bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting Wellness as a Primordial Prevention Strategy for Achieving Sustainable Public Health in the Post-Covid 19 Era
Authors: Veliah Geetha K. , Venkatsubramanian Padma
Published: March 2024

The global scenario of a contracted economy over 4% and distraught healthcare systems due to the 2019 pandemic behooves us to redesign our strategies to move towards holistic approaches that allow health and wellbeing to be uniquely viewed within their contexts, promising sustainability. World-over, communities are more aware of the connectedness with nature and the role of positive behaviors. Disproportionate investments go into secondary and tertiary cure in healthcare systems and there is a minimal uptake of primary prevention. Investments in primordial prevention (PP) that can help achieve sustainable health are inadequate. PP is defined as an approach that prevents the risk factors for disease conditions from manifesting through maintenance of good health by embracing healthy environment, diet, and lifestyle behaviors, to function optimally. We propose integration of wellness as a primordial prevention strategy for sustainable public health using the 3 Ps: People, Places, and Policies/Programs. Wellness is holistic and multi-dimensional and is a primordial prevention concept as it focuses on people thriving based on a positive approach to health. The authors point out that the stumbling block in public health is due to unsustainable behavior as a result of misplaced priorities.
From Ancient Zhiguai Tales to Contemporary Animation: A Study of Visual Rhetoric in ‘Yao-Chinese Folktales’ (2023)
Authors: Aiqing Wang , Whyke Thomas William
Published: March 2024

This study delves into the use of visual rhetorical strategies in 中国奇谭 Zhongguo Qitan ‘Yao-Chinese Folktales’ (2023), particularly focusing on 鹅鹅鹅 E E E ‘Goose Mountain’ (henceforth ‘Goose’) directed by Hu Rui. We assert that ‘Goose’ transcodes and reinterprets the ancient Chinese zhiguai novella 阳羡书生 Yangxian Shusheng ‘The Scholar from Yangxian’ (henceforth ‘Scholar’) for a contemporary audience through the use of visual rhetoric, leading to a compelling contemporary rendition of this tale. As a silent animation, ‘Goose’ does so by adeptly incorporating visual depictions, especially animal-related imagery and ink painting aesthetics, drawn from the broader traditional zhiguai myths, or tales of the strange and traditional Chinese culture. The core argument hinges on visual rhetoric’s transformative potential. In ‘Goose’, the connection between tradition and contemporaneity is established through metaphor and metonymy. Initially a literary figure of speech, metaphor and metonymy now encompasses ‘visual rhetoric’, widely applied in interpreting visual arts. Visual rhetoric often employs various elements such as colour, shape, size, objects, composition and texture to convey information. This study highlights the role played by the inseparable link between traditional zhiguai narratives, the minzu/national style, and the contemporary animation technology in ‘Goose’, a transformative role that revitalizes ancient traditions to resonate with today’s viewership.
Smartphone resilience: ICT in Ukrainian civic response to the Russian full-scale invasion
Authors: Zarembo Kateryna , Knodt Michèle , Kachel Jannis
Published: March 2024

In modern warfare, digitalization has blurred the line where civilian ends and military begins. Embedded in the participative warfare theoretical paradigm, this article looks into how the information and communication technologies (ICT) enable civic resilience under the conditions of the foreign armed aggression. Specifically, the authors explore how smartphones and smartphone applications empowered the Ukrainian civil society in the aftermath of the Russian full-scale invasion of 2022. Based on an online survey and semi-structured interviews, the article highlights how the device and its features not only allowed civilians to adapt to living in conditions of a constant threat, but also to respond and support the defence from the rear. The authors conclude that, while the smartphone becomes an ‘online resilience hub’, acquiring many new functions like a mobile office, an online volunteer (frontline logistics and procurement) hub, an air-threat warner, a first-hand news source and so on, its security provision functions are not unconditional and may turn to the opposite, depending on the physical circumstances on the ground as well as the virtual information battlefield.
Perceptions and digitalisation of outbreak management in UK health services: A cross-sectional survey
Authors: Wynn Matthew
Published: March 2024

Background

Global challenges arise from infectious diseases which represent significant challenges to the provision of healthcare, requiring efficient management procedures to limit transmission. Evaluating current outbreak management processes within UK healthcare services is essential for identifying strengths, weaknesses, and potential improvements.

Objectives

This study aimed to assess infection prevention and control (IPC) practitioners' access to outbreak management (OM) data. Secondary objectives involved determining IPC practitioners’ perceptions of outbreak management processes and the state of digitalisation of OM in the UK.

Methods

National cross-sectional survey data were collected to evaluate current outbreak management approaches. To supplement this, information requests were sent to the 10 largest teaching and research NHS hospital trusts in England.

Findings

The survey received 55 responses with 53 considered for analysis. Out of 10 NHS trusts, nine provided completed FOI responses, while one was unable to provide data.

Discussion

The study offers unique insights into prevailing outbreak management practices within UK health services. Although positive perceptions surround key outbreak management stages, concerns arise, including varying confidence levels in surveillance processes' robustness, efficacy of management interventions, and communication effectiveness.

Conclusions

The study highlights challenges with OM processes in the UK, including issues like poor surveillance and delayed outbreak detection. Positive practitioner perceptions contrast with concerns over data collection, follow-up, and limited digitalisation, relying on basic tools like Excel and Word, hindering retrospective learning.
Time in Range Analysis in Automated Insulin Delivery Era: Should Day and Nighttime Targets be the Same?
Authors: Maia Ariana , Subias Andujar David , Yuste Cristina , Albert Lara , Vilaverde Joana , Cardoso Maria Helena , Rigla Mercedes
Published: March 2024

Introduction:

Hybrid closed-loop systems (HCLS) use has shown that time in range (TIR) tends to improve more during the nighttime than during the day. This study aims to compare the conventional TIR, currently accepted as 70 to 180 mg/dL, with a proposed recalculated time in range (RTIR) considering a tighter glucose target of 70 to 140 mg/dL for the nighttime fasting period in T1DM patients under HCLS.

Methods:

We conducted a retrospective study that included adults patients receiving treatment with Tandem t:slim X2 Control-IQ. Daytime TIR was characterized as glucose values between 70 and 180 mg/dL during the 07:01 to 23:59 time frame. Nighttime fasting TIR was specified as glucose values from 70 to 140 mg/dL between 00:00 and 07:00. The combination of the daytime and nighttime fasting glucose targets results in an RTIR, which was compared with the conventional TIR for each patient. The 14 days Dexcom G6 CGM data were downloaded from Tidepool platform and analyzed.

Results:

We included 22 patients with a mean age of 49.7 years and diabetes duration of 24.7 years, who had been using automatic insulin delivery (AID) HCLS for a median of 305.3 days. We verified a mean conventional TIR of 68.7% vs a mean RTIR of 60.3%, with a mean percentage difference between these two metrics of −8.4%. A significant decrease in conventional TIR was verified when tighter glucose targets were considered during the nighttime period. No significant correlation was found between the percentage difference values and RTIR, even among the group of patients with the lowest conventional TIR.

Conclusions:

Currently, meeting the conventional TIR metrics may fall short of achieving an ideal level of glycemic control. An individualized strategy should be adopted until further data become available for a precise definition of optimal glucose targets.
Favorable Clinical Outcomes After Humeral Head Depressor Muscle Coactivation Training With EMG for Patients With Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial
Authors: Kararti Caner , Özüdoğru Anıl , Basat Hakkı Çağdaş , Özsoy İsmail
Published: March 2024

Background:

The coactivation (Co-A) of shoulder muscles that contribute to humeral head depression can lead to mechanical unloading of the subacromial structures during abduction and thus can be beneficial for patients with arthroscopic rotator cuff repair (ARCR). The present study aims to examine the effectiveness of humeral head depressor muscle Co-A (DM-Co-A) training on clinical outcomes in a sample of patients with ARCR.

Hypothesis:

We hypothesized that DM-Co-A training with medioinferior vector during glenohumeral exercises can improve clinical results in the rehabilitation of ARCR.

Study Design:

Randomized controlled single-blind study.

Level of Evidence:

Level 1B.

Methods:

A total of 27 patients who underwent ARCR after a medium-sized rotator cuff tear and completed their Phase 1 training with ≥80% compliance were included. Together with 14 weeks of conservative treatment (6 weeks of Phase 2 training and 8 weeks of Phase 3 training), synchronized “DM-Co-A Training” was applied to the treatment group with an electromyography (EMG) biofeedback (EMG-BF) device. Patients in the treatment group were asked to voluntarily activate the humeral head depressor muscles guided by visual and auditory feedback of the EMG-BF device during the Phase 2 and Phase 3 conservative treatment exercises performed by the control group. Demographic characteristics of the participants were recorded. Visual analog scale and universal goniometer were used to assess pre- and posttreatment pain severity and joint range of motion, respectively. The Disabilities of Arm, Shoulder and Hand Questionnaire, Revised Oxford Shoulder Score, Modified Constant-Murley Shoulder Score, and the Western-Ontario Rotator Cuff Index were used to assess functionality.

Results:

There was a clinically meaningful improvement in pain severity, active ROM excluding internal rotation, and functionality in the treatment group compared with the control group ( P < 0.05).

Conclusion:

A 14-week duration DM-Co-A with EMG may be beneficial in the postoperative rehabilitation of patients after ARCR.
Arthroscopic Implantation of a Cell-Free Bilayer Scaffold for the Treatment of Knee Chondral Lesions: A 2-Year Prospective Study
Authors: Gudas Rimtautas , Staškūnas Mantas , Mačiulaitis Justinas , Gudaitė Emilė , Aleknaite-Dambrauskiene Ieva
Published: March 2024

Objective

The main objective of this study is to assess the safety and clinical efficacy of a cell-free bilayer scaffold (MaioRegen Chondro+ by Fin-Ceramica) in patients affected by chondral knee lesions of different origin and localization.

Design

Thirty-one patients with focal chondral lesions of the knee were arthroscopically treated with MaioRegen Chondro+. All patients were prospectively evaluated for a minimum of 2 years using the International Knee Documentation Committee (IKDC) Questionnaire and the Tegner Activity Scale. Cartilage repair was assessed based on the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) 2.0 score at 12 months. Follow-up at 36 months was available for 25 out of 31 patients.

Results

From baseline to 6-, 12-, and 24-month follow-up, IKDC score significantly improved by 19.5 ± 7.27 (95% confidence interval [CI]: 16.9-22.2, P < 0.001), 30.8 ± 7.63 (95% CI: 28.0-33.6, P < 0.001), and 36.2 ± 8.00 points (95% CI: 33.3-39.2, P < 0.001), respectively. Tegner scores documented a substantial clinical improvement as early as 12 months after surgery (change of −0.6 ± 0.62; 95% CI: −0.8 to −0.4, P < 0.001), reaching the preinjury values. There was a statistically significant increase in the MOCART scores ( P < 0.001). Comparable results were observed regardless of preintervention demographic characteristics, lesion site or etiology, or the number of treated sites. Notably, the significant clinical benefit was maintained in a subset of patients who reached 3-year follow-up. No adverse events were reported in the entire analyzed population.

Conclusion

MaioRegen Chondro+ is a safe and effective device for the treatment of knee chondral lesions, enabling a significant clinical improvement for at least 2 years.
Hydrogel-Based Matrix-Associated Autologous Chondrocyte Implantation Shows Greater Substantial Clinical Benefit at 24 Months Follow-Up than Microfracture: A Propensity Score Matched-Pair Analysis
Authors: Gaissmaier Christoph , Angele Peter , Spiro Robert C. , Köhler Annette , Kirner Alexandra , Niemeyer Philipp
Published: March 2024

Objective

To compare substantial clinical benefit (SCB) of a hydrogel-based, matrix-associated autologous chondrocyte implantation (M-ACI) method versus microfracture (MFx) in the treatment of knee cartilage defects.

Design

Propensity score matched-pair analysis, using the MFx control group of a phase III study as comparator for M-ACI treatment in a single-arm phase III study, resulting in 144 patients in the matched-pair set.

Results

Groups were comparable regarding baseline Knee Injury and Osteoarthritis Outcome Score (KOOS), sex, age, body mass index, symptom duration, smoking status, and previous knee surgeries. Defect sizes in the M-ACI group were significantly larger than in the MFx group (6.4 cm2 vs. 3.7 cm2). Other differences concerned location, number, and etiology of defects that were not considered to influence the interpretation of results. At 24 months, significantly more patients in the M-ACI group achieved SCB in KOOS pain (72.2% vs. 48.6%; P = 0.0108), symptoms (84.7% vs. 61.1%, P = 0.0039), sports/recreation (84.7% vs. 56.9%, P = 0.0008), and quality of life (QoL; 72.2% vs. 44.4%, P = 0.0014). The SCBs for KOOS activities in daily living and International Knee Documentation Committee score were higher for M-ACI but not significantly different from MFx. The SCB rates consistently favored M-ACI from 3 months onward. The highest improvements from baseline at 24 months in patients with SCB were observed for KOOS sports/rec. (M-ACI: 60.8 points, MFx: 55.9 points) and QoL (M-ACI: 58.1, MFx: 57.4).

Conclusion

Hydrogel-based M-ACI demonstrated superior SCB in KOOS pain, symptoms, sports/rec., and QoL compared with MFx in patients with knee cartilage defects through 2 years follow-up.
Informality at the heart of sustainable development
Authors: Finn Brandon Marc
Published: March 2024

As a term, the ‘structure of informality’ aims to elucidate how informality is produced, and why it persists. I argue that informality is engendered through the informal/formal dialectic, which constitutes a multiscalar process that creates global inequalities across time and space. We can better understand informality by studying colonial socio-spatial inequalities created through urbanization. Taking seriously the arguments put forward by Cobbinah and Olajide, I argue that the structure of informality must also be applied to understand contemporary neocolonial practices in relation to sustainable development. These practices include the use and misuse of informality in relation to three topics: (1) as a mode of generating and sustaining socio-spatial and economic inequalities; (2) the nascent and undertheorized relationship between informality and climate change; and (3) the importance of understanding and theorizing global informality at the heart of sustainable development to influence policy and practice. These topics have grown in salience because of the global push towards decarbonization, and despite informality being a dominant mode of economic, spatial, and political life in most of the world. Informality lies at the heart of sustainable development, thus making it essential to re-energize debates on its structures, forms, and driving forces.
The extraordinary task of crafting a more ‘ordinary’ geography: Post-vanguardism and the art of not-knowing best
Authors: Wills Jane
Published: March 2024

This commentary responds to the provocations in Shawn Bodden's paper, ‘Working through our differences', in which he draws on the work of the late Clive Barnett and Ordinary Language Philosophy to advocate for a more ‘ordinary’ orientation to geographical inquiry. In the interests of generating wider debate, I push Bodden to go a step further and fully embrace the extraordinary task he is asking us to take on. The consequences of his argument imply that we need to reject the vanguardist approach taken by many human geographers over the past 50 years. We need to start to embrace the art of not-knowing best. I draw attention to the resources of pragmatist philosophy to help us to think how to do this.
COVID-19 vaccines and vaccinations coverage on news portals: Framing, Tone, and Source Analysis
Authors: Demuyakor John , Avenyo Stevens Justice , Amankwah Adwoa Sikayena
Published: March 2024

A comparative quantitative content analysis was adopted to explore the frames, tones, and information sources for the coverage of COVID-19 vaccines and vaccination in four countries in Africa. The news portals and countries for this study were purposively sampled based on the World Press Freedom Index released by Reporters Without Borders for 2021. Namibia, South Africa, Ghana, and Botswana are among the top ten countries in Africa with the best Media Freedoms. The findings showed that Ghana’s news portals’ coverage of COVID-19 vaccines and vaccination campaigns used mainly unofficial sources in the coverage of COVID-19 vaccines and vaccination stories, whereas Botswana, Namibia, and South African media used official sources. Other findings show that Ghana’s news portals covered COVID-19 vaccines and vaccination stories in a negative tone and employed conflict and economic consequence frames. Botswana, Namibia, and South African news portals, however, adopted neutral and positive tones and framed them according to human interest, responsibility, and morality. The results suggest that the text of the news articles from the four African countries’ coverage of the COVID-19 vaccines and vaccination adopted different generic framing styles, and the tones were predominantly a mixture of positive, neutral, and negative.
Mapping the Field of Entrepreneurial Versus Managerial Abilities: A New Trend of Dynamic Capabilities-A Bibliometric Analysis
Authors: Pennetta Selene , Anglani Francesco , Reaiche Carmen , Boyle Stephen
Published: March 2024

Personality traits, skills, competencies, and capabilities —also generally known as abilities—are terms widely used within the business domain in both the managerial and entrepreneurial contexts. Although the differences between entrepreneurial and managerial roles have been widely discussed among scholars, the literature still fails to identify the abilities that distinguish these roles. Moreover, new capabilities common to both fields have also recently emerged, related to both entrepreneurial and managerial roles, that are strictly connected to the rapid change and uncertain dynamics of the global economy. This research contributes to knowledge by disclosing this new group of capabilities, also known as dynamic capabilities. A bibliometric analysis has been conducted to examine the evolutionary intricacies of both entrepreneurial and managerial roles while shedding light on the specific skills creating these dynamic capabilities.
“Pap smear horror stories, self loathing, feeling like I was less of a woman”: A qualitative content analysis of an online vaginismus forum
Authors: Mettela Swathi , Chima Melissa , Costigan Heather , Stuckey-Peyrot Heather , Baweja Ritika , Riley Kristin
Published: March 2024

Objective:

To understand what concerns and experiences people with vaginismus share online anonymously but may not share with clinicians.

Methods:

Two researchers compiled all comments and posts made from November 2019 to April 2020 within an online vaginismus forum ( n = 311) for content analysis. Two researchers separately performed inductive coding, categorized quotes into overarching categories and codes, and resolved inconsistencies with a third-party adjudicator.

Results:

Our analysis highlighted three key categories: “psychosocial concerns” (34%), “discussion of pain” (33%), and “lack of access to vulvovaginal healthcare” (34%). The category “psychosocial concerns” comprised of the codes “shame and/or social isolation” (12%), “mental health comorbidities” (9%), “fear of partner separation” (7%), “cultural/religious stigma” (2%), “partner separation” (2%), and “fear of infertility or vaginal delivery” (1%). The category “discussion of pain” comprised of the codes “successful therapies” (16%), “sexual pain” (9%), “nonsexual pain” (6%), and “unsuccessful therapies” (2%). The category “lack of access to vulvovaginal healthcare” comprised of the codes “lack of standardized therapy guidelines” (8%), “self diagnosis” (7%), “fertility testing and/or treatments limited by vaginismus” (5%), “clinicians dismissing symptoms” (4%), “inadequate clinician knowledge about vaginismus” (2%), “inadequate health and sex education in schools” (2%), “geographical barriers” (2%), and “COVID-19” (2%).

Conclusion:

This novel qualitative study of an online vaginismus forum highlights the need for a patient-centered approach to inform future research, medical education, and clinical practice. Our findings suggest we reevaluate the standard of care for patients with vaginismus and expand on existing knowledge of the impact of sexual health stigma on social and health outcomes.
Do Lucky People Reciprocate More? The Effect of Outcome Bias on Trustworthiness
Authors: Muchtar Pyan Amin
Published: March 2024

This study investigates how reciprocity works in a simple trust game when the subjects are framed as either lucky or unlucky. We induce luckiness perception to the second mover by introducing uncertainty with a different combination of possible multipliers, allowing us to observe the effect of outcome bias on trustworthiness while controlling for the wealth effect. We do not find a significantly different level of trustworthiness between lucky second movers and unlucky second movers. The result suggests the null effect of outcome bias on reciprocal behaviour.

JEL Classifications: C91, D01, D63, D91
Pain Research and Treatment: Policy Implications
Authors: Tajerian Maral , Alvarado Sebastian
Published: March 2024

Pain is a subjective experience for which we lack a thorough mechanistic understanding. While it has often been considered a secondary symptom of a disease, research has revealed that chronic pain can be recognized as a disease of its own. Preclinical studies often use animal models to understanding the pathology and test potential therapies with clinical trials of novel analgesics often showing underwhelming results. From a clinician's perspective, pain can be challenging to treat without incurring undesirable drug effects. Pain research, diagnosis, and treatment have changed dramatically over the last two decades. This has coincided with shifts in reliance on opioid-based approaches to managing pain. Here we present an overview of recent advances in preclinical research, novel approaches to diagnosis and treatment, along with considerations for animal care. Collectively, this report may provide a guide on which to base relevant policy changes that would meet the demands of societal need and satisfy the need for scientific evidence.
The Cost-Effectiveness of Smoking Cessation Programs for Prevention of Wound Complications Following Total Ankle Arthroplasty: A Break-Even Analysis
Authors: Kim Andrew H. , ElNemer William , Cartagena-Reyes Miguel A. , Marrache Majd , Thompson John M. , Aiyer Amiethab A.
Published: March 2024

Background:

Tobacco use significantly increases the rate of wound complications in patients undergoing total ankle arthroplasty (TAA). Preoperative optimization through smoking cessation programs significantly minimizes the rate of infection and improves wound healing in arthroplasty procedures. Despite its utility, minimal research has examined the cost-effectiveness of preoperative smoking cessation programs to reduce the need for extracapsular irrigation and debridement (I&D) due to wound complications following TAA.

Methods:

The cost of an I&D procedure was obtained from our institution’s purchasing records. Baseline wound complication rates among tobacco users who have undergone TAA and smoking cessation program cost were obtained from literature. A break-even economic analysis was performed to determine the absolute risk reduction (ARR) to economically justify the implementation of preoperative smoking cessation programs. Different smoking cessation program and I&D costs were tested to account for variations in each factor. ARR was then used to calculate the number needed to treat (NNT) to prevent a single I&D while remaining cost-effective.

Results:

Smoking cessation programs were determined to be economically justified if it prevents 1 I&D surgery out of 8 TAAs among tobacco users (ARR = 12.66%) in the early postoperative period (<30 days). ARR was the same at the literature high (27.3%) and weighted literature average (13.3%) complication rates when using the cost of I&D surgery at our institution ($1757.13) and the literature value for a smoking cessation program ($222.45). Cost-effectiveness was maintained with higher I&D surgery costs and lower costs of smoking cessation treatment.

Conclusion:

Our model’s input data suggest that the routine use of smoking cessation programs among tobacco users undergoing TAA is cost-effective for risk reduction of I&D surgery in the early postoperative period. This intervention was also found to be economically warranted with higher I&D costs and lower smoking cessation program costs than those found in the literature and at our institution. Level of Evidence: Level III, economic and decision analysis.
Freebie Debates and Budgetary Priorities: Economic Growth-led India or Inclusive India
Authors: Kumar Ajit
Published: March 2024

This article discusses the current debate in India centred on freebie schemes and budgetary priorities. Both are being shaped by India’s political economy within and by globalisation forces outside. Targeting high growth rates and making economies competitively fit are driving this globalization forces. Should budgets prioritise growth or distribution? The Bhagwati–Sen debate provides us insights into the pros and cons of this apparent choice. Economic growth in India has been reasonably good, but not enough employment has been created. The decline in poverty rate has been slower, and in absolute numbers, a staggering number are still poor. India, an erstwhile colonised nation-state, is currently focusing on an infrastructure-led growth budget. The current governing elites assume that growth will take place and benefits eventually will trickle down. It rests its hopes largely on the middle class for high growth rates. The counter-elite voice demands more budgetary allocation for the Indian labouring poor, largely rural. This allocation will widen the participatory base of the economy. The two viewpoints presented here represent two perspectives: an economic growth-led India and an inclusive India. This debate has significant implications for re/distributive policies and programmes and human development.
Vibration studies of an axially moving epoxy-carbon nanofiber composite beam in thermal environment—Effect of various nanofiber reinforcements
Authors: Marynowski Krzysztof
Published: March 2024

Free vibrations of an axially moving multiscale composite beam in thermal environment are analyzed. The beam material is epoxy resin with variously reinforced and randomly oriented or aligned in electric field carbon nanofibers (CNFs). To describe the thermomechanical properties of the beam material, published dynamic characteristic of stationary multiscale composites were taken into consideration. Using the frequency–temperature equivalence principle, the nanocomposite material of the beam is modeled using four-parameter fractional rheological model. The dynamic characteristics of the multiscale polymer beam in the frequency domain made it possible to determine the partial equation of motion of the axially moving beam. The Galerkin method is used to solve the governing partial differential equation. The effects of various nanofiber reinforcements of randomly oriented, and aligned in electric field fibers at different temperatures, on the free vibration of the axially moving beam are investigated.
Investigating Length of Stay Patterns and Its Predictors in the South Wales Trauma Network
Authors: Wang Zihao , Rostami-Tabar Bahman , Haider Jane , Naim Mohamed , Haider Javvad
Published: March 2024

Background:

Length of stay (LOS) is frequently employed as a performance metric for trauma care. Following the establishment of the trauma network worldwide, the assessment and prediction of LOS in different levels of trauma centres have been extensively studied. However, assessing the total patient length of stay from a whole trauma network perspective is unclear. The objective of this study was to systematically analyse the overall Length of Stay (LOS) pattern within the SWTN before its establishment and in the immediate time after its foundation and, secondly, to assess the association between relevant impact factors and LOS.

Methodology:

A retrospective secondary analysis based on the trauma admission dataset from Trauma Audit and Research Network(TARN) dataset was conducted. The studied sample covered around 18000 patients admitted to trauma centres from South Wales Major trauma network between January 2012 and October 2021. The primary outcome is the total length of stay in the trauma network. Statistical tests were applied to examine the difference between normal and outlier LOS. Data visualisation was utilised to demonstrate the LOS patterns and potential association between LOS and relevant demographic and clinical predictors.

Results:

The distribution of length of stay in SWTN follows a right-skewed distribution with a median of 10 (IQR, 5–18) and a mean of 15.92 days. There were 1520 patients with outliers for LOS. A significant difference (p¡ 0.05) was found between the normal and outlier groups of LOS based on demographic (age, gender and residential information) and clinical characteristics(ward type, maximum of anatomically-based injury severity score(AIS) and probability of survival). Age group, maximum AIS score on specific injured region, ward type and its interaction effect with the number of admissions may associated with the LOS. Specifically, patients admitted to the geriatric ward exhibited notably prolonged LOS, and individuals with more than 2 admissions to long-term care and recovery-related wards such as neurosurgical rehabilitation, spinal injuries and burns wards also displayed elevated LOS.

Conclusion:

Our finding supports prior evidence indicating elderly people are vulnerable to longer stays. Moreover, concerning the types of admission wards, patients admitted to rehabilitation wards who underwent more than 2 hospitalisations also faced an increased risk of prolonged stay. Based on these results, policymakers and healthcare providers should contemplate expanding the allocation of medical resources to this demographic to mitigate the length of stay and optimise associated healthcare costs.
Performance-based probabilistic liquefaction-induced ground settlement procedure
Authors: Olaya Franklin , Bray Jonathan , Abrahamson Norman
Published: March 2024

Performance-based procedures represent an improvement over current state-of-practice procedures that treat the assessment of seismic demand and engineering response parameters independently. Procedures used in current practice generally provide estimates of liquefaction-induced ground settlement that are inconsistent with the desired ground settlement hazard level. A recently developed probabilistic procedure to estimate liquefaction-induced ground settlement is employed to develop a new performance-based procedure that estimates ground settlement which accounts for key sources of uncertainty. The ground-motion intensity and ground settlement estimations are integrated in the proposed procedure to produce hazard curves for liquefaction-induced ground settlement. The hazard curve for ground settlement links different hazard levels with their corresponding values of ground settlement by evaluating a wide range of ground-motion intensities and site characterization parameters with their associated uncertainties. The proposed performance-based procedure also permits the evaluation of different sources of uncertainty and their effects on the ground settlement estimate.
Cardiovascular events reported in patients with B-cell malignancies treated with zanubrutinib
Authors: Moslehi Javid J. , Furman Richard R. , Tam Constantine S. , Salem Joe-Elie , Flowers Christopher R. , Cohen Aileen , Zhang Meng , Zhang Jun , Chen Lipeng , Ma Han , Brown Jennifer R.
Published: March 2024

First-generation Bruton tyrosine kinase (BTK) inhibitor, ibrutinib, has been associated with an increased risk of cardiovascular toxicities. Zanubrutinib is a more selective, next-generation BTK inhibitor. In this analysis, incidence rates of atrial fibrillation, symptomatic (grade ≥2) ventricular arrhythmia, and hypertension were evaluated in a pooled analysis of 10 clinical studies with zanubrutinib monotherapy in patients (N = 1550) with B-cell malignancies and a pooled analysis of head-to-head studies comparing zanubrutinib with ibrutinib (ASPEN cohort 1; ALPINE). Among the 10 studies, most patients (median age, 67 years) were male (66.3%) and had CLL/SLL (60.5%). Overall incidence and exposure-adjusted incidence rates (EAIR) for atrial fibrillation, symptomatic ventricular arrhythmia, and hypertension were lower with zanubrutinib than ibrutinib. Despite a similar prevalence of preexisting cardiovascular events in ASPEN and ALPINE, atrial fibrillation/flutter incidence rates (6.1% vs 15.6%) and EAIR (0.2 vs 0.64 persons per 100 person-months; P < .0001) were lower with zanubrutinib than with ibrutinib. Symptomatic ventricular arrhythmia incidence was low for both zanubrutinib (0.7%) and ibrutinib (1.7%) with numerically lower EAIR (0.02 vs 0.06 persons per 100 person-months, respectively) for zanubrutinib. The hypertension EAIR was lower with zanubrutinib than ibrutinib in ASPEN but similar between treatment arms in ALPINE. The higher hypertension EAIR in ALPINE was inconsistent with other zanubrutinib studies. However, fewer discontinuations (1 vs 14) and deaths (0 vs 6) due to cardiac disorders occurred with zanubrutinib versus ibrutinib in ALPINE. These data support zanubrutinib as a treatment option with improved cardiovascular tolerability compared with ibrutinib for patients with B-cell malignancies in need of BTK inhibitors. These trials were registered at www.ClinicalTrials.gov as # NCT03053440, NCT03336333, NCT03734016, NCT04170283, NCT03206918, NCT03206970, NCT03332173, NCT03846427, NCT02343120, and NCT03189524.
Asymmetric voltage amplification using a capacitive load energy management circuit in a triboelectric nanogenerator
Authors: Jeong Jiwon , Ko Jiyoung , Kim Jinhee , Lee Jongjin
Published: March 2024

We investigated the polarity dependence of a capacitive energy management circuit in a triboelectric nanogenerator (TENG) power system. In a half-wave rectifying circuit, the Simulation Program with Integrated Circuit Emphasis and analytical models show that the charge dump to the load varied depending on the polarity of the rectifying circuit even with the same charge output from TENG. Depending on the polarity of the rectifying circuit, a fast saturation of the direct current (DC) output voltage or a high DC output voltage was obtained. Experiments with a half-wave rectifier and Bennet doubler confirmed our simulation and theoretical results. The charge dump from the minimum capacitance of the separated TENG to the load capacitance and the charge dump from the maximum capacitance of the contacted TENG to the load resulted in asymmetric charging behavior. We concluded that it is necessary to analyze the TENG and the capacitive energy management circuit as a single system rather than considering them as independent units in the rectifying circuit of the TENG. This work can provide insights for the design of triboelectric energy harvesting systems.
RNA-binding proteins potentially regulate the alternative splicing of apoptotic genes during knee osteoarthritis progression
Authors: Zhang Zheng , Dong Limei , Tao Hai , Dong Yusong , Xiang Wei , Tao Fenghua , Zhao Yingchun
Published: March 2024

Background

Alternative splicing (AS) is a principal mode of genetic regulation and one of the most widely used mechanisms to generate structurally and functionally distinct mRNA and protein variants. Dysregulation of AS may result in aberrant transcription and protein products, leading to the emergence of human diseases. Although considered important for regulating gene expression, genome-wide AS dysregulation, underlying mechanisms, and clinical relevance in knee osteoarthritis (OA) remain unelucidated. Therefore, in this study, we elucidated and validated AS events and their regulatory mechanisms during OA progression.

Results

In this study, we identified differentially expressed genes between human OA and healthy meniscus samples. Among them, the OA-associated genes were primarily enriched in biological pathways such as extracellular matrix organization and ossification. The predominant OA-associated regulated AS (RAS) events were found to be involved in apoptosis during OA development. The expression of the apoptosis-related gene BCL2L13, XAF1, and NF2 were significantly different between OA and healthy meniscus samples. The construction of a covariation network of RNA-binding proteins (RBPs) and RAS genes revealed that differentially expressed RBP genes LAMA2 and CUL4B may regulate the apoptotic genes XAF1 and BCL2L13 to undergo AS events during OA progression. Finally, RT-qPCR revealed that CUL4B expression was significantly higher in OA meniscus samples than in normal controls and that the AS ratio of XAF1 was significantly different between control and OA samples; these findings were consistent with their expected expression and regulatory relationships.

Conclusions

Differentially expressed RBPs may regulate the AS of apoptotic genes during knee OA progression. XAF1 and its regulator, CUL4B, may serve as novel biomarkers and potential therapeutic targets for this disease.
Association between triglyceride-glucose index and hypertension: a cohort study based on the China Health and Nutrition Survey (2009–2015)
Authors: Wang Su , Wang Qian , Yan Xianliang
Published: March 2024

Aim

Insulin resistance (IR) may participate in the pathogenesis of hypertension by mediating low-grade systemic inflammation. The triglycerides-glucose (TyG) index has recently been suggested as a reliable alternative biochemical marker of IR compared with traditional methods. Herein, we speculated TyG index may also be associated with hypertension.

Methods

Data of adults were extracted from the China Health and Nutrition Survey (CHNS) in 2009–2015 in this retrospective cohort study. The TyG index was calculated using the formula: TyG = Ln [fasting triglycerides (mg/dL) ×fasting glucose (mg/dL)/2]. Associations between TyG index and hypertension were evaluated by univariate and multivariate logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses of age and gender were also performed. In addition, we assessed the interaction effect between TyG index and body mass index (BMI) on hypertension in participants with different age and gender.

Results

Among 3,413 eligible participants, 1,627 (47.67%) developed hypertension. The average TyG index in hypertension group and non-hypertension group was 8.58 and 8.39 respectively. After adjusting for covariates, we found that compared with participants with TyG index ≤ 8.41 (median value), those who had higher TyG index seemed to have higher odds of hypertension [OR = 1.17, 95%CI: (1.01–1.37)]. Similarly, this association was also discovered in participants who aged ≤ 65 years old [OR = 1.19, 95%CI: (1.01–1.39)] or were female [OR = 1.35, 95%CI: (1.10–1.65)]. Additionally, there was a potential additive interaction effect between obesity and TyG index on hypertension.

Conclusion

High TyG index was associated with high odds of hypertension in general population in China, but the causal relationship between them needed further exploration.
Facilitators and barriers to home blood pressure monitoring among pregnant women in Ghana: a mixed-methods analysis of patient perspectives
Authors: Newman Noah , Beyuo Titus K. , Nartey Betty A. , Segbedzi-Rich Elorm , Pangori Andrea , Moyer Cheryl A. , Lori Jody R. , Oppong Samuel A. , Lawrence Emma R.
Published: March 2024

Background

The benefit of home blood pressure monitoring during pregnancy and in low-resource settings is incompletely understood. The objective of this study was to explore the experiences, barriers, and facilitators of home blood pressure monitoring among pregnant women in Ghana.

Methods

This concurrent triangulation mixed-methods study was conducted at an urban tertiary hospital in Ghana. Participants were recruited from adult pregnant women presenting for routine antenatal care. Upon enrollment, participants’ demographics and history were collected. At the next study visit, participants received audiovisual and hands-on training on using an automatic blood pressure monitor; they then monitored and logged their blood pressure daily at home for 2–4 weeks. At the final study visit, verbally administered surveys and semi-structured interviews assessed participant’s experiences. Quantitative data were analyzed using R version 4.2.2, and frequencies and descriptive statistics were calculated. Qualitative data were imported into DeDoose 9.0.78 for thematic analysis.

Results

Of 235 enrolled participants, 194 completed surveys; of those, 33 completed in-depth interviews. Participants’ mean age was 31.6 (SD 5.3) years, 32.1% had not previously given birth, and 31.1% had less than a senior high school education. On a 4-point Likert scale, the majority reported they “definitely” were able to remember (n = 134, 69.1%), could find the time (n = 124, 63.9%), had the energy (n = 157, 80.9%), could use the blood pressure monitor without problems (n = 155, 79.9%), and had family approval (n = 182, 96.3%) while engaging in home blood pressure monitoring. 95.88% (n = 186) believed that pregnant women in Ghana should monitor their blood pressure at home. Qualitative thematic analysis demonstrated that most participants liked home blood pressure monitoring because of increased knowledge of their health during pregnancy. While most participants found measuring their blood pressure at home doable, many faced challenges. Participants’ experiences with five key factors influenced how easy or difficult their experience was: 1) Time, stress, and daily responsibilities; 2) Perceived importance of BP in pregnancy; 3) Role of family; 4) Capability of performing monitoring; 5) Convenience of monitoring.

Conclusions

Among pregnant women in urban Ghana, home blood pressure monitoring was perceived as positive, important, and doable; however, challenges must be addressed.
Prognostic marker CD27 and its micro-environmental in multiple myeloma
Authors: Wang Xinya , Luo Keyang , Xu Qiuting , Chi Liqun , Guo Yiwei , Jia Chuiming , Quan Lina
Published: March 2024

Background

The Cluster of Differentiation 27 (CD27) is aberrantly expressed in multiple myeloma (MM) -derived. This expression facilitates the interaction between tumor and immune cells within TME via the CD27-CD70 pathway, resulting in immune evasion and subsequent tumor progression. The objective of this study is to investigate the correlation between CD27 expression and the prognosis of MM, and to elucidate its potential relationship with the immune microenvironment.

Methods

In this research, CD27 expression in T cells within the 82 newly diagnosed MM microenvironment was assessed via flow cytometry. We then examined the association between CD27 expression levels and patient survival. Subsequent a series of bioinformatics and in vitro experiments were conducted to reveal the role of CD27 in MM.

Results

Clinical evidence suggests that elevated CD27 expression in T cells within the bone marrow serves as a negative prognostic marker for MM survival. Data analysis from the GEO database has demonstrated a strong association between MM-derived CD27 and the immune response, as well as the hematopoietic system. Importantly, patients with elevated levels of CD27 expression were also found to have an increased presence of MDSCs and macrophages in the bone marrow microenvironment. Furthermore, the PERK-ATF4 signaling pathway has been implicated in mediating the effects of CD27 in MM.

Conclusions

We revealed that CD27 expression levels serve as an indicative marker for the prognosis of MM patients. The CD27- PERK-ATF4 is a promising target for the treatment of MM.
Assessing colposcopy competencies in medically underserved communities: a multi-center study in China
Authors: Cui Xiaoli , Wang Huike , Chen Mingyang , Seery Samuel , Xue Peng , Qiao Youlin , Shang Yuhong
Published: March 2024

Background

Colposcopy plays an essential role in diagnosing cervical lesions and directing biopsy; however, there are few studies of the capabilities of colposcopists in medically underserved communities in China. This study aims to fill this gap by assessing colposcopists’ competencies in medically underserved communities of China.

Methods

Colposcopists in medically underserved communities across China were considered eligible to participate. Assessments involved presenting participants with 20 cases, each consisting of several images and various indications. Participants were asked to determine transformation zone (TZ) type, colposcopic diagnoses and to decide whether biopsy was necessary. Participants are categorized according to the number of colposcopic examinations, i.e., above or below 50 per annum.

Results

There were 214 participants in this study. TZ determination accuracy was 0.47 (95% CI 0.45,0.49). Accuracy for colposcopic diagnosis was 0.53 (95% CI 0.51,0.55). Decision to perform biopsies was 0.73 accurate (95% CI 0.71,0.74). Participants had 0.61 (95% CI 0.59,0.64) sensitivity and a 0.80 (95% CI 0.79,0.82) specificity for detecting high-grade lesions. Colposcopists who performed more than 50 cases were more accurate than those performed fewer across all indicators, with a higher sensitivity (0.66 vs. 0.57, p = 0.001) for detecting high-grade lesions.

Conclusions

In medically underserved communities of China, colposcopists appear to perform poorly at TZ identification, colposcopic diagnosis, and when deciding to biopsy. Colposcopists who undertake more than 50 colposcopies each year performed better than those who perform fewer. Therefore, colposcopic practice does improve through case exposure although there is an urgent need for further pre-professional and clinical training.