bluuebunny/crossref_metadata_2025 huggingface dataset:
Coping During the COVID-19 Pandemic: A Qualitative Study of Healthcare Workers in Saudi Arabia
Authors: Alshagrawi Salah
Published: July 2023

The COVID-19 pandemic has had a substantial global impact, attributable to its extensive prevalence, transmission, and consequential morbidity and mortality rates. Healthcare workers (HCWs), in particular, have faced difficult pandemic-related circumstances during and after the COVID-19 pandemic, including a rise in mortality, increased workloads and job hours, insufficient equipment, supplies, and resources, and concern about acquiring and/or transferring COVID-19 to loved ones. This type of exposure increased the risk of negative psychological outcomes such as acute stress, depression, sleep difficulties, insomnia, moral injury, burnout, post-traumatic stress disorder, depression, and anxiety. Using a qualitative research design, the purpose of this research is to gain insight into the coping mechanisms employed by HCWs in Saudi Arabia amidst the COVID-19 pandemic. The results of the thematic analysis indicated that a majority of the participants demonstrated the ability to determine and employ diverse coping mechanisms in response to the stress and anxiety arising from the COVID-19 pandemic. HCWs encountered difficulties in implementing their typical coping mechanisms amidst the pandemic, due to a range of obstacles. However, HCWs employed a variety of coping strategies, both internal and external, that were influenced by contextual variables such as self-care, self-control, internal motivation, social support, social media, and organizational climate to enhance their resilience and coping strategies. The study findings offer insight into the types of assistance and provisions that can be implemented at both the personal and institutional levels to prepare HCWs to manage heightened levels of stress, with the ultimate aim of enhancing their psychological health and overall wellness.
Cases of Mixed Schwannoma–Meningioma With and Without Neurofibromatosis 2 with Emphasis on Tumorigenesis
Authors: Rajeswarie Rangasamy Thiruvengadam , Mallik Dattatraya , Rudrappa Satish , Gopal Swaroop
Published: July 2023

Concurrent occurrence of schwannoma and meningiomas are rare, and are found especially in association with neurofibromatosis type 2 (NF2). Occurrence of mixed tumor without the aforementioned conditions is extremely rare. We present three cases of mixed tumor in different locations, including two with NF2 and one without NF2. We analyse the relationship of mixed tumor with NF2 and its clinical implications. Presence of mixed schwannoma–meningioma should prompt screening for NF2. Thus aids in early diagnosis of unsuspected NF2 cases. We observed that irrespective of different locations, cases with NF2 showed frequent recurrence of schwannoma as compared to case who did not fit in the existing clinical criteria for NF2. Collision tumor and thereby NF2 mutations indicates the prognosis and recurrence of the tumor, thereby guides in deciding the management.
The Diagnostic Value of the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Deep Venous Thrombosis: A Systematic Review and Meta-Analysis
Authors: Hu Chenming , Zhao Bin , Ye Qianling , Zou Jun , Li Xiang , Wu Huaping
Published: July 2023

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging tools that can be used in the diagnosis of deep venous thrombosis (DVT). This study aims to evaluate the diagnostic value of NLR and PLR for patients with DVT. Our meta-analysis included 11 eligible studies and extracted relevant diagnostic indicators. Of these studies, 4 focused on the NLR, 1 on the PLR, while 6 evaluated both. For the 10 studies on NLR, the pooled sensitivity, specificity, positive-likelihood ratio, and negative-likelihood ratio were 74%, 66%, 2.16, and 0.4, respectively. The estimated diagnostic odds ratio (DOR) was 5.3, and the area under the curve (AUC) of the summary receiver operating characteristic (SROC) curves was 0.74. For the 7 studies on the PLR, the pooled sensitivity, specificity, positive-likelihood ratio, and negative-likelihood ratio were 0.65, 0.77, 2.89, and 0.45, respectively. The estimated DOR was 6.64, and the SROC-AUC was 0.79. Our findings showed that the NLR and PLR exhibit moderate diagnostic accuracy and may be helpful biomarkers for the diagnosis of DVT. Future prospective, well-designed studies with large sample sizes will be required to provide additional evidence to establish cutoff values and clinical value of these indicators.
Analysis of risk factors for abdominal aortic calcification in dialysis patients and its influence on long-term recovery
Authors: Cao Qianying , Yang Fan , Lian Xiaoying , Li Xiangnan , Li Zhongxin
Published: July 2023

This study investigated the risk factors of abdominal aortic calcification (AAC) in patients with stage 5 chronic kidney disease (CKD) and the effects of AAC and different dialysis methods on the 3-year survival rate of patients with stage 5 CKD. A retrospective cohort study was conducted on stage 5 CKD patients who received dialysis treatment. The general data were collected, and all fasting venous blood samples were harvested before the first dialysis to detect biochemical markers. The AAC was evaluated by lateral abdominal X-ray. The patients were followed up with a cut-off date of March 31, 2022, with all-cause mortality as the endpoint event. A total of 205 patients were included. multivariable Cox regression analysis confirmed that AAC (hazard ratio (HR) = 2.173, 95% CI 1.029–4.588, p = 0.042), advanced age (HR = 1.061, 95% CI 1.031–1.093, p < 0.001), duration of dialysis (HR = 1.015, 95% CI 1.007–1.032, p < 0.001), diabetes (HR = 3.966, 95% CI 2.164–7.269, p < 0.001), and hypertension (HR = 1.897, 95% CI 1.089–3.303, p = 0.024) were independent risk factors for 3-year mortality. However, peritoneal dialysis (HR = 0.366, 95% CI 0.165–0.812, p = 0.013), high albumin (HR = 0.882, 95% CI 0.819–0.950, p = 0.001), and high hemoglobin (HR = 0.969, 95% CI 0.942–0.997, p = 0.031) were protective factors for 3-year mortality in stage 5 CKD patients. Increased age, long-term dialysis, high level of intact parathyroid hormone, diabetes, and hypertension are closely related to the occurrence of AAC in patients with stage 5 CKD. In addition, AAC is an independent risk factor for all-cause mortality in patients with stage 5 CKD.
Tele-orthodontics education model for orthodontic residents: A preliminary study
Authors: Masood Hayat , Rossouw Paul E , Barmak Abdul B , Malik Shaima
Published: July 2023

Objectives

Tele-orthodontics is an important medium to use for diagnosis and treatment planning and to refer patients for specific treatment when deemed necessary. The effectiveness of the Tele-orthodontics Education Model serves to improve resident's knowledge, confidence, and skills in delivering tele-orthodontic patient care. The purpose of this educational single-arm pre-test–post-test interventional study was to assess and educate orthodontic residents (6 year-one, and 6 year-two) to appropriately use tele-orthodontics.

Methods

The Tele-orthodontics Education Model utilizes three learning modules, a questionnaire before and after the training to assess participant knowledge, confidence and skills levels, three online multiple-choice questionnaires, three explanatory videos and an in-person simulation session. The Blackboard Learning Management System (virtual learning platform) facilitates access to the various modules of the program. Within each learning module, a participant's knowledge level was determined by utilizing five multiple-choice questions before and after each module. The various modules were introduced to the participants and then evaluated by reviewing the participant's responses to the multiple-choice questions.

Results

Twelve orthodontic residents completed the model in one session. Everyone fully completed the questionnaire. Post-test results showed higher mean scores for all questions addresses knowledge, the mean confidence, and skills score for post-test showed no change when compared to pre-test.

Conclusions

This education model was effective in improving basic knowledge in tele-orthodontics among first, and second-year orthodontic residents. We hypothesize that the residents are more informed and prepared for future tele-orthodontic practices.
Disrupting Cisheteropatriarchy in Society and the Workplace: The Role of HRD Education
Authors: Mauldin Sage A.
Published: July 2023

In recent years, there has been a surge of anti-LGBTQ+ laws in the United States. These laws undoubtedly reinforce cisheteropatriarchal ideologies that heterosexuality and gender conformity are the only acceptable ways of being, while other forms of sexuality and gender identity are unnatural, immoral, and deserve punishment. Given that the workplace, mirroring the broader society, exhibits the prejudices and preconceptions that are ingrained in our cultural milieu, it is incumbent upon human resource development (HRD) education to expose students to the ways in which cisheteropatriarchy structures workplaces so, as HRD practitioners, they can work towards disrupting it.
Sensitivity to Change and Responsiveness of the Upper Extremity Fugl-Meyer Assessment in Individuals With Moderate to Severe Acute Stroke
Authors: Huynh Baothy P. , DiCarlo Julie A. , Vora Isha , Ranford Jessica , Gochyyev Perman , Lin David J. , Kimberley Teresa J.
Published: July 2023

Background

The Fugl-Meyer Assessment-Upper Extremity (FMA-UE) is a widely used outcome measure for quantifying motor impairment in stroke recovery. Meaningful change (responsiveness) in the acute to subacute phase of stroke recovery has not been determined.

Objective

Determine responsiveness and sensitivity to change of the FMA-UE from 1-week to 6-weeks (subacute) after stroke in individuals with moderate to severe arm impairment who received standard clinical care.

Methods

A total of 51 participants with resulting moderate and severe UE hemiparesis after stroke had FMA-UE assessment at baseline (within 2 weeks of stroke) and 6-weeks later. Sensitivity to change was assessed using Glass’s delta, standardized response means (SRM), standard error of measure (SEM), and minimal detectable change (MDC). Responsiveness was assessed with the minimal clinically important difference (MCID), estimated using receiver operating characteristic curve analysis with patient-reported global rating of change scales (GROC) and a provider-reported modified Rankin Scale (mRS) as anchors.

Results

The MCID estimates were 13, 12, and 9 anchored to the GROC Arm Weakness, GROC Recovery, and mRS. Glass’s delta and the SRM revealed large effect sizes, indicating high sensitivity to change, (∆ = 1.24, 95% CI [0.64, 1.82], SRM = 1.10). Results for the SEM and MDC were 2.46 and 6.82, respectively.

Conclusion

The estimated MCID for the FMA-UE for individuals with moderate to severe motor impairment from 1 to 6-weeks after stroke is 13. These estimates will provide clinical context for FMA-UE change scores by helping to identify the change in upper-extremity motor impairment that is both beyond measurement error and clinically meaningful.
“A Legend From Before You Were Born”: Final Fantasy VII, Folklore, and Popular Culture
Authors: Bukač Zlatko , Katić Mario
Published: July 2023

In this article, we focus on the folklore created by the players and communities of the critically acclaimed and popular Japanese role-playing game Final Fantasy VII (Square Enix, 1997). The formation of what we call Final Fantasy VII fan folklore is presented here as a mixture of the game's transmediality (with official walkthroughs and guidebooks) and elements of the game kept secret by the developers (as well as several false rumors), which were carefully discovered and circulated by the players through an oral tradition (offline and later online) that circulate to this day. By conducting a narrative analysis of the official commercial for Final Fantasy VII Remake (Square Enix, 2020), we argue that the creation of Final Fantasy VII fan folklore has become an important contemporary experiential feature of a nostalgic turn in the gaming industry, and we show that remakes and new editions of older popular products rely heavily on the specific new form of folklore that goes beyond one game.
Dupuytren Disease Surgical Treatment: A Randomized Clinical Trial Comparing Partial Fasciectomy by Bruner Approach Versus Zetaplasty
Authors: Leão Renan G. , de Moraes Vinicius Y. , Nakachima Luis R. , Belloti João C. , Santos João B. G.
Published: July 2023

Background:

Dupuytren is a fibroproliferative pathology leading to contracture of the palmar fascia. Several approaches have been described for the surgical treatment with partial fasciectomy with few comparisons in literature. Our purpose is to compare the functional outcomes between the partial fasciectomy performed by Bruner type incision and zetaplasty incision.

Methods:

The method used was a randomized clinical trial including adult patients of both sexes with surgical indication for Dupuytren disease presented to a reference center. Patients were randomly and consecutively allocated in the groups 1:1. We recorded the Disabilities of the Arm, Shoulder, and Hand (DASH) score; range of motion for active and passive extension of the metacarpophalangeal (MP) and proximal interphalangeal (PIP) joints; visual analog scale for pain; and complications.

Results:

In all, 62 patients were included, with 48 patients reaching the minimum follow-up of 6 months with 63 operated fingers. In the Bruner approach group, we obtained a correction of the active and passive extension of the MP of 28° and of the PIP of 23°. In the zetaplasty group, correction of MP was 30° for active and passive, and 18° for active extension and 16° for passive extension of the PIP. The reduction in the DASH score was 10 points in the Bruner group and 22 points in the zetaplasty group. There was no statistically significant effect of the type of treatment on preoperative and postoperative differences in any of the parameters evaluated.

Conclusions:

There were no statistically significant differences between the 2 techniques for self-reported functional outcomes or objective measures of physical examination.
Randomized controlled dose-escalation design to evaluate the safety of a novel pharmacological cardiopulmonary resuscitation strategy
Authors: Benson Sydney , Yannopoulos Demetri , Aufderheide Tom P , Murray Thomas A
Published: July 2023

Background/aims

The motivating randomized controlled phase I trial evaluates three sodium nitroprusside doses in a novel sodium nitroprusside-enhanced cardiopulmonary resuscitation strategy for improved end-organ perfusion relative to local standard of care. Sodium nitroprusside is a vasodilator with an established safety profile in other indications, whereas the local standard of care uses vasoconstrictors, typically epinephrine. The purpose of the proposed trial is to identify the highest safe dose of sodium nitroprusside in this new context as excessive doses may cause severe hypotension with compromised end-organ perfusion.

Methods

The proposed phase I trial design expands upon traditional dose-finding designs to include a randomized control arm, which is needed to assess safety through the relative increase in serum lactate on hospital admission. For guiding dose escalation, we propose and compare six Bayesian models which characterize expected serum lactate as a function of sodium nitroprusside dose and randomization group. Each model makes a different assumption about the expected change in serum lactate across control cohorts concurrently randomized with each dose. Model selection aims to minimize the expected number of times that a dose is incorrectly classified as safe or unsafe while sample size selection targets an expected number of incorrectly classified doses. Randomization is 1:1 for the initial cohort, and for subsequent cohorts is chosen to maximize the lower confidence bound.

Results

The spike-and-slab model minimizes the expected number of times that a dose is incorrectly classified as safe or unsafe under the most scenarios in the motivating three-dose trial, but all six models exhibit relatively similar performance. A 2:1 randomization ratio for the second and third cohorts maximizes the lower confidence bound when using the spike-and-slab model. With the optimal design, on average, 70 individuals will ensure 1 incorrectly classified dose in 6 opportunities.

Conclusion

We recommend that the motivating trial use the spike-and-slab model with a 1:1 randomization ratio for the initial cohort and 2:1 randomization ratio for subsequent cohorts; however, the simpler fixed effects approaches performed similarly well.
Modifiable vascular risk factors contribute to stroke in 1080 NOTCH3 R544C carriers in Taiwan Biobank
Authors: Lin Hung-Jen , Chen Chih-Hao , Su Ming-Wei , Lin Chien-Wei , Cheng Yu-Wen , Tang Sung-Chun , Jeng Jiann-Shing
Published: July 2023

Background and aim:

Previous studies have suggested cardiovascular risk factors increase the risk of not only common sporadic stroke but also of stroke in patients with monogenic stroke disorders including CADASIL. We investigated the effects of the NOTCH3 Arg544Cys (R544C) variant and associated vascular risk factors on stroke in the Taiwanese population.

Methods:

This study was conducted using data from the Taiwan Biobank, consisting of at least 130,000 Han Chinese participants. The genotype was derived from customized genome-wide arrays for 650,000 to 750,000 single-nucleotide polymorphisms (SNPs). Individuals with NOTCH3 R544C were subsequently matched with noncarriers based on the propensity score at a 1:10 ratio by demographic and cardiovascular risk factors. The odds ratio (OR) for stroke or other phenotypes in NOTCH3 R544C carriers and matched noncarriers was then calculated. Univariate and multivariate regression analyses were performed on cardiovascular risk factors in NOTCH3 R544C carriers with and without stroke. The polygenic risk score (PRS) model, adopted from the UK Biobank, was then applied to evaluate the role of NOTCH3 R544C in stroke.

Results:

From the 114,282 participants with both genotype and questionnaire results, 1080 (0.95%) harbored the pathogenic NOTCH3 R544C variant. When compared to the matched controls ( n = 10,800), the carriers presented with a history of stroke (OR: 2.52, 95% confidence interval (CI) (1.45, 4.37)), dementia (OR: 30.1, 95% CI (3.13, 289.43)), and sibling history of stroke (OR: 2.48, 95% CI (1.85, 3.34)) phenotypes. The risk of stroke increased with every 10-year increase in age ( p = 0.006, Cochran–Mantel–Haenszel test). Among NOTCH3 R544C carriers, 16 (1.3%) of the 1080 carriers with a stroke history were older, male, and more likely to have hypertension, diabetes, dyslipidemia, and a family history of stroke. In the stepwise multivariate analysis, hypertension (OR: 11.28, 95% CI (3.54, 43.3)) and diabetes mellitus (OR: 4.10, 95% CI (1.31, 12.4)) were independently associated with stroke. Harboring the NOTCH3 R544C variant in the Taiwan Biobank is comparable with a 6.74 standard deviations increase in individual’s polygenic risk score for stroke.

Conclusion:

While the NOTCH3 R544C variant alone increased the risk of stroke, modifiable vascular risk factors also played a role in the occurrence of stroke in Taiwanese community-dwelling individuals carrying the NOTCH3 variant.
Neuroimaging correlates of post-stroke fatigue: A systematic review and meta-analysis
Authors: Jolly Amy A , Zainurin Adriana , Mead Gillian , Markus Hugh S
Published: July 2023

Background:

Fatigue is a common and disabling symptom following stroke, but its underlying mechanisms are unknown. Associations with a number of imaging features have been proposed.

Aims:

We aimed to assess whether neuroimaging parameters could better inform our understanding of possible causes of post-stroke fatigue (PSF) through systematic review and meta-analysis.

Methods:

Using a predefined protocol registered with PROSPERO (ID: CRD42022303168), we searched EMBASE, MEDLINE, PubMed, and PsycInfo for studies assessing PSF and computerized tomography (CT), magnetic resonance (MR), positron emission tomography (PET) imaging, or diffusion tensor imaging (DTI). We extracted neuroimaging parameters and narratively analyzed study results to assess any association with PSF. Where there were 3+ similar studies, we carried out a meta-analysis using inverse-variance random-effects model to estimate the total association of each neuroimaging parameter on PSF. The risk of bias was assessed using the Newcastle and Ottawa Scale.

Results:

We identified 46 studies ( N = 6543); in many studies, associations with fatigue were secondary or subanalyses (28.3%). Imaging parameters were assessed across eight variables: lesion lateralization, lesion location, lesion volume, brain atrophy, infarct number, cerebral microbleeds, white matter hyperintensities (WMHs), and network measures. Most variables showed no conclusive evidence for any association with fatigue. Meta-analysis, where possible, showed no association of the following with PSF; left lesion lateralization (OR: 0.88, 95% CI (0.64, 1. 22) ( p  = 0.45)), infratentorial lesion location (OR: 1.83, 95% CI (0.63, 5.32) ( p  = 0.27)), and WMH (OR: 1.21, 95% CI (0.84, 1.75) ( p  = 0.29)). Many studies assessed lesion location with mixed findings; only one used voxel-symptom lesion-mapping (VSLM). Some small studies suggested an association between altered functional brain networks, namely frontal, fronto-striato-thalamic, and sensory processing networks, with PSF.

Conclusion:

There was little evidence for the association between any neuroimaging parameters and PSF. Future studies should utilize advanced imaging techniques to fully understand the role of lesion location in PSF, while the role of altered brain networks in mediating PSF merits further research.
From (Apt) Contempt to (Legal) Dishonor: Two Kinds of Contempt and the Penalty ofAtimia
Authors: Rocchi Linda
Published: July 2023

That contempt and dishonor are closely related has been shown not only in recent discussions of the subject, but also in Aristotle's investigation of emotions in the judiciary. In this paper, I will discuss the ways in which the ancient Greeks—and, in particular, the polis of Athens—institutionalized what Bell calls “apt contempt” (i.e., contempt as a response to actual and serious faults of character which stems from the contemnor's concern for the values at stake) through the legal penalty of atimia (“dishonor”). Not only does Athenian evidence prove Bell's point that contempt can be “apt”—it also represents an early case study of a community that formalized such “apt” contempt in law and in the formal enactment of collectively approved social norms. And yet, the Greeks were also aware of the potential ambivalence of notions such as “contempt” and “dishonor.” This ambivalence is likely to have been one of the factors that catalyzed a differentiation, within the semantic field of atimia, between “dishonoring” ( atiman/ atimoun) and “disrespecting” ( atimazein)—between “apt” and “inapt” contempt.
Development of pediatric acute care education (PACE): An adaptive electronic learning (e-learning) environment for healthcare providers in Tanzania
Authors: Meaney Peter Andrew , Hokororo Adolfine , Masenge Theopista , Mwanga Joseph , Kalabamu Florence Salvatory , Berg Marc , Rozenfeld Boris , Smith Zachary , Chami Neema , Mkopi Namala , Mwanga Castory , Agweyu Ambrose
Published: July 2023

Globally, inadequate healthcare provider (HCP) proficiency with evidence-based guidelines contributes to millions of newborn, infant, and child deaths each year. HCP guideline proficiency would improve patient outcomes. Conventional (in person) HCP in-service education is limited in 4 ways: reach, scalability, adaptability, and the ability to contextualize. Adaptive e-learning environments (AEE), a subdomain of e-learning, incorporate artificial intelligence technology to create a unique cognitive model of each HCP to improve education effectiveness. AEEs that use existing internet access and personal mobile devices may overcome limits of conventional education. This paper provides an overview of the development of our AEE HCP in-service education, Pediatric Acute Care Education (PACE). PACE uses an innovative approach to address HCPs’ proficiency in evidence-based guidelines for care of newborns, infants, and children. PACE is novel in 2 ways: 1) its patient-centric approach using clinical audit data or frontline provider input to determine content and 2) its ability to incorporate refresher learning over time to solidify knowledge gains. We describe PACE's integration into the Pediatric Association of Tanzania's (PAT) Clinical Learning Network (CLN), a multifaceted intervention to improve facility-based care along a single referral chain. Using principles of co-design, stakeholder meetings modified PACE's characteristics and optimized integration with CLN. We plan to use three-phase, mixed-methods, implementation process. Phase I will examine the feasibility of PACE and refine its components and protocol. Lessons gained from this initial phase will guide the design of Phase II proof of concept studies which will generate insights into the appropriate empirical framework for (Phase III) implementation at scale to examine effectiveness.
Debating the “Chineseness” of a mobile game in online communities
Authors: Li Qian , Li Xiaotian
Published: July 2023

After its global popularity and commercial success, Genshin Impact, a Chinese-developed, Japanese anime-style mobile game, provokes online discussions on whether such a game of cultural hybridity exemplifies “authentic Chineseness.” Based on online ethnography in the fan communities, this article investigates a two-year debate on whether GI should be considered a symbol of China’s “cultural export” to other countries. It reveals that players construct multiple meanings of authentic Chineseness, including GI’s integration of Chinese cultural elements, telling “the China story,” and its patriotism and “political correctness” in China. This article contributes to the project of de-westernizing cultural studies by revealing how the meanings of cultural authenticity are constructed in a Global South context. Moreover, players situate “Chineseness” in the power relations among China, Japan, and the West, and associate cultural appropriation in the increasing hybridization process with global soft power competition. It reveals that the construction of cultural authenticity as a relational concept is shaped by others defined in a contingent, contextual, and multilateral way, and that the construction process is conditioned by domestic and international power relations, thus contributing to the project of going beyond dichotomous thinking in cultural studies.
Generating metainferences in mixed methods research: A worked example in convergent mixed methods designs
Authors: Younas Ahtisham , Fàbregues Sergi , Creswell John W
Published: July 2023

Metainferences, or the insights derived from integrating quantitative and qualitative inferences at the end of a study, are crucial for achieving added value and synergy in mixed methods research. There is an ongoing need to understand how researchers generate metainferences, especially considering their pivotal role in helping researchers achieve full quantitative and qualitative integration. While some examples of metainferences generation are available in the mixed methods literature, more explicit guidance is required. Approaches to developing metainferences must also be contextual, as inferences of this type are contingent on the nature and purpose of the mixed methods study, the type of mixed methods design, and the quality of the research data. This paper describes a seven-step process for generating metainferences using a convergent mixed methods study as an exemplar. These steps consist of identifying knowledge, experience, and data-driven inferences from the quantitative and qualitative data; developing inference association maps to draw metainferences; and assessing the validity of metainferences using backward working heuristics. This paper contributes to mixed methods research by shedding light on the development of metainferences in convergent designs and by providing practical and tangible tools for making sense of the complexity of the analysis and interpretation tasks involved in the process of generating metainferences.
Examining the Mental Health Care Needs and Outcomes of Young People Transitioning from Out-of-Home Care (OOHC) in Australia
Authors: Mendes Philip , Chaffey Eswen
Published: July 2023

Young people transitioning from out-of-home care (OOHC), often called care leavers, are known to experience mental health challenges. This article presents a scoping review of research studies completed on the mental health care needs and outcomes of care leavers in Australia from 2015 to 2021. Incorporating 17 studies consisting of six peer-reviewed papers and 11 grey literature reports, the review identified several common concerns pertaining to high levels of poor mental health and psychosocial complexity. These concerns were attributed to a number of factors including placement instability, inadequate access to specialist mental health support services, and limited workforce skills and training. Some sub-groups of care leavers such as young parents, those leaving residential care, Aboriginal and Torres Strait Islander care leavers, and an older cohort who had experience of institutional OOHC in earlier decades, were noted to be at particular risk. Nevertheless, some strategies for improving policy and practice were highlighted including more concrete transition planning that established links with support services prior to leaving care, an extension of OOHC till at least 21 years of age, provision of further supports such as trauma-informed approaches targeted towards the specific needs of this vulnerable population and culturally responsive programs for Indigenous youth. A limitation of the review was that most studies included were completed before the introduction of extended OOHC in all Australian jurisdictions, and hence do not reflect the positive influence of extended care on transition pathways including mental health. Future research should specifically examine the impact of extended care models on mental health care needs and outcomes.
The Next Step: Current Sexual Lifestyles and Future Intentions
Authors: Schweers Jennifer
Published: July 2023

Using data from a nationally representative survey of sexual behavior in the United Kingdom, this visualization shows participants’ current sexual lifestyles and their ideal lifestyles five years from now. It demonstrates strong preferences for relationship progression toward cohabitation, marriage, and monogamy. Only a small minority of participants express a long-term preference for casual relationships, no sexual relationship, or any nonmonogamous lifestyle. Of currently nonmonogamous participants, a majority indicate a preference for a monogamous future, although a significant minority of nonmonogamous participants who are cohabiting or married wish to keep their lifestyles in five years’ time.
Ill-Fitting Dental Appliances and Oral Cancer: A Systematic Review and Case Report
Authors: Yusuf Cynthia T. , Heron Matthew J. , Girard Alisa O. , Zhu Katherine J. , Lopez Christopher D. , Yang Robin
Published: July 2023

Background:

Associations between the use of dental appliances and oral cancer remain controversial. No studies have reported a relationship between dental appliances in the setting of cleft palate management and oral cancer. This study characterizes the correlation between dental appliances and oral cancer and includes a case report of a patient with a history of cleft palate repair who later developed oral squamous cell carcinoma (OSCC).

Methods:

We performed a systematic review for studies from 1980 to 2022 of patients who had dental prostheses and who were subsequently diagnosed with OSCC. Variables included the percentage of OSCC cases wearing dental appliances, intraoral cancer location, and noted associations between reported risk factors and OSCC.

Results:

Of the 6323 patients from the 31 articles analyzed, the most common specified locations for the neoplastic lesion were at the gingiva and lateral border of the tongue. Seventeen studies found an association between OSCC and denture use (54.8%), while 9 studies (29.0%) specifically found a positive association between oral sores and OSCC. Our case patient had complete dental extraction at the age of 12 with subsequent life-long dentures. At age 69, he presented with invasive OSCC.

Conclusions:

Chronic irritation from ill-fitted dental appliances are associated with oral sores and cancer. This study reports a cleft palate repair patient with lifelong use of dentures who presented with OSCC despite having no known risk factors for oral cancer.
The attributes senior high school mathematics teachers and their students value in mathematics learning
Authors: Davis Ernest Kofi , Abass Amidu Tikiwi
Published: July 2023

Valuing in mathematics is one of the areas in mathematics education that has attracted the attention of mathematics education researchers in recent times. While efforts have been made to research the attributes students value in their mathematics learning, the same cannot be said about attributes teachers and their students value in mathematics learning, and value alignment in mathematics learning between teachers and students. This paper reports on a study that sought to explore what teachers and their students value and the alignment between attributes teachers and their students value in learners’ mathematics learning. A survey of what students and their teachers value in learners’ mathematics learning was conducted with 690 senior high school students and 66 teachers from nine schools, using adapted What I Find Important in my mathematics learning questionnaires. A multistage sampling procedure involving the use of stratified random sampling and purposive sampling procedures was used to select the research participants. The data obtained from the study were then analysed, using frequency counts, mean and standard deviation and principal component analysis. The results from the study revealed that the senior high school mathematics teachers valued Authority, Engagement, Strategy and Communication in students’ mathematics learning, while the students valued Authority, Relevance, Understanding, Engagement, Strategies, ICT and Achievement in their own mathematics learning; an indication of a gap in valuing among the two groups of research participants. Implications of the findings for mathematics teaching and learning as well as in-service and pre-service education programmes are provided.
Learning Wagogo (Nindo) Music: Pathway Through World Music Pedagogy
Authors: Mapana Kedmon , Campbell Patricia Shehan
Published: July 2023

In East Africa, Tanzania’s musical expressions are rich and varied, and typically a combination of music and dance. A description of Nindo, a multipart vocal music form of the central Tanzanian Wagogo community, is provided, and a tribute is offered to the legacy of an important village artist, Mchoya, of the musical form that is begin continued by his progeny. A learning pathway, following the dimensions of World Music Pedagogy, is outlined for experiencing Nindo, and resources and references are recommended for teachers to facilitate listening, viewing, singing and dancing, and developing intercultural understanding.
A comprehensive analysis of adverse events in the first 30 days of phase 1 pediatric CAR T-cell trials
Authors: Silbert Sara K. , Madan Sanna , Holland Elizabeth M. , Steinberg Seth M. , Little Lauren , Foley Toni , Epstein Monica , Sarkisian Angela , Lee Daniel W. , Nikitina Ekaterina , Kakumanu Showri , Ruppin Eytan , Shalabi Haneen , Yates Bonnie , Shah Nirali N.
Published: July 2023

The tremendous success of chimeric antigen receptor (CAR) T cells in children and young adults (CAYAs) with relapsed/refractory B-cell acute lymphoblastic leukemia is tempered by toxicities such as cytokine release syndrome (CRS). Despite expansive information about CRS, profiling of specific end-organ toxicities secondary to CAR T-cell therapy in CAYAs is limited. This retrospective, single-center study sought to characterize end-organ specific adverse events (AEs) experienced by CAYAs during the first 30 days after CAR T-cell infusion. AEs graded using Common Terminology Criteria for Adverse Events were retrospectively analyzed for 134 patients enrolled in 1 of 3 phase 1 CAR T-cell trials (NCT01593696, NCT02315612, and NCT03448393), targeting CD19 and/or CD22. A total of 133 patients (99.3%) experienced at least 1 grade ≥3 (≥Gr3) AE across 17 organ systems, of which 75 (4.4%) were considered dose- or treatment-limiting toxicities. Excluding cytopenias, 109 patients (81.3%) experienced a median of 3 ≥Gr3 noncytopenia (NC) AEs. The incidence of ≥Gr3 NC AEs was associated with the development and severity of CRS as well as preinfusion disease burden (≥ 25% marrow blasts). Although those with complete remission trended toward experiencing more ≥Gr3 NC AEs than nonresponders (median, 4 vs 3), nonresponders experiencing CRS (n = 17; 37.8%) had the highest degree of NC AEs across all patients (median, 7 vs 4 in responders experiencing CRS). Greater understanding of these toxicities and the ability to predict which patients may experience more toxicities is critical as the array of CAR T-cell therapies expand. This retrospective study was registered at www.clinicaltrials.gov as NCT03827343.
Respiratory infections predominate after day 100 following B-cell maturation antigen–directed CAR T-cell therapy
Authors: Little Jessica S. , Tandon Megha , Hong Joseph Seungpyo , Nadeem Omar , Sperling Adam S. , Raje Noopur , Munshi Nikhil , Frigault Matthew , Barmettler Sara , Hammond Sarah P.
Published: July 2023

Infections are an important complication after B-cell maturation antigen (BCMA)–directed chimeric antigen receptor (CAR) T-cell therapy and risks may differ between the early and late periods. We evaluated infections in 99 adults who received a first BCMA–directed CAR T-cell therapy (commercial and investigational autologous BCMA CAR T-cell products at the recommended phase 2 dose) for relapsed/refractory multiple myeloma between November 2016 and May 2022. Infections were recorded until day 365, if patients experienced symptoms with a microbiologic diagnosis, or for symptomatic site-specific infections treated with antimicrobials. One-year cumulative incidence functions were calculated based on time to first respiratory infection using dates of infection-free death and receipt of additional antineoplastic therapies as competing risks. Secondary analysis evaluated risk factors for late respiratory infections using univariate and multivariable Cox regression models. Thirty-seven patients (37%) experienced 64 infectious events over the first year after BCMA–directed CAR T-cell therapy, with 42 early infectious events (days, 0-100), and 22 late infectious events (days, 101-365). Respiratory infections were the most common site-specific infection and the relative proportion of respiratory infections increased in the late period (31% of early events vs 77% of late events). On multivariable analysis, hypogammaglobulinemia (hazard ratio [HR], 6.06; P = .044) and diagnosis of an early respiratory viral infection (HR, 2.95; P = .048) were independent risk factors for late respiratory infection. Respiratory infections predominate after BCMA CAR T-cell therapy, particularly after day 100. Hypogammaglobulinemia and diagnosis of an early respiratory infection are risk factors for late respiratory infections that may be used to guide targeted preventive strategies.
Linking information on unemployment benefit sanctions from different datasets about welfare receipt: proceedings and research potential
Authors: Schmidtke Julia
Published: July 2023

Most studies on benefit sanctions within the German welfare system rely on established datasets about welfare receipt. This paper analyzes how using a dataset from the operational system of the German Federal Employment Agency for processing welfare claims can contribute to further research on benefit sanctions. For this purpose, I use a random sample of welfare recipients with at least one sanction between 2016 and 2018. First, this allows the detailed analysis of time lags between different steps in the sanction process. Second, linking this dataset with established datasets allows the identification of imposed sanctions for which sanction periods could not be (fully) implemented. This is largely explained by individuals leaving the welfare system between sanction events and sanction periods, e.g., by taking up employment. Third, the paper shows differences in benefit cuts across subgroups. This opens up paths for future research.
Identification of key modules and driving genes in nonalcoholic fatty liver disease by weighted gene co-expression network analysis
Authors: Song Zhengmao , Wang Yun , Lin Pingli , Yang Kaichun , Jiang Xilin , Dong Junchen , Xie Shangjin , Rao Rong , Cui Lishan , Liu Feng , Huang Xuefeng
Published: July 2023

Background

Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive liver fat deposition, and progresses to liver cirrhosis, and even hepatocellular carcinoma. However, the invasive diagnosis of NAFLD with histopathological evaluation remains risky. This study investigated potential genes correlated with NAFLD, which may serve as diagnostic biomarkers and even potential treatment targets.

Methods

The weighted gene co-expression network analysis (WGCNA) was constructed based on dataset E-MEXP-3291. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to evaluate the function of genes.

Results

Blue module was positively correlated, and turquoise module negatively correlated with the severity of NAFLD. Furthermore, 8 driving genes (ANXA9, FBXO2, ORAI3, NAGS, C/EBPα, CRYAA, GOLM1, TRIM14) were identified from the overlap of genes in blue module and GSE89632. And another 8 driving genes were identified from the overlap of turquoise module and GSE89632. Among these driving genes, C/EBPα (CCAAT/enhancer binding protein α) was the most notable. By validating the expression of C/EBPα in the liver of NAFLD mice using immunohistochemistry, we discovered a significant upregulation of C/EBPα protein in NAFLD.

Conclusion

we identified two modules and 16 driving genes associated with the progression of NAFLD, and confirmed the protein expression of C/EBPα, which had been paid little attention to in the context of NAFLD, in the present study. Our study will advance the understanding of NAFLD. Moreover, these driving genes may serve as biomarkers and therapeutic targets of NAFLD.
Rare case of exostosin 1/exostosin 2-related membranous lupus nephritis concomitant with dual ANCA- and anti-GBM antibody-associated crescentic glomerulonephritis effectively diagnosed by mass spectrometry: a case report
Authors: Yamazaki Takuya , Takahashi Haruka , Takeuchi Kazuhiro , Sakamoto Emi , Tominaga Kenta , Sakurabayashi Syun , Abe Tetsuya , Sano Takashi , Wada Yukihiro , Kuwahara Naomi , Shimizu Akira , Takeuchi Yasuo
Published: July 2023

Background

Recent developments in mass spectrometry (MS) have revealed target antigens for membranous nephropathy (MN), including phospholipase A2 receptor and exostosin 1/exostosin 2 (EXT1/2). EXT1/2 are known antigens of autoimmune disease-related MN, especially membranous lupus nephritis. We describe the case of an elderly man who developed nephrotic syndrome followed by progressive renal dysfunction.

Case presentation

A 78-year-old man presented with rapidly progressive renal dysfunction with proteinuria and hematuria. Three years previously, he had developed leg edema but did not receive any treatment. Laboratory tests showed elevated anti-nuclear antibody (Ab), anti-dsDNA Ab titer, and hypocomplementemia, indicating systemic lupus erythematous. Myeloperoxidase anti-neutrophil cytoplasmic Ab (ANCA) and anti-glomerular basement membrane (GBM) Ab were also detected. The renal pathologic findings were compatible with crescentic glomerulonephritis (GN), whereas non-crescentic glomeruli exhibited MN without remarkable endocapillary or mesangial proliferative change. Immunofluorescence microscopy revealed glomerular IgG, C3, and C1q deposition. All IgG subclasses were positive in glomeruli. Anti-PLA2R Ab in serum was negative. MS analysis was performed to detect the antigens of MN, and EXT1/2 was detected in glomeruli. Therefore, we reached a diagnosis of membranous lupus nephritis concurrent with both ANCA-associated vasculitis and anti-GBM-GN. The simultaneous occurrence of these three diseases is extremely rare.

Conclusions

This is the first report of EXT1/2-related membranous lupus nephritis concurrent with ANCA-associated vasculitis and anti-GBM-GN. This case demonstrates the usefulness of MS in diagnosing complicated cases of MN.
Antiretroviral therapy non-adherence and its relationship with cognitive impairment, alcohol use disorder, and depression in adolescents living with HIV
Authors: Olashore Anthony A. , Chiliza Bonginkosi , Paruk Saeeda
Published: July 2023

Objective

We aimed to compare antiretroviral non-adherence in the behaviourally infected (BIAs) and congenitally infected adolescents (CIAs) and explore its associations with depression, cognitive impairment, and alcohol use disorder (AUD) in adolescents living with HIV(ALWHIV) in Botswana.

Methods

This study was a cross-sectional, comparative, multi-center research that involved collecting samples from different HIV clinics in Botswana. Of the 622 ALWHIV, 223 were identified as BIAs and 399 as CIAs. They were evaluated using various tools such as MINI-KID for psychiatric disorders, DSM-5 for AUD, CAT-rapid for cognitive assessment, and Visual Analogue Scale (VAS) for non-adherence (the outcome). The data were analysed using both bivariate and multivariate regression analyses.

Results

The participants’ mean age (SD) was 17.7(1.60). The CIAs were more likely to have cognitive impairment (t -7.25; p < 0.01), while the BIAs had more depression (χ2 = 5.86; p = 0.016) and AUD (χ2 = 4.39; p = 0.036) and were more likely to be non-adherent (t = 3.14; p = 0.002). In the CIA group, cognitive impairment (AOR = 2.86; 95% CI:1.77–4.64) (AOR = 2.79; 95%CI:1.73–4.48) and depression (AOR = 2.69; 95%CI:1.48–4.90 were associated with ART non-adherence. In the BIA group, depression (AOR = 2.55; 95%CI:1.27–5.16), AUD (AOR = 2.58; 95%CI:1.21–5.49) and struggling to accept status (AOR = 2.54; 95%CI:1.41–4.56) predicted non-adherence to treatment.

Conclusion

The two groups of adolescents differ regarding ART non-adherence and associated psychosocial issues, indicating the need for differentiated care to address non-adherence in the ALWHIV, especially in high-burden, resource-constrained settings, such as Botswana.