bluuebunny/crossref_metadata_2025 huggingface dataset:
Images of protest in movement parties’ social media communication
Authors: Hoffmann Matthias , Neumayer Christina
Published: April 2024

This research investigates the strategic use of protest imagery on social media by movement parties, bridging the gap between protest and institutional politics. We apply a mixed-methods analysis of 9584 Facebook, Twitter, and Instagram image posts by seven movement parties between 2015 and 2021. We find that protest images frequently serve to amplify movement grievances. Yet, parties’ involvement with contentious protest forms undergoes temporal shifts, influenced mainly by their evolving positions within the polity. Moreover, parties’ engagement with protest images differs by country and ideological leaning. Movement parties on the Right express a conflictual position between supporting and delegitimizing different protests. Conversely, Left-leaning counterparts tend to support protest, yet veer toward deradicalization and emphasizing symbolism over disruptive tactics, once they become more institutionalized. This research highlights the intricate relationship between movement parties, protest, and visual narratives on social media, in light of the interplay between movements and institutional politics.
Immaterial intimacy: The neoliberal entanglement of digital technologies in social movement volunteer work
Authors: Gantt-Shafer Jessica
Published: April 2024

Outside of visible moments of mass mobilization, ongoing latent work, such as direct service and mutual aid, is a long-standing tradition in social movements. Yet, like all labor, personal digital devices have changed the norms and practices of direct service social movement work. In this article, as situated in the technology–media–movement complex (TMMC), I analyze qualitative interview data ( N = 26) with volunteers from a yearlong ethnographic project at an abortion fund hotline in the reproductive justice movement in the US South. To name hotline volunteers’ digital care labor, I offer the term immaterial intimacy to describe its ubiquitous, ephemeral, and intimate nature. I argue immaterial intimate labor enabled the organization to provide a responsive service, but relied on individualized digital volunteer work, existing within gendered and neoliberal norms. I discuss and question the use of personal digital technologies for direct service volunteer work in contemporary social movements.
Epistemic stitching of race, power, and modernity in recent work on white supremacy
Authors: Halvorson Britt , Reno Joshua
Published: April 2024

This essay examines the recent anthropological literature on white supremacy. We argue that this ethnographic literature presents innovative approaches for a theory of race, power, and capitalist modernity applicable to anthropology as a whole. To highlight this literature's analytical contributions, we pursue a close but not exhaustive review of recent studies of white supremacy, showing how ethnographers have expanded an influential theoretical foundation by braiding together or “epistemically stitching” their work on white supremacy to a variety of other theoretical conversations in anthropology. We suggest this epistemic stitching—an important form of theory-building in anthropology that creatively ties together theoretical conversations and leaves evidence of that labor—provides important insights into the workings of white supremacy by drawing together critical theories of race with several different theoretical influences, from new materialism and critical anthrohistory to studies of empire.
Medicalisation, depoliticisation and reproductive stratification: lessons from Canada's Muskoka Initiative
Authors: Potvin Jacqueline
Published: April 2024

Based on critical discourse analysis of Canada's Muskoka Initiative (2010–15), this article outlines how medicalisation contributes to the depoliticisation and technocratisation of global maternal health, while reinforcing patterns of reproductive stratification. By constructing maternal health as a problem of managing medicalised risk, the Muskoka Initiative was able to position family planning as a risk-minimising practice that can improve health by averting pregnancy among populations deemed high risk. Interpreting this construction through the lenses of reproductive justice and biopolitics, I argue that this construction contributes to reproductive stratification and exemplifies how medicalised discourses have replaced overt discourses of population control within development policy, while continuing to discourage reproduction among racialised women in the Global South.
Spall size estimation for wind turbine pitch bearings: observation, signal processing method and experiments
Authors: Zhang Chao , Zhang Long
Published: April 2024

It is essential to continuously monitor the spall size of wind turbine pitch bearings to prevent severe faults and catastrophic failure. In the field of spall size estimation for bearings, an essential step is to extract the entry and impact signals simultaneously. And this would become more difficult when it comes to the wind turbine pitch bearings due to the limited fault signals and heavy noise. In this paper, a coherent procedure is proposed to estimate the spall size for wind turbine pitch bearings. Firstly, the characteristics of entry and impact signals in actual wind turbine pitch bearings are observed to be low-frequency and high-frequency dominated, respectively. On the basis of characteristics analysis, a novel two-stage signal processing method called the wavelet augmented sparse dictionary, is proposed to extract the entry and impact signals, which combines the discrete wavelet transform and sparse representation technique. Finally, the spall size is calculated according to aforementioned extraction and geometric constraints. Results from real-world experiments demonstrate the effectiveness of the proposed method.
Informed consent in clinical practice: Old problems, new challenges
Authors: Ng Isaac KS
Published: April 2024

Informed consent is a fundamental tenet of patient-centred clinical practice as it upholds the ethical principle of patient autonomy and promotes shared decision-making. In the medicolegal realm, failure to meet the accepted standards of consent can be considered as medical negligence which has both legal and professional implications. In general, valid consent requires three core components: (1) the presence of mental capacity – characterised by the patient’s ability to comprehend, retain information, weigh options and communicate the decision, (2) adequate information disclosure – based on the ‘reasonable physician’ or ‘reasonable patient’ standards and (3) voluntariness in decision-making. Nonetheless, in real-world clinical settings, informed consent is not always optimally achieved, due to various patient, contextual and systemic factors. In this article, I herein discuss three major challenges to informed consent in clinical practice: (1) patient literacy and sociocultural factors, (2) psychiatric illnesses and elderly patients with cognitive impairment and (3) artificial intelligence in clinical care, and sought to offer practical mitigating strategies to address these barriers.
Critical Inquiry in and Against 21st-Century Authoritarian Times
Authors: Eaton Paul William , Flint Maureen Alice , Smithers Laura
Published: April 2024

This paper forwards critical inquiry as a tool for hope against authoritarian movements in American public higher education. We utilize a speculative case study approach to interrogate the present moment, with its rising tide of authoritarian fascism in the United States and its manifestations in higher education. Rather than viewing this case (and its analogue) as solvable, we orient to it as a predicament. After introducing the problem of authoritarianism in higher education and presenting a speculative case rendering of it, we shift to explore three critical theories: queer theory, futures studies, and speculative feminisms. We use each of these theories to reorient the predicament the case study presents. To read the case with these theories enacts critical anticipatory practices, offering new questions by which to teach and inquire with critical theory in our present fascistic moment. Such enactments spark hope for imagining participatory democratic futures.
Experiences of Adult Siblings of Individuals With an Intellectual Disability and Pervasive Support Needs
Authors: Dorsman N. I. , Luijkx J. , van der Schans C. P. , van der Putten A. A. J. , Waninge A.
Published: April 2024

Siblings are important in the lives of individuals with an intellectual disability and pervasive support needs; however, adults’ experiences of the things they do with or for their siblings with pervasive support needs remain underexplored. This study examined positive and challenging aspects of their roles related to their siblings. An online questionnaire was completed by 55 adults whose siblings had pervasive support needs. An inductive approach was used to thematically analyze open-ended questions about their experiences. The respondents described rewarding experiences of being with their siblings, combined with a sense of care and responsibility, and noted how their experiences were affected by their siblings’ support needs. “Being of service” was experienced as both rewarding and as a demanding responsibility. Collaboration with family members and health care professionals was another overarching theme. Our findings highlighted the valuable mutual contributions of siblings in each other’s life when one of them has pervasive support needs. Understanding adults’ experiences relating to their siblings who have pervasive support needs enables service providers to facilitate their contact and support. In addition, these findings can provide input for government agencies and organizations that provide support for people with disabilities by increasing awareness about siblings’ perspectives.
How to Curate and Digitize Bryozoa: Experiences at the Santa Barbara Museum of Natural History
Authors: Geiger Daniel L. , Delnavaz Vanessa , Gour Alexandria N. , Henderson Van
Published: April 2024

We report on curation and digitization experiences of a large collection of Bryozoa (>19,759 of estimated 38,000 lots digitized, >1,000 type lots). Storage of one to two histology slides in capped glass vials and larger series in twenty-five-slot histology boxes is optimal. Bulk dry material is stored in acid-free containers (cardboard, plastic). Fluid specimens are stored in 70 percent ethanol, with small specimens housed in 20 ml scintillation vials with conical polypropylene lined screw caps. Digitizing is most effective by georeferencing immediately. Unidentified material should at least be roughly identified (family, genus) to encourage loans and ensuing expert identification. Taxonomy and nomenclature are challenging and require an experienced taxonomist. Approaches to specimen counts are discussed.
Blood Flow Restriction Training in the Young Athlete
Authors: Weaver Adam P. , Dunkle Zachary , Giampetruzzi Nicholas , Prue Jennifer , Pacicca Donna , Roman Dylan P.
Published: April 2024

Blood flow restriction training (BFRT) is increasing in popularity in the rehabilitation setting due to its believed impact on mitigating muscle atrophy, maintaining muscle mass and improving muscle function after musculoskeletal injury. This intervention has shown to be an effective option for addressing muscle strength and atrophy during earlier phases of rehabilitation when higher loads are not tolerated after injury. Although this intervention appears to be a safe and effective approach in sports medicine environments, there is limited information on the young athlete population. The purpose of this study is to provide a detailed overview of mechanisms, safety considerations, and clinical applications specific to the young athlete after musculoskeletal injury.
The appointment-based model in community pharmacies: Patient demographics and reimbursable clinical services uptake in Ontario
Authors: Tilli Tiana , Mathers Annalise , Lin Qiqi , Bhaidani Saleema , Baker Jen , Wei Louis , Grootendorst Paul , Cadarette Suzanne M. , Dolovich Lisa
Published: April 2024

Background:

Community pharmacies typically require patients to request medication refills. The appointment-based model (ABM) is a proactive approach that synchronizes refills and schedules patient–pharmacist appointments. These appointments provide opportunities for medication reviews, medication optimization and health promotion services. The primary aim of this study was to describe the types of patients who received an ABM service in a community pharmacy in Ontario in 2017. The secondary aim was to describe reimbursable clinical service uptake.

Methods:

In September 2017, the ABM was implemented across 3 Ontario community pharmacies within a Canadian pharmacy banner. Patients who filled at least 1 chronic oral medication and consented to enrolment were eligible. In December 2018, data were extracted from pharmacies using pharmacy management software. Descriptive statistics and frequencies were generated.

Results:

Analysis of 131 patients (51.1% female; mean ± SD age 70.8 ± 10.5 years) revealed patients were dispensed a mean ± SD of 5.1 ± 2.7 medications, and 73 (55.7%) experienced polypharmacy. Hypertension (87.8%) and dyslipidemia (68.7%) were the most common medical conditions. There were 74 (56.5%) patients who received ≥1 medication review service (MedsCheck). Of 79 unique drug therapy problems (DTPs) identified, the most common categories related to patients needing additional drug therapy and adverse drug reactions.

Discussion and conclusion:

Patients enrolled in the ABM were generally older adults experiencing polypharmacy. The ABM presented opportunities for DTP identification and delivery of reimbursed services. Findings support continued exploration of the ABM to support integration of clinical services within community practice.
Insulation from loss: Exploring the impact of changing relationships in the liminal period between reoffending and desistance, and substance misuse and recovery
Authors: Coghlan Megan
Published: April 2024

This article focuses on changes to relationships during the transition to desistance. This is important as liminality in offending behaviour is well-established meaning that people may move forward and backward through the offending cycle. Research on the nature of relationships as people move towards desistance is thus essential to understand the impact of change for individuals during a period of transition. This article explores the impact of change to relationships for both men and women contributing to gendered understandings of transitions to desistance. Based on interviews with 18 men and 10 women completing probation, two themes emerged to describe the impact of change, which were loss and gain, and rebuilding. These themes explain how changes to relationships can hinder or encourage desistance in the liminal period from reoffending to desistance.
SARS-CoV-2 seroprevalence screening study of a children’s hospital health care workers
Authors: Pluss Olivia , Berman Stephen , Lamb Molly , Knight Vijaya , Roell Yannik , Berkowitz Steven , Jaenisch Thomas
Published: April 2024

Background

Health care workers (HCWs) are front line responders to the COVID-19 pandemic, but limited data is available for pediatric HCWs, as the research response has largely focused on adult patients and medical personnel that treat these patients.

Methods

We conducted a cross-sectional study of SARS-CoV-2 seroprevalence and risk factors in HCWs at a Children’s Hospital in CO, USA from September 2020 to April 2021. Pediatric HCWs were defined as clinical care providers and administrative staff. Seroprevalence was determined using the Epitope SARS-CoV-2 anti-Nucleocapsid IgG assay (San Diego, CA) and the Euroimmun SARS-CoV-2 anti-Spike Protein IgG assay. Risk factors and vaccination status were assessed via questionnaire.

Results

Overall, 110 HCWs were enrolled, 79 subjects were positive for anti-S antibodies and negative for anti-N antibodies, indicating COVID-19 vaccination. 31 subjects had neither anti-N or anti-S antibodies, indicating no exposure to SARS-CoV-2 and no vaccination. 3/110 had a nucleocapsid serology consistent with a SARS-CoV-2 prior infection. Seroprevalence was observed at 2.7%. It was noted that asthma requiring medication was associated with positive serostatus.

Conclusions

During the winter 2020/21, SARS-CoV-2, we found a 2.7% seroprevalence of pediatric HCW at a children’s hospital in Colorado. We compared this with publicly available seroprevalence data for seroprevalence rates of pediatric HCWs globally. This suggests that this specific children’s hospital COVID-19 personal protective equipment (PPE) and infection control guidelines were effective in limiting SARS-CoV-2 in hospital transmission at the children’s hospital prior to the presence of the Delta variant.
Teachers creating anti-colonial futures: Exploring curriculum conversations with teachers through autobiographical reflection
Authors: Roofe Carmel
Published: April 2024

Teachers’ understanding of their personal histories is beneficial to their understanding and conceptualisation of their roles as teacher professionals. Insights from such understanding in post-colonial societies help to shape teachers’ consciousness about how they can run their own course (curriculum) to create liberating experiences for themselves and those they teach. This paper draws on the autobiographical method of currere to deconstruct stories of four in-service teachers about their teaching and learning experiences as students in Jamaican classrooms and how these experiences intertwine with their current professional practice. Findings derived from the teachers’ written reflections revealed that perceptions about types of schools and the associated consequences remain the largest area of complexity and representation of coloniality for teachers. Linked to this is the skills teachers themselves demonstrate and the positive and negative emotions those skills evoke for students. The teachers also expressed their responsibility towards advocating for self and their students as opportunities to create change and resist coloniality. The paper therefore offers recommendations for teachers and teachers of teachers (teacher educators) on how to build anti-colonial futures through curriculum conversations with their students.
Predictors of fuel poverty and the equity of local fuel poverty support: secondary analysis of data from Bradford, England
Authors: Little E , Barnes A , Power M
Published: April 2024

Aims:

Addressing fuel poverty is a critical public health issue given its recent rise in prevalence across Europe. Although previous research identifies national risk markers of fuel poverty, evidence is lacking on whether these are consistent across local geographies, and the equity of local interventions. In the UK’s current economic climate, it is more crucial than ever that services benefit households in greatest need. This study aimed to determine significant predictors of fuel poverty among households in Bradford, England, comparing them to national-level predictors, and evaluate if households possessing significant fuel poverty predictors were equitably referred to a local fuel poverty service (Warm Homes Healthy People, WHHP).

Methods:

A multivariate logistic regression model determined significant fuel poverty predictors in Bradford using household-level data from the Energy Saving Trust and the Low Income High Costs fuel poverty definition. Statistical testing highlighted significant differences in predictors of fuel poverty between households referred to WHHP and all Bradford households.

Results:

Significant ( p < .05) predictors of fuel poverty included: living in an area with lower average household incomes and higher proportion of ethnic minority individuals, and living in a property with a lower energy efficiency rating. Households living in a detached or older property, and homeowners were more likely to be fuel poor. Differences in the direction of the relationship with fuel poverty were identified between some national and local predictors. Most predictors were significantly ( p < .05) overrepresented among WHHP households, suggesting equitable service reach. Ethnic minorities, younger people, and multiperson households were underrepresented.

Conclusions:

Local fuel poverty predictors were similar to many national-level predictors, but identified differences in the direction of the relationship between some national and local predictors reaffirm the value of locally focused research. WHHP successfully targeted households possessing key predictors, but should ensure that ethnic minorities, younger people, and multiperson households are equitably referred.
First Accuracy and User-Experience Evaluation of New Continuous Glucose Monitoring System for Hypoglycemia Due to Hyperinsulinism
Authors: Worth Chris , Worthington Sarah , Auckburally Sameera , O’Shea Elaine , Ahmad Sumera , Fullwood Catherine , Salomon-Estebanez Maria , Banerjee Indraneel
Published: April 2024

Introduction:

Patients with congenital hyperinsulinism (HI) require constant glucose monitoring to detect and treat recurrent and severe hypoglycemia. Historically, this has been achieved with intermittent self-monitoring blood glucose (SMBG), but patients are increasingly using continuous glucose monitoring (CGM). Given the rapidity of CGM device development, and increasing calls for CGM use from HI families, it is vital that new devices are evaluated early.

Methods:

We provided two months of supplies for the new Dexcom G7 CGM device to 10 patients with HI who had recently finished using the Dexcom G6. Self-monitoring blood glucose was performed concurrently with paired readings providing accuracy calculations. Patients and families completed questionnaires about device use at the end of the two-month study period.

Results:

Compared to the G6, the G7 showed a significant reduction in mean absolute relative difference (25%-18%, P < .001) and in the over-read error (Bland Altman +1.96 SD; 3.54 mmol/L to 2.95 mmol/L). This resulted in an improvement in hypoglycemia detection from 42% to 62% ( P < .001). Families reported an overall preference for the G7 but highlighted concerns about high sensor failure rates.

Discussion:

The reduction in mean absolute relative difference and over-read error and the improvement in hypoglycemia detection implies that the G7 is a safer and more useful device in the management of hypoglycemia for patients with HI. Accuracy, while improved from previous devices, remains suboptimal with 40% of hypoglycemia episodes not detected.
Writing Qualitatively as a Process of Becoming Through Creative Nonfiction
Authors: Rylak Danielle , Mason Madeline , Riske Amanda
Published: April 2024

In this manuscript, we take up the invitation by the editors of this special issue to contribute to answering the question: “What does it mean to write qualitatively?” Drawing on speculative realism, we describe writing qualitatively as a relational process of becoming through writing and reading creative nonfiction. We reflect on our experiences as researchers, subjects, collaborators, writers, and readers through lens of relational power. By collaborating to craft an immersive true story that revealed larger truths to readers, we were affected by each other, created ourselves out of what we had taken in, and influenced each other and others after being affected by them in our processes of relational becoming.
In-Season Training Load Variation - Heart Rate Recovery, Perceived Recovery Status, and Performance in Elite Male Water Polo Players: A Pilot Study
Authors: Botonis Petros G. , Arsoniadis Gavriil G. , Smilios Ilias , Toubekis Argyris G.
Published: April 2024

Background:

Increased training and competition demands of the in-season period may disturb athlete fatigue and recovery balance. The aim of this study was to describe the training load distribution applied in a competitive period and the training adaptations and fatigue/recovery status of elite water polo players.

Hypothesis:

Effective workload management during tapering (TAP) would restore player recovery and enhance performance.

Study Design:

Case series.

Level of Evidence:

Level 4.

Methods:

Training load, perceived recovery, maximal speed in 100- and 200-meter swim, heart rate (HR) during submaximal swimming (HRsubmax) and HR recovery (HRR) were assessed in 7 outfield water polo players a week before starting a normal training microcycle (NM), after NM, and after congested (CON) and TAP training blocks in the lead-up to the Final Eight of the European Champions League.

Results:

Training load was higher in NM compared with CON and TAP by 28.9 ± 2.6% and 42.8 ± 2.1% ( P < 0.01, d = 11.54, and d = 13.45, respectively) and higher in CON than TAP by 19.4 ± 4.2% ( P < 0.01, d = 3.78). Perceived recovery was lower in CON compared with NM and TAP ( P < 0.01, d = 1.26 and d = 3.11, respectively) but not different between NM and TAP ( P = 0.13, d = 0.62). Both 100- and 200-meter swim performance was improved in TAP compared with baseline ( P < 0.01, d = 1.34 and d = 1.12, respectively). No differences were detected among other training blocks. HRsubmax and most HRR were similar among the training periods.

Conclusion:

Effective management of training load at TAP can restore recovery and improve swimming performance without affecting HR responses.

Clinical Relevance:

Despite lower workloads, CON training impairs perceived recovery without affecting performance; however, a short-term training load reduction after a CON fixture restores recovery and improves performance.
Leadership Education and Development: An Exploration of Australian Academic Educators’ Perceptions of Leadership Education for Health and Human Service Sector Leaders
Authors: Fennell Kate L. , Van Dam Pieter Jan , Stephens Nicola , Holloway Adele
Published: April 2024

The purpose of this study was to explore the nature of postgraduate leadership courses and programs offered by Australian Higher Education Institutions for leaders and potential leaders in the Health & Human Service (H&HS) sector including structure, content, and teaching practices from the perspective of educators. Ten educators from a range of institutions were interviewed. Interview data was coded and analyzed using Inductive Content Analysis. Six global categories represent the broad range of experiences and perspectives of participants in this study. Findings demonstrate formal education has the potential to positively impact the development of leaders in the H&HS sector.
Expression of Chondrogenic Potential Markers in Cultured Chondrocytes from the Human Knee Joint
Authors: Bonello John-Peter , Tse M. Yat , Robinson Trevor J. G. , Bardana Davide D. , Waldman Stephen D. , Pang Stephen C.
Published: April 2024

Objectives

While substantial progress has been made in engineering cartilaginous constructs for animal models, further research is needed to translate these methodologies for human applications. Evidence suggests that cultured autologous chondrocytes undergo changes in phenotype and gene expression, thereby affecting their proliferation and differentiation capacity. This study was designed to evaluate the expression of chondrogenic markers in cultured human articular chondrocytes from passages 3 (P3) and 7 (P7), beyond the current clinical recommendation of P3.

Methods

Cultured autologous chondrocytes were passaged from P3 up to P7, and quantitative polymerase chain reaction (qPCR) was used to assess mRNA expression of chondrogenic markers, including collagen type I (COLI), collagen type II (COLII), aggrecan (AGG), bone morphogenetic protein 4 (BMP4), transcription factor SOX-9 (SOX9), proteoglycan 4 (PGR4), and transformation-related protein 53 (p53), between P3 and P7.

Results

Except for AGG, no significant differences were found in the expression of markers between passages, suggesting the maintenance of chondrogenic potential in cultured chondrocytes. Differential expression identified between SOX9 and PGR4, as well as between COLI and SOX9, indicates that differences in chondrogenic markers are present between age groups and sexes, respectively.

Conclusions

Overall, expression profiles of younger and male chondrocytes exhibit conversion of mature cartilage characteristics compared to their counterparts, with signs of dedifferentiation and loss of phenotype within-group passaging. These results may have implications in guiding the use of higher passaged chondrocytes for engineering constructs and provide a foundation for clinical recommendations surrounding the repair and treatment of articular cartilage pathology in both sexes.
eCLIPs bifurcation remodeling system for treatment of wide-neck bifurcation aneurysms: A systematic review and meta-analysis of safety and efficacy
Authors: Ghozy Sherief , Ramzan Abdullah , Kobeissi Hassan , Motawei Ahmed Sallam , Abdelghaffar Mariam , Dmytriw Adam A , Kallmes David F , Kadirvel Ramanathan
Published: April 2024

Background

Wide neck bifurcation aneurysms (WNBAs) are a subtype of aneurysms that are especially complex to treat. We aim to conduct a systematic review and meta-analysis to synthesize the available literature on the safety and efficacy of employing endovascular clip system (eCLIPs) in the treatment of WNBAs.

Methods

We report this study in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines. PubMed, Embase, Web of Science, and Scopus were queried for this review. Screening and extraction were performed by at least two authors to ensure accuracy and completeness, and a senior author arbitrated any discrepancies. All data were analyzed using R software version 4.3.0. and random-effects model.

Results

Four studies were finally included, of which three were prospective and one was retrospective. Successful adjunctive coiling occurred in 91.38% (95% CI = 70.71–97.9) of cases and overall technical success was achieved in 88.61% (95 CI = 75.54–95.15) of cases. The pooled complete occlusion (Raymond-Roy Class I) was 50.65% (95% CI = 39.63–61.60) and adequate occlusion (Raymond-Roy Class I/II) was 84.42% (95% CI = 74.53–90.93). Thrombo-embolic complication had a pooled rate of 1.22% (95% CI = 0.17–8.15), retreatment rate was 6.10% (95% CI = 2.56–13.83), and mortality reported in 3.66% (95% CI = 1.18–10.74) of patients.

Conclusion

The use of eCLIPs may be a safe and efficacious treatment for WNBAs. Future randomized controlled trials are needed for further validation of the findings.
Gut microbiota in MAFLD: therapeutic and diagnostic implications
Authors: Alghamdi Waleed , Mosli Mahmoud , Alqahtani Saleh A.
Published: April 2024

Metabolic dysfunction-associated fatty liver disease (MAFLD), formerly known as nonalcoholic fatty liver disease, is becoming a significant contributor to chronic liver disease globally, surpassing other etiologies, such as viral hepatitis. Prevention and early treatment strategies to curb its growing prevalence are urgently required. Recent evidence suggests that targeting the gut microbiota may help treat and alleviate disease progression in patients with MAFLD. This review aims to explore the complex relationship between MAFLD and the gut microbiota in relation to disease pathogenesis. Additionally, it delves into the therapeutic strategies targeting the gut microbiota, such as diet, exercise, antibiotics, probiotics, synbiotics, glucagon-like peptide-1 receptor agonists, and fecal microbiota transplantation, and discusses novel biomarkers, such as microbiota-derived testing and liquid biopsy, for their diagnostic and staging potential. Overall, the review emphasizes the urgent need for preventive and therapeutic strategies to address the devastating consequences of MAFLD at both individual and societal levels and recognizes that further exploration of the gut microbiota may open avenues for managing MAFLD effectively in the future.
Use of virtual reality exercises in disaster preparedness training: A scoping review
Authors: Alshowair Abdulmajeed , Bail Jean , AlSuwailem Fatima , Mostafa Asmaa , Abdel-Azeem Amro
Published: April 2024

Background:

The scope and number of disasters have increased over the years. This has called for more robust disaster preparedness training and plans. The use of virtual reality exercises in addition to tabletop exercises is considered a new approach to the preparation of disaster preparedness plans. Virtual reality exercises are being developed to either replace or complement current traditional approaches to disaster preparedness training.

Objectives:

To review and summarize the current existing literature regarding the effectiveness, advantages and limitations of using virtual reality exercises in disaster preparedness as a complementary/replacement mechanism for real-time drills and tabletop exercises.

Methods:

In this scoping review, we searched PubMed, Cochrane, EMBASE, PLOS, and Google Scholar for research publications involving virtual reality exercises in disaster training from 2008 to 2022 using “AND” and “OR” operators for the keywords “disaster,” “preparedness,” “virtual reality,” and “tabletop.” From a total of 333 articles that resulted in our search and were then evaluated by the authors, 55 articles were finally included in this review.

Results:

Virtual reality exercises are found to be better in the formulation of disaster preparedness plans compared to tabletop exercises. Virtual reality exercises can be used as the primary means of creating a real-life-like experience in disaster preparedness training and proved at least as better complementary to tabletop exercises. Virtual reality exercises have many advantages over traditional real-life or tabletop exercises and are more cost-effective, but some drawbacks are still identified.

Conclusion:

The advantages of virtual reality exercises are remarkable and underline their benefits and uses versus costs. We highly encourage decision-makers and institutions dealing in disaster preparedness to adopt using virtual reality exercises in training for disaster preparedness.
Prolonged grief in relatives of deceased patients due to COVID-19 is associated with anxiety and depressive symptoms: A survey-based study in Peru
Authors: Moya-Salazar Jeel , Soto Elizabeth , Cañari Betsy , Goicochea Eliane A , Zuñiga Nahomi , Jaime-Quispe Alexis , Contreras-Pulache Hans
Published: April 2024

Objective:

Funeral practices have undergone significant changes during the COVID-19 pandemic. Thus, the death of a family member from this disease has altered the typical course of the bereavement process. Therefore, this study seeks to determine the relationship between the levels of grief, anxiety, and depression in relatives of patients who died from COVID-19 in Peru.

Methods:

A total of 250 volunteers were obtained, but after applying the inclusion criteria and not being able to contact five of them, the sample consisted of 115 participants over 18 years of age who lost a family member to COVID-19 between 2020 and 2021. They developed the Prolonged Grief Questionnaire-13 and the Zung Anxiety and Depression Questionnaires, in virtual surveys using Google FormTM (Google, CA).

Results:

Our analysis revealed that all cases of anxiety (18.3%) were present in individuals experiencing prolonged grief (76.5%), while 49.5% (57/115) of participants exhibited symptoms of depression. Furthermore, we identified a significant association between prolonged grief and both anxiety ( p = 0.005) and depression ( p < 0.001). Prolonged grief predominantly affected females (45.2%) and individuals aged 31–40 years (28.7%) ( p < 0.001). Regarding predictors of anxiety symptoms, we found that both age group ( p = 0.035) and grief ( p < 0.001) played significant roles. Gender ( p = 0.019) and grief ( p < 0.001) emerged as predictors of depression, while gender alone predicted grief in relatives of individuals who succumbed to COVID-19 ( p = 0.019).

Conclusion:

Our results suggest a clear association between prolonged grief and mental health issues among relatives of COVID-19 patients who have passed away. Consequently, it is imperative to provide comprehensive psychological and spiritual support throughout the grieving process, aiming to mitigate the negative impact of traumatic events.
Nurse-led UTI service provides consistent care and reduces pressure on consultant clinics
Authors: De Silva Supun , Rashid Mustafa , Seymour Coral , Hussain Paulette , Eylert Maike
Published: April 2024

Objectives:

To publish the five-year outcomes of the nurse-led urinary tract infection (UTI) clinic, which is the first-ever outpatient nurse-led service for women with recurrent urinary tract infections.

Materials and Methods:

This report is on a single UK centre review of outcomes including patients seen in a nurse-led UTI clinic between January 2017 and December 2021.

Results:

A total of 1425 patients were audited. The median wait from referral time was 18 weeks. Standard ultrasound of kidneys, ureter and bladder (KUB) was offered to most patients which detected an abnormality in 17.5% (n = 240/1374) of scans, and flexible cystoscopy (selective) was positive in 11.9% (n = 46/386) mainly for benign pathologies. At 6 months, 80.6% of patients were discharged, with only 10.9% of patients requiring referral to the consultant urology clinic. Four urothelial cancers were picked up in the absence of red-flag symptoms on the referral, each one much quicker than the average wait for general consultant clinics at the point of referral.

Conclusions:

A well-run, protocol-driven nurse-led UTI clinic provides consistent care to women with recurrent UTIs. More than 80% of patients can be successfully discharged at 6 months which reduces pressure on consultant clinics.

Level of evidence:

Not applicable
A locally optimised machine learning approach to early prognostication of long-term neurological outcomes after out-of-hospital cardiac arrest
Authors: Pey Vincent , Doumard Emmanuel , Komorowski Matthieu , Rouget Antoine , Delmas Clément , Vardon-Bounes Fanny , Poette Michaël , Ratineau Valentin , Dray Cédric , Ader Isabelle , Minville Vincent
Published: April 2024

Background

Out-of-hospital cardiac arrest (OHCA) represents a major burden for society and health care, with an average incidence in adults of 67 to 170 cases per 100,000 person-years in Europe and in-hospital survival rates of less than 10%. Patients and practitioners would benefit from a prognostication tool for long-term good neurological outcomes.

Objective

We aim to develop a machine learning (ML) pipeline on a local database to classify patients according to their neurological outcomes and identify prognostic features.

Methods

We collected clinical and biological data consecutively from 595 patients who presented OHCA and were routed to a single regional cardiac arrest centre in the south of France. We applied recursive feature elimination and ML analyses to identify the main features associated with a good neurological outcome, defined as a Cerebral Performance Category score less than or equal to 2 at six months post-OHCA.

Results

We identified 12 variables 24 h after admission, capable of predicting a six-month good neurological outcome. The best model (extreme gradient boosting) achieved an AUC of 0.96 and an accuracy of 0.92 in the test cohort.

Conclusion

We demonstrated that it is possible to build accurate, locally optimised prediction and prognostication scores using datasets of limited size and breadth. We proposed and shared a generic machine-learning pipeline which allows external teams to replicate the approach locally.
Transfer of probationers under EU law: Rehabilitation and the question of legitimacy in the Netherlands
Authors: Martufi Adriano , van Noorloos Marloes
Published: April 2024

This article analyses the thorniest issues raised by the implementation in the Netherlands of Framework Decision 2008/947/JHA, often referred to as ‘European Probation Order’. It delves into Dutch law and practice regarding mutual recognition of probation measures and alternative sanctions and analyses how the Netherlands deals with principled questions with respect to the legitimacy of the transfer of probationers, both as a mechanism in itself and with respect to the ultimate goal of promoting social rehabilitation. The analysis focuses on (i) the basic tenets of the Dutch implementation (goals, competent authorities and application in Dutch legal practice); (ii) challenging issues regarding the types of probation measures and alternative sanctions eligible for recognition and the implementation of refusal grounds and (iii) how procedural rights and informed consent of the sentenced person are dealt with in relation to social rehabilitation.
Complex left appendage morphology is associated with Embolic Stroke of Undetermined Source
Authors: Nardi Agmon Inbar , Barnea Rani , Levi Amos , Murad Omar , Shafir Gideon , Naftali Jonathan , Schellekes Nadav , Shiyovich Arthur , Kornowski Ran , Auriel Eitan , Hamdan Ashraf ,   Cardiac CT for Undetermined Source of Embolic Stroke (CaCTUSES) Working Group
Published: April 2024

Introduction:

Variations in the left atrial appendage (LAA) morphology are associated with different embolic risk in patients with atrial fibrillation (AF). Data are scarce regarding the association between LAA morphology and Embolic stroke of undetermined source (ESUS).

Patients and methods:

Using cardiac computed tomography (CCT) scans, LAA morphology was categorized as either chicken wing (CW), cactus, windsock, or cauliflower. Furthermore, we examined the presence of large secondary lobes arising from the main lobe, considering their existence as indicative of a complex LAA morphology. LAA morphologies were compared between ESUS ( n = 134) and AF patients ( n = 120); and between ESUS patients with ( n = 24) and without ( n = 110) subsequent AF diagnosis during long-term follow-up.

Results:

ESUS patients had a significantly higher prevalence of cauliflower morphology compared to AF group (52% vs 34%, respectively, p = 0.01); however, no significant difference was found between the groups when categorizing LAA morphology to either CW or non-CW. ESUS patients had significantly higher prevalence of large secondary lobes compared with AF patients (50% vs 29%, respectively, p = 0.001). When comparing ESUS patients with and without AF diagnosis during follow-up (20–48 months of follow-up, median 31 months), there were no significant differences in the prevalence of the “classical” morphologies, but large secondary lobes were significantly more prevalent among those without subsequent AF diagnosis.

Conclusion:

ESUS patients have a high prevalence of complex LAA morphology, which might be associated with an increased risk for thrombus formation even in the absence of AF.
Brazilian housing movements and the right to the city
Authors: D’Ottaviano Camila
Published: April 2024

Since the 1970s, popular movements organized around the struggle for housing have been strong in São Paulo. Based on four central agendas – slums and precarious neighborhoods upgrading; better rental conditions; urban improvements and land tenure in peripheral subdivisions; and public funding for housing production – housing movements have consolidated as an essential political player in São Paulo, intersecting with the struggles for health, education, transportation, and urban infrastructure. With local action and national organization, São Paulo’s housing movements are responsible for empowering the community, qualifying their dialogue, preparing for confrontations with the public authorities, and ensuring access to housing through public programs via organized building squatting. This paper analyzes the importance of São Paulo housing movements and its prominent female participants in São Paulo in conquering social rights.
Evaluation of ChatGPT’s Response to Common Patient Questions for Total Ankle Arthroplasty
Authors: Gauthier Chase , Kung Justin , Bakaes Yianni , Gonzalez Tyler , Strasser Nicholas L. , Park Joseph , Jackson J. Benjamin
Published: April 2024

Introduction/Purpose:

Many patients use the internet as a source for medical information regarding their medical condition. However, the accuracy and reliability of the information is variable. The recent release of general population facing artificial intelligence (AI) chatbot programs has created a potential alternative medical information source for patients. Our study examined the accuracy of the information provided by ChatGPT for total ankle arthroplasty (TAA), as determined by four fellowship-trained foot and ankle orthopedic surgeons.

Methods:

GPT-4, the latest ChatGPT model, was asked the 12 of the most common questions patients have regarding TAA. Its responses were recorded and evaluated by four fellowship-trained foot and ankle orthopedic surgeons on a scale of 1 – 4, with 1 representing an excellent response not requiring clarification and 4 representing an unsatisfactory response requiring significant clarification. Averages of scores for each question were recorded and an average of every score was used to develop an overall accuracy score.

Results:

The overall accuracy score of GPT-4 was 1.35. The responses by GPT-4 received a score of 1 for 32 of 48 (66.7%) responses. There was found to be no significant difference in scores for any of GPT-4’s responses.

Conclusion:

Our study found that GPT-4 performed well in providing accurate and near complete information to commonly questions asked to physicians by patients regarding TAA. Our results suggest that AI models, like GPT-4, may be an effective alternative source of medical information for patients. Further study with subsequent AI models and direct patient interaction may shed further light on the utility of this potential patient education modality. ChatGPT Response Accuracy Score Accuracy scores for ChatGPT, as determined by four foot and ankle fellowship-trained orthopedic surgeons