bluuebunny/crossref_metadata_2025 huggingface dataset:
Complementary or Competing? Studying the Relationship between E-Scooter Sharing and Bikesharing in Austin, Texas
Authors: Chen Peng , Hu Songhua
Published: June 2024

The correlation between e-scooter sharing (ESS) and docked bikesharing (DBS) remains ambiguous. This study compared usage patterns between the two modes in Austin, Texas, aiming to unveil their evolving relationship. To account for nonlinear effects, generalized additive mixed models were employed. The findings indicate that both ESS and DBS programs achieved success in densely populated urban areas, areas with younger and higher-income populations, as well as on university campuses. However, a one-sided competitive relationship emerged, with ESS surpassing DBS. For policy implications, local governments should reassess and harmonize their policies to determine the cost-effectiveness of preserving a declining DBS program.
Facilitators and Barriers to Developing a Research Program: A Focused Ethnography of New Tenure-Track PhD-Prepared Nursing Faculty
Authors: Savard Winnifred , Raymond Christy , Richter Solina , Olson Joanne K. , Paul Pauline
Published: June 2024

Background

Creating a research program is a critical requirement for new PhD-prepared tenure-track nursing faculty in Canada.

Purpose

The purpose of this article is to present key findings of new faculty members focusing on facilitators and barriers to development of their research program.

Method

We conducted focused ethnography research examining the experience of 17 new faculty members from across Canada.

Results

The following themes were identified: teaching release, preparation from PhD program, intense feelings, supports and processes, mentoring, obtaining grants, and effects of the COVID-19 pandemic.

Conclusions

Implications for practice include identifying ways to facilitate faculty retention as they develop their research program. This research will be of interest to deans of nursing and new faculty members.
Characterizing Intimate Partner Violence-Caused Brain Injury in a Sample of Survivors in the Two Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning Community
Authors: Stranges Tori N. , Marshall Rory A. , Godard Rebecca , Simonetto Deana , van Donkelaar Paul
Published: June 2024

Research in the field of intimate partner violence-caused brain injury (IPV-BI) has predominantly focused on heterosexual women, ignoring the unique needs of the Two Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning (2S/LGBTQ) community. The purpose of this exploratory research was to better understand the prevalence of IPV and IPV-BI in 2S/LGBTQ relationships where IPV was defined as physical, psychological, financial, sexual, and/or identity-based abuse from a current of former intimate partner. This study used a cross sectional internet-based survey that ran from September to December of 2022. In addition to descriptive statistics, prevalence rates and their corresponding Wilson Score confidence intervals are reported to estimate the proportion of individuals who experienced IPV and IPV-BI. Finally, for both gender identity and sexual orientation, we tested whether participants with each identity had differing levels of brain injury severity compared to participants who did not hold that identity using Mann–Whitney U tests. In total, 170 2S/LGBTQ+ adults responded to the survey. Among the respondents, 54% identified as Two-Spirit, 24% identified as gay, 17% identified as queer, 14% identified as bisexual, and 8% identified as lesbian or pansexual, respectively. Respondents were predominantly multiracial, post-secondary educated, full-time employed, cisgender women (35%) or cisgender men (19%). The overwhelming majority reported lifetime prevalence of IPV at 98% ( n = 166, 95% CI [94.11, 99.08]). Additionally, 68% ( n = 115, 95% CI [60.29, 74.22]) of participants reported symptoms consistent with an IPV-BI. These results are consistent with the findings that the 2S/LGBTQ community are at heightened risk of experiencing physical IPV. These findings are the first to our knowledge to report a high rate of symptoms consistent with an IPV-BI in the 2S/LGBTQ population.
“Your Connection is Unstable”: Remote Socialization and Effects on Organizational Assimilation
Authors: Myers Karen K. , Endacott Camille G. , Snyder Jacova
Published: June 2024

This study examined remote socialization of knowledge workers who began work remotely and the immediate and more distal effects on their organizational assimilation (OA) and other outcomes. We identify potential aftereffects as reported from interviews with 21 workers collected soon after entry and also approximately a year later to understand these longer-term effects. The data demonstrate their job competency and recognition were least affected, their ability to develop familiarity with others and role negotiation were moderately affected, and involvement and acculturation were significantly affected. Remote socialization reduced organizational identification when participants felt less connection, linked to turnover. Early-career (vs. mid-career) newcomers reported more disappointments, which led to breaches of their psychological contracts and premature turnover. We discuss theoretical and practical implications for remote socialization and the longer-term distal effects on their OA and connection to their organization.
Hunting stability improvement for high-speed trains through modification of wheel/rail contact relation
Authors: Liang Yaru , Wei Lai , Zeng Jing , Luo Ren , Wang Qunsheng
Published: June 2024

The hunting stability is an important issue for vehicle systems that determines the maximum operating speeds of the high-speed trains. In this paper, the research background for the three abnormal vibration phenomena of the high-speed trains caused by the hunting stability problems, including the “VIP Chair Shaking,” “Bogie Alarm,” and “Carbody Sway” problems, are introduced. Firstly, the reason why the vehicle hunting motion loses its stability is investigated from the viewpoint of wheel/rail contact relation. Then, a modified wheel profile is recommended in order to solve or relieve the stability problem, in which the slope at the flange root for the original wheel profile is decreased and the slope at the wheel tread end is increased. Furthermore, the numerical model for a high-speed passenger car is established to verify the dynamic performance of the modified wheel profile. Finally, the dynamic test for the vehicle equipped with the modified wheels is carried out using full-scale roller test rig to validate the theoretical analysis. It can be seen from simulations and validation tests that the wheel/rail contact relation and the dynamic performance including the hunting stability and ride comfort for the high-speed vehicle with the modified wheel are improved significantly compared with the original wheel.
Patterns of Force: The Relationship Between Officer-Involved Homicides of Black and Hispanic Citizens and Metropolitan Residential Segregation
Authors: Gibbons Joseph , Beck Audrey , Finch Brian Karl , Thomas Kyla
Published: June 2024

The increase in the prevalence of highly publicized police officer-involved homicides (OIHs) of Black and Hispanic community members has eroded trust in law enforcement. This study posits that these OIHs are a manifestation of the structural disparities resulting from racial/ethnic segregation in metropolitan areas. We use Poisson panel Generalized Linear Mixed-Effects Models to estimate this relationship with data from the Fatal Encounters project, American Community Survey, and various police department data sources. These models demonstrate that segregation characterized by the uneven distribution of Blacks to Whites is positively related to Black OIHs. Likewise, segregation characterized by the uneven distribution of Hispanics to Whites is positively associated with Hispanic OIHs. Meanwhile, the isolation of Blacks from Whites is negatively related to OIHs, and the isolation of Hispanics from Whites has no significant association with OIHs. These diverging relationships indicate the association of segregation to OIHs is more nuanced than previously argued.
Investigating adherence to tyrosine kinase inhibitors in renal cancer
Authors: Angus Fiona , Wang Yubo , Rigg Alexander , Chen Li-Chia
Published: June 2024

Introduction

Tyrosine kinase inhibitors (TKIs) have been used as the first-line treatment for many patients with renal cell carcinoma (RCC), the seventh most common cancer in the United Kingdom. However, suboptimal adherence to TKIs can result in poor clinical prognosis. This study quantified RCC patients’ adherence to TKIs and explored factors associated with suboptimal adherence.

Method

This retrospective cohort study was conducted at a specialist oncology tertiary hospital in Northwest England, using pharmacy dispensing records between November 2021 and March 2022. TKI prescriptions dispensed to patients with RCC were extracted to calculate the persistency gaps (≥7 or ≥14 days) and medication possession ratio (MPR). Multilevel regression analysis was conducted to associate MPR and persistency gaps with specific patient-related and TKI-related factors. This study did not require ethics approval.

Results

Of the 2225 prescriptions dispensed to 109 patients, 469 (23.4%) and 274 (13.7%) persistency gaps of ≥7 and ≥14 days were identified. About 75% and 92% of patients had a persistency gap of ≥7 days within the first 90 days and 180 days. The length of time since the first TKI prescription ( p < 0.001) and the use of sunitinib( p = 0.003) were significantly associated with the number of prescription gaps of ≥7 days. Moreover, the median MPR was 95.6% (interquartile range: 90.7%, 100.1%). Similarly, the length of time since the first TKI prescription was dispensed ( p < 0.001) and the use of sunitinib ( p = 0.034) were significantly associated with MPR.

Discussion and conclusion

This single-centre study found that patients with RCC generally adhere to TKIs (MPR > 90%), but many patients experienced a persistency gap. The crucial window to mitigate TKI utilisation is within 180 days after the initial dispensing of TKIs. Further large-scale studies are required to comprehensively investigate other factors associated with adherence to TKIs and develop interventions to improve adherence and medication use problems.
Effect of the addition of black garlic on the quality parameters of jerked beef meat with pork
Authors: Lopes Ranúsia Maria de Melo , Grisi Cristiani Viegas Brandão , Almeida Jorge Luiz Santos de , Silva Janiele Ferreira da , Mangolim Camila Sampaio , Sousa Solange de , Pascoal Leonardo Augusto Fonseca
Published: June 2024

The objective of this work was to evaluate the effects of the replacement of nitrite by natural antioxidants from black garlic (BG) on the quality parameters of jerked beef meat with pork for 60 days. Four formulations were prepared: control, 0.02% of sodium nitrite in brine curing, w/v (CON); 1.5% BG in brine curing, w/v (ASU); 1.5% BG in dry curing, w/w (ASS); and 1.5% of BG in the brine curing, w/v and 1.5% of BG in dry curing, w/w (ASUS). Nutritional composition, pH, water activity, shear force, fatty acid profile, color, and oxidative stability of the formulations were analyzed. The addition of BG did not affect the nutritional composition, pH, water activity, shear force, and fatty acid profile. On the other hand, it resulted in lower weight loss after centrifugation and lower values of L* and a*. TBARS values from the 30th day of storage were lower in the ASUS formulation, while carbonyl compounds at all times were lower than in the CON formulation. Results suggest that BG was an efficient alternative to nitrite in controlling protein oxidation during storage. Thus, the use of pork for the manufacture of jerked beef can be an alternative, and black garlic can be applied as a natural additive to the replacement of nitrite. In addition, black garlic was efficient in improving the oxidative stability of the jerked beef meat with pork.
CircWHSC1 (CircNSD2): A Novel Circular RNA in Multiple Cancers
Authors: Zhang Xiaomin , Yuan Yiran , Wang Xiaoxiao , Wang Heyue , Zhang Lei , He Jiefeng
Published: June 2024

Circular RNAs (circRNAs) are a type of non-coding RNA (ncRNA) that possesses a unique single-stranded circular structure. They are primarily formed through alternative splicing of pre-mRNA (messenger RNA). The primary biological function of circRNAs is to regulate gene expression at both the transcriptional and post-transcriptional levels. Recent studies have increasingly demonstrated a close association between the dysregulation of circRNAs and the progression of diverse cancers, where they can function as either tumor suppressors or oncogenes. circWHSC1 (circNSD2) is a circular ncRNA that originates from the first 2 exons of the Wolf-Hirschhorn syndrome candidate gene (WHSC1). As Chen 2019 discovery that circWHSC1 (circNSD2) functions as a sponge for miRNAs and promotes cancer, this circRNA has garnered significant interest among researchers. circWHSC1 (circNSD2) has been found to be up-regulated in various malignant tumors, including nasopharyngeal carcinoma, lung cancer, breast cancer, liver cancer, colorectal cancer, ovarian cancer, cervical cancer, and endometrial cancer. It exerts its effects on cancer by either inhibiting or promoting the expression of related genes through direct or indirect pathways, ultimately affecting cancer proliferation, invasion, and prognosis. This article provides a comprehensive review and discussion of the biological roles of circWHSC1 (circNSD2) and its target genes in various cancers, as well as the latest research progress on related molecular biological regulatory mechanisms. Furthermore, the potential significance of circWHSC1 (circNSD2) in future clinical applications and transformations is thoroughly analyzed and discussed.
During-experience involvement and dining experience
Authors: Akhoondnejad Arman
Published: June 2024

Involvement has been viewed as a central tenet of experience. Nevertheless, the predominant types of involvement in the service and marketing literatures arguably fail to fully capture the involvement of customers throughout their experiences. As a result, this research proposes a new type of involvement, namely situated involvement to investigate how tourists’ interest in/motivation for a dining experience is enhanced in restaurants. The research also investigates whether such involvement impacts the dining experiences. The findings from 20 interviews in Queenstown, New Zealand reveal 13 themes related to factors contributing to situated involvement. Moreover, it appears that situated involvement plays a positive role in dining experiences of tourists.
Heritage work in extractive zones
Authors: Baird Melissa F
Published: June 2024

This paper explores the role of heritage work in extractive zones, focusing on how different stakeholders—industries, communities, and governments—leverage heritage to assert claims and achieve visibility. This paper is based on a multiyear research project examining the now-canceled Jordan Cove Energy Project and Pacific Connector Pipeline in Oregon. The focus here centers on defining heritage work and its use by various actors to navigate claims of legitimacy and access. I argue that in extractive contexts, heritage work is more than legal work or documentation; it is also a tool that communities use to refuse the erasure of connections to land and culture and to affirm connections. By defining heritage work and extractive zones in the same frame, this paper directs attention to how heritage is taken up, dismissed, legitimized, or valorized.
First They Scream, Then They Laugh: The Cognitive Intersections of Humor and Fear
Authors: Hye-Knudsen Marc , Kjeldgaard-Christiansen Jens , Boutwell Brian B. , Clasen Mathias
Published: June 2024

On the surface, fear and humor seem like polar opposite states of mind, yet throughout our lives they continually interact. In this paper, we synthesize neurobiological, psychological, and evolutionary research on fear and humor, arguing that the two are deeply connected. The evolutionary origins of humor reside in play, a medium through which animals benignly explore situations and practice strategies, such as fight or flight, which would normally be accompanied by fear. Cognitively, humor retains the structure of play. Adopting a view of humor as requiring two appraisals, a violation appraisal and a benign appraisal, we describe how fear-inducing stimuli can be rendered benignly humorous through contextual cues, psychological distance, reframing, and cognitive reappraisal. The antagonistic relationship between humor and fear in terms of their neurochemistry and physiological effects in turn makes humor ideal for managing fear in many circumstances. We review five real-world examples of humor and fear intersecting, presenting new data in support of our account along the way. Finally, we discuss the possible therapeutic relevance of the deep connection between humor and fear.
Where to Start: Creating a Roadmap for Collection Storage Planning Through a Collaborative Values-Based Approach: A National Endowment for the Humanities Sustaining Cultural Heritage Collections project at The New York Public Library
Authors: Fifield Rebecca
Published: June 2024

Collection storage is one of the most complex collaborations a museum, library, or archive can undertake. A high-level initial assessment can help overcome the inertia and complexity that overwhelms larger organizations due to the number of stakeholders, spaces, and collections. Large institutions need to rise above room-level preservation issues and focus on global, values-based thinking. With support from the Sustaining Cultural Heritage Collections (SCHC) program of the National Endowment for the Humanities (NEH), The Research Libraries of the New York Public Library (NYPL) designed a collaborative pre-planning exercise to inform long-range collection storage planning for over fifty storage areas within its Manhattan research centers. Pulling together experts in architecture, preservation environment, and sustainability to review NYPL’s storage needs in collaboration with an internal team of stakeholders, the project established foundations for ongoing values-based collaborative planning. Project design and considerations on synthesizing observations into recommendations are discussed in this article.
Digital instructional leadership and teaching practices in an emergency context: Evidence from Italy
Authors: Moulin Léonard , Soncin Mara
Published: June 2024

With the COVID-19 pandemic, students around the world faced a disruption of unprecedented intensity. In Italy as in many other countries, for several months emergency remote teaching was the only possible form of schooling. The impacts of the COVID-19 on student achievement could be heterogeneous, depending notably on teachers’ digital instructional practices. Moreover, it was also possible that school principals’ approach to digital instructional leadership would have an impact on student outcomes. In this article, we explore these impacts using a two-level latent class analysis on a representative survey of primary and middle schools at the national level. We begin by analyzing how teachers and principals can be grouped on the basis of their instructional approach and practices during the pandemic, and examine the interaction between the two roles within schools. In the second step, by linking our survey to INVALSI standardized test scores in 2021, we analyze teachers’ and principals’ practices during the emergency on student academic performance. Our results highlight that teachers who were particularly involved in relations and communication with staff and students were (a) more likely to have highly involved principals and (b) associated with better student performance in mathematics one year later.
Lost in time and space? Multisensory processing of peripersonal space and time perception in people with frequent experiences of depersonalisation
Authors: Ferroni Francesca , Arcuri Edoardo , Ardizzi Martina , Chinchella Nicola , Gallese Vittorio , Ciaunica Anna
Published: June 2024

Perception of one’s own body in time and space is a fundamental aspect of self-consciousness. It scaffolds our subjective experience of being present, in the here and now, a vital condition for our survival and well-being. Depersonalisation (DP) is characterised by a distressing feeling of being “spaced out,” detached from one’s self, as well as atypical “flat” time perception. Using an audio-tactile paradigm, we conducted a study looking at the effect of DP experiences on peripersonal space (PPS)—the space close to the body—and time perception. Strikingly, we found no difference in PPS perception in people with higher DP experiences (High DPe) versus low occurrences of DP experiences (Low DPe). To assess time perception, we used the mental time travel (MTT) task measuring the individuals’ capacity to take one’s present as a reference point for situating personal versus general events in the past and the future. We found an overall poorer performance in locating events in time relative to their present reference point in High DPe. By contrast, Low DPe showed significant variation in performance when answering to relative past events, while High DPe did not. Our study sheds light on the close link between altered sense of self and egocentric spatiotemporal perception in individuals with DP experiences, the third most common psychological symptom in the general population.
Finding congressional voice: Fenno’s paradox and congressional public relations in the aftermath of the 2017 congressional baseball shooting
Authors: Reed Joel Lansing
Published: June 2024

Scholarship on congressional public relations has been limited and largely focused on the relationships between individual members and their constituents rather than on Congress as an institution. Unlike other organizations, the United States Congress lacks a cohesive organizational identity, with members often “running against Congress” or bifurcated into partisan camps. On June 14th, 2017, shooter James Hodgkinson opened fire on Republican members of Congress, their staff, and members of their families as they practiced for the annual Congressional Baseball Game for Charity, a rare but long-standing tradition of bipartisan camaraderie among members. In the days that followed, members in both chambers responded to the attack through statements, interviews, floor speeches, and social media posts. I analyze 106 of these messages through the lenses of organizational voice and organizational identity. I argue that by positioning the attack as an assault on Congress and on the purity of America’s pastime, members rejected partisan framings of the attack while espousing a shared rejection of political violence. Most importantly, members constituted a cohesive, bipartisan identity for Congress that stood in opposition to dominant trends of affective polarization and declining social capital among members. The study illustrates the constitutive potential of restorative rhetoric following a disaster and the unique insights to be gleaned from an institutional understanding of congressional public relations.
Quantitative microbial risk assessment for Escherichia Coli O157: H7 via drinking water in the Gaza Strip, Palestine
Authors: Abuzerr Samer , Hadi Mahdi , Zinszer Kate , Nasseri Simin , Yunesian Masud , Mahvi Amir Hossein , Nabizadeh Ramin , Mohammed Shimels Hussien
Published: June 2024

Introduction:

Microbial contamination of drinking water, particularly by pathogens such as Escherichia coli O157: H7, is a significant public health concern worldwide, especially in regions with limited access to clean water like the Gaza Strip. However, few studies have quantified the disease burden associated with E. coli O157: H7 contamination in such challenging water management contexts.

Objective:

This study aimed to conduct a comprehensive Quantitative Microbial Risk Assessment to estimate the annual infection risk and disease burden attributed to E. coli O157: H7 in Gaza’s drinking water.

Methods:

Applying the typical four steps of the Quantitative Microbial Risk Assessment technique—hazard identification, exposure assessment, dose-response analysis, and risk characterization—the study assessed the microbial risk associated with E. coli O157: H7 contamination in Gaza’s drinking water supply. A total of 1317 water samples from various sources across Gaza were collected and analyzed for the presence of E. coli O157: H7. Using Microsoft ExcelTM and @RISKTM software, a Quantitative Microbial Risk Assessment model was constructed to quantify the risk of infection associated with E. coli O157: H7 contamination. Monte Carlo simulation techniques were employed to assess uncertainty surrounding input variables and generate probabilistic estimates of infection risk and disease burden.

Results:

Analysis of the water samples revealed the presence of E. coli O157: H7 in 6.9% of samples, with mean, standard deviation, and maximum values of 1.97, 9.74, and 112 MPN/100 ml, respectively. The risk model estimated a median infection risk of 3.21 × 10-01 per person per year and a median disease burden of 3.21 × 10-01 Disability-Adjusted Life Years per person per year, significantly exceeding acceptable thresholds set by the WHO.

Conclusion:

These findings emphasize the urgent need for proactive strategies to mitigate public health risks associated with waterborne pathogens in Gaza.
Prevalence of Chronic Kidney Disease in Individuals With Type 2 Diabetes Within Primary Care: A Cross-Sectional Study
Authors: Silva-Tinoco Ruben , Cuatecontzi-Xochitiotzi Teresa , Morales-Buenrostro Luis E. , Gracia-Ramos Abraham Edgar , Aguilar-Salinas Carlos A. , Castillo-Martínez Lilia
Published: June 2024

Aims:

To assess the prevalence and risk factors for chronic kidney disease (CKD) among adults with type 2 diabetes within primary care.

Methods:

This cross-sectional study evaluated 1319 individuals receiving standard care across 26 primary units from July 2017 to January 2023. The estimated glomerular filtration rate (eGFR) and albuminuria were used for the diagnosis of CKD. CKD was defined by eGFR values of <60 mL/min/1.73 m2 and/or albumin-to-creatine ratio ≥30 mg/g. Logistic regression was applied to identify factors associated with CKD and study variables.

Results:

The median age of participants (60.6% females) was 55 years and the median diabetes duration was 10 years. The overall CKD prevalence in the study population was 39.2%. Within the CKD group, the prevalence rates of albuminuria, albuminuria coupled with low eGFR and isolated low eGFR were 72.1%, 19%, and 8.9%, respectively. The prevalence of CKD was 30.6% among participants under 40 years old and a higher value was observed in middle-aged adults with early-onset diabetes (at age <40 years) compared with the later-onset group. Multivariable analyses identified associations between CKD and factors such as age, the male sex, diabetes duration, hypertension, retinopathy, and metformin use.

Conclusion:

A relatively high prevalence of CKD, especially in non-elderly adults, was revealed in this primary care study. Early recognition strategies for CKD are crucial for timely prevention within primary care.
School Counselors’ Hope, Stress, and Job Satisfaction
Authors: Niles Jennifer K. , Mullen Patrick R. , Kitching Emily , Schofield Kyle
Published: June 2024

Objective: Previous studies suggest hope may protect against stress and burnout. Hope has also been associated with higher levels of job satisfaction for individuals across professions. However, no research has yet explored the relationships among school counselors’ hope, stress, and job satisfaction. Method: We conducted a hierarchical regression with a sample of school counselors ( N = 450) to examine whether hope would predict school counselors’ job satisfaction, even in the presence of stress. We sought to examine the extent to which the subscales of hope (pathways and agency) predict school counselors’ reported job satisfaction and to what extent hope pathways and agency continue to predict school counselors’ reported job satisfaction when stress is added to the model. Results: Our findings indicated that hope predicted job satisfaction, suggesting that participants who reported overall hope were also more satisfied with their jobs. When we added stress to the model, the pathways subscale of hope remained a significant predictor of job satisfaction. Conclusions: These findings provide new insights into the usefulness of hope as it relates to school counselors’ job satisfaction and stress. We offer implications for practice, training, and future research.
Testing the Market Efficiency of Cryptocurrency: Evidence from Bitcoin
Authors: Mallesha L.  , Archana H. N.
Published: June 2024

Due to recent developments, several countries have given the green light to cryptocurrencies, and big companies now accept them as a payment method. This article aimed to assess the random walk behaviour of the cryptocurrency market by analysing Bitcoin returns. The study observed daily Bitcoin closing prices from January 2016 to December 2023. We employed rigorous statistical tests, including the run test, generalised spectral test, automatic portmanteau test and wild bootstrap automatic variance ratio test. Furthermore, the rolling window technique was used to discern whether market efficiency was time-varying or static, involving dividing the data into four fixed rolling windows. Our overall empirical results revealed that Bitcoin price fluctuations were unpredictable, inferring market efficiency. The findings implied that Bitcoin prices adhered to a random walk pattern, making it challenging to identify abnormal trends in this emerging market.
The Harms of Unnecessary CT Pulmonary Angiography: A Case Report and Literature Review
Authors: Alagha Zakaria , Bills Ean , Alastal Maha , Ghallab Muhammad , Al-Astal Amro , Mahdi Ahmed
Published: June 2024

Pulmonary embolism (PE) poses a significant health risk in the United States, with high mortality rates. Clinicians maintain a low threshold for suspecting PE, potentially leading to deviation from guideline-recommended algorithms and unnecessary computed tomography pulmonary angiography (CTPA). This case discusses a 46-year-old woman who presented with symptoms suggestive of PE following a prolonged road trip. Despite a low Wells score and negative D-dimer results, she underwent CTPA, resulting in an unnecessary and harmful interventional radiology–guided thrombectomy. This highlights the importance of adhering to guidelines in PE diagnosis to mitigate potential harms associated with the overuse of available medical tools.
Time to Rethink Intended Learning Outcomes for Sustainable Development? A Qualitative Exploration and Reflection of Course Syllabuses in Swedish Undergraduate Physiotherapy Education
Authors: Swärdh Emma , Brodin Nina , Pettersson Anna , Palstam Annie
Published: June 2024

OBJECTIVE

Several calls to action for the implementation of education for sustainable development in health profession education have been put forth during the last few years. The aim was therefore to explore and describe sustainability-focused intended learning outcomes (SD-ILOs) in curricula of undergraduate physiotherapy education in Sweden.

METHODS

Using a deductive, descriptive, and qualitative approach, SD-ILOs in programs ( n = 8) and course syllabuses ( n = 143) from eight higher education institutions providing physiotherapy undergraduate education in Sweden were analyzed. SD-ILOs were described based on the subject content or condition, level of cognitive processes, sustainability learning dimensions, and key sustainability competencies.

RESULTS

Six of the eight physiotherapy programs provided course syllabuses with SD-ILOs. However, only 3% ( n = 36) of all ILOs were sustainability-focused. A larger part of the SD-ILOs, 78% ( n = 28) was described within the cognitive dimension of learning, and 80% ( n = 27) were linked to either the cognitive process ‘understanding’ or ‘analyzing’. The most frequently identified key competency in the SD-ILOs was ‘systems-thinking’ n = 10 (28%), and 30% ( n = 11) lacked key competency.

CONCLUSION

There is an urgent need for rapid initiatives to enhance sustainable development education in Swedish undergraduate physiotherapy education. Pedagogical approaches that cover not only cognitive dimensions of learning for sustainable development but also socio-emotional and behavioral dimensions, as well as more complex cognitive learning processes must also be developed. The current lack of key sustainability competencies further emphasizes the necessity to enrich physiotherapy curricula with action-oriented learning to develop powerful future sustainability agency within healthcare and the public health arena.
Short-Term Radiographic Outcomes of Bone Versus Metallic Augmented, Central Screw Type Baseplate in Reverse Total Shoulder Arthroplasty: Matched Case-Control Study
Authors: Lo Eddie Y , Nazemi Monia , Ouseph Alvin , Edwards Audrene S , Weingast Nancy , Krishnan Sumant G
Published: June 2024

Background

Although glenoid bone grafting and metallic augmented baseplates have demonstrated success in restoring the glenohumeral joint line in the recent literature, there remain no consensus guidelines defining the use of one versus the other.

Methods

Between 2017 and 2020, 15 primary RTSA with screw-in metallically augmented glenoid baseplates were identified and 2:1 matched by age, sex, and body mass index with primary bony-augmented glenoid baseplate patients. Patients with previous glenoid implantation or fracture were excluded. Charts, routine radiographic series (Grashey, Scapula Y, Axillary lateral), and 3-dimensional computed tomography (3D CT) scans were retrospectively reviewed. Structural patient-specific metal or bony augmentation was indicated based on preoperative glenoid morphology as identified by 3D CT. Aseptic failure was identified as hardware breakage and/or shift in glenoid baseplate component position.

Results

There were 45 eligible cases with mean age of 65.7 years (range 44-85 years) and 65.5 years (range 42-82 years) for the metallic-augmented and bone graft group, respectively. Correspondingly, mean follow up was 22.6 months (range 12-53 months), and 27.3 months (range 11-53 months). At latest follow up, there were no baseplate failures in the metallic augment group and 2 baseplate failures (7%) in the bone graft group at a mean of 42.5 months (range 32-53 months) postoperatively. Mean age of the bone failure group was 64.5 years (range 64-65 years).

Conclusion

Contemporary reversed shoulder arthroplasty glenoid baseplate designs appear to have low incidence of failure. Further analysis is necessary to determine if a critical degree of glenoid retroversion or inclination is preferable with a specific form of augmentation.

Level of Evidence

III; Retrospective Cohort Comparison.
Comprehensive seismic performance analyses of pile-supported transmission tower-line systems considering ground motion spatial variation and incident direction
Authors: Li Chao , Yang Pei , Li Hong-Nan , Hao Hong , Pan Haiyang , Tian Li , Ma Ruisheng
Published: June 2024

Pile-supported transmission tower-line systems (PTTSs) play a vital and indispensable role in reliable and efficient transmission of electricity. Their safety and normal operation under earthquake events are of great importance. Previous studies on seismic performance of PTTSs have typically been conducted under the assumptions of fixed foundations, uniform excitations, and deterministic seismic incident direction along the transmission lines, which do not necessarily reflect the real scenarios in earthquakes. To address this problem, a comprehensive seismic performance analysis approach is proposed for PTTSs spanning uneven sites, in which the influences of soil–structure interaction (SSI), depth-varying spatial ground motions (DSGMs), and seismic incident directions are thoroughly considered. In particular, the finite element model of a realistic PTTS is first established, and its accuracy is verified by static loading tests performed for the full-scale transmission tower. Then, the simulation approach for DSGMs considering the effects of wave passage, bidirectional coherence, and local site is introduced, and the DSGMs at heterogeneous site of the PTTS under various incident directions are stochastically synthesized. Finally, the seismic responses and fragilities of the PTTS are computed by utilizing the DSGMs from various incident directions as inputs. The results demonstrated that SSI, seismic excitation type, and incident direction can significantly affect the seismic performance of the PTTS, especially for the tower located at a soft site. Under various seismic incident directions, the difference between the largest and smallest fragility median peak ground acceleration (PGA) of the PTTS can reach more than 40%, and the conventional 0°, 90°, or 180° excitation may not be the most adverse incident direction. This study can provide an in-depth understanding of the seismic performance of PTTSs constructed along the sites with complex and varying geological conditions, which benefits the rational and reliable designs of large-scale transmission networks to ensure their safety and functionality under earthquake hazards.
Optimizing liver health before and after gene therapy for hemophilia A
Authors: Ragni Margaret V. , Mead Henry , de Jong Ype P. , Kaczmarek Radoslaw , Leavitt Andrew D. , Long Brian , Nugent Diane J. , Sabatino Denise E. , Fong Sylvia , von Drygalski Annette , Walsh Christopher E. , Luxon Bruce A.
Published: June 2024

Gene therapy for severe hemophilia A uses an adeno-associated virus (AAV) vector and liver-specific promoters that depend on healthy hepatocyte function to achieve safe and long-lasting increases in factor VIII (FVIII) activity. Thus, hepatocyte health is an essential aspect of safe and successful gene therapy. Many people living with hemophilia A have current or past chronic hepatitis C virus infection, metabolic dysfunction–associated steatosis or steatohepatitis, or other conditions that may compromise the efficacy and safety of AAV-mediated gene therapy. In addition, gene therapy may induce an immune response to transduced hepatocytes, leading to liver inflammation and reduced FVIII activity. The immune response can be treated with immunosuppression, but close monitoring of liver function tests and factor levels is necessary. The long-term risk of hepatocellular carcinoma associated with gene therapy is unknown. Routine screening by imaging for hepatocellular carcinoma, preferable every 6 months, is essential in patients at high risk and recommended in all recipients of hemophilia A gene therapy. This paper describes our current understanding of the biologic underpinnings of how liver health affects hemophilia A gene therapy, and provides practical clinical guidance for assessing, monitoring, and managing liver health both before and after gene therapy.
Titration of anti-IL-5 biologics in severe asthma: an open-label randomised controlled trial (the OPTIMAL study)
Authors: Soendergaard Marianne Baastrup , Bjerrum Anne-Sofie , Rasmussen Linda Makowska , Lock-Johansson Sofie , Hilberg Ole , Hansen Susanne , von Bulow Anna , Porsbjerg Celeste
Published: June 2024

Background

Anti-interleukin (IL)-5 biologics effectively reduce exacerbations and the need for maintenance oral corticosteroids (mOCS) in severe eosinophilic asthma. However, it is unknown how long anti-IL-5 treatment should be continued. Data from clinical trials indicate a gradual but variable loss of control after treatment cessation. In this pilot study of titration, we evaluated a dose-titration algorithm in patients who had achieved clinical control on an anti-IL-5 biologic.

Methods

In this open-label randomised controlled trial conducted over 52 weeks, patients with clinical control (no exacerbations or mOCS) on anti-IL-5 treatment were randomised to continue with unchanged intervals or have dosing intervals adjusted according to a titration algorithm that gradually extended dosing intervals and reduced them again at signs of loss of disease control. The OPTIMAL algorithm was designed to down-titrate dosing until signs of loss of control, to enable assessment of the longest dosing interval possible.

Results

Among 73 patients enrolled, 37 patients were randomised to the OPTIMAL titration arm; 78% of patients tolerated down-titration of treatment. Compared to the control arm, the OPTIMAL arm tended to have more exacerbations during the study (32%versus17%; p=0.13). There were no severe adverse events related to titration, and lung function and symptoms scores remained stable and comparable in both study arms throughout.

Conclusion

This study serves as a proof of concept for titration of anti-IL-5 biologics in patients with severe asthma with clinical control on treatment, and the OPTIMAL algorithm provides a potential framework for individualising dosing intervals in the future.
Longitudinal validation of King's Sarcoidosis Questionnaire in a prospective cohort with mild sarcoidosis
Authors: Møller Janne , Prior Thomas Skovhus , Hilberg Ole , Birring Surinder , Bendstrup Elisabeth
Published: June 2024

Background

Quality of life is impaired in patients with sarcoidosis. The King's Sarcoidosis Questionnaire (KSQ) is a brief questionnaire assessing health-related quality of life in patients with sarcoidosis, comprising subdomains of General Health Status (GHS), Lung, Medication, Skin and Eyes. The aim of this study was to enhance the validation of the KSQ, incorporating longitudinal validation and known-groups validity in a cohort with mild sarcoidosis.

Methods

The KSQ was linguistically validated according to guidelines. Patients with sarcoidosis completed KSQ and other questionnaires at baseline, after 2 weeks and at 12 months. Forced vital capacity (FVC) was measured. Concurrent validity, reliability and responsiveness were assessed.

Results

In patients (n=150), the KSQ had moderate to strong correlations with the Short Form-12 (Mental Component Summary), the King's Brief Interstitial Lung Disease questionnaire and the Fatigue Assessment Scale (r=0.30–0.70) and weak correlations with the Short Form-12 (Physical Component Summary) and FVC (r=0.01–0.29). The KSQ GHS and Lung domains were able to discriminate between groups of patients stratified according to fatigue, treatment and FVC. The KSQ had high internal consistency (Cronbach's α=0.73–0.90) and repeatability (interclass correlation coefficients 0.72–0.81). Correlations to comparable questionnaires at baseline were moderate or strong for the GHS, Lung and GHS–Lung subdomains and weak or moderate for FVC. The KSQ was responsive to changes over time.

Conclusion

This study strengthened the validation of the KSQ by introducing known-groups validity and assessments of responsiveness over 12 months in patients with mild sarcoidosis.
Prevalence of refractory and unexplained chronic cough in adults treated in cough centre
Authors: Kukiełka Paweł , Moliszewska Katarzyna , Białek-Gosk Katarzyna , Grabczak Elżbieta M. , Dąbrowska Marta
Published: June 2024

Background

Refractory chronic cough and unexplained chronic cough pose significant clinical challenges, impairing patients’ quality of life. However, a precise definition of refractory chronic cough remains elusive. This study aimed to assess the prevalence of refractory and unexplained chronic cough among patients referred to our cough centre and to analyse the prevalence of refractory chronic cough relative to its definition.

Methods

This prospective cohort study included all patients who were diagnosed at a cough clinic between 2018 and 2022. The response to therapy was measured based on reduction in cough severity (viaa visual analogue scale) and improvement in cough-related quality of life (viathe Leicester Cough Questionnaire). Refractory chronic cough was defined as persistent cough severity, with no or minimal improvement (change in visual analogue scale <30 mm) after two or more treatment attempts and cough severity ≥40 out of 100 mm on the visual analogue scale.

Results

Of 201 patients treated for chronic cough, only three (1.5%) were diagnosed with unexplained chronic cough. Among 166 patients monitored for therapy response, 71 (42.8%) experienced a cough severity reduction of ≥30 mm on the visual analogue scale, while 100 (60.2%) showed an improvement of ≥1.5 points on the Leicester Cough Questionnaire. Based on the basic refractory chronic cough definition, 51 of 166 patients (30.7%) were diagnosed with refractory chronic cough. If applying stricter criteria (persistent severe cough (≥40 mm on the visual analogue scale), insufficient therapy response (<30 mm reduction on the visual analogue scale) and <1.5-point improvement on the Leicester Cough Questionnaire), 45 of 166 patients (27.1%) would be diagnosed with refractory chronic cough.

Conclusions

Refractory chronic cough is common in patients referred to cough clinics. The prevalence of refractory chronic cough differs slightly depending on the diagnostic criteria. Therefore, the definition of refractory chronic cough used in routine practice needs to be clarified.
Genome-wide association study of BNT162b2 vaccine-related myocarditis identifies potential predisposing functional areas in Hong Kong adolescents
Authors: She Chun Hing , Tsang Hing Wai , Yang Xingtian , Tsao Sabrina SL , Tang Clara SM , Chan Sophelia HS , Kwan Mike YW , Chua Gilbert T , Yang Wanling , Ip Patrick
Published: June 2024

Vaccine-related myocarditis associated with the BNT162b2 vaccine is a rare complication, with a higher risk observed in male adolescents. However, the contribution of genetic factors to this condition remains uncertain. In this study, we conducted a comprehensive genetic association analysis in a cohort of 43 Hong Kong Chinese adolescents who were diagnosed with myocarditis shortly after receiving the BNT162b2 mRNA COVID-19 vaccine. A comparison of whole-genome sequencing data was performed between the confirmed myocarditis cases and a control group of 481 healthy individuals. To narrow down potential genomic regions of interest, we employed a novel clustering approach called ClusterAnalyzer, which prioritised 2,182 genomic regions overlapping with 1,499 genes for further investigation. Our pathway analysis revealed significant enrichment of these genes in functions related to cardiac conduction, ion channel activity, plasma membrane adhesion, and axonogenesis. These findings suggest a potential genetic predisposition in these specific functional areas that may contribute to the observed side effect of the vaccine. Nevertheless, further validation through larger-scale studies is imperative to confirm these findings. Given the increasing prominence of mRNA vaccines as a promising strategy for disease prevention and treatment, understanding the genetic factors associated with vaccine-related myocarditis assumes paramount importance. Our study provides valuable insights that significantly advance our understanding in this regard and serve as a valuable foundation for future research endeavours in this field.