bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Case of Recurrent Renal Infarcts With Unique Etiologies in Different Kidneys Occurring Six Years Apart
Authors: Perkins Kaitlyn , Anderi Emilyn , Costandi Mariam , Passalacqua Karla D. , Budzynska Katarzyna
Published: December 2024

Renal infarcts are uncommon, difficult to diagnose, and can lead to long‐term kidney disease. Because they have numerous etiologies and patients may present with nonspecific symptoms, renal infarcts may be mistaken for other common conditions. A 50‐year‐old woman presented to the emergency department (ED) with flank pain, nausea, and vomiting. Computed tomography (CT) revealed multiple right kidney infarcts, transthoracic echocardiography revealed mitral valve stenosis with no evidence of atrial fibrillation, and hypercoagulability tests were negative. High‐intensity anticoagulation therapy resolved the infarcts and she was discharged on warfarin. Six years later, at the age of 56, the woman again presented to the ED with back pain, nausea, vomiting, and fever. She had undergone valvuloplasty to repair the mitral valve stenosis 1 month before this ED visit, and warfarin had been discontinued shortly after the procedure. CT imaging and ultrasonography showed no evidence of infarcts and electrocardiogram was normal. Although urinalysis was negative for infection, pyelonephritis was suspected per CT results. However, renal function and leukocytosis did not improve after 2 days of antibiotic therapy. Radioisotope renal scan then revealed infarcts in the left kidney. Anticoagulation therapy again led to recovery, and the patient was discharged back on warfarin. After the recurrent infarct, monitoring and cardiac care have led to adequate long‐term management, and no evidence of atrial fibrillation has ever been observed. This case illustrates the challenging diagnosis of an unusual presentation of recurrent renal infarct, where each infarct was suspected to have a unique and independent etiology: mitral valve stenosis in the first and hypercoagulability from withdrawal of warfarin in the second. Because no clear risk or symptom profiles exist for renal infarcts, this unusual condition should be considered when patients do not respond to treatment for other renal problems, especially those with cardiovascular disease.
Prevalence of Gastroparesis and the Impact of Metformin in Diabetic Patients: A Cross‐Sectional Study in Riyadh, Saudi Arabia
Authors: Aldali Jehad A. , Asseri Mushabbab K. , Almufarrij Haneen A. , Alromih Aroob M. , Alajlan Albandari M. , Alrashed Khawlah A. , ALghadeer Atheer I. , Almutawa Bushra I. , Alshalani Abdulrahman
Published: December 2024

Background: The prevalence of gastroparesis in individuals with diabetes mellitus varies significantly across different studies. This study is aimed at estimating the prevalence of gastroparesis among diabetic patients in Riyadh, Saudi Arabia, and evaluating the association between metformin use and clinical manifestations of gastroparesis.

Methods: This cross‐sectional study employed an online survey distributed via Google Forms, targeting patients at a diabetes clinic. The survey comprised three sections, including the Gastroparesis Cardinal Symptom Index (GCSI). Eligible participants were those diagnosed with either type 1 or type 2 diabetes mellitus and aged 18 or older.

Results: The study included 385 participants, with the majority diagnosed with type 2 diabetes (55.6%) for over 10 years (59.5%). A significant proportion had poorly controlled blood glucose levels (56.6%) and were taking metformin (50.9%). Among gastrointestinal (GI) symptoms, “stomach fullness” was reported most frequently (53.2%), whereas “vomiting” was reported least often (17.9%). GCSI scores did not differ significantly between type 1 and type 2 diabetes patients (p = 0.88). However, patients with diabetes durations of less than 3 years, those with durations of 5–7 years controlled blood glucose levels, and those on metformin exhibited higher GCSI scores (p = 0.20, p = 0.02, and p = 0.10, respectively).

Conclusion: This study identified some commonalities as well as differences in the prevalence and symptomatology of gastroparesis among diabetic patients. We observed no significant variation in GCSI scores between type 1 and type 2 diabetes. Nevertheless, higher GCSI scores were associated with shorter diabetes durations, controlled blood glucose levels, and metformin use. However, due to the small sample size and reliance on self‐reported data, one should interpret the study’s findings with caution.
Genetic variation of HPA axis activity in farm animals and beyond
Authors: Mormede Elena , Mormede Pierre
Published: December 2024

Background: Many experimental data in several species clearly demonstrate the important genetic contribution to variations in HPA axis activity. The influence of corticosteroid hormones on adaptive processes and on production traits such as growth rate, feed efficiency, carcass composition and meat quality is a strong impetus to the search for the molecular bases of these differences for efficient genetic selection.
Summary: Three main sources of genetic variability have been documented so far in farm animal species, the adrenal cortex sensitivity to ACTH regulating corticosteroid hormone production, the bioavailability of corticosteroid hormones and especially corticosteroid-binding globulin capacity, and glucocorticoid receptor function. The effect of single mutations may be dependent on the genetic background and genetic variation of cortisol levels may have different functional consequences depending on the molecular mechanisms responsible for this change.
Key Messages: Understanding the genetic basis of HPA axis activity allows the development of genomic tools and breeding technologies aimed at improving adaptive capacity and stress tolerance in farm animals and their use as valuable models for the genetic study of the HPA axis and the correlation with adaptation, metabolism and other functions regulated by adrenal hormones, and associated pathologies (obesity, cardiovascular, etc.). The next step will be to explore HPA axis variability from a system genetics perspective including the multiple sources of variation and their interactions. This multifactorial approach is a prerequisite to the use of the HPA axis phenotypes in the genetic selection for more productive and robust animals, with a high level of production of quality products.
Systemic Cancer Hallmarks as Novel Markers Associated with Progression-free Survival in Gastroenteropancreatic Neuroendocrine Tumor Patients Undergoing PRRT
Authors: Padwal Mahesh Kumar , Parghane Rahul Vithalrao , Chakraborty Avik , Ujaoney Aman Kumar , Anaganti Narasimha , Basu Sandip , Basu Bhakti
Published: December 2024

Introduction: Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous group of tumors often detected at the metastatic stage. The aim of this study was to profile the peripheral blood transcriptome through RNA-Seq and investigate the association of the systemic cancer hallmarks with progression-free survival in PRRT-treated GEP-NET patients. Methods: The cohorts were: discovery cohort [PRRT-naïve well-differentiated GEP-NETs, n=59; age- and sex-matched healthy individuals, n=38], and independent evaluation cohort [GEP-NETs, n=66]. Peripheral blood transcriptomes were profiled through RNA sequencing and cancer hallmarks were identified via Gene Set Enrichment Analysis (GSEA). Activities of cancer hallmarks in each sample were calculated using Gene Set Variation Analysis (GSVA). Differentially expressed genes were identified with DESeq2. Progression-free survival was used as a primary endpoint and prognostic association was evaluated using univariate and multivariate COXPH analyses. Results: RNA-Seq captured global changes in the peripheral blood transcriptome of GEP-NET patients. Peripheral blood transcriptome of NET patients showed differential enrichment of 30 systemic cancer hallmarks viz., TNF-α signaling via NF-κB, IL2/STAT5 signaling, TNF-α response, TNF-γ response, IL6/JAK/STAT signaling, TGF-β signaling, heme metabolism. etc. In the univariate analyses, two cancer hallmarks were prognostically significant (p<0.05) in GEP-NETs. Heme metabolism and IL2/STAT5 signaling were statistically significant in the Discovery cohort (n=58) and independent evaluation cohort (n=66). In multivariate COXPH analyses, heme metabolism and IL2/STAT5 signaling were independently associated with PFS in GEP-NET patients undergoing PRRT. Conclusions: This study provides comprehensive coverage of the peripheral blood transcriptome of GEP-NET patients via RNA-Seq and identifies systemic cancer hallmarks as independent prognostic factors in NETs.
”Real-life” Data of Zanubrutinib in Patients with Waldenström Macroglobulinemia - A Multi-Center Retrospective Study
Authors: Itchaki Gilad , Benjamini Ohad , Levi Mor , Nemets Anatoly , Ygna Shai , Assaly Mahdi , Gourevitch Anna , Gatt Moshe , Saban Revital , Raanani Pia , Vaxman Iuliana
Published: December 2024

Introduction: Waldenström macroglobulinemia (WM) is a rare indolent lymphoma. Zanubrutinib (ZAN), a second-generation BTK inhibitor, has been approved for the treatment of WM in any line of therapy in 2021. Between November 2020 and January 2022, an expanded access program of ZAN opened in Israel for the treatment of patients with relapsed refractory (RR)-WM or those ineligible for chemotherapy or ibrutinib in first line. Methods: This is a multi-center retrospective study aiming to provide real-world data on ZAN in patients with WM in Israel. Demographic and clinical data were collected and coded from electronic files. Response was evaluated by the investigator’s assessment. As the program closed, patients transitioned to commercial ZAN. Results: 13 patients (12 RR; 1 treatment-naive) were enrolled across 8 centers in Israel. The median age at ZAN initiation was 71 years (range, 50-85); 6 were males; 10 had high IPSS-WM. RR pts had a median of 1 (1-4) prior lines of therapy. Other than progressive disease after chemoimmunotherapy (CIT), the most common considerations for choosing ZAN were patients’ age and/or comorbidities (n=5), as well as ibrutinib toxicity. The initial ZAN dose was reduced in 4 pts. The median time on ZAN was 19.5 months (2.9-29.5). Of 12 evaluable patients, the ORR was 83% with 3 minor responses, 6 PR, and 1 VGPR. With a median follow-up of 19.6 months, 7 patients were still on ZAN, 5 progressed, 4 while on ZAN, and 1 after ZAN was stopped due to AE. 18 months PFS and OS were 60.5% and 77%, respectively. Eight (61%) patients had AEs of any grade, and 3 (23%) of grade 3-4; 2 stopped ZAN due to congestive heart failure and extreme fatigue. Conclusion: The results of this real-world high-risk population are consistent with prospective studies highlighting the efficacy and safety of ZAN.
Real-world survival outcomes in patients with different types of cancer managed with immune checkpoint inhibitors
Authors: Nieder Carsten , Aanes Siv Gyda , Stanisavljevic Luka , Mannsåker Bård , Haukland Ellinor Christin
Published: December 2024

Introduction: Immune checkpoint inhibitors (ICI) are now standard of care in systemic treatment for many types of metastatic cancer, often together with cytotoxic chemotherapy. Monitoring of treatment efficacy against clinical trial benchmarks in real-world populations and subgroups such as elderly patients is necessary. Based on the results of a previous study, we evaluated age-related survival differences in a larger cohort.
Methods: Retrospective analysis of 272 patients managed in a rural real-world setting, after exclusion of those who had received neoadjuvant, adjuvant or maintenance ICI treatment. We defined four different survival categories: death within 3 months of the first ICI dose, 3-6 months survival, 6-12 months survival, and >12 months survival. All surviving patients were followed for >12 months. Actuarial overall survival was assessed too. Age was stratified in 10-year increments.
Results: Non-small cell lung cancer (NSCLC) and malignant melanoma represented the most common tumor types. Median age was 70 years. Median actuarial overall survival was 13.6 months (5-year estimate 16%). The best survival was recorded in patients 61-70 years of age. The highest rate of early death within 3 months (29%) was seen in those aged >80 years. Long-term survival was not observed in this age-group, in contrast to all others.
Conclusion: Satisfactory survival was observed in this elderly patient cohort, but survival varied with tumor type and performance status. Age was not a major determinant of survival. However, the oldest patients were at higher risk of short survival.
Serendipitous Discovery of Lipemia Retinalis in a Premature Infant: A Case Report
Authors: Nikkhah Homayoun , Karrabi Narges , Yazdani Ehsan , Nezameslami Rezvan
Published: December 2024

Introduction: Lipemia retinalis (LR) is a rare ocular condition characterized by a creamy white appearance of the retinal vessels, which is indicative of significantly elevated serum triglyceride (TG) levels. This condition is particularly noteworthy in pediatric populations, especially in preterm infants who are at risk for various metabolic disorders. Case Presentation: We report a case of LR in a 44-day-old preterm infant identified during routine retinopathy of prematurity (ROP) screening. Unusual retinal findings led to metabolic investigations, revealing elevated TG levels confirming LR. The infant was managed with a dietary regimen including skimmed milk, resulting in a substantial decrease in TG levels and complete resolution of the retinal changes. Conclusion: Fundus examination serves as a portal to the systemic health of an individual, enabling rare identification of LR, indicative of underlying dyslipidemia. This case underscores the necessity for comprehensive metabolic screening in preterm infants, particularly during ROP assessments. Furthermore, it emphasizes the effectiveness of dietary interventions in managing LR. The favorable outcomes stress the significance of early detection of LR in pediatric patients and implementing nutritional strategies to enhance metabolic well-being, thereby averting severe hypertriglyceridemia complications.
Radial Access Approach to Peripheral Vascular Interventions: A Scientific Statement From the American Heart Association
Authors: Kovacic Jason C. , Skelding Kimberly A. , Arya Shipra , Ballard-Hernandez Jennifer , Goyal Mayank , Ijioma Nkechinyere N. , Kicielinski Kimberly , Takahashi Edwin A. , Ujueta Francisco , Dangas George ,   on behalf of the American Heart Association Cardiovascular Interventions Science Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Cardiovascular Radiology and Intervention
Published: December 2024

Transradial arterial access has transformed the field of coronary interventions, where it has several advantages over femoral access, such as reduced bleeding and access site complications, improved patient comfort, shorter time to ambulation after the procedure, reduced length of hospital stay, and potentially reduced mortality rates. Because of these benefits, as well as the concurrent expanding indications for various endovascular therapies, there is growing interest in adopting radial access for peripheral vascular interventions. However, radial access can present challenges, and specialized equipment for peripheral interventions through this route are under development. Nevertheless, a growing number of studies, largely comprising single-center and registry data, have broadly suggested that transradial arterial access is likely to be safe and associated with reduced bleeding and local access site complications for most peripheral interventions compared with transfemoral access. Large, prospective randomized trials are lacking, and the question of any effect on mortality rates has not been addressed. Whereas the field of transradial arterial access for peripheral vascular interventions is in development, it is clear that this approach, at least with available equipment, will not be suitable for all patients, and careful case selection is paramount. Furthermore, the remaining knowledge gaps must be addressed, and robust outcome data obtained, to allow full understanding of the factors that determine optimal patient, lesion, and equipment selection. Nevertheless, the use of transradial arterial access for peripheral vascular interventions holds great promise, particularly if the necessary technologic advances are rapid and favorable clinical trial data continue to emerge.
On the Classicism of “Non-classical” Psychology
Authors: Kravtsov Gennady G. , Kravtsov Oleg G.
Published: December 2024

Background. The article discusses the current problem of the methodological foundations of psychological science. The article argues that the dangerous crisis for psychology, which was analysed by L.S. Vygotsky has not gone away, but moved from an acute form to a chronic one. “Methodological pluralism” in modern psychology is the triumph of blatant eclecticism. The authors see the main reason for the impasse which psychology has reached as the desire of this science to become like positive sciences from the field of natural science.
Objective. The purpose of the article is to substantiate the point of view according to which L.S. Vygotsky created the only possible scientific psychology of the future, which will rightfully be classical.
Method. The article discusses the fundamental principles and postulates of the cultural-historical approach, and outlines ways of research conceptualising the idea of a systemic and semantic structure of consciousness.
Results. The authors analysed the methodological and philosophical foundations of psychological science. Based on the analysis carried out, the article highlights the approach proposed by L.S. Vygotsky.
Conclusions. Comparison of the scientific fate of Galileo with the scientific fate of L.S. Vygotsky allowed the authors to assert that neither one nor the other discoverer of a fundamentally new method of comprehending reality had like-minded people during their lifetime. Their theoretical and methodological bar was raised too high, which made their work inaccessible to understanding by their contemporaries. The article concludes that the legacy of L.S. Vygotsky is not the historical past of psychological science, but its only possible and most promising future.
Book review: Sharmila Purkayastha, Of Captivity and Resistance: Women Political Prisoners in Postcolonial India
Authors: Scott Gemma
Published: December 2024

Sharmila Purkayastha, Of Captivity and Resistance: Women Political Prisoners in Postcolonial India. Cambridge University Press, 2023, 325 pp.
Political and Programmatic Health Decentralisation in Karnataka State: An Evidence-based Rural Participatory Decision-making
Authors: Nanjunda D.C.
Published: December 2024

Health decentralisation is a dynamic tool for providing quality and inclusive healthcare. The effectiveness of the administration of an institutional-quality healthcare delivery system focusing on health decentralisation has been under question for the last three decades. Also, examining the successes of decentralisation and the correlation between autonomy, decision space (degree of decentralisation) and health outcomes is gaining momentum today. The major aim of this research study is to assess the effectiveness of Panchayati Raj Institutions (PRIs) in managing the rural healthcare system in the state of Karnataka (South India). The study has used mixed methods, drawing samples from PRIs and Public Health Institutions. The study has found some notable issues in rescheduling decentralised health administrative structures, reducing benefaction and political meddling and implementing performance-based resource distribution. It is concluded that structural, dynamic and geographically specific reforms in age-old administrative procedures are very essential in the administrative and financial management systems of PRIs for effective health decentralisation in India.
Voter Intimidation as a Tool of Mobilization or Demobilization? Evidence from West Bengal, India
Authors: Daxecker Ursula , Deglow Annekatrin , Fjelde Hanne
Published: December 2024

This study presents new theory and evidence on the repertoire of electoral intimidation, suggesting that threats can be used to deter rival party supporters from voting but also to mobilize citizens to vote for a particular party. We expect these strategies to unfold in the same electoral context, but differ in targeting and incidence; while threats to demobilize are concentrated in closely contested areas and occur more frequently overall, threats to mobilize target fewer voters and are centered in parties’ own strongholds. Recognizing the difficulty of surveying citizens about sensitive experiences, we combine qualitative material from local news with evidence from a list experiment embedded in an original survey conducted after the 2019 elections in the Indian state of West Bengal. Our empirical findings corroborate our expectations: areas without overt violence may nevertheless be highly coercive, underlining the importance of studying the full repertoire of electoral violence.
Flourishing, Cinematic Self, and Sense of Self as Predictors of Death Anxiety: A Gender-Invariant Model
Authors: Gomes Alexandra , AL-Dossary Saeed A. , Sousa Cátia , Gonçalves Gabriela
Published: December 2024

This research delved into the intricate landscape of death anxiety, a profound psychological phenomenon that deeply influences individuals’ perceptions and responses to mortality. Through a meticulous examination of key psychological factors – flourishing, cinematic self, and sense of self – we aimed to unravel the complexities surrounding this existential concern. With a diverse sample of 327 Portuguese participants, our study sheds light on the significant role these constructs play in shaping individuals' experiences of death anxiety. Notably, we highlight the profound impact of a robust sense of self in mitigating anxiety levels. Additionally, our exploration of gender dynamics revealed consistent patterns across diverse groups, underscoring the universal nature of these psychological processes. By providing a nuanced understanding of death anxiety and its determinants, our study offers valuable insights for the development of tailored interventions aimed at alleviating psychological distress and promoting well-being in individuals facing existential concerns.
Influence of layering variation with addition of bio-fillers on mechanical and thermal performances of hybrid polyester composites
Authors: Tripathy Chetana , Mohapatra Deepak Kumar , Deo Chitta Ranjan , Mishra Chandrakanta
Published: December 2024

The extensive application of composites reinforced with synthetic or natural fibers and bio-fillers represents a recent advanced trend in research. This research seeks to assess the optimal ratio of wood dust (WD) and fish scale powder (FSP) for forming a hybrid filler mix to reinforce Palmyra Palm leaf stalk (P)/Glass (G) polyester laminate, aiming to improve its mechanical and thermal properties. The ideal ratio is identified by evaluating the mechanical properties of various weight fraction combinations of WD and FSP filler in polyester. The test results showed that the optimal filler hybridization ratio is 5 wt.% WD and 10 wt.% FSP. Hybrid laminates are then produced by combining equal layers of glass and palm leaf stalk fiber in different stacking configurations, incorporating an optimal mixture of hybrid fillers. The experimental findings revealed that, the inclusion of an optimal blend of WD and FSP filler results in improvements in mechanical properties, with a 51.93% increase in tensile strength, a 36.27% boost in flexural strength, a 20.48% rise in impact resistance, and a 10.08% enhancement in micro-hardness. Additionally, the findings revealed that the laminate with GPPG stacking order shows the highest mechanical properties compared to other stacking sequences. To further examine the thermal degradation and various failure mechanisms, Thermo-gravimetric analysis (TGA) and fractography study using a Scanning Electron Microscope (SEM) are conducted.
Predefined-time event-triggered adaptive neural practical tracking control for flexible-joint robot
Authors: Yang Man , Liu Siwen , Wang Huanqing , Niu Ben , Shen Haikuo
Published: December 2024

This paper researches the predefined-time event-triggered adaptive neural practical tracking control problem for flexible-joint robot system. An improved predefined-time command filter is utilized to get rid of the “explosion of complexity” problem, and the filter errors can be eliminated by an improved error compensation mechanism. Moreover, as an effective approximation tool, radial basis function neural networks are exploited to tackle the nonlinear terms existing in flexible-joint robot system. Finally, the communication burden of the system is reduced by using event-triggered technology, and an advanced adaptive predefined-time event-triggered controller is designed. The actual controller in the control scheme is updated only when it meets the conditions of the event-triggered mechanism. For flexible-joint robot system, the resulting control scheme makes the tracking error approach to a small neighborhood of zero, and all signals of the closed-loop system remain bounded within the predefined time. The effectiveness of the proposed controller is directly illustrated by the simulation results.
Changes in perception of prognosis in the last year of life of patients with advanced cancer and its associated factors: Longitudinal results of the eQuiPe study
Authors: Versluis M.A.J. , van de Poll-Franse L.V. , Zijlstra M. , van Laarhoven H.W.M. , Vreugdenhil G. , Henselmans I. , Brom L. , Kuip E.J.M , van der Linden Y.M. , Raijmakers N.H.J.
Published: December 2024

Background:

Many patients with advanced cancer are unaware of their limited prognosis, however little is known about the change in awareness during the last year of their lives.

Aim:

To investigate changes in the perception of prognosis in the last year of life of patients with advanced cancer and its associated factors.

Design:

Prospective, longitudinal, multicentre, observational study in patients with advanced cancer (eQuiPe). Patients completed 3-monthly follow-up questionnaires until death.

Setting/participants:

Adult patients diagnosed with advanced cancer were recruited by their treating physician or self-enrolled in one of the forty Dutch hospitals. Only deceased patients with available prognostic data were included for analysis ( n = 801).

Results:

Perception of prognosis changes in the last year of life with an increase in the percentage of patients who are aware of their limited prognosis (from 15% to 40%). Especially in the last 6 months of life, most of the changes were towards a more realistic perception of prognosis. Patients who did not want to know their prognosis remained relatively stable in their wish not to know (range: 14%–18%). Time to death was associated with having a perception of prognosis of < 1 year, >1 year or not knowing the prognosis, but was not associated with not wanting to know the prognosis.

Conclusion:

Becoming aware of their limited prognosis may make patients with advanced cancer more receptive to start end-of-life discussions. Although some patients prefer not to know their prognosis, it remains important to respectfully explore their preferences and wishes for end-of-life care.
What is important to young people in care during adolescence? A qualitatively driven photo-elicitation study
Authors: Matthews Tom , Hugh-Jones Siobhan
Published: December 2024

A feature of being a young person in care is that your life is overseen by a range of professionals, who make decisions that affect you. There is a lack of research into the experiences of young people in care to inform these decisions from the perspective of the young people. A need for research that allows young people in care to contribute to the literature about what is important to them during adolescence was established. This exploratory study used a participant-led, photo-elicitation methodology with six young people (13–15 years) who lived in foster care. A photo-elicitation interview was conducted in which participants brought photographs of what was important to them which they then discussed. Data were analysed using Interpretative Phenomenological Analysis.

 Participants described their experiences as being embedded in the place they lived, with their development being shaped by the possibilities this provided. Participants described what was important to them as: being seen and heard; a part of their place and being with others; finding space to escape to; relationships with their pets; and getting to know themselves. Discussion of how this relates to existing knowledge, and relevant clinical implications and future research directions, are discussed based on this analysis.
Complex Multimorbidity and Trajectories of Functional Disabilities in the Last Three Years of Life: A Prospective Cohort Study of Older Adults in Japan
Authors: Kato Daisuke , Kawachi Ichiro , Saito Junko , Kondo Naoki
Published: December 2024

We sought to understand the impact of multimorbidity (MM) on the trajectories of functional decline in the last three years of life among older people in Japan. We used nationwide longitudinal cohort data with 6-year follow-up and analyzed 3731 functionally independent residents aged 65 years and older. The primary outcome was the five trajectory groups of functional disability in the last three years of life, defined by group-based trajectory modeling (GBTM). The explanatory variable was two alternative definitions of MM: basic MM (BMM; two or more comorbid diseases) versus complex MM (CMM; three or more body system disorders due to disease). A multinomial logistic regression analysis showed both MMs were associated with earlier trajectories of functional decline (maximum odds ratio: BMM 1.12 [0.99–1.27]; CMM 1.29 [1.16–1.44]). Preventing MMs, especially CMM, by providing appropriate care and support could contribute to healthy longevity by delaying the onset of functional disability.
Early-Life Parental Affection, Social Relationships in Adulthood, and Later-Life Cognitive Function
Authors: Thomas Patricia A. , Teas Elizabeth , Friedman Elliot , Barnes Lisa L. , Sauerteig-Rolston Madison R. , Ferraro Kenneth F.
Published: December 2024

Objective

Although research has demonstrated the long-term health consequences of childhood adversities, less is known about the long-term impact of positive childhood experiences, such as parental affection.

Method

Using longitudinal data (1995–2014) from the Midlife in the United States (MIDUS) study, we analyze structural equation models estimating direct and indirect pathways from early-life parental affection to changes in later-life cognitive function through relationship quality in adulthood among Black and White older adults ( N = 1983).

Results

Analyses revealed significant indirect effects of parental affection on better cognitive function through higher levels of social support (both average social support and family social support) in adulthood in the full sample and among Black respondents. Indirect pathways through relationship strain and through friend support were not significant.

Discussion

This work elevates the importance of promoting positive parental relationships during childhood, with implications for better social relationships in adulthood and cognitive function in later life.
Predicting prognosis, immune landscape, and drug targets with a novel signature for hepatocellular carcinoma
Authors: Qiu Xinqi , Huang Wentao , Liang Jun , Chen Hao , Sha Weihong , Lyu Yanlin , Chen Kequan , Yang Hongwei , Zhang Qingfang
Published: December 2024

Background

Despite advances in therapeutics, hepatocellular carcinoma (HCC) remains one of the most malignant types of digestive tract cancers with a poor prognosis. Pyroptosis is a form of programmed cell death induced by inflammatory caspases. Recent studies have identified pyroptosis, a form of programmed cell death induced by inflammatory caspases, as playing a role in tumorigenesis and cancer progression. However, the functions and mechanisms of pyroptosis in HCC are barely explored.

Methods

Gene expression and clinical data were derived from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A prognostic signature and nomogram were constructed by on differentially expressed genes and clinical data. Pathway enrichment and immune cell infiltration were further analyzed. Potential drugs to modulate the pathways were explored.

Results

In this study, a pyroptosis-related gene signature was developed and identified to be significantly correlated with the survival of HCC patients. Additionally, a nomogram on the basis of pyroptosis-related genes was constructed with distinct prognostic values. Furthermore, the pyroptosis-related gene signature might correlate with immune-related pathways and the regulation of the immune microenvironment, and several compounds (KIN001-220, TPCA-1, LY-303511, physostigmine, vemurafenib, etc.) could potentially reverse the pathogenic gene-expression patterns.

Conclusions

Our study provides evidence that pyroptosis is involved in HCC development, progression and immune microenvironment, which is promising in predicting the prognosis and developing targeted therapy.
Admission diagnoses and outcomes among hospitalized people living with HIV during pre-COVID-19, COVID-19 and post-COVID-19 pandemic periods
Authors: Panutat Pattarapoom , Khawcharoenporn Thana
Published: December 2024

Background

Data on the impact of coronavirus disease 2019 (COVID-19) on hospitalization and outcomes among people living with HIV (PLHIV) are limited.

Methods

A retrospective cohort study was conducted among PLHIV hospitalized during the pre-COVID-19, COVID-19, and post-COVID-19 periods.

Results

Of the 310 PLHIV included, 117, 125 and 68 were admitted during the three periods, respectively and 115 (37%) were newly diagnosed with HIV. Median CD4 cell counts and proportions of those with antiretroviral therapy (ART) adherence rates ≥95% at admission were different between the three periods [(206, 97 and 138 cells/mm3 ( p = .02) and 97%, 89% and 100% ( p = .06), respectively]. Of the 310 PLHIV, admission diagnoses were non-AIDS-related (62%) and AIDS-related (38%). Most of the non-AIDS-related diagnoses were infections other than opportunistic infections (OIs) (40%) while OIs were the most common for AIDS-related diagnoses (88%). The types of admission diagnoses were comparable between the three periods. Hospital mortality rates were 10%, 13% and 16% during pre-COVID-19, COVID-19 and post-COVID-19 periods, respectively ( p = .80). By multivariable analysis, intensive care unit admission, underlying malignancy, monthly income less than $USD 400, and admission CD4 less than 50 cells/mm3 were independently associated with hospital mortality.

Conclusions

Although admission during COVID-19 pandemic period was not associated with increased mortality, we observed the impact of the pandemic on the lower CD4 cell count and ART adherence at admission among hospitalized PLHIV. Interventions to improve early care engagement, ART adherence, and close monitoring for those with identified mortality risks are needed for better HIV care, especially during pandemics.
Theory and experiment for autonomous quadrotor flight via bounded robust finite-time homogeneous sliding mode control: A roadmap to search and rescue
Authors: Messaoui Aimen Abdelhak , Mechali Omar , Louali Rabah , Nemra Abdelkrim
Published: December 2024

This paper introduces a new saturated robust control technique for quadrotor aircraft modeled by second-order Ordinary Differential Equations (ODEs), considering disturbances in the control channel (matched disturbances). The control design employs a Sliding Mode Control (SMC) approach, featuring in: (i) a novel saturated homogeneous sliding manifold, (ii) a novel tracking controller, namely, Bounded Robust Finite-Time Homogeneous Sliding Mode Control (BRFTHSMC). An Improved Fixed-time Convergent Extended State Observer (IFCESO) is incorporated into the control scheme to handle disturbances. Together the BRFTHSMC and the IFCESO establish a reliable Active Disturbance Rejection Control (ADRC) framework. The latter ensures finite-time convergence of the errors quantities to the origin along with effective disturbance rejection. Rigorous stability analysis is conducted based on Lyapunov theory. Beside control design, another distinguishing theoretical outcome of this paper in the form of Corollary is the extension of the present results to integrator-type systems (higher-order systems). The study is substantiated through MATLAB®/Simulink simulations and Robot Operating System (ROS)/Gazebo implementation, validating the theoretical foundation. Extensive experimental tests on real hardware, including attitude and Cartesian trajectory tracking under various disturbances, further affirm the theoretical findings. The synthesized control system surpasses alternative methods in terms of control signal’s boundedness, finite-time tracking stability, transient response performance, and steady-state precision. Notably, the control input circumvents singularity challenges observed in conventional SMC approaches. In addition to trajectory tracking experiments, the controller’s effectiveness is demonstrated in real-world search and rescue scenarios. Therefore, a Deep Neural Network (DNN) algorithm, based on a MS COCO-pretrained Single Shot Detector (SSD-Mobilenet-v2), is employed for a person detection mission in an unknown search area.
Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Abdominis Plane Block and Ultrasound-guided Bilateral Quadratus Lumborum Block for Postoperative Pain in Robotic Prostatectomy: A Randomised Comparative Study
Authors: Vinitha B  , Ganesan Arunnya , Chirravur Pradeep
Published: December 2024

Background and Aims:

After robotic procedures, one of the most important things that helps patients recover quickly is postoperative pain control. When administered as a truncal block for postoperative analgesia in patients undergoing robotic prostatectomy, the quadratus lumborum block (QLB) can be quite successful. Our study aimed to evaluate the effectiveness of bilateral ultrasound-guided transversus abdominis plane block and bilateral ultrasound-guided QLB for postoperative pain relief following robotic prostatectomy.

Methods:

In this prospective randomised double-blinded study, 50 eligible patients were randomly divided into the QL group (n = 25) and transversus abdominis plane (TAP) group (n = 25). At the end of the surgery, for the QL group, an ultrasound-guided lateral QL block was performed with 20 mL of 0.375% ropivacaine on either side and for group TAP, an ultrasound-guided TAP block was performed with 20 mL of 0.375% ropivacaine on either side. The postoperative visual analogue scale (VAS) score at rest and movement over 12 hours at different intervals and the time to initiate the first rescue analgesia were the primary and secondary objectives, respectively.

Result:

The group that received an ultrasound-guided QL block had a better VAS score both at rest and movement over 12 hours post-surgery. Additionally, the mean duration required to take the first rescue analgesic was 6.1 ± 0.7 hours in the TAP block, while in the QL block group, it was 10.6 ± 0.9 hours, which was statistically significant.

Conclusion:

According to our research, patients who received QL block experienced more effective pain management. Furthermore, the initial rescue analgesia time needed was delayed. Thus, QL block is a useful technique for relieving pain in patients having robotic prostatectomy.
How to Use Instructional Assessments for Explicit Instruction of Text-Writing Fluency
Authors: Datchuk Shawn M. , Young Murphy K. , Allen Abigail A. , Zimmermann Leah M.
Published: December 2024

Many students with learning disabilities (LD) struggle to develop text-writing fluency: the skill of accurately and efficiently composing multiple words into sentences and passages understandable to readers. In prior studies, researchers have used instructional assessments to control for task difficulty and identify precise areas of text-writing fluency to address using explicit instruction. In this article, guidance is provided on how to use instructional assessments—a type of curriculum-based assessment—to inform explicit instruction of text-writing fluency for students with LD. In addition to detailed steps, considerations for implementation and variation are discussed.
Successful Use of Intraoperative Modified Valsalva Maneuver for Atrial Flutter Reversal in Pediatric Cardiac Surgery: Case Report and Review of Literature
Authors: Cruz Suárez Gustavo A. , Pombo Jiménez Andrés , Calderón Miranda Camilo A. , Vélez Moreno Juan F. , Alzate-Ricaurte Sergio , Arias Millán Juan C.
Published: December 2024

This case report describes the successful use of an intraoperative modified Valsalva maneuver to reverse atrial flutter in a pediatric patient with complex congenital heart disease undergoing systemic-to-pulmonary shunt surgery. The technique involved manipulating the Adjustable Pressure Limiting (APL) valve on the anesthesia machine to simulate the hemodynamic effects of the modified Valsalva maneuver, allowing for non-invasive management of supraventricular tachycardia without pharmacological intervention or electrical cardioversion. This intervention stabilized the patient’s arrhythmia, maintaining hemodynamic stability throughout the procedure. The case highlights the potential of the maneuver as a safe, effective, and non-invasive alternative for arrhythmia management in pediatric cardiac surgeries, advocating for further research to validate this approach and possibly integrate it into standard practice for similar clinical scenarios.
Optimizing Surgical Site Infection Prevention in Dermatologic Surgery
Authors: Sapijaszko Mariusz , Samadi Sana , Chow Eunice Y.
Published: December 2024

We aim to review modifiable risk factors and practices for surgical site infections (SSIs) reduction in cutaneous surgeries. The existing norms are assessed with the latest evidence, with the aim of enhancing and optimizing intra and postoperative strategies. This review seeks to offer an updated summary of the results of evidence for SSI reduction strategies tailored for practicing general dermatologists. Searches were conducted for “cutaneous surgery surgical site infection complications” using PubMed Central® and DynaMed®. Articles with pragmatic guideline recommendations were selected. We found evidence for intraoperative factors such as non-sterile gloves, brushless hand scrubbing/simple hand washing, sterile materials, and chlorhexidine gluconate as a skin antiseptic. For postoperative factors, there is a lack of evidence to support the use of topical antibiotic ointments, dressings, or waiting 48 hours before wetting to prevent SSI. Several intra/postoperative factors not specific to dermatologic procedures are briefly discussed for additional context. Several SSI risk factors are inherent to patients or necessary procedures; however, dermatologists have identified modifiable risk factors and developed protocols to mitigate SSI risks intraoperatively and postoperatively. By questioning established practices in cutaneous surgery aimed at preventing SSIs, we can work towards the optimal utilization of resources. This dual-focused approach not only enhances the efficiency of the healthcare system but also diminishes the risks associated with SSIs. It is important to acknowledge that this review does not encompass all factors essential for consideration in these recommendations. Nonetheless, it will approach these factors with an evidence-based lens, placing SSI prevention at the forefront.
‘It depends entirely on the nature of those supports’: Community perceptions of the appropriateness of early support services for autistic children
Authors: Sulek Rhylee , Edwards Chris , Monk Ruth , Patrick Lee , Pillar Sarah , Whitehouse Andrew JO , Waddington Hannah
Published: December 2024

Autistic advocates emphasise the need for neurodiversity-affirming and strengths-based approaches to support services; however, little is known about broader community perspectives regarding the appropriateness of offering early support services to autistic children. This co-designed mixed-methods study employed surveys to gather insights from 253 participants in Australia and New Zealand, including autistic adults, parents, and professionals. Participants shared views on the appropriateness of early support services for autistic children. About half of participants indicated that it was appropriate to provide early support services, while the other half indicated that it depended on the nature of those support services. Reflexive thematic analysis resulted in three overarching themes which explain these views. ‘They are children first, after all’ emphasises the importance of preserving childhood experiences and involving children in decision-making. ‘We shouldn’t be aiming to fix the child’ underscores the need for support services to align with neurodiversity-affirming approaches. Finally, ‘Supports are beneficial’ highlights the perceived positive impact that early, individualised support services can provide for autistic children. These findings predominantly signal a shift away from medicalised models towards a neurodiversity-affirming approach across participant groups.

Lay abstract

We do not know much about what support services people think are okay for young autistic children. This study was a survey of 253 people. We asked autistic adults, parents, and professionals from Australia and New Zealand whether they thought it was okay to provide support services to autistic children. About half the people who shared their thoughts said it was okay to provide support services to autistic children and the other half said it depended on what the support service was like. They had three main ideas about whether support services were okay or not. The first one is that we should remember that these autistic children are children first, so we need to keep their childhood experiences in mind and let them have a say in decisions. The second is that we should not try to ‘fix’ the child, but instead, use supports that respect and understand the unique ways the child thinks. The final idea is that early, personalised help is good for autistic children and can make a positive difference in their lives. This study suggests that we should focus on what each child needs, think about how children can join in, and provide help in ways that respect autistic children.
The geographic frame matters (too): How journalistic role performance varies in domestic, foreign, and mixed news
Authors: Boudana Sandrine , Cohen Akiba A , Mellado Claudia
Published: December 2024

The growing body of comparative studies on journalistic role performance has generally neglected the geographic frame of the news. Based on a content analysis of 145,817 news items published in 365 outlets (print, online, radio, and television) in 37 countries, we compare the performance of six journalistic roles in four geographic frame categories: domestic, foreign, and mixed news (domestic news with foreign involvement and foreign news with domestic involvement). Findings show that the level of the four news categories is equal for the watchdog and civic roles but varies for the others: the service role is more dominant in domestic news; the infotainment role is higher in foreign news; and the interventionist and loyal-facilitator roles are more prevalent in mixed news than in purely domestic or foreign news. These results are moderated by the level of country freedom, which facilitates or constrains the journalists’ performance of the various roles in these news categories. Thus, our study connects the geographic frame to the political contexts of reporting countries, providing a more accurate picture of how journalistic role performance varies in the four news categories. The discussion presents possible explanations for, and theoretical implications of, the findings.