bluuebunny/crossref_metadata_2025 huggingface dataset:
A mixed methods investigation into athletic trainer and dietitian's nutrition practices for sport-related concussion patients
Authors: Weber Rawlins Michelle L , Valovich McLeod Tamara C
Published: August 2023

Background

Nutrients may have implications following concussion, such as inflammation reduction or neuroprotection. The purpose of this study was to describe nutrition practices of athletic trainers (AT) and dietitians for patients regarding sport-related concussion, with respect to prevention, recommendations, and barriers to implementation.

Hypotheses

Due to the descriptive nature of this study, hypotheses were not warranted.

Study Design

Mixed methods.

Level of Evidence

Level 3.

Methods

A survey was distributed through professional memberships and included multiple-choice and open-ended items about nutritional practices regarding concussions. Participants included 1465 ATs and 51 dietitians accessing the survey (AT: age = 35.7 ± 11.4 years, females = 43.1%; dietitians: age = 31.8 ± 8.17 years, females = 45.1%). Open-ended survey responses regarding nutritional practices for concussion prevention, recommendations, and changes following concussion were analyzed by identifying key words or repeating phrases, theme development and categories into an initial codebook, using the codebook on responses, and coding all responses with the finalized codebook. Barriers to implementation was analyzed with descriptive statistics.

Results

Themes were identified for prevention strategies, and recommendations and changes following concussion. For concussion prevention, ATs noted overall health, specific target nutrients, barriers and limited research support, while dietitians identified overall health, specific target nutrients, recommendations/guidelines as themes. Post-injury themes for patient recommendations and changes were noted as overall health, specific target nutrients, resources, interprofessional collaboration by ATs, whereas dietitians identified overall health, specific target nutrients, interprofessional collaboration. ATs and dietitians noted numerous barriers including the lack of clinician knowledge and athlete compliance.

Conclusions and Clinical Relevance

ATs and dietitians are utilizing nutritional practices regarding concussion in numerous ways by focusing on use for whole body, brain health and specific targets such as omega fatty acids, hydration, micronutrients/supplements, and macronutrients. With these findings and the barriers listed by respondents, we can use this information to design focused research to influence evidence-based nutritional practices and concussion.
Application of Innovative Subject Recruitment System for Batch Enrollment: A Pilot Study
Authors: Wi Chung-Il , King Katherine S. , Ryu Euijung , Natoli Traci L. , Miller Ryan P. , Spiten Matthew J. , Borah Bijan J. , Takahashi Paul Y. , Yao Xiaoxi , Noseworthy Peter A. , Pignolo Robert J. , Juhn Young J.
Published: August 2023

Introduction:

Using a digital process that leverages electronic health records (EHRs) can ease many of the challenges presented by the traditional enrollment process for clinical trials. We tested if automated batch enrollment using a technology-enabled subject recruitment system (TESRS) enhances recruitment while preserving representation of research subjects for the study population in our study setting.

Methods:

An ongoing community-based prospective adult cohort study was used to randomize 600 subjects who were eligible by age and residential address to TESRS (n = 300) and standard mailing method (n = 300), respectively, for 3 months. Then, TESRS was initiated and included automatic identification of patients’ preference for being contacted (online patient portal vs postal mail) from EHRs and automatic sending out of invitation letters followed by completion of a short online survey for checking eligibility and the digital consent process if eligible. We compared (1) median time to consent from invitation sent out per subject and total subjects recruited after a 3-month recruitment period, (2) the estimated study staff’s time, and (3) representation of sociodemographic characteristics (e.g., age, sex, race, SES measured by HOUSES index, and rural residence) between subjects recruited via TESRS and those via traditional mailing methods.

Results:

Median age of randomized subjects (n = 600) was 63 years with 52.0% female and 89.2% non-Hispanic White. Over a 3-month period, results showed consent rate via TESRS was 13% (39/297) similar to 11% (31/295) via standard mailing. However, recruitment was significantly faster with the TESRS approach (median 7 vs 26 days) given the study staff’s effort. Study staff’s time saved by using TESRS compared to standard mailing approach was estimated at 40 min per subject (equivalent to 200 h for 300 subjects). No significant differences in characteristics of research subjects from the study population were found.

Conclusion:

Our study demonstrated the utility of TESRS as a subject recruitment digital technology which significantly enhanced the recruitment effort while reducing the study staff burden of recruitment while maintaining the consistency of characteristics of recruited subjects. The strategy and support for implementing and testing TESRS in other study settings should be considered.
Antibiotic Prescription Patterns in Children Under 5 Years of Age With Acute Diarrhea in Quito-Ecuador
Authors: Sánchez Xavier , Calderón Nathali , Solis Olga , Jimbo-Sotomayor Ruth
Published: August 2023

Background:

Diarrheal disease remains a significant cause of child mortality, particularly in regions with limited access to healthcare and sanitation. Inappropriate practices, including unjustified medication prescriptions, pose challenges in the management of acute diarrhea (AD), especially in low- and middle-income countries.

Objective:

This study analyzed antibiotic prescription patterns and assessed compliance with Integrated Management of Childhood Illness (IMCI) guidelines in children under 5 with AD in the Ministry of Public Health (MOPH) Ambulatory Care Centers of Quito city, Ecuador.

Methods:

A cross-sectional design was used, collecting electronic health records (EHR) of patients diagnosed with AD from 21 health facilities in District 17D03. A probabilistic and stratified sampling approach was applied. Patient characteristics, prescriber characteristics, treatments, and compliance of IMCI guideline recommendations were evaluated. A stepwise logistic regression analysis examined the association between antibiotic prescription and patient and physician characteristics.

Results:

A total of 359 children under 5 years of age were included, with 58.77% being girls. 85.24% of the cases of AD were attributed to gastroenteritis and colitis of infectious and unspecified origin. Amebiasis and other protozoal intestinal diseases accounted for 13.37% and 1.11% of the cases, respectively. The completion rates of recording various IMCI parameters varied; parameters such as duration of diarrhea, presence of blood in stool, and evidence of sunken eyes had high completion rates (100%, 100%, and 87.47%, respectively), while parameters like state of consciousness, presence of thirst, and type of diarrhea had low completion rates (0.28%, 0.28%, and 0.84%, respectively). None of the cases had all parameters fully recorded. Antimicrobials were prescribed in 38.72% of the cases. Children aged 3 to 5 years had higher odds of receiving antimicrobial prescription for AD (aOR: 4.42, 95% CI 2.13-9.18, P < .0001) compared to those under 1 year, after adjusting for the number of loose stools per day, gender, and age of the health professional.

Conclusion:

Variations in IMCI guideline compliance were observed, with no cases fully adhering to the guidelines. Antimicrobial prescription rates were notably high, especially among older children. Further research and specialized interventions are necessary to gain comprehensive insight into the factors underlying non-compliance with the IMCI guidelines.
Technical Recommendations for Computed Tomography Guidance of Intervention in the Right Ventricular Outflow Tract: Native RVOT, Conduits, and Bioprosthetic Valves
Authors: Han B. Kelly , Garcia Santiago , Aboulhosn Jamil , Blanke Phillip , Martin Mary Hunt , Zahn Evan , Crean Andrew , Overman David , Hamilton Craig C. , Hanneman Kate , Semple Thomas , Armstrong Aimee
Published: August 2023

This consensus document for the performance of cardiovascular computed tomography (CCT) to guide intervention in the right ventricular outflow tract (RVOT) in patients with congenital heart disease (CHD) was developed collaboratively by pediatric and adult interventionalists, surgeons, and cardiac imagers with expertise specific to this patient subset. The document summarizes definitions of RVOT dysfunction as assessed by multimodality imaging techniques and reviews existing consensus statements and guideline documents pertaining to indications for intervention. In the context of this background information, recommendations for CCT scan acquisition and a standardized approach for reporting prior to surgical or transcatheter pulmonary valve replacement are proposed and presented. It is the first Imaging for Intervention collaboration for CHD patients and encompasses imaging and reporting recommendations prior to both surgical and percutaneous pulmonary valve replacement.
Research Interdisciplinarity and Citation Impact: A Network Analysis of Social Networking Sites Research
Authors: Zheng Jingwei , Zhang Ke , Han Boya , Hou Jiayi
Published: August 2023

The influence of interdisciplinary research has become a trending topic in library and information science. However, research examining the influence of interdisciplinarity on scholars is still limited. This current study examines the interdisciplinarity from the author co-citation network approach. We focus on the field of social networking sites (SNS) research, namely studies about online platforms that people use for networking (e.g., Facebook), and examine whether interdisciplinarity would promote academic impact. About 2,489 articles in the field of SNS published from 2014 to 2016 were retrieved, with 611 first authors cited by those articles identified. The interdisciplinarity of the scholar was assessed in the author co-citation networks using two indexes: betweenness centrality and constraint. We identified four primary disciplines of SNS research in 2014 to 2016. Interdisciplinarity indexes were used to predict the scholarly impact in this field in the next 3-year interval (2017–2019), measured by citation counts. We found that citation number was predicted by betweenness centrality but not by constraint. Theoretical and practical implications of interdisciplinarity in research activities are discussed.
A Chinese Perspective on Writing English Abstracts: Challenges, Errors, Improvement Tips, and Critical Reflections
Authors: Chen Bin , Huang Jinyan
Published: August 2023

This study examined Chinese EFL researchers’ English abstract writing in language education. Using open-ended questionnaires, it first investigated 24 Chinese EFL researchers’ perceptions of their challenges in writing English abstracts. Using generalizability theory and follow-up interviews, it then invited 16 experienced English journal reviewers to assess 27 published English abstracts written by Chinese EFL researchers to identify common errors and suggest improvement tips. Finally, it examined eight selected Chinese EFL researchers’ critical reflections on the English journal reviewers’ assessment of the 27 English abstracts. The results indicated that Chinese EFL researchers experienced several challenges in writing English abstracts. Further, the English reviewers’ assessment of the 27 abstracts was consistent and reliable. The common errors were associated with the accuracy, non-evaluative nature, coherence and readability, and conciseness of an English abstract. The English reviewers provided tips for improvement, and Chinese EFL researchers expressed their critical reflections on their assessment. Educational implications are discussed.
Effects of a Human Papilloma Virus (HPV) Prevention Education among Girls in 6th Grade Elementary School, South Korea
Authors: Kim Jeon Hee , Park Soonyoung , Cho Youngmi , Sok Sohyune
Published: August 2023

Studies on human papillomavirus (HPV) prevention education and its educational effects for elementary school students are necessary. This study aimed to examine the effects of human papillomavirus (HPV) prevention education on knowledge about cervical cancer, HPV, immunization, and attitude about immunization among girls in the sixth grade elementary school of South Korea. A quasi-experimental pretest-posttest control group design is used. The sample included 131 girls (Intervention: n = 65, Control: n = 66) in the sixth grade elementary school of South Korea. Human papillomavirus (HPV) prevention education included the contents of the definition of human papillomavirus, types of human papillomavirus, human-papillomavirus-related diseases, cervical cancer, human papillomavirus prevention methods, types of vaccines, vaccination effects, vaccination costs, vaccination frequency for 12-year-old girls, and recommended vaccination age. Human papillomavirus (HPV) prevention education was applied on the intervention group in a total of one 40-minute class in the classroom. There were statistically significant differences in knowledge about cervical cancer ( t = 9.712, p < .001), knowledge about HPV ( t = 9.638, p < .001), knowledge about immunization ( t = 5.178, p < .001), and attitude about immunization ( t = 3.113, p = .002) between the groups. This study suggests that human papillomavirus (HPV) prevention education was an effective intervention for improving knowledge about cervical cancer, knowledge about HPV, knowledge about immunization, and attitude about immunization. In public health education, human papillomavirus (HPV) prevention education can be implied for Korean girls in sixth grade elementary school.
Integrated Model for the Factors Determining the Academic’s Remote Working Productivity and Engagement: Empirical Study
Authors: Al-Dmour Hani , Al Hasan Rima , Thneibat Motasem , Masa’deh Ra’ed , Alkhadra Wafa , Al-Dmour Rand , Alalwan Ali
Published: August 2023

This empirical study aims to examine and validate the factors influencing productivity among remote academic staff in Jordanian higher education institutions during the Covid-19 crisis, with a specific focus on the mediating role of employee engagement. A comprehensive conceptual framework is developed by integrating relevant studies on remote work-from-home, productivity, and engagement, along with insights from in-depth interviews. Employing a descriptive correlational survey design, the study explores the relationships among the study factors using a quantitative approach. Data is collected from a random sample of 408 remote academic staff members who worked from home during Covid-19. The findings robustly support the proposition that organizational, individual, technological, and client-related factors significantly and positively influence academic productivity through the mediation of employee engagement. These results emphasize the importance of considering these interrelated factors holistically to enhance productivity and engagement in remote academic work. The study contributes to a deeper understanding of remote work dynamics and provides practical insights for improving productivity and engagement in the Jordanian higher education context.
Smartphone Use Among Resident Physicians: Prevalence and Risk Factors in Clinical Practice
Authors: Costa Chiara , Teodoro Michele , Coco Manuela , Verduci Francesca , Giambò Federica , Italia Sebastiano , Alibrandi Angela , Fenga Concettina
Published: August 2023

Personal mobile phone has become an integral part of our lives. In the medical field, the growing popularity of medicine applications allows more rapid communication among healthcare professionals and quick access to helpful information, which facilitates and improves patient care practice. The use of smartphones during work activities by healthcare professionals can cause a lack of attention and errors while carrying out health procedures. The result might be an increased threat endangering the safety of patients. The purpose of the present study was to investigate the level of nomophobia (a psychological condition regarded as a fear of being detached from mobile phone connectivity) and its correlations with the use of smartphones in clinical practice, distraction due to personal use and policies regarding mobile phones use in a sample of resident doctors of a University of Southern Italy. A cross-sectional study was carried out on 204 hospital residents divided into three areas depending on their duties: clinical, surgical, and services. Two tools were used: nomophobia questionnaire (NMP-Q) and a composite questionnaire investigating smartphone use in the specific healthcare setting. Sixty percent of participants were affected by a moderate level of nomophobia and 10% by a severe degree, jeopardizing both the work and social relationships of young doctors. Smartphone use can certainly represent a helpful support tool for clinical practice; consequently, we believe it would be appropriate to find instruments to screen smartphone dependence or compulsive use to further prevent, early diagnose or treat this detrimental disorder for health professionals.
The association of sociodemographic, nutrition, and sanitation on stunting in children under five in rural area of West Java Province in Indonesia
Authors: Permatasari Tria Astika Endah , Chadirin Yudi , Ernirita  , Elvira Feby , Putri Bella Arinda
Published: August 2023

Background:

The prevalence of stunting in Indonesia has decreased gradually. The strategy to reduce stunting is currently prioritized on improving socio-economic levels, fulfilling food intake, and sanitation conditions. This study aims to analyze the association between sociodemographics, nutrition, and sanitation on stunting in rural West Java Province in Indonesia.

Design and methods:

A cross-sectional study was conducted in May–August 2022 among 247 mother-children pairs, selected by systematic random sampling from a rural area of West Java Province in Indonesia. The sociodemographic characteristics were measured using a structured questionnaire. The nutritional status of the children under five was assessed by length/height-for-age (HAZ), and was calculated using WHO Anthro software. Sanitation is assessed using observation and interviews with a structured questionnaire.

Results:

The prevalence of stunting in children under five was 20.7% (5.3% severely stunted and 15.4% stunted). Binary logistic regression analysis using SPSS version 22.0 show that mother’s height as the dominant factor associated with stunting in children under five (AOR = 3.45, 95% CI: 1.12–4.67, p = 0.008). In addition, children’s age (AOR = 0.250, 95% CI: 0.104–0.598, p = 0.002); balanced diet practices (AOR = 1.57, 95% CI: 0.965–2.56, p = 0.069), and building materials (AOR = 1.869, 95% CI: 0.87–4.00, p = 0.108 are also related to stunting in children under five.

Conclusions:

Efforts to improve maternal nutrition need to be carried out from the period before pregnancy to the first 1000 days of life. Education on healthy home indicators, especially the use of this type of building materials for houses, needs to be done to improve sanitation as an effort to prevent stunting in children under five.
Insulin-Induced Lipohypertrophy Treated With Liposuction: A Review of Case Reports
Authors: Mangan Jack , Levine Emma , Barrett Kaitlyn
Published: August 2023

Introduction: Lipohypertrophy is the most reported cutaneous complication of insulin injection. In cases refractory to conservative management, liposuction has been proposed as a treatment. This review aims to evaluate the use of liposuction for the treatment of insulin-induced lipohypertrophy. Methods: A literature search was conducted to identify case reports and case series that met inclusion criteria. Demographic, procedural, and outcome data were collected and summarized. Results: Ten case reports and 1 case series met eligibility criteria; 18 patients (16 female) with a mean age of 31 years were included for analysis. The primary indication for lipectomy was cosmetic (100%), followed by pain (16.7%), injection difficulty (16.7%), and poor glycemic control (11.1%). Ten patients (55.6%) underwent general anesthesia for their procedure, while 8 (44.4%) received local anesthesia. Thighs (53.8%) were the most common anatomical site of liposuction, followed by the upper arm (19.2%), abdomen (15.4%), buttocks (7.7%), and the flank (3.8%). The median volume of adipose tissue removed per site was 300 mL (range: 25-600 mL), while the total volume per patient was 910.8 mL (range: 200-2900 mL). The average postoperative follow-up time was 5.3 months (range: 2-10 months). Three patients reported postoperative improvement of glycemic control; 100% of patients were satisfied with their procedure. Small surface irregularities were reported in 2 patients. Conclusion: Although future investigations are warranted, these results may indicate that the use of liposuction to treat insulin-induced lipohypertrophy is a safe and effective procedure that achieves improved cosmetics with high patient satisfaction and enhanced glycemic control.
Republication of “Preliminary Experience Using Bioactive Glass Wedges for Cotton Osteotomy”
Authors: Borenstein Todd , Gonzalez Tyler , Krevolin Janet , Den Hartog Bryan , Thordarson David
Published: August 2023

Background:

Medial cuneiform dorsal opening wedge (Cotton) osteotomy is often used for treating forefoot varus in patients undergoing surgery for stage II posterior tibialis tendon dysfunction. The goal of this study was to examine the radiographic outcomes of Cotton osteotomy with bioactive glass wedge to assess for both maintenance of correction and clinical results and complications. We hypothesized that bioactive glass wedges would maintain correction of the osteotomy with low complication rates.

Methods:

Between December 2015 and June 2016, the charts of 17 patients (10 female and 7 male) who underwent Cotton osteotomy using bioactive glass wedges were retrospectively reviewed. Patient age averaged 56.8 years (range, 16-84). The average follow-up was 6.5 months. Radiographs were reviewed to assess for initial correction and maintenance of correction of medial column sag as well as for union. Charts were reviewed for complications.

Results:

The medial column sag correction averaged 15.6% on the final postoperative lateral radiograph. Meary angle averaged 19 degrees (3.14-42.8 degrees) preoperatively and 5.5 degrees (0.4-20.7 degrees) at final follow-up. All patients achieved clinical and radiographic union. One patient developed neuropathic midfoot pain and was managed with sympathetic blocks. One patient had a delayed union that healed at 6 months without surgical intervention. No patients required the use of custom orthotics or subsequent surgical procedures.

Conclusion:

Cotton osteotomy with bioactive glass wedges produced consistent correction of the medial column with low risk.

Level of Evidence:

Level IV, case series.
Efficacy of endoscopic trans-papillary gallbladder stenting and drainage in acute calculous cholecystitis in high-risk patients: a systematic review and meta-analysis
Authors: Malik Adnan , Malik Muhammad Imran , Amjad Waseem , Javaid Sadia
Published: August 2023

Background and aims:

Acute calculous cholecystitis (ACC) represents about one-third of all surgical emergencies. The gold standard management of ACC is laparoscopic cholecystectomy. Although cholecystectomy is a safe procedure, it may be dangerous and contraindicated in patients with complex comorbidities. Endoscopic transpapillary gallbladder stenting (ETGBS) and drainage had been widely used to manage patients suffering from ACC with comorbidities.

Methods:

We searched PubMed, SCOPUS, Web of Science, and Cochrane Library for relevant studies assessing the use of ETGBS in patients suffering from ACC with various comorbidities. Risk of bias assessment was performed using the National Institues of Health (NIH) tool. We included the following outcomes: clinical success, technical success, late complications, and pancreatitis.

Results:

We included seven studies that met our inclusion criteria. We found that the pooled proportion of clinical success, technical success, late complications, and pancreatitis was [91.3%, 95% confidence interval (CI) (86.8%, 95.9%)], [92.8%, 95% CI (89%, 96.5%)], [5.4%, 95% CI (2.9%, 7.9%)], and [3.5%, 95% CI (1.2%, 5.8%)], respectively.

Conclusion:

We found that an ETGBS was an effective and well-tolerated method for the treatment of cholecystitis, especially in high-risk individuals.
What’s Next? On Better Supporting Women of Color Clinicians in University Counseling Centers
Authors: Wang Lei , Truong Nancy N. , Palacio Alysha , Unterberger Jeffrey E.
Published: August 2023

As university counseling centers (UCCs) are diversifying, research on the experiences of clinicians of color, particularly women of color (WOC), and how they navigate their sociocultural identities at UCC workplace settings remains limited. We used a qualitative thematic analysis approach to explore the current support they receive, suggestions for UCCs to better support WOC, and suggestions for other WOC interested in pursuing a career at UCCs. A total of 56 participants responded to an online survey. Two broad themes emerged with the data around (a) existing and expanding support from UCCs for WOC and (b) advice for WOC interested in pursuing a career in UCCs. Subthemes delineated were (a) professional development and support and (b) workplace climate. While most participants named how their agencies supported them, many provided suggestions on how UCCs can improve from the process of recruitment, retention, leadership, and professional development to being respectful of WOC’s boundaries and needs. Related to workplace climate, participants appreciated the spaces created for either them or their clients of color. They suggested UCCs to be strategic in providing spaces where genuine feedback can be provided, creating various spaces for WOC (e.g., listserv, lunch group), and facilitating ongoing diversity training and discussions. Participants also imparted their wisdom to WOC through encouragement and practical advice. This study centers the voices of WOC clinicians and discusses the importance of self-advocacy, the various supports needed from institutions, and how White supervisors and mentors can better serve their WOC supervisees and trainees.
Normalisation by default and normalisation by design: A systematic review of empirical studies on the normalisation of prison life
Authors: van de Rijt Jill , van Ginneken Esther F.J.C. , Boone Miranda M.
Published: August 2023

Normalisation is an important principle when shaping life in prison. The conceptualisation and operationalisation of normalisation are not straightforward, which merits a systematic review of the literature. This article reports the results from such a review, drawing on 16 empirical studies from a range of countries. Four relevant domains of normalisation in prison were identified: design, facilities and services, atmosphere, and identity. Additionally, the origins and dominant norms underpinning normalisation were found to differ depending on the local context: ‘normalisation by default’ resulted from resource scarcity and the importation of pre-existent roles, hierarchies and goods, while ‘normalisation by design’ was an intentional effort to shape prison conditions in line with conventional norms. These different manifestations were associated with different limitations and possible benefits. The article also discusses how normalisation is related to resocialisation and responsibilisation, and offers underexplored areas that deserve attention in future research.
Case report on the use of canakinumab for treatment of recurrent fevers and proteinuria in refractory systemic lupus erythematosus
Authors: Yavari Kimia , Grisanti Joseph
Published: August 2023

Systemic lupus erythematosus (SLE) is a chronic multiorgan autoimmune disease with a wide range of clinical manifestations and a characteristic renal involvement leading to proteinuria. There remains an unmet need in SLE disease management as standard treatments including anti-inflammatory drugs, corticosteroids, antimalarial agents, and immunosuppressant therapies are not always effective in moderating disease activity. We report a 41-year-old Caucasian female patient with a 12-year history of SLE complicated by debilitating nocturnal fevers and WHO Class IV lupus nephritis who for years was refractory to standard therapies but improved dramatically with canakinumab, an interleukin-1β (IL-1β)antagonist. This is the first case of the use of canakinumab in SLE. The standard interventions demonstrated no significant impact on her proteinuria (>3 g/24 h), joint complaints, and nocturnal fevers. Additionally, her anti-dsDNA levels remained elevated, and her kidney function did not improve significantly. In contrast, the introduction of canakinumab provided a rapid reduction in nocturnal fevers within 6 weeks (i.e. decreased in frequency by 90%). Her proteinuria has also dropped from 3.5 g/24 h to 0.274 g/24 h, and her prednisone has been tapered and discontinued. In addition, her renal function has improved with an average glomerular filtration rate (GFR) level of 84.14 ± 7.56. There has also been a significant decrease in both erythrocyte sedimentation rate (ESR) and anti-dsDNA levels compared with the previous treatments. We report that canakinumab could potentially represent the next step in SLE patients’ treatment who have failed conventional therapies or who are intolerant to them. In this case, the addition of canakinumab facilitated the tapering and ultimately discontinuing of corticosteroids. This case represents the first successful use of canakinumab in the treatment of refractory fevers and diffuse proliferative glomerulonephritis in SLE.
TikTok Videos and Sustainable Apparel Behavior: Social Consciousness, Prior Consumption and Theory of Planned Behavior
Authors: A Lin Carolyn , Wang Xihui , Dam Linda
Published: August 2023

Extant research addressing the relations between TikTok videos and sustainable apparel consumption behavior is limited. This study explores these relations by testing the following theories and constructs: social consciousness, prior sustainable apparel purchasing, attitude toward TikTok videos (featuring sustainable apparel content), and theory of planned behavior. Results from an online survey supported the proposed conceptual framework, suggesting that cognitive, affective, and behavioral factors relevant to sustainable apparel consumption had a positive influence on sustainable apparel purchase intention.
Public Discourse of Genetically Modified Organisms in China: An Investigation of Commenting and Reposting Behaviors on Social Media
Authors: Yu Nan , Song Yunya , Xu Qian
Published: August 2023

This study examined the factors affecting user engagement in the genetically modified organism (GMO) discourse on one of the most popular social media platforms in China. A content-analysis study was conducted with a sample of the most commented GMO posts on social media and over 7000 comments. Firstly, posts from well-known and government accounts facilitated the online discourse of GMOs. Secondly, the nature of the event and the features of GMO messages influenced how users engaged with the online discussion. Thirdly, among the commenters, female users were more likely to agree with the original posts whereas male users were more likely to repost the message. In conclusion, social media users held negative attitudes toward GMOs as they tended to repost more and agree more when GMO risks were mentioned. Source and message features, as well as commenters’ characteristics, were found to have a significant impact on user engagement. Social media continued to serve as an important public space to facilitate public debate on a controversial scientific topic.
Unpacking immediate public behavioral responses to earthquakes: A study focusing on the role of fatalism and fear
Authors: Sun Lei , Liu Xingyu
Published: August 2023

Compared to the numerous studies on the public’s seismic preparedness, few studies have focused on actual behavioral responses to earthquakes. According to an investigation of immediate public behavioral responses to an earthquake in the Beijing–Tianjin–Hebei region of China, this study found that the public’s response behaviors included two main patterns of self-protection and milling. It reveals that the adoption of a behavioral pattern is the result of a complex interaction of cultural and psychological factors related to fatalism and emotional response. Specifically, fatalism reduces the possibility of an individual engaging in self-protective activities. However, fear motivates a positive response. The findings in this study suggest that earthquake resilience can be enhanced through both cultural pathways and cognitive processes. These findings shed new light on earthquake behavioral science and aid policymakers in developing strategies for disaster education and emergency training, especially for people who hold fatalistic beliefs about disaster risk reduction.
Evidence-Based Practices Via Remote Service Delivery for Early Intervention in Rural Communities
Authors: Howe Elizabeth , Riggleman Samantha , Passmore Amanda
Published: August 2023

The COVID-19 pandemic increased the use of remote service delivery in early childhood intervention (EI), and this increased use is promising for young children with disabilities living in rural communities. However, the increase in remote service delivery requires a greater understanding of using evidence-based practices (EBP) delivered by EI providers via this mode. Remote service delivery adds a new context to EI services requiring study to identify (a) what works for whom and under what conditions, (b) how an evidence-based practice delivered remotely results in positive outcomes for young children and caregivers, and (c) the independent variables that influence those outcomes. This position paper explains the importance of remote service delivery for improving access to EBP for young children with disabilities and their families in rural communities using a conceptual framework. The conceptual framework includes three essential factors described in depth in this article. First, the conceptual framework can support researchers in designing rigorous studies to deliver evidence-based practices remotely. Second, the conceptual framework can support EI programs and providers in identifying EBP for service delivery for young children and families in rural communities.
A phase 2 trial of CD24Fc for prevention of graft-versus-host disease
Authors: Magenau John , Jaglowski Samantha , Uberti Joseph , Farag Sherif S. , Riwes Mary Mansour , Pawarode Attaphol , Anand Sarah , Ghosh Monalisa , Maciejewski John , Braun Thomas , Devenport Martin , Lu Susan , Banerjee Bhramori , DaSilva Carolyn , Devine Steven , Zhang Mei-Jie , Burns Linda J. , Liu Yang , Zheng Pan , Reddy Pavan
Published: August 2023

Patients who undergo human leukocyte antigen–matched unrelated donor (MUD) allogeneic hematopoietic stem cell transplantation (HSCT) with myeloablative conditioning for hematologic malignancies often develop acute graft-versus-host disease (GVHD) despite standard calcineurin inhibitor–based prophylaxis in combination with methotrexate. This trial evaluated a novel human CD24 fusion protein (CD24Fc/MK-7110) that selectively targets and mitigates inflammation due to damage-associated molecular patterns underlying acute GVHD while preserving protective immunity after myeloablative conditioning. This phase 2a, multicenter study evaluated the pharmacokinetics, safety, and efficacy of CD24Fc in combination with tacrolimus and methotrexate in preventing acute GVHD in adults undergoing MUD HSCT for hematologic malignancies. A double-blind, placebo-controlled, dose-escalation phase to identify a recommended dose was followed by an open-label expansion phase with matched controls to further evaluate the efficacy and safety of CD24Fc in preventing acute GVHD. A multidose regimen of CD24Fc produced sustained drug exposure with similar safety outcomes when compared with single-dose regimens. Grade 3 to 4 acute GVHD–free survival at day 180 was 96.2% (95% confidence interval [CI], 75.7-99.4) in the CD24Fc expansion cohort (CD24Fc multidose), compared with 73.6% (95% CI, 63.2-81.4) in matched controls (hazard ratio, 0.1 [95% CI, 0.0-0.6]; log-rank test, P = .03). No participants in the CD24Fc escalation or expansion phases experienced dose-limiting toxicities (DLTs). The multidose regimen of CD24Fc was well tolerated with no DLTs and was associated with high rates of severe acute GVHD–free survival after myeloablative MUD HSCT. This trial was registered at ClinicalTrials.gov as #NCT02663622.
How I treat transplant-eligible patients with myelofibrosis
Authors: Kröger Nicolaus , Wolschke Christine , Gagelmann Nico
Published: August 2023

Despite the approval of Janus kinase inhibitors and novel agents for patients with myelofibrosis (MF), disease-modifying responses remain limited, and hematopoietic stem cell transplantation (HSCT) remains the only potentially curative treatment option. The number of HSCTs for MF continues to increase worldwide, but its inherent therapy-related morbidity and mortality limit its use for many patients. Furthermore, patients with MF often present at an older age, with cytopenia, splenomegaly, and severe bone marrow fibrosis, posing challenges in managing them throughout the HSCT procedure. Although implementation of molecular analyses enabled improved understanding of disease mechanisms and subsequently sparked development of novel drugs with promising activity, prospective trials in the HSCT setting are often lacking, making an evidence-based decision process particularly difficult. To illustrate how we approach patients with MF with respect to HSCT, we present 3 different clinical scenarios to capture relevant aspects that influence our decision making regarding indication for, or against, HSCT. We describe how we perform HSCT according to different risk categories and, furthermore, discuss our up-to-date approach to reduce transplant-related complications. Last, we show how to harness graft-versus-MF effects, particularly in the posttransplant period to achieve the best possible outcomes for patients.
DHODH: a promising target in the treatment of T-cell acute lymphoblastic leukemia
Authors: Sexauer Amy N. , Alexe Gabriela , Gustafsson Karin , Zanetakos Elizabeth , Milosevic Jelena , Ayres Mary , Gandhi Varsha , Pikman Yana , Stegmaier Kimberly , Sykes David B.
Published: August 2023

Patients with relapsed or refractory T-cell acute lymphoblastic leukemia (T-ALL) have a poor prognosis with few therapeutic options. With the goal of identifying novel therapeutic targets, we used data from the Dependency Map project to identify dihydroorotate dehydrogenase (DHODH) as one of the top metabolic dependencies in T-ALL. DHODH catalyzes the fourth step of de novo pyrimidine nucleotide synthesis. Small molecule inhibition of DHODH rapidly leads to the depletion of intracellular pyrimidine pools and forces cells to rely on extracellular salvage. In the absence of sufficient salvage, this intracellular nucleotide starvation results in the inhibition of DNA and RNA synthesis, cell cycle arrest, and, ultimately, death. T lymphoblasts appear to be specifically and exquisitely sensitive to nucleotide starvation after DHODH inhibition. We have confirmed this sensitivity in vitro and in vivo in 3 murine models of T-ALL. We identified that certain subsets of T-ALL seem to have an increased reliance on oxidative phosphorylation when treated with DHODH inhibitors. Through a series of metabolic assays, we show that leukemia cells, in the setting of nucleotide starvation, undergo changes in their mitochondrial membrane potential and may be more highly dependent on alternative fuel sources. The effect on normal T-cell development in young mice was also examined to show that DHODH inhibition does not permanently damage the developing thymus. These changes suggest a new metabolic vulnerability that may distinguish these cells from normal T cells and other normal hematopoietic cells and offer an exploitable therapeutic opportunity. The availability of clinical-grade DHODH inhibitors currently in human clinical trials suggests a potential for rapidly advancing this work into the clinic.
Phase 1 study of vibecotamab identifies an optimized dose for treatment of relapsed/refractory acute myeloid leukemia
Authors: Ravandi Farhad , Bashey Asad , Foran James , Stock Wendy , Mawad Raya , Short Nicholas , Yilmaz Musa , Kantarjian Hagop , Odenike Olatoyosi , Patel Anand , Garcha Raman , Ainsworth William Barrett , Clynes Raphael , Kanodia Jitendra , Ding Ying , Li Huajiang , Kye Steve , Mims Alice
Published: August 2023

Acute myeloid leukemia (AML), an aggressive malignancy with unmet medical need, lacks immunotherapeutic options. CD123, the cellular receptor for interleukin-3, expressed in AML is an attractive target for tumor-specific therapy. Vibecotamab (XmAb14045), a humanized bispecific antibody, monovalently binds both CD3 and CD123 to recruit cytotoxic T cells to kill CD123+ tumor cells. This phase 1 study’s primary objectives were safety and tolerability and identification of a maximum tolerated dose/recommended dose for use as monotherapy in patients with relapsed/refractory AML. Identification of a recommended phase 2 vibecotamab dose comprised 3 step-up doses (Week 1), which were noted to reduce cytokine response syndrome (CRS), followed by weekly dosing (1.7 μg/kg, Cohort -1D). In 16 of 120 patients, at least 1 treatment-emergent adverse event was classified as a dose-limiting toxicity. CRS, the most common adverse event (59.2%), managed with premedication, were mostly ≤grade 2. A secondary objective was assessment of efficacy in patients with CD123-expressing leukemias. A total of 10 of 111 (9.0%) efficacy-evaluable patients with AML achieved an overall response of morphologic leukemia-free state or better with an overall objective response rate (ORR) of 9.0%. Response was only observed in patients receiving a target dose of 0.75 μg/kg or higher (n = 87) in which the efficacy-evaluable ORR was 11.5%. Response was associated with lower baseline blast counts in blood and bone marrow (<25%) suggesting potential benefit. This trial was registered at www.clinicaltrials.gov as #NCT02730312.
Improving the lightfastness and thermal stability of black urushi (oriental lacquer) by kraft lignin oleate
Authors: Tsuchiya Takao , Narita Chieko , Yamada Kazushi , Moreno Adrian , Sipponen Mika H. , Tsuda Hitomi , Okahisa Yoko
Published: August 2023

Urushi, an oriental lacquer, is sensitive to light and easily deteriorates upon light exposure, leading to the fading and loss of gloss of its coatings. In this study, we attempted to improve the lightfastness of black urushi by utilizing the UV-absorbing properties of kraft lignin. Oleic acid-esterified kraft lignin was prepared and added to the black urushi to improve the compatibility. No aggregation of oleic acid-esterified lignin occurred in the black urushi, and the physical properties of the films were maintained to a large extent. A possible chemical interaction between lignin and black urushi was suggested upon thermal analysis. It was also found that the addition of lignin improved the thermal dimensional stability of black urushi. Finally, the high gloss factor of the black urushi film was maintained by adding oleic acid-esterified lignin after 168 h of light irradiation. Oleic acid-esterified lignin therefore appears as a promising functional additive to improve photostability of urushi coatings.
Clinical characterization of patients with HLA-B27-associated uveitis and evaluation of the impact of systemic treatment on the recurrence rate: a cross-sectional study
Authors: Pineda-Sierra Juan Sebastián , Cifuentes-González Carlos , Rojas-Carabali William , Muñoz-Vargas Paula Tatiana , Henao-Posada Alejandro , de-la-Torre Alejandra
Published: August 2023

Introduction

Despite HLA-B27-associated uveitis is one of the most frequent etiologies of uveitis worldwide, there are scarce studies on the clinical spectrum of this disease and the implications of therapeutic strategies used in the Latin-American population, with none conducted in Colombia. Thus, this study aimed to describe the clinical characteristics of a cohort of patients with positive HLA-B27-associated uveitis in Colombia and evaluate the impact of systemic treatment on the recurrence rate.

Methods

We retrospectively reviewed 490 clinical charts of patients with uveitis, searching for those with positive HLA-B27-associated uveitis over eight years in a referral center in Bogotá, Colombia. We used descriptive statistics to summarize demographic and clinical characteristics and conducted a Chi-square test, Fisher Exact test, Spearman correlation, and Mann–Whitney test to assess associations between treatment strategies and the recurrences rate.

Results

We analyzed 39 patients (59% females) with positive HLA-B27-associated uveitis, with a median age at the first consultation of 44.5 years (Range: 2–80) and a mean follow-up time of 86.4 weeks (1.65 years). Most patients had unilateral uveitis (53.8%) and an anterior anatomical diagnosis (76.6%); two had anterior chamber fibrinous reaction, and only one had hypopyon. Most patients did not show associated systemic symptoms (66.7%). Topical corticosteroids, NSAIDs, methotrexate, mydriatics, and adalimumab were the most used treatments. The most common complications included cataracts, posterior synechiae, and macular edema. We identified that the rate of recurrences decreases over time (r = -0.6361, P = 0.002571), and this decrease seems to be associated with the initiation of disease-modifying antirheumatic drugs (DMARDs) in chronic and recurrent cases.

Conclusion

The clinical spectrum of HLA-B27-associated uveitis in Colombian patients is distinct from other latitudes. Notably, we found a female predominance, older age at presentation, higher frequency of bilateral and vitreous involvement, and lower frequency of concomitant systemic diseases. Additionally, our results suggest that DMARDs such as methotrexate and biologic agents are good therapeutic options to avoid recurrences in chronic and recurrent cases.