bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Vestibuloocular Reflex Gain and Dynamic Visual Acuity Responsible of Oscillopsia After Complete Unilateral Vestibular Loss?
Authors: Drapier Emeline , Regrain Edwin , Seidermann Laurent , Van Nechel Christian , Labrousse Marc , Kleiber Jean-Charles , Bazin Arnaud , Brenet Esteban , Dubernard Xavier
Published: August 2024

Background

Acute and complete unilateral vestibular deafferentation induces a significant change in ipsilateral vestibuloocular reflex gain, making the patient unable to stabilize gaze during active or passive head movements. This inability creates the illusion that the visual environment is moving, resulting in persistent visual discomfort during rapid angular or linear acceleration of the head. This is known as oscillopsia. Our objective was to understand if the spontaneous sensation of oscillopsias after complete unilateral vestibular deafferentation by vestibular neurotomy at 5 days (D5) and at 3 months (M3) is correlated with the loss of vestibuloocular reflex gain and dynamic visual acuity.

Methods

Retrospective cohort study was conducted in an otolaryngology tertiary care center (2019-2022) on patients with complete unilateral vestibular loss by vestibular neurotomy. They were divided into 2 groups according to the presence (group G1) or absence (group G2) of a spontaneous complaint of oscillopsia assessed at M3. Severity of oscillopsias evaluated by Oscillopsia Severity Questionnaire. Vestibuloocular reflex gain based on video head impulse test (vHIT) and the dynamic visual acuity were measured for each group at D5 and M3. Categorical variables were compared using χ2 test and quantitative variables using the nonparametric Wilcoxon-Mann-Whitney test.

Results

All patients have a complete vestibular deafferentation at D5 and M3. At D5 (G1 = 8 patients, G2 = 5 patients), there is no significant difference for ipsilateral and contralateral vestibuloocular reflex gains and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.68 ± 1.03 in G1 and 1.23 ± 1.03 in G2 ( P < .05). At M3 (G1 = 9 patients, G2 = 6 patients), there is no significant difference between groups for epidemiologic and clinical data and for vestibuloocular reflex and dynamic visual acuity losses. The Oscillopsia Severity Questionnaire was 2.10 ± 0.63 in G1 and 1.24 ± 0.28 in G2 ( P < .05).

Conclusions

The spontaneous disabling sensation of oscillopsia after complete unilateral vestibular loss is well assessed by the Oscillopsia Severity Questionnaire but cannot be explained by objective vestibular tests assessing vestibuloocular reflex gain (vHIT) or dynamic visual acuity loss at D5 or M3. Further studies are needed to measure the sensation of oscillopsia under real-life conditions and to identify the factors responsible for its persistence.

Trial registration:

Retrospectively registered.
Investigation of the Anti-Diabetic Potential of Coccinia barteri (Hook.F.) Leaf Using in Vitro and in Silico Molecular Docking Approaches
Authors: Onugwu Sabastine Obinna , Obi Patrick Ebele , Okoh Ginikachukwu , Onugwu Adaeze Linda , Madubugwu Rosemary Chidera , Osita Tracy , Nnamani Ogochukwu Henrietta , Odoh Uchenna Estella , Ezugwu Christopher Obodike
Published: August 2024

Objectives/Background

Several plants with various chemical constituents have been widely explored for managing diabetes mellitus. One of the most common strategies is the inhibitors of the α-amylase and α-glucosidase, key regulatory enzymes in diabetes. This study aims to investigate the anti-diabetic activity of methanolic extract of Coccinia barteri leaves using in vitro α-amylase enzyme inhibition assay and in silico molecular docking study.

Methods

The dried pulverized leaf of Coccinia barteri was extracted by maceration using methanol. Qualitative and quantitative phytochemical analyses of the powdered leaf extract were carried out using standard procedures. The extract was fractionated using n-hexane, ethyl acetate, n-butanol and aqueous methanol. In vitro anti-diabetic study of the different fractions and sub-fractions was investigated by α-Amylase Inhibition Assay. Sub-fractions of the ethyl acetate fraction of C.barteri leaf with the highest in vitro anti-diabetic activity were subjected to GC-MS analysis. The compounds detected by GC-MS were selected as ligands for α-amylase and α-glucosidase in the molecular docking study.

Results

The phytochemical analysis revealed the presence of saponins, alkaloids, tannins, glycosides, steroids, flavonoids, and cyanide. Compared to the control drug, the ethyl acetate fraction of Coccinia barteri leaf gave a 2-fold lower IC50. GCMS chromatogram of the most active sub-fraction revealed the presence of 18 major compounds. Piperine showed good binding affinity (−6.9 kcal/mol) to α-amylase and displayed hydrogen bonding with ARG 344 and HIS 210, along with pi alkyl bonds with TRP 83, HIS 80, LEU 166, and LEU 232. For α-glucosidase, piperine and 2,4-di-tertbutylphenol surpassed the standard with binding energies of −7.1 kcal/mol and - 6.9 kcal/mol, respectively. Drug likeness and toxicity assessments confirmed adherence to Lipinski's rule, with both compounds showing non-mutagenic and non-tumorigenic properties.

Conclusion

The ethyl acetate fraction of the Coccinia barteri leaf exhibits potential anti-diabetic activity, which may be attributed to the inhibition of α-amylase and α-glucosidase, by its constituents, piperine and 2,4-di-tertbutylphenol.
Comparison of the Efficacy and Safety of 12 Chinese Patent Medicines for Treating Primary Osteoporosis Patients: A Systematic Review and Network Meta-Analysis
Authors: Peng Qinglin , Han Jie , Wu Ruiqi , Wu Yukun , Chen Feng , Lai Yu
Published: August 2024

Objective: To elucidate the effectiveness and safety of different traditional Chinese medicines (TCMs) for treating primary osteoporosis (POP) using network meta-analysis. Materials and Methods: We conducted a systematic review and network meta-analysis to assess the efficacy and safety of Chinese patent medicine (CPM) combined with conventional Western medicine for POP treatment. From March 5, 2004, to March 5, 2024, electronic databases such as the Cochrane Library, VIP, PubMed, Embase, CBM, Wanfang, CNKI, and Web of Science were comprehensively searched. Only randomized controlled trials (RCTs) were included in this systematic review. After screening and data extraction, the Cochrane risk of bias evaluation tool was utilized to assess the methodological quality of the included studies. Stata 15.1 was utilized to synthesize the data. Results: In total, 44 studies involving 4859 patients were included. There were 2577 patients in the treatment group and 2282 in the control group, with 12 types of CPMs. Qing'e Pill, in combination with conventional treatment, significantly improved the total effective rate [relative risk (RR) = 2.57, 95% confidence interval (CI) (1.32, 5.00)]. In combination with conventional treatment, Liuwei Dihuang Pill significantly increased the bone mass density (BMD) of the lumbar spine [WMD = 0.17, 95% CI (0.05, 0.28)] and femoral neck [WMD = 0.23, 95% CI (0.11, 0.35)]. Furthermore, Hugu capsules effectively decreased the VAS score [WMD = −2.48, 95% CI (−3.85, −1.11)]. The presence of the genus Gusongbao markedly decreased the serum ALP concentration [WMD = −15.67, 95% CI (−32.73, 1.39)]. In all studies, no serious adverse reactions were noted, with most studies suggesting only mild gastrointestinal reactions. Conclusions: CPM and conventional treatment combo enhances POP therapy; each CPM offers unique benefits. More high-quality RCTs needed for conclusions. Meds tailored to patient traits in clinics.
Effect of COVID-19 on Injury Incidence and Severity in Professional Female Football Players: A Cohort Prospective Study
Authors: Moreno-Pérez Víctor , Courel-Ibáñez Javier , Oliva-Lozano José María , Celda David Barrachina , Buil Miguel Ángel , Miguel Israel Álvarez , Armada-Cortes Estrella , Gasulla-Angles Pablo , Martínez Honorio Martínez , Sebastía-Paredes Víctor , González-Ródenas Joaquín , Del Coso Juan
Published: August 2024

Background:

Earlier statements suggested a negative impact of coronavirus disease 2019 (COVID-19) infection on sports performance and injury risk. With the COVID-19 pandemic under control and the dominance of a less-severe strain of the virus, there is a need to confirm whether these adverse effects still apply to the current situation.

Hypothesis:

Infected players would have a higher noncontact muscle injury incidence compared with noninfected counterparts.

Study Design:

Cohort observational study.

Level of Evidence:

Level 3.

Methods:

Seven teams (n = 147 players) competing in the Spanish professional women’s football league (Liga F) were prospectively monitored during the 2021-2022 season. Data from noncontact injuries were recorded and classified following the latest consensus statement from the International Olympic Committee. COVID-19 was certified by the medical staff by regular polymerase chain reaction analysis.

Results:

Ninety-two players suffered at least 1 noncontact muscle injury during the season. Injury incidence during the season was similar in players with COVID-19 (n = 83) and players without infection (5.1 ± 6.7 versus 4.9 ± 10.0 injuries/1000 h of play, respectively; P = 0.90). Players with COVID-19 were not more likely to suffer noncontact injuries compared with those players without infection ( R2 = 0.02; odds ratio [OR] 95% confidence interval [95% CI] = 0.36-1.38; P = 0.31). There was no effect of COVID-19 on the days of absence due to injury ( R2 = 0.01; OR 95% CI = 1.00-1.01; P = 0.44) or in the classification of the severity of the injury ( P = 0.79).

Conclusion:

COVID-19 has no significant effect on noncontact injury incidence and severity in professional female football players.

Clinical Relevance:

Currently, COVID-19 infection does not alter noncontact muscle injury risk in professional football and requires no further attention in terms of injury management. Usual return-to-play protocols apply to COVID-19 considering the particularities of each player since the severity of infection, period of inactivity, and effects on the player’s health and performance.
Angle-Specific Analysis of Isokinetic Quadriceps and Hamstring Strength at 6 and 12 Months After Unilateral ACL Reconstruction
Authors: Shi Huijuan , Huang Hongshi , Li Hanjun , Yu Yuanyuan , Ren Shuang , Liu Hui , Ao Yingfang
Published: August 2024

Background:

Quadriceps and hamstring strength deficits are related to the increased risk of reinjury after anterior cruciate ligament reconstruction (ACLR).

Hypothesis:

Knee angle-specific quadriceps and hamstring strength differences would be observed in patients with ACLR 6 and 12 months after surgery.

Study Design:

Case-series.

Level of Evidence:

Level 4.

Methods:

A total of 23 postprimary unilateral ACLR patients followed-up at 6 and 12 months postoperatively and 25 controls were included. Isokinetic knee extension and flexion strength were evaluated at 60 deg/s from 20° to 90°. Statistical parametric mapping were performed to explore the angle-specific strength and the limb symmetry index (LSI).

Results:

At 6 months postoperatively, the reconstructed leg demonstrated lower knee extension and flexion strength than the contralateral (20°-77°, 24°-90°) ( P < 0.01) and control legs (22°-90°, 40°-82°) ( P < 0.01). From 6 months to 12 months, knee extension (60°-90°) and flexion (20°-79°) strength improved in the reconstructed leg ( P < 0.05), while LSI remained unchanged ( P > 0.02). At 12 months, knee extension strength differences persisted in the reconstructed leg compared with the contralateral (20°-81°) and controls (25°-63°) ( P < 0.01). ACLR patients had lower LSI of knee extension strength at 6 (20°-59°) and 12 (24°-57°) months postoperatively than the controls ( P < 0.02).

Conclusion:

The reconstructed leg exhibited differences in knee extension strength compared with the contralateral and control legs. Although bilateral knee extension strength increased from 6 to 12 months postoperatively, LSI did not show improvement during this period.

Clinical Relevance:

Quadriceps restoration was observed only in knee flexion angles greater than 60° compared with controls. Future studies should investigate whether knee extension strength, especially in lower flexion angles, can be enhanced through rehabilitation programs. Furthermore, assessing the impact of this improvement on long-term outcomes and reinjury risk in ACLR patients is warranted.
Enhancement of the impact resistance of masonry walls using fiber-reinforced polymer composites
Authors: Lee Dongkeun , Shin Alex Hak-Chul
Published: August 2024

Many civilian structures are masonry ones. However, masonry walls are susceptible to impact loading. Despite the vulnerability, research on enhancing the impact resistance of masonry walls is substantially scarce, especially under high-velocity impact. Hence, in this study, the effect of fiber-reinforced polymer (FRP) composites on the impact resistance of masonry walls was numerically investigated, especially considering high-velocity impact loading. For this purpose, finite element analysis (FEA) was implemented deploying LS-DYNA. In modeling, the Add Erosion and the Smooth Particle Hydrodynamics options were employed to effectively represent impact behaviors of masonry walls subject high-velocity impact loading. Firstly, the developed masonry wall models were validated by comparing the numerical results with experimental ones. Using the verified numerical models, various parametric studies were performed. The main parameters were the directions and types of fiber, different velocities of an impactor, and the number of impactors. Based on the study, the near-surface-mounted (NSM) FRP method was found to be inefficient in improving the impact resistance of masonry walls. Although the externally-bonded (EB) FRP technique was more effective than the NSM FRP one, the impact behavior varied depending on the types and number of FRP. For instance, strengthening a masonry wall using one layer of high-modulus carbon FRP (HCFRP) EB sheet resulted in the perforation of the HCFRP sheet due to the low ultimate strain of HCFRP sheet. Although one layer of standard CFRP (SCFRP) EB sheet was effective to prevent a masonry wall from being perforated against one impactor, the strengthened masonry wall was penetrated by multiple impactors. It was found that two woven SCFRP EB sheets were optimum to evade the perforation of masonry walls subject to high-velocity impact loading. Furthermore, equations for correlations between the maximum impact force and impact energy are proposed.
Non-invasive assessment of hepatic fibrosis among patients with chronic hepatitis B virus infection in three tertiary hospitals in Nigeria
Authors: Oluwagbenga Oguntoye Oluwatosin , Lukman Olaitan Abdulkareem , Ihiovi Umoru Benedict , Gideon Osasona Oluwadamilola , Maryjoy Ifeorah Ijeoma , Elijah Ariyo Olumuyiwa , Samson Jegede Oluwatosin , Adenike Oguntoye Oluwafunmilayo
Published: August 2024

Objective:

This study aimed to assess hepatic fibrosis, using noninvasive tests, among patients with chronic hepatitis B virus infection in Nigeria.

Methods:

The study was a retrospective cross-sectional, hospital-based, multicentered study. The data of adult Nigerians who were aged 18 years and above who had been diagnosed with chronic hepatitis B infection and were not on treatment were extracted from three tertiary health institutions across Nigeria. Sociodemographic and relevant clinical data were obtained from the case notes of the patients. Fibrosis-4 and aspartate aminotransferase platelet ratio index scores were calculated to determine the presence and severity of liver fibrosis in the patients. The data obtained were analyzed using Statistical Package for the Social Sciences (version 25.0). A p-value of less than 0.05 was considered as statistically significant.

Results:

The data of a total of 234 patients were extracted for this study from across 3 tertiary hospitals in Nigeria. There were 132 (56.4%) males and 102 (43.6%) females in a ratio of 1.29:1 with a mean age of 37.92 ± 12.34 years. The fibrosis-4 score of the patients showed that 62.8% had “Normal/Mild Fibrosis,” 25.6% had “Moderate Fibrosis,” and 11.5% had “Severe Fibrosis/Cirrhosis.” The aspartate aminotransferase platelet ratio index score of the patients showed that 64.1% had “No Fibrosis,” 20.9% had “Mild Fibrosis,” 6.4% had “Moderate Fibrosis,” and 8.5% had “Severe Fibrosis/Cirrhosis.” The median fibrosis-4 score of the patients was 1.18 (0.77–1.74), while the median aspartate aminotransferase platelet ratio index score was 0.40 (0.26–0.69). Liver ultrasonography detected cirrhosis in 8.5% of the patients. All the patients were not yet on treatment for hepatitis B infection.

Conclusion:

The prevalence of hepatic fibrosis is high among patients with chronic hepatitis B virus infection in Nigeria and a large number of these patients were not yet on therapy. Noninvasive assessment of hepatic fibrosis should be considered as a critical part of the work-up of patients with chronic hepatitis B infection.
Validity of the Smombie Scale: Sensitivity and specificity in identifying pedestrian risk group
Authors: Oh Sumi , Park Sunhee
Published: August 2024

Objective

The objective of this study was to determine the most effective cut-off point for the Smombie Scale and evaluate its ability to screen for pedestrian safety risks among young adults.

Methods

Data were obtained from an online sample of 396 Korean young adults aged 18–39 years. Latent profile analysis was used to distinguish the risk group as a reference measure for the Smombie Scale. Discriminative power was assessed using sensitivity, specificity, receiver operating characteristic (ROC) curves, and the area under the ROC curve. The cut-off points were estimated from the Youden index and the balanced score.

Results

The latent profile analysis showed two different classes: “risk group” of 17.8% and “others.” Based on the latent profile analysis, sensitivity, and specificity analysis showed that an adequate cut-off point of 2.78 of five points or higher was associated with a high risk of distracted walking.

Conclusion

The Smombie Scale is a good predictor of problematic smartphone use on the road and can be used as a screening tool for assessing risk levels among young adult pedestrians.
A Multidisciplinary Approach to Staphylococcus aureus Triple-Valve Infective Endocarditis With Multi-Organ Involvement
Authors: Mansouri Seena , Sulaiman Zoheb Irshad , Chao Andrew W.
Published: August 2024

Multivalvular endocarditis is a rare and potentially fatal complication that can occur in people who inject drugs. Currently, there are few cases that have been studied or reported in literature. A complication of this manifestation that worsens prognosis and treatment is the distribution of septic emboli throughout the body which highlights the dissemination of the infection. There are no specific guidelines on the treatment of multivalvular endocarditis, but its complexity can present challenges in administering medical and surgical treatment. In this case of a 37-year-old man with infective endocarditis of 3 valves, a comprehensive work-up found septic emboli in the lungs, kidneys, ribs, spine, and brain with ophthalmologic involvement that resulted in visual impairment. This case highlights important complications that can occur with septic emboli and management of these issues using a multidisciplinary approach including the treatment of substance use disorder.
A View in the Dark: Two Cases of Acute Esophageal Necrosis in the Setting of Diabetic Ketoacidosis
Authors: Bathobakae Lefika , Bashir Rammy , Patel Dhruv , Wilkinson Tyler , Mekheal Nader , Melki Gabriel , Cavanagh Yana , Baddoura Walid
Published: August 2024

Acute esophageal necrosis (AEN), also known as Gurvits syndrome, is a rare and potentially life-threatening condition characterized by necrosis of the esophageal mucosa. Acute esophageal necrosis is often associated with critical conditions, such as myocardial infarction, diabetic ketoacidosis (DKA), coronavirus disease 2019 (COVID-19) infection, or post-surgical complications. Patients typically present with nausea, hematemesis, acute dysphagia, and melena. Given its high mortality rate, prompt detection with upper endoscopy and early initiation of treatment are crucial. Most cases of Gurvits syndrome are managed conservatively using intravenous fluids, proton pump inhibitors, and antibiotics. Herein, we present a case series of AEN in the setting of DKA. Both patients received supportive care and were discharged in a stable condition.
Malay Translation and Validation of the Oslo Sports Trauma Research Center Questionnaire on Health Problems
Authors: Hadi Wan Ikram Shah bin , Mohamed Mohd Nahar Azmi bin , Ahmad Shushami Ahmad Hazwan bin , Abdul Karim Samihah binti
Published: August 2024

Background:

The Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H) is a proven surveillance method to register acute injury, overuse injury, or illness in athletes. However, it has not yet been translated into Malay.

Purpose:

To translate, culturally adapt, and validate the OSTRC-H into Malay using internationally established guidelines.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

The Malay translation of the OSTRC-H (OSTRC-H.M) was distributed to 54 elite (ie, professional) and recreational athletes. Face validity, content validity, and construct validity were assessed for the validity measurement properties, while test-retest and internal consistency were used for reliability measurement properties.

Results:

The content validity index was satisfactory at 0.93. The OSTRC-H.M showed good internal consistency, with a Cronbach α value of .84. Confirmatory factor analysis showed a good model for construct validity, with values of 0.99 and 0.04 for comparative fit index and root mean square error of approximation, respectively. Per-item intraclass correlation coefficients (ICCs) for test-retest reliability ranged from 0.55 to 0.80. The overall test-retest reliability of the questionnaire was good (ICC, 0.8; 95% CI, 0.63-0.88; P < .001).

Conclusion:

The OSTRC-H.M was found to be valid and reliable and therefore acceptable for application among Malay-speaking athletes.
Persistent hypomagnesaemia caused by HNF1B-MODY in a patient on platinum-based chemotherapy: A case report and review
Authors: Hayes Michael , Holian John
Published: August 2024

We report a case of a 60 year-old female with persistent refractory hypomagnaesemia caused by HNF1B gene deletion. Her hypomagnaesemia had been attributed to the use of adjuvant platinum chemotherapy administered 2 years previously following a haemicolectomy for colorectal cancer. However it emerged that she had HNF1B gene deletion and had been diagnosed with MODY thirteen years previously. Her hypomagnaesemia was in fact longstanding and predated chemotherapy use. Previous abdominal imaging showed bilateral renal cysts and uterine didelphys which are consistent with anatomical features of HNF1B dysfunction. Her hypomagnaesemia is most likely related to HNF1-MODY. She continues to be managed with regular magnesium infusions and will likely require this as a lifelong measure. This case served as a reminder to look beyond medications as a potential cause for hypomagnesaemia and consider rare genetic conditions.
Decoy politics: How settler states deflect Indigenous threats
Authors: Collie James , Alcantara Christopher
Published: August 2024

Anglo settler states like Australia, Canada, New Zealand and the United States were built through the dispossession of Indigenous lands and through the disruption of Indigenous political, social and economic systems. Over time, however, Indigenous nations have challenged the unjust foundations of these states, forcing settler states to respond with repression but also with accommodation, especially in the face of successful Indigenous mobilization. Yet even during these moments, state actors have resisted changes to state sovereignty, sometimes by creating new institutions that seem responsive, but which simply reinforce the status quo. To make sense of these moments, we introduce the concept of “decoy politics” and develop a theory for why states might turn to decoy politics, with a particular focus on Canada. Our findings suggest decoy politics may help explain why reconciliation with Indigenous nations remains difficult despite seemingly genuine attempts at meaningful institutional and policy change.
Unraveling the mystery of urban expansion in the Guangdong-Hong Kong-Macao Greater Bay Area: Exploring the crucial role of regional cooperation
Authors: Zhang Xianchun , Zou Yucheng , Xia Chang , Lu Ya’nan
Published: August 2024

Existing scholarship extensively explores the dynamics, determinants, and consequences of urban expansion, yet there is scant literature examining the impact of regional cooperation upon the directions and spatial forms of urban expansion amidst the fast-urbanizing process. This study focuses on the Guangdong-Hong Kong-Macao Greater Bay Area (GBA), a developed megacity-region in southern China, to probe whether the notable urban expansion observed in contemporary China has been profoundly influenced by collaborative efforts among jurisdictions. Through the spatial metrics and panel data regression spanning the period from 2010 to 2018, this study unveils that regional cooperation has extended from coastal cities towards hinterland cities within the GBA. Consequently, urban land in most cities has undergone expansion in diverse directions. Furthermore, in contrast to economic and social cooperation, regional institutional cooperation emerges as the most influential factor driving external urban expansion. Additionally, heterogeneous results reveal that regional cooperation drives the external expansion of ordinary cities towards core cities. In contrast, the inertia within the urban system demonstrates strong path dependence on the pattern of adjacent expansion, contrasting with the external expansion facilitated by regional cooperation. In summary, this study illuminates the genesis and dynamics of urban expansion amid the city-regionalization process, going beyond interpretations confined to the municipal scale.
The waste of nations: Household trash and the affective politics of recycling in Israel
Authors: Fried Talia
Published: August 2024

Solid waste treatment is an acute concern for countries facing waning landfilling capacity, increasingly strict controls on waste transport and treatment, and the persistent threat of climate change. These challenges are typically met by neoliberal and technocratic solutions that privatize public services while encouraging curbside recycling. I examine such an effort to promote curbside recycling in Israel. Drawing on extensive fieldwork in the Israeli recycling world, and on anthropology, geography, science and technology studies and critical waste studies literatures, I interrogate the affective politics of household waste recycling in Israel over the past decade and attempts to configure a Europeanized and moral national space through recycling. I describe the cultural and ethnonational repertoires through which curbside recycling was naturalized in the Israeli landscape, how recycling was mutually animated with a range of sociopolitical concerns that far exceeded its financial or environmental significance, and how these mutually shaped waste as a social–environmental problem. I argue that social and material conditions gave rise to a dual process, in which both the problem of waste, and its necessary solutions, were actively and mutually constructed. This paper contributes to comparative literatures on national cultures of waste recycling, shedding light on how a project of Western ecological modernization was translated and became locally meaningful in Israel's settler-colonial context, how household waste was ontologically coproduced in this process, and how its stakes were experienced, voiced, and materialized.
The effectiveness of opioid stewardship interventions in healthcare: A Making Healthcare Safer rapid review
Authors: Waldfogel Julie M , Rosen Michael A , Sharma Ritu , Zhang Allen , Bass Eric B. , Dy Sydney M
Published: August 2024

Objective

Opioid stewardship interventions promote appropriate use of opioids. We synthesized evidence from recent studies on the effectiveness of opioid stewardship interventions in United States healthcare settings on opioid prescribing and clinical outcomes.

Methods

We followed the Evidence-based Practice Center Program's rapid review processes. We searched PubMed and Cochrane for original studies meeting specified inclusion criteria from January 2016 (correlating with the Centers for Disease Control and Prevention Pain Guidelines) to April 2023, supplemented by gray literature searches.

Findings

Our search identified 13 randomized controlled trials and 6 nonrandomized studies. Randomized controlled trials addressed interventions involving multiple components (typically combining prescriber education, care management, and facilitated access to resources), clinical decision support (CDS) or electronic health records (EHR), and patient education and engagement, mainly in ambulatory chronic pain. Multicomponent interventions and opioid stewardship practices involving CDS or EHR were associated with decreased opioid prescribing or reduced doses and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence for all outcomes). Patient engagement and education interventions had mixed results for opioid prescribing outcomes (insufficient strength of evidence) and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence).

Conclusions

Selected opioid stewardship interventions may be effective for reducing opioid prescribing without adversely affecting clinical outcomes. Interventions to reduce opioid prescribing should monitor unintended consequences and include access to nonpharmacological pain management resources with patient education and engagement.
Association between TNF-α, cortisol levels, and exposure to PM10 and PM2.5: a pilot study
Authors: Dolcini Jacopo , Landi Rosaria , Ponzio Elisa , Picchini Laura , Luciani Aurora , Formenti Luca , Svegliati Baroni Silvia , Gabrielli Armando , D’Errico Marcello Mario , Barbadoro Pamela
Published: August 2024

Purpose

The most harmful atmospheric pollutant for human health is particulate matter (PM). We analyzed the correlation between short-term lag exposure to PM10 and PM2.5, salivary cortisol and TNF-α level, and methylation levels of the TNF-α promoter.

Methods

A pilot study including 20 subjects. Eight salivary samples for each subject at various times of the day were collected for comparing cortisol levels and TNFα detection. TNFα promoter methylation levels on salivary DNA were analyzed. Regression analyses were performed using generalized linear mixed models between the different outcomes and 4, 3, 2 and 1 day’s lag values of PM10/PM2.5.Generalized additive mixed model (GAMM) was used to evaluate any potential deviation from linearity.

Results

Area under the curve with respect to the ground (AUCg) showed a statistically positive association with 4-, 3-, 2-, and 1-day lag of exposure to PM10. Area under the curve with respect to the increase (AUCi) showed a statistically negative association with 4-, 3- and 1-day lag of exposure to PM10. TNFα showed statistically significant association with both exposures, PM10 and PM2.5, at 4-, 3-, 2-, and 1-day lag.

Conclusions

Regarding cortisol levels there is an increase of overall hormone levels but a less dynamism of the system to answer to external stressors. Increase of TNF-α may reflect increased levels of oxidative stress and inflammation due to pollution exposure.
Biosynthesized silver nanoparticles mediated by Ammi visnaga extract enhanced systemic resistance and triggered multiple defense-related genes, including SbWRKY transcription factors, against tobacco mosaic virus infection
Authors: Aseel Dalia G. , Ibrahim Omar M. , Abdelkhalek Ahmed
Published: August 2024

Background

Tobacco mosaic virus (TMV) is a highly infectious plant virus that affects a wide variety of plants and reduces crop yields around the world. Here, we assessed the effectiveness of using Ammi visnaga aqueous seed extract to synthesize silver nanoparticles (Ag-NPs) and their potential to combat TMV. Different techniques were used to characterize Ag-NPs, such as scanning and transmission electron microscopy (SEM, TEM), energy-dispersive X-ray spectroscopy (EDS), fourier transform infrared spectroscopy (FTIR), and dynamic light scattering (DLS).

Results

TEM demonstrated that the synthesized Ag-NPs had a spherical form with an average size of 23–30 nm and a zeta potential value of -15.9 mV, while FTIR revealed various functional groups involved in Ag-NP stability and capping. Interestingly, the Pre-treatment of tobacco plants (protective treatment) with Ag-NPs at 100–500 µg/mL significantly suppressed viral symptoms, while the Post-treatment (curative treatment) delayed their appearance. Furthermore, protective and curative treatments significantly increased chlorophyll a and b, total flavonoids, total soluble carbohydrates, and antioxidant enzymes activity (PPO, POX and CAT). Simultaneously, the application of Ag-NPs resulted in a decrease in levels of oxidative stress markers (H2O2 and MDA). The RT-qPCR results and volcano plot analysis showed that the Ag-NPs treatments trigger and regulate the transcription of ten defense-related genes (SbWRKY-1, SbWRKY-2, JERF-3, GST-1, POD, PR-1, PR-2, PR-12, PAL-1, and HQT-1). The heatmap revealed that GST-1, the primary gene involved in anthocyanidin production, was consistently the most expressed gene across all treatments throughout the study. Analysis of the gene co-expression network revealed that SbWRKY-19 was the most central gene among the studied genes, followed by PR-12 and PR-2.

Conclusions

Overall, the reported antiviral properties (protective and/or curative) of biosynthesized Ag-NPs against TMV lead us to recommend using Ag-NPs as a simple, stable, and eco-friendly agent in developing pest management programs against plant viral infections.
A randomised, two-arm (1:1 ratio), double blind, placebo controlled phase III trial to assess the efficacy, safety, cost and cost-effectiveness of Rituximab in treating de novo or relapsing NS in patients with MCD/FSGS (TURING)
Authors: C Willcocks Lisa , Qian Wendi , Cader Ruzaika , Gatley Katrina , Siddiqui Hira , Tabebisong Endurance , Champion Karlena , Kronbichler Andreas , Lightstone Liz , Jayne David , Wilson Edward , Griffith Megan
Published: August 2024

Background

Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) are a spectrum of disease causing the nephrotic syndrome (NS), characterised by proteinuria with debilitating oedema, as well as a high risk of venous thromboembolic disease and infection. Untreated, 50–60% patients with FSGS progress to end stage kidney disease after 5 years. These diseases respond to immunosuppression with high dose glucocorticoids, but 75% will relapse as the glucocorticoids are withdrawn, leading to significant morbidity associated with prolonged use. In children, the B cell depleting monoclonal antibody rituximab reduces relapse risk, but this drug has not been tested in randomised controlled trial in adults.

Methods

130–150 adults with new or relapsing MCD/FSGS, from UK Renal Units, are being randomised to receive either rituximab (two 1 g infusions two weeks apart) or placebo. Partipicipants are recruited when they present with nephrosis, and all are treated with glucocorticoids as per KDIGO guidelines. Once in remission, prednisolone is withdrawn according to a pre-specified regimen. If in remission at 6 months, participants receive a further dose of trial drug. If they relapse, they are unblinded, and if they have received placebo, they are offered open label rituximab with protocolised prednisolone as in the main phase of the trial. The primary end point is time from remission to relapse. A number of secondary endpoints will be assessed including the effect of rituximab on: (1) NHS and societal resource use and hence cost: (2) safety: (3) other measures of efficacy, such as achievement of partial and complete remission of NS and the preservation of renal function: (4) health status of participant.

Trial Registration

TURING received ethical approval on 14 Jun 2019 - REC reference: 19/LO/0738. It is registered on EudraCT, with ID number: 2018-004611-50, with a start date of 2019-06-14.
Local government interventions for improving the health and wellbeing of tenants in private rented housing: developing initial program theory to inform evaluation in the United Kingdom
Authors: McClatchey Rachael , Ferraro Claire F. , Turner Ellis , Harris Jennifer , Banks Jonathan
Published: August 2024

Background

Housing is an important wider determinant of health. Private Rented Sector (PRS) housing is generally the worst quality of housing stock across tenures. Although a wide range of interventions are available to local governments to manage and improve the quality of PRS housing and therefore the health of tenants, there is limited evidence about the extent to which these are used. This study aims to explore what drives the use of different interventions in different local governments, to better understand and inform local strategies.

Methods

As the first realist evaluation on this topic, the range of available interventions was informed by a Local Government Association toolkit. Consistent with realist approaches, retroductive analysis of intervention-context-mechanism-outcome configurations helped to develop and refine Initial Programme Theories (IPTs). Data sources included local government housing documents, a survey and eleven semi-structured interviews with housing officers.

Results

Using data for 22 out of the 30 local governments in the South West region of the United Kingdom, eight IPTs were developed which act on different levels from individual PRS team leaders to system wide. The IPTs include a belief in market forces, risk adverse to legal challenge, attitude to enforcement, relational approaches to partnership working, job security and renumeration, financial incentives drive action, and system-level understanding of the drivers of poor health, inequalities and opportunities for cost-savings. The findings suggest that limited objective health outcomes are being used to understand impact, which hinders interpretation of the effectiveness of all mechanisms.

Conclusion

Interventions that bring about positive outcomes in managing PRS housing are unlikely to be universal; they depend on the context which differs across place and over time. The proposed IPTs highlight the need for strategies to be tailored considering the local context and should be evaluated in subsequent phases of study.
Citizens’ perspectives on healthy weight approaches in low SEP neighborhoods: a qualitative study from a systems perspective
Authors: ter Bogt Maud J. J. , Te Riele Yentl Z. , Kooijman Piet G. C. , Heszler Anita N. , van der Meer Saskia , van Roon Rob , Molleman Gerard R. M. , van den Muijsenbergh Maria , Fransen Gerdine A. J. , Bevelander Kirsten E.
Published: August 2024

Background

The physical and the social environment are important predictors of healthy weight, especially in low socioeconomic position (SEP) neighborhoods. Many Dutch municipalities have implemented a healthy weight approach (HWA). Yet, there is room for improvement. This system science study examined what influences the utilization of HWA facilities and activities, and what aspects can help to achieve a desired systems change (also called leverage point themes (LPTs)) in the HWA system as perceived by citizens living in low SEP neighborhoods.

Method

All research phases were performed with four citizens co-researchers. Forty-seven citizens living in low SEP neighborhoods were semi-structurally interviewed about the neighborhood HWA facilities and municipal HWA activities. A rapid coding qualitative analysis approach was applied per topic. The topics were citizens’ healthy living description, personal circumstances, and satisfaction with foot and cycle paths, sports facilities, playgrounds, green spaces, museums and theaters, community centers, churches, healthcare, school, food supplies, contact with neighborhood, unfamiliar and/or unused activities, familiar and used activities, unavailable but desired (lacking) activities, and reaching citizens.

Results

The utilization of HWA facilities and activities was influenced by the overarching themes of social cohesion, familiarity, reaching citizens, maintenance, safety, physical accessibility, financial accessibility, social accessibility, fit with personal context, and fit with the neighborhood’s specific needs. Different overarching themes stood out across different facilities and activities. LPTs indicated the overarching themes needed in combination with one another for a specific activity or facility to increase utilization. For example, the LPT regarding foot and cycle paths was “accessible, safe, and maintained foot and cycle paths”. The LPTs regarding familiar and used activities were “customized activities; information provision (e.g., about possibilities to join without paying); social contact, meeting others, and everyone feels included”.

Conclusion

Conducting inclusive qualitative research from a systems perspective among citizens living in low SEP neighborhoods has contributed valuable insights into their needs. This enables practical implementation of HWAs by providing a deeper understanding of the LPTs within the HWA system. LPTs can help HWA stakeholders to further develop current HWAs toward systems approaches. Future research could study the leverage points that may contribute to LPT implementation.
Five years on: analysis of university lecturers’ experiences of the French government’s health promotion education program
Authors: Monpierre Mathilde , Frachon Adèle , Eguiluz Alexandra , Martinot Pauline , Tenenbaum Annabelle
Published: August 2024

Background

The National Health Promotion Intervention Program by Student (HPIPS) is a French government educational program introduced in 2018, aiming at developing all health students’ health promotion knowledge and abilities, as well as implementing health promotion interventions for specific subpopulations in the general public. Its pedagogical framework was elaborated in 2018 and then evaluated by the French Council for Public Health in 2022, highlighting certain difficulties for the program to be homogeneously implemented in France. The aim of this study was to explore and describe the experiences and feedback of university lecturers in charge of this HPIPS training.

Methods

Semi-structured interviews were conducted with HPIPS lecturers from various health fields and from French universities, and a qualitative content analysis was carried out.

Results

Fourteen interviews were conducted during the autumn of 2022 with HPIPS program university lecturers including five doctors, three dentists, two nurses, two pharmacists, one midwife, and one physiotherapist from eight different towns belonging to six regions. Depending on the professional background, the component, and the local resources available, the teaching experience varied from one lecturer to another. A number of difficulties arose in setting up this educational program and complying with the latter legislation. The work overload was considerable, and the lecturers’ heavy commitments some lecturers to be discouraged, especially since some lecturers were not trained in health promotion abilities. Although interprofessionality was a strength of this HPIPS, it was also its main challenge. Pedagogical innovations were developed, notably through the use of digital technology; cross-disciplinary collaboration was established; and lecturers–students specific boundaries have emerged thanks to this health promotion project.

Conclusions

In France, setting up the HPIPS rapidly was experienced as a real pedagogical challenge for the interviewed university lecturers. While most of them noted the positive and beneficial contributions made by the introduction of prevention and health promotion intervention skills for health students, they also shared recommendations in order to match the ambitions and increase the HPIPS impact on the development of a culture of prevention and health promotion among health students.
Improving selection procedures in health professions education from the applicant perspective: an interview study
Authors: Fikrat-Wevers S. , Stegers-Jager K. M. , Mulder L. M. A. , Cheung J. , Van Den Broek W. W. , Woltman A. M.
Published: August 2024

Introduction

Applicant perceptions of selection impact motivation and performance during selection, and student diversity. However, in-depth insight into which values underly these perceptions is lacking, creating challenges for aligning selection procedures with applicant perceptions. This qualitative interview study aimed to identify values applicants believe should underlie selection, and how, according to applicants, these values should be used to make specific improvements to selection procedures in undergraduate health professions education (HPE).

Methods

Thirty-one applicants to five undergraduate HPE programs in the Netherlands participated in semi-structured interviews using Appreciative Inquiry, an approach that focuses on what goes well to create vision for improvement, to guide the interviews. Transcriptions were analyzed using thematic analysis, adopting a constructivist approach.

Results

Applicants’ values related to the aims of selection, the content of selection, and the treatment of applicants. Applicants believed that selection procedures should aim to identify students who best fit the training and profession, and generate diverse student populations to fulfill societal needs. According to applicants, the content of selection should be relevant for the curriculum and profession, assess a comprehensive set of attributes, be of high quality, allow applicants to show who they are, and be adapted to applicants’ current developmental state. Regarding treatment, applicants believed that selection should be a two-way process that fosters reflection on study choice, be transparent about what applicants can expect, safeguard applicants’ well-being, treat all applicants equally, and employ an equitable approach by taking personal circumstances into account. Applicants mentioned specific improvements regarding each value.

Discussion

Applicants’ values offer novel insights into what they consider important preconditions for the design of selection procedures. Their suggested improvements can support selection committees in better meeting applicants’ needs.