bluuebunny/crossref_metadata_2025 huggingface dataset:
Decoding Radiology Reports: Artificial Intelligence-Large Language Models Can Improve the Readability of Hand and Wrist Orthopedic Radiology Reports
Authors: Butler James J. , Acosta Ernesto , Kuna Michael C. , Harrington Michael C. , Rosenbaum Andrew J. , Mulligan Michael T. , Kennedy John G.
Published: August 2024

Background:

The purpose of this study was to assess the effectiveness of an Artificial Intelligence-Large Language Model (AI-LLM) at improving the readability of hand and wrist radiology reports.

Methods:

The radiology reports of 100 hand and/or wrist radiographs, 100 hand and/or wrist computed tomography (CT) scans, and 100 hand and/or wrist magnetic resonance imaging (MRI) scans were extracted. The following prompt command was inserted into the AI-LLM: “Explain this radiology report to a patient in layman’s terms in the second person: [Report Text].” The report length, Flesch reading ease score (FRES), and Flesch-Kincaid reading level (FKRL) were calculated for the original radiology report and the AI-LLM–generated report. The accuracy of the AI-LLM report was assessed via a 5-point Likert scale. Any “hallucination” produced by the AI-LLM–generated report was recorded.

Results:

There was a statistically significant improvement in mean FRES scores and FKRL scores in the AI-LLM–generated radiograph report, CT report, and MRI report. For all AI-LLM–generated reports, the mean reading level improved to below an eighth-grade reading level. The mean Likert score for the AI-LLM–generated radiograph report, CT report, and MRI report was 4.1 ± 0.6, 3.9 ± 0.6, and 3.9 ± 0.7, respectively. The hallucination rate in the AI-LLM–generated radiograph report, CT report, and MRI report was 3%, 6%, and 6%, respectively.

Conclusions:

This study demonstrates that AI-LLM effectively improves the readability of hand and wrist radiology reports, underscoring the potential application of AI-LLM as a promising and innovative patient-centric strategy to improve patient comprehension of their imaging reports. Level of Evidence: IV.
Predictors for thoracic aortic growth in patients with type B aortic dissection after thoracic endovascular aortic repair
Authors: Chen Yonghui , Ren Jianli , Liu Zongwei , Cui Dongsheng , Wang Shuaishuai , Bi Jiaxue , Dai Xiangchen
Published: August 2024

Objective

To identify independent predictors of thoracic aortic growth in patients with type B aortic dissection (TBAD) undergoing thoracic endovascular aortic repair (TEVAR).

Methods

A retrospective analysis of the patients undergoing TEVAR for TBAD or intramural hematoma (IMH) from April 2014 to April 2023 was performed. The baseline morphological data of TBAD was established through computed tomography angiography (CTA) before discharge. Patients were divided into two groups based on aortic growth: growth and no growth. Aortic growth defined as an increase ≥5 mm in thoracic maximal aortic diameter during any serial follow-up CTA measurement. Logistic regression following propensity score matching (PSM) was used to identify independent predictors for aortic growth. Receiver operating characteristic curve and cutoff value of independent predictors were calculated. Linear regression was used to establish a correlation between anatomical variables and follow-up aortic diameter.

Results

A total of 145 patients with TBAD ( n = 122) or IMH ( n = 23) undergoing TEVAR were included, with a male of 83.4% and a mean age of 56 ± 14.1 years. Patients in growth group and no growth group was 26 (17.9%) and 119 (80.1%), respectively. After using PSM method, matched regression analysis showed residual maximal tear diameter (OR = 0.889, 95% CI 0.830-0.952, p = 0.001) and follow-up aortic diameter (OR = 0.977, 95% CI 0.965-0.989, p < 0.001) were independent predictors for aortic growth. The cutoff value was 8.55 mm for residual tear diameter and 40.65 mm for follow-up maximal aortic diameter. The residual maximal tear diameter showed a linear correlation with follow-up aortic diameter (DW = 1.74, R2 = 6.2%, p = 0.033).

Conclusions

This study suggested that residual maximal tear diameter >8.55 mm and follow-up aortic diameter >40.65 mm could predict aortic growth in patients with TBAD undergoing TEVAR.
The distinctive role of vowel harmony in visual word recognition: The case of Turkish
Authors: Özkan Zeynep G. , Özdemir Berceste , Gómez Pablo , Perea Manuel
Published: August 2024

Vowel harmony is a phenomenon in which the vowels in a word share some features (e.g., frontness vs. backness). It occurs in several families of languages (e.g., Turkic and Finno-Ugric languages) and serves as an effective segmenting cue in continuous speech and when reading compound words. The present study examined whether vowel harmony also plays a role in visual word recognition. We chose Turkish, a language with four front and four back vowels in which approximately 75% of words are harmonious. If vowel harmony contributes to the formation of coherent phonological codes during lexical access, harmonious words will reach a stable orthographic-phonological state more rapidly than disharmonious words. To test this hypothesis, in Experiment 1, we selected two types of monomorphemic Turkish words: harmonious (containing only front vowels or back vowels) and disharmonious (containing front and back vowels)—a parallel manipulation was applied to the pseudowords. Results showed faster lexical decisions for harmonious than disharmonious words, whereas vowel harmony did not affect pseudowords. In Experiment 2, where all words were harmonious, we found a small but reliable advantage for disharmonious over harmonious pseudowords. These findings suggest that vowel harmony helps the formation of stable phonological codes in Turkish words, but it does not play a key role in pseudoword rejection.
The technification of domestic abuse: Methods, tools and criminal justice responses
Authors: Sugiura Lisa , Button Mark , Nurse Jason RC , Tapley Jacki , Saglam Rahime Belen , Hawkins Chloe , Frederick Brian , Blackbourn Dean
Published: August 2024

Methods of domestic abuse are progressively incorporating computer misuse and other related online offences and digital tools, escalating opportunities for perpetrators to monitor, threaten and humiliate their victims. Drawing on empirical research involving media case study analysis, a technology review and interviews undertaken with 21 professionals and service providers supporting domestic abuse victims, this article outlines the context in England and Wales regarding the methods, tools and criminal justice responses involved in what we conceptualise as the technification of domestic abuse. As technology continues to deeply intertwine with our daily lives, it is undeniable that its involvement within domestic abuse encompasses harmful behaviours that pose an increasing risk of harm, and unless effective criminal justice interventions are implemented, this risk will inevitably grow even further.
‘This uh. . . young lady young gentleman’: Gender attribution in the context of a gender-ambiguous robot
Authors: de Rijk Lynn , Breukelman Mieke , Dalmaijer Evi , Stommel Wyke
Published: August 2024

For humanoid robots, gender-ambiguous presentation is implemented as a potential way to avoid gender-stereotypical design. Using conversation analysis, we look at video recorded user interaction in the presence of a designedly gender-ambiguous robot, showing how this design choice is actually dealt with within a social context. Robot gender becomes relevant initially when a user refers to the robot with a dual-gendered package (‘young lady young gentleman’), with another user proposing ‘her’ for the robot, and the talk then evolving to the pursuit of agreement on the robot’s proposed femininity. Robot gender attribution is treated by these users as a collaborative endeavor rather than an individual choice. It includes displays of accountability and orientations to delicateness of gender attribution. By implication, the analysis shows that ambiguous design shifts the burden of gender attribution from robot designers to users.
Performance without understanding: How ChatGPT relies on humans to repair conversational trouble
Authors: Pütz Ole , Esposito Elena
Published: August 2024

LLM-based chatbots’ ability to generate contextually appropriate and informative texts can be taken as an indication that they are also able to understand text. We argue instead that the separation of the two competences to generate and to understand text is the key to their performance in dialog with human users. This argument requires a shift in perspective from a concern with machine intelligence to a concern with communicative competence. We illustrate our argument with empirical examples of what conversation analysis calls ‘repair’, showing that the management of trouble by chatbots is not based on an underlying understanding of what is going on but rather on their use of the feedback by human conversational partners. In the conclusion we suggest that strategies for the interaction between chatbots and users should not aim to improve computational skills but to develop a new communicative competence.
Medical record-keeping educational interventions for medical students and residents: a systematic review
Authors: Emekli Emre , Coşkun Özlem , Budakoğlu Işıl İrem
Published: August 2024

Background:

Medical records, encompassing patient histories, progress notes, and more, play a crucial role in patient care and treatment, healthcare communication, medico-legal matters, and supporting financial documentation.

Objective:

Despite their significance, literature suggests inconsistencies in record quality and insufficient formal medical record-keeping education for medical students and residents. The study aimed to identify and evaluate the effectiveness of educational interventions by conducting a systematic review.

Method:

A literature search covering 2003–2023 and review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was undertaken.

Results:

The literature search identified 44 relevant studies for inclusion. Educational methods, including lectures, feedback, workshops and discussions, addressed different components of the clinical record. The review revealed positive impacts on participant satisfaction, skills and attitudes related to record-keeping. However, some studies reported no significant positive outcomes, emphasising the need for higher-level evidence. Most studies adopted a single-group pretest–posttest design, presenting challenges in control group implementation. The Kirkpatrick evaluation levels were primarily at level 2, with few studies reaching level 3. The absence of studies at level 4 suggested the need for more robust evidence. Studies targeted medical residents more frequently than medical students, with a lack of interventions during the first year of medical education.

Conclusion:

Despite limitations including language bias and methodological variations, the review revealed diverse educational strategies and highlighted the necessity for more randomised controlled trials and studies providing higher-level evidence to enhance clinical record-keeping skills among medical students and residents.

Implications:

Medical record-keeping educational interventions can significantly improve the documentation skills of medical students and residents, thereby enhancing patient care, communication and medico-legal compliance.
Characterizing Dysphonia After Pediatric Open Airway Reconstruction: Systematic Review and Meta-Analysis
Authors: Dahan Zachary , Pincivy Alix , Nhan Carol , Bergeron Mathieu
Published: August 2024

Background

Pediatric laryngotracheal stenosis often requires open airway reconstruction. While these surgeries establish an airway for adequate ventilation, many patients develop subsequent dysphonia. Numerous studies have reported outcomes related to voice.

Objective

This study aims to evaluate dysphonia in pediatric patients following open airway reconstruction, focusing on acoustic parameters, perceptual voice quality, and voice-related quality of life.

Methods

A comprehensive search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across 6 databases identified articles involving pediatric patients who underwent open airway reconstruction and reported postoperative vocal acoustic parameters, perceptual voice quality, voice-related quality of life, or vocal mechanics. Articles were assessed for bias risk, and common outcomes were synthesized qualitatively and quantitatively using meta-analyses.

Results

Among 4089 articles, 21 were included, involving 497 pediatric patients. Laryngotracheoplasty was the most common procedure followed by cricotracheal resection. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) scale was frequently used to assess voice quality, with a mean score of 55.6 [95% confidence intervals (CIs): 47.9-63.3]. Voice-related quality of life was measured using the pediatric Voice Handicap Index (pVHI) and Pediatric Voice-Related Quality of Life Survey, with mean scores of 35.6 (95% CI: 21.4-49.7) and 83.7 (95% CI: 74.1-93.2), respectively. The fundamental frequency was 210.5 (95% CI: 174.6-246.3). Other common findings included supraglottic phonation, anterior commissure blunting, posterior glottic diastasis, and abnormal vocal cord mobility.

Conclusion

Pediatric patients experiencing dysphonia after open airway reconstruction exhibited moderately decreased voice quality and reduced voice-related quality of life. However, there was inconsistency in study protocols and outcome measures used. Preserving voice quality during airway reconstruction is crucial to avoid negative impacts on quality of life.
Chronic Adaptation of the Coracohumeral Space and Subscapularis Tendon in Professional Baseball Pitchers
Authors: Schofield Matthew R. , Paul Ryan W. , Buchheit Paul , Rauch Joseph , Thomas Stephen J.
Published: August 2024

Background:

Pitchers frequently experience anterior shoulder pain, possibly associated with coracohumeral impingement; however, whether the coracohumeral distance (CHD) and/or subscapularis tendon adapt chronically (bilateral difference) due to pitching, and whether clinical measures are associated with CHD and subscapularis tendon organization have not been evaluated in professional pitchers.

Hypothesis:

The authors hypothesized that dominant arm CHD would be smaller than the nondominant arm, dominant subscapularis tendon would have increased spatial frequency (ie, be more disorganized), and humeral retroversion (HR) would predict CHD and subscapularis tendon organization.

Level of Evidence:

Level 4.

Methods:

Healthy professional baseball pitchers were recruited during their preseason physical examination. Bilateral diagnostic ultrasound measured CHD, HR, and posterior capsule thickness (PCT), and quantified subscapularis tendon organization. External rotation, neutral, and crossbody CHD was measured.

Results:

Overall, 52 healthy professional baseball pitchers participated. The dominant arm of pitchers demonstrated a significantly narrower CHD in all 3 positions ( P < 0.01), increased scapular protraction (163 vs 156 mm; P < 0.01), and increased spatial frequency of the subscapularis tendon (1.8 vs 1.6 peaks/mm; P < 0.01). HR was associated with CHD in 30° of external rotation ( R2 = 0.12; P < 0.01), neutral rotation ( R2 = 0.11; P < 0.01), and the crossbody position ( R2 = 0.28; P < 0.01). PCT was associated with CHD in 30° of external rotation ( R2 = 0.16; P = 0.05). HR and CHD in 30° of external rotation was associated most strongly with subscapularis tendon organization ( R2 = 0.11; P = 0.03).

Conclusion:

The dominant shoulder of professional pitchers presents with a smaller CHD, more scapular protraction, and more subscapularis tendon disorganization than the nondominant shoulder.

Clinical Relevance:

Professional pitchers demonstrate chronic CHD and subscapularis tendon adaptations, which may increase their risk for anterior shoulder pain and subscapularis tendon injury.
“Recurrent Pleomorphic Xanthoastrocytoma Presenting with Diffuse Leptomeningeal Spread”
Authors: Zagardo Valentina , Viola Anna , Scalia Gianluca , Palmisciano Paolo , Umana Giuseppe Emmanuele , Ferini Gianluca
Published: August 2024

We have read with great interest the recent paper by Grigsby-Rocca et al regarding recurrent pleomorphic xanthoastrocytoma (PXA) with leptomeningeal dissemination. While acknowledging the challenges in managing such cases, we wish to highlight the role of radiotherapy for symptom palliation and potential life extension. We report a case of a 27-year-old woman with recurrent anaplastic PXA and diffuse leptomeningeal spread, who was offered radiotherapy to the spinal axis. Initially presenting with headaches and seizures, she underwent surgical excision, postoperative radiotherapy, and temozolomide. Despite initial disease control, subsequent recurrences required additional surgeries and systemic therapies. With disease progression to leptomeningeal spread, radiotherapy was administered, resulting in clinical stability. This case underscores the importance of considering palliative radiotherapy to improve quality of life and potentially prolong survival in patients with recurrent PXA and leptomeningeal dissemination.
The politics of belonging in early childhood contexts: A comprehensive picture, critical factors and policy recommendations
Authors: Johansson Eva , Emilson Anette , Einarsdottir Johanna , Puroila Anna-Maija , Piskur Barbara
Published: August 2024

This study aims to provide a comprehensive understanding of belonging in early educational institutions based on key findings developed within the international project Politics of belonging: promoting children’s inclusion in educational settings across border (85644). The research questions are: What are the main empirical and theoretical contributions to the understanding of belonging in early childhood institutions? and What kinds of critical factors regarding belonging can be identified? This study applies Yuval-Davies’ theory about the politics of belonging. The data consists of key findings from 28 publications from the aforementioned project. Theoretically, the project provides a novel perspective regarding processes related to belonging in early educational institutions. Such processes involve transgressing, defending and defining borders dictating who is inside or outside these communities. Empirically, the project contributes knowledge about how belonging is performed in practice. Belonging manifests as a joint enterprise involving children, educators, parents and policymakers; it is also multifaceted and powerladen. This study delineates critical elements of children’s belonging. On a micro level, these elements require specific forms of agency amongst children and specific forms of responsibility amongst educators, which exert consequences on a macro level. The discussion concludes with five recommendations regarding policy and practice.
ChatGPT v4 outperforming v3.5 on cancer treatment recommendations in quality, clinical guideline, and expert opinion concordance
Authors: Tsai Chung-You , Cheng Pai-Yu , Deng Juinn-Horng , Jaw Fu-Shan , Yii Shyi-Chun
Published: August 2024

Objectives

To assess the quality and alignment of ChatGPT's cancer treatment recommendations (RECs) with National Comprehensive Cancer Network (NCCN) guidelines and expert opinions.

Methods

Three urologists performed quantitative and qualitative assessments in October 2023 analyzing responses from ChatGPT-4 and ChatGPT-3.5 to 108 prostate, kidney, and bladder cancer prompts using two zero-shot prompt templates. Performance evaluation involved calculating five ratios: expert-approved/expert-disagreed and NCCN-aligned RECs against total ChatGPT RECs plus coverage and adherence rates to NCCN. Experts rated the response's quality on a 1-5 scale considering correctness, comprehensiveness, specificity, and appropriateness.

Results

ChatGPT-4 outperformed ChatGPT-3.5 in prostate cancer inquiries, with an average word count of 317.3 versus 124.4 ( p < 0.001) and 6.1 versus 3.9 RECs ( p < 0.001). Its rater-approved REC ratio (96.1% vs. 89.4%) and alignment with NCCN guidelines (76.8% vs. 49.1%, p = 0.001) were superior and scored significantly better on all quality dimensions. Across 108 prompts covering three cancers, ChatGPT-4 produced an average of 6.0 RECs per case, with an 88.5% approval rate from raters, 86.7% NCCN concordance, and only a 9.5% disagreement rate. It achieved high marks in correctness (4.5), comprehensiveness (4.4), specificity (4.0), and appropriateness (4.4). Subgroup analyses across cancer types, disease statuses, and different prompt templates were reported.

Conclusions

ChatGPT-4 demonstrated significant improvement in providing accurate and detailed treatment recommendations for urological cancers in line with clinical guidelines and expert opinion. However, it is vital to recognize that AI tools are not without flaws and should be utilized with caution. ChatGPT could supplement, but not replace, personalized advice from healthcare professionals.
A Global Outlook on AI-Predicted Impacts of ChatGPT on Contemporary Education
Authors: Kanbul Sezer , Adamu Idris , Mohammed Yakubu Bala
Published: August 2024

This article presents a research investigation focusing on the effects of ChatGPT utilization on sustainable education and development. The study employed five machine learning (XGBoost, RF, SVM, GBDT, and ANN) models for predicting the impacts of ChatGPT usage in education, aiming at identifying the potential benefits of ChatGPT usage on learners, tutors, and possible future implications using the data collected via social networking sites. A total of 2,936 datasets concerning the impacts of ChatGPT utilization on sustainable education were analyzed. Four of the research AI-predictive models predicted the impacts of ChatGPT usage on sustainable education and development with greater accuracy with [Formula: see text] values of >.96. However, the XGBoost and RF models outperformed the other models with [Formula: see text] values >.98. The results indicate that the XGBoost model achieved the highest accuracy with [Formula: see text] > .98, training time(s) 8.4157, and testing time 0.0618 respectively. Furthermore, findings of the study revealed that utilization of ChatGPT increases students’ interest in learning, self-confidence, and ability to study independently. Also, the results of the study will provide valuable insights for education stakeholders in understanding the potential benefits, and future implications of ChatGPT usage on sustainable education, and provide direction for upcoming studies.
SVOD Multi-Homing Users in Six Countries: Analyzing Legacy Media Usage, Demographics, Lifestyle, Expectations, and Usage Habits
Authors: Kim Hayeon , Lee Sang Woo
Published: August 2024

Subscription to multiple subscription video-on-demand (SVOD) services, known as multi-homing, is increasingly prevalent. This research explores the relationship between multi-homing and traditional media consumption and identifies the key factors that predict multi-homing tendencies among SVOD users. We analyzed data from 2019 to 2021 across the U.S., Canada, China, Japan, Germany, and France to investigate the impact of SVOD usage on legacy media viewing time, and then explored the predictors of multi-homing behaviors. Our findings indicate that multi-homing users are more inclined to consume content on legacy media platforms, such as terrestrial or cable television, compared with single-homing users. Critical differentiators between multi-homing and single-homing users include demographic profiles, lifestyle preferences, content expectations, and usage habits, particularly in terms of account sharing and primary devices for content consumption. These results are crucial for both SVOD and traditional media providers, as they offer strategic guidance for companies to effectively operate in various international markets. Such a comprehensive analysis of multi-homing behavior also offers a new perspective on the dynamics of global media consumption.
Romantic Attachment and Emerging Adults’ Future Expectations: Moderation Role of Self-Regulation
Authors: Reis Joana , Nunes Filipa , Matos Paula Mena , Mota Catarina Pinheiro
Published: August 2024

The characteristics of Western societies pose significant challenges to how emerging adults view their futures. In the present study, we analyzed the associations between romantic attachment, self-regulation, and future expectations of emerging adults controlling the sex and age of participants. More specifically, we analyzed the moderating role of goal-setting, decision-making, and learning from mistakes (self-regulation dimensions) in the links between trustful, dependent, avoidant, and ambivalent romantic relationships and future expectations. The sample, collected by convenience in Portugal, includes 571 emerging adults (76.2% were female and 23.8% were male) aged between 18 and 30 years ( M = 23.31; SD = 3.35). Our results indicate significant associations between trust, dependent, avoidant, and ambivalent romantic relationships, with different dimensions of future expectations. Findings indicated that goal-setting moderates the association between dependent and avoidant romantic relationships and pessimism. We discuss these findings based on attachment theory, considering the relevance of emotional bonds and self-regulatory processes in future planning.
Exploring the Significance of Nurse Introduction for Positive Patient Experience in Saudi Arabia
Authors: Al Sherim Mona , AL Hamidi Sami Abdulrahman
Published: August 2024

Empathy plays an important role in nursing so that the patients are provided with quality care and are satisfied with the services provided. Saudi Arabian patient interactions, including initial exploring, tend not to be formulaically initiated as in other countries. In this current study, the researcher aimed to highlight the critical role of nurse introductions in creating a desirable patient experience in the inpatient centers of Ministry Of Health hospitals in Saudi Arabia. This study was a cross-sectional secondary data analysis using the National Health Links/Presses Ganey surveys for every quint between the period 2021 and 2022. The methodology comprised an in-depth analysis of the Patient Experience Management Program (PXMP) survey that was involved as the uniform survey concluded by the Health Links/PressGaney. During the analysis, however, the results were found to have significant differences as 71.3% of the patients had a very good impression of their overall patient experience. This was specifically designed to address specific issues such as personal characteristics. The results of this study contribute to the understanding of what drives the nurses-patient interactions and forge the need for enhancing the way nurses are introduced to their patients to increase the average level of satisfaction of patients in the Ministry Of Health hospitals in Saudi Arabia. This study recommends that Saudi nurses should be trained to establish rapport in their interactions with patients as this promotes patient-centeredness and subsequently patients’ experiences and care outcomes.
Medical Error: Using Storytelling and Reflection to Impact Error Response Factors in Family Medicine Residents
Authors: Adkins Sherry , Alta’any Rahaf , Brar Kewaljit , Kauser Humaira , Hughbanks Savannah , Rabah Kelly , Flowers Stacy
Published: August 2024

I am a healer, yet sometimes I do more harm than good…David Hilfiker, 1984:

Objectives

Medical error is common and significantly impacts patients, physicians, learners, and public perception of the medical system; however, residents receive little formal training on this topic. Research on error response in practicing physicians is limited, and even more so on medical education interventions to improve this. This study evaluates a curriculum developed to foster the sharing of faculty medical error stories, practice of constructive coping strategies, and growth in resident confidence in managing error.

Methods

Researchers identified factors related to effective physician error management and recovery to develop a targeted intervention for family medicine residents. The intervention consisted of three one hour didactic sessions in a medium-sized midwestern, urban family medicine residency program over the course of 6 months. Instructional methods included guided reflection after mentor storytelling, small group discussion, role play, and self-reflection.

Results

Of the 30 residents, 22 (73%) completed the preintervention survey, and 15 (50%) completed the postintervention survey. While most residents reported having experienced error (55%), fewer than half of the residents reported they knew what to do when faced with medical errors (46%). This increased to 93% after intervention. Personal error stories from mentors were the most desired type of training reported by residents preintervention, but this was surpassed by legal and malpractice concerns in the postintervention survey. Rates of reported error story sharing increased after the intervention. Residents reported self-efficacy (I can be honest about errors) and self-awareness (I acknowledge when I am at increased risk for error) also increased with intervention. However, these changes did not reach statistical significance.

Conclusions

Family medicine residents are receptive to learning from peers and mentors about error management and recovery. A brief intervention can impact the culture around disclosure and support. Future research should focus on the impact of targeted interventions on patient-oriented outcomes related to medical error.
Disrupting Dichotomies, Dismantling Hegemonies: Studying Caste Reality in Fiction Through Omprakash Valmiki’s Amma and Other Stories
Authors: Saundarya
Published: August 2024

In the Hindi belt, Dalit literature has taken full shape in the post-Ambedkarite and post-Mandal Commission moments, making this literature layered with the understanding of caste, caste politics and its subtleties, with the central question revolving around the issue of realism. The genre of Dalit fiction transcends the societal and literary boundaries that are guided by hegemonic forces and lifts the cloak of invisibility from the ‘other’. It has the potential to disrupt the dichotomy between the centre and the periphery. By undertaking a critical study of Omprakash Valmiki’s anthology Amma and Other Stories, published in 2008, this article is an attempt to locate the creative and liberating power of Dalit fiction that is seamlessly interwoven with reality. Primarily placed in the rural and urban areas of the state of Uttar Pradesh, Valmiki’s writing situates the Dalit reality directly in front of the readers, all the while challenging the representation and prominent discourse of the Hindi literary tradition. It is in the context of realism that this article focuses on the new kind of realism brought in by Dalit fiction and the revolutionary inversion undertaken by it, which subverts and dismantles the hegemonic traditions of society and literature.
Amygdala fMRI—A Critical Appraisal of the Extant Literature
Authors: Varkevisser Tim , Geuze Elbert , van Honk Jack
Published: August 2024

Even before the advent of fMRI, the amygdala occupied a central space in the affective neurosciences. Yet this amygdala-centred view on emotion processing gained even wider acceptance after the inception of fMRI in the early 1990s, a landmark that triggered a goldrush of fMRI studies targeting the amygdala in vivo. Initially, this amygdala fMRI research was mostly confined to task-activation studies measuring the magnitude of the amygdala’s response to emotional stimuli. Later, interest began to shift more towards the study of the amygdala’s resting-state functional connectivity and task-based psychophysiological interactions. Later still, the test-retest reliability of amygdala fMRI came under closer scrutiny, while at the same time, amygdala-based real-time fMRI neurofeedback gained widespread popularity. Each of these major subdomains of amygdala fMRI research has left its marks on the field of affective neuroscience at large. The purpose of this review is to provide a critical assessment of this literature. By integrating the insights garnered by these research branches, we aim to answer the question: What part (if any) can amygdala fMRI still play within the current landscape of affective neuroscience? Our findings show that serious questions can be raised with regard to both the reliability and validity of amygdala fMRI. These conclusions force us to cast doubt on the continued viability of amygdala fMRI as a core pilar of the affective neurosciences.
Overview of Sleeve Gastrectomy and Roux-en-Y Bypass for Gastroparesis
Authors: Broderick Ryan C. , Horgan Santiago
Published: August 2024

Gastroparesis is a rare disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. Initial management of gastroparesis consists of dietary modification, prokinetic agents, antiemetics, and optimizing underlying medical conditions (eg, glycemic control in diabetic patients). In a subset of patients, surgical intervention may be necessary such as with gastric pacemaker, pyloroplasty/pyloromotomy, or G-POEM. A further subset of patients may require sleeve gastrectomy or conversion to Roux-en-Y gastric bypass. Here, we focus on the indications and outcomes of sleeve gastrectomy and Roux-en-Y bypass for treatment of refractory gastroparesis.
Numerical study on the tensile properties of a cylindrical specimen with chopped basalt fibre thermosetting resin matrix composites
Authors: Li Hengzhe , Yuan Haiping , Zuo Xiaohan , Huang Jingting , Zou Yangyao , Pan Luyang , Gu Ziang
Published: August 2024

For several decades, the disadvantages of traditional metallic rock and soil support structures have become increasingly prominent. As a result, it is urgent to seek lightweight, high-strength, durable and green economic substitute products made from the basalt fibre reinforced composites. Combining the two-phase material summing principle of composite material mechanics and the extension and application of Mohr–Coulomb strength criterion, the uniaxial tensile computing model of a cylindrical polymer specimen containing randomly distributed and discontinuous basalt fibres was established in accordance with the numerical simulation software Flac3D. Furthermore, the influence laws and intrinsic mechanism of the number of discrete fibres and different fibre distribution angles on the integral axial tensile properties of a cylindrical specimen with chopped basalt fibre thermosetting resin matrix composites were investigated and elucidated, and the stress–strain curve of basalt fibre thermosetting resin matrix composites were obtained. Consequently, the results have indicated that: i) the axial tensile strength of the polymer system can be enhanced through the incorporation of a moderate quantity of chopped fibres, with the resultant improvement typically not surpassing a 10% increment; ii) when the number of fibres has increased to the quantitative state, namely, the fibre density reaches 1.02 pieces/cm3 or more, the amplification of axial tensile strength of composite material will be controlled; iii) the fibre distribution directions, are maintaining a 0° parallel state to the axial direction of the specimen and the ones of load application, will ensure that the tensile strength of the composite can be sufficiently utilized. As the production process within the composite industry have become increasingly adept, the research results hold substantial value for further promoting the development, testing and optimizing application of various types of high-performance basalt fibre reinforced composite products.
Optimization of a mHealth Physical Activity Promotion Intervention With Mindful Awareness for Young Adult Cancer Survivors: Design and Methods of Opt2Move Full Factorial Trial
Authors: Reading Jean Miki , Solk Payton , Starikovsky Julia , Hasanaj Kristina , Wang Shirlene D , Siddique Juned , Sanford Stacy D , Salsman John , Horowitz Bruriah , Freeman Hannah , Alexander Jacqueline , Sauer Christina , Spring Bonnie , Victorson David , Phillips Siobhan M
Published: August 2024

Background

Opt2Move is a theory-guided moderate and vigorous physical activity (MVPA) promotion trial that uses multiphase optimization strategy (MOST) methodology to evaluate the individual and combined effects of four intervention components in a full factorial experiment among young adult cancer survivors (YACS; N = 304). All participants will receive the core mHealth MVPA intervention, which includes a Fitbit and standard self-monitoring Opt2Move smartphone application. YACS will be randomized to one of 16 conditions to receive between zero and four additional components each with two levels (yes v. no): E-Coach, buddy, general mindfulness, and MVPA-specific mindfulness.

Objective

The primary aim is to determine the individual and combined effects of the components on MVPA post-intervention (12-weeks) and at 24-week follow-up. The secondary aim is to examine how changes in MVPA are associated with patient-reported outcomes, light-intensity activity, sedentary time, and sleep duration and quality. Potential mediators and moderators of component effects will also be examined.

Results

Results will support the selection of a package of intervention components optimized to maximize MVPA to be tested in a randomized controlled trial.

Conclusion

Opt2Move represents the first systematic effort to use MOST to design an optimized, scalable mHealth MVPA intervention for YACS and will lead to an improved understanding of how to effectively change YACS’ MVPA and ultimately, improve health and disease outcomes.
Hybrid researching race-related issues during COVID-19: Methodological conundrums
Authors: Bagchi Suparna
Published: August 2024

In the present article, I discuss important ethical considerations that I made as a doctoral researcher while conducting a partially virtual research study on a sensitive topic during COVID-19. I start by briefly discussing my research topic. Following this, drawing from unanticipated situations that I encountered, I critically analyze procedural ethical guidelines by asking ethical committees to consider flexibility to fulfill the desired research objectives. Furthermore, I take examples from my research to describe how I tried to establish rapport and trust with participants involving minors and key workers amidst the pandemic. I then discuss how I solved the ethical challenges involving students’ informed consent and complicated phases of negotiation concerning data collection. I adopted a responsible-cum-response-able strategy, which developed eventually as I progressed through my study during the successive stages of the pandemic. The key to this strategy was to go with the flow flexibly, realistically, and responsibly without losing sight of the ethical considerations. I conclude by maintaining that it is vital for a researcher to practice reflexivity throughout the study not simply to tick boxes for institutional approval but to ensure integrity for rigorous research.
The intestinal microbiota and cellular therapy: implications for impact and mechanisms
Authors: Xie Jiayi , Smith Melody
Published: August 2024

The microbiota, comprising bacteria, fungi, and viruses residing within our bodies, functions as a key modulator in host health and states, including immune responses. Studies have linked microbiota and microbiota-derived metabolites to immune cell functions. In this review, we probe the complex relationship between the human microbiota and clinical outcomes of cellular therapies that leverage immune cells to fight various cancers. With a particular emphasis on hematopoietic cell transplantation and chimeric antigen receptor T-cell therapy, we explore the potential mechanisms underpinning this interaction. We also highlight the interventional applications of the microbiota in cellular therapy while outlining future research directions in the field.
Recreating chronic respiratory infectionsin vitrousing physiologically relevant models
Authors: Grassi Lucia , Crabbé Aurélie
Published: August 2024

Despite the need for effective treatments against chronic respiratory infections (often caused by pathogenic biofilms), only a few new antimicrobials have been introduced to the market in recent decades. Although different factors impede the successful advancement of antimicrobial candidates from the bench to the clinic, a major driver is the use of poorly predictive model systems in preclinical research. To bridge this translational gap, significant efforts have been made to develop physiologically relevant models capable of recapitulating the key aspects of the airway microenvironment that are known to influence infection dynamics and antimicrobial activityin vivo. In this review, we provide an overview of state-of-the-art cell culture platforms andex vivomodels that have been used to model chronic (biofilm-associated) airway infections, including air–liquid interfaces, three-dimensional cultures obtained with rotating-wall vessel bioreactors, lung-on-a-chips andex vivopig lungs. Our focus is on highlighting the advantages of these infection models over standard (abiotic) biofilm methods by describing studies that have benefited from these platforms to investigate chronic bacterial infections and explore novel antibiofilm strategies. Furthermore, we discuss the challenges that still need to be overcome to ensure the widespread application ofin vivo-like infection models in antimicrobial drug development, suggesting possible directions for future research. Bearing in mind that no single model is able to faithfully capture the full complexity of the (infected) airways, we emphasise the importance of informed model selection in order to generate clinically relevant experimental data.
Pathogenesis-driven treatment of primary pulmonary alveolar proteinosis
Authors: Lettieri Sara , Bonella Francesco , Marando Vincenzo Alfredo , Franciosi Alessandro N , Corsico Angelo Guido , Campo Ilaria
Published: August 2024

Pulmonary alveolar proteinosis (PAP) is a syndrome that results from the accumulation of lipoproteinaceous material in the alveolar space. According to the underlying pathogenetic mechanisms, three different forms have been identified, namely primary, secondary and congenital. Primary PAP is caused by disruption of granulocyte−macrophage colony-stimulating factor (GM-CSF) signalling due to the presence of neutralising autoantibodies (autoimmune PAP) or GM-CSF receptor genetic defects (hereditary PAP), which results in dysfunctional alveolar macrophages with reduced phagocytic clearance of particles, cholesterol and surfactant. The serum level of GM-CSF autoantibody is the only disease-specific biomarker of autoimmune PAP, although it does not correlate with disease severity. In PAP patients with normal serum GM-CSF autoantibody levels, elevated serum GM-CSF levels is highly suspicious for hereditary PAP. Several biomarkers have been correlated with disease severity, although they are not specific for PAP. These include lactate dehydrogenase, cytokeratin 19 fragment 21.1, carcinoembryonic antigen, neuron-specific enolase, surfactant proteins, Krebs von Lungen 6, chitinase-3-like protein 1 and monocyte chemotactic proteins. Finally, increased awareness of the disease mechanisms has led to the development of pathogenesis-based treatments, such as GM-CSF augmentation and cholesterol-targeting therapies.
On the evaluation of synthetic longitudinal electronic health records
Authors: Achterberg Jim L. , Haas Marcel R. , Spruit Marco R.
Published: August 2024

Background

Synthetic Electronic Health Records (EHRs) are becoming increasingly popular as a privacy enhancing technology. However, for longitudinal EHRs specifically, little research has been done into how to properly evaluate synthetically generated samples. In this article, we provide a discussion on existing methods and recommendations when evaluating the quality of synthetic longitudinal EHRs.

Methods

We recommend to assess synthetic EHR quality through similarity to real EHRs in low-dimensional projections, accuracy of a classifier discriminating synthetic from real samples, performance of synthetic versus real trained algorithms in clinical tasks, and privacy risk through risk of attribute inference. For each metric we discuss strengths and weaknesses, next to showing how it can be applied on a longitudinal dataset.

Results

To support the discussion on evaluation metrics, we apply discussed metrics on a dataset of synthetic EHRs generated from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) repository.

Conclusions

The discussion on evaluation metrics provide guidance for researchers on how to use and interpret different metrics when evaluating the quality of synthetic longitudinal EHRs.
Factors influencing nurse practitioner panel size in team-based primary care: a qualitative case study
Authors: Martin-Misener Ruth , Donald Faith , Rayner Jennifer , Carter Nancy , Kilpatrick Kelley , Ziegler Erin , Bourgeault Ivy , Bryant-Lukosius Denise
Published: August 2024

Background

Lack of access to health care is a worldwide public health crisis. In primary care it has led to increases in the implementation of nurse practitioners and heightened interest in their patient panel capacity. The aim of this study was to examine factors influencing nurse practitioner patient panel size in team-based primary care in Ontario, Canada.

Methods

We used a multiple case study design. Eight team-based primary care practices including rural and urban settings were purposively selected as cases. Each case had two or more nurse practitioners with a minimum of two years experience in the primary care setting. Interviews were conducted in-person, audio recorded, transcribed and analysed using content analysis.

Results

Forty participants, including 19 nurse practitioners, 16 administrators (inclusive of executives, managers, and receptionists), and 5 physicians were interviewed. Patient, provider, organizational, and system factors influenced nurse practitioner patient panel size. There were eight sub-factors: complexity of patients’ health and social needs; holistic nursing model of care; nurse practitioner experience and confidence; composition and functioning of the multidisciplinary team; clerical and administrative supports, and nurse practitioner activities and expectations. All participants found it difficult to identify the panel size of nurse practitioners, calling it— “a grey area.” Establishing and maintaining a longitudinal relationship that responded holistically to patients’ needs was fundamental to how nurse practitioners provided care. Social factors such as gender, poverty, mental health concerns, historical trauma, marginalisation and literacy contributed to the complexity of patients’ needs. Participants indicated NPs tried to address all of a patient’s concerns at each visit.

Conclusions

Nurse practitioners have a holistic approach that incorporates attention to the social determinants of health as well as acute and chronic comorbidities. This approach compels them to try to address all of the needs a patient is experiencing at each visit and reduces their panel size. Multidisciplinary teams have an opportunity to be deliberate when structuring their services across providers to meet more of the health and social needs of empanelled patients. This could enable increases in nurse practitioner panel size.