bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of mast cells in the pathogenesis of oral submucous fibrosis: a systematic review and meta-analysis
Authors: Bijai Laliytha Kumar , Aboalela Ali A. , Albalawi Farraj , Khanagar Sanjeev B , Iyer Kiran
Published: October 2024

Background

Oral Submucous Fibrosis (OSMF) is an oral potentially malignant disorder (OPMD) that commonly occurs in the South Asian population as there is high usage of areca nut. There has been extensive research on the pathogenesis and treatment of this condition. It is well-established in the scientific literature that mast cells (MC) have a definitive role in several inflammatory disorders. OSMF being a chronic inflammatory disorder, is also expected to have increased MCs. Hence, this review aims to evaluate the role of MCs in the pathogenesis of OSMF.

Methods

A systematic search of articles was performed by two of the authors independently in PubMed, Scopus, Embase, Web of Science, and Google Scholar using the appropriate keywords and Boolean terms. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. The meta-analysis was performed with R studio software (Version: 4.4.0, Year: 2024, Company: The R foundation for statistical computing).

Results

The search retrieved 36 studies, of which 16 were suitable for the review. There is evidence for a marked increase in the number of MCs in OSMF than the normal mucosa upon analyzing the retrieved articles. However, when comparing the grades of OSMF, there are variations in the reports. As all the retrieved articles were case-control studies, the risk of bias was analyzed using the Modified New Castle Ottawa Scale. All the studies scored in the good category (Score 6–9). The pooled effect size shows the Standard Mean Deviation (SMD) to be 0.09, 95% confidence interval (CI) [-0.18;0.37] to lie on either side of no effect. Hence the role of MCs in OSMF has not been established because of homogeneity and consistent sampling error.

Conclusion

Our systematic review does suggest a definitive role of mast cells in the progression of OSMF. However, there is a lack of methodological rigor in the included studies. This may contribute to diluting the results.
COVID-19 vaccination and lethality reduction: a prospective observational study in Venezuela during the last two waves
Authors: Forero-Peña David A. , Leyva Jéssica L. , Valenzuela María V. , Omaña-Ávila Óscar D. , Regalado-Gutiérrez Oriana A. , Mendoza-Millán Daniela L. , Sánchez-Ytriago Elisanny A. , Lahoud-El Hachem Andrea C. , Farro Katherine R. , Maita Ana K. , González Romina del C. , Rodriguez-Saavedra Carlis M. , Hernández-Medina Fernando , Camejo-Ávila Natasha A. , Freitas-de Nobrega Diana C. , Celis Rodrigo T. , Forero-Peña José L. , Martínez Alfonso , Grillet María E. , Landaeta María E. , Carrión-Nessi Fhabián S.
Published: October 2024

Background

In Venezuela, the predominant vaccines administered are BBIBP-CorV and Gam-COVID-Vac. Despite robust evidence from randomized clinical trials validating the effectiveness of COVID-19 vaccines in mitigating hospitalization and mortality, there is still a lack of post-authorization safety studies conducted within this demographic population.

Methods

A prospective observational study from October 5, 2021 to March 31, 2022 encompassed COVID-19 vaccinated and unvaccinated patients from four sentinel hospitals in Venezuela. Patient lethality was predicted using Charlson Comorbidity index. Clinical outcomes were assessed through WHO’s COVID-19 Clinical Progression Scale.

Results

Out of the 175 patients  assessed, 85 (48.6%) were vaccinated. The median Charlson Comorbidity index was 3 points, with no statistically significant differences observed between the groups (p = 0.2). A total of 50 (28.6%) patients died during the study period, with higher proportion of deaths in unvaccinated patients (35.6% vs. 21.2%, p = 0.035). Advanced age (OR = 1.043, 95% CI = 1.015–1.071, p = 0.002) was associated with increased death risk, whereas vaccination against COVID-19 (OR = 0.428, 95% CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95% CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95% CI = 0.093–0.917, p = 0.035) were associated with decreased death risk.

Conclusion

During the third and fourth waves of the pandemic, COVID-19 vaccination was associated with a 57% reduction in lethality among patients in four public hospitals in Venezuela.
Yiqihuoxue decoction (GSC) inhibits mitochondrial fission through the AMPK pathway to ameliorate EPCs senescence and optimize vascular aging transplantation regimens
Authors: Liu Yinan , Niu Zenghui , Wang Xue , Xiu Chengkui , Hu Yanhong , Wang Jiali , Lei Yan , Yang Jing
Published: October 2024

Background

During the aging process, the number and functional activity of endothelial progenitor cells (EPCs) are impaired, leading to the unsatisfactory efficacy of transplantation. Previous studies demonstrated that Yiqihuoxue decoction (Ginseng-Sanqi-Chuanxiong, GSC) exerts anti-vascular aging effects. The purpose of this study is to evaluated the effects of GSC on D-galactose (D-gal)induced senescence and the underlying mechanisms.

Methods

The levels of cellular senescence-related markers P16, P21, P53, AMPK and p-AMPK were detected by Western blot analysis (WB). SA-β-gal staining was used to evaluate cell senescence. EPCs function was measured by CCK-8, Transwell cell migration and cell adhesion assay. The morphological changes of mitochondria were detected by confocal microscopy. The protein and mRNA expression of mitochondrial fusion fission Drp1, Mff, Fis1, Mfn1, Mfn2 and Opa1 in mitochondria were detect using WB and RT–qPCR. Mitochondrial membrane potential, mtROS and ATP of EPCs were measured using IF. H&E staining was used to observe the pathological changes and IMT of the aorta. The expressions of AGEs, MMP-2 and VEGF in aorta were measured using Immunohistochemical (IHC). The levels of SOD, MDA, NO and ET-1 in serum were detected by SOD, MDA and NO kits.

Results

In vitro, GSC ameliorated the senescence of EPCs induced by D-gal and reduced the expression of P16, P21 and P53. The mitochondrial morphology of EPCs was restored, the expression of mitochondrial Drp1, Mff and Fis1 protein was decreased, the levels of mtROS and ATP were decreased, and mitochondrial function was improved. Meanwhile, the expression of AMPK and p-AMPK increased. The improvement effects of GSC on aging and mitochondrial morphology and function were were hindered after adding AMPK inhibitor. In vivo, GSC improved EPCs efficiency, ameliorated aortic structural disorder and decreased IMT in aging mice. The serum SOD level increased and MDA level decreased, indicating the improvement of antioxidant capacity. Increased NO content and ET-1 content suggested improvement of vascular endothelial function. The changes observed in SOD and MMP-2 suggested a reduction in vascular stiffness and the degree of vascular damage. The decreased expression of P21 and P53 indicates the delay of vascular senescence.
Adolescent mental health services in West Africa: a comparative analysis of Burkina Faso, Ghana, and Niger
Authors: Amenah Michel Adurayi , Ibrahim Nassirou , Tapsoba Ludovic Deo Gracias , Novignon Jacob , Fenny Ama Pokuaa , Agyepong Irene A. , da Silva Roxane Borges , Ensor Tim
Published: October 2024

Background

Adolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context.

Methods

The study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services.

Results

The findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates.

Conclusion

The study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.
A validated heart-specific model for splice-disrupting variants in childhood heart disease
Authors: Lesurf Robert , Breckpot Jeroen , Bouwmeester Jade , Hanafi Nour , Jain Anjali , Liang Yijing , Papaz Tanya , Lougheed Jane , Mondal Tapas , Alsalehi Mahmoud , Altamirano-Diaz Luis , Oechslin Erwin , Audain Enrique , Dombrowsky Gregor , Postma Alex V. , Woudstra Odilia I. , Bouma Berto J. , Hitz Marc-Phillip , Bezzina Connie R. , Blue Gillian M. , Winlaw David S. , Mital Seema
Published: October 2024

Background

Congenital heart disease (CHD) is the most common congenital anomaly. Almost 90% of isolated cases have an unexplained genetic etiology after clinical testing. Non-canonical splice variants that disrupt mRNA splicing through the loss or creation of exon boundaries are not routinely captured and/or evaluated by standard clinical genetic tests. Recent computational algorithms such as SpliceAI have shown an ability to predict such variants, but are not specific to cardiac-expressed genes and transcriptional isoforms.

Methods

We used genome sequencing (GS) (n = 1101 CHD probands) and myocardial RNA-Sequencing (RNA-Seq) (n = 154 CHD and n = 43 cardiomyopathy probands) to identify and validate splice disrupting variants, and to develop a heart-specific model for canonical and non-canonical splice variants that can be applied to patients with CHD and cardiomyopathy. Two thousand five hundred seventy GS samples from the Medical Genome Reference Bank were analyzed as healthy controls.

Results

Of 8583 rare DNA splice-disrupting variants initially identified using SpliceAI, 100 were associated with altered splice junctions in the corresponding patient myocardium affecting 95 genes. Using strength of myocardial gene expression and genome-wide DNA variant features that were confirmed to affect splicing in myocardial RNA, we trained a machine learning model for predicting cardiac-specific splice-disrupting variants (AUC 0.86 on internal validation). In a validation set of 48 CHD probands, the cardiac-specific model outperformed a SpliceAI model alone (AUC 0.94 vs 0.67 respectively). Application of this model to an additional 947 CHD probands with only GS data identified 1% patients with canonical and 11% patients with non-canonical splice-disrupting variants in CHD genes. Forty-nine percent of predicted splice-disrupting variants were intronic and > 10 bp from existing splice junctions. The burden of high-confidence splice-disrupting variants in CHD genes was 1.28-fold higher in CHD cases compared with healthy controls.

Conclusions

A new cardiac-specific in silico model was developed using complementary GS and RNA-Seq data that improved genetic yield by identifying a significant burden of non-canonical splice variants associated with CHD that would not be detectable through panel or exome sequencing.
Recommendations for the creation of benchmark datasets for reproducible artificial intelligence in radiology
Authors: Sourlos Nikos , Vliegenthart Rozemarijn , Santinha Joao , Klontzas Michail E. , Cuocolo Renato , Huisman Merel , van Ooijen Peter
Published: October 2024

Various healthcare domains have witnessed successful preliminary implementation of artificial intelligence (AI) solutions, including radiology, though limited generalizability hinders their widespread adoption. Currently, most research groups and industry have limited access to the data needed for external validation studies. The creation and accessibility of benchmark datasets to validate such solutions represents a critical step towards generalizability, for which an array of aspects ranging from preprocessing to regulatory issues and biostatistical principles come into play. In this article, the authors provide recommendations for the creation of benchmark datasets in radiology, explain current limitations in this realm, and explore potential new approaches.

Clinical relevance statement

Benchmark datasets, facilitating validation of AI software performance can contribute to the adoption of AI in clinical practice.

Key Points

Benchmark datasets are essential for the validation of AI software performance.

Factors like image quality and representativeness of cases should be considered.

Benchmark datasets can help adoption by increasing the trustworthiness and robustness of AI.

Graphical Abstract
The spatial impact of a Western diet in enriching Galectin-1-regulated Rho, ECM, and SASP signaling in a novel MASH-HCC mouse model
Authors: Setayesh Tahereh , Hu Ying , Vaziri Farzam , Wei Dongguang , Wan Yu-Jui Yvonne
Published: October 2024

Background

Hepatocellular carcinoma (HCC) arising from metabolic dysfunction-associated steatohepatitis (MASH) presents a significant clinical challenge, particularly given the prevalence of the Western diet (WD). The influence of diet on the tumor microenvironment remains poorly understood. Galectin-1 (Gal-1) is a biomarker for HCC and has a crucial role in liver carcinogenesis. Our previous studies demonstrated that silencing Gal-1 effectively treats mouse HCC. However, the impacts of a WD on Gal-1 signaling on MASH to HCC progression are unknown, and this study addresses these knowledge gaps.

Methods

We developed a novel MASH-HCC mouse model. Using spatial transcriptomics and multiplex immunohistochemistry (IHC), we studied the effects of a WD on the liver and tumor microenvironment. By modulating Gal-1 expression through silencing and overexpression, we explored the location-specific impacts of WD on Gal-1 signaling.

Results

Pathways such as Rho signaling, extracellular matrix (ECM) remodeling, and senescence-associated secretory phenotypes (SASP) were prominently activated in WD-induced metabolic dysfunction-associated fatty liver disease (MAFLD) and MASH-HCC, compared to healthy livers controls. Furthermore, Rho GTPase effectors, ECM remodeling, neutrophil degranulation, cellular stress, and cell cycle pathways were consistently enriched in human and mouse MASH-HCC. Spatially, these pathways were enriched in the tumor and tumor margins of mouse MASH-HCC. Additionally, there was a notable increase in CD11c and PD-L1-positive cells from non-tumor tissues to the tumor margin and inside the tumor of MASH-HCC, suggesting compromised immune surveillance due to WD intake. Moreover, MASH-HCC exhibited significant Gal-1 induction in N-Cadherin-positive cells, indicating enhanced epithelial-to-mesenchymal transition (EMT). Modulating Gal-1 expression in MASH-HCC further established its specific roles in regulating Rho signaling and SASP in the tumor margin and non-tumor tissues in MASH-HCC.

Conclusion

WD intake significantly influences vital cellular processes involved in Gal-1-mediated signaling, including Rho signaling and ECM remodeling, in the tumor microenvironment, thereby contributing to the development of MASH-HCC.
Effect of Programed Walking Exercise Using Bot Fit in Younger Adults
Authors: Lee Su-Hyun , Kim Eunmi , Kim Jinuk , Kim Dongwoo , Lee Dokwan , Lee Hwang-Jae , Kim Yun-Hee
Published: October 2024

Introduction

Physical inactivity and sedentary behavior both increase the risk of chronic disease and mortality. Regular participation in physical activity and reducing sedentary behavior play important roles in maintaining physical health and disease prevention.

Objective

The purpose of this study was to investigate the effect of programed walking exercise using a wearable hip exoskeleton, Bot Fit on muscle strength, muscle effort, and the kinematics of the pelvis in younger adults.

Methods

We designed three parallel experimental conditions and randomly assigned participants to one of three groups: those assigned to exercise using an interval program of Bot Fit (interval group), those who used a power program of Bot Fit (power group), and a control group who exercised without Bot Fit. A total of 45 young adults participated in 18 exercise-intervention sessions over six weeks, and all participants were assessed at two time points: before and after the 18 exercise sessions. Each assessment evaluated muscle strength, muscle effort, and the kinematics of the pelvis during walking. In addition, the number of steps, distance, energy expenditure, and heart rate for 30 min during the exercise sessions were recorded.

Results

A significant increase in the maximum voluntary contraction (MVC) of the left biceps femoris (BF) was evident in the interval group, while significant changes in the MVC of the bilateral BF were seen in the power group after Bot Fit exercise. A significant decrease of muscle effort in the right BF in the interval group and right lumbar erector spinae and bilateral BF in the power group were also observed. In addition, the symmetry index of pelvic tilt significantly improved in the interval group, and greater exercise volume and intensity in both the interval and power groups compared with the control group were confirmed as measured by the number of steps, distance, energy expenditure, and heart rate.

Conclusions

The results of this study confirmed the beneficial effect of programed walking exercise using the Bot Fit on muscle strength of trunk and lower extremities, muscle effort, and pelvic movement symmetry in younger adults. Personalized exercise programs can be provided for younger adults using various resistance or assistance modes of robotic device with the Bot Fit.

Trial Registration

ClinicalTrials.gov, NCT05862077. Registered 22 March 2022, https://register.clinicaltrials.gov/.
The lived experience of co-production: Reflective accounts from the InCLUDE project
Authors: Izzidien Shayma , Stemp Rachael , Akram Sakab , Ahmed Sabbir , Rangel-Cristales Alay , Irvine Karen , Sharma Shivani , Midgley Nick
Published: October 2024

Background

The value of co-produced research in health and social care is increasingly recognised, but accounts into the processes and individual experiences of co-producing research are lacking. This paper describes the personal journeys of four researchers (two experts by foster caring experience and two experts by profession) throughout the life course of a co-produced research project exploring the barriers and facilitators to inclusive research in foster caring, the InCLUDE project.

Methods

Each researcher kept a diary throughout the InCLUDE project of their personal reflections, questions, and learning. These were synthesised and reviewed by the researchers and two colleagues external to the team, and key themes were extracted.

Results

Narratives constructed from the diaries are presented in relation to distinct aspects of the co-production journey, alongside illustrative quotes. These aspects include: motivations for starting the project; making sense of the project; defining roles and responsibilities; challenges; and reflections on acquired knowledge and skills. From these insights, the researchers present recommendations for others endeavouring to engage in co-produced research. These include: recognising vulnerabilities and challenges during the early stages of a project; creating safe spaces; seeing the value of diversity; harnessing individual strengths; establishing a strong routine; and ensuring equal voice.

Conclusions

This paper presents a novel perspective on the realities of co-produced research by documenting the lived experiences of researchers within the context of foster care research. It highlights the importance of both measurable, tangible project outcomes, and the personal and skills growth of team members. The consistent use of diaries is encouraged as a valuable practice to capture learning, progress and achievements throughout the co-production process.
Psychometric evaluation of the Adelphi Adherence Questionnaire (ADAQ©) in adults with osteoarthritis
Authors: Clarke Nathan , Trigg Andrew , Arbuckle Rob , Stochl Jan , Higgins Victoria , Bentley Sarah , Piercy James
Published: October 2024

Background

Medication non-adherence is a common issue in chronic illness. The World Health Organization has recognized a need for a valid and reliable method of measuring adherence to understand and mitigate non-adherence. This study aimed to psychometrically evaluate the English version of the Adelphi Adherence Questionnaire (ADAQ©), a questionnaire designed to assess patient-reported medication adherence across multiple therapy areas, in patients with Osteoarthritis (OA).

Methodology

Data from the Adelphi OA Disease Specific Programme™, a survey of physicians and their consulting adult patients with OA conducted in the United States, November 2020 to March 2021, was used to assess the psychometric properties of the ADAQ. Patients completed the ADAQ, Adherence to Refills and Medication Scale (ARMS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and EQ-5D-3L. The measurement model of the 13-item ADAQ was assessed and refined using latent variable modelling (Multiple Indicator Multiple Cause, confirmatory and exploratory factor analyses, item response theory, Mokken scaling, and bifactor analyses). Correlational analyses (Spearman’s rank and polyserial as appropriate) with ARMS, WOMAC, and EQ-5D-3L scores assessed construct validity. Anchor- and distribution-based analyses were performed to estimate between-group clinically important differences (CID).

Results

Overall, 723 patients were included in this analysis (54.5% female, 69.0% aged ≥ 60). Latent variable modelling indicated a unidimensional reflective model was appropriate, with a bifactor model confirming an 11-item essentially unidimensional score. Items 12 and 13 were excluded from scoring as they measured a different concept. The ADAQ had high internal reliability with omega hierarchical and Cronbach’s alpha coefficients of 0.89 and 0.97, respectively. Convergent validity was supported by moderate correlations with items of the ARMS, and physician-reported adherence and compliance. Mean differences in ADAQ score between high and low adherence groups yielded CID estimates between 0.49 and 1.05 points, with a correlation-weighted average of 0.81 points.

Conclusion

This scoring model showed strong construct validity and internal consistency reliability when assessing medication adherence in OA. Future work should focus on confirming validity across a range of disease areas.
Performance of dual-energy subtraction in contrast-enhanced mammography for three different manufacturers: a phantom study
Authors: Gennaro Gisella , Vatteroni Giulia , Bernardi Daniela , Caumo Francesca
Published: October 2024

Background

Dual-energy subtraction (DES) imaging is critical in contrast-enhanced mammography (CEM), as the recombination of low-energy (LE) and high-energy (HE) images produces contrast enhancement while reducing anatomical noise. The study's purpose was to compare the performance of the DES algorithm among three different CEM systems using a commercial phantom.

Methods

A CIRS Model 022 phantom, designed for CEM, was acquired using all available automatic exposure modes (AECs) with three CEM systems from three different manufacturers (CEM1, CEM2, and CEM3). Three studies were acquired for each system/AEC mode to measure both radiation dose and image quality metrics, including estimation of measurement error. The mean glandular dose (MGD) calculated over the three acquisitions was used as the dosimetry index, while contrast-to-noise ratio (CNR) was obtained from LE and HE images and DES images and used as an image quality metric.

Results

On average, the CNR of LE images of CEM1 was 2.3 times higher than that of CEM2 and 2.7 times higher than that of CEM3. For HE images, the CNR of CEM1 was 2.7 and 3.5 times higher than that of CEM2 and CEM3, respectively. The CNR remained predominantly higher for CEM1 even when measured from DES images, followed by CEM2 and then CEM3. CEM1 delivered the lowest MGD (2.34 ± 0.03 mGy), followed by CEM3 (2.53 ± 0.02 mGy) in default AEC mode, and CEM2 (3.50 ± 0.05 mGy). The doses of CEM2 and CEM3 increased by 49.6% and 8.0% compared with CEM1, respectively.

Conclusion

One system outperformed others in DES algorithms, providing higher CNR at lower doses.

Relevance statement

This phantom study highlighted the variability in performance among the DES algorithms used by different CEM systems, showing that these differences can be translated in terms of variations in contrast enhancement and radiation dose.

Key Points

DES images, obtained by recombining LE and HE images, have a major role in CEM.

Differences in radiation dose among CEM systems were between 8.0% and 49.6%.

One DES algorithm achieved superior technical performance, providing higher CNR values at a lower radiation dose.

Graphical Abstract
Relationship between peroneus longus tendon graft thickness and anthropometric variables: a radiographic study using ultrasonography
Authors: Kilic Koray Kaya , Dogruoz Fırat , Egerci Omer Faruk , Yuncu Murat , Yapar Aliekber , Kose Ozkan
Published: October 2024

Background

This study aimed to evaluate the predictive value of anthropometric measurements for two-stranded peroneus longus tendon (PLT) graft thickness using ultrasonography

Materials and methods

A prospective study was conducted on 204 healthy volunteers (102 males and 102 females) aged 18–40 years. Anthropometric measurements were recorded, including height, weight, body mass index (BMI), fibular length, calf circumference, and ankle circumference. The Tegner Activity Scale (TAS) was used to assess activity levels. PLT cross-sectional area (CSA) was measured using ultrasonography. Two-stranded PLT graft thickness was calculated using the previously reported formula by Luo et al. A thickness of less than 8 mm of PLT graft was accepted as an insufficient autograft for anterior cruciate ligament reconstruction (ACLR). Correlation and regression analyses were performed to identify predictors of two-stranded PLT graft thickness. Receiver operating characteristic (ROC) analysis was performed to establish the best threshold values.

Results

Males had a significantly greater PLT CSA (0.17 ± 0.03 cm2) and predicted two-stranded PLT graft thickness (8.1 ± 0.6 mm) compared with females (0.15 ± 0.03 cm2 and 7.5 ± 0.6 mm, respectively; p < 0.001 for both). Correlation analysis revealed that two-stranded PLT graft thickness positively correlated with height, weight, BMI, fibular length, calf circumference, ankle circumference, and Tegner Activity Scale in both genders, with stronger correlations observed in females. The logistic regression model identified height and calf circumference as significant predictors of sufficient two-stranded PLT graft thickness (≥ 8 mm) in males, while calf circumference and the TAS were significant predictors in females. ROC analysis demonstrated that calf circumference and the TAS had acceptable discriminatory abilities in females, with 36.25 cm and ≥ 4 cutoff points, respectively. However, no anthropometric variables in males exhibited strong discriminatory abilities for predicting two-stranded PLT graft thickness

Conclusions

Calf circumference and the TAS are significant predictors for two-stranded PLT autograft thickness in females. However, no anthropometric variables in males could be used strongly for prediction. These anthropometric measurements can assist in preoperative planning and decision-making, potentially improving ACLR outcomes by ensuring adequate graft thickness in females.

Level of evidence: Level II prospective study
Aggression in psychiatry: a bibliometric analysis
Authors: Bulut Melisa , Yıldırım Nazmiye
Published: October 2024

Background

Aggression is a common problem in psychiatric clinics, and many studies have been conducted on the issue over the years. This study bibliometrically examines the characteristics and trends of aggression studies in psychiatry, such as the branches, publication years, types, publishers, and impact factors, and compares the focus areas of psychiatry and psychiatric nursing on aggression, to guide future research and readers on this topic. Bibliometric analysis was performed with network metrics, citation analysis, co-authorship analysis, science mapping, and network visualization techniques using WoS analysis reports and the VOSviewer program with data obtained from the Web of Science database on January 11, 2024.

Results

Most studies on aggression in psychiatry were published in 2019 as English articles. Then, 3.37% of these studies are in psychiatric nursing, mainly from Australia. In contrast, most psychiatric studies are from the USA. Psychiatry studies focus on causes, types, and relationships with psychiatric disorders, while psychiatric nursing studies emphasize aggressive attitudes, risk assessment, and aggression management.

Conclusions

It appears that studies on aggression continue to remain current in the literature and will continue to do so, considering that aggression is an ongoing clinical problem worldwide. Despite this, studies on assessing and managing the risk of aggression are still lacking. Future studies should prioritize the management of aggression. While the study showed the presence of multidisciplinary and international collaborations, it is recommended that these collaborations be further expanded. Findings may inform researchers’ keyword and journal choices.
Spectrum of liver affection in children with sickle cell disease: case series
Authors: Ebeid Fatma S. E. , Farghal Noura B. , Aly Nihal H.
Published: October 2024

Background

Sickle cell hepatopathy (SCH) is a relatively uncommon complication of sickle cell disease (SCD), yet it does not accommodate variations in presentation, outcome, or severity according to age.

Aim

To present SCH characteristics and assess the effect of implementation of a high-suspicion systematic diagnostic approach and early intervention plan of management.

Methods

This case series presented the characteristics of five children with SCD with variable hepatic manifestation and implemented a diagnostic approach that included testing the transaminases and bilirubin in any patient with any suspicion of liver affection.

Results

The five patients had a complicated SCD history. They all presented with fever, abdominal pain, and deepening of jaundice. The final diagnosis was reached with a more individualized approach; two had significant coagulopathy and were diagnosed with sickle cell intrahepatic cholestasis, while one had normal synthetic functions of the liver with rising transaminases and bilirubin levels, as well as high titer of Epstein–Barr virus diagnosed as acute viral hepatitis complicated with sickle cell hepatic crisis. One other patient had markedly elevated bilirubin with mild elevation of transaminases, and magnetic resonance cholangiopancreatography showed acute extrahepatic biliary dilatation treated by endoscopic removal of the stone. The fifth patient proved to have portal vein thrombosis by portal duplex causing portal hypertension and decompensated liver. The management plan included early exchange transfusion to keep their hemoglobin S (HbS) below 15% which was performed in three of the patients, in addition to aggressive supportive measures for correction of coagulopathy with full recovery and normalization of their liver functions.

Conclusion

Despite the diagnostic challenges, the lack of standard diagnostic criteria, and the overlapping clinical presentation of SCH, the management and outcomes improved by following a systematic diagnostic approach.
Study of CRP, ferritin, and D-dimer in COVID-19 RICU patients as per HRCT severity in assiut university hospitals
Authors: Abdel-Ghany Mohamed F. , El-Karn Atef Farouk Mohamed , Anis Mina Ibraheem , Youssif Sahar Farghly
Published: October 2024

Background

Inflammatory markers were found to be elevated in patients with coronavirus disease (COVID-19). C-reactive protein (CRP), serum ferritin, and D-dimer levels may predict morbidity and mortality in (COVID-19) patients. Radiology plays a key role in the diagnosis, management, and follow-up of this disease. This study aimed to describe the radiological features of (COVID-19) infection, measure C-reactive protein (CRP), D-dimer, and ferritin levels and to correlate them with patient’s outcome and to consider them as predictors of morbidity and mortality in (COVID-19) patients.

Methods

This prospective cross-sectional analytic study had been done on 159 patients aged ≥ 18 years old, admitted at Assiut University Hospital RICU from November 2021 to November 2022, diagnosed as COVID-19 by positive RT-PCR. All patients were categorized on bases of HRCT chest disease reporting and data system (CO-RADS) scoring system into non-severe (CO-RADS 1,2,3) and severe (CO-RADS 4,5) groups. Inflammatory markers such as CRP, ferritin, and D-dimer were measured. Age, sex, comorbidities, need to mechanical ventilation MV, and mortality rate were reported. Correlation between HRCT(CO-RADS) score, inflammatory markers, and patient’s outcome was assessed.

Results

Higher CRP and serum ferritin levels, lower lymphocytic count, and higher frequency of need for mechanical ventilation were significantly greater in the severe group (P < 0.0001). Predictors of morbidity and mortality were CRP ≥ 133 mg/dl, DM, presence of chronic chest disease (P < 0.0001). A higher mortality rate was in patients of the severe group (65%) versus (9%) in the non-severe group (P < 0.0001).

Conclusions

HRCT scan and measurement of CRP and ferritin plasma levels can be considered significant predictors for future prognosis and can early identify patients at risk of death and need for MV. Male gender, presence of DM, and chronic chest diseases are risk factors for severe illness.
Διδάσκοντας Μαθηματικά σε παιδιά με Ειδικές Εκπαιδευτικές Ανάγκες στο πλαίσιο της Συμπεριληπτικής Εκπαίδευσης
Authors: Ρίζος Ιωάννης , Φούκας Ευάγγελος
Published: October 2024

Η επιλογή των κατάλληλων διδακτικών εργαλείων και ο τρόπος χρήσης τους στη διδασκαλία των Μαθηματικών στο νέο συμπεριληπτικό σχολείο αποτελεί ένα κρίσιμο ζήτημα για τη σύγχρονη Μαθηματική Εκπαίδευση. Στο άρθρο αυτό παρουσιάζουμε δύο συμπεριληπτικές διδακτικές μεθόδους που αναπτύξαμε κατά το σχολικό έτος 2022-2023 σε δύο διαφορετικά σχολικά περιβάλλοντα προκειμένου να εισαγάγουμε μαθηματικές ενότητες σε μαθητές και μαθήτριες Γυμνασίου με Ειδικές Εκπαιδευτικές Ανάγκες. Τα αποτελέσματα της έρευνας έδειξαν ότι η αξιοποίηση ενός νέου οπτικού βοηθήματος στη Γεωμετρία, καθώς και χειραπτικού υλικού στην Άλγεβρα βοήθησαν τα παιδιά να κάνουν σημαντικά βήματα προς το ξεπέρασμα του σχολικού άγχους που τα διακατείχε, να εμπλακούν ενεργά στην εκπαιδευτική διαδικασία και να πετύχουν σε ικανοποιητικό βαθμό τους μαθησιακούς στόχους. Στο τέλος του άρθρου συζητάμε ορισμένες διδακτικές προεκτάσεις αλλά και πιθανούς περιορισμούς της έρευνας.
Application of digital twin for industrial process control: A case study of gauge-looper-tension optimized control in strip hot rolling
Authors: Sun Jie , Chen Shang , Ding Cheng-yan , Peng Wen , Zhang Dian-hua
Published: October 2024

Background During the hot rolling process, the performance of most control systems gradually degrades due to equipment aging and changing process conditions. However, existing gauge-looper-tension control method remain restricted by a lack of intelligent parameter maintenance strategies. Methods To address this challenge and enhance the smart manufacturing capabilities of strip hot rolling, based on the digital twin method, this paper proposes a data-driven optimized control method for the gauge-looper-tension system of strip hot rolling. First, a hot rolling process model is constructed based on a digital twin method to serve as an evaluation and optimization platform. Subsequently, relevant data are collected to calculate the Hurst index for identifying the performance of the controller during the rolling process. Additionally, for controllers with poor Hurst index values, the crayfish optimization algorithm is employed for adjusting controller parameters to maximum the Hurst index. Results A real case of hot rolling steel production was used to validate the proposed data-driven optimized control method. Experimental results demonstrate that the proposed evaluation method can effectively recognize the state of gauge-looper-tension controller. Moreover, after optimizing the controller parameters through crayfish optimization algorithm (COA), the value of Hurst index showed significant improvement. Conclusions The proposed digital twin -based optimized control method effectively enhance the manufacturing capability and maintain strategy of hot rolling steel production. Through the proposed method, the Hurst index of gauge-looper-tension system increasing from 0.574 to 0.862.
Linkages between service recovery system and customer justice perceptions: A multi-level model of employee service recovery performance
Authors: Rao Abhishek S , Pai P Yogesh , Sethumadhavan Lakshminarayanan
Published: October 2024

Past research aimed at service recovery has focused on actions that are taken to retain customers, and the possibility of overcoming the mistakes of service delivery, though the multidimensional nature of the service recovery process has begun to move beyond the complaint handling process. In this paper, we identify the most important issues addressed in service recovery and present a framework for addressing them. We used an extensive integrative review methodology. Between 1988 and 2017 the number of articles in these journals was kept between 26 and 30. The majority took a business perspective to study services recovery, while a minority took an inter-disciplinarity perspective. The study’s findings are expected to provide insights into the antecedents and consequences of service recovery performance, particularly how job resources and demands influence employee burnout and work engagement, which in turn affect service recovery performance and customer perceptions of justice. The research aims to contribute to the discourse on service recovery by building a multi-level model that explains the service recovery performance of frontline employees and the impact of the service recovery system on customer justice perceptions. Thus, this research is expected to contribute to robust conclusions on the antecedents and consequences of employee service recovery performance nested within the unit-level construct, i.e., the service recovery system.
Does cross-cultural adjustment affect employee work commitment? Assessing the role of work factors within selected mission hospitals in Kenya
Authors: Chepkirui Abigael , Thiong'o Simon M.
Published: October 2024

Background Globalization has expanded the scope of business with many companies relying on the contribution of expatriates to fill skills gap in foreign business operations, transferring management knowledge, launching new operations, and coordinating activities on a global scale. Expatriates, however, face challenges that stem from cultural differences. Their commitment levels depend on how well and how quickly they adjust to the unfamiliar culture(s) of the host country. Methods This study sought to investigate the implications of work factors on commitment of expatriates working in selected mission hospitals in Kenya. It was anchored on the provisions of the Three-Component Commitment and International Adjustment theories and a randomly selected sample of 112 respondents from a target population of 156 medical expatriates. Results and conclusions The results depicted that work-related factors significantly affected employee commitment (β= -1.033, p=0.000). To conclude, we argue that employee commitment amongst expatriates can be enhanced through work factors’ cross-cultural adjustment. We further recommend setting up of cross-cultural adjustment policies for expatriate workers within the workplace, particularly in mission hospitals.
Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol
Authors: Yallew Walelegn W. , Fasil Rediet , Berhanu Della , Wolde Konjit , Teshite Dedefo , Sethi Reena , Yenokyan Gayane , Woldemariam Yenealem , Suhowatsky Stephanie , Hyre Anne , Noguchi Lisa , Worku Alemayehu
Published: October 2024

Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021).
Intertexte et réécriture du Drame de l’Homme, de la Femme et de Dieu dans 'Partage de midi' de Paul Claudel
Authors: Bidaud Samuel
Published: October 2024

This article examines the way in which Paul Claudel, in Partage de midi [Break of Noon], actualizes and rewrites several founding texts whose themes echo those of his play – which represents nothing more than the Drama of Man, Woman and God, based on an autobiographical source, Claudel’s love for Rosalie Vetch. In this perspective, we can distinguish two types of intertexts. The first is secular and corresponds to the legend of Tristan and Iseult, from which Claudel takes up narrative patterns and dramatic motifs, ranging from onomastics to the love potion drunk on the boat and to forbidden and fatal love. However, he places these elements in a different existential and religious context, marked by free will and the grace of a God who can always draw good from evil. The second intertext is with the Bible, in particular with two books of the Old Testament, the Song of Songs and the Book of Hosea, but also more broadly with the beginning of Genesis and the end of the Gospels, which allows Claudel to lead Mesa and Ysé to the repentance in the last act of the play and to affirm the reconciliation of Man and Woman in God.
Canon y Premio Nobel: un estado de la cuestión
Authors: Francés Díez M. Àngels , Lluch Gemma
Published: October 2024

This paper poses the following question: as a world institutional award, what is the influence of the Nobel Prize in Literature over the construction of the global canon? To answer it, we start from previous resea rch and analyze the studies on canon and Nobel Prize published in scientific journals indexed in the two main international databases: Web of Science, by Clarivate Analytics, and Scopus, by Elsevier, since both cover the current scientific production. After reading the articles which are relevant for the research objective, the centres of interest of this critical literature can be grouped into three large blocks: the concept of World Literature and its relationship with the Nobel Prize; the canonical characteristics of the works by Nobel Prize winners, and the influence of Nobel Prize in the process of creating the world canon. The conclusions question the monolithic and monumental character of the literary canon and advocate for a more transparent approach to its construction that considers economic and ideological aspects (beyond the formal or artistic value of the texts) as crucial for understanding its nature and evolution. For example, E. Lameborshi’s concept of ideological fluency and R. Walkowitz’s born translated novels are useful for understanding to what extent the common concepts of World Literature and canon have recently been redefined.
Home in Han Suyin’s 'Till Morning Comes' from the Perspective of New Cultural Geography
Authors: Hu Xiaoling , Termizi Arbaayah Ali
Published: October 2024

Viewed through the lens of new cultural geography, a geographical landscape is a symbolic system showing the beliefs and values of society, as in the case of the home landscape. The article employs Mike Crang’s concepts of landscape and home to examine different homes in Han Suyin’s Till Morning Comes (1982). From leaving homes, searching for homes to returning homes, Stephanie, an American woman in diaspora, is exposed to different cultures, experiencing a sense of home in China, a sense of homelessness in both China and America, and a sense of being between worlds. In the process of searching for a home, Stephanie constructs her identity as a Chinese and eventually as a world citizen. The home in the novel is more than just a dwelling place; it is a place signifying cultural identity and a meaningful space that influences the identity transformation of a diasporic woman. The article therefore uses a textual analysis approach to explore how homes are represented and how a diasporic woman’s identity is affected by the home landscape she experiences in Till Morning Comes. This novel’s exploration of home illuminates the unique experience of a diasporic woman, highlighting the importance of re-evaluating Han’s work within the framework of contemporary cultural geography.