bluuebunny/crossref_metadata_2025 huggingface dataset:
Patients’ perspectives on the challenges associated with receiving non-oral pulmonary arterial hypertension treatment: a mixed methods study
Authors: Aguirre-Camacho Aldo
Published: November 2024

Background:

Impaired quality of life (QoL) among pulmonary arterial hypertension (PAH) patients has been often attributed to increased symptomatology, functional disability, and poor mental health; however, the unique impact that PAH treatments may exert on the daily lives of patients remains underexplored.

Objectives:

To gain insight into the day-to-day challenges associated with receiving non-oral PAH treatments, and the specific impact these may exert on patients’ QoL, above and beyond that exerted by PAH itself.

Design:

Explanatory sequential mixed methods design.

Methods:

Eighty-three PAH patients provided information on demographic and clinical characteristics, and completed measures of symptomatology, functional disability, QoL, psychological well-being, and perceived stress. Nine of these patients also participated in a focused group discussion and interviews.

Results:

No group differences in symptomatology and functional disability were observed between patients receiving oral-only and non-oral PAH therapy; however, patients on non-oral therapy reported poorer QoL, after taking into consideration the effect of relevant covariates (i.e., age, level of symptomatology and functional disability, psychological well-being, and perceived stress) that could have confounded the observed group differences in QoL. Participants who started on non-oral medications acknowledged they had experienced significant improvements in health status. However, they also stated that transitioning from oral to non-oral therapy elicited great apprehension and that non-oral therapy regimens interfered with daily activities, resulted in added difficulties for self-management, and negatively impacted their subjective well-being.

Conclusion:

Non-oral therapy regimens may pose challenges beyond those posed by PAH itself, potentially resulting in an added burden to the QoL of PAH patients.
Addressing current challenges in population health intervention research for health promotion
Authors: Fillol Amandine , Fonquerne Leslie , Collange Fanny , Decroix Charlotte , Martin-Fernandez Judith , Aromatario Olivier , Lamy Sébastien , Delpierre Cyrille , Cousson-Gélie Florence , Cambon Linda
Published: November 2024

This article explores the role of population health intervention research (PHIR) in enhancing health promotion in France, stressing the importance of a more in-depth understanding and thorough analysis of healthcare interventions. Established in 2022, the So-RISP network aims to structure the PHIR field, consolidating expertise from renowned teams specializing in PHIR, primary cancer prevention, and addiction. In January 2023, So-RISP members convened a national workshop. The workshop aimed to share the specificities of PHIR and particularly to clarify the use of theories in PHIR. A qualitative analysis of this workshop was conducted to aid in building a shared and well-defined knowledge base for PHIR stakeholders. Results highlight the necessity of developing a unified terminology and increasing reflexivity among PHIR stakeholders for enhanced effectiveness. The article also identifies key challenges, including the need for interdisciplinary collaboration, facilitating social transformation, and integrating various contexts in intervention analysis.
Antibody–drug conjugates in patients with advanced/metastatic HER2-low-expressing breast cancer: a systematic review and meta-analysis
Authors: Michelon Isabella , Dacoregio Maria Inez , Vilbert Maysa , Priantti Jonathan , do Rego Castro Caio Ernesto , Vian Lucas , Tarantino Paolo , Azambuja Evandro de , Cavalcante Ludimila
Published: November 2024

Background:

Until recently, targeted therapies have failed to benefit patients with human epidermal growth factor receptor 2 (HER2)-low-expressing breast cancer (BC). Nevertheless, antibody–drug conjugates (ADCs) have reshaped their prognosis.

Objectives:

We performed a systematic review and meta-analysis to assess the effectiveness of ADCs in patients with HER2-low advanced/metastatic (a/m) BC.

Design:

This study is a systematic review and meta-analysis.

Data sources:

We searched PubMed, Embase, and Cochrane databases as well as the American Society of Clinical Oncology, European Society for Medical Oncology, and San Antonio Breast Cancer Symposium conference proceedings.

Methods:

Studies evaluating ADCs (trastuzumab deruxtecan (T-DXd), sacituzumab govitecan (SG), MRG002, and RC48-ADC) in patients with HER2-low a/mBC were included. We used R software (v.4.2.2) and random effects models for all analyses. Heterogeneity was assessed using the I2 test.

Results:

Overall, 14 studies were included (five real-world studies and nine clinical trials (CTs)), with 2883 HER2-low a/mBC patients: 808 received treatment of physician’s choice (TPC), and 2075 ADCs. Most were treated with T-DXd ( n = 1691), followed by SG ( n = 310), MRG002 ( n = 56), and RC48-ADC ( n = 18). Patients treated with T-DXd achieved a significantly higher objective response rate (ORR), disease control rate (DCR), and clinical benefit rate (CBR) than those receiving other ADCs. In the pooled analysis of four randomized CTs, ADCs statistically prolonged progression-free survival ( n = 1828, hazard ratio (HR) 0.50, 95% confidence interval (CI) 0.36–0.68, I2 = 82%, p < 0.001) and overall survival ( n = 1546, HR 0.70, 95% CI 0.57–0.86, I2 = 43%, p < 0.001) compared with TPC. Patients on ADCs also achieved a greater antitumor response than TPC, including better ORR (odds ratio (OR), 3.7, 95% CI 2.5–5.6, I2 = 59%, p < 0.001), DCR (OR, 2.7, 95% CI 2.1–3.5, I2 = 0%, p < 0.001), and CBR (OR, 3.6, 95% CI 2.6–5.2, I2 = 56%, p < 0.01).

Conclusion:

Our systematic review and meta-analysis confirms the efficacy of ADCs in HER2-low a/m BC patients over TPC. Future studies should focus on bringing ADCs into earlier lines of therapy in this population.

Trial registration:

This study was registered in PROSPERO (CRD42024452962).
Perspective review: lessons from successful clinical trials and real-world studies of systemic therapy for metastatic pheochromocytomas and paragangliomas
Authors: Jimenez Camilo , Baudrand Rene , Uslar Thomas , Bulzico Daniel
Published: November 2024

Pheochromocytomas and paragangliomas (PPGLs) are orphan tumors with the potential to spread to distant organs such as the lymph nodes, the skeleton, the lungs, and the liver. These metastatic tumors exhibit high rates of morbidity and mortality due to their frequently large tumor burden, the progression of the disease, and the excessive secretion of catecholamines that lead to cardiovascular disease and gastrointestinal dysmotility. Several molecular drivers responsible for the development of PPGLs have been described over the last 30 years. Although therapeutic options are limited, substantial progress has been made in the recognition of effective systemic therapies for these tumors. Successful clinical trials with radiopharmaceuticals such as high-specific-activity meta-iodobenzylguanidine and tyrosine kinase inhibitors such as cabozantinib and sunitinib have been recently published. This review will discuss the results of these studies and their impact on current clinical practices. In addition, this review will provide valuable information on how to design clinical trials to treat patients with metastatic PPGLs with novel medications.
Pharmacological and Therapeutic Biofunction of Dendrobium nobile: A Critical Review
Authors: Jain Archana , Sarsaiya Surendra , Gong Qihai , Wu Qin , Shi Jingshan
Published: November 2024

Dendrobium nobile ( D. nobile), an orchid species deeply rooted in traditional medicine, has garnered considerable attention for its potential pharmacological and therapeutic properties. This critical review provides a comprehensive analysis of the bioactive compounds present in D. nobile and explores their diverse pharmacological effects. The phytochemistry of D. nobile has been discussed, highlighting its major constituents and bioactive compounds with specific properties. The pharmacological profile of D. nobile has been investigated in various domains. Notably, its strong antioxidant activity and ability to scavenge free radicals have been shown to support its immune-modulating, anti-inflammatory, and neuroprotective effects. Intriguingly, these orchids display promising anticancer, antidiabetic, cardiovascular, renoprotective, hepatoprotective, and wound-healing properties. The mechanisms underlying these effects were explored, including molecular pathways and signalling cascades. However, factors influencing its chemical composition, such as environmental conditions, cultivation techniques, and postharvest processing, must be considered for consistent therapeutic outcomes. The safety and toxicity profiles derived from acute and chronic toxicity studies were examined. In future studies, exploring the untapped therapeutic potential and elucidating the intricate mechanisms of action are promising. This review underscores the pharmacological richness of D. nobile, revealing its potential to contribute to modern medicine while emphasising the need for further investigation to harness its full therapeutic benefits.
Cross-Cultural Adaptation and Validation of Foot and Ankle Ability Measure (FAAM) for Arabic-Speaking Patients
Authors: Almousa Sulaiman A.
Published: November 2024

Background

The original English Foot and Ankle Ability Measure (FAAM) is widely adopted to track changes in foot and ankle function. The aim of this study is to translate it to an Arabic version of FAAM (FAAM-A), and then to assess the validity and reliability of the FAAM-A version.

Methodology

One hundred five consecutive Arabic-speaking participants with different foot and ankle pathologies completed the FAAM-A. Fifty-six males and 49 females with a mean age of 39.8 years; 78.1% respondents have completed high school or higher. Convergent and divergent validities were assessed using correlation coefficients between the FAAM-A subscales and the short form-36 (SF-36), physical function (PF), physical component summary (PCS), mental health (MH), and mental component summary (MCS). Cronbach’s alpha was calculated to assess internal consistency. A subgroup of 20 participants filled the FAAM-A twice to test for test-retest reliability, using intraclass correlation coefficients (ICCs) and minimal detectable changes (MDCs).

Results

The average FAAM-A was 55.32 and 43.23 for the activity of daily life (ADL) and Sports subscales, respectively. FAAM-A ADL subscale had a moderate correlation with the PF, 0.565; PCS, 0.546; and MCS, 0.447; and a low correlation with MH, 0.34. The sports subscale had a moderate correlation with the PF (0.529), PCS (0.513), and a low correlation with MCS (0. 395) and MH (0. 297). Cronbach’s alpha was 0.97 and 0.95 for ADL and sports subscales, respectively. Intraclass correlation coefficient was 0.99 for both subscales. Minimal detectable change at a 95% confidence level was 6.81 and 8.19 for the ADL and sports subscales, respectively.

Conclusion

The FAAM-A is proven to be valid and reliable instrument for assessing foot and ankle disability. It is an effective tool for clinical assessment and research within Arabic-speaking populations.

Level of Evidence:

Level II, Prospective cohort study
Radiology-pathology correlation: Rosai–Dorfman disease
Authors: Benson John C , Pais Alex B , Mark Ian T , Tobin William O , Chen John J , Meyer Frederic B , Hunt Christopher H , Giannini Caterina
Published: November 2024

Rosai–Dorfman Disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare non-Langerhans cell histiocytic neoplasm. Although the disease classically presents as massive painless lymphadenopathy in young adults, RDD can also involve the central nervous system in some patients. CNS lesions, can cause headaches, neurologic deficits, and even neurologic deficits. The imaging appearance of CNS RDD typically mimics that of meningiomas: well-circumscribed dural-based lesions that often have dural tails. However, some imaging clues also exist that might help a radiologist recognize RDD, even before histopathologic confirmation. This radiology-pathology report of a patient with CNS RDD highlights the most pertinent clinical, imaging, and pathologic features of CNS RDD, and discusses what the neuroradiologist needs to know about the disease.
The impact of granulocyte colony-stimulating factor and decitabine-containing conditioning in myelodysplastic syndrome patients with iron overload undergoing allogeneic hematopoietic stem cell transplantation: a retrospective study
Authors: Zhao Wenshu , Zeng Xiangzong , Pan Danqi , Xuan Li , Fan Zhiping , Huang Fen , Xu Na , Sun Jing , Liu Qifa , Dai Min
Published: November 2024

Background:

Iron overload is considered an unfavorable prognosis in myelodysplastic syndrome (MDS) even in those undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although iron chelation therapy has improved the prognosis of these patients to some extent, the effect has not yet been satisfactory.

Objectives:

This study aimed to investigate the impact of granulocyte colony-stimulating factor and decitabine (G-DAC)-containing conditioning in iron-overloaded MDS patients undergoing allo-HSCT.

Design:

This was a retrospective study.

Methods:

One hundred and ninety-seven patients were enrolled in this retrospective study. Based on the level of serum ferritin (SF) and conditioning regimen, all patients enrolled were divided into four groups: SF < 1000 µg/L with G-DAC conditioning (cohort 1), SF < 1000 µg/L with non-G-DAC conditioning (cohort 2), SF ⩾ 1000 µg/L with G-DAC conditioning (cohort 3), and SF ⩾ 1000 µg/L with non-G-DAC conditioning (cohort 4). The clinical features and prognosis of the four groups were analyzed.

Results:

Significant differences in the 2-year overall survival (OS), disease-free survival (DFS), and the cumulative incidence of non-relapse mortality (NRM) were observed between the four groups. Multivariate analysis revealed that SF ⩾ 1000 µg/L was a risk factor for OS, DFS, and NRM while G-DAC-containing conditioning was a protective factor. Intriguingly, when cohort 1 to cohort 4 were included in the multivariate analysis, only cohort 4 was a risk factor for OS, DFS, and NRM, cohort 3 had no difference in prognosis compared with patients with SF < 1000 µg/L.

Conclusion:

The poor prognosis of patients with iron overload may be overcome by G-DAC-containing conditioning partly.
Synchronized application of closed-loop NMES and precision tACS in post-stroke hand rehabilitation: a protocol of neurorehabilitation trial
Authors: Tashiro Syoichi , Takemi Mitsuaki , Yamada Shin , Tsuji Tetsuya
Published: November 2024

Background:

Severe upper extremity paresis due to stroke is a significant clinical sequela. Neuromuscular electrical stimulation (NMES)-based rehabilitation has demonstrated promising results along with cortical plasticity. Transcranial alternating current stimulation (tACS) has gained attention due to its unique ability to entrain endogenous oscillatory brain rhythms with injected AC frequency, offering the potential for modifying brain conditions to enhance rehabilitative interventions. Because repetitive motor execution in rehabilitation training requires a smooth transition of the brain state despite often being impaired secondary to stroke, combining NMES and tACS may offer better treatment efficacy.

Aim:

This study proposes a phase I/II trial of an outpatient comprehensive rehabilitative treatment combining the integrated volitional-control electrical stimulation (IVES), a closed-loop NMES, and the timing-specified focal tACS in individualized beta frequency (dynamic-precision tACS) targeting severe hand paresis in patients with chronic stroke, aiming to demonstrate the feasibility of combination treatment.

Design:

Double-blind randomized cross-over trial.

Methods:

The repetitive facilitative finger extension training utilizing closed-loop NMES is combined with dynamic-precision tACS on the primary motor cortex to assist post-movement beta-rebound. Together with regular occupational therapy, we propose a comprehensive outpatient neurorehabilitative regimen. Here, a total of 10 sessions will be conducted using a cross-over design using real and sham tACS.

Analysis:

The perception and fatigue from stimulation will be investigated as the primary outcomes. The efficacy of improving sensorimotor function and their background physiological mechanisms will be evaluated as the secondary outcomes.

Discussion:

This phase I/II trial will be the first to combine tACS and neurorehabilitation using functional electrical stimulation. A weekly outpatient protocol with cheap devices may offer a new treatment paradigm toward functional recovery for chronic stroke patients with severe upper extremity paresis.

Ethics and trial registration:

This study was approved by the Ethics Committee of Kyorin University Faculty of Medicine (814-01). The trial was registered in a public database: UMIN000048274.
Social disparities on PrEP use and awareness among sexual and gender minorities using smartphones in India
Authors: Agarwal Harsh , Yeatts Karin , Chung Stephanie R. , Harrison-Quintana Jack , Torres Thiago S.
Published: November 2024

Background:

Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention strategy. However, in countries such as India where PrEP is driven by the private healthcare system and there is no centralized reporting, it is unknown which populations benefit from PrEP and which populations are being left behind.

Objectives:

We examined and characterized PrEP use and awareness among the sexual and gender minorities using smartphones in India and found measures of association of PrEP use.

Design:

This is a cross-sectional study design.

Methods:

We used Grindr—a widely used geosocial mobile application—to conduct a national cross-sectional survey in India, including respondents who were 18 years or older and reported sex with men (those who identified as cis-gender females were excluded). We examined overall PrEP awareness and PrEP use, then calculated adjusted prevalence odds ratio and 95% confidence intervals to understand PrEP use correlation with socio-behavioral factors.

Results:

Out of the total of 3116 eligible participants, 30.3% ( N = 947) were aware of PrEP and 3.1% ( N = 97) reported current PrEP use. Our multivariate regression model found that there was a statistically significant association of PrEP use with higher income, being employed, preferred language as English for survey, relationship status as single, and use of party drugs. At the same time, there was a statistically significant association of PrEP awareness with age group, having higher education as a graduate or above, higher income, use of party drugs, and multiple sexual partners.

Conclusion:

We found overall low awareness and low PrEP use in our cross-sectional sample. PrEP use and awareness were higher among those who belonged to higher-income groups. Including PrEP in existing programmatic interventions by government and NGOs may contribute to PrEP scale-up, which is urgent to stop the HIV epidemic in India.
Upper limb disabilities and associated factors among breast cancer survivors: A quantitative cross-sectional study
Authors: John Davidson Okwudili , Amaeze Augustine , Ransome Onyinyechi Peace , John Jeneviv Nene , Okezue Obinna Chinedu , Iyare Oluwatoyin , Ugwu Ngozi Immaculata
Published: November 2024

Objectives:

Complications following breast cancer treatment result in chronic upper limb disabilities. To plan an informed and effective rehabilitation for timely intervention to prevent, mitigate, or manage the functional impairments for breast cancer survivors, especially in settings with limited resources, the burden of upper limb disabilities needs to be ascertained. This study examined upper limb disabilities and associated factors among breast cancer survivors.

Methods:

This cross-sectional quantitative study recruited 60 breast cancer survivors using purposive sampling method. Text messages and face-to-face interactions were used to inform participants about the study. Disability of the Arm, Shoulder and Hand questionnaire was used to ascertain the upper limb disabilities. To determine lymphedema, tape measurements of upper limb circumference were translated into a limb volume with the geometric formula for a truncated cone. Visual analogue scale, hand dynamometer, and goniometer were used to measure pain, grip strength, and shoulder range of movement, respectively. Descriptive statistics were used to summarize data. Linear regression was used to determine the correlation between upper limb disabilities and selected variable. Alpha level was set at p < 0.05.

Result:

The prevalence of upper limb disabilities was 73%. Pain, lymphedema, shoulder range of movement, and grip strength showed strong correlation with upper limb disabilities. Pain and lymphedema increased by around 0.095 and 0.061 units, respectively, for every unit increase in disability. Conversely, there was a decrease of 1.394, 0.770, 0.285, and 0.045 in shoulder flexion, shoulder abduction, grip strength, and body mass index, respectively, for every unit increase in disability.

Conclusion:

Upper limb disabilities had high prevalence and significantly correlated with every variable that was examined. The high prevalence of upper limb disabilities and their interaction with related variables calls to action for routine screening and prompt intervention to identify, prevent, or manage upper limb functional impairments in breast cancer survivors.
Renal function outcomes in living kidney donors in a transplant center in Colombia
Authors: Torres Rodolfo , Reina Maricely , Montero Camilo , Tunjano Andres , Andrade David , Mancera Valeria , Amaya Maria , Arias Lizeth , Castellanos Laura , Vanegas Valentina
Published: November 2024

Introduction:

Living kidney donation is currently low in Colombia, and this is associated with the lack of knowledge of the risks and renal function outcomes of potential donors; there are no studies that evaluate these outcomes. The objective of this study is to evaluate the outcomes of renal function, the incidence of metabolic diseases, arterial hypertension, as well as the finding of albuminuria and/or proteinuria in living kidney donors with a 2-year follow-up post donation.

Methods:

Observational study in living kidney donor patients, in which renal function outcomes were evaluated between the predonation period and up to 24 months postdonation.

Results:

Ninety-one patients were included, with a median predonation glomerular filtration rate of 98 ml/min/1.73 m2, interquartile range (90.5–109), and 24-month postdonation of 66.3 ml/min/1.73 m2 interquartile range (57.9–75). A total of 60.26% of the population was in stage 2 at the end of follow-up and no patient had a glomerular filtration rate less than 30 ml/min/1.73 m2 or required renal support therapy.

Conclusion:

A living donor evaluation process based on risk factor stratification and adequate assessment of renal function was found to generate safe renal function outcomes both in the perioperative period and in medium- and long-term follow-up.
Exploring ideal nasal aesthetics in Thailand: Trends and participants’ awareness of rhinoplasty
Authors: Kaewsomnuk Chunanuch , Suetrong Surapol , Reechaipichitkul Wisoot , Chainansamit Seksun , Kasemsiri Pornthep , Komany Kan , Piromchai Patorn
Published: November 2024

Backgrounds:

Beauty standards vary across cultures and regions. To date, no research has identified ideal nasal profiles for Thai individuals. This study aims to determine the preferred nasal aesthetics among the Thai population.

Methods:

This cross-sectional study employed an online self-assessment questionnaire to investigate the ideal nasal profiles among Thai adults aged 18–60. Data were collected from participants across all regions of Thailand and included demographic information, rhinoplasty intentions, and perceptions of ideal nasal features.

Results:

Of the 1452 respondents, 35.74% (519 individuals) have either undergone or plan to undergo rhinoplasty, while the remaining 64.26% (933 individuals) expressed either no interest or uncertainty about the procedure. The ideal nasolabial angle was found to be between 97 and 108 degrees for males and 88 to 98 degrees for females, respectively. Male participants in the rhinoplasty and control groups exhibited statistically significant differences in nasolabial angle ( p = 0.017), nasofrontal angle ( p < 0.001), and alar-intercanthal distance ratio ( p < 0.001). Female participants demonstrated statistically significant differences between groups in nasofacial angle ( p < 0.001) and nasolabial angle ( p < 0.001).

Conclusions:

Our study identified distinct ideal nasal profiles among the Thai general population and those considering rhinoplasty. Our findings differed from the neoclassical orbitonasal proportion (canon V). These findings offer insights into contemporary Thai beauty standards for the nose, which can inform clinical decision-making in nasal treatment.
“UPDATE: I’m pregnant!”: Inferring global downloads and reasons for using menstrual tracking apps
Authors: Rampazzo Francesco , Raybould Alyce , Rampazzo Pietro , Barker Ross , Leasure Douglas
Published: November 2024

Objective

The market for smartphone apps tracking menstrual cycles has expanded in recent years. These apps market themselves as empowering users to achieve their reproductive goals and maximize the chance of pregnancy. This paper presents the first open-access quantification of menstrual tracking app downloads globally, covering both the Global North and South. We also explore macro and micro-level reasons for app usage, testing national associations with downloads and analyzing user reviews.

Methods

We use data on app installations, reviews, and ratings from the Google Play Store and Apple App Store to estimate global app downloads using a Bayesian model. We perform regressions to test for national predictors of use, and multilingual topic models to analyze/cluster reviews left by users to understand individual reasons for use.

Results

We find that the majority of downloads are for three apps: Clue, Flo, and Period Tracker. Higher modern contraceptive prevalence and internet access are associated with more downloads, while low-income countries tend to have fewer. In low-income countries, a higher unmet need for family planning and total fertility rate are associated with more downloads. Individual reviews reveal the most common reasons for use are menstrual cycle tracking, achieving a pregnancy, community engagement, and avoiding pregnancy.

Conclusion

Existing research on menstrual tracking apps is largely confined to the Global North, but our study finds the use of these apps to be as prevalent throughout the Global South. Future research needs to urgently understand the implications these apps could have in a diversity of contexts.
Grieving World of Warcraft’s Chinese server shutdown
Authors: Xu HongLan , de Wildt Lars
Published: November 2024

Twenty years of game scholarship established that players form profound attachments to the virtual worlds and inhabitants of Massively Multiplayer Online [MMO-]games, that are near-indistinguishable from their attachment to offline relationships. However, the shutdown of World of Warcraft’s Chinese servers on January 24th, 2023, ended those attachments on a massive scale for millions of players, after 18 years. How did Chinese players experience and grieve their loss after the World of Warcraft [ WoW] server shutdown? By examining this online catastrophic event, we research the shadow-side of attachment: grief over the loss of one’s online home, body, labor, community, and memories of formative life events. Through a multi-sited ethnography we take a social-constructionist approach to study the grief of Chinese players: on Taiwanese WoW servers, WeChat groups, online forums, and Bilibili, where they collectively mourn this large-scale case of massively multiplayer online loss. Juxtaposing our findings with existing research on MMO attachment, our analysis shows how players expressed grief over the loss of (1) their world, (2) their virtual body, (3) their hard work, (4) their friends and social network, and over (5) their nostalgia for an intimate part of their lives. We conclude that, counter to the implicit project of previous scholarship, online and offline attachment are different precisely because of the paradoxically material and ultimately ephemeral nature of virtual worlds, as revealed by the Chinese WoW server shutdown. MMO games indeed feel just as real, embodied, and social as offline everyday life: until the switch is flipped. As such, all online worlds include the looming but inevitable possibility of their complete erasure: of their world, its inhabitants, and all they hold dear.
The Interrelationships Between Young English-as-a-Foreign-Language (EFL) Learners’ Perceived Value in Reading Storybooks, Reading Self-efficacy, and Proficiency
Authors: Tsang Art , Yeung Susanna Siu-sze
Published: November 2024

Despite much attention having been paid to foreign language (FL) reading and related variables such as self-efficacy, relatively few studies have focused on young learners, and even fewer on storybooks, arguably the commonest genre read by children worldwide for language learning. As FL learning commences at a young age in many contexts globally, it is of importance to examine how FL children’s perceptions of storybooks and reading self-efficacy relate to their proficiency. In the present study, 96 Grade 5 English-as-a-foreign-language (EFL) learners in Hong Kong completed a questionnaire (measuring their perceived value in English storybooks and English reading self-efficacy) and various proficiency tests (vocabulary size, word reading, reading fluency, and reading comprehension). Drawing on Expectancy-Value Theory (EVT), the interrelationships between the variables were analyzed using hierarchical regression and mediation. The findings revealed that self-efficacy was a significant positive predictor of all aspects of EFL proficiency while value was predictive of vocabulary and word reading only. Self-efficacy was also found to be a significant mediator between value and some areas of proficiency investigated. The study advances our understanding of EVT in which value and self-efficacy seem to have stronger predictive power of lower-order aspects of proficiency (vocabulary size and word reading) than a higher-order aspect (reading comprehension). The article ends with a brief discussion of the implications of the findings.
Papillary Muscle Rupture in the Setting of Streptococcus lutetiensis Endocarditis
Authors: Leker Kristy , Patel Arti , Zahid Annam
Published: November 2024

Papillary muscle rupture is commonly linked to ischemic events, occurring typically postmyocardial infarction. However, iatrogenic and nonischemic etiologies can play a role in papillary muscle rupture, including infective endocarditis. The case presented herein is an 85-year-old female with a history of heart failure with preserved ejection fraction (HFpEF), who presented with progressive dyspnea despite furosemide therapy, and was discovered to have a flail posterior mitral valve leaflet secondary to papillary muscle rupture associated with Streptococcus lutetiensis endocarditis. Transthoracic echocardiography revealed flail posterior mitral valve leaflet with newly appreciated severe wide-open mitral regurgitation. Emergent mitral valve repair was performed with a successful MitraClip placement. Patient had an atypical presentation without ischemic symptomology or electrocardiogram (EKG) changes indicative of ischemia. Despite transesophageal echocardiography, not revealing vegetations, infective endocarditis was presumed due to presence of Streptococcus lutetiensis bacteremia, osteomyelitis, elevated inflammatory markers, and clinical presentation. Papillary muscle rupture results in severe mitral regurgitation that is a medical emergency that requires prompt diagnosis and management from a multidisciplinary team. Therefore, it is imperative to ensure clinical insight into the multiple etiologies of papillary muscle rupture to provide timely treatment.
AI Awareness and Motivation to Learn in Leading AI-Powered Business Communication
Authors: Başar Ufuk , Tekeoğlu Aşkım Nurdan Tümbek , Demir Ayşegül
Published: November 2024

This research aimed to determine whether employees’ digital leadership perceptions were related to their attitude toward using AI-powered business communication tools, whether their AI awareness had a mediating role, and whether their motivation to learn had a moderating role in this process. This cross-sectional research collected data from 354 white-collar employees from a telecommunication company through a questionnaire survey. Results indicated that participants’ digital leadership perceptions resulted in a positive attitude toward using AI-powered business communication tools. Participants’ AI awareness mediated this relationship, and their motivation to learn moderated the relationship between digital leadership perceptions and AI awareness.
No Matter How You Slice It, Black Students Are Punished More: The Persistence and Pervasiveness of Discipline Disparities
Authors: Darling-Hammond Sean , Ho Eric
Published: November 2024

Years ago, a groundbreaking review of student data from the 2013–2014 school year indicated that Black students were overrepresented among those experiencing punishment in a variety of contexts. In the intervening decade, new data has emerged, schools have implemented policies to reduce racial disparities, researchers have highlighted new methods of measuring disparities, and pundits have reignited debates about the degree and pervasiveness of disparities. Clarity is needed. Are Black students experiencing more exclusion and punishment than their peers? If so, of what kinds and in what contexts? This article responds by reviewing the most recent federal data, measuring Black overrepresentation across six types of punishment, three comparison groups, 16 subpopulations, and seven types of measurement. We generate 1,581 unique estimates of Black overrepresentation and find evidence that, no matter how you slice it, Black students are overrepresented among those punished. We conclude with policy recommendations to reduce widespread and enduring racial disparities.
NGSS-Designed Curriculum Materials for the Middle Grades: Results from a Study on Student Learning in Physical Science
Authors: Murphy Robert F. , Harris Christopher J. , Feng Mingyu , Iveland Ashley , Rego Melissa , Rutstein Daisy , Huang Kevin
Published: November 2024

A new generation of science curriculum materials is being developed and made widely available across K–12. These materials, along with their associated professional learning, are expected to play a pivotal role in transforming science instruction to meet the vision of A Framework for K–12 Science Education and the performance expectations of the Next Generation Science Standards. This study investigated one of the first widely available middle school curriculum programs designed for the NGSS, Amplify Science 6–8. The study team conducted a randomized experiment to examine the implementation and efficacy of the middle school curriculum program (materials plus teacher professional learning) for improving seventh grade students’ learning in physical science. Findings show that students in schools where the program was implemented significantly outperformed peers in the comparison condition on an NGSS-focused physical science assessment. These findings underscore the importance of conducting additional research on NGSS-designed curriculum programs across other grade levels and within different science domains.
The White Way to Hire Presidents: Racism in the Search and Appointment Process
Authors: Liera Román , Ching Cheryl D. , Rall Raquel M. , Chase Megan M. , Bensimon Estela M.
Published: November 2024

In this critical qualitative study, we draw on interviews with sitting Presidents of Color in one state to explore the racialized dimensions of the college and university presidential search and appointment process. Informed by Ray’s racialized organization tenets of whiteness as a credential and racialized agency, our findings show that participants felt hyper-scrutinized and judged against white, masculine standards, norms, and expectations and had to endure explicit and implicit undermining of their potential for campus leadership. Our findings provide practice implications and recommendations for making presidential searches and appointments in higher education more racially equitable and inclusive.
Mathematics Motivation and Mathematics Performance: Does Gender Play a Role?
Authors: Bohrnstedt George W. , Zhang Jizhi , Li Mengyi , Ikoma Sakiko , Park Bitnara Jasmine , Broer Markus
Published: November 2024

Using structural equation modeling, a previous study investigated the longitudinal relationships of role-related mathematics identity, efficacy, and interest to grade 12 mathematics performance. The results indicated that both mathematics identity and educational expectations at grade 11 were statistically and substantively significant predictors of grade 12 mathematics achievement in the presence of other factors such as grade 9 mathematics achievement, high school mathematics coursetaking, educational expectations at grades 9 and 11, as well as student and school background socio-demographic factors. The current study uses multiple group structural equation modeling and shows that the model derived in the previous study holds for males and females equally well. The study also found that females’ levels of motivation (except for interest) were lower than males’ at both points in time and that the males’ and females’ means on the motivation variables declined equally from grade 9 to grade 11. Implications of the findings are discussed.
“It was not normal, and I had to find a doctor and tell him.” Kenyan Women's Response to Cervical Cancer Symptoms
Authors: Mkuu Rahma , Hungu Charity , Makokha Francis , Harvey Idethia , Kithaka Benda , Mweni Sharon , Mungo Chemtai , Rivero-Mendoza Daniela , Hall Jaclyn M. , Mutegi Joystacy , Ochieng Dorothy , Kaindi John , Horsburgh K. Ann , Fisher Carla , Salloum Ramzi G.
Published: November 2024

This study aimed to characterize the cervical cancer diagnosis experience of Kenyan women undergoing treatment for cervical cancer. We analyzed qualitative interviews with 29 women living in rural Kenya who were currently undergoing cervical cancer treatment at Machakos Cancer Care and Research Centre at Machakos Level 5 Referral Hospital in eastern Kenya. Semistructured qualitative interviews were conducted in Kiswahili and English and then de-identified and translated to English during transcription. The main themes generated were identified through an inductive approach to determine how women experienced cervical cancer symptoms and their process of navigating healthcare. Three themes emerged from the qualitative interviews: (1) delaying seeking care, (2) misinterpreting or misdiagnoses, and (3) grappling with the costly diagnosis process. Women misattributed early signs of cervical cancer to benign conditions. Women sought care only after experiencing severe symptoms. When they sought care, women reported facing lengthy and costly screening processes before receiving a cervical cancer diagnosis. There is a need to educate women on the early symptoms of cervical cancer and to increase the institutional capacity and availability of cervical cancer screening resources in healthcare facilities.
Book review: Christian Strümpell, Steel Town Adivasis: Industry and Inequality in Eastern India
Authors: Noy Itay
Published: November 2024

Christian Strümpell, Steel Town Adivasis: Industry and Inequality in Eastern India (New Delhi: Social Science Press, 2023), 390 pp., ₹1,375, ISBN: 9789383166572 (Hardback).
Deep reinforcement learning for spatial resource allocation: A case study of school districting
Authors: Zhang Di , Mu Senlin , Mango Joseph , Li Xiang
Published: November 2024

Spatial resource allocation is a multi-objective spatial optimization problem with multiple constraints. The division of school districts is a classic problem of spatial resource allocation. This paper proposes a new dynamically districting optimization method based on deep reinforcement learning to optimize the global effect of school districting. In the proposed method, the school district’s constantly adjusted allocation process is regarded as a multi-step Markov decision-making process. The method combines the advantages of a deep convolutional neural network with reinforcement learning for real-time response and flexibility, and directly learns behavioural policies based on the input of changing school district states. According to various constraints, this algorithm optimizes the distance of students to school and the utilization rate of schools, and it proposes a better allocation plan. To demonstrate its validity, the proposed method was evaluated using real datasets of two school districts in the United States. The experimental results studied in six different scenarios show that, compared with traditional algorithms, the new proposed method requires less prior knowledge and is globally optimal, and can provide a better allocation plan for school districting, which reduces the distance between students and schools and balances the utilization rate of schools.
Implementation of a strategy to manage EMS COVID-19 patient disposition with physician consultation: A retrospective descriptive study
Authors: Summers James , Drennan Ian R , Turner Linda , Huiskamp Maud , Gorsline W Scott , Merko Michael , Hillier Morgan
Published: November 2024

Objective: During the COVID-19 pandemic, there was concern that those accessing the 9-1-1 system could overwhelm hospitals. To alleviate this strain, emergency medical services (EMS) in Ontario, Canada, implemented a medical directive allowing paramedics to assess, treat and discharge low acuity patients with suspected COVID-19. Consultation with an EMS physician was required to ensure patient safety. The goal of the study was to measure compliance with and safety of this strategy. Methods: In this retrospective study, we assessed applications of the directive within the catchment of the Sunnybrook Centre for Prehospital Medicine from 1 January 2021, through 31 March 2022. We also monitored whether non-transported patients accessed the 9-1-1 system again within 7 days. Results: Overall, 122 patients were considered by paramedics to have met the COVID-19 medical directive, and, therefore, an EMS physician was contacted. Of these, 53.7% (65/122) were female, and mean age (SD) was 46.8 years (SD 17), range 5 to 96 years. In only 20% (25/122) of cases were all patient assessment findings reported to the EMS physician and within the appropriate ranges specified in the medical directive. The EMS physician approved non-transport in 83% (101/122) of cases. Of those not transported, 12% (12/99) accessed 9-1-1 again within 7 days. Conclusions: We present a non-transport option for patient management, a novel concept within Ontario's paramedic regulatory framework. Assessments provided by paramedics included telephone consultation with EMS physicians. There were no instances in which patient safety was known to have been impacted. Needed is further study of non-transport strategies for low acuity patients that ensure patient safety and study of training strategies to enhance compliance with decision-making tools and joint decision making between paramedics and physicians regarding patient disposition.
Inflammatory Waldenström macroglobulinemia is associated with clonal hematopoiesis: a multicentric cohort
Authors: Debureaux Pierre-Edouard , Poulain Stéphanie , Harel Stéphanie , Passet Marie , Templé Marie , Friedrich Chloé , Forgeard Nathalie , Elessa Dikelele , Plas William , Chat Laureen , Lazarian Grégory , Willems Lise , Royer Bruno , Talbot Alexis , Vaugeois Tristan , Theves Floriane , Terré Alexandre , Brignier Anne , Malphettes Marion , Krzisch Daphné , Frenzel Laurent , Davi Frédéric , Bravetti Clotilde , Nguyen-Khac Florence , Dupuis Jehan , Cuccuini Wendy , Bouscary Didier , Hermine Olivier , Roos-Weil Damien , Kosmider Olivier , Clappier Emmanuelle , Espéli Marion , Balabanian Karl , Arnulf Bertrand
Published: November 2024

Inflammatory form of Waldenström macroglobulinemia (iWM) predicts outcomes after immuno-chemotherapy and Bruton tyrosine kinase inhibitors, but its origin is unknown. Here, we unravel increased clonal hematopoiesis in patients with iWM (61% vs 23% in noninflammatory WM), suggesting a contribution of environmental cells to iWM.
Single-cell sequencing of full-length transcripts and T-cell receptors with automated high-throughput Smart-seq3
Authors: Chuang Hsiu-Chun , Li Ruidong , Huang Huang , Liu Szu-Wen , Wan Christine , Chaudhuri Subhra , Yue Lili , Wong Terence , Dominical Venina , Yen Randy , Ngo Olivia , Bui Nam , Stoppler Hubert , Yi Tangsheng , Suthram Silpa , Li Li , Sun Kai-Hui
Published: November 2024

We developed an automated high-throughput Smart-seq3 (HT Smart-seq3) workflow that integrates best practices and an optimized protocol to enhance efficiency, scalability, and method reproducibility. This workflow consistently produces high-quality data with high cell capture efficiency and gene detection sensitivity. In a rigorous comparison with the 10X platform using human primary CD4 + T-cells, HT Smart-seq3 demonstrated higher cell capture efficiency, greater gene detection sensitivity, and lower dropout rates. Additionally, when sufficiently scaled, HT Smart-seq3 achieved a comparable resolution of cellular heterogeneity to 10X. Notably, through T-cell receptor (TCR) reconstruction, HT Smart-seq3 identified a greater number of productive alpha and beta chain pairs without the need for additional primer design to amplify full-length V(D)J segments, enabling more comprehensive TCR profiling across a broader range of species. Taken together, HT Smart-seq3 overcomes key technical challenges, offering distinct advantages that position it as a promising solution for the characterization of single-cell transcriptomes and immune repertoires, particularly well-suited for low-input, low-RNA content samples.