bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel In Vivo Rat Mesentery Model for Studying Tumor Spheroid-Induced Microvascular Remodeling
Authors: Lampejo Arinola O. , Fonseca Perez Luciana , Girgis Miriam M. , Sharma Blanka , Siemann Dietmar W. , Murfee Walter L.
Published: December 2024

Introduction: The tumor microenvironment is comprised of neoplastic cells and a variety of host cell types. Investigation of cell dynamics within this environment has motivated in vitro and ex vivo biomimetic model development. Our lab recently introduced the tumor spheroid-rat mesentery model to investigate cancer-induced lymphatic/blood vessel remodeling. To validate the physiological relevance of this model, the objective of this study was to determine the effect of tumor spheroids on microvascular remodeling after transplantation onto rat mesenteric.
Methods: Spheroids derived from H1299 lung cancer cells were seeded onto rat mesenteric tissues during a survival surgical procedure. Tissues were harvested 3-5 days post-seeding and stained with PECAM and LYVE-1 to identify blood and lymphatic vessels respectively.
Results: At all timepoints, cancer cells remained adhered to the tissue. Tissues seeded with tumor spheroids were shown to have increased vascular density, capillary sprouting, and tortuosity compared to sham tissues exposed to sterile saline only. Tumor spheroids also induced the formation of lymphatic/blood vessel connections and LYVE-1 negative protrusions emerging from lymphatic vessels.
Conclusion: Overall, this study underscores the use of in vivo modeling to aid in the discovery of novel vascular growth dynamics and offers new methodologies for studying tumor-induced remodeling.
Novel Method to Assess Macrophage Phenotype Using Eluted Media
Authors: Mahdi Furqan , Lillyman David , Ney Kayla , Wachs Rebecca A.
Published: December 2024

Introduction: Macrophages exist on a spectrum from pro-inflammatory (M1) to pro-healing (M2). Characterization of macrophage phenotype is important to understand tissue healing and response. The gold standard for assessing macrophage phenotypes is immunocytochemistry (ICC), which stains inducible Nitric Oxide Synthase (iNOS) and arginase (Arg1), the proteins secreted before nitrite and urea production. The ICC method is an endpoint assay, time-consuming, and costly. Therefore, a more effective method to assess the phenotype of macrophages in vitro is needed. Based on the phenotype of the macrophage, arginine gets metabolized differently. If arginine is metabolized by M1 macrophages it produces nitrite and if it is metabolized by M2 macrophages it produces urea. A method that leverages arginine metabolism through secreted products (urea and nitrite) has the potential to determine macrophage phenotype in real-time.
Methods: Rat bone marrow-derived macrophages were cultured to be naïve or polarized to M1-like or M2-like. The ICC method was used to determine the intensity of the iNOS and Arg1 staining. Nitrite and urea kits were utilized to measure the concentration of nitrite and urea in the media eluted from the various phenotypes. Nitrite and urea concentrations were compared to ICC results to validate the new method.
Results: ICC revealed the iNOS staining was significant and 2.5 folds higher in M1-like macrophages and the Arg1 staining was significant and 1.5 folds higher in the M2-like macrophages. The nitrite concentration was significant and 4 folds higher in the M1-like macrophage. The urea concentration was significant and 2.5 folds higher in the M2-like macrophage media. A correlation analysis showed that iNOS staining intensity and nitrite concentration levels had a linear correlation as well as Arg1 staining intensity and urea concentration levels.
Conclusion: Data confirm that the determination of nitrite and urea concentration can be utilized to assess macrophage phenotypes.
SARS-CoV-2-vaccination in primary humoral immunodeficiency - Experience from a German lung clinic
Authors: Rosendahl Sophie , Trudzinski Franziska C. , Polke Markus , Herth Felix J.F. , Kreuter Michael , Giese Thomas
Published: December 2024

During the COVID-19 pandemic the effectiveness of vaccines against SARS-CoV-2 in immunodeficient patients did not only affect the individual risk of these vulnerable patients but endangered the selection of new variants of concern due to prolonged virus shedding by these patients.
In a tertiary center for pulmonary diseases, we investigated the immune response of 11 patients with primary humoral immunodeficiency and 13 healthy controls on the humoral and cellular level after full vaccination with a mRNA or vector vaccine against SARS-CoV-2.
In the majority of patients (73%), we found antibodies against the Spike protein above the thresh-old of positivity. Likewise, patients showed a promising cellular response: the upregulated production of INFγ, TNFα and CXCL10 by T cells did not differ from the response of healthy controls.
These results stress the importance to further discern an adequate immunological correlate of protection and the need to follow the effect of booster immunizations in this population at risk.
α2-3 Sialic acids-decorated allergens exert a tolerogenic effect on CD4 T cells from Der p 2 – allergic patients
Authors: Keumatio Doungtsop Brigitte-Carole , Nardini Eleonora , Peterse Evert E. , Kalay Hakan , Versteeg Serge A. , Ree Ronald Van , de Jong Esther E.C. , Kooyk Yvette Van
Published: December 2024

Background : Allergen-specific immunotherapy (AIT) is so far the only disease-modifying therapy for allergy, resulting in a long-lasting tolerance. However, the existing safety concerns and the need for more efficacious alternatives that shorten the duration of treatment have stimulated research into the development of novel alternatives. Some of these novel alternatives involve modifying allergens with molecules that target innate immunomodulatory receptors to suppress the immune activity of immune cells.
Method : Freshly prepared monocyte-derived dendritic cells (moDCs) from mite-allergic and non-atopic volunteers were treated with α2-3 sialic acid-conjugated recombinant Der p 2 ((sia)-Der p 2) and unconjugated Der p 2 in culture and matured with Toll-like receptor (TLR) 1/2 (Pam3CSK4) (Pam3) and 2/4 (lipopolysaccharide) (LPS) agonists, followed by co-culture with autologous CD4+ T cells. Secretion of cytokines in supernatants were measured by ELISA and expression of cell surface and intracellular markers was measured by flow cytometry.
Results : Sia-Der p 2 unlike Der p 2, modulated moDCs from mite-allergic volunteers by reducing expression of CD83 and CXCR5. We also observed that sia-Der p 2-treated moDCs in the presence of Pam3 and LPS significantly suppressed the proportion of CD25+, Ki67+, IL-13+ and IFN-y+ CD4+ T cells of mite-allergic volunteers while Der p 2-treated moDCs did not. Sia-Der p 2-treated moDC did not alter these CD4+ T cell populations in non-atopic volunteers.
Conclusion : Our data suggests that Der p 2 conjugated with α2-3 sialic acids modifies moDCs and promotes the differentiation of allergen specific CD4+ T cells towards a regulatory profile.
A comparative cross-sectional study of hair density, hair shaft diameter of different severities of anterior scalp marginal traction alopecia in women.
Authors: Anaba Ehiaghe Lonia , Sani Hadiza
Published: December 2024

Introduction: Hair density (HD) studies of marginal traction alopecia (MTA) are few. We aimed to document the HD/cm2, number of hair shafts (HS) per pilosebaceous unit (PU) and HS diameter of different grades of anterior scalp margin MTA (AMTA).
Methods: A cross-sectional descriptive study of 401 women over a 9-months period in 2023. The severity of AMTA was scored using the marginal traction alopecia severity score (M-TAS). Phototrichoscopic evaluation of HD/cm2, HS diameter and number of HS) per PU was done on the alopecic intertemporal, right and left temporal and, the non-alopecic right temporal and intertemporal scalp sites.
Results: The HD/cm2 of the non-alopecic intertemporal scalp site ranged from 282-519 cm2 compared to that of the AMTA which ranged from 14-349/cm2, p<0.001. With increasing severity of AMTA, there was a significant decrease in HD: Grade 1 had HD of 227.56/cm2 compared to 131.22/cm2 in grade 4 at the intertemporal area, p<0.001. HS diameter ranged from 0.0087-0.0200mm in Grade 1 and 0.0078 – 0.0100 in Grade 4. Single hair units in 100%.
Conclusion: Anterior scalp marginal alopecia results in a significant reduction of hair density, hair shaft diameter and number of hair strands. Preventative education on hair care practices and hair styles is advocated.
ISPAD Clinical Practice Consensus Guidelines 2024: Glycemic Targets
Authors: de Bock Martin , Agwu Juliana Chizo , Deabreu Matt , Dovc Klemen , Maahs David M. , Marcovecchio M. Loredana , Mahmud Farid H. , Nóvoa-Medina Yeray , Priyambada Leena , Smart Carmel E. , DiMeglio Linda A.
Published: December 2024

Summary of what is New or Different

1. This chapter recommends a target HbA1c of ≤6.5% (48mmol/mol) for those who have access to advanced diabetes technologies like continuous glucose monitoring (CGM) and automated insulin delivery (AID). This target should be encouraged for all children and adolescents living with diabetes when safely achievable. In other settings, the HbA1c target is ≤7.0% (53mmol/mol). The emphasis on the lower HbA1c target is deliberate, based on the growing evidence that achieving HbA1c levels below previous targets can significantly reduce the risk of developing diabetes complications and that when adequate technology and healthcare professional support are available, these lower glycemic targets can be safely achieved without increasing the risk of hypoglycemia or adding to the care burdens.
2. These glycemic goals may be individualized based on an assessment of the potential challenges for the person with diabetes and their caregivers.
3. The relationship between glycemic targets and rates of excess body weight are discussed.
4. The glycemic target chapter is also more succinct compared to previous iterations. This chapter is meant to provide updated guidance on overall glycaemic management alongside other ISPAD consensus guidelines that provide further context and information, including specific populations (e.g. pre-schooler children, limited care settings), or situations (e.g. exercise).
Revision of the subgenus Chalcotaenia of Paracupta (Coleoptera: Buprestidae: Chrysochroinae) and specification of Buprestis xanthocera Boisduval, 1835 as the type-species of the genus Paracupta
Authors: FRANK DAVID
Published: December 2024

Subgenus Chalcotaenia Deyrolle, 1864 of Paracupta Deyrolle, 1864 is revised based on comparative study of extensive material including types of all described taxa. Buprestis xanthocera Boisduval, 1835 is specified as the type-species of genus Paracupta Deyrolle, 1864 and redescribed. Four new species are described: Paracupta (Chalcotaenia) gottwaldi sp. nov. from Solomon Islands: Ranongga Island; P. (C.) horaki sp. nov. from Indonesia: Seram Island; P. (C.) jakli sp. nov. from Solomon Islands: Guadalcanal and Malaita islands; P. (C.) laperousei sp. nov. from Indonesia: Bacan, Halmahera and Mandioli islands. Neotype is designated for Chrysodema lamberti Laporte de Castelnau & Gory, 1837 [Paracupta (Chalcotaenia) lamberti] and lectotype is designated for Buprestis xanthocera Boisduval, 1835 [Paracupta (Paracupta) xanthocera] to ensure their correct application and recognition in future. One new synonymy of subgenus: Paracupta Deyrolle, 1864 = Bojasinskia Hołyński, 2009 and one new synonymy of species: Buprestis xanthocera Boisduval, 1835 = Paracupta leveri Théry, 1934 are established. Paracupta isabellina Kerremans, 1900, P. rennelli Hołyński, 2014 and P. toxopeusi Obenberger, 1932 are transferred to subgenus Chalcotaenia. All herein included taxa are illustrated with colour photographs of habitus and the male aedeagus. A key to all taxa is presented.
A Randomized Non-Inferiority Clinical Trial of 14Fr Thal versus 28Fr Tube Thoracostomy for Traumatic Hemothorax
Authors: McCartt Jason , Ross Samuel Wade , Cunningham Kyle W. , Wang Huaping , Sealey Leslie , Brake Julia , Christmas Ashley , Sachdev Gaurav , Green John , Thomas Bradley W.
Published: December 2024

Background

The traditional treatment of traumatic hemothorax (HTX) is large bore chest tubes (CT) ≥28Fr. Recent evidence shows 14Fr pigtail catheters are as effective in drainage of HTX as larger CT. However, this has not been shown in 14Fr Thal tubes, a straight chest tube placed utilizing Seldinger technique.

Methods

A single center, prospective randomized controlled trial was performed at an ACS verified Level 1 trauma center comparing 14Fr Thal CT (14CT) to 28Fr CT (28CT) between May 2017 and September 2021. The primary outcome was failure of drainage of hemothorax requiring additional intervention. Secondary outcomes included duration of chest tube placement, length of stay, tube-specific complications, and 90-day hospital readmission. Farrington-Manning approach was used for non-inferiority tests. Wilcoxon 2-samples test or t test was used for continuous variables, and Pearson chi-square or Fisher exact test was used for categorical variables.

Results

109 patients were included in the randomized trial. There were 54 patients in the 14CT cohort, and 55 patients in the 28CT cohort. The primary outcome of drainage failure was similar between groups (8.3% 14CT vs 3.9% 28CT). Using a 15% non-inferiority margin 14CT is non-inferior to 28CT. No differences were identified in secondary outcomes.

Conclusion

14Fr Thal tubes have similar efficacy in drainage of traumatic hemothorax when compared with 28Fr chest tubes with similar complication rates (NCT03167723).
The political economy of accountability: Philanthropy’s ‘double dispossession’ of racial justice organizations under racial capitalism
Authors: Saifer Adam , Zanoni Patrizia
Published: December 2024

Prompted by the Black Lives Matter movement, and COVID-19’s deepening of inequalities, philanthropic foundations are increasingly claiming racial justice as a core part of their mission and strategy. This study uses a racial capitalism lens to examine racial justice organizations’ (RJOs) accountability relations towards the philanthropies that fund them. Drawing on interviews with leaders of Canadian RJOs, we unveil how the racial partitioning of leaders, fantasy and partners in these relations materially and symbolically dispossesses RJOs and the communities they represent. Our study complements the extant literature, which focuses on the depoliticization and co-optation effects of RJO–philanthropy accountability relations. Instead, we show how these accountability relations enforce ‘double dispossession’, thereby reproducing the racial capitalist political economy on which philanthropy is predicated. Our analysis indicates that philanthropy for racial justice, as it is currently practised, is impossible. We further identify the conditions under which it could become feasible.
(Re)defining the smart city at national level? Coexisting narratives of urban sustainability governance in Germany
Authors: Büttner Leonie , Kress Nele
Published: December 2024

While the question of how the Smart City (SC) concept is mobilised at global and local levels is well researched, few studies have focused on the national level. In this article, we seek to better understand the role of the national level regarding the embedding and creation of SCs. More specifically, we explore the German Smart Cities Dialogue Platform, established by the German government in 2016 as a place where ways of thinking about and acting on the SC are produced and stabilised. Drawing on key concepts of governmentality, we analyse dominant narratives of the SC in Germany, focusing on how the national SC discourse shapes the governance of urban sustainability. We show that the national level in Germany plays a decisive role in embedding and creating the SC, as it mediates between globally prevailing ideas of the SC and local realities. By linking the SC to nationally prevailing values, norms and political cultures such as sustainability, the common good, civil rights and digital sovereignty, a corrective to globally dominant techno-euphoric narratives of the SC is created. At the same time, the (re)definition at the national level promotes an ecological modernisation approach to sustainable urban development to the exclusion of alternative visions of urban sustainability pathways.
SMARP: A 3D ALARA planning tool based on the virtual reality technology
Authors: Zhao Y. , Liu L. , Wang C. , Li H. , Song P. , He J. , Chen X. , Cheng J. , Wang Y. , Cao Q. , Liu R.
Published: December 2024

The SMARP, a 3D ALARA planning tool, is developed to improve the efficiency of nuclear installation operations and reduce the radiation exposure of radiation practitioners. The tool is an integration of multiple technologies, including virtual reality, 3D model reconstruction, radiation monitoring, radiation field calculation and visualisation. Based on the radiation field, it allows a dose assessment by integrating radiological information with 3D models of the actual environments. This paper will address some of the key techniques and applications of the tool.
Protection of the environment from exposure to ionising radiation: why and how evolution is timely for the ICRP system
Authors: Garnier-Laplace J. , Martinez N.E. , Copplestone D. , Schneider T. , Mayall A. , Larsson C-M.
Published: December 2024

Currently, several task groups are addressing complementary aspects in support of improved ICRP's recommendations and ultimately, a more robust approach to protection of the environment from deleterious effects of exposure to ionising radiation. In this context, ongoing developments are briefly presented, with some examples of new methods that have been conceived and implemented (e.g. statistical extrapolation models to quantify the range of radiosensitivity within a taxonomic class and derive transparently and systematically benchmark values or ranges such as the Derived Consideration Reference levels- DCRLs). This paper also addresses the main goals of the ongoing task groups dealing with various aspects of Environmental Radiological Protection (ERP) and their interactions, and the potential need for reformulation of the goal(s) for ERP. The approaches taken by the task groups and the outcomes of their work are expected to inform an inclusive and holistic justification and optimisation process to be considered in the review of the general recommendations of the ICRP.
Nuclear industry experiences in radiation exposures
Authors: Bryant P.A. , Lips M. , Coates R. , Hondros J. , Takala J. , Zic J. , Maruyama K. , Gorlin S.
Published: December 2024

The ‘As Low As Reasonably Achievable’ (ALARA) principle is one of the 3 fundamental elements of radiation protection. Noting that ionising radiation is both encountered naturally in the environment as part of everyday life, and artificially as part of a range of practices, the ALARA principle aims to provide a means of optimising radiation exposures. Since the introduction of the principle the nuclear industry has had a good track record of progressively reducing occupational and environmental exposures across the nuclear fuel cycle. However, recent industry feedback has highlighted that as the exposures continue to decline, there is evidence that its application in the purest sense can result in a disproportionate outcome in terms of wider non-radiological hazards, and / or use of resources both physical and human. This is leading to a general push for day-to-day exposures in nuclear power generation to be far lower than other forms of energy generation, sectors such as medical or minerals refinement, or compared to exposures we get from natural sources of radioactivity. This is at great cost for what is a negligible improvement in public protection. With the ongoing concerns of climate change, many countries have made a commitment to embrace low carbon energy systems. In support of this ambition new nuclear power has been identified as a key part of the energy mix, highlighting the need to further develop the ALARA concept, to ensure a fair treatment of the perceived ‘unique’ radiological risk of nuclear power. This paper explores feedback from industry in relation to optimising radiation exposures in the Nuclear Industry. This includes the need for the evolution of the ALARA principle to ensure it embeds ‘ALL Hazards’, ensures a sustainable outcome, and is informed by stakeholder engagement, along with the need for a graded approach to radiological protection, to ensure that improvement plans are based on clearly defined-value benefits based on judgements of reasonableness, and not in response to external pressures to ‘minimise exposure’. Feedback also highlighted the need to ensure we continue to tackle the Radiation Protection ‘Skills Gap’ and have sufficient skilled resources to meet the current and future needs of the industry in the context of climate change.
Working alliance patterns in a context of supported employment programmes for people with a severe mental illness: An employment specialist perspective
Authors: Charette-Dussault Élyse , Corbière Marc
Published: December 2024

Background: 

Developing a good working alliance with clients with a severe mental illness (SMI) is a core competency of the employment specialist (ES). The ES's assessment of the working alliance was found to be related to the client's acquisition of a job in the regular market but we have little information on the processes and factors involved.

Objective: 

To understand the development of the work alliance as assessed by the ES and its relationship to the client's acquisition of employment. Factors that may facilitate or hinder the development and evolution of the alliance were also explored.

Methods: 

Cluster analysis was used to define alliance development patterns, while frequency analyses were used to identify differences between the patterns in terms of whether the clients with SMI obtained (or not) employment. Interviews with ESs explored factors that may have explained the different patterns.

Results: 

Three patterns of working alliance were found and the one most often linked to client employment was the very high and stable pattern. The factors that might explain the different patterns are complex and interrelated.

Conclusion: 

The results can be considered in the ES's initial and ongoing training on the working alliance and the implementation of quality supported employment programmes.
Effectiveness of bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) as switch strategy in virologically-suppressed patients: real world data from a monocentric cohort
Authors: Passerotto RA , Lamanna F , Salvo PF , Iannone V , Steiner RJ , Carbone A , Farinacci D , D'Angelillo A , Baldin G , Ciccullo A , Di Giambenedetto S , Torti C , Borghetti A
Published: December 2024

Introduction

BIC/FTC/TAF showed efficacy and tolerability in randomized trials as a switch strategy in virologically-suppressed people living with HIV. We evaluated its effectiveness in a real-life setting.

Methods

A retrospective monocentric cohort including 431 virologically-suppressed (HIV-RNA <50 copies/ml) people switching to BIC/FTC/TAF in the period 2018–2022 was evaluated. Probabilities of virological failure (VF, i.e.2 consecutive HIV-RNA ≥50 copies/ml or a single HIV-RNA ≥200 copies/ml) and of treatment discontinuation (TD) were estimated by Kaplan–Meier, and predictors of both outcomes were identified through multivariable Cox regression. Analysis-of-variance for repeated measures was used to examine changes in CD4 count and CD4-to-CD8 ratio.

Results

Overall, 16 VF occurred during 22 months of median follow-up time. Estimated probabilities of VF at 1, 2 and 3 years were 2.0% (95% CI 1.04.2%), 2.9% (95% CI 1.5%–5.6%) and 5.5% (95% CI 3.2%–9.2%), respectively. Caucasian ethnicity and a history of previous VF independently predicted VF. TD occurred in 42 cases, predominantly for simplification. One discontinuation due to VF was reported. No predictors of discontinuation were identified. An increase in CD4-to-CD8 ratio over 3 years was evidenced ( p < 0.001). Total cholesterol decreased over 3 years ( p < 0.001). Triglycerides did not significantly change ( p = 0.465).

Conclusions

BIC/FTC/TAF demonstrated high effectiveness, tolerability and safety.
Football fan choreographies as multimodal performances
Authors: Hiippala Tuomo , Callies Marcus
Published: December 2024

This article examines football fan choreographies as multimodal performances. Fan choreographies, which are regularly organized by supporter groups at football stadia around the world, combine collective embodied actions with diverse media such as banners and flags. Choreographies serve multiple communicative purposes ranging from celebrating a team to commemorating events or protesting against unwanted developments. The article proposes a novel approach to analysing fan choreographies, building on previous research on linguistic, communicative and semiotic aspects of football, which are combined with recent theories of multimodal semiotics. By employing a methodology that uses the notion of materiality as a foundation for multimodal analysis, the article demonstrates how choreographies integrate various media that differ in their potential for meaning-making into complex spatiotemporal organizations. The results, which underline the nature of choreographies as collective social actions that are strongly anchored in football culture and embedded within society at large, illustrate how applying theories of multimodality can provide an improved understanding of performances more generally.
Resilience in Times of Crisis: Stressors and Coping Strategies during Pandemics in Egypt
Authors: Adib Hagar , Hammad Hadeer , Ammar Nesma
Published: December 2024

Background

Psychological distress in response to pandemics is debated to have a serious and long-lasting impact on consumers’ well-being. The unprecedented nature of pandemics is associated with a wide range of life stressors and coping strategies that vary across countries. Understanding the stressors and coping strategies during pandemics is imperative for social and business reasons.

Focus of the Article

The study contributes to the area of positive behavior change during critical life events where social marketing can play a profound role in undertaking downstream marketing initiatives that promote adaptive coping strategies for handling emergent threats and stressors.

Research Question

What coping mechanisms are employed to handle the stressors during times of change? How do individual’s appraisals of the potential threat and self-efficacy affect their coping strategies?

Importance to Social Marketing Field

The study provides valuable insights to inform social marketing strategies by enriching the field of health communication within social marketing. By exploring the psychological and emotional stressors as well as the coping strategies, this research underscores the importance of targeted communication strategies to support community well-being and resilience.

Methods

To provide evidence on stressors and coping strategies during COVID-19, a sample of 50 Egyptian adults were interviewed.

Results

The majority of the participants mentioned the fear of losing loved ones, health threats, and uncertainty as the main stressors. Emotion-focused coping was adopted more often than problem-focused coping. Pursuing hobbies and home tasks and seeking support from family and friends were among the most used coping strategies. High self-efficacy was found to be associated with problem-focused coping strategies.

Recommendations for Research and Practice

Findings add to the growing literature demonstrating the unique impacts of COVID-19 on consumers’ well-being and their corresponding coping strategies. The specific types of coping strategies people endorse in managing stress and building resilience in handling the pandemic offer important policy and managerial implications.

Limitations

Given the qualitative nature of the study, the sample size limits the generalizability of the results. Despite the rich insights generated from the qualitative investigation, employing quantitative methods in future studies would help in examining the impact of coping strategies on consumers’ well-being.
Toward a new conceptual framework: Employing a Black feminist approach to the recruitment and retention of Black women faculty in health and medical degree programs
Authors: Wade Jeannette M
Published: December 2024

The sociodemographic makeup of the professoriate in health and healthcare has been shown to have direct implications for graduation rates among minoritized populations, diversity in healthcare, the prevalence of health equity scholarship, and population health broadly. Black women academics, who navigate higher education as members of two minoritized groups, need to be intentionally recruited and retained using tailored approaches. Given the historical and ongoing dearth of Black women faculty in health and healthcare, and the mounting literature on health equity highlighting the benefits of Black women representation in healthcare, I propose an approach to the recruitment and retention of Black women using a Black feminist theory. This conceptual framework outlines barriers to recruiting and retaining Black women faculty, as well as culturally tailored and gender-specific means to mitigate them, to create a safe space for Black women scholars to seek employment and thrive once they are there.
Exploration of attitudes towards research: Operating department practitioners and theatre nurses
Authors: Conway Nigel , Bradburn Amy , Howcutt Sarah
Published: December 2024

Background:

A lack of awareness of who should conduct research, conflicting workload priorities, lack of research skills, lack of confidence and lack of supportive relationships are often cited as barriers for undertaking research within the perioperative environment. Building a robust research capacity for Operating Department Practitioners and Theatre Nurses to engage with and lead primary research is critical to develop perioperative clinical outcomes, and for professional and research excellence.

Aims:

This study aimed to explore the attitudes of Operating Department Practitioners and Theatre Nurses towards research.

Methods:

An online questionnaire was distributed nationally between 1 October 2022 and 31 December 2022. The questionnaire received 164 responses from 114 Operating Department Practitioners, 44 Theatre Nurses and 6 respondents identifying as other.

Findings:

These revealed that those with a positive attitude towards research were most likely to have obtained a Master’s level qualification (i.e. MSc) and had gained experience in research post-registration. When explored further, the overall positive attitude to research was found to be possibly linked to a belief in the usefulness of research and to prior exposure. The findings of this study can be used to help support, inform and strengthen research in clinical practice and research career aspirations.

Conclusion:

Analysis of the data suggests that participants holding a Master of Science degree and having previous experience of research reported a more positive attitude to research. When the specific attitudes to research were explored individually, there was also some evidence that the overall positive attitude to research was more likely to be related to a belief in the usefulness of research.
Digital health applications in Germany: Explorative pilot study on the challenges of approval from the perspective of manufacturers
Authors: Ataiy Omed , Burniki Mia , Sohrabi Keywan , Groß Volker , Scholtes Michael , Schudt Florian
Published: December 2024

Objective

Digital health applications are digital medical products (e.g. apps and web applications) that are prescribed by healthcare service providers and reimbursed by health insurances. Before digital health applications can be prescribed, manufacturers must fulfill the requirements of the approval process. The aim of this study is to identify the challenges faced by digital health applications manufacturers in the German fast-track process.

Methods

Use of a questionnaire-based online survey with 10 digital health applications manufacturers from March to October 2023. The survey design is based on the German digital health application regulation and the digital health application guideline. Data collection via LimeSurvey and HubSpot and data visualization in bar charts.

Results

Digital health applications manufacturers see the fast-track process as a challenge, especially in terms of demonstrating positive care effects and compliance with regulatory standards. Challenges include conducting clinical trials, negotiating pricing and improving market acceptance even with innovative approaches. Views on the profitability and relevance of the digital health application model are varied, with concerns over pricing and market strategies predominating.

Conclusions

The fast-track approval of digital health applications in Germany is a significant barrier to innovation and market entry. Collaboration between stakeholders is essential to optimizing processes while ensuring safety and accessibility for patients. However, even with the limitations, the results provide insights for future research and policy refinements that are necessary to improve the implementation of digital health applications in healthcare.
The Political Economy of Priority Setting and Resource Allocation in European Oral Health Policy
Authors: Sarroukh Z. , Jeurissen P. , Akter S. , Listl S.
Published: December 2024

Aim:

Pressing oral health care challenges pose prioritization dilemmas for governments. This study aimed to identify key determinants of prioritization in oral health policy in Denmark, Germany, the Netherlands, and the United Kingdom, as part of a series of the DELIVER project.

Methods:

A literature review based on a search of PubMed and Google Scholar articles related to these countries from January 1, 2000, to October 17, 2023, and key informant interviews with policy makers were conducted to identify key trends in oral health policy choices and determinants of priority setting and resource allocation processes.

Results:

A total of 249 articles were included, and 6 key informants were interviewed. The overarching focus identified was the accessibility of dental care, primarily characterized by incremental and localized programs for vulnerable groups. Supply-side arrangements consisted of adaptations to population needs, including financial incentives for providers and adjusted service delivery models such as task shifting. Several interventions of quality management were found, particularly in Germany. A funnel was produced to illustrate 3 stages driving oral health policy choices. These were political accountability to address population demand, stakeholder influence through negotiations and lobbying, and bureaucratic justification of policy innovations. While findings highlighted political attention on oral health care through public outcry, complex negotiations and limited data formed bottlenecks of prioritization.

Conclusion:

Prioritization in oral health policy seems to be dominated by fragmented investments in incremental services of delivery rather than synergized reforms such as granular package designs. While some contexts showed political traction for oral health policy, complex negotiations strained by interests of private professionals and challenges of limited evidence result in difficulties in constraining oral health care within public spending targets. This has placed oral health policy in a state of inertia, where insufficient public resources meet the force of content exerted by the private sector.

Knowledge Transfer Statement:

This study can inform policy makers and researchers to understand the various stakeholder roles in maintaining the status quo of oral health policy and the processes creating the bottlenecks preventing progression in improving oral health care systems. This understanding could lead to novel approaches to oral health policy making and the appropriate data acquisition and analysis to aid oral health policy.
Inequities in Unmet Oral Care Needs after a Swedish Subsidization Reform: An Intersectional Analysis
Authors: Anticona C. , Suominen A.L. , Bastos J.L. , Lif Holgerson P. , Gustafsson P.E.
Published: December 2024

Introduction:

The main strategy to achieve equal provision of oral care in Sweden has been to offer partial subsidies for the adult population. However, their effects on unmet oral care needs (UOCNs) have not been extensively assessed.

Objective:

This study used an intersectionality framework to examine 1) the overall frequency of UOCNs, 2) single-indicator inequities, and 3) intersectional inequities in total UOCNs and financial-related UOCNs (FUOCNs) in Sweden before and after implementation of a partial subsidization reform in 2008.

Methods:

Data from 12 national surveys conducted over 2004 to 2018 were divided into 3 periods: prereform (2004 to 2007), early postreform (2008 to 2011), and late postreform (2012 to 2018). The analytic sample consisted of 98,177 respondents aged 24 to 84 y. Changes in the prevalence of UOCNs were estimated by inferential statistics. Single-indicator and intersectional inequities were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy, across 48 strata defined by gender, age, educational level, income, and immigrant status.

Results:

The prevalence of total UOCNs and FUOCNs decreased significantly early after the reform, followed by a slight rebound. Relative inequities increased by education, income, and immigrant status after the reform and decreased for age. The discriminatory accuracy for both types of UOCNs was moderate and improved marginally but significantly with the inclusion of the intersectional strata. Most intersectional strata showed greater FUOCN inequities after the reform.

Conclusions:

Contrary to expected, larger inequities in FUOCNs were identified in most intersectional strata after the reform. The moderate discriminatory accuracy suggested that Sweden could benefit from future strategies to foster equity that are universal but proportionately more intense among the intersectional strata with greater inequities (proportionate universalism).

Knowledge Transference Statement:

This analysis highlighted the benefit of adopting the principle of proportionate universalism as a strategy to reduce unmet oral care needs in Sweden. This would mean implementing universal strategies and specific support measures for the most vulnerable social groups as a future oral care policy change in Sweden.
CAR T-cells in autoimmunity: game changer or stepping stone?
Authors: Mougiakakos Dimitrios , Meyer Everett , Schett Georg
Published: December 2024

The advent of chimeric antigen receptor (CAR) T-cells has revolutionized the treatment landscape for hematologic malignancies, and emerging evidence suggests their potential in autoimmune diseases (AIDs). This article examines the early successes and future implications of B-cell-targeting CAR T-cell therapy in AIDs. Initial applications, particularly in refractory systemic lupus erythematosus (SLE), have demonstrated significant and durable clinical remissions, with accompanying evaluation of the immune system suggesting a so-called "reset" of innate inflammation and adaptive autoimmunity. This has generated widespread interest in expanding this therapeutic approach. CAR T-cells offer unique advantages over other treatment modalities, including very deep B-cell depletion and unique therapeutic activity within inflamed tissues and associated lymph structures. However, the field must address key concerns, including long-term toxicity, particularly the risk of secondary malignancies, and future accessibility given the higher prevalence of AIDs compared to malignancies. Technological advances in cell therapy, such as next-generation CAR T-cells, allogeneic off-the-shelf products and alternative cell types such as regulatory CAR T-cells, are being explored in AIDs to improve efficacy and safety. In addition, bispecific antibodies are emerging as potential alternatives or complements to CAR T-cells, potentially offering comparable efficacy without the need for complex logistics, lymphodepletion and the risk of insertional mutagenesis. As the field evolves, cellular therapists will play a critical role in the multidisciplinary teams managing these complex cases. The transformative potential of CAR T-cells in AIDs is undeniable, but careful consideration of safety, efficacy, and implementation is essential as this novel therapeutic approach moves forward.
Effects of elastic therapeutic taping on reducing drooling in children with neurological disorders: a systematic review of randomized controlled trials
Authors: Lam Krystal Tsz Ting , Hung Alex Tsz Wai , Lau Kendy , Lee Eric Kam Pui
Published: December 2024

Background & aims

Effective treatment for anterior drooling in children with neurological disorders can lead to improved social interactions, reduced physical complications such as perioral infections, and enhanced quality of life for both patients and their parents. Elastic therapeutic taping (ETT) has emerged a novel intervention for drooling, but its evidence was limited. This study systematically reviewed the effectiveness of ETT on reducing anterior drooling in children with neurological disorders.

Methods

Multiple electronic databases, such as Ovid MEDLINE, Embase, and Cochrane Library were searched from inception till 30th October 2024. Randomized controlled trials (RCTs) were included if they: (a) used ETT as a treatment for drooling or swallowing difficulties; (b) included participants aged < 18 years old; (c) included participants with anterior drooling and neurological disorders; (d) compared effects of ETT alone or combined with other treatments (e.g. oral motor therapy (OMT)) with no taping, sham taping or other treatments, and (e) published in English. The Cochrane Risk-of-Bias tool was used to assess risk of bias for the included studies.

Results

Seven parallel-arm RCTs, which were conducted in South/southwest Asia, Africa, South America and Middle East, were included. In total, 220 children aged 1 to 11 were included, of which 97 received solely ETT in 4 studies, while 24 received ETT plus OMT in 2 studies. ETT combined with OMT was more effective in reducing drooling in the included 2 RCTs, though the results of ETT alone were inconsistent, likely due to heterogeneity observed in control conditions, application methods, and outcome measures. No side effects were reported in all studies.

Conclusions

This review suggests that ETT combined with OMT is effective in reducing drooling in children with neurological disorders, with no evidence of side effects.

Trial registration

(PROSPERO no.: CRD42023488664)
Functional study of ZmHDZ4 in maize (Zea mays) seedlings under drought stress
Authors: Xie Xiaowen , Ren Zhenzhen , Su Huihui , Abou-Elwafa Salah Fatouh , Shao Jing , Ku Lixia , Jia Lin , Tian Zhiqiang , Wei Li
Published: December 2024

Background

Maize is a major feed and industrial crop and pivotal for ensuring global food security. In light of global warming and climate change, improving maize tolerance to water deficit is crucial. Identification and functional analysis of drought tolerance genes have potential practical importance in understanding the molecular mechanisms of drought stress.

Results

Here, we identified a maize Homeodomain-Leucine Zipper I, ZmHDZ4, in maize seedlings that is associated with drought tolerance. We demonstrated that ZmHDZ4 has transcriptional activation activity, exclusively localized in the nucleus. Several Cis-acting elements associated with abiotic stress have been identified in the core promoter region of ZmHDZ4. Under drought-stressed conditions, transgenic maize plants overexpressing ZmHDZ4 exhibited significantly higher relative water content and peroxidase (POD) and superoxidase dismutase (SOD) activities compared to wide-type plants, while displaying lower malondialdehyde (MAD) content. The expressions of ZmMFS1-88, ZmGPM573, and ZmPHD9 were significantly repressed in the ZmHDZ4-OE plants under drought-stressed conditions, indicating that ZmMFS1-88, ZmGPM573, and ZmPHD9 were the candidate target genes of ZmHDZ4.

Conclusions

ZmHDZ4 is involved in the regulation of drought stress tolerance in maize by participating in osmotic regulation, sugar metabolism pathways, and hormone regulation.
Epidemiology of talus fractures in Finland: a nationwide register study from 1997 to 2020
Authors: Brushtein Evgenii , Partio Nikke , Huttunen Tuomas T. , Repo Jussi P. , Mäenpää Heikki , Mattila Ville M.
Published: December 2024

Background

The aim of this study was to estimate the nationwide incidence of talus fractures (per 100 000 person-years) and to determine the incidence of operative treatment in the Finnish population.

Methods

Based on Finnish Care Register for Health Care data, all patients 18 years and older admitted to hospital with talar fractures between 1997 and 2020 were included.

Results

During the 24-year study period, 5247 patients with primary or secondary diagnoses of talar fracture were identified. The mean incidence during the whole study period was 50.4 per 100 000 person-years. There was a clear increase starting from the year 2009 (61.4 per 100 000 person-years), that continued and the incidence in 2018 raised up to 106.8 person-years. The total incidence of operations performed on talar fractures remained almost the same during the study period (9.1 per 100 000 person-years from 1997 to 2020).

Conclusions

While the incidence of performed operations had remained stable, the incidence of talar fractures in Finland has increased during the last decades. The increase was more prominent in men. The observed change is possibly due to the progress and availability of computer tomography.

Level of Evidence

III