bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of National Health Service (NHS) orthodontic practitioners in Wales, UK. Part 2: job satisfaction perceptions of the workforce 2021–2022
Authors: Lewis Benjamin RK , Spicer Olivia J , Moons Kirstie , McLaughlin William S
Published: January 2024

Objective:

To ascertain the perceptions of the Welsh NHS orthodontic workforce regarding their job satisfaction and work life balance.

Design:

Descriptive cross-sectional survey.

Participants and setting:

Clinicians providing NHS orthodontic treatment in Wales.

Methods:

An anonymised, email-distributed, electronic, two-part survey (onlinesurveys.ac.uk) of the Welsh NHS orthodontic workforce working within Wales was undertaken. The survey consisted of three sections: (1) demographic information (part 1); (2) respondents’ working pattern (part 1); and (3) perceptions of professional job satisfaction and work/life balance (part 2). The responses received were exported into an Excel spreadsheet for descriptive analysis. The free-text comments were collated for each question and subsequently underwent a content analysis to identify any common themes.

Results:

Part 2 of the survey yielded an overall response rate of 69.6% (n = 78). Over 96% (n = 75) of respondents felt that they had ‘made the right career choice, including 100% of orthodontic trainees, orthodontic specialists and orthodontic consultants. Of the respondents, 88.5% (n = 69) said they ‘enjoyed going to work’, with the remaining being mostly neutral in their opinion. Of the respondents, 79.5% (n = 62) felt they were able to ‘provide their patients the optimum care’ and 64.1% (n = 50) felt that more demands were being placed upon them by patients and parents. Overall, 52.6% (n = 41) of survey respondents believed it was becoming increasingly difficult to achieve an effective work/life balance, and this was more prevalent among male respondents (61.5%, n = 16) than female respondents (48.1%, n = 25), although this difference was not statistically significant ( P >0.05).

Conclusions:

Over 96% of respondents felt they have chosen the right career and that flexibility and a good working environment are important to job satisfaction. Respondents felt that there are increasing demands being placed upon them by patients/parents, employers, the Regulators, the Government and Health Boards. This is leading to increased difficulty in achieving a satisfactory work/life balance, especially among male respondents.
Effect of biomimetic fish scale structure on the drag reduction performance of Clark-Y hydrofoil
Authors: Yan Hao , Xie Tengzhou , Wang Fei , Zeng Yishan , Ai Jiaqiu
Published: January 2024

A hydrofoil is a basic shape of fluid machinery blades, and its drag reduction performance is an important reference index in the field of fluid transportation. When fluid flows around a hydrofoil, it generates friction drag and pressure drag, greatly reducing the hydrofoil’s hydraulic performance. This study designs a bionic drag reduction structure by arranging fish scales on a Clark-Y hydrofoil. The overlapping size, thickness, and coverage area of fish scales are taken as design parameters, and the optimal design scheme is attained by using the Taguchi method. Large eddy simulation is used to numerically simulate various schemes. Results show that when the overlapping size O is 2.00 mm, the thickness h is 0.36 mm, the initial position x/C of the fish scale covering is 0 (where C is the chord length of the hydrofoil), and the hydrofoil exhibits excellent drag reduction performance. The total drag reduction rate of the hydrofoil is up to 35.15%, and the drag reduction rate of friction drag and pressure drag is up to 39.56% and 25.64%, respectively. The lift–drag ratio of the hydrofoil increases by 18.04%. The bionic fish scale structure effectively inhibits turbulence, thereby reducing the drag caused by the transformation of laminar flow to turbulence.
A creative form-finding tool: Deformation of plastic sheets due to the influence of temperature and gravity
Authors: Patiño Ever , Maya Jorge , Obregón Andrés
Published: January 2024

A form-finding technique based on the deformation of plastic sheets by the action of gravity and temperature increase is proposed, allowing the exploration of complex geometries to support form-giving processes within architecture projects, both by students and practitioners. Using an analog and computational approach, the ideal material for the technique was selected from a multifactorial experiment. Semi-structured analog experimentation was carried out based on inputs, rules, and outputs previously identified, and the resulting models were morphologically analyzed, to later translate the components of the analog experimentation into a computational algorithm to carry out computational experimentation. The technique can be used as a generator of novel forms possessing adequate transformational qualities. Finally, potential applications of the technique and avenues for future research are presented.
Analysing Data With Members of a Stigmatised Community: Experiences, Reflections and Recommendations for Best Practice From the Finding the Formula Community Analysis Group
Authors: Grant Aimee , McNamara Tara , Cooper Jonie , Dvorak Susan , Dolling Abbie , Ellis Rebecca , McIntyre Carol , Jones Sara , Brown Amy
Published: January 2024

Participatory research approaches hold potential to better understand society through valuing lived experience. Formula feeding babies is routinely stigmatised in the UK, despite inadequate support to facilitate breastfeeding. Our community science project investigated the safety of powdered infant formula preparation in the home through the completion of an at-home experiment and a research diary with closed and open questions ( n = 151). To add validity to the interpretation of open text data in research diaries, a community analysis group of five formula-feeding mothers was established. The community analysts undertook inductive thematic analysis through a series of analysis group meetings focused around data extracts, contributed to the study’s empirical outputs and this methodological output, meeting 23 times over a nine-month period. Detailed notes were taken during meetings and the methodological elements of these were thematically analysed with the community analysts to produce this article, with extracts from the academic researchers’ field notes added where relevant. The overarching themes, presenting both positive experiences and areas for improvement, focused on: (i) clarity of expectations and the impact this had on community analysts’ confidence, (ii) the stigmatising topic area and how this was managed by the facilitators, and (iii) feeling valued, in relation to honoraria, inclusion in outputs and community analysts coming to recognise their own expertise. Furthermore, the community analysts co-produced recommendations for including community analysts in future research. It provides guidance on how this can be appropriately costed for and supported by funding bodies and research teams, as well as providing guidance on recruitment and chairing meetings. We hope that this article can provide valuable input into how to involve the community more inclusively as research partners in qualitative analysis related to stigmatised topics.
Design and utilization of thrust fluctuation of slotted-tubular permanent magnet linear motor: Mechatronics for low-frequency vibration forming machine
Authors: Gao Jingzhou , Du Wei , Zheng Zhenhao , Zhao Shengdun , He Weiming
Published: January 2024

Usually, the conventional low-frequency vibration forming machine has a main transmission mechanism as the driving source to provide forming force and an auxiliary mechanism as the vibration source to generate vibration force. The transmission chain is long and the structure is complex and bloated, which affects the forming process and product quality. This paper presents a novel mechatronics idea of low-frequency vibration forming machine, which uses a slotted tubular permanent magnet synchronous linear motor (slotted-TPMLM) as both the driving source and the vibration source. The key is that the slotted-TPMLM provides sufficient forming force accompanied with a certain low-frequency vibration force. Consequently, this paper focuses on the thrust fluctuation caused by the structure. Firstly, the effect of end force and the influence of cogging force are discussed in detail through Fourier analyses, especially the stator adjustment length and pole-slot combination. Then, the slotted-TPMLM is designed, manufactured, and tested. The results show that the slotted-TPMLM can provide a certain low-frequency vibration force (low frequency of 4.8 Hz at 100 mm/s and 48 Hz at 1000 mm/s), which meets the technical requirements. Consequently, the feasibility of the novel mechatronics idea of a low-frequency vibration forming machine has been verified. This research will contribute to the field of linear motors and metal forming machines.
“A vision of the possible”: The life and works of Gray Cavender
Authors: Banner Francine
Published: January 2024

This essay is a tribute to the life and career of Dr. Gray Cavender.
Metacognitive Feelings: A Predictive-Processing Perspective
Authors: Fernández Velasco Pablo , Loev Slawa
Published: January 2024

Metacognitive feelings are affective experiences that concern the subject’s mental processes and capacities. Paradigmatic examples include the feeling of familiarity, the feeling of confidence, or the tip-of-the-tongue experience. In this article, we advance an account of metacognitive feelings based on the predictive-processing framework. The core tenet of predictive processing is that the brain is a hierarchical hypothesis-testing mechanism, predicting sensory input on the basis of prior experience and updating predictions on the basis of the incoming prediction error. According to the proposed account, metacognitive feelings arise out of a process in which visceral changes serve as cues to predict the error dynamics relating to a particular mental process. The expected rate of prediction-error reduction corresponds to the valence at the core of the emerging metacognitive feeling. Metacognitive feelings use prediction dynamics to model the agent’s situation in a way that is both descriptive and directive. Thus, metacognitive feelings are not only an appraisal of ongoing cognitive performance but also a set of action policies. These action policies span predictive trajectories across bodily action, mental action, and interoceptive changes, which together transform the epistemic landscape within which metacognitive feelings unfold.
Reclassification of RAS/BRAF allele mutations predicts the survival benefit of triplet chemotherapy in metastatic colorectal cancer
Authors: Zhang Xiang , Ma Haizhong , He Yinjun , He Wenguang , Chen Nan , Li Yandong , Zhong Weixiang , Wu Guosheng , Zhou Xile , Hua Hanju , Ye Feng , Cai Hui , Jiang Weiqin
Published: January 2024

Background:

Different RAS/BRAF allele mutations imply distinct biological properties in various solid tumors. Recently, several studies have focused on the predictive and prognostic roles of various RAS/BRAF allele mutations in colorectal cancer (CRC) but the results remain controversial.

Methods:

Between March 2017 and September 2022, the patients diagnosed as stages I–IV CRC with detailed medical records including next-generation sequencing (NGS) data and clinicopathological follow-up information available at our center were enrolled. Survival data were estimated using the Kaplan–Meier method, and the difference was tested in a log-rank test. Multivariate tests were carried out using Cox models.

Results:

A total of 1029 CRC patients were included, and the incidence of RAS/BRAF mutation was 58.4%. The hypermutated cohort was defined as patients with microsatellite instability-H or POLE/D mutation. In the non-hypermutational cohort, only KRAS G13D mutation was associated with a higher incidence and inferior disease-free survival in patients with stage I-III CRC. In the cohort of patients with non-hypermutated metastatic colorectal cancer (mCRC), we assessed the risk of various RAS/BRAF allele mutations and subsequently reclassified patients into four groups based on first-line median progression-free survival: wild type (group 1), low-risk RAS/BRAF mutation (group 2, RAS/BRAF mutations other than KRAS G13D/G12V/G12C or BRAF V600E), high-risk RAS mutation (group 3, KRAS G13D/G12V/G12C), and BRAF V600E mutation (group 4). mCRC patients with high-risk RAS mutation could significantly benefit from intensive triplet chemotherapy (hazard ratio, 2.54; 95% confidence interval, 1.36–5.12; p = 0.0091).

Conclusion:

In the non-hypermutated CRC cohort, the prognostic risk of various RAS/BRAF allele mutations varied between local and metastatic CRC. KRAS G13D mutation tended to be the only prognostic marker for stages I–III CRC; however, KRAS G13D/G12V/G12C mutations collectively defined a high-risk subgroup of mCRC patients with poor prognosis, who would benefit from intensive triplet chemotherapy.
Pre-operative hand therapy management of Dupuytren’s disease: A systematic review
Authors: Fernando Joep Jannick , Fowler Christy , Graham Tanya , Terry Kim , Grocott Patricia , Sandford Fiona
Published: January 2024

Introduction

Dupuytren’s Disease is a fibroproliferative disorder of the hand, with a heterogenous pathogenesis, ranging from early-stage nodule development to late-stage digital contractures. Hand therapy intervention is not routinely provided pre-operatively. The objective of this systematic review was to explore the efficacy of hand therapy interventions provided for pre-operative Dupuytren’s Disease.

Methods

A systematic review was undertaken of the databases CENTRAL, CINAHL, OVID Medline and OVID EMBASE, PubMed, BNI, Web of Science, with grey literature and reference searches conducted from database inception to April 2022, and confirmed in August 2023. Included studies required non-surgical intervention and outcome data on individuals with Dupuytren’s Disease who have not had surgical intervention. Two reviewers conducted the searches, independently assessed eligibility and completed methodological quality assessments. Data were summarised narratively.

Results

Seventeen studies were selected for final inclusion. Interventions included Extracorporeal Shockwave Therapy (ESWT), Corticosteroid Injection (CSI), Splinting, Massage and Stretching, Ultrasound Therapy (US), Temperature Controlled High Energy Adjustable Laser (THEAL). ESWT positively maintained or improved pain, active range of motion (AROM), Disabilities of the Arm Shoulder, and Hand (DASH) scores, and grip strength. US positively maintained or improved ROM and grip. Splinting positively maintained or improved ROM, CSI positively improved nodule size. Cross Frictional Massage positively impacted AROM and THEAL improved pain and DASH scores.

Conclusions

Outcomes from therapeutic interventions for pre-operative management of Dupuytren’s Disease were largely positive. However, there is a need for further high-quality research into these interventions to understand their full potential for the management of Dupuytren’s Disease.
The reliability and applicability of the Ten Test in hand injuries: A systematic review
Authors: Chua Marcel , Seth Ishith , Rozen Warren M
Published: January 2024

Introduction

The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It’s quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT’s reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages.

Methods

A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool.

Results

This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of −0.71.

Conclusion

Our findings underscore the TT’s high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT’s use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.
Short- and Long-Term Effects on Glucose Control of Nonadherence to Insulin Therapy in People With Type 2 Diabetes An In Silico Study
Authors: Visentin Roberto , Cobelli Claudio , Sieber Jochen , Dalla Man Chiara
Published: January 2024

Background:

Strict adherence to multiple daily insulin (MDI) therapy is a cornerstone for the achievement of good glucose control in people with advanced type 2 diabetes (T2D). Here, we aim to in silico assess glucose control in T2D subjects with poor adherence to MDI therapy.

Methods:

We tuned the Padova T2D Simulator, originally describing early-stage T2D physiology, around advanced T2D people. One hundred in silico advanced T2D subjects were generated and equipped with optimal MDI therapy: specifically, basal and bolus insulin amounts and injection times were individualized for each subject by applying titration algorithms that iteratively update insulin dose based on glucose deviation from its target. Then, the effect of nonadhering to MDI therapy was assessed using standard glucose control metrics calculated in two 6-month 3-meal/day in silico scenarios: in Scenario 1, subjects received the optimal basal and prandial insulin bolus at each meal; in Scenario 2, subjects received optimal basal insulin and randomly delayed or skipped the prandial insulin bolus in 3 lunches during working days and 1 dinner during weekends.

Results:

A statistically significant degradation was found in all glucose control outcome metrics in Scenario 2 versus Scenario 1: e.g., percent time above 180 mg/dL increased by 22.2% and glucose management index by 0.2%.

Conclusions:

Impaired adherence to MDI therapy in T2D leads to glucose control deteriorations in both short and long terms. Interestingly, short-term hyperglycemia seems being contrasted by residual endogenous insulin secretion, which statistically increased by 3-fold after delayed/skipped insulin boluses compared with optimal ones.
Advancements in Managing Wound Biofilm: A Systematic Review and Meta-analysis of Randomized Controlled Trials on Topical Modalities
Authors: Astrada Adam , Pamungkas Rian Adi , Abidin Khoirul Rista
Published: January 2024

Despite numerous available agents claiming anti-biofilm properties on wounds, the substantiating evidence remains inconclusive. This study aimed to assess the immediate impact of topical wound treatments on wound biofilm and healing outcomes in acute and chronic ulcers. We comprehensively searched PubMed, ClinicalTrials.gov, and Google Scholar. In addition, eligible gray literature was incorporated. English-language randomized controlled trials (RCTs), observational, cohort, and case-control studies targeting biofilm prevention, inhibition, or elimination across diverse wound types were included. Primary outcomes included biofilm presence and elimination, supplemented by secondary outcomes encompassing reduced wound size, complete closure, and diminished infection indicators. Bacterial load reduction and biofilm presence were also assessed. Twenty-eight articles met the inclusion criteria. Various modalities were identified, including biofilm-visualization techniques, such as wound blotting and handheld autofluorescence imaging. Pooled analysis for the primary outcomes was infeasible due to limited eligible studies and data-reporting challenges. As for the secondary outcomes, the pooled analysis for complete surgical wound closure (2 RCTs, yielding n=284) and presence of surgical site infections/inflammation (2 RCTs, yielding n=284) showed no significant difference, with a log odds ratio (LOD) of 0.58 (95% confidence interval [CI]: −.33, 1.50) and LOD −0.95 (95% CI: −3.54, 1.64; τ2 = 2.32, Q = 2.71, P = .10), respectively. Our findings suggest insufficient evidence to support anti-biofilm claims of topical modalities. Clinicians’ skill appears to play a pivotal role in biofilm elimination and wound healing enhancement, with potential optimization through visual-guided techniques, such as wound blotting and autofluorescence imaging. More rigorous clinical trials are warranted to ascertain the efficacy of these techniques.

Level of Evidence: Therapeutic, 1A
Parallax and Distortion in Fluoroscopy Units
Authors: Brown Joseph R. , Hill Zachary P. , Groeschl Ross , Mendicino Robert W. , Steginsky Brian , Houser Joshua
Published: January 2024

Background

Parallax is an imaging phenomenon where an object appears to be at different positions when viewed from different angles. Distortion can occur secondary to internal fluoroscopic, or external environmental, factors. Fluoroscopy is a vital tool to assist surgeons intraoperatively. However, parallax and distortion can lead to inaccuracy, potentially leading to incorrect surgical decisions. The purpose of this study was to investigate the prevalence of parallax/distortion in large fluoroscopy units at a level-1 trauma center.

Methods

Two types of C-arm models were evaluated, including (1) round image intensifiers, and (2) flat plate detectors (FPD). A square plexiglass grid with embedded wire at ½-in intervals was created, with a round metal washer secured centrally. The grid was placed 16 in from the image intensifier. A metal ball bearing (BB) was secured to the center of the x-ray tube. Fluoroscopic images were obtained until the BB and washer were “center-center.” A straight blade served as a fiducial marker to ensure there was no off-axis angulation. Standard anterior-posterior and lateral views were obtained. External factors were considered, tested, and limited. Images were printed and the patterns of parallax/distortion were identified.

Results

All 11/11 (100%) of fluoroscopy units had some degree of parallax and/or distortion. We noted 3 different patterns, including sigmoidal, converging, and diverging. The FPD units had less apparent distortion overall; however, two-thirds (66%) were off-axis in the x- and y-axes in relation to the fiducial marker.

Conclusion

All fluoroscopy units had varying degrees and patterns of parallax/distortion. We noted less overall distortion in FPDs. However, some of these units may produce images that are off-axis. This research has important implications for improving the accuracy of intraoperative fluoroscopy. Musculoskeletal surgeons should understand the limitations of fluoroscopy and how to combat parallax distortion to improve surgical outcomes and reduce patient morbidity.

Level of Evidence:

Level V
When Social Media Attack: How Exposure to Political Attacks on Social Media Promotes Anger and Political Cynicism
Authors: Hasell Ariel , Halversen Audrey , Weeks Brian E.
Published: January 2024

Political cynicism is rising in many democracies throughout the world. At the same time, people increasingly use social media to access news and political information. However, much of the political content people see on these platforms is hostile, uncivil, and attacking. This study examines whether exposure to these political attacks on social media is associated with political cynicism and, if so, whether negative emotions like anger and anxiety play a mediating role in this process. Using data from a panel survey of American adults ( N = 1,800) collected during the 2020 U.S. presidential election, this study examines whether exposure to political attacks on social media is related to both emotions about the state of the country and political cynicism. Data indicate that people who were exposed to more political attacks on social media were more politically cynical. Further, perceived exposure to political attacks on social media was associated with more anger about the state of the United States, which was subsequently related to greater levels of political cynicism. The results provide evidence that exposure to political attacks on social media might contribute to both negative emotions about the country and political cynicism.
An Intriguing Case of Expanded Dengue Syndrome With Co-existing Encephalitis, Pancreatitis, and Hepatitis: The Classic Thalamic “Double-Doughnut” Sign Revisited
Authors: Biswas Uttam , León-Ruiz Moisés , Ghosh Ritwik , Joarder Utsab , Islam Khandokar Misbahul , Bheeman Raghul , Benito-León Julián
Published: January 2024

Background

Dengue neuro-infection can present with symptoms ranging from mild to severe. Atypical presentations, such as expanded dengue syndrome, pose diagnostic and therapeutic challenges. Neuroimaging findings, particularly the “double-doughnut” sign on brain magnetic resonance imaging (MRI), have emerged as one of the most valuable aids in diagnosing complex cases of central nervous system infection by dengue virus.

Case Presentation

We report the case of a 35-year-old female from rural West Bengal, India, with expanded dengue syndrome. The patient presented with fever, headaches, body aches, and sudden disorientation over minutes, which progressed to a coma. Neurological examination revealed profound unconsciousness and nuchal rigidity. Laboratory findings were consistent with dengue infection, including altered liver and pancreatic enzyme levels. The diagnosis was facilitated by identifying the “double-doughnut” sign on the brain MRI, which suggested dengue encephalitis. This finding and clinical and serological evidence guided the treatment strategy.

Discussion

The “double-doughnut” sign, though not exclusive to dengue encephalitis, proved crucial in this case, aiding in differentiating from other causes of encephalitis. Recognition of this sign can be pivotal in diagnosing expanded dengue syndrome, facilitating timely and appropriate intervention, and improving patient outcomes. This case also underscores the importance of considering dengue in the differential diagnosis of encephalitis, especially in endemic areas. Also, this case’s excellent outcome (both clinically and radiologically) was noteworthy.
Hyperbaric oxygen therapy for sudden hearing loss in enlarged vestibular aqueduct syndrome: A case report and review of literature
Authors: Lee Genevieve Min , Kim Soo Joang , Kwek James Wei Ming , Chan Ching Yee
Published: January 2024

A 12-year-old girl with known bilateral enlarged vestibular aqueducts presented with vertigo and sudden profound hearing loss in her only hearing ear after COVID-19 infection. The hearing remained unchanged after systemic steroids, prompting treatment with salvage intratympanic dexamethasone and hyperbaric oxygen therapy with improvement in her hearing. This case report highlights the success of hyperbaric oxygen therapy in treating sudden sensorineural hearing loss and aims to raise awareness on its role in treating sudden hearing loss in patients with enlarged vestibular aqueduct.
Humoral Response Following 3 Doses of mRNA COVID-19 Vaccines in Patients With Non-Dialysis-Dependent CKD: An Observational Study
Authors: Enilama Omosomi , Yau Kevin , Er Lee , Atiquzzaman Mohammad , Oliver Matthew J. , Romney Marc G. , Leis Jerome A. , Abe Kento T. , Qi Freda , Colwill Karen , Gingras Anne-Claude , Hladunewich Michelle A. , Levin Adeera
Published: January 2024

Background:

Chronic kidney disease (CKD) is associated with a lower serologic response to vaccination compared to the general population. There is limited information regarding the serologic response to coronavirus disease 2019 (COVID-19) vaccination in the non-dialysis-dependent CKD (NDD-CKD) population, particularly after the third dose and whether this response varies by estimated glomerular filtration rate (eGFR).

Methods:

The NDD-CKD (G1-G5) patients who received 3 doses of mRNA COVID-19 vaccines were recruited from renal clinics within British Columbia and Ontario, Canada. Between August 27, 2021, and November 30, 2022, blood samples were collected serially for serological testing every 3 months within a 9-month follow-up period. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike, anti-receptor binding domain (RBD), and anti-nucleocapsid protein (NP) levels were determined by enzyme-linked immunosorbent assay (ELISA).

Results:

Among 285 NDD-CKD patients, the median age was 67 (interquartile range [IQR], 52-77) years, 58% were men, 48% received BNT162b2 as their third dose, 22% were on immunosuppressive treatment, and COVID-19 infection by anti-NP seropositivity was observed in 37 of 285 (13%) patients. Following the third dose, anti-spike and anti-RBD levels peaked at 2 months, with geometric mean levels at 1131 and 1672 binding antibody units per milliliter (BAU/mL), respectively, and seropositivity rates above 93% and 85%, respectively, over the 9-month follow-up period. There was no association between eGFR or urine albumin-creatinine ratio (ACR) with mounting a robust antibody response or in antibody levels over time. The NDD-CKD patients on immunosuppressive treatment were less likely to mount a robust anti-spike response in univariable (odds ratio [OR] 0.43, 95% confidence interval [CI]: 0.20, 0.93) and multivariable (OR 0.52, 95% CI: 0.25, 1.10) analyses. An interaction between age, immunoglobulin G (IgG) antibody levels, and time was observed in both unadjusted (anti-spike: P = .005; anti-RBD: P = .03) and adjusted (anti-spike: P = .004; anti-RBD: P = .03) models, with older individuals having a more pronounced decline in antibody levels over time.

Conclusion:

Most NDD-CKD patients were seropositive for anti-spike and anti-RBD after 3 doses of mRNA COVID-19 vaccines and we did not observe any differences in the antibody response by eGFR.
“Memes Save Lives”: Stigma and the Production of Antivaccination Memes During the COVID-19 Pandemic
Authors: Baker Stephanie Alice , Walsh Michael James
Published: January 2024

Disinformation research is increasingly concerned with the hierarchies and conditions that enable the strategic production of false and misleading content online. During the COVID-19 pandemic, it was revealed that 12 influencers were responsible for a significant volume of antivaccine disinformation. This article examines how influencers use antivaccination memes for commercial and political gain. Drawing on a 12-month digital ethnography of three disinformation producers on Instagram and Telegram, we conceptualize their strategy of meme warfare in terms of the logics of spoiled identity, demonstrating how stigma is used to galvanize and recast the antivaccination movement around themes of persecution and moral superiority. Dispensing with the idea that content moderation has forced disinformation “underground,” we find that disinformation producers configure memes to adapt to specific platforms by directing mainstream audiences to less regulated platforms, personal newsletters, and sites. By examining the tactics and techniques disinformation producers use to spread antivaccination messaging online, we question the effectiveness of content moderation policies as a solution to regulate influencers whose visibility and status strategically straddle multiple sites in the broader information ecosystem.
Unipolar Hip Hemiarthroplasty in Geriatric Patients: A Prospective Study and Analysis of Clinical and Radiological Outcomes
Authors: Ghanimeh Joe , Abusaq Ibrahim , Villatte Guillaume , Descamps Stéphane , Boisgard Stéphane , Erivan Roger
Published: January 2024

Introduction

Femoral neck fractures (FNF) in the geriatric population are commonly treated with hip replacement procedures, such as total hip arthroplasty, unipolar hip hemiarthroplasty (UHA), and bipolar hip hemiarthroplasty (BHA). The optimal treatment remains controversial, considering outcomes and cost-effectiveness, with UHA often being cheaper. This prospective observational study aims to evaluate UHA’s clinical and radiological outcomes, safety, and survivorship compared to existing literature.

Methods

We followed 90 elderly patients who underwent UHA following FNF. We assessed patients using the Parker score before and after surgery, as well as Harris Hip Score (HHS), and Postel-Merle d’Aubigné (PMA) scores postoperatively. All complications, acetabular erosions and heterotopic ossifications (HO), were documented.

Results

One year post-surgery, 26.7% of patients had passed away, mostly due to declining general health status. Systemic complications occurred in 14.4% of cases, with a 1.1% rate of deep surgical site infections. A single dislocation resulted from excessive stem anteversion. UHA implant survival rate was 97.8% after 4 years. The Parker score remained stable, and HHS at 6 and 12 months was 71.5 ± 12.9 and 70.9 ± 11.8, respectively, while PMA score was 14.3 ± 2.4 and 14.5 ± 2.1, respectively. Five hips showed Baker I acetabular wear. HO were noted as Brooker I in 12 patients, II in 4 patients, and IV in 1 patient.

Discussion

UHA exhibited comparable systemic complication rates, implant survivorship, and dislocation rates to those in the literature for both UHA and BHA. The deep surgical site infection rate was lower than reported for BHA. Patients’ functional and mental abilities did not decline based on clinical scores. Acetabular wear in UHA was similar to its bipolar counterpart, while HO were only minor findings with no clinical implications.

Conclusion

In elderly patients, UHA demonstrated clinical and radiological outcomes similar to BHA in existing literature. UHA may represent a cost-effective alternative for patients with limited life expectancy.
The Effect of Patient Aggression on Healthcare Workers’ Mental Health and Anxiety Mediated by Psychological Well-being during the COVID-19 Outbreak
Authors: Hassanie Souad , Karadas Georgiana , Olugbade Olusegun A. , Saidy Jeannette
Published: January 2024

The aftermath effects including overstressed health systems, increased number of cases, death rates, and patient aggression have significant implications on the healthcare workers’ psychological well-being. Building on both the Health Belief Model and Conservation of Resources theory, this study examined the impact of patient aggression on healthcare workers’ psychological well-being, anxiety, and mental health during the COVID-19 pandemic. Further, the study tested the mediating role of psychological well-being in the abovementioned relationships. Data obtained from 549 Lebanese healthcare workers in private hospitals in a two-wave survey was used to evaluate the proposed study’s relationships, using confirmatory factor analysis and structural equation modeling. The results indicated that patient aggression has significant negative impact on healthcare workers’ psychological well-being and mental health while it increases anxiety. Further, psychological well-being partially mediated the relationship between patient aggression and anxiety. Theoretical contributions, practical implications of the study, and suggestions for further studies are discussed.
The Right-Ear Advantage in Static and Dynamic Cocktail-Party Situations
Authors: Wächtler Moritz , Sandmann Pascale , Meister Hartmut
Published: January 2024

When presenting two competing speech stimuli, one to each ear, a right-ear advantage (REA) can often be observed, reflected in better speech recognition compared to the left ear. Considering the left-hemispheric dominance for language, the REA has been explained by superior contralateral pathways (structural models) and language-induced shifts of attention to the right (attentional models). There is some evidence that the REA becomes more pronounced, as cognitive load increases. Hence, it is interesting to investigate the REA in static (constant target talker) and dynamic (target changing pseudo-randomly) cocktail-party situations, as the latter is associated with a higher cognitive load than the former. Furthermore, previous research suggests an increasing REA, when listening becomes more perceptually challenging. The present study examined the REA by using virtual acoustics to simulate static and dynamic cocktail-party situations, with three spatially separated talkers uttering concurrent matrix sentences. Sentences were presented at low sound pressure levels or processed with a noise vocoder to increase perceptual load. Sixteen young normal-hearing adults participated in the study. The REA was assessed by means of word recognition scores and a detailed error analysis. Word recognition revealed a greater REA for the dynamic than for the static situations, compatible with the view that an increase in cognitive load results in a heightened REA. Also, the REA depended on the type of perceptual load, as indicated by a higher REA associated with vocoded compared to low-level stimuli. The results of the error analysis support both structural and attentional models of the REA.
Evolution of explorative and exploitative search strategies in collective foraging
Authors: Garg Ketika , Smaldino Paul E , Kello Christopher T
Published: January 2024

Evolutionary theories of foraging hypothesize that foraging strategies evolve to maximize search efficiency. Many studies have investigated the central trade-off between explore–exploit and how individual foragers manage it under various conditions. For foragers in groups, this trade-off can be affected by the social environment, influencing the evolution of individual search strategies. Previous work has shown that when learning socially, explorative search strategies can optimize group search efficiency. However, social learning can cause discrepancies in strategies that benefit the group versus an individual. We model the evolution of explorative and exploitative strategies using Lévy exponents under different levels of social learning and investigate their effect on individual and group search efficiencies. We show that reliance on social learning can lead to the evolution of mixed groups that are not optimally efficient. Exploiters can have a selective advantage in scrounging findings by explorers, but too many exploiters can diminish group efficiencies. However, greater opportunities for social learning can increase the benefits of explorative strategies. Finally, we show that area-restricted search can help individuals balance exploration and exploitation, and make groups more efficient. Our results demonstrate how exploration and exploitation must be balanced at both individual and collective levels for efficient search.
The diagnostic accuracy of point-of-care ultrasound parameters for airway assessment in patients undergoing intubation in emergency department—an observational study
Authors: Pillai Aadya , Arora Poonam , Kabi Ankita , Chauhan Udit , Asokan Reshma , Akhil P. , Shankar Takshak , Lalneiruol D. J. , Baid Himanshi , Chawang Hannah
Published: January 2024

Background

Endotracheal intubation is an essential resuscitative procedure in the emergency setting. Airway assessment parameters such as the Mallampati classification are difficult to perform in an emergency setting. As point-of-care ultrasound (POCUS) assessment of airway parameters does not require patients to perform any mandatory action, ultrasound may become the potential first-line noninvasive airway assessment tool in the emergency department (ED). The use of POCUS in the ED has not been sufficiently studied. Using POCUS in airway assessment for predicting difficult intubation may be the next step in successful airway management.

Methodology

The study was an observational study conducted at the ED of the All India Institute of Medical Sciences (Rishikesh). The treating emergency physician recorded the patient history and systemic examination along with an indication for intubation. The POCUS assessment of airway parameters pre-epiglottis to epiglottic vocal cord ratio (Pre-E/E-VC), tongue thickness, hyomental distance, and distance from skin to the hyoid bone was performed by the study investigator. During laryngoscopy, Cormack-Lehane (CL) grading was assessed. The data was entered and analyzed.

Results

Seventy patients who required intubation in the ED were enrolled in the study. Among the study population, 48.6%, 28.6%, 14.3%, 1.4%, and 7.1% were classified with the following CL grading: 1, 2a, 2b, 3a, and 3b, respectively. At a cutoff of ≥ 1.86, Pre-E/E-VC predicts difficult laryngoscopy (AUC 0.835) with a sensitivity of 83% and a specificity of 94%. At a cutoff of ≥ 5.98 cm, tongue thickness predicts difficult laryngoscopy (AUC 0.78) with a sensitivity of 83% and a specificity of 88%. At a cutoff of hyomental distance ≤ 6 cm, it predicts difficult laryngoscopy with a sensitivity of 83% and a specificity of 88%. All parameters can act as a promising tool for predicting difficult laryngoscopy, with the single best parameter being Pre-E/E-VC.

Conclusion

Assessment of the airway with POCUS may be helpful to the emergency physician when the clinical airway assessment parameters fail to predict difficult laryngoscopy as most patients requiring intubation are uncooperative. Assessment of the parameters in our study Pre-E/E-VC, tongue thickness, and hyomental distance can act as a promising tool for predicting difficult laryngoscopy in the emergency scenario.
A transcriptomic examination of encased rotifer embryos reveals the developmental trajectory leading to long-term dormancy; are they “animal seeds”?
Authors: Hashimshony Tamar , Levin Liron , Fröbius Andreas C. , Dahan Nitsan , Chalifa-Caspi Vered , Hamo Reini , Gabai-Almog Oshri , Blais Idit , Assaraf Yehuda G. , Lubzens Esther
Published: January 2024

Background

Organisms from many distinct evolutionary lineages acquired the capacity to enter a dormant state in response to environmental conditions incompatible with maintaining normal life activities. Most studied organisms exhibit seasonal or annual episodes of dormancy, but numerous less studied organisms enter long-term dormancy, lasting decades or even centuries. Intriguingly, many planktonic animals produce encased embryos known as resting eggs or cysts that, like plant seeds, may remain dormant for decades. Herein, we studied a rotifer Brachionus plicatilis as a model planktonic species that forms encased dormant embryos via sexual reproduction and non-dormant embryos via asexual reproduction and raised the following questions: Which genes are expressed at which time points during embryogenesis? How do temporal transcript abundance profiles differ between the two types of embryos? When does the cell cycle arrest? How do dormant embryos manage energy?

Results

As the molecular developmental kinetics of encased embryos remain unknown, we employed single embryo RNA sequencing (CEL-seq) of samples collected during dormant and non-dormant embryogenesis. We identified comprehensive and temporal transcript abundance patterns of genes and their associated enriched functional pathways. Striking differences were uncovered between dormant and non-dormant embryos. In early development, the cell cycle-associated pathways were enriched in both embryo types but terminated with fewer nuclei in dormant embryos. As development progressed, the gene transcript abundance profiles became increasingly divergent between dormant and non-dormant embryos. Organogenesis was suspended in dormant embryos, concomitant with low transcript abundance of homeobox genes, and was replaced with an ATP-poor preparatory phase characterized by very high transcript abundance of genes encoding for hallmark dormancy proteins (e.g., LEA proteins, sHSP, and anti-ROS proteins, also found in plant seeds) and proteins involved in dormancy exit. Surprisingly, this period appeared analogous to the late maturation phase of plant seeds.

Conclusions

The study highlights novel divergent temporal transcript abundance patterns between dormant and non-dormant embryos. Remarkably, several convergent functional solutions appear during the development of resting eggs and plant seeds, suggesting a similar preparatory phase for long-term dormancy. This study accentuated the broad novel molecular features of long-term dormancy in encased animal embryos that behave like “animal seeds”.
Navigating the doctor-patient-AI relationship - a mixed-methods study of physician attitudes toward artificial intelligence in primary care
Authors: Allen Matthew R. , Webb Sophie , Mandvi Ammar , Frieden Marshall , Tai-Seale Ming , Kallenberg Gene
Published: January 2024

Background

Artificial intelligence (AI) is a rapidly advancing field that is beginning to enter the practice of medicine. Primary care is a cornerstone of medicine and deals with challenges such as physician shortage and burnout which impact patient care. AI and its application via digital health is increasingly presented as a possible solution. However, there is a scarcity of research focusing on primary care physician (PCP) attitudes toward AI. This study examines PCP views on AI in primary care. We explore its potential impact on topics pertinent to primary care such as the doctor-patient relationship and clinical workflow. By doing so, we aim to inform primary care stakeholders to encourage successful, equitable uptake of future AI tools. Our study is the first to our knowledge to explore PCP attitudes using specific primary care AI use cases rather than discussing AI in medicine in general terms.

Methods

From June to August 2023, we conducted a survey among 47 primary care physicians affiliated with a large academic health system in Southern California. The survey quantified attitudes toward AI in general as well as concerning two specific AI use cases. Additionally, we conducted interviews with 15 survey respondents.

Results

Our findings suggest that PCPs have largely positive views of AI. However, attitudes often hinged on the context of adoption. While some concerns reported by PCPs regarding AI in primary care focused on technology (accuracy, safety, bias), many focused on people-and-process factors (workflow, equity, reimbursement, doctor-patient relationship).

Conclusion

Our study offers nuanced insights into PCP attitudes towards AI in primary care and highlights the need for primary care stakeholder alignment on key issues raised by PCPs. AI initiatives that fail to address both the technological and people-and-process concerns raised by PCPs may struggle to make an impact.