bluuebunny/crossref_metadata_2025 huggingface dataset:
K-12 content teachers designing language tasks: A follow-up to Erlam, 2016
Authors: Tigchelaar Magda , David Virginia , Eldemerdash Amira , Protacio Selena , Piazza Susan
Published: January 2023

This study, a follow-up to the research reported by Erlam, investigated K-12 content teachers’ ability to design tasks for content instruction in U.S. schools. Thirty-nine K-12 teachers who were enrolled in an English as a second language (ESL) teaching methods course participated in the study and each designed two language learning tasks. Two researchers rated the tasks following Ellis and Shintani’s four task criteria, as in Erlam. The study addressed the questions: (1) How successful are content teachers in designing tasks that satisfy Ellis and Shintani’s criteria? (2) Which of the criteria do teachers find easiest and most difficult to satisfy? and (3) Do the teachers improve in meeting the criteria in a second round of task designs? Ninety-two percent and 95% of the tasks satisfied three of the four criteria in task designs 1 and 2, respectively. The teachers excelled most at creating contexts for meaningful communication (92%) and including an information gap (92%) in their first tasks. Incorporating a clearly defined outcome was the most difficult criterion (66%) for teachers to achieve. There was no significant improvement from Task 1 to Task 2 in successfully incorporating the four criteria. The content teachers incorporated more of the task features than the foreign language teachers in Erlam. Over 90% met the majority of the criteria, compared to 82% in Erlam’s study. Another important difference was that participants in Erlam’s study found the easiest criteria to address was including an outcome, and they struggled most to allow learners to use their own linguistic resources and incorporate a gap. The content teachers in the follow-up study struggled most to include an outcome, but consistently incorporated communication gaps and grew in their ability to ensure that learners use their own linguistic resources. This suggests that language teachers may focus more readily on language forms, while content teachers focus more on meaningful content than on language, providing support for learners to focus on meaning.
‘Maybe we just seem like easy targets’: A qualitative analysis of autistic adults’ experiences of interpersonal violence
Authors: Gibbs Vicki , Pellicano Elizabeth
Published: January 2023

Research has consistently found high rates of victimisation among autistic children. There is emerging evidence that disproportionate victimisation continues into adulthood, however the extent, nature and impact and the mechanisms that underlie high rates of interpersonal violence are not well understood. Here we investigate the nature and impact of violence experiences using qualitative methods. Twenty-two autistic adults who had experienced interpersonal violence during adulthood participated in semi-structured interviews. We analysed the data using a thematic analysis to identify key themes. Violence was commonplace in their own lives and in the lives of other autistic people that they knew, to the extent that violence had become normalised. They spoke of the impacts of these experiences on their mental health, self-concept and subsequent relationships and of how these impacts were exacerbated when their disclosures were dismissed by others. They reported that certain autistic characteristics might make them more vulnerable and of how such characteristics were often shaped by repeated experiences of invalidation and pressure to conform within a neurotypical world. These findings demonstrate the importance of developing ways to improve the personal safety of autistic people which must include the broader social factors that at least partly contribute to these distressing experiences.

Lay abstract

Research has consistently shown that autistic children are more likely to be victimised than non-autistic children. More recently, studies have also found that autistic adults report experiencing more violence than non-autistic adults however the circumstances surrounding these incidents and the reasons for this are not clear. We wanted to learn more about violence during adulthood for autistic people including what led up to these incidents and what happened afterwards. We spoke to 22 autistic adults who had experienced violence and analysed what they told us to look for common themes. They told us that violence was commonplace in their own lives and in the lives of other autistic people that they know, so much so that they had even come to expect it to happen. They also talked about the negative effect these experiences had on their mental health, the way they felt about themselves and their ability to trust people. This was made worse if people did not believe them when they disclosed what had happened to them. They told us that certain autistic characteristics might make them more vulnerable like being too trusting or going along with people just to please them. They thought that some of these characteristics had been shaped by their experiences, especially being told that that their thoughts, feelings or behaviours were wrong and being pressured to change the way they behaved to ‘fit in’. These findings are important in helping us to understand how to improve the personal safety of autistic people.
Changeable sexualities and fluid masculinities: The intersections of sexual fluidity with hegemonic masculinity
Authors: Grave Rita , Pinho Ana R , Marques António M , Nogueira Conceição
Published: January 2023

This article explores the concept of sexual fluidity and its applicability to men’s sexual experiences by approaching the surveillance and control of hegemonic masculinity. We carried out semi-structured interviews with 15 participants aged between 20 and 53 who state having experienced sexual fluidity. The analysis conveys how sexuality is a work in progress while highlighting the intersections of masculinities and sexualities in a heteronormative, mononormative, sexually rigid, and hegemonically masculine social context. The results indicate the potential flexibility, malleability, and changeability of all sexual identities, orientations, and experiences when disengaging from a heteronormative approach in sexual relations.
Chatbot features for anxiety and depression: A scoping review
Authors: Ahmed Arfan , Hassan Asmaa , Aziz Sarah , Abd-alrazaq Alaa A , Ali Nashva , Alzubaidi Mahmood , Al-Thani Dena , Elhusein Bushra , Siddig Mohamed Ali , Ahmed Maram , Househ Mowafa
Published: January 2023

Chatbots can provide valuable support to patients in assessing and guiding management of various health problems particularly when human resources are scarce. Chatbots can be affordable and efficient on-demand virtual assistants for mental health conditions, including anxiety and depression. We review features of chatbots available for anxiety or depression. Six bibliographic databases were searched including backward and forwards reference list checking. The initial search returned 1302 citations. Post-filtering, 42 studies remained forming the final dataset for this scoping review. Most of the studies were from conference proceedings (62%, 26/42), followed by journal articles (26%, 11/42), reports (7%, 3/42), or book chapters (5%, 2/42). About half of the reviewed chatbots had functionality targeting both anxiety and depression (60%, 25/42), whereas 38% (16/42) targeted only depression, 38% (16/42) anxiety and the remaining addressed other mental health issues along with anxiety and depression. Avatars or fictional characters were rarely used in these studies only 26% (11/42) despite their increasing popularity. Mental health chatbots could benefit in helping patients with anxiety and depression and provide valuable support to mental healthcare workers, particularly when resources are scarce. Real-time personal virtual assistance fills in this gap . Their role in mental health care is expected to increase.
Prediction of diabetes prescription volumes of various geographies using regression techniques
Authors: Mistry Pritesh
Published: January 2023

Background: Increasing diabetes prevalence is a major public health concern. In this study we ask whether linked open data can be used to predict prescription volumes of drugs used in the treatment of diabetes across small geographies of England. Methods: We propose and demonstrate a methodology of utilising publicly available open data to infer the geo-spatial distribution of prescribed drugs for diabetes, at the lower layer super output area level. Multiple datasets are acquired, processed, and linked together, enabling a more in-depth analysis. Combining these linked datasets with published deprivation factors of geographies across England, we build highly predictive regression models. Results: Regression models were trained and are capable of accurately predicting diabetes prescribing volumes based on deprivation indicators of various geographies across England. Models built with data covering the city of Bradford, England, produced a predicted against actual correlation value of R2 = 0.672 using multiple linear regression and 0.775 using Least Absolute Shrinkage and Selection Operator (LASSO). Median age and air quality factors proved to be significant markers for diabetes prescribing. Conclusions: The results of this study suggest our methodology is robust and accurate. Such predictive models are useful to health authorities in light of increasing costs and increasing prevalence of diabetes. While using publicly available open data negates any issues of data privacy.
The infant/toddler teacher as willful subject: A critical narrative analysis of gendered discursive regimes in US-based early care and education
Authors: Sorrells Cassie , Madrid Akpovo Samara , Leclerc Meghan
Published: January 2023

Dominant narratives of teacher emotion in early care and education rely on historical discourses of white femininity and white maternalism to position early childhood teachers as naturally adept and selfless caretakers of young children. Missing from these narratives, however, is the reality that emotion-display rules and norms are often enforced on teachers through surveillance and social control, and that teachers whose emotion displays veer outside the bounds of the dominant narratives experience punitive professional and personal backlash. This qualitative case study utilizes critical narrative analysis and post-structural feminist perspectives to explore the emotional experiences of Lauren, a white, female infant/toddler teacher, as she navigated the emotional experience of teaching during the early days of the COVID-19 pandemic in the USA. The data is drawn from a larger study guided by the following research question: “What are the emotional experiences of early childhood teachers during the COVID-19 pandemic?” The findings in this article leverage Michel Foucault's concept of the “docile body” and Sara Ahmed's concept of the “willful subject” to interpret themes of discursive enforcement and teacher resistance to teacher emotion-display norms and rules. These findings problematize the dominant construction of the idealized emotional landscape of early care and education and present in its place a portrait of surveillance and resistance in a discursive struggle of power against emotional will.
Researcher positionality in eliciting young children’s perspectives
Authors: Patton Karen , Winter Karen
Published: January 2023

Research that uses innovative approaches to elicit the views of young children has grown hugely over the last 20 years. Against a backdrop of a greater acceptance of children’s rights and sociological approaches to understanding children and childhood, with their combined emphasis on the competences and capacities of children, it is now accepted that young children can be engaged with to seek their views, experiences and perspectives as part of research studies. The range of methodological approaches is extensive including arts and play based methods, digitally based games, the use of photography and recordings. This article focuses on issues connected with researcher positionality that arose in a research study that sought to elicit children’s views about their early childhood settings using a teddy bear called ‘Ted’. The article draws attention to contingent and contextual nature of children’s engagement in research processes and methods and therefore the critical importance of researchers developing detailed reflexive accounts of their positionality, so that the contextual and relational aspects of methodological processes and the findings that emerge, are as transparent as possible. Implications for other similar types of research are considered.
Neuromyelitis Optica Spectrum Disorder: Case Description and Information for Speech-Language Pathologists
Authors: Burda Angela , Banwart Courtney , Engels Madison , Hogelucht Heather , Lilly Lauren , Mingus Hallee , Nair Deepthy , Simon Madison
Published: January 2023

Neuromyelitis optica spectrum disorder (NMOSD) is an acquired neurological disorder primarily affecting physical and visual functioning. There is a lack of empirical evidence in the existing literature about the nature of speech, language, and cognitive deficits associated with NMOSD. Hence, this case study provides assessment information about a 32-year-old female diagnosed with NMOSD who was administered the following formalized tests via teleconference: the Apraxia Battery for Adults–2nd edition, Cognitive Linguistic Quick Test, and Western Aphasia Battery-Revised. The participant, classified as having anomic aphasia, demonstrated good auditory and reading comprehension, writing difficulties, apraxia of speech, and mild difficulties with cognitive tasks requiring writing.
Ventriloquism as Method: Writing Differently and Thinking Philosophically
Authors: Yan Dave , Bright David , Prosser Howard , Poole Adam
Published: January 2023

This article argues for ventriloquism as a method of (post)qualitative inquiry for appropriating the voice of the Other and amplifying multi-voiced selves. Thinking with embodied figures, ventriloquism captures philosophical conceptions of the subject and object through the self and other. To sustain the existence of “abject” voices, we orient readers’ attention to the creative feature of the “material dimension” through literary devices. The deliberate uses of bold italicized text and footnotes are one instance. We propose that the intention of ventriloquial writing is not to find something that exists in that lived experience, but to re-orient our thought to understand be(com)ing the Other within a liminal space. By refusing conventional methodologies, ventriloquism may serve as an ontological response to St. Pierre’s (2021) call for experimenting and creating other “new forms of inquiry” (p. 7).
Impact of Baseline Expectancy on Outcome Prediction of Real and Sham Acupuncture for Persistent Chemotherapy-Induced Peripheral Neuropathy Pain in Solid Tumor Survivors: A Secondary Analysis of a Randomized Clinical Trial
Authors: Li Xiaotong , Zhi Lilly , Han Katherine Y. , Li Susan Q. , Ahmad Khalada , Seluzicki Christina , Wang Rui , Bao Ting
Published: January 2023

Background:

Chemotherapy-induced peripheral neuropathy (CIPN) pain significantly worsens cancer survivors’ quality of life. Expectancy may play an important role in acupuncture response. We sought to explore whether expectancy predicts pain outcome in real acupuncture (RA) and sham acupuncture (SA) in cancer survivors.

Methods:

We analyzed data from a randomized clinical trial that evaluated the effect of RA on CIPN symptoms compared to SA and wait list control (WLC) in 75 cancer survivors. This secondary analysis was limited to CIPN pain measured by the Numeric Rating Scale (NRS), graded from 0 to 10. Interventions were delivered over 8 weeks. SA was implemented using a combination of non-acupuncture points and a non-insertion procedure. Patient expectancy was measured by the Acupuncture Expectancy Scale (AES) 3 times during the study. We used a linear regression model to evaluate if the NRS score was associated with the baseline AES score at the end of treatment (week 8), adjusting for baseline NRS score.

Results:

AES was similar among 3 groups at baseline (RA: 11.8 ± 2.7; SA: 12.1 ± 3.8.; WLC: 14.6 ± 4.2; P = .062). Baseline AES was not found to be significantly associated with the week 8 NRS score among patients in all RA, SA, and WLC groups (all P > .05). However, we found a trend that higher baseline AES predicted lower NRS score at week 8 in the SA group: a one-point higher score on baseline expectancy was associated with a 0.3-point reduction in NRS pain score ( P = .059) at week 8.

Conclusions:

The association of baseline expectancy and acupuncture response was similar between RA and SA. However, SA seemed to rely more on expectancy than RA. Further studies with larger sample sizes are needed to confirm this finding.
Gene therapy for hemophilia: looking beyond factor expression
Authors: Yamaguti-Hayakawa Gabriela G , Ozelo Margareth C
Published: January 2023

Hemophilia A (factor VIII [FVIII] deficiency) and hemophilia B (factor IX [FIX] deficiency) are the X-linked recessive bleeding disorders that clinically manifest with recurrent bleeding, predominantly into muscles and joints. In its severe presentation, when factor activity is less than 1% of normal, hemophilia presents with spontaneous musculoskeletal bleeds and may progress to debilitating chronic arthropathy. Management of hemophilia has changed profoundly in the past decades. From on-demand to prophylactic factor concentrate replacement, the treatment goal shifted from controlling bleeds to preventing bleeds and improving quality of life. In this new scenario, gene therapy has arisen as a paradigm-changing therapeutic option, a one-time treatment with the potential to achieve sustained coagulation FVIII or FIX expression even within the normal range. This review discusses the critical impact of adeno-associated virus (AAV) gene transfer in hemophilia care, including the recent clinical outcomes, changes in disease perceptions, and its treatment burden. We also discuss the challenging scenario of the AAV-directed immune response in the clinical setting and potential strategies to improve the long-lasting efficacy of hemophilia gene therapy efficacy.
Latent Profiles of Responding on the Massachusetts Youth Screening Instrument-2 Subscale Scores by Race/Ethnicity among Juvenile Justice-Involved Boys and Girls
Authors: Jaggers Jeremiah W. , Modrowski Crosby A. , Kerig Patricia K. , Kilshaw Robyn E. , Cambron Christopher , Allen Ashley K.
Published: January 2023

The Massachusetts Youth Screening Instrument (MAYSI-2) is one of the most widely utilized screening measures for detecting mental health concerns among youth entering juvenile detention settings. Previous research has demonstrated clear patterns of sex differences in the severity of mental health symptoms among detained boys and girls. However, few studies have examined potential racial or ethnic differences in MAYSI-2 scores, which is a significant limitation. This study examined sex and racial/ethnic differences in patterns of youth responses on the MAYSI-2. Data were collected from a total of 5417 youth detained in a short-term detention facility in the Mountain West. Results of latent profile analyses demonstrated that, among both boys and girls, youths’ racial/ethnic identity was associated with distinct patterns of responding on the MAYSI-2. These findings have implications for informing screening in the juvenile justice system and increasing recognition and response to ethnic/racial and sex differences among detained youth.
Medical Sports Injuries in American Football Players
Authors: Matusak Mark E. , Yau Catherine C. , Fibel Kenton H.
Published: January 2023

Most injuries in American football are orthopedic, but the medical team must also be prepared to recognize and manage injuries beyond the musculoskeletal system that may result from trauma to the face, chest, abdomen, and pelvic regions. Failure to promptly identify such injuries in athletes can be life-threatening or permanently disabling. The literature on many of the nonorthopedic sports injuries is limited but can aid in understanding injury presentation, imaging modalities of choice, and initial management. Safe return-to-play decision-making requires a thoughtful approach through the use of available data and an understanding of pathophysiology and tissue healing.
How Are Radial Height and Radial Shortening Defined in the Treatment of Distal Radius Fractures? A Critical Review
Authors: Chan Peter Y. W. , Silver Jeremy M. , Phelan Joseph , Moore Kyle , Green Anna , Katt Brian
Published: January 2023

Background:

Radial height is a radiographic parameter used to guide the treatment of distal radius fractures. However, it is often used synonymously with other terms, and there are substantial discrepancies in its measurement/definition. These discrepancies can alter the measurement of radial height and affect treatment decisions. The purpose of this review is to identify the different definitions of radial height in the literature relevant to distal radius fractures.

Methods:

A literature review was conducted in the PubMed/MEDLINE database from inception to 2022. Full-length, English-language studies that pertained to distal radius fractures and reported radial height as a recorded measurement were included. The method of radial height measurement (definition) was extracted from included studies. Level of evidence was determined by the Oxford Centre for Evidence-based Medicine Levels of Evidence tool.

Results:

A total of 385 studies were identified. Of these, 183 (47.5%) did not provide a definition for radial height. Of the studies that defined radial height, 50.9% (103/202) measured radial height from the radial styloid to the distal ulna, 10.9% (22/202) measured from the radial styloid to the distal radius, and 29.2% (59/202) were “other” definitions.

Conclusions:

There is substantial discrepancy in the way that radial height is measured and reported. We advocate for a standardized measurement of radial height (synonymous with radial length) from the radial styloid to the distal ulnar articular surface. Radial shortening is a different measurement and requires comparison with a reference value.
Tendon Transfers, Nerve Grafts, and Nerve Transfers for Isolated Radial Nerve Palsy: A Systematic Review and Analysis
Authors: Jain Nirbhay S. , Barr Meaghan L. , Kim Daniel , Jones Neil F.
Published: January 2023

Background:

Isolated radial nerve palsy is a debilitating injury that may potentially be reconstructed with either tendon transfers, nerve grafts, or nerve transfers. Currently, there is no consensus on the optimal technique for reconstruction. We performed a systematic review and analysis to determine which surgical intervention provides the best clinical outcomes.

Methods:

A systematic review was conducted according to PRISMA guidelines. Twenty-nine papers met inclusion criteria. Grading scales of function and strength were converted into a tripartite scoring system to compare outcomes between techniques. χ2 analyses were performed with a P value < .05.

Results:

Seven hundred fifty-four patients were analyzed. Tendon transfers resulted in the highest percentage of good outcomes (82%) and the lowest percentage of poor outcomes (9%). Tendon transfers were superior to nerve grafts and nerve transfers for restoration of wrist extension. Nerve transfers for wrist extension were superior to nerve transfers for finger extension. Nerve grafts and nerve transfers had equivalent rates of good and poor clinical outcomes.

Conclusions:

This study analyzed reported outcomes of tendon transfers, nerve grafts, and nerve transfers for reconstruction of isolated radial nerve palsy. On pooled analysis, tendon transfers had higher rates of superior clinical outcomes as compared with nerve transfers and nerve grafts. Tendon transfers should be considered first-line reconstruction for isolated radial nerve palsy as nerve-based reconstruction is less predictable and reproducible.
Risk Factors Associated With de Quervain Tenosynovitis in Postpartum Women
Authors: Daglan Efrat , Morgan Samuel , Yechezkel Matan , Rutenberg Tal Frenkel , Shemesh Shai , Iordache Sorin D. , Kadar Assaf
Published: January 2023

Background:

De Quervain (DQ) disease is caused by stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis. This condition affects women 6 times more than men and is also commonly reported in pregnant and lactating women. The natural course of the disease and associated risk factors are not well understood. In this study, we described the gestational risk factors associated with postpartum DQ.

Methods:

Sixty-three postpartum women with DQ were included in final study population. Medical records were reviewed for patient characteristics, including age, comorbidities, and body mass index (BMI), and gestational information, including length of pregnancy, gestation number, single or twin birth, and weight at birth. Odds ratio (OR) for developing DQ tenosynovitis were calculated with the control group of 630 postpartum women without DQ who gave birth between 2012 and 2020 in the same district.

Results:

Length of pregnancy (>40 weeks, OR = 5.81 [3.29-10.28]), first childbirth (OR = 2.23 [1.32-3.77]), and weight (BMI > 25, OR = 2.08 [1.14-3.81]) were all statistically significant risk factors associated with developing DQ. Number of fetuses > 1 (OR = 0.98 [0.29-3.33]) and birth weight more than 3.5 kg (OR = 0.60 [0.30-1.21]) were not associated with higher risk of DQ.

Conclusions:

Gestational risk factors associated with developing postpartum DQ include first pregnancy and long pregnancy of more than 40 weeks. Interestingly, child’s birthweight and number of fetuses, both factors that might increase load on the first dorsal compartment while holding the child, were not shown to increase the risk of postpartum DQ.
How should online antenatal and parenting education be structured according to parents? Qualitative findings from a mixed-methods retrospective study
Authors: Wallace Heather Julie , Bayes Sara , Davenport Cindy , Grant Melissa
Published: January 2023

Background:

Over the past 50 years, the content and structure of antenatal education classes have varied to reflect social norms of the time, the setting and context in which they have been held and who has facilitated them. In recent times, antenatal and parenting education classes have become a smorgasbord of information, offering a range of diverse content. Where and how parents-to-be may access formal antenatal and parenting education classes are also varied. Even before the lockdown challenges of the Covid-19 pandemic, many antenatal and parenting education classes had become available and accessible online. While the flexibility and accessibility of this option are apparent, scant research to date has reported on parents’ experiences of undertaking online antenatal education.

Objectives:

The objectives of this study were to explore new parents’ experiences of engaging in online antenatal education, and to discover how consumers of online antenatal education perceive it should be designed and delivered.

Design/Methods:

A mixed-methods design was used for this study, which was conducted with 294 past enrolees in a range of online antenatal and early parenting education programmes delivered by one private provider in Australia. The past enrolees were invited to participate in the study by email, wherein a link to an online information sheet and survey containing closed- and open-ended questions was provided. The responses to the open-ended questions that are reported in this article were analysed using a thematic approach that involved coding, sub-categorizing and then categorizing the data.

Results:

A total of 108 participants provided qualitative data about the delivery and design of online antenatal education and information. The data were captured in three themes: video control and content, accessibility and pre-/intra-programme support.

Conclusions:

The results of this study provide important insights for the development of online antenatal education programmes and courses that will be of interest to antenatal educators, maternity services and maternity care policy developers. Specifically, millennial parents want trustworthy and accurate antenatal education that is delivered in a framework that aligns with and builds on adult-learning principles. The diversity of families and of expectant parents’ learning styles is also important to recognize in antenatal education curricula.
Exploring the carry-over of top-down attentional settings in dynamic conditions
Authors: Thompson Catherine , Jalali Maryam , Hills Peter J
Published: January 2023

A top-down attentional set can persist from a relevant task to an irrelevant task, influencing allocation of attentional resources, visual search, and performance. While this “carry-over” effect has been found across numerous experiments, past studies have utilised paradigms that present similar tasks to the same spatial location. The present research explored whether attentional settings persist in more dynamic situations. In Experiment 1, participants played a computer game that encouraged a horizontal, vertical, or random spread of search. After 10 or 30 s, they moved 90° to their right and monitored a driving video for hazards. Eye movements to the videos were not affected by the characteristics of the preceding game, revealing no carry-over of attentional settings. One possible explanation for this was the visuospatial shift between the tasks. To explore this further, Experiment 2 adopted a similar paradigm to previous research; participants searched horizontal, vertical, or random letter strings before completing an image search. In one block the tasks were presented to the same screen, and in one block the tasks were presented to different screens (incorporating a 90° visuospatial shift mid-trial). Carry-over was found in the one-screen block, with a significantly wider horizontal search and a narrower vertical search in the pictures after a horizontal letter search. However, there was no carry-over from the letter to the picture task in the two-screen block. This indicates the flexibility of attentional control in dynamic situations, and it is suggested that persistence of attentional settings will be most costly under stable conditions.
Disease-modifying therapies for relapsing/active secondary progressive multiple sclerosis – a review of population-specific evidence from randomized clinical trials
Authors: Bayas Antonios , Christ Monika , Faissner Simon , Klehmet Juliane , Pul Refik , Skripuletz Thomas , Meuth Sven G.
Published: January 2023

Although the understanding of secondary progressive multiple sclerosis (SPMS) is evolving, early detection of relapse-independent progression remains difficult. This is further complicated by superimposed relapses and compensatory mechanisms that allow for silent progression. The term relapsing multiple sclerosis (RMS) subsumes relapsing-remitting multiple sclerosis (RRMS) and SPMS with relapses. The latter is termed ‘active’ SPMS, for which disease-modifying therapies (DMTs) approved for either RMS or active SPMS can be used. However, the level of evidence supporting efficacy and safety in SPMS differs between drugs approved for RMS and SPMS. Our review aims to identify current evidence from published clinical trials and European public assessment reports from the marketing authorization procedure on the efficacy, especially on progression, of DMTs approved for RMS and SPMS. To identify relevant evidence, a literature search has been conducted and European public assessment reports of DMTs approved for RMS have been screened for unpublished data specific to SPMS. Only two clinical trials demonstrated a significant reduction in disability progression in SPMS study populations: the EXPAND study for siponimod, which included a typical SPMS population, and the European study for interferon (IFN)-beta 1b s.c., which included patients with very early and active SPMS. Both DMTs also achieved significant reductions in relapse rates. Ocrelizumab, cladribine, ofatumumab, and ponesimod are all approved for RMS – ocrelizumab, ofatumumab, and ponesimod based on an RMS study, cladribine based on an RRMS study. Data on efficacy in SPMS are only available from post hoc analyses of very small subgroups, representing only up to 15% of the total study population. For these DMTs, approval for RMS, including active SPMS, was mainly based on the assumption that the reduction in relapse rate observed in patients with RRMS can also be applied to SPMS. Based on that, the potential of these drugs to reduce relapse-independent progression remains unclear.
Early neurological deterioration in patients with acute ischemic stroke: a prospective multicenter cohort study
Authors: Liu Hongbing , Liu Kai , Zhang Ke , Zong Ce , Yang Hongxun , Li Yapeng , Li Shen , Wang Xin , Zhao Jiawei , Xia Zongping , Song Bo , Xu Xuming , Gao Yuan
Published: January 2023

Background:

There is still no precise knowledge of the causes of progression in patients with acute ischemic stroke (AIS), and we are unable to predict patients at risk.

Objective:

To explore the frequency, predictive factors, and the prognosis of early neurological deterioration (END) in patients with AIS

Methods:

In this prospective multicenter observational study, we assessed patients with AIS admitted to 18 hospitals in Henan, China. We defined END as an increase of ⩾2 points in total National Institutes of Health Stroke Scale (NIHSS) score or ⩾1 point in the motor items of the NIHSS within 7 days after admission. Risk factors were analyzed using multivariate logistic regression models. Prognosis was evaluated using the modified Rankin Scale (mRS), with poor prognosis defined as mRS 3–6.

Results:

A total of 9114 patients with AIS within 24 h of symptom onset were enrolled in the study. END occurred in 1286 (14.1%) patients. The highest incidence (62.5%) of END occurred within 24 h after admission. After adjusting potential confounders, age, body mass index, waist–hip ratio, systolic blood pressure, baseline NIHSS, disabled at baseline, history of atrial fibrillation, diabetes mellitus, intracranial arterial stenosis, infarct location in the lenticulostriate artery area and cerebral watershed, neutrophils, lymphocytes, uric acid, and triglycerides were identified as independent predictors for END. END was significantly associated with poor prognosis at 90 days, and the adjusted OR was 1.74 (95% CI: 1.53–1.97).

Conclusion:

One in seven hospitalized patients with AIS may experience END within 24 h of onset. The highest incidence of END occurred within 24 h of admission and decreased steeply with time. Easily identifiable risk factors predict END and could help understand the causal mechanisms and thereby prevent END.
Healthcare resource use in myasthenia gravis: a US health claims analysis
Authors: Mahic Milada , Bozorg Ali , Rudnik Jan , Zaremba Piotr , Scowcroft Anna
Published: January 2023

Background:

There are limited data on the impact of myasthenia gravis (MG) on real-world healthcare resource use (HCRU) and patient burden in the United States.

Objectives:

This study aims to assess HCRU in patients with MG using data from a US health claims database.

Design:

A retrospective, database study of adult patients newly diagnosed with MG, using the IBM® MarketScan® Commercial Claims and Encounters and Medicare supplemental health insurance claims database.

Methods:

Patients with ⩾2 MG International Classification of Disease diagnosis codes ⩾3 months apart were followed from the date of their first MG diagnosis record or start of treatment. HCRU and use of immunoglobulins and plasma exchange during follow-up was assessed, as well as comorbidities, hospitalizations, emergency room (ER) visits, intensive care unit (ICU) admissions, and specialist visits per year after diagnosis, and compared with age- and sex-matched non-MG controls.

Results:

During 2010–2019, 7194 patients were followed for up to 10 years (median = 2.3 years). During follow-up, patients with MG were 2.6-fold more likely than controls to be hospitalized, and 4.5-fold more likely to be admitted to an ICU. Risk and numbers of ER admission, hospitalization, and ICU visits were the highest in the 12 months post-diagnosis of MG and were consistently higher than controls during follow-up. MG was the main cause for most hospitalizations.

Conclusion:

Patients with MG have higher HCRU, compared with the age- and sex-matched non-MG controls. The early years after MG diagnosis are a period of particularly high healthcare burden, with many patients requiring hospitalization and ICU care to manage serious exacerbations.
Comparison of efficacy and tolerability of adjuvant therapy for resected high-risk stage III-IV cutaneous melanoma: a systemic review and Bayesian network meta-analysis
Authors: Ba He , Zhu Fangyuan , Zhang Xiaoze , Mei Zubing , Zhu Yaodong
Published: January 2023

Background:

Although immune checkpoint inhibitors (ICIs) and targeted therapies have been widely used as adjuvant treatment for resected melanoma, the optimal therapy remains controversial. Therefore, we conducted this updated network meta-analysis (NMA) to assess the efficacy and tolerability of adjuvant therapies for cutaneous melanoma.

Methods:

PubMed, Embase, Cochrane library, and Web of Science were systematically searched for relevant literatures published in the last 30 years. Disease-free survival (DFS), overall survival (OS), and serious adverse events were considered as the efficacy and tolerability outcomes.

Results:

In all, 27 randomized controlled trials (RCTs) including 16,709 stage III–IV melanoma patients were enrolled in this NMA. For BRAF wild-type melanoma, our analysis showed that both nivolumab and pembrolizumab demonstrated significantly better DFS and tolerability than ipilimumab (10 mg/kg). Nivolumab, pembrolizumab, ipilimumab (3 mg/kg), and ipilimumab (10 mg/kg) all appeared to be effective in prolonging OS, but no therapy demonstrated significantly better OS than ipilimumab (10 mg/kg). Nivolumab + ipilimumab showed the best DFS, but did not appear to be effective in improving OS and ranked only seventh in tolerability. Vaccines and granulocyte-macrophage colony-stimulating factor therapies were well tolerated, but all failed to improve the DFS or OS in stage III melanoma patients. In terms of BRAF mutation-positive melanoma, ICIs (nivolumab + ipilimumab, nivolumab, pembrolizumab, ipilimumab; 10 mg/kg) exhibited comparable efficacy to dabrafenib + trametinib, and all these therapies showed significantly better DFS than placebo.

Conclusion:

Considering efficacy and tolerability, nivolumab and pembrolizumab seem to be preferable adjuvant therapies for patients with stage III–IV melanoma. For BRAF mutation-positive patients, more RCTs are still required to determine which is better between ICIs and targeted therapy.
Stretching, Bracing, and Devices for the Treatment of Osteoarthritis-Associated Joint Contractures in Nonoperated Joints: A Systematic Review and Meta-Analysis
Authors: Campbell T. Mark , Westby Marie , Ghogomu Elizabeth Tanjong , Fournier John , Ghaedi Bahareh Bahram , Welch Vivian
Published: January 2023

Context:

Many patients with osteoarthritis (OA) develop range of motion (ROM) restrictions in their affected joints (contractures), associated with worse outcomes and rising healthcare costs. Effective treatment guidance for lost ROM in OA-affected joints is lacking.

Objective:

A systematic review and meta-analysis evaluating the effectiveness of stretching and/or bracing protocols on native (nonoperated) joint ROM in the setting of radiographically diagnosed OA.

Data Sources:

Seven databases, English-language.

Study Selection:

Studies including participants with radiographically diagnosed OA in any native joint evaluating the effect of stretching or bracing on ROM.

Study Design:

Systematic review and meta-analysis.

Level of Evidence:

Level 2.

Data Extraction:

Two reviewers independently screened articles for inclusion and assessed risk of bias in included trials. Primary outcomes were ROM, pain, and adverse events (AEs).

Results:

We identified 6284 articles. A total of 9 randomized controlled trials, all evaluating the knee, met eligibility criteria. For stretching, 3 pooled studies reported total ROM, which improved by mean difference (MD) of 9.3° (95% CI 5.0°,13.5°) versus controls. Two pooled studies showed improved knee flexion ROM (MD 10.8° [7.3°,14.2°]) versus controls. Five studies were pooled for knee extension with mean improvement 9.1° [3.4°,14.8°] versus controls. Seven pooled studies showed reduced pain (standardized MD 1.9 [1.2,2.6]). One study reported improved knee extension of 3.7° [2.9°,4.5°] with use of a device. No studies used orthoses. One study reported on AEs, with none noted. Performance bias was present in all included studies, and only 3 studies clearly reported blinding of outcome assessors. Strength of evidence for primary outcomes was considered moderate.

Conclusion:

There was moderate-quality evidence that stretching is an effective strategy for improving knee total, flexion and extension ROM, and pain. Our findings suggest that stretching to regain joint ROM in OA is not futile and that stretching appears to be an appropriate conservative intervention to improve patient outcomes as part of a comprehensive knee OA treatment plan before arthroplasty.
Efficacy of Cryoablation on Chronic Rhinitis Management: A Systematic Review and Meta-Analysis
Authors: Young Kurtis , Bulosan Hannah , Kejriwal Sameer , Liang Jonathan , Wu Arthur W. , Tang Dennis M. , Birkeland Andrew C. , Steele Toby O.
Published: January 2023

Background

ClariFix for posterior nasal nerve ablation has been approved for use since 2017, and this is the first study attempting to synthesize and assess the efficacy of this new device on the management of chronic rhinitis.

Objective

The primary objective of this meta-analysis is to assess the efficacy of ClariFix in the symptomatic management of patients with chronic rhinitis. The main outcome measure is the mean difference in the reflective total nasal symptom score (rTNSS).

Methods

A systematic search of Pubmed/Medline, Web of Science, and EBSCOhost was conducted from inception to May 2022. Peer-reviewed clinical trials reporting postcryotherapy rTNSS at both 1- and 3-month intervals for patients with chronic rhinitis were included. A random-effects model was utilized for meta-analysis. Study heterogeneity, bias, and overall quality were all assessed. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The primary outcome measures included mean differences in rTNSS from baseline to both 1- and 3-month postoperative time points. Secondary measures included other questionnaires including the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ).

Results

There were 5 studies that met the criteria (247 individuals). The pooled rTNSS mean difference from baseline to 1 and 3 months postoperatively was found to be −3.48 points (95% CI: −3.73 to −3.23, I2 = 0.13). and −3.50 (95% CI: −3.71 to −3.29, I2 = 0.00), respectively. The mean difference from baseline to 3 months postoperatively regarding the RQLQ was found to be −1.53 (95% CI: −1.74 to −1.31, I2 = 0.00). The most common adverse effects included facial or surgical site pain (40.4%), followed by headache (18.2%), oral numbness (11.1%), and sinusitis (4.0%).

Conclusions

The findings of this systematic review suggest that cryoablation with Clarifix is an effective treatment modality for chronic rhinitis. However, higher-quality randomized controlled trials will need to be performed to affirm the findings of this study.
Eosinophilia attention, diagnosis, treatment, and awareness in physicians: a cross-sectional survey
Authors: Chen Bigui , Fu Yu , Wang Zhufeng , Rong Qiuping , Zhang Qingling , Xie Jiaxing , Kong Xuetao , Jiang Mei
Published: January 2023

Background:

Patients with incidental eosinophilia is becoming increasingly common in clinical practice. But it remains challenging to diagnose and treat owing to its complex etiology. The awareness of physicians and the strategies of diagnosis and treatment toward eosinophilia are still unclear.

Objective:

We aimed to evaluate attention, diagnosis, treatment, and awareness of eosinophilia among physicians, as well as factors influencing clinical practice, and to find ways to improve the efficacy of this disease.

Design:

This is a cross-sectional survey.

Methods:

A cross-sectional study was conducted from 1 to 4 June 2021 in a tertiary hospital. Self-administered and validated electronic questionnaire was used to investigate the attention toward eosinophilia, the strategies of diagnosis and treatment, and the awareness in physicians.

Results:

A total of 607 valid questionnaires were collected, with a response rate of 84.5%. Among the responders, 65.4% of physicians claimed to be familiar with patients with eosinophilia but only 11.0% of them had read the relevant guidelines or expert consensus. Among 207 physicians who had ever diagnosed patients with eosinophilia, only 19.4% had performed detailed examinations. The accuracy of awareness questions was 1.6–53.5%, and only 26.5% of physicians had high levels of awareness. An increase in the awareness level of up to 2.82 folds was seen among physicians with factors such as job title, encountering patients with eosinophilia, linking patients’ conditions to peripheral blood eosinophil count, and paying attention to guidelines.

Conclusion:

This study highlighted the importance of raising awareness and knowledge of eosinophilia among physicians in China. More works on education about eosinophilia guideline are needed, which may help physicians make decision with more benefits to patients.
Recuperating labour's environmental potential
Authors: Corwin Julia
Published: January 2023

In response to Carr's article, ‘Repair and care: Locating the work of climate crisis’, I explore how repair labour demonstrates the importance of skilled, hands-on labour for responding to times of breakdown and change. Like scholarship on apprenticeship and practical enskilment, repair work demonstrates how labour entails working with the material world and other workers, and hands-on engagement with complex and changing systems. Instead of approaching labour and environmental concerns as separate and often antagonistic, I believe attending to the embodied and relational nature of labour may provide insight on how to work towards a more just socio-environmental future.
The politics of knowledge: Feminist strategies for transformation
Authors: Harcourt Wendy
Published: January 2023

In my commentary, I take up the challenge of finding an academically fuelled strategy to make the necessary deep inroads into the Sustainable Development Goals by looking at lessons learnt from the struggles of the transnational feminist movement involved in UN multilateral debates and the transformative work of feminist political ecology on the ethics of care and caring-with others, including more-than-human others. I propose these feminist strategies offer some insights in how to shift dominant knowledge systems.
Density and the compact city
Authors: McFarlane Colin
Published: January 2023

The ‘compact city’ agenda has become commonplace and is often presented as an urban ‘good’ in mainstream urban research, policy, and practice. Haarstad et al.'s intervention aims to bring critical geographical research to this debate, and is a very welcome one. In this response, I reflect on the debates on the compact city, consider its links to research on high density urbanisms, and present some questions for taking this critical urban debate forward.