bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Integrated Treatment Programs for Severe Concurrent Substance Use and Mental Disorders: Insights on Overdose from the ROAR CANADA Project: Améliorer les programmes de traitement intégré pour les troubles mentaux et les troubles liés à l’usage de substances psychoactives graves et concomitants : aperçu de la problématique des surdoses dans le cadre du projet ROAR CANADA
Authors: Schütz Christian G. , Nicholls Tonia , Schmid Laura , Penner Sydney , Massey Myra , Thiessen Karina A. , Todesco Stefanie , Rafizadeh Reza , Cowie Kiefer , Syan Sabrina K. , MacKillop James
Published: February 2025

Objective

This paper summarizes methods and initial overdose-related results from the Reducing Overdose and Relapse: Concurrent Attention to Neuropsychiatric Ailments and Drug Addiction (ROAR CANADA) project. ROAR CANADA is a longitudinal observational study of individuals with severe concurrent substance use and mental disorders (also called dual disorders or dual diagnosis). The study sampled patients treated at two tertiary treatment centres in British Columbia, Red Fish Healing Centre and Heartwood Centre, along with a concurrent treatment unit at St. Joseph's in Ontario. These facilities have implemented evidence-based integrated treatment programs. Our first analysis explores selected baseline characteristics as potential risk factors for drug overdose in this population.

Method

Sociodemographic factors, trauma history, and impulsivity were part of a more comprehensive longitudinal assessment. In this first investigation, we use bivariate analysis and logistic and linear regression modelling to examine these variables in relation to overdose history.

Results

Overall, 291 of 450 participants (64.7%) reported a history of ≥1 overdose. Across the three centres, patients had a lifetime average of 7.6 ( SD = 12.9) overdoses. The prevalence and mean number of overdoses were somewhat higher among Red Fish patients (74.5% and 8.5, respectively). Adverse childhood events, lifetime trauma history, and impulsivity were all high, but only lifetime trauma history emerged as significantly associated with overdose across all treatment centres. Impulsivity indicators were selectively associated with overdose by site, but not consistently within the overall sample.

Conclusions

These results highlight the importance of prioritizing trauma-informed care in the treatment of individuals with severe concurrent substance use and mental disorders, who are at high risk of overdose. The integration of trauma treatment into existing programs may enhance patient outcomes and contribute to the ongoing evolution of effective care strategies for this complex population. These findings are particularly relevant in light of the overdose crisis.
Predicting Placement in Residential Treatment in a Drug Court Program
Authors: Koetzle Deborah , Garman Julie , Sudula Susruta
Published: February 2025

With a growing emphasis on alternatives to incarceration for high-risk/high-need individuals who use drugs or alcohol, there is an increased need for intensive treatment services in the community. The current study examines referrals to residential treatment in a drug court setting. Using a sample of 378 drug court participants, this study compares characteristics of drug court participants who received traditional drug court services and those who received residential services. Multivariable logistic regression model analyses indicate that drug of choice (i.e., heroin/opiate use), substance use severity (i.e., early onset of drug use at 15 years and below), and noncompliance (i.e., rearrests prior to referral) were significant predictors of referral to and placement in residential treatment, when controlling for demographic characteristics (i.e., age, race, gender). Research and policy implications are discussed.
Health Behaviors and Executive Function in Late Adulthood: A Time-Varying Effect Modeling Analysis
Authors: Jung Myungjin , Kim Heontae , Patrick Zakary , Lee Seomgyun
Published: February 2025

Objective

Cognitive decline in older adults is a public health issue, with modifiable factors like obesity and sleep potentially influencing this trajectory. Previous research on their relationship with executive function has shown mixed results, particularly across older adulthood.

Methods

This study utilized time-varying effect modeling (TVEM) to assess the impact of body mass index (BMI) and sleep on executive function in older adults aged 60 to 79, using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 and 2013–2014 cycles ( N = 2543). Executive function was evaluated using the Digit Symbol Substitution Test (DSST).

Results

Findings indicated that while BMI did not significantly affect cognition, adequate sleep (7–8 hours) was linked to better executive function, especially in individuals aged 63 to 65.

Conclusion

These results highlight sleep’s importance for cognitive health and suggest interventions focusing on sleep and weight management to mitigate age-related cognitive decline.
Optimum Design of Polycentric Knee Hinges Based on Analysis of Knee-exoskeleton Closed Kinematic Chain
Authors: Asker Ahmed , Omar Mohamed , Zhang Junyang , Wang Ke , Li Ruifeng , Xie Shengquan
Published: February 2025

Knee exoskeletons are devices that can enhance users’ mobility and strength. Their compatibility with the user’s joint motion is crucial for proper functioning. Typically, knee hinges are designed to replicate the instantaneous center of rotation (ICR) of an average knee. This study represents a knee exoskeleton worn by a user as a one DoF closed-kinematic chain, which enables calculating the displacement between the exoskeleton and the user’s thigh. The problem of optimizing the exoskeleton hinges to yield low relative movements during flexion and extension motions is formulated based on the proposed analysis. Also, the 4-bar knee model was simulated with different exoskeleton hinge designs to demonstrate the ability of the proposed analysis to predict the relative motions under different alignment conditions. The performance of an optimized polycentric geared knee hinge is then compared experimentally with that of a typical fixed center hinge. Experimental results showed that the optimized polycentric hinge yields less relative motion and a lower chance of exoskeleton migration. The proposed method emphasizes the importance of minimizing relative motion rather than replicating the knee’s ICR and provides a systematic way to design and evaluate various knee hinge designs.
Insertion/deletion polymorphism of the angiotensin-converting enzyme gene in lupus nephritis at Cho Ray hospital, Vietnam
Authors: Nguyen Anh N. L. , Le Anh T. , Lee Vincent W. S. , Tran Huong T. B.
Published: February 2025

Introduction: The pathogenesis for poor kidney outcomes in lupus nephritis (LN) remains uncertain. There is limited evidence on the association between angiotensin-converting enzyme (ACE) I/D polymorphism and LN with kidney failure. Objectives: To determine the distribution of ACE I/D alleles and genotypes and the correlation between ACE I/D polymorphism and kidney outcomes in LN participants. Subjects and Methods: A cross sectional study was conducted at Cho Ray Hospital (12/2021-07/2023). The LN participants were stratified into 3 groups based on the kidney function and kidney replacement therapy (KRT) on admission. The ACE I/D polymorphism was identified by the polymerase chain reaction. Results: Among 208 LN participants, 71 were in group 1 (eGFR > 60), 55 in group 2 (eGFR ≤ 60 without KRT), 82 in group 3 (eGFR ≤ 60 with KRT). The skewed distribution among 3 groups were observed in D allele (20.4%, 35.5%, 37.2% in group 1, 2, 3, respectively, p = .003) and DD genotype (2.8%, 14.6%, 12.2% in group 1, 2, 3, respectively, p = .005). The ID/DD genotypes increased the susceptibility of kidney failure (eGFR ≤ 60 vs eGFR > 60: OR = 8.26 for DD genotype, OR = 2.31 for ID genotype) and KRT (KRT vs no KRT: OR = 2.01 for ID genotype). Conclusions: The D allele and ID/DD genotypes are linked with the susceptibility of kidney failure in LN participants.
The Cold War Public Relations Campaign for the Atlas Missile and Nuclear Deterrent Strategy in the Great Plains, 1958–1962
Authors: Matzke Rebecca Berens
Published: February 2025

The Cold War was not merely an international diplomatic and military conflict; it was a ‘total war’, demanding that the US government mobilize the consent of all Americans to counter the Soviet Union. From 1958 to 1962, the US Air Force and its contractors conducted a public relations campaign in Nebraska for the first-generation Atlas ICBM. Publicizing the Atlas was key to both its purpose and context: to create a credible deterrent, to reassure the US public after the shock of Sputnik, and to convince average Americans to accept nuclear missiles in their midst.
Child Welfare System Change: An Evolutionary/Revolutionary Approach [Pryce’s Response to Dettlaff’s “Abolition of the Child Welfare System”] (Point-Counterpoint)
Authors: Pryce Jessica
Published: February 2025

This article is temporarily under embargo.
Professional adaptation of former servicemen after Russo-Ukrainian war: World experience and ways of improvement
Authors: Yaroshenko Oleg M. , Maliuha Lesya Ju. , Kravtsov Danylo M. , Halkina Nataliia M. , Zatynaichenko Kyryl V.
Published: February 2025

Background

The issue of professional adaptation of servicemen who return to civilian life after dismissal from the Armed Forces of Ukraine and other military formations is highly relevant. This urgency depends on the dramatic changes in their living conditions and requires mastering the rules of behavior and communication in civilian life, improving the existing knowledge, competencies, and skills, and promoting successful employment.

Objective

The purpose of the work is to study modern institutional approaches to the process of labor adaptation of former servicemen, to study the experience of foreign countries, and to formulate ways to improve the Ukrainian system of professional adaptation of former servicemen.

Methods

Drawing on a range of scientific methods including dialectics, systematic analysis, synthesis, deduction, and induction, this study aims to understand modern institutional approaches to labor adaptation for former servicemen.

Results

The study draws attention to the valuable experiences of other countries, including the United States, Sierra Leone, and the United Kingdom, in successfully reintegrating military personnel into civilian life. These examples provide insights into various aspects of social and professional adaptation, such as vocational training, retraining, social housing, and the early initiation of reintegration efforts.

Conclusions

The findings of this study hold practical significance for institutions and organizations involved in supporting the transition of servicemen to civilian life. By providing insights into effective strategies and approaches, this research aims to contribute to the development of more comprehensive and successful professional adaptation programs for former servicemen, ultimately facilitating their successful integration into civilian society.
Pharmacotherapy and psychological support: Integrating pharmacists into comprehensive cancer care – a literature review
Authors: Ali Haneen Badreldin , Dike Ujunwa P , Khan Muhammad Burhan , Khusrau Naiba
Published: February 2025

Cancer presents significant physical and mental challenges to patients. Therefore, psychological assessment is important following a cancer diagnosis, as well as during and after chemotherapy. In cancer treatment, the goal of healthcare providers, including pharmacists, should be to deliver holistic care that addresses important aspects of patients’ health, with particular emphasis on their psychological readiness to combat their diseases. This article reviews published literature from Google Scholar and PubMed to examine the relevant pharmacotherapy and psychotherapy approaches to managing psychological issues in cancer patients. This article also discusses how pharmacists can be integrated into cancer patients’ mental health care, while highlighting the potential benefits and challenges associated with this approach. We conclude that the integration of pharmacists into psychological care and support for cancer patients holds promise due to their knowledge of cancer chemotherapy, their ability to improve their knowledge about psychological care, and their capacity to collaborate with other healthcare professionals in cancer treatment.
Conceptualizing Professional Stigma Toward Forensic Mental Health Service Users: Results of a Qualitative Inquiry
Authors: Vorstenbosch Ellen , Escuder-Romeva Gemma , Haro Josep Maria , Bulten Erik
Published: February 2025

Forensic service users may face double stigma due to severe mental illness and a history of criminal offending. Professional stigma, involving stigmatizing attitudes and behaviors among mental healthcare professionals, can impede treatment and rehabilitation. Research on professional stigma, particularly toward forensic service users, is scarce. We explore relevant concepts of professional stigma using a Delphi consensus study and focus group. The Delphi study involved 98 experts across five panels (academics publishing about stigma or forensic mental healthcare, forensic and community mental healthcare professionals, and forensic service users), who evaluated the relevance of 85 stigma-related items on a 7-point Likert-scale. Consensus was reached on 26 items, including stereotypes, prejudices, and discrimination, reflecting dangerousness, fear, recovery potential, and restrictions. The focus group, involving seven forensic service users, yielded experiences with professional stigma, including recovery pessimism, perceived dangerousness, devaluation through offenses, dismissive reactions, differential treatment, intrusive behavior, and restrictions. Our findings highlight the complexity of conceptualizing professional stigma and provide a foundation for developing an instrument to assess it. Future research will evaluate the psychometric properties of this instrument, which is essential for identifying and addressing stigma in forensic and community mental healthcare, ultimately improving care and rehabilitation outcomes for forensic service users.
Cost-Effective Modeling for Management Options in Charcot Neuroarthropathy
Authors: Shehaj Andrea , Dopke Kelly M. , Paracha Abdul Wasay , Mansfield Kirsten , Pitcher Michaela D. , Saloky Kaitlin , Stauch Christopher , Ozdemir Erdi , Aynardi Michael
Published: February 2025

Charcot neuropathic arthropathy (CN) impacts peripheral lower extremity nerves, leading to joint destruction, and has a significant economic burden on the healthcare system. This economic burden is further exacerbated by the projected increase in diabetes mellitus cases over the coming decades, with a corresponding anticipated rise in CN. This study assesses CN management costs through a single institution retrospective chart review and cost-effectiveness through economic modeling by utilizing a well-established equation to determine the cost-effectiveness of conservative management. This retrospective chart review from a single academic center analyzed costs and outcomes for CN patients undergoing exostectomy, arthrodesis, major amputation, minor amputation, or casting from 2000-2022. This retrospective review analyzed 216 CN patients (average age 58, 54% male). Costs were $57 949 for exostectomy, $149 009 for arthrodesis, $40 313 for major amputation, $55 035 for minor amputation, $125 851 for failed casting, and $8233 for casting. We conducted a break-even analysis that determined that intervention with casting was cost-effective compared to failed casting. Total contact casting is a cost-effective first-line treatment for CN, capable of managing non-advanced cases effectively and reducing the economic burden of surgical intervention. This study provides a critical framework for practitioners to assess cost-effectiveness in various institutional contexts.
A Cross-Sectional Analysis of College Students’ Diet, Mental Health, and Hindrances to Healthy Lifestyles
Authors: Budnick Steven , Peters Mallory , Dowthwaite Jodi
Published: February 2025

Objective: To determine whether dietary intake and restrictions on diet are correlated with sleep, academic achievement, and/or mental health in a college population. Methods: We used Qualtrics to survey a large public university in the Northeast for Fall 2022, Spring 2023, and Fall 2023 academic semesters (n = 98;104;90) for campus demographics, diet quality, dietary restrictions, food insecurity, sleep quality and quantity, stress (PSS), anxiety (GAD-7), depression (PHQ-9), and academic success (GPA). We performed Spearman rho and Pearson r analyses (IBM SPSS, alpha = 0.05). Results: Diet quality correlated positively with GPA (Rho = 0.265, P < 0.05), dietary restrictions (Rho = 0.498, P < 0.05), and sleep hours (r = 0.284, P < 0.05), but negatively with anxiety (Rho = −0.300, P < 0.01), stress (r = −0.225, P < 0.05), and depression (r = −0.434, P < 0.05). Food insecurity correlated positively with anxiety (Rho = 0.488, P < 0.001), stress (r = 0.557, P < 0.001), and depression (r = 0.489, P < 0.001), but negatively with GPA (Rho = −0.390, P < 0.05). Sleep quality correlated negatively with stress (r = −0.269, P = 0.008), depression (r = −0.350, P < 0.001), and anxiety (Rho = −0.248, P = 0.014). Conclusions: Correlations among diet, food insecurity, dietary restrictions, sleep, and mental health metrics suggest that improvements in diet benefit students’ lifestyles. However, more restrictive diets do not appear to be deleterious, implying a reduced need for dietary interventions in this population.
Ameliorating Effect of Triticum aestivum (WG) Against Cisplatin-Induced Nephrotoxicity: Role of Cytokines, Free Radicals and Apoptotic Cascade
Authors: Alshahrani Saeed , Muzafar Hisham M. A. , Tripathi Pankaj , Alam Mohammad Firoz , Rehman Zia ur , Tripathi Rina , Moni Sivakumar S. , Alqahtani Saad S. , Ashafaq Mohammad , Taha Manal Mohamed Elhassan , Nomier Yousra
Published: February 2025

Objectives

Cisplatin (CP) is a most potent chemotherapeutic agent; however, CP causes nephrotoxicity that limits its therapeutic utility. Triticum aestivum called wheatgrass (WG) is a strong antioxidant and potent detoxifying herb that has not only been studied for anticancer activity but also for efficacy and safety when combined with anticancer drugs. This study investigated the efficacy of WG against CP-induced nephrotoxicity.

Methods

Male rats were allocated into five sets of six rats in each: (1) normal control (NC), (2) CP-treated (7.5 mg/kg) as positive control (PC), (3) WG-200 mg/kg alone, and (4) CP with WG-100, and (5) CP with WG-200 mg/kg groups. Hydro-alcoholic extract of WG was administered orally to the animals for two weeks, and CP was administered intraperitoneally to the respective groups on the 10th day to induce nephrotoxicity. Serum was used for kidney function and kidneys for histological examination and quantification of apoptosis markers, pro-inflammatory cytokines and oxidative stress.

Results

CP-induced nephrotoxicity was apparent from histological damage and increased levels of BUN, Cr and UA. CP also caused an increase in malondialdehyde and decreased superoxide dismutase (SOD), glutathione (GSH), catalase (CAT) activities and led to up-regulation of pro-inflammatory cytokines and apoptosis markers. WG caused a significant decrease in Cr, BUN, UA, MDA and increase in GSH, SOD and CAT activities.

Conclusion

WG ameliorated histological damage and led to a reversal of cytokines and apoptosis markers. Both doses of WG effectively ameliorated CP-induced nephrotoxicity; thus, during chemotherapy, WG could be a promising adjunct to CP.
Global finance capitalism: Rebirth or denouement?
Authors: Narsiah Sagie
Published: February 2025

The rise of neoliberalism is coincident with the dominance of financial capitalism in its global form. Moreover, there are those who would argue that neoliberalism is synonymous with global financial capitalism. There is no doubt that what we have witnessed during the ascendance of neoliberalism is the dominance of global finance capital over industrial capital. Yet, while the obituary of capitalism in this form has been penned multiple times, it remains very much alive, proliferating even on a global scale creating ever sharper cleavages between the (mega) rich and the growing masses of the poor. In this paper we examine neoliberalism as a policy regime and its role in the proliferation of global capitalism. The analysis takes the form of a consideration of key texts that examine the macro, meso, and micro incarnations of global finance capitalism. The architecture of global finance capital is examined through a consideration of asset managers who exert growing influence on contemporary development. The micro aspects of the system through which extraction of capital is facilitated are examined culminating in a consideration of the future of the system.
Outpatient primary care cardiology referrals: Referral patterns, risk stratification and clinical outcomes
Authors: Chua Yi Yi , Jiang Yilin , Wang Sinead Zhen , Phoon Ian , Yeo Khung Keong , Chua Terrance Siang Jin , Yap Jonathan
Published: February 2025

Introduction

With an increasing burden of cardiovascular disease, there has been rising demands for outpatient cardiology services. In this study, we reviewed the cardiology referral patterns from primary care to a tertiary cardiac centre, and evaluated their longer term clinical outcomes based on referral symptomatology as well as risk stratification.

Methods

Consecutive outpatients referred from primary care to a national cardiac centre between March 2015 to December 2020 were included. Patients with known coronary artery disease (CAD) were excluded. Chest pain patients were stratified by pre-test probability (PTP) of obstructive CAD using chest pain risk scores and the rest by age and sex. Outcomes studied included mortality and major adverse cardiovascular events (MACE).

Results

A total of 33,244 patients (11,865 chest pain, 3427 palpitations, 2844 dyspnoea) were included. In patients with chest pain, the 3-year mortality and MACE rates were 1.25% and 3.19% respectively. Patients with higher PTP of CAD demonstrated significantly higher rates of adverse events. In patients with palpitations, the 3-year mortality and MACE rates were 0.86% and 1.55% respectively. Males aged >65years had significantly higher risk of 3-year mortality ( p < .00.5). In patients with dyspnoea, the 3-year mortality and MACE rates were 3.34 and 4.44% respectively. Subsets of younger age and/or female sex had lower rates of adverse events.

Conclusions

While long term adverse clinical outcomes were generally low in this stable outpatient cohort, risk stratification allowed for identification of an even lower risk subset of patients for whom additional testing may potentially not yield incremental clinical benefit.
MoodMover: Development and usability testing of an mHealth physical activity intervention for depression
Authors: Tang Yiling , Gierc Madelaine , La Henry , Kim Juehee , Liu Sam , Lam Raymond W , Puterman Eli , Faulkner Guy
Published: February 2025

Background

Physical activity (PA) is recognized as a modifiable lifestyle factor for managing depression. An application(app)-based intervention to promote PA among individuals with depression may be a viable alternative or adjunct to conventional treatments offering increased accessibility.

Objective

This paper describes the early stages of the development process of MoodMover, a 9-week app-based intervention designed to promote PA for people with depression, including its usability testing.

Methods

Development of MoodMover followed the initial stages of the Integrate, Design, Assess, and Share (IDEAS) framework. The development process included (1) identifying intervention needs and planning; (2) intervention development; and (3) usability testing and refinement. Usability testing employed a mixed-methods formative approach via virtual semi-structured interviews involving goal-oriented tasks and administration of the mHealth App Usability Questionnaire (MAUQ).

Results

Drawing on formative research, a multidisciplinary research team developed the intervention, guided by the Multi-Process Action Control framework. Nine participants engaged in the usability testing with the MoodMover prototypes receiving an average MAUQ score of 5.79 (SD = 1.04), indicating good to high usability. Necessary modifications were made based on end-users' feedback.

Conclusions

The development of MoodMover, the first theoretically informed app-based PA intervention for individuals with depression, may provide another treatment option, which has wide reach. The comprehensive usability testing indicated interest in the app and strong perceptions of usability enabling a user-centered approach to refine the app to better align with end-users' preferences and needs. Testing the feasibility and preliminary efficacy of the refined MoodMover is now recommended.
Adult-Onset Presentations of Retinopathy Associated With Short Telomere Syndromes
Authors: Light Jacob , Schratz Kristen E. , Nanegrungsunk Onnisa , Rudnick Noam , Armanios Mary , Bressler Neil M.
Published: February 2025

Purpose: To describe the association between short telomere syndrome and exudative retinopathies in adults. Methods: This case series compared the presentation, course of treatment, and visual outcomes of 2 patients with adult-onset retinopathy associated with short telomere syndrome. Results: In Case 1, a 53-year-old man initially presented with bilateral retinal telangiectasias and preretinal hemorrhage in the left eye, which was followed by multiple vitreous hemorrhages. In the subsequent 15 years, the patient was diagnosed with pulmonary fibrosis, liver cirrhosis, and a RTEL1 gene mutation, consistent with short telomere syndrome. In Case 2, a previously asymptomatic 26-year-old man with paternally inherited short telomere syndrome ( TERC gene mutation) presented with floaters, bilateral peripheral retinal capillary nonperfusion, and an aneurysmal lesion with surrounding exudation. Conclusions: Short telomere syndromes, with systemic features that can be life-threatening, can manifest initially in adulthood with retinal telangiectasia, aneurysmal lesions, exudation, or peripheral retinal capillary nonperfusion, preceding systemic manifestations. Because the systemic manifestations of retinal telangiectasia and peripheral retinal capillary nonperfusion are progressive and can be life-threatening, recognizing these findings in adults with retinal telangiectasia is crucial.
Sub-Inner Limiting Membrane Hemorrhage Secondary to Dengue Fever Treated With Nd: YAG Laser Hyaloidotomy
Authors: Urzedo Ana Bárbara Dias Lopes , Michels Bruna Depieri , Hokazono Kenzo
Published: February 2025

Purpose: To report a patient with a sub-inner limiting membrane (ILM) hemorrhage secondary to dengue fever treated with neodymium:YAG (Nd:YAG) laser hyaloidotomy. Methods: A single case was evaluated. Results: A 41-year-old man presented with sudden vision loss in the left eye 10 days after being diagnosed with dengue fever. Fundoscopy showed a sub-ILM macular hemorrhage in the left eye. Out of concern for retinal toxicity and to quickly restore visual acuity (VA), an Nd:YAG laser hyaloidotomy was performed. One month after the procedure, the VA in the left eye improved from 0.1 to 1.0 with complete resolution of the hemorrhage. Conclusions: Given the substantial increase in cases of dengue fever and its possible ophthalmologic involvement, this case highlights the importance of an ophthalmologic examination with fundoscopy in patients with a sub-ILM hemorrhage and the possibility of treatment with an Nd:YAG laser.
Brief Overview of the Trials Presented at ESC Congress 2024
Authors: Nagula Praveen , Parvathareddy Krishna Mala Konda Reddy
Published: February 2025

In this issue, we briefly overview the important trials presented at the European Society of Cardiology (ESC) Congress 2024 in London, United Kingdom. The trials are categorized under the following headings.
Disparities in Diabetes Distress and Nutrition Management Among Black and Hispanic Adults: A Mixed Methods Exploration of Social Determinants
Authors: Silver Santana R. , Jones Kayla C. , Kim Emily M. , Khaw-Marchetta Stephanie , Thornton Sophia , Kremer Kristen , Walkey Allan , Drainoni Mari-Lynn , Fantasia Kathryn L.
Published: February 2025

Purpose

The purpose of this study was to explore self-reported diabetes management strategies, social determinants of health (SDOH), and barriers to care among people with diabetes receiving care in a safety-net setting to identify factors contributing to disparities in outcomes for Black and Hispanic adults and inform future interventions.

Methods

Sequential, explanatory, mixed methods study comprised a survey of adults with diabetes seen in primary care at a safety-net hospital in New England, followed by qualitative semistructured interviews with a subset of the Black and Hispanic respondents. Descriptive statistics, chi-square and t tests were used to analyze quantitative data. The health equity implementation framework was used to guide qualitative data collection and directed content analysis.

Results

A total of 496 respondents completed the survey; 48 Black and Hispanic adults participated in interviews. Diabetes-related distress was significantly higher among Black and Hispanic participants compared to White participants. Nutrition management use was significantly lower among Black and Hispanic participants. Qualitative findings suggest that SDOH and lack of education and support, specifically, nutrition and access to self-management resources, contributed to diabetes-related distress and prevented optimal self-management.

Conclusions

High rates of diabetes-related distress and low rates of nutrition management were identified in Black and Hispanic adults in a safety-net setting. Qualitative interviews demonstrated a relationship between adverse SDOH and lack of nutrition education with diabetes distress and challenges to self-management, potentially contributing to disparities in outcomes. Findings suggest that increased uptake of nutrition therapy and self-management education and support may be critical for improving diabetes outcomes and promoting health equity.
A Minimally Time-Consuming Method for Regular, Ongoing Outcome Assessments in a Rural Diabetes Self-Management Education and Support Program: Validation via Retrospective Pre-Post Studies
Authors: Zhang Xin , McGettigan Tiaha E.
Published: February 2025

Purpose

The purpose of this study was to introduce and validate a minimally time-consuming method for regular, ongoing assessments of practice- and individual-level outcomes in a rural diabetes self-management education and support (DSMES) program.

Methods

The method involves a report developed within an electronic health record system to capture the initial A1C data of patients in the program and their most recent A1C data at the time the report is run. To validate the method’s ability to continuously assess outcomes, 3 retrospective pre-post studies were conducted over 3 consecutive months: October, November, and December 2023. The subjects were individuals with type 2 or type 1 diabetes who completed their initial visits in the program during these months. A1C changes in patient cohorts and their statistical significance were analyzed as practice-level outcomes, and individual-level outcomes were monitored by plotting and analyzing patient data.

Results

The report accurately captured data, enabling minimally time-consuming analyses. The method allowed both continuous assessment of program effectiveness based on A1C changes and monitoring of individual patient progress. Statistically significant reductions in average A1C were observed for subjects seen in October and December 2023 (but not in November) and across the combined data from all 3 months. Data plotting helped identify individual subjects who may benefit from follow-up.

Conclusions

The method is feasible and accurate for ongoing outcome assessments, providing timely feedback to clinicians and promoting practice changes to improve patient outcomes. It is also flexible and adaptable to other DSMES programs.
Disciplined autonomy: A failed platform-cooperativism initiative in Brazil
Authors: Estima Walmir , Lemos André
Published: February 2025

This study seeks to gain an understanding of the power relations in a failed platform-cooperativism initiative in Araraquara, São Paulo, Brazil, in 2022. The project was started by a worker cooperative that acquired a Bibi Mob platform franchise and was supported by the city's solidarity-economy incubator. The project failed eight months after its inception. We examine the datafication process in the app in order to analyse how the power relations of global infrastructural platforms – Google and Amazon in particular – contributed to the end of the initiative. The workers’ local actions were constrained by disciplinary power imposed by the global platform ecosystem. Drawing on this Latin American experience, we argue that the infrastructural power wielded by dominant actors within the platform economy is exercised through a disciplinary apparatus, significantly restricting local actors’ autonomy, and acting as a form of what we term ‘disciplined autonomy’.
Pre-Transplant MRD Does Not Seem to Impact Survival in NPM1-Mutated AML Undergoing Allogeneic Stem Cell Transplantation
Authors: Fraccaroli Alessia , Jurinovic Vindi , Hirschbühl Klaus , Elena Stauffer , Koch Katrin , Breitkopf Stephan , Haebe Sarah , Drolle Heidrun , Rothenberg-Thurley Maja , Dufour Annika , Metzeler Klaus H , Spiekermann Karsten , Hentrich Marcus , Hausmann Andreas , Verbeek Mareike , Schmid Christoph , Herold Tobias , Tischer Johanna
Published: February 2025

Whether patients with acute myeloid leukemia (AML) harboring Nucleophosmin mutations (NPM1mut) with measurable residual disease (MRD) should undergo allogeneic stem cell transplantation (alloSCT) in complete remission (CR) remains subject of debate. This study aimed to assess whether the presence of bone marrow (BM) NPM1mut MRD, detected using a RT-qPCR assay with a sensitivity of 10-5, could influence the benefit derived from alloSCT. Data from four German transplantation centers were analyzed including 174 AML NPM1mut patients who underwent a first alloSCT between 2011-2022. Among 122 patients transplanted in complete remission (CR), pre-alloSCT MRD was positive in 54%. After alloSCT, the cumulative rate of BM MRD negativity increased from 65% by day +30 to 73% by day +100, with FLT3-ITD and ELN risk profile significantly impacting on MRD conversion rate at day +30. No significant difference in leukemia-free survival (LFS) and overall survival (OS) based on pre-transplant MRD status (3y LFS MRD+ 60% vs MRD- 74%, HR 1.5, p=0.28; 3y OS MRD+ 68% vs MRD- 78%, HR 1.42, p=0.39) was observed. Outcomes between MRD persistence and molecular relapse did not differ (p=0.8). Whereas adverse molecular risk features (HR 4.69, p=0.003) and relapsed/refractory disease (HR 2.83/3.59, p=0.005/0.001) were associated with unfavorable prognosis, administration of post-transplant maintenance improved survival in multivariable analysis (HR 0.48, p=0.06). Our findings suggest that in patients with NPM1mut AML MRD positivity as assessed per qPCR at time of transplant does not impact posttransplant outcomes of NPM1mut AML.
Mechanistic insights into 5-aminolevulinic acid photodynamic therapy for acne vulgaris: targeting lipogenesis via the OLR1-Wnt/β-catenin pathway
Authors: Yan Jia , Zhang Linglin , Zeng Qingyu , Qian Yitao , Li Ke , Liu Xiaojing , Wu Yun , Yan Yu , Zhang Haiyan , Cheung Szeman , Liu Jia , Sroka Ronald , Wang Xiuli , Shi Lei
Published: February 2025

Acne vulgaris, a prevalent chronic inflammatory skin disorder, is often characterized by hyperactive sebaceous glands and excessive sebum production, presenting a significant therapeutic challenge. While 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is clinically effective in treating moderate to severe acne, the molecular mechanisms underlying its therapeutic effects remain largely unexplored. In this study, we investigated the impact of ALA-PDT on lipid metabolism in an acne-like mouse model and in immortalized human sebocytes (XL-i-20), focusing on the role of the OLR1-Wnt/β-catenin pathway. We employed transcriptomic analysis, lipid staining, and gene silencing techniques to dissect the molecular interactions induced by ALA-PDT. Our findings revealed that ALA-PDT significantly reduces lipogenesis by upregulating OLR1, which in turn suppresses the SREBP1-FAS axis, thereby decreasing lipid accumulation in sebocytes. Furthermore, activation of the OLR1-Wnt/β-catenin pathway was essential for these lipogenic effects, as silencing OLR1 or activating Wnt/β-catenin signaling reversed lipogenesis inhibition. This study elucidates a novel mechanistic pathway in ALA-PDT-mediated acne treatment, highlighting OLR1 as a promising target for future therapeutic strategies.
Sequence-based GWAS in 180,000 German Holstein cattle reveals new candidate variants for milk production traits
Authors: Križanac Ana-Marija , Reimer Christian , Heise Johannes , Liu Zengting , Pryce Jennie E. , Bennewitz Jörn , Thaller Georg , Falker-Gieske Clemens , Tetens Jens
Published: February 2025

Background

Milk production traits are complex and influenced by many genetic and environmental factors. Although extensive research has been performed for these traits, with many associations unveiled thus far, due to their crucial economic importance, complex genetic architecture, and the fact that causal variants in cattle are still scarce, there is a need for a better understanding of their genetic background. In this study, we aimed to identify new candidate loci associated with milk production traits in German Holstein cattle, the most important dairy breed in Germany and worldwide. For that purpose, 180,217 cattle were imputed to the sequence level and large-scale genome-wide association study (GWAS) followed by fine-mapping and evolutionary and functional annotation were carried out to identify and prioritize new association signals.

Results

Using the imputed sequence data of a large cattle dataset, we identified 50,876 significant variants, confirming many known and identifying previously unreported candidate variants for milk (MY), fat (FY), and protein yield (PY). Genome-wide significant signals were fine-mapped with the Bayesian approach that determines the credible variant sets and generates the probability of causality for each signal. The variants with the highest probabilities of being causal were further classified using external information about the function and evolution, making the prioritization for subsequent validation experiments easier. The top potential causal variants determined with fine-mapping explained a large percentage of genetic variance compared to random ones; 178 variants explained 11.5%, 104 explained 7.7%, and 68 variants explained 3.9% of the variance for MY, FY, and PY, respectively, demonstrating the potential for causality.

Conclusions

Our findings proved the power of large samples and sequence-based GWAS in detecting new association signals. In order to fully exploit the power of GWAS, one should aim at very large samples combined with whole-genome sequence data. These can also come with both computational and time burdens, as presented in our study. Although milk production traits in cattle are comprehensively investigated, the genetic background of these traits is still not fully understood, with the potential for many new associations to be revealed, as shown. With constantly growing sample sizes, we expect more insights into the genetic architecture of milk production traits in the future.
Frailty in older adults admitted to hospital: outcomes from the Western Sydney Clinical Frailty Registry
Authors: McDonagh Julee , Lindley Richard I , Byth Karen , John Reejamol , Ferguson Caleb
Published: February 2025

Objectives

To examine baseline frailty and its association with rehospitalisation and mortality within 12 months among older adults enrolled in the Western Sydney Clinical Frailty Registry.

Design

Prospective observational cohort study.

Setting and participants

592 adults admitted to an acute geriatric medicine service in NSW, Australia, were included in this study.

Methods

The Western Sydney Clinical Frailty Registry is a study of adults admitted to acute geriatric wards in a 570-bed two-site district general hospital in Western Sydney, NSW, Australia. Recruitment began in April 2020 and is ongoing. Each participant is recruited while an inpatient and followed up for 12 months, including baseline visits and three-, six- and 12-month follow-ups via telephone interviews. The primary outcome of this study was rehospitalisation and/or mortality at 12 months.

Results

Median age 82 years; half the cohort were classified as mild-moderately frail, and 21% were classified as severely frail. A total of 134 participants died (22.6%) within the 12-month follow-up period. Increased cumulative incidence of first rehospitalisation and/or death during the first 12 months post-discharge was significantly associated with higher modified Charlson comorbidity (p < 0.001) and Clinical Frailty Scale (CFS) scores (p < 0.001). Compared to the ‘non-frail’ group (CFS 1–4), those who were severely frail (CFS 7–9) had an 85% increased risk of rehospitalisation and/or death (95% CI 1.36–2.52), and those who were mild-moderately frail (CFS 5–6) had a 52% increased risk after adjusting for effects of the other variables (95% CI 1.18–1.94).

Conclusions

Frailty is very common in older adults admitted to acute geriatric services. Assessing frailty using the CFS is feasible and is independently predictive of rehospitalisation and mortality. Our findings suggest that integrating frailty assessment into clinical practice goes beyond simple risk stratification, offering valuable insights for tailored clinical management strategies.
Exploring predictors of the five-time sit-to-stand test based on cross-sectional findings from the Swedish National Study on Aging and Care (SNAC)
Authors: Niklasson Joakim , Fagerström Cecilia , Backåberg Sofia , Bergman Patrick , Lindberg Terese
Published: February 2025

Background

As we age, staying physically active and reducing sedentary behavior becomes crucial. To understand how to achieve this, factors related to daily physical function such as five-time sit-to-stand (STS) time should be explored. This study aimed to investigate the associations between STS time, self-rated physical activity, physical function, health-related quality of life, physical and mental health in community-dwelling older adults aged ≥ 60 years.

Method

Cross-sectional design with self-reported and objectively measured data from adults aged ≥ 60 years (n = 819), acquired from the Swedish National Study on Aging and Care. Data was analyzed through multiple linear regression.

Results

The model (R2 = 0.268) showed that STS time was predicted by grip strength (β’ = -0.204, p < 0.05), age (β’ = 0.202, p < 0.05), health-related quality of life (β’ = -0.192, p < 0.05), having fallen within the preceding twelve months (β’ = -0.127, p < 0.05), physical activities of perceived light to moderate intensity (β’ = -0.121, p < 0.05), one-leg stand (β’ = -0.099, p < 0.05), and education level (β’ = -0.092, p < 0.05). For STS time, health-related quality of life (β = -0.354, confidence interval [CI] (-0.509)–(-0.199)), having fallen within the preceding twelve months (β = -0.222, CI (-0.365)–(-0.078)), and physical activities of perceived light to moderate intensity (β = -0.166, CI (-0.278)–(-0.053)) were the most prominent predictors.

Conclusion

The model highlights the importance of grip strength and health-related quality of life in predicting STS time in older adults. Clinicians can use these insights to develop interventions that maintain physical function by regularly assessing and monitoring these factors. Future research should explore the relationship between fall history, faster STS time, and the impact of grip strength and health-related quality of life on sedentary behavior among older adults.
Turkish adaptation, validity, and reliability study of the Quality of Life Gravidarum (QOL-GRAV) scale
Authors: Ayan Gamze , Apay Serap Ejder
Published: February 2025

Background

The study aims to adapt the validity and reliability of the Pregnancy Quality of Life Scale in Turkish society.

Methods

The study was carried out methodologically between April 2021 and April 2022 at Bayburt State Hospital, the only public hospital operating in the city center of Bayburt. In the study, a total of 355 pregnant women who met the research criteria and volunteered to participate were examined without selecting a sample. Validity and reliability analysis of language and content validity, explanatory and confirmatory factor analysis, and Cronbach- α coefficient were used.

Results

The factor structure of the Turkish form of the scale was consistent with the original form. As a result of the explanatory appropriate. The internal consistency coefficient was calculated as the total Cronbach-α coefficient of the scale was 0.628 for the first trimester, and 0.628 for the II. trimester 0.727 for trimester, III. Trimester it is 0.698 for a trimester.

Conclusion

As a result of the validity and reliability study, the Turkish version of the Pregnancy Quality of Life Scale can be used as a valid and reliable measurement tool.
Keratoconus with two consecutive re-emergences: a case report
Authors: Zhang Peicheng , Wu Yanchao , Ma Lixiao , Wang Dong
Published: February 2025

Background

Keratoconus is a common disease in clinical practice, and deep anterior lamellar keratoplasty(DALK) is a conventional treatment for keratoconus, which is effective and not easy to recur after surgery.

Case presentation

The author presents a rare case report involving a 21-year-old patient with Consecutive re-emergences of Keratoconus. He underwent DALK for keratoconus in his left eye in 2012 and experienced re-emergence 3 years later, followed by a second deep lamellar keratoplasty in the same year. In 2019, the patient experienced re-emergence of keratoconus and underwent a third deep lamellar keratoplasty in the same eye. Genetic testing was performed, and no abnormal genes were identified. Postoperative follow-up emphasized the management of chronic allergic conjunctivitis (CAC) and the correction of eye-rubbing habits. To date, he has not experienced any further re-emergence.

Conclusions

Keratoconus is a complex disorder with a multifaceted etiology and pathogenesis, including genetic, environmental, biomechanical, and cellular factors. Its treatment usually requires multiple considerations, including the choice of surgical methods, anti-inflammatory therapy, and correction of eye rubbing habits to guide patients for subsequent treatment interventions.