bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of a dedicated venous stent for the treatment of iliofemoral venous obstruction: A single center experience
Authors: Huang Yulong , Xie Xinsheng , Huang Guoqiang , Hong Xiang , Hong Shichai , Fu Weiguo , Lu Weifeng
Published: December 2024

Background

Endovascular recanalization with venous stenting is the preferred treatment for iliofemoral venous obstruction. We reviewed our institutional experience and mid-term outcomes with endovascular therapy for iliofemoral venous obstruction using the VenovoTM Self-expanding Venous Stent (BARD Peripheral Vascular, Inc., Tempe, AZ, USA).

Methods

Between October 2022 and March 2024, patients with iliofemoral venous obstruction treated with VenovoTM Self-expanding Venous Stents were retrospectively analyzed. Patients were monitored at 3, 6, and 12 months. The primary endpoint was 12-month primary patency, defined as computed tomography venography-derived stenosis <50% and no target venous revascularization. Secondary endpoints included stent intimal hyperplasia and pain venous clinical severity scores (VCSSs).

Results

We evaluated 51 limbs from 40 patients (mean age: 61.7 ± 10.7 years; 26 females), including three acute deep venous thrombosis (DVT)cases, six post-thrombotic syndrome (PTS) cases, and 42 non-thrombotic iliofemoral vein lesion cases. All (100%) underwent successful endovascular treatment, with five undergoing combined stent deployment. The interventional operation-related complication rate was 1/51 (1.96%). The median follow-up was 14.6 months (range: 12–18 months). The primary patency rate at 1 year was 90%. Freedom from stent intimal hyperplasia at 12 months was 74.51% (38/51), and 3.92% (2/51) had in-stent stenosis >50%, which was reduced after high-pressure balloon dilation at 6 months. The mean VCSS decreased from a baseline of 13.1.7 ± 3.7 to 3.3 ± 1.6 at 12 months ( p < .0001). No complications were noted during follow-up.

Conclusions

Stenting iliofemoral venous obstruction using the VenovoTM Self-expanding Venous Stent appears to be safe and effective, with a high rate of 1-year clinical patency and a low reintervention rate.
Global citizenship and the geographical scale of young people’s political engagement
Authors: Rye Ståle Angen
Published: December 2024

In recent years, the concept of global citizenship has been widely incorporated into educational programmes worldwide, ranging from primary schools to higher education. Nevertheless, scholars in the field of political geography have tended to view this concept as less relevant to young people’s political engagement. Based on this foundation, this paper discusses how notions of geographical scale can offer a more comprehensive understanding of global citizenship education. The discussion focuses on identifying descriptive and pragmatic/normative conceptions of global citizenship. The paper concludes by suggesting that research on the political geographies of young people can contribute to a critical approach to global citizenship education by offering an alternative to conventional notions of the geographical scale as a hierarchical organisation of society.
Treatment of symptomatic bipartite patella in patients <21 years of age: A systematic review and treatment algorithm
Authors: Hines Kristen E , Liu David S , Steele Amy E , Gabriel Daniel , Prabhat Anjali , Yen Yi-Meng , Hogue Grant Douglas
Published: December 2024

Purpose:

The purpose of this study is to develop an evidence-based algorithm for the management of symptomatic bipartite patella in the pediatric and adolescent population based on a systemic review of the published literature.

Methods:

A systematic review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines on PubMed and Embase, selecting for studies discussing the management of symptomatic bipartite patella.

Results:

Five studies met criteria, involving 315 knees (314 patients, average age 15.8 years). All patients presented with symptomatic bipartite patella and underwent an initial trial of conservative management. Seventy-six percent (239 knees) achieved full resolution of symptoms after conservative management at a median of 1.9 months. The remaining 76 knees (24.12%) had persistent symptoms requiring operative intervention. Surgical techniques included surgical excision, screw fixation, synchondrosis drilling, lateral release, and both arthroscopic and open interventions (92.1%). Most patients (90.79%) who underwent surgical intervention had partial or complete resolution of their symptoms. Seven of 76 knees (9.21%) needed management postoperatively for pain due to trauma, residual symptomatic ossicles, and hardware complications. Of these, four patients required reoperations (average 2 years). The remaining three patients had satisfactory outcomes with an additional course of conservative management and oral analgesics.

Conclusion:

Management of symptomatic bipartite patella should begin with a trial of conservative management. With refractory symptoms lasting greater than 3 months, surgical intervention may be considered with positive outcomes of partial or complete resolution of symptoms. The proposed algorithm is provided to guide physician management of symptomatic BPP in pediatric or adolescent patients.
Optimal use of BTK inhibitors in Waldenström’s macroglobulinemia: combination or single drug approach?
Authors: Solia Eirini , Kastritis Efstathios
Published: December 2024

Waldenström macroglobulinemia is an indolent B-cell lymphoma which although remains incurable, there are a lot of treatment options. Today, Bruton tyrosine kinase inhibitors have a central role in the management of the disease either as monotherapy or combination with other regimens, due to their efficacy, ease of administration, and safety profile. However, there is still active clinical investigation to further increase their efficacy and improve safety profile. Combinations based on BTK inhibitors may offer advantages. Second- and third-generation BTK inhibitors are also evaluated in combinations aiming to improve the depth of response, overcome genetic factors associated with poorer outcomes and reduce toxicity and duration of therapy.
Implementing interdisciplinary Buurtzorg derived teams in Danish municipalities – Qualitative descriptive study
Authors: Olivares Bøgeskov Benjamin , Segoli Gry
Published: December 2024

This study aims to identify positive experiences and challenges from the implementation of interdisciplinary teams in homecare and nursing, inspired by the Buurtzorg model, in two Danish municipalities. To address challenges in homecare nursing, Danish municipalities are adapting the Dutch Buurtzorg model of self-managed interdisciplinary teams. Understanding the goals, methods, challenges and initial experiences of these adaptations is essential for evaluating their impact on the quality of care. A qualitative descriptive approach was employed, involving researchers who supported, followed, and compared the municipalities over two years (2021–2023). The Standards for Reporting Qualitative Research (SRQR) checklist was used to ensure quality and transparency. Data collection included participatory observation, eleven focus group interviews and 10 individual interviews with managers and healthcare personnel, engaging approximately 197 individuals. Results highlight two main themes: (A) Positive experiences: team collaboration provided flexibility to adapt care to the patient's perspective, contributing to improved work satisfaction and (B) Challenges lie not in the concept but in the implementation: unclear structures and roles, and resistance to cultural change. Successful team establishment requires cultural and structural changes; without clear structures, sustainability and replicability are compromised. Unlike other studies, positive results are attributed to team collaboration rather than self-management.
Learning by Doing: Description and Assessment of an Experiential Undergraduate Public Health Research Methods Course Curriculum
Authors: Lederer Alyssa M.
Published: December 2024

Students have overwhelmingly negative perceptions about research methods courses and these attitudes may influence students’ learning outcomes. Yet research methods education is crucial for undergraduate public health students’ professional and personal development and there is a lack of information available regarding effective curricular models. This paper therefore describes SPH-H494: Research and Evaluation Methods in Public Health, a required undergraduate semester-long academic course with a student-centered, experiential, and collaborative approach. Grounded in Social Cognitive Theory, the course takes students through the research process step-by-step. Students apply their newfound knowledge and skills through the primary course project—conducting a primary research study in a research team on a topic of public health significance and shared interest. The course approach and content are comprehensively described. Based on an anonymous post-course survey with closed- and open-ended questions administered in Fall 2023, students had positive feedback about the course; the vast majority reported they were satisfied with their course experience and that the course benefited their public health knowledge, skillset, and current/future public health practice. Students found conducting their own research study in a research team, the scaffolded nature of the assignments and course approach, and interactive class activities most helpful in understanding course concepts. Student feedback provides preliminary evidence of the utility of the course model. Lessons learned and recommendations for course implementation and future research are provided.
Telehealth Usability Among Rural and Low-Income Populations: A Survey of Wyoming Medicaid Members
Authors: Homer Rafael , Biller Sandra , Schumaker Brant , Johnson Paul E.
Published: December 2024

Telehealth has been shown as a tool to improve health access and outcomes in rural areas. There is less literature examining the usability and utility of telehealth by rural and low-income populations. Existing literature focuses on examining telehealth usability for specific telehealth platforms and specific use cases. There is minimal literature broadly examining telehealth usability in rural and low-income populations. Using the Telehealth Usability Questionnaire in conjunction with demographic questions, we examined telehealth usability in the Wyoming Medicaid population. Additionally, we explored whether factors such as rurality, age, gender, and whether the visit was behavioral, affected usability scores. (1) We found that overall, usability scores were high in all cases. (2) Wyoming Medicaid clients with behavioral visits demonstrated statistically significant increased usability scores compared to the already positive scores in patients with nonbehavioral visits. (3) The other variables we examined did not show any statistically significant differences in usability scores. (4) These results demonstrate broad usability of telemedicine in a rural and low-income population and may be used to justify expansion of telehealth services.
Prevalence of Transparent Research Practices in Psychology: A Cross-Sectional Study of Empirical Articles Published in 2022
Authors: Hardwicke Tom E. , Thibault Robert T. , Clarke Beth , Moodie Nicholas , Crüwell Sophia , Schiavone Sarah R. , Handcock Sarah A. , Nghiem Khanh An , Mody Fallon , Eerola Tuomas , Vazire Simine
Published: December 2024

More than a decade of advocacy and policy reforms have attempted to increase the uptake of transparent research practices in the field of psychology; however, their collective impact is unclear. We estimated the prevalence of transparent research practices in (a) all psychology journals (i.e., field-wide), and (b) prominent psychology journals, by manually examining two random samples of 200 empirical articles ( N = 400) published in 2022. Most articles had an open-access version (field-wide: 74%, 95% confidence interval [CI] = [67%, 79%]; prominent: 71% [64%, 77%]) and included a funding statement (field-wide: 76% [70%, 82%]; prominent: 76% [70%, 82%]) or conflict-of-interest statement (field-wide: 76% [70%, 82%]; prominent: 73% [67%, 79%]). Relatively few articles had a preregistration (field-wide: 7% [2.5%, 12%]; prominent: 14% [8.5%, 19%]), materials (field-wide: 16% [9%, 24%]; prominent: 19% [12%, 27%]), raw/primary data (field-wide: 14% [7%, 21%]; prominent: 16% [9.5%, 24%]), or analysis scripts (field-wide: 8.5% [4.5%, 13%]; prominent: 14% [9.5%, 19%]) that were immediately accessible without contacting authors or third parties. In conjunction with prior research, our results suggest transparency increased moderately from 2017 to 2022. Overall, despite considerable infrastructure improvements, bottom-up advocacy, and top-down policy initiatives, research transparency continues to be widely neglected in psychology.
Spatial proximity in artists’ social networks: The Shanghai art world, 1912–1948
Authors: Zheng Jane , Zhang Sabrina P.Y. , Fan Zhen , He Jie , Leung Yuen-Sang
Published: December 2024

This paper presents a comprehensive digital mapping of artists’ residential locations and social networks in Republican Shanghai, aiming to enhance our understanding of the role of spatial proximity in the development and expansion of artists’ networks, and, based on this, to reconceptualize the ‘art world.’ Our findings suggest that spatial proximity does not influence the development or maintenance of artists’ networks, which instead form a city-wide network of pipelines. However, the clustering of key nodes in primary art clusters indicates that spatial proximity is a necessary but insufficient condition for artists to expand their networks and establish themselves as leading figures. The paper further explores the dynamics of these primary art clusters, revealing mechanisms such as spatial-network synergies, the formation of intimate master-pupil relationships through co-residence, and group imaging and place branding centered around prominent artists.
“I liked school, but school didn’t like me”: Autistic young adults’ reflections on their mainstream primary school experiences
Authors: Billington Jo , Loucas Tom , Knott Fiona
Published: December 2024

A substantial literature indicates that autistic children and young people are much more likely than their non-autistic peers to have difficult school experiences and poor educational outcomes. However, how autistic people describe and make sense of their school experiences has received less attention from researchers, especially in relation to primary school, the period of formal state education in the United Kingdom for children from the age of five to eleven years old. Furthermore, little is known about how early school experiences impact on the lives of autistic adults, particularly in terms of identity development. Using thematically analysed data collected from focus group and one-to-one interviews, this study aimed to contribute towards this gap in the literature by documenting the subjective accounts of six autistic young adults. The findings show that the participants’ primary school experiences were characterised by routine invalidations and hostilities from peers and school staff which led to anxiety about social acceptability. These early negative experiences had long lasting implications in terms of self-concept and general wellbeing. Recommendations for teacher training and education policy are discussed.

Lay Abstract

We know from previous research that lots of autistic children and young people have difficult school experiences. But we know less about what these experiences feel like for autistic people, especially in relation to the primary school years. We also know very little about what autistic adults remember about their primary school experiences and how such experiences affect their sense of identity. Our study aimed to address this gap in the research by asking a group of 6 autistic young adults about their experiences of mainstream primary school. We held a focus group discussion for 5 participants and 1 participant chose to be interviewed instead. They told us that they were regularly bullied by peers and teachers for being different. They also told us that the impact of these early negative experiences was still being felt in adulthood. These findings suggest that autistic children's school experiences may be improved by focusing on changing school cultures and attitudes to be more welcoming and accepting of autistic ways of being. We briefly discuss ways in teacher training and educational policy might play a role in this.
Staff and Providers’ Perceptions of Patients’ PrEP Candidacy, Acceptability, and Adherence in Methadone Clinic Settings
Authors: Jaiswal Jessica , Grin Benjamin , Gagnon Kelly , John Tejossy , Walters Suzan , Griffin Marybec , Kay Emma
Published: December 2024

Background:

People who use drugs and patients in substance use treatment may be placed at high risk for HIV due to mixing sex and drugs, potential engagement in sex work, and injection drug use. However, pre-exposure prophylaxis (PrEP) adoption among these populations remains low. Methadone clinics, a main point of contact with the healthcare system for this population, are a missed opportunity to offer biomedical HIV prevention. Understanding provider and staff perceptions of patients’ PrEP-related candidacy, acceptability, and adherence is a critical first step to informing PrEP implementation in substance use treatment settings.

Methods:

Thirty semistructured interviews were conducted at 2 methadone clinics in Northern New Jersey between January and April 2019. Participants included methadone counselors, medical providers, front desk staff, intake coordinators, and other clinic staff members.

Results:

Three major themes were identified: (1) provider and staff’s perceptions of who would benefit most from PrEP, (2) perceptions of patients’ acceptability of PrEP, and (3) perceptions of patients’ ability to take a pill every day. Broadly, staff perceived younger patients to be better PrEP candidates than older patients, expressed cautious optimism that PrEP would be acceptable to their patient populations, and were mixed in terms of their perceptions of patients’ ability to adhere to PrEP. Notably, staff largely did not mention patients who inject drugs as potential PrEP candidates, suggesting a missed opportunity.

Conclusion:

To promote PrEP implementation in methadone clinics, staff and providers should receive training around screening for PrEP eligibility in order to maximize the benefits of PrEP for various subpopulations, especially those who inject. Importantly, discussions around sexual behavior and injection drug use must be approached in an open, non-stigmatizing manner. These findings can be used to inform future interventions to integrate PrEP services into substance use treatment settings.
Impact of a Web-Based Curriculum on Internal Medicine Resident Use of Stigmatizing Language for Substance Use Disorder
Authors: Samberg Diana , Spinella Sara , Rothenberger Scott , Tetrault Jeanette M. , Childers Julie
Published: December 2024

Background:

Addiction is a chronic, treatable disorder, yet it carries considerable stigma. Stigmatizing language biases how clinicians view patients with substance use disorders (SUDs) and negatively affects patient care. While national medical organizations have recommended educational initiatives to reduce the stigma associated with SUDs, studies of initiatives are lacking. We aimed to improve documentation of SUDs and reduce measured stigma by teaching standardized, non-stigmatizing language.

Methods:

We created an online, 25-minute interactive curriculum about vocabulary for addiction and why language matters. Before and 8 weeks after completing the curriculum, internal medicine residents viewed a video encounter between a physician and a “challenging” simulated patient with opioid use disorder, then completed a case write-up and a SUD stigma survey. We analyzed the frequency of usage of stigmatizing terms and quantified participants’ stigma levels.

Results:

During the fall of 2020, UPMC Internal Medicine residents completed the curriculum. In all, 98 participants (out of ~150) completed the pre-curriculum assessment, and 39 completed the entire course. In pre-curriculum write-ups, stigmatizing terminology was used 4 times more often than clinical terminology (30 terms per 100 write-ups versus 7.6, P = .032). Clinical terminology was used 134% more often post-curriculum than pre-curriculum (24 terms per 100 write-ups vs 7.6), but this result was not significant. There was no difference between measured stigma levels pre- and post-curriculum. In total, 34/45 (75.6%) participants who completed the post-curriculum survey said that they learned new information, and 32/45 (71.1%) would recommend it to others.

Conclusions:

There were trends toward improvement in language, including decreased use of stigmatizing terminology and increased usage of clinical terminology, though not statistically significant. The curriculum was well-received, but the study was limited in participation by the COVID-19 pandemic. However, the simple design of the curriculum—a short, web-based module—allows for easy delivery to workers across the healthcare sector.
State Variation in Uptake of Pharmacy-Based CLIA-Waived Testing: Impact of Laws and Regulations
Authors: Adams Alex J. , Klepser Donald G. , Klepser Michael E.
Published: December 2024

Background: Community pharmacies have grown to be an increasingly important provider of CLIA-waived tests, just second to physician offices as the venue with the most waivers. Yet, individual variation is still observed across states with respect to the percentage of pharmacies holding a CLIA-waiver, with a reported range of 10.7% in Massachusetts to 87.9% in Delaware. Objective: To identify how state laws can either impede or enhance access to POCT services by pharmacies by comparing the percentage of pharmacies in each state holding a CLIA-waiver to the legal model for POCT services in each state. Methods: Data from the U.S. Centers for Disease Control and Prevention CLIA Laboratory Search website reported on December 4, 2023, were used to determine the number of pharmacies holding CLIA-waivers in each state. This was then divided by the number of community pharmacies in each state, as reported in the 2023 National Community Pharmacy Association Digest, and then compared with 2 public reports on pharmacy CLIA laws. Results: States categorized as allowing pharmacists to independently perform CLIA-waived tests in public reports actually had a lower percentage of pharmacies with a CLIA-waiver (49.60%) than those categorized as not allowing CLIA-waived tests (60.19%). As many as 10 241 pharmacies hold a CLIA-waiver in states that did not affirmatively report that pharmacists ordering lab tests was allowed. Conclusion: The paradoxical finding is likely a result of the underreporting of pharmacist CLIA-waived testing authority given the complexity of pharmacy law relative to other professions. Simplifying pharmacy law through adoption of a “standard of care” regulatory approach may enhance patient access to POCT services moving forward.
Work participation after receiving multidisciplinary treatment or acceptance and commitment therapy intervention for return to work: long-term follow-up of a randomized controlled trial among sick-listed individuals with mental disorders and/or chronic pain
Authors: Berglund Erik , Anderzén Ingrid , Helgesson Magnus , Lytsy Per , Andersén Åsa
Published: December 2024

Background

The return-to-work (RTW) process for individuals on long-term sick leave can be complex. Vocational rehabilitation may facilitate RTW; however, many intervention studies often have relatively short follow-up periods. The purpose of this study was to assess long-term work participation 2–7 years after the initiation of a three-armed randomized controlled trial aimed at RTW for individuals on long-term sick leave because of mental disorders and/or chronic pain.

Methods

This study followed 220 participants out of 402 (response rate 55%, 205 female) who had previously participated in a randomized controlled trial. They were allocated to one of three groups: multidisciplinary team assessment and individualized treatment (MDT), acceptance and commitment therapy (ACT) or a control group. The participants were followed up at two, three, four, five, six, and seven years after inclusion. The outcome, work participation, was assessed using registry data and defined as having the main source of annual income from paid work during the follow-up years.

Results

Participants in the MDT intervention group were, to a larger extent, in paid work during follow-up in years four (9.0% points), five (2.5% points), six (7.6% points), and seven (4.1% points) after inclusion, compared to the control group. Participants in the ACT intervention group were, to a larger extent, in paid work during follow-up in years four (14.8% points), six (17.6% points), and seven (13.9% points) after inclusion, compared to the control group.

Conclusion

This study, primarily involving female individuals on long-term sick leave, suggests that both MDT and ACT interventions can improve long-term work participation. The results also indicate some time-lag effect of the interventions.

Trial registration

The original randomized study was registered at the Clinicaltrials.gov Register Platform (ID NCT03343457); registered on November 15, 2017 (retrospectively registered).
Best practices in the laboratory diagnosis, prognostication, prediction, and monitoring of Graves’ disease: role of TRAbs
Authors: Kalra Sanjay , Selim Shahjada , Shrestha Dina , Somasundaram Noel , Raza Syed Abbas , Baruah Manash P. , Bhattacharya Saptarshi , Gadve Sharvil , Bantwal Ganapathi , Sahay Rakesh
Published: December 2024

Graves' disease (GD) is an autoimmune disorder characterized by activation of the TSH receptor by stimulatory autoantibodies (TSH Receptor Antibodies, or TRAbs), leading to unregulated thyroid hormone production. Diagnosis is largely based on the typical clinical picture and laboratory thyroid panel. Establishment of elevated serum levels of TRAbs by competitive binding assay or cell-binding assay has its unique role in diagnosis and management of GD, especially in the differential diagnosis, therapy selection, prognostication, evaluation of thyroid function during pregnancy, peri-conceptional and neonatal thyroid workup, and in certain special situation. Inclusion of TRAbs in GD diagnostic algorithm can improve cost-effectiveness of GD management. The current best practice guidelines were developed to provide evidence-based recommendations in the use of TRABs in GD management for healthcare providers in South Asia. A panel of endocrinologists with minimum 10 years of clinical experience in thyroid disorders reviewed existing literature and their quality, and after deliberation and discussion, developed 21 recommendations surrounding the best practices surrounding the role of TRAbs in GD management.
Decision-making about palliative sedation for patients with cancer: a qualitative study in five European countries linked to the Palliative sedation project
Authors: Van der Elst Michael , Payne Sheila , Arantzamendi Maria , Preston Nancy N. , Koper Ian , Belar Alazne , Brunsch Holger , Surges Séverine M. , Adile Claudio , Grassi Yasmine , Cockshott Zoe , Hasselaar Jeroen , Menten Johan ,   Palliative Sedation Consortium
Published: December 2024

Background

Palliative sedation refers to the proportional use of titrated medication which reduces consciousness with the aim of relieving refractory suffering related to physical and psychological symptoms and/or existential distress near the end of life. Palliative sedation is intended to be an end of life option that enables healthcare professionals to provide good patient care but there remains controversy on how it is used. Little is known about decision-making processes regarding this procedure. The aim of this study was to explore decision-making processes in palliative sedation based on the experiences and perceptions of relatives and healthcare professionals.

Methods

We conducted a qualitative interview study with dyads (a bereaved relative and a healthcare professional) linked to 33 deceased patient with cancer who had palliative sedation, in seven in-patient palliative care settings in five countries (Belgium, Germany, Italy, the Netherlands, and Spain). A framework analysis approach was used to analyse the data.

Results

Two main themes are defined: 1) Decision-making about palliative sedation is a complex iterative process, 2) Decision-making is a shared process between the patient, healthcare professionals, and relatives. Decision-making about palliative sedation appears to follow an iterative process of shared information, deliberation, and decision-making. The patient and healthcare professionals are the main stakeholders, but relatives are involved and may advocate for, or delay, the decision-making process. Starting palliative sedation is reported to be an emotionally difficult decision for all parties.

Conclusions

As decision-making about palliative sedation is a complex and iterative process, patients, relatives and healthcare professionals need time for regular discussions. This requires a high level of engagement by healthcare professionals, that takes into account patients’ wishes and needs, and helps to facilitate decision-making.
A generation at risk: the unseen consequences of Nepal’s nursing shortage on undergraduate nursing students clinical education
Authors: Ghimire Animesh , Neupane Mamata
Published: December 2024

Background

The global nursing shortage has particularly severe consequences in resource-constrained countries like Nepal, where a significant outflow of healthcare professionals exacerbates the crisis. While the impact on patient care, workforce dynamics, and organizational challenges within healthcare settings have been extensively researched, the profound implications of this crisis for nursing education remain underexplored. This qualitative study sheds light on the often-unseen consequences of the nursing shortage on undergraduate nursing students’ clinical education.

Methods

Data were collected from three focus group discussions involving eighteen final-year nursing students from two tertiary institutions. The first two discussions took place in June 2024, with the third one in July 2024. Thematic analysis was employed to identify and interpret the key themes.

Results

Four overarching themes emerged: (1) Compromised Learning, highlighting the detrimental impact on skill acquisition and student preparedness; (2) Abandoned in the Field, revealing the emotional toll of isolation, with students describing themselves as “ghosts, silently observing from the sidelines”; (3) Forging Ahead, showcasing the unintended resilience and resourcefulness of students seeking alternative knowledge sources; and (4) Digital Mentors, spotlighting the innovative use of Artificial Intelligence (AI) as a supplementary learning tool in overburdened clinical settings.

Conclusion

The nursing shortage in Nepal has created a challenging and often isolating clinical learning environment (CLE) for students. While their resilience and adaptability are commendable, these qualities are not substitutes for nurse staffing shortages and inadequate mentorship. This study underscores the urgent need for systemic change, including increased investment in the nursing workforce, cultivating a supportive learning environment, and integrating technology into nursing education. These findings have implications for Nepal and other resource-constrained settings grappling with the challenges of a nursing shortage.
DNA methylation models of protein abundance across the lifecourse
Authors: Waterfield Scott , Yousefi Paul , Suderman Matt
Published: December 2024

Background

Multiple studies have shown that DNA methylation (DNAm) models of protein abundance can be informative about exposure, phenotype and disease risk. Here we investigate and provide descriptive details of the capacity of DNAm to capture non-genetic variation in protein abundance across the lifecourse.

Methods

We evaluated the performance of 14 previously published DNAm models of protein abundance (episcores) in peripheral blood from a large adult population using the Avon Longitudinal Study of Parents and Children (ALSPAC) at ages 7–24 and their mothers antenatally and in middle age (N range = 145–1464). New age-specific episcores were trained in ALSPAC and evaluated at different ages. In all instances, episcore–protein associations were evaluated with and without adjustment for genetics. The association between longitudinal protein stability and longitudinal episcore projection was also evaluated, as was sex-specificity of episcores derived solely in female participants.

Findings

Of the 14 Gadd episcores, 10 generated estimates associated with abundance in middle age, 9 at age 24, and none at age 9. Eight of these episcores explained variation beyond genotype in adulthood (6 at age 24; 7 at midlife). At age 9, the abundances of 22 proteins could be modelled by DNAm, 7 beyond genotype of which one trained model generated informative estimates at ages 24 and in middle age. At age 24, 31 proteins could be modelled by DNAm, 19 beyond genotype, of which 5 trained models generated informative estimates at age 9 and 8 in middle age. In middle age, 23 proteins could be modelled, 13 beyond genotype, of which 3 were informative at age 9 and 7 at age 24.

Interpretation

We observed that episcores performed better at older ages than in children with several episcores capturing non-genetic variation at all ages.
In vitro and ex vivo evaluation of preclinical models for FAP-targeted theranostics: differences and relevance for radiotracer evaluation
Authors: van der Heide Circe D. , Campeiro Joana D. , Ruigrok Eline A. M. , van den Brink Lilian , Ponnala Shashikanth , Hillier Shawn M. , Dalm Simone U.
Published: December 2024

Background

Fibroblast activation protein (FAP) is an attractive target for cancer theranostics. Although FAP-targeted nuclear imaging demonstrated promising clinical results, only sub-optimal results are reported for targeted radionuclide therapy (TRT). Preclinical research is crucial in selecting promising FAP-targeted radiopharmaceuticals and for obtaining an increased understanding of factors essential for FAP-TRT improvement. FAP is mainly expressed by cancer-associated fibroblasts in the tumor stroma and less on cancer cells themselves. Therefore, other (complex) factors impact FAP-TRT efficacy compared to currently clinically applied TRT strategies. For accurate evaluation of these aspects, selection of a representative preclinical model is important. Currently mainly human cancer cell lines transduced to (over)express FAP are applied, lacking clinical representation. It is unclear how these and more physiological FAP-expressing models compare to each other, and whether/how the model influences the study outcome. We aimed to address this by comparing FAP tracer behavior in FAP-transduced HT1080-huFAP and HEK293-huFAP cells, and endogenous FAP-expressing U-87 MG cancer cells and PS-1 pancreatic stellate cells. [111In]In-FAPI-46 and a fluorescent FAP-targeted tracer (RTX-1370S) were used to compare tracer binding/uptake and localization in vitro and ex vivo. Additionally, FAP expression was determined with RT-qPCR and anti-FAP IHC.

Results

Although FAP expression was highest in HEK293-huFAP cells and cell line derived xenografts, this did not result in the highest tracer uptake. [111In]In-FAPI-46 uptake was highest in HT1080-huFAP, closely followed by HEK293-huFAP, and a 6-10-fold lower uptake for U-87 MG and PS-1 cells. However, ex vivo U-87 MG xenografts only showed a 2-fold lower binding compared to HT1080-huFAP and HEK293-huFAP xenografts, mainly because the cell line attracts murine fibroblasts as demonstrated in our RT-qPCR and IHC studies.

Conclusions

The interaction between FAP and FAP-targeted tracers differs between models, indicating the need for appropriate model selection and that comparing results across studies using different models is difficult.
Simulation analysis of the damage and recovery process in natural disasters: a case study of high-speed railways in Sichuan Province, China
Authors: Wu Junyi , Ishiro Taku
Published: December 2024

This study employs a dynamic input–output model to simulate the recovery process of a high-speed railway and the subsequent regional economic recovery following an earthquake. The analysis considers the impact of earthquakes of varying magnitudes on Sichuan Province, its neighboring areas, and the entire nation of China. The simulation is conducted against the backdrop of the restoration and reconstruction efforts in Sichuan Province post-earthquake. The findings reveal that the recovery speed of the high-speed railway transportation sector is influenced not only by the established recovery time, but also by the pace of recovery in adjacent industrial sectors and external inputs. Accelerated recovery in adjacent industrial sectors contributes to a faster recovery of the high-speed railway transportation sector. Furthermore, once the adjacent industrial sectors return to normal levels of recovery, the high-speed railway transportation sector follows suit, reaching the established recovery rate. In terms of regional economic recovery, provinces with smaller economies experience higher rates of economic reduction due to earthquakes. Conversely, provinces with a significant proportion of high-speed railways in their economies witness higher rates of economic reduction following seismic events. The insights derived from this study hold practical significance for guiding regional economic and transportation recovery and reconstruction efforts post-major earthquakes.
A comparison of survival and behavior of lake whitefish following transmitter implantation using electro- or chemical immobilization
Authors: Izzo Lisa K. , Dembkowski Daniel J. , Binder Thomas R. , Hansen Scott P. , Vandergoot Christopher S. , Isermann Daniel A.
Published: December 2024

Background

The number of telemetry studies focused on lake whitefish (Coregonus clupeaformis) in the Laurentian Great Lakes has steadily increased over the last decade, but field tests of immobilization methods used for tag implantation, which have the potential to affect survival and behavior of fish after release, are lacking. We compared post-tagging survival and behavior of lake whitefish that were immobilized for tag implantation using electroimmobilization via a transcutaneous electrical nerve stimulation (TENS) unit or by chemical immobilization via exposure to 10% eugenol.

Results

Acoustic tags were implanted into 126 adult lake whitefish (N = 126; N = 67 TENS treatment group, N = 59 eugenol treatment group) collected from the Fox River, Wisconsin, during the spawning period in November 2021. We found no significant differences between treatments in the number of days that lake whitefish spent in the Fox River following tagging (TENS mean = 13.4 days, eugenol mean = 14.7), and also found that the proportions of fish within each treatment group that returned to the Fox River during fall 2022 (51% from TENS treatment group, 49% from eugenol treatment group) did not differ from the proportions for all fish that were confirmed to be alive at that time. The best Cormack–Jolly–Seber model indicated no differences in survival between the two treatment groups (monthly survival = 0.980, 95% CI 0.970–0.987). Fish immobilized using TENS underwent almost immediate induction and recovery from surgeries, while fish immobilized using eugenol had induction times that ranged 167–487 s (mean = 347 s) and recovery times that ranged 51–2358 s (mean = 1242 s).

Conclusions

Short- and long-term behavior (time to exit of Fox River, return to Fox River in the next spawning season) and monthly survival estimates of lake whitefish did not differ between the immobilization treatments. Either method may be suitable for immobilization during tag implantation, but the additional time needed for induction and recovery of fish when using eugenol may be a limiting factor in some field-based tagging situations.
Selective retinoid X receptor agonism promotes functional recovery and myelin repair in experimental autoimmune encephalomyelitis
Authors: Kasheke Gracious D. S. , Hendy Basmah A. M. , Dorighello Gabriel G. , Uccelli Nonthué A. , Gothié Jean-David M. , Novorolsky Robyn J. , Oulton Madison J. , Asainayagam Jude , Makarov Adam I. , Fraser Kaitlyn S. , Vuligonda Vidyasagar , Sanders Martin E. , Kennedy Timothy E. , Robertson George S.
Published: December 2024

Evidence that myelin repair is crucial for functional recovery in multiple sclerosis (MS) led to the identification of bexarotene (BXT). This clinically promising remyelinating agent activates multiple nuclear hormone receptor subtypes implicated in myelin repair. However, BXT produces unacceptable hyperlipidemia. In contrast, IRX4204 selectively activates the retinoid X receptor (RXR). Given compelling links between RXR activation and increased myelin repair, we employed IRX4204 to investigate the impact of RXR agonism alone on functional recovery in mice subjected to experimental autoimmune encephalomyelitis (EAE). Since gait deficits are common in MS, we used machine learning to obtain highly sensitive and reliable measurements of sagittal hindleg joint movements for mice walking on a treadmill. IRX4204 not only blocked the progressive loss of knee and ankle movements but also reversed joint movement impairments in EAE mice. Our biochemical, transcriptional and histological measurements in spinal cord suggest these gait improvements reflect increased axon survival and remyelination and reduced inflammation. Using microglia, astrocytes and oligodendrocyte progenitor cells, we present additional data suggesting that IRX4204 may act on multiple glial subtypes to orchestrate myelin repair. These results inform the discovery of restorative neural therapeutics for MS by demonstrating that selective RXR agonism is sufficient for effective myelin repair. Moreover, our findings support the therapeutic potential of IRX4204 to promote functional recovery in MS.
Characteristic visual phenotypes in Korean wild mice (KWM/Hym)
Authors: Jamiyansharav Munkhdelger , Shin Haesol , Kim Boyoung , Kim Hongkyung , Han Soo Jung , Seong Je Kyung , Suh Jun Gyo , Seo Kyoung Yul
Published: December 2024

Background

In the last few decades, numerous efforts have been made to develop a better mouse model to overcome the current limitations of laboratory inbred mouse models such as have a weaker and simpler immune status. As part of these efforts, in Korea, the Hallym university medical genetics research team has been developing a new inbred strain of Korean wild mouse KWM/Hym. It was suggested that this strain, which is derived from wild mice, might be useful for genetic research and may become a valuable tool for overcoming some limitations seen in inbred mice that are currently used in the laboratory. Furthermore, for this study, we aimed to determine the visual phenotype of this unique strain KWM/Hym, and consider whether and if they are suitable for visual research. To analyze their visual phenotype, we performed the functional and morphological examinations in KWM/Hym mice and compared the results with laboratory mice which are the most common background strain.

Results

KWM/Hym had a thin corneal phenotype, thin but well-ordered retina due to their light body weight characteristic, and normal visual function similar to control mice. Unexpectedly, the KWM/Hym mice developed cataracts only at around 25 weeks old.

Conclusions

We suggest Korean wild mouse KWM/Hym is useful for visual experiments and could be an animal model of eye disease in humans.
The Value of LC-MS/MS in Apparent Bilateral Aldosterone Suppression in Adrenal Venous Sampling for Primary Aldosteronism
Authors: Li Wei , Zhou Qixin , He Yifan , He Wenwen , Song Ying , Hu Jinbo , Wang Yue , Luo Ting , Li Qifu , Yang Shumin
Published: December 2024

Context

Adrenal venous sampling (AVS) is recommended for subtyping primary aldosteronism (PA); however, it is unreliable when apparent bilateral aldosterone suppression (ABAS) occurs, defined as aldosterone/cortisol ratio in the adrenal vein being bilaterally lower than that in the inferior vena cava. The value of liquid chromatography–tandem mass spectrometry (LC-MS/MS) in PA subtyping when ABAS occurs is unclear.

Objective

This work aimed to determine whether LC-MS/MS can reduce the occurrence of ABAS and misdiagnosis of PA subtyping.

Methods

Aldosterone and cortisol in AVS samples from 219 patients with PA were measured by LC-MS/MS and immunoassay (IA). Then ABAS occurrence and misdiagnosis rate of PA subtyping were calculated.

Results

Among 219 patients with PA, 111 and 60 received nonadrenocorticotropin (non-ACTH) and ACTH-stimulated AVS, respectively, and 48 received both. In unstimulated AVS, LC-MS/MS reduced the ABAS occurrence compared to IA (10.7% [17/159] vs 3.1% [5/159]). Among 159 patients with unstimulated AVS, there were 77 patients who had final subtyping diagnosis based on postoperative outcomes. The misdiagnosis rate of IA and LC-MS/MS was 10.4% (8/77) and 9.1% (7/77), respectively. However, misdiagnosis was more common in patients with ABAS than in those without ABAS. For IA, 5 out of 6 ABAS patients were misdiagnosed, while 3/71 non-ABAS patients were misdiagnosed. For LC MS/MS, only one ABAS patient had follow-up outcome and he was misdiagnosed, while 6 of 76 non-ABAS patients were misdiagnosed. Similar results were found in ACTH-stimulated AVS.

Conclusion

LC-MS/MS measurement of aldosterone and cortisol is a new resolution when ABAS occurs.
Mitochondrial tRNA modifications: functions, diseases caused by their loss, and treatment strategies
Authors: Chujo Takeshi , Tomizawa Kazuhito
Published: December 2024

Mitochondrial tRNA (mt-tRNA) modifications play pivotal roles in decoding and sustaining tRNA stability, thereby enabling the synthesis of essential respiratory complex proteins in mitochondria. Consequently, loss of human mt-tRNA modifications caused by mutations in the mitochondrial or nuclear genome can cause life-threatening mitochondrial diseases such as encephalopathy and cardiomyopathy. In this article, we first provide a comprehensive overview of the functions of mt-tRNA modifications, the responsible modification enzymes, and the diseases caused by the loss of mt-tRNA modifications. We then discuss progress and potential strategies to treat these diseases, including taurine supplementation for MELAS patients, targeted deletion of mtDNA variants, and overexpression of modification-related proteins. Finally, we discuss factors that need to be overcome to cure “mitochondrial tRNA modopathies.”
Francesco O. Zamboni. At the Roots of Causality: Ontology and Aetiology from Avicenna to Fakhr al-Dīn al-Rāzī (Nedenselliğin Köklerinde: İbn Sînâ’dan Fahreddin Râzî’ye Ontoloji ve Etiyoloji/Neden Bilimi)
Authors: Signori Marco
Published: December 2024

Francesco O. Zamboni. At the Roots of Causality: Ontology and Aetiology from Avicenna to Fakhr al-Dīn al-Rāzī (Nedenselliğin Köklerinde: İbn Sînâ’dan Fahreddin Râzî’ye Ontoloji ve Etiyoloji/Neden Bilimi), Leiden, Boston: Brill, 2023. xi + 344 sayfa. ISBN 9789004684874.