bluuebunny/crossref_metadata_2025 huggingface dataset:
News portals as a gateway to civic engagement: the case of South Korea
Authors: Kim Dam Hee , von Herrmann Joshua , Nah Seungahn
Published: October 2023

Applying the communication mediation model and the communication infrastructure theory in the Korean news media environment, the current study investigates the potential of news portals as a gateway to civic engagement through online discussion. Specifically, this study distinguishes the active use of news portals for information about community issues and public affairs (e.g. commenting, passing along and searching for information) from the passive use of news portals (i.e. simple reception of information). An analysis of a national survey of 1294 Korean adults shows that active, not passive, use of news portals positively predicts online community discussion to subsequently increase cognitive, psychological, and behavioral dimensions of civic engagement: neighborhood belonging, collective efficacy, and civic participation. Importantly, active portal use's indirect positive relationship with civic engagement through online community discussion is stronger among people with higher news portal credibility. Implications are further discussed in the context of Korean news portals.
First Nations media in the Closing the Gap era: Navigating the new self-determination
Authors: Thomas Archie , Nolan David , McCallum Kerry , Waller Lisa Jane , McDuffie Magali
Published: October 2023

In 2020, a new Closing the Gap Agreement and an associated Joint Communications Strategy committed the Australian Government and state and territory governments to working with First Nations media to advance Closing the Gap aims, after lobbying by First Nations Media Australia. The new attention to First Nations media occurs after two decades of government disregard. We observe how First Nations media organisations have consistently advocated for a form of self-determination through First Nations-controlled communications, laying the groundwork for this shift. In doing so, they strategically adopt a political discourse to critique and promote reform of policy frameworks in their interests, highlighting tensions around the conceptualisation and practice of self-determination. We consider what may be required for a revised (re)adoption of self-determination as a policy to shift state-led governance, and to overcome the significant failures and limitations of policy processes.
Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people
Authors: Kim So Yoon , Song Da-Yea , Bottema-Beutel Kristen , Gillespie-Lynch Kristen
Published: October 2023

This systematic review examined 26 studies that implemented interventions to reduce stigma toward autistic people; the intervention recipients were primarily non-autistic people. Participants in the included studies were primarily White K-12 or undergraduate students. Most studies utilized one-time video or computer-based instruction, and more recent interventions tended to utilize online platforms. Studies varied in several respects: whether an autistic person was involved in the development and/or delivery of interventions, the intervention content, and the types and internal consistencies of the outcome variables. Risks of bias were prevalent. Masked outcome variables were used infrequently, and investigators were usually aware of group allocation. Among randomized controlled trials, the randomization processes were not sufficiently described, and non-randomized studies of interventions frequently did not account for confounding factors that could explain changes in stigma. Many non-randomized studies of interventions made unwarranted, causal claims about the intervention effectiveness on stigma reduction, and most studies did not sufficiently address limitations related to study design and risk of bias. The recommended areas of improvement include identifying active ingredients of interventions, measuring reliable changes in behaviors and attitudes, and targeting structural stigma. In addition, more robust procedures such as randomizing participants, using masked variables, and controlling baseline differences should be utilized.

Lay abstract

How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people’s behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.
Is blood thicker than water? Perceptions on the role of stepparents in medical decisions among minors
Authors: Willekens Manon , De Coninck David , de Winter Peter , Matthijs Koen , Lierman Steven , Boone Ingrid , Toelen Jaan
Published: October 2023

Alternative family configurations are becoming more prevalent, yet current legislative statutory does not support stepparents in medical decisions for their stepchildren. We investigate opinions of Belgian and Dutch adults regarding inclusion of stepparents in medical decision-making in minors. We make two observations. First, participants wanted stepparents to be involved in cases when medical information had to be shared or informed consent signed. Second, when stepparents object against previously approved medical interventions by a biological parent, respondents were less likely to support stepparents. Participants with stepchildren were likely to favour inclusion of stepparents in decision-making. Overall, our findings indicate that Belgian and Dutch adults view stepparents as potential executive actors in medical decision-making for minors, but not as primary decision-makers. This study is a first step in showing to what extent stepparents could be included in medical information and decision-making regarding stepchildren. We reflect on these findings in light of implications for medical practice and legislative shortcomings.
Failing women and girls during Covid-19: The limits of regional gender norms in Africa
Authors: Barlow Matt , Grugel Jean , Saka Lilian , Murray-Evans Peg
Published: October 2023

How do we account for the ability or otherwise of regional organisations in the global South to enable equitable and inclusive responses to the COVID-19 pandemic? We answer this question with a focus on Africa and in relation to the rights of women and girls. Drawing on theoretical insights from Feminist Global Health Security and from data on the African Union, other regional organisations in Africa and from non-governmental organisations, local activists and medical centres, we show that regional organisations acted quickly to identify the gendered socio-economic and health needs of women and girls and alerted member states to their responsibility to consider gender rights in their policy responses. But weak gender norms led to a disconnect between this early recognition of the importance of policies to protect women and girls and the behaviour of regional organisations, which could not lead a gender sensitive response or engineer one in member state governments.
Working from paradise? An analysis of the representation of digital nomads’ values and lifestyle on Instagram
Authors: Miguel Cristina , Lutz Christoph , Majetić Filip , Perez-Vega Rodrigo
Published: October 2023

Digital nomads (DNs) are highly mobile professionals who work while travelling and travel while working. Their lifestyle has gained increasing academic attention, also from a communication perspective. Despite initial work on the topic, little is known about the self-presentation practices of DNs on social media. To address this lack of evidence and focusing on Instagram as a key platform for this group, we adopt a Goffmanian perspective. By using semi-structured interviews, we provide an in-depth analysis of their self-presentational practices, specifically their content strategies, imagined audience and use of platform affordances. The interviews included photo elicitation as a central element. The findings show how DNs highlight independence and freedom, de-emphasize work in favour of leisure and travel, develop audience management strategies that are mindful of the imagined audiences’ situation, while trying to foster reliability and authenticity and greatly value the flexibility and ephemerality of the Stories feature.
The dark side of entertainment? How viral entertaining media build an attention base for the far-right politics of The Epoch Times
Authors: Peng Yilang , Yang Tian , Fang Kecheng
Published: October 2023

To amplify their audience reach, far-right outlets need a calculated and coordinated array of acts to set the stage for audience attention and to build a communication network that spreads their messages. We examined the Facebook newsfeed history of The Epoch Times ( N = 117,274 posts from 2013 to 2020), which transitioned from a niche anti-China publication to an influential player in US far-right politics. We found that US partisan issues helped the outlet attract immediate audience engagement, but such content did not invite audience growth and engagement with future content. In contrast, viral entertaining videos, while seemingly benign and mundane, demonstrated superb effects in getting audience responses, accumulating followers, and boosting engagement with subsequent posts. We argue that entertainment media is a crucial component of the extreme politics landscape that directs the flows of political attention, which could exert a “ripple effect” on assembling audience networks.
Hyperprogressive Disease (HPD) in Solid Tumours Receiving Immune Checkpoint Inhibitors in a Real-World Setting
Authors: Kanjanapan Yada , Guduguntla Geetha , Varikara Ashwati Krishnan , Szajer Jeremy , Yip Desmond , Cockburn John , Fadia Mitali
Published: October 2023

Introduction: Hyperprogressive disease (HPD) is a state of accelerated tumor growth from cancer immunotherapy, associated with poor outcome. The reported incidence is 6% to 29% among studies using varying definitions of HPD, with no predictive biomarkers. Tumor infiltrating lymphocytes (TILs) are prognostic and predictive for immunotherapy benefit in various tumor types, but have only been tested for correlation with HPD in one study. Objectives: The objective of the study was to determine the prevalence of HPD in solid tumor patients treated with immune checkpoint inhibitor therapy in a real-world setting, and to assess clinicopathological features as potential biomarkers for HPD. Methods: We conducted a retrospective analysis of solid tumor patients treated with immune checkpoint inhibitors at a single institution. Imaging pre-immunotherapy and postimmunotherapy were assessed for HPD, and correlated against clinicopathological factors, including TILs and programmed death-ligand 1 (PD-L1) status through archival tumor assessment. HPD was defined per Matos et al as response evaluation criteria in solid tumors (RECIST) progressive disease, minimum increase in measurable lesions of 10 mm, plus increase of ≥40% in sum of target lesions compared with baseline and/or increase of ≥20% in sum of target lesions compared with baseline plus new lesions in at least 2 different organs. Results: HPD occurred in 11 of 87 patients (13%), and associated with inferior overall survival (median 5.5 months vs 18.3 months, P = .002). However, on multivariate analysis, only liver metastases (hazard ratio [HR] 4.66, 95% confidence interval [CI] 2.27-9.56, P < .001) and PD-L1 status (HR 0.53, 95% CI 0.30-0.95, P = .03) were significantly associated with survival. Presence of liver metastases correlated with occurence of HPD ( P = .01). Age, sex, and monotherapy versus combination immunotherapy were not predictive for HPD. PD-L1 status and TILs were not associated with HPD. Conclusions: We found 13% HPD among solid tumor patients treated with immunotherapy, consistent with the range reported in prior series. Assessment for HPD is feasible outside of a clinical trials setting, using modified criteria that require comparison of 2 imaging studies. Liver metastases were associated with risk of HPD, while TILs and PD-L1 status were not predictive for HPD.
Parenteral Vancomycin in the Treatment of MRSA-Associated Diabetic Foot Infections: An Unnecessary Risk
Authors: Joseph Warren S. , Kosinski Mark A. , Rogers Lee C.
Published: October 2023

Diabetic foot infections (DFIs) are a common and costly complication of diabetes. Soft tissue and bone infections in DFIs frequently lead to amputation and/or sepsis which can be costly for both the patient and the healthcare system. Staphylococcus aureus is the most commonly identified causative agent in DFIs, and people with diabetes may have an increased risk of infection with methicillin-resistant Staphylococcus aureus (MRSA). In addition to increased susceptibility to severe infection, MRSA in DFIs is associated with high rates of treatment failure, morbidity, and hospitalization costs meaning appropriate treatment is a high priority. While hospitalized patients are usually treated with intravenous (IV) vancomycin, this can be costly in terms of inpatient stays, staffing costs, and adverse events. For example, vancomycin-associated acute kidney injury not only delays hospital discharge and increases costs but is also a particular concern for patients with diabetes who already have an increased risk of kidney problems. Vancomycin-resistant strains of S. aureus have also been identified, which means that alternative treatment options may need to be explored. Treatment alternatives to IV vancomycin, including oral antibiotics, have been shown to provide similar efficacy, with reduced costs, outpatient or home-based administration, and with fewer serious adverse effects. Although infectious disease specialists often use IV vancomycin alone, or in combination, as a first-line therapeutic option, they are increasingly seeing the value of outpatient or at-home oral antibiotics as an alternative. This manuscript reviews the evidence for true costs of vancomycin therapy for MRSA-associated DFIs and examines the alternatives.
Resident Perceptions of Virtual Reality Versus Dry Lab Simulation for Advanced Shoulder Arthroscopy Resident Training
Authors: Rivera Jessica C. , Johnson Anthony E. , Burns Travis C. , Roach Christopher J.
Published: October 2023

Introduction

Surgical training using simulation can fill gaps in traditional surgical residency learning. We hypothesize that arthroscopy training conducted on a virtual reality simulator will be preferred by orthopaedic surgery residents over a traditional dry lab simulation model.

Methods

38 orthopaedic surgery residents at a single U.S. residency program were randomized to train for a shoulder arthroscopy procedure using either a virtual reality simulator or a table-top dry lab simulator. Training and learning preferences were then asked of the resident participants.

Results

Junior residents were likely to report training preference for the virtual reality simulator compared to senior residents [15/24 (62.5%) v. 8/14 (57.1%); P = .043]. Simulator preference was not influenced by subspecialty interest, prior arthroscopy experience, or simulator experience. Virtual reality simulation was associated with positive attitude towards arthroscopy and high chance of reporting learning gains on general arthroscopic understanding. Senior residents were 4.7 times more likely than juniors to report learning gains via staff discussion pre- and post-operatively. A majority of residents [34/38 (89.5%)] reported, however, wanting more simulation for training surgical skills.

Conclusion

Simulation is a desired and potentially valuable adjunct to training orthopaedic residents in arthroscopy. Training needs do evolve; and junior arthroscopists may benefit more from virtual reality platforms for general skills. Senior residents preferred dry lab simulation, possibly because it allowed for handling of actual instruments and implants.
Singularity avoidance method for dual-arm closed-chain system based on damped least squares
Authors: Zhang Qin , Liu Zhenyu , Chai Hui , Li Yueyang
Published: October 2023

When two manipulators cooperate to clamp a rigid object, a closed chain with both ends fixed is formed. The singularity of a single manipulator causes the closed chain to be at a singularity, which results in uncertainty in the velocity mapping between the terminal and joint space. This study proposes a closed-chain singularity processing method for dual-arm collaboration, adopting the Jacobian pseudoinverse method based on damped least squares to obtain an approximate solution. During the solution process, the adaptive damping factor is improved by cubic polynomials, and the optimal damping factor is determined by quadratic sequence programming. Furthermore, this study analyzes the kinematic constraints of the closed-chain system and constructs a closed-chain Jacobian to judge whether the system is in a singular region. Finally, the effectiveness of the proposed method is verified through simulations.
An unexpected encounter and outcome between endobronchial lipoma and carcinoma: a case report and literature review
Authors: Yang Yang , Liu Jun , Chen Songkuan , Yang Guangzhao , Mao Guoqun , Han Xiaoyu , Wang Jian
Published: October 2023

Bronchial lipoma is a rare benign tumor of the lung, which is often misdiagnosed due to concomitant pulmonary diseases. In addition, the coexistence of endobronchial lipoma and lung cancer is extremely unusual. To date, no related computed tomography (CT) images have been reported. The patient was a 53-year-old man, who was admitted to our hospital with cough, yellow phlegm, and fever for 1 week. The CT image showed an irregular mass in the medial segment of the right middle lobe (B4a) with surrounding ground glass opacity, and another solid nodule in the right lower lobe (B6b). Unfortunately, after 2 weeks of anti-inflammatory treatment, the bronchial invasion of the B4a nodule did not decrease significantly, so further bronchoscopy was carried out and tumor resection was performed using endoscopic mucosal resection with a ligation device (EMR-L). During the follow-up 4 months, it was found that the B6b nodule was marked enlargement and then removed. The lesions of the B4a and B6b were confirmed as endobronchial lipoma and squamous cell carcinoma (T1aN0M0) by histopathology and immunohistochemical staining, respectively, and no postoperative radiotherapy or chemotherapy was performed. Regrettably, after 29 months of follow-up, we observed recurrence and slow enlargement of the lipoma in its original location, progressive emphysema in both lungs, and solitary chest wall metastasis from the B6b squamous cell carcinoma that had been resected. Therefore, endobronchial endoscopy resection should be carefully selected for larger endobronchial lipoma. If it is accompanied by early squamous cell carcinoma (T1aN0M0), we still recommend active postoperative chemoradiotherapy.
Late pregnancy in women with renal transplants: A multidisciplinary guide
Authors: Mallett Carmen , Scale Rachel , Metodiev Yavor , Ali Aamna , Thomas Helen , Khalid Usman , Griffin Sian
Published: October 2023

Kidney transplant recipients are at risk of complications in late pregnancy, with increased rates of pre-eclampsia, intrauterine growth restriction and preterm birth. It is recommended that these women receive more intensive monitoring after 20 weeks’ gestation, ideally provided by a multidisciplinary team in a tertiary centre. This review focuses on the management of late pregnancy in kidney transplant recipients, from the perspective of different members of the multidisciplinary team. This includes evidence and guidance to inform the nephrologist, obstetrician, obstetric anaesthetist, transplant surgeon, midwife, and a summary of the woman's perspective. The review outlines a late pregnancy and early postnatal care pathway as a common algorithm to be used by the whole multidisciplinary team.
The practice of social protection policies in China: a systematic review on how left-behind children’s mental health can be optimised
Authors: Hung J , Chen J , Chen O
Published: October 2023

Aims:

By discussing the mental health challenges faced by left-behind children, this article recommends or comments on existing social protection policies that can affect left-behind children’s mental health at the micro-, meso- and macro-levels to holistically understand how a range of parties can jointly socially include left-behind children, a process which is conducive to the latter’s mental health development.

Methods:

J.H. carried out a systematic review by searching through the English bibliographical databases Google Scholar, Web of Science and Scopus, in addition to Chinese bibliographic databases CNKI, Wanfang Data and VIP Chinese Science and Technology Periodicals. Here J.H. searched for the words (‘social protection’ OR ‘socially protected’) AND (‘mental health’ OR ‘psychological wellbeing’ OR ‘mental problems’ OR ‘psychological problems’) AND (‘left-behind children’ OR ‘LBC’ OR ‘leftover children’) AND (‘China’ OR ‘Chinese’). Publication dates of the search results were limited to between 2010 and 2022.

Results:

One of the primary problems encountered by left-behind children is their inadequate home supervision. A further study indicates that parental migration serves as a crucial risk factor for child depression. State-level provision of insurance programmes helps curtail these children’s encounters of mental health challenges. Moreover, an improvement in family and school protection is essential when optimising the protection system for left-behind rural Chinese children from poor villages. It is necessary for upper-level government units to re-structure their lower-level counterparts to improve the local administration. This allows lower-level government units to exploit preferential policies, refine relevant regulations and policies on child protection, and facilitate the establishment of social organisations where local policies can be successfully implemented to socially include and protect left-behind children in villages.

Conclusions:

At the meso-level, community environment construction should be emphasised. At macro- and meso-levels, government authorities and social organisations should encourage the marketisation of hiring professional surrogate parents. At the micro-level, migrant parents should proactively take an initiative to contact their left-behind children via telecommunications.
Mental health help-seeking in Mexico
Authors: Gearing Robin E. , Brewer Kathryne B. , Washburn Micki , Yu Miao , de la Cruz Pedro Isnardo , Garcia Andres Adelaide , Torres Luis R.
Published: October 2023

Most people in need of mental health services in Mexico do not seek formal support or professional services to address their mental health needs. Understanding help-seeking behaviors is crucial to addressing underutilized mental health services and to leverage health promotion efforts. Data were collected as part of a larger research project on stigma and help-seeking for mental-health-related concerns in Mexico. A convenience sample of 469 adults residing in Mexico City participated in the study using an experimental vignette methodology assessing stigma toward individuals with mental health conditions, along with characteristics and demographic correlates of help-seeking. All survey measures were administered in Spanish. A structural regression was conducted for the outcome ‘openness to professional help seeking for mental health problems’ as a latent variable. Compared with males, females were more open to professional help seeking ( b = 0.09, p = 0.038), as were people who endorsed higher spirituality ( b = 0.01, p = 0.006); while people who experienced self-stigma were less open to professional help-seeking for mental health concerns ( b = −0.15, p = 0.005). Self-stigma was a major driver of low service utilization. Contrary to previous studies, spirituality was a significant positive predictor of professional help-seeking. A more nuanced understanding of mental health help-seeking in Mexico can be useful for outreach efforts to increase service utilization both in Mexico and among Latinos in the United States (US). Given historical, geographic, and cultural ties with the US, it is important to understand mental health help-seeking in Mexico, which may relate directly to help-seeking behaviors in many US Latinos who have immigrated to the US. Directions for future research and practice implications are discussed, including a roadmap for health promotion activities.
Europe’s demography and what to do about it
Authors: Novotný Vít
Published: October 2023

Among the EU’s challenges, demography is probably the least conspicuous. This does not, however, mean that it is unimportant—quite the contrary. While in the past, it was visible only in population statistics, in the 2020s the lack of a labour force has become obvious to anyone with an interest in the European welfare state and the EU’s competitiveness. Population ageing, caused by increasing longevity and persistently low birth rates, cannot be addressed by encouraging women to have more children or by bringing in non-EU migrants. These methods are ineffective, and often resented. Instead, the key to improving the state of the EU’s demographic and economic prospects lies in increasing labour participation rates. This can be done by pushing up the statutory retirement age and creating the right conditions for older people, women, minority groups and diasporas to enter the world of work. While the latter measures are also not easy to implement, they are still more politically and socially viable than boosting immigration and birth rates.
Europe’s quest for sustainability: An opportunity for centre–right parties?
Authors: Hefele Peter
Published: October 2023

The reasons for the decline of European centre–right parties since the 1990s are widely debated and subject to different explanations. One such explanation is that there has been a lack of an overarching narrative. In recent years, sustainability has become a dominant concept in European political debates. The article analyses whether this concept could become the core of a new political vision for centre–right parties and should no longer be considered only a leftist–green project. Three significant aspects of sustainability are discussed: future value creation, foreign relations and the future of democracy. In all three fields, there is a huge potential to redefine sustainability beyond the narrow environmentalist understanding, linking this approach to a long history of conservative, Christian Democratic thinking. For Europe as a global actor, sustainability could become a key component of its normative power, with many opportunities to link up with similar initiatives in other world regions.
Beware what lies beneath: Pragmatic policies for reconciling debt and growth
Authors: Drea Eoin
Published: October 2023

The EU has a plethora of investment needs. However, the scale of the required investments will not be reached if the EU’s financial stability is called into question. This article calls for a set of pragmatic policies which can generate significant economic growth and raise living standards. This growth will be a key ingredient in increasing employment, improving competitiveness and strengthening budgetary sustainability. The associated fiscal space will also contribute significantly to narrowing the investment gap in the next decade and beyond. The article sets out three pillars—stability and governance, growth and fairness, and budgetary accountability—as the key drivers in building a pragmatic economic programme which bridges the gap between fiscal conservatism and future expenditure. It further identifies the need to refocus on the single market as a key economic driver. It also calls for any discussion on further joint EU borrowing programmes to be postponed until funding sources for the existing Recovery Fund are agreed and its overall economic effectiveness can be analysed.
Walking on eggshells: The twin transition and Europe’s quest to de-risk from China
Authors: Leino Janne
Published: October 2023

In March 2023 European Commission President Ursula von der Leyen presented the term ‘de-risking’ in the context of the EU’s future engagement with China. This article examines how Europe should de-risk from China, scrutinising some of the European policies, actions and challenges behind this term and the newly launched European Economic Security Strategy. The article also examines how the EU should counter Chinese activities and narratives, in third countries as well as in Europe, while increasing its own engagement in countries which are crucial for the EU’s (twin) digital and green transitions.

The article concludes that the EU should (1) fully implement its current trade instruments before creating new ones; (2) develop a comprehensive method and clear criteria for a common and holistic risk assessment of China; (3) communicate its goals in a transparent manner, especially to those countries and partners which are needed for the twin transition; and (4) refocus its financial instruments to develop concrete meaningful projects in these key countries, either bilaterally or together with other like-minded countries.
Will Europe’s next crisis be a water crisis?
Authors: Elsner Gisela
Published: October 2023

Water is an important factor in the effects of climate change and, at the same time, it is a victim of global warming. Extreme weather events such as prolonged heat, which causes droughts and flash flooding, have been reported by various European countries. Given these challenges, many EU member states have set up action plans for water management. The recent National Water Strategy from the German federal government is one of them. While these policies help to tackle country-specific challenges, given the fact that Europe shares water resources, coordinated action is also needed at the EU level. The EU Water Framework Directive and related legislation are key instruments in this regard. However, the implementation of water-related policies and regulations at EU level needs to shift from crisis management to risk management, taking an integrated, cross-sector approach, in order to prevent water challenges from becoming Europe’s next crisis.
Media plurality assessment as a public interest concern in UK merger control
Authors: Kokkoris Ioannis
Published: October 2023

In the UK, following the enactment of the Communications Act 2003, amending the Enterprise Act 2002, the assessment of mergers involving broadcaster and/or newspaper enterprises is subject to – alongside the regular competition standard under the ‘substantial lessening of competition’ (SLC) test – a public interest standard. Under this standard, certain media mergers need to be assessed pursuant to the following considerations: media plurality, broadcasting standard objectives and free expression of opinion grounds. While the statute defines these terms ambiguously, it does provide guidance to the Secretary of State, the competition authority and the courts to decide how the statute is intended to be applied consistently. The paper will analyse how the media plurality test has been applied, some of the considerations of the CMA and OFCOM, and in doing so it will touch on the discretion of the decision making stakeholders.
Evaluation of a mobile-application educational intervention on the knowledge, attitude, and practice of patients in postoperative care for lumbar disk herniation surgery: A randomized control trial
Authors: Sadeghpour Ezbarami Sohaila , Zarei Fatemeh , Haghani Shima
Published: October 2023

Objective:

We aimed to evaluate the impact of a mobile-based educational program on patients’ postoperative care for lumbar disk herniation surgery.

Methods:

A randomized controlled trial was conducted at Fayaz-Bakhsh Hospital, Tehran, Iran. Patients with lumbar disc herniation surgery experience were randomized to the intervention and control groups (learning with the LUmbar CAring Training-app). Participants’ knowledge, attitudes, and practices of postoperative care for lumbar disc herniation surgery were assessed using a validated questionnaire at three-time points: pre-test (baseline), post-test one (immediately after program completion), and post-test two (8 weeks after program completion). The primary outcome measures were knowledge, attitudes, and practices scores variations. Secondary outcomes were not considered in our study.

Results:

In total, 150 patients were enrolled, with 75 patients in each group. Patients in the intervention group demonstrated increased knowledge, modified attitudes, and practice than those in the control group ( p < 0.05). The post-test knowledge, attitudes, and practices scores in the intervention group were significantly higher than those in the control group ( p < 0.05).

Conclusion:

Mobile-application-based education was a practical and feasible approach to improve patients’ postoperative care for lumbar disc herniation surgery in Iran.
Hospitals and Medicine in Medieval and Early Modern India
Authors: Rezavi Syed Ali Nadeem
Published: October 2023

Hospitals and the practice of medicine have been known in India since long. This paper focuses on hospitals (bīmāristān, dārush shifā’ and shifā’-khāna) that were established during the fourteenth to seventeenth centuries in the Indian subcontinent. This is a theme that needs to be studied, for our primary sources do reveal some information about these institutions. The help of a miniature from Bāburnāma, illustrated during the reign of Akbar, is taken to demonstrate how imperial shifā’-khānas were organised.
Examination of the endocrine-disrupting properties of “active chlorine generated from seawater by electrolysis” in response to the European Biocidal Products Regulation: current knowledge and methodological challenges
Authors: Kinani Said , Achawi Salma , Ronga-Pezeret Sylvaine , Piotrowski Aleksandra , Gauthey-Lapize Christine , Tonk Ilse , Wenker Mira , Nesslany Fabrice
Published: October 2023

Background

Currently, active chlorine is considered the most effective treatment for preventing biofouling of structures in contact with seawater. This compound falls under the scope of the EU Biocidal Products Regulation, which includes since 2018 a requirement to assess all active ingredients for their potential endocrine-disrupting properties on humans and non-target organisms. Therefore, this study examines the endocrine-disrupting (ED) potential of active chlorine based on the European Chemicals Agency and European Food Safety Authority guidance (ED TGD). It includes two approaches: (i) a systematic literature review using appropriate search terms and (ii) an in silico assessment, both supported by expert judgement. Finally, the feasibility and relevance of in vitro tests were examined by considering the stability of chlorine and the applicability domain of the recommended in vitro assays.

Results

No significant adversity or endocrine activity based on EATS (estrogen, androgen, thyroid, and steroidogenesis)-modalities were evidenced based on the literature data. However, these modalities remain understudied and further datasets are needed for a comprehensive assessment. The in silico approach revealed a low probability of binding between active chlorine and a set of 14 human nuclear receptors, for both agonist and antagonist effects. This is not surprising given the great structural difference between active chlorine and natural ligands. The in vitro investigation of the ED potential of active chlorine raises several operational limits, including: (i) its instability (t1/2 < 48 h) which is incompatible with a reasonable time window between collection and ex situ analysis; (ii) its rapid and complete reaction with several essential nutrients in cell culture media; (iii) its documented cytotoxicity on various cell lines; and (iv) its exclusion from the scope of certain OECD guidelines.

Conclusions

Overall, neither the in silico evaluation nor the systematic literature review performed indicates a significant adversity based on EATS-mediated parameters or EATS-related endocrine activities. This study highlights the challenges of performing a comprehensive ED assessment for a data-poor chemical and questions the relevance of transposing generic methodologies to the case of unstable and inorganic molecules.
Small networks of expressed genes in the whole blood and relationships to profiles in circulating metabolites provide insights in inter-individual variability of feed efficiency in growing pigs
Authors: Juigné Camille , Becker Emmanuelle , Gondret Florence
Published: October 2023

Background

Feed efficiency is a research priority to support a sustainable meat production. It is recognized as a complex trait that integrates multiple biological pathways orchestrated in and by various tissues. This study aims to determine networks between biological entities to explain inter-individual variation of feed efficiency in growing pigs.

Results

The feed conversion ratio (FCR), a measure of feed efficiency, and its two component traits, average daily gain and average daily feed intake, were obtained from 47 growing pigs from a divergent selection for residual feed intake and fed high-starch or high-fat high-fiber diets during 58 days. Datasets of transcriptomics (60 k porcine microarray) in the whole blood and metabolomics (1H-NMR analysis and target gas chromatography) in plasma were available for all pigs at the end of the trial. A weighted gene co-expression network was built from the transcriptomics dataset, resulting in 33 modules of co-expressed molecular probes. The eigengenes of eight of these modules were significantly ($$P \le 0.05$$P≤0.05) or tended to be ($$0.05 < P \le 0.10$$0.05<P≤0.10) correlated to FCR. Great homogeneity in the enriched biological pathways was observed in these modules, suggesting co-expressed and co-regulated constitutive genes. They were mainly enriched in genes participating to immune and defense-related processes, and to a lesser extent, to translation, cell development or learning. They were also generally associated with growth rate and percentage of lean mass. In the whole network, only one module composed of genes participating to the response to substances, was significantly associated with daily feed intake and body adiposity. The plasma profiles in circulating metabolites and in fatty acids were summarized by weighted linear combinations using a dimensionality reduction method. Close association was thus found between a module composed of co-expressed genes participating to T cell receptor signaling and cell development process in the whole blood and related to FCR, and the circulating concentrations of polyunsaturated fatty acids in plasma.

Conclusion

These systemic approaches have highlighted networks of entities driving key biological processes involved in the phenotypic difference in feed efficiency between animals. Connecting transcriptomics and metabolic levels together had some additional benefits.
Decreased lipid levels in adult with congenital heart disease: a systematic review and Meta-analysis
Authors: Ma Fengdie , Li Peiqiang , Zhang Shasha , Shi Wenjing , Wang Jing , Ma Qinglong , Zhao Meie , Nie Ziyan , Xiao Handan , Chen Xinyi , Xie Xiaodong
Published: October 2023

Background

Metabolic disorders were a health problem for many adults with congenital heart disease, however, the differences in metabolic syndrome-related metabolite levels in adults with congenital heart disease compared to the healthy population were unknown.

Methods

We collected 18 studies reporting metabolic syndrome-associated metabolite levels in patients with congenital heart disease. Data from different studies were combined under a random-effects model using Cohen’s d values.

Results

The results found that the levels of total cholesterol (Cohen’s d -0.68, 95% CI: -0.91 to -0.45), high-density lipoprotein cholesterol (Cohen’s d -0.63, 95% CI: -0.89 to -0.37), and low-density lipoprotein cholesterol (Cohen’s d -0.32, 95% CI: -0.54 to -0.10) were significantly lower in congenital heart disease patients compared with controls. Congenital heart disease patients also had a lower body mass index (Cohen’s d -0.27, 95% CI: -0.42 to -0.12) compared with controls. On the contrary, congenital heart disease patients had higher levels of hemoglobin A1c (Cohen’s d 0.93, 95% CI: 0.17 to 1.70) than controls. Meanwhile, there were no significant differences in triglyceride (Cohen’s d 0.07, 95% CI: -0.09 to 0.23), blood glucose (Cohen’s d -0.12, 95% CI: -0.94 to 0.70) levels, systolic (Cohen’s d 0.07, 95% CI: -0.30 to 0.45) and diastolic blood pressure (Cohen’s d -0.10, 95% CI: -0.39 to 0.19) between congenital heart disease patients and controls.

Conclusions

The lipid levels in patients with congenital heart disease were significantly lower than those in the control group. These data will help in the health management of patients with congenital heart disease and guide clinicians.

PROSPERO registration number

CRD42022228156.
Metabolism and gene sequence variation in Turicella otitidis implies its adaptability and pathogenicity in extra-otic infection: a systematic review
Authors: Ahamad Afrinash , Yuan Cuishan , Chung Casey , Blair Briana , Tran Amy , Tehreem Bushra
Published: October 2023

Turicella otitidis belongs to the Corynebacteriaceae family and is a normal inhabitant of the ear and exists in a commensal relationship with its host. In children, T. otitidis is frequently associated with otitis media. The emergence of Turicella otitidis as a pathogen is concerning, particularly due to the limited availability of data on its pathogenic properties. The objective of this study is to conduct a systematic review of T. otitidis infections occurring in both the ear and other anatomical sites, and to summarize the differences in metabolism and genome sequences between isolates obtained from the ear and blood.
ChatGPT and mycosis– a new weapon in the knowledge battlefield
Authors: Jin Yi , Liu Hua , Zhao Bin , Pan Weihua
Published: October 2023

As current trend for physician tools, ChatGPT can sift through massive amounts of information and solve problems through easy-to-understand conversations, ultimately improving efficiency. Mycosis is currently facing great challenges, including high fungal burdens, high mortality, limited choice of antifungal drugs and increasing drug resistance. To address these challenges, We asked ChatGPT for fungal infection scenario-based questions and assessed its appropriateness, consistency, and potential pitfalls. We concluded ChatGPT can provide compelling responses to most prompts, including diagnosis, recommendations for examination, treatment and rational drug use. Moreover, we summarized exciting future applications in mycosis, such as clinical work, scientific research, education and healthcare. However, the largest barriers to implementation are deficits in indiviudal advice, timely literature updates, consistency, accuracy and data safety. To fully embrace the opportunity, we need to address these barriers and manage the risks. We expect that ChatGPT will become a new weapon in in the battlefield of mycosis.
Regulation of HHLA2 expression in kidney cancer and myeloid cells
Authors: Shigemura Tomonari , Perrot Nahuel , Huang Zimo , Bhatt Rupal S. , Sheshdeh Aseman Bagheri , Ahmar Nourhan El , Ghandour Fatme , Signoretti Sabina , McDermott David F. , Freeman Gordon J. , Mahoney Kathleen M.
Published: October 2023

Background

The immune checkpoint HERV-H LTR-associating 2 (HHLA2) is expressed in kidney cancer and various other tumor types. Therapeutics targeting HHLA2 or its inhibitory receptor KIR3DL3 are being developed for solid tumors, including renal cell carcinoma (RCC). However, the regulation of HHLA2 expression remains poorly understood. A better understanding of HHLA2 regulation in tumor cells and the tumor microenvironment is crucial for the successful translation of these therapeutic agents into clinical applications.

Methods

Flow cytometry and quantitative real-time PCR were used to analyze HHLA2 expression in primary kidney tumors ex vivo and during in vitro culture. HHLA2 expression in A498 and 786-O ccRCC cell lines was examined in vitro and in subcutaneous tumor xenografts in NSG mice. Monocytes and dendritic cells were analyzed for HHLA2 expression. We tested a range of cytokines and culture conditions, including hypoxia, to induce HHLA2 expression.

Results

Analysis of HHLA2 expression revealed that HHLA2 is expressed on tumor cells in primary kidney tumors ex vivo; however, its expression gradually diminishes during a 4-week in vitro culture period. A498 and 786-O ccRCC tumor cell lines do not express HHLA2 in vitro, but HHLA2 expression was observed when grown as subcutaneous xenografts in NSG immunodeficient mice. Induction experiments using various cytokines and culture conditions failed to induce HHLA2 expression in A498 and 786-O tumor cell lines in vitro. Analysis of HHLA2 expression in monocytes and dendritic cells demonstrated that only IL-10 and BMP4, along with IL-1β and IL-6 to a lesser extent, modestly enhanced HHLA2 protein and mRNA expression.

Conclusions

HHLA2 expression is induced on kidney cancer cells in vivo by a tumor microenvironmental signal that is not present in vitro. HHLA2 expression is differentially regulated in kidney cancer epithelial cells and monocytes. Cytokines, particularly IL10, that induce HHLA2 expression in monocytes fail to upregulate HHLA2 expression in tumor cell lines in vitro. These findings underscore the importance of the interplay between tumor cell and tumor microenvironmental signals in the regulation of HHLA2. Further investigation is warranted to elucidate the mechanisms involved in HHLA2 regulation and its implications for therapeutic development.
Evolution of demarcation line after pneumatic retinopexy—a case report
Authors: Venkatesh Ramesh , Prabhu Vishma , Handa Ashit , Acharya Isha , Mangla Rubble , Joshi Aishwarya , Chhablani Jay
Published: October 2023

Background

Demarcation line in a rhegmatogenous retinal detachment (RD) is a classic finding noted in chronic cases. In this case report, we describe a case of evolution of post-operative demarcation line after pneumatic retinopexy (PnR) in a subtotal rhegmatogenous RD.

Case description

A 31-year-old male diagnosed with acute, subtotal, macula-off rhegmatogenous RD in the left eye of 15-day duration underwent PnR on the same day. His presenting visual acuity was 6/48 in the left eye. Transconjunctival cryopexy was performed to the retinal break at the same sitting and 0.5 cc of 100% perfluoroproprane (C3F8) gas was injected in the vitreous cavity and right lateral position was advised to the patient.

Result

A pigmentary demarcation line was noted extending the nasal part of the macula along the most dependent part of the detachment on the immediate post-operative day and was more obviously visible on the 2nd and then on the 11th post-operative day. The visual acuity at the last follow-up visit improved to 6/18. Successful reattachment of the retina was noted on the last follow-up visit.

Conclusion

Post-operative demarcation lines after RD surgery could develop due to subretinal migration of pigments and along the most-dependent part depending upon post-operative positioning of the patient. Careful post-operative positioning, particularly in macula splitting RDs could be important to avoid pigment accumulation along the foveal area.