bluuebunny/crossref_metadata_2025 huggingface dataset:
Recovery and long-term outcome after neurosurgical closure of spinal CSF leaks in patients with spontaneous intracranial hypotension
Authors: Volz Florian , Fung Christian , Wolf Katharina , Lützen Niklas , Urbach Horst , Kraus Luisa Mona , Omer Mazin , Beck Jürgen , El Rahal Amir
Published: August 2023

Introduction

Spontaneous intracranial hypotension due to a spinal cerebrospinal fluid leak causes orthostatic headaches and impacts quality of life. Successful closure rates are often reported, whereas data on long-term outcome are still scarce.

Methods

Between April 2020 and December 2022 surgically treated patients completed the Headache Impact Test-6 prior to surgery and at 14 days, three months, six months, and 12 months postoperatively. In addition to the Headache Impact Test-6 score, we extracted data related to orthostatic symptoms.

Results

Eighty patients were included. Median Headache Impact Test-6 score preoperatively was 65 (IQR 61–69), indicating severe and disabling impact of headaches. At three months headache impact significantly improved to 49 (IQR 44–58) (p < 0.001) and remained stable up to 12 months (48, IQR 40–56), indicating little to no impact of headaches on quality of life. The need to lie down “always” or “very often” was reduced from 79% to 23% three months postoperatively (p < 0.001).

Conclusions

Surgical closure of spinal CSF leaks significantly improves the impact of headaches in the long term. At least three months should be expected for recovery. Despite permanent closure of the CSF-leak, a quarter of patients still have relevant long-term impairment, indicating the need for further research on its cause and possible treatment.
Evaluation of Driver Comprehension and Compliance of Red-Colored Pavement Markings for Transit Lanes in Portland, Oregon
Authors: McNeil Nathan , Monsere Christopher , Dill Jennifer
Published: August 2023

Many U.S. agencies have experimented with red-colored pavement markings in transit lanes to enhance the message that they are restricted to transit vehicles. This study evaluated nontransit drivers’ comprehension of and compliance with red-colored lane markings in transit priority lanes intended to communicate lane restrictions and appropriate turning and merging locations. Two complementary research methods were used: 1) an online survey of drivers’ comprehension of red-colored pavement markings, and 2) evaluation of video collected at locations pre and post installation of red-colored pavement markings. In the survey, most drivers recognized the red pavement color as a restriction on use, but most did not associate it specifically with transit, or understand the intended meaning of the broken red bar patterns designed to designate a merge area. However, we observed relatively high compliance rates with the transit lane restrictions, and the red pavement coloring was generally associated with improved compliance. Of the 22,803 vehicles observed at these locations, 206 were observed driving in the transit lanes, accounting for a violation rate of 0.9%. For the locations with pre and post data, driving-in-transit-lane violations were either reduced or there was no significant change. For locations with shared turn and transit lanes, between 62% and 76% of drivers merged as intended, and we observed an increase in appropriate merging behavior with the addition of red pavement color.
The Behavioral Inhibition System and Engagement With, and Influence By, COVID-19 and Election-Based Misinformation
Authors: McGarry Presley , Shortland Neil , Anastasio Natalie , Palmieri Michael
Published: August 2023

The negative impact of misinformation on public discourse and public safety is increasingly a focus of attention. From the COVID-19 pandemic to national elections, exposure to misinformation has been linked to conflicting perceptions of social, economic, and political issues, which has been found to lead to polarization, radicalization, and acts of violence at the individual and group level. While a large body of research has emerged examining the development and spread of misinformation, little has been done to examine the human processes of being exposed to, and influenced by, misinformation material online. This article uses reinforcement sensitivity theory to examine the effect of individual differences in the Behavioral Inhibition System (BIS) on the behavioral and cognitive intentions to engage in violence after exposure to misinformation online. Using an online panel sample (Mechanical Turk), and a behavioral study that involved exposure to, and interaction with, misinformation, this study found that trait BIS score impacted how much individuals engaged with misinformation, as well as their ensuing activism and radicalism toward the narratives that were depicted. This study identified that engagement with misinformation impacted intentions for activism and radicalism, as did trait BIS. However, these effects were present for both misinformation and correct information conditions. These findings highlight the importance of BIS-related processes and raise important questions about the degree to which we need to think about online influence as a general process versus specific processes that directly relate to the effect of misinformation.
Intimate Partner Violence Perpetration Among Sexual Minority Young Adults: Associations With Alcohol Use, PTSD Symptoms, Internalized Homophobia, and Heterosexist Discrimination
Authors: Basting Evan J. , Medenblik Alyssa M. , Garner Alisa R. , Sullivan Jacqueline A. , Romero Gloria J. , Shorey Ryan C. , Stuart Gregory L.
Published: August 2023

Lesbian, gay, bisexual, queer, and other sexual minority (LGBQ+) young adults report similar or higher rates of intimate partner violence (IPV) perpetration than their heterosexual peers. Elevated IPV risk among LGBQ+ young adults may be attributable to experiencing heterosexist discrimination and internalized homophobia. In addition, LGBQ+ people report disproportionate posttraumatic stress disorder (PTSD) symptoms, alcohol use, and IPV perpetration in dating relationships. Thus, this study explored which combinations of IPV risk factors (i.e., experiencing heterosexist discrimination, internalized homophobia, PTSD symptoms, alcohol use) related to forms of IPV perpetration, inclusive of psychological, physical, and sexual forms, in a sample of 342 LGBQ+ young adults. Internalized homophobia was related to psychological IPV perpetration at high and medium levels of PTSD symptoms and only high levels of alcohol use. PTSD symptoms and alcohol use interacted to predict psychological IPV perpetration; and PTSD symptoms related to increased psychological IPV perpetration at high and medium, but not low, alcohol use levels. Alcohol use was positively related to physical IPV perpetration. No other risk factors or interactions were significantly related to physical or sexual IPV perpetration. Results were consistent with prior findings that linked internalized homophobia, alcohol use, and PTSD symptoms to IPV perpetration and highlight the interacting nature of these IPV perpetration risk factors. Comprehensive IPV interventions with LGBQ+ young adults should evaluate the impact of simultaneously targeting these multiple IPV risk factors considering their interacting contributions to IPV perpetration risk. More research is needed to examine the temporal relations between minority stress, PTSD symptoms, alcohol use, and IPV perpetration.
Linked Fate and Social Identity: Black and White Women’s Attitudes About Abortion and MeToo
Authors: Kretschmer Kelsy , Stout Christopher , Ruppanner Leah
Published: August 2023

The recent social and political inequalities women face in the United States have raised new questions about how distinct groups of women respond to a changing landscape. Here, we assess how racial and political differences shape women’s social identity as women and its association with support for abortion and the MeToo movement. Using original survey data, we find that for both Black and white women, gender-linked fate—the belief that one’s fate is tied to the well-being of the gender group—is predicted by political ideology and associated with attitudes about abortion and the MeToo movement. In contrast, social identity as a woman—when one feels deeply tied to and represented in a particular gender group—was common across the political spectrum and insignificant in predicting attitudes about these gendered political issues.
Sunn hemp hessian cloth reinforced thermoplastic composites: Effects of chemical treatment and gamma-ray irradiation
Authors: Shohrawardy Mohammed Hossan S , Mina Md Forhad , Alam AKM M , Khan Ruhul Amin
Published: August 2023

Untreated and alkali-treated Sunn hemp hessian cloth-reinforced high-density polyethylene (HDPE) composites were prepared by the compression molding method. The fabricated composites contained 40, 45, 50, 55, 60, and 65wt% fiber contents and were optimized. 55wt% fiber contents reinforced composites showed better mechanical properties. This composite was alkali treated and irradiated under gamma-ray at doses 2.5‒7.5 kGy at the rate of 6 kGy/h. The X-ray diffraction (XRD) result indicates that the crystallinity of the alkali-treated Sunn hemp-reinforced HDPE composites shows a higher value than those of untreated and irradiated composites. Better adhesion between fiber and matrix was observed from surface micrographs. Fourier-transform infrared (FTIR) spectroscopy reveals cross-linking between fiber and matrix. The water intake properties of irradiated composite show more hydrophobic nature than that of untreated and alkali-treated composites. The tensile strength of the gamma-ray irradiated composites are 20% and 33% greater than that of untreated and alkali-treated composites. Similar results are found for Young’s modulus. At a certain dose of 5 kGy, the irradiated composites show improved thermal, mechanical, and structural properties than untreated and alkali-treated composites.
Structural design and cavitation performance research of single-acting sliding vane pump under high rotational speed and petroleum medium
Authors: Zhao Yan , Feng Zi-Ming , Sun Deqing , Liu Qicheng , Sun Yi , Zhang Shuang
Published: August 2023

In order to study the effect of the structural parameters of the sliding vane pump and the cavitation performance of the sliding vane pump, the computational fluid dynamics method was used to numerically simulate the internal flow field of the single-acting sliding vane pump. The calculation results show that the maximum local gas volume fraction of the pump with only one suction cavity and one discharge cavity is 1.54%, which is much lower than the cavitation volume fraction of other pumps, and the negative effect of cavitation is greatly reduced; as the number of the sliding vanes increases, The cavitation area of the sliding vane pump gradually decreases; when the rotor speed is 1500 r/min, the minimum and maximum local gas volume fraction of the sliding vane pump are 1.28% (the number of the sliding vanes is three) and 2.82% (the number of the sliding vanes is 6), respectively; the local gas volume fraction of the sliding vane pump with odd sliding vane is obviously smaller than that of the similar sliding vane pump with even number of sliding vanes, and the more the number of sliding vanes, the higher the gas content of the cavitation area of the sliding vane pump. Appropriately reducing the number of sliding vanes and selecting an odd number of sliding vanes can effectively improve the cavitation performance of the pump.
Midwifery students’ experiences: Violations of dignity during childbirth
Authors: Haseli Arezoo , Khosravi Shahla , Hajimirzaie Saiedeh Sadat , Feli Rozhin , Rasoal Dara
Published: August 2023

Background

The principle of human dignity is woven into the ethical principles of the midwifery profession, noted as both an obligation and a human right.

Research Objectives

The aim of this study is to explore the experiences of midwifery students regarding threats to women's dignity during childbirth.

Research Design

This is a qualitative study with explorative design. Participants and Research Context: The research was carried out in 2022 at Kermanshah University of Medical Sciences, involving 32 midwifery students in individual interviews that lasted between 30 and 90 minutes. These participants aged 21 to 28 years, with an average age of 23.5 years, provided their perspectives on the matter.

Results

Four key themes described the threats to women’s dignity during childbirth: 1) professional incompetence, 2) abuse of power imbalance, 3) caring only for physical and not mental health, and 4) structural issues within the healthcare system. Professional incompetence was characterized by outdated practices and lack of adherence to evidence-based medicine. Abuse of power imbalance was demonstrated in instances where the authoritative position of healthcare providers was misused, thereby disrupting the respectful care that women are entitled to receive. The disproportionate emphasis on physical health over mental health was evidenced by the disregard for mothers' psychological well-being during childbirth. Lastly, systemic structural issues emerged as significant impediments, revealing the need for system-wide changes. Ethical considerations: This study was approved by the Ethics Committee of the Research Deputy at Kermanshah University. Participation was voluntary and the confidentiality were maintained.

Conclusion

The findings underscore the role that unprofessional behavior, ethical lapses in medical practices, and systemic challenges play in undermining maternal dignity during childbirth. These threats necessitate urgent attention and must be adequately addressed in policy development and program implementation to safeguard the dignity of mothers during childbirth.
A Blended Approach to Organizational Learning in Indian Software Industry
Authors: Shukla Ashutosh , Dubey Ashish Mohan , Pandey Sunil Kumar
Published: August 2023

Organizational learning (OL) has been one of the pioneering fields in debating the survival, sustainability and competitive edge of an organization in a dynamic environment. Primarily, it integrates generative learning, the sharing of knowledge, reliance on standard processes on the one hand and experimentation on the other, thereby enabling a culture that fosters co-creation and team learning. Although OL does not restrict itself to knowledge-based firms, software companies have been purposefully chosen in the present study on account of their rich access to a variety of knowledge specific to the different industries they serve, the dynamic environment under which they operate and the periodic upgrading of their technological capabilities. Given these features, it is safe to assume that IT companies are in the best position to explore OL in comparison to firms belonging to other industries. The study attempts to describe OL in software firms in India. The current study adopts a mixed-method approach, where OL is discussed through both quantitative and qualitative lenses, and the findings are triangulated for discussing OL in software firms in India. The research paves a way to focus on building a learning infrastructure and making the learning link tangible as the key requirements to discuss OL in software firms.
The Efficacy of Hospice-In-Place Care Versus Traditional Inpatient Care
Authors: Butler Emily , Hanson Claire , Khan Taaseen , Mwarumba Tuzo , Daniels Derek , Turchan Maxim , Bonnet Kemberlee , Schlundt David , Harper Kelly , Bennett Marc , Charles David
Published: August 2023

Introduction: The hospice-in-place program at Vanderbilt University Medical Center (VUMC) is available to patients and families who elect for hospice benefits and are too unstable to be transported for hospice care. The goal of this study was to assess the satisfaction of family members of patients who died while hospitalized at VUMC and received hospice-in-place compared to the families of patients who did not receive hospice care. Methods: Next-of-kin satisfaction was measured through the administration of qualitative interviews and quantitative questionnaires. Semi-structured interviews were audio-recorded, and transcripts were analyzed using an iterative inductive-deductive approach to develop a conceptual framework. Participants were also asked to respond to a 10-question satisfaction questionnaire. Results: Forty participants were enrolled: 20 next-of-kin of patients who received hospice-in-place and 20 next-of-kin of patients who passed without hospice. Factors influencing satisfaction were organized into a conceptual framework with three categories: individual-level factors, systems-level factors, and modifying factors. For the questionnaires, the hospice-in-place group had a mean satisfaction score of 4.54 (0.76) out of five, while the non-hospice group had a mean score of 4.14 (1.00). A comparison of the two groups’ responses did not show a statistically significant difference ( P = 0.06). Discussion: Quantitative findings of this study showed improved satisfaction but were unable to show a significant difference in satisfaction with hospice-in-place compared to traditional care. Questionnaire results suggest that both types of care yield high satisfaction scores and are successfully supporting patients and families. The conceptual framework also adds to the understanding of end-of-life experiences at VUMC.
Populism and Support for Political Violence in the United States: Assessing the Role of Grievances, Distrust of Political Institutions, Social Change Threat, and Political Illiberalism
Authors: Piazza James A.
Published: August 2023

As populist parties and politicians have grown in prominence in democracies, scholars have turned their attention to the causes, and consequences, of populist attitudes among citizens. Some preliminary research indicates that individuals with populist attitudes are more likely to express support or tolerance for the use of violence to achieve political objectives. In this study, I examine this relationship further by investigating factors that mediate the effect of populism on endorsement of political violence. Using an original survey of more than 1300 subjects in the United States, I evaluate four elements that theoretically mediate the relationship between populism and support for political violence: economic grievances; distrust of political institutions; perception that social and demographic changes in the United States are threatening; and preferences for politically illiberal or nondemocratic rule. I find that the effect of populism on support for political violence is mediated through fear of social/demographic change and preference for illiberal rule but not through economic grievances or distrust of political institutions. Taken together, over 50% of the effect of populism on support for political violence is mediated through heightened anxiety about social and demographic changes in the U.S. and illiberal attitudes.
The Cerebellum and the Motor Cortex: Multiple Networks Controlling Multiple Aspects of Behavior
Authors: Spampinato Danny Adrian , Casula Elias Paolo , Koch Giacomo
Published: August 2023

The cerebellum and its thalamic projections to the primary motor cortex (M1) are well known to play an essential role in executing daily actions. Anatomic investigations in animals and postmortem humans have established the reciprocal connections between these regions; however, how these pathways can shape cortical activity in behavioral contexts and help promote recovery in neuropathological conditions remains not well understood. The present review aims to provide a comprehensive description of these pathways in animals and humans and discuss how novel noninvasive brain stimulation (NIBS) methods can be used to gain a deeper understanding of the cerebellar-M1 connections. In the first section, we focus on recent animal literature that details how information sent from the cerebellum and thalamus is integrated into an broad network of cortical motor neurons. We then discuss how NIBS approaches in humans can be used to reliably assess the connectivity between the cerebellum and M1. Moreover, we provide the latest perspectives on using advanced NIBS approaches to investigate and modulate multiple cerebellar-cortical networks involved in movement behavior and plasticity. Finally, we discuss how these emerging methods have been used in translation research to produce long-lasting modifications of cerebellar-thalamic-M1 to restore cortical activity and motor function in neurologic patients.
A Constrained Factor Mixture Model for Detecting Careless Responses that is Simple to Implement
Authors: Kam Chester Chun Seng , Cheung Shu Fai
Published: August 2023

Using constrained factor mixture models (FMM) for careless response identification is still in its infancy. Existing models have overly restrictive statistical assumptions that do not identify all types of careless respondents. The current paper presents a novel constrained FMM model with more reasonable assumptions that capture both longstring and random careless respondents. We provide a comprehensive comparison of the statistical assumptions between the proposed model and two previous constrained models. The proposed model was evaluated using both real data ( N = 1,455) and statistical simulation. The results showed that the model had a superior fit, stronger convergent validity with other indicators of careless responding, more accurate parameter recovery and more accurate identification of careless respondents when compared to its predecessors. The proposed model does not require additional data collection effort, and thus researchers can routinely use it to control careless responses. We provide user-friendly syntax with detailed explanations online to facilitate its use.
Bipolar disorder: Diagnosis, treatment and future directions
Authors: Lane Natalie M , Smith Daniel J
Published: August 2023

Bipolar disorder is a relatively common mental illness, characterised by recurrent episodes of mania (or hypomania) and major depression, and associated with a significant burden of morbidity and premature mortality. Physicians across all specialities are likely to encounter individuals with the condition within their clinical practice. This short review provides an up-to-date overview of the clinical features, epidemiology, pathophysiology, evidence-based management, prognosis and future directions for treatment and research in bipolar disorder. Aspects of cross-specialty relevance are highlighted, including the physical health burden associated with the condition, and the side effects and safety considerations of medication regimes used in bipolar disorder.
Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video)
Authors: Nakamura Junichi , Ogura Takeshi , Ueno Saori , Okuda Atsushi , Nishioka Nobu , Uba Yuki , Tomita Mitsuki , Bessho Kimi , Hattori Nobuhiro , Nishikawa Hiroki
Published: August 2023

Background:

If the guidewire becomes kinked by the needle, guidewire manipulation may be difficult, and can cause complications such as guidewire shearing or injury during endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS). To overcome this matter, we have previously described a technical tip for preventing guidewire injury, termed ‘liver impaction technique’. However, its technical feasibility has been not reported in the setting of a large patient cohort.

Objectives:

The aim of study was to evaluate the clinical usefulness of the liver impaction technique during EUS-HGS.

Design:

Retrospective, single-center study.

Methods:

This retrospective study included consecutive patients who underwent EUS-HGS between April 2018 and September 2022. The primary outcome of this study was the technical success rate of guidewire insertion using the liver impaction technique.

Results:

A total of 166 patients were enrolled in this study. Initial successful guidewire insertion without using liver impaction technique was obtained in 108 patients (65.1%). Among 58 patients in whom guidewire insertion failed initially, guidewire advancement into the periphery of the bile duct was observed in 32 patients (55.2%) and into a non-interest bile duct branch was observed in 26 patients (44.8%). Liver impaction technique contributed to increasing the technical success rate of guidewire insertion from 65.1% to 95.8%. Overall, adverse events were observed in 12 patients (7.2%; bile peritonitis n = 9, cholangitis n = 3), and these adverse events were Grade I. Among patients who underwent liver impaction technique ( n = 58), adverse events were observed in two patients (3.4%; bile peritonitis). Also, guidewire sharing was not observed in any patients during liver impaction technique.

Conclusions:

In conclusion, the liver impaction technique may be helpful during EUS-HGS to obtain successful guidewire insertion into the biliary tract of interest.
Exceptional response to cetuximab monotherapy after failure of immunotherapy with a checkpoint inhibitor in a patient with metastatic head and neck squamous cell cancer: case report and review of the literature
Authors: Bloomer Chance H. , Gavrila Elena , Burcher Kimberly M. , Kalada John M. , Chang Mark J. , Gebeyehu Rediet R. , Asare Elsabeth , Khoury Lara M. , Kinney Rebecca , Frizzell Bart , Sullivan Christopher A. , Bunch Paul M. , Porosnicu Mercedes
Published: August 2023

Immunotherapy with PD-1 inhibitors monotherapy or combined with chemotherapy comprises the first-line palliative treatment for patients with recurrent or metastatic head and neck squamous cell cancers (R/M HNSCC). The established survival advantage among responders is overshadowed by the high percentage of patients failing the standard PD-1 inhibitor-based treatments. Salvage therapies are direly needed. However, no current standards are available. We present the case of a 65-year-old patient with heavily pretreated laryngeal squamous cell carcinoma who had an exceptional response to cetuximab monotherapy following the failure of immunotherapy with the PD-1 inhibitor nivolumab. We reviewed the literature for other cases of exceptional response to cetuximab, clinical studies investigating the combined or sequential administration of cetuximab and PD-1 inhibitors, and the mechanistic rationale for consideration of cetuximab as a potential salvage treatment after immunotherapy with PD-1 inhibitors. In addition to the specific epidermal growth factor receptor inhibitory effect, cetuximab, as an immunoglobulin G1 isotype, binds NK cells and elicits antibody-dependent cellular toxicity, triggering a domino of immunostimulatory, and immunoinhibitory effects that actually might decrease the cetuximab anticancer efficacy. However, in a tumor microenvironment exposed to previous treatment with a PD-1 inhibitor, the effects of the PD-1 inhibitor followed by cetuximab on innate and adaptative immune response appear to synergize. Specifically, persistent immune checkpoint inhibitors’ consequences may negate downstream immunosuppressive effects of cetuximab caused through PD-1/PD-L1 upregulation, making it a more potent treatment option. Besides the potential synergistic effect on antitumor immune response with previous immune checkpoint inhibitors therapy, cetuximab is the only targeted agent approved for treating R/M HNSCC, making it a most advantageous candidate for further treatment validation studies as salvage treatment post-immunotherapy.
Fluorescence-based Evaluation of the Efficacy of Augmented Reality-assisted Toothbrush on Oral Hygiene Practices Among 6–8 Years Old Children
Authors: Dey S , Deshmukh S , Umamaheshwari S  , Dheeraj L  , Sinchan HG
Published: August 2023

Aim:

Effective toothbrushing is the most simple way to maintain a child’s oral hygiene for a cavity-free mouth. Yet, most children find it an uninteresting task and they fail to understand its scientific basis. Augmented reality (A-R)-assisted toothbrushes for pediatric population are commercially available to make toothbrushing interactive, interesting, and educative for the child, aided by gamification providing an interactive videogame platform between the real and the virtual world. The aim of the study was to evaluate the efficacy of A-R-assisted brushing experience of children with respect to fluorescence imaging data and plaque Streptococcus mutans count at clinical and microbiological levels, respectively.

Materials and Methods:

A total of 32 children in the age group of 6-8 years were included and allocated in two study groups (A-R-assisted toothbrushing and manual toothbrushing). Fluorescence-based lesion area scoring was done using FC, Duerr Dental, Vistaproof, Germany. Microbiological analysis of plaque Streptococcus mutans was done to evaluate change in bacterial count. The parameters were recorded again after two weeks. Pre- and post-intervention scores were subjected to statistical analysis.

Results:

Significantly higher reduction of fluorescent scores and mean bacterial count were found in A-R-assisted tooth-brushing group when compared to that of manual toothbrushing.

Conclusion:

Based on the findings of the study, A-R-assisted toothbrushing proves to be an effective tool for motivating and maintaining oral hygiene among children and efforts should be made in incorporating this practice in daily domestic healthcare.
Epidemiology of Acute and Overuse Injuries in Underwater Rugby
Authors: Lutter Christoph , Gräber Sina , Jones Gareth , Groß Justus , Tadda Lukas , Tischer Thomas
Published: August 2023

Background:

Underwater rugby (UWR) is a team sport. Athletes require a high degree of strength, endurance, speed, and coordination involving intense physical contact. Currently, a paucity of literature exists regarding injury occurrence in UWR.

Purpose:

To examine the nature and prevalence of acute and overuse injuries in UWR.

Study Design:

Descriptive epidemiology study.

Methods:

Between November 2020 and March 2021, a total of 720 German UWR athletes were invited to take an online survey developed by orthopaedic specialists with UWR athletes. Data were recorded regarding general and health-related information, training habits, acute injuries that necessitated an interruption in training and/or doctor consultation, as well as overuse injuries. Overuse injuries were evaluated using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire. Statistical analyses included t tests or rank sum tests depending on normality of distribution. A nonparametric Kruskal-Wallis 1-way analysis of variance on ranks was used for nonnormally distributed data among several groups.

Results:

This study included 161 active athletes (mean ± SD, 36.1 ± 11.9 years old; 75.3% male) for analysis, of whom 90.1% were competing regularly. The performance-level distribution was as follows: first German national league (n = 73), second German national league (n = 46), state league (n = 17), district league (n = 1), and no league (n = 24). The mean ± SD sport-specific training workload was 5.6 ± 3.0 h/wk, including UWR training, additional swimming (n = 71; 44.1%), strength (n = 70; 43.5%), and/or endurance training (n = 102; 63.4%). Acute injuries were recorded in 78.9% of all athletes. The most typical locations for acute injuries were hand/finger (42.4%), head/face (concussion, ruptured eardrum; 18.1%), wrist (5.5%), or spine (5.0%). Overuse injuries were reported by 42.9% of the participants. The predominant locations for overuse injuries were hand/finger (18.8%), shoulder/clavicle (14.1%), spine and wrist (10.7% each), head/face (8.7%), and ankle joint and knee (6.7% each).

Conclusion:

In the current study, 3 of 4 athletes reported at least 1 acute injury, and 2 of 5 athletes reported at least 1 overuse injury. Leading injury regions were the hand/finger, head/ear, wrist, and spine.
Analysis of the vibrational characteristics of diamane nanosheet based on the Kirchhoff plate model and atomistic simulations
Authors: Zheng Zhuoqun , Deng Fengyu , Su Zhu , Zhan Haifei , Wang Lifeng
Published: August 2023

Single layer diamond—diamane, has been reported with excellent mechanical properties. In this work, molecular dynamics (MD) simulation and Kirchhoff plate model are utilized to investigate the vibrational characteristics of diamane sheets. The mechanical parameters of diamane sheets, including bending stiffness, Young’s modulus, Poisson’s ratio and coefficient of thermal expansion, are calibrated by using MD simulations. The natural frequencies and corresponding modal shapes of the diamane sheets predicted by the Kirchhoff plate model agree well with that obtained from the MD simulations. It is found that the edges exert marginal effect on the modal shapes when free boundary conditions are applied. Additionally, the Kirchhoff plate model considering the thermal expansion provides reasonable prediction for the natural frequencies of the diamane sheets with all boundary clamped under varying temperatures. This study offers valuable insights into the vibrational properties of diamane sheets, from both a simulation and theoretical standpoint. The findings would be beneficial for the design of nanoscale mechanical resonators utilizing these novel carbon materials.
scSNPdemux: a sensitive demultiplexing pipeline using single nucleotide polymorphisms for improved pooled single-cell RNA sequencing analysis
Authors: Wong John K. L. , Jassowicz Lena , Herold-Mende Christel , Seiffert Martina , Mallm Jan-Philipp , Lichter Peter , Zapatka Marc
Published: August 2023

Background

Here we present scSNPdemux, a sample demultiplexing pipeline for single-cell RNA sequencing data using natural genetic variations in humans. The pipeline requires alignment files from Cell Ranger (10× Genomics), a population SNP database and genotyped single nucleotide polymorphisms (SNPs) per sample. The tool works on sparse genotyping data in VCF format for sample identification.

Results

The pipeline was tested on both single-cell and single-nuclei based RNA sequencing datasets and showed superior demultiplexing performance over the lipid-based CellPlex and Multi-seq sample multiplexing technique which incurs additional single cell library preparation steps. Specifically, our pipeline demonstrated superior sensitivity and specificity in cell-identity assignment over CellPlex, especially on immune cell types with low RNA content.

Conclusions

We designed a streamlined pipeline for single-cell sample demultiplexing, aiming to overcome common problems in multiplexing samples using single cell libraries which might affect data quality and can be costly.
Rapid neck elongation in Sauropterygia (Reptilia: Diapsida) revealed by a new basal pachypleurosaur from the Lower Triassic of China
Authors: Liu Qi-Ling , Cheng Long , Stubbs Thomas L. , Moon Benjamin C. , Benton Michael J. , Yan Chun-Bo , Tian Li
Published: August 2023

Neck elongation has appeared independently in several tetrapod groups, including giraffes and sauropod dinosaurs on land, birds and pterosaurs in the air, and sauropterygians (plesiosaurs and relatives) in the oceans. Long necks arose in Early Triassic sauropterygians, but the nature and rate of that elongation has not been documented. Here, we report a new species of pachypleurosaurid sauropterygian, Chusaurus xiangensis gen. et sp. nov., based on two new specimens from the Early Triassic Nanzhang-Yuan’an Fauna in the South China Block. The new species shows key features of its Middle Triassic relatives, but has a relatively short neck, measuring 0.48 of the trunk length, compared to > 0.8 from the Middle Triassic onwards. Comparative phylogenetic analysis shows that neck elongation occurred rapidly in all Triassic eosauropterygian lineages, probably driven by feeding pressure in a time of rapid re-establishment of new kinds of marine ecosystems.
Quick adaptation of the organisation of general practices during the COVID-19 pandemic in the Netherlands
Authors: Groenewegen Peter P. , van den Muijsenbergh Maria , Batenburg Ronald , Van Poel Esther , van den Broek Stijn , Bussche Pierre Vanden , Willems Sara
Published: August 2023

Background

General practices have adapted the practice organisation to the circumstances of the COVID-19 pandemic. In this article we describe several adjustments in general practices in the field of patient flow management, appointments, triage, referral and infection prevention. We also examined how practices relate to the policy of the government and of the professional organisations during the pandemic.

Methods

A cross-sectional online survey was conducted among a sample of 893 general practitioners (GPs) during February and March 2021. The response rate was 17%. Because the questionnaire concerns practices and not individual GPs, one practice owner per practice received an invitation with a link to the online questionnaire. One reminder has been sent.

Results

General practices adapted their organisation during the corona pandemic, partly based on information and advice from their professional organisations. The adjustments were necessary to ensure that patient care continued as much and as safely as possible, often remotely. The use of video consultations quickly increased from 6% to 65% of the practices. The cooperation with neighbouring practices improved and practices felt supported by the professional organisations.

Conclusions

The pandemic itself, remote care and stricter patient flow management have put pressure on the quality of care and patient safety. The accessibility of the practices was sometimes limited. In the perception of patients, this was stronger than in reality.
Associations between cadmium exposure and whole-body aging: mediation analysis in the NHANES
Authors: Zhang Ya , Liu Mingjiang , Xie Ruijie
Published: August 2023

Introduction

Even though cadmium (Cd) exposure and cellular senescence (telomere length) have been linked in previous studies, composite molecular aging biomarkers are more significant and reliable factors to consider when examining the connection between metal exposure and health outcomes. The purpose of this research was to assess the association between urinary cadmium (U-Cd) and whole-body aging (phenotypic age).

Methods

Phenotypic age was calculated from chronological age and 9 molecular biomarkers. Multivariate linear regression models, subgroup analysis, and smoothing curve fitting were used to explore the linear and nonlinear relationship between U-Cd and phenotypic age. Mediation analysis was performed to explore the mediating effect of U-Cd on the association between smoking and phenotypic age.

Results

This study included 10,083 participants with a mean chronological age and a mean phenotypic age of 42.24 years and 42.34 years, respectively. In the fully adjusted model, there was a positive relationship between U-Cd and phenotypic age [2.13 years per 1 ng/g U-Cd, (1.67, 2.58)]. This association differed by sex, age, and smoking subgroups (P for interaction < 0.05). U-Cd mediated a positive association between serum cotinine and phenotypic age, mediating a proportion of 23.2%.

Conclusions

Our results suggest that high levels of Cd exposure are associated with whole-body aging.
Association of blood total immunoglobulin E and eosinophils with radiological features of bronchiectasis
Authors: Ren Jiaqi , Chen Ai , Wang Jun , Chang Chun , Wang Juan , Sun Lina , Sun Yongchang
Published: August 2023

Background

Our study aimed to investigate whether serum total IgE and blood eosinophils were associated with radiological features of bronchiectasis in a Chinese cohort.

Methods

We retrospectively enrolled bronchiectasis patients who visited Peking University Third Hospital from Jan 1st, 2012 to Oct 7th, 2021. The clinical, laboratory and chest CT characteristics were analyzed in association with serum total IgE level and blood eosinophil count.

Results

A total of 125 bronchiectasis patients were enrolled, with 50.4% (63/125) female, and a mean age of 62.4 ± 14.1 years. The median serum total IgE level and blood eosinophil count were 47.7 (19.8, 123.0) KU/L and 140 (90, 230) cells/µl, respectively. In patients with a higher than normal (normal range, 0–60 KU/L) total IgE (43.2%, n = 54), more lobes were involved [4 (3, 5) vs. 3 (2, 4), p = 0.008], and mucus plugs were more common (25.9% vs. 9.9%, p =0.017) on HRCT, as compared to those with a normal level of total IgE. The higher IgE group was more likely to have bilateral involvement (p = 0.059), and had numerically higher Smith and Bhalla scores, but the differences were not statistically significant. In patients with an eosinophil count ≥ 150 cells/µl (49.6%, n = 62), the number of lobes involved was greater [4 (3, 5) vs. 3 (2, 4), p = 0.015], and the Smith and Bhalla scores were higher [9 (5, 12) vs. 6 (3, 9), p = 0.009, 7 (5, 11) vs. 5 (3, 9), p = 0.036]. The Smith score was correlated positively with the eosinophil count (r = 0.207, p = 0.020). Fractional exhaled nitric oxide (FeNO) was correlated with total IgE (r = 0.404, p = 0.001) and eosinophil count (r = 0.310, p = 0.014).

Conclusions

Our study demonstrated that serum total IgE and the blood eosinophil count were associated with the radiological extent and severity of bronchiectasis, necessitating further investigation on the role of T2 inflammation in structural abnormalities of this heterogeneous disease.
Cost-effectiveness analysis of Smart Triage, a data-driven pediatric sepsis triage platform in Eastern Uganda
Authors: Li Edmond C. K. , Tagoola Abner , Komugisha Clare , Nabweteme Annette Mary , Pillay Yashodani , Ansermino J. Mark , Khowaja Asif R.
Published: August 2023

Background

Sepsis, characterized by organ dysfunction due to presumed or proven infection, has a case-fatality over 20% in severe cases in low-and-middle income countries. Early diagnosis and treatment have proven benefits, prompting our implementation of Smart Triage at Jinja Regional Referral Hospital in Uganda, a program that expedites treatment through a data-driven triage platform. We conducted a cost-effectiveness analysis of Smart Triage to explore its impact on patients and inform multicenter scale up.

Methods

The parent clinical trial for Smart Triage was pre-post in design, using the proportion of children receiving sepsis treatment within one hour as the primary outcome, a measure linked to mortality benefit in existing literature. We used a decision-analytic model with Monte Carlo simulation to calculate the cost per year-of-life-lost (YLL) averted of Smart Triage from societal, government, and patient perspectives. Healthcare utilization and lost work for seven days post-discharge were translated into costs and productivity losses via secondary linkage data.

Results

In 2021 United States dollars, Smart Triage requires an annuitized program cost of only $0.05 per child, but results in $15.32 saved per YLL averted. At a willingness-to-pay threshold of only $3 per YLL averted, well below published cost-effectiveness threshold estimates for Uganda, Smart Triage approaches 100% probability of cost-effectiveness over the baseline manual triage system. This cost-effectiveness was observed from societal, government, and patient perspectives. The cost-effectiveness observed was driven by a reduction in admission that, while explainable by an improved triage mechanism, may also be partially attributable to changes in healthcare utilization influenced by the coronavirus pandemic. However, Smart Triage remains cost-effective in sensitivity analyses introducing a penalty factor of up to 50% in the reduction in admission.

Conclusion

Smart Triage’s ability to both save costs and avert YLLs indicates that patients benefit both economically and clinically, while its high probability of cost-effectiveness strongly supports multicenter scale up. Areas for further research include the incorporation of years lived with disability when sepsis disability weights in low-resource settings become available and analyzing budget impact during multicenter scale up.

Trial registration

NCT04304235 (registered on 11/03/2020, clinicaltrials.gov).
A novel phage carrying capsule depolymerase effectively relieves pneumonia caused by multidrug-resistant Klebsiella aerogenes
Authors: Cui Xiaohu , Du Bing , Feng Junxia , Feng Yanling , Fan Zheng , Chen Jinfeng , Cui Jinghua , Gan Lin , Fu Tongtong , Tian Ziyan , Zhang Rui , Yan Chao , Zhao Hanqing , Xu Wenjian , Xu Ziying , Yu Zihui , Ding Zanbo , Li Zhoufei , Chen Yujie , Xue Guanhua , Yuan Jing
Published: August 2023

Background

Klebsiella aerogenes can cause ventilator-associated pneumonia by forming biofilms, and it is frequently associated with multidrug resistance. Phages are good antibiotic alternatives with unique advantages. There has been a lack of phage therapeutic explorations, kinetic studies, and interaction mechanism research targeting K. aerogenes.

Methods

Plaque assay, transmission electron microscopy and whole-genome sequencing were used to determine the biology, morphology, and genomic characteristics of the phage. A mouse pneumonia model was constructed by intratracheal/endobronchial delivery of K. aerogenes to assess the therapeutic effect of phage in vivo. Bioinformatics analysis and a prokaryotic protein expression system were used to predict and identify a novel capsule depolymerase. Confocal laser scanning microscopy, Galleria mellonella larvae infection models and other experiments were performed to clarify the function of the capsule depolymerase.

Results

A novel lytic phage (pK4-26) was isolated from hospital sewage. It was typical of the Podoviridae family and exhibited serotype specificity, high lytic activity, and high environmental adaptability. The whole genome is 40,234 bp in length and contains 49 coding domain sequences. Genomic data show that the phage does not carry antibiotic resistance, virulence, or lysogenic genes. The phage effectively lysed K. aerogenes in vivo, reducing mortality and alleviating pneumonia without promoting obvious side effects. A novel phage-derived depolymerase was predicted and proven to be able to digest the capsule, remove biofilms, reduce bacterial virulence, and sensitize the bacteria to serum killing.

Conclusions

The phage pK4-26 is a good antibiotic alternative and can effectively relieve pneumonia caused by multidrug-resistant K. aerogenes. It carries a depolymerase that removes biofilms, reduces virulence, and improves intrinsic immune sensitivity.