bluuebunny/crossref_metadata_2025 huggingface dataset:
Disinformation discourse as boundary work in journalism. A comparison between South Africa and France
Authors: Lunga Carolyne , Renaud Pauline
Published: May 2024

The COVID-19 pandemic has proved fertile ground for disinformation, confronting journalists with several challenges. Not only have they faced an unprecedented flood of fabricated stories, but they also had to report about a crisis while experiencing it themselves. This study analyses how journalists made sense of disinformation during the COVID-19 pandemic. Comparing the perceptions of journalists in South Africa and France, countries which are in the Global South and Global North, respectively, offers a new lens to the study of journalistic discourse and its functions in relation to the context it emerges from. Based on in-depth interviews with journalists in South Africa and France, this study argues that while journalistic discourses present many similarities when making sense of pandemic-related disinformation, they follow different patterns when discussing and affirming their professional authority in the face of this phenomenon.
Was thalidomide a placebo hypnotic?
Authors: Justman Stewart
Published: May 2024

Six decades ago the world learned that thalidomide, a seemingly non-toxic sedative and hypnotic, caused severe birth defects including the flipper-like deformity of the arms known as phocomelia. When thalidomide was tested against placebo by the trialist Louis Lasagna in 1960 (while the drug was banned from the U.S. marketplace), he found the 100-mg dosage equivalent to placebo, as well as greatly inferior to the 200-mg dosage, in producing sleep. Even as these findings were made known, a 100-mg dose of thalidomide was in general use as a sleep aid for pregnant women. It appears that unbeknownst to themselves, an untold number of pregnant women around the world who were prescribed thalidomide incurred the risks of a teratogen in return for the benefits of a sugar pill.
Deep Learning-Based Prediction of Radiation Therapy Dose Distributions in Nasopharyngeal Carcinomas: A Preliminary Study Incorporating Multiple Features Including Images, Structures, and Dosimetry
Authors: Wang Yixuan , Piao Zun , Gu Huikuan , Chen Meining , Zhang Dandan , Zhu Jinhan
Published: May 2024

Purpose: Intensity-modulated radiotherapy (IMRT) is currently the most important treatment method for nasopharyngeal carcinoma (NPC). This study aimed to enhance prediction accuracy by incorporating dose information into a deep convolutional neural network (CNN) using a multichannel input method. Methods: A target conformal plan (TCP) was created based on the maximum planning target volume (PTV). Input data included TCP dose distribution, images, target structures, and organ-at-risk (OAR) information. The role of target conformal plan dose (TCPD) was assessed by comparing the TCPD–CNN (with dose information) and NonTCPD–CNN models (without dose information) using statistical analyses with the ranked Wilcoxon test ( P < .05 considered significant). Results: The TCPD–CNN model showed no statistical differences in predicted target indices, except for PTV60, where differences in the D98% indicator were < 0.5%. For OARs, there were no significant differences in predicted results, except for some small-volume or closely located OARs. On comparing TCPD–CNN and NonTCPD–CNN models, TCPD–CNN's dose-volume histograms closely resembled clinical plans with higher similarity index. Mean dose differences for target structures (predicted TCPD–CNN and NonTCPD–CNN results) were within 3% of the maximum prescription dose for both models. TCPD–CNN and NonTCPD–CNN outcomes were 67.9% and 54.2%, respectively. 3D gamma pass rates of the target structures and the entire body were higher in TCPD–CNN than in the NonTCPD–CNN models ( P < .05). Additional evaluation on previously unseen volumetric modulated arc therapy plans revealed that average 3D gamma pass rates of the target structures were larger than 90%. Conclusions: This study presents a novel framework for dose distribution prediction using deep learning and multichannel input, specifically incorporating TCPD information, enhancing prediction accuracy for IMRT in NPC treatment.
Iliopsoas Bursitis Compressing an External Iliac Vein Stent
Authors: Butler Brandon , Baker Rebecca , Box Lyndon
Published: May 2024

We report a case of external iliac vein (EIV) compression due to iliopsoas bursitis. A 78-year-old man with a prior left total hip arthroplasty (THA) and left lower extremity (LLE) deep vein thrombus (DVT) presented with chronic LLE edema. Initial ultrasound examination revealed deep venous reflux and evidence of ipsilateral outflow vein obstruction. A left groin mass thought to be a hernia was noted. Conservative management was unsuccessful. Subsequent venography and intravascular ultrasound demonstrated severe stenosis of the distal EIV. A stent was placed but could not be fully expanded despite repeated venoplasty. Following the procedure, pelvic computed tomography (CT) showed extrinsic compression of the EIV and stent likely caused by iliopsoas bursitis.
Human–robot mechanics model using hip torque identification with a dual-arm nursing-care transfer robot
Authors: Yang Zhiqiang , Lu Hao , Chen Mengqian , Guan Qifei , Liu Qiming , Guo Shijie
Published: May 2024

In response to the growing demand for robotic interventions to mitigate the profound physical strain experienced by caregivers during transfers, dual-arm robotic systems have emerged as a focal point of interest in the caregiving community due to their adaptability and versatility. However, the accuracy of existing human–robot mechanics model is insufficient, impacting the execution of transfer tasks. To enhance the model’s precision, an improved model is proposed, integrating hip torque identification. This proposed methodology involves the simplification of the human structure based on the kinematic attributes associated with the embrace of individuals by robotic arms and the subsequent computation of its inertial parameters. Accordingly, the application of D’Alembert’s principle is employed to analyze the impact of embracing motion, human posture, and the position of human–robot contact on the forces exerted on the human. This culminates in the establishment of a model. Considering the static indeterminacy predicament inherent in the model, a biomechanical data set is curated for the dual-arm transfer scenario. Leveraging this data set, a deep neural network utilizing multilayer perceptron is trained to accurately identify hip torque, thereby improving the model. Accordingly, a robotic transfer platform featuring dual arms is developed and trailed on six subjects with varying anatomical profiles. The results show that the constructed model has high accuracy. This study provides critical mechanics insights for dual-arm transfer tasks, offering potential application value in the field of nursing and rehabilitation.
Lessons should be learned: Why did we not learn from the Spanish flu?
Authors: Köntös Zoltán
Published: May 2024

COVID-19 has become a global pandemic that has affected millions of people worldwide. The disease is caused by the novel coronavirus that was first reported in Wuhan, China, in December 2019. The virus is highly contagious and can spread from person to person through respiratory droplets when an infected person coughs, sneezes, talks, or breathes. The symptoms of COVID-19 include fever, cough, and shortness of breath, and in severe cases, it can lead to respiratory failure, pneumonia, and death. The Spanish flu, caused by the H1N1 influenza virus, and the COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 are two of the most significant global health crises in history. While these two pandemics occurred almost a century apart and are caused by different types of viruses, there are notable similarities in their impact, transmission, and public health responses. Here are some key similarities between the Spanish flu and SARS-CoV-2. The Spanish flu pandemic of 1918–1919 stands as one of the deadliest pandemics in human history, claiming the lives of an estimated 50 million people worldwide. Its impact reverberated across continents, leaving behind a legacy of devastation and lessons that, unfortunately, seem to have been forgotten or ignored over time. Despite the advancements in science, medicine, and public health in the intervening century, humanity found itself facing a strikingly similar situation with the outbreak of the COVID-19 pandemic. Additionally, amidst the search for effective measures to combat COVID-19, novel approaches such as iodine complexes, such as Iodine-V has emerged as potential interventions, reflecting the ongoing quest for innovative solutions to mitigate the impact of pandemics. This raises the poignant question: why did we not learn from the Spanish flu?
Lower gastrointestinal bleeding as a complication of enteric fever: A case report
Authors: Abay Zenahebezu , Bhat Naresh , Tadesse Abilo
Published: May 2024

Enteric fever is a systemic bacterial infection caused by enteroinvasive, gram-negative bacilli, named Salmonella enterica serovar typhi and Salmonella enterica serovar paratyphi. It presents with hectic fever, headache, malaise, bowel habit changes, and abdominal pain. Diagnosis is usually confirmed by blood culture. Gastrointestinal complications of enteric fever include intestinal bleeding, bowel perforation, pancreatitis, and cholecystitis. We encountered a case of lower gastrointestinal bleeding (hematochezia) as a complication of enteric fever. A 35-year-old male patient presented to Aster CMI hospital, India, with an intermittent fever of 2-week duration associated with dry cough, loss of appetite, abdominal pain, and generalized body weakness. Four days after admission, he experienced three episodes of lower gastrointestinal bleeding. Upon physical examination, he was hemodynamically stable and had a high-grade fever, mild hepatomegaly, tipped splenomegaly, and lower abdominal tenderness. Blood culture grew Salmonella typhi. Abdominal ultrasound showed ileocolonic thickening with enlarged mesenteric lymph nodes. Abdominal computed tomography scan displayed enlarged mesenteric lymph nodes with surrounding fat strands. A colonoscopy revealed multiple shallow, punched-out, and punctate ileocolonic ulcerative lesions, with stigmata of active bleeding at caecal ulcers. Colonoscopy-guided biopsy suggested multifocal active colitis favoring infective etiology. Diagnosis of blood culture-confirmed enteric ulcer was made. He was treated with ceftriaxone 1 g iv twice daily for 10 days and rehydrated with intravenous fluids. Adrenaline injection was done at the site of bleeding ulcers, and hemostasis was secured. Other additional medications were antipyretics, anti-emetics, multivitamins, and proton pump inhibitors. He was fever-free on the third day of admission and discharged after 10 days of hospital stay. He was appointed to follow-up clinic after a week. He was completely healthy on the day of the first follow-up clinic visit and planned to resume his duties. Enteric fever remains a common public health problem in most developing countries. Early suspicion and prompt institution of appropriate antibiotics are crucial in the reduction of systemic and local complications of enteric fever. Since gastrointestinal complications of enteric fever are less often encountered in the antibiotic era, clinicians should be cognizant of an enteric ulcer as a cause of lower gastrointestinal bleeding.
Roles of Entrepreneurial Resource Acquisition and Family Support in Internet Use and Women’s Entrepreneurial Competence
Authors: Wan Wei , Wu Hong , Hu Hui-Ling
Published: May 2024

Women have become an increasingly important force in entrepreneurship, and their relatively low entrepreneurial competence has aroused widespread attention from the academia. Drawing from the resource-based theory and the social support theory, this study aims to explore the impact of Internet use on women’s entrepreneurial competence and the roles of entrepreneurial resource acquisition and family support in this relationship. After collecting a sample of 328 women entrepreneurs in China, this study demonstrates that Internet use is positively related to women’s entrepreneurial competence, and this relation is partially mediated by entrepreneurial resource acquisition. Moreover, family support moderates the relation between Internet use and entrepreneurial resource acquisition as well as the mediating effect of entrepreneurial resource acquisition. The results of the current study contribute to revealing how Internet use affects women’s entrepreneurial competence, including its direct and indirect effects and boundary conditions. Practical implications for policy-makers and female entrepreneurs are also provided.
The Dilemma of Mouthpiece: Work Adjustment and Career Decision of News Presenters in Transformation of Chinese Broadcast Media
Authors: Cui Jiayong , Yi Youjun
Published: May 2024

Guided by the theory of work adjustment (TWA), this study endeavors to investigate the relationship between the work adjustment of news presenters and their career decisions. Taking into account the unique circumstances of the Chinese media landscape and the applicability of TWA, a qualitative research design was adopted, in which 35 news presenters were interviewed to generate data that could be coded to construct a theoretical framework. The findings reveal that the disenchantment of professional authority and the bureaucratic management of Chinese official media have resulted in a negative work adjustment experience for news presenters. However, the study discovered no substantial departure of current news presenters from the industry. Despite the unpleasant work adjustment experiences, the ultra-stability of their jobs offered by official media and the appeal of occupational fame have drawn news presenters back to their existing careers. This study constructed a contextual framework to comprehend the work adjustment phenomenon among Chinese state-affiliated institutions, and offered advice for media managers and students of Broadcasting and Hosting Art major.
Evaluation of Agricultural Sustainable Development and Analysis of Coupling Coordination in Food Security Areas from the Perspective of Food Security
Authors: Liu Liwei , Zhu Tianli , Dai Yingjie
Published: May 2024

Agriculture is the foundation of the national economy, and the issue of food security is the cornerstone of national development. Heilongjiang province is China’s largest commercial grain base. How to achieve the sustainable agricultural development of Heilongjiang province under the problem of food security is of great significance. This article takes the five aspects of population system, social system, economic system, resource system, and environmental system, with a total of 29 secondary indicators as the basis for evaluation, the sustainable development and coordination of agriculture in Heilongjiang from 2005 to 2018 were evaluated by using entropy method and coupling degree model. The evaluation results showed that development methods of extensive agriculture greatly increased the grain output of Heilongjiang province from 2005 to 2007, but the level of sustainable agricultural development continued to decline, and there were also threats to the long-term development of food security. Although the sustainable level had been continuously improved since 2007, the whole system is still in the stage of low-level coupling and serious maladjustment. From the results of each subsystem, the coordination degree of population-environment system continues to decline, and the coordination degree of resource-environment system fluctuates in the low-level coordination state, which indicates that there is an obvious development in coordination among subsystems in Heilongjiang province, which restricts comprehensive and coordinated development of agricultural system. Based on the empirical analysis, this article takes Heilongjiang province as an example, and puts forward suggestions for sustainable agricultural development from the perspective of ensuring food security.
Racial Disparities in Immediate Breast Reconstruction after Mastectomy: A Systematic Review and Meta-Analysis
Authors: Qazi Shurjeel Uddin , Aman Sarah , Wajid Muhammad Hassaan , Qayyum Zainab , Shahid Muhammad Bilal , Tanvir Alina , Javed Sania , Saeed Mahnoor , Razia Eesha , Nayyar Alina , Rehman Osama Abdur , Khosa Faisal
Published: May 2024

Background: In the past few decades, there has been a gradual increase in breast reconstruction post mastectomy; however, there exists a conflict about whether race has an influence on reconstruction rates. Methods: We conducted an electronic search from MEDLINE and Cochrane CENTRAL from their inception to September 2022. Primary outcome was disparity in rates of Immediate Breast Reconstruction (IBR) in racial minorities. Odds ratios were pooled using a random-effects model. All statistical analyses were performed on the Review Manager. Quality of included studies was assessed using the Joanna Briggs Institute critical appraisal checklist. Results: Twenty studies ( n = 1 840 671) were identified. The pooled analysis of all the studies showed that subjects in racial minorities were significantly less likely to receive IBR as compared to White subjects (OR = 0.62, [95% confidence interval: 0.57-0.68; P < .01, I2 = 97%]. Subgroup analyses revealed that Asian subjects were the least likely to undergo IBR among different minorities (OR = 0.43). Conclusion: There exists a significant disparity in rates of IBR in different racial minorities as compared to White subjects. Future studies are warranted to assess factors contributing to such disparities in provision of healthcare.
Perioperative Management of Antithrombotic Therapy in Patients Undergoing Plastic and Reconstructive Surgery: A Practical Tool Based on Current Guidelines
Authors: Behroozian Tara , Fang Evan , Douketis James , Retrouvey Helene , Thoma Achilles
Published: May 2024

Introduction: Given the aging population, plastic surgeons are increasingly faced with the challenge of balancing procedural bleeding risk with thromboembolic risk in patients receiving antithrombotic therapies undergoing elective procedures. Guideline recommendations remain unclear in this population, which contributes to heterogeneity in clinical practices. We present a practical approach that summarizes guideline recommendations to facilitate the perioperative management of patients requiring surgery who are already on antithrombotic agents. Methods: Due to the scarcity of plastic surgery-specific guidelines, recommendations were primarily adapted from the 2022 American College of Chest Physicians guidelines on perioperative management of antithrombotic therapy as they are recognized as authoritative and widely used in clinical practice. Results: A clinical practice conceptual framework was adapted based on preexisting guidelines, dividing decision-making into 3 steps: (1) assessing the procedural bleeding risk; (2) assessing the patients’ thromboembolic risk; and (3) determining appropriate management according to antithrombotic agent type. Specific indications are provided for continuing, stopping, and bridging anticoagulants and antiplatelet agents, as well as for consultation with a cardiologist or hematologist. Conclusion: The present framework can be implemented in plastic surgeons’ clinical practice to guide the management of patients on antithrombotic therapies, while minimizing nonessential referrals to the thrombosis service. The lack of plastic surgery-specific guidelines on this topic highlights a need for further research to “bootstrap” the risk categorization of plastic surgical procedures and their appropriate perioperative management.
Toward an Ethnoracial Ontology for the Study of Race and Ethnicity: The Case of African Americans and Black Immigrants in the United States
Authors: Ifatunji Mosi Adesina
Published: May 2024

One of the central issues in the study of race and ethnicity is ontology. That is, after decades of scientific inquiry, we continue to debate definitions for race and ethnicity. Broadly speaking, the questions that frame this debate are: what is race, what is ethnicity, are they the same, or are they different? As this debate continues, many are using an amalgamated term— ethnoracial. However, there is yet no formal definition or ontology for this term. Indeed, most seem to use it to avoid getting entangled in the often contentious and still ongoing debate on ontologies for race and ethnicity. That is, most seem to use this term to avoid questions and concerns associated with the underlying ‘nature’ of these group formations and, instead, seek to focus the readers’ attention on their descriptions of and explanations for the associated intergroup identities, conflicts and disparities. Within this context, and given certain anomalies I have come across in my studies of the relative positioning of African Americans and Black immigrants in the United States, I am calling for the formal development of a new ontology for the study of race and ethnicity. The crux of my argument is that, since processes of racialization and/or ethnogenesis emerge in the wake of human migrations—to include international migration, internal migration, colonialism, and slavery—they yield a single underlying ontology— ethnoraciality.
Kids, courts and canines: Evaluating the Justice Facility Dog Program through a therapeutic lens in the Perth Children's Court
Authors: Rock Suzanne , Gately Natalie
Published: May 2024

Court environments can be stressful and induce anxiety in victims, witnesses, and other court users. Taking heed from justice facilities in other jurisdictions, the Children's Court of Western Australia introduced Winston, a justice facility dog, at the Perth Children's Court facility to help reduce the stress and anxiety of victims, witnesses, and court users. This article presents survey ( n = 55) and interview data ( n = 17) from staff and stakeholders who reported positive changes in the court atmosphere, with limited negative impacts on the running of the court. Surveys were also conducted with child victims/survivors ( n = 13), caregivers ( n = 44), and other court users (including accused young people; n = 23). Children and caregivers’ results indicated significantly reduced stress and anxiety levels associated with attending the Children's Court after interacting with the facility dog. When analysed through a lens of therapeutic jurisprudence, the positive impacts on court-user well-being and limited impact on the court and legal processes solidified the therapeutic principles of the program. The findings of this study highlight that justice systems could implement similar positive therapeutic programs at other courts to reduce negative impacts on people attending and working at the facilities.
Promoting teaching improvement in elementary mathematics: A case with inverse relations
Authors: Ding Meixia , Mochaourab Rana , Spiro Benjamin
Published: May 2024

In this study, we examine two U.S. elementary teachers’ use of worked examples, representations, and deep questions in elementary mathematics lessons both before and after a project intervention designed to promote teaching improvement. This intervention was guided by a cognitive construct containing these three aspects, which were demonstrated via cross-cultural video lessons of both U.S. and Chinese teachers. We specifically analyze two teachers (Ann and Bea) who taught first-grade lessons on the topic of inverse relations. Although their lessons were rated similarly in year 1, the rating of their lessons in year 4, post-intervention, demonstrated different patterns of change. While Ann's use of worked examples and representations underwent no significant improvement, Bea spent more time unpacking a single worked example with a representational sequence fading from concrete to abstract (also called “concreteness fading”). Neither teacher showed improvement in asking deep questions. An analysis of the teachers’ responses to the project intervention revealed that their video noticing skills and personal takeaways were related to the areas of teaching where they improved. Other factors such as teachers’ prior knowledge, beliefs, and textbook resources, also played a role in teaching changes. These findings shed light on a recent endeavor called the “science of improvement” in mathematics teaching, which seeks to document teaching changes and the underlying mechanisms that might induce these changes. Implications for both research and practice are discussed.
Gaps during pediatric to adult care transfer escalate acute resource utilization in sickle cell disease
Authors: Howell Kristen E. , Kayle Mariam , Smeltzer Matthew P. , Nolan Vikki G. , Mathias Joacy G. , Nelson Marquita , Anderson Sheila , Porter Jerlym S. , Shah Nirmish , Hankins Jane S.
Published: May 2024

Guidelines recommend transfer to adult health care within 6 months of completing pediatric care; however, this has not been studied in sickle cell disease (SCD). We hypothesized that longer transfer gaps are associated with increased resource utilization. Transfer gaps were defined as the time between the last pediatric and first adult visits. We estimated the association between varying transfer gaps and the rates of inpatient, emergency department (ED), and outpatient visits, using negative binomial regression. Health care utilization was evaluated in a mid-south comprehensive program for a follow-up period of up to 8 years (2012-2020) and was restricted to the first 2 years of adult health care. In total, 183 young adults (YAs) with SCD (51% male, 67% HbSS/HbSβ0-thalassemia) were transferred to adult health care between 2012 and 2018. YAs with transfer gaps ≥6 months compared with <2 months had 2.01 (95% confidence interval [CI], 1.31-3.11) times the rate of hospitalizations in the 8-year follow-up and 1.89 (95% CI, 1.17-3.04) when restricted to the first 2 years of adult health care. In the first 2 years of adult care, those with transfer gaps ≥6 months compared with <2 months, had 1.75 (95% CI, 1.10-2.80) times the rate of ED encounters. Those with gaps ≥2 to <6 months compared with <2 months had 0.71 (95 % CI, 0.53-0.95) times the rate of outpatient visits. Among YAs with SCD, a longer transfer gap was associated with increased inpatient and decreased outpatient encounters in adult health care and more ED encounters in the first 2 years of adult health care. Strategies to reduce the transfer gaps are needed.
Utility of microRNA analysis in exhaled breath condensate of sarcoidosis and mediastinal tuberculosis patients: a pilot study
Authors: Pattnaik Bijay , PB Sryma , Bhatraju Naveen , Mittal Saurabh , Arava Sudheer , Jain Deepali , Nayak Baibaswata , Tiwari Pavan , Hadda Vijay , Mohan Anant , Agrawal Anurag , Guleria Randeep , Madan Karan
Published: May 2024

Background

Sarcoidosis and tuberculosis (TB) are the two most common causes of granulomatous mediastinal lymphadenopathy. These often exhibit overlapping clinical and radiological characteristics, rendering accurate diagnosis difficult. MicroRNA (miRNA) analysis is increasingly utilised as a potential biomarker for various diseases. Exhaled breath condensate (EBC) is a noninvasive technique for biomarker evaluation in different respiratory conditions. We attempted to identify differentially expressed miRNAs in the EBC of sarcoidosis and mediastinal TB patients.

Methods

EBC was obtained from subjects with a definitive diagnosis of sarcoidosis and mediastinal TB. EBC was also obtained from age- and sex-matched control subjects. From EBC, miRNA isolation, cDNA preparation and qPCR array were performed. Differentially expressed miRNAs were shortlisted. Further validation was conducted in the EBC of a new subset.

Results

Subjects with a definitive diagnosis of sarcoidosis (50) and TB (50), and control subjects (50) were included. qPCR array from EBC (20 subjects from each group) shortlisted eight differentially expressed miRNAs (miR-126, miR-132, miR-139-3p, miR-139-5p, miR-181c, miR-454, miR-512-3p and miR-362-5p). In the validation set (EBC of 30 subjects from each group), miR-126 and miR-132 were differentially expressed significantly. The miR-126 and miR-132 expression ratio could differentiate sarcoidosis from mediastinal TB with an AUC of 0.618 (82% specificity and 41% sensitivity).

Conclusion

While EBC miRNA expression is significantly and differently altered in sarcoidosis and mediastinal TB, a simple ratiometric approach failed to provide clinically useful signatures for differentiating between the two in patients with mediastinal lymphadenopathy.
Mixed response of trace element concentrations in fluvial sediments to a flash flood in a former mining area
Authors: Weber Alexandra , Lehmkuhl Frank
Published: May 2024

Background

Floods, especially flash floods, are the major transporting agent for fluvial sediments, whose pollution is a global concern. As floods result in the dispersion of and exposure to these sediments, a profound understanding of sedimentary dynamics during flood events and the related pollutant dispersion is of relevance. However, the characteristics of extreme flood events concerning pollutant dynamics are insufficiently known so far.

Results

In a Central European catchment impacted by intense industrial activities and former mining, over the course of five years, we surveyed six high-discharge events, five of them approx. bankfull discharge and one major flash flood event, supplemented by sampling of bank sediments. Fluvial sediments were analyzed for elemental composition by X-Ray fluorescence and for grain size distribution of the fine faction by laser diffraction. By applying a local enrichment factor, trace metal(loid) signatures in these sample sets were compared. Furthermore, Positive Matrix Factorization was used to investigate the trace metal(loid)s’ sources.

The sediments deposited by minor flooding had continual trace metal(loid) signatures. However, for the extreme event, significant divergencies arose and persisted for the following years: The enrichment of anthropogenically influenced elements increased, with a slowly decreasing trend in the subsequent two years. Naturally dominated metal(oid)s decrease in enrichment without indicating a return to original levels. In contrast, other elements were insensitive to the extreme event. Positive Matrix Factorization identified anthropogenic influences in elements originating from copper and lead processing and mining activities. Furthermore, bed sediments and a natural background factor were found to dominate the non-anthropogenically influenced metal(loid)s.

Conclusions

In between extreme events, winnowing processes slowly alter the elemental composition of bed sediments. The depletion of such sediments due to the flash flood proves catchment-wide flushing, which induces a natural resetting of the geochemical signals. This ability to renew is an integral part of resilience in fluvial systems. This mechanism is disturbed by industrial activities in floodplains. The exceptional flooding reaches infrastructure that is assumed to be safe and, therefore, unprotected. These additional sources can shift flood sediments’ trace metal(loid) signature, which has a long-lasting impact on the catchment sediments. However, the modifications depend on the flooding extent, possible emitters, and protection measures.
A case report of pediatric-onset MS associated uveitis
Authors: Mahdizad Zahra , Zarei Mohammad , Fakhredin Hanieh , Samiee Reza , Heidari Hora , Ebrahimiadib Nazanin
Published: May 2024

Background

To report a case of Pediatric-onset MS associated uveitis managed with local and systemic medications.

Case presentation

An 11-year-old boy who was diagnosed with Pediatric-onset MS (POMS) with the first presentation of left optic neuritis in another center, was referred to our clinic with the complaint of non-improved vision in the left eye despite receiving IV 5gr methylprednisolone. After the ophthalmologic examinations, the patient was diagnosed as bilateral POMS-associated intermediate uveitis, and local treatment with corticosteroid was administered to both eyes. He was continued on systemic therapy such as Rituximab and five sessions of plasmapheresis. After four months, the patient's vision improved from FC at 50cm to 9/10 in the left eye. The intensity of intraocular inflammation decreased in both eyes. In fluorescein angiography findings, the optic disc, as well as vascular leakage, subsided bilaterally.

Conclusion

Despite its rarity, POMS-associated uveitis presents a considerable challenge that necessitates the collaborative efforts of neurologists and ophthalmologists to achieve the most effective treatment outcomes.
Viral myocarditis in combination with genetic cardiomyopathy as a cause of sudden death. An autopsy series
Authors: Callon Domitille , Joanne Pierre , Andreoletti Laurent , Agbulut Onnik , Chevalier Philippe , Fornès Paul
Published: May 2024

Sudden cardiac death (SCD) is a major public health issue worldwide. In the young (< 40 years of age), genetic cardiomyopathies and viral myocarditis, sometimes in combination, are the most frequent, but underestimated, causes of SCD. Molecular autopsy is essential for prevention. Several studies have shown an association between genetic cardiomyopathies and viral myocarditis, which is probably underestimated due to insufficient post-mortem investigations. We report on four autopsy cases illustrating the pathogenesis of these combined pathologies. In two cases, a genetic hypertrophic cardiomyopathy was diagnosed in combination with Herpes Virus Type 6 (HHV6) and/or Parvovirus-B19 (PVB19) in the heart. In the third case, autopsy revealed a dilated cardiomyopathy and virological analyses revealed acute myocarditis caused by three viruses: PVB19, HHV6 and Epstein-Barr virus. Genetic analyses revealed a mutation in the gene coding for desmin. The fourth case illustrated a channelopathy and a PVB19/HHV6 coinfection. Our four cases illustrate the highly probable deleterious role of cardiotropic viruses in the occurrence of SCD in subjects with genetic cardiomyopathies. We discuss the pathogenetic link between viral myocarditis and genetic cardiomyopathy. Molecular autopsy is essential in prevention of these SCD, and a close collaboration between cardiologists, pathologists, microbiologists and geneticians is mandatory.
Pancreatic cancer in Saudi Arabia (2005–2020): increasing trend
Authors: Elwali Nasr Eldin , AlShareef Saad Mohammed , Khamis Ammar H. , Elhassan Moawia M. A.
Published: May 2024

Pancreatic cancer, a highly fatal malignancy, has shown a global rise in the incidence and mortality rates. However, these rates vary significantly across different regions worldwide. This study aims to assess the incidence and mortality of pancreatic cancer in Saudi Arabia. We collected the data from 16 annual cancer incidence reports in Saudi Arabia for the study period (2005–2020) and from the WHO's IARC Global Cancer Observatory website. Although the burden of pancreatic cancer in Saudi Arabia is relatively lower compared to global rates, the disease incidence has shown a steady increase over the study period, in addition to regional variations within the country. The disease predominantly affects the elderly population, aged 50 years and above in both genders, with males exhibiting higher rates than females. Further studies are required to identify the potential risk factors for pancreatic cancer in the Saudi population.
Does integrated health management within a county medical consortium improve rural type 2 diabetic patients’ self-management behavior and quality of life? An empirical analysis from Eastern China
Authors: Peng Mingyao , Li Li , Shi Xinyi , Wang Zhonghua
Published: May 2024

Background

Levels of self-management behaviors (SMB) and quality of life (QoL) are suboptimal in Chinese adults with type 2 diabetes (T2D), especially in rural China. Integrated health management within a county medical consortium, featuring multi-level teams of doctors, nurses, and other professionals offering follow-up services such as check-ups, assessments, treatment, and health education, is promising in improving this. This study aimed to assess the effect of integrated health management within a county medical consortium on the SMB and QoL of rural T2D patients in China.

Methods

Based on a survey conducted on the county medical consortium in Eastern China, this study initially employed propensity score matching (PSM), a nonparametric technique, to precisely estimate the average treatment effect on the treated (ATT) of integrated health management on SMB and QoL in rural T2D patients. Subsequently, quantile regression was also performed to estimate the relationship between the implementation of integrated health management, sociodemographic factors, follow-up services (offered during integrated health management) and both SMB and QoL.

Results

The ATT values for SMB and QoL, representing the net effect of integrated health management within a county medical consortium on SMB and QoL, were significantly positive. They ranged from 4.34 to 4.67 for SMB and from 0.89 to 1.06 for QoL, respectively, based on the four different PSM modalities. The results of quantile regression also revealed a statistically significant positive association between the implementation of integrated health management and both SMB (coef. = 4.15) and QoL (coef. = 1.54). These findings suggest that integrated health management within a county medical consortium can effectively improve SMB and QoL in rural T2D patients. Furthermore, frequency of follow-up service and health behavior guidance were positively associated with SMB and QoL. Conversely, on-call follow-up services, medication guidance and follow-up services at medical institutions were negatively correlated with SMB or QoL.

Conclusions

The study highlights the effectiveness of integrated health management within a county medical consortium in improving SMB and QoL among individuals with T2D in rural China. The findings offer invaluable insights for the advancement of chronic disease management in rural areas of developing countries.
Situation analysis on the integration of refractive error services provided by optometrists into the national health services in Kenya
Authors: Muma Shadrack , Naidoo Kovin Shunmugam , Hansraj Rekha
Published: May 2024

Introduction

Even though the burden of uncorrected refractive error could potentially be addressed through innovative and cost-effective approaches, integration of the services into the National Health Services (NHS) is desirable. However, minimal information exists on the current situation warranting the need for evidence about the integration of refractive error service provided by optometrists into the national health services in Kenya.

Methods

A situation analysis of the Kenyan refractive error services provided by optometrists within the NHS was undertaken based on access to service delivery, service coverage, and human resource. A strengths, weaknesses, opportunities, and threats analysis was undertaken based on the existent evidence to identify the core factors that could potentially facilitate or hinder the integration of refractive error services provided by optometrists within the National Health Services. The proportion of optometrists to be integrated in the NHS was estimated based on the minimum ratios recommended by the World Health Organization.

Results

A section of tertiary and secondary healthcare facilities in Kenya have specific services to address refractive errors within the NHS with most facilities lacking such services. Treatment of refractive error occurs at the level of eye care general services. There are 11,547 health facilities offering primary care services in Kenya. However, none of them offers refractive error services and only a section of facilities offering county health referral services provides eye care services which is limited to refraction without provision of spectacles. The existing workforce comprises of ophthalmologists, optometrists and ophthalmic clinical officers, together with nurses and other general paramedical assistants. Optometrists, ophthalmologists and ophthalmic clinical officers are allowed to undertake refraction. However, optometrists majorly practices in the private sector. Centralization of eye care services in urban areas, weak referral systems, and a shortage in the workforce per population was observed.

Conclusions

The Kenyan NHS should advocate for primary care and reorient the current hospital-based delivery approach for refractive error services. This is attributed to the fact that provision of refractive error services at primary care remains effective and efficient and could translate to early detection of other ocular conditions. The existing human resources in the eye health ecosystem in Kenya should maximize their efforts towards addressing uncorrected refractive error and optometrists should be integrated into the NHS.
Subtrochanteric fracture after core decompression for osteonecrosis of the femoral head: a case report and literature review
Authors: Li Shihong , Huang Chen , Wang Wei , Chen Song , Deng Bing , Yin Li , Amu Yida , Ye Lijuan , Jing Dan , Song Benjing , Xie Qingyun , Liao Dongfa
Published: May 2024

Background

Osteonecrosis of the femoral head (ONFH) is a common clinical disease. Improper treatment can lead to femoral head collapse and hip joint dysfunction. Core decompression is particularly important for early ONFH. However, subtrochanteric fractures after core decompression cause some clinical problems.

Case presentation

This article describes a 34-year-old male patient with early ONFH. After core decompression, he suffered a subtrochanteric fracture of the femur while bearing weight on the affected limb when going up stairs. He was subsequently treated with open reduction and intramedullary nail fixation.

Conclusion

When core decompression is used to treat ONFH, the location or size of the drill hole, whether a tantalum rod or bone is inserted, and partial weight-bearing of the affected limb may directly affect whether a fracture occurs after surgery. It is hoped that this case report can provide a reference for clinical orthopedic surgeons in the treatment of early ONFH.
Biomechanical comparison of polyetheretherketone rods and titanium alloy rods in transforaminal lumbar interbody fusion: a finite element analysis
Authors: Li Jie , Cao Shuai , Zhao Bo
Published: May 2024

Background

Whether polyetheretherketone (PEEK) rods have potential as an alternative to titanium alloy (Ti) rods in transforaminal lumbar interbody fusion (TLIF) remains unclear, especially in cases with insufficient anterior support due to the absence of a cage. The purpose of this study was to investigate biomechanical differences between PEEK rods and Ti rods in TLIF with and without a cage.

Methods

An intact L1-L5 lumbar finite element model was constructed and validated. Accordingly, four TLIF models were developed: (1) Ti rods with a cage; (2) PEEK rods with a cage; (3) Ti rods without a cage; and (4) PEEK rods without a cage. The biomechanical properties were then compared among the four TLIF constructs.

Results

With or without a cage, no obvious differences were found in the effect of PEEK rods and Ti rods on the range of motion, adjacent disc stress, and adjacent facet joint force. Compared to Ti rods, PEEK rods increase the average bone graft strain (270.8-6055.2 µE vs. 319.0-8751.6 µE). Moreover, PEEK rods reduced the stresses on the screw-rod system (23.1–96.0 MPa vs. 7.2–48.4 MPa) but increased the stresses on the cage (4.6–35.2 MPa vs. 5.6–40.9 MPa) and endplates (5.7–32.5 MPa vs. 6.6–37.6 MPa).

Conclusions

Regardless of whether a cage was used for TLIF, PEEK rods theoretically have the potential to serve as an alternative to Ti rods because they may provide certain stability, increase the bone graft strain, and reduce the posterior instrumentation stress, which might promote bony fusion and decrease instrumentation failure.
The mediating effect of sleep duration on metabolic syndrome severity in adults: a structural equation modeling approach
Authors: Hemati Niloufar , Satari Shabnam , Khazaie Habibolah , Salimi Yahya , Najafi Farid , Pasdar Yahya , Darbandi Mitra
Published: May 2024

Background

Metabolic syndrome (MetS) is associated to sleep duration. It is crucial to identify factors that disrupt sleep regulation. The study aimed to assess the indirect effect of risk factors related to MetS severity through sleep duration by utilizing a structural equation model (SEM).

Methods

The study involving 3,935 adults from the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study. MetS severity scores were the outcome variables. SEM was employed to explore the relationships, utilizing IBM SPSS and AMOS version 23.

Results

The mean MetS severity score was higher in women compared to men (0.25 vs. 0.16, P = 0.003). In men, socioeconomic status (SES) has a positive direct effect (β = 0.048) and a negative indirect effect (β=-0.006) on MetS severity. Increased physical activity is directly (β=-0.036) and indirectly (β=-0.093) associated with reducing MetS severity. Nap duration is directly linked to an increase (β = 0.072) but has an indirect effect (β=-0.008) in decreasing MetS severity. In women, SES has a direct (β=-0.020) and indirect (β=-0.001) inverse relationship with MetS severity. Increased physical activity is directly (β=-0.048) and indirectly (β=-0.036) associated with decreasing MetS severity in women. Nap duration is directly associated with an increase in MetS severity (β=-0.018) but indirectly contributes to its reduction (β=-0.002). Sleep duration not only directly affects MetS severity but is also influenced by age, SES, physical activity, obesity and nap duration.

Conclusion

Physical activity, SES, and nap duration directly and indirectly effect the MetS severity. Sleep duration was recognized as a mediating variable that supports the indirect effects.
Deep learning model for differentiating nasal cavity masses based on nasal endoscopy images
Authors: Tai Junhu , Han Munsoo , Choi Bo Yoon , Kang Sung Hoon , Kim Hyeongeun , Kwak Jiwon , Lee Dabin , Lee Tae Hoon , Cho Yongwon , Kim Tae Hoon
Published: May 2024

Background

Nasal polyps and inverted papillomas often look similar. Clinically, it is difficult to distinguish the masses by endoscopic examination. Therefore, in this study, we aimed to develop a deep learning algorithm for computer-aided diagnosis of nasal endoscopic images, which may provide a more accurate clinical diagnosis before pathologic confirmation of the nasal masses.

Methods

By performing deep learning of nasal endoscope images, we evaluated our computer-aided diagnosis system’s assessment ability for nasal polyps and inverted papilloma and the feasibility of their clinical application. We used curriculum learning pre-trained with patches of nasal endoscopic images and full-sized images. The proposed model’s performance for classifying nasal polyps, inverted papilloma, and normal tissue was analyzed using five-fold cross-validation.

Results

The normal scores for our best-performing network were 0.9520 for recall, 0.7900 for precision, 0.8648 for F1-score, 0.97 for the area under the curve, and 0.8273 for accuracy. For nasal polyps, the best performance was 0.8162, 0.8496, 0.8409, 0.89, and 0.8273, respectively, for recall, precision, F1-score, area under the curve, and accuracy. Finally, for inverted papilloma, the best performance was obtained for recall, precision, F1-score, area under the curve, and accuracy values of 0.5172, 0.8125, 0.6122, 0.83, and 0.8273, respectively.

Conclusion

Although there were some misclassifications, the results of gradient-weighted class activation mapping were generally consistent with the areas under the curve determined by otolaryngologists. These results suggest that the convolutional neural network is highly reliable in resolving lesion locations in nasal endoscopic images.