bluuebunny/crossref_metadata_2025 huggingface dataset:
Stability of orifice-compensated air bearing with rectangular shape considering air film thickness
Authors: Zhang Penghai
Published: April 2024

A theoretical model of the orifice-compensated air bearing with rectangular shape is built to study the stability, the stiffness and the air consumption considering the air film thickness. The study shows that, the pocket volume ratio of less than 0.03 is recommended to avoid the pneumatic hammer. The stability is good and the air consumption is small when the bearing has the high stiffness. Strict control of the structural deformation is crucial as it can significantly affect the stability. Increasing the nozzle number can improve the stability and avoid the choked flow. The findings are of great importance for the design of the orifice-compensated air bearing.
Sexual harassment as a gender inequality and a form of workplace discrimination: A South African perspective
Authors: Malatjie Khomotso Rosina , Mbajiorgu Grace
Published: April 2024

Sexual harassment is not a new phenomenon in South Africa. The continued existence of sexual harassment in the workplace specifically targeted at female employees undermines the constitutional rights to equality, human dignity, privacy, physical and psychological integrity, and fair labour practices. Against this backdrop, this article examines the different contributory factors that exacerbate or provide an enabling environment for sexual harassment to persist namely; gender inequality, sexist attitudes, and inefficient grievance procedures. Using an in-depth analysis of literature scholarly works, government reports, and legislative frameworks aimed at preventing sexual harassment in the workplace, and the selected jurisprudence of the courts, this article scrutinises the phenomenon of sexual harassment as a gendered harm. It evaluates whether there are adequate measures aimed at assisting victims of sexual harassment and gender inequalities in South Africa. Finally, in its conclusion, the article argues that, for labour legislation to efficiently address the prevalence of sexual harassment it should adopt a threefold function namely to address sexual harassment as a form of an unfair labour practice, gender discrimination and psychosocial harm.
The moderating effect of social support on the effectiveness of a web-based, computer-tailored physical activity intervention for older adults
Authors: Alley Stephanie J , Schoeppe Stephanie , Moore Hayley , To Quyen G , van Uffelen Jannique , Parker Felix , Duncan Mitch J , Schneiders Anthony , Vandelanotte Corneel
Published: April 2024

This study aimed to assess the moderating effect of social support on the effectiveness of a web-based, computer-tailored physical activity intervention for older adults. In the Active for Life trial, 243 inactive adults aged 65+ years were randomised into: (1) tailoring + Fitbit ( n = 78), (2) tailoring-only ( n = 96) or (3) control ( n = 69). For the current study, participants were categorised as having higher ( n = 146) or lower ( n = 97) social support based on the Duke Social Support Index (DSSI_10). Moderate-to-vigorous physical activity (MVPA) was measured through accelerometers at baseline and post-intervention. A linear mixed model analysis demonstrated that among participants with lower social support, the tailoring + Fitbit participants, but not the tailoring only participants increased their MVPA more than the control. Among participants with higher social support, no differences in MVPA changes were observed between groups. Web-based computer-tailored interventions with Fitbit integration may be more effective in older adults with lower levels of social support.
Identifying disputants’ attitudinal variations in family mediations: A data mining approach
Authors: Xu Qingxin
Published: April 2024

This article combines linguistic analysis and data mining methods to explore variations in speakers’ evaluative meaning-making in conflict talks. It focuses on conflict style construction through evaluative language, specifically how disputants advance attitudes. The corpus consists of 230 minutes of family mediation talks involving 12 divorcing spouses. The research draws from the Appraisal framework to analyse evaluative meaning-making at a discourse semantics level, capturing both explicit and implicit attitudes, as well as the scaling and dialogic framing of attitudes. Data exploration uses clustering algorithms via RStudio to identify variations in disputants’ discursive behaviour. The findings uncover three conflict styles based on disputants’ preference for attitude advancement formulations, with varying degrees of assertiveness and forcefulness. This study’s contributions include a holistic treatment of evaluative meaning-making, the marriage of digital tools to nuanced linguistic annotation, and a novel interpretation for conflict style. The findings offer fresh insights into disputants’ discursive self-presentation in confrontational exchanges.
Skin deep: A review of early childhood policy affordances for anti-racist practice in England and Scotland
Authors: Tembo Shaddai , Bateson Simon
Published: April 2024

The role of anti-racism in early childhood remains a salient concern for many educators working with young children. Yet to what extent, and through what socio-political paradigms, government guidance supports proactive engagement remains an area to be mapped and explored. In this article, through a critical scoping review we aim to consider the context and policy landscape for anti-racist practice in Scotland and England and examine confluences and divergences between each country.
Psychic TV: The Paranormal as Popular Culture in Japanese Television of the 1990s
Authors: Johnson Daniel
Published: April 2024

NIGHT HEAD was a science fiction drama that aired on Japan’s Fuji TV between 1992 and 1993. The series arrived during a wave of interest in the paranormal, a trend that was embraced by commercial television in both dramatic programs and variety/infotainment talk shows. This boom of interest in the paranormal happened within the thriving economic and cultural environment of Japan’s Bubble Era, a period that saw a rapid expansion of television in addition to the prosperity of markets in real estate and industry. NIGHT HEAD portrays a darker vision of 90s Japan, using visual effects and moody, intense images and sounds to conjure a desperate sensibility. This article will offer an analysis of the “attractive” paranormal turn in Japan during the 1990s, using NIGHT HEAD as a case for considering the intersection of youth, visual effects, and the desire for an alternative way of understanding the world beyond rationality.
Feasibility of a warp-knitted shape memory alloy rehabilitation glove
Authors: Lee Soo-Min , Shin Gyomyung , Im Hyucksoon , Oh Midum , Castro Avalos Sofia , Yoon Mi-Jeong , Kim Joon-Sung , Park Juyeon , Ahn Sung-Hoon
Published: April 2024

Shape memory alloys (SMAs) have an innate property that allows them to return to a memorized form when stimulated. They have been recently designed as flexible fabrics for use in wearable assistive devices. This study aimed to develop a rehabilitation assistive glove with good wearability for a hemiplegic patient using a knitted SMA with a high-unidirectional contractile response. We fabricated warp-knitted SMA actuators, which had higher contractile responses than those of weft-knitted SMA. The use of a knitting loom allowed these actuators to fit all the fingers of a patient. We developed a full-fabric glove, placed the SMA wires on the finger regions to form a tendon-driven structure, and attached knitted SMA actuators to the dorsal and palmar sides of the hand to assist flexion and extension. The joint range of motion after glove actuation increased by 11.620% and 141.710% in flexion and extension, respectively. The range of motion improved more with glove rehabilitation than with thermal stimulation or no actuation. The grip force also increased by 52.400% after rehabilitation exercises. The safety of the heat generated during actuation was confirmed, and its applicability as a thermal stimulus was validated (based on increased skin temperature). These outcomes suggest the practical potential of warp-knitted SMAs in fully fabricated wearable assistive devices.
Optimizing Wound Healing: Examining the Influence of Biopolymers Through a Comprehensive Review of Nanohydrogel-Embedded Nanoparticles in Advancing Regenerative Medicine
Authors: Ahmadi Mahsa , Sabzini Mahdi , Rastgordani Shima , Farazin Ashkan
Published: April 2024

Nanohydrogel wound healing refers to the use of nanotechnology-based hydrogel materials to promote the healing of wounds. Hydrogel dressings are made up of a three-dimensional network of hydrophilic polymers that can absorb and retain large amounts of water or other fluids. Nanohydrogels take this concept further by incorporating nanoscale particles or structures into the hydrogel matrix. These nanoparticles can be made of various materials, such as silver, zinc oxide, or nanoparticles derived from natural substances like chitosan. The inclusion of nanoparticles can provide additional properties and benefits to the hydrogel dressings. Nanohydrogels can be designed to release bioactive substances, such as growth factors or drugs, in a controlled manner. This allows for targeted delivery of therapeutics to the wound site, promoting healing and reducing inflammation. Nanoparticles can reinforce the structure of hydrogels, improving their mechanical strength and stability. Nanohydrogels often incorporate antimicrobial nanoparticles, such as silver or zinc oxide. These nanoparticles have shown effective antimicrobial activity against a wide range of bacteria, fungi, and other pathogens. By incorporating them into hydrogel dressings, nanohydrogels can help prevent or reduce the risk of infection in wounds. Nanohydrogels can be designed to encapsulate and release bioactive substances, such as growth factors, peptides, or drugs, in a controlled and sustained manner. This targeted delivery of therapeutic agents promotes wound healing by facilitating cell proliferation, reducing inflammation, and supporting tissue regeneration. The unique properties of nanohydrogels, including their ability to maintain a moist environment and deliver bioactive agents, can help accelerate the wound healing process. By creating an optimal environment for cell growth and tissue repair, nanohydrogels can promote faster and more efficient healing of wounds.
Empowering Families and Providers With a Lifestyle Medicine Approach to Pediatric Obesity
Authors: Amati J. Blakely , Brackbill Erin L.
Published: April 2024

Pediatric overweight and obesity is a complex chronic medical condition with a multitude of contributing factors. Rates are now nearly double what they were before the COVID-19 pandemic and if the current trajectory holds it is anticipated that by 2050 one in every two US children will experience obesity before the age of thirty-five. Pediatric obesity guidelines emphasize referral to intensive health behavior and lifestyle therapy programs, but these are difficult to access. Front line providers caring for children can use a lifestyle medicine approach within the medical home to make lifestyle changes easier. Lifestyle Medicine can promote a family-oriented, weight-neutral approach by (1) Educating and equipping providers to assess readiness to change and providing high-quality motivational interviewing and lifestyle counseling, (2) Equipping patients and their families with tools involving the six lifestyle interventions to optimize health starting an early age, and (3) Offering a longitudinal uniform office approach to effectively prevent, manage and often reverse obesity and related comorbidities through healthy habit change.
A novel recurrent self-evolving fuzzy neural network for consensus decision-making of unmanned aerial vehicles
Authors: Chen ZY , Meng Yahui , Wang Ruei-Yuan , Jiang Rong , Chen Timothy
Published: April 2024

Currently, for years, unmanned aerial vehicles have been widely applied in a comprehensive realm. By enhancing computer photography and artificial intelligence, it can automatically discriminate against environmental objectives and detect events that occur in the real scene. The application of collaborative unmanned aerial vehicles will offer diverse interpretations which support a multiperspective view of the scene. Due to diverse interpretations of unmanned aerial vehicles usually deviates, thus, unmanned aerial vehicles require a consensus interpretation for the scenario. To previous purposes, this study presents an original consensus-based method to pilot multi-unmanned aerial vehicle systems for achieving consensus on their observation as well as constructing a group situation-based depiction of the scenario. Further, a fuzzy neural network generalized prediction control system known as a recurrent self-evolving fuzzy neural network is mainly used to ensure stability through the use of a descending gradient online learning rule. At the same time, users can think along the lines of evolutionary biological design. Unmanned aerial vehicles can be modeled as system experts for solving group problems that require the definition of conditions that best describe the scene. First, this method allows each unmanned aerial vehicle to set high-level conditions for detection events by aggregating events based on fuzzy information. These aggregated events are modeled by a fuzzy system ontology, which allows each unmanned aerial vehicle to report its preferences in conditions. Therefore, the interpretation of each drone is compressed to achieve a collective interpretation of the state. The final polls, consent and affinity polls confirmed the final decision group’s reliability ratings. The rated consensus indicates how well the collective interpretation of the scene matches each drone’s point of view.
Evaluating treatment efficacy in hospitalized COVID-19 patients, with applications to Adaptive COVID-19 Treatment Trials
Authors: Lin Dan-Yu , Wang Jianqiao , Gu Yu , Zeng Donglin
Published: April 2024

Background

The current endpoints for therapeutic trials of hospitalized COVID-19 patients capture only part of the clinical course of a patient and have limited statistical power and robustness.

Methods

We specify proportional odds models for repeated measures of clinical status, with a common odds ratio of lower severity over time. We also specify the proportional hazards model for time to each level of improvement or deterioration of clinical status, with a common hazard ratio for overall treatment benefit. We apply these methods to Adaptive COVID-19 Treatment Trials.

Results

For remdesivir versus placebo, the common odds ratio was 1.48 (95% confidence interval (CI) = 1.23–1.79; p < 0.001), and the common hazard ratio was 1.27 (95% CI = 1.09–1.47; p = 0.002). For baricitinib plus remdesivir versus remdesivir alone, the common odds ratio was 1.32 (95% CI = 1.10–1.57; p = 0.002), and the common hazard ratio was 1.30 (95% CI = 1.13–1.49; p < 0.001). For interferon beta-1a plus remdesivir versus remdesivir alone, the common odds ratio was 0.95 (95% CI = 0.79–1.14; p = 0.56), and the common hazard ratio was 0.98 (95% CI = 0.85–1.12; p = 0.74).

Conclusions

The proposed methods comprehensively characterize the treatment effects on the entire clinical course of a hospitalized COVID-19 patient.
Novel application of nanomedicine for the treatment of acute lung injury: a literature review
Authors: Chen Xianfeng , Tang Zhanhong
Published: April 2024

Nanoparticles have attracted extensive attention due to their high degree of cell targeting, biocompatibility, controllable biological activity, and outstanding pharmacokinetics. Changing the size, morphology, and surface chemical groups of nanoparticles can increase the biological distribution of agents to achieve precise tissue targeting and optimize therapeutic effects. Examples of their use include nanoparticles designed for increasing antigen-specific immune responses, developing vaccines, and treating inflammatory diseases. Nanoparticles show the potential to become a new generation of therapeutic agents for regulating inflammation. Recently, many nanomaterials with targeted properties have been developed to treat acute lung injury/acute respiratory distress syndrome (ALI/ARDS). In this review, we provide a brief explanation of the pathological mechanism underlying ALI/ARDS and a systematic overview of the latest technology and research progress in nanomedicine treatments of ALI, including improved nanocarriers, nanozymes, and nanovaccines for the targeted treatment of lung injury. Ultimately, these nanomedicines will be used for the clinical treatment of ALI/ARDS.
Reclassification of Genetic Testing Results: A Case Report Demonstrating the Need for Structured Re-Evaluation of Genetic Findings
Authors: Schott Clara , Colaiacovo Samantha , Baker Cadence , Weir Matthew A. , Connaughton Dervla M.
Published: April 2024

Rationale:

Alport Syndrome (AS) is a progressive genetic condition characterized by chronic kidney disease (CKD), hearing loss, and eye abnormalities. It is caused by mutations in the genes COL4A3, COL4A4, and COL4A5. Heterozygous mutations in COL4A4 and COL4A3 cause autosomal dominant Alport Syndrome (ADAS), and a spectrum of phenotypes ranging from asymptomatic hematuria to CKD, with variable extra-renal features. In the past, heterozygous mutations in these genes were thought to be benign, however recent studies show that about 30% of patients can progress to CKD, and 15% can progress to end stage kidney disease (ESKD).

Presenting Concerns:

We present a case of a woman who was noted to have microscopic hematuria pre-living kidney donation. Genetic testing revealed a heterozygous variant of uncertain significance (VUS) in the COL4A4 gene. VUSs are medically nonactionable findings and data show that VUSs can be detected in 41% of all patients who undergo clinical genetic testing. VUSs frustrate clinicians and patients alike. Although they cannot be used in medical decision-making, data suggest that reanalysis can result in the reclassification of a VUS over time.

Diagnosis:

Post-donation, the index patient had a higher than anticipated rise in serum creatinine, raising a concern for possible intrinsic kidney disease. Kidney biopsy was deemed high risk in the setting of a unilateral kidney thereby limiting possible diagnostic intervention to determine the cause of disease.

Intervention:

Re-evaluation of prior genetic testing results and reassessment of the previously identified VUS in COL4A4 was performed 5-years post-donation. These analyses, along with the addition of new phenotypic data and extended pedigree data, resulted in the reclassification of the previously identified VUS to a likely pathogenic variant.

Outcomes:

This case demonstrates the importance of structured, periodic re-evaluation of genetic testing results. With the ever-changing landscape of genetics in medicine, the interpretation of a VUS can be dynamic and therefore warrant caution in living kidney donor evaluations. Studies have shown that about 10% of VUSs can be upgraded to a pathogenic classification after an 18- to 36-month interval. Structured re-evaluation of genomic testing results has not yet been integrated into clinical practice and poses a unique challenge in living kidney donation.

Novel findings:

This case report highlights the variability of the ADAS phenotype caused by pathogenic heterozygous variants in the type 4 collagen genes. It supports the nomenclature change from a benign hematuria phenotype to ADAS, particularly when additional risk factors such as proteinuria, focal segmental glomerulosclerosis or glomerular basement membrane changes on kidney biopsy are present, or as in this case, evidence of disease in other family members.
Miscommunication and Mismatched Expectations: Challenges in an EFL Writing Center
Authors: Mack Lindsay
Published: April 2024

Recently writing centers are expanding to Asian higher education contexts. However, there is a scarcity of research from writing centers in Asian settings and from non-native English speaker (NNES) tutor perspectives. Therefore, the purpose of this study is to enrich understandings of the challenges and expectations perceived by NNES tutors during tutoring writing sessions with intermediate level Japanese EFL (English as Foreign Language) students. A qualitative approach was employed utilizing two data collection methods: 16 interviews with writing tutors, and two quasi-focus groups. Thematic analysis of the data revealed five major categories for challenges perceived by NNES tutors: miscommunication, student silence, mismatched expectations, interpretation of teacher feedback and error correction. It is argued that these are the main challenges that EFL writing tutors face and hence indicate the necessity to train tutors how to deal with them. The implications for creating Asian writing centers and tutor training are discussed.
Characteristics of Rodeo Injuries and Suggestions for Injury Prevention: A Systematic Review
Authors: Box McKenna W. , Wilson Freddie , Pasque Charles B. , Smith Chase D.
Published: April 2024

Background:

Rodeo is a globally popular sport, with its athletes prone to various types of injuries. There is no systematic review discussing rodeo injuries across all age groups.

Purpose:

To (1) review the published literature on incidence, types of injuries, and factors leading to injuries in rodeo athletes; (2) provide prevention recommendations for health care providers; and (3) identify gaps in the research.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A comprehensive search of available literature was electronically performed through MEDLINE, Embase, and SPORTDiscus databases using the key terms “rodeo” and “injury” or “trauma” between 1995 and 2021. A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which identified 116 eligible studies. Outcome data included frequency of injuries, risk factors for injury, and types of injury.

Results:

A total of 23 studies met the inclusion criteria (N = 2105 athletes), of which 13 were retrospective studies. In the included studies, the injury rate per competition exposure (CE) ranged from 4.2 to 19.1 injuries per 1000 CE. Sprains and strains accounted for the highest percentage of injury types, ranging from 15% to 34%. The knee was the most common location of injury, making up 11.1% to 17% of injuries. Concussions occurred in up to 15.3% of injuries for all events and up to 77% of injuries in roughstock events. Of all rodeo events reported, bull riding caused the highest percentage of injuries, making up 19.4% to 58.4% of injuries, and bareback had the second highest at 15.3% to 28.8% of injuries.

Conclusion:

There was a high prevalence of various injury types and mechanisms in rodeo. Improved injury surveillance and the introduction of a comprehensive standardized injury reporting system would be helpful in the future prevention, diagnosis, and treatment of rodeo injuries.
Association Between MRI Signal Intensity of the Repaired Lateral Meniscus and Residual Anterolateral Knee Laxity After ACL Reconstruction
Authors: Chiba Daisuke , Yamamoto Yuji , Kimura Yuka , Sasaki Eiji , Sasaki Shizuka , Tsuda Eiichi , Ishibashi Yasuyuki
Published: April 2024

Background:

Anterolateral knee laxity (ALLx) has been linked to tears of the lateral meniscus (LM) and anterior cruciate ligament (ACL) injury.

Purpose:

To investigate the longitudinal relationship between the signal intensity (SI) of the repaired LM on magnetic resonance imaging (MRI) and residual ALLx after ACL reconstruction (ACLR).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 87 patients who underwent double-bundle ACLR and lateral meniscal repair (mean age, 23.5 years; body mass index, 23.7 kg/m2; 56 women) at a single institution between 2010 and 2019. Proton density-weighted (PDW) and T2-weighted (T2W) MRI was performed at 3, 6, and 12 months postoperatively, and the SI ratio (SIR) was calculated as ( SI of the repaired LM)/( SI of the posterior cruciate ligament). At the 12-month follow-up, ALLx was evaluated using the pivot-shift test; an International Knee Documentation Committee grade ≥1 indicated residual ALLx.

Results:

Overall, 12 patients (13.8%) exhibited ALLx at 12 months postoperatively. At 3 months postoperatively, the SIR on PDW images (SIR-PDW) was significantly higher in patients with ALLx versus those without ALLx (1.98 ± 0.77 vs 1.49 ± 0.52, respectively; P = .007); there was no difference in the SIR on T2W images between the groups. SIR-PDW at 3 months postoperatively was correlated negatively with patient age ( r = -0.308, P = .004). When patients were stratified into a younger (≤22 years; n = 53; ALLx = 7 [13.2%]) and an older (>22 years; n = 34; ALLx = 5 [14.7%]) group, the area under the receiver operating characteristic curves (AUCs) for SIR-PDW in the younger group were statistically significant for predicting the prevalence of ALLx at all follow-up times (AUCs, 0.733-0.788) with optimal cutoff values of 2.00 at 3 months, 1.50 at 6 months, and 1.50 at 12 months. Logistic regression analysis revealed that if younger patients consistently had higher SIR-PDW values than the cutoff values, they were more likely to have residual ALLx (odds ratios, 10.24-23.57).

Conclusion:

For younger patients who underwent both ACLR and lateral meniscal repair, higher MRI SI of the repaired LM was associated with a higher prevalence of residual ALLx.
The Effect of First Metatarsal Shortening and Sagittal Displacement on Forefoot Pressure in MIS Hallux Valgus Correction
Authors: Lopez Andres , Haupt Edward T. , Porter Giselle M. , Bakaes Yianni , Shi Glenn , Jackson J. Benjamin , Myers Paisley , Gonzalez Tyler
Published: April 2024

Introduction/Purpose:

Minimally invasive surgical (MIS) treatment of hallux valgus (HV) deformity is increasing in popularity. A 2mm-diameter burr is used to create a distal first metatarsal osteotomy prior to capital fragment translation and fixation. The metatarsal will shorten by the burr’s diameter (2mm). Plantar or dorsal capital fragment displacement may also cause load transference and possibly transfer metatarsalgia. In this study, we examine the effect of MIS HV on forefoot loading mechanics with respect to metatarsal shortening and sagittal plane displacement.

Methods:

Four lower-limb cadaveric specimens were studied. A pedobarography pressure-sensing mat was used to record forefoot plantar pressure in a controlled weightbearing stance position.10 Control and post-osteotomy measurements were obtained with the capital fragment fixated in 3 possible positions: 0mm, 5mm dorsal, and 5mm plantar displacement. Pedobarography data yielded pressure data within measurable graphical depictions. Raw mean contact pressure measurements were taken under the first and fifth metatarsal heads to establish medial and lateral forefoot loading pressure ratios. A priori power analysis was performed based on previous peer-reviewed pedobarographic data and our study was adequately powered.

Results:

40 measurements were recorded and ratios of medial-to-lateral forefoot loading were constructed. Medial forefoot pressure change control versus 0mm displacement, and control versus dorsal displacement was not found to be statistically significant (p=0.525, p=0.55 respectively). Significant medial pressure increase was identified comparing control versus plantar displacement (p=0.006). Lateral pressure increased significantly with dorsal displacement of the osteotomy (p=0.013).

Conclusion:

MIS hallux valgus correction does not appear to cause increase in lateral forefoot pressure loading when sagittal plane displacements are controlled. Plantar displacement increases medial loading, and dorsal displacement increases lateral loading. The clinician must consider metatarsal head position post-osteotomy, as decrease in medial loading and subsequent increase in lateral loading may lead to lateral forefoot pain and transfer metatarsalgia.
Nature as Medicine and Classroom: Evaluating an Innovative, Outdoor Course for Medical and Dental Students
Authors: Trudel Sierra M. , Winter Emily L. , Guerrera Mary P.
Published: April 2024

Background

There is a growing, global awareness and recognition of the important, interdependent relationships between our natural world and human health. Several contemporary health organizations have placed calls to action and emphasize an urgent need for collaboration and interdisciplinary research, education, and clinical work to address the increasing degradation of our planetary and human health. With more research dedicated to nature’s health impacts, health professions schools would benefit by including such training in their programs while also cultivating a comprehensive mind-body health perspective to support both the health of student practitioners and their future patients.

Objective

The present program evaluation investigates a five-day outdoor mini-course covering nature-based health techniques at a medical and dental school in the American Northeast. This unique outdoor course combines nature, creativity, and reflection within the context of modern medicine.

Methods

A concurrent mixed-method design using descriptive statistics, quantitative and qualitative data from students’ anonymous final course evaluations and final reflection projects are evaluated.

Results

Data suggests that students benefitted from their experience during this five-day course. Students provided feedback reinforcing the enjoyment and transformative outcomes gleaned from the course experiences. Students entered the course describing feeling stressed, overwhelmed, and overextended, not uncommon for learners in medical and dental school, and completed the course describing the acquisition of applicable skills, increased attention and mindfulness, creativity, and connection to the natural world.

Conclusions

Students described a positive experience of the course. Several areas of personal and professional development were also described, such as improvements within cognitive domains, enhanced connection with nature, others, and themselves, increased mindfulness, and overall improved well-being. Findings have implications for medical and dental programs on how such innovative training may lean into the work of nature-based care to provide for the whole person.
Reassessing the chronic lymphocytic leukemia International Prognostic Index in the era of targeted therapies
Authors: Langerbeins Petra , Giza Adam , Robrecht Sandra , Cramer Paula , von Tresckow Julia , Al-Sawaf Othman , Fink Anna Maria , Fürstenau Moritz , Kutsch Nadine , Simon Florian , Goede Valentin , Hoechstetter Manuela , Niemann Carsten Utoft , da Cunha-Bang Caspar , Kater Arnon , Dubois Julie , Gregor Michael , Staber Philipp Bernhard , Tausch Eugen , Schneider Christof , Stilgenbauer Stephan , Eichhorst Barbara , Fischer Kirsten , Hallek Michael
Published: April 2024

We evaluated the chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) in patients with CLL treated first line with targeted drugs (n = 991) or chemoimmunotherapy (n = 1256). With a median observation time of 40.5 months, the 3-year progression-free survival (PFS) rates for targeted drug–treated patients varied by CLL-IPI risk group: 96.5% (low), 87.6% (intermediate), 82.4% (high), and 78.7% (very high). Differences between consecutive CLL-IPI risk groups were observed for intermediate vs low and high vs intermediate, but not very high vs high. CLL-IPI factors β2-microglobulin, immunoglobulin heavy variable (IGHV) status, and TP53 status each retained prognostic value for PFS. The 3-year overall survival (OS) rates by CLL-IPI risk groups were 100%, 96%, 93.9%, and 89.4%, respectively, with no differences between consecutive risk groups. Age, Binet stage, β2-microglobulin, and TP53 status each retained prognostic value for OS. In chemoimmunotherapy patients (median observation time, 66.9 months), 3-year PFS rates for CLL-IPI risk groups were 78.1%, 51.4%, 40.1%, and 16.5%, respectively; corresponding 3-year OS rates were 97.4%, 93.1%, 81.8%, and 57.3%. In a matched-pair analysis, PFS differences in targeted therapies (n = 812) vs chemoimmunotherapy (n = 812) across all risk groups and OS differences in all but patients at low risk were demonstrated. The CLL-IPI maintains its prognostic value in predicting PFS outcomes with targeted drugs, but its impact in predicting survival appears diminished. Targeted therapies showed enhanced outcomes over chemoimmunotherapy, highlighting their effectiveness across various risk groups. Our findings support ongoing assessment of prognostic tools in CLL treatment evolution. These trials were registered at www.ClinicalTrials.gov as #NCT02345863, #NCT02401503, #NCT02689141, #NCT02445131, #NCT02758665, #NCT02950051, #NCT02242942, #NCT00262782, #NCT00281918, and #NCT01010061.
Shared and divergent mental health characteristics of ADNP-, CHD8- and DYRK1A-related neurodevelopmental conditions
Authors: Neuhaus Emily , Rea Hannah , Jones Elizabeth , Benavidez Hannah , Miles Conor , Whiting Alana , Johansson Margaret , Eayrs Curtis , Kurtz-Nelson Evangeline C. , Earl Rachel , Bernier Raphael A. , Eichler Evan E.
Published: April 2024

Background

Neurodevelopmental conditions such as intellectual disability (ID) and autism spectrum disorder (ASD) can stem from a broad array of inherited and de novo genetic differences, with marked physiological and behavioral impacts. We currently know little about the psychiatric phenotypes of rare genetic variants associated with ASD, despite heightened risk of psychiatric concerns in ASD more broadly. Understanding behavioral features of these variants can identify shared versus specific phenotypes across gene groups, facilitate mechanistic models, and provide prognostic insights to inform clinical practice. In this paper, we evaluate behavioral features within three gene groups associated with ID and ASD – ADNP, CHD8, and DYRK1A – with two aims: (1) characterize phenotypes across behavioral domains of anxiety, depression, ADHD, and challenging behavior; and (2) understand whether age and early developmental milestones are associated with later mental health outcomes.

Methods

Phenotypic data were obtained for youth with disruptive variants in ADNP, CHD8, or DYRK1A (N = 65, mean age = 8.7 years, 40% female) within a long-running, genetics-first study. Standardized caregiver-report measures of mental health features (anxiety, depression, attention-deficit/hyperactivity, oppositional behavior) and developmental history were extracted and analyzed for effects of gene group, age, and early developmental milestones on mental health features.

Results

Patterns of mental health features varied by group, with anxiety most prominent for CHD8, oppositional features overrepresented among ADNP, and attentional and depressive features most prominent for DYRK1A. For the full sample, age was positively associated with anxiety features, such that elevations in anxiety relative to same-age and same-sex peers may worsen with increasing age. Predictive utility of early developmental milestones was limited, with evidence of early language delays predicting greater difficulties across behavioral domains only for the CHD8 group.

Conclusions

Despite shared associations with autism and intellectual disability, disruptive variants in ADNP, CHD8, and DYRK1A may yield variable psychiatric phenotypes among children and adolescents. With replication in larger samples over time, efforts such as these may contribute to improved clinical care for affected children and adolescents, allow for earlier identification of emerging mental health difficulties, and promote early intervention to alleviate concerns and improve quality of life.
Correlated evolution between body size and echolocation in bats (order Chiroptera)
Authors: Castro Mario G. , Amado Talita Ferreira , Olalla-Tárraga Miguel Á.
Published: April 2024

Background

Body size and echolocation call frequencies are related in bats. However, it is unclear if this allometry applies to the entire clade. Differences have been suggested between nasal and oral emitting bats, as well as between some taxonomic families. Additionally, the scaling of other echolocation parameters, such as bandwidth and call duration, needs further testing. Moreover, it would be also interesting to test whether changes in body size have been coupled with changes in these echolocation parameters throughout bat evolution. Here, we test the scaling of peak frequency, bandwidth, and call duration with body mass using phylogenetically informed analyses for 314 bat species. We specifically tested whether all these scaling patterns differ between nasal and oral emitting bats. Then, we applied recently developed Bayesian statistical techniques based on large-scale simulations to test for the existence of correlated evolution between body mass and echolocation.

Results

Our results showed that echolocation peak frequencies, bandwidth, and duration follow significant allometric patterns in both nasal and oral emitting bats. Changes in these traits seem to have been coupled across the laryngeal echolocation bats diversification. Scaling and correlated evolution analyses revealed that body mass is more related to peak frequency and call duration than to bandwidth. We exposed two non-exclusive kinds of mechanisms to explain the link between size and each of the echolocation parameters.

Conclusions

The incorporation of Bayesian statistics based on large-scale simulations could be helpful for answering macroevolutionary patterns related to the coevolution of traits in bats and other taxonomic groups.
In silico analysis of intestinal microbial instability and symptomatic markers in mice during the acute phase of severe burns
Authors: Hou Bochen , Zhang Honglan , Zhou Lina , Hu Biao , Tang Wenyi , Ye Bo , Wang Cui , Xu Yongmei , Zou Lingyun , Hu Jun
Published: April 2024

Background

Severe burns may alter the stability of the intestinal flora and affect the patient’s recovery process. Understanding the characteristics of the gut microbiota in the acute phase of burns and their association with phenotype can help to accurately assess the progression of the disease and identify potential microbiota markers.

Methods

We established mouse models of partial thickness deep III degree burns and collected faecal samples for 16 S rRNA amplification and high throughput sequencing at two time points in the acute phase for independent bioinformatic analysis.

Results

We analysed the sequencing results using alpha diversity, beta diversity and machine learning methods. At both time points, 4 and 6 h after burning, the Firmicutes phylum content decreased and the content of the Bacteroidetes phylum content increased, showing a significant decrease in the Firmicutes/Bacteroidetes ratio compared to the control group. Nine bacterial genera changed significantly during the acute phase and occupied the top six positions in the Random Forest significance ranking. Clustering results also clearly showed that there was a clear boundary between the communities of burned and control mice. Functional analyses showed that during the acute phase of burn, gut bacteria increased lipoic acid metabolism, seleno-compound metabolism, TCA cycling, and carbon fixation, while decreasing galactose metabolism and triglyceride metabolism. Based on the abundance characteristics of the six significantly different bacterial genera, both the XGboost and Random Forest models were able to discriminate between the burn and control groups with 100% accuracy, while both the Random Forest and Support Vector Machine models were able to classify samples from the 4-hour and 6-hour burn groups with 86.7% accuracy.

Conclusions

Our study shows an increase in gut microbiota diversity in the acute phase of deep burn injury, rather than a decrease as is commonly believed. Severe burns result in a severe imbalance of the gut flora, with a decrease in probiotics and an increase in microorganisms that trigger inflammation and cognitive deficits, and multiple pathways of metabolism and substance synthesis are affected. Simple machine learning model testing suggests several bacterial genera as potential biomarkers of severe burn phenotypes.
A movement for movement: an exploratory study of primary healthcare professionals’ perspectives on implementing the Royal College of General Practitioners’ active practice charter initiative
Authors: Leese Callum J. , Mann Robert H. , Al-Zubaidi Hussain , Cockcroft Emma J.
Published: April 2024

Background

Regular physical activity (PA) results in extensive physical, psychological, and social benefits. Despite primary care being a key point of influence for PA behaviours in the UK, research indicates poor application of PA interventions in this context. To address this, the Royal College of General Practitioners’ (RCGP) developed and implemented the Active Practice Charter (APC). The aim of the study was to evaluate the perceived impact and acceptability of the APC initiative from the perspective of primary healthcare professionals (PHPs).

Methods

An online exploratory cross-sectional survey was designed to assess the perceived impact, experiences, and challenges of the APC initiative, from the perspective of PHPs. The survey was distributed by the RCGP via email to 184 registered APC practices across the UK.

Results

Responses were reviewed from staff (n = 33) from 21 APC practices. Initiatives used by APC practices included: educational programmes, partnerships with PA providers, referral systems, and infrastructure investment. Perceived benefits included: increased awareness about PA, staff cohesion, and improved well-being. However, staff felt the APC had limited effect due to implementation barriers, including: a lack of engagement, time, resources, and funding.

Conclusion

This is the first evaluation of any nationwide UK-based initiative engaging GP practices in promoting PA. Acknowledging the limitations in response rate, although support exists for the RCGP APC, the evaluation highlights challenges to its implementation. Nonetheless, the wide reach of the RCGP, combined with the cited staff and patient benefits, demonstrates the significant potential of the APC initiative. Given the need to address physical inactivity nationally, further development the APC offers a possible solution, with further research required to overcome the challenges to implementation.
Level of interleukin 17 in inflammatory bowel disease and its relation with disease activity
Authors: Menesy Ayman , Hammad Mohamed , Aref Salah , Abozeid Fatma Adel Mourad
Published: April 2024

Background

Inflammatory bowel disease (IBD) is a chronic relapsing inflammatory disorder of the gastrointestinal tract (GIT).It results in progressive intestinal epithelium structural and functional damage that necessitates lifetime medication.Thereis imbalance in the production of T helper 1 (Th1), Th2 and Th17 cytokines. This plays a crucial role in the chronic inflammatory process and the defective immune response to pathogenic agents; thus promoting the recurrence of the disease.Our aim of this study was to detect serum IL-17 levels in IBD patients and its relation with disease activity.

Methods

This was a single center case control study, conducted at hepatology and gastroenterology unit, Mansoura specialized Medical Hospital, Egypt.Patients who were included were aged 18–65 years, diagnosed either Ulcerative Colitis (UC)or Crohn’s Disease (CD) based on previous colonoscopy.IBD activity was measured for UC using the MAYO score and CD using the CD activity index (CDAI). Fifty five patients were UC, 24 patients were CD, 21 patients were control.Patients who were excluded were under 15 years old, with history of GIT malignancy, or any serious comorbidities. Study protocol was approved by Institution Research Board (IRB) of Mansoura Medical College.All patients were subjected to full history taking, routine physical examination, colonoscopy and laboratory investigations including serum IL-17 levels by ELISA besides CBC, CRP, ESR and fecal calprotectin.

Results

Serum IL-17 level was increased significantly among UC; median (min-max) = 72(21–502)pg/ml, in CD 54.5(25–260) versus control 19 (14–35), P < 0.001.However, it was not correlated to the disease activity either Mayo score of UC or CDAI of CD.There was significant correlation to the extent of inflammation in UC affecting the colon (either proctosigmoiditis, left sided colitis or pan colitis), also to the type of CD (either inflammatory, stricturing or fistulizing) by P < 0.05.It was not correlated significantly with any of the IBD activity markers (CRP, ESR, or fecal calprotectin).Yet there was negative significant correlation with Hb level (r =-0.28, p = 0.005).There was not significant association between median serum level of IL-17 & duration of disease (P = 0.6).However, median IL-17 was higher among hospitalized cases than non-hospitalized (73 & 55, pg/ml respectively; p < 0.002). AUC was significantly differentiating between IBD and control group = 0.993 with the best-detected cut off point from curve 32 pg/ml yielding sensitivity of 97.5% and specificity of 95.2%.

Conclusion

Serum IL-17 increases in colonic inflammation significantly more than in control group, however its increase is not correlated to IBD activity.
The causal relationship of human blood metabolites with the components of Sarcopenia: a two-sample Mendelian randomization analysis
Authors: Peng Wenxi , Xia Zhilin , Guo Yaxuan , Li Linghong , He Jianrong , Su Yi
Published: April 2024

Background

Sarcopenia is a progressive loss of muscle mass and function. Since skeletal muscle plays a critical role in metabolic homeostasis, identifying the relationship of blood metabolites with sarcopenia components would help understand the etiology of sarcopenia.

Methods

A two-sample Mendelian randomization study was conducted to examine the causal relationship of blood metabolites with the components of sarcopenia. Summary genetic association data for 309 known metabolites were obtained from the Twins UK cohort and KORA F4 study (7824 participants). The summary statistics for sarcopenia components [hand grip strength (HGS), walking pace (WP), and appendicular lean mass (ALM)] were obtained from the IEU Open GWAS project (461,089 participants). The inverse variance weighted method was used, and the MR-Egger, weighted median, and MR-PRESSO were used for the sensitivity analyses. Metabolic pathways analysis was further performed.

Results

Fifty-four metabolites associated with sarcopenia components were selected from 275 known metabolites pool. Metabolites that are causally linked to the sarcopenia components were mainly enriched in amino sugar and nucleotide sugar metabolism, galactose metabolism, fructose and mannose metabolism, carnitine synthesis, and biotin metabolism. The associations of pentadecanoate (15:0) with ALM, and 3-dehydrocarnitine and isovalerylcarnitine with HGS were significant after Bonferroni correction with a threshold of P < 1.82 × 10− 4 (0.05/275). Meanwhile, the association of hyodeoxycholate and glycine with the right HGS, and androsterone sulfate with ALM were significant in the sensitivity analyses.

Conclusion

Blood metabolites from different metabolism pathways were causally related to the components of sarcopenia. These findings might benefit the understanding of the biological mechanisms of sarcopenia and targeted drugs development for muscle health.