bluuebunny/crossref_metadata_2025 huggingface dataset:
High prevalence of cardiometabolic risk factors amongst young adults in the United Arab Emirates: the UAE Healthy Future Study
Authors: Mezhal Fatima , Oulhaj Abderrahim , Abdulle Abdishakur , AlJunaibi Abdulla , Alnaeemi Abdulla , Ahmad Amar , Leinberger-Jabari Andrea , Al Dhaheri Ayesha S. , AlZaabi Eiman , Al-Maskari Fatma , Alanouti Fatme , Alameri Fayza , Alsafar Habiba , Alblooshi Hamad , Alkaabi Juma , Wareth Laila Abdel , Aljaber Mai , Kazim Marina , Weitzman Michael , Al-Houqani Mohammad , Ali Mohammad Hag , Tuzcu E. Murat , Oumeziane Naima , El-Shahawy Omar , Al-Rifai Rami H. , Sherman Scott , Shah Syed M. , Alzaabi Thekra , Loney Tom , Almahmeed Wael , Idaghdour Youssef , Ahmed Luai A. , Ali Raghib
Published: March 2023

Background

Cardiovascular disease (CVD) is the leading cause of death in the world. In the United Arab Emirates (UAE), it accounts for 40% of mortality. CVD is caused by multiple cardiometabolic risk factors (CRFs) including obesity, dysglycemia, dyslipidemia, hypertension and central obesity. However, there are limited studies focusing on the CVD risk burden among young Emirati adults. This study investigates the burden of CRFs in a sample of young Emiratis, and estimates the distribution in relation to sociodemographic and behavioral determinants.

Methods

Data was used from the baseline data of the UAE Healthy Future Study volunteers. The study participants were aged 18 to 40 years. The study analysis was based on self-reported questionnaires, anthropometric and blood pressure measurements, as well as blood analysis.

Results

A total of 5167 participants were included in the analysis; 62% were males and the mean age of the sample was 25.7 years. The age-adjusted prevalence was 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. The CRFs were distributed differently when compared within social and behavioral groups. For example, obesity, dyslipidemia and central obesity in men were found higher among smokers than non-smokers (p < 0.05). And among women with lower education, all CRFs were reported significantly higher than those with higher education, except for hypertension. Most CRFs were significantly higher among men and women with positive family history of common non-communicable diseases.

Conclusions

CRFs are highly prevalent in the young Emirati adults of the UAE Healthy Future Study. The difference in CRF distribution among social and behavioral groups can be taken into account to target group-specific prevention measures.
Effects of receiving renal biopsy on the prognosis of chronic kidney disease patients with impaired renal function
Authors: Zhang Tianyi , Yang Xiaoqian , Zhang Minfang , Zhou Wenyan , Jin Yan , Zhou Hang , Zhou Yin , Wang Qin , Mou Shan
Published: March 2023

Background

Impaired renal function was not a recognized indication for renal biopsy. The effects of receiving renal biopsy on the renal functional prognosis for chronic kidney disease (CKD) patients with impaired renal function need to be explored.

Methods

This study retrospectively enrolled 300 renal function impaired CKD patients in Renji Hospital from January 2015 to December 2017, 150 of them received percutaneous renal biopsy while the others did not. The endpoint was ≥ 50% estimated glomerular filtration rate (eGFR) decline from baseline or development of end-stage renal disease (ESRD). Kaplan-Meier analysis with log-rank test was performed to compare the renal survival probability between patients receiving renal biopsy or not. Univariate and multivariate analysis with Cox regression were conducted with predictors of poor renal outcomes in the study cohort.

Results

The median follow-up period was 37.6 months. During the follow-up period, the eGFR of the biopsy group increased from 52.2 ± 14.4 to 67.4 ± 37.8 ml/min/1.73 m², but decreased from 55.3 ± 17.1 to 29.8 ± 19.1 ml/min/1.73 m² in the non-biopsy group. Patients who received renal biopsy had significantly higher renal survival probability (P < 0.001). Cox regression analysis revealed that 24-hour urine protein excretion (24 h UPE) more than 1 g/d was an independent predictor for poor renal outcomes in the non-biopsy group but not in the renal biopsy group (HR = 1.719, P = 0.040).

Conclusion

CKD patients with impaired renal function are recommended to receive renal biopsy to make pathological diagnoses, especially for those with the 24-hour urine protein excretion more than 1 g/d.
Validation of the pathological narcissistic inventory (PNI) and its brief form (B-PNI) in the Arabic language
Authors: Malaeb Diana , Asan A. Esin , Fekih-Romdhane Feten , Azzi Vanessa , El Dine Abir Sarray , Hallit Souheil , Pincus Aaron L.
Published: March 2023

Background

The Pathological Narcissism Inventory (PNI) is a multidimensional measure developed to assess narcissistic grandiosity and narcissistic vulnerability. We aimed to validate the Arabic version of the original Pathological Narcissistic Inventory (PNI) and its brief form (B-PNI) in a community sample of Lebanese adults.

Methods

The English language PNI items were translated into Arabic following a rigorous translation, back-translation, and linguistic evaluation. A total of 401 participants were administered the translated PNI, as well as previously validated Arabic versions of the Big Five Inventory-2, the Rosenberg Self-esteem Scale, the Patient Health Questionnaire (PHQ-9), and the Impulsivity-8 Scale.

Results

Exploratory and confirmatory analyses supported the existence of seven first-order and two second-order factors of the PNI and B-PNI. Except for exploitativeness where females scored lower than males, no other significant differences by gender were observed for the remaining PNI subscale scores. Additionally, scores on all the subscales exhibited good reliability, while the associations with external measures supported the concurrent validity of the translated instrument.

Conclusion

The results of this study suggest that scores on the PNI and B-PNI are highly reliable with satisfactory concurrent and factorial validity, providing an assessment of broadly defined pathological narcissism among the Lebanese young adult population. The availability of the Arabic PNI and its brief form should facilitate improved understanding of pathological narcissism in Arabic cultures and the different factors that govern narcissistic personality pathology.
Valproate-related neutropenia and lithium-related leukocytosis in patients treated with clozapine: a retrospective cohort study
Authors: Yang Chia-Chun , Wang Xi-Yu , Chou Po-Han , Lin Ching-Hua
Published: March 2023

Background

Neutropenia is a noteworthy side effect of clozapine, which might warrant this drugs’ discontinuance for safety. Studies have revealed that the risk of neutropenia increases with concurrent administration of valproate, but the evidence was limited. Conversely, lithium may have an ameliorating effect on clozapine-induced neutropenia. This study explored the effects of valproate and lithium on white blood cell counts in patients treated with clozapine.

Methods

We retrospectively investigated the electronic medical records from one tertiary psychiatric hospital in Taiwan and enrolled patients discharged between January 1, 2006, and December 31, 2017, with clozapine prescriptions. We scrutinized their demographic data, medications, and hematological results at discharge and during follow-up outpatient clinic visits over the subsequent 3 years. Patients were classified into four groups: clozapine only (CLO), clozapine and valproate (CLO + VAL), clozapine and lithium (CLO + Li), and clozapine, valproate, and lithium (CLO + VAL + Li). We also identified hematological events (neutropenia or leukocytosis) of these patients during outpatient follow-ups.

Results

Of the included 1084 patients, 55(5.1%) developed neutropenia. Concurrent valproate use (odds ratio [OR] = 3.49) and older age (p = .007) were identified as risk factors. Moreover, 453 (41.79%) patients developed leukocytosis. Younger age; male sex; and concurrent use of lithium (OR = 3.39, p < .001), clozapine daily dosage, and benzodiazepines were the risk factors for leukocytosis.

Conclusion

Concurrent valproate use and older age are associated with the development of neutropenia in patients treated with clozapine. Concurrent lithium usage, younger age, male sex, and concurrent benzodiazepine use might be related to leukocytosis.
What is manipulation? A new definition
Authors: Evans David W. , Lucas Nicholas
Published: March 2023

Background

Definitions are important in healthcare. Unfortunately, problems can be found withall existing definitions of manipulation.

Methods

This paper derives a set of eligibility criteria from prior definitions of manipulation to inform what should (and should not) be incorporated within a valid definition. These criteria were then used to select components from currently available empirical data to create a new definition.

Results

The resulting definition of manipulation is: “Separation (gapping) of opposing articular surfaces of a synovial joint, caused by a force applied perpendicularly to those articular surfaces, that results in cavitation within the synovial fluid of that joint.” The corresponding definition for the mechanical response of a manipulation is: “Separation (gapping) of opposing articular surfaces of a synovial joint that results in cavitation within the synovial fluid of that joint.” In turn, the action of a manipulation can be defined as: “A force applied perpendicularly to the articular surfaces.”

Conclusions

We believe these definitions to be valid (derived from and consistent with all available empirical data), complete (containing all necessary components), minimally sufficient (minimal redundancy, and sufficient to distinguish manipulation from other physical interventions), and robust (able to withstand important limitations embodied within sensible eligibility criteria). It is hoped that the simplicity and clarity of these definitions, and the transparency of their formation, will encourage their wide adoption in clinical, research, educational and professional settings.
A clinical study of the piezosurgery, high-speed contra-angle handpiece, and the combined application of both for extraction of embedded supernumerary teeth
Authors: Maihemaiti Maihepireti , Ainiwaer Ailimaierdan , Wang Ling
Published: March 2023

Objectives

To compare the effectiveness of three methods: high-speed contra-angle handpiece (HSCAH), piezosurgery, and combined in the extraction of different locations and types of embedded supernumerary teeth.

Methods

Sixty cases with different locations and different types of embedded supernumerary teeth were randomly divided into three groups for extraction by HSCAH, piezosurgery, and the combination of both, and the intraoperative and postoperative conditions of the three groups were compared and analyzed.

Results

In the extraction of embedded supernumerary teeth in the inverted, horizontal, and root tip positions, the piezosurgery group required significantly longer operative time and reduced intraoperative bleeding compared with the HSCAH and the piezosurgery combined with the HSCAH; it could effectively relieve postoperative pain and facial swelling. In the extraction of oblique, orthodontic, middle, and crown segments of embedded supernumerary teeth, the use of a piezosurgery combined with an HSCAH can effectively reduce the operative time, while the factors of bleeding, postoperative pain, and facial swelling not statistically significant when compared with a piezosurgery. Compared with the HSCAH and combined piezosurgery, piezosurgery can significantly reduce the fear of patients.

Conclusion

Piezosurgery is effective in extracting embedded supernumerary teeth in inverted, horizontal, and apical positions, effectively reducing intraoperative and postoperative trauma and shortening the time required for healing. The piezosurgery combined with an HSCAH can effectively reduce intraoperative and postoperative trauma when extracting embedded supernumerary teeth in oblique, orthodontic, middle, and crown positions. piezosurgery is a technique suitable for the treatment of patients with fear.
“It’s like asking for a necktie when you don’t have underwear”: Discourses on patient rights in southern Karnataka, India
Authors: Putturaj Meena , Van Belle Sara , Krumeich Anja , NS Prashanth , Engel Nora
Published: March 2023

Background

Ensuring patient rights is an extension of applying human rights principles to health care. A critical examination of how the notion of patient rights is perceived and enacted by various actors through critical discourse analysis (CDA) can help understand the impediments to its realization in practice.

Methods

We studied the discourses and discursive practices on patient rights in subnational policies and in ten health facilities in southern Karnataka, India. We conducted interviews (78), focus group discussions (3) with care-seeking individuals, care-providers, health care administrators and public health officials. We also conducted participant observation in selected health facilities and examined subnational policy documents of Karnataka pertaining to patient rights. We analyzed the qualitative data for major and minor themes.

Results

Patient rights discourses were not based upon human rights notions. In the context of neoliberalism, they were predominantly embedded within the logic of quality of care, economic, and consumerist perspectives. Relatively powerful actors such as care-providers and health facility administrators used a panoply of discursive strategies such as emphasizing alternate discourses and controlling discursive resources to suppress the promotion of patient rights among care-seeking individuals in health facilities. As a result, the capacity of care-seeking individuals to know and claim patient rights was restricted. With neoliberal health policies promoting austerity measures on public health care system and weak implementation of health care regulations, patient rights discourses remained subdued in health facilities in Karnataka, India.

Conclusions

The empirical findings on the local expression of patient rights in the discourses allowed for theoretical insights on the translation of conceptual understandings of patient rights to practice in the everyday lives of health system actors and care-seeking individuals. The CDA approach was helpful to identify the problematic aspects of discourses and discursive practices on patient rights where health facility administrators and care-providers wielded power to oppress care-seeking individuals. From the practical point of view, the study demonstrated the limitations of care-seeking individuals in the discursive realms to assert their agency as practitioners of (patient) rights in health facilities.
Alleviating the hypoxic tumor microenvironment with MnO2-coated CeO2 nanoplatform for magnetic resonance imaging guided radiotherapy
Authors: Pi Fen , Deng Xuanru , Xue Qian , Zheng Lan , Liu Hongxing , Yang Fang , Chen Tianfeng
Published: March 2023

Background

Radiotherapy is a commonly used tool in clinical practice to treat solid tumors. However, due to the unique microenvironment inside the tumor, such as high levels of GSH, overexpressed H2O2 and hypoxia, these factors can seriously affect the effectiveness of radiotherapy.

Results

Therefore, to further improve the efficiency of radiotherapy, a core–shell nanocomposite CeO2–MnO2 is designed as a novel radiosensitizer that can modulate the tumor microenvironment (TME) and thus improve the efficacy of radiation therapy. CeO2–MnO2 can act as a radiosensitizer to enhance X-ray absorption at the tumor site while triggering the response behavior associated with the tumor microenvironment. According to in vivo and in vitro experiments, the nanoparticles aggravate the killing effect on tumor cells by generating large amounts of ROS and disrupting the redox balance. In this process, the outer layer of MnO2 reacts with GSH and H2O2 in the tumor microenvironment to generate ROS and release oxygen, thus alleviating the hypoxic condition in the tumor area. Meanwhile, the manganese ions produced by degradation can enhance T1-weighted magnetic resonance imaging (MRI). In addition, CeO2–MnO2, due to its high atomic number oxide CeO2, releases a large number of electrons under the effect of radiotherapy, which further reacts with intracellular molecules to produce reactive oxygen species and enhances the killing effect on tumor cells, thus having the effect of radiotherapy sensitization. In conclusion, the nanomaterial CeO2–MnO2, as a novel radiosensitizer, greatly improves the efficiency of cancer radiation therapy by improving the lack of oxygen in tumor and responding to the tumor microenvironment, providing an effective strategy for the construction of nanosystem with radiosensitizing function.

Conclusion

In conclusion, the nanomaterial CeO2–MnO2, as a novel radiosensitizer, greatly improves the efficiency of cancer radiation therapy by improving the lack of oxygen in tumor and responding to the tumor microenvironment, providing an effective strategy for the construction of nanosystems with radiosensitizing function.
Right ventricle-specific therapies in acute respiratory distress syndrome: a scoping review
Authors: Ganeriwal Simran , Alves dos Anjos Gabriele , Schleicher Mary , Hockstein Maxwell A. , Tonelli Adriano R. , Duggal Abhijit , Siuba Matthew T.
Published: March 2023

Objective

To summarize knowledge and identify gaps in evidence regarding treatment of right ventricular dysfunction (RVD) in acute respiratory distress syndrome (ARDS).

Data sources

We conducted a comprehensive search of MEDLINE, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials.

Study selection

Studies were included if they reported effects of treatments on right ventricular function, whether or not the intent was to modify right ventricular function.

Data extraction

Data extraction was performed independently and in duplicate by two authors. Data items included the study design, patient population, type of intervention, comparison group, and RV-specific outcomes.

Data synthesis

Of 1,430 studies screened, 51 studies reporting on 1,526 patients were included. By frequency, the included studies examined the following interventions: ventilator settings (29.4%), inhaled medications (33.3%), extracorporeal life support (13.7%), intravenous or oral medications (13.7%), and prone positioning (9.8%). The majority of the studies were non-randomized experimental studies (53%), with the next most common being case reports (16%). Only 5.9% of studies were RCTs. In total, 27% of studies were conducted with the goal of modifying RV function.

Conclusions

Given the prevalence of RVD in ARDS and its association with mortality, the dearth of research on this topic is concerning. This review highlights the need for prospective trials aimed at treating RV dysfunction in ARDS.
Micellar eco-friendly HPLC method for simultaneous analysis of ternary combination of aspirin, atorvastatin and ramipril: application to content uniformity testing
Authors: Abdallah Nora A. , El-Brashy Amina M. , Ibrahim Fawzia A. , El-Awady Mohamed I.
Published: March 2023

Background

Cardiovascular disease medications such as aspirin (ASP), statins like atorvastatin (ATR), and blood pressure-lowering drugs including ACE inhibitors like ramipril (RAM) have been included in the World Health Organization (WHO) Essential Medicines List (EML) for many years. Therefore, there is a strong demand to develop a simple, rapid, and sensitive analytical method that can detect and quantitate the ternary mixture of these analytes in pharmaceutical preparations in a short run time. Lately, the analytical community focused on eliminating or reducing hazardous chemicals and solvents usage.

Results

A green, fast, selective, and cost-effective micellar HPLC method was established and validated for the concurrent determination of ternary combination of ASP, ATR, and RAM in the pure form and pharmaceutical preparations. Resolution of the three drugs was achieved by using a monolithic column and a micellar mobile phase consists of 0.3% triethylamine (TEA) in 90: 10 an aqueous solution of 0.12 M sodium dodecyl sulfate (SDS): n-propanol, (v/v). The pH was adjusted to 2.5 using orthophosphoric acid and a flow rate of 1.5 mL/min. was applied. To ensure method reproducibility, Valsartan (VAL) was utilized as an internal standard (IS). The UV detection of the studied drugs was performed at 210 nm. Good linearity for the three drugs was obtained over the concentration ranges of 1.0-200.0 mg/mL, 0.5-200.0 mg/mL, and 5.0-100.0 mg/mL with correlation coefficients of 0.9998,0.9999 and 0.9999 for ASP, ATR, and RAM respectively. The method sensitivity was revealed by the relatively small values of limits of detection (LOD) (0.19, 0.13 and 0.30 mg/mL) and limits of quantitation (LOQ) (0.63, 0.44 and 0.99 mg/mL) for ASP, ATR, and RAM, respectively. The retention times of ASP, ATR and RAM were 1.50, 2.3 and 4.3 min., respectively.

Conclusions

The suggested technique was employed for the analysis of the three drugs in their prepared tablets maintaining the recommended pharmaceutical ratio without any interference from excipients. The method was further extended to content uniformity testing of RAM. The results were validated according to international council for harmonisation (ICH) guidelines.
How does the increase in foreign players affect football?
Authors: Sever Ozan , Ciğerci Erdem , Öztop Melih , İpekoğlu Gökhan , Gönülateş Süleyman , Akyildiz Zeki , Nobari Hadi
Published: March 2023

Background

In the study, we tried to analyze the effects of foreign players on Turkish Super League matches. For this purpose, in this long-term study, 1836 competition data played in 6 seasons between 2014 and 2020 was obtained from www.mackolik.com each year.

Method

Pearson's correlation coefficient applied between 18 different variables (goal, shoot, pass, cross, corner, offside, foul, yellow card, red card, accurate shot, percentage of the precise pass, rate of accurate access on opponent's field, the difference of ball possession percentage, shot difference, pass difference, big team superiority, home team superiority) and the number of foreign players (NoFP, active foreign players in 90 min.).

Result

In the Turkish Super League, within six seasons (2014–20), the NoFP in a match increased from 10.43 (38.06%) to 17.99 (64.26%). The increment was partially linear and statistically significant (F = 594.85) in all seasons. A positive association was found between NoFP several of passes (r = 0.219), percentage of accurate passes (r = 0.133), percentage of precise passes on the opponent's field (r = 0.139), exact pass difference between opponents (r = 0.114), and ball possession difference between opponents (r = 0.113). Fouls committed decreased with the increase of NoFP (r = -0.250). Although the win probability of the teams named The Big Three (Fenerbahçe, Galatasaray, and Beşiktaş) decreased from 67% (2014 season rate) to 50% in the last two seasons, no association was identified between the NoFP and big team superiority.

Conclusions

Consequently, NoFP increment may improve the game quality by increasing accurate passes and passes in the opponent's field. The number of passes and the ball possession percentage difference between opponent teams may indicate that one team has control of the game by keeping possession or the other is tactically giving possession. These findings may suggest that the game evolved into half-field, tactical, set-play, possessioning competition. Analyzing variables such as game speed, intensity, the duration of the ball in play, running distance, energy consumption, and fatigue markers may light future studies.
Melanoma of unknown primary origin with skeletal muscle metastasis: a case report
Authors: Andrianandrasana Ny Ony Tiana Florence , Randrianarisoa Rova Malala Fandresena , Navoly Patty , Ranaivoson Mirana Andoniaina Christiana , Vololontiana Hanta Marie Danielle , Rafaramino Florine
Published: March 2023

Background

Melanoma is usually discovered from an irregular skin patch or a modification of a preexisting patch. Cutaneous and lymph node metastases are common. Muscle metastases are rare. We report a case of melanoma with infiltration of the gluteus maximus, which had normal dermatological examination.

Case presentation

A 43-year-old Malagasy man with no history of skin surgery was admitted with progressively worsening dyspnea. On admission, he presented with superior vena cava syndrome, painless cervical lymphadenopathy, and a painful swelling in the right buttock. Skin and mucous membrane examination did not reveal any abnormal or suspicious lesions. The biology was limited to a C-reactive protein of 40 mg/L, a white blood cell count of 23 G/L, and a lactate dehydrogenase level of 1705 U/L. The computed tomography scan showed several lymphadenopathies, compression of the superior vena cava, and a tissue mass at the expense of the gluteus maximus. Cervical lymph node biopsy and cytopuncture of the gluteus maximus were consistent with a secondary melanoma location. A stage IV melanoma of unknown primary origin, and with stage TxN3M1c associated with lymph node metastases and extension to the right gluteus maximus, was suggested.

Conclusions

Melanoma of unknown primary origin accounts for 3% of diagnosed melanomas. Diagnosis is difficult in the absence of a skin lesion. Patients are diagnosed with multiple metastases. Muscle involvement is unusual and may suggest a benign pathology. In this context, biopsy remains essential for diagnosis.
Peripheral nerve injuries in children—prevalence, mechanisms and concomitant injuries: a major trauma center’s experience
Authors: Aman Martin , Zimmermann Kim S. , Boecker Arne H. , Thielen Mirjam , Falkner Florian , Daeschler Simeon , Stolle Annette , Kneser Ulrich , Harhaus Leila
Published: March 2023

Background

Peripheral nerve injuries are severe conditions with potential lifelong impairment, which is especially meaningful for the pediatric population. Knowledge on prevalence, injury mechanisms and concomitant injuries is, therefore, of utmost importance to increase clinician awareness and enable early diagnosis and treatment. As current literature on pediatric nerve lesions and concomitant injuries is scarce, we aimed to analyze all details of our patient population.

Methods

A total of 110 667 patients treated at our level 1 trauma center from 2012 to 2021 were evaluated for pediatric peripheral nerve injuries, causes, concomitant injuries and assessed for lesion classification (in continuity, partial lesion, dissection) and further relevant intraoperative findings.

Results

We found 5026 patients of all ages with peripheral nerve lesions, whereof 288 were pediatric, resulting in a prevalence of 5.7% of pediatric patients with nerve injuries. Mean age was 12.4 ± 4.6 years. Most common lesions were digital nerves (48.2%), followed by median (14.9%), ulnar (14.6%), radial (8.8%), peroneal nerve (5.2%) and brachial plexus injuries (2.1%). Of all pediatric nerve injuries, 3.8% were iatrogenic, only 30.2% had preserved continuity and 47.3% a concomitant vessel injury. Fractures were accompanied in 22.6%.

Discussion

We observed that a large proportion of injures had complete transections, often accompanied by concomitant vessel injuries especially in distally located injuries, highlighting the importance of early surgical exploration. Radial, ulnar and lower extremity nerve injuries were often associated with fractures. Early surgical nerve repair is key to improve motor and sensory outcomes. Knowledge on mechanisms and concomitant injuries facilitates timely diagnosis and treatment, thereby potentially preventing lifelong impairment.
Analysis of soil electrical resistivity and hydraulic conductivity relationship for characterisation of lithology inducing slope instability in residual soil
Authors: Olabode Oladunjoye P. , San Lim H.
Published: March 2023

Slope instability occurrences as damaging shallow-landslides in the residual soil around mountains has been widely studied with geophysical, geotechnical and hydrogeological techniques but relating soil electrical resistivity to hydraulic conductivity for characterisation of lithology inducing of these landslides is not common. In this study, we used Electrical Resistivity Tomography (ERT) data and Hydraulic Conductivity (HC) data obtained from soil samples collected within 1–4.5 m depth in the borehole to assess the characteristics of soil that can induce landslide in the study location. The HC data were derived empirically from Beyer, Kozeny-Carman and Slitcher formula which were validated with HC obtained from laboratory experiment. The Empirical Derived Hydraulic Conductivities (EDHC) were correlated with the soil resistivity. The result shows a strong correlation between soil resistivity and HC with regression values of R2 = 0.9702, R2 = 0.9153 and R2 = 0.9232 for Beyer, Kozeny-Carman and Slitcher formula, respectively. The ERT model revealed a possible sliding surface between two contrasting resistive top material and underneath conductive materials at about 4 m depth. The HC assessment result corroborated the ERT model result because high and low-HC values were obtained in the borehole soil samples within 0–4 m and > 4 m depths from EDHC, respectively. The low-HC zone below 4 m depth was responsible for the occurrences of the shallow-landslides in the study.
A highly challenging balance training intervention for people with multiple sclerosis: a feasibility trial
Authors: Wallin A. , Franzén E. , Ekman U. , Piehl F. , Johansson S.
Published: March 2023

Background

Balance training interventions with a gradual progression of difficulty and highly challenging tasks designed specifically for people with multiple sclerosis (MS) are rare. The objective was to adapt a balance training intervention originally developed for Parkinson’s disease through a co-design process and then conduct a pilot trial in MS to evaluate the feasibility of a large, full-scale study.

Methods

Twelve people with MS with mild to moderate overall MS-disability were included in this single-group feasibility trial. Participants received one-hour training sessions twice or three times weekly for 10 weeks. The assessment included tests of physical and cognitive functioning and patient-reported quality of life-related outcomes. Data on feasibility aspects were collected at baseline and follow-up assessments and three times during the intervention period to inform the recruitment process, as well as to monitor retention and inclusion rates, study procedures, intervention delivery, and dynamic changes in the selected potential outcome measures. Progression criteria were used to determine whether to proceed to a full-scale trial. Descriptive statistics were used to present the data.

Results

Out of six progression criteria, only retention and attendance at training sessions were not met. Reasons reported for not completing the intervention period mainly depended on external circumstances beyond the control of the study. In contrast, study procedures, intervention delivery, and intervention content (progression, adjustment, and control of challenge level of exercises) were considered feasible for a future, full-scale trial. The Mini-BESTest, which was used for the assessment of balance control, was considered suitable as the primary outcome in a full-scale trial with no ceiling or floor effects. Further, the Mini-BESTest showed a positive trend in outcome response with a median difference of 3.5 points between baseline and follow-up assessments. The power calculation performed suggests a feasible number of participants for recruitment.

Conclusions

Overall trial aspects and intervention delivery were deemed feasible for a full-scale trial, but adjustments are needed to increase retention and attendance.
German translation, cross-cultural adaption and validation of the Venous Clinical Severity and Venous Disability Scores
Authors: Hofmann Amun , Deinsberger Julia , Kienzl Philip , Rigler Eva , Anzengruber Florian , Weber Benedikt
Published: March 2023

Background

The Venous Clinical Severity Score (VCSS) and the Venous Disability Score (VDS) represent assessment tools for chronic venous disease (CVD) combining physician and patient reported outcomes. To date, German versions are not available. The present study aimed at translating the VCSS and VDS into German and validating the questionnaires.

Methods

Translations of VCSS and VDS were compiled based on published guidelines considering potential differences in the use of German language in different countries. For validation, 33 patients with chronic venous disease and 5 healthy individuals were included in the pre-testing phase. Patients were examined twice by independent investigators to validate test–retest-validity culminating in 142 limb examinations. Internal consistency, inter-rater dependence and external reliability were subsequently evaluated.

Results

All assessed metrics showed good internal consistency. Intra-class correlation coefficients were .75 for the VDS, .98 for the VCSS of the right leg and .90 for the VCSS of the left leg, indicating inter-rater independence. Furthermore, VCSS scores showed a modest positive correlation with CEAP C class and both VCSS and VDS showed a negative correlation with the physical component of the SF-12, indicating adequate external reliability.

Conclusion

A pan-cultural German version of both the VCSS and VDS was established and validated as reliable tools to evaluate the severity of CVD in German speaking countries.
The phantasm of zero suicide
Authors: Sjöstrand Manne , Eyal Nir
Published: March 2023

Governments and non-governmental organisations are increasingly adopting a ‘zero-suicide’ goal, but what such a goal precisely involves is unclear. Ostensibly it strongly prioritises the prevention and elimination of all suicide. We argue that, so understood, a societal goal of zero suicide risks contravening several ethical principles. In terms of beneficence and non-maleficence, a ‘zero-suicide’ goal risks being inefficient and may burden or harm many people. Autonomy-wise, a blanket ban on all suicide is excessive. As regards social justice, zero suicide risks focusing on the symptoms of social malaise instead of the structures causing it. With respect to transparency, a ‘zero’ goal that cannot be met makes these authorities look detached and risks frustration, distrust and, worse, stigmatisation of suicide and of mental health conditions. Instead, we propose a middle path for suicide prevention, founded on harm reduction, ‘soft group paternalism’ and efforts directed at increased quality of life for disadvantaged groups. Although soft group paternalism respects autonomy, this approach permits coercive interferences in certain circumstances. We hope that the justificatory framework tying together these largely familiar elements is novel and sensible.
Axon–axon interactions determine modality-specific wiring and subcellular synaptic specificity in a somatosensory circuit
Authors: Galindo Samantha E. , Wood Abby J. , Cooney Patricia C. , Hammond Luke A. , Grueber Wesley B.
Published: March 2023

Synaptic connections between neurons are often formed in precise subcellular regions of dendritic arbors with implications for information processing within neurons. Cell–cell interactions are widely important for circuit wiring; however, their role in subcellular specificity is not well understood. We studied the role of axon–axon interactions in precise targeting and subcellular wiring of Drosophila somatosensory circuitry. Axons of nociceptive and gentle touch neurons terminate in adjacent, non-overlapping layers in the central nervous system (CNS). Nociceptor and touch receptor axons synapse onto distinct dendritic regions of a second-order interneuron, the dendrites of which span these layers, forming touch-specific and nociceptive-specific connectivity. We found that nociceptor ablation elicited extension of touch receptor axons and presynapses into the nociceptor recipient region, supporting a role for axon–axon interactions in somatosensory wiring. Conversely, touch receptor ablation did not lead to expansion of nociceptor axons, consistent with unidirectional axon–axon interactions. Live imaging provided evidence for sequential arborization of nociceptive and touch neuron axons in the CNS. We propose that axon–axon interactions and modality-specific timing of axon targeting play key roles in subcellular connection specificity of somatosensory circuitry.
Grade 3 invasive breast cancer masquerading as a hematoma—the importance of concordance in the clinical and imaging pathway
Authors: Menezes Ramona , Kostic Daniella , Moyle Penelope
Published: March 2023

Cystic lesions of the breast are an everyday encounter in the symptomatic breast clinic. While the vast majority of cystic lesions are benign, it is important to be aware of the imaging manifestations that indicate a sinister pathology and the pitfalls of biopsy in a complex cystic lesion which make the diagnosis challenging. We present a case of cystic Grade 3 breast cancer and highlight the imaging characteristics and clinical-radiological concordance that achieved the correct diagnosis.
Εκπαίδευση και νεολαία στην κατεχόμενη Λάρισα (1941-1944)
Authors: Μήτσιου Δέσποινα-Μαρία
Published: March 2023

Αντικείμενο της μελέτης "Εκπαίδευση και Νεολαία στην κατεχόμενη Λάρισα (1941-1944)" αποτελεί η διερεύνηση των εκπαιδευτικών και κοινωνικών πραγμάτων στη Λάρισα την περίοδο της κατοχής. Η ιταλογερμανική κατοχή δημιούργησε μία νέα πραγματικότητα, η οποία είχε αντίκτυπο στην κοινωνία, την πολιτική, την οικονομία και την εκπαίδευση. Επιπλέον, η στάση των κατακτητών επηρέασε σε μεγάλο βαθμό τη στάση των πολιτών και κυρίως της νεολαίας, αλλά καθόρισε και τη λειτουργία της εκπαίδευσης. Η παρούσα μελέτη αποτελεί μία ερευνητική προσέγγιση της τοπικής ιστορίας της εκπαίδευσης κατά την παραπάνω περίοδο. Ως χρονικά όρια τίθενται η 19η Απριλίου, ημέρα εισβολής των Γερμανών κατακτητών στην πόλη μέχρι και την απελευθέρωσή της στις 23 Οκτωβρίου 1944. Τα γεγονότα εκτυλίσσονται στη Λάρισα με αναφορές και στην ευρύτερη περιοχή, εφόσον υπάρχει σύνδεση ή συσχετισμός με όσα διαδραματίστηκαν στην περιοχή της Λάρισας.
Μελέτη της αθηροσκληρυντικής καρδιοπάθειας σε σχέση με τη διάδραση του επικαρδιακού λίπους
Authors: Καραμπέτσου Νικολέτα
Published: March 2023

Εισαγωγή: Το επικαρδιακό λίπος αποτελεί έναν σπλαγχνικό λιπώδη ιστό, ο οποίος φαίνεται πως διαδραματίζει καθοριστικό ρόλο στην εμφάνιση διαφόρων καρδιαγγειακών παθήσεων, όπως η στεφανιαία νόσος. Σκοπός: Στη μελέτη αυτή διερευνήσαμε τις τοπικές διαφορές του επικαρδιακού λίπος όσον αφορά στην τοπική φλεγμονώδη αντίδραση, ενώ ταυτόχρονα μελετήσαμε και τη σημασία της μέτρησης του πάχους του επικαρδιακού λίπους. Μέθοδοι: Τριάντα δύο ασθενείς με προχωρημένη στεφανιαία νόσο που υπεβλήθησαν σε χειρουργείο αορτοστεφανιαίας παράκαμψης εντάχθηκαν στη μελέτη αυτή. Δείγματα επικαρδιακού λίπους προερχόμενα από τον πρόσθιο κατιόντα ελήφθησαν τόσο από το σημείο της στένωσης του προσθίου κατιόντα όσο και από μη στενωτικές περιοχές του αγγείου αυτού. Αποτελέσματα: Η μέση ηλικία των ατόμων που εντάχθηκαν στη μελέτη αυτή ήταν 64±1.1 έτη, ενώ το μέσο πάχος του επικαρδιακού λίπους ήταν 7.4± 1.9 χιλιοστά. Συνολικά 11 παράγοντες φλεγμονής μελετήθηκαν και πραγματοποιήθηκε σύγκριση των συγκεντρώσεών τους ανάμεσα στα στενωτικά και μη στενωτικά τμήματα. Εφτά από τους παράγοντες αυτούς παρουσίασαν στατιστικά σημαντικά υψηλότερες τιμές στα δείγματα του επικαρδιακού λίπους προερχόμενα από την περιοχή στένωσης του προσθίου κατιόντα συγκριτικά με τις μη στενωτικές περιοχές. Ο παράγοντας νέκρωσης των όγκων (TNF-α), καθώς και η ιντερλευκίνη 1 α (IL- 1 α) παρουσίαζαν θετική συσχέτιση και με κλινικές συννοσηρότητες, όπως ο σακχαρώδης διαβήτης. Συμπεράσματα: Το περιστεφανιαίο επικαρδιακό λίπος αποτελεί πηγή έκκρισης φλεγμονωδών παραγόντων, οι οποίοι συμβάλλουν στην τοπική φλεγμονώδη αντίδραση στα άτομα με προχωρημένη στεφανιαία νόσο.
Εκτίμηση του μυοκαρδιακού εμφράκτου σε τυχαιοποιημένους ασθενείς με οξύ στεφανιαίο σύνδρομο με ανάσπαση του ST διαστήματος, οι οποίοι υποβάλλονται σε θρομβόλυση, υπό κλοπιδογρέλη η τικαγρελόρη
Authors: Πετούσης Στυλιανός
Published: March 2023

Στο έμφραγμα του μυοκαρδίου με ανάσπαση του διαστήματος (STEMI) η ταχύτερη και ισχυρότερη αντιαιμοπεταλιακή δράση της τικαγρελόρης σε σχέση με την κλοπιδογρέλη ,αλλά και οι άλλες αναφερόμενες πλειοτροπικές της δράσεις μπορεί να έχει ως αποτέλεσμα μεγαλύτερη προστασία του μυοκαρδίου και περιορισμό του εμφράγματος του μυοκαρδίου.Ο σκοπός της μελέτης αυτής ήταν να συγκρίνει το αποτέλεσμα της τικαγρελόρης και της κλοπιδογρέλης στον δείκτη της διάσωσης του μυοκαρδίου σε ασθενείς με STEMI oι οποίοι υποβάλλονται σε θρομβόλυση.Περιλήφθηκαν σαρανταδύο ασθενείς με STEMI οι οποίοι αντιμετωπίστηκαν με θρομβόλυση και οι οποίοι είχαν προηγουμένως τυχαιοποιηθεί σε αγωγή με τικαγρελόρη (21) η κλοπιδογρέλη (21) σε συνδυασμό με ασπιρίνη. Η περιοχή του ισχαιμικού μυοκαρδίου σε κίνδυνο (Area At Risk -AAR) υπολογίστηκε με την χρήση των αγγειογραφικών μεθόδων BARI και APPROACH.Το τελικό μέγεθος του μυοκαρδιακού εμφράκτου (Final Infarct Size-FIS) ποσοτικοποιήθηκε με μαγνητική καρδίας μεταξύ του 1035όυ και του 6όυ μήνα μετά . Ο δείκτης διάσωσης του μυοκαρδίου υπολογίστηκε ως (ΑΑR-FIS)/AAR X 100%. To πρωτεύον καταληκτικό σημείο της μελέτης ήταν ο δείκτης μυοκαρδιακής διάσωσης (Myocardial Salvage Index). Δευτερεύοντα καταληκτικά σημεία ήταν το τελικό μέγεθος του μυοκαρδιακού εμφράκτου (FIS) και το κλάσμα εξωθήσεως της αριστερής κοιλίας (Left Ventricle Ejection Fraction-LVEF) υπολογιζόμενο από την μαγνητική καρδίας.Χρησιμοποιώντας το BARI score για τον υπολογισμό της αρχικής μυοκαρδιακής περιοχής σε κίνδυνο η μέση τιμή του μυοκαρδιακού δείκτη διάσωσης του μυοκαρδίου ήταν 52.25±30.5 για την ομάδα της κλοπιδογρέλης και 54.29±31.08 για την ομάδα της τικαγρελόρης (p=0,83),ενώ υπολογίζοντας την περιοχή του μυοκαρδίου σε κίνδυνο με την χρήση του APPROACH score οι τιμές ήταν 51.94±30 και 53.09±32.39 (p=0,9) αντίστοιχα.To τελικό μέγεθος του μυοκαρδιακού εμφράκτου ως ποσοστό της αριστερής κοιλίας ήταν 10.7% ± 8.25 στην ομάδα της κλοπιδογρέλης και 12.09% ± 8.72 στην ομάδα της τικαγρελόρης. Το κλάσμα εξωθήσεως εκτιμώμενο με την μαγνητική καρδίας δεν διέφερε μεταξύ των δύο ομάδων.Τα αποτελέσματα αυτής της μελέτης υποδεικνύει ότι η χορήγηση της τικαγρελόρης σε ασθενείς με STEMI οι οποίοι υποβάλλονται σε θρομβόλυση προσφέρει παρόμοιο βαθμό διάσωσης του μυοκαρδίου συγκρινόμενη με την κλοπιδογρέλη
Community engagement in maternal and perinatal death surveillance and response (MPDSR): Realist review protocol
Authors: Mbuo Mary , Okello Immaculate , Penn-Kekana Loveday , Willcox Merlin , Portela Anayda , Palestra Francesca , Mathai Matthews
Published: March 2023

Background: While there has been a decline in maternal and perinatal mortality, deaths remain high in sub-Saharan Africa and Asia. With the sustainable development goals (SDGs) targets to reduce maternal and perinatal mortality, more needs to be done to accelerate progress and improve survival. Maternal and perinatal death surveillance and response (MPDSR) is a strategy to identify the clinical and social circumstances that contribute to maternal and perinatal deaths. Through MPDSR, an active surveillance and response cycle is established by bringing together different stakeholders to review and address these social and clinical factors.

Community engagement in MPDSR provides a strong basis for collective action to address social factors and quality of care issues that contribute to maternal and perinatal deaths. Studies have shown that community members can support identification and reporting of maternal and/or perinatal deaths. Skilled care at birth has been increasing globally, but there are still gaps in quality of care. Through MPDSR, community members can collaborate with health workers to improve quality of care. But we do not know how community engagement in MPDSR works in practice; for whom it works and what aspects work (or do not work) and why. This realist review answers the question: which strategies of community engagement in MPDSR produce which outcomes in which contexts?

Methods: For this realist review, we will identify published and grey literature by searching relevant databases for articles. We will include papers published from 2004 in all languages and from all countries.

We have set up an advisory group drawn from academia, international organizations, and practitioners of both MPDSR and community engagement to guide the process.

Conclusion: This protocol and the subsequent realist review will use theoretical approaches from the community engagement literature to generate theory on community engagement in MPDSR.

Prospero registration number:  CRD42022345216
Host determinants of TB disease as targets for HDTs development: A study protocol
Authors: Rajkumar-Bhugeloo Kerishka , Moodley Denelle , Mpotje Thabo , Marakalala Mohlopheni J
Published: March 2023

Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a major global health challenge. New diagnostic and therapeutic strategies are required to curb TB transmission. Here we outline a protocol to validate inflammatory proteins as potential biomarkers of TB disease and to evaluate the candidate genes as potential targets for host-directed therapy (HDT) development. Blood will be isolated from healthy, latent TB infected (LTBI) individuals and TB patients, and expression profiles of genes of interest will be determined using qPCR. A human monocytic cell line will be utilized to knock down genes of interest and to evaluate their contribution to Mtb infection. Pharmaceutical interception of target genes will be performed in peripheral blood mononuclear cells (PBMCs) infected with Mtb. This work will result in identification of TB associated inflammatory markers that can also be targeted for HDT development.
The Factors Influencing Teachers' Willingness to Remain in Rural Areas After the Expiration of Their Compulsory Service Contract: A Case Study in Enshi Prefecture, Hubei Province, China
Authors: Dong Yuanli , Bo-qin Liao , Abbas Safdar , Hoon Peow See , Zhang Jian
Published: March 2023

Quality education can only be achieved with the assistance of experienced and qualified teachers. In order to ensure quality education in disadvantaged areas in China, it is necessary to keep experienced teachers in rural areas. This paper investigates factors that could influence rural teachers’ decision to stay or not on teaching at the expiry of their service contract. As a part of project, “Research on rural Teacher Training Mode in Minority Areas of Hubei Province in post-poverty Era “data from 1193 rural teachers who had qualified from a government teacher training programme from selected villages under the jurisdiction of the Enshi Prefecture, Hubei province was collected. As part of the survey, a number of factors are examined that influence a teacher's willingness to stay or leave, as well as remedial measures that are deemed necessary to prevent teachers from leaving. For the analysis of the data, SPSS 25 and AMOS 24 were used. The study found that the teachers have a high willingness to stay on the job after the contract expires. Among the factors contributing to their willingness are the local cultural environment, the local infrastructure attachment to the area, and the school's working environment. Wage income, professional identity, professional development, and school working conditions also play an important role as maintenance factors. There is a direct relationship between the rural infrastructure and a person's willingness to continue working after the expiration of a contract, and there is also direct relationship between the local attachment and the cultural atmosphere of the local community. Local attachment is the dominant factor, the local infrastructure is a secondary improvement area, and salary, promotion of opportunities, respect for teachers and education are in the priority improvement area. Finally, the paper proposes that the retention of rural teachers should be based on the cultivation of local attachment, rural revitalization, improvement of health factors and construction of “UGSR–P” cultivation of community.