bluuebunny/crossref_metadata_2025 huggingface dataset:
A comprehensive review of diagnosis and management of alcohol-associated hepatitis
Authors: Philips Cyriac Abby
Published: November 2024

Alcohol-associated hepatitis is an extreme form of alcohol-related liver disease associated with high short-term mortality. Currently, there are no authorized therapies for the treatment of severe alcohol-associated hepatitis. Important diagnostic steps for alcohol-associated hepatitis include recognizing the presence of an alcohol use disorder, distinguishing alcohol-related liver disease from metabolic-dysfunction-associated steatotic liver disease, ruling out alternative causes of acute hepatitis, confirming the diagnosis with validated criteria or a liver biopsy, and using the model for end-stage liver disease score to predict clinical outcome and initiate therapy. Due to the lack of other effective therapy options, corticosteroids continue to be used as initial treatment for patients with severe alcohol-associated hepatitis. Patients who do not improve while on steroid treatment and are ideal candidates should be considered for curative liver transplantation as soon as possible. Avoiding unnecessary and ineffective pharmacological and interventional therapy can help to keep costs down. If a patient is not a good candidate for a transplant or is rapidly deteriorating in health due to a condition such as acute or chronic liver failure, a salvage/bridge to transplant should be pursued through enrolment in a clinical trial program. The role of healthy donor stool transplant and targeted bacteriophage therapy seems promising, pending prospective controlled trials.
A case report of SMARCA4-deficient gastric cancer and review of the literature
Authors: Chen Lin , Cheng Zhengyi , Xu Yuqiao , Fang Guodong , Fang Hangrong
Published: November 2024

We report the case of a 50-year-old female with gastric carcinoma. The tumor was positive for epithelial and other immunological markers; however, SMARCA4 was completely inactivated. The histological and immunophenotypic findings were consistent with a diagnosis of SMARCA4-DTS. Next-generation sequencing identified a frameshift mutation in SMARCA4. The pathological diagnosis was SMARCA4-deficient gastric carcinoma. The tumor exhibits a poor response to conventional chemotherapy and has a poor prognosis; therefore, correct diagnosis is necessary. Moreover, new therapies such as EZH2 inhibitors and etoposide should be considered in cases where conventional chemotherapy is ineffective.
Atypical presentation of anti-small ubiquitin-like modifier 1 and melanoma differentiation-associated gene 5 antibody positive dermatomyositis presenting with significant inflammatory myopathy on biopsy and normal creatine kinase levels: A case report
Authors: Sama Srikar , Rasheed Nidaa , Shen Kyle , Khanlou Negar , Han Karam , Rodriguez-Pla Alicia
Published: November 2024

Idiopathic inflammatory myopathies are characterized by chronic inflammation of skeletal muscle. The main subtypes of idiopathic inflammatory myopathies include dermatomyositis, polymyositis, and necrotizing autoimmune myopathies. Dermatomyositis is characterized by symmetrical proximal muscle weakness, distinctive skin lesions, and systemic manifestations. Dermatomyositis commonly presents with elevated creatinine kinase levels. However, we report a case of a 19-year-old female presenting with dermatomyositis positive for anti-small ubiquitin-like modifier 1 and melanoma differentiation-associated gene 5 antibodies presenting with classic signs and symptoms like progressive proximal muscle weakness, dysphagia, hyperpigmented rash, and Gottron’s papules but had severe inflammatory myopathy on muscle biopsy and normal creatinine kinase levels. This case emphasizes an atypical presentation of dermatomyositis where she did not have amyopathic dermatomyositis despite having a positive anti-melanoma differentiation-associated gene 5 antibody and normal creatinine kinase. This underscores the importance of history and physical examination despite contradictory laboratory results.
Atypical presentation of psoriasis on the breast of an elderly woman: A case report
Authors: Adjei Susuana , Taha Mohamad R , Patel Anisha B , Tyring Stephen K
Published: November 2024

Psoriasis is a chronic, inflammatory skin disease that affects over 60 million adults and children globally. It is classically characterized by pink plaques covered with silver scales on the extensor surfaces, trunk, or scalp. In this report, we describe the case of a woman in her late 60s with psoriasis presenting as a painful plaque on her left breast. This case highlights the importance of considering psoriasis as a differential diagnosis in patients with unilateral breast plaques, even in the absence of typical psoriasis scaling elsewhere on the body.
Online Privacy, Young People, and Datafication: Different Perceptions About Online Privacy Across Antigua & Barbuda, Australia, Ghana, and Slovenia
Authors: Farthing Rys , Koren Ošljak Katja , Akuetteh Teki , Camacho Kadian , Smith-Nunes Genevieve , Zhao Jun
Published: November 2024

Children and young people’s online privacy is increasingly challenged by the datafication of the digital world, and this is an increasingly important area of policy concern. Understanding what young people understand online privacy to be, and what they want done to protect it, is key to creating effective and rights-realizing policy responses. This article explores young people’s perceptions across four countries and finds they have nuanced understandings about online privacy and clear, robust ideas about how to improve it. Context mattered, and their online privacy concerns and ideal protections were often informed by their socio-political context and awareness of and trust in datafication.
A Financing Constraints Paradox? Internal Finance and Capital Structure Link for Tourism Firms: Asian Emerging Market evidence
Authors: Tuğsal Doruk Ömer , Martial Gohore Bi Irie Claude
Published: November 2024

The aim of the study is to investigate the relationship between the internal financial and capital structure of an organization in the travel and tourism sector. The study shows how financial constraints on tourism companies affect their ability to finance themselves. The study also shows a relationship between tax shielding and financial leverage. This study analyzes panel data collected over a 21 year period, from 1998 to 2019, from over 100 publicly traded tourism companies in three Asian countries. A panel data methodology and the generalized method of moments estimation (GMM) were used in this empirical study. To support our hypothesis, using a generic method to evaluate parameter estimation will be our most effective method to improve the literature. Overall, the results show that financially stressed tourism firms use their option of debt-free tax avoidance to increase leverage. There is also a positive correlation between tax haven and leverage for firms with limited resources. The correlations between financial leverage and corporate debt supported by the results theoretically support the pecking order. By providing useful insights into the tax shielding of non-debt, which is significantly correlated with leverage for firms operating in tourism, this study closes the gap in firms’ capital structure decisions regarding access to finance.

JEL Classification: G0, G01, L25
From a Community to a ‘Scheduled Tribe’: A Ethnographic Study of the Hatti
Authors: Bharadwaj Arun , Thakur Ratika , Sinha Anil Kishore
Published: November 2024

The Hatti community of the Trans-Giri region of Sirmaur District with its recent inclusion in Article 342 of the Indian constitution was designated as Scheduled Tribe (ST). The research article is an ethnographic account of the Hatti Tribe of the Trans-Giri region of Sirmaur District, Himachal Pradesh. The study documents the rich culture and tradition of the Hattis in the existing social institutions of caste, family, marriage, kinship, political organisation and religion on account of fieldwork that was conducted in seven villages. The caste system of the Hatti observes strict defined hierarchies, their pre-determined roles and often determines occupation. It is divided into upper, middle and lower caste, with each caste further divided into sub-categories. The institution of kinship amongst the Hattis is unique and the recognition of kin is extended to the father’s father brother family such that kinship is identified and terminology is used for father’s father family. In addition, they recognise both consanguine and affinal kin and there is no distinct kinship term for lineal and collateral kin. The institution of marriage is also unique in its own way with five types of marriages that are known to take place in the area. Some of them are polyandrous marriage, monogamous marriage, remarriage usually/often after divorce, child marriage and marriage by elopement. Interestingly, all marriages have a different cultural process to solemnise the wedding. The political organisation of the Hattis is known by Khumbli, a traditional council that governs the law and order in the villages, is categorised as per village territories and is still considered the first place to resort differences. There is a close relationship between political and religious organisation such that many a times dispute resolution may take place at the deity level. The Hatti reflect a similar culture and tradition to the Jaunsari, a recognised ST in Uttarakhand. The existing Daichara between the two tribes is one of the strong indicators of common ancestral lines. The ethnographic account of the Hatti tribe in the research article is the first of its kind that documents the culture of the Hatti after they were granted the status of the ST before it embarked on the journey of planned development.
Examining the Reliability and Validity of Coding Perceived Force Severity and Bracing in the NHL Concussion Spotter Program
Authors: Riegler Kaitlin E. , Echemendia Ruben , Meeuwisse Willem , Comper Paul , Hutchison Michael G. , Delaney J. Scott , Bruce Jared M.
Published: November 2024

Background:

Data obtained from the National Hockey League (NHL) have shown that a risk prediction model, including both visible signs and mechanisms of injury, improves the identification of possible concussion. However, only about half of concussions diagnosed by club medical staff in the NHL exhibit visible signs. At present, the NHL concussion spotter protocol does not include central league spotters’ subjective judgments of the severity of forces associated with a direct hit to the head (perceived force severity [PFS]) or whether players brace before a hit (bracing).

Purpose:

To examine the interrater reliability, preliminary validity, and association with concussion diagnosis of central league spotter determinations of PFS and bracing.

Study Design:

Cross-sectional study.

Methods:

Video footage of 1071 events after a direct or indirect blow to the head were observed from the 2020-2021 and 2021-2022 NHL seasons. These events were classified into 4 groups: concussion with visible signs; concussion without visible signs; no concussion with visible signs; and no concussion without visible signs. A total of 50 events were randomly selected from the total events in each group. Then, 2 raters (NHL central league spotters) coded PFS for each of the 200 video events as low, medium, or high. Bracing was coded as no bracing, insufficient bracing, or full bracing.

Results:

Interrater reliability was fair to moderate for the categorical and continuous ratings of both PFS (κ = 0.36 and 0.45, respectively) and bracing (κ = 0.40 and 0.49, respectively). There was no significant association between concussion diagnosis and either PFS ( Z = 0.00, P = .99) or bracing ( Z = 0.77, P = .44). Exploratory, post hoc analyses suggested a possible relationship between bracing and reduced concussion risk among a select subsample of events with no visible signs ( r = −0.29, P < .01).

Conclusion:

The interrater reliability for PFS and for bracing was fair to moderate. Neither PFS nor bracing were significantly related to concussion diagnosis, but they were significantly associated with other visible signs and mechanisms of injury.
Toward a coping-in-combination approach: The benefits of combining coping strategies for purpose in life of the self-employed
Authors: Lerman Michael , Ju Huiqing , Nikolaev Boris
Published: November 2024

The self-employment coping literature typically treats coping strategies separately. In contrast to this approach, we introduce a control perspective to examine the effects of combining coping strategies on a highly salient well-being outcome for the self-employed: purpose in life. Drawing on the Midlife in the United States (MIDUS) dataset ( N = 693), moderation analysis reveals that persistence and positive reappraisal mitigate the negative effect of lowering aspirations on purpose in life. In robustness tests, we find consistent results across similar well-being indicators. Our evidence highlights the need to study specific coping strategies in tandem and provides a more nuanced perspective on the differential effects of both primary (i.e., persistence) and secondary (i.e., positive reappraisal and lowering aspirations) coping strategies.

JEL CLASSIFICATION: I - Health, Education, and Welfare
Gaza Crisis and the Arabic Press: A Discourse Analysis
Authors: Priya Lakshmi
Published: November 2024

The Hamas attack of October 7, 2023, and the Israeli military response have been widely covered in the Arabic press, reinforcing the popular narrative of a strong and aggressive Israeli state and the victimized Palestinians. The coverage underlines the wide support for Palestinians in the Arabic press. Broadly, one can divide the Arabic press into state-aligned and independent media, with the former’s coverage reflecting the opinions of the respective governments, while the latter showcases the views of non-state actors. A key trend that emerges is the strong anti-Israel sentiments prevailing in the Arab countries and the increased support for Palestinian statehood. Notably, there are serious discussions about the possibility of a two-state solution and the role Arab governments can play in convincing the two warring sides. There are some nuanced and veiled criticisms of Hamas’s actions that triggered the current spate of violence. A closer reading of select international Arabic-language media (print and online) reveals the nuanced shifts in their coverage toward the Israeli-Palestinian conflict.
Israel as India’s Pivot in the IMEC
Authors: Hameed Sameena
Published: November 2024

India’s policy on the Middle East has broadly been bilateral and in the process, it had to strike a fine balance in furthering relations with countries that are rivals. Its “Look West” policy, introduced in 2005, made some inroads in the Middle East, enlarging its economic and strategic footprints. In recent years, it has stepped up its engagements through minilateral and multilateral frameworks by joining India, Israel, the United States, and the United Arab Emirates (UAE) (I2U2) grouping and jointly launching the India-Middle East-Europe Economic Corridor (IMEC). The I2U2 was launched in 2020 for expansive economic cooperation in vital areas of water, energy, transportation, space, health, and food security. It was catalyzed in the backdrop of the Abraham Accords. In September 2023, during the G20 summit in New Delhi, seven countries, namely, India, Saudi Arabia, the UAE, France, Germany, Italy, the United States, and the European Union (EU), signed a Memorandum of Understanding for the IMEC. The October 7, 2023 attack on Israel and its attendant consequences have threatened to derail this multilateral cooperation, but India and other signatories have remained steadfast in their commitment to IMEC, raising hope for its future.
No (Startup) Experience Required: Entrepreneurship Education Effectiveness for Early Career Graduates
Authors: McMahon Sean R. , Henshaw Graham , Dowin Kennedy Elena , Brannon David L. , Podlesny Anna Obedkova , Powell Kathleen I.
Published: November 2024

Entrepreneurship as a discipline in higher education has enjoyed significant growth in student enrollment and attention. Venture formation drives employment and innovation, and founding a startup remains the ultimate incarnation of entrepreneurship. Yet, evidence shows that most entrepreneurship students will not start a new venture upon graduation. This research looks beyond venture formation to explore early career outcomes of entrepreneurship education (EE) graduates as compared to alumni with no EE. Alumni were surveyed one to five years following graduation from three universities in the United States, resulting in the examination of responses of 353 participants, 107 of whom completed a major, minor, or concentration in entrepreneurship. Human capital theory was employed to investigate the impact of EE on early career success. Findings of the study confirm a positive relationship between EE and venture formation, but also indicate EE increases generalizable competencies and indicators of professional advancement. Further, entrepreneurial behaviors mediate the relationship between EE and professional competencies, and professional competencies mediate the relationship between EE and advancement. This suggests that no startup is required for students of entrepreneurship to achieve early success and advancement, as the active, experiential, and goal-oriented nature of EE accentuates generalizable workplace attributes desired by employers.
Medical influence: what does success look like?
Authors: Wintz Diane , Wright Kelly , Schaffer Kathryn B.
Published: November 2024

Background:

Social media influencers have revolutionized information, gaining viewers, retention, and interest with short videos. Medical teams could potentially benefit from this medium for educating patients. Defining success in this endeavor remains unclear.

Objective:

We are a surgeon-nurse team that sought to promote our messages on social media to gain viewers and interest in our website.

Design:

An educational podcast focusing on end-of-life discussions was linked to social media platforms, including Instagram and TikTok, to gain views on our website.

Methods:

Eleven podcast episodes were produced and published over a 3-month period, between November 2023 and January 2024. The podcast episodes were promoted to “similar clients” based on internal algorithms by a podcast streaming service, Spotify. The promotion provided by Spotify and website views were compared to responses evident by other social media posts.

Results:

After 3 months of publishing podcast episodes on Spotify, with free publicity, our podcast gained 10,400 promotions, 486 listeners, 49 followers, and approximately 1200 random website views. In comparison, the podcast content garnered more than 50,000 video clip views on TikTok and Instagram, after funding these brief video promotions. TikTok and Instagram both charged $20 or more per promotion. Paid promotion opportunities resulted in no website visits or podcast followers.

Conclusion:

Our own experience with social media promotion was inadequate in generating interest in our content. The authors would encourage other teams to be strategic with paid promotions and to consider engaging a marketing expert to improve the potential for mass interest in content and promotional efficiency. Additionally, based on these findings, the authors would appreciate more transparency in the algorithms behind successful promotions to better understand “what success looks like” for medical messaging.
Lateral Meniscus Allograft Transplant With Capsulodesis and an Osteochondral Allograft to the Lateral Femoral Condyle
Authors: Garcia Jose Rafael , Allende Felicitas , Chahla Jorge
Published: November 2024

Background:

Anterior cruciate ligament (ACL) injuries frequently present with lateral meniscal injuries, and when irreparable, this may lead to meniscectomy, increasing the risk for osteoarthritis. Lateral meniscal allograft transplant (LMAT) can restore knee function and proper contact pressures. When combined with osteochondral allograft (OCA) for chondral defects, results are highly positive.

Indications:

LMAT is indicated in relatively young patients (<50 years of age) with a symptomatic, meniscus-deficient knee that has failed conservative treatment. The knee must be stable, without articular cartilage damage that cannot be repaired, and patients should be able to adhere to postoperative rehabilitation and future care. Indications for OCA include young, active patients with posttraumatic osteochondral defects, osteonecrosis, osteochondritis dissecans, large focal defects, previous cartilage repair failure, or patellofemoral joint cartilage lesions.

Technique Description:

After a diagnostic arthroscopy is performed and concomitant injuries are ruled out, the lateral meniscal tissue is debrided to a 1- to 2-mm rim for the recipient site preparation. Tibial sockets for root fixation are created using tibial guides and passing sutures are placed. A capsulodesis is performed to reduce meniscal extrusion by securing the lateral capsule through a transtibial tunnel to the anteromedial tibial cortex with high-strength sutures. A meniscal allograft, prepared with bone plugs, is introduced through an enlarged anterolateral portal. After it is accurately positioned, it is stabilized using Fast-Fix Flex devices and circumferential sutures. The bone plug sutures are then fixed through the tibial tunnels to the anteromedial tibial cortex with a button. The large cartilage defect is addressed with an OCA transplant, involving defect measurement, careful reaming, and press-fit insertion of a donor plug, ensuring congruent articulation.

Results:

Patients can expect improved clinical outcomes and high patient satisfaction with LMAT and concomitant OCA. The use of bone plugs minimizes soft tissue dissection while achieving solid osseous fixation.

Discussion/Conclusions:

LMAT with OCA leads to restored contact pressures to near-physiological levels, a high patient satisfaction of over 85%, and mean allograft survival of 16 years.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Is limiting the temperature increase to 1.5°C still possible?
Authors: Peters Glen P.
Published: November 2024

It is always possible to find arguments to make 1.5°C forever possible, but they increasingly diverge from reality. It is time to admit that the world will cross 1.5°C and the likelihood of returning below 1.5°C via overshoot is slim. But, failing on 1.5°C does not mean the world has failed. The Paris Agreement is about balancing risks in a ‘well below 2°C’ world, and that level of ambition remains achievable despite a less certain climate outcome. We no longer need scenarios with impossibly steep emission declines to 1.5°C, but more nuanced country-level scenarios integrating national circumstances and feasible ambitions. This is harder for researchers, but more confronting for policy makers. Crossing 1.5°C is not a time to give up but a time to acknowledge our failures and find a new hope moving forward.
Trimming the UCERF3-TD logic tree: Model order reduction for an earthquake rupture forecast considering loss exceedance
Authors: Porter Keith , Milner Kevin , Field Edward
Published: November 2024

The Uniform California Earthquake Rupture Forecast version 3-Time Dependent depicts California’s seismic faults and their activity. Its logic tree has 5760 leaves. Considering 30 more model combinations related to ground motion produces 172,800 distinct models representing so-called epistemic uncertainties. To calculate risk to a portfolio of buildings, one also considers millions of earthquakes and spatially correlated ground-motion variability. We offer a tree-trimming technique that retains the probability distribution of portfolio loss and identifies the leading sources of uncertainty for further study. We applied it to a California statewide building portfolio and various levels of nonexceedance probability between one in 100 and one in 2500. We trimmed the logic tree from 172,800 leaves to as few as 15. The result: a supercomputer that would otherwise run 24 h to estimate the distribution of one-in-250-year loss can calculate it in moments with the reduced-order model. Others can use the reduced-order model to calculate risk to different California portfolios, and scientists can prioritize study to reduce the remaining epistemic uncertainty.
Mineralogy and genetic considerations of the metamorphosed As-rich manganese ore mineralisation at the Diely occurrence near Poráč, Northern Gemeric Unit, Western Carpathians, Slovakia
Authors: Myšľan Pavol , Števko Martin , Mikuš Tomáš , Vrtiška Luboš
Published: November 2024

The Diely occurrence of metamorphosed As-rich manganese mineralisation is located in the Spišsko-gemerské rudohorie Mountains near the Poráč village and comprises Early Palaeozoic metamorphic rocks of the Gemeric Unit in the Western Carpathian region. Mineralisation is situated in the narrow tectonically delineated belt of Rakovec Group rocks consisting of mafic metavolcanic material generated during the back-arc submarine volcanic activity of the Early Ordovician–Silurian period. The Mn mineralisation is hosted in siliceous laminated lenses (metacherts) embedded in metabasalts and its tuffs. Manganese ore consists of quartz, braunite, rhodonite, nambulite, rhodochrosite, kutnohorite, OH-bearing garnets with dominant andradite composition, hematite, aegirine, aegirine–augite, ferri-ghoseite, ferri-winchite, baryte and pyrophanite. The mineralisation is cross-cut by a system of narrow younger veins composed dominantly of As-enriched minerals of the pyrosmalite group (schallerite, mcgillite and friedelite), tiragalloite, manganberzeliite, brandtite, sarkinite and svabite, associated with hematite, rhodochrosite, kutnohorite, baryte and quartz. Formation of manganese mineralisation at the Diely occurrence was caused by migration of seawater into the basaltic oceanic crust where increasing temperatures and acidity generated hydrothermal fluids enriched in manganese. The Mn-bearing hydrothermal fluids were enriched in Li, providing an additional substituent in the mineralisation. Following initial stages, the subsequent Variscan and Alpine tectonometamorphic events resulted in formation of three main mineralisation stages distinguishable by paragenetic relations and the mineral composition. Based on metamorphic association and amphibole geobarometric calculations, the peak metamorphic conditions reached was upper greenschist facies. The Diely occurrence near Poráč represents a unique metamorphosed manganese mineralisation with abundant arsenates and arsenosilicates previously unknown in the Western Carpathian region.
Small cell lung cancer and neuroendocrine tumours
Authors: Pandjarova Ivelina , Mercieca Darlene , Gijtenbeek Rolof G.P. , Pereira João Oliveira , Fantin Alberto , Castaldo Nadia , Keramida Elli , Pannu Kanwar , Konsoulova Assia , Aujayeb Avinash
Published: November 2024

Lung cancer is one of the leading causes of death worldwide. It can broadly be divided into small cell lung cancer (SCLC) and nonsmall cell lung cancer. There have been many advances over the recent years in both fields. The purpose of this review is to provide a concise summary of SCLC for the general respiratory readership.
Pro: indwelling pleural catheters cause harm to patients
Authors: Iqbal Beenish , Bedawi Eihab , Rahman Najib M.
Published: November 2024

Malignant pleural effusions (MPE) tend to recur and require definitive treatment with either chest drain and talc pleurodesis or indwelling pleural catheters (IPCs), which offer similar symptomatic benefits. In recent years, IPCs have become popular due to the presumed convenience of an outpatient procedure followed by home drainage leading to a misconception of IPCs being an ideal treatment for MPE. However, IPCs predispose the patient to multiple complications and have significant physical and psychological implications that are under-recognised. Patients require additional clinical reviews, hospital admissions and treatment for these complications related to IPCs. Additionally, there is a huge psychological impact of living with a home catheter that is a constant reminder of their cancer and this has been shown to affect quality of life negatively. Hence, IPCs should not be considered the “ideal” treatment for MPE management and clinicians should reflect the equipoise of the evidence for the benefits and accurately reflect the adverse effects of IPCs in their discussions with patients to facilitate informed decision making.
Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management
Authors: Jovanovic Dragana , Ceriman-Krstic Vesna , Kabalak Pınar Akın , Viola Lucia , Papatheodosiou Konstantinos
Published: November 2024

Palliative care pertains to the holistic multidimensional concept of “patient-centred” care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients’ symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient–physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians,i.e.pneumologists/thoracic oncologists.
m6A-modified circCacna1c regulates necroptosis and ischemic myocardial injury by inhibiting Hnrnpf entry into the nucleus
Authors: Jia Yi , Yuan Xiaosu , Feng Luxin , Xu Qingling , Fang Xinyu , Xiao Dandan , Li Qi , Wang Yu , Ye Lin , Wang Peiyan , Ao Xiang , Wang Jianxun
Published: November 2024

Background

Circular RNAs (circRNAs) are differentially expressed in various cardiovascular diseases, including myocardial infarction (MI) injury. However, their functional role in necroptosis-induced loss of cardiomyocytes remains unclear. We identified a cardiac necroptosis-associated circRNA transcribed from the Cacna1c gene (circCacna1c) to investigate the involvement of circRNAs in cardiomyocyte necroptosis.

Methods

To investigate the role of circCacna1c during oxidative stress, H9c2 cells and neonatal rat cardiomyocytes were treated with hydrogen peroxide (H2O2) to induce reactive oxygen species (ROS)-induced cardiomyocyte death. The N6-methyladenosine (m6A) modification level of circCacna1c was determined by methylated RNA immunoprecipitation quantitative polymerase chain reaction (MeRIP–qPCR) analysis. Additionally, an RNA pull-down assay was performed to identify interacting proteins of circCacna1c in cardiomyocytes, and the regulatory role of circCacna1c in target protein expression was tested using a western blotting assay. Furthermore, the MI mouse model was constructed to analyze the effect of circCacna1c on heart function and cardiomyocyte necroptosis.

Results

The expression of circCacna1c was found to be reduced in cardiomyocytes exposed to oxidative stress and in mouse hearts injured by MI. Overexpression of circCacna1c inhibited necroptosis of cardiomyocytes induced by hydrogen peroxide and MI injury, resulting in a significant reduction in myocardial infarction size and improved cardiac function. Mechanistically, circCacna1c directly interacts with heterogeneous nuclear ribonucleoprotein F (Hnrnpf) in the cytoplasm, preventing its nuclear translocation and leading to reduced Hnrnpf levels within the nucleus. This subsequently suppresses Hnrnpf-dependent receptor-interacting protein kinase 1 (RIPK1) expression. Furthermore, fat mass and obesity-associated protein (FTO) mediates demethylation of m6A modification on circCacna1c during necrosis and facilitates degradation of circCacna1c.

Conclusion

Our study demonstrates that circCacna1c can improve cardiac function following MI-induced heart injury by inhibiting the Hnrnpf/RIPK1-mediated cardiomyocyte necroptosis. Therefore, the FTO/circCacna1c/Hnrnpf/RIPK1 axis holds great potential as an effective target for attenuating cardiac injury caused by necroptosis in ischemic heart disease.

Graphical Abstract
Isolated hydatid cyst in the medial rectus muscle: unveiling a rare orbital occurrence
Authors: Attar Alireza , Khademi Behzad , Jalalpour Mohammad Hassan
Published: November 2024

Background

Orbital hydatid disease, while rare, should be included in the differential diagnosis of unilateral proptosis, particularly in endemic areas. Accurate diagnosis and comprehensive management are essential for effective treatment and favorable long-term outcomes.

Case Presentation

A 12-year-old boy presented with a one-month history of diplopia and left-sided proptosis. A CT scan revealed a cystic mass within the left medial rectus muscle. Surgical intervention confirmed the presence of a hydatid cyst following cyst rupture and irrigation with hypertonic saline. The patient underwent a two-month course of albendazole therapy. Initially, the patient experienced persistent exotropia and diplopia, but at the three-year follow-up, he exhibited no diplopia or proptosis and only mild residual exotropia.

Conclusion

This case underscores the importance of considering orbital hydatid cysts in the differential diagnosis of unilateral proptosis in endemic regions. Heightened awareness, accurate diagnosis, and a tailored therapeutic approach, including surgical removal and antiparasitic treatment, are crucial for successful management and improved long-term outcomes.
Balancing between reality, ideality, and equity: critical reflections from recruiting key informants for qualitative health research
Authors: Luetke Lanfer Hanna , Krawiec Sarah , Schierenbeck Miriam , Touzel Victoria , Reifegerste Doreen
Published: November 2024

Background

Key informant interviews (KII) are a widely used method in qualitative health research to gain in-depth insights from individuals with specialized knowledge, experience, or access that is crucial to the research topic. However, there is growing criticism regarding how the selection of key informants is insufficiently described in research. This opacity is problematic as the authority and knowledge of key informants may be given undue weight in research findings, potentially overshadowing other non-expert samples. The resulting imbalance in representation can lead to favoring certain viewpoints while marginalizing others, and thereby reinforcing existing inequities.

Methods

Using our KII study as an example, we demonstrate how we initially composed an ideal sample based on theoretical considerations and subsequently operationalized it in the field. We employed a selective recruitment strategy informed by intersectional theory, targeting physicians with migration backgrounds from Middle Eastern countries for a study on cancer prevention and screening. Our recruitment process combined direct methods, including database searches and email outreach, with indirect methods like snowball sampling and engagement with multipliers. The recruitment strategy was iterative, allowing for ongoing assessment and adaptation to ensure a diverse and representative sample.

Results

The KII study successfully recruited 21 physicians with diverse social categories, including different genders, migration backgrounds, language skills, and medical specialties. Direct recruitment was more effective than indirect methods and allowed for greater control in reaching out to specific subsamples. It highlights the importance of flexible and persistent recruitment strategies to achieve the desired sample.

Conclusions

This KII study underscores the interplay between methodological ideals and the practical realities of recruiting a diverse, carefully composed sample of key informants in health research. Our intersectional approach aimed to ensure equitable representation by considering power dynamics and refining recruitment strategies, while balancing the challenges of real-world fieldwork-such as engaging busy physicians with specific recruitment criteria-with practical adaptability. Our KII study emphasizes the need for ongoing reflexivity to balance ideality and equity with practical feasibility.
Design, creation, and use of the Test Us Bank (TUB) COVID-19 sample biorepository
Authors: Broach John , Achenbach Chad , Behar Stephanie , O’Connor Laurel , Tarrant Seanan , Ferranto Julia , Wright Colton , Hartin Paul , Orwig Taylor , Nanavati Janvi , Kalibala Benedict , Woods Kelsey , Shaw Bernadette , Flahive Julie , Barton Bruce , Hafer Nathaniel , Herbert Carly , Fahey Nisha , Gibson Laura , Simin Karl , Kowalik Timothy , Ward Doyle V. , Mirza Agha W. , Murphy Robert L. , Caputo Matthew , Buchholz Bryan , Fantasia Heidi , Koren Ainat , Marchand Lisa , Oludare Simisola , Sogade Felix , Ritland Dana , Davis Cedrice , Grenier Allen , Baron Christi , Brent Ellie , McKenney Jennifer Bacani , Elder Nancy , Michaels LeAnn , Ferrara Laura , Theron Grant , Palmer Zaida , Levy Barcey , Daly Jeanette , Parang Kim , Schmidt Megan , Buxton Denis , Heetderks William , Manabe Yukari C. , Soni Apurv , McManus David
Published: November 2024

Shortly after the first case of SARS-CoV-2 was diagnosed a public health emergency (PHE) was declared and a multi-agency response was initiated within the US federal government to create and propagate testing capacity. As part of this response, an unprecedented program designated Rapid Acceleration of Diagnostics (RADx) Tech was established by the National Institutes of Health (NIH) to facilitate the development of point-of-care tests for the COVID-19. The RADx Tech Clinical Studies Core (CSC), located at the University of Massachusetts Chan Medical School (UMass Chan), with partnering academic, private, and non-governmental organizations around the country, was tasked with developing clinical studies to support this work. This manuscript details development of a biorepository specifically focused on the collection and storage of samples designed for diagnostic platform development. It highlights the unified collection and annotation process that enabled gathering a diverse set of samples. This diversity encompasses the geography and backgrounds of the participants as well as sample characteristics such as variant type and RT-PCR cycle threshold (CT) value of the corresponding reference sample on a uniform clinical reference platform.
A deep learning based method for left ventricular strain measurements: repeatability and accuracy compared to experienced echocardiographers
Authors: Rogstadkjernet Magnus , Zha Sigurd Z. , Klæboe Lars G. , Larsen Camilla K. , Aalen John M. , Scheirlynck Esther , Singstad Bjørn-Jostein , Droogmans Steven , Cosyns Bernard , Smiseth Otto A. , Haugaa Kristina H. , Edvardsen Thor , Samset Eigil , Brekke Pål H.
Published: November 2024

Background

Speckle tracking echocardiography (STE) provides quantification of left ventricular (LV) deformation and is useful in the assessment of LV function. STE is increasingly being used clinically, and every effort to simplify and standardize STE is important. Manual outlining of regions of interest (ROIs) is labor intensive and may influence assessment of strain values.

Purpose

We hypothesized that a deep learning (DL) model, trained on clinical echocardiographic exams, can be combined with a readily available echocardiographic analysis software, to automate strain calculation with comparable fidelity to trained cardiologists.

Methods

Data consisted of still frame echocardiographic images with cardiologist-defined ROIs from 672 clinical echocardiographic exams from a university hospital outpatient clinic. Exams included patients with ischemic heart disease, heart failure, valvular disease, and conduction abnormalities, and some healthy subjects. An EfficientNetB1-based architecture was employed, and different techniques and properties including data set size, data quality, augmentations, and transfer learning were evaluated. DL predicted ROIs were reintroduced into commercially available echocardiographic analysis software to automatically calculate strain values.

Results

DL-automated strain calculations had an average absolute difference of 0.75 (95% CI 0.58–0.92) for global longitudinal strain (GLS), and 1.16 (95% CI 1.03–1.29) for single-projection longitudinal strain (LS), compared to operators. A Bland–Altman plot revealed no obvious bias, though there were fewer outliers in the lower average LS ranges. Techniques and data properties yielded no significant increase/decrease in performance.

Conclusion

The study demonstrates that DL-assisted, automated strain measurements are feasible, and provide results within interobserver variation. Employing DL in echocardiographic analyses could further facilitate adoption of STE parameters in clinical practice and research, and improve reproducibility.
Are rates of clinical interventions during pregnancy and childbirth different for refugees and asylum seekers in high-income countries? A scoping review
Authors: Bukkfalvi-Cadotte Alix , Naha Gargi , Khanom Ashra , Brown Amy , Snooks Helen
Published: November 2024

Background

Adequate maternity care and appropriate clinical interventions during labour and delivery can reduce adverse perinatal outcomes, but unnecessary interventions may cause harm. While studies have shown that refugees and asylum seekers face important barriers when accessing maternity care, there is a lack of high-quality quantitative data on perinatal health interventions, such as induction of labour or caesarean sections, among refugees and asylum seekers and the findings reported in the literature tend to be inconsistent. Our goal was to examine and synthesise the evidence regarding the rates of intrapartum clinical interventions in women who are refugees and asylum seekers in high-income countries compared to other population groups.

Methods

We conducted a scoping review of peer-reviewed studies published in English since 2011 that report original quantitative findings regarding intrapartum clinical interventions among refugees and asylum seekers in high-income countries compared to those in non refugee, non asylum seeker populations. We examined reported rates of clinical pain relief, labour induction and augmentation, episiotomies, instrumental deliveries, and caesarean sections.

Results

Twenty-five papers were included in the review. Findings indicate that refugees and asylum seekers were less likely to receive pain relief, with 16 out of 20 data points showing unadjusted ORs ranging from 0.20 (CI: 0.10–0.60) to 0.96 (CI: 0.70–1.32). Similarly, findings indicate lower odds of instrumental delivery among refugees and asylum seekers with 14 of 21 data points showing unadjusted ORs between 0.25 (CI: 0.15–0.39) and 0.78 (CI: 0.47–1.30); the remaining papers report no statistically significant difference between groups. There was no discernable trend in rates of labour induction and episiotomies across studies.

Conclusions

The studies included in this review suggest that asylum seekers and refugees are less likely to receive clinical pain relief and experience instrumental delivery than non-refugee groups in high-income countries. This review strengthens our understanding of the links between immigration status and maternity care, ultimately informing policy and practice to improve perinatal health and the provision of care for all.
Cytokine and growth factor correlation networks associated with morbidities in extremely preterm infants
Authors: Golubinskaya Veronika , Nilsson Holger , Rydbeck Halfdan , Hellström William , Hellgren Gunnel , Hellström Ann , Sävman Karin , Mallard Carina
Published: November 2024

Background

Cytokines and growth factors (GF) have been implicated in the development of retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD). We hypothesize that even small coordinated changes in inflammatory proteins or GFs may reveal changes in underlying regulating mechanisms that do not induce obvious changes in concentration of individual proteins. We therefore applied correlation network analysis of serum factors to determine early characteristics of these conditions.

Methods

Concentrations of 17 cytokines and five GFs were measured and analysed in blood samples from cord blood, on day one and during the following month in 72 extremely preterm infants. Spearman’s correlation networks distinguishing BPD and severe ROP patients from non-affected were created.

Results

Most cytokine concentrations correlated positively with each other and negatively with GFs. Very few individual cytokines differed between patients with and without ROP or BPD. However, networks of differently correlated serum factors were characteristic of the diseases and changed with time. In ROP networks, EPO, G-CSF and IL-8 (cord blood), BDNF and VEGF-A (first month) were prominent. In BPD networks, IL-1β, IGF-1 and IL-17 (day one) were noted.

Conclusions

Network analysis identifies protein signatures related to ROP or BPD in extremely preterm infants. The identified interactions between serum factors are not evident from the analysis of their individual levels, but may reveal underlying pathophysiological mechanisms in the development of these diseases.
Associations of generalized anxiety and social anxiety symptoms with sleep duration, amount of intense exercise, and excessive internet use among adolescents
Authors: Kajastus Kati , Kiviruusu Olli , Marttunen Mauri , Ranta Klaus
Published: November 2024

Background

Among adolescents, symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are not only clinically significant but also continuingly increasing. During adolescence, individuals begin to establish distinct, self-determined lifestyle patterns. This study seeks to identify the associations between such lifestyle factors and the prevalence of GAD and SAD symptoms.

Methods

The analyzable sample was based on a cross-sectional, nationally representative survey of Finnish 14–18 year old students from comprehensive schools, general upper secondary schools, and vocational institutions. The sample consisted of 60,252 boys and 71,118 girls, with the mean age of 16.05 years (standard deviation 1.06). Symptoms were identified using the GAD-7 (cutpoint of 10), the Mini-SPIN (cutpoint of 6), and the PHQ-2 (cutpoint of 3). Logistic regression models for both GAD and SAD symptoms were stratified by comorbidity group variables.

Results

GAD symptoms were closely related to excessive internet use and decreased sleep duration among adolescents, regardless of comorbidity with depression or SAD. SAD symptoms were associated with excessive internet use and a lack of intense exercise, independent of comorbid depression or GAD.

Conclusions

The findings underscore the importance of considering lifestyle factors when developing interventions to mitigate GAD and SAD symptoms in adolescents. Interventions and policy recommendations aiming at improving adolescents’ health behaviour and mental health should take into account the intertwining of these factors.