bluuebunny/crossref_metadata_2025 huggingface dataset:
Black cultural intermediaries: Difference, neoliberalism and the negotiation of Black cultural value
Authors: Nwonka Clive
Published: February 2024

In recent years, the UK screen industries have exhibited a renewed interest in racial difference that can be understood as the outcome of policy interventions into the unequal labour practices within film production and film culture. This has emerged with new modes of Black cultural visibility that have accompanied the increased presence of mainstream, publicly funded feature films. Here, the increasing body of Black filmic practitioners who have now occupied the creative status of writer-director is an outcome of not just the expanded and strategic racial equality agenda within the UK film industry, nor the intrinsic need to extend the representation of Black identities and related themes and characterisations within the screen industrial landscape. In identifying a conjunctural shift in Black cultural politics and the production of Blackness as a cultural value through film as a linear social and political phenomenon that has produced a heightened moment of cultural visibility, this article identifies how the presence of industrial actors as creative practice within Black film production and presentation has inaugurated a glacial but no less significant period of industrial reconfiguration and subsequently, new forms of cultural meaning being ascribed to the cultural image of the Black writer-director. As Black Britishness comes into a greater industrial visibility in the film sector, its entanglements with neoliberalist logics of the marketed individual frame the Black cultural intermediary as the inevitable outcome of Black cultural identity’s continued trajectory into the popular.
Impact of climate change on the potential of free-cooling strategies for a retrofitted building in a hot climate
Authors: Sobhy Issam , Brakez Abderrahim , Benhamou Brahim
Published: February 2024

This paper’s objective and novelty is to understand the impact of different natural ventilation strategies as well as the effect of a proposed smart controlled ventilation strategy on cooling energy saving and thermal comfort in a residential building. Afterwards, an investigation of the Climatic Potential of Natural Ventilation (CPNV) in hot and dry climates, and particularly the potential of the night ventilation strategy under present and future climates, was made. Two prediction climate change scenarios, RCPs 2.6 and 8.5, were considered for two periods. The results, obtained by a validated simulation, have shown the beneficial effect of night ventilation, since it could reduce cooling load by 9% and would keep the operative temperature below 30°C. Nevertheless, the potential of this natural ventilation strategy would be reduced in the future due to climate change. Indoor overheating has been projected to increase drastically. The summer thermal behaviour will be greatly aggravated in the future. Indeed, the CPNV in the summer nights will be decreased by 25%. However, the climate change will affect the winter natural ventilation potential in the future. The results also highlighted that the annual Total Climatic Potential of Natural Ventilation could be increased by 1% for RCP 2.6 and decreased by 4.9% for RCP 8.5.
Transferred expectations of human presence: Folk theories among older adults who are inexperienced users of online services
Authors: Sakariassen Hilde , Ytre-Arne Brita
Published: February 2024

This study analyses the expectations of older adults who are inexperienced users of online media and services, examining their sense-making processes when using the internet for informational and practical purposes. Research on older users often focuses on access and abilities, but this study instead explores older adults’ expectations of what it means to interact online. We apply a ‘folk theory’ framework to illuminate underlying perceptions that guide behaviours, by asking which folk theories older adults draw on to make sense of their experiences with the internet. The empirical data originates from qualitative in-depth interviews and participant observation sessions with 25 people aged 65–98 years in Norway. We identify four interconnected folk theories under the shared theme of transferring expectations from the offline world: expecting human involvement, expecting visibility, lack of a human safety net, and human limitations and social conventions. Our analysis shows how such folk theories inform user decisions, including hindrances and problem-solving, as older adults adapt to digital services in everyday life.
Impact of jittering on raster- and distance-based geostatistical analyses of DHS data
Authors: Altay Umut , Paige John , Riebler Andrea , Fuglstad Geir-Arne
Published: February 2024

Fine-scale covariate rasters are routinely used in geostatistical models for mapping demographic and health indicators based on household surveys from the Demographic and Health Surveys (DHS) program. However, the geostatistical analyses ignore the fact that GPS coordinates in DHS surveys are jittered for privacy purposes. We demonstrate the need to account for this jittering, and we propose a computationally efficient approach that can be routinely applied. We use the new method to analyse the prevalence of completion of secondary education for 20-49 year old women in Nigeria in 2018 based on the 2018 DHS survey. The analysis demonstrates substantial changes in the estimates of spatial range and fixed effects compared to when we ignore jittering. Through a simulation study that mimics the dataset, we demonstrate that accounting for jittering reduces attenuation in the estimated coefficients for covariates and improves predictions. The results also show that the common approach of averaging covariate values in windows around the observed locations does not lead to the same improvements as accounting for jittering.
Group-Related Variables in Intervention Programs for Intimate Partner Violence Perpetrators: A Systematic Review
Authors: Roldán-Pardo Manuel , Lila Marisol , Santirso Faraj A. , Gracia Enrique
Published: February 2024

Intervention programs for male intimate partner violence (IPV) perpetrators mostly use the group intervention modality. Notwithstanding, the literature has neglected the study of group-related variables and their possible association with these interventions’ functioning and outcomes. This systematic review aimed to analyze group-related variables, their predictors, and their relation to the functioning and outcomes of intervention programs for IPV perpetrators. The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following databases were searched from inception to November 2022: Web of Science, Scopus, PUBMED, and PsycINFO. Of the 5,941 identified studies, 13 were included in the review. The main predictors of group-related variables were: intervention stage, motivational strategies, and leadership (counseling approach). The group-related variables as predictors of intervention outcomes were: group management behaviors and support (facilitator behavior within the group); positive confrontation, protherapeutic behavior, active involvement, positive interaction with peers, and positive interaction with the facilitator (participant behavior within the group); and group cohesion and group climate (group dynamics). Group cohesion and participants’ protherapeutic behavior stood out for their association with positive treatment outcomes (i.e., greater participation and working alliance, lower rates of violent behavior during follow-up). The findings from this review suggest that group processes are key factors in intervention programs for IPV perpetrators, and a better understanding of how these group processes are shaped, and how they can contribute to positive program outcomes, provides a new approach and insights to improve their effectiveness.
One for All—Can We Have and Do We Want a First-Line Monotherapy for Epilepsy?
Authors: Steriade Claude
Published: February 2024

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Caution: Benzodiazepines in Pregnancy and Risk of Adverse Perinatal Outcomes
Authors: Munger Clary Heidi M.
Published: February 2024

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Do Not Sleep on It! Prognosis of First-Ever Unprovoked Seizure From Sleep
Authors: Feyissa Anteneh M.
Published: February 2024

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Navigating School-Family-Community Partnerships, Integrative STEM Pedagogy, and Divergent Perspectives
Authors: Rose Mary Annette , Stith Krista Marie , Geesa Rachel Louise
Published: February 2024

This case study focuses on the preferred instructional approaches of integrative STEM education as students encounter authentic problems in their community, analyze data, and share their evidenced-based explanations and solutions with external audiences. As the case unfolds, school leaders encounter tensions among family and community members, and school representatives about students’ learning experiences in integrative STEM education. This examination reveals the roles of school leaders as risk managers and instructional facilitators in maintaining fruitful partnerships with family and community members in a rural school district, while also preparing students to be solution-finders related to mitigating climate change.
Communicating About Precision Transplantation Tools
Authors: Murdoch Blake , Sapir-Pichhadze Ruth , de Chickera Sonali Natasha , Caulfield Timothy
Published: February 2024

Purpose of review:

Precision tools that ensure molecular compatibility can help prevent rejection and improve kidney transplantation outcomes. However, these tools will generate controversy because they are perceived to and can in fact impact equity in the ethics of allocation. They may also affect the extent to which physicians can advocate for their patient fiduciaries, as generally required by Canadian professional ethics and law.

Sources of information:

Electronic databases such as Google Scholar and PubMed were searched for peer-reviewed literature, and Google search engine was used to identify the news articles, jurisprudence, legal information, and other relevant websites cited.

Methods:

We discuss controversies precision transplantation tools will likely generate, consider what challenges will arise from their implementation, and provide recommendations of avenues and content for communication to address these issues.

Key findings:

Communication about the translation of new precision tools will be challenging as media portrayals of transplantation often focus on individual narratives about access to transplantation and fail to center the issues of utility, allocation, and rejection. Incomplete portrayals of this nature will need to be countered with explanations of how new precision tools can be of net benefit when implemented equitably, as maintaining trust in the donation and transplantation system is key.

Limitations:

Our manuscript focuses on precision medicine applications pertaining to the implementation of molecular compatibility in transplantation. Distinct communication content and avenues may need to be considered in other contexts.

Implications:

Clear, accurate, and strategic communication is key to managing translation of precision medicine tools. For this purpose, we provide detailed recommendations for stakeholder engagement, content, and avenues for communicating about precision transplantation tools.
From City Hall to Twitter: Navigating political context in US mayors’ online engagement
Authors: Ding Minshuai
Published: February 2024

Twitter has become an indispensable tool for politicians and officials, including US mayors as heads of local governments, to engage with constituents in real time and convey their political agendas. However, there is limited research on the relationship between the political context associated with the role of mayor and their ways of communication on Twitter. This study explores the Twitter usage patterns of mayors of the 100 largest US cities in the light of two unique political contexts: partisan affiliation and form of municipal government. By conducting a twofold statistical analysis, this study found significant differences in Twitter usage patterns between mayor groups based on political context factors. However, regression analysis revealed that these differences were not caused by political party or form of government, but rather were more related to the city’s size in population. Differences in political context factors were not found strong predictors of the variation of Twitter usage patterns of mayors. The Communication Theory of Identity directs this twist to another potential scenario: identity gaps might exist within the mayors’ layers of identity construct. In addition, factors intrinsic to the city, such as its population size, have a substantial impact on the way mayors communicate on Twitter.
Factors enhancing the intention to migrate from more developed to less developed areas
Authors: Chow Cheng , Fong Eric
Published: February 2024

Despite the prevalence of global migration flows from more developed to less developed areas, few studies have been conducted on this phenomenon. This research utilizes data recently collected in 2020 regarding migration intentions among residents of Hong Kong considering moving from Hong Kong to the Chinese mainland. Our study aims to understand the role of social networks and perceptions of destinations in migration intentions. The results suggest that social networks, perceptions of governance quality, and perceived knowledge of the overall development plan for destinations are significantly related to the intention to migrate from more developed to less developed areas. The analysis further indicates an indirect relationship where strong social networks enhance the perception of governance quality and the understanding of development plans to reinforce migration intentions. These findings underscore the complexity of migration dynamics and highlight the need for a nuanced understanding of migration drivers beyond economic factors.
The Influence of Comminution and Posterior Ligamentous Complex Integrity on Treatment Decision Making in Thoracolumbar Burst Fractures Without Neurologic Deficit?
Authors: Aly Mohamed M. , Dandurand Charlotte , Dvorak Marcel F. , Öner Cumhur F. , Schnake Klaus , Mujis Sanders , Benneker Lorin M. , Vialle Emiliano , Rajasekaran Shanmuganathan , El-Skarkawi Mohammad , Kanna Rishi M. , Holas Martin , Popescu Eugen Cezar , Tee Jin W. , Camino-Willhuber Gaston , Joaquim Andrei Fernandes , Kenyan Ory , Chhabra Harvinder Singh , Bigdon Sebastian , Spiegel Ulrich , Schroeder Gregory D. , Canseco Jose A. , Vaccaro Alexander R. , Bransford Richard J.
Published: February 2024

Study Design

A prospective study.

Objective

to evaluate the impact of vertebral body comminution and Posterior Ligamentous Complex (PLC) integrity on the treatment recommendations of thoracolumbar fractures among an expert panel of 22 spine surgeons.

Methods

A review of 183 prospectively collected thoracolumbar burst fracture computed tomography (CT) scans by an expert panel of 22 trauma spine surgeons to assess vertebral body comminution and PLC integrity. This study is a sub-study of a prospective observational study of thoracolumbar burst fractures (Spine TL A3/A4). Each expert was asked to grade the degree of comminution and certainty about the PLC disruption from 0 to 100, with 0 representing the intact vertebral body or intact PLC and 100 representing complete comminution or complete PLC disruption, respectively.

Results

≥45% comminution had a 74% chance of having surgery recommended, while <25% comminution had an 86.3% chance of non-surgical treatment. A comminution from 25 to 45% had a 57% chance of non-surgical management. ≥55% PLC injury certainity had a 97% chance of having surgery, and ≥45-55% PLC injury certainty had a 65%. <20% PLC injury had a 64% chance of having non-operative treatment. A 20 to 45% PLC injury certainity had a 56% chance of non-surgical management. There was fair inter-rater agreement on the degree of comminution (ICC .57 [95% CI 0.52-.63]) and the PLC integrity (ICC .42 [95% CI 0.37-.48]).

Conclusion

The study concludes that vetebral comminution and PLC integrity are major dterminant in decision making of thoracolumbar fractures without neurological deficit. However, more objective, reliable, and accurate methods of assessment of these variables are warranted.
Robot-Assisted Lumbar Pedicle Screw Placement Based on 3D Magnetic Resonance Imaging
Authors: Altorfer Franziska C. S. , Burkhard Marco D. , Kelly Michael J. , Avrumova Fedan , Sneag Darryl B. , Chazen J. Levi , Tan Ek T. , Lebl Darren R.
Published: February 2024

Study Design

Human Cadaveric Study.

Objective

This study aims to explore the feasibility of using preoperative magnetic resonance imaging (MRI), zero-time-echo (ZTE) and spoiled gradient echo (SPGR), as source data for robotic-assisted spine surgery and assess the accuracy of pedicle screws.

Methods

Zero-time-echo and SPGR MRI scans were conducted on a human cadaver. These images were manually post-processed, producing a computed tomography (CT)-like contrast. The Mazor X robot was used for lumbar pedicle screw-place navigating of MRI. The cadaver underwent a postoperative CT scan to determine the actual position of the navigated screws.

Results

Ten lumbar pedicle screws were robotically navigated of MRI (4 ZTE; 6 SPGR). All MR-navigated screws were graded A on the Gertzbein-Robbins scale. Comparing preoperative robotic planning to postoperative CT scan trajectories: The screws showed a median deviation of overall 0.25 mm (0.0; 1.3), in the axial plane 0.27 mm (0.0; 1.3), and in the sagittal plane 0.24 mm (0.0; 0.7).

Conclusion

This study demonstrates the first successful registration of MRI sequences, ZTE and SPGR, in robotic spine surgery here used for intraoperative navigation of lumbar pedicle screws achieving sufficient accuracy, showcasing potential progress toward radiation-free spine surgery.
Feasibility study of the Digital Patient Benefit Assessment Scale (P-BAS): A Digital Tool to Assess Individual Patient Goals
Authors: van Erp Rozemarijn A.L. , de Rooij Sophia E. , Wymenga A.N. Machteld , Zeegers A.V.C.M. Elgun , van der Palen Job
Published: February 2024

The study objective was to assess the feasibility of the Patient Benefit Assessment Scale (P-BAS), a digital tool designed to enable older outpatients (≥70 years) to elucidate at home their individual goals regarding their current medical issue. Several digital tools are developed to assist older people in identifying their goals, thereby facilitating the process of shared decision making. However, studies on the feasibility of these digital tools, especially in older patients, are limited. Data were collected from 36 older patients. The study comprised three stages. In stage I and II, cognitive interviews were conducted to strengthen the feasibility of the P-BAS. In stage III, 80% of the patients completed the P-BAS independently at home. The cognitive interviews provided insight into patients’ interpretation and individual understanding of the digital visual P-BAS and associated opportunities for improvement, which were subsequently implemented. One conclusion is that the digital visual P-BAS might be of added value for patients and contributes to the process of shared decision making, assuring that the goals of the patient will be into account in treatment options. Findings are useful for researchers interested in technological tools that contribute to shared decision making.
Status and Just Gender Pay Gaps: Results of a Vignette Study
Authors: Wysieńska-Di Carlo Kinga , Karpiński Zbigniew
Published: February 2024

The authors present results from a multifactorial survey experiment conducted on a sample of Polish working-age adults querying their evaluations of just pay for men and women. The experiment was designed to investigate whether gender pay gaps are considered fair and to what extent they can be explained by status-based processes. Respondents rated the fairness of the earnings of hypothetical men and women with different ages and parenthood statuses in 21 occupations. The occupations differed in prestige and gender composition. The authors find that perceived just earnings for women are marginally lower than they are for otherwise identical men, regardless of respondents’ characteristics. Just gender pay gaps are largest among incumbents of high-prestige occupations and in male-dominated and gender-balanced occupations. The authors also find that motherhood penalties are not acceptable. In fact, respondents view both men and women with more than two children as deserving of a parenthood bonus.
Study of Nd:YAG laser micro-drilling machinability and parametric optimization of graphite/Epoxy and carbon black/Epoxy nanocomposites
Authors: Mishra Lipsamayee , Mahapatra Trupti Ranjan , Mishra Debadutta , Mishra Punyapriya , Padhi Pratap Chandra
Published: February 2024

Accurate estimation of the influence of process parameters on the drilled hole quality is imperative for reducing the defects like the taper and the microstructural changes around the holes are frequently encountered during the processing of advanced composite materials involving the laser drilling operations. In this work, the Nd:YAG laser micro-drilling of graphite powder (GP)/Epoxy and carbon black (CB)/Epoxy nanocomposites is performed. The impact of lamp current, cutting speed, assisted air pressure, pulse frequency, and band width on the hole quality attributes, specifically the heat affected zone (HAZ), taper and rate of material removal (RMR) are investigated. The experimentations are planned as per Taguchi’s standardized design and contemporary meta-heuristic accelerated particle swarm optimization (APSO) algorithm and the Whale optimization algorithm (WOA) have been utilized to define optimum controllable process parameters. The assortment of the acquired optimum conditions are justified by performing confirmatory tests. GP/Epoxy composites outperform CB/Epoxy composites in terms of hole quality. For single-objective optimization, improvements in taper, HAZ, and RMR for GP/Epoxy and CB/Epoxy nanocomposites are (14.47%, 10.54%, and 16.86%) and (14.64%, 12.72%, and 24.90%), respectively. In multi-performance optimization, WOA exhibits the least error compared to actual values and leads to improved taper (32.64%, 1.29%) and HAZ (10.58%, 10.09%) in GP/Epoxy and CB/Epoxy nanocomposites.
Cleaning an Indian City: A Case of Indore Municipal Corporation
Authors: Samuel Mercy , Yadav Akshita , Warsi Asad
Published: February 2024

The case is based on Indore Municipal Corporation, a city government in Madhya Pradesh, India. It revolves around the challenges a city government navigated through to become the cleanest city in India in the cleanliness ranking (Swachh Sarvekshan). In 2014, the Indian government launched the Clean India Mission. The cleanliness of cities was assessed in this mission based on several metrics, and Indore was placed 25th in 2016 among 73 cities and has continued to rank first in the country in subsequent years. Waste management was a major problem for the city, and the key to waste management is waste segregation. In order to transform, Indore had to go for segregated waste collection from residential and commercial sectors. Waste segregation cannot happen without effective citizen engagement as it is the citizens who generate waste and if they collect it in a segregated manner at their end the disposal can also happen in a similar fashion. This requires mobilizing citizens towards a new habit. Mobilizing residents in a country and city with compounded diversity in literacy, education, culture, religious views and customs was a complicated undertaking that required significant investment and political resolve. Also, before involving the community, the system needs to be redesigned so that it aligns with the altered practice at the citizens’ end. Citizens need to believe that their efforts were manifesting into something fruitful for society. The Municipal Commissioner was in a dilemma as to what kind of engagement strategy would work. Would information, education and communication be enough, or it required something more and beyond. This case tries to demonstrate the specific challenges and impacts that such a campaign brings and the learnings it generates in terms of citizen engagement, institutional arrangements and mechanisms of governance to benefit most and importantly envisage how the change can be sustained for long.
Step-by-Step Stereotactic Radiotherapy Planning of Liver Metastasis: A Radiation Oncology from Simulation to Execution (ROSE) Guide
Authors: Patro Kanhu Charan , Avinash Ajitesh , Boya Rakesh Reddy , Bhattacharya Partha Sarathi , Pilaka Venkata Krishna Reddy , Muvvala Mrutyunjayarao , Kumar Ayyalasomayajula Anil , Aketi Srinu , Kaliyappan Senthilnatham , Radhakrishnan Kaviya Lakshmi , Madasu Bhargava Krishna
Published: February 2024

Background

Stereotactic body radiotherapy (SBRT) is an important treatment modality in liver metastasis in which surgery is not feasible or when the patient denies surgery. With the recent advances in treatment planning systems and real-time image-guided treatment delivery, we can now deliver high doses of radiation in a small number of fractions to the target with high precision and minimal dose to the organs at risk (OARs).

Objective

To describe the procedural steps for radiation planning of SBRT of Liver Metastasis.

Methods

The step-by-step procedure for stereotactic planning of liver metastasis has been described using a clinical scenario of liver metastasis.

Results

The stereotactic radiation planning of liver metastasis starts with the basic history and relevant clinical evaluation followed by tissue confirmation of the diagnosis of liver metastasis. The SBRT planning for liver metastasis starts with the positioning of the patient using a body immobilization device. This is followed by the use of any of the motion management techniques during the computed tomography (CT) simulation. Magnetic resonance imaging (MRI) of the abdomen should be done in the prescribed format to achieve uniformity in radiation planning. After CT and MRI image fusion, contouring of the target, OARs, and radiation planning should be done. The plan evaluation includes target and OAR coverage index, conformity, homogeneity gradient index, and beam arrangement. After radiation plan evaluation, quality assurance and dry run are done. Then treatment is delivered using the same motion management technique that was used during the CT simulation.

Conclusion

The article highlights the sequential process of radiation planning for SBRT in liver metastasis―starting from simulation, planning, evaluation of plan, and treatment
Tibial Supra-Tubercular Deflexion Osteotomy During Revision Anterior Cruciate Ligament Reconstruction
Authors: Moran Thomas E. , Klosterman Emma L. , Tagliero Adam J. , Goodloe J. Brett , Miller Mark D.
Published: February 2024

Background:

A deflexion osteotomy may reduce anterior translational forces imparted upon an anterior cruciate ligament (ACL) reconstruction (ACL-R) graft, thereby reducing risk of ACL graft failure in patients with excessive congenital posterior tibial slope.

Indications:

A 13-year-old female competitive soccer player with 13.7° of posterior tibial slope presented with failure of a prior ACL-R.

Technique Description:

A vertical incision is made along the medial border of the patellar tendon and the proximal tibia is exposed. The planned osteotomy is templated under fluoroscopic guidance by placement of 2.4-mm Steinmann pins. A supra-tubercular deflexion osteotomy is made with a sagittal saw and osteotomes, with care to maintain the posterior cortical hinge. Compression staples are utilized for fixation of the osteotomy site. Revision ACL-R is then performed.

Results:

There were no immediate complications following surgery. Surgical management led to radiographic improvement of the patient's posterior tibial slope and clinical resolution of anterior translational knee instability.

Discussion/Conclusion:

The senior author's preferred technique for a tibial supra-tubercular deflexion osteotomy in association with a revision ACL-R is presented. A deflexion osteotomy is a surgical option for patients with excessive (>12°) posterior tibial slope in the setting of a prior failed ACL-R. This case demonstrates the efficacy of a tibial supra-tubercular deflexion osteotomy in the revision ACL-R setting by reducing posterior tibial slope, thereby lessening anterior translational forces on the ACL graft in a patient at high risk of graft failure.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Collaborative Cultural Intermediation and Communitainment Value in the Creator Economy: The Expanding Case of Webtoons
Authors: Wang Dingkun , Yecies Brian
Published: February 2024

A robust web of semi-veiled unpaid cultural intermediation in the South Korean-born Webtooniverse is marking a rapidly shifting ecology of an emergent digital mediasphere. Networks of participatory fans swarming around serialized webtoons are facilitating indirect translation in this webcomic domain in previously understudied ways. Shedding light on this protoindustrial communicative phenomenon, this study investigates some of the nuanced collaboration involved in the Korean fantasy–action superhero webtoon Sidekicks (2014 -) and how its global fans are leveraging convergent technological affordances to generate a new source of communitainment value. An analysis of the indirect translation activities on the Webtoons platform, which is fueling a transnational IP frenzy of its own, demonstrates how this exploited labor is central to a content production and consumption process that challenges current understandings of the creator economy and its participatory culture dynamics.
Correlation Between Fetal Umbilical Artery and Middle Cerebral Artery Doppler Indices in Preeclamptic and Normotensive Pregnancies
Authors: Rose Sybil , Farooq Syed Muhammad Yousaf , Fatima Mehreen , Gilani Syed Amir , Shams Rana Athar , Ramzan Iqra
Published: February 2024

Objective:

To assess the correlation between fetal umbilical artery (UA) and middle cerebral artery (MCA) Doppler indices in a cohort of preeclamptic and normotensive pregnancies.

Materials and Methods:

This cross-sectional analytical study recruited 70 pregnant women (28–40 weeks of gestation) using a non-probability convenient technique. The study included 33 patients with preeclampsia and 37 normotensive participants.

Results:

In the normotensive group, a significant ( P = .00) strong correlation ( r = 0.72) was observed between UA velocity, systolic/diastolic (S/D) ratio, and pulsatility index (PI), and MCA velocity; a significant ( P = .00) correlation ( r = 0.56) between UA, S/D ratio, and the MCA resistive index (RI); a significant ( P = .00) moderate correlation ( r = 0.66) between S/D ratio, UA velocity, and MCA velocity; a significant ( P = .00) negative correlation ( r = −0.50) between UA velocity, RI, and MCA PI; a significant ( P = .01) negative correlation ( r = −0.44) between UA velocity, RI, and MCA S/D ratio. In contrast, in the preeclamptic group, we observed a substantial ( P = .01) moderate correlation ( r = 0.43) between UA, PI, and MCA velocity; a significant ( P = .04) correlation ( r = 0.368) between UA, RI, and MCA PI; a significant ( P = .05) moderate correlation ( r = 0.35) between UA, PI, and MCA RI; a significant ( P = .00) strong correlation ( r = 0.83) between UA S/D ratio UA and MCA velocity.

Conclusion:

This study suggests potential diagnostic value in Doppler measurements for assessing preeclampsia-related vascular changes. However, caution is warranted owing to a split sample and limited statistical power, necessitating further research for validation.
Impact of folic acid supplementation on ischemia‒reperfusion-induced kidney injury in rats: folic acid prophylactic role revisited
Authors: Hamed Aya E. H. , Khedr Sherif , Ghonamy Elsayed , Mahmoud Faten A. , Ahmed Mona A.
Published: February 2024

Folic acid (FA), with its anti-inflammatory and antioxidant properties, may offer protection against ischemia–reperfusion (IR) injury. This study investigated whether FA safeguards rat kidneys from IR by targeting high mobility group box-1 (HMGB1), a key inflammatory mediator. Fifty adult male Wistar rats were randomly allocated into four groups: control, IR, IR + FA pretreatment, and FA alone. Compared to controls, IR significantly impaired renal function and elevated levels of malondialdehyde, HMGB1, NF-κB, and caspase 3. FA pretreatment effectively reversed these detrimental changes, protecting renal function and minimizing tissue damage. The FA-alone group showed no significant differences compared to the control group, indicating no adverse effects of FA treatment. Mechanistically, FA inhibited HMGB1 expression and its downstream activation of NF-κB and caspase 3, thereby quelling inflammation and cell death. FA shields rat kidneys from IR-induced injury by suppressing HMGB1-mediated inflammation and apoptosis, suggesting a potential therapeutic avenue for IR-associated kidney damage.
Enabling personalised disease diagnosis by combining a patient’s time-specific gene expression profile with a biomedical knowledge base
Authors: Verma Ghanshyam , Rebholz-Schuhmann Dietrich , Madden Michael G.
Published: February 2024

Background

Recent developments in the domain of biomedical knowledge bases (KBs) open up new ways to exploit biomedical knowledge that is available in the form of KBs. Significant work has been done in the direction of biomedical KB creation and KB completion, specifically, those having gene-disease associations and other related entities. However, the use of such biomedical KBs in combination with patients’ temporal clinical data still largely remains unexplored, but has the potential to immensely benefit medical diagnostic decision support systems.

Results

We propose two new algorithms, LOADDx and SCADDx, to combine a patient’s gene expression data with gene-disease association and other related information available in the form of a KB, to assist personalized disease diagnosis. We have tested both of the algorithms on two KBs and on four real-world gene expression datasets of respiratory viral infection caused by Influenza-like viruses of 19 subtypes. We also compare the performance of proposed algorithms with that of five existing state-of-the-art machine learning algorithms (k-NN, Random Forest, XGBoost, Linear SVM, and SVM with RBF Kernel) using two validation approaches: LOOCV and a single internal validation set. Both SCADDx and LOADDx outperform the existing algorithms when evaluated with both validation approaches. SCADDx is able to detect infections with up to 100% accuracy in the cases of Datasets 2 and 3. Overall, SCADDx and LOADDx are able to detect an infection within 72 h of infection with 91.38% and 92.66% average accuracy respectively considering all four datasets, whereas XGBoost, which performed best among the existing machine learning algorithms, can detect the infection with only 86.43% accuracy on an average.

Conclusions

We demonstrate how our novel idea of using the most and least differentially expressed genes in combination with a KB can enable identification of the diseases that a patient is most likely to have at a particular time, from a KB with thousands of diseases. Moreover, the proposed algorithms can provide a short ranked list of the most likely diseases for each patient along with their most affected genes, and other entities linked with them in the KB, which can support health care professionals in their decision-making.
Maternal sepsis and factors associated with poor maternal outcomes in a tertiary hospital in Tigray, Ethiopia: a retrospective chart review
Authors: Abera Bisrat Tesfay , Teka Hale , Gebre Daniel , Gebremariam Tsega , Berhe Ephrem , Gidey Hagos , Amare Birhane , Kidanemariam Rahel , Gebru Marta Abrha , Tesfay Fireweyni , Zelelow Yibrah Berhe , Yemane Awol , Gebru Fanus , Tekle Ashenafi , Tadesse Habtom , Yahya Mohammedtahir , Tadesse Ytbarek , Abraha Hiluf Ebuy , Alemayehu Mussie , Ebrahim Mohamedawel Mohamedniguss
Published: February 2024

Background

Maternal sepsis is the third leading cause of maternal death in the world. Women in resource-limited countries shoulder most of the burdens related to sepsis. Despite the growing risk associated with maternal sepsis, there are limited studies that have tried to assess the impact of maternal sepsis in resource-limited countries. The current study determined the outcomes of maternal sepsis and factors associated with having poor maternal outcomes.

Methods

A facility-based retrospective cross-sectional study design was employed to assess the clinical presentation, maternal outcomes, and factors associated with maternal sepsis. The study was conducted in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia, from January 1, 2017, to December 31, 2021. Sociodemographic characteristics, clinical characteristics and outcomes of women with maternal sepsis were analyzed using a descriptive statistic. The association between dependent and independent variables was determined using multivariate logistic regression.

Results

Among 27,350 live births, 298 mothers developed sepsis, giving a rate of 109 maternal sepsis for every 10,000 live births. There were 22 maternal deaths, giving rise to a case fatality rate of 7.4% and a maternal mortality ratio of 75 per 100,000 live births. Admission to the intensive care unit and use of mechanical ventilator were observed in 23.5% and 14.1% of the study participants, respectively. A fourth (24.2%) of the mothers were complicated with septic shock. Overall, 24.2% of women with maternal sepsis had severe maternal outcomes (SMO). Prolonged hospital stay, having parity of two and above, having the lung as the focus of infection, switchof antibiotics, and developing septic shock were significantly associated with SMO.

Conclusions

This study revealed that maternal sepsis continues to cause significant morbidity and mortality in resource-limited settings; with a significant number of women experiencing death, intensive care unit admission, and intubation attributable to sepsis. The unavailability of recommended diagnostic modalities and management options has led to the grave outcomes observed in this study. To ward off the effects of infection during pregnancy, labor and postpartum period and to prevent progression to sepsis and septic shock in low-income countries, we recommend that concerted and meticulous efforts should be applied to build the diagnostic capacity of health facilities, to have effective infection prevention and control practice, and to avail recommended diagnostic and management options.
Development and validation of a nomogram for predicting overall survival in patients with sinonasal mucosal melanoma
Authors: Zhu Zhenzhen , Wang Weiqing , Zha Yang , Wang Xiaowei , Aodeng Surita , Wang Lei , Liu Yuzhuo , Lv Wei
Published: February 2024

Background

Sinonasal mucosal melanoma (SNMM) is a relatively rare malignant tumour with a poor prognosis. This study was designed to identify prognostic factors and establish a nomogram model to predict the overall survival (OS) of patients with SNMM.

Methods

A total of 459 patients with SNMM were selected from the Surveillance, Epidemiology, and End Results (SEER) database as the training cohort. Univariate and multivariate Cox regression analyses were used to screen for independent factors associated with patient prognosis and develop the nomogram model. In addition, external validation was performed to evaluate the effectiveness of the nomogram with a cohort of 34 patients with SNMM from Peking Union Medical College Hospital.

Results

The median OS in the cohort from the SEER database was 28 months. The 1-year, 3-year and 5-year OS rates were 69.8%, 40.4%, and 30.0%, respectively. Multivariate Cox regression analysis indicated that age, T stage, N stage, surgery and radiotherapy were independent variables associated with OS. The areas under the receiver operating characteristic curves (AUCs) of the nomograms for predicting 1-, 3- and 5-year OS were 0.78, 0.71 and 0.71, respectively, in the training cohort. In the validation cohort, the area under the curve (AUC) of the nomogram for predicting 1-, 3- and 5-year OS were 0.90, 0.75 and 0.78, respectively. Patients were classified into low- and high-risk groups based on the total score of the nomogram. Patients in the low-risk group had a significantly better survival prognosis than patients in the high-risk group in both the training cohort (P < 0.0001) and the validation cohort (P = 0.0016).

Conclusion

We established and validated a novel nomogram model to predict the OS of SNMM patients stratified by age, T stage, N stage, surgery and radiotherapy. This predictive tool is of potential importance in the realms of patient counselling and clinical decision-making.
Does interferential current provide additional benefit to orthopedic rehabilitation for the patients with proximal humeral fractures? A randomized controlled study
Authors: Duran Emine , Durmaz Berrin , Atamaz Funda Çalış , Kadı Mehmet Resul , Küçük Levent
Published: February 2024

Background

Approximately 80% of all proximal humeral fractures (PHFs) are non-displaced or minimally displaced fractures, which can be treated with conservative treatment. This study investigated the effect of interferential current (IFC) added to orthopedic rehabilitation on shoulder function, pain, and disability in patients with PHF.

Methods

This study was a prospective, double-blind, randomized, placebo-controlled conducted in physical medicine and rehabilitation outpatient clinic. Thirty-five patients were randomly separated into the IFC group (n = 18) and the sham group (n = 17). The orthopedic rehabilitation program was applied to all patients by the same physiotherapist three times a week for four weeks. Patients in the IFC group received the intervention for 20 minutes 3 times a week before the exercise. The same pads were performed for the sham group, but no electrical stimulation was applied. Constant-Murley score (CMS) for shoulder function, visual analog scale (VAS) activity pain, disabilities of the arm, shoulder, and hand (DASH) score, and paracetamol intake were recorded post-treatment, at 6 weeks and 18 weeks post-treatment.

Results

The demographic and fracture characteristics were not different between the groups. Significant differences were observed in the IFC and sham group in intragroup comparisons of total CMS, VAS activity pain, DASH score, and paracetamol intake over time (p < 0.001). Significant improvement over time was valid for all pairwise comparisons in both groups. However, no significant differences were detected between the IFC and sham group.

Conclusion

IFC added to orthopedic rehabilitation could not appear to be an electrotherapy modality that could potentially benefit shoulder function and disability in patients with PHF.
The transcultural adaptation and validation of the Chinese version of the Oral Health Literacy Scale for Diabetic Patients
Authors: Zhao Ying , Zhao Hang , Yu Hongyu
Published: February 2024

Background

Diabetic patients’ oral health concerns are a reality for every diabetic patient in China. The attitudes of diabetic patients toward early identification of oral literacy influence oral literacy in diabetes patients. Diabetes patients' oral health literacy is critical for providing focused education and therapies. However, no instrument exists to measure oral health literacy in Chinese diabetic patients. In this study, the English version of the oral health literacy among people living with diabetes (OHLD) scale was cross-culturally validated to provide a reliable tool for assessing the oral health literacy of diabetic patients in China.

Objective

The oral literacy among people living with diabetes (OHLD) scale was Chineseized and its reliability and validity tested, and the OHLD scale was revised to test the reliability and validity of the Chinese version of the OHLD scale and to provide a tool for assessing the oral health literacy of diabetic patients in China.

Methods

A modified version of the Brislin translation model was used, cross-cultural adaptation was performed through expert consultation and pre-survey, and expert opinion was used to assess content validity to form the Chinese version of the Oral Health Literacy Scale for Diabetic Patients, which was administered to 420 diabetic patients in two tertiary hospitals in Liaoning Province from March to August 2023. The reliability of the scale was tested. SPSS 25.0 and AMOS 23.0 were used to analyze the data.

Results

The Chinese version of the OHLD scale consisted of three dimensions and 10 entries. Structure of the validity analysis: three factors were extracted from the exploratory factors with a cumulative variance contribution of 79.794%; Content validity results:An item’s content validity index (I-CVI) was 0.857 to 1 at the entry level, and the content validity index of the scale (S-CVI) was 0.928 at the scale level. The results of the reliability analyses were: the Cronbach's alpha coefficient for the total scale was 0.908; the Cronbach's alpha coefficients for the factors and dimensions were 0.853 to 0.922; the split-half reliability was 0.827; and the test–retest reliability was 0.848. The results of the validation factor analysis showed that (χ2/df) was 1.430, the root mean square of the error of approximation (RMSEA) was 0.045, the comparative fit index (CFI) was 0.989, and the Tucker Lewis index (TLI) was 0.985, which showed that the model had an overall good fit.

Conclusion

The Chinese version of the OHLD scale has good reliability and validity and can be used as a valid tool for assessing diabetes mellitus patients in China.
Disparities in treatment modalities and survival among older patients with high-grade serous ovarian cancer
Authors: Cai Yan , Shu Tong , Zheng Hong
Published: February 2024

Background

Undertreatment of ovarian cancer is common among older women. We aimed to evaluate the treatment modalities offered to older patients and their impact on overall survival (OS).

Methods

The study identified 5,055 patients with high-grade serous ovarian cancer and 3584 patients with advanced stage (IIIC + IV) disease from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 2010, to December 31, 2017. We performed comparisons of OS and ovarian cancer-specific survival (OCSS) across age groups using a Cox proportional hazards model.

Results

Very elderly patients (≥ 75 years old) received treatment with significantly less surgical complexity, such as no lymphadenectomy (59.7% vs. 48.6%; p < 0.001) and a lower rate of optimal debulking surgery (44.0% vs. 52.7%; p < 0.001), as well as lower rates of chemotherapy (78.2% vs. 89.4%; P<0.001) and standard treatment (70.6% vs. 85%; p < 0.001). High proportions of both very elderly and elderly patients received neoadjuvant chemotherapy (NACT), with no significant difference (38.7% vs. 36.2%; P = 0.212). Patients aged ≥ 75 years had significantly worse OS and OCSS.

Conclusion

With increasing age, the survival rate of women with ovarian cancer decreases significantly. Noticeably fewer ovarian cancer patients aged over 75 years receive standard treatments, and more very elderly patients are treated with NACT.