bluuebunny/crossref_metadata_2025 huggingface dataset:
Social complexity and the emergent state
Authors: Pourvand Kaveh
Published: July 2024

Many political philosophers assume the state can coherently reform a society's legal system to realize just, society-wide distributive outcomes. Gerald Gaus invoked social complexity to highlight the limitations of this ambition. Complexity theory holds that interdependent social interaction in large-scale societies leads to unpredictable outcomes. For Gaus, complexity constrains what the state can accomplish. The state does not know how to reform the legal system to achieve ambitious distributive goals. However, Gaus did not model the state itself as a complex system. This is the contribution of this paper. I argue that the state is not a unitary agent that comprehensively oversees the legal system. Rather, the state is a network of interaction between myriad political agents and the legal system is an emergent outcome of this interaction—the result of human action but not an overall design.
Application, understanding, and appropriation of the Montessori method for persons with dementia: A qualitative pilot study
Authors: Donadey Méryl , Broc Guillaume , Erkes Jérôme , Lembach Marie , Camp Cameron , Bayard Sophie
Published: July 2024

The Montessori method applied in nursing homes is a person-centered approach targeting the enhancement of autonomy, well-being, and quality of life for older adults with dementia. Despite its potential in the aging field, its operationalization remains unclear in the context of institutionalization. This study aims to outline the method’s components and adoption factors using a behavior change intervention framework among professionals from a French institution demonstrating a high level of method application. We employed a qualitative descriptive approach based on thematic analysis. Nine professionals from the same institution underwent a semi-structured individual interview within the facility. The findings were modeled using the Behavior Change Intervention Ontology. We obtained a final framework defining the intervention, mechanisms of action, exposure, contextual factors, and behavioral outcomes. The method is based on values, principles, and techniques such as facilitation, choice, meaningful activities, environmental adjustments, and specific tools. Applied continuously to residents, families, and professionals, its implementation is influenced by several contextual factors leading to practice changes at various levels. This study constitutes both a theoretical and practical contribution, providing a better definition of the method and the key factors influencing its appropriation.
Territorial imagination: social media, visual images, and affect in Iranian Kurdistan
Authors: Moradi Sanan
Published: July 2024

Thousands of Iranian Kurds took to the streets in October 2014 in solidarity with the Syrian Kurds’ resistance against the so-called Islamic State (IS), and again in September 2017 to support Iraqi Kurds’ independence referendum. The demonstrations were momentous, given their size, scope, and defiance of the Iranian state’s security measures aimed at suppressing manifestations of Kurdish identity on the streets and on social media. This article examines the use of social media during the demonstrations. Specifically, it investigates how Iranian Kurds utilized social media and visual images to situate the demonstrations within the larger Kurdish resistance in the region and frame the Kurdish movement spatially. Deploying digital methods and poststructural discourse analysis, the article examines a small set of social media posts and draws on semi-structured interviews to deepen and contextualize the analysis. Findings illustrate the role of affect and emotion in enabling bodies to connect, resist the state’s securitized territoriality, and produce a particular territorial imagination – one that foregrounds Kurdistan as a meaningful non-state geopolitical construct. The article emphasizes the mutually constitutive relations between the affective-emotional and the discursive-symbolic by foregrounding users’ agency in connecting with social media and visual images. Highlighting the production of minoritized territorial imaginations, the paper contributes to the literature on social media, visuality, and space.
Nurses as Petitioners: A Legal Mapping of State Extreme Risk Protection Order Laws
Authors: Lindley Lisa C. , Policastro Christina N. , Svynarenko Radion , Davis Heather A. , Beebe Lora Humphrey
Published: July 2024

Gun violence is a leading public health concern in the US; subsequently, firearm-related violence prevention is a top priority for policymakers. Extreme risk protection order (ERPO) laws are a state-level attempt to reduce gun-related injuries and deaths. These court-issued orders prohibit people found to be dangerous to themselves or others from temporarily purchasing or possessing a firearm. Six states (Colorado, Connecticut, Hawaii, Maryland, Michigan, New York) and the District of Columbia have passed or amended their laws to include nurses as ERPO petitioners. The study's purpose was to conduct a review of state ERPO laws that included nurses as petitioners. Using a legal mapping approach, information on nurse ERPO petitioning was extracted from the seven jurisdictions. ERPO laws with nurse petitioners were passed between 1999 and 2023. Nurse petitioners included advanced practice registered nurse (n = 3), clinical nurse specialists (n = 3), nurse practitioner (n = 3), professional nurse (n = 2), and register nurse (n = 1). Psychiatric/mental health (n = 2) and school nurses (n = 2) were specified. Statutes differed in the handling of disclosed health information as part of the ERPO petition, as well as how health information would be handled by the court (e.g. sealed by the court, confidential by the court, returned to provider/disposed of post-hearing/order.) Three statutes exempted petitioners from civil and/or criminal liability, if petitions were submitted in good faith. Two of these states extended protection from liability to all petitioners, while one only referenced petitioners who were healthcare providers. The study findings have important policy, clinical, and research implications.
The Impact of Cerebral Visual Impairment on Social Skills and Sensory Processing
Authors: Kılıç Eray , Cemali Mustafa , Akı Esra
Published: July 2024

Limited evidence exists on the impact of cerebral visual impairment (CVI) on developmental domains in toddlers. This study investigated whether CVI influences social skills and sensory processing in toddlers with cerebral palsy (CP). The study included toddlers with CP, with or without CVI, and typically developing (TD) toddlers. All parents completed the demographic information form. Social skills were assessed by the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). Sensory processing was evaluated by the Infant/Toddler Sensory Profile (ITSP). Analysis of covariance was employed to assess the disparity in BITSEA and ITSP scores. Toddlers with CP and CVI group demonstrated lower social competence than the other groups ( p < .05). Having CVI did not cause a statistically significant difference in sensory processing among toddlers with CP ( p > .05). CVI significantly affects social competence in toddlers with CP but does not affect sensory processing.
Physical Activity Habits Among Physicians: Data From the Athens Medical Association
Authors: Lampsas Stamatios , Marinos Georgios , Lambrinos Dimitrios , Theofilis Panagiotis , Gialamas Ioannis , Pantelidis Panteleimon , Zakynthinos George E , Kalogera Vasiliki , Pililis Sotirios , Korakas Emmanouil , Lambadiari Vaia , Papavassiliou Kostas A. , Oikonomou Evangelos , Siasos Gerasimos
Published: July 2024

Background: Physicians’ exercise habits vary across different medical specialties and health service infrastructure. We assessed physicians’ exercise performance according to the recommendations of the 2020 European Society of Cardiology Guidelines. Methods: This cross-sectional study comprised 742 physicians of the Athens Medical Association (AMA), Greece. Utilizing a self-administered questionnaire, physicians’ exercise habits, demographics, specialty, and infrastructure [Hellenic National Health care System (HNHS) or Private System (PS)] were assessed. Subjects were categorized: Moderate-intensity weekly exercise ≥150 min. (Group A); Moderate-intensity weekly exercise <150 min. (Group B). Results: 53.4% of AMA members met the recommended exercise criteria, averaging 240 ± 285 min./week. Significant differences were noted between Group A and B in male sex (58.3% vs 43.1%, P < 0.001), Body Mass Index (24.7 ± 3.8 kg/m2 vs 26.2 ± 4.7 kg/m2, P < 0.001), Smoking (17.4% vs 23.5%, P = 0.04), Diabetes Mellitus (6.6% vs 11.8%, P = 0.01), and activity monitoring wearables usage (45.2% vs 29.8%, P < 0.001). Significantly more doctors in the PS categorized in Group A ( P = 0.008). After adjustment for confounders, HNHS reported 33% decreased odds of achieving the exercise recommendations compared to PS (Odds Ratio: 0.676; 95% CI: 0.484-0.943, P = 0.03). Conclusion: Several factors affect adherence of AMA members to exercise goals. HNHS AMA doctors are less adherent to exercise recommendations, emphasizing the need to strengthen prevention strategies.
Analysis and simplified model calculation of residual stress in U-rib welding of steel bridge deck
Authors: Gu Lixiong , Hong Jieming , Ma Niujing
Published: July 2024

This article examines residual stress generation in U-ribbed steel bridge deck during welding, focusing on post-welding changes in the base material’s residual stress pattern. A thermo-elasto-plastic finite element analysis model was established to conduct numerical simulations of the welding process, summarizing the residual stress changes near the weld seam, the conclusion was drawn that the tensile and compressive forms of transverse residual stress on the upper and lower surfaces of the base plate were inconsistent. To validate the proposed numerical simulation method’s accuracy, the blind hole method was employed to measure welding-induced residual stress, and finite element analysis calculated calibration coefficients A and B, demonstrating the method’s effectiveness. Comparison of experimental measurements with numerical simulation outcomes validate the finite element simulation method’s accuracy and the adopted methodology’s feasibility. Based on these findings, a piecewise linear fitting approach was adopted to develop a simplified model of welding residual stress. The simplified model provides the initial conditions of residual stress for mechanical calculation of U-rib of the same type.
Optotagging and characterization of GABAergic rostral ventromedial medulla (RVM) neurons
Authors: Follansbee Taylor , Le Chang Henry , Iodi Carstens Mirela , Guan Yun , Carstens Earl , Dong Xinzhong
Published: July 2024

The transmission of nociceptive and pruriceptive signals in the spinal cord is greatly influenced by descending modulation from brain areas such as the rostral ventromedial medulla (RVM). Within the RVM three classes of neurons have been discovered which are relevant to spinal pain modulation, the On, Off, and Neutral cells. These neurons were discovered due to their functional response to nociceptive stimulation. On cells are excited, Off cells are inhibited, and Neutral cells have no response to noxious stimulation. Since these neurons are identified by functional response characteristics it has been difficult to molecularly identify them. In the present study, we leverage our ability to perform optotagging within the RVM to determine whether RVM On, Off, and Neutral cells are GABAergic. We found that 27.27% of RVM On cells, 47.37% of RVM Off cells, and 42.6% of RVM Neutral cells were GABAergic. These results demonstrate that RVM On, Off, and Neutral cells represent a heterogeneous population of neurons and provide a reliable technique for the molecular identification of these neurons.
Pregnancy-related maternal mortality in the state of Georgia: Timing and causes of death
Authors: Kondracki Anthony J , Li Wei , Mokhtari Manouchehr , Muchandi Bhuvaneshwari , Ashby John A , Barkin Jennifer L
Published: July 2024

Background:

The maternal mortality rate in the United States is high and disparities among non-Hispanic White and non-Hispanic Black women remain. In the State of Georgia, the pregnancy-related death rate is among the worst in the nation.

Objective:

To examine current pregnancy-related deaths in the State of Georgia using measures of timing and cause-specific mortality across maternal sociodemographic characteristics.

Design:

This cross-sectional study of pregnancy-related deaths in Georgia was based on 2016–2019 maternal mortality data obtained from the Georgia Department of Public Health.

Methods:

Our study analysis involved complete-case data of maternal deaths identified as pregnancy-related deaths ( n = 129). Statistical analyses included two distinct population-level measures: (a) timing (i.e. during pregnancy, 0 to 60 days, 61 to 180 days, and 181 to 365 days postpartum) and (b) cause-specific deaths patterned by sociodemographic groups of women and by rural and urban county of residence. Categorical variables were compared using the Chi square or Fisher’s exact test and presented as numbers and percentages. A post hoc power analysis was conducted to inform whether there was sufficient power to detect statistically significant effects given available sample sizes.

Results:

Among a total of 129 pregnancy-related deaths, 30 (23.3%) deaths occurred during pregnancy and 63 (48.8%) deaths occurred within the first 60 days postpartum. Pregnancy-related deaths were disproportionally common among non-Hispanic Black, 25 to 34 years old, and poorly educated women. Three leading underlying causes, cardiomyopathy (22.7%), hemorrhage (21.6%), and cardiovascular or coronary disease (20.4%), accounted for about 65% of all pregnancy-related deaths. Mental health conditions were common causes of death among non-Hispanic White women during pregnancy and in late postpartum.

Conclusion:

Continued monitoring, collecting and analyzing reliable data will help identify root causes and find ways to eliminate the disproportionate burden of pregnancy-related deaths in the State of Georgia.
Institutional requirement and central tracking of RCR training of all researchers and research eligible individuals
Authors: Lake-Bullock Helene , Smith Jenny , Matuszak Emily , Chun Jeeyoung , Hill Jennifer , Clark Billy , Lodder Laura , Wolf Baron , Cassis Lisa
Published: July 2024

The University of Kentucky has required that all researchers and research-eligible individuals complete RCR training every 2 years to ensure there is at least a baseline of RCR training throughout the wider research community. The overall goal is to create a research climate that fosters RCR across the institution for approximately 14,400 researchers and research eligible faculty, staff, and trainees engaged in research or creative work. A systematic data strategy was developed and implemented to identify individuals required to complete the RCR training and included real-time data tracking using data analytic tools and sophisticated data models. The RCR training consists of the completion of online asynchronous modules and an in-person RCR training event where case studies are discussed to apply the learning gained from the online modules and prepare participants to practice ethical decision-making in future real-world problem-solving. A train-the-trainer approach was implemented to conduct the in-person RCR training of all researchers and research eligible individuals. A library of interactive case scenarios was developed for the mandatory in-person RCR training applicable to various disciplines across the institution. A survey of participants on the RCR training provided empirical data from approximately 12% of participants. Over 72% of respondents indicated the training positively impacted their behavior. An initiative of this magnitude and reach is the broadest of its kind in the United States (US) and the article outlines the procedures and experiences in implementing the project.
Physical performance estimation in practice: A systematic review of advancements in performance prediction and modeling in cycling
Authors: Stessens Loes , Gielen Jasper , Meeusen Romain , Aerts Jean-Marie
Published: July 2024

Physical performance in cycling is commonly evaluated with laboratory-based performance markers. However, these markers are not monitored on a regular basis, mainly due to the high costs of testing equipment, invasive sampling and time-intensive protocols. The use of mathematical modeling offers a promising alternative allowing for consistent performance monitoring, identification of influential variables affecting performance, and facilitation of planning, monitoring, and predictive analysis. Wearable technology, such as physiological and biomechanical sensors, can be integrated with mathematical models to enhance the practicality of performance monitoring and enable real-time feedback and personalized training recommendations. In this systematic review, we attempted to provide an overview of the developments in predicting and modeling of performance in cycling and their respective practical applications. The PRISMA framework yielded 52 studies that met the inclusion criteria. The models were discussed according to their modeling goal: characterizing kinetics, alternatives to the gold-standard, training control, observing training effects, predicting competitive performance and optimizing performance. Field-based models and technological advancements were highlighted as solutions to the limitations of gold-standard testing. Due to the lower accuracies of modeling techniques, the gold-standard laboratory-based methods of testing will not be replaced by mathematical models. However, models do form a more practical alternative for regular monitoring and a powerful tool for training and competition optimization. A modeling technique needs to be individualized to the goal and the person and be as simple as possible to allow regular monitoring. Ideally, the technique would work in the field, uses submaximal exercise intensities and integrates technological advancements such as wearable technology and machine learning to increase the practicality even more.
‘It's about putting the learning into context’: A multimethod, multiple perspective exploration of the process of learning in introductory coach education
Authors: Allen Justine B. , Reid Colleen , Macdonald Stephen
Published: July 2024

Coach education continues to be an integral part of coaches’ learning journey, but their usefulness has also been questioned. Given the disparity in research findings, the purpose of this study was to further our understanding of the role of the coach developer in the learning process within introductory level coach education courses. Drawing on Moon's stages of learning and using multiple methods (observation, interviews, focus groups), we explored multiple perspectives (coaches, coach developers and researcher observer) of the activities and learning situations within introductory courses (judo, basketball, paddlesports). In total, three courses were observed, each lasting two days (48 hours of observation), six coach developers participated in an interview (45–60 minutes each) and 18 coaches participated in one of five focus groups (20–300 minutes each). Through our thematic analysis, we developed three themes: structure supports the learning process; National Governing Body resources are just a starting point for learning; a deep approach to learning can be facilitated. Our findings suggest that despite criticisms of large-scale approaches to coach education, they were useful to coaches and coach developers were able to facilitate some deep learning. Furthermore, the quality of coach education programmes was largely dependent on the expertise of coach developers in their roles. Questions are raised about the conceptualisation of learner-centred approaches to coach education delivery.
Vulnerability or resilience tweets? A comparative analysis of media outlets versus non-governmental organizations visual representations of the 2023 Morocco earthquake survivors
Authors: Elhosary Menna
Published: July 2024

This comparative study explores the vulnerability/resilience visual framing pattern in the survivors-related visuals tweeted by 16 media outlets and 18 non-governmental organizations during the 2023 Morocco earthquake. The study proposes a vulnerability/resilience framework and investigates its potential impact on X engagement metrics. The results indicate discrepancies between media outlets and non-governmental organizations in their vulnerability/resilience perspectives as well as their gendered representations of the survivors. Theoretical and practical implications of visual framing and strategic crisis communication are further discussed.
Digitally witnessable war from pereklychka to propaganda: Unfolding Telegram communication during Russia’s war in Ukraine
Authors: Bareikytė Miglė , Makhortykh Mykola
Published: July 2024

The witnessing of wars is being transformed by digital platforms. In this article, the authors empirically investigate and develop the novel approach to the study of witnessing, in particular the non-institutionalized form of inconspicuous digital witnessing which thrives in platform communities in the context of Russia’s war in Ukraine. By empirically examining communication practices on Telegram, a highly popular platform in Ukraine, the article explores the ways in which online platforms enable the rise of inconspicuous witnessing. Using a mixed-method approach, the authors trace the changes in digital witnessing practices in the beginning and during different periods of the Russian occupation, by investigating over 2,000 messages from a specific Telegram channel with over 150,000 users devoted to one occupied Ukrainian city. By identifying a number of changes in the analysed Telegram chat communication practices over time, they propose an empirically-grounded concept of the digitally witnessable war that acknowledges the critical polyvocality of contemporary war witnessing practices.
Genetic issues in ICP
Authors: Zöllner Julia , Williamson Catherine , Dixon Peter H
Published: July 2024

Intrahepatic cholestasis of pregnancy (ICP) is the commonest gestational liver disorder with variable global incidence. Genetic susceptibility, combined with hormonal and environmental influences, contributes to ICP aetiology. Adverse pregnancy outcomes linked to elevated serum bile acids highlight the importance of comprehensive risk assessment. ABCB4 and ABCB11 gene variants play a significant role in about 20% of severe ICP cases. Several other genes including ATP8B1, NR1H4, ABCC2, TJP2, SERPINA1, GCKR and HNF4A have also been implicated with ICP. Additionally , ABCB4 variants elevate the risk of drug-induced intrahepatic cholestasis, gallstone disease, gallbladder and bile duct carcinoma, liver cirrhosis and abnormal liver function tests. Genetic variations, both rare and common, intricately contribute to ICP susceptibility. Leveraging genetic insights holds promise for personalised management and intervention strategies. Further research is needed to elucidate variant-specific phenotypic expressions and therapeutic implications, advancing precision medicine in ICP management.
Bullous lung disease in pregnancy: a case report
Authors: McMahon Gabriela , McCarthy Claire M. , Weedle Rebecca , Magee Colm , Eaton Donna , Donnelly Jennifer C.
Published: July 2024

Bullous lung disease presenting as a pneumothorax in pregnancy has not been reported in the literature to date. We present the case of a woman in her third pregnancy presenting to routine antenatal clinic with a secondary spontaneous pneumothorax in the third trimester. We describe the multidisciplinary approach to her management with obstetrics, obstetric anaesthesiology, cardiothoracic surgery and midwifery. This included decision making around conservative management in the initial disease course, preparation for delivery and a plan for definitive surgery postnatally. Caesarean section was performed at 36 weeks’ gestation owing to worsening chest pain. The underlying pathological process was deemed to be bullous lung disease which was confirmed on histology obtained from a video-assisted thoracoscopic surgery procedure done postnatally. We demonstrate the importance of the multidisciplinary team approach in the care of complex and rare medical conditions in pregnancy.
Sex determination in blue-fronted parrot (Amazona aestiva) using head and radiographic biometry
Authors: Cunha Gabriele Bortolotto , Silva Erika Paola Pereira , da Costa Junior Jair Duarte , Hirano Líria Queiroz Luz
Published: July 2024

Similar to most Psittaciformes, the blue-fronted parrot ( Amazona aestiva) lacks sexual dimorphism. In this way, sexing methods have been investigated to assist in the reproductive management and medical care of these birds. This study aimed to assess head and radiographic biometry for sex identification of blue-fronted parrots. Six head measurements and 23 radiographic measurements of 52 carcasses (24 males and 28 females) were taken. Males exhibited higher mean values than females for most of the measurements. For head biometry, the proposed discriminant equation containing rhinotheca length and head plus rhinotheca length allowed for correct sexing of 60% of males and 88% of females, while for radiographic biometry the discriminant equation containing head heigh and right alula length allowed the discrimination of 84.6% of males and 66.7% of females. This is the first study evaluating the use of radiographic biometry for sexing psittaciforms. Both biometric methods are suitable for sexing blue-fronted parrots when DNA sampling is not possible, since they are low-cost, provide immediate results, and are non-invasive techniques.
The association between the insurance provider and rates of surgical stabilization for the treatment of glenohumeral dislocation: A nationwide retrospective analysis
Authors: Alex Albright J , Barhouse Patrick S , Byrne Rory A , Jayachandran Nishant , Khatri Surya , Andra Keaton , Testa Edward J , Daniels Alan H , Owens Brett D
Published: July 2024

Background

Public insurance has recently been associated with a decreased likelihood of receiving surgery to address glenohumeral instability in several state-specific analyses. The purpose of this study is to expand this literature and analyze this association in a nationwide sample.

Methods

A national insurance claims database was used to identify shoulder dislocations between 2011 through 2019. Patients were stratified by insurance status (Medicaid or commercial) and age (5–24, 25–44, and 45–64 years). Billing codes were used to identify surgical stabilization and recurrent dislocations. Multivariable logistic regression was performed to compare the likelihood of surgical stabilization and recurrent instability.

Results

Of 292 672 patients, those with Medicaid were 48% less likely to receive surgery within 30 days, 32% less likely within 1 year, and 31% less likely within 2 years of their dislocation. When compared to those with commercial insurance, patients aged 45–64 years with Medicaid were the least likely to undergo surgery to address their shoulder instability (OR = 0.51, 95% CI, 0.40–0.65, p < 0.001).

Conclusion

Patients with Medicaid insurance are less likely to have their glenohumeral dislocation managed surgically, highlighting the limited healthcare access of patients with Medicaid insurance.
Clinical Predictors of Cisplatin Chemoradiation-Induced Ototoxicity in HPV-Positive Oropharyngeal Squamous Cell Carcinoma: A Case-Control Study
Authors: Lee John JW. , Alamleh Salahaldin , Zhan Luna Jia , Hueniken Katrina , Mahler Mary B. , Billfalk-Kelly Astrid , Davies Joel , Brown M. Catherine , Spreafico Anna , Huang Shao Hui , Hope Andrew , Xu Wei , Goldstein David P. , Liu Geoffrey
Published: July 2024

Background

Cisplatin-based chemoradiation is a standard treatment for many patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC), an etiologically distinct subset of head and neck cancer. Although associated with good long-term survival, clinical risk factors for ototoxicity have been understudied in this population. This study aimed to evaluate clinical predictors associated with ototoxicity in HPV-positive OPSCC patients treated with cisplatin chemoradiation.

Methods

This retrospective case-control study included 201 adult patients (>18 years) with histologically confirmed HPV-positive OPSCC who received cisplatin chemoradiation as their primary treatment from 2001 and 2019 at a single tertiary cancer center. Ototoxicity was determined using baseline and follow-up audiometry and the Common Terminology Criteria for Adverse Events v5.0 grading criteria (Grade ≥2). Multivariable logistic regression [adjusted odds ratio (aOR)] identified significant predictors that increased the odds of ototoxicity.

Results

A total of 201 patients [165 males; median (IQR) age, 57 (11) years] were included in the study. The incidence of ototoxicity in the worst ear was 56.2%, with the greatest hearing loss occurring at high frequencies (4-8 kHz), resulting in a loss of 12.5 dB at 4 to 6 kHz and 20 dB at 6 to 8 kHz. High-dose cisplatin administration compared to weekly administration [aOR 4.93 (95% CI: 1.84-14.99), P = .003], a higher mean cochlear radiation dose [aOR 1.58 (95% CI: 1.12-2.30), P = .01], smoking history [aOR 2.89 (95% CI: 1.51-5.63), P = .001], and a 10 year increase in age [aOR 2.07 (95% CI: 1.25-3.52), P = .006] were each independently associated with increased odds of ototoxicity.

Conclusions

Clinical predictors of ototoxicity in HPV-positive OPSCC patients treated with cisplatin-based chemoradiation include the use of a high-dose cisplatin regimen, higher cochlear radiation doses, a history of smoking, and older age. With the rising incidence of this malignancy in Western countries and overall improved survivorship, our research motivates future studies into risk stratification and earlier interventions to mitigate and reduce the risk of ototoxicity.
Effects of Etanercept on Experimental Osteoarthritis in Rats: Role of Histone Deacetylases
Authors: Wen Zhi-Hong , Tang Chi-Chieh , Lin Yen-You , Yao Zhi-Kang , Hsieh Shih-Peng , Gar-Hwa-Lai  , Chen Wu-Fu , Jean Yen-Hsuan
Published: July 2024

Objective

Mounting evidence suggests that histone deacetylases (HDAC) inhibitors reduce cartilage destruction in animal models of osteoarthritis (OA). Tumor necrosis factor (TNF)-α-blocking treatment for OA may provide effective joint protection by slowing joint damage. To investigate the effects of intraperitoneal administration of etanercept (a TNF-α inhibitor) on OA development in rats and changes in the nociceptive behavior of rats and expression of HDACs, RUNX2, and MMP13 in cartilage.

Methods

Induction of OA in Wistar rats was accomplished through anterior cruciate ligament transection (ACLT). One or five milligrams (mg) of etanercept was administered intraperitoneally for 5 consecutive weeks after ACLT to the ACLT + etanercept (1 and 5 mg/kg) groups. Nociceptive behavior and changes in knee joint width were analyzed. Cartilage was evaluated histologically and immunohistochemically.

Results

ACLT + etanercept significantly improved mechanical allodynia and weight-bearing distribution compared to ACLT alone. In OA rats treated with etanercept, cartilage degeneration and synovitis were significantly less pronounced than those in ACLT rats. OA-affected cartilage also showed reduced expression of HDAC 6, 7, RUNX-2, and MMP-13 in response to etanercept but increased expression of HDAC4.

Conclusion

Our study demonstrated that etanercept therapy (1) attenuated the development of OA and synovitis in rats, (2) reduced nociception, and (3) regulated chondrocyte metabolism, possibly by inhibiting cell HDAC6 and HDAC7, RUNX2, and MMP13 and increasing HDAC4 expression. Based on new evidence, etanercept may have therapeutic potential in OA.
Using the world health organisation eye care competency framework to guide curriculum development – a case study
Authors: Chong Guang W. W. , Tan Lay S. C. , Zhang Karen K. , Thiyagarajan Jayabaskar , Lim Siew L. , Drury Vicki , Lee Yew-J. , Chung Sze T. , Yu Mitasha
Published: July 2024

The provision of eye care services faces global challenges due to ageing populations and a shortage of trained eye care personnel. The World Health Organisation Eye Care Competency Framework provides a set of competencies that may be used for workforce planning and the development of an eye care workforce. Using a backward design, we mapped the Eye Care Competency Framework against established curricula. It was found that this was a useful framework for novice program designers to refer to when planning programs and may be beneficial in standardising programs to ensure a minimum standard is met.
Patient educational materials on non-steroidal anti-inflammatory drugs
Authors: Goh Bandy Qiuling , Lim Cynthia Ciwei , Kai Xuan Toh Sheila , Lee Puay Hoon , Tan Ngiap Chuan
Published: July 2024

Introduction

Effectiveness of Patient Education Materials (PEMs) on NSAIDs is subjected to whether the patient is able to read and comprehend the information provided. This study assessed the readability, understandability and actionability of English-language NSAID-related PEMs targeted at patients or caregivers in Singapore.

Methods

PEMs obtained from healthcare institutions in Singapore and from two frequently used internet search engines using search terms “NSAID” or “non-steroidal anti-inflammatory drug” were analysed by two reviewers using Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG) to assess the readability of the PEMs. Patient Education Materials Assessment Tool for printable materials (PEMAT-P) and United Kingdom Association for Accessible Formats (UKAAF) was used to assess the PEMs’ understandability, actionability and physical properties.

Results

All 74 PEMs that were reviewed, except one, were assessed to be beyond readability of the general population which was defined as grade 6 and below. Their mean FKGL and SMOG scores were 13.3 ± 2.8 and 14.4 ± 2.1 respectively. There were no significant differences in the FKGL ( p = .20) and SMOG scores ( p = .52) between local and non-local PEMs. The PEMs satisfied majority of UKAAF’s requirements. The PEMs’ understandability and actionability scores were 80.5 ± 8.0% and 52.5 ± 19.0% respectively.

Conclusions

Current NSAIDs-related PEMs are pegged too high at a level for a significant portion of population in Singapore to read and comprehend the information for them to take appropriate actions to ensure safe use of NSAIDs to manage their medical conditions. However, they are generally well-designed to facilitate reading of the materials.
Patients’ perspectives on a programme to reduce emergency department use for low acuity conditions
Authors: Goh Wan Xi , Ong Rebecca Hui Shan , Rebello Salome Antonette , Goh Priscilla Sook Kheng , Ahmad Edris Atikah , How Choon How , Tiruchittampalam Mohan , Oh Hong Choon , Lim Steven Hoon Chin
Published: July 2024

Background

Emergency Department (ED) crowding is a global public health issue with low-acuity ED attendances (LAA) being widely identified as contributors to the issue. A primary care partnership programme, GPFirst, was developed to encourage low-acuity patients to visit their General Practitioners (GP) first, instead of the ED. We utilised a qualitative approach to gain an understanding of participants’ perceptions of GPFirst, their health-seeking behaviours, and explore recommendations for enhancing GPFirst.

Methods

A qualitative study design, underpinned by an interpretivist approach, was employed. Purposive sampling was used to recruit 12 GPFirst patients from a single tertiary care centre for semi-structured interviews. These interviews were analysed using Braun and Clarke’s reflexive thematic analysis.

Results

Participants’ age ranged from 25 to 63 years old. Four themes were identified. Firstly, “ perceptions of GPs”, described the variations in participants’ perceptions about GPs. Secondly, “patients’ expectations of GPFirst”, noted the ED fee subsidy and prioritisation of ED care as key expectations of GPFirst. Thirdly, “facilitators and barriers to utilising GPFirst” highlighted the facilitators and barriers that influenced participants’ health-seeking behaviours and finally “recommendations for programme improvement” offered strategies for improvements.

Conclusion

This is the first qualitative study to examine participants’ perceptions of GPFirst. Recommendations may inform future programme redesign to optimise patient experience and facilitate programme uptake, contributing to overall efforts to reduce ED crowding locally. Future research may consider exploring GPFirst providers’ perspectives to elicit facilitators and barriers in implementation.
Mayer-Rokitansky-Küster-Hauser syndrome type II: A rare case report
Authors: Sfar Kaouthar , Imrani Kaoutar , Chait Fatima , Essetti Sara , Maslouhi Kaoutar , Moatassim Billah Nabil , Nassar Ittimade
Published: July 2024

MRKH syndrome, or Mayer-Rokitansky-Küster-Hauser syndrome, a rare congenital disease, manifests as a complete or partial aplasia of the uterus and the vagina’s upper two-thirds with normal external genitalia and functioning ovaries. Mayer-Rokitansky-Küster-Hauser syndrome can occur in isolation (type I) or in conjunction with other congenital extragenital deformities affecting the kidneys, skeleton, heart, eyes, or auditory system (type II). The diagnosis of Mayer-Rokitansky-Küster-Hauser syndrome typically relies on imaging studies, with transabdominal ultrasonography serving as the primary modality. However, magnetic resonance imaging is considered the gold standard for detailed assessment of internal genital anatomy. We present the case of an 18-year-old woman without any notable medical history who exhibited primary amenorrhea. Mayer-Rokitansky-Küster-Hauser syndrome type II was suspected on pelvic ultrasound and subsequently confirmed via magnetic resonance imaging. The patient was provided with psychological assistance and planned for vaginoplasty.
Treatment of a resistant case of schizoaffective disorder with lumateperone: A case report
Authors: Shahab Muhammad Hamza , Prasad Sakshi , Kalli Stefani , Usmani Sadia S , Liaqat Sumbul , Umer Mohammad , Amuk Williams Ozge Ceren , Ashraf Nauman
Published: July 2024

To this day, there exists skepticism about the reliability and clinical utility of the diagnostic criteria and classification of schizoaffective disorder. In addition, the treatment of schizoaffective disorder, especially of treatment-resistant cases, has been minimally investigated. As a result, formulating official treatment guidelines for schizoaffective disorder has been challenging. We present a case of a 27-year-old female, diagnosed with schizoaffective disorder, bipolar type, for whom, for over 5 years, trials of traditional treatments, to include psychotherapy, pharmacotherapy, and electroconvulsive therapy, were either partially effective or discontinued due to intolerable side effects. The subsequent off-label use of lumateperone led to an adequate response. Lumateperone is an atypical antipsychotic, approved by the Food and Drug Administration for schizophrenia and bipolar depression in adults. Interestingly, it has a similar structure and mechanism of action to paliperidone, the only Food and Drug Administration-approved medication for schizoaffective disorder. Through this case report, as an example of lumateperone’s effectiveness and tolerability, as well as a literature review of its pharmacodynamics, we make the case that lumateperone emerges as a promising option for schizoaffective disorder, especially treatment-resistant cases.
Remedy or tragedy: Acalypha indica-induced acute oxidative hemolysis associated with acute kidney injury and infective endocarditis: An initial presentation of G6PD Deficiency: A case report
Authors: Charles J.C. , Kiriwandeniya K.G.K.U. , Liyanapathirana K.V. , Gunarathna R.D.S. , Mendis S. , Liyanarachchi G.G.
Published: July 2024

Acalypha indica is used as an herbal broth in Sri Lanka for medicinal purposes. It can induce acute oxidative hemolysis and severe methemoglobinemia in G6PD deficiency patients. Leptospirosis is an endemic infection in Sri Lanka, resembling the clinical presentation of acute oxidative hemolysis in G6PD deficiency. As the presentation can mimic leptospirosis, a high index of suspicion is maintained when an infective focus is not identified in patients with fever, jaundice, and hematuria. Here, we present a case of a 33-year-old male patient with hemolysis following Acalypha herbal broth ingestion. He has recovered from acute oxidative hemolysis with supportive management, but he acquired infective endocarditis during inward stay through the central intravenous line, necessitating valve replacement.
Navigating cultural and pedagogical challenges: An autoethnographic study of a Vietnamese EFL lecturer-researcher’s experiences in the Mekong Delta
Authors: Thao Le Thanh , Thuy Pham Trut
Published: July 2024

This qualitative study presents an autoethnographic exploration of the challenges faced by a Vietnamese English as a Foreign Language (EFL) lecturer-researcher in conducting autoethnographic research. Situated in the complex socio-cultural landscape of Vietnam, particularly within the Mekong Delta region, this study provides an in-depth analysis of the unique interplay between personal experiences and broader educational and cultural contexts. The research employs reflective writings and self-recording videos as primary data sources, offering a rich narrative of the lecturer-researcher’s professional and personal journey. The findings reveal a multifaceted array of challenges. These include navigating cultural and personal biases in teaching practices, balancing traditional and student-centered pedagogies, and grappling with the role of English as both a global language and a potential agent of cultural dominance. The study also uncovers the emotional labor inherent in autoethnographic research and the complexities of maintaining professional identity in a postcolonial educational setting. Through its focus on a Vietnamese EFL context, the study contributes significantly to the discourse on critical pedagogy and postcolonial theory. It highlights the need for heightened cultural sensitivity and reflexivity in educational research and practice, advocating for pedagogical approaches that are both effective and culturally responsive. The findings and implications of this study are particularly relevant for educators, researchers, and policymakers in similar postcolonial and multicultural educational contexts.
Impact of High-Quality Higher Education on Public Good: Evidence From Corporate Philanthropy of Listed Companies in China
Authors: Zhou (周晓岚) Xiaolan , Wu (吴凯霖) Kailin
Published: July 2024

Purpose

The study uses the data of listed companies in China from 2012 to 2020 to investigate the impact of top managers’ high-quality university educational backgrounds and their native places on Chinese enterprises’ participation in public good.

Design/Approach/Methods

A linear regression method was used.

Findings

Higher education plays an important role in the promotion of public good. From the perspective of behavior and intensity, high-quality higher education highlights a unique role in the depth and intensity of corporate philanthropy. There is regional heterogeneity among top managers in promoting enterprises’ participation in public good: Top managers born in Midwest China are more likely to promote enterprises’ participation in public good.

Originality/Value

This study empirically tested the theoretical results of past domain-specific research, focusing on the impact of top managers’ background (education and place of origin) on the engagement of listed companies in public good. It proposes a set of innovative and comprehensive indicators to measure companies’ engagement in public good, and explores the influence of managers’ higher education quality on the firm's engagement in economic and educational causes, as well as the level of such engagement.
Examining China's “Double Reduction” Policy: Promises and Challenges for Balanced and Quality Development in Compulsory Education
Authors: Chen (陈丽翠) Licui , Lin (林双木) Shuangmu
Published: July 2024

Purpose

This study provides an overview of the “double reduction” policy promulgated in 2021, through which the Chinese government attempts to relieve the burden of excessive school homework and off-campus tutoring for students in compulsory education.

Design/Approach/Methods

This study draws on policy documents and relevant literature to interpret policy origins, core values, and major measures. The positive effects and challenges faced in implementing policies for the balanced and high-quality development of compulsory education were analyzed.

Findings

Students’ academic burden is deeply rooted in Chinese historical and sociocultural contexts. The “double reduction” policy shows the Chinese government's strong aspiration to promote holistic education for students and pursue the universal provision of balanced, high-quality school education. Despite some positive effects at the implementation level, challenges remain unaddressed. To achieve a policy vision, it calls for a deep reflection on the high-stakes examination system and collective efforts from stakeholders within or outside the education system.

Originality/value

This study helps elucidate the “double reduction” policy and compulsory education development in China.
Effects of Frailty Syndrome on Osteoporosis, Focusing on the Mediating Effect of Muscle Strength and Balance in Community-Dwelling Older Adults (≥60 years) in Iran: Results From the Amirkola Health and Aging Project Cohort Study
Authors: Shamsalinia Abbas , Hosseini Seyed Reza , Bijani Ali , Ghadimi Reza , Kordbageri Mohammad Reza , Saadati Kiyana , Ghaffari Fatemeh
Published: July 2024

Introduction

For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults.

Material and Methods

This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests.

Results

The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis.

Conclusion

From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis.