bluuebunny/crossref_metadata_2025 huggingface dataset:
University education facilitates uptake of disease-modifying therapies for multiple sclerosis: A community-based study using the UK MS Register
Authors: Das Joyutpal , Rog David J , Middleton Rod , Rodgers Jeff W , Nicholas Richard
Published: January 2024

Background:

Higher education is associated with better job opportunities and higher income.

Objectives:

Herein, the impact of education on the uptake of disease-modifying therapies (DMTs) for multiple sclerosis (MS) in a publicly funded health care system was examined using the UK MS Register.

Methods:

All adult participants with relapsing remitting MS diagnosed between 2008 and 2021 were included. Those without data regarding their education levels were excluded. Binary, multinomial and Cox regression models were used to examine the association between education levels and uptake of DMTs.

Results:

A total of 6317 participants fulfilled all inclusion and exclusion criteria. A total of 1826/2923 (62%) participants with a university education were treated with DMTs, compared to 1788/3394 (53%) participants with school/diploma received DMTs with an odds ratio of 1.318 (1.178–1.473). Participants with a university education were more likely to be treated with both moderate- and high-efficacy DMTs, compared to others, with odds ratios of 1.227 (1.087–1.385) and 1.545 (1.325–1.802), respectively. University education was also a positive predictor for faster initiation of DMTs, and, importantly, higher-efficacy DMTs.

Conclusion:

In a publicly funded health care system, despite intended equality of access, university education was associated with a higher uptake of DMTs.
United in misperception? How politicians and party electorates assess each other’s policy preferences
Authors: Kübler Marie
Published: January 2024

For representation to work, voters and politicians need to know each other’s policy preferences. While we know that this may not be the case for voters, a growing body of research shows that politicians also regularly misperceive the position of the public or their party’s electorate. However, the two strands of literature are usually not linked, and there is a lack of studies that analyse the mutual (mis)perceptions of citizens and elites. To fill this gap, this paper uses data from three waves of the German Longitudinal Election Study to compare the mutual perceptions of candidates and their party electorates on the left-right scale and on three policy issues. Three findings are noteworthy: First, candidates are only slightly more accurate than voters. Second, in contrast to previous studies, there is no evidence of a conservative bias among politicians. Third, projection plays an important role in both voters’ and candidates' misperceptions. Where both groups think the others are is strongly influenced by their own preferences.
Homeostasis Theory of Well-being
Authors: Marks David F
Published: January 2024

The Homeostasis Theory of Well-being proposes a homeostatic modular system for the creation of human well-being. This article aims to: (i) provide a proof-of-concept demonstration of the feasibility of the theory in its biopsychosocial context; (ii) indicate prima facie empirical support for the homeostatic nature of the 16 proposed modules; (iii) discuss the similarities to and differences from other homeostasis theories of well-being. Following the Central Limit Theorem, any homeostatic system with multiple inputs produces outputs with a Gaussian distribution. The data-base of studies contains approximately 2000 publications reporting U- or inverse U-shaped curves for the 16 homeostatic domains specified in the theory. The Homeostasis Theory of Well-being remains speculative and requires controlled longitudinal study to determine the scientific validity of the causal network proposed by the theory. The theory has implications for our understanding of humans’ drive for balance, equilibrium and stability in this increasingly uncertain world.
Associations of dietary patterns and perceived stress with memory deficits in patients with heart failure
Authors: Wang Mei , Wang Lyu , Yang Mei , Zhang Xiuting , Fan Xiuzhen
Published: January 2024

This study aimed to examine the relationships between dietary patterns and perceived stress with memory deficits in 291 patients with heart failure aged 45–85 years. A total of 142 (48.8%) patients reported memory deficit. Three dietary patterns were identified by K-means clustering: nut-fruit-dairy, meat-processed, and traditional (high intake of cereals) diets. Compared to the traditional diet, the nut-fruit-dairy diet and meat-processed diet were associated with lower levels of deficits in short-term memory, delayed memory, and overall memory. What’s more, perceived stress was positively associated with deficits in short-term memory and overall memory, but the association was only found in patients adhering to the traditional diet using stratified analyses. Our findings suggest that adhering to a healthy diet may be conducive to improving deficits in short-term memory, delayed memory, and overall memory, while also buffering the adverse association between perceived stress and deficits in short-term memory and overall memory.
Persistence Modeling in Marketing: Descriptive, Predictive, and Normative Uses
Authors: Dekimpe Marnik G. , Hanssens Dominique M.
Published: January 2024

There is general agreement that a firm’s scarce marketing resources should be managed for the purpose of long-term profitable growth. Putting that premise into practice is difficult, as only the short-term impact of marketing actions can be readily observed. Persistence modeling has become a well-accepted tool for long-run impact detection. Its consistent use across a broad range of settings has resulted in novel empirical generalizations on the long-run effectiveness of several marketing instruments and has contributed unique insights on, among others, (i) the marketing-finance interface, (ii) the role of new media, and (iii) the mediating role of a broad set of mindset metrics. Moreover, the recent addition of a more normative focus has added considerably to the actionability of these insights.
The inter-generational construction of religious in/authenticity in the rituals of British Pakistani Muslims
Authors: Rafiq Zeeshan , Dunnett Susan
Published: January 2024

This paper explores the phenomenon of rituals as a contested intersection of religion and ethnicity and demonstrates how changes in religio-ethnic inclinations of various generations of immigrant communities influence the religious authenticity/inauthenticity of rituals. Its focus is the British Pakistani Muslim community in the UK where the emerging second and subsequent generations of British Muslims have started to redefine and contest their religious and ethnic identities. The findings, derived through interview and observation, reveal that religion has become the preeminent marker of identity, eclipsing that of ethnic identity. Through reciprocal socialization, the first generation are relearning an Islam from younger generations that is unfettered by cultural bonds. We illustrate how and why rituals are deemed inauthentic and abandoned. Findings demonstrate that authenticity/inauthenticity provides a potential outlet for reflexive consumers to assert agency against ethnic norms and ideological hailings that are at odds with their emergent religious identities. Accordingly, the study conceptualizes emergent inauthenticity to explain this phenomenon and delineates the role of boundary work and contamination in the authentication and rejection of rituals.
What we inherit and what we create. Making the case for an interpretive approach to societal cultures
Authors: Chevrier Sylvie
Published: January 2024

To deal with the omnipresence of otherness in today’s culturally-complex world, Cross-Cultural Management (CCM) investigates the interrelations between culture and management. The most recent research denaturalizes culture to emphasize the construction of otherness as an instrument of power plays. Thus, it refutes the very possibility of vast national cultures, given the cultural diversity found in modern societies. This conceptual article revisits the notion of culture and provides a definition that makes it possible to grasp both what is inherited and what is created in ‘otherness’. It draws upon an interpretive approach to culture which, although still overlooked in English-language research on CCM, has for several decades been developed in France. The socalled Gestion & Société approach posits that the root causes of otherness lie in the diversity of culturally-shared major fears and ideal ways of living together to counteract them. This approach breaks new ground by emphasizing the inherited cultural references underlying the individuals’ sense-making and by acknowledging the individual agency of the stakeholders who use these references to create new intercultural arrangements in cross-cultural encounters at work. A language metaphor is used to show how the inherited part of culture and the part that is created are articulated. Examples of empirical findings illustrate the benefits of this approach to overcome the critical effects of otherness. The value of its contribution to the understanding of otherness is assessed in comparison with other interpretive approaches, and avenues for future research are discussed.
A conceptual model of an effective early childhood physical literacy pedagogue
Authors: Barratt Jaime , Dudley Dean , Stylianou Michalis , Cairney John
Published: January 2024

Physical inactivity has become increasingly prevalent among young children in early childhood education and care settings. One promising way to intervene and promote physical activity in these settings is to develop children’s physical literacy. Where most children spend their weekday in early childhood settings in the care of early childhood educators, the educators are viewed as ‘change agents’ and become responsible for developing children’s physical literacy. Thus, early childhood educators must possess adequate skills, knowledge, and practices to promote such development. However, research has yet to conceptualize a theory which identifies the significant capabilities and competencies that make early childhood educators, what we propose, an Effective Early Childhood Physical Literacy Pedagogue. Therefore, this paper draws on early childhood research regarding physical literacy, physical activity, and active play, to present a conceptual model theorizing an Effective Early Childhood Physical Literacy Pedagogue. Within this model, we propose educators’ professional identity and implementation of play-based pedagogy are essential characteristics of an Effective Early Childhood Physical Literacy Pedagogue. Furthermore, educators’ physical literacy capabilities (psychomotor, affective, social, and cognitive) are recognized as the vehicle that drives the aforementioned characteristics to be the Effective Early Childhood Physical Literacy Pedagogue. This conceptual model provides implications for future research to appropriately assess and target physical literacy interventions towards early childhood educators.
Parental behaviors towards preschool age children in Croatia
Authors: Pažur Monika , Drvodelić Maja , Domović Vlatka
Published: January 2024

This article investigates the frequency of what we define as supportive and unsupportive parental behaviors and whether there is a statistically significant difference in the frequency of parental behaviors in reference to different parental characteristics (level of education, employment status, socio-economic status). This research involved a sample of 3500 parents of children aged 5 and 6. The results show that such supportive parental behaviors are used more frequently than unsupportive ones. Still, approximately 25% of parents implement modes of behavior that the literature suggests hinders children’s optimal development, whereas for 10% the frequency of such behaviors is very high. The results confirm that the level of education, employment status, and socio-economic family status represent significant factors in the quality of parental care. Moreover, these can enhance the risk factors in given familial contexts. In the process of creating support programs and finding ways of strengthening family resilience, and other public policies and strategies to prevent risks of social exclusion caused by familial factors, it is important to bear in mind the heterogeneity of the risks of social exclusion within the family and to respond to the specific needs and challenges of different parents and children. When it comes to developing policy, a one-size-fits all approach should, be avoided.
Supporting literacy development in kindergarten through teacher-facilitated play
Authors: Pyle Angela , Wickstrom Hanna , Gross Olivia , Kraszewski Ellen
Published: January 2024

Teacher-facilitation of play is proposed as an effective method for supporting early literacy learning, however, educators remain uncertain how to balance child-autonomy in play while also directing play toward explicit academic objectives. In response, this study sought to understand how kindergarten teachers can successfully facilitate play to support early literacy development. Classroom observations and semistructured interviews were gathered and qualitatively analyzed to identify key perspectives and classroom practices that lead to the educators’ successful facilitation of play to support literacy. Results of this study showed how different core literacy skills can be supported through different types of play, with each offering unique and critical opportunities for learning. Results also demonstrated how a multitude of core literacy skills can be supported through guided approaches to play, and begin to illustrate how teachers are facilitating a continuum of guided play to support literacy learning.
Supporting language diversities through story circles
Authors: Flynn Erin Elizabeth
Published: January 2024

This current study shows the range of culturally-shaped, storytelling patterns present in three multicultural, multilingual preschool classrooms serving children from families with lower socioeconomic status in the U.S. Stories were collected in the context of a small group, child-led storytelling activity called story circles. Results show that story circles encourage diverse story forms and topics that reflect interdependent conceptions of self in young learners. In their stories, young children demonstrate the early emerging potential for cultivating linguistic and cultural dexterity in early childhood by surfacing and centering multiple meaning-making patterns in the classroom, rather than solely topic-centered, linear, temporal stories that predominate in U.S. schools.
Methodologizing Transnationality: Relational Writing as Collective Inquiry
Authors: Lee Sun Young , Son Minhye , Kim Taeyeon , Jung Jin Kyeong , Jang Soo Bin
Published: January 2024

How can we take transnationality as a space of in-betweenness to generate new possibilities, moving beyond geographically bounded spans between countries? This article presents five authors’ collective inquiry on transnational positionalities, which we practiced through the relational, transformative, and reflective writing of the self in a community space. We staged the collaborative writing into two processes: the emergent process of thematic writing and the relay writing. Interweaving “I” and “we” voices that cannot be captured through categorical thinking, our collaborative quest resists normative identity politics, proposing writing as a method of collective inquiry for the nuanced understanding of the transnationality that embraces flows, margins, and uncertainties. Collaborative writing, we argue, is a transformative opportunity for methodologizing transnationality and decolonizing qualitative inquiry.
When the Perpetrator is Found Not Guilty: Implications for the Treatment of Adolescent Sexual Assault Survivors
Authors: Willis Brendan , O’Donohue William
Published: January 2024

Sexual assault survivors can experience a wide variety of psychological consequences—from none to Major Depression Disorder to Substance use and, most commonly, Acute Stress Disorder/Post Traumatic Stress Disorder. These clinical outcomes depend on the severity of the assault, as well as pre-assault psychological status, and post-assault social support, the effectiveness of therapy, and events that occur during therapy. This case study will focus on one particular event that can arise during the treatment of a survivor of sexual assault, namely the impact of a not guilty verdict on the survivor occurring during the course of therapy. The client in question experienced an immediate and significant increase in depressive symptoms and the course of therapy needed to be altered significantly to respond to the not guilty verdict rendered during the therapy process. This case study will explore how therapy was altered in response to this guilty verdict and the lessons that were learned from this experience in order to better prepare assault survivors who are involved in legal proceedings during their therapy. Overall, this case study demonstrated the vital need to prepare survivors who plan to testify in court against the perpetrator beforehand for all possible outcomes of the trial. Furthermore, the case study demonstrated the need to implement effective interventions in the aftermath of a trial to help buffer against the effects of a “not guilty” verdict.
Efficacy and Safety of Traditional Chinese Medicines as a Complementary Therapy Combined With Chemotherapy in the Treatment of Gastric Cancer: An Overview of Systematic Reviews and Meta-Analyses
Authors: Xie Weijian , Zhang Yunsong , Tang Jingyun , Zhu Xiaolin , Wang Shijun , Lu Meiqi
Published: January 2024

Background:

In China, traditional Chinese medicines (TCMs), as a complementary therapy combined with chemotherapy, is widely used in the treatment of gastric cancer (GC). In order to systematically evaluate and synthesize existing evidence to provide a scientific basis for the efficacy and safety of this complementary therapy, we present an overview of systematic reviews (SRs) and meta-analyses (MAs) on the topic of TCMs as a complementary therapy in combination with chemotherapy for the treatment of GC.

Methods:

SRs/MAs on TCMs combined with chemotherapy for GC were comprehensively searched in 8 databases. Methodological quality, risk of bias, reporting quality, and quality of evidence were assessed using the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic (ROBIS) scale, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA 2020), as well as the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Results:

Thirteen published SRs/MAs were included in our study. In terms of methodology, all SRs/MAs were considered to be of very low quality. Only 3 SRs/MAs has been assessed as low risk of bias. None of the SRs/MAs has been fully reported on the checklist. A total of 97 outcome indicators extracted from the included SRs/MAs were evaluated, and only 1 item was assessed as high quality.

Conclusions:

TCMs may be an effective and safe complementary therapy in combination with chemotherapy for the treatment of GC. However, this conclusion must be treated with caution as the quality of the evidence provided by SRs/MAs is generally low.
Is cryptoaltruism transforming the nonprofit sector? Lessons from the Ukrainian nonprofits during the Russia-Ukraine War
Authors: Chen Wendy D. , Murtazashvili Ilia
Published: January 2024

Cryptoaltruism refers to the ways in which distributed ledger technologies, especially blockchains, are changing the nature of the nonprofit sector. This study specifically investigates how the blockchain technology has been used by Ukrainian nonprofits during the current Russia-Ukraine War. To link this to the more general literature on blockchains, we consider whether blockchains are used primarily as a general-purpose technology or as an institutional technology which redefines how nonprofits coordinate activities. Our analysis of Ukrainian nonprofits provides evidence supporting both perspectives. Widespread acceptance of cryptocurrency suggests blockchains are an efficiency-enhancing new technology. We also show that novel applications on nonfungible tokens to preserve art and culture and to raise funds, as well as uses of blockchains to address challenges with trust, lend support to the idea of blockchains as an innovative institutional technology that is transforming the nature of the nonprofit sector. This study intends to motivate further development of the emergent agenda on cryptoaltruism and its role in the nonprofit sector.
Between-Day Reliability of the Gait Characteristics and Their Changes During the 6-Minute Walking Test in People With Multiple Sclerosis
Authors: Santinelli Felipe Balistieri , Ramari Cintia , Poncelet Marie , Severijns Deborah , Kos Daphne , Pau Massimiliano , Kalron Alon , Meyns Pieter , Feys Peter
Published: January 2024

Background

Gait characteristics and their changes during the 6-minute walking test (6MWT) in people with multiple sclerosis (pwMS) have been described in the literature, which one may refer to as walking fatigability in the body function level of the International Classification of Functioning, Disability, and Health. However, whether these metrics are reliable is unknown.

Objective

To investigate the between-day reliability of the gait characteristics and their changes in pwMS and healthy controls (HCs).

Methods

Forty-nine pwMS (EDSS 4.82 ± 1.22 and 54.7 ± 9.36 years) and 23 HCs (50.6 ± 6.1 years) performed the 6MWT, as fast as possible but safely while wearing Inertial Measurement Units. Gait characteristics were measured in the pace, rhythm, variability, asymmetry, kinematics, coordination, and postural control domains and were obtained in intervals of 1 minute during the 6MWT. In addition, gait characteristics change in the last minute compared with the first minute were calculated for all gait variables using a fatigability index (ie, distance walking index). The intraclass correlation coefficient (ICC), Bland–Altman Plots, and Standard error of measurement were applied to investigate reliability.

Results

Reliability of gait characteristics, minute-by-minute, and for their changes (ie, using the fatigability index) ranged from poor to excellent (pwMS: ICC 0.46-0.96; HC: ICC 0.09-0.97 and pwMS: ICC 0-0.72; HC: ICC 0-0.77, respectively).

Conclusion

Besides coordination, at least 1 variable of each gait domain showed an ICC of moderate or good reliability for gait characteristics changes in both pwMS and HC. These metrics can be incorporated into future clinical trials and research on walking fatigability. Clinical Trial Registration: NCT05412043.
The risky news sharing quotient (RNSQ): A research instrument for exploring news-sharing behaviour that spreads fake news
Authors: Martin Tania Josephine , Vázquez Yoan Gutiérrez , Sepúlveda-Torres Robiert , Abreu Salas José Ignacio
Published: January 2024

The spread of fake news (FN) has attracted attention from disciplines ranging from social sciences to Artificial Intelligence. This work is novel because it explores the news-sharing behaviour of social-media users, focussing on those that spread FN, rather than the psychological motivations behind them. The 14-item Risky News-Sharing Quotient (RNSQ) was developed and Exploratory Factor Analysis discovered three relevant factors: (i) news-sharing behaviour that contributes to debunking FN; (ii) news-sharing frequency and attitudes to sharing; and (iii) news-sharing behaviour that contributes to the spread of FN. The study, conducted among university students, found that 75% reported risky news-sharing behaviour that spreads FN. No link was found between perceiving FN as a problem and debunking it. Moreover, 83% of survey participants were unable to identify a FN story. Overall, the findings suggest an inability to apply knowledge of the relevant FN detection strategies to debunk FN, but importantly an apparent lack of motivation to check the veracity of a news story. From these conclusions, better-informed educational intervention strategies can be implemented to address the FN problem in-situ, such as promoting the importance of responsible news-sharing by raising awareness of how the spread of FN can impede the proper functioning of societies.
Brief mindfulness-based meditation enhances the speed of learning following positive prediction errors
Authors: Golubickis Marius , Tan Lucy B G , Jalalian Parnian , Falbén Johanna K , Macrae Neil C
Published: January 2024

Recent research has demonstrated that mindfulness-based meditation facilitates basic aspects of cognition, including memory and attention. Further developing this line of inquiry, here we considered the possibility that similar effects may extend to another core psychological process—instrumental learning. To explore this matter, in combination with a probabilistic selection task, computational modelling (i.e., reinforcement drift diffusion model analysis) was adopted to establish whether and how brief mindfulness-based meditation influences learning under conditions of uncertainty (i.e., choices based on the perceived likelihood of positive and negative outcomes). Three effects were observed. Compared with performance in the control condition (i.e., no meditation), mindfulness-based meditation (1) accelerated the rate of learning following positive prediction errors; (2) elicited a preference for the exploration (vs. exploitation) of choice selections; and (3) increased response caution. Collectively, these findings elucidate the pathways through which brief meditative experiences impact learning and decision-making, with implications for interventions designed to debias aspects of social-cognitive functioning using mindfulness-based meditation.
Association between high-resolution magnetic resonance vessel wall imaging characteristics and recurrent stroke in patients with intracranial atherosclerotic steno-occlusive disease: A prospective multicenter study
Authors: Yuan Weizhuang , Liu Xiaoyun , Yan Zhongrui , Wu Bo , Lu Baoquan , Chen Beilei , Tian Daishi , Du Ailian , Li Litao , Liu Changyun , Liu Guangzhi , Gong Tao , Shi Zhimin , Feng Feng , Liu Caiyan , Meng Yao , Lin Qianqian , Li Mingli , Xu Wei-Hai
Published: January 2024

Background:

High-resolution magnetic resonance vessel wall imaging (HRMR-VWI) is a promising technique for identifying intracranial vulnerable plaques beyond lumen narrowing. However, the association between HRMR-VWI characteristics and recurrent stroke remains uncertain.

Aims:

This study aimed to investigate the association between HRMR-VWI characteristics and recurrent ipsilateral stroke in patients with symptomatic intracranial atherosclerotic steno-occlusive disease (ICAS).

Methods:

This multicenter, observational study recruited first-ever acute ischemic stroke patients attributed to ICAS (>50% stenosis or occlusion) within 7 days after onset. Participants were assessed by multiparametric magnetic resonance imaging (MRI) including diffusion-weighted imaging, three-dimension time-of-flight magnetic resonance angiography, and three-dimensional T1-weighted HRMR-VWI. The patients were recommended to receive best medical therapy and were systematically followed up for 12 months. The association between HRMR-VWI characteristics and the time to recurrent ipsilateral stroke was investigated by univariable and multivariable analysis.

Results:

Two hundred and fifty-five consecutive patients were enrolled from 15 centers. The cumulative 12 month ipsilateral recurrence incidence was 4.1% (95% confidence interval (CI): 1.6–6.6%). Patients with recurrent ipsilateral stroke exhibited higher rates of intraplaque hemorrhage (IPH) (30.0% vs 6.5%) and eccentric plaque (90.0% vs 48.2%), and lower occurrence of occlusive thrombus (10.0% vs 23.7%). Plaque length (5.69 ± 2.21 mm vs 6.67 ± 4.16 mm), plaque burden (78.40 ± 7.37% vs 78.22 ± 8.32%), degree of stenosis (60.25 ± 18.95% vs 67.50% ± 22.09%) and remodeling index (1.07 ± 0.27 vs 1.03 ± 0.35) on HRMR-VWI did not differ between patients with and without recurrent ipsilateral stroke. In the multivariable Cox regression analysis, IPH (hazard ratio: 6.64, 95% CI: 1.23–35.8, p = 0.028) was significantly associated with recurrent ipsilateral stroke after adjustment. Conclusions: Our results suggest intraplaque hemorrhage (IPH) is significantly associated with recurrent ipsilateral stroke and has potential value in the selection of patients for aggressive treatment strategies.

Data access statement:

Data from this study are available and can be accessed upon request.
Analysis of coverage of the 11 March 2004 Madrid train bombings in Spain’s El País and El Diario Vasco through war and peace journalism frames
Authors: Meade Melissa R , Pineda Richard
Published: January 2024

This study examines the way in which two major Spanish newspapers, El País and El Diario Vasco, framed the 11 March 2004 (11-M) Madrid train bombings through peace journalism or war journalism, based on Peace Studies theorist Johan Galtung’s classification. An analysis of the news articles in the immediate aftermath of the bombings finds both frames present. The incumbent Spanish government initially tried to use the news media as a vehicle to present a premature interpretation that the Basque separatist group ETA perpetrated the attacks, even trying to pass a United Nations resolution. However, some journalistic coverage of the events in the week after the 11-M attacks portrayed the Spanish people’s sentiments regarding Spain’s support of the US in the Iraq war, Spaniards’ engagement with their democracy, including massive street protests, and parallels between the Iraqi people’s suffering and the Spanish train bombing victims. Other journalistic coverage focused on the perspectives of high-level Spanish government officials, emphasized the importance of prevailing in ‘the war on terror’, and provided an ‘us–them’ orientation.
Redrawing the lesbian: The memory of lesbian feminism in Kate Charlesworth’s Sensible Footwear: A Girl’s Guide
Authors: Belia Vasiliki
Published: January 2024

Kate Charlesworth’s graphic narrative Sensible Footwear: A Girl’s Guide (2019), part memoir and part documentary of lesbian, gay, bisexual, transgender, queer, and intersex life and activism in the United Kingdom from 1950 to 2019, remembers the time when the LGBTQI+ and feminist movements met and influenced each other deeply, namely in lesbian feminism of the 1970s and 1980s. Drawing on feminist historiography and memory studies, this article discusses the role the figure of the lesbian has played in the collective memory of lesbian feminism. With a focus on the expressive capacities of comics, it examines how the work revisits this figure at a time when women’s and LGBTQI+ rights face a backlash led by anti-gender campaigners, some of whom draw on discourses associated with lesbian feminism. It concludes that the work challenges dominant narratives about the relationship between lesbian, queer, and trans feminism and enables a reconsideration of these movements as parts of a common political project.
Comparison between high-flow nasal cannula and conventional oxygen therapy in COVID-19 patients: a systematic review and meta-analysis
Authors: Wang Jian-chao , Peng Yun , Dai Bing , Hou Hai-jia , Zhao Hong-wen , Wang Wei , Tan Wei
Published: January 2024

Background:

High-flow nasal cannula (HFNC) and conventional oxygen therapy (COT) are important respiratory support strategies for acute hypoxemic respiratory failure (AHRF) in coronavirus disease 2019 (COVID-19) patients. However, the results are conflicting for the risk of intubation with HFNC as compared to COT.

Objectives:

We systematically synthesized the outcomes of HFNC relative to COT in COVID-19 patients with AHRF and evaluated these outcomes in relevant subpopulations.

Design:

This study was designed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources and methods:

We searched PubMed, EMBASE, Web of Science, Scopus, ClinicalTrials.gov, medRxiv, BioRxiv, and the Cochrane Central Register of Controlled Trials for randomized controlled trials and observational studies that compared the efficacy of HFNC with COT in patients with COVID-19-related AHRF. Primary outcomes were intubation rate and mortality rate. Secondary outcomes were the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2), respiratory rate, hospital length of stay, intensive care unit (ICU) length of stay, and days free from invasive mechanical ventilation.

Results:

In total, 20 studies with 5732 patients were included. We found a decreased risk of requiring intubation in HFNC compared to COT [odds ratio (OR) = 0.61, 95% confidence interval (CI): 0.46–0.82, p = 0.0009, I2 = 75%]. Similarly, we found HFNC was associated with lower risk of intubation rate compared to COT in the subgroup of patients with baseline PaO2/FiO2 < 200 mmHg (OR = 0.69, 95% CI: 0.55–0.86, p = 0.0007, I2 = 45%), and who were in ICU settings at enrollment (OR = 0.57, 95% CI: 0.38–0.85, p = 0.005, I2 = 80%). HFNC was associated with an improvement of PaO2/FiO2 and respiratory rate compared to COT. The use of HFNC compared to COT did not reduce the mortality rate, days free from invasive mechanical ventilation, hospital length of stay, or ICU length of stay.

Conclusion:

Compared to COT, HFNC may decrease the need for tracheal intubation in patients with COVID-19-related AHRF, particularly among patients with baseline PaO2/FiO2 < 200 mmHg and those in ICU settings.

Trial registration:

This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (no. CRD42022339072).
Echoendoscopic ultrasound pancreatic adenocarcinoma diagnosis and theranostic approach: should KRAS mutation research be recommended in everyday practice?
Authors: Béchade Dominique , Palmieri Lola-Jade , Bonhomme Benjamin , Pernot Simon , Léna Jeanne , Fonck Marianne , Pesqué Sophie , Boillet Gautier , Italiano Antoine , Roseau Gilles
Published: January 2024

Background:

The impact of KRAS mutation testing on pancreatic ductal adenocarcinoma (PDAC) samples by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for reducing the need to repeat EUS-FNA has been demonstrated. Such testing however is not part of standard practice for endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB).

Objectives:

We aim to analyse the proportion of non-contributive samples by EUS-FNB and to evaluate the impact of KRAS mutation testing on the diagnosis, theranostics and survival.

Design:

In this retrospective study, the impact on diagnosis and survival of KRAS testing for contributive and non-contributive samples by EUS-FNB was analysed.

Methods:

The EUS-FNB samples, combined with KRAS testing using the Idylla® technique on liquid-based cytology from patients with PDAC between February 2019 and May 2023, were retrospectively reviewed. The cytology results were classified according to the guidelines of the World Health Organization System for Reporting Pancreaticobiliary Cytopathology (WHOSRPC).

Results:

A total of 85 EUS-FNB specimens were reviewed. In all, 25 EUS-FNB samples did not lead to a formal diagnosis of PDAC according to the WHOSRPC (30.2%). Out of these 25, 11 (44%) could have been considered positive for a PDAC diagnosis thanks to the KRAS mutation test without carrying out further diagnosis procedures. The sensitivity of KRAS mutation testing using the Idylla technique was 98.6%. According to the available data, survival rates were not statistically different depending on the type of mutation.

Conclusion:

KRAS mutation testing on liquid-based cytology using the Idylla or equivalent technique, combined with the PDAC EUS-FNB sample, should become a standard for diagnosis to avoid delaying treatment by doing another biopsy. Furthermore, knowledge of the KRAS status from treatment initiation could be used to isolate mutations requiring targeted treatments or inclusion in clinical research trials, especially for wild-type KRAS PDAC.
Epidemiology of Stingers in the National Football League, 2015-2019
Authors: Lamplot Joseph D. , Petit Camryn , Lee Rebecca , Mack Christina D. , Herzog Mackenzie M. , Solomon Gary S. , Diekfuss Jed A. , Myer Greg D. , Hammond Kyle
Published: January 2024

Background:

Transient traumatic neuropraxia of either the brachial plexus or cervical nerve root(s) is commonly described as a “stinger” or “burner” by the athlete. Stingers in American Football commonly occur acutely as isolated injuries; however, concomitant injuries, including cervical spine pathologies, have also been reported.

Hypothesis:

Among National Football League (NFL) athletes, the incidence rate of stingers is higher during the regular season than during the preseason and among positions with high velocity impacts such as running backs, linebackers, defensive backs, and receivers.

Study Design:

Retrospective epidemiology study.

Level of Evidence:

Level 4.

Methods:

Aggregation of all in-game injuries with a clinical impression of “neck brachial plexus stretch” or “neck brachial plexus compression” entered into the NFL injury surveillance database through the centralized league-wide electronic medical record system over 5 years (2015-2019 seasons). Incidence rates per player-play were calculated and reported.

Results:

A total of 691 in-game stingers occurred during the study period, with a mean of 138.2 per year. Average single-season injury risk for incident stinger was 3.74% (95% CI, 3.46%-4.05%). The incidence rate was higher during regular season games than during preseason games (12.26 per 100,000 player-plays [11.30-13.31] vs 8.87 [7.31-10.76], P < 0.01, respectively). The highest reported stinger incidence rates were among running backs and linebackers (both >15 per 100,000 player-plays). Among stingers, 76.41% did not miss time. Of those that resulted in time lost from football activities, mean time missed due to injury was 4.79 days (range, 3.17-6.41 days). Concomitant injuries were relatively low (7.09%).

Conclusion:

In-game stinger incidence was stable across the study period and occurred most frequently in running backs and linebackers. Stingers were more common during the regular season, and most players did not miss time. Concomitant injuries were relatively rare.

Clinical Relevance:

An improved understanding of the expected time loss due to stinger and concomitant injuries may provide insight for medical personnel in managing these injuries.
Neuromyelitis Optica Spectrum Disorder Resembling Wernicke’s Encephalopathy: A Case Report and Review of the Literature
Authors: Lynch Sloan , Saez Calveras Nil , Amin Anik
Published: January 2024

We describe a case of Neuromyelitis Optica Spectrum Disorder (NMOSD) mimicking Wernicke’s Encephalopathy (WE) to highlight an atypical presentation of NMOSD. A 39-year-old female presented with subacute encephalopathy and progressive ophthalmoplegia. Her MRI revealed T2 hyperintensities involving the mammillary bodies, periaqueductal grey matter, medial thalami, third ventricle, and area postrema. Whole blood thiamine levels were elevated and she did not improve with IV thiamine. CSF was notable for lymphocytic pleocytosis and elevated protein. She tested positive for serum Aquaporin-4 (AQP4) antibody. Subsequent imaging revealed multilevel lesions in the cervical and thoracic spinal cord. Her CSF GFAP antibody also came back positive. She steadily and significantly improved after high-dose IV steroids and plasmapheresis. She later started on chronic rituximab therapy. This represents a unique case of NMOSD presenting with the classical clinical and imaging features of WE, as opposed to the typical presenting symptoms of NMOSD. As such, demyelinating disorders should be considered when there is concern for diencephalic and midline pathologies, particularly without classic WE risk factors. Conversely, clinicians should be aware of secondary nutritional complications arising from severe area postrema syndrome.
Dual Antiplatelet Non-Responder: Resistance to Clopidogrel and Ticagrelor
Authors: Kuhn Anna Luisa , Singh Jasmeet , Puri Ajit S.
Published: January 2024

Background

Dual antiplatelet therapy is often required for neurointerventional procedures, especially when a stent or flow diverter is placed in the cervical and intracranial vessels. Patients are usually started on aspirin and clopidogrel given the simplicity of the once daily regimen with reasonable cost. Unfortunately, about a third of patients do not show the desired antiplatelet response to clopidogrel and another agent needs to be introduced. Ticagrelor is a potent antiplatelet medication that has a favorable pharmacological profile and has emerged as a reliable alternative to clopidogrel in recent years. Despite ticagrelor non-responders being rare, they do exist, and identification of these patients is important.

Results

A 74-year-old female was incidentally found to harbor a right posterior communicating aneurysm which was successfully treated electively with stent-assisted coiling. Platelet inhibition testing revealed non-responsiveness to Clopidogrel. Ticagrelor was initiated but the patient’s platelet reactivity unit remained in the normal range. Management algorithms to maximize a patient’s ticagrelor response by facilitating enteral absorption were applied but no platelet inhibition was achieved. The patient was eventually identified as a true ticagrelor non-responder.

Conclusion

Resistance to antiplatelet medication can result in devastating complications with permanent neurological deficits. Ticagrelor non-responders are rare but do exist. Platelet inhibition testing should be part of the preprocedural workup for neurointerventions.
Substance use disorder-associated infections’ treatment with dalbavancin enabling outpatient transition (SUDDEN OUT) – an investigator-initiated single-arm unblinded prospective cohort study
Authors: Krsak Martin , Scherger Sias , Miller Matthew A. , Cobb Vincent , Montague Brian T. , Henao-Martínez Andrés F. , Molina Kyle C.
Published: January 2024

Background:

Severe gram-positive infections are frequent in people who inject drugs, and successful completion of treatment presents unique challenges in this population.

Objectives:

We aimed to evaluate the feasibility of a long-acting antibiotic, dalbavancin, as an alternative to standard-of-care antibiotics for severe infections due to vancomycin-susceptible pathogens requiring ⩾2 weeks of therapy.

Design:

We designed an investigator-initiated single-arm unblinded prospective cohort study to evaluate the safety and efficacy of an early switch to dalbavancin in two doses administered 1 week apart.

Methods:

We screened patients admitted with bloodstream infection, osteomyelitis, septic arthritis, infective endocarditis or deep abscesses, and comorbid substance use disorder (SUD) for eligibility. Consenting patients were switched to dalbavancin within 7 days from their index culture. They were monitored in the hospital for efficacy and safety of the treatment until the second dose of dalbavancin 7 days later and then discharged if stable. Study participants were evaluated with a decision support engine for a hypothetical appropriate level of care regarding their SUD after discharge. Their follow-up was planned for 12 months from the index culture, either in-person or via telehealth/telephone.

Results:

The enrollment was terminated early due to significant loss-to-follow-up. In all, 11 patients were enrolled, 4 completed 12 months of follow-up, 2 completed 8 months of follow-up, and 1 was seen once after discharge. The remaining five patients were lost to follow-up immediately after discharge. All 11 patients continued to improve after switching to dalbavancin between the first and second doses. There were two per-protocol failures of treatment. Dalbavancin was well tolerated, though some adverse events were reported.

Conclusion:

Dalbavancin may be a safe and effective alternative for an early switch in treating severe gram-positive infections.

Trial registration:

The trial was registered as NCT04847921 with clinicaltrials.gov.
Early Versus Delayed Surgery for Elderly Traumatic Cervical Spinal Injury: A Nationwide Multicenter Study in Japan
Authors: Segi Naoki , Nakashima Hiroaki , Ito Sadayuki , Yokogawa Noriaki , Sasagawa Takeshi , Watanabe Kota , Nori Satoshi , Funayama Toru , Eto Fumihiko , Nakajima Hideaki , Terashima Yoshinori , Hirota Ryosuke , Hashimoto Ko , Onoda Yoshito , Furuya Takeo , Yunde Atsushi , Ikegami Shota , Uehara Masashi , Suzuki Hidenori , Imajo Yasuaki , Uei Hiroshi , Sawada Hirokatsu , Kawaguchi Kenichi , Nakanishi Kazuo , Suzuki Nobuyuki , Oshima Yasushi , Hasegawa Tomohiko , Iizuka Yoichi , Tonomura Hitoshi , Terai Hidetomi , Akeda Koji , Seki Shoji , Ishihara Masayuki , Inoue Gen , Funao Haruki , Yoshii Toshitaka , Kaito Takashi , Kiyasu Katsuhito , Tominaga Hiroyuki , Kakutani Kenichiro , Sakai Daisuke , Ohba Tetsuro , Otsuki Bungo , Miyazaki Masashi , Murotani Kenta , Okada Seiji , Imagama Shiro , Kato Satoshi
Published: January 2024

Study Design

Retrospective multicenter study.

Objectives

The effectiveness of early surgery for cervical spinal injury (CSI) has been demonstrated. However, whether early surgery improves outcomes in the elderly remains unclear. This study investigated whether early surgery for CSI in elderly affects complication rates and neurological outcomes.

Methods

This retrospective multicenter study included 462 patients. We included patients with traumatic acute cervical spinal cord injury aged ≥65 years who were treated surgically, whereas patients with American Spinal Injury Association (ASIA) Impairment Scale E, those with unknown operative procedures, and those waiting for surgery for >1 month were excluded. The minimum follow-up period was 6 months. Sixty-five patients (early group, 14.1%) underwent surgical treatment within 24 hours, whereas the remaining 397 patients (85.9%) underwent surgery on a standby basis (delayed group). The propensity score-matched cohorts of 63 cases were compared.

Results

Patients in the early group were significantly younger, had significantly more subaxial dislocations (and fractures), tetraplegia, significantly lower ASIA motor scores, and ambulatory abilities 6 months after injury. However, no significant differences in the rate of complications, ambulatory abilities, or ASIA Impairment Scale scores 6 months after injury were observed between the matched cohorts. At 6 months after injury, 61% of the patients in the early group (25% unsupported and 36% supported) and 53% of the patients in the delayed group (34% unsupported and 19% supported) were ambulatory.

Conclusions

Early surgery is possible for CSI in elderly patients as the matched cohort reveals no significant difference in complication rates and neurological or ambulatory recovery between the early and delayed surgery groups.