bluuebunny/crossref_metadata_2025 huggingface dataset:
An Impressive Response to Zoldronic Acid Treatment for Chronic Recurrent Multifocal Osteomyelitis: A Case Report
Authors: Awadh Nabaa Ihsan , Gorial Faiq I. , Khalid Khalid Burhan , Al-Obaidi Ahmed Dheyaa , Khudhair Adil Saudi , Fayadh Noor Abbas Hummadi
Published: October 2024

Chronic recurrent multifocal osteomyelitis (CRMO) is a rare, non-infectious inflammatory disease with a prevalence of 1 to 2/106, causing multiple lytic bone lesions. There are no established protocols for treating CRMO; thus, current practice is largely empirical. Data on the use of zoledronic acid (ZA) in juvenile CRMO are scarce. A 12-year-old male child with a history of multiple aseptic osteomylitis, affecting the chest wall, right ankle, and wrist, had no fever. Cultures and a bone biopsy ruled out infection or malignancy. The patient’s condition stayed stable while taking naproxen (20 mg/kg/day) and methotrexate (10 mg/week) for 1.5 years until he experienced right elbow pain, swelling, no overlying skin erythema, and a restricted range of motion. The laboratory tests all came back normal, including white blood cell (WBC) count, erythrocyte sedimentation rate, C-reactive protein, and immunoglobin assays. The magnetic resonance imaging showed a focal lesion in the medial humeral condyle with increased signal intensity on T2 and short tau inversion recovery, mild joint effusion, and no cortical break. Thus, intravenous ZA infusion commenced at 0.0125 mg/kg initially, followed by 0.025 mg/kg 3 months later, with a marked improvement in the patient’s clinical symptoms and radiological findings. Non-steroidal anti-inflammatory drugs and methotrexate were initially effective in treating our patient’s condition, but a recurrence necessitated treatment modification. To the best of our knowledge, this case is the first documented instance of the use of ZA in CRMO in Iraq and Arab nations.
Exploring the Link Between Calcaneal Apophysis Maturation and Heel Pain in Youth Baseball Players
Authors: Honma Yuki , Tsutsui Toshiharu , Sakamaki Wataru , Higuchi Akina , Nakamura Emi , Torii Suguru
Published: October 2024

Background:

Calcaneal apophysitis is the most common cause of heel pain in children and adolescents. However, the relationship between skeletal maturity and heel pain in the specific youth cohort is unclear.

Purpose:

To clarify the relationship between the maturity stages of the calcaneal apophysis and heel pain in youth baseball players.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A total of 336 youth male baseball players participated in this study. Ultrasound scanning of the calcaneal apophysis was performed along the longitudinal line connecting the middle of the Achilles tendon, the middle of the calcaneus, and the second toe, between the proximal calcaneal edge and the medial calcaneal tubercle. The authors classified the maturity of the calcaneal apophysis into 5 stages, from nonpresence of the apophysis (stage 1) to complete fusion (stage 5). The diagnosis of heel pain was based on subjective report of feeling pain on the squeeze test. The relationship between the maturity stages and physical characteristics was investigated using 1-way analysis of variance or the Kruskal-Wallis test, and the relationship between the maturity stages and heel pain was investigated using the chi-square test.

Results:

Of the 336 players, 49 had heel pain, for a prevalence of 14.6%. Eighteen (5.4%) players had unilateral heel pain, and 31 (9.2%) players had bilateral heel pain. There were no significant differences in the maturity stages of the calcaneal apophysis between the players with no heel pain and those with heel pain. However, no players had heel pain during stage 5, when the calcaneus had completed its maturation.

Conclusion:

The prevalence of heel pain was 14.6% in Japanese youth male baseball players. There was no relationship between the maturity stages of the calcaneal apophysis and heel pain. Heel pain that could be associated with calcaneal apophysitis did not occur during stage 5, when maturation of the calcaneal apophysis was complete.
Evaluating the Effectiveness of a Structural Allograft in Medial Open Wedge High Tibial Osteotomy in Patients With and Without a Lateral Hinge Fracture
Authors: Hung Yueh-Ting , Lee Kun-Han , Chang Wei-Lin , Tsai Shang-Wen , Chen Cheng-Fong , Wu Po-Kuei , Chen Wei-Ming
Published: October 2024

Background:

A lateral hinge fracture is a common complication in medial open wedge high tibial osteotomy (MOWHTO) and is associated with delayed union or nonunion. A comparison of outcomes between patients with or without a lateral hinge fracture after MOWHTO with a structural allograft has not been investigated.

Purpose:

To validate the outcomes of MOWHTO with a structural allograft, especially in the presence of a lateral hinge fracture.

Study Design:

Case series; Level of evidence, 4.

Methods:

We conducted a single-surgeon cohort study at a tertiary referral hospital between April 2017 and August 2022 and included patients who had undergone MOWHTO with a structural allograft for isolated medial compartment osteoarthritis with genu varum. We compared the incidence of delayed union or nonunion events and functional scores between patients with a lateral hinge fracture and those without using the Fisher exact test and independent t test.

Results:

A total of 88 MOWHTO procedures (77 patients) were analyzed. The overall incidence of lateral hinge fractures was 29.5% (n = 26), including type I (n = 20 [22.7%]) and type II (n = 6 [6.8%]). Notably, 42.3% (n = 11) of these fractures had not been detected intraoperatively but during the follow-up visits. The overall Knee Society Score (KSS), Knee Society Score–Function (KSS-F), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were 90.0 ± 10.0, 93.4 ± 10.8, and 93.8 ± 7.1 points, respectively. None of the patients had delayed union or nonunion, and none underwent a reoperation because of bony union problems. The functional scores (KSS, KSS-F, and WOMAC) were not different between patients who had a lateral hinge fracture and those who did not ( P > .05).

Conclusion:

The routine use of a structural allograft was associated with satisfactory outcomes after MOWHTO, regardless of whether there was a lateral hinge fracture.
Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 10-Year Follow-up
Authors: Balasingam Sadesh , Karikis Ioannis , Rostgård-Christensen Lars , Ahldén Mattias , Sernert Ninni , Kartus Jüri
Published: October 2024

Background:

Biocomposite screws reportedly provide equivalent graft fixation in anterior cruciate ligament reconstruction (ACLR) to metallic screws while simplifying subsequent imaging and surgery. One purported complication of biocomposite screws is paradoxical tunnel widening. Previous studies on beta-tricalcium phosphate screws have only reported outcomes at short- and midterm follow-up.

Purpose:

To radiographically assess the tibial tunnel 10 years after ACLR using hamstring tendon autografts and biocomposite interference screws in anatomic single-bundle (SB) and double-bundle (DB) methods.

Study Design:

Case series; Level of evidence, 4.

Methods:

Of the 105 initially recruited patients, 61 (58%) completed all follow-up evaluations for inclusion in this long-term study. A total of 26 patients received anatomic SB ACLR and 35 patients received DB ACLR with biocomposite interference screws containing beta-tricalcium phosphate in the tibia. Weightbearing anteroposterior and lateral radiographs of the index knee were taken in the early postoperative period and at 2, 5, and 10 years postoperatively; computed tomography (CT) imaging was performed at 10-year follow-up. Subjective and objective clinical assessments were recorded preoperatively and at 10-year follow-up.

Results:

The mean follow-up period was 122 months. In 76% of radiographs in the SB group, the width of the tibial tunnel had not increased at 10 years compared with the early postoperative period. The mean tibial tunnel volume on CT in the SB group was 2.04 cm3 (± 0.85 cm3). In the DB group, the posterolateral tunnel width had not increased in 69% of radiographs; the same was found in 63% of radiographs for the anteromedial tunnel at 10-year follow-up. The mean posterolateral tunnel volume on CT was 2.04 cm3 (±1.92 cm3) and the mean anteromedial tunnel volume was 1.38 cm3 (±0.54 cm3). There was no correlation between tunnel widths and KT-1000 arthrometer assessments. There was a moderate but statistically significant correlation between SB tibial tunnel volume on CT imaging and KT-1000 arthrometer anterior 134 N side-to-side difference ( r = 0.45; P = .039).

Conclusion:

Most patients’ tibial tunnels had not increased on 1 or both radiographic views at 10-year follow-up compared with the early postoperative period after ACLR using biocomposite interference screws, with no obvious negative effect on outcomes. However, the tunnels were still visible in most patients at 10 years on standard radiographs and CT imaging.
Epidemiology of Early Neonatal Mortality in an Eastern Ethiopian NICU: Insights From Hiwot Fana Specialized University Hospital
Authors: Bushra AbdulmalikAbdela , Kassa NegaAssefa , Ayana Desalegn Admassu , Weldesenbet Adisu Birhanu , KebirMuhammad Mohammedin KebirHussen , Chunkele Biniam Petros , Ahmed Ibsa Abdusemed , Huka Alo Edin
Published: October 2024

Background. Early neonatal mortality remains a significant public health challenge in Ethiopia. Therefore, this study is designed to investigate the magnitude and underlying factors associated with early neonatal mortality among infants admitted to the Neonatal Intensive Care Unit at Hiwot Fana Specialized University Hospital in Eastern Ethiopia.  Methods. an institutional-based cross-sectional study was conducted from November 20 to December 20, 2021, by reviewing the medical records of 432 neonates admitted from September 11, 2018, to September 10, 2021. Data were cleaned, entered into Epi Data 3.1, and analyzed using Stata 15. Bivariable and multivariable logistic regression analyses were employed with statistical significance set at a P-value <.05.  Results. The study found that the magnitude of early neonatal mortality was 10.6% (95% CI: 8.06, 13.94). The primary contributors to early neonatal mortality was early onset neonatal sepsis (56%), preterm birth (52.2%), and perinatal asphyxia (32.6%). Notably, early onset neonatal sepsis (Adjusted Odds Ratio [AOR] = 2.31, 95% confidence interval [CI]: 1.06, 5.05), respiratory distress syndrome (AOR = 3.98, 95% CI: 1.97, 8.05), and low birth weight (AOR = 3.70, 95% CI: 1.67, 8.18) were independently associated with early neonatal mortality.  Conclusion. The study focuses on the significance of early neonatal mortality in Ethiopia, with key factors such as early onset neonatal sepsis, respiratory distress syndrome, and low birth weight contributing to this issue. The advancements in preventive interventions and early management of high-risk neonates offer promise in reducing early neonatal deaths.
Determining Consensus Alignment and Barriers of Neonatal Thermal Management in Nepal Using a Modified Delphi Process
Authors: Tomlin Brandon , Lamichhane Bibec , Dhungana Ranjan , Richards Grace , Grubb Peter , Mahato Anamika , Fassl Bernhard , Judkins Allison
Published: October 2024

Objective. Neonatal hypothermia is a worldwide health burden with an incidence ranging from 32% to 85% in hospitals and 11% to 92% in homebirths. It is prevalent in Nepal and associated with increased morbidity and mortality. The study objective was to identify key practice standards of newborn thermal management in Nepal. Methods. Our subjects included 6 lead newborn physicians from major birthing centers in Kathmandu. A modified Delphi process was used to identify the top 5 key practice standards for newborn thermoregulation in the hospital, health post, and home, compiled from 14 World Health Organization recommended practices. Results. There was consensus in all ranked practices except using radiant heat sources in the hospital and performing Kangaroo Mother Care in the homebirths. Comments conveyed that interventions during the immediate delivery phase were most impactful and feasible. Conclusion. Nepali physicians prioritized thermoregulatory practices during the immediate resuscitation period over the post-resuscitation period.
Chronic Symptomatology Among Infants, Children, and Adolescents Within 12 Months After SARS-CoV-2 Infection
Authors: Read Jennifer S. , Singh Devika , Luebbers Kimberly P. , Kelso Patsy T. , Callas Peter W. , Leyse Jessie L. , Levine Mark A.
Published: October 2024

Objective. The objective of this public health surveillance project was to estimate the proportion of persons under the age of 18 years with confirmed SARS-CoV-2 infection who developed chronic symptoms and to further characterize the symptoms and associated factors. Methods. Parents provided information during a telephone interview or through a web-based questionnaire. Results. Of 212 infants, children, and adolescents, 11 (5.2%) experienced a wide range of mild to severe chronic symptoms following SARS-CoV-2 infection, with 90% indicating inability to continue normal activities. Factors associated with chronic symptoms were pre-existing chronic medical conditions overall, certain categories of symptoms (eg, neurologic/psychiatric symptoms), and specific symptoms experienced with the acute SARS-CoV-2 infection (eg, fatigue, vomiting). Conclusion. Future research regarding chronic symptomatology among persons with confirmed SARS-CoV-2 infection would benefit from the use of standardized definitions of the timing and duration of chronic symptoms and from the enrollment of comparison groups.
A Revised Taxonomy of Educational Objectives for AI-Natives: Reimagining Thinking Skills in the Age of AI
Authors: Panthalookaran Varghese
Published: October 2024

Unlike other technologies that augment human physical skills and abilities, artificial intelligence (AI) technologies interact with human thinking skills nurtured through various educational processes. Hence, advances in these technologies challenge the education sector to reimagine the suitable intellectual formation of students in the AI age. It is observed that as soon as AI tools acquire certain cognitive skills, humans tend to delegate those skills to such tools, risking redundancy in their personal and professional lives. Therefore, anticipating an ever-increasing involvement of AI tools in various cognitive processes, educational systems must equip students with both AI-collaborative and AI-complementary thinking skills, making them resilient to the advancements of AI technologies. Furthermore, it demands that educators continually redefine the spectrum of thinking skills required for and imparted to students in the AI age. This article aims to develop a comprehensive taxonomy of educational objectives for AI-natives by reimagining thinking skills relevant in the AI age. It is intended to help educational policymakers worldwide reimagine the appropriate set of thinking skills relevant for students in the AI age. Additionally, the article provides important insights to restructure contemporary educational practices to meet the requirements of the holistic formation of the AI-natives.
Psychological Scars Shouldn’t be Ignored: Addressing Factors Linked to Depression among Individuals with Laparoscopic Sleeve Gastrectomy
Authors: Selim Abeer , Musaudi Emad , Rashwan Zohour Ibrahim , Alenezi Maha , Alshalawi Rasha , Nafea Majd , Shaib Alya , Ibrahim Alyaa , Eweida Rasha Salah
Published: October 2024

Introduction

Although bariatric surgeries have been linked to improved mental health, yet, some individuals develop depression.

Objectives

The present study aimed to assess the levels of depression and examine factors linked to depression among individuals with laparoscopic sleeve gastrectomy (LSG) in Saudi Arabia.

Methods

A cross-sectional design using a digital online survey was used to collect data. Depression was assessed using the Patient Health Questionnaire among individuals with LSG.

Results

A total of 344 eligible participants were included in the study. A significant percentage of the participants, almost one-third, were suffering from depression 27% ( n = 94). Moderate to severe depression levels among participants were significantly associated with postoperative complications [odds ratio, OR: 2.92 (95% CI: 1.42–6.01, p = .003)] and having preoperative psychological disorders before LSG [OR: 3.68 (95% CI: 1.88–7.26, p < .001)]. In contrast, lower levels of depression were significantly associated with believing LSG has achieved its goals [OR: 0.46 (95% CI: 0.22–0.97, p = .014)] and recommending LSG to family or friends [OR: 0.15 (95% CI: 0.05–0.44, p = .001)].

Conclusion

There is an evident link between depression and experiencing postoperative complications and suffering from psychological disorders before LSG. The findings of the current study would pave the road for the development of psychological strategies designed to break the cyclic pattern of occurrence of depression as well as optimize the success and maintenance of this treatment modality and support recovery for individuals undergoing LSG.
Effective Surveillance That “Doesn’t Work”: Inferences and Social Control in New York City Public Housing
Authors: Owens Lisa Lucile
Published: October 2024

In New York City, public housing residents are subject to constant, concentrated electronic surveillance that is beset by inequalities in application and the potential for adverse outcomes. In the literature, there is little insight into either the process by which such systems function or the impacts of this intensified exposure. This article explores, in particular, the role of inference in determining the effectiveness of surveillance. Through an analysis of qualitative data gathered through interviews with public housing residents, this article argues that surveillance, notwithstanding its actual function, is associated with powerful inferences about its functional possibilities. Findings address a source of endogeneity in existing surveillance-related studies, demonstrating how inferences about electronic surveillance notwithstanding their actual surveillant functionality may be related to the use of avoidance practices.
Work Schedules, Finances, and Freedom: Work Schedule Fit and Platform Dependence among Gig Workers on Amazon’s Mechanical Turk Platform
Authors: Reynolds Jeremy , Quintero Daniel Felipe Pinzón , Aguilar Julieta , Kincaid Reilly
Published: October 2024

Formally, gig workers determine their work hours. Gig platforms, however, shape work schedules with many tools, including ratings, deadlines, pay, and competition. The platform dependence perspective suggests that gig workers who rely on platform income are especially vulnerable to manipulation and often fail to fulfill their scheduling preferences. We offer one of the first quantitative tests of this prediction while also examining if the theory applies to highly flexible online gig work. Using a U.S. sample of Amazon Mechanical Turk workers, we find that mismatches between preferred and actual schedules are common and increase with hours worked. As predicted, mismatches are especially prevalent among platform-dependent respondents, but group differences are only significant for the minority of respondents working more than 30 hours per week. More research is needed to understand schedule mismatches among low-hour gig workers and how “strategic neglect” may help generate them.
Keeping Libertarianism Alive in the Academy: Organizations, Scholars, and the Idea Pipeline
Authors: Cooper Zosia , Binder Amy J. , Kidder Jeffrey L.
Published: October 2024

In this article, the authors draw on the literatures about academic career pipelines and the sociology of ideas to understand how an outside group of organizations provides resources to aspiring scholars as young as high schoolers and as senior as emeriti professors. One of the goals of these organizations is to promote libertarian ideas in the academy. The authors show how, in contrast to other academic pipeline building, libertarian-leaning organizations fear that their perspectives encounter resistance in the progressive field of higher education. Therefore, to keep libertarian ideas alive, they pursue strategies to guarantee a supply of graduate students for eventual academic jobs and provide professors with relatively easy access to funding, granting them autonomy vis-à-vis their home institutions. This funding may be used in part for programs that specifically hire libertarian PhDs, which in turn provide young scholars with a step ladder into the academy. The authors call this set of strategies an “idea pipeline.” On the whole, these efforts are designed to make a career studying libertarian ideas more desirable and viable for those inclined toward these viewpoints and to ward off the demise of libertarian thought in the academy.
Is Lung Cancer Screening Knowledge Associated with Patient-Centered Outcomes? A Multi-institutional Cohort Study
Authors: Schweiger Liana , Golden Sara E. , Sullivan Donald R. , Ilea Ian , Rice Sean P. M. , Melzer Anne C. , Datta Santanu , Davis James M. , Slatore Christopher G.
Published: October 2024

Introduction. The Centers for Medicare and Medicaid Services mandate that clinicians use a shared decision-making interaction to provide information about the harms and benefits of lung cancer screening (LCS). Methods. We enrolled patients from 3 geographically diverse medical centers after a decision-making interaction about undergoing LCS but before receiving a low-dose computed tomography (CT) scan. We performed the primary analysis based on the primary knowledge question, “Which of these conditions do you think that the CT scan screens for?” We used the knowledge summary score in secondary analyses. We evaluated LCS care experience by using validated instruments to measure participant-reported communication quality (Consultation Care Measure), perception of the primary LCS clinician (Consumer Assessment of Health Care Providers and Systems), and decision conflict (Decisional Conflict Scale). Results. Of the 409 participants, 44% correctly answered the primary LCS knowledge question. Clinician communication quality was rated positively by 93% of participants. Most (93%) participants rated their LCS clinician as good. Only 14% reported decision conflict. Correctly answering the primary LCS knowledge question was associated with higher patient-clinician communication quality scores (b = 0.4; 95% confidence interval [CI] [0.1, 0.7]; R2 change = 0.03) and higher LCS clinician ratings (b = 0.4; 95% CI [0.0, 0.7]; R2 change = 0.02) but not with decision conflict. In secondary analyses, higher total LCS knowledge score was associated with lower Decisional Conflict Scale scores (b = −2.2; 95% CI [−3.4, −0.9]; R2 change = 0.24), indicating lower decision conflict. Conclusions. After an LCS decision-making interaction, many patients do not retain basic knowledge about LCS but nevertheless had low levels of decision conflict. Primary LCS knowledge may be important but insufficient to ensure high-quality, patient-centered LCS care.

Highlights

Survey of patients with a lung cancer screening (LCS) decision-making interaction. Only 44% of patients correctly answered the knowledge question about LCS. Primary LCS knowledge was not associated with decision conflict. Patient knowledge about LCS may not equate to high-quality patient-centered care.
Risk factors for intracerebral hemorrhage by five specific bleeding sites: Japan Public Health Center-based Prospective Study
Authors: Ariyada Kenichi , Yamagishi Kazumasa , Kihara Tomomi , Muraki Isao , Imano Hironori , Kokubo Yoshihiro , Saito Isao , Yatsuya Hiroshi , Iso Hiroyasu , Tsugane Shoichiro , Sawada Norie ,   for the JPHC Study Group
Published: October 2024

Background:

Evaluating the risk factors for intracerebral hemorrhage is indispensable for primary prevention. However, the pathogenesis varies depending on the bleeding site, and few prospective studies have explored risk factors in detail for each site.

Participants and methods:

The Japan Public Health Center-based Prospective Study is a prospective study comprising a population-based sample of Japanese adults in 1990 (Cohort I) and in 1993 (Cohort II). A total of 34,137 participants (11,907 men and 22,230 women) were enrolled in this study and followed up until 2009 for Cohort I and until 2012 for Cohort II. The association between risk factors (age, sex, blood pressure, serum cholesterol, triglycerides, blood glucose, body mass index, smoking, and drinking status) and intracerebral hemorrhage by its bleeding site (lobes, putamen, thalamus, cerebellum, and brainstem) was assessed using Cox proportional hazards analysis.

Results:

During a median 20-year follow-up, 571 intracerebral hemorrhage events occurred. Hypertension was associated with an increased risk of total intracerebral hemorrhage, but not lobar hemorrhage. The multivariable hazard ratio (95% confidence intervals) was 2.09 (1.75–2.50) for total intracerebral hemorrhage. In contrast, a low serum total cholesterol level was associated only with lobar hemorrhage (1.73 (1.01–2.96)). Heavy drinking was associated with the risk of total and putamen hemorrhage, and obesity was associated with the risk of putamen hemorrhage.

Discussion and conclusion:

The present study identified different risk factors depending on the bleeding site of intracerebral hemorrhage.
Suprachoroidal Triamcinolone Acetonide Injection to Treat Macular Edema: A Review
Authors: Rahman Samra , Tayyab Haroon , Siddiqui M.A. Rehman
Published: October 2024

Purpose: To review the available literature on the efficacy and safety of suprachoroidal triamcinolone acetonide for the treatment of chorioretinal diseases. Methods: The results of a literature review were analyzed. Results: This review included 17 clinical studies of triamcinolone acetonide administration (6, diabetic macular edema; 1, central retinal vein occlusion [RVO]; 2, branch RVO; 7, noninfectious uveitis; 1, cystoid macular edema after cataract surgery). Overall, suprachoroidal triamcinolone acetonide was shown to be effective in decreasing macular thickness and increasing visual acuity (VA) in cases of chorioretinal diseases. The most frequently reported adverse events were eye pain, cataract, and increased intraocular pressure. Conclusions: Except for 3 sufficiently powered trials of suprachoroidal triamcinolone acetonide for macular edema associated with noninfectious uveitis, most other studies were clinical trials with small samples. These studies found that suprachoroidal triamcinolone acetonide has a satisfactory safety and efficacy profile. Further research with sufficiently large samples is required to confirm the potential role of suprachoroidal triamcinolone acetonide in retinal diseases.
The Evolving Role of HR in Indian Start-ups: From Administration to Strategic Leadership
Authors: Ajitha S.
Published: October 2024

The landscape of Indian start-ups has undergone a transformative journey marked by innovation, entrepreneurship and technological disruption. This evolution is mirrored in the changing role of human resources (HR) within these enterprises. From its initial focus on administrative functions, HR in Indian start-ups has evolved into a strategic partner, contributing significantly to success and growth. This article delves into the historical foundations of HR, tracing its progression through distinct eras, from administrative roles to strategic leadership in the current landscape. Drawing distinctions between HR practices in multinational corporations (MNCs) and start-ups, the article highlights key differences. Emphasising the pivotal role of HR in addressing start-up challenges, it explores the importance of hiring individuals who align with the start-up context. Case studies illustrate agile talent acquisition, innovation culture, workforce development and more. The article presents a comprehensive overview of HR’s transformative journey in Indian start-ups, navigating challenges and contributing to strategic leadership in a dynamic ecosystem.
Understanding end-of-life doula care provision: reporting on the design of a bereavement survey to evaluate doula support
Authors: Bashir Kirsten , Clare Emma , Pestano Catherine , Ramsey-Jones Esther , Borgstrom Erica
Published: October 2024

Background:

Delivery of consistent patient-centred care at end-of-life care continues to challenge healthcare providers and research continues to suggest that peoples’ needs are not being reliably met. Consequently, healthcare services are looking to innovate how support is provided, such as commissioning doulas to support dying people and those close to them.

Objective:

Within the United Kingdom, there is little existing research about peoples’ experience of receiving end-of-life doula support. This paper outlines the design of a survey for the family or friends of a person who received end-of-life doula support.

Design:

To evaluate the role of an end-of-life doula in supporting the dying person and those who care for them, we designed a post-bereavement survey as part of a wider evaluation strategy of doula services. Following multiple literature reviews and an iterative process of consulting with the professional organisation and previous service users, a questionnaire was developed to collect this data. This survey is hosted online, with paper copies available to widen accessibility.

Conclusion:

End-of-life doula support is a relatively new area of provision for dying people and those important to them, such as family and friends. It is even more innovative to have doula support commissioned as part of a locality’s healthcare service. There is a dire need for empirical research to understand the impact of this further. The process of researching the area and designing the evaluation survey for this service revealed the complexity of the role and the difficulty of capturing what was found to be helpful for the dying person and those around them.
Neuroanatomical anomalies due to a defect in the FGF3 gene, associated with the Labyrinthine Aplasia, Microtia and Microdontia syndrome: insights from the placement of auditory brainstem implants in two siblings
Authors: Frijns Johan H. M. , Geerders (Roos) M. G. S. , Scholing Esther , Verbist Berit M. , Koot Radboud W. , Malessy Martijn J. A. , Boermans Peter-Paul B. M. , Briaire Jeroen J.
Published: October 2024

Here, we describe two congenitally deaf male siblings with the same compound heterozygotic, likely pathogenic mutations in the FGF3 gene, associated with the labyrinthine aplasia, microtia and microdontia (LAMM) syndrome. Both children had bilateral cochleovestibular aplasia, precluding cochlear implantation. The elder brother received an auditory brainstem implant (ABI) with very limited auditory responses. During the ABI-surgery of the younger subject, it was discovered that excellent auditory responses could be obtained when the electrode array was placed considerably more caudally and more medially than standard. It was observed that the foramen of Luschka, the entrance to the lateral recess of the fourth ventricle was located more caudally. In view of this observation the good auditory development of the latter child, it was decided to give the older child a contralateral ABI. Again, it turned out that the anatomy of the brainstem was abnormal with a more caudal location of the foramen of Luschka and the cochlear nucleus, and this child is showing good progress with his auditory development. It is concluded that one should be aware of the anatomical differences at the level of the brainstem when placing an ABI in children with this genetic disorder (and most likely also in the LAMM syndrome). This also underpins the need of a multidisciplinary approach with closely collaborating team members and good family guidance when diagnosing and treating children with rare deafness.
The mineralogical composition of the zeolitic rocks of Santorini Island and their potential use as feed additives and nutrition supplements
Authors: Mytiglaki Christina , Kovaiou Soultana Kyriaki , Vogiatzis Dimitrios , Kantiranis Nikolaos , Filippidis Anestis
Published: October 2024

The zeolitic rocks of Akrotiri, on Santorini Island (Aegean Sea, Greece), can be grouped according to the zeolite minerals present. The first group includes zeolitic rocks that contain only clinoptilolite, the second group contains clinoptilolite and mordenite and the third group contains only mordenite. Clinoptilolite accounts for up to 56 wt.% and mordenite for up to 69 wt.% of the rocks. All samples contain feldspars (8–36 wt.%), clay minerals (6–8 wt.%), quartz (3–6 wt.%), opal-CT (2 wt.%), amphibole (2–4 wt.%) and amorphous materials (4–7 wt.%). The studied samples were classified chemically as andesites or dacites. The ammonium-exchange capacity of the studied samples was 104–158 meq 100 g–1. According to Commission Implementing Regulation (EU) No. 651/2013, zeolitic rocks that contain ≥80 wt.% clinoptilolite, ≤20 wt.% clay minerals and are free of fibrous minerals and quartz can be used as feed additives in animal husbandry. Zeolites with fibrous habit (mordenite, erionite, secondarily roggianite and mazzite) and SiO2 minerals such as quartz, cristobalite and tridymite can be dangerous to both humans and animals. The mineralogical study showed that, due to their low clinoptilolite content and the presence of both quartz and fibrous mordenite, the studied zeolitic rocks do not conform with European Regulation No. 651/2013. As a result, their use as feed additives and nutrition supplements is prohibited.
Induction of factor VIII tolerance by hemophilia gene transfer to eradicate factor VIII inhibitors
Authors: Young Guy
Published: October 2024

Patients with hemophilia A can develop antifactor antibodies to factor VIII. The incidence is ∼30%, and such patients suffer worse morbidity and mortality. The only proven method to eradicate these inhibitors is via immune tolerance induction therapy, which consists of infusing factor VIII concentrates at regular intervals. This approach is effective ∼65% of the time, leaving at least a third of patients who develop inhibitors with this lifelong problem. Although emicizumab has greatly improved the quality of life of inhibitor patients, eradicating the inhibitor remains an important treatment goal. Animal models have shown the potential for gene therapy to induce tolerance. A recent abstract describing a study in humans demonstrated the potential for successful tolerance induction. This article will describe the rationale for using gene therapy to induce tolerance and provide this author's viewpoint on the importance and possible historic significance of attempting to eradicate inhibitors with this approach.
Lower-intensity CPX-351 plus venetoclax induction for adults with newly diagnosed AML unfit for intensive chemotherapy
Authors: Uy Geoffrey L. , Pullarkat Vinod , Baratam Praneeth , Stuart Robert K. , Walter Roland B. , Winer Eric S. , Wang Qi , Faderl Stefan , Chakravarthy Divya , Menno Diane , Cheung Ronald S. , Lin Tara L.
Published: October 2024

Preclinical data suggest a rationale for combining CPX-351, a dual-drug liposomal encapsulation of daunorubicin and cytarabine, with venetoclax, a B-cell lymphoma-2 inhibitor. This phase 1b study evaluated lower-intensity CPX-351 combined with venetoclax in adults with acute myeloid leukemia (AML) considered unfit/ineligible for intensive chemotherapy. In a dose-exploration phase using a 3+3 design, patients received stepwise dosing of CPX-351 IV on days 1 and 3 plus venetoclax 400 mg orally on days 2 to 21 per cycle to determine the recommended phase 2 dose (RP2D) for this combination. During the expansion phase, additional patients received CPX-351 plus venetoclax at the identified RP2D. The primary end points were the RP2D and safety of CPX-351 combined with venetoclax. Secondary end points included preliminary efficacy and pharmacokinetics. Overall, 35 patients were enrolled in the study. A RP2D of CPX-351 30 units/m2 (daunorubicin 13.2 mg/m2 and cytarabine 30 mg/m2) plus venetoclax 400 mg was established. The safety profile of the combination was consistent with the known safety profiles of CPX-351 and venetoclax. Complete remission (CR)/CR with incomplete hematologic recovery (CRi) was achieved by 17 of 35 patients (49%), all after cycle 1; of these, 14 were negative for measurable residual disease. CR was achieved by 1 of 8 patients (13%) with a mutation in TP53, and CR/CRi was achieved by 15 of 26 patients (58%) with wild-type TP53. This study highlights that lower-intensity therapy of CPX-351 plus venetoclax as induction therapy provides a well-tolerated treatment option in adults with AML deemed unfit for intensive chemotherapy. This trial was registered at www.ClinicalTrials.gov as #NCT04038437.
Access barriers to anti-CD19+ CART therapy for NHL across a community transplant and cellular therapy network
Authors: Battiwalla Minoo , Tees Michael , Flinn Ian , Pantin Jeremy , Berdeja Jesus , Gregory Tara , Maris Michael , Bhushan Vikas , Vance Estil , Mathews John , Bachier Carlos , Shaughnessy Paul , Ramakrishnan Aravind , Malik Shahbaz , Mori Shahram , Martin Casey , Billups Rocky , Blunk Betsy , LeMaistre Charles F. , Majhail Navneet S.
Published: October 2024

We analyzed access barriers to anti-CD19+ chimeric antigen receptor T cells (CARTs) for non-Hodgkin lymphoma (NHL) within a community-based transplant and cell therapy network registry. A total of 357 intended recipients for approved anti-CD19+ CARTs were identified between 2018 to 2022. The median age at referral was 61 years; referral years were 2018 (4%), 2019 (14%), 2020 (18%), 2021 (26%), and 2022 (38%). Diagnoses included diffuse large B cell (69%), follicular (13%), follicular/large (7%), mantle cell (4%), or other (7%). Axicabtagene ciloleucel (62%), tisagenlecleucel (16%), brexucabtagene autoleucel (13%), and lisocabtagene maraleucel (9 %) were infused into 182 patients. The median durations between referral to consultation, consultation to apheresis, and collection to infusion were 11, 107, and 32 days, respectively. The median duration from consultation to CART infusion declined steadily from 207 days in 2019 to 108 days in 2022 (P < .0001). A total of 124 patients (41%) did not receive CART, mostly for disease progression (34%) or poor health (15%). Multivariable logistic regression showed no significant differences in demographic, financial, or social determinants compared with those receiving CART. Notably, the proportion of ineligible patients declined from 53% in 2018-2020 to 34% by 2021-2022 (P = .001). In conclusion, 41% of community patients were unable to access timely CART therapy, mostly due to attrition from disease-related causes, and the overall time to infusion exceeded 4 months. Time to infusion and the proportion receiving CARTs improved over time. Reducing time to apheresis, early referral, and attention to salvage/bridging strategies are necessary.
Impact of thrombocytopenia on bleeding and thrombotic outcomes in adults with cancer-associated splanchnic vein thrombosis
Authors: Andersen Michael , Fernandez Turizo Maria J. , Dodge Laura E. , Hsu Charles , Barnum Kevin , Berry Jonathan , Zwicker Jeffrey I. , Patell Rushad
Published: October 2024

Malignancy is a risk factor for splanchnic vein thrombosis (SpVT). Data on the natural history of cancer-associated SpVT are limited. This was a single-center, retrospective cohort study of 581 adult patients with cancer and SpVT. We aimed to characterize the impact of thrombocytopenia on major bleeding and progression or recurrence of SpVT within 1 year of an initial cancer-associated SpVT diagnosis. Baseline thrombocytopenia (platelet <100 × 103/μL within 15 days of SpVT diagnosis) was present in 39.5% of patients. A total of 39.2% of patients received therapeutic anticoagulation within 2 weeks of an SpVT diagnosis. The cumulative 1-year incidence of major bleeding was 10.7% (95% confidence interval [CI], 8.2-13.2) and 16.2% (95% CI, 13.2-19.2) for SpVT recurrence/progression. In the multivariable regression analysis, therapeutic anticoagulation was associated with increased major bleeding (adjusted risk ratio [aRR], 1.74; 95% CI, 1.08-2.81) and decreased progression/recurrence of SpVT (aRR, 0.55; 95% CI, 0.35-0.86). Baseline thrombocytopenia was not independently associated with either major bleeding (aRR, 0.76; 95% CI, 0.43-1.34) or progression/recurrence of SpVT (aRR, 1.14; 95% CI, 0.73-1.78). A secondary analysis using inverse probability of treatment weighting with propensity scores for baseline thrombocytopenia corroborated that patients with thrombocytopenia did not have an increased bleeding risk (adjusted hazard ratio [aHR], 0.81; 95% CI, 0.48-1.39). The multivariable analysis in which platelets were treated as a time varying covariate also did not reveal an association with major bleeding (aHR, 0.89; 95% CI, 0.55-1.45). Bleeding and thrombosis progression were frequent in patients with cancer-associated SpVT. Anticoagulation was associated with increased major bleeding and decreased thrombotic progression; thrombocytopenia did not impact the outcomes.
Role of fibroblasts in nonfibrotic autoimmune skin diseases
Authors: He Yuexi , Han Zhenxin , Zhang Qiuli , Liu Lin , Chang Jianmin
Published: October 2024

Autoimmune diseases, a disease characterized by immune imbalance caused by the human immune system mistakenly attacking its own components, include vitiligo, psoriasis and atopic dermatitis (AD). Previous studies on autoimmune diseases have focused mainly on immune cells, keratinocytes and endothelial cells. Fibroblasts, the main cells that secrete the extracellular matrix (ECM) in the dermis, have been studied thoroughly in terms of fibrosis and wound healing. However, an increasing number of studies have shown that fibroblasts play an important role in nonfibrotic autoimmune skin diseases. In this article, the previously reported role of fibroblasts in nonfibrous autoimmune skin diseases such as psoriasis, vitiligo and AD is summarized to provide new ideas for the treatment of this disease.
Fungi as versatile biocatalytic tool for treatment of textile wastewater effluents
Authors: Pundir Ashok , Thakur Mohindra Singh , Prakash Suraj , Kumari Neeraj , Sharma Niharika , Parameswari Ettiyagounder , He Zhongqi , Nam Sunghyun , Thakur Mamta , Puri Sunil , Puranik Shriniketan , Kumar Sunil , Madhu  , Kumar Manoj
Published: October 2024

Textile wastewater poses a significant environmental challenge, primarily due to the presence of diverse contaminants, especially textile dyes. Untreated release of these effluents directly into aquatic systems can lead to esthetic degradation, eutrophication, reduced photosynthetic activity, and accumulation of hazardous substances. Although conventional treatment methods are employed for reducing the contaminant load in effluents, they often are less efficient, thus prompting the exploration of innovative alternatives. Current review highlights myco-remediation as an inexpensive, promising and environmentally sustainable solution. Fungi, with their diverse decontamination mechanisms such as biosorption, biotransformation, and immobilization, prove effective in reducing heavy metals, persistent organic pollutants, and emerging contaminant levels present in these effluents, However, more research effort is needed to apply the biodegradation strategy to decompose completely the “forever chemicals” per‐ and polyfluorinated alkyl substances. Fungi play a key role in degrading and decolorizing textile dyes due to their biocatalytic activity mediated by the production of oxidative enzymes, such as laccases, lignin peroxidases, and manganese peroxidases, as well as their dye adsorption capabilities. This comprehensive review concentrates on fungi-based remediation of textile wastewater effluents, including the mechanisms they employ. While most studies concentrate on effluent treatment, this review also explores the concurrent utilization of biomass and growth kinetics for efficient reduction in pollutant concentrations. Further, the current work showed data on optimization of growth conditions such as pH, temperature and nutrient requirements that lead to efficient effluent decontamination.
Longitudinal investigation of a single variant SARS-CoV-2-outbreak in the immunologically naïve population of Ulvik, Norway
Authors: Mortensen Nicolay , Wensaas Knut-Arne , Solem Unni , Sivertsen Audun , Grewal Harleen M. S. , Rortveit Guri , Ulvestad Elling , Litleskare Sverre
Published: October 2024

Purpose

To perform an extensive investigation of the clinical features and long-term complications among the n = 134 adults and children with nucleic acid amplification test (NAAT) verified SARS-CoV-2-infection in the immunologically naïve population of Ulvik, Norway, during the single variant B.1.1.7 outbreak in late January through February 2021.

Methods

Every infected person regardless of whether symptoms of COVID-19 were present was invited to answer a web-based questionnaire at two- and seven months after testing positive. The period from initial infection to the first questionnaire was assessed retrospectively, and the time points at two- and seven months were assessed prospectively.

Results

A total of 87 of 134 (65%) NAAT-positive persons answered the first questionnaire, of which 35/87 (40%) were children, and 74 of 87 (85%) answered the second questionnaire. Children experienced symptoms less often than adults during the acute phase of infection (51% (18/35) versus 81% (42/52) (p = .004)). At two-months follow-up 88% (53/60) of participants with symptoms during the acute phase, including all children, reported no longer having symptoms. Among those with persisting symptoms at seven months, fatigue (18/25) and insomnia (16/24) were common.

Conclusion

In an immunologically naïve population infected with the SARS-CoV-2 B.1.1.7 variant, the clinical features of acute phase symptoms were similar to previous studies. Children underwent asymptomatic infection more often than adults, and adults more often experienced persisting symptoms. Insomnia and fatigue were common complaints among those with persisting symptoms seven months after infection.
Calculation of virtual 3D subtraction angiographies using conditional generative adversarial networks (cGANs)
Authors: Müller Sebastian Johannes , Einspänner Eric , Klebingat Stefan , Zubel Seraphine , Schwab Roland , Fuchs Erelle , Diamandis Elie , Khadhraoui Eya , Behme Daniel
Published: October 2024

Objective

Subtraction angiographies are calculated using a native and a contrast-enhanced 3D angiography images. This minimizes both bone and metal artifacts and results in a pure image of the vessels. However, carrying out the examination twice means double the radiation dose for the patient. With the help of generative AI, it could be possible to simulate subtraction angiographies from contrast-enhanced 3D angiographies and thus reduce the need for another dose of radiation without a cutback in quality. We implemented this concept by using conditional generative adversarial networks.

Methods

We selected all 3D subtraction angiographies from our PACS system, which had performed between 01/01/2018 and 12/31/2022 and randomly divided them into training, validation, and test sets (66%:17%:17%). We adapted the pix2pix framework to work on 3D data and trained a conditional generative adversarial network with 621 data sets. Additionally, we used 158 data sets for validation and 164 for testing. We evaluated two test sets with (n = 72) and without artifacts (n = 92). Five (blinded) neuroradiologists compared these datasets with the original subtraction dataset. They assessed similarity, subjective image quality, and severity of artifacts.

Results

Image quality and subjective diagnostic accuracy of the virtual subtraction angiographies revealed no significant differences compared to the original 3D angiographies. While bone and movement artifact level were reduced, artifact level caused by metal implants differed from case to case between both angiographies without one group being significant superior to the other.

Conclusion

Conditional generative adversarial networks can be used to simulate subtraction angiographies in clinical practice, however, new artifacts can also appear as a result of this technology.