bluuebunny/crossref_metadata_2025 huggingface dataset:
Data as capital and ethical implications in digital sport business models
Authors: Read Daniel , Smith Aaron CT
Published: May 2023

Professional sport has entered the digital economy as organisations adopt data-driven business model innovations. The purpose of this article is to highlight the potential ethical vulnerabilities sport organisations and their leaders face when adopting digital sport business models. Here, we treat data as a species of capital that can be converted into economic capital once it undergoes a computational transformation via a data-driven business model innovation. We argue for two advantages in this approach. First, it helps make transparent the mechanisms through which digital sport business models work. Second, it reveals how the extraction and application of big data exacerbates inequitable power relationships between sport organisations and supporters – the big data divide – that leads to ethical vulnerabilities for sport organisations and their consumers. We suggest that sport consumers might be particularly vulnerable to digital data risk as a consequence of their high levels of brand loyalty and involvement, which tend to encourage trust in the sport properties soliciting, analysing, and monetising their data. Platform broadcasting partnerships, e-ticketing in smart stadiums, and cryptocurrency-based fan tokens are used as examples of data-driven business model innovations based on the conversion of data to capital, demonstrating how sport organisations risk violating the trust of supporters when using digital strategies. The article concludes with directions for future research to deliver an ethically informed data-driven sports industry.
Engaging with care in an early intervention for psychosis program: The role of language, communication, and culture
Authors: Maraj Anika , Ferrari Manuela , MacDonald Kathleen , Peters Matthew , Joober Ridha , Shah Jai L. , Iyer Srividya N.
Published: May 2023

Language is an important aspect of communication and language status is known to impact healthcare accessibility, its perceived suitability, and outcomes. However, its influence on treatment engagement and/or disengagement is unknown. Our study therefore sought to investigate the impact of language on service disengagement in an early intervention psychosis program in Montreal, Quebec (a province with French as the official language). We aimed to compare service disengagement between a linguistic minority group (i.e., English) vis-à-vis those whose preferred language was French and to explore the role of language in service engagement. Using a mixed methods sequential design, we tested preferred language and several sociodemographic characteristics associated with service disengagement in a time-to-event analysis with Cox proportional hazards regression models ( N = 338). We then conducted two focus groups with English (seven patients) and French speakers (five patients) to further explore differences between the two linguistic groups. Overall, 24% ( n = 82) disengaged from the service before the two-year mark. Those whose preferred language was English were more likely to disengage ( n = 47, 31.5%) than those whose preferred language was French ( n = 35, 18.5%; χ2 = 9.11, p < .01). This remained significant in the multivariate regression. In focus groups, participants identified language as one aspect of a complex communication process between patients and clinicians and highlighted the importance of culture in the clinical encounter. Language status of patients plays an important role in their engagement with early psychosis services. Our findings underscore the value of establishing communication and cultural understanding in creating clinical/therapeutic alliance.
Experimental investigation on fabrication, characterization and properties of spark plasma sintered alumina-based tungsten carbide composites reinforced by carbon nanotubes
Authors: Dar Yunis Ahmad , Ahmad Sheikh Nazir
Published: May 2023

In this study, the alumina-based tungsten carbide (WC-Al2O3) composites reinforced by different weight percentages of carbon nanotubes were successfully prepared by the advanced spark plasma sintering technique. This study has the novelty that such composites with the given compositions were never sintered before using spark plasma sintering. The WC-Al2O3-CNTs composites were fabricated to design advanced tool materials with an optimum set of mechanical and thermal properties for high-temperature cutting applications. The experimental results revealed considerable growth in micro-hardness and fracture toughness in WC-Al2O3-CNTs composites as compared to WC-Al2O3 composites. The ideal set of mechanical properties was acquired by WC-Al2O3-CNTs-0.5 composite which also exhibited a minimum value of grain size. At higher concentrations of carbon nanotubes, the mechanical properties of composites tend to degrade due to the agglomeration of carbon nanotubes. The study presented better results in sintered composites than the composites fabricated through other sintering techniques. The improved strengthening and toughening results of WC-Al2O3-CNTs composites along with the fine microstructures were mainly acquired by inhibiting grain growth during sintering, improved dispersion of the constituents in the composites (electron probe microscopy analysis/wavelength dispersive spectroscopy mapping) and consolidation at shorter sintering periods in spark plasma sintering. A thermal study was also conducted to discuss the thermal stability of sintered composites at ambient as well as at higher temperatures to estimate the behavior of thermal conductivity and thermal diffusivity of composites at different temperatures.
Effectiveness of Waterpik® for oral hygiene maintenance in orthodontic fixed appliance patients: A randomised controlled trial
Authors: Tyler Daniel , Kang Jing , Goh Hock Hoe
Published: May 2023

Objective:

To establish whether the use of a WaterPik® alongside a manual toothbrush (WaterPik® + MTB) is more effective for maintaining oral hygiene compared to the use of a manual toothbrush alone (MTB) in patients wearing fixed orthodontic appliances.

Design:

A single-centre, two-arm, parallel-group, single-blind, randomised controlled clinical trial with a 1:1 allocation ratio.

Setting:

Orthodontic department at York Hospital, York Teaching Hospitals NHS Foundation Trust, UK.

Participants:

A total of 40 fit and well participants, aged 10–20 years, being treated with upper and lower fixed orthodontic appliances.

Methods:

Participants were randomly allocated, using stratified block randomisation, to the control group (MTB) or intervention group ‘(Waterpik® + MTB)’. Plaque, gingival and interdental bleeding indices were recorded at baseline, 8 weeks, 32 weeks and 56 weeks. A generalised linear mixed model was used to assess differences between groups.

Results:

An interim analysis of results was performed with 40 patients recruited and 85% of data collected. The overall mean differences between the groups were as follows: plaque index = 0.199 ( P = 0.88, 95% confidence interval [CI] −0.24 to 0.27); gingival index = −0.008 ( P = 0.94, 95% CI −0.22 to 0.20); and interdental bleeding index = 5.60 ( P = 0.563, 95% CI −13.22 to 24.42). No statistical difference between the two groups was found for any variable. The trial was stopped at this point.

Conclusions:

In terms of oral hygiene, our study did not find evidence to support the claim of benefit of using a Waterpik® in addition to a manual toothbrush for patients wearing fixed orthodontic appliances.
Towards a framework for light-dosimetry studies: Quantification metrics
Authors: Hartmeyer SL , Andersen M
Published: May 2023

Light dosimetry aims to measure personal light exposure with wearable sensors, which is a complex multistep procedure. The resulting data may be used to investigate non-visual effects of light in real-life settings, to validate laboratory findings and answer questions pertaining to implications in applied contexts. However, personal light exposure patterns are usually complex and can be quantified in many ways. Various measurement and analysis methods have been applied across previous studies, complicating comparability and interpretation of results. To improve the quality and comparability of light-dosimetry research, a framework with consensus guidelines for light-dosimetry procedures is needed. To provide the groundwork towards such a framework, we reviewed previous light-dosimetry studies to identify considerations regarding measurement and data quantification. Here, we review metrics for quantifying light-dosimetry data in terms of the characteristics known to modulate non-visual responses. Overall, various metrics have been employed across studies, with several metrics for each characteristic. We provide a description of each metric, discuss their properties and provide example calculations for the application to light-dosimetry data. Moreover, we propose considerations for data quantification and possible research strategies for future studies. To facilitate exploration and use of the identified metrics, corresponding functions are provided in an openly accessible R-package.
A Randomized Controlled Pilot Trial Comparing Effects of Qigong and Exercise/Nutrition Training on Fatigue and Other Outcomes in Female Cancer Survivors
Authors: Zimmerman Chloe S. , Temereanca Simona , Daniels Dylan , Penner Cooper , Cannonier Tariq , Jones Stephanie R. , Kerr Catherine
Published: May 2023

Cancer-related fatigue (CRF) is a common and burdensome, often long-term side effect of cancer and its treatment. Many non-pharmacological treatments have been investigated as possible CRF therapies, including exercise, nutrition, health/psycho-education, and mind-body therapies. However, studies directly comparing the efficacy of these treatments in randomized controlled trials are lacking. To fill this gap, we conducted a parallel single blind randomized controlled pilot efficacy trial with women with CRF to directly compare the effects of Qigong (a form of mind-body intervention) (n = 11) to an intervention that combined strength and aerobic exercise, plant-based nutrition and health/psycho-education (n = 13) in a per protocol analysis. This design was chosen to determine the comparative efficacy of 2 non-pharmacologic interventions, with different physical demand intensities, in reducing the primary outcome measure of self-reported fatigue (FACIT “Additional Concerns” subscale). Both interventions showed a mean fatigue improvement of more than double the pre-established minimal clinically important difference of 3 (qigong: 7.068 ± 10.30, exercise/nutrition: 8.846 ± 12.001). Mixed effects ANOVA analysis of group × time interactions revealed a significant main effect of time, such that both groups significantly improved fatigue from pre- to post-treatment ( F(1,22) = 11.898, P = .002, generalized eta squared effect size = 0.116) There was no significant difference between fatigue improvement between groups (independent samples t-test: P = .70 ), suggesting a potential equivalence or non-inferiority of interventions, which we could not definitively establish due to our small sample size. This study provides evidence from a small sample of n = 24 women with CRF that qigong improves fatigue similarly to exercise-nutrition courses. Qigong additionally significantly improved secondary measures of mood, emotion regulation, and stress, while exercise/nutrition significantly improved secondary measures of sleep/fatigue. These findings provide preliminary evidence for divergent mechanisms of fatigue improvement across interventions, with qigong providing a gentler and lower-intensity alternative to exercise/nutrition.
Towards Representational Adequacy: A Critical Analysis of Transgender Representation in Tell Me Why
Authors: McLaren Jackson
Published: May 2023

While transgender representation in media has improved in quantity over the last decade, the representation of transgender men in video games is still limited. In this work, I examine the character Tyler from the game Tell Me Why as a critical case study toward the representational adequacy of transgender people in video games. Through a focus on character design, narrative, paratexts, and game reception, I explore the ways Tyler is a more complex example of transgender representation. Additionally, I argue that the act of bringing transgender people into character creation results in a more complex representation.
Distilled neural state-dependent Riccati equation feedback controller for dynamic control of a cable-driven continuum robot
Authors: Samadi Khoshkho Mohammadamin , Samadikhoshkho Zahra , Lipsett Michael G
Published: May 2023

This article presents a novel learning-based optimal control approach for dynamic control of continuum robots. Working and interacting with a confined and unstructured environment, nonlinear coupling, and dynamic uncertainty are only some of the difficulties that make developing and implementing a continuum robot controller challenging. Due to the complexity of the control design process, a number of researchers have used simplified kinematics in the controller design. The nonlinear optimal control technique presented here is based on the state-dependent Riccati equation and developed with consideration of the dynamics of the continuum robot. To address the high computational demand of the state-dependent Riccati equation controller, the distilled neural technique is adopted to facilitate the real-time controller implementation. The efficiency of the control scheme with different neural networks is demonstrated using simulation results.
Sophoridine alleviates hyperalgesia and anxiety-like behavior in an inflammatory pain mouse model induced by complete freund’s adjuvant
Authors: Rong Zheng , Yang Le , Chen Yue , Qin Yan , Cheng Cai-Yan , Zhao Jun , Li Long-Fei , Ma Xue , Wu Yu-Mei , Liu Shui-Bing , Liang Yan-Ni , Zhao Ming-Gao
Published: May 2023

Chronic pain, along with comorbid psychiatric disorders, is a common problem worldwide. A growing number of studies have focused on non-opioid-based medicines, and billions of funds have been put into digging new analgesic mechanisms. Peripheral inflammation is one of the critical causes of chronic pain, and drugs with anti-inflammatory effects usually alleviate pain hypersensitivity. Sophoridine (SRI), one of the most abundant alkaloids in Chinese herbs, has been proved to exert antitumor, antivirus and anti-inflammation effects. Here, we evaluated the analgesic effect of SRI in an inflammatory pain mouse model induced by complete Freund’s adjuvant (CFA) injection. SRI treatment significantly decreased pro-inflammatory factors release after LPS stimuli in microglia. Three days of SRI treatment relieved CFA-induced mechanical hypersensitivity and anxiety-like behavior, and recovered abnormal neuroplasticity in the anterior cingulate cortex of mice. Therefore, SRI may be a candidate compound for the treatment of chronic inflammatory pain and may serve as a structural basis for the development of new drugs.
Digital and socio-civic skills development and young people’s perceptions of digital citizenship in the UK
Authors: Peart Mark , Higgins Steve , Gutiérrez-Esteban Prudencia , Cubo Delgado Sixto
Published: May 2023

Digital Citizenship is an emerging field of research but there is still a lack of knowledge into what works and how to implement educational practices to develop digital citizenship. The objective of this paper is to evaluate the relationship between young people’s participatory profile and their perceptions of the development of digital and socio-civic skills, and to understand how young people exercise their citizenship in the United Kingdom. The study consists of 124 responses to an online questionnaire. The analysed data suggests that the current framing of citizenship education curriculum in the UK is still focused on more traditional forms of political participation and more work needs to be done in terms of developing citizenship education for a digital era.
Modified contralateral C7 transfer to restore ulnar nerve function without sacrificing median nerve recovery: an experimental study
Authors: Chen Xi , Guo Jinding , Zhou Yingjie , Lao Jie , Zhao Xin , Rui Jing
Published: May 2023

Contralateral C7 (cC7) transfer is a technique used in patients with total brachial plexus avulsion. An ulnar nerve graft (UNG) is usually used, as intrinsic function is not expected to be restored due to length of reinnervation required. In this study, we attempted to improve intrinsic function recovery by preserving the deep branch of the ulnar nerve (dbUN) and reanimating it with the anterior interosseous nerve (AIN) after cC7 transfer. Fifty-four rats were divided into the following three groups: Group A, traditional cC7 transfer to the median nerve with a UNG; Group B, cC7 transfer preserving and repairing the dbUN with the terminal branch of the AIN; Group C, same as Group B; however, the dbUN was coapted after 1 month with the AIN. At 3, 6 and 9 months postoperatively, the results of electrodiagnostic and histomorphometric examinations of the interosseous muscle were significantly better in Groups B and C, without affecting AIN recovery. In conclusion, the modified cC7 transfer technique can potentially improve intrinsic function recovery without affecting median nerve recovery.
Chemical Constituents and Neuroprotective Activity of Hypericum hookerianum
Authors: Hong Vu Duy , Vu Van Tuan , Selvaraj Baskar , Tuyen Nguyen Manh , Khoi Nguyen Minh , Thuan Nguyen Duy , Thuong Phuong Thien , Lee Jae Wook
Published: May 2023

Objective/Background

The Hypericum hookerianum is widely distributed in Asian countries and prevalently used in traditional herbal medicines for its significant antioxidant, antipyretic, and anticancer properties. To date, very limited reports are available regarding the phytochemical profile, and there are no reports that have studied the neuroprotective potentials of this plant.

Experimental Methods

The aerial parts of H. hookerianum were collected from the Sapa mountainous district, Lao Cai province of Vietnam. The extracts were prepared using methanol, n-butanol, ethyl acetate, and chloroform and fractionated by normal-phase silica gel column chromatography to isolate compounds. The purity of the isolated compounds was analyzed by liquid chromatography combined with mass spectrometry. The structures were studied using nuclear magnetic resonance spectroscopy. All the isolates were evaluated for their neuroprotective activity against the neurotoxicity induced by glutamate in HT-22 hippocampal cells and 6-hydroxydopamine (6-OHDA) in SH-SY5Y neuroblastoma cells. The fluorescent dye calcein-AM image assay was used to measure the cell viability.

Results

Bioassay-guided fractionation of the aerial parts of H. hookerianum led to the isolation of 20 previously reported compounds (1-20), including 3 flavonoids (1-3), 2 xanthones (4 and 5), 1 chalcone (6), 4 lignans (7-0), 1 chromone-C-glycoside (11), 1 cinnamic acid derivative (12), 7 phloroglucinols (13-9), and 1 stilbene (20). The structures of the compounds were determined by spectroscopic methods and compared with the reported data. The extracts and isolated compounds showed neuroprotection in both cell models. The compounds 4-hydroxy-2,6,4′-trimethoxydihydrochalcone (6, EC50 = 1.48 µM) and sesamin (10, EC50 = 2.85 µM) exhibited significant neuroprotective effects in HT-22 and SH-SY5Y cells, respectively.

Conclusion

This is the first report on the neuroprotection of extracts and isolated compounds from H. hookerianum. The results provide information for further studies to develop products for the prevention and treatment of neurological disorders.
Comparison of Strength and Power Characteristics Before ACL Rupture and at the End of Rehabilitation Before Return to Sport in Professional Soccer Players
Authors: Maestroni Luca , Turner Anthony , Papadopoulos Konstantinos , Cohen Daniel , Sideris Vasileios , Graham-Smith Philip , Read Paul
Published: May 2023

Background:

Strength and power is often reduced on the involved versus contralateral limb and healthy controls after anterior cruciate ligament (ACL) reconstruction, but no study has compared with preinjury values at the time of return to sport (RTS).

Hypothesis:

Divergent recovery patterns in strength and power characteristics will be present at RTS relative to preinjury baseline data and healthy matched controls.

Study Design:

Cohort study.

Level of Evidence:

Level 3.

Methods:

Isokinetic strength tests, bilateral and single-leg countermovement jumps (CMJ; SLCMJ) were measured before ACL rupture in 20 professional soccer players. These then had surgical reconstruction (ACL group) and completed follow-up testing before RTS. Healthy controls (uninjured group) were tested at the same time as the ACL group preinjury. Values recorded at RTS of the ACL group were compared with preinjury. We also compared the uninjured and ACL groups at baseline and RTS.

Results:

Compared with preinjury, ACL normalized quadriceps peak torque of the involved limb (difference = -7%), SLCMJ height (difference = -12.08%), and Reactive Strength Index modified (RSImod) (difference = -5.04%) were reduced after ACL reconstruction. No significant reductions in CMJ height, RSImod, and relative peak power were indicated at RTS in the ACL group when compared with preinjury values, but deficits were present relative to controls. The uninvolved limb improved quadriceps (difference = 9.34%) and hamstring strength (difference = 7.36%) from preinjury to RTS. No significant differences from baseline were shown in SLCMJ height, power, and reactive strength of the uninvolved limb after ACL reconstruction.

Conclusion:

Strength and power in professional soccer players at RTS after ACL reconstruction were often reduced compared with preinjury values and matched healthy controls.

Clinical Relevance:

Deficits were more apparent in the SLCMJ, suggesting that dynamic and multijoint unilateral force production is an important component of rehabilitation. Use of the uninvolved limb and normative data to determine recovery may not always be appropriate.
Effects of a gap between the central and surrounding regions with luminance gradients on the feeling of being dazzled
Authors: Hanada Mitsuhiko
Published: May 2023

The feeling of being dazzled is evoked by images consisting of an achromatic uniform center, surrounded by regions with luminance gradients. As the perceptual distinctness of the central region has been suggested to contribute to the feeling of being dazzled, we examined the effects of a gap between the central and surrounding regions on the feeling of being dazzled. The stimulus comprised a disk with uniform luminance surrounded by an annulus, of which the luminance was decreased from the inner boundary to the periphery. Three luminance profiles (linear, logistic, and inverse-logistic) of the surrounding luminance ramps were used. The distinctness of the disk decreased in the order of logistic, linear, and inverse-logistic profiles. The luminance of the disk, the maximum luminance of the annulus, and the gap size were also varied. When the luminance continuously transitioned from the disk to the annulus, the feeling of being dazzled was stronger for the inverse-logistic annulus luminance profile, compared with the logistic and linear profiles without a gap; however, it was not different for the three profiles with a gap. Further, the feeling of being dazzled increased when a gap was introduced for the logistic and linear profiles, but not for the inverse-logistic profile. These results suggest that the feeling of being dazzled was reduced by the perceptual indistinctness of the central disk for the logistic and linear annulus luminance profiles, while the gap restored the feeling of being dazzled by making the central disk perceptually distinct.
The changing policy ideals for parental cooperation in early childhood education and care
Authors: Schmidt Lene S. K. , Alasuutari Maarit
Published: May 2023

How parents spend time with their children, what they teach their children and how they raise them in the early years have again become topics of policymaking and public debate. There is an intensive discussion about parental involvement in early childhood education and care (ECEC). The Organisation for Economic Co-operation and Development’s Starting Strong series provides ECEC policy guidelines for national governments that include guides for parental involvement. With inspiration from the sociocultural policy approach, this paper suggests that there has been a shift in the Starting Strong series from underlining policy ideals for parental partnership to focussing on the learning environment. This paper examines how these transnational ideals (re)appear, transform and shift in the ECEC policy documents released in the first two decades of the 21st century in two Nordic countries: Denmark and Finland. Both Nordic countries have been involved in the Starting Strong series since the turn of the millennium. The paper also outlines how transnational ideals have become entangled in policy documents in these Nordic contexts in varied ways and how parental involvement is politicised across each of the two countries. We argue that this politicisation not only marks an intensification in parenting but also attempts to institutionalise the ECEC–family relationship, implying that the parent as well as the child must be enlightened. Thus, we seek to question the process of problematising the parent and the child’s home in the policies and to enable new thinking and action to address this issue.
The geopolitics of queer solidarity
Authors: Kearns Gerry
Published: May 2023

Responding to the parallel that Tucker draws between the divergent geopolitical accounts of the decline of British power from the late-nineteenth century and the focus he proposes for sexuality in accounts of the current decline of US power, this commentary reconsiders the geopolitics of the solidarities around sexuality that Tucker highlights. I find the geopolitics of aid too colonial in their intent and effects to be called a solidarity. I extend Tucker's focus on homonationalism to consider how conservative sexualities are complicit in the modern rise of autocracy and incipient fascism.
Vitamins and minerals, education, and self-care need during preconception to 1000 days of life in Southeast Asia: An expert panel opinion
Authors: Jaisamrarn Unnop , Esteban-Habana Maria Antonia , Padolina Christia S , Decena Ditas Cristina D , Dee Marlyn T , Damodaran Premitha , Bhaskaran Vinodhini , Garg Vandana , Dorado Egbert , Hu Henglong
Published: May 2023

Addressing maternal malnutrition and its drivers is paramount in Southeast Asia. This article summarizes the key clinical learnings and evidence-based opinions from the experts to understand the need for vitamins and minerals supplementation, education, and self-care from preconception to the first 1000 days of life, which warranted further attention since COVID-19 pandemic. Evidence describing the importance of vitamins and minerals during preconception, pregnancy, and lactation stages was identified using literature databases. A pre-meeting survey was conducted to determine the current practices and challenges in Southeast Asia. Based on the literature review and clinical experience, experts defined the topics, and an online meeting was held on 13th July 2021. During the meeting, nine experts from Southeast Asia provided evidence-based opinion on the vitamins and minerals supplementation, education, and self-care need during preconception, pregnancy, and lactation stages. The expert opinions underpin maternal malnutrition as a prevalent issue and discuss appropriate interventions and prevention strategies for women in Southeast Asia. The recent pandemic further impacted nutrition status, pregnancy, and neonatal health outcomes. The expert panel emphasized a need to improve existing inadequacies in education, self-care, and social support, and discussed the role of policymakers in addressing the barriers to dietary changes. As inadequacies in regular vitamins and minerals supplementation, education, and self-care for women of reproductive age implicate maternal and child health outcomes, there is an urgent need for addressing malnutrition concerns in this population. Thus, a strong partnership between policymakers, healthcare professionals, and other relevant sectors is required.
Effectiveness of workplace-based interventions to promote wellbeing among menopausal women: A systematic review
Authors: Rodrigo Chithramali Hasanthika , Sebire Elinor , Bhattacharya Sohinee , Paranjothy Shantini , Black Mairead
Published: May 2023

Menopausal symptoms are known to affect quality of life and work productivity. This systematic review aimed to describe the range and effectiveness of workplace-based interventions for menopause. MEDLINE, PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PsycINFO, EconLit, and SCOPUS were searched from the inception until April 2022. Quantitative interventional studies evaluating physical/virtual workplace-based interventions aiming to improve well-being, work, and other outcomes, that involved women in menopausal transition, or their line managers/supervisors were eligible for inclusion. Two randomized controlled trials and three uncontrolled trials, comprising 293 women aged 40–60 years and 61, line managers/supervisors, were included in the review. Results were narratively synthesized due to the heterogeneity of interventions and outcomes and we found that only a limited range of interventions have been evaluated for their ability to support women going through menopausal transition in the workplace. Self-help cognitive behavioural therapy (CBT); Raja yoga; and health promotion (involving menopause consultations, work–life coaching and physical training) improved menopausal symptoms significantly. Self-help CBT was associated with a significant improvement in mental resources for work, presenteeism, and work and social adjustment. Awareness programs significantly improved knowledge and attitudes of both employees and line managers/supervisors about menopause. The interventions have mostly been evaluated in small studies with selected populations but have improved menopausal symptoms and work outcomes. A customizable menopause wellbeing intervention package incorporating these evidence-supported interventions should be developed and implemented on a wider scale within organizations alongside robust evaluation of its effectiveness.
Assessment of functionalities and attitude toward telemedicine for patients with cardiovascular disease
Authors: Knaepen Lieselotte , Falter Maarten , Scherrenberg Martijn , Dendale Paul , Desteghe Lien , Heidbuchel Hein
Published: May 2023

Introduction

Many patients with cardiovascular diseases are only seen by a physician once or twice a year unless urgent symptoms. Recent years have shown an increase in digital technologies to follow patients remotely, that is, telemedicine. Telemedicine can be supportive for follow-up of patients at continuous risk. This study investigated patients’ attitude toward telemedicine, the defined features they consider important and future willingness to pay.

Methods

Cardiology patients with various types of prior telemedicine follow-up or who never had a telemonitoring follow-up were included. A new self-developed survey was implemented electronically and took 5–10 min to complete.

Results

In total, 231 patients (191 telemedicine [T] and 40 controls [C]), were included. Most participants owned a smartphone (84.8%) and only 2.2% of the total participants did not own any digital device. The most important feature of telemedicine cited in both groups was personalization (i.e., personalized health tips based on medical history, 89.6%; personalized feedback on entered health parameters 86.1%). The most important motivating factor for the use of telemedicine is recommendation by a physician (84.8%), while the reduction of in-person visits is a minor reason (24.7%). Only half of the participants (67.1%) would be willing to pay for telemedicine tools in the future.

Conclusion

Patients with cardiovascular disease have a positive attitude to telemedicine, especially when it allows for more personalized care, and when it is advocated by the physician. Participants expect that telemedicine becomes part of reimbursed care. This calls for interactive tools with proven efficacy and safety, while guarding unequal access to care.
Autoimmune Hepatitis Disguised as Iron Overload Syndrome: Diagnostic Dilemma in a Nigerian Man
Authors: Ugonabo Onyinye , Chudy-Onwugaje Kenechukwu
Published: May 2023

Autoimmune hepatitis (AIH) is an extremely rare cause of chronic liver disease (CLD) in sub-Saharan Africa—there have only been 3 reported cases of AIH in Nigeria, a country of about 200 million people. We report the first case of AIH in a male patient in Nigeria and highlight its unusual presentation. A 41-year-old man with jaundice and malaise for 3 months was referred for evaluation after investigations revealed deranged liver enzymes and a cirrhotic liver. Laboratory evaluation revealed high serum immunoglobulin G, but there was also marked elevation of serum ferritin and transferrin saturation, resulting in a diagnostic dilemma between AIH and an iron overload condition such as hemochromatosis. A liver biopsy was crucial in providing a definitive diagnosis of AIH. Despite its rarity, clinicians should maintain a high index of suspicion for AIH in sub-Saharan Africa and should proceed to a liver biopsy when the cause of CLD is unclear.
Determinants of Antenatal Care Visits in Bangladesh: A Quantile Regression Analysis
Authors: Akter Mst. Bithi , Mahmud Anis , Karim Md. Rezaul
Published: May 2023

Background

Maternal and infant mortality is a major problem in a developing country like Bangladesh and these deaths are mostly related to incomplete antenatal care (ANC) visits. Adequate ANC visits for women are crucial in controlling maternal and infant mortality.

Aims

To investigate factors associated with ANC visits among women of reproductive age (15-49) in Bangladesh using the Bangladesh Demographic Health Survey 2017–2018 (BDHS) data.

Methods

This study included 5012 respondents, of whom 2414 women (48.2%) were complete ANC visits and 2598 women (51.8%) were incomplete ANC visits. Quantile regression was used for analysis indicating that the effects of different covariates functioned differently across the utilization of antenatal care visits. The results revealed the women's educational level, birth order number, sex of household head, and wealth index were highly significant on the lower, middle, and higher quantiles of the number of incomplete ANC visits. Besides, in the higher quantiles (for example, 75% quantile), the place of residence was highly significant. For division variables, Rajshahi, Rangpur, and Khulna were highly significant in lower and middle quantiles, while Dhaka, Khulna, Mymensingh, and Rajshahi were insignificant in higher quantiles.

Conclusions

This study observed that education, wealth index, birth order of children, and place of residence are associated with utilization of ANC visits and significantly influence maternal mortality. These determinations can help healthcare programmers and policymakers to take appropriate policies and programs for complete antennal care visits among pregnant women in Bangladesh. In order to increase the number of ANC visits among women, it is necessary to establish a mutually coordinated and trusting relationship between the government, non-governmental organizations and NGOs.
A Community-Based Cross-Sectional Study on Latrine Utilization and Associated Factors Among Rural Community of East Meskan District, Gurage Zone, Southern Ethiopia
Authors: Zewede Elsabet Negussie , Bekele Nardos Tilahun , Negussie Yohannes Mekuria , Getahun Mihiret Shawel , Gurara Abenet Menene
Published: May 2023

Background

Using sanitary facilities is proven to enhance health and halt the spread of fecal-to-oral disease. Despite efforts to improve the availability of latrine facilities in developing countries like Ethiopia, finding a village that is entirely free of open defecation remains difficult. To determine the need for intervention programs and promote regular latrine usage, local data is essential.

Objectives

This study aimed to assess latrine utilization and associated factors among households in East Meskan District, Southern Ethiopia.

Methods

A community-based cross-sectional study was conducted among 630 households from April 15 to May 30, 2022. A simple random sampling technique was used to select the study households. Data were collected using an interviewer-administered structured questionnaire and an observational checklist. The collected data were then entered into Epi-Info version 7.1 and analyzed using SPSS version 21. In binary logistic regression analysis, independent variables with a P-value < .25 were considered candidates for multiple logistic regression analysis. The association was expressed in odds ratio with a 95% confidence interval (CI), and significance was declared at P-value < .05 in the final model.

Results

The magnitude of latrine utilization was 73.3% (95% CI: 69.7, 76.8) in the study district. Husband being family head (adjusted odds ratio [AOR] = 12.9; 95% CI: 5.78 ,28.90), being female (AOR = 16.4; 95% CI: 6.52, 41.27), family size less than 5 (AOR = 24.2; 95% CI: 11.49, 51.09), absence of school children (AOR = 0.3; 95% CI: 0.13, 0.51), and greater than 2 years since latrine was constructed (AOR = 14; 95% CI: 7.18, 27.41) had a significant association with latrine utilization.

Conclusion

In this study, utilization of latrines was low compared to the national target plan. Family head, sex, family size, presence of school children, and length of years in which the latrine was constructed were factors associated with latrine utilization. Thus, regular supervision of early latrine construction and utilization in communities is essential.
Unsorted Significance: Examining Potential Pathways to Extreme Political Beliefs and Communities on Reddit
Authors: Mann Marcus , Zulli Diana , Foote Jeremy , Ku Emily , Primm Emily
Published: May 2023

Violent political extremists often point to online communities as motivating their behavior. However, researchers studying online exposure to extremism through structural mechanisms such as algorithms have not found strong evidence of their influence. At the same time, models of offline radicalization processes emphasize the importance of personal motivations, such as desire for significance and community, but do not fully account for online contexts. The authors integrate these approaches, which are both interested in worsening political extremism, asking, (1) What are the pathways to extreme content and communities online? and (2) What are the perceptions of extremism in online communities? Through interviews with politically active Redditors, the authors identify three motivations for initial engagement with fringe political communities: political unsorting of the self, political exceptionalism, and virtuous participation. The authors argue these motivations are potentially important seeds of political extremism and discuss the implications for supporting healthy political discourse online.
Endoscopy and Antireflux Surgery: A Technical Review of Pre- and Postoperative Evaluation and Recognizing Patterns of Failure
Authors: Dunn Colin P. , Eriksson Sven E. , Jobe Blair A. , Ayazi Shahin
Published: May 2023

Endoscopic evaluation after antireflux surgery is a challenge, due to the complexity of anatomy, variations in anatomical repairs, and the various patterns of failure. Studies have demonstrated that endoscopy reports of postoperative examinations are often inaccurate and inconsistent. The key to consistent high quality endoscopic examinations of the integrity of an antireflux surgery is a sound foundation in the native anatomical gastroesophageal junction and an understanding of the anatomy of the various postoperative configurations. This review will clarify the critical details necessary to perform a detailed endoscopic evaluation of the patient with suspected gastroesophageal reflux, and highlight key features to distinguish the intact repair from the dysfunctional one. It first explores the anatomical components of the native gastroesophageal junction and the unique geometric architecture that manifests in the physiologic reflux barrier. Then details the essential structures to evaluate and techniques to perform in an endoscopic examination prior to an antireflux surgery. It then systematically examines the altered anatomy and postoperative changes in endoscopic appearance after Nissen, Toupet, and Dor fundoplication, Collis gastroplasty, magnetic sphincter augmentation, and transoral incisionless fundoplication. Finally, to aid in the endoscopic diagnosis of specific dysfunction, it discusses the various patterns of failure after antireflux surgery, their characteristic endoscopic appearances, and the most useful adjunct testing modalities to augment the endoscopic examination when diagnosis is unclear.
Unilateral Severe Condylar Resorption Following Internal Fixation in Bilateral Mandibular Condylar Fracture
Authors: Sasaki Ryo , Sangu Miyamoto Noriko , Okamoto Toshihiro
Published: May 2023

Study Design

Case Report

Objective:

A severe condylar resorption following internal fixation of the mandibular condylar fracture is rarely reported.

Methods

A 35-year-old female caused bilateral condylar base fracture due to fall. She had no connective tissue autoimmune disease, no temporomandibular joint (TMJ) problems, and no history of the orthodontic treatment. Each fractures of condyles were fixed by 2 none-locking titanium miniplates on ideal lines of the osteosynthesis.

Results:

6 months after surgery, although patient showed no malocclusion and no TMJ pain, panoramic X-ray showed left side condylar head resorption. Twelve months after surgery, bilateral plate removal was performed. Twenty-six months after internal fixation, panoramic X-ray showed bone formation at the left side of the condylar head. Magnetic resonance imaging of the TMJ showed left TMJ disc displacement without reduction and severe deformity of the left condylar head.

Conclusions

The condylar resorption might be caused by increasing functional loading due to new position of the condyle following osteosynthesis. Possible contributors for condylar resorption following osteosynthesis were: (1) internal fixation in bilateral condylar fracture, (2) disc displacement without reduction, and (3) female patient (hormonally-mediated theory, eg estrogen). However, the mechanize of condylar resorption was unclear and the further studies were necessary.
LSC17 score complements genetics and measurable residual disease in acute myeloid leukemia: an ALFA study
Authors: Vasseur Loïc , Fenwarth Laurène , Lambert Jérôme , de Botton Stéphane , Figeac Martin , Villenet Céline , Heiblig Maël , Dumas Pierre-Yves , Récher Christian , Berthon Céline , Lemasle Emilie , Lebon Delphine , Lambert Juliette , Terré Christine , Celli-Lebras Karine , Dombret Hervé , Preudhomme Claude , Cheok Meyling , Itzykson Raphael , Duployez Nicolas
Published: May 2023

Whether the LSC17 gene expression can improve risk stratification in the context of next generation sequencing–based risk stratification and measurable residual disease (MRD) in patients with intensively treated AML has not been explored. We analyzed LSC17 in 504 adult patients prospectively treated in the ALFA-0702 trial. RUNX1 or TP53 mutations were associated with higher LSC1 scores while CEBPA and NPM1 mutations were associated with lower scores. Patients with high LSC17 scores had a lower rate of complete response (CR) in a multivariable analysis (odds ratio, 0.41; P = .0007), accounting for European LeukemiaNet 2022 (ELN22), age, and white blood cell count (WBC). LSC17-high status was associated with shorter overall survival (OS) (3-year OS: 70.0% vs 52.7% in patients with LSC17-low status; P < .0001). In a multivariable analysis considering ELN22, age, and WBC, patients with LSC17-high status had shorter disease-free survival (DFS) (hazard ratio [HR], 1.36; P = .048) than those with LSC17-low status. In 123 patients with NPM1-mutated AML in CR, LSC17-high status predicted poorer DFS (HR, 2.34; P = .01), independent of age, WBC, ELN22 risk, and NPM1-MRD. LSC-low status and negative NPM1-MRD identified a subset comprising 48% of patients with mutated NPM1 with a 3-year OS from CR of 93.1% compared with 60.7% in those with LSC17-high status and/or positive NPM1-MRD (P = .0001). Overall, LSC17 assessment refines genetic risk stratification in adult patients with AML treated intensively. Combined with MRD, LSC17 identifies a subset of patients with NPM1-mutated AML with excellent clinical outcome.
Empagliflozin improves renal ischemia–reperfusion injury by reducing inflammation and enhancing mitochondrial fusion through AMPK–OPA1 pathway promotion
Authors: Yang Wenbo , Li Xiaoli , He Liujie , Zhu Shuyang , Lai Shicong , Zhang Xiaopeng , Huang Zixiong , Yu Biyue , Cui Chunping , Wang Qiang
Published: May 2023

Background

Renal ischemia–reperfusion injury (IRI) is one reason for renal transplantation failure. Recent studies have shown that mitochondrial dynamics is closely related to IRI, and that inhibition or reversal of mitochondrial division protects organs against IRI. Optic atrophy protein 1 (OPA1), an important factor in mitochondrial fusion, has been shown to be upregulated by sodium-glucose cotransporter 2 inhibitor (SGLT2i). Also, the antiinflammatory effects of SGLT2i have been demonstrated in renal cells. Thus, we hypothesized that empagliflozin could prevent IRI through inhibiting mitochondrial division and reducing inflammation.

Methods

Using hematoxylin–eosin staining, enzyme linked immunosorbent assay (ELISA), flow cytometry, immunofluorescent staining, terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) staining, real-time PCR, RNA-sequencing, and western blot, we analyzed renal tubular tissue from in vivo and in vitro experiments.

Results

Through animal experiments and sequencing analysis, we first confirmed the protection against IRI and the regulation of mitochondrial dynamics-related factors and inflammatory factors by empagliflozin pretreatment. Then, through hypoxia/reoxygenation (H/R) cellular experiments, we confirmed that empagliflozin could inhibit mitochondrial shortening and division and upregulate OPA1 in human renal tubular epithelial cell line (HK-2) cells. Subsequently, we knocked down OPA1, and mitochondrial division and shortening were observed, which could be alleviated by empagliflozin treatment. Combined with the previous results, we concluded that OPA1 downregulation leads to mitochondrial division and shortening, and empagliflozin can alleviate the condition by upregulating OPA1. We further explored the pathway through which empagliflozin functions. Related studies have shown the activation of AMPK pathway by empagliflozin and the close correlation between the AMPK pathway and OPA1. In our study, we blocked the AMPK pathway, and OPA1 upregulation by empagliflozin was not observed, thus demonstrating the dependence of empagliflozin on the AMPK pathway.

Conclusion

The results indicated that empagliflozin could prevent or alleviate renal IRI through antiinflammatory effects and the AMPK–OPA1 pathway. Ischemia–reperfusion injury is an inevitable challenge in organ transplantation. It is necessary to develop a new therapeutic strategy for IRI prevention in addition to refining the transplantation process. In this study, we confirmed the preventive and protective effects of empagliflozin in renal ischemia–reperfusion injury. Based on these findings, empagliflozin is promising to be a preventive agent for renal ischemia–reperfusion injury and can be applied for preemptive administration in kidney transplantation.