bluuebunny/crossref_metadata_2025 huggingface dataset:
Place-Based Policy and Neighborhood Business Density: Impacts of the Community Development Block Grant Program
Authors: McCullough Meredith
Published: March 2024

Amid slowing economic convergence between regions and growing disparities within cities, spatially targeted “place-based” policies are often employed to attract businesses and create jobs in economically distressed areas. Yet, many questions remain concerning what type of place-based investments contribute to local business development, and how these investments can be effectively targeted. This paper sheds light on these questions by evaluating the firm impacts of one of the longest running place-based programs in the United States, the Community Development Block Grant. Using panel data on nearly 9,000 ZIP codes across 50 metropolitan areas and two-way fixed effects methods, I examine whether and under what conditions CDBG investments grow the number of businesses in a targeted community. Results suggest that CDBG activities increase business density in a community within five years of investment, with gains primarily driven by economic development and property acquisition activities in ZIP codes with low-to-moderate levels of poverty.
Local Governments, Pandemic Aid, and Community Violence Intervention
Authors: Kass Amanda , Rocco Philip
Published: March 2024

Expenditures on police departments account for significant portions of local government budgets in the United States. Yet activism on police reform and changing views on the causes of violence have called into question law enforcement's role in public safety. While intergovernmental transfers have historically supported traditional policing, the American Rescue Plan Act's Coronavirus State and Local Fiscal Recovery Funds (CSLFRF) affords cities the opportunity to disrupt the status quo by providing them with the federal funds and flexibility to reshape their public safety policies around Community Violence Interventions (CVIs). This article examines how 13 cities that participated in a White House convened collaborative used CSLFRF aid to support CVIs. Our analysis reveals significant variation in how these cities in allocated CSLFRF dollars to CVI programs, suggesting that the combination of federal aid and White House encouragement has thus far led to incremental policy changes, whose durability remains an open question.
Managing suspected myasthenia gravis and myositis induced by pembrolizumab in a Jehovah's Witness sarcoma patient
Authors: Hutchinson Alexander , Eskens Danielle , Chan Abigail , Bhargava Anika , Bycroft Ryan
Published: March 2024

Introduction

Immune checkpoint inhibitors (ICIs) can cause a spectrum of adverse events known as immune-related adverse events (irAEs) that resemble autoimmune responses. Immune-mediated myasthenia gravis (MG) is a rare and serious neurologic adverse event that has been associated with ICIs requiring prompt treatment. In the Jehovah's Witness population, typical management of these adverse events may not be options, and alternative treatment choices would be needed.

Case report

73-year-old Jehovah's Witness patient with high-grade undifferentiated pleiomorphic sarcoma who developed immune-mediated MG approximately 4 weeks after initiation of pembrolizumab. On the day of admission, the patient presented with a three-day history of worsening ptosis, right greater than left. He was later found to be seronegative for MG.

Management and outcome

The patient required therapy with pyridostigmine, steroids, and agreed to plasma exchange (PLEX) prior to discharge. He achieved near resolution of his neurologic symptoms, and pembrolizumab was discontinued. He later underwent radical resection of the left thigh soft tissue sarcoma and superficial inguinal lymph node dissection. He is now on active surveillance.

Discussion

While neurologic adverse events typically present 6 weeks after initiation of ICIs, MG has been reported occurring as early as 4 weeks after initiation. This rare and serious adverse event requires prompt treatment, and clinicians need to be aware of the alternative treatment options in this unique patient population. Early conversations regarding blood products and factions must be had to develop a treatment plan in accordance with the patient's personal decisions.
Structural MRI measures are associated with fatigue severity and persistence in a large, real-world cohort of people with multiple sclerosis
Authors: Simpson Alexandra C , Hu Chen , Mowry Ellen M , Naismith Robert T , Fitzgerald Kathryn C , Nourbakhsh Bardia
Published: March 2024

Background:

Results of research on radiological hallmarks of multiple sclerosis (MS) fatigue have been conflicting.

Objective:

To investigate the associations of lesion and brain compartment volumes with fatigue severity and persistence in people with multiple sclerosis (PwMS).

Methods:

The Multiple Sclerosis Partners Advancing Technology and Health Solutions (MS PATHS) network collects standardized data during routine care of PwMS from 10 healthcare institutions. Magnetic resonance imaging (MRI) predictors included baseline brain parenchymal (BPF) and gray matter fractions (GMF) and T2 lesion volume (T2LV). The Quality of Life in Neurological Disorders (Neuro-QOL) fatigue subscore was analyzed linearly and categorically using T-score cutpoints, with a period of elevated symptoms defined as T-score ⩾ mean + 0.5 SD over follow-up.

Results:

At baseline, of 4012 participants (average age: 45.6 ± 11.8 years; 73% female; 31% progressive MS), 2058 (51%) had no fatigue, 629 (16%) had mild fatigue, and 1325 (33%) had moderate-to-severe fatigue. One SD greater baseline BPF and GMF were associated with 0.83 ( p < 0.001) and 0.38 ( p = 0.02) lower values in the baseline Neuro-QOL fatigue T-score. A 1 SD lower log of total T2LV was associated with a 0.49 ( p < 0.001) lower baseline fatigue T-score. Higher BPF and lower T2LV at baseline were associated with lower odds of subsequent periods of elevated fatigue.

Conclusion:

Baseline lesion burden and lower generalized whole-brain volumes were associated with MS fatigue in cross-sectional and longitudinal analyses in a large, real-world cohort of PwMS.
How about meeting Fernando Pessoa? A journey into hotel brand anthropomorphism and personality on social media
Authors: Ruppelt Hans , Almeida Sofia , Campos Ana Cláudia
Published: March 2024

Competition in the hospitality industry is fierce and hotels need to enhance guest engagement in order to remain competitive. Building brand anthropomorphism (BA) and personality is acknowledged as a marketing strategy for achieving this goal. More and more, this engagement is taking place online, with hotels’ social media playing a critical role in the process. However, it is acknowledged that there is scarce knowledge on how hotels build BA and personality in online settings. Accordingly, this research aims at examining the implementation of BA and personality in hotels adopting a qualitative approach, by focusing on the study of the case of Lisboa Pessoa Hotel (Portugal) and its use of social media for this purpose. Netnography was applied in the analysis. Results provide evidence that developing BA and personality are strategies with the potential to increase guest engagement. As implications, hotel managers are recommended to attend to the need of humanising their hotel brand. This study is one of the first to examine implementation of hotel BA and personalisation through social media.
Strip-searching as abjectification: Racism and sexual violence in British policing
Authors: Duff Koshka , Kemp Tom
Published: March 2024

This article examines police strip-searching practices in the UK. Drawing on newly acquired Freedom of Information data, publicly available testimonies, thematic analysis of official literature and media reports, and first-hand experience, we advance three arguments. First, strip-searching is used systematically, not exceptionally, and targets young people and people of colour, especially Black young men and boys. Second, strip-searching in practice is demonstrably excessive when measured against its stated rationales of ‘crime’ detection and ‘caring’ for detainees; we unpick the circular logics through which it is legitimized in official and public discourse. Third, drawing on Sharpe's notion of the abject, we argue that strip-searching, as a form of normalized sexual violence folded into the rubric of ‘care’, is part of a project of abjectification that aims to exclude the individuals and groups it targets from social and political subjecthood.
(Un)grounded language ideologies: A brief history of translanguaging theory
Authors: MacSwan Jeff , Rolstad Kellie
Published: March 2024

Aims:

The authors develop a contrast between grounded and ungrounded language ideologies, defining grounded ideologies as those which are anchored empirically and ungrounded ideologies as those which are not. This framework guides a description of the history of translanguaging theory from early translanguaging theory, grounded in empirical research on codeswitching and other scholarship on bilingualism, to late translanguaging theory, which changed under the influence of a postmodernist approach to language policy known as deconstructivism. The authors further discuss charges of “abyssal thinking” attributed to those who do not accept deconstructivism.

Approach:

The approach is argumentative.

Data and Analysis:

The authors draw on a wide range of previously published empirical work to support their conclusions.

Conclusions:

The authors conclude that late translanguaging theory is at odds with empirical research and holds negative consequences for pluralist language ideologies and civil rights advocacy.

Originality:

The article makes original contributions to language ideology, the history of translanguaging theory, and the relationship between language theory and language ideology.

Significance:

The article makes a significant critical contribution to the literature on multilingual language theory by drawing attention to significant limitations of translanguaging theory as a resource for language ideology.
Liquid chromatography-electrospray ionization-mass spectrometry/mass spectrometry characterization of depsides and depsidones from the Chilean lichen Parmotrema perlatum
Authors: Castañeta Grover , Sepulveda Beatriz , Areche Carlos
Published: March 2024

Lichens are recognized by their unique compounds and diverse applications in food, medicines, and cosmetics. Using ultra-high pressure liquid chromatography, coupled with a high-resolution mass spectrometer, metabolomic profiling of the lichen Parmotrema perlatum, from a methanolic extract, was performed. Based on characteristic fragmentation patterns, twenty-five lichenic substances were tentatively identified including 5 depsides, 12 depsidones, 2 diphenyl ethers, 1 aromatic considered as possible artifact, 1 dibenzofuran, 1 carbohydrate, 1 organic acid, and 2 undefined compounds. To the best of our knowledge, this is a more complete report of their phytochemistry from P perlatum. Our findings of the P perlatum profile may contribute and complement the current data of the Parmotrema genus.
A feature vector with insensitivity to the position of the outer race defect and its application in rolling bearing fault diagnosis
Authors: Zhang Jianqun , Zhang Qing , Feng Wenzong , Qin Xianrong , Sun Yuantao
Published: March 2024

The fault diagnosis of rolling bearings is very important in industrial applications, which can avoid accidents and reduce operation and maintenance costs. Although the position of the bearing outer race defect has a significant impact on rolling bearing vibration response, most existing intelligent bearing fault diagnosis methods do not take this into account. In this paper, we establish a dynamic model of rolling bearing to clarify the influence of the outer race defect position on the dynamic response, and propose a feature vector that is insensitive to the outer race defect positions. First, the vibration characteristics of the outer race faults with different defect positions are analyzed, and the impact is evaluated using six indicators. Second, three indicators of insensitivity to the bearing outer race defect positions are constructed as the feature vector for bearing fault diagnosis. Finally, a bearing fault diagnosis method considering the positions of outer race defect is proposed based on the constructed feature vector and K nearest neighbor classifier. The diagnosis results of three datasets formed by experimental signals show that the constructed feature vector can separate different bearing states. Compared with the existing two diagnosis methods, the proposed diagnosis method obtains higher recognition accuracy, in the case of different outer race defect positions of the training set and the testing set. The above research results are expected to provide a reference for rolling bearing fault diagnosis, especially when considering the influence of the outer race defect positions.
An Eye for A Foot: Alarming Unawareness of Diabetic Retinopathy Among Diabetic Foot Patients
Authors: Güven Hikmet Erhan , Sensoy Eyüpcan , Citirik Mehmet
Published: March 2024

This study aims to determine the awareness of diabetic retinopathy in patients hospitalized for diabetic foot ulcers, examine their clinical and demographic characteristics, and evaluate their treatment needs. In this prospective study, 62 consequent patients with diabetic foot ulcers who were hospitalized for further treatment in Diabetic Foot Department between June and August 2023 were subjected to ophthalmological examinations. Detailed anterior and posterior segment examinations were performed. Clinical and demographic characteristics and HbA1c levels were recorded. Thirty-nine patients (62.9%) were male and 23 (37.1%) were female. The mean age was 61 ± 11.4 years. The patients had diabetes mellitus (DM) for an average of 19.2 ± 9.6 years. The average HbA1c value of the patients was 9 ± 2.3%. Minor amputation was performed in 35 of 62 patients (56.5%) during treatment. Thirty-one patients (50%) were unaware of the risk of diabetic retinopathy. Of those “unaware” 31 patients, 26 (83.9%) had diabetic retinopathy. Diabetic retinopathy was detected in 57 patients (91.9%) and 3-month interval ophthalmological follow-up screening was recommended for 77 eyes. Eighty percent of the patients never had ophthalmological examination. Intravitreal (IV) injection was performed in 44 eyes, panretinal photocoagulation (PRP) in 2 eyes, and intravenous injection + PRP + vitreoretinal surgery in one eye. Diabetic foot ulcers and diabetic retinopathy are often accompanied by each other. Patients should be informed about this and strongly encouraged to undergo routine ophthalmological examinations, especially when they have advanced diabetic foot disease. Diabetic foot surgeons should keep in mind that a poor eye cannot detect diabetic foot problems.
Genetic Testing in Epilepsy: Improving Outcomes and Informing Gaps in Research
Authors: Habela Christa W. , Schatz Krista , Kelley Sarah A.
Published: March 2024

While the diagnosis of epilepsy relies on the presence of seizures, it encompasses a group of phenotypically and etiologically diverse disorders in which seizures may only be one of a constellation of symptoms. There are genetic, structural, and metabolic causes, but most epilepsy syndromes have some genetic predisposition. The importance of genetics in the diagnosis and management of epilepsy has been increasingly recognized over the past 2 decades. With increased access to testing tools and new recommendations that all patients with unexplained epilepsy get genetic testing, it is becoming part of routine clinical care. Increased testing has resulted in an explosion in the number of genes and genetic changes identified and it is changing our understanding of the mechanisms of epileptogenesis. Advances in both clinical genetics and scientific discovery are expanding our potential to impact patient care as well as creating dilemmas. This brief review will highlight where we are regarding our ability to obtain a genetic diagnosis, how diagnoses impact patient care, and the next likely frontiers in diagnosis and management.
Getting Excited About Chloride Cotransporters: Neuroinflammation and Inhibition
Authors: Sawant-Pokam Punam A. , Metcalf Cameron S.
Published: March 2024

[Box: see text]
Training Teachers of Children With Moderate to Significant Support Needs to Contingently Respond to Child-Initiated Social Participation Behaviors During Centers
Authors: Holt Ashley K. , Drasgow Erik , Wolfe Katie
Published: March 2024

Teachers of young children with moderate to significant support needs may have insufficient training to implement naturalistic instructional practices such as contingent responding. Naturalistic instructional practices are well researched, but limited studies exist on training teachers to use contingent responses to support children increasing child-initiated social participation behaviors during centers. We used a multiple baseline design across four special education teachers to measure the effects of a training package incorporating behavior skills training (BST) and emailed performance feedback (EPF) on increasing teachers’ contingent responses to children with limited child-initiated social participation behaviors during centers. Results indicate that BST with a checklist and EPF with graphs increased the four teachers’ percentage of contingent responses, and similar levels were observed during maintenance probes. Programming common stimuli during BST resulted in all teachers providing contingent responses to at least one other child in their classroom who had few child-initiated social participation behaviors.
Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study
Authors: Galvão Wagner Rodrigues , Castro Silva Luana Karoline , Viana Ramon Távora , Oliveira Pedro Henrique Avelino , Jucá Renata Viana Brígido de Moura , Martins Henrique Resende , Rabelo Michelle , Fachin-Martins Emerson , Lima Lidiane Andréa Oliveira
Published: March 2024

Introduction

Currently studies indicate the need to incorporate the user`s perspective in the testing of new assistive technologies. The objective of this paper is to test a baropodometric insole prototype for monitoring and treatment weight-bearing asymmetry, according to the Participatory Design.

Methods

We used a qualitative case study approach during the testing phase of the baropodometric insole prototype. The focus group approach addressed topics related to the experience and accessibility of the potential user in conjunction with professionals, researchers, and physiotherapy students. Facilitators, barriers, and requirements for the device were collected through audio recordings of the discussions during and after prototype testing.

Results

Key steps in the prototype testing process were divided into (1) Test of the prototype according to the Participatory Design, divided into Who, When, How, and Why the potential user was involved in the study; and (2) Facilitators, barriers and requirements to improve the prototype.

Conclusions

The baropodometric insole prototype can be seen as a promising device for monitoring and treating weight-bearing asymmetry.
Application of hybrid control algorithm on the vehicle active suspension system to reduce vibrations
Authors: Nguyen Tuan Anh , Iqbal Jamshed , Tran Thi Thu Huong , Hoang Thang Binh
Published: March 2024

This research proposes a hybrid control algorithm to enhance smoothness in a vehicle’s motion. The control signal is synthesized from two separate controllers, Proportional Integral Derivative (PID) and Sliding Mode Control (SMC), to achieve superior control performance. The novelty of the proposed control algorithm lies in using a double-loop algorithm to determine the controller parameters. The algorithm proposed in this research involves two computational processes to determine the model’s optimal values including the raw value and the acceptable value. The proposed control algorithm has been simulated considering three specific cases corresponding to the three types of road stimuli. The results demonstrate that the values of sprung mass displacement and acceleration dropped considerably with the application of the proposed algorithm. Moreover, the change in vertical force at the wheel is also reduced with the application of the algorithm particularly in the third case where the vertical force at the wheel has reached to zero. The average values of vehicle body displacement are found to be 166.17 mm (for passive case), 54.20 mm (for PID), and 42.52 mm (for SMC). The proposed control algorithm managed to reduce this value to 8.95 mm as evidenced by simulation results. Finally, the response of the control system when subjected to an excitation signal from the road surface further demonstrates efficacy of the proposed hybrid control algorithm.
Decompressive craniectomy: A primer for acute care practitioners
Authors: Brindley Peter George , Sanderson Mark , Anderson Dustin , O’Kelly Cian
Published: March 2024

Decompressive craniectomy (DC) involves surgical removal of the skull that overlies swollen, imperiled, brain. This is done to combat intracranial hypertension and mitigate a vicious cycle of secondary brain injury. If, instead, this pathophysiology goes uninterrupted, it can mean brain herniation and brain stem death. As such, DC can save lives when all else fails. Regardless, it is no panacea and can also “ruin deaths,” and leave patients profoundly disabled. DC is not a new procedure; however, this therapy is increasingly noteworthy due to advances in neurocritical care, alongside ethical concerns. We cover the physiological rationale, the surgical basics, the trial data, and focus on secondary decompression (for refractory intracranial pressure (ICP)) rather than primary decompression (i.e. during evacuation of an intracranial mass). Given that DC should not be undertaken indiscriminately, we conclude by introducing ways in which to discuss DC with families and colleagues. Our goal is to provide a primer and common resource for the multidisciplinary team. We aim to increase not only knowledge but wisdom, prudence, collegiality, and family-focused care.
Disparities in heart failure between White, Black, and Hispanic young adults: insights from the National Health and Nutrition Examination Survey
Authors: M. Talha Khawaja , Almas Talal , Minhas Abdul Mannan Khan , Salah Husam , Jamil Adeena , Johnson Heather M. , Jain Vardhmaan , Antoine Steve , S. Khan Sadiya , Khan Muhammad Shahzeb
Published: March 2024

Background:

The prevalence of heart failure (HF) is increasing among young adults in the United States with pervasive racial and ethnic differences in this population.

Objective:

To evaluate contemporary associations between race and ethnicity, clinical comorbidities, and outcomes among young to middle-aged adults with HF.

Methods:

A retrospective analysis was performed using the National Health and Nutrition Examination Survey. All participants with a self-report of HF aged 20–64 years from 2005 to 2018 were included and stratified by race and ethnicity [non-Hispanic (NH) Whites, NH Blacks, and Hispanics]. Data on baseline characteristics including age, sex, marital status, citizenship, education level, body mass index, insurance, waist circumference, cigarette smoking, marijuana use, and relevant clinical comorbidities were included. Weighted logistic regression was performed to estimate adjusted odds ratios (aOR) to determine the association of race and ethnicity with HF. Cox proportional-hazards models were used to assess the association of race and ethnicity with all-cause and cardiac mortality.

Results:

A total of 1,940,447 young to middle-aged adults had self-reported HF between 2005 and 2018, of whom 61% were NH White, 40% were NH Black, and 22% were Hispanic. When compared with NH White adults, NH Black adults had higher odds of HF adjusted for age, sex, insurance status, marital status, education level, citizenship status, and clinical comorbidities (adjusted aOR 2.63, 95% CI: 1.71–4.05, p < 0.001). There was no significant difference in the odds of HF between Hispanic and NH White adults (aOR 1.18, 95% CI: 0.64–2.18, p = 0.585). NH Black adults had higher mean systolic and diastolic blood pressure, and a comparable or lower burden of cardiovascular and non-cardiovascular clinical comorbidities compared with NH White and Hispanic adults. No statistical significance was noted by race and ethnicity for all-cause and cardiac mortality during a follow-up of 5 years.

Conclusion:

NH Black young to middle-aged adults were more likely to have HF which may be related to higher blood pressure given the largely similar burden of clinically relevant comorbidities compared with other racial and ethnic groups.
Retrospective subgroup analysis of fecal microbiota, live-jslm (REBYOTA®) administered by colonoscopy under enforcement discretion for the prevention of recurrent Clostridioides difficile infection
Authors: Knapple Whitfield L. , Yoho David S. , Sheh Alexander , Thul Joan , Feuerstadt Paul
Published: March 2024

Background:

Fecal microbiota, live-jslm (RBL; REBYOTA®), is the first Food and Drug Administration (FDA)-approved, single-dose, rectally administered, microbiota-based live biotherapeutic product for preventing Clostridioides difficile infection (CDI) recurrence. Alternative routes of administration are of clinical interest.

Objectives:

Evaluate the safety and efficacy of RBL administration via colonoscopy.

Design:

Retrospective analysis of electronic medical records of participants administered RBL via colonoscopy under FDA enforcement discretion.

Methods:

The number of participants with treatment and/or procedure-emergent adverse events (TEAEs) was evaluated. Treatment success and sustained clinical response, defined as the absence of CDI recurrence within 8 weeks and 6 months, respectively, were evaluated.

Results:

TEAEs were experienced by 75% (6/8) of participants; most were mild to moderate in severity, and none due to RBL or its administration. Most participants had treatment success (80%; 8/10); 75% (6/8) had sustained clinical response.

Conclusion:

Real-world safety and efficacy of RBL administered via colonoscopy were consistent with clinical trials of rectally administered RBL.

Graphical abstract

[Formula: see text]
Research Co-production Within Humanitarian Health: Reflections on Our Practice
Authors: Lokot Michelle , Zreik Thurayya
Published: March 2024

Research co-production is recognized as important for humanitarian health actors, as part of the growing drive towards localizing and decolonizing aid. Despite recognition that co-production is challenging to implement, reflexive accounts of co-production efforts remain limited. In this paper, we critically examine the role of co-production within a multi-partner research collaboration in Lebanon involving multiple academic, civil society and government-affiliated partners based in the UK and in Lebanon. Through interactive reflection sessions and interviews with research team partners, we document how co-production principles were embedded into our project, explore contextual factors influencing the collaboration, identify successes and challenges to co-production and identify future opportunities for research co-production. We find mixed understandings of co-production between team members and siloed efforts to co-produce within our partnership. We identify key challenges to co-production including contextual factors related to Lebanon and COVID-19, institutional power dynamics, budgets, difficulties in engaging service users and availability of stakeholders to co-produce, while mapping examples of successful co-production in our project. Our study emphasizes the importance of ensuring shared understandings of the scope of co-production at the outset of projects and suggest the collaborative analysis processes provide a key opportunity for researchers to embed co-production principles.
Resisting the Neoliberal Academy: Justice-Oriented (Re)Imaginings Through Critical Qualitative Inquiry
Authors: Kraemer-Holland Angela , Díaz Manuel
Published: March 2024

Even as educational institutions (re)produce inequitable forms of power and knowledge, critical qualitative inquiry often challenges these exclusionary, confining ways of being and knowing perpetuated within academic spaces. Drawing upon a conceptual framework that unites critical qualitative inquiry, poststructuralism, and intersectionality, this work interrogates how neoliberal academic spaces complicate detachment from and our un-learning of narrow ways of scholarly being and knowing, what and whose knowledge counts in these spaces, and our enactment of knowledge and power circulation more broadly. By framing our positions as critical public intellectuals, we utilize co-authorship between a practitioner and practitioner-oriented scholar to unpack narrow, whitewashed, neoliberal notions of expertise often entrenched and normalized within realms of pedagogy and scholarship. Finally, we seek to challenge and (re)envision such maintenance of singular perspectives, voices, and knowledge bases, arguing that critical qualitative inquiry can and should meet such a moment to upend existing structures.
Intra-Articular Injection of Interleukin-8 Neutralizing Monoclonal Antibody Effectively Attenuates Osteoarthritis Progression in Rabbits
Authors: Yang Junjun , Wang Xin , Zhang Yingbo , He Rui , Fu Zhenlan , Wang Rong , Ma Yanming , Fu Dejie , Meng Shuo , Cai Wang , Zhou Yizhao , Chen Cheng , Chen Guangxing , Gong Xiaoyuan
Published: March 2024

Objective

Cytokines are implicated in the pathogenesis of osteoarthritis (OA), and this study aims to assess the therapeutic potential of an IL-8 neutralizing monoclonal antibody (mAb) for OA intervention.

Design

The study employed a rabbit model of OA induced by anterior cruciate ligament transection (ACLT) surgery to investigate the effects of an interleukin (IL)-8 neutralizing mAb, with hyaluronic acid (HA) used as a positive control. Primary outcomes assessed in the rabbits included cartilage repair, synovitis, joint effusion, changes in footprints, and lower limb loading conditions.

Results

Compared to HA, intra-articular injection of the IL-8 neutralizing mAb demonstrated a more pronounced attenuation of OA progression and enhancement of cartilage repair. We observed a reduction in synovitis and joint effusion, indications of bone marrow edema, as well as improvements in lower limb function. In knees treated with the neutralizing IL-8 mAb, there was a significant decrease in IL-8 levels within the synovial tissues.

Conclusions

The IL-8 neutralizing mAb exhibits promising therapeutic potential in the management of OA by attenuating inflammation and facilitating cartilage repair. However, further investigations are warranted to comprehensively elucidate the underlying mechanisms, optimize treatment protocols, and ensure the long-term safety and efficacy of this innovative therapeutic approach.
Intracranial findings in spontaneous intracranial hypotension: Does the severity of abnormalities correspond with certainty and/or multifocality of cerebrospinal fluid leaks?
Authors: Benson John C , Mark Ian T , Madhavan Ajay A , Johnson-Tesch Benjamin , Diehn Felix E , Carr Carrie M , Kim Dong Kun , Brinjikji Waleed , Verdoorn Jared T
Published: March 2024

Background and Purpose

Spontaneous intracranial hypotension (SIH) is caused by spinal cerebrospinal fluid (CSF) leaks. This study assessed whether the certainty and/or multifocality of CSF leaks is associated with the severity of intracranial sequelae of SIH.

Materials and Methods

A retrospective review was completed of patients with suspected SIH that underwent digital subtraction myelogram (DSM) preceded by brain MRI. DSMs were evaluated for the presence or absence of a CSF leak, categorized both as positive/negative/indeterminate and single versus multifocal. Brain MRIs were assessed for intracranial sequelae of SIH based on two probabilistic scoring systems (Dobrocky and Mayo methods). For each system, both an absolute “numerical” score (based on tabulation of findings) and “categorized” score (classification of probability) were tabulated.

Results

174 patients were included; 113 (64.9%) were female, average age 52.0 ± 14.3 years. One or more definite leaks were noted in 76 (43.7%) patients; an indeterminate leak was noted in 22 (12.6%) patients. 16 (16.3%) had multiple leaks. There was no significant difference in the severity of intracranial findings between patients with a single versus multiple leaks ( p values ranged from .36 to .70 using categorized scores and 0.22–0.99 for numerical scores). Definite leaks were more likely to have both higher categorized intracranial scores (Mayo p = .0008, Dobrocky p = .006) and numerical scores ( p = .0002 for Mayo and p = .006 for Dobrocky).

Conclusions

Certainty of a CSF leak on diagnostic imaging is associated with severity of intracranial sequelae of SIH, with definite leaks having significantly more intracranial findings than indeterminate leaks. Multifocal leaks do not cause greater intracranial abnormalities.
Student’s physical activity engagement through social media: A study in COVID-19 lockdown
Authors: Shirotriya Awadhesh Kumar , Mukhopadhyay Kishore , Joshi Deepti , Vishwakarma Rakesh
Published: March 2024

The use of social media is increasingly prevalent for many reasons and academic literature suggests that social media helps encourage physical activity. This research investigated how social media content affected the physical activity of students during the COVID-19 lockdown and subsequent COVID-19 pandemic restrictions. This descriptive cross-sectional study took place between February 2021 and May 2021 at three different academic institutions located in various states in India. A self-made questionnaire consisting of 10 close-ended and 3 open-ended questions was designed to assess students’ utilization of social media to gather knowledge of physical activities from different platforms. A web-based survey was used to collect data from 606 students (of whom 361 (59.57%) were male and 243 (40.10%) were female) from different courses and degree levels using criterion-based purposive sampling. Close-ended questions were analyzed using the percentage method and open-ended questions were analyzed with a collaborative data analysis approach which revealed three themes namely interest, self-care and impact. The results of this study indicate that students are taking help from social media to carry out their physical activities. The outcomes of this study will serve as the baseline information which is helpful in developing and validating methods that best capture the diverse needs of teachers and students within the context of online delivery of physical activities.
Digital skills of health care professionals in cancer care: A systematic review
Authors: Leena Tuominen , Jenna Poraharju , Carme Carrion , Leeni Lehtiö , Helena Leino-Kilpi , Sònia Moretó , Minna Stolt , Virpi Sulosaari , Heli Virtanen
Published: March 2024

Background

The digital transformation of healthcare enables new ways of working in cancer care directing attention on the digital skills of healthcare professionals. This systematic review aims to identify existing evidence about digital skills among health care professionals in cancer care to identify the needs for future education and research.

Methods

Database searches were conducted in PubMed, CINAHL, Web of Science, Scopus, Cochrane and ERIC to identify studies until March 2023. The inclusion criteria were digital skills of health care professionals in cancer care as described by themselves, other health care professionals, patients or significant others. The CASP tool was used for quality assessment of the studies. Data was analysed following inductive content analysis.

Results

The search produced 4563 records, of which 24 studies were included (12 qualitative, 10 quantitative, 1 mixed methods design and 1 strategy paper). Four main categories were identified describing HCPs’ required skills, existing skills and development areas of digital skills in cancer care: Skills for information technology, Skills for ethical practice, Skills for creating a human-oriented relationship and Skills for digital education and support. In development areas, one more main category, Skills for implementing digital health, was identified.

Conclusion

The digital skills of health care professionals in cancer care are multifaceted and fundamental for quality cancer care. The skills need to be assessed to provide education based on actual learning needs. The review findings can be used for education and research in this field.
Sensing the impact of extreme heat on physical activity and sleep
Authors: Cheong So-Min , Gaynanova Irina
Published: March 2024

Introduction

This study assesses the person-specific impact of extreme heat on low-income households using wearable sensors. The focus is on the intensive and longitudinal assessment of physical activity and sleep with the rising person-specific ambient temperature.

Methods

This study recruited 30 participants in a low-income and predominantly Black community in Houston, Texas in August and September of 2022. Each participant wore on his/her wrist an accelerometer that recorded person-specific ambient temperature, sedentary behavior, physical activity intensity (low and moderate to vigorous), and sleep efficiency 24 h over 14 days. Mixed effects models were used to analyze associations among physical activity, sleep, and person-specific ambient temperature.

Results

The main findings include increased sedentary time, sleep impairment with the rise of person-level ambient temperature, and the mitigating role of AC.

Conclusions

Extreme heat negatively affects physical activity and sleep. The negative consequences are especially critical for those with limited use of AC in lower-income neighborhoods of color. Staying home with a high indoor temperature during hot days can lead to various adverse health outcomes including accelerated cognitive decline, higher cancer risk, and social isolation.
“The Critical Services Are Out of Reach”-Diabetes Management and the Experiences of South Asian Immigrants in Ontario
Authors: Waqar Minal , Kuuire Vincent Z.
Published: March 2024

Type 2 diabetes is a serious chronic condition affecting millions of people worldwide. South Asians (individuals originating from Pakistan, India, Bangladesh, Sri Lanka, and Nepal) represent a high-risk ethnicity for developing type 2 diabetes (T2D) and experience a high prevalence of the disease, even in migrant populations. The objective of this study was to investigate perceptions and experiences of South Asians living with T2D in Ontario, and their utilization of diabetes related services within the provincial healthcare system. Data were obtained from 20 in-depth interviews with South Asian participants diagnosed with T2D and living in the Greater Toronto Area. Our findings indicate a dissatisfaction with Ontario’s coverage for diabetes services; varying uptake of recommended health tests, exams, and monitoring equipment; low utilization of additional resources (diabetes centers); and a need for primary care physicians to better facilitate awareness and utilization of available coverages and resources in the community. This study provides support for the fact that even in Canada’s universal healthcare system, disparities exist, particularly for ethnic minorities, and that a universal prescription drug coverage component is a crucial step forward to ensure equitable access to health services utilization for all.
Planting Seeds for Food Is Medicine: Pre-Implementation Planning Methods and Formative Evaluation Findings From a Multi-Clinic Initiative in the Midwest
Authors: Wetherill Marianna S. , Bridges Kristina M. , Talavera Gabrielle E. , Harvey Susan P. , Skidmore Brandon , Burger Elizabeth Stewart
Published: March 2024

Food is medicine (FIM) initiatives are an emerging strategy for addressing nutrition-related health disparities increasingly endorsed by providers, payers, and policymakers. However, food insecurity screening protocols and oversight of medically-tailored food assistance programs are novel for many healthcare settings. Here, we describe the pre-implementation planning processes used to successfully engage federally-qualified health centers (FQHCs) across Kansas to develop new FIM initiatives. A Kansas-based philanthropic foundation facilitated pre-implementation planning for FQHCs over 17 months across 3 stages: 1) Community inquiry, 2) FIM learning event with invitation for FQHC attendees to request pre-implementation funding, and 3) Pre-implementation planning workshops and application assignments for FQHC grantees to develop a FIM implementation grant proposal. We evaluated satisfaction and perceived utility of these pre-implementation planning activities via post-workshop surveys and qualitative comparisons of FIM design components from pre-implementation and implementation grant applications. All 7 FQHCs attending the learning event applied for and were awarded pre-implementation planning grants; 6 submitted an implementation grant application following workshop completion. FQHCs rated pre-implementation support activities favorably; however, most clinics cited limited staff as a barrier to effective planning. As compared to pre-implementation planning grant proposals, all FQHCs elected to narrow their priority population to people with pre-diabetes or diabetes with better articulation of evidence-based nutrition prescriptions and intervention models in their final program designs. In the midst of a nationwide FIM groundswell, we recommend that funders, clinic stakeholders, and evaluators work together to devise and financially support appropriate pre-implementation planning activities prior to launching new FIM initiatives.
The 2023 AO Spine-Praxis Guidelines in Acute Spinal Cord Injury: What Have We Learned? What Are the Critical Knowledge Gaps and Barriers to Implementation?
Authors: Fehlings Michael G. , Moghaddamjou Ali , Evaniew Nathan , Tetreault Lindsay A. , Alvi Mohammed Ali , Skelly Andrea C. , Kwon Brian K.
Published: March 2024

Study Design

Narrative summary of the 2023 AO Spine-Praxis clinical practice guidelines for management in acute spinal cord injury (SCI).

Objectives

The objective of this article is to summarize the key findings of the clinical practice guidelines for the optimal management of traumatic and intraoperative SCI (ISCI). This article will also highlight potential knowledge translation opportunities for each recommendation and discuss important knowledge gaps and areas of future research.

Methods

Systematic reviews were conducted according to accepted methodological standards to evaluate the current body of evidence and inform the guideline development process. The summarized evidence was reviewed by a multidisciplinary guidelines development group that consisted of international multidisciplinary stakeholders. The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of the evidence for each critical outcome and the “evidence to recommendation” framework was used to formulate the final recommendations.

Results

The key recommendations regarding the timing of surgical decompression, hemodynamic management, and the prevention, diagnosis, and management of ISCI are summarized. While a strong recommendation was made for early surgery, further prospective research is required to define what constitutes sufficient surgical decompression, examine the role of ultra-early surgery, and assess the impact of early surgery in different SCI phenotypes, including central cord syndrome. Furthermore, additional investigation is required to evaluate the impact of mean arterial blood pressure targets on neurological recovery and to determine the utility of spinal cord perfusion pressure measurements. Finally, there is a need to examine the role of neuroprotective agents for the treatment of ISCI and to prospectively validate the new AO Spine-Praxis care pathway for the prevention, diagnosis, and management of ISCI. To optimize the translation of these guidelines into practice, important barriers to their implementation, particularly in underserved areas, need to be explored. Ultimately, these recommendations will help to establish more personalized approaches to care for SCI patients.

Conclusions

The recommendations from the 2023 AO Spine-Praxis guidelines not only highlight the current best practice in the management of SCI, but reveal critical knowledge gaps and barriers to implementation that will help to guide further research efforts in SCI.
Prospective Randomized Comparison of Minimally Invasive Tlif versus Open Tlif: Clinical Effectiveness and Restoration of Working Capacity in Railway Workers
Authors: Byvaltsev Vadim A. , Kalinin Andrei A. , Pestryakov Yurii Ya. , Hozeev Dmitriy V. , Kundubayev Rustem A. , Biryuchkov Mikhail Y. , Riew K. Daniel
Published: March 2024

Study Design

Randomized Clinical Trial.

Objective

To compare the clinical efficacy and restoration of working capacity after MI (minimally invasive)-TLIF and O (open)-TLIF in railway workers with lumbar degenerative disease.

Methods

83 patients, who were indicated for two-level lumbar decompression and fusion were randomly assigned to one of two groups: group 1 (n = 44) had MI-TLIF procedure and group 2 (n = 39) had O-TLIF procedure. The functional status was assessed using SF-36, ODI and VAS for back and leg pain, preoperatively, at discharge, and at 3, 6, and 12 months postoperatively. MRI and CT were obtained 1-year follow-up. The percentage of patients who returned to work at 1-year, work intensity and the time to return to work post-operatively were analyzed.

Results

At 1-year follow-up, the MI-TLIF group had significantly better ODI, VAS and SF-36 scores compared to the O-TLIF group. The postoperative MRIs revealed a statistically significantly less multifidus muscle atrophy in the MI group compared to the Open group. At 1-year follow-up, a comparable fusion ratio between MI group and Open group was recorded. After MI-TLIF procedure, depending on the workload, patients had a statistically significantly earlier return to work ( P < .05) and statistically significantly higher return to work rate compared with the O-TLIF group ( P < .05).

Conclusions

The use of two-level MI-TLIF in railway workers has made it possible to significantly improve long-term clinical results, reduce the risk of surgical complications, muscle atrophy and time to return to work compared to O-TLIF.
Factors Influencing Use of Medicinal Herbs
Authors: Krsnik Sabina , Erjavec Karmen
Published: March 2024

In countries with a long tradition of folk herbal medicine that is not integrated into the health system, consumer interest in medicinal herbs has increased. Considering the lack of knowledge about the factors influencing the use of medicinal herbs, the aim of this study was to identify the most important factors of herbal use in Slovenia. Factors were assessed in June 2023 using a nationwide sample ( N = 508). Results show that almost half of the respondents are not familiar with medicinal herbs, however, 86% use them at least a few times a year. The “familiarity with medicinal herbs” had the strongest direct effect on the use of medicinal herbs, followed by the “social impact of the herbalist” and the “perceived usefulness of medicinal herbs.” There is a need to create a new approach to integrative medicine policy and the use of medicinal herbs in Slovenia by developing educational programs, training professionals, establishing guidelines for the safe and effective use of herbs, and advocating for reimbursement by health insurance companies.
Chronic Sorrow in Stage 4 Cancer: A Spiritual Challenge
Authors: Lane Annette M
Published: March 2024

Living with Stage 4 cancer impacts how individuals conceptualize themselves and how they conduct their everyday lives. Within this synopsis, I describe my experiences living with progressing Stage 4 breast cancer. The construct of chronic sorrow is applied to my experiences. I suggest that grief and chronic sorrow are largely spiritual issues and give examples of my spiritual practices. Finally, recommendations are offered for healthcare professionals.