bluuebunny/crossref_metadata_2025 huggingface dataset:
Radiofrequency ablation of atrial fibrillation: A 14 years’ experience at a tertiary care center in Thailand
Authors: Tokavanich Nithi , Leelapatana Pattranee , Chokesuwattanaskul Ronpichai , Prechawat Somchai , Rungpradubvong Voravut
Published: September 2023

Background

The result of atrial fibrillation (AF) ablation varies across centers. Most data are derived from the Western world, while data from Southeast Asian countries are lacking. We aimed to investigate the outcomes of AF ablation in Thailand.

Method

We performed a retrospective analysis of patients who underwent AF ablation in a tertiary care center, between the years 2006–2020. Details of AF ablation, including pulmonary vein isolation (PVI), and complex fractionated atrial electrogram (CFAE) ablation, were classified. The success rate of AF ablation is determined by freedom from AF beyond 3 months blanking period. Combined success rate of AF ablation was reported along with the success rate of each technique (PVI, CFAE, and combine PVI plus CFAE).

Result

We identified a total of 171 patients who underwent the first AF ablation. Ninety-four (55%) patients went through PVI, 55 (32%) patients for CFAE ablation, and 22 (13%) patients for PVI plus CFAE ablation. Overall freedom from AF was 73% at 12 months, 66% at 24 months, and 55% at 36 months. The success rate of PVI was 79% at 12 months, 74% at 24 months, and 59% at 36 months. The success rate of CFAE ablation was 63% at 12 months, 51% at 24 months, and 47% at 36 months.

Conclusion

Catheter ablation of AF is proven safe and effective in Thai population.
Complexity and function of family involvement in advance care planning: A qualitative study of perspectives from people living with advanced cancer, family members and healthcare professionals
Authors: Kishino Megumi , Koffman Jonathan , Nagatomi Hiroaki , Yuasa Misuzu , Ellis-Smith Clare
Published: September 2023

Background:

Family members can support advance care planning conversations. However, how family involvement in advance care planning operates to achieve goal-concordant care remains unclear.

Aim:

To explore how family involvement impacts the process of advance care planning for advanced cancer patients and their family members to achieve goal-concordant care in Japan.

Design:

Qualitative study incorporating semi-structured in-depth interviews with thematic analysis informed by Family Systems Theory.

Setting/participants:

Medical oncology departments at two tertiary hospitals in Japan. A purposive sample of 13 advanced cancer patients, 10 family members and 9 healthcare professionals who cared for them.

Results:

Twenty-five interviews were conducted, comprising 7 dyads of patients and their family members and 18 individual interviews. Four themes were identified: characteristics of patients and family members and their views on illness and advance care planning; family context and communication; interactions with healthcare professionals and societal and cultural influences; and family members’ acceptance, preparation and confidence. Family involvement was observed as being variable at an individual level and also across generations. Family members provided patients with the instrumental and emotional support that facilitated the advance care planning process. Family involvement enabled family members to better prepare for realising patients’ wishes. It increased family members’ confidence in surrogate decision-making.

Conclusions:

Two mechanisms of how family involvement may enable goal-concordant care were identified: family members’ support provision and their preparation for realising patients’ wishes. Healthcare professionals should assess family’s readiness to engage in advance care planning, and the time required to prepare them for the process.
Bone marrow edema at ligament insertion is an accurate MRI sign of deltoid ligament injury
Authors: Tong Jiahui , Li Hong , Li Hongyun , Hua Yinghui
Published: September 2023

Background

Magnetic resonance imaging (MRI) is effective in diagnosing deltoid ligament (DL) injury but its sensitivity in chronic cases is low. Additional diagnostic signs are required to reduce the risk of a false negative diagnosis.

Purpose

To evaluate the added diagnostic value of bone marrow edema at the ligament insertion (BMELI) of DL to the MRI assessment of chronic DL injury.

Material and Methods

One hundred patients who consecutively came to our institution between November 2018 and December 2021 and underwent arthroscopic surgery for chronic ankle instability (CAI) were enrolled in the present study. Preoperative MR images were retrospectively reviewed by two orthopedic surgeons to evaluate the sensitivity, specificity and interobserver reliability of three MRI signs in diagnosing chronic DL injury, namely, abnormal ligamentous morphological characteristics (ALMC), BMELI and medial clear space (MCS).

Results

Taking arthroscopy as the reference standard, there were 34 patients with and 66 without DL injury. ALMC had 64.71% (22/34; 46.47–79.70) sensitivity and 83.33% (55/66; 71.71–91.00) specificity, BMELI had 70.59% (24/34; 52.33–84.29) sensitivity and 95.45% (63/66; 86.44–98.82) specificity and MCS had 26.47% (9/34; 13.51–44.65) sensitivity and 92.42% (61/66; 82.50–97.18) specificity. Compared with ALMC, BMELI had similar efficacy in superficial cases ( P = 0.06) and greater efficacy in deep cases ( P = 0.04). All three signs showed good interobserver agreement (kappa values all above 0.7).

Conclusion

BMELI can reliably indicate concomitant injury to the DL in CAI patients. Using BMELI as a sign of chronic DL injury when ALMC is unclear may reduce the risk of a false negative diagnosis.
Short-term Rentals and Disorder in a Cannabis Tourism Destination
Authors: Roth Jeffrey J.
Published: September 2023

Short-term rentals (also referred to as “home sharing” or “vacation home rentals”) are a form of temporary housing in which units are leased to travelers for a limited time. Theories such as social disorganization and routine activities suggest possible connections between short-term rental presence and crime or disorder, and existing studies have confirmed that relationship under certain circumstances. However, there are unexplored questions about whether the findings hold true in places with novel demographic, cultural, or touristic features. The present study contributes to this literature by considering the relationship between short-term rentals and disorder across census block groups in a cannabis tourism destination (Denver, Colorado), while controlling for hotel presence, sporting venues, cannabis dispensaries, liquor establishments, and other socio-demographic features. The effects of short-term rental density varied by listing type (entire unit or private room) and were diminished by the inclusion of usage (guest reviews) in the models. Also considered are Denver regulations that may contribute to the limited effects of short-term rentals observed here, as are directions for new research.
Safe and sound: Strengthening cybersecurity in healthcare through robust staff educational programs
Authors: Jerry-Egemba Nma
Published: September 2023

This article emphasizes the importance of comprehensive cybersecurity education programs in the healthcare industry. The rapid development of technology in healthcare has brought numerous advantages, including electronic health records and telehealth services. However, these advancements also expose the healthcare industry to significant cybersecurity risks. The healthcare industry is an attractive target for cybercriminals due to the presence of sensitive personal and financial information. Current regulations, such as HIPAA and PIPEDA, are in place to protect patient information, but 95% of healthcare industry breaches result from human error. Healthcare organizations must prioritize robust cybersecurity measures and implement comprehensive education programs for all healthcare professionals. This article recommends tailoring educational content to different healthcare roles and incorporating ongoing learning and awareness as essential elements of cybersecurity education. Overall, it calls for a holistic approach to cybersecurity education in healthcare to protect patient information and mitigate cyberthreats.
Effect of Improved Nursing Strategy on Prognosis of Immunosuppressed Patients With Pneumonia and Sepsis: A Prospective Cohort Study
Authors: Luo Hongbo , Han Wen , Zhang Jiahui , Cheng Wei , Li Dongkai , Zhao Mingxi , Cui Na , Zhu Huadong
Published: September 2023

Objectives: To investigate the effect of our improved nursing strategy on prognosis in immunosuppressed patients with pneumonia and sepsis. Methods: Immunosuppressed patients (absolute lymphocyte count <1000 cells/mm3) with pneumonia and sepsis were enrolled and divided into a control group and treatment group. The treatment group received the improved nursing strategy. The primary outcome in this study was 28-day mortality. Results: In accordance with the study criteria, 1019 patients were finally enrolled. Compared with patients in the control group, those in the treatment group had significantly fewer days on mechanical ventilation [5 (4, 7) versus 5 (4, 7) days, P = .03] and lower intensive care unit (ICU) mortality [21.1% (132 of 627) vs 28.8% (113 of 392); P = .005] and 28-day mortality [22.2% (139 of 627) vs 29.8% (117 of 392); P = .006]. The treatment group also had a shorter duration of ICU stay [9 (5, 15) vs 11 (6, 22) days, P = .0001] than the control group. The improved nursing strategy acted as an independent protective factor in 28-day mortality: odds ratio 0.645, 95% confidence interval: 0.449-0.927, P = .018. Conclusion: Our improved nursing strategy shortened the duration of mechanical ventilation and the ICU stay and decreased ICU mortality and 28-day mortality in immunosuppressed patients with pneumonia and sepsis. Trial registration: ChiCTR.org.cn, ChiCTR-ROC-17010750. Registered 28 February 2017.
Antipsychotic Use for ICU Delirium and Associated Inflammatory Markers
Authors: Torbic Heather , Chen Alyssa , Lumpkin Mollie , Yerke Jason , Mehkri Omar , Abraham Susamma , Wang Xiaofeng , Duggal Abhijit , Scheraga Rachel G.
Published: September 2023

Purpose: We sought to evaluate critically ill patients with delirium to evaluate inflammatory cytokine production and delirium progression and the role of antipsychotics. Materials and Methods: Adult critically ill patients with confirmed delirium according to a positive CAM-ICU score were included and IL-6 and IL-8 levels were trended for 24 h in this single-center, prospective, observational cohort study. Results: A total of 23 patients were consented and had blood samples drawn for inclusion. There was no difference in IL-6 and IL-8 levels at baseline, 4 to 8 h, and 22 to 28 h after enrollment when comparing patients based on antipsychotic exposure. We identified 2 patient clusters based on age, APACHE III, need for mechanical ventilation, and concomitant infection. In cluster 1, 5 (33.3%) patients received antipsychotics versus 5 (62.5%) patients in cluster 2 ( P = .18). Patients in cluster 1 had more co-inflammatory conditions ( P < .0001), yet numerically lower baseline IL-6 ( P = .18) and IL-8 levels ( P = .80) compared to cluster 2. Patients in cluster 1 had a greater median number of delirium-free days compared to cluster 2 (17.0 vs 6.0 days; P = .05). Conclusions: In critically ill patients with delirium, IL-6 and IL-8 levels were variable and antipsychotics were not associated with improvements in delirium or inflammatory markers.
Glucose-induced pseudohypoxia and advanced glycosylation end products explain peritoneal damage in long-term peritoneal dialysis
Authors: Krediet Raymond T , Parikova Alena
Published: September 2023

Long-term peritoneal dialysis is associated with the development of peritoneal membrane alterations, both in morphology and function. Impaired ultrafiltration (UF) is the most important functional change, and peritoneal fibrosis is the major morphological alteration. Both are caused by the continuous exposure to dialysis solutions that are different from plasma water with regard to the buffer substance and the extremely high-glucose concentrations. Glucose has been incriminated as the major cause of long-term peritoneal membrane changes, but the precise mechanism has not been identified. We argue that glucose causes the membrane alterations by peritoneal pseudohypoxia and by the formation of advanced glycosylation end products (AGEs). After a summary of UF kinetics including the role of glucose transporters (GLUT), and a discussion on morphologic alterations, relationships between function and morphology and a survey of the pathogenesis of UF failure (UFF), it will be argued that impaired UF is partly caused by a reduction in small pore fluid transport as a consequence of AGE-related vasculopathy and – more importantly – in diminished free water transport due to pseudohypoxia, caused by increased peritoneal cellular expression of GLUT-1. The metabolism of intracellular glucose will be reviewed. This occurs in the glycolysis and in the polyol/sorbitol pathway, the latter is activated in case of a large supply. In both pathways the ratio between the reduced and oxidised form of nicotinamide dinucleotide (NADH/NAD+ ratio) will increase, especially because normal compensatory mechanisms may be impaired, and activate expression of hypoxia-inducible factor-1 (HIF-1). The latter gene activates various profibrotic factors and GLUT-1. Besides replacement of glucose as an osmotic agent, medical treatment/prevention is currently limited to tamoxifen and possibly Renin/angiotensis/aldosteron (RAA) inhibitors.
The application of additive manufacturing to heat exchangers for oscillatory flow: A case study
Authors: Hamood Ahmed , Jaworski Artur J , Blunt Liam , Townsend Andrew
Published: September 2023

Additive manufacturing is an option for the fabrication of heat exchangers for thermoacoustic applications. In thermoacoustic devices, heat exchangers are placed in oscillatory flow. A careful consideration of heat exchanger geometries examines the application of methodologies to optimise heat transfer and the temperature gradient. Additive manufacturing is proposed as an alternative fabrication technique that can overcome the current limitations of conventional fabrication machining. Six identical crossflow heat exchangers were made and tested, three from stainless steel and three from aluminium. The oscillatory flow moves back and forth through circular cross-section channels, and water flows in channels perpendicular to them. Heat transfer and temperature gradients were investigated at different drive ratios and mean pressures.
Dynamic instability analysis of timoshenko FG sandwich nanobeams subjected to parametric excitation
Authors: Zanjanchi Nikoo Moein , Lezgi Milad , Sabouri Ghomi Saeid , Ghadiri Majid
Published: September 2023

According to the nonlocal theory, the dynamic instability and vibration of functionally graded (FG) porous sandwich nanobeams resting on a visco-elastic foundation under axial harmonic load are studied. In this paper the Timoshenko and nonlocal continuum theory are employed to take shear deformation, rotational bending and small-scale effects into account. The governing equations of motion are extracted using the nonlinear Von-Karman, and Hamilton approaches. Then, to turn the partial differential equations (PDEs) into ordinary differential equations (ODEs) in the case of equations of motion, the method of Galerkin is employed, followed by the use of the multiple time scale method to solve the resulting equations. According to the results of this study, it can be claimed that the porosity ratio is more effective than porosity distribution and nonlocal parameters on the amplitude response and dynamic instability regions. Moreover, to examine thermal increments, foundation characteristics, slenderness, and thickness ratios, the bifurcation diagrams are drawn and discussed. It is found that foundation and geometric characteristics are of the highest significance in the nonlinear response of the Timoshenko nanobeams. The main intention of this study is to present a holistic idea about the porous materials used in sandwich structures which can be used in many composite structures in aircraft and automobiles.
Effects of process parameters on cutting forces, material removal rate, and specific energy in trochoidal milling
Authors: Wagih Mohamed , Hassan Mohsen A , El-Hofy Hassan , Yan Jiwang , Maher Ibrahem
Published: September 2023

Trochoidal milling has been developed to enhance tool life during slot machining. It is characterized by reduced cutting forces, cutting temperature, and tool wear as compared to conventional milling processes. It is effective in machining difficult-to-cut materials, high-speed machining, and groove corners. However, this process has not been deeply investigated enough to discover its advantages and optimize its parameters. A full factorial design of 144 experiments has been applied in this paper to investigate extensively the effects of axial depth of cut, feed rate, and trochoidal step on material removal rate, cutting forces, and specific energy in trochoidal milling. Trochoidal step and axial depth of cut almost have the same contributions on cutting forces by 32% and 31% respectively, followed by feed rate by 25%. Feed rate, trochoidal step, and axial depth of cut influence the material removal rate by 37%, 30%, and by 19% respectively. The contributions of feed rate, trochoidal step, and axial depth of cut on relative specific energy are 57%, 24%, and 8% respectively. The increase of axial depth of cut increases the maximum resultant force till a threshold value, then it stabilizes. This behavior occurred due to the increase of the maximum engagement angle to a certain limit, then it does not increase any more. Both feed rate and trochoidal step linear affect maximum resultant force and material removal rate, while the relationships are non-linear for specific energy. It is recommended to machine slots in full depth with the highest possible trochoidal step and feed rate, considering the increase of tool wear and surface roughness. It is preferred to use a cutting tool of a large helix angle and small diameter to reduce the threshold axial depth of cut. Overall, this study is significant in characterizing, designing, and optimizing of trochoidal milling through experimental work.
Slip slope change detection based on active drive force excitation
Authors: Fichtinger Andreas , Edelmann Johannes , Plöchl Manfred , Höll Manuel , Unterreiner Michael
Published: September 2023

Identification of the available friction potential is crucial for road safety but difficult, in particular at normal driving. This paper aims to contribute by presenting an effect-based method for slip slope change detection related to friction potential changes at all wheel-drive vehicles applying active drive force excitation. The proposed estimation approach relies above all on the wheel speeds and the axle/wheel drive forces of the front and rear axle. Different types of periodic active drive force excitation that are superimposed to the drive force requested by the driver while maintaining the desired level of speed or acceleration are investigated w.r.t. the availability of the estimates and overall effectiveness of the estimator. Vehicle tests are performed to evaluate theoretical results and the (co-)driver’s perception of the active drive force excitation. Results from both the simulation study and vehicle tests show that the proposed method allows to reliably estimate slip slope changes at all-wheel drive vehicles in driving conditions with low levels of drive force excitation.
Analysis of isotropic stiffened plate structure
Authors: Singh Deepak Kumar , Agarwal Preeti
Published: September 2023

The analysis of stiffened plate has been carried out using finite element method. The study is divided into static and dynamic analyses. Primarily, free vibration frequencies of the stiffened plate have been determined followed by determination of deflection and von Mises stress for the stiffened plate subjected to the unit uniformly distributed load (1 kN/m2). Further, deflection and von Mises stress are determined, when the plate structure is subjected to hydrostatic loading. The analyses, static and dynamic, have been done using ANSYS Workbench 15.0. A single flat stiffener is used to stiffen the plate structure and the results are evaluated by varying the stiffener geometry, keeping the volume of material almost same as the unstiffened plate. Stiffened plate structure is very popular in the structural engineering domain and has a wide range of engineering applications from ship to aerospace structures. The material used to model stiffener is extracted from the primary plate for keeping the same volume of material. The plate structure is stiffened to reduce the out-of-plane bending even if the same (approximately) amount of material is utilised. Eight-noded plate bending and two-noded beam elements are used to model the plate and stiffener, respectively. The obtained results are compared with the published results and the effect of varying stiffener geometry is further examined. It may be concluded that the response of the stiffened plates are better compared to unstiffened plate even if the same or even less quantity of material is utilised in stiffening. The present findings are useful for the designers when the plate structure is influenced by the surrounding fluid.
Optimal design of hedge-algebras–based controller for vibration control of vehicle suspension systems
Authors: Mac Thi-Thoa , Nguyen Tien-Duy , Bui Hai-Le , Tran Ngoc-An
Published: September 2023

This study aims to investigate an optimal design problem for vibration control of vehicle suspension models for reducing dynamic responses of the systems. The controller is constructed and optimized based on the approach of the hedge-algebras theory. Optimized parameters include fuzziness measures and reference ranges of state and control variables. Objective functions are considered to minimize the car body vibration and other essential objectives. Initial and optimized controllers have validated their stability through a newly proposed method using rule surfaces of the hedge-algebras–based controller. The controllers based on hedge-algebras theory have higher performance than controllers in previous publications and ensure the system stability and robustness to changes in the car body and wheel masses. The optimal approach in the present work allows determining values of design variables that are appropriate for the controlled models instead of using a trial–error method to evaluate these variables. In addition, the proposed approach to test the system stability allows simplifying this task for controllers using hedge-algebras theory.
Dr Ayub Khan Ommaya (1930–2008): The eventful life of a revolutionary neurosurgeon
Authors: Usman Salim , Roy Sakshi , Ahluwalia Arjun , Shah Muhammad Hamza
Published: September 2023

Dr Ayub Khan Ommaya (1930–2008) was a pioneering figure in the field of neurosurgery, with a particular focus on traumatic brain injury. As history books have held, he was a man of great intellect and vision, possessing a rare combination of scientific rigour and compassionate empathy. One of Dr Ommaya's most notable contributions was his development of the Ommaya reservoir, a device used to deliver drugs directly into the brain. This groundbreaking technology transformed the treatment of brain tumours and other neurological disorders, enabling clinicians to administer medications with unprecedented precision and efficacy. From his groundbreaking research on traumatic brain injury to his visionary invention of the Ommaya reservoir, Ommaya's legacy continues to inspire and inform the work of countless medical professionals around the world. This historical paper delves into Ommaya's remarkable life story, highlighting his extraordinary contributions to the field of neurosurgery.
Mechanisms of Herba Epimedii in Lung Cancer Treatment: A Combination of Molecular Docking and Network Pharmacology Analyses
Authors: Zhang Jinhua
Published: September 2023

Introduction

Lung cancer (LC) ranks among the most prevalent malignant neoplasms globally. As a Traditional Chinese medicine (TCM), Herba Epimedii has been commonly used for treating LC. However, the specific mechanism of LC remains to be elucidated.

Objectives

This research aimed to explore the mechanisms of Herba Epimedii in treating LC according to molecular docking and network pharmacology.

Materials and Methods

The active components (ACs) and targets of Herba Epimedii were screened through the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. LC targets were retrieved from GeneCards and DisGeNET databases. Cytoscape v3.9.0 was employed to construct a “drug-component-disease-target” network. The STRING database and Cytoscape 3.9.0 software were utilized to establish a PPI network. The DAVID database was used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. The AutoDock software was employed for molecular docking verification, and the Pymol software was applied for visual processing.

Results

Herba Epimedii acted on 108 LC treatment targets through 22 ACs. Five core components were screened, including quercetin, luteolin, kaempferol, anhydroicaritin, and 8-isopentenyl-kaempferol, while 12 core targets were screened, including TP53, AKT1, MYC, CASP3, ESR1, JUN, HIF1A, VEGFA, TNF, CCND1, EGFR, and IL-6. GO enrichment analysis mainly involved positive regulation of gene expression, positive regulation of the apoptotic process, enzyme binding, identical protein binding, macromolecular complex, nucleoplasm, etc. KEGG enrichment analysis mainly involved p53, interleukin-17, PI3K-Akt, and other signaling pathways. Five core components all demonstrated excellent binding activities with the core targets.

Conclusion

The mechanisms of Herba Epimedii in LC treatment may involve multiple components, targets, and pathways, inducing apoptosis, and inhibiting proliferation, invasion, metastasis, and drug resistance of LC cells.
Modeling, heat dissipation design, and force tracking control for temperature-dependent hysteresis of magnetorheological damper
Authors: Zhu Wei , Yang Fufeng , Rui Xiao-ting
Published: September 2023

The temperature-dependence (T-dependence) characteristics of magnetorheological fluids (MRFs) cause the damping force of magnetorheological dampers (MRDs) to change with temperature. The rapid temperature rise can lead to performance degradation or even failure of MRFs, reduced damping force of MRDs, and decline in control performance. In this paper, numerical simulations and predictions of the temperature rise characteristics of the MRD are performed and heat sinks are designed and optimized. The experimental results verify the efficiency of the simulations and predictions, and the heat sinks can significantly reduce the rate of temperature increase and improve the ability of the damper to operate for long hours. In order to accurately compensate for T-dependence characteristics of the MRD, a T-dependence hysteresis model and a model-based feedforward force tracking control method with disturbance observation of the MRD are proposed and validated by experiments. The experimental results indicate that the proposed T-dependence model has better prediction accuracy than the general hysteresis model, and the feedforward control method achieves good force tracking performance even without expensive force sensors.
Digital Video as a Discussion Board: A Case Study and Collaborative Autoethnography of Experiences
Authors: Avery Tiffany , Cody Jessica , Griffiths Katherine , Khodai Kristina , Lenahan Ashley , Meluso Maria , Sanada Yudai , Seabaugh Kayla , Stanton Rhonda , Woodall Emily
Published: September 2023

This article presents a case study of an online class in technical and professional communication pedagogy (the teaching of technical and professional writing) that uses digital video technology for discussions. Because students in the class share their experiences using the video technology, the study uses a collaborative autoethnography framework to learn if the digital technology, Flipgrid, would enhance students’ experiences with discussions in an online class compared to their experiences with discussions on traditional discussion boards. Providing such exposure to a new technology tool can help students gain the confidence that is necessary for learning new technologies in the workplace. When the technology did not provide the hoped-for results after a few weeks, the class stopped using it, returning to the traditional discussion board in the learning management system, which can be more effective when teachers participate and organize students into small groups. Reflecting on what happened, students in the class collaborated on this article to share their experiences.
Owning the Lies
Authors: Giorgio Grace Ann
Published: September 2023

This autoethnography contests notions that family secrets and lies are always disruptive to family cohesion by exploring how secrets and lies hold a family together. Drawing from shared memories, I address my siblings directly to reveal our experiences of navigating our parents’ secrets and lies from each other that contributed to our own adoption of such practices. The story shows how we eventually found better ways to support our parents and one another into adulthood by learning to “own the lies” and not eschew them. Owning the lies means knowing each of our love debts to one another and to the social worlds we inhabit beyond the family dynamic.
Tyrosine kinase inhibitor-induced immune hemolytic anemia; three different drugs in three separate cases
Authors: Güzel Halil Göksel , Kıvrak Salim Derya
Published: September 2023

Introduction

Molecular multitargeted small tyrosine kinase inhibitory (TKI) agents such as axitinib, sunitinib and pazopanib are commonly used in several types of solid tumors. Anemia is not a rare effect of these drugs which may occur at all grades. However, drug-induced immune hemolytic anemia (IHA), a very rare condition is distinctive from other types of anemia with its specific mechanism and management strategy.

Case Reports

We reported three different TKI-induced IHA cases that occurred due to axitinib, sunitinib, and pazopanib, respectively. The first two cases were diagnosed with renal cell carcinoma and the last one was diagnosed with soft tissue sarcoma. They all presented with the characteristic symptoms of anemia and hemolysis. All the cases were detected positive for the complement C3d direct antiglobulin (direct coombs) test.

Management and Outcomes

Discontinuation of the causative drug and 1 mg/kg/day dose of corticosteroid treatment were able to control IHA in all three cases. Excluding the other factors of IHA and an evident laboratory and clinical benefit after withholding the TKI led to the diagnosis of TKI-related IHA in each case.

Discussion

TKIs are relatively new in clinical practice and are being used for more indications and in more patients. To our knowledge#these three cases are unique in terms of axitinib#sunitinib#and pazopanib-related IHA.
Optical coherence tomography angiography in birdshot chorioretinopathy
Authors: Pichi Francesco , Lembo Andrea , Nucci Paolo , Neri Piergiorgio
Published: September 2023

Purpose

To describe the retinal vascular changes in birdshot chorioretinopathy (BSCR) using optical coherence tomography angiography (OCTA) and to compare them with changes in macular thickness.

Methods

In this multicenter study, patients with a diagnosis of BSCR and a positive HLA-A29 underwent fluorescein angiography, spectral domain optical coherence tomography (SD-OCT), and OCTA. The foveal avascular zone (FAZ) and the area of capillary non-perfusion were manually measured by two examiners in fluorescein angiography (FA) and 3 × 3-mm OCTA images of the superficial retinal layer. These measurements were compared to central retinal thickness. To calculate normal capillary density, we collected data from 22 controls who had OCTA performed on one visit only.

Results

A total of 44 eyes with BSCR were enrolled. The mean automated parafoveal superficial capillary density in BSCR eyes was 0.47 ± 0.03. The differences between the foveal capillary density of BSCR patients and healthy subjects were statistically significant ( P < 0.001). The mean area of FAZ manually measured on the 3 × 3 mm unsegmented OCTA images was larger in eyes with BSCR (1.34 ± 0.41 mm2; P < 0.0001). Measurement of FAZ area showed good interobserver ( κ 0.88) and intraobserver repeatability ( κ 0.79) on OCTA images. The intraclass correlation coefficient for FAZ measurements on FA between the two observers was 0.48. The OCT retinal thickness maps of all BSCR eyes demonstrated statistically significant thinning compared to those of control subjects ( P < 0.01).

Conclusion

Our study demonstrates the potential contribution of OCTA as a new non-invasive imaging technology that monitors disease activity in BSCR patients.
Did COVID-19 Change the Availability and Use of Clean Energy for Cooking? Evidence From Ghana
Authors: Prah Rebecca KD , Jack Darby , Tawiah Theresa , Iddrisu Seidu , Abubakari Sulemana Watara , Mujtaba Mohammed Nuhu , Tetteh Richard Joshua , Gyaase Stephaney , Twumasi Mieks , Saah Jason , Wilson Joseph , Addo Sheila , Pope Daniel , Asante Kwaku Poku , Puzzolo Elisa
Published: September 2023

A major part of Ghana’s current household energy policy is focused on using a branded cylinder recirculation model (BCRM) to promote the safe use of Liquefied Petroleum Gas (LPG) for primary cooking. The implementation of the BCRM is expected to increase LPG adoption by households to the announced policy goal of 50% of the population by 2030. We investigated the impact of the COVID-19 pandemic on the implementation of the BCRM, availability, and household use of cleaner fuels. This was assessed using existing data on clean fuel use prior to the COVID-19 pandemic. Additional data was collected using questionnaire-based household surveys and qualitative interviews. It was found that the expansion of BCRM was significantly impacted by the COVID-19 pandemic. Planning activities such as baseline data collection and stakeholder engagement were delayed due to the COVID-19 restrictions. Changes in household incomes during the pandemic had the biggest percentage effect on household choice of cooking fuel, causing a regression in some cases, to polluting fuel use. This study provides insights that could be valuable in future understanding of the interactions between pandemic control measures and economic disruptions that may affect household energy choices for cooking.
The constitutive entanglement between open office spacing and grouping: The production of sociomaterial control
Authors: Perriton Emma
Published: September 2023

This article explores the emergence of sociomaterial practices and control dynamics of open office spacing by emphasising the constitutive entanglement between open office spacing and grouping. With a Baradian approach to and agential realist ontology of sociomateriality, the article aims to gain a deeper and more comprehensive understanding of working together by rethinking the conventional notions of and relations between groups and space. An ethnographic field study uncovers how sociomaterial grouping practices emerge and intraact through the constitutive entanglement between open office spacing and grouping. Insights from this study show how these grouping practices are reconfigured in three different yet intraactive ways: as cultural, hierarchising and belonging practices. Further, the observations reveal how grouping practices produce control in new ways in the form of sociomaterial control through the visibility, transparency and materiality of open spacing, which carry implications for the design and collaborative organising of open offices, including privacy, embodied experiences, informal hierarchy, power relations and feelings of belonging, particularly for newcomers.
Sustainable development of urban food tourism: A cultural globalisation approach
Authors: Stalmirska Anna Maria , Ali Alisha
Published: September 2023

Using cultural globalisation as a lens, this article examines the tensions between global and local in food tourism to support urban destinations in realising their sustainability outcomes. This is achieved through investigating the supplier perspective by drawing data from a case study of the cities of York and Sheffield, England. The findings shed light on how food supply side representatives perceive these cultural globalisation tensions by revealing the intrinsic socio-cultural values of tourism promotion and observing how culture and globalisation can work mutually to support sustainable destination development. This study concludes that cultural globalisation sensitises us to the dialectic tension between homogenisation and heterogenisation, which can serve as an impetus for developing sustainable food tourism.
Tension management and support when leaving a gang
Authors: Forkby Torbjörn , Alstam Kristina , Örnlind Henrik
Published: September 2023

Gangs are commonly presented in research as an attractive alternative for those who feel excluded and unrecognized in “ordinary” society. Gang life is volatile, however, and violence (open or suppressed) is more or less omnipresent. Exiting a gang seems to be motivated by both thoughts of a better life and disappointment in the gang's failure to meet hopes and expectations.

Findings

From an analysis of former gang members exit processes, this article investigates what about gang life was stressful and motivated participants dropout, how they coped with tensions, and elaborates how social work could use this tension productively to support people exiting gangs. The data consist primary of interviews with 20 former gang members and 42 professionals. Organizational theory was used in combination with theories on liminality and identity reformation to understand how tensions occurred in gang life, how they were managed, and what caused exit.

Applications

Social workers may help members exit from gangs by supporting and strengthening their motivations to leave, stimulating their self-reflection, and reminding them of their past transformative. Most important, gang members should be helped to recognize the positive urges that drew them towards gangs and refocus those wishes for community to general society.
U.S. social work students’ attitudes on social media as treatment modality: A prepandemic national survey
Authors: Ricciardelli Lauren A , Dillard Dana R , Quinn Adam E , Skinner Jeff , Nackerud Larry
Published: September 2023

The present U.S.-based study adds to the ongoing discourse on the ethical use of digital technology in social work practice, made more urgent by the coronavirus disease 2019 (COVID-19). Following the achievement of Human Subjects approval, we obtained a stratified, random sample of 150 institutions of higher education with Council on Social Work Education-accredited undergraduate and graduate social work programs. Prior to COVID-19, we administered a 61-item, Likert-scale survey to social work program directors via email, who then communicated this information to student listservs. A total of 430 social work student responses were retained for analysis. The survey instrument included items related to the students’ social media use, their attitudes toward social media, and their knowledge of social media’s impact on society. Rao-Scott chi-square tests for independence were used to ascertain statistical relationships between U.S. social work students’ responses to the survey item, social media should be used as a treatment modality, and student demographic variables that include: Age, program level, course format, and social media use.

Findings

Statistically significant relationships were determined to exist between social work students’ endorsement of social media as a treatment modality and: (1) Age and (2) program level. Conversely, no significant relationships were found regarding (1) course format and (2) social media use.

Applications

Implications for social work professional education are discussed. Recommendations for future social work research are provided: (1) A national replication study; (2) qualitative studies; (3) a comparative study with social work educators and practitioners; (3) a global study; and (4) ongoing evaluation of direct practice methods.
A comparison of chronic conditions and health characteristics between cancer survivors and non-cancer survivors
Authors: Singh Anjin , Gallaway Michael Shayne , Rascon Addey
Published: September 2023

Objective

Cancer survivors have unique healthcare needs. An important consideration for survivorship is chronic diseases and health risk factors. The purpose of this study is to describe demographics, risk factors, and comorbid health conditions in adult cancer survivors.

Method

We analyzed 2019 Arizona Behavioral Risk Factor Surveillance System data to compare cancer survivors to non-cancer survivors (aged 18 or older) to assess differences between the two populations. Adjusted and unadjusted population-based estimates and 95% confidence intervals were calculated, and multivariable logistic regression models were performed.

Results

Eight thousand nine-hundred and twenty (8920) respondents (1007 survivors; 7913 non-cancer survivors) were included. Compared to non-cancer survivors, cancer survivors were more likely to be female, 65 years and older, non-Hispanic white, veterans, and less likely to be employed. Survivors had higher rates of coronary heart disease, stroke, chronic obstructive pulmonary disease, kidney disease, hypertension, arthritis, multiple chronic conditions, being overweight, and being a former smoker. Survivors were more likely to report fair/poor health than non-cancer survivors.

Discussion

These findings can be used by healthcare and public health practitioners to evaluate the programmatic efforts and resources, implement targeted interventions toward cancer survivors, and improve health and quality of life.
Carbocation rearrangement, methyl migration, and long-range hydrogen transfer in phenyl fatty acid esters
Authors: Lang Jian-Qiao , Gang Hong-Ze , Mu Bo-Zhong , Yang Shi-Zhong
Published: September 2023

Various isomers can be observed in the Friedel–Crafts alkylation of benzene. However, the mechanism and influence of these isomerization reactions were still unclear. In this work, several methyl phenylundecanoate were analyzed by gas chromatography–mass spectrometry to explore the isomerization of the Friedel–Crafts alkylation. The results showed that there were three isomerization reactions in the Friedel–Crafts alkylation reaction: five isomers of methyl 6–10-phenylundecanoate due to carbocation rearrangement, five isomers of methyl 6–9-methyldecanoate and methyl undecanoate due to methyl migration, and the loss of neutral alcohol molecular fragments due to hydrogen transfer. At higher reaction temperature, carbocation migration was more active and the formation of methyl undecanoate isomers was observed. There was a competitive relationship between the production of methyl undecanoate isomers and methyl phenylundecanoate isomers. In addition, the hydrogen transfer could be initiated in the presence of unsaturated bonds and alcohol molecules lost as a fragment. The hydrogen from the phenyl groups, which were at a different position on the carbon chain of fatty acid esters, could be transferred to the ester group. It was found that hydrogen could be transferred intramolecularly over a long range. This work revealed the isomerization process in the Friedel–Crafts alkylation and further deepened the understanding of alkylation.
Depicting conflict in Kosovo and Rwanda: comparative analysis of child victims of ethnic genocide in the Associated Press, 1990
Authors: Siddiqui-Ali Sadaf , Jeon Jehoon
Published: September 2023

When images of children in conflict situations are selected for a Western audience, what roles do the images fulfill for the audience? A content analysis of photographs provided by the Associated Press of children in Rwanda and Kosovo suggests that news agencies frame children of conflicts differently, as passive agents or success stories, in accordance with ideological and organizational guidelines. The findings of this study show that the Associated Press depicts children in Rwanda in racially stereotypical ways in comparison to their Kosovar counterparts. The current research examines the ways that news media depict children of color in the context of war and conflict.
The therapeutic potential of targeting cardiac RGS4
Authors: Del Calvo Giselle , Baggio Lopez Teresa , Lymperopoulos Anastasios
Published: September 2023

G protein-coupled receptors (GPCRs) play pivotal roles in regulation of cardiac function and homeostasis. To function properly, every cell needs these receptors to be stimulated only when a specific extracellular stimulus is present, and to be silenced the moment that stimulus is removed. The regulator of G protein signaling (RGS) proteins are crucial for the latter to occur at the cell membrane, where the GPCR normally resides. Perturbations in both activation and termination of G protein signaling underlie numerous heart pathologies. Although more than 30 mammalian RGS proteins have been identified, each RGS protein seems to interact only with a specific set of G protein subunits and GPCR types/subtypes in any given tissue or cell type, and this applies to the myocardium as well. A large number of studies have provided substantial evidence for the roles various RGS proteins expressed in cardiomyocytes play in cardiac physiology and heart disease pathophysiology. This review summarizes the current understanding of the functional roles of cardiac RGS proteins and their implications for the treatment of specific heart diseases, such as heart failure and atrial fibrillation. We focus on cardiac RGS4 in particular, since this isoform appears to be selectively (among the RGS protein family) upregulated in human heart failure and is also the target of ongoing drug discovery efforts for the treatment of a variety of diseases.
METTL3 Regulates the m6A Modification of NEK7 to Inhibit the Formation of Osteoarthritis
Authors: Xiong Xiaochuan , Xiong Hao , Peng Jun , Liu Yingjie , Zong Yang
Published: September 2023

Objective

Osteoarthritis (OA) is a common degenerative joint disease. The occurrence of OA slowly destroys the soft tissue structure of the patient’s joint. Severe cases could lead to disability. Current studies had shown that inhibition of chondrocytes pyroptosis could slow down the progression of OA. Our work aimed to explore the specific mechanisms and ways of regulating this process.

Design

In this work, the level of N6-methyladenosine (m6A) in clinical tissues was detected by ribonucleic acid (RNA) m6A dot blot. qRT-PCR (quantitative real-time polymerase chain reaction) was used to detect the messenger RNA (mRNA) expression level of m6A modified enzyme in clinical tissues. MTT (3-(4,5)-dimethylthiahiazo(-z-y1)-3,5-di-phenytetrazoliumromid) and flow cytometry were used to detect the effect of sh-METTL3 (methyltransferase like 3) and NIMA-related kinase 7 (NEK7) transfection on chondrocytes pyroptosis in OA. Western blot was used to detect the protein expression levels of pyroptosis-related proteins. ELISA (enzyme-linked immunosorbent assay) was used to measure the protein concentration of inflammatory cytokines. The SRAMP online database was used to predict the m6A site of NEK7. HE staining was used to assess the progression of OA in mice.

Results

The level of m6A in clinical samples of OA patients was higher, and METTL3 was significantly higher expressed in clinical samples of OA patients. We provided evidence that low expression of METTL3 inhibited chondrocytes pyroptosis. In addition, Rescue experiments and in vivo experiments had shown that METTL3 in combination with NEK7 inhibited the progression of OA by promoting chondrocytes pyroptosis.

Conclusions

METTL3 regulates m6A modification of NEK7 and inhibits OA progression.