bluuebunny/crossref_metadata_2025 huggingface dataset:
“The Sense of Wonder”: Gaming Capital and Nostalgia for Inexperience in Magic: The Gathering
Authors: Medlock Kyle W.
Published: February 2024

Popular culture media is a potent wellspring of nostalgia. From remakes and revivifications to perpetual production, aesthetics of nostalgia are commonplace among fan communities who continually encounter and experience both collective and personal pasts during engagement. Existing research has overlooked the role that fans’ gaming capital holds in the emergence of nostalgia, especially in leisure communities such as the trading card game, Magic: The Gathering. Drawing from qualitative interviews with Magic: The Gathering players in Australia, this paper applies the theory of gaming capital to illustrate how the continual acquisition of knowledge ultimately results in nostalgic attachment to times in which one knew very little. While the experience and knowledge gained by transitioning from novice to adept is seen positively, this paper argues it is nonetheless permeated by a pervading sense of loss. Paradoxically, gaming capital bifurcates into a parallel stream of value, specifically nostalgia for lost wonder and inexperience.
Cadence as a Behavioral Target in Physical Activity Interventions: A Narrative Review
Authors: Jake-Schoffman Danielle E. , White T. Isaac , Lavoie Hannah A. , Monroe Courtney M. , Christou Demetra D.
Published: February 2024

Behavioral interventions targeting moderate- to vigorous-intensity physical activity (MVPA) to ensure health benefits can be strengthened by a simple metric that helps adults understand if they are exercising at the target intensity. Laboratory studies have established that a cadence of 100 steps/min is equivalent to MVPA, but intervention application is largely unexplored. The aim of this narrative review was to describe how cadence has been implemented in behavioral interventions. PubMed, PsychInfo, and SCOPUS were searched with a standardized search string. Studies were included if peer-reviewed interventions reporting on targeting MVPA increases for adults through cadence or if non-intervention programs directly targeting cadence. Of 232 unique studies identified, 6 were included in the final sample. Cadence was monitored using subjective cues (n = 3), time-oriented goals (n = 2), step-counting (n = 2), auditory cues (n = 2), and visual cues (n = 2), and measured by pedometers (n = 5) or mp3 player (n = 1). No studies reported detailed participant instructions to teach cadence. Results suggest that use of cadence in behavioral interventions is feasible but nascent. Reviewed studies provided insufficient detail to replicate methods and there was no consensus on best practices for implementing cadence. Results point to the potential utility of cadence and offer approaches for future refinement and standardization.
Comprehensive research and analysis on obstacle–singularity–joint limit avoidance of redundant robot
Authors: Li Yu , Wang Liang
Published: February 2024

Redundant robots can complete other tasks while performing main task and have excellent motion performance. Although redundant robots have redundancy characteristics, they may still fall into singular configuration or cannot overcome joint limits due to the limitation of their own structure and motion law. Besides, currently, most of the research mainly focus on obstacle avoidance at the end of the robot. So comprehensive study is conducted on avoidance of obstacle, singularity, and joint limit of redundant robot. Firstly, the kinematics model of robot is obtained by D-H matrix method. Space vector distance method is proposed to calculate the position relationship between robot and obstacle, and potential function is constructed. Based on gradient projection method, using the damped generalized inverse and the weighted norm method, the mathematical models of obstacle avoidance, singularity avoidance, and joint limit avoidance are constructed. The simulation results show that the robot can avoid the obstacle in three-dimensional redundant space. At the same time, manipulability and minimum singular value of the robot are always positive. After adding the function of avoiding joint limit, during the whole control process, the motion range of joint angle is reduced and the angular velocity is relatively small, which ensure the motion stability of robot. Namely, the singular configuration and joint limit of robot are avoided. The research is of great significance for practical application of redundant robot.
The incidence, pathogenesis, and management of non-clear cell renal cell carcinoma
Authors: Naik Priyanka , Dudipala Harshitha , Chen Yu-Wei , Rose Brent , Bagrodia Aditya , McKay Rana R.
Published: February 2024

Renal cell carcinoma (RCC) is the most common type of kidney cancer and is divided into two distinct subtypes, clear cell renal cell carcinoma (ccRCC) and non-clear cell renal cell carcinoma (nccRCC). Although many treatments exist for RCC, these are largely based on clinical trials performed in ccRCC and there are limited studies on the management of nccRCC. Non-clear cell RCC consists of multiple histological subtypes: papillary, chromophobe, translocation, medullary, collecting duct, unclassified, and other rare histologies. Due to variations in pathogenesis and therapeutic response, therapy should be tailored to specific variant histologies. For patients with localized nccRCC, surgical resection remains the gold standard. In the metastatic setting, the standard of care has yet to be clearly defined, and most guidelines recommend clinical trial participation. General therapeutic options include immunotherapy, either as monotherapy or in combination, targeted therapies such as vascular endothelial growth factor tyrosine kinase inhibitors and MET inhibitors, and chemotherapy in certain subtypes. Here we present a review of the incidence and pathogenesis of the various subtypes, as well as available clinical data to support therapeutic recommendations for these subtypes. We also highlight currently available clinical trials in nccRCC and future directions in investigating novel treatment modalities tailored to patients with variant histology.
MR-based Bony 3D models enable radiation-free preoperative patient-specific analysis and 3D printing for SCFE patients
Authors: Lerch Till D , Kaim Tilman , Grob Valentin , Hanke Markus , Schmaranzer Florian , Steppacher Simon D , Busch Jasmin D , Ziebarth Kai
Published: February 2024

Objectives:

Slipped capital femoral epiphyses (SCFE) is a common pediatric hip disease with the risk of osteoarthritis and impingement deformities, and 3D models could be useful for patient-specific analysis. Therefore, magnetic resonance imaging (MRI) bone segmentation and feasibility of 3D printing and of 3D ROM simulation using MRI-based 3D models were investigated.

Methods:

A retrospective study involving 22 symptomatic patients (22 hips) with SCFE was performed. All patients underwent preoperative hip MR with pelvic coronal high-resolution images (T1 images). Slice thickness was 0.8–1.2 mm. Mean age was 12 ± 2 years (59% male patients). All patients underwent surgical treatment. Semi-automatic MRI-based bone segmentation with manual corrections and 3D printing of plastic 3D models was performed. Virtual 3D models were tested for computer-assisted 3D ROM simulation of patients with knee images and were compared to asymptomatic contralateral hips with unilateral SCFE (15 hips, control group).

Results:

MRI-based bone segmentation was feasible (all patients, 100%, in 4.5 h, mean 272 ± 52 min). Three-dimensional printing of plastic 3D models was feasible (all patients, 100%) and was considered helpful for deformity analysis by the treating surgeons for severe and moderate SCFE. Three-dimensional ROM simulation showed significantly (p < 0.001) decreased flexion (48 ± 40°) and IR in 90° of flexion (–14 ± 21°, IRF-90°) for severe SCFE patients with MRI compared to control group (122 ± 9° and 36 ± 11°). Slip angle improved significantly (p < 0.001) from preoperative 54 ± 15° to postoperative 4 ± 2°.

Conclusion:

MRI-based 3D models were feasible for SCFE patients. Three-dimensional models could be useful for severe SCFE patients for preoperative 3D printing and deformity analysis and for ROM simulation. This could aid for patient-specific diagnosis, treatment decisions, and preoperative planning. MRI-based 3D models are radiation-free and could be used instead of CT-based 3D models in the future.
Transaction Costs for Delivering HIV&AIDS Prevention Services in Uganda
Authors: Khanakwa Sarah , Mbonigaba Josue
Published: February 2024

The dwindling international funding for HIV&AIDS, limited domestic resources and the growing need for HIV&AIDS services in low-income countries make the cost-minimization of HIV&AIDS services essential to address the shortage of funds. Previous HIV/AIDS studies have addressed the budget constraints using quantitative methods in economic evaluation. Transaction cost analysis in HIV&AIDS service implementation—guided by the Transaction cost economics (TCE) theory sources of costs— asset specificity, service measurability, and opportunism—have not been sufficiently analyzed in the literature, nor have qualitative approaches been applied. Guided by TCE theory, this study (1) characterized transaction complexity levels needed in HIV&AIDS prevention services to safeguard asset specificity and services measurability and avoid opportunism in Uganda, (2) compared the relative transaction costs across three modes of HIV&AIDS prevention services, and (3) assessed whether the HIV&AIDS prevention services mode with the least transactions costs matched the proposition of the transaction (TCE) theory to guide HIV&AIDS transactions design. Data was collected from October to December 2020 from three dominant HIV&AIDS prevention services modes in Rakai, Lira and Mukono in Uganda. These modes were: (1) “ Public sector provision” mode, (2) Community-led HIV&AIDS Initiative—CHAI mode, and (3) Determined, Resilient, Empowered, AIDS-free, Mentored and Safe—DREAMS mode. These modes corresponded to respective TCE theory provision mode constructs: “ Internal integration,”“ Partnership,” and “ Contracting out.” In each HIV& AIDS prevention services mode, the study conducted key informant interviews, a review of documents, and a focus group discussion. Transaction cost data were analyzed across the three modes based on TCE theory’s sources of transaction costs ( aspect specify, service measurability and opportunism). Safeguarding asset specificity and services measurability in Uganda required transactions characterized by mixed-level complexity whilst avoiding opportunism required transactions characterized by high-level complexity. Based on these transaction characteristics requirements, the “ partnership” (CHAI) was HIV&AIDS prevention service mode most matching the TCE theory for cost minimization in Uganda. The evidence further suggested that CHAI had the least complex transactions to safeguard asset specificity, deal with HIV&AIDS service measurability, avoid opportunism, and hence the lowest transaction cost levels. The “ partnership” (CHAI) was the least costly in dealing with asset specificity, service measurability and opportunism in Uganda and was the most aligned with the proposition of the TCE theory. The findings imply that the TCE theory can be used to guide HIV&AIDS prevention services provision in Uganda.
Financial Inclusion and Economic Growth: Comparative Panel Evidence from Developed and Developing Asian Countries
Authors: Hussain Shahzad , Rehman Ajid ur , Ullah Sabeeh , Waheed Abdul , Hassan Shoaib
Published: February 2024

We investigate the empirical nexus between financial inclusion and economic growth for an extended sample of 21 Asian countries spanning over a period from 2004 to 2019. Further, we also conducted a sub-sample analysis by dividing the overall samples into developed and developing countries. Our results reveal a significant positive long-term impact of financial inclusion on economic growth in Asia. Our pair-wise causality test shows bidirectional causality between financial inclusion and economic development. Our robust results are consistent across various estimation techniques. Our findings suggest that the influence of financial inclusion on economic growth is more pronounced in developing countries compared to developed countries. Our results hold across subsamples. These findings posit important policy insights to enable the policy-makers in designing policies that ensure efficient and inclusive financial system on an equitable basis to achieve sustainable economic growth.

JEL classification: O16; O57; C38; C33
Egyptian Journalists’ Perceptions of Digital Journalism Training Effectiveness
Authors: Fahmy Nagwa , Abdulmajeed Attia Maha
Published: February 2024

This study examines the perceptions of Egyptian journalists of the effectiveness of professional training in digital journalism and determines the training-needs of journalists to adapt to innovative journalism practices. The study applies mixed descriptive methods based on The Motivation–Hygiene theory of what motivates employees. Data analysis is based on an online questionnaire with a snowball sample of 134 Egyptian journalists from different media outlets and in-depth interviews with 10 journalists and professional trainers, between June 2019 and August 2020. Findings reveal that the impact of hygiene factors is stronger than that of motivation factors. This study shows that hygiene factors negatively influence professional training and inhibit any positive impacts of motivation factors. The findings of this study are significant to media organizations and professional training providers.
Perceived Institutional Environment and Entrepreneurial Behavior: The Mediating Role of Risk-Taking Propensity and Moderating Role of Human Capital Factors
Authors: Zhuang Jiahao , Sun Hongyi
Published: February 2024

With an emphasis on combining individual and environmental factors in entrepreneurship, this study aims to explore the relationship between the perception of the institutional environment, risk-taking propensity, and start-up readiness by drawing on the institutional theory and human capital theory. This study collected data online and finally got 580 respondents aged 18 to 40. Through SmartPLS software, results reveal that perceived regulatory and cognitive environments influence risk-taking propensity, and risk-taking propensity influences start-up readiness. Moreover, prior entrepreneurial experience positively moderates the relationship between risk-taking propensity and start-up readiness. However, we do not find the direct and moderating effects of entrepreneurship education. This study theoretically contributes to institutional theory, human capital theory, and entrepreneurial behavior with a self-developed construct –“start-up readiness.” This study also provides practical implications for educators and policymakers based on the findings. This study was limited to one personality trait and future research could examine other traits. In addition, more future studies can adopt this measurement scale to measure the entrepreneurial behavior of people in different regions and other human capital factors are worth studying in future research.
Who Is More Eager to Relocate to a Sustainable Retirement Village? Male or Female, Young or Elderly
Authors: Wong Wong Ming , Li Hexuan , Wang Yifan
Published: February 2024

This paper examines the influence of consumers’ gender and age on the relationship between their attitudes and purchase intentions for choosing a sustainable retirement village, drawing on the Ecological Theory of Aging and the Theory of Reasoned Goal Pursuit. About 931 research participants were collected in China through an online research firm, which distributed questionnaires to its sampling database. Partial Least Squares Structural Equation Modeling was employed to test the proposed hypotheses. The study reveals that (1) consumers’ attitudes toward sustainable retirement villages mediate the relationship between social and environmental sustainability and purchase intentions; (2) The link between the attributes of sustainable retirement villages and consumers’ purchase intentions is mediated by their attitudes, which are not influenced by the consumers’ gender or age. This research demonstrates that neither the gender nor age of consumers significantly impact their attitudes and purchase intentions regarding sustainable retirement villages. The scope of this study is constrained by its sample and variables, as the research subject focuses specifically on Chinese consumers’ attitudes and intentions toward sustainable retirement villages.
The Evidence for the Use of Osteobiologics in Hybrid Constructs (Anterior Cervical Discectomy and Fusion and Total Disc Replacement) in Multilevel Cervical Degenerative Disc Disease: A Systematic Review
Authors: Hoelen Thomay-Claire A. , Willems Paul C. , Loenen Arjan , Meisel Hans Jörg , Wang Jeffrey C. , Jain Amit , Buser Zorica , Arts Jacobus J. ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study Design

Systematic review

Objective

Examine the clinical evidence for the use of osteobiologics in hybrid surgery (combined anterior cervical discectomy and fusion (ACDF) and total disc replacement (TDR)) in patients with multilevel cervical degenerative disc disease (DDD).

Methods

PubMed and Embase were searched between January 2000 and August 2020. Clinical studies investigating 18-80 year old patients with multilevel cervical DDD who underwent hybrid surgery with or without the use of osteobiologics were considered eligible. Two reviewers independently screened and assessed the identified articles. The methodological index for non-randomized studies (MINORS) tool and the risk of bias (RoB 2.0) assessment tool were used to assess risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to evaluate quality of evidence across studies per outcome.

Results

Eleven studies were included. A decrease in cervical range of motion was observed in most studies for both the hybrid surgery and the control groups consisting of stand-alone ACDF or TDR. Fusion rates of 70-100% were reported in both the hybrid surgery and control groups consisting of stand-alone ACDF. The hybrid surgery group performed better or comparable to the control group in terms of adjacent segment degeneration. Studies reported an improvement in visual analogue scale for pain and neck disability index values after surgery compared to preoperative scores for both treatment groups. The included studies had moderate methodological quality.

Conclusions

There is insufficient evidence for assessing the use of osteobiologics in multilevel hybrid surgery and additional high quality and controlled research is deemed essential.
Complications With Demineralized Bone Matrix, Hydroxyapatite and Beta-Tricalcium Phosphate in Single and Two-Level Anterior Cervical Discectomy and Fusion Surgery
Authors: Cabrera Juan P. , Muthu Sathish , Mesregah Mohamed Kamal , Rodrigues-Pinto Ricardo , Agarwal Neha , Arun-Kumar Viswanadha , Wu Yabin , Vadalà Gianluca , Martin Christopher , Wang Jeffrey C. , Meisel Hans Jörg , Buser Zorica ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study Design

Systematic literature review.

Objectives

To analyze the evidence available reporting complications in single or two-level anterior cervical discectomy and fusion (ACDF) using a demineralized bone matrix (DBM), hydroxyapatite (HA), or beta-tricalcium phosphate (β-TCP).

Methods

A systematic review of the literature using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases was performed in August 2020 to identify studies reporting complications in one or two-level ACDF surgery using DBM, HA, or β-TCP. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.

Results

A total of 1857 patients were included, 981 male and 876 female, across 17 articles; 5 prospective, and 12 retrospectives. We noted heterogeneity among the included studies concerning the study design and combination of graft materials utilized in them. However, we noted a higher incidence of adjacent segment disease (17.7%) and pseudoarthrosis (9.3%) in fusion constructs using DBM. Studies using β-TCP reported a higher incidence of pseudoarthrosis (28.2%) and implant failures (17.9%).

Conclusions

Degenerative cervical conditions treated with one or two-level ACDF surgery using DBM, HA, or β-TCP with or without cervical plating are associated with complications such as adjacent segment disease, dysphagia, and pseudarthrosis. However, consequent to the study designs and clinical heterogeneity of the studies, it is not possible to correlate these complications accurately with any specific graft material employed. Further well-designed prospective studies are needed to correctly know the related morbidity of each graft used for achieving fusion in ACDF.
Analysis of Complications in Multilevel Anterior Cervical Discectomy and Fusion Using Osteobiologics Other than Bone Morphogenetic Protein: A Systematic Review
Authors: Cabrera Juan P. , Agarwal Neha , Mesregah Mohamed Kamal , Rodrigues-Pinto Ricardo , Wu Yabin , Martin Christopher , Buser Zorica , Wang Jeffrey C. , Meisel Hans Jörg ,   the AO Spine Knowledge Forum Degenerative
Published: February 2024

Study design

Systematic review.

Objectives

The aim of this study is to analyze the complications related to multilevel anterior cervical discectomy and fusion (ACDF) using osteobiologics other than bone morphogenetic protein (BMP).

Methods

A systematic review of the literature was conducted using PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov databases. The search to identify studies reporting complications in multilevel ACDF surgery using osteobiologics other than bone morphogenetic protein was performed in August 2020. The study was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).

Results

A total of 584 articles were found after searching the databases and removing duplicates. Next, screening was performed in a double reviewer process, and 153 eligible articles—with 4 retrospective studies—in full-text were selected; these met all inclusion criteria. A total of 197 patients received 3-level ACDF, while 72 patients received 4-level ACDF. Osteobiologics were used in all selected articles, allograft was used in 4 studies, autologous bone graft was utilized in 3 articles, and hydroxyapatite was used in 1 article. The main complications reported were dysphagia, adjacent segment disease, and pseudarthrosis.

Conclusions

Given the limited evidence, no conclusions on complications in multilevel ACDF using osteobiologics other than BMP could be made. However, descriptively, the most common complications found were dysphagia, adjacent segment disease, and pseudoarthrosis. Further prospective studies separately analyzing complications in multilevel ACDF by osteobiologics and a number of treated levels are needed.
Structural Allograft Versus Mechanical Interbody Devices Augmented With Osteobiologics in Anterior Cervical Discectomy and Fusion: A Systematic Review
Authors: Jain Amit , Dhanjani Suraj , Harris Andrew , Cartagena Miguel , Babu Jacob , Riew Daniel , Shin John , Wang Jeffrey C. , Yoon S. Tim , Buser Zorica , Meisel Hans Jörg ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study Design

Systematic Literature Review

Objective

Perform a systematic review evaluating postoperative fusion rates for anterior cervical discectomy and fusion (ACDF) using structural allograft vs various interbody devices augmented with different osteobiologic materials.

Methods

Comprehensive literature search using PubMed, Embase, The Cochrane Library, and Web of Science was performed. Included studies were those that reported results of 1–4 levels ACDF using pure structural allograft compared with a mechanical interbody device augmented with an osteobiologic. Excluded studies were those that reported on ACDF with cervical corpectomy; anterior and posterior cervical fusions; circumferential (360° or 540°) fusion or revision ACDF for nonunion or other conditions. Risk of bias was determined using the Cochrane review guidelines.

Results

8 articles reporting fusion rates of structural allograft and an interbody device/osteobiologic pair were included. All included studies compared fusion rates following ACDF among structural allograft vs non-allograft interbody device/osteobiologic pairs. Fusion rates were reported between 84% and 100% for structural allograft, while fusion rates for various interbody device/osteobiologic combinations ranged from 26% to 100%. Among non-allograft cage groups fusion rates varied from 73-100%. One study found PEEK cages filled with combinations of autograft, allograft, and demineralized bone matrix (DBM) to have an overall fusion rate of 26%. In one study comparing plate and zero-profile constructs, there was no difference in fusion rates for two-level fusions.

Conclusion

There was limited data comparing fusion outcomes of patients undergoing ACDF using structural allograft vs interbody devices augmented with osteobiologic materials to support superiority of one method.
Do Osteobiologics Augment Fusion in Anterior Cervical Discectomy and Fusion Surgery Performed With Mechanical Interbody Devices (Polyether ether ketone, Carbon Fiber, Metal Cages) and is the Fusion Rate Comparable to that With Autograft? A Systematic Review
Authors: Arun-Kumar Viswanadha , Corluka Stipe , Buser Zorica , Wu Yabin , El-Sharkawi Mohammad , Carazzo Charles André , Ponugoti Nikhil , Wang Jeffrey C. , Meisel Hans Jörg ,   AO Spine Knowledge Forum Degenerative
Published: February 2024

Study design

Systematic Review of the Literature.

Objective

The purpose of this study was to perform a systematic review describing fusion rates for anterior cervical discectomy and fusion (ACDF) using autograft vs various interbody devices augmented with different osteobiologic materials.

Methods

A systematic review limited to the English language was performed in Medline, Embase and Cochrane library using Medical Subject Heading (MeSH) terms. Studies that evaluated fusion after ACDF using autografts and osteobiologics combined with PEEK, carbon fibre, or metal cages were searched for. Articles in full text that met the criteria were included in the review. The main outcomes evaluated were the time taken to merge, the definition of the fusion assessment, and the modality of the fusion assessment. The risk of bias of each article was assessed by the MINORS score or ROB 2.0 depending on the randomisation process.

Results

The total number of references reviewed was six hundred and eighty-two. After applying the inclusion criteria, 54 were selected for the retrieval of the full text. Eight studies were selected and included for final analysis in this study. Fusion rates were reported between 83.3% and 100% for autograft groups compared to 46.5% and 100% for various interbody device/osteobiological combinations. The overall quality of the evidence in all radiographic fusion studies was considered insufficient due to a serious risk of bias.

Conclusion

Mechanical interbody devices augmented with osteobiologics performed similarly to autografts in terms of reliability and efficacy. Their time to fusion and fusion rate were comparable to autografts at the end of the final follow-up.
Fostering Students’ Personal and Professional Growth: Responding to Error During the Internal Medicine Clerkship
Authors: Schmude Michelle , Adonizio Tanja , Ellison Halle B , Shoemaker Margrit
Published: February 2024

OBJECTIVES

Developing professionalism is critical to medical education; accordingly, professionalism curricula may be implemented longitudinally throughout undergraduate medical education. Here we share our experiences addressing student response to medical error as a component of professionalism education during the core clerkship year.

METHODS

This pretest–posttest study reports medical students’ knowledge regarding learning and growing in response to medical error. Students complete an online module, Beyond Recovery: Learning and Growing in the Wake of an Error, during the Internal Medicine Clerkship. We analyzed matched pre- and posttest responses using the Wilcoxon signed-rank test.

RESULTS

Pre- and posttest queries addressed 5 key elements during clinician assessment of medical error: self-expectations of perfection, long-term guilt following an error, likelihood of leaving the medical profession following an error, ability to address error with patients and families, and ability to grow in response to medical error. Results indicate students felt significantly more comfortable after completing the module in key components of managing emotions and responses in the wake of an error.

CONCLUSION

Benefits observed in medical students’ perspectives include improved ability to move forward following medical error, ability to engage with affected patients and families, and capacity to learn from mistakes. Despite these positives, students’ high self-expectations of perfectionism were unchanged.
Assessing hand and global disability in a cohort of Algerian patients with systemic sclerosis: Construct validities of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire
Authors: Benmostefa Nouria , Malek Rachid , Robert Marie , Chaigne Benjamin , Slimani Samy , Rouabhia Samir , Roula Daoud , Djamel Mallem , Mouthon Luc
Published: February 2024

Objective:

The study aimed to assess the construct validity of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire in Algerian patients with systemic sclerosis.

Methods:

Consecutive Algerian patients who fulfilled the American College of Rheumatology/European League Against Rheumatism criteria for systemic sclerosis were included. In addition to disease characteristics, global disability and hand disability were assessed using the Arabic Health Assessment Questionnaire and the Arab Hand Function Index, respectively. Construct validity was assessed by convergent and divergent validity (Spearman’s rank correlation coefficient) and factor analysis. The scale reliability was assessed using the Cronbach’s alpha.

Results:

We evaluated 100 systemic sclerosis patients (83 females) of mean ± standard deviation age 46.7 ± 12.3 years, including 59 limited cutaneous systemic sclerosis and 41 diffuse cutaneous systemic sclerosis. Raynaud’s phenomenon was detected in 99 patients and digital ulcers in 25. Gastrointestinal tract involvement and interstitial lung disease were detected in 86/100 (86%) and 46/72 (63.9%) patients, respectively. Anti-topoisomerase I and anti-centromere antibodies were detected in 33/76 (43.4%) and 23/76 (30.3%) patients, respectively. The Arab Hand Function Index had a good construct validity with a total score explaining 61% of the variance of the Arabic Health Assessment Questionnaire which also had a good construct validity. Factor analysis of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire items extracted two factors explaining 64% of the variance for the Arab Hand Function Index and one factor explaining 55% of the variance for the Arabic Health Assessment Questionnaire. The Arab Hand Function Index and the Arabic Health Assessment Questionnaire were reliable questionnaires with a Cronbach’s alpha >0.8.

Conclusion:

In Algerian patients with systemic sclerosis, Arab Hand Function Index and Arabic Health Assessment Questionnaire have a good construct validity and reliability.
Increasing Teacher Retention and Supporting Students With Low-Incidence Disabilities Through University Partnership
Authors: Barnett Emerson , Huang Ting
Published: February 2024

The shortage of teachers is amplified in rural areas where educators work with students with low-incidence disabilities (LID; visual or hearing impairment; significant cognitive impairment; any impairment for which a small number of personnel with highly specialized skills and knowledge are needed for children to receive early intervention services). This scarcity is closely linked to the lack of accessible knowledge for these teachers. Both a high attrition rate and lack of expertise negatively affect the educational outcomes of students with LID. We propose school–university partnerships (SUPs) to alleviate these challenges. This position paper presents the critical elements of a comprehensive SUP by synthesizing programs reported in the literature, including the following elements (a) instructional, assessment, and online resources; (b) mentorship; and (c) professional development. We specifically identify how these elements can improve outcomes of students with LID and alleviate the rural special education teacher shortage. Finally, we discuss the implications of this proposed SUP and implications for practices, policy, and research.
Proteomic analysis of breast cancer based on immune subtypes
Authors: Jeon Yeonjin , Lee GunHee , Jeong Hwangkyo , Gong Gyungyub , Kim JiSun , Kim Kyunggon , Jeong Jae Ho , Lee Hee Jin
Published: February 2024

Background

Immunotherapy is applied to breast cancer to resolve the limitations of survival gain in existing treatment modalities. With immunotherapy, a tumor can be classified into immune-inflamed, excluded and desert based on the distribution of immune cells. We assessed the clinicopathological features, each subtype’s prognostic value and differentially expressed proteins between immune subtypes.

Methods

Immune subtyping and proteomic analysis were performed on 56 breast cancer cases with neoadjuvant chemotherapy. The immune subtyping was based on the level of tumor-infiltrating lymphocytes (TILs) and Klintrup criteria. If the level of TILs was ≥ 10%, it was classified as immune-inflamed type without consideration of the Klintrup criteria. In cases of 1–9% TIL, Klintrup criteria 1–3 were classified as the immune-excluded subtype and Klintrup criteria not available (NA) was classified as NA. Cases of 1% TILs and Klintrup 0 were classified as the immune-desert subtype. Mass spectrometry was used to identify differentially expressed proteins in formalin-fixed paraffin-embedded biopsy tissues.

Results

Of the 56 cases, 31 (55%) were immune-inflamed, 21 (38%) were immune-excluded, 2 (4%) were immune-desert and 2 (4%) were NA. Welch’s t-test revealed two differentially expressed proteins between immune-inflamed and immune-excluded/desert subtypes. Coronin-1A was upregulated in immune-inflamed tumors (adjusted p = 0.008) and α-1-antitrypsin was upregulated in immune-excluded/desert tumors (adjusted p = 0.008). Titin was upregulated in pathologic complete response (pCR) than non-pCR among immune-inflamed tumors (adjusted p = 0.036).

Conclusions

Coronin-1A and α-1-antitrypsin were upregulated in immune-inflamed and immune-excluded/desert subtypes, respectively. Titin's elevated expression in pCR within the immune-inflamed subtype may indicate a favorable prognosis. Further studies involving large representative cohorts are necessary to validate these findings.
JMJD3 regulate H3K27me3 modification via interacting directly with TET1 to affect spermatogonia self-renewal and proliferation
Authors: Wang Jin , Liu Lingling , Li Zebin , Wang Haoyu , Ren Yuanyuan , Wang Kaisheng , Liu Yang , Tao Xinjie , Zheng Liming
Published: February 2024

Background

In epigenetic modification, histone modification and DNA methylation coordinate the regulation of spermatogonium. Not only can methylcytosine dioxygenase 1 (TET1) function as a DNA demethylase, converting 5-methylcytosine to 5-hydroxymethylcytosine, it can also form complexes with other proteins to regulate gene expression. H3K27me3, one of the common histone modifications, is involved in the regulation of stem cell maintenance and tumorigenesis by inhibiting gene transcription.

Methods

we examined JMJD3 at both mRNA and protein levels and performed Chip-seq sequencing of H3K27me3 in TET1 overexpressing cells to search for target genes and signaling pathways of its action.

Results

This study has found that JMJD3 plays a leading role in spermatogonia self-renewal and proliferation: at one extreme, the expression of the self-renewal gene GFRA1 and the proliferation-promoting gene PCNA was upregulated following the overexpression of JMJD3 in spermatogonia; at the other end of the spectrum, the expression of differentiation-promoting gene DAZL was down-regulated. Furthermore, the fact that TET1 and JMJD3 can form a protein complex to interact with H3K27me3 has also been fully proven. Then, through analyzing the sequencing results of CHIP-Seq, we found that TET1 targeted Pramel3 when it interacted with H3K27me3. Besides, TET1 overexpression not only reduced H3K27me3 deposition at Pramel3, but promoted its transcriptional activation as well, and the up-regulation of Pramel3 expression was verified in JMJD3-overexpressing spermatogonia.

Conclusion

In summary, our study identified a novel link between TET1 and H3K27me3 and established a Tet1-JMJD3-H3K27me3-Pramel3 axis to regulate spermatogonia self-renewal and proliferation. Judging from the evidence offered above, we can safely conclude that this study provides new ideas for further research regarding the mechanism of spermatogenesis and spermatogenesis disorders on an apparent spectrum.
Salicylic acid inducing the expression of maize anti-insect gene SPI: a potential control strategy for Ostrinia furnacalis
Authors: Chen Yuanlong , Yang Siyuan , Zeng Wei , Zheng Xu , Wang Pan , Fu Haiyan , Yang Fengshan
Published: February 2024

Background

Due to being rooted in the ground, maize (Zea mays L.) is unable to actively escape the attacks of herbivorous insects such as the Asian corn borer (Ostrinia furnacalis). In contrast to the passive damage, plants have evolved defense mechanisms to protect themselves from herbivores. Salicylic acid, a widely present endogenous hormone in plants, has been found to play an important role in inducing plant resistance to insects. In this study, we screened and identified the insect resistance gene SPI, which is simultaneously induced by SA and O. furnacalis feeding, through preliminary transcriptome data analysis. The functional validation of SPI was carried out using bioinformatics, RT-qPCR, and heterologous expression protein feeding assays.

Results

Both SA and O. furnacalis treatment increased the expression abundance of SA-synthesis pathway genes and SPI in three maize strains, and the upregulation of SPI was observed strongly at 6 hours post-treatment. The expression of SPI showed a temporal relationship with SA pathway genes, indicating that SPI is a downstream defense gene regulated by SA. Protein feeding assays using two different expression vectors demonstrated that the variation in SPI protein activity among different strains is mainly due to protein modifications.

Conclusions

Our research results indicate that SPI, as a downstream defense gene regulated by SA, is induced by SA and participates in maize's insect resistance. The differential expression levels of SPI gene and protein modifications among different maize strains are one of the reasons for the variation in insect resistance. This study provides new insights into ecological pest control in maize and valuable insights into plant responses to SA-induced insect resistance.
Behavioral pain scale may not be reliable in awake non-verbal intensive care patients: a case control study
Authors: Waydhas Christian , Ull Christopher , Cruciger Oliver , Hamsen Uwe , Schildhauer Thomas A. , Gaschler Robert , Weckwerth Christina
Published: February 2024

Background

The evaluation of pain in patients, unable of oral communication, often relies on behavioral assessment. However, some critically ill patients, while non-verbal, are awake and have some potential for self-reporting. The objective was to compare the results of a behavioral pain assessment with self-reporting in awake, non-verbal, critically ill patients unable to use low-tech augmentative and alternative communication tools.

Methods

Prospective cohort study of intubated or tracheotomized adult, ventilated patients with a RASS (Richmond Agitation Sedation Scale) of -1 to + 1 and inadequate non-verbal communication skills in a surgical intensive care unit of a tertiary care university hospital. For pain assessment, the Behavioral Pain Scale (BPS) was used. Self-reporting of pain was achieved by using an eye tracking device to evaluate the Numeric Rating Scale (NRS) and the pain/discomfort item of the EuroQol EQ-5D-5 L (EQ-Pain). All measurements were taken at rest.

Results

Data was collected from 75 patients. Neither the NRS nor the EQ-Pain (r < .15) correlated with the BPS. However, NRS and EQ-Pain were significantly correlated (r = .78, p = < 0.001), indicating the reliability of the self-reporting by these patients. Neither the duration of intubation/tracheostomy, nor cause for ICU treatment, nor BPS subcategories had an influence on these results.

Conclusions

Behavioral pain assessment tools in non-verbal patients who are awake and not in delirium appear unreliable in estimating pain during rest. Before a behavioral assessment tool such as the BPS is used, the application of high-tech AACs should be strongly considered.

Trial registration

German Clinical Trials Register, Registration number: DRKS00021233. Registered 23 April 2020 - Retrospectively registered, https://drks.de/search/en/trial/DRKS00021233.
Process evaluation of a tailored nudge intervention to promote appropriate care and treatment of older patients at the end-of-life
Authors: Bracci Ella L. , Barnett Adrian G. , Brown Christine , Callaway Leonie , Cardona Magnolia , Carter Hannah E. , Graves Nicholas , Hillman Kenneth , Lee Xing J. , McPhail Steven M. , White Ben P. , Willmott Lindy , Harvey Gillian
Published: February 2024

Background

Non-beneficial treatment affects a considerable proportion of older people in hospital, and some will choose to decline invasive treatments when they are approaching the end of their life. The Intervention for Appropriate Care and Treatment (InterACT) intervention was a 12-month stepped wedge randomised controlled trial with an embedded process evaluation in three hospitals in Brisbane, Australia. The aim was to increase appropriate care and treatment decisions for older people at the end-of-life, through implementing a nudge intervention in the form of a prospective feedback loop. However, the trial results indicated that the expected practice change did not occur. The process evaluation aimed to assess implementation using the Consolidated Framework for Implementation Research, identify barriers and enablers to implementation and provide insights into the lack of effect of the InterACT intervention.

Methods

Qualitative data collection involved 38 semi-structured interviews with participating clinicians, members of the executive advisory groups overseeing the intervention at a site level, clinical auditors, and project leads. Online interviews were conducted at two times: implementation onset and completion. Data were coded to the Consolidated Framework for Implementation Research and deductively analysed.

Results

Overall, clinicians felt the premise and clinical reasoning behind InterACT were strong and could improve patient management. However, several prominent barriers affected implementation. These related to the potency of the nudge intervention and its integration into routine clinical practice, clinician beliefs and perceived self-efficacy, and wider contextual factors at the health system level.

Conclusions

An intervention designed to change clinical practice for patients at or near to end-of-life did not have the intended effect. Future interventions targeting this area of care should consider using multi-component strategies that address the identified barriers to implementation and clinician change of practice.

Trial registration

Australia New Zealand Clinical Trial Registry (ANZCTR), ACTRN12619000675123p (approved 06/05/2019).
Imaging patterns of Lophomonas blattarum infection in the respiratory tract: a registry-based analysis
Authors: Taheri Amirmasoud , Fakhar Mahdi , Sharifpour Ali , Banimostafavi Elhamsadat , SafaNavaei Sepideh , Abedi Siavash , Mehravaran Hossein , Aliyali Masoud , Shafahi Ahmad , Delpzir Asieh
Published: February 2024

Background

Lophomonas blattarum is an emerging protozoan that mostly infects the lower respiratory tract and causes pulmonary lophomoniasis. Radiologic findings in patients with pulmonary lophomoniasis have yet to be studied. Thus, we conducted a registry-based clinical investigation to evaluate the radiologic findings of lophomoniasis.

Methods

In this cross-sectional study, 34 Lophomonas positive patients were enrolled. Demographic data, relevant characteristics, and radiologic findings of the patients were recorded and analyzed.

Results

Thirty-four (male = 18, female = 16) patients with an average age of 52.21 ± 20.48 years old were examined. Radiological findings such as Alveolar consolidation (26.5%), Ground glass opacity (5.9%), Centrilobular nodules (23.5%), Tree -in- bud (38.2%), Cavitation (23.5%), Pleural effusion (23.5%), Interstitial opacity (8.8%), Lymphadenopathy (23.5%), Bronchocele (5.9%), Bronchiectasis (29.4%), Nodules (8.8%) and Mass (11.8%) were obtained, that the frequency of all radiological findings was less than 50%.

Conclusion

In this study, the most common radiological findings in patients with lophomoniasis were tree-in-bud nodules, alveolar consolidation, bronchiectasis, and centrilobular nodules which were mostly seen in the right lung and its middle and lower lobes. Given that the radiologic findings of this disease are unknown, it can be considered in differential diagnosis.