bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral arterial catheter securement and catheter survival in the pediatric intensive care unit
Authors: Pilarz Mary S , Walker Sarah B , Rowland Matthew J
Published: March 2024

Background:

Peripheral arterial catheters (PACs), and their associated complications, are common in the pediatric intensive care unit (PICU). Accidental catheter displacement and non-functional PACs are the most common complications, and this may be related to inadequate catheter securement. There is mixed guidance on the best way to secure PACs to prevent complications. The authors hypothesized that sutures would not be associated with a decreased risk of malfunction or accidental removal.

Methods:

This was a single center retrospective cohort study at a quaternary-care PICU. PICU patients with a peripheral arterial catheter placed in the PICU from 7/2020 to 1/2023 were included. The primary outcome was unplanned PAC removal. A univariate and multivariate Cox proportional hazards regression analysis was performed, using patient weight, sedation, paralytic, and role of the proceduralist as covariates. The secondary outcome was survival probability. A log-rank test was used to compare survival curves.

Results:

Of 761 PACs that met inclusion criteria in 437 unique patients, 599 were sutured (78.7%) and 162 were un-sutured (21.3%). In 257 cases (33.8%), the PAC had an unplanned removal. Among all PACs, the median duration of PAC placement was 5.3 days (IQR 2.1–10.5 days). There was an unplanned removal rate of 42.2% (68) in the un-sutured group and 31.4% (188) in the sutured group ( p < 0.001). In multivariable analysis, sutured PACs were also associated with a lower rate of unplanned removal (hazard ratio, 0.59; 95% CI, 0.44–0.78). Use of continuous sedation was also associated with an increased risk of unplanned removal of PACs (hazard ratio, 1.54; 95% CI, 1.10–2.16). There was a 50% survival probability at 13.3 days for un-sutured PACs and 23.7 days for sutured PACs.

Conclusions:

Suturing is associated with fewer unplanned removals and longer catheter survival, compared to un-sutured PACs in pediatric patients.
Patient Learning Pathway: Identifying Patient Competencies in Teledermatology for Effective Management of Dermatological Conditions
Authors: Montiel Corentin , Jackson Mathieu , Clovin Tiffany , Bogdanova Eleonora , Côté Catherine , Descoteaux Annie , Wong Caroline , Dumez Vincent , Pomey Marie-Pascale , Hanna Dominique
Published: March 2024

Background:

Dermatology consultations in Québec, Canada, face accessibility challenges, with most dermatologists concentrated in urban areas. Teledermatology, offering remote diagnosis and treatment, holds promise in overcoming these limitations. However, concerns regarding patient-doctor relationships and logistical issues exist.

Objectives:

This article aims to introduce a dermatology patient learning pathway (PLP) developed by the Centre of Excellence on Partnership with Patients and the Public (CEPPP), focusing on knowledge, abilities, and skills mobilized by patients and their loved ones at key moments of the life course with an illness, as well as emerging educational needs.

Methods:

The PLP development was co-developed with dermatology patient and caregiver partners, stakeholders, and the CEPPP team. The process encompassed stakeholder engagement, exploration, recruitment of patient and caregiver partners, co-development of the PLP draft, and validation through consensus building.

Results:

The PLP methodology led to the creation of 44 learning objectives, comprising a total of 107 subobjectives. These objectives were organized into 8 phases of the patient life course with a dermatological condition: (1) prevention and predisposition; (2) discovery, self-examination, or observation of a change; (3) first consultation; (4) wandering; (5) consultation with a dermatologist; (6) diagnosis; (7) treatments; and (8) living with it.

Conclusions:

The dermatology PLP serves as a resource outlining patient competency across different stages of managing a dermatological condition throughout their life course. In the context of teledermatology, the PLP might facilitate patient and caregiver engagement by helping select appropriate information and tools to support active participation in care.
Notes on notes: A critical reflection on clinical writing in music therapy practice
Authors: Grundy Ian
Published: March 2024

Therapeutic encounters are swathed in writing from referral and consent forms, clinical and process notes, evaluations and assessments to reports. However, there has been very little research into the broader meaning, function and context of writing in music therapy. In this article, I hope to encourage music therapists to think critically about the writing they produce and use in clinical practice. I draw on guidance from professional bodies, theories of memory, phenomenology, existentialism, the psychoanalytic perspectives on language of Lacan and Kristeva and post-modern ideas around the meaning and contextual understanding of a text through the writings of Foucault, Barthes and McLuhan. I encourage more reflexivity regarding the role of the music therapist’s self and intersubjective elements within the writing. I ask what influence the act of writing itself exerts on clinical practice and reflect on the role of language and its adequacy for describing the music therapy encounter. I further explore how music therapists contextualise the writing they produce, speculating on some of its functions in relation to the therapist, client and institution. In conclusion, I argue that clinical writing in all its forms potentially has a powerful impact on the therapy process as a whole.
Impact of misinformation from generative AI on user information processing: How people understand misinformation from generative AI
Authors: Shin Donghee , Koerber Amy , Lim Joon Soo
Published: March 2024

This study examines the impact of artificial intelligence (AI) on the ways in which users process and respond to misinformation in generative artificial intelligence (GenAI) contexts. Drawing on the heuristic–systematic model and the concept of diagnosticity, our approach examines a cognitive model for processing misinformation in GenAI. The study’s findings revealed that users with a high-heuristic processing mechanism, which affects positive diagnostic perception, were more likely to proactively discern misinformation than users with low-heuristic processing and low-perceived diagnosticity. When exposed to misinformation from GenAI, users’ perceived diagnosticity of misinformation can be accurately predicted by the ways in which they perform heuristic systematic evaluations. With this focus on misinformation processing, this study provides theoretical insights and relevant recommendations for firms to be more resilient in protecting users from the detrimental impacts of misinformation.
The Demos of the democratic firm
Authors: González-Ricoy Iñigo , Magaña Pablo
Published: March 2024

Despite growing interest in workplace democracy, the question whether nonworker stakeholders, like suppliers and local communities, warrant inclusion in the governance of democratic companies, as workers do, has been largely neglected. We inspect this question by leaning on the boundary problem in democratic theory. We first argue that the question of who warrants inclusion in democratic workplaces is best addressed by examining why workplace democracy is warranted in the first place, and offer a twofold normative benchmark—addressing objectionable corporate power and upholding efficiency—to assess the principles of democratic inclusion on offer. Against this benchmark, we next argue that the All-Affected Principle is unfit due to its over- and underinclusive extensional results, and that the All-Subjected Principle, whose variants we examine alongside their extensional results, holds more promise when coupled with independent considerations of justice or a constrained variant of the All-Affected Principle. These combinations need not entirely preclude, but speak against, nonworker stakeholder inclusion.
Mothers’ Perspectives: Daily Life When Your Child Has Sensory Differences
Authors: Allen Susan , Branson Amanda , Lane Shelly J. , Knott Fiona J.
Published: March 2024

A child’s sensory processing and sensory integration (SP-SI) differences can be a barrier to participation in daily life for both child and mother. Supporting mothers is advocated for, but little is known about the everyday experiences of these mothers. To gain an understanding of daily life for mothers and their children with SP-SI differences. Qualitative semi-structured interviews with six mothers were analyzed through thematic analysis. Theme 1 described the impact of child SP-SI on daily life, including challenges in occupations across environments, adaptations required, and the lack of knowledge and understanding from social and professional networks. Theme 2 identified what helps: empowering mothers through relationships based on listening, gaining knowledge, and understanding, and adapting the activity and the environment. Mothers report that their child’s SP-SI differences impact daily occupations and social relationships. In addition, supportive relationships, adapting activities, and adapting the environment, support participation.
Disco Pinball: Declining Games and Depression in Disco Elysium
Authors: Banfi Ryan
Published: March 2024

This essay examines the influence of the pinball industry's late twentieth-century decline on Disco Elysium's (ZA/UM, 2019) narrative. Reference points to pinball must be sought out in Disco Elysium as they are hidden, but once found they implore the player to consider the downfall of games. Gleaning from academic work on ZA/UM's text, archival research, pinball history, and by using formal narrative analysis this paper explains how the downturn of the pinball industry conveys Disco Elysium's political strife—namely capitalism's detrimental influence on the fictional district of Martinaise.
Bridge Babies and Rebuilding America: Reproductive Commodification in Death Stranding
Authors: Curry Audrey Michelle
Published: March 2024

Hideo Kojima's 2019 video game Death Stranding has sold over 10 million copies since 2022. The game's plot features a post-apocalyptic United States where female bodies become commodities to produce babies, which the government utilizes as equipment to rebuild the country. The purpose of this paper is to analyze how the government's, the terrorists’, and the player character's words and actions reinforce or reject traditional patriarchal views about reproduction. I first establish a background in post-apocalyptic narratives by synthesizing themes from The Handmaid's Tale, The Road, and The Walking Dead. Using feminist post-structuralism, I analyze how reproductive commodification is prioritized over ethics by the government, rejected in favor of general destruction to the greater good by the terrorists, and is used only when absolutely necessary by the player character. I finally argue that commodification narratives are typical within post-apocalyptic narratives, are harmful, and have the potential to influence real-world politics.
Shoe customization in a mass-production mode
Authors: Bondar Oleksander , Chertenko Liliia , Spahiu Tatjana , Shehi Ermira
Published: March 2024

There is a growing trend where footwear is considered a fashion item by increasing in this way the number of footwear products in the market. This is translated to carbon footprints which is a global issue. Reducing the number of footwear can be achieved by focusing on customization. Shifting from mass production to customization is highly supported by digital technologies. A case study of shoe customization in the mass production mode is presented. Implemented in a shoe manufacturing environment, the possibility of using one node of the bottom in combination with various options for the shoe not only results in success in terms of fit and comfort but at the same time promotes sustainable production. This methodology aligns with the sustainability goals in the footwear industry while expanding the range of shoes.
Post-stroke emotionalism: Diagnosis, pathophysiology, and treatment
Authors: Broomfield Niall M , Blake Joshua , Gracey Fergus , Steverson Tom
Published: March 2024

Background:

Post-stroke emotionalism affects one in five stroke sufferers 6 months after their stroke, but despite its frequency remains a poorly understood stroke symptom. The literature is limited, especially compared to other frequently observed neurological conditions such as aphasia and visual neglect.

Aim and Methods:

This narrative review presents a summary of the post-stroke emotionalism literature, to inform clinical practice and future research. We cover discussion of definitions, prevalence, neurobiology, predisposing and precipitating factors, and treatment.

Results:

Increasing evidence suggests that damage to specific areas functionally linked to emotion expression or regulation processes, disruption to structural pathways and those related to serotonin production and modulation individually or in concert give rise to emotionalism-type presentations. A range of emotionalism measurement tools have been used in research contexts making between study comparisons difficult. Testing for Emotionalism after Recent Stroke–Questionnaire (TEARS-Q) has recently been developed to allow standardized assessment. Treatment options are limited, and there have been few adequately powered treatment trials. Antidepressants may reduce severity, but more trial data are required. There have been no randomized-controlled trials of non-pharmacological interventions.

Conclusions:

More research is needed to improve recognition and treatment of this common and disabling symptom. We conclude with research priorities and recommendations for the field.
‘But we didn’t put it to a vote!’. A case study of direct-democratic decision-making in formal education
Authors: Retalis Yorgos
Published: March 2024

The current study examined the unofficial implementation of direct-democratic decision-making assemblies in three typical public (state) schools of consecutive educational levels (kindergarten, primary and middle school) in a village in Greece. The study drew on Michel Foucault’s analysis of power technologies and power relations in disciplinary dispositives like Education. The main aim of the study was to investigate the ways in which both pupils and teachers engaged with the disciplinary technology inherent in the educational dispositive and to document their conceptualization and attitudes towards these direct-democratic assemblies. The research methodology utilized participant observation and semi-structured interviews. Findings indicated that the disciplinary technology continued to function as per the dominant dispositive, despite the implementation of direct-democratic decision-making assemblies, while pupils generally exhibited a sense of empowerment, displaying support and being influenced in their daily lives by the assemblies’ governmentality. Minor challenges concerning the implementation of such assemblies are addressed and further possibilities of such implementations are discussed.
Teachers-as-pressed-flowers: Unpacking ‘inert benevolence’ towards pupils who require additional support or advocacy to thrive in schools
Authors: Cunningham Clare
Published: March 2024

The notion of inert benevolence has been written about in the context of primary school teachers working with languages beyond English (Cunningham and Little, 2022). However, the concept has a broader relevance for those working in education and this paper seeks to explore it more fully, through the use of the metaphor of a flower press in order to understand how the power of numerous factors bearing down on teachers leads to inert benevolence.
Characteristics Associated With Elevated Time Below Range in Elderly Patients With Type 1 Diabetes Using an Automated Insulin Delivery System
Authors: Gómez Medina Ana María , Parra Prieto Darío A. , Henao Carrillo Diana Cristina , Gómez Claudia Milena , Muñoz Velandia Oscar Mauricio , Caicedo Sandra , Kerguelen Villadiego Alfonso Luis , Rodríguez Hortúa Luis Miguel , Lucero Pantoja Oscar David , Uribe Valencia Mauricio , García Guete María Margarita , Robledo Gómez Sofia , Rondón Sepúlveda Martin
Published: March 2024

Background:

This study investigated the characteristics associated with an increased risk of hypoglycemia, in elderly patients with type 1 diabetes mellitus (T1D) using automated insulin delivery (AID) systems.

Methods:

Cross-sectional observational study including patients >60 years, using sensor-augmented insulin pump therapy with predictive low-glucose management (SAPT-PLGM), hybrid closed-loop (HCL), and advanced hybrid closed-loop (AHCL), for more than three months. A geriatric assessment was performed, and body composition was determined to investigate its association with achieving time below range (TBR) <70 mg/dL goals.

Results:

The study included 59 patients (47.5% of men, mean age of 67.6 years, glycated hemoglobin [HbA1c] of 7.5 ± 0.6%, time in range (TIR) 77.8 ± 9.9%). Time below range <70 and <54 mg/dL were 2.2 ± 2.3% and 0.4 ± 0.81%, respectively. Patients with elevated TBR <70 mg/dL (>1%) had higher HbA1c levels, lower TIR, elevated time above range (TAR), and high glycemic variability. Regarding body composition, greater muscle mass, grip strength, and visceral fat were associated with a lower TBR <70 mg/dL. These factors were independent of the type of technology used, but TIR was higher when using AHCL systems compared with SAPT-PLGM and HCL systems.

Conclusions:

In elderly patients treated with AID systems with good functional status, lower lean mass, lower grip strength, and lower visceral fat percentage were associated with TBR greater than 1%, regardless of the device used. A similar finding along was found with CGM indicators such as higher HbA1c levels, lower TIR, higher TAR, and higher CV. Geriatric assessment is crucial for personalizing patient management.
Indications, Associated Procedures, and Results of Ankle Plafond-Plasty for Varus Ankle Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Zielli Simone Ottavio , Mazzotti Antonio , Artioli Elena , Marcolli Daniele , Arceri Alberto , Bonelli Simone , Faldini Cesare
Published: March 2024

Backgrounds

Plafond-plasty is a joint-preserving procedure to treat varus ankle osteoarthritis (OA) with asymmetrical joint involvement. The aim of this systematic review and meta-analysis was to evaluate indications, different surgical techniques, associated procedures, and results of plafond-plasty in varus ankle OA and to analyze the level of evidence (LOE) and quality of evidence (QOE) of the included studies.

Methods

A systematic review of the literature was performed using MEDLINE, Embase, and Cochrane.

Results

Five studies evaluating 99 ankles were included. A non-rigid varus ankle deformity and an ankle OA Takakura stage 3b or less were the most recommended pre-operative indications. Meta-analysis showed a significant post-operative improvement in clinical and radiological parameters. Many associated surgical procedures have been reported, the most frequent being medial additional supramalleolar osteotomy and lateral ankle ligament reconstruction. The level of evidence and methodological quality assessment of the included studies showed an overall low quality.

Conclusion

Plafond-plasty seems to be a promising surgical option when managing varus ankle OA with asymmetrical joint involvement, extending the indications for joint sparing surgery. Additional associated procedures should be carefully evaluated case-by-case.

Levels of Evidence:

IV
A Large Lambl’s Excrescence Causing Embolic Stroke in a Young Patient: A Case Report and Review of Literature
Authors: Abou-El-Hassan Hadi , Azhar Yusra , Ikram Asad , Kulik Tobias , Torbey Michel T.
Published: March 2024

Lambl’s excrescences (LEs) are thin, filiform and hypermobile strands that develop at the valvular coaptation sites of the heart. Since first described in 1856 by Vilém Dušan Lambl, there has been an increasing number of reports of central and peripheral emboli arising from cardiac LEs. LEs have been linked to ischemic strokes irrespective of age and comorbidities. We report one of the youngest reported cases in literature of an embolic stroke in a 25-year-old woman caused by a LE. A comprehensive workup was performed that revealed a large aortic valve LE. The patient was discharged on dual anti-platelet therapy with outpatient cardiology follow-up for surveillance echocardiograms. We then surveyed the literature and reviewed case reports and observational studies of LEs linked to systemic emboli. We found that most LEs are present on left-sided high-pressure valves especially the ventricular aspect of the aortic valves and that most reported cases of cerebral embolism had aortic valve LEs. The management of cardioembolic stroke secondary to LEs remains unclear. LEs have not been identified as a definite etiology of cardioembolic strokes warranting the need for large-scale studies to help guide the management of cardiac LEs in the setting of ischemic stroke.
Evidence-Based Update on the Surgical Technique and Clinical Outcomes of Retrograde Drilling: A Systematic Review
Authors: Yasui Youichi , Miyamoto Wataru , Shimozono Yoshiharu , Tsukada Keisuke , Kawano Hirotaka , Takao Masato
Published: March 2024

Background

Retrograde drilling is an established surgical technique to treat osteochondral lesions of the talus (OLT). It involves non-trans-articular drilling to induce subchondral bone revascularization and bone formation without damaging the overlying articular cartilage. The present study aimed to elucidate the heterogeneity of clinical studies on retrograde drilling for OLT.

Design

A systematic search of the MEDLINE, Web of Science, EMBASE, and Cochrane Library databases for studies published between January 1996 and August 27, 2022, was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by two independent reviewers. The included studies were evaluated for their level of evidence (LoE) and quality of evidence (QoE) using the Modified Coleman Methodology Score. Variables reporting surgical and clinical outcomes and complications were evaluated.

Results

Eleven studies with 207 ankles were included (mean follow-up period = 31.1 months). The mean LoE was 3.8 (LoE 3: two studies, LoE 4: nine studies), and the mean QoE was 50.8 (fair: three studies, poor: eight studies). Ten studies used the American Orthopedic Foot and Ankle Society (AOFAS) score, which improved from 57.9 preoperatively to 86.1 postoperatively. The period and protocol of conservative treatment, lesion character, surgical technique, and postoperative protocol were inconsistent or underreported.

Conclusions

This systematic review revealed that low LoE and poor QoE, coupled with heterogeneity among the included studies, impede definitive conclusions regarding the effectiveness of this technique. Consequently, well-designed clinical trials are essential to develop standardized clinical guidelines for using retrograde drilling in OLT.
Personality and Cultural Income Differences Shape the Life Satisfaction Gap Between Aging Immigrants and Natives in Europe
Authors: Bleidorn Wiebke , Lenhausen Madeline R. , Richter David , Hopwood Christopher J.
Published: March 2024

The present study examined the size and possible sources of life satisfaction differences between immigrants and natives in a sample of over 55,000 adults (aged 50+ years) across 16 European countries and Israel. Consistent with theory and prior research, immigrants reported lower life satisfaction than natives on average, while the size of the life satisfaction gap varied substantially across individuals and countries. Low neuroticism and high extraversion reduced the life satisfaction gap, suggesting that these personality traits may serve as internal resources for immigrants when faced with migration-related stressors. In contrast, we found a wider life satisfaction gap between immigrants and natives in high-income countries, suggesting that economic disparities between immigrants and natives in prosperous nations may contribute to the observed life satisfaction gap.
Digitally Connected, Evolutionarily Wired: An Evolutionary Mismatch Perspective on Digital Work
Authors: van Vugt Mark , Colarelli Stephen M. , Li Norman P.
Published: March 2024

This paper makes the case for an evolutionary mismatch between digital work and the way human ancestors engaged in work. Psychological adaptations for producing things that early humans needed to survive and thrive, such as cognitive mechanisms for obtaining and processing food, toolmaking, and learning valuable working skills, evolved in the context of small networks of hunter–gatherers. These adaptations are central to understanding the significance of work in human evolution. Evolutionary mismatches operate when novel environments cue ancestral adaptations in ways that no longer provide adaptive benefits. We argue that digital work, although efficient and productive, is misaligned with some fundamental human needs, preferences, and routines, thereby illuminating a potential dark side. Yet digitalization also offers opportunities for matching the modern work environment to our evolved work psychology. We conclude with an agenda for advancing research in industrial and organizational psychology on digital work from an evolutionary mismatch perspective.
From hot pot to high tech: Haidilao’s transformation through digital technologies for sustainable business in the restaurant industry
Authors: Loh Chin Moi , Perdana Arif , Lee Kuan-Huei
Published: March 2024

The pandemic has brought many challenges to the restaurant industry but highlighted the importance of embracing digital transformation that enhances organisations’ competitive advantage and sustainable business. The success story of Haidilao, a popular hot pot restaurant, inspires those striving to overcome difficulties and learn from their digital transformation journey. By staying adaptable, proactive and customer-focused, Haidilao has leveraged digital platforms to offer new and innovative services, such as an online ordering and delivery, an intelligent kitchen, an innovative WeChat strategy and even a Cloud Video Conferencing Service to enhance the attractiveness of the dining experience. Haidilao’s story demonstrates the power of innovation and customer-centricity in driving successful digital transformations for sustainable business in the restaurant industry.
Traversing Emotional Spaces: Social Media Affordances and Emotion Regulation in Times of Physical Isolation
Authors: Peng Lulu , Wang Jinping , Zheng Nanxiao , Guo Xiaoping
Published: March 2024

People’s emotional life is increasingly interwoven with social media. Against the background of the COVID-19 pandemic and lockdown in China, this study investigated social media affordances enacted during people’s emotion regulation processes. By analyzing in-depth interviews with 27 Shanghai residents going through a 2-month lockdown, we identified intersections between social media affordances and different emotion regulation processes: selectivity and intrapersonal emotion regulation; visibility and emotional self-presentation; bandwidth and interpersonal emotion regulation; connectivity and collective emotion regulation. This study extended our knowledge of mediated emotion regulation processes and enriched our understanding of the dynamic relations between users, media technologies, and emotional and social contexts.
Assessment of Mild Cognitive Impairment Using CogEvo: A Computerized Cognitive Function Assessment Tool
Authors: Satoh Toru , Sawada Yoichi , Saba Hideaki , Kitamoto Hiroshi , Kato Yoshiki , Shiozuka Yoshiko , Kuwada Tomoko , Shima Sayoko , Murakami Kana , Sasaki Megumi , Abe Yudai , Harano Kaori
Published: March 2024

Introduction/Objectives:

To assess the utility of the computerized cognitive function assessment tool, CogEvo, as a screening tool for mild cognitive impairment in primary care, we explored the relationship between CogEvo performance, age, and the severity of cognitive dysfunction evaluated by the Mini-Mental State Examination (MMSE).

Methods:

The observational cross-sectional study included 209 individuals’ data (mean age 79.4 ± 8.9 years). We conducted a correlation analysis between CogEvo and MMSE scores, compared the performance among the 3 cognitive function groups (MMSE ≥ 28 group; MMSE24-27 group; MMSE ≤ 23 group) using the MMSE cut-off, and evaluated CogEvo’s predictive accuracy for cognitive dysfunction through ROC analysis.

Results:

Both total CogEvo and MMSE scores significantly decreased with age. A significant positive correlation was observed between total CogEvo and MMSE scores, but a ceiling effect was detected in MMSE performance. Significant differences were observed in the total CogEvo score, including orientation and spatial cognitive function scores, among the 3 groups. CogEvo showed no educational bias. ROC analyses indicated moderate discrimination between the MMSE ≥ 28 group and the MMSE24-27 and MMSE ≤ 23 groups.

Conclusions:

The computer-administered CogEvo has the advantage of not exhibiting ceiling effects or educational bias like the MMSE, and was found to be able to detect age-related cognitive decline and impairment.
“New Heights” in Storytelling?: Considerations for Cross-National Analyses of Broadcasters’ Social Media Coverage of the Paralympics
Authors: Antunovic Dunja , Bundon Andrea , Lehrfeld Lindsey , Gancayco Peter
Published: March 2024

Prior to the 2022 Beijing Paralympic Games, rights-holding broadcasters in multiple countries promised record-amount of coverage, including on digital platforms. This paper analyzes how NBC and CBC, the broadcasters in the U.S. and Canada, respectively, utilized social media platforms during the Paralympic Games. We employed two methodological approaches. The first draws on agenda diversity literature to provide a quantitative, descriptive analysis of Paralympics-related posts, interactions with other accounts, and gender representations. The second approach draws on research on the televisual logic of digital media to identify and interpret presentation, sequence, and visualization patterns. Our multidimensional analysis found differences in the volume of Paralympics-related posts and the utilization of interactive elements, across the two broadcasters. The coverage on both accounts highlighted home-nation athletes and their competitions, which shaped gender representations and the rhythm of social media coverage. Both broadcasters followed established sequences of mega-events, with the exception of an international conflict. CBC relied primarily on one journalist to provide updates and curling-related recaps, while NBC directed audiences to watch sports where U.S. athletes succeeded. We discuss the theoretical and methodological implications of cross-national comparative coverage of the Paralympics.
Esophageal Perforation Presenting Initially as Multiple Brain Abscesses Secondary to Streptococcus intermedius
Authors: Swied Muhammed Yaman , Alom Mulham , Daaboul Obada , Azzawi Muaataz , Swied Abdul
Published: March 2024

Brain abscess is a life-threatening infection that can occur secondary to contiguous or hematogenous spread. Several underlying conditions can lead to brain abscesses, such as dental infection, otitis media, sinusitis, and immunosuppression. Esophageal perforation leading to brain abscesses is extremely rare. We report a rare case of a 32-year-old man who presented to the emergency department with progressive headaches and upper-extremity weakness. Upon further evaluation, computed tomography (CT) revealed multiple brain abscesses secondary to Streptococcus intermedius infection. The patient eventually underwent esophagogastroduodenoscopy (EGD), which showed a perforation in the middle third of the esophagus. This case highlights the importance of considering esophageal perforation as a predisposing condition for brain abscesses.
Promising Response of Olaparib in Patient With Germline ATM-Mutated Metastatic Gastric Cancer
Authors: Chan Kok Hoe , Rutazanaa Darius , Wray Curtis , Thosani Nirav , Yang Victor , Cen Putao
Published: March 2024

Gastric cancer ranks as the fifth leading cause of global cancer incidences, exhibiting varied prevalence influenced by geographical, ethnic, and lifestyle factors, as well as Helicobacter pylori infection. The ATM gene on chromosome 11q22 is vital for genomic stability as an initiator of the DNA damage response, and mutations in this gene have been associated with various cancers. Poly ADP-ribose polymerase (PARP) inhibitors, such as olaparib, have shown efficacy in cancers with homologous recombination repair deficiencies, notably in those with ATM mutations. Here, we present a case of a 66-year-old patient with germline ATM-mutated metastatic gastric cancer with very high CA 19-9 (48 000 units/mL) who demonstrated an exceptional response to the addition of olaparib to chemo-immunotherapy and subsequent olaparib maintenance monotherapy for 12 months. CA 19-9 was maintained at low level for 18 months. Despite the failure of a phase II clinical trial on olaparib in gastric cancer (NCT01063517) to meet its primary endpoint, intriguing findings emerged in the subset of ATM-mutated patients, who exhibited notable improvements in overall survival. Our case underscores the potential clinical utility of olaparib in germline ATM-mutated gastric cancer and emphasizes the need for further exploration through larger clinical trials. Ongoing research and clinical trials are essential for optimizing the use of PARP inhibitors, identifying biomarkers, and advancing personalized treatment strategies for gastric cancer.
Prevalence and Predictors of Concomitant Meniscal Surgery During Pediatric and Adolescent ACL Reconstruction: Analysis of 4729 Patients Over 20 Years at a Tertiary-Care Regional Children's Hospital
Authors: Pruneski James A. , Tavabi Nazgol , Heyworth Benton E. , Kocher Mininder S. , Kramer Dennis E. , Christino Melissa A. , Milewski Matthew D. , Yen Yi-Meng , Micheli Lyle , Murray Martha M. , Garcia Andujar Rafael A. , Kiapour Ata M.
Published: March 2024

Background:

The rate of concomitant meniscal procedures performed in conjunction with anterior cruciate ligament (ACL) reconstruction is increasing. Few studies have examined these procedures in high-risk pediatric cohorts.

Hypotheses:

That (1) the rates of meniscal repair compared with meniscectomy would increase throughout the study period and (2) patient-related factors would be able to predict the type of meniscal operation, which would differ according to age.

Study Design:

Cohort study (prevalence); Level of evidence, 2.

Methods:

Natural language processing was used to extract clinical variables from notes of patients who underwent ACL reconstruction between 2000 and 2020 at a single institution. Patients were stratified to pediatric (5-13 years) and adolescent (14-19 years) cohorts. Linear regression was used to evaluate changes in the prevalence of concomitant meniscal surgery during the study period. Logistic regression was used to determine predictors of the need for and type of meniscal procedure.

Results:

Of 4729 patients (mean age, 16 ± 2 years; 54.7% female) identified, 2458 patients (52%) underwent concomitant meniscal procedures (55% repair rate). The prevalence of lateral meniscal (LM) procedures increased in both pediatric and adolescent cohorts, whereas the prevalence of medial meniscal (MM) repair increased in the adolescent cohort ( P = .02). In the adolescent cohort, older age was predictive of concomitant medial meniscectomy ( P = .031). In the pediatric cohort, female sex was predictive of concomitant MM surgery and of undergoing lateral meniscectomy versus repair ( P≤ .029). Female sex was associated with decreased odds of concomitant LM surgery in both cohorts ( P≤ .018). Revision ACLR was predictive of concomitant MM surgery and of meniscectomy (medial and lateral) in the adolescent cohort ( P < .001). Higher body mass index was associated with increased odds of undergoing medial meniscectomy versus repair in the pediatric cohort ( P = .03).

Conclusion:

More than half of the young patients who underwent ACLR had meniscal pathology warranting surgical intervention. The prevalence of MM repair compared with meniscectomy in adolescents increased throughout the study period. Patients who underwent revision ACLR were more likely to undergo concomitant meniscal surgeries, which were more often meniscectomy. Female sex had mixed effects in both the pediatric and adolescent cohorts.
The HOMESIDE Study—A Research Project to Support People Living With Dementia and Their Family Caregivers: Preliminary Report on Reading Intervention
Authors: Smrokowska-Reichmann Agnieszka , Janus Edyta , Tamplin Jeanette , Odell-Miller Helen , Stensæth Karette , Wenborn Jennifer , Viken Rønnaug Modell , Wosch Thomas , Bukowska Anna A. , Sousa Tanara Vieira , Baker Felicity Anne
Published: March 2024

The behavioral and psychological symptoms of dementia (BPSD) can be challenging for family caregivers to cope with, leading to distress and fatigue. It is therefore important to offer effective strategies to reduce the impact of BPSD. The HOMESIDE randomized controlled trial (RCT) was testing purposefully developed interventions to improve the quality of life and wellbeing of dyads of people with dementia and family caregivers as a result of reduction of BPSD. HOMESIDE RCT was conducted in Australia, Germany, Norway, Poland and the United Kingdom between 2019 and 2022. The study design was a three-arm parallel-group single-blinded, pragmatic RCT with a sample size of 432 dyads. Dyads were randomly allocated to one of three treatment conditions: Music Intervention plus Standard Care; or Reading Intervention plus Standard Care; or Standard Care only. The Reading Intervention (RI) within the HOMESIDE RCT aimed to evoke shared discussion, reminiscence, meaningful shared experiences and consequently enrich everyday life, interaction and the emotional connection between the caregiver (CG) and carereceiver (CR); as well as to enhance activities of daily living and to promote relaxation or stimulation as appropriate. This paper describes the underlying conceptual framework, the content, and delivery of the Reading Intervention within the HOMESIDE RCT.
Risk factors for pregnancy-associated heart failure with preserved ejection fraction and adverse pregnancy outcomes: a cross-sectional study
Authors: Lee Seon Ui , Park Jae Young , Hong Subeen , Wie Jeong Ha , Shin Jae Eun , Choi Sae Kyung , Kim Woo Jeng , Kim Yeon Hee , Jo Yun Sung , Park In Yang , Kil Kicheol , Ko Hyun Sun
Published: March 2024

Background

Although pregnancy-associated heart failure with preserved ejection fraction (HFpEF) is increasing and contributing to maternal morbidity, little is known about its impact on pregnancy. We examined the risk factors for and adverse pregnancy outcomes of HFpEF in pregnant women.

Methods

We conducted a cross-sectional analysis of pregnancy-related hospitalizations from 2009 to 2020 using the perinatal database of seven multicenters. Cases of HFpEF were identified using the International Classification of Diseases and echocardiography findings. The patients were categorized into the HFpEF and control groups. Risk factors were evaluated using multivariate logistic regression analysis to generate odds ratios (OR) and 95% confidence intervals (CI). Furthermore, adjusted associations between HFpEF and adverse pregnancy outcomes were determined. Risk scores for the stratification of women at a high risk of HFpEF were calculated using a statistical scoring model.

Results

Of the 34,392 women identified, 258 (0.76%) were included in the HFpEF group. In multivariate analysis, HFpEF was significantly associated with old maternal age (OR, 1.04; 95% CI 1.02–1.07), multiple pregnancy (OR, 2.22; 95% CI 1.53–3.23), rheumatic disease (OR, 2.56; 95% CI 1.54–4.26), pregnancy induce hypertension (OR 6.02; 95% CI 3.61–10.05), preeclampsia (OR 24.66; 95% CI 18.61–32.66), eclampsia or superimposed preeclampsia (OR 32.74; 95% CI 21.60–49.64) and transfusion in previous pregnancy (OR 3.89; 95% CI 1.89–8.01). A scoring model to predict HFpEF with those factors achieved an area under the curve of 0.78 at cutoff value of 3. Women with HFpEF also had increased odds ratios of intensive care unit admission during the perinatal period (odds ratio, 5.98; 95% confidence interval, 4.36–8.21) and of postpartum hemorrhage (odds ratio, 5.98; 95% confidence interval, 2.02–3.64).

Conclusions

Pregnancy-associated HFpEF is associated with adverse pregnancy outcomes. A scoring model may contribute to screening HFpEF using echocardiography and preparing adverse pregnancy outcomes.
The role of Neutrophil counts, infections and Smoking in mediating the Effect of Bronchiectasis on Chronic Obstructive Pulmonary Disease: a mendelian randomization study
Authors: Gu Lei , Liu Wei , Huang Jian-an , Zhu Lujian , Hu Xiaowen , Yue Jian , Lin Jing
Published: March 2024

Background

The causality of the relationship between bronchiectasis and chronic obstructive pulmonary disease (COPD) remains unclear. This study aims to investigate the potential causal relationship between them, with a specific focus on the role of airway inflammation, infections, smoking as the mediators in the development of COPD.

Methods

We conducted a two-sample Mendelian randomization (MR) analysis to assess: (1) the causal impact of bronchiectasis on COPD, sex, smoking status, infections, eosinophil and neutrophil counts, as well as the causal impact of COPD on bronchiectasis; (2) the causal effect of smoking status, infections and neutrophil counts on COPD; and (3) the extent to which the smoking status, infections and neutrophil counts might mediate any influence of bronchiectasis on the development of COPD.

Results

COPD was associated with a higher risk of bronchiectasis (OR 1.28 [95% CI 1.05, 1.56]). Bronchiectasis was associated with a higher risk of COPD (OR 1.08 [95% CI 1.04, 1.13]), higher levels of neutrophil (OR 1.01 [95% CI 1.00, 1.01]), higher risk of respiratory infections (OR 1.04 [95% CI 1.02, 1.06]) and lower risk of smoking. The causal associations of higher neutrophil cells, respiratory infections and smoking with higher COPD risk remained after performing sensitivity analyses that considered different models of horizontal pleiotropy, with OR 1.17, 1.69 and 95.13, respectively. The bronchiectasis–COPD effect was 0.99, 0.85 and 122.79 with genetic adjustment for neutrophils, respiratory infections and smoking.

Conclusion

COPD and bronchiectasis are mutually causal. And increased neutrophil cell count and respiratory infections appears to mediate much of the effect of bronchiectasis on COPD.
Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue?
Authors: Keicher Franca , Zirkel Janina , Leutritz Tobias , König Sarah
Published: March 2024

Background

Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study.

Methods

An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany.

Results

The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs.

Conclusion

We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.
Development of a communication platform for patients with head and neck cancer for effective information delivery and improvement of doctor–patient relationship: application of treatment journey-based service blueprint
Authors: Koo Yoo-Ri , Kim Eun-Jeong , Nam Inn-Chul
Published: March 2024

Background

Effective communication and information delivery enhance doctor–patient relationships, improves adherence to treatment, reduces work burden, and supports decision-making. The study developed a head and neck cancer (HNC) communication platform to support effective delivery of information about HNC treatment and improve the doctor-patient relationship.

Methods

This study was structured in three main phases: 1) The requirement elicitation phase sought an understanding of the HNC treatment journey and service failure points (FPs) obtained through patient/medical staff interviews and observations, along with a review of the electronic health record system; 2) The development phase involved core needs analysis, solutions development through a co-creation workshop, and validation of the solutions through focus groups; and 3) the proposed HNC communication platform was integrated with the current treatment system, and the flow and mechanism of the interacting services were structured using a service blueprint (SB).

Results

Twenty-two service FPs identified through interviews and observations were consolidated into four core needs, and solutions were proposed to address each need: an HNC treatment journey map, cancer survivor stories, operation consent redesign with surgical illustrations, and a non-verbal communication toolkit. The communication platform was designed through the SB in terms of the stage at which the solution was applied and the actions and interactions of the service providers.

Conclusions

The developed platform has practical significance, reflecting a tangible service improvement for both patients and medical staff, making it applicable in hospital settings.