bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally invasive extracorporeal circulation versus conventional cardiopulmonary bypass in patients undergoing cardiac surgery (MiECS): Rationale and design of a multicentre randomised trial
Authors: Anastasiadis Kyriakos , Antonitsis Polychronis , Papazisis Georgios , Haidich Bettina , Liebold Andreas , Punjabi Prakash , Gunaydin Serdar , El-Essawi Aschraf , Rao Vivek , Serrick Cyril , Condello Ignazio , Nasso Giuseppe , Bozok Sahin , Daylan Ahmet , Argiriadou Helena , Deliopoulos Apostolos , Karapanagiotidis Georgios , Ashkanani Fatma , Moorjani Narain , Cale Alex , Erdoes Gabor , Bennett Mark , Starinieri Pascal , Carrel Thierry , Murkin John
Published: August 2024

Introduction

The ultimate answer to the question whether minimal invasive extracorporeal circulation (MiECC) represents the optimal perfusion technique in contemporary clinical practice remains elusive. The present study is a real-world study that focuses on specific perfusion-related clinical outcomes after cardiac surgery that could potentially be favourably affected by MiECC and thereby influence the future clinical practice.

Methods

The MiECS study is an international, multi-centre, two-arm randomized controlled trial. Patients undergoing elective or urgent coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or combined procedure (CABG + AVR) using extracorporeal circulation will be randomized to MiECC or contemporary conventional cardiopulmonary bypass (cCPB). Use of optimized conventional circuits as controls is acceptable. The study design includes a range of features to prevent bias and is registered at clinicaltrials.gov (NCT05487612).

Results

The primary outcome is a composite of postoperative serious adverse events that could be related to perfusion technique occurring up to 30 days postoperatively. Secondary outcomes include use of blood products, ICU and hospital length of stay (30 days) as well as health-related quality of life (30 and 90 days).

Conclusions

The MiECS trial has been designed to overcome perceived limitation of previous trials of MiECC. Results of the proposed study could affect current perfusion practice towards advancement of patient care.
Chronic Cannabis users exhibit altered oscillatory dynamics and functional connectivity serving visuospatial processing
Authors: Castelblanco Camilo A , Springer Seth D , Schantell Mikki , John Jason A , Coutant Anna T , Horne Lucy K , Glesinger Ryan , Eastman Jacob A , Wilson Tony W
Published: August 2024

Background:

Cannabis is the most widely used psychoactive drug in the United States. While multiple studies have associated acute cannabis consumption with alterations in cognitive function (e.g., visual and spatial attention), far less is known regarding the effects of chronic consumption on the neural dynamics supporting these cognitive functions.

Methods:

We used magnetoencephalography (MEG) and an established visuospatial processing task to elicit multi-spectral neuronal responses in 44 regular cannabis users and 53 demographically matched non-user controls. To examine the effects of chronic cannabis use on the oscillatory dynamics underlying visuospatial processing, neural responses were imaged using a time-frequency resolved beamformer and compared across groups.

Results:

Neuronal oscillations serving visuospatial processing were identified in the theta (4–8 Hz), alpha (8–14 Hz), and gamma range (56–76 Hz), and these were imaged and examined for group differences. Our key results indicated that users exhibited weaker theta oscillations in occipital and cerebellar regions and weaker gamma responses in the left temporal cortices compared to non-users. Lastly, alpha oscillations did not differ, but alpha connectivity among higher-order attention areas was weaker in cannabis users relative to non-users and correlated with performance.

Conclusions:

Overall, these results suggest that chronic cannabis users have alterations in the oscillatory dynamics and neural connectivity serving visuospatial attention. Such alterations were observed across multiple cortical areas critical for higher-order processing and may reflect compensatory activity and/or the initial emergence of aberrant dynamics. Future work is needed to fully understand the implications of altered multispectral oscillations and neural connectivity in cannabis users.
Comparison of QCT and DEXA findings for lumbar vertebra in young adults and the elderly
Authors: Açikgöz Güneş , Bora Aydın , Nur Süreyya
Published: August 2024

Background

The use of dual-energy X-ray absorptiometry (DEXA) and quantitative computed tomography (QCT) methods are important for the diagnosis and follow-up of osteoporosis, and are used especially in cases to determine the degree of osteoporosis and the risk of fracture, monitoring the effectiveness of the treatment applied.

Purpose

To compare the parameters measured using the DEXA method from the lumbar (L1-L4) vertebrae and the Hounsfield unit (HU) values measured with QCT at the same levels among young adults and the elderly.

Material and Methods

The study included 155 patients (age range = 26–93 years). A total of 57 (36.8%) patients (age range = 26–64 years) were defined as the first group, and 98 (63.2%) patients (aged ≥65 years) were defined as the second group. T-test and correlation analysis were performed to compare bone mineral density (BMD), T score, and HU values measured using DEXA and QCT.

Results

A statistically significant difference was found between T score, lumbar total BMD, and HU values according to age and sex ( P < 0.05). When the values measured from lumbar vertebrae were compared using both DEXA and CT, a high correlation was found between them.

Conclusion

In the study, it was observed that QCT attenuation measurements of the lumbar spine measured between different age groups provided reliable results in terms of BMD scanning, as in DEXA. It should be noted that QCT has a longer imaging time and higher radiation dose compared to DEXA, and unnecessary scans should be avoided.
Bricolage Strategies, Stakeholder Engagement, and the Geographic Expansion of Social Enterprises
Authors: Ko Wai Wai , Liu Gordon
Published: August 2024

Social enterprises (SEs), hybrid entities balancing revenue generation and social or environmental goals, often employ bricolage due to resource constraints. Interviews with 37 SE managers unveiled two pivotal bricolage strategies—utilizing SE status–related marketing resources and leveraging available technological resources—as well as how their interplay influences geographical expansion and the contingent roles of stakeholder participation in facilitating their impact. Quantitative studies of 778 U.K. SEs confirm that the predominant facilitator of geographic expansion is the utilization of status-related marketing resources, surpassing the impact of leveraging available technological resources. SEs’ efforts to utilize SE status–related marketing resources should be harmonized with community participation, whereas SEs aiming to leverage available technological resources should align their efforts with employee participation. We also underscore the substitution dynamic between these two bricolage strategies. However, SEs prioritizing employee participation are better positioned to mitigate the challenges arising from this substitution than those emphasizing community participation.
‘Are You a Real Woman?’: Stigma and the Childfree Indian Woman
Authors: Babu Meera Suresh
Published: August 2024

India, a highly pronatalist country, places motherhood as a core element in defining women. Therefore, it is in this context that the choice of more and more women to be childfree needs to be analysed. This study attempted to explore the stigma and social exclusion faced by childfree women at home and in social settings. The qualitative methodology involving narrative enquiry was used to conduct in-depth interviews of 10 childfree women in India. It was found that stigma ranges from a very subtle manner of questioning to exclusion from certain domains, which often leads to self-regulated exclusion. Studies on the childfree community in India are only just emerging and are limited to the reasons behind childfree choices, while the current study extends to reveal the consequences of the childfree choice.
A Case Series on Complexities in Recognition and Management of Tourette Syndrome with Variable Behavioral Presentations: Comorbidity Versus Umbrella Construct
Authors: Ray Anindya Kumar , Mitra Saikat
Published: August 2024

In Tourette syndrome (TS), apart from multiple motor and vocal tics, there are often myriads of associated conditions apparently similar to attention-deficit-hyperactivity-disorder (ADHD), obsessive-compulsive-disorder (OCD), mood-and-conduct disorder, learning difficulties, etc. On the other hand, tic disorders often occur as co-morbidity with many neurodevelopmental disorders such as ADHD, OCD and mood disorders, and pharmacotherapy of these behavioral conditions may worsen the tics. So, the confusion lies whether to separately code and manage the different neurodevelopmental disorders or assume an umbrella construct of “TS-plus,” as suggested by some researchers. In this background, we share three cases of children and adolescents having multiple tics with mixed behavioral presentations of ADHD/OCD/mood disorders that created a lot of diagnostic dilemma and treatment-related complications in prior psychiatric consultations. They were finally diagnosed as “TS-plus” and managed with low-dose-risperidone-mono-pharmaco-therapy and psychological interventions. In conclusion, psychiatrists should be vigilant for Tourette-syndrome while handling children with repetitive motor behaviors along with hyperactivity, obsession-compulsion, mood-conduct, etc. Assumption of an umbrella-construct approach of “TS-plus” may be beneficial in limiting the number of diagnosis and their separate pharmacotherapy, which may worsen the clinical scenario.
Navigating East: Exploring Northeast India’s Perspective on the Look (Act) East Policy
Authors: Bhattacharya Joyati
Published: August 2024

The early 1990s witnessed a strategic shift in India’s foreign policy with the introduction of the Look (Act) East Policy. The policy was conceptualised originally to meet the challenges of the post-Cold War world politics. The idea that Northeast India can develop in the process of the implementation of the policy and can be a gateway to South East Asia was realised rather late in the early part of the twenty-first century. Since then, the expectations around the Look (Act) East Policy have been remarkable. The change in nomenclature as ‘Act East’ in 2014 has further strengthened the hope about the potential impact of the policy in Northeast India. However, without addressing the issues of concern within Northeast India and cultivating sufficient local resources, it remains impossible for the states in the Northeast to abruptly hope for redemption across the mountains from Southeast Asia. Against this backdrop, the present study aims to comprehend the implications of the policy for Northeast India, evaluates the prospect of participation of the North-Eastern states and examines the perspective of the locals on the basis of primary data collected for the study.
Diabetic Brachial Plexopathy: A Case Report
Authors: Hegde Megha , Raj Saurav , Tikadar Dhananjay , Nyamagoud Sanatkumar B.
Published: August 2024

Diabetes is known to cause an array of central and peripheral neurological conditions. Among the neuropathic complications associated with diabetes are distal symmetrical polyneuropathy, amyotrophy, polyradiculopathy, autonomic neuropathy, and cranial mononeuropathies. Notably, brachial plexopathy has not been documented as a complication of diabetes. A 50-year-old man with a history of diabetes mellitus presented with severe pain and progressive weakness in his right upper limb. Laboratory investigations, immunopathological analyses, and cerebrospinal fluid examination yielded normal results. The electrodiagnosis and imaging studies were consistent with bilateral brachial plexus neuritis. This unique presentation does not align with the rare diabetic polyradiculopathy of the upper limbs commonly linked to diabetic amyotrophy. The association between diabetes mellitus and brachial plexopathy is uncommon, indicating a possible occurrence of a rare subtype within diabetic neuropathies.
What do data rights do for workers? A critical analysis of trade union engagement with the datafied workplace
Authors: Dencik Lina , Brand Jessica , Murphy Sarah
Published: August 2024

There has been a substantial increase in calls for so-called workers’ ‘data rights’, including amongst trade unions. Unions see them as a way of tackling some of the challenges of the datafied workplace but questions have also been asked about their relation to employment regulation and wider efforts within the labour movement. In this article we draw on a review of trade union documents along with interviews with 15 trade unions in the United Kingdom to critically engage with data rights as an avenue for protecting and advancing workers’ interests. We argue that while trade unions see possible strategic gains through the pursuit of data rights, such rights are only fully meaningful if pursued in conditions that enable wider workplace democracy. In the absence of such conditions data rights can distract from efforts to foster worker power and may even serve to legitimise what are perceived to be oppressive technologies.
Comparing the trends of MBS telepsychiatry and consultant physician telehealth services from 2017 to 2022: A retrospective study
Authors: Woon Luke S-C , Allison Stephen , Bastiampillai Tarun , Kisely Steve , Maguire Paul , Pring William , Reay Rebecca , Looi Jeffrey CL
Published: August 2024

Objective

The Medicare Benefit Schedule (MBS) telehealth items were expanded in March 2020 during the COVID-19 pandemic. We measured the use of MBS telepsychiatry items compared to consultant physician telehealth items within the context of these item changes, to understand differences in telepsychiatry and physician telehealth utilisation.

Methods

Monthly counts of face-to-face and telehealth (videoconferencing and telephone) MBS items for psychiatrists and physicians from January 2017 to December 2022 were compiled from Services Australia MBS Item Reports. Usage levels were compared before and after telehealth item expansion. Usage trends for MBS telepsychiatry and physician telehealth items were compared in time-series plots.

Results

Telehealth item expansion resulted in a greater rise of telepsychiatry services from 3.8% beforehand to 43.8% of total services subsequently, compared with physician telehealth services (from 0.6% to 20.0%). More physician telehealth services were by telephone compared with telepsychiatry services. Time-series of both telehealth services displayed similar patterns until mid-2022, when physician telehealth services declined as telephone items were restricted. Telepsychiatry services consistently comprised a greater proportion of total services than physician telehealth services.

Conclusions

MBS psychiatrist services showed a more substantial and persistent shift to telehealth than physician services, suggesting a greater preference and use of telepsychiatry.
Community musicking and musical cognition among adungu music communities of the Acholi people from Awach, Gulu district, Northern Uganda
Authors: Isabirye James
Published: August 2024

This ethnographic inquiry investigated the nature of musical cognition that engagements in the Ugandan Acholi people’s adungu music culture engender, what can be understood about musical cognition in nonwesternized oral community music-making experiences, and how this might inform school music education theory and practice. Schooling in Uganda mostly upholds colonial epistemes that separate cognitive, affective, and psychomotor domains, and position the arts and culture at the periphery of school experiences. Through a thematic analysis of data from interviews, focus group discussions, and observations of Anyim Lac troupe music community engagements, this study found that sociomusical experiences engender musical cognition where the musical spirit, mind, body, and environment interactions birth musical understanding. Musical cognition was understood as a holistic process of reflecting, creating, recreating, and acting emotionally where these musical spirit, mind, body, and environment interactions are shaped by culture. Since humans perceive, perform, and learn music as the embodiment of the interaction between musical spirit, mind, body, and environment, educators might need to create contexts where learners engage in learning experiences in ways that embed awareness of the intertwined nature of musical spirit, mind, body, and environment in those meaning-making processes.
Investigating if and how string teachers instruct and support the self-regulation of students’ practice in online lessons
Authors: Utermohl de Queiroz Dora , López-Íñiguez Guadalupe , Foletto Clarissa
Published: August 2024

Existing literature indicates that music teachers and educators working online need to encourage students to adopt self-regulating behaviors to succeed in their learning and performance. This study examines if and how string teachers promote selected self-regulated learning (SRL) processes in online lessons; specifically, how they teach and support motivation, self-efficacy, and task strategies for the self-regulation of students’ practice. Five string teachers and seven students at different levels of musical development participated in this study. The data sources included semi-structured interviews with teachers and lesson recordings. We analyzed the data using a coding scheme based on self-regulated learning theory. Our findings report that teachers used practices that can indirectly contribute to the self-regulation of students’ practice, such as using digital tools to help plan practice, discussing repertoire with the student, and requiring recordings to motivate students to practice. However, teachers’ direct approaches to instructing self-regulated learning behaviors did not stimulate students’ reflection; consequently, the development of students’ metacognition was poor. Therefore, a prominent implication underscored by this study highlights the potential created when online music educators take advantage of twenty-first-century technologies and the outstanding need to replace some traditional nineteenth-century approaches to music learning with more student-centered practices in which self-regulated learning plays a central role.
Effectiveness of cladribine compared to fingolimod, natalizumab, ocrelizumab and alemtuzumab in relapsing-remitting multiple sclerosis
Authors: Roos Izanne , Sharmin Sifat , Malpas Charles , Ozakbas Serkan , Lechner-Scott Jeannette , Hodgkinson Suzanne , Alroughani Raed , Eichau Madueño Sara , Boz Cavit , van der Walt Anneke , Butzkueven Helmut , Buzzard Katherine , Skibina Olga , Foschi Matteo , Grand’Maison Francois , John Nevin , Grammond Pierre , Terzi Murat , Prévost Julie , Barnett Michael , Laureys Guy , Van Hijfte Liesbeth , Luis Sanchez-Menoyo Jose , Blanco Yolanda , Oh Jiwon , McCombe Pamela , Ramo Tello Cristina , Soysal Aysun , Prat Alexandre , Duquette Pierre , Yamout Bassem I , Khoury Samia , van Pesch Vincent , Macdonell Richard , José Sá Maria , Slee Mark , Kuhle Jens , Maimone Davide , Spitaleri Daniele LA , Willekens Barbara , Asmi Abdallah Al , Tallantyre Emma , Robertson Neil P , Coles Alasdair , L Brown J William , Kalincik Tomas
Published: August 2024

Background:

Comparisons between cladribine and other potent immunotherapies for multiple sclerosis (MS) are lacking.

Objectives:

To compare the effectiveness of cladribine against fingolimod, natalizumab, ocrelizumab and alemtuzumab in relapsing-remitting MS.

Methods:

Patients with relapsing-remitting MS treated with cladribine, fingolimod, natalizumab, ocrelizumab or alemtuzumab were identified in the global MSBase cohort and two additional UK centres. Patients were followed for ⩾6/12 and had ⩾3 in-person disability assessments. Patients were matched using propensity score. Four pairwise analyses compared annualised relapse rates (ARRs) and disability outcomes.

Results:

The eligible cohorts consisted of 853 (fingolimod), 464 (natalizumab), 1131 (ocrelizumab), 123 (alemtuzumab) or 493 (cladribine) patients. Cladribine was associated with a lower ARR than fingolimod (0.07 vs. 0.12, p = 0.006) and a higher ARR than natalizumab (0.10 vs. 0.06, p = 0.03), ocrelizumab (0.09 vs. 0.05, p = 0.008) and alemtuzumab (0.17 vs. 0.04, p < 0.001). Compared to cladribine, the risk of disability worsening did not differ in patients treated with fingolimod (hazard ratio (HR) 1.08, 95% confidence interval (CI) 0.47–2.47) or alemtuzumab (HR 0.73, 95% CI 0.26–2.07), but was lower for patients treated with natalizumab (HR 0.35, 95% CI 0.13–0.94) and ocrelizumab (HR 0.45, 95% CI 0.26–0.78). There was no evidence for a difference in disability improvement.

Conclusion:

Cladribine is an effective therapy that can be viewed as a step up in effectiveness from fingolimod, but is less effective than the most potent intravenous MS therapies.
Ride comfort and impact factor of a seven-span continuous cable-stayed bridge
Authors: Kim Chul-Woo , Kimura Shinya , Sugiyama Hiroki , Sato Akinori , Ono Kazuyuki
Published: August 2024

This study was conducted to investigate the vibration serviceability and impact coefficient of a seven-span continuous cable-stayed bridge planned for an expressway extension using a three-dimensional vehicle–bridge coupled vibration analysis. For the bridge design, deflection under the designed live load of the continuous cable-stayed bridge did not meet the deflection limit specified in “Japanese Design Specifications for Highway Bridges.” The excessive deflection indicates the possibility of poor vibration serviceability. To clarify the bridge vibration serviceability, the dynamic responses of the bridge and passing vehicles were examined using the three-dimensional vehicle–bridge coupled vibration analysis. The three-dimensional analysis was validated by comparing the vibration response of a single-span steel cable-stayed bridge in service subjected to vehicle running tests with those numerical responses from the three-dimensional analysis. The ride comfort of vehicles on the bridge was assessed in terms of vibration serviceability according to the ISO 2613-1 international standard for evaluating whole-body vibration exposure. The observation from the simulation-based investigation demonstrated that the vehicle response does not exceed the ride comfort limit irrespective of vehicle, road, and running conditions. In other words, the findings confirmed a negligible effect of large deflections on driving safety. The impact factors were found to be less than 1.05 for the main girder, less than 1.03 for the main tower base, and less than 1.04 for the cable. The impact factor was greatest when several vehicles were running at resonant headway.
Better perceived health among the Swedish-speaking minority as compared with the Finnish-speaking majority in Finland: a cross-sectional study with an intergenerational perspective
Authors: Suominen Sakari , Stark Ekman Diana , Saarela Jan , Volanen Salla-Maarit , Stenlund Säde , Sillanmäki Lauri , Sumanen Markku
Published: August 2024

Background:

Previous research has shown that the Swedish speaking minority in Finland has slightly but significantly better health compared with the Finnish speaking majority. However, a clear explanation for this is lacking.

Aim:

The aim of the study was to explore differences of perceived health comparing three groups: Swedish speakers with reported dominance of Swedish also in the preceding generation; contemporary Finnish speakers with reported dominance of Finnish in the preceding generation and a group with a reported mixed-language structure of Finnish and Swedish between generations.

Individuals and methods:

Health and Social Support is an on-going population-based survey initiated in 1998 ( N = 64,797), aimed at working-age adults. The present study is based on the 2012 follow-up survey, which included a question on the dominating language (Swedish or Finnish) of the respondents and their parents. The outcome was perceived health, which in this study was dichotomized to very good/good and intermediate/poor/very poor. The statistical analysis was carried with logistic regression, using SAS software. Age, gender and occupational training were included as covariates in the multivariable analysis.

Results:

This study found that the Swedish-speaking group in Finland report better perceived health compared with the Finnish-speaking group (odds ratio 1.28, 95% confidence interval 1.04–1.57, p < 0.001). The health of the mixed language-speaking group fell between the other two groups.

Conclusions:

The results gave some support to a culturally mediated mechanism for the health advantage of Swedish speakers. Cultural features of Swedish-speaking groups in Finland may also support health promotion of the Finnish-speaking majority.
Analysis of the application of CPMV model to the thermal comfort of passengers in high-speed rail carriages
Authors: Xu Chengcheng , Shao Suola , Wei Wenjian , Li Shuhong , Li Nan
Published: August 2024

Due to the popularization of high-speed rail (HSR), there have been increasing concerns of passengers about the thermal comfort of HSR air conditioning. The corrected predicted mean vote (CPMV) model considering the impact of solar radiation on indoor thermal comfort has been previously proposed and validated for accuracy in office buildings. To verify the accuracy of the CPMV model in evaluating the thermal comfort of passengers inside HSR carriages, the field study on HSR in the Yangtze River Delta region of China was conducted in winter and summer. The results indicate thermal sensation vote values obtained from passengers fit well with CPMV values. When the temperature is high in summer and low in winter, the CPMV model ignores people’s ability to adapt and tolerate harsh environments. In addition, the thermal preference temperature of passengers in summer is 0.57°C higher than the neutral temperature, indicating that there is an overcooling situation in summer. The study recommends to lower the set temperature of summer air conditioning in HSR. This study contributes to the promotion of the CPMV model on HSR and provides technical support for the design of air-conditioning systems for HSR carriages from the perspective of thermal comfort of passengers.
What Is Quantitative Research? An Overview and Guidelines
Authors: Lim Weng Marc
Published: August 2024

In an era of data-driven decision-making, a comprehensive understanding of quantitative research is indispensable. Current guides often provide fragmented insights, failing to offer a holistic view, while more comprehensive sources remain lengthy and less accessible, hindered by physical and proprietary barriers. This gap underscores the urgent need for a clear, accessible guide that demystifies quantitative research, a necessity not just for academic rigor but for practical application. Against this backdrop, this guide offers an overview of quantitative research, elucidating its core motivations, defining characteristics, and methodological considerations. The necessity, importance, relevance, and urgency of quantitative research are articulated, establishing a strong foundation for the subsequent discussion, which delineates the scope, objectivity, goals, data, and methods that distinguish quantitative research, alongside a balanced inspection of its strengths and shortcomings, particularly in terms of data collection and analysis. The guide also addresses various design considerations, ranging from the choice between primary and secondary research, cross-sectional and longitudinal studies, to experimental and non-experimental designs. The crucial role of pretesting and piloting instruments is underscored, with a discussion of its goals, focal areas, and participant selection. Data considerations are also examined, covering sampling approaches, sample size determination, and data and resource maximization strategies, as well as comprehensive data preparation techniques including handling missing data, managing outliers, standardizing variables, and verifying assumptions. The guide further delves into analysis considerations, spotlighting the assessment of psychometric properties, diverse analytical approaches, and essential robustness checks. The guide concludes by demystifying the hypothesis testing process, detailing the formulation of null and alternative hypotheses, the interpretation of statistical significance, and the issue of Type I, Type II, Type III, and Type IV errors. Therefore, this guide serves as a valuable compass for researchers seeking to navigate the multifaceted aspects of quantitative research, ensuring rigorous, reliable, and valid scientific inquiry.
‘All your image are belong to us’: heritagization, archiving and historicization of memes
Authors: Schafer Valérie , Pailler Fred
Published: August 2024

From the ‘Dancing baby’, ‘All your base are belong to us’ and the ‘Hampster dance’ in the second half of the 1990s to Bernie’s mittens at the US presidential inauguration, through to ‘Disaster girl’ and ‘Distracted boyfriend’, among others, memes have become an important part of our (visual) digital culture over the last 20 years. This article demonstrates why memes should be considered a critical part of our born-digital heritage, by examining their connections to digital histories and trajectories, as well as their role in pop, visual and digital culture. The authors then map the diversity of stakeholders who contribute to this heritagization and the many challenges involved in meme preservation and archiving, including curation, agency, meaning and value.
Percutaneous Transluminal Angioplasty Alleviate Pediatric Postthrombotic Syndrome: A Case Report and Literature Review
Authors: Tan HaiBin , Zhang Xiaocong , Wang Weice , Liang Linguo , Peng Yucheng
Published: August 2024

Purpose:

Postthrombotic syndrome (PTS) is one of the long-term sequelae of deep vein thrombosis (DVT), and effective symptom management in pediatric PTS remains a challenge, with interventional therapy rarely explored in this population. We present a successful case of interventional treatment pediatric PTS, resulting in a remarkable amelioration of her symptoms.

Case Report:

This case features a 6-year-old girl diagnosed with hyperinsulinemia, leading to a hypoglycemic coma. Following a mini-pancreatic partial pancreatectomy, she required further intensive care in the pediatric intensive care unit. It was during this period that left lower extremity DVT was identified, prompting warfarin anticoagulation therapy. During the anticoagulation period, she had several bleeding events and was switched to anticoagulation with low molecular heparin. One month later, the left common iliac vein and external iliac vein was found to be completely occluded. Over time, she experienced a gradual onset of lower limb swelling and pain, which, after 6 months, was accompanied by perineal edema and venous claudication. As a result, she underwent successful percutaneous transluminal angioplasty. In addition, the anticoagulation regimen was adjusted to rivaroxaban. At the 8-month follow-up, we observed significantly improvement in her postoperative lower extremity swelling and symptoms related to venous occlusion had completely disappeared. Moreover, vascular imaging confirmed improvement in stenosis and uninterrupted blood flow.

Conclusions:

In our review of pediatric PTS studies, we observed limited options to alleviate symptoms, and interventional treatments have not been reported. Our case study, demonstrating the safe and effective use of percutaneous transluminal angioplasty, helps to illuminate this area and alleviate pediatric PTS symptoms.

Clinical Impact

This case validates the efficacy and safety of using percutaneous transluminal angioplasty (PTA) for the treatment of postthrombotic syndrome (PTS) in pediatric patients. This interventional approach offers significant symptomatic relief and improves quality of life, especially in cases where traditional anticoagulation therapies fail or lead to complications. The successful case presented emphasizes the necessity of considering endovascular interventions for children with moderate to severe PTS, particularly when conservative management is ineffective. This research underscores the potential for PTA to be adopted in clinical practice, offering a promising new approach for managing pediatric PTS.
Experiences of Elementary Students with Complex Support Needs in Segregated Special Education Classrooms: A Mixed Methods Study
Authors: Kurth Jennifer A. , Lockman Turner Elissa , Zagona Alison L. , Kim Geonhwa , Loyless Roxanne
Published: August 2024

Over 90% of students with complex support needs are taught in self-contained (segregated) special education classrooms for most of their school day, despite accumulating evidence these classrooms are not associated with positive student outcomes. Yet placement in these segregated classrooms persists, in part because of assumptions about the degree of specialized, intensive, and individualized instruction that occurs in these settings. We observed a national sample of 30 students with complex support needs using time sampling and fieldnote data in this convergent parallel mixed methods study to describe (a) the ecobehavioral characteristics of classrooms, (b) the learning activities occurring in classrooms, and (c) how the materials, supports, and learning activities explain student experiences in these classrooms. Quantitative time sampling data indicated that students experienced passive learning opportunities and downtime, with few occasions to engage with other peers or grade-aligned content. Qualitative fieldnote data provided context for the quantitative results. These findings provide a picture of the low expectations that persist in segregated classrooms and contradict the need to remove students from general education to learn in segregated classrooms.
The Chronic Conditions Care Collaborative (4C Collaborative): A Platform for Improving Diabetes and Heart Disease Outcomes in Rural South Carolina
Authors: Grant Brittney , Mandelbaum Jennifer , Curry Khristian , Myers Kristian , James Michele , Brightharp Courtney , Hicks Shauna
Published: August 2024

Rural U.S. counties experience racial, geographic, and socioeconomic disparities in chronic diseases. Collaborations among stakeholders in rural areas are needed to make measurable changes in health care outcomes in South Carolina. The Chronic Conditions Care Collaborative (4C Collaborative) was developed to provide an opportunity for health care teams in medically underserved areas of South Carolina to convene to improve diabetes and heart disease outcomes. The 4C Collaborative was a quality improvement (QI) learning collaborative focused on the identification of patients with undiagnosed hypertension, team-based care through medication therapy management (MTM), and diabetes management. All QI work was approached through a health equity lens. Fifteen medical practices across two cohorts participated in the 4C Collaborative and gained access to more than 35 hours of educational content and guided action steps to create systemic changes specific to the needs of their patient population. Participation also conferred access to one-on-one technical assistance with faculty subject-matter experts. The activities within the 4C Collaborative allowed health care practices to identify areas of improvement within their practices and test improvement strategies through Plan-Do-Study-Act (PDSA) cycles. Best practices and lessons learned from learning collaborative participants were compiled into storyboards and presented during end of program celebrations.
Early neurological deterioration in acute lacunar ischemic stroke: Systematic review of incidence, mechanisms, and prospects for treatment
Authors: Werring David J , Ozkan Hatice , Doubal Fergus , Dawson Jesse , Freemantle Nick , Hassan Ahamad , Le Suong Thi Ngoc , Mallon Dermot , Mendel Rom , Markus Hugh S , Minhas Jatinder S , Webb Alastair J S
Published: August 2024

Background:

Cerebral small vessel disease (CSVD) causes between 25% and 30% of all ischemic strokes. In acute lacunar ischemic stroke, despite often mild initial symptoms, early neurological deterioration (END) occurs in approximately 15–20% of patients and is associated with poor functional outcome, yet its mechanisms are not well understood.

Aims:

In this review, we systematically evaluated data on: (1) definitions and incidence of END, (2) mechanisms of small vessel occlusion, (3) predictors and mechanisms of END, and (4) prospects for the prevention or treatment of patients with END.

Summary of review:

We identified 67 reports (including 13,407 participants) describing the incidence of END in acute lacunar ischemic stroke. The specified timescale for END varied from <24 h to 3 weeks. The rate of END ranged between 2.3% and 47.5% with a pooled incidence of 23.54% (95% confidence interval (CI) = 21.02–26.05) but heterogeneity was high ( I2 = 90.29%). The rates of END defined by National Institutes of Health Stroke Scale (NIHSS) decreases of ⩾1, ⩾2, ⩾3, and 4 points were as follows: 24.17 (21.19–27.16)%, 22.98 (20.48–25.30)%, 23.33 (16.23–30.42)%, and 10.79 (2.09–23.13)%, respectively, with lowest heterogeneity and greatest precision for a cutoff of ⩾2 points. Of the 20/67 studies (30%) reporting associations of END with clinical outcome, 19/20 (95%) reported worse outcomes (usually measured using the modified Rankin score at 90 days or at hospital discharge) in patients with END. In a meta-regression analysis, female sex, hypertension, diabetes, and smoking were associated with END.

Conclusions:

END occurs in more than 20% of patients with acute lacunar ischemic stroke and might provide a novel target for clinical trials. A definition of an NIHSS ⩾2 decrease is most used and provides the best between-study homogeneity. END is consistently associated with poor functional outcome. Further research is needed to better identify patients at risk of END, to understand the underlying mechanisms, and to carry out new trials to test potential interventions.
Combination approach for CDC73-related parathyroid carcinoma in an adolescent female patient: a case report and literature review
Authors: Kim Ekaterina , Kalinchenko Natalia , Eremkina Anna , Urusova Liliya , Salimkhanov Rustam , Mokrysheva Natalia
Published: August 2024

Parathyroid carcinoma (PC) is extremely rare in children and adolescent. PC is more often sporadic, but also it could be associated with germline mutations. The clinical features of primary hyperparathyroidism (PHPT) are nonspecific in children and adolescent, which delays the diagnosis for years. This case of PC in a pediatric patient, caused by germline heterozygous pathogenic variant in exon 1 of the CDC73 gene (c.70 G > T, p. Glu24Ter) is the first to be reported in Russia. Due to the rarity of pediatric parathyroid malignancy, the diagnosis of this endocrine neoplasm remains a challenge. The main difficulties that we faced in the management of the patient were the morphological confirmation of diagnosis, multiple surgical interventions, and disseminated PC metastases. We describe a 13-year-old girl with delayed diagnosis of PC and subsequent local recurrence after several surgeries, who underwent specific radiation therapy that allowed controlling hypercalcemia.
Upward and Downward Prosocial Influence Across Levels of a Social Hierarchy: Field and Experimental Evidence About Authorities of U.S. Counties
Authors: Jung Haesung ,   Grid for the Reduction of Vulnerability, Albarracín Dolores
Published: August 2024

Although people often engage in prosocial behavior when witnessing prosocial others, little is known about whether and how prosociality spreads across different positions within a social hierarchy. One field study involving 79 U.S. counties found a positive association between the prosociality of community members and their authorities, providing preliminary evidence of similarity in willingness to improve community well-being across levels of a social hierarchy. A follow-up experiment testing the relative magnitude of downward and upward prosocial influence showed that participants playing the role of authorities were more responsive to the prosociality of community members. Findings further showed that the greater response to prosocial influence among authorities was due to their greater optimism. The article ends with a discussion of the theoretical and practical implications of these findings and directions for future research.
Tocilizumab Treatment in a Patient of Refractory Anti-EJ Positive ASyS: A Case Report
Authors: Jiajia Jin , Jia Li , Wanlong Wu , Shuhui Sun , Xiaodong Wang , Shuang Ye
Published: August 2024

Anti-synthetase syndrome (ASyS) is an autoimmune disease characterized by the presence of autoantibodies to aminoacyl-tRNA synthetases accompanied with various organ involvements, including the lung, joints, and skin. The ASyS-related interstitial lung disease (ILD) can be seen in the vast majority of patients. The extent of lung involvement has a significant impact on patient prognosis; the occurrence of rapid-progressive ILD could prominently increase mortality. The mainstay of treatment is prednisone in combination with conventional synthetic disease-modifying anti-rheumatic drugs or some biologic disease-modifying anti-rheumatic drugs (DMARDs). Tocilizumab (TCZ), a recombinant humanized anti-interleukin (IL)-6 receptor monoclonal antibody, has also been used to treat some systemic autoimmune rheumatic diseases associated with ILD. Although the most recent American College of Rheumatology (ACR) Guideline for the Treatment of Interstitial Lung Disease conditionally recommends against the use of TCZ as a treatment option for people with idiopathic inflammatory myopathy (IIM)-ILD progression despite initial ILD treatment, the treatment effect of TCZ in ASyS patients remains obscure, particularly for refractory cases with anti-non-Jo1 antibodies. This report describes a case of Chinese ASyS patients with anti-EJ-positive antibodies who presented with typical proximal muscle weakness, elevated creatine kinase, and ILD with non-specific interstitial pneumonia (NSIP) pattern, along with typical skin involvement such as mechanic’s hand. The patients were resistant to various treatments, including rituximab (RTX), but benefited from TCZ. In this case, TCZ shows good therapeutic efficacy in a fatal acute exacerbation of ILD with a hyperinflammatory status, resulting in a relative remission of the disease flare and full preservation of lung function with a positive long-term treatment outcome.
Book review: Pratinav Anil, Another India: The Making of the World’s Largest Muslim Minority, 1947–77
Authors: Khan Aamir Jamal
Published: August 2024

Pratinav Anil, Another India: The Making of the World’s Largest Muslim Minority, 1947–77. Hurst, 2023, 432 pp. £25.00 (Hardback). ISBN: 9781787388086.
Inhibition of RHOA activity preserves the survival and hemostasis function of long-term cold-stored platelets
Authors: Hegde Shailaja , Akbar Huzoor , Wellendorf Ashley M. , Nestheide Shawnagay , Johnson James F. , Zhao Xueheng , Setchell Kenneth D. , Zheng Yi , Cancelas Jose A.
Published: August 2024

Patients with thrombocytopenia require platelet transfusion to prevent and stop hemorrhage. Cold storage of platelets results in complex molecular lesions, including changes in membrane microdomains that are recognized by host macrophages and hepatocyte counter-receptors, resulting in phagocytosis and clearance upon transfusion. For this reason, platelets are stored at room temperature, a method that confers increased risk of bacterial contamination. By applying signaling analysis and genetic and pharmacological approaches, we identified that cold-induced activation of RAS homolog family, member A (RHOA) GTPase causes the major hallmarks of platelet cold storage lesions. RHOA deficiency renders murine platelets insensitive to cold storage–induced damage, and pharmacological inhibition by a RHOA activation inhibitor, R-G04, can prevent the cold storage–induced lesions. RHOA inhibition prevents myosin activation and clathrin-independent formation and internalization of lipid rafts enriched in active glycosyltransferases as well as abnormal distribution of GPIbα. RHOA inhibition further prevents the metabolic reprogramming of cold storage–induced lesions and allows the maintenance of glycolytic flux and mitochondria-dependent respiration. Importantly, human platelets transfused in mice after cold storage, in the presence of R-G04 or its more potent enantiomer S-G04, can circulate in vivo at similar levels as room temperature–stored platelets while retaining their hemostatic activity in vivo, as assessed by bleeding time correction in aspirin-treated mice. Our studies provide a mechanism-based translational approach to prevent cold storage–induced damage, which is useful for human platelet transfusion in patients with thrombocytopenia.
Evaluating the impact of a year-long external mentorship pilot program in classical hematology
Authors: Qureshy Zoya , Nair Pooja , Vesely Sara K. , King Allison A. , Lee Alfred I. , Connell Nathan T. , von Drygalski Annette , Wong-Sefidan Ida , Murphy Martina C. , Mistry Ronak H. , Zon Rebecca L. , Reid Erin G. , Fritz Josel , Park Soo J.
Published: August 2024

Effective mentorship is a pivotal factor in shaping the career trajectory of trainees interested in classical hematology (CH), which is of critical importance due to the anticipated decline in the CH workforce. However, there is a lack of mentorship opportunities within CH compared with medical oncology. To address this need, a year-long external mentorship program was implemented through the American Society of Hematology Medical Educators Institute. Thirty-five hematology/oncology fellows interested in CH and 34 academically productive faculty mentors from different institutions across North America were paired in a meticulous process that considered individual interests, experiences, and background. Pairs were expected to meet virtually once a month. Participation in a scholarly project was optional. A mixed-methods sequential explanatory design was used to evaluate the program using mentee and mentor surveys, a mentee interview, and a mentee focus group. Thirty-three mentee-mentor pairs (94.2%) completed the program. Sixty-three percent of mentee respondents worked on a scholarly project with their mentor; several mentees earned publications, grants, and awards. Mentee perception that their assigned mentor was a good match was associated with a perceived positive impact on confidence (P = .0423), career development (P = .0423), and professional identity (P = .0302). Furthermore, 23 mentees (66%) accepted CH faculty positions after fellowship. All mentor respondents believed that this program would increase retention in CH. This mentorship program demonstrates a productive, beneficial way of connecting mentees and mentors from different institutions to improve the careers of CH trainees, with the ultimate goal of increasing retention in CH.