bluuebunny/crossref_metadata_2025 huggingface dataset:
Rare Sites and White Saviours? Gendered Orientalism, Radicalization, and the Construction of Muslim Women Soccer Players in TSN’s Radical Play
Authors: Ali Adam Ehsan
Published: February 2024

In 2016, Canada sports broadcaster TSN aired a documentary, Radical Play, which focuses on the players of football team Diverse City FC, many of whom are Muslim and wear hijabs. As posited in the documentary, following the lifting of FIFA’s ban on the wearing of the hijab, soccer became the women’s vehicle for gaining more confidence and agency, which they use to become social media “crusaders” who fight the online radicalization of girls and women. Utilizing theories of gendered Orientalism, I analyze Radical Play by exploring how Muslim sportswomen are constructed in relation to sport, radicalization, and empowerment. I argue that Radical Play frames Diverse City FC’s story through Western rescue discourses and construct a modernizing process where Muslim girls are said to be empowered by the power of Western sport. The constructed transformation of the women into radicalization informants that keep their communities’ safe acts as a preferred outcome of colonial benevolence and acceptance towards “development subjects.” While the main narrative of Radical Play is leveraged by gendered forms of Orientalism, a critical reading shows how the players voices create cracks in this overarching story that help unsettle dominant understandings of Muslim sportswomen.
The Role of Trabecular, Ligamentous-Intervertebral Disk and Facet Joints Systems: A Finite Element Analysis in the L4-S1 Vertebrae
Authors: Guerrero-Vargas José Alejandro , Sanchez-Quinones Pablo , Pinzón Brayan Felipe , Vélez-Muriel Melisa , Madriñan-Navia Humberto , Laverde-Frade Leonardo
Published: February 2024

Study Design

Descriptive.

Objectives

Trabecular bone in the vertebrae is critical for the distribution of load and stress throughout the neuroaxis, as well as the intervertebral disk, ligamentous complex, and facet joints. The objective was to assess the stress and strain distribution of the L4-S1 spine segment by a finite element analysis.

Methods

A lumbosacral spine model was built based on a CT-Scan. Trabecular-to-cortical bone distribution, ligaments, intervertebral disk, and facet joints with cartilage were included. A perpendicular force was applied over the L4 upper terminal plate of 300 N, 460 N and 600 N in neutral, plus 5 Nm and 7.5 Nm for flexion and extension movements. Maximum principal stress and total deformation were the main studied variables.

Results

Trabecular bone confers resistance to axial loads on the vertebrae by elastic capacity and stress distribution. MPS and TD showed axial stress attenuation in the nucleus pulposus and longitudinal ligaments, as well as load distribution capacity. Facet joints and discontinuous ligaments showed greater TD values in flexion moments but greater MPS values in extension, conferring stability to the lumbosacral junction and axial load distribution.

Conclusion

We propose 3 anatomical systems for axial load distribution and stress attenuation in the lumbosacral junction. Trabecular bone distributes loads, while the ligamentous-intervertebral disk transmits and attenuate axial stress. Facet joints and discontinuous ligaments act as stabilizers for flexion and extension postures. Overall, the relationship between trabecular bone, ligamentous-intervertebral disk complex and facet joints is necessary for an efficient load distribution and segmental axial stress reduction. This slide can be retrieved from the Global Spine Congress 2023.
The climate-nature emergency and higher education
Authors: Marginson Simon
Published: February 2024

The Climate-Nature Emergency (CNE) is an existential crisis that makes urgent the need to fundamentally transform the dominant model of social and economic development. Amid the wreckage created by competitive accumulation and hyper consumption, the crucial need is to develop a sustainable moral order, embodying constructive human-nature and human-human relations. Following Durkheim, the main components of a moral order are the state, which is the crucial repository of collective interest, and individuals who take responsibility for self-improvement and the implementation of social values. The CNE foregrounds the capacity of states everywhere to both organise centrally and foster devolved community agency that can effectively address local problems and disasters. Working with government, higher education has a central role to play in advancing and defending science, fostering skills and knowledge in government, and in developing reflexive agents effective in social action in all of the local, communal, national, regional and global scales. The CNE also calls up the need to overhaul the curriculum to render it consistent with ecological survival. Higher education has an advanced capacity to cooperate across national borders and can assist nation-states in the difficult but vital process of building stable global cooperation. In addressing these issues, China and higher education in China have strong endogenous traditions, ancient and recent, on which to draw, including the consensual role of the Sinic state, which when functioning effectively draws on widespread public support; governance through deep devolution within the framework of central policies; Confucian self-cultivation with its capacity to foster consciously reflective lifelong learners; and tianxia an approach to global cooperation founded in moral values and norms of conduct rather than coercion. When combined with the Western respect for personal freedom and initiative, these qualities have much to offer in addressing the CNE, not only in China but across the world.
Devi Temple, Pahari, Loharu Rulers and History: Understanding the People’s Mind
Authors: Kumar Rajesh
Published: February 2024

It is believed that Devi Temple, Pahari is 850 years old; however, neither the archival sources nor the inscriptions are available to authenticate the hearsay. But, a 1904 British document has reference to Pahari ki Mandhi. Hence, with reference to the examination of the 304 archival files about Loharu State in the National Archives of India, contemporary traditions, popular songs, interviews, newspaper reports, other digital media plate forms and so on, this article authenticates that Devi (Pahari Mata) is not only 120 years old, but its history goes far beyond. Nevertheless, it has also been observed that the people’s beliefs in Devi show that whether there is a written history or not, but it has marked deep imprints on their mind. Devi is in every sphere of people’s life. It can be authenticated from the popular songs sung during the Ratijaga. Further, the role of blue bloods in the renovation of Devi temple at different intervals of time, placing other deities in the temple complex, construction of 48 Dharamshala in the compound for the pilgrims, and so on have been studied. It also discusses the role of Loharu rulers in sociocultural and economic life of the people. The religious policies of the state have also been examined. Simultaneously, it has also discussed the fair during Durga Puja [every six months Chaitra (March) and Aasoj (October)] and its cultural activities and of course people’s enthusiasm.
Belzutifan, HIF-2α Inhibitor, and Clear Cell Renal Cell Carcinoma With Somatic Von-Hippel-Lindau Loss-of-Function Mutation
Authors: Chan Kok Hoe , Li Ningjing , Lador Ran , Amsbaugh Mark , Gonzalez Anneliese , Cen Putao
Published: February 2024

The Von-Hippel-Lindau (VHL) gene, acting as a tumor suppressor, plays a crucial role in the tumorigenesis of clear cell renal cell carcinoma (ccRCC). Approximately 90% of individuals with advanced ccRCC exhibit somatic mutations in the VHL gene. Belzutifan, orally administered small-molecule inhibitor of hypoxia-induced factor-2α, has demonstrated promising efficacy in solid tumors associated with germline loss-of-function mutations in VHL, including ccRCC. However, its impact on cases with somatic or sporadic VHL mutations remains unclear. Here, we present 2 cases where belzutifan monotherapy was employed in patients with advanced ccRCC and somatic loss-of-function mutations in VHL. Both patients exhibited a swift and sustained response, underscoring the potential role of belzutifan as a viable option in second or subsequent lines of therapy for individuals with somatic VHL mutations. Despite both patients experiencing a pulmonary crisis with respiratory compromise, their rapid response to belzutifan further emphasizes its potential utility in cases involving pulmonary or visceral crises. This report contributes valuable insights into the treatment landscape for advanced ccRCC with somatic VHL mutations.
Student Reflections on Enhancing Cultural Awareness in Health Education Specialists: Insights From a Collaborative Online International Learning (COIL) Experience
Authors: Harris Jessica Maureen , Seo Minjung
Published: February 2024

Immersive global learning experiences like Collaborative Online International Learning (COIL) offer students cross-cultural knowledge, awareness, and language fluency, fostering critical analysis, and problem-solving. This paper focuses on U.S. and Dutch students’ perceptions of personal growth as future health education specialists regarding cultural sensitivity and competence within a COIL course. The study explores valuable skills for professionals engaging with diverse populations, contributing to the literature on faculty-led internationalization initiatives. Both the COIL research model and the cultural intelligence (CQ) framework guided the design and implementation of the COIL course. A thematic analysis of self-reflection narratives from N = 49 undergraduate students from the U.S. and the Netherlands revealed categories and themes related to cultural perspectives in health promotion, cultural sensitivity and competence, and essential skills for health education specialists. The findings demonstrate the impact of COIL on students’ cultural perspectives and knowledge, their awareness of cultural norms, and the importance of diverse strategies and approaches in health promotion. The study highlights the value of COIL courses in developing cultural understanding within educational settings and provides insights for educators and students interested in engaging with diverse populations.
Patient Survey Regarding Non-Medical Burdens of Care at a Parental Fetal Care Center
Authors: Gregory Emily J , Abbasi Aleeza H , Markham Kara B
Published: February 2024

Recognizing the paucity of literature describing the non-medical effects of care at a tertiary parental fetal care center upon families, the purpose of the study was to better examine the potential barriers that our patients face related to care in a parental fetal care center. An anonymous survey was sent via email to patients who received care from 2015 to 2021. The survey included questions regarding demographics, fetal diagnoses, non-medical expenses related to care, and the impact of care on patient relationships, employment, and other children. 453 patients (15.9%) responded out of the 2684 emails sent. 58.3% of patients traveled >100 miles to reach our referral center, with 20% traveling >300 miles. 42.6% of patients reported non-medical expenditures exceeding $1000, with nearly 1 in 10 reporting expenditures of >$5000 (8.6%). Overall, 38.2% of women reported moderate to severe financial burdens related to receiving care at the parental fetal care center. This study illuminates the financial and social burdens that care at a tertiary parental fetal care center imposes upon families. By acknowledging these barriers, we can strive to minimize them to best provide equitable access to high-quality fetal care services.
The Time is Ripe: The Case for Nutrition in Graduate Medical Education in the United States
Authors: Agusala Bethany , Broad Leib Emily , Albin Jaclyn
Published: February 2024

A poor-quality dietary pattern is a leading risk factor for chronic disease and death in the United States, and the costs of medical care continue to unsustainably rise. Despite this reality, nutrition training for physicians fails to adequately prepare for them to address the complex factors that influence diet-related disease. Expanding nutrition education for physicians-in-training is imperative to equip them for the growing demand of food is medicine services and is also supported by recent policy efforts in the United States as well as the governing bodies of graduate and undergraduate medical education. A multisector approach that links graduate medical education, clinical care delivery innovation, and health and food policy experts provides momentum to advance nutrition education as a core strategy for food is medicine expansion globally.
Implementation of a Liver Transplant-Specific TEE Guide to Expand TEE Utilization and Improve Workflow During Orthotopic Liver Transplantation
Authors: Stoker Alexander D. , Khurmi Narjeet , Girardo Marlene E. , Frasco Peter E
Published: February 2024

OBJECTIVES

Transesophageal echocardiography (TEE) is being increasingly utilized during orthotopic liver transplantation to guide perioperative management. Obstacles of improving TEE utilization include the challenge of becoming familiar with the TEE machine, optimizing TEE images, and translating skills acquired in didactic or simulator center-based training into clinical use.

METHODS

In an effort to expand TEE utilization and improve workflow among the liver transplantation (LT) anesthesiologists at our institution, a LT-specific TEE guide was created to serve as a reference and educational tool during LT. A 26-question survey was distributed to all LT anesthesiologists before and 6 months after implementation of the LT-specific TEE guide.

RESULTS

All seven LT anesthesiologists completed the survey questions during the study period. No statistically significant difference was detected in participant-reported confidence in optimizing targeted TEE views, performing technical aspects of the exam, navigating the knobs on the TEE machine, or in ability to identify abnormal cardiac pathology during the study period. One participant became basic-TEE certified during the study period.

CONCLUSIONS

Implementing a liver transplant-specific TEE guide is a strategy to expand TEE utilization, encourage longitudinal TEE education and reinforce concepts learned from hands-on education sessions; however, we did not detect a difference in participant-reported confidence of performing a TEE exam, ability to identify abnormal cardiac pathology or altering workflow. Further studies with larger sample sizes will be needed to evaluate the effectiveness of a LT-specific TEE guide.
Value Dynamics: The Pathways of Realisation
Authors: Bhattarai Raj Kumar
Published: February 2024

This article explores the role of intention-centred value preference in shaping pathways of realisation for individuals and organisations. The author argues that a focus on instrumentality, success and happiness is often at odds with more selfless forms of value realisation, and that this tension can derail value actors from their intended paths. The author defines value as the worthiness of a matter characterised by the hopefulness of the concerned actor(s) and emphasises the importance of understanding the phenomena of novelty, continuity and discontinuity in relation to value dynamics. Value dynamics encompass the processes of value creation, protection and destruction, and require careful assessment through qualitative and quantitative means to determine the state of optimism realisation and value congruence. Value congruence refers to the alignment of assumptions, actions and achievements concerning the value. To address the dynamic nature of value, the author presents a comprehensive conceptual framework consisting of nine principal pathways built on the principle of reciprocity across value actors, functions and realisations. This framework works under the premise that value does not remain static but keeps changing. It offers a practical framework for promoting value congruence in individuals and organisations.
Identification and expression analysis of ATP-binding cassette (ABC) transporters revealed its role in regulating stress response in pear (Pyrus bretchneideri)
Authors: Kou Xiaobing , Zhao Zhen , Xu Xinqi , Li Chang , Wu Juyou , Zhang Shaoling
Published: February 2024

Background

ATP-binding cassette (ABC) transporter proteins constitute a plant gene superfamily crucial for growth, development, and responses to environmental stresses. Despite their identification in various plants like maize, rice, and Arabidopsis, little is known about the information on ABC transporters in pear. To investigate the functions of ABC transporters in pear development and abiotic stress response, we conducted an extensive analysis of ABC gene family in the pear genome.

Results

In this study, 177 ABC transporter genes were successfully identified in the pear genome, classified into seven subfamilies: 8 ABCAs, 40 ABCBs, 24 ABCCs, 8 ABCDs, 9 ABCEs, 8 ABCFs, and 80 ABCGs. Ten motifs were common among all ABC transporter proteins, while distinct motif structures were observed for each subfamily. Distribution analysis revealed 85 PbrABC transporter genes across 17 chromosomes, driven primarily by WGD and dispersed duplication. Cis-regulatory element analysis of PbrABC promoters indicated associations with phytohormones and stress responses. Tissue-specific expression profiles demonstrated varied expression levels across tissues, suggesting diverse functions in development. Furthermore, several PbrABC genes responded to abiotic stresses, with 82 genes sensitive to salt stress, including 40 upregulated and 23 downregulated genes. Additionally, 91 genes were responsive to drought stress, with 22 upregulated and 36 downregulated genes. These findings highlight the pivotal role of PbrABC genes in abiotic stress responses.

Conclusion

This study provides evolutionary insights into PbrABC transporter genes, establishing a foundation for future research on their functions in pear. The identified motifs, distribution patterns, and stress-responsive expressions contribute to understanding the regulatory mechanisms of ABC transporters in pear. The observed tissue-specific expression profiles suggest diverse roles in developmental processes. Notably, the significant responses to salt and drought stress emphasize the importance of PbrABC genes in mediating adaptive responses. Overall, our study advances the understanding of PbrABC transporter genes in pear, opening avenues for further investigations in plant molecular biology and stress physiology.
Comparison of the adherence of nontypeable haemophilus influenzae to lung epithelial cells
Authors: Rong Yuwei , Liu Zihao , Wang Heping , Zhao Zuguo
Published: February 2024

Objective

Nontypeable Haemophilus influenzae (NTHi) plays an important role in respiratory tract infections, and adherence to lung epithelial cells is the first step in lung infections. To explore the role of NTHi in childhood lung infections, a comparative study was conducted on the adherence of strains isolated from sputum culture and bronchoalveolar lavage fluid to A549 lung epithelial cells.

Methods

Haemophilus influenzae strains were obtained from the sample bank of Shenzhen Children’s Hospital, and identified as NTHi via PCR detection of the capsule gene bexA. NTHi obtained from healthy children’s nasopharyngeal swabs culture were selected as the control group, and a comparative study was conducted on the adherence of strains isolated from sputum culture or bronchoalveolar lavage fluid of patients to A549 cells.

Results

The adherence bacterial counts of NTHi isolated from the nasopharyngeal cultures of healthy children to A549 cells was 58.2 CFU. In patients with lung diseases, NTHi isolated from bronchoalveolar lavage fluid was 104.3 CFU, and from sputum cultures was 115.1 CFU, both of which were significantly higher in their adherence to A549 cells compared to the strains isolated from the healthy control group. There was no significant difference in adherence between the strains isolated from sputum cultures and bronchoalveolar lavage fluid (t = 0.5217, p = 0.6033).

Conclusion

NTHi played an important role in childhood pulmonary infections by enhancing its adherence to lung epithelial cells.
Monitoring trends in the absolute lymphocyte count and the neutrophil-to-lymphocyte ratio in patients with breast cancer receiving eribulin
Authors: Su Meng-Xia , Lin Hsiang-Wen , Nguyen Hanh T. H. , Lin Tien-Chao , Chen Chih-Jung , Wang Hwei-Chung , Wu Chen-Teng , Wu Yao-Chung , He Geng-Yan , Liu Liang-Chih , Huang Chih-Hao
Published: February 2024

Background

Studies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients’ survival outcomes.

Methods

We retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival.

Results

There were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals.

Conclusion

We showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients’ survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.
Cancer patterns in Iran: a gender-specific spatial modelling of cancer incidence during 2014–2017
Authors: Faramarzi Sharareh , Kiani Behzad , Faramarzi Shahla , Firouraghi Neda
Published: February 2024

Background

Cancer is a significant public health concern and the second leading cause of death. This study aims to visualize spatial patterns of top common cancer types and identify high-risk and low-risk counties for these cancers in Iran from 2014 to 2017.

Methods

In this study, we analyzed 482,229 newly diagnosed cancer cases recorded by the Iranian National Population-Based Cancer Registry from 2014 to 2017. We employed a purely spatial scanning model and local Moran I analysis to explore spatial patterns across Iran.

Results

Approximately 53% of all cases were male. The average age of cancer diagnosis was 62.58 ± 17.42 years for males and 56.11 ± 17.33years for females. Stomach cancer was the most common cancer in men. The northern and northwestern regions of Iran were identified as high-risk areas for stomach cancer in both genders, with a relative risk (RR) ranging from 1.26 to 2.64 in males and 1.19 to 3.32 in females. These areas recognized as high-risk areas for trachea, bronchus, and lung (TBL) cancer specifically in males (RR:1.15–2.02). Central regions of Iran were identified as high-risk areas for non-melanoma skin cancers in both genders, ranking as the second most common cancer (RR:1.18–5.93 in males and 1.24–5.38 in females). Furthermore, bladder cancer in males (RR:1.32–2.77) and thyroid cancer in females (RR:1.88–3.10) showed concentration in the central part of Iran. Breast cancer, being the most common cancer among women (RR:1.23–5.54), exhibited concentration in the northern regions of the country. Also, northern regions of Iran were identified as high-risk clusters for colon cancer (RR:1.31–3.31 in males and 1.33–4.13 in females), and prostate cancer in males (RR:1.22–2.31). Brain, nervous system cancer, ranked sixth among women (RR:1.26–5.25) in central areas.

Conclusions

The study's revelations on the spatial patterns of common cancer incidence in Iran provide crucial insights into the distribution and trends of these diseases. The identification of high-risk areas equips policymakers with valuable information to tailor targeted screening programs, facilitating early diagnosis and effective disease control strategies.
Spectrum of variants associated with inherited retinal dystrophies in Northeast Mexico
Authors: Villafuerte-de la Cruz Rocio A. , Garza-Garza Lucas A. , Garza-Leon Manuel , Rodriguez-De la Torre Cesar , Parra-Bernal Cinthya , Vazquez-Camas Ilse , Ramos-Gonzalez David , Rangel-Padilla Andrea , Espino Barros-Palau Angelina , Nava-García Jose , Castillo-Velazquez Javier , Castillo-De Leon Erick , Del Valle-Penella Agustin , Valdez-Garcia Jorge E. , Rojas-Martinez Augusto
Published: February 2024

Background

Inherited retinal dystrophies are hereditary diseases which have in common the progressive degeneration of photoreceptors. They are a group of diseases with clinical, genetic, and allelic heterogeneity. There is limited information regarding the genetic landscape of inherited retinal diseases in Mexico, therefore, the present study was conducted in the northeast region of the country.

Methods

Patients with inherited retinal dystrophies were included. A complete history, full ophthalmological and medical genetics evaluations, and genetic analysis through a targeted NGS panel for inherited retinal dystrophies comprising at least 293 genes were undertaken.

Results

A total of 126 patients were included. Cases were solved in 74.6% of the study’s population. Retinitis pigmentosa accounted for the most found inherited retinal disease. Ninety-nine causal variants were found, being USH2A and ABCA4 the most affected genes (26 and 15 cases, respectively).

Conclusions

The present study documents the most prevalent causative genes in IRDs, as USH2A, in northeastern Mexico. This contrasts with previous reports of IRDs in other zones of the country. Further studies, targeting previously unstudied populations in Mexico are important to document the genetic background of inherited retinal dystrophies in the country.
Associations of sleep disorders with all-cause and cause-specific mortality in cancer survivors: a cross-sectional analysis of the NHANES 2005–2016
Authors: Nong Jingying , Tong Jinzhuo , Wang Ruotian , Shi Kejian , Zhang Yi
Published: February 2024

Background

The circadian clock and endoplasmic reticulum stress signaling play important roles in oncogenesis and development of cancer. Sleep disorders have been linked to an elevated risk of mortality in general populations. Nonetheless, the evidence for the sleep disorders-mortality association among cancer patients is limited. We aimed to prospectively investigate the association of sleep disorders with all-cause, cancer, and cardiovascular disease (CVD) mortality among cancer individuals.

Methods

We assessed 3187 participants with cancer from the National Health and Nutrition Examination Survey 2005–2016 cohorts with a median follow-up time of 83.0 months. Multivariable Cox proportional hazards models estimated the adjusted hazard ratio (HR) and 95% confidence interval (CI).

Results

Multivariable Cox proportional hazards models showed that sleep disorders were associated with a higher risk of all-cause mortality (HR 1.23, 95%CI: 1.06,1.42), cancer mortality (HR 1.30, 95%CI: 1.02, 1.66), and cardiovascular disease mortality (HR 1.35, 95%CI: 1.02, 1.80). After the total group was stratified by gender, the high HRs were observed in men (P < 0.05), not in women. The correlation between sleep disorders and higher long-term mortality was also significant after individuals who died within 2 years of follow-up were excluded, with HR 1.24 (95%CI: 1.07, 1.45) in model I, HR 1.20 (95%CI: 1.02, 1.42) in model II for long-term all-cause mortality, HR (95%CI: 1.00, 1.74) in model I for long-term cancer mortality, and HR 1.5 (95%CI:1.12, 2.02) in model I, HR 1.45 (95%CI: 1.06, 1.99) in model II for long-term CVD mortality.

Conclusions

Sleep disorders were associated with a higher risk of all-cause mortality, cancer mortality, and CVD mortality, as well as long-term mortality in cancer patients. Our finding underlies the importance of screening for sleep disorders for all cancer survivors and the urge to integrate sleep health as an important part of cancer care more effectively. Male individuals may be particularly vulnerable and could benefit from more frequent screening.
Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany: a nationwide survey
Authors: Herbolsheimer Florian , Peters Annette , Wagner Sarah , Willich Stefan N. , Krist Lilian , Pischon Tobias , Nimptsch Katharina , Gastell Sylvia , Brandes Mirko , Brandes Berit , Schikowski Tamara , Schmidt Börge , Michels Karin B. , Mikolajczyk Rafael , Harth Volker , Obi Nadia , Castell Stefanie , Heise Jana K. , Lieb Wolfgang , Franzpötter Katrin , Karch André , Teismann Henning , Völzke Henry , Meinke-Franze Claudia , Leitzmann Michael , Stein Michael J. , Brenner Hermann , Holleczek Bernd , Weber Andrea , Bohn Barbara , Kluttig Alexander , Steindorf Karen
Published: February 2024

Background

The COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups.

Methods

Between April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants’ physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions.

Results

Out of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO’s physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI: .117; .126) while engaging in more sedentary behavior (M = 0.24; 95% CI: .240; .247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines.

Conclusions

Mobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks.
Exposure to earthquakes and development of ischemic heart disease
Authors: Han Changwoo
Published: February 2024

Background

The evidence regarding the effect of earthquake exposure on the development of cardiovascular diseases is limited. This study evaluated the association between the 2016 Gyeongju earthquake, which had a magnitude of 5.8, and over 600 subsequent aftershocks occurring within a year in Korea, with the development of ischemic heart disease (IHD) among residents of Gyeongju.

Methods

Ten years (2010–2019) of medical records from a randomly selected cohort of residents (n = 540,858) in Gyeongju and 3 control cities were acquired from the national health insurance service. Employing difference-in-difference and meta-analyses, the risks of IHD development of Gyeongju residents before (reference: Sep 2014 to Aug 2015; period 1: Sep 2015 to Aug 2016) and after (period 2: Sep 2016 to Aug 2017; period 3: Sep 2017 to Aug 2018; period 4: Sep 2018 to Aug 2019) the earthquake were estimated.

Results

The monthly average incidence of IHD in Gyeongju was 39.5 persons (per 1,000,000) for reference period and 38.4 persons for period 1. However, the number increased to 58.5 persons in period 2, and 49.8 persons in period 3, following the earthquake. The relative risk (RR) [with a 95% confidence interval] of developing IHD among Gyeongju residents increased by 1.58 times (1.43, 1.73) in period 2, 1.33 times (1.21, 1.46) in period 3, and 1.15 times (1.04, 1.27) in period 4, in comparison to both the control cities and the pre-earthquake reference period. The increase in RR was particularly noticeable among women, adults aged 25–44, and individuals with lower incomes.

Conclusions

The major earthquake in Korea was associated with an increase in the development of IHD among local residents. Individuals exposed to earthquakes may benefit from cardiovascular health surveillance.
The interaction of perfluoroalkyl acids and a family history of diabetes on arthritis: analyses of 2011–2018 NHANES
Authors: Yang Shuting , Li Xuqi , Jiang Zhengdong
Published: February 2024

Whether a family history of diabetes (FHD) and exposure to perfluoroalkyl acids (PFAAs) are correlated with an increased risk of developing arthritis remains unclear. This cross-sectional study was conducted to explore the correlations between FHD or exposure to PFAAs and arthritis as well as their interaction using the National Health and Nutrition Examination Survey (NHANES). In total, 6,194 participants aged ≥ 20 years from the 2011–2018 NHANES were enrolled. PFAAs are a cluster of synthetic chemicals, including perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorodecanoic acid (PFDA) and perfluorohexane sulfonic acid (PFHxS). FHD was evaluated using self-reported questionnaires. Arthritis was classified into three types, rheumatoid arthritis (RA), osteoarthritis (OA), and others, which were diagnosed using questionnaires. Generalized linear models (GLMs) were used to test the correlation between FHD and arthritis. To examine the joint effects of PFAAs and FHD on arthritis, interaction terms were applied in the GLM. Arthritis incidence was 26.7% among all participants. FHD was associated with both RA [OR = 1.70 (95% CI: 1.15–2.50)] and other types of arthritis [OR = 1.62 (95% CI: 1.21–2.16)]. However, the relationship between FHD and OA was not significant after adjustment (P = 0.18). Interaction outcomes indicated that higher PFDA levels increased the association between FHD and arthritis. FHD is associated with an increased incidence of arthritis, which may be increased by PFDA. Given the heavy burden of arthritis, preventive measures for arthritis and reduction of PFAAs exposure for patients with FHD are required.
Investigation of infant deaths associated with critical congenital heart diseases; 2018–2021, Türkiye
Authors: Çaylan Nilgün , Yalçin Sıddika Songül , Tezel Başak , Üner Oben , Aydin Şirin , Kara Fatih
Published: February 2024

Background

The aim of this study was to examine the characteristics of infant mortality associated with critical congenital heart disease (CCHD).

Methods

In a cross-sectional study, data for the study were obtained through Death Notification System, Birth Notification System and Turkish Statistical Institute birth statistics.

Results

Of all infant deaths, 9.8% (4083) were associated with CCHD, and the infant mortality rate specific to CCHD was 8.8 per 10,000 live births. CCHD-related infant deaths accounted for 8.0% of all neonatal deaths, while the CCHD specific neonatal death rate was 4.6 per 10,000 live births. Of the deaths 21.7% occurred in the early neonatal, 30.3% in the late neonatal and 48.0% in the post neonatal period. Group 1 diseases accounted for 59.1% (n = 2415) of CCHD related infant deaths, 40.5% (n = 1652) were in Group 2 and 0.4% (n = 16) were in the unspecified group. Hypoplastic left heart syndrome was the most common CCHD among infant deaths (n = 1012; 24.8%). The highest CCHD related mortality rate was found in infants with preterm birth and low birth-weight while multiparity, maternal age ≥ 35 years, twin/triplet pregnancy, male gender, maternal education in secondary school and below, and cesarean delivery were also associated with higher CCHD related infant mortality rate. There was at least one non-cardiac congenital anomaly/genetic disorder in 26.1% of all cases.

Conclusion

CCHD holds a significant role in neonatal and infant mortality in Türkiye. To mitigate CCHD-related mortality rates, it is crucial to enhance prenatal diagnosis rates and promote widespread screening for neonatal CCHD.
Comparison of knee flexor strength recovery between semitendinosus alone versus semitendinosus with gracilis autograft for ACL reconstruction: a systematic review and meta-analysis
Authors: Matteucci Angelo , Högberg Johan , Piussi Ramana , Wernbom Mathias , Franceschetti Edoardo , Longo Umile Giuseppe , Samuelsson Kristian , Lövgren Johan , Hamrin Senorski Eric
Published: February 2024

Background

Whether there is a difference in harvesting the semitendinosus tendon alone (S) or in combination with the gracilis tendon (SG) for the recovery of knee flexor strength after anterior cruciate ligament (ACL) reconstruction remains inconclusive. Therefore, this study aimed to assess the recovery of knee flexor strength based on the autograft composition, S or SG autograft at 6, 12, and ≥ 24 months after ACL reconstruction.

Methods

A systematic review and meta-analysis was conducted following the PRISMA guidelines. A comprehensive search was performed encompassing the Cochrane Library, Embase, Medline, PEDRo and AMED databases from inception to January 2023. Inclusion criteria were human clinical trials published in English, comprised of randomized controlled trials (RCTs), longitudinal cohort-, cross-sectional and case–control studies that compared knee flexor strength recovery between S and SG autografts in patients undergoing primary ACL reconstruction. Isokinetic peak torques were summarized for angular velocities of 60°/s, 180°/s, and across all angular velocities, assessed at 6, 12, and ≥ 24 months after ACL reconstruction. A random-effects model was used with standardized mean differences and 95% confidence intervals. Risk of bias was assessed with the RoBANS for non-randomized studies and the Cochrane RoB 2 tool for RCTs. Certainty of evidence was appraised using the GRADE working group methodology.

Results

Among the 1,227 patients from the 15 included studies, 604 patients received treatment with S autograft (49%), and 623 received SG autograft (51%). Patients treated with S autograft displayed lesser strength deficits at 6 months across all angular velocities d = -0.25, (95% CI -0.40; -0.10, p = 0.001). Beyond 6 months after ACL reconstruction, no significant difference was observed between autograft compositions.

Conclusion

The harvest of S autograft for ACL reconstruction yields superior knee flexor strength recovery compared to SG autograft 6 months after ACL reconstruction, irrespective of angular velocity at isokinetic testing. However, the clinical significance of the observed difference in knee flexor strength between autograft compositions at 6 months is questionable, given the very low certainty of evidence and small effect size. There was no significant difference in knee flexor strength recovery between autograft compositions beyond 6 months after ACL reconstruction.

Trial registration

CRD42022286773.
Advances in prosthetics and orthotics
Authors: Moisan Gabriel , Zong-Hao Ma Christina
Published: February 2024

Over the past years, the field of prosthetics and orthotics has seen incredible innovations that used to be perceived as science fiction. This editorial aims to shed light on such exciting developments, exploring how they are addressing the challenges faced by individuals with limb impairments and musculoskeletal conditions.
Correlation between metabolic syndrome and periurethral prostatic fibrosis: results of a prospective study
Authors: Ren Jingwen , Li Yuanyuan , Zhang Xueyuan , Xiong Min , Zhang Heng , An Lingyue , Cao Ying , Xia Shujie , Luo Guangheng , Tian Ye
Published: February 2024

Background

Prostatic fibrosis, characterized by the accumulation of myofibroblasts and collagen deposition, is closely associated with LUTS and may lead to mechanical obstruction of the urethra. Additionally, Metabolic Syndrome (MetS), characterized by central obesity, high blood sugar, lipid metabolism disorders, and hypertension, is increasingly recognized as a proinflammatory condition linked to prostate inflammation.

Methods

Clinical data from 108 subjects who underwent transurethral resection of the prostate or bipolar plasmakinetic enucleation of the prostate were prospectively collected between June 2021 and August 2022. Patients were divided in two groups according to whether or not they had a diagnosis of MetS. Specimens were stained with Masson trichrome and the periurethral prostatic fibrosis extent was evaluated using quantitative morphometry.

Results

Forty-three patients (39.8%) were diagnosed with MetS. Patients with MetS showed a significantly greater extent of prostatic fibrosis than the others (68.1 ± 17.1% vs. 42.5 ± 18.2%, P < 0.001), and there was a positive correlation between the number of positive MetS parameters and the extent of prostatic fibrosis (R2 = 0.4436, P < 0.001). Multivariate regression analysis revealed that central obesity (B = 2.941, 95% confidence interval, 1.700–3.283), elevated fasting glucose (B = 1.036, 95% confidence interval, 0.293–1.780), reduced HDL cholesterol (B = 0.910, 95% confidence interval, 0.183–1.636) and elevated triglycerides (B = 1.666, 95% confidence interval, 0.824–2.508) were positively correlated to prostatic fibrosis. Elevated blood pressure, however, was unrelated to prostatic fibrosis (B = 0.009, 95% confidence interval, -0.664–0.683).

Conclusions

The present findings suggest that prostatic fibrosis is positively correlated with MetS and its components including central obesity, elevated fasting glucose, reduced high density lipoprotein cholesterol and elevated triglycerides.
COVID-19 home remedy consumption and perceived effectiveness among adult population in Brunei Darussalam: a PLS-SEM approach
Authors: Zaim Siti Nurzaimah Nazhirah , Idris Deeni Rudita , Abdul Rahman Hanif
Published: February 2024

Background

The Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 affects the respiratory system and causes severe acute respiratory infections. Several cultures have influenced the use of home remedies to ease mild symptoms of COVID-19 sometimes alongside conventional medicine. The aim of this study was to investigate the usage of COVID-19 home remedies among the adult population in Brunei.

Methods

The study design was a cross-sectional study using an online survey and distributed nationwide. The statistical analysis of the data included descriptive statistics describing the sociodemographic characteristics of the respondents, their experience with COVID-19 infection, consumption of general home remedies and COVID-19 home remedy, their practice of COVID-19 home remedy use, and their attitude towards the general use of home remedy. Sub-group analysis including Pearson's chi-square test and Fisher's exact test was computed for the variables in relation to the COVID-19 home remedy use and the perceived effectiveness of the types of home remedy. Multivariate analysis including Partial Least Squares Structural Equation Modelling (PLS-SEM) was applied to determine the correlations between the factors and outcomes measured.P-value less than 0.05 is considered statistically significant.

Results

There was a total of 864 eligible responses included in the study. The primary findings showed COVID-19 home remedy was used by 72.2% of the study participants. Most frequently used types of COVID-19 home remedy were cloves (37%), lemon (37%), and honey (23%). There was an infrequent usage of coconut (4.6%), eucalyptus oil (3.7%),habbatussauda(3.5%), traditional/ herbal cough syrup (2.4%), and turmeric (2.2%). The PLS-SEM demonstrated that ‘Experience’ appears to be a central endogenous variable that affects the decision on the use of COVID-19 home remedy. This relationship is mediated by ‘Safety’, ‘Source’, and ‘Opinion’ which have significant contributions to the outcome, accounting for 98.2% of the variance explained (R-square = 0.982).

Conclusions

The outcome of this study establishes the baseline prevalence of COVID-19 home remedy consumption among Bruneian residents and compared the previous study on Brunei’s general use of traditional medicine. The present findings could help nurses and other healthcare professionals in Brunei understand the practice of Bruneian adults on the consumption of home remedies for COVID-19.
Pan-cancer characterization of cell-free immune-related miRNA identified as a robust biomarker for cancer diagnosis
Authors: Wu Peng , Zhang Chaoqi , Tang Xiaoya , Li Dongyu , Zhang Guochao , Zi Xiaohui , Liu Jingjing , Yin Enzhi , Zhao Jiapeng , Wang Pan , Wang Le , Li Ruirui , Wu Yue , Sun Nan , He Jie
Published: February 2024

Minimally invasive testing is essential for early cancer detection, impacting patient survival rates significantly. Our study aimed to establish a pioneering cell-free immune-related miRNAs (cf-IRmiRNAs) signature for early cancer detection. We analyzed circulating miRNA profiles from 15,832 participants, including individuals with 13 types of cancer and control. The data was randomly divided into training, validation, and test sets (7:2:1), with an additional external test set of 684 participants. In the discovery phase, we identified 100 differentially expressed cf-IRmiRNAs between the malignant and non-malignant, retaining 39 using the least absolute shrinkage and selection operator (LASSO) method. Five machine learning algorithms were adopted to construct cf-IRmiRNAs signature, and the diagnostic classifies based on XGBoost algorithm showed the excellent performance for cancer detection in the validation set (AUC: 0.984, CI: 0.980–0.989), determined through 5-fold cross-validation and grid search. Further evaluation in the test and external test sets confirmed the reliability and efficacy of the classifier (AUC: 0.980 to 1.000). The classifier successfully detected early-stage cancers, particularly lung, prostate, and gastric cancers. It also distinguished between benign and malignant tumors. This study represents the largest and most comprehensive pan-cancer analysis on cf-IRmiRNAs, offering a promising non-invasive diagnostic biomarker for early cancer detection and potential impact on clinical practice.