bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review and Meta-Analysis of the Association between Childhood Exposure to Intimate Partner Violence and Intimate Partner Violence Victimization/Perpetration in Adulthood in Africa
Authors: Wadji Dany Laure , Pirro Teresa , Langevin Rachel
Published: October 2024

Intimate partner violence (IPV) is widespread in many African countries. Evidence, mainly from Western countries, shows that exposure to IPV in childhood is an important risk factor for experiences of IPV in adulthood. However, to date, no systematic review has synthesized the evidence on this association for individuals living in Africa, which is the goal of the current study. We used three search strategies: database searches (e.g., MEDLINE and PsycINFO), manual searches, and machine learning tools (e.g., Connected Papers). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included peer-reviewed studies (in French or English) that reported quantitative or qualitative associations between childhood exposure to IPV and later IPV victimization/perpetration. A total of 48 studies from 29 African countries were included ( N = 520,000 participants). Pooled effects indicated an association between childhood exposure to IPV and IPV victimization for females (odds ratio [OR] = 2.46, 95% CI [2.09, 2.91], p < .001) and males (OR = 1.76, 95% CI [1.57, 1.97], p < .001). Similarly, males (OR = 1.92, 95% CI [1.60, 2.29], p < .001) and females (OR = 3.04, 95% CI [2.51, 3.69], p < .001) who were exposed to IPV in childhood were more likely to perpetrate IPV compared to those with no childhood exposure. Effect sizes varied substantially across studies (0.89–5.66), suggesting that other risk factors should be considered in future studies. This review provides unique insights on cycles of IPV in Africa that may usefully inform practice and research.
Plasma-derived Exosomal miR-25-3p and miR-23b-3p as Predictors of Response to Chemoradiotherapy in Esophageal Squamous Cell Carcinoma
Authors: Jing Zhao , Guo Zhen , Zhang Chuanfeng
Published: October 2024

Background

Exosomal miRNAs have emerged as promising biomarkers for cancer. However, little is known about the role of exosomal miRNAs in the response prediction of esophageal squamous cell carcinoma (ESCC) patients treated with chemoradiotherapy (CRT).

Methods

In this prospective study, 40 ESCC patients treated by CRT were enrolled from January 2021 to June 2022. Exosomes were isolated from plasma through EXODUS platform. We used small RNA sequencing in 14 samples of ESCC patients (7 responders, 7 non-responders) and the selected exosomal miRNAs were further validated in the extended cohort of 40 ESCC patients by quantitative real-time polymerase chain reaction (qRT-PCR).

Results

In the discovery phase, we identified five significantly differentially expressed exosomal miRNAs from miRNA sequencing data between the responder and non-responder patients. In the extended groups of responders (n = 27) and non-responders (n = 13), only miR-23b-3p ( p = 0.035, AUC = 0.708) and miR-25-3p ( p < 0.001, AUC = 0.932) were confirmed to have the predictive ability to distinguish non-responders from responders. The patients with low levels of miR-25-3p had a significantly shorter progression-free survival (PFS) than those with high levels ( p = 0.035). Multivariate Cox regression analysis revealed that miR-25-3p may serve as an independent predictive biomarker of PFS in ESCC patients received CRT.

Conclusion

Exosomal miR-25-3p and miR-23b-3p serve as promising biomarkers for predicting the early effectiveness of CRT in locally advanced ESCC patients, whereas miR-25-3p is a novel prognostic marker for ESCC. However, further larger prospective studies are needed to confirm their utility for individualized treatment decision in ESCC.
The Other Squid Game: How Splatoon 3 Promotes a Culture of Coziness, Inclusivity, and Becoming-Cephalopod
Authors: Matovinovic Nikolas
Published: October 2024

The 2021 Netflix series Squid Game's themes of economic critique are often framed as contradicting the exploitative nature of its ancillary texts like Squid Game: The Challenge (Netflix 2023), a reality series that materially reproduces many of the same hardships that the narrative series ostensibly condemns. This paper argues that this is a product of the series’ emphasis on interactive screen media as a marketing and production tool without accounting for how this modal difference would alter the themes of the series’ narrative. The Nintendo multiplayer shooter Splatoon 3 (2022) serves as a useful example of how these challenges can be overcome within the context of a popular multimedia franchise. This is done through the game's emphasis on an ecological coziness whereby principles of cozy gaming and a cephalopod-like tentacular approach to screen media create a text whose themes and inclusive community standards do not exhibit the contradictions seen in Squid Game.
Nation and its students: Reflections on educational activism from a public university in Delhi, India
Authors: Sinha Soumodip
Published: October 2024

This article examines contemporary facets of student mobilization that unfolded with the introduction of the Citizenship Amendment Act of 2019 (CAA). Taking cues from a premier public university in India, the article explores how CAA-driven activism enabled the political socialization of students, and how such a process was entangled with their identities and ideologies. It provides an ethnographic description of student mobilizations for and against the amended citizenship laws to show that (1) the space of the university has witnessed a steady resurgence insofar as the questions of nationalism and nation-building are concerned, (2) higher education in India is at a paradoxical crossroads, and is traversing through rapid neoliberalisation and burgeoning religious nationalism, and (3) ‘competing nationalisms’ between student organizations are on display, where each group believes that their idea of the nation is more suitable than another. Using Pierre Bourdieu’s conceptual armory, the article’s contribution lies in arguing that campus activism leads to the formation of dispositions that enable and assist in the production of political capital among student activists. It concludes that the university then serves as a platform and creates further pathways for accumulating such capital.
Adapting general anaesthesia for a patient with class III obesity and obstructive sleep apnoea undergoing day case laparoscopic cholecystectomy: A case report
Authors: Scott Bevan Michael
Published: October 2024

This report describes the anaesthesia provided for a class III obese patient with obstructive sleep apnoea, undergoing an elective laparoscopic cholecystectomy. Several adaptations were required to provide safe anaesthesia. A McGrath video laryngoscopy was utilised for intubation. The patient was positioned in the ramped position, thereby increasing time to desaturation on induction of anaesthesia. Pressure controlled ventilation – volume guaranteed mode was selected for ventilation to provide consistent tidal volumes. An increased level of positive end-expiratory pressure was utilised to minimise atelectasis. Drug doses were carefully considered and calculated with the aid of The Society for Obesity and Bariatric Anaesthesia dose calculator. The airway management adaptations provided an unobstructed view for intubation. Peak airway pressures during surgery remained within safe limits and no atelectasis was evident postoperatively. Pain was kept under control and desaturation was avoided during postanaesthetic care. The patient was discharged home later that evening.
Remembering activism: Means and ends
Authors: Merrill Samuel , Rigney Ann
Published: October 2024

This editorial introduces the 12 articles collected in this special issue on Remembering Activism: Explorations in the memory-activism nexus. It frames the articles within current debates in the field of memory studies and social movement studies on the entanglements between memory work, on the one hand, and activism directed towards social transformation, on the other. In particular, it highlights the ways in which the memory of earlier activism is mobilised within later movements; in the process, it also identifies various forms of activist memory work where remembrance is an integral part of the activist repertoire and one of the means used to achieve political ends.
Navigating victimhood: Women’s life writing and activist memory in Turkey
Authors: Drechselová Lucie
Published: October 2024

Owing to its gendered connotations of powerlessness, passivity and lack of agency, victimhood is an uncomfortable category for many veteran women activists from the left-wing revolutionary movements of the 1960s and 1970s. Based on an empirical study of the autobiographies of women activists in Turkey, this article is framed by the activist turn in memory studies, which has shifted scholarly attention away from victimhood, trauma and suffering towards social movements and memories of struggles. It considers a form of ‘activist victimhood’ as an identity under construction. The article shows how veteran female activists in Turkey navigate this category and transform it for strategic purposes. Memories of imprisonment and state-inflicted violence have legitimised women’s speaking out and have opened up a space for the circulation of women’s life stories. The article describes how activist women through autobiographies navigate the gendered positions historically attributed to them, adapting as well as challenging them.
Hepaticogastrostomy versus hepaticogastrostomy with antegrade stenting for malignant biliary obstruction: a systematic review and meta-analysis
Authors: Paraskevopoulos Panagiotis , Obeidat Mahmoud , Bednárik Dániel , Martinekova Petrana , Veres Dániel Sándor , Faluhelyi Nándor , Mikó Alexandra , Mátrai Péter , Hegyi Péter , Erőss Bálint
Published: October 2024

Background:

Combining antegrade stenting (AGS) and hepaticogastrostomy (HGS) is an increasingly used endoscopic ultrasound-guided intervention when stenting by endoscopic retrograde cholangiopancreatography is impossible.

Objectives:

We comprehensively assessed the benefits and downsides of combined AGS and HGS (HGS procedure with AGS, HGAS).

Data sources and methods:

From 788 HGS and 295 HGAS cases, a random-effects meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Five electronic databases were searched for studies on HGS with or without AGS from inception until May 2024. The odds ratio (OR) and pooled rates were used for single and two-arm comparisons with 95% confidence intervals (CI).

Results:

From 26 eligible studies. The pooled technical and clinical success was 94% (CI: 92%–96%) and 88% (CI: 84%–91%) for HGS and 89% (CI: 83%–93%) and 94% (CI: 89%–97%) for HGAS, respectively. Pooled OR of HGAS and HGS showed an OR = 0.38 (CI: 0.07–2.00) for technical success and an OR = 1.02 (CI: 0.50–2.06) for clinical success. The pooled adverse event rates were 20% (CI: 16%–25%) for HGS and 14% (CI: 9%–20%) for HGAS, whereas pooled OR showed an OR = 1.09 (CI: 0.30–3.94). For re-intervention, an OR = 0.37 (CI: 0.27–0.52) was found. Time to stent dysfunction increased, HGAS 333 (CI: 280–Not reached) and HGS 209 (CI: 120–325) with no change in overall survival HGS 117 (CI: 94–147) and 140 (CI: 105–170).

Conclusion:

The use of HGAS appears to increase clinical success and reduce the need for re-intervention. Overall adverse event rates were similar but bile leakage prevalence was decreased. Time to stent dysfunction seems to increase with no change in overall survival.

Trial registration:

Our protocol was prospectively registered with PROSPERO (CRD42024509412).
Long-term analysis of infections and associated risk factors in patients with multiple sclerosis treated with ocrelizumab: pooled analysis of 13 interventional clinical trials
Authors: Derfuss Tobias , Bermel Robert , Lin Chien-Ju , Hauser Stephen L. , Kappos Ludwig , Vollmer Timothy , Comi Giancarlo , Giovannoni Gavin , Hartung Hans-Peter , Weber Martin S. , Wang Jianmei , Jessop Nikki , Chognot Cathy , Craveiro Licinio , Bar-Or Amit
Published: October 2024

Background:

Patients with multiple sclerosis (PwMS) have an increased risk of infections.

Objectives:

To characterize incidence, clinical characteristics, outcomes and risk factors of infections, and serious infections (SIs) in ocrelizumab (OCR)-treated PwMS.

Design:

Post-hoc analysis of pooled data from 6155 patients in 13 clinical trials.

Methods:

Descriptive analyses of clinical characteristics and outcomes were reported over ⩽14 years. A Poisson Generalized Estimating Equation model was constructed to examine risk factors in a subgroup of patients with longer exposure to OCR ( n = 2092).

Results:

Over a median (max) treatment period of 3.7 (13.9) years, 420/6155 patients (6.8%) experienced 583 SIs, excluding coronavirus disease 2019. Incidence rates in relapsing multiple sclerosis (RMS; 1.50 per 100 patient years [95% confidence interval (CI): 1.34–1.68]) and progressive multiple sclerosis (PMS; 3.70 [95% CI: 3.27–4.17]) remained stable over this period. Lower respiratory tract, urinary tract, abdominal and gastrointestinal, and skin infections were the most commonly reported SIs. Most SIs (~90%) resolved, and treatment with OCR was continued in >80% of cases. The presence of 1 or ⩾2 comorbidities (rate ratio = 1.66, 2.73, respectively), recent relapse activity (2.06), and Expanded Disability Status Scale (EDSS) score ⩾6.0 (2.02) were significant risk factors for SIs in patients with RMS treated over a median (max) period of 8.3 (11.2) years. In patients with primary PMS treated over a median (max) period of 7.1 (11.8) years, an EDSS score ⩾6.0 was associated with the greatest risk of SIs, a 4-fold increase (rate ratio, 4.31), followed by abnormal immunoglobulin (Ig)M levels (1.89), the presence of ⩾2 comorbidities (1.80), and having overweight/obesity (1.46). Time on OCR and abnormal IgG levels were not significantly associated with an increased SI risk.

Conclusion:

Continuous long-term treatment with OCR is associated with a manageable infection risk profile. Optimal disease control and addressing modifiable risk factors may reduce the risk of infections.
Thrombectomy for patients with a large infarct core: a study-level meta-analysis with trial sequential analysis
Authors: Jhou Hong-Jie , Yang Li-Yu , Chen Po-Huang , Lee Cho-Hao
Published: October 2024

Background:

The effectiveness and safety of endovascular treatment compared with medical management alone regarding outcomes for patients with a large infarct core remain uncertain.

Objectives:

To juxtapose the clinical outcomes of thrombectomy versus the best medical care in patients with a large infarct core.

Design:

Systematic review and meta-analysis.

Data sources and methods:

We conducted searches in PubMed, Cochrane, and Embase for articles published up until November 8, 2023. Randomized trials were selected for inclusion if they encompassed patients with large vessel occlusion and sizable strokes receiving thrombectomy. The primary outcome was functional outcomes at 3 months after pooling data using random-effects modeling. Safety outcomes included mortality at 3 months, symptomatic intracranial hemorrhage (SICH), and decompressive craniectomy. We performed a trial sequential analysis to balance type I and II errors.

Results:

From 904 citations, we identified six randomized trials, involving a cohort of 1897 patients with a large ischemic region. Of these, 953 individuals underwent endovascular thrombectomy. At 3 months, thrombectomy was significantly correlated with better neurological prognosis, as evidenced by the increased odds of good functional outcomes (odds ratio (OR), 2.90; 95% confidence interval (CI), 2.08–4.05) and favorable functional outcomes (OR, 2.40; 95% CI, 1.86–3.09). Mortality rates did not demonstrably diminish as a consequence of the endovascular management (OR, 0.78; 95% CI, 0.58–1.06). However, the incidence of SICH was greater in the thrombectomy group compared to those with only medical treatment (5.5% vs 3.2%; OR, 1.77; 95% CI, 1.11–2.83). The application of trial sequential analysis yielded definitive evidence regarding favorable function outcomes and a shift in the distribution of modified Rankin scale scores at 3 months; however, others remained inconclusive.

Conclusion:

The results from most of the included trials display consistency. Meta-analysis of these six randomized trials offers high-quality evidence that thrombectomy significantly mitigates disability in patients with a large infarction, while also increasing the risk of SICH.

Trial registration:

PROSPERO, CRD42023480359.
Exploring the Adoption Phenomenon of Artificial Intelligence by Doctoral Students Within Doctoral Education
Authors: Oliveira Joey , Murphy Tim , Vaughn Ginger , Elfahim Salim , Carpenter Rob E.
Published: October 2024

The adoption of artificial intelligence (AI) in academia is an emerging field of interest. However, there is scant literature that explores the phenomenon of AI adoption by graduate students in doctoral education. This study employs collaborative autoethnography to explore and better understand the nuances of how doctoral students experience AI technologies within academic pursuits. A critical analysis of data revealed that the collective researcher-participant experiences offered the primary overarching theme of adoption strategy, with four distinct subthemes: adoption fear, adoption resistance, adoption feasibility, and adoption ethics. The findings suggest a balanced approach to AI adoption depends on the development of comprehensive strategies that are informed by a deep understanding of both the technological capabilities and the human factors involved. We urge both doctoral students and educators involved in doctoral programs to think critically about these identified themes. For doctoral students, this analysis offers valuable insights into challenges associated with integrating AI technologies into formal learning environments, potentially enhancing a management strategy for their doctoral studies. Educators tasked with integrating and evaluating AI technologies for doctoral coursework may develop a deeper understanding of the challenges their students may encounter during the adoption process.
Is the Frequency of a Targeted Neuromuscular Training Program a Factor in Modifying Knee Joint Loading During Typical Netball Landing Tasks?
Authors: Boey Desmond , Joseph Ranald , Lee Marcus
Published: October 2024

Background:

Unplanned sidestep cutting and forward single-leg jump-landing contribute to non-contact anterior cruciate ligament (ACL) injuries in netball. Neuromuscular training programs (NMTPs) have shown promising results in reducing injury risk in certain populations when compliance is high. Compliance is easier to achieve when NMTPs are effective yet require minimal time for completion.

Hypothesis:

Once- and thrice-weekly intervention groups would be equally effective in reducing knee abduction and internal rotation moments during forward single-leg jump landing and unplanned sidestep cutting.

Study Design:

Randomized controlled trial.

Level of Evidence:

Level 3.

Methods:

External peak knee abduction and peak knee internal rotation moments during unplanned sidestep cutting and forward single-leg jump-landing were assessed pre- and post-intervention for 17 elite-level female netballers assigned randomly to either a once-weekly or thrice-weekly group. Regular netball training continued throughout the intervention, which lasted 6 weeks (30 minutes/session). One-way analysis of covariance (α = 0.05) was utilized to compare post-intervention peak knee abduction and peak knee internal rotation moments between groups, controlling for pre-intervention knee moments during the forward single-leg jump-landing and unplanned sidestep cut. Paired t tests were used to examine within-group changes in knee moments pre- versus post-intervention.

Results:

For unplanned sidestep cuts on the right leg, both groups differed significantly, with the once-weekly group displaying a decrease in peak knee internal rotation moments [ F(1,14) = 5.23; P = 0.04] whereas the thrice-weekly group did not. No other significant group interactions were found.

Conclusion:

A condensed NMTP with targeted exercises, performed once-weekly as part of regular training, shows potential to reduce peak knee internal rotation moments that are injurious to the ACL during unplanned sidestep cutting in adult female netballers.

Clinical Relevance:

A once-weekly targeted NMTP would pose minimal disruption to a high-performing athlete’s training schedule and likely increase compliance to ensure the success of the NMTP.
Training Model for Extended Career Athletes: A Narrative Review
Authors: Caparros Toni
Published: October 2024

Context:

Today’s elite and professional sports tend to feature older, more seasoned athletes, who have longer sporting careers. As advancing age can potentially limit peak performance, balancing training load is necessary to maintain an optimal state of performance and extend their sports career.

Objective:

To describe an appropriate training model for extended career athletes.

Data Sources:

Medline (PubMed), SPORTDiscus, ScienceDirect, Web of Science, and Google Scholar.

Study Selection:

A search of the literature between January 1, 2015 and November 22, 2023 was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Study Design:

Narrative review.

Level of Evidence:

Level 4.

Data Extraction:

Data were extracted from studies related to the management of training and performance of athletes with extended and long careers.

Results:

A total of 21 articles related to extended careers were found. Key themes from these papers included: expertise, biological maturation, and specificity; epidemiology and health; athlete monitoring; strength training; load management and detraining; success management.

Conclusion:

A training model for extended career athletes should balance the deleterious effects of age with the athletes’ knowledge of, and expertise within, the sport. Designing specific training that accommodates previous injuries, training load intolerances, and caters for quality of life after retirement should be key considerations. Load management strategies for athletes with extended careers should include strength training adaptations to minimize pain, load-response monitoring, a broad range of movement, recovery and intensity activities, and the avoidance of large training load peaks and periods of inactivity.
Mapping the landscape of telemedicine and technology in behavioral addiction treatment: A bibliometric review
Authors: Tan Hui Shan , Syidda  , Zhang Melvyn WB
Published: October 2024

Background

Behavioral addiction (BA) involves compulsive behaviors causing distress or interference with normal functions, akin to substance addiction. Presently, only gambling and gaming disorders are recognized, necessitating further exploration into behaviors like binge-eating, shopping, and internet addiction. Telemedicine, utilizing information and communication technologies, offers remote healthcare services. Reviews on internet-based interventions for BA show mixed efficacy, particularly for gambling disorder. However, research predominantly focuses on gambling, neglecting other BAs. This bibliometric review aims to map research trends and highlight gaps, emphasizing the need for broader telemedicine interventions beyond internet-based treatments.

Objectives

Examine the existing literature regarding telemedicine and technology-driven interventions for BA by analyzing the current research status and delineating publication patterns. Furthermore, highlight possible future research directions.

Results

Analysis revealed increasing research output, notably from Asian countries. Virtual reality (VR) interventions for gaming addiction and smartphone applications for managing addictive behaviors emerged prominently. Research gaps exist, particularly for other BA types.

Conclusions

Telemedicine and technology show promise for BA treatment, especially in gambling disorder. However, research gaps remain, necessitating further investigation across diverse BA types and populations. This review provides insights into the evolving landscape of telemedicine and technology in BA treatment, highlighting the need for continued research.
Contested agendas and discursive strategies of sustainability: A critical analysis of promotional discourses at the World Expo
Authors: Lee Kyungsun Karen , Kim Michael Dokyum
Published: October 2024

Sustainability is a global discourse that relies on local commitment, yet few studies have compared how different countries interpret it based on their socioeconomic contexts. This study examines the agendas and the discursive strategies of sustainability at Expo 2020's Sustainability District, approached as a site of international public relations, through content and thematic analyses of the exhibition materials. Findings show that developed countries predominantly focused on economic and environmental dimensions, emphasizing green technology, energy, and responsible consumption and production. Their discourses aligned with the logic of ecological modernization, prioritizing corporate interests and techno-centric solutions. In contrast, less-developed countries were more likely to address all four dimensions of sustainability—social, economic, environmental, and cultural—highlighting issues such as gender equality, poverty, peace, and cultural preservation. These exhibitions reflected the complex realities faced by these countries due to environmental degradation and global political-economic dependencies. This paper argues that the predominant discourse of sustainable development, as reflected in the promotional materials of highly developed countries, reinforces corporatized and technocratic perspectives, thereby marginalizing concerns related to cultural preservation and distributive justice.
Knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia: a cross-sectional study
Authors: Larebo Yilma Markos , Anshebo Abebe Alemu , Behera Sujit Kumar , Gopalan Natarajan
Published: October 2024

Background:

Ethiopia is a country with a high endemicity of the hepatitis B virus, and the primary mode of transmission for this virus is mother-to-child transmission. However, the country lacks a comprehensive plan for viral hepatitis surveillance, prevention, and control.

Objectives:

To assess the knowledge, attitudes, and practices toward preventing and controlling hepatitis B virus infection among pregnant women attending antenatal care at a University Hospital in Central Ethiopia.

Design:

A hospital-based cross-sectional study was conducted among pregnant women from October to November 2023 at a University Hospital in Central Ethiopia.

Methods:

A total of 412 pregnant women were selected and included in the study using a systematic random sampling technique. An interviewer-administered questionnaire was used to collect the data. The collected data were imported into Epi-data version 3.1 and then exported to the Statistical Package for Social Sciences version 25 for analysis. In the bivariate analysis, variables with a p-value less than 0.25 were included in the multivariate analysis. A logistic regression model was used. A p-value <0.05 indicated statistical significance.

Results:

The overall response rate was 94.1%. Of the total 412 respondents, 37.6% exhibited good practices. Notably, pregnant women within the age categories of 29–39 years (adjusted odds ratio (AOR): 0.31; 95% confidence interval (CI): 0.15, 0.64) and ⩾40 years (AOR: 0.17; 95% CI: 0.06, 0.50), residing in rural areas (AOR: 0.35; 95% CI: 0.17, 0.70), with smaller family sizes (AOR: 0.13; 95% CI: 0.07, 0.25), lacking information about hepatitis B virus infection (AOR: 5.15; 95% CI: 2.91, 9.13), having a positive attitude (AOR: 0.03; 95% CI: 0.02, 0.06), and possessing good knowledge (AOR: 0.38; 95% CI: 0.20, 0.71) were significantly associated with poor practice.

Conclusion:

This study revealed that pregnant women had a low level of knowledge, attitudes, and practices related to hepatitis B virus infection prevention and control. A greater understanding is necessary to effectively prevent and control the spread of infection through prioritized health education programs targeting pregnant women. These programs must focus on raising awareness through campaigns that promote knowledge and immunization for their children.
Understanding the nature and impact of cognitive fluctuations and sleep disturbances in dementia with Lewy bodies: A qualitative caregiver study
Authors: Matterson Ellie , Wilson-Menzfeld Gemma , Olsen Kirsty , Taylor John-Paul , Elder Greg J
Published: October 2024

Objectives:

Dementia with Lewy bodies is characterised by rapid fluctuations in attention, which are known as “cognitive fluctuations.” Despite the fact that cognitive fluctuations are considered to be a core dementia with Lewy bodies symptom, they are very difficult to define and measure using existing quantitative subjective measurement tools, which are typically completed by caregivers. Cognitive fluctuations are also likely to be influenced by various aspects of sleep, but this is as yet unexplored. The primary aim of this qualitative study was to investigate the phenomenology of cognitive fluctuations in dementia with Lewy bodies by understanding caregiver experiences.

Methods:

Seven caregivers of people with dementia with Lewy bodies completed one-to-one semistructured interviews, which were conducted by telephone. Caregivers were asked to describe the nature, frequency, duration and potential triggers of cognitive fluctuations that were experienced by the individual with dementia with Lewy bodies. Caregivers were also asked about the subjective sleep experience of the individual with dementia with Lewy bodies, and about their own sleep experiences. Interviews were audio recorded, transcribed verbatim and analysed using Thematic Analysis.

Results:

Caregivers reported that there was a great deal of individual variation in the frequency, duration and severity of cognitive fluctuations. Patient sleep disturbances, including excessive daytime sleepiness, nocturnal awakenings, restless legs and sleep apnoea, were common. However, the impact of sleep alterations or experiences upon the fluctuations was reported to be less clear. Caregivers also reported that their own sleep was negatively affected, potentially due to actively listening for overnight events and behaviours.

Conclusions:

Qualitatively, caregivers report that dementia with Lewy bodies cognitive fluctuations show large individual variations in terms of their frequency, duration and severity, but that subjectively, sleep may not consistently influence this symptom. Specific, caregiver-focussed interventions are likely to be necessary to maintain good sleep health in dementia with Lewy bodies caregivers.
Radiation therapy for a case of poikilodermatous plaques in an otherwise healthy young man: A case report
Authors: Biba Ursula , Poppens McKayla J , Collier Erin K , Cheng Kyle
Published: October 2024

Poikilodermatous mycosis fungoides is a rare variant of cutaneous T-cell lymphoma that is often misdiagnosed given its diverse clinical presentation. Often diagnosed as vitiligo or morphea, poikilodermatous mycosis fungoides can be asymptomatic or present as pruritic lesions. Discrepant signs and symptoms can lead to diagnostic delays. No consensus on its treatment currently exists, but treatment options include corticosteroids, phototherapy, and radiation. Here, we present a case of poikilodermatous mycosis fungoides in an otherwise healthy young man who showed limited improvement after years of treatment with topical antifungals, topical steroids, and phototherapy. Improvement was seen following a single session of radiation therapy, highlighting radiation’s potential in cases resistant to traditional first-line treatments. We propose that radiation may be efficacious for the treatment of poikilodermatous mycosis fungoides in cases of delayed diagnosis or resistance, and further research is needed to investigate radiation monotherapy as a treatment option for poikilodermatous mycosis fungoides.
Human cystic echinococcosis detected in mesentery: A case report
Authors: Schandiz Hossein , Nasser Salah NM , Ekeberg Bente , Pedersen Mette K , Leegaard Truls M , Sauer Torill
Published: October 2024

Cystic echinococcosis, although rare in Europe, presents a diagnostic challenge when encountered, especially in atypical locations such as the mesentery. This case report is significant because it highlights the unique presentation of mesenteric hydatid cysts, emphasizing the importance of considering uncommon etiologies in differential diagnosis, particularly in immigrant populations. The novelty of this case lies in its rarity and the diagnostic dilemma it posed, ultimately leading to successful management through prompt recognition and accurate diagnosis. A 33-year-old pregnant female from East Africa presented with intermittent abdominal pain during pregnancy. Imaging revealed a cystic mass adjacent to the mesentery, initially misdiagnosed as an ovarian cyst. Postpartum, she developed acute abdominal symptoms, leading to a revised diagnosis of a ruptured hydatid cyst. Antiparasitic treatment and surgical intervention were initiated, resulting in successful management. This case underscores the necessity of prompt recognition and accurate diagnosis of rare conditions such as mesenteric hydatid cysts, particularly in immigrant populations. A multidisciplinary approach is crucial for optimal patient care in such cases.
A young woman with unexpected panhypopituitarism: Case Report
Authors: Humes Kathryn
Published: October 2024

Nausea and vomiting are common symptoms most frequently caused by gastrointestinal etiologies. Alternatively, panhypopituitarism is a rare condition in which two or more pituitary hormones are deficient. In this case, we describe a 25-year-old type II diabetic woman with severe and persistent nausea and vomiting. She had lost 9 kg of weight since her symptoms began 5 weeks prior. Vital signs were normal, and laboratory studies showed metabolic acidosis thought to be due to fasting ketosis. She underwent an extensive gastrointestinal workup and treatment plan without successful control or abatement of symptoms. Upon further questioning, she was found to have been experiencing secondary amenorrhea and body hair changes. Testing revealed panhypopituitarism with severe adrenocorticotropic hormone and cortisol deficiency. She was started on immediate treatment, and her symptoms resolved in less than 24 h. Imaging showed suspected Rathke’s cyst, which has since been removed. Based on similar cases and neuroanatomy, we suspect that her symptoms were due to her severe cortisol deficiency, such that a lack of sympathetic tone leads to increased vagal tone and increased neuronal signals from the brain’s emetic center. This conclusion is further supported by the rapidity of resolution of her nausea and vomiting. This case highlights this rare and severe case of panhypopituitarism and also comments on the importance of a thorough history and physical exam, which ultimately lead to the uncovering of an unexpected diagnosis.
Hypokalaemic myopathy associated with iatrogenic hypercorticism in a cat
Authors: Tiozzo Ambrosi Annamaria , Lovato Giorgia , Pintore Laura , Callegari Carolina , Tamborini Alice
Published: October 2024

Case summary

A 12-year-old castrated male domestic shorthair cat was referred for investigation of lethargy, hindlimb weakness with plantigrade stance and ventroflexion of the neck. The cat was fed a balanced diet and had received methylprednisolone acetate at a dose of 20 mg intramuscularly every 6 months for 6 years. On blood work, severe hypokalaemia and marked elevation of muscle enzymes were noticeable. The findings were suggestive of hypokalaemic myopathy. Urine fractional excretion of potassium (FEk) was moderately high (9.04%), and serum aldosterone was below the reference interval. An adrenocorticotropic hormone (ACTH) stimulation test was compatible with adrenal suppression. Upon hospitalisation, the patient was given intravenous (IV) Ringer lactate solution supplemented with potassium chloride and oral potassium citrate. The serum potassium concentration normalised by the fifth day of hospitalisation; therefore, IV potassium supplementation was suspended. The cat was discharged with oral potassium and the dose was gradually reduced over time. After 4 months, the cat was clinically normal; the serum potassium concentration remained within the normal range and the adrenal glands showed some response to ACTH stimulation. Potassium supplementation was therefore discontinued. One month later, the serum potassium concentration was still within normal limits and at the time of writing (7 months after presentation), no clinical signs had reoccurred.

Relevance and novel information

This report describes a case of hypokalaemic myopathy associated with iatrogenic hypercorticism in a cat. This condition was successfully treated with supplementation of potassium and a complete clinical remission was achieved within 4 months.
Dubbing language-therapy CINEma-based in aphasia post-stroke (DULCINEA): A feasibility randomized crossover controlled trial
Authors: Fuentes Blanca , Jordi-Perea Pablo , Sempere-Iborra Cristian , Tarifa-Rodríguez Aida , de Celis-Ruiz Elena , Martín Alonso Marta , Ruiz-Ares Gerardo , Rigual Ricardo , Rodríguez-Pardo Jorge , Alonso-López Elisa , Alonso de Leciñana María , Virués-Ortega Javier , Borobia Alberto M , Jiménez-González María , Martínez-Balaguer María , Blanco Paloma , Bueno Nereida
Published: October 2024

Background

Helping people recover from aphasia is among the top 10 research priorities relating to life after stroke.

Objective

We aimed to evaluate the feasibility of dubbing techniques (using newly developed software) for post-stroke aphasia therapy and explore its potential efficacy.

Methods

Randomised, crossover, interventional, feasibility trial that included patients with chronic post-stroke non-fluent aphasia. The intervention consisted of an individualised programme (16 sessions; 8 weeks) based on dubbing words and sentences progressively adapted to the severity of the aphasia. Patients were allocated to groups that underwent therapy within the first 3 months, or between 3 and 6 months from inclusion, each group serving as the control during the non-therapy periods. Outcomes were the pre-post differences in the Communicative Activity Log, the Boston Diagnostic Aphasia Examination, the General Health Questionnaire-12, the Stroke Aphasia Quality of Life Scale, and the Western Aphasia Battery Revised, administered by psychologists blinded to the patients’ allocation.

Results

Recruitment was limited due to COVID-19 and prematurely stopped because of funding coming to an end. A total of 23 patients were randomised, 20 of whom completed the study (1 withdrew consent, and 2 dropped out). The adherence rate to the allocated group was 95.3%. No statistically significant differences were found in any of the outcomes; however, 17 (85%) patients reported subjective improvements in communication skills.

Conclusions

This trial shows the feasibility of dubbing therapy (using dedicated software) for patients with post-stroke non-fluent aphasia. Although it lacks statistical power, certain effects on language and communication cannot be ignored.
Lived experiences of school counsellors: Needs after the earthquake
Authors: Çitil Akyol Canan
Published: October 2024

School counsellors who work with children and young people within the education system and have experienced trauma themselves can be significantly affected by challenging events. The current research focussed on understanding the post-trauma needs of school counsellors who continue their work in earthquake-affected regions. A phenomenological design was used in this study. Twenty-two school counsellors who experienced the 7.7 and 7.6 magnitude Maraş earthquakes in Türkiye in 2023 and are still working in the affected areas were interviewed. The findings showed that the needs of school counsellors after the earthquake could be categorized into three themes: (1) I want practice, not theory, (2) I want hope for myself and (3) I want people for my profession. Specifically, school counsellors reported a need for trauma and crisis intervention training, individual support, supervision and physical resources (e.g. collaboration, accommodation and stationery). The implications for school counselling are discussed.
Racialized experiences and perspectives of international students enrolled in a Christian University: A preliminary qualitative analysis
Authors: Kim Paul Youngbin , Govender Mika , Bau Katharine E , Chiangpradit Nicole V
Published: October 2024

Research regarding the experiences and perspectives of international students at Christian institutions around race and racism remains underdeveloped. As a preliminary, qualitative investigation, the current study explored the experiences and perspectives of 10 international students enrolled at a Christian institution located in the Pacific Northwest region of the United States. Themes that emerged included perspectives on how race is viewed in their country of origin, reports of racialized experiences in the U.S., perspectives on how racial conversations might be improved, views on how education has contributed to more activism and a sense of personal responsibility, religion’s role in racial justice, and media’s role in racial justice. The findings point to the value of highlighting the experiences of international students at Christian institutions, and they point to some promising implications for those in Christian higher education working to help international students flourish.
Protective Factors Related to Desistance in Sexual Offending: A Scoping Review
Authors: Garant Etienne , Ouellet Frédéric
Published: October 2024

Although most offenders who have committed a sex crime will not reoffend, an excessive amount of attention has been paid to the process that leads a minority to commit a new offense. What are the protective factors that contribute to the absence of recidivism among most of these sex offenders? This scoping review provides an overview of the current state of the literature on desistance among sex offenders as well as a list of the empirically tested protective factors that contribute to it. Peer-reviewed articles and grey literature were retrieved through database searches and reference harvesting following the elaboration of an internal grid composed of approximately 20 keywords and specific inclusion criteria. Articles were included if the majority of each study’s sample had committed a sex offense, factors explaining desistance from sexual offending were explicitly addressed, and all participants in the various studies were still considered desistors at the time of our search. From a database of 6,556 articles published between 1985 and 2022, 26 studies were retained, and more than 150 different protective factors were identified and grouped into 32 distinct subcategories. Our analysis revealed that the selected studies conceptualize desistance differently and that this choice not only affects the protective factors identified but could also influence ideas about how to intervene with sex offenders.
Exploring the Influence of Digital Infrastructure on Fiscal Self-Sufficiency: Empirical Evidence From 29 Provincial in China
Authors: Mai Wenjun , Li Cunlin , Chen Yanpeng , Mai Lijun
Published: October 2024

As a major emerging economy, China government debt burden on local governments remains substantial, so enhance fiscal self-sufficiency and debt sustainability is so important. Utilizing panel data spanning from 2004 to 2020 across 29 provincial-level governments in China, this study employs the SYS-GMM approach to empirically validate the significant negative impact of digital infrastructure development on governments’ fiscal self-sufficiency rates. Furthermore, the research shows the significant positive mediating role of technological expenditure efficiency between digital infrastructure and fiscal self-sufficiency, implying that digital infrastructure can enhance fiscal self-sufficiency by augmenting technological innovation efficiency. Under the moderating effect mechanism, fiscal decentralization positively moderates the relationship between digital infrastructure and fiscal self-sufficiency. Heterogeneity analysis reveals that the impact of digital infrastructure on fiscal self-sufficiency is more pronounced in high-density regions. At the same time, its effect is less significant in low-density areas, indicating regional disparities in China’s digital infrastructure development. The contribution of this study is grounded in fiscal decentralization theory, policy recommendations advocate granting local governments greater autonomy over tax categories and broadening their fiscal revenue. Concurrent efforts should be directed towards deepening reforms in the fiscal and taxation systems, as well as budget management mechanisms.
The Effect of Farmer’s Cognition on the Inconsistency Between Behavior and Intention in Manure Application
Authors: Bi Xuehao , Zou Wei
Published: October 2024

Manure utilization in China is below optimum due to the inconsistency between farmers’ behavior and their intention to apply manure to their crops. With increasing constraints on the availability of chemical fertilizer and their impact on the environment, understanding how farmers’ perceptions affect their intention and behavior toward manure application is an issue for the implementation of sustainable agricultural development. This study uses primary survey data from 653 farmers. A probit model was used to assess the influence of cognition on farmers’ intentions, behavior, and the inconsistency between them in the use of manure application. Heterogeneity analysis was conducted to identify differences between farmers with different education levels and operation scales. The results showed that enhancing subjective norms, perceived behavioral control, and behavioral attitudes could increase their intention and behavior. Furthermore, improving the perceived behavioral control and behavioral attitudes of farmers would reduce the inconsistency between behavior and intention. In addition, some differences were identified in the role of farmers’ cognition with different education levels and operation scales. In general, it is necessary to enhance farmers’ comprehensive cognition of the value of manure through publicity and popularization of technology, reduce farmers’ perceptions about difficulties in applying manure through new policies and subsidies, and stimulate farmers’ enthusiasm to participate in the practice.
Intelligent Enhancements in Differentiated Language Education: A Case Study Focused on Learner Needs
Authors: jingyi Xie , Pamintuan Cavin
Published: October 2024

This study investigates methods and effectiveness of implementing Differentiated Instruction (DI) in intelligent education based on learners’ learning needs. The paper employs a mixed-method approach to collect and analyze data from various learner groups. Guided by the assessment results of the KANO model, the research prioritizes attributes for intelligent enhancement during the learning process and devises appropriate methods for instructional interventions. Experimental results demonstrate that DI tailored to learning needs effectively enhances language teaching achievements. Specifically, in language education, regarding Performance Attributes (PA), meticulous segmentation of instructional content is crucial to correspond with specific language knowledge. For Threshold Attributes (TA), emphasis should be placed on fostering autonomous learning and adaptive communicative functions during the teaching process. Regarding Excitement Attribute (EA), it is essential to consider the distinctive needs of learner groups. Finally, the paper discusses collaborative issues among teaching teams, learners, and technical teams.