bluuebunny/crossref_metadata_2025 huggingface dataset:
Species-Site Suitability Assessment of Bamboo and Its Detailed Study in Different Agroecological Zones of Kenya
Authors: Lohani Tarun Kumar , Sigu Gordon , Oduor Nellie , Reza Selim , Durai Jayaraman
Published: September 2023

The site suitability assessment of Bamboo in Kenya was studied for diverse agroecological zones (AEZs) comprising one indigenous and fifteen exotic bamboo species in nine different AEZs of Kenya. Three bamboo clumps from each species that were at least five years old were assessed to accurately capture data on growth performance and yield. Soil samples collected at 0–30 cm depth from different areas varied considerably. The proportion of soil varied across the bamboo planting sites (F(1,11) = 24.94;

p

 < 0.001), soil pH in the planting sites varied significantly (F(1,11) = 13.92;

p

 < 0.001), and soil bulk densities had different results (F(1,11) = 13.92;

p

 < 0.001). The lowest bulk density (0.61 ± 0.01) was recorded in Kakamega (UM1), while the highest (1.63 ± 0.01) was reported in Gede. Data on characteristics of clumps and internode length and wall thickness integrated through GenStat statistical software using ANOVA entail a huge variation in growth performance for each bamboo species across planting sites. Morphological characters were also studied in detail. The mean height, diameter, and stocking density were comparatively lower even in elevated zones that were only 200 m below its natural range. This resulted in an extremely low yield, which is not viable for economic investment. The species is unsuitable for plantation establishment outside its natural range of 2300 m–3200 m above the sea level (a.s.l.). Plantation below this range will not dissipate but will not attain a healthy growth. The primary use will be restricted for ornamental and conservation purposes such as scaffolding, roof construction, and fabrication of basic household furniture.
The Evaluation of an Integrated Tobacco Treatment Specialist in Primary Care
Authors: Miller Rachel E. , Hill Jennifer M. , Meyer Amanda F. , Ward Kenneth
Published: September 2023

Background. Primary care providers play a key role in screening for tobacco use and assessing desire to quit. Tobacco treatment specialists (TTS) are certified in helping patients who desire tobacco cessation. A primary care nurse practitioner within one Midwestern healthcare organization obtained TTS certification and integrated specialized tobacco cessation visits within a primary care clinic from February 2021 to February 2022. Purpose. To determine the efficiency and effectiveness of an integrated TTS-certified nurse practitioner (TTS-NP) in a primary care setting 1-year postimplementation. Method. This program evaluation utilized retrospective electronic health record review and included thirty-three patients. The logic model served as a framework to define efficiency and effectiveness. Results. Patients were referred by a provider (57.6%), nurse (15.2%), or self (27.3). Patients opted for in-person initial visits (81.8%) more than virtual (18.2%). Of a total of 73 scheduled visits, 8 (11%) were no-showed. Patients who self-referred had the lowest no-show rate (5.6%) compared to those referred by a provider (12.8%) or nurse (12.5%). Of the patients included, 87.9% set a goal quit date. Average time until first and second follow-up was 34.6 and 130.4 days after goal quit date. Follow-up was defined as the date of the patient’s first message reply to the TTS-NP, or first visit following the goal quit date. A total of 51.9% (n = 14) and 63% (n = 17) reported cessation at the first and second follow-up. TTS-NP visit’s cost, independent of any other coverage, was less than other specialty visits in primary care. Conclusion. TTS-NP visits in primary care enabled patients to benefit from lower cost and longitudinal follow-up within a familiar setting. Over half of patients achieved cessation. Results of this program evaluation suggest support for TTS-certified providers in primary care.
Prognostic Value of Modified Coronary Flow Capacity Derived From [
15
O]H
2
O Positron Emission Tomography Perfusion Imaging
Authors: de Winter Ruben W. , Jukema Ruurt A. , van Diemen Pepijn A. , Schumacher Stefan P. , Somsen Yvemarie B.O. , van de Hoef Tim P. , van Rossum Albert C. , Twisk Jos W.R. , Maaniitty Teemu , Knuuti Juhani , Saraste Antti , Nap Alexander , Raijmakers Pieter G. , Danad Ibrahim , Knaapen Paul
Published: September 2023

BACKGROUND:

Coronary flow capacity (CFC) is a measure that integrates hyperemic myocardial blood flow and coronary flow reserve to quantify the pathophysiological impact of coronary artery disease on vasodilator capacity. This study explores the prognostic value of modified CFC derived from [
15
O]H
2
O positron emission tomography perfusion imaging.

METHODS:

Quantitative rest/stress perfusion measurements were obtained from 1300 patients with known or suspected coronary artery disease. Patients were classified as having myocardial steal (n=38), severely reduced CFC (n=141), moderately reduced CFC (n=394), minimally reduced CFC (n=245), or normal flow (n=482) using previously defined thresholds. The end point was a composite of death and nonfatal myocardial infarction.

RESULTS:

During a median follow-up of 5.5 (interquartile range, 3.7–7.8) years, the end point occurred in 153 (12%) patients. Myocardial steal (hazard ratio [HR], 6.70 [95% CI, 3.21–13.99];
P
<0.001), severely reduced CFC (HR, 2.35 [95% CI, 1.16–4.78];
P
=0.018), and moderately reduced CFC (HR, 1.95 [95% CI, 1.11–3.41];
P
=0.020) were associated with worse prognosis compared with normal flow, after adjusting for clinical characteristics. Similarly, in the overall population, increased resting myocardial blood flow (HR, 3.05 [95% CI, 1.68–5.54];
P
<0.001), decreased hyperemic myocardial blood flow (HR, 0.68 [95% CI, 0.52–0.90];
P
=0.007) and decreased coronary flow reserve (HR, 0.55 [95% CI, 0.42–0.71];
P
<0.001) were independently associated with adverse outcome. In a model adjusted for the combined use of perfusion metrics, modified CFC demonstrated independent prognostic value (overall
P
=0.017).

CONCLUSIONS:

[
15
O]H
2
O positron emission tomography–derived resting myocardial blood flow, hyperemic myocardial blood flow, coronary flow reserve, and CFC are prognostic factors for death and nonfatal myocardial infarction in patients with known or suspected coronary artery disease. Importantly, after adjustment for clinical characteristics and the combined use of [
15
O]H
2
O positron emission tomography perfusion metrics, modified CFC remained independently associated with adverse outcome.
Self-Organization of Nonlinearly Coupled Neural Fluctuations Into Synergistic Population Codes
Authors: Ma Hengyuan , Qi Yang , Gong Pulin , Zhang Jie , Lu Wen-lian , Feng Jianfeng
Published: September 2023

Neural activity in the brain exhibits correlated fluctuations that may strongly influence the properties of neural population coding. However, how such correlated neural fluctuations may arise from the intrinsic neural circuit dynamics and subsequently affect the computational properties of neural population activity remains poorly understood. The main difficulty lies in resolving the nonlinear coupling between correlated fluctuations with the overall dynamics of the system. In this study, we investigate the emergence of synergistic neural population codes from the intrinsic dynamics of correlated neural fluctuations in a neural circuit model capturing realistic nonlinear noise coupling of spiking neurons. We show that a rich repertoire of spatial correlation patterns naturally emerges in a bump attractor network and further reveals the dynamical regime under which the interplay between differential and noise correlations leads to synergistic codes. Moreover, we find that negative correlations may induce stable bound states between two bumps, a phenomenon previously unobserved in firing rate models. These noise-induced effects of bump attractors lead to a number of computational advantages including enhanced working memory capacity and efficient spatiotemporal multiplexing and can account for a range of cognitive and behavioral phenomena related to working memory. This study offers a dynamical approach to investigating realistic correlated neural fluctuations and insights to their roles in cortical computations.
The Prospect and Limitations of Digital Diplomacy: The Case of Indonesia
Authors: Triwibowo Albert
Published: September 2023

One facet of information and communication technology in diplomacy is how and to what extent states implement digital tools in their diplomatic practices. This article focuses on the Indonesian Ministry of Foreign Affairs (MoFA) and argues that it has performed the early stages of digital diplomacy, during which it is carried out for information dissemination purposes and is mainly influenced by the domestic agenda. The research finds that Indonesian digital diplomacy is affected by various factors that have a substantial effect on the MoFA’s digital diplomacy plan of action. This article is a qualitative study supported mainly by primary data from interviews with Indonesian diplomats, high-ranking officials in the Indonesian MoFA, and Indonesian scholars and citizens. The focus is on the social media activity of the Indonesian MoFA on Twitter (@Kemlu_RI), Facebook (Kementerian Luar Negeri RI) and Instagram (kemlu_ri) from 2020 to April 2022.
Pooled Longitudinal Dataset on the Assessment of an Apprenticeship-Based Entrepreneurship Intervention in Nigeria
Authors: Olofinyehun Adedayo , Adeyeye Jumoke , Egbetokun Abiodun , Olomu Michael , Oluwadare Jessica , Sanni Maruf , Orisadare Monica
Published: September 2023

This dataset presents longitudinal data collected through four surveys (in six-monthly intervals) of fresh university and polytechnic graduates in Nigeria. The data were collected from 21,940 unique young men and women who underwent National Youth Service Corps (nysc) programme across ten states in Nigeria. The nysc programme is a compulsory one-year national service that all Nigerians under the age of 30 years must undergo after graduation. A key component of the one-year service is the Skills Acquisition and Entrepreneurship Development (saed) programme of the nysc. The dataset is useful for many purposes. It contains enough information to fully profile the entrepreneurship and apprenticeship characteristics of the fresh graduates. Moreover, it can be used to quantify the potential pool of future entrepreneurs among highly educated Nigerian youth. The dataset was originally used to assess the impact of saed, being an apprenticeship-based entrepreneurship intervention, on entrepreneurial outcomes among young persons. However, its use may also extend to an assessment of the impact of compulsory entrepreneurship training in the Nigerian university system that produced most of the respondents.
The Impacts of Grid Spacing and Station Network on Surface Analyses and Forecasts in Beijing Winter Olympic Complex Terrain
Authors: Song Linye , Yang Lu , Cheng Conglan , Hasi Aru , Chen Mingxuan
Published: September 2023

This study investigates the impacts of grid spacing and station network on surface analyses and forecasts including temperature, humidity, and winds in Beijing Winter Olympic complex terrain. The high-resolution analyses are generated by a rapid-refresh integrated system that includes a topographic downscaling procedure. Results show that surface analyses are more accurate with a higher targeted grid spacing. In particular, the average analysis errors of surface temperature, humidity, and winds are all significantly reduced when the grid size is increased. This improvement is mainly attributed to a more realistic simulation of the topographic effects in the integrated system because the topographic downscaling at higher grid spacing can add more details in a complex mountain region. From 1 km to 100 m, 1–12-h forecasts of temperature and humidity are also largely improved, while the wind only shows a slight improvement for 1–6-h forecasts. The influence of station network on the surface analyses is further examined. Results show that the spatial distributions of temperature and humidity at a 100-m space scale are more realistic and accurate when adding an intensive automatic weather station network, as more observational information can be absorbed. The adding of a station network can also reduce forecast errors, which can last for about 6 h. However, although surface winds display better analysis skill when more stations are added, the wind at the mountaintop region sometimes encounters a marginally worse effect for both analysis and forecast. The results are helpful to improve the analysis and forecast products in complex terrain and have some implications for downscaling from a coarse grid size to a finer grid.
An Evaluation of IMERG and ERA5 Quantitative Precipitation Estimates over the Southern Ocean Using Shipborne Observations
Authors: Montoya Duque E. , Huang Y. , May P. T. , Siems S. T.
Published: September 2023

Recent voyages of the Australian R/V Investigator across the remote Southern Ocean have provided unprecedented observations of precipitation made with both an Ocean Rainfall and Ice-Phase Precipitation Measurement Network (OceanRAIN) maritime disdrometer and a dual-polarization C-band weather radar (OceanPOL). This present study employs these observations to evaluate the Global Precipitation Measurement (GPM) Integrated Multi-satellitE Retrievals for GPM (IMERG) and the fifth major global reanalysis produced by ECMWF (ERA5) precipitation products. Working at a resolution of 60 min and 0.25° (∼25 km), light rain and drizzle are most frequently observed across the region. The IMERG product overestimated precipitation intensity when evaluated against the OceanRAIN but captured the frequency of occurrence well. Looking at the synoptic/process scale, IMERG was found to be the least accurate (overestimated intensity) under warm-frontal and high-latitude cyclone conditions, where multilayer clouds were commonly present. Under postfrontal conditions, IMERG underestimated the precipitation frequency. In comparison, ERA5’s skill was more consistent across various synoptic conditions, except for high pressure conditions where the precipitation frequency (intensity) was highly overestimated (underestimated). Using the OceanPOL radar, an area-to-area analysis (fractional skill score) finds that ERA5 has greater skill than IMERG. There is little agreement in the phase classification between the OceanRAIN disdrometer, IMERG, and ERA5. The comparisons are complicated by the various assumptions for phase classification in the different datasets.

Significance Statement

Our best quantitative estimates of precipitation over the remote, pristine Southern Ocean (SO) continue to suffer from a high degree of uncertainty, with large differences present among satellite-based and reanalysis products. New instrumentation on the R/V Investigator, specifically a dual-polarization C-band weather radar (OceanPOL) and a maritime disdrometer (OceanRAIN), provide unprecedented high-quality observations of precipitation across the SO that will aid in improving precipitation estimates in this region. We use these observations to evaluate the IMERG and ERA5 precipitation products. We find that, in general, IMERG overestimated precipitation intensity, but captured the frequency of occurrence well. In comparison, ERA5 was found to overestimate the frequency of precipitation. Using the OceanPOL radar, an area-to-area analysis finds that ERA5 has greater skill than IMERG.
The relationships among activity information, personal recovery, and related psychosocial factors in psychiatric day-care users in Japan
Authors: Isaji Hikari , Hoshino Aiko , Asakura Tatsumi , Yamashita Yuji , Murata Natsumi , Kito Aki
Published: September 2023

Introduction:

Psychiatric day-care services play a central role in community-based care in Japan. Recovery and related psychosocial factors are critical in promoting community participation of people with mental illness. This study aimed to reveal the relationships among activity information, personal recovery, and related psychosocial factors in day-care users.

Method:

Forty day-care participants answered self-report questionnaires. The following assessments were applied: Recovery Assessment Scale, Occupational Questionnaire, Perceived Devaluation Discrimination Scale, and 26-item version of World Health Organization Quality of Life (QOL). The correlations among the factors were analyzed.

Results:

Data for 35 people were analyzed. Total recovery score was strongly correlated with total WHOQOL-26 score ( r = 0.76, p < 0.001). Total QOL score was positively related with the value of activities ( r = 0.46, p < 0.05). Social QOL and total stigma score had a significant negative relationship ( r = −0.44, p < 0.05).

Conclusion:

Participation in activities was suggested to improve QOL. Although there was a strong relationship between recovery and QOL, it was unclear to what extent participation in activities was related to recovery. We should consider approaches regarding other factors to fully accomplish community integration and personal recovery.
Efficacy and Safety of the Phytochemical Product Linfadren in the Management of Patients With Persistent Ankle Edema Following Trauma or Surgery: A Randomized Controlled Trial
Authors: Cacchio Angelo , Calvisi Vittorio , Di Carlo Giancarlo , Petralia Giuseppe , Angelozzi Massimo
Published: September 2023

Background:

Persistent posttraumatic/postsurgery ankle edema (PPAE) is edema that persists from 2 weeks to 3 months after injury or surgery. PPAE has negative effects on the healing process and quality of life. This study aimed to evaluate the efficacy of a phytochemical product containing diosmin, coumarin, and arbutin (Linfadren) in addition to the conventional treatment, in patients with PPAE.

Methods:

Between October 2018 and February 2020, 60 outpatients with PPAE (42 with ankle fractures and 18 with ankle sprains) were enrolled and randomized (1:1 ratio) to receive either 6-week conventional treatment plus Linfadren (study group) or conventional treatment alone (control group). Primary outcome was ankle edema as measured by the “figure-of-8-20” method. Secondary outcomes were ankle function measured by the Lower Extremity Functional Scale (LEFS), and patient’s overall perceived treatment efficacy. Tolerability of Linfadren was also evaluated. Assessments were performed at baseline, at end of treatment (6 weeks after baseline), and 3 months after the end of treatment (follow-up). A subgroup analysis was also conducted for the injury type (fracture/sprain) to identify if this factor affected the results of the primary outcome measure.

Results:

At the end of treatment, the study group had a significantly greater improvement in ankle edema, improved ankle function, and more patients who considered this treatment effective compared with the control group. The measured difference in circumference by the figure-of-8-20 method averaged 4% at 6 weeks and 5% at 3 months. No difference between groups was seen in rescue medication. No adverse events were recorded. Subgroup analysis revealed no significant influence of the injury type on the primary outcome measure.

Conclusion:

Linfadren in addition to conventional treatment was more effective than conventional treatment alone in patients with PPAE.

Level of Evidence:

Level I, randomized controlled trial.
Qualitative study of Oncology Clinicians’ Perceptions of Barriers to Offering Clinical Trials to Underserved Populations
Authors: Perez Giselle K. , Oberoi Anjali R. , Finkelstein-Fox Lucy , Park Elyse R. , Nipp Ryan D. , Moy Beverly
Published: September 2023

Introduction

Cancer clinical trials represent the “gold standard” for advancing novel cancer therapies. Optimizing trial participation is critical to ensuring the generalizability of findings across patients, yet trial enrollment rates, particularly among minority and socioeconomically disadvantaged populations, remain suboptimal.

Methods

We conducted in-depth interviews with oncologists at a large academic medical center to explore their (1) attitudes and perceived barriers to offering clinical trials to minority and socioeconomically disadvantaged patients, and (2) recommendations for improving the enrollment of minority and socioeconomically disadvantaged patients in cancer clinical trials.

Results

Of 23 medical oncologists approached, 17 enrolled (74% response rate; mean age = 47; female = 42%; White = 67%). Content analysis revealed several barriers to enrollment: (1) ethical dilemmas; (2) ambivalence about trial risks and benefits; and (3) concern about patient well-being. Concerns about the legitimacy of informed consent, perceived lack of equipoise, and fear of personal bias influenced clinicians’ decisions to recommend trials during treatment discussions. Concerns about creating an imbalance between trial risks and benefits among patients with high-level needs, including patients with literacy, psychiatric, and other socioeconomic vulnerabilities, impacted clinicians’ enthusiasm to engage in trial discussions. Clinicians identified patient, provider, and system-level solutions to address challenges, including increasing patient and clinician support as well as involving external personnel to support trial enrollment.

Conclusion

Findings reveal multi-level barriers to offering cancer clinical trials to underrepresented patients. Targeted solutions, including system level changes to support clinicians, patient financial support, and implementation of clinical trial navigation programs were recommended to help reduce access barriers and increase enrollment of underrepresented patients into cancer clinical trials.
Comparative Analysis of First-Line FOLFOX Treatment With and Without Anti-VEGF Therapy in Metastatic Colorectal Carcinoma: A Real-World Data Study
Authors: Brenner Ronen , Amar-Farkash Shlomit , Klein-Brill Avital , Rosenberg-Katz Keren , Aran Dvir
Published: September 2023

Background

FOLFOX (leucovorin calcium [folinic acid], fluorouracil, and oxaliplatin) combined with or without anti-VEGF therapy represents one of the primary first-line treatment options for metastatic colorectal carcinoma (mCRC). However, there is limited comparative data on the impact of anti-VEGF therapy on treatment effectiveness, survival outcomes, and tumor location.

Methods

This retrospective, comparative study utilized data from the AIM Cancer Care Quality Program and commercially insured patients treated at medical oncology clinics in the US. We analyzed 1652 mCRC patients who received FOLFOX, of which 1015 (61.4%) were also treated with anti-VEGF therapy (VEGF cohort).

Results

Patients in the VEGF cohort exhibited a higher frequency of lung (33% vs 23%; P < .001) and liver metastases (74% vs 62%; P < .001), underwent fewer liver surgeries prior to treatment (1.2% vs 3.6%; P = .002), and had a higher proportion of right-sided tumors (27% vs 18%; P = .001). Adjusted analysis revealed no significant difference in overall survival (OS) between patients treated with and without anti-VEGF (median survival: 25.4 vs 26.0 months; P = .4). FOLFOX-only treated patients experienced higher rates of post-treatment hospitalizations (22% vs 15%; P < .001). Notably, left-sided tumors treated with anti-VEGF showed a trend toward decreased OS (median survival: 26.8 vs 33 months; P = .09).

Conclusion

Our real-world data analysis suggests that the addition of anti-VEGF to FOLFOX offers limited and short-lived benefits in the context of mCRC and may provide differential survival benefit based on tumor sidedness.
A Predictive Model for the Early Death of Breast Cancer With Synchronous Liver Metastases: A Population-Based Study
Authors: Liu Shaochun , Jia Yingxue , Chai Jiaying , Ge Han , Huang Runze , Li Anlong , Cheng Huaidong
Published: September 2023

Background

Breast cancer liver metastasis (BCLM) is a severe condition often resulting in early death. The identification of prognostic factors and the construction of accurate predictive models can guide clinical decision-making.

Methods

A large sample of data from the Surveillance, Epidemiology, and End Results (SEER) database was analyzed, including 3711 patients diagnosed with de novo BCLM between 2010 and 2015. Predictive models were developed using histograms, and stepwise regression addressed variable collinearity. Internal validation was performed, and results were compared to similar studies.

Results

In this study of 3711 BCLM patients, 2571 didn't have early death. Out of the 1164 who died early, 1086 had cancer-specific early death. Prognostic factors for early death, including age, race, tumor size, and lymph node involvement, were identified. A nomogram based on these factors was constructed, accurately predicting early all-cause and cancer-specific death.

Conclusions

Valuable insights into the prognosis of BCLM patients were provided, and important prognostic factors for early death were identified. The developed nomogram can assist clinicians in identifying high-risk patients for early death and inform treatment decisions.
Healthcare Professionals’ Resilience During the COVID-19 and Organizational Factors That Improve Individual Resilience: A Mixed-Method Study
Authors: Simões de Almeida Raquel , Costa Ana , Teixeira Inês , Trigueiro Maria João , Dores Artemisa Rocha , Marques António
Published: September 2023

Healthcare workers are a susceptible population to be psychologically affected during health crises, such as the recent COVID-19 pandemic. Resilience has been pointed out in the literature as a possible protective factor against psychological distress in crisis situations. This can be influenced by internal and external factors, such as individual characteristics and organizational factors. Thus, this study aims to characterize the overall resilience levels among healthcare professionals in Portugal and to understand the perspectives of this healthcare workers regarding organizational factors that improve individual resilience. This is a mixed-method study: a first quantitative study using a cross-sectional design to administer the Resilience Scale for Adults (RSA) to 271 healthcare professionals (Mage 33.90, SD = 9.59 years, 90.80% female), followed by a qualitative study through 10 in-depth interviews. The mean score for the total RSA was 178.17 (SD = 22.44) out of a total of 231. Qualitative analysis showed 4 major themes on factors that enhance resilience: “Professional’s Training,” “Support and Wellbeing Measures,” “Reorganization of Services” and “Professional Acknowledgment.” The findings may contribute to the development of targeted interventions and support systems to enhance resilience and well-being among healthcare workers.
Is duration of residence a proxy for acculturation? The case of health risk behaviors among international immigrants
Authors: Juárez Sol P. , Honkaniemi Helena , Gustafsson Nina-Katri , Berg Lisa
Published: September 2023

Aims:

Among international immigrants, health changes by duration of residence are commonly interpreted as an expression of acculturation to the receiving country context. This study compares changes in immigrants’ health risk behaviors by duration of residence to changes by acculturation levels, in order to assess whether duration of residence can be regarded as a proxy for acculturation.

Methods:

Using data from a previous systematic review, we identified 17 quantitative studies examining changes in alcohol, tobacco and drug use, physical inactivity, and diet by both duration of residence and acculturation level in the same population. We compared the directionality and consistency of these associations through tabulation and vote counting.

Results:

The majority of studies reported no or inconsistent changes in health risk behaviors by duration of residence versus by acculturation, including with opposite directionality. Four studies reported significant estimates with consistent directionality, while five reported consistent, non-significant estimates.

Conclusions:

Our findings suggest that duration of residence should not be used as a proxy for acculturation when studying health risk behaviors among immigrants. Researchers should consider additional time-dependent factors to explain behavioral changes by duration of residence.
Be my AI—micro-volunteering in the time of ChatGPT
Authors: Mukhopadhyay Mayukh
Published: September 2023

Purpose: This case study explores the evolution of Be My Eyes, a micro-volunteering platform connecting blind and visually impaired individuals with sighted volunteers. The case analyzes the challenges faced by the founder, Hans Jørgen Wiberg, in balancing the company's social mission with its financial sustainability. It also examines the impact of technological advancements, specifically generative artificial intelligence, on the platform's business model. Pedagogical Objective: The case study aims to provide insights into the challenges of balancing social impact and financial sustainability in a social enterprise context. It also explores the potential of technological advancements in shaping business models and discusses the ethical implications of integrating technology into social enterprises. Case Positioning and Setting: This case study is suitable for undergraduate and graduate courses in entrepreneurship, social enterprise, and innovation management. It can also be used in courses on technology and society or business ethics. The case is set in Denmark, where Be My Eyes was founded, and covers the period from the platform's inception till the present day.
A case of markedly impaired wound repair with angiostatic pazopanib in a patient who had Mohs surgery for a basal cell carcinoma
Authors: Nahm William J , de Imus Gail , Mathe Christopher A , Saap Liliana , Joseph Saiyan , Chen Stanley , Falanga Vincent
Published: September 2023

This case report highlights the adverse effects of pazopanib, a vascular endothelial growth factor receptor inhibitor, on wound healing after Mohs surgery. A 79-year-old male with metastatic renal cell carcinoma of the lung, on 600 mg daily pazopanib, underwent Mohs surgery for a nodular basal cell carcinoma on his right leg. Despite multiple wound care strategies, his wound deteriorated over 4 months. Discontinuing pazopanib resulted in rapid wound closure within 2 months. However, metastatic lung nodules grew, prompting treatment with immune checkpoint inhibitors, nivolumab, and ipilimumab, which were discontinued due to complications. Near-complete wound healing was observed prior to reintroducing pazopanib (6 months after initial discontinuation), which again led to wound deterioration. Pazopanib negatively impacts wound repair by inhibiting cell proliferation and angiogenesis. Depending on the malignancy or tumor, cessation of pazopanib, or switching to a course of immune checkpoint inhibitors may be warranted perioperatively.
Effects of WeChat platform-based continuing care on self-management and quality of life in patients with arthritis: A quasi-experimental study
Authors: Jingmeng Chen , Qiqi Xu , Jian Peng , Guixing Yu , Siman Lv , Yuying Jiang , Yuru Hu , Qu Shen
Published: September 2023

Objective

To assess the effects of WeChat platform-based continuing care for arthritis on patients’ self-management, self-efficiency, quality of life (QoL), and medication compliance.

Methods

A study was conducted on arthritis patients recruited between December 2017 and February 2018 and divided into two groups. The intervention group received continuing care from the WeChat platform and regular follow-ups, while the control group only received regular follow-ups. The outcomes in both groups were assessed using questionnaires twice: before the study (T0) and eight weeks after T0 (T1), which consists of the evaluation of self-management, QoL, self-efficacy, and medication compliance.

Results

There were 23 people in each of the intervention and control groups completed two outcome measures. At eight weeks, participants in the intervention group showed an improvement in psychological QoL, cognitive symptom management, and self-efficacy, compared to the control group (QoL scores: mean difference in change between groups was 12.29, 95% CI: 4.51, 20.07, p < 0.001; cognitive symptom management: mean difference in change between groups was 0.65, 95% CI: 0.24, 1.05, p < 0.001; self-efficacy: mean difference in change between groups was 0.69, 95% CI: 0.14, 1.24, p < 0.05). Self-management, self-efficacy, and psychological quality of life were significantly improved in the intervention group before and after the intervention ( p < 0.05).

Conclusion

Using the WeChat platform for continuing care is useful in improving the psychological state, self-efficacy, and self-management ability of patients with arthritis. The study is relevant to Clinical Practice.
Chinese Subtitling of Participants in an English Film Mission Impossible: Ghost Protocol: A Narrative-Informed Visual-Verbal Reference
Authors: Chen Yuping
Published: September 2023

Against the backdrop of increased attention to semiotic relations in audiovisual translation, this qualitative study examines the subtitling of characters and objects from verbal reference to visual information in the presenting and presuming systems in film. By comparatively analyzing the visual-verbal endophora, exophora, and homophora in the DVD and the YYeTs fansubbed Chinese subtitles of an English film Mission Impossible: Ghost Protocol, it is found that there is a stronger visual-verbal link in the DVD subtitle, in which the visual information functions to generalize unfamiliar world knowledge pertaining to uniquely presumed characters to meet target audiences half way, omit redundant verbal information concerning explicitly presumed characters, and explicitate indefinite lexical items relating to explicitly and implicitly presumed objects. A narrative-friendly subtitle is therefore produced featuring conciseness, high readability, and good comprehensibility. However, the visual-verbal link in the fansubbed subtitle is comparatively weak due to the predominantly employed literal translation in subtitling presented/presumed characters/objects, in which the visual information is detached from the verbal content, leaving viewers with redundant or unspecific verbal messages. Extra processing effort is therefore required for constructing film narratives. These findings elucidate the significance of visual-verbal reference in subtitling presented/presumed participants for the sake of film narratives.
Structural Musculotendinous Parameters That Predict Failed Tendon Healing After Rotator Cuff Repair
Authors: Olthof Maurits G.L. , Flück Martin , Borbas Paul , Valdivieso Paola , Toigo Marco , Egli Fabian , Joshy Jethin , Filli Lukas , Snedeker Jess G. , Gerber Christian , Wieser Karl
Published: September 2023

Background:

Healing of the rotator cuff after repair constitutes a major clinical challenge with reported high failure rates. Identifying structural musculotendinous predictors for failed rotator cuff repair could enable improved diagnosis and management of patients with rotator cuff disease.

Purpose:

To investigate structural predictors of the musculotendinous unit for failed tendon healing after rotator cuff repair.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Included were 116 shoulders of 115 consecutive patients with supraspinatus (SSP) tear documented on magnetic resonance imaging (MRI) who were treated with an arthroscopic rotator cuff repair. Preoperative assessment included standardized clinical and imaging (MRI) examinations. Intraoperatively, biopsies of the joint capsule, the SSP tendon, and muscle were harvested for histological assessment. At 3 and 12 months postoperatively, patients were re-examined clinically and with MRI. Structural and clinical predictors of healing were evaluated using logistic and linear regression models.

Results:

Structural failure of tendon repair, which was significantly associated with poorer clinical outcome, was associated with older age (β = 1.12; 95% CI, 1.03 to 1.26; P = .03), shorter SSP tendon length (β = 0.89; 95% CI, 0.8 to 0.98; P = .02), and increased proportion of slow myosin heavy chain (MHC)–I/fast MHC-II hybrid muscle fibers (β = 1.23; 95% CI, 1.07 to 1.42; P = .004). Primary clinical outcome (12-month postoperative Constant score) was significantly less favorable for shoulders with fatty infiltration of the infraspinatus muscle (β = –4.71; 95% CI, –9.30 to –0.12; P = .044). Conversely, a high content of fast MHC-II muscle fibers (β = 0.24; 95% CI, 0.026 to 0.44; P = .028) was associated with better clinical outcome.

Conclusion:

Both decreased tendon length and increased hybrid muscle fiber type were independent predictors for retear. Clinical outcome was compromised by tendon retearing and increased fatty infiltration of the infraspinatus muscle. A high content of fast MHC-II SSP muscle fibers was associated with a better clinical outcome.

Registration:

NCT02123784 ( ClinicalTrials.govidentifier ).
Bulk brain tissue cell-type deconvolution with bias correction for single-nuclei RNA sequencing data using DeTREM
Authors: O’Neill Nicholas K. , Stein Thor D. , Hu Junming , Rehman Habbiburr , Campbell Joshua D. , Yajima Masanao , Zhang Xiaoling , Farrer Lindsay A.
Published: September 2023

Background

Quantifying cell-type abundance in bulk tissue RNA-sequencing enables researchers to better understand complex systems. Newer deconvolution methodologies, such as MuSiC, use cell-type signatures derived from single-cell RNA-sequencing (scRNA-seq) data to make these calculations. Single-nuclei RNA-sequencing (snRNA-seq) reference data can be used instead of scRNA-seq data for tissues such as human brain where single-cell data are difficult to obtain, but accuracy suffers due to sequencing differences between the technologies.

Results

We propose a modification to MuSiC entitled ‘DeTREM’ which compensates for sequencing differences between the cell-type signature and bulk RNA-seq datasets in order to better predict cell-type fractions. We show DeTREM to be more accurate than MuSiC in simulated and real human brain bulk RNA-sequencing datasets with various cell-type abundance estimates. We also compare DeTREM to SCDC and CIBERSORTx, two recent deconvolution methods that use scRNA-seq cell-type signatures. We find that they perform well in simulated data but produce less accurate results than DeTREM when used to deconvolute human brain data.

Conclusion

DeTREM improves the deconvolution accuracy of MuSiC and outperforms other deconvolution methods when applied to snRNA-seq data. DeTREM enables accurate cell-type deconvolution in situations where scRNA-seq data are not available. This modification improves characterization cell-type specific effects in brain tissue and identification of cell-type abundance differences under various conditions.
Pressure- vs. volume-controlled ventilation and their respective impact on dynamic parameters of fluid responsiveness: a cross-over animal study
Authors: Zitzmann Amelie , Bandorf Tim , Merz Jonas , Müller-Graf Fabian , Prütz Maria , Frenkel Paul , Reuter Susanne , Vollmar Brigitte , Fuentes Nora A. , Böhm Stephan H. , Reuter Daniel A.
Published: September 2023

Background and goal of study

Pulse pressure variation (PPV) and stroke volume variation (SVV), which are based on the forces caused by controlled mechanical ventilation, are commonly used to predict fluid responsiveness. When PPV and SVV were introduced into clinical practice, volume-controlled ventilation (VCV) with tidal volumes (VT) ≥ 10 ml kg− 1 was most commonly used. Nowadays, lower VT and the use of pressure-controlled ventilation (PCV) has widely become the preferred type of ventilation. Due to their specific flow characteristics, VCV and PCV result in different airway pressures at comparable tidal volumes. We hypothesised that higher inspiratory pressures would result in higher PPVs and aimed to determine the impact of VCV and PCV on PPV and SVV.

Methods

In this self-controlled animal study, sixteen anaesthetised, paralysed, and mechanically ventilated (goal: VT 8 ml kg− 1) pigs were instrumented with catheters for continuous arterial blood pressure measurement and transpulmonary thermodilution. At four different intravascular fluid states (IVFS; baseline, hypovolaemia, resuscitation I and II), ventilatory and hemodynamic data including PPV and SVV were assessed during VCV and PCV. Statistical analysis was performed using U-test and RM ANOVA on ranks as well as descriptive LDA and GEE analysis.

Results

Complete data sets were available of eight pigs. VT and respiratory rates were similar in both forms. Heart rate, central venous, systolic, diastolic, and mean arterial pressures were not different between VCV and PCV at any IVFS. Peak inspiratory pressure was significantly higher in VCV, while plateau, airway and transpulmonary driving pressures were significantly higher in PCV. However, these higher pressures did not result in different PPVs nor SVVs at any IVFS.

Conclusion

VCV and PCV at similar tidal volumes and respiratory rates produced PPVs and SVVs without clinically meaningful differences in this experimental setting. Further research is needed to transfer these results to humans.
Association of intraoperative cerebral and somatic tissue oxygen saturation with postoperative acute kidney injury in adult patients undergoing multiple valve surgery
Authors: Zhang Hui , Zhang Taoyuan , Hou Lihong , Zhao Jing , Fan Qianqian , Wang Lini , Lu Zhihong , Dong Hailong , Lei Chong
Published: September 2023

Background

The association between tissue oxygenation with postoperative acute kidney injury (AKI) in adult patients undergoing multiple valve surgery has not been specifically studied.

Methods

In this prospective exploratory cohort study, 99 patients were enrolled. The left forehead, the left forearm, the left upper thigh, and the left renal region tissue oxygen saturation using near-infrared spectroscopy were monitored. The association between each threshold and AKI was assessed. The relative and absolute thresholds were < 70%, < 75%, < 80%, < 85%, < 90%, < 95%, and < 100% baseline, and baseline-standard deviation (SD), -1.5 SD, -2 SD, -2.5 SD, and -3 SD. Multivariate logistic regression analysis was adopted to explore the association.

Results

AKI occurred in 53 (54%) patients. The absolute value-based SrrO2 thresholds associated with AKI were baseline-3 SD (odds ratio [OR], 4.629; 95% confidence interval [CI], 1.238–17.314; P = 0.023) and baseline-2.5 SD (OR, 2.842; 95% CI, 1.025–7.881; P = 0.045) after adjusting for the potential confounders, those are renal region tissue oxygen saturation of 55% and 60%, but not statistically significant after correcting for multiple testing (corrected P = 0.114 and 0.179, respectively).

Conclusion

The SrrO2 desaturation, defined as < baseline – 2.5 SD or < baseline – 3 SD, may be associated with AKI. The thresholds need to be verified in future large-scale studies.

Trial registrations

The study was registered at ClinicalTrials.gov, first trial registration: 26/10/2017, identifier: NCT03323203.
A validation study for wide-range remote assessment of cognitive functions in the healthy older Japanese population: a pilot randomised crossover trial
Authors: Takakura Yuki , Otsuki Mika , Takagi Ryo , Houkin Kiyohiro
Published: September 2023

Background

The assessment of a wide range of cognitive functions using video teleconference (VTC) systems cannot be applied in practice yet. We aimed to determine the feasibility and reliability of previously unvalidated remote cognitive function tests in Japan using common information and communication technology (ICT) devices, software, and VTC systems compared with face-to-face (FTF) assessment.

Methods

The sample consisted of 26 participants from senior citizens clubs and an employment service centre in Sapporo Japan, including 11 females and 15 males (age averaged 78.6 ± 6.8 years). Tests included the RCPM, Story recall, 10/36 spatial recall, selective reminding test, SDMT, PASAT, FAB, TMT-A, TMT-B, visual cancellation task, digit span, tapping span. The experimental design was a counterbalanced crossover randomised controlled trial. Intraclass correlations (ICCs), paired-samples t-tests, Cohen’s Kappa (κ) coefficients, and Wilcoxon signed-rank test were calculated to compare the scores between VTC and FTF assessments.

Results

All ICCs were significant and ranged from 0.47 (RCPM time) to 0.92 (RCPM score and PASAT), with a mean ICC of 0.75. Digit span using Cohen’s Kappa (κ) coefficient was significant, but the tapping span was not. Paired samples t-test showed statistically significant differences in SDMT, RCPM time, and cancellation time.

Conclusions

The results suggest that remote video conference-based neuropsychological tests even using familiar devices and software may be able to assess a wide range of cognitive functions in the Japanese older population. As for the processing speed tasks, we need to create our own standards for the remote condition. For the tapping span, we should consider increasing the number of trials.
Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center
Authors: Wainwright Sam , Caskey Rachel , Rodriguez Aida , Holicky Abigail , Wagner-Schuman Melissa , Glassgow Anne Elizabeth
Published: September 2023

Background

Postpartum depression (PPD) impacts fathers as well as mothers, and is estimated to affect between 8 and 13% of fathers. Paternal PPD is a risk factor for worsened quality of life, poor physical and mental health, and developmental and relational harms in the father-mother-child triad. There are no current recommendations for PPD screening among fathers. Paternal PPD screening was piloted in an intergenerational postpartum primary care clinic.

Methods

The pilot was carried out in an intergenerational postpartum primary care clinic located at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers’ permission. A novel survey instrument was used to collect demographic/social data, as well as mental health history and current stress levels; an Edinburgh Postnatal Depression Scale (EPDS) was also administered. Screenings were completed by social workers; data were collected in REDCap and descriptive statistics were calculated in SAS.

Results

29 fathers were contacted and 24 completed screening (83%). Mean age was 31 years (range 19–48). Most (87%) identified as belonging to a racial or ethnic minority group. Fathers self-reported low rates of stress and preexisting mental health conditions, but 30% screened positive for PPD on EPDS (score of ≥ 8, or suicidal ideation). Gaps in health care were found, as one-quarter (26%) of fathers were uninsured and half (54%) did not have a primary care provider. After screening, two requested mental health services, and three established new primary care with a physician.

Conclusions

Participation was high in a PPD screening pilot for fathers in a primary care setting. This small sample of fathers demonstrated significant peripartum mental health challenges unlikely to have been identified otherwise. For some participants, engaging in PPD screening was an effective tool to prompt their subsequent engagement with general health care. This pilot is a step toward incorporating the health of fathers into models for supporting the health of families. Expanding screening for paternal PPD into routine primary care is necessary to reach more affected fathers.