bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Clinical, Economic, and Health Resource Utilization Impacts of Prefilled Syringes Versus Conventional Medication Administration Methods: Results From a Systematic Literature Review
Authors: Benhamou Dan , Weiss Mia , Borms Matthias , Lucaci Julia , Girgis Haymen , Frolet Cecile , Baisley Wesley T. , Shoushi Gio , Cribbs Kristen A. , Wenk Manuel
Published: November 2023

Objective:

The objective of this systematic review was to assess the clinical, economic, and health resource utilization outcomes associated with the use of prefilled syringes in medication administration compared with traditional preparation methods.

Data Sources:

We conducted a systematic literature review to evaluate outcomes such as medication errors, wastage, time savings, and contamination in prefilled syringes. Our search encompassed multiple databases, including PubMed and Embase, for studies published between January 1, 2017, and November 1, 2022.

Study selection and data extraction:

Peer-reviewed publications meeting our inclusion criteria underwent rigorous screening, including title, abstract, and full-text article assessments, performed by two reviewers.

Data synthesis:

Among reviewed articles, 24 met our eligibility criteria. Selected studies were primarily observational (46%) and conducted in Europe (46%). Our findings indicated that prefilled syringes consistently reduced medication errors (by 10%-73%), adverse events (from 1.1 to 0.275 per 100 administrations), wastage (by up to 80% of drug), and preparation time (from 4.0 to 338.0 seconds) (ranges varied by drug type, setting, and dosage). However, there was limited data on contamination. Economically, prefilled syringes reduced waste and error rates, which may translate into overall savings.

Relevance to patient care and clinical practice:

This review highlights the value of prefilled syringes, which can streamline medication delivery, save nursing time, and reduce preventable medication errors. Moreover, prefilled syringes have the potential to minimize medication wastage, optimizing resource utilization and efficiency in health care settings.

Conclusion and relevance:

Our findings provide new insights into clinical and economic benefits of prefilled syringe adoption. These benefits include improved medication delivery and safety, which can lead to time and cost reductions for health care departments, hospitals, and health systems. However, further real-world research on clinical and economic outcomes, especially in contamination, is needed to better understand the benefits of prefilled syringes.
Natural logarithm sliding mode control for vibration control application
Authors: Wijaya Andika Aji , Yakub Fitri , Akmeliawati Rini , Aljazzar Salem , Kojima Akira
Published: November 2023

This paper presents the control synthesis of a nonlinear sliding mode control, known as the “ natural logarithm sliding mode control” (lnSMC), for a general n-th order system. The lnSMC offers a simple and straightforward design approach because it only requires tuning two design parameters. The first parameter has a physical meaning corresponding to the bounds of the state variables, which can be easily determined without a trial-and-error process. The second parameter is related to the controller’s feedback gains, which ensure that the system dynamics converged to the sliding surface. Lyapunov stability theory is used to analyze the closed-loop system and finite-time convergence stability. As a case study, the natural logarithm sliding mode controller is designed to suppress the vibration in a simple spring-mass system and an active suspension system. The simulation study shows that the proposed controllers have significant vibration suppression performance. Furthermore, the simulation study indicates that the sliding mode controller designed by using the natural logarithm sliding manifold outperforms the standard linear sliding manifold counterpart. In addition, due to the nature of the nonlinear switching function that creates boundary states, lnSMC has a huge potential to be applied in a wider area of vibration control.
Mistuning identification and model updating of a blisk with piezoelectric excitation components
Authors: Li Anlue , Fan Yu , Wang Hui , Wu Yaguang , Li Lin
Published: November 2023

Integrally bladed disks (blisks) are extensively used in military and commercial aircraft engines. There are inevitable deviations between blades called mistuning, leading to the vibration localization of blisks, which potentially results in high cycle fatigue (HCF). Furthermore, the dynamic performance is sensitive to mistuning patterns. Hence, to predict the vibration response of mistuned blisks accurately, the mistuning pattern needs to be identified experimentally and verified under traveling wave excitation (TWE). Piezoelectric TWE is a promising testing technique for blisk dynamics in a non-rotating state, offering advantages such as high excitation force, wide bandwidth, and a simple setup. However, piezoelectric materials are generally arranged on blades forming an electromechanically coupled structure, which challenges the existing mistuning identification methods. In this paper, an integral mistuning identification and model updating method with traveling wave excitation verification is developed. The detuning strategy is used to split natural frequencies of blades, whereupon the response is measured blade by blade. Measured response functions of isolated blades can be retrieved by data reconstruction. Then, the mistuning patterns of elastic modulus and damping ratio are identified by Kirchhoff-plate theory and half-power bandwidth method, respectively. Experimental studies are carried out to validate the method. A dummy blisk with piezoelectric patches is designed and the dynamic properties are calculated. Blade-by-blade measurement and TWE test are conducted. Results show that natural frequencies of the updated model are in excellent agreement with the measured ones. Under TWE, the deviations of natural frequencies for all blades are less than 0.25%. The response deviation of the updated model is decreased by 89.4% on average compared with the original model and the average response deviation of the updated model is 7.4%.
Serial mediation of illness perception and beliefs about medicines in the relationship between patient satisfaction and medication adherence: An evaluation of self-regulatory model in rheumatoid arthritis and ankylosing spondylitis patients
Authors: Temeloglu Sen Esin , Sertel Berk Hanife Ozlem , Rezvani Aylin
Published: November 2023

This study examined the effect of patient satisfaction on medication adherence through serial mediation of Self Regulatory Model (SRM) components which are illness perception and beliefs about medicines in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). The 222 outpatients ( nRA = 112; nAS = 110) were administered a sociodemographic form, the Medication Adherence Report Scale, the Brief Illness Perception Questionnaire, the Short Assessment of Patient Satisfaction, and the Beliefs about Medicines Questionnaire. The results showed that SRM components fully mediated the relationship between patient satisfaction and medication adherence. This proposed model had acceptable and better fit indices than the alternative model where patient satisfaction was introduced as a direct predictor. Furthermore, patient satisfaction, illness perception, and beliefs about medicines had an extremely good relationship, so these may be interpreted as variables of a latent construct of the illness experience which deserves further research in these group of patients.
Evaluating a new supported employment internship programme for autistic young adults without intellectual disability
Authors: Ashworth Maria , Heasman Brett , Crane Laura , Remington Anna
Published: November 2023

Supported employment initiatives have been shown to increase employment rates for autistic people who want to enter the workforce. Despite the success of supported employment initiatives in increasing employment rates, little is known about the first-hand experiences and views of those involved. In the current study, we examined the experiences and views of autistic young adults without intellectual disability (‘interns’), employers and parents regarding a previously unevaluated paid internship scheme that offers tailored support for interns and employers before, during and after the internship, the Employ Autism network. In total, 51 participants (19 interns, 22 employers, 10 parents), across eight internships, engaged in semi-structured interviews. Reflexive thematic analysis was used to identify three themes, shared across participant groups: (1) the internship was ‘an invaluable experience’, (2) the internship helped break down autism-specific barriers to employment and (3) stakeholder groups had some unmet expectations. Drawing on this multi-informant qualitative evaluation of a novel supported employment scheme, we derive recommendations of best practice for supported employment initiatives for autistic young adults without intellectual disability.

Lay abstract

Internships designed for autistic people can help them to find employment, but there is little research about the experiences of those involved with internship schemes. To learn more about a new paid internship scheme in the United Kingdom, the Employ Autism network, we interviewed 19 interns, who were autistic young adults without intellectual disability taking part in one of eight different internships. We also interviewed 22 employers (who worked with the interns), and 10 parents (who supported their children in the internship). The interns, employers and parents told us that the Employ Autism network was a valuable experience that helped the interns become more confident. Also, the parents said it helped the interns become more independent. All the groups said the Employ Autism network removed common barriers to employment, and interns and parents said it would help interns get a job in future. Employers and interns said they understood each other better during the internship, and employers said the internship made them think about how their organisations might have accidentally had barriers in place that could stop autistic people getting employed (barriers that they wanted to address in future). However, all groups said some expectations of the internship were not met. These findings suggest the Employ Autism network is helpful for autistic young adults without intellectual disability and employers, but that there are ways that the internships could be improved in future. We discuss the lessons we can learn from the Employ Autism network that might help others who are thinking about setting up, or getting involved in, similar internship schemes.
Intraoperative Bivalirudin Use in Patient Undergoing Femoral Endarterectomy with Heparin-Induced Thrombocytopenia: Case Report and Review of the Literature
Authors: Haffler Zachary J. , Hughes Travis G. , Yeager Lauren S.
Published: November 2023

Purpose

To describe the intraoperative use of bivalirudin during lower extremity revascularization in the setting of heparin-induced thrombocytopenia (HIT).

Case Summary

A 65 year-old man presented with left common iliac, external iliac, and femoral artery occlusion necessitating revascularization with left femoral endarterectomy and common and external iliac stent angioplasty. Three months before the femoral endarterectomy, the patient was hospitalized for a coronary artery bypass procedure. During this admission, the patient tested positive for the presence of heparin-PF4 antibody complexes. With the patient’s recent history of HIT, bivalirudin was selected as the optimal agent for intraoperative anticoagulation. Bivalirudin was administered as a 50 mg bolus, followed by a continuous infusion initiated at 1.75 mg/kg/hr. Repeated bivalirudin boluses were necessary to maintain an activated clotting time (ACT) necessary for the revascularization procedures and recurrent subacute thrombi despite appropriate ACT values.

Discussion

Bivalirudin has been utilized for cardiopulmonary bypass and carotid endarterectomy (CEA), but data for dosing in lower extremity revascularization are lacking. As the risk for thrombosis with HIT continues for months after diagnosis, it is important to elucidate optimal dosing of non-heparin anticoagulant options, such as the direct thrombin inhibitor, bivalirudin. The absence of validated dosing strategies for bivalirudin can result in prolonged operative times, increased risk of bleeding, and inadequate anticoagulation.

Conclusion

Bivalirudin is an appropriate agent for intraoperative anticoagulation in lower extremity revascularization. However, further investigation into the optimal intraoperative bivalirudin dosing regimen is necessary.
Policy Feedback & Research Methods: How Qualitative Research Designs With Marginalized Groups Inform Theory
Authors: Kopec Anna
Published: November 2023

As a body of literature that informs and analyzes the effects of policy, policy feedback research will benefit from more qualitative research designs with marginalized populations. Qualitative research designs allow for theoretical and conceptual development, as well as ensure multiple perspectives are fully captured. This article argues that qualitative methods with different populations will expand applications of policy feedback theory and lead to critical insights for its development. Three examples of potential areas of theory development are outlined including informing the variable of participation, examining more nuanced effects of specific policy elements, and understanding the interactions of multiple policies. The article concludes with the suggestion of more mixed-method designs utilizing qualitative approaches involving participants to test existing hypotheses and inform new relationships. Policy feedback theory raises vital questions of democratic legitimacy and policy effectiveness that benefit from research conducted with, and informed by, marginalized populations.
Evaluation of the impact of redeployment during the COVID-19 pandemic: results from a multi-centre survey
Authors: Taylor Rachel M , Hughes Luke , Fern Lorna A , Hogg Julie , Petrella Anika
Published: November 2023

Background:

The COVID-19 pandemic brought unprecedented upheaval for healthcare systems globally. Rapid changes in the way nurses were asked to work brought about many challenges, especially with the requirement for nurses to move into intensive care and high dependency areas to deliver care for the increasing number of critically ill patients.

Aim:

The purpose of this evaluation was to assess the impact of these changes on nurses who were redeployed during the first acute phase of the pandemic and explore factors associated with burnout.

Methods:

A redeployment survey, containing 42 items in four domains (preparation for redeployment, safety and support, perceived competence, reflections and emotional impact) was administered online to nurses who had been redeployed in two hospitals in England, one urban and one rural. Bivariate correlations and a multiple linear regression model were conducted to explore associations between perceptions of leadership, training, communication and feeling valued with levels of emotional exhaustion.

Results:

Valid responses were received from 240/618 (39%) nurses. The majority of respondents felt it was their duty to work where they were asked (79%), were prepared to work where needed (72%) and were consulted on changes to their working hours (55%). However, nurses were nervous about the new role (75%) and felt they had a lack of choice regarding redeployment (66%) and the way it was implemented (50%). Multiple regression analysis showed that lack of training (β = 0.18) and feeling undervalued (β = 0.48) was positively associated with emotional exhaustion, which accounted for 38% of the variance among redeployed nurses.

Conclusions:

To mitigate the risk of nurses developing burnout as a result of redeployment, there is a need for training to upskill them so they feel competent in doing the changed role. Additionally, nursing leadership needs to support nurses feeling valued as individuals in their role.
Onomatopoeia, Sound Effects and Humour in Japanese Anime and US Animation Films and Television
Authors: Ye Lei
Published: November 2023

Onomatopoeia are words signifying sounds by phonetically imitating or suggesting them. Research into the use of onomatopoeia in literature, language and comics has been rich and varied while the study of the use of onomatopoeia in film, television and their functions has so far been limited. This article focuses on two aspects: (a) the relationship between onomatopoeia and sound effects in US animation and Japanese anime; and (b) audiovisual humour caused by the use of onomatopoeia and sound effects in US animation and Japanese anime. The author introduces classifications and usage patterns of onomatopoeia in English and Japanese, and analyses the different types of onomatopoeia and sound effects in recent popular US animation films and TV, and in Japanese anime and their contributions to creating humour by applying humour theory (incongruity theory in particular). This study combines film analysis, soundtrack analysis, linguistic analysis and theories of humour, and will be of interest to students and scholars of film, sound, linguistics, psychology and other subjects interested in the study of onomatopoeia and audiovisual humour.
Tactical skills in tennis: A systematic review
Authors: Sanchez Mencia Eneko , Campos-Rius Josep , González Santamaría Xabier , Borrajo Mena Erika
Published: November 2023

The present work consists of a systematic review of studies related to tactical skills in tennis. Through the PRISMA methodology, studies related to the subject are identified, categorised and analysed using four of the most important databases: Web of Science, Scopus, EBSCO SPORTDiscus and APA PsychInfo. For the present review, 34 studies published on the subject between the years 2000 and 2022 are used to demonstrate the authorship and participating subjects, as well as the skill level, methodology used, tactical aspects analysed and the results/conclusions most relevant to each of the investigations. The results are deductively divided into eight detected variables: anticipation, game knowledge, strategy, problem representation, situational awareness, execution, player skill level and identity. Finally, possible future lines are presented for a better understanding of tactical skills.
Internationalization of Higher Education, University Quality Service, and International Students’ Loyalty in Malaysia
Authors: Amzat Ismail Hussein , Mohd Ali Hairuddin , Ibrahim Mohd Burhan , Othman Azam , Bin Salleh Mohamad Johdi , Alade Najimdeen Abdul Hakeem
Published: November 2023

This quantitative study examines the effects of internationalization practices on university quality service and students’ loyalty as perceived by international students in Malaysian public universities. A total of 1,575 international students from 10 different public universities in Malaysia and from different home countries participated in this study. Stratified sampling was used to select the international students by dividing the population into continents. Data were collected using questionnaires and analyzed using SmartPLS Structural Equation Model (PLS-SEM). The findings of PLS-SEM confirmed the effect of internationalization of higher education practice and university quality service on international student loyalty in Malaysia. It was also found the effect of internationalization of higher education practice on university quality service. The research reported here adds to the growing body of knowledge on foreign student satisfaction and perceptions of quality, internationalization of education, and student mobility. It also helps provide some insights for the education industry in Malaysia and beyond in their effort to gain global recognition in the field of academic teaching, research, and professional development.
Return to Sports Activity After Reverse Total Shoulder Arthroplasty
Authors: Kim Hyun Gon , Kim Seung-Ho , Kim Su Cheol , Park Jong Hun , Kim Jae Soo , Kim Bo Taek , Lee Sang Min , Yoo Jae Chul
Published: November 2023

Background:

There are little published data on return to sports (RTS) after reverse total shoulder arthroplasty (RTSA).

Purpose:

To (1) determine the rate and timing of RTS after RTSA in an Asian population, (2) analyze predictive factors for RTS, and (3) determine the relationship between RTS after RTSA and clinical/radiological outcomes.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective review was performed on consecutive patients with diagnosis of irreparable rotator cuff tear (RCT), cuff tear arthropathy (CTA), or degenerative osteoarthritis who underwent RTSA between May 2017 and May 2020. Included were patients who played sports preoperatively in ≤3 years and had ≥2-year follow-up. Patients were divided into 2 groups based on responses to a telephone survey about RTS after RTSA: those who returned to sports (group A) and those who did not (group B). Patient characteristics, pre- and postoperative clinical features and functional scores, and radiologic outcomes (acromial fracture, scapular notching, heterotopic ossification, and loosening of humeral and glenoid component) were compared between the groups.

Results:

Of 59 eligible patients, 44 patients (28 in group A, 16 in group B) were included. The RTS rate after RTSA was 63.6%, and the mean RTS time was 9.1 months (range, 3-36 months). There was a significant group difference in body mass index (BMI) (group A, 24.3 ± 2.1; group B, 27.1 ± 4.4; P = .01) and preoperative diagnosis (CTA/irreparable RCT/degenerative osteoarthritis diagnoses: group A, 13/12/3; group B, 3/6/7; P = .03). Patients in group A showed significantly higher forward flexion ( P = .03) and higher Simple Shoulder Test score ( P = .02) than group B at final clinical follow-up. No significant difference in radiological outcomes was found between the groups.

Conclusion:

Patients with a low BMI and those diagnosed with CTA or irreparable RCT were found to have better RTS rates after undergoing RTSA, and forward flexion and Simple Shoulder Test scores at final follow-up were significantly higher in the RTS group, with no significant differences in complications.
Association of Instability History and Off-Track Hill-Sachs Lesions in Anterior Shoulder Instability
Authors: Delgado Cristina , Luengo-Alonso Gonzalo , Valencia Maria , Martínez-Catalán Natalia , Calvo Emilio
Published: November 2023

Background:

The glenoid track concept is now widely accepted, and its evaluation is considered essential for making decisions about surgery.

Purpose:

To define preoperative descriptive data and clinical and functional features in patients with anterior glenohumeral instability according to glenoid track status and to analyze the influence of off-track Hill-Sachs (HS) lesions on preoperative shoulder function.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Preoperative magnetic resonance imaging or computed tomography scans were used to measure the glenoid track. Descriptive data and preoperative objective and subjective clinical and functional features were compared between patients with on-track HS lesions versus off-track HS lesions. Multivariate regression analysis was conducted to identify potential risk factors for off-track HS lesion development.

Results:

A total of 235 patients (201 men, 34 women; mean age, 29.6 ± 8.6 years) were included— 134 shoulders (57%) with on-track HS lesions and 101 shoulders (43%) with off-track HS lesions. Age <20 years at first dislocation, number of dislocations, and ≥2 years between first dislocation and surgery were significantly different between the study groups ( P = .005, P = .0001, and P = .01, respectively). Regarding these characteristics, the odds ratios for the risk of developing an off-track lesion were 2.67 (95% CI, 1.2-5.99)—1.2 times higher for each additional instability episode (95% CI, 1.025-1.14) and 2.42 times higher (95% CI, 1.176-4.608) for patients whose first dislocation was ≥2 years before surgery, respectively. Patients with off-track HS lesions had a significantly greater degree of instability ( P = .04), worse Rowe scores (48.8 ± 15.3 vs 54.8 ± 28.3 for on-track HS lesions; P = .04), and lower Western Ontario Shoulder Instability scores (975 ± 454 vs 1179 ± 428 for on-track HS lesions; P = .01).

Conclusion:

Characteristics related to a history of instability (age <20 years at first instability episode, larger number of dislocations, ≥2 years between first dislocation and surgery) were found to be risk factors for the development of an off-track HS lesion in this study. Off-track lesions led to a higher degree of instability and worse objective and subjective preoperative shoulder function versus on-track HS lesions.
Cyber Preparedness of the Indian Armed Forces
Authors: Poornima B.
Published: November 2023

The Indian armed forces today face a significant threat of cyberattacks, particularly from hostile neighbouring states like China and Pakistan. Cyberattacks could potentially damage or cripple critical weapons platforms, major communications and ISR (intelligence, surveillance, and reconnaissance) systems, and vital infrastructure, undermining the military’s preparedness and war-fighting capabilities. How prepared is the Indian military to neutralise cyberattacks from adversaries such as China and Pakistan? This is the central question that this article attempts to address. The article contends that the delayed development of technical, policy, and organisational measures in the cyber domain indicates vulnerabilities in the Indian military’s current state of cyber preparedness, leaving room for enemy cyberattacks. It emphasises the need for immediate actions to address the critical gaps in India’s cybersecurity strategy. In particular, the Indian military must focus on drastically strengthening its defensive cyber capabilities to neutralise potential enemy cyberattacks on weapons platforms, communication and ISR systems, and critical infrastructure. The article concludes that without enhanced defensive cyber capabilities, India’s military modernisation may fall short of responding adequately to technology-driven warfare threats from the hostile states in the neighbourhood.
The Indian Navy Navis in Mari Amissa: At a Crossroads in the Twenty-first Century
Authors: Singh Ashutosh
Published: November 2023

This article hypothesises that the Indian Navy’s modernisation is directionless, the Latin phrase ‘Quod perierat navis’ meaning ‘a lost ship’ metaphorically representing the Indian Navy. While China’s naval expansion is set to revive great power naval brinkmanship in the twenty-first century, India’s naval modernisation appears rudderless without a critical appraisal of new challenges and countermeasures. This article hypothesises that this stems from the lack of an objective maritime doctrine resulting in a confused capability acquisition programme. The article puts forward three questions: First, is there a military strategy or white paper on India’s maritime threats and strengths? Second, is the Indian Navy bolstering its marine defences? Third, how might limited resources optimise capacities to meet challenges? To evaluate Indian Navy modernisation, this article will employ a qualitative method to explore the strategic objectives and utilisation of emerging naval technologies by the Indian Navy and its prospective rivals, and conclude by proposing suitable course corrections.
Incidence of Total Blindness After Central Retinal Artery Occlusion With Ocular Neovascularization
Authors: Chawla Harshvardhan , Redrick Hayley J. , Pannell Joshua T. , Goldblatt Nathaniel P. , Mazzulla D. Anthony , Benevento Joseph D. , Puri Sidharth
Published: November 2023

Purpose: To determine the time-based incidence of total blindness after central retinal artery occlusion (CRAO) with secondary ocular neovascularization (ONV). Methods: In this retrospective cohort study, electronic records were queried using ICD-9 and ICD-10 codes to identify patients with secondary ONV post-CRAO. Patients with possible alternative ONV etiologies, previous panretinal photocoagulation (PRP), and/or previous antivascular endothelial growth factor (anti-VEGF) therapy were excluded. Clinical data included demographics, medical comorbidities, ONV manifestations, medical/surgical management, and best-corrected visual acuity (BCVA). Kaplan-Meier analysis was performed with total blindness (defined as a BCVA of no light perception) as the outcome of interest. Results: Of 345 eyes with CRAO, 34 met the inclusion criteria with a mean (±SD) follow-up of 22.0 ± 26.2 months. ONV management included PRP (70.6%), glaucoma drainage implant surgery or transscleral cyclophotocoagulation (32.4%), and intravitreal anti-VEGF therapy (mean 2.8 ± 5.6 injections per patient). The cumulative incidence of total blindness was 49.4% (95% confidence interval, 27.2%-71.6%) at 24 months, with 53.3% of cases occurring within 4 months of ONV onset. Conclusions: Post-CRAO ONV is associated with a high risk for progression from severe vision loss to total blindness. Neovascular glaucoma can present up to 4 months after CRAO, challenging the paradigm of “30-day-glaucoma.” Routine gonioscopy should extend through this period, while glaucoma surgery can delay further vision loss. These findings can be used to counsel patients on the importance of follow-up adherence.
Canonical and Non-Canonical Roles of SNX1 and SNX2 in Endosomal Membrane Dynamics
Authors: Da Graça Juliane , Morel Etienne
Published: November 2023

Sorting nexins (SNXs) are a family of membrane-binding proteins known to play a critical role in regulating endocytic pathway sorting and endosomal membrane trafficking. Among them, SNX1 and SNX2 are members of the SNX–BAR subfamily and possess a membrane-curvature domain and a phosphoinositide-binding domain, which enables their stabilization at the phosphatidylinositol-3-phosphate (PI3P)-positive surface of endosomes. While their binding to PI3P-positive platforms facilitates interaction with endosomal partners and stabilization at the endosomal membrane, their SNX–BAR region is pivotal for generating membrane tubulation from endosomal compartments. In this context, their primary identified biological roles—and their partnership—are tightly associated with the retromer and endosomal SNX–BAR sorting complex for promoting exit 1 complex trafficking, facilitating the transport of cargoes from early endosomes to the secretory pathway. However, recent literature indicates that these proteins also possess biological functions in other aspects of endosomal features and sorting processes. Notably, SNX2 has been found to regulate endosome–endoplasmic reticulum (ER) contact sites through its interaction with VAP proteins at the ER membrane. Furthermore, data from our laboratory show that SNX1 and SNX2 are involved in the tubulation of early endosomes toward ER sites associated with autophagy initiation during starvation. These findings shed light on a novel role of SNXs in inter-organelle tethering and communication. In this concise review, we will explore the non-retromer functions of SNX1 and SNX2, specifically focusing on their involvement in endosomal membrane dynamics during stress sensing and autophagy-associated processes.
Juvenile Alexander Disease and Cleidocranial Dysplasia: A Rare Combination of Genetic Abnormalities in a Pediatric Patient
Authors: Chen-Carrington P. Annie , Henry Christopher , Goodreau Adam , Rhodes Jennifer
Published: November 2023

Cleidocranial dysplasia (CCD) and Alexander disease (AxD) are rare, autosomal dominant disorders that are characterized by a mutation in the runt-related transcription factor 2 ( RUNX2) and the glial fibrillary acidic protein ( GFAP) genes, respectively. There is no known relationship between RUNX2 and GFAP which would cause co-morbidity. We report a rare case of a 13-year-old with CCD who came to the clinic complaining of a 2-year history of progressively worsening episodic exacerbations of bulbar, ataxia, nystagmus, kyphoscoliosis, and nausea, but was intact cognitively. Initial diagnosis was a difficult process because preliminary symptoms for Juvenile AxD overlapped with previously diagnosed CCD and the initial genetic test identified our patient’s GFAP gene as a variant of uncertain significance. Our experience emphasizes the importance of continuing to report pathogenic variants of GFAP for AxD to build on our existing compendium of variants for GFAP for quicker and more efficient diagnosis of AxD.
A Student-Affirming Approach to Middle School Classroom Music: Four Guiding Principles for Curriculum and Instruction
Authors: Dissinger Meagan
Published: November 2023

Students who enter middle school may discover few or no opportunities for music participation beyond the Western ensemble paradigm. However, the explorative experiences of elementary general music can continue to thrive in middle school classroom music. In order for middle school classroom music programs to maximize potential, they must be valued and supported equitably, and invite creativity, questioning, and co-learning. In this article, I discuss four guiding principles for a middle school general music curriculum that is culturally responsive, generationally relevant, and student-centered. When teachers adopt these values, middle school classroom music can affirm students’ musical and nonmusical identities and pave the way for growth in individuals and the music education, performance, and composition fields at large.
Using GarageBand for Mac in the International Baccalaureate Middle Years Programme
Authors: Norman Timothy David
Published: November 2023

In this column, I describe a composition activity that involved students in the International Baccalaureate Middle Years Programme using GarageBand for Mac to explore the musical element of texture.
U-shaped association between serum Klotho and accelerated aging among the middle-aged and elderly US population: a cross-sectional study
Authors: Li Heng , Miao Shuai , Zhang Min , Zhang Peng , Li Yan-Bin , Duan Rui-Sheng
Published: November 2023

Background

Phenotypic age acceleration, which reflects the difference between phenotypic age and chronological age, is an assessment to measure accelerated aging. Klotho is a protein related to slower aging, but its association with accelerated aging remains unclear.

Methods

Based on data from the 2007–2010 National Health and Nutrition Examination Survey, phenotypic age was calculated using chronological age and 9 aging-related biomarkers. A total of 4388 participants aged 40 to 79 years with measured serum Klotho and calculated phenotypic age were enrolled. The association between serum Klotho and phenotypic age acceleration was estimated using multivariable linear regression models. The possible nonlinear relationship was examined with smooth curve fitting. We also conducted a segmented regression model to examine the threshold effect.

Results

The association between serum Klotho and phenotypic age acceleration followed a U-shaped curve (p for nonlinearity < 0.001), with the inflection point at 870.7 pg/ml. The phenotypic age acceleration significantly decreased with the increment of serum Klotho (per SD increment: β -1.77; 95% CI, -2.57 ~ -0.98) in participants with serum Klotho < 870.7 pg/ml, and increased with the increment of serum Klotho (per SD increment:β, 1.03; 95% CI: 0.53 ~ 1.54) in participants with serum Klotho ≥ 870.7 pg/ml.

Conclusion

There was a U-shaped association between serum Klotho and accelerated aging among the middle-aged and elderly US population.
Accuracy of biomicroscopy, ultrasonography and spectral-domain OCT in detection of complete posterior vitreous detachment
Authors: Zvorničanin Jasmin , Zvorničanin Edita , Popović Maja
Published: November 2023

Background

To evaluate the accuracy of preoperative biomicroscopy (BM), ultrasonography (US), and spectral domain optical coherence tomography (SD-OCT) to determine complete posterior vitreous detachment (PVD) confirmed by intraoperative findings of triamcinolone acetonide-assisted pars plana vitrectomy (PPV).

Methods

This prospective study included all consecutive patients admitted for surgical treatment of the epiretinal membrane (ERM) and macular hole (MH). The presence of complete PVD was determined one day before PPV using BM, US, SD-OCT. The preoperative findings were compared to the PVD status determined during PPV.

Results

A total of 123 eyes from 123 patients were included in the study. Indications for PPV included ERM in 57 (46.3%), full thickness macular hole in 57 (46.3%) and lamellar macular hole in 9 (7.3%) patients. Complete PVD during PPV was observed in 18 (31.6%; 95%CI:18.7–49.9) patients with ERM and 13 (19.7%; 95%CI:10.4–33.7) patients with MH. The sensitivity of preoperative BM, US, SD-OCT was 48.4% (95%CI:30.2–66.9), 61.3% (95%CI:42.2–78.2) and 54.8% (95%CI:36.0–72.7) respectively. The specificity of preoperative BM, US, SD-OCT was 81.5% (95%CI:72.1–88.9), 90.2% (95%CI:82.2–95.4) and 85.9% (95%CI:77.0–92.3) respectively. With a prevalence of 25.2% of PVD in our sample the positive predictive value of preoperative BM, US, SD-OCT was 46.9% (95%CI:29.1–65.3), 67.9% (95%CI:47.6–84.1) and 56.7% (95%CI:37.4–74.5) respectively.

Conclusion

Preoperative BM, US, and SD-OCT showed relatively low sensitivity but also good specificity in assessing complete PVD. A combination of all three diagnostic methods can provide a good assessment of the vitreoretinal interface state.
Clinical characteristics and management of autoimmune enteropathy in children: case reports and literature review
Authors: Jin Meng , Gong Youzhe , Liu Wenwen , Zhong Xuemei
Published: November 2023

Background

Autoimmune enteropathy (AIE) defined by intractable diarrhoea and nonceliac enteropathy with villous atrophy, is a rare digestive disease. Case reports of this disease are sporadic and the clinical characteristics of AIE is seldom discussed.

Purpose

We evaluate the clinical, laboratory, histopathological features, response to therapy and outcome of AIE in children.

Method

We conducted a retrospective analysis of five children with AIE in our hospital. A comprehensive search of MEDLINE was performed using PubMed, through keywords of “autoimmune enteropathy, pediatric or children”. The clinical manifestations, endoscopic results, pathological results, and medication therapy of these children were collected and the cases were divided into two groups, infants (≤ 1 year old) and children (> 1 year old).

Results

Five cases treated in our department: one case took eight years to make the final diagnosis; one case was positive for anti-intestinal epithelial cell (AE) antibody; three cases showed crypt apoptosis in histopathology; and two cases showed celiac-like changes. All cases were responsive to glucocorticoid therapy in the early stage of treatment, while three cases required immunosuppressant maintenance. After reviewing the literature, we performed a statistical analysis of 50 cases with a male-to-female ratio of 31:19. Among them, 35 patients (70%) were within 1 year of age, and their clinical manifestations were mainly watery stool (43 cases, 86%), weight loss (28 cases, 56%), abdominal distension (3 cases, 6%), serum AE or anti-goblet cell (AG) antibody positivity (32 cases, 64%), other immune-related antibodies (21 cases, 42%), gene mutations (9 cases, 18%), and family history (21 cases, 42%). All the children showed different degrees of intestinal villous atrophy. Thirty-seven (74%) of the children were treated early, and their clinical symptoms were relieved. Comparing the cases between different age groups, it was found that the mortality rate of children with onset in infancy was higher (P < 0.05), and there was no difference in other autoimmune diseases, AE antibody positivity rates, and other antibodies between the two groups. In addition to survival rate between different age group (P = 0. 005), there was no difference in sex, autoantibody positivity rate, single gene mutation, or family history between the two groups (P > 0.05) through analysis of mortality and clinical remission cases.

Conclusion

Endoscopic examination and mucosal pathological examination should be performed to diagnose AIE in children with watery stool and weight loss who fail to be treated with diet therapy. Immunotherapy is the core of medical management of AIE and can improve prognosis. Children with a poor prognosis in infancy should be actively treated to reduce mortality rates associated with AIE.
Relationship of sleep-quality and social-anxiety in patients with breast cancer: a network analysis
Authors: He Chunyan , He Yang , Yang Tianqi , Wu Chao , Lin Yawei , Yan Jiaran , Chang Wei , Chang Fenxia , Wang Yameng , Wu Shengjun , Cao Baohua
Published: November 2023

Background

There is a complex relationship between social anxiety and sleep quality. However, network analysis studies of associations between social anxiety and sleep quality are lacking, particularly among patients with breast cancer. The current study aimed to extend this research to a sample of patients with breast cancer and to examine symptom-level associations between social anxiety and sleep quality using network analysis.

Methods

Network analysis was conducted to explore their associations and identify bridge items of social anxiety and sleep quality.

Results

The network structure revealed 9 important edges between social anxiety and sleep quality. “Subjective sleep quality” had the highest EI value in the network. “Working difficulty under watching” and “Sleep disorders” had the highest BEI values in their own communities.

Conclusion

There are complex pathological correlation pathways between social anxiety and sleep quality in breast cancer patients. “Subjective sleep quality”, “Working difficulty under watching” and “Sleep disorders” have the potential to be intervention targets for sleep disorder-social anxiety comorbidity. Medical staff can take corresponding interventions according to the the centrality indices and bridge centrality indicators identified in this study, which is likely to effectively reduce the comorbidity of sleep disorders and social anxiety.
Advanced glycation end products measured by skin autofluorescence and subclinical cardiovascular disease: the Rotterdam Study
Authors: Chen Jinluan , Arshi Banafsheh , Waqas Komal , Lu Tianqi , Bos Daniel , Ikram M. Arfan , Uitterlinden André G. , Kavousi Maryam , Zillikens M. Carola
Published: November 2023

Background

Advanced glycation end products (AGEs) have been linked to cardiovascular disease (CVD), especially coronary heart disease (CHD), but their role in CVD pathogenesis remains unclear. Therefore, we investigated cross-sectional associations of skin AGEs with subclinical atherosclerosis, arterial stiffness, and hypertension after confirming their relation with CHD.

Methods

In the population-based Rotterdam Study, skin AGEs were measured as skin autofluorescence (SAF). Prevalent MI was obtained from digital medical records. Carotid plaques, carotid intima-media thickness (IMT), coronary artery calcification (CAC), pulse wave velocity (PWV), and hypertension were assessed. Associations of SAF with endophenotypes were investigated in logistic and linear regression models adjusting for common cardiovascular risk factors. Effect modification by sex, diabetes mellitus, and chronic kidney disease (CKD) was tested.

Results

3001 participants were included (mean age 73 (SD 9) years, 57% women). One unit higher SAF was associated with the presence of carotid plaques (OR 1.2 (0.92, 1.57)), a higher max IMT (0.08 SD (0.01, 0.15)), higher CAC (OR 2.2 (1.39, 3.48)), and PWV (0.09 SD (0.01, 0.16)), but not with hypertension (OR 0.99 (0.81, 1.21)). The associations with endophenotypes were more pronounced in men and participants with diabetes or CKD with significant interactions.

Conclusions

Previously documented associations between SAF and CVD, also found in our study, may be explained by the endophenotypes atherosclerosis and arterial stiffness, especially in men and individuals with diabetes or CKD, but not by hypertension. Longitudinal studies are needed to replicate these findings and to test if SAF is an independent risk factor or biomarker of CVD.

Trial registration: The Rotterdam Study has been entered into the Netherlands National Trial Register (NTR; www.trialregister.nl) and the WHO International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/network/primary/en/) under shared catalogue number NTR6831.
Regulating bulb dormancy release and flowering in lily through chemical modulation of intercellular communication
Authors: Zhao Yajie , Pan Wenqiang , Xin Yin , Wu Jingxiang , Li Rong , Shi Jinxin , Long Shuo , Qu Lianwei , Yang Yingdong , Yi Mingfang , Wu Jian
Published: November 2023

Lily is a bulbous plant with an endogenous dormancy trait. Fine-tuning bulb dormancy release is still a challenge in the development of bulb storage technology. In this study, we identified three regulators of symplastic transport, 2,3-Butanedione oxime (BDM), N-Ethyl maleimide (NEM), and 2-Deoxy-D-glucose (DDG), that also regulate bulb dormancy release. We demonstrated that BDM and DDG inhibited callose synthesis between cells and promoted symplastic transport and soluble sugars in the shoot apical meristem (SAM), eventually accelerating bulb dormancy release and flowering in lilies. Conversely, NEM had the opposite effect. These three regulators can be flexibly applied to either accelerate or delay lily bulb dormancy release.
Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review
Authors: Kotani Yuki , Turi Stefano , Ortalda Alessandro , Baiardo Redaelli Martina , Marchetti Cristiano , Landoni Giovanni , Bellomo Rinaldo
Published: November 2023

Background

It is unclear how often survival benefits observed in single-center randomized controlled trials (sRCTs) involving critically ill patients are confirmed by subsequent multicenter randomized controlled trials (mRCTs). We aimed to perform a systemic literature review of sRCTs with a statistically significant mortality reduction and to evaluate whether subsequent mRCTs confirmed such reduction.

Methods

We searched PubMed for sRCTs published in the New England Journal of Medicine, JAMA, or Lancet, from inception until December 31, 2016. We selected studies reporting a statistically significant mortality decrease using any intervention (drug, technique, or strategy) in adult critically ill patients. We then searched for subsequent mRCTs addressing the same research question tested by the sRCT. We compared the concordance of results between sRCTs and mRCTs when any mRCT was available. We registered this systematic review in the PROSPERO International Prospective Register of Systematic Reviews (CRD42023455362).

Results

We identified 19 sRCTs reporting a significant mortality reduction in adult critically ill patients. For 16 sRCTs, we identified at least one subsequent mRCT (24 trials in total), while the interventions from three sRCTs have not yet been addressed in a subsequent mRCT. Only one out of 16 sRCTs (6%) was followed by a mRCT replicating a significant mortality reduction; 14 (88%) were followed by mRCTs with no mortality difference. The positive finding of one sRCT (6%) on intensive glycemic control was contradicted by a subsequent mRCT showing a significant mortality increase. Of the 14 sRCTs referenced at least once in international guidelines, six (43%) have since been either removed or suggested against in the most recent versions of relevant guidelines.

Conclusion

Mortality reduction shown by sRCTs is typically not replicated by mRCTs. The findings of sRCTs should be considered hypothesis-generating and should not contribute to guidelines.