bluuebunny/crossref_metadata_2025 huggingface dataset:
The development of the Autism Stigma and Knowledge Questionnaire, Second edition (ASK-Q-2), through a cross-cultural psychometric investigation
Authors: Harrison Ashley J , Madison Matthew , Naqvi Nilofer , Bowman Karrah , Campbell Jonathan
Published: August 2024

The Autism Stigma and Knowledge Questionnaire (ASK-Q) was developed and validated to assess autism knowledge across cultural contexts. Given the wide international use of the measure, the current study aimed to re-examine the measurement properties of the ASK-Q. Using a large, international database ( n = 5064), psychometric analyses examined both item discrimination and differential item functioning across four countries. These analyses identified 18 items in need of examination for removal or refinement and retention. Further review by a team of autism experts identified additional changes required to minimize item stigma and increase item cross-cultural sensitivity and accuracy. These changes resulted in the ASK-Q, Second edition (ASK-Q-2), a briefer measure, that maintained the original four-factor structure and excellent internal consistency, but that now has even higher reliability for use in cross-cultural contexts.

Lay abstract

The Autism Stigma and Knowledge Questionnaire (ASK-Q) was developed to assess autism knowledge across cultural contexts. The current study aimed to examine cultural equivalence of the measure using a large, international database. These analyses identified 18 items in need of examination for removal or revision. A team of autism experts recommended several additional changes to reduce stigma and increase cross-cultural sensitivity and accuracy of the items on the measure. These changes resulted in a briefer measure with maintained statistical support.
Evolution of asexual identities in India: Shaping asexual conversations through lived experiences and digital platforms
Authors: Malavika  , Kachhap Bibhuti M
Published: August 2024

The ideation of asexuality is inherently radical and subversive, as it challenges the centrality of sex and sexual behaviour in a heteronormative society. This article aims to study the emergence and construction of Indian asexual discourse by examining the lived experiences and narratives of Indian asexual individuals. A mixed-methods qualitative approach is employed, utilizing semi-structured interviews conducted through snowball sampling, along with an analysis of online Indian asexual platforms. Additional data were gathered from digital asexual archives, dating sites, and social media platforms that actively engage in discussions about Indian asexual experiences, desires, and intimacy. Emerging Indian asexualities are constituting a novel ethos in Indian sexual practices by creating an alternative language of desire and intimacy.
Crisis
Authors: Hoff Isaac , Happer Catherine
Published: August 2024

Owing to its prominence in everyday life, media, culture, economy and politics, we follow the lead of Marie Moran in taking a keywords-as-method approach to ‘crisis’. In doing so, we explore its changing meaning from a decisive moment to something more permanent. We argue this change is because of the proliferation, proximity and visibility of numerous interlocking, converging crises that are being experienced by a greater number of people across a range of spatiotemporal scales which produces a political imagination defined by incipience. Taken together, these illuminate how the changed meaning of ‘crisis’ is both a response to, and constitutive of the material conditions of lived experience, as well as our social, cultural and political imaginaries in the contemporary moment.
Real-world occupational therapy interventions for early-stage dementia: Characteristics and contextual barriers
Authors: Edwards Bethan M , Busse Monica , Clouston Teena J , Hannigan Ben
Published: August 2024

Aim

There is an absence of evidence generated in a UK context to support interventions based on occupational therapists’ core skills for people living with early-stage dementia. To inform the development of a programme theory and a future evaluation, this paper aimed to describe real-world (routine) community-based occupational therapy interventions for this population and contextual barriers.

Method

Occupational therapy practitioners ( n = 21) from five Health Boards in Wales, UK participated in semi-structured interviews ( n = 17) which were audio recorded, transcribed, and analysed thematically.

Findings

The availability of, and access to, real-world community-based interventions was variable, and associated with multilevel contextual barriers (resources, understanding of dementia specialist occupational therapy, professional influence, and evidence base). Where available and accessible, contents comprised a pre-intervention component (relational work, assessment, and goal setting) and intervention component (personalised problem-solving and coping strategies, emotional support, and advice and signposting), to meet needs associated with everyday activities and poor wellbeing. Variation in mode, duration, contents, and who received interventions, was associated with contextual barriers.

Conclusion

Findings indicate that the development of an intervention programme theory and future evaluation design, will need to account for the impact context may have on the variability of real-world intervention characteristics, and how this in turn may influence outcomes.
The long way round: drawing to know by ‘not knowing’
Authors: Macleod Deirdre
Published: August 2024

While the reflexive and investigative potential of observational drawing is now acknowledged clearly within human geography, drawing practices are still most often brought to bear upon research subjects once they have been defined, rather than in helping to identify subjects for investigation. Reflecting upon the author’s own experience of artistic fieldworking, this article explores how expanded drawing can help researchers hold positions of ‘not knowing’ and maintain an openness to the possibilities that exist within a site during their earliest encounters with it. It is argued here that some forms of expanded drawing can foster ‘not knowing’ by offering access to information about the field beyond the visual, through direct and close physical engagement with it. By shifting emphasis towards sensory and embodied information, expanded drawing can generate fragmentary, partial and fugitive understandings which can unsettle assumptions about a place. Cultivating such positions of ‘not knowing’ can open up the field, break down pre-conceived object hierarchies and enable the site to ‘speak back’ and be heard more evenly. Expanded drawing also has the capacity to foster new relations between the researcher and their site as they persistently and intimately interrogate it. This is proposed as a form of ‘noticing-as-care’; a tentative artistic counter-strategy which may reveal unevenness in the attention paid across post-industrial landscapes undergoing regeneration, where areas of profound neglect and hyper-curation often sit close to each other.
Semi-supervised learning for efficient water leakage segmentation in tunnel infrastructure
Authors: Wang Wenjun , Su Chao
Published: August 2024

Water leakage segmentation based on computer vision allows for efficient monitoring and maintenance, ensuring the safety and integrity of tunnel infrastructure. In this study, a semisupervised learning method with self-training via pseudo-labels is proposed to overcome the dependence of conventional computer vision models on high-quality labeled data. Strong data augmentation is first injected into the unlabeled data to establish a robust self-training baseline and differentiate similar predictions between teacher and student networks. To mitigate the accumulation of erroneous pseudo-labels and their potential impact on performance, we chose to retrain using only reliable, unlabeled images. The unlabeled images are prioritized based on their overall stability. By considering image-level contextual information, the selection process offers a more suitable approach for segmentation compared to conventional pixelwise methods. The experimental results highlight the method’s capability to enhance model performance with a limited amount of labeled data, surpassing the effectiveness of other semisupervised methods.
Simulation-driven unsupervised fault diagnosis of rolling bearing under time-varying speeds
Authors: Xu Zhenli , Tang Guiji , Pang Bin
Published: August 2024

Simulation models incorporating fault mechanisms can acquire sufficient samples with rich fault information, providing an effective solution to deep learning-driven bearing fault diagnosis in case of sample scarcity. However, the simulation models in the previous studies are mainly designed for constant speed conditions and cannot generate effective source data aligning with the variable speed conditions. Moreover, the fault impacts of bearing exhibit time-varying characteristics under variable speed conditions, causing the obstacle of the fault feature representation of the deep learning model. Therefore, this article investigates an analytical fault simulation model-driven unsupervised fault diagnosis of rolling bearing under time-varying speeds. The simulation model can customize high-quality data that match the specific variable speed conditions. The proposed network can extract robust discriminable feature representation by designing multiscale enhanced temporal convolution transformer network and enables the feature alignment of the target and simulation samples under a pseudolabel guided domain adaptation training strategy. The effectiveness and superiority of the proposed method in addressing the bottleneck problems of bearing unsupervised fault diagnosis under variable speed conditions, including condition matching data generation and time-varying feature representation, is demonstrated using two different bearing datasets.
Association of serum syndecan-1 concentrations with albuminuria in type 2 diabetes
Authors: Kakutani Yoshinori , Morioka Tomoaki , Yamazaki Yuko , Ochi Akinobu , Fukumoto Shinya , Shoji Tetsuo , Emoto Masanori
Published: August 2024

Introduction

Syndecan (SDC)-1 is a transmembrane heparan sulfate proteoglycan and is a major component of endothelial glycocalyx (EG). This study aimed to investigate the association of serum SDC-1 concentration as a marker of EG degradation with albuminuria in type 2 diabetes.

Methods

We included 370 patients with type 2 diabetes and 219 individuals with no diabetes. The individuals with estimate glomerular filtration rate <30 mL/min/1.73 m2 were excluded.

Results

Serum SDC-1 concentration was higher in type 2 diabetes than in no diabetes. The presence of diabetes was independently associated with log [SDC-1] in multivariate analysis. In type 2 diabetes, serum SDC-1 concentration was correlated with log [urinary albumin-to-creatinine ratio (ACR)]. Moreover, log [SDC-1] was an independent determinant of log [ACR] after adjustment for known risk factors of albuminuria.

Conclusions

Serum SDC-1 concentration was higher in patients with type 2 diabetes compared to individuals with no diabetes and an independent determinant of ACR. This study implicates the role of the EG degradation in albuminuria in type 2 diabetes.
A Novel RNA Methylation-Related Prognostic Signature and its Tumor Microenvironment Characterization in Hepatocellular Carcinoma
Authors: Liu Luzheng , Chen Jiacheng , Ye Fei , Yan Yanggang , Wang Yong , Wu Jincai
Published: August 2024

Introduction

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors of the digestive system. RNA methylation plays an important role in tumorigenesis and metastasis, which could alter gene expression and even function at multiple levels, such as RNA splicing, stability, translocation, and translation. In this study, we aimed to conduct a comprehensive analysis of RNA methylation-related genes (RMGs) in HCC and their relationship with survival and clinical features.

Methods

A retrospective analysis was performed using publicly available HCC-related datasets. The differentially expressed genes (DEGs) between HCC and controls were identified from TCGA-LlHC and intersected with RMGs to obtain differentially expressed RNA methylation-related genes (DERMGs). Regression analysis was used to screen for prognostic genes and construct risk models. Simultaneously, clinical, immune infiltration and therapeutic efficacy analyses were performed. Finally, multivariate cox regression was used to identify independent risk factors, and quantitative real-time polymerase chain reaction (qRT-PCR) was used to validate the expression levels of the core genes of the model.

Results

A 21-gene risk model for HCC was established with excellent performance based on ROC curves and survival analysis. Risk scores correlated with tumor grade, pathologic T, and TNM stage. Immune infiltration analysis showed correlations with immune scores, 11 immune cells, and 30 immune checkpoints. Low-risk patients showed a higher susceptibility to immunotherapy. The risk score and TNM stage were independent prognostic factors. qRT-PCR confirmed higher expression of PRDM9, ALPP, and GAD1 in HCC.

Conclusions

This study identified RNA methylation-related signature genes in HCC and constructed a risk model that predicts patient outcomes and reflects the immune microenvironment. Prognostic genes are involved in complex regulatory mechanisms, which may be useful for cancer diagnosis, prognosis, and therapy.
Interdisciplinary Integrative Oncology Group-Based Program: Evaluation of Long-Term Effects on Resilience and Use of Complementary and Alternative Medicine in Patients With Cancer
Authors: Von Reusner Marek Jonas , Märtens Bettina , Barthel Stephanie , Weiser Axel , Ziert Yvonne , Steinmann Diana , Babadağ-Savaş Burcu
Published: August 2024

Background:

Cancer often causes reduced resilience, quality of life (QoL) and poorer overall well-being. To mitigate these problems, complementary and alternative medicine (CAM) is widely used among patients with cancer. This study aimed to evaluate the long-term effects of an interdisciplinary integrative oncology group-based program (IO-GP) on the resilience and use of CAM in patients with cancer.

Methods:

This was a prospective, observational, single-center study. Resilience (RS-13), CAM usage (I-CAM-G), QoL (SF-12) and health-related lifestyle factor (nutrition, smoking, alcohol consumption and physical exercise) data were collected for 70 patients who participated in a 10-week IO-GP between January 2019 and June 2022 due to cancer. The IO-GP is offered at the setting of a university hospital and is open to adult patients with cancer. It contains elements from mind-body medicine and positive psychology, as well as recommendations on healthy diet, exercise and CAM approaches. Patients who completed the IO-GP at least 12 months prior (1-4.5 years ago) were included in this study. Statistical analysis included descriptive analysis and parametric and nonparametric tests to identify significant differences ( P < .05).

Results:

Resilience increased significantly ≥12 months after participation in the IO-GP (n = 44, P = .006, F = 8.274) and had a medium effect size ( r = .410). The time since the IO-GP was completed (“12-24 months,” “24-36 months,” and “>36 months”) showed no statistically significant interaction with changes in resilience ( P = .226, F = 1.544). The most frequently used CAM modalities within the past 12 months were vitamins/minerals (85.7%), relaxation techniques (54.3%), herbs and plant medicine (41.1%), yoga (41.4%) and meditation (41.4%). The IO-GP was the most common source informing study participants about relaxation techniques (n = 24, 64.9%), meditation (n = 21, 72.4%) and taking vitamin D (n = 16, 40.0%). Significantly greater levels of resilience were found in those practicing meditation ( P = .010, d = −.642) or visualization ( P = .003, d = −.805) compared to non-practitioners.

Conclusion:

IO-GPs have the potential to empower patients with cancer to continue using CAM practices—especially from mind-body medicine—even 1 to 4.5 years after completing the program. Additionally, resilience levels increased. These findings provide notable insight into the long-term effects of integrative oncology interventions on resilience and the use of CAM, especially in patients with breast cancer.
Resecting Lower Segment Inferior Vena Cava Leiomyosarcoma With Middle Segment Extension While Avoiding Renal Morbidity
Authors: Kushwaha Naveen Kumar , Jaiswal Pradeep , Singh Vijay Pratap , Dhaman Pawan Kumar
Published: August 2024

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare and aggressive mesenchymal tumor, with less than 400 reported cases to date. Complete resection of the tumor with clear margins is the only proven curative treatment, providing survival benefits. Nonetheless, leiomyosarcomas in the middle segment or those extending up to it within the inferior vena cava (IVC) frequently necessitate renal reimplantation or nephrectomy, with rates varying between 56% and 75%. In this case report, we present a 65-year-old female with lower segment IVC leiomyosarcoma with middle segment extension, successfully resected and reconstructed while avoiding associated renal reimplantation or nephrectomy morbidity.
The Spinal Cord Injury Self-Management Program: A Pilot
Authors: Kraus Bridget , Wolf Timothy J.
Published: August 2024

People with chronic spinal cord injury (SCI) experience a higher rate of secondary health conditions (SHCs) which affect their health and well-being. Self-management (SM) is a proven intervention approach, but formal programs may need to be tailored for the SCI population to reflect their needs and values. We sought to examine the feasibility and acceptability of the Spinal Cord Injury Self-Management (SCISM) Program and estimate its effect. A total of 32 individuals with SCI participated in the program. The primary outcomes were feasibility, acceptability, SHCs, and goal attainment. Participants were assessed at baseline, postintervention, and 3-month follow-up. Findings indicated that the SCISM Program was feasible and acceptable for use with moderate positive effects on SHCs and large positive effects in goal attainment. People with chronic SCI want to continue improving SM skills. The SCISM Program is feasible, acceptable, and should be examined further to reduce SHCs following SCI.
Introduction to the special issue: Urban governance and policy
Authors: Cai Rong , Chen Na
Published: August 2024

At a time when urbanization has become a topic of public concern, it is highly important to consider the impact of governance approaches on our understanding of the urban and urban policies. Urban areas are vibrant, multifaced, and interrelated systems that require nuanced governance and thoughtful policy-making to thrive. Effective urban governance and policy are essential for tackling issues like infrastructure development, affordable housing, environmental sustainability, and social equity. This special issue delves into the complexities of urban governance and policy, exploring the strategies, frameworks, and innovations that can help cities manage growth and improve the quality of life for their inhabitants. We organized this special issue around the theme of urban governance to highlight the critical importance of these topics for ongoing progress in urban studies.
Brain-Hand Function Relationships Based on Level of Grasp Function in Chronic Left-Hemisphere Stroke
Authors: Rizor Elizabeth , Fridriksson Julius , Peters Denise M. , Rorden Chris , Bonilha Leonardo , Yourganov Grigori , Fritz Stacy L. , Stewart Jill Campbell
Published: August 2024

Background and Objective

The biomarkers of hand function may differ based on level of motor impairment after stroke. The objective of this study was to determine the relationship between resting state functional connectivity (RsFC) and unimanual contralesional hand function after stroke and whether brain-behavior relationships differ based on level of grasp function.

Methods

Sixty-two individuals with chronic, left-hemisphere stroke were separated into three functional levels based on Box and Blocks Test performance with the contralesional hand: Low (moved 0 blocks), Moderate (moved >0% but <90% of blocks relative to the ipsilesional hand), and High (moved ≥90% of blocks relative to the ipsilesional hand).

Results

RsFC in the ipsilesional and interhemispheric motor networks was reduced in the Low group compared to the Moderate and High groups. While interhemispheric RsFC correlated with hand function (grip strength and Stroke Impact Scale Hand) across the sample, contralesional RsFC correlated with hand function in the Low group and no measures of connectivity correlated with hand function in the Moderate and High groups. Linear regression modeling found that contralesional RsFC significantly predicted hand function in the Low group, while no measure correlated with hand function in the High group. Corticospinal tract integrity was the only predictor of hand function for the Moderate group and in an analysis across the entire sample.

Conclusions

Differences in brain-hand function relationships based on level of motor impairment may have implications for predictive models of treatment response and the development of intervention protocols aimed at improving hand function after stroke.
The MTGO Virtual Economy: A Case Study on a “Play-to-Earn” Game That has Existed Since Before Cryptocurrency Was Even Invented
Authors: Ramos Mark Louie F.
Published: August 2024

MTGO is a virtual simulation of the popular tabletop game, Magic: The Gathering Online. For over 20 years, it has developed a robust virtual game economy that is connected to the real-world market through the game's set redemption feature. In this case study, it is shown that the different facets of the MTGO economy have enabled it to thrive while avoiding or naturally addressing problems such as hyperinflation that have commonly arose in other virtual game economies, including those that fall under the contemporary and at times controversial concept of play-to-earn model games. Through this expository paper, it is argued that the MTGO economy is a rich source of information that is worth exploring for the benefit of fields such as game development research, game behaviors research, and experimental economics.
Exploration of small molecule compounds targeting abdominal aortic aneurysm based on CMap database and molecular dynamics simulation
Authors: Li Fushan , Zhuo Liqing , Xie Fangtao , Luo Haiping , Li Ying , Lin Huyu , Li Xiaoguang
Published: August 2024

Objective

The mitigation of abdominal aortic aneurysm (AAA) growth through pharmaceutical intervention offers the potential to avert the perils associated with AAA rupture and the subsequent need for surgical intervention. Nevertheless, the existing effective drugs for AAA treatment are limited, necessitating a pressing exploration for novel therapeutic medications.

Methods

AAA-related transcriptome data were downloaded from GEO, and differentially expressed genes (DEGs) in AAA tissue were screened for GO and KEGG enrichment analyses. Small molecule compounds and their target proteins with negative connectivity to the AAA expression profile were predicted in the Connectivity Map (CMap) database. Molecular docking and molecular dynamics simulation were performed to predict the binding of the target protein to the small molecule compound, and the MM/GBSA method was used to calculate the binding free energy. Cluster analysis was performed using the cluster tool in the GROMACS package. An AAA cell-free model was built, and CETSA experiments were used to demonstrate the binding ability of small molecules to the target protein in cells.

Results

A total of 2244 DEGs in AAA were obtained through differential analysis, and the DEGs were mainly enriched in the tubulin binding biological function and cell cycle pathway. The CMap results showed that Apicidin had a potential therapeutic effect on AAA with a connectivity score of -97.74, and HDAC4 was the target protein of Apicidin. Based on literature, HDAC4-Apicidin was selected as the subsequent research object. The lowest affinity of Apicidin-HDAC4 molecular docking was -8.218 kcal/mol. Molecular dynamics simulation results indicated that Apicidin-HDAC4 could form a stable complex. MM/GBSA analysis showed a total binding free energy of −55.40 ± 0.79 kcal/mol, and cluster analysis showed that there were two main conformational clusters during the binding process, accounting for 22.4% and 57.8%, respectively. Apicidin could form hydrogen bonds with surrounding residues for stable binding. CETSA experiment proved the stable binding ability of Apicidin and HDAC4.

Conclusion

Apicidin inhibited HDAC4 in AAA and exhibited favorable protein-ligand interactions and stability, making it a potential candidate drug for treating AAA.
Outcomes of drug-coated balloon angioplasty in patients with dyslipidemia in the BIOLUX P-III registry: A subgroup analysis
Authors: Dodd James Evan , Hanna Joseph , Brodmann Marianne , Golledge Jonathan , Zeller Thomas , Moscovic Matej , Dahm Johannes , Troisi Nicola , Tepe Gunnar , Wong Jacqueline , Ward Natalie C. , Mwipatayi Bibombe Patrice
Published: August 2024

Objectives

The aim of this study was to assess the mid-term outcomes of the use of drug-coated balloons (DCBs) to treat infrainguinal peripheral arterial disease (PAD) in patients with dyslipidemia.

Methods

BIOLUX P-III is a prospective, international, multicenter, all-comers registry-based study that was conducted at 44 sites with follow-ups at 6, 12 and 24 months. The present study is a subgroup analysis comparing the outcomes associated with endovascular revascularization with those associated with Passeo-18 lux DCBs in patients with and without dyslipidemia. The proportions of patients free from major adverse events (defined as device- or procedure-related mortality within 30 days, clinically driven target lesion revascularization (CD-TLR) and major target limb amputation), target vessel revascularization, and patient-reported outcomes within 24 months postintervention were compared between the two groups.

Results

A total of 876 patients with symptomatic PAD who underwent peripheral revascularization with DCBs and had information on their dyslipidemia status were included; 588 of those patients had dyslipidemia. There was no difference in the proportion of patients free from MAEs between the groups. The percentages of patients who were 6, 12 and 24 months free from CD-TLR were significantly lower in the dyslipidemia group than in the nondyslipidemia group (86.3% vs 91.9% at 2 years, p = .0183). Similarly, the percentage of patients free from target vessel revascularization was lower in the dyslipidemia group at all timepoints (83.3% vs 89.3% at 2 years, p = .0203). There was no difference in mortality or major or minor limb amputation rates. Other secondary outcomes were similar between the groups.

Conclusions

Compared to those without dyslipidemia, patients with symptomatic PAD and dyslipidemia who underwent revascularization with a Passeo-18 lux DCB had greater rates of CD-TLR and TVR. However, having dyslipidemia did not increase the risk of mortality or limb amputation.

Clinical Trial Registration

NCT02276313.
Attitudes towards the sexuality of adults with intellectual disabilities: Family, staff, community and student perspectives
Authors: Correa Ana Belén , Castro Ángel , Gil-Llario María Dolores
Published: August 2024

Background: The sexual expression of adults with intellectual disabilities can be hindered by negative attitudes towards their sexuality. This study aims to examine current attitudes of staff, family, community and students towards the sexuality of adults with intellectual disabilities and how sociodemographic variables may influence these attitudes. Methods: 305 participants completed an online questionnaire, including the ASEXID scale. Results: Scores were highest for the normalising attitude and lowest for the negative attitude, with intermediate scores for the paternalistic attitude. Staff and university students exhibited a more normalising attitude than families and community. Community participants exhibited a more negative attitude than staff and students. Older age was associated with less normalising and more paternalistic attitudes. Being male with a more negative attitude. Discussion: These findings should be taken into account by professionals. Intermediate scores on the paternalistic attitude may mediate difficulties in supporting adults with intellectual disabilities in their sexuality.
Examining the effect of permit-less carry laws on violent crime rates in Alaska, Arizona, Arkansas, and Wyoming
Authors: Jorgensen Cody
Published: August 2024

In recent years, many states have loosened regulations regarding carrying a concealed firearm. Permit-less carry laws allow citizens who are legally allowed to own firearms to carry a concealed firearm in public without obtaining a permit. This trend is an evolution of right-to-carry legislation that swept the United States beginning in the late 1980s. Research tends to find that right-to-carry laws increase violent crime. This study examines the effect of permit-less carry laws, independent of right-to-carry laws, on violent crime rates in Alaska, Arizona, Arkansas, and Wyoming, the first states to adopt permit-less carry legislation, using a 50 state panel data set from years 1995 to 2019. The synthetic control method was employed to find that permit-less carry laws were associated with an increase in aggravated assault in Alaska but generally not associated with variations in violent crime rates in the other states. In sum, moving from right-to-carry to permit-less carry was not found to cause an additional increase in violence on top of existing right-to-carry laws.
Does the distal radioulnar joint orientation influence the outcome of ulnar shortening osteotomy: a retrospective study
Authors: Meuser Stefan , Ueberberg Johanna , Kernich Nikolaus , Weber Carolyn , Richter Martin
Published: August 2024

The aim of this retrospective study was to evaluate the long-term outcome of ulnar shortening osteotomy. A total of 66 patients treated with an ulnar shortening osteotomy for a primary or post-traumatic ulnar impaction syndrome were included, with a median follow-up time of 75 months.

There was a positive correlation between the sigmoid notch angle and the final QuickDASH score, but no correlation with final range of motion, grip strength or pain level. Radiological signs of osteoarthritis of the distal radioulnar joint were seen in 20% of patients, yet there was no correlation between the development of distal radioulnar joint osteoarthritis and the sigmoid notch angle. No symptomatic distal radioulnar joint osteoarthritis was observed.

Ulnar shortening osteotomy is a good option to treat patients with ulnar impaction syndrome regardless of the distal radioulnar joint angle.

Level of evidence: IV
Safety and risk factors for bleeding complications of radial probe endobronchial ultrasound-guided transbronchial biopsy
Authors: Bae Eunhye , Hwang Hyeontaek , Kim Joong-Yub , Park Young Sik , Cho Jaeyoung
Published: August 2024

Background:

Radial probe endobronchial ultrasound (radial EBUS) is widely used to diagnose pulmonary lesions; however, the diagnostic value of radial EBUS-guided transbronchial biopsy (TBB) varies, and its complications (especially the risk of bleeding) are not properly understood.

Objectives:

In this study, we evaluated the diagnostic performance and rate of complication of this procedure, and investigated the risk factors associated with the procedure-related bleeding events.

Design:

A retrospective cohort study.

Methods:

This was a retrospective study that included consecutive patients who underwent radial EBUS-guided TBB. Radial EBUS was performed under moderate sedation in inpatients or outpatients. The severity of bleeding was graded using the standardized definitions of bleeding.

Results:

Of 133 patients (median age, 69 years; men 57.1%) included, 41 were outpatients (30.8%). The diagnostic accuracy, sensitivity, and specificity for malignancy were 76.1% (89/117), 71.1% (69/97), and 100% (20/20), respectively. The diagnostic accuracy ranged from 66.9% to 79.0%, depending on the classification of undiagnosed cases as either false negatives or true negatives. Twenty-seven patients (20.3%) developed complications (pneumothorax, 3; pneumonia, 5; complicated pleural effusion, 2; bleeding event grade 2 or higher, 21). Of the 41 outpatients, two developed complications (pneumothorax without intervention, 1; grade 2 bleeding event, 1). Of the 21 patients (15.8%) with procedure-related bleeding events, 18 had grade 2, and three had grade 3 bleeding complications. In multivariate analysis, a large size of ⩾30 mm (adjusted odds ratio (OR), 5.09; p = 0.03) and central lesion (adjusted OR, 3.67; p = 0.03) were significantly associated with the risk of grade 2 or higher bleeding events.

Conclusion:

Our results suggest that radial EBUS-guided TBB is an accurate and safe method for diagnosing pulmonary lesions. Clinically significant procedure-related bleeding was rare. The central location and larger size (⩾30 mm) of pulmonary lesions were risk factors for grade 2 or higher bleeding events.
Performance of a Novel Continuous Glucose Monitoring Device in People With Diabetes
Authors: Mader Julia K. , Waldenmaier Delia , Mueller-Hoffmann Wiebke , Mueller Katrin , Angstmann Michael , Vogt Gerhard , Rieger Cosima C. , Eichenlaub Manuel , Forst Thomas , Freckmann Guido
Published: August 2024

Background:

In this multicenter study, performance of a novel continuous glucose monitoring (CGM) system was evaluated.

Methods:

Adult participants with diabetes were included in the study. They each wore three sensors of the CGM system on the upper arms for up to 14 days. During four in-clinic visits, frequent comparison measurements with capillary blood glucose (BG) samples were performed. The primary endpoint was the 20/20 agreement rate (AR): the percentage of CGM readings within ±20 mg/dL (at BG values <100 mg/dL) or ±20% (at BG values ≥100 mg/dL) of the comparator. Further evaluations included mean absolute relative difference (MARD) and 20/20 AR in different BG ranges and across the wear time.

Results:

Data from 48 participants and 139 sensors were analyzed. During in-clinic sessions the 20/20 AR was 90.5% and the MARD was 9.2%. For BG ranges <70, 70-180, and >180 mg/dL, 20/20 AR was 94.3%, 89.0%, and 92.5%, respectively. At the beginning, middle, and end of sensor wear time, 20/20 AR was 92.8%, 91.5%, and 85.9%, respectively. The 14-day survival probability was 82.4%. Pain and bleeding after sensor insertion were within the expected range. Based on the study outcome, the use of the device is regarded as safe.

Conclusions:

The system showed a good performance compared to capillary BG measurements. This level of accuracy could be shown over the entire measurement range, especially in the low glycemic range, and the whole wear time of the sensors. The results of this study are supporting a non-adjunctive use of the device.
Comparison of Telemedicine-Administered Thrombolytic Therapy for Acute Ischemic Stroke by Neurology Subspecialty: A Cross-Sectional Study
Authors: Loggini Andrea , Hornik Jonatan , Henson Jessie , Wesler Julie , Nelson Madison , Hornik Alejandro
Published: August 2024

Background and Purpose

To determine if any difference exists in safety and outcomes of thrombolytic therapy for acute ischemic stroke administered via telemedicine, based on the subspeciality of the treating neurologist.

Methods

We performed a retrospective cross-sectional study using data from our local stroke registry of thrombolytic therapy administered via telemedicine at our rural stroke network over 5 years. The cohort was divided in 2 groups based on the subspecialty of the treating neurologist: vascular neurology (VN) and neurocritical care (NCC). Demographics, clinical characteristics, stroke metrics, thrombolytic complications, and final diagnosis were reviewed. In-hospital mortality and mRS and 30 days were noted.

Results

Among 142 patients who received thrombolytic therapy via telemedicine, 44 (31%) were treated by VN specialists; 98 (69%) by NCC specialist. There was no difference in baseline characteristics and stroke metrics between the 2 groups. Compared to NCC, VN had a trend toward higher, but non-significant, sICH (6% vs 1%, P = 0.05). In a logistic regression analysis, correcting for NIHSS, SBP, door-to-needle time, and use of antiplatelet therapy, the type of neurology subspecialty was not independently associated with development of sICH (OR: 0.141, SE: 0.188, P = 0.141). The rate of in-hospital mortality was also similar between VN and NCC (7% vs 5%, P = 0.8). In a model that accounted for stroke severity, no association was established between the type of neurology subspecialty and mRS at 30 days (OR: 1.589, SE: 0.662, P = 0.266).

Conclusions

Safety and outcome of thrombolytic therapy via telemedicine was not influenced by the subspecialty of treating neurologist. Our study supports the expansion of telemedicine for acute stroke patients in rural and underserved areas.
Exploring patient’s perspective of barriers to diabetic medication adherence in Jazan, Saudi Arabia, using the social determinants of health model
Authors: Khardali Amani , Aladwani Alanood , Alzahrani Fahad , Madkhali Osama A , Al Qahtani Saad , Qadri Marwa , Adawi Morghma Deffeallah , Hakamy Mohammed
Published: August 2024

Background:

Type 2 diabetes mellitus is usually associated with long-term macrovascular and microvascular complications that negatively impact the patient’s quality of life and add economic burden to the healthcare system. Understanding patients’ perspectives on medication nonadherence is essential for planning the appropriate methods and strategies to improve medication adherence among patients with uncontrolled diabetes.

Aim:

Therefore, this study aims to explore patients’ perceptions of the barriers to medication adherence through the Social Health determinants framework.

Method:

After obtaining ethical approval, qualitative face-to-face interviews with a sample of patients with type 2 diabetes mellitus (uncontrolled diabetes) were conducted. Interviews were audio-recorded, and then the data were analyzed using thematic analysis to identify essential themes related to the patient’s views.

Results:

Fifteen patients with type 2 diabetes mellitus were interviewed. Potential barriers to antidiabetic medications were identified and categorized based on the Social Determinants of Health domains. The patient’s health perceptions and behaviors were found to positively or negatively impact medication adherence. Beliefs toward antidiabetic medications, polypharmacy, medication-related problems, and the relationship between patients and their healthcare providers that related to healthcare access and quality domains were also reported as potential barriers to medications. Financial constraints, social stigma, and family support were other social health determinants factors that were found to have either positive or negative impacts on adherence. Nevertheless, using mobile health applications was suggested to facilitate medication adherence.

Conclusion:

Social Determinants of Health, such as education about type 2 diabetes mellitus, quality and access to healthcare, and social stigma and support, might significantly affect medication adherence among type 2 diabetes mellitus patients. This study’s findings can aid the development of suitable patient-specific tools and strategies to enhance medication adherence.
Long-term results of nasolacrimal duct and inferior turbinate swing technique for inverted papilloma of the maxillary sinus
Authors: Nakamaru Yuji , Suzuki Masanobu , Shizuki Ken , Honma Aya , Nakazono Akira , Kimura Shogo , Watanabe Ryosuke , Kano Satoshi , Tsushima Nayuta , Suzuki Takayoshi , Homma Akihiro
Published: August 2024

Background:

We developed a technique to preserve the entire nasolacrimal duct and inferior turbinate, by swinging the nasolacrimal duct upward and the inferior turbinate backward; that is, a nasolacrimal duct and inferior turbinate swing technique for sinonasal inverted papilloma of the maxillary sinus. In this study, we evaluated the long-term results of this technique.

Methods:

A retrospective analysis was performed on the data for 53 consecutive pathologically confirmed inverted papilloma patients who were treated using nasolacrimal duct and inferior turbinate swing technique. The frequency of recurrence, the degree of nasolacrimal duct and inferior turbinate preservation, and the frequency of adverse events were assessed.

Results:

The median follow-up period was 51 months (mean 62.5 months; range 10–187 months). No cases of recurrence within the maxillary sinus were observed among the cases treated using this technique, whereas three (5.7%) of the 53 cases experienced recurrence in areas other than the maxillary sinus. We could preserve the nasolacrimal duct in all cases. On the other hand, the inferior turbinate was resected during surgery in one case. No epiphora, dacryocystiits, numbness of the cheek, or collapse of the ala of the nose was observed.

Conclusion:

This nasolacrimal duct and inferior turbinate swing technique method is a safe and effective method for the excision of primary or recurrent inverted papilloma and demonstrates low rates of recurrence and complications.
Hidradenitis suppurativa patient requiring cardiac procedure with inguinal access: Case management with ertapenem
Authors: Mainville Laurence , MacHaalany Jimmy , Veillette Hélène
Published: August 2024

Hidradenitis suppurativa is a chronic inflammatory skin disease that usually presents in young adults with painful abscesses in intertriginous areas. We present a case of severe hidradenitis suppurativa (Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA) = 5; Hurley stage III) investigated by cardiology and respirology specialists for dyspnea. The patient’s symptoms required right-sided cardiac catheterization via the right femoral vein in the inguinal area. The patient was able to undergo this invasive cardiac procedure without infectious complications using multidisciplinary management (dermatology, cardiology, respirology, internal medicine, and infectious diseases specialists), intravenous ertapenem 1 g/day for 6 weeks perioperatively, biologic therapy, and treatment of diabetes with semaglutide. The administration of ertapenem preoperatively and postoperatively of an invasive procedure can be beneficial, particularly when the upcoming intervention requires access to skin areas severely affected by hidradenitis suppurativa. Comorbidities such as obesity and diabetes should be addressed as their treatment might contribute to improve hidradenitis suppurativa.
Pubic symphysis osteomyelitis associated with costal osteitis caused by Staphylococcus aureus after trauma: A case report
Authors: Bouazra Raghda , Feki Afef , Sellami Imen , Zribi Chema , Gassara Zouhour , Ben Djemaa Samar , Ezzeddine Mariam , Kallel Mohamed Hédi , Fourati Hela , Baklouti Sofien
Published: August 2024

Osteomyelitis of the pubic symphysis is a rare infectious disease commonly caused by the opportunistic bacteria Staphylococcus aureus and Pseudomonas aeruginosa. The clinical context includes fever, and pubic, or abdominal pain, thus should prompt a biological, microbiological, and radiological assessment. We report the case of a 16-year-old patient who developed inflammatory pygalgia in a febrile context laboratory examination showed an elevation of C-reactive protein and sedimentation rate. Pelvic X-rays and magnetic resonance showed bilateral bone lysis and destruction of the edges of the pubic symphysis, in addition to a pubic pelvic collection. Bacteriological examination revealed by methicillin-sensible S. aureus. The patient was put on antibiotic therapy for 2 months with good clinical and radiological evolution without surgical debridement. In conclusion, osteomyelitis of pubic symphysis can be misdiagnosed because of its atypical manifestations. Recovery is often achieved if adequate treatment is started early.
3,4-Methylenedioxymethamphetamine (MDMA) consumption in Aotearoa New Zealand: A quantitative survey exploration
Authors: Whelan Jai , Noller Geoff , Ward Ryan D
Published: August 2024

The prevalence of 3,4-methylenedioxymethamphetamine (MDMA) consumption is relatively high in Aotearoa New Zealand, but MDMA use has not been investigated in detail. We explored consumption behaviours and a range of MDMA-related factors, including motivations, subjective effects, and reflections about personal MDMA use via a cross-sectional survey. A total of 1180 respondents (59.2% female, 15% Māori, aged 18–65, Median = 23.5) partially completed the survey, whilst 915 completed most questions. All included respondents had used MDMA in the past 5 years. Median reported MDMA consumption per session was 151 to 200 mg. The majority (88.9%) reported use in the last year, with house parties being the most common setting of consumption. Fortnightly or more frequent use was reported by 14.1%, and 53% reported 21 or more use occasions. Concomitant use with other drugs was common, and the median number of standard drinks consumed in addition to MDMA was 7 to 9. Enhancement (fun, feeling good) was the primary motivation for consumption, followed by social motivations. Motivations scores for MDMA consumption also differed significantly to motivations for alcohol consumption. Reflections about MDMA use were mainly positive and suggest that many respondents perceived that they had benefitted from their MDMA consumption, although a minority also reported increased memory or concentration problems and paranoia. These findings present a detailed overview of MDMA consumption in Aotearoa and show that most individuals use infrequently and consume within a lower risk dose range. However, some participants reported frequent and high-dose consumption, presenting as targets of harm reduction messaging and education. The concomitant use of MDMA and large amounts of alcohol also presents another avenue for public health messaging and intervention.
Improving acute kidney injury alerts in tertiary care by linking primary care data: An observational cohort using routine care data
Authors: Joosse Huibert-Jan , Groenestege Wouter Tiel , Vernooij Robin WM , De Groot Mark CH , Hoefer Imo E , van Solinge Wouter W , Kok Maarten B , Haitjema Saskia
Published: August 2024

Objective

Acute kidney injury (AKI) is easily missed and underdiagnosed in routine clinical care. Timely AKI management is important to decrease morbidity and mortality risks. We recently implemented an AKI e-alert at the University Medical Center Utrecht, comparing plasma creatinine concentrations with historical creatinine baselines, thereby identifying patients with AKI. This alert is limited to data from tertiary care, and primary care data can increase diagnostic accuracy for AKI. We assessed the added value of linking primary care data to tertiary care data, in terms of timely diagnosis or excluding AKI.

Methods

With plasma creatinine tests for 84,984 emergency department (ED) visits, we applied the Kidney Disease Improving Global Outcome guidelines in both tertiary care-only data and linked data and compared AKI cases.

Results

Using linked data, the presence of AKI could be evaluated in an additional 7886 ED visits. Sex- and age-stratified analyses identified the largest added value for women (an increase of 4095 possible diagnoses) and patients ≥60 years (an increase of 5190 possible diagnoses). We observed 398 additional visits where AKI was diagnosed, as well as 185 cases where AKI could be excluded. We observed no overall decrease in time between baseline and AKI diagnosis (28.4 days vs. 28.0 days). For cases where AKI was diagnosed in both data sets, we observed a decrease of 2.8 days after linkage, indicating a timelier diagnosis of AKI.

Conclusions

Combining primary and tertiary care data improves AKI diagnostic accuracy in routine clinical care and enables timelier AKI diagnosis.