bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the influence of head kinematics on head injury metrics and factors to consider for football helmet design
Authors: Chatham Lillian S , Young Trevor S , Wojcik Richard M , Bell Lyssa A , Torbati Amir H , Carpenter Robert Dana , Jenkins Peter E , Poddar Sourav K , Yakacki Christopher M
Published: August 2023

There is a need to understand the relationship between head kinematics, impact severity metrics, and overall helmet performance as sports-related concussions continue to be prevalent. This study evaluates these relationships, emphasizing newly developed severity metrics that consider both translational and rotational contributions. Impact tests were performed following the NFL testing protocol on four prominent football helmets. The resulting data was used to determine Head Acceleration Response Metric (HARM), Diffuse Axonal Multi-Axis General Evaluation (DAMAGE), and Head Injury Criterion (HIC). HARM scores, a combination of HIC and DAMAGE, were ultimately used to solve for a Helmet Performance Score. When analyzing all impacts, DAMAGE showed a stronger correlation to HARM than HIC ( R2 = 0.76 vs R2 = 0.57); however, the strongest correlation existed between peak resultant angular velocity (PRAV) and HARM ( R2 = 0.87). When examining impacts at only the side, side upper (SU), and oblique front (OF) locations grouped together, HIC demonstrated the strongest correlation to HARM in the study ( R2 = 0.96). PRAV was the best predictor for HARM over peak resultant linear acceleration (PRLA) and peak resultant angular acceleration for four of the six impact locations (C, D, FMCO, and FMS) when analyzing the sites individually. The remaining locations (SU and OF) best predicted HARM using PRLA. These results are presented and discussed to aid in the research, design, and development of football helmets.
Evaluation of serum cytokines and acute phase proteins as possible pharmacodynamic biomarkers to monitor endoscopic remission during ustekinumab therapy in patients with Crohn’s disease
Authors: Van den Berghe Nathalie , Alsoud Dahham , Verstockt Bram , Vermeire Séverine , Declerck Paul , Thomas Debby
Published: August 2023

Background:

Since not all Crohn’s disease (CD) patients respond adequately to ustekinumab therapy, biomarkers could aid to monitor treatment response and optimize therapeutic outcomes.

Objectives:

To explore the dynamics of serum biomarker concentrations to monitor the response to ustekinumab treatment in CD patients.

Design:

Retrospective, exploratory study to evaluate concentrations of serum cytokines and acute phase proteins and their relation to endoscopic remission in CD patients during ustekinumab treatment.

Methods:

Serum concentrations of 16 proteins including cytokines and acute phase proteins were measured using the Mesoscale Discovery Platform in serum of healthy controls ( n = 13), and CD patients ( n = 61) at baseline (week 0), week 8 and week 24 during ustekinumab treatment. Endoscopic remission was defined as simple endoscopic score for CD (SES-CD) <3 after 6 months of therapy.

Results:

Absolute concentrations of serum amyloid A protein (SAA; week 8), IL-6 (week 24), AGP (weeks 8 and 24), interferon (IFN)-γ (weeks 8 and 24), lipopolysaccharide binding protein (LBP; weeks 8 and 24) and IL-22 (weeks 8 and 24) were significantly lower in endoscopic remitters compared to non-responders ( p-values ranging between <0.001 and <0.05). SAA (week 8) and AGP (week 24) were the biomarkers with the highest area under the ROC curve (AUROC; 0.761 and 0.760, respectively) for identifying patients in endoscopic remission, though their performance was not superior to C-reactive protein (CRP) or faecal calprotectin. AUROCs of the predictive probability of biomarker combinations showed superiority in discriminating endoscopic remitters from non-responders in comparison to single biomarker measurements, but not as compared to faecal calprotectin.

Conclusion:

Although not superior to faecal calprotectin, measurement of AGP, SAA, LBF, IFN-γ, IL-6 and IL-22 concentrations, and combinations thereof with or without CRP and faecal calprotectin, during ustekinumab therapy might contribute to adequate monitoring of treatment response in CD patients.
At admission hemodynamic instability is associated with increased mortality and rebleeding rate in acute gastrointestinal bleeding: a systematic review and meta-analysis
Authors: Tari Edina , Frim Levente , Stolcz Tünde , Teutsch Brigitta , Veres Dániel Sándor , Hegyi Péter , Erőss Bálint
Published: August 2023

Background:

Acute gastrointestinal bleeding (GIB) is a life-threatening event. Around 20–30% of patients with GIB will develop hemodynamic instability (HI).

Objectives:

We aimed to quantify HI as a risk factor for the development of relevant end points in acute GIB.

Design:

A systematic search was conducted in three medical databases in October 2021.

Data sources and methods:

Studies of GIB patients detailing HI as a risk factor for the investigated outcomes were selected. For the overall results, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated based on a random-effects model. Subgroups were formed based on the source of bleeding. The Quality of Prognostic Studies tool was used to assess the risk of bias.

Results:

A total of 62 studies were eligible, and 39 were included in the quantitative synthesis. HI was found to be a risk factor for both in-hospital (OR: 5.48; CI: 3.99–7.52) and 30-day mortality (OR: 3.99; CI: 3.08–5.17) in upper GIB (UGIB). HI was also associated with higher in-hospital (OR: 3.68; CI: 2.24–6.05) and 30-day rebleeding rates (OR: 4.12; 1.83–9.31) among patients with UGIB. The need for surgery was also more frequent in hemodynamically compromised UGIB patients (OR: 3.65; CI: 2.84–4.68). In the case of in-hospital mortality, the risk of bias was high for 1 (4%), medium for 13 (48%), and low for 13 (48%) of the 27 included studies.

Conclusion:

Hemodynamically compromised patients have increased odds of all relevant untoward end points in GIB. Therefore, to improve the outcomes, adequate emergency care is crucial in HI.

Registration:

PROSPERO registration number: CRD42021285727.
Efficacy and safety of vonoprazan–amoxicillin dual therapy for Helicobacter pylori first-line treatment: a single-center, randomized, controlled trial
Authors: Wang Xiaolei , Teng Guigen , Dong Xinhong , Dai Yun , Wang Weihong
Published: August 2023

Background:

With the increase in antibiotic resistance, the success rate of Helicobacter pylori ( H. pylori) eradication therapy has declined in recent years. Vonoprazan–amoxicillin (VA) dual therapy has been reported to be a promising regimen.

Objectives:

To compare the efficacy and safety of VA dual therapy and bismuth quadruple therapy containing amoxicillin and clarithromycin for H. pylori first-line eradication, and to further analyze the effects of clarithromycin resistance on eradication rate.

Design:

This study was a single-center, open-label, randomized controlled trial.

Methods:

Treatment-naïve H. pylori-infected patients were randomly allocated 1:1 to the VA group (vonoprazan 20 mg twice daily and amoxicillin 750 mg four times daily, for 14 days) or the RBAC group (rabeprazole 10 mg, bismuth potassium citrate 220 mg, amoxicillin 1000 mg and clarithromycin 500 mg twice daily, for 14 days). H. pylori clarithromycin resistance and CYP2C19 gene polymorphisms were detected with real-time polymerase chain reaction (PCR) technique. The eradication rates and adverse events were analyzed.

Results:

A total of 151 patients were enrolled. The intention-to-treat (ITT), modified intention-to-treat (mITT), and per-protocol (PP) eradication rates and their 95% confidence intervals (95% CIs) were 94.6% (86.0–98.3%), 98.6% (91.3–99.9%), and 98.5% (90.9–99.9%) for VA group and 87.0% (77.0–93.3%), 91.8% (82.3–96.6%), and 93% (83.7–97.4%) for RBAC group. The eradication rate of the VA group was noninferior to the RBAC group in ITT, mITT, and PP analyses ( p < 0.0001). In patients infected with strains of clarithromycin resistance point mutation, the eradication rate of the RBAC group decreased to lower than 90%, but the difference from the VA group did not achieve statistical significance (ITT eradication rate: 81.5% in the RBAC group and 96.2% in the VA group, p = 0.192). The incidence of adverse events in the VA group was 39.2%, which was significantly lower than that in the RBAC group (79.2%, p = 0.000).

Conclusion:

The efficacy of VA dual therapy is noninferior to RBAC in H. pylori first-line eradication, with fewer adverse reactions.

Registration:

This study was registered at the Chinese Clinical Trial Registry (ChiCTR2100052550) on 30 October 2021.
Handgrip strength and risk of malnutrition are associated with an increased risk of hospitalizations in inflammatory bowel disease patients
Authors: Bedard Katherine , Taylor Lorian , Rajabali Naheed , Kroeker Karen , Halloran Brendan , Meng Guanmin , Raman Maitreyi , Tandon Puneeta , Abraldes Juan G. , Peerani Farhad
Published: August 2023

Background:

In patients with inflammatory bowel disease (IBD), frailty is independently associated with mortality and morbidity.

Objectives:

This study aimed to extend this work to determine the association between the clinical frailty scale (CFS), handgrip strength (HGS), and malnutrition with IBD-related hospitalizations and surgeries.

Design:

IBD patients ⩾18 years of age were prospectively enrolled from two ambulatory care clinics in Alberta, Canada.

Methods:

Frailty was defined as a CFS score ⩾4, dynapenia as HGS < 16 kg for females and <27 kg for males, malnutrition using the subjective global assessment (SGA), and the risk of malnutrition using either the abridged patient-generated SGA (abPG-SGA), or the Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT). Logarithm relative hazard graphs and multivariable logistic regression models adjusting for relevant confounders were constructed.

Results:

One hundred sixty-one patients (35% ulcerative colitis, 65% Crohn’s disease) with a mean age of 42.2 (±15.9) years were followed over a mean period of 43.9 (±10.1) months. Twenty-seven patients were hospitalized, and 13 patients underwent IBD-related surgeries following baseline. While the CFS (aHR 1.34; p = 0.61) and SGA (aHR 0.81; p = 0.69) did not independently predict IBD-related hospitalizations, decreased HGS (aHR 3.96; p = 0.03), increased abPG-SGA score (aHR 1.07; p = 0.03) and a SaskIBD-NRT ⩾ 5 (aHR 4.49; p = 0.02) did. No variable was independently associated with IBD-related surgeries.

Conclusion:

HGS, the abPG-SGA, and the SaskIBD-NRT were independently associated with an increased risk of IBD-related hospitalizations. Future studies should aim to validate other frailty assessments in the IBD population in order to better tailor care for all IBD patients.
Hip Impingement of severe SCFE patients after in situ pinning causes decreased flexion and forced external rotation in flexion on 3D-CT
Authors: Lerch Till D , Kim Young-Jo , Kiapour Ata , Boschung Adam , Steppacher Simon D , Tannast Moritz , Siebenrock Klaus A , Novais Eduardo N
Published: August 2023

Introduction:

In situ pinning is an accepted treatment for stable slipped capital femoral epiphysis. However, residual deformity of severe slipped capital femoral epiphysis can cause femoroacetabular impingement and forced external rotation.

Purpose/questions:

The aim of this study was to evaluate the (1) hip external rotation and internal rotation in flexion, (2) hip impingement location, and (3) impingement frequency in early flexion in severe slipped capital femoral epiphysis patients after in situ pinning using three-dimensional computed tomography.

Patients and methods:

A retrospective Institutional Review Board-approved study evaluating 22 patients (26 hips) with severe slipped capital femoral epiphysis (slip angle > 60°) using postoperative three-dimensional computed tomography after in situ pinning was performed. Mean age at slipped capital femoral epiphysis diagnosis was 13 ± 2 years (58% male, four patients bilateral, 23% unstable, 85% chronic). Patients were compared to contralateral asymptomatic hips (15 hips) with unilateral slipped capital femoral epiphysis (control group). Pelvic three-dimensional computed tomography after in situ pinning was used to generate three-dimensional models. Specific software was used to determine range of motion and impingement location (equidistant method). And 22 hips (85%) underwent subsequent surgery.

Results:

(1) Severe slipped capital femoral epiphysis patients had significantly (p < 0.001) decreased hip flexion (43 ± 40°) and internal rotation in 90° of flexion (−16 ± 21°, IRF-90°) compared to control group (122 ± 9° and 36 ± 11°). (2) Femoral impingement in maximal flexion was located anterior to anterior–superior (27% on 3 o’clock and 27% on 1 o’clock) of severe slipped capital femoral epiphysis patients and located anterior to anterior–inferior (38% on 3 o’clock and 35% on 4 o’clock) in IRF-90°. (3) However, 21 hips (81%) had flexion < 90° and 22 hips (85%) had < 10° of IRF-90° due to hip impingement and 21 hips (81%) had forced external rotation in 90° of flexion (< 0° of IRF-90°).

Conclusion:

After in situ pinning, patient-specific three-dimensional models showed restricted flexion and IRF-90° and forced external rotation in 90° of flexion due to early hip impingement and residual deformity in most of the severe slipped capital femoral epiphysis patients. This could help to plan subsequent hip preservation surgery, such as hip arthroscopy or femoral (derotation) osteotomy.
Spinal osteoid osteoma in the pediatric population: A management algorithm and systematic review
Authors: Farid Alexander R , Liu David S , Morcos Mary M , Hogue Grant D
Published: August 2023

Purpose:

The purpose of this study is to develop an accessible step-wise management algorithm for the management of pediatric spinal osteoid osteomas (OOs) based on a systematic review of the published literature regarding the diagnostic evaluation, treatment, and outcomes following surgical resection.

Methods:

A systematic review of the literature was conducted on PubMed to locate English language studies reporting on the management of pediatric spinal OOs. Data extraction of clinical presentation, management strategies and imaging, and treatment outcomes were performed.

Results:

Ten studies reporting on 85 patients under the age of 18 years presenting with OOs were identified. Back pain was the most common presenting symptom, and scoliosis was described in 8 out of 10 studies, and radicular pain in 7 out of 10 studies. Diagnostic, intraoperative, and postoperative assessment included radiographs, computed tomography (CT) scans, magnetic resonance imaging (MRI), bone scans, and frozen section. Treatment options varied, including conservative management, open surgical resection with or without intraoperative imaging, and percutaneous image-guided treatment. All included studies described partial or complete resolution of pain in the immediate postoperative period.

Conclusions:

The proposed algorithm provides a suggested framework for management of pediatric spinal OOs based on the available evidence (levels of evidence: 3, 4). This review of the literature indicated that a step-wise approach should be utilized in the management of pediatric spinal OOs.
Best Practices for Developing a Diabetes mHealth App
Authors: Holtz Bree E. , Mitchell Katharine
Published: August 2023

The widespread use of smartphones in the United States has led to a surge in mHealth apps designed to support people with various health issues. Yet the effectiveness and long-term impacts of these apps still need to be determined. This article presents a case study of the development of MyT1DHero, an mHealth app for people with type 1 diabetes, to identify best practices for app development. We propose four essential best practices based on the insights gained from this case study: incorporating theoretical frameworks, prioritizing user feedback, engaging key stakeholders, and establishing a robust data-collection foundation. These findings have practical implications for researchers and developers seeking to create effective mHealth interventions. Furthermore, we suggest future research directions to advance the development and implementation of innovative health technologies.
A new beginning: can omidubicel emerge as the next, viable alternative donor source?
Authors: Gandhi Arpita P. , Newell Laura F. , Maziarz Richard T.
Published: August 2023

Umbilical cord blood (UCB) transplantation (CBT) has been an important alternative donor option for patients lacking matched related donor (MRD) or unrelated donor (URD) grafts. Only 30% of patients with high-risk hematologic malignancies have a human leukocyte antigen (HLA)-identical sibling; subjects without a MRD option are referred for HLA-matched URD selection, or utilize alternative donor sources such as HLA-mismatched URD, UCB, or haploidentical donor grafts. While CBT demonstrates an excellent graft- versus-leukemia (GVL) effect, use of UCB as a graft source is limited due to a lower cell dose that can result in delayed engraftment and an immature immune system with increased infectious risk as a consequence. Together, increased transplant related mortality (TRM) has been associated with UCB allografts. Omidubicel is an ex vivo expanded single cord blood product that has demonstrated rapid engraftment, improved immune reconstitution, and reduced infectious complications in clinical trials. Omidubicel has now been granted U.S. Food & Drug Administration approval to enhance neutrophil recovery and decrease infectious risk. This review will focus on CBT, benefits and barriers to using this alternative donor source, and finally the potential advancements with incorporation of omidubicel in the transplant setting for malignant and non-malignant diseases.
High burden of sexually transmitted infections among under-resourced populations in the Dominican Republic
Authors: Amesty Silvia , Perez-Figueroa Rafael , Stonbraker Samantha , Halpern Mina , Donastorg Yeycy , Perez-Mencia Martha , Lantigua Flavia , Soriano Leidy , Baez-Caraballo Pamela , Gilbert Jeffrey , Buccini Frank , Sharp James , Hernandez Brian , Gelfond Jonathan , Cardwell Ethan , Nicholas Catherine , Egan Kelsey A. , Gomes Angelina , Van Dyke Elizabeth , Nicholas Stephen W. , Grodman Marc , Taylor Barbara S.
Published: August 2023

Background:

Sexually transmitted infections (STIs) are a major health issue, exacerbated by limited financial and infrastructural resources in developing countries.

Methods:

Prevalence of STIs was assessed in two urban centers of the Dominican Republic (DR) among populations at high risk for STIs: pregnant youth, men who have sex with men (MSM), trans women (TG), batey residents, female sex workers, and people living with human immunodeficiency virus (HIV). We conducted a cross-sectional survey and biological specimen collection to screen for Chlamydia trachomatis, Neisseria gonorrhea, Mycoplasma genitalium, Trichomonas vaginalis (trichomoniasis), Treponema pallidum (syphilis), HIV, hepatitis B and C, and human papillomavirus (HPV) among at-risk populations between 2015 and 2018. Ureaplasma urealyticum testing was also conducted even though it is not considered a STI. A non-probability community sample was recruited. Descriptive statistics examined the prevalence of STIs by population.

Results:

A total of 1991 subjects participated in the study. The median age was 26 years (range: 18–65). Most participants were female (65.3%), heterosexual (76.7%), and were not partnered (55.7%). Most of the participants reported unprotected vaginal sex in the last 6 months (54%); among MSM and TG almost half of the participants reported unprotected anal sex in the last 6 months and 17.6% reported drug use in the last 6 months. Almost half of the participants (49%) tested positive for one or more STIs. The most prevalent STI was Chlamydia trachomatis (12.8%), and human papillomavirus (11.9%). Among transgender women, 65.3% tested positive for an STI, 64.8% of female sex workers tested positive for an STI, and 53.8% of pregnant adolescents tested positive for an STI.

Conclusion:

There is a high prevalence of STIs among key and under resourced populations in the DR. Our findings highlight the need to conduct further research to optimize prevention and care strategies for structurally vulnerable and under resourced populations in the DR.
Clozapine-induced eosinophilia: A case report
Authors: Das Soumitra , Itrat Annie , Hernandez Mary Elizabeth Trejo , Subedi Rasish , Jogarajah Thusanth , Vashist Sreshatha , Daggala Nikitha
Published: August 2023

Schizophrenia is a chronic neuropsychiatric illness defined by the appearance of positive, and negative symptoms and/or cognitive impairment. Antipsychotic drugs are predominantly used in the treatment of psychotic disorders, but not all patients with schizophrenia respond to every antipsychotic medication. Clozapine is one of the best atypical antipsychotics and is highly effective in treating treatment-resistant schizophrenia. Evidence suggests that clozapine appears to be effective in lowering the risk of suicide, extrapyramidal side effects, and relapse in patients with schizophrenia. Per contra, clozapine is not the first-line treatment due to its unalterable aftereffects such as agranulocytosis, metabolic syndrome, seizures, and rarely, eosinophilia. Eosinophilia can be life-threatening. Eosinophils infiltrate different tissues and cause inflammation in multiple organs causing end-organ damage. The current study aimed to report the incidence of eosinophilia associated with clozapine use in patients with schizophrenia. Literature on clozapine-induced eosinophilia is relatively scarce. Understanding the progression and management of clozapine-induced eosinophilia and its end-organ effects is imperative. While there is insufficient data about the guidelines in the management of clozapine-induced eosinophilia, this study contributes to understanding the patterns of the disease progression with clozapine dosage. A case study was done on a patient with schizophrenia and autistic spectrum disorder who was on clozapine. Data on how eosinophil levels varied with clozapine dosing was analyzed and documented. The evidence of clozapine dosage affecting eosinophil and C-reactive protein levels in this patient was summarized in a table and a narrative review.
The broad spectrum of tyrosine kinase inhibitors. Treatment of a rare EGFR R776H mutation with Osimertinib: Case report
Authors: Cui Joyce , Tabbara Sana , Chadha Juskaran
Published: August 2023

EGFR mutations comprise a sizeable portion of non-small cell lung cancers. While the most common EGFR mutation consists of exon 19 in-frame deletions and exon 21 point mutations, rare EGFR mutations have become a more frequent occurrence. Currently, no clinical guidelines exist for the treatment of such mutations. In this case, we see a 68-year-old non-small cell lung cancer male patient with a history of smoking presenting with a rare exon 20 R776H EGFR mutation who demonstrates a response to Osimertinib, further exploring potential standard treatments for patients with rare EGFR mutations.
Decoding brain calcifications: A single-center descriptive case series and examination of pathophysiological mechanisms
Authors: Srichawla Bahadar S , Andrade Eduardo , Kipkorir Vincent
Published: August 2023

Brain calcifications, previously known as Fahr’s disease, is a rare neurological disorder marked by various clinical symptoms, including movement disorders, cognitive impairment, and psychiatric disturbances. Despite its clinical importance, its pathophysiology is unclear and there are no specific treatments. We present four cases of brain calcifications from our tertiary care center, with three female patients (75%) and an average age of 63 years. Our cohort featured both genetic and endocrine etiologies, including one primary familial brain calcification case with a c.852del frameshift mutation in the SLC20A2 gene, and two endocrinopathy-related cases. One patient had an acute stroke which may have been contributed by brain calcifications. Computerized tomography and magnetic resonance imaging scans revealed basal ganglia and dentate nucleus calcifications. Treatment involved physical and occupational therapy in all patients. Hypoparathyroidism-related brain calcifications were treated with oral supplementation with calcitriol, calcium, and vitamin D. Three patients showed improvement or stability of their symptoms. This case series underscores the diverse clinical presentations and etiologies of brain calcifications. The complex pathophysiology involves disrupted Ca+2-PO43- homeostasis, deficient cellular PO43- transport, and vascular irregularities in genetic etiologies. Future research should focus on identifying novel genetic mutations, understanding molecular pathways, and refining diagnostic techniques. Integrating multidisciplinary approaches may improve diagnosis, management, and prognosis for patients with this intricate neurological disorder.
Supporting rural health services through regional networks: Observations of a formalized model
Authors: Kornelsen Jude , Humber Nancy , Ebert Sean , Skinner Tom
Published: August 2023

Introduction

In many jurisdictions internationally, distributed networks of clinical care have emerged as a planning principle to meet the needs of rural communities. Such networks rely on productive relationships between small rural sites and larger regional centres as the mechanism for training and backup and as the pathways for transfer when triage to a higher level of care is required. This paper explores the impact of the Rural Surgical Obstetrical Network (RSON) initiative on regional relationships between networked sites in order to provide data on the efficacy of networked models of healthcare. Implementation of networked care may ultimately lead to better patient care.

Methods

This qualitative study involved interviews and focus groups over 4 years with 169 rural healthcare workers and hospital administrators at different RSON sites. Data was analysed inductively using thematic analysis.

Results

Findings revealed three primary areas considered in the context of RSON funding: improved relationships (primarily through clinical coaching and the consequent building of reciprocal trust) and increased regional coordination of patient care through more efficient triage pathways and increased involvement of specialists through outreach care in rural communities. Continued lack of engagement with regional specialists was reported by a minority of participants.

Discussion

RSON provided a supportive infrastructure that benefitted both rural and regional services namely through funding for clinical coaching and quality improvement initiatives which enabled overall improved provider relationships between sites. This strengthened a regional approach to optimal patient care that should be supported on an ongoing basis.
Grindr Tourism Among Tourists, Locals, and Immigrants: Dating App Impacts for Social Relations, Gay Tourism, and Digital Convergence
Authors: Katz Rachel A.
Published: August 2023

Dating app tourism is a phenomenon that intersects both digital mobile media applications and tourism networks. As such, it represents a new but little-examined frontier in the study of sexuality, technology, and identity formation. Using a qualitative sociological approach, this exploratory study identifies Grindr tourism practices and their consequences for gay tourism, tourist-local relations, and digitally mediated social life. With Tel Aviv as the research site, Grindr tourism practices were analyzed using 19 in-depth interviews and six audio diaries. The concept of embedded learning is used to understand the communication that results from contemporary mobile media-integrated tourism. Grindr tourism practices are viewed as mutually beneficial by tourists, locals, and immigrants. Findings indicate that Grindr tourism contributes to tourists’ embedded learning about travel destinations, immigrants’ acclimation and friendship networks, and locals’ self-ascribed cosmopolitan, multicultural identities. The research also uncovered wider issues affecting sexuality, communication, migration movements, ethnicity, and the economic bodies that support large-scale tourism. Specifically, Grindr is used as a tool to arrange independent, mobile, non-institutionalized travel that serves as an alternative to LGBT + tourism industry institutions. Not only is Grindr tourism indicative of shifting travel practices, but it also reflects dating apps’ overarching tendency toward the convergence of multiple social functions into one platform.
The Spillover Effect of Emotional Labor: How It Shapes Frontline Employees’ Proactive Innovation Behavior
Authors: Ma Chunhao , Wang Biying , Sun Caozhi , Lin Le
Published: August 2023

Frontline employees can generate tremendous value for both the customer and the organization through innovation. While prior research has revealed that frontline employees’ emotional labor significantly affects their own creativity, it is unclear whether it has a spillover effect on other frontline employees (i.e., co-workers) and how it shapes their behaviors, especially proactive innovation behavior. Based on emotion-as-social-information (EASI) theory, we construct a mechanism model to illustrate this aforementioned spillover effect. By analyzing the questionnaires collected from 268 frontline employees in China, we found that (1) deep acting (surface acting) of co-worker influences frontline employee’s proactive innovation behavior positively (negatively); (2) affective commitment plays a mediating role between emotional labor and proactive innovation behavior; and (3) emotional sensitivity reinforces the positive (negative) effect of deep acting (surface acting) on proactive innovation behavior. The conclusions provide valuable insight into understanding the spillover effects of emotional labor among frontline employees.
Toward a Sustainable Human Resources Management: Linking Green Human Resources Management Activities with ISO Standards
Authors: Akdeniz Ekin
Published: August 2023

The main idea of this study focuses on how green human resource management (GHRM) can be utilized effectively by discovering practical implementation areas in organizations. The purpose of this research is to link GHRM activities with ISO standards, and contribute to effective utilization of GHRM as a result of implementation of ISO standards in organizations, help in wider practical use of both, thus contribute to sustainability and environmental management (EM). Three hundred seventeen studies on GHRM activities were examined in the scan performed using the Scopus database (as an auxiliary step), 10 prominent GHRM activities were selected from these studies, and mapping the 10-item GHRM activity list with ISO standards formed the core body of the study. Methodologically, document analysis—supported by systematic literature review (SLR) and qualitative synthesis/analysis—was used. Separate links were established for each GHRM activity, each has its own findings detailed in its own subsection, and the established links are summarized in figures in Results & Discussion, depicting seven activities on primary link with 10 standards. Although the linkage of GHRM with ISO standards gives the expected result that HRM standards are dominant, the facts expressed by other related standards as a secondary benefit are also important. Along with the EM standard 14001, which is crucial to be employed in the background, it is observed that quality management (QM) and occupational health & safety (OH&S) management has also emerged as supporting fields in connection of GHRM activities with ISO standards.
Digital Economy, Agricultural Technology Innovation, and Agricultural Green Total Factor Productivity
Authors: Zhang Yi-feng , Ji Min-xuan , Zheng Xiu-zhi
Published: August 2023

The digital economy is integral in driving economic growth, particularly of high-quality standards. Against the backdrop of the “Double Carbon” project, exploring the impact of the digital economy on green agricultural development bears tremendous practical significance. Thus, this study aims to investigate how the digital economy affects agricultural green total factor productivity (GTFP). The entropy-TOPSIS method and SBM-GML index are used to measure core variables quantitatively. In addition, two-way fixed effects panel data models, Tobit, and intermediary effect models are implemented. Three research findings emerge. First, China’s agricultural GTFP level generally experiences an upward trend, and the development of the digital economy has a significant positive effect on increasing agricultural GTFP. Second, the digital economy mainly promotes agricultural technology innovation that boosts agricultural GTFP. Third, Western China experiences a more significant positive effect of the digital economy on agricultural GTFP than Central and Eastern China. Finally, based on the findings, this paper proposes relevant policy recommendations to promote green and sustainable agriculture development.
Increasing Trend of Studying Abroad for Residency Training Among Medical Students
Authors: Çalışkan S. Ayhan , Tümer Umay Ruchan , Karaca Ozan
Published: August 2023

Physician emigration from developing and underdeveloped countries to developed countries is a growing problem that is taking place in current times and is an obstacle in achieving global health. Social circumstances, economic demands, as well as modern medical technologies and desire to pursue better career opportunities, are all driving factors for medical graduates’ emigration. This study investigates Turkish medical students’ intentions of pursuing residency training abroad and explores associated factors that play a significant role in instilling the tendency of moving overseas. A cross-sectional study was conducted at Ege University, Faculty of Medicine, İzmir, Turkey. Students’ future specialty intentions, preferred country for residency training, and the contributing factors in their decisions were questioned via an online survey questionnaire. Out of 617 students included in the study analysis, 183 (29.7%) expressed their desire for going abroad for residency training and Germany, United States of America, United Kingdom, and Canada were the top preferred destinations where 40 (25.3%) reported planning to stay permanently. Mother’s level of education and student’s training/ understanding of advanced levels of any foreign language were found significantly associated with the developed intention of going abroad for residency training. Qualitative analysis revealed better “living standards/conditions” was the most frequently uttered reason for studying abroad. It’s vital to know reasons out why medical school graduates want to go to another country. A better understanding of this issue will aid in developing actions to reduce the proclivity of medical graduates to relocate.
Macronutrient intake in stunted and non-stunted toddlers in Jember, Indonesia
Authors: Elisanti Alinea Dwi , Jayanti Resy Dwi , Amareta Dahlia Indah , Ardianto Efri Tri , Wikurendra Edza Aria
Published: August 2023

Background:

Stunting is a condition of toddlers who experience growth failure due to chronic nutrient deficiencies that must be addressed immediately, if children lack nutrients continuously, it can affect their nutritional status and will cause children to be shorter than their age. The purpose of this study was to determine the differences in macronutrient intake in stunted and non-stunted toddlers in Jember, Indonesia.

Design and methods:

Type of analytical observational research with case control design, sampling technique using simple random sampling. The number of subjects needed in each group is 66 stunting toddlers and 66 non-stunting toddlers with total subjects used are 132 toddlers.

Results:

There are differences in macronutrient intake: energy, protein, fat, and carbohydrates between stunted and non-stunted toddlers with a higher average value of food intake per day for non-stunted toddlers than for stunted toddlers.

Conclusions:

There are differences in macronutrient intake between stunted and non-stunted toddlers in Jember, Indonesia with a p-value = 0.000 < 0.05.
Pediatric Pilomatrixomas: Four Atypical Clinical Presentations
Authors: Melloni-Magnelli Laura Fortunata , González-Gaytán Daniel , Sepulveda-Valenzuela Marbella , Peña-Jiménez Claudia Yenensi , Martínez-Leija Hector , Villarreal Enrique G.
Published: August 2023

Pilomatrixoma, also called Malherbe's calcifying epithelioma or pilomatrixoma, is a benign adnexal tumor that originates from keratinocytes (cells of the hair matrix, the internal sheath of the hair root or the cortex) and constitutes the second most prevalent skin neoplasm in children. These lesions are typically slow-growing, firm, nodules located on the head, neck, trunk, and extremities (in decreasing order of frequency). Due to the rarity, combined with their varied clinical presentations, pilomatrixomas are often misdiagnosed. Current pilomatrixoma classification schemes remain controversial. In this article, we present 4 pediatric patients that exemplify different clinical and atypical scenarios of the same tumor. Accordingly, we invite future studies to create a novel system for the classification of pilomatrixomas based on atypical clinical characteristics, including lesion morphology, number, size, and anatomic location.
Role of Panchayati Raj Institution and Tribal Rights in Forest Resources Management: A Study of Mayurbhanj District of Odisha
Authors: Soren Phulamani , Naik Iswar Chandra
Published: August 2023

Most tribal people have been living in forest areas but do not officially permit rights to their homes, lands and livelihoods. India is the land of tribes, constituting 8.6% of its population. Tribes have been closely related to the forest, and their life and livelihood depend on the availability of forest resources in India. Forest ecosystems are crucial for biodiversity, watershed protection and the livelihood of indigenous communities. In Odisha, the forest has become and is considered a potential natural resource. Forests have been interdependent and interrelated for the tribal people in Odisha for generations. According to the well-being of the tribal people, they have depended on their habits, culture and style of life in the forests through separable entities like forest and tribal culture. Everything in the forest has been fulfilled, including social, economic, cultural, religious and medicinal needs, which the forest dwellers require. Aside from the aspects mentioned above, the study investigates the role of Panchayati Raj institutions in managing forest resources for the benefit of tribal people. It focuses on the tribe members’ level of awareness following the passage of the Panchayat Extension to the Scheduled Area Act.
Outcomes and Complications After Bone Marrow Aspirate Harvest From the Calcaneus
Authors: Encinas Rodrigo , Phillips Tammy , Hall Sarah , Jackson J. Benjamin , Gonzalez Tyler
Published: August 2023

Background:

Bone marrow aspirate (BMA) is used with the putative goal of enhancing healing of injured tissue. The most common sites to harvest BMA are the iliac crest, the tibia, and the calcaneus. Investigators have found that the tibia and calcaneus have fewer progenitor cells than the iliac crest. This retrospective review evaluates the efficacy and safety profile of harvesting BMA from the calcaneus bone. We hypothesized that harvesting BMA from the calcaneus will have high efficacy and safety profile with low complication rates.

Methods:

A retrospective chart review of patients undergoing bone marrow aspiration from the calcaneus bone from January 2019 to October 2022 was performed. The main data points evaluated were patient satisfaction and pain level, follow-up times, quantity of BMA harvested, fusion rates, and complications including nerve damage, infections, and nonunions.

Results:

There were 45 (34 female and 11 male) patients who underwent 45 procedures. The average age, BMI, and amount of BMA were 45.1 years (range 23-79), 33.1 (range 19.2-61.3), and 10.3 mL (range 2-40), respectively. There was no pain reported at the final follow-up in 32 patients (71.1%), and there was minimal to no pain in the area of surgery in the remaining 13 patients (28.9%). The 10 cases of fusion successfully healed with combined use of allograft and BMA. The average follow-up time was 12.3 months (range 2.4-33.7). There were no infections, wound complications, or nerve injuries.

Conclusion:

Harvesting BMA from the calcaneus bone is a safe procedure. In this heterogenous series where BMA augmented other surgical strategies, patients had little to no pain and there were no cases of wound complication or iatrogenic neuropraxia after undergoing bone marrow harvest from the calcaneus.

Level of Evidence:

Level IV, case series.
The Role of Perceived Sleep Quality in Cardiovascular Health Factors and Behaviors Among Young Adults With Type 1 Diabetes
Authors: Griggs Stephanie , Huynh Johnathan , Rieke Jorden , Howard Quiana
Published: August 2023

Purpose:

The purpose of this study was to determine the associations between perceived sleep quality and individual cardiovascular health (CVH) factors (A1C and body mass index [BMI]) and CVH behaviors (physical activity and dietary diabetes self-management) in young adults ages 18 to 25 years with type 1 diabetes (T1D).

Methods:

Associations among perceived sleep quality and CVH factors and behaviors were examined using multivariable linear regression in 69 participants ages 18 to 25 years (mean age 21.4 ± 2.0, mean T1D duration 9.7 ± 5.6 years).

Results:

Lower perceived sleep quality was associated with multiple lower CVH factors and behaviors (higher A1C and BMI, lower physical activity, poorer diet) even after adjusting for covariates (age, T1D duration, sex assigned at birth).

Conclusion:

Experimental studies are needed to better understand the impact of modifying sleep habits on both short- and long-term CVH in adults with T1D.
Unmasking the Mask Issue on Reddit: An Investigation of Online Public Deliberation around the Mask Controversy in the United States
Authors: Li Li , Reed Dillon
Published: August 2023

The aim of this investigation was to explore U.S. Americans’ mask attitude and their public deliberation processes on Reddit during the COVID-19 pandemic. With the assistance of “Key Features of Deliberative Conversation and Discussion” variables developed by Gastil and Black, the current project used content analysis method to analyze 524 Reddit posts on mask-wearing issues during two time periods of 2020 (February–March and July). The results showed that Reddit users’ attitude changed over time and there was a significant association between user attitude and most analytical and social deliberation process except for creating information base. The above results were generally supported when different time periods were considered. The present study also revealed that at the time of great uncertainty, users demonstrated a “deficit mode,” which results from expertise knowledge deficits and calls for expert enhancement in information dissemination and problem-solving. Besides the positive correlation between public attitude and policy agenda, there was a general lack of interest in social factors, thus harming the quality of online public deliberation processes. Limitations and implications were discussed.
Molecular MRD is strongly prognostic in patients with NPM1-mutated AML receiving venetoclax-based nonintensive therapy
Authors: Othman Jad , Tiong Ing S. , O'Nions Jenny , Dennis Mike , Mokretar Katya , Ivey Adam , Austin Michael , Latif Anne-Louise , Amer Mariam , Chan Wei Yee , Crawley Charles , Crolla Francesca , Cross Joe , Dang Ray , Elliot Johnathon , Fong Chun Y. , Galli Sofia , Gallipoli Paolo , Hogan Francesca , Kalkur Pallavi , Khan Anjum , Krishnamurthy Pramila , Laurie John , Loo Sun , Marshall Scott , Mehta Priyanka , Murthy Vidhya , Nagumantry Sateesh , Pillai Srinivas , Potter Nicola , Sellar Rob , Taylor Tom , Zhao Rui , Russell Nigel H. , Wei Andrew H. , Dillon Richard
Published: August 2023

Assessment of measurable residual disease (MRD) by quantitative reverse transcription polymerase chain reaction is strongly prognostic in patients with NPM1-mutated acute myeloid leukemia (AML) treated with intensive chemotherapy; however, there are no data regarding its utility in venetoclax-based nonintensive therapy, despite high efficacy in this genotype. We analyzed the prognostic impact of NPM1 MRD in an international real-world cohort of 76 previously untreated patients with NPM1-mutated AML who achieved complete remission (CR)/CR with incomplete hematological recovery following treatment with venetoclax and hypomethylating agents (HMAs) or low-dose cytarabine (LDAC). A total of 44 patients (58%) achieved bone marrow (BM) MRD negativity, and a further 14 (18%) achieved a reduction of ≥4 log10 from baseline as their best response, with no difference between HMAs and LDAC. The cumulative rates of BM MRD negativity by the end of cycles 2, 4, and 6 were 25%, 47%, and 50%, respectively. Patients achieving BM MRD negativity by the end of cycle 4 had 2-year overall of 84% compared with 46% if MRD was positive. On multivariable analyses, MRD negativity was the strongest prognostic factor. A total of 22 patients electively stopped therapy in BM MRD-negative remission after a median of 8 cycles, with 2-year treatment-free remission of 88%. In patients with NPM1-mutated AML attaining remission with venetoclax combination therapies, NPM1 MRD provides valuable prognostic information.
The “chi-chi” of Ginkgo biloba L. grows downward with horizontally curving tracheids having compression-wood-like features
Authors: Higuchi Seiichi , Aoki Dan , Matsushita Yasuyuki , Yoshida Masato , Yagami Sachie , Fukushima Kazuhiko
Published: August 2023

The old Ginkgo biloba L. trees often develop cylindrical woody structures that grow downward from the underside of the large branches near the trunks. This structure is traditionally called “chi-chi” (a breast) in Japan. The structure of chi-chi has not been investigated in detail because of the rarity of such old trees of G. biloba. This study examined the chi-chi from wood anatomy and chemistry viewpoints. After debarking, there were many woody bulges and latent buds. There were hollows corresponding to these latent buds on the inner side of the bark. In the transverse section obtained from the tip part of the chi-chi sample, we found tracheids curving in a horizontal plane, and the parenchymatous latent bud tissue is the center of the swirl. Microscopic observations and X-ray micro-computed tomography suggest the growing course of the chi-chi due to several swirls contiguous to each other. From these observations, the downward growth of the chi-chi starting from the cambium cell division might be driven by the woody bulges with latent buds. The cell walls of the curved tracheids were not thickened, not rounded, and had no intercellular spaces, but their S3 layers disappeared. Furthermore, the results of thioacidolysis and acetyl bromide analyses exhibited p-hydroxyphenyl subunits deposition to lignin and high lignin content on the tip part of the chi-chi. These results suggest that the curved tracheids in the chi-chi have compression-wood-like properties to some extent.