bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a novel multicomponent treatment in women with fibromyalgia: A randomized clinical trial
Authors: Araya-Quintanilla Felipe , Álvarez-Bueno Celia , Cavero-Redondo Iván , Ramírez-Vélez Robinson , Sepúlveda-Loyola Walter , Gutiérrez-Espinoza Héctor
Published: October 2024

Background

Multicomponent treatment is commonly used. However, there are no studies that included graded motor imagery and therapeutic neuroscience education to multicomponent treatment for patients with fibromyalgia This study aims to compare the short-term effects (at 12 weeks) of a multicomponent treatment combined with graded motor imagery and therapeutic neuroscience education versus standard treatment in patients with FM.

Methods

The study was a single-blinded randomized controlled trial. Sixty-five women with a clinical diagnosis of FM were randomly allocated (1:1) into two groups. The experimental group ( n = 33) received a novel multicomponent treatment combined with graded motor imagery and neuroscience education. The control group ( n = 32) received a standard treatment including pharmacotherapy and standard physician education. The primary outcome was pain intensity assessed with the Numeric Pain Rating Scale (NPRS). The secondary outcomes were changes in the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK-17), and the Pittsburgh Sleep Quality Index (PSQI) scores. All outcomes were assessed at baseline and 12 weeks.

Results

All of the participants completed the trial. The between-group mean differences at 12 weeks were: NPRS-1.18 points (95% confidence interval [CI] -0.4 to -1.8; η2 = 0.47; p < .001); FIQ-16.21 points (95% CI -10.9 to -22.1; η2 = 0.58; p < .001); PCS total domain −12.5 points (95% CI -7.2 to -17.8; η2 = 0.61; p < .001); TSK-17-6.15 points (95% CI -3.5 to -8.7; η2 = 0.52; p < .001); and PSQI-2.74 points (95% CI -1.4 to 4.0; η2 = 0.54; p < .001). All differences were statistically significant in favor of the novel multicomponent treatment group and had a large effect size.

Conclusions

In the short term, a novel multicomponent treatment, including graded motor imagery and neuroscience education, was an effective therapeutic intervention for improving clinical outcomes compared with standard treatment in women with FM. Additional studies are needed to support long-term clinical effectiveness in these patients.
Dramatic devastative complications in a patient with catastrophic antiphospholipid syndrome: A Case report and literature review
Authors: Shakhshir Ali , Dweekat Mo’tasem Z. , Awashra Ameer , Nouri Ahmad , Rabee’ Hadi , Shamlawi Alaa , Al-ali Khaled
Published: October 2024

Catastrophic antiphospholipid syndrome (CAPS) is a very severe form of the classic antiphospholipid syndrome (APS). Although CAPS occurs in less than 1% of all patients with APS, it is considered a life-threatening condition. This report highlights an interesting case of a 45-year-old male diagnosed with CAPS. Unfortunately, the diagnosis was followed by devastating complications. Moreover, this report tried to gather the significant medical information available about CAPS in light of the obvious shortage of epidemiology, signs, symptoms, mechanisms of action and options of treatment in relation to the current guidelines.
Machine learning-based risk prediction model for medication administration errors in neonatal intensive care units: A prospective direct observational study
Authors: Henry Basil Josephine , Lim Wern Han , Syed Ahmad Sharifah M. , Menon Premakumar Chandini , Mohd Tahir Nurul Ain , Mhd Ali Adliah , Seman Zamtira , Ishak Shareena , Mohamed Shah Noraida
Published: October 2024

Objective

Neonates’ physiological immaturity and complex dosing requirements heighten their susceptibility to medication administration errors (MAEs), with the potential for severe harm and substantial economic impact on healthcare systems. Developing an effective risk prediction model for MAEs is crucial to reduce and prevent harm.

Methods

This national-level, multicentre, prospective direct observational study was conducted in neonatal intensive care units (NICUs) of five public hospitals in Malaysia. Randomly selected nurses were directly observed during medication preparation and administration. Each observation was independently assessed for errors. Ten machine learning (ML) algorithms were applied with features derived from systematic reviews, incident reports, and expert consensus. Model performance, prioritising F1-score for MAEs, was evaluated using various measures. Feature importance was determined using the permutation-feature importance for robust comparison across ML algorithms.

Results

A total of 1093 doses were administered to 170 neonates, with mean age and birth weight of 33.43 (SD ± 5.13) weeks and 1.94 (SD ± 0.95) kg, respectively. F1-scores for the ten models ranged from 76.15% to 83.28%. Adaptive boosting (AdaBoost) emerged as the best-performing model (F1-score: 83.28%, accuracy: 77.63%, area under the receiver operating characteristic: 82.95%, precision: 84.72%, sensitivity: 81.88% and negative predictive value: 64.00%). The most influential features in AdaBoost were the intravenous route of administration, working hours, and nursing experience.

Conclusions

This study developed and validated an ML-based model to predict the presence of MAEs among neonates in NICUs. AdaBoost was identified as the best-performing algorithm. Utilising the model's predictions, healthcare providers can potentially reduce MAE occurrence through timely interventions.
User experiences of an AI application for predicting risk of sexually transmitted infections
Authors: King Alicia J , Latt Phyu Mon , Soe Nyi Nyi , Temple-Smith Meredith , Fairley Christopher K , Chow Eric PF , Phillips Tiffany R
Published: October 2024

Objective

Awareness of one's individual risk of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) is a necessary precursor to engagement with prevention strategies and sexual health care. Web-based sexual health applications may improve engagement in sexual health prevention and care by providing individualised and evidence-based sexual health information. The STARTOnline ( Supporting Timely and Appropriate Review and Treatment Online) study sought the views of sexual health service users on three web-based sexual health applications to better understand their usefulness, acceptability and accessibility. This paper reports the views and experiences of users of one of the applications called MySTIRisk. MySTIRisk estimates the risk of three common STIs and HIV using data from attendees of a metropolitan sexual health service.

Methods

This study used a bespoke qualitative design, informed by a developmental evaluation approach. Melbourne Sexual Health Centre clinic attendees’ views were sought using semi-structured interviews conducted between October 2023 and January 2024 via videoconferencing, telephone and on site at the clinic. Data was analysed using qualitative data analysis methods.

Results

A diverse group of 14 participants described an ideal pathway to better sexual health outcomes that might be facilitated by use of the MySTIRisk application, particularly for individuals with limited sexual health knowledge, or affected by stigma and geographical barriers. This pathway was described as: 1) being concerned about my sexual health; 2) checking my STI risk easily and privately; 3) understanding and trusting the result; and 4) deciding how to look after my health. Factors that might influence this pathway were also described, including areas for improvement in accessibility and acceptability.

Conclusion

These findings support the role of web-based sexual health applications in facilitating access to sexual health education and behavioural change and underscore the importance of codesign approaches in improving their uptake and impact.
Global Green Finance: Roadmap for India
Authors: Anand Yukta , Pandey Asheesh
Published: October 2024

Climate change, and especially, ‘climate deterioration’ is an alarming situation for the global scenario, and thus, the need for developing financial services and products that aim to reduce the effects of these changes is the need of the hour. This long-felt need has given birth to a new form of investing, known as green finance or broadly, sustainable finance. So, it can be said that green finance is a subset under the larger umbrella of the concept of sustainable finance. This article tries to bring to the knowledge of the readers the basic understanding of the concept of green finance, its various instruments available globally and its developments at the global and Indian level, highlighting the three stages of green finance’s evolution and its major theories. Further, it reveals the global presence of major green finance instruments like green bonds and its types, green mutual funds (MFs) and green stock exchanges. The article also deals with the concepts of emissions trading system and European Union’s Carbon Border Tax. The discussion becomes more specific in the subsequent sections, drawing the present picture of green finance concerning the Indian scenario—its green bank, green bonds, green MF and green stock exchange. Reserve Bank of India’s recent guidelines regarding green finance and India’s presidency at the last held G20 summit are also discussed, finally concluding with mapping the road ahead for India.
Primary lymphoepithelioma-like carcinoma within an intralobular pulmonary sequestration
Authors: Hekelaar N , van Uffelen R , van Vliet AC , Varin OC , Westenend PJ
Published: October 2024

A 31-yr-old Chinese female, a nonsmoker, presented with digital clubbing and coughing. Diagnostic evaluation revealed a pulmonary sequestration in the left lower lobe. During surgery a tumour was discovered, which turned out to be a lymphoepithelioma-like carcinoma. These tumours are mainly found in Asians, and are associated with the Epstein Barr virus and not with smoking. They are thought to have a better prognosis and to be more chemosensitive. The need for surgical treatment of pulmonary sequestration and the recognition of lymphoepithelioma-like carcinoma as a distinct clinicopathological entity is emphasized.
Bleomycin stimulates lung fibroblast and epithelial cell lines to release eosinophil chemotactic activity
Authors: Sato E , Koyama S , Robbins RA
Published: October 2024

The presence of eosinophils in the lungs of patients with pulmonary fibrosis correlates with poor prognosis or resistance to therapy. Furthermore, eosinophils localize to areas undergoing active fibrosis. It was hypothesized that a human lung fibroblast (HFL-1) and a human lung epithelial cell line (BEAS-2B) might release eosinophil chemotactic activity (ECA) in response to bleomycin, a chemotherapeutic agent associated with pulmonary fibrosis. HFL-1 and BEAS-2B cells were cultured in the presence of bleomycin and their supernatant fluids evaluated for ECA by means of a Boyden chamber method. HFL-1 and BEAS-2B cells released ECA in a dose- and time-dependent manner in response to bleomycin, and partial characterization revealed that the ECA was heterogeneous. ECA release from HFL-1 and BEAS-2B cells was significantly reduced by a leukotriene B4 (LTB4) receptor antagonist and an antibody directed against granulocyte-macrophage colony-stimulating factor. HFL-1 cells released LTB4, eotaxin, and GM-CSF constitutively, and BEAS-2B cells released LTB4, eotaxin, regulated on activation, normal T-cell expressed and presumably secreted, and GM-CSF constitutively. In both cases, the release of GM-CSF was significantly increased in response to bleomycin. These data suggest that lung fibroblasts and epithelial cells may modulate eosinophil recruitment into the lung in bleomycin-induced pulmonary fibrosis.
Recombinant DNase in cystic fibrosis: a protocol for targeted introduction through n-of-1 trials. Scottish Cystic Fibrosis Group
Authors: Bollert FG , Paton JY , Marshall TG , Calvert J , Greening AP , Innes JA
Published: October 2024

Nebulized recombinant human deoxyribonuclease (DNase) reduces sputum viscosity and improves lung function in some cystic fibrosis patients, but individual responses are unpredictable. The aim of this study was to investigate how DNase can be targeted to those cystic fibrosis patients who would benefit most. The Scottish Cystic Fibrosis Group agreed on a randomized, double-blind, placebo-controlled n-of-1 assessment protocol. Patients underwent a maximum of three 4-week assessment periods (2 weeks saline, 2 weeks DNase each). Measurements performed at hospital (exercise, oximetry and spirometry) and home (symptom scores) were used to derive a scoring system to discriminate maximally between DNase and placebo effects. The data on 89 4-week assessments in 52 patients were reported. Twenty-four patients have completed the assessment process (12 responders and 12 nonresponders) to date. Forced expiratory volume in one second (FEVI) was the best discriminator of response, rising by >200 mL after DNase in 33 of 89 (37%) assessments compared with 3 of 89 (3%) after saline. N-of-1 trials, while laborious, permitted genuine treatment effects to be quantified within individuals with confidence, permitting appropriate treatment targeting. This provides a model of how other new expensive therapies may be introduced to maximize patient benefit.
Persistent syphilitic ocular manifestations despite treatment: a case series
Authors: Zhang Sairi , Rickels Kaersti L. , Krishnan Vignesh , Uwaydat Sami H.
Published: October 2024

Background

Penicillin has remained the most effective treatment for syphilis for several decades. Syphilitic retinal manifestations may persist following treatment and cause visual problems. In this case series, we describe three syphilis patients with persistent posterior segment manifestations due to chronic inflammation, incomplete treatment, and reinfection.

Case series

Recommended initial treatment for all patients was 14 days of intravenous penicillin. Oral prednisone was added 48 h after initiation of penicillin therapy. Case 1: A 48-year-old female presented with gradual vision loss for two months. Fundus imaging revealed syphilitic outer retinopathy (SOR), papillitis, and acute syphilitic posterior placoid chorioretinopathy (ASPPC). After treatment, she had persistent cystoid macular edema (CME) and was treated with intravitreal triamcinolone injections and ketorolac drops. Case 2. A 24-year-old male presented with sudden vision loss for two days. On imaging, he had ASPPC, papillitis, and SOR. IV penicillin treatment was given for 10 days only. He had persistent SOR and was retreated with doxycycline and prednisone. Case 3: A 52-year-old male presented with eye pain and visual loss for one week. There was evidence of ASPPC and papillitis on imaging. One month after treatment, he had persistent papillitis and was restarted on oral prednisone. One year later, he was found to have recurrent ASPPC and was confirmed to be reinfected with syphilis, for which he was retreated.

Conclusion

When treating persistent syphilitic ocular manifestations, we recommend checking that the penicillin treatment was complete and the RPR titers are declining. If both hold true, then the affected eye should be treated with anti-inflammatory therapy. Other factors that contribute to poor visual prognosis include treatment delay, poor initial visual acuity, macular edema, and HIV coinfection.
Knowledge, attitudes, and practices regarding malaria transmission and prevention in an indigenous Maijuna community: a qualitative study in the Peruvian Amazon
Authors: Hogan Kathryn M. , Gilmore Michael , McCarron Graziella P. , Griffiths Brian M. , Koehler Jeffrey W. , García Guillermo A. , von Fricken Michael E.
Published: October 2024

Background

Peru is a low-endemic transmission area for malaria, where the majority (84%) of incident malaria cases are localized to the department of Loreto, which is composed of several geographically isolated rural communities. Recent intervention efforts targeting at-risk Indigenous populations that live in riverine communities in Loreto place emphasis on preventive behaviours to decrease transmission. However, malaria related behaviour change is often dependent upon local knowledge, beliefs, and practices, especially in areas where malaria is viewed an embedded and unavoidable aspect of life.

Methods

This exploratory case study used semi-structured interviews conducted in Spanish between February and March of 2019 to examine the knowledge, attitudes, and practices related to malaria prevention among the Indigenous Maijuna people of Sucusari, Loreto, Peru. Participants who consented were also administered a rapid diagnostic test (RDT) upon the time of interview.

Results

A total of 33 community members were interviewed, and 31 were tested via malaria rapid diagnostic tests, with RDT filter paper subsequently tested using PCR. All test results were negative for malaria. Themes that emerged included: varying knowledge of methods to prevent malaria, reports of observed changes in malaria incidence over time, confusion surrounding malaria transmission, treatment-seeking as a common behaviour, the belief that medications are effective, and the acceptance of bed nets which were viewed as a lifestyle norm.

Conclusion

These shared narratives should be used as a foundation for further studies and health interventions among communities in the Peruvian Amazon with limited access to health services where culturally resonant, community-based health programming is essential to improving health. Takeaways regarding confusion surrounding malaria transmission should also be considered.
Using the 12-item short-form health survey (SF-12) to evaluate self-rated health in an environmental justice community
Authors: Fawkes Leanne S. , Roh Taehyun , McDonald Thomas J. , Horney Jennifer A. , Chiu Weihsueh A. , Sansom Garett T.
Published: October 2024

The Greater Fifth Ward (GFW) is a Northeast Houston, Texas, neighborhood with a legacy of industrial contamination and a confirmed cancer cluster. To understand self-rated health in the GFW, community-based participatory research (CBPR), was used to promote the inclusion of all partners. CBPR involves the community during each stage of the research process from design to research dissemination. A complete census was conducted, and 114 surveys were obtained in the environmental justice (EJ) community from July to November 2021. EJ communities shoulder an unfair burden of environmental exposures, pollution, and poor built environments. Mental and physical health were measured using the validated 12-item Short Form Health Survey (SF-12v2). We posited that the Black or African American (Black/AA) community would have lower mental composite scores (MCS) and physical composite scores (PCS) compared to the nation and their White counterparts. The MCS and PCS were calculated and compared against the national mean. Overall, participants had higher MCS and lower PCS than the national mean. Black/AA males and females had lower MCS compared to their White counterparts. White females had the lowest PCS among all respondents, significantly lower than the national average. MCS was lower among those who lived in the neighborhood longer. Burdens from pollution may impact residents’ health and perceived health. Targeted interventions or programs that improve mental or physical health would benefit this community and other inequitably burdened neighborhoods.
Exploring body uneasiness in severe and enduring eating disorders: insights from clinical practice
Authors: Meneguzzo Paolo , Todisco Patrizia
Published: October 2024

Introduction

Body uneasiness is a central facet of body image disturbances observed in individuals with eating disorders (EDs). This study aimed to address gaps in understanding body uneasiness in severe and enduring eating disorders (SE-EDs) and explore variations in psychopathology between individuals with different durations of the disorder. We hypothesized that patients with SE-ED might develop habitual behaviors that contribute to ambivalence toward treatment and the persistence of symptoms.

Methods

A sample of 360 ED patients was evaluated at the beginning and end of a specialized intensive rehabilitation program. All patients completed the Eating Disorder Examination Questionnaire (EDE-Q) and the Body Uneasiness Test (BUT). They were divided into two groups: SE-ED (> 7 years) and acute (aED, < 3 years) duration.

Results

Compulsive self-monitoring showed a significant change between the start and end of treatment, differing between groups, with a larger change observed in SE-ED (p < 0.048). In SE-ED, it was associated with lower chances of dropout (p = 0.044), opposite to aED (p = 0.009). Treatment responses were primarily related to eating psychopathology, further highlighting differences between the two groups.

Conclusions

This study underscores the possible presence of a habit in SE-ED and the importance of tailoring interventions to address unique needs based on the duration of the disorder. Furthermore, it highlights the need for further research to improve treatment outcomes in SE-EDs.
Structural control on the shallow tremor distribution linked to seamount subduction: insights from high-resolution seismic imaging in Hyuga-nada
Authors: Ma Yanxue , Nakata Rie , Mochizuki Kimihiro , Hashimoto Yoshitaka , Hamada Yohei
Published: October 2024

Tectonic tremors occur around the subducting seamount of the Kyushu Palau Ridge (KPR) in Hyuga-nada, Japan. We investigate the relationship between tremor activity and structural and physical characteristics using high-resolution reflection seismic imaging of the KR0114-8 line, encompassing areas with both high and low occurrences of tremors. The reflection data are reprocessed using broadband processing, reflection tomography and Kirchhoff pre-stack depth migration. The resulting image delineates complex deformation and lithological boundaries, such as the accretionary prism, underthrust sediments, décollement, and top of the seamount. The observed splay faults and seafloor uplift to the west of the KPR, coupled with frequent tremors, confirm the compressional stress regime on the leading side of the subducting seamount. A stress shadow over the seamount effectively suppresses tremors. Numerous faults indicate significant deformation of the overburden when positioned on the leading side of the seamount. The trailing side exhibits a compressional stress regime, rather than an extensional one, as evidenced by the development of in-sequence thrusts and frequent tremors. Local physical, mechanical, and structural factors critically influence the tremor activity. The increased frequency of tremors is correlated with the thickness of the underthrust sediments and presence of in-sequence thrusts, whereas it is inversely correlated with the reflectivity of the décollement. Several potential mechanisms for this phenomenon include elevated pore pressure above the décollement and/or within the underthrust sediments, as well as structural effects. High-resolution velocity imaging, scientific drilling, and precise tremor-depth estimation are essential for advancing our understanding of these mechanisms.

Graphical abstract
H Antigen expression modulates epidermal Keratinocyte Integrity and differentiation
Authors: Jin Seon-Pil , Oh Jang-Hee , Kim Namjoo Kaylee , Chung Jin Ho
Published: October 2024

Background

ABO blood group antigens (ABH antigens) are carbohydrate chains glycosylated on epithelial and red blood cells. Recent findings suggest reduced ABH expression in psoriasis and atopic dermatitis, a chronic inflammatory skin disease with retained scale. H antigen, a precursor for A and B antigens, is synthesized by fucosyltransferase 1 (FUT1). Desmosomes, critical for skin integrity, are known to require N-glycosylation for stability. We investigate the impact of H antigens, a specific type of glycosylation, on desmosomes in keratinocytes.

Method

Primary human keratinocytes were transfected with FUT1 siRNA or recombinant adenovirus for FUT1 overexpression. Cell adhesion and desmosome characteristics and their underlying mechanisms were analyzed.

Result

The knockdown of FUT1, responsible for H2 antigen expression in the skin, increased cell-cell adhesive strength and desmosome size in primary cultured keratinocytes without altering the overall desmosome structure. Desmosomal proteins, including desmogleins or plakophilin, were upregulated, suggesting enhanced desmosome assembly. Reduced H2 antigen expression via FUT1 knockdown led to increased keratinocyte differentiation, evidenced by elevated expression of differentiation markers. Epidermal growth factor receptor (EGFR) has been described to be associated with FUT1 and promotes cell migration and differentiation. The effects of FUT1 knockdown were recapitulated by an EGFR inhibitor concerning desmosomal proteins and cellular differentiation. Further investigation demonstrated that the FUT1 knockdown reduced EGFR signaling by lowering the levels of EGF ligands rather than directly regulating EGFR activity. Moreover, FUT1 overexpression reversed the effects observed in FUT1 knockdown, resulting in the downregulation of desmosomal proteins and differentiation markers while increasing both mRNA and protein levels of EGFR ligands.

Conclusion

The expression level of FUT1 in the epidermis appears to influence cell-cell adhesion and keratinocyte differentiation status, at least partly through regulation of H2 antigen and EGFR ligand expression. These observations imply that the fucosylation of the H2 antigen by FUT1 could play a significant role in maintaining the molecular composition and regulation of desmosomes and suggest a possible involvement of the altered H2 antigen expression in skin diseases, such as psoriasis and atopic dermatitis.
Improved access and care through the implementation of virtual Hallway, a consultation platform in Nova Scotia: preliminary findings from a feasibility evaluation
Authors: Tomblin Murphy Gail , Sampalli Tara , Koto Prosper , Chamberland-Rowe Caroline , Guk Julia , Ventura Nelson , Hartlen Justin , Rasic Daniel , Allen Jonathan , Benson Kianna , MacNeil Ryan
Published: October 2024

Background

While previous studies have examined various platforms that enable providers to connect, Virtual Hallway (VH) stands out with its unique features. The value add is that this online platform connects primary care providers and specialists for synchronous phone-based conversations and aims to reduce referrals and enhance the quality of referrals. VH allows providers to easily log in, select the required specialty, book call times, receive reminders, and have calls documented, ensuring a high connection rate. In May 2022, the provincial health authority in Nova Scotia, a Canadian province, and VH initiated a feasibility study facilitated through the Health Innovation Hub in Nova Scotia. The goal was to enable primary care providers to connect with specialists, thereby reducing wait times and unnecessary referrals, and facilitating timely access to relevant clinical direction for patients. The current evaluation assessed utilization, value for money in economic analysis, and consultation experiences.

Methods

The study used post, cross-sectional, and cost-benefit study designs. We collected data through various methods, including administratively recorded utilization, theory-driven surveys, and cost data. Utilization was measured by the number of completed consults and the number of healthcare professionals using the VH platform. We analyzed the data using a combination of descriptive statistics and a cost-benefit analysis, which also involved conducting probabilistic sensitivity analysis.

Results

The study found that approximately 84% of the VH consultations avoided needing in-person specialist referrals. The return on investment was 1.8 (95% CI: 0.8 to 3.0), indicating that the monetary value of the measurable benefits associated with VH exceeded the value of the resources invested. The provider experience survey revealed high satisfaction levels with VH across user groups, with 92% of specialists and 96% of primary care providers reporting being satisfied or highly satisfied with their experience. These positive indicators of provider experience were further supported by the fact that 97% of respondents agreed or strongly agreed that they intended to continue to use VH in their practice, and 97% of respondents agreed or strongly agreed that they would recommend VH to a colleague.

Conclusions

The study suggests that VH was well-received by users, with high levels of satisfaction reported and a reduced need for in-person referrals. It also represented value for money. Further research could explore how the availability of virtual health services can lead to reduced utilization of healthcare resources among different groups of patients.
Iatrogenic Cushing Syndrome and Adrenal Suppression Presenting as Perimenopause
Authors: Andres Sarah M , Galina Jesse M , Berga Sarah L
Published: October 2024

Secondary adrenal insufficiency is a life-threatening condition that may arise in the setting of iatrogenic Cushing syndrome. Intra-articular corticosteroid injections (IACs) are a standard treatment for osteoarthritis, and they carry a high risk of secondary central adrenal suppression (SAI). We present the case of a 43-year-old woman who was referred to reproductive endocrinology for evaluation of abnormal uterine bleeding with a provisional diagnosis of perimenopause. She reported new-onset type 2 diabetes mellitus, abdominal striae, hot flashes, and irregular menses. Laboratory evaluation revealed iatrogenic Cushing syndrome and SAI attributable to prolonged use of therapeutic IACs for osteoarthritis. Treatment included hydrocortisone replacement and discontinuation of IACs followed by hydrocortisone taper over the following 16 months that resulted in the return of endogenous ovarian and adrenal function. This case demonstrates the many hazards of prolonged IAC use, including suppression of ovarian and adrenal function and iatrogenic SAI.
Atypical Imaging Findings in a Cortisol-producing Adrenal Adenoma Predominantly Composed of Lipid-poor Compact Cells
Authors: Kawata Satoshi , Obata Yoshinari , Akai-Samoto Aya , Mukai Kosuke , Miyashita Kazuyuki , Shimomura Iichiro
Published: October 2024

Cortisol-producing adrenal adenomas consist of a mixture of lipid-rich clear and lipid-poor compact cells in varying proportions. Most adenomas are mainly composed of lipid-rich clear cells and typically exhibit low computed tomography (CT) attenuation values, high uptake on 131I-adosterol scintigraphy, and mild accumulation on 18F-fluorodeoxyglucose positron emission tomography/CT. However, adenomas predominantly composed of lipid-poor compact cells are rare, with limited evidence regarding their imaging characteristics. A 27-year-old woman with weight gain and a moon face was referred to our hospital. She presented with hypertension, dyslipidemia, low plasma ACTH levels, and autonomous cortisol secretion. We diagnosed this patient with ACTH-independent Cushing syndrome with a left adrenal tumor. The adrenal tumor exhibited imaging findings atypical for an adenoma, including high CT attenuation values, negative uptake on 131I-adosterol scintigraphy, and strong accumulation on 18F-fluorodeoxyglucose positron emission tomography/CT. Histopathological analysis indicated that the tumor was a rare type of adenoma, predominantly composed of lipid-poor compact cells. These findings and recent reports suggest that the proportion of compact cells can influence the imaging findings. Therefore, in the differential diagnosis, it is important to recognize that cortisol-producing adrenal adenomas predominantly composed of compact cells can present with atypical imaging findings.
Res-publica/public management, nation, and economic development in the life and work of Luiz Carlos Bresser-Pereira
Authors: Varela Carmen Augusta , Mello Cristina Helena Pinto de , Levy Evelyn , Rebolho José Marcio
Published: October 2024

This Forum of the journal Cadernos de Gestão Pública e Cidadania (CGPC) seeks to acknowledge the contributions, trajectory, and impact of Professor Luiz Carlos Bresser-Pereira, fostering discussions centered on his work, both in academia and in public and private management. In 2022, Professor Bresser-Pereira was recognized as the most cited Latin American economist internationally (Latin America Top 100 Economics & Econometrics Scientists 2022). His prolific work spans a wide array of subjects. In 1981, he founded the Brazilian Journal of Political Economy (Revista de Economia Política), linked to the Center for Political Economy, where he has served as both president and editor. Since 2004, he has been instrumental in the Economics Forum at the São Paulo School of Economics, Fundação Getulio Vargas (FGV EESP). His works reflect a strong interdisciplinary approach, integrating fields such as philosophy, social and political sciences, economics, management, scientific methodology, and history.
Gestão de pessoas: desafios e oportunidades em uma empresa familiar
Authors: Ferreira Patricia Itala , Peixoto Guimarães Maria Isabel
Published: October 2024

A TOBALO, empresa familiar, atua há mais de três décadas com construção e incorporação imobiliária. Seu fundador ocupa o cargo de diretor-presidente até hoje. Devido a um recente processo de aquisição, resolveu implantar um processo de avaliação de desempenho, tendo contratado Fernanda com esse objetivo. Ela resolveu iniciar sua atuação com um diagnóstico da gestão de pessoas na TOBALO. Vários pontos de atenção foram identificados por Fernanda e ela terá que lidar com eles, ao mesmo tempo em que precisa implantar o processo de avaliação de desempenho. Este Caso para Ensino pretende proporcionar aos alunos a oportunidade de identificar problematizações relacionadas a gestão de pessoas, diversidade e inclusão, cultura organizacional e segurança psicológica. Na seção Notas de Ensino são detalhados: sinopse e fonte dos dados, possíveis aplicações do caso, objetivos de ensino, perguntas norteadoras e respostas, roteiro para discussão em sala de aula e sugestões de bibliografia.
Can indoor plants reduce formaldehyde levels in the anatomy dissection hall? A study to evaluate the practicality of using plants in reducing formaldehyde levels
Authors: Joshi Adish G , Punja Dhiren , Punja Rohini
Published: October 2024

Background Formaldehyde a commonly used embalming fluid for the preservation of cadavers, produces numerous short and long-term side effects on the students and staff working with it. Indoor plants have been shown to reduce atmospheric formaldehyde levels. The purpose of the study was to compare the efficacy of indoor plants in reducing formaldehyde levels in ambient air to levels deemed safe by WHO standards Methods The study was conducted in the storage room of the Anatomical dissection hall. 7 potted plants of one variety were kept in the storage room for 14 days and the Formaldehyde reading was measured using a VOC (Volatile Organic Compound) monitor. Then the same was done with no plant. This cycle was repeated 2 more times, with two different plant species. The three spieces of plants used for this study were as follows: Dracaena trifasciata, Epipremnum aureum, Spathiphyllum. Results The results were analysed and compared and it was determined that the effect of having a plant present versus having no plant present on the Formaldehyde concentration in the air was inconclusive as Dracaena trifasciata failed to reject the null hypothesis altogether (p-value>0.05), while Epipremnum aureum and Spathiphyllum rejected the null hypothesis (p-value<0.05), however they both had a weak positive correlation with formaldehyde concentration. Conclusion The efficacy of indoor plants in reducing formaldehyde levels in ambient air needs to be further explored and validated since all the prior studies conducted were in controlled environment and should be done in a real time scenario for its practical and beneficial uses.
Dynamic participation in local energy communities with peer-to-peer trading
Authors: Perger Theresia , Auer Hans
Published: October 2024

Background Energy communities and local electricity markets (e.g., as peer-to-peer trading) are on the rise due to increasingly decentralized electricity generation and favorable adjustment of the legal framework in many European countries. Methods This work applies a bi-level optimization model for dynamic participation in peer-to-peer electricity trading to determine the optimal parameters of new participants who want to join an energy community, based on the preferences of the members of the original community (e.g., environmental, economic, or mixed preference). The upper-level problem chooses optimal parameters by minimizing an objective function that includes the prosumers’ cost-saving and emission-saving preferences, while the lower level problem maximizes community welfare by optimally allocating locally generated photovoltaic (PV) electricity between members according to their willingness-to-pay. The bi-level problem is solved by transforming the lower level problem by its corresponding Karush-Kuhn-Tucker (KKT) conditions. Results The results demonstrate that environment-oriented prosumers opt for a new prosumer with high PV capacities installed and low electricity demand, whereas profit-oriented prosumers prefer a new member with high demand but no PV system capacity, presenting a new source of income. Sensitivity analyses indicate that new prosumers’ willingness-to-pay has an important influence when the community must decide between two new members. Conclusions The added value of this work is that the proposed method can be seen as a basis for a selection process between a large number of potential new community members. Most important future work will include optimization of energy communities over the horizon several years.
Experimental Modelling of Water-Wave Interactions with a Flexible Beam
Authors: Rehman Wajiha , Bunnik Tim , Bokhove Onno , Kelmanson Mark
Published: October 2024

A series of fluid-structure-interaction (FSI) experiments is presented for studying water-wave interactions with a flexible beam in a wide range of sea conditions, thereby yielding a repository of FSI test-case data. The aim is to use these experimental data in order to validate FSI solvers commonly employed by the maritime industry in the design of fixed-foundation, offshore wind turbines. The experimental set-up allows simultaneous measurements of beam deflections and their effect on incident and reflected waves. In addition, the study is carried out in a wide range of sea conditions ranging from regular-to-irregular and moderate-to-extreme wave height and steepness. The study of such a wide range of conditions makes the experiments suitable for providing reliable data in the validation of a suite of mathematical and numerical FSI solvers, i.e., linear, nonlinear and high-fidelity. The data from the experiments are made publicly available through open-source data-sharing platforms.
Approximation Algorithms for Dynamic Inventory Management on Networks
Authors: DeValve Levi , Myles Jabari
Published: October 2024

We provide the first approximation algorithm for dynamic inventory management on a network with stochastic demand and backlogging. Specifically, under a mild cost condition, we prove the cost of a specially designed base-stock policy is less than 1.618 times the cost of an optimal policy. We develop a novel stochastic programming analysis to prove this result: We carefully calibrate two stochastic programs (providing upper and lower bounds on the optimal policy), and compare their objectives. The upper bound arises from a new class of base-stock policies we define to address the currently unresolved issue of how to assign and fulfill backlogs in a system with fulfillment flexibility. We show the optimal policy in this class takes a simple and intuitive form: backlogs are assigned to their lowest cost activities for replenishment, and the ordered resources for those activities are committed to the backlogs for fulfillment. Next, the lower bound stochastic program is derived through a novel cost accounting scheme that captures the tradeoff between current inventory decisions and future backlog decisions. We then exploit this tradeoff to bound the ratio of the two stochastic program objectives and prove our main result. We also demonstrate our policy’s practicality with numerical simulations that show it performs within 1% of optimal on average across a wide range of problem instances. Finally, we show that our techniques and results extend to more general settings, demonstrating their potential for broader applicability. Importantly, our approach extends to problems with lead times, where we prove an approximation guarantee for base-stock policies that is independent of both the lead time and network structure. Thus, our work provides the new managerial insight that properly designed base-stock policies can be effective in network settings.

This paper was accepted by Victor Martínez-de-Albéniz, operations management.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2022.02965 .
Adult life with congenital heart disease: a letter to my 10-year-old self
Authors: Greenaway Beth
Published: October 2024

Reflecting on her experience of life with congenital heart disease, Beth Greenaway shares key lessons that may have helped her younger self and describes how she maintains a positive outlook on her condition.
A state-of-the-art review of community-based palliative care services in rural areas of Southern Minnesota and the United States
Authors: Vorbeck Ellen , Abbott-Anderson Kristen , Reed Alicia , Mondejar-Pont Meritxell
Published: October 2024

Background:

This state-of-the-art (SOTA) review aimed to understand the historical, current and future of rural community palliative care services (PCS) with a primary focus in rural southern Minnesota communities and the United States.

Methods:

This review followed the six step SOTA systematic review process described by Barry et al (2022) and examined articles from 2010–2023 regarding rural PCS.

Results:

Historical and current research consistently supported the benefits of PCS and reported the top facilitators as a clear definition of palliative care and PCS. The top barriers included a lack service provision, funding/resources, national policies/regulation, and shortages of trained providers in rural communities.

Conclusions:

Barriers to the provision of PCS have not improved based on this review in rural areas and must be addressed to reduce healthcare disparities for rural populations.
Hospice educators’ perspectives on e-learning in palliative care education in Ireland
Authors: Callinan Joanne
Published: October 2024

Background:

Knowledge of and understanding the palliative care approach should be a core competency in all healthcare settings. E-learning offers the potential to deliver palliative care education and meet this challenge.

Aim:

To examine hospice educator’s perspectives of e-learning in palliative care education.

Methods:

Semi-structured interviews were conducted with a purposeful sample of hospice educators on the island of Ireland (Republic of Ireland and Northern Ireland). These were transcribed and the data was analysed thematically.

Findings:

Many factors were considered when using e-learning: objectives of the programme, learner’s characteristics, topic suitability (as palliative care is very emotive) and organisational factors. Barriers to using e-learnning were the preparation time required and developing expertise in e-learning. Support mechanisms for hospice educators to share knowledge would be beneficial.

Conclusions:

Educators were keen to adopt a blended approach in their teaching. While acknowledging the challenges and limitations of e-learning, educators felt that e-learning has a positive role in palliative care education.
Research Roundup
Authors: Green Laura
Published: October 2024

Synopses of a selection of recently published research articles of relevance to palliative care
Optimization and multiphysics analysis of high-performance lithium niobate modulators
Authors: Wang Huangfan , Chen Hao , Yang Shaohua , Dong Huafeng , Wu Fugen , Liao Wenyuan
Published: October 2024

Thin-film lithium niobate electro-optic modulators (TFLN EOMs) are
widely utilized across various fields due to their exceptional
performance. In this theoretical study, we optimized a TFLN EOM
featuring a multimode interference coupler, cosine-curved waveguides,
and a modulating arm straight waveguide structure. By tuning the
etching depth, waveguide width, and geometric parameters of the
traveling wave electrodes, we achieved a half-wave voltage-length
product of 1.6V⋅cm and a 3 dB bandwidth of approximately
140 GHz. Additionally, we performed a multiphysics analysis to
investigate the temperature characteristics of the modulator. The
results indicate that increased temperature induces thermal-optic
effects in the material, leading to changes in the waveguide’s
refractive index and the optical beam phase, which results in
increased insertion loss. Moreover, the stress generated by thermal
expansion is concentrated in the modulator’s waveguide, representing a
weak point that is prone to failure.
Tolerances of the alignment of fibers to photonic integrated circuits
Authors: Gradkowski Kamil
Published: October 2024

This work presents the solutions to the alignment of two Gaussian beams representing two sides of the optical connection between a fiber and a photonic integrated circuit (PIC). The focus is to use these solutions to derive equations that allow for the straightforward calculation of alignment tolerances for displacement in all three directions, as well as two axes of rotations. These equations can be used to aid in the design of photonic packages by allowing the determination of precision necessary for fabrication of mechanical alignment features, in addition to packaging process development.
Action observation intervention using three-dimensional movies improves the usability of hands with distal radius fractures in daily life-A nonrandomized controlled trial in women
Authors: Usuki Kengo , Ueda Hiroaki , Yamaguchi Toshiya , Suzuki Takako , Hamaguchi Toyohiro
Published: October 2024

Objective

Prolonged immobilization of joints after distal radius fracture (DRF) causes cerebral disuse-dependent plasticity (DDP) and deterioration of upper extremity function. Action observation therapy (AOT) can improve DDP.

Trial design

This nonrandomized controlled trial (UMIN 000039973) tested the hypothesis that AOT improves hand-use difficulties during activities of daily living in patients with DRF.

Method

Right-handed women with volar locking plate fixation for DRF were divided into AOT and Non-AOT groups for a 12-week intervention. The primary outcome was difficulty in using the fractured hand, assessed with the Japanese version of the Patient-related Wrist Evaluation (PRWE). The secondary outcomes were range of motion (ROM) of the injured side and gap between measured ROM and patient-estimated ROM. The survey was administered immediately post operation and at postoperative weeks 4, 8, and 12. The AOT group used a head-mounted display and three-dimensional video during ROM exercises. The Non-AOT group used active ROM exercises alone. A generalized linear model (GLM) was used to confirm interactions and main effects by group and time period, and multiple comparisons were performed.

Results

Thirty-five patients were assigned to the AOT group (n = 18, median age, 74 years) or the Non-AOT group (n = 17, median age, 70 years). In the GLM, PRWE Total, PRWE Specific, and PRWE Usual scores revealed interactions between groups and periods. The post-hoc test revealed that the PRWE Specific scores (z = 3.43, p = 0.02) and PRWE Usual scores (z = 7.53, p<0.01) were significantly lower in the AOT group than in the Non-AOT group at 4 weeks postoperatively, whereas PRWE Total scores (z = 3.29, p = 0.04) were lower at 8 weeks postoperatively.

Conclusions

These results suggested that AOT can improve hand-use difficulties in right-handed women after DRF surgery. AOT positively affects the motor imagery of patients with DRF and can reverse the patient’s perceived difficulty in using the fractured hand during rehabilitation.