bluuebunny/crossref_metadata_2025 huggingface dataset:
Homogenized and Lyophilized Amniotic Membrane Dressings for the Treatment of Diabetic Foot Ulcers in Ambulatory Patients
Authors: Carro Gabriela Verónica , Guerbi Ximena , Berra Mariano , Rodriguez María Gabriela , Noli María Laura , Fuentes Mariana , Ticona Miguel Angel , Michelini Flavia , Berra Alejandro
Published: April 2024

Background:

Diabetic foot ulcers (DFUs) constitute a complication that occurs in 19% to 34% of patients with diabetes mellitus (DM). The aim of this study is to describe median days to healing, average velocity of wound closure, and percentage of wound surface closed at 3, 6, and 12 weeks through the use of homogenized and lyophilized amniotic membrane (hAMpe) dressings for the treatment of DFUs in ambulatory patients.

Methods:

An observational, descriptive, longitudinal study was performed. Patients presenting with granulation-based DFU, after proper debridement, were included from August 19, 2021, until July 14, 2023. hAMpe dressings placed every 3 days were used for the treatment of these ulcers.

Results:

Sixteen patients were included with a mean age of 52.38 (8.07) years. The analyzed lesions were postsurgical ulcers in 15 of the 16 included patients. Median ulcer size was 19.5 cm2 (6.12-36). The median ABI was 1.10 (1-1.14). The median days to healing was 96 (71-170). The median percentage closure of the wound at 3 weeks was 41% (28.9%-55.3%), at 6 weeks it was 68.2% (48.6%-74.2%), and at 12 weeks it was 100% (81%-100%). The average velocity closure was 1.04% per day (95% CI 0.71%-1.31%). It was higher during the closure of the first 50% of the ulcer, 2.12% per day (95% CI 0.16%-4.09%), and decreased from 50% to 25% of the ulcer size to 0.67% per day (95% CI 0.23%-1.10%) and from 25% to closure to 0.47% per day (95% CI 0.14%-0.80%), P < .001.

Conclusion:

These results are difficult to compare to other studies given the higher surface area of the ulcers included in our sample. The development of hAMpe dressings enables patients to apply them without requiring assistance from health care teams and was not associated with any recognized complications.
Persisting Cost Overruns in Public Infrastructure Projects: Lessons From the Belgian Case
Authors: Molinari Laura , Haezendonck Elvira , Van Rompay Katrien , Mabillard Vincent , Dooms Michaël
Published: April 2024

Public authorities are expected to provide a salient infrastructure network, with only limited financial resources. However, many of these infrastructure projects go over budget and, therefore, research about these cost overruns is necessary to better understand the dynamics at work and provide solutions. We conclude that in Belgium, and broader, solutions need to be found for relational issues internal and external to the project core. Before a lot of attention was given to technical and legal project aspects, while our insights show that we should focus more on the relational aspects.
Safety Assessment of Streptococcus salivarius UBSS-01 in Rats and Double-Blind Placebo-Controlled Study in Healthy Individuals
Authors: Jatoth Bindhu S. , Rahman Ziaur , Dandekar Manoj P. , Venkataraman Rajesh , Shivalingegowda Ravi K. , Manuel Gloriya G.
Published: April 2024

Streptococcus salivarius is a common, harmless, and prevalent member of the oral microbiota in humans. In the present study, the safety of S. salivarius UBSS-01 was evaluated using in silico methods and preclinical and clinical studies. In an acute toxicity study, rats were administered with 5 g/kg (500 × 109 CFU) S. salivarius UBSS-01. The changes in phenotypic behaviors and hematological, biochemical, electrolytes, and urine analyses were monitored. No toxicity was observed at 14 days post-treatment. The no observable effects limit (NOEL) of S. salivarius UBSS-01 was >5 g/kg in rats. In a 28-day repeat dose toxicity study, rats were administered S. salivarius UBSS-01 once daily at doses of 0.1, 0.5, and 1 g/kg (10, 50, and 100 billion CFU/kg, respectively) body weight. S. salivarius UBSS-01 did not influence any of the hematology parameters and clinical chemistry parameters in plasma and serum samples after 28-day repeated administration. No structural abnormality was observed in the histological examination of organs. Whole genome analysis revealed the absence of virulence factors or genes that may transmit antibiotic resistance. In the double-blind study with 60 human participants (aged 18–60 years), consumption of S. salivarius UBSS-01 for 30 days was found to be safe and results were comparable with placebo treatment These findings indicate that S. salivarius UBSS-01 may be safe for human consumption.
Combined superficial keratectomy, alcohol delamination and amniotic membrane patch with fibrin glue in Salzmann nodular degeneration
Authors: Messina Marco , Poddi Maria , De Santi Nicola , Bianchi Eduardo , Cagini Carlo
Published: April 2024

Purpose

To describe the outcomes of five Salzmann's Nodular Degeneration (SND) cases treated with a combination of alcohol delamination, superficial keratectomy and amniotic membrane patch with fibrin glue.

Methods

Five patients affected by SND with significant discomfort and decreased visual acuity were evaluated with refraction, best corrected visual acuity, Break-up time test, corneal topography, Anterior Segment of Optical Coherence Tomography and images of anterior segment with a full slit lamp examination. All the patients underwent alcohol delamination of the corneal epithelium followed by superficial keratectomy to remove the subepithelial nodules. A patch of amniotic membrane was applied to all of them with a ring shape and a banana shape in two patients due to the location of the disease. A bandage contact lens was inserted. The patch was kept in place for 14 days. Another bandage contact lens was inserted for 21 days until the corneal epithelium had completely healed.

Results

The surgical procedure was successful in removing the nodules in all patients. Vision was restored in all cases with a significant regularization of the corneal surface and reduction of ocular discomfort. After a 12-month follow-up, none of the patients showed recurrence of the disease.

Conclusions

Combining alcohol delamination with superficial keratectomy and amniotic membrane patch with fibrin glue is an effective procedure for the management of SND to regularize the corneal surface and avoid the recurrence of subsequent nodules. This report is the first description of the outcomes of SND cases treated with a combination of the aforementioned techniques.
Keep your enemies safer: technical cooperation and transferring nuclear safety and security technologies
Authors: Ding Jeffrey
Published: April 2024

Even during the Cold War, the United States and the Soviet Union cooperated on nuclear safety and security. Since accidental or unauthorized nuclear detonations anywhere threaten peace everywhere, it seems straightforward that states more experienced in developing nuclear safety and security technologies would transfer such methods to other states. Yet, the historical record is mixed. Why? While existing explanations focus on the political costs and proliferation risks faced by the transferring state, this article argues that specific technological features condition the feasibility of assistance. For more complex nuclear safety and security technologies, robust technical cooperation is crucial to build the necessary trust for scientists to transfer tacit knowledge without divulging sensitive information. Leveraging elite interviews and archival evidence, my theory is supported by four case studies: US sharing of basic nuclear safety and security technologies with the Soviet Union (1961–1963); US withholding of complex nuclear safety and security technologies from China (1990–1999) and Pakistan (1998–2003); and US sharing of complex nuclear safety and security technologies with Russia (1994–2007). My findings suggest the need to examine not only the motivations behind nuclear assistance but also the process by which it occurs and the features of the technologies involved, with implications for how states cooperate to manage the global risks of emerging technologies.
Rethinking rigour to embrace complexity in peacebuilding evaluation
Authors: Apgar Marina , Bradburn Helene , Rohrbach Livia , Wingender Leslie , Cubillos Rodriguez Edwin , Baez-Silva Arias Angela , Dioma Alamousa , Fairey Tiffany , Gray Stephen , Alak Ayak Chol Deng , Deprez Steff
Published: April 2024

The field of peacebuilding evaluation has evolved over time in response to the complex nature of peace efforts. However, it still predominantly relies on evaluation models that aim to measure discrete peace outcomes adhering to rigid notions of rigour. The inclusive rigour framework presented in this article responds to this challenge, adding to complexity-aware and epistemologically plural approaches to build credible causal explanations in conditions of uncertainty. It identifies three interconnected domains of evaluation design and practice: effective methodological bricolage, meaningful participation and inclusion, utilisation and impact. Rigour here is not defined by methodological choice alone, but rather, relies on an active view of evolving methodological choices throughout an iterative process as maximum use value and meaningful participation are sought. Using three cases, we highlight the critical role of partnership arrangements and associated evaluation cultures and mindsets underpinned by power dynamics that enable or hinder the practice of inclusive rigour.
What influences online users’ tourism information sharing?: A study based on regulatory focus theory
Authors: Lian Tonghui , Li Sixin
Published: April 2024

The emergence of social media has had a huge impact on the tourism industry, as it has become a pivotal platform for the dissemination and interaction of tourism information. This study investigated the impact of information completeness (complete vs. incomplete), information timeliness (timely vs. lagging), and information interestingness (interesting vs. uninteresting) on online users’ tourism information sharing, incorporating regulatory focus as the control variable. Employing the experimental method, this study focused on a case related to tourism information sharing on Weibo about Wuzhen. The results reveal that online users are more inclined to share tourism information when it is perceived as complete, timely, and interesting. Key findings reveal that the regulatory focus of online users may be used as a moderating variable. A noticeable promotion of regulatory focus amplifies the positive correlation between information completeness, timeliness, interestingness, and online users’ tourism information sharing. This study may help enhance the quality of tourism information on online platforms and optimize the mechanisms for sharing tourism information online.
Sensing a Heartbeat: A New Perspective on Self-Tracking Technologies through the Integration of Interoception
Authors: Foerster Desiree
Published: April 2024

Fitness trackers are increasingly used by their wearers to monitor and optimise their exercise, health, and well-being. What is usually not considered is the role our interoceptive sense, the sense for inner-bodily processes, plays in the interpretation of body data and the formation of habits. By including neuroscientific research, perspectives from pragmatist philosophy, and science and technology studies into the analysis of self-tracking devices, this article will give a perspective on the scope and the effects of the involvement of the interoceptive sense in self-tracking practices. By offering a critical analysis of the contextualisation of experience through self-tracking devices, this article will argue that interoceptive awareness provides the context to make sense of body data. I propose here that paying greater attention to how interoception is involved in the mediation of bodily processes and activities through tracking devices can give novel insights into self-tracking as an embodied and affective practice.
Power, position and social relations: Is the espoused absence of hierarchy in Open Dialogue naïve?
Authors: Einboden Rochelle , Dawson Lisa , McCloughen Andrea , Buus Niels
Published: April 2024

Open Dialogue practitioners aim to reduce social hierarchies by not privileging any one voice in social network conversations, and thus creating space for a polyphony of voices. This sits in contrast to the traditional privileging of those voices credited with more knowledge or power because of social position or professional expertise. Using qualitative interviews, the aim of this current study was to explore Open Dialogue practitioners’ descriptions of challenges in implementing Open Dialogue at a women’s health clinic in Australia. Findings revealed how attempts to rhetorically flatten hierarchies among practitioners created challenges and a lack of clarity regarding roles and responsibilities. As the practitioners tried to adjust to new ways of working, they reverted to taking up engrained positions and power aligned with more conventional social and professional roles for leading therapy and decision-making. The findings raise questions about equity-oriented ways of working, such as Open Dialogue, where intentions of creating a flattened hierarchy may allow power structures and their effects to be minimised or ignored, rather than actively acknowledged and addressed. Further research is needed to consider the implications that shifting power relations might have on the roles and responsibilities of practitioners in the move to equity-oriented services.
Why Is My Team Wearing Rainbow Jerseys? Exploring Effects of DEI Messages on Sports Fans’ Responses
Authors: Fleischman David , Mulcahy Rory , English Peter , Florence Emma , de Villiers Scheepers Retha , Rönnberg Malin
Published: April 2024

The current research explores the impact of fans’ team identification on their emotional responses towards diversity, equity and inclusion (DEI) initiatives by sporting organisations. Using the theoretical lens of Construal Level Theory (CLT), two experimental studies were conducted in Australia ( n = 386) and the US ( n = 402) to understand how fans’ level of team identification and the framing of communication by sporting organisations influence their emotional responses. The findings suggest that fans with low levels of team identification are more likely to feel disgust towards abstract reasoning for DEI initiatives and are more likely to abandon their support for the team. In contrast, fans with high levels of team identification were less likely to feel disgust and less likely to abandon their support for the team. These results have important implications for both theory and practice. Theoretical implications of this research suggest that CLT can provide a useful framework for understanding the emotional responses of fans towards DEI initiatives. The findings also support previous research suggesting team identification is an important predictor of fan behaviour. Practical implications of this research suggest that sports marketers and organisations should carefully consider their communication strategies when promoting DEI initiatives.
Crafting Inclusive Marketing Campaigns: Insights and Influential Factors in the Indian Context
Authors: Upadhyay Saurabh , Tuli Nikhita , Kumar Harish
Published: April 2024

With increasing diversity of consumers in the marketplace, marketers have begun to embrace inclusive marketing practices. However, there is still a lack of research on the topic, making it difficult for managers to understand how to design and execute effective campaigns. This study aims to fill this gap by identifying the key factors that contribute toward an impactful inclusive marketing campaign. The study used a sequential mixed-methods approach and first conducted interviews with 29 LGBTQIA+ and non-LGBTQ consumers to gain insights into their perceptions of effective inclusive campaigns. In the study’s second phase, ten industry experts provided inputs for the Fuzzy DEMATEL method to identify critical factors for an effective campaign. The findings revealed seven essential factors: social acceptance of the community, use of community-specific symbols, authentic communication about community issues, top management’s approach, inclusive hiring practices, brand history, and legal market structure, which were then grouped into social, communication-related, brand-related, organization-specific, and other macro-level categories. The study fills an important gap in the inclusive marketing literature and can serve as a practical guide for marketers to design and implement inclusive campaigns.
Research on fault diagnosis method based on the Markov transition field with enhanced properties and AM-MSCNN under different external environmental interference
Authors: Chen Xihui , Fan Jiapeng , Yu Hongkun , Xing Zihao , Yang Guanxiong , Ding Kun
Published: April 2024

The mechanical equipment often faces complex working environments in practical operating conditions, and the external environmental interference generated by operating conditions, environmental factors and other components causes the vibration signals to exhibit characteristics with frequency distortion and multi-modality. The existing fault diagnosis methods rarely consider the issue of external environmental interference. Aiming at the background of fault diagnosis under external environment interference, a fault diagnosis method based on Markov transfer field (MTF) with enhanced properties and multi-scale convolutional neural network with attention mechanism (AM-MSCNN) is proposed. The fault features embedded in vibration signals under external environmental interference can be extracted, and an important contribution to the fault diagnosis method under external environmental interference can be made. Firstly, an interference mode selection model based on symplectic geometry modal decomposition is constructed to address the issues of distortion and multi-modality caused by external environmental interference. Next, a two-dimensional feature extraction method based on the MTF with enhanced properties is established. The challenge of extracting temporal correlation features from one-dimensional vibration signals affected by external environmental interference is addressed by Markov transition probability. The impact of external environmental interference can be mitigated, and that has strong anti-interference capability and robustness. Finally, an attention mechanism that can adaptively assign weights is designed, and the AM-MSCNN model is designed to effectively extract global features by incorporating attention mechanisms in the parallel layers of MSCNN and the attention mechanism helps to suppress external environmental interference and improve the diagnostic results. An experimental platform for simulating the typical faults under external environmental interference is constructed, and the experimental results demonstrate that the proposed method exhibits superior generalization performance under varying degrees of different interference environments. The overall average accuracy reaches 92.2%, and the highest accuracy reaches 94.0% for external interference working conditions.
Results of Palliative Stenting in Malignant Superior Vena Cava Syndrome Analyzing Self-Expanding Stainless Steel and Nitinol Venous Bare Metal Stents
Authors: Rioja Artal Sara , González Martínez Victor , Royo Serrando Josep , Delgado Daza Rafael , Moga Donadeu Lluis
Published: April 2024

Purpose:

The purpose was to analyze the technical, clinical, and survival outcomes of our patients with malignant superior cava vein syndrome (SVCS) treated with endovascular approach and analyze the efficacy of different stent types used.

Material and Methods:

It is an observational, retrospective, single-center study. From 2006 to 2023, 42 patients (32 male, 10 female, mean age 62 years, age range, 41-87 years) underwent percutaneous stent placement for malignant SVCS. One stainless steel stent (Wallstent) and 2 venous nitinol stent type (Sinus-XL, Venovo) were used. Follow-up mean was 276 days.

Results:

A total of 53 stents were deployed. Clinical success was 97.6% in less 24 hours. Technical success was achieved in 97.6%. No complications were found except 1 patient died during the procedure due to stent migration and atrial dissociation (2.3%). Overall intraprocedural stent migration rate was 11.9% (18.8% stainless steel stent, 9.6% nitinol stent, p>0.05). Overall survival rates were 87.8%, 41.99%, and 34.12%, and overall primary patency rates were 100%, 93.3%, 91.6% at 1, 6, and 12 months, respectively.

Conclusions:

Endovascular treatment is a safe and effective therapeutic option for SVCS with high technical and clinical success rates and low complication and recurrence rates.

Clinical impact

The malignant superior cava vein syndrome is a rare clinical entity treated classically with radiation and chemotherapy with a slower response, or surgical bypass, which is an aggressive surgical technique. Endovascular treatment offers a low-invasive technique with quick clinical resolution and good permeability results. However, further studies are lacking to deal with procedure technical characteristics, stent type used, technical complications, and medium- and long-term patency studies. This study aims to evaluate all these items, analysing self-expanding stainless steel and nitinol venous bare metal stents, and add value to endovascular treatment, confirming the good results of this technique.
Tomboys’ Pathways to Prison in Thailand: Insubordination, Support, Sacrifice, and Suffering
Authors: Jeffries Samantha , Thipphayamongkoludom Yodsawadi , Chuenurah Chontit , Wood William R , Ryan Michelle
Published: April 2024

This paper presents findings from a feminist pathways study undertaken with imprisoned Tomboys, a gender sexual minority group in Thailand. Utilizing life-history interviews, we mapped Tomboys’ journeys into prison. Results showed two pathways. The first, insubordinate lifestyles, was characterized by substance abuse and life-long lawbreaking. The second pathway - support, sacrifice, suffering - was marked by romantic love and familial caregiving. Many of the experiences and central mechanisms that constituted both trajectories aligned with those found in previous feminist pathways and queer criminological scholarship. Nevertheless, qualities distinct to Tomboys’ incarceration journeys were also identified.
Intelligent multi-fault identification and classification of defective bearings in gearbox
Authors: Damou Ali , Ratni Azeddine , Benazzouz Djamel
Published: April 2024

Bearing faults in gearbox systems pose critical challenges to industrial operations, needing advanced diagnostic techniques for timely and accurate identification. In this paper, we propose a new hybrid method for automated classification and identification of defective bearings in gearbox systems with identical rotating frequencies. The method successfully segmented the signals and captured specific frequency components for deeper analysis employing three distinct signal processing approaches, ensemble empirical mode decomposition EEMD, wavelet packet transform WPT, empirical wavelet transform EWT. By decomposing vibration signals into discrete frequency bands using WPT, relevant features were extracted from each sub-band in the time domain, enabling the capturing of distinct fault characteristics across various frequency ranges. This extensive set of features is then served as inputs for machine learning algorithm in order to identify and classify the defective bearing in the gearbox system. Random forest RF, decision tree DT, ensemble tree ET classifiers showcased a notable accuracy in classifying different fault types and their localizations. The new approach shows the high performance of the diagnostic gearbox with a minimum of accuracy (Min = 99.95 %) and higher stability (standard deviation = 0.1).
Equivalent method for assessment of bearings at operational types of loadings
Authors: Wang Shuancheng , Zhou Shuwei , Yang Bing , Zhou Shiqi , Xiao Shoune
Published: April 2024

To investigate the effect of various factors on bearing stress response, Huber-Hencky-von Mises stress serves as a bridge, the equivalent interrelation between radial loading, axial loading, and temperature of bearing is studied using finite element method (FEM). Symbolic regression (SR) algorithm is employed to analyze simulation results, establishing a functional expression between independent and dependent variables by optimizing combinations of variables, constants, and functional forms. The results showed that within the specified force and temperature values, the curved surface of the equivalent correlation function, trained using the SR algorithm, demonstrates smoothness. Both training and validation data exhibit a strong correlation with this curved surface. Among the three factors, temperature exerts the greatest influence on bearing stress values, followed by radial loading, and axial loading components had the smallest impact.
Clinical efficacy of sodium aescinate administration following endovenous laser ablation for varicose veins
Authors: Yang Xinrui , Jin Jian , Huang Siyi , Qiu Peng , Wang Ruihua , Ye Kaichuang , Lu Xinwu
Published: April 2024

Background

Endovenous interventions and minimally invasive procedures are effective in the management of varicose veins. However, they can cause postoperative discomfort.

Objective

To evaluate the clinical efficacy of sodium aescinate (SA) in improving edema, pain, vein-specific symptoms, and quality of life in patients following endovenous laser ablation (EVLA) for varicose veins.

Methods

In this single-center randomized controlled trial (RCT), patients were allocated into two groups: in Group A, 60 mg SA was administered twice daily for 20 days, and in Group B (control), no venoactive drug was prescribed. The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification system for chronic venous disorders was used to assess the varicose veins. The circumferences of the calf and ankle were recorded for evaluating edema. The 10-point Visual Analog Scale (VAS), Venous Clinical Severity Score (VCSS), and Aberdeen Varicose Veins Questionnaire (AVVQ) were used to measure the pain intensity, overall varicose vein severity, and patient’s quality of life, respectively.

Results

The study included 87 patients (mean age, 59.9 ± 10.7 years; 54 men) with CEAP class C2–C5 varicose veins who underwent EVLA and phlebectomy or foam sclerotherapy. The calf circumference recovered quicker in Group A than in Group B by days 10, 21, and 30 (difference from baseline was 1.04 ± 0.35 vs 2.39 ± 1.15 [ p < .001], 0.48 ± 0.42 vs1.73 ± 1.00 [ p < .001], and 0.18 ± 0.64 vs 0.82 ± 0.96 [ p < .001], respectively). The ankle circumference recovered quicker in Group A than in Group B by days 10 and 21 (the difference from baseline was 1.37 ± 0.52 vs 2.36 ± 0.93 [ p < .001] and 0.58 ± 0.60 vs 1.14 ± 0.88 [ p = .002], respectively). Pain relief was achieved quicker in Group A than in Group B (0.257 ± 1.097 [ p = .0863] vs 0.506 ± 1.250 [ p = .0168] by day 21). There were no significant differences in the VCSS and AVVQ scores between both groups. There were no drug-related adverse effects.

Conclusions

SA, in combination with compression therapy, can relieve edema and alleviate pain in patients following EVLA for varicose veins.
Talking back to the wall: Problematizing trans/national media and counter-publics in border politics
Authors: Cabas-Mijares Ayleen , Shaban Sara , Mislán Cristina
Published: April 2024

This study presents a textual analysis of the discourses that emerged in Mexican national newspapers and on Twitter about Donald Trump’s calls for a border wall in 2017. As the case of Israel’s border wall became entangled in this discussion, discourse in print and social media engaged in a re-evaluation of alliances and solidarities between Mexico, the Jewish-Mexican community and Israel. The findings show print and online media discourse to be remarkably consistent in terms of the voices that were elevated, the targets of criticism, and the enabling of vilifying narratives about the Palestinian struggle against Israeli occupation.
Temporal association between atrial fibrillation and ischemic stroke: Systematic review and meta-analysis
Authors: D’lima Jessica , Thijs Vincent , Lim Han S , Rodrigues Thalys Sampaio , Beaudoin Ann-Marie
Published: April 2024

Background:

Paroxysmal atrial fibrillation (PAF) is strongly associated with ischemic stroke. Continuous cardiac implantable electronic devices (CIEDs) can assess PAF episodes over prolonged periods. Studies that attempted to find a temporal association between PAF and ischemic stroke were inconclusive. Thus, we performed a systematic review and meta-analysis to assess this relationship.

Aims:

This study aimed to assess the temporal association between AF episodes and stroke within 30 days of the arrhythmic episode. The secondary outcome is a temporal association within a 90-day period.

Summary of review:

A total of 2804 studies that discussed the temporal relationship between PAF and ischemic stroke were screened, and 7 studies were included in the meta-analysis. Among the 4041 patients included in these studies, there were 138 patients with device detected PAF episodes and stroke. Four studies used a 30-day window for temporality and the pooled odds ratio (OR) showed a significant association (OR 4.11 (95% CI 1.03–16.40)). The three studies reporting on AF and stroke within a 90-day window did not find a significant temporal relationship (OR 0.43 (95% CI 0.13–1.41)). Finally, the pooled result of those seven studies did not show a significant association (OR 1.51 (95% CI 0.44–5.17)).

Conclusion:

This meta-analysis supports a temporal relationship between PAF and ischemic stroke within a 30-day window. Establishing this relationship is important for individualized risk prediction and targeted anticoagulation treatment.

Data access statement:

The data will be made available upon reasonable request.
A Randomized Controlled Trial of Tenecteplase Versus Standard of Care for Minor Ischemic Stroke with Proven Occlusion (TEMPO-2): Rational and design of a multicenter, randomized open-label clinical trial
Authors: Singh Nishita , Kenney Carol C , Butcher Ken S , Buck Brian , Barber Philip A , Field Thalia S , Choi Philip M , Yu Amy YX , Kleinig Timothy , Appireddy Ramana , Molina Carlos A , Muir Keith W , Hill Michael D , Coutts Shelagh B
Published: April 2024

Background:

Almost half of acute ischemic stroke patients present with mild symptoms and there are large practice variations in their treatment globally. Individuals with an intracranial occlusion who present with minor stroke are at an increased risk of early neurological deterioration and poor outcomes. Individual patient data meta-analysis in the subgroup of patients with minor deficits showed benefit of alteplase in improving outcomes; however, this benefit has not been seen with intravenous alteplase in published randomized trials.

Design:

TEMPO-2 (A Randomized Controlled Trial of Tenecteplase Versus Standard of Care for Minor Ischemic Stroke With Proven Occlusion) is a prospective, open label with blinded outcome assessment, randomized controlled trial, designed to test the superiority of intravenous tenecteplase (0.25 mg/kg) over nonthrombolytic standard of care, with an estimated sample size of 1274 patients. Adult patients presenting with acute ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) ⩽ 5 and visible arterial occlusion or perfusion deficit within 12 h of onset are randomized to receive either tenecteplase (0.25 mg/kg) or standard of care. The primary outcome is return to baseline neurological functioning, measured by the modified Rankin scale (mRS) at 90 days. Safety outcomes include death and symptomatic hemorrhage (intra or extra-cranial). Other secondary outcomes include mRS 0–1, mRS 0–2, ordinal shift analysis of the mRS, partial, and full recanalization on follow-up computed tomography angiogram.

Conclusion:

Results of this trial will aid in determining whether there is benefit of using tenecteplase (0.25 mg/kg) in treating patients presenting with minor stroke who are at high risk of developing poor outcomes due to presence of an intracranial occlusion.

Data access statement:

Data will be available upon reasonable request.
‘Could we possibly see your tattoo? If not that’s totally fine!’ Holocaust survivors’ playful activism on TikTok
Authors: Manca Stefania , Marino Francesco , Taibi Davide
Published: April 2024

Over the past few years, digitalisation has led to the development of new forms of Holocaust memory, with advances in digital technology reshaping and introducing alternative ways of remembering, understanding and representing the Holocaust. The purpose of this study is to examine how three Holocaust survivors – Lily Ebert (100), Gidon Lev (88) and Tova Friedman (85) – share their firsthand experiences on TikTok by segmenting traumatic memories using the platforms’ audio–visual aesthetic and adapting their testimonies for the attention spans of young users. Based on 1-year content production and detailed analysis of 84 videos across the three profiles, a mixed-methods approach was applied to identify how each survivor interacts with their ‘fans’ using a unique communication style and with distinct goals. The results of the multimodal analysis show that the three survivors are engaged in meaningful acts of playful online activism on the memory of the Holocaust by bringing testimony and daily life together, in order to protect historical facts and combat antisemitism and Holocaust distortion.
Lateral effects of infection prevention measures during COVID-19 pandemic on hospital-acquired Clostridioides difficile infection
Authors: Mylona Eleni , Kostourou Sofia , Veini Fani , Kolokotroni Chrysoula , Belesiotou Eleni , Kaziani Katerina , Argyropoulou Athina , Papastamopoulos Vasileios
Published: April 2024

Background: Systematic surveillance of Clostridioides difficile infection (CDI) in our institution showed a reduction in the incidence of healthcare associated CDI (HA-CDI) during COVID-19 pandemic. Aim: Our objective was to search for factors related to this reduction. Methods: We retrospectively studied the trend of the incidences of HA-CDI, Multidrug Resistant (MDR) organisms, total antibiotic and chlorine consumptions as well as the influence of the last two on the incidence of HA-CDI. Results: During COVID-19 pandemic, the HA-CDI incidence was reduced with respect to the previous years, although total antibiotic consumption was found to increase ( p < .01). MDR organisms’ incidence was found to increase ( p < .01), as well as the chlorine consumption ( p = .04) which was the only factor to be related to the decreased rates of HA-CDI (r = −0.786, p < .05). Discussion: In our institution, COVID-19 epidemic overlapped with the reduction in the HA-CDI’s incidence. This could be due to faithful compliance with the contact precaution measures but then, we would expect the incidence of MDR organisms to decrease as well. Chlorine usage for environmental cleaning was generalized during pandemic. It was the only factor to be related to the decreased rates of HA-CDI, highlighting the importance of environmental cleaning as a measure for HA-CDI prevention.
Attitudes of U.S. Public Broadcasters: A Liberal Helping of Interpretive Journalism
Authors: Jastrzebski Stan , Willnat Lars
Published: April 2024

Even though U.S. public broadcasting has existed for more than 50 years, little research has been done on the attitudes of its journalists. This study, based on a sample of 394 U.S. public media journalists, represents the largest-scale effort to date to catalog the professional values and beliefs of these professionals. Our findings suggest these journalists are more liberal than both the U.S. population and commercial journalists, though they find it important not to be seen as partisan in their work. And while more people of color work in public broadcasting than in commercial media, public media journalists are unsatisfied with the diversity in their newsrooms and how it represents the communities they serve. When asked about their preferred professional roles, U.S. public media journalists tend to identify more with the interpretive and populist-mobilizer functions of journalism than the adversarial and disseminator functions.
Mechanisms of Erzhi Pill in Treating Lupus Nephritis Explored by GEO Gene Chips Combined with Network Pharmacology and Molecular Docking
Authors: Ru Xue , Zhang Yi , Chen Xiaolei , Sun Xingqian , Lv Honglin , Fan Tao
Published: April 2024

Background: The study focused on exploring Erzhi Pill's molecular mechanism in treating lupus nephritis (LN) for the first time by means of network pharmacology, combined with molecular docking (MD) and GEO database analysis. Materials and Methods: Multiple databases were utilized to select compounds and targets of Erzhi Pill and targets of LN. We built a protein-protein interaction network which was later imported into Cytoscape to screen core regulatory genes. The GEO chip was analyzed to verify the key targets and apply Discovery Studio for MD of those screened effective components with hub targets. The drug-disease intersection targets were performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Results: CASP3 and MMP9 had significant differences by GEO chip analysis. Luteolin and MMP9 have the highest binding affinity through MD. GO and KEGG analysis suggested that Erzhi Pill effect on LN were closely related to cell apoptosis, oxidative stress, and lipid metabolism. Conclusions: Erzhi Pill has been found to treat LN in various ways through multi-component, multi-target interaction, and multi-pathway.
Comparative Analysis of Pigments, Phenolics, and Bioactivities of Three Camellia Species Growing in Vietnam
Authors: Vu Danh C. , Nguyen Trang H. D. , Tran-Trung Hieu , Tuan Nguyen Hoang , Nguyet Nguyen T. M.
Published: April 2024

Objective/Background: Camellia L. , belonging to the Theaceae family, is a diverse group of plant species native to various regions of Asia. Methods: Chlorophyll and carotenoid contents in leaves of three Camellia species, namely Camellia quephongensis, Camellia yokdonensis, and Camellia longii, were determined using a spectrophotometric method. Phenolic compounds of the leaf extracts were quantified using high-performance liquid chromatography. Additionally, antioxidant activity, anti-α-amylase and in vitro antiinflammatory properties of the extracts were evaluated. Results: The total carotenoid content in C. longii was the highest, whereas the total chlorophyll content in this species was the lowest. Most of the phenolic compounds in C. quephongensis were found at the greatest concentrations compared to the other species. The extract from C. quephongensis exhibited the strongest antioxidant properties estimated by ABTS and DPPH free radical scavenging assays. This activity was shown to be comparable with that of ascorbic acid. All the Camellia extracts may possess a much less potent anti-α-amylase activity in comparison with acarbose. They could also be weaker than diclofenac with respect to in vitro anti-inflammatory activity evaluated by albumin denaturation inhibition assay. Conclusions: The findings of this investigation provide the initial insights into pigments and phenolics present in the various Camellia species and pave the way for the development of functional foods that could potentially offer a range of health benefits.
Variability in Surgical Case Volume Performed During ACGME-Accredited Orthopaedic Foot and Ankle Fellowship Training
Authors: Silvestre Jason , Reid Jared J. , Scott Daniel J. , Aiyer Amiethab A. , Gross Christopher E.
Published: April 2024

Introduction

Previous studies have demonstrated a positive correlation between case volume and outcomes in foot and ankle surgery. This study elucidates surgical case volume benchmarks for Accreditation Council for Graduate Medical Education (ACGME)–accredited orthopaedic foot and ankle fellowship training in the United States.

Methods

The ACGME provided case logs for orthopaedic residents and foot and ankle fellows (2018-2021). Variabilities in reported fellowship case volumes were defined as the fold-difference between 90th and 10th percentiles. Reported case volumes were compared between training cohorts with parametric tests.

Results

Case logs from 65 orthopaedic foot and ankle fellows and 3146 orthopaedic residents were included. Fellows reported 1.3- to 1.5-fold more foot and ankle cases during fellowship training than during residency training (P < .001). On average, orthopaedic foot and ankle fellows reported 405.4 cases and most were arthrodesis (17%), forefoot reconstruction (17%), mid/hindfoot reconstruction (13%), tendon repair/transfer (12%), and trauma ankle hindfoot (11%). Case categories with the highest variabilities were amputation (14.8-fold difference), infection/tumor (11.6-fold difference), arthroscopy (9.2-fold difference), and calcaneus (8.7-fold difference).

Discussion

Case volume benchmarks can assist trainees and faculty during orthopaedic foot and ankle training. More research is needed to determine case minimum requirements needed for autonomous practice in foot and ankle surgery.

Level of Evidence:

Level III
Comparing Rates of Radiographic Baseplate Loosening Between Cement and Cementless INFINITY Total Ankle Prostheses
Authors: Millstein Ian Daniel , Koneru Manisha , Dibato John Epoh , Gentile Pietro , Mahjoub Adel , Freeland Erik
Published: April 2024

Introduction

Total ankle replacement is indicated for end-stage ankle osteoarthritis. Periprosthetic radiolucency, from separation between the bone and implant, is suggested to be indicative of potential prosthesis failure risk. Anchoring implants with cement may mitigate this. This study aimed to compare rates of periprosthetic radiolucency between patients with cement-affixed and cementless implants.

Methods

A retrospective analysis was performed on 28 patients who underwent total ankle replacement with the INFINITY Total Ankle System (Wright Medical, Memphis, Tennessee) implant between January 2016 and May 2022. Anteroposterior, mortise, and lateral ankle X-rays were reviewed by 2 independent reviewers for tibiotalar angle, talar tilt, and periprosthetic radiolucency. The Wilcoxon rank-sum test and chi-square test were performed.

Results

The incidence of periprosthetic radiolucency at the most recent follow-up did not significantly differ between cement and cementless groups (57.1% in both groups, P = 1.0). Follow-up tibiotalar and talar tilt angles were not significantly different (P > .51 for all comparisons)

Conclusions

Patients with cemented implants had a similar incidence of periprosthetic radiolucency compared with patients with cementless prostheses. Understanding of long-term clinical outcomes will help inform optimal operative approaches for ankle prostheses.

Levels of Evidence:

Therapeutic, Level III, Retrospective cohort study
High Openness and Low Conscientiousness Predict Green Party Preferences and Voting
Authors: Bleidorn Wiebke , Schilling Thomas , Hopwood Christopher J.
Published: April 2024

A substantial rise of vote shares of Green parties across European countries suggests an increasing support of environmental issues. A critical question for researchers and policymakers alike is, who endorses Green parties? Here, we examined the Big Five personality predictors of green partisanship, voting behavior, and party switching in a nationally representative sample of more than 27,000 Germans collected over a period of 16 years. Consistent with previous research, high openness and low conscientiousness emerged as the strongest personality predictors of green partisanship and voting behavior. Critically, high openness also predicted the likelihood to switch to a Green party vote across two federal elections. These effects held when controlling for demographics and environmental concerns, suggesting that the association between personality and support for Greens reflects more than social norms or attitudes about the environment. We close with a discussion of the theoretical and practical implications of these findings.
Fixing a Hole: a retrospective cohort study evaluating HAV, HBV, tetanus screening, and vaccination during hospitalization in persons who use substances
Authors: Streifel Amber C. , Rivera Sarti Jose Eduardo , Sikka Monica K. , Conte Michael , Winders Bradie , Varley Cara D.
Published: April 2024

Background:

Rates of serious injection-related infections in persons who use drugs have increased. Resulting admissions are an opportunity for screening and vaccination of preventable infections such as hepatitis A virus (HAV), hepatitis B virus (HBV), and tetanus.

Design and methods:

We conducted a retrospective review of adults with documented substance use admitted for bacterial infection between July 2015 and March 2020. We evaluated HAV, HBV, and tetanus vaccination status at admission, along with screening for HAV and HBV infection and immunity. We identified the proportion of patients at risk for infection who received HAV, HBV, and tetanus vaccines during admission and patient-level factors associated with vaccination.

Results:

We identified 280 patients who met our inclusion criteria. Of the 198 (70.7%) patients at risk for HAV, infectious disease providers recommended vaccination for 21 (10.6%) and 15 (7.6%) received HAV vaccine. Of the 174 (62.1%) patients at risk for HBV, infectious disease providers recommended vaccination for 32 (18.3%) and 25 (14.4%) received HBV vaccine. A large proportion of patients (31.4%, 88) had no documentation of prior tetanus vaccination, and infectious disease providers recommended tetanus vaccination for three (1.1%) and five patients (1.8%) received a tetanus booster. Infectious disease consult vaccine recommendations were statistically significantly associated with HAV or HBV vaccination prior to discharge.

Conclusion:

Over 70% of our population is at risk for one or more of these preventable infections. Efforts are needed to maximize inpatient screening and vaccination for HAV, HBV, and tetanus in patients with barriers to care.
Three cycles of mobile app design to improve HIV self-management: A development and evaluation study
Authors: Kim Gwang Suk , Kim Layoung , Baek Seoyoung , Shim Mi-So , Lee SangA , Kim Ji Min , Yoon Jong Yae , Kim Jin , Choi JunYong , Choi Jae-Phil
Published: April 2024

Objective

Employing three cycles of Design Science Research (DSR) to develop a mobile app ‘ESSC (Excellent Self Supervised HIV Care)’ to improve self-management among people living with HIV (PLWH).

Methods

This study is based on the DSR framework comprising three iterative cycles. In the Relevance cycle, PLWH participated in a survey of mobile health (mHealth) experiences and needs. In the Rigor cycle, the information-motivation-behavioural skills (IMB) model was applied to foundations of the app, and HIV specialists verified the contents. Experts evaluated the heuristic system and the app quality with the Mobile Application Rating Scale (MARS). In the Design cycle, ESSC was built on the findings of the other two cycles, and end-users tested the usability using uMARS.

Results

The contents of the app were developed based on user requirements. The IMB model led ESSC to supplement motivational components for self-management, which built five functions: information contents; health life records including mental and sexual health; interactive counselling with healthcare providers; setting health goals after watching videos; and my page for self-reflection. To reduce social stigma and promote acceptance of the information-driven app, we created animated characters with neutral and bright features. The HIV specialists evaluated content validity as highly appropriate. The MARS score by the overall raters was between 3- acceptable and 4- good: functionality, 4.38; information, 4.12; aesthetics, 3.96; engagement, 3.37; and subjective quality, 3.25.

Conclusions

The DSR approach is effective for implementing usable and useful mHealth. The ESSC app would be feasible and contribute PLWH to retention in care.