bluuebunny/crossref_metadata_2025 huggingface dataset:
Trimethylamine-N oxide enhances post-stroke depression progression via ROS-p38/MAPK signaling
Authors: Hu Yikui , Liu Yujie , Wang Hua , Wang Xun
Published: December 2024

Introduction

Post-stroke depression (PSD) is one of the common complications after stroke. Trimethylamine-N oxide (TMAO) has been reported to exacerbate brain injury after ischemic stroke, and its expression is positively related to the severity of depressive symptoms. This study was performed to investigate the role and mechanism of TMAO in PSD.

Methods

The classical stroke model was combined with spatial constraint stress to establish a PSD mouse model, and the effect of TMAO on the depression-like behavior of the PSD mouse model was evaluated using the tail suspension test and the forced swimming test. ELISA was employed to measure the concentration of TMAO and cortisol. RT-qPCR, Western blot, and Immunohistochemistry assay were implemented to determine mRNA and protein expression. Endothelial permeability was assessed using the fluorescein isothiocyanate-dextran permeability assay in vitro. Reactive oxygen species (ROS) level was examined with a ROS detection kit.

Results

TMAO dose-dependently exacerbated depression-like behavior, induced the activation of the p38/mitogen-activated protein kinase (MAPK) signaling pathway, downregulated the abundance of tight junction proteins, and resulted in the dysregulation of neurotrophic mediators in the PSD mouse model in vivo. Further, TMAO increased endothelial permeability and activated reactive oxygen species-p38/MAPK signaling. By introducing the p38/MAPK pathway inhibitor SB203580, TMAO was found to downregulate the expressions of tight junction proteins and promoted endothelial permeability via p38/MAPK signaling activation.

Discussion

By activating the ROS-P38/MAPK pathway, TMAO enhanced the permeability of the blood–brain barrier after stroke. These mechanisms resulted in the dysregulation of neurotrophic mediators, ultimately leading to PSD progression.
The Psychological Effects of Guillain-Barré Syndrome: A Grounded Theory Study
Authors: Bell Katie , Summers S. J. , Moffitt Jenna , Hill Geoff
Published: December 2024

Guillain–Barré syndrome is a rare neurological condition. Research has increased our understanding of the etiology, prognosis, and effective medical treatment of the illness. There is a lack of understanding regarding the psychological effects and what could help patients. This study aimed to begin to address this using constructivist grounded theory. Eleven interviews were conducted with participants who had received a diagnosis of Guillain–Barré syndrome in the preceding 4 years. The model that emerged identified two key processes: “Loss, determination, and adjustment” and “The unknown.” “Receiving support,” “Obtaining knowledge,” and “Experiencing hope” assist in navigating these psychological effects. The findings emphasize the all-encompassing effects of Guillain–Barré syndrome, illustrating the need for rehabilitation professionals to alleviate uncertainty and foster practices that could facilitate patients’ navigation through the illness. Recommendations for further research are provided.
Exploring the Correlation Between Palliative Care Training in Brazil and Compassion Fatigue: A Cross-Sectional Study
Authors: Lucio Gabriela Vieira , Rodrigues de Oliveira Lima Gabriela , Dias Faustino Ana Júlia , Alvarez Camila Wenceslau , Marangoni Eliana , Cruvinel Agnes , Cruvinel Thiago , Corrêa da Costa Ribeiro Sabrina , Garcia Alencar Julio Cesar
Published: December 2024

Background

The literature lacks conclusive evidence regarding whether palliative care training confers a protective or predisposing influence on compassion fatigue. The present study hypothesizes that training in palliative care is associated with minor compassion fatigue levels among physicians and an improvement in their confidence in several procedures.

Aim

To explore the physicians experiences with and without palliative care training who work as general practitioners in order to assess the prevalence of compassion fatigue in these groups.

Methods

This is a quantitative and qualitative cross-sectional survey. For data analysis, Mann-Whitney and Pearson’s chi-squared test tests were used considering P < 0.05 for significance.

Results

The majority respondents had no training in palliative care (77.8%), however, 58.3% declared that they cared for at least 1 palliative care patient every 2 shifts - an intermediate frequency in our analysis. Trauma levels among doctors were classified as medium (24 ± 6), burnout as low (19 ± 5) and compassion as medium (41 ± 5). Professionals without training in palliative care had higher rates of burnout ( P = 0.002), but there was no association between training and rates of trauma or compassion.

Conclusions

Doctors with training in palliative care in Brazil showed lower burnout rates when working as general practitioners in secondary hospitals. This could instigate the implementation of educational programs in palliative care at hospitals and the further development of the field so as to improve professionals’ performance at patients’ treatment. There was no difference between Trauma and Compassion scores.
Identifying optimal candidates and interventions in physical therapy and exoskeletal and end-effector robot-assisted gait training for balance, gait, and cognition: A longitudinal study of 190 patients with stroke
Authors: Kim Yunhwan , Kim Heejun , Park Seonmi , Shin Jiwon , Park Haeun , Choi Jongeun , Kim Hansung , Park Myungsook , You Joshua Sung H.
Published: December 2024

Background

Optimal candidates and interventions for advanced robot-assisted stroke gait rehabilitation remain unknown.

Objective

We aimed to determine the optimal therapeutic efficacy for balance, sensorimotor and locomotor functions, daily activity, and cognition between the lower-entering functional ambulation category (L-FAC) and higher-entering FAC (H-FAC) groups.

Methods

190 stroke patients received conventional physical therapy (CPT), exoskeletal robotic-assisted gait training (RAGT), or end-effector RAGT (eRAGT), each comprising 60-min/session, two times per week for 10–20 weeks. Standardized clinical tests included the Fugl–Meyer assessment of the lower extremities, Berg balance scale, FAC, modified Barthel index, and mini-mental state examination. A two-way analysis of variance was performed, with significance set at P < 0.05.

Results

Both groups demonstrated significant improvements. Compared with the H-FAC group, L-FAC group achieved the most notable improvements in sensorimotor function, balance, gait, daily activity, and cognition after RAGT, followed by CPT and eRAGT ( P < 0.05).

Conclusions

RAGT was more effective than CPT and eRAGT on sensorimotor function, balance, and gait function in patients with stroke with L-FAC. We identified the optimal candidates and interventions for balance, gait, and cognition patients with stroke.
Statistical damage model with strain softening for lime-stabilized rammed earth after elevated temperature
Authors: Luo Yi , Ye Chao , Ni Pengpeng , Zeng Zhixing , Liu Yixian
Published: December 2024

Many historical earthen buildings are damaged due to fire exposure in the past. It is important to understand the strength degradation of rammed earth after elevated temperature for guiding the strategy of building protection or rehabilitation. A total of 24 unconfined compression tests are conducted on lime-stabilized rammed earth specimens after elevated temperature up to 700°C. A quasi-linear reduction in strength and stiffness is found for rammed earth with the increase of temperature. At high temperature, the ductility of rammed earth is enhanced, e.g., strain at peak strength of 2.5% and 1.5% at 700°C and 20°C, respectively. Microstructural analyses demonstrate that with the increase of temperature, the specimen becomes more porous with reduced calcium carbonate precipitation, explaining the strength reduction. A new thermal damage model is proposed to describe the behavior of rammed earth after elevated temperature, in which the closure of pores is captured to show unrecoverable deformation, and the skeleton part is simulated using a thermal damage variable in a statistical manner to present the damage evolution (strain softening). By comparing with the measured stress-strain curves, one can confirm that the proposed method can provide effective prediction for the response of rammed earth after elevated temperature.
In situ torque transmissibility frequency response function measurements of a centrifugal pendulum vibration absorber in a torque converter clutch damper
Authors: Jurmu Luke , Robinette Darrell , Blough Jason , Reynolds Craig
Published: December 2024

This investigation details torsional testing and characterization of torque converter clutch (TCC) damper variants containing centrifugal pendulum absorbers (CPAs) utilized in light duty production vehicles. Data collected on a torque converter dynamometer test stand was used to correlate a nonlinear model of the combination TCC damper and CPA when locked with zero relative slip speed. The range of test torques and speeds are related to when driveline, chassis and body noise and vibration concerns are high and the damper-CPA combination are required to provide maximum isolation. To facilitate model correlation efforts, modified configurations of the same torque converter design were procured, enabling separation of damping effects from the CPA and damper springs. Under load, the locked TCC was torsionally excited to acquire torque transmissibility frequency response functions (TTFRFs). The anti-resonance of the CPA was measured, and the viscous damping coefficient estimated. A manual tuning and modified half-power bandwidth method were used to estimate the equivalent viscous damping of the CPA. Additional test cases included torsional excitation amplitude and oil temperature to ascertain differences in CPA response and tuning order. The objective of the investigation is to demonstrate the influence of damper spring and CPA integration, extraction of CPA damping from actual hardware and the utility of including representative damping in model-based design of future damper-CPA assemblies.
Changes in Caregivers’ Use of the Online Medical Record Pre- and Post-COVID: Analysis of the Health Information National Trends Survey, 2018–2022
Authors: Raj Minakshi , Chen TsungYen , Iott Bradley , Anthony Denise
Published: December 2024

Little is known about online medical record (OMR) use among caregivers, including changes in OMR use through the COVID-19 pandemic. This study compares OMR use among caregivers and non-caregivers before and during the COVID-19 pandemic, identifies reasons for non-use, and examines the association between caregiving status and characteristics with OMR use. Secondary data analysis of the nationally representative Health Information National Trends Survey data from 2018 to 2022 ( n = 14,034). Caregivers were more likely to use the OMR post-COVID (51.8%) compared with pre-COVID (44.7%). Caregiving was significantly associated with increased likelihood of OMR use post-COVID (odds ratio = 1.67), but not pre-COVID. The increased use of OMR among caregivers during COVID-19 highlights the potential of OMRs as a support tool for caregivers’ health and well-being. Interventions and policies to improve OMR engagement must address persisting disparities across demographic groups and encourage caregivers’ OMR use to support their role and enhance their personal health management.
Evaluation of cyclin-dependent kinase 4/6 inhibitor-induced serum creatinine elevations in patients with hormone receptor positive breast cancer
Authors: Ly Emily , Howard Frederick M , Chen Nan , Hahn Olwen , Fleming Gini F , Nanda Rita , Patel Shivani , Thimothy Lida , Yang Heng
Published: December 2024

Background

Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6i) have improved the efficacy of endocrine therapy in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer (BC) and are now used in both early-stage and metastatic disease. Recent case reports suggest that pseudo-serum creatinine (Scr) elevations are likely a class effect of CDK4/6i.

Methods

This single-center retrospective analysis included patients aged ≥18 years who received at least one dose of palbociclib, ribociclib, or abemaciclib for the treatment of HR+/HER2- BC in the early or advanced setting. The primary objective was the incidence of pseudo-Scr elevation for each of the three agents. CDK4/6i-induced pseudo-Scr elevation was suspected when the Scr elevation could not be fully attributed to other causes. Secondary endpoints included the grade, onset, duration, and clinical consequences of pseudo-Scr elevation.

Results

143 patients were included. Pseudo-Scr elevation was suspected in patients treated with palbociclib, ribociclib, or abemaciclib, with incidences of 16% (8/50), 14% (6/43), and 20% (10/50), respectively. Rates did not significantly differ between agents ( p = 0.727). Among patients with CDK4/6i-induced pseudo-Scr elevation, all events were grade 1 (8.3%) or 2 (91.7%). The median onset from treatment initiation to first Scr elevation was 33.5, 42, and 21.5 days, for palbociclib, ribociclib, or abemaciclib, respectively.

Conclusion

Pseudo-Scr elevation appears to be a class effect of CDK4/6i, with similar rates of Scr elevation observed across the three agents currently FDA approved.
Genetic testing: practical dos and don’ts for cats
Authors: Lyons Leslie A
Published: December 2024

Practical relevance:

A significant number of genetic variants are known for domestic cats and their breeds. Several DNA variants are causal for inherited diseases and most of the variants for phenotypic traits have been discovered. Genetic testing for these variants can support breeding decisions for both health and aesthetics. Genetic testing can also be used to monitor for the health of, or provide targeted therapy for, an individual cat and, more widely, can progress scientific discovery. Technological improvements have led to the development of large panel genetic testing, which can provide many DNA results for a low cost.

Clinical challenges:

With the development of large panel genetic testing has come companies that can carry out this service, but which company is best to use may not always be clear - more tests are not necessarily better. Usage and interpretation of genetic data and how the results are presented by commercial laboratories may also be confusing for veterinary practitioners and owners, leading to misinterpretations for healthcare, improper genetic counseling, and poor breed and population management.

Evidence base:

The information provided in this review draws on scientific articles reporting the discovery, and discussing the meaning and implications, of DNA variants, as well as information from the Online Mendelian Inheritance in Animals (OMIA) website, which documents all the DNA variant discoveries. The author also provides suggestions and recommendations based on her personal experience and expertise in feline genetics.

Audience:

This review is aimed at general practitioners and discusses the genetic tests that can be performed, what to consider when choosing a testing laboratory and provides genetic testing counseling advice. Practitioners with a high proportion of cat breeder clientele will especially benefit from this review and all veterinarians should realize that genetic testing and genomic medicine should be part of diagnostic plans and healthcare for their cat clients.
Predictive value of preoperative gluteus and iliacus muscle volumes for patient-reported outcomes following total hip replacement: a three-dimensional volumetric analysis
Authors: Ham Dae-Woong , Choi Gil Won , Yoo Yi Sack , Kim Chul-Ho
Published: December 2024

Introduction:

This study aimed to investigate the relationship between hip muscle mass and patient-reported outcomes (PROs) after total hip arthroplasty (THA) surgery for hip disease using 3D volumetric measurements of the gluteus muscle group and iliac muscle.

Materials and Methods:

Between January 2020 and December 2021, 85 patients who had undergone unilateral THA for osteoarthritis or osteonecrosis of the femoral head were enrolled. Using a 3D modeler program, automatically generated 3D reconstructed images of the hip muscles were obtained, and volumetric measurements were performed. Both unadjusted and height (m2)-adjusted muscle volumes of the gluteus maximus (unadjusted volume: GmaxV; adjusted volume: GmaxI), gluteus medius (unadjusted volume: GmedV; adjusted volume: GmedI), gluteus minimus (unadjusted volume: GminV; adjusted volume: GminI), and iliacus (unadjusted volume: IliacV; adjusted volume: IliacI) muscles were measured on the affected side and both sides. Pearson correlation analysis between muscle volumes and postoperative 12-month PROs were performed.

Results:

The preoperative Gmax volume on the affected side was significantly associated with post-operative PROs, especially mHHS (GmaxV: p = 0.026; GmaxI: p = 0.005) and UCLA scores (GmaxV: p = 0.006; GmaxI: p = 0.002). For measurements on both sides, Gmed volume was the sole index showing a significant correlation with postoperative UCLA scores (GmedV: p = 0.023; GmedI: p = 0.043).

Conclusions:

The current study suggests that preoperative gluteus muscle volume may have predictive value for postoperative PROs of hip disease patients who have undergone THA surgery.
Understanding the complex network of objectively assessed cognition and self-reported psychological symptoms in people with multiple sclerosis
Authors: van Dam Maureen , Röttgering Jantine G , Nauta Ilse M , de Jong Brigit A , Klein Martin , Schoonheim Menno M , Uitdehaag Bernard MJ , Hulst Hanneke E , Douw Linda
Published: December 2024

Background:

Literature on the intricate relationship between self-reported and objectively assessed cognitive functioning suggests a discrepancy between self-reported cognitive complaints (SCC) and actual test performance.

Objectives:

To investigate the interplay between patient-reported outcome measures (PROMs) and objective cognitive functioning using network analysis in people with multiple sclerosis (PwMS).

Methods:

We collected PROMs on anxiety, depression, fatigue and SCC, and cognitive functioning across six domains ( n = 703 PwMS; 71% female, mean age = 46.3 ± 11.2 years). We constructed cognitive symptom networks using Gaussian Graphical Models, in which the aforementioned variables were presented as nodes linked by regularized partial correlations. We compared global network strength between relevant subgroups.

Results:

The networks primarily showed clustering of PROMs and cognitive domains into two separate modules, with weaker links connecting both modules. Global network strength was lower for PwMS with impaired information processing speed (IPS; indicating lower symptom interrelatedness) compared to those with preserved IPS (3.57 versus 4.51, p = 0.001), but not when comparing SCC subgroups ( p = 0.140).

Conclusions:

Cognitive symptom networks deepen our understanding of the discrepancy between self-reported and objectively assessed cognitive functioning. Lower symptom interrelatedness in PwMS with impaired IPS might suggest a nonlinear relation between PROMs and cognitive domains, which depends on the cognitive status.
Impact of windows on the indoor thermal environment of Chinese Chuandou-style timber residential houses: Tests and simulations
Authors: Wang Huanyi , Zhou Li , Tang Honggang
Published: December 2024

Model tests and simulations were conducted to investigate the influence of windows on the thermal environment of Chinese Chuandou-style timber residential houses. Besides, the thermal comfort of the house was also analyzed. The test results indicated that the measured temperature curves have obvious five-stage characteristics. The air temperature in the attic during the daytime was higher than that in the room, especially when the windows were open. During the daytime, when the windows were closed, the indoor air temperature was higher than the outdoor air temperature, while when the windows were fully open, the opposite pattern was observed. Numerical simulations showed that increasing the window–wall ratio could lead to an increase in indoor air temperature during the daytime, and decreasing the window width–height ratio would slightly reduce the indoor air temperature. The window opening degree has a significant impact on the indoor thermal environment, the higher the window opening degree, the lower the indoor air temperature during the daytime. Further, reducing the window heat transfer coefficient could also lead to a slight increase in indoor air temperature. The thermal comfort of the house was poor during the daytime in summer, but it was slightly improved when the windows were open.
Punitiveness and atrocity: Why do some Filipinos support mass violence?
Authors: Deinla Imelda B , Yap Jurel K , Mendoza Gabrielle Ann S , Ballar Kier Jesse , Domingo Cristine Lian
Published: December 2024

Amidst the aftermath of the controversial war on drugs during Duterte's presidency in the Philippines, this study seeks to understand characteristics of Filipino punitiveness. The institutionalization of state violence, historical context of authoritarian rule, and societal acceptance of extreme measures prompt an examination of public attitudes toward crime, punishment, and violence in the Philippines. This study used survey data on Filipino respondents and identified five distinct punitiveness clusters using latent class analysis. This study employed Kruskal–Wallis (KW) tests and chi-squared tests to explore factors associated with differences in cluster characteristics. The analysis found that the extremely punitive group exhibited significantly higher levels of satisfaction with President Marcos Jr., a strong preference for authoritarian detachment, and lower trust in institutions compared to the other clusters. They support harsher penal policies including informal or extralegal methods such as torture, social cleansing, and use of violence to attain social progress. This study confirms the convergence of punitiveness and penal populism, where highly punitive citizens endorse strong leaders and extralegal measures that result in atrocities.
Secondary haemophagocytic lymphohistiocytosis associated with scrub typhus: A case report with a brief review of literature
Authors: Chatterjee Rupak , Chandra Atanu , Mukherjee Sumana , Chatterjee Nandini , Dasgupta Sugata
Published: December 2024

Scrub typhus is a very important cause of acute undifferentiated febrile illness in the Asia-Pacific region. Haemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening condition characterised by widespread immune system activation, resulting in tissue damage throughout multiple organ systems. HLH is categorised into primary HLH, arising from intrinsic defects in lymphocytes and macrophages, and secondary HLH, primarily triggered by infections or connective tissue disorders. HLH is one of the rarest complications of scrub typhus. We present the case of a previously healthy young man who presented to our facility with a history of acute febrile illness. Clinical examination revealed an eschar and subsequent laboratory investigations confirmed the diagnosis of scrub typhus. The patient’s haematological parameters showed pancytopenia, raising suspicion of this rare association. Confirmatory tests established the diagnosis of HLH, and the patient achieved an uneventful recovery following treatment for the underlying illness and supportive care.
The Construction of British Columbia's Palliative Care Benefits Policy and Implications for Nursing Practice
Authors: Elliott Carly , Brown Helen , Wytenbroek Lydia , Havaei Farinaz (Naz)
Published: December 2024

Nurses have a critical role to play in creating, implementing, critiquing, and advancing health policy within diverse contexts to ensure people living with life-limiting illness receive equitable and ethical access to palliative care services and programs. This article describes a critical analysis of the British Columbia's Palliative Care Benefits (BCPCB). The BCPCB is a provincial government program in British Columbia (B.C.), Canada, that provides eligible residents with palliative care services at home. Utilizing Fairclough's Dialectical–Relational Critical Discourse Analysis, the study investigates the process by which BCPCB determines B.C. residents’ eligibility and access to resources proportionate to their need, function, illness burden, and urgency. This article reviews the construction of palliative care in Canada and how current biomedical perspectives construct palliative care policy and services in B.C. The findings indicate that the BCPCB program produces vague, discriminatory, and ableist prognostication practices through the implementation of its eligibility policy. This article also suggests that palliative care nurses are optimally positioned for policy influence: to critique, disrupt, and transform the BCPCB Program and palliative care practices.
Psychocorrection of Male Sexual Dysfunctions: A Clinical Study in Ukraine
Authors: Spytska Liana
Published: December 2024

This study aimed to investigate the effects of psychotherapeutic interventions, specifically cognitive-behavioral sexual therapy, using the example of erectile dysfunction in a cohort of 58 Ukrainian men under the age of 40 years. To achieve this goal, questionnaire methods were employed, including questions from the International Index of Erectile Function and the Perceived Stress Scale, along with statistical data processing and subsequent discussion. Psychotherapeutic intervention demonstrated its effectiveness from the short-term perspective and over a period of 6 months, with a significant improvement in erectile function indicators and a reduction in distress scores in the group of patients undergoing combined therapy ( p < .05). Monotherapy with phosphodiesterase-5 inhibitors, as first-line drug choices, also proved effective. However, considering that erectile dysfunction had an established psychogenic nature, the symptoms of the condition returned to the baseline level after 6 months. Providing psychosexual education and studying adaptive sexual responses with the disruption of maladaptive cognitive patterns should be a key goal in the treatment of psychogenic sexual dysfunctions. It is important to note that men may encounter difficulties in the practical application of various cognitive-behavioral sexual therapy techniques. Nevertheless, psychotherapy is considered a promising approach to treatment, especially in the context of countries where the topic of sexual education remains taboo, and the number of men seeking professional psychological help is very low, as is the case in Ukraine.
Injury Profiling in Male Police Cadets During Initial Training Phase: A Retrospective Cohort Study
Authors: Dhahbi Wissem , Ben Saad Helmi , Dergaa Ismail , Souaifi Marouen , Chamari Karim
Published: December 2024

Musculoskeletal injuries during the “Initial Training Phase” (ITP) are a major medical problem faced by law enforcement agencies worldwide. Aiming to develop an injury prevention strategy, we examined the incidence, type, associated factors, and severity of injuries and secondarily tracked their evolution over time by batches in a police academy. A retrospective cohort study was conducted using prospectively collected injury data on 979 newly recruited male police cadets enrolled in eight batches between 2015 and 2023. Among the 376 injured participants (age: 18.1 ± 0.3 years, body-mass: 75.8 ± 12.5 kg, body-height: 173.7 ± 4.0 cm, body mass index [BMI]: 25.1 ± 4.1 kg·m-2, body-fat percentage: 18.1% ± 5.1%), 405 injuries were recorded during the ITP. Musculoskeletal injury data were analyzed according to type, associated-factors, severity, and evolution across batches. Almost half of the recruits (41.4%) sustained at least one musculoskeletal injury. Based on injury frequency (39–69 case) and exposure time (20,944.5–43,006.5 hours per participant) indices, and with an implication of scientific training tips, the long-term follow-up over-batches showed that the injury incidence was decreased 2.5-fold from Batch 1 to Batch 8 ( p < .0001). Most injuries occurred between Weeks 2 and 5 (80% cumulative). The most common injury type was medial tibial stress syndrome (36.0%), followed by iliotibial band syndrome (12.6%), and ankle sprain (10.4%). This injury profile aligns with previous studies on law enforcement recruits, although comparisons should be made cautiously due to variations in training programs and recruit characteristics between agencies. The most frequently reported perceived potential contributors of injuries were vitamin and mineral deficiencies (20.7%), overweight/obesity (19.1%), and harsh physical activities (13.0%). During ITP, almost half of the recruits sustained at least one musculoskeletal injury, most of them in the fourth week. Some of the major associated factors of injury could be controlled resulting in a potential reduction of the injury incidence by up to 2.5 times. Implementing tailored fitness programs, incorporating subjective and objective training load assessments, and enhancing monitoring could significantly decrease injury rates, improve recruit readiness, and reduce resource and time waste on injury treatment.
Is “Arousal,” as a Scientific Concept, Worse than Useless?
Authors: Sander David
Published: December 2024

This paper discusses (i) the usefulness and (ii) the clarity of the concept of arousal. In discussing its usefulness, I argue that we can explain some key “arousal effects” without relying on the concept of arousal. To do so, I consider the role of the appraisal of affective relevance as a process mainly subserved by the amygdala and explaining emotional effects on attention, memory, and learning. Then, with respect to the clarity of the concept of arousal, I use the componential approach to emotion to suggest that further research may investigate whether the umbrella term “arousal” covers five different concepts (energy, sympathetic nervous system activity, intensity, strength, and salience), each corresponding to a specific component of emotion.
HoloLens® platform for healthcare professionals simulation training, teaching, and its urological applications: an up-to-date review
Authors: Tătaru Octavian Sabin , Ferro Matteo , Marchioni Michele , Veccia Alessandro , Coman Oana , Lasorsa Francesco , Brescia Antonio , Crocetto Felice , Barone Biagio , Catellani Michele , Lazar Alexandra , Petrisor Marius , Vartolomei Mihai Dorin , Lucarelli Giuseppe , Antonelli Alessandro , Schips Luigi , Autorino Riccardo , Rocco Bernardo , Azamfirei Leonard
Published: December 2024

The advancements of technological devices and software are putting mixed reality in the frontline of teaching medical personnel. The Microsoft® HoloLens 2® offers a unique 3D visualization of a hologram in a physical, real environment and allows the urologists to interact with it. This review provides a state-of-the-art analysis of the applications of the HoloLens® in a medical and healthcare context of teaching through simulation designed for medical students, nurses, residents especially in urology. Our objective has been to perform a comprehensively analysis of the studies in PubMed/Medline database from January 2016 to April 2023. The identified articles that researched Microsoft HoloLens, having description of feasibility and teaching outcomes in medicine with an emphasize in urological healthcare, have been included. The qualitative analysis performed identifies an increasing use of HoloLens in a teaching setting that covers a great area of expertise in medical sciences (anatomy, anatomic pathology, biochemistry, pharmacogenomics, clinical skills, emergency medicine and nurse education, imaging), and above these urology applications (urological procedures and technique, skill improvement, perception of complex renal tumors, accuracy of calyx puncture guidance in percutaneous nephrolithotomy and targeted biopsy of the prostate) can mostly benefit from it. The future potential of HoloLens technology in teaching is immense. So far, studies have focused on feasibility, applicability, perception, comparisons with traditional methods, and limitations. Moving forward, research should also prioritize the development of applications specifically for urology. This will require validation of needs and the creation of adequate protocols to standardize future research efforts.
School-Focused Communication Apps: Strengthening the Connection Between School Nurses and the School Community
Authors: Ongiri Sarah A.
Published: December 2024

Timely and accurate two-way communication between the school nurse and the families and school communities they work with is essential in supporting student health and success. Modern technology has allowed for virtual communication beyond the use of a telephone or email. Real-time messages can be sent to individual family members or specific groups using school-focused communication applications. This article will provide an overview of the basic features of popular school communication apps that the school nurse can use. Best practices when using these apps will also be discussed.
Disentangling the good, the bad, and the neutral of co-present mobile phone use: A new perspective on “partner phubbing”
Authors: Frackowiak Michal , Sophie Russell Pascale , Vowels Matthew J. , Hilpert Peter
Published: December 2024

Studies show that the use of smartphones in the presence of a partner may result in lower relationship quality, intimacy, and increased conflict. Such co-present phone use, often referred to as “phubbing” or “technoference,” has been problematized in the literature. However, few studies have hitherto explored the possibility that using phones in each other's presence may not cause any relational harm and might even support relationship maintenance. Only recently did the critiques and theoretical frameworks begin to expand our understanding of the broader role of smartphones in dyadic interactions. In this study, we tested whether co-present phone use is always perceived as negative, or if it could also be neutral or positive. We employed quantitative methods and content coding of free responses to understand the participants’ experiences and reasoning in different evaluations. We analyzed the responses of British participants ( N = 383) living with their partner, who were enrolled via Prolific to take part in the study. The analyses revealed that only 15% of participants perceived their partner's phone use as negative, the majority evaluating it as neutral or positive. Most participants reported that their partner's phone use had no impact on their time together or was integrated with other activities. Those who reported a negative impact attributed it to the partner's lack of attention. The present study challenges the existing literature and highlights the need for a conceptual expansion of smartphone-related behaviors in dyads.
Integrating ChatGPT: Enhancing postpartum mental healthcare with artificial intelligence (AI) support
Authors: Alam Sultan , Sohail Shahab Saquib
Published: December 2024

We are writing to extend the discourse on the innovative work published in digital health on the feasibility of videoconferencing-based therapy groups for postpartum depression and anxiety. The pragmatic evaluation demonstrated promising outcomes in terms of acceptability, appropriateness, and group process, suggesting that this modality is a viable alternative to traditional in-person therapy, especially in addressing the challenges faced by new mothers. Building on this study, we propose considering the integration of artificial intelligence (AI)-driven tools such as ChatGPT2 into such group therapy settings. ChatGPT, a large language model developed by OpenAI, has demonstrated considerable potential in generating therapeutic dialogs, offering empathetic responses, and assisting in therapeutic guidance. It can be employed as a supplementary tool to enhance the therapeutic process by providing personalized, real-time responses during or between sessions.
Novel Use of the Right Atrial Appendage as a Neopulmonary Valve in a Child With Infective Endocarditis
Authors: Siddharth Bharat , Dammalapati Pavan Kumar , V Vasudev , Said Sameh
Published: December 2024

Infective endocarditis (IE) is a serious complication following any cardiac surgery. Pseudomonas as the causative organism is very rare. The authors report a case of IE post cardiac surgery for ventricular septal defect closure which was found to be caused by Pseudomonas involving the pulmonary valve. It was successfully managed by resection of a considerable amount of vegetation that had damaged the pulmonary valve. A previously placed patch was removed and pulmonary valve reconstruction using the right atrial appendage was accomplished.
Self-Concept Clarity and Romantic Breakup Distress in Argentina and the United States
Authors: Arana Fernán , Rice Kenneth G. , Wetstone Hannah
Published: December 2024

This study implemented a culturally sensitive approach to understanding self-concept clarity and relationship breakup distress reported by emerging adults in Argentina and the USA. Due to cultural tendencies involving individuality and interpersonal connections, we expected that country would moderate the association between self-concept clarity and breakup distress, with Argentinians showing a stronger inverse association between self-concept clarity and breakup distress compared to North Americans. In a sample of 270 emerging adults (160 from Argentina, 110 from the USA), we first evaluated measurement invariance then used a structural model to test breakup distress regressed on self-concept clarity. The major analyses controlled for six relationship breakup-related potential confounds. Contrary to expectations, results indicated that North Americans demonstrated a stronger negative relationship between self-concept clarity and breakup distress compared to Argentinians. Our findings highlight the importance of further cross-cultural research in understanding the complexities of self-concept clarity in diverse cultural contexts.
Is There a Need for Functional Radiographs in Diagnosing Lumbar Instability?
Authors: Lutschounig Marie-Christine , Sigmund Irene Katharina , Steiner Irene , Rienmüller Anna , Stihsen Christoph , Windhager Reinhard , Grohs Josef Georg
Published: December 2024

Study Design

Retrospective radiological database analysis.

Objective

The aim of this study was to assess the value of functional radiography (FRF = flexion; FRE = extension) compared to MRI and standing sagittal plane full spine radiography (SP) with low-grade spondylolisthesis.

Methods

Sagittal translation (ST) and rotation (SR) were measured between all lumbar levels to assess instability. The differences for ST and SR of SP and FRE as well as MRI and FRF were calculated. In addition, the lumbar lordosis, the sacral slope, the pelvic tilt and the pelvic incidence were measured.

Results

Radiological datasets of 55 patients with 165 lumbar segments fulfilled inclusion criteria. Instability was diagnosed in 20 segments (12.1%) with SP/MRI compared to 14 segments (8.5%) using FRF/FRE with ST. SR functional radiographs showed instability in 41 segments (25%) and 23 segments (14%) using SP/MRI. The intraclass correlation coefficients (ICC) of ST between SP and FRE for L3/L4, L4/L5, and L5/S1 were 0.74, 0.84 and 0.97, respectively, indicating moderate to excellent agreement between imaging methods. For SP/FRE, the ICCs of the SR were 0.72, 0.61 and 0.64, respectively with moderate agreement. The ICCs of the ST for L3/4, L4/5, and L5/S1 showed moderate to good agreement between MRI and FRF with values of 0.52, 0.77, and 0.80, respectively. Regarding SR, poor agreement between MRI and FRF was observed. The ICCs for L3/4, L4/5, L5/S1 were 0.16, 0.23 and 0.23.

Conclusion

Based on our results, instability may also be diagnosed by calculating the difference in the ST in SP and MRI without additional functional radiographs. However, FRF showed translational instability more clearly than MRI in some patients and might still be an asset in borderline cases.
Century-long evolution of Chinese oral communication teaching and research
Authors: Li Yin-Die , Pan Yong , Kwek Bernetta Z. W.
Published: December 2024

In linguistics, Chinese oral communication is important for maintaining and enhancing the utilization and innovation of Chinese language in China. However, traditional Chinese language teaching focuses more on writing and reading than on oral skills. Based on China’s historical milestone, Chinese oral communication is taught according to its characteristics. This century-old historical progression of Chinese oral communication teachings can be divided into five stages: the foundational period dedicated to unifying both spoken and written language, the awakening period focusing on the emergence of the spoken language education, the exploratory period focusing on unidirectional pragmatics, the transitional period inclining towards multi-interactive pragmatics, and the transformational period expanding the context of pragmatics. Therefore, it proposes new requirements Chinese oral communication education should practice in order to cultivate positive communicators with “expressive power” in this new era.
How I Do It: Management of Upper Gastrointestinal Perforations and Leaks (With Video)
Authors: Haddad James D. , Shah Shawn L.
Published: December 2024

Transmural gastrointestinal (GI) tract defects are defined as a complete interruption of the gastrointestinal lumen, and can be characterized as perforations, leaks, and fistulae. Each arise from distinct mechanisms and must be managed with an approach tailored accordingly. While traditionally managed surgically, the emergence of a variety of tools and techniques have enabled endoscopists to offer a less invasive alternative to effectively manage gastrointestinal leaks and perforations. Herein, in this “How I Do It” overview, we focus on the assessment and endoscopic management of GI perforations and leaks, including device selection, adjunctive techniques, and post-procedural considerations.
Invisible and Replaced: The Female Ghost Workers in the History of Information Technology From the Perspective of Media Archaeology
Authors: Keyu Zhang
Published: December 2024

Drawing on Marxist feminism, this article provides general literature analyses and conducts interviews of Chinese participants to explore woman's historical roles as telephone operators, punched card operators, and artificial intelligence (AI) trainers. This article highlights women's significant but marginalized technical labor across different stages of technological revolutions. It examines how patriarchal and capitalist systems confine women to low-end technical roles, perpetuating their invisibility and vulnerability to technological unemployment. In the end, the study advocates that the state should intervene into platform capitalism and promote gender equity through technical education and long-term opportunities.
Lung parenchymal and cardiac appearances on CTPA impact survival in chronic thromboembolic pulmonary hypertension: results from the ASPIRE Registry
Authors: Abdulaal Lojain , Maiter Ahmed , Dwivedi Krit , Sharkey Michael J. , Alabed Samer , Alkhanfar Dheyaa , Rothman Alexander , Rajaram Smitha , Condliffe Robin , Kiely David G. , Swift Andrew J.
Published: December 2024

Background

Chronic thromboembolic pulmonary hypertension (CTEPH) is commonly evaluated using CT pulmonary angiography (CTPA). We evaluated the frequency and impact of parenchymal and cardiac abnormalities on survival in CTEPH.

Methods

Patients were identified from the ASPIRE (Assessing-the-Spectrum-of-Pulmonary-Hypertension-Identified-at-a-Referral-Centre) Registry. Kaplan-Meier analysis was used to assess survival.

Results

290 patients (55% female, mean age 65±14 years) with CTEPH were included. Mosaic perfusion was noted in 83%, lung infarction in 73% and parenchymal lung disease in 28%. The severity of mosaic perfusion and lung infarction correlated with markers of disease severity (p<0.001). Whereas the presence of mosaic perfusion was associated with improved survival in all patients (p=0.03), it did not predict outcome in those undergoing pulmonary endarterectomy (PEA) (p=0.6) and those not undergoing PEA (p=0.22). The presence of lung infarction had no impact on mortality. The presence of co-existing lung disease was associated with a worse survival (p<0.008), in patients not undergoing PEA. Mosaic perfusion was less common in patients with parenchymal lung disease (65%) compared to those without parenchymal lung disease (90%), p<0.001. Increased right: left ventricular ratio and aortic diameter predicted worse outcome (p<0.002).

Conclusion

Lung parenchymal and cardiac changes on CTPA predict outcome in CTEPH. Co-existing parenchymal lung disease is not uncommon and when present may mask the presence of mosaic perfusion. This study highlights the importance of systematically evaluating the lung parenchyma and cardiac changes in patients with CTEPH.
Anaphylaxis
Authors: Abrams Elissa M. , Alqurashi Waleed , Fischer David A. , Vander Leek Timothy K. , Ellis Anne K.
Published: December 2024

Anaphylaxis is an acute, potentially fatal systemic hypersensitivity reaction with varied mechanisms and clinical presentations. Although prompt recognition and treatment of anaphylaxis are imperative, both patients and healthcare professionals often fail to recognize and diagnose its early signs. Clinical manifestations vary widely, however, the most common signs are cutaneous symptoms, including urticaria and angioedema. Immediate intramuscular administration of epinephrine into the anterolateral thigh is first-line therapy, and is always safe even if the diagnosis is uncertain. The mainstays of long-term management include specialist assessment, allergen avoidance measures, and the provision of an epinephrine auto-injector with an individualized anaphylaxis emergency plan. This article provides an overview of the causes, clinical features, diagnosis, and acute as well as long-term management of anaphylaxis.
Angioedema
Authors: Lacuesta Gina , Betschel Stephen D. , Tsai Ellie , Kim Harold
Published: December 2024

Angioedema can occur in the absence of urticaria and can be broadly divided into three main categories: mast cell-mediated (e.g., histamine), non-mast-cell-mediated (bradykinin-induced) and idiopathic angioedema. Non-mast-cell-mediated angioedema is largely driven by bradykinin. Bradykinin-induced angioedema can be hereditary, acquired or drug-induced, such as with angiotensin-converting enzyme (ACE) inhibitors. Although bradykinin-mediated angioedema can be self-limited, it can cause significant morbidity and laryngeal involvement may lead to fatal asphyxiation. The mainstays of management for angioedema are: (1) to avoid specific triggers (if possible and where known) and (2) treatment with medication (if indicated). For hereditary angioedema (HAE), there are specifically licensed treatments that can be used for the management of attacks, or for prophylaxis in order to prevent attacks. In this article, the authors will review the causes, diagnosis and management of angioedema.