bluuebunny/crossref_metadata_2025 huggingface dataset:
In Science Journals
Authors: Yeston Jake S. , Grocholski Brent , Smith Jesse , Jiang Di , Vignieri Sacha , Scanlon Seth Thomas , VanHook Annalisa M. , Nusinovich Yevgeniya , Maroso Mattia , Hurtley Stella , Suleymanov Yury , Lavine Marc S. , Malo Courtney
Published: August 2024

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NIH director offers support for Asian researchers
Authors: Kaiser Jocelyn
Published: August 2024

Six years into agency’s efforts to curtail foreign interference, some say it should apologize
Surgical management of the diaphragmatic defect in congenital diaphragmatic hernia: a contemporary review
Authors: Jank Marietta , Boettcher Michael , Keijzer Richard
Published: August 2024

Worldwide, 150 children are born each day with congenital diaphragmatic hernia (CDH), a diaphragmatic defect with concomitant abnormal lung development. Patients with CDH with large defects are particularly challenging to treat, have the highest mortality, and are at significant risk of long-term complications. Advances in prenatal and neonatal treatments have improved survival in high-risk patients with CDH, but surgical treatment of large defects lacks standardization. Open repair by an abdominal approach has long been considered the traditional procedure, but the type of defect repair (patch or muscle flap) and patch material (non-absorbable, synthetic or absorbable, biological) remain subjects of debate. Increased experience and improved techniques in minimally invasive surgery (MIS) have expanded selection criteria for thoracoscopic defect repair in cardiopulmonary stable patients with small defects. However, the application of MIS to repair large defects remains controversial due to increased recurrence rates and unknown long-term effects of perioperative hypercapnia and acidosis resulting from capnothorax and reduced ventilation. Current recommendations on the surgical management rely on cohort studies of varying patient numbers and data on the long-term outcomes are sparse. Here, we discuss surgical approaches for diaphragmatic defect repair highlighting advancements, and knowledge gaps in surgical techniques (open surgery and MIS), patch materials and muscle flaps for large defects, as well as procedural adjuncts and management of CDH variants.
Effect of Microwave Roasting on the Physicochemical, Functional, Rheological, and Antioxidant Properties of Kodo Millet Flour
Authors: Singh Dhananjay Kumar , Kurichh Ritesh , Bist Yograj , Kheto Ankan , Kumar Yogesh , Sharma Rajiv , Shikha Deep , Saxena Dharmesh Chandra
Published: August 2024

In this study, Kodo millet grains were roasted in the microwave at 360, 720, and 900 W for 3 and 5 min and pan‐roasted at 195°C for 5 min. The Kodo millet flours (KMFs) were characterized on the basis of physical, functional, pasting, rheological, antioxidant, morphological, and structural properties. After roasting, the bulk density (BD) of all treated samples decreased, while the tap density, Hausner’s ratio, and compressibility index (CI) increased with roasting. Higher microwave power (720 and 900 W) and duration time (5 min) resulted in lower L∗ values and higher a∗ and b∗ values. The roasting in pan and microwave significantly improved the water absorption capacity (WAC) of flour. However, the destruction of hydrophobic functional groups resulted in a significant reduction in the oil absorption capacity (OAC). The pasting and rheological curves confirmed that low power can improve the pasting properties, producing thick pastes. However, the pan and microwave roasting (MWR) at 900 W for 5 min degraded starch and resulted in a flat pasting curve. Scanning electron microscope (SEM) micrographs also confirmed this, showing pore space formation, initiated at a power of 720 W and becoming more noticeable until 900 W, when the structure is destroyed. The X‐ray diffraction (XRD) patterns of all samples suggested a type A crystalline structure, and the degree of crystallinity increased with microwave power, except for the 900 W for 5 min and the pan‐roasted KMF. The antioxidant activity (AOA) of all roasted samples was higher than that of the control sample, except for 900 W for 5 min. Total flavonoid content (TFC) decreased in all KMF compared to the control, except 360 W for 3 min. Furthermore, all microwave‐roasted KMF showed significantly higher total phenolic content (TPC) than control and pan‐roasted KMF. These findings provide valuable information on optimizing the roasting process to improve the nutritional and functional properties of KMF.
Figure 4 from Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun
Published: August 2024

A, MCs promote tumor growth in vivo. Allograft model of the dorsal of tongue of the C3H / HeJ mouse using the squamous cell carcinoma cell line SCC7. B, A larger tumor volume was found in the experimental group compared with the control group at 7, 9, 11, 13, and 15 days. C, Weight of mice inoculated with a mixture of SCC7 and BMMCs was lower than that of mice inoculated with a mixture of SCC7 and PBS at 14 to 16 days. D and E, Mice inoculated with a mixture of SCC7 tumor cells and BMMCs showed a significantly higher volume. F and G, H&E staining identified the development of OSCC, and more CD117 (marker of MCs, P = 0.048), Ki67 (P < 0.001), and pan-CK (P < 0.001) positive cells found in the group inoculated with a mixture of SCC7 and BMMCs, whereas more CD8 positive cells were found in the control group. *, P < 0.05; ***, P < 0.001.
Figure 2 from Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun
Published: August 2024

A, Cox regression analysis of an independent OLK dataset GSE26549 showed that the conversion of the resting to activated MC infiltration increased the risk of malignant transformation to OSCC. B, Cox regression analysis of the OSCC dataset GSE41613 showed that increased activated MC infiltration was associated with poor overall survival and C, cancer-specific survival in OSCC. Cox regression analysis of the TCGA HNSC cohort showed that increased activated MC infiltration was associated with D, poorer overall survival and E, cancer-specific survival in HNSC.
Data from Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun
Published: August 2024

Abstract
The role of mast cell (MC), a common myeloid-derived immune cell, in the development of oral squamous cell carcinoma (OSCC) is unclear. The aim of this study was to investigate MC infiltration in oral precancer and oral cancer. The evaluation of immune cell infiltration and its association with prognosis in OSCC used RNA sequencing and multiple public datasets. Multiplex immunofluorescence was used to explore the infiltration of MC in the microenvironment of OSCC and oral precancer and the interaction with CD8+ cells. The role of MC in OSCC progression was verified by in vivo experiments. The resting MC infiltration was mainly present in oral precancer, whereas activated MC infiltration was significantly higher in OSCC. Activated MC was associated with malignant transformation of oral precancer and poor prognosis of OSCC. In vivo studies showed that MC promoted the growth of OSCC. The infiltration of activated MC was negatively correlated with the infiltration of CD8+ T cells. The subtype of MC containing tryptase without chymase (MCT) was significantly higher in OSCC compared with oral precancer and was associated with poor survival. Furthermore, spatial distance analysis revealed a greater distance between MCT and CD8+ cells, which was also linked to poor prognosis in OSCC. Cox regression analysis showed that MCT could be a potential diagnostic and prognostic biomarker. This study provides new insights into the role of MC in the immune microenvironment of OSCC. It might enhance the immunotherapeutic efficacy of OSCC by developing targeted therapies against MC.
Significance:
In this study, we investigated the role of mast cells (MC) in oral precancer and oral cancer and demonstrated that MCs are involved in oral cancer progression and may serve as a potential diagnostic and prognostic marker. It might improve the immunotherapeutic efficacy through developing targeted therapies against MCs.
Plastic Bronchitis in Noonan Syndrome: Further Evidence Suggesting a Higher Risk of Lymphatic Abnormalities in Individuals Harboring Variants in PTPN11 Residue p.Phe285
Authors: Pires Lucas Vieira Lacerda , Da Cás Eduardo , de Melo Letícia Cole , Nakaie Cleyde Mirian Aversa , Aiello Vera Dermachi , Yamamoto Guilherme Lopes , Honjo Rachel Sayuri , Kim Chong Ae , Bertola Débora Romeo
Published: August 2024

Introduction: Noonan syndrome (NS) is a Mendelian phenotype, member of the RASopathies, a group of clinically overlapping multisystem disorders caused by germline variants in the RAS-MAPK signaling pathway genes. Among the clinical findings in NS, lymphatic abnormalities (LAs) are diagnosed in approximately 30%, mostly in individuals harboring variants in RIT1 and SOS2. This genotype-phenotype correlation is not precise, and recent evidence suggests a higher prevalence of LAs in individuals harboring variants on p.Phe285 residue in PTPN11, the main gene responsible for NS. Case Presentation: Here, we report a novel case of NS harboring the PTPN11:p.Phe285Ser variant that evolved with chylothorax and presented the rare finding of plastic bronchitis, an uncommon and underdiagnosed pulmonary disease, characterized by production of cohesive and branching casts filling the airways. We also provide a review of other individuals with NS and LA harboring variants on Phe285 residue in PTPN11 from our service and from the literature and compared its prevalence with the most commonly affected residue in PTPN11-related NS (p.Asn308), which indicated that variants in the p.Phe285 residue might predispose to LA. Conclusion: We suggest that, when this variant is identified in an individual, clinicians should be warned of a possible higher prevalence of LA and a prompt evaluation should be performed if any clinical signs are noticed.
The Lived Experience of Patients With Chronic Kidney Disease: Insights From DISCOVER CKD
Authors: Pollock Carol , Carrero Juan-Jesus , Kanda Eiichiro , Ofori-Asenso Richard , Palmer Ewelina , Niklasson Anna , Linder Andrew , Woodward Helen , Pentakota Surendra , Garcia Sanchez Juan Jose , Kashihara Naoki , Fishbane Steven , Pecoits-Filho Roberto , Wheeler David C.
Published: August 2024

Introduction: Chronic kidney disease (CKD) can have a profound impact on patients’ lives. However, multinational data on patients’ lived experience with CKD are scarce.

Methods: Individuals from the prospective cohort of DISCOVER CKD (NCT04034992), an observational cohort study, were recruited to participate in one-to-one telephone interviews to explore their lived experience with CKD. A target of 100 participant interviews was planned across four countries (Japan, Spain, the UK, and the USA). These qualitative interviews, lasting ~60–90 min, were conducted in the local language by trained interviewers with specific experience in CKD, between January and June 2023. Transcribed interviews were translated into English for coding and analysis. Data were coded using qualitative research software.

Results: Of the 105 participants interviewed, 103 were included in the final analysis. The average time since CKD diagnosis was 9.5 years, and at least half (50.5%) of participants had CKD Stage 3A or 3B. CKD diagnosis was an emotional experience, driven by worry (n = 29/103; 28.2%) and shock (n = 26/103; 25.2%), and participants often reported feeling inadequately informed. Additional information was frequently sought, either online or via other healthcare providers. The proportion of participants reporting no impacts of CKD on their lives was highest in those with CKD Stage 1 and 2 (64.3%). Conversely, every participant in the CKD Stage 5 on dialysis group reported some impact of CKD on their lives. Across all participants, the most reported impacts were anxiety or depression (37.9%) or ability to sleep (37.9%). The frequency of the reported impacts appeared to increase with disease severity, with the highest rates observed in the dialysis group. In that group, the most frequently reported impact was on the ability to work (80.0%).

Conclusion: Findings from this multinational qualitative study suggest that patients may experience symptoms and signs of disease prior to diagnosis; however, these are often non-specific and may not be directly associated with CKD. Once diagnosed, the burden of CKD can have a diverse, negative impact on various aspects of patients’ lives. This highlights the need for early identification of at-risk individuals, and the importance of early CKD diagnosis and management with guideline-directed therapies to either prevent further deterioration of CKD or slow its progression, thus reducing symptom burden and improving quality of life.
BIM-FM como suporte à gestão de espaços de edificações públicas: uma aplicação de verificação automática de regras
Authors: Teixeira Alessandra , Scheer Sergio
Published: August 2024

La eficiencia en la gestión de los bienes de la administración pública es relevante para promover mejoras en la calidad del presupuesto público. En el ámbito del gobierno brasileño, existe una cantidad importante de propiedades y datos sobre la ocupación de espacios a gestionar y una falta de sistemas de información adecuados. En este contexto, la implementación de tecnologías puede impulsar la gestión hacia la digitalización. La adopción del Building Information Modeling (BIM) promueve la transformación digital en la industria de la construcción. El uso de Facility Management se abrevia con el término BIM-FM. Este artículo aborda BIM-FM para el análisis de ocupación de espacios y tiene como objetivo validar una herramienta de verificación automática de reglas para analizar criterios de ocupación. Se adoptó la Investigación en Ciencias del Diseño (DSR) como método para realizar el trabajo. Para su aplicación se seleccionó un edificio en funcionamiento por la administración pública. El artefacto DSR son las pautas para reproducir el estudio. De los resultados se observaron beneficios en la aplicación de la herramienta, destacando la capacidad de realizar simulaciones para lograr la máxima ocupación optimizada. Se obtuvieron valores de aumento de población o redimensionamiento de área. Asimismo, se identificó la necesidad de revisar los requisitos de dimensionamiento de espacios propuestos por la administración pública. Se demostró que la aplicación es útil para la toma de decisiones de los gestores y que el escenario de sobredimensionamiento de espacios refuta los ideales de contención de costos exigidos por la administración pública.
Virtual Reality study on signage in subway ventilation and emergency exit structures
Authors: Cuperschmid Ana Regina Mizrahy , Nanni Douglas Henrique Dantas
Published: August 2024

Aunque las emergencias que requieren la evacuación del área son raras, pueden llevar a situaciones tensas y caóticas. Considerando esto, las simulaciones de evacuación desempeñan un papel crucial para comprender puntos críticos a lo largo de las rutas de salida y sugerir posibles mejoras. En el contexto de las líneas de metro, hay ocasiones en que es necesario planificar estructuras para Ventilación y Salida de Emergencia (en portugués: VSE - Ventilação e Saída de Emergência) entre las estaciones. El uso de señalización de emergencia es obligatorio, y su finalidad es ayudar a las personas a elegir la ruta más rápida y segura para salir del área. Este estudio tiene como objetivo evaluar y comparar la eficacia de dos propuestas distintas de señalización de salida de emergencia dentro de un proyecto VSE en el sistema de metro de São Paulo, utilizando Realidad Virtual (VR). Las simulaciones realizadas en un ambiente virtual involucraron a participantes voluntarios, divididos en dos grupos, cada uno experimentando propuestas de señalización diferentes. A lo largo de la simulación, se registraron los tiempos de evacuación y se observó el comportamiento de los participantes. Además, se administró un cuestionario para evaluar el perfil, las experiencias, el bienestar de los participantes y la eficacia percibida de la señalización. Los resultados indicaron que los escenarios con señalización de mayor tamaño facilitaron evacuaciones más rápidas de las VSE, sugiriendo que es el escenario más favorable para la seguridad de los usuarios.
Collecting Duct Pro(Renin) Receptor Contributes to Unilateral Ureteral Obstruction–Induced Kidney Injury via Activation of the Intrarenal RAS
Authors: Luo Renfei , Yang Kevin T. , Wang Fei , Zheng Huaqing , Yang Tianxin
Published: August 2024

BACKGROUND:

Although the concept of the intrarenal renin-angiotensin system (RAS) in renal disease is well-described in the literature, the precise pathogenic role and mechanism of this local system have not been directly assessed in the absence of confounding influence from the systemic RAS. The present study used novel mouse models of collecting duct (CD)–specific deletion of (pro)renin receptor (PRR) or renin together with pharmacological inhibition of soluble PRR production to unravel the precise contribution of the intrarenal RAS to renal injury induced by unilateral ureteral obstruction.

METHODS:

We examined the impact of CD-specific deletion of PRR, CD-specific deletion of renin, and S1P (site-1 protease) inhibitor PF429242 treatment on renal fibrosis and inflammation and the indices of the intrarenal RAS in a mouse model of unilateral ureteral obstruction.

RESULTS:

After 3 days of unilateral ureteral obstruction, the indices of the intrarenal RAS including the renal medullary renin content, activity and mRNA expression, and Ang (angiotensin) II content in obstructed kidneys of floxed mice were all increased. That effect was reversed with CD-specific deletion of PRR, CD-specific deletion of renin, and PF429242 treatment, accompanied by consistent improvement in renal fibrosis and inflammation. On the other hand, renal cortical renin levels were unaffected by unilateral ureteral obstruction, irrespective of the genotype. Similar results were obtained via pharmacological inhibition of S1P, the key protease for the generation of soluble PRR.

CONCLUSIONS:

Our results reveal that PRR-dependent/soluble PRR–dependent activation of CD renin represents a key determinant of the intrarenal RAS and, thus, obstruction-induced renal inflammation and fibrosis.
A Machine Learning-Based Prediction of Malaria Occurrence in Kenya
Authors: Muriithi Dennis , Lumumba Victor , Okongo Mark
Published: August 2024

For many years’ malaria has been a health public concern in Kenya as well as many parts of Africa and other parts of the world. The purpose of this study is to develop and evaluate a supervised machine learning model to predict malaria occurrence (final malaria test results) in Kenya. The study investigated twelve predictor variables on the outcome variable (malaria test results), where five machine learning models namely; k-nearest neighbors, support vector machines, random forest, tree bagging, and boosting, were estimated. During the model evaluation, random forest emerged as the best overall model in the classification and prediction of final malaria test results. The model attained a higher classification accuracy of 97.33%, sensitivity of 71.1%, specificity of 98.4%, balanced accuracy of 84.7% and an area under the curve of 98.3%. From the final model, the presence of plasmodium falciparum emerged most important feature, followed by region, endemic zone and anemic level. The feature with the least importance in predicting final malaria test results was having mosquito nets. In conclusion, employing Machine learning algorithms enhances early detection, optimizing resource allocation for interventions, and ultimately reducing the incidence and impact of malaria in the Kenya. The study recommends allocation of resources and funds to areas with the presence of plasmodium falciparum, region susceptible to malaria, endemic zones and anemic prone areas.
Predictive Ability of the Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) in Medical-Surgical Units
Authors: Shirk Heather , Kreider Christy , Bell Theodore , Gervase Suzanne , Buchko Barbara L. , Danford Cynthia A.
Published: August 2024

Background:

Workplace violence persists in health care with nurses reporting physical and verbal abuse from aggressive patients causing emotional stress and lost workdays. The Dynamic Appraisal of Situational Aggression–Inpatient Version (DASA-IV) was developed to measure risk for aggression in patients with behavioral health conditions in psychiatric and emergency department settings. The DASA-IV has not been validated with adult patients admitted to medical-surgical units.

Objective:

To determine whether DASA-IV scores are predictive of aggressive events in adults hospitalized on medical-surgical units.

Methods:

This multisite study used a case-control design. DASA-IV scores and acts of aggression were extracted from the medical record retrospectively to validate the appraisal’s predictability. Receiver operating characteristic (ROC) and area under the curve (AUC) were used to correlate DASA-IV scores with aggressive events.

Results:

DASA-IV assessments (N=156 999; mean [SD] 10.1 [10.7]/patient; range 1-220) were collected from 13 611 patients. Patients were primarily White (86.1%) and female (51.7%). Aggression (n = 509 patients; 3.7%) was significantly associated with older age, male sex, smoking, illicit drug use, and high DASA-IV scores. AUC of the ROC analysis for the DASA-IV showed a 97% probability (95% confidence interval [CI] 0.964-0.977) that an aggressive patient would have a higher score on the DASA-IV than a nonaggressive patient. Binary logistic regression predicted that for every point increase in the DASA-IV, there was a 3.51 (95% CI 3.38-3.63) times increased risk for aggression ( B  = 1.255, SE = 0.18, Wald = 4766.6, P < .001).

Conclusions:

This study is the first to validate use of the DASA-IV in medical-surgical populations, demonstrating predictive ability for aggressive incidents. The DASA-IV can be used successfully in medical-surgical populations for early identification of potential aggression.
A unique technique for thoracoabdominal aortic repair for 10 years: Normothermic iliac perfusion
Authors: Song Jian , Ji Yumeng , Hou Bin , Gao Shiqi , Zhou Chenyu , Cao Fangfang , Qiu Juntao , Yu Cuntao
Published: August 2024

Background

The modality of thoracoabdominal aortic repair (TAAR) is mainly based on left heart bypass (LHB) in western countries, while in our team, it is mainly based on a unique technique, normothermic iliac perfusion, and there is a lack of systematic reports and long-term results. To describe the operative technique and summarize the patient characteristics and outcomes of TAAR with normothermic iliac perfusion in our team in the last decade. Meanwhile, to explore the influence of different previous surgical history on prognosis.

Methods

137 consecutive patients who received TAAR with normothermic iliac perfusionby single surgeon from 2012 to 2022 were retrospectively analyzed. Operative details were described and data were grouped according to previous surgical history. Early operative mortality and adverse events were summarized. Survival over time was estimated by the Kaplan–Meier curve.

Results

The average age of the cohort was 42.39 ± 11.76 years old, 70.07% were male. 63 (46%) patients had no previous surgery, 53 (39%) patients had total arch replacement with frozen elephant trunk (TAR_FET), and 21 (15%) patients had thoracic endovascular aortic repair (TEVAR). Operative mortality was 4.38%, the incidence of early paraplegia was 6.57%, and previous surgery had no significant effect on prognosis ( p = .294). Cumulative survival was 92.1% at 3 years and 90.8% at 5 years.

Conclusions

The normothermic iliac perfusionfor TAAR is feasible regardless of previous surgery, as long as there are no complicating factors. And the early outcomes are satisfactory and the long-term outcomes are reliable.
Linking crises: Connections between climate change and COVID-19 during American, Canadian, Dutch, and Lithuanian national elections (2020-2021)
Authors: van Dooremalen Thijs , Sniečkutė Marija , Gaižauskaitė Inga , Lachance Anne
Published: August 2024

Crisis responses are created in reference to the meanings of other crises. We develop the notion of ‘linking crises’ to capture this phenomenon and apply it to two contemporary global crises: climate change and COVID-19. Concretely, we study four crisis linkage dimensions in American, Canadian, Dutch, and Lithuanian party manifestos for national elections from the pandemic heydays (2020–2021): (1) how often links were drawn; (2) the issues they were related to; (3) the argumentative strategies for making connections; and (4) and the political level on which this occurred. We find many cross-national similarities. For instance, in every country links with economic and environmental issues were very present, an argumentative trope of ‘building back better’ was employed by various political parties, and the majority of the connections were made at supra-national levels. These findings bring up the question of when cross-national parity in crisis responses does (not) occur.
Shielded by Education? The Buffering Role of Education in the Relationships Between Changes in Mental Health and Physical Functioning Through Time Among Older Europeans
Authors: Settels Jason
Published: August 2024

This study investigated among older Europeans how physical function limitations lead to depressive symptoms and reductions in quality of life and well-being, and vice-versa. Further examined was how years of education moderate these relationships. These objectives were pursued using a sample of Europeans aged 50+ years ( N = 46,492) within waves 5 (2013) and 6 (2015) of the Survey of Health, Ageing and Retirement in Europe. The analyses employed conditional change multilevel mixed-effects linear regressions. Mental health was found to affect physical function limitations, and vice-versa. More education significantly reduced only how earlier mental health problems lead to later physical function limitations, plausibly because of the former’s higher controllability. Thus highlighted are education-linked psychosocial resources’ protective effects.
Book review: Heta Pandit (Transl.), Grinding Stories Retold: Songs from Goa
Authors: Jassal Smita Tewari
Published: August 2024

Heta Pandit (Transl.), Grinding Stories Retold: Songs from Goa. The Heritage Network, 2021, 175 pages, ₹900 (Hardback). ISBN: 978-93-5566-083-1.
Exploring the Health Impact of Intersectional Minority Identity Stressors on Arab Sexual Minority Women Migrants to the United States
Authors: Chaudhry Aeysha , Hebert-Beirne Jennifer , Alessi Edward J. , Khuzam Maya Z. , Mitchell Uchechi , Molina Yamile , Wasfie Dhuha , Fox Samara , Abboud Sarah
Published: August 2024

Using an intersectionality lens and the minority stress theory as our theoretical grounding, this qualitative study is the first to examine the mental health of Arab sexual minority women (SMW) migrants to the United States. The study aimed to (1) explore the perceptions and experiences of intersectional minority identity–related life stressors and (2) discern their impact on the mental health of first-generation Arab SMW migrants. From December 2022 to March 2023, we conducted 20 semi-structured interviews with Arab SMW migrants. Guided by principles of community engagement in research, four community advisors, including three Arab SMW migrants and a mental health service provider, assisted in mock interviews, recruitment, and data analysis. This enriched our thematic analysis providing a nuanced understanding of Arab SMW migrant experiences. Participants reflected diverse nationalities, socioeconomic statuses, and religions and identified as lesbian, bisexual, or queer. Our sample included asylum seekers, documented migrants, and non-binary individuals (assigned female at birth). Findings revealed three major themes: (1) Community- and Interpersonal-Level Stressors, (2) Strategies for Coping with Stressors, and (3) Impact of Intersectional Life Stressors on Mental Health. Community- and interpersonal-level stressors included challenges navigating migration-related stressors, rejection and discrimination from the Arab, queer, and dominant-group (i.e., non-Arab, non-White) communities, and experiences of invalidation of their intersectional identities. Coping mechanisms included avoidance, identity concealment, and seeking social support. Participants reported various mental health impacts, from anxiety, depression to suicidal thoughts, emphasizing the urgency for tailored interventions. Participants called for the development of support groups specifically for Arab SMW migrants.
Safety of Phenobarbital Versus Benzodiazepines for Alcohol Withdrawal in Critically Ill Patients With Primary Neurologic Injuries
Authors: Deveau Robert , Wong Adrian , Eche Mary , Yankama Tuyen , Fehnel Corey R.
Published: August 2024

Background:

Alcohol withdrawal syndrome (AWS) is a complication of alcohol use disorder that manifests as a range of symptoms. Symptom-triggered benzodiazepines (BZDs) are often used as first-line treatment of AWS. However, recent literature suggests phenobarbital (PHB) may be safer and more efficacious, but studies are limited by exclusion of patients with neurological injuries.

Objective:

We aimed to evaluate the safety of PHB compared to BZDs for the management of AWS among patients with primary neurologic injuries.

Methods:

Retrospective cohort study of patients with primary neurologic injuries admitted to an ICU who received PHB or symptom-triggered BZD for AWS between December 2013 and February 2020. The primary outcome was incidence of oversedation, defined as Richmond Agitation Sedation Scale (RASS) scores from −5 to −3 within 24 hours of initial PHB or BZD dose. Secondary outcomes included largest decrease in RASS, need for mechanical ventilation, and additional sedative use within 24 hours of initial PHB or BZD dose. A multivariable analysis was performed to evaluate the association of PHB administration with the primary outcome.

Results:

Among 600 patients treated for AWS, 84 patients were included in our analysis (PHB, n = 56; BZD, n = 28). In the unadjusted analysis, there were no differences between the PHB and BZD groups for the primary outcome of oversedation (21.4 vs. 7.1%, P = 0.13), or secondary outcomes of decrease in RASS ( P = 0.34), or new ventilator requirement ( P = 0.55). Patients who received PHB had higher rates of additional sedative use ( P < 0.01). Multivariable regression revealed an increase in oversedation among intubated patients ( P = 0.014), while PHB administration was not independently associated with oversedation ( P = 0.516).

Conclusion and Relevance

Phenobarbital did not independently increase the risk of oversedation compared to BZD for AWS in patients with primary neurologic injuries. Future studies should determine optimal dosing of PHB in this population.
Satisfaction with police and reporting online victimization: The role of immigration status
Authors: Rosenberg Dennis
Published: August 2024

The goal of this study was to test the link between satisfaction with police functioning and the intention to report online victimization to the police while considering the place of birth. Performance theory served as the study's theoretical framework. Data were obtained from the 2020 Israel Social Survey. The sample comprised adult internet users who did not experience online victimization ( N = 3937). The results show a positive association between satisfaction with police performance and the likelihood of intending to report online victimization to this authority. However, this relationship was found to vary in accordance with immigration status. The association was more pronounced in the native-born and pre-1990 immigrant group compared with the post-1990 immigrant group. The results supported performance theory and suggest that the police should act in a more satisfying way to be considered as a primary address for individuals who fall victim to cybercrime, especially members of disadvantaged social groups.
Potential misinformation in large language model descriptions of upper extremity diseases
Authors: Sayegh George E. , Ring David , Jayakumar Prakash
Published: August 2024

When a large language model was prompted to discuss upper extremity conditions and correct instances of misinformation in responses, there was notable persistent misinformation, reinforcement of unhelpful thinking and reduction of independent management of one’s health (agency).
Use of a remote assessment pathway for diagnosis of carpal tunnel syndrome
Authors: Macdonald Katie , Pearson Hugh , Frew Georgina H. , Rust Philippa
Published: August 2024

We undertook a retrospective cohort study of a remote carpal tunnel syndrome assessment pathway created in response to limitations caused by the COVID-19 pandemic. Between July 2020 and September 2021, 702 patients referred from primary care (general practice) were assessed in a nurse-led telephone clinic using the carpal tunnel questionnaire of Kamath and Stothard (2003) . Depending on their questionnaire score, patients were referred either for nerve conduction studies or a consultant hand surgeon review for diagnosis and treatment planning. Questionnaire scores of 3 and above accurately predicted a likely diagnosis of carpal tunnel syndrome in 83% of patients, and a diagnosis was unlikely in 90% of those with a score below 3. The pathway resulted in an estimated cost savings of £24,436 (€28,862, US$30,945) in comparison with the pre-pandemic service. However, some limitations in the pathway may have impacted effective patient management and we suggest possible improvements.

Level of evidence: III
Interdisciplinary Approaches to LGBTQ+ Inclusion in Education: A Qualitative Study from Slovenia
Authors: Ferbežar Nika , Štefanec Vesna , Gavriloski Tretjak Marko , Kopinič Alja
Published: August 2024

Educational institutions are not always adequately equipped to deal independently with the challenges that LGBTQ+ students experience during their studies, necessitating interdisciplinary approaches. The aim of our study was to identify needs and opportunities for interdisciplinary collaboration aimed at addressing issues related to the well-being of LGBTQ+ youth in education. In our qualitative study, we conducted interviews with 27 LGBTQ+ people between the ages of 17 and 41 who are or have been part of the Slovenian education system at some point in their lives. We identified four possible areas where educational institutions have the potential to improve the well-being of LGBTQ+ youth through interdisciplinary interventions: educational climate and representation of LGBTQ+ people, mental health promotion and mental disorder prevention, inclusive sex education, and homelessness among LGBTQ+ youth. We see opportunities for interdisciplinary collaboration between schools and mental health professionals, LGBTQ+ specific non-governmental organizations (NGOs), NGOs addressing LGBTQ+ youth homelessness, and health centers and services. The adversities experienced by LGBTQ+ youth in education are often closely intertwined with their everyday lives, intersectional and thus very complex. The solutions to overcome these challenges should therefore be systemic, pragmatic, and interdisciplinary. For comprehensive discussions on interdisciplinary interventions in education, future studies should also consider the perspectives of educators and other relevant stakeholders.
When to avoid glue injection of varices - A case of radiology guided embolization of bleeding ectopic duodenal varices
Authors: Chan Gemaine Kar Mun , Tan Yi Yuan , Tey Tze Tong , Kumar Rajneesh , Irani Farah Gillan
Published: August 2024

Isolated duodenal variceal hemorrhage is rare and has a high mortality rate, but the diagnosis and treatment can be challenging. We describe a case in which endoscopic variceal injection was deemed too high risk and not feasible due to patient factors of rapid blood flow and an unstable scope position. Eventually, an interventional radiology (IR) based embolization technique, using a combination of coils and glue, was successful in achieving hemostasis. This case presents an alternative strategy for clinicians in managing duodenal variceal bleeding.
Surgical treatment of a Salmonella-related infective native aortic aneurysm: A case report
Authors: Vy Tran Thanh , Bang Ho Tat , Doan Ngoc Tuan Pham , Thuy Tran Thi Mai , Vu Phan Ton Ngoc , Cuong Lam Thao
Published: August 2024

Infective native abdominal aortic aneurysms are a life-threatening condition with a high mortality rate. We report the case of a 53-year-old male patient who presented with abdominal pain and fever. Laboratory results showed an elevated white blood cell count and C-reactive protein levels. Blood cultures detected Salmonella species, and computed tomography revealed a saccular abdominal aortic aneurysm. After 14 days of preoperative antibiotic therapy, the patient underwent a successful surgical bypass from the descending thoracic aorta, through the diaphragm and muscle layers of the anterior abdominal wall, to the bilateral common femoral arteries. The patient was discharged after 30 days of hospitalization and continued antibiotic treatment for another 30 days. Follow-up clinical evaluations and imaging studies showed good recovery and no signs of infection. This case highlights the importance of combining appropriate antibiotic therapy with surgical intervention in managing infective native aortic aneurysms. In particular, an extra-anatomical approach from the descending aorta can be a viable option in selected cases of infected aortic aneurysms, providing an effective means to achieve thorough debridement and prevent future graft infections.
A variant of unknown significance in the COL4A5 gene-related renal disease: A novel case report
Authors: Trinka Teresa , Faizan Mohammed
Published: August 2024

In this case report, we report our findings of a variant of uncertain significance in the COL4A5 gene in four family members. Patient 0 is a 16-year-old female with no prior medical history referred to Pediatric Nephrology for the evaluation of microscopic hematuria. Upon further investigation, she was found to have a family history of both microscopic hematuria and kidney disease, prompting genetic testing and intimation of a possible cause and inheritance pattern for kidney disease and hematuria in the COL4A5 gene.
Comparing Emergency Nursing Measures Before and During COVID-19: A Retrospective Study of Assessment, Triage, and Workflow
Authors: Misan Nofar , Wilf-Miron Rachel , Saban Mor
Published: August 2024

Background

The COVID-19 pandemic significantly impacted emergency department (ED) operations and patient care. Understanding its effects on nursing processes, triage accuracy, and wait times is pivotal for optimizing outcomes.

Objectives

This study aimed to analyze the differences in nursing processes, triage accuracy, and wait times before and during the COVID-19 pandemic.

Design

A retrospective cohort study.

Methods

The study analyzed 224 electronic medical records from a single ED, with 120 records from the pre-pandemic period (January 2019–February 2020) and 104 records from the pandemic period (March 2020–March 2021). Dependent variables included missed nursing care per validated scales, triage accuracy per Emergency Severity Index, and wait times for nursing triage and physician examination. Independent factors encompassed sociodemographic, clinical characteristics, and organization dynamics.

Results

Sociodemographic and clinical profiles were comparable between periods. Triage accuracy remained high except for older patients. Nursing triage wait times differed little, yet physician examination and urgent case waits decreased amidst the pandemic. Nursing documentation completeness, such as recording patient status and mental state, augmented during this crisis period.

Conclusion

This evaluation identified differences in triage accuracy, wait times, and documentation completeness before and during the COVID-19 pandemic period at a single institution. Patient age and clinical status influenced some metrics. Lessons from comparing precrisis benchmarks to intra-pandemic nursing performance may guide pandemic preparedness strategies. Further research is warranted to optimize emergency processes and outcomes during public health emergencies, as well as examine strategies through multicenter investigations comparing prepandemic to intra-pandemic performance to provide broader insights into challenges and inform efforts to bolster emergency care through future crises.
Focused Extracorporeal Shock Wave Therapy for Painful Delayed Union or Nonunion of Fractures of Interphalangeal Coalition
Authors: Shimozono Yoshiharu , Mori Daisuke , Mizuno Yasuyuki , Funakoshi Noboru , Kobayashi Masahiko , Matsuda Shuichi , Yamashita Fumiharu
Published: August 2024

Background:

Interphalangeal coalition is characterized by fusion of interphalangeal joint between the middle and distal phalanges. Interphalangeal coalition fractures often result in delayed union or nonunion. The purpose of this study was to evaluate the results of focused extracorporeal shock wave therapy (ESWT) for painful delayed union or nonunion of fractures of the interphalangeal coalition.

Methods:

The study group consisted of 9 patients (9 feet) diagnosed with painful delayed union or nonunion due to persistent pain and no tendency toward bony union for at least 3 months after the interphalangeal coalition fracture on plain radiographs between 2021 and 2023 were included. The mean age was 51.3 years (23-64). Focused ESWT was performed in all patients. The mean time from the date of injury to the start of ESWT was 16.1 weeks (12-15). ESWT was performed every 2 weeks, with each session consisting of 3000 impulses (0.15-0.25 mJ/mm2). Plain radiographs were used to confirm bone union, and visual analog scale (VAS) scores were used for pain assessment.

Results:

Complete bony union was documented in all 9 patients. The application of focused ESWT was performed a mean of 2.7 times (2-4), and the mean duration from the initiation of treatment to the confirmation of bony union was 7.4 weeks (3.6-12.7). In all cases, the symptoms of swelling and pain were alleviated. The VAS scores exhibited significant improvement, with the mean VAS score decreasing from 3.8 (2-6) before ESWT to 0 after the achievement of union ( P < .001).

Conclusion:

In this small cohort, all patients with painful delayed union or nonunion of fractures at the interphalangeal coalitions achieved complete bony fusion after focused ESWT. Moreover, bony union was observed within 2 months of ESWT initiation. These findings suggest that focused ESWT may be a valuable treatment option for painful delayed union or nonunion of interphalangeal coalition fractures.

Level of Evidence:

Level IV, case series.
Association Between Klotho and Cardiac Abnormalities in Pre-dialysis CKD Patients
Authors: Kumar Manoj , Chaitanya Vinod , Verma Himanshu , Madan Charu , Ansari Anwar Hussain , Sharma Sourabh , Raju Sree Bhushan
Published: August 2024

Introduction

The onset and progression of chronic kidney disease (CKD) are strongly linked to a decrease in Klotho, which was once thought to have an anti-aging effect. The specific mechanism of this enzyme’s connection with CKD and its related co-morbidities has to be investigated further. Present study aimed to test Klotho levels in various phases of CKD and to study their correlation with cardiac morbidity.

Methods

Present study was single-center, observational, cross-sectional study conducted in all genders with age ≥18 years who presented with CKD stages G1-G5 ND. All cases underwent battery of investigations including estimation of serum Klotho & FGF 23 levels along with 2D echocardiography.

Results

Most study participants were found to be in CKD stage G2 (24%) followed by stages G4 and G5 (18% each). On cardiac evaluation, low LVEF was detected in 38% cases, diastolic dysfunction in 44% & LV hypertrophy in 48% cases. There was a negative correlation between serum Klotho levels and LVH ( P = .009), LVEF ( P = .015) or LV diastolic dysfunction ( P = .005). Likewise, there was positive correlation between serum FGF 23 levels and LVH ( P = .0001), LVEF ( P = .0001) or LV diastolic dysfunction ( P = .0001).

Conclusions

With our study, we want to emphasize the prognostic value of Klotho and FGF 23 in routine evaluation of CKD patients. Low serum Klotho & high FGF 23 levels were associated with low left ventricular ejection fraction (LVEF), left ventricular hypertrophy (LVH) and left ventricular dysfunction among CKD patients.
The relationship between lifestyle habits and obesity among students in the Eastern province of Saudi Arabia: using the Arab Teens Lifestyle (ATLS) questionnaire
Authors: Woodman Alexander , Coffey Margaret , Cooper-Ryan Anna-Mary , Jaoua Nizar
Published: August 2024

Background

The Arab Teens Lifestyle (ATLS) questionnaire was an initiative to assess the lifestyle habits influencing obesity rates in the Middle East and North Africa (MENA) region, including physical activity (PA) patterns, sedentary and eating behaviours. Since its implementation, the ATLS questionnaire has been used in several studies among different age groups and populations. This instrument has not previously been administered among the university students of the Eastern Province of Saudi Arabia, where the obesity rates are the highest in the country. This research was the first that aimed to identify lifestyle habits influencing the rates of obesity among 18-25-year-old university students in the Eastern Province of the Kingdom of Saudi Arabia (KSA) using the ATLS questionnaire.

Methods

Quantitative cross-sectional research among n = 426 students of the Eastern Province of Saudi Arabia using the ATLS questionnaire.

Results

Out of n = 426 participants, n = 200 (47%) were categorised (using body mass index) as normal weight; n = 113 (26.5%) were overweight, and n = 73 (17.1%) were obese. The findings showed that most of the nutritional, PA, and sedentary behavioural factors (e.g., screen time) in the questionnaire were not associated with obesity status amongst the participants. In the obese group, more of the males that consumed fruits, French fries, cakes, sweets and doughnuts more than three times per week were likely to be obese, which was not the case for females.

Conclusion

The reported lifestyles of the students could potentially lead to long-term negative health effects, which is of concern given the rising rates of overweight, obesity, and obesity-related non-communicable diseases (NCDs) among the Kingdom’s adult and ageing population. Further studies are recommended to explore the knowledge, attitudes, and perceptions of Saudi students in the Eastern Province in relation to PA, sedentary behaviours, and dietary habits, along with their views on how these can be improved.