bluuebunny/crossref_metadata_2025 huggingface dataset:
Rehab-AMD: co-design of an application for visual rehabilitation and monitoring of Age-related Macular Degeneration
Authors: González-Montero Guadalupe , Guijarro Mata-García María , Moreno Martínez Carlos , Recas Piorno Joaquín
Published: August 2024

Background

The increasing demand for remote medical care, driven by digital healthcare advancements and the COVID-19 pandemic, necessitates effective solutions tailored to patients and healthcare practitioners. Co-design, involving collaboration between software developers, patients, and healthcare practitioners, prioritizes end-user needs. Research indicates that integrating patient perspectives enhances user experience and usability. However, its application in healthcare has been limited to small projects. This work focuses on co-designing a technological solution to enhance the monitoring and visual rehabilitation of individuals with Age-Related Macular Degeneration (AMD), a condition that significantly impacts the quality of life in people over 60. Current vision rehabilitation systems lack personalization, motivation, and effective progress monitoring. Involving patients and healthcare practitioners in the design process aims to ensure the final product meets their needs.

Methods

The project employs iterative and collaborative principles, involving a vision rehabilitation expert and two AMD patients as active users in the application’s development and validation. The process begins by establishing requirements for user accounts and rehabilitation exercises. It continues with an initial approach extended through user validation. Co-design is facilitated by specific workshops marking each project iteration, totaling four workshops, along with continuous communication sessions between experts and developers to validate design decisions. Initial requirements gathering and constant feedback from end-users, the visual rehabilitator, and patients are crucial for refining the product effectively.

Results

The workshops produced a prototype featuring a test to monitor changes and progression and 15 visual rehabilitation exercises. Numerous patient and vision rehabilitation-driven software modifications led to a final design that is responsive and adaptive to end-user needs.

Conclusions

The Rehab-AMD pilot project aims to develop a collaborative and adaptive software solution for AMD rehabilitation by actively involving stakeholders and applying iterative design principles. Co-design in the Rehab-AMD solution proves to be a methodology that identifies usability issues and needs from the initial design stages. This approach ensures that software developers create a final product that is genuinely useful and manageable for people with AMD and the targeted vision rehabilitators.
Implementing workplace health promotion in nursing – A process evaluation in different care settings
Authors: Lützerath Jasmin , Bleier Hannah , Gernert Madeleine , Schaller Andrea
Published: August 2024

Objective

Workplace health promotion (WHP) in Germany is receiving increasing support from health insurance funds. Nevertheless, there is hardly any knowledge on the process of how health outcomes are achieved, especially in nursing. The aim of the study was to find out how and what can be implemented in different care settings and to examine the reactions and interactions of the participants under routine conditions.

Methods

Guided by a logic model, a holistic WHP approach was implemented in four acute care hospitals, seven inpatient care facilities and four outpatient care services from April 2021 to October 2022. Data on realized WHP interventions, participant assessment and topics of work design was collected and analyzed descriptively.

Results

The realized WHP interventions were adapted depending on the content and context. Mainly short relaxation interventions were delivered or those with an event character were received by participants. The highest participation rate of planned participants was achieved in team building training. Participants predominantly assessed WHP interventions as useful, the quality as (very) good and were generally (very) satisfied with the intervention components. For work design topics, intentions for the design of work organization were mainly documented in action plans.

Conclusion

Cooperation with practitioners in research should be continued as a contribution to quality development. This could provide suggestions as to which content adjustments lead to greater acceptance by the target group in a specific context.

Trial registration

The project was registered in the German Clinical Trial Register (DRKS00024961, 2021/04/09).
Modeling of the native knee with kinematic data derived from experiments using the VIVO™ joint simulator: a feasibility study
Authors: Henke Paul , Meier Johanna , Ruehrmund Leo , Brendle Saskia A. , Krueger Sven , Grupp Thomas M. , Lutter Christoph , Woernle Christoph , Bader Rainer , Kebbach Maeruan
Published: August 2024

Background

Despite advances in total knee arthroplasty, many patients are still unsatisfied with the functional outcome. Multibody simulations enable a more efficient exploration of independent variables compared to experimental studies. However, to what extent numerical models can fully reproduce knee joint kinematics is still unclear. Hence, models must be validated with different test scenarios before being applied to biomechanical questions.

Methods

In our feasibility study, we analyzed a human knee specimen on a six degree of freedom joint simulator, applying a passive flexion and different laxity tests with sequential states of ligament resection while recording the joint kinematics. Simultaneously, we generated a subject-specific multibody model of the native tibiofemoral joint considering ligaments and contact between articulating cartilage surfaces.

Results

Our experimental data on the sequential states of ligament resection aligned well with the literature. The model-based knee joint kinematics during passive flexion showed good agreement with the experiment, with root-mean-square errors of less than 1.61 mm for translations and 2.1° for knee joint rotations. During laxity tests, the experiment measured up to 8 mm of anteroposterior laxity, while the numerical model allowed less than 3 mm.

Conclusion

Although the multibody model showed good agreement to the experimental kinematics during passive flexion, the validation showed that ligament parameters used in this feasibility study are too stiff to replicate experimental laxity tests correctly. Hence, more precise subject-specific ligament parameters have to be identified in the future through model optimization.
Hydrogel-coated and active clearance chest drains in cardiac surgery: real-world results of a single-center study
Authors: Jenkins Freya Sophie , Morjan Mohammed , Minol Jan-Philipp , Farkhondeh Nora , Dalyanoglu Ismail , Yilmaz Esma , Immohr Moritz Benjamin , Korbmacher Bernhard , Boeken Udo , Lichtenberg Artur , Dalyanoglu Hannan
Published: August 2024

Purpose

Cardiac surgery patients require chest drains for postoperative fluid drainage. Innovations in this field include chemical drain coating and manual clot extraction systems, aiming to provide reduced clotting and improved patient comfort. This study compares outcomes using hydrogel-coated, active clearance and conventional chest drains.

Methods

Patients with cardiac surgery at our institution from January 2023 to September 2023 were included. Drain allocation was based on surgeon’s choice, with either a combination of hydrogel-coated and conventional, active clearance and conventional, or conventional drains alone. Drain data and clinical outcomes were recorded prospectively.

Results

One hundred seventy-eight patients (62.9 ± 11.7 years, 67.4% male) received a total of 512 chest drains intraoperatively. Hydrogel-coated and active clearance drains showed higher drainage volumes than conventional drains (p < 0.001, respectively). Patency was lowest in conventional drains (36.7% vs. 98.8% for hydrogel-coated, p < 0.001, and vs. 96.6% for active clearance drains, p < 0.001). Conventional drains showed 5.9 times the odds (95% CI 2.0–25.2) of large pleural effusions compared to hydrogel-coated and 12.0 times the odds (95% CI 1.9–504.1) compared to active clearance drains. Patients with hydrogel-coated drains had the shortest length of stay (p < 0.001).

Conclusion

Hydrogel-coated and active clearance drains show improved outcomes compared to conventional drains in cardiac surgery.
Exploring the relationship between media use and depressive symptoms among gender diverse youth: findings of the Mental Health Days Study
Authors: Klinger Diana , Plener Paul L. , Marboe Golli , Karwautz Andreas , Kothgassner Oswald D. , Dienlin Tobias
Published: August 2024

Background

Over the past decades, media use has become a key aspect of young people’s daily lives, significantly shaping their social interactions, learning processes, and recreational pursuits. At the same time, healthcare professionals and researchers are increasingly concerned about the impact of media use on young people’s mental health. This concern is particularly relevant for gender diverse youth who may have distinct experiences with media that could impact their mental health uniquely compared to their peers, such as increased exposure to cyberbullying and negative content regarding their gender identity. This study aims to explore the associations between media use and depressive symptoms among youth and examine if gender moderates this association.

Methods

This study utilized a cross-sectional design involving a school-based sample of 8158 participants (Mage = 14.05 years, SD = 2.45, Ndiverse = 144) from Austria. Participants completed a survey assessing their media use and depressive symptoms using the Patient Health Questionnaire-9 (PHQ-9). Media use was measured by asking participants to report their daily usage in hours and minutes across various categories, including smartphone use, streaming services, social networks, and other media types. Multiple regression analyses were conducted to examine relationships between different forms of media use and depressive symptoms. Moderation analyses were performed using the PROCESS macro for SPSS to explore the role of gender.

Results

For gender diverse youth, multiple regression analysis identified streaming services (β = 0.265, p = .005) and social networks (β = 0.189, p = .037) as significant predictors of depressive symptoms in gender diverse youth. Moderation analyses conducted with the entire sample showed that gender moderates the relationship between depressive symptoms and smartphone use (B = - 0.008, p = .014), with the effect being the most negative for gender diverse individuals.

Conclusion

The findings underscore the complex relationship between media use and depressive symptoms among gender diverse youth, emphasizing the moderating role of gender. These results underline the need for gender-sensitive approaches in media literacy and mental health interventions. Stakeholders should be aware of risks and benefits of different media types to foster healthy media engagement.
Possible link between familial susceptibility to cancer and the level of oxidative stress in thyroid cancer patients
Authors: Javakhishvili Ivane , Mardaleishvili Kote , Buleishvili Maka , Mantskava Maia , Chkhikvishvili Irakli , Kalmakhelidze Sophio , Kipiani Nina , Sanikidze Tamar
Published: August 2024

Background

Hereditary cancer is estimated to account for up to 10% of the worldwide cancer burden; 5% of all thyroid cancers are thought to be genetic. Inheritance of a deleterious mutation in genes associated with a high lifetime risk of developing cancer. Cancer-predisposing genes can promote the initiation and progression of thyroid cancer by enhancing the activation of major signaling pathways through oxidative stress mechanisms.

Aim

Identification of the possible link between familial susceptibility to cancer and the level of oxidative stress in thyroid cancer patients.

Methods

Patients with thyroid cancer (with and without genetic predisposition) were investigated. Study participants were treated in Limited Liability Company (LLC) “Oncology Scientific Research Center” (Tbilisi, Georgia). The study group was collected between 2020 and 2021. In patients’ blood, the thyroid hormones content (free Triiodothyronine (fFT3), free Thyroxine (fFT4), bound Triiodothyronine (FT3), bound Thyroxine (FT4), Thyroid-stimulating hormone (TSH)), and oxidative stress intensity (total activity of non-enzymatic antioxidant system (TAA) and the lipid peroxidation product, malondialdehyde (MDA), content) were investigated.

Results

The difference in free and bound forms of T3 and T4 levels in the blood serum between patients with thyroid cancer (Group 2 and Group 3) and the control group (Group 1) was not statistically significant (F1,2=0.5, p1,2=0.8, F1,3=2.31, p1,3=0.16). In patients with thyroid cancer the TSH level significantly increased compared to the control group (Group 1) (TSH (mean ± Std error): Group 1– 1.21 ± 0.12, Group 2–2.45 ± 0.11 (F1,2=107, p1,2<0.001), Group 3–2.47 ± 0.17 (F1,3=150, p1,3<0.001)) and the MDA levels increased by 4–5 fold. In patients with thyroid cancer from families with cancer aggregation(Group 2), the level of TAA statistically significantly decreased (F1 − 2=200; p1 − 2<0.001), in patients without genetic predisposition to cancer(Group 3), the level of TAA did not change compared to the control (F1 − 3= 2.13; p1 − 3=0.15),

Conclusions

Oxidative stress plays a critical role in tumorigenesis, and antioxidant/oxidant imbalance may contribute to the malignant transformation of normal tissue. In patients with familial susceptibility to cancer mutations of several genes, which are involved in the regulation of oxidative metabolism, may contribute to the disruption of the redox balance, increase the level of oxidative stress, and contribute to the development of thyroid cancer.
Association of anti-Ro-52 antibodies with occurrence of interstitial lung disease in patients with idiopathic inflammatory myopathy
Authors: Weng Chia-Tse , Huang Tang-Hsiu , Wu Chun-Hsin , Sun Yuan-Ting
Published: August 2024

Background

Anti-Ro-52 antibodies have been associated with interstitial lung disease (ILD) in various autoimmune diseases. However, their role in ILD among patients with idiopathic inflammatory myopathies (IIMs) is relatively underexplored. This study aimed to investigate the association between anti-Ro-52 antibodies and the occurrence of ILD in individuals with IIMs.

Methods

This retrospective observational study included 604 patients who underwent myositis autoantibody testing between July 2018 and January 2021 at our hospital and were diagnosed with either IIMs or IIM-mimics. Comparative analyses were conducted between IIMs and IIM-mimics, as well as within the IIM group between cases with and without ILD. Logistic regression or Firth’s logistic regression analyses were employed to assess the risk of ILD development in different IIM subgroups and myositis antibody categories.

Results

This study included 190 patients with IIM and 414 patients with IIM-mimics. Patients with IIM demonstrated higher incidence of ILD, concurrent autoimmune disease, and a greater likelihood of various myositis autoantibodies when compared to the IIM-mimics group. Within the IIM patient cohort, those with ILD exhibited a later age of onset of IIM, an increased mortality rate, and a more frequent presence of anti-aminoacyl-tRNA synthetase (ARS) antibodies compared to those without ILD. The presence of any myositis-specific antibody (MSA) was associated with a six-fold increased risk of ILD, while dual positivity for MSA and anti-Ro-52 antibodies conferred a twenty-fold risk. Anti-ARS antibodies carried a 14-fold increased risk of ILD, which escalated to 38-fold in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies. Anti-Ro-52 antibodies alone increased the risk eight-fold.

Conclusions

Among patients with IIM, the presence of ILD was linked to higher mortality. Certain autoantibodies, notably anti-ARS and anti-Ro-52 antibodies, were associated with an increased risk of ILD. The greatest risk of ILD was observed in cases of dual positivity for anti-ARS and anti-Ro-52 antibodies.
Structural visualization analysis applied to the preservation of architectural heritage: the case of stilted houses in southwest Hubei, China
Authors: Qian Cheng , Wang Tong , Yu Sihan
Published: August 2024

Wooden buildings represent a unique aspect of China’s architectural heritage. However, over time, these buildings have suffered varying degrees of structural damage, particularly those located in China’s mountainous regions. Frequent natural disasters and inconvenient transportation further exacerbate the vulnerability of these structures. This study focuses on the typical wooden stilt houses found in the Wuling Mountain area of southwest Hubei. The different forms of columns and beams, as well as the overall structural symmetry of the stilt houses, were classified into five common structural types. Precise digital models were established via real photos and collected dimensional data, and these five models were evaluated for static, buckling, utilization, and ultimate limit states. The results indicate that: (1) overall symmetrical structures perform better than asymmetrical ones; (2) structures where all columns are grounded and act as support columns exhibit the best overall mechanical performance; and (3) transverse-tie beams(chuanfang) primarily serve a connecting role rather than a load-bearing role, thus an excess of transverse-tie beams(chuanfang) can reduce the stability of the building structure. Based on the analysis results, targeted protective measures and recommendations were proposed and verified through structural evaluations. These initiatives provide new methods and insights for the protection of architectural heritage.
Optical coherence tomography angiography based prognostic factors and visual outcomes in primary rhegmatogenous retinal detachment after pars plana vitrectomy
Authors: Torres-Costa Sónia , Ribeiro Margarida , Tavares-Correia João , Godinho Gonçalo , Alves-Faria Pedro , Falcão Manuel , Sousa Amândio Rocha
Published: August 2024

Purpose

To evaluate the visual outcomes and changes in the retinal microcirculation in patients with primary rhegmatogenous retinal detachment (RRD) following successful pars plana vitrectomy (PPV).

Methods

Nine macula-on RRD and 23 macula-off RRD eyes were retrospectively evaluated. Clinical data was collected at admission and 3 months after PPV. Optical coherence tomography angiography (OCTA) was performed 3 months after PPV. Superficial vascular plexus data obtained with OCTA was compared between affected and fellow eyes and according to macular involvement. Quantitative measurements of the superficial retinal capillary associated with the preoperative and intraoperative factors were analyzed.

Results

Overall RRD inner vessel densities (IVD), full vessel densities (FVD), inner perfusion densities (IPD) and full perfusion densities (FPD) were significantly and positively correlated with best corrected visual acuity (BCVA)(p = 0.002, p = 0.006, p = 0.009, p = 0.023, respectively). In the macula-off RRD, IVD and FVD were significantly decreased compared with macula-on RRD (p = 0.014 and p = 0.034, respectively) and significantly correlated with a longer duration and larger extension of detachment. Higher differences of IVD and FVD between the fellow and affected eyes were significantly correlated with worse BCVA in the macula-off subgroup.

Conclusion

Macula-off RRD presented worse OCTA superficial vascular parameters compared with the macula-on group and fellow eyes, which were correlated with a poorer visual outcome and exacerbated by a longer duration and larger extension of the detachment. Macula-off RRD causes not only retinal structural damage but also a reduction in retinal perfusion despite successful anatomical repair.
Kinetic Profiling of RAS Mutations With Circulating Tumor DNA in the Canadian Cancer Trials Group CO.26 Trial Suggests the Loss of RAS Mutations in Neo-RAS-Wildtype Metastatic Colorectal Cancer Is Transient
Authors: Wu Florence T.H. , Topham James T. , O'Callaghan Chris J. , Feilotter Harriet , Kennecke Hagen F. , Drusbosky Leylah , Renouf Daniel J. , Jonker Derek J. , Tu Dongsheng , Chen Eric X. , Loree Jonathan M.
Published: August 2024

PURPOSE

In metastatic colorectal cancer (mCRC), RAS mutations drive resistance to anti–epidermal growth factor receptor antibodies. It is unclear whether RAS mutations ever become clonally undetectable.

METHODS

CO.26 was a phase II clinical trial that assessed durvalumab + tremelimumab in heavily pretreated mCRC. RAS mutation status was tracked over time using circulating tumor DNA (ctDNA) sequencing at baseline, week 8, and on progression.

RESULTS

Among the 95 patients with KRAS/NRAS mutations in their archival tumor tissue, 6.3% (6/95) had undetectable RAS mutations in ctDNA collected at baseline or week 8 of the CO.26 study. Of these, 67% (4/6) of disappearances were transient, with the same mutation reappearing with progressive disease. In three cases, the simultaneous persistence of other preexisting CRC-associated truncal mutations could not be demonstrated, suggestive of low tumor shedding of ctDNA, leaving the incidence of true clonal reversion to RAS-wildtype (WT) possibly as low as 3.2% (3/95). Fewer patients in the neo- RAS-WT group (33%) had greater than four lesions at trial baseline compared with patients with persistent RAS mutations (75%), P = .046. The likelihood of synchronous metastases at cancer diagnosis (33% v 63%; P = .15) or liver metastases at trial baseline (50% v 68.5%; P = .17) was not significantly different between patients with disappearing versus persistent RAS mutations. Overall survival from stage IV diagnosis (hazard ratio, 0.77 [95% CI, 0.35 to 1.72]; P = .52) was not significantly different between those with disappearing versus persistent RAS mutations. The disappearance of RAS mutations was not associated with primary tumor sidedness ( P = .41), archival BRAF/MEK/ERK-mutant status ( P = .16/1.00/.09), nor baseline ctDNA HER2 amplifications ( P = 1.00).

CONCLUSION

We identified a 3.2%-6.3% prevalence of the neo- RAS-WT phenomenon in the CO.26 trial. However, 67% of apparent cases were transient with subsequent re-emergence.
Opioid Dose Variation in Cardiac Surgery: A Multicenter Study of Practice
Authors: Fisher Clark , Janda Allison M. , Zhao Xiwen , Deng Yanhong , Bardia Amit , Yanez N. David , Burns Michael L. , Aziz Michael F. , Treggiari Miriam , Mathis Michael R. , Lin Hung-Mo , Schonberger Robert B.
Published: August 2024

BACKGROUND:

Although high-opioid anesthesia was long the standard for cardiac surgery, some anesthesiologists now favor multimodal analgesia and low-opioid anesthetic techniques. The typical cardiac surgery opioid dose is unclear, and the degree to which patients, anesthesiologists, and institutions influence this opioid dose is unknown.

METHODS:

We reviewed data from nonemergency adult cardiac surgeries requiring cardiopulmonary bypass performed at 30 academic and community hospitals within the Multicenter Perioperative Outcomes Group registry from 2014 through 2021. Intraoperative opioid administration was measured in fentanyl equivalents. We used hierarchical linear modeling to attribute opioid dose variation to the institution where each surgery took place, the primary attending anesthesiologist, and the specifics of the surgical patient and case.

RESULTS:

Across 30 hospitals, 794 anesthesiologists, and 59,463 cardiac cases, patients received a mean of 1139 (95% confidence interval [CI], 1132–1146) fentanyl mcg equivalents of opioid, and doses varied widely (standard deviation [SD], 872 µg). The most frequently used opioids were fentanyl (86% of cases), sufentanil (16% of cases), hydromorphone (12% of cases), and morphine (3% of cases). 0.6% of cases were opioid-free. 60% of dose variation was explainable by institution and anesthesiologist. The median difference in opioid dose between 2 randomly selected anesthesiologists across all institutions was 600 µg of fentanyl (interquartile range [IQR], 283–1023 µg). An anesthesiologist’s intraoperative opioid dose was strongly correlated with their frequency of using a sufentanil infusion (r = 0.81), but largely uncorrelated with their use of nonopioid analgesic techniques (|r| < 0.3).

CONCLUSIONS:

High-dose opioids predominate in cardiac surgery, with substantial dose variation from case to case. Much of this variation is attributable to practice variability rather than patient or surgical differences. This suggests an opportunity to optimize opioid use in cardiac surgery.
The Sword is Mightier Than the Pen: An Interview with Margaret Atwood
Authors: Wendland Aaron James
Published: August 2024

In this article, Aaron James Wendland asks world-renowned author, Margaret Atwood, about: the power of poetry and literature; the relationship between fiction and political commentary; the social and political impact of her dystopian and anti-authoritarian work; modern utopias and the role of hope in utopian writing; her undergraduate studies in logic and the history of philosophy; and the ancient quarrel between poetry and philosophy.
Utopia, Dystopia, and Democracy: Teaching Philosophy in Wartime Ukraine
Authors: Bila Orysya , Duclos Joshua
Published: August 2024

In this essay we explore a variety of instrumental and intrinsic values associated with teaching philosophy in wartime Ukraine. Duclos, an American, argues that teaching philosophy in Ukraine can cultivate habits of thought and action that promote democratic citizenship while opposing authoritarian dogmatism. Duclos further argues that the intrinsic joy associated with philosophical activity should not be overlooked, even in times of crisis. Conscious of Ukraine’s Soviet past, Bila, a Ukrainian, cautions against using philosophers and philosophy departments as an ideological arm of any political party. She then argues that philosophy has value as a distinct form of thinking with the power to provide consolation. Finally, she identifies philosophical activity as agent of creative change. To teach philosophy in wartime Ukraine is to advance these instrumental and intrinsic values with an eye towards influencing the Ukrainian society that will emerge after the war.
How to measure peripherality at the city scale. A model proposal
Authors: Grosel Mikołaj
Published: August 2024

The phenomenon of peripherality is increasingly applied to urban space. At the same time, there is no scientific consensus on how to analyse and measure peripherality. This article presents a tool for analysing peripherality at the urban scale – the Opportunity Potential Model (OPM) – based on the intervening opportunity mechanism. The article describes how the model works and presents an example of its use: an analysis of the peripherality of the Jagodno neighbourhood in Wrocław (Poland). The model takes into account three dimensions of peripherality (geographical, material and social) to create a comprehensive analysis. The case study shows not only the degree of peripherality of the study area but, above all, the possibilities of the model – its advantages and disadvantages in the process of peripherality analysis and possible further uses.
Benefits of bariatric surgery on glycemic control in patients with type 2 diabetes mellitus. A narrative review.
Authors: Krzemińska Katarzyna , Kubas Maria , Kuszneruk Julia , Kłusek Magdalena , Czerwik Julia
Published: August 2024

Introduction and purposes:
Obesity is a critical global health challenge, closely linked to a range of serious conditions, including metabolic syndrome, insulin resistance, and an increased likelihood of developing type 2 diabetes. Affecting over two billion people worldwide, obesity necessitates a multifaceted approach to treatment, encompassing lifestyle changes, pharmaceutical interventions, and surgical procedures. Among the surgical options, bariatric surgeries such as sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are particularly prominent.
Materials and Methods: A systematic literature search was conducted using PubMed and Google Scholar. The search employed terms such as 'glycemia', 'bariatric surgery', ‘metabolic surgery’ 'RYGB', 'diabetes type 2’, ‘Postprandial hyperinsulinemic hypoglycemia’ 'hypoglycemia' ‘dumping syndrome’.  Articles published between 2019 and 2024 were included in the search.
Results: Bariatric surgery is well-documented for its significant impact on glycemic control and overall physical health, resulting in substantial reductions in both HbA1c levels and BMI. Remarkably, many patients with type 2 diabetes achieve remission of the disease following surgery, regardless of their pre-surgery BMI. However, the enhanced glycemic control achieved through bariatric procedures can also lead to an increased risk of developing postprandial hyperinsulinemic hypoglycemia (PHH). This condition arises as a complication from the surgery, where blood sugar levels drop excessively after meals due to an overproduction of insulin.
Conclusion: Despite this potential risk, the overall benefits of bariatric surgery in managing and potentially reversing type 2 diabetes are profound.
Creatine - the impact of supplementation on the human body
Authors: Wydra-Rojek Aleksandra , Łakoma Aleksandra , Marzec Weronika Zofia , Choiński Maciej , Wasiewicz-Ciach Paulina , Kuczyński Piotr , Marszałek Anna , Marzec Marcelina Teresa , Kutyła Katarzyna , Mokot Wojciech Jan
Published: August 2024

Introduction
Creatine is an endogenously occurring compound in the human body and one of the most extensively studied dietary supplements used worldwide. It is synthesized in the human body, primarily in the kidneys and liver, and is supplied through a diet rich in animal-based foods. Creatine is a nitrogenous compound composed of three amino acids: glycine, arginine, and methionine. It plays a crucial role in the body's metabolism, and therefore, the function of many organs and systems depends on its levels.
Aim of the study
The aim of this study was to discuss the role that creatine plays in the body. A summary of the effects of creatine supplementation in sports and various disease conditions was provided. The study also explored the metabolism of creatine and focused on the best available form of creatine and its dosing regimen.
Materials and methods
The study was based on articles searched in the PubMed database, published between 2006 and 2023. The following keywords were used for the search: "creatine," "creatine supplementation," "creatine monohydrate," "creatine supplement," and "creatine effects."
Conclusion
Creatine is one of the most popular chemical compounds that occur endogenously in the muscle cells of the body. It is a nitrogenous compound primarily produced in the liver, and its levels can be further increased with creatine supplements. The most widely available and well-studied form on the market is creatine monohydrate. Until recently, creatine supplementation was only associated with sports, but it is now used in various disease conditions and supports the function of many organs.
Effects of physical activity on the cardiovascular system
Authors: Gańko Tomasz , Szafrańska Weronika , Kahan Weronika , Poborowska Dominika , Wojaczek Marta , Bąk Emilia , Fordymacki Jacek , Polańska Katarzyna , Najjar Oliwia
Published: August 2024

Introduction:
It has been known for years that physical activity has a significant impact on human health and function. It is also inextricably linked to the cardiovascular system. It induces a number of positive changes in the cardiovascular system, both in the short term and in the long term. However, cardiovascular disease is the leading cause of death in Poland and patients affected by it constitute a very large group. In addition to appropriate pharmacotherapy, appropriately selected training and physical activity, the load and intensity of which will be planned individually for each patient, is also important.
Aim of the study:
The aim was to show how cardiovascular function changes during physical activity and what type of physical activity would be most appropriate in patients with cardiovascular disease.
Materials and methods:
The review is based on an analysis of scientific papers and materials collected from Pumbed, Google Scholar and other scientific articles using the keywords: physical activity, physical exertion, cardiovascular disease, training, cardiovascular primary and secondary prevention
Conclusions:
A number of changes in cardiovascular function occur during physical activity. Changes include: heart rate, blood pressure, stroke volume, cardiac output, arterio-venous difference and blood flow redistribution. By knowing how the above parameters change, we are able to offer patients with cardiovascular disease training at an appropriate frequency, intensity or load. With such tailored training, patients will be able to improve their physical parameters safely and without any concerns.
Comprehensive Review of TORCH Syndrome: Characterization and Prevention Strategies
Authors: Konopka Agata , Szczepaniak Zuzanna , Wdowiak Natalia , Lissak Karina , Komarów Małgorzata , Choinka Martyna , Karasińska Dominika , Kalisiak Jakub
Published: August 2024

Abstract: 
Introduction: TORCH syndrome refers to a group of symptoms caused by congenital infections with teratogenic pathogens, including Toxoplasma gondii, Varicella, Treponema pallidum, Parvovirus B19, Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV). It can also encompass infections like HIV, Zika virus (ZIKV), hepatitis B, and SARS-CoV-2. These pathogens can pass through the placenta, overcoming various placental barriers. Infections during pregnancy can result in severe consequences for both the fetus and the mother. Common symptoms in newborns include low birth weight, rashes, hepatosplenomegaly, cardiac anomalies, jaundice, chorioretinitis, and microcephaly, with 2% to 3% of congenital anomalies attributed to perinatal infections. The incidence of these infections varies globally. 
Purpose of the work: This study aims to review and characterize TORCH syndrome and the prevention of TORCH infections.
Materials and methods:  A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: TORCH syndrome / infections during pregnancy / perinatal infections / Toxoplasmosis / Rubella / CMV infection / Herpes Simplex Virus infection / Parvovirus B19 / Treponema pallidum / vaccinations before and during pregnancy / maternal nutrition. 
Results: TORCH syndrome is a significant issue causing congenital diseases, premature births, and intrauterine deaths, impacting babies throughout their lives. Most complications can be prevented with proper prophylaxis and early treatment. Increasing awareness and providing education for women from preconception through the early postnatal period is essential. Addressing TORCH syndrome remains a major medical challenge, but improving management offers hope for better outcomes.
Pioneering practice
Authors: O’Sullivan June , Baldwin Alex , Wolejko Dorota
Published: August 2024

In part one of this Practice Insight Supplement, CEO of London Early Years Foundation June O’Sullivan, showcases the practice at Colville Nursery. June discusses their work to mitigate the impact of parents being in prison for the Community Corner column. She shares more about how skateboard play has been encorporated for their youngest children in the Play Experience Case Study, with deputy manager Alex Baldwin and nursery teacher Dorota Wolejko.
‘False evidence appearing real’: the evolution of pre-criminal safeguarding for childhood radicalisation in the UK
Authors: Vaughn Leona
Published: August 2024

This article critiques the unique ‘pre-criminal safeguarding’ framework introduced for children by PREVENT – the UK’s counter-terrorism policy and legislation – as one that is anti-child protection. Reviewing the ‘evidence’ within the original turn in policy to address ‘childhood radicalisation’, it proposes that this ‘pre-crime’ focus on identifying children suspected of being at risk of causing future harm through terrorist activity, has implicitly aged, classed, gendered and racialised underpinnings. Utilising research from the time of the PREVENT duty enactment, practitioner insights of the duty’s impact on supporting children and their families in the Liverpool city region are revelatory for understanding how PREVENT’s implicitly biased foundations were reinforced and given life through praxis. ‘False evidence appearing real’ describes not only this problematic suspicion-based praxis but also the practices generating the ‘official statistics’ to this day being presented as ‘evidence’ of the need to implement the PREVENT duty for children.
Dual channel D-shaped SPR sensor for efficient detection of change in refractive index of analytes
Authors: Nahid Elora , Kaysir Md Rejvi , Islam Md Jahirul , Hossain Sheikh Shahriar , Rahman Mohammad Shaifur
Published: August 2024

Over the past ten years, significant advancements have been made in the field of D-shaped Surface Plasmon Resonance (SPR)-based optical fiber refractive index (RI) sensors which can be effectively used in chemical, biological, and health monitoring applications. Among single and dual/multi-channel SPR sensors, single-channel SPR sensors require analyte filling, emptying, and cleaning stages which is time-consuming and expensive. This work focuses on the design and performance investigation of a dual-channel D-shaped SPR sensor that can be used for the efficient detection of changes in the RI of analytes between two channels. The finite element method is used for the performance evaluation of the designed sensor, where the RI of the analyte of one channel is kept constant and that of the other channel is varied to observe the effect of change in RI difference from the known value. The proposed sensor can effectively detect the RI of analytes in the range of 1.33–1.40. The maximum wavelength and amplitude sensitivities are found to be 46000 nm/RIU and 6.96 RIU-1, respectively. In addition, it exhibits comparable wavelength and amplitude resolutions of 1.30 × 10­−05 RIU and 1.75 × 10−08 RIU, respectively with asymmetrical RIs in two channels. Besides, the single-channel D-shaped SPR sensor having the same design parameters as the dual channel shows the maximum wavelength and amplitude sensitivities of 44000 nm/RIU and -59.22 RIU-1, with wavelength and amplitude resolutions of 2.27 × 10−6 RIU and 1.01 × 10−09 RIU, respectively. Thus, the designed dual-channel D-shaped SPR sensor has the provision for determining the RI differences of analytes, which could be used to check the consistency of RI among different batches of analytes for the same biological sample.
High-quality Phase-only Fourier Hologram Generation with Camera-in-the-loop
Authors: Yeom Han-Ju , Hong Keehoon , Park Minsik
Published: August 2024

In this paper, we propose an optimization method for Fourier holograms that enables high-quality optical reconstruction of phase-only Fourier holograms. We define the amplitude of the input image for Fourier hologram calculation as an optimization plane within a camera-in-the-loop (CITL) framework to generate computer-generated holograms (CGHs) with superior optical reconstruction quality. Unlike traditional CITL methods that optimize phase holograms, our proposed method optimizes input amplitudes that exhibit a high correlation with the original input images in the Fourier hologram. Leveraging this correlation, we introduce a neural network model, PFHNet, to infer the optimized input amplitudes from the original images, thereby addressing the time-consuming nature of the traditional CITL algorithm, which is hindered by repetitive calculations. During the training process, PFHNet employs our proposed CITL to account for non-ideal forward propagation, i.e., optical propagation. Optical experiments demonstrate that both our proposed CITL method and PFHNet effectively reduce noise in the Fourier optical path.
Beyond diagnostic connectivity: Leveraging digital health technology for the real-time collection and provision of high-quality actionable data on infectious diseases in Uganda
Authors: Mujuni Dennis , Tumwine Julius , Musisi Kenneth , Otim Edward , Farhat Maha Reda , Nabulobi Dorothy , Abdunoor Nyombi , Tumuhairwe Arnold Kennedy , Mugisa Marvin Derrick , Oola Denis , Semitala Fred , Byaruhanga Raymond , Turyahabwe Stavia , Joloba Moses
Published: August 2024

Automated data transmission from diagnostic instrument networks to a central database at the Ministries of Health has the potential of providing real-time quality data not only on diagnostic instrument performance, but also continuous disease surveillance and patient care. We aimed at sharing how a locally developed novel diagnostic connectivity solution channels actionable data from diagnostic instruments to the national dashboards for disease control in Uganda between May 2022 and May 2023. The diagnostic connectivity solution was successfully configured on a selected network of multiplexing diagnostic instruments at 260 sites in Uganda, providing a layered access of data. Of these, 909,674 test results were automatically collected from 269 “GeneXpert” machines, 5597 test results from 28 “Truenat” and >12,000 were from 3 digital x-ray devices to different stakeholder levels to ensure optimal use of data for their intended purpose. The government and relevant stakeholders are empowered with usable and actionable data from the diagnostic instruments. The successful implementation of the diagnostic connectivity solution depended on some key operational strategies namely; sustained internet connectivity and short message services, stakeholder engagement, a strong in-country laboratory coordination network, human resource capacity building, establishing a network for the diagnostic instruments, and integration with existing health data collection tools. Poor bandwidth at some locations was a major hindrance for the successful implementation of the connectivity solution. Maintaining stakeholder engagement at the clinical level is key for sustaining diagnostic data connectivity. The locally developed diagnostic connectivity solution as a digital health technology offers the chance to collect high-quality data on a number of parameters for disease control, including error analysis, thereby strengthening the quality of data from the networked diagnostic sites to relevant stakeholders.
Antimicrobial use in laboratory rodent facilities in Australia and New Zealand- a cross-sectional survey of veterinarians and facility managers
Authors: Wilcox Rebbecca S. , Marenda Marc S. , Devlin Joanne M. , Wilks Colin R.
Published: August 2024

This cross-sectional study surveyed veterinarians and facility managers to characterise the use of antimicrobials in laboratory rodent facilities within Australia and New Zealand. Most facilities (71%) reported routine administration of antimicrobials. The indications for antibiotic use reflected those described in publications and differed significantly to reasons for use in non-laboratory animals. Antimicrobials used include those of critical importance to human health, and access to these drugs is unregulated, as prescription-only classes are ordered through research catalogues, without human or veterinary physician prescriptions. The ways in which antimicrobials are used in Australian and New Zealand rodent facilities are likely contributing to antimicrobial resistance within rodent populations, particularly as they are largely administered in drinking water, risking subtherapeutic dosing. Much antimicrobial use reported is unnecessary and could be replaced with changes to husbandry and handling. The generation of resistance in both pathogenic and commensal microbes may also represent a work health and safety issue for humans working with these animals. Reported disposal of antimicrobials included discharge into wastewater, without inactivation, and some respondents reported disposal of substrate, or soiled bedding, nesting material, and disposable enrichment items, from treated animals and medicated feed into landfill, without prior inactivation. Environmental contamination with resistant microbes and antimicrobials is a significant driver of antimicrobial resistance. As such, significant opportunities exist to implement judicious and responsible use of antimicrobials within research rodent facilities in Australia and New Zealand, with a particular focus on instituting aseptic surgery, optimising dosing regimens, and inactivation of medicated water and substrate before disposal.
A protocol for a cluster randomized controlled trial to assess the impact of Balika Bodhu: A combined empowerment and social norm based sexual and reproductive health and rights intervention for married adolescent girls in rural Bangladesh
Authors: Mamun Mahfuz Al , Mahmud Sultan , Antu Jannatul Ferdous , Talukder Aloka , Naved Ruchira Tabassum
Published: August 2024

Introduction

Sexual and reproductive health and rights (SRHR) are vital for both individual well-being and development. Bangladesh has made long strides in improving SRHR over the last few decades. However, the progress has been uneven across various groups of reproductive-aged females, with the married adolescent girls (MAGs) often being more vulnerable to denial of SRHR than other women. This study intends to develop Balika Bodhu, a combined empowerment and social norm intervention for promoting SRHR among the MAGs and assess its impact.

Methods

The evaluation will employ a mixed-method two-arm Cluster Randomized Controlled Trial (CRCT) design, where Arm 1 receives the intervention, and Arm 2 serves as the control. The trial will cover 32 clusters (villages) in Rajbari Sadar sub-district, randomized into two equally distributed study arms. A total of 1,120 MAGs aged 15–19 years will be randomly selected from the clusters (35 per cluster) to form a cohort. The MAGs, their husbands, selected elderly women (26 per village) and influential community members (26 per village) will receive group sessions in the intervention clusters. The MAGs and their husbands will be interviewed at baseline and endline. A randomly selected cross-sectional sample of community members aged 35–59 years at baseline and endline will also be surveyed to measure attitudes and social norm regarding SRHR of MAGs. Qualitative data will be collected using 32 In-depth Interviews, six Key Informant Interviews, and eight Focus Group Discussions from two intervention villages. Intention-to-treat (ITT) analysis will be performed to assess the impact of the intervention. Narrative analysis and the Grounded Theory approach will be used to analyze the qualitative data.

Conclusion

Rigorous evaluation of Balika Bodhu should contribute to the literature on what works and what does not in addressing denial of SRHR to MAGs using empowerment and social norm intervention and inform policies and programs.

Trial registration

Clinicaltrials.gov: identifier: NCT06126770; Date: Oct 7, 2023. Version 1.