bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors for the Recurrence of Instability After Lateral Ankle Ligament Repair
Authors: Luthfi Andi Praja Wira Yudha , Nakasa Tomoyuki , Ikuta Yasunari , Sumii Junichi , Nekomoto Akinori , Kawabata Shingo , Adachi Nobuo
Published: May 2023

Background:

Arthroscopic anterior talofibular ligament (ATFL) repair is widely performed for chronic lateral ankle instability (CLAI). Although many studies have reported excellent outcomes with this procedure, the recurrence of instability remains a common concern. Therefore, this study aimed to analyze the risk factors for the recurrence of instability after arthroscopic repair for CLAI.

Methods:

Fifty-six ankles of 53 patients with a mean age of 31.8 ± 14.7 years were retrospectively reviewed. All patients underwent arthroscopic ATFL repair. If instability remained immediately after ATFL repair, calcaneofibular ligament (CFL) repair was performed. The Ankle Activity Score (AAS) was assessed preoperatively, and clinical outcomes including the Japanese Society for Surgery of the Foot scale, Karlsson-Peterson scores, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) were evaluated preoperatively and at the final follow-up. Talar tilt angle (TTA) was assessed preoperatively and 1 year postoperatively. Ankles were divided into 2 groups—nonrecurrence (postoperative TTA, <6 degrees) and recurrence (postoperative TTA, ≥6 degrees)—and clinical outcomes were compared.

Results:

Sixteen ankles showed recurrent instability, whereas 40 did not. AAS, TTA, and social functioning in the SAFE-Q were significantly higher in the recurrence group than those in the nonrecurrence group preoperatively. In addition, the rate of poor ATFL remnant quality and the number of CFLs not repaired despite the preoperative injury diagnosis were significantly higher in the recurrence group than in the nonrecurrence group.

Conclusion:

Arthroscopic repair for ATFL and CFL deficiencies with preoperative high activity, poor remnant quality, and neglected CFL injury can result in the recurrence of instability. Appropriate surgical procedures to prevent the recurrence of instability should be selected for these ankles.

Level of Evidence:

Level IV, retrospective case series.
Re-Examining the Reliability and Validity of the SWPBIS Tiered Fidelity Inventory
Authors: Grasley-Boy Nicolette M. , Gage Nicholas A. , Lombardo Michael , Anderson Lucas
Published: May 2023

School-wide positive behavior interventions and supports (SWPBIS) is widely implemented across the United States. Evidence suggests that SWPBIS, when implemented with fidelity, has a significant and positive impact on schools, including lower suspensions and higher reading and mathematics achievement. A critical component of this research is measuring fidelity of SWPBIS implementation in schools. In this study, we re-evaluated the reliability and validity of a widely used fidelity tool, the Tiered Fidelity Inventory (TFI), within a single-state sample. Using data from 693 schools in the U.S. state of California, we found a hierarchical factor structure based on subscales and tiers fit the data best when controlling for the multilevel nature of the data; however, there was no relation between the latent fidelity variables and changes in suspensions. Implications of these results are discussed, including different approaches to scoring and conceptualizing fidelity of implementation for SWPBIS, along with considerations for future research using the TFI.
Bilateral acute iris transillumination (BAIT) syndrome: Differential diagnosis based on clinical, OCT and UBM findings
Authors: Cronemberger Sebastião , Vasconcelos-Santos Daniel Vítor , Correia de Carvalho Clóvis , Carvalho José Herculano , Calixto Júlia , Diniz-Filho Alberto
Published: May 2023

Introduction

Bilateral acute iris transillumination (BAIT) is a relatively new syndrome whose etiopathogenesis is still not fully understood. It is characterized by acute bilateral onset of intense pigment dispersion in the anterior chamber, iris depigmentation with severe transillumination defects, accentuated pigment deposition in the angle, and elevated intraocular pressure (IOP). In literature, the first case was of bilateral acute iris depigmentation (BADI) reported in 2004 in a 77-year-old woman. In 2019, Perone et al. published a review about BAIT syndrome. They reported a total of 79 cases have been published up that date, mainly in Europe and especially in Turkey and Belgium. The majority of reported cases were of bilateral acute iris depigmentation (BADI). BAIT syndrome might be mainly confused with acute iridocyclitis, acute primary angle-closure (APAC) and pigment dispersion syndrome (PDS). In relation to BAIT, controversies still exist regarding the etiology being the differential diagnosis of paramount importance for adequate treatment.

Purpose

To report a case of BAIT syndrome associated to refractory glaucoma and to discuss the differential diagnosis based on clinical, OCT and UBM findings.

Methods

We present a case of BAIT syndrome in which clinical, OCT and UBM findings have pointed out the similarities and, mainly the diagnosis differences with other ocular diseases.

Conclusions

BAIT syndrome with accentuated IOP rise must be differentiated of other ocular diseases. It requires urgent clinical therapy and/or surgical management as occurred in the present case for avoiding structural damage in OCT and visual field loss. OCT and UBM are critical for early recognition, differential diagnosis and management.
In Silico Analysis of MicroRNA Expression Data in Liver Cancer
Authors: Abu-Shahba Nourhan , Hegazy Elsayed , Khan Faiz M. , Elhefnawi Mahmoud
Published: May 2023

Abnormal miRNA expression has been evidenced to be directly linked to HCC initiation and progression. This study was designed to detect possible prognostic, diagnostic, and/or therapeutic miRNAs for HCC using computational analysis of miRNAs expression. Methods: miRNA expression datasets meta-analysis was performed using the YM500v2 server to compare miRNA expression in normal and cancerous liver tissues. The most significant differentially regulated miRNAs in our study undergone target gene analysis using the mirWalk tool to obtain their validated and predicted targets. The combinatorial target prediction tool; miRror Suite was used to obtain the commonly regulated target genes. Functional enrichment analysis was performed on the resulting targets using the DAVID tool. A network was constructed based on interactions among microRNAs, their targets, and transcription factors. Hub nodes and gatekeepers were identified using network topological analysis. Further, we performed patient data survival analysis based on low and high expression of identified hubs and gatekeeper nodes, patients were stratified into low and high survival probability groups. Results: Using the meta-analysis option in the YM500v2 server, 34 miRNAs were found to be significantly differentially regulated ( P-value ⩽ .05); 5 miRNAs were down-regulated while 29 were up-regulated. The validated and predicted target genes for each miRNA, as well as the combinatorially predicted targets, were obtained. DAVID enrichment analysis resulted in several important cellular functions that are directly related to the main cancer hallmarks. Among these functions are focal adhesion, cell cycle, PI3K-Akt signaling, insulin signaling, Ras and MAPK signaling pathways. Several hub genes and gatekeepers were found that could serve as potential drug targets for hepatocellular carcinoma. POU2F1 and PPARA showed a significant difference between low and high survival probabilities ( P-value ⩽ .05) in HCC patients. Our study sheds light on important biomarker miRNAs for hepatocellular carcinoma along with their target genes and their regulated functions.
A scoping review of autism research conducted in Central Asia: Knowledge gaps and research priorities
Authors: Zakirova-Engstrand Rano , Yakubova Gulnoza
Published: May 2023

Very little is known about the status of autism research in Central Asia. The purpose of this scoping review was to examine the scope and focus of the peer-reviewed research studies conducted with autistic people and their families in five Central Asian countries—Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. The electronic databases of EBSCO Host and Web of Science were used for systematic search of literature. Eleven articles that met eligibility criteria were included in the review and analyzed for topics and research areas outlined in the Interagency Autism Coordinating Committee Strategic Plan. Ten of these studies were conducted in Kazakhstan and one in Uzbekistan using qualitative, quantitative, and mixed-methods research designs. Five of the seven research areas—Diagnosis, Biology, Risk Factors, Services, and Treatment and Interventions—were represented in these studies, while there were no studies identified in the areas of Lifespan Issues or Infrastructure and Surveillance, highlighting a gap in research. None of the studies reported co-authorship of scientists from Central Asian countries. The review identified knowledge gaps and research needs to guide future research in autism in Central Asia to address the needs of autistic individuals and their families living in this region.

Lay abstract

Very little is known about the status of autism research in Central Asia. Through the library databases, we identified and reviewed 11 scientific studies conducted with autistic people and their families in five Central Asian countries—Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Of the 11 studies, 10 were conducted in Kazakhstan and 1 in Uzbekistan. Within these limited number of research studies, different topics such as diagnosis, risk factors of autism, biology, and various service and intervention areas were addressed. We identified several knowledge gaps and research priorities to address the needs of autistic people, their families, and professionals in Central Asia.
Gratitude to Ken Plummer
Authors: González-López Gloria
Published: May 2023

The author weaves her favorite quotes from Ken Plummer’s celebrated book, Telling Sexual Stories with her own voice to offer a modest tribute and express her gratitude to him. In this exercise of creative writing, she celebrates his contributions to her intellectual and professional growth as a feminist ethnographer, a witness to endless sexual stories with populations of Mexican origin in both countries, the United States and Mexico. The author reflects on the priceless lessons she learned from him, since that day she listened to him from a corner at the American Sociological Association conference, when she was a shy graduate student.
The mediated circulation of the United Kingdom’s YouthStrike4Climate movement’s discourses and actions
Authors: Cammaerts Bart
Published: May 2023

The circulation of the discourse as well as the direct actions of the United Kingdom’s YouthStrike4Climate movement is analysed by considering the production of movement discourses in conjunction with the way in which the movement self-mediates those discourses and actions, the way the mainstream media represents them and how they were received by non-activist citizens as well as political elites. It was found that the movement discourse invokes crisis and a sense of emergency to act; the need for a green new deal is proposed with an emphasis on intersectional climate justice and more democracy and inclusion of youth voices. The Internet, social media and cloud-based platforms were used a lot, to communicate both outwards and inwards. However, the resonance of social media engagement was relatively low. Mainstream media resonance, on the contrary, was quite high and overall relatively positive, although there was also evidence of belittlement and misogyny. The movement has played its role, among others, to increase awareness of climate change and the need to act, but the direct actions of the movement were less supported and there is also still a gap in terms of class and race, which will require a more embodied rather than performative intersectionality with regard to environmental issues.
Construction of normality in the gecekondu settlement: Experience of place, social pressure, and tactics
Authors: Bektaş Ata Leyla
Published: May 2023

This article aims to interrogate the construction of normality with a view to a squatter metropolitan setting in İzmir, Turkey. In doing so, I focus on the everyday experiences of the inhabitants in Limontepe and frame them in the context of place-making. I read the concept of ‘normal’ through Bourdieu’s notion of habitus and refer to women’s micro-practices in drawing its contours. Women, living within the boundaries of normality use tactics to cope with the existing normal and related interventions to their bodies, movements, and thoughts. Ethnographic research is the key to understanding inhabitants’ gendered experiences with space.
‘He Wei Gui’: The wisdom and action of tourism photography vendors to handle conflicts in Canton Tower Scenic Area
Authors: Guo Qiang , Wen Tong , Zhang Bo , Li Jieyi
Published: May 2023

Given both the popularity of street vendors and the government resistance to them in tourism governance, we interview vendors between September 2014 and May 2021 to gain insights into the interactions and conflicts between vendors, local enterprises and government departments in Canton, China. We derive a theory of ‘He Wei Gui’ from Chinese Confucian culture and adopt discourse analysis to investigate how informal tourism photography vendors in the Canton Tower Scenic Area resolve their conflicts. We argue that photography vendors have developed a harmonious but fragile coexistence through the use of measures such as fuzzification of public space, flexible industry regulations, output of emotional capital and normalised ways, thereby demonstrating the business acumen of little people. In contrast to the existing trend of ‘rigid governance’, the authors suggest applying ‘flexible management’ in the informal economy and tourism governance, and giving prominence to the principal role of informal operators or little people. In addition, this flexible management reflects the tacit consent from all the stakeholders, the active suing for nonviolent solution from the vulnerable and the willingness of modifying or even creating rules for balancing the distribution of the interests from the dominant stakeholder. The key to this flexible management is that authorities take the investment of emotional capital of the vulnerable groups into consideration. This leads to fuzzy governance which blurs and integrates emotions into the rules, making it possible to solve the conflicts in a more flexible way.
A hybrid thrusting system for increasing the endurance time of multirotor unmanned aerial vehicles
Authors: Bdour Jawad , Sababha Belal H
Published: May 2023

One of the most significant disadvantages of electric multirotor unmanned aerial vehicles is their short flight time compared to fuel-powered unmanned aerial vehicles. This is mainly due to the low energy density of electric batteries. Fuel has much more energy density when compared to batteries. Electric-powered motors in multirotor unmanned aerial vehicles cannot be replaced with fuel-based engines because the stability and control of multirotor unmanned aerial vehicles rely on the high response rates of electric motors. One of the possible solutions to overcome this problem of short endurance times is by using hybrid thrusting systems that combine the advantages of both fuel and electrical propulsion systems, where high maneuverability and long endurance flight time could be achieved. In this work, hybrid thrusting and power systems for multirotor unmanned aerial vehicles are studied. Targeted hybrid thrusting systems consist of combustion engines, electric motors, and their power sources. Then a hybrid thrusting system-based quadrotor unmanned aerial vehicle model is developed. The article presents the altitude and attitude control systems of the developed hybrid thrusting system-based unmanned aerial vehicle. The presented hybrid quadcopter model comprises four electric motors and one fuel engine. The fuel engine used in this work is a 4.07 cc internal combustion engine targeting 2–3 kg unmanned aerial vehicles with up to 5 kg maximum takeoff weight. The developed hybrid quadrotor unmanned aerial vehicle achieved a 139% improvement in flight time when compared with traditional electric-based quadrotor unmanned aerial vehicles. The article also reports on other flight time-related issues such as the optimal fuel mass to battery size ratio to maximize the endurance time of the quadrotor unmanned aerial vehicles.
Therapeutic targets in alcohol-associated liver disease: progress and challenges
Authors: Adekunle Ayooluwatomiwa Deborah , Adejumo Adeyinka , Singal Ashwani K.
Published: May 2023

Alcohol-associated liver disease (ALD) is a complex disease with rapidly increasing prevalence. Although there are promising therapeutic targets on the horizon, none of the newer targets is currently close to an Food and Drug Administration approval. Strategies are needed to overcome challenges in study designs and conducting clinical trials and provide impetus to the field of drug development in the landscape of ALD and alcoholic hepatitis. Management of ALD is complex and should include therapies to achieve and maintain alcohol abstinence, preferably delivered by a multidisciplinary team. Although associated with clear mortality benefit in select patients, the use of early liver transplantation still requires refinement to create uniformity in selection protocols across transplant centers. There is also a need for reliable noninvasive biomarkers for prognostication. Last but not the least, strategies are urgently needed to implement integrated multidisciplinary care models for treating the dual pathology of alcohol use disorder and of liver disease for improving the long-term outcomes of patients with ALD.
Impact of prehospital stroke triage implementation on patients with intracerebral hemorrhage
Authors: Almqvist Tove , Falk Delgado Anna , Sjöstrand Christina , Ahmed Niaz , Berglund Annika , Eriksson Einar , Mazya Michael V.
Published: May 2023

Background:

Little is known about how prehospital triage using large vessel occlusion (LVO) stroke prediction scales affects patients with intracerebral hemorrhage (ICH).

Objectives:

We aimed to investigate whether the Stockholm Stroke Triage System (SSTS) implemented in 2017 has affected timing and outcomes of acute ICH neurosurgery, and to assess system triage accuracy for ICH with a neurosurgical indication or LVO thrombectomy.

Design:

Observational cohort study.

Methods:

In the Stockholm Region, we compared surgical timing, functional outcome, and death at 3 months in patients transported by code-stroke ground ambulance who had ICH neurosurgery, 2 years before versus 2 years after SSTS implementation. We also calculated triage precision metrics for treatment with either ICH neurosurgery or thrombectomy.

Results:

A total of 36 patients undergoing ICH neurosurgery were included before SSTS implementation and 30 after. No significant difference was found in timing of neurosurgery [median 7.5 (4.9–20.7) versus 9.1 (6.1–12.5) h after onset], distribution of functional outcomes (median 4 versus 4), and death at 3 months [3/29 (9%) versus 5/35 (17%)] before versus after implementation, respectively. The SSTS routed a larger proportion of patients subsequently undergoing ICH neurosurgery directly to the comprehensive stroke center: 13/36 (36%) before versus 18/30 (60%) after implementation. Overall system triage accuracy for ICH neurosurgery or thrombectomy was high at 90%, with 92% specificity and 65% sensitivity.

Conclusion:

The SSTS, initially designed for prehospital LVO stroke triage, routed more patients with neurosurgical indication for ICH directly to the comprehensive stroke center. This did not significantly affect surgical timing or outcomes.
The Goudge Inquiry and Forensic Pathology in Canada
Authors: Milroy Christopher M.
Published: May 2023

Aims:

This article analyses the effects of The Inquiry into Pediatric Forensic Pathology in Ontario, commonly known as the Goudge Inquiry, and its effects upon forensic pathology in Canada.

Methods:

The Goudge Inquiry was a Government of Ontario public inquiry that examined the delivery of pediatric forensic pathology services to the Ontario Coroner’s Office and the Canadian criminal justice system. The inquiry was conducted by Mr. Justice Goudge, a court of Appeal Judge and made substantial recommendations of improving forensic pathology in a Coroner system and its role in delivering evidence to the criminal justice system. This article reviews the inquiry and discusses the effect of the inquiry on the development of forensic pathology in Canada and academic literature about the inquiry.

Results:

The Inquiry has had important effects on the role of all expert witnesses in the courts and is the most substantial examination of forensic pathology by any judicial inquiry.

Conclusions:

The Goudge Inquiry has been considered a significant success, being described as transformative.
A Focused Review of the Pharmacological Potentials of Terrein as an Anticancer Agent
Authors: Goutam Jyoti , Sharma Gunjan , Yadav Vandana , Pathak Gauri , Kharwar Ravindra Nath , Sharma Divakar
Published: May 2023

Terrein is one of the most important biomolecules of fungal origin being studied from a medicinal perspective. Secondary metabolites are the intermediate products produced during the metabolism of organisms for a large number of functions, for example, defense and communication signals. From the outset, terrein has largely been studied as an anticancer secondary biomolecule. Aspergillus terreus is the only fungal source of some valuable drugs and mycotoxins. From the beginning, a few species of Aspergillus were known to be viable chemical factories. Terrein is a potent biological molecule present in the fungus that is responsible for its medicinal and agricultural values. Numerous evaluations conducted on terrein showed it to have marked biological activities (antimicrobial, antiproliferative, anti-oxidative, and others). To date, terrein has emerged as a very attractive therapeutic regimen against cancer due to its dual targeting nature; tumor angiogenesis and cell proliferation. This focused review provides details of the therapeutic value of terrein and its modes of action as an anticancer agent. Besides this, terrein has other marked bioactivities and manifold uses in the field of medicine, which have also been discussed here.
Neuro-Sweet Syndrome: A Diagnostic Conundrum
Authors: Acurio Karlos , Chuquilin Miguel
Published: May 2023

Sweet Syndrome presents as acute fever, leucocytosis and characteristic skin plaques. It can involve many organ systems but rarely affects the nervous system. We report the case of a 51-year-old female that presented with fever, rash, headache and encephalopathy. Brain magnetic resonance imaging showed extensive T2 hyperintensities involving cerebral hemispheres, cerebellum, and brainstem. A skin biopsy revealed dermal infiltration by neutrophils consistent with Sweet Syndrome. She started steroid treatment with a good clinical response. Further questioning revealed that she had a similar episode 10 years prior that had been diagnosed as acute disseminated encephalomyelitis. Neuro-Sweet Syndrome can present with a great array of symptoms and relapses over long periods of time making the diagnosis difficult without a high degree of suspicion. Clinicians should consider this syndrome in the setting of acute encephalitis with white matter lesions that are highly responsive to steroids particularly in the presence of previous similar symptoms.
Gummatous Neurosyphilis With Transient Worsening of Neurological Symptoms After Treatment Initiation
Authors: Ariza Hutchinson Valeria , Shnawa Aya , Lerner David P. , Wener Kenneth , Cervantes-Arslanian Anna , Burns Joseph D.
Published: May 2023

Cerebral syphilitic gumma is an atypical presentation of neurosyphilis, the clinical manifestations of which depend on the size and location of the lesions. It radiologically presents as enhancing nodular lesion(s) in brain parenchyma. We present a case of a patient with cerebral syphilitic gummas who had worsening neurological symptoms a few hours after initiation of anti-syphilitic antibiotic treatment. We aim to illustrate the clinical and radiological characteristics that might be helpful to clinicians when approaching the challenges they might encounter while treating neurosyphilis.
Developing Educational Leadership in Mathematics and Science: Insights From Teaching and Learning Faculty
Authors: Cunningham Kathleen M. W. , Snodgrass Rangel Virginia , Lochmiller Chad R. , Farmer Matthew
Published: May 2023

This study extends existing research on content-specific leadership for mathematics and science and educational leadership preparation. Interview data from mathematics and science education faculty reveal that principals should know what questions to ask teachers about instruction, be able to identify high-quality mathematics and science teaching in classrooms, recognize specific considerations related to mathematics and science, and attend to equity in science and mathematics classrooms. Interview data suggest principals support mathematics and science by fostering a culture that values mathematics and science, providing resources, prioritizing depth in instruction, dedicating time for inquiry and exploration, and trusting and empowering teachers with expertise.
Theorising urban development in China: ‘State entrepreneurialism’ from the ground up
Authors: Wu Fulong
Published: May 2023

Instead of generating a grand theory from urban China, I have a rather modest aim – how we might use the political-economic perspective to better understand China's urban development politics. Rather than treating empirical materials and theoretical insights as discrete entities, describing China should itself be regarded as a process of theorisation, contributing to a more global Urban Studies. We illustrate how ‘state entrepreneurialism’, as a quite peculiar form of governance, is generated from the conjunctural development of global capitalism and its crises. Hence, the role of the state is not a starting point for theoretical enquiry but rather a historical and material development of China's political economy.
“The Cult of Greta Thunberg”: De-legitimating Climate Activism with “Religion”
Authors: Kyyrö Jere , Äystö Tuomas , Hjelm Titus
Published: May 2023

Contemporary climate activism has often been called a “religion” or a “cult.” We investigate what is done with climate religion discourse (CRD), by whom, and to what ends. Our case study concerns Finland, one country out of many where forms of climate activism are regularly dismissed by equating them with “irrational” religion. We find that political parties and newspaper columnists use terms and phrases such as “millenarianism,” “prophet,” “Messiah,” “cult,” “apocalypse,” “Virgin Mary of climate religion,” and “children’s crusade.” We argue that these are examples of strategic othering in the Finnish context. We observe that this religionizing stems from the activism’s incompatibility with prevalent economic rationality, and that gender is a significant theme in CRD use. An unintended consequence of CRD is that it constructs those forms of religion, which do not disturb modernity and the capitalist order as more legitimate than others.
Stepping back from Data and AI for Good – current trends and ways forward
Authors: Aula Ville , Bowles James
Published: May 2023

Various ‘Data for Good’ and ‘AI for Good’ initiatives have emerged in recent years to promote and organise efforts to use new computational techniques to solve societal problems. The initiatives exercise ongoing influence on how the capabilities of computational techniques are understood as vehicles of social and political change. This paper analyses the development of the initiatives from a rhetorical slogan into a research program that understands itself as a ‘field’ of applications. It discusses recent academic literature on the topic to show a problematic entanglement between the promotion of initiatives and prescriptions of what ‘good’ ought to be. In contrast, we call researchers to take a practical and analytical step back. The paper provides a framework for future research by calling for descriptive research on the composition of the initiatives and critical research that draws from broader social science debates on computational techniques. The empirical part of the paper provides first steps towards this direction by positioning Data and AI for Good initiatives as part of a single continuum and situating it within a historical trajectory that has its immediate precursor in ICT for Development initiatives.
Attitudes and associated factors of patients’ adoption of patient accessible electronic health records in China — A mixed methods study
Authors: Liu Jing , Gong Xiaoqian , Weal Mark , Dai Wei , Hou Shengchao , Ma Jingdong
Published: May 2023

Background

Although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example.

Objective

The study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies.

Methods

This study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected.

Results

The findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention.

Conclusion

It is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design.
Automated Framing of Climate Change? The Role of Social Bots in the Twitter Climate Change Discourse During the 2019/2020 Australia Bushfires
Authors: Daume Stefan , Galaz Victor , Bjersér Petter
Published: May 2023

Extreme weather-related events like wildfires have been increasing in frequency and severity due to climate change. Public online conversations that reflect on these events as climate emergencies can create awareness and build support for climate action but are also used to spread misinformation and climate change denial. To what extent automated social media accounts—“social bots”—amplify different perspectives of such events and influence climate change discourses, remains unknown, however. We use Twitter and the 2019/2020 Australia bushfires as a case study to explore this issue. Utilizing more than 1 million Tweets, we identify how climate change is framed in the context of those fires, and to what extent social bots affect specific climate change frames, including the spread of misinformation. Our results show that climate change represents a substantial part of online conversations about fires. The bushfires are primarily framed as a climate change issue including its measurable impacts and political perspectives. Climate denial represents a small share of this conversation and receives limited amplification. Social bots seemingly contribute to the climate change conversation, both through frames that support and oppose climate action, and amplify to larger degree frames appealing to emotions, such as sympathy or humor. We also find that Twitter discussions about the role of social bots in spreading climate denial are amplified more than actual climate-critical frames propagated by bots. A complex interplay between social bots, Twitter conversations, and online news media is emerging, which shapes discussions about climate change and wildfires.
Mitochondrial Myopathy in a 21-Year-Old Man Presenting With Bilateral Lower Extremity Weakness and Swelling
Authors: Bharathidasan Kavya , Evans Abbie , Fernandez Fabiana Monte Alegre Olmos , Motes Arunee Tansrisook , Nugent Kenneth
Published: May 2023

Bilateral lower extremity weakness and swelling can have several causes. Although often underdiagnosed, mitochondrial myopathy is more prevalent in the general population than more commonly suspected diseases, such as Guillain-Barre syndrome. The clinical manifestations of mitochondrial disease can be broadly classified into 3 categories: chronic progressive external ophthalmoplegia, skeletal muscle-central nervous system syndromes, or pure myopathy. Cardiac abnormalities occur in 30% to 32% of cases, mostly in the form of hypertrophic cardiomyopathy, dilated cardiomyopathy, or conduction abnormalities. We report a case of a 21-year-old student who developed bilateral lower limb weakness, pain, and swelling diagnosed with mitochondrial myopathy on muscle biopsy. Initial laboratory tests revealed elevated creatinine kinase, brain natriuretic peptide, troponin, myoglobin, and lactic acid and reduced serum bicarbonate. Cardiac workup revealed systolic heart failure with a reduced ejection fraction. Endomyocardial biopsy revealed punctate foci of lymphocytic myocarditis. However, cardiac magnetic resonance imaging did not reveal either myocarditis or an infiltrative cardiac disease. An extensive autoimmune and infection work-up was negative. A muscle biopsy from the patient’s rectus femoris revealed scattered ragged-blue fibers (stained with NADH dehydrogenase), scattered ragged-red fibers on modified Gomori trichrome stain, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy. The patient was treated successfully with furosemide, metoprolol, and methylprednisolone. Adult-onset mitochondrial myopathy is a rare clinical disorder, and our experience stresses the importance of using an inter-disciplinary team approach to diagnose uncommon clinical disorders with widely variable multisystem involvement.
How do Specialists Address Contraceptive Care Compared to General Practitioners in a Federally Qualified Health Center in Maryland
Authors: Hart Leah , Beaudoin Jarett , Parsons Georgia , Alonge Olakunle
Published: May 2023

Objectives:

To determine associations between primary provider specialty and the contraceptive care that patients receive in a Federally Qualified Health Center setting in Maryland.

Methods:

A study of reproductive-age patients and their providers was performed from January 2018 to December 2021. A pooled crosssectional survey of electronic medical record data for 44 127 encounters of 22 828 patients was performed to calculate the odds of contraceptive care being addressed by patients who had General Practitioner, OB/GYN, pediatrician, or infectious disease (ID) specialists as their primary providers.

Results:

In 19 041 encounters (43%), contraception was addressed through either counseling alone, documentation of a contraceptive prescription, or long-acting reversible contraceptive (LARC) placement procedure. After adjusting for insurance status and race/ethnicity, the odds ratio (OR) of contraceptive care delivery was statistically significantly higher for OB/GYN providers compared to General Practitioners—OR 2.42 (CI 2.29-2.53) and statistically significantly lower for ID providers—OR 0.69 (CI 0.61-0.79). There was a non-statistically significant difference for Pediatricians—OR 0.88 (CI 0.77-1.01).

Conclusion:

The provision of contraceptive care, a critical aspect of comprehensive primary care delivered in an FQHC setting, varies by provider specialty, and may be negatively influenced by Ryan White funding related structures. There is a need to intentionally design robust referral and tracking systems to ensure contraceptive care is equitably accessible to all, regardless of assigned primary care provider specialty or HIV status.
Does Microfinance Singlehandedly Empower Women? A Case Study of Bangladesh
Authors: Pervin Sajeda , Ismail Mohammad Nazari , Md Noman Abu Hanifa
Published: May 2023

The role played by microfinancing in the empowerment of women has been a subject of debate in recent literature. By employing the case study method, this paper explores the influencing determinants. Data was obtained from a field interview comprised of 20 female microfinance borrowers and their male family members, as well as focus group discussions and participant observation. The economic, social, and political empowerment of the interviewed women were assessed using Kabeer’s empowerment framework, and the results reveal that microfinancing does not influence the economic and political dimensions of female empowerment; instead, microfinancing was observed to empower women socially, particularly with respect to their participation in major decision-making. The results further indicate that the age, family type, educational level, financial literacy, and training of female microfinance clients play important roles in their empowerment.
The Say Wallahi Generation: A Narrative Study of Bicultural Identity for Somali American Emerging Adults
Authors: Said Roun , Grier-Reed Tabitha
Published: May 2023

This qualitative study used narrative inquiry to examine how five Midwestern Somali American emerging adults negotiated their Somali culture and their American culture into a coherent sense of self. Participants were primarily women ( n = 4) and students (three undergraduate and one graduate). Merging or hybridizing cultural identities was one way participants found integration. Shifting or alternating identities was another. In general, dominant and conflicting cultural narratives presented challenges to integration and connected to themes of acculturative dissonance, exclusion, and contested American identity. Yet, robust competing narratives were transformative, undergirding the themes of Integrated and Owning It and Shifting Identities. Unlike conflicting narratives which existed in negative tension with dominant narratives, competing narratives existed in positive tension and provided a basis for frame-switching which empowered participants to shift identities with ease even as they contended with multiple master narratives.
Massive and Irreparable Rotator Cuff Tears: A Review of Current Definitions and Concepts
Authors: Sheth Mihir M. , Shah Anup A.
Published: May 2023

Background:

While massive and irreparable rotator cuff tears (MIRCTs) have been abundantly studied, inconsistent definitions in the literature and theories about pain and dysfunction related to them can be difficult to navigate when considering an individual patient.

Purpose:

To review the current literature for definitions and critical concepts that drive decision-making for MIRCTs.

Study Design:

Narrative review.

Methods:

A search of the PubMed database was performed to conduct a comprehensive literature review on MIRCTs. A total of 97 studies were included.

Results:

Recent literature reflects added attention to clarifying the definitions of “massive, “irreparable,” and “pseudoparalysis.” In addition, numerous recent studies have added to the understanding of what generates pain and dysfunction from this condition and have reported on new techniques for addressing them.

Conclusion:

The current literature provides a nuanced set of definitions and conceptual foundations on MIRCTs. These can be used to better define these complex conditions in patients when comparing current surgical techniques to address MIRCTs, as well as when interpreting the results of new techniques. While the number of effective treatment options has increased, high-quality and comparative evidence on treatments for MIRCTs is lacking.
Doing diversity work in higher education: Systemic inequality, institutional change, and campus attitudes
Authors: Magnus Amy M , Coutin Susan Bibler , Leslie Frances
Published: May 2023

Diversity work remains one of the most critical, yet complicated and contentious efforts in higher education. To promote transformative institutional change, a university in California, United States developed an innovative, federally funded community-building model designed to institutionalize diversity efforts. As part of this model, a cross-sectional climate survey was administered in 2010, 2014, and 2018 to learn more about perceptions of campus diversity-oriented work. We present a qualitative, Critical Race Theory analysis of faculty and graduate student responses to the open-ended question, “What do you think we should know about diversity at [this university]?” These data offer a window into a unique period of American history when politics were, and continue to be, especially contentious and social inequality was, and is, at the forefront of American consciousness. We conclude with respondent-inspired suggestions for moving higher education toward social justice.
Perspectives of lignite post-mining landscapes under changing environmental conditions: what can we learn from a comparison between the Rhenish and Lusatian region in Germany?
Authors: Gerwin Werner , Raab Thomas , Birkhofer Klaus , Hinz Christoph , Letmathe Peter , Leuchner Michael , Roß-Nickoll Martina , Rüde Thomas , Trachte Katja , Wätzold Frank , Lehmkuhl Frank
Published: May 2023

Background

The decision of the German federal government to cease lignite mining until 2038 or—if possible—already earlier until 2030, will cause manifold transition processes in the remaining lignite mining districts of Germany. The two largest districts are located in geographically opposite regions: The Rhineland in the western part and Lusatia in the east of Germany. As particularly these two mining districts will experience severe changes in their socioeconomic as well environmental conditions, the federal government has adopted comprehensive economic support measures. However, the environmental changes will also cause altered ecosystem functions and services to be provided by the future post-mining landscapes.

Results

In this paper, the two main lignite-producing regions of Germany are compared with regard to their natural and cultural settings. The economic situation and its history are reflected and differences are outlined. Part of the disparities in the cultural development can be explained by very different natural conditions, especially edaphic factors and climatic situation. Because of dissimilar geological settings, different mining technologies were developed and are in use in the two regions with distinct effects on the resulting post-mining landscapes.

Conclusion

The long-standing and manifold lignite mining activities have radically restructured the landscapes in Lusatia and the Rhineland. With the ongoing decline of the mining industry and its complete cessation, presumably within the next decade, both regions will alter their faces significantly. These changes offer both challenges but also opportunities with respect to the post-mining landscapes and their ecosystem services they are going to provide. The prerequisites for a positive socioeconomic development and for sustainable land-use concepts that also consider ecological aspects are different for both regions. However, or especially because of these differences, the knowledge exchange and experience transfer between both mining regions are pivotal for the success of this extensive transformation process.
Integrated bioinformatics analysis for conducting a prognostic model and identifying immunotherapeutic targets in gastric cancer
Authors: Liu YaLing , Li Dan , Chen Yong , Liu YiJuan , Lin YiJuan , Huang XunRu , Wu Ting , Wang ChengDang , Ding Jian
Published: May 2023

Background

Gastric cancer is the third leading cause of death from cancer worldwide and has a poor prognosis. Practical risk scores and prognostic models for gastric cancer are lacking. While immunotherapy has succeeded in some cancers, few gastric cancer patients benefit from immunotherapy. Immune genes and the tumor microenvironment (TME) are essential for cancer progression and immunotherapy response. However, the roles of immune genes and the tumor microenvironment in immunotherapy remain unclear. The study aimed to construct a prognostic prediction model and identify immunotherapeutic targets for gastric cancer (GC) patients by exploring immune genes and the tumor microenvironment.

Results

An immune-related risk score (IRRS) model, including APOH, RNASE2, F2R, DEFB126, CXCL6, and CXCL3 genes, was constructed for risk stratification. Patients in the low-risk group, which was characterized by elevated tumor mutation burden (TMB) have higher survival rate. The risk level was remarkably correlated with tumor-infiltrating immune cells (TIICs), the immune checkpoint molecule expression, and immunophenoscore (IPS). CXCL3 and CXCL6 were significantly upregulated in gastric cancer tissues compared with normal tissues using the UALCAN database and RT-qPCR. The nomogram showed good calibration and moderate discrimination in predicting overall survival (OS) at 1-, 3-, and 5- year for gastric cancer patients using risk-level and clinical characteristics.

Conclusion

Our findings provided a risk stratification and prognosis prediction tool for gastric cancer patients and further the research into immunotherapy in gastric cancer.
Computational analysis of missense variant CYP4F2*3 (V433M) in association with human CYP4F2 dysfunction: a functional and structural impact
Authors: Farajzadeh-Dehkordi Mahvash , Mafakher Ladan , Samiee-Rad Fatemeh , Rahmani Babak
Published: May 2023

Background

Cytochrome P450 4F2 (CYP4F2) enzyme is a member of the CYP4 family responsible for the metabolism of fatty acids, therapeutic drugs, and signaling molecules such as arachidonic acid, tocopherols, and vitamin K. Several reports have demonstrated that the missense variant CYP4F2*3 (V433M) causes decreased activity of CYP4F2 and inter-individual variations in warfarin dose in different ethnic groups. However, the molecular pathogenicity mechanism of missense V433M in CYP4F2 at the atomic level has not yet been completely elucidated.

Methods and results

In the current study, we evaluated the effect of the V433M substitution on CYP4F2 using 14 different bioinformatics tools. Further molecular dynamics (MD) simulations were performed to assess the impact of the V433M mutation on the CYP4F2 protein structure, stability, and dynamics. In addition, molecular docking was used to illustrate the effect of V433M on its interaction with vitamin K1. Based on our results, the CYP4F2*3 variant was a damaging amino acid substitution with a destabilizing nature. The simulation results showed that missense V433M affects the dynamics and stability of CYP4F2 by reducing its compactness and stability, which means that it tends to change the overall structural conformation and flexibility of CYP4F2. The docking results showed that the CYP4F2*3 variant decreased the binding affinity between vitamin K1 and CYP4F2, which reduced the activity of CYP4F2*3 compared to native CYP4F2.

Conclusions

This study determined the molecular pathogenicity mechanism of the CYP4F2*3 variant on the human CYP4F2 protein and provided new information for understanding the structure-function relationship of CYP4F2 and other CYP4 enzymes. These findings will aid in the development of effective drugs and treatment options.