bluuebunny/crossref_metadata_2025 huggingface dataset:
Specters of Intersectionality
Authors: Gebruers Cecilia
Published: July 2024

The article presents the optical and spectral facets of the notion of intersectionality in their materiality, in their forms as bodies and ghosts, doors, and thresholds. Scholarship on intersectionality has focused on critiquing the legal assumption that considers categories of discrimination to correspond to discrete aspects of identity, due to its negative effect of rendering certain experiences unrepresentable. As a consequence, the optical approach seeks to expose intersections and to reveal what remains hidden under these discrete frames. I would like to take the opportunity to write about Goodrich’s law, to delve into an additional register that is underdeveloped but, I argue, contained in the legal concept of intersectionality. Intersectionality has not addressed the spectral, the search for becoming, or the intent to conceptualize an encounter without anticipation, announcement, or previsions, even if that implies defying what a concept entails. Both are inextricably connected. Here I will distinguish the optical and the spectral aspects of the theory. The optical or operational side of intersectionality offers a door while the specter that phantasmatically sustains and holds intersectionality’s impulse in legal practice allows the manifestation of the illegible within the legible.
Danazol’s use for menstrual suppression in transgender individuals: A retrospective multi-site cohort study
Authors: Scatoni Ava , Roberts Zaine , Boskey Elizabeth R , Staffa Steven , Roden Rosemary Claire , Redwood Emile , Grimstad Frances
Published: July 2024

Background:

Danazol is a synthetic progestin with androgenic effects that is approved by the Food and Drug Administration for treatment of endometriosis, benign fibrocystic breast disease, and hereditary angioedema. In recent years, increasing numbers of transgender and nonbinary individuals seeking menstrual suppression have been offered danazol due to its potential to both induce amenorrhea and cause reversible androgenic side effects including pigmentation of vellus hairs and voice changes, which may be desirable in this population. There are currently no studies assessing use of danazol within the transgender population for menstrual suppression.

Objective:

This study’s primary aim was to evaluate the use of danazol as a menstrual suppression agent in transgender patients.

Design:

This was a retrospective multisite cohort study of all individuals who had been on danazol at two tertiary care centers between 2000 and 2022.

Methods:

All patients prescribed danazol were identified using a search of the electronic medical records. For demographic purposes, comparisons were made between those who did and did not use danazol for the purpose of menstrual suppression. A detailed chart review was then performed to analyze the experiences of menstrual suppression in transgender and nonbinary patients.

Results:

Most transgender and nonbinary patients on danazol for menstrual suppression remained on it at their most recent follow-up visit, and many charts noted improvements in gender dysphoria, pelvic pain, dysmenorrhea, endometriosis, and heavy menstrual bleeding. Most transgender patients achieved amenorrhea.

Conclusion:

Danazol may be a reasonable option for menstrual suppression in transgender and nonbinary patients. Our findings show its potential to not only induce amenorrhea but cause desired androgenic symptoms and improve gender dysphoria, pelvic pain, dysmenorrhea, endometriosis, and heavy bleeding. While the androgenic effects of danazol are less desirable in cisgender populations, it is an attractive option for menstrual suppression in transgender and nonbinary patients.
A hackathon as a promoter of environmental citizenship among fifth-grade students—the attitudes of students, educators, ornithologists, and people working in high-tech
Authors: Gal Adiv
Published: July 2024

This qualitative study examined the perceptions of 42 fifth-grade students (ages 11–12) along with 8 staff members, 9 ornithologists, and 10 high-tech experts who participated in a hackathon event. This was the culmination of a learning process designed to find environmental, technological, and humane solutions to the competition between the Lesser Kestrel (native species) and the Myna (invasive species). Using three sources of data gathering—analyses of drawings, an open questionnaire, and focus group interviews—the study examined to what extent, if any, a hackathon, as a pedagogical tool, might promote environmental citizenship principles among fifth graders according to Berkowitz’s components of environmental citizenship. The findings show that the students expanded their ecological literacy, discussed civic literacy characteristics, adopted environmental values and their self-efficacy to act to find an environmental, technological, and human solution to the competition between the Lesser Kestrel-Myna interaction. Therefore, it can be said that the educational program and the hackathon succeeded in promoting environmental citizenship according to Berkowitz’s components.
Prediction of obstetric outcomes in sickle cell patients based on tricuspid regurgitant velocity
Authors: Lacasse Audrey , Williams Vincent , Ganguli Pallavi , Grand’Maison Sophie , Wo Bilan , Cyr Veronique , Tardif Marie-Lou , Caron Nadia , Viau-Lapointe Julien , Naessens Veronique , Mahone Michele
Published: July 2024

Background

Transthoracic echocardiography, a validated tool for risk assessment in non-pregnant population with sickle cell disease (SCD), uses tricuspid regurgitant velocity (TRV) over 2.5 m/s is an independent mortality risk factor. Its applicability in obstetrics lacks sufficient evidence.

Methods

In this multicenter retrospective cohort study across five tertiary centers, we aimed to validate TRV as a determinant of increased maternal and fetal risk. Data was collected on 93 women and included 21 patients with TRV of at least 2.5 m/s. The maternal primary composite outcome included occurrence of vaso-occlusive crisis, acute chest syndrome, gestational hypertension, preeclampsia, and mortality. The fetal primary composite outcome comprised perinatal mortality, premature delivery, reduced birth weight, and fetal distress.

Results

Adverse maternal and fetal events arose in both groups with no statistical difference.

Conclusion

This study cannot support TRV of 2.5 m/s or more as an independent predictor of adverse obstetric outcomes among women with SCD.
Extracellular vesicles: A potential new way to assess cholestasis
Authors: Useckaite Zivile
Published: July 2024

Extracellular vesicles (EVs) are small, nonreplicating, lipid-encapsulated nanoparticles that carry protein and nucleic acid cargo derived from their tissue of origin. Due to their capacity to provide comparable insights to solid organ biopsy through a minimally invasive collection procedure, EVs provide an attractive biomarker source. This review will provide an insight, how EVs in circulation may provide a novel way to assess cholestasis and will address the possibility of getting a better understanding of the mechanisms of cholestasis of pregnancy through the use of serial hepatic-specific EVs as a window.
Coronary intravascular lithotripsy in contemporary practice: challenges and opportunities in coronary intervention
Authors: Gupta Ankush , Shrivastava Abhinav , Dugal Jaskaran Singh , Chhikara Sanya , Vijayvergiya Rajesh , Singh Navreet , Mehta Ajit Chandrakant , Mahesh Nalin Kumar , Swamy Ajay
Published: July 2024

Percutaneous coronary intervention (PCI) of calcified coronary arteries is associated with poor outcomes. Poorly modified calcified lesion hinders the stent delivery, disrupts drug-carrying polymer, impairs drug elution kinetics and results in under-expanded stent (UES). UES is the most common cause of acute stent thrombosis and in-stent restenosis after PCI of calcified lesions. Angiography has poor sensitivity for recognition and quantification of coronary calcium, thereby mandating the use of intravascular imaging. Intravascular imaging, like intravascular ultrasound and optical coherence tomography, has the potential to accurately identify and quantify the coronary calcium and to guide appropriate modification device before stent placement. Available options for the modification of calcified plaque include modified balloons (cutting balloon, scoring balloon and high-pressure balloon), atherectomy devices (rotational atherectomy and orbital atherectomy) and laser atherectomy. Coronary intravascular lithotripsy (IVL) is the newest addition to the tool box for calcified plaque modification. It produces the acoustic shockwaves, which interact with the coronary calcium to cause multiplanar fractures. These calcium fractures increase the vessel compliance and result in desirable minimum stent areas. Coronary IVL has established its safety and efficacy for calcified lesion in series of Disrupt CAD trials. Its advantages over atherectomy devices include ease of use on workhorse wire, ability to modify deep calcium, no debris embolization causing slow flow or no-flow and minimal thermal injury. It is showing promising results in modification of difficult calcified lesion subsets such as calcified nodule, calcified left main bifurcation lesions and chronic total occlusion. In this review, authors will summarize the mechanism of action for IVL, its role in contemporary practice, evidence available for its use, its advantages over atherectomy devices and its imaging insight in different calcified lesion scenarios.
Flavone From Plants—Uncommonly Common? A Comprehensive Review
Authors: Valant-Vetschera Karin , Brecker Lothar , Schinnerl Johann
Published: July 2024

Flavone is a very simple and unsubstituted flavonoid of restricted distribution in the plant kingdom. Historically it is known for a long time as major constituent of many Primula and Dionysia exudates produced by glandular hairs in unusually large amounts, often as a farinose (mealy) deposit on aerial plant parts. The ecological function of this unique farinose deposit and its main compound flavone is still not really understood. Concerning flavone, a knowledge gap exists about its biosynthetic origin, when compared to all of the flavonoid biosynthetic routes known to date. Thus, this review addresses not only the history of this compound and its occurrence in plants and in their respective compartments, but also discusses ideas on its putative biosynthesis. Furthermore, we provide up-to-date analytical data on this compound from a natural source, rather than from chemosynthesis, in a comprehensive way. Eco-functional aspects complement this study that is intended to be highly stimulating for future research in ecology and evolution.
Flavonoid Variability in Carica papaya L. var. Sekaki Leaf Maturation and Its Association With Sexual Differentiation Using Targeted Metabolomics
Authors: Misnan Norazlan Mohmad , Afzan Adlin , Omar Maizatul Hasyima , Low Kah Hin
Published: July 2024

Background

Carica papaya L. is a dioecious plant with leaves known for their medicinal and nutritional value due to their rich phytochemical content, including flavonoids. Phytochemical variability arising from plant maturity and sex differences may influence the bioactivity of the plant.

Objectives

This research aims to investigate the variations of flavonoids in C. papaya leaves across different maturation stages and the impact of sex differences on the accumulation of these compounds.

Methods

An ultra-high performance liquid chromatography–tandem mass spectrometry method was developed to quantify 6 flavonoids (manghaslin, clitorin, rutin, nicotiflorin, quercetin, and isorhamnetin) in the leaves simultaneously. The acquired data were further analyzed using chemometric tools.

Results

Significantly higher concentrations of flavonoids were observed in shoots and young leaves in comparison to older leaves. Furthermore, distinct variations in flavonoid composition between male and female plants were also observed, especially in young leaves, as evidenced by hierarchical clustering analysis. Further analysis of flavonoid content indicates that clitorin, nicotiflorin, and rutin could serve as chemical markers to differentiate maturation stages and sexes.

Conclusion

The study revealed significant variations in flavonoid concentrations during leaf development and between male and female plants, highlighting the importance of understanding these differences for unlocking the full potential of C. papaya leaves in medical and nutritional applications.
Integrated Network Pharmacology, Molecular Docking, and Experimental Validation to Explore Potential Mechanisms of Sinomenine in the Treatment of Osteoarthritis
Authors: Wang Shaojun , Lai Fanglin , Xiang Ting , Xu Yan
Published: July 2024

Objective

To systematically explore the targets and signaling pathways of sinomenine (SIN) in the treatment of osteoarthritis (OA) using integrated network pharmacology, molecular docking, and experimental validation.

Methods

The TCMSP, SwissADME, and Pharmmapper databases were used to predict SIN targets, while the databases of GeneCards, DisGeNET, OMIM, and DrugBank were selected to acquire OA targets. Subsequently, the intersection targets of SIN and OA disease were collected using the Veeny platform. Then, the protein-protein interaction (PPI) network map of “SIN-targets-OA” was established using String database and Cytoscape software. Additionally, the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed through the Database for Annotation, Visualization and Integrated Discovery (DAVID). Additionally, the potential proteins of SIN against OA were validated via molecular docking technique. Finally, the experimental validation was performed in SW1353 cells induced by interleukin (IL)-1β.

Results

A total of 315 potential targets of SIN and 4300 OA-associated targets were collected from public databases, and 42 intersecting potential targets of SIN and OA disease acquired. Then, the PPI network diagram of “SIN-targets-OA” was acquired that comprised a total of 43 nodes and 82 edges. Moreover, 173 GO and 21 KEGG pathway entries were screened with a P-value <.05. Among them, peroxisome proliferator-activated receptor (PPAR) and IL-17 are the core signaling pathways. Molecular docking technique indicated strong binding energies of SIN with PPAR (−6.1 kcal/mol) and IL-17 (−6.3 kcal/mol). Lastly, SIN at the concentration of 50 μmol/L has a significant effect on IL-1β-induced SW1353 cells by the inhibition of PPAR-γ and IL-17A proteins without cytotoxicity.

Conclusion

This work revealed the underlying targets and signaling pathways of SIN against OA using integrated network pharmacology molecular docking, and experimental validation. These findings provide scientific evidence for the clinical application of SIN for OA treatment.
Exploring (Un)Covered Potentials of Industrial Hemp (Cannabis sativa L.) Essential Oil and Hydrolate: From Chemical Characterization to Biological Activities
Authors: Šovljanski Olja , Aćimović Milica , Sikora Vladimir , Koren Anamarija , Saveljić Anja , Tomić Ana , Tešević Vele
Published: July 2024

Objectives

The present study focused on exploring the chemical composition of essential oil and corresponding hydrolate obtained by steam distillation of industrial hemp ( Cannabis sativa L.) cultivar “Helena” (low THC content).

Methods

Chemical characterization of industrial hemp essential oil and hydrolate was performed by gas chromatographic and gas chromatographic-mass spectrometric analysis, while biological activities included antimicrobial and antioxidant tests. Antimicrobial activity was determined by measuring diameters of the inhibition zone by using a disc-diffusion method with nine microbial strains from ATCC culture. Moreover, minimal inhibitory concentration (MIC) as well as time-kill kinetic studies, antiadhesion, and antibiofilm formation potential were also evaluated. Antioxidant activity was evaluated through three different antioxidant assays: 2,2-diphenyl-1-picrylhydrazyl (DPPH●), 2,2′-azinobis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS●+), and reducing power (RP).

Results

The gas chromatography mass spectrometry analysis showed that the main compound in the essential oil was trans-caryophyllene (37.4%), followed by caryophyllene oxide (12.4%) and α-humulene (11.0%), while in the hydrolate it was 1,8-cineole (11.5%). Results showed that industrial hemp essential oil and hydrolate exhibited no antimicrobial activity against gram-negative bacteria, yeasts, and fungi, while gram-positive bacteria were sensitive. Therefore, in the following step, MIC was determined by microdilution method. The lowest MIC for essential oil (12.5%) was obtained for Enterococcus faecalis and Staphylococcus aureus, while this value doubled for Listeria monocytogenes. Conversely, the MIC for hydrolate was 100% for all gram-positive bacteria. Antioxidant activity showed that industrial hemp essential oil and hydrolate have potential as natural sources of antioxidants.

Conclusion

This research confirmed the previously proven antimicrobial and antioxidant activities of industrial hemp essential oil. The novelty lies in the antimicrobial and antioxidant activity of hydrolate, which is practically waste, but has great potential to be a useful by-product.
Racial Discrimination Against Service Employees: The Influence of Managers and Employees’ Responses
Authors: Woo Bongki , Kim Kawon
Published: July 2024

This study investigates how managers’ and targeted Asian employees’ responses to customer-perpetrated racial discrimination affect the observing customers’ perceptions and behavioral intention. Using two experimental designs, Study 1 examines the effect of managers’ responses (i.e., avoidance, employee support, and customer support), and Study 2 tests targeted employees’ responses (avoidance, confrontation, and venting) to racial discrimination on observing customer’s revisit intention. In addition, this study examines the moderating role of the severity of racial discrimination. Across two studies, this research provides evidence that observing customers tend to rate managers as fair when they support the targeted employees. Also, observing customers rate the targeted employees as competent when they professionally confront the customers which led to a higher level of revisit intention. This study expands the hospitality literature by focusing on racial discrimination against Asian American and offers practical guidance on how managers and employees should respond to racial discrimination.
Using Storytelling to Enrich Expressiveness Among Young String Players
Authors: Ho Weatherly Katy Ieong Cheng
Published: July 2024

Utilizing Participatory Action Research (PAR), this study centered on the experiences of three young string players and a violin instructor employing storytelling as an approach to enhance expressiveness. Collaborating with the violin instructor to craft an initial approach and framework for the young string players, it was revealed that storytelling approach positively shapes the connection between young string players and their learning. The findings indicated that the storytelling approach facilitated a profound comprehension of tonality, form, articulations, and dynamics, converting technical aspects into elements with which young string players could meaningfully engage. By converting technical intricacies into relatable and expressive components, the storytelling approach emerges as a dynamic pedagogical tool that bridges the gap between theoretical understanding and practical musical engagement for young string players.
Intraventricular schwannomas: A case report and a literature review
Authors: Hattab Rashid M. , Jarrar Zeid , Al Sharie Sarah , Al-Hussaini Maysa , Obeidat Mouness
Published: July 2024

Intraventricular schwannomas are extremely rare, typically benign tumors originating from Schwann cells, which are not normally found within the ventricular system. Their presence challenges conventional understanding of tumor origins and complicates diagnosis and management. We report the case of a 19-year-old female presenting with a drop attack and headache, with no significant medical history. MRI revealed a heterogeneously enhancing lesion in the right lateral ventricle. Differential diagnoses included malignant tumors; however, histopathological examination post-surgical resection confirmed an intraventricular schwannoma. Postoperative outcomes were favorable, with successful CSF diversion via a right occipital ventriculoperitoneal shunt for isolated right temporal hydrocephalus. This case is notable for its atypical presentation in a young patient, challenging the conventional understanding that intraventricular schwannomas primarily affect older individuals. In addition, the correct diagnosis and successful management of a rare intraventricular schwannoma underscores the importance of considering this rare diagnosis in patients with nonspecific neurological symptoms and intraventricular lesions. This case, alongside the literature review, enriches the body of evidence on intraventricular schwannomas, highlighting the critical role of surgical intervention and the need for a comprehensive diagnostic approach.
Aspergillus terreus pulmonary infection in a patient with late-onset combined immunodeficiency: a case report with literature review
Authors: Lodha Naman , Shankar Meena Durga , Bhellum Pyrus , R. Neetha T. , C. Sadiya F. , Khatod Yash , Jain Vidhi , Kumar Deepak , Yadav Taruna
Published: July 2024

Common variable immunodeficiency (CVID) is the most common humoral immune deficiency in adults, characterized by recurrent sinopulmonary bacterial infections. Invasive fungal infections are rarely associated with CVID. Late-onset combined immunodeficiency (LOCID) is a recently recognized variant of CVID with low CD4 counts and immunoglobulins deficiency. The current study reveals the first documented case of invasive pulmonary aspergillosis ( Aspergillus terreus) in a patient with LOCID. A 52-year-old female with a recurrent history of sinopulmonary infections presented with acute onset fever and shortness of breath. Blood culture and bronchoalveolar lavage culture grew A. terreus. Further evaluation revealed low immunoglobulins (IgG, IgM and IgA). Moreover, she also had low CD4 counts (<200 cells/µL). The patient was successfully treated with voriconazole and immunoglobulin therapy. Finally, the study discusses LOCID as a potential risk factor for invasive fungal infections, which can be easily overlooked and cause poor outcomes.
Discovering optimal ballot wording using adaptive survey design
Authors: Lee Diana Da In , Green Donald P
Published: July 2024

Survey researchers are sometimes tasked with sifting through possible ways of phrasing a question in order to discover the wording that maximizes the proportion of respondents who answer in a particular way. One example occurs when a political interest group seeks to phrase a ballot measure on a given topic in a way that will garner as much voter support as possible. The present study illustrates how adaptive sample allocation can be used quickly and efficiently for this purpose. Using the example of a ballot measure on ranked choice voting, we show that adaptive design was better suited to identify the most promising ballot wording than a more conventional static design. We provide an open-source software R package and instructions for survey researchers seeking to implement adaptive experiments.
Ionised hypercalcaemia in a cat with extrahepatic biliary tract obstruction secondary to a bile duct vegetal foreign body
Authors: Pichard Diane , Bernard Pauline , Fenet Marion , Garnier Paul , Schoffit Sarah , Manzoni Sarah , Benchekroun Ghita , Manassero Mathieu , Freiche Valérie
Published: July 2024

Case summary

A 10-year-old neutered female domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, vomiting and lethargy. The biochemistry panel revealed increased hepatic enzyme activity and serum amyloid A concentration. Haematological values were within reference intervals. An abdominal ultrasound identified a hyperechoic spindle-shaped structure within the common bile duct and a suspected secondary subobstruction, associated with signs of intra- and extrahepatic biliary tract inflammation. During hospitalisation, the cat developed severe and sustained ionised hypercalcaemia. Exploratory surgery was elected as a result of the lack of clinical improvement, despite supportive treatment and suspected retrograde migration of the spindle-shaped structure. Two grass awns were extracted at the junction of an extrahepatic duct and the common bile duct via choledochotomy using intraoperative ultrasound guidance. A stent was then placed in the bile duct to prevent subsequent bile leakage. Histopathology of the liver revealed a moderate neutrophilic and lymphoplasmacytic inflammation with rare bacterial colonies. Escherichia coli was cultured from a bile sample. No specific cause of hypercalcaemia was identified. The cat recovered uneventfully from surgery. Hepatic enzyme activities and hypercalcaemia progressively decreased within a few weeks after surgery and remained within the reference intervals without treatment. Therefore, hypercalcaemia was suspected to be secondary to a foreign body-related granulomatous reaction.

Relevance and novel information

To our knowledge, only one other feline case report of biliary tract obstruction secondary to a biliary foreign body has been described in the literature. This is also the first case reporting the use of intraoperative ultrasound to localise a vegetal foreign body within the biliary tract of a cat. This case is also unique because of the onset of hypercalcaemia suspected to be secondary to a foreign body-related granulomatous reaction.
Experiences of rural clinicians accessing specialist support via telehealth for trauma and emergency care in Queensland, Australia
Authors: Santomauro Chiara , McLanders Mia , Rae Andrew
Published: July 2024

Objective

Trauma and emergency patients presenting to rural facilities require time-critical treatment and management that is sometimes beyond the scope of clinicians in the facility. In Queensland, Australia's second largest state, telehealth infrastructure facilitates 24/7 communication between rural clinicians and tertiary-based critical care specialists. We sought to understand the current state of Queensland's emergency telehealth system from the perspective of direct end-users to inform future improvement efforts and resource allocation.

Methods

Semi-structured interviews were conducted with 11 rural Queensland clinicians who use telehealth to access specialist support during critical presentations. Qualitative data were analysed in three inductive phases: immersion; a combination of process coding and in vivo coding; and focused coding.

Results

The findings highlight that emergency telehealth support provides benefits beyond better patient care, as it fosters collegiality and alleviates professional isolation. Three key themes were identified: (a) strategies for overcoming challenges in providing trauma and emergency care in rural Queensland; (b) factors that affect perceptions of telehealth effectiveness; and (c) how support for rural trauma and emergency care can be improved. To provide context for the themes, a summary of scene-setting data is also provided.

Conclusions

There are both advantages and disadvantages for rural clinicians accessing telehealth specialist support for critical care. Although telehealth is seen as a vital service that supports rural clinicians and benefits patient care, the findings suggest that tools, systems and processes surrounding rural trauma and emergency care could benefit from streamlining, integration, and the introduction of fit-for-purpose technologies. Addressing limitations of efficiencies would improve support for rural clinicians and likely improve patient outcomes for rural communities.
Cognitive-enhanced eHealth psychosocial stepped intervention for managing breast cancer-related cognitive impairment: Protocol for a randomized controlled trial
Authors: Serra-Blasco Maria , Souto-Sampera Arnau , Medina Joan C. , Flix-Valle Aida , Ciria-Suarez Laura , Arizu-Onassis Alejandra , Ruiz-Romeo Marina , Jansen Femke , Rodríguez Ana , Pernas Sonia , Ochoa-Arnedo Cristian
Published: July 2024

Introduction

Breast cancer often leads to cancer-related cognitive impairment (CRCI), which includes both objective and subjective cognitive deficits. While psychosocial interventions benefit quality of life and distress reduction, their impact on cognitive deficits is uncertain. This study evaluates the integration of a cognitive module into a digital psychosocial intervention for breast cancer patients.

Methods

In this randomized controlled trial (RCT), 88 recently diagnosed breast cancer (BC) patients will receive the ICOnnecta't program (control group) – a digital stepped intervention addressing a variety of psychosocial needs. The experimental group ( n = 88) will receive ICOnnecta’t plus a cognitive module. Assessments at baseline, 3, 6, and 12 months will measure the interventions’ impact on cognition, emotional distress, medication adherence, quality of life, post-traumatic stress, work functioning and healthcare experience. Feasibility and cost-utility analyses will also be conducted.

Results

The cognitive module includes three levels. The first level contains a cognitive screening using FACT-Cog Perceived Cognitive Impairment (PCI). Patients with PCI <54 progress to a cognitive psychoeducational campus (Level 2) with content on cognitive education, behavioural strategies and mindfulness. Patients with persistent or worsened PCI (≥6) after 3 months move to Level 3, an online cognitive training through CogniFit software delivered twice a week over 12 weeks.

Conclusions

This study assesses whether integrating a cognitive module into a digital psychosocial intervention improves objective and subjective cognition in breast cancer patients. Secondary outcomes explore cognitive improvement's impact on psychosocial variables. The research will contribute to testing efficacious approaches for detecting and addressing cognitive dysfunction in breast cancer patients.

Trial registration

ClinicalTrials.gov, NCT06103318. Registered 26 October 2023, https://classic.clinicaltrials.gov/ct2/show/NCT06103318?term=serra-blasco&draw=2&rank=4
Digital mental health strategies used by young people in Aotearoa New Zealand during the COVID-19 pandemic: ‘Just do it yourself, DIY’
Authors: Gibson Kerry , Trnka Susanna , Jonas Monique , Pomare Pikihuia , Thompson Shauney , Tiatia-Siau Jemaima , Aimiti Ma'ia'i KDee , Aoake Miriama , Bouttier-Esprit Thibaut , Spray Imogen , Vyas Sanchita
Published: July 2024

Objective

With rising rates of mental health distress amongst youth during the COVID-19 pandemic, digital resources have been identified as a valuable tools for delivering support to young people. However, many of the websites and apps developed by professionals to support the youth do not take account of the importance young people place on exercising their own agency in managing their mental health. This article investigates how young people in Aotearoa New Zealand used digital resources to manage their mental health needs during the COVID-19 pandemic.

Methods

The study gathered information from semi-structured interviews with 34 young people aged 16–22 years. The data was analysed using reflexive thematic analysis.

Results

Six themes were identified including: searching for online information about mental health; evaluating digital mental health resources; controlling mood through online activity; looking for escape in the virtual world; staying connected online; and giving and receiving support.

Conclusion

Young people's practices demonstrated their investment in their own agency, a general reluctance to engage with professional resources and recognition of the need to balance the risks and benefits of the informal strategies they preferred. Young people appeared sceptical of professionally-designed mental health resources and interventions and preferred to adapt and re-purpose the wide range of platforms and networks available in their informal digital worlds.
Exploratory analysis of swallowing behaviour in community-dwelling older adults using a wearable device: Differences by age and ingestant under different task loads
Authors: Tsujimoto Masashi , Hisajima Tomoko , Matsuda Saho , Tanaka Seiya , Suzuki Keisuke , Shimokakimoto Tomoya , Toyama Yoshio
Published: July 2024

Objective

To develop a new method of evaluating swallowing behaviour.

Methods

Sixty-nine healthy participants were divided into a younger (16 males and 16 females, mean age 39.09 ± 12.16 years) and older (18 males and 19 females, mean age 71.43 ± 5.50 years) group. The participants ingested water and yoghurt twice (directed and free swallowing) at rest and after performing simple daily life tasks (calculation and exercise). To measure swallowing frequency, we employed a smartphone-based, portable and neck-worn swallowing-sound-monitoring device. This device monitors swallowing behaviour continuously by collecting biological sounds from the neck without imposing behavioural restrictions. A neural network model of swallowing sound identification by deep learning was used for the subsequent evaluation. This device was used to obtain two types of saliva-swallowing sounds associated with different ingestants, at rest and after performing a stimulating task. Furthermore, we assessed the associated subjective psychological states.

Results

The younger group showed a higher directed swallowing frequency (for both water and yoghurt) than the older group did. Regarding the type of ingestant, the swallowing frequency for yoghurt was higher during free swallowing in both the young and the older groups. ‘Feeling calm’ was reported significantly more often in the older group after swallowing yoghurt following exercise.

Conclusions

Swallowing status in daily life was measured non-invasively using a wearable mobile device. It is important to consider the type of ingestant, daily living activities, and age when assessing swallowing.
Digital Catharsis or Harmful Exposure? A Thematic Analysis of Self-Directed Violence Reddit Posts
Authors: Lundeen Lindsay A. , McCall John R. , Bradshaw Amanda Sams , LeBlanc Erika L. , Humphrey Lizy
Published: July 2024

Many feel uncomfortable discussing self-directed violence with individuals in their social circle, often leading to concerned posts on social media. Previous studies address self-harm, suicide, and nonsuicidal self-injury; however, minimal literature combines suicide and nonsuicidal self-injury to explore common themes representing self-directed violence. This study identified themes from suicide and self-harm subreddit communities, with themes common to each subreddit comprising themes of self-directed violence. Using 1,989 Reddit posts from suicide and self-harm communities, we employed an inductive thematic analysis to explore how users discussed self-directed violence within anonymous online communities. Ultimately, the impact of using Reddit for discussion of self-directed violence depends on the individual. We generated six themes, with two from self-harm data (i.e., graphic descriptions of self-harm behavior and continued self-harm to manage emotions), two from suicide data (i.e., support-seeking to replace social connections and triggering moments initiating suicide-related thoughts, plans, and behavior), and two themes embodying self-directed violence (i.e., prevention through creative expression and safety for discussion mainly exists online). Despite attempts to provide help-seeking resources, the use of Reddit for connection and inquiry about coping skills for self-directed violence cessation could increase users’ risk for detrimental mental health impacts from the inclusion of detailed descriptions of self-harm, suicide plans, past attempts, suicide or nonsuicidal self-injury means, and suicide notes left for loved ones. Given the delicate balance of seeking support and increasing exposure to graphic content, it is crucial to discuss the nuances of Reddit exchanges with Reddit users, practitioners, moderators, and developers.
From ASCII lanterns to synthetic livestreams: Three decades of Chinese digital folklore
Authors: de Seta Gabriele
Published: July 2024

The history of the internet in China is often narrated from the standpoint of infrastructural development, commercial growth, and social change—a framework that foregrounds governmental policies, corporate decisions, and large-scale public debates. And yet, in parallel to these processes, the widespread adoption of the internet and its domestication by hundreds of millions of Chinese users have resulted in a long history of digital folklore: everyday, vernacular practices responding to this new communication medium through creativity and invention. By extending the concepts of folk, the lore and the vernacular to the realm of digital media, the analytical framework of digital folklore helps understanding the relationship between creativity and new communication technologies. Drawing on a rich body of academic research on the topic, this short essay reviews three decades of Chinese digital folklore, highlighting the continuities and peculiarities of vernacular creativity throughout the country’s internet history.
Mothers' experiences of breastfeeding support and breastfeeding specialists' views on breastfeeding promotion in Finland – a qualitative interview study
Authors: Antila Katja , Pöyhönen Niina , Ohtonen-Jones Saija , Sormunen Marjorita
Published: July 2024

Promoting and supporting breastfeeding influences positively the health and well-being of both babies and mothers. However, many factors, such as maternal health, family and community support, cultural norms, societal aspects, educational level, and even marketing, affect breastfeeding. The aim of the present study was to describe mothers’ experiences and wishes for breastfeeding support and specialists’ views on breastfeeding promotion. Semi-structured interviews were undertaken individually with breastfeeding mothers ( n = 14) and breastfeeding specialists ( n = 9). The data were analyzed using inductive content analysis and reported using the COREQ guidelines. Mothers were content with practical, individual, and peer support for breastfeeding. Most mothers experienced insufficient support from family services and social networks. Breastfeeding specialists suggested that the breastfeeding service system should be strengthened, and support should be given both prenatally and on special occasions. They described the importance of interaction skills and breastfeeding-counselling education.
Evaluating electoral reforms and its consequences in Indonesia and Thailand (2000–2023)
Authors: Lestari Kalimah Wasis , Fitrianto Hari , Mungkornchai Asama , Muzaqqi Fahrul , Wardhani Nuke Faridha
Published: July 2024

This article investigates electoral reforms in Indonesia and Thailand in the 21st century, highlighting important dimensions of the electoral changes and their consequences in disproportionality and the effective number of parties. In the first stage, we identify electoral changes and the ideal goals of electoral reform. Second, we compare each election's results by calculating disproportional results and the effective number of parties, followed by in-depth interviews with key stakeholders (N = 8) to uncover the evaluation and recommendation for a better future of the electoral system in both countries. The analysis reveals the government's motivation behind the electoral system chosen. In Indonesia, the reforms addressed realising the limited pluralism party system raised a thorny debate among small to medium parties about rescuing their seats in parliament. Otherwise, the Thai government accommodates small parties by waiving the electoral threshold. We identify that different people in positions of power in each country cause different ideal goals. This research contributes to developing an understanding that elite motivation outweighs the public good in designing electoral reform. While in Thailand the control to determine which electoral system is chosen seems more centralised by the junta military, the shift of the electoral system in Indonesia is strongly motivated by political actors in order to gain their pragmatic interests.
The Fate of the Left Ventricular Outflow Tract Following Interrupted Aortic Arch Repair
Authors: Luo Shuhua , Schoof Paul H. , Hickey Edward , Morgan Conall , Korsuize Nina A. , Grotenhuis Heynric B. , Mertens Luc , Varenbut Jaymie , Deng Mimi Xiaoming , Haranal Maruti , Border William , Schlosser Brian , Arsdell Glen Van , Alsoufi Bahaaldin
Published: July 2024

Objectives: To examine the probability of left ventricular outflow tract (LVOT) reintervention following interrupted aortic arch (IAA) repair in neonates with LVOT obstruction (LVOTO) risk. Methods: This retrospective multicenter study included 150 neonates who underwent IAA repair (2003-2017); 100 of 150 (67%) had isolated IAA repair (with ventricular septal defect closure) and 50 of 150 (33%) had concomitant LVOT intervention: conal muscle resection (n = 16), Ross-Konno (n = 7), and Yasui operation (n = 27: single-stage n = 8, staged n = 19). Demographic and morphologic characteristics were reviewed. Factors associated with LVOT reoperation were explored using multivariable analysis. Results: Concomitant LVOT intervention was more likely in neonates with type B IAA, bicuspid aortic valve, aberrant right subclavian artery, smaller aortic valve annulus, and ascending aorta dimensions. On follow-up, five-year freedom from LVOT reoperation was highest following Ross-Konno (100%), 77% following Yasui (mainly for neo-aortic regurgitation), 77% following isolated IAA repair (mainly for LVOTO), and 47% following IAA repair with concomitant conal resection, P = .033. While all patients had low peak LVOT gradient at time of discharge, those who had conal resection developed higher gradients on follow-up ( P = .007). Ross-Konno and Yasui procedures were associated with higher right ventricular outflow tract (RVOT) reoperation. In the cohort following isolated IAA repair, aortic sinus Z score was associated with LVOT reoperation. Conclusions: Both Yasui and Ross-Konno operations effectively mitigate late LVOTO risk. The highest risk of reintervention for LVOTO was associated with conal muscle resection while the lowest risk is associated with Ross-Konno. The RVOT reoperation risk in patients who had Ross-Konno or Yasui does not seem to affect survival.
Tweets, Triumphs, and Tensions: A Machine Learning Approach to Decoding Multi-Tier Thematic Framing of the 2022 Beijing Winter Olympics on Social Media
Authors: Xu Chenglong , Qian Tyreal Yizhou , Yang Lei , Liu Dongfeng
Published: July 2024

The current study explored the thematic framing of the 2022 Beijing Winter Olympics on X (Twitter), examining how these thematic frames and audience engagement varied across various content creator tiers—mega, macro, micro, and nano content creators—throughout the year surrounding the event. Through the lens of the framing theory, we employed LDA topic modeling and identified three dominant thematic frames: athletic achievements and competition results, international participation dynamics including boycotts and diplomatic engagements, and geopolitical undertones reflecting on the host nation and global conflicts. A noticeable relationship between thematic frames and engagement levels was observed consistently across creator tiers, with athleticism and contest outcomes garnering sustained attention, underscoring its pivotal role in event discussions. Moreover, our findings revealed unique engagement patterns across creator tiers. Mega creators amplified reactions to sports achievements. Macro creators displayed varied engagement, suggesting responsiveness to ongoing events. Micro creators saw fluctuating engagement with a focus on geopolitical issues. Nano creators actively engaged with both sports achievements and political discussions. Overall, the study illuminates the complexities of media representations and audience perceptions, while dissecting the impactful role played by different tiers of content creators in driving public engagement with a global sporting spectacle.
Facial Hyperpigmentation: A Rare Side Effect of Adalimumab
Authors: Mrad Malek , Tabka Mariam , Souissi Asmahane , Chelly Ines , Mokni Mourad
Published: July 2024

This report describes a case of facial hyperpigmentation in a patient with Crohn’s disease receiving adalimumab, a tumor necrosis factor (TNF)-alpha inhibitor. The onset of hyperpigmentation coincided with adalimumab administration, and its discontinuation resulted in significant improvement. Histopathological findings suggest a postinflammatory process at the dermo-epidermal junction. However, the precise mechanism remains unclear.
Pulmonary Contusion—An Unusual Clinical and Radiological Presentation: Case Report
Authors: Castrillón Ana Isabel , Sua Luz F. , Sanchez Alvaro , Fernández-Trujillo Liliana
Published: July 2024

Pulmonary contusion (PC), defined as damage to the lung parenchyma with edema and hemorrhage, has classically been associated with acceleration-deceleration injuries. It is a frequent pathology in clinical practice. However, its clinical presentation and imaging findings are nonspecific. Patients with this entity can present with findings that can range from mild dyspnea to life-threatening respiratory failure and hemodynamic instability. We present the case of a 61-year-old man, a former smoker, who presented to the emergency department after suffering blunt chest trauma. On admission, he complained of only mild shortness of breath, and his vital signs were typical. Initial imaging identified asymmetric pulmonary infiltrates and mediastinal lymphadenopathy; this was suspicious for additional pathology in addition to PC. After an exhaustive evaluation, a neoplastic or infectious disease process was ruled out. Even though the patient presented with a clinical deterioration of respiratory function compatible with secondary acute respiratory distress syndrome, there was a complete recovery after supportive measures and supplemental oxygen. In conclusion, the nonspecific clinical and imaging findings in patients with pulmonary contusion warrant a complete evaluation of these cases. An early diagnosis is essential to establish adequate support and monitoring to prevent possible complications that could worsen the patient’s prognosis.
Negative Lifestyle Factors Specific to Aging Persons Living with HIV and Multimorbidity
Authors: Smith William Pastor
Published: July 2024

The primary goal of medical care during the pre-antiretroviral therapy (ART) era was to keep persons living with human immunodeficiency virus (HIV) alive, whereas since the advent of ART, the treatment objective has shifted to decreasing viral loads and infectiousness while increasing CD4+ T-cell counts and longevity. The health crisis, however, is in preventing and managing multimorbidity (ie, type 2 diabetes), which develops at a more accelerated or accentuated pace among aging persons living with HIV. Relative to the general population and age-matched uninfected adults, it may be more difficult for aging HIV-positive persons who also suffer from multimorbidity to improve negative lifestyle factors to the extent that their behaviors could support the prevention and management of diseases. With recommendations and a viable solution, this article explores the impact of negative lifestyle factors (ie, poor mental health, suboptimal nutrition, physical inactivity, alcohol use) on the health of aging individuals living with HIV.