bluuebunny/crossref_metadata_2025 huggingface dataset:
Reimagining Mission in and from Africa: A contextual analysis of OM Mission Approach in Southern Africa
Authors: White Peter , September Tresenia
Published: October 2024

The activities of mainline Western missionaries in Africa have been discussed by scholars from various perspectives, but much attention has not been given to mission organizations that are not affiliated with any denomination. This article therefore focuses on the work and mission approach of Operation Mobilisation (OM) in Africa. The article is based on empirical data gathered through interviews with twelve OM country leaders in Southern Africa (Angola, Lesotho, Malawi, Mozambique, South Africa, Tanzania, Zambia, and Zimbabwe). The key aim of the interviews was to establish from the OM leaders serving in the Southern African countries their self-understanding of the local context and the contextual implications for OM's work in and from the continent. It was to also establish some opportunities and challenges for missions for the African church and Western Established Mission Organizations WEMOs. The article argues for contextual consideration of OM’s mission agenda, missionary training, and discipleship approach in Africa.
Role of baseline soluble tumor necrosis factor receptor 2 as a biomarker in primary podocytopathy: Implications for renal impairment and disease progression
Authors: Nagaram Srinivas , Charles Priscilla , Nisha Yadav , Stephen Norton , Hanumanthappa Nandeesha , Parameswaran Sreejith , Chinnakali Palanivel , Nachiappa Ganesh Rajesh
Published: October 2024

Background

Podocytopathies, including minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and collapsing glomerulopathy (CG), are kidney diseases that damage glomerular podocytes, leading to heavy proteinuria and nephrotic syndrome (NS). Inflammation plays a critical role in the progression of chronic kidney disease (CKD), with recent studies linking inflammatory biomarkers to declining kidney function. Tumor necrosis factor-alpha (TNF-α), an essential inflammatory cytokine, interacts with its circulating receptors, TNFR1 and TNFR2. The TNF-α pathway has been implicated in the pathogenesis of FSGS and MCD. Increased circulating TNFR2 levels have been associated with worsening renal function in podocytopathies, suggesting that the TNF-α inflammatory pathway significantly contributes to disease progression.

Methods

We conducted a study involving 53 patients with biopsy-proven MCD or FSGS and 53 healthy, age- and gender-matched controls. All patients were followed for 18 months. We analyzed serum and urine TNFR2 levels and gene expression at baseline and after three months. To assess the ability of TNFR2 to predict persistent decline in estimated glomerular filtration rate (eGFR < 30 mL/min/1.73m2), remission, and relapse, we employed Cox regression analysis. Additionally, we evaluated its prognostic utility for predicting progression to stage 4 CKD using ROC curve analysis.

Results

Serum and urine TNFR2 levels were significantly elevated in patients compared to controls. Serum TNFR2 was a significant predictor in univariate Cox regression analysis for persistent eGFR decline (HR 1.017, 95% CI: 1.003 to 1.032, p = 0.018), remission (HR 0.995, 95% CI: 0.992 to 0.999, p = 0.006), and relapse (HR 1.005, 95% CI: 1.001 to 1.010, p = 0.029). The ROC curve analysis demonstrated that serum TNFR2 levels had a strong prognostic ability for predicting progression to stage 4 CKD, with an AUC of 0.848 (95% CI: 0.737—0.960), sensitivity of 81%, and specificity of 71%.

Conclusion

This study underscores the critical role of circulating TNFR2 in kidney injury among patients with primary podocytopathy. Elevated TNFR2 levels are significant predictors of persistent eGFR decline and disease relapse, highlighting their potential as biomarkers for disease progression and prognosis.
Self-stigma in alcohol dependence scale: development and validity of the short form
Authors: Rieckhof Sophia , Leonhard Anya , Schindler Stephanie , Lüders Juliane , Tschentscher Nicole , Speerforck Sven , Corrigan Patrick W. , Schomerus Georg
Published: October 2024

Background

Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma.

Methods

We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings.

Results

The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models.

Discussion

The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD.
Influence of inpatient withdrawal treatment on drug safety in alcohol use disorder — a quasi-experimental pre-post study
Authors: Schröder Sebastian , Schulze Westhoff Martin , Bleich Stefan , Bode Henry , Jendretzky Konstantin Fritz , Krichevsky Benjamin , Glahn Alexander , Heck Johannes
Published: October 2024

Objective

Most patients with alcohol use disorder (AUD) regularly take medication. Alcohol interacts negatively with many commonly prescribed medications. Little is known about whether the risk of potential alcohol-medication and drug-drug interactions increases or decreases in patients with AUD during inpatient withdrawal treatment. The aim of our study was to determine the prevalence and characteristics of potential alcohol-medication and drug-drug interactions in patients with AUD before and after withdrawal treatment in an addiction unit.

Design

Prospective monocentric quasi-experimental pre-post study.

Methods

Medication records before and after withdrawal treatment were analyzed and screened for potential alcohol-medication (pAMI) and drug-drug interactions (pDDI) using the drugs.com classification and the AiDKlinik® electronic interaction program, respectively.

Results

We enrolled 153 patients with AUD who were treated in an addiction unit of a university hospital in Germany. Of these, 67.3% experienced at least one pAMI before and 91.5% after withdrawal treatment. In total, there were 278 pAMIs classified as “mild,” “moderate,” or “severe” before and 370 pAMIs after withdrawal treatment. Additionally, there were 76 pDDIs classified as “moderate,” “severe,” or “contraindicated combinations” both before and after withdrawal treatment.

Conclusion

The risk of exposure to pAMIs and pDDIs increases during inpatient withdrawal treatment in patients with AUD. Improvements in the quality of prescribing should particularly focus on the use of antihypertensives and opioids.
Learning how to explore spiritual aspects in encounters with patients with chronic pain: a pre-test post-test trial on the effectiveness of a web-based learning intervention
Authors: Schmitz Felix Michael , Buzzi Ann-Lea , Brem Beate Gabriele , Schnabel Kai Philipp , Berger-Estilita Joana , Roten Fredy-Michel , Peng-Keller Simon , Guttormsen Sissel
Published: October 2024

Background

Integrating spiritual aspects into treatment plans can release essential resources for coping with chronic pain. However, some spiritual aspects may also induce distress and hinder the coping process. There is a lack of evidence regarding how to perform the clinical tasks of exploring spiritual aspects and of instruments assessing related competencies. Therefore, we developed a web-based learning module to provide education on the subject alongside corresponding assessment instruments. The module presents the InSpiRe (Integration of Spirituality and/or Religion in patient encounters) protocol. The instruments encompass cognitive, affective, and behavioral dimensions.

Methods

This paper aims to determine (i) the learning effects associated with completing the web-based spiritual-care learning module and (ii) the reliability and validity of the instruments employed. To address these aims, we conducted a pre-test/post-test trial with N = 32 randomly selected fourth-year medical students. During the pre-test, we assessed the students’ knowledge, attitudes, and self-efficacy regarding exploring spiritual aspects. For this purpose, we developed a short-answer knowledge test, an attitude questionnaire, and a self-efficacy scale. Additionally, the students explored spiritual aspects with a simulated patient portraying a person with chronic pain. Three trained raters evaluated the students’ performances using a self-developed scale. In the intervention phase, the students completed the 45-minute learning module on a personal computer. The module presented InSpiRe-related content as text and step-by-step video demonstrations, including hints that denote critical actions. The subsequent post-test was identical to the pre-test.

Results

The internal consistency was suitable for all respective instruments, and there was an indication of solid validity of the performance test. After completing the spiritual care learning module, the students showed statistically significant increases in knowledge scores and significant positive shifts in their attitudes and levels of self-efficacy regarding exploring spiritual aspects. They also attained significantly higher performance scores in the same regard.

Conclusions

Completing the spiritual-care module is associated with meaningful learning effects on cognitive, affective, and behavioral dimensions related to exploring spiritual aspects, as demonstrated in the post-test conducted shortly after the intervention. Due to good reliability and validity scores, the self-developed instruments can be applied appropriately.
Self-assessed levels of preparedness, engagement willingness and teaching preferences on antibiotic use of medical and pharmacy students in Romanian universities: a cross-sectional study
Authors: Ghiga Ioana , Pitchforth Emma , Popescu Gabriel Adrian , Fulop Ibolya , Lundborg Cecilia Stålsby , Machowska Anna
Published: October 2024

Background

To effectively support health professionals in optimizing antibiotic prescribing and dispensing, policymakers need to understand how these professionals are trained, feel prepared and want to be educated. The study aimed to assess the current situation and explore potential improvements in antibiotic use among future health professionals in Romania by: (i) evaluating their self-assessed preparedness on antibiotic-related topics, (ii) understanding their perceptions of their role in antibiotic stewardship, and (iii) gathering their recommendations for optimizing antibiotic use.

Methods

A survey of students’ self-assessment of technical preparedness, engagement willingness, expectations, teaching preferences, training received and evolution of situation in Romania. Overall, 41 and 38 questions were asked to medical and pharmacy students respectively. Scores were calculated for preparedness, engagement willingness and teaching preferences to enable various comparisons. Exploratory factor analysis was used to explore the questionnaire construct.

Results

A total of 479 participants completed the survey- 233 medical students from 7 universities and 246 pharmacy students from 4 universities. Median overall preparedness score indicated that most students felt prepared in at least 14 questions (out of 22 for medical students, and 19 for pharmacy students). Engagement scores for medical and pharmacy students were similar (2 and 3 out of 4). Overall, more than half reported that ‘yes, very likely’ they received adequate training to ensure the appropriate use of antibiotics in their professional areas (n = 254, 53.5%). Medical and pharmacy students with low preparedness scores expressed a need for more education. Most of both medical and pharmacy students considered the antibiotic situation in Romania ‘will get worse’ (n = 159, 33.5%).

Conclusions

The study’s findings have important implications for the education and training of future Romanian health professionals and highlight the need for further research on optimal and standardized tools to allow for periodic monitoring and evaluation of progress into preparedness, engagement willingness and teaching preferences on antibiotic use.
The impact of nurse managers’ boundary spacing leadership on the relationship between nurses’ work embeddedness and innovative work behaviors
Authors: Sorour Marwa Samir , Abdelaliem Sally Mohammed Farghaly , Khattab Sabrein Ali Khalifa
Published: October 2024

Aim

This study was designed to examine the nurse managers’ boundary-spacing leadership’s impact on the relationship between nurses’ work embeddedness and innovative work behaviors.

Background

In today's evolving healthcare environment, innovation is essential for enhancing patient care, optimizing resources, and supporting healthcare professionals. Nurses are pivotal in driving bedside innovation, but cultivating a culture of innovation within nursing teams involves more than just promoting creative ideas.

Methods

This is a descriptive correlational study that was conducted at one governmental hospital in Tanta, Egypt. Using Nurse Managers Boundary-Spacing Scale for assessing boundary-spacing leadership, The Global Job Embeddedness Scale for measuring work embeddedness, and Innovative Work Behavior Scale for assessing innovative work behavior, 250 nurses were surveyed. Data analysis was run using descriptive and inferential analysis. Correlation and regression analysis were used to examine the study hypotheses.

Results

There is a statistically significant positive relationship between boundary-spacing leadership and work embeddedness (r = 0.615, p < 0.001). Boundary-spacing leadership accounted for 56% of the variance in work embeddedness and 36% of the variance in nurses' innovative work performance. These results highlight the pivotal role of boundary-spacing leadership in both enhancing nurses' work embeddedness and boosting their innovative behaviors. The substantial variance explained by boundary-spacing leadership underscores its critical influence on fostering a supportive and innovative work environment within the nursing field.

Conclusion

Boundary spacing leadership style involves connecting internal and external resources, fostering information exchange, and advocating for the nursing team. While work embeddedness positively correlated with innovative work performance, its impact was less significant than boundary-spacing leadership. This suggests that feeling attached to the organization fosters innovation, but leadership style has a stronger influence. Furthermore, the study found a positive and significant correlation between innovative work performance and both work embeddedness and nurse managers' boundary spacing leadership.

Practical Implications

The findings emphasize that boundary-spacing leadership is crucial for enhancing both nurses' work embeddedness and innovative behaviors. Healthcare organizations should focus on developing these leadership skills to create a supportive work environment, foster innovation, and improve staff retention
Nesfatin-1 expression and blood plasma concentration in female dogs suffering from cystic endometrial hyperplasia and pyometra and its possible interaction with phoenixin-14
Authors: Rybska Marta , Skrzypski Marek , Billert Maria , Wojciechowicz Tatiana , Łukomska Anna , Pawlak Piotr , Nowak Tomasz , Pusiak Karolina , Wąsowska Barbara
Published: October 2024

Background

Nesfatin-1 is a neuropeptide that regulates the hypothalamic-pituitary-gonadal axis and may play a role in uterus function. It is co-expressed with other peptides, such as phoenixin, which can influence sex hormone secretion. Our previous research has confirmed that phoenixin-14 is involved in the development of cystic endometrial hyperplasia (CEH) and pyometra in dogs. Therefore, based on the similarities and interactions between these neuropeptides, we hypothesized that nesfatin-1 might also regulate the reproductive system in dogs. This study aimed to determine the expression of nesfatin-1 and its interaction with phoenixin-14 in dogs with CEH or pyometra compared to healthy females, and concerning animals’ body condition score (BCS 4–5/9 vs. BCS > 5/9).

Results

The analysis of nesfatin-1 in the uterus of bitches consisted of qPCR, western blot and immunofluorescence assays, and ELISAs. The results showed significantly higher nesfatin-1 encoding gene, nucleobindin-2 mRNA (Nucb2) and nesfatin-1 protein expression in overweight females and those suffering from CEH or pyometra compared to healthy animals. The immunoreactivity of nesfatin-1 was elevated in the uteri of bitches with higher BCS > 5/9. Moreover, nesfatin-1 blood concentrations increased in all examined overweight bitches. In the case of phoenixin signals, we found opposite results, regardless of the female body condition score.

Conclusion

The etiology of CEH and pyometra are not fully known, although we have expanded the level of knowledge with respect to the possible interaction of nesfatin-1 and phoenixin in female dogs’ uteri. They interact oppositely. With increasing female body weight, the expression of nesfatin-1 in the uterus and its peripheral blood concentration increased. However, for female dogs affected by CEH and pyometra, a decreased level of phoenixin-14, irrespective of their body condition score is characteristic. This knowledge could be crucial in the development of biomarkers for these conditions, which may lead to earlier recognition.
The effect of prebiotic fibre on the gut microbiome and surgical outcomes in patients with prosthetic joint infection (PENGUIN) - study protocol for a randomised, double-blind, placebo-controlled trial (ACTRN12623001273673)
Authors: Sharma Deepti K. , Ramadass Balamurugan , Callary Stuart A. , Meade Anthony , Dash Rishikesh , Clothier Robyn , Atkins Gerald J. , Solomon L. Bogdan , Ramasamy Boopalan
Published: October 2024

Background

Prosthetic Joint Infection (PJI) is the most devastating complication of arthroplasty surgery and affects 1–5% of patients. Despite strict adherence to aseptic protocols and preventive measures, infection is the most common reason for revision arthroplasty, and the incidence is increasing. Treatment of PJI is challenging and often requires repeated major surgeries with sequentially poor results. The continued occurrence of PJI, and persistence after treatment, brings into question the current treatment paradigm. Preclinical evidence suggests a link between altered gut health and the risk of PJI in arthroplasty patients. Resistant starches helps to restore gut physiology by enhancing the beneficial microbiome and producing short-chain fatty acids, which have several health-conferring properties. The primary aim of this study is to investigate the effect of a commercially available prebiotic fibre formulation on the gut microbiome in PJI patients planned for a two-stage revision surgery.

Methods

A double-blind placebo-controlled trial will assess the effect of 8-week supplementation of a commercially available prebiotic supplement in patients presenting with first-time PJI undergoing two-stage revision surgery. The supplementation phase will start after the first stage revision, and 80 patients will be randomised to receive either a test product (34 g of resistant starch) or a placebo (custard powder) daily for eight weeks. Stool and blood specimens will be collected at baseline, four weeks and eight weeks after the first-stage surgery and once at second-stage surgery. Gut microbiome profile, inflammatory cytokines and gut permeability biomarkers will be measured. Tissue specimens will be collected intra-operatively during first and second-stage surgeries. Baseline dietary patterns and gut symptoms will be recorded using validated questionnaires. Treatment outcomes will be reported for both cohorts using the Delphi criterion at one and two years after second-stage surgery.

Discussion

This will be the first study to investigate the relationship between gut health optimisation and preventing PJI recurrence in arthroplasty patients. If supplementation with resistant starch improves gut health and reduces systemic inflammation, optimising the gut microbiome will be a recommended preoperative management strategy for arthroplasty patients.

Trial registration no

ACTRN12623001273673.
Clinical characteristics and treatment outcomes of women with recurrent uterine leiomyosarcoma
Authors: Yuan Hua , Wang Yaxi , Li Ning , Wu Lingying , Yao Hongwen
Published: October 2024

Objective

To determine the clinical characteristics and treatment outcomes of women with recurrent uterine leiomyosarcoma (uLMS).

Methods

We conducted a retrospective cohort study to evaluate the clinical characteristics and survival of women with recurrent uLMS and identify prognostic factors.

Results

Overall, 71 patients with first recurrence of uLMS were included in our study. 19 patients (26.8%) received systemic therapy and 52 patients (73.2%) received secondary cytoreductive surgery (SCS). In SCS subgroup (n = 52), a complete resection with no residual disease was performed in 47 patients (90.4%). 38.5% (20/52) patients received non-reproductive organ surgeries. 10 (19.2%) patients had received thoracic surgery because of lung-only recurrence. Bowel, bladder surgery was performed in 8 (15.4%), 3 (5.8%) patients, respectively. 1 (1.9%) patient had received liver surgery. The median follow-up duration was 38.7 months (range: 2.7-317.6 months). 41 (57.7%) patients died during follow-up. 5-year OS for the entire cohort was 52.9%. Patients experienced first recurrence after initial diagnoses within 12 months (n = 24) had a worse 5-year OS than those after 12 months (n = 47) (17.0% vs. 69.1%, P < 0.001). 5-year OS for the SCS and non-SCS subgroup was 62.0% and 28.0%, respectively (P < 0.001). Multivariate analysis showed time to fist recurrence within 12 months (HR = 4.60, 95% CI: 1.49–14.4, P = 0.008) was an independent predictor of decreased 5-year OS in SCS subgroup.

Conclusions

SCS is an important treatment choice for recurrent uLMS and seems to have benefited patients. Time to fist recurrence within 12 months is an independent predictor of decreased 5-year OS in SCS subgroup.
Safety and efficacy of human amniotic membrane plug transplantation in cases of macular hole. A scoping review
Authors: Quiroz-Reyes Miguel A. , Quiroz-Gonzalez Erick A. , Quiroz-Gonzalez Miguel A. , Lima-Gomez Virgilio
Published: October 2024

Background

Recently, there has been a surge of literature utilizing the human amniotic membrane (hAM) to manage cases of macular holes. In this scoping review, we aimed to systematically narrate the literature to identify cases of macular holes that are managed using hAM and explore the visual and anatomical outcomes to inform future research questions.

Methods

This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A detailed database search strategy (Scopus, Embase, Medline, and Cochrane Central) was developed to identify English-language published articles that reported using hAM to manage macular holes. All human clinical studies were included for a narrative data synthesis divided across study types.

Results

The database search identified 82 articles, of which 34 were eligible for full-text review (0 randomized controlled trials (RCTs), 12 non-RCTs, 10 retrospective reviews, ten published case reports, and two clinical trial registries). The non-RCTs included patients with macular holes related to a wide range of retinal diseases, including retinal detachment, recurrent holes, and high myopia. Only two non-RCTs reported comparative data with a control group, but the study characteristics differed, and quantitative synthesis was impossible. Most retrospective interventional series and individual case reports reported a success rate of 93 -100% in hole closure and improvement in best-corrected visual acuity. None of the studies reported adverse effects after a hAM transplantation.

Conclusion

The hAM effectively seals macular holes without any safety concerns, improving anatomical and visual outcomes in all macular holes.
Research on distribution automation security situational awareness technology based on risk transmission path and multi-source information fusion
Authors: Liu Jingzhi , Yang Hongyi , Qu Quanlei , Liu Zhidong , Cao Yang
Published: October 2024

It may be difficult for existing methods to make full use of the correlation and complementarity of various kinds of information when processing multi-source information. In order to accurately perceive the security situation of distribution automation and ensure the safe and stable operation of distribution network, the multi-source information fusion distribution automation security situation awareness technology based on risk transmission path is studied. Based on the risk transmission path, the distribution automation security situational awareness factors are analyzed, and the main factors affecting the distribution automation security situation are divided into two dimensions: internal source and external source, and eight main awareness factors; Different types of sensors are set in the main areas of security situational awareness factors to collect data of different awareness factors. Using ant colony algorithm to optimize DS evidence fusion method, data with different perception factors are fused, and data fusion results with different perception factors are obtained. The distribution automation security situational awareness model is constructed, and the security situational awareness results are obtained based on the data fusion results of the awareness factors. If the results are higher than the set threshold, the abnormal signal can be output to determine the area where the distribution automation abnormal equipment is located. The experimental results show that the multi-source data fusion effect of this method is good, and it can accurately perceive the security status of different nodes of the experimental object at different time nodes.
Weak reflection enhancement and picking from ultrasonic pitch-catch measurements in a cased-hole
Authors: Wang Qiang , Wang Hua , Shi Shaopeng , Fang Zhilong
Published: October 2024

Ultrasonic logging is a widely used technology to assess the cement bond condition in a cased-hole. Advanced ultrasonic pitch-catch measurements can capture reflections at the cement-formation interface (in short, the third interface echo [TIE]), which enables the evaluation of the bond condition, casing eccentering, and the velocity of the material in the cement annulus. However, the usage is limited by the TIE arrival picking due to the low amplitude that results from the eccentered tool and casing, overlapping with the tool-casing multiple reflections, as well as interference from the primary zero-order antisymmetric Lamb wave (A0). We develop a two-step method to enhance and accurately pick the TIE arrivals. We first use mathematical morphological filtering with a neural network framework to mitigate the influence of A0. Then, we use the local window multichannel singular-spectrum analysis to suppress the effect of tool-casing multiples on the TIE. In the second step, we develop a sinusoidal search method with a path postcorrection algorithm to track the TIE arrivals from the enhanced TIE waveforms automatically. Synthetic and field data results show that our TIE processing can effectively eliminate the A0 mode and suppress tool-casing multiples. In addition, the picked TIE arrivals are consistent with actual TIE curves.
Cost–utility analysis of adapted problem adaptation therapy for depression in mild-to-moderate dementia caused by Alzheimer's disease: PATHFINDER randomised controlled trial
Authors: Panca Monica , Howard Robert , Cort Elizabeth , Rawlinson Charlotte , Gould Rebecca L. , Wiegand Martin , Downey Anne Marie , Banerjee Sube , Fox Chris , Harwood Rowan , Livingston Gill , Moniz-Cook Esme , Russell Gregor , Thomas Alan , Wilkinson Philip , Freemantle Nick , Hunter Rachael Maree
Published: October 2024

Background

Depression is common in people with dementia, and negatively affects quality of life.

Aims

This paper aims to evaluate the cost-effectiveness of an intervention for depression in mild and moderate dementia caused by Alzheimer's disease over 12 months (PATHFINDER trial), from both the health and social care and societal perspectives.

Method

A total of 336 participants were randomised to receive the adapted PATH intervention in addition to treatment as usual (TAU) (n = 168) or TAU alone (n = 168). Health and social care resource use were collected with the Client Service Receipt Inventory and health-related quality-of-life data with the EQ-5D-5L instrument at baseline and 3-, 6- and 12-month follow-up points. Principal analysis comprised quality-adjusted life-years (QALYs) calculated from the participant responses to the EQ-5D-5L instrument.

Results

The mean cost of the adapted PATH intervention was estimated at £1141 per PATHFINDER participant. From a health and social care perspective, the mean difference in costs between the adapted PATH and control arm at 12 months was −£74 (95% CI −£1942 to £1793), and from the societal perspective was −£671 (95% CI −£9144 to £7801). The mean difference in QALYs was 0.027 (95% CI −0.004 to 0.059). At £20 000 per QALY gained threshold, there were 74 and 68% probabilities of adapted PATH being cost-effective from the health and social care and societal perspective, respectively.

Conclusions

The addition of the adapted PATH intervention to TAU for people with dementia and depression generated cost savings alongside a higher quality of life compared with TAU alone; however, the improvements in costs and QALYs were not statistically significant.
Patient trust in the use of machine learning-based clinical decision support systems in psychiatric services: A randomized survey experiment
Authors: Perfalk Erik , Bernstorff Martin , Danielsen Andreas Aalkjær , Østergaard Søren Dinesen
Published: October 2024

Background

Clinical decision support systems (CDSS) based on machine-learning (ML) models are emerging within psychiatry. If patients do not trust this technology, its implementation may disrupt the patient-clinician relationship. Therefore, the aim was to examine whether receiving basic information about ML-based CDSS increased trust in them.

Methods

We conducted an online randomized survey experiment in the Psychiatric Services of the Central Denmark Region. The participating patients were randomized into one of three arms: Intervention = information on clinical decision-making supported by an ML model; Active control = information on a standard clinical decision process, and Blank control = no information. The participants were unaware of the experiment. Subsequently, participants were asked about different aspects of trust and distrust regarding ML-based CDSS. The effect of the intervention was assessed by comparing scores of trust and distrust between the allocation arms.

Results

Out of 5800 invitees, 992 completed the survey experiment. The intervention increased trust in ML-based CDSS when compared to the active control (mean increase in trust: 5% [95% CI: 1%; 9%], p = 0.0096) and the blank control arm (mean increase in trust: 4% [1%; 8%], p = 0.015). Similarly, the intervention reduced distrust in ML-based CDSS when compared to the active control (mean decrease in distrust: −3%[−1%; −5%], p = 0.021) and the blank control arm (mean decrease in distrust: −4% [−1%; −8%], p = 0.022). No statistically significant differences were observed between the active and the blank control arms.

Conclusions

Receiving basic information on ML-based CDSS in hospital psychiatry may increase patient trust in such systems.
Randomized Controlled Trial of Acceptance and Commitment Therapy for Fatigue Interference With Functioning in Metastatic Breast Cancer
Authors: Mosher Catherine E. , Lee Shieun , Addington Elizabeth L. , Park Seho , Lewson Ashley B. , Snyder Stella , Hirsh Adam T. , Bricker Jonathan B. , Miller Kathy D. , Ballinger Tarah J. , Schneider Bryan P. , Storniolo Anna Maria , Newton Erin V. , Champion Victoria L. , Johns Shelley A.
Published: October 2024

PURPOSE

Fatigue is a highly prevalent and disabling symptom for patients with metastatic breast cancer (MBC). Evidence-based interventions for managing fatigue in advanced cancer populations are lacking. This phase II randomized controlled trial tested the effect of acceptance and commitment therapy (ACT) on fatigue interference with functioning in patients with MBC.

METHODS

Eligible patients were women with stage IV breast cancer who had moderate to severe fatigue interference. Patients completed a baseline assessment that included self-report measures of fatigue interference with activities, mood, and cognition (primary outcome) and sleep interference with functioning, engagement in daily activities, and quality of life (QOL; secondary outcomes). Then patients were randomly assigned to six weekly telephone-delivered sessions of either ACT (n = 116) or education/support (n = 120). Follow-up assessments occurred at 2 weeks, 3 months, and 6 months postintervention (means, 9.69, 20.51, and 33.59 weeks postbaseline, respectively).

RESULTS

Linear mixed model analyses showed that compared with patients in the education/support condition, patients in the ACT condition reported significantly less fatigue interference (
P
= .018). These results were significant at 2 weeks and 6 months postintervention. ACT's effect on sleep interference was not statistically significant after the Sidak adjustment for multiple comparisons (
P
= .037). ACT patients showed a steady decline in sleep interference, a trend that was not found for education/support patients. Engagement in daily activities and QOL did not significantly differ between study groups, except for functional QOL (
P
= .006). Compared with education/support patients, ACT patients showed significantly better functional QOL at 2 weeks and 6 months postintervention.

CONCLUSION

Results suggest that a brief, telephone-delivered ACT intervention can reduce fatigue interference with functioning in patients with MBC.
The Earliest Known Text in Latin by a Nahuatl Speaker: Juan de Tlaxcala, “Verba sociorum domini Petri Tlacauepantzi” (1541)
Authors: Laird Andrew
Published: October 2024

In the 1500s, don Pedro de Montezuma, son of Motecuhzoma Xocoyotzin (Montezuma II), petitioned for the return of land and estates in Tula, fifty miles away from Mexico City. A report that was compiled in Latin in 1541, now generally known as “Verba sociorum domini Petri Tlacauepantzi,” remains an important source for his contested claim. This article presents a transcription and the first translation of the document into English. After (1) a synopsis and elucidation of its content, the introductory discussion will (2) highlight linguistic and scribal evidence to show that the text was written by a speaker of Nahuatl, (3) confirm Pedro de Montezuma’s identification of the writer as Juan de Tlaxcala, and (4) offer some concluding reflections on the significance of his use of Latin in this context.
Chemomechanical regulation of EZH2 localization controls epithelial–mesenchymal transition
Authors: Sacco Jessica L. , Vaneman Zachary T. , Self Ava , Sumner Elix , Kibinda Stella , Sankhe Chinmay S. , Gomez Esther W.
Published: October 2024

The methyltransferase enhancer of zeste homolog 2 (EZH2) regulates gene expression, and aberrant EZH2 expression and signaling can drive fibrosis and cancer. However, it is not clear how chemical and mechanical signals are integrated to regulate EZH2 and gene expression. We show that culture of cells on stiff matrices in concert with transforming growth factor (TGF)-β1 promotes nuclear localization of EZH2 and an increase in the levels of the corresponding histone modification, H3K27me3, thereby regulating gene expression. EZH2 activity and expression are required for TGFβ1- and stiffness-induced increases in H3K27me3 levels as well as for morphological and gene expression changes associated with epithelial–mesenchymal transition (EMT). Inhibition of Rho associated kinase (ROCK) proteins or myosin II signaling attenuates TGFβ1-induced nuclear localization of EZH2 and decreases H3K27me3 levels in cells cultured on stiff substrata, suggesting that cellular contractility, in concert with a major cancer signaling regulator TGFβ1, modulates EZH2 subcellular localization. These findings provide a contractility-dependent mechanism by which matrix stiffness and TGFβ1 together mediate EZH2 signaling to promote EMT.
A lexicological perspective on the pandemic: the case study of Estonia
Authors: Raet Mai
Published: October 2024

The linguistic innovation spurred by the pandemic was remarkable, drawing significant attention in language studies. Although this phenomenon has been studied to some extent in Estonian, the research has primarily been published in Estonian, limiting its accessibility to a broader, non-Estonian-speaking audience. To address this gap, this article identifies the most essential Estonian COVID-19 pandemic-related vocabulary of the public domain 2020–2022. Data was gathered from the Combined Dictionary of Estonian and the Estonian National Corpus 2023, analysis employed mixed methods. A total of 182 lexical items were examined, 91 identified as neologisms, and 22 classified as the ‘core lexicon’. 10 semantic categories were established to delineate the main components of Estonian corona discourse. Keyness scores were calculated to monitor changes in the relevance and shifts in thematic focus. This study illustrates how smaller language communities modify their lexicon in response to global crises, aiming to enhance the comprehension of linguistic resilience and language evolution.

Kokkuvõte. Mai Raet: Leksikoloogiline vaade pandeemiale: juhtumiuuring Eesti näitel. Koroonapandeemia tõi kaasa mitmeid uusi sõnu ja väljendeid, mis loodi spetsiaalselt sellega seotud nähtuste nimetamiseks ja kirjeldamiseks. Lisaks sai üldkeeles tavapäraseks kasutada meditsiini ja viroloogia erialakeelde kuuluvaid termineid, mis olid varasemalt laiemale elanikkonnale vähetuntud. Ehkki pandeemiaga seotud sõnavara on maailmas laialdaselt uuritud, puudub eesti keele kohta põhjalikum ülevaade. Seetõttu on siinse töö eesmärk see lünk täita: artiklis identifitseeritakse ja analüüsitakse Eesti koroonadiskursuse kõige iseloomulikumad keelendid aastatel 2020–2022. Andmete kogumiseks kasutati Eesti keele ühendkorpust 2023 ja EKI ühendsõnastikku 2023. Kokku analüüsiti 182 leksikaalset elementi, neist 22 moodustasid eesti koroonaaja tuumsõnavara, 91 kategoriseeriti koroonaneologismidena. Eesti koroonadiskursuse põhikomponentide tuvastamiseks loodi 10 semantilist kategooriat ning vaatlusaluse perioodi jooksul toimunud temaatiliste nihete kaardistamiseks kasutati Sketch Engine’i esilduvusskoori (keyness score). Siinne artikkel annab ühelt poolt sissevaate Eesti koroonakogemusse, teisalt illustreerib, kuidas väiksema kõnelejate arvuga keel suudab globaalsetele muutustele adekvaatselt ja kiiresti reageerida.
Features of liver structural organization in posttraumatic stress disorder
Authors: Chorniy Sofiia , Denefil Olga , Miroshnyk Viktoriia
Published: October 2024

Posttraumatic stress disorder (PTSD) is a severe psychological condition resulting from traumatic experiences, leading to long-term physiological changes in the body. It affects mental health and induces hormonal imbalances that disrupt the hypothalamus-pituitary-adrenal axis, influencing multiple organ systems. While PTSD is often linked with comorbid conditions like depression and anxiety, its effects on the hepatobiliary system are less understood.
Aim. This study aimed to assess PTSD's impact on liver morphology in rats of different sexes and compare the severity of changes between males and females, contributing to the understanding of stress-related physiological effects.
Materials and Methods. The experiment involved 40 Wistar rats, divided into control and PTSD-induced groups for both sexes. A validated stress induction protocol was used, followed by a thorough morphological analysis of liver specimens fixed in 10% formalin and stained with hematoxylin-eosin. Histopathological evaluation focused on liver architecture, hepatocyte condition, vascular integrity, and cellular organization.
Results. Control animals displayed standard liver structure, while PTSD-induced groups exhibited significant morphological changes, such as dystrophic alterations in hepatocytes, congestion in hepatic veins, and the formation of blood clots. Female rats showed more pronounced changes than males, including hepatocyte swelling and vacuolization, indicating heightened cellular stress and reduced regenerative capacity.
Conclusions. The findings highlight that PTSD-related liver changes were more significant in female rats, emphasizing the importance of considering gender differences in stress-related disorders. These alterations suggest a complex interaction between chronic psychological stress and liver physiology, warranting further research on mechanisms by which PTSD affects the hepatobiliary system and potential therapeutic interventions. for at-risk populations.
Quadriceps Crush Contusion in Athletes: The Effectiveness of Orthobiologic Treatment with Platet-Rich Plasma (PRP)
Authors: Korta Karolina , Bieńko Marta , Marchaj Magdalena , Bieńko Mateusz , Putra Anna , Król Tomasz , Toborek Michalina , Niedziela Natalia , Maciąg Maria , Bednarz Karolina
Published: October 2024

Introduction: Quadriceps contusion is a common injury in contact sports like football, rugby, and basketball, resulting from a direct blow to the anterior thigh. This causes muscle damage, bleeding, and inflammation. While often considered minor, poor management can lead to complications, delayed recovery, and impaired athletic performance.
Purpose: The purpose of this review is to evaluate the effectiveness and the role of orthobiologic treatments such as PRP in enhancing healing and functional recovery for a swift return to sport.
Summary: Quadriceps contusion, resulting from direct trauma to the quadriceps muscle group, leads to hematoma formation and varying degrees of injury severity. Diagnosis is primarily clinical, often supported by ultrasound and MRI to assess the extent of muscle damage. Treatment is typically non-operative, involving rest, ice, compression, physical therapy, and a gradual return to activity. One significant complication is myositis ossificans, characterized by abnormal bone formation within the muscle, which can cause chronic pain and restricted movement. Recent advances, such as ultrasound-guided PRP injections, offer promising results by enhancing healing, relieving pain, and accelerating functional recovery. PRP therapy, particularly popular among athletes, promotes tissue repair by stimulating cell regeneration and reducing inflammation, helping speed up recovery and potentially lowering the risk of complications like myositis ossificans. Although preliminary evidence supports the effectiveness of PRP in helping athletes return to play sooner, more research is needed to validate its full impact on musculoskeletal injuries. Continued exploration of nonoperative treatment and rehabilitation protocols is also necessary to ensure optimal outcomes. Preventive strategies, including the use of protective gear and conditioning exercises to strengthen muscles, are critical in reducing the risk of injury and enhancing athletic performance.
Wilson’s disease: A Comprehensive Review of Genetics, Pathophysiology, Clinical Symptoms, Diagnostic Techniques and Current Treatment
Authors: Wdowiak Natalia , Choinka Martyna , Konopka Agata , Szczepaniak Zuzanna , Adamska Kinga
Published: October 2024

Introduction: Wilson's disease (WD) is a genetic disease, inherited in an autosomal recessive manner, caused by a mutation in the ATP7B gene, which results in impaired excretion of copper in the bile. This causes the accumulation of copper in various tissues and organs, leading to their damage. The range and severity of symptoms are wide, so diagnosis is difficult and requires a high index of suspicion. The most common clinical symptoms are hepatic and neuropsychiatric symptoms. Diagnosis is based primarily on clinical suspicion, typical symptoms and reduced serum ceruloplasmin concentration. Treatment includes pharmacological therapies, and in some cases liver transplantation is necessary. Wilson's disease, if left untreated, inevitably leads to serious disability and death.
 
Purpose of the work: This study aims to review and characterize the clinical and pathophysiological aspects of Wilson’s disease.
 
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: Wilson’s disease, Copper metabolism, Copper toxicity, ATP7B, Ceruloplasmin, Gene Mutation
 
Results: Wilson's disease is a rare genetic disorder that can lead to severe disability and even death. For this reason, rapid diagnosis and appropriately selected and individualized treatment play a key role. Wilson's disease remains a major diagnostic challenge, but new techniques for its diagnosis, such as genotype analysis, mainly through sequencing, as well as newborn screening, may significantly improve patient prognosis in the future.
Instytut Studiów Strategicznych w Krakowie: 30 lat historii
Authors: Fyderek Łukasz , Pawnik Agnieszka , Szymańska-Klich Anna
Published: October 2024

Niniejsza publikacja jest zarówno podsumowaniem, jak i świadectwem ostatnich 30 lat działalności Instytutu Studiów Strategicznych, założonego w 1993 roku pod nazwą Fundacja „Międzynarodowe Centrum Rozwoju Demokracji”. Pragniemy przypomnieć o najważniejszych wydarzeniach, które miały miejsce podczas dotychczasowej działalności Instytutu – o celach i dążeniach Fundacji, projektach i działaniach, które przyczyniały się do ich realizacji. Publikacja ta jest również podziękowaniem składanym wszystkim, którzy współpracowali z Instytutem, bez których wkładu wypełnienie jego misji nie byłoby możliwe.