bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing occupational participation among justice-involved people ‘with a personality disorder’: Quantitative assessments and their properties
Authors: Connell Catriona , McKay Elizabeth Anne
Published: June 2024

Introduction:

There is little evidence for what influences occupational participation for justice-involved people ‘with a personality disorder’ living in community contexts, and no validated occupational participation assessments specific to this group. We assessed a sample of justice-involved people ‘with a personality disorder’ to ascertain what influences occupational participation using commonly applied assessments and evaluated their construct validity.

Method:

As part of a mixed-methods study, a purposive sample of 18 justice-involved people ‘with a personality disorder’ were scored on the Model of Human Occupational Screening Tool and Occupational Performance History Interview–Version Two scales. Mean scores were calculated per Model of Human Occupational Screening Tool (MOHOST) item and Occupational Performance History Interview–Version Two (OPHI-II) items and scales and compared to published data. Mann–Whitney U Tests were used to identify within-sample differences based on demographic characteristics.

Results:

Participants had low scores on MOHOST items and OPHI-II items and scales. Differences were identified compared to published data. Within-sample differences were most apparent in comparisons by employment status and ethnicity. The OPHI-II scales did not operate as intended with this population and recommended adjustments impacted its construct validity.

Conclusion:

Replication is required with a larger random sample. Integrating these data with qualitative exploration would further elucidate factors influencing occupational participation in this population.
Development and Validation of a Predictive Model for Early Identification of Cognitive Impairment Risk in Community-Based Hypertensive Patients
Authors: Li Yan , Xin Jimei , Fang Sen , Wang Fang , Jin Yufei , Wang Lei
Published: June 2024

Objective: To investigate the risk factors for the development of mild cognitive dysfunction in hypertensive patients in the community and to develop a risk prediction model. Method: The data used in this study were obtained from two sources: the China Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 1121 participants from CHARLS were randomly allocated into a training set and a validation set, following a 70:30 ratio. Meanwhile, an additional 4016 participants from CLHLS were employed for external validation of the model. The patients in this study were divided into two groups: those with mild cognitive impairment and those without. General information, employment status, pension, health insurance, and presence of depressive symptoms were compared between the two groups. LASSO regression analysis was employed to identify the most predictive variables for the model, utilizing 14-fold cross-validation. The risk prediction model for cognitive impairment in hypertensive populations was developed using generalized linear models. The model’s discriminatory power was evaluated through the area under the receiver operating characteristic (ROC) curve and calibration curves. Results: In the modeling group, eight variables such as gender, age, residence, education, alcohol use, depression, employment status, and health insurance were ultimately selected from an initial pool of 21 potential predictors to construct the risk prediction model. The area under the curve (AUC) values for the training, internal, and external validation sets were 0.777, 0.785, and 0.782, respectively. All exceeded the threshold of 0.7, suggesting that the model effectively predicts the incidence of mild cognitive dysfunction in community-based hypertensive patients. A risk prediction model was developed using a generalized linear model in conjunction with Lasso regression. The model’s performance was evaluated using the area under the receiver operating characteristic (ROC) curve. Hosmer–Lemeshow test values yielded p = .346 and p = .626, both of which exceeded the 0.05 threshold. Calibration curves demonstrated a significant agreement between the nomogram model and observed outcomes, serving as an effective tool for evaluating the model’s predictive performance. Discussion: The predictive model developed in this study serves as a promising and efficient tool for evaluating cognitive impairment in hypertensive patients, aiding community healthcare workers in identifying at-risk populations.
Improving staff wellness via an after-hours healthy sustainable meals program: A general surgery residency pilot
Authors: Lalande Annie , Alexis Stephanie , Gadhari Neha , Mak Sunny , Zhao Jiaying , MacNeill Andrea J.
Published: June 2024

Healthcare worker wellness is foundational to delivering quality care. Yet, healthcare facilities often lack access to healthy and sustainable food overnight and on weekends. Healthy, low-carbon meals were provided free of charge after hours to on-call General Surgery residents at the University of British Columbia and the impact on resident well-being assessed using pre- and post-intervention surveys. Financial and time stress reduced significantly with the provision of meals ( P’s < .01), while emotional and physical stress levels did not change. Average meal expenses decreased from $33 to $10 ( P < .001). Increasing food access on call is an impactful intervention to improve resident health and well-being.
Control strategy for trading off solar power and control input while rendezvous and docking
Authors: Abhijeet Abhijeet , Kumar Tanya K , Giri Dipak K
Published: June 2024

This paper presents a novel strategy for decoupling the attitude and orbit equations of a CubeSat for rendezvous and docking with an uncontrollable cooperative target. For computing a safe trajectory, the proposed control algorithm takes into account the solar energy received by the CubeSat. The CubeSat is equipped with a thruster for orbit maneuvers, magnetic coils for attitude control, and four fixed single-sided rectangular solar panels. The coupled dynamics arising from the dynamical model of the spacecraft is solved using a novel weighted vector-based approach. This paper presents a linearized nonlinear optimal control problem arising in small spacecrafts while trying to maximize solar energy input in the rendezvous and docking process. An intermediate orbit is defined and used to divide the problem into two different optimal control problems: rendezvous optimization and docking optimization problems. A geometrical approach based on the shape of the chaser and the target is contemplated for collision avoidance while docking. The proposed controller design is modified whenever the sunlight is obstructed by the Earth, and the maneuvering controls are redesigned accordingly for optimal rendezvous and docking. Numerical simulations have been carried out to show the efficacy of the proposed concept for steering the trade-off between solar energy and control input during the rendezvous and docking of CubeSat with a tumbling target.
Basiliximab Treatment for Patients With Steroid-Refractory Acute Graft-Versus-Host Disease Following Matched Sibling Donor Hematopoietic Stem Cell Transplantation
Authors: Jiang Xin-Ya , Zhang Xiao-Hui , Xu Lan-Ping , Wang Yu , Yan Chen-Hua , Chen Huan , Chen Yu-Hong , Han Wei , Wang Feng-Rong , Wang Jing-Zhi , Sun Yu-Qian , Mo Xiao-Dong , Huang Xiao-Jun
Published: June 2024

Basiliximab is an important treatment for steroid-refractory acute graft-versus-host disease (SR-aGVHD). We performed this retrospective study to evaluate the efficacy and safety of basiliximab treatment in SR-aGVHD patients following matched sibling donor hematopoietic stem cell transplantation (MSD-HSCT) ( n = 63). Overall response rate (ORR) was 63.5% and 54% at any time and at day 28 after basiliximab treatment. Grade III–IV aGVHD before basiliximab treatment predicted a poor ORR after basiliximab treatment. The rates of virus, bacteria, and fungi infections were 54%, 23.8%, and 3.1%, respectively. With a median follow-up of 730 (range, 67–3,042) days, the 1-year probability of overall survival and disease-free survival after basiliximab treatment were 58.6% (95% confidence interval [CI] = 47.6%–72.2%) and 55.4% (95% CI = 44.3%–69.2%), respectively. The 3-year cumulative incidence of relapse and non-relapse mortality after basiliximab treatment were 18.9% (95% CI = 8.3%–29.5%) and 33.8% (95% CI = 21.8%–45.7%), respectively. Comorbidities burden before allo-HSCT, severity of aGVHD and liver aGVHD before basiliximab treatment showed negative influences on survival. Thus, basiliximab was safe and effective treatment for SR-aGVHD following MSD-HSCT.
A Novel Complication in COVID-19 Patients: Case Report of Rectus Sheath Hematoma
Authors: Rezaian Somaye , Rezaian Mohamad , Hosseinpour Ali
Published: June 2024

The COVID-19 pandemic has had an enormous impact on the healthcare systems. Along with its common complications, novel complications such as Rectus Sheath Hematoma (RSH) have been reported. We present 2 cases of RSH. (A) A 63-year-old woman with a known case of COVID-19 with severe cough presented sudden tachycardia and hypogastric pain; on physical examination, a huge lower abdominal tender mass was noticed. All the differential diagnoses were ruled out. (B) A 57-year-old woman with COVID-19 started complaining of tachycardia, pain, and a mass in the lower abdomen. On the physical examination, a lower abdominal tender mass was noticed. Both of the patients underwent an abdomen CT scan which confirmed a huge RSH. Conservative treatment and cessation of anticoagulant medications were continued. Both of them recovered and no evidence of further expansion was seen after 4 weeks of follow-up.
A framework for examining hybridity: The case of academic explanatory journalism
Authors: Bartleman Michelle , Dubois Elizabeth , Macdonald Isabel
Published: June 2024

Across a number of disciplines, hybridity is regularly invoked when two previously distinct elements – whether objects, concepts, frameworks, practices, models, mediums or institutions – are brought together. However, this is often done with a vague theoretical nod. Labeled a hybrid and left at the level of broad theory, scholarship has tended to ignore a critical issue: what happens when the disparate elements of a hybrid are introduced in practice? This conceptual paper takes the case of academic explanatory journalism, a nascent intentional collaborative practice between academic authors and journalist editors, in order to illustrate how the theoretical concept of hybridity plays out in practice. This particular case presents a number of opportunities and benefits within a Western democratic context. However, our examination highlights that without a more nuanced discussion of how hybridization plays out in real life, its potential benefits are compromised. We propose a five-step framework that can be applied to other examples of hybridity, across varied disciplines beyond media and communication studies. This five-step framework helps uncover the complications that might arise when disparate elements are hybridized, moving from theory into practice. The approach helps create the space and understanding needed to design solutions pre-emptively.
Factors that support children and young people to express their views and to have them heard in healthcare: An inductive qualitative content analysis
Authors: Davies Clare , Waters Donna , Fraser Jennifer
Published: June 2024

Despite development of healthcare charters supporting Article 12 of The United Nations Convention on the Rights of the Child, children and young people remain largely silenced in discussions about their healthcare. This article is based on the premise that children and young people should be able to exercise their right to express their views and be heard in all matters that affect their lives. This study examined children’s and young people’s experiences of expressing their views and having them heard in an Australian healthcare context. Using child-centred inquiry and ‘draw, write, and tell’ methods, data were collected from 20 children and young people. Five factors that supported children and young people to express their views and have their views heard were identified: time, relationships with health professionals, communication, teamwork, and family support. By paying attention to these factors, clinicians and others in health settings can better facilitate child-centred practices and support children and young people to express their views and have those views heard.
Comparative analysis of static and vibration characteristics of glass fiber reinforced epoxy mono composite leaf spring and conventional steel leaf spring
Authors: GS Divya , Solomon Jenoris Muthiya , BR Mahesh , Ramesh Lalvani J Isaac Joshua
Published: June 2024

Leaf springs play a vital role in heavy-duty vehicles by offering substantial load support, durability, and convenient maintenance. Lightweight leaf springs enhance vehicle performance, offering benefits like improved fuel efficiency and a smoother ride. Glass fiber reinforced composites enhance fuel efficiency and durability, providing corrosion resistance. Their design flexibility improves ride comfort, and damping properties enhance vehicle stability. The examination conducted through finite element analysis, utilizing ANSYS software, demonstrated a substantial 75.32% decrease in weight for the E-Glass-Epoxy composite leaf spring (GECLS), affirming its efficacy in enhancing strength, reducing weight, and enhancing stiffness. This underscores its superiority as a viable alternative to traditional steel leaf springs (SLS) in vehicular applications. The mono-GECLS exhibited a natural frequency that was found to be 1.9 times higher than that observed in the traditional SLS. It indicates the potential to mitigate resonance issues. After analysing the SLS and GECLS using ANSYS, it was observed that the GECLS exhibits greater values in deflection, natural frequency, and strain energy, measuring 4.659 mm, 29.98 Hz, and 440.68 mJ, respectively, compared to its steel counterpart. Conversely, the SLS demonstrates elevated values in stress, mass, and density, with readings of 283.84 MPa, 3.7695 kg, and 5920 kg/m³, respectively.
Freelance journalism in Zimbabwe: Challenges and opportunities
Authors: Tshuma Lungile , Ndlovu Mphathisi , Dhladhla Zinzile N
Published: June 2024

In Zimbabwe, the comatose economy has had an impact on the media industry. Since 2000, media houses have been shutting down due to lack of financial support or poor business environment. For some news organisations, they have been retrenching their staff as a cost cutting measure. This has also led to retrenched journalists to write for other publications as freelance journalists. This study examines the state of freelance journalism in Zimbabwe. It aims to assess their role and contribution to the media industry, challenges they face, and also the survival strategies they are adopting. This qualitative study is informed by Bourdieu’s field theory. It used in-depth interviews while thematic analysis was employed in analyzing data. Findings demonstrates that freelance journalists are contributing to the growth of media industry in Zimbabwe by writing on specialised beats like science reporting. Besides such contributions, findings further demonstrated that freelance journalism is seen as ‘curse’ as journalists are easily harassed by the state agents who rarely recognizes someone not working for an established organisation.
US Juvenile Justice Purpose Clauses: Themes and Evaluation Opportunities
Authors: Pelletier Emily K.
Published: June 2024

Juvenile justice systems across the United States have a common history of rehabilitative ideals and federally required due process protections; however, each state maintains goals for its juvenile justice system specific to that state. The goals stated in the purpose clauses of the states’ juvenile justice codes offer an evaluative opportunity to determine whether the policies, programs, and practices within the juvenile justice system are congruent with the statutory goals. The qualitative thematic analysis of state purpose clauses presented in this study reveals goals beyond the traditional conceptualizations of a rehabilitative juvenile justice system and constitutional due process protections. The multiple, overlapping goals of each state’s juvenile justice system invites stakeholders to conduct evaluations to determine the alignment of each state’s goals with the structure of its juvenile justice system.
Identifying the Sylvian Triangle on CT angiography: A technique for detecting distal middle cerebral artery occlusions
Authors: Sozio Stephen J. , Castro Alexandra , Sundararajan Sri Hari , Schonfeld Steven , Gupta Gaurav , Prendergast Nancy C. , Keller Irwin A. , Roychowdhury Sudipta
Published: June 2024

Medium vessel occlusions (MeVOs), defined as occlusion of the M2/M3 and A2/A3 segments of the middle cerebral artery (MCA) and anterior cerebral artery, can be challenging to visualize on CT angiography (CTA) and MR angiography (MRA), given the anatomic complexity of the mid- and distal intracranial vasculature and smaller vessel caliber (Leary MC, Kidwell CS, Villablanca JP, et al. Validation of computed tomographic MCA “dot” sign: an angiographic correlation study. Stroke 2003; 34: 2636–2640; Luijten SPR, Wolff L, Duvekot MHC, et al. Diagnostic performance of an algorithm for automated large vessel occlusion (LVO) detection on CTA. J Neurointerv Surg 2022; 14: 794–798). In turn, the appearance of a sudden vessel cutoff in these vascular distributions on CTA or MRA is not always straightforward and may represent true occlusion, variant anatomy, and/or artifact (Leary MC, Kidwell CS, Villablanca JP, et al. Validation of computed tomographic MCA “dot” sign: an angiographic correlation study. Stroke 2003; 34: 2636–2640; Luijten SPR, Wolff L, Duvekot MHC, et al. Diagnostic performance of an algorithm for automated LVO detection on CTA. J Neurointerv Surg 2022; 14: 794–798). Given the importance of rapidly establishing an accurate diagnosis in the setting of stroke, combined with recent clinical trials and movements promoting the efficacy of endovascular therapeutic approaches to treat MeVOs, it remains imperative to detect such occlusions accurately and quickly on imaging. In turn, we present five imaging patterns of the Sylvian Triangle on sagittal reformatted images from CTA Head examinations, which our practice has utilized to assess patency of the M2 and M3 divisions. This approach is rapidly deployable and can be utilized by radiology and non-radiology healthcare providers alike, thus facilitating rapid and accurate diagnosis of MeVO, timely evaluation of candidacy for endovascular therapy, and ultimately supporting favorable door-to-intervention time and successful patient outcomes.
p-Cymene and pachymic acid alleviate adalimumab-resistance cell line inflammatory response via inhibiting PI3K/AKT/mTOR signaling pathway
Authors: Gu Jia-Bo , Wang Jun , Yang Yang , Ye Xiao-Rui , Zhang Chun-Xia , Zhang Xin-Yi , Liu Jian-Lei , Jin Hei-Ying
Published: June 2024

Background: In the management of inflammatory bowel disease, the emergence of drug resistance to monoclonal antibodies has come out as a significant impediment to achieving desired therapeutic outcomes. However, extensive evidence has substantiated that the induction of autophagy holds promise in counteracting the development of drug resistance. In this regard, the utilization of traditional Chinese medicine presents a potential avenue for alleviate drug resistance, specifically through Peilan and Fuling. Consequently, the objective of this study aims to investigate the regulatory effects of p-Cymene and pachymic acid on the autophagy signaling pathway, with the ultimate goal of reducing inflammatory response and alleviating drug resistance. Methods: The RAW 264.7 murine macrophage cell line was subjected to induction using varying concentration gradients of adalimumab in order to establish an adalimumab-resistant cell line. The cell growth curve and viability were assessed using the CCK-8 assay. The expression of cytokines was determined through the implementation of ELISA. The autophagy signaling pathway was evaluated using Western blot analysis. Results: p-Cymene and pachymic acid were found to exert an inhibitory effect on the proliferation of the adalimumab-resistant cell line. Additionally, treatment with p-Cymene and pachymic acid resulted in a decrease in the levels of proinflammatory cytokines, namely TNF-α, IL-1β, and IL-6, while concurrently increasing the level of IL-10. p-Cymene and pachymic acid demonstrated the capacity to suppress the expression of autophagy-related proteins and mRNA including PI3K, AKT, and mTOR. Conclusions: p-Cymene and pachymic acid exhibit the potential to alleviate adalimumab-resistance and ameliorate the inflammatory response, primarily through the activation of the PI3K/AKT/mTOR signaling pathway. These findings suggest that traditional Chinese medicine holds promise as a viable treatment option for mitigating monoclonal antibody resistance in inflammatory bowel disease.
Anatomical Structures at Risk in Percutaneous Distal Bunionette Correction
Authors: Nihalani Shrey , Scheinberg Mila , McCrosson Matthew , Yeager Matthew T. , Rutz Robert W. , Hargreaves Mathew , Mohammed Zuhair J. , Singh Swapnil , Shah Ashish
Published: June 2024

Bunionette deformity is an incredibly pervasive issue in our society with almost a quarter of individuals being affected by it. As it is so common, there are numerous techniques and approaches to correct the deformity. Currently, there is a growing trend that favors percutaneous osteotomy of the bunionette. As there are multiple osteotomy sites, there are anatomical considerations that must be made at each one. The purpose of this study was to investigate the anatomic structures at risk during distal osteotomy of bunionette deformity using a Shannon burr. Using 11 fresh cadaver specimens, the fifth metatarsal was accessed through a carefully marked portal. A Shannon burr was employed for the osteotomy. Dissections were performed to assess potential damage to critical structures, including the lateral dorsal cutaneous nerve (LDCN), abductor digiti minimi (ADM), and extensor digitorum longus (EDL). Measurements were taken from the osteotomy site to each structure. The distal osteotomy site was on average greater than 8 mm from the EDL and ADM, whereas it was 1.64 mm from the LDCN. The Shannon burr made contact with and transected the LDCN on 2 occasions. However, previous studies have highlighted potential anatomical variations of the LDCN that arise distally. The study underscored the challenges posed by minimally invasive approaches to treating bunionette deformity and highlighted the need for cautious consideration when using percutaneous methods.

Level of Clinical Evidence: 5
Technological advances in lower-limb tele-rehabilitation: A review of literature
Authors: Ettefagh Alireza , Roshan Fekr Atena
Published: June 2024

Tele-rehabilitation is a healthcare practice that leverages technology to provide rehabilitation services remotely to individuals in their own homes or other locations. With advancements in remote monitoring and Artificial Intelligence, automatic tele-rehabilitation systems that can measure joint angles, recognize exercises, and provide feedback based on movement analysis are being developed. Such platforms can offer valuable information to clinicians for improved care planning. However, with various methods and sensors being used, understanding their pros, cons, and performance is important. This paper reviews and compares the performance of recent vision-based, wearable, and pressure-sensing technologies used in lower limb tele-rehabilitation systems over the past 10 years (from 2014 to 2023). We selected studies that were published in English and focused on joint angle estimation, activity recognition, and exercise assessment. Vision-based approaches were the most common, accounting for 42% of studies. Wearable technology followed at approximately 37%, and pressure-sensing technology appeared in 21% of studies. Identified gaps include a lack of uniformity in reported performance metrics and evaluation methods, a need for cross-subject validation, inadequate testing with patients and older adults, restricted sets of exercises evaluated, and a scarcity of comprehensive datasets on lower limb exercises, especially those involving movements while lying down.
Comparison of Surgical Outcomes After Posterior Decompression by Junior or Senior Surgeons for Patients With Cervical Ossification of the Posterior Longitudinal Ligament: Results From Retrospective Multicenter Cohort Study
Authors: Okubo Toshiki , Nagoshi Narihito , Kono Hitoshi , Kobayashi Yoshiomi , Tsuji Osahiko , Aoyama Ryoma , Isogai Norihiro , Ishihara Shinichi , Takeda Kazuki , Ozaki Masahiro , Suzuki Satoshi , Matsumoto Morio , Nakamura Masaya , Watanabe Kota , Ishii Ken , Yamane Junichi
Published: June 2024

Study Design

Retrospective multicenter study.

Objectives

To investigate surgical outcomes following posterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) when performed by board-certified spine (BCS) or non-BCS (NBCS) surgeons.

Methods

We included 203 patients with cervical OPLL who were followed for a minimum of 1 year after surgery. Demographic information, medical history, and imaging findings were collected. Clinical outcomes were assessed preoperatively and at the final follow-up using the Japanese Orthopedic Association (JOA) score and the visual analog scale (VAS) for the neck. We compared outcomes between BCS surgeons, who must meet several requirements, including experience in more than 300 spinal surgeries, and NBCS surgeons.

Results

BCS surgeons performed 124 out of 203 cases, while NBCS surgeons were primary in 79 cases, with 73.4% were directly supervised by a BCS surgeon. There was no statistically significant difference in surgical duration, estimated blood loss, and perioperative complication rates between the BCS and NBCS groups. Moreover, no statistically significant group differences were observed in each position of the C2-7 angle and cervical range of motion at preoperation and the final follow-up. Preoperative and final follow-up JOA scores, VAS for the neck, and JOA score recovery rate were comparable between the two groups.

Conclusions

Surgical outcomes, including functional recovery, complication rates, and cervical dynamics, were comparable between the BCS and NBCS groups. Consequently, posterior decompression for cervical OPLL is considered safe and effective when conducted by junior surgeons who have undergone training and supervision by experienced spine surgeons.
The Pencil Exercise
Authors: Cassinelli Juan , Delsol Philippe , Rieussec Clémentine , Barth Johannes
Published: June 2024

Background:

Voluntary posterior shoulder instability is a rare condition, with a prevalence of 0.5% to 2.6% in young adults, in which the patient is able to provoke a dislocation or subluxation through voluntary activation of the muscles. Studies have shown results that highlight the importance of abnormal cortical activation in this population and suggest physiotherapeutic treatment as first line.

Indications:

Currently, there are a wide range of options of physiotherapeutic treatment for this condition, such as muscle reinforcement, scapulohumeral coordination, and/or muscle activation with electrodes, all with acceptable results. Simple, low-cost neuromotor rehabilitation is based on the simplicity of a different approach. We believe that with distal-proximal neuromotor rehabilitation we can improve a physiological muscle function.

Technique Description:

The goal of the pencil exercise is to stimulate the cerebral cortex by making circular movements with a pen between the fingers, bridging abnormal voluntary stimulation and activation of the shoulder muscles, allowing the patient to focus, by the view, only on hand movements.

Results:

In this case, we have achieved the bypass of the abnormal voluntary stimulation and activation of the shoulder muscles and improve the patient's physiological shoulder function with the implementation of the pencil exercise.

Conclusion:

This technique may be an effective option for the treatment of voluntary posterior shoulder dislocation because it is based on the stimulation of the cerebral cortex and not on traditional physiotherapeutic or surgical interventions. It is important to note that more research is needed to validate the results of this technique and determine its long-term efficacy.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Community pharmacists’ treatment patterns and counselling of acute diarrhea in children: A simulation-based cross-sectional study
Authors: Anaam Mohammed
Published: June 2024

Background:

Diarrhea is a significant global health concern, particularly among children, and its impact is particularly pronounced in countries with limited resources and ongoing conflicts, such as Yemen. Diarrheal diseases remain one of the leading causes of morbidity and mortality in children under the age of 5 years worldwide.

Objectives:

The aim of our study is to assess the treatment patterns and counseling of community pharmacists regarding the management of acute diarrhea in children in Yemen.

Design:

A simulation-based cross-sectional study was carried out targeting community pharmacy professionals in Sana’a city.

Methods:

A questionnaire and simulated client methods were used to assess the pharmacists’ evaluation of a case based on five indicators including the child’s age, diarrhea frequency, presence of fever, and blood or mucus. In addition, the pharmacists’ recommendations and counseling were also evaluated.

Results:

During the study, a total of 100 pharmacists were visited and evaluated using both a questionnaire and simulation. The results demonstrated that 43.0% of the pharmacists utilized all five indicators in the questionnaire, with a mere 3.0% using all five indicators in the simulation. Oral rehydration solution (ORS) alone was recommended by 42.0% of the pharmacists and in combination with other drugs by 47.0% in the questionnaire, and the rest (11.0%) recommended only other drugs; while in the simulation, 7.0% of the pharmacists referred the patients to clinic, only 6.0% recommended ORS alone, 47.0% gave ORS plus other drugs including antibiotics, and 40.0% dispensed only antibiotics. In regards to counseling, 89.0% of pharmacists reported that they would explain to the patient regarding the recommended medicine during the questionnaire, and only 36.0% gave any sort of explanation to the simulated client.

Conclusion:

In the current study, community pharmacists did not ask enough questions to accurately evaluate a child with acute diarrhea during the simulation. This finding has apparently differed from their responses in the questionnaire. Furthermore, the pharmacists failed to provide sufficient dietary advice, and their recommendation of ORS was inadequate.
Disempowered by Leadership: Tales from the Middle of the Organisational Pyramid
Authors: Bagchi Soumendra Narain , Sharma Rajeev
Published: June 2024

In this article we explore middle-level managers’ stories of their experiences in which they were either empowered or disempowered by organisational leadership. An exploration of the stories reveals how leaders can, inadvertently, erode the power and the authority of middle-level managers. An unintended consequence of leadership’s involvement in decisions that are middle mangers’ domain, disempowerment at the middle management level in an organisation arising out of leadership decisions offers an alternate way to explore and understand leadership and middle-management disempowerment in organisations.
Flexible Atg1/ULK complex composition activates selective autophagy for phosphate starvation
Authors: Fangma Yijia , Chen Zhong , Zheng Yanrong
Published: June 2024

The molecular basis for bulk autophagy activation due to a deficiency in essential nutrients such as carbohydrates, amino acids, and nitrogen is well understood. Given autophagy functions to reduce surplus to compensate for scarcity, it theoretically possesses the capability to selectively degrade specific substrates to meet distinct metabolic demands. However, direct evidence is still lacking that substantiates the idea that autophagy selectively targets specific substrates (known as selective autophagy) to address particular nutritional needs. Recently, Gross et al. found that during phosphate starvation (P-S), rather than nitrogen starvation (N-S), yeasts selectively eliminate peroxisomes by dynamically altering the composition of the Atg1/ULK kinase complex (AKC) to adapt to P-S. This study elucidates how the metabolite sensor Pho81 flexibly interacts with AKC and guides selective autophagic clearance of peroxisomes during P-S, providing novel insights into the metabolic contribution of autophagy to special nutritional needs.
Alpha-fetoprotein and APRI as predictive markers for patients with Type C hepatitis B-related acute-on-chronic liver failure: a retrospective study
Authors: Li Chunyan , Hu Hao , Bai Chengzhi , Xu Huaqian , Liu Lin , Tang Shanhong
Published: June 2024

Background

Type C hepatitis B-related acute-on-chronic liver failure (HBV-ACLF), which is based on decompensated cirrhosis, has different laboratory tests, precipitating events, organ failure and clinical outcomes. The predictors of prognosis for type C HBV-ACLF patients are different from those for other subgroups. This study aimed to construct a novel, short-term prognostic score that applied serological indicators of hepatic regeneration and noninvasive assessment of liver fibrosis to predict outcomes in patients with type C HBV-ACLF.

Method

Patients with type C HBV-ACLF were observed for 90 days. Demographic information, clinical examination, and laboratory test results of the enrolled patients were collected. Univariate and multivariate logistic regression were performed to identify independent prognostic factors and develop a novel prognostic scoring system. A receiver operating characteristic (ROC) curve was used to analyse the performance of the model.

Results

A total of 224 patients with type C HBV-ACLF were finally included. The overall survival rate within 90 days was 47.77%. Age, total bilirubin (TBil), international normalized ratio (INR), alpha-fetoprotein (AFP), white blood cell (WBC), serum sodium (Na), and aspartate aminotransferase/platelet ratio index (APRI) were found to be independent prognostic factors. According to the results of the logistic regression analysis, a new prognostic model (named the A3Twin score) was established. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was 0.851 [95% CI (0.801-0.901)], the sensitivity was 78.8%, and the specificity was 71.8%, which were significantly higher than those of the MELD, IMELD, MELD-Na, TACIA and COSSH‐ACLF II scores (all P < 0.001). Patients with lower A3Twin scores (<-9.07) survived longer.

Conclusions

A new prognostic scoring system for patients with type C HBV-ACLF based on seven routine indices was established in our study and can accurately predict short-term mortality and might be used to guide clinical management.
Point prevalence surveys of antibiotic prescribing in children at a tertiary hospital in a resource constraint, low-income sub-Saharan African country—the impact of an antimicrobial stewardship program
Authors: Akintan Patricia , Oshun Philip , Osuagwu Chioma , Ola-bello Olafoyekemi , Fajolu Iretiola , Roberts Alero , Temiye Edamisan , Oduyebo Oyinlola
Published: June 2024

Background

Resistance to multiple antibiotics by several pathogens has been widely described in children and has become a global health emergency. This is due to increased use by parents, caregivers, and healthcare providers. This study aims to describe the prevalence rates of antibiotic prescribing, ascertain the impact of antimicrobial stewardship programs, and target improving the quality of antibiotic prescribing in the paediatric population over time in a hospital.

Method

A point prevalence survey of antibiotic use was performed yearly for 4 years to monitor trends in antibiotic prescribing. Data from all patients admitted before 8 a.m. on the day of the PPS were included. A web-based application designed by the University of Antwerp was used for data entry, validation, and analysis (http://www.global-pps.com).

Results

A total of 260 children, including 90 (34.6%) neonates and 170 (65.4%) older children, were admitted during the four surveys. Overall, 179 (68.8%) patients received at least one antibiotic. In neonates, the prevalence of antibiotic use increased from 78.9 to 89.5% but decreased from 100 to 58.8% in older children. There was a reduction in the use of antibiotics for prophylaxis from 45.7 to 24.6%. The most frequently prescribed antibiotic groups were third generation cephalosporins and aminoglycosides. The most common indications for antibiotic prescription were sepsis in neonates and central nervous system infection in older children. The documentation of reason in notes increased from 33 to 100%, while the stop-review date also increased from 19.4 to 70%.

Conclusion

The indicators for appropriate antibiotic prescription improved over time with the introduction of antibiotic stewardship program in the department.
Acute stress disorder and associated factors among adult trauma patients in Ethiopia: a multi-institutional study
Authors: Hagos Tewodros Guay , Tamir Tadesse Tarik , Workneh Belayneh Shetie , Abrha Nega Nigussie , Demissie Negesu Gizaw , Gebeyehu Daniel Ayelegne
Published: June 2024

Introduction

Acute stress disorder (ASD) is a mental disorder that happens after someone experienced traumatic event within duration of less than a month. Other studies conducted in different countries revealed that adults with a trauma had experienced acute stress disorder. This results in substantial distress and interferes with social and day to day activities. Despite the high burden of this problem, very little is known about the prevalence and risk factors for acute stress disorder in adults with traumatic injuries in Ethiopia.

Objective

This study was aimed to assess the prevalence of acute stress disorder and associated factors among adult trauma patients attending in northwest Amhara Comprehensive Specialized Hospitals, Ethiopia 2022.

Methods

An institutional based cross-sectional study design was employed among 422 adult trauma patients from May– June 2022. Systematic sampling technique was applied to recruit study participants. Data were collected through interviewer administered questionnaires using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, acute stress disorder measurement tools. Then, it was entered into Epi-Data version 4 and exported to STATA version 14 for analysis. Bivariate and multivariable binary logistic regressions model were carried out to identify factors significantly associated acute stress disorder.

Result

The prevalence of acute stress disorder among adult trauma patients in northwest Amhara comprehensive specialized hospitals was found to be 44.15% (95% CI: 39.4%, 49.0%) with 99% of response rate. In multivariate logistic analysis younger age (21–29) (AOR = 0.33 95% CI: 0.14–0.77), (30–39) (AOR = 0.35 95% CI: 0.15–0.85), (40–49) (AOR = 0.28 95% CI: 0.10–0.76) respectively, presence of complication (AOR = 2.22 95% CI: 1.36–3.60), prolonged length of hospital stay (AOR = 1.89 95% CI: 1.21–2.95) and having low (AOR = 3.21, 95% CI: 1.66–6.19) and moderate (AOR = 1.99, 95%, CI: 1.14–3.48) social support were factors significantly associated with acute stress disorder.

Conclusion and recommendation

This study showed that the prevalence of acute stress disorder among the adult study participants who experienced traumatic events was high as compared to other literatures. Age, complication, prolonged hospital stay and social support were factors significantly associated with ASD at p-value < 0.05. This indicates the need for early identification and interventions or ASD care services from health workers of psychiatric ward.
Screening indicators to evaluate the clinical significance of drug-drug interactions in polypharmacy among older adults with psychiatric disorders: a delphi study
Authors: Liu Yu , Li Xuefeng , Yang Man , Ding Yaping , Ji Minghui
Published: June 2024

Background

Polypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of drug-drug interactions (DDIs) in polypharmacy. We aimed to identify indicators suitable for evaluating the clinical significance of DDIs in polypharmacy in older adults with psychiatric disorders.

Methods

The online tools were used to distribute and collect the questionnaires. The Delphi method was applied to analyze experts’ opinions. The degree of authority and coordination of experts were analyzed using the coefficient of variation, coefficient of coordination, expert’s judgment factor, familiarity with the study content factor, and Kendall coordination coefficient. Statistical analysis was conducted using the IBM SPSS® Statistics Package version 26.0.

Results

After three rounds of expert consultation, five primary and eleven secondary indicators were identified. The primary “pharmacodynamic indicator” included “severity of adverse drug reactions”, “duration of adverse drug reaction”, “symptom relief”, “time to onset of symptomatic relief”, “number of days in hospital”, and “duration of medication”. The secondary “pharmacokinetic indicator” contained “dosage administered” and “dosing intervals”. The primary “patient tolerance indicator” contained one secondary indicator of “patient tolerability”. The primary indicator “patient adherence” contained one secondary indicator of “patient adherence to medication”. The primary indicator “cost of drug combination” contained one secondary indicator of “readmission”. These indicators were used to determine the clinical significance of DDIs during polypharmacy.

Conclusions

The clinical significance of drug combinations should be taken into account when polypharmacy is used in the elderly. The five primary indicators and eleven secondary indicators might be preferred to evaluate their risks and benefits. Medication management in this population requires a multidisciplinary team, in which nurses play a key role. Future research should focus on how to establish efficient multidisciplinary team workflows and use functional factors to assess DDIs in polypharmacy for psychiatric disorders.
Predictive factors for postoperative outcomes after reverse shoulder arthroplasty: a systematic review
Authors: Crutsen J. R. W. , Lambers Heerspink F. O. , van Leent E. A. P. , Janssen E. R. C.
Published: June 2024

Background

The use of reverse total shoulder arthroplasty (RTSA) has increased at a greater rate than other shoulder procedures. In general, clinical and functional outcomes after RTSA have been favorable regardless of indication. However, little evidence exists regarding patient specific factors associated with clinical improvement after RTSA. Predicting postoperative outcomes after RTSA may support patients and physicians to establish more accurate patient expectations and contribute in treatment decisions. The aim of this study was to determine predictive factors for postoperative outcomes after RTSA for patients with degenerative shoulder disorders.

Methods

EMBASE, PubMed, Cochrane Library and PEDro were searched to identify cohort studies reporting on predictive factors for postoperative outcomes after RTSA. Authors independently screened publications on eligibility. Risk of bias for each publication was assessed using the QUIPS tool. A qualitative description of the results was given. The GRADE framework was used to establish the quality of evidence.

Results

A total of 1986 references were found of which 11 relevant articles were included in the analysis. Risk of bias was assessed as low (N = 7, 63.6%) or moderate (N = 4, 36.4%). According to the evidence synthesis there was moderate-quality evidence indicating that greater height predicts better postoperative shoulder function, and greater preoperative range of motion (ROM) predicts increased postoperative ROM following.

Conclusion

Preoperative predictive factors that may predict postoperative outcomes are: patient height and preoperative range of motion. These factors should be considered in the preoperative decision making for a RTSA, and can potentially be used to aid in preoperative decision making.

Level of evidence

Level I; Systematic review.
System analysis based on Anoikis-related genes identifies MAPK1 as a novel therapy target for osteosarcoma with neoadjuvant chemotherapy
Authors: Wu Zhouwei , Yu Jiapei , Han Tao , Tu Yiting , Su Fang , Li Shi , Huang Yixing
Published: June 2024

Background

Osteosarcoma (OS) is the most common bone malignant tumor in children, and its prognosis is often poor. Anoikis is a unique mode of cell death.However, the effects of Anoikis in OS remain unexplored.

Method

Differential analysis of Anoikis-related genes was performed based on the metastatic and non-metastatic groups. Then LASSO logistic regression and SVM-RFE algorithms were applied to screen out the characteristic genes. Later, Univariate and multivariate Cox regression was conducted to identify prognostic genes and further develop the Anoikis-based risk score. In addition, correlation analysis was performed to analyze the relationship between tumor microenvironment, drug sensitivity, and prognostic models.

Results

We established novel Anoikis-related subgroups and developed a prognostic model based on three Anoikis-related genes (MAPK1, MYC, and EDIL3). The survival and ROC analysis results showed that the prognostic model was reliable. Besides, the results of single-cell sequencing analysis suggested that the three prognostic genes were closely related to immune cell infiltration. Subsequently, aberrant expression of two prognostic genes was identified in osteosarcoma cells. Nilotinib can promote the apoptosis of osteosarcoma cells and down-regulate the expression of MAPK1.

Conclusions

We developed a novel Anoikis-related risk score model, which can assist clinicians in evaluating the prognosis of osteosarcoma patients in clinical practice. Analysis of the tumor immune microenvironment and chemotherapeutic drug sensitivity can provide necessary insights into subsequent mechanisms. MAPK1 may be a valuable therapeutic target for neoadjuvant chemotherapy in osteosarcoma.