bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel approach to remove retained lens material: Suction-assisted elevation and anterior chamber phacoemulsification
Authors: De Vitto Antonia Maria Luce , Santorum Paolo , Bertelli Enrico
Published: August 2024

Purpose

To describe and evaluate the feasibility of a novel pars plana vitrectomy (PPV) technique for the removal of retained lens material (RLM), which obviates the need for either 20-gauge intravitreal fragmentation or perfluorocarbon-assisted elevation.

Methods

Interventional case series. After thorough 23-gauge PPV, the hard lens material is engaged and held adherent to the vitreous cutter using aspiration, then raised into the anterior chamber. There, a standard phacoemulsification probe, inserted through a corneal incision, is used to fragment and remove the material.

Results

Three eyes of 3 patients were operated on. In all eyes, RLM could be removed completely. Postoperatively, 2 of 3 eyes (67%) achieved 20/20 best-corrected visual acuity. No complications such as glaucoma, cystoid macular edema, corneal edema, or retinal detachments were recorded. Intraoperatively, retinal tears were detected in 2 of 3 (67%) eyes and treated with endolaser retinopexy and fluid-air exchange. One eye subsequently developed macular hole requiring further surgery.

Conclusion

Suction-assisted lens elevation may be a viable and convenient technique to remove RLM during PPV. Although the comparison with other methods is beyond the scope of this preliminary study, visual outcomes and complication rates were encouraging and should be validated in a larger group of patients.
Multiple medications and quality of life of Nigerians with primary open angle glaucoma
Authors: Nnubia Chinasa Anderline , Nwosu Sebastian Ndulue Ntuko , Okpala Nonso Ejikeme , Apakama Akunne Ijeoma , Orji Ifeanyi James , Uba-Obiano Chizoba Udoka , Onyiaorah Adaora Amaoge
Published: August 2024

Purpose

To determine the impact of multiple medications on the quality of life of primary open angle glaucoma (POAG) patients on medical treatment at Guinness Eye Centre Onitsha, Nigeria

Materials and Methods

Adult patients diagnosed with POAG who were undergoing medical therapy were selected through systematic sampling. They were asked to provide information on socio-demographic background, the number and types of glaucoma medications they were using and any adverse effects encountered while using these medications. The patients’ quality of life was assessed by utilizing the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and all patients completed ocular examination. Data analysis was with Statistical Package for Social Sciences (SPSS) version 23.

Results

One hundred and seventy-one patients, aged 40–83 years, mean 59.1 ± 11.1 were studied; there were 79(46.2%) males and 92(53.8%) females. One hundred and nine (63.7%) patients were on multiple medications. Side effects of treatment increased with increasing number of medications. The mean quality of life score in monotherapy group and double therapy group were 89.3 ± 15.8 and 80.2 ± 21.1 respectively; while that in ≥ triple therapy group was 78.9 ± 18.8. This decrease in mean quality of life score with increasing number of medications was statistically significant in bivariate analysis ( P < 0.01), however, multiple regression analysis showed that the number of medications did not significantly affect the quality of life scores after adjusting for confounding variables( p = 0.881).

Conclusion

Among the patients studied, use of multiple medications, unlike visual acuity (VA) and severity of glaucoma, was not an independent predictor of quality of life.
Effectiveness and safety of istent inject as an interventional glaucoma approach for uncontrolled open-angle glaucoma
Authors: Vizzari Gabriele , Ceruti Piero
Published: August 2024

Introduction

To describe the results of iStent inject implantation as a standalone procedure in early-stage uncontrolled glaucoma, with results up to 24 months.

Methods

A retrospective, single-center case series that recruited patients with open-angle glaucoma (OAG), uncontrolled IOP (defined as ≥18 mmHg), and who are receiving 1–4 glaucoma medications were implanted the iStent inject as a standalone procedure. Exclusion criteria were the contraindications of iStent inject implantation. Primary outcome measures were IOP at 6, 12, 18, and 24 months compared to baseline, and the number of medications at baseline and 24 months.

Results

Eighty-eight eyes from 88 patients, aged 57.6 ± 9.8 years, were included. Ten eyes underwent a subsequent glaucoma procedure during follow-up and were excluded from the analysis. The mean IOP (mmHg) was reduced from 20.54 ± 1.42 at baseline to 15.99 ± 1.98 and 16.15 ± 2.21 (n = 78, p < 0.001) at the 12- and 24-month follow-up, respectively, and the mean number of medications was reduced from 2.35 ± 0.70 to 1.31 ± 0.80 (p < 0.001) at 24 months. Of those eyes, 59% had ≥20% reduction in IOP at 24 months, 91% had an IOP ≤18 mmHg at 24 months, and 71.8% were receiving fewer medications. At 24 months, 14.1% of eyes were medication-free, compared to none at baseline. No serious intraoperative or postoperative adverse events occurred.

Discussion

iStent inject can effectively control intraocular pressure in mild glaucoma, reducing medication reliance and improving patient quality of life.
Posterior staphyloma-induced serous maculopathy: Evolution and successful treatment with subthreshold micro pulse Laser
Authors: Kathare Rupal , Gandhi Priyanka , Prabhu Vishma , Bavaskar Snehal , Chhablani Jay , Venkatesh Ramesh
Published: August 2024

Purpose

To describe the evolution of posterior staphyloma-induced serous maculopathy (PSISM) in a patient with myopic tilted disc syndrome and its treatment with subthreshold micro pulse laser (SMPL) therapy.

Case description

A 38-year-old male, diagnosed previously with classical features of myopic tilted disc syndrome presented to the retina clinic after 5 years from the initial presentation with blurred vision in the right eye for 6 months, visual acuity of 6/15 and findings of serous macular detachment (SMD) and subretinal precipitates at the upper margin of the posterior staphyloma. Retinal imaging ruled out other causes of SMD such as chronic central serous chorioretinopathy, myopic macular neovascularisation and dome shaped macula. A diagnosis of PSISM was confirmed. The left eye fundus and macula was normal.

Results

Confluent SMPL burns were applied across the SMD. The serous maculopathy resolved over a period of 2 months and visual acuity improved to 6/9. No recurrence of SMD was noted even after 14 months post SMPL.

Conclusion

PSISM develops gradually in eyes with myopic titled disc syndrome. SMPL is a viable therapeutic option in the management of PSISM and should be considered early in the treatment options.
Significantly increasing multiple sclerosis prevalence in Australia from 2010 to 2021
Authors: Campbell Julie A , Simpson-Yap Steve , Taylor Bruce V , van der Mei Ingrid , Laslett Laura , Henson Glen , Zhao Ting , Palmer Andrew J
Published: August 2024

Background:

Multiple sclerosis (MS) prevalence is increasing globally.

Objectives:

To determine whether increased prevalence is continuing within Australia using our validated prescription-based ascertainment method.

Methods:

We used methods employed in our 2010 and 2017 prevalence estimates. Disease-modifying therapy (DMT) prescriptions were extracted from Australia’s Pharmaceutical Benefits Scheme data for January–December 2021. DMT penetrance was calculated using data from the Australian MS Longitudinal Study. We divided the total number of monthly prescriptions by 12 or 2 (except alemtuzumab), adjusted for DMT penetrance and Australian population estimates. Prevalences in Australian states/territories were age-standardised. 2021 prevalence estimates were compared with 2010 and 2017 prevalence estimates using Poisson regression.

Results:

Number of people with MS in Australia in 2021 was 33,335; an increase of 7728 from 2017 (30.2%) and 12,092 from 2010 (56.6%) and increasing at a faster rate than population change (+10.1%, +14.1%). Age-standardised prevalence was 136.1/100,000 (increased from 103.7/100,000 in 2017). The previously demonstrated positive latitudinal gradient in 2010 and 2017 persisted in 2021, with Tasmania (southernmost state) having the highest prevalence (age-standardised: 203.5/100,000) while northernmost states had the lowest.

Conclusions:

In line with global trends, MS prevalence is escalating in Australia, particularly in higher-latitude states. MS prevention is crucial to halt this disturbing trend.
Tourists’ visual attention to cultural landscapes under crowding stimuli: An eye-tracking approach
Authors: Wang Mengqing , Li Peizhe , Xiao Xiao , Zhang Honglei , Lu Junyu , Xu Yuhua
Published: August 2024

Research on visual attention and perceived crowding in culture-oriented tourism destinations remains scant. This study examines the effects of varying environmental stimuli on tourists’ visual attention to cultural landscapes. Eye-tracking experiments and self-reported surveys were used to collect data ( n = 50). Participants were asked to view photos presenting varying environmental stimuli (e.g. crowding, mask-wearing measurement, etc.) in two culture-oriented tourism destinations (indoor and outdoor culture-oriented tourism destinations), followed by a questionnaire survey. Findings revealed that tourists paid more attention to the human crowds than cultural landscape when social density increased. Perceived crowding was significantly influenced by visual attention to cultural landscapes in both indoor and outdoor tourism destinations, with more silent effects in indoor settings. The findings of this study extend the normative theory of crowding and dual-process theory, and provide practical insights to optimize design for cultural landscapes and facilities to minimize tourists’ perceived crowding in culture-oriented tourism destinations.
Association between childhood family structure and health-related quality of life at middle age: A longitudinal study of Northern Finland Birth Cohort 1966
Authors: Varis Heidi , Heikkala Eveliina , Mikkola Ilona , Nordström Tanja , Taanila Anja , Keinänen-kiukaanniemi Sirkka , Hagnäs Maria
Published: August 2024

Aims:

This longitudinal study evaluated the association between childhood family structure and health-related quality of life (HRQoL) at middle age.

Methods:

The data on childhood family structure at the age of 14 years (‘two-parent family’, ‘one parent not living at home/no information on father’ and ‘father or mother deceased’) and HRQoL (measured by 15D (15-dimensional)) at the age of 46 were collected from the Northern Finland Birth Cohort 1966 using postal questionnaires. We used the binary logistic regression model to estimate the associations between childhood family structures and the lowest 15D quartile (reference: all other quartiles). The associations were adjusted for offspring mothers’ factors during pregnancy (mothers’ educational and occupational status).

Results:

Of the 6375 participants, the offspring belonging to the ‘one parent not living at home/no information on father’ family structure subgroup had higher odds ratio of belonging to the lowest 15D quartile than the offspring of ‘two-parent families’ (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.31–2.36, p<0.001 for females; adjusted OR 1.86, 95% CI 1.28–2.70, p=0.001 for males). There were no statistically significant associations between the ‘father or mother deceased’ subgroup and the lowest 15D quartile among the offspring.

Conclusions:

A single-parent family origin (due to reasons other than parental death) in childhood was significantly associated with impaired HRQoL at middle age. These results provide new perspectives for understanding the long-standing associations on living in a single-parent family.
Performance and environmental impact of ethanol-kerosene blends as sustainable aviation fuels in micro turbo-engines
Authors: Cican Grigore , Mirea Radu
Published: August 2024

The research experimentally examines the viability of ethanol (E) as a sustainable aviation fuel (SAF) when mixed with kerosene (Ke) – Jet A aviation fuel + 5% Aeroshell oil. Various blends of ethanol and kerosene (10%, 20%, and 30% vol. of ethanol added in kerosene) were subjected to testing in an aviation micro turbo-engine under different operational states: idle, cruise, and maximum power. During the tests, monitoring of engine parameters such as burning temperature, fuel consumption, and thrust force was conducted. The study also encompassed the calculation of crucial performance indicators like burning efficiency, thermal efficiency, and specific consumption for all fuel blends under maximum power conditions. Physical-chemical properties of the blends, encompassing density, viscosity, flash point, and calorific power, were determined. Furthermore, elemental analysis and FTIR were used for chemical composition determination. The research delved into analyzing the air requirements for stoichiometric combustion and computed resulting emissions of CO2 and H2O. Experimental assessments were performed on the Jet Cat P80® micro-turbo engine, covering aspects such as starting procedures, acceleration, deceleration, and emissions of pollutants (CO and SO2) during diverse engine operational phases. The outcomes reveal that the examined fuel blends exhibited stable engine performance across all tested conditions. This indicates that these blends hold promise as sustainable aviation fuels for micro turbo-engines, presenting benefits in terms of diminished pollution and a more ecologically sound raw material base for fuel production.
Below-the-Ankle Antegrade Teleferic Technique: New Approach for Below-the-Ankle Revascularization in Challenging Cases of Chronic Limb-Threatening Ischemia
Authors: Lobato Marta , Ysa August , Arruabarrena Amaia , Martínez Esther , Fonseca Juan L. , Patrone Lorenzo
Published: August 2024

Purpose:

To describe a novel bailout technique to approach below-the-ankle (BTA) chronic total occlusions or plantar-arch severe disease where the balloon/catheter is unable to follow the crossing guidewire and no other described recanalization approach is feasible.

Technique:

When facing a complex BTA revascularization, if the guidewire crosses but the balloon cannot progress due to a lack of pushability, an antegrade puncture of the infrapopliteal vessel where the tip of the guidewire lays is performed. The guidewire is then carefully navigated through this distal BTA vessel into the needle to achieve its rendezvous and externalization. A low-profile balloon is inserted through the femoral access and advanced till the non-crossable point of the BTA vessels. A torque device is then attached to the proximal hub of the balloon, and the through-and-through guidewire is subsequently pulled from the new distal access, allowing the balloon to be dragged across the lesion together with the wire.

Conclusion:

The below-the-ankle antegrade teleferic (BAT) technique may be considered for highly complex BTA revascularization procedures where the wire crosses the lesion, but no other device can be tracked over it.

Clinical Impact

The clinical impact of this article lies in the description of a bailout technique for BTA revascularization where the guidewire crosses, but no device can be advanced. This technique can be helpful in scenarios where failure to achieve success could result in limb loss. The BAT technique provides a solution in extremely challenging cases, enhancing technical success, improving outcomes and potentially preserving the limbs of patients who would otherwise face amputation, if not revascularized. The video shows the BAT technique performed with a support catheter under fluoroscopy: antegrate puncture of the DP, advancement of the support catheter over the wire, rendezvous of the guidewire in the catheter and subsequent externalization of the wire.
A Comparative Study of Cognitive and Motor Performance in Liver Recipients
Authors: Ergene Tuba Yüksel , Akay Ümit , Karadibak Didem , Özsoy İsmail
Published: August 2024

Introduction: Neurocognitive and motor impairments are often observed both before and after liver transplantation, resulting in inefficiencies in dual-task performance. Specific aim: The aim of this study was to evaluate the motor-cognitive dual-task performance in liver recipients, with a particular emphasis on cognition, performance status, and the impact of the COVID-19 pandemic. Design: A prospective, cross-sectional, web-based design with a control group was used. The study included 22 liver transplant recipients and 23 controls. Participants completed a motor-cognitive dual-task test (timed up and go test, TUG), a cognitive assessment (mini mental state examination), and a physical performance test (5-repetition sit-to-stand test). The study also used a functional performance status scale (The Karnofsky performance status) and assessed fear of coronavirus disease (fear of COVID-19 scale). Dual-task interference was assessed and the rate of correct responses per second was calculated to assess cognitive performance. Results: The results indicated no statistically significant difference in TUG time and TUG correct responses per second between the groups (group × condition interactions; P > 0.05). There was no significant difference in cognitive and motor dual-task interference during the TUG test between the two groups (P > 0.05). The Karnofsky Performance Status score was significantly correlated with TUG motor dual-task interference (r = −0.424 and P = 0.049). Conclusion: This study suggests that dual-task performance does not differ in cognitive or motor performance between liver recipients and healthy controls under the same dual-task condition. However, further controlled studies are needed to improve the generalizability of these findings.
Patients’ and Providers’ Perspectives of the Transition of Care from Hospital to Community for Hispanic/Latino Adults with Diabetes
Authors: Padilla Blanca Iris , Granados Emily , Corsino Leonor
Published: August 2024

Introduction: Transition of care is a critical point of care for Hispanic/Latino patients with diabetes, who face higher rates of diabetes-related complications and hospital readmission and challenges during the transition of care from hospital to the community. Methods: Using semi-structured interviews, with questions tailored to each group, we explored patients’ and providers’ perspectives of their experiences and challenges during the transition of care of Hispanic/Latino adult patients with diabetes from the hospital to the community. Results: Overlapping themes emerged from both patient and provider interviews identifying common barriers regarding the transition of care, including discordance due to language/communication barriers, perceived burden/nuisance, lack/unawareness of available resources, and lack of patient education. Conclusions: Findings in this study provide a frame of reference that can be used to address challenges facing Hispanic/Latino patients with diabetes. The uniqueness of this study is its exploration of the perspectives of patients and healthcare providers and the overlapping themes that emerged. Additionally, timely outpatient follow-up care, education, and reducing communication discordance can help with lowering readmission rates for patients with diabetes, especially those who are medically disadvantaged and have language barriers.
Effects of DLPFC tDCS Followed by Treadmill Training on Dual-Task Gait and Cortical Excitability in Parkinson’s Disease: A Randomized Controlled Trial
Authors: Wong Pei-Ling , Yang Yea-Ru , Huang Shih-Fong , Wang Ray-Yau
Published: August 2024

Background

Gait disturbances are exacerbated in people with Parkinson’s disease (PD) during dual-task walking (DTW). Transcranial direct current stimulation (tDCS) has been shown to exert beneficial effects on gait performance and cortical excitability in PD; however, its combined effects with treadmill training (TT) remain undetermined.

Objective

To investigate the effects of tDCS followed by TT on DTW performance and cortical excitability in individuals with PD.

Methods

Thirty-four PD participants were randomized to dorsal lateral prefrontal cortex (DLPFC) tDCS and TT group (DLPFC tDCS + TT group) or sham tDCS and TT group (sham tDCS + TT group) for 50 minutes per session (20 minutes tDCS followed by 30 minutes TT), 12 sessions within 5 weeks (2-3 sessions each week). Outcome measures included cognitive dual-task walking (CDTW), motor dual-task walking (MDTW), usual walking performance, cortical excitability, functional mobility, cognitive function, and quality of life.

Results

The DLPFC tDCS + TT group exerted significantly greater improvement in CDTW velocity ( P = .046), cadence ( P = .043), and stride time ( P = .041) compared to sham tDCS + TT group. In addition, DLPFC tDCS + TT group demonstrated a significant increase in resting motor threshold of stimulated hemisphere compared with sham tDCS + TT group ( P = .026). However, no significant differences between groups were found in MDTW performance and other outcomes.

Conclusion

Twelve-session DLPFC tDCS followed by TT significantly improved CDTW performance and decreased cortical excitability more than TT alone in individuals with PD. Applying DLPFC tDCS prior to TT could be suggested for gait rehabilitation in individuals with PD.

Clinical trial registration number:

Australian New Zealand Clinical Trials Registry ACTRN12622000101785
One improved YOLOX-s algorithm for lightweight section-steel surface defect detection
Authors: Pan Jian-Zhou , Yang Chi-Hsin , Wu Long , Huang Xiao , Qiu Sijie
Published: August 2024

This study introduces an improved lightweight section-steel surface detection (ILSSD) YOLOX-s algorithm model to enhance feature fusion performance in single-stage target detection networks, addressing the low accuracy in detecting defects on section-steel surfaces and limited computing resources at steel plants. The ILSSD YOLOX-s model is improved by introducing the deep-wise separable convolution (DSC) module to reduce parameter count, a dual parallel attention module for improved feature extraction efficiency, and a weighted feature fusion path using bi-directional feature pyramid network (BiFPN). Additionally, the CIoU loss function is employed for boundary frame regression to enhance prediction accuracy. Based on the NEU-DET dataset, experimental results demonstrate that the ILSSD YOLOX-s algorithm model achieves a 75.9% mean average precision with an IoU threshold of 0.5 (mAP@0.5), an improvement of 7.1 percentage points over the original YOLOX-s model, with a detection speed of 78.4 frames per second (FPS). Its practicality is validated through training and validating it with a lightweight section-steel surface defect dataset from an industrial steel plant, further confirming its viability for industrial defect detection applications.
Characteristics of rehabilitation protocols following operative treatment of terrible triad elbow injuries and the influence of early motion: A systematic review and meta-analysis
Authors: Larwa Joseph , Buchanan Timothy R , Janke Rachel L , Burns Madison Q , Wright Logan , Hao Kevin A , Cueto Robert J , Hones Keegan M , Aibinder William R , Wright Thomas W , Schoch Bradley S , King Joseph J
Published: August 2024

Background

As no consensus exists on the optimal postoperative rehabilitation protocol in terrible triad injuries, we sought to characterize the reported protocols and relate them to postoperative range of motion (ROM) measures and Mayo Elbow Performance Score (MEPS).

Methods

A systematic review was performed by searching PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles on the operative treatment of terrible triad injuries reporting postoperative rehabilitation protocols were included. Included studies were descriptively summarized. Methodologic quality was assessed using the Methodological Index for Non-randomized Studies criteria. Meta-analysis compared postoperative ROM measures and the MEPS between patients initiating passive ROM exercises at ≤7 days vs. >7 days.

Results

Our review included 36 articles with 1123 elbows (66% male, mean age: 43 years, follow-up: 27 months). Of the studies reporting physical therapy protocols, it was most commonly initiated at 7 days postoperatively (6/36, 17%), passive ROM exercises at 7 days (3/25, 12%), and active ROM at 21 days (4/26, 15%). On meta-analysis, early passive ROM initiation was not associated with improved elbow ROM or MEPS.

Discussion

While rehabilitation protocols commonly advised passive ROM at one week post-operatively, meta-analysis did not support functional benefits of early passive ROM.

Study design

Systematic Review; Level of evidence, 4.
Research on Water-Soluble Constituents and Anti-Aging Effect of the Leaves of Nelumbo nucifera Gaertn
Authors: Cheng Rong-Qian , Zhang Heyanhao , Chang Jun
Published: August 2024

Objective: This study aimed to isolate and elucidate the structure of water-soluble constituents from Nelumbo nucifera Gaertn. leaves and evaluate their anti-aging effect. Methods: The natural products were isolated from the 60% aqueous acetone extract of the leaves of N. nucifera by column chromatography on MCI gel CHP 20P, YMC-Gel ODS-AQ-HG, and TSK gel Toyopearl HW-40F. Their structures were elucidated using high-resolution-electrospray ionization-mass spectrometry, one-dimensional and two-dimensional nuclear magnetic resonance spectroscopy, and electronic circular dichroism spectroscopy. The anti-aging activity was evaluated in the Caenorhabditis elegans model. Results/Conclusion: One novel flavonoid nuciferanoid (1), together with eleven known compounds, were isolated from the extract of the leaves of N. nucifera. Among them, compound 1 could be a starting point for further development of anti-aging drugs.
Soft tissue aneurysmal bone cyst presenting as an enlarging neck mass: Case report and review of the head and neck literature
Authors: Chan Stephen A , Benson John C , Neben Wittich Michelle A , Chatzopoulos Kyriakos , Garcia Joaquin J. , Geiersbach Katherine B , Gruber Lucinda M , Wermers Robert A , Pignolo Robert J , Rose Peter S , Van Abel Kathryn M
Published: August 2024

Soft tissue aneurysmal bone cysts (STABCs) are rare neoplasms histopathologically identical to aneurysmal bone cysts. These benign lesions are characterized by thin, peripheral ossification and no skeletal continuity. STABC may be difficult to distinguish from myositis ossificans (MO) and malignant entities from imaging and fine needle aspiration, due to rarity and overlapping features. We present a case of a STABC occurring in the paraspinal cervical muscles. The imaging, histopathology, molecular analysis, and treatment are discussed. Four other published cases of STABC of the head and neck are reviewed.
The Invitation of Do’ikayt: Mystical anarchism and the Jewish Left
Authors: Izenson Andy
Published: August 2024

This paper is a transcript of a talk given by Andy Izenson at the Jewish Left symposium at Boston University's Institute on Culture, Religion, and World Affairs on May 3rd, 2024.
In Palantir we trust? Regulation of data analysis platforms in public security
Authors: Ulbricht Lena , Egbert Simon
Published: August 2024

Organizations increasingly rely on digital technologies to perform tasks. To do so, they have to integrate data banks to make the data usable. We argue that there is a growing, academically underexplored market consisting of data integration and analysis platforms. We explain that, especially in the public sector, the regulatory implications of data integration and analysis must be studied because they affect vulnerable citizens and because it is not just a matter of state agencies overseeing technology companies but also of the state overseeing itself. We propose a platform-theory-based conceptual approach that directs our attention towards the specific characteristics of platforms—such as datafication, modularity, and multilaterality and the associated regulatory challenges. Due to a scarcity of empirical analyses about how public sector platforms are regulated, we undertake an in-depth case study of a data integration and analysis platform operated by Palantir Technologies in the German federal state of Hesse. Our analysis of the regulatory activities and conflicts uncovers many obstacles to effective platform regulation. Drawing on recent initiatives to improve intermediary liability, we ultimately point to additional paths for regulating public sector platforms. Our findings also highlight the importance of political factors in platform regulation-as-a-practice. We conclude that platform regulation in the public sector is not only about technology-specific regulation but also about general mechanisms of democratic control, such as the separation of power, public transparency, and civil rights.
Doing place through data: Proliferation, profiling and the perils of portrayal in local climate action
Authors: Knox Hannah
Published: August 2024

Building on work which has shown the role of digital technologies in reframing environmental relations, this paper explores ethnographically how environmental data is reconfiguring the concept of place. The paper takes as its focus an action-research project within a UK based, citizen-oriented initiative called Newtown Energy Futures, in which we sought to enfold climate and energy data into a social-justice informed attempt at climate action. By exploring how the project used data as an invitation for citizens to engage with and participate in local infrastructural and environmental dynamics, the paper sheds light on how environmental data came to participate in the making of place and in doing so raised questions about how to rebuild the socio-material relations through which ‘a sense of place’ might be reproduced. As climate and energy data increasingly demand that places become enrolled into environmental projects our findings suggest that data enables place to emerge as a ‘socio-technical potentiality’ an observation that has implications both for both engagement with, and the study of data and place. In practical terms, we suggest that this refiguration of place has the effect of creating hopeful trajectories for change, whilst also posing difficult questions about the limits of participation in a data-infused form of place-based politics.
The Feasibility and Effects of Self-Acupressure on Symptom Burden and Quality of Life in Hemodialysis Patients: A Pilot RCT
Authors: Parker Kristen , Raugust Shauna , Vink Becky , Parmar Kuljit , Fradsham Allan , Armstrong Marni
Published: August 2024

Background:

Symptom burden among long-term hemodialysis (HD) patients is high, and addressing symptoms has been identified as a key research priority by patients. Acupressure has shown some effectiveness in management of symptoms in patients with HD.

Objective:

The purpose of this study was to explore the feasibility and the effect of implementing a self-administered acupressure intervention on symptom burden and quality of life for in-center HD patients.

Design:

A pilot randomized controlled study.

Setting:

Two outpatient community HD clinics between in Calgary, Alberta, Canada.

Patients or Sample or Participants:

Patients on HD for at least 3 months and with at least one symptom score rated greater than moderate were eligible for the study.

Methods:

Participants were randomized into either the (1) self-acupressure + usual care or (2) usual care alone group. Participants in the acupressure group were given a wooden acupressure tool and taught how to self-administer protocol on 6 acupressure sites for the 4-weeek study duration. Feasibility outcomes were assessed through satisfaction surveys and attrition. Other outcomes included quality of life and symptom scores by validated questionnaires (EQ-5D-5L and Integrated Palliative Outcome Score—Renal [IPOS-Renal]).

Results:

Thirty-two participants were successfully enrolled in the study; acceptability was high with study completion at 98% in the intervention group and 82% adherence rate to the 4-week protocol. Participants in the intervention group reported an improved change score in quality of life (EQ-5D-5L Index Score change = +0.053; EQ-5D-5L visual analog scale score change = +6.7). Participants in the intervention group also reported improved symptom scores (IPOS-Renal overall change = −2.8).

Limitations:

Small sample size and intervention duration are limitations of this pilot study.

Conclusions:

The results from this study suggest that self-acupressure was acceptable and feasible in this sample of HD patients. Self-acupressure may have a role for supporting the management of symptoms in HD patients. These pilot results can be used to inform larger more definitive investigations.
The impact of informal care provision on the quality of life of adults caring for persons with mental health problems: A cross-sectional assessment of caregiver quality of life
Authors: Bremmers Leonarda G M , Fabbricotti Isabelle N , Gräler Eleonora S , Uyl-de Groot Carin A , Hakkaart-van Roijen Leona
Published: August 2024

This study assessed the quality of life of informal caregivers for individuals with mental health problems in the Netherlands. An online survey was administered to a panel of informal caregivers in June 2020 ( n = 261). Informal caregivers of persons with mental problems were found to have an exceptionally low quality of life. A high subjective burden ( p < .001), lower perseverance time ( p = .016), low caregiver overall health status ( p = .004) and psychological wellbeing ( p = .008), younger caregiver age ( p = .011), child caregiving responsibilities ( p = .025), and no social support network ( p = .038) were associated with worse quality of life scores. These findings shed light on the significant challenges faced by informal caregivers of persons with mental health problem. This raises concerns about the long-term sustainability of informal care and mental healthcare reform.
Interpretable prediction of acute respiratory infection disease among under-five children in Ethiopia using ensemble machine learning and Shapley additive explanations (SHAP)
Authors: Tadese Zinabu Bekele , Hailu Debela Tsegaye , Abebe Aschale Wubete , Kebede Shimels Derso , Walle Agmasie Damtew , Seifu Beminate Lemma , Nimani Teshome Demis
Published: August 2024

Background

Although the prevalence of childhood illnesses has significantly decreased, acute respiratory infections continue to be the leading cause of death and disease among children in low- and middle-income countries. Seven percent of children under five experienced symptoms in the two weeks preceding the Ethiopian demographic and health survey. Hence, this study aimed to identify interpretable predicting factors of acute respiratory infection disease among under-five children in Ethiopia using machine learning analysis techniques.

Methods

Secondary data analysis was performed using 2016 Ethiopian demographic and health survey data. Data were extracted using STATA and imported into Jupyter Notebook for further analysis. The presence of acute respiratory infection in a child under the age of 5 was the outcome variable, categorized as yes and no. Five ensemble boosting machine learning algorithms such as adaptive boosting (AdaBoost), extreme gradient boosting (XGBoost), Gradient Boost, CatBoost, and light gradient-boosting machine (LightGBM) were employed on a total sample of 10,641 children under the age of 5. The Shapley additive explanations technique was used to identify the important features and effects of each feature driving the prediction.

Results

The XGBoost model achieved an accuracy of 79.3%, an F1 score of 78.4%, a recall of 78.3%, a precision of 81.7%, and a receiver operating curve area under the curve of 86.1% after model optimization. Child age (month), history of diarrhea, number of living children, duration of breastfeeding, and mother's occupation were the top predicting factors of acute respiratory infection among children under the age of 5 in Ethiopia.

Conclusion

The XGBoost classifier was the best predictive model with improved performance, and predicting factors of acute respiratory infection were identified with the help of the Shapely additive explanation. The findings of this study can help policymakers and stakeholders understand the decision-making process for acute respiratory infection prevention among under-five children in Ethiopia.
Non-linearities Caused by “Too Much Finance Effect”: Exploring the Myth and Reality for Developed and Developing Countries
Authors: Ullah Wasim , Zubir Ahmad Shauqi Mohamad , Ariff Akmalia Mohamad
Published: August 2024

Existing literature on relationship between financial development (FD) and economic growth (EG) has presented dichotomous observations: a linear relationship by many of the studies and yet an inverted U-shaped relationship observed by number of renowned researchers. Most of the studies used narrow measures like credit to GDP growth ratio for measurement of financial development. Moreover, many of the researches have taken only the post-Global Financial Crisis data or neglected the data pre-1990s and most of the researches related to developing countries are on single-country data. Therefore, this relationship requires re-estimation to arrive at some conclusive results. This paper explores the relationship between financial development and economic for both developed and developing countries based on broader measures of financial development (financial access, financial depth, and financial efficiency). Panel Corrected Standard Error regression model is used to evaluate the relationship for 23 developed and 35 developing countries. Our results observe contrasting facts for developed and developing countries. For developed countries, we observed an inverted U-shaped relationship between FD and EG. The contributing sub-components of FD are financial depth and efficiency. However, financial access is observed to have a U-shaped relationship. However, for developing countries, we don’t observe an inverted U-shaped relationship but linear relationship between FD and EG. The contributing sub-components are financial depth and financial efficiency.
Pedagogical Effects of CLIL in Asia’s Higher Education: An Empirical Reassessment
Authors: Lee Jia-Ying
Published: August 2024

This research was a quasi-experiment that examined the effects of CLIL in an educational context in Taiwan’s higher education. Two groups of first-year undergraduate students were involved. One (65 students) was taught with CLIL; the other (59), the conventional approach. Their knowledge of the content and learning attitudes (self-efficacy and motivation) were quantitatively compared through achievement tests and a questionnaire. A qualitative semi-structured survey asked both groups for their perspectives on and perceptions of the treatments. The quantitative results show that both approaches were significantly effective for improving students’ knowledge of the content of the target subject (literary text), but the EG outperformed the CG. Likewise, both groups had positive learning attitudes to their treatments, but the EG also outweighed the CG. Furthermore, the qualitative accounts generated diverse results, reflecting the underlying difference between the approaches but showing that both approaches were welcomed. However, the conventional method was more favored than CLIL, mostly because of the participants’ learning preferences or because of the learning patterns which they had formed over years of studying in the specific cultural-education system (i.e., that of Taiwan) chosen for the study.
Substance Use Disorder and Suicidal Ideation in Rural Maryland
Authors: Ahuja Manik , Jain Monika , Mamudu Hadii , Al Ksir Kawther , Sathiyaseelan Thiveya , Zare Shahin , Went Nils , Fernandopulle Praveen , Schuver Trisha , Pons Amanda , Dooley McKenzie , Nwanecki Chisom , Dahal Kajol
Published: August 2024

Background

Rural areas in the United States have been disproportionately burdened with high rates of substance use, mental health challenges, chronic stress, and suicide behaviors. Factors such as a lack of mental health services, decreased accessibility to public health resources, and social isolation contribute to these disparities. The current study explores risk factors to suicidal ideation, using emergency room discharge data from Maryland.

Methods

The current study used data from the Healthcare Cost and Utilization Project (HCUP) State Emergency Department Databases (SEDD) from the State of Maryland. Logistic regression was used to assess the association between ICD-10 coded opioid use disorder, alcohol use disorder, cannabis use disorder, major depressive disorder, and the outcome variable of suicidal ideation discharge. We controlled for income, race, age, and gender.

Results

Lifetime major depressive disorder diagnosis (odds ration [OR] = 79.30; 95% confidence interval [CI] 51.91-121.15), alcohol use disorder (OR = 6.87; 95% CI 4.97-9.51), opioid use disorder (OR = 5.39; 95% CI 3.63-7.99), and cannabis use disorder (OR = 2.67; 95% CI 1.37-5.18) were all positively associated with suicidal ideation.

Conclusions

The study highlights the strong link between prior substance use disorder, depression, and suicidal ideation visit to the emergency room, indicating the need for prevention and intervention, particularly among those in rural areas where the burden of suicidal ideation and chronic stress are high. As health disparities between rural and urban areas further widened during the COVID-19 pandemic, there is an urgent need to address these issues.
Utility of Water Siphon Maneuver during Barium Esophagography in Diagnosis of Gastroesophageal Reflux
Authors: Henning Justin , Wadowski Benjamin , Arias-Espinosa Luis , Taylor Jordan S. , Knotts Rita , Horwitz Daniel , Malcher Flavio , Khan Abraham , Dane Bari , Damani Tanuja
Published: August 2024

Background:

The water siphon maneuver (WSM) is performed during barium swallow test (BST) to elicit gastroesophageal reflux (GERD) in patients without identifiable spontaneous reflux. The objective of this study was to measure the correlation between WSM-induced reflux with pathologic GERD as determined by gold standard ambulatory pH testing.

Methods:

A retrospective review of consecutive adult patients that underwent both BST with WSM and pH testing at our institution from 2015 to 2019 (n = 228). Pathologic GERD was defined as total esophageal acid exposure time >6% on pH testing (Lyon consensus). Exclusion criteria included history of foregut procedures and pH testing on proton pump inhibitors. Correlation between WSM-induced reflux and GERD by pH testing was assessed using Fisher’s exact test.

Results:

A total of 116 patients were included. Pathologic GERD was diagnosed on 28.4% (n = 33) of pH tests while reflux was observed in 69.8% (n = 81) of WSM. There was no correlation between positive WSM and pH test-detected pathologic GERD ( P = .415). The sensitivity and specificity of WSM for GERD relative to pH testing were 63.6% and 27.7% while positive and negative predictive values were 25.9% and 65.7%, respectively. Accuracy of the WSM was consistently low across both wireless or impedance pH testing and for the entire cohort (n = 228).

Conclusion:

This is the largest study to date comparing WSM during BST to ambulatory pH testing in the evaluation of GERD. WSM has limited sensitivity and negative predictive value for pathologic GERD, and therefore cannot reliably confirm or discard this diagnosis.
Snapping Biceps Femoris Repair: A Rare Cause of Lateral Knee Pain
Authors: Tagliero Adam J. , Tadepalli Vaibhav R. , Werner Brian C.
Published: August 2024

Background:

Snapping biceps femoris syndrome (SFS) represents a rare clinical entity in which the biceps femoris subluxates over the fibular head in deep flexion. Two primary pathophysiologies have been described including a prominent or abnormal fibular head morphology. Others have implicated an anomalous biceps femoris insertion. The diagnosis is made clinically, with operative and nonoperative intervention strategies available for treatment.

Indications:

SFS often results in audible snapping and associated pain at the lateral fibular head. When recalcitrant to nonoperative management, surgical intervention can lead to resolution of symptoms. We present the case of a college-aged male who has bilateral symptoms, worse on the right, which have resulted in significant activity modification and daily discomfort recalcitrant to anti-inflammatory medication and physical therapy.

Technique Description:

The patient was placed supine on the operating room table with an ipsilateral bump under the hip to assist in exposure of the lateral aspect of the knee. Examination under anesthesia (EUA) confirmed the snapping biceps femoris. A lateral approach to the knee and a common peroneal neurolysis was performed. The biceps femoris insertional anatomy was examined for anomalous tendon insertion or insertional tearing. The prominent fibular head was exposed and resected, with careful attention not to disrupt the lateral collateral ligament or popliteofibular ligament insertion sites. The biceps femoris was then repaired to the prepared bony bed of the fibula with one double-loaded suture anchor. Repeat EUA confirmed complete resolution of snapping even with maximal internal rotation of the tibia; this was carefully examined again with the tourniquet deflated to ensure its compressive effect was not partially responsible for the resolution.

Results:

Published data pertaining to SFS is limited to case reports and small case series. With appropriate indications, surgical intervention yields promising results with a high percentage of patients returning to prior level of activity or prior participation level in sport.

Discussion/Conclusion:

SFS can be diagnosed with a careful clinical assessment. When recalcitrant to nonoperative management, it is effectively treated with surgical intervention to restore normal fibular anatomy, and prevent recurrent instability and persistent pain. The presented technique allows for appropriate management of these rare injuries.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.