bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflux May Weaken Therapeutic Effect of Immune Checkpoint Inhibitors on Head and Neck Squamous Cell Carcinoma: A Proposed Risk Prediction Model Based on LPR/GERD-Related Genes
Authors: Ju Jun , Wang Jia , Zhang Chun , Liu Zhi
Published: October 2023

Laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) involve in head and neck diseases. Their association with carcinogenesis of head and neck squamous cell carcinoma (HNSCC) has attracted increasing attention in recent years. We established a risk prediction model
based on LPR/GERD-related genes (RRGs), to investigate the relationship between LPR/GERD and HNSCC, and explore their relevant mechanisms. To establish the risk model, the TCGA-HNSC project from the Cancer Genome Atlas (TCGA) database was used to conduct training and internal validation assays,
and the GSE65858 project and five other TCGA projects involving different kinds of tumors were used to conduct the external validation assays. Twelve RRGs were determined to construct risk signature. Kaplan–Meier curves and receiver operating characteristic curves for the model were
used to predict 1-, 3-, and 5-year overall survival (OS), particularly for patients with laryngeal squamous cell carcinoma (LSCC). The proportions of immune cells in high-risk group, including T cells, CD8+ T cells, NK cells, myeloid dendritic cells, B lineage, and monocytic lineage, were
significantly lower (P <0.05). Interestingly, risk score was negatively associated with immune checkpoint-related genes expression. The predicted therapeutic sensitivity of immune checkpoint inhibitors (ICIs) in high-risk group was lower (7.27±1.08 vs. 7.80±1.12, P
= 4.6×10−6). Moreover, the predicted IC50 of Erlotinib (EGFR inhibitor) and Parthenolide (NF-κB inhibitor) was lower in high-risk group (P = 2.6×10−12 and 2.7×10−7, respectively). LPR/GERD may shorten
the OS of HNSCC, especially LSCC. The most important finding from this study is that, the HNSCC patients suffering from LPR/GERD benefit less from ICIs.
Long Chain Non-Coding RNA MSC-AS1 Promote Invasion and Migration of Prostate Cancer Through Regulating microRNA-190a-3p
Authors: Zhu Qianhao , Yu Rikao , He Renqiang , Song Dawei , Liu Weihua
Published: October 2023

We investigated the role of the lncRNA MSC-AS1 in prostate cancer (PCa) by analyzing its expression in 56 pairs of PCa tissues and adjacent tissues. We examined the relationship between MSC-AS1 expression, clinicopathological indicators, and patient prognosis. In PCa cell lines, we
overexpressed or knocked down MSC-AS1 and assessed its impact on cell function using transwell assays and wound healing tests. We explored the interaction between MSC-AS1 and miR-190a-3p using luciferase reporter assays. Our findings showed significantly higher MSC-AS1 expression in PCa tumor
specimens compared to adjacent tissues. High MSC-AS1 expression correlated with increased incidence of lymph node and distant metastasis. Overexpressing MSC-AS1 reduced cell invasiveness and migration, while knocking it down enhanced these abilities. We observed decreased miR-190a-3p expression
in PCa tissues, negatively correlating with MSC-AS1 expression. Modulating miR-190a-3p expression counteracted the effects of MSC-AS1 on cell invasiveness and migration. In conclusion, our study highlights the association of MSC-AS1 with metastasis and poor prognosis in PCa patients, suggesting
its involvement in the malignant progression of the disease via miR-190a-3p modulation. MSC-AS1 holds potential as a prognostic biomarker for PCa and a therapeutic target for novel treatment strategies. Further research is needed to understand the underlying mechanisms and validate the clinical
implications of targeting MSC-AS1 and miR-190a-3p in PCa management.
Meteorological Research Enabled by Rapid-Scan Radar Technology
Authors: Bodine David J. , Griffin Casey B.
Published: October 2023

The scientific community has long acknowledged the importance of high-temporal-resolution radar observations to advance science research and improve high-impact weather prediction. Development of innovative rapid-scan radar technologies over the past two decades has enabled radar volume scans of 10–60 s compared to 3–5 min with traditional parabolic dish research radars and the WSR-88D radar network. This review examines the impact of rapid-scan radar technology, defined as radars collecting volume scans in 1 min or less, on atmospheric science research spanning different subdisciplines and evaluates the strengths and weaknesses of the use of rapid-scan radars. In particular, a significant body of literature has accumulated for tornado and severe thunderstorm research and forecasting applications, in addition to a growing number of studies of convection. Convection research has benefited substantially from more synchronous vertical views, but could benefit more substantially by leveraging multi-Doppler wind retrievals and complementary in situ and remote sensors. In addition, several years of forecast evaluation studies are synthesized from radar testbed experiments, and the benefits of assimilating rapid-scan radar observations are analyzed. Although the current body of literature reflects the considerable utility of rapid-scan radars to science research, a weakness is that limited advancements in understanding of the physical mechanisms behind observed features have been enabled. There is considerable opportunity to bridge the gap in physical understanding with the current technology using coordinated efforts to include rapid-scan radars in field campaigns and expanding the breadth of meteorological phenomena studied.

Significance Statement

Recently developed rapid-scan radar technologies, capable of collecting volumetric (i.e., three-dimensional) measurements in 10–60 s, have improved temporal sampling of weather phenomena. This review examines the impact of these radar observations from the past two decades on science research and emerging operational capabilities. Substantial breadth and impact of research is evident for tornado research and forecasting applications, in addition to documentation of other rapidly evolving phenomena associated with deep convection, such as tornadoes, hail, lightning, and tropical cyclones. This review identifies the strengths and weaknesses of how these radars have been used in scientific research to inform future studies, emerging from the increasing availability and capability of rapid-scan radars. In addition, this review synthesizes research that can benefit future operational radar decisions.
Unpacking the global climate politics-to-local nexus: Renewables, community struggles, and social impacts
Authors: Martínez Nain
Published: October 2023

Accelerating renewable energy deployment is imperative to address the climate crisis, yet projects commonly face community resistance and local cancellation. Accordingly, interest has risen in social impact assessments (SIAs) to evaluate social viability and strengthen management. However, mainstream approaches overlook upstream political economy dynamics that shape projects and drive opposition. Analyzing renewable developments in Mexico reveals how international negotiations and national policies produce rushed, large-scale projects in marginalized territories, igniting rural social struggles. While SIA practices can be enhanced, upstream policies constrain their scope to reshape misaligned projects and performance to address complex sociocultural contexts. This prompts questioning why vulnerable regions bear concentrated impacts and the need to explore alternative development pathways, despite SIAs implementation.
“Receive the Holy Spirit”
Authors: Ford David F.
Published: October 2023

A pivotal moment in the Gospel of John comes when the resurrected Jesus breathes the Spirit into his disciples and sends them as he was sent. The double thrust of Johannine spirituality is desiring Jesus and desiring what he desires: on the one hand, going deeper into relationship with Jesus in trust, understanding and love; and, on the other hand, going deeper into the world now, inspired by how Jesus was sent, with learning, praying, and loving as the core practices of disciples.
High School Concert Band Directors’ Self-Efficacy for Classroom Management
Authors: Regier Bradley J.
Published: October 2023

The purpose of this study was to examine relationships between high school concert band directors’ self-efficacy for classroom management, efficacious sources, and classroom management behaviors. Participants ( N = 271) completed the Band Director Self-Efficacy for Classroom Management scale and responded to items about their demographic and school characteristics, formal preparatory experiences, stress from student behavior, support and trust, and satisfaction with recent classroom management. Additionally, participants rated their effectiveness for using classroom management behaviors. Participants’ level of satisfaction with their recent classroom management was the strongest positive predictor of their self-efficacy for classroom management scores, followed by their ratings of parent resource support. When participants indicated higher stress from student behavior or higher administration resource support, they also had lower self-efficacy for classroom management scores. Results indicated that several classroom management behaviors predicted participants’ self-efficacy, including establishing routines and procedures, keeping students on task, and rarely referring to the music score or lesson plan. Implementing and refining effective classroom management behaviors may improve the likelihood of directors gaining positive mastery experiences and lessen the influence of stress from student behavior on their self-efficacy for classroom management.
Direct Care Nurses’ Needlestick Injury Experiences: A Qualitative Descriptive Study
Authors: Min Deulle , Kim Dahee , Lee Yewon
Published: October 2023

Background:

Even when education and the use of safety equipment are emphasized, nurses frequently experience needlestick injuries. Understanding the risk situations and coping mechanisms for needlestick injuries experienced by nurses facilitates their prevention.

Objectives:

We aimed to explore and describe the phenomenon of needlestick injuries through the research questions: (1) What causes nurses to suffer from needlestick injuries? (2) How to cope after a needlestick injury? and (3) What are the recommendations for needlestick injury prevention?

Methods:

This qualitative descriptive study involved focus group interviews with 31 direct care nurses in 6 groups who had experienced needlestick injuries while working in different acute care hospitals across 3 regions in South Korea. Data were collected from January 29 to March 29, 2022, and analyzed using thematic analysis.

Results:

The average age of the participating nurses was 29.7 years. The following 3 themes were identified: various needlestick injury experiences, post-needlestick injury coping, and expectations regarding needlestick injuries.

Conclusions:

Risk situations and coping mechanisms of nurses who experienced needlestick injuries were diverse. Emergency situations and novice nurses were the causes of most of the needlestick injuries. Often, personal protective equipment was found cumbersome. Reporting needlestick injuries depended on the work environment.
Optimisation of a Method for the Differentiation of Human Umbilical Cord-derived Mesenchymal Stem Cells Toward Renal Epithelial-like Cells
Authors: Habib Rakhshinda , Fahim Shumaila , Wahid Mohsin , Ainuddin Jahanara
Published: October 2023

Human umbilical cord-derived mesenchymal stem cells (hucMSCs) can differentiate into multiple cell lineages, but few methods have been developed to generate kidney lineage cells. Due to their human origin, pluripotent nature and immunomodulatory properties, these stem cells are attractive candidates for clinical applications such as the repair or regeneration of damaged organs. This study evaluated the renal differentiation potential of hucMSCs, when exposed for 10 days to optimised concentrations of retinoic acid, activin-A and bone morphogenetic protein-7 (BMP-7) in various combinations, with and without the priming of the cells with a Wnt signalling pathway activator (CHIR99021). The hucMSCs were isolated and characterised according to surface marker expression (CD73, CD90, CD44, CD146 and CD8) and tri-lineage differentiation potential. The expression of key marker genes ( OSR1, TBXT, HOXA13, SIX2, PAX2, KRT18 and ZO1) was examined by qRT-PCR. Specific marker protein expression (E-cadherin, cytokeratin-8 and cytokeratin-19) was analysed by immunocytochemistry. CHIR99021-primed cells treated with the retinoic acid, activin-A and BMP-7 cocktail showed epithelial cell-like differentiation — i.e. distinct phenotypic changes, as well as upregulated gene and protein expression, were observed that were consistent with an epithelial cell phenotype. Thus, our results showed that hucMSCs can efficiently differentiate into renal epithelial-like cells. This work may help in the development of focused therapeutic strategies, in which lineage-defined human stem cells can be used for renal regeneration.
Risk factors of paternal postpartum depression among Latino fathers: Treatment implications
Authors: Parchment Tyrone M. , Paredes Tania , Freeman Jordan , Palacios Malaika
Published: October 2023

Several studies of paternal postpartum depression (PPD) typically use homogenous samples. As a growing population and susceptibility to experiencing postpartum depression, little is known about the risk factors associated with paternal postpartum depression among Latino fathers. The nonrandomized convenience sampling strategy yielded a heterogeneous sample of 101 Latino fathers. Predictors of paternal PPD were coping skills, age, having a partner in PPD treatment, and egalitarian gender attitudes were estimated using a single logistic regression model. A second logistic regression model was performed using STATA’s stepwise estimation to obtain a final model with only significant predictors for paternal PPD symptoms. Results from the logistic regression models indicate that Latino fathers who reported higher maladaptive coping skills had increased odds of being above the clinical cutoff for paternal PPD ( OR: 1.99, 95%CI: 1.02–3.90, p < .05). The results of the stepwise logistic regression indicated that increased maladaptive coping skills ( OR: 2.14, 95%CI: .11–4.13) as well as having a partner in PPD treatment ( OR: 2.66, 95%CI: .84–8.44) increased the odds of scoring above the clinical cutoff for paternal PPD. In addition, being older decreased the odds of scoring above the clinical cutoff for paternal PPD ( OR: .87, 95%CI: .77–.99). Findings indicate that when a Latino father is younger, endorses maladaptive coping skills and has a partner in PPD treatment, it is associated with increased odds of paternal PPD. In addition, culturally responsive treatment implications for Latino men are discussed.
Analyzing patterns of political news evaluation among university students in Northeast Thailand
Authors: Jitsaeng Khanittha
Published: October 2023

Through social media and digital platforms, fake news and both professional as well as non-professional news sources are increasingly circulated, thus having a greater impact on people's lives and society. As a result, evaluating news has emerged as a crucial skill. However, it is yet unclear what variables contribute to this increase. To offer more insights, this study attempts to investigate through political news accessibility the factors influencing political news assessment of university students in Northeast Thailand. This study was a quantitative research, and the theory underlying it was news literacy. 1200 samples from undergraduate students from state, private, and autonomous universities were obtained through a multi-stage sampling. 400 questionnaires, utilized as a research tool, were distributed to each type of university for data collection. In order to examine the reliability of the research instrument, Cronbach's alpha was also used in a pre-test stage along with a content validity analysis of the questionnaire. For all elements, the alpha coefficient was 0.93. The findings demonstrated that political news assessment was most influenced by political news accessibility, which is the intervening variable (Beta = 0.265); followed by political news exposure from social media (Beta = 0.217); inner drives for the follow-up of political news (Beta = 0.190); influence of groups and social networks (Beta = 0.170); specific characteristics of the Internet (Beta = 0.151); importance of political news (Beta = 0.147); political news exposure from websites (Beta = 0.099); benefits of political news (Beta = 0.075); and political news exposure from print media (Beta = 0.042). The student characteristic factor, motivation for political news exposure factor, and political news exposure factor accounted for 67.45 percent of the variance in explaining political news evaluation among Thai students, through political news accessibility (R2 = 0.6745). Consequently, improving these elements will lead to better political news evaluation.
Three-dimensional vessel wall imaging with 1.5-T MRI to visualize invisible occluded cerebral artery
Authors: Kumagai Kosuke , Hayashi Miyuka , Takahashi Takahiro , Honma Hiroyuki , Nishida Shou , Hayashi Shinji , Ishihara Hideaki
Published: October 2023

Background

Endovascular thrombectomy (EVT) is performed for acute ischemic stroke (AIS) caused by large vessel occlusion; therefore, preoperative visualization of the occluded invisible vessel course reduces complications and ensures success. Three-dimensional (3D) proton density-weighted (PDW) vessel wall imaging (VWI) using variable refocusing flip angle pulse-turbo spin-echo sequences (VRFA-TSE) with 3.0-T magnetic resonance imaging (MRI) can provide this information.

Purpose

To assess the effectiveness of 3D PDW-VWI using 1.5-T MRI without VRFA function.

Material and Methods

Five consecutive patients with AIS caused by large vessel occlusion underwent EVT in our institute. VWI with 1.5-T MRI using 3D PDW-fast spin echo (FSE) technique was added to conventional brain imaging.

Results

PDW-FSE was successfully performed in all cases. 3D PDW-FSE was useful to visualize both the anterior and posterior circulations by clearly revealing invisible vessels but could not demonstrate the length and size of the clot in all five cases.

Conclusion

3D PDW-FSE with 1.5-T MRI without VRFA could clearly depict the course of the invisible occluded artery and might support favorable outcomes after EVT in patients with AIS.
Impact of Mandated Case Review Policy on Opioid Discontinuation and Mortality Among High-Risk Long-Term Opioid Therapy Patients: The STORM Stepped-Wedge Cluster Randomized Controlled Trial
Authors: Li Yufei , Barr Kyle D. , Trafton Jodie A. , Oliva Elizabeth M. , Garrido Melissa M. , Frakt Austin B. , Strombotne Kiersten L.
Published: October 2023

Background:

Although long-term opioid therapy (LTOT) has its own risks, opioid discontinuation could pose harm for high-risk Veterans Health Administration (VHA) patients receiving LTOT. There is limited information on the impact of a mandate requiring providers to perform case reviews on high-risk patients with an active opioid prescription (ie, mandated case review policy) on opioid discontinuation and mortality.

Methods:

Our study is a secondary data analysis of a 23-month stepped-wedge cluster randomized controlled trial between April 2018 and March 2020. The study included 10 685 LTOT patients with a predicted risk of a serious adverse event between the top 1% to 5% nationally who entered the risk range between 4/18/2018 and 11/9/2019. We examined whether the mandated case review policy had an impact on opioid discontinuation and mortality for the patients.

Results:

Among 10 685 LTOT patients (88.2% male; mean [SD] age, 61.1 [11.7] years), 29.1% experienced discontinuation and the mortality rate was 9.5%. Patients under mandated case review had a decreased risk of opioid discontinuation (average marginal effect [AME], −11.16 [95% CI, −15.30 to −7.01] percentage points) and all-cause mortality (AME, −3.31 [95% CI, −5.63 to −1.00] percentage points), relative to patients who were not under the mandate.

Conclusions:

The VHA mandated case review policy was associated with lower probability of discontinuation and all-cause mortality for high-risk patients receiving LTOT. Interventions that maintain care engagement while optimizing pain management for high-risk patients may be beneficial for minimizing mortality and other risks associated with discontinuation.
On 3D printed polyvinylidene fluoride-based smart energy storage devices
Authors: Mehta Ankush , Singh Rupinder , Pabla BS , Kumar Vinay
Published: October 2023

Polyvinylidene fluoride (PVDF) is one of the established thermoplastics with inherent piezoelectric characteristics. In the past two decades, a lot of work has been reported on the use of virgin Polyvinylidene fluoride thermoplastics for sensing applications. But hitherto little has been reported on 3D printing of secondary (2°) recycled Polyvinylidene fluoride as a smart energy storage device (ESD). This work is focused on exploring the possibilities for 3D printing of smart energy storage device comprising of Polyvinylidene fluoride having (melt flow index (MFI) 30 g/(10 min) as per ASTM D 1238) reinforced with MnO2, graphite, ZnCl2, and N [Formula: see text] Cl in different weight proportions to form a feedstock filament for fused deposition modeling (FDM) in the first stage. The MFI of Polyvinylidene fluoride composites reinforced with MnO2, graphite, ZnCl2, and N [Formula: see text] Cl (34.095, 8.480, 42.982, 11.807 g/(10 min) respectively) was ascertained for possible 3D printing on FDM. The results suggest that even with an acceptable MFI of prepared 2° recycled Polyvinylidene fluoride, the same was not printable. Further for possible 3D printing on FDM, low-density polyethylene (LDPE) was blended in a Polyvinylidene fluoride matrix, and successful 3D printing-based energy storage device was prepared in the second stage. The study also highlights the mechanical, and morphological properties of Polyvinylidene fluoride composites have been improved after processing with a twin-screw extruder (TSE) by using different input parameters (screw temperature (T), screw speed (S), and load (L)). Overall, the study suggests that the proportion of LDPE, MnO2, graphite, ZnCl2, and N [Formula: see text] Cl has a significant effect on the rheological, mechanical, and morphological properties. The results have been supported with scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and Fourier-transformed infrared spectroscopy (FTIR) analysis.
Rethinking Attentional Habits
Authors: Giménez-Fernández Tamara , Luque David , Shanks David R. , Vadillo Miguel A.
Published: October 2023

Attentional habits acquired by visual statistical learning cause enduring biases toward specific locations. These habits, driven by recent search history, are thought to be independent of both goal-directed and stimulus-driven attentional mechanisms. This theoretical claim is based on three characteristics that these habits apparently exhibit, that is, they are inflexible, implicit, and efficient. We review methodological limitations in previous studies and briefly describe recent results that challenge this new framework. We conclude that it might be premature to assume that attentional habits are based on a special search history process that differs from the two traditionally recognized attentional mechanisms.
Impact of the COVID-19 Pandemic on the Community Pharmacy Workforce
Authors: Bacci Jennifer L. , Pollack Samantha W. , Skillman Susan M. , Odegard Peggy Soule , Danielson Jennifer Hookstra , Frogner Bianca K.
Published: October 2023

This study sought to describe the impact of the COVID-19 pandemic on community pharmacy practice and its workforce. Interviews were conducted with 18 key informants from pharmacy associations and community pharmacists representing chain and independent pharmacy organizations across the United States from January to May 2022. Interview notes were analyzed using a rapid content analysis approach. Four themes resulted: (a) patient care at community pharmacies focused on fulfilling COVID-19 response needs; (b) pharmacists’ history as immunizers and scope of practice expansions facilitated COVID-19 response efforts; (c) workforce supply shortages impeded COVID-19 response efforts and contributed to burnout; and (d) maintaining community pharmacy workforce’s readiness will be critical to future emergency preparedness and response efforts. Formalizing scope of practice expansion policies and reimbursement pathways deployed during the COVID-19 pandemic could facilitate the community pharmacy workforce’s ability to address ongoing public health needs and respond to future public health emergencies.
Approximate determination of shear stresses for a 2D beam made of a non-Green elastic solid
Authors: Bustamante Roger
Published: October 2023

Shear stresses for a two-dimensional (2D) beam are calculated modifying the classical method developed by Jouravski, for the case the linearized strain tensor is assumed to be a nonlinear function of the Cauchy stresses. Two problems are studied, namely, the case of a cantilever beam with a point load on its free edge (considering a rectangular and a circular cross-section) and the three-point flexural test for a beam of rectangular cross-section. Numerical results are obtained for the particular case of a bimodular constitutive model for rock, and the results for the shear stresses are compared with the predictions of the classical theory of strength of materials for such problems, assuming a linearized elastic body.
Nuha: A study of the conduct of everyday life of a British Yemeni young person
Authors: Ahmed Huda Kamel
Published: October 2023

There is a lack of research that focuses on the lived experiences of British Yemeni young people in the UK as they pertain to their learning and development. This paper aims to bridge the gap by exploring the case of Nuha, an 18-year-old British Yemeni young woman, as she navigates the conduct of her everyday life. The paper presents a developed conceptual model and associated methodological approach for exploring Nuha. It does so by first reviewing what might be viewed as dominant approaches to the study of ethnic young people’s experiences that advocate a social identity theory. A critique of such thinking is developed that takes issue with much of this writing that has the potential for an essentialised abstracted approach. The paper instead advocates the use of a subjectively focused, practice orientated and yet culturally sensitive approach to exploring human behaviour in the context of the conduct of everyday life. Based on an analytical matrix that is developed from such thinking, I examine Nuha’s life experiences using Dreier’s theory of a person. In doing so, I recognise the additional importance of personhood in practice that provide a reference point for exploring more deeply the learning and development of Nuha. The research is generated through a case study narrative that is analysed dialectically through theory, recognising how theory is simultaneously driven by the data. The paper concludes with arguments made about the centrality of an extended and developed sense of the conduct of everyday life to get at the nuanced evolving sense of being and doing for British Yemeni young people.
Variation in telehealth use for endocrine care: Patterns and predictors under the “new normal”
Authors: Vimalananda Varsha G , Arao Kevin , Qian Shirley , Leibowitz Alison , Zupa Margaret F , Benzer Justin , Fincke B Graeme , Zocchi Mark , Meterko Mark , Berlowitz Dan , Sitter Kailyn E , Wormwood Jolie B
Published: October 2023

Introduction

Use of telehealth for outpatient endocrine care remains common since onset of the COVID-19 pandemic, though the context for its use has matured. We aimed to describe the variation in telehealth use for outpatient endocrine visits under these “new normal” conditions and examine the patient, clinician-, and organization-level factors predicting use.

Methods

Retrospective cross-sectional study using data from the U.S. Department of Veterans Affairs (VA) Corporate Data Warehouse on 167,017 endocrine visits conducted between 3/9/21 and 3/8/22. We used mixed effects logistic regression models to examine 1) use of telehealth vs. in-person care among all visits and 2) use of telephone vs. video among the subsample of telehealth visits.

Results

Visits were in person (58%), by telephone (29%), or by video (13%). Unique variability in telehealth use at each level of the analysis was 56% patient visit, 24% clinician, 18% facility. The strongest predictors were visit type (first vs. follow up) and clinician and facility characteristics. Among telehealth visits, unique variability in telephone (vs. video) use at each level was 44% patient visit, 24% clinician, 26% facility. The strongest predictors of telephone vs. video were visit type, patient age, and percent of the facility's population that was rural.

Conclusions

We found wide variation in use of telehealth for endocrinology under the “new normal”. Future research should examine clinician and facility factors driving variation, as many may be amenable to influence by clinical leaders and leveraged to enhance the availability of telehealth for all clinically appropriate patients.
Telehealth versus face-to-face delivery of cognitive behavioural therapy for insomnia: A systematic review and meta-analysis of randomised controlled trials
Authors: Scott Anna Mae , Peiris Ruwani , Atkins Tiffany , Cardona Magnolia , Greenwood Hannah , Clark Justin , Glasziou Paul
Published: October 2023

Objective

This systematic review and meta-analysis compared the effectiveness of the delivery of care to patients with insomnia via telehealth to its delivery face-to-face.

Methods

We searched Medline, Embase, and Cochrane CENTRAL from inception to 11 January 2023, and conducted a citation analysis on 13 June 2023. No language restrictions were imposed. We included randomised controlled trials. Where feasible, mean differences were calculated; we used a random effects model.

Results

Four trials (239 patients) were included. There were no significant differences between telehealth and face-to-face for insomnia severity scores shortly post-intervention (MD 1.13, 95% CI −0.29–2.55) or at 3 months (mean difference (MD) 1.79, 95% CI −0.01–3.59). There were no differences in Short Form-36 physical and mental scores, Work and Social Adjustment scores, and sleep quality components. Depression scores did not differ post-intervention or at 3 months (MD 0.42, 95% CI −2.42–3.26). Functioning likewise did not differ post-intervention or at 3 months (standardised mean difference (SMD) 0.15, 95% CI −0.37–0.67, P = 0.58). Treatment satisfaction did not differ (one trial) or favoured the face-to-face group (one trial).

Conclusions

Telehealth may be a viable alternative to the face-to-face provision of cognitive behavioural therapy for insomnia to patients with insomnia. However, the volume of the existing evidence is limited, therefore additional trials are needed, evaluating cognitive behavioural therapy for insomnia and other therapies for individuals for whom cognitive behavioural therapy for insomnia is not effective, and conducted with a wider range of populations, providers and settings.
Disclosure to unknowing victims in criminal justice investigations: Questions of vulnerability, ethics and practice
Authors: Ost Suzanne , Gillespie Alisdair A.
Published: October 2023

This article explores the situation in which a victim who has been identified during a criminal justice investigation is unaware of the crime committed against them. We argue that unknowing victims possess a unique vulnerability because discovering their victim status is highly likely to have harmful effects. Where law enforcement officers (LEOs) remain unaware of the victim's knowledge of the crime, this should be perceived as a clue to potential vulnerability. Any subsequent disclosure of the crime to an unknowing victim is an external intervention that exposes them to the risk of harm, thereby raising significant ethical questions. Yet the ethical ramifications of disclosure are not considered in the policing literature and there is no specific professional guidance in England and Wales (and beyond) on this situation. Focusing on two of the primary crime contexts in which a victim can be unknowing (sexual offences and fraud), we scrutinise the ethical issues surrounding LEOs disclosing to an unknowing victim, aligning our analysis with the College of Policing's Code of Ethics and vulnerability-related risks guidelines, and a therapeutic jurisprudence approach to policing.
Conscious sedation by sedation-trained interventionalists versus anesthesia providers in patients with acute ischemic stroke undergoing endovascular thrombectomy: A propensity score-matched analysis
Authors: Padmanaban Varun , Grzyb Chloe , Velasco Cesar , Richardson Alicia , Cekovich Erin , Reichwein Raymond , Church Ephraim W , Wilkinson David A , Simon Scott D , Cockroft Kevin M
Published: October 2023

Background

The appropriate choice of perioperative sedation during endovascular thrombectomy for ischemic stroke is unknown. Few studies have evaluated the role of nursing-administered conscious sedation supervised by a trained interventionalist.

Objective

To compare the safety and efficacy of endovascular thrombectomy for ischemic stroke performed with nursing-administered conscious sedation supervised by a trained interventionalist with monitored anesthesia care supervised by an anesthesiologist.

Methods

A retrospective review of a prospectively collected stroke registry was performed. The primary outcome was functional independence at 90 days, defined as a modified Rankin score of 0–2. Propensity score matching was performed to control for known confounders including patient comorbidities, access type, and direct-to-suite transfers.

Results

A total of 355 patients underwent endovascular thrombectomy for large vessel occlusion between 2018 and 2022. Thirty five patients were excluded as they arrived at the endovascular suite intubated. Three hundred and twenty patients were included in our study, 155 who underwent endovascular thrombectomy with nursing-administered conscious sedation and 165 who underwent endovascular thrombectomy with monitored anesthesia care. After propensity score matching, there were 111 patients in each group. There was no difference in modified Rankin score 0–2 at 90 days (26.1% vs 35.1%, p = 0.190). Patients undergoing monitored anesthesia care received significantly more vasoactive medications (23.4% vs 49.5%, p < 0.001) and had a lower intraoperative minimum systolic blood pressure (134 vs 123  mmHg, p < 0.046). There was no difference in procedural efficacy, safety, intubation rates, and postoperative complications.

Conclusion

Perioperative sedation with nursing-administered conscious sedation may be safe and effective in patients undergoing endovascular thrombectomy for ischemic stroke.
Use of a menthol popsicle in managing postoperative thirst in patients undergoing radical prostatectomy: A randomized clinical trial
Authors: da Silva Tâmara Taynah Medeiros , Teixeira Fernanda de Castro , Matias de Araújo Sara Cristina , Pinheiro Thaís Brunna Maurício , Fernandes Costa Isabel Karolyne , Medeiros Kleyton Santos de , Ribeiro Kátia Regina Barros , Dantas Daniele Vieira , Dantas Rodrigo Assis Neves
Published: October 2023

Background and aim: Thirst is a real bother that most patients feel in the immediate postoperative period when they still need to fast. Many approaches regarding symptomatic relief strategies have been described in the literature, but strategies with cold water and/or menthol are effective in quenching thirst, as they act on pre-absorptive mechanisms. This study aims to evaluate the effectiveness of using menthol popsicles in relieving postoperative thirst in patients undergoing radical prostatectomy. Material and methods: This is a randomized controlled clinical trial with a quantitative approach. In all, 44 patients were evaluated in the immediate postoperative period of radical prostatectomy, with the intensity and discomfort of thirst being evaluated initially and subsequently. The study consisted of two groups: (1) the placebo group, popsicles without the addition of menthol substrates and (2) the experimental group, popsicles with the addition of 0.05% minty substrates. Results: The results demonstrate that the sociodemographic and clinical characteristics were homogeneous at the α = 5% significance level, except the occupation variable. The test detected changes in the intensity and discomfort of thirst in relation to the pre- and post-intervention times for the primary outcome when the groups were analyzed separately and for the interaction of the group versus time, there was no statistical difference between the groups. Conclusion: It was possible to prove that both the menthol popsicle and the popsicle without the addition of menthol were effective in relieving postoperative thirst in patients undergoing radical prostatectomy, but there was no statistically significant difference when comparing the two groups.

Trial registration: The Brazilian Registry of Clinical Trials (RBR-8c3chr7).
Developing a prototype digital risk mitigation pathway for children and young people admitted to acute paediatric NHS care in mental health crisis: Protocol of the Safety Assessment in Paediatric healthcare Environments (SAPhE) pathway study
Authors: Manning Joseph C. , Marufu Takawira C. , Carter Tim , Bolton Sarah , Breedon Philip , Craven Michael , Frost Kate , Harbottle Anthony , Hendron Elizabeth , Patel Julian , Rad Laura , White Peter , Wood Damian , Albelbisi Zaki , Kaltsa Aikaterina , Stevenson Callum , Landa Pavan , Coad Jane ,   for the SAPhE Pathway Study Investigators
Published: October 2023

Background

Globally, there are increasing numbers of Children and young people (CYPs) experiencing a mental health crisis requiring admission to acute paediatric inpatient care. These CYPs can often experience fluctuating emotional states accompanied by urges to self-harm or attempt to end their life, leading to reduced safety and poorer experiences. Currently, in the UK National Health Service (NHS) there are no standardised, evidence-based interventions in acute paediatric care to mitigate or minimise immediate risk of self-harm and suicide in CYP admitted with mental health crisis.

Objective

To outline the protocol for the SAPhE Pathway study which aims to: 1) identify and prioritise risk mitigation strategies to include in the digital prototype, 2) understand the feasibility of implementing a novel digital risk mitigation pathway in differing NHS contexts, and 3) co-create a prototype digital risk mitigation pathway.

Methods

This is a multi-centre study uses a mixed-methods design. A systematic review and exploratory methods (interviews, surveys, and focus groups) will be used to identify the content and feasibility of implementing a digital risk mitigation pathway. Participants will include healthcare professionals, digital experts and CYP with experience of mental health conditions. Data will be collected between January 2022 and March 2023 and analysed using content and thematic analysis, case study, cross-case analysis for qualitative data and descriptive statistics for quantitative data. Findings will inform the experience-based co-design workshops.

Ethics and Dissemination

The study received full ethical approval from NHS REC [Ref: 22/SC/0237 and 22/WM/0167]. Findings will be made available to all stakeholders using multiple approaches.
A Systematic Review and Meta-analysis of Risk Factors for an Infection After Anterior Cruciate Ligament Reconstruction
Authors: Zhang Lei , Yang Runze , Mao Yunhe , Fu Weili
Published: October 2023

Background:

Identifying risk factors for an infection after anterior cruciate ligament reconstruction (ACLR) and following targeted preventive strategies can effectively reduce this potentially serious complication.

Purpose:

To perform a systematic review and meta-analysis to identify the risk factors for an infection after ACLR.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

The PubMed, Embase, and Web of Science databases were searched from inception to September 1, 2022, for prospective and retrospective studies investigating risk factors for any type of infection after ACLR. Odds ratios (ORs) or mean differences were calculated for potential risk factors if ≥2 studies assessed the same risk factor. A qualitative analysis of variables was performed if a meta-analysis could not be conducted.

Results:

A total of 17 studies with 141,991 patients were included in this review. The overall pooled infection rate was 0.86% (range, 0.24%-5.50%). There were 20 risk factors identified for analysis. Of these, 7 variables independently increased the odds of an infection after ACLR: (1) male sex (OR, 1.90 [95% CI, 1.33-2.73]), (2) diabetes (OR, 2.69 [95% CI, 1.66-4.35]), (3) hamstring tendon autograft (OR, 2.51 [95% CI, 2.03-3.10]), (4) revision ACLR (OR, 2.31 [95% CI, 1.22-4.37]), (5) professional athlete status (OR, 6.21 [95% CI, 1.03-37.38]), (6) lateral tenodesis (OR, 3.45 [95% CI, 1.63-7.28]), and (7) corticosteroid use (OR, 7.83 [95% CI, 3.68-16.63]). No significant associations were found between postoperative infections and age, body mass index, smoking, meniscal repair, or outpatient surgery.

Conclusion:

This review revealed that an increased risk of infections after ACLR was associated with male sex, diabetes, hamstring tendon autograft, revision surgery, professional athlete status, lateral tenodesis, and steroid use. Knowledge of the risk factors associated with an infection after ACLR may facilitate the identification of high-risk cases and the implementation of preventive measures to mitigate the serious consequences of this complication.
Impact of Quadriceps Tendon Graft Thickness on Electromechanical Delay and Neuromuscular Performance After ACL Reconstruction
Authors: Parrino Rosalia L. , Adams Will , Letter Michael I. , Ripic Zachary , Baraga Michael G. , Kaplan Lee D. , Harrah Tanner , Tremblay Julien , Luxenburg Dylan , Conti Joseph , Best Thomas M. , Signorile Joseph F.
Published: October 2023

Background:

Both partial- and full-thickness quadriceps tendon (QT) graft harvests are used for anterior cruciate ligament reconstruction (ACLR).

Purpose:

To evaluate the impact of QT graft harvest depth (full or partial thickness) on electromechanical delay (EMD), peak torque (PT), and rate of torque development (RTD) after ACLR.

Study Design:

Controlled laboratory study.

Methods:

A total of 26 patients who underwent either partial-thickness (n = 14) or full-thickness (n = 12) autograft QT ACLR were recruited between June and November 2021 (>1 year before participation). Patients performed isokinetic knee extension testing with surface electromyography of the quadriceps muscles. Mixed repeated-measures analysis of variance with least significant difference post hoc testing was used to determine significant differences (mean difference [MD] ± SE) or interactions for all variables.

Results:

A significant speed×depth interaction was seen for the vastus medialis ( P = .005). Pairwise analyses showed significantly longer EMD for the partial-thickness graft than the full-thickness graft (MD ± SE, 19.92 ± 6.33 ms; P = .006). In the partial-thickness graft, the EMD was significantly longer at 90 deg/s versus 180 deg/s (MD ± SE, 19.11 ± 3.95 ms; P < .001) and 300 deg/s (MD ± SE, 16.43 ± 5.30 ms; P = .006). For PT, the full-thickness graft had a significantly lower PT on the operated versus nonoperated side at all speeds (MD ± SE: 90 deg/s, −57.0 ± 10.5 N·m, P < .001; 180 deg/s, −26.0 ± 10.2 N·m, P = .020; 300 deg/s, −20.3 ± 8.9 N·m, P = .034). For RTD, the full-thickness graft showed significantly Slower RTD for the operated versus nonoperated side at all time points (MD ± SD: RTD0-25 (0-25% of the range of motion), −131.3 ± 50.9 N·m/s, P = .018; RTD25-50, −197.0 ± 72.5 N·m/s, P = .014; RTD50-75, −113.3 ± 39.8 N·m/s, P = .013; RTD75-100, −149.4 ± 35.9 N·m/s, P < .001).

Conclusion:

Compared with partial-thickness QT, full-thickness QT showed a shorter vastus medialis EMD at higher loading, and therefore greater stiffness, as well as slower RTD and lower PT across all testing speeds.

Clinical Relevance:

The impact of full-thickness QT autograft on EMD and neuromuscular performance should be considered for ACLR.
The evolution of the planning system in the process of large-scale and rapid urbanization in China
Authors: Shi Yulong , Lian Xin
Published: October 2023

Urban planning is a fundamental policy tool for countries to manage their land use and spatial development. As a nation’s economic, social and technological development undergoes changes, so does its planning system evolve dynamically to address the challenges of each era. In China, with the average annual urban population increasing 17.25 million since 1978, the spatial distribution of population and economic resources has undergone unprecedented great changes. The transformation of China’s planning system during the rapid and large-scale urbanization process could be divided into four stages: restoration of urban plan and establishment of the planning system (1978–1990); growth and development of the planning system under the market-oriented economic system (1990–2000); integration of urban and rural planning (2000–2010); exploring and forming a unified spatial planning system under the guidance of ecological civilization construction (2010–). This paper analyzes the characteristics of urbanization in China since the reform and opening up, the related era-specific issues and the policy responses, then elaborates the new landmark planning types that emerged in each stage, as well as summarizing the evolution process. There is no “standard, universal paradigm” in the process of building a country’s planning system, and no unchanging template or unified approach to achieving it.
Plasmodium falciparum exploits CD44 as a coreceptor for erythrocyte invasion
Authors: Baro Barbara , Kim Chi Yong , Lin Carrie , Kongsomboonvech Angel K. , Tetard Marilou , Peterson Nana Ansuah , Salinas Nichole D. , Tolia Niraj H. , Egan Elizabeth S.
Published: October 2023

The malaria parasite Plasmodium falciparum invades and replicates asexually within human erythrocytes. CD44 expressed on erythrocytes was previously identified as an important host factor for P falciparum infection through a forward genetic screen, but little is known about its regulation or function in these cells, nor how it may be used by the parasite. We found that CD44 can be efficiently deleted from primary human hematopoietic stem cells using CRISPR/Cas9 genome editing, and that the efficiency of ex vivo erythropoiesis to enucleated cultured red blood cells (cRBCs) is not affected by lack of CD44. However, the rate of P falciparum invasion was reduced in CD44-null cRBCs relative to isogenic wild-type control cells, validating CD44 as an important host factor for this parasite. We identified 2 P falciparum invasion ligands as binding partners for CD44, erythrocyte binding antigen 175 (EBA-175) and EBA-140 and demonstrated that their ability to bind to human erythrocytes relies primarily on their canonical receptors, glycophorin A and glycophorin C, respectively. We further show that EBA-175 induces phosphorylation of erythrocyte cytoskeletal proteins in a CD44-dependent manner. Our findings support a model in which P falciparum exploits CD44 as a coreceptor during invasion of human erythrocytes, stimulating CD44-dependent phosphorylation of host cytoskeletal proteins that alter host cell deformability and facilitate parasite entry.