bluuebunny/crossref_metadata_2025 huggingface dataset:
Supine versus prone percutaneous nephrolithotomy in management of patient with complex renal stone diseases
Authors: Maiti Krishnendu , Khare Kani Dayal , Pal Dilip Kumar
Published: March 2024

Objectives:

Compare the surgical outcomes, safety, stone free rate, hospital stay, and complication of prone and supine PCNL in case of complex renal stone.

Materials and methods:

This is an observational study conducted in our institute, it consist of 120 patients over the period of 2 years from July 2021 to June 2023, all the patients were divided into two groups: 60 patients underwent modified supine percutaneous nephrolithotomy (PCNL) and remaining 60 patients underwent standard prone PCNL. The measured data included operative time, number of punctures, blood loss, stone-free rate, length of hospital stays, and rate of complications.

Results:

The two groups were comparable in mean age, male to female ratio, number of punctures, number of tract, size of tract, residual calculi in follow up period, blood transfusion, re-do surgery, chest complication, hospital stay, and postoperative fever and pain. The mean operating time was 1.59 h in supine PCNL and 2.49 h in prone PCNL. The p value was significant ( p = 0.001).

Conclusions:

By this study we observed that the supine PCNL is associated with statistically significant reduced operating time as compared to conventional prone PCNL with advantages of not putting the patient in prone position. The postoperative complications such as pain and fever were not significant when compared in both groups. We conclude our study and found that, the supine PCNL is an equally effective in treating complex renal stone as compared to prone PCNL.
Quality of Cities’ Networks of Plans and Prospects for Flood Resilience
Authors: Roy Malini , Woodruff Sierra , Meerow Sara , Hannibal Bryce , Matos Melina , Gilbertson Philip
Published: March 2024

Urban flood resilience is a function of the collective intent of all planning efforts or network of plans. Yet, most studies focus on single plan types; it is unclear whether plans work cohesively. We asked to what extent do networks of plans uniformly foster resilience to flooding. We adapted plan quality evaluation methodology to evaluate four cities’ networks of plans. All four networks uniformly state goals, including flood resilience and sustainability goals, but exclude details on flood exposure and vulnerability. Moreover, all four networks lack implementation guidelines. We identify opportunities for more integrated planning to tackle flooding and climate change.
Critical Sociology of Media and Communication: Connecting a Disconnected Field
Authors: Bilić Paško , Allmer Thomas
Published: March 2024

The sociology of media and communications was never explicitly defined – nor was there ever an explicit debate about the sub-field. Not having a clear anchor makes it hard to define what its critical component should be. Nonetheless, a rich yet disconnected tradition of sociology and critical political economy allows flexibility to reconsider communication and social relations in the broader societal dynamics of capitalism. Specifying a critical sociological approach to communication can help better define the role of communication at the micro, mezzo and macro levels of society. The multi-paradigmatic heritage of sociological theory can provide new ways of criticising communication power in contemporary society. Diverse contemporary developments in the critique of political economy give a breadth of understanding of the capitalist mode of production and its internal dynamics. Sociology can add depth to understanding social relations within and beyond the production, distribution and consumption process. This introduction sets out the framework for the special issue.
TikTok as a site of social protest in Iran’s Gen-Z uprising
Authors: Walsh Tom
Published: March 2024

This paper argues that understanding the power of TikTok’s visual discourse is a crucial part of conceptualising the character, inspiration, and ambition of Iran’s Gen-Z-led uprising, both at home and across the diaspora. TikTok is a social media platform that depends on visuality. As such, it creates its own specific forms of messaging. This paper seeks to apply an innovative methodology of ‘Visual Discourse Tracing’ to the Iranian protests. It uses this carefully devised, process-driven method, to highlight the core ways in which TikTok has amplified the message of the Iranian protests, connecting to the grassroots movement and to the longer history of Iranian women’s struggle for freedom. Visuality and social media have been crucial in shaping the character of these contemporary protests, necessitating proper theorisation when understanding the wider Iranian protest movement.
A Review of Traditional Chinese Medicine Syndrome Research on Type 2 Diabetes Mellitus and its Common Chronic Complications
Authors: You Zhiyuan , Lu Junhong , Xu Yifeng , Wang Yiqin , Hao Yiming
Published: March 2024

Type 2 diabetes mellitus is the leading cause of diabetes complications in China, threatening people’s health and quality of life seriously. Over the past few years, with the change in lifestyle and dietary habits, the course of diabetes mellitus is gradually prolonged, and complications in diabetic patients are becoming increasingly common, so scholars have studied the syndrome associated with this disease, which has led to certain research findings. The purpose of this article is to summarise the research progress of diabetes mellitus, diabetic nephropathy, diabetic retinopathy, diabetes mellitus with heart disease, diabetic peripheral neuropathy, and other chronic complications of diabetes mellitus from two aspects of literature and clinical research, present directions and strategies for standardising syndrome types of diabetes mellitus and its common chronic complications.
Prevalence and Characteristics of Pathological Fractures in Patients Referred to Specialist Palliative Care: A Retrospective Study From India
Authors: Kuriakose Jyothsna , Surendran Sumith , Deodhar Jayita K. , P Prasun , Sonawane Rutula N. , Jayaseelan Prarthna
Published: March 2024

Background: Prevalence of pathological fractures in palliative care is less studied. This study aimed to determine the annual prevalence of pathological fractures and describe the characteristics and treatments in patients with pathological fractures referred to a specialist palliative care clinic in a tertiary care cancer center in India. Methods: Data of adult cancer patients newly referred to the specialist palliative care clinic over 1 year with a clinico-radiological diagnosis of pathological fracture was included. Key outcomes of interest were annual prevalence, clinical characteristics, symptoms and treatments offered. Results: 75 out of 5800 (1.29%) patients newly referred to the clinic over 1 year had pathological fractures. Lung cancer was the most common primary diagnosis (n = 23).Dorsal spine (n = 25) was the most common site of fracture. Pain was the predominant symptom. Mean pain score was 7.04(SD = 1.75) and 42 patients (56%) required strong opioids for analgesia. Only 11 (16%) patients underwent surgical fixation. Median duration from diagnosis of cancer to occurrence of fracture was found to be 329 days. Treatment goals changed to best supportive care in 33 patients (44%) post fracture. Patients with bone and soft tissue neoplasms and those who received only chemotherapy previously had a higher risk of occurrence of fractures. Conclusion: Annual prevalence of pathological fractures in patients referred to the specialist palliative care clinic was 1.29%. It was associated with significant symptom burden and affected oncological treatments. Close monitoring of patients with bone metastases is crucial and proactive implementation of prophylactic measures to prevent such skeletal related events is warranted.
How the Intensity of Preference for Ideological Judges Influences Court Support
Authors: Krewson Christopher N. , Owens Ryan J.
Published: March 2024

Recent research shows that many people support courts based on their ideological congruence with those courts and their decisions. But people likely hold varying degrees of intensity in their preferences for judges who will implement conservative or liberal policy. We suspect that court support is a function of that intensity. Our results agree. Court support turns on the intensity with which people prefer conservative, moderate, or liberal judges. In fact, accounting for the strength with which people prefer ideological judges explains more of their support for courts than some existing approaches.
SMARCA4-Deficient Undifferentiated Tumor of the Esophagus: Diagnostic Pitfalls in Immunohistochemical Profiles
Authors: Chakrabarti Rana , Lin Sherman , Wang Hui , Cecchini Matthew
Published: March 2024

SMARCA4-deficient undifferentiated tumors (SMARCA4-UT) are a newly described entity and are typically seen in the thoracic cavity. However, these tumors have been described in other body sites, including the esophagus. These tumors are rare, aggressive neoplasms, characterized by the loss of protein product of SMARCA4 (Brahma-related gene-1) and the preservation of INI1 (SMARCB1) expression. Here, we present two tumors of SMARCA4-UT of the esophagus with its microscopic appearance and immunohistochemical profile. We also include a literature review of SMARCA4-deficient tumors of the tubular gastrointestinal tract with their immunohistochemical and mismatch repair profiles for each specimen. Due to its non-specific histologic appearance and variable staining in expanded immunohistochemical panels, this tumor frequently overlaps with other tumor types, making the diagnosis of SMARCA4-UT challenging. These tumors are often associated with intestinal metaplasia of the esophagus and are thought to represent a high-grade undifferentiated transformation of a conventional esophageal adenocarcinoma. These tumors are typically associated with poor clinical outcomes and have poor response to conventional therapies. Currently, there are no standard guidelines for treatment of these tumors; however, palliative radiotherapy and systemic chemotherapy may provide benefit. More recently, immunotherapy and novel therapeutic targets have shown some promise for these patients.
Assessing Between- and Within-Person Reliabilities of Items and Scale for Daily Procrastination: A Multilevel and Dynamic Approach
Authors: Luo Xiaohui , Hu Yueqin , Liu Hongyun
Published: March 2024

Intensive longitudinal data (ILD) has been collected to capture the dynamic fluctuations of procrastination; however, researchers have typically measured daily procrastination by modifying trait measures (e.g., adding a time reference “today”) without adequately testing their reliabilities. The main purpose of this study was to use an advanced approach, dynamic structural equation modeling, to assess the between- and within-person reliabilities of a widely used six-item measure of daily procrastination. A total of 252 participants completed retrospective measures of various types of trait procrastination and daily measures of procrastination over 34 consecutive days. The results showed that the entire scale for daily procrastination and five of its six items had high between- and within-person reliabilities, but one item had much lower reliabilities, suggesting that this item may be inappropriate in everyday contexts. Furthermore, we found moderate to strong associations between the latent trait factor of procrastination and trait measures of procrastination. In addition, we identified substantial between-person variation in person-specific reliabilities and explored its relevant factors. Overall, this study assessed the reliabilities of a daily measure of procrastination, which facilitated future studies to obtain more reliable and consistent results and to better estimate the reliability of ILD.
A Long Way to Go: A Scenario for Clinical Trials of PI3K Inhibitors in Treating Cancer
Authors: Trigueiros Bárbara Adriana Ferreira dos Santos , Santos Ivan José Santana , Pimenta Fabricia Pires , Ávila Andréa Rodrigues
Published: March 2024

Background

Alterations in PI3K function are directly related to cancer, making PI3K inhibitors suitable options for anticancer therapies. Information on therapy using different types of PI3K inhibitors is available in literature, providing indications of trends in developing new therapies. Although some studies on PI3K inhibitors for cancer treatment provide clinical evidence, they do not allow a careful search for potential PI3K inhibitors conducted by development indicators. Here, we performed a foresight study of clinical trials involving PI3K inhibitors from the past 11 years using indicators of clinical evolution to identify technological trends and provide data for supporting recommendations for new study designs.

Methods

A comprehensive foresight study was designed based on documents from clinical trials on PI3K inhibitors to perform a systematic and comparative analysis, in order to identify technological trends on new cancer therapies.

Results

Our results demonstrate that total number of clinical trials has decreased over the years and, currently, there is a clear prevalence of studies using isoform-specific inhibitors in combined interventions. Clinical trials in Phases I and II were the most frequently found in the database, whereas Phase III trials correspond to 7% of studies. The measurement of clinical trials progression using indicators (drugs in Phase III profile, top-10 drugs, and top-10 combined drugs) demonstrated that the 3 new medicines BKM120, IBI-376, and PF-05212384 have a high potential to provide more efficient cancer treatment in combined interventions. These data also include the groups of targets for each drug, providing a useful and reliable source for design new combinations to overcome the resistance and the poor tolerability observed in some PI3K therapies.

Conclusions

The establishment of development indicators based on clinical trials for cancer treatment was useful to highlight the clinical investment in 3 new PI3K drugs and the advantages of combine therapy using FDA-approved drugs.
Adenosine and Cortical Plasticity
Authors: Martínez-Gallego Irene , Rodríguez-Moreno Antonio
Published: March 2024

Brain plasticity is the ability of the nervous system to change its structure and functioning in response to experiences. These changes occur mainly at synaptic connections, and this plasticity is named synaptic plasticity. During postnatal development, environmental influences trigger changes in synaptic plasticity that will play a crucial role in the formation and refinement of brain circuits and their functions in adulthood. One of the greatest challenges of present neuroscience is to try to explain how synaptic connections change and cortical maps are formed and modified to generate the most suitable adaptive behavior after different external stimuli. Adenosine is emerging as a key player in these plastic changes at different brain areas. Here, we review the current knowledge of the mechanisms responsible for the induction and duration of synaptic plasticity at different postnatal brain development stages in which adenosine, probably released by astrocytes, directly participates in the induction of long-term synaptic plasticity and in the control of the duration of plasticity windows at different cortical synapses. In addition, we comment on the role of the different adenosine receptors in brain diseases and on the potential therapeutic effects of acting via adenosine receptors.
Wavelet denoising based on comprehensive index optimization and improved L2 regularization for load identification
Authors: Li Chenxi , Wu Chengjun , Zhang Chao
Published: March 2024

Load identification, as an inverse problem, is still one of the challenges in the field of vibration engineering. In this paper, a comprehensive load identification method combining entropy weight Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) noise reduction evaluation algorithm and improved L2 regularization method is proposed to improve the load identification accuracy from the following two perspectives. Firstly, the entropy weight TOPSIS method is used to evaluate the wavelet denoising scheme comprehensively, and the optimal denoising scheme is found to reduce the noise interference in the process of inverse problem solving. Secondly, we introduce a new regularization filter function, and search for the regularization parameters by Generalized Cross-Validation (GCV) criterion and one-dimensional optimization algorithm to improve the ill-posedness of the inverse problem. Finally, the simulation and experimental verification of single-source load identification are carried out with the scaled crankcase model, while the accuracy is compared with the Tikhonov regularization method. The results show that the integrated algorithm proposed in this paper can improve the accuracy of load identification while overcoming the inadequacy of inverse problem. Unlike previous studies, the comprehensive evaluation method of denoising effect introduced in this paper provides a way to judge the denoising effect in practical engineering, and the experimental model is closer to practical engineering structures, which shows potential engineering application value.
Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy
Authors: Nyman Johanna , Salanterä Sanna , Pasanen Miko , Parisod Heidi
Published: March 2024

Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents’ health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents ( n = 781) were randomized to the control group ( n = 394) and the health game intervention group ( n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.
Public Financing of Professional Sports Facilities and Drug Asset Forfeiture
Authors: Blemings Benjamin , Humphreys Brad
Published: March 2024

Local governments provide many crucial services from limited budgets, yet often subsidize the profitable, private businesses in professional sports leagues in the United States. Policing represents one important public service. Policing typically constitutes large portions of government budgets and also generates revenue through fines and forfeitures. Existing evidence suggests that large municipal expenditures in other areas can have an ambiguous effect on policing outcomes. This paper addresses the question of whether large public expenditures on sports facilities affect drug asset forfeiture using two-way fixed effects (TWFE) and generalized dynamic model specifications (GDMS). The results are similar across estimation methods, with static TWFE results suggesting a treatment effect of $1,274–5,589 in additional forfeiture per million in subsidies and results from the newer GDMS estimators suggesting $7,703 per million in subsidies. The results imply that, beyond generating no tangible local economic benefits, public subsidization of sports facilities also leads police to make up budget shortfalls by more aggressive policing, which has important implications for racial equity.
Failure analysis of gear using continuous wavelet transform applied in the context of wind turbines
Authors: Medeiros Alexandre , Cardoso Raphael , Oliveira Júnior José , Alves Salete
Published: March 2024

One of the main reasons for failure in the wind turbine is the wear between the gear teeth during the power conversion and changes in the rotation speed, which is also generally associated with changes in the lubrication regimes. In this sense, vibration and signal analysis are frequently used in predictive maintenance as they usually permit the identification of deviations in the proper functioning of the equipment. Thus, this work aims to apply the continuous wavelet transform (CWT) to correlate gear wear and vibration signals, using visual and straightforward analysis. An experimental setup of a gear system was used to analyze vibration signals from different tooth gear damages. Gears with different levels and modes of damage were used in order to evaluate the sensitivity of vibration signals to them. The features from vibration signals were extracted by Morlet wavelet analysis. Results demonstrate that the proposed method accurately detected the early failure by visualization in frequency–time maps.
The current application and evidence for robotic approach in abdominal surgery: A narrative literature review
Authors: Dohrn Niclas , Burgdorf Stefan Kobbelgaard , de Heer Pieter , Klein Mads Falk , Jensen Kristian Kiim
Published: March 2024

The current application of robotic surgery is evolving at a high pace in the current years. The technical advantages enable several abdominal surgical procedures to be performed minimally invasive instead of open surgery. Furthermore, procedures previously performed successfully using standard laparoscopy are now performed with a robotic approach, with conflicting results. The present narrative review reports the current literature on the robotic surgical procedures typically performed in a typical Scandinavian surgical department: colorectal, hernia, hepato-biliary, and esophagogastric surgery.
Legal reality or legal mirage? Examining the relationship between police violence, legal consciousness, and the promise of civil legal justice
Authors: Rocha Beardall Theresa
Published: March 2024

Race-and-class-subjugated communities continue to experience disproportionate police violence despite increased attention to this longstanding problem. This study examines how residents make sense of the legal issues that arise from these encounters and turn to civil law for assistance. I do so by unifying scholarship on police encounters, legal consciousness, and access to justice to consider the obstacles everyday people encounter when they consider filing a civil legal claim in the aftermath of police violence. Drawing on ethnographic fieldwork and interviews with 24 residents and two attorneys specializing in police brutality, I find that all residents, but especially those who sought civil legal justice, experienced what this study calls a legal mirage—which occurs when a knowable legal process exists to pursue one’s rights, but a variety of barriers (e.g., structural, human, financial) make that process unreachable. Three obstacles reinforced this mirage: difficulties obtaining competent representation, unresponsiveness when securing evidence, and frustration navigating municipal indemnification. I conclude by outlining the practical implications of this research for advocates looking to increase access to civil legal services and reduce police violence. Without these interventions, civil legal justice may remain elusive and beyond the reach of everyday people.
An experimental investigation on feasibility of submerged ultrasonic spot welding of thermoplastics
Authors: Bose Sandeep , Chelladurai Hussain Mohamed , Kanaiyaram Ponappa
Published: March 2024

Although conventional methods such as mechanical fastening, adhesive bonding and hot air welding have proven effective in dry conditions, they exhibit diminished efficacy in submerged environments. Hence, a thermoplastic welding technique with minimal dependence on surrounding media is essential. Ultrasonic spot welding (USW) represents a promising approach to thermoplastic joining, offering high efficiency and low operating costs. In this study, we investigate the efficacy of water-submerged ultrasonic spot welding (S-USW) for joining amorphous polyvinyl chloride (PVC) to PVC and semi-crystalline polypropylene (PP) to PP under submerged conditions. Our experimental results show that S-USW leads to a remarkable 39% and 21% increase in lap-shear strength for PVC/PVC and PP/PP welds, respectively, as compared to traditional USW techniques. We corroborate these findings with additional metrics such as Shore-D hardness tests, optical microscopy and scanning electron microscopy imagery, which collectively confirm the improved efficacy of S-USW over USW for joining PVC and PP.
The Russian threat and the consolidation of the West: How populism and EU-skepticism shape party support for Ukraine
Authors: Hooghe Liesbet , Marks Gary , Bakker Ryan , Jolly Seth , Polk Jonathan , Rovny Jan , Steenbergen Marco , Vachudova Milada Anna
Published: March 2024

Support for Ukraine against Russian aggression has been strong across Europe, but it is far from uniform. An expert survey of the positions taken by political parties in 29 countries conducted mid-2023 reveals that 97 of 269 parties reject one or more of the following: providing weapons, hosting refugees, supporting Ukraine's path to European Union membership, or accepting higher energy costs. Where the perceived threat from Russia is most severe, we find the greatest levels of support for Ukraine. However, ideology appears to be far more influential. The level of a party's populist rhetoric and its European Union skepticism explain the bulk of variation in support for Ukraine despite our finding that many strongly populist and European Union-skeptical parties take moderate pro-Ukraine positions when in government.
The creation of culturally responsive school environments in Ireland: Factors that assist in reducing the gap between policy and practice
Authors: Foley Aron , Faas Daniel , Darmody Merike
Published: March 2024

Ireland’s cultural identity has transformed significantly in the past few decades as a result of large-scale inward migration. Consequently, the creation of culturally responsive school environments has become a major concern in policy discourses in recent years. Despite the prevalence of such discourses, research on the cultural responsiveness of the four major primary school types in Ireland, and what factors influence the gap between policy and practice across these school types has remained sparse. Addressing this lacuna in research, this exploratory multi-method study draws on data collected from teachers, principals, and parents. This study highlights several factors that assist students from culturally and religiously diverse backgrounds to develop a sense of school belonging and explores the challenges associated with implementing policies related to creating culturally responsive classrooms in Irish primary schools. This study holds international relevance as it highlights key factors facilitating schools’ response to the growing migration trend experienced throughout Europe.
Neoadjuvant PD-1 Plus Chemotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma
Authors: Qian Ting , Liu Delin , Cao Guochun , Chen Zhipeng , Zhang Qin
Published: March 2024

Background

Clinical studies have shown that programmed cell death-1 (PD-1) inhibitors can activate T cells and inhibit cancer growth. Therefore, the use of a PD-1 inhibitor plus chemotherapy as neoadjuvant chemotherapy for locally advanced esophageal cancer is worth further exploration.

Methods

Patients with locally advanced esophageal squamous cell carcinoma were enrolled in this study to receive two cycles of a preoperative combination of toripalimab, paclitaxel, and cisplatin. Efficacy was evaluated after two treatment cycles. The patients’ postoperative pathological staging was analyzed and compared. Surgery was performed within 42 days of the start date of the last chemotherapy cycle.

Results

Neoadjuvant immunochemotherapy achieved a high pathologic complete response (pCR) rate (29.0%), major pathological response rate (41.9%), and objective response rate (80.6%) and demonstrated statistically significant downstaging after neoadjuvant therapy ( P < .05) with manageable treatment-related adverse effects. No significant association was found between PD-L1 level and pCR ( P = .365). In addition, R0 resection was achieved in all 31 (100%) patients during surgery. For all the included patients, the one-year progression-free survival rate was 87.1% (95% CI: 75.3%-98.9%), the one-year overall survival (OS) rate was 96.8% (95% CI: 79.8%-95.9%), and the two-year OS rate was 83.9% (95% CI: 71.6%-92.2%).

Conclusions

Our findings indicate that this combination may be a potential neoadjuvant therapy regimen in this setting.
Of Hearth and Home: Professional Wellness After Hours
Authors: Ainger Timothy J. , Bensalem-Owen Meriem , Fong-Isariyawongse Joanna , Luedke Matthew William
Published: March 2024

Burnout is a prevalent problem in the contemporary practice of medicine. Defined by the Agency for Healthcare Research and Quality as, “a long-term stress reaction marked by emotional exhaustion, depersonalization, and a lack of sense of personal accomplishment,” this multifactorial condition has significant implications for the clinicians who suffer it, their patients, and families. Neurologists suffer some of the highest rates of burnout. Burnout research on interventions often focus on the work environment. In this article, we will focus on burnout’s effects on home life and features of home life that can impact resiliency, specifically sleep hygiene.
The Problem of Compromise in Conservation and Exhibit Decision Making
Authors: Waller Robert , Henderson Jane
Published: March 2024

A key challenge in managing collections is optimizing the value to society they offer, both now and in the future. This challenge can be framed as an issue requiring compromise, or, it can be considered as an opportunity to optimize. The goal is to help heritage professionals engage in constructive decision-making. By focusing on high-level institutional gains and benefits, while avoiding picking battles over less significant issues, a compromise and win-lose mindset can be avoided. The multiple objectives involved in creating a safe and effective exhibit can lead to conflict and unhelpful digging in of positions among team members. Understanding factors that contribute to conflict and identifying some means of avoiding or minimizing those factors can lead to teamwork at a higher level. Collection management challenges are explored, in a practical way, to reveal how simple changes in thinking habits and perspective can improve decisions and outcomes. A range of heuristics that shape our instinctive decision-making are explained and illustrated to create the opportunity for insight into how these unconsciously create an unnecessarily conflict-based response. Strategies for shifting perspective are discussed and offered as a route to identifying mutually beneficial outcomes.
Women, Empire, and Entomology: An Object Biography of Eleanor Glanville’s Pipevine Swallowtail, c. 1700
Authors: Pflug Michele D.
Published: March 2024

Today, the gentlewoman Eleanor Glanville (1655–1709) is often remembered as the first lady of British butterflies. In Glanville’s own lifetime, she gained a reputation amongst London naturalists as an astute collector of butterflies from the South West region of England. Yet, a turn towards Glanville’s material archive, namely, her extant specimens held at the Natural History Museum, London, reveals Glanville’s success as a collector of rare butterflies from the Americas and thus, her complicity in colonial collecting. This article provides an object biography of a single pipevine swallowtail or Battus philenor, c. 1700, labeled “Glandvill.” It follows the butterfly specimen from its obscure origins in the Americas, to Glanville’s residence in the Atlantic port city of Bristol, and to London naturalists’ cabinets of curiosities, where it would became part of a collection that helped found the British Museum, the first public museum of its kind. The life cycle of this object attests to the role that empire played in building one woman’s collection of insects and her contributions to the making of present-day museums. It also suggests that while empire opened up opportunities for some women naturalists, it did not necessarily advance their reputations as collectors.
Balancing Ethics and Culture: A Scoping Review of Ethico-Cultural and Implementation Challenges of the Individual-Based Consent Model in African Research
Authors: Appiah Richard , Raviola Giuseppe , Weobong Benedict
Published: March 2024

Objective: This review explores the ethico-cultural and implementation challenges associated with the individual-based informed consent (IC) model in the relatively collectivistic African context and examines suggested approaches to manage them. Methods: We searched four databases for peer-reviewed studies published in English between 2000 to 2023 that examined the ethico-cultural and implementation challenges associated with the IC model in Africa. Results: Findings suggest that the individual-based IC model largely misaligns with certain African social values and ethos and subverts the authority and functions of community gatekeepers. Three recommendations were proffered to manage these challenges, that researchers should: adopt a multi-step approach to IC, conduct a rapid ethical assessment, and generate an African-centered IC model. Conclusions: A pluriversal, context-specific, multi-step IC model that critically harmonizes the cultural values of the local population and the general principles of IC can minimize ethics dumping, safeguard the integrity of the research process, and promote respectful engagement.
The Social Organization of Post-Secondary Music Students’ Work and Health: An Institutional Ethnography Protocol
Authors: Sabo Jeffrey , Oikarinen Mona , Wijsman Suzanne , Peacock David , Visentin Peter , Araújo Liliana S. , Zavitz Kyle , Guptill Christine
Published: March 2024

Researchers have found that many post-secondary music students suffer from physical and mental health issues. However, researchers have mainly studied these problems at the individual level, with little investigation of how music students’ work is shaped by the coordinating effects of policies, texts, and discourses at and beyond their local site. This paper describes a protocol for an international project that will explore the health of music students in the context of their daily work. Using an institutional ethnography approach, we will examine the social organization of music students’ work at three universities: two in Canada and one in Australia. This will be the first set of studies that use institutional ethnography specifically for the purpose of understanding how the social organization of music students’ work shapes their health. Data will be collected using several methods common to institutional ethnography: interviews, focus groups, observations, and collecting texts. Data analysis will begin during the data collection process and proceed in two fluid stages. The first stage will involve a detailed investigation of the pertinent work activities at each music school. The second will involve linking that work to specific social relations within and beyond the institution. After data analysis has been completed at all three sites, findings will be compared to one another to identify commonalities and differences in how students’ work is organized. Findings of the entire project may inform policy-making and lead to positive change at the institutions studied, as well as others where similar social organization may occur. The novel approach described here will provide opportunities to expand current knowledge about music students’ work and health beyond what has been learned through approaches that focus on students’ individual behaviours and attributes.
Comparison of a brand-name drug and its generic drugs - Impact of anti-human immunodeficiency virus drug exposure on the intestinal epithelial barrier
Authors: Takizawa Yusuke , Nagai Yuka , Ishii Miho , Yasunaga Satoshi , Aizawa Yuki , Furuya Takahito , Kurita Takuro , Masuda Junichi , Nakajima Takanori
Published: March 2024

The use of unapproved anti-human immunodeficiency virus (HIV) drugs for its treatment and prevention has recently increased in Japan. Our research group investigated generic drugs of the Truvada combination tablet (TVD) that have not been approved in Japan, and reported differences in the pharmaceutical properties of their formulations. We also demonstrated that the pharmaceutical excipients in generic drugs may differ from those in TVD, and showed that some pharmaceutical excipients may affect epithelial cell barrier function. The present study investigated differences in the effects of TVD and its generic drugs (Generic A and Generic B) on epithelial cell barrier function. No significant differences were observed in epithelial cell barrier function following exposure to TVD, Generic A, and Generic B. However, significant increases in the mRNA levels of ABCB1 and Occludin, which regulate the epithelial cell barrier, were detected following exposure to Generic B. Therefore, the administration of Generic B for a longer duration or at a higher concentration may lead to changes in epithelial barrier function. Since the treatment and prevention of HIV requires the long-term (chronic) administration of drugs, the drugs used may change, such as from a brand-name drug to a generic drug and also from one generic drug to another. The present results suggest that the effects of brand-name and generic drugs, such as on intestinal epithelial barrier function, may differ with changes in the drugs being administered.
The ethically significant difference between dual use and slippery slope arguments, in relation to CRISPR-Cas9: philosophical considerations and ethical challenges
Authors: Kropf Mario
Published: March 2024

Biomedical research, on the one hand, contributes to important goals from generation of knowledge about the human body to the development and testing of therapeutics of all kinds. On the other hand, it can produce serious and sometimes unforeseeable consequences. In the ethical analysis of these two aspects of biomedical research, two important argumentative strategies play a major role. First, slippery slope arguments are used to warn of potential risks and to highlight knowledge-based limitations. Second, a dual-use problem describes the challenge that already established techniques can be used for both morally wrong and morally right purposes. These two argumentative strategies appear to share several similarities, which will be investigated in this article. For this purpose, the article will first provide clear working definitions for both types of argument. This lays the foundation for the further ethical analysis. In a second step, and in order to investigate the similarities and differences of the argumentative strategies with an example from current ethical debates, CRISPR-Cas9, a currently very promising tool of genome editing, will be examined. The extent to which the possible applications of this genome editing tool can be addressed by slippery slope arguments or the dual use problem will be investigated. For this purpose, selected studies involving the use of CRISPR-Cas9 will be examined. Based on this two-step, analytic and example-based comparison of slippery-slope argumentation and dual-use considerations, the article will detail the ethically relevant difference between the two argumentative strategies and at the same time contribute to the ongoing ethical debate about CRISPR-Cas9.
Individual patient data meta-analysis of the effects of fluoxetine on functional outcomes after acute stroke
Authors: Mead Gillian , Graham Catriona , Lundström Erik , Hankey Graeme J , Hackett Maree L , Billot Laurent , Näsman Per , Forbes John , Dennis Martin
Published: March 2024

Background:

Three large randomized controlled trials of fluoxetine for stroke recovery have been performed. We performed an individual patient data meta-analysis (IPDM) on the combined data.

Methods:

Fixed effects meta-analyses were performed on the combined data set, for the primary outcome (modified Rankin scale (mRS) at 6 months), and secondary outcomes common to the individual trials. As a sensitivity analysis, summary statistics from each trial were created and combined.

Findings:

The three trials recruited a combined total of 5907 people (mean age 69.5 years (SD 12.3), 2256 (38%) females, 2–15 days post-stroke) from Australia, New Zealand, United Kingdom, Sweden, and Vietnam; and randomized them to fluoxetine 20 mg daily or matching placebo for 6 months. Data on 5833 (98.75%) were available at 6 months. The adjusted ordinal comparison of mRS was similar in the two groups (common OR 0.96, 95% CI 0.87 to 1.05, p = 0.37). There were no statistically significant interactions between the minimization variables (baseline probability of being alive and independent at 6 months, time to treatment, motor deficit, or aphasia) and pre-specified subgroups (including age, pathological type, inability to assess mood, proxy or patient consent, baseline depression, country). Fluoxetine increased seizure risk (2.64% vs 1.8%, p = 0.03), falls with injury (6.26% vs 4.51%, p = 0.03), fractures (3.15% vs 1.39%, p < 0.0001) and hyponatremia (1.22% vs 0.61%, p = 0.01) but reduced new depression (10.05% vs 13.42%, p < 0.0001). At 12 months, there was no difference in adjusted mRS (n = 5760; common OR 0.98, 95% CI 0.89 to 1.07). Sensitivity analyses gave the same results.

Interpretation:

Fluoxetine 20 mg daily for 6 months did not improve functional recovery. It increased seizures, falls with injury, and bone fractures but reduced depression frequency at 6 months.
Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists
Authors: Newington Lisa , Ceh Daniel , Sandford Fiona , Parsons Vaughan , Madan Ira
Published: March 2024

Introduction

Musculoskeletal disorders affect over a third of the UK adult population and are a common reason for sick leave from work. The aims of this study were to describe the reported provision of work participation support for adults with hand and upper limb conditions by UK hand therapists, and to identify potential training needs in this area.

Methods

A previous survey of the Australian Hand Therapy Association was adapted for the UK. The electronic questionnaire was distributed to members of the British Association of Hand Therapists. Eligible individuals were UK-based occupational therapists or physiotherapists whose role included the assessment and/or treatment of patients ≥18 years with hand or upper limb issues.

Results

There were 123 participants (17% response rate). The most frequently reported work participation interventions were discussing graded return to work and sign-posting patients to speak with their doctor. The Allied Health Professionals Health and Work Report and Fit Note were not regularly used, and respondents reported low levels of confidence in issuing these documents. Barriers to providing work recommendations included a perceived lack of time, skills, knowledge and training. Facilitators included the patient discussing work as a rehabilitation goal.

Conclusion

Development opportunities for UK hand therapists include increasing patient awareness that they can ask for work-related advice and documentation, promoting existing health and work training, developing hand therapy-specific resources, and ensuring access to electronic Fit Notes. International opportunities include the continuation of this survey with a focus on generating exemplar work participation strategies to inform further research.
Use of family planning information by primary healthcare clinic managers in South Africa
Authors: Moloko Sophy Mogatlogedi , Ramukumba Mokholelana Margaret
Published: March 2024

Background:

Routine family planning data in South Africa are managed using a routine health information system, which facilitates data collection, storage, processing, presentation and dissemination. Healthcare providers generate data daily as they carry out their duties. The information generated should be used for planning and evaluating health program performance and policy development.

Objective:

To explore the use of family planning information by primary healthcare (PHC) clinic managers in South Africa.

Method:

A qualitative descriptive exploratory study was carried out in 11 PHC clinics in Tshwane District. Individual semi-structured interviews were conducted with 11 clinic managers. The data were analysed using a thematic analysis approach.

Results:

Managers used the information to disseminate performance and feedback, monitor the program’s performance and make decisions to improve the family planning service. However, they experienced challenges that hampered the effective use of the information.

Conclusion:

The use of family planning information is critical for improving the performance of the program. The clinics need sufficient skilled healthcare providers who are able to provide comprehensive family planning and generate accurate and reliable information that can be used to improve the service. Collaboration between the private and public sectors is critical in monitoring the program’s performance.
Surgical treatment for congenital vertebral anomalies with bilateral bifid intrathoracic rib in association: A series of five cases
Authors: Zhang Hanwen , Zhu Lining , Jiao Jiahao , Guo Dong , Zhang Xuejun , Yao Ziming
Published: March 2024

Background:

Congenital scoliosis is often associated with costal deformities, of which a bilateral bifid intrathoracic rib is very rare. The aim of this study was to retrospectively summarize the clinical manifestations, imaging characteristics, treatment strategies, and postoperative outcomes of five patients with bilateral bifid intrathoracic rib.

Methods:

We retrospectively reviewed the imaging findings and medical records of five pediatric patients (two girls, three boys) with bilateral bifid intrathoracic rib who were surgically treated for congenital kyphoscoliosis (mean age = 8 years). The clinical manifestations, imaging characteristics, treatment strategies, and postoperative outcome were summarized.

Results:

Four of five patients showed abnormalities from birth. All five patients presented with kyphoscoliosis and a fused vertebral body or lamina. The bilateral bifid intrathoracic rib was located at T2–3 in three patients, T7 in one patient, and T10 in one patient. Various congenital spinal deformities and multiple system malformations were present in all five patients. Three patients had preoperative neurological deficits. For corrective surgery, one patient received a traditional growing rod implantation, one patient underwent resection of a bony septum, and three patients underwent spinal osteotomy. One patient suffered complete paralysis of the lower limbs after surgery.

Conclusion:

Bilateral bifid intrathoracic rib is a rare anomaly that typically occurs in patients with serious kyphoscoliosis. Bilateral bifid intrathoracic rib patients show similar clinical and radiological characteristics and are likely to exhibit neurological deficits before or following corrective surgery. Spinal surgeons should be aware of the high risk of permanent neurological complications related to surgery in these patients.

Level of evidence:

level IV.