bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between lower extremity physical function and physical activity after ischemic stroke: Longitudinal findings from the MOBITEC-Stroke project
Authors: Jäger Christoph , Ryan Michelle , Rommers Nikki , Schär Janine , Weibel Robert , Kressig Reto W , Schmidt-Trucksäss Arno , Engelter Stefan , Peters Nils , Hinrichs Timo , Rössler Roland
Published: October 2024

Background:

Stroke often results in physical impairments. Physical activity is crucial for rehabilitation, enhancing mobility, strength, and overall health. This study examines the association between Timed Up-and-Go (TUG) test performance and changes in physical activity to improve lower extremity physical function.

Methods:

The MOBITEC-Stroke Cohort Study (“Recovery of mobility function and life-space mobility after ischemic stroke”) included patients with a first incidence of stroke. Data assessed 3 and 12 months after stroke were used for analysis. Linear regression model adjusted for age, sex, instrumental activities of daily living, Falls Efficacy Scale-International, modified Ranking Scale, and National Institutes of Health Stroke Scale-score was used to examine the relationship between lower extremity physical function (i.e., TUG) and change in physical activity (i.e., minutes of physical activity measured with a wrist-worn accelerometer over 1 week).

Results:

Longitudinal data of 49 patients (65% male, mean age 71.2 (SD: 10.4) years) were analyzed. Mean daily physical activity was 291.6 (SD: 96.2) min at 3 months and 298.9 (SD: 94.4) min at 12 months, with a change from 3 to 12 months of 7.3 min (95% CI: −9.4 to 24.0; p = 0.394) post-stroke. We observed significant relationships between the baseline TUG performance and the change in total physical activity over 9 months ( p = 0.011) and between the change of TUG performance over time and the change in total physical activity ( p = 0.022).

Conclusion:

Our findings indicate that better initial lower extremity physical function and higher improvements in function over time are associated with a greater increase in physical activity levels after stroke. This suggests that interventions aimed at maintaining and improving lower extremity physical function may positively affect physical activity levels.
Bridging the gap: Leveraging telemedicine and IT infrastructure to connect outpatient oncology practices with specialized expert teams in the management of rare tumors
Authors: Kasprzak Julia , Goering Timothy , Berger-Thürmel Karin , Kratzer Vanessa , Prompinit Wuthichai , Wichert Sven P. , Leutner Simon , Langermann Norbert , von Bergwelt-Baildon Michael , Heinemann Volker , Algül Hana , Zünkeler Martin , Nasseh Daniel ,   on behalf of the TARGET Group *
Published: October 2024

Objectives

The treatment of rare tumors often necessitates the involvement of highly specialized teams, typically based in larger medical centers or university hospitals, which are often lacking in rural areas. The German TARGET (the Trans-sectoral Personalized Care Concept for Patients with Rare Cancers) project aims to improve the network between outpatient oncology practices and more centralized expert teams via telemedicine.

Methods

The primary work involved conceptualizing the implementation of project requirements based on feedback from various TARGET project teams, and ultimately, the method of implementation using the software CentraXX. Key requirements included the utilization of an electronic health record (EHR), incorporating appropriate access mediums such as smartphones, and utilizing user-specific certificates to ensure secure and tailored access. The implementation considered technical aspects, data protection regulations, and the need for user-friendly interfaces, particularly for older patients with cancer with limited technological proficiency.

Results

The results detail the successful implementation of the project requirements using CentraXX, which facilitated the implementation of an EHR, access mediums (patient app), and browser access for outpatient doctors, addressing the project's technical, security, and usability needs.

Conclusion

This article presents an overview of the requirements associated with the TARGET project and outlines how they were met in terms of the IT infrastructure. By focusing on the IT implementation rather than the medical trial results, this work aims to provide valuable insights and guidance for similar projects seeking to improve telemedicine networks and digital information exchange in the context of rare cancer treatment.
A step-by-step roadmap for the development and deployment of an electronic health record sidecar application that tracks patient outcomes: The RA PRO dashboard
Authors: Schmajuk Gabriela , Nasrallah Catherine , Berrean Beth , Prugh Jonathan , Wilson Cherish , Hamblin Alicia , Young Cammie , Jacobsohn Lindsay , Kay Julia , Li Jing , Kersey Emma , Subash Meera , Murray Sara , Yazdany Jinoos
Published: October 2024

Objective

Despite interest in optimizing the electronic health record (EHR) to facilitate chronic disease care for conditions like rheumatoid arthritis (RA), progress in this area has been slow. EHR sidecar applications offer one solution, but little guidance exists to facilitate their successful development, deployment, and maintenance in the healthcare setting. We aimed to provide a roadmap for how to develop and deploy an EHR sidecar application based on our experience building a new EHR-integrated, patient-facing visualization tool that displayed disease outcomes to RA patients during a clinical visit (the “RA PRO dashboard”) in a large academic health center.

Methods

We describe the technical design and implementation of the RA PRO dashboard; report clinic workflow adaptations to incorporate this new technology; and discuss the resources required and challenges encountered in maintaining this application.

Results

The RA PRO dashboard required extensive human-centered design work, regulatory approvals, software development, user testing, integration with Epic-based workflows, and maintenance. Key requirements were prioritized based on the anticipated effects on usefulness and ease of use. Implementation science strategies were used to improve use of the dashboard in clinic and included education for patients, staff, and clinicians; reports of actual use of the dashboard and data quality; and regular meetings between the research team and clinicians to discuss and address barriers to use.

Conclusion

Successful development and deployment of an EHR-integrated application are resource-intensive and require technical, operational, and educational innovations. The roadmap presented in this study can serve as a resource for future developers.
Frail older adults with insomnia experiences of using weighted blankets: A qualitative study
Authors: Telhede Eva Hjort , Arvidsson Susann , Karlsson Staffan
Published: October 2024

Insomnia is common among frail older people living in nursing homes. The aim of the study was to explore how frail older people with insomnia experience the use of a weighted blanket. The study was conducted in nine nursing homes in Sweden. A total of 19 people (4 men, 15 women) aged 67 years and older were included. The study had an inductive qualitative design. Consolidated Criteria for Reporting Qualitative Research (COREQ) was utilized as a checklist to ensure transparency and comprehensiveness and enhance reliability by guaranteeing that all relevant aspects of the research process are thoroughly documented. The semi-structured interviews were analyzed with qualitative content analysis. The results formed four categories: Experiencing proximity, which raised older people’s encounters with the weighted blankets; Changes in sleeping patterns, where older people encountered the weighted blanket’s influence in changing sleep patterns; Experiencing conditions for use, where frail older people experienced the right conditions; and Stimulating senses, where frail older people experienced changes in their senses. Frail older people experienced that weighted blankets could provide comfort, positively influence sleep patterns, and reduce anxiety. This intervention can be considered valuable and offers a possible alternative to medication for frail older people with insomnia.
Research Output, Key Topics, and Trends in Productivity, Visibility, and Collaboration in Social Sciences Research on COVID-19: A Scientometric Analysis and Visualization
Authors: Hamdan Walaa , Alsuqaih Hanan
Published: October 2024

COVID-19 has caused a surge in scientific publications, with increased collaboration. This study aims to elucidate scientific output, focal topics, emerging themes, and trends and patterns of productivity, visibility, and collaboration within social sciences research (SSR) on COVID-19. A scientometric analysis was conducted utilizing Biblioshiny and VOSviewer software. About 65,742 records published on WOS between 2020 and 2022 were analyzed. Topics such as “telehealth,”“well-being,” and “inequalities,” were among the key topics while “interventions” and “mental well-being” were among emerging key topics. Collaboration patterns were regional. Harvard Medical School, the University of Toronto, and the University of Oxford emerge as leaders in collaboration, productivity, and influence. The USA, Italy, India, Spain, and Brazil serve as regional hubs for facilitating collaboration. The USA, England, and China exhibit leadership and influence, playing pivotal roles In shaping the global research. These findings are important for policymakers, funding agencies, and researchers in cultivating future research topics and collaborative efforts. The findings can inform strategic decision-making, resource allocation, and policy development to address present and future health crises. Additionally, these efforts contribute to advancing global sustainability initiatives and promoting human well-being. Encouraging international collaboration is essential, particularly for tackling the regional challenges encountered by countries with limited domestic research capabilities. Future research can improve the methodology used by di-versifying data sources beyond WOS.
Digital Health Literacy Predictors and COVID-19 Online Information-Seeking Behaviors Among University Students from Romania
Authors: Glodici Emilia A. , Brînzac Monica G. , Rusu Andreea , Cherecheş Răzvan M. , Ungureanu Marius I. , Coman Mădălina A.
Published: October 2024

In addition to the infectious disease, the COVID-19 pandemic was accompanied by an infodemic that worsened the outbreak. Increased digital health literacy (DHL) skills and information-seeking behaviors are crucial for accessing, understanding, and evaluating online health information, especially during a pandemic, where misinformation imposes immediate health consequences. This study explores the predictors of DHL among Romanian students and their information-seeking behaviors during the COVID-19 pandemic. Data was collected through a cross-sectional study design over 3 months (December 2020–February 2021) and a self-reported web-based questionnaire from 1,381 university students from Romania assessing DHL and information-seeking behaviors. We used descriptive statistics, Cronbach Alpha coefficients, and univariate and multivariate binary logistic regressions to explore DHL’s predictors in the Romanian sample. Results showed that overall, the study sample had high levels of DHL. However, almost half of the respondents reported having problems assessing whether the information searched related to coronavirus is reliable or not, and 95% shared someone else’s private information online. Age, subjective social status, gender, and chronic diseases were identified as predictors for DHL. Students’ DHL skills need to be strengthened using tailored educational programs and interventions emphasizing the quality, accuracy, and timely provision of online information on official public health platforms. Additional actions include fostering collaborations between educational institutions and public health authorities, alongside developing smartphone applications for real-time guidance on health topics. It is of the utmost importance to address the spread of the infodemic through different strategies, to combat misinformation among university students.
Impact of Local Government Debt on Regional Innovation and Entrepreneurship: Evidence from China
Authors: Dai Li , Yang Yuqi , Bao Yifan , Li Zongze
Published: October 2024

Local government debt serves as a crucial source of funding for local governments to provide public services and steer regional economic development. Exploring the impact of local government debt on regional innovation and entrepreneurship holds significant practical importance. This paper uses the data of 295 cities in China from 2015 to 2020 and uses the fixed effect model for empirical analysis. Our findings reveal a positive association between local government debt and regional innovation and entrepreneurship. This positive effect is attributed to the amplification of both the venture capital agglomeration effect and the technology agglomeration effect. Moreover, this relationship is particularly pronounced in cities characterized by high fiscal transparency, officials’ promotion pressure, and poor business environment. Ultimately, this paper enriches the existing literature by enhancing our comprehension of the economic implications of local government debt and the factors influencing regional innovation and entrepreneurship. Furthermore, it furnishes empirical evidence regarding the effectiveness of local government debt management in China.
Risk Factors for Acute Intraoperative Bradycardia in Patients Undergoing Gender-affirming Mastectomy
Authors: Thornton Sarah M. , Shaffrey Ellen C. , Bay Caroline C. , Verhagen Joshua C. , Wirth Peter J. , Edalatpour Armin , Israel Jacqueline S. , Gast Katherine M. , Rao Venkat K.
Published: October 2024

Purpose: Gender-affirming mastectomy surgery is highly desired within both transmasculine and nonbinary patient populations. The development of cardiac arrhythmias has been reported within this population. Acute intraoperative bradycardia in patients undergoing gender-affirming mastectomy has not been well described previously. This study aimed to describe the frequency of acute intraoperative relative bradycardia in patients undergoing gender-affirming mastectomies and identify potential risk factors that contribute to its occurrence. Methods: A retrospective review was performed for all patients who underwent gender-affirming mastectomy at a single institution. Data regarding patient demographics, comorbidities, and perioperative course were collected. Patients were separated into those who did and did not develop acute intraoperative bradycardia. The definition of relative intraoperative bradycardia was a heart rate below sixty beats per minute. Logistic regression was performed to determine which variables were predictive of bradycardia. Results: A total of 337 patients underwent gender-affirming mastectomy between January 2018 and January 2023. Of these patients, 144 (42.7%) experienced acute intraoperative relative bradycardia, with 97 (67.4%) requiring anesthetic intervention and 5 (3.5%) requiring halting or abortion of surgery. Two patients (1.4%) required compressions for asystole. Fluoxetine as an outpatient medication (OR: 2.63, P = .002) and harvest of a nipple graft (OR: 2.77, P = .018) were associated with a significantly increased risk of developing acute intraoperative bradycardia. Conclusion: Acute intraoperative relative bradycardia may be a unique phenomenon in patients undergoing gender-affirming mastectomies due to variables specific to this patient population. A future study comparing patients undergoing gender-affirming mastectomy to those undergoing elective breast surgeries is forthcoming to assess further risk factors.
Institutional Duality in Land Administration: Insights from Collaborative Governance in Ghana
Authors: Ibrahim Abdul-Salam , Akanbang Bernard Afiik Akanpabadai , Yakubu Ibrahim , Nunbogu Abraham Marshall , Kansanga Moses , Kuuire Vincent
Published: October 2024

The global drive for collaboration towards addressing society’s growing complex challenges is gaining more credence in land administration. Collaborative land governance is crucial in Africa, where the duality in land governance, as expressed in the coexistence of statutory and customary land governance institutions, has been a longstanding source of land conflicts. Drawing theoretical insights from collaborative governance and using in-depth interviews with stakeholders across both customary and statutory land governance systems, this study examines the interplay of factors that militate against effective collaborative land governance in Ghana. Findings show that while the legislative framework on land administration in Ghana authorises collaboration, the challenges of limited trust and awareness of land laws, poor facilitative leadership and inadequate resources militate against collaborative land governance. We argue that the weak manifestation of the well-intentioned legislative frameworks for collaborative land governance calls for increased attention to implementation gaps in equal footing to policy formulation.
A Multicenter Analysis of 3 Decades of Hip Arthroscopy: Evolving Techniques and Growing Patient Volumes From 1988 to 2022
Authors: Conyer Ryan T. , Cleary Emmett J. , Wang Allen S. , Boos Alex M. , Crowe Matthew M. , Economopoulos Kostas J. , Krych Aaron J. , Levy Bruce A. , Hevesi Mario
Published: October 2024

Background:

The number of hip arthroscopies performed in the United States has grown significantly over the past several decades, with evolving indications and emerging techniques.

Purposes:

To (1) examine the evolution of hip arthroscopy at 3 tertiary referral centers between 1988 and 2022 and (2) quantify trends in patient demographics and procedures performed.

Study Design:

Case series; Level of evidence, 4.

Methods:

A retrospective analysis was performed of all patients undergoing hip arthroscopy at 3 academic centers between 1988 and 2022. Demographic data were collected using standardized forms and operative notes, and intraoperative images were manually reviewed for each patient to determine the specific procedures performed at the time of the hip arthroscopy. Surgical procedures were plotted over time to evaluate trends. Patients were divided into 3 time periods for comparison: early hip arthroscopy from 1988 to 2008, 2009 (the time of the first labral repair in our cohort) to 2015, and 2016 to 2022.

Results:

A total of 3000 patients (age, 35.7 ± 13.8 years; age range, 10-89 years; female sex, 2109 (70.3%); body mass index, 27.4 ± 6.3 kg/m2) underwent arthroscopic hip procedures between 1988 and 2022. The mean number of cases increased from a mean of 3.2 per year in 1988-2008 to 285.9 per year in 2016-2022 ( P < .001). Labral treatment at the time of primary hip arthroscopy evolved from 100% debridement and 0% repair in 1988-2008 to 5.0% debridement, 94.0% repair, and 1.0% labral reconstruction in 2016-2022 ( P < .001). Cam resection increased from 4.1% in 1988-2008 to 86.9% in 2016-2022 ( P < .001). By 2022, 45 out of 325 cases (13.8%) were revisions. The rate of capsular repair at the time of primary hip arthroscopy increased from 0.0% in 1988-2008 up to 81.0% in 2016-2022.

Conclusion:

There has been a significant growth of hip arthroscopy volumes as well as a significant transition from use as a tool for diagnosis and labral debridement to procedures restoring native anatomy including labral repair, cam resection, capsular repair, periacetabular osteotomy, and gluteal repair.
Effect of a Preoperative Subacromial Epinephrine Injection on Visualization During Shoulder Arthroscopic Surgery: A Randomized Controlled Trial
Authors: Feinstein Shawn , Svetgoff Reese A. , Harmon Jordan , Siahaan Jacob , Ngo Daniel H. , Fullick Robert K. , Flores Steven E. , Shupe Paul G. , Gregory Bonnie P. , Gregory James M.
Published: October 2024

Background:

The addition of epinephrine to arthroscopic irrigation fluid has been shown to improve surgeon-rated visual clarity during shoulder arthroscopic surgery. Subacromial injections of epinephrine are also used for this purpose.

Purpose/Hypothesis:

To assess the influence of a preoperative subacromial epinephrine injection on surgeon visualization during subacromial shoulder arthroscopic surgery. It was hypothesized that the epinephrine injection would improve surgeon-rated visual clarity.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A double-blind randomized controlled trial including adult patients undergoing shoulder arthroscopic surgery in the beach-chair position requiring visualization of the subacromial space was performed. Patients in the epinephrine group (n = 30) received a preoperative subacromial injection of bupivacaine and epinephrine, and those in the control group (n = 30) received a preoperative subacromial injection of bupivacaine. Epinephrine was added to the first 10 L of arthroscopic irrigation fluid in all patients. The primary outcome was surgeon-rated visual clarity throughout the procedure that was recorded at the end of the procedure using a visual analog scale (VAS) scored from 0 (worst) to 10 (best). Secondary outcomes included an increase in pump pressure during the procedure, total operative time, and the intraoperative use of blood pressure–modulating medications.

Results:

Rotator cuff repair was performed in 88.3% of patients (25/30 epinephrine; 28/30 control), with multiple procedures performed in 85.0% of patients (23/30 epinephrine; 27/30 control). The VAS score for visual clarity was slightly better in the epinephrine group compared with the control group, although the difference was neither statistically nor clinically significant (8.3 ± 1.4 vs 7.5 ± 1.8, respectively; P = .09). There was no difference between the epinephrine and control groups in the need for an increase in pump pressure to improve visualization (8/30 [26.7%] vs 7/30 [23.3%], respectively; P > .99), total operative time (62.0 ± 19.4 vs 64.0 ± 30.1 minutes, respectively; P = .90), or the intraoperative use of blood pressure–modulating medications (20/30 [66.7%] vs 17/30 [56.7%], respectively; P = .60). There were no perioperative adverse events in either group.

Conclusion:

The addition of a subacromial epinephrine injection before shoulder arthroscopic surgery resulted in a small improvement in visual clarity that was neither statistically nor clinically significant, with no adverse effects reported in this study.

Registration:

NCT05244525 (ClinicalTrials.gov)
Complications and Radiographic Outcomes of Tibial Tubercle Osteotomy at Minimum 5-Year Follow-up
Authors: Yalcin Sercan , Seals Karrington , Joo Peter , Fulkerson John P. , Farrow Lutul D.
Published: October 2024

Background:

Tibial tubercle osteotomy (TTO) is a commonly utilized surgery in the treatment of patellofemoral instability and chondrosis. A number of case series studies have reported on the mid- and long-term outcomes with varying complication rates.

Purpose:

To report the incidence of major complications after TTO and the rate of progression of knee osteoarthritis at midterm follow-up.

Study Design:

Case series; Level of evidence, 4.

Methods:

All patients who underwent primary TTO between January 1, 2010 and December 31, 2015, and who had ≥5 years of clinical follow-up data were included. Patient demographics and clinical and radiographic outcomes were recorded. Risk factors for complications were identified using multivariate logistic regression analysis.

Results:

A total of 72 patients were included. The mean follow-up period was 104.8 months (range, 67-138 months). The overall complication rate was 38.9% (28/72 patients), and the incidence of major complications was 6.9%. Univariate logistic regression analysis revealed that patients with a history of smoking were more likely to experience a complication (odds ratio = 4.33 [95% CI, 1.29-14.53]; P = .02). Multivariate analysis with TTO as the main predictor indicated that complication rates were not affected by TTO procedure (TTO vs TTO+other), number of screws, or distalization. There was also no difference between anteromedialization and medialization TTO techniques. The rate of patients with Kellgren-Lawrence grade 3 to 4 increased from 12.0% preoperatively to 23.9% at the final follow-up. New osteophyte formation was detected in 5.8% of patients on anteroposterior radiographs and in 9.1% of patients on lateral radiographs.

Conclusion:

In the current study, TTO was found to have a major complication rate of 6.9% at midterm follow-up. Smoking was a risk factor for major complications. Only 11.9% of patients had progression in tibiofemoral osteoarthritis at midterm follow-up.
Assessment of Hypospadias Patient Education Using Large Language Models
Authors: Naz Rüya , Deliağa Hasan , Kaya Mete
Published: October 2024

Background: Artificial intelligence (AI) language models have emerged as tools capable of generating human-like text-to-user prompts on a wide range of topics. However, it is known that the performance and content quality of these language models have not been evaluated in certain medical fields. The aim of our study is to evaluate the performance of AI language models ChatGPT and Bard in providing parent information about hypospadias and compare the quality of the information with reference to a source. Methods: In this study, 38 frequently asked questions about hypospadias that were publicly posted on social media and websites by reputable institutions and societies were evaluated. The quality of responses was evaluated using the global quality score (GQS) with reference to the European Association of Urology guidelines. The number of words and sentences of the responses were recorded by the researchers. Results: In this study, it was found that the response quality of Bard was higher than ChatGPT in the question group related to the preoperative preparation category ( p = .042). The quality of ChatGPT and Bard's responses to the other questions, except for the questions in the preoperative preparation category, was similar and above average. It was found that the number of words ( p < .001) and sentences ( p < .001) of Bard's responses to the questions were higher than ChatGPT. Discussion: Large language models (LLMs) had limitations in providing parents with quality information about hypospadias. Parents should therefore be careful when using LLMs as a source of information.
Political Context and State-Level Health Behavior Disparities
Authors: VanHeuvelen Jane S. , Wang Yi , VanHeuvelen Tom
Published: October 2024

Geographical residence predicts health and well-being. Population health, life expectancy, and mortality are partially the outcome of the characteristics of one’s social policy context. Yet how do such links occur? We extend focus from health outcomes to health behaviors and from a policy context to a broader political context. Using 20 waves of the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System between 1993 and 2021 in combination with the Correlates of State Policy Project, we find that right-leaning political contexts—both policies and public attitudes—are predictive of riskier health behaviors. Counterfactual simulations show that these associations are due less to states becoming more different over time but rather, with political contexts increasing in their predictiveness over time. Results from this study broaden the pathways linking local politics to health and identify a key antecedent, health behaviors, that helps explain political context’s influence on health.
Effect of Electrical Stimulation of Lingual Nerve on Xerostomia: A Randomized Controlled Trial
Authors: Xu K. , Ma S. , Jia S. , Chen L. , Wei J. , Liu Q. , Tian M. , Ji Z. , Dong Y. , Wang X. , Tay F.R , Zhang T. , Jiao K. , Niu L.
Published: October 2024

Introduction:

Xerostomia is a subjective sensation of dry mouth affecting millions of people worldwide. Current management has limitations, often causing side effects. This study aims to investigate whether electrical stimulation of the lingual nerve could offer effective relief for xerostomia sufferers.

Methods:

Eligible participants were randomly assigned (1:1) to either the experimental or sham group, receiving electrical stimulation of the lingual nerve (n = 24) or sham stimulation (n = 23) for 12 wk. The primary outcome is the changes in xerostomia score using a 100-mm visual analog scale throughout the therapy. Participants assessed their dryness and assigned corresponding scores, with lower scores indicating more severe dry mouth. Secondary outcomes included remission rate in dry mouth frequency, changes in stimulated/unstimulated salivary flow rate (SSFR/USFR), and changes in Oral Health Impact Profile–14 (OHIP-14) questionnaire scores, where higher scores indicate greater impact on oral quality of life.

Results:

At week 12, the electrical stimulation group showed greater improvement in xerostomia score compared to the sham group, with a mean between-group difference of 13.8 (95% confidence interval [CI], 10.0–17.6). The therapeutic effect of electrical stimulation was also confirmed by secondary outcomes. The remission rate of dry mouth was higher at 12 wk in the electrical stimulation group (61.9% [95% CI, 40.9%–79.3%] vs. 28.6% [95% CI, 13.8%–50.0%]). Participants in the electrical stimulation group also experienced a greater increase in USFR, with a mean difference of 14.5 (6.1–23.0) μL/min. Moreover, they exhibited significant improvement in OHIP-14 score after 12 wk of therapy, with a mean between-group difference of −10.0 (–13.9 to −6.2). No significant difference was observed between the 2 groups for SSFR (P = 0.702).

Conclusions:

Electric stimulation offers promise as a noninvasive, nonpharmacological strategy for the management of xerostomia. Further research is needed to understand its long-term effectiveness, optimal parameters, and underlying mechanisms.

Knowledge Transfer Statement:

The study confirmed that electrical stimulation of the lingual nerve is a promising noninvasive and nonpharmacological modality for relief of xerostomia.
Social Vulnerability Index and Dental Caries in Children: An Exploratory Study
Authors: Pellegrom J. , Pickett K. , Kostbade G. , Tiwari T.
Published: October 2024

Objective:

This retrospective cross-sectional study evaluated the association between caries outcomes in a pediatric population visiting a dental clinic and the social vulnerability index, an area-based measure capturing 4 main social determinants of health: socioeconomic status, household composition/disability, minority status/language, and housing/transportation.

Methods:

The Centers for Disease Control Social Vulnerability Index (SVI) and electronic dental record data of children (0 to 18 y) reporting a caries diagnosis at the Children’s Hospital Colorado in 2020 were extracted for 9,201 children. Logistic regressions were used to test the association between SVI and the presence or absence of dental caries, adjusting for age, sex, ethnicity, and race.

Results:

Children with a caries diagnosis had a greater mean overall SVI percentile (62.0, standard deviation [SD] = 29.1) compared with patients without a caries diagnosis (59.1, SD = 29.8; P < 0.001). With each 10-point increase in the overall SVI percentile, having a caries diagnosis visit was 2.7% more likely compared with having a visit without a caries diagnosis (odds ratio [OR] 1.027, 95% confidence interval [CI] 1.012, 1.042; P = 0.0004). Those with an overall SVI percentile between 51 and 75 were 23% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.23, 95% CI 1.07, 1.42; P = 0.003), and those with a percentile >75 were 23.6% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.236, 95% CI 1.09, 1.40; P = 0.001).

Conclusion:

Children (0 to 18 y) living in socially vulnerable environments or areas were more likely to have a caries diagnosis at their dental exam.

Knowledge Transfer Statement:

This study showed an association between social determinants of health demonstrating social vulnerability and dental caries in children. Ultimately, understanding upstream factors for children living in socially vulnerable areas could support policymakers in creating more effective policies to support socially vulnerable populations.
Intensified post-stroke care improves long-term dysphagia recovery after acute ischemic stroke: Results from the STROKE CARD trial
Authors: Karisik Anel , Bader Vincent , Moelgg Kurt , Buergi Lucie , Dejakum Benjamin , Komarek Silvia , Boehme Christian , Toell Thomas , Mayer-Suess Lukas , Sollereder Simon , Rossi Sonja , Meier Patricia , Schoenherr Gudrun , Willeit Johann , Willeit Peter , Lang Wilfried , Kiechl Stefan , Knoflach Michael , Pechlaner Raimund
Published: October 2024

Introduction:

Dysphagia is common after acute ischemic stroke and entails considerable morbidity and mortality. Here, we investigated the impact of intensified care on swallowing recovery after stroke.

Patients and methods:

In this secondary analysis of STROKE-CARD, a randomized intervention trial of intensified post-stroke care, dysphagia was assessed by speech therapists at admission for acute ischemic stroke, at hospital discharge, and after 12-months. Patients randomized to STROKE-CARD care additionally received a detailed dysphagia follow-up at 3-months, including a standardized dysphagia examination, instructions on further exercises and compensation mechanisms and, if necessary, referral for further speech therapy.

Results:

Dysphagia was present initially after stroke in 236 (16.6%; median age 82 (73–88), 44.1% female) of 1419 patients, with similar prevalence in both study groups at hospital admission ( p = 0.239) and discharge ( p = 0.870). At follow up, 14 (9.5%) of 147 in the intervention group and 18 (20.2%) of 89 in the control group suffered from persistent dysphagia ( p = 0.020). There was better dysphagia recovery in the intervention group also under multivariable adjustment for age, sex, functional disability at 12-months, severe dysphagia at hospitalization, mode of feeding, cognitive impairment, thrombolysis, and stroke localization (odds ratio, 0.41, 95% confidence interval: 0.17 to 0.96).

Discussion and conclusion:

Intensified post-stroke care improved dysphagia recovery within 1 year after acute ischemic stroke, highlighting the potential of targeted interventions for enhancing stroke outcomes.
Efficacy and safety of digital nerve block for pain management during sharp debridement of digital ulcers in systemic sclerosis: A prospective observational study
Authors: Bixio Riccardo , Mastropaolo Francesca , Nava Francesca , Veliaj Olta , Fracassi Elena , Viapiana Ombretta , Rossini Maurizio , Idolazzi Luca
Published: October 2024

Introduction:

Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis and vascular abnormalities, often leading to the development of digital ulcers (DUs). DUs are painful and debilitating, significantly impacting patients’ quality of life. Effective pain management during debridement is crucial, yet there is no consensus on the optimal approach. This study evaluates the efficacy and safety of digital nerve block (DNB) using lidocaine and mepivacaine for pain control during sharp debridement of DUs in SSc patients.

Methods:

This prospective observational study was conducted from September 2023 to May 2024 at the Rheumatology Operating Unit, University of Verona. Patients were randomized to receive either 1 mL of 2% lidocaine or 2% mepivacaine for DNB. Pain levels were assessed using a categorical grading scale during the injection and debridement. The outcomes were pain control and performance of lidocaine versus mepivacaine.

Results:

The cohort developed 46 ulcers. The pain was abolished in almost all patients. Lidocaine achieved faster anaesthesia (127.92 ± 34.32 s) compared with mepivacaine (252.65 ± 49.89 s, p < 0.001). Mepivacaine resulted in less pain during injection ( p = 0.006). No significant difference in pain levels during debridement was observed between the two anaesthetics. Three mild adverse effects (Raynaud’s phenomenon) were reported. All procedures were completed successfully, and 35 ulcers healed with a mean time of 6.1 ± 7.77 weeks.

Conclusions:

DNB with mepivacaine provides effective pain control during DU debridement in SSc patients, with lower injection site pain and comparable efficacy to lidocaine. The procedure is safe, well-tolerated and facilitates successful ulcer healing. Further studies with larger cohorts are warranted to confirm these findings.
Multiple myeloma and the potential of new checkpoint inhibitors for immunotherapy
Authors: Kamali Ali N. , Hamedifar Haleh , Eisenhut Michael , Bautista Jose M.
Published: October 2024

Multiple myeloma (MM), a cancer of the bone marrow, is categorized as the second most common hematological malignancy of adults in the Western world. Despite dramatic improvements in immunotherapies in the field of cancers, MM immunotherapy has not been promising until now. Recent clinical studies of immune checkpoint inhibitor therapy, either alone or in combination with anticancer drugs, showed excessive side effects or low efficacy, particularly in advanced MM patients. In this context, lymphocyte levels of exhaustion markers play a pivotal role in the MM tumor microenvironment (TME). Hence in the present review, the mechanisms relevant to MM of five inhibitory molecules including T-cell immunoreceptor with Ig and ITIM domains (TIGIT), T-cell immunoglobulin, and mucin domain 3 (Tim-3), lymphocyte activation gene-3 (LAG-3), V-domain Ig Suppressor of T-cell activation and killer immunoglobulin-like receptors along with bispecific T-cell antibodies (BsAbs) will be discussed. Further, we summarized the underlying biology of these checkpoints in cancer and their rapidly emerging role in pathways in MM along with presenting recent clinical trials in context.
Better Together: Interorganellar Communication in the Regulation of Proteostasis
Authors: Kohler Andreas , Kohler Verena
Published: October 2024

An extensive network of chaperones and folding factors is responsible for maintaining a functional proteome, which is the basis for cellular life. The underlying proteostatic mechanisms are not isolated within organelles, rather they are connected over organellar borders via signalling processes or direct association via contact sites. This review aims to provide a conceptual understanding of proteostatic mechanisms across organelle borders, not focussing on individual organelles. This discussion highlights the precision of these finely tuned systems, emphasising the complicated balance between cellular protection and adaptation to stress. In this review, we discuss widely accepted aspects while shedding light on newly discovered perspectives.
Strip mining in thick overburden context: A review
Authors: Oubah Redouane , Ouadif Latifa , Zerradi Youssef , Soufi Amine , Driouch Anas
Published: October 2024

Among surface mining methods, strip mining is a widely used technique for extracting mineral resources. This method is suitable for most near-surface stratiform sedimentary deposits and has historically been linked to surface mining of deposits such as coal, phosphates, and other natural substances. Given the significant economic interest that strip mining represents, it is in the best interest of mining companies to exploit as much of the reserves as possible using this technique, as it offers many advantages compared to open-pit or underground methods, particularly regarding safety and ore recovery rates. Today, the exploited deposits have become deeper, making the strip mining process more complex. Hence, there is a need for certain adaptations and the introduction of new techniques to address these geological conditions that threaten the feasibility of this method. This article explores the challenges that strip mining faces in contexts of thick overburden and subsequently presents the various techniques proposed by researchers worldwide aimed at overcoming these difficulties. The paper is based on an in-depth review of existing literature that deals with case studies of open-cast mines in different contexts. The examination of various approaches and techniques used for optimizing exploitation under thick overburden conditions by strip mining, along with their limitations, is presented.
Diffuse Large B Cell Lymphoma: Immunohistochemical Classification According to Hans Algorithm and Association With Outcome in A Moroccan Institution
Authors: Taybi M , Bourkhime H , Khammar Z , Alami Drideb N , Berrady R , Benmiloud S , Elfakir S , Bouguenouch L , Tahiri L , Chbani L , Hammas N
Published: October 2024

Background:

The most prevalent subtype of non-Hodgkin lymphoma is diffuse large B-cell lymphoma (DLBCL). Germinal center B-cell (GCB) and non-germinal center B-cell (non GCB) are the two main biologically different molecular subtypes identified utilizing an immunohistochemistry-based approach.

Aim:

Our objective in this study is to analyze the impact of immunohistochemical subtypes of DLBCL (GCB or non GCB) on demographic and clinicopathological parameters, response to chemotherapy and survival outcomes.

Subjects and methods:

This is a retrospective study including 106 cases of DLBCL collected in the department of pathology, Hassan II university hospital, Fez (Morocco), over a period of 12 years (January 2010-September 2022). The subtypes of DLBCLs were defined according to Hans algorithm, using immunohistochemistry by three biomarkers (CD10, BCL6, MUM1).

Statistical analysis used:

Independent t tests and analyses of variance were used for the comparison of mean values. We employed the SPSS 26.0 program to achieve this. A statistically significant value was set at P < .05.

Results:

Seventy-five patients (71%) were non-GCB subtype, while thirty-one patients (29%) had the GCB immunosubtype. We have found a significant ( P < .05) correlations between DLBCL immunosubtypes and treatment responses on one hand and survival in the other hand. In the GCB subtype, the response rate and survival were significantly improved. A significant association was found between Ki 67 expression and survival on univariate analysis. On multivariate analysis, we note a correlation between Ki 67 expression, DLBCL immunohistochemical subtypes and survival outcome.

Conclusion:

Non GCB subtype is associated with poor response to treatment and inferior survival outcome compared to GCB subtype in Moroccan context, especially when combined with high expression of Ki 67 marker.
A diffractive approach to multimodal transcription: Materialising entanglements between humans and non-humans
Authors: Byrne Fiona
Published: October 2024

Posthumanism is a transdisciplinary paradigm which challenges our anthropocentric gaze when carrying out research. In this article, I argue that multimodality aligns with the posthuman paradigm, and that multimodal analysis can be a useful tool when completing empirical posthuman research. I present empirical data from a study on pre-schoolers’ creativity with tablet computers which combined multimodal methods and a posthuman theoretical lens. Data were analysed using multimodal (intra) action analysis. Multimodal (inter) action analysis focuses on social action and interaction between humans, whereas multimodal (intra) action analysis focuses on the entanglement between human and non-human. Drawing upon Haraway and Barad’s “diffraction”, a methodological alternative to reflexivity, multiple different multimodal transcripts of the same audio-visual data were created and then read through one another to see what “differences made a difference”. Repeatedly engaging with the data in different formats allowed me to slow down and pay attention to (intra) activity between humans and non-humans. The unique contribution of this paper is in my transfer of methods and concepts between multimodality and posthumanism, particularly the use of a diffractive approach to reading multimodal transcripts.
Implications of COVID-19 relief packages on livelihoods of rural dwellers in border towns along Southwestern Ghana
Authors: Alhassan Issahaku , Donkor Nyavor Abednego , Asekere George
Published: October 2024

The global efforts to curtail the livelihood crises brought about by the eruption of the COVID-19 pandemic witnessed the adoption of livelihood strategies in the form of relief packages. Using a quantitative analytic framework, the article sheds light on recipients’ perspectives on the various government interventions in Ghana, focusing on how socio-economic and political inequalities in Ghana shaped access to pandemic relief support for rural dwellers in border towns in Southwestern Ghana. The findings suggest that, despite the partisan twist, the relief packages positively impacted intended beneficiaries in their short-term income-generation activities. Furthermore, it reduced the vulnerability of rural start-up businesses and brought the establishment of new health facilities to augment the infrastructural development of the area. The article concludes that the pandemic provided insight into how rural communities can better leverage relief packages to improve their livelihood conditions.
Genetic alteration of class I HLA in cutaneous T-cell lymphoma
Authors: Kwang Alexa C. , Duran George E. , Fernandez-Pol Sebastian , Najidh Safa , Li Shufeng , Bastidas Torres Armando N. , Wang Erica B. , Herrera Melba , Bandali Tarek I. , Kurtz David M. , Kim Youn H. , Khodadoust Michael S.
Published: October 2024

Abnormalities involving class I HLA are frequent in many lymphoma subtypes but have not yet been extensively studied in cutaneous T-cell lymphomas (CTCLs). We characterized the occurrence of class I HLA abnormalities in 65 patients with advanced mycosis fungoides or Sézary syndrome. Targeted DNA sequencing, including coverage of HLA loci, revealed at least 1 HLA abnormality in 26 of 65 patients (40%). Twelve unique somatic HLA mutations were identified across 9 patients, and loss of heterozygosity or biallelic loss of HLA was found to affect 24 patients. Although specific HLA alleles were commonly disrupted, these events did not associate with a decrease in the total class I HLA expression. Genetic events preferentially disrupted HLA alleles capable of presenting greater numbers of putative neoantigens. HLA abnormalities co-occurred with other genetic immune evasion events and were associated with worse progression-free survival. Single-cell analyses demonstrated that HLA abnormalities were frequently subclonal. Through analysis of serial samples, we observed that disrupting class I HLA events change dynamically over the disease course. The dynamics of HLA disruption are highlighted in a patient who received pembrolizumab and in whom resistance to pembrolizumab was associated with the elimination of an HLA mutation. Overall, our findings show that genomic class I HLA abnormalities are common in advanced CTCL and may be an important consideration in understanding the effects of immunotherapy in CTCL.