bluuebunny/crossref_metadata_2025 huggingface dataset:
Icariin-loaded chitosan/β-glycerophosphate thermosensitive hydrogel enhanced infection control and bone regeneration in canine with infectious bone defects
Authors: Shao Bing , Fu Yang , Li Bo , Huo Siming , Du Jiayu , Zhang Xuliang , Yin Xin , Li Yanfei , Cao Zheng , Song Miao
Published: October 2024

Faced with infectious bone defects, the development of a thermosensitive hydrogel containing icariin (ICA) represents a promising therapeutic strategy targeting infection control and bone regeneration. In this study, we prepared and evaluated the physicochemical properties, in vitro and in vivo drug release, antimicrobial activity, anti-inflammatory properties, and bone repair effects of ICA/Chitosan/β-Glycerophosphate (ICA/CTS/β-GP) thermosensitive hydrogel. Our findings demonstrate that the ICA/CTS/β-GP thermosensitive hydrogel undergoes a liquid-to-gel transition at body temperature, which is crucial for maintaining local drug release at the defect site. Additionally, the hydrogel exhibited sustained release of ICA over 28 days, showing high antimicrobial activity against Staphylococcus aureus and good biocompatibility in blood compatibility tests. In a canine model of infectious bone defects, the ICA/CTS/β-GP thermosensitive hydrogel showed effective infection control and modulated inflammation, vascular formation, and bone factor expression, while also activating the Wnt/β-catenin signaling pathway. In conclusion, the ICA/CTS/β-GP thermosensitive hydrogel could control infection and repair bone tissue. Its antimicrobial and osteogenic properties provide hope for its clinical application.
Can AI Lie? Chabot Technologies, the Subject, and the Importance of Lying
Authors: Black Jack
Published: October 2024

This article poses a simple question: can AI lie? In response to this question, the article examines, as its point of inquiry, popular AI chatbots, such as, ChatGPT. In doing so, an examination of the psychoanalytic, philosophical, and technological significance of AI and its complexities are located in relation to the dynamics of truth, falsity, and deception. That is, by critically considering the chatbot’s ability to engage in natural language conversations and provide contextually relevant responses, it is argued that what separates the AI chatbot from anthropocentric debates, which allude to some form of conscious recognition on behalf of AI, is the importance of the lie – an importance which a psychoanalytic approach can reveal. Indeed, while AI technologies can undoubtedly blur the line between lies and truth-speaking, in the case of the AI chatbot, it is detailed how such technology remains unable to lie authentically or, in other words, is unable to lie like a human. For psychoanalysis, the capacity to lie bears witness to the unconscious and, thus, plays an important role in determining the subject. It is for this reason that rather than uncritically accepting the chatbot’s authority – an authority that is easily reflected in its honest responses and frank admissions – a psychoanalytic (Lacanian) perspective can highlight the significance of the unconscious as a distorting factor in determining the subject. To help elucidate this argument, specific attention is given to introducing and applying Lacan’s subject of enunciation and subject of the enunciated. This is used to assert that what continues (for now) to set us apart from AI technology is not necessarily our ‘better knowledge’ but our capability to consciously engage in acts of falsehood that function to reveal the social nuances and significances of the lie.
Modeling and simulation of novel bio-emulated flow field with improved branch channels on PEMFC performance
Authors: Bondada Yeswanth Yadav , Golagani Naga Srinivasulu , Gundalabhagavan Amarnath
Published: October 2024

The channel geometry of the bipolar plate in the proton exchange membrane fuel cell (PEMFC) significantly influences its performance. In this study, a bio-emulated flow field (BEFF) pattern in the bipolar plate was used based on the external carotid artery design with its branches. A comprehensive investigation was conducted using a three-dimensional (3-D) multiphase computational fluid dynamics (CFD) model on bio-emulated flow fields with branch channels of zero (BE-0), six (BE-6), and ten (BE-10). The results obtained were compared with traditional parallel flow fields (TPFF) and traditional serpentine flow fields (TSFF). The BE-10 results showed reduced pressure drop, uniform distribution of reactants, and higher power output compared with other configurations. The peak power density of BE-10 surpassed that of TPFF by approximately 45.07% and exceeded BE-0 by 10.39%. The novel BEFF structure with an increase in branch channels showed that the reactants, temperature, and static pressure distribution are more uniform with better water management.
Pre-specifiable fixed-time control for quadrotor aircraft with output constraints
Authors: Sun Xiaoxuan , Li Qing , Wang Jie , Yao Qijia
Published: October 2024

For the controller design of quadrotor aircraft with six-DOF, a pre-specifiable fixed-time method combined with state constraints is researched in this paper. The 6-DOF aircraft model is divided into position loop and attitude loop through time scale decomposition method for the convenience of decoupling. Adaptive pre-specifiable fixed-time controllers for the position subsystem and attitude subsystem are proposed to ensure the desired trajectory and the desired attitude angle can be reached within a fixed-time which is independent of initial conditions. Meanwhile, the convergence time can be user-assignable in advance. Time-varying state constraints are considered in the controller design process in order to guarantee the safety of the system and prolong the life of actuator. The Barrier Lyapunov function is applied to ensure quadrotor aircraft’s output constraints are not violated. Finally, the effectiveness of the proposed controller is verified by the simulation experiment.
How Does Legal Culture Matter for Climate Mobilities? A Case Study in an Unplanned Coastal Settlement in Urban Mozambique
Authors: Halliday Simon , Hoddy Eric , Ensor Jonathan , Wamsler Christine , Boyd Emily , Macome Amelia
Published: October 2024

This article responds to the general neglect of legal culture in the study of climate mobilities. It presents a case study of climate mobilities in an unplanned settlement in Maputo, Mozambique, exploring how legal culture influenced residents’ decision-making processes as they navigated climate-related risks in their daily lives. We demonstrate that legal culture can facilitate climate mobilities. However, we argue that the role of legal culture in enabling climate mobilities is potentially very complex. Our case study uncovered a nuanced ‘ecosystem’ of land laws in Mozambique, comprising two official systems – formal and informal. Despite their contradictory substantive content regarding land rights, these systems functioned symbiotically, allowing residents of unplanned settlements to mitigate the effects of climate risks. This apparent paradox is explained through the analytical lenses of jurisdiction, scale and temporality. We also argue that this ‘ecosystem’ of land laws can only fully be understood within the broader context of Mozambique's political economy, which attracts foreign investment and promotes urban development, often at the expense of those living in unplanned settlements. Future research into the significance of legal culture for climate mobilities must not only be attuned to the plurality of legal orders in play but also consider the scales and temporalities through which they operate. Furthermore, they must also interrogate the interplay between law and broader political, economic and social contexts.
Exploring Indigenous Ways of Childbirth Management and its Perinatal Outcomes During Cyclonic Periods in Hilly Tribal Homebirth Settings: A Qualitative Observational Study
Authors: V Srividhya Samakya , Pati Sanghamitra , Acharya Subhendu Kumar
Published: October 2024

Objective

This study explores the cultural-based management of childbirth vulnerabilities in the hilly regions during cyclone periods, where the land mass has been frequently exposed to floods during and aftermath of cyclones due to low-high cyclonic depressions in the Bay of Bengal coast.

Methods

The present study was a community-based qualitative observational study conducted for three weeks immediately after the two cyclonic periods occurred between October and December 2022. With the purposive sampling method, 21 postpartum mothers were selected on the inclusion criteria, of having had childbirth around the cyclonic period of ‘Sitrang’ (late October 2022) and ‘Mandous’ (early December 2022). Semi-structured in-depth interview schedules were employed to document socio-demographic profiles and probed for their cultural ways of managing childbirth complications and neonatal exposures to infections during the cyclonic period.

Results

Views of 21 mothers were coded into three themes with two sub-themes each according to repeated frequencies of information. The themes were (a) Striving for Safe Childbirths; (b) Surviving with Traditional Capacities; (c) Strength and Sustenance. The results indicated that home deliveries were considered safest over institutional deliveries except in the cases of complicated childbirths confirmed difficult by the traditional birth attendants (TBA). Rough climatic conditions compounded by geographical distance, lack of appropriate financial help and timely transportation facilities were the major prevailing factors influencing their childbirth practices during the cyclonic periods.

Conclusion

Disasters do not alone influence childbirth outcomes, but the evidence is still mixed. The expediency of birth technology has effectively managed childbirth vulnerabilities. Ensured sleep, rest and enough food had also been disturbed during and aftermath cyclones. The results showed an urgent need for focused planning on tribal areas for gestation, birthing and postpartum people during natural disasters.
Board Games and Creativity: Playfulness as a Mediator
Authors: Mercier Maxence , Bourgeois-Bougrine Samira , Lubart Todd
Published: October 2024

Background

Games, and board games in particular, have shown themselves to be a promising avenue to help improve creative potential. However, these findings do not explain the reason as to why board games would be linked to or improve creativity. This paper focuses on one particular variable that could mediate the links between board game play habits and creativity: playfulness.

Method

This quantitative study first examined whether board game play habits are positively related to two creativity measures: creative self-concept and creativity in the workplace. Furthermore, it was hypothesized that playfulness would have a mediating effect between board game play habits and creativity outcomes. Data was collected from 327 French workers using online recruitment through social networks, by means of a questionnaire-based survey.

Results

Results show that board game play habits are positively correlated with both creativity in the workplace and creative self-concept. Furthermore, the adult playfulness dimension of fun-seeking motivation mediate the relationship between board game play habits and both creativity in the workplace and creative self-concept.

Discussion

Playing more board games is associated with higher playfulness, which in turn is associated with more creativity in the workplace and higher creative self-concept. These findings suggest that encouraging board game play, notably playing a broad range of board games, could help foster playfulness and thus improve creativity.
Feeling Grounded: Exploring the Sense of Groundedness in Cultural Tourism Driven by Live Streaming Technology
Authors: Guo Lingyun , Du Yanhui , Meng Shengyuan
Published: October 2024

As information and communication technology advances, the on-site experience of traditional field tourism is being transformed into a virtual experience under digital tourism. The sense of groundedness occurs when tourists connect to the geography, humanity, and history of destination. Little is known about how technology, marketing, and tourism resources can be combined to enrich the authenticity of the virtual tourism experience. This study explores the main characteristics of groundedness in cultural tourism to address this research gap. It develops and validates the scale for measuring tourism experience based on live streaming technology. The findings also reveal groundedness as a driver of tourists’ willingness and behavior to participate. The study theoretically promotes the development of groundedness and the emerging research on digital cultural tourism marketing. Meanwhile, the study results provide stakeholders with an attractive and implementable tourism perceptual experience—groundedness—implying references for overall sustainable destination development.
Vibration control of a longitudinally vibrating rod connected through an elastic coupler by installing a nonlinear vibration reduction coupler
Authors: Yan Wanjun , Cui Haijian , Hu Jie , Li Sheng
Published: October 2024

To study the potential application of the longitudinal vibration control of a rod coupling system by employing NESs, this study proposes a nonlinear vibration reduction coupler (NVRC), where the NVRC can be regarded as the NES which is installed between the two elastic structures. The introduction of NVRC is aimed at controlling the longitudinal vibration of the rod system. Based on the Lagrange method (LM), the longitudinal vibration analysis model of a rod system connected through a linear elastic coupler and an NVRC is established, in which the longitudinal vibration responses of the rod system with an NVRC are predicted. In the numerical analysis, the correctness and stability of LM in calculating longitudinal vibration responses of the rod system with an NVRC are verified, where the chosen reasons for observation points are explained. It can be concluded that the introduction of NVRC can reduce the vibration of each resonance area of the rod system at the same time. Under certain parameters, the vibration characteristics of the rod system are changed by employing NVRC. Furthermore, nonlinear stiffness and viscous damping of NVRC can be chosen as the adjustable parameters that strengthen the vibration reduction ratio of the rod system. Overall, the longitudinal vibration of the rod system can be effectively controlled by choosing reasonable parameters of NVRC. The introduction of NVRC provides an effective way to control the longitudinal vibration of the rod system.
Perioperative Outcomes: Polycarbonate Polyurethane Artificial Blood Vessel Versus Polyester Artificial Blood Vessel
Authors: Gu Yuanrui , Zhou Zeming , Sun Yangxue , Gao Shiqi , Yu Cuntao , Ouyang Chenxi
Published: October 2024

Objective:

The objective of this study was to compare the perioperative performance of the novel large-diameter composite polycarbonate polyurethane graft and the polyester graft.

Methods:

In this study, we retrospectively analyzed 14 patients with thoracic aortic prosthesis replacement from 2016 to 2021. The preoperative, intraoperative, and postoperative data of the 2 groups were assessed in detail.

Results:

We defined the patients with polyester grafts as the control group and the patients with polycarbonate polyurethane grafts as the experimental group. The total operation time of the experimental group was significantly shorter than that of the control group, which were 159.29±38.13 minutes and 252.57±64.40 minutes, respectively (p<0.001). The length of time from aortic opening to the end of operation in the experimental group was significantly shorter than that in the control group, which were 70.43±8.08 minutes and 124.71±37.59 minutes, respectively (p<0.001). The mean total drainage of pleural fluid was lower in the experimental group than in the control group (383.43±139.68 mL vs. 828.00±457.27 mL; p<0.05). The mean postoperative in-hospital time was shorter in the experimental group than in the control group (6.71±0.75 days vs. 9.43±2.82 days; p<0.05).

Conclusions:

This study provides preliminary evidence that the novel artificial blood vessel has good mechanical properties, histocompatibility, hemocompatibility, and anti-seepage function in the human body. A multicenter randomized controlled trial is needed for further validation.

Clinical Impact

The novel hybrid polycarbonate polyurethane (PCU)/polyester three-layered large-diameter artificial blood vessel simulates the internal, middle, and external layers of the human blood vessels. The inner and outer layer are made of PCU, and the middle reinforcing layer is woven by polyester. Because of the three-layered structure, this artificial blood vessel has excellent anti-seepage and anti-infection functions. the inner and outer layers of the blood vessel made of PCU let this artificial blood vessel has excellent blood compatibility, outstanding biocompatibility, high endothelialization rate, and 100% patency. By comparing the perioperative outcomes with the polyester artificial blood vessel, we find it has good mechanical properties, histocompatibility, hemocompatibility and anti-seepage function in the human body.
More is Different in mTORopathies
Authors: Wang Yu
Published: October 2024

[Box: see text]
Dopamine Dilemma Overexcites the Hippocampus in Alzheimer's Disease
Authors: Wong Jennifer C.
Published: October 2024

[Box: see text]
Nav1.1gating Against the Current: Ndnf Interneurons Hold Strong in Dravet Syndrome
Authors: Voskobiynyk Yuliya , Paz Jeanne T.
Published: October 2024

[Box: see text]
Agency, Structure, and Organization: School-Wide Approaches to Dismantling Injustice
Authors: Cruz Rebecca A. , Shin Claire J. , McClam Rachel S.
Published: October 2024

Schools and districts have long grappled with race- and disability-based exclusionary discipline inequities. Research on the topic has uncovered a variety of systems that maintain such disparities, including school policies and practices that exacerbate the problem. Researchers and practitioners have increasingly considered school context and practices as mediators of both special education and exclusionary discipline risk. Although educational leaders are often required to review policies, practices, and procedures that contribute to inequities, few tools exist for practical translation toward school-wide solutions. This case is designed to help school and district leaders translate theory and research into practical actions for transformational change. The case provides considerations for designing and implementing culturally responsive Multi-Tiered Systems and Supports within a given school context, including climate and programming.
Macromolecular structure development of dry-spinning UHMWPE fibers through the industrial high-ratio hot-drawing process
Authors: Li Fangquan , Li Xin
Published: October 2024

Ultra-high molecular weight polyethylene (UHMWPE) and its decalin suspension were subjected to several industrial processes including swelling, dissolving, spinning, drying, and multi-stage high-ratio hot drawing to fabricate UHMWPE fibers (UPE fibers). The morphologies and architectures of the UPE fibers at different drawing stages were characterized by polarizing optical microscope (POM), scanning electron microscope (SEM) and atomic force microscopy (AFM). The aggregation structure evolution of UHMWPE macromolecules during the high-ratio hot-drawing process was studied by differential scanning calorimeter (DSC), wide-angle X-ray diffraction (WAXD), small angle X-ray scattering (SAXS) and other testing methods. The experimental results demonstrated that the UHMWPE/decalin spinning suspension was extruded from the spinneret hole to form a fine spinning flow, followed by the formation of the transitional-state fibers at different processing stages, and finally the ready-made fibers. The total drafting ratio of the UPE fibers after fabrication reached more than 600 times. The diameter of the single UPE filament was reduced to 5.66 μm with elevated drawing ratios. The crystal structure of the prepared UPE fibers was progressively improved, and the folding-chain crystals of fibers gradually transformed into extended-chain crystals. The mechanical properties of the UPE fibers were significantly improved. The fracture strength of the as-spun UPE fibers reaches 48.1 cN/dtex, which endows the fibers with specific characteristics such as ultra-fine denier and ultra-high strength.
Quality prediction for rocket body structure manufacturing process based on improved ELM
Authors: Yao Jiayu , Liu Haijiang
Published: October 2024

In the current multi-variety and small-batch production mode, this paper proposes a quality prediction method for rocket body structure manufacturing process based on improved extreme learning machine (ELM). Aiming at the non-optimal problems caused by random selection of input layer weights and hidden layer bias of ELM, particle swarm optimization (PSO) is combined with gravitational search algorithm (GSA) to form a hybrid algorithm to optimize the random parameters of ELM. Taking a weld in a rocket body structure as an example, the weld width prediction model based on improved ELM is established and verified. The results show that compared with the prediction model based on the standard ELM and the prediction model based on PSO-ELM, the prediction model based on improved ELM has higher prediction accuracy, and its prediction deviation does not exceed 2.5%, which can effectively predict the weld width.
The state of individual participant data sharing for the highest-revenue medicines
Authors: Modi Natansh D , Li Lee X , Logan Jessica M , Wiese Michael D , Abuhelwa Ahmad Y , McKinnon Ross A , Rowland Andrew , Sorich Michael J , Hopkins Ashley M
Published: October 2024

Background

Amid growing emphasis from pharmaceutical companies, advocacy groups, and regulatory bodies for sharing of individual participant data, recent audits reveal limited sharing, particularly for high-revenue medicines. Therefore, this study aimed to assess the individual participant data-sharing eligibility of clinical trials supporting the Food and Drug Administration approval of the top 30 highest-revenue medicines for 2021.

Methods

A cross-sectional analysis was conducted on 316 clinical trials supporting approval of the top 30 revenue-generating medicines of 2021. The study assessed whether these trials were eligible for individual participant data sharing, defined as being publicly listed on a data-sharing platform or confirmed by the trial sponsors as in scope for independent researcher individual participant data investigations. Information was gathered from various sources including ClinicalTrials.gov, the European Union Clinical Trials Register, and PubMed. Key factors such as the trial phase, completion dates, and the nature of the data-sharing process were also examined.

Results

Of the 316 trials, 201 (64%) were confirmed eligible for sharing, meaning they were either publicly listed on a data-sharing platform or confirmed by the trial sponsors as in scope for independent researcher individual participant data investigations. A total of 102 (32%) were confirmed ineligible, and for 13 (4%), the sponsor indicated that a full research proposal would be required to determine eligibility. The analysis also revealed a higher rate of individual participant data sharing among companies that utilized independent platforms, such as Vivli, for managing their individual participant data-sharing process. Trials not marked as completed had significantly lower eligibility for individual participant data sharing.

Conclusion

This study highlights that a substantial portion of trials for top revenue-generating medicines are eligible for individual participant data sharing. However, challenges persist, particularly for trials that are marked as ongoing and for trials where the sharing processes are managed internally by pharmaceutical companies. Data-sharing rates could be improved by adopting open-access individual participant data-sharing models or using independent platforms. Standardizing policies to facilitate immediate individual participant data availability for approved medicines is necessary.
The effects of online facial muscle training with resonance vocalization on mental health in postpartum women: A single-arm pilot study
Authors: Okamoto Rumiko , Terasawa Eriko , Usui Atsumi , Matsushima Midori , Okayama Hisayo
Published: October 2024

Background:

Mental health problems among expectant and nursing mothers also affect their infants, partners, and families. While physical activity is a potential method for preventing postpartum depression (PPD), it is difficult for postpartum women to find the time for physical exercise. A recent study reported that improving communication between expectant couples can be used as a preventive intervention for PPD, and a systematic review and meta-analysis recently reported decreased facial emotional expressivity in individuals with different non-psychotic disorders. Therefore, we focused on facial muscle training and its potential as prevention for PPD.

Objective:

We evaluated the effectiveness of online facial muscle training with resonance vocalization using real-time video conferencing programs on the PPD of postpartum women at 2–3 months.

Design:

We recruited 20 postpartum women and used a single-arm, prospective, pre-post design.

Methods:

All subjects participated in 30 min of online facial muscle training with resonance vocalization once a week for 4 weeks. The first and final sessions were performed using a real-time remote chat application, and the second and third sessions were performed on demand. Scores on the Edinburgh Postnatal Depression Scale (EPDS) as an indicator of PPD were used as the primary outcome. Secondary outcomes included the appearance ratio of a happy facial expression, analyzed using FaceReader™; mood, which was measured using a visual analog scale; and stress level, which was measured using a smartwatch.

Results:

The training had a significant effect on EPDS, appearance ratio of a happy facial expression, and mood; however, it did not affect physical stress.

Conclusions:

In the future, intervention studies with a higher evidence level, such as a crossover randomized controlled trial, are required.
The Misadventures of Giuseppe Chiarini's Circus in Mexico, or a Survival Guide for Itinerant Entertainers in Turbulent Times
Authors: Snow K. Mitchell
Published: October 2024

Press coverage of Giuseppe Chiarini's circus in Mexico during the downfall of Maximilian shows the entertainment entrepreneur adapting and altering his promotional messaging in response to a volatile political climate. That Chiarini operated a transnational enterprise at the time allows direct comparisons of the differing messaging he employed between Mexico and the United States on two controversial issues: republican versus imperial forms of government that divided Mexico and slavery that divided the United States. His politically splintered audiences in Mexico also offered differing interpretations of the import of his company's performance, and subsequently employed his circus to bolster the emergence of a national symbol. The record in Mexico suggests that the circus's methods of communication were less resistant to the application of political meaning than they were flexible in incorporating such meanings, allowing for them to attract and maintain the most diverse, and therefore largest, possible public.
The Texas Landscape: Accounting for Migrant Mortality and the Challenges of a Justice of the Peace Medicolegal System
Authors: Siegert Courtney C. , Kaplan Molly A. , Herrmann Nicholas P. , Spradley M. Kate
Published: October 2024

Executive Summary

This paper details the structural and resource challenges in Texas related to identifying migrant decedents, investigating their deaths, repatriating them, and adhering to legal and ethical requirements in addressing this humanitarian tragedy. While actors working on migrant decedent investigations in Arizona can map and provide accurate counts of migrant deaths, this is not yet possible for Texas cases.

Texas’ mixed Medical Examiner/Justice of the Peace medicolegal system suffers from fragmentation across county jurisdictions, lack of resources, and minimal access to investigative tools for transnational families. These challenges produce a landscape where unidentified presumed migrants may structurally disappear (e.g., buried in temporarily marked graves as unidentified persons with no investigation or case tracking).

The article highlights the work of Operation Identification (OpID), a humanitarian project formed to assist border counties with recovering, identifying, and repatriating migrant decedents. OpID’s extensive community outreach and collaboration with governmental and nongovernmental partners in the United States and Latin America have improved practices in some Texas counties. However, systemic change is still needed to address this humanitarian disaster. The article proposes that presumed migrant decedents be managed using a disaster victim identification (DVI) approach, which prioritizes identification, rather than how and why someone dies. It also proposes the establishment of regional Migrant Identification Centers (MICs) to streamline identification and repatriation efforts, while ensuring compliance with Texas law by Justices of the Peace (JPs). Centralization, the article argues, can lead to more accurate counts of migrant deaths and lay the groundwork for greater resources. The article also supports increased access to national databases including the National Combined DNA Indexing System (CODIS) and the National Missing and Unidentified Persons System (NamUs). It argues that transnational families of missing persons be afforded expanded access to investigative tools (e.g., NamUs)
Effectiveness of a Social-Emotional Learning Program for Both Teachers and Students
Authors: Bergin Christi , Tsai Chia-Lin , Prewett Sara , Jones Eli , Bergin David A. , Murphy Bridget
Published: October 2024

This study investigated the effects of the Leader in Me (LiM), a social-emotional learning program implemented in thousands of schools. A mixed-method design included (1) a collective case study in four diverse, high-implementing elementary schools and (2) a post hoc quasi-experiment using propensity score 1:3 matching of 117 LiM and 348 non-LiM schools to compare achievement and discipline incident rates. The case study indicated that participants perceived LiM as improving social-emotional competencies for both teachers and students. Teachers reported being more prosocial, feeling more camaraderie, using more effective discipline, developing better teacher-student relationships, and enjoying teaching more. Students were more prosocial, confident and motivated, and had fewer problem behaviors. School climate improved. Results replicated across four diverse schools. The quasi-experiment supported results of the collective case study. Schools implementing LiM had higher mathematics and ELA, but not science, scores on state proficiency exams and fewer discipline incidents.
Neurochemistry and functional connectivity in the brain of people with Charles Bonnet syndrome
Authors: Bridge Holly , Wyllie Abigail , Kay Aaron , Rand Bailey , Starling Lucy , Millington-Truby Rebecca S. , Clarke William T. , Jolly Jasleen K. , Ip I. Betina
Published: October 2024

Background:

Charles Bonnet syndrome (CBS) is a condition in which people with vision loss experience complex visual hallucinations. These complex visual hallucinations may be caused by increased excitability in the visual cortex that are present in some people with vision loss but not others.

Objectives:

We aimed to evaluate the association between γ-aminobutyric acid (GABA) in the visual cortex and CBS. We also tested the relationship among visually evoked responses, functional connectivity, and CBS.

Design:

This is a prospective, case-controlled, cross-sectional observational study.

Methods:

We applied 3-Tesla magnetic resonance spectroscopy, as well as task-based and resting state (RS) connectivity functional magnetic resonance imaging in six participants with CBS and six controls without CBS. GABA+ was measured in the early visual cortex (EVC) and in the lateral occipital cortex (LOC). Participants also completed visual acuity and cognitive tests, and the North-East Visual Hallucinations Interview.

Results:

The two groups were well-matched for age, gender, visual acuity and cognitive scores. There was no difference in GABA+ levels between groups in the visual cortex. Most participants showed the expected blood oxygenation level dependent (BOLD) activation to images of objects and the phase-scrambled control. Using a fixed effects analysis, we found that BOLD activation was greater in participants with CBS compared to controls. Analysis of RS connectivity with LOC and EVC showed little difference between groups. A fixed effects analysis showed a correlation between the extent of functional connectivity with LOC and hallucination strength.

Conclusion:

Overall, our results provide no strong evidence for an association between GABAergic inhibition in the visual cortex and CBS. We only found subtle differences in visual function and connectivity between groups. These findings suggest that the neurochemistry and visual connectivity for people with Charles Bonnet hallucinations are comparable to a sight loss population. Differences between groups may emerge when investigating subtle and transient changes that occur at the time of visual hallucinations.
First report of uncommon mycobacteria in post LASIK keratitis: Mycobacterium wolinskyi
Authors: van Delden Sébastien , Buvelot Hélène , Bravetti Giorgio Enrico , Pham Truong-Thanh , Thumann Gabriele , Massa Horace
Published: October 2024

Laser assisted in situ keratomileusis (LASIK) surgery is the leading and most performed refractive surgery nowadays. A possible complication of LASIK surgery is infectious keratitis which can lead to disastrous corneal damage and result in permanent loss of vision. LASIK procedures have become increasingly accessible, and the demand for refractive surgery has risen among patients, challenging the medical field to improve the prevention of post-operative infections. Nevertheless, a wide range of pathogens have been described as responsible for post-LASIK keratitis. However, non-tuberculous mycobacterial keratitis remains an infrequent occurrence and is poorly described in the literature. To the best of our knowledge, this is the first ever reported case of post-LASIK keratitis caused by Mycobacterium wolinskyi. We describe the clinical and microbial characteristics, leading to its challenging treatment choice.
Chronic kidney disease in Kuwait: a multicenter study of two cohorts with different levels of access to public healthcare
Authors: AlSahow Ali , AlYousef Anas , AlSabti Nasser , AlHelal Bassam , AlRajab Heba , AlQallaf Ahmed , Bahbahani Yousif , AlKandari Abdulrahman , Mazroue Ahmad , Dewidar Noha , Nessim Gamal , Mekky Ahmad Atef , Sherif Mohamed , Zamel Hesham , Abdalla Ahmed , Kumar Rajeev
Published: October 2024

Introduction

Kuwait has a large expatriate community who experience both restricted access to public health services and lower income than Kuwaiti citizens. Given these conditions, we examined differences in characteristics and management of chronic kidney disease (CKD) between Kuwaitis and expatriates.

Methods

Clinical and laboratory data for adult CKD Stages 3–5 not on dialysis (CKD 3–5 ND) patients with native kidneys attending nephrology clinics in all Ministry of Health hospitals collected from January 1, 2022, to December 31, 2022. Cohort was then divided into Kuwaiti patients and expatriates patients for comparison.

Results

We collected data from 2,610 patients (eGFR: 30.8 ml/min/1.73m2; age: 62.6 years; males: 56.7%; Kuwaitis: 62.1%). Kuwaitis were older (63.94 vs. 60.3 years, p < 0.001), with lower mean eGFR (30.4 vs. 31.5 ml/min/1.73m2, p = 0.052) than non-Kuwaitis, however, Kuwaitis had lower mean blood pressure (137.2/76.5 vs. 139.1/78.9 mmHg, p = 0.006), lower HbA1c in diabetics (7.59 vs. 7.82%, p = 0.010), and better lipid profile despite higher body mass indexes (29.6 vs. 28.9 kg/m2, p = 0.002). Both groups had high diabetes mellitus and hypertension rates. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were used in only 22.6% and renin-angiotensin-aldosterone system inhibitors (RAASi) in only 46.2%.

Conclusion

CKD 3–5 ND is caused by diabetes mellitus in 56.6% of cases, and the majority have hypertension. In our study, non-Kuwaitis had higher eGFR; however, restricted public healthcare access and lower income can lead to an unhealthy diet and suboptimal care, which may cause higher blood pressure, higher HbA1c, and a higher dyslipidemia rate. RAASi and SGLT2i utilization must increase to combat CKD, and antihypertensive selection must improve.
The impact of physical activity on progression-free and overall survival in metastatic breast cancer based on molecular subtype
Authors: Ziegler Philipp , Hartkopf Andreas D. , Wallwiener Markus , Häberle Lothar , Kolberg Hans-Christian , Hadji Peyman , Tesch Hans , Ettl Johannes , Lüftner Diana , Müller Volkmar , Michel Laura L. , Belleville Erik , Wimberger Pauline , Hielscher Carsten , Huebner Hanna , Uhrig Sabrina , Wurmthaler Lena A. , Hack Carolin C. , Mundhenke Christoph , Kurbacher Christian , Fasching Peter A. , Wuerstlein Rachel , Untch Michael , Janni Wolfgang , Taran Florin-Andrei , Lux Michael P. , Wallwiener Diethelm , Brucker Sara Y. , Fehm Tanja N. , Schneeweiss Andreas , Goossens Chloë
Published: October 2024

Background

Although adequate physical activity has been shown to be beneficial in early breast cancer, evidence in metastatic breast cancer is sparse and contradictory, which could be related to distinct effects of physical activity on the different molecular cancer subtypes. Therefore, we here evaluated the effect of physical activity on progression-free and overall survival (PFS, OS) in metastatic breast cancer, specifically looking at molecular subtypes.

Methods

International Physical Activity Questionnaire (IPAQ) questionnaires, filled out by patients enrolled in the prospective PRAEGNANT registry (NCT02338167; n = 1,270) were used to calculate metabolic equivalent task (MET) minutes, which were subsequently categorized into low (n = 138), moderate (n = 995) or high IPAQ categories (n = 137). Cox regression analyses were used to evaluate the impact of IPAQ categories and its interaction with molecular subtypes on PFS and OS.

Results

Patient and tumor characteristics were equally distributed across IPAQ categories. HER2pos, HRpos and TNBC were present in 23.1%, 65.7% and 11.2% of patients, respectively. IPAQ scores did not have an impact on PFS and OS in addition to established prognostic factors, either overall or in particular molecular subtypes (PFS: p = 0.33 and OS: p = 0.08, likelihood ratio test). Exploratory analyses showed higher overall survival rates for high IPAQ categories compared to low/moderate IPAQ categories in luminal B-like breast cancer.

Conclusions

Self-reported physical activity using the IPAQ questionnaire did not significantly affect PFS or OS in patients suffering from metastatic breast cancer. Nevertheless, some hypothesis-generating differences between molecular subtypes could be observed, which may be interesting to evaluate further.
Exploring the prevalence of chlamydial and gonorrheal infections in pregnant women: a multicenter study in Egypt
Authors: El-Gibaly Omaima , Wahba Momdouh , Gamaleldin Nahla , Hashish Alaa , Ibrahim Mostafa Nasr , Khalifa Ahmed Khedr , Mohammed Sherif Yehia , wasfy Mohamed Ahmed , Eldosky Sara Ali Mohammed , Amin Wagdy , Elsayed Heba , Amin Mariam Taher
Published: October 2024

Background

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study’s main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections.

Methods

A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test.

Results

The prevalence of CT infections was 0.29% (95% CI, 0.10–0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results.

Conclusions

This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. Trial registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.
The questions on violence (FOV) tool for interpersonal violence inquiry in Swedish healthcare settings – evaluation of content validity, face validity and test-retest reliability
Authors: Lövestad Solveig , Sjöström Karin , Björk Josefin , Örmon Karin
Published: October 2024

Background

Previous research indicates that routine inquiry or screening conducted by healthcare providers may significantly increase the identification of interpersonal violence. There is a lack of comprehensive instruments to routinely assess patients about interpersonal violence and violence against children in the household. The purpose of this study was to assess the content validity, face validity and reliability of the Questions on Violence (FOV) tool, an instrument specifically designed for routine inquiries about interpersonal violence in healthcare settings within the Swedish context.

Methods

The content validity, face validity and reliability of the FOV instrument was assessed through (1) a content validity index with six experts in the field of intimate partner violence, (2) cognitive interviews with nine patients recruited from a primary healthcare facility, and (3) an evaluation of the test-retest reliability based on responses from 37(50.0%) university students. The intraclass correlation coefficient, model 2.1, was calculated to assess the degree of correlation and agreement between the two measurements.

Results

Calculations based on the content validity index indicated that five out of seven items had excellent content validity (≥ 0.78). The average content validity index of included items was 0.88, which is slightly below the recommended threshold for excellent content validity. The results based on the cognitive interviews revealed that participants found the seven items to be relevant and easy to understand. Overall, the participants agreed that the concept of ‘close relationships’ primarily encompassed intimate partners, family members, and close friends. The value of the intraclass correlation coefficient was 0.85 (0.77–0.91; CI 95%), indicating good reliability with an interval of good to excellent test-retest reliability.

Conclusions

The results demonstrate that the seven-item FOV instrument has good content and face validity as well as good to excellent test-retest reliability. The current study provides healthcare professionals with a short yet comprehensive instrument for identifying patients who have experienced or perpetrated different forms of interpersonal violence.
Sex disparities in the prevalence, incidence, and management of diabetes mellitus: an Australian retrospective primary healthcare study involving 668,891 individuals
Authors: Mnatzaganian George , Lee Crystal Man Ying , Cowen Gill , Boyd James H. , Varhol Richard J. , Randall Sean , Robinson Suzanne
Published: October 2024

Background

In Australia, diabetes is the fastest growing chronic condition, with prevalence trebling over the past three decades. Despite reported sex differences in diabetes outcomes, disparities in management and health targets remain unclear. This population-based retrospective study used MedicineInsight primary healthcare data to investigate sex differences in diabetes prevalence, incidence, management, and achievement of health targets.

Methods

Adults (aged ≥ 18 years) attending 39 general practices in Western Australia were included. Diabetes incidence and prevalence were estimated by age category. Health targets assessed included body mass index (BMI), blood pressure, blood lipids, and glycated haemoglobin (HbA1c) levels. Medical management of diabetes-associated conditions was also investigated. Time-to-incident diabetes was modelled using a Weibull regression. A multilevel mixed-effects logistic regression model investigated risk-adjusted sex differences in achieving the HbA1c health target (HbA1c ≤ 7.0% (≤ 53 mmol/mol)).

Results

Records of 668,891 individuals (53.4% women) were analysed. Diabetes prevalence ranged from 1.3% (95% confidence interval (CI) 1.2%-1.3%) in those aged < 50 years to 7.2% (95% CI 7.1%-7.3%) in those aged ≥ 50 years and was overall higher in men. In patients younger than 30 years, incidence was higher in women, with this reversing after the age of 50. Among patients with diabetes, BMI ≥ 35 kg/m2 was more prevalent in women, whereas current and past smoking were more common in men. Women were less likely than men to achieve lipid health targets and less likely to receive prescriptions for lipid, blood pressure, or glucose-lowering agents. Men with incident diabetes were 21% less likely than women to meet the HbA1c target. Similarly, ever recorded retinopathy, nephropathy, neuropathy, hypertension, dyslipidaemia, coronary heart disease, heart failure, peripheral vascular disease and peripheral artery disease were higher in men than women.

Conclusions

This research underscores variations in diabetes epidemiology and management based on sex. Tailoring diabetes management should consider the patient's sex.