bluuebunny/crossref_metadata_2025 huggingface dataset:
The evolution of blood–brain barrier permeability changes after stroke and its implications on clinical outcome: A systematic review and meta-analysis
Authors: Bernardo-Castro Sara , Sousa João André , Martins Emanuel , Donato Helena , Nunes César , d’Almeida Otília C , Castelo-Branco Miguel , Abrunhosa Antero , Ferreira Lino , Sargento-Freitas João
Published: March 2023

Background:

Blood–brain barrier permeability (BBBp) is a key process involved in ischemic stroke pathophysiology. However, there is a lack of consensus on how BBBp evolves after the ischemia injury, and its clinical relevance at different timepoints post stroke.

Aims:

The main objective of this study is to assess BBBp evolution through stroke phases and its implications on patient outcomes.

Methods:

We screened PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials up to 31 December 2021. We included research quantitatively using neuroimaging to assess BBBp in stroke patients. BBBp in the different phases was evaluated by a random-effect model based on the standardized mean difference (SMD) between the ipsilateral and contralateral sides of the brain. We performed a subgroup analysis on clinical outcome, reperfusion treatment, haemorrhagic transformation, and imaging method.

Results:

We identified 3761 studies, of which 22 (1592 patients and 1787 evaluations) were included in our study. Overall, 17 studies reported BBBp for the hyperacute phase, 8 for the acute, 5 for the subacute, and 2 for the chronic phase. All phases were associated with increased BBBp: 0.74 (0.48–0.99), 1.68 (0.94–2.42), 1.98 (0.96–3.00), and 1.00 (0.45–1.55), respectively. An increase in BBBp was associated with hemorrhagic transformation in the hyperacute phase and with improved functional outcomes in the late subacute phase.

Conclusion:

BBBp is persistently increased after stroke, peaking in the acute and subacute phases. The degree of BBBp influences patient outcomes depending on stroke phase. Our findings support the clinical relevance of BBBp dynamics in stroke care.
Re-examining the nomenclature of congenital failure of formation in the upper limb: a historical perspective
Authors: Chan Claudia C. H. , McGee Pauline , Hooper Geoffrey , Lam Wee Leon
Published: March 2023

In this study, we studied historical case notes to examine nomenclature of congenital upper limb anomalies and explore the changes in terminologies over time. Original diagnoses were reclassified according to previously published classifications and the most recent Oberg, Manske and Tonkin system. Two hundred and thirty-eight case notes were obtained from the period 1961–1991. Hand plate malformations where the diagnosis was obvious or traumatic defects, were excluded. Eighty-six cases (106 extremities) were finally included where an ambiguous diagnosis, such as ‘congenital absence’ was initially given. None of the re-classifications matched the original diagnoses except for cleft hand and radial dysplasia ( n = 31). Eighteen phocomelia-type limbs were re-classifiable when seen as a continuum of longitudinal deficiency, but not as an intercalary deficit. This study provided further insights into the evolving nature of nomenclature in congenital upper limb anomalies, especially for the condition of phocomelia.

Level of evidence: IV
The efficacy of N-acetylcysteine in chronic obstructive pulmonary disease patients: a meta-analysis
Authors: Huang Chienhsiu , Kuo Sufang , Lin Lichen , Yang Yalun
Published: March 2023

Background:

N-acetylcysteine (NAC) may reduce acute exacerbations of chronic obstructive pulmonary disease through an antioxidant effect. Due to the heterogeneity in studies, the currently available data do not confirm the efficacy of oral NAC therapy in chronic obstructive pulmonary disease patients. We hypothesize that chronic obstructive pulmonary disease patients receiving regular oral NAC therapy do not achieve improved clinical outcomes.

Objectives:

The purpose of this meta-analysis was to determine the efficacy of long-term oral NAC therapy in chronic obstructive pulmonary disease patients.

Data sources and methods:

The literature search was performed using the PubMed, Web of Science, and Cochrane Library databases to identify all included clinical studies. Studies were eligible for inclusion only if they directly compared the outcomes of NAC versus placebo in adults with chronic obstructive pulmonary disease between 1 January 2000 and 30 May 2022. All studies were included if they reported one or more of the following outcomes: number of patients with no acute exacerbations, forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), St George’s Respiratory Questionnaire score, glutathione level, and adverse events.

Results:

Nine randomized controlled trials were included in the meta-analysis. There were 1061 patients in the NAC group and 1076 patients in the placebo group. The current meta-analysis provides evidence that the number of patients with no acute exacerbations (965 patients receiving NAC therapy, 979 control group patients), change in FEV1 (433 patients receiving NAC therapy, 447 control group patients), change in FVC (177 patients receiving NAC therapy, 180 control group patients), change in St George’s Respiratory Questionnaire score (128 patients receiving NAC therapy, 131 control group patients), change in glutathione levels (38 patients receiving NAC therapy, 40 control group patients), and adverse events (832 patients receiving NAC therapy, 846 control group patients) were not significantly different between the two groups.

Conclusion:

NAC did not reduce the risk of acute exacerbation or ameliorate the decline in lung volume in chronic obstructive pulmonary disease patients.
Comparison of clinical efficiency between intra-articular injection of platelet-rich plasma and hyaluronic acid for osteoarthritis: a meta-analysis of randomized controlled trials
Authors: Chen Lili , Jin Shirong , Yao Yunheng , He Sixian , He Jinshen
Published: March 2023

Background:

Platelet-rich plasma (PRP) and hyaluronic acid (HA) are non-surgical treatments for osteoarthritis (OA), but the comparison of their efficiency is still inconclusive.

Objectives:

The objectives of this study were to compare the efficacy of PRP and HA in the treatment of OA by meta-analysis and to explore the effects of different injection times and leukocyte concentration on the efficacy of PRP.

Design:

Meta-analysis and subgroup analysis were conducted. The data were analyzed by Review Manager v5.4.1.

Data sources and methods:

Articles were retrieved and screened from PubMed, the Cochrane Library, Web of Science, and Embase. The outcome included the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the visual analog scale (VAS), adverse events (AEs), the International Knee Documentation Committee (IKDC), and the satisfaction rate.

Results:

A total of 30 articles involving 2733 patients were included. The total WOMAC score and IKDC score of the PRP group were better than those of the HA group at the last follow-up time, while there was no significant difference in AEs, satisfaction rate, and VAS between the two groups. In our subgroup analysis, there was no significant difference between single-injection PRP and triple-injection PRP. Leukocyte-poor PRP (LP-PRP) was better than leukocyte-rich PRP (LR-PRP) in IKDC, but there was no significant difference between them in the other scores.

Conclusions:

In the treatment of OA, compared with HA, PRP performed better in the improvement of the patient’s function. There was no significant difference in VAS and AEs between the two groups, and the safety was comparable. LP-PRP looked to be superior to LR-PRP in functional recovery, but there appeared to be no significant difference in pain relief between them. There was no significant difference between single PRP and triple PRP in the subgroup analysis.
Identifying poorly performing listed firms using data analytics
Authors: Fung Derrick WH
Published: March 2023

This study presents a teaching case that analyzes the applicability of the Z-Score bankruptcy prediction model to manufacturing firms listed in Hong Kong. Although the Z-Score model has been studied extensively, there are very few studies in the context of the Hong Kong stock market. Given that the Hong Kong stock market has high retail investor participation and low liquidity, whether the Z-Score model is relevant to Hong Kong investors is an important but unanswered question. The Z-Score model predicts the bankruptcy of firms by considering financial ratios involving firm liquidity, solvency, profitability, leverage, and activity. Financial and stock return data on the manufacturing firms listed in the Hong Kong Stock Exchange from 1981 to 2020 are collected from Thomson Reuters Datastream to examine the applicability of the Z-Score model in Hong Kong. Firms are then classified into bankrupt or non-bankrupt groups based on their Z-Scores. The annual stock returns in the subsequent year are analyzed for the two groups after classification. When the Z-Score threshold is set at 0, investing in the non-bankrupt group and short-selling the bankrupt group earns an annual return of 11.99% in the subsequent year. The results are robust to alternative periods and lagged values of the Z-Score. This suggests that stock prices do not reflect all the accounting data and that investors can increase their returns using the Z-Score model. As retail investors have limited resources, it may be difficult for them to fully implement the Z-Score model for a portfolio that consists of thousands of stocks. However, they can still avoid substantial losses by not investing in firms with low Z-Scores.
Examining the characteristics and virtues associated with servant leadership in public relations
Authors: Neill Marlene S , Meng Juan
Published: March 2023

Are servant leadership and ethics of care being practiced by public relations leaders? This study involved in-depth interviews with 32 public relations leaders working in a variety of organizational settings in the United States and provided insights from men and women, including people of color. We found evidence of an “other oriented approach” to leadership that involved prioritizing the needs and concerns of employees and a genuine concern for the wellbeing of others. The findings are consistent with characteristics associated with both servant leadership and ethics of care. The public relations leaders were able to provide specific examples of how these perspectives impacted their decision making and specific ways they demonstrate that they care about their employees. The leaders engaged in active listening, which allowed them to identify employee needs. They then had to access whether or not they could meet those needs, and at times that involved assisting employees in leaving the organization. Implications for theory and practice are included.
Knowledge of Jordanian women of reproductive age who underwent bariatric surgery and its effect on birth outcomes: A cross-sectional study
Authors: Assaf Zainah , Taha Hana , Moonesar Immanuel Azaad , Obeidat Firas , Badran Eman F , Al-Nabelsi Mazen , Al Qutob Raeda
Published: March 2023

Objectives:

This study aims at exploring the knowledge of women of reproductive age who underwent bariatric surgery in Jordan regarding its effect on birth outcomes.

Methods:

A cross-sectional study was conducted on 183 women (aged 15–49) who had undergone bariatric surgery at the Jordan University Hospital in Amman, Jordan, between 2016 and 2019, using telephone interviews with conveniently selected participants’ samples. The survey tool obtained data on women’s knowledge and other sociodemographic, obstetric health, and bariatric surgery information. Unfavorable birth outcomes include preterm delivery, small for gestational age, congenital abnormalities, low birth weight, and admission to the neonatal critical care unit.

Results:

More than half of the participants did not know about the possible unfavorable birth outcomes after bariatric surgery and related practice guidelines. This is shown in their median score of 3 (interquartile range: 2–4) out of a maximum possible score of 8. Women who had a good score (>4) had received counseling about unfavorable bariatric surgery outcomes from their surgeon ( p < 0.013); those who had educational qualifications higher than secondary school ( p < 0.001) as well as those who were employed ( p < 0.008) and believed that the surgery would affect the newborn ( p < 0.001). The median score was also unfavorably associated with the parity of the participants ( p < 0.003).

Conclusion:

The extent of knowledge regarding the unfavorable birth outcome of bariatric surgery is low among women who underwent bariatric surgery at Jordan University Hospital in Jordan. Improving health literacy and information on bariatric surgery implications on pregnancy and birth outcomes amongst women of reproductive age is a recommendation from this study.
Research Letter: Is the 129S1/SvImJ Mouse Strain More Suitable to Study Anticoagulant-Related Nephropathy Than the C57BL/6 Strain?
Authors: Medipally Ajay , Xiao Min , Satoskar Anjali A , Biederman Laura , Ivanov Iouri , Mikhalina Galina , Brodsky Sergey
Published: March 2023

Background:

We have previously demonstrated that excessive anticoagulation with warfarin or dabigatran may result in acute kidney injury with red blood cell (RBC) tubular casts in some patients with chronic kidney disease, and this condition was named anticoagulant-related nephropathy (ARN). 5/6 nephrectomy (5/6NE) rats treated with warfarin or dabigatran reproduce the main pathologic features of human ARN. We had reported that 5/6NE C57BL/6 mice only partially develop ARN with increased serum creatinine and hematuria but no RBC tubular casts in the kidney.

Objectives:

The aim of this study was to investigate whether ARN can develop in 5/6NE 129S1/SvImJ mice.

Methods:

5/6NE was performed in 129S1/SvImJ mice. Three weeks after 5/6NE, mice were treated with warfarin (1.0 and 1.5 mg/kg/day) or vehicle for 7 days. Serum creatinine, hematuria, and prothrombin time (PT) were monitored daily. Renal morphology was evaluated at the end of the studies.

Results:

Treatment with warfarin resulted in PT elevation 2 to 3 folds from baseline (1.0 mg/kg/day warfarin) and 4 to 5 folds from baseline (1.5 mg/kg/day warfarin) by day 7. Serum creatinine and hematuria elevated by day 7 in a dose-dependent manner. Histologically, 2 of 8 (25%) 5/6NE mice had RBCs in the tubules, and there was acute tubular epithelial cell injury in all warfarin-treated 5/6NE 129S1/SvImJ mice.

Conclusions:

Our findings suggest that 129S1/SvImJ mouse strain is a more suitable murine model to study ARN than C57BL/6 mouse strain.
Prevalence and Pattern of Congenital Heart Diseases in School Children in Dongguan, China
Authors: Kang GuanYang , Xiao JianMin , Wang Jieying , Zhang HuiQing
Published: March 2023

Background

To determine the prevalence and pattern of congenital heart disease (CHD) among elementary school children in Dongguan, China.

Methods

Between November 2011 and November 2012, 540,574 school children from 449 elementary schools were screened for CHD by trained doctors in Dongguan. The school children who were suspected to have CHD were referred to a pediatric cardiologist and/or an echocardiographer for a complete evaluation.

Results

The total prevalence of CHD was 2.14 per 1,000 school children (1,157/540,574). The most common form of CHD was isolated ventricular septal defect (37.77%; 437/1,157), followed by isolated atrial septal defect (20.22%; 234/1,157) and patent ductus arteriosus (9.94%; 115/1,157). With respect to sex, CHD was equally distributed between males and females.

Conclusion

Our data show that the prevalence of CHD in Dongguan is not as high as expected and that isolated ventricular septal defect is the predominant pathology. Echocardiography plays a crucial role in the diagnosis of CHD.
A Multidimensional Cyber Defense Exercise: Emphasis on Emotional, Social, and Cognitive Aspects
Authors: Maennel Kaie , Brilingaitė Agnė , Bukauskas Linas , Juozapavičius Aušrius , Knox Benjamin James , Lugo Ricardo Gregorio , Maennel Olaf , Majore Ginta , Sütterlin Stefan
Published: March 2023

Hands-on and practical learning has been key to cybersecurity education and training success. Cyber Defense Exercises (CDX) are a common approach to training, testing, and verifying technical and soft skills. However, full-scale CDX implementation is also an expensive training event. In order to advance such exercises to the next level, CDX organizers should further focus on educational, psychological, and cross-domain relationships. The paper discusses and proposes a multidimensional approach for CDX that balances cognitive, emotional, and social aspects critical for successful interdisciplinary learning. We share our experience incorporating knowledge from well-known psychology theories to CDX. We derive and describe seven elementary ingredients if a CDX is to meet the interdisciplinary and critical thinking needs of defensive cyberspace operations.
Exploring the Dark Side of Esports Online Spectatorship: Passion as a Mediator and Collective Narcissism as a Moderator
Authors: Qian Tyreal Yizhou , Sonkeng Katja , Luo Lei
Published: March 2023

The rise of esports as an emerging spectator phenomenon has led to a growing number of esports fans who participate in online discussions and communities. With a larger and more diverse fan base, the increased engagement has also caused a surge in online toxicity. In this study, we seek to understand how online toxicity is stimulated through team identification, passion, and collective narcissism in esports online spectatorship. Survey data ( n = 467) was collected from fans of professional esports teams competing in Riot Games’ League of Legends Pro League in China and analyzed using Partial least squares structural equation modelling. Mediation and moderation analyses were conducted to verify the proposed hypotheses. We provided an improved understanding of the enactment of online toxicity and showed how team identification would manifest in both obsessive passion and harmonious passion. The identified bifurcated mediation effects of obsessive passion and harmonious passion as well as the moderating role of collective narcissism in the team identification-obsessive passion relationship extended the literature on team identification and dysfunctional fandom in esports. Our study offered new insights into the negativities associated with esports online spectatorship and proposed a passion-oriented strategy to mitigate online toxicity among esports fans.
Comparison between wide-awake local anaesthesia no tourniquet surgery and traditional local anaesthesia surgery for limb operations
Authors: Ng Sing Yuen , Yip Emily Ka Yan
Published: March 2023

Background: In traditional local anaesthesia surgeries, tourniquets are used to reduce blood loss. However, it may induce tourniquet pain. If a long tourniquet time is anticipated, regional or general anaesthesia may be required. Wide-awake local anaesthesia no tourniquet (WALANT) surgery suggests blood loss can be controlled by the use of adrenaline instead of a tourniquet. This study aims to investigate the difference in patient's pain perception, satisfaction and hemostasis control between two groups of patients, the WALANT group, who underwent WALANT surgery, and the traditional group, who underwent traditional local anaesthesia with tourniquet surgery. Methods: This was a prospective cohort study of patients who underwent common orthopaedic local anaesthesia surgeries in a regional hospital between January 2020 and December 2020. Operations were performed by two groups of surgeons: WALANT group and traditional group. Data were collected via questionnaires which included patients’ demographics, diagnosis and operation type, surgeon experience, dosage and type of local anaesthesia use, tourniquet use, operation time, hemostasis status, difficulty of operation, patient's pain perception (pain during LA injection, wound site pain during operation, tourniquet pain, post-operative pain) and satisfaction. The data were analysed by Mann–Whitney U test with SPSS. Results: A total of 143 questionnaires were collected. The WALANT group suffered from less wound site pain during operation ( p = 0.008), less tourniquet pain ( p < 0.001) and less post-operative pain ( p < 0.001). WALANT group had a longer operation time ( p = 0.002). Both the traditional group and WALANT group were commented to have good haemostasis with a median score of 1 and 2, respectively, although the difference in hemostasis control value was significant ( p < 0.001). Conclusion: WALANT surgery was safe and could achieve similar hemostasis with no limitation of tourniquet time and could significantly reduce post-operative pain compared with traditional local anaesthesia with tourniquet use. Level of evidence: Level II.
Management of Scaphoid Pseudoarthrosis Surgery with Wide-Awake Local Anesthesia No Tourniquet (WALANT) Versus Axillary Block Anesthesia: Comparison of Patient Satisfaction
Authors: Altaş Okyar , Bayram Serkan , Aydin Ahmet Serhat , Ayik Ömer , Durmaz Hayati
Published: March 2023

Objectives: We aimed to compare clinical and functional results of treatment of scaphoid pseudoarthrosis between patients undergoing wide-awake local anesthesia no tourniquet (WALANT) versus axillary block anesthesia. Methods: The patients diagnosed with scaphoid non-union who underwent pseudoarthoris surgery were divided into WALANT group ( n  =  12) and axial block group ( n  =  11). Visual analog scores (VAS) were measured by calling the patients via phone on postoperative days 1, 2, 3, and 7. The VASs were also measured on the 14th day during patient check-ups. At the end of 12 months, Michigan Hand Questionnaire was used to assess clinical recovery. Bone union rate and surgery time were also investigated. Radiological and clinical examinations were compared between the groups. Results: Eleven patients (91.7%) in the WALANT group and 10 patients (90.9%) in the axillary block group achieved bone union ( P  =  .94). Although there was no significant difference in preoperative VAS score between the groups, the WALANT group had significantly lower VAS score of the first 3 days postoperatively. However, there was no significant difference in VAS score between the groups on the seventh and 14th day postoperatively. There was no significant difference between the groups regarding Michigan score, time to surgery, time to union and operation time. Conclusion: The scaphoid pseudoarthrosis surgery can be done safely with WALANT technique which has significant lower VAS score on the first 3 days postoperatively.
Superabsorbent Polymer Sponge for Saliva Absorption Pad
Authors: Sankar Paila Ravi , Lathikumari Sreejith Sasidharan , Saraswathy Manju
Published: March 2023

Aim:

Saliva is a significant hindrance to most dental procedures (e.g., root canal treatment) as the flow of saliva increases in patients undergoing dental treatment due to anxiety. Saliva absorption pads based on superabsorbent polymers can provide a dry oral environment to ease the dental treatment procedure and reduce the swallowing reflexes common during cotton use. This study focused on developing an indigenous saliva absorption pad using biodegradable superabsorbent polymer (BSAP) sponges.

Materials and Methods:

BSAP sponges were synthesized using carboxymethyl cellulose (CMC) as the base matrix. Different crosslinking mechanisms were implemented to prepare BSAP sponges, such as ionic crosslinking using aluminum ammonium sulfate (AlAS) and chemical crosslinking using methylene bisacrylamide. Three different BSAP sponges (Sap-2, SAP-PAA-1, and SAP-PAA-2) were characterized for their free swell capacity and thermal degradation kinetics along with other characterization techniques to optimize the composition for saliva absorption pad. One-way ANOVA was used for statistical evaluation.

Results:

SAP-2, synthesized using 10 wt.% AlAS showed the highest free swell capacity in water and saline (83.21 ± 3.8 g/g and 40.7 ± 3.4 g/g, respectively). However, the moisture content of the particular BSAP sponge was higher (~13%) compared to the standard limit (ISO 17190-4:2001(E)). It was observed that as the crosslinking density increases free swell capacity increases to a threshold point and decreases thereafter. As reported earlier, percentage swelling was controlled by multiple factors including crosslinking that opposes swelling and polymer/water interaction and Donnan pressure that promotes swelling.

Conclusion:

BSAP sponge based on crosslinked CMC matrix is highly advantageous in developing saliva absorption pad. Hydrophobic surface modification is recommended to reduce the moisture content to improve the storage stability of BSAP sponges.
SCN2A- Associated Episodic and Persistent Ataxia with Cerebellar Atrophy: A Case Report
Authors: Murray Maeve , Martindale Jaclyn M. , Otallah Scott I.
Published: March 2023

SCN2A, a gene that codes for a sodium channel highly expressed in the cerebellum, has been linked to a heterogeneous phenotype, including episodic ataxia (EA) and epilepsy, among other symptoms1. Given the rarity of SCN2A-associated EA and its recent description, it is important the genotype-phenotype relationship of SCN2A-associated EA be better defined for prognosis and optimizing future management. Thus, we describe a 2-year-old boy with a SCN2A variant causing an initial prolonged episode of profound ataxia lasting 4 months, cerebellar atrophy, and persistent mild ataxia with episodic exacerbations. Due to the patient’s lack of early epilepsy, prolonged initial episode of ataxia, and cerebellar atrophy, this case broadens the scope of the SCN2A variant phenotype. SCN2A should be considered as a cause of early onset ataxia in children with targeted testing or as part of Whole Exome Sequencing (WES) in patients with new onset persistent or EA with or without seizures.
‘Can Subaltern Speak?’: Discourse Without Considering Caste an Exploitative Institution
Authors: Dhaktode Nitin
Published: March 2023

Gramsci’s idea of Subaltern was applied by Indian subaltern study groups to analyse the struggle of the marginalized. Gayatri Chakravorty Spivak raises the question of whether subalterns can speak considering their position in society. In contradictory, the social reform movement suggest they can speak about building their capabilities. The social reformers, such as Mahatma Jyotiba Phule, Chhatrapati Shahu Maharaj and Dr Ambedkar fought against caste and gender-based discrimination giving importance to empowering the marginalized through various ways and means. Education was considered the most effective tool to create consciousness about suffering and pain. The idea of justice is all about the pain and pleasure that once pain gives pleasure to the oppressor which was identified by these social reformers who worked to ensure justice by challenging the oppressive system. However, Spivak misses this perspective in the debates. Her arguments focus on gender, from a class perspective and consciously ignore the caste angel. The question she raises leads to a discussion on the basic idea of subaltern and marginalized groups. This article presents a critical discussion on the idea of ‘subaltern’ and its arguments.
Psoriasis Involving Special Areas is Associated with Worse Quality of Life, Depression, and Limitations in the Ability to Participate in Social Roles and Activities
Authors: Blauvelt Andrew , Gondo George C. , Bell Stacie , Echeverría Cristina , Schmitt-Egenolf Marcus , Skov Lone , van de Kerkhof Peter , McCormick Howard Leah , Strober Bruce
Published: March 2023

Background

Psoriasis severity has traditionally been categorized as mild, moderate, and severe. Commonly, cut-offs for severe disease require a body surface area (BSA) involvement of ≥10% or a Psoriasis Area Severity Index (PASI) > 10. However, clinical experience challenges these traditional measures and requirements, as patients with less extensive psoriasis may have disease that severely impacts quality of life.

Objective

The objective of the present study was to further explore the extent of patient burden when psoriasis affects special locations.

Methods

A total of 69,190 individuals living in the U.S were invited to participate in a patient advocacy survey by telephone and or web interviews over the course of 3 years (2019-2021). The survey instrument consisted of validated patient-reported outcome measures, measuring disease-specific quality of life (Dermatology Life Quality Index, DLQI), depression (Patient Health Questionnaire (PHQ)-2 and (PHQ)-9), and the ability to participate in social roles and activities (PROMIS Ability to Participate in Social Roles and Activities (SF-4a). Chi-square tests were performed to explore association between psoriasis involvement on special locations and patient outcomes and multivariate logistic regression models were then constructed, to assess impact of having psoriasis on special locations patient outcomes, controlling for potential confounding factors.

Results

A total of 4129 individuals completed the survey. 3594 (84.4%) of patients surveyed reported psoriasis involving special areas of the bodysuch as the scalp, face, hands, feet, or genitalia. Involvement of special areas is associated with worse quality of life and depression. 35-71% of patients with 10% or less total BSA involvement experienced a moderate-to-extremely large effect on these life function domains. When adjusting for age, sex, and body surface area, psoriasis involvement of a special location was associated with poorer patient reported outcomes, including a 46% less likelihood of reporting their skin disease as having “no or only a small effect on QoL,” a 30% less likelihood of having a “normal l ability to participate in social roles and activities,” and a 126% higher likelihood of f having depression.

Conclusion

Real-world data presented here demonstrate that psoriasis involving special areas is associated with adverse life consequences, including poor quality of life and depression.
Patients’ experiences of non-conveyance following an Australian ambulance service paramedic response: A constructivist grounded theory exploration
Authors: King Robbie , Oprescu Florin I , Lord Bill , Flanagan Belinda , Downer Terri
Published: March 2023

Understanding patient experience is associated with quality, safe, and effective healthcare. However, there is a scarcity of knowledge explaining how patients experience non-conveyance, a setting where individuals receive unscheduled ambulance service response and paramedic-led care that results in a decision to not attend a hospital emergency department (ED). This research project aimed to investigate patients’ experiences of non-conveyance within an Australian ambulance service setting. Constructivist Grounded Theory methods were used to generate and analyse data from in-depth, semi-structured interviews with 21 participants who received paramedic-led healthcare from an Australian ambulance service between August 2020 and October 2021 that resulted in non-conveyance. A substantive theory centred on ‘Restoring self-efficacy’ was generated. It comprises three categorical concepts and their interconnected relationships, explaining how patients experience non-conveyance. ‘Losing independence’ conceptualises how a precipitating event forces patients to realise their circumstantial vulnerabilities, motivating action to seek support that leads to ambulance service response. ‘Restoring self-confidence’ emerged as the core concept, central to overall experience and a key influence on patients navigating the non-conveyance decision. When patients perceive that they have received professionally thorough and compassionate healthcare from paramedics, they form a trusting partnership resulting in the interpretation that their circumstances do not require conveyance to ED. With this reconstructed perspective, patients demonstrate increased ability for ‘Self-management’, by continuing to cope with their circumstances on their own after the episode of care. This paper provides a theoretical model for understanding how patients experience non-conveyance. Experience is influenced by dynamic, complex factors associated with restoring self-efficacy in relation to managing a health topic of interest. Restoration of self-efficacy was influenced by the patients’ interpretation of their interactions with paramedics. Future research may consider investigating the impacts of applying this knowledge to paramedic education and practice, and to quality indicators surrounding non-conveyance situations.
Racism in Health Services for Adolescents: A Scoping Review
Authors: Hilario Carla , Louie-Poon Samantha , Taylor Mischa , Gill Gurjeet K. , Kennedy Megan
Published: March 2023

Addressing racism within health systems and services is critical to addressing health vulnerabilities and promoting health equity for racialized populations. Currently, there is limited knowledge about the ways in which racism affects health services for adolescents. A scoping review was undertaken following the Joanna Briggs Institute Manual for Evidence Synthesis methodology and guided by the research questions: (1) What are the characteristics of the literature examining racism in health service use for adolescents? (2) What are the foci of the literature on systemic racism and health services for adolescents? A systematic literature search was conducted in April 2021 to identify all relevant published studies. The search identified 3049 unique articles, with a total of 13 articles included in this review. Multiple levels of racism were examined in the included articles across various health care settings. Five foci were identified: racism prevention, missed care, quality of care, racial bias, and experiences of racism. Our review indicates a current emphasis on interpersonal racism within this field of study, with emergent discussion of the impact of systemic racism. However, greater attention is needed that would investigate multiple forms of racism (institutional, interpersonal, internalized) in relation to specific contexts and adolescent populations.
A mutant cotton fatty acid desaturase 2-1d allele causes protein mistargeting and altered seed oil composition
Authors: Shockey Jay , Gilbert Matthew K. , Thyssen Gregory N.
Published: March 2023

Background

Cotton (Gossypium sp.) has been cultivated for centuries for its spinnable fibers, but its seed oil also possesses untapped economic potential if, improvements could be made to its oleic acid content.

Results

Previous studies, including those from our laboratory, identified pima accessions containing approximately doubled levels of seed oil oleic acid, compared to standard upland cottonseed oil. Here, the molecular properties of a fatty acid desaturase encoded by a mutant allele identified by genome sequencing in an earlier analysis were analyzed. The mutant sequence is predicted to encode a C-terminally truncated protein lacking nine residues, including a predicted endoplasmic reticulum membrane retrieval motif. We determined that the mutation was caused by a relatively recent movement of a Ty1/copia type retrotransposon that is not found associated with this desaturase gene in other sequenced cotton genomes. The mutant desaturase, along with its repaired isozyme and the wild-type A-subgenome homoeologous protein were expressed in transgenic yeast and stably transformed Arabidopsis plants. All full-length enzymes efficiently converted oleic acid to linoleic acid. The mutant desaturase protein produced only trace amounts of linoleic acid, and only when strongly overexpressed in yeast cells, indicating that the missing C-terminal amino acid residues are not strictly required for enzyme activity, yet are necessary for proper subcellular targeting to the endoplasmic reticulum membrane.

Conclusion

These results provide the biochemical underpinning that links a genetic lesion present in a limited group of South American pima cotton accessions and their rare seed oil oleic acid traits. Markers developed to the mutant desaturase allele are currently being used in breeding programs designed to introduce this trait into agronomic upland cotton varieties.
HIV-1 Tat amino acid residues that influence Tat-TAR binding affinity: a scoping review
Authors: Gotora Piwai Terry , van der Sluis Rencia , Williams Monray Edward
Published: March 2023

HIV-1 remains a global health concern and to date, nearly 38 million people are living with HIV. The complexity of HIV-1 pathogenesis and its subsequent prevalence is influenced by several factors including the HIV-1 subtype. HIV-1 subtype variation extends to sequence variation in the amino acids of the HIV-1 viral proteins. Of particular interest is the transactivation of transcription (Tat) protein due to its key function in viral transcription. The Tat protein predominantly functions by binding to the transactivation response (TAR) RNA element to activate HIV-1 transcriptional elongation. Subtype-specific Tat protein sequence variation influences Tat-TAR binding affinity. Despite several studies investigating Tat-TAR binding, it is not clear which regions of the Tat protein and/or individual Tat amino acid residues may contribute to TAR binding affinity. We, therefore, conducted a scoping review on studies investigating Tat-TAR binding. We aimed to synthesize the published data to determine (1) the regions of the Tat protein that may be involved in TAR binding, (2) key Tat amino acids involved in TAR binding and (3) if Tat subtype-specific variation influences TAR binding. A total of thirteen studies met our inclusion criteria and the key findings were that (1) both N-terminal and C-terminal amino acids outside the basic domain (47–59) may be important in increasing Tat-TAR binding affinity, (2) substitution of the amino acids Lysine and Arginine (47–59) resulted in a reduction in binding affinity to TAR, and (3) none of the included studies have investigated Tat subtype-specific substitutions and therefore no commentary could be made regarding which subtype may have a higher Tat-TAR binding affinity. Future studies investigating Tat-TAR binding should therefore use full-length Tat proteins and compare subtype-specific variations. Studies of such a nature may help explain why we see differential pathogenesis and prevalence when comparing HIV-1 subtypes.
Determinants of health facility delivery among young mothers aged 15 – 24 years in Nigeria: a multilevel analysis of the 2018 Nigeria demographic and health survey
Authors: Olubodun Tope , Rahman Semiu Adebayo , Odukoya Oluwakemi Ololade , Okafor Ifeoma P. , Balogun Mobolanle Rasheedat
Published: March 2023

Background

Young mothers aged 15 to 24 years are particularly at higher risk of adverse health outcomes during childbirth. Delivery in health facilities by skilled birth attendants can help reduce this risk and lower maternal and perinatal morbidity and mortality. This study assessed the determinants of health facility delivery among young Nigerian women.

Methods

A nationally representative population data extracted from the 2018 Nigeria Demographic and Health Survey of 5,399 young women aged 15–24 years who had had their last birth in the five years before the survey was analysed. Data was described using frequencies and proportions. Bivariate and multivariate analyses were carried out using Chi-Square test and multilevel mixed effect binary logistic regression. All the analysis were carried out using STATA software, version 16.0 SE (Stata Corporation, TX, USA)..

Results

Of the total sampled women in the 2018 NDHS, 5,399 (12.91%) formed our study population of young women 15 -24 years who had their last birth in the preceding five years of the survey. Only 33.72% of the young mothers utilized health facility for delivery. Women educated beyond the secondary school level had 4.4 times higher odds of delivering at a health facility compared with women with no education (AOR 4.42 95%, CI 1.83 – 10.68). Having fewer children and attending more antenatal visits increased the odds of health facility delivery. With increasing household wealth index, women were more likely to deliver in a health facility. The odds of health facility delivery were higher among women whose partners had higher than secondary level of education. Women who lived in communities with higher levels of female education, skilled prenatal support, and higher levels of transportation support were more likely to deliver their babies in a health facility.

Conclusion

Strategies to promote institutional delivery among young mothers should include promoting girl child education, reducing financial barriers in access to healthcare, promoting antenatal care, and improving skilled birth attendants and transportation support in disadvantaged communities.
Influence of joint volume on range of motion after arthroscopic rotator cuff repair
Authors: Kim Jung-Han , Min Young-Kyoung , Kim Dae-Yoo , Park Jun-Ho , Seo Young-Chae , Seo Won-Seok
Published: March 2023

Background

Capsular contracture is a well-known etiology in the primary stiff shoulder; thus capsular contracture and resultant decreased joint volume could lead to postoperative stiffness, which is a commonly reported morbidity after arthroscopic rotator cuff repair (ARCR). The purpose of this study was (1) to quantify the joint volume (total joint volume and each quadrant compartmental volume) using computed tomography arthrography (CTA) and (2) to demonstrate the relationship between joint volume and postoperative range of motion (ROM) after ARCR.

Materials and methods

Eighty-three patients (60 ± 5.11 years, men = 26, women = 57) who had undergone ARCR between January 2015 to December 2020 due to small to medium full-thickness tear and followed by CTA 6 months postoperatively were retrospectively reviewed. An image reconstruction program (3D Slicer, version 4.11.2 software) was used to calculate the joint volume (total joint volume and quadrant compartment joint volumes; anteroinferior, anterosuperior, posterosuperior and posteroinferior). For shoulder ROM, data including scaption (Sc), external rotation on side (ERs), external rotation at 90° (ER90), and internal rotation on back (IRb) were collected 6 months postoperatively. An evaluation of the correlation between joint volume and each shoulder motion was performed.

Results

There were moderate correlations between the total joint volume and each motion (Sc: Pearson coefficient, 0.32, p = 0.0047; ERs: Pearson coefficient, 0.24, p = 0.0296; ER90: Pearson coefficient, 0.33, p = 0.0023; IRb: Pearson coefficient, 0.23, p = 0.0336). Among the quadrant compartments, the anteroinferior (Sc: Pearson coefficient, 0.26, p = 0.0199; ERs: Pearson coefficient, 0.23, p = 0.0336; ER90: Pearson coefficient, 0.25, p = 0.0246; IRb: Pearson coefficient, 0.26, p = 0.0168) and posterosuperior (Sc: Pearson coefficient, 0.24, p = 0.029; ER90: Pearson coefficient, 0.29, p = 0.008; IRb: Pearson coefficient, 0.22, p = 0.0491) and posteroinferior (Sc: Pearson coefficient, 0.30, p = 0.0064; ER90: Pearson coefficient, 0.29, p = 0.0072) showed moderate correlations with each shoulder motion.

Conclusion

Total joint volume, anteroinferior compartment joint volume, posterosuperior compartment joint volume and posteroinferior compartment joint volume were related to postoperative ROM after ARCR. Perioperative methods to increase the joint volume, especially the anteroinferior, posterosuperior and posteroinferior parts of the capsule may prevent postoperative stiffness after ARCR.

Level of Evidence

Level III; Retrospective Case-Control Study.
Association of bone mineral density with trichlorophenol: a population-based study
Authors: Yan Zijian , Xiong Xianmei , Tao Jiasheng , Wang Sheng
Published: March 2023

Background

Trichlorophenols (TCPs) are metabolites of several organochlorine chemicals, including chlorobenzene, hexachlorocyclohexane, and chlorophenoxy acid, present in air, surface water, soil, and sediment. Many studies have shown that endocrine disruptors (EDs)may contribute to decreased bone mass and the increased risk of osteoporosis. However, the relationship between TCP and bone mineral density (BMD) has not been studied yet.

Methods

We conducted a cross-sectional study by using data from the 2005–2010 National Health and Nutrition Examination Survey (NHANES). TCP levels were measured in urine samples from 3385 participants and bone mineral density was obtained by dual X-ray absorptiometry (DXA) lumbar spine and femur scanning. Multiple regression analysis, stratified analysis, curve fitting analysis, and trend tests were used to assess the relationship between TCP and BMD.

Result

After adjusting for confounding factors, the results of multiple regression analysis only showed that ln-2,4,5-TCP was negatively associated with BMD of lumbar spine. In stratified analyses, Male, Menstruating Female and Menopausal Female were divided into three groups for analysis. The results showed that ln-2,4,5-TCP and ln-2,4,6-TCP were not statistically associated with BMD in total femur, femoral neck, femoral tuberosity, intertrochanteric femur and lumbar spine, which was also confirmed by curve fitting analyses and trend tests.

Conclusion

This study demonstrated that 2,4,5-TCP and 2,4,6-TCP in urine samples were not significantly associated with BMD in the US population. Therefore, 2,4,5-TCP and 2,4,6-TCP may not be detrimental to BMD.
“My everyday life has returned to normal”- Experiences of patients and relatives with a palliative day care clinic: a qualitative evaluation study
Authors: Müller Anne , Paul Alfred , Best Johannes , Kunkel Stephanie , Voltz Raymond , Strupp Julia
Published: March 2023

Purpose

Palliative day care clinics (PDCCs) complement inpatient and home palliative care and provide access to a range of multi-professional services. However, they are not part of standard care in Germany. Yet, international studies show that PDCCs have a positive impact on e.g. quality of life.

To evaluate one of the first
PDCCs in Germany (Aschaffenburg-Alzenau (PDCC-AA)) by describing the
experiences, satisfaction, challenges, wishes of patients and relatives and
possible alternatives to treatment in the PDCC.

Methods

Qualitative study using semi-structured
telephone interviews. Data was analyzed using qualitative structuring content
analysis according to Kuckartz with deductive a priori categories and inductive
subcategories.

Results

A total of 31 patients and 38 relatives
completed telephone interviews. The majority of patients were diagnosed with a cancer
or tumor disease. The following four main themes emerged: (1) alternatives to
treatment at the PDCC, (2) symptom relief, (3) sense of security, (4) “everyday
life framing” (normality of everyday life).

Participants valued the medical
treatment (especially for pain), psychosocial support given and having direct
access to a range of services (e.g., wound care and pleural drainage), while
relatives valued being provided respite services. A sense of security,
availability of therapies, and devoted time that healthcare providers spent to
explain e.g., treatment options were mentioned most positively, as well as
confidence in dealing with the illness. As to whether there was an alternative
to treatment in the PDCC, some saw further inpatient stays, the emergency room
or care by general practitioners as options (although not preferred). Patients
expressed concern that they were not treated and informed according to their
needs in other care settings.

Conclusions

PDCCs may close a gap between
inpatient and home palliative care. Participants mentioned that hospital stays
can be delayed or even prevented.