bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Three Cases of Primary Hypogalactia in Jalisco, Mexico
Authors: Sandoval-Pinto Elena , García-Gutiérrez Mariana , Acosta-Real Sara , Sierra-Díaz Erick , Cremades Rosa
Published: October 2023

Introduction:

Human lactation should be taken into account as an important issue for the international agenda. Despite advances in lactation information and knowledge, insufficient milk production is still a concern for mothers and health practitioners, including International Board Certified Lactation Consultants and others. Primary hypogalactia, or insufficient milk production is uncommon, but should be considered when there is poor weight gain and decreased urine output in infants despite good latch-on and suckling, or anatomic differences in the physical exam of the lactating breast.

Main Issue:

This case series presents three cases illustrating insufficient milk production resulting in infants who experienced significant dehydration and poor weight gain.

Management:

Primary hypoplasia was diagnosed by means of a thorough interview and physical examination that entailed a consultation with a physician who was also an International Board Certified Lactation Consultant.

Conclusion:

Awareness of an infant’s feeding needs and proper evaluation of a child’s health status is paramount if health care providers are to identify the important factors contributing to breastfeeding problems. In some instances, breastfeeding goals cannot be achieved, and then the provider’s role becomes support in coming to terms with persistent insufficient milk production, and coordinating appropriate supplementation to meet each baby’s nutritional needs.
Does Basel III – Liquidity Coverage Ratio Affect the Profitability of Indian Public Sector Banks?
Authors: Rajdeep Shrujan , Patra Biswajit
Published: October 2023

The article analyses the interrelation between the Liquidity Coverage Ratio (LCR) and the profitability of Indian public sector banks from March 2015 to March 2022. It uses the panel data technique to explain these relations. Further, this article also looked at the interactive effect of LCR through advances and the interest rate. It has gone through pre- and post-diagnostic checks finalizing the model and variables. The findings of the result surprisingly imply that Basel III regulatory directives like LCR positively impact the bank profitability in India rather than general apprehension about the negative impact. However, the interactive effects of LCR through advances negatively influence the banks’ profitability. Variables such as deposits, Economic Policy Uncertainty (EPU) and Gross Domestic Product (GDP) have no statistically significant relation with banks’ profitability. This article recommends that Basel III guidelines should not be looked at negatively for the performance of banks.
Characterization of CD3+/CD20+ canine large-cell lymphoma
Authors: Howard Cory M. , Anderson Steffanie , Harrington Bonnie
Published: October 2023

Immunophenotyping of canine large-cell lymphoma (LCL) for B-cell and T-cell surface antigens is commonly performed to better predict the clinical outcome. Expression of surface antigen CD3 is associated with T-cell malignancies; surface antigen CD20 is expressed on B cells. However, a small subset of canine LCLs expresses both CD3 and CD20 (CD3+/CD20+); this form of lymphoma remains poorly defined at the molecular level. In a retrospective study, we aimed to better characterize immunophenotypic properties and antigen receptor clonality of CD3+/CD20+ LCL. We selected formalin-fixed, paraffin-embedded tissues from 10 cases of CD3+/CD20+ LCL and breed-matched controls of peripheral large T-cell lymphoma (PTCL) and diffuse large B-cell lymphoma (DLBCL). Using PCR for antigen receptor rearrangement (PARR), we identified monoclonal T-cell receptor gamma (TCRγ) rearrangements in all CD3+/CD20+ cases. Three of 10 cases had monoclonal rearrangements in the immunoglobulin heavy chain (IgH), supportive of cross-lineage rearrangement. There was no significant difference in the frequency of antigen receptor rearrangement between CD3+/CD20+ and PTCL cases. In comparison with DLBCL, CD3+/CD20+ LCL had TCRγ rearrangement more frequently and IgH rearrangement less frequently, respectively. Immunolabeling of the B-cell marker PAX5 occurred less frequently in all CD3+/CD20+ LCL cases compared to the DLBCL controls. Immunolabeling for BCL-2 was robust, regardless of immunophenotype. Nuclear Ki67 positivity was variable in CD3+/CD20+ cases, indicating a heterogeneity in proliferation. Overall, cases of canine CD3+/CD20+ LCL had properties similar to PTCL, suggesting a similar histogenesis of these 2 subsets.
Faking Good on Self-Reports Versus Informant-Reports of Emotional Intelligence
Authors: Walker Sarah A. , MacCann Carolyn
Published: October 2023

Research demonstrates that people can fake on self-rated emotional intelligence scales. As yet, no studies have investigated whether informants (where a knowledgeable informant rates a target’s emotional intelligence) can also fake on emotional intelligence inventories. This study compares mean score differences for a simulated job selection versus a standard instructed set for both self-ratings and informant-ratings on the Trait Emotional Intelligence Questionnaire—Short Form (TEIQue-SF). In a 2 × 2 between-person design, participants ( N = 81 community volunteers, 151 university students) completed the TEIQue-SF as either self-report or informant-report in one of two instruction conditions (answer honestly, job simulation). Both self-reports ( d = 1.47) and informant-reports ( d = 1.56) were significantly higher for job simulation than “answer honestly” instructions, indicating substantial faking. We conclude that people can fake emotional intelligence for both themselves (self-report) and on behalf of someone else (informant-report). We discuss the relevance of our findings for self- and informant-report assessment in applied contexts.
Navigating the Cycle of Dysregulation in the Inclusive Setting: A Guide to Prevent and Resolve Student Crisis Events
Authors: Cramer Allie M. , Filderman Marissa J.
Published: October 2023

Students with emotional and behavioral disorders (EBD) can exhibit severely challenging behaviors that lead to events of crisis in an inclusive classroom. This article provides practitioners with an overview of the cycle of dysregulation experienced by some students with EBD. The article includes descriptions of stages in the dysregulation cycle, observable behaviors of students “in” the various stages, and step-by-step directions for teachers and other education professionals aiming to guide students successfully through each cycle stage and prevent further crisis.
The Archived Child: Strategies for Amplifying Children’s Contributions to History
Authors: Gleason Mona
Published: October 2023

Using examples drawn from letters written by rural youth from the western Canadian province of British Columbia during the interwar period, I explore three interrelated interpretive strategies or dispositions for amplifying young peoples’ contributions to history: empathic inference, relational agency, and the axiom that children are heirs to the future. The letters are part of a larger archival collection of the province’s Elementary Correspondence School, the first of its kind in Canada, and provide historians with uniquely valuable child and youth focused perspectives on schooling, family, work, and other aspects of their lives. Supported by examples from the letters, I argue that young peoples’ contributions to historical change are most clearly legible when interpretive strategies, including the historical methods and methodological dispositions historians adopt, reject traditional conceptions of history as exclusively or mainly adult driven.
Inactive Matrix Gla Protein in Relation to Renal and Cardiac Functions and Cardiac Valvular Calcification Among Type 2 Diabetes Patients
Authors: Reda Sara , Fawzy Olfat , Sayed Doaa , Mohamed Ghada , Khidr Emad Gamil
Published: October 2023

Background:

Matrix Gla protein (MGP) is a robust innate suppressor of the detrimental process of vascular calcification in the human body.

Objectives:

The interrelationship between circulating MGP levels and renal and cardiac dysfunction, besides echocardiographic calcification score (ECS) was investigated in a sample of type 2 diabetes (T2D) patients.

Methods:

The study included 130 subjects. They were 95 patients with T2D and 35 age- and sex-matched healthy controls. Patients were further subdivided into 52 T2D patients without DKD (eGFR ⩾ 60 ml/minute/1.73 m²) and 43 T2D persons with DKD (eGFR > 60 ml/minute/1.73 m²). Serum MGP levels, determined by ELISA, renal function tests, lipid profile, and echocardiography were studied in all participants.

Results:

Significantly elevated circulating inactive MGP level was noted in individuals having T2D compared to controls. It correlated negatively with eGFR and left ventricular (LV) diastolic and systolic functions and positively with indices of LV hypertrophy. ECS was significantly increased in both T2D groups compared to controls and in DKD group compared to the diabetic group without DKD. A significant positive correlation was observed between inactive MGP and ECS.

Conclusion:

Serum inactive MGP may contribute to the development of DKD and to the associated process of cardiac valvular calcification. It may be a beneficial diagnostic marker for early prediction of cardiac calcification and preclinical LV systolic and diastolic dysfunction in T2D patients, especially in those complicated with DKD.
Legitimacy and Respectability on the Skin: Bruises, Women’s Rugby and Situational Meaning
Authors: Branchu Charlotte
Published: October 2023

Drawing upon ethnographic fieldwork, this article explores amateur rugby women’s reflexive negotiation of the bruises they earn as a result of the physicality of the game. On one hand, participants take pride in body marks that confirm their athletic strength and rugby identity and which grants them respect and belonging. On the other hand, these body marks can be anchors of stigma, signalling women’s rugby bodies as ‘deviant’ to non-initiated audiences. The article unpacks this tension between bruises as empowering or disempowering artefacts by demonstrating the situational and interactional nature of gendered dispositions and expectations. I show that the moral and symbolic order of entrenched gendered expectations is perpetuated in the flesh, but that it must be understood as being produced and reproduced in situ through intercorporeal processes. Through the analysis of bruises, I argue that to study bodies is to study (social) space.
Engagement with written corrective feedback: Examination of feedback types and think-aloud protocol as pedagogical interventions
Authors: Tabari Mahmoud Abdi , Sato Masatoshi , Wang Yizhou
Published: October 2023

This study examined the combined effects of written corrective feedback (WCF) and think-aloud protocols (TAPs) as two types of pedagogical intervention for improving the revision quality of second language (L2) writing. With a quasi-experimental design, it explored whether TAPs trigger deeper processing of WCF under two WCF-type conditions: direct or indirect WCF. Participants were 80 high-intermediate learners of English as a second language (ESL) at a US university who were divided into (1) direct WCF+TAPs; (2) direct WCF-only; (3) indirect WCF+TAPs; and (4) indirect WCF-only. The impacts of the interventions were gauged by changes in seven subsystems of complexity–accuracy–lexis (CAL) between the first and final drafts of narrative essays. Results showed differential impacts of the four conditions depending on the linguistic dimensions, including some negative impacts of TAPs. Participants’ comments during TAP sessions were used to triangulate the interventions’ effects. We conclude that WCF and TAPs promoted different types of processing; while WCF contributed to the potential restructuring of learners’ interlanguage systems, TAPs triggered learners’ higher-order thinking and served as a self-reflection tool to make strategic decisions in revising the text.
Health perceptions and attitudes on mobile health apps in China
Authors: Zhang Xiaoni , Raghavan Vijay , Yang Xueyan
Published: October 2023

Since the COVID-19 pandemic, the use of mobile health apps has been increasing significantly. Many have started using mobile health apps to manage their health and well-being. People need to develop healthy habits that will increase their job productivity, life expectancy and improve their social relationships. This study tests the Health Belief Model with adults in China in influencing health motivation and in turn improving their health behavior. A mobile and online survey was developed, and 120 usable responses were collected. A structural equation modeling was used to test the relationships between perceived benefits, perceived susceptibility, perceived barriers, health motivation, and health behavior. We found perceived self-efficacy, perceived benefits, and perceived susceptibility predicts health motivation, and health motivation predicts health behavior. We did not find that perceived barrier is a predictor for health motivation. We conclude that to encourage behavioral change, it is important to enhance self-efficacy and address the benefits; in the meantime, educating people on susceptibility is also important.
Towards the individuated journalistic worker in pandemic times: Reflections from Greece and Cyprus
Authors: Vatikiotis Pantelis , Maniou Theodora A , Spyridou Paschalia (Lia)
Published: October 2023

Drawing on a comparative qualitative analysis using semi-structured interviews, this study examines the impact of the COVID-19 crisis on journalists’ working conditions and practices in Greece and Cyprus. The findings provide empirical evidence that the crisis had a significant impact on journalistic work: changing patterns in labour conditions, advancing the role of the individuated worker; cumulating levels of professional risks and stress; increasing insecurity and pressures in the sector – aspects that undermine journalism capacity to offer useful information needed for an informed and engaged citizenry. Still, these changes in both countries are not solely driven by the pandemic situation. Rather the recent crisis seems to have deepened structural pathogenies of journalism in both Greece and Cyprus, including sustainability issues intensified by the recent economic crisis, the lack of a strong professional culture that makes journalism vulnerable to political pressures, as well as dependences and deficiencies in interacting with new technologies.
Reflexivity in global social policy: Introduction to the special issue
Authors: Berten John , Wolkenhauer Anna
Published: October 2023

This introduction sets the scene for the five papers of the special issue on ‘Reflexivity in Global Social Policy’. It argues that a reflexivity lens can deepen a self-critical assessment of the field and its boundaries, and contribute to more conceptual and analytical nuance. The introduction reviews existing approaches that reflect on the key building blocks of the field – ideas, terminology, and theory – and makes a case for addressing the porous boundaries between scholarship and practice. It subsequently suggests the two notions of perspectivity and performativity to inform further reflexive analyses, before introducing the five papers and five forum contributions that constitute this issue.
Parametric optimization of culture chamber for cell mechanobiology research
Authors: Guo Xutong , Wang Ziqi , Gao Lilan , Zhang Chunqiu
Published: October 2023

Mechanical signals influence the morphology, function, differentiation, proliferation, and growth of cells. Due to the small size of cells, it is essential to analyze their mechanobiological responses with an in vitro mechanical loading device. Cells are cultured on an elastic silicone membrane substrate, and mechanical signals are transmitted to the cells by the substrate applying mechanical loads. However, large areas of non-uniform strain fields are generated on the elastic membrane, affecting the experiment’s accuracy. In the study, finite-element analysis served as the basis of optimization, with uniform strain as the objective. The thickness of the basement membrane and loading constraints were parametrically adjusted. Through finite-element cycle iteration, the “M” profile basement membrane structure of the culture chamber was obtained to enhance the uniform strain field of the membrane. The optimized strain field of culture chamber was confirmed by three-dimensional digital image correlation (3D-DIC) technology. The results showed that the optimized chamber improved the strain uniformity factor. The uniform strain area proportion of the new chamber reached 90%, compared to approximately 70% of the current chambers. The new chamber further improved the uniformity and accuracy of the strain, demonstrating promising application prospects.
TRIM29 promotes the progression of colorectal cancer by suppressing EZH2 degradation
Authors: Chen Yuanjian , Ma Jun , Zhang Mingming
Published: October 2023

Colorectal cancer (CRC) is commonly diagnosed at the advanced stage and has a high mortality rate. Tripartite Motif Containing 29 (TRIM29) is an oncogene in numerous malignancies including CRC. However, the molecular mechanism of TRIM29 is largely unknown. In this study, we investigated the biological functions of TRIM29 and the underlying mechanisms. The expression of TRIM29 and Enhancer of Zeste Homolog 2 (EZH2) was predicted using the bioinformatic analysis and measured using a quantitative real-time polymerase chain reaction (PCR) and immunohistochemical assay. The biological functions of TRIM29 were analyzed using a cell counting kit-8, EdU and transwell assays, scratch test, and flow cytometry. The interaction between TRIM29 and EZH2 was assessed using protein immunoprecipitation. The stability of EZH2 was evaluated by treating it with cycloheximide. Our results indicated that TRIM29 levels were upregulated in CRC. Overexpression of TRIM29 promoted CRC cell proliferation and migration and suppressed apoptosis. The opposite result was obtained when TRIM29 was silenced. TRIM29 interacted with EZH2 mechanically and enhanced the protein stability of EZH2. Depletion of EZH2 reversed the effects of TRIM29, regarding its biological behaviors. Moreover, downregulation of TRIM29 inhibited tumor growth and improved the histopathological prognosis. In conclusion, EZH2 interacted with silenced TRIM29 to suppress its stability, thereby inhibiting cell proliferation, migration, and tumor growth, and promoting apoptosis in CRC. Our findings suggested that TRIM29 is a promising target for CRC therapy.
Dietary supplementation with L-leucine reduces nitric oxide synthesis by endothelial cells of rats
Authors: Tekwe Carmen D , Luan Yuanyuan , Meininger Cynthia J , Bazer Fuller W , Wu Guoyao
Published: October 2023

This study tested the hypothesis that elevated L-leucine concentrations in plasma reduce nitric oxide (NO) synthesis by endothelial cells (ECs) and affect adiposity in obese rats. Beginning at four weeks of age, male Sprague-Dawley rats were fed a casein-based low-fat (LF) or high-fat (HF) diet for 15 weeks. Thereafter, rats in the LF and HF groups were assigned randomly into one of two subgroups ( n = 8/subgroup) and received drinking water containing either 1.02% L-alanine (isonitrogenous control) or 1.5% L-leucine for 12 weeks. The energy expenditure of the rats was determined at weeks 0, 6, and 11 of the supplementation period. At the end of the study, an oral glucose tolerance test was performed on all the rats immediately before being euthanized for the collection of tissues. HF feeding reduced ( P < 0.001) NO synthesis in ECs by 21% and whole-body insulin sensitivity by 19% but increased ( P < 0.001) glutamine:fructose-6-phosphate transaminase (GFAT) activity in ECs by 42%. Oral administration of L-leucine decreased ( P < 0.05) NO synthesis in ECs by 14%, increased ( P < 0.05) GFAT activity in ECs by 35%, and reduced ( P < 0.05) whole-body insulin sensitivity by 14% in rats fed the LF diet but had no effect ( P > 0.05) on these variables in rats fed the HF diet. L-Leucine supplementation did not affect ( P > 0.05) weight gain, tissue masses (including white adipose tissue, brown adipose tissue, and skeletal muscle), or antioxidative capacity (indicated by ratios of glutathione/glutathione disulfide) in LF- or HF-fed rats and did not worsen ( P > 0.05) adiposity, whole-body insulin sensitivity, or metabolic profiles in the plasma of obese rats. These results indicate that high concentrations of L-leucine promote glucosamine synthesis and impair NO production by ECs, possibly contributing to an increased risk of cardiovascular disease in diet-induced obese rats.
Autotaxin–lysophosphatidic acid receptor 5 axis evokes endothelial dysfunction via reactive oxygen species signaling
Authors: Janovicz Anna , Majer Aliz , Kosztelnik Mónika , Geiszt Miklós , Chun Jerold , Ishii Satoshi , Tigyi Gábor József , Benyó Zoltán , Ruisanchez Éva
Published: October 2023

Lysophosphatidylcholine (LPC) is a bioactive lipid that has been shown to attenuate endothelium-dependent vasorelaxation contributing to endothelial dysfunction; however, the underlying mechanisms are not well understood. In this study, we investigated the molecular mechanisms involved in the development of LPC-evoked impairment of endothelium-dependent vasorelaxation. In aortic rings isolated from wild-type (WT) mice, a 20-min exposure to LPC significantly reduced the acetylcholine chloride (ACh)–induced vasorelaxation indicating the impairment of normal endothelial function. Interestingly, pharmacological inhibition of autotaxin (ATX) by GLPG1690 partially reversed the endothelial dysfunction, suggesting that lysophosphatidic acid (LPA) derived from LPC may be involved in the effect. Therefore, the effect of LPC was also tested in aortic rings isolated from different LPA receptor knock-out (KO) mice. LPC evoked a marked reduction in ACh-dependent vasorelaxation in Lpar1, Lpar2, and Lpar4 KO, but its effect was significantly attenuated in Lpar5 KO vessels. Furthermore, addition of superoxide dismutase reduced the LPC-induced endothelial dysfunction in WT but not in the Lpar5 KO mice. In addition, LPC increased H2O2 release from WT vessels, which was significantly reduced in Lpar5 KO vessels. Our findings indicate that the ATX–LPA–LPA5 receptor axis is involved in the development of LPC-induced impairment of endothelium-dependent vasorelaxation via LPA5 receptor–mediated reactive oxygen species production. Taken together, in this study, we identified a new pathway contributing to the development of LPC-induced endothelial dysfunction.
Standardized measurement of balance and mobility post-stroke: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable
Authors: Van Criekinge Tamaya , Heremans Charlotte , Burridge Jane , Deutsch Judith E , Hammerbeck Ulrike , Hollands Kristen , Karthikbabu Suruliraj , Mehrholz Jan , Moore Jennifer L , Salbach Nancy M , Schröder Jonas , Veerbeek Janne M , Weerdesteyn Vivian , Borschmann Karen , Churilov Leonid , Verheyden Geert , Kwakkel Gert
Published: October 2023

Background:

Mobility is a key priority for stroke survivors. Worldwide consensus of standardized outcome instruments for measuring mobility recovery after stroke is an essential milestone to optimize the quality of stroke rehabilitation and recovery studies and to enable data synthesis across trials.

Methods:

Using a standardized methodology, which involved convening of 13 worldwide experts in the field of mobility rehabilitation, consensus was established through an a priori defined survey-based approach followed by group discussions. The group agreed on balance- and mobility-related definitions and recommended a core set of outcome measure instruments for lower extremity motor function, balance and mobility, biomechanical metrics, and technologies for measuring quality of movement.

Results:

Selected measures included the Fugl-Meyer Motor Assessment lower extremity subscale for motor function, the Trunk Impairment Scale for sitting balance, and the Mini Balance Evaluation System Test (Mini-BESTest) and Berg Balance Scale (BBS) for standing balance. The group recommended the Functional Ambulation Category (FAC, 0–5) for walking independence, the 10-meter Walk Test (10 mWT) for walking speed, the 6-Minute Walk Test (6 MWT) for walking endurance, and the Dynamic Gait Index (DGI) for complex walking. An FAC score of less than three should be used to determine the need for an additional standing test (FAC < 3, add BBS to Mini-BESTest) or the feasibility to assess walking (FAC < 3, 10 mWT, 6 MWT, and DGI are “not testable”). In addition, recommendations are given for prioritized kinetic and kinematic metrics to be investigated that measure recovery of movement quality of standing balance and walking, as well as for assessment protocols and preferred equipment to be used.

Conclusions:

The present recommendations of measures, metrics, technology, and protocols build on previous consensus meetings of the International Stroke Recovery and Rehabilitation Alliance to guide the research community to improve the validity and comparability between stroke recovery and rehabilitation studies as a prerequisite for building high-quality, standardized “big data” sets. Ultimately, these recommendations could lead to high-quality, participant-specific data sets to aid the progress toward precision medicine in stroke rehabilitation.
A roadmap for research in post-stroke fatigue: Consensus-based core recommendations from the third Stroke Recovery and Rehabilitation Roundtable
Authors: English Coralie , Simpson Dawn B , Billinger Sandra A , Churilov Leonid , Coupland Kirsten G , Drummond Avril , Kuppuswamy Annapoorna , Kutlubaev Mansur A , Lerdal Anners , Mahmood Amreen , Moseley G Lorimer , Pittman Quentin J , Riley Ellyn A , Sutherland Brad A , Wong Connie HY , Corbett Dale , Mead Gillian
Published: October 2023

Rationale:

Fatigue affects almost half of all people living with stroke. Stroke survivors rank understanding fatigue and how to reduce it as one of the highest research priorities.

Methods:

We convened an interdisciplinary, international group of clinical and pre-clinical researchers and lived experience experts. We identified four priority areas: (1) best measurement tools for research, (2) clinical identification of fatigue and potentially modifiable causes, (3) promising interventions and recommendations for future trials, and (4) possible biological mechanisms of fatigue. Cross-cutting themes were aphasia and the voice of people with lived experience. Working parties were formed and structured consensus building processes were followed.

Results:

We present 20 recommendations covering outcome measures for research, development, and testing of new interventions and priority areas for future research on the biology of post-stroke fatigue. We developed and recommend the use of the Stroke Fatigue Clinical Assessment Tool.

Conclusions:

By synthesizing current knowledge in post-stroke fatigue across clinical and pre-clinical fields, our work provides a roadmap for future research into post-stroke fatigue.
A new modeling method to predict the mechanical properties of braided composites
Authors: Dhimole Vivek Kumar , Kabir Humayun , Cho Chongdu
Published: October 2023

The present research signifies a new modeling method for calculating the stiffness of braided composites. In previous works, the modeling approach has been related to repetitive unit cells for analysis of braided composites based on a single area or a few added areas. Also, no confirmed modeling method has recently been available for braided composites because of different fibers’ configuration considerations. Therefore, there is no preferred one, and fiber bundle arrangements are complex in practicality; it is unclear whether their shape is straight or curved. Also, the previously proposed mesoscale repetitive unit cell models have many elements and nodes in the finite element analysis phase, so applying periodic boundary and mesh conditions can mislead the results when they are used. So current research proposes a multi-cell multi-domain strategy and verifies it for modeling and computation of mechanical properties while showing the significance of braiding path and manufacturing process. The currently proposed method is tested with selected sections’ configuration and shown for actual braided composites’ scenario. So, according to the literature, the section is modeled as a complex shape with a squeezing effect. Then, that model is analyzed, and calculated properties are verified by the existing methods and found results with a maximum and minimum difference of 2.7% and 0.25%, respectively. Afterward, it is divided into cells, which are then analyzed and checked to determine which number of simplistic division stages can represent a section. It is found that a minimum of 15 divisions can be defined with a maximum 2% difference, and over that has approximately the same results as of the current considered section model. Additionally, the study examines how the elastic constants of 2D braided composites are influenced by the braiding angle and fiber volume fractions.
Comparative efficacy and safety of novel immuno-chemotherapy for extensive-stage small-cell lung cancer: a network meta-analysis of randomized controlled trial
Authors: Zhu Youwen , Liu Kun , Zhu Hong , Cao Hui , Zhou Yangying
Published: October 2023

Background:

Recently, several new first-line immune checkpoint inhibitors (ICIs) plus chemotherapy have been approved for patients with extensive-stage small-cell lung cancer (ES-SCLC). However, direct comparisons between first-line treatments are lacking. Therefore, we indirectly compared the efficacy and safety of specific treatment strategies to inform physicians’ and patients’ clinical decisions.

Methods:

The Pubmed, Cochrane, Embase, and Web of Science databases were searched from 1 January 2000 to 27 November 2022, for randomized clinical trials (RCTs) assessing first-line immuno-chemotherapies for ES-SCLC. A fixed-effect multivariable meta-regression model was established for frequentist network meta-analysis and hazard ratios (HRs) with 95% confidence intervals (95% CI) were computed to compare the effects of immuno-chemotherapies on patient overall survival (OS) and progression-free survival (PFS), while risk ratios with 95% CI were used for treatment- and immune-related adverse events (AEs). The p score values were then used to rank treatments based on their odds of being the best treatment option. The research protocol was registered with the PROSPERO (CRD42022383254).

Results:

Seven studies involving 3822 patients were eligible for analysis. Serplulimab plus chemotherapy had better OS outcomes compared to chemotherapy (HR = 0.63; 95% CI: 0.49–0.82) and ipilimumab plus chemotherapy (HR = 0.67; 95% CI: 0.50–0.90). It additionally exhibited better PFS outcomes compared to chemotherapy (HR = 0.48; 95% CI: 0.39–0.60), adebrelimab (HR = 0.72; 95% CI: 0.53–0.97), atezolizumab (HR = 0.62; 0.46–0.85), durvalumab (HR = 0.60; 95% CI: 0.45–0.80), durvalumab and tremelimumab (HR = 0.57; 95% CI: 0.43–0.76), ipilimumab (HR = 0.57; 95% CI: 0.44–0.73), and pembrolizumab (HR = 0.64; 95% CI: 0.48–0.86) plus chemotherapy. Serplulimab plus chemotherapy was linked to the greatest odds of effectively reducing the odds of death ( p score = 0.87) and progression ( p score = 0.99) while exhibiting a good safety profile.

Conclusion:

Serplulimab plus chemotherapy exhibited the best survival outcomes with manageable AEs. Thus, serplulimab plus chemotherapy may represent the optimal best first-line treatment option for ES-SCLC patients.
The new combination of oxygen saturation with age shock index predicts the outcome of COVID-19 pneumonia
Authors: Oh Sangyeop , Lee Kyoungmi
Published: October 2023

Introduction:

Emergency departments around the world have been struggling to deal with patients with COVID-19 and presumed COVID-19. Triaging patients who need further medical support is the key matter to emergency physicians as the delay of proper treatment may worsen the results. The aim of this study was to validate the ability of age shock index and hypoxia-age-shock index at the time of presentation to the emergency department to predict case fatality in patients with COVID-19 pneumonia.

Methods:

We only included patients who had COVID-19-associated pneumonia who needed in-hospital treatment. The vital signs and oxygen saturation used in the study were collected, especially from the triage sector, before patients were given supplemental oxygen.

Results:

A total of 241 patients enrolled in the study. The case fatality rate was 27%. The median age of the study samples was 78 (66–86) years with 133 male and 108 female patients. Hypoxia-age-shock index showed the best performance in analysis (odds ratio 15.1, 95% confidence interval: 5.1–44.4; adjusted odds ratio 8.6, 95% confidence interval: 2.8–26.8).

Conclusion:

The hypoxia-age-shock index was a strong predictor for in-hospital mortality of COVID-19 pneumonia. Furthermore, when it was compared with age shock index, hypoxia-age-shock index showed better performance in predicting fatality of the disease.
Endobronchial valve treatment in chronic obstructive pulmonary disease: A qualitative study of patients’ expectations
Authors: Farver-Vestergaard Ingeborg , Mousing Camilla Askov , Løkke Anders , Bock Kathrine , Christensen Thomas Decker , Bendixen Morten , Bendstrup Elisabeth , Jørgensen Lotte Hasling Kodbøl , King Karoline Litrup
Published: October 2023

Objectives:

Endobronchial valve (EBV) treatment is a treatment option for selected patients with severe chronic obstructive pulmonary disease (COPD) to reduce dyspnea and improve quality of life. However, the procedure is associated with risk of complications, and not all patients achieve the expected outcomes. The present study explores patients’ expectations while waiting for EBV treatment.

Methods:

Fifteen patients accepted for EBV treatment at Aarhus University Hospital in Denmark from October 2020 to June 2021 participated in a 30-min, semi-structured interview about (1) the experience of living with COPD and (2) expectations regarding EBV.

Results:

Four themes were identified: a life of reduced quality; hopes and expectations; information about EBV; and perception of risks. Most patients described their lives as not worth living, and they hoped that EBV would give them their physical and social lives back, while also being aware that EBV would probably not work miracles. Patients’ information seeking was influenced by their hopes and expectations to the treatment. They filtered out negative information, focusing on the hope for a positive outcome. This made them willing to run the risk of complications.

Conclusion:

Living a life of considerably reduced quality, patients might have an increased focus on potential positive effects of EBV treatment while filtering out information about potential side effects. This might bias their decision-making process.
Palmoplantar keratoderma, pseudo-ainhum and knuckle pads in an African patient: A case report
Authors: Govender Kellicia Courtney , Pillay Somasundram
Published: October 2023

Hereditary palmoplantar keratoderma is a rare heterogenous group of genodermatoses characterised by hyperkeratosis of the palms and soles. Genetic alterations affecting proteins of the keratin cytoskeleton, cornified cell envelope, desmosomes and gap junction proteins have been implicated in the pathogenesis of inherited palmoplantar keratoderma. Reports of palmoplantar keratoderma in the African population are scarce. Herein, we report a case of a 29-year-old HIV-infected African female, who presented to a tertiary hospital with complaints of a painful left fourth toe, secondary to a constriction band. Her background history is significant for prior constriction bands involving her toes, some of which progressed to auto-amputations and childhood-onset thickening of the palmoplantar skin. Examination revealed diffuse transgrediens palmoplantar keratoderma with associated clinical findings of pseudo-ainhum and knuckle pads. A systemic workup was non-contributory. Next-generation sequencing genetic testing detected two variants of undetermined significance in gap junction protein beta 4, a connexin-encoding gene, and in the rhomboid 5 homolog 2 gene. Her phenotype remains discordant with our genetic findings. Her clinical features are instead consistent with overlapping phenotypes of gap junction protein beta 2-related connexin disorders: Vohwinkel syndrome and Bart–Pumphrey syndrome. Our case underlines the genetic heterogeneity of palmoplantar keratoderma and the diagnostic challenges it presents. Our patient required surgical amputation of the affected toe and is receiving ongoing dermatological management. Early recognition, appropriate referral and management are required to avert the debilitating consequences of mutilating keratoderma and improve the quality of life.
Stroke Subtype Among Individuals With Chronic Kidney Disease
Authors: Noor Salmi T. , Bota Sarah E. , Clarke Anna E. , Petrcich William , Kelly Dearbhla , Knoll Greg , Hundemer Gregory L. , Canney Mark , Tanuseputro Peter , Sood Manish M.
Published: October 2023

Background:

It is widely accepted that there is a stepwise increase in the risk of acute ischemic stroke with chronic kidney disease (CKD). However, whether the risk of specific ischemic stroke subtypes varies with CKD remains unclear.

Objective:

To assess the association between ischemic stroke subtypes (cardioembolic, arterial, lacunar, and other) classified using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) and CKD stage.

Design:

retrospective cohort study.

Setting:

Ontario, Canada.

Patients:

A total of 17 434 adults with an acute ischemic stroke in Ontario, Canada between April 1, 2002 and March 31, 2013, with an estimated glomerular filtration rate (eGFR) measurement or receipt of maintenance dialysis captured in a stroke registry were included.

Measurements:

Kidney function categorized as an eGFR of ≥60, 30-59, <30 mL/min/1.73 m2, or maintenance dialysis. Ischemic stroke classified by TOAST included arterial, cardioembolic, lacunar, and other (dissection, prothrombotic state, cortical vein/sinus thrombosis, and vasculitis) types of strokes.

Methods:

Adjusted regression models.

Results:

In our cohort, 58.9% had an eGFR of ≥60, 34.7% an eGFR of 30-59, 6.0% an eGFR of <30 and 0.5% were on maintenance dialysis (mean age of 73 years; 48% women). Cardioembolic stroke was more common in patients with non-dialysis-dependant CKD (eGFR 30-59: 50.4%, adjusted odds ratio [OR] 1.20, 95% confidence interval [CI]: 1.02, 1.44; eGFR<30: 50.6%, OR 1.21, 95% CI: 1.02, 1.44), whereas lacunar stroke was less common (eGFR 30-59: 22.7% OR 0.85, 95% CI: 0.77, 0.93; eGFR <30: 0.73, 95% CI: 0.61, 0.88) compared with those with an eGFR ≥60. In stratified analyses by age and CKD, lacunar strokes were more frequent in those aged less than 65 years, whereas cardioembolic was higher in those aged 65 years and above.

Limitations:

TOAST classification was not captured for all patients.

Conclusion:

Non-dialysis CKD was associated with a higher risk of cardioembolic stroke, whereas an eGFR ≥60 mL/min/1.73 m2 was associated with a higher risk of lacunar stroke. Detailed stroke subtyping in CKD may therefore provide mechanistic insights and refocus treatment strategies in this high-risk population.
Evaluation and Enhancement of Triaging Services Through Quality Improvement Tools at Primary Health Care Level: A Clinical Audit Study
Authors: Majeed Ansif Pallath , Alkubaisi Noora , Harikumar Kiran , Al Mujalli Hanan , Ali Shah Abdul , Khan Sharifullah , Sarip Socor Soraimah
Published: October 2023

Background:

The effective and efficient operation of emergency services at healthcare depends on triage decisions. Successfully implementing a triage system improves patient care, communication, and self-assurance.

Methods:

A baseline audit was conducted by reviewing a sample of 554 triage health records in September 2021. Many gaps were identified in the practice, and action plans were developed for improving it. Following the implementation of the action plan, a re-audit was conducted in September 2022 with a sample of 470 medical records.

Results:

Evidence suggested that nurses had made progress in correctly allocating the medical emergency triage category from 63% at baseline to 90% at the reaudit. The over-triage decreased in accordance with this adjustment, from 37% to 10%. Compliance with the suggested time target of 5 minutes for physicians to attend medical emergencies has shown a small improvement from 48% at baseline to 55% in the re-audit. Similar improvements were demonstrated in the other triage categories.

Conclusion:

A problem may have several causes, and since it is impossible to address every one of them, prioritizing the causes is usually the best course of action. Inadequate triage classification by nurses was one of the key reasons for the delay in physician appointment times in triage clinics. Triage nurses’ abilities should be enhanced to make this triage judgment. The audit team suggested that nurses should be given problem-based training, which will enhance the entire triage procedure.
Deconstructing Summary Writing: Further Exploration of L2 Reading and Writing
Authors: Qin Jingjing , Groombridge Timothy
Published: October 2023

The hybrid nature of reading-to-write tasks calls for more empirical research on understanding the relationship between L2 reading, writing, and proficiency. This study examines summaries written by 46 Emirati university students, who were asked to write a 150-word summary of an expository text on the topic of “consumerism” during class hours. The summary was assessed based on an analytic rubric. It was also assessed quantitatively in terms of the inclusion of the number of important ideas from the source text, namely, content analysis scores. In addition, the students’ language proficiency, reading proficiency, and writing proficiency had already been externally ascertained with their recent IELTS scores. Significantly positive correlations were found between summary scores and IELTS reading scores, IELTS writing scores, and IELTS proficiency scores. Only a significantly positive relationship was found between content analysis scores and IELTS reading scores, but not the IELTS writing scores and IELTS proficiency scores. This implies the importance of enhancing students’ reading, writing, and language proficiency to help them write an effective summary, and reading in itself is insufficient in the production of an effective summary.
Exploring Research Issues and Potential Future Directions in Industry 4.0 Adoption in SMEs: A Comprehensive Analysis and Integration
Authors: Kumar Love , Sharma Rajiv Kumar
Published: October 2023

This study used a bibliometric approach and thematic analysis to explore the evolution of research in Industry 4.0, analysing 421 articles published between 2010 and 2022. This study aimed to investigate the annual scientific production, most-cited articles, keyword and keyword co-occurrence analysis, theme breakthroughs and future thematic directions. The authors identified four potential themes for future research: artificial intelligence (AI)-powered sustainable smart manufacturing ecosystem, small- and medium-sized enterprises and Industry 4.0: Digital innovation impact, internet of things (IoT)-enabled digital servitization for smart factories and ecosystems and dynamic capabilities in digital transformation. This study provides practical and theoretical guidance for I4.0 implementation, identifying potential themes for future work that offer practical implications for policymakers and industry practitioners, while also offering theoretical implications for developing new theories and frameworks.
Age Group Differences in the Association Between Sleep Status and Frailty Among Community-Dwelling Older Adults: The SONIC Study
Authors: Mizuno Toshiki , Godai Kayo , Kabayama Mai , Akasaka Hiroshi , Kido Michiko , Isaka Masaaki , Kubo Mio , Gondo Yasuyuki , Ogawa Madoka , Ikebe Kazunori , Masui Yukie , Arai Yasumichi , Ishizaki Tatsuro , Rakugi Hiromi , Kamide Kei
Published: October 2023

Objective: We aimed to determine whether the association of sleep status with frailty differs between age groups of older adults. Method: This cross-sectional study was part of the observational Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. Subjects were community-dwelling older adults in their 70s and 80s. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study criteria (J-CHS). Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep status. Poor sleep quality was defined as a PSQI global score ≥6. Sleep duration was categorized as short (<6 hr), normal (6–8), and long (>8). We performed multivariable logistic regression to investigate the association between sleep status and frailty separately for each age group adjusted for multiple covariates. Results: In those in their 70s, long sleep duration and sleep medication use were independently associated with frailty. In those in their 80s, poor sleep quality was independently associated with frailty. Conclusions: The association between sleep status and frailty was different between age groups. The findings underscore the importance of incorporating the evaluation of sleep quantity and non-pharmacological therapies in those in their 70s and the evaluation of sleep quality in those in their 80s to help prevent the onset of frailty.
Impact of Advanced Cardiac Sonographers on Exam Completeness in the Echocardiography Laboratory
Authors: Guthrie Joy D. , Bierig Serena M.
Published: October 2023

Objective:

Laboratory accreditation has been shown to impact variability and completeness. However, little data exist demonstrating the impact of personnel credentialing on completeness and efficiency. Therefore, the aim of this study was to evaluate exam completeness and efficiency among staff with an advanced cardiac sonographer (ACS) credential, Registered Diagnostic Cardiac Sonographer or Registered Cardiac Sonographer and noncredentialed staff.

Materials and Methods:

Retrospective review of adult and pediatric echocardiograms at eight facilities in three states. Exam completeness was compared with Intersocietal Accreditation Commission (IAC) standards and completeness by pathology was compared with the American Society of Echocardiography (ASE) standards.

Results:

This study was based on the review of 1147 patient cases. Of the cases reviewed, 60.3% were performed by credentialed (non-ACS) sonographers, 28.3% were completed by credentialed ACS, and 11.3% by noncredentialed staff. The credentialed staff completed exams ≤ 12 hours. The exams were reviewed for compliance with IAC standards and completed by ACS staff: 80.0% in aortic stenosis and 55.6% in non-ACS staff. Those patient cases for mitral regurgitation (14/19) were 73.7% IAC compliant, cases completed by credentialed non-ACS (20/56) were 35.7% compliant, and those completed by noncredentialed sonographers (2/11) only 18.2% were compliant. Cases specific to patent ductus arteriosus were 92.1% compliant with IAC standards that were completed by ACS compared with 77.9% completed by non-ACS staff. Cases of pulmonary hypertension were also evaluated for IAC compliance and 61.8% met the standard with ASE versus 41.7% completed by non-ACS.

Conclusion:

Examinations performed by ACS are more often complete in important pathology. Examination efficiency is highest among credentialed sonographers.