bluuebunny/crossref_metadata_2025 huggingface dataset:
Electromyographic Analysis of Large Muscle Activity in Progressive Collapsing Foot Deformity
Authors: Bhatia Aanchal , Ajoy Shiv Manik , Galagali Dev Anand , Debur Ramesh
Published: July 2024

Background

There are various deformities described in the spectrum of Progressive Collapsing Foot Deformity (PCFD) which not only have adverse effects on the foot but also on the entire lower limb. Early lower limb muscular fatigue and pain during exertion is the most common complaint of patients with PCFD. Surface electromyography (sEMG) provides an accurate assessment of muscle activity. In this study, we aim to compare the activities of quadriceps, hamstrings, and gastrosoleus muscle groups of adult patients with PCFD with normal lower limbs and correlate the radiological parameters and functional effects of PCFD with the activities.

Methods

Thirty patients with bilateral PCFD and 30 controls underwent weight-bearing anteroposterior (AP), lateral, and hindfoot alignment radiographs of the foot. Radiographic parameters of PCFD were assessed. Surface electromyography was used to assess the quadriceps, hamstrings, and gastrosoleus activities, and this was compared between the 2 groups and correlated with radiological measurements of PCFD. Tegner activity questionnaire was used to assess the functional effects of collapsed arch.

Results

Electrical activities of all muscle groups were significantly higher in cases than controls. Meary’s angle and hindfoot moment arm had significant correlations with hamstring activity (P = .013) and gastrosoleus activity (P = .027), respectively. Tegner scores of cases were significantly lower than those of controls (P = .041).

Conclusions

The PCFD causes an increase in activity of large muscles of the affected lower limb which act on joints other than those in the foot. This finding may be due to several compensatory mechanisms that counteract the deforming forces. This may be a cause for the frequent complaint, early fatigue, and hence functional impairment. However, most radiological parameters did not correlate with muscle activities and larger study size may be required for further association.

Levels of Evidence:

Diagnostic: Level 3.
Simplifying venous outflow: Prolonged venous transit as a novel qualitative marker correlating with acute stroke outcomes
Authors: Yedavalli Vivek S , Lakhani Dhairya A , Koneru Manisha , Balar Aneri B , Greene Cynthia , Hoseinyazdi Meisam , Nabi Mehreen , Lu Hanzhang , Xu Risheng , Luna Licia , Caplan Justin , Dmytriw Adam A , Guenego Adrien , Heit Jeremy J , Albers Gregory W , Wintermark Max , Urrutia Victor , Huang Judy , Nael Kambiz , Leigh Richard , Marsh Elisabeth B , Hillis Argye E , Llinas Rafael H
Published: July 2024

Background

Prolonged venous transit (PVT), defined as presence of time-to-maximum [Formula: see text] 10 s within the superior sagittal sinus (SSS) and/or torcula, is a novel, qualitatively assessed computed tomography perfusion surrogate parameter of venous outflow with potential utility in pretreatment acute ischemic stroke imaging for neuroprognostication. We aim to characterize the correlation between PVT and neurological functional outcomes in thrombectomy-treated patients.

Methods

A prospectively-collected database of large vessel occlusion acute ischemic stroke patients treated with thrombectomy was retrospectively analyzed. Spearman’s rank correlation coefficient and point-biserial correlations were performed between PVT status (i.e., no region, either SSS or torcula, or both), 90-day modified Rankin score (mRS), mortality (mRS 6), and poor functional outcome (mRS 4-6 vs 0-3).

Results

Of 128 patients, correlation between PVT and 90-day mRS ([Formula: see text] = 0.35, p < 0.0001), mortality (r = 0.26, p = 0.002), and poor functional outcome (r = 0.27, p = 0.002) were significant.

Conclusion

There is a modest, significant correlation between PVT and severity of neurological functional outcome. Consequently, PVT is an easily-ascertained, qualitative metric that may be useful as an adjunct for anticipating a patient’s clinical course. Future analyses will determine the significance of incorporating PVT in clinical decision-making.
Cardioprotective effects of sodium glucose cotransporter 2 inhibitor versus dipeptidyl peptidase 4 inhibitor in type 2 diabetes: A meta-analysis of comparative safety and efficacy
Authors: Shrestha Abhigan Babu , Halder Anupam , Rajak Kripa , Jha Saroj Kumar , Lamichhane Ramesh , Oishee Arefin Naher , Chowdary Nayanika Tummala , Pokharel Pashupati , Shrestha Sajina , Adhikari Lukash , Adhikari Bikash , Rajak Aman , Haider Khan Jalal , Mainali Nischal
Published: July 2024

Background:

Sodium glucose cotransporter 2 inhibitors are recommended for the treatment of heart failure due to their cardioprotective effects, despite primarily being used as antidiabetic medications. However, the comparative profile of two antidiabetic drugs, sodium glucose cotransporter 2 inhibitors with dipeptidyl peptidase 4 inhibitor remains unclear.

Study hypothesis:

This study aims to compare the safety and efficacy profiles of sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor drugs.

Methods:

A comprehensive search was conducted in PubMed, Scopus, Web of Science, Google Scholar, and ClinicalTrials.gov using appropriate Medical Subject Headings terms from inception until February 23, 2023. The outcomes were pooled using a random-effects model for hazard ratio with a 95% confidence interval. A p-value of <0.05 was considered statistically significant.

Results:

Twelve studies were included after systematic screening, with a sample size of 745,688 for sodium glucose cotransporter 2 inhibitors and 769,386 for dipeptidyl peptidase 4 inhibitor. The mean age in each group was 61.1 (8.52) and 61.28 (9.25) years, respectively. Upon pooling the included articles with sodium glucose cotransporter 2 inhibitors versus dipeptidyl peptidase 4 inhibitor, the primary outcome of all-cause death demonstrated an hazard ratio of 0.64 (0.57, 0.70), I2: 65.54%, p < 0.001, and major adverse cardiovascular events yielded an hazard ratio of 0.76 (0.65, 0.86), I2: 87.83%, p < 0.001. The secondary outcomes included myocardial infarction with an hazard ratio of 0.84 (0.78, 0.90), I2: 47.64%, p < 0.001, stroke with an hazard ratio of 0.81 (0.75, 0.87), I2: 36.78%, p < 0.001, and hospitalization with an hazard ratio of 0.62 (0.53, 0.70), I2: 83.32%, p < 0.001.

Conclusion:

Our findings suggest that compared to dipeptidyl peptidase 4 inhibitor, initiating treatment with sodium glucose cotransporter 2 inhibitors provides cardiovascular disease protection and may be considered in patients with type 2 diabetes.
Three constants of Chinese internet research: Statism, cacophony, and liminal movements
Authors: Qiu Jack Linchuan
Published: July 2024

This essay reflects on three constants in Chinese internet research over the past 30 years, namely, statism, cacophony, and liminal movements. Reflecting on these three constants shall help us better appreciate the variations and dynamism of Chinese internet research from the past into the future.
Factors Influencing College Students’ Learning Intention to Online Teaching Videos During the Pandemic in China
Authors: Hao Yinhua , Zeng Xiangmin , Yasin Megat Al Imran , Boon Sim Ng
Published: July 2024

To explore the influencing factors of college students’ learning intention to online teaching videos during the pandemic, this study considered 696 college students from Huangshan University in China. The T-test and ANOVA were utilized to analyze gender, grade, and discipline on college students’ learning intention, and the regression analysis was utilized to explore four aspects including performance expectancy, effort expectancy, social influence, and facilitating conditions on college students’ learning intention. The results indicate the following: first, using descriptive analysis, it is observed that college students did not exhibit a positive learning attitude toward online teaching videos during the pandemic. Second, the t test and one-way analysis of variance indicate that grades between freshmen and seniors significantly influence the learning intention of college students to online teaching videos, whereas genders and disciplines do not. Third, through regression analysis, it is observed that performance expectancy, effort expectancy, social influence, and facilitating conditions significantly influence college students’ learning intention to online teaching videos. This study stipulates the following research proposals: resource construction, the optimization of the online teaching environment, advanced technology and psychological counseling. It is expected that the findings will provide references for studies on online teaching resources and online learning.
Measuring the Financial Sustainability and its Influential Factors in Microfinance Sector of Pakistan
Authors: Maeenuddin  , Hamid Shaari Abd , Nassir Annuar MD , Fahlevi Mochammad , Aljuaid Mohammed , Jermsittiparsert Kittisak
Published: July 2024

Financial sustainability is one of the major issues in the development process, particularly in developing countries. Microfinance started with two basic objectives of poverty reduction and women empowerment. However, unsustainable microfinance providers cannot assist the poor for a longer period of time, due to uncertainty about their existence. This study investigates that how financial sustainability of Pakistan’s microfinance sector is affected by various factors. A new financial sustainability index has been developed to measure the financial sustainability. Generalized Method of Moments (GMM) approach is employed to analyze the panel data from 34 Pakistani MFPs, yielding 344 MFI-years of observations from 2006 to 2018. The findings reveal that increase in loan size, female borrowers, liquidity, and leverage significantly enhances the financial viability of Microfinance Providers in Pakistan. However, the total borrowers and the operating cost per borrower negatively affect the financial sustainability of MFPs in Pakistan. MFIs needs to be financially independent, with less or no support from government or donor agencies. Financially sustainable MFPs contributes in the achievement of the 8 out of 17 Sustainable Development of Goals (2030 SDGs) of the United Nation. The data for 2018 onwards is seriously affected by COVID-19, which cannot be included in the current data set. Hence, researchers in future analyze the data from the pre-COVID-19 and post-COVID-19 periods to compare the analysis and examine the pandemic’s impact.
Protected, But Unprotected: Qualitatively Exploring the Experiences of Western Australian Academics During the COVID-19 Pandemic
Authors: Phillips Matthew James
Published: July 2024

The COVID-19 pandemic has impacted on the ways in which academics engage in their work, with many unique demands, anxieties, and pressures placed on them. Adjustments to the work and home lives have been made as a result. I explored how Western Australian academics experienced working in higher education during the COVID-19 pandemic. 11 participants were interviewed, and data was analyzed using reflexive thematic analysis. Findings illustrated (1) how Western Australian academics initially reacted to the building COVID-19 concern, and its impacts on higher education, (2) the ways in which Western Australian academics responded to the daily changes, and (3) the lessons learned from the pandemic to assist academics moving forward. Overall, the findings of this study contribute to a growing body of literature on the impact of the COVID-19 pandemic on higher education and provide important insights into the experiences of Western Australian academics.
Professional Caregivers’ Communicative Resilience and Flourishing During the COVID-19 Pandemic: When Disruption Lasts
Authors: Bisel Ryan S. , Rush Katherine Ann , Roeder Arden C.
Published: July 2024

The pandemic was a prolonged and ongoing work disruption, especially for professional caregivers. This explanatory sequential mixed method study revealed that caregivers’ communicative resilience (CR) was positively associated with their experience of flourishing and negatively associated with burnout and intentions to turnover—indicating that CR is, indeed, predictive of the wellbeing of professionals coping with a lengthy disruption at work. Analysis of professional caregivers’ ( N = 264) survey responses demonstrated that the continuity factor of CR predicted wellbeing outcomes (i.e., flourishing, burnout, and turnover intentions). However, the change factor of CR did not. Then, highly communicatively resilient caregivers ( n = 11) were interviewed to explore their lived experiences of flourishing—experiences characterized by positive emotions while doing meaningful and rewarding work. Implications for positive communication scholarship in organizations conclude the paper.
A World of Possibilities: Introducing Positive Communication Scholarship to Inspire Better Business and Organizational Communication Research
Authors: Mirivel Julien C. , Fuller Ryan P.
Published: July 2024

This special issue is an invitation to study business communication with a positive perspective. For decades, researchers in business communication have predominantly explored the problems, challenges, and issues facing organizations and leadership communication. Whether those include exploring the nature of crisis (e.g, Waller & Iluzada), communication responses and outcomes of sexual harassment (e.g., Mills & Scudder), or the role of internal communication in culture creation (e.g., Yue, Men, & Ferguson), researchers’ theoretical and methodological lenses are often used to critique, point to, or reveal the problematic nature of business life. In this special issue, we want to celebrate the extraordinary, what works well in organizations, and the nature of positive communication and its inspirational force for people and organizations. Specifically, we argue that Positive Communication Scholarship should inspire better practice. To support this endeavor, we begin with a brief history of the positive communication movement in the field of communication. Then, using this history, we define positive communication scholarship and describe what it will help our discipline accomplish. We also introduce the articles featured in this special issue, advance an agenda for future research, and end with a call to action.
The Role of Supervisory Communication Frequency in Moderating the Impact of Innovation Knowledge Management on Innovation Performance
Authors: Chen Chih-Hung
Published: July 2024

Innovation Performance (IP) serves as a measure of a company’s effectiveness in translating innovative endeavors into tangible outcomes, encompassing new products, processes, services, and enhancements to existing offerings. This study investigates the relationship between IP, Innovation Knowledge Management (IKM), which includes Innovation Culture (IC) and Knowledge Management (KM), and Supervisory Communication Frequency (SCF). SCF refers to the frequency and quality of communication between supervisors and subordinates, influencing the impact of IKM on IP. Using a structured questionnaire, 320 valid responses were collected from companies listed on the Taiwan Stock Exchange (TWSE). Data analysis employed Structural Equation Modeling (SEM) and Process Macro Model 1, with reliability and validity assessed based on criteria from Hair et al. and Fornell and Larcker. Discriminant validity was confirmed with construct correlations lower than the square root of the average variance extracted (AVE). Path analysis revealed significant differences in IP scores across SCF frequency groups (F (4, 315) = 12.47, p < .001), with three monthly interactions showing the highest mean IP score (M = 3.6905, SD = 0.9375). These findings highlight the importance of regular supervisor-employee interactions alongside robust KM and IC practices for optimal innovation outcomes.

JEL Code: O32 - Management of Technological Innovation and R&D; M15 - IT Management; L25 - Firm Performance: Size, Diversification, and Scope; O31 - Innovation and Invention: Processes and Incentives
Primary Isolated Arthrodesis of the First Metatarsophalangeal Joint for Hallux Rigidus: Clinical, Radiologic, and Pedobarographic Evaluation
Authors: Fragnière Nicolas , Kameni-Hekam Maeva , Cissé Amadou , Vienne Patrick
Published: July 2024

Background:

Arthrodesis of the first metatarsophalangeal joint is an effective treatment of advanced hallux rigidus. Numerous options have been described for performing this intervention. The aim of this study was to evaluate the outcomes following a consistent surgical technique of joint preparation with hand tools and fixation with 2 crossed screws and a dorsal compression plate.

Methods:

Thirteen patients (16 feet) who underwent primary isolated arthrodesis of the first metatarsophalangeal joint between March 2019 and June 2021 were available for clinical, radiologic, and pedobarographic evaluation at a minimum of 12 months after surgery. American Orthopaedic Foot & Ankle Society scores, numerical pain rating scale, the radiologic hallux valgus and intermetatarsal 1-2 angles as well as the distribution of plantar pressure during gait were compared between the pre- and postoperative conditions.

Results:

After an average follow-up period of 26 months, union was achieved in all cases and the mean AOFAS score raised significantly by 39 points. All the patients were satisfied with the result. Only 1 patient complained of mild residual pain at walk. Hardware removal was performed in 2 cases. The mean hallux valgus angle dropped from 12.3 to 6.3 degrees. The mean postoperative dorsiflexion angle was 21.6 degrees. After the procedure, peak pressure was significantly higher beneath the first metatarsal head and heel, whereas pressure-time integral was significantly lower beneath the hallux and medial lesser toes.

Conclusion:

Arthrodesis of the first metatarsophalangeal joint with 2 crossed screws and a dorsal compression plate is a safe and effective treatment of advanced hallux rigidus. This procedure provides adequate pain relief and functional improvement of gait.

Level of Evidence:

Level IV, therapeutic, retrospective case series.
Deciding My Future: Making Decisions and Planning for Supports
Authors: Dean Evan E. , Hagiwara Mayumi , Linnenkamp Brad , Shogren Karrie A.
Published: July 2024

Supported Decision Making (SDM) is a way for people with complex support needs to get the support they need to make important life decisions. Using SDM, a person selects the type of support (e.g., a trusted person and technology) that bridges the gap between their decision-making experience and abilities and the demands of the decisions they need to make. In this article, we describe an intervention that was developed in partnership with people with complex support needs, Deciding My Future. The intervention supports people with complex support needs to make decisions and plan for support. A case study is provided to illustrate how Deciding My Future can be used to support decision-making.
Development and psychometric properties of the Clinical Anxiety Scale for People with Intellectual Disabilities (ClASP-ID)
Authors: Mingins Jessica Eliza , Tarver Joanne , Pearson Effie , Edwards Georgina , Bird Megan , Crawford Hayley , Oliver Chris , Shelley Lauren , Waite Jane
Published: July 2024

Background

There is a critical need for the development of dependable and valid anxiety assessment tools suitable for people with moderate to severe intellectual disabilities, particularly those who speak few or no words. Distinguishing anxiety from distress caused by physical discomfort (pain) or characteristics associated with autism, prevalent in this population, necessitates specialised assessment tools. This study (a) developed a parent-report anxiety questionnaire tailored for individuals with severe to moderate intellectual disabilities, potentially with a co-diagnosis of autism, and (b) evaluated the psychometric attributes of this novel measure.

Methods

A comprehensive approach involving literature reviews, inspection of existing tools, and interviews with clinicians and parents guided the creation of the Clinical Anxiety Scale for People with Intellectual Disabilities. The tool was completed by parents or caregivers (N = 311) reporting on individuals aged 4 or older with intellectual disabilities.

Results

Exploratory factor analysis indicated a four-factor structure encompassing anxiety, pain, low energy/withdrawal, and consolability. The anxiety factor explained the most variance in scores (26.3%). The anxiety, pain, low energy/withdrawal subscales demonstrated robust internal consistency (α = 0.81-0.92), and convergent, divergent, and discriminant validity. Robustness of these subscales was further evidenced by test-retest reliability (ICC = 0.79-0.88) and inter-rater reliability (ICC = 0.64-0.71). Subgroup analyses consistently demonstrated strong psychometric properties among individuals diagnosed with non-syndromic autism (N = 98), children (N = 135), adults (N = 175), and across diverse communication abilities within the sample. Moreover, individuals diagnosed with both autism and anxiety exhibited significantly higher scores on the anxiety subscale compared to those without an anxiety diagnosis, while showing no difference in autism characteristic scores.

Conclusions

The findings indicate that the Clinical Anxiety Scale for People with Intellectual Disabilities is a promising measure for use across diverse diagnostic groups, varying communication abilities, and with people with moderate to severe intellectual disabilities.
HD-ZIP IV Gene ROC1 Regulates Leaf Rolling and Drought Response Through Formation of Heterodimers with ROC5 and ROC8 in Rice
Authors: Tao Zhihuan , Miao Xuexia , Shi Zhenying
Published: July 2024

Leaf morphology is a crucial agronomic characteristic of rice that influences crop yield directly. One primary cause of rice leaf rolling can be attributed to alterations in bulliform cells. Several HD-ZIP IV genes have been identified to be epidemical characterized and function in leaf rolling in rice. Still others need to be studied to fully understand the overall function of HD-ZIP IV family. Among the nine ROC genes encoding HD-ZIP IV family transcription factors in rice, ROC1 exhibits the highest expression in the leaves. Overexpression of ROC1 decreased the size of bulliform cells, and thus resulted in adaxially rolled leaves. To the contrary, knockout of ROC1 (ROC1KO) through Crispr-cas9 system enlarged bulliform cells, and thus led to abaxially rolled leaves. Moreover, ROC1KO plants were sensitive to drought. ROC1 could form homodimers on its own, and heterodimers with ROC5 and ROC8 respectively. Compared to ROC1KO plants, leaves of the ROC1 and ROC8 double knocked out plants (ROC1/8DKO) were more severely rolled abaxially due to enlarged bulliform cells, and ROC1/8DKO plants were more drought sensitive. However, overexpression of ROC8 could not restore the abaxial leaf phenotype of ROC1KO plants. Therefore, we proved that ROC1, a member of the HD-ZIP IV family, regulated leaf rolling and drought stress response through tight association with ROC5 and ROC8.
Histone acetylation risk model predicts prognosis and guides therapy selection in glioblastoma: implications for chemotherapy and anti-CTLA-4 immunotherapy
Authors: Jin Xingyi , Qin Zhigang , Zhao Hang
Published: July 2024

Background

Glioblastoma is characterized by high aggressiveness, frequent recurrence, and poor prognosis. Histone acetylation-associated genes have been implicated in its occurrence and development, yet their predictive ability in glioblastoma prognosis remains unclear.

Results

This study constructs a histone acetylation risk model using Cox and LASSO regression analyses to evaluate glioblastoma prognosis. We assessed the model’s prognostic ability with univariate and multivariate Cox regression analyses. Additionally, immune infiltration was evaluated using ESTIMATE and TIMER algorithms, and the SubMAP algorithm was utilized to predict responses to CTLA4 inhibitor. Multiple drug databases were applied to assess drug sensitivity in high- and low-risk groups. Our results indicate that the histone acetylation risk model is independent and reliable in predicting prognosis.

Conclusions

Low-risk patients showed higher immune activity and longer overall survival, suggesting anti-CTLA4 immunotherapy suitability, while high-risk patients might benefit more from chemotherapy. This model could guide personalized therapy selection for glioblastoma patients.
Investigation of cross-opsonic effect leads to the discovery of PPIase-domain containing protein vaccine candidate to prevent infections by Gram-positive ESKAPE pathogens
Authors: Sadones Océane , Kramarska Eliza , Laverde Diana , Berisio Rita , Huebner Johannes , Romero-Saavedra Felipe
Published: July 2024

Background

Enterococcus faecium and Staphylococcus aureus are the Gram-positive pathogens of the ESKAPE group, known to represent a great threat to human health due to their high virulence and multiple resistances to antibiotics. Combined, enterococci and S. aureus account for 26% of healthcare-associated infections and are the most common organisms responsible for blood stream infections. We previously showed that the peptidyl-prolyl cis/trans isomerase (PPIase) PpiC of E. faecium elicits the production of specific, opsonic, and protective antibodies that are effective against several strains of E. faecium and E. faecalis. Due to the ubiquitous characteristics of PPIases and their essential function within Gram-positive cells, we hypothesized a potential cross-reactive effect of anti-PpiC antibodies.

Results

Opsonophagocytic assays combined with bioinformatics led to the identification of the foldase protein PrsA as a new potential vaccine antigen in S. aureus. We show that PrsA is a stable dimeric protein able to elicit opsonic antibodies against the S. aureus strain MW2, as well as cross-binding and cross-opsonic in several S. aureus, E. faecium and E. faecalis strains.

Conclusions

Given the multiple antibiotic resistances S. aureus and enterococci present, finding preventive strategies is essential to fight those two nosocomial pathogens. The study shows the potential of PrsA as an antigen to use in vaccine formulation against the two dangerous Gram-positive ESKAPE bacteria. Our findings support the idea that PPIases should be further investigated as vaccine targets in the frame of pan-vaccinomics strategy.
Clinical characteristics and outcomes of overt gastrointestinal bleeding in children undergoing haploidentical hematopoietic stem cell transplantation: a single-center retrospective analysis
Authors: Qi Shanshan , Zhang Lannan , Chen Zhi , Wang Zhuo , Ding Lili , Du Yu , Xiong Hao
Published: July 2024

Background

Overt gastrointestinal bleeding (GIB) is a potentially serious and life-threatening condition in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, relatively little information is available regarding overt GIB in children.

Objectives

To assess the prevalence, clinical patterns, and outcomes of overt GIB in children undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT).

Methods

A total of 123 consecutive patients with malignant or non-malignant blood disorders who received haplo-HSCT were reviewed in our hospital between October 2017 and October 2022. Overt GIB was determined as hematemesis, melena or hematochezia. Continuous variables were compared by Mann Whitney U test. Categorical parameters were compared by the χ2 test or Fisher’s exact test. Kaplan-Meier curves and log-rank tests were used to assess overall survival (OS), non-relapse mortality (NRM) and relapse. Univariate and multivariate analyses were performed to identify potential risk factors of overt GIB development.

Results

The median follow-up was 26.3 (range,1.7–74.8) months. Overt GIB occurred in 31 patients (25.2% incidence), with a median time elapsed after haplo-HSCT of 376 days (range, 58–1275 days). Compared with the non-GIB group, patients with overt GIB had reduced OS and increased NRM. In multivariate analysis, grade III–IV gut acute graft versus-host disease (aGvHD), thrombotic microangiopathy (TMA) and cytomegalovirus (CMV) viremia were significant risk factors for the occurrence of overt GIB after haplo-HSCT.

Conclusions

Overt GIB is a frequent complication after haplo-HSCT in pediatric patients, and associated with worse survival. Grade III–IV gut aGvHD, TMA and CMV viremia were associated with its development.
Robot-assisted versus traditional fixation for the treatment of calcaneal fractures: a meta-analysis
Authors: Shi Jiaxiao , Shen Jiaxin , Guo Wei , Zhang Chaochao
Published: July 2024

Objective

With the development of surgical technology, the level of digital medicine is constantly improving. The birth of new technologies has a certain impact on traditional methods. At present, robot-assisted technology has been applied to patients with calcaneal fractures, which poses a challenge to traditional surgery. We aimed to assess whether robot-assisted internal fixation confers certain surgical advantages through a literature review.

Design

The databases PubMed, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), and the Wanfang Data Knowledge Service Platform were systematically searched for both randomized and nonrandomized studies involving patients with calcaneal fractures.

Main results

Five studies were identified that compared clinical indexes. For the clinical indexes, robot-assisted surgery is generally feasible because of intraoperative fluoroscopy, complications, the Gissane angle, the calcaneal width, and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score 3 and 6 months after the operation (P < 0.05). However, on the operation time, Böhler’s angle at 3 and 6 months, Gissane angle and calcaneal width at 6 months after the operation did not show good efficacy compared with those of the traditional group (P > 0.05).

Conclusions

Based on the current evidence, the advantages of robot-assisted fixation over traditional fixation are clear. The long-term clinical effects of the two methods are also good, and the short-term effect of robot assistance is better. However, the quality of some studies is low, and more high-quality randomized controlled trials (RCTs) are needed for further verification.
Clinical evaluation of resection of functional area gliomas guided by intraoperative 3.0 T MRI combined with functional MRI navigation
Authors: Tian Luoyi , Peng Nan , Qian Zhongrun , Hu Jinpeng , Cheng Wei , Xia Yanghua , Cheng Chuandong , Ji Ying
Published: July 2024

Background

In assessing the clinical utility and safety of 3.0 T intraoperative magnetic resonance imaging (iMRI) combined with multimodality functional MRI (fMRI) guidance in the resection of functional area gliomas, we conducted a study.

Method

Among 120 patients with newly diagnosed functional area gliomas who underwent surgical treatment, 60 were included in each group: the integrated group with iMRI and fMRI and the conventional navigation group. Between-group comparisons were made for the extent of resection (EOR), preoperative and postoperative activities of daily living based on the Karnofsky performance status, surgery duration, and postoperative intracranial infection rate.

Results

Compared to the conventional navigation group, the integrated navigation group with iMRI and fMRI exhibited significant improvements in tumor resection (complete resection rate: 85.0% vs. 60.0%, P = 0.006) and postoperative life self-care ability scores (Karnofsky score) (median ± interquartile range: 90 ± 25 vs. 80 ± 30, P = 0.013). Additionally, although the integrated navigation group with iMRI and fMRI required significantly longer surgeries than the conventional navigation group (mean ± standard deviation: 411.42 ± 126.4 min vs. 295.97 ± 96.48 min, P<0.0001), there was no significant between-group difference in the overall incidence of postoperative intracranial infection (16.7% vs. 18.3%, P = 0.624).

Conclusion

The combination of 3.0 T iMRI with multimodal fMRI guidance enables effective tumor resection with minimal neurological damage.
The impact of parental dental anxiety and oral health literacy on child oral health and dental-visit patterns: a cross-sectional study
Authors: Gudipaneni Ravi Kumar , Alzabni Khalid Maziad D. , Alrashedi Faisal Fraih A. , Alruwaili Dimah Hamoud J. , Albalawi Farah Awad , Alanazi Asrar Helal , Alshamri Buthainah Saleh , Almaeen Saud Hamdan , Manchery Nithin , Bawazir Omar A.
Published: July 2024

Background

Identifying the risk indicators of parental dental anxiety (PDA) and oral health literacy (OHL) can help oral healthcare professionals recognise challenges in this field. Armed with the appropriate information, they can effectively engage with parents to build trust and promote early and regular child dental visits.

Objectives

This study aimed to investigate the association between PDA and OHL with the sociobehavioural characteristics of families, self-reported child oral health (presence of ≥ 1 untreated decayed teeth) and the dental visit patterns amongst children living in Al Jouf Province, Kingdom of Saudi Arabia.

Subjects and methods

A total of 430 parents with children aged ≥ 14 years were invited using a systematic random sampling method. PDA was assessed using the Dental Anxiety Scale-Revised (DAS-R) scale, and parents’ OHL was measured using the Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30). The relationships amongst participant characteristics, PDA and OHL were evaluated through the Chi-square and ANOVA. Additionally, binary regression analysis was conducted to identify predictor variables associated with PDA and OHL. A P value of < 0.05 was considered statistically significant.

Results

Children with ≥ 1 untreated decayed tooth were 2.5 times more likely to have PDA (95% confidence interval [CI] = 1.37, 4.37). Children who visited the dentist in < 6 months had 93% lower likelihood to have PDA (adjusted odds ratio (AOR) = 0.07; 95% CI = 0.03, 0.18). Parents aged 20–25 years were 81% less likely to have OHL than those above 30 years (AOR = 0.19; P = 0.038). Similarly, parents with medium family income were 52% less likely to have OHL than the high-income group (AOR = 0.48; P = 0.013). Finally, parents of children who visited the dentist within < 6 months were 34 times more likely to have OHL than those whose children visited the dentist > 12 months ago (AOR = 34.94; P < 0.001).

Conclusion

PDA and OHL were significantly affected by parental age, family income, the presence of ≥ 1 untreated decaying tooth and the child dental visit patterns. During a child’s first dental visit, paediatric dentists should always assess the PDA, OHL and sociobehavioural characteristics of a family by using appropriate scales and semistructured interviews.
Evaluation of fracture resistance and marginal fit of implant-supported interim crowns fabricated by conventional, additive and subtractive methods
Authors: Elsareef Safaa Salah , Azer Amir Shokry , Morsy Noha
Published: July 2024

Background

Interim crowns are utilized for restoring implants during and after the process of osseointegration. However, studies on adaptation and fracture strength of implant-supported interim crowns are rare.

Aim of the study

The aim of this in vitro study is evaluating marginal fit and fracture resistance of conventional, subtractive, and additive methods of fabricating implant-supported interim crowns.

Materials and methods

An implant was placed in an epoxy resin model with a missing first molar. A scan body was attached, and scanned with an intraoral scanner (IOS), the STL file was used to fabricate eighteen master models with standardized implant digital analogue spaces. The digital analogues and their corresponding abutments were attached to the master models and scanned with the IOS, the STL files were used to fabricate eighteen crowns using three different techniques (n = 6): conventional (CR); from Autopolymerizing composite resin, subtractive (SM); milled from PMMA resin blanks, and additive (AM); from 3D printed resin material. The crowns were fitted and cemented on their corresponding abutments and subjected to cyclic loading and thermocycling. The marginal fit was evaluated using a stereomicroscope. The crowns were then loaded until fractured in a universal testing machine. The Shapiro–Wilk and the Kolmogorov-Smirnov tests revealed that data of Marginal gap was non-parametric. Kruskal-Wallis test followed by the Dunn test was used (α = 0.05). While data of Fracture resistance test was parametric. ANOVA (F-test) was used followed by the Tukey test (α = 0.05).

Results

For marginal gap, a significant difference was shown between the study groups (P = .001) according to Kruskal–Wallis test. Groups SM and AM had significantly lower marginal gap values compared to group CR (P = .003). No significant difference was found between groups SM and AM (P = .994). For fracture resistance, One-way ANOVA revealed a significant difference in fracture resistance between study groups (P < .001). Group SM had significantly higher fracture strength followed by group AM and group CR (P = .001).

Conclusions

Group SM and AM showed better marginal adaptation than group CR. Group SM showed superior fracture resistance compared to other groups. All study groups showed acceptable marginal gap and fracture resistance.
The influence of assisted reproductive technologies-related stressors and social support on perceived stress and depression
Authors: Gupta Aditi , Lu Emily , Thayer Zaneta
Published: July 2024

Background

While assisted reproductive technologies (ART) have helped many people experiencing infertility become pregnant, the ART process can take a psychological toll. This study examined whether and how perceived stress- and depression-related symptoms vary among individuals at different stages of the infertility and ART process, and whether ART-specific stressors and emotional support are associated with mental health symptomatology.

Methods

Data were collected using an online REDCap survey administered between July 2021 and March 2022. The survey was administered to 240 participants who had experienced infertility, including those who had not yet accessed ART, those undergoing ART but who were not yet pregnant, those currently pregnant through ART, and those who had given birth in the last year through ART. Each participant completed the Cohen Perceived Stress Scale (range 0–40) and the Edinburgh Depression Scale (range 0–30). Participants who had undergone ART were asked about their experience of ART-specific stressors and how helpful partner and provider support had been during the ART process. Survey data were analyzed using ANOVA and multivariate linear regressions.

Results

88% of participants reported medium or high levels of perceived stress, and 43.8% of respondents showed probable indications of depression. Perceived stress and depression symptoms were significantly higher for individuals currently undergoing, but not yet pregnant from, ART treatments. These effect sizes were substantial; for example, depression scores in this group were five points higher than among currently pregnant individuals and nine points higher than among postpartum individuals. For the subset of participants who had used or were currently undergoing ART (N = 221), perceived social stigma and the physical and time demands of ART were significantly associated with higher stress and depression symptoms, while partner emotional support was associated with lower perceived stress.

Conclusions

The ART process exacerbates perceived stress and depression symptoms among individuals experiencing infertility. Given the potential long-term impacts on both parent and child wellbeing, clinicians and policymaking groups, including the American Society for Reproductive Medicine (ASRM), should consider making access to mental health services a standard of care during infertility treatment.
Chemopreventive effect of modified zeng-sheng-ping on oral squamous cell carcinoma by regulating tumor associated macrophages through targeting tnf alpha induced protein 6
Authors: Wang Jiaqi , Lin Feiran , Zhou Yongxiang , Cong Yuyi , Yang Sen , Wang Sujuan , Guan Xiaobing
Published: July 2024

Background

Oral squamous cell carcinoma (OSCC) is the most common malignancy of the head and neck. Zeng-Sheng-Ping, composed of Sophora tonkinensis Gagnep., Bistorta officinalis Delarbre, Sonchus arvensis L., Prunella vulgaris L., Dioscorea bulbifera L., and Dictamnus dasycarpus Turcz., was regarded as an anti-cancer drug with significant clinical efficacy, but was discontinued due to liver toxicity. Our research group developed a modified Zeng-Sheng-Ping (ZSP-M) based on original Zeng-Sheng-Ping that exhibited high efficiency and low toxicity in preliminary investigations, although its pharmacodynamic mechanism is still unclear. Here, we aimed to elucidate the pharmacodynamic material basis of ZSP-M and investigate its chemopreventive effect on OSCC by modulating tumor associated macrophages (TAMs).

Methods

Components of ZSP-M were characterized using ultra-performance liquid chromatography-mass spectrometry. Chemopreventive effect induced by ZSP-M against experimental oral cancer was investigated using the 4-nitroquinoline N-oxide precancerous lesion mouse model. RNA sequencing analysis was used to gain a global transcriptional view of the effect of ZSP-M treatment. A cell co-culture model was used to study the targeted effect of ZSP-M on TAMs and the biological properties of OSCC cells and to detect changes in TAM phenotypes. The binding of ZSP-M active compounds to TNF alpha induced protein 6 (TNFAIP6) protein was analyzed by molecular docking and dynamic simulation.

Results

Forty main components of ZSP-M were identified, the most abundant of which were flavonoids. ZSP-M inhibited the degree of epithelial dysplasia in precancerous lesions by inhibiting the expression of the TNFAIP6 and CD163 proteins in the precancerous lesions of the tongue. ZSP-M inhibited proliferation, colony formation, migration and invasion of SCC7 cells by targeting TAMs. ZSP-M reduced the expression of CD163+ cells, inhibited the expression of TNFAIP6 protein, Arg1 mRNA and Il10 mRNA in TAMs, and reduced IL-10 cytokine release in the co-culture environment. This effect was maintained after the addition of recombinant TNFAIP6 protein. Computer simulations showed that trifolirhizin and maackiain are well-connected to TNFAIP6.

Conclusions

ZSP-M counteracts the immunosuppressive action of TAMs by specific targeting of TNFAIP6, thereby exerting chemopreventive activity of OSCC.
Ethics, design, and implementation criteria of digital assistive technologies for people with dementia from a multiple stakeholder perspective: a qualitative study
Authors: Köhler Stefanie , Perry Julia , Biernetzky Olga A. , Kirste Thomas , Teipel Stefan J.
Published: July 2024

Background

Dementia impairs the ability of people with dementia to be autonomous and independent. They need support from third parties, who should ideally respect their autonomy and independence as much as possible. Supporting people with dementia can be very burdensome for caregivers and numbers of patients increase while numbers of potential caregivers decline. Digital assistive technologies (DATs) that directly support patients or their caregivers may help bridging the increasing gap between need of support and available resources. DATs have the potential to preserve the autonomy and independence of people with dementia and promote their abilities, if they are properly designed in close interaction with future users. In our study, we focused on ethical concerns, technological requirements, and implementation criteria for DAT in general and specifically to support outdoor mobility of people with dementia.

Methods

We applied a qualitative approach and conducted a World Café (2 tables, n = 7) and an online focus group (n = 6) with people with dementia, relatives, healthcare professionals, scientists, ethics experts, and experts for digitally-assisted medical care. We descriptively analyzed the data using a content analysis approach.

Results

The participants reported technological (e.g., lack of Wi-Fi), financial (e.g., expensive devices or lack of budget for DATs), political (e.g., legal hurdles such as the European Medical Device Law or data protection regulations) as well as user-related hurdles (e.g., lack of digital competence) for the implementation of DAT in dementia care. Among the issues discussed were the importance of autonomy, independence, safety, privacy, and questions of decision making capacity in DAT’s use. Participants identified opportunities and benefits in self-learning, situation-aware DATs and wished for dementia-friendly communities. They emphasized the value of personal interaction that should not be replaced, but rather supported by DAT.

Conclusion

The results revealed multiple hurdles and ethical concerns for DAT use and provided recommendations for designing and implementing DATs. Further investigations are needed on the impact of DAT on personal interactions in caregiving and the role of DAT in dementia-friendly communities.
A qualitative study of the barriers and facilitators impacting the implementation of a quality improvement program for emergency departments: SurgeCon
Authors: Anaraki Nahid Rahimipour , Mukhopadhyay Meghraj , Jewer Jennifer , Patey Christopher , Norman Paul , Hurley Oliver , Etchegary Holly , Asghari Shabnam
Published: July 2024

Background

The implementation of intervention programs in Emergency Departments (EDs) is often fraught with complications due to the inherent complexity of the environment. Hence, the exploration and identification of barriers and facilitators prior to an implementation is imperative to formulate context-specific strategies to ensure the tenability of the intervention.

Objectives

In assessing the context of four EDs prior to the implementation of SurgeCon, a quality improvement program for ED efficiency and patient satisfaction, this study identifies and explores the barriers and facilitators to successful implementation from the perspective of the healthcare providers, patients, researchers, and decision-makers involved in the implementation.

Settings

Two rural and two urban Canadian EDs with 24/7 on-site physician support.

Methods

Data were collected prior to the implementation of SurgeCon, by means of qualitative and quantitative methods consisting of semi-structured interviews with 31 clinicians (e.g., physicians, nurses, and managers), telephone surveys with 341 patients, and structured observations from four EDs. The interpretive description approach was utilized to analyze the data gathered from interviews, open-ended questions of the survey, and structured observations.

Results

A set of five facilitator-barrier pairs were extracted. These key facilitator-barrier pairs were: (1) management and leadership, (2) available resources, (3) communications and networks across the organization, (4) previous intervention experiences, and (5) need for change.

Conclusion

Improving our understanding of the barriers and facilitators that may impact the implementation of a healthcare quality improvement intervention is of paramount importance. This study underscores the significance of identifing the barriers and facilitators of implementating an ED quality improvement program and developing strategies to overcome the barriers and enhance the facilitators for a successful implementations. We propose a set of strategies for hospitals when implementing such interventions, these include: staff training, champion selection, communicating the value of the intervention, promoting active engagement of ED staff, assigning data recording responsibilities, and requiring capacity analysis.

Trial registration

ClinicalTrials.gov. NCT04789902. 10/03/2021.