bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Prophylactic Radiotherapy to the Lymphatic Drainage Area Necessary for Patients With Stage III Ovarian Cancer After Chemotherapy Following Surgery?
Authors: Shen Jing , Tao Yinjie , Zhou Jingya , Guan Hui , Zhen Hongnan , Yan Junfang , Hou Xiaorong , Liu Zhikai , Hu Ke , Zhang Fuquan
Published: June 2024

Background

For patients with stage III epithelial ovarian cancer, there are limited studies on the effects of postoperative adjuvant radiotherapy (RT). Here we assessed the therapeutic efficacy and toxicity of postoperative radiotherapy to the abdominal and pelvic lymphatic drainage area for stage III epithelial ovarian cancer patients, who had all received surgery and chemotherapy (CT).

Methods

We retrospectively collected patients with stage III epithelial ovarian cancer after cytoreductive surgery (CRS) and full-course adjuvant CT. The chemoradiotherapy (CRT) group patients were treated with intensity modulated radiotherapy (IMRT) to the abdominal and pelvic lymphatic drainage area in our hospital between 2010 and 2020. A propensity score matching analysis was conducted to compare the results between the CRT and CT groups. Kaplan-Meier analysis estimated overall survival (OS), disease-free survival (DFS), and local control (LC) rates. The log-rank test determined the significance of prognostic factors.

Results

A total of 132 patients with median follow-up of 73.9 months (9.1-137.7 months) were included (44 and 88 for the CRT and RT groups, retrospectively). The baseline characteristics of age, histology, level of CA12-5, surgical staging, residual tumour, courses of adjuvant CT, and courses to reduce CA12-5 to normal were all balanced. The median DFS time, 5-year OS, and local recurrence free survival (LRFS) were 100.0 months vs 25.9 months ( P = .020), 69.2% vs 49.9% ( P = .002), and 85.9% vs 50.5% ( P = .020), respectively. The CRT group mainly presented with acute haematological toxicities, with no statistically significant difference compared with grade III intestinal adverse effects (3/44 vs 6/88, P = .480).

Conclusion

This report demonstrates that long-term DFS could be achieved in stage III epithelial ovarian cancer patients treated with IMRT preventive radiation to the abdominal and pelvic lymphatic area. Compared with the CT group, DFS and OS were significantly prolonged and adverse effects were acceptable.
Regimes of Visibility of Sexual Violence in the French Catholic Church (1950–2020): An Analysis Through Television News
Authors: Dubec Sophie , Morin Céline , Atlani-Duault Laetitia
Published: June 2024

Sexual violence in the Catholic Church (SVCC) has recently become a major public issue, and mass media have played an important role in its visibilization. While to date, studies of media coverage of SVCC have mainly covered short time periods and concentrated on print media, our article covers a long time-frame (1950–2020) and focuses on television news. It provides an important contribution to the field of media and religion study by providing both a case study, focusing on France and delineating four “regimes of visibility” of SVCC in television news, and a methodological toolbox for similar studies in other countries.
A (m)Other’s Work Is Becoming Undone: Liminal Belonging and Trans Potentialities
Authors: Watts Meghan A. , Dominguez Cristina M.
Published: June 2024

In this relational ethnography, we write as two white afab genderqueer/trans parents who often find ourselves at best pulled between spaces and parts of ourselves, and at worst pressured to choose between the false dichotomy of our “illegible” place within transness/queerness and “aparent” place within motherhood. Weaving together autoethnographic vignettes of our lived experiences with the writings of QTBIPOC thinkers and pedagogues and their anti-racist white comrades, we reflect on themes of liminality, loneliness, hope, grieving, and love in mothering, kin, and community building and theorize, as queer trans (m)othering mother-ers, about the trans potentialities of being/becoming-with-longing queerly.
Silent Case of Pediatric Osteoarticular Tuberculosis: A Case Report and Review of the Literature
Authors: Alshrouf Mohammad Ali , Elifranji Zuhdi O , Halayqeh Sereen , Al-Saber Munther , Karam Abdulrahman M
Published: June 2024

Introduction:

Tuberculosis (TB) is one of the most prevalent infectious diseases globally, often presenting with nonspecific symptoms that can obscure diagnosis, especially when it manifests in uncommon sites such as osteoarticular tuberculosis (OA-TB).

Case presentation:

We report a rare case of a 9-year-old male diagnosed with right knee tuberculosis after enduring severe symptoms for several months. Despite multiple negative biopsies and aspirates during initial debridement surgeries, a biopsy taken 6 months later confirmed the presence of Mycobacterium tuberculosis (MTB). The patient was subsequently treated with debridement and anti-tubercular therapy.

Conclusion:

This case underscores the critical need to consider tuberculosis in patients presenting with chronic bone pain to avoid misdiagnosis, particularly in the developing world. The atypical presentation of osteoarticular tuberculosis in this young patient emphasizes the need for healthcare professionals to recognize subtle symptoms. Advanced imaging studies like MRI and microbiological evaluations, including site biopsies, are essential for accurate diagnosis. Increased awareness and collaborative research are crucial to improving the understanding and management of pediatric osteoarticular tuberculosis and extrapulmonary tuberculosis.
Identifying Factors Affecting the Survival of Patients with HIV-Associated B-Cell Lymphoma Using a Random Survival Forest Model
Authors: Zhao Huihui , Zhu Chuandong , Lian Yun , Cheng Yu , Zhu Fang , Wang Jing , Zheng Qin
Published: June 2024

Background:

There have been no reports about the application of random survival forest (RSF) model to predict disease progression of HIV-associated B-cell lymphoma.

Methods:

A total of 44 patients with HIV-associated B-cell lymphoma who were referred to Nanjing Second Hospital from 2012 to 2019 were included. The RSF model was used to find predictors of survival, and the results of the RSF model were compared with those of the Cox model. The data were analyzed using R software (version 4.1.1).

Results:

One-, 2-, and 3-year survival rates were 74.5%, 57.7%, and 48.6%, respectively, and the median survival was 59.0 months. The first 3 most important predictors of survival included lactate dehydrogenase (LDH), absolute monocyte count (AMC), and white blood cells (WBCs) count. The median survival of high-risk patients was only 4.0 months. Areas under the curve (AUCs) of the RSF model remained at more than 0.90 at 1, 2, and 3 years. The RSF model displayed a lower prediction error rate (21.9%) than the Cox model (25.4%).

Conclusions:

Lactate dehydrogenase, AMC, and WBCs count are the most important prognostic predictors for patients with HIV-associated B-cell lymphoma. Much larger prospective and/or multicentre studies are required to validtae this RSF model.
The impact of cognate vocabulary on explicit L2 rule learning
Authors: Sanahuja Noèlia , Erdocia Kepa
Published: June 2024

According to Hopp’s Lexical Bottleneck Hypothesis, difficulties in second language (L2) lexical processing may lead to non-target syntactic computations. In line with this hypothesis, cognates – which are processed faster than non-cognates, as defined by the cognate facilitation effect – can ease L2 syntactic processing. In order to investigate whether cognates additionally facilitate L2 syntax learning, we had two groups of Spanish natives learn an artificial language drawing on Basque. Each group explicitly learnt a set of either Spanish–Basque cognates or non-cognates and a word order grammatical rule. Then, two sentence–picture matching tasks tested their ability to apply the rule (1) with cognates vs. non-cognates and (2) with novel cognate words. Results showed that, in both cases, cognate learners were better at applying the rule than non-cognate learners. This finding suggests that the cognate facilitation effect and its role in the Lexical Bottleneck Hypothesis can be extended from L2 processing to L2 learning. We end by mentioning possible implications of our results for second language teaching in adulthood.
Learner agency and potential for creativity in writing task design and Chinese EFL students’ flow experiences in writing: A contextual perspective
Authors: Wu Qiaoxia , Albert Ágnes
Published: June 2024

Ensuring learner agency and potential for creativity in task design are likely to elicit different flow experiences among learners, either facilitating or impeding their task engagement and oral or written performance in foreign language learning contexts. However, so far little attention has been paid to the role of these factors in learners’ flow experiences in task-based second language (L2) writing. This study aimed to investigate the relationships between different task conditions operationalized as a teacher-generated content task (TGT), a learner-generated content task (LGT), and a creative task (CT), and learners’ flow experiences by utilizing Czimmermann and Piniel’s adaptation of Egbert’s flow questionnaire. Moreover, the study also examined the possible role that study contexts might play in students’ flow experiences in English writing. Our investigation involved two groups of Chinese learners studying in Hungary and China, 40 students in total, who produced 120 narratives and filled in a flow questionnaire after each completed task. MANOVA results showed a significant main effect for the study context, suggesting that Chinese learners in Hungary experienced more flow in all of the writing tasks while their peers in China experienced more anti-flow on them. Despite the fact that multivariate analyses did not reveal a main effect for task conditions for either flow or anti-flow experiences or an interaction between study contexts and task conditions, findings from univariate follow-up analyses warrant a closer examination of possible task and interaction effects.
Phonological development of Spanish–Valencian bilingual children
Authors: Fuenzalida-Muñoz Claudio
Published: June 2024

Purpose:

The purpose of this study is to investigate the phonological development of bilingual children in Spanish and Valencian to provide additional cross-linguistic evidence concerning the specificities of bilingual phonological acquisition compared with that of monolingual children. The comparison between Valencian/Spanish-bilingual and Spanish-monolingual children will focus on the production of codas and phonological processes.

Methodology:

Ten typically developing Valencian/Spanish bilingual and 10 typically developing Spanish-monolingual children aged between 2;9 and 5;6 (mean of 4;1) were assessed through a confrontation naming task.

Data and Analysis:

The subjects were classified according to being monolingual or bilingual and to the language in which the task was performed. The data analysis consisted of comparing between-groups and within-groups all the variables considered for this study through means and percentage correct.

Findings:

The major findings indicated a complex interrelation between language of input and monolingualism/bilingualism. Despite common trends in the development observed across groups, the bilingual children differed from the Spanish monolinguals in significant areas such as codas and phonological processes. There were also differences within the same bilingual sample between language performance in Valencian and Spanish.

Implications:

These results suggest that the frequency of distribution of certain phonological features in the input language will lead to a specific pattern of acquisition that is not standard across languages. Bilinguals appear to acquire two phonological systems that differ from monolingual children’s, suggesting that learning more than one language gives rise to an interaction between the two phonologies.

Originality:

The current study designed a very sophisticated confrontation naming task whose stimuli could be the initial draft of a phonological assessment. It also collected and analysed speech samples that constitute a valuable database for future research. Finally, it provides important additional evidence concerning bilingual acquisition, a topic that is crucial to a better understanding of the processes involved in language acquisition.
Education for flourishing: A social contract for foundational competencies
Authors: Duraiappah Anantha
Published: June 2024

This essay is a commentary on Curren et al., ‘Finding consensus on well-being in education’. It acknowledges a growing international consensus that presents educational systems need to change and argues the case for consensus on flourishing as the overall purpose of education can be strengthened by drawing on economists’ work on well-being with respect to the inclusive wealth of nations. It emphasizes the need for tangible and measurable indicators that educators can use when implementing Curren et al.’s recommendations and outlines the International Science and Evidence based Education assessment’s suggestion of a ‘whole brain’ approach to education for flourishing.
A Retrospective Cohort Study of Patient Risk Factors and Pelvic Venous Reflux Patterns on Treatment Outcomes With Pelvic Vein Embolisation
Authors: Strong Sophie Michelle , Cross Amy Charlotte , Sideris Michail , Whiteley Mark Steven
Published: June 2024

Objective

To identify the effects of patient risk factors and pelvic venous reflux (PVR) patterns on treatment outcomes of Pelvic Vein Embolisation (PVE) for Pelvic Venous Disorder (PeVD).

Methods

We performed a retrospective cohort review assessing population, intervention, comparison, and outcomes (PICO) for women undergoing PVE for PVR January 2017–January 2021. We identified 190 patients who had completed both questionnaires and who had given consent for their information to be used for research (Median age 46, IQR 40-52). The distribution of pathological pelvic venous reflux found on transvaginal duplex ultrasound (TVDUS) was analysed for all patients. Pre- and post-procedure symptom burden scores were studied using a standardised questionnaire protocol. We used inferential univariate non-parametric statistics to describe our data.

Results

190 cases were reviewed; 62.6% (119/190) premenopausal, 11.1% (21/190) perimenopausal, 25.3% (48/190) postmenopausal and menopausal status not documented 1% (2/190). 10.1% (19/188) were nulliparous (average age 34 years; range 20-55 years). There was a statistically significant improvement in all symptoms and in the appearance of varicosities on TVDUS post-PVE ( P < 0.05) of the ovarian vein plexus, uterus plexus, arcuate veins, vaginal wall, peri-urethral, peri-anal, haemorrhoids, labial and proximal thigh. The locations of veins requiring embolisation having demonstrated reflux were analysed; 82.8% (154/186) underwent embolisation of at least one internal iliac vein tributary and ovarian vein embolisation. Age, parity, menopausal status and previous laparoscopy did not affect symptom improvement ( P > 0.05). No significant complications such as coil migration were observed.

Conclusions

PVE is an effective treatment for pelvic pain due to PeVD and its diagnosis should not be limited to multiparous women of childbearing age, as a significant proportion of patients who benefited from PVE were either nulliparous and/or postmenopausal.
Battle Fatigue: Parents, Institutionalized Ableism, and the “Fight” for Inclusive Education
Authors: Lalvani Priya , Osieja Eileen
Published: June 2024

This qualitative study examined the experiences of parents who sought inclusive education for their children with intellectual disabilities or extensive support needs. Data were collected from 33 participants in the form of narratives that emerged through semi-structured interviews and analyzed using a phenomenological methodology. Findings revealed the existence of problematic special education practices and illuminated the mechanisms through which ability-based segregation in schools is institutionally sanctioned. Many parents reported that placement in a general education environment with the provision of support was not considered by professionals at their children’s Individualized Education Program (IEP) meetings. Instead, they were informed that education in separate classrooms was in their children’s best interest. Parents pushed back and advocated for access and inclusivity, often investing immense amounts of time and resources toward this end. The findings shed light on special education discourses that are entrenched in ableist notions about disability and uphold an implicit ideology of separate but equal for students with certain disabilities.
Patients Engaged in Losing Weight Preoperatively Experience Improved Outcomes After Hiatal Hernia Repair
Authors: Turcotte Justin J. , Chang Yu-Wei W. , Park Adrian E.
Published: June 2024

Background

Adherence to preoperative weight loss recommendations may serve as a surrogate for the level of engagement in hiatal hernia (HH) patients. This study aims to evaluate the relationship between achieving preoperative weight loss goals and outcomes after HH repair.

Methods

A retrospective review of 235 patients undergoing laparoscopic HH repair at a single institution was performed. Patients were grouped based on the percentage of weight loss goal achieved. Low achievement was defined as the bottom quartile of goal achievement (≤75%); high achievement was defined as the top quartile (≥140%). Baseline characteristics, clinical outcomes, and patient reported outcomes (PROMs) were compared between groups.

Results

131/235 (55.7%) achieved their weight loss goal. No differences in baseline characteristics or clinical outcomes were observed between the low and high achievement groups. While both groups experienced improvements in PROMs postoperatively, patients in the high achievement group demonstrated significantly lower symptom burden at one-month postoperatively. Further, high-achievement patients were more likely to experience complete resolution of common HH symptoms at one-month postoperatively, including no difficulty swallowing food, no breathing difficulties or choking episodes, no choking when eating food, no choking when drinking liquid, and no regurgitation of food or liquid.

Conclusions

In patients undergoing laparoscopic HH repair, patients achieving their preoperative weight loss goals experienced less overall symptom burden and lower prevalence of common symptoms one-month postoperatively than those with low levels of goal achievement. These results demonstrate that patients can take an active role in improving their own surgical outcomes and health status.
Evaluation of a Large Language Model’s Ability to Assist in an Orthopedic Hand Clinic
Authors: Kotzur Travis , Singh Aaron , Parker John , Peterson Blaire , Sager Brian , Rose Ryan , Corley Fred , Brady Christina
Published: June 2024

Background:

Advancements in artificial intelligence technology, such as OpenAI’s large language model, ChatGPT, could transform medicine through applications in a clinical setting. This study aimed to assess the utility of ChatGPT as a clinical assistant in an orthopedic hand clinic.

Methods:

Nine clinical vignettes, describing various common and uncommon hand pathologies, were constructed and reviewed by 4 fellowship-trained orthopedic hand surgeons and an orthopedic resident. ChatGPT was given these vignettes and asked to generate a differential diagnosis, potential workup plan, and provide treatment options for its top differential. Responses were graded for accuracy and the overall utility scored on a 5-point Likert scale.

Results:

The diagnostic accuracy of ChatGPT was 7 out of 9 cases, indicating an overall accuracy rate of 78%. ChatGPT was less reliable with more complex pathologies and failed to identify an intentionally incorrect presentation. ChatGPT received a score of 3.8 ± 1.4 for correct diagnosis, 3.4 ± 1.4 for helpfulness in guiding patient management, 4.1 ± 1.0 for appropriate workup for the actual diagnosis, 4.3 ± 0.8 for an appropriate recommended treatment plan for the diagnosis, and 4.4 ± 0.8 for the helpfulness of treatment options in managing patients.

Conclusion:

ChatGPT was successful in diagnosing most of the conditions; however, the overall utility of its advice was variable. While it performed well in recommending treatments, it faced difficulties in providing appropriate diagnoses for uncommon pathologies. In addition, it failed to identify an obvious error in presenting pathology.
A Nationwide Analysis on Major Upper Extremity Amputations and Replantations
Authors: Stögner Viola A. , Hauc Sacha C. , Hosseini Helia , Williams Mica C. G. , Boroumand Sam , Huelsboemer Lioba , Kauke-Navarro Martin , Pomahac Bohdan , Colen David
Published: June 2024

Background:

The loss of an upper extremity is a severely disabling condition made medically challenging by the limited window for replantation. This study aims to investigate the burden of traumatic major upper extremity amputations in the United States and uncover possibilities for improvements in treatment.

Methods:

The Healthcare Cost and Utilization Project’s National Inpatient Sample was screened for International Classification of Diseases-9/10 diagnosis/procedure codes for traumatic and nontraumatic major upper extremity amputations and replantations within the years 2008 to 2017. The resulting pool of cases was analyzed for multiple variables, including level of injury, patient demographics, hospital type and location, length of stay, costs, comorbidities, and complications.

Results:

A total of 15 155 major upper extremity amputations were recorded, of which 15.20% (n = 2305) were traumatic amputations—almost half of them related to the upper arm (49.6%; P = .0002). The great majority of replantations, however, was conducted at the lower arm level (87.4%; P < .0001), with an overall replantation rate of 22.3%. Nontraumatic amputations were overall associated with significantly higher burden of comorbidities relative to traumatic amputations except for long-term alcohol use ( P < .0001). Both, amputations and replantations, were predominantly treated in large urban teaching hospitals, and were significantly more likely to occur in white men. The Southern region of the United States was handling the highest proportion of amputations in the United States, but had the lowest likelihood of replantation.

Conclusion:

This study provides an overview of the national trends in major traumatic upper extremity amputations and replantations, revealing potential health care shortcomings.
Posterior Interosseous Nerve Palsy in Rheumatoid Arthritis: A Systematic Review
Authors: Kowalski Brooke , Zarkadis Nicholas J. , Harris Mitchell , Scanaliato John , Dunn John
Published: June 2024

The purpose of this systematic review is to describe the pathoanatomy, presentation, diagnostic workup, treatment modalities, and outcomes of posterior interosseous nerve (PIN) palsy in patients with rheumatoid arthritis (RA). All reported cases of PIN palsy in patients with RA were reviewed to yield 72 cases of PIN palsy in 70 patients. The male-to-female ratio was 1:2.7. Pain involving the elbow was very common (20/33 cases reporting this information), and paralysis or weakness of digit extension was noted in 27/33 cases and 6/33 cases, respectively. Only 1 of the 54 cases undergoing surgical intervention reported persistent weakness, and this 1 patient had undergone a 3-month trial of conservative management. In conclusion, Appropriate pharmacologic management in conjunction with magnetic resonance imaging (MRI) and ultrasound monitoring may be used for conservative management, but surgical decompression should still be utilized for patients with a compressive disease pathology who fail to improve with 6 weeks of conservative treatment, or for those with advanced disease on initial presentation.
Fabrication of CMC/PVA/Dextrin-Based Polymeric Membrane for Controlled Release of Cefixime With Enhanced Antibacterial Activity
Authors: Nazir Arif , Abbas Mazhar , Iqbal Dure Najaf , Ameen Fadia , Al-Mijalli Samiah H. , Ahmad Naveed , Iqbal Munawar
Published: June 2024

This study focuses on the investigation of the significance of polymers in drug delivery approaches. The carboxymethyl cellulose (CMC), polyvinyl alcohol (PVA) and dextrin-based hydrogel membrane were prepared and employed for the sustained release of third-generation oral antibiotic (cefixime). Different proportions of CMC, PVA and dextrin were blended and hydrogel membranes were fabricated via solvent casting method. The prepared membrane was characterized by FTIR, SEM, UV-visible, TGA and swelling analysis. Cefixime drug was incorporated in the CMC/PVA/dextrin matrix and drug release was investigated. The sustained release of the tested drug (cefixime) was investigated and the drug was released in 120 min in the phosphate-buffered saline (PBS) solution. The antibacterial activity of the prepared membrane was promising against Proteus vulgaris, salmonella typhi, Escherichia coli and Bacillus subtilis strains. The swelling capabilities, thermal stability and non-toxic nature of the prepared CMC/PVA/dextrin membrane could have potential applications for cefixime drug in delivery in a controlled way for the treatment of infectious diseases.
Evaluating the High-Volume, Low-Complexity Surgical Hub Programme: A Qualitative Research Protocol and Further Reflection on Designing Big, Complex Qualitative Studies
Authors: Scantlebury Arabella , Adamson Joy
Published: June 2024

In this paper, we outline our qualitative protocol for the largest, independent, mixed-method, evaluation of the High Volume-Low Complexity Surgical Hubs programme in England – The MEASURE study. In addition to serving as a protocol paper, we outline the key methodological considerations and adaptations that are needed when designing big qualitative studies – complex (multi-site, multi-stakeholder), multi-method (e.g. interviews, observations, documents) qualitative research involving a large number of participations ( n = 100+). This paper expands on our previous methodological work, where we used our experience of undertaking a big qualitative study as part of a mixed-method evaluation of a national emergency care-based initiative, to outline the methodological considerations and uncertainties for designing and analysing “big” qualitative studies. In this paper, we put these considerations into practice by providing a transparent account of our qualitative study design. The methodological reflections which we present are centred around the areas where we feel there is the most uncertainty for big qualitative research: study design, sampling (of case sites and stakeholders) and analysis. Underpinning this uncertainty are broader challenges which utilising this approach incite. Namely, that striving for both breadth (national-level insights) and depth (local variation and context), challenges paradigmatic norms and expectations and forces either methodological innovation, or the adaption of existing qualitative methods. We hope this paper provides transparency and insight into an area of qualitative research which has, potentially due to a perception of “safety in numbers” been inherently trusted and rarely scrutinised. Ultimately, we hope that by providing a transparent account of our study design and the challenges we have faced that we continue to encourage discussion and innovation in this evolving area of qualitative research.
Paying Attention to Educational Practices: Observing Educational Activities Through Schatzki’s Practice Theory
Authors: Jiménez Jairo , Reyes Ramírez Olga Lucía
Published: June 2024

Practice theory has recently gained renewed attention in educational research. However, analyzing educational activities through a theory of practice generally results in the need to explain the relationships among determination, practice activity and practice organization. This article instead seeks to present new ways to see and narrate educational practices based on (a) Schatzki’s practice theory, particularly his idea of human activity as an indeterminate temporal spatial event, and (b) a particular approach to observe and relate to educational practices based on Tim Ingold’s and Jan Masschelein’s work on education and attention. We focus on an exploratory approach that promotes ‘attention’ as a pivotal attitude to observe what happens during educational practices. The main argument is that in addition to understanding, explaining, and attempting to change the forces that shape educational practices, there is an interesting narrative of what happens in present educational activities.
Streamlining the ethical-legal governance of cross-border health data sharing during global health emergencies
Authors: Andanda Pamela , Mlotshwa Langelihle
Published: June 2024

Global health emergencies often lead to a proliferation of health-related research and resultant data, which is shared across borders to help control the outbreak of disease and support decision-making regarding public health interventions. However, efforts to share data can be hindered by diverse international ethical and legal frameworks. The frameworks aim to govern coordinated processing, sharing and transfer of health data across borders thus placing burdens on researchers who are willing or obligated to share data. In this paper, we investigate ethical values and legal principles that can be applied to ensure a more streamlined approach in the governance of cross-border health data sharing during global health emergencies. A scoping review approach was used to better understand emerging evidence about issues related to the ethical and legal governance of cross-border health data sharing. We first highlight the challenges of sharing health data across borders. We then discuss how the challenges might be overcome through the application of ethical values and legal principles that have been identified in literature. This is followed by a proposal for possible ways of streamlining the governance of health data sharing from ethical and legal perspectives in a bid to better prepare for future global health emergencies and promote the responsible sharing of health data.
Dual use concerns in artificial intelligence and the neurosciences: How medical research can end up in war
Authors: Krauel Elisabeth , Frewer Andreas
Published: June 2024

Dual Use Research of Concern (DURC) has been well analyzed regarding the life sciences. This article explores the topic of younger fields of medical research and their potential for misuse, especially in the military context. The areas of research considered are artificial intelligence, neurotechnology, and neuroenhancement. Each of these areas have brought forward highly promising new research. However, in light of the current armed conflicts in Europe and in the Middle East, there is a need to consider what the potential harmful consequences of medical research are. Using the example of war, this article demonstrates various instances of how current medical research could be—or is being—misused and discusses various possible solutions to the dual use dilemma. The main finding is that there needs to be a more concise and international effort to prevent the misuse of research. The raising of awareness in the general medical research community for the topic of DURC is one of the simplest steps that should be undertaken in order to ensure the non-maleficence of global research. Additionally, considering the potentially far-reaching consequences of DURC, it is time to consider the introduction of a new intergovernmental agency to monitor research and establish safeguards in order to cover all fields of research.
Accuracy and Functionality of Select Continuous Glucose Monitoring Systems Are Not Impacted by Implantable Cardioverter Defibrillator Devices
Authors: Lazar Dylan , Tao Michael , Matievich William , Kastanos Kevin , Dunn Timothy C.
Published: June 2024

Background:

Increasing numbers of individuals with diabetes are adopting use of continuous glucose monitoring (CGM) in their daily self-management. Many of these individuals have advanced heart disease. Implantable cardioverter defibrillator (ICD) devices can effectively reduce arrhythmic death and all-cause mortality in individuals with advanced heart disease. However, the potential impact of ICD devices on CGM system accuracy and functionality has not been well studied.

Methods:

This evaluation assessed whether FreeStyle Libre (FL) CGM systems can coexist and function within the same patient in the presence of wireless interference devices, including current ICD devices. Interferer sources included Wi-Fi devices, Bluetooth devices, cellular mobile devices, implantable medical devices, Bluetooth Low-Energy (BLE) devices, BLE accessory devices and BLE mobile devices, and ICD-programmer interferers. Five testing methodologies were used to evaluate the accuracy and functionality of the CGM systems when exposed to ICD functions: high-energy emergency shocking, pacing modes, anti-tachycardia pacing mode (ATP), and DC Fibber mode.

Results:

All acceptance criteria and testing requirements were met for the CGM and ICD system for wireless coexistence evaluation.

Conclusions:

Our findings demonstrated that coexisting ICD devices and FL CGM systems provide safe and effective wireless communications with functional and accurate transfer of data during scenarios expected in clinical use.
When the Logics of Media, Law, and Politics Collide: The Mediatization of Finnish Constitutional Review
Authors: Harjuniemi Timo , Dahlberg Maija , Kantola Anu
Published: June 2024

Mediatization scholarship has extensively analyzed how media logic affects societal institutions. Media logic is, however, not the only powerful institutional logic at play in modern societies. Other institutions have their respective logics that reciprocally impact processes of mediatization. In this article, we show how the logics of the media, law, and politics collide in constitutional review at the heart of democratic politics. Constitutional rights are playing increasingly visible roles in societies as charged political issues of high newsworthiness. Via an institutionalist approach to mediatization, we illustrate how media, legal, and political logics coexist and compete within constitutional review. By building on sixty-four interviews carried out between autumn 2019 and spring 2021 with key actors—political journalists, members of parliament, secretaries, and legal experts—involved in the work of the Constitutional Law Committee of the Finnish Parliament, we show how journalists, politicians, and legal experts advance their own logics as constitutional actors and seek to manage and mitigate the interinstitutional conflict between law, politics, and the media. We demonstrate how various formal and informal practices regulate Constitutional Law Committee members’ interactions with journalists and social media behavior and legal experts’ relationship with the media. We thus concur with the analyses suggesting that mediatization is a dynamic process in which various institutional logics collide, struggle for power, and recede to make room for different logics.
The relationship between post-traumatic stress disorder and gastrointestinal disease in United States Military Veterans
Authors: Kent Kelsey G
Published: June 2024

Background:

This study examined the relationship between gastrointestinal disease and post-traumatic stress disorder in U.S. military Veterans. Based on literature and clinical practice data sources from the U.S. Veterans Administration, gastrointestinal disease and post-traumatic stress disorder were hypothesized to be positively correlated in Veterans.

Objectives:

This study aimed to determine the frequency with which gastrointestinal disease and post-traumatic stress disorder are diagnosed comorbidities, a diagnosis of gastrointestinal disease accompanies a diagnosis of post-traumatic stress disorder, and a diagnosis of post-traumatic stress disorder accompanies a diagnosis of a gastrointestinal disease.

Methods:

The methodology was a retrospective, correlational design using data collected from the U.S. Department of Veterans Affairs patient database.

Results:

The results were that post-traumatic stress disorder is bi-directionally correlated with the gastrointestinal diseases of gastroesophageal reflux disease, peptic ulcer disease, functional dyspepsia, Crohn’s disease, diverticular disease, irritable bowel syndrome, and the symptoms of constipation and nausea/vomiting within Veterans who served during wartime periods. The study also found that post-traumatic stress disorder is not correlated with ulcerative colitis in Veterans.

Conclusions:

The conclusions are that clinicians who see a presentation of post-traumatic stress disorder should be screening for gastrointestinal disease, while primary care and gastroenterology providers treating gastrointestinal disease should be screening for a history of trauma, as improved diagnosis rates may lead to improved treatment.
Postpartum cardiomyopathy with congestive heart failure: A case report
Authors: Jayte Mohamed , Mohamud Abshir , Dubad Farah
Published: June 2024

Postpartum cardiomyopathy is a type of heart failure that occurs during late pregnancy or early postpartum without clear causes. It poses significant health risks. Recognition and management are crucial for better outcomes. We describe a case of a 23-year-old Ugandan woman who developed heart failure symptoms 1 month after giving birth. Physical examination revealed signs of congestive heart failure. Chest X-ray showed cardiomegaly, leading to a diagnosis of postpartum cardiomyopathy based on clinical criteria. Treatment involved diuretics, beta-blockers, angiotensin receptor blockers, SGLT2 inhibitors, and bromocriptine. This case underscores the importance of considering postpartum cardiomyopathy in the postpartum period. Prompt diagnosis and comprehensive management through a multidisciplinary approach can improve patient outcomes. Further research is needed to deepen our understanding of this condition.
Understanding “smaller-scale” platforms: An ethnographic case study of Chinese-owned multinational infotech enterprises
Authors: Liu Tingting , Pertierra Anna Cristina
Published: June 2024

This article develops the concept of “smaller-scale platforms,” distinguishing them from both large-scale, infrastructural platforms (such as Silicon Valley giants and Chinese infotech monopolies), and small, single-use platforms. To do so, it presents an ethnographic case study of the Chinese-owned, multinational entertainment live-streaming platform, Bigo Live. The article argues that smaller-scale platforms, positioned at the fringe of the internet business ecosystem, are non-infrastructural yet still serve as integral components of the larger, global platform economy and international trade. The ethnography presented shows how smaller-scale platforms target niche and occasionally unconventional markets, offering specialized services within agile, cross-platform, and transnational business sectors. The ethnography also depicts the naturalization of the Chinese “internet thinking” business model, as well as unusual and even extreme events among Chinese expatriate platform personnel, local non-Chinese employees, guilds of live-streamers, the live-streaming audience, and other stakeholders operating within complex geopolitical contexts. Finally, the paper delineates prospective research trajectories stemming from the theorization of smaller-scale platforms, articulating potential inquiries that could enhance scholarly understanding within this field.
Why Do We Listen to Audiobooks? The Role of Narrator Performance, BGM, Telepresence, and Emotional Connectedness
Authors: Ji Dan , Liu Boquan , Xu Jinghong , Gong Jiankun
Published: June 2024

Audiobooks have gained significant popularity in China and other regions worldwide. While scholars and practitioners have extensively researched strategies to develop the audiobook market, limited attention has been given to the factors influencing audiences’ attitude toward audiobooks, which is a gap this study aimed to explore. Survey data was collected from a total of 537 consumers and analyzed using partial least squares structural equation modeling. The results indicate that experiencing telepresence and emotional connectedness while listening to audiobooks positively contributes to audiences’ affective outcomes, fostering their favorable attitude. The findings also reveal that narrator performance, background music, and the narrative style of an audiobook can potentially enhance telepresence and emotional connectedness. These results provide both theoretical insights and practical suggestions for audiobook publishers and other industry players.
Infant Exploratory Behaviors During the Strange Situation Procedure: Links With Attachment Quality and Temperament
Authors: van Setten Lianne , Ledebt Annick , Oosterman Mirjam , Schuengel Carlo , de Moor Marleen H. M.
Published: June 2024

The secure base phenomenon was ascribed to changes in exploration observed during Ainsworth’s Strange Situation Procedure (SSP), related to the quality of the attachment relationship. However, infant temperament was not taken into consideration. The current study aims to replicate Ainsworth’s findings regarding infant exploration and attachment quality during the SSP and extend the findings by examining the role of infant temperament. One hundred thirty-two mother-infant dyads participated in the SSP when infants were 12 months old. Video recordings were coded for attachment quality and for duration of locomotion, duration of engagement with toys, and quality of engagement with toys. Temperamental activity level and fear were assessed with the Infant Behavior Questionnaire. Results showed that—irrespective of infant temperament—infants with insecure-resistant attachment relationships engaged less with toys compared to infants with secure or insecure avoidant relationships, and these differences were amplified during separation from the mother. Duration of engagement with toys was thus a robust indicator of attachment-related infant exploratory behavior. Duration of locomotion increased in response to separation from the mother and decreased after reunion. This likely reflects a mix of exploratory and proximity seeking behavior, and was more affected by controlling for temperamental fear. For quality of engagement with toys, no associations with attachment and temperament were found. During the SSP, the manifestation of the secure base phenomenon depended on the combination of the type of exploratory behaviors and the quality of the attachment relationship, but also on infant temperament.
Communities of Style: Artistic Transformation and Social Cohesion in Hollywood, 1930 to 1999
Authors: Burgdorf Katharina , Wittek Mark , Lerner Jürgen
Published: June 2024

How do social and stylistic relations in cultural fields coevolve under changing contextual conditions? Artistic communities cohere through collaborations and shared stylistic orientations among artists, but little is known about the structure and interplay of these relational processes. The authors contribute to previous studies by conducting a large-scale investigation of social and stylistic networks among Hollywood filmmakers. In particular, the authors examine how the interplay between artists’ collaborations and shared references changed throughout Hollywood’s history. Using data from the Internet Movie Database and applying relational hyperevent models, the authors analyze the coevolution of collaboration and reference networks among 15,553 Hollywood film professionals who participated in 6,800 films between 1930 and 1999. The authors complement prior sociological efforts through a longitudinal perspective on the structure of social and stylistic networks across three meaningful historical periods: before, during, and after Hollywood’s artistic transformation in the 1960s. The findings show that filmmakers are more likely to collaborate if they previously used the same references, but they are less likely to adopt the references of their previous collaborators. In addition, the results highlight that the structure of relational processes in cultural fields varies over time as the contextual conditions for tie formation change.
Pars Plana Vitrectomy Without Intravenous Anesthesia: Technique, Safety, and Outcomes
Authors: Tien Karena X. , Romo Erica , Adam Murtaza K.
Published: June 2024

Introduction: To describe the technique, safety profile, and outcomes of performing pars plana vitrectomy (PPV) without intravenous (IV) anesthesia. Methods: This retrospective single-surgeon study comprised patients who had PPV without IV sedation between September 2018 and April 2022. Patients elected to undergo PPV without sedation or with oral sedation via sublingual triazolam administered 30 minutes preoperatively. Sub-Tenon bupivacaine and lidocaine were administered at the initiation of each case. A circulating nurse monitored patient vitals and electrocardiogram tracings without anesthesiologist support. Adverse events (AEs), visual acuity (VA), supplemental block administration, and reoperation rates were documented. Results: A total of 357 PPVs in 319 patients (mean age 68.75 ± 11.17 years [SD]; range, 36.82-98.57) were performed for surgical indications including vitreous floaters, intraocular lens or cataract surgery complications, retinal detachment, vitreous hemorrhage, and epiretinal membrane. Twenty-three cases were performed without sedation, and 334 were performed with oral sedation. For eyes with a follow-up longer than 1 month (n = 324), the preoperative VA of 0.68 ± 0.77 logMAR improved to 0.31 ± 0.46 logMAR postoperatively ( P < .01). No intraoperative complications, systemic AEs, need to cease surgery prematurely, or conversion to IV sedation occurred. Five eyes (1.77%) required intraoperative supplemental sub-Tenon block administration, and 95% of patients who had a reoperation (n = 10) or fellow-eye surgery (n = 28) requested the same method of anesthesia without IV sedation. Conclusions: Vitreoretinal surgery with a sub-Tenon block and oral sedation can be safely performed without the support of an anesthesiologist. Additional trials are needed to further quantify patient comfort, surgeon experience, and complication rates.