bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-eclampsia as a predictor of early-onset cardiovascular impairment among young women (PREECARDIA study): protocol for a prospective cohort study
Authors: Turé Ruben , Damasceno Albertino , Rodrigues Amabelia , Barai Eunice , Cissé Almame , Sanca Gabriel , Iafa Tida , Jalo Waldir , Embalo Bubacar , Dju Marcos , Iala Vasco , Lunet Nuno
Published: December 2024

Introduction

Pre-eclampsia is a pregnancy-related complication estimated to affect up to 8% of pregnancies worldwide. It is associated with an increased risk of postpartum sustained hypertension, coronary artery disease, cerebrovascular disease, peripheral arterial disease and cardiovascular-related mortality. Nevertheless, these associations have seldom been addressed in younger women from sub-Saharan Africa (SSA). Hence, this study aims to assess the association between pre-eclampsia and cardiovascular impairment within the first year after delivery, among younger women in SSA.

Methods and analysis

This is a prospective cohort study conducted at Hospital Nacional Simão Mendes in Bissau, Guinea-Bissau. A total of 230 pregnant women aged below 25 years (115 diagnosed with pre-eclampsia and 115 normotensive age-matched pregnancies), will be enrolled after their 20th gestational week. Exclusion criteria include diabetes, hypertension or other serious maternal diseases present before pregnancy. Participants will be assessed at baseline (pre-labour period), 4 and 12 months after delivery; evaluations started in March 2023 and are expected to end in December 2026. At each follow-up assessment, the women will have their blood pressure measured with a digital sphygmomanometer and a 24-hour ambulatory blood pressure monitor. Cardiac and renal function will be assessed using echocardiography and laboratory testing, respectively. Primary outcomes include the mean differences in cardiovascular and renal parameters between women who had pre-eclampsia and those who had normotensive pregnancies. Age, parity, age at first pregnancy, family history of cardiovascular diseases, smoking habits, gestational diabetes diagnosed before pre-eclampsia, body mass index and labour complications will be considered a priori as potential confounders of the association between pre-eclampsia and postpartum cardiovascular impairment.

Ethics and dissemination

This study was approved by the Comité Nacional de Ética em Pesquisa na Saúde, Guinea-Bissau (008/CNES/INASA/2023), and participants provide written informed consent. Results will be disseminated among the scientific community and the public.
Burden of digestive congenital anomalies among children aged 0–14 years in 204 countries and territories, 1990–2021: results from the Global Burden of Disease Study 2021
Authors: Luo Xi , Luo Jie , Zhao Jinhua , Du Jun , Lu Deqin , Gu Huajian
Published: December 2024

Objectives

We aim to delineate the digestive congenital abnormalities burden in children under 14 years old between 1990 and 2021.

Design

We implemented data from the Global Burden of Disease (GBD) 2021 database to evaluate digestive congenital abnormalities burden with different measures in 204 countries and territories from 1990 to 2021. We present precise estimations with 95% uncertainty intervals. In addition, we computed the estimated annual percentage change (EAPC) to examine the temporal patterns of these indicators.

Setting

It uses prevalence, deaths and disability-adjusted life years (DALYs) data from the GBD study to analyse this issue.

Participants

Patients with digestive congenital abnormalities diagnosis.

Outcomes

Total numbers, age-standardised rates (ASRs) of prevalence, mortality and DALYs and their EAPCs were the main outcomes among children aged 0–14 years.

Results

In 2021, 2206.79 thousand prevalent cases were reported worldwide, with digestive congenital anomalies accounting for 47.16 thousand deaths and 4324.56 thousand DALYs among children aged 0–14 years. Digestive congenital anomalies prevalence was mitigated by 8.15% between 1990 and 2021, with the global ASR of prevalence declining to 40.09 per 100 000. Digestive congenital anomalies mortality was mitigated by 35.35% between 1990 and 2021, with an ASR of deaths declining to 0.77 per 100 000. The worldwide burden of digestive congenital anomalies decreased by 34.96% in terms of DALYs from 1990 to 2021, with an ASR of 70.44 DALYs per 100 000 population. There was a significant hindrance in the prevalence, particularly among older children. The likelihood of digestive congenital abnormalities peaked during infancy (2–4 years) in all regions.

Conclusion

We highlight promising global declines in the digestive congenital anomalies burden among children over the past 32 years. Prevalence, deaths and DALYs associated with these anomalies have shown consistent decreases, although regional variations persist. These findings offer crucial insights for shaping effective prevention and management strategies for paediatric digestive congenital anomalies.
Cost efficiency of inpatient rehabilitation following acquired brain injury: the first international adaptation of the UK approach
Authors: Lannin Natasha A , Crotty Maria , Cameron Ian D , Chen Zhibin , Ratcliffe Julie , Morarty Jacqui , Turner-Stokes Lynne
Published: December 2024

Objectives

To adapt and apply a model for evaluating the functional benefits and cost efficiency of specialist inpatient rehabilitation to the Australian context, comparing functional outcomes and savings in the cost of ongoing care after acquired brain injury.

Design

An observational cohort analysis of prospectively collected clinical data from admission to discharge, with follow-up to 3 years.

Setting

A newly established state-wide inpatient postacute rehabilitation unit in Victoria, Australia for patients with moderate to severe acquired brain injury.

Participants

This study included consecutive patients admitted to the programme during its first 2 years’ operation (January 2016 to December 2017). Inclusion criteria consisted of complete outcome measures recorded on admission and discharge, total n=196, mean age 44.6 years (range 17–78), males:females 72:28%, aetiology:trauma n=124 (63%), stroke n=42 (21%), diffuse n=18 (9%) and other-mixed n=12 (7%).

Interventions

Specialist inpatient multidisciplinary rehabilitation.

Outcome measures

Dependency and care costs: Northwick Park Dependency Scale/Care Needs Assessment (NPCNA); Functional independence: UK Functional Assessment Measure. Cost efficiency: (a) Time is taken to offset rehabilitation costs by savings in NPCNA-estimated costs of ongoing care and (b) net projected lifetime savings.

Results

Median length of stay 75 (IQR: 33.5–169.5) days, mean episode costs were $A147 044 (95% CI $A126 436, $A167 652). There was a significant reduction in dependency between admission and discharge on all measures (Holm-Bonferroni corrected p<0.001) which was sustained at follow-up in those traced at 1–3 years. Savings were greatest in the highest-dependency group. Estimated mean overall reduction in ‘weekly care costs’ was $A7206, offsetting the cost of rehabilitation within 5.53 months (95% CI 2.27, 8.78). Mean projected net lifetime savings were $A13.4 million (95% CI $A11.4, $A15.4) per patient.

Conclusions

This study provides proof of principle for use of the NPCNA cost-efficiency model outside the UK and yields further evidence that rehabilitation for patients with complex disabilities represents value for money. For every dollar spent on inpatient rehabilitation in this cohort, an estimated $A91 was saved in ongoing care costs.
Compliance to international guidelines and rational use of antibiotics in urinary tract infections in a country without national guidance: a cross-sectional study
Authors: El Khoury Joe , Saleh Nadine , Lahoud Nathalie , Maison Patrick , Hleyhel Mira
Published: December 2024

Background

Urinary tract infections (UTIs) are among the most common bacterial infections, and appropriate antimicrobial therapy with agents that minimise resistance is crucial. Despite international concern, adherence to guidelines is still suboptimal. This study aims to determine the effect of the absence of national guidelines and the rate of conformity to international guidelines among physicians in antibiotic (ATB) prescriptions for the treatment of UTIs in adults and detect the factors that are associated with a higher rate of non-compliance.

Methods

Patient-related characteristics and the prescribed ATBs were gathered from patients' medical files, and a questionnaire was directed to physicians to elicit the factors involved in decision-making. Four criteria were evaluated: molecule conformity, daily dose conformity, duration conformity and global conformity.

Results

37 Lebanese physicians and 185 prescriptions were included. The most prevalent class of ATBs was fluoroquinolones (30.3%). Global conformity to guidelines was 31.4%, while conformity on drug choice, daily dose and duration of treatment was 83.2%, 74.7% and 41.6%, respectively. There were no differences in conformity rates according to the physician’s specialty (p=0.135). Physicians who studied in an American-system university had an increased risk of non-conformity (adjusted OR (aOR=2.107, p=0.018). Patients with higher education levels, or presenting with fever or chills, were more likely to get a non-compliant prescription (aOR=2.140, p=0.032 and aOR=4.947, p=0.033, respectively).

Conclusion

In a country with no local guidelines, non-conformity to international guidelines is high. Larger national studies are needed with immediate interventions to enhance physicians’ prescribing practices. After local guidelines were established, it would be interesting to compare the rate of adherence to these guidelines.
Multifaceted approach to reduce duplicate therapy errors in the emergency department
Authors: Huang Huiling , Sunku Srivatsava , Ong Hui Shan , Chan Jonathan Kim Yang , Sim Guek Gwee
Published: December 2024

Medication errors continue to pose a significant risk to patient safety, accounting for half of the avoidable harm in healthcare systems around the world. In emergency departments (EDs), factors such as high patient loads and emergent nature of care increase the likelihood of such errors. An audit conducted at the ED of Changi General Hospital Singapore from January 2019 to July 2022 revealed that the duplicate therapy error comprised 31% of all reported medication errors. Therapeutic duplication occurs when the same or pharmacologically equivalent agents are prescribed concurrently to a patient. These errors not only jeopardise patient safety but also place additional strain on healthcare resources and lead to stress among the staff involved.

This quality improvement (QI) project aims to reduce duplicate therapy error by 50% 3 months post-intervention at the ED. Beginning in August 2022 and continuing through December 2023, the project followed a structured approach comprising four phases: problem identification, identifying root causes, developing of targeted interventions and ensuring sustainability. Phase 1 involved an audit from January 2019 to July 2022 to determine the extent and types of medication errors in the ED. In phase 2, a root cause analysis (RCA) of the medication error identified key issues such as system knowledge deficits, inadequate IT processes, environment, policies and procedures and gaps in care coordination. Based on these findings, targeted interventions were developed and implemented in phase 3. Phase 4 focused on sustaining improvements through ongoing audits.

The QI project successfully met its goal of reducing duplicate therapy error rates by 50% post-intervention. Additionally, it completely eliminated duplicate therapy errors in certain medication categories.

In conclusion, through targeted interventions, active engagement of relevant stakeholders and ongoing efforts to sustain and enhance improvement, a safer healthcare environment can be achieved for patients.
Faecal microbiota transplantation for eradicatingHelicobacter pyloriinfection: clinical practice and theoretical postulation
Authors: Ye Zhi-Ning , Eslick Guy D , Huang Shao-Gang , He Xing-Xiang
Published: December 2024

The sustained increase in antibiotic resistance leads to a declining trend in the eradication rate ofHelicobacter pylori(H. pylori) infection with antibiotic-based eradication regimens. Administration of a single probiotic shows limited efficacy in eradicatingH. pyloriinfection. This review indicates that faecal microbiota transplantation (FMT), a novel therapeutic approach, either as a monotherapy or adjunctive therapy, exhibits beneficial effects in terms of the eradication ofH. pyloriinfection and the prevention of adverse events. The role of FMT inH. pylorieradication may be associated directly or indirectly with some therapeutic constituents within the faecal suspension, including bacteria, viruses, antimicrobial peptides and metabolites. In addition, variations in donor selection, faecal suspension preparation and delivery methods are believed to be the main factors determining the effectiveness of FMT for the treatment ofH. pyloriinfection. Future research should refine the operational procedures of FMT to achieve optimal efficacy forH. pyloriinfection and explore the mechanisms by which FMT acts againstH. pylori.
Prevalence and functional impact of chronotropic incompetence in amyloid cardiomyopathy: a multicentre analysis
Authors: Magrì Damiano , Ermolaev Nikita , Willixhofer Robin , Gallo Giovanna , Fiori Emiliano , Maruotti Antonello , Fantozzi Paolo , Castiglione Vincenzo , Capelle Christophe D J , Kronberger Christina , Vergaro Giuseppe , Passino Claudio , Salvioni Elisabetta , Del Torto Alberico , Baggiano Andrea , Contini Mauro , Emdin Michele , Barbato Emanuele , Badr Eslam Roza , Agostoni Piergiuseppe
Published: December 2024

Background

Little evidence is available about heart rate (HR) response to exercise as well as its relationship with functional capacity in amyloid cardiomyopathy. Then, in a multicentre cohort of patients with amyloid cardiomyopathy, we investigated the prevalence of chronotropic incompetence (CI) and its relationships with cardiopulmonary exercise testing (CPET) variables.

Methods

Data from 172 outpatients with amyloid cardiomyopathy who performed a maximal CPET and who had no significant rhythm disorders were analysed.

Results

The prevalence of CI differed depending on the age-predicted peak HR (pHR%) cut-off value adopted, ranging from 16% to 59%. pHR% correlated non-linearly with peak oxygen uptake (pVO2), either as expressed as a percentage of the maximum predicted or as mL/kg/min (p<0.001). Although to a lesser extent, pHR% correlated inversely with ventilatory efficiency (p<0.001). A pHR%≤75% resulted in the most accurate cut-off value in identifying a moderate-to-severe exercise impairment (sensitivity 72%; specificity 73%; area under the curve 77.2%).

Conclusions

CI is prevalent in patients with amyloid cardiomyopathy in sinus rhythm, its percentage varying according to the pHR% cut-off value. A blunted exercise-induced HR response correlated with a poor exercise capacity even in this setting of patients, a pHR%≤75% cut-off value being possibly useful in centres without CPET availability to identify a significant exercise impairment.
Optimal surgical timing for congenital diaphragmatic hernia in a non-ECMO center: a retrospective study
Authors: Feng Zhong , Wei Yan-Dong , Wang Ying , Li Jing-Na , Liu Chao , Zhang Hui , Wang Fei , Wu Tao , Jiang Yu-Lin , Ma Lishuang
Published: December 2024

Background

This study aims to address the timing of repair for severe congenital diaphragmatic hernia (CDH) without the use of extracorporeal membrane oxygenation (ECMO) and to determine the feasibility of an earlier intervention to avoid deaths associated with non-repair in patients who are more challenging to stabilize without ECMO.

Methods

This single-center retrospective study was conducted on neonates with CDH from 2013 to 2023. Based on the timing of surgery, the patients were classified into three groups: <24 hours (group A), 24–48 hours (group B) and ≥48 hours (group C). The 90-day survival rates were analyzed using Kaplan-Meier curves and compared among groups via log-rank tests. The independent factors related to survival assessed using the multivariate Cox regression model.

Results

Of 132 CDH infants, the overall 90-day survival rate was 81.8% (108/132), with a median operative time of 26.00 (24.00, 38.50) hours. A significant difference was observed in the 90-day survival rate among the three groups: 60.5% (23/38) in group Avs.91.3% (74/81) in group Bvs.84.6% (11/13) in group C (log-rankp<0.001). In mild and severe cases and those with an oxygen index ≥7.5, group A resulted in significantly reduced survival rates. Multivariate Cox regression analysis indicated that surgical timing <24 hours remained an independent mortality-related risk factor in infants with CDH.

Conclusions

Repair surgery should be performed at least 24 hours after birth. The optimal timing for CDH neonates in non-ECMO centers appears to be 24–48 hours after birth, which can prevent the loss of treatment opportunities for severe cases.
HaaS in Environmental Computing: Hadoop-as-a-Service for Big Data Mining in Environmental Computing Applications
Authors: Varde Aparna S.
Published: December 2024

This article addresses the importance of HaaS (Hadoop-as-a-Service) in cloud technologies, with specific reference to its usefulness in big data mining for environmental computing applications. The term environmental computing refers to computational analysis within environmental science and management, encompassing a myriad of techniques, especially in data mining and machine learning. As is well-known, the classical MapReduce has been adapted within many applications for big data storage and information retrieval. Hadoop based tools such as Hive and Mahout are broadly accessible over the cloud and can be helpful in data warehousing and data mining over big data in various domains. In this article, we explore HaaS technologies, mainly based on Apache's Hive and Mahout for applications in environmental computing, considering publicly available data on the Web. We dwell upon interesting applications such as automated text classification for energy management, recommender systems for ecofriendly products, and decision support in urban planning. We briefly explain the classical paradigms of MapReduce, Hadoop and Hive, further delve into data mining and machine learning over the MapReduce framework, and explore techniques such as Naïve Bayes and Random Forests using Apache Mahout with respect to the targeted applications. Hence, the paradigm of Hadoop-as-a-Service, popularly referred to as HaaS, is emphasized here as per its benefits in a domain-specific context. The studies in environmental computing, as presented in this article, can be useful in other domains as well, considering similar applications. This article can thus be interesting to professionals in web technologies, cloud computing, environmental management, as well as AI and data science in general.
Clinical analogy resolution performance for foundation language models
Authors: Villena Fabián , Quiroga Tamara , Dunstan Jocelyn
Published: December 2024

Using extensive data sources to create foundation language models has revolutionized the performance of deep learning-based architectures. This remarkable improvement has led to state-of-the-art results for various downstream NLP tasks, including clinical tasks. However, more research is needed to measure model performance intrinsically, especially in the clinical domain. We revisit the use of analogy questions as an effective method to measure the intrinsic performance of language models for the clinical domain in English. We tested multiple Transformers-based language models over analogy questions constructed from the Unified Medical Language System (UMLS), a massive knowledge graph of clinical concepts. Our results show that large language models are significantly more performant for analogy resolution than small language models. Similarly, domain-specific language models perform better than general domain language models. We also found a correlation between intrinsic and extrinsic performance, validated through PubMedQA extrinsic task. Creating clinical-specific and language-specific language models is essential for advancing biomedical and clinical NLP and will ensure a valid application in clinical practice. Finally, given that our proposed intrinsic test is based on a term graph available in multiple languages, the dataset can be built to measure the performance of models in languages other than English.
An Empirical Study on Common Sense-Violating Bugs in Mobile Apps
Authors: Fan Fu , Jiang Yanjie , Chen Tianyi , Zhang Hengshun , Zhang Yuxia , Niu Nan , Liu Hui
Published: December 2024

Mobile applications are widely used by billions of users in their daily work and life. Such GUI software is prone to bugs, potentially degrading user experience. Notably, many bugs in mobile apps are reported by end-users who cannot access the requirements of the app or test cases accompanied by explicitly specified test oracles. It may suggest that such bugs are not identified in the traditional way, i.e., by comparing the actual behaviors of the apps against their expected behaviors explicitly specified in the requirements or test cases. Instead, such bugs are often identified by comparing the actual behaviors against users’ common knowledge of apps, noted as common sense. We refer to such bugs as common sense-violating bugs. Although it is well-known that common sense-violating bugs are common in mobile apps, it remains unclear how popular they are and what kind of common sense principles are violated by them, let alone the relationship among the violated common sense principles. To this end, in this paper, we conduct the first large-scale empirical study on common sense-violating bugs in open-source mobile apps. We manually analyzed 2,808 real-world bug reports across 948 open-sourced mobile apps on GitHub. Our analysis results suggest that 1,006 (35.8%) out of the 2,808 bugs pertain to common sense-violating bugs. From those common sense-violating bugs, we identified a set of common sense principles violated by the buggy behaviors, and built a taxonomy for the common sense principles. Such principles fall into three categories: UI content-related common sense principles, UI layout-related common sense principles, and interaction-related common sense principles. By analyzing the frequency of the common sense principles being violated, we observed that a small set of common sense principles were frequently violated by the majority of common sense-violating bugs: 18 common sense principles, accounting for only 5% of the violated common sense principles, were violated by more than half of the common sense-violating bugs. These findings suggest that identifying the most frequent common sense-violating bugs could be achieved by using a small set of critical common sense principles, which may significantly reduce the cost of common sense-based bug detection. Finally, to demonstrate the feasibility of automated bug detection with common sense-based test oracles, we propose an automated approach to validating whether a given test run violates the most frequently violated common sense principle: No raw error message. Our evaluation results suggest that the automated approach is accurate, whose precision and recall are 91.3% and 91.6%, respectively.
A comment on the physiological basis for longitudinal motion of the arterial wall
Authors: Cinthio Magnus , Petäjä Artturi , Erlöv Tobias , Ahlgren Åsa Rydén
Published: December 2024

The longitudinal motion and the intramural shear strain of the arterial wall increase dramatically in response to blood pressure, thereby impacting the vascular wall microenvironment. Exposure to a sedentary lifestyle has been identified as an independent risk factor for cardiovascular disease, but it has been shown that intermittent physical activity embedded into everyday life is enough to improve cardiovascular health. Marked changes in longitudinal motion already at a low workload may explain this finding. However, to understand the mechanism linking longitudinal motion and cardiovascular health, an understanding of the physiological basis for the longitudinal motion of the arterial wall is needed. The factors underlying the longitudinal motion of the arterial wall in vivo are numerous and intertwined. As a comment and complement to the recent review by Athaide et al. ( Am J Physiol Heart Circ Physiol 322: H689–H701, 2022), we propose and discuss a comprehensive cardiovascular mechanical scenario based on the current literature. In this scenario, blood pressure, typically acting in the radial direction, also acts directly in the longitudinal direction through a tapered geometry. This complements ventricular contraction, ventricular-vascular coupling, arterial diameter change, arterial stiffness in both the radial and longitudinal directions, and prestretch of the arterial wall. In addition, we consider the geometry of the arterial tree and intramural friction of the arterial wall. Together, these important cardiovascular mechanical factors form the pattern of longitudinal motion of the arterial wall, indicating that the longitudinal motion of the arterial wall is important for cardiovascular health.
Analysis of Energy Absorption Self‐Recovery Characteristics of Composite Bionic Thin‐Walled Tube and Its Influencing Factors
Authors: Wu Yongqiang , Liu Weidong , Liu Zhixin
Published: December 2024

In this paper, a bionic thin‐walled tube structure with a ponytail stem, a fractal structure of branches, and a honeycomb structure was designed and fabricated by additive manufacturing (AM) technology using NiTi alloy as the substrate. In the quasi‐static compression test, the energy absorption (EA) ability, deformation model, and shape memory effect of the thin‐walled tube are studied and analyzed in depth. The experimental results show that the inner fractal structure can make the thin‐walled tube absorb more energy. Among them, when the thickness is 0.3 mm, the length of the inner honeycomb structure is 3 mm, and the fractal structure angle is 80°, the bionic thin‐walled circular tube corresponding to the structural parameters shows better EA characteristics. Meanwhile, the shape memory effect of various structures was explored by loading and unloading experiments and water bath heating. The results show that the shape memory effect of the biomimetic structure is very excellent, and the highest shape memory recovery rate can reach 98.13%. This high shape memory recovery rate has great application prospects in fields such as smart materials and devices. This research will help to promote the development of materials science and engineering and provide new ideas and methods for achieving efficient and high‐performance materials’ applications.
Analysis of Interference Effects and Calculation Model for Crack Initiation Strength in X‐Type Jointed Rock Mass After Freeze–Thaw Cycles
Authors: Hu Xuemei , Liu Shunyuan , Liu Hao , Zhang Xingqiu , Deng Zhengding
Published: December 2024

Rock masses characterized by X‐type joints are prevalent in cold region rock engineering projects. A precise understanding of the mechanical mechanisms governing the fracture initiation strength of these jointed rock masses after experiencing freeze–thaw damage is paramount for ensuring the safety and stability of associated engineering structures. Leveraging the mutual constraint relationship between the displacements at the tips of intersecting joints under compressive shear conditions, a computational approach has been developed to determine the stress intensity factor at the tip of the main joint, taking into account the interference effects arising from both main and subjoints. Furthermore, the fine‐grained defects within the rock mass are abstracted as elliptical microcracks, and deterioration equations for rock cohesion and fracture toughness under freeze–thaw cycling are derived using frost heave theory. Taking into account the mutual interference effects between main and subjoints, as well as the degradation of rock mechanical properties caused by freeze–thaw cycles, a computational approach for determining the initiation strength of X‐type jointed rock masses has been developed. The validity of this method has been confirmed through rigorous model testing. The findings reveal that the wing cracks in X‐type jointed rock masses predominantly propagate along the tips of the main joints, while the extension of subjoints is constrained. When the X‐joints have the same inclination, the initiation strength of the subjoint exceeds that of the single‐joint rock mass when its inclination is less than the main joint’s but is lower when the subjoint’s inclination exceeds that of the main joint. The interference effect between oppositely inclined intersecting joints enhances the initiation strength of the rock mass, with the maximum occurring when the subjoint is at an inclination of 120°. When the freezing time is less than 18 h and the temperature is below −16°C, variations in both time and temperature are more sensitive in affecting the initiation strength of the X‐jointed rock mass. Rocks with a high elastic modulus and low tensile strength experience a greater rate of freeze–thaw damage, and brittle rocks are more susceptible to frost heaving failure.
Comprehensive Analysis of Thrombotic Microangiopathy Following Renal Transplantation
Authors: Fattal Ittai , Steinmetz Tali , Donin Natalie , Tobar Ana Foigelman , Rozen-Zvi Benaya , Rahamimov Ruth , Nesher Eviatar , Shirazi Idit , Mor Eytan , Babai Ilan , Fishelson Zvi
Published: December 2024

Background: Thrombotic microangiopathy is a severe complication of renal transplantation. Little is known about risk factors, incidence of autoantibodies against complement components, and prognosis.

Methods: Clinical and laboratory data were retrospectively collected for 13 patients diagnosed with post‐transplant thrombotic microangiopathy (PT‐TMA) in 2011–2018. Enzyme‐linked immunosorbent assay (ELISA) results were compared to transplant recipients without PT‐TMA and healthy controls.

Results: Nine patients (69%) had potential PT‐TMA risk factors other than exposure to calcineurin inhibitors (CNIs). Stratification by time to PT‐TMA yielded two groups. Patients diagnosed within 6 months of transplantation (n = 6) were characterized by positive donor‐specific antibody (DSA) test, complement‐associated renal disease, and acute rejection. Two had IgG and IgA autoantibodies to complement Factors H and I, respectively. Patients diagnosed ≥ 3 years after transplantation (n = 7) had a high rate of infection. Renal biopsy yielded dense deposits in 6 patients, and only one with primary immune complex renal disease. Within 2 years, graft failure requiring dialysis occurred in 6 patients (46%). Three patients with early‐onset PT‐TMA showed improved renal function and remained stable under eculizumab treatment. Epstein–Barr virus (EBV)–associated post‐transplant lymphoproliferative disorder (EPTLD) developed in 3 patients, 2 of whom had received eculizumab for more than 5 years. Five patients (39%) died during follow‐up.

Conclusion: In this study, PT‐TMA was associated with other risk factors besides CNI exposure, with differences by time of onset from transplantation. Prognosis was generally poor but better for early‐onset PT‐TMA managed with eculizumab. The development of late EPTLD in 3 patients raises concerns.
Cinnamaldehyde Attenuates the Expression of IBA1 and GFAP to Inhibit Glial Cell Activation and Inflammation in the MPTP‐Induced Acute Parkinson’s Disease Model
Authors: Jiao Panpan , An Yingfeng , Wu Suhui , Li Hanbing , Li Genlin
Published: December 2024

Cinnamaldehyde (CA), the primary bioactive compound in cinnamon (Cinnamomum cassia Presl, Lauraceae, Cinnamomum), holds potential therapeutic benefits for Parkinson’s disease (PD). To scrutinize the impact and mechanisms of CA on 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP)‐induced PD, male C57BL/6 mice were randomly allocated to CA (150, 300, and 600 mg/kg), model, Madopar, and control group (n = 12). The Open Field, Pole‐jump, and Rotarod experiments assessed exercise capacity and anxiety levels. HPLC evaluated the levels of neurotransmitters. Immunohistochemistry was utilized to detect the expression of TH and GFAP. WB and RT‐qPCR determine the expression levels of apoptosis‐related genes and proteins in the substantia nigra and striatum. The findings revealed that CA not only enhanced motor abilities and reduced anxiety but also elevated the levels of TH, DOPAC, DA, 5‐HIAA, HVA, and 5‐HT in the substantia nigra and striatum. Moreover, it protected DA neurons and downregulated the expression of Bax, Casp3, and Bax/Bcl-2 mRNA and proteins, while increasing the expression of Bcl-2 mRNA compared to the model group. Furthermore, CA was observed to inhibit glial cell activation, leading to reduced levels of GFAP and IBA1 in the substantia nigra and striatum. This resulted in decreased expression of inflammatory factors such as iNOS and NF‐κBp65 proteins in these regions, consequently mitigating neuroinflammation. These results suggest that CA exerts a neuroprotective effect in acute PD model mice by suppressing glial cell activation, modulating the expression of apoptotic genes, and alleviating neuroinflammation and apoptosis induced by MPTP.
Predictive Value of the Prehospital RACE Scale for Large Vessel Occlusion in Acute Stroke Patients
Authors: Truong Anh Tuan Le , Tran Hang Thi Minh , Phan Loc Dang , Nguyen Huong Bich Thi , Nguyen Trung Quoc , Le Tra Vu Son , Chiem Duc Nguyen , Nguyen Huy , Nguyen Thanh N. , Nguyen Thang Huy
Published: December 2024

Introduction: Prehospital stroke scales have been developed to identify anterior large vessel occlusion (LVO) in acute ischemic stroke (AIS) patients for direct transport to thrombectomy-capable hospitals. However, its performance in a Vietnamese population remains unknown. We aimed to evaluate the predictive value of the Rapid Arterial oCclusion Evaluation (RACE) scale for LVO detection in patients with ischemic stroke presenting within 24 h in Vietnam. Methods: This was a prospective study of patients with AIS admitted at People’s 115 Hospital between May 2022 and October 2022. All patients were assessed with the RACE scale with five items: facial palsy (scored 0–2), arm motor function (0–2), leg motor function (0–2), gaze (0–1), and aphasia or agnosia (0–2). LVO was diagnosed by CTA or MRA. Receiver operating characteristic curve, sensitivity, specificity, and accuracy of the RACE scale were analyzed to evaluate its predictive value for LVO. Results: There were 318 patients included. LVO was detected in 121/318 patients (37.6%). The higher the RACE score, the higher the proportion of patients with LVO (p < 0.001). Receiver operating characteristic curves showed capacity to predict LVO of the RACE scale with an area under the curve (AUC) of 0.767. The optimal RACE cutoff was ≥5 with sensitivity = 0.68, specificity = 0.79, positive predictive value = 0.67, negative predictive value = 0.80, and overall accuracy = 0.75. RACE ≥5 had higher sensitivity and same specificity for detecting LVO in AIS patients within 6-h versus 6–24-h window (AUC = 0.79 vs. 0.75, sensitivity = 0.74 vs. 0.65, specificity = 0.79 vs. 0.80, accuracy = 0.77 vs. 0.74). Conclusions: The RACE scale is a simple tool that can accurately identify AIS patients with LVO. This tool may be useful for early detection of LVO patients and should be validated in the prehospital setting in Vietnam.
THE EFFECT OF UNIONS ON OCCUPATIONAL HEALTH AND SAFETY: A QUALITATIVE STUDY ON ISSUES AND PROPOSED SOLUTIONS WITH YOL-İŞ UNION REPRESENTATIVES
Authors: Ölmezoğlu İri Necla İrem , Özçelik Ali Riza
Published: December 2024

The present study aims to examine the participation of unions in occupational health and safety activities and to provide solutions. Interviews were conducted with a union’s 7 workplace representatives affiliated with the Yol-İş Union and employed in the private sector, and the data obtained were analyzed using the content analysis method. It was found that unions contribute significantly to the occupational health and safety process, and they also support the process by conducting awareness-raising activities such as OHS-related training, translation of books, and distribution of brochures. To enhance effectiveness, it is necessary to add clauses to the Collective Labor Agreements that prioritize health and safety, empower representatives, and grant them authority and oversight in relation to occupational health and safety. It is also suggested as a solution proposal that labor unions should increase their workplace visits and address occupational health and safety issues during these visits.
Law Wars: Academia and the Manufacture of International Humanitarian Law
Authors: Wilson Page
Published: December 2024

Despite the emergence of much critical discourse on the conventional history of international humanitarian law (IHL) over the last decades, the way in which this conventional history is told and re-told remains virtually unaltered in one key area of dissemination: teaching materials. By conducting an in-depth examination of these materials, this article uncovers the techniques used over time to generate and perpetuate the conventional IHL history. In so doing, it helps to explain how and why the conventional IHL history continues largely unchanged in textbooks to this day.
Consensus, Disagreement, and the Criteria of Authenticity
Authors: Archer Joel
Published: December 2024

Recent scholarship has challenged the use of the so-called ‘criteria of authenticity’ in historical Jesus studies. One common argument draws attention to the fact that those who employ the criteria have produced an abundance of radically incompatible portraits of Jesus. The failure to generate any significant consensus in Jesus studies is therefore attributed to the criteria themselves. In response, I distinguish three versions of this line of reasoning, and I argue that none is persuasive. Scholarly disagreement, I argue, is ubiquitous across academic fields, and historical Jesus studies is not unique in this respect. There may be compelling reasons to discard or downplay the criteria of authenticity, but scholarly disagreement is not among them.
On the Margins of Emancipation: the Ambivalence of the Struggles of Evictees from the ZACA Project in Ouagadougou (Burkina Faso)
Authors: Lefebvre Félix
Published: December 2024

In Ouagadougou, the capital of Burkina Faso, the ZACA project, an urban renewal project, involved the destruction of inner-city neighbourhoods, and the displacement of their 12,000 inhabitants, mostly to outlying areas. Similar to other instances of forced evictions and displacements in metropolitan areas, this project has been widely used as an indicator of urban inequality, demonstrating the seizure of city centres by the upper classes and the prioritization of exchange value in neoliberal urbanism. It has also generated impulses for change through the promotion of new lifestyles, notably through the unprecedented communication campaign entrusted to the Synergie agency. In the face of this strategy, which emphasised the “modernity” of the project, tradition seemed to be an issue of struggle for the inhabitants, strongly emphasised in some speeches, and the customary authorities appeared as key actors whose support was sought by the various sides. While these injunctions may have seemed violent to a large part of the inhabitants of the zone and may partly explain the violent mobilisations that took place against the project, they may have constituted desirable horizons for others, especially the youth, making the social consequences of the ZACA project more ambivalent. By examining the testimonies of a father and his son evicted from the ZACA more than ten years after the event, and other field data, we will see that the reading of these events differs according to generation, revealing the importance of age-related inequalities in Burkinabè society. A radical change such as the expulsion from the neighbourhood of origin, if it consisted in an undeniable spatial marginalisation, could also have allowed the son to reshuffle the cards of social determinism, which he saw as a means of emancipation. In the end, this article argues for a complex reading of the accumulation of inequalities in urban societies, out of univocal logic.
A Historical Perspective on Political Culture in Contemporary African Politics
Authors: Nzally Jimmy Hendry
Published: December 2024

This article offers a historical but critical perspective on the influence of colonisation on political cultures in African states. It seeks to interrogate how colonialism has influenced Africa’s political systems. There is little literature that exists to explain the influence of colonialism on contemporary African politics. As an oppressive system, colonialism was rooted in white dominance, “racial hierarchy”, and exploitation. This led to the setting up of coerced institutionalised colonial systems of government. Notable examples were the British indirect rule system and assimilation by the French. This encounter led to the dismantling of Africa’s precolonial traditional systems of governance and their replacement with oppressive colonial systems. This article argues that colonial structures led to the instituting of, among other things, ethnic fragmentation, one-party states and military takeovers. This underpins “contemporary” discourse as it relates to democratic and non-democratic political cultures in Africa.

The main sources used in this study are literature studies, but the article also uses a variety of other sources to investigate political cultures. This includes analysing reports and historiographical and postcolonial theorising. The article makes a unique contribution to colonial, postcolonial and, more so, contemporary discourse on Africa’s political culture. Using the framework of Almond and Verba (1963), the article identifies three classifications of political culture: participant, subject and parochial. Thus, the article not only to applies this theoretical framework as it is but adapting it to the African context. It includes a salient focus on The Gambia’s 2016 presidential elections, which led to the democratic transition from autocracy.
Against Isolation: Multilingualism, Transnationalism and Literary Dialogue in Dutch–Afrikaans Formations. A Report with Critical Reflections on a Research Programme
Authors: T’Sjoen Yves
Published: December 2024

This research report pushes back against isolationist accounts of linguistic autonomy, not only in Afrikaans, but across languages and literary traditions. Starting with a focus on recent interactions between Afrikaans and Dutch literary polysystems (both in the Netherlands and Flanders), it combines a critical perspective on ‘minor literatures’ with methods based in functional literary and cultural interactions. I propose a generalisable transversal and multi-linguistic approach to the study of global literary and linguistic polysystems. This contribution focuses especially on the potential of multilingualism and translation to generate literary histories that can accommodate international and cross-cultural networking and exchange, thereby to complicate separatist constructions of linguistic heritage and identity.
Masticatory Stress Maintains Mucosal Homeostasis via M2 Polarization
Authors: Ning M.Z. , Zhai X.T. , Wang X. , Liu H. , Wang J.S. , Wang X.G. , Wang S.L. , Hu L.
Published: December 2024

In addition to breaking down food, mastication plays regulatory roles in tissue homeostasis. During mastication, the oral mucosa is subjected to masticatory stress, and the maintenance between mucosal damage and repair is a key process. Despite rapid healing in the oral mucosa during chewing, the molecular mechanisms underlying repair remain unclear. In this study, we investigated the impact of masticatory stress on masticatory mucosal wound healing. Our data showed that reduced masticatory stress on the oral mucosa in mice fed a soft food diet resulted in decelerated hard palate mucosal wound healing and decreased numbers of Ki67-positive cells as compared with the hard food diet group. An RNA sequencing analysis revealed lower expression levels of the mechanosensitive gene Piezo1 in the hard palate mucosa, as well as lower levels of transforming growth factor β1 ( Tgf-β1) and Tgf-β receptor 2 ( Tgf-βr2), in the soft food diet group than the hard food diet group. Immunofluorescence staining, flow cytometry, and polymerase chain reaction analyses demonstrated that masticatory stress induced M2 polarization of macrophages surrounding the wound in the hard food diet group, leading to increased Tgf-β1 secretion. The specific deletion of Piezo1 in macrophages ( Piezo1DLysm) attenuated masticatory stress–induced accelerated healing in mice. These findings reveal the crucial role of masticatory stress–induced Piezo1 expression in tissue repair, potentially influencing M2 polarization of mucosal macrophages and Tgf-β1 secretion. These findings underscore the pivotal role of physical stimulation in the immune response and tissue repair and may provide important insights into therapeutic interventions for tissue repair.
Educating Ungrounded Values: Interrogating Political Versus Academic Epistemologies in Music Teacher Education
Authors: Richerme Lauren Kapalka
Published: December 2024

All music education endeavors depend on the hierarchical ordering of values. Although philosophical researchers have considered which values should inform music education practices, both the nature of values and possible epistemologies or ways of thinking about values have gone largely unexamined in the music education literature. The twofold purpose of this philosophical inquiry is to examine differences between political versus academic epistemologies and to consider the benefits and limitations of utilizing these contrasting ways of knowing during preservice music teacher preparation. Political epistemologies involve promoting narrow values, encouraging emotional attachments to them, and treating them as unquestionable. Although political epistemologies enable professional cohesion that can sustain and improve practice, they limit both complexity and critiques of actions associated with favored values. Political epistemologies can also reinforce echo chambers, causing students who anticipate counterarguments to harden their initial stances. Alternatively, academic epistemologies involve sustained, rigorous, dispassionate analysis of the complexities surrounding competing values and their associated consequences. Academic epistemologies enable music educators to reimagine their actions and engage with stakeholders promoting contrasting values. Both political and academic epistemologies can serve a key role in preservice music teacher education, and teacher educators might question when and why they favor each in their practices.