bluuebunny/crossref_metadata_2025 huggingface dataset:
The concomitant use of the renin–angiotensin system inhibitors and survival outcomes of patients with pancreatic adenocarcinoma: an analysis from a tertiary center
Authors: Tseng Kuan-Yu , Hsu Chiann-Yi , Shih Yu-Hsuan , Lin Hsin-Chen , Li You-Cheng , Jerry Teng Chieh-Lin , Chou Cheng-Wei
Published: May 2024

Background:

The limited efficacy of chemotherapy in improving survival in pancreatic ductal adenocarcinoma (PDAC) necessitates the exploration of novel strategies to overcome treatment resistance.

Objectives:

This study aimed to investigate the impact of combining renin–angiotensin system (RAS) blockers with chemotherapy on survival outcomes in patients with PDAC.

Design:

Patients with PDAC were enrolled in the retrospective study.

Methods:

We analyzed patients with PDAC ( n = 384) at our institution between 2014 and 2021. Survival outcomes, including event-free survival (EFS) and overall survival (OS), were analyzed according to the concomitant use of RAS blockers.

Results:

Among the 384 patients in the study, 70 (18.2%) concomitantly received angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Patients in the ACEI/ARB group, characterized by older age and more comorbidities, displayed a significantly superior 12-month EFS rate (22.86% versus 13.69%, p = 0.008) compared to the non-ACEI/ARB group, while OS remained similar between the groups. In the multivariate analysis, the use of ACEI/ARB was associated with better 12-month EFS (hazards ratio = 0.71, 95% confidence interval: 0.52–0.96; p = 0.024). Poor performance, advanced disease status, and higher CA19-9 levels were associated with poor survival outcomes.

Conclusion:

Concomitant use of ACEIs/ARBs in patients with pancreatic cancer resulted in significantly better 12-month EFS. Age, performance status, disease status, and higher CA19-9 levels were independent predictors of survival. The combination strategy might provide better treatment outcomes in patients with PDAC.
Assessing Electoral Personalism in Latin American Presidential Elections
Authors: Luján Diego , Acosta y Lara Federico
Published: May 2024

Latin American democracies have been characterised as the product of personalistic leaders relying on their unique qualities to achieve and maintain political power. However, this characterisation has lacked conceptual and empirical development since the term “personalism” has been used to account simultaneously for a particular type of electoral appeal seeking to mobilise and persuade voters and for the concentration of power in a single political leader. This article advances in conceptualising electoral personalism as a strategy followed by political elites appealing to voters based on the personal characteristics of leaders and candidates, distinguishing it from personalisation as the concentration of power in a single leader. Based on statistical analysis, we propose two novel indicators of electoral personalism and assess its prevalence among Latin American countries. The article also advances in exploring its political, economic, and social determinants at the aggregate and individual levels.
Changes in Chemical Constituents and Kidney-Yang Tonifying of Traditional Herbs After Processing: A Brief Review
Authors: Truong Minh-Nhut , Nguyen Thi Hong-Hieu , Tran Hoang-Huy , Le Thi Lan-Phuong
Published: May 2024

Background

Kidney-Yang deficiency is one of the common medical syndromes in traditional medicine, characterized by symptoms such as weakness, coldness in the lower back and knees, cold, fatigue, etc. In clinical practice, Yang tonifying medicines are often used to treat patients with Kidney-Yang deficiency. Moreover, the medicinal processing method according to the principles of traditional medicine can enhance the effects on the Kidney of these herbs. This brief overview aims to gather and assess the post-processing modifications to the chemical composition and the kidney-Yang tonifying effects of specific traditional herbal remedies.

Methodology

Firstly, all kidney-Yang tonifying herbs were collected. Next, the selection was made based on the herbs with processing procedures specified in Circular 30/2017/TT-BYT issued by the Vietnamese Ministry of Health. All studies on the chemical composition and/or effects of processed drugs were searched in the PubMed and Google Scholar databases using the search formula: processed + scientific name of herbal medicine. Finally, among the studies on the changes in effects after processing, only studies on the tonifying Yang effect were included in this review.

Results

The kidney Yang-nourishing effects of the five traditional herbal medicines prescribed in Circular 30/2017/TT-BYT by the Ministry of Health of Vietnam (Radix Morindae officinalis, Cortex Eucommiae, Herba Cistanches, Semen Cuscutae, and Radix Dipsaci) have been demonstrated through several studies and summarized. From the PubMed and Google Scholar databases, 25 studies were collected for the review. Additionally, the changes in composition and content of certain active compounds in these herbal medicines have also been searched and reported.

Conclusion

This report provides a brief overview of the differences between chemical constituents and kidney-Yang tonifying of some traditional herbs after processing to partially contribute scientific evidence for standardizing the preparation processes and serve as an important reference for clinical practitioners of traditional medicine.
Adverse event profiles of drug-induced liver injury caused by antidepressant drugs: a disproportionality analysis
Authors: Jiang Aidou , Wei Chunyan , Zhu Weiwei , Wu Fengbo , Wu Bin
Published: May 2024

Background:

Antidepressants are widely used to manage depression and other psychiatric diseases. A previous study revealed that hepatotoxicity was the main adverse event related to antidepressants. Therefore, drug-induced liver injury (DILI) caused by antidepressants deserves more attention.

Objectives:

To investigate DILI adverse events reported due to antidepressant use in the United States Food and Drug Administration Adverse Events Reporting System (FAERS) database.

Research design:

A disproportionality analysis of spontaneously reported adverse events was conducted to assess the association between antidepressant drugs and DILI.

Methods:

FAERS data from 1 January 2004 to 31 December 2021 were compiled and analyzed using the reporting odds ratio (ROR) and information component (IC).

Results:

As per the FAERS database, of the 324,588 cases that were administered antidepressants, 10,355 were identified as cases with DILI. Among the identified 42 antidepressants, nefazodone ( n = 47, ROR = 7.79, IC = 2.91), fluvoxamine ( n = 29, ROR = 4.69, IC = 2.20), and clomipramine ( n = 24, ROR = 3.97, IC = 1.96) had the highest ROR for cholestatic injury; mianserin ( n = 3, ROR = 21.46, IC = 3.99), nefazodone ( n = 264, ROR = 18.67, IC = 3.84), and maprotiline ( n = 15, ROR = 5.65, IC = 2.39) for hepatocellular injury; and nefazodone ( n = 187, ROR = 12.71, IC = 0.48), clomipramine ( n = 35, ROR = 2.07, IC = 0.26), and mirtazapine ( n = 483, ROR = 1.96, IC = 0.94) for severe drug-related hepatic disorders. Only nefazodone elicited hepatic failure signals ( n = 48, ROR = 18.64, IC = 4.16). There are limited reports on the adverse reactions of relatively new antidepressant drugs, such as milnacipran, viloxazine, esketamine, and tianeptine, and those not approved by the Food and Drugs Administration, such as reboxetine and agomelatine.

Conclusion:

A significant association was observed between DILI and nefazodone. Duloxetine and clomipramine were associated with three DILI categories, except hepatic failure. The disproportionality analysis cannot conclude on a definite causal link between antidepressants and DILI. Additional research is required to assess new-generation antidepressants for their propensity to cause DILI.
Analysis of self-regulated learning strategies used by online learners
Authors: Öztürk Mücahit , Türker Pınar Mıhcı
Published: May 2024

This study is a qualitative survey research that examines the self-regulated learning strategies used by students in the blended online learning process. Participants were made up of 67 pre-service teachers studying at a faculty of education. A questionnaire form was used to determine students’ self-regulated learning strategies. The self-regulated learning strategies were classified under three themes: before the lesson, during the lesson, and after the lesson. The strategies used before the lessons were organizing the environment, planning, motivating oneself, and physiological and psychological readiness. During the online lessons, students used strategies such as taking notes, attention focusing, help seeking, effort management, self-discipline, taking a break, and time management. After the lessons, students used strategies such as reviewing records, organizing and transforming, practicing, working with additional resources, help seeking, self-testing, and completing tasks. Furthermore, the study results that were revealed to be different from the results of similar studies were discussed and recommendations for future studies were made. In addition, the study revealed that the strategies used by the students differed according to their communication modes. While synchronous and blended groups used more self-regulated learning strategies, asynchronous students used less self-regulated learning strategies.
Clinical characteristics, outcome, and factors associated with mortality of pulmonary mucormycosis: a retrospective single-center study from Pakistan
Authors: Khalid Rameesha , Khanum Iffat , Habib Kiren , Ali Akbar Shoukat , Farooqi Joveria , Iqbal Nousheen , Ejaz Taymmia , Jabeen Kauser , Irfan Muhammad
Published: May 2024

Introduction and objective:

Pulmonary mucormycosis is a rare but rapidly progressive fatal disease. Limited data exist on the outcomes and factors associated with poor prognosis of pulmonary mucormycosis. The objective of this study was to evaluate clinical characteristics, factors associated with mortality, and outcomes of pulmonary mucormycosis at a tertiary care hospital in Pakistan.

Methods:

This was a retrospective observational study conducted at a tertiary care hospital in Karachi, Pakistan. Medical records of hospitalized patients diagnosed with proven or probable pulmonary mucormycosis between January 2018 and December 2022 were reviewed. Univariate and regression analyses were performed to identify factors associated with mortality.

Results:

Fifty-three pulmonary mucormycosis patients (69.8% male) were included, with mean age of 51.19 ± 21.65 years. Diabetes mellitus was the most common comorbidity [ n = 26 (49.1%)]. Chronic lung diseases were present in [ n = 5 (9.4%)], and [ n = 16 (30.2%)] had concurrent coronavirus disease 2019 (COVID-19) pneumonia. The predominant isolated Mucorales were Rhizopus [ n = 32 (60.3%)] and Mucor species [ n = 9 (17%)]. Main radiological findings included consolidation [ n = 39 (73.6%)] and nodules [ n = 14 (26.4%)]. Amphotericin B deoxycholate was prescribed in [ n = 38 (71.7%)], and [ n = 14 (26.4%)] of patients received combined medical and surgical treatment. The median [interquartile range (IQR)] hospital stay was 15.0 (10.0–21.5) days. Intensive care unit (ICU) care was required in [ n = 30 (56.6%)] patients, with 26 (49.1%) needing mechanical ventilation. Overall mortality was seen in 29 (54.7%) patients. Significantly higher mortality was found among patients requiring mechanical ventilation 20/29 (69%, p = 0.002). Immunosuppression ( p = 0.042), thrombocytopenia ( p = 0.004), and mechanical ventilation ( p = 0.018) were identified as risk factors for mortality on multivariable analysis.

Conclusion:

This study provides essential insights into the clinical characteristics, outcomes, and mortality factors associated with pulmonary mucormycosis. The mortality rate was high (54.7%), particularly in patients with immunosuppression, thrombocytopenia, and those who required mechanical ventilation.
Cost-effectiveness of l-glutamine versus crizanlizumab for adults with sickle cell disease: model focused on reducing pain episode costs from Qatar’s healthcare perspective
Authors: Adel Ahmad M , Abushanab Dina , Al-Badriyeh Daoud , Hamad Anas , Alshurafa Awni , Yassin Mohamed A
Published: May 2024

Objectives:

Treatment options for preventing vaso-occlusive crises among sickle cell disease patients are on the rise, especially if hydroxyurea treatment has failed. This economic analysis is conducted to assess the comparative clinical effectiveness, safety, and acquisition cost of l-glutamine and crizanlizumab for older adolescents and adults (⩾16 years old) with sickle cell disease in Qatar, with an emphasis on treatment costs and acute pain crises.

Methods:

We conduct a decision-tree model, where we compare the clinical and economic outcomes of two novel Food and drug administration (FDA)-approved medications which are available in Qatar; l-glutamine and crizanlizumab over a time horizon of 1 year in a hypothetical cohort of adult sickle cell disease patients from a Qatar healthcare perspective. The main outcome is incremental cost per sickle cell disease-related acute pain crises averted. Model clinical parameters were derived from individual drug randomized trials, published literature, whereas cost parameters from Qatar healthcare payer system (2020–2021). A sensitivity analysis was carried out, and the study results were robust around model inputs. Costs were converted to 2020 US dollars.

Results:

Study results showed that both treatment modalities’ costs were the main driver of this analysis, with an average annual cost of the treatments per patient being $189,014 for crizanlizumab (5 mg/kg), $143,798 for crizanlizumab (2.5 mg/kg), and $74,323 for l-glutamine. The probability of no first-time sickle cell disease-related vaso-occlusive crises averted was 0.001/year for glutamine, 0.26/year for crizanlizumab (5 mg/kg), and 0.34/year for crizanlizumab (2.5 mg/kg). Lower dose crizanlizumab (2.5 mg/kg) dominated the higher one (5 mg/kg). The incremental cost-effectiveness ratio of crizanlizumab (2.5 mg/kg), when compared to l-glutamine was $81,265 per sickle cell disease-related vaso-occlusive crises averted. When comparing crizanlizumab (5 mg/kg) and l-glutamine, crizanlizumab (5 mg/kg) showed higher efficacy, yet the crizanlizumab incremental cost-effectiveness ratio was at $459,620 than l-glutamine.

Conclusions:

Crizanlizumab (2.5 mg/kg) may be a cost-effective intervention, yet it is not the approved dose for preventing vaso-occlusive crises in adolescents and adults with sickle cell disease. Crizanlizumab (5 mg/kg) was more cost-effective than the approved l-glutamine per sickle cell disease vaso-occlusive crisis prevented. Of note, we primarily focused on modeling acute vaso-occlusive pain, which limited our ability to consider other key outcomes in sickle cell disease.
Association of medical comorbidities in obese subjects diagnosed with heparin-induced thrombocytopenia
Authors: Darok Matthew , Daly Alexander , Walter Vonn , Krawiec Conrad
Published: May 2024

Objectives:

Heparin-induced thrombocytopenia can occur in obese subjects. The medical comorbidities associated with obesity may contribute to the pathogenesis of this disease. It is unknown, however, which specific medical comorbidities and if higher odds of thrombosis are present in obese heparin-induced thrombocytopenia patients. We sought to determine whether obese heparin-induced thrombocytopenia subjects had higher odds of both comorbidities and thrombosis, hypothesizing that this patient population would have higher odds of both these conditions.

Methods:

This was a multi-center retrospective study utilizing TriNetX©, an electronic health record database, in subjects aged 18–99 years diagnosed with heparin-induced thrombocytopenia. The cohort was divided into two groups (1) non-obese (body mass index < 30 kg/m2) and (2) obese (body mass index ⩾ 30 kg/m2). We evaluated patient characteristics, diagnostic, laboratory, medication, and procedure codes.

Results:

A total of 1583 subjects (696 (44.0%) non-obese and 887 (56.0%) obese) were included. Obese subjects had higher odds of diabetes with complications (OR = 1.73, 95% CI = 1.35–2.22, p < 0.001) and without complications (OR = 1.81, 95% CI = 1.47–2.22, p < 0.001). This association was still present after correcting for demographic and clinical factors. There were no increased odds of thrombosis observed in the obesity group.

Conclusions:

Our study found that obese heparin-induced thrombocytopenia subjects had higher odds of having a diabetes mellitus comorbidity, but did not have higher odds of thrombosis. Given obesity is considered a hypercoagulable state, further study may be needed to understand why obese subjects diagnosed with heparin-induced thrombocytopenia do not have higher rates of thrombosis.
Assessing the causal association between sleep apnea and the human gut microbiome composition: A two-sample Mendelian randomization study
Authors: Yu Min , Chen Xuehui , Huang Xin , Gao Xuemei
Published: May 2024

Background:

Studies have linked gut microbiota dysbiosis with sleep apnea; however, no causal relationship was found in human subjects. Finding new targets for the pathophysiology of sleep apnea might be made possible by systematically investigating the causal relationship between the human gut microbiota and sleep apnea.

Methods:

A two-sample Mendelian randomization analysis was conducted. The human gut microbiome composition data, spanning five taxonomic levels, were acquired from a genome-wide association study that included 18,340 participants from 24 cohorts. Genome-wide association study data for sleep apnea were obtained from the Sleep Disorder Knowledge Portal for primary analysis and the FinnGen consortium for meta-analysis. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy.

Results:

Using inverse-variance weighted analysis, eight microbial taxa were initially found to be substantially linked with the apnea-hypopnea index. Only three microbial taxa remained significant associations with sleep apnea when combined with the FinnGen consortium (the class Bacilli: B = 8.21%, 95% CI = 0.93%–15.49%; p = 0.03; the order Lactobacillales: B = 7.55%, 95% CI = 0.25%–4.85%; p = 0.04; the genus RuminococcaceaeUCG009: B = −21.63%, 95% CI = −41.47% to −1.80%; p = 0.03).

Conclusions:

Sleep apnea may lead to gut dysbiosis as significant reductions in butyrate-producing bacteria and increases in lactate-producing bacteria. By integrating genomes and metabolism, the evidence that three microbiome species are causally linked to sleep apnea may offer a fresh perspective on the underlying mechanisms of the condition.
The experiential employer brand: An application to salespeople
Authors: Poujol Fanny Juliet , Pezet Eric , Wallace James , Tanner John F
Published: May 2024

Employer brand conceptualizations have done much to support stronger recruiting practices for workers. Employer brand literature, though, fails to encapsulate an experiential approach and to consider that work can be consumed. Beginning with the recommendation by Mosley to apply an experiential approach of the employer brand, this research identifies specific dimensions of the experiential employer brand (EEB) in sales. The field sales position is unique in its impact on the firm’s success and customer experience, as well as its boundary-spanning nature and the high rate of mobility afforded salespeople due to high demand. A failure to match promised and actual work experiences can lead to rapid turnover particularly among salespeople because they can easily find other work. For these reasons, we explore the EEB over five studies applying Holbrook’s experiential brand framework. Five studies resulted in an EEB framework, revealing specific dimensions of the EEB. Two steps (focus group and analysis of 651 work experience commentaries posted on glassdoor.com) inform the creation of an EEB scale, which subsequent studies ( n = 234 and n = 210 salespeople) test. The EEB approach can help firms and sales managers to understand the experiential nature of their employer brand and enhance the appeal of their offers.
Beyond the Bell curve
Authors: Corcoran Stephanie
Published: May 2024

One of the most important, and neglected, aspects of the school assessment process is the feedback phase. The purpose of this exploratory study was to examine the extent to which feedback is being conducted, training in feedback, and the types of feedback practices used in school settings. One hundred thirty-two school assessment professionals were surveyed, and results suggest that most believe in the importance of test feedback and are utilizing it. Results of this study also indicate that test feedback practices are lacking with most practitioners simply plotting scores on a bell curve. Recommendations for more culturally responsive, meaningful, and ethical feedback practices are discussed, including how to incorporate therapeutic assessment values and techniques in school settings.
Strategies for Accessible Breast Screening for People With Intellectual Disability
Authors: Weise Janelle , Cvejic Rachael , Trollor Julian
Published: May 2024

Introduction:

People with intellectual disability are less likely to participate in breast screening than people without intellectual disability. They experience a range of barriers to accessing breast screening, however, there is no consensus on strategies to overcome these barriers. Our objective was to reach consensus on the strategies required for accessible breast screening for people with intellectual disability.

Methods:

Fourteen experts participated in a modified on-line Delphi that used Levesque’s model of health care access as the theoretical framework. At the end of each round descriptive and thematic analyses were completed. Data was then triangulated to determine if consensus was reached.

Results:

After 3 rounds, 9 strategies were modified, 24 strategies were added and consensus was reached for 52 strategies across the 5 dimensions of access. Key areas of action related to (i) decision making and consent, (ii) accessible information, (iii) engagement of peer mentors, (iv) service navigators, and (v) equipping key stakeholders.

Conclusions:

The resulting strategies are the first to articulate how to make breast screening accessible and can be used to inform health policy and quality improvement practices.
Determination of COVID-19 Late Disorders as Possible Long-COVID and/or Vaccination Consequences
Authors: Sadat Larijani Mona , Bavand Anahita , Banifazl Mohammad , Ashrafian Fatemeh , Moradi Ladan , Ramezani Amitis
Published: May 2024

In this era in which the vast majority of the global population have developed COVID-19 infection and/or got vaccinated against it, identification of the late disorders as the vaccines’ side effect or long-COVID manifestation seems essential. This study included the vaccinated individuals of 4 different vaccine regimens including inactivated virus-based, subunit protein, and adenovirus-based vaccines in a follow-up schedule 6-month post the booster shot. All the documented vaccine adverse events were thoroughly assessed considering the cases’ medical history by Adverse Events Committee of Pasteur Institute of Iran. Totally 329 individuals who got 3 doses of vaccination were followed 6 months after the booster shots among whom 41 (12.4%) cases with the mean age of 40.9 ± 10.48 years had a type of disorder. Gynecological and osteoarticular involvements were the most common recorded disorders of which 73.1% were possibly linked to vaccination outcomes and the rest were affected by both long-COVID-19 and vaccination. Notably, the average time of symptoms persistence was 155 ± 10.4 days. This study has the advantage of long-term follow-up which presents various forms of late events in each episode of COVID-19 infection and vaccination. About 26.8% of people with persistent complications suffered from both long-COVOD/ vaccination in whom the differentiation between the vaccine side effect and long-COVID manifestation was quite challenging. Long-term follow-up studies in large population seems essential to outline the role of long-COVID and vaccination regarding persistent complications.
Patients Aged 80 or More With Distal Radius Fractures Have a Lower One-Year Mortality Rate Than Age- and Gender-Matched Controls: A Register-Based Study
Authors: Arvidsson Linnea , Landgren Marcus , Harding Anna Kajsa , Abramo Antonio , Tägil Magnus
Published: May 2024

Introduction

With a rapidly ageing population, the number of distal radius fractures (DRFs) in the elderly will increase dramatically. The aim of this retrospective register study was to examine the 1- and 5-year mortality in DRF patients aged 80 years or more and correlate the overall survival to factors not related to the fracture itself.

Material and Methods

Patients aged ≥80 diagnosed with DRFs in Lund University Hospital in Sweden in the period 2010-2012 were extracted from the prospective Lund Distal Radius Fracture register. One- and 5-year standardised mortality rates (SMRs) were calculated using the Swedish standard population as a reference. Medical records were searched for non-fracture-related factors including comorbidity, medications, cognitive impairment and type of living. Cox proportional hazard regression models were used to identify prognostic factors for all-cause mortality.

Results

The study cohort included 240 patients, with a mean age of 86. The overall 1-year mortality was 5% (n = 11/240) and the 5-year mortality was 44% (n = 105/240). The 1-year SMR was .44 (CI .18-.69, P < .01) when indirectly adjusted for age and gender and compared to the Swedish standard population. The 5-year SMR was .96 (CI .78-1.14). The patients’ ability to live independently in their own home had the highest impact on survival.

Discussion

The 1-year mortality rate among the super-elderly DRF patients was only 44% of that expected. Possibly, a DRF at this age could be a sign of a healthier and more active patient.

Conclusions

The DRF patients aged 80 or more had a substantially lower mortality rate 1 year after fracture compared to the age- and gender-matched standard population. Patients living independently in their own homes had the longest life expectancy. Treatment should not be limited solely because of old age, but individualised according to the patient’s ability and activity level.
School Counselors’ Experiences With Adverse Childhood Experiences
Authors: Walsh Robyn , Zyromski Brett , Betters-Bubon Jennifer , Shrewsbury-Braxton Sarah
Published: May 2024

Adverse childhood experiences (ACEs) are potentially traumatic events occurring in the household or community that hold painful or distressing outcomes for children immediately and in their future (Centers for Disease Control and Prevention, 2019). School counselors work with children and young adolescents suffering from negative mental health outcomes as a result of ACEs (Hunt et al., 2017; Jimenez et al., 2016; Kaess et al., 2013; Kerker et al., 2015; Koball et al., 2021; Zhang & Mersky, 2020). Further, school counselors often work with minoritized populations, who are at a greater risk for racialized trauma (Cronholm et al., 2015; Merrick et al., 2018; Thurston et al., 2018). Research has not identified the extent to which school counselors are aware of ACEs and use that knowledge to inform their practice. This study fills a gap in the literature by investigating how school counselors understand and address ACEs, using a descriptive phenomenological approach. We identified three themes and various subthemes from the data and offer discussion and implications of the research for school counselors and counselor educators.
“We Still Find a Way to Smile”: Black School Counselors Reclaiming Black Joy and Resistance
Authors: Mayes Renae D. , Drake Riley , Hollins Sylvia A. , White Shontell M. , Webster Ashanti E.
Published: May 2024

Antiracism in school counseling calls for an active stance in addressing racism in K–12 schools while building homeplace to affirm and protect students. As such, this qualitative study focuses on how Black school counselors understand and reclaim Black joy and resistance as a part of homeplace, a place where students’ humanity is affirmed and honored. This study revealed three themes: (a) We’ve Done Been Knowing, (b) It’s One and the Same, and (c) When Two or More Are Gathered. Findings are foundational toward building a firm understanding of Black joy and resistance while recognizing the educative power of Black school counselors.
Investigating the Role of Intercultural Mediators in Enhancing Asylum-Seeking Migrants’ Access to Health Care Services in Serbia
Authors: Buch Mejsner Sofie , Davidović Maša , Kristiansen Maria , Mahato Sweta , Eklund Karlsson Leena
Published: May 2024

Migrants are especially susceptible to inequitable access to health care services and their access to health care may be further compromised by the tradition of informal patient payments in the Western Balkan countries. As a particularly vulnerable group, this study focused on the asylum-seeking migrants and the role of informal patient payments as an avenue for migrants’ health care access in Serbia. Qualitative interviews were conducted in August and September of 2018 with civil servants (intercultural mediators and information workers, n = 8) and asylum-seeking migrants ( n = 6). Data was analyzed using the phenomenological hermeneutical approach. The study showed that intercultural mediators had a pivotal role in shaping better and quicker access to health care services for asylum-seeking migrants in Serbia, which also lowered their exposure to informal patient payments. A commonness in paying informally was found in Serbia, especially due to the high value put into doctors and the lacking resources of the health care system. The asylum-seeking migrants seemed exempted from such payments. Reducing these informal patient payments for health care is highly important to facilitate equity in access to health care
Full-ceramic resin-bonded fixed dental prostheses: A systematic review
Authors: Habibzadeh Sareh , Khamisi Faranak , Mosaddad Seyed Ali , Fernandes Gustavo Vicentis de Oliveira , Heboyan Artak
Published: May 2024

Despite the development of implant-supported prostheses, there are still patients for whom conservative treatments such as resin-bonded fixed dental prostheses (RBFDPs) are more appropriate. This study’s objective was to analyze the available research on full-ceramic RBFDPs. In this study, Web of Science, MEDLINE/PubMed, Scopus, Embase, Cochrane Library, and Google Scholar databases were searched for articles published in English between 2010 and 2020. A total of 14 studies were reviewed based on the eligibility criteria. The results showed that using a cantilever design with one abutment had an advantage over two abutments. Additionally, it was proposed that preparations designed with retentive aids, such as a proximal box, groove, and pinhole, could improve RBFDP survival rates. IPS e.max ZirCAD, In-Ceram alumina, and zirconia CAD/CAM were the most commonly used framework materials. Most studies used air abrasion, salinization, or hydrofluoric acid for surface treatment. Adhesive resin cements were the most frequently used type of cement. The survival rate of In-Ceram ceramics (85.3%–94.8%) was lower than that of In-Ceram zirconia and IPS e.max ZirCAD. Debonding, followed by framework fracture, was the leading cause of failure. Following 3–10 years follow-up, the survival percentage of all-ceramic RBFDPs ranged from 76% to 100%. Although RBFDPs have demonstrated satisfactory success as a conservative treatment, long-term follow-ups and higher sample sizes in clinical research are required to gain more reliable outcomes on the clinical success rate of various RBFDP designs.
Extracranial-Intracranial Microsurgical Bypass Using a Y-Shaped Vein Graft From the Hand
Authors: Karir Aneesh , Tuckett Sydnee , Fomenko Anton , Kaufmann Anthony M. , Buchel Edward W.
Published: May 2024

While extracranial-intracranial (EC-IC) bypass is commonly performed by neurosurgeons with specific expertise in cerebrovascular surgery, they can also be performed together with microvascular plastic surgeons. At our institution, some EC-IC bypass cases have evolved to be performed by neurosurgeons and plastic surgeons in a combined approach. Given the plastic surgeons’ expertise and volume of experience in performing microvascular surgery, their skills are utilized in performing the donor vessel dissection as well as the bypass itself. This paper outlines a Canadian perspective on collaboration between plastic surgeons and neurosurgeons in performing EC-IC bypass along with a case report illustrating the use of a dorsal hand Y-shaped vein graft for EC-IC bypass, which has not been described in the literature to date.
The Impact of LMX and Job Stress on Service Quality of Police Personnel Through the Mediating Role of Job Satisfaction and Moderating Role of Social Support
Authors: Yadav Mohit , Naim Mohammad Faraz , Poluru Nitin Vihari , Joshi Yatish , Srivastava Anugamini P.
Published: May 2024

This study examines how leader–member exchange (LMX) and job stress affect the calibre of service provided by police personnel, considering the mediating effects of job satisfaction and the moderating effects of social support. Structural equation modelling was used to analyse data from 1,273 people from North India and 552 police personnel. According to the findings, job satisfaction acts as a buffer between job stress and the good effects of LMX on service quality. Particularly at moderate and higher levels, social support reduces the mediation effect of job satisfaction between LMX and service quality as well as between job stress and service quality. This study offers insights to improve service quality for Indian police personnel through the presentation of a comprehensive framework that tackles job stress, job satisfaction, LMX and social support.
Splenic Laceration: A Case-Study Analysis
Authors: Newland Kaitlin , Colln-Appling Christina Von , Infanti Mraz Megan A.
Published: May 2024

Twelve-year-old S.L. was at riding practice atop her horse when she lost control and fell to the ground. As she landed, the horse became startled and, in attempt to run away, stepped on the child. S.L. was not wearing a protective vest during the incident and the horse's hind limb landed on S.L.'s abdomen. This case report will examine the care of a pediatric patient diagnosed with a splenic laceration sustained during an equestrian accident.
Remote Patient Monitoring for Postoperative Pediatric Patients with Peripheral Nerve Catheters
Authors: McKee Vickie , Williams Michaela , Denker Kylee
Published: May 2024

Background: Close follow up of postoperative orthopedic and pectus excavatum surgical patients discharged with a nerve catheter is required to ensure adequate pain management and recognize medication toxicity. Assessing ambulatory pediatric patients using a smartphone application is convenient and effective. Methods: A novel Remote Patient Monitoring (RPM) program was developed to improve follow-up and ability to assess postoperative pain management, analgesic toxicity, and catheter site. Adherence and successful graduation were measured to determine the success of the program. Additionally, patient and caregiver experience and opioid use were measured. Interventions: Patients were enrolled in RPM postoperatively for four days. The RPM nursing team reviewed patient reported data in real-time to address concerns and develop a plan of care. Pain management education was provided via video prior to removing the nerve catheter. Results: Adherence to RPM is over 90% for both populations, with 82% success rate in orthopedic patients and 93% success rate in pectus excavatum patients. Experience scores have been high, and opioid prescriptions have been reduced by half for the orthopedic population. Conclusions: RPM is an effective tool used to manage pediatric postoperative orthopedic and pectus excavatum surgical patients with significant patient and caregiver buy-in.
Within-Year Teacher Turnover in Head Start and Children’s School Readiness
Authors: Markowitz Anna J.
Published: May 2024

Teachers in early childhood education (ECE) settings are central to providing children with high-quality experiences that promote both early development and long-term well-being; unfortunately, rates of teacher turnover are high in ECE settings. There are strong theoretical reasons to assume turnover is negatively linked with children’s academic and socioemotional development, but few empirical studies test this hypothesis. Using an econometric fixed effects approach in two waves of data from the nationally representative Head Start Family and Child Experiences Survey, this study provides the first national estimate of the relationship between within-year lead teacher turnover and children’s development in Head Start. I find an annual within-year turnover rate of ~9%, about twice that of K–12, and that turnover is negatively associated with children’s language outcomes alongside suggestive evidence for behavioral outcomes.
Elderly Individuals’ Satisfaction With Own Physical Activity Predicts Their Need for Care 3 Years Later
Authors: Hasegawa Junko
Published: May 2024

This study investigated how elderly individuals’ exercise satisfaction in snowy areas relates to their health indicators and future care needs. Survey data were collected from individuals aged ≥65 years who lived in snowy-cold regions. Participants completed measures of exercise satisfaction, frailty, quality of life (QOL), and cardiovascular health study during the winter and spring of 2019, with a follow-up measure in 2022 to assess care needs. Findings revealed an association between exercise satisfaction, QOL, and frailty indicators, irrespective of the season. Notably, winter exercise satisfaction showed a stronger correlation with future care needs compared to spring exercise satisfaction. Those expressing low winter exercise satisfaction were significantly more likely to require increased care 3 years later than those reporting no inactivity. Although physical activity was not measured directly, the findings underscore that perceptions of exercise satisfaction during snowy seasons can predict future care needs in older adults. The influence of seasonal variations and subjective exercise satisfaction on long-term care requirements is vital for tailored interventions and improved healthcare strategies for older adults in cold regions.
Exploring Putative Causal Associations between Diet and Periodontal Disease Susceptibility
Authors: Ying X.X. , Hou Y. , Zheng X. , Ma J.X. , Wu M.L. , Liu M. , Liu X.Y. , Zhang K.L.
Published: May 2024

Introduction:

Dietary factors may play an important role in periodontal health. However, current evidence from observational studies remains inconclusive.

Objective:

This study aimed to investigate the causal relationships between dietary exposures and periodontal disease risks using Mendelian randomization analysis.

Methods:

Large-scale genome-wide association study summary statistics for 20 dietary factors were obtained from the MRC-IEU consortium. Multivariable and univariable 2-sample Mendelian randomization analyses were performed to assess the causal effects of each dietary exposure on 6 periodontal outcomes, including gingivitis and periodontitis.

Results:

Genetically predicted higher dried fruit intake was significantly associated with reduced risks of acute gingivitis (odds ratio [OR]: 0.02; 95% confidence interval [CI]: 0.00–0.42; P = 0.01) and bleeding gums (OR: 0.96; 95% CI: 0.93–0.99; P = 0.01). Higher fresh fruit and water intake showed protective effects against chronic gingivitis (OR: 0.18; 95% CI: 0.04–0.91; P = 0.04 and OR: 0.15; 95% CI: 0.04–0.53; P = 0.00) and bleeding gums (OR: 0.95; 95% CI: 0.92–0.981; P = 0.00 and OR: 0.98; 95% CI: 0.96–0.99; P = 0.02). Alcohol intake frequency and processed meat intake were risk factors for bleeding gums (OR: 1.01; 95% CI: 1.00–1.02; P = 0.01 and OR: 1.05; 95% CI: 1.01–1.08; P = 0.00) and painful gums (OR: 1.01; 95% CI: 1.00–1.01; P = 0.00 and OR: 1.02; 95% CI: 1.01–1.03; P = 0.00). Most of the causal relationships between genetic predisposition to the specified dietary factors and periodontal diseases remained statistically significant (P < 0.05) after adjusting for genetic risks associated with dentures, smoking, and type 2 diabetes in multivariable Mendelian randomization models.

Conclusions:

The findings suggest potential protective effects of higher fruit and water intake against gingivitis and other periodontal problems, while alcohol and processed meat intake may increase the risks of periodontal disease. Our study provides preliminary causal evidence on the effects of diet on periodontal health and could inform prevention strategies targeting dietary habits to improve oral health.

Knowledge Transfer Statement:

This study suggests that fruit and water intake may protect against periodontal disease, while alcohol and processed meats increase risk, informing dietary guidelines to improve oral health.
Compact city and urban planning: Correlation between density and local amenities
Authors: Jama Teemu , Tenkanen Henrikki , Lönnqvist Henrik , Joutsiniemi Anssi
Published: May 2024

Many scholars and planners emphasise the role of compact cities in sustainable urban development. Compact urban form is seen as a way to encourage people, for example, to drive less and walk more, which reduces transport-related GHG emissions. This argument, however, is strongly dependent on local amenity development that can support such local living. In plan-making, a common practice is to try to ensure the realisation of services with a high Gross Floor Area (GFA) residential infill development to raise the local population density. In this paper we are seeking quantitative insight on the resolution under which urban density, as measured by GFA volume, correlates with the growth of urban amenities and liveability. Specifically, we are seeking the direction in which correlation changes when moving from a larger geographical scale (low resolution) towards a smaller scale (high resolution) of walkable reach. Our study shows a clear correlation between urban amenities and planned GFA at low-resolution scales, but that correlation decreases at higher-resolution scales (walkable neighbourhood level), indicating that urban amenities tend to cluster in different locations than density is planned. Based on these findings, we argue that, if the aim of urban planning is to foster the growth of local amenities, it should shift its focus towards larger patterns of urban development rather than emphasising GFA in detailed plan-making.
Thickened Retinal Nerve Fiber Layer Without Hypermyelination in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay
Authors: Suarez Mallory K. , Martin Timothy J. , Ong Sally S.
Published: May 2024

Purpose: To report the retinal findings in a patient with autosomal recessive spastic ataxia of Charlevoix-Saguenay. Methods: A case was evaluated. Results: A 16-year-old male patient with a known diagnosis of autosomal recessive spastic ataxia of Charlevoix-Saguenay was referred for evaluation of retinal hypermyelination given its frequent association with the condition. The patient was asymptomatic with a best-corrected visual acuity of 20/20. Optical coherence tomography of the peripapillary retinal nerve fiber layer (RNFL) showed bilateral thickening in each eye (average thicknesses: 180 µm, right eye; 177 µm, left eye). An examination showed no myelinization of the RNFL. Conclusions: Most studies to date describe RNFL thickening secondary to hypermyelination as a characteristic finding in autosomal recessive spastic ataxia of Charlevoix-Saguenay. This case provides evidence that this thickening may be a result of hypertrophy rather than hypermyelination. Further investigation is needed to define the pathophysiologic cause of RNFL thickening in autosomal recessive spastic ataxia of Charlevoix-Saguenay.
Development and validation of machine learning models to predict the need for haemostatic therapy in acute upper gastrointestinal bleeding
Authors: Nazarian Scarlet , Lo Frank Po Wen , Qiu Jianing , Patel Nisha , Lo Benny , Ayaru Lakshmana
Published: May 2024

Background:

Acute upper gastrointestinal bleeding (AUGIB) is a major cause of morbidity and mortality. This presentation however is not universally high risk as only 20–30% of bleeds require urgent haemostatic therapy. Nevertheless, the current standard of care is for all patients admitted to an inpatient bed to undergo endoscopy within 24 h for risk stratification which is invasive, costly and difficult to achieve in routine clinical practice.

Objectives:

To develop novel non-endoscopic machine learning models for AUGIB to predict the need for haemostatic therapy by endoscopic, radiological or surgical intervention.

Design:

A retrospective cohort study

Method:

We analysed data from patients admitted with AUGIB to hospitals from 2015 to 2020 ( n = 970). Machine learning models were internally validated to predict the need for haemostatic therapy. The performance of the models was compared to the Glasgow-Blatchford score (GBS) using the area under receiver operating characteristic (AUROC) curves.

Results:

The random forest classifier [AUROC 0.84 (0.80–0.87)] had the best performance and was superior to the GBS [AUROC 0.75 (0.72–0.78), p < 0.001] in predicting the need for haemostatic therapy in patients with AUGIB. A GBS cut-off of ⩾12 was associated with an accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 0.74, 0.49, 0.81, 0.41 and 0.85, respectively. The Random Forrest model performed better with an accuracy, sensitivity, specificity, PPV and NPV of 0.82, 0.54, 0.90, 0.60 and 0.88, respectively.

Conclusion:

We developed and validated a machine learning algorithm with high accuracy and specificity in predicting the need for haemostatic therapy in AUGIB. This could be used to risk stratify high-risk patients to urgent endoscopy.
Doing registering, gearing up, and launching: Understanding student multimodality and the process of class participation
Authors: Takahashi Junko
Published: May 2024

This multimodal conversation analytic (MCA) study investigates the embodied process of student self-selection – voluntary participation - in the American graduate classroom. Student participation has frequently been a central topic of investigation in the field of educational linguistics. In American graduate classrooms, in particular, participation is considered significant and students are encouraged to make frequent oral contributions; for instance, so as to ensure that teachers can gauge how much they have learned, and to enhance student learning (e.g., Cohen, 1991; Fassinger, 1995; Rocca, 2010). Building on Kääntä’s (2014) research on students’ “doing embodied noticing” through the process of self-selection for correction initiation in the classroom, the current study analyzed 38 hours of videotaped graduate-level classes and uncovered the three main embodied self-selection stages—doing registering, gearing up, and launching—through which students tend to progress during their preparation for self-selection. It further demonstrates a variation in the form of “expedited processes”—the practices some students use to self-select earlier than others—followed by examples and discussion of how educators can turn these findings into practice and enable a wider range of students to achieve effective self-selection in a classroom.