bluuebunny/crossref_metadata_2025 huggingface dataset:
Appropriateness of Artificial Intelligence Chatbots in Diabetic Foot Ulcer Management
Authors: Shiraishi Makoto , Lee Haesu , Kanayama Koji , Moriwaki Yuta , Okazaki Mutsumi
Published: February 2024

Type 2 diabetes is a significant global health concern. It often causes diabetic foot ulcers (DFUs), which affect millions of people and increase amputation and mortality rates. Despite existing guidelines, the complexity of DFU treatment makes clinical decisions challenging. Large language models such as chat generative pretrained transformer (ChatGPT), which are adept at natural language processing, have emerged as valuable resources in the medical field. However, concerns about the accuracy and reliability of the information they provide remain. We aimed to assess the accuracy of various artificial intelligence (AI) chatbots, including ChatGPT, in providing information on DFUs based on established guidelines. Seven AI chatbots were asked clinical questions (CQs) based on the DFU guidelines. Their responses were analyzed for accuracy in terms of answers to CQs, grade of recommendation, level of evidence, and agreement with the reference, including verification of the authenticity of the references provided by the chatbots. The AI chatbots showed a mean accuracy of 91.2% in answers to CQs, with discrepancies noted in grade of recommendation and level of evidence. Claude-2 outperformed other chatbots in the number of verified references (99.6%), whereas ChatGPT had the lowest rate of reference authenticity (66.3%). This study highlights the potential of AI chatbots as tools for disseminating medical information and demonstrates their high degree of accuracy in answering CQs related to DFUs. However, the variability in the accuracy of these chatbots and problems like AI hallucinations necessitate cautious use and further optimization for medical applications. This study underscores the evolving role of AI in healthcare and the importance of refining these technologies for effective use in clinical decision-making and patient education.
Challenges Requiring New Thinking in Museum Security
Authors: Demes Francis , Juarez Jaime , Clark James H.
Published: February 2024

Our goal is to provide guidance to those responsible for security involving the protection of cultural property. It’s important to note that the authors here are speaking from positions as practitioners. Our experience in operations, security design, as well as careers in cultural property protection that provided knowledge through trial and error over time as well as working with colleagues in the development of industry best practices as a result of those trials, were instrumental in helping us form the opinions contained in the article. Hence the absence of research and academic references in this article.
Understanding the Injury Mechanism in Hamate Hook Fractures by Investigating Fracture Morphologies: A Case Series Study
Authors: Suzuki Ayumi , Kanda Toshihiro
Published: February 2024

Background:

Many studies have described hamate hook fractures resulting from direct force from sporting tools. However, several authors have reported fractures that did not occur during swing-related activities. This study aimed to understand the injury mechanism of fractures by investigating their morphologies.

Methods:

We selected patients with hamate hook fractures and collected data on computed tomography scans, injury causes, and how athletes handled sporting tools.

Results:

We investigated 50 patients, and the study cohort included 32 patients who sustained injuries during sports: 24 during baseball (group A) and 8 during other sports (group B). Sixteen patients sustained injuries from falls (group C), and 2 had their hands crushed while using an industrial press machine (group D). In group A, most patients had a fracture line starting from the middle section of the radial side, accompanied by osteosclerotic changes in their lower hand. In group B, most patients had fracture morphologies similar to those of most patients in group A. The main morphology of fractures in group C was a transverse fracture at the base. Two patients in group D had minimal fragments at the tip of the hooks.

Conclusions:

Our results question the theory that most hamate hook fractures in athletes are caused by direct force exerted on the palm because the fracture morphology was different from that of patients injured by acute trauma from direct force. Instead, these fractures likely stem from an indirect mechanism involving repetitive force generated by the tendons and muscles acting on the hook.
Simple coiling of middle meningeal artery embolization for chronic subdural hematoma: An inverse probability of treatment weighting matched cohort study
Authors: Perng Pang-Shuo , Chuang Ming-Tsung , Wong Chia-En , Chang Yu , Sun Yuan-Ting , Wang Hao-Kuang , Lee Jung-Shun , Wang Liang-Chao , Huang Chih-Yuan
Published: February 2024

Background

Middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) has gained much attention in recent years. However, unintended embolization may occur when employing liquid embolic agents or particles. We present our clinical experience in simple coiling of MMAE to manage CSDH.

Methods

Patients underwent either surgical evacuation or MMAE with simple coiling for CSDH were reviewed. Clinical and radiographic outcomes were assessed at admission, 1-month, and 6-month intervals. Two treatment groups were matched with inverse probability of treatment weighting.

Results

One hundred twelve patients were included, with 27 patients in MMAE group and 87 patients in surgery group. In MMAE group, significant reductions were observed in hematoma width (admission vs. 1-month, 2.04 [1.44–2.60] cm vs. 0.62 [0.37–0.95] cm, p < 0.001). The adjusted odds ratio (aOR) of surgical rescue rate (0.77 95%CI 0.13–4.47, p = 0.77), hematoma reduction (>50%) (0.21 95%CI 0.04–1.07, p = 0.06), and midline shift improvement rate (3.22, 95%CI 0.84–12.4, p = 0.09) had no substantial disparities between two groups at 1-month follow-up. In addition, no significant difference was noted between two groups in terms of hematoma reduction (>50%) at 6-month follow-up (aOR 1.09 95%CI 0.32–3.70, p = 0.89). No procedure-related complications were found in MMA embolization group.

Conclusion

Simple coiling for MMA had comparable outcomes with surgical evacuation for CSDH. Our findings suggest that simple coiling can be an alternative choice for liquid agents or particles in MMA embolization for CSDH with acceptable safety.
Effect of laser shock peening on the retention ability of surface roughness in forged Cr5 steel
Authors: Wu Xuexing , Chen Yuchao , Yang He , Cheng Xiangli , Liu Bo , Liu Tao , Zhang Xihuang , Ren Lei , Tu Huan , Wei Yanpeng
Published: February 2024

The roughness retention ability of the work roll surface during the cold rolling process is of great significance, especially in the production of the high-quality rolling section. Laser shock peening (LSP) is an advanced and effective surface treatment technique to improve the fatigue life, wear resistance, and other mechanical characteristics of metal components. Current studies commonly examined the reinforcement effect of single and multiple LSP treatments on Cr5 steel samples through XRD analysis, hardness testing, and residual stress measurements of different parameters. In addition, the abrasion test is widely conducted to determine the wear resistance. Compared to unprocessed samples, LSP could promote grain refinement and thus significantly increase the hardness and residual stress. Furthermore, the slight decrease in surface roughness shows that LSP treatment is an effective approach to slowing down the roughness decline rate and prolonging the roller service life. It is also found that multiple LSP impacts could remarkably improve the surface roughness retention of Cr5 steel, in which the optimal laser power density was around 23 GW/cm2.
Assessing the impact of risk-based data monitoring on outcomes for a paediatric multicentre randomised controlled trial
Authors: Le Marsney Renate , Johnson Kerry , Chumbes Flores Jenipher , Coetzer Shelley , Darvas Jennifer , Delzoppo Carmel , Jolly Arielle , Masterson Kate , Sherring Claire , Thomson Hannah , Ergetu Endrias , Gilholm Patricia , Gibbons Kristen S
Published: February 2024

Background/Aims

Regulatory guidelines recommend that sponsors develop a risk-based approach to monitoring clinical trials. However, there is a lack of evidence to guide the effective implementation of monitoring activities encompassed in this approach. The aim of this study was to assess the efficiency and impact of the risk-based monitoring approach used for a multicentre randomised controlled trial comparing treatments in paediatric patients undergoing cardiac bypass surgery.

Methods

This is a secondary analysis of data from a randomised controlled trial that implemented targeted source data verification as part of the risk-based monitoring approach. Monitoring duration and source to database error rates were calculated across the monitored trial dataset. The monitored and unmonitored trial dataset, and simulated trial datasets with differing degrees of source data verification and cohort sizes were compared for their effect on trial outcomes.

Results

In total, 106,749 critical data points across 1,282 participants were verified from source data either remotely or on-site during the trial. The total time spent monitoring was 365 hours, with a median (interquartile range) of 10 (7, 16) minutes per participant. An overall source to database error rate of 3.1% was found, and this did not differ between treatment groups. A low rate of error was found for all outcomes undergoing 100% source data verification, with the exception of two secondary outcomes with error rates >10%. Minimal variation in trial outcomes were found between the unmonitored and monitored datasets. Reduced degrees of source data verification and reduced cohort sizes assessed using simulated trial datasets had minimal impact on trial outcomes.

Conclusions

Targeted source data verification of data critical to trial outcomes, which carried with it a substantial time investment, did not have an impact on study outcomes in this trial. This evaluation of the cost-effectiveness of targeted source data verification contributes to the evidence-base regarding the context where reduced emphasis should be placed on source data verification as the foremost monitoring activity.
The estrogen receptor and metabolism
Authors: Xiao Zizi , Liu Haijun
Published: February 2024

Across the globe, metabolic syndrome, hyperuric acid, and their related diseases, such as cardiovascular disease, diabetes, and insulin resistance, are increasing in incidence due to metabolic imbalances. Due to the pathogenesis, women are more prone to these diseases than men. As estrogen levels decrease after menopause, obesity and metabolic disorders are more likely to occur. Men are also affected by hyperuric acid. To provide ideas for the prevention and treatment of metabolic syndrome and hyperuricemia, this article reviews and analyzes the relationship between estrogen receptors, metabolic syndrome, and hyperuricemia.
Introduction to the novel model of preoperative Multi - Domain Risk Stratification (pMDRS)
Authors: Iddagoda Mayura Thilanka
Published: February 2024

Preoperative risk stratification is an important step in surgical procedures. The current scoring systems do not predict accurate overall surgical outcomes in complex comorbid patients. The novel model of preoperative multi-domain risk stratification is described in this article, which categorises patients in to three risk groups, aiming to modify the risk for optimal surgical outcomes.
Transient osteoporosis of the hip in pregnancy
Authors: Morton Adam , Savard-Heppel Jennifer
Published: February 2024

Transient osteoporosis of the hip is an uncommon bone marrow oedema syndrome of unknown pathophysiology affecting previously healthy pregnant women and young to middle-aged men. The disorder is characterised by hip pain, reduced mobility, and the risk of fracture, which is significantly higher in pregnant than in non-pregnant individuals. Diagnosis is by magnetic resonance imaging. Other than a single case-control study, published literature is limited to case series and case reports, with no evidence to guide management, risk of fracture, mode of delivery, safety of breastfeeding and risk of recurrence. An international pregnancy registry may be useful to try to answer some of these questions.
Safety and Efficacy of Switching SAR341402 Insulin Aspart and Originator Insulin Aspart vs Continuous Use of Originator Insulin Aspart in Adults With Type 1 Diabetes: The GEMELLI X Trial
Authors: Shah Viral N. , Al-Karadsheh Amer , Barnes Cathy , Mandry Jose , Nakhle Samer , Wernicke-Panten Karin , Kramer Daniel , Schmider Wolfgang , Pierre Suzanne , Teichert Lenore , Rotthaeuser Baerbel , Mukherjee Bhaswati , Bailey Timothy S.
Published: February 2024

Background:

SAR341402 insulin aspart (SAR-Asp) is a rapid-acting insulin analog developed as an interchangeable biosimilar to the marketed insulin aspart reference product (NovoLog; NN-Asp). GEMELLI X was a randomized controlled trial to assess outcomes with a biosimilar in line with the US Food and Drug Administration requirements for designation as an interchangeable biosimilar. This report assessed whether multiple switches between SAR-Asp and NN-Asp lead to equivalent safety and efficacy compared with continuous use of NN-Asp in adults with type 1 diabetes (T1D) treated with multiple daily injections, using once-daily insulin glargine U100 (Lantus) as the basal insulin.

Methods:

This open-label randomized (1:1), parallel-group, phase 3 trial compared four × four weeks of alternating use of individually titrated SAR-Asp and NN-Asp (NN-Asp for first four weeks, SAR-Asp in last four weeks; switching group) vs 16 weeks of continuous use of NN-Asp (nonswitching group). End points included pharmacokinetics, immunogenicity, adverse events, hypoglycemia, insulin dose, and change in efficacy parameters.

Results:

Of the 210 patients randomized, 200 (95.5%) completed the trial. Patients assigned to switching group (n = 104) and nonswitching group (n = 106) showed similar safety and tolerability, including anti-insulin aspart antibody responses, adverse events, and hypoglycemia. At week 16, there was no relevant difference between switching vs nonswitching groups in the change from baseline in glycated hemoglobin (least square [LS] mean difference = 0.05% [95% confidence interval [CI] = −0.13, 0.22]; 0.50 mmol/mol [−1.40, 2.39]), fasting plasma glucose (LS mean difference = 0.23 mmol/L [95% CI = −1.08, 1.53]; 4.12 mg/dL [−19.38, 27.62]), and changes in insulin dosages.

Conclusions:

Alternating doses of SAR-Asp and NN-Asp compared with continuous use of NN-Asp showed similar safety, immunogenicity, and clinical efficacy in adults with T1D. This study supports interchangeability between SAR-Asp and NN-Asp in T1D management.
Day case Rezum™ water vapour therapy for urinary retention secondary to benign prostatic hyperplasia
Authors: Noureldin Mohamed , Alabed Allat Omar , Elnabarawy Ramzy , Alnoomani Mohamed , Abdelmotagly Yehia , Gehring Tina , Rajkumar Govindaraj N , Emara Amr , Hindley Richard G
Published: February 2024

Objectives:

Rezum (Boston Scientific) water vapour therapy is an effective day case minimally invasive surgical treatment (MIST) for men with troublesome lower urinary tract symptoms (LUTSs) due to benign prostatic obstruction. The potential place for MISTs in the treatment of patients with urinary retention or permanent catheter dependence is currently unclear.

Patients and Methods:

A total of 48 patients presenting with retention of urine (out of a total of 524 patients) over a 4-year period from 2017 underwent Rezum treatment. All patients were followed up at 3, 6 and 12 months after the procedure. At each visit, flow rate, post void residual urine, and patient reported outcome measures (PROMs) including International Prostate Symptom Score (IPSS) were recorded.

Results:

A total of 34 patients had an indwelling catheter prior to treatment and 14 were self-catheterising. The mean age was 67 years (standard deviation (SD) = 3) with a mean prostate volume of 56 mL (SD = 6). The average number of injections per case was 8 (SD1), which included median lobe (ML) treatment in one man. 75% of the patients passed their post treatment trial without catheter (TWOC). IPSS improved to 6 ( p = 0.001) in 12 months.

Conclusion:

The results from this cohort of patients are encouraging. Further evaluation with longer follow-up is required. The addition of MISTs to the portfolio of options for men with retention of urine may offer a streamlined and efficient alternative to the conventional treatments, and help therefore to reduce the national waiting list, and allow men a more rapid solution avoiding prolonged catheterisation.

Level of evidence:

Not applicable.
Refined image quality assessment for color fundus photography based on deep learning
Authors: Guo Tianjiao , Liu Kun , Zou Haidong , Xu Xun , Yang Jie , Yu Qi
Published: February 2024

Purpose

Color fundus photography is widely used in clinical and screening settings for eye diseases. Poor image quality greatly affects the reliability of further evaluation and diagnosis. In this study, we developed an automated assessment module for color fundus photography image quality assessment using deep learning.

Methods

A total of 55,931 color fundus photography images from multiple centers in Shanghai and the public database were collected and annotated as training, validation, and testing data sets. The pre-diagnosis image quality assessment module based on the multi-task deep neural network was designed. The detailed criterion of color fundus photography image quality including three subcategories with three levels of grading was applied to improve precision and objectivity. The auxiliary tasks such as the localization of the optic nerve head and macula, the classification of laterality, and the field of view were also included to assist the quality assessment. Finally, we validated our module internally and externally by evaluating the area under the receiver operating characteristic curve, sensitivity, specificity, accuracy, and quadratic weighted Kappa.

Results

The “Location” subcategory achieved area under the receiver operating characteristic curves of 0.991, 0.920, and 0.946 for the three grades, respectively. The “Clarity” subcategory achieved area under the receiver operating characteristic curves of 0.980, 0.917, and 0.954 for the three grades, respectively. The “Artifact” subcategory achieved area under the receiver operating characteristic curves of 0.976, 0.952, and 0.986 for the three grades, respectively. The accuracy and Kappa of overall quality reach 88.15% and 89.70%, respectively, on the internal set. These two indicators on the external set were 86.63% and 88.55%, respectively, which were very close to that of the internal set.

Conclusions

This work showed that our deep module was able to evaluate the color fundus photography image quality using more detailed three subcategories with three grade criteria. The promising results on both internal and external validation indicated the strength and generalizability of our module.
Peripheral Creator Cultures in India, Ireland, and Turkey
Authors: Bidav Tugce , Mehta Smith
Published: February 2024

Drawing on Indian, Irish, and Turkish YouTube creators’ perceptions of their work, this article focuses on peripheral creator work cultures to broaden the understanding of creator labor precarity. We situate creator labor within not only the platform architectures but also within the geographical specificities of media production, distribution, and consumption. In doing so, we demonstrate that peripheral creators face distinctive struggles for visibility and survival in screen industries that emerge from their heterogeneous sociocultural and linguistic contexts. Based on the interviews with creators and streaming service executives conducted between 2017 and 2023, the findings reveal that creators’ choice of language and place of practice distinctly affects their global reach, visibility, and their ability to sustain a career in screen industries.
Access to MAT: Participants’ Experiences With Transportation, Non-Emergency Transportation, and Telehealth
Authors: Boyd Jennifer , Carter Martha , Baus Adam
Published: February 2024

Introduction:

Access to medication assisted treatment (MAT) for opioid use disorder (OUD) in the United States is a significant challenge for many individuals attempting to recover and improve their lives. Access to treatment is especially challenging in rural areas characterized by lack of programs, few prescribers, and transportation barriers. This study aims to better understand the roles that transportation, Medicaid-funded non-emergency medical transportation (NEMT), and telehealth play in facilitating access to MAT in West Virginia (WV).

Methods:

We developed this survey using an exploratory sequential mixed methods approach following a review of current peer-reviewed literature plus information gained from 3 semi-structured interviews and follow-up discussions with 5 individuals with lived experience in MAT. Survey results from 225 individuals provided rich context on the influence of transportation in enrolling and remaining in treatment, use of NEMT, and experiences using telehealth. Data were collected from February through August 2021.

Results:

We found that transportation is a significant factor in entering into and remaining in treatment, with 170 (75.9%) respondents agreeing or strongly agreeing that having transportation was a factor in deciding to go into a MAT program, and 176 (71.1%) agreeing or strongly agreeing that having transportation helps them stay in treatment. NEMT was used by one-quarter (n = 52, 25.7%) of respondents. Only 13 (27.1%) noted that they were picked up on time and only 14 (29.2%) noted that it got them to their appointment on time. Two thirds of respondents (n = 134, 66.3%) had participated in MAT services via telehealth video or telephone visits. More preferred in-person visits to telehealth visits but a substantial number either preferred telehealth or reported no preference. However, 18 (13.6%) reported various challenges in using telehealth.

Conclusions:

This study confirms that transportation plays a significant role in many people’s decisions to enter and remain in treatment for OUD in WV. Additionally, for those who rely on NEMT, services can be unreliable. Finally, findings demonstrate the need for individualized care and options for accessing treatment for OUD in both in-person and telehealth-based modalities. Programs and payers should examine all possible options to ensure access to care and recovery.
Augmenting Effect of Inclusive and Ambidextrous Leadership on Public University Academic Staffs’ Innovative Performance: The Mediating Role of Innovative Work Behavior
Authors: Wahab Faridah Ab , Subramaniam Anusuiya , Ho Jo Ann , Bali Mahomed Anuar Shah
Published: February 2024

This study aims to address a gap in research by examining the relationship between leadership styles, innovative work behavior, and innovative performance among academic staff at public universities. Specifically, the study seeks to identify the extent to which inclusive and ambidextrous leadership styles can facilitate innovative performance, examine whether innovative work behavior enhances innovative performance, and discover whether innovative work behavior mediates the relationship between inclusive and ambidextrous leadership styles and innovative performance among academic staff at public universities. A critical survey was conducted using a questionnaire among academic staff at two public universities located on the east coast of Peninsular Malaysia, generating 300 responses. The study used SPSS 27.0 and SEM with AMOS 24.0 to analyze the results. The findings of this study show that inclusive and ambidextrous leadership are positively associated with innovative work behavior. The study also found that innovative work behavior facilitates innovative performance. The study highlights the mediating effect of innovative work behavior on the relationship between leadership styles and academic staff’s innovative performance, offering important insights into how public universities can improve their academic staff’s innovative performance through effective leadership and work behavior strategies.
Citations of Publications on Foreign Direct Investments into Agribusiness: Nature, Variability and Drivers
Authors: Agyei-Henaku Kofi A. A-O. , Badu-Prah Charlotte , Srofenyoh Francis , Gidiglo Ferguson K. , Agyeiwaa-Afrane Akua , Djokoto Justice G.
Published: February 2024

The recognition that one publication receives from another is a citation. The nature of these references (citations), their variability and the drivers of the citations concerning the subject of foreign investment in agribusiness are unknown. Consequently, we investigated the nature, variability, and drivers of the citations in the writings on foreign investment in agribusiness. We used 406 studies extracted from Google Scholar through Publish or Perish Software and modeled with a two-part regression analysis. The results show that peer-reviewed publications, age of publication, full text in Google scholar, collaborative publications and self-citation enhance citations. Review articles and publishing in journals with impact factors do not promote citations. To make an impact through citations, authors and funders must focus on peer review, full text, and collaborative publications and engage in self-citation.
A Case Study of Instructors’ Explanations in Online EMI Lectures in China
Authors: Liang Hongmei
Published: February 2024

The purpose of this study was to reveal features of instructors’ explanations in online EMI lectures in China. Through a mixed methods case study, the researcher examined the distribution and linguistic realizations of different types of explanations in the lectures of two online EMI courses and how the instructors and students perceived the explanations. The results showed that instructors’ explanations were prevalent in the lectures of both courses with expositions being the most dominant type regardless of subject contents whereas the other explanation types such as comparisons, clarifications, additions, justifications, solutions and generalizations being subject-specific. Moreover, both instructors were capable of using various linguistic devices for different types of explanations despite some linguistic mistakes in explanations. The results also showed that instructors chose particular types of explanations mainly because of the specific teaching aims and methods of the course, and that students were positive about instructors’ use of different types of explanations in the lectures except for the suggestions that one of the instructors’ pronunciation be improved and more visual means be used to aid explanations. The study has implications for future research on enhancing EMI instructors’ explanatory capacity and addressing students’ linguistic discomfort with EMI lectures in a broader sense.
The Use of Osteobiologics in Single versus Multi-Level Anterior Cervical Discectomy and Fusion: A Systematic Review
Authors: Hoffmann Jim , Ricciardi Guillermo A. , Yurac Ratko , Meisel Hans Jörg , Buser Zorica , Qian Bangping , Vergroesen Pieter-Paul A. ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study Design

Systematic literature review.

Objectives

In this study we assessed evidence for the use of osteobiologics in single vs multi-level anterior cervical discectomy and fusion (ACDF) in patients with cervical spine degeneration. The primary objective was to compare fusion rates after single and multi-level surgery with different osteobiologics. Secondary objectives were to compare differences in patient reported outcome measures (PROMs) and complications.

Methods

After a global team of reviewers was selected, a systematic review using different repositories was performed, confirming to PRISMA and GRADE guidelines. In total 1206 articles were identified and after applying inclusion and exclusion criteria, 11 articles were eligible for analysis. Extracted data included fusion rates, definition of fusion, patient reported outcome measures, types of osteobiologics used, complications, adverse events and revisions.

Results

Fusion rates ranged from 87.7% to 100% for bone morphogenetic protein 2 (BMP-2) and 88.6% to 94.7% for demineralized bone matrix, while fusion rates reported for other osteobiologics were lower. All included studies showed PROMs improved significantly for each osteobiologic. However, no differences were reported when comparing osteobiologics, or when comparing single vs multi-level surgery specifically.

Conclusion

The highest fusion rates after 2-level ACDF for cervical spine degeneration were reported when BMP-2 was used. However, PROMs did not differ between the different osteobiologics. Further blinded randomized trials should be performed to compare the use of BMP-2 in single vs multi-level ACDF specifically.
Comparative Complications Associated With BMP Use In Patients Undergoing ACDF for Degenerative Spinal Conditions: Systematic Review and Meta-Analysis
Authors: Martin Christopher T. , Holton Kenneth , Broida Samuel E. , Hickmann Anne-Katrin , Bakker Caitlin , Lender Paul A. , Watanabe Kota , Meisel Hans Jörg , Buser Zorica , Presciutti Steven M. , Yoon Sangwook Tim ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study Design

Systematic Review and Meta-Analysis.

Objectives

To compare complication incidence in patients with or without the use of recombinant human Bone Morphogenic Protein-2 (BMP2) undergoing anterior cervical discectomy and fusion (ACDF) for degenerative conditions.

Methods

A systematic search of eight online databases was conducted using PRISMA guidelines. Inclusion criteria included English language studies with a minimum of 10 adult patients undergoing instrumented ACDF surgery for a degenerative spinal condition in which BMP2 was used in all patients or one of the treatment arms. Studies with patients undergoing circumferential fusions, with non-degenerative indications, or which did not report post-operative complication data were excluded. Patients with and without BMP2 were compared in terms of the incidence of dysphagia/dysphonia, anterior soft tissue complications (hematoma, seroma, infection, dysphagia/dysphonia), nonunion, medical complications, and new neurologic deficits.

Results

Of 1832 preliminary search results, 27 manuscripts were included. Meta-analysis revealed the relative risk of dysphagia or dysphonia (RR = 1.39, CI 95% 1.18 – 1.64, P = <.001), anterior soft tissue complications (RR = 1.43, CI 95% 1.25-1.64, P = <.001), and medical complications (RR = 1.32, CI 95% 1.06-1.66, P = .013) were statistically significant in the BMP2 group while the relative risk of non-union (RR = .5, CI 95% .23 - 1.13, P = .09) trended lower in the BMP2 group. Neurological deficit (RR = 1.06, CI 95% .82-1.37, P = .66), and additional medical complications (RR = 1.53, CI 95% .98-2.38, P = .06) were not found to be statistically different between the groups.

Conclusions

This meta-analysis identified a high rate of arthrodesis when BMP2 was used in ACDF, but confirmed increased rates of dysphagia and anterior soft tissue complications. Surgeons may consider reserving BMP2 implementation for cases with a high risk of non-union, and should be aware of the risk of airway compromise.
Machine learning based predictive model of Type 2 diabetes complications using Malaysian National Diabetes Registry: A study protocol
Authors: Abas Mohamad Zulfikrie , Li Ken , Hairi Noran Naqiah , Choo Wan Yuen , Wan Kim Sui
Published: February 2024

Background:

The prevalence of diabetes in Malaysia is increasing, and identifying patients with higher risk of complications is crucial for effective management. The use of machine learning (ML) to develop prediction models has been shown to outperform non-ML models. This study aims to develop predictive models for Type 2 Diabetes (T2D) complications in Malaysia using ML techniques.

Design and methods:

This 10-year retrospective cohort study uses clinical audit datasets from Malaysian National Diabetes Registry from 2011 to 2021. T2D patients who received treatment in public health clinics in the southern region of Malaysia with at least two data points in 10 years are included. Patients with diabetes complications at baseline are excluded to ensure temporality between predictors and the target variable. Appropriate methods are used to address issues related to data cleaning, missing data imputation, data splitting, feature selection, and class imbalance. The study uses 7 ML algorithms, including logistic regression, support vector machine, k-nearest neighbours, decision tree, random forest, extreme gradient boosting, and light gradient boosting machine, to develop predictive models for four target variables: nephropathy, retinopathy, ischaemic heart disease, and stroke. Hyperparameter tuning is performed for each algorithm. The model training is performed using a stratified k-fold cross-validation technique. The best model for each algorithm is evaluated on a hold-out dataset using multiple metrics.

Expected impact of the study on public health:

The prediction model may be a valuable tool for diabetes management and secondary prevention by enabling earlier interventions and optimal resource allocation, leading to better health outcomes.
Discourse in Research-Practice Partnership Meetings: A Comparison of Conditions Across Contexts
Authors: Zala-Mezö Enikö , Datnow Amanda
Published: February 2024

Research-practice partnerships (RPPs) are gaining international attention as they promise to close the gap between research and practice in education. As RPPs bring together participants with diverse expertise, how people dialogue to collectively learn and address problems of practice is critically important. Analyzing video data from RPP meetings in Switzerland and the United States, this micro-analytic study examines the extent of generative discourse in RPP meetings and the conditions under which it occurs. Since RPPs vary significantly along a number of dimensions, it is useful to compare them to see how these features influence discourse and learning. Across the Swiss and US contexts, almost half of the meeting time was generative—altering meanings and/or creating new knowledge and perspectives. Discourse patterns varied, however, reflecting the different sizes, purposes, and activity structures of the RPPs. Examining meeting discourse across conditions may help promote knowledge generation and continuous improvement in RPPs.
The suitability and acceptability of a co-designed prototype psychoeducational activity book for autistic children aged five-eleven years
Authors: Powell Lauren , Wheeler Gemma , Redford Chris , Stott Jonathan
Published: February 2024

Background and aims

Evidence suggests that autistic children and young people (CAYP) can benefit from age-appropriate psychoeducation. Co-design is a methodology that iteratively involves end users and stakeholders in producing an intervention which may increase engagement and impact. Few age-appropriate co-designed psychoeducation resources for autistic CAYP exist. Therefore, a paper-based resource was co-designed for autistic CAYP who attend mainstream primary education. The resource aims to educate CAYP about their autism and provide strategies to support them to live well with their autism.

Methods

This paper describes the evaluation of the prototype resource through online workshops with 12 families and input from four specialist clinicians. The suitability and acceptability of the resource was explored, and sketch notes were taken for respondent validity and engagement purposes.

Results

A reflexive thematic analysis identified six themes and two subthemes: (1) content appropriateness (subtheme: strategies and unpredictability); (2) relating to content, (3) feelings and emotions, (4) terminology (subtheme: literal thinking); (5) positivity, and (6) communication aid. Suggested improvements were also identified. Results suggest the resource is suitable and acceptable.

Conclusions

Future intervention development research may consider individual differences of autistic CAYP and the co-design of resources for other age groups of neurodiverse populations.
Securing financial returns in politically uncertain worlds: Finance and urban water politics in Brazil
Authors: Cruxên Isadora A
Published: February 2024

Studies of financialization have highlighted how politics, particularly through the state, drives the increasing entanglement of financial actors and rationales in the production of urban space. This article shifts the angle to consider the challenges that uncertain politics pose for such entanglement. Looking beyond techno-calculative practices, it explores how finance works politically to sustain value extraction within fragmented regulatory landscapes. It does so through historical and ethnographic analysis of financial investment in urban water and sanitation provision in Brazil, drawing on fieldwork, interviews, and a new dataset on public-private contracts to interrogate how private water companies navigate politico-regulatory relations under financial investors like private equity. It shows that while these providers were quite engaged in local politics under their original owners (construction groups), under financial investors they sought to “escape” it by curbing ties to public officials, reducing the autonomy of local subsidiaries, and successfully lobbying for national standards on regulatory norms. It argues these centralizing efforts constituted forms of centripetal politics meant to enhance asset monitoring, increase regulatory legibility, and reduce political uncertainty. The findings illuminate how financial investors work across political scales to navigate political risk and sustain financial value, thus problematizing the conventional analytical focus on how finance capitalizes on local forms of entrepreneurial politics. Crucially, they reveal the need to treat institutional environments not simply as filters for financial investment but as objects of political contestation by financial actors. This allows for blurring the boundaries between finance and politics, and for politicizing finance.
Vaccination in Prevention of Acute Cardiovascular Events in Adults
Authors: Sinha Sudhir Chandra , Reddy G Venkateshwara
Published: February 2024

Epidemiological studies have shown that acute coronary events, heart failure, atrial fibrillation with fast ventricular rate and brain stroke events have increased prevalence in winter season. Infections have a pivotal role in triggering such events. Vaccination against influenza and pneumococcus has been documented to prevent such events in large epidemiological studies. Majority of the deaths during Corona virus-19 (COVID-19) pandemic were related to cardiovascular event apart from serious lung condition. Vaccination has been proven to reduce risk of recurrent hospitalizations and death especially in sick and frail patients with heart failure, chronic obstructive lung diseases, renal failure and acute coronary syndromes. It becomes more relevant in countries like India where patient has to pay huge amounts for hospitalization from the pocket. On the other hand, it reduces unnecessary strain on the healthcare manpower and resources. Practice of vaccination in addition to guidelines based pharmacological, device or surgical therapy, is to help both the patients and physicians.
Does moral valence influence the construal of alternative possibilities?
Authors: Engelmann Neele , Hannikainen Ivar R.
Published: February 2024

It is often thought that an agent may be held morally responsible for bringing about a negative outcome only if they could have done otherwise. Inspired by previous research linking moral judgment to free will ascriptions and representations of possibility, we probe the reverse link: Does learning about a morally undesirable outcome make preferable alternatives appear more possible? We find modest evidence that this could be the case. In a preregistered experiment, we presented 317 participants with animated footage of a traffic accident in which two bystanders fail to intervene as a third person gets run over by bus, and manipulated whether the victim was evil, virtuous, or neutral. Judging from the same visual input, people indicate that saving an evil victim would have been slightly less possible than saving a virtuous or neutral victim, and arriving at the conclusion that it would have been possible demanded more time. Using drift-diffusion modeling to better understand the underlying cognitive processes, we found that participants were biased against counterfactual attempts to save the evil victim’s life, but then gathered evidence toward their decisions at the same rate regardless of the victim’s morality.
USF1 transcriptionally activates USP14 to drive atherosclerosis by promoting EndMT through NLRC5/Smad2/3 axis
Authors: Zhang Zhiwen , Guo Quan , Ma Chao , Zhao Zhenzhou , Shi Qingbo , Yu Haosen , Rao Lixin , Li Muwei
Published: February 2024

Background

Endothelial-to-Mesenchymal Transformation (EndMT) plays key roles in endothelial dysfunction during the pathological progression of atherosclerosis; however, its detailed mechanism remains unclear. Herein, we explored the biological function and mechanisms of upstream stimulating factor 1 (USF1) in EndMT during atherosclerosis.

Methods

The in vivo and in vitro atherosclerotic models were established in high fat diet-fed ApoE−/− mice and ox-LDL-exposed human umbilical vein endothelial cells (HUVECs). The plaque formation, collagen and lipid deposition, and morphological changes in the aortic tissues were evaluated by hematoxylin and eosin (HE), Masson, Oil red O and Verhoeff-Van Gieson (EVG) staining, respectively. EndMT was determined by expression levels of EndMT-related proteins. Target molecule expression was detected by RT-qPCR and Western blotting. The release of pro-inflammatory cytokines was measured by ELISA. Migration of HUVECs was detected by transwell and scratch assays. Molecular mechanism was investigated by dual-luciferase reporter assay, ChIP, and Co-IP assays.

Results

USF1 was up-regulated in atherosclerosis patients. USF1 knockdown inhibited EndMT by up-regulating CD31 and VE-Cadherin, while down-regulating α-SMA and vimentin, thereby repressing inflammation, and migration in ox-LDL-exposed HUVECs. In addition, USF1 transcriptionally activated ubiquitin-specific protease 14 (USP14), which promoted de-ubiquitination and up-regulation of NLR Family CARD Domain Containing 5 (NLRC5) and subsequent Smad2/3 pathway activation. The inhibitory effect of sh-USF1 or sh-USP14 on EndMT was partly reversed by USP14 or NLRC5 overexpression. Finally, USF1 knockdown delayed atherosclerosis progression via inhibiting EndMT in mice.

Conclusion

Our findings indicate the contribution of the USF1/USP14/NLRC5 axis to atherosclerosis development via promoting EndMT, which provide effective therapeutic targets.
Bio-functionalized carbon dots for signaling immuno-reaction of carcinoembryonic antigen in an electrochemical biosensor for cancer biomarker detection
Authors: Chellachamy Anbalagan Amarnath , Korram Jyoti , Doble Mukesh , Sawant Shilpa N.
Published: February 2024

Early diagnosis of cancer demands sensitive and accurate detection of cancer biomarkers in blood. Carbon dots (CDs) bio-functionalization with antibodies, peptides or aptamers have played significant role in cancer diagnosis and targeted cancer therapy. Herein, a biosensor for detection of cancer biomarker carcinoembryonic antigen (CEA) in blood serum has been designed using CDs bio-functionalized with HRP-conjugated CEA antibody (CUCDs@CEAAb2) as detection probe. CDs were synthesized by upscaling of cow urine, a nitrogen rich biomass waste, by hydrothermal method. Detection probe based on CDs resulted in 3.5 times higher sensitivity as compared to conventional electrochemical sandwich immunoassay. To further improve the sensor performance, hyper-branched polyethylenimine grafted poly amino aniline (PEI-g-PAANI) was used as the sensing interface, which enabled immobilization of higher amount of capture antibody. Detection of CEA in human blood serum coupled with wide linear range (0.5–50 ng/ml), good specificity, stability, reproducibility and low detection limit (10 pg/ml) signified the excellence of CUCDs based CEA immunosensor. CUCDs exhibited excitation wavelength dependent fluorescence property and showed strong blue emission under UV irradiation. MTT assay indicated that the material is not toxic towards human dental pulp stem cells (hDPSCs) and MG63 osteosarcoma cells (cell viability > 90%). The present study demonstrates a methodology for valorization of animal waste to a cost-effective carbon based functional nanomaterial for clinical detection of cancer biomarkers.
COVID-19 shock, fiscal subsidies, and consumption resilience of new energy vehicles: evidence from Shanghai, China
Authors: Li Xin , Sun Lei , Li Guangqin
Published: February 2024

New energy vehicles are regarded as an important measure for improving air quality, reducing oil dependence, fostering emerging industries, and promoting high-quality development. Since 2009, the Chinese government has been committed to promoting new energy vehicles through various policy measures, such as fiscal subsidies. Meanwhile, the outbreak of the COVID-19 pandemic at the end of 2019 has brought great impact on the economy and society. Thus, it is a topic of research to determine if the fiscal subsidy policy can assist new energy vehicles to resist the pandemic’s impact and build consumption resilience. Current researches lack enough attention to the role of fiscal subsidy policy in enhancing consumption resilience under the pandemic impact. By utilizing monthly sales data of new energy vehicles in Shanghai from January 2018 to February 2021, this study employs regression discontinuity (RD) analysis and the combination of the RD with the differences-in-differences (DID) model, to comprehensively evaluate the impact of the COVID-19 pandemic on new energy vehicle consumption and the effectiveness of fiscal subsidy policies in enhancing consumption resilience. The findings reveal that the COVID-19 pandemic shock, with a bandwidth of 3 months, led to a 23% decrease in new energy vehicles sales. In comparison with unsubsidized vehicles, sales of subsidized new energy vehicles significantly increased by 15–80% during the pandemic shock, indicating that fiscal subsidies are crucial in enhancing the consumption resilience of new energy vehicles. Compared with other country-specific new energy vehicles, the subsidy effect of domestic new energy vehicles is relatively inadequate during the pandemic shock. The retreat from subsidy policies has contributed to a decline in the consumption of new energy vehicles in response to the pandemic shock. It is necessary to further improve the consumption resilience of domestic new energy vehicles and pure electric vehicles.