bluuebunny/crossref_metadata_2025 huggingface dataset:
The economics of second-home tourism: Are there expenditure reallocation effects from accommodation savings?
Authors: Boto-García David , Baños Pino José Francisco
Published: May 2023

Second-home tourism is a popular tourism activity by which people spend leisure time away from home at second residences. Given the budget constraint, savings from not having to pay for the accommodation might produce expenditure reallocation effects on other items. This paper examines the differences in expenditure between tourists who stay at market accommodations versus those at second homes considering distinct categories. Using microdata for around 37,000 tourists in Spain travelling in the summer periods of 2017, 2018 and 2019, we estimate Craggit-type regressions to study potential reallocation effects in recreational activities, bars and restaurants, and other items including purchases at supermarkets and goods for personal care. We find that tourists at second homes spend significantly less in bars and restaurants, tourism activities and other items. There is no evidence of reallocation effects in expenditure at destination, suggesting that the economic contribution of second-home tourism is lower than typically assumed.
Exploring social stages of play through eye to I© intervention model
Authors: Schuchert Sara Ann , Khattar Shivangi , Tekkar Purva , Rathour Aastha , Dawar Savita , Gupta Parul
Published: May 2023

The study explores the role of the Eye to I© intervention model in facilitating advancement through social stages of play in which skills contribute to the quality of social interaction and communication in children with autism. Data were collected on 11 participants, ages of 2–6 years, formally diagnosed with autism, receiving Eye to I© Social Communication therapy at Potentials Therapy Center, New Delhi, India. Eye to I© is developed in-house at Potentials and is further discussed in the paper. All participants attended a form of group intervention. A mixed-method design included quantitative measures administered pre and post intervention (Communication DEALL Developmental Checklist, Communication Matrix) and video coding of Social Communication sessions. Qualitative measures were semi-structured parent interviews conducted at the end of intervention. Thematic analysis and quantitative statistical analysis results show that by the end of the Eye to I© intervention period children engaged in social stages of play of greater developmental complexity and showed increased scores in assessments of social skills as well as generalization of skills. This suggests that skill acquisition necessary to directly support two diagnostic criteria areas of autism as per DSM-V; i.e., communication and social interaction occurred during the period of intervention.
‘It takes a long time to become young’: A critical feminist intersectional study ofVogue’s Non-Issue
Authors: Kenalemang-Palm Lame M
Published: May 2023

Older female celebrities are increasingly visible in popular media culture, but what kinds of representations are being offered? By deploying a feminist intersectional perspective and adopting Multimodal Critical Discourse Analysis (MCDA), this article interrogates how British Vogue’s Non-Issue communicates ideas and values about ageing and how the magazine constructs discourses through which women’s ageing is understood. The analysis shows that the Non-Issue represents older women as radical and empowered subjects. The rhetoric of freedom and choice, central to postfeminism, is prominent in the magazine and aligns with neoliberal discourses of successful ageing. Such discourses encourage women to confine themselves to never-ending, rigid forms of self-surveillance, self-monitoring and self-disciplining that ultimately subject the older female body to a ‘new’ set of bodily inscriptions and prescriptions that reinforce patriarchal standards of beauty. These standards of beauty are, however, challenged in the magazine through a recuperated do-it-yourself discourse of punk spirit rebellion that works to commodify women’s empowerment, yet still reduces women to how they look.
A systematic literature review of the motivations to share fake news on social media platforms and how to fight them
Authors: Melchior Cristiane , Oliveira Mírian
Published: May 2023

This review aims (a) to investigate the motivations to share fake news on Social Media Platforms (SMPs) according to the Self-Determination Theory (SDT); (b) to identify the solutions to fight these motivations and the agents in charge of implementing them; and (c) the user’s role in this process. We reviewed 64 journal articles published up to April 2022. Misinformation belief and entertainment stood out as the most cited intrinsic motivations, while self-promotion, conspiracy theory, and political ideology were the most cited extrinsic motivations in the reviewed literature. The main solutions to fight fake news spreading on SMPs are improving users’ digital literacy, refining interventions, rating headlines, and sources, and promoting users’ engagement to consume content sustainably. These interventions should be adopted by four agents: governments, SMPs, civil society, and private health organizations. However, the role of SMP users themselves is critical in this process.
Incremental learning BiLSTM based on dynamic proportional adjustment mechanism and experience replay for quantitative detection of blade crack propagation
Authors: Shen Junxian , Ma Tianchi , Song Di , Xu Feiyun
Published: May 2023

In the traditional quantitative detection model for blade cracks in centrifugal fan, it is assumed that the data distribution is fixed or stable. However, the new data brought by the crack propagation would break the stable distribution, thereby disturbing the old data, and resulting in a decrease in the detection performance of the model. To overcome catastrophic forgetting and reduce the extra computational cost of retaining intact old data, a quantitative detection method based on incremental learning bidirectional long short-term memory (BiLSTM) with dynamic proportional adjustment mechanism and experience replay for blade crack propagation is proposed. First, a basic BiLSTM model is constructed by inputting the data of cracks with a length of 0–5 mm. Second, the fully connected layer features in the model are selected for t-distributed stochastic neighbor embedding (t-SNE) dimensional reduction, and the Kullback–Leibler divergence is used as an indicator of feature distribution evaluating the representative old data. Third, a dynamic proportional adjustment mechanism for the old data retention proportion is constructed according to the feature distribution index and the model detection accuracy. Finally, the data of the crack with a length of 6–10 mm are gradually input to proceed with the incremental learning of the model. Verified by the measured data of the centrifugal fan, the model can adjust the retained number of old crack length data dynamically, and import new crack length data for incremental learning, making it characterized by high detection accuracy, stability, and plasticity for the quantitative detection of crack length propagation in blades.
Examining Cybersexism in Online Gaming Communities: A Scoping Review
Authors: Vergel Pablo , La parra-Casado Daniel , Vives-Cases Carmen
Published: May 2023

Cybersexism in the context of online gaming communities, as epitomized by the Gamergate incident back in 2014, has been an issue for a while for gamer women, yet it has not received proper attention. In this scoping review, we have aimed to assess its main characteristics, its consequences for gamer women, its triggers and predictors, and related prevention and mitigation policies provided by the existing research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines were applied to the design of the scoping review. Empirical studies were accessed via database searches. The following databases were prospected: Scopus, ProQuest, Web of Science, PsycINFO, PubMed, and ACM from March to May 2021. A total of 33 studies were included in the final analysis after database searching, filtering, and snowballing. Most of the selected studies (66%, n = 22) were focused on the manifestations of cybersexism in gaming communities, with gender-driven trash-talking being the main one. The main drivers and triggers behind cybersexist behaviors were also the research topic in 66% ( n = 22) of the studies and the consequences and coping strategies were studied in 52% ( n = 17) of the articles. Furthermore, 12% ( n = 4) of the studies assessed policies and actions to prevent cybersexism. Cybersexism and its manifestations are a reality that conditions gamer women, provoking avoidance and ultimately withdrawal from gaming and, therefore, creating inequality, impairing full digital citizenship, and widening the digital gender gap.
Study on terahertz spectrum variation of inner package with different wrapped objects
Authors: Wang Jie , Yan Shihan , Peng Liang , Zhang Hua , Zhu Lianghong , Long Sha , Wu Hao , Zhang Xiaoxuan
Published: May 2023

Terahertz (THz) nondestructive testing has emerged as a promising tool for public security check due to its superior detection accuracy and sensitivity for hidden objects under clothing. However, it is unknown if material composition and textile structure of clothing will influence the THz spectrum of the hidden objects. In this paper, the THz time domain spectroscopy (THz-TDS) was used to detect several natural and artificial fabrics containing pure amino acids with characteristic absorption peaks between 0.2 and 1.6 THz. The results show that the absorption peaks of AAs of various cloth materials have different degrees of decrease and redshift. In addition, the absorption peaks of the THz spectrum disappear when the textile structure is destroyed. Moreover, the simulation results also verify that the textile structure has an obvious effect on the THz field distribution. In this sense, it is necessary to analyze the material composition and textile structure when detecting hidden objects under clothing using the THz signal.
“Hair: In Three Styles”
Authors: LeBlanc Loo Rosalynde
Published: May 2023

In this creative, nonfiction piece, the author embodies a poetic autoethnography that explores the politics of Black hair and skin color in shifting socio-cultural contexts across 40 years. The exploration is not just about hair, but the politics of hair that are rooted in social constructions of beauty, gender, identity, and the relationality of living and loving across time and bodies. Here, the notion of style is explored as the politics of preference and desire; as a technique of doing, of caring for oneself, of being and being seen; as a way of remembering; as evidence of choices having been made.
Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in a Case of Ultra-High Risk for Psychosis With Emotional Comorbidity
Authors: Peláez Trinidad , López-Carrillero Raquel , Subirana-Mirete Judit , Ochoa Susana , Osma Jorge
Published: May 2023

This case study aims to describe the application of the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders in the case of a 30-year-old patient with a diagnosis of Ultra-high Risk for Psychosis (UHR) and comorbid anxiety and depression. UP is a psychological intervention that uses cognitive-behavioral techniques whose objective is to reduce emotional dysregulation, which is one of the transdiagnostic mechanisms of emotional disorders. UP has demonstrated its efficacy in samples of patients with emotional disorders. Frank was a 30-year-old man diagnosed with UHR and other emotional disorders (major depressive disorder, bulimia nervosa, generalized anxiety disorder, and social anxiety disorder) who underwent the UP intervention in 15 group and online sessions, lasting 2 hours each, over the course of 4 months. At the 6-month follow-up evaluation, Frank presented significant improvement in all emotional and functioning variables: anxious and depressive symptoms, negative and positive affect, neuroticism and extraversion, emotional dysregulation, maladjustment, and quality of life. There was also a reduction in subthreshold psychotic symptoms. Frank no longer met the criteria for any emotional disorder. We also found an improvement trend, although not significant, in other variables such as insight and cognitive biases measured with specific questionnaires for psychosis. Frank attended all treatment and follow-up sessions and rated the program very positively. UP may be a clinically useful treatment for young people with comorbid UHR and emotional disorders in the early stages of mental health illnesses that could improve clinical and functional outcomes.
Impact of Time to Fixation on Outcomes of Operative Treatment of Intra-articular Distal Radius Fractures
Authors: Grier A. Jordan , Chen Kallie J. , Paul Alexandra V. , Green Cynthia L. , Richard Marc J. , Ruch David S. , Pidgeon Tyler S.
Published: May 2023

Background:

The incidence of operative treatment of distal radius fractures (DRFs) has increased recently, but the optimal timing for surgical fixation remains unclear. We hypothesized that: (1) an increase in time to fixation of intra-articular DRFs would increase the likelihood of postoperative complications; and (2) increased time from injury to fixation would lead to longer surgical time and worse range of motion (ROM) outcomes.

Methods:

We retrospectively reviewed 299 fractures in 284 adult patients who underwent open reduction and internal fixation (ORIF) of a closed, intra-articular DRF at our institution over a 10.5-year period. Demographic information, time to surgery (TTS) from injury, surgical time, tourniquet time, complications, and final postoperative ROM were collected for logistic regression modeling to predict the risk of postoperative complication.

Results:

Twenty-seven (9.0%) patients experienced postoperative complications. The median TTS (Q1-Q3) for all patients was 7.0 (4.0-12.0) days. Patients who experienced an early postoperative complication had significantly longer median TTS (10.0 days) than those who did not (7.0 days). Patients with longer TTS were more likely to experience a complication (odds ratio, 1.11; 95% confidence interval, 1.04-1.19; P = .006). Tourniquet time and final wrist ROM were not related to TTS. A logistic regression analysis found that early complication rate doubles at 7.0 days after injury (from 3.5% to 6.9%).

Conclusions:

Patients with operative intra-articular distal radius fractures should ideally be fixed within 7 to 10 days of injury to minimize the risk of early postoperative complications. The tourniquet time and final ROM were not associated with time to surgery.
Beneficial Effect of Rosuvastatin Therapy on Spleen Injury Induced by Gamma Irradiation in Rats: Targeting Nrf2/EPRE Pathway
Authors: Fahim Thanaa M. , Mohamed Marwa Abd EL-Hameed , Abdelrahman Sahar S. M. , Lotfy Dina M.
Published: May 2023

Purpose

The present study investigates the new approach of rosuvastatin (RUV) administration as a drug for the management of spleen injury induced by gamma irradiation.

Main Methods

Forty rats were used and divided equally into 4 groups: control group, irradiated group, IRR + rosuvastatin group (10 mg/Kg b. wt), and IRR + rosuvastatin group (20 mg/kg b. wt) for 7 days orally.

Results

The possible curative effect can be illustrated via the improvement of hematopoietic cell count (Hb, RBCs, and WBCs) and oxidative stress markers (MDA and GST) in addition to biochemical parameters including [heme oxigenase-1 (HO-1), nuclear erythroid 2-related factor (Nrf2), NOD-, LRR- and pyrin domain- containing protein 3 (NLRP3) inflammasome] and immune assay of nuclear factor kappa beta (NF-kB P65) and inducible nitric oxide synthase (iNOS). Histological pictures emphasize the biochemical findings. Rosuvastatin treatments by using two different doses improve the tested parameters. High-dose administration of RUV (20 mg/kg p.o.) recorded better results than the low dose (10 mg/kg p.o.).

Conclusion

Our results suggested that rosuvastatin reversed the radiation-induced spleen-damaging effects. So, RUV can be introduced to the market as a new therapy for the management of spleen damages.
Association of serum lipid levels and clinical outcomes in early breast cancer patients
Authors: Dong Shuwen , Yu Jing , Chen Xiaosong , Shen Kunwei
Published: May 2023

Background:

The association between dyslipidaemia and breast cancer remains controversial, especially regarding the dynamic changes in lipid levels.

Objectives:

This study aimed to elucidate the role of serum lipid levels and the changes in disease outcomes in patients with breast cancer.

Methods:

The lipid profiles of patients with breast cancer who underwent surgery between 2013 and 2017 were retrospectively reviewed. The lipid profiles comprised triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein. Serum lipid levels were categorized into three groups based on the tertiles. The Wilcoxon test was used to compare changes in serum lipid levels during follow-up. Hazard ratios (HRs) for survival outcomes were estimated using a multivariate Cox regression analysis.

Results:

A total of 3499 women diagnosed with nonmetastatic invasive breast cancer were included in this study, with a median follow-up of 60.4 months. We confirmed that each 1-tertile increased TG at baseline [HR = 1.19, 95% confidence interval (CI) 1.02–1.39] and 1-year follow-up (HR = 1.46, 95% CI 1.07–1.98) led to worse relapse-free survival (RFS). A lower risk of disease relapse was observed with each 1-tertile upregulation in HDL at 1-year follow-up (HR = 0.72, 95% CI 0.56–0.92). Receiving systemic therapies tends to induce an elevation in plasma lipid levels 1 year after surgery, especially in terms of TG. Regarding the prognostic value of dynamic changes in lipid levels, patients with sustained high levels of TG had poorer RFS (HR = 1.90, 95% CI 1.16–3.11), whereas maintaining high levels of HDL led to better survival (HR = 0.60, 95% CI 0.37–0.97).

Conclusion:

High TG at baseline and during follow-up was associated with worse disease outcome in early breast cancer patients. Systemic treatment would lead to an elevation of serum lipid levels. Patients with sustained high HDL level at 1-year follow-up after surgery had a superior prognosis, warranting further clinical evaluation.
First Metatarsal Rotation After Scarf Osteotomy for Hallux Valgus
Authors: Najefi Ali-Asgar , Alsafi Mohammad Khalid , Katmeh Rateb , Zaveri Amit Kamal , Cullen Nicholas , Patel Shelain , Malhotra Karan , Welck Matthew
Published: May 2023

Background

Recurrence after surgical correction of hallux valgus may be related to coronal rotation of the first metatarsal. The scarf osteotomy is a commonly used procedure for correcting hallux valgus but has limited ability to correct rotation. Using weight-bearing computed tomography (WBCT), we aimed to measure the coronal rotation of the first metatarsal before and after a scarf osteotomy, and correlate these to clinical outcome scores.

Methods

We retrospectively analyzed 16 feet (15 patients) who had a WBCT before and after scarf osteotomy for hallux valgus correction. On both scans, hallux valgus angle (HVA), intermetatarsal angle (IMA), and anteroposterior/lateral talus-first metatarsal angle were measured using digitally reconstructed radiographs. Metatarsal pronation angle (MPA), alpha angle, sesamoid rotation angle, and sesamoid position were measured on standardized coronal WBCT slices. Preoperative and postoperative (12 mo) clinical outcome scores (Manchester Oxford Foot Questionnaire and Visual Analogue Scores) were captured.

Results

Mean HVA was 28.6 ± 10.1° preoperatively and 12.1 ± 7.7° postoperatively (P < .001). Mean IMA was 13.7 ± 3.8° preoperatively and 7.5 ± 3.0° postoperatively (P < .001). Before and after surgery, there were no significant differences in MPA (11.4 ± 7.7 and 11.4 ± 9.9°, respectively; P = .75) or alpha angle (10.9 ± 8.0 and 10.7 ± 13.1°, respectively; P = .83). There were significant improvements in sesamoid rotation angle (SRA) (26.4 ± 10.2 and 15.7 ± 10.2°, respectively; P = .03) and sesamoid position (1.4 ± 1.0 and 0.6 ± 0.6, respectively; P = .04) after a scarf osteotomy. There were significant improvements in all outcome scores after surgery. Poorer outcome scores correlated with greater postoperative MPA and alpha angles (r = .76 (P = .02) and .67 (P = .03), respectively).

Conclusion

A scarf osteotomy does not correct first metatarsal coronal rotation, and worse outcomes are linked to greater postoperative metatarsal rotation. Rotation of the metatarsal needs to be measured and considered when planning hallux valgus surgery. Further work was needed to compare postoperative outcomes with rotational osteotomies and modified Lapidus procedures when addressing rotation. Level of Evidence: 4
Early Outcomes of Third-Generation Minimally Invasive Chevron–Akin (MICA) Osteotomy for Symptomatic Hallux Valgus Deformity
Authors: Madi Naji S. , Braunstein Jacob , Fletcher Amanda N. , Doumat George , Parekh Selene G.
Published: May 2023

Hallux valgus is a common progressive forefoot deformity. Although open techniques have shown good outcomes, no technique has been shown to be superior to other techniques. The current third generation of minimally invasive Chevron–Akin (MICA) technique features a percutaneous procedure with a stable internal fixation. The technique used in this study resulted in stable internal fixation; however, 1 screw was used in intramedullary fashion in the majority of cases. The purpose of this study is to review the early outcomes of MICA. Electronic Health Records (EHR) were queried for patients who underwent MICA to treat hallux valgus (HV) deformity, by a single surgeon. The primary clinical outcomes assessed were visual analog pain score (VAS), rate of revision surgery, and recurrence. Radiographic outcomes were assessed including pre and postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and bony foot width. The secondary outcomes included postoperative complications. A total of 91 feet underwent MICA to correct symptomatic HV deformity. The mean age of this cohort was 53.63 ± 15.42 years, mean body mass index (BMI) of 26.81 ± 6.21 kg/m2, mean follow-up of 6.33 ± 6.39 months and 87 feet belonged to female patients. Patients showed significant improvement in VAS and radiographic outcomes at final follow-up, with a mean improvement of 10.70° ± 6.42°, 2.39° ± 3.55°, and 5.30 mm ± 4.23 mm for the HVA, IMA, and bony foot width, respectively. Two patients (2.2%) required revision surgery for nonunion and removal of symptomatic hardware. One patient had a second metatarsal fracture treated nonoperatively. No feet had recurrence, hardware loosening, infection, or scar hypersensitivity. The current study reported on early outcomes for MICA. This technique appears to be effective and safe with no failure of fixation in our patients. We showed in our short-term follow-up, MICA led to significant improvement in pain and radiographic scores.

Levels of Evidence: III, retrospective study
Digital transformation towards a sustainable circular economy: Can it be the way forward?
Authors: Akarsu Tugra Nazli
Published: May 2023

The circular economy became a widely accepted economic model among businesses and policymakers as it aims to maximise resources while reducing waste, and energy usage, and mitigate the impact on climate and the environment. The digitalization and digital transformation of the circular economy make this business model even more sustainable and inclusive by improving resource flow and empowering consumers to make better-informed decisions. This case focuses on how Oddbox—a circular economy enabler company, uses digital transformation to facilitate a food rescue mission and promote sustainable growth. The discussion centres on how digitalization and digital transformation in the circular economy have enabled a more sustainable business model that creates social impact and captures value.
Digitalization Improves Enterprise Performance: New Evidence by Text Analysis
Authors: Ren Chen , Lee Sang-Joon , Hu Chenxi
Published: May 2023

The reform of digitalization has deeply influenced the development mode and production methods of traditional production in China. However, the impact of digitalization on the management performance of Chinese listed companies are not well investigated and there is a gap in the establishment of digitalization effective measurement variable. In order to fill this gap, this article constructs a variable to measure the application degree of “digitalization” at the company level. By analyzing the text of the annual reports of Chinese listed companies from 2009 to 2020, the effective variables to measure “digitalization” are determined. Based on this, the development status and determinants of enterprise digital applications and the impact of digitalization on enterprise performance are discussed. Thus, by analyzing the panel data of these companies, the relationship among the age of the enterprise, the knowledge level of the board of directors, the proportion of fixed assets, the company’s assets, and the degree of enterprise digitalization are evaluated. At last, according to the evaluated results, the relationship between the degree of digitalization and the performance of enterprises is analyzed. In this article, our analysis helps to solve the “IT production paradox” problem, and also to provides data and theoretical support for digitalization to improve corporate performance to a certain extent. Furthermore, the digitalization measurement variable laid out in this article provides a foundation for future research on the relationship between digitalization and corporate performance.
Effects of Teacher Collaboration on Teaching Practices in China and England: A Structural Equation Model With TALIS 2018 Data
Authors: Xie Wei , Sui Yongying , Liu Xinling , Liu Shujie
Published: May 2023

Teacher collaboration has gradually become a common idea in the reform of teacher education all over the world. However, up to now, the current situation of teacher collaboration is still isolated and conservative to a certain extent. How to avoid being mere formality and promote the development of teachers’ cooperative practice effectively has become an urgent problem for educational researchers and practitioners. Based on the data of TALIS 2018, this study focuses on the impact of teacher cooperation on teaching practice in China and the United Kingdom, with teacher self-efficacy playing the mediating role. Above all, SPSS 23.0 was used for data preparation, descriptive statistics, and Pearson product difference correlation analysis. Then, maximum likelihood estimation and robust standard deviation (MLD) were applied to estimate confirmatory factor analysis and structural equation model through Mplus 7.4. In addition, bootstrap self-help sampling method was adopted to test the mediating effect. About the direct effects of teacher collaboration on teaching practices, the results indicated that exchange and co-ordination was positively related to clarity of instruction in both China and England while professional collaboration was not significantly related to clarity of instruction in the two countries. In terms of the mediating role of self-efficacy between teacher collaboration and teaching practices, the study revealed the indirect effects of professional collaboration on three sub-scales of teaching practices exist via teacher self-efficacy in both China and England. Theoretical and managerial implications regarding using teacher self-efficacy as a mediating variable to examine the effect of common collaboration forms on specific teaching practices were discussed. Limitations and further research were also offered.
YouTube as a source of patient information for pterygium surgery
Authors: Ozturkmen Cem , Berhuni Mustafa
Published: May 2023

Background:

Patients use the YouTube platform to get information about pterygium surgery, and this affects the treatment decisions of the patients.

Objectives:

The purpose of this study was to analyze the quality and reliability of YouTube videos as educational resources about pterygium surgery.

Design:

This is a register-based retrospective study.

Methods:

This was a retrospective, record-based study. A YouTube search was performed using the terms ‘pterygium surgery’ and ‘pterygium eye surgery’, resulting in the evaluation of a total of 200 videos. In the end, 122 English-language videos about pterygium surgery were recruited to study. All videos were rated with the DISCERN, the Journal of the American Medical Association (JAMA), and the Global Quality Score (GQS) systems.

Results:

The mean DISCERN, JAMA, and GQS values were 38.9 ± 10.9, 1.8 ± 0.8, and 2.2 ± 1, respectively. The YouTube videos about pterygium surgery had been uploaded by a physician in 63 (51.6%) and non-physicians in 59 (48.4%) cases. There was no significant difference between the two groups in terms of general characteristics and scores.

Conclusions:

Our results show that YouTube videos about pterygium surgery have low quality and credibility and are not sufficient in terms of providing patient information.

Registration:

Not applicable.
Can peace operations mitigate the effect of armed conflict on malnutrition? Evidence from Côte d’Ivoire
Authors: Beardsley Kyle , Beardsley Jessica
Published: May 2023

Armed conflict increases food insecurity leading to malnutrition especially in women, but can peace operations mitigate the increased prevalence of malnutrition in conflict zones? This study uses women’s nutrition outcomes—key indicators of societal health and peace potential in a community—as a lens through which one can understand downstream, long-term, consequences of exposures to violence both with and without the presence of United Nations peacekeepers. Comparing data of adult women in Côte d’Ivoire from the Demographic and Health Surveys, across two waves that cover pre-conflict and post-conflict periods, shows that peace-operation deployments mitigated the relationship between conflict and malnutrition. Exposure to armed conflict in the absence of peace operations is associated with an increased propensity for underweight, while exposure to armed conflict in the presence of peacekeeping troops is not associated with an increased propensity for underweight. A cross-national analysis using data from the Food and Agriculture Organization also confirms that food security, as well as cereal and meat production, in the wake of conflict improves with peace-operation deployments.
Perioperative outcomes in different anesthesia techniques for patients undergoing hip fracture surgery: a systematic review and meta-analysis
Authors: Ma Bo , Xie Haibiao , Ling Huayong , Ma Wuhua
Published: May 2023

Background

Previous studies of the perioperative effects of general and regional anesthesia in adult patients undergoing effects of different anesthesia techniques on patients undergoing hip fracture surgery have not produced consistent results. The aim of this systematic review and meta-analysis was to compare the hip fracture surgery.

Methods

We performed a systematic review and meta-analysis to compare the effects of general anesthesia with regional anesthesia on in-hospital mortality, 30-day mortality, postoperative pneumonia, and delirium in adult hip fracture patients (≥ 18 years). Between January 1, 2022, and March 31, 2023, a systematic search was performed for retrospective observational and prospective randomized controlled studies in PubMed, Ovid Medline, Cochrane Library, and Scopus.

Results

Twenty-one studies including 363,470 patients showed higher in-hospital mortality in the general anesthesia group compared with regional anesthesia (OR = 1.21; 95% CI 1.13–1.29; P < 0.001, n = 191,511). The 30-day mortality (OR = 1.00; 95% CI 0.96–1.05; P = 0.95, n = 163,811), the incidence of postoperative pneumonia (OR = 0.93; 95% CI 0.82–1.06; P = 0.28, n = 36,743) and the occurrence of postoperative delirium in the two groups (OR = 0.94; 95% CI 0.74–1.20; P = 0.61, n = 2861) had no significant difference.

Conclusion

Regional anesthesia is associated with reduced in-hospital mortality. However, the type of anesthesia did not affect the occurrence of 30-day mortality, postoperative pneumonia, and delirium. A large number of randomized studies are needed in the future to examine the relationship between type of anesthesia, postoperative complications, and mortality.
ATF2 loss promotes 5-FU resistance in colon cancer cells via activation of the ATR-Chk1 damage response pathway
Authors: Yang Hao , Huebner Kerstin , Hampel Chuanpit , Erlenbach-Wuensch Katharina , Selvamani Selva Babu , Shukla Vikas , Geppert Carol I. , Hartmann Arndt , Mahadevan Vijayalakshmi , Schneider-Stock Regine
Published: May 2023

Background

The role of ATF2 in colon cancer (CC) is controversial. Recently, we reported that low ATF2 expression is characteristic of highly invasive tumors, suggesting that ATF2 might also be involved in therapy resistance. 5-Fluorouracil (5-FU) is the best-known chemotherapeutic drug for CC, but drug resistance affects its curative effect. To date, the role of ATF2 in the 5-FU response remains elusive.

Methods/Results

For our study, we had available HCT116 cells (wild-type p53) and HT29 colon tumor cells (mutant p53) and their corresponding CRISPR‒Cas9-generated ATF2-KO clones. We observed that loss of ATF2 triggered dose- and time-dependent 5-FU resistance in HCT116 cells by activating the DNA damage response (DDR) pathway with high p-ATRThr1989 and p-Chk1Ser317 levels accompanied by an increase in the DNA damage marker γ-H2AX in vitro and in vivo using the chicken chorioallantoic membrane (CAM) model. Chk1 inhibitor studies causally displayed the link between DDR and drug resistance. There were contradictory findings in HT29 ATF2-KO cells upon 5-FU exposure with low p-Chk1Ser317 levels, strong apoptosis induction, but no effects on DNA damage. In ATF2-silenced HCT116 p53−/− cells, 5-FU did not activate the DDR pathway. Co-immunoprecipitation and proximity ligation assays revealed that upon 5-FU treatment, ATF2 binds to ATR to prevent Chk1 phosphorylation. Indeed, in silico modelling showed reduced ATR-Chk1 binding when ATF2 was docked into the complex.

Conclusions

We demonstrated a novel ATF2 scaffold function involved in the DDR pathway. ATF2-negative cells are highly resistant due to effective ATR/Chk1 DNA damage repair. Mutant p53 seems to overwrite the tumor suppressor function of ATF2.
Enhancing endoscopic foraminal decompression in adult isthmic spondylolisthesis: the potential influence of lateral recess isthmic spur and our case series of an innovative craniocaudal interlaminar approach via unilateral biportal endoscopic spinal surgery
Authors: Wu Tsung-Mu , Kim Moon-Chan , Hwang Jin-Ho , Choi Dae-Jung
Published: May 2023

Background

The NASS guideline cannot recommend any of the surgical treatment options toward adult isthmic spondylolisthesis (AIS) since 2014. After the introduction of endoscopic decompression, instead of treating the spondylolysis itself, treatment can specifically target the refractory radicular pain developed during the degeneration progress without devastating the peripheral soft tissue. However, we noticed that endoscopic transforaminal decompression seems to be less effective in AIS compared to other types of degenerative spondylolisthesis. Thus, we came up with a novel craniocaudal interlaminar approach, utilizing the proximal adjacent interlaminar space to perform bilateral decompression and observed the pathoanatomy of pars defect directly and tried to identify the cause of decompression failure.

Methods

From January 2022 to June 2022, 13 patients with AIS underwent endoscopic decompression via the endoscopic craniocaudal interlaminar approach and were followed up for at least 6 months. Visual Analogue Scale, Oswestry Disability Index and MacNab scores were recorded to monitor patients’ clinical recovery. All endoscopic procedures were recorded and reviewed to illustrate the pathoanatomy.

Results

Four patients required minor revision via the same technique. One of them required it due to incomplete isthmic spur resection, two due to neglected disc protrusion, and the other due to root subpedicular kinking in higher grade anterolisthesis. All patients’ clinical condition improved significantly subsequently. After reviewing the endoscopic video, we have observed that the hook-like, ragged spur originating from the isthmic defect extends beyond the region around the foramen. Instead, it extends proximally into the adjacent lateral recess, resulting in impingement along the fracture edge above the index foramen and, in some cases, even in the extraforaminal area.

Conclusions

The broad spanning isthmic spur extending to the proximal adjacent lateral recess might be the reason why the transforaminal approach yielded less satisfactory results due to the incomplete decompression result from approach related restriction. Our study demonstrated an optimistic outcome by applying decompression from the upper level. Therefore, we propose that the craniocaudal interlaminar approach might be a better route for decompression in adult isthmic spondylolisthesis.
Salivary stimulatory effect of novel low level transcutaneous electro neurostimulator in geriatric patients with xerostomia
Authors: Ramadoss Ramya , Krishnan Rajkumar , Raman Swarnalakshmi , Padmanaban Rajashree , Anbuelangovan Nagarathinam , Eswaramoorthy Rajalakshmanan
Published: May 2023

Background

Xerostomia (dryness of the mouth) is one of the most common long-term consequences of ageing, and it causes a tremendous impact on the function and morphology of the salivary ductal system. As a consequence, it leads to a decrease in the amount of salivary output and also affects the overall quality of life. The purpose of this study was to determine whether electrostimulation using a custom designed transcutaneous electrical nerve stimulation (TENS) device will help to improve the quality of secreted saliva following electrostimulation.

Methods

One hundred thirty-five participants underwent the intervention for three months, twice daily (80 Hz). Pre-intervention and post-intervention unstimulated saliva were collected. Parameters such as salivary pH, cortisol level, salivary antioxidants, total protein, the viscosity of saliva, and microbial carriage were analysed.

Results

Salivary pH, cortisol, microbial cultures, viscosity, and antioxidants showed a significant difference at the end of the 3rd month (p < 0.05). Irrespective of the patient's age, gender, and common underlying systemic illnesses (diabetes and hypertension), a significant change in the quality of the salivary analytes was observed.

Conclusion

The study emphasises the use of a custom designed TENS device in improving the quality of secreted saliva among old patients with oral dryness.
Factors affecting the intention of Iranian rural women to use medicinal herbs
Authors: Saadi Heshmatollah , Jafari Somayeh , Karimi Saeid
Published: May 2023

Background

This study aimed to identify factors affecting the behavioral intention of Iranian rural women to use medicinal herbs. The research model was developed by integrating “dissatisfaction with modern medicine” into the “theory of planned behavior”.

Methods

Data were collected through questionnaire from a sample of 260 Iranian rural women, which were randomly selected. The validity and reliability of the scale were confirmed using expert opinions and Cronbach’s alpha method, respectively.

Results

Based on the results of structural equation modeling, attitude (β = 0.44; p < 0.01), subjective norms (β = 0.27; p < 0.01) and dissatisfaction with modern medicine (β = 0.11; p < 0.05) had significant positive effects on rural women’s intention to use medicinal herbs. In addition, subjective norms indirectly affected rural women’s intention to use medicinal herbs through attitude (β = 0.23; p < 0.01).

Conclusions

Subjective norms was a key factor in determining the intention of Iranian rural women to use medicinal herbs, followed by attitude and dissatisfaction with modern medicine. Therefore, this study could contribute to our understanding on how the intention of Iranian rural women to use medicinal herbs was influenced by different factors.
Longitudinal care continuity and avoidable hospitalization: the application of claims-based measures
Authors: Cheng Shou-Hsia , Chen Chi-Chen , Lin Yueh-Yun
Published: May 2023

Background

Longitudinal continuity between a patient and his/her primary care physician is an important aspect in measuring continuity of care (COC). The majority of previous studies employed questionnaire surveys to patients to measure the continual relationship between patients and their physicians. This study aimed to construct a provider duration continuity index (PDCI) by using longitudinal claims data and to examine its agreement with commonly used COC measures. Then, this study investigated the effects of the various types of COC measure on the likelihood of avoidable hospitalization while considering the level of comorbidity.

Methods

This study constructed a 4-year panel (from 2014 to 2017) of the nationwide health insurance claims data in Taiwan. In total, 328,044 randomly selected patients with 3 or more physician visits per year were analyzed. Two PDCIs were constructed to measure the duration of interaction between a patient and his/her physicians over time. The agreement between the PDCIs and three commonly used COC indicators, the Usual Provider of Care index, the Continuity of Care Index, and the Sequential Continuity Index, were examined. Generalized estimating equations were conducted to examine the association between COC and avoidable hospitalization by the level of comorbidity.

Results

The results showed that the correlations among the three commonly used COC indicators were high (γ = 0.787 ~ 0.958) and the correlation between the two longitudinal continuity measures was moderate (γ = 0.577 ~ 0.579), but the correlations between the commonly used COC indicators and the two PDCIs were low (γ = 0.001 ~ 0.257). All COC measures, both the PDCIs and the three commonly used COC indicators, showed independent protective effects on the likelihood of avoidable hospitalization in three comorbidity groups.

Conclusion

The duration of interaction between patients and physicians is an independent domain in measuring COC and has a significant effect on health care outcomes.
Exploring the organisational structure of networks for exercise oncology provision: a social network analysis of OnkoAktiv
Authors: Voland Annelie , Köppel Maximilian , Peters Stefan , Wiskemann Joachim , Wäsche Hagen
Published: May 2023

Background

Structured exercise programs provide considerable health benefits for cancer patients. Therefore, various OnkoAktiv (OA) networks were established in Germany with the aim to connect cancer patients with certified exercise programs. However, knowledge about the integration of exercise networks into cancer care systems and conditions of interorganisational collaboration is lacking. The aim of this work was to analyse the OA networks to guide further network development and implementation work.

Methods

We used methods of social network analysis within a cross-sectional study design. Network characteristics were analysed such as node and tie attributes, cohesion and centrality. We classified all networks into their level of organisational form in integrated care.

Results

We analysed 11 OA networks with 26 actors and 216 ties on average. The smallest network counted 12 actors/56 ties, the largest 52/530. 76% of all actors operated within the medical/exercise sector, serving 19 different medical professions. In smaller “linkage” networks, several individual professionals were linked “from service to service”, whereas the more integrated networks revealed a core-periphery-structure.

Discussion

Collaborative networks enable the involvement of professional actors from different operational fields. This study provides an in-depth understanding of underlying organisational structures that provides information for further development of exercise oncology provision.

Trial registration

Not applicable, as no health care intervention was performed.
A case report: Marfan syndrome with X trisomy and FBN1 and SDHB mutations
Authors: Lin Jiansheng , Lin Yanyu , Wang Gaoxiong
Published: May 2023

Background

Marfan syndrome (MFS) is a rare autosomal dominant connective tissue disorder affecting the cardiovascular, skeletal, and ophthalmic systems. This report aimed to describe a novel genetic background and treatment prognosis of MFS.

Case presentation

A proband was initially diagnosed with bilateral pathologic myopia and suspected MFS. We performed whole exome sequencing and found a pathogenic nonsense FBN1 mutation in the proband, which confirmed the diagnosis of MFS. Notably, we identified a second pathogenic nonsense mutation in SDHB, which increased the risk of tumours. In addition, the proband karyotype was X trisomy, which may cause X trisomy syndrome. At the 6-month follow-up after posterior scleral reinforcement surgery, the proband's visual acuity improved significantly; however, myopia was still progressing.

Conclusions

We report a rare case of MFS with a X trisomy genotype, a mutation in FBN1 and a mutation in SDHB for the first time, and our findings could be helpful for the clinical diagnosis and treatment of this disease.
The atherogenic index of plasma and carotid atherosclerosis in a community population: a population-based cohort study in China
Authors: Huang Qin , Liu Zeyu , Wei Minping , Huang Qing , Feng Jie , Liu Zunjing , Xia Jian
Published: May 2023

Background

The atherogenic index of plasma (AIP) is an important alternative metabolic biomarker of atherosclerosis and cardiovascular diseases. Nevertheless, the correlation between the AIP and carotid atherosclerosis is unknown among the general population.

Methods

A total of 52,380 community residents, aged ≥ 40 years who underwentcervical vascular ultrasound from December 2017 to December 2020 in Hunan China, were selected for retrospective analysis. The AIP was calculated as a logarithmically converted ratio of triglycerides (TG) to high-density lipoprotein-cholesterol (HDL-C). The participants were divided into AIP quartile groups (Q1-Q4). Logistic regression models and restricted cubic spline analyses were used to examine the association of the AIP with carotid atherosclerosis. Stratified analyses were applied to control for confounding factors. The incremental predictive value of the AIP was further assessed.

Results

After adjusting for traditional risk factors, an increased AIP was associated with a higher rate of carotid atherosclerosis (CA), increased carotid intima-media thickness (CIMT), and plaques [odds ratio, OR (95% confidence interval, CI): 1.06 (1.04, 1.08), 1.07 (1.05, 1.09), and 1.04 (1.02, 1.06) per 1-SD increase in the AIP, respectively]. Compared with those participants in the quartile 1 group, those in the quartile 4 group had a greater risk of CA [OR 1.18, 95% CI (1.12, 1.25)], increased CIMT [OR 1.20, 95% CI (1.13, 1.26)], and plaques [OR 1.13, 95% CI (1.06, 1.19)]. However, we did not observe an association between the AIP and stenosis [0.97 (0.77, 1.23), p for trend = 0.758]. Restricted cubic spline analyses also showed a cumulative increase in the risk of CA, increased CIMT, and plaques but not stenosis severity (> 50%) with an increase of the AIP. Subgroup analyses showed that a more significant association between the AIP and the prevalence of increased CA was detected in younger subjects (aged < 60 years) with a body mass index (BMI) of ≥ 24 and fewer comorbidities. Additionally, the AIP provided incremental predictive capacity over established risk factors for CA, as shown by an improvement in the net reclassification index (NRI) and integrated discrimination index (IDI) (all P < 0.05).

Conclusions

An elevated AIP in a community-based population is associated with a higher rate of CA. the AIP could serve as a potential biomarker for CA risk assessment.