bluuebunny/crossref_metadata_2025 huggingface dataset:
TABLE 3 from Universal Viral Screening of Patients with Newly Diagnosed Cancer in the United States: A Cost-efficiency Evaluation
Authors: Vaidya Riha , Unger Joseph M. , Loomba Rohit , Hwang Jessica P. , Chugh Rashmi , Tincopa Monica A. , Arnold Kathryn B. , Hershman Dawn L. , Ramsey Scott D.
Published: September 2023

Pragmatic screening approach results
FIGURE 1 from Universal Viral Screening of Patients with Newly Diagnosed Cancer in the United States: A Cost-efficiency Evaluation
Authors: Vaidya Riha , Unger Joseph M. , Loomba Rohit , Hwang Jessica P. , Chugh Rashmi , Tincopa Monica A. , Arnold Kathryn B. , Hershman Dawn L. , Ramsey Scott D.
Published: September 2023

Tornado diagram of most influential inputs for cost per case detected of screening for HCV alone (A), HBV alone (B), HBV and HCV (C), and HBV, HCV, and HIV together (D). For each of the four most efficient screening strategies, the figure displays the results from a one-way sensitivity analysis that examines the impact of changing the value of one input at a time on the cost per case detected for the screening strategy. The vertical axis indicates the cost per case detected in the base case scenario for each strategy.
Successful Kidney-Sparing Systemic Therapy for a High-Risk Ureteral Carcinoma Case
Authors: Yuan Pu , Li Xinwei , Yuan Yujie , Xu Peiyuan , Wang Hui
Published: September 2023

Upper tract urothelial carcinoma (UTUC) refers to the malignancies located from renal calices toward the end of the ureter and could be classified as renal pelvis carcinoma and ureteral carcinoma. For high-risk UTUC cases with a normal contralateral kidney, radical nephroureterectomy is the standard treatment. As for low-risk UTUC cases or solitary kidney cases, kidney-sparing therapy may be a better choice. Besides, to prevent postoperative recurrence, systemic therapy should be applied, though the investigation is still ongoing. In this case report, we reported a rare case diagnosed with high-risk ureteral carcinoma, but he underwent kidney-sparing therapy due to chronic kidney disease. Recurrence has occurred after segmental ureterectomy. But through the utilization of ablation, bladder instillation, and tislelizumab, endoscopy and CT were normal in the follow-up (the patient refused to take washings from the upper urinary tract) for more than a year. In all, the utilization of ureteroscopic retrograde tumor ablation, BCG bladder instillation, and tislelizumab injection to treat high-risk ureteral carcinoma for kidney-sparing therapy have filled in the gap in this field, which should be promoted to help more patients in similar situations.
Groundwater recharge estimation using chloride mass balance method on the southern slope of Merapi Volcano, Indonesia
Authors: Adi Restu Dwi Cahyo , Wilopo Wahyu , Setiawan Hendy
Published: September 2023

Groundwater is a main resource for the majority of Indonesian people as a source of clean water to meet their daily needs. The increase in groundwater use is unavoidable due to increasing development in Indonesia, especially in Yogyakarta. Groundwater recharge is important in the hydrological cycle to meet groundwater needs. Therefore, this study aims to estimate groundwater recharge by the chloride mass balance (CMB) method on the southern slope of Merapi Volcano in Yogyakarta, Indonesia. This research was conducted in the rainy and dry seasons from August 2022 until January 2023. This research collects annual rainfall near the study area from the Meteorology, Climatology, and Geophysics Agency (BMKG) Yogyakarta station, monthly data collected from eighteen samples of groundwater station, and monthly data collected from fifteen samples of rainwater in the study area. The chemical content of groundwater and rainwater samples is analyzed using argentometry to obtain chloride concentration. The result of annual rainfall in the study area is 3,603.878 mm/year. The average chloride concentration in rainwater is 1.1 mg/L, while the average chloride concentration in groundwater is 8.015 mg/L. The CMB method calculation showed that the recharge in the study area ranges from 171.65 to 1,711.29 mm/year. The groundwater recharge has a positive correlation with elevation and rainfall. High groundwater recharge is also found in the northern area due to fractured lava aquifer.
eNOS Regulates Lymphatic Valve Specification by Controlling β-Catenin Signaling During Embryogenesis in Mice
Authors: Iyer Drishya , Mastrogiacomo Diandra M. , Li Kunyu , Banerjee Richa , Yang Ying , Scallan Joshua P.
Published: September 2023

BACKGROUND:

Lymphatic valves play a critical role in ensuring unidirectional lymph transport. Loss of lymphatic valves or dysfunctional valves are associated with several diseases including lymphedema, lymphatic malformations, obesity, and ileitis. Lymphatic valves first develop during embryogenesis in response to mechanotransduction signaling pathways triggered by oscillatory lymph flow. In blood vessels, eNOS (endothelial NO synthase; gene name:
Nos3
) is a well-characterized shear stress signaling effector, but its role in lymphatic valve development remains unexplored.

METHODS:

We used global
Nos3

−/−

mice and cultured human dermal lymphatic endothelial cells to investigate the role of eNOS in lymphatic valve development, which requires oscillatory shear stress signaling.

RESULTS:

Our data reveal a 45% reduction in lymphatic valve specification cell clusters and that loss of eNOS protein inhibited activation of β-catenin and its nuclear translocation. Genetic knockout or knockdown of eNOS led to downregulation of β-catenin target proteins in vivo and in vitro. However, pharmacological inhibition of NO production did not reproduce these effects. Co-immunoprecipitation and proximity ligation assays reveal that eNOS directly binds to β-catenin and their binding is enhanced by oscillatory shear stress. Finally, genetic ablation of the
Foxo1
gene enhanced FOXC2 expression and partially rescued the loss of valve specification in the eNOS knockouts.

CONCLUSIONS:

In conclusion, we demonstrate a novel, NO-independent role for eNOS in regulating lymphatic valve specification and propose a mechanism by which eNOS directly binds β-catenin to regulate its nuclear translocation and thereby transcriptional activity.
Inflammatory Cell–Derived MYDGF Attenuates Endothelial LDL Transcytosis to Protect Against Atherogenesis
Authors: Xu Jinling , Ma Huaxing , Shi Lingfeng , Zhou Hui , Cheng Yangyang , Tong Jiayue , Meng Biying , Xu Xiaoli , He Kaiyue , Ding Sheng , Zhang Jiajia , Yue Ling , Xiang Guangda
Published: September 2023

BACKGROUND:

Inflammation contributes to the pathogenesis of atherosclerosis. But little is known about the potential benefits of inflammatory cells to atherosclerosis. The aim of this study was to investigate the function of inflammatory cells/endothelium axis and determine whether and how inflammatory cell–derived MYDGF (myeloid-derived growth factor) inhibited endothelial LDL (low-density lipoprotein) transcytosis.

METHODS:

In in vivo experiments, both loss- and gain-of-function strategies were used to evaluate the effect of inflammatory cell–derived MYDGF on LDL transcytosis. We generated monocyte/macrophage-targeted MYDGF-null mice on an Ldlr (LDL receptor)
−/−
background in the loss-of-function strategy and restored the inflammatory cell–derived MYDGF by bone marrow transplantation and inflammatory cell–specific overexpression of MYDGF mice model in the gain-of-function strategy. In in vitro experiments, coculture experiments between primary mouse aortic endothelial cells and macrophages and mouse aortic endothelial cells supplemented with or without recombinant MYDGF were conducted.

RESULTS:

Inflammatory cell–derived MYDGF deficiency aggravated endothelial LDL transcytosis, drove LDL uptake by artery wall, and thus exacerbated atherosclerosis in vivo. Inflammatory cell–derived MYDGF restoration by bone marrow transplantation and inflammatory cell MYDGF overexpression alleviated LDL transport across the endothelium, prevented LDL accumulation in the subendothelial space, and subsequently ameliorated atherosclerosis in vivo. Furthermore, in the in vitro study, macrophages isolated from MYDGF
+/+
mice and recombinant MYDGF attenuated LDL transcytosis and uptake in mouse aortic endothelial cells. Mechanistically, MYDGF inhibited MAP4K4 (mitogen-activated protein kinase kinase kinase kinase isoform 4) phosphorylation, enhanced activation of Akt (protein kinase B)-1, and diminished the FoxO (forkhead box O) 3a signaling cascade to exert protective effects of MYDGF on LDL transcytosis and atherosclerosis.

CONCLUSIONS:

The findings support a role for inflammatory cell–derived MYDGF served as a cross talk factor between inflammatory cells and endothelial cells that inhibits LDL transcytosis across endothelium. MYDGF may become a novel therapeutic drug for atherosclerosis, and the beneficial effects of inflammatory cell in atherosclerosis deserve further attention.
With What Voice Does China Speak? Sinology, Orientalism and the Debate on Sinologism
Authors: Sobral Pedro
Published: September 2023

The arrival of postcolonial theory in China and the country’s global rise came with the realization that its self-image is often distorted by Western ideological discourse, conveyed through Western Sinology. Drawing from Edward Said’s Orientalism, some Chinese scholars have classified the ideological dimensions of Western Sinology as Sinologism, and have pointed out its implications for China’s capacity to think of itself on its own terms. The concept has sparked debate mainly inside Chinese academia about the objective quality of Western Sinology. This article will attempt a critical overview of two major formulations of Sinologism, underlining its major presuppositions and placing the notion in the broader context of China’s anxieties of “academic colonization” by Western intellectual practices. It will conclude by arguing that attempts to discredit Western Sinology rely on some problematic assumptions and suggests East-West comparative studies as an alternative way of dialectically constructing Chinese identity.
After 50 years of social impact assessment, is it still fit for purpose?
Authors: Vanclay Frank
Published: September 2023

Social impact assessment is a field of applied social research that is now over 50 years old. With its ongoing evolution in practice and thinking, social impact assessment is a valued part of project development and will continue to be so. Over time, there has been a shift in understanding, from social impact assessment being a regulatory tool to now being the process of managing social issues throughout the life of a project. The range of issues considered has become much wider, now also including human rights. More than a tool or approach, social impact assessment is a discourse, a body of scholars and practitioners, a paradigm, and a philosophy about development and the rights of affected communities. The proper consideration of social impacts is now expected by all project stakeholders and is a requirement of international standards and project financing. There is now recognition of the need for projects to gain and maintain social acceptance, or a social license to operate and grow. Key current issues include: human rights; doing good rather than just doing no harm; benefit-sharing arrangements; Indigenous-led social impact assessment and community-based social impact assessment; and gender, LGBTQI+, two-spirit people, and intersectionality. Social impact assessment is increasingly being used to assist communities in negotiating Impact and Benefit Agreements (or Community Development Agreements).
Transfer of Minors to Adult Court in California: Investigating the Legal/Demographic Factors that Make the Difference
Authors: Goldschmied Nadav , Ramona Ally , Stilman Eden , Bomberger Emily , Lehman Francesca , Malek Kristina , Minagawa Rahn
Published: September 2023

In light of California’s passage of Proposition 57 in 2016, the present study examined the relationship between legal/demographic variables and decisions to transfer juveniles to the adult court system. Following Prop 57, transfer decisions were entrusted solely with judges and prosecutors could no longer direct file. We used a sample of 106 reports written by forensic psychologists on behalf of the defense examining the life circumstances of minors who allegedly committed serious crimes. Close to two-thirds of minors were kept in the juvenile system whereas the rest were transferred. Utilizing regression analysis, we found that minors with at least one murder charge were more likely to end up in adult court. In regards to race, we detected an overall considerable overrepresentation of Black and Latino juveniles and an underrepresentation of Whites with charges against them but no support of racial bias in transfer decisions in our restricted data set.
Alcohol Consumption and Violent Offending: Findings From a Longitudinal Study on Korean Youth from Mid to Late Adolescence
Authors: Lee Yeungjeom , Cardwell Stephanie M. , Kim Jihoon
Published: September 2023

Although past research highlights a close relationship between alcohol and crime, its role as a static (i.e., stable) and dynamic (i.e., changing) risk factor of violent delinquency has been less studied. Cross-lagged dynamic panel models were employed to address this issue based on a longitudinal Korean adolescent sample. Despite the significant independent effects of baseline individual differences in alcohol use, its impact on violence was no longer statistically significant when accounting for within-individual changes in alcohol consumption. However, we also found interaction effects between baseline and within-individual changes in alcohol consumption; youth who consume more alcohol at earlier ages and engage in more alcohol use over time are more likely to engage in violence. Findings stress the importance of studying static and dynamic factors and their interaction to provide a greater understanding of violent delinquency. Limitations and implications for policy and practices are discussed.
“‘Why? Why? Why?’ is the question of the course”: Master’s of Public Administration students’ perspectives on their learning in a standalone ethics course and the implications for ethics education throughout the curriculum
Authors: Perun Stefan A
Published: September 2023

This paper reported the findings from 18 qualitative interviews of students across two sections of an elective, standalone ethics course in a Network of Schools of Public Policy, Affairs and Administration (NASPAA) accredited Master’s of Public Administration (MPA) program at a northeast university. The findings suggested that a survey of normative ethical theories and opportunities to practice applying those theories to case studies in public administration led students to uncover the values upon which they stood and consider the strengths and deficiencies of those values in practice. Students generally described the value of this learning experience as developing the ability to identify and systematically consider the reason and logic of their ethical perspectives, consider alternatives presented by others, and take a principled stance. Implications of these findings for embedding ethics education across the curriculum in NASPAA accredited programs was considered.
The expansion of China’s market margins: Navigating contingencies and conjunctures
Authors: Fu Wenying
Published: September 2023

In this exchange piece, I engage with Weber’s critical analysis, destabilizing the ideological dichotomy of the big bang approach versus experimental gradualism. I suggest that China’s past decades of conspicuous economic success are attributed to the political tactics of navigating the variegated sociospatial contingencies, as well as the conjunctures of new rounds of spatial division of labor globally in the 1980s. In sum, I point to the role of the arts of governmentality in reconfiguring domestic economic geography to sustain and facilitate the expansion of market margins for the growth of state power.
Natural History, Pathophysiology, and Recent Management Modalities of Intraventricular Hemorrhage
Authors: Essibayi Muhammed Amir , Ibrahim Abdallah Omar , Mortezaei Ali , Zaidi Saif Eddine , Vaishnav Dhrumil , Cherian Jacob , Parikh Gunjan , Altschul David , Labib Mohamed
Published: September 2023

Intraventricular hemorrhage (IVH) is a clinical challenge observed among 40–45% of intracerebral hemorrhage (ICH) cases. IVH can be classified according to the source of the hemorrhage into primary and secondary IVH. Primary intraventricular hemorrhage (PIVH), unlike secondary IVH, involves only the ventricles with no hemorrhagic parenchymal source. Several risk factors of PIVH were reported which include hypertension, smoking, age, and excessive alcohol consumption. IVH is associated with high mortality and morbidity and several prognostic factors were identified such as IVH volume, number of ventricles with blood, involvement of fourth ventricle, baseline Glasgow Coma Scale score, and hydrocephalus. Prompt management of patients with IVH is required to stabilize the clinical status of patients upon admission. Nevertheless, further advanced management is crucial to reduce the morbidity and mortality associated with intraventricular bleeding. Recent treatments showed promising outcomes in the management of IVH patients such as intraventricular anti-inflammatory drugs, lumbar drainage, and endoscopic evacuation of IVH, however, their safety and efficacy are still in question. This literature review presents the epidemiology, physiopathology, risk factors, and outcomes of IVH in adults with an emphasis on recent treatment options.
Exploring the training of school principals as educational leaders in Mexico
Authors: Orozco Gonzalez Lourdes Estefhany
Published: September 2023

The study aimed to investigate novice principals’ pre-role training in educational leadership. The research was originally intended as a mixed-methods approach; an online questionnaire was applied for data collection to answer the research question: Are public secondary school principals trained to be successful leaders when they undertake this role in Mexico? The questionnaire explored principals’ pre-role formal and informal training, their sense of readiness and the main challenges undertaking the position. It reached 29 responses ( n = 29), this very small sample is not representative, but provides insights for examining larger trends in school leaders’ training/preparation in Mexico. Most participants of this study did not have formal pre-appointment training in educational leadership. This seems to be related to Mexican recruitment processes for principalship, where leadership instruction is not required. Informal pre-role training/preparation was more reported to be helpful by participants. Their leadership was limited mainly by challenges related to administrative tasks. The study suggests the need to analyse and improve the Mexican recruitment process for principals, addressing pre-role training and job induction. If larger-scale studies corroborate this scenario, more detailed recommendations would be developed.
Disability, trauma, and the place of affect in identity: Examining performativity in visual impairment rehabilitation
Authors: Watermeyer Brian , Botha Michelle
Published: September 2023

This paper examines rehabilitation services for visually impaired individuals as, in part, an amplified instantiation of disciplinary social forces maintaining heteronormative, ableist, and neoliberal norms. We problematise traditional rehabilitation's predominantly material focus, which elides experiences that are internal, emotional, relational, and reflective of issues of identity and social belonging, while creating links between gendered and ableist performativity. To do this, we draw on two qualitative data sources: firstly, interview data from a study of rehabilitation service organisations in South Africa, and secondly, a vignette provided by the second author, which describes a graduation ceremony (a performative ritual at a rehabilitation organisation). By means of a critical feminist disability studies lens, we consider the transmission of meanings and performative imperatives in these services, which tend to disallow the expression and processing of socially engendered trauma, thereby limiting the ability of visually impaired individuals to explore secure and authentic self-identities. Through the prism of visual impairment rehabilitation, commonalities between forces of dehumanisation resonant in the lives of both women and people with disabilities are brought to light, with implications for secure identities based on diversity, as well as for the creation of caring societies that embrace the reality of interdependence.
Spectral decoupled correction algorithm for multi-input multi-output random vibration control
Authors: Zheng Ronghui , Liu Chuang , Feng GuoSong , Wei Xiaohui , Chen HuaiHai
Published: September 2023

The multi-output response spectral replication correction algorithms for the multi-shaker random vibration test are investigated. In the existing matrix power correction algorithm, the control of auto and cross spectral densities is coupled which may bring some unexpected errors. The ideal spectral correction mode is that the control of auto and cross spectral densities should be independent of each other. For this purpose, a novel spectral decoupled correction algorithm is proposed with a spectral decoupling decomposition method in this work. Two lower triangular matrices are introduced to modify the auto and cross spectral densities separately during equalization procedure. Due to the positive definite constraint for the power spectral matrix, the coherence coefficient and phase difference in the cross spectral densities cannot be controlled independently when the number of the control channels is more than two. A simulation example is provided and the control results with the matrix power correction algorithm and proposed spectral decoupled correction algorithm are compared. Finally, a tri-axial shaker random vibration test is carried out and the results prove the effectiveness and feasibility of the proposed method.
Composing Cultural Connections: Exploring Tensions of Creating Composite Ethnodramatic Characters
Authors: Hradsky Danielle
Published: September 2023

This article discusses tensions of creating composite characters in ethnodramas, with particular focus on characters’ cultural identities. Six teacher characters were composed from 12 research participants for Connections, an ethnodrama that highlights the importance of cultural identity when engaging with teaching for reconciliation between First Nations and non-Indigenous Australians. This article presents the author’s ethnodrama methodology, as well as excerpts from the ethnodrama itself, before unpacking complexities related to composing characters’ cultural identities. It is suggested that composing characters protects participant anonymity but opens new possibilities and uncertainties that should be carefully considered as part of the ethnodramatic process.
Why do Role Perceptions Matter? A Qualitative Study on Role Conflicts and the Coping Behavior of Dutch Municipal Enforcement Officers
Authors: van der Meer Joëlle , Vermeeren Brenda , Steijn Bram
Published: September 2023

This study examines municipal enforcement officers’ role perceptions because their role has shifted from a traditional officer to a broader, social role within the community as a “city host.” Furthermore, we investigate whether role perceptions influence how officers cope with role conflicts. Interviews showed that municipal enforcement officers perceive sufficient discretion in their work and develop their own role perceptions. Some officers adopt a networking role and cooperate with various parties while others fulfill a narrower role as a bureaucrat and rely heavily on rules and protocols. Some officers successfully balance both roles. The way municipal enforcement officers perceive their role has an influence on their coping behavior. Given the belief that there should be a shift from bureaucratic styles of policing towards a broader, more social, role in communities, organizations should be aware that role perceptions play an important role in how officers behave.
Visual results and subjective satisfaction after implantation of two different trifocal diffractive intraocular lenses models (AcrySof IQ PanOptix and AT LISA tri 839 MP)
Authors: Boris Malyugin , Olga Fomina , Nikolay Sobolev , Alexander Belokopytov , Eliya Levinger , Boris Knyazer , Krauthammer Mark , Yahalomi Tal , Asaf Achiron
Published: September 2023

Background

This study aimed to compare visual results following the implantation of two distinct diffractive trifocal IOLs utilizing various vision evaluation techniques and subjective satisfaction.

Methods

The study included 32 eyes receiving AcrySof IQ PanOptix implantation and 32 receiving AT LISA tri 839 MP. Post-operative examination at one year included uncorrected visual acuity (UCVA), distance-corrected visual acuity (DCVA) at 4 m, 80 cm, 60 cm, and 40 cm, Contrast sensitivity under photopic and mesopic conditions, and a questionnaire on subjective quality of vision, optical phenomena, and spectacle independence.

Results

The two groups were similar in baseline demographics, pre-operative visual, biometric data (except for axial length), and surgical paraments. The PanOptix outperformed the AT LISA tri in the intermediate range when using the standard visual acuity testing (UCVA: 0.23 ± 0.14 logMAR vs. 0.31 ± 0.17 logMAR, p = 0.04; BCVA: 0.21 ± 0.12 vs. 0.28 ± 0.14, p = 0.03) and in the intermediate and far range when using the interactive computer program (intermediate: UNVA “E” optotype test: 0.05 ± 0.12 vs. 0.12 ± 0.13, p = 0.03; Far: UNVA “E” optotype: 0.07 ± 0.12 vs. 0.13 ± 0.10, p = 0.05). In addition, the PanOptix group had higher contrast sensitivity under photopic and mesopic conditions with and without glare at all spatial frequencies. There was no difference in subjective outcomes between the groups.

Conclusions

Patients who received PanOptix IOL had better visual outcomes for intermediate and far with higher contrast sensitivity under various conditions. Based on patients ‘ needs and demands, these results could support discussion when tailoring the optimal multifocal IOl.
The social behavior of traveling with dogs: Drivers, behavioral tendencies, and experiences
Authors: Hoy Lori S. , Stangl Brigitte , Morgan Nigel
Published: September 2023

Increases in dog guardianship and the demand for dog-friendly travel services present an opportunity for tourism providers, but this market can still be undervalued or taken for granted. A better understanding of the social behavior and experiences of traveling with dogs is required to discern what impacts guardians’ behavioral tendencies to travel with their dogs. Built on past literature and the reflective-impulsive model (RIM) of social behavior, a conceptual model was developed based on four social representations/perceptions (human–dog symbiotic relationship, dog well-being beliefs, information acquisition, and perceived risks) that influence guardians’ motivational orientation (intrinsic motivation) and behavioral tendencies (intention and behavioral schema) to travel with their dogs. A mixed methods design, with an online survey ( N = 611) to test the model using partial least squares structural equation modeling (PLS-SEM) and semi-structured interviews ( N = 34), was used to develop a better understanding of the social representations and experiences of guardians traveling with their dogs. Results from the quantitative analysis show that dog well-being beliefs had the strongest positive impact, while both dog well-being beliefs and information acquisition impacted motivation and behavioral tendencies. Perceived risks had a negative effect only on behavioral schema, while the human–dog symbiotic relationship required intrinsic motivation to drive behavioral patterns. Qualitative findings highlight the lived experiences of those traveling with their dogs, emphasizing that human and dog well-being and enjoyment are important to guardians, while issues persist with guardians finding adequate dog-friendly travel information and concerns regarding risks remain. Theoretical and managerial implications are provided.
Mental health and access to care among the Roma population in Europe: A scoping review
Authors: Guerrero Zoe , Civišová Dagmar , Winkler Petr
Published: September 2023

The Roma are Europe’s largest ethnic minority group, and often face discrimination and social exclusion. Social strife and lack of access to healthcare are associated with increased symptoms of psychopathology. We aimed to review evidence on mental health outcomes and on access to mental healthcare among the Roma population in Europe. We systematically searched five databases (PsycINFO, Global Health, Social Policy and Practice, Web of Science and PubMed) and conducted a grey literature search in August 2020. We identified 133 studies, 26 of which were included for final analysis. We present the results using a narrative synthesis. The available literature indicates a relatively high prevalence of anxiety, depression and substance abuse among Roma, and females seem to be more affected than males. Roma children exhibit more externalizing and internalizing disorders when compared with non-Roma children. Mental health and perceived well-being among the Roma population are strongly linked to social determinants of health such as housing or economic income. Access to mental healthcare is limited for Roma people because of several barriers pertaining to language, lack of information regarding available services, and the insurance and economic status of Roma people. Roma people report mainly negative experiences with mental health services, including a lack of understanding from healthcare providers, and instances of racism and discrimination. There is a need for more research on mental health and access to healthcare in Roma people. Future studies should be participatory in order to provide guidelines for mental healthcare that addresses the needs of the Roma population.
Brake Early: RGS14 in CA2 Limits Seizures and Oxidative Stress After SE
Authors: Metcalf Cameron S.
Published: September 2023

[Box: see text]
Opportunities and challenges of pharmacovigilance in special populations: a narrative review of the literature
Authors: Li Yanping , Wu Yuanlin , Jiang Tingting , Xing Haiyan , Xu Jing , Li Chen , Ni Rui , Zhang Ni , Xiang Guiyuan , Li Li , Li Ziwei , Gan Lanlan , Liu Yao
Published: September 2023

The relatively new discipline of pharmacovigilance (PV) aims to monitor the safety of drugs throughout their evolution and is essential to discovering new drug risks. Due to their specific and complex physiology, children, pregnant women, and elderly adults are more prone to adverse drug reactions (ADRs). Additionally, the lack of clinical trial data exacerbates the challenges faced with pharmacotherapy in these populations. Elderly patients tend to have multiple comorbidities often requiring more extensive medication, which adds additional challenges for healthcare professionals (HCPs) in delivering safe and effective pharmacotherapy. Clinical trials often have inherent limitations, including insufficient sample size and limited duration of research; as some ADRs are attributed to long-term use of a drug, these may go undetected during the course of the trial. Therefore, the implementation of PV is key to insuring the safe and effective use of drugs in special populations. We conducted a thorough review of the scientific literature on PV systems across the European Union, the United States, and China. Our review focused on basic physiological characteristics, drug use, and PV for specific populations (children, pregnant women, and the elderly). This article aims to provide a reference for the development of follow-up policies and improvement of existing policies as well as provide insight into drug safety with respect to patients of special populations.
Client experiences with telehealth using LINE for consultation and assessment of adverse effects of contraceptive implants during the COVID-19 pandemic in Thailand
Authors: Phianphitthayakul On-anya , Li Jiayu , Rongkapich Ratthapong , Karroon Parichart , Vatrasresth Jarika , Jaisamrarn Unnop , Santibenchakul Somsook
Published: September 2023

Objective

This study aimed to examine clients’ experiences with telehealth use for contraceptive implant consultation.

Methods

An online, self-administered survey was conducted with women who used contraceptive implants and faced adverse effects, inquired about side effects, or had concerns. Clients received consultations via LINE, which is a free chat application widely used in Thailand. Participants completed a questionnaire regarding their experiences and satisfaction within 7 days after using the service and a follow-up questionnaire to inquire about the need for in-person services 30 days after using the service.

Results

The participants were 200 women, with a response rate of 82%. Overall, 94% of participants were satisfied with the consultation. Moreover, 37.5% received a message response within 6 hours, and most (89.5%) got a response within 24 hours. The three most frequently reported symptoms were abnormal bleeding or spotting, mood swings, and itching or pain at the surgical site. Most adverse effects were managed through online consultation. Approximately one-third of the participants required in-person visits 30 days after telehealth consultation.

Conclusions

Telehealth consultation for contraceptive implant follow-up resulted in high client satisfaction. Most adverse effects could be managed using telehealth services. Therefore, telehealth could ensure sustained accessibility to reproductive healthcare during and post-COVID-19.
Combining augmented and virtual reality simulation training to improve geriatric oral care performance in healthcare assistants: A randomized controlled trial
Authors: Lin Yi-Ching , Lin Pei-Chen , Lin Pei-Chao , Lin Cheng-Yu , Kabasawa Yuji , Choi Yong-Keum , Huang Hsiao-Ling
Published: September 2023

Objective

Healthcare assistants (HCAs) are frontline caregivers for older adults. This study evaluated the effectiveness of combining augmented reality (AR) and virtual reality (VR) to implement oral healthcare simulation training for HCAs.

Methods

An experimental design was adopted. HCAs were recruited and randomly assigned to an AR/VR group ( n = 40) or a control group ( n = 40). The AR/VR group received 2.5 h of AR/VR training. Participants were trained on the Bass brushing technique through AR and on scenario-based oral care procedures for various physical and oral health conditions in older adults through VR. A self-administered questionnaire was employed to collect data before and after the training. Generalized estimating equations were used to analyze the differences between pretest and posttest results.

Results

After the training, the HCAs in the AR/VR group achieved a significantly greater increase in their level of oral care-related knowledge (β = 2.55, effect size [ES] = 1.62), self-efficacy (β = 4.23, ES = 0.75), and behavioral intention (β = 2.10, ES = 0.55) relative to the control group.

Conclusion

This study revealed that the application of an AR/VR simulation system can effectively improve the geriatric oral care performance of HCAs.
Fractal imagination and Christian formation
Authors: Jordan Richard , Ward Thomas M.
Published: September 2023

We make two interventions in two evolving scholarly literatures. First, we show how fractal metaphors escape a recurring dichotomy in Christian pedagogical scholarship, the either/or of alienation from one’s object of study versus union with it in “an act of love.” Second, we try to replace recent interdisciplinary work’s emphasis on “complexity” with “irreducibility.” Fractals allow us to define these concepts and develop alternative “ways of knowing” with greater rigor. Both interventions bear directly on Christian formation, and so we derive five ways the Christian classroom can combat spiritual alienation and instead cultivate the “fractal imagination” of our students.
‘My body tells me to stay here’: Materiality, identity and everyday politics in Wentang Town, China
Authors: Li Peng , Tian Siyu , Yao Luchao , Feng Dan
Published: September 2023

This paper explores the relations of materiality, identity formation and everyday politics in the governance of geothermal resource in contemporary China. Drawing on ethnographic data, we found that the materiality of geothermal water in its lively and dynamic forms plays agentic roles in discourse constructions, embodied experiences and material practices, shaping the socio-natural politics. The social relations, contestations and conflicts are rooted in the ontological differences of geothermal water as understood by the competing actors. The study of geothermal water contributes to recent debates on the agency of materials in urban political ecology studies as well as exploring everyday politics by highlighting the multiplicity and heterogeneity of actors and the ways in which identity formations are mobilized in everyday governance. This paper sheds light on the heterogeneous configurations of urbanization processes and resource governance.
Recurrent sigmoid volvulus secondary to a large pedunculated colonic lipoma
Authors: Alwali Ahmed , Kamaleddine Imad , Erbersdobler Andreas , Schafmayer Clemens , Alsfasser Guido
Published: September 2023

Symptomatic colon lipoma is a rare occurrence in clinical practice, and its association with sigmoid volvulus is even rarer. We present a case of a man in his 70s who presented to our emergency department with suspected intestinal obstruction. Upon examination, sigmoid volvulus was diagnosed and successfully treated endoscopically through decompression and detorsion. However, the patient experienced a recurrence, leading to the decision to perform sigmoid resection as a Hartmann’s procedure. Subsequently, a prolapsed tumor was observed through the stoma, which was endoscopically resected, revealing a pedunculated submucous colonic lipoma. This case report highlights the potential association between sigmoid volvulus and the presence of a large colon lipoma. Thus, giant colonic lipoma should be considered as a differential diagnosis among the causes of colonic volvulus.
Establishment and validation of a prognosis nomogram for MIMIC-III patients with liver cirrhosis complicated with hepatic encephalopathy
Authors: Yan Wansheng , Yao Zhihui , Ou Qiutong , Ye Gang
Published: September 2023

Introduce

The purpose of this study was to establish a comprehensive prognosis nomogram for patients with liver cirrhosis complicated with hepatic encephalopathy (HE) in the intensive care unit (ICU) and to evaluate the predictive value of the nomogram.

Method

This study analyzed 620 patients with liver cirrhosis complicated with HE from the Medical Information Mart for Intensive Care III(MIMIC-III) database. The patients were randomly divided into two groups in a 7-to-3 ratio to form a training cohort (n = 434) and a validation cohort (n = 176). Cox regression analyses were used to identify associated risk variables. Based on the multivariate Cox regression model results, a nomogram was established using associated risk predictor variables to predict the 90-day survival rate of patients with cirrhosis complicated with HE. The new model was compared with the Sequential organ failure assessment (SOFA) scoring model in terms of the concordance index (C-index), the area under the curve (AUC) of receiver operating characteristic (ROC) analysis, the net reclassification improvement (NRI), the integrated discrimination improvement (IDI), calibration curve, and decision curve analysis (DCA).

Results

This study showed that older age, higher mean heart rate, lower mean arterial pressure, lower mean temperature, higher SOFA score, higher RDW, and the use of albumin were risk factors for the prognosis of patients with liver cirrhosis complicated with HE. The use of proton pump inhibitors (PPI) was a protective factor. The performance of the nomogram was evaluated using the C-index, AUC, IDI value, NRI value, and DCA curve, showing that the nomogram was superior to that of the SOFA model alone. Calibration curve results showed that the nomogram had excellent calibration capability. The decision curve analysis confirmed the good clinical application ability of the nomogram.

Conclusion

This study is the first study of the 90-day survival rate prediction of cirrhotic patients with HE in ICU through the data of the MIMIC-III database. It is confirmed that the eight-factor nomogram has good efficiency in predicting the 90-day survival rate of patients.
Factors contributing to flares of ulcerative colitis in North India- a case-control study
Authors: Rana Vishavdeep Singh , Mahajan Gaurav , Patil Amol N. , Singh Anupam K. , Jearth Vaneet , Sekar Aravind , Singh Harjeet , Saroch Atul , Dutta Usha , Sharma Vishal
Published: September 2023

Background

Ulcerative colitis is a relapsing and remitting disease that may be associated with flares. The causes of flares in the Indian setting are not well recognized.

Methods

The present prospective case-control study was conducted at a single center in North India. Cases were defined as patients admitted for flare of ulcerative colitis, while controls were patients in remission enrolled from the outpatient department. The basis of the diagnosis of flare was a simple clinical colitis activity index (SCCAI) of ≥ 5 and endoscopic activity, while remission was based on SCCAI < 4 and a normal fecal calprotectin. A questionnaire evaluating recent infections, stress, drug intake (antibiotics, pain medication), adherence to therapy, and use of complementary and alternative therapy (CAM) was administered.

Results

We included 84 patients (51 with flare and 33 in remission) with a median age of 38 years, of whom 47 (55.9%) were males. The two groups were similar for baseline parameters, including age (38, 23–50 and 38, 25.5–48.5 years), male gender (52.9% and 60.6%), extent of disease, extraintestinal manifestations (21.6% and 12.1%), use of 5-aminosalicylates (76.5% and 90.9%). The thiopurine use was lower in those having a flare (15.7% and 36.4%). Amongst the predictors of flare, the recent infections (39.2% and 30.3%), recent travel (31.4 and 27.3%), eating outside food (47.1% and 39.4%), consumption of milk products (88.2% and 75.8%), use of pain medication (43.1% and 33.3%) and recent stress (62.7% and 60.6%) were similar between cases and controls. The rates of antibiotic use (29.4% and 6.1%), lack of adherence (50.9% and 15.2%), and intake of CAM (70.6% and 33.3%) were higher in those with flare. Patients attributed a lack of adherence to the cost of therapy, presumed cure (due to lack of symptoms), and fear of adverse effects.

Conclusion

Lack of adherence to inflammatory bowel disease therapies and recent CAM and antibiotic intake was higher in patients with flares of UC. The study makes ground for educational intervention(s) promoting knowledge and adherence to IBD therapies.
Support in acute situations when a community health nurse is called: experiences of older patients, their significant others, and involved healthcare professionals- a qualitative interview study
Authors: Forsgärde Elin-Sofie , Rööst Mattias , Svensson Anders , Fridlund Bengt , Elmqvist Carina
Published: September 2023

Background

Care decisions for older patients in acute situations are challenging to make, and there is limited knowledge of support in home healthcare settings, where older patients receive ongoing health care from, for example, community health nurses. Therefore, this study aimed to describe the support for all involved in acute situations when a community health nurse was called, as experienced by older patients, their significant others and healthcare professionals involved.

Methods

The study was conducted using a phenomenological reflective lifeworld research approach, in which meanings of the study phenomenon were analyzed. The included participants were those who had been involved in acute situations. Twelve participants from four acute situations were interviewed. The participant included three older patients, one significant other, four community health nurses, one registered nurse student, one specialist in general practice, and two ambulance personnel, with one being a registered nurse and the other a specialist ambulance nurse.

Results

Support in decision-making was received from the knowledge of temporality, which provided a comprehensive understanding based on past and present knowledge of the older patient. The knowledge of temporality allowed for the early detection of new symptoms and facilitated care decisions tailored to the older patient. There was a dependency on pre-existing mutual interpersonal support, and confidence developed through relational, caring, and medical competence.

Conclusions

The advantages of temporality, confidence and mutual interpersonal support in acute situations highlight the importance of enhancing relational continuity in home healthcare settings and establishing a structural collaboration among community health nurses, specialists in general practice, and ambulance personnel. This collaboration aims to provide support for making decisions regarding tailored care.
Empirical cefepime+vancomycin versus ceftazidime+vancomycin versus meropenem+vancomycin in the treatment of healthcare-associated meningitis: results of the multicenter Ephesus study
Authors: Sipahi Oguz Resat , Akyol Deniz , Ormen Bahar , Cicek-Senturk Gonul , Mermer Sinan , Onal Ugur , Amer Fatma , Saed Maysaa Abdallah , Ozdemir Kevser , Tukenmez-Tigen Elif , Oztoprak Nefise , Altin Ummugulsum , Kurtaran Behice , Popescu Corneliu Petru , Sakci Mustafa , Suntur Bedia Mutay , Gautam Vikas , Sharma Megha , Kaya Safak , Akcil Eren Fatma , Kaya Selcuk , Turunc Tuba , Ergen Pınar , Kandemir Ozlem , Cesur Salih , Bardak-Ozcem Selin , Ozgiray Erkin , Yurtseven Taskın , Erdem Huseyin Aytac , Sipahi Hilal , Arda Bilgin , Pullukcu Hüsnü , Tasbakan Meltem , Yamazhan Tansu , Aydemir Sohret , Ulusoy Sercan
Published: September 2023

Background

Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM).

Materials/methods

This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018.

Results

Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p < 0.05). Microbiological success on Day 3–5, end of treatment (EOT) clinical success (80% vs. 54.8%% vs 57.9%), and overall success (EOT success followed by one-month survival without relapse or reinfection 65% vs. 51.6% vs. 45.3%), EOT all cause mortality (ACM) and day 30 ACM (15% vs. 22.6% vs. 26%) did not differ significantly (p > 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34).

Conclusions

Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.