bluuebunny/crossref_metadata_2025 huggingface dataset:
Genetic Evidence for Causal Association Between Atrial Fibrillation and Dementia: A Mendelian Randomization Study
Authors: Li Mingxiao , Jiang Chao , Lai Yiwei , Wang Yufeng , Zhao Manlin , Li Sitong , Peng Xiaodong , He Liu , Guo Xueyuan , Li Songnan , Liu Nian , Jiang Chenxi , Tang Ribo , Sang Caihua , Long Deyong , Du Xin , Dong Jianzeng , Ma Changsheng
Published: August 2023

Background

The knowledge gap regarding whether the correlation between atrial fibrillation (AF) and dementia in observational studies is causation or driven by other shared risk factors remains substantially unfilled.

Methods and Results

We performed a comprehensive 2‐sample Mendelian randomization study to evaluate the causal effect of AF on overall dementia and its subtypes, including vascular dementia, Alzheimer dementia, Lewy body dementia, and frontotemporal dementia. The primary results in inverse variance–weighted analyses were further validated by various Mendelian randomization sensitivity analyses. Additionally, we conducted multivariable Mendelian randomization to examine 10 candidate mediators of the causal association of AF and dementia. Genetic predisposition to AF was modestly associated with an increased risk of overall dementia (odds ratio, 1.140 [95% CI, 1.023–1.271];
P
=0.018) and strongly associated with vascular dementia (odds ratio, 1.350 [95% CI, 1.076–1.695];
P
=0.010). Genetically predicted AF indicated neutral effects on Alzheimer dementia, Lewy body dementia, and frontotemporal dementia. In multivariable Mendelian randomization analysis, the total effect of AF on overall dementia was remarkably attenuated by adjusting for genetic effect for ischemic stroke (odds ratio, 1.068 [95% CI, 0.953–1.197];
P
=0.259) and low cardiac output (odds ratio, 1.046 [95% CI, 0.926–1.181];
P
=0.475), indicating that the causal association of genetically predicted AF with dementia was potentially mediated by ischemic stroke and low cardiac output. The causal effect of genetically predicted AF on dementia was independent of cerebral small‐vessel disease and brain volume phenotypes.

Conclusions

Our findings provided novel evidence supporting the causal effect of genetically predicted AF on dementia mediated by ischemic stroke and low cardiac output. Future clinical trials are warranted to evaluate the potential role of appropriate AF management in dementia prevention.
Positive Predictive Value of
International Classification of Diseases, Ninth Revision, Clinical Modification
, and
International Classification of Diseases, Tenth Revision, Clinical Modification
, Codes for Identification of Congenital Heart Defects
Authors: Ivey Lindsey C. , Rodriguez Fred H. , Shi Haoming , Chong Cohen , Chen Joy , Raskind‐Hood Cheryl L. , Downing Karrie F. , Farr Sherry L. , Book Wendy M.
Published: August 2023

Background

Administrative data permit analysis of large cohorts but rely on
International Classification of Diseases, Ninth Revision, Clinical Modification
(
ICD‐9‐CM
), and
International Classification of Diseases, Tenth Revision, Clinical Modification
(
ICD‐10‐CM
) codes that may not reflect true congenital heart defects (CHDs).

Methods and Results

CHDs in 1497 cases with at least 1 encounter between January 1, 2010 and December 31, 2019 in 2 health care systems, identified by at least 1 of 87
ICD‐9‐CM
/
ICD‐10‐CM
CHD codes were validated through medical record review for the presence of CHD and CHD native anatomy. Interobserver and intraobserver reliability averaged >95%. Positive predictive value (PPV) of
ICD‐9‐CM
/
ICD‐10‐CM
codes for CHD was 68.1% (1020/1497) overall, 94.6% (123/130) for cases identified in both health care systems, 95.8% (249/260) for severe codes, 52.6% (370/703) for shunt codes, 75.9% (243/320) for valve codes, 73.5% (119/162) for shunt and valve codes, and 75.0% (39/52) for “other CHD” (7
ICD‐9‐CM
/
ICD‐10‐CM
codes). PPV for cases with >1 unique CHD code was 85.4% (503/589) versus 56.3% (498/884) for 1 CHD code. Of cases with secundum atrial septal defect
ICD‐9‐CM
/
ICD‐10‐CM
codes 745.5/Q21.1 in isolation, PPV was 30.9% (123/398). Patent foramen ovale was present in 66.2% (316/477) of false positives. True positives had younger mean age at first encounter with a CHD code than false positives (22.4 versus 26.3 years;
P
=0.0017).

Conclusions

CHD
ICD‐9‐CM
/
ICD‐10‐CM
codes have modest PPV and may not represent true CHD cases. PPV was improved by selecting certain features, but most true cases did not have these characteristics. The development of algorithms to improve accuracy may improve accuracy of electronic health records for CHD surveillance.
Biomarker, Imaging, and Clinical Factors Associated With Overt and Covert Stroke in Patients With Atrial Fibrillation
Authors: De Marchis Gian Marco , Krisai Philipp , Werlen Laura , Sinnecker Tim , Aeschbacher Stefanie , Dittrich Tolga D. , Polymeris Alexandros A. , Coslovsky Michael , Blum Manuel R. , Rodondi Nicolas , Reichlin Tobias , Moschovitis Giorgio , Wuerfel Jens , Lyrer Philippe A. , Fischer Urs , Conen David , Kastner Peter , Ziegler André , Osswald Stefan , Kühne Michael , Bonati Leo H. ,   for the Swiss-AF Investigators
Published: August 2023

BACKGROUND:

Atrial fibrillation is a major risk factor for stroke and silent brain infarcts. We studied whether a multimodal approach offers additional insights to the CHA
2
DS
2
-VASc score in predicting stroke or new brain infarcts on magnetic resonance imaging (MRI) over a 2-year follow-up.

METHODS:

Swiss-AF is a prospective, multicenter cohort study of patients with known atrial fibrillation. We included patients with available brain MRI both at enrollment and 2 years later. The dates of the baseline and follow-up visits ranged from March 2014 to November 2020. The primary outcome was assessed 2 years after baseline and was defined as a composite of clinically identified stroke or any new brain infarct on the 2-year MRI. We compared a multivariable logistic regression model including prespecified clinical, biomarker, and baseline MRI variables to the CHA
2
DS
2
-VASc score.

RESULTS:

We included 1232 patients, 89.8% of them taking oral anticoagulants. The primary outcome occurred in 78 patients (6.3%). The following baseline variables were included in the final multivariate model and were significantly associated with the primary outcome: white matter lesion volume in milliliters (adjusted odds ratio [aOR], 1.91 [95% CI, 1.45–2.56]), NT-proBNP (N-terminal pro-B-type natriuretic peptide; aOR, 1.75 [95% CI, 1.20–2.63]), GDF-15 (growth differentiation factor-15; aOR, 1.68 [95% CI, 1.11–2.53]), serum creatinine (aOR, 1.50 [95% CI, 1.02–2.22]), IL (interleukin)-6 (aOR, 1.37 [95% CI, 1.00–1.86]), and hFABP (heart-type fatty acid–binding protein; aOR, 0.48 [95% CI, 0.31–0.73]). Overall performance and discrimination of the new model was superior to that of the CHA
2
DS
2
-VASc score (C statistic, 0.82 [95% CI, 0.77–0.87] versus 0.64 [95% CI, 0.58–0.70]).

CONCLUSIONS:

In patients with atrial fibrillation, a model incorporating white matter lesion volume on baseline MRI and selected blood markers yielded new insights on residual stroke risk despite a high proportion of patients on oral anticoagulants. This may be relevant to develop further preventive measures.
Environmental Terrorism Twenty Years On
Authors: Chalecki Elizabeth L.
Published: August 2023

In 2002, a few months after 9/11, I published one of the very first academic examinations of environmental terrorism: what was included in this term and what wasn’t, who might commit such terrorism, and what sorts of environmental resources were vulnerable. Since then, it has been the subject of academic and government analyses. Now, twenty years later, it is time to revisit the concept in light of worsening anthropogenic climate change, the rise of authoritarian states and ecofascism, and gray-zone conflicts in international relations.
Can We Turn People into Pain Pumps? On the Rationality of Future Bias and Strong Risk Aversion
Authors: Braddon-Mitchell David , Latham Andrew J. , Miller Kristie
Published: August 2023

Future-bias is the preference, all else being equal, for negatively valenced events to be located in the past rather than the future, and positively valenced ones to be located in the future rather than the past. Strong risk aversion is the preference to pay some cost to mitigate the badness of the worst outcome. People who are both strongly risk averse and future-biased can face a series of choices that will guarantee them more pain, for no compensating benefit: they will be pain pumped. Thus, combining these preferences is rationally impermissible. Dougherty (2011) argues that this gives us reason to think that future-bias is rationally impermissible. This argument, and a similar one presented by Greene and Sullivan (2015), relies on the idea that if several preferences are not rationally combinable, then in the absence of some explanation of why they are not combinable, we should conclude that (at least) one of them is rationally impermissible. We take up this question by, inter alia, reflecting on the empirical results of a study we ran that probes people’s risk averse and future-biased preferences. We argue that the data, in conjunction with other considerations, suggests that we should not infer from the irrationality of the combination of these preferences to the irrationality of one of the preferences singly. We also argue that given the descriptive data about these preferences, there is no reason to think that, if one of them is rationally impermissible, then it is future-bias. Finally, we reflect on the general issue of whether individual preferences are rationally evaluable.
Nomenclatural revision of the names of Celtis (Cannabaceae) described for Africa, and lectotypification of one Asian name
Authors: ZAMENGO HENRIQUE BORGES , CHAMORRO DEBORA , GAGLIOTI ANDRÉ LUIZ , PEDERNEIRAS LEANDRO CARDOSO
Published: August 2023

N/A
Review of the genus Nesomalium Steel, 1964 (Coleoptera, Staphylinidae, Omaliinae), with description of two new species from Ewing and Chatham islands
Authors: SHAVRIN ALEXEY V. , HLAVÁČ PETER
Published: August 2023

The New Zealand genus Nesomalium Steel, 1964 (Omaliini) with six species is reviewed and redescribed, and briefly compared with related genera. All species are redescribed and illustrated, including two new species: N. marrisi sp. n. from Chatham Island and N. lescheni sp. n. from Ewing Island (Auckland islands). Lectotypes are designated for Omalium insulare Kiesenwetter, 1877 and O. pacificum Kiesenwetter, 1877. The key to species is provided. Nesomalium insulare (Kiesenwetter, 1877) is recorded from Adams and Ewing islands for the first time.
Clistoabdominalis Skevington, 2001 (Diptera: Pipunculidae) of Colombia, with description of a new species and an updated key to males of the Neotropical species
Authors: RAMOS-PASTRANA YARDANY , MARQUES DAYSE WILLKENIA A. , RAFAEL JOSÉ ALBERTINO
Published: August 2023

Clistoabdominalis Skevington, 2001 has a cosmopolitan distribution and is a poorly studied genus of big-headed flies (Pipunculidae) in the Neotropical Region, completely unknown in Colombia. A new species is described from protected areas and conflict territories of limited access in Colombia, namely Clistoabdominalis lucyae sp. nov. (type-locality: Parque Nacional Natural Tayrona). Clistoabdominalis spinitibialis (Hardy, 1954) is recorded for the first time in Colombia, and an amended diagnosis provided. Illustrations and a dichotomic key to the Neotropical species of Clistoabdominalis are also presented.
New species of the genus Dolophilodes Ulmer 1909 (Trichoptera: Philopotamidae) from Singalila National Park, West Bengal, India
Authors: PANDHER MANPREET SINGH , KAUR SIMARJIT , PAREY SAJAD H.
Published: August 2023

This paper is another contribution to knowledge of the caddisfly fauna of India. Here we describe and illustrate three new species of Dolophilodes Ulmer 1909: D. dhritiae sp. nov., D. similis sp. nov., and D. laminata sp. nov. all from Singalila National Park, West Bengal. With these additions, genus Dolophilodes is now represented by 9 species from India.
Checklist of parasitic isopods from Brazil: Bopyroidea and Cryptoniscoidea (Isopoda: Cymothoida: Epicaridea)
Authors: RIBEIRO FELIPE BEZERRA , HORCH AMANDA PORCIUNCULA
Published: August 2023

All species of Brazilian parasitic isopods belonging to Epicaridea (Bopyroidea and Cryptoniscoidea) known to date, including references and distribution information, are listed. The list comprises 37 valid species, 18 of which are endemic to the country, 17 are also recorded from other countries in the Americas, and only two species are distributed outside of the American continent as well. Synonym list, known hosts and distribution are given for each of the species, along with taxonomic and ecological remarks when relevant.
An unexpected new species of Anomala Samouelle, 1819 from southern Italy (Coleoptera: Scarabaeidae: Rutelinae), including description of its larva and ecological notes
Authors: ULIANA MARCO , TOMASI FILIPPO , GALLERATI VALERIO
Published: August 2023

Anomala phantasma Uliana, Tomasi & Gallerati, new species is described from the Salento peninsula, southern Italy, including its third-instar larva. The new species is close to Anomala devota (P. Rossi, 1790), from which it differs for characters of the external anatomy, of the paramera and the endophallus. The most striking diagnostic difference is found in the setation of pronotum, limited to a narrow stripe on the midline in A. phantasma, new species, whereas it is present on the whole surface in A. devota. The new species is also compared with A. matzenaueri Reitter, 1918, a poorly known species endemic of the opposite side of the Adriatic coast. Anomala phantasma, new species is a day-active species, possibly limited to maquis and shrublands lining sandy beaches.
South-East Asian populations of Karualona cf. karua (King. 1853) (Crustacea: Cladocera: Chydoridae) belong to a separate species
Authors: SINEV ARTEM Y. , SEMENYUK IRINA I.
Published: August 2023

Study of populations of Karualona cf. karua (King, 1853) (Сrustacea: Cladocera) from South-East Asia and Sri Lanka revealed that they belong to an undescribed taxon. Karualona fatimae sp. nov. differs from the Australian K. karua s. str. by a very small basal spine of postabdominal claw and the presence of small denticle on the anterior margin of labral keel. The latter character is unique for the genus. Morphology, distribution and phylogenetic position of the new species are discussed. Our data suggest that the diversity of Karualona is underestimated in most tropical regions, with at least one more undescribed taxon present in South-East Asia and one more taxon in Australia. An updated key for genus Karualona Dumont & Silva-Briano, 2000 of the Eastern Hemisphere is provided.
A new species of Aulacaspis Cockerell, 1893 (Hemiptera: Coccomorpha: Diaspididae) infesting cardamom from India
Authors: JOSHI SUNIL , MOHAMMED NAFEESA , MENDONCE VIYOLLA PAVANA
Published: August 2023

A new species of scale insect in the genus Aulacaspis (Hemiptera: Coccomorpha: Diaspididae) is described and illustrated from Kerala, India. Aulacaspis elettaria Joshi & Nafeesa sp. n. was collected from the host plant Elettaria cardamomum (L.) Maton (Zingiberaceae). Biological notes on the species are provided, including information on the occurrence, spread and pest status of this species in Kerala. An identification key based on adult females is given to separate Indian species of Aulacaspis.
Association between child, early, and forced marriage and extreme weather events: A mixed-methods systematic review
Authors: Doherty Fiona C , Rao Smitha , Radney Angelise R
Published: August 2023

This systematic review examines current evidence on the association between extreme weather and child, early, and forced marriage (CEFM). Studies published in English between 1990 and 2022 were identified through ten databases, and independently screened for inclusion followed by data extraction, quality assessment, and narrative synthesis. Of the 20 studies included, CEFM was a major theme in the qualitative studies; quantitative and mixed-method studies noted a positive association between extreme weather and CEFM. Limitations include reporting bias, non-representative samples, and limited geographic coverage. Health professionals and social workers must recognize the complexities surrounding CEFM and extreme weather, which will worsen amid climate change.
Colonial crises of imagination, climate fictions, and English literary education
Authors: Truman Sarah E.
Published: August 2023

This paper argues that the contemporary climate crises we see around our planet correlate with a colonial crisis of (literary) imagination. The author engages with Caribbean literary scholar Sylvia Wynter and other anti-colonial scholars to trace how the colonial literary imagination is rooted in the euro-western humanism and racial capitalism that governs the west, the stories and literary forms that frame it, and whose logics continue to be rehearsed across the disciplines—particularly in English literatures taught in school. The paper then argues that to understand the histories of this crisis of imagination and its link to climate crises, and perhaps paradoxically access literature’s speculative potential to imagine different climate futures, literary educators and scholars need to prioritize literatures and literary critiques that are embedded in a different relationship to the imagination and ecology.
The damages of stigma, the benefits of prestige: Examining the consequences of perceived residential reputations on neighbourhood attachment
Authors: Otero Gabriel , Ramond Quentin , Méndez María Luisa , Carranza Rafael , Link Felipe , Ruiz-Tagle Javier
Published: August 2023

This study examines how perceived residential reputations – that is, how people think non-residents assess the reputation of their neighbourhood – affect neighbourhood attachment, including residents’ sense of belonging, local civic membership, social relationships and compliance with social rules and norms in the neighbourhood. We focus on Santiago, the capital city of Chile: a highly segregated context. We use data from the Chilean Longitudinal Social Survey (ELSOC, 2016–2019) and information on neighbourhood characteristics. Results show that perceived residential reputations affect neighbourhood attachment, even after adjusting for time-invariant individual heterogeneity and lagged dependent variables. Specifically, perceived stigma reduces residents’ neighbourhood identification, physical rootedness, trust and sociability with neighbours, while positive perceived reputations improve these components of neighbourhood attachment, although to a lesser extent. However, perceived residential reputations do not affect the formation of strong ties between neighbours or local participation, suggesting that residential reputations mainly influence affective components of neighbourhood attachment. We conclude that perceived residential reputations reinforce the influence of individual characteristics and objective neighbourhood conditions in producing diverging patterns of neighbourhood attachment, with broader implications for social inequality in the city.
High-Performance Work Systems in the Healthcare Industry: A Systematic Literature Review
Authors: Karthik Padamata , Devi Vangapandu Rama
Published: August 2023

This research study aims to unveil the key features of contemporary literature on high-performance work systems (HPWS) in the domain of healthcare by carrying out a systematic literature review of relevant scientific studies from existing literature published in top-rated journals (Australian Business Deans Council (ABDC) listed). The article aims to develop a comprehensive understanding of theoretical foundations, concepts, level of the study, variables and recent trends in the area. The Scopus database is used to identify the scientific publications for this study. Based on the search query and inclusion & exclusion criteria, the short-listing process resulted in 72 articles published between 2006 and 2021. From the short-listed articles, the authors have identified 45 relevant studies connected to the HPWS area in the healthcare domain that was published in top-rated journals listed in ABDC. The authors have systematically analysed the selected studies. A critical review of the existing literature helped gather and present details relating to the theoretical framework referred to, intervening variables, performance outcomes, methodological concerns, etc., Also, research gaps have been identified and the avenues for future research are suggested. In addition to this, the authors have conducted a bibliometric analysis to check for the domain knowledge structure, trending topics and themes of HPWS research in the healthcare industry.
Crisis, Experience, ‘Excentricity’
Authors: Gafijczuk Dariusz
Published: August 2023

This paper explores the relationship between crisis and experience, concentrating on ‘excentric positionality’ in relation to the shared world, as presented in the work of Helmuth Plessner. A by-product of the 1920s Weimar Germany, Plessner’s philosophical anthropology, it is argued, presents us with a forgotten blueprint for transitive and compositional approaches to the social world. Instead of the familiar ‘crisis of experience’ used to diagnose ‘what has gone wrong’, it allows us to re-learn how to work with ‘the experience of crisis’ itself. The latter holds the key to a different type of approach based on ‘xeno-communication’. This type of communication utilizes the productive potential of crisis in its uncertainty and hesitation before a decision, showing a way to extend and enlarge experience itself. Cultivation of these ‘excentric’ dynamics in turn suggests new ‘excentric methodologies’ based on a more flexible fit between concepts and the worlds they are meant to describe. ‘Excentric methodologies’ constitute a type of experience-based, analytical response to the shared world. They work with phenomena across spaces and problems, analytically utilizing their joint emergence from the fundamental imbalance and discontinuity characteristic of the human environment.
Durability and efficacy of the ELVeS® Radial® 2ring slim fiber for multiple ablations
Authors: Verbist Jürgen , Laeremans Veerle , Gryffroy Fien , Van den Eynde Wouter , Heerinckx Caroline , Haesen Dorien
Published: August 2023

Objectives

To prove that the ELVeS® Radial® 2ring slim fiber (Biolitec AG, Wien, Austria) is safe and effective, with a reliable fiber durability.

Methods

This prospective, non-randomized, registry recruited patients with venous incompetence of the great saphenous vein, with or without concomitant incompetence of the small, anterior accessory and posterior accessory saphenous veins. Anatomic success, clinical success and pain were assessed.

Results

150 patients (410 veins) underwent endovenous laser ablation (EVLA). Mean number of veins treated was 2.7 (1–7) with a mean total length of 80.7 cm. 98.3% occlusions were observed after 12 months. Clinical improvement was significant with reduced venous clinical severity scores at 1 month (1.7 ±1.9; p < .0001) and 12 months (0.7 ±1.3; p < .0001) versus pre-operation (4.4 ± 2.2). Mean pain level after 1-week was 5.8/100. No major surgery- or device-related complications occurred.

Conclusions

1470-nm EVLA with the 2ring slim fiber is a highly effective treatment option well tolerated by patients. Despite intensive use, fiber integrity was preserved.

Clinical registration

The study protocol was registered in clinicaltrials.gov (NCT03810677).
Diagnostic performance of 18F-labeled PSMA PET/CT in patients with biochemical recurrence of prostate cancer: a systematic review and meta-analysis
Authors: Yang Yuan-Yuan , Liu Zhi-Mou , Peng Ru-Chen
Published: August 2023

Background

After initial treatment of prostate cancer, increases in prostate-specific antigen (PSA) levels commonly signify potential relapse or metastasis. 18F-labeled prostate-specific membrane antigen (PSMA) is considered a promising treatment due to its favorable physical properties.

Purpose

To investigate the diagnostic value of 18F-PSMA PET/CT for the recurrence and/or metastasis of biochemical recurrence of prostate cancer (BRPca).

Material and Methods

A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library databases. Combined sensitivity and specificity values for the use of 18F-PSMA PET/CT in patients with BRPca were obtained. The quality of the studies was tested using the Diagnostic Accuracy Research Quality Assessment tool. Meta-analysis was performed using STATA 15 software, and heterogeneity was subsequently tested.

Results

A total of 16 studies (1162 patients) were enrolled and had significant heterogeneity. The pooled sensitivity, specificity, and AUC values for 18F-PSMA PET/CT in the diagnosis of prostate recurrence and/or metastasis were 0.93 (0.89–0.95), 0.94 (0.85–0.98), and 0.96 (0,94–0.98), respectively. Meta-regression analyses showed that the sources of heterogeneity did not relate to ligands, study designs, or participants. The pooled sensitivity and specificity values of 18F-DCFPyL PET/CT were 0.90 (0.85–0.94) and 0.89 (0.85–0.93), respectively. The pooled sensitivity and specificity values of 18F-PSMA-1007 PET/CT were 0.89 (0.85–0.93) and 0.93 (0.70–0.99), respectively. The per-patient pooled sensitivity and specificity values were 0.92 (0.86–0.96) and 0.83 (0.41–0.97), respectively. The per-lesion pooled sensitivity and specificity values were 0.91 (0.86–0.94) and 0.91 (0.86–0.94), respectively.

Conclusion

According to our meta-analysis, 18F-PSMA PET/CT has the potential to be critical for the diagnosis of recurrence and/or metastasis in patients with BRPca.
Choroidal metastasis from gastric cancer: A case report and review of the literature
Authors: Huang Yan-Ying , Zhu Li-Yan , Li Zhao-Dong
Published: August 2023

Choroidal metastatic tumours from gastric cancer (GC) are rare compared with breast and lung cancer. Here, we report a patient with GC who presented to our ophthalmology clinic with a one-week history of left eye visual disorder and pain. Fundoscopic and B-scan examinations suggested a choroidal metastatic tumour. Computed tomography (CT) and magnetic resonance imaging (MRI) scans confirmed our initial diagnosis. Histopathology and immunohistochemical findings showed the tumour most likely originated from the gastrointestinal tract. Although the patient was well after eye removal, he died two months after surgery. Metastasis of GC should be a consideration when a patient with a history of GC presents with eye pain, decreased vision, and/or high intraocular pressure.
Application of recombinant human thrombopoietin in pregnant women with immune thrombocytopenia: a single-center experience of four patients and literature review
Authors: Yu Jingdi , Miao Peiwen , Qian Shenxian
Published: August 2023

The management of pregnant women with immune thrombocytopenia who fail to respond to corticosteroids and intravenous immunoglobulin is an intractable clinical challenge because of the limited availability of evidence-based information. Recombinant human thrombopoietin (rhTPO) is recommended for refractory immune thrombocytopenia (ITP). To date, however, few studies have investigated rhTPO treatment during pregnancy. We retrospectively reviewed four cases who were diagnosed with ITP and treated with rhTPO during pregnancy in our center from January 2015 to June 2020. Of the four cases, two (50%) responded to rhTPO treatment. No adverse events were noted in the newborns. Our findings indicate that rhTPO treatment is safe for patients with refractory gestational ITP, and that subcutaneous injection is a convenient delivery method that does not lead to adverse events. Thus, rhTPO may be a viable alternative treatment option for patients with refractory gestational ITP who do not respond to first-line therapies.
Mind the gap with Europe. Why public interest cannot be a good reason to perform observational and epidemiological research?
Authors: Cagnazzo Celeste , Ficara Bruno , Palermo Federica , Fagioli Franca
Published: August 2023

The consequences of the Italian privacy legislation, that represents a very restrictive implementation of the general European regulation on data protection, have mainly been felt at the level of observational research. In this field is not always possible to obtain the consent of subjects, and as for retrospective studies, it is not currently clear which is the correct regulatory procedure to follow. This uncertainty in the law’s implementation has given way to multiple interpretations, making it difficult to obtain a homogeneous path in Italy. However, it is possible that the observation point has been totally wrong so far and that it would be more correct to choose a different legal bases than consent, both to preserve scientific progress and collective ethics, without losing the protection of the subject. This approach, which has already been followed by other European countries, could bring us closer to the rest of Europe and allow us to competitively participate in community projects that we are often cut off from.
Systemic avian poxvirus infections associated with the B1 subclade of canarypox virus
Authors: Sinnott Devinn M. , Burchell Jennifer , Witte Carmel , Burns Rachel , Kubiski Steven
Published: August 2023

Avian poxvirus infections typically manifest as 2 forms: cutaneous (“dry”) pox, characterized by proliferative nodules on the skin, and diphtheritic (“wet”) pox, characterized by plaques of caseous exudate in the oropharynx and upper respiratory and gastrointestinal tracts. Systemic spread of virus to visceral organs beyond the skin and mucous membranes is rarely reported. Out of 151 cases diagnosed with avian poxvirus over a 20-year period at a zoological institution, 22 were characterized as having systemic involvement based on histopathology and molecular findings. Gross lesions in systemic cases included soft white nodules scattered throughout the liver, spleen, and kidneys. Two histopathologic patterns emerged: (1) widespread histiocytic inflammation in visceral organs with intrahistiocytic viral inclusions and (2) severe, localized dry or wet pox lesions with poxvirus-like inclusions within dermal and subepithelial histiocytes. In situ hybridization targeting the core P4b protein gene confirmed the presence of poxvirus DNA within histiocytes in both patterns. Polymerase chain reaction was performed targeting the reticuloendothelial virus long terminal repeat (REV LTR) flanking region and the core P4b protein gene. Sequences of the REV LTR flanking region from all systemic pox cases were identical to a previously described condorpox virus isolated from an Andean condor with systemic pox. Sequences of the core P4b protein gene from all systemic pox cases grouped into cluster 2 of the B1 subclade of canarypox viruses. Systemic involvement of avian poxvirus likely occurs as a result of infection with certain strain variations in combination with various possible host and environmental factors.
Terra Incognita: California Transit Agency Perspectives on Demand, Service, and Finance in the Age of COVID-19
Authors: King Hannah , Wasserman Jacob L. , Taylor Brian D.
Published: August 2023

The COVID-19 pandemic upended transit use, finance, and management. To investigate these effects two years into the pandemic, we conducted 21 semi-structured interviews with senior managers at transit agencies in the most populous U.S. state, California. We found that the pandemic generated many operational and managerial challenges for transit agencies. Ridership plummeted, then slowly recovered, but is still well below pre-pandemic levels at most agencies. Commuter trips to and from major job centers were especially slow to return. In response to decreased demand, public health concerns, and uncertain finances, many agencies cut services and spending early on. As a result, fare revenues declined, in some cases precipitously. However, federal pandemic relief funds proved essential in filling budgetary gaps, stabilizing finances, preventing layoffs, and maintaining services. Other transit subsidies mostly bounced back robustly. Our interviews suggest that, though California transit agencies experimented with free fares, few fareless programs were made permanent. Their challenges include considerable uncertainty associated with future travel demand, looming financial shortfalls at systems that formerly had high farebox recovery and are still drawing on federal pandemic funds to backfill their fare revenue losses, and protracted labor shortages of drivers and mechanics that are preventing many systems from providing desired levels of service.
Challenges of implementing complexity in healthcare
Authors: Nason Richard
Published: August 2023

Complexity is a form of system that is relevant in virtually all aspects and levels of healthcare. The importance and relevance of the science of complexity for healthcare has been written about extensively for over two decades. The problem this article addresses is that complex systems and how to manage them still appear to be relatively unknown nor well understood by most stakeholders of healthcare. The ignorance of complexity science includes multiple dimensions of healthcare, including frontline practitioners, support staff, and healthcare administrators. An additional challenge is to also involve policy-makers, and indeed the general public in advancing their appreciation of how this still evolving field of study can improve healthcare efficiency and outcomes. A third challenge is acceptance and willingness to embrace complexity. This article discusses a framework for evaluating complexity acceptance, as well as the unique challenges that the existing healthcare infrastructure and culture exhibit that are hindering adoption of complexity. Suggestions are put forward for further exploration and consideration.
Unsettling Feminism in Social Work: Toward an Indigenous Decolonial Feminism
Authors: BlackDeer Autumn Asher
Published: August 2023

Feminism and social work alike are complicit in historic colonial projects and further this agenda into the present day through the perpetuation of white supremacy. As social work moves to reckon with historic harms and decolonial feminist discourse proliferates, it remains to be seen how feminist social work will acknowledge or account for the legacy of systemic violence against Indigenous peoples and make meaningful changes going forward. The combination of close reading of the literature and the embodiment of experiential and cultural knowledge informs the development of the Indigenous decolonial feminist framework. Decolonial feminism in social work offers a pathway for Indigenous sovereignty – a collective liberation created and defined by Indigenous peoples for Indigenous peoples. Indigenous decolonial feminism requires a commitment to achieve social justice that is in direct alignment with the overall aim of social work. The present work will delineate an Indigenous decolonial feminism, situate this work within the current feminist social work landscape, and call for the field to engage in critical strategizing for social change and embodied decolonization.
On investigation of flexural, morphological, and shape memory properties for 3D printed PLA-PVDF NFs-PLA interleave composite structures for smart gripper applications
Authors: Thakur Vishal , Singh Rupinder , Kumar Ranvijay
Published: August 2023

In the present study, the flexural, morphological, and shape memory properties of polylactic acid (PLA) matrix sandwiched with polyvinylidene difluoride (PVDF) Nanofibers (NFs) interleave composite structures have been investigated for applications of 4D printing such as smart grippers, and smart actuators. Firstly, an electrospinning process was carried out to form a PVDF NFs mat (thickness: 0.10–0.20 mm) under a flow rate of 3 µL/sec, an applied voltage of 12 kV, and a TCD of 100 mm. Further, the PVDF NFs mat was deposited in between the PLA layers, primed through fused filament fabrication (FFF) based 3D printing to manufacture the PLA-PVDF NFs-PLA based structures. In the next stage, the flexural properties were investigated for manufactured composite structures. The results highlight that the flexural strength of the composites was enhanced by 6.47% as compared to PLA. Results of the study are supported by a scanning electron microscope (SEM), X-ray diffraction (XRD), Fourier transform infrared (FTIR), V-I, V-R, and shape memory analysis. The finding of the study suggests that composite structures primed by higher mat thickness and zig-zag infill pattern have resulted in higher electrical resistance and better shape memory effect. However, increasing the voltage in the composite structure having higher mat thickness with a zig-zag fill pattern has resulted in a higher resistance drop.
Optimization of process conditions of Powder Mixed Electric Discharge Machining of Nickel based Superalloy using Grey Wolf Optimizer algorithm
Authors: Jenarthanan MP , Ramesh S
Published: August 2023

The Powder-Mixed Electric Discharge Machining (PMEDM) process has been drawing the attention of researchers since it could successfully overcome some of the limitations of the conventional Electric Discharge Machining (EDM) process. There was extensive research carried out on the PMEDM process to explore various possibilities for enhancing the process output. In the present work, an experimental study has been undertaken to investigate the influence of three conductive powders: zinc, cobalt, and molybdenum, while machining Nimonic 75, a nickel-based superalloy, by the EDM process. The work material considered in the study has been widely used in the aerospace industries and in applications involving higher temperatures. The experiments were carried out based on the Response Surface Methodology using the Box–Behnken design. Using the experimental data, regression equations were formed to predict the outcome of the process, which are Material Removal Rate (MRR), Electrode Wear Ratio (EWR), and Surface Roughness (SR). This work attempted to optimize the EDM machining parameters using the Grey Wolf Optimizer (GWO) algorithm combined with the Utility concept. The optimum conditions obtained by the GWO algorithm were: Powder – Molybdenum; Concentration of powder – 5.4 g/L; Discharge current – 4 A; Duty factor – 0.8.
The effect of flipped-jigsaw learning models on ethical decision-making
Authors: Ziyai Nasibe Yağmur , Bozkurt Ramazan , Kilickiran Hatice , Dogu Ozlem
Published: August 2023

Background

Ethical decision-making education in nursing can be taught effectively by combining different teaching models that support the visualisation of taught concepts and integrating theory into practice.

Objectives

The study aims to examine the effect of flipped and jigsaw learning models on ethical decision-making and ethical sensitivity in nursing.

Research design

We used a nested mixed design. A pretest-posttest single-group quasi-experimental design was used in the quantitative part, and a case study method was used in the qualitative part.

Participants and research context

This study was conducted in fall semester with second-year nursing students who studied an ethics course for the first time, using two different collaborative learning models. In the quantitative part, ethical dilemma and ethical sensitivity scales were made as pre-test with 117 and post-test with 128 students. In the qualitative part, a semi-structured three focus group interviews was conducted with 16 students.

Ethical considerations

After obtaining the approval of the University’s ethics committee, the study was carried out after obtaining participants’ informed written and verbal consent.

Findings

Students’ perspectives changed positively after training. This was related to six cases in section A of the Ethical Dilemma Scale. In part B, Practical Consideration (PC) and Principled Thinking (PT) mean scores were similar, showing no significant difference. For Familiarity in section C, it was determined that 68.4% of students in the pre-test and 77.3% in the post-test were familiar with similar dilemmas. The ethical sensitivity scale’s total scores were in a similar range. In the qualitative stage, ethical decision-making, ethical sensitivity, ethical dilemma and the improvement process were obtained as a theme.

Conclusions

There was an increase in the level of ethical sensitivity and familiarity with ethical dilemmas of nursing students after education. Flipped and jigsaw learning models can be used for nursing ethics courses.
Construction of Decision Making Advisory Service System in China: Reflections on the Contemporary Era
Authors: Pang Runyu
Published: August 2023

The Central Committee of the Communist Party of China (CPC) has proposed that Jiangsu should ‘explore the way for the development of the whole country’. Therefore, Jiangsu has naturally become a testing ground and demonstration site for accelerating the construction of an innovative country. This paper takes the construction of a decision-making advisory system in Jiangsu Province, China, as an example. By examining the current situation and problems of the construction of a decision-making advisory system for electricity and energy in Jiangsu Province, it examines the internal logic of optimising the management system and mechanism of decision-making institutions and the scientific and democratic decision-making of the government for the construction of an innovative country. This is of great theoretical and practical significance for understanding the development of decision-making advisory research in the country.
Corporate Governance and Islamic Behavioural Finance: A Review from Malaysia and GCC Countries
Authors: Loang Ooi Kok
Published: August 2023

This study examines the mediating effect of investors’ sentiment on the relationship between corporate governance (CG) and herding and risk-averse behaviour in the Shariah-compliant stocks in Malaysia and Gulf Cooperation Council (GCC) countries. Panel data and quantile regressions are adopted, and the research timeframe is 2017 to 2021. The result shows that remuneration. Audit Committee, risk management and internal control and engagement with stakeholders significantly and positively correlate to Malaysia, Kuwait, Oman, Qatar, Saudi and the UAE stock returns. Board responsibility is the only variable significant in Malaysia, Saudi and the UAE. The result implies a full mediation as the CG has caused the changes in investors’ sentiment and subsequently triggered the investors to herd and become risk-averse. The impact of CG is more pronounced in the upper and lower quantiles of the returns of Malaysia, Saudi and the UAE, as well as the median quantile of Bahrain, Kuwait, Oman and Qatar. The result of this study contributes to policymakers, regulators and practitioners in identifying the best CG practices that assist the Shariah-compliant stocks in Malaysia and GCC countries to gain a better stock return, investors’ sentiment and behaviour. The results assist the governments in the impact and benefits of adopting CG in different Islamic countries.
Decision tree-based data mining approach for the evaluation of survival in primary malignant bone tumors: A surveillance, epidemiology and end results database study
Authors: Yapar Dilek , Yapar Aliekber , Tokgöz Mehmet Ali , Bilge Uğur
Published: August 2023

Purpose

This study aimed to conduct a large-scale population-based study to understand the epidemiological characteristics of Primary Malignant Bone Tumors (PMBTs) and determine the prognostic factors by concurrently using the classical statistical method and data mining methods.

Methods

Patients included in this study were extracted from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database: “Incidence-SEER Research Data, 18 Registries, Nov 2020 Sub”. Patients with unclassified and incomplete information were excluded. This search algorithm resulted in a dataset comprising 6234 cases. Survival analyses were performed with Kaplan-Meier curves and the Log-rank test. Multivariate Cox regression analysis determined the independent prognostic factors of PMBT. A decision tree-based data mining technique was used in this study to confirm the prognostic factors.

Results

5-years survival rate was 63.6% and 10-years survival rate was 55.3% in the patients with PMBT. Sex, age, median household income, histology, primary site, grade, stage, metastasis, and the total number of malignant tumors were determined as independent risk factors associated with overall survival (OS) in the multivariate COX regression analysis. The prognostic factors resulting in five terminal nodes in the decision tree (DT) included stage, age, and grade. The stage was the most important determining factor for vital status. The terminal node with the shortest number of surviving patients included 801 (72.3%) deaths in 1102 patients with distant stage, and hazard ratio was calculated as 5.4 (95% CI: 4.9–5.9; p < .001). These patients had a median survival of only 17 months.

Conclusions

Rules extracted from DTs provide information about risk factors in specific patient groups and can be used by clinicians making decisions on individual patients. We recommend using DTs in combination with COX regression analysis to determine risk factors and the effect of these factors on survival.
Botulinum Toxin to Improve Scar Quality in Cleft Lip Repair: A Systematic Review
Authors: Martinez Paul F. , Rogers Ashley E. , Mantilla-Rivas Esperanza , Hughes Helena , Melo Leal Daniela , Rana Md Sohel , Manrique Monica , Rogers Gary F. , Oh Albert K.
Published: August 2023

Objective

Cleft lip repair (CLR) can be complicated by hypertrophic scar or keloid. Botulinum toxin type A (BTA) may improve postoperative scarring by reducing muscle tension and cytokine activity at the scar site. This systematic review analyzes the available evidence regarding the effect of BTA on scar quality after CLR.

Design

The search was conducted in 6 different databases in accordance with PRISMA guidelines (PubMed, Scielo, Embase, Scopus, Web of Science, and Cochrane) using “botulinum toxin” and “cleft lip” as keywords.

Setting

Academic hospital

Patients

Exclusive to patients who underwent CLR and BTA injection

Outcome measures

Mean visual analog scores (VAS), mean Vancouver scar scale (VSS), scar width, and BTA or CLR-related complications.

Results

Five studies for a total of 216 patients met inclusion criteria. Four studies reported on primary CLR during infancy while 1 study recruited older patients seeking revision. All patients had BTA (range: 1-2 units/kg) injected in the orbicularis oris muscle. One study documented BTA injections in additional perioral muscles. All 4 studies that measured scar width and had a saline control arm found a significant decrease in width with BTA injection. Improvement of VAS and VSS with BTA was reported in 3 of 5 studies and 2 of 5 studies, respectively. There were no reports of complications associated with BTA or CLR.

Conclusion

The existing studies support the use of BTA injection to improve scar quality following CLR with low concern for complication. Further investigations with a greater number of patients are necessary.
Ergonomics for Cleft Providers: A Brief Communication
Authors: Hamdan Usama S. , Najjar Wassim , Vyas Raj M. , Schuster Lindsay , Hussein Sara , Younan Robert A. , Haddad Mario , Annan Beyhan , Johnson Adam , Swanson Jordan W.
Published: August 2023

Musculoskeletal (MSK) injuries are the most common and debilitating work-related injuries among healthcare providers. These injuries often occur due to a lack of awareness and insufficient guidance during the early years of medical training. Recognizing the need to address this issue, the Comprehensive Cleft Care Workshop (CCCW) has taken steps to integrate an ergonomics session into its curriculum. The goal of this initiative is to enhance awareness on ergonomics, improve the integration of ergonomics into daily routine, and ultimately reduce the occurrence of MSK injuries among healthcare professionals.