bluuebunny/crossref_metadata_2025 huggingface dataset:
Deciphering a Beetle Clock: Individual and Sex-Dependent Variation in Daily Activity Patterns
Authors: R Reshma , Prüser Tobias , Schulz Nora K. E. , Mayer Paula M. F. , Ogueta Maite , Stanewsky Ralf , Kurtz Joachim
Published: July 2024

Circadian clocks are inherent to most organisms, including cryptozoic animals that seldom encounter direct light, and regulate their daily activity cycles. A conserved suite of clock genes underpins these rhythms. In this study, we explore the circadian behaviors of the red flour beetle Tribolium castaneum, a significant pest impacting stored grain globally. We report on how daily light and temperature cues synchronize distinct activity patterns in these beetles, characterized by reduced morning activity and increased evening activity, anticipating the respective environmental transitions. Although less robust, rhythmicity in locomotor activity is maintained in constant dark and constant light conditions. Notably, we observed more robust rhythmic behaviors in males than females with individual variation exceeding those previously reported for other insect species. RNA interference targeting the Clock gene weakened locomotor activity rhythms. Our findings demonstrate the existence of a circadian clock and of clock-controlled behaviors in T. castaneum. Furthermore, they highlight substantial individual differences in circadian activity, laying the groundwork for future research on the relevance of individual variation in circadian rhythms in an ecological and evolutionary context.
Shallow lake response to Holocene climate variation in south-central Minnesota, USA
Authors: Tennent E Rae , Maxbauer Daniel P , Umbanhowar Charles E
Published: July 2024

Sedimentary deposits in lakes across the upper Midwest record the co-evolution of climate and biogeochemistry since the retreat of the Laurentide Ice Sheet at the end of the last glacial period. Here, we report on a Holocene lake sediment record from Chub Lake, a shallow (3 m depth) eutrophic lake system in south-central Minnesota. High-resolution elemental data from scanning XRF along with variations in organic matter, carbonate minerals, clastic material, biogenic silica, charcoal, and carbon isotopes reveal internally consistent patterns of hydroclimatic influence on this shallow lake system from 11,300 years BP to present. In particular, authigenic carbonate mineral formation and preservation in Chub Lake appears to be well suited as a moisture proxy beginning around 9700 BP up until ∼2300 BP, when a combination of more humid climates and basin-infilling change the hydrology of Chub Lake. This work emphasizes the importance of evaluating shallow lake sediment records both as important archives of climate proxies and case studies on how changing climates impact aquatic systems.
Engaging evaluation as a catalyst: Artists and arts managers voices in reshaping the Australian Performing Arts Market
Authors: Gattenhof Sandra
Published: July 2024

Australian Performing Arts Market (APAM) is the Australia Council for the Arts key strategic engagement to develop national and international touring opportunities for Australian contemporary performing arts. The Market has been delivered since 1994 in four Australian cities hosted by differing cultural venues. Over a sequence of three iterations from 2014 to 2018 the APAM presenting venue, Brisbane Powerhouse, made a commitment to reshape the delivery of the Market. Positioning the Market as a cultural intermediary, this discussion outlines how the Market engaged with evaluative data to transform from a transactional model to a relational focus by foregrounding the experience of artists, companies, and art managers. The findings show how planned and ongoing stakeholder engagement influenced the focus of the Market, and the significance of artist and arts manager voices were in transforming the Market experience away from a focus on buying and selling to collaboration and exchange.
Devising Isolation Forest-Based Method to Investigate the sRNAome of Mycobacterium tuberculosis Using sRNA-seq Data
Authors: Maity Upasana , Aggarwal Ritika , Balasubramanian Rami , Venkatraman Divya Lakshmi , R Hegde Shubhada
Published: July 2024

Small non-coding RNAs (sRNAs) regulate the synthesis of virulence factors and other pathogenic traits, which enables the bacteria to survive and proliferate after host infection. While high-throughput sequencing data have proved useful in identifying sRNAs from the intergenic regions (IGRs) of the genome, it remains a challenge to present a complete genome-wide map of the expression of the sRNAs. Moreover, existing methodologies necessitate multiple dependencies for executing their algorithm and also lack a targeted approach for the de novo sRNA identification. We developed an Isolation Forest algorithm-based method and the tool Prediction Of sRNAs using Isolation Forest for the de novo identification of sRNAs from available bacterial sRNA-seq data ( http://posif.ibab.ac.in/ ). Using this framework, we predicted 1120 sRNAs and 46 small proteins in Mycobacterium tuberculosis. Besides, we highlight the context-dependent expression of novel sRNAs, their probable synthesis, and their potential relevance in stress response mechanisms manifested by M. tuberculosis.
Smarter homes, smarter surveillance? Exploring intimate surveillance practices in modern day households
Authors: Dereymaeker Julie , Schokkenbroek Janneke M , Martens Marijn , De Wolf Ralf
Published: July 2024

Smart home technologies (SHT) are becoming more and more widespread. The commodification of the household and the surveillance of family life by companies have understandably sparked numerous questions. It should not be forgotten, however, that SHT also bring family members convenient tools to surveil each other. Parental and partner surveillance, further referred to as intimate surveillance, have rarely been studied with regard to the smart home. This article empirically explores intimate surveillance behaviours, intentions and motivations by drawing on an online survey study ( n = 715) with parents and partners. Overall, the results show that intimate surveillance takes place with SHT, that parental surveillance intentions are higher than partner surveillance intentions and that care is considered a relevant motivation for intimate surveillance. Furthermore, this study invites to be mindful of the specificities of surveillance practices, and encourages researchers to be explicit about their assumptions on the underlying motivations for intimate surveillance.
Digital technologies meet soft laddering: A critical reflective perspective
Authors: Bartoli Chiara , Mattiacci Alberto , Nosi Costanza
Published: July 2024

This study contributes to the academic discourse on the evolution of virtual qualitative enquiries in the wake of the accelerated adoption of digital technology following the COVID-19 pandemic. Employing a critical-reflection approach, this study explored the experiences of investigators who conducted 150 soft laddering interviews, either online or face-to-face. The research provides a theoretical reflection on online soft laddering and its application with new technological tools, such as video conferencing and social media, demonstrating how these tools mitigate logistical and relational limitations while enhancing data collection scope and reach. The findings indicate that technological advancements are fostering a gradual hybridisation of digital and physical methods, particularly those utilising synchronous interviews. As the physical and digital realms converge, this trend leads to the phygitalisation of qualitative research.
Disease Activity and Bone Microarchitectural Phenotype in Patients With Axial Spondyloarthritis
Authors: Russell Linda , Mannstadt Insa , Ashany Dalit , Mintz Douglas N. , Yuan Weijia , Heiting Chloe , Glaser Katherine Kayla , Tornberg Haley , McMahon Donald , Goodman Susan M. , Stein Emily M.
Published: July 2024

Background:

Axial spondyloarthritis (AxSpA) is a chronic rheumatic disease characterized by spine inflammation, abnormal bone growth, and paradoxically osteoporosis and vertebral fractures. The pathogenesis of skeletal deficits in this disease is poorly understood.

Purpose:

We sought to evaluate volumetric bone mineral density (vBMD) and bone microarchitecture in patients with AxSpA and to identify disease-related factors associated with skeletal abnormalities.

Methods:

We enrolled patients between 2018 and 2021 as part of a 2-year prospective study at a single institution investigating skeletal health and the skeletal effects of interleukin-17 (IL-17) treatment. Patients with AxSpA who met Assessment in SpondyloArthritis International Society (ASAS) classification criteria by X-ray or had evidence of active inflammation on magnetic resonance imaging suggestive of sacroiliitis were referred to the study by their rheumatologists. We excluded those with a history of fragility fracture, multiple myeloma, Cushing’s disease, primary hyperparathyroidism, osteomalacia, untreated vitamin D deficiency, secondary osteoporosis, or other systemic rheumatic diseases, as well as use of oral steroids for 2 or more weeks in the 6 months prior or current use of hormone replacement therapy, current oral bisphosphonate, past or current intravenous bisphosphonate, teriparatide, or denosumab therapies. A total of 1606 patients were screened for eligibility. Of these, 30 participants were enrolled (mean age 43 years, 50% male). Patients with AxSpA had dual-energy X-ray absorptiometry (DXA) measurements of areal BMD (aBMD) and high-resolution peripheral quantitative computed tomography (HR-pQCT) measurements of vBMD microarchitecture and failure load by finite element analysis. Standardized disease assessment tools used included the Bath Ankylosing Spondylitis Disease Activity (BASDAI), Metrology Index (BASMI), and Functional Index (BASFI).

Results:

In the 30 included patients, mean DXA and HR-pQCT Z-scores were within 1 standard deviation (SD) of normal for all indices, except for total vBMD in males (–1.2 SD below mean). Mean symptom duration was 11.7 years and mean scores for BASDAI, BASFI, and BASMI were 4.6, 3.6, and 2.7, respectively (range 1–10, 10 = severe limitation). Longer disease duration was associated with more severe skeletal deficits at the hip and tibia—specifically, lower hip aBMD, lower meta- and inner-trabecular vBMD, lower trabecular number, and higher trabecular separation and heterogeneity.

Conclusion:

This study of 30 patients with AxSpA found that abnormalities in bone density and microarchitecture at weightbearing sites were associated with longer disease duration. Because of its small sample size, larger studies are needed to better characterize the pathogenic disease factors that govern skeletal damage in AxSpA.
Do Social Deprivation and Surgical Volume Influence Outcomes Following Distal Radius Fracture Fixation?
Authors: Goodman Avi D. , Brodeur Peter , Kosinski Lindsay R. , Cruz Aristides I. , Akelman Edward , Gil Joseph A.
Published: July 2024

Background:

Distal radius fractures account for nearly 25% of fractures in adults, with a trend toward operative fixation. The objective of this study was to assess the relationship between surgeon and hospital volume with complications following distal radius fixation.

Methods:

A retrospective study was performed using the New York Statewide Planning and Research Cooperative System database from 2009 to 2015. Outpatient claims were identified for distal radius fractures and surgery. The facility and surgeon’s identifier were used to calculate annual procedure volume. The risk for infection, carpal tunnel surgery, and revision/hardware removal was analyzed, and Social Deprivation Index (SDI) was linked to each patient. Patient demographics and rate of complications were compared across hospital and physician volume.

Results:

A total of 14 748 patients were included, finding Federal and self-pay insurance associated with low-volume (LV) facility care and private insurance with high-volume (HV) facilities. The SDI for patients treated by LV surgeons and hospitals was significantly higher compared with HV providers. Low-volume facilities and surgeons had a higher 3-month risk of infection requiring reoperation. High-volume facilities were less likely to treat Hispanic patients, those with comorbidities, higher SDI, and with Federal or self-pay insurance.

Conclusions:

Patients treated by LV surgeons and facilities had a higher risk of infection requiring surgery within 3 months than those treated by HV providers. Low-volume facilities were more likely to treat patients who were Hispanic, Federally insured, and with comorbidities and higher SDI than HV facilities, increasing their risk for disadvantaged care.

Level of Evidence:

Level III.
Lifelong education policies in Europe and Latin America
Authors: Huka Britshy R , Ximenes Adalciza A , Haan Videlindah AS
Published: July 2024

“Lifelong Education Policies in Europe and Latin America” offers an insightful examination of lifelong learning policies through the lens of policy studies, focusing on the similarities and differences between Europe and Latin America. The book delves into various dimensions of employment policies, adult education and learning, vocational education and training, and higher education. It particularly emphasizes the formulation and implementation of these policies by policymakers and the interplay among educational authorities, employers, and providers at local, regional, and national levels. This comparative approach is pivotal in broadening the comprehension of lifelong learning within compensatory and upskilling initiatives.
Addressing the risks of dual use research: who is responsible?
Authors: Lev Ori , Keren Arnon
Published: July 2024

This article addresses the question of how the responsibilities for addressing the risks of dual use research ought to be divided. We begin by presenting the maximalist claim that proposes that since scientists are well placed to judge the potential for misuse of their studies, they alone are responsible for addressing these risks. Before assessing this position, we consider a claim that rejects the maximalist position, namely that scientists need not consider the possibility that their studies might be misused because the goods of science are so important, they should not spend time on anything but generating valuable knowledge. This claim, we argue, fails, as these goods do not always outweigh the risks of misuse. Given this conclusion we turn to assess two versions of the maximalist claim. The first suggests that when a possibility of misuse arises, scientists ought to adopt the precautionary principle (PP) to discharge their moral responsibilities. We argue that PP is problematic as it does not give much guidance on what scientists should do. An alternative to meeting scientists’ moral responsibilities is through applying a risk-benefit analysis; however, due to epistemic biases and limitations, scientists are prone to make mistakes in their analysis. We thus suggest an alternative approach, in which responsibilities are divided between scientists and agents that can conduct an analysis that is more likely to generate unbiased and comprehensive conclusions on how the risks of dual use research, should be addressed.
Long-term efmoroctocog alfa prophylaxis improves perceived pain, mental, and physical health in patients with hemophilia A: post hoc analysis of phase III trials using patient-reported outcomes
Authors: Raheja Priyanka , Kragh Nana , Bystrická Linda , Eriksson Daniel , Aroui Khaoula , Mezghani Marwa , Barbier Sylvaine , Linari Silvia
Published: July 2024

Background:

Hemophilia-associated bleeding and resultant joint pain and mobility restrictions can predispose patients to poor health-related quality of life (HRQoL). Therefore, efficacy of a treatment needs to address more than just annualized bleed rates.

Objectives:

Describe the evolution of HRQoL, pain, and activity in patients with hemophilia A, treated with efmoroctocog alfa prophylaxis.

Design:

A post hoc analysis from Kids A-LONG (NCT01458106), A-LONG (NCT01181128), and long-term extension study ASPIRE (NCT01454739) assessed change in pain and activity-related patient-reported outcomes (PROs).

Methods:

Physical health, pain, and HRQoL were assessed by PROs for a cumulative treatment duration of up to ~6 years. The primary endpoint was change from baseline in EuroQoL (EQ)-5D and Haemophilia Quality of Life Questionnaire (Haem-A-QoL).

Results:

118 adult/adolescents and 71 pediatric patients were included. The proportion of adults and adolescents reporting no problem in the EQ-5D analysis of ‘ pain/discomfort’ significantly increased from A-LONG baseline (35.04%; 41/117) to ASPIRE month 30 (44.68%; 21/47; p = 0.024). Mean (standard deviation) Haem-A-QoL subdomain scores for ‘ feeling’ and ‘ physical health’ at A-LONG baseline improved by −3.24 (15.13; p = 0.018) and −3.85 (23.07; p = 0.047), respectively, at study end. Proportion of pediatric patients reporting no problem on the EQ-5D analysis of ‘ pain/discomfort’, significantly increased from A-LONG baseline (75.0%; 42/56) to ASPIRE baseline (95.56%; 43/45; p = 0.046). Satisfaction levels for pediatric patients were high at A-LONG baseline and maintained until study end.

Conclusion:

Long-term efmoroctocog alfa prophylaxis reduces pain and improves HRQoL in adult and adolescent patients with hemophilia A. In pediatric patients, it reduces perceived pain and maintains satisfaction levels.

Trial registration:

NCT01458106, NCT01181128, NCT01454739.
Optogenetically modified human embryonic stem cell-derived otic neurons establish functional synaptic connection with cochlear nuclei
Authors: Chen Yanni , Mu Wenbo , Wu Yongkang , Xu Jiake , Li Xiaofang , Hu Hui , Wang Siqi , Wang Dali , Hui Bin , Wang Lang , Dong Yi , Chen Wei
Published: July 2024

Spiral ganglia neurons (SGNs) impairment can cause deafness. One important therapeutic approach involves utilizing stem cells to restore impaired auditory circuitry. Nevertheless, the inadequate implementation of research methodologies poses a challenge in accurately assessing the functionality of derived cells within the circuit. Here, we describe a novel method for converting human embryonic stem cells (hESCs) into otic neurons (ONs) and assess their functional connectivity using an optogenetic approach with cells or an organotypic slice of rat cochlear nucleus (CN) in coculture. Embryonic stem cell-derived otic neurons (eONs) exhibited SGN marker expression and generated functional synaptic connection when cocultured with cochlear nucleus neurons (CNNs). Synapsin 1 and VGLUT expression are found in the cochlear nucleus of brain slices, where eONs projected processes during the coculture of eONs and CN brain slices. Action potential spikes and INa+/IK+ of CNNs increased in tandem with light stimulations to eONs. These findings provide further evidence that eONs may be a candidate source to treat SGN-deafness.
Vonoprazan-associated Clostridioides difficile infection: an analysis of the Japanese Adverse Drug Event Report and the FDA Adverse Event Reporting System
Authors: Ouyang Mengling , Zou Shupeng , Cheng Qian , Shi Xuan , Zhao Yazheng , Sun Minghui
Published: July 2024

Background:

Prolonged or excessive use of acid suppressants may increase the risk of Clostridioides difficile infection (CDI) by altering the intestinal microecosystem. Vonoprazan, a novel potassium-competitive acid blocker, exhibits a faster and more sustained acid-suppressive effect than proton pump inhibitors (PPIs). Therefore, vonoprazan may have a greater impact on the gut microbiota, potentially resulting in CDI.

Objectives:

This study aimed to explore the potential relationship between acid suppressants and CDI by the Japan Adverse Drug Event Report (JADER) and the FDA Adverse Event Reporting System (FAERS) databases.

Design:

A retrospective analysis of the JADER and FAERS databases was examined by disproportionality analysis.

Methods:

We performed signal detection analyses of CDI induced by vonoprazan and PPIs using the JADER and FAERS databases. The association between acid suppressants and CDI was calculated using the reporting odds ratio (ROR) and corresponding 95% confidence interval (95% CI). When the lower limit of the 95% CI is exceeded by 1, the association is considered statistically significant.

Results:

In the JADER database, the ROR (95% CI) for vonoprazan and PPIs based on suspect drug reports was 15.84 (12.23–20.50) and 2.51 (1.92–3.28), respectively. In the FAERS database, the ROR (95% CI) for vonoprazan and PPIs based on primary and secondary suspect drug reports was 11.50 (6.36–20.82) and 1.42 (1.34–1.51), respectively. Subgroup analysis showed that elderly patients aged 60 years and older were more strongly associated with CDI. The ROR (95% CI) for vonoprazan and PPIs in patients aged 60 years and older in the JADER database was 15.35 (11.59–20.33) and 1.65 (1.14–2.39), respectively. Similarly, the ROR (95% CI) for vonoprazan and PPIs in the FAERS database was 12.56 (6.26–25.20) and 1.43 (1.31–1.57), respectively. Excluding the effect of Helicobacter pylori ( H. pylori) infection, the use of acid suppressants was still associated with CDI.

Conclusion:

While signal detection analysis based on the JADER and FAERS databases could not establish causality, our study demonstrated that both vonoprazan and PPIs were significantly associated with CDI. Vonoprazan showed a stronger association with CDI in both databases.
Exploring the uptake of sexual and reproductive health services for lesbians and bisexual women in Bulawayo, Zimbabwe. A quantitative enquiry
Authors: Khozah Methembe Yotamu , Nunu Wilfred Njabulo
Published: July 2024

Background:

Sexual and reproductive healthcare is essential for all individuals, including LGBTQ+ individuals. However, lesbians and bisexual women often lack tailored services, leading to underutilization. This study aimed to assess the availability and uptake of sexual and reproductive health services for lesbian and bisexual Bulawayo women.

Methods:

A cross-sectional study surveyed 67 lesbian and bisexual women recruited through the Voice of the Voiceless Organization. The participants completed a structured questionnaire on available services, factors influencing their uptake, and access challenges. Cross-tabulation was used to examine the associations between variables. Data were analyzed using Microsoft Excel and STATA Version 15 S.E.

Results:

Most respondents were bisexual women aged 35 years. Cross-tabulations revealed significant associations between delayed or avoided services and the absence of specific services for lesbians and bisexual women as well as the presence of gender identity nondiscrimination policies.

Conclusion:

Sexual and reproductive health programs play a vital role in meeting lesbian and bisexual women’s needs. Improving service uptake requires strengthening the linkages between clinics and sexual health education programs, providing lesbian and bisexual women-friendly clinical services, and ensuring access to comprehensive information.
Pure large-cell neuroendocrine carcinoma of the ovary with a somatic BRCA1 mutation: The first reported case and the review of the literature
Authors: Wang Musen , Gao Fei , Wang Xiao , Guo Yebing , Zhang Hongkai
Published: July 2024

Pure large-cell neuroendocrine carcinomas of the ovary are extremely rare, so there is a lack of molecular information on this type of cancer. Herein, we presented a pure primary large-cell neuroendocrine carcinomas of the ovary in a 72-year-old female with a pathogenic somatic mutation at the c.5332+1g>a splice site of the BRCA1 gene and with no TP53 mutation. She was uneventful 32 months after the operation and chemotherapies. To the best of our knowledge, this is the first report of a BRCA1 somatic mutation in the ovary large-cell neuroendocrine carcinomas. Testing BRCA1/2 mutations in patients with large ovarian cell neuroendocrine carcinomas might provide an opportunity for their future target treatments. It would expand our understanding.
Factors Associated With Vaccination Refusal Among a Sample of the Jordanian Population
Authors: Abu Ghaboush Reham , Olimat Hmoud S. , Hammour Shoroug Abu , Al Buniaian Nada A. , Anabtawi Manal F. , Alqdah Talal A. , Alajmi Abduruhman F. , Altarawneh Mahmoud I.
Published: July 2024

Using a questionnaire, this study investigated the numerous factors affecting the Jordanian population’s rejection of COVID-19 vaccines. The data were collected in 2020 to 2021. Using the chi-square test, t-test, Cramer’s V-test, and analysis of variance, we found that most of the Sample (72.6%) obtained information on COVID-19 and its vaccines from social media, radio, and television. In comparison, 31.1% and 35.4% of the Sample obtained from government/official sources or health specialists, respectively, with a lesser share relying on colleagues (13.7%) and scientific lectures (17.5%). Furthermore, depending on the participants’ characteristics, there were significant differences in the information sources or abstinence factors. Several factors were associated with vaccine refusal and hesitancy, including contradictory/conflicting information, lack of trust in vaccines/manufacturers, doubt about the vaccines’ effectiveness, and the belief that the risks of COVID-19 are minimal. Based on these findings, we present several recommendations for policymakers.
What Drives or Decelerates Generation Z? An Empirical Study Navigating Consumer Buying Intentions in Online Shopping
Authors: Singh Prakash
Published: July 2024

This study provides a comprehensive exploration of factors impacting the online buying intentions of Generation Z consumers by studying perceived risk, perceived usefulness, perceived ease of use, perceived privacy and perceived security, customer trust, and trust toward sellers. Furthermore, the study augments the Technology Acceptance Model (TAM), which can assist in formulating marketing strategies for online marketers and companies to enrich their online shopping platforms and entice more Generation Z consumers. This study employed a quantitative research approach to explore how perceived risk, perceived usefulness and perceived ease of use, perceived privacy and perceived security, customer trust, and trust toward sellers impact online buying intentions among Generation Z consumers. The data were collected employing a 5-point Likert scale questionnaire and analyzed using the SmartPLS software. Generation Z consumers’ online buying intentions are directly impacted by perceived risk, perceived usefulness, perceived ease of use, perceived privacy and perceived security, customer trust, and trust toward sellers. Applying these factors, the TAM model augmented the theoretical understanding of the online buying intentions of Generation Z consumers in the Indian context. Companies and marketers can employ the study’s insights to develop targeted online marketing campaigns that cater to the manifold needs of Generation Z consumers. The study furnishes a theoretical perspective of the intricate interplay of factors impacting consumers’ online buying intentions. The study on Generation Z consumers’ online buying intentions had several limitations, including a small sample size, quantitative technique, and geographical context limited to India.
The Difference Between Throwing and Practice Volumes in Youth Softball Athletes With and Without Upper Extremity Pain
Authors: Bordelon Nicole M. , Gober Peyton , Holtz Kaila A. , Plummer Hillary , Downs-Talmage Jessica L. , Strunk Kamden K. , Zaremski Jason L. , Oliver Gretchen D.
Published: July 2024

Background:

Research indicates that mechanics differ between athletes with and without upper extremity pain; however, it is unclear which modifiable risk factors exist for throwing-related pain in softball athletes.

Purpose:

To determine whether sport specialization, throwing, practice, and strength and conditioning training volumes vary between youth softball athletes with and without upper extremity pain. It was hypothesized that youth softball athletes with upper extremity pain would participate in softball year-round and have greater throwing, practice, and strength and conditioning volumes compared with those without pain.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 232 youth softball athletes from travel ball, middle school, and high school leagues were invited to complete a survey to assess pain, sport specialization, throwing, practice, and strength and conditioning training volumes. Participants were classified into upper extremity pain and no pain groups based on their survey answers. The responses were compared between groups using Mann-Whitney U and chi-square tests.

Results:

A total of 101 athletes—with a mean ± SD age of 13.3 ± 2.3 years, height of 161 ± 13.4 cm, and weight of 59.8 ± 14.8 kg—completed the survey and were included for analysis. The response rate was 43.53%, with 22 athletes in the upper extremity pain group and 79 athletes in the no pain group. A significant difference was observed between hours devoted per week to off-season softball practice ( U, 626.6; Z =–2; P = .045), where those without upper extremity pain spent 4 fewer median hours (6 hours) practicing softball per week in the off-season compared with those with pain (10 hours). Also, a significant difference was found between the number of throws during an in-season game ( U, 457; Z, –2.28; P = .022), where those without upper extremity pain reported 21 fewer median throws (70 throws) during an in-season game compared with those with pain (91 throws). Furthermore, 77% of those who reported upper extremity pain continued to play despite their pain. There were no other significant differences between demographic characteristics, specialization, injury history, and primary position, as well as throwing, practice, and strength and conditioning volumes.

Conclusion:

Our study demonstrates that youth softball athletes with upper extremity pain had more throws during in-season games and increased hours per week devoted to off-season practice than athletes without upper extremity pain. Our findings support the need for softball stakeholders (eg, coaches, clinicians, parents, and administrators) to engage in further research and recommendations regarding in-season pitch counts and off-season rest.
Positive Communication Practices for Enhancing Collaboration
Authors: Mickel Amy E.
Published: July 2024

Collaboration is the process of people working together toward a common goal and occurs in a wide range of contexts. When done well, almost anything is possible. Because of its potential, collaboration is touted as one of the most promising ways to address today’s most difficult and complex problems. However, not all collaborative efforts realize their potential for a variety of reasons, including the relational aspects of collaboration. Central to collaboration and its efficacy, interpersonal relationships can be enhanced through positive communication. This research explores positive and negative communication patterns in collaborative contexts. Thematic analysis is applied to qualitative data collected from 278 participants involved in varied collaborative efforts. Fifteen collaborative communication practices emerge as playing an important role in fostering collaboration. Findings from this research contribute to the growing field of positive communication scholarship by offering positive communication practices that people can employ to strengthen interpersonal relationships in collaborative efforts. Guidance on ways practitioners can apply these findings is provided.
Is NEWS of value for patients with acute stroke?
Authors: van Valburg Mariëlle K , Vernooij Lisette M , Kalkman Cornelis J , van der Worp H Bart
Published: July 2024

Background:

Patients with acute stroke are at risk of respiratory or circulatory compromise resulting in vital instability, which can be captured through the widely used aggregated National Early Warning Score (NEWS). We aimed to assess the relation between vital instability (defined as NEWS of five or higher) and death or dependency at 90 days after stroke.

Methods:

In this observational cohort study we studied 763 patients with ischaemic stroke ( n = 400), intracerebral haemorrhage (ICH) ( n = 146) or subarachnoid haemorrhage (SAH) ( n = 217), hospitalized to a Dutch tertiary referral hospital from 1 January 2017 to 31 December 2018. We calculated NEWS for each 8 h time span during the first 72 h after hospitalization. We also decomposed NEWS into its three components respiration, circulation and consciousness. The primary outcome was death or dependency (modified Rankin Scale score ⩾3) at 90 days after stroke. The association of vital instability with functional dependency was examined using Poisson regression.

Results:

Two hundred and twenty-seven (58%) patients with ischaemic stroke, 101 (69%) with ICH and 142 (65%) with SAH had at least one episode of vital instability. In patients with ischaemic stroke or SAH, vital instability was associated after adjustment for confounders with death or dependency (adjusted relative risk 1.55 ((95% CI) 1.25–1.93 and 2.13 (1.35–3.36), respectively)). This was mainly driven by impaired consciousness, which was associated with death or dependency in all types of stroke. Respiratory insufficiency and circulatory instability were associated with death or dependency only in SAH.

Conclusion:

Vital instability in the first 72 h of hospitalization for ischaemic stroke or SAH is associated with death or dependency at 90 days. Impaired consciousness was the main driver of this relationship. NEWS may not be appropriate for patients with acute stroke, mainly due to the dichotomous manner in which the level of consciousness is classified, and modification of NEWS should be considered for these patients
Surgical Management of Achilles Tendon Ruptures in the United States 2006-2020, an ABOS Part II Oral Examination Case List Database Study
Authors: Brodeur Peter G. , Salameh Motasem , Boulos Alexandre , Blankenhorn Brad D. , Hsu Raymond Y.
Published: July 2024

Background:

In correlation with a growing body of evidence regarding nonoperative management for Achilles tendon rupture (ATR), studies from Europe and Canada have displayed a decreasing incidence in surgical management, which has not been noted in the United States. The primary objective of this study is to evaluate the US trend in ATR repair volume.

Methods:

The American Board of Orthopaedic Surgery (ABOS) Part II Oral Examination Case List Database was used. All cases using Current Procedural Terminology codes for primary ATR repair were requested from the years 2006-2020. Total submitted Achilles repair volume, the number of candidates submitting an Achilles repair case, and the overall submitted case volume per examination year was analyzed. Poisson and linear regressions were used to determine statistically significant trends.

Results:

The total number of Achilles repair cases submitted for the ABOS Part II Oral Examination significantly increased from 2006 to 2011 and then decreased until 2020. Taking Achilles repair cases as a proportion of total orthopaedic cases submitted, the same trend was seen. The number of candidates submitting an Achilles repair case increased from 2006 to 2009 and then decreased until 2020. Foot and Ankle fellowship-trained candidates submitted an increasing number of ATR repair cases per candidate during the time period studied.

Conclusion:

This is the first study to demonstrate a decline in the volume of ATR repair in the United States. The decline in ATR repair volume seen in the ABOS Part II Case Lists does not match previously published US surgeon practice patterns but is not necessarily generalizable to beyond this period. Although the overall ATR repair volume in the ABOS Part II Case Lists is decreasing, we found Foot and Ankle fellowship-trained surgeons are operating on an increasing number of ATRs during their board collection period.

Level of Evidence:

Level III, retrospective cohort study.
Comparison of Minimally Invasive Chevron Akin and Open Lapidus Surgery in Older Patients at a Minimum 1-Year Follow-Up
Authors: Boden Allison L. , DiGiovanni Grace M. , Masry Seif El , Ellis Scott J. , Johnson A. Holly , Conti Matthew S.
Published: July 2024

Background:

Hallux valgus deformity affects more than 35% of people aged ≥65 years. Surgical correction in this population can be more complicated because of poor bone quality, worse deformity, and postoperative recovery challenges. The purpose of this study was to compare the radiographic and clinical outcomes of patients aged ≥65 years who underwent either open Lapidus or minimally invasive chevron Akin osteotomy for bunion correction.

Methods:

A retrospective review identified 62 patients aged ≥65 years who were treated surgically for hallux valgus with at least 1-year postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores (physical function and pain interference). Preoperative and at least 6-month postoperative radiographs were measured for the hallux valgus angle and intermetatarsal angle. PROMIS scores were obtained preoperatively and at 1 and/or 2 years postoperatively. Differences in demographic, clinical, and radiographic outcomes were assessed using the Mann Whitney U test and P values were adjusted for a false discovery rate of 5%.

Results:

There was no difference between the MIS and open cohorts in pre- or postoperative radiographic measurements or clinical outcomes at any time point. At 1 year postoperatively, both groups had statistically significant improvements in the PROMIS pain interference domain but only the MIS group had a statistically significant improvement in the PROMIS physical function domain. Clinical significance was equivocal. At 2 years postoperatively, there were clinically and statistically significant improvements in the PROMIS pain interference and physical function domains for the open and MIS groups.

Conclusion:

Patients in both surgical groups had improvement in radiographic measurements and 2-year PROMIS scores, although there was no clinical or statistical difference found between groups. MIS and open surgical techniques appear to be safe and effective in correcting hallux valgus in older patients; however, patients may need to be counseled that maximum improvement after surgery may take more than 1 year.

Level of Evidence:

Level III, retrospective cohort study.
Electrophysiological differences of randomized deep sedation with dexmedetomidine versus propofol
Authors: Servatius Helge , Kueffer Thomas , Erdoes Gabor , Seiler Jens , Tanner Hildegard , Noti Fabian , Haeberlin Andreas , Madaffari Antonio , Branca Mattia , Dütschler Sophie , Theiler Lorenz , Reichlin Tobias , Roten Laurent
Published: July 2024

Background

Dexmedetomidine and propofol are common sedatives in intensive care units and for interventional procedures. Both may compromise sinus node function and atrioventricular conduction.

The objective of this prospective, randomized study is to compare the effect of dexmedetomidine with propofol on sinus node function and atrioventricular conduction.

Methods

In a tertiary care center in Switzerland we included from September 2019 to October 2020 160 patients (65 ± 11 years old; 32% female) undergoing first ablation for atrial fibrillation by cryoballoon ablation or by radiofrequency ablation.

Patients were randomly assigned to deep sedation with dexmedetomidine (DEX group) versus propofol (PRO group). A standard electrophysiological study was performed after pulmonary vein isolation with the patients still deeply sedated and hemodynamically stable.

Results

Eighty patients each were randomized to the DEX and PRO group. DEX group patients had higher baseline sinus cycle length (1022 vs. 1138 ms; p = 0.003) and longer sinus node recovery time (SNRT400; 1597 vs. 1412 ms; p = 0.042). However, both corrected SNRT and normalized SNRT did not differ. DEX group patients had longer PR interval (207 vs. 186 ms; p = 0.002) and AH interval (111 vs. 95 ms, p = 0.008), longer Wenckebach cycle length of the atrioventricular node (512 vs. 456 ms; p = 0.005), and longer atrioventricular node effective refractory period (390 vs. 344 ms; p = 0.009). QRS width and HV interval were not different. An arrhythmia, mainly atrial fibrillation, was induced in 33 patients during the electrophysiological study, without differences among groups (20% vs. 15%, p = 0.533).

Conclusions

Dexmedetomidine has a more pronounced slowing effect on sinus rate and suprahissian AV conduction than propofol, but not on infrahissian AV conduction and ventricular repolarization. These differences need to be taken into account when using these sedatives.

Trial registration

ClinicalTrials.gov number NCT03844841, 19/02/2019
High prevalence of late presentation with advanced HIV disease and its predictors among newly diagnosed patients in Kumasi, Ghana
Authors: Sakyi Samuel Asamoah , Kwarteng Samuel , Senu Ebenezer , Effah Alfred , Opoku Stephen , Oppong Success Acheampomaa , Yeboah Kingsley Takyi , Abutiate Solomon , Lamptey Augustina , Arafat Mohammed , Afari-Gyan Festus Nana , Agordzo Samuel Kekeli , Mensah Oscar Simon Olympio , Owusu Emmauel , Buckman Tonnies Abeku , Amoani Benjamin , Enimil Anthony Kwame
Published: July 2024

Background

Late presentation with advanced HIV disease (LP-AHD) remains a significant challenge to Human Immunodeficiency Virus (HIV) care, contributing to increased morbidity, mortality, and healthcare costs. Despite global efforts to enhance early diagnosis, a considerable proportion of individuals with HIV infection are unaware of being infected and therefore present late for HIV care. For the first time in Ghana, this study assessed the prevalence of LP-AHD and associated factors among people diagnosed with HIV (PDWH).

Method

This bi-center retrospective cross-sectional study included 315 PDWH at the Aniniwah Medical Centre and Komfo Anokye Teaching Hospital, both in Kumasi, Ghana. A well-structured questionnaire was used to collect data on sociodemographic, clinical, lifestyle and psychosocial factors from the study participants. Statistical analyses were done in SPSS version 26.0 and GraphPad Prism version 8.0 at significant p-value of < 0.05 and 95% confidence interval. Predictors of LP-AHD were assessed using binary logistic regression models.

Results

This study observed that, 90 out of the 315 study PDWH (28.6%) reported late with advanced HIV disease (AHD). Participants within the age group of 36–45 years (adjusted Odds Ratio [aOR]: 0.32, 95% CI: 0.14–0.69; p = 0.004) showed a significantly decreased likelihood of LP-AHD. However, participants who perceived cost of HIV care to be high (aOR: 7.04, 95% CI: 1.31–37.91; p = 0.023), who were diagnosed based on clinical suspicion (aOR: 13.86, 95 CI: 1.83–104.80; p = 0.011), and missed opportunities for early diagnosis by clinicians (aOR: 2.47, 95% CI: 1.30–4.74; p = 0.006) were significantly associated with increased likelihood of LP-AHD.

Conclusion

The prevalence of LP-AHD among PDWH in Ghana is high. Efforts to improve early initiation of HIV/AIDS care should focus on factors such as the high perceived costs of HIV care, diagnosis based on clinical suspicion, and missed opportunities for early diagnosis by physicians.
Hemoadsorption therapy for myoglobin removal in rhabdomyolysis: consensus of the hemoadsorption in rhabdomyolysis task force
Authors: Forni Lui , Aucella Filippo , Bottari Gabriella , Büttner Stefan , Cantaluppi Vincenzo , Fries Dietmar , Kielstein Jan , Kindgen-Milles Detlef , Krenn Claus , Kribben Andreas , Meiser Andreas , Mitzner Steffen , Ostermann Marlies , Premuzic Vedran , Rolfes Caroline , Scharf Christina , Schunk Stefan , Molnar Zsolt , Zarbock Alexander
Published: July 2024

Background

Rhabdomyolysis describes a syndrome characterized by muscle necrosis and the subsequent release of creatine kinase and myoglobin into the circulation. Myoglobin elimination with extracorporeal hemoadsorption has been shown to effectively remove myoglobin from the circulation. Our aim was to provide best practice consensus statements developed by the Hemoadsorption in Rhabdomyolysis Task Force (HRTF) regarding the use of hemadsorption for myoglobin elimination.

Methods

A systematic literature search was performed until 11th of January 2023, after which the Rhabdomyolysis RTF was assembled comprising international experts from 6 European countries. Online conferences were held between 18th April − 4th September 2023, during which 37 consensus questions were formulated and using the Delphi process, HRTF members voted online on an anonymised platform. In cases of 75 to 90% agreement a second round of voting was performed.

Results

Using the Delphi process on the 37 questions, strong consensus (> 90% agreement) was achieved in 12, consensus (75 to 90% agreement) in 10, majority (50 to 74%) agreement in 13 and no consensus (< 50% agreement) in 2 cases. The HRTF formulated the following recommendations: (1) Myoglobin contributes to the development of acute kidney injury; (2) Patients with myoglobin levels of > 10,000 ng/ml should be considered for extracorporeal myoglobin removal by hemoadsorption; (3) Hemoadsorption should ideally be started within 24 h of admission; (4) If myoglobin cannot be measured then hemoadsorption may be indicated based on clinical picture and creatinine kinase levels; (5) Cartridges should be replaced every 8–12 h until myoglobin levels < 10,000 ng/ml; (6) In patients with acute kidney injury, hemoadsorption can be discontinued before dialysis is terminated and should be maintained until the myoglobin concentration values are consistently < 5000 ng/ml.

Conclusions

The current consensus of the HRTF support that adjuvant hemoadsorption therapy in severe rhabdomyolysis is both feasible and safe and may be an effective method to reduce elevated circulating levels of myoglobin.