bluuebunny/crossref_metadata_2025 huggingface dataset:
South Sudan and the cultural politics of East Africa
Authors: Mondesire Zachary
Published: May 2023

South Sudan joined the East African Community (EAC), a regional economic and political organization in 2016. It 2011, it became the newest nation-state in the world when it seceded from Sudan. As a result, the new state of South Sudan is at a crossroads of multiple processes of unification and fragmentation. I analyze this moment of accession as one characterized by both substantive practices of political institution-building and intimate ideas about cultural belonging. In this context, a trans-border cultural imagination has become entangled with technocratic expertise committed to harmonious regional integration. The process of accession represents a broader socio-political formation that contains ideas about family, the colonial legacy, cultural continuity, and geopolitical relationships that are primarily narrated and experienced as transnational. Regional integration has therefore become a site of desire, frustration, futurity, and the production of normative ideals. To address these intersecting processes and ideas, the author develops region-craft and geopolitical intimacy to make sense of how they take shape on multiple scales of social and political life. The broader stakes of this process are making sense of the unequal dynamics of power that I argue emerge as intra-African discourses of asymmetrical competency and paternalism.
Flügge shell theory and solution for the vibration analysis of a thin elastic cylindrical panel of varying curvature
Authors: Badry Ahmed , Safwat Ahmed , Khalifa Mousa
Published: May 2023

In this paper, the free vibration behavior of isotropic and orthotropic cylindrical shell panels with variable curvature subjected to certain ends boundary conditions is analyzed by the transfer matrix technique and solved by the Romberg integration approach. Flügge’s shell theory is employed to model the governing three-dimensional equations of vibration and Fourier’s approach is used to deform the displacement fields as trigonometric functions in the longitudinal direction. As a result of a semi-analytical procedure is conducted, the coupled governing equations of panel problem can be written in a matrix partial differential equation of first order with variable coefficients and reduced from the two-dimensional problem to one-dimensional one which is solved numerically as an initial-value problem. The proposed model is applied to get the natural frequencies and mode shapes for the vibration behavior of two-side simply-supported cylindrical panels with simply-supported, free-free, clamped-free and clamped-clamped ends boundary conditions lying at their curved edges. The sensitivity of the vibration behavior to the variety of curvature, panel parameters and material orthotropy of shell is studied.
The Canvas of Science Education
Authors: Bardapurkar Abhijeet
Published: May 2023

The canvas of science education needs to be viewed in its totality to prevent the confounding of some basic issues and to enable us to evaluate the fads and fashions in educational practice. Policies and processes in education are tacitly shaped by theories in the humanities and social sciences. Inadequate understanding of these theories, or the lack of attention to uncalled-for implications of their practical import, takes education in undesirable directions. To be a good science teacher has never been easy. The teacher is a master of knowledge in science. But that is not all. She is equally committed to the principles governing the practice and communication of science.
Dignity in Action in the Home Hospice: The Narrative Selection of a Multidisciplinary Staff
Authors: Spector-Mersel Gabriela , Yakov Gila
Published: May 2023

Home hospice (HH) is a palliative care framework that is becoming more and more common in Western countries. HH staff face unique challenges, resulting mainly from their multiple clients and the provision of care in a private territory. Despite the recognized role of professionals in preserving end-of-life (EOL) dignity, how HH staff conceive of EOL dignity has remained unexplored. To fill this lacuna, we invited the multidisciplinary staff of an Israeli HH to recount unguided narratives of dignity and indignity in the HH. We analyzed the mechanisms of narrative selection in each story and in the entire dataset, particularly regarding two dimensions of dignity: situation—whether the recounted cases present dignity, indignity, or both; and relations—who provides (in)dignity to whom. The analysis revealed four interconnected end-points: HH is a dignity-providing framework; HH staff provide and promote dignity; HH dignity as relations and communication; and HH dignity as a holistic process whose boundaries are expanded and blurred, both spatially and temporally. The differences between these and other findings on healthcare professionals’ perspectives of EOL dignity highlight the uniqueness of HH staff, and possibly the distinctiveness of the Israeli case with its traditional familial values. Importantly, the findings were generated due to the narrative paradigm guiding the study. The unique attributes of the narrative text enabled us to capture the dynamic temporal nature of dignity-in-action, as embedded in the staff’s daily practice. Implications for training professionals to preserve EOL dignity in HH and other EOL care frameworks are discussed.
To Operate or Not to Operate? Reconstructive Surgical Burden and Quality of Life of Pediatric Patients with Facial Differences
Authors: Modi Rishi N. , Blum Jessica D. , Ataseven Burçin , Belza Caitlyn C. , Montes Edna , Leung Karen L. , Zaldana-Flynn Michelle , Rapoport Chelsea S. , Choi Alyssa K. , Ewing Emily , Malcarne Vanessa L. , Gosman Amanda A.
Published: May 2023

Objective

The Craniofacial Condition Quality of Life Scale (CFC-QoL) was used to evaluate the relationship between surgical burden and quality of life (QoL)

Design

Patient-parent dyads completed the CFC-QoL which queries the following QoL domains: Bullying, Peer Problems, Psychological Impact, Family Support, Appearance Satisfaction, and Desire for Appearance Change. Stepwise multivariate linear regressions were performed for each QoL domain.

Setting

Urban tertiary care center

Patients, participants

Pediatric patients with facial differences, and their parents.

Intervention

Survey study

Main Outcome Measure(s)

Demographic, diagnostic, and surgical characteristics were collected. Surgical burden was calculated as the standard deviation from the mean number of surgeries per diagnostic cohort.

Result

Patients ( N  =  168) were majority female (57.1%) and Hispanic (64.3%). Diagnoses were cleft lip and/or palate (CLP, n  =  99) or other craniofacial conditions (CFC, n  =  69). Average patient age was 2.3  ±  5.6 years at first reconstructive surgery and 12.3  ±  3.4 years at study enrollment. Patients received an average of 4.3  ±  4.1 reconstructive surgeries. Worse Bullying was associated with higher surgical burden. Worse Peer Problems was associated with higher surgical burden, but only for children with non-CLP CFCs. Worse Family Support was associated with CFC diagnosis, female sex, and higher surgical burden. Worse Psychological Impact was associated with higher surgical burden. Worse Appearance Satisfaction was associated with younger age and with lower surgical burden. Greater Desire for Appearance Change was associated with older age, higher surgical burden, CLP diagnosis, female sex, and non-Hispanic ethnicity. Socioeconomic status did not predict QoL per patient self- or parent-proxy report.

Conclusions

Higher surgical burden was associated with worse QoL outcomes in multiple domains.
Reductions in Customer Commitment: An Empirical Study on Pure Downgrade versus Hybrid Downgrade
Authors: Zhou Chenxi , Lin Liming , Guo Zhaoyang , Jiang Juncai
Published: May 2023

While service providers strive to maintain customer relationships, a nontrivial number of customers downgrade their services, something that has been particularly true during the post-pandemic period or economic recession. Studying downgrade behavior is vital because it damages the bottom-line performance of service providers and reflects a reduced customer commitment. Unlike previous studies, we further divide downgrade behavior based on whether there is a change in the product category, that is, a downgrade to a lower-priced service option within the same product category (“pure downgrade”) versus a downgrade to a lower-priced service option in a different product category (“hybrid downgrade”). An analysis of customer data collected from a major telecommunications company shows fundamental differences in the determinants and consequences of these two downgrades. Transaction-related variables, such as service usage, have a significantly stronger positive effect on the likelihood of hybrid downgrade than on that of pure downgrade. Conversely, relationship-related variables like relationship length have an inverted U-shaped effect on pure downgrade but barely affect the likelihood of hybrid downgrade. Interestingly, customers who engage in pure downgrade are more likely to churn than those who engage in hybrid downgrade. The empirical findings offer valuable insights on customer relationships and churn management.
Reflections on Orders of Gender, Cultural Mandates and Masculinities in Latin America
Authors: Olavarría José A.
Published: May 2023

At least four gender orders overlap, fuse and coexist with one another in Latin America. Each one—original, traditional, modern, neoliberal—has required the configuration of masculinities and femininities. They are orders that remain intertwined or fused; reinforcing and transforming the configurations of previous orders. The meta-order (patriarchy) has not definitively transformed the relations between men and women, nor between men and women and themselves. This article reflects on gender orders, cultural mandates and the findings from research in the region.
Abstractions in International Relations: on the mystification of trans, queer, and subaltern life in critical knowledge production
Authors: Stoffel Alexander , Birkvad Ida Roland
Published: May 2023

This paper identifies a common process of mystification within academic knowledge production today: the treatment of subordinated groups as mere metaphors or rhetorical figures for academic theorizing. We witness it when academics ask what trans might teach us about transnationality, when we are invited to reflect on what might be queer about modern warfare, or when nation-states are described as subaltern. Trans, queer, and subaltern populations are routinely fetishized within scholarship on the “traditional” International Relations concerns of statecraft, migration, security, and so on. This tendency serves a mystifying function by disabling scholars from examining the social relations that shape and organize their lives and histories. This paper proceeds in three parts. First, to understand the origins and logics of this self-mystifying process, this paper returns, via Stuart Hall, to Karl Marx’s methodological writings on abstraction. It contributes to the formalization of his methodology for contemporary IR scholarship by drawing a distinction between the fetishization of abstraction and the concretization of abstraction. Second, the paper explores how abstracted subject positions have been fetishized within three fields of international studies: trans studies, queer theory, and subaltern studies. Third, after elaborating a critique of this mystifying move, the paper outlines alternative approaches that instead seek to concretize the abstractions queer, trans, and subaltern by attending to their specific historical and social determinations. These strategies of demystification, we argue, carry forward a founding commitment of critical theory that is all too often abandoned within scholarly knowledge production today.
Effect of anterior communicating artery patency on the flow velocity in bilateral carotid artery stenosis after carotid endarterectomy
Authors: Xia Mingyu , Hua Yang , Jia Lingyun , Liu Beibei , Jiao Liqun , Ma Yan
Published: May 2023

Background:

The effect of anterior communicating artery (ACoA) patency on the flow velocity of the extracranial carotid arteries is unclear.

Methods:

A total of 285 patients with carotid artery stenosis were included between January 2019 and January 2021. All patients received unilateral carotid endarterectomy (CEA). The patients were classified into ACoA-patent (161) and ACoA-nonpatent (124) groups using digital subtraction angiography (DSA) and/or computed tomography angiography (CTA). The peak systolic velocity (PSV) and end-diastolic velocity (EDV) measured by carotid duplex ultrasonography (CDU) were compared between both groups, pre- and post-CEA.

Results:

There was no significant difference in the risk factors for cerebrovascular disease between the two groups. Within 1 week after CEA, the PSV and EDV on operative and nonoperative carotid (contralateral carotid in the same patient) arteries decreased significantly (both p < 0.01). Comparison of nonoperative carotid artery pre- and post-CEA between the two groups showed that post-CEA PSV and EDV in the ACoA-patent group were significantly lower than that of pre-CEA (PSV and EDV, t = 11.507 and 6.716, respectively, both p < 0.001) (according to the Society of Radiologists in Ultrasound Consensus Conference [SRUCC] PSV standard). There was no significant difference in the ACoA-nonpatent group (PSV: t = 1.924, p = 0.057; EDV: t = 1.237, p = 0.218). In the nonoperative carotid artery of the ACoA-patent group, the degree of stenosis assessed by CDU was inconsistent with that of DSA/CTA (κ = 0.294), whereas that in the ACoA-nonpatent group had a high consistency (κ = 0.982). Among 161 ACoA-patent cases, 68 showed overestimated stenosis.

Conclusions:

The patent ACoA increases PSV and EDV, causing an overestimation of carotid artery stenosis.
A survey of epidemic management data models
Authors: Gao Yongchao , Wang Qiuyue , Fox Mark S , Qian Heng
Published: May 2023

The COVID-19 epidemic has demonstrated the important role that data plays in the response to and management of public health emergencies. It has also heightened awareness of the role that ontologies play in the design of semantically precise data models that improve data interoperability among stakeholders. This paper surveys vocabularies and ontologies relevant to the task of achieving epidemic-related data interoperability. The paper first reviews 16 vocabularies and ontologies with respect to the use cases. Next it identifies patterns of knowledge that are common across multiple vocabularies and ontologies, followed by an analysis of patterns that are missing, based on the use cases. Conclusions show that existing vocabularies and ontologies provide significant coverage of the concepts underlying epidemic use cases, but there remain gaps in the coverage. More work is required to cover missing but significant concepts.
Timelines, convoy circles, and ecomaps: Positing diagramming as a salient tool for qualitative data collection in research with forced migrants
Authors: Ekoh Prince Chiagozie , Sitter Kathleen
Published: May 2023

Visual elicitation methods, such as diagramming, are growing in their use with vulnerable populations, trauma-informed research, and social work studies where the use of traditional oral interviews alone may be lacking in their ability to increase access to different areas of human consciousness. The adoption and designing of innovative diagramming and visual methods have the potential to push the boundaries of data collection in understanding the experiences of forced migrants. However, scholars have seldom adopted this method in forced migration research. In this article, the authors explore three diagramming methods-timelines, convoy circles, and ecomaps-to highlight the possibilities of their use for social work research with forced migrants. The benefits of utilising these methods in support of the unique characteristics and challenges of forced migrants are also discussed. The article concludes by identifying several limitations while advocating for the adoption and documentation of the use of diagramming in studies with forced migrants.
Development and Validation of Prognostic Nomograms Based on Lymph Node Ratio for Young Patients with Gastric Cancer: A SEER-Based Study
Authors: Chen Yi-Ru , Tian Zhen-Yi , Wang Mei-Qian , Sun Mei-Ling , Wu Jin-Zhen , Wang Xin-Ying
Published: May 2023

Purpose

To investigate the role of lymph node ratio (LNR) in young patients with gastric cancer (GC) and develop nomograms to predict the survival of young GC patients.

Methods

This retrospective study enrolled stage I-III GC patients before the age of 40 between 2010 and 2016 from the Surveillance, Epidemiology, and End Results (SEER) database. Cox proportional hazards models were used to determine the prognosticators and create the nomograms incorporating LNR to predict overall survival (OS) and cancer-specific survival (CSS). The discriminating superiority of the nomograms was examined using calibration curves, C-index, receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and integrated discrimination improvement (IDI) by comparing with the TNM staging. The performance of the nomograms for risk stratification was analyzed by the Kaplan–Meier method.

Results

Based on the significant prognosticators identified in multivariate survival analysis, the nomograms were established and showed LNR as the third strongest predictor. The C-index of the nomograms for OS and CSS were higher than those of the TNM staging (OS: 0.773 vs 0.665; CSS: 0.769 vs 0.666). The ROC curves for the nomograms to predict survival exhibited superior sensitivity and specificity when compared with the TNM staging. The calibration plots, DCA curves, and IDI values of the nomograms also demonstrated adequate fit and ideal net benefit in prediction and clinical utility. The Kaplan–Meier analysis observed remarkable differences in patients divided into different risk subgroups ( P < .001).

Conclusions

These results found the clinical outperformance of the LNR-based nomograms for predicting survival in young stage I-III GC patients. Our nomograms may improve accuracy of survival risk prediction and facilitate individualized care of young stage I-III GC patients.
Effects of Managing Cancer and Living Meaningfully on Cancer-Related Fatigue and Cytokine Levels in Gastrointestinal Cancer Patients
Authors: Cai Yinlian , Zhang Qianqian , Gan Chen , Xu Jian , Yu Sheng , Tang Lingxue , Yao Senbang , Li Wen , Huang Runze , Cheng Huaidong
Published: May 2023

Objective:

To evaluate the effects of managing cancer and living meaningfully (CALM), a psychological intervention with semi-structured interviews, on cancer-related fatigue (CRF), quality of life (QOL), and sleep quality in patients with gastrointestinal (GI) cancer, which may be accompanied by changes in cytokine levels.

Methods:

A total of 152 GI cancer patients with CRF were enrolled in the study during treatment. Patients were randomly assigned to CALM or usual care (UC) groups. Patients in the CALM group received 12 weeks of CALM plus usual care, and patients in the UC group received usual care plus usual health education. All study participants were evaluated at baseline and at 12 weeks using the Revised Piper Fatigue Scale, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 30, and the Pittsburgh Sleep Quality Index scale, while cytokine levels were measured.

Results:

At 12 weeks, the differences in total CRF, QOL, sleep quality, IL-6, IL-4, and TNF-α levels were statistically significant not only in the CALM group compared to patients in the UC group ( t = −7.902, t = 2.163, t = −2.187, t = 3.313, t = −4.120, t = −3.853, respectively; P < .05), but also in the CALM group compared to baseline ( t = 11.331, t = −5.492, t = 5.450, t = −2.418, t = 2.186, t = 2.699, respectively; P < .05). Additionally, the total CRF at 12 weeks was correlated with IL-4, IL-6, and TNF-α levels ( r = −.30, r = .31, r = .32, respectively; P < .001).

Conclusions:

CALM alleviated CRF and improved QOL and sleep quality in patients with GI cancer, and these improvements were accompanied by changes in IL-4, IL-6, and TNF-α levels.
Patterns of HIV Disclosure and its Impact on the HIV Care Continuum Among Black Men who Have Sex With Men in South Carolina
Authors: Yang Xueying , James Titilayo A. , Brown Monique J. , Brown Tony , Zarsadias Sydney , Zhang Ran , Shi Fanghui , Li Xaoming
Published: May 2023

Addressing the psychosocial concerns of Black men who have sex with men (MSM), such as HIV disclosure, is critical for effective HIV treatment efforts. Black MSM living with HIV experience multiple psychosocial challenges, such as “triple stigma” due to their sexual orientation, racial minority status, and HIV status, which hinder their HIV disclosure and subsequent HIV care-seeking behavior. Our study sought to examine the HIV disclosure patterns and their impact on the HIV care continuum among Black MSM using a qualitative approach. Semi-structured interviews were carried out among 28 Black MSM aged ≥18 years old living in South Carolina. A thematic analysis process was employed for data analysis. The emerging themes of facilitators of HIV disclosure included the sense of personal responsibility to disclose one’s HIV status within the context of a relationship and having other family members living with HIV, while the barriers included fear of family rejection or religious reasons. A few participants preferred to disclose to friends due to the less shame in sharing their status to friends than other confidants (e.g., family members). HIV disclosure was found to be a facilitator for linkage to care and retention in care through social support obtained from disclosure confidants. Helping patients to identify a single person (e.g., family member) to share their HIV status may offer equivalent benefits to wider disclosure. Interventions occurring at multiple levels (e.g., targeting religious groups) and within multiple contexts are needed to promote HIV disclosure and improve clinical outcomes in the Black MSM community.
Protective Effect of Tunisian Red Seaweed (Corallina officinalis) Against Bleomycin-Induced Pulmonary Fibrosis and Oxidative Stress in Rats
Authors: Dhaouafi Jihen , Abidi Anouar , Nedjar Naima , Romdhani Montassar , Tounsi Haifa , Sebai Hichem , Balti Rafik
Published: May 2023

Idiopathic pulmonary fibrosis is a chronic and progressive respiratory disease whose diagnosis and physiopathogenesis are still poorly understood and for which, until recently, there were no effective treatments. Over the past few decades, many studies have demonstrated that marine macroalgae such as red seaweeds are potential alternative sources of useful bioactive compounds possessing various physiological and biological activities. The present study was aimed to investigate the effect of Corallina officinalis aqueous extract (COAE) against bleomycin (BLM)-induced lung fibrosis in rat. Thus, Wistar rats were divided into 4 groups of 10 each: control, BLM (2 mg/kg), BLM/COAE-150 mg/kg and BLM/COAE-300 mg/kg once a day for 21 days. Obtained results showed that COAE is rich in phenolic compounds and exhibited relatively high antioxidant activity. COAE might significantly reduce the damage caused by BLM by rewarding the decline in weight and pulmonary index in rats given only BLM. Moreover, lungs, liver and kidneys lipid peroxidation, and sulfhydryl group levels were reversed significantly in a dose‐dependent manner in the COAE‐treated groups. BLM decreased superoxide dismutase (SOD) and catalase (CAT) activities, while COAE administration increased the antioxidant enzyme activities. Histopathologically, COAE attenuates the severity of the inflammatory lungs state caused by instillation of BLM in rats. These findings suggest that COAE can be a potential therapeutic candidate against BLM-induced lung fibrosis.
Use of steerable sheaths for complex aortic procedures
Authors: Harrison Ben , Bond Richard
Published: May 2023

Objectives

To demonstrate the ease with which steerable sheaths, designed for cardiac electrophysiological applications, can be used to aid endovascular treatment of a wide range of non-cardiac vascular disease and to assist with target vessel cannulation in branched and fenestrated aortic grafts.

Methods

A retrospective medical chart review was carried out to identify cases from a single vascular surgery unit (2019–2022) where the HeartSpan Steerable Sheath (HSS) (Merit Medical, South Jordan, UT, USA) was utilised to enable endovascular management of complex vascular pathology. A case presentation of branch graft insertion performed entirely via distal access is described and used to help identify pertinent sheath characteristics and technical considerations, and to illustrate the advantages and disadvantages of the design for modified use in target vessel cannulation.

Results

The HSS was used in the endovascular treatment of different vascular pathologies in 15 patients (23 target vessels) where access to the vessels using standard catheters and approaches was not possible. Cannulation and subsequent stenting were successful for 21 of the 23 target vessels in total. Of these cases, the HSS was used as an adjunct for deployment of fenestrated endovascular graft systems when conventional techniques for canulation of target vessels had failed on five occasions. On another four occasions, the HSS enabled full deployment of the entire Zenith® t-Branch™ Thoracoabdominal Endovascular Graft system from an exclusively femoral approach. An additional three cases involved use of the HSS for superior mesenteric artery cannulation in patients with mesenteric ischaemia. The device was also used once in each of the following cases: contralateral common iliac cannulation, cannulation of contralateral internal iliac artery for coil embolisation, and access of a contralateral iliac branched device. There were no stent dislocations and all aortic branches that were patent at the completion of each case remained so 1-year post procedure.

Conclusion

Steerable sheaths designed for cardiac electrophysical applications, like the HSS Introducer, can be successfully utilised for cannulation of challenging target vessels in a wide range of aortic endovascular procedures. This modified approach may salvage cases that would otherwise be considered inoperable in regions of the world where steerable sheaths designed for aortic use are not readily available.
Interplay between leadership and school-level conditions: A review of literature on the Teaching and Learning International Survey (TALIS)
Authors: Ahn Joonkil , Wang Yinying , Lee Yujin
Published: May 2023

We combined network analysis and meta-analysis to systematically review the literature on the Teaching and Learning International Survey, focusing on the interplay between leadership practices and school-level conditions. Our initial network analysis utilized 83 nodes (variables in the reviewed studies) and 214 ties (variable associations), whereas our subsequent meta-analysis employed 21 selected variable associations. Results suggested that leadership practices interplayed with school-level conditions through multiple, interconnected variable associations with a range of effect sizes. First, variables concerning teacher working conditions and teacher qualifications indicated relatively smaller effects than teacher self-efficacy. Second, the association between teacher self-efficacy and teacher collaboration indicated the strongest effect among other variable associations, followed by the relationship between collective teacher perceptions of distributed leadership and teacher job satisfaction. Third, variables regarding teacher perceptions of the principal's leadership effectiveness had larger effect sizes than the principal's self-assessment of their leadership practices. Results further suggested teacher self-efficacy and teacher collaboration as the two most prominent variables that would potentially play a bridging role between leadership practices and school-level conditions. We provide implications for educational leadership practices and research.
#Stand with women in Afghanistan: Civic participation, symbolism, and morality in political activism on Twitter
Authors: Bouvier Gwen , Machin David
Published: May 2023

At the time of writing, it had become common to find trending social media hashtags where users were expressing their feelings about current social and political issues through a range of symbolic gestures, such as striking a pose, wearing a garment, or changing their personal icon. Scholars had begun to consider such gestures in regard to whether they constitute a meaningful form of civic participation or activism. In the present paper, we seek to contribute to this literature by using multimodal critical discourse analysis to examine the contents of one Twitter hashtag where users participate in this form of activism: #StandWithWomenlnAfghanistan. Aligning with emerging scholarship on the nature of online affective publics, the analysis shows that those tweeting do not align with clear and specific issues, causalities, or solutions based on contextual understanding. On the one hand, symbolic gestures can be thought of as vernaculars that support a heterogeneous, fuzzy, and incoherent set of meanings. Yet on the other hand, across the posts using this hashtag, we find a discourse where injustice and solutions are based on notions of individual identity and freedom of expression rooted in the liberal democratic traditions of the European Enlightenment, here brought to bear on the hugely diverse and specific lives of women in Afghanistan. For many scholars, it is such ethnocentrism that underpins the very imperialist imagining of Afghanistan that led to, and legitimized, the invasion and occupation in the first place.
Resolution rates in clinical trials for microbiota restoration for recurrent Clostridioides difficile infection: an updated systematic review and meta-analysis
Authors: Tariq Raseen , Pardi Darrell S. , Khanna Sahil
Published: May 2023

Background:

Microbiota restoration is highly effective to treat recurrent Clostridioides difficile infection (CDI) in observational studies (cure rates >90%) but efficacy in controlled clinical trials appears to be lower.

Objectives:

To perform an updated meta-analysis to assess the efficacy of microbiota restoration for recurrent CDI in open-label registered prospective clinical trials compared to randomized controlled trials (RCTs).

Design:

A systematic review and meta-analysis was conducted.

Data Sources and Methods:

A systematic search of various databases was performed up to July 2022 to identify studies of interest. Clinical trials of microbiota restoration for recurrent CDI with clinical resolution with one dose were included. We calculated weighted pooled rates (WPRs) with 95% confidence intervals (CIs).

Results:

In all, 19 clinical trials with 1176 recurrent CDI patients were included. Of the patients treated with microbiota restoration, 897 experienced a clinical cure with a single microbiota restoration therapy (WPR, 78%; 95% CI, 71–85%). There was significant heterogeneity among studies with an I2 of 88%. Analysis of trials with a control arm (non-microbiota restoration) revealed CDI resolution in 373 of 523 patients (WPR, 72%; 95% CI, 60–82%) with microbiota restoration. Among the nine open-label clinical trials, CDI resolution was seen in 524 of 653 patients after initial microbiota restoration (WPR, 84%; 95% CI, 74–92%). Comparison of resolution rates between RCTs and open-label trials revealed a lower cure rate in RCTs compared to open-label trials (WPR, 73 versus 84%, p < 0.0001).

Conclusions:

Microbiota restoration in a randomized controlled setting leads to lower resolution rates compared to open label and observational settings, likely due to stricter definitions and inclusion criteria. Resolution rates in open-label studies were similar to observational studies.
Percutaneous tibial nerve stimulation in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients: a historically controlled study
Authors: Carilli Marco , Pacini Patrizio , Serati Maurizio , Iacovelli Valerio , Bianchi Daniele , Petta Filomena , Pastore Serena , Amato Ivana , Fede Spicchiale Claudia , D’Ippolito Giulia , Pletto Simone , Cavaleri Yuri , D’Amico Andrea , Parisi Isabella , Finazzi Agrò Enrico
Published: May 2023

Background:

Percutaneous tibial nerve stimulation (PTNS) is widely used in the treatment of neurogenic detrusor overactivity (NDO) in multiple sclerosis (MS); however, controlled studies are still lacking. Objective: To assess effectiveness of PTNS in MS patients with NDO unresponsive to pharmacological and behavioural therapies.

Methods:

MS patients with NDO were enrolled. Inclusion criteria were NDO not responding to pharmacological and behavioural therapies. Exclusion criteria were the presence of relevant comorbidities and urinary tract infections. Patients were evaluated using 3-day bladder diaries and validated questionnaires at baseline, after 4 weeks of educational therapy and after 12 PTNS sessions. The primary outcome measure was the percentage of patients considered responders after the behavioural therapy and after the PTNS in a historical controlled fashion (definition of ‘responder’ was reduction ⩾50% of urgency episodes).

Results:

A total of 33 patients (26 women, 7 men) were enrolled. Two patients dropped out for reasons not related to the protocol. Two out of 31 patients (6.5%) and 21/29 (72.4%) were considered responders at visits 1 and 2, respectively. In PTNS responders, a statistically significant improvement in both bladder diary results and standardized questionnaire scores was recorded, compared with that obtained with behavioural therapy alone. No serious adverse events were reported.

Conclusion:

This historically controlled study suggests that PTNS may be effective in improving NDO in MS patients.
Cardiovascular Disease Risk Factor Profile of Experienced Male Amateur Marathon Runners: A Systematic Review
Authors: O’Riordan Catherine , Savage Eileen , Newell Micheál , Flaherty Gerard , Hartigan MSc Irene
Published: May 2023

Context:

Male amateur marathon runners represent a unique subset of the population who may be at increased risk of cardiovascular disease (CVD) due to their underlying risk factors and their involvement in vigorous exercise such as marathon running.

Objective:

To assess the modifiable risk factors (MRFs) of CVD in experienced male amateur marathon runners and health interventions on CVD risk factors.

Data Sources:

CINAHL, Cochrane Library, Embase, Medline, and SPORTDiscus.

Study Selection:

Studies selected according to the inclusion criteria.

Study Design:

Systematic review.

Level of Evidence:

Level 3.

Data Extraction:

The publication dates included were from June 1, 2008 to February 29, 2020. Published primary epidemiological, observational, randomized controlled trial (RCT) and/or non-RCT studies assessing the MRFs of CVD and health interventions on CVD risk factors in male amateur marathon runners aged ≥18 years and written in the English language were included in the review.

Results:

Five studies met the inclusion criteria for analysis. These included male amateur marathon runners (n = 862), aged 42 to 77 years. Hypertension, hyperlipidemia, smoking, and alcohol use were MRFs positively associated with an increased risk of coronary atherosclerosis found in a subset of male marathon runners. No studies examined health interventions on CVD risk factors in any of the included studies. All 5 studies were of good quality from the National Heart, Lung, and Blood Institute quality assessment tools used. The risk of bias was low to moderate.

Conclusion:

There is a paucity of observational studies evaluating the CVD MRFs. Negative lifestyle behaviors exist within this population despite their engagement in physical exercise through marathon running. Marathon running does not negate the long-term effects caused by past negative lifestyle behaviors. This systematic review identifies that this population may not be aware of their possible risk of atherosclerosis and, consequently, CVD.
Effect of Different Nonstarter Compensatory Strategies on Training Load in Female Soccer Players: A Pilot Study
Authors: Díaz-Serradilla Elba , Castillo Daniel , Rodríguez-Marroyo José Antonio , Raya González Javier , Villa Vicente José Gerardo , Rodríguez-Fernández Alejandro
Published: May 2023

Background:

In soccer, the day of the week with the highest external load is match day (MD), with starters (>60 minutes per match) showing higher levels of physical fitness and seasonal high-intensity loading. It is necessary, therefore, to determine training strategies to reduce the differences between starters and nonstarters. The aim of this study was to analyze and compare the external load of different training compensatory strategies with match external load in female nonstarters.

Hypothesis:

A strategy combining small-sided games (SSG) and running-based drills (RBD) would reproduce match demands, with RBD leading to greater high-intensity running and SSG leading to a greater number of accelerations and decelerations.

Study Design:

Descriptive and comparative study.

Level of Evidence:

Level 4.

Methods:

The training and match external load of 14 female players belonging to the same reserve squad of a Spanish First Division Club (Liga Reto Iberdrola) was registered. In the first session after the match (MD+1), nonstarters (<60 minutes in the match) performed 1 of 3 different compensatory strategies: RBD, SSG, or a mixed intervention combining the previous strategies (RBD+SSG). Starters carried out a recovery session.

Results:

A marked difference in load was observed between the compensatory training strategies and MD. In comparison with MD, RBD showed greater high-intensity and sprint distances and lower acceleration, SSG showed less high-intensity running and sprint distances, lower peak velocity, and greater acceleration, and RBD+SSG registered lower accelerations. In addition, nonstarters covered greater high-intensity running and sprint distances in RBD and achieved higher accelerations in SSG.

Conclusion:

RBD and SSG compensatory strategies could be recommended to nonstarter female soccer players in MD+1 to compensate for match external load deficits.

Clinical Relevance:

This study provides comprehensive information on the compensatory exercises of female soccer players, which can be useful for strength and conditioning coaches when developing recovery strategies during a microcycle.
Young children’s negotiation of language policies and multilingual curriculum at an ethnic minority elementary school in rural China
Authors: Wang Jue
Published: May 2023

Through interpreting the status of Hoche language and cultural practices from community voices, this ethnographic case study conducted in a minority language school centers on five Han and Hoche ethnic minority children’s positions toward multi-language learning. My research explores how these children negotiate the policies and multilingual curriculum that illuminates the multilayered tensions between local issues and global transformation. Findings indicate that policies situate Hoche as a romantic representation of the past, whereas the narratives I gathered from Hoche and Han children’s attitudes and ideologies about language show that younger generations are oriented toward future opportunities and influenced by globalization. This work contributes to scholarship on the education of minority children during a period of rapid industrialization by extending our understanding of ethnicity, diversity, and inclusivity issues via children’s perspectives. Shedding light onto the lives of Hoche and other ethnic minority children’s language practices, this paper is a call to urgently address power inequities in the ideologies and pedagogies enacted in service of Indigenous reclamation.
The psychedelic afterglow phenomenon: a systematic review of subacute effects of classic serotonergic psychedelics
Authors: Evens Ricarda , Schmidt Marianna Elisa , Majić Tomislav , Schmidt Timo Torsten
Published: May 2023

Background:

Classic serotonergic psychedelics have anecdotally been reported to show a characteristic pattern of subacute effects that persist after the acute effects of the substance have subsided. These transient effects, sometimes labeled as the ‘psychedelic afterglow’, have been suggested to be associated with enhanced effectiveness of psychotherapeutic interventions in the subacute period.

Objectives:

This systematic review provides an overview of subacute effects of psychedelics.

Methods:

Electronic databases (MEDLINE, Web of Science Core Collection) were searched for studies that assessed the effects of psychedelics (LSD, psilocybin, DMT, 5-MeO-DMT, mescaline, or ayahuasca) on psychological outcome measures and subacute adverse effects in human adults between 1950 and August 2021, occurring between 1 day and 1 month after drug use.

Results:

Forty-eight studies including a total number of 1,774 participants were eligible for review. Taken together, the following subacute effects were observed: reductions in different psychopathological symptoms; increases in wellbeing, mood, mindfulness, social measures, spirituality, and positive behavioral changes; mixed changes in personality/values/attitudes, and creativity/flexibility. Subacute adverse effects comprised a wide range of complaints, including headaches, sleep disturbances, and individual cases of increased psychological distress.

Discussion:

Results support narrative reports of a subacute psychedelic ‘afterglow’ phenomenon comprising potentially beneficial changes in the perception of self, others, and the environment. Subacute adverse events were mild to severe, and no serious adverse events were reported. Many studies, however, lacked a standardized assessment of adverse effects. Future studies are needed to investigate the role of possible moderator variables and to reveal if and how positive effects from the subacute window may consolidate into long-term mental health benefits.
Clinical presentation and organ-based outcomes of Multifocal fibrosclerosis: A systematic review
Authors: Vahidy Ahmed Safi , Tebha Sameer Saleem , Chavarria Yeny , KC Sandip , Sharma Shristi
Published: May 2023

Objectives:

Multifocal fibrosclerosis is a rare disorder causing progressive fibrosis of multiple organ systems. Existing data on the disease show that there are multiple manifestations of the disease, with different outcomes. However, quantitative data are scarce, prompting the need for our investigation.

Method:

A comprehensive systematic review was performed from inception to November 16, 2022, with the restriction of English language, not including review articles. Article screening and extraction was performed independently, and shortlisted articles were assessed for bias. Analysis was performed using SPSS Version 25 (IBM® SPSS® Statistics; Chicago, IL, USA). Data were presented as frequencies and percentages, with a confidence interval of 95%.

Result:

This review included 134 patients, with 78 (58.2%) males. Mean age was 53.6 years and included two pediatric patients. The most common comorbidity was diabetes (9.7%). Prevalent presenting symptoms included pain (47.8%) and swelling (35.1%). A mean of 2.51 organs or anatomical sites was affected, retroperitoneum (64.2%) being most affected. The pancreas (30.0%) and digestive system (47.0%) were the organs/organ systems most affected. Patients had favorable outcomes in 79.1% of cases, 87.3% had no relapse, and 91.8% of patients survived the condition.

Conclusion:

The findings in this study provide a quantitative measurement of the demographics, presentations, organ manifestations, and outcomes of multifocal fibrosclerosis. We found the disease to be prevalent in males in Japan or the United States, with the abdomen and its organs being commonly involved.
CLIPPERS manifesting with dizziness: Recognizable and treatable
Authors: El Harras Yahya , Choayb Safaa , Berrada Kenza , Fikri Meryem , Ech-Cherif Kettani Najwa , Jiddane Mohamed , Touarsa Firdaous
Published: May 2023

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids is a very rare entity which is considered as a treatable condition. In some cases, clinical and radiological findings, associated to favorable evolution on steroids therapy can be sufficiently distinguishable to diagnose chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. We report the case of a 50-year-old man, suffering from acute dizziness with right facial paralysis and limited ocular abduction with his magnetic resonance imaging showing large confluent T2 and fluid-attenuated inversion recovery brainstem hyperintensities extending into the upper cervical spinal cord, infiltrating the basal ganglia and the thalami, with some punctate hyperintensities “peppering” the medial aspects of cerebellar hemispheres. This case illustrates atypical imaging features of chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids on magnetic resonance imaging and our work also reviews different studies in the literature and highlights the differential diagnosis.
Do cognition and emotion matter? A study of COVID-19 vaccination decision-making in college students
Authors: Chen Nien-Tsu Nancy , Kee Kimmy , Villalobos Bianca T , Ortiz Miriam , Lee HyeSun
Published: May 2023

The unparalleled speed of COVID-19 vaccine development has necessitated an expansion of existing knowledge on vaccination decision-making. The current study explored (1) how cognitions and emotions shaped college students’ COVID-19 vaccination decisions, and (2) where vaccination-inclined and vaccination-hesitant students converged and diverged in their decision-making process. Seventy-seven students participated in 26 focus groups to discuss their complex thoughts and feelings regarding COVID-19 vaccination, offering a more nuanced understanding of COVID-19 vaccination decision-making that has not been fully captured by quantitative studies. Thematic analysis found that vaccination-inclined participants and their hesitant counterparts reported differential patterns of positive and negative emotions, systematic appraisals, and heuristics in decision-making. Future research should investigate the roles of hope and relief, non-health-related benefits of vaccination, social trust, and interpersonal influence in vaccination decision-making.