signaling pathways, particularly through the PERK/eIF2 axis, presents a promising therapeutic strategy for AML intervention. These insights into the role of the NLRP3 inflammasome offer potential avenues for improving the prognosis and treatment outcomes of AML patients.