bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographics, clinical characteristics, and real-world treatment patterns among patients with beta-thalassemia: a retrospective medical record abstraction study
Authors: Cappellini Maria Domenica , Glassberg Mrudula B. , Meyers Juliana , Jimenez Maria , Nham Tram , Bueno Luciana , Sieluk Jan , Yucel Aylin , Alashkar Ferras
Published: December 2024

Background:

Beta-thalassemias (BTs) are characterized by deficient or absent synthesis of the beta-globin subunit, leading to anemia. Patient characteristics and treatment patterns in these patients may vary.

Objective:

This retrospective study evaluated demographics, clinical characteristics, and treatment patterns in patients with transfusion-dependent BT (TDT) and non-transfusion-dependent BT (NTDT).

Methods:

Medical records of adults with TDT or NTDT in the United Kingdom, France, Germany, Spain, and Canada with ⩾5 years of history within the practice were evaluated.

Results:

Among patients with TDT ( N = 118), mean (standard deviation (SD)) age was 36.1 (11.9) years, and 28.8% were female; among patients with NTDT ( N = 96), mean (SD) age was 36.6 (9.8) years, and 38.5% were female. Among patients with TDT, 21.2% received transfusions every 2 weeks or more frequently, 28.8% every 3 weeks, 26.3% every 4 weeks, and 21.2% less frequently than 4 weeks. Patients with TDT had a mean (SD) of 2.4 (0.6) units of blood transfused per transfusion, with a pretransfusion hemoglobin (Hb) level of 6.9 (1.3). In total, 84.4% of patients with NTDT had at least one transfusion, and the mean (SD) number of transfusions among patients with NTDT was 15.9 (15.9). Among patients with NTDT, the mean (SD) units of blood per transfusion were 2.2 (0.6) units, and the mean (SD) Hb level prior to transfusion was 7.4 (1.2) g/dL. Iron chelation therapy was received by 70.3% of TDT patients and 45.8% of NTDT patients.

Conclusion:

This study found that both patients with NTDT and TDT have low pretransfusion Hb levels. A high number of patients, especially patients with TDT, were not treated according to the current recommendations on target hemoglobin level, thereby highlighting the importance of national reference centers for improving long-term outcomes and quality of life in these patients.
On the fracture of aluminum plates perforated by rigid flat-nosed projectiles
Authors: Rosenberg Zvi , Vayig Yaniv
Published: December 2024

We present a series of 2D numerical simulations for the perforation process of aluminum plates impacted by rigid steel cylinders. The simulations accounted for the residual velocities of these projectiles as a function of their impact velocities, as obtained recently by several workers. The aluminum plates in these works were made of the quasi-brittle 2024-T351 and 7075-T651 alloys, and the more ductile 6061-T651 alloy. The material properties of these alloys, for their strength and failure parameters, were taken from published works. We find that the ductility/brittleness property of these alloys is related to the different values of their corresponding strains to failure at shear states. Our simulations for the two quasi-brittle alloys resulted in good agreement with the measured data. On the other hand, the simulations for the 6061-T651 alloy agreed with the corresponding data only when we used a relatively low value of the Taylor-Quinney coefficient for this alloy. We also highlight various problems with the issue of mesh sensitivity in simulating the perforation of metallic plates by rigid cylinders. Particularly, we found that these simulations do not converge to definite values for the residual velocities even when the mesh size is reduced to 0.025 mm. Moreover, we found that the experimental data for the residual velocities can be accounted for by different failure curves, depending on the mesh size of the simulation. Thus, a given failure criterion cannot be validated by such simulations.
Successful myomectomy during pregnancy for the indication of acute lower abdominal pain with red degenerative myoma or ovarian torsion? “Case report”
Authors: Dinsa Leta Hinkosa , Eticha Amenu Diriba , Terefe Mathewos Tamene
Published: December 2024

Uterine fibroids are benign tumors, arising from uterine smooth muscle cells. They are one of the most common benign tumors of the female genital tract among childbearing women, occurring in 20%–50% of women of reproductive age. The association of uterine myomas with pregnancy is high. This occurrence is constantly increased, linked to the onset of pregnancies, leading to the incidence of myomas gradually rising with age, hence the emergence of ultrasound reveals during routine ultrasound examinations of pregnancies, that were previously asymptomatic. Myomectomy during the second trimester was done and pregnancy continued safely to the third trimester. After successfully repairing it, the pregnant woman followed her antenatal care at Wollega University Referral Hospital, Western Oromia, Ethiopia. We presented the 20-year-old primigravida lady with a complaint of lower abdominal pain and a slight fever. We found a non-pedunculated, attached to the uterus via a broad base) myoma measuring 4 × 4 cm on 2D pelvic ultrasound. We admitted the client and gave her conservative management after we put her on antibiotics. Despite antibiotics, the pain persists we decided to manage it through an operation after we counseled the client about the potential complications. Then we removed the myoma without manipulating the uterus and it was a successful myomectomy without complicating the fetomaternal conditions. Currently, fetomaternal conditions are safe, and the woman is following her antenatal care at Wollega University’s Referral Hospital. In the majority of cases of women with fibroids, pregnancy comes with complications, according to literature data, The coexistence of the myoma with pregnancy: increased frequency of spontaneous abortions and premature births, increased risk of bearing ablation, higher incidence of maternal-fetal incommunicability, incorrect position of the fetus, more often performed cesarean surgery, higher probability of postpartum hemorrhage. Prenatal myomectomy can be safely performed in the first and second trimesters of pregnancy; however, it is recommended to deliver the baby via cesarean section, due to fear of intrauterine rupture of the uterus.
Topical high concentration oxygen with hyaluronic acid: A safe and effective treatment for vaginal atrophy and sexual function improvement
Authors: Lami Alessandra , Manta Andra Catalina , Amati Veronica , Alvisi Stefania , Baldassarre Maurizio , Carli Alessia , Lucchetta Giada , Seracchioli Renato , Meriggiola Maria Cristina
Published: December 2024

Background

Genitourinary syndrome of menopause (GSM) is a condition affecting many postmenopausal women. Among the available treatments, the vaginal natural oxygenation device (VNOD) is a new promising option.

Aim

To evaluate the safety and the effectiveness of vaginal high concentration (HC) oxygen (O2) and hyaluronic acid (HA) in postmenopausal women with vaginal atrophy (VA).

Methods

Study 1: Ten subjects received HA and O2 at a concentration of 21% (sham group) and ten at 95% (treatment group). All subjects completed five sessions of VNOD. Evaluations and questionnaires were completed at baseline, before each session and at one-month follow-up: Visual Analogue Scale, Vaginal Health Index (VHI), Vaginal Maturation Value (VMV), Menopause Quality Of Life (MeNQoL), Female sexual function index (FSFI) and Female sexual distress scale (FSDS). Study 2: 52 postmenopausal women with VA completed the same protocol of study 1 with HC O2 and HA.

Results

Treatment was well-tolerated. In study 1, in the treatment group we recorded significant improvements in VHI score ( p-value 0.001), VMV ( p-value 0.005) and in the psychosocial, physical and sexual domains of the MeNQoL compared to sham group. In study 2, all women experienced a significant improvement in VHI ( p-value <0.001), FSFI total score ( p-value 0.007), desire ( p-value 0.004), lubrication ( p-value 0.006), satisfaction ( p-value 0.042), pain ( p-value 0.001) domains, FSDS score ( p-value 0.003) and MeNQoL sexual domain ( p-value <0.001).

Conclusion

The preliminary results of this study suggest that VNOD is a safe and effective treatment for VA in postmenopausal women, and improves sexual function.
Reconstruction of a body wall defect using diaphragm lateralisation and advancement, latissimus dorsi, and internal and external abdominal oblique muscle flaps in a cat
Authors: Kooner Kiren , Rubiños Carlos
Published: December 2024

Case summary

A cat aged 12 years and 7 months was referred to a multidisciplinary hospital for investigation of feline injection site sarcoma (FISS) on the left thoracolumbar region. A CT examination of the mass revealed a multi-lobulated mass affecting the body wall, extending from the level of lumbar vertebrae L2 to L4. The mass was excised with 5 cm lateral margins, including resection of the 13th left rib, the caudal edge of the latissimus dorsi (LD) muscle, full-thickness abdominal wall and sections of the lumbar epaxial muscles. To reconstruct the defect, a combination of muscle flaps was used. This included diaphragmatic advancement and lateralisation, rotation of the LD, and creation of transposition flaps from the internal abdominal oblique and external abdominal oblique muscles, ensuring closure without tension. Skin closure required mobilising an inguinal flank fold flap. The cat was discharged from hospital 3 days postoperatively. Histopathology confirmed a diagnosis of FISS with clean wide margins. A gradual return to normal activity and complete healing of the surgical site was reported on follow-up, with one minor complication related to the skin flap (bruising at the base of the inguinal flank fold flap).

Relevance and novel information

This report describes the use of the aforementioned combination of muscle flaps to close a major abdominal wall defect in a cat with an excellent outcome. Practitioners can consider this technique when planning tissue reconstruction after FISS resection.
Nasal telangiectatic osteosarcoma with direct extension to the brain in a domestic shorthair cat
Authors: Silva Anahi Souza , Sousa Ana Lívia Vasconcelos de , Diniz Nanci Sousa Nilo Bahia , Macêdo Isabel Luana de , Costa Júnior Jair Duarte da , Martins Christine Souza , Melo Cristiano Barros de , Castro Márcio Botelho de
Published: December 2024

Case summary

This case report describes the clinical and pathological features of telangiectatic osteosarcoma (TOS) with brain invasion in a 4-year-old female domestic shorthair cat. The cat presented with respiratory distress, epistaxis, anorexia and significant nasal obstruction. A rhinoscopy revealed an amorphous white neoformation in the left nasal cavity. Despite treatment, the cat’s condition deteriorated and it succumbed to the disease. Necropsy and histopathologic examination revealed an infiltrative malignant neoplasm with osteoid matrix and sarcomatous cells surrounding blood-filled non-vascular spaces. Immunohistochemistry showed positive staining for bone cell markers and vimentin, while endothelial markers were negative, confirming TOS.

Relevance and novel information

Nasal diseases in cats present significant diagnostic challenges due to similar clinical signs, such as respiratory distress and nasal discharge. Nasal osteosarcomas are rare, and TOS is the rarest subtype, characterized by blood-filled spaces within an aggressive osteolytic lesion. This case highlights the diagnostic complexities and poor prognosis associated with TOS in cats, emphasizing the need for advanced imaging and immunohistochemical tests for accurate diagnosis. Given the aggressive nature and rapid progression of TOS, it should be considered in differential diagnoses of feline nasal obstructive lesions.
Amyloidosis and the Syncopal Enigma
Authors: Strelow Brittany , Middleton Hayden , Young Kathleen A. , Olson Nicole , Boucher Lauren , Cera Alanna , Boswell Christopher L.
Published: December 2024

Background:

Syncope is a common presenting complaint in the outpatient setting and requires a thoughtful and meticulous approach to history-taking skills. This is crucial in discerning cardiac versus non-cardiac etiologies, underscoring the pivotal role of healthcare professionals in the diagnostic process.

Case Report:

This is a case of a 76-year-old male who presented to the primary care clinic following an episode of syncope with abrupt loss of consciousness. Given the presentation, there was a high suspicion of cardiac etiology, and further testing was pursued. An electrocardiogram (ECG) demonstrated normal sinus rhythm with a pre-existing first-degree atrioventricular (AV) block. The Holter monitor was without sustained arrhythmias. A dobutamine stress echocardiogram was negative for myocardial ischemia, though a resting transthoracic echocardiogram demonstrated findings consistent with cardiac amyloidosis. Further evaluation with cardiology confirmed the diagnosis of transthyretin (ATTR) cardiac amyloidosis. He was initiated on appropriate treatment and underwent a dual chamber implantable cardioverter defibrillator (ICD) given his presentation. The patient ultimately succumbed to his disease 5 years after his diagnosis.

Conclusion:

If the cardiac etiology of syncope is suspected, further cardiac structural evaluation is necessary. Cardiac amyloidosis, although rare, is a cause of cardiogenic syncope that should not be overlooked. It should be considered in the differential diagnosis in the appropriate clinical setting, highlighting the need for a broad and comprehensive approach to diagnosis.
Teacher Cognition of Gender Gap in the English Language Literacy: A Malaysian Narrative
Authors: Abdullah Hazlina , Idrus Mohd Muzhafar , Gao Xuesong (Andy) , Muhammad Siti Salmiah
Published: December 2024

Literacy is an important foundation skill which is central to success in any learning area. The existence of gender differences in literacy is therefore of major concern and has spurred a large amount of research. In spite of the extant literature regarding boys’ language literacy underachievement, the topic has not yet become outdated. Gender gaps still persist with varying inconclusive beliefs and conclusions. This article tackles one of the many general causes of gender gap namely the school practices, with specific reference to teachers. The purpose of this study is to discover teachers’ cognition regarding second language literacy performance of boys and girls. Nine English language teachers with varied career experiences from four primary schools in Negeri Sembilan, Malaysia were interviewed. Four major themes have emerged regarding Malaysian teachers’ constructions of gender gaps in L2 literacy, and from the findings, the researchers put forward the conception of L2 literacy gendered differences at the level of Malaysian primary schools through the lenses of English teachers which consists of four components: manifestation; admission; motives; and teacher sentiments. By understanding these components on how male and female students respond differently to activities performed in language classes, teachers can improve their engagement with learners from various backgrounds.
Planning for Parenthood: Using Sociodemographic Characteristics to Predict Expectations for the Timing and Number of Children Among Emerging Adults
Authors: Dover Carson R. , Willoughby Brian J.
Published: December 2024

The purpose of this study is to analyze parenthood expectations (expected age to have a first child and number of children hoped for) in emerging adulthood, and how these expectations can be predicted by various sociodemographic factors. We draw on theoretical work on emerging adulthood, marital paradigms, and marital horizons theories in conceptualizing parenthood expectations, including one’s parenting horizon. Using a large, national sample of emerging adults in the U.S., we used a latent profile analysis to examine expectation groups. We also found that parenting salience, religiosity, and marital salience were the most consistent predictors of parenthood expectations. In addition, we also found that race and relationship status may also be important factors to consider when it comes to the parenthood expectations that emerging adults have. Our study expands our understating of how emerging adults conceptualize the salient transition to parenthood.
Does Position of Pedicle Screws Correlate With Adjacent Segment Degeneration? An Average 6-Year Follow-Up Retrospective Study
Authors: Latallade Valentino , Pereira Duarte Matías , Huespe Iván A. , Kido Gonzalo , Petracchi Matías , Gruenberg Marcelo
Published: December 2024

Study Design

Retrospective case serie.

Objectives

Assess the correlation between pedicle screw (PS) position of the first instrumented vertebra (FIV) with proximal adjacent segment degeneration (ASD) development or progression.

Methods

Patients ≥55 years who have undergone lumbar fusion with a minimum 2-year follow-up were included. Radiographic PS position was assessed by the angle between the first PS and the upper vertebral endplate (VE) and by the PS tip-VE distance. Radiographic parameters of ASD included: disc height, disc angle, and vertebral listhesis. ASD magnetic resonance imaging (MRI) parameters included: disc degeneration and lumbar stenosis. ROC curve analysis was performed to identify the best cut-off points in correlation with lumbar stenosis.

Results

Forty-eight patients were included with an average follow-up of 6 years. All 48 included patients developed some degree of ASD whether on radiographic or MRI parameters. PS tip-VE distance and PS-VE angle were both positively correlated with: (1) Delta (Δ) lumbar stenosis; (2) Δ Disc degeneration; and (3) Δ Disc height. ROC curve analysis correlating PS tip-VE distance and PS-VE angle with an increase in the canal stenosis severity ≥2° resulted in a cut-off point of 36% and 9.5°, respectively.

Conclusions

The cranial orientation (PS-VE angle) of the pedicle screw in the first instrumented vertebra, along with a shorter pedicle screw tip-vertebral endplate distance (PS tip-VE), positively correlated with ASD progression at an average 6-year follow-up. Protective values against lumbar stenosis were identified as a PS tip-VE distance ≥36% of the first instrumented vertebra height and a PS-VE angle ≤9.5° relative to the upper vertebral endplate.
Joint Effusion at 3 Months After Anterior Cruciate Ligament Reconstruction: Its Risk Factors and Association With Subsequent Muscle Strength and Graft Remodeling
Authors: Kikuchi Naoya , Kanamori Akihiro , Arai Norihito , Okuno Kosuke , Yamazaki Masashi
Published: December 2024

Background:

Joint effusion at 3 months after anterior cruciate ligament (ACL) reconstruction is a risk factor for ACL reinjury. However, factors associated with joint effusion at 3 months postoperatively and the effect of joint effusion on subsequent quadriceps muscle strength and graft remodeling remain unknown.

Purposes:

To identify factors associated with joint effusion and investigate the association between joint effusion and quadriceps muscle strength and graft remodeling in the postoperative period.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

In this retrospective multicenter study, the medical records of patients who underwent single-bundle ACL reconstruction between 2015 and 2021 were reviewed. The study included the data of 174 patients (mean age, 23.5 ± 10.6 years). Demographic data, including sex, age at surgery, time from injury to surgery in months, body mass index, preinjury Tegner activity score, presence of meniscus, and chondral injuries, were collected. Magnetic resonance imaging was performed 3 months postoperatively. Joint effusion was defined as grade 3 (range of grades, 0-3) according to the ACL Osteoarthritis Score. Isokinetic strength testing was performed at 60 deg/s, while the limb symmetry index (LSI) of quadriceps strength was evaluated at 6 months postoperatively. Moreover, graft remodeling was evaluated using magnetic resonance imaging-derived signal intensity ratio (SIR) measures at 1 year postoperatively. The authors used multivariate logistic and linear regression analyses to identify the factors influencing joint effusion at 3 months and those associated with postoperative quadriceps strength LSI and SIR values, respectively.

Results:

Greater preinjury Tegner activity scores (odds ratio, 1.59; 95% CI, 1.08 to 2.34; P = .02) increased the odds of joint effusion at 3 months postoperatively. Multivariable linear regression analysis revealed that joint effusion (β = −23.8; 95% CI, −36.0 to −11.7; P < .001) was an independent factor associated with LSI of the quadriceps. Furthermore, joint effusion (β = 1.33; 95% CI, 0.53 to 2.14; P = .001) was associated with a higher SIR value of the reconstructed graft.

Conclusion:

The preinjury Tegner activity score was a factor associated with joint effusion at 3 months postoperatively, and joint effusion was associated with subsequent muscle weakness and delayed graft remodeling.
The Silent Divide: Leader-Member Exchange, Communication Anxiety, and Age-Related Defensive Silence
Authors: Greer Rebecca J. , Talbert Neil
Published: December 2024

Modern workplace demographics are changing and so too are workplace relationships. This research explores the impact of poor leader relationships on voice behaviors—more specifically, defensive silence. Results indicate a negative relationship between leader-member exchange (LMX) and defensive silence, a positive relationship between communicative anxiety and defensive silence, and a negative relationship between communicative anxiety and LMX. Additionally, a significant interaction is found between age, years of supervisory experience, LMX, and defensive silence. Theoretical and practical implications for workplace relationships are discussed.
The Chilling Effects of Tennessee’s Prohibited Concepts Law: What Is the Potential Role of School Board Members and Superintendents?
Authors: Frasier Amanda Slaten
Published: December 2024

Prohibited concept laws have a chilling effect on teaching, resulting in the erasure of social justice topics; however, the extent to which district-level actors support such laws or the role they play in perpetuating the effect is unclear. I offer a framework for understanding how district-level policy messaging contributes to the chilling effect in the context of increased partisanship and nationalized politics at the local level. I use survey data to describe school board members’ and superintendents’ perceptions of Tennessee’s PK–12 Prohibited Concepts Law. Overall, there is support for the law, but there are significant differences between the perspectives of school board members and superintendents, with the latter more likely to express neutrality. There are no differences by location, but there are significant differences based on political affiliation and perspectives about state control of curriculum, supporting the larger trend of increased nationalized partisanship of local politics.
Urban maintenance as compromise: Coming to terms with the multispecies city
Authors: Wilson Helen F
Published: December 2024

The paper examines the role of maintenance and repair in the multispecies city as central to understanding the relationship between non-human life and infrastructure. The focus of the paper is the black-legged kittiwake, a pelagic species of gull. Kittiwakes have long-used artificial structures for nesting, but the rapid growth of seabird colonies in UK towns and cities has seen their inhabitation of urban infrastructure pose new challenges. Drawing on ethnographic research from the eastern coast of England, the paper develops the notion of ‘maintenance as compromise’ to capture how forms of infrastructural maintenance reflect an adjustment or coming to terms with new ecological proximities. Through three cases, namely, non-human inhabitation of an iconic infrastructure, routine infrastructural work in the form of street cleaning, and transformational repairs that support the use of buildings by breeding birds, the paper argues that undertaking maintenance as a form of compromise not only allows for messy co-presence, but demonstrates an understanding of infrastructure that takes the lifeworlds of non-humans seriously. However, while such a coming to terms indicates a shift in the politics of knowledge, attending to the collective life of infrastructure reveals the simultaneous constraints and tensions that make radical propositions for alternative futures difficult to imagine. The paper thus concludes by underlining the complex motivations that shape practices of repair and maintenance in the multispecies city, the problem with taking such works as a sign of shifting ethical relations, and the expertise and unknowns that are involved in responding to non-human inhabitations of infrastructure.
Report from the Fourth International Last Aid Conference: Last Aid and networks in community palliative care
Authors: Bollig Georg , Voltz Raymond , Zelko Erika
Published: December 2024

The Fourth International Last Aid Conference was held from 4th to 6th September 2024 in Cologne, Germany. Seventy-three participants from 16 different countries and nationalities participated in the Fourth International Last Aid conference in the Mildred Scheel Academy and the Department of Palliative Medicine at the University Hospital of Cologne, Germany. The main topics of the conference were experiences with Last Aid Courses, research on public palliative care education (PPCE) and networks in community palliative care from different countries. The speakers from different countries around the world presented experiences with networking in community care, PPCE and lessons learned from the implementation of Last Aid Courses and different course formats in different countries. The contribution of research and the past and future work of the Last Aid International Research Group (LARGI) for the development of Last Aid was presented and discussed. This report provides an overview of the conference topics, the presentations by international experts from around the world and the most important results and implications.
A novel computational model based on molecular chain dynamics: Quantification and evaluation of interfacial interactions in polymer-based composite materials
Authors: Li Rui , Xu Yang , Zhang Kaihu , Wu Zhoubin , Ma Ning , Ouyang Xiao
Published: December 2024

This study aims to develop a novel computational model to accurately quantify the interfacial interactions between matrix resin and fillers in polymer-based composites, thereby overcoming the limitations of existing theories and computational models in assessing interfacial interactions, such as limited application scope and unclear boundary conditions. By exploring the dynamic behavior of matrix resin molecular chains, a theoretical model for interfacial interactions was constructed based on molecular chain dynamics theory, and corresponding computational formulas were derived. To validate the model, bisphenol A epoxy resin and hollow glass microspheres were selected as experimental materials, and experimental studies were conducted using dynamic thermomechanical analysis and other methods. The results demonstrate that the proposed molecular chain dynamics model can accurately quantify the interfacial interactions in polymer-based composites, successfully determining the interfacial interaction parameter A value of 0.42 between bisphenol A epoxy resin and hollow glass microspheres, which falls into the category of “ordinary interfacial interaction.” This study not only provides a solid theoretical foundation for the optimization design and performance enhancement of composites but also holds broad application prospects in fields such as military aviation, aerospace, naval equipment, and high-end terrestrial equipment, potentially driving advancements in composite material design technology.
‘What else can we do to create an inclusive environment?’ Human resources specialists about dyslexic and neurodivergent employees
Authors: Černickaja Karin , Sokolová Lenka
Published: December 2024

Although symptoms of dyslexia tend to restrict it to the school environment, it is a lifelong condition. Research has focused primarily on prevention and intervention within educational spaces; however, studies indicate that dyslexic individuals continue to face challenges and barriers also in workplaces. This study aims to explore the reflections of human resources specialists on their knowledge and beliefs about dyslexic employees and on their attitudes and practices toward dyslexic employees. Themes were developed through reflexive thematic analysis. Human resources specialists have some basic knowledge about dyslexia and its impact on employees. However, their beliefs are based on their assumptions and experience encountering dyslexic employees, which are rather rare. In general, they are open to help building more inclusive workplaces, but for now these steps to equality are based on individual approaches, which requires disclosure from the employee. Dyslexic employees may not feel psychological safety at work, leading to non-disclosure.

Lay abstract

Research has been focused primarily on prevention and intervention within educational spaces; however, studies indicate that dyslexic individuals continue to face challenges and barriers also in workplaces. This study aimed to explore human resources specialists’ reflections on their knowledge and beliefs about dyslexic employees and on their attitudes and practices toward dyslexic employees. Human resources specialists have some basic knowledge about dyslexia and its impact on employees. However, their beliefs are based on their assumptions and experience encountering dyslexic employees, which are rather rare. In general, they are open to help building more inclusive workplaces, but for now these steps to equality are based on individual approaches, which requires disclosure from the employee. To build more inclusive environments, we must raise awareness not only between human resources specialists, but also other employees (colleagues), and importantly between dyslexic employees, who might not know about their rights and possibilities provided by their companies.
Cognitive benefits of folic acid supplementation during pregnancy track with epigenetic changes at an imprint regulator
Authors: Hilman L. , Ondičová M. , Caffrey A. , Clements M. , Conway C. , Ward M. , Pentieva K. , Irwin R. E. , McNulty H. , Walsh C. P.
Published: December 2024

Background

The human ZFP57 gene is a major regulator of imprinted genes, maintaining DNA methylation marks that distinguish parent-of-origin-specific alleles. DNA methylation of the gene itself has shown sensitivity to environmental stimuli, particularly folate status. However, the role of DNA methylation in ZFP57’s own regulation has not been fully investigated.

Methods

We used samples and data from our previously described randomised controlled trial (RCT) in pregnancy called Folic Acid Supplementation in the Second and Third Trimester (FASSTT), including follow-up of the children at age 11. Biometric and blood biochemistry results were examined for mothers and children. Methylation of ZFP57 was analysed by EPIC arrays, pyrosequencing and clonal analysis, and transcription assessed by PCR-based methods. Functional consequences of altered methylation were examined in cultured cells with mutations or by inhibition of the main DNA methyltransferases. DNA variants were examined using pyrosequencing and Sanger sequencing, with results compared to published studies using bioinformatic approaches. Cognitive outcomes were assessed using the Wechsler Intelligence Scale for Children 4th UK Edition (WISC-IV), with neural activity during language tasks quantified using magnetoencephalography (MEG).

Results

Here we show that methylation at an alternative upstream promoter of ZFP57 is controlled in part by a quantitative trait locus (QTL). By altering DNA methylation levels, we demonstrate that this in turn controls the expression of the ZFP57 isoforms. Methylation at this region is also sensitive to folate levels, as we have previously shown in this cohort. Fully methylated alleles were associated with poorer performance in the Symbol Search and Cancellation subtests of WISC-IV in the children at age 11 years. There were also differences in neural activity during language tasks, as measured by MEG. Analysis of published genome-wide studies indicated other SNPs in linkage disequilibrium with the mQTL were also associated with neurodevelopmental outcomes.

Conclusions

While numbers in the current RCT were small and require further validation in larger cohorts, the results nevertheless suggest a molecular mechanism by which maternal folic acid supplementation during pregnancy may help to counteract the effects of folate depletion and positively influence cognitive development in the offspring.
Reasons for unsafe abortion in Iran after pronatalist policy changes: a qualitative study
Authors: Haseli Arezoo , Rahnejat Nasrin , Rasoal Dara
Published: December 2024

Background

In Iran, restrictive abortion laws have led to widespread unsafe abortions, posing significant health risks. The 2021 Family and Youth Protection Law further restricted access to reproductive health services in an effort to boost birth rates. The purpose of this qualitative study is to explore the reasons women sought abortions in an illegal context, based on their own experiences.

Methods

This exploratory qualitative study involved in-depth interviews with 46 women in Kermanshah, Iran, between April and August 2024. All participants had experienced incomplete abortions after undergoing unsafe procedures. Data were analyzed using conventional content analysis and thematic analysis with MAXQDA 10 software to identify key themes in the women's experiences. To ensure the study's rigor, we applied Guba and Lincoln’s criteria, including credibility, dependability, confirmability, and transferability.

Results

Five main themes emerged from the interviews: economic hardship, pursuit of a prosperous life, unstable marital relationships, health and fertility issues, and cultural factors. Economic challenges, such as unemployment and lack of basic necessities, were the most frequently cited reasons for seeking unsafe abortions. Health issues, including unplanned pregnancies and fear of fetal anomalies, also played a significant role, alongside cultural stigmas related to age, illegitimacy, and gender preferences.

Conclusion

This study sheds light on the multifaceted factors driving unsafe abortions in Iran following pronatalist policy changes. A holistic approach is recommended to address the interconnected economic, social, and cultural challenges that contribute to this issue. By implementing such comprehensive strategies, policymakers and stakeholders can work to reduce the prevalence of unsafe abortion practices and foster improved health and well-being for women.
Removal technologies of microplastics in soil and water environments: review on sources, ecotoxicity, and removal technologies
Authors: Yang Ji Won , Park Chanhyuk , Jho Eun Hea
Published: December 2024

Microplastics (MP) in the environment has attracted extensive attention due to their ubiquitous occurrence and potential toxic effects; but less attention has been given to the removal technologies of MP in different environmental media. This review covers the sources, ecotoxicities, and removal technologies of MP in soil and water environments reported in previous studies to derive the future research directions for MP removal technologies. Previous studies reported various sources contribute to MP present in soil and water environments, indicating that the source control may be a better strategy than contaminated media treatment for management of MP contamination. Similarly, different terrestrial and aquatic organisms have been used to determine the toxic effects of MP with different characteristics. Previous ecotoxicity studies of MP on soil organisms cover only a small number of species compared to that of MP on aquatic organisms. Therefore, further studies are necessary to investigate the ecotoxic effects of MP on a broader range of soil organisms. Also, since the characteristics of MP are diverse, more ecotoxicity studies in both water and soil environments are required. The review provides an overview of various removal technologies for MP in soil and water and identifies gaps in existing studies. Although more studies have been conducted for removal of MP in water than in soil, they remain in their early stages. More studies are needed for removal of MP removal in soil than in water. With MP in water, most studies have been carried out on a lab scale with artificial wastewaters, thus, studies with natural waters in a pilot or field scale are required. Overall, this review highlights the need for further studies on MP removal technologies for real world applications.
Viral sepsis: diagnosis, clinical features, pathogenesis, and clinical considerations
Authors: Xu Ji-Qian , Zhang Wan-Ying , Fu Jia-Ji , Fang Xiang-Zhi , Gao Cheng-Gang , Li Chang , Yao Lu , Li Qi-Lan , Yang Xiao-Bo , Ren Le-Hao , Shu Hua-Qing , Peng Ke , Wu Ying , Zhang Ding-Yu , Qiu Yang , Zhou Xi , Yao Yong-Ming , Shang You
Published: December 2024

Sepsis, characterized as life-threatening organ dysfunction resulting from dysregulated host responses to infection, remains a significant challenge in clinical practice. Despite advancements in understanding host-bacterial interactions, molecular responses, and therapeutic approaches, the mortality rate associated with sepsis has consistently ranged between 10 and 16%. This elevated mortality highlights critical gaps in our comprehension of sepsis etiology. Traditionally linked to bacterial and fungal pathogens, recent outbreaks of acute viral infections, including Middle East respiratory syndrome coronavirus (MERS-CoV), influenza virus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among other regional epidemics, have underscored the role of viral pathogenesis in sepsis, particularly when critically ill patients exhibit classic symptoms indicative of sepsis. However, many cases of viral-induced sepsis are frequently underdiagnosed because standard evaluations typically exclude viral panels. Moreover, these viruses not only activate conventional pattern recognition receptors (PRRs) and retinoic acid-inducible gene-I (RIG-I)-like receptors (RLRs) but also initiate primary antiviral pathways such as cyclic guanosine monophosphate adenosine monophosphate (GMP-AMP) synthase (cGAS)-stimulator of interferon genes (STING) signaling and interferon response mechanisms. Such activations lead to cellular stress, metabolic disturbances, and extensive cell damage that exacerbate tissue injury while leading to a spectrum of clinical manifestations. This complexity poses substantial challenges for the clinical management of affected cases. In this review, we elucidate the definition and diagnosis criteria for viral sepsis while synthesizing current knowledge regarding its etiology, epidemiology, and pathophysiology, molecular mechanisms involved therein as well as their impact on immune-mediated organ damage. Additionally, we discuss clinical considerations related to both existing therapies and advanced treatment interventions, aiming to enhance the comprehensive understanding surrounding viral sepsis.
Adjuvant local antibiotic therapy in the management of diabetic foot osteomyelitis
Authors: Metaoy Sara , Rusu Iulia , Pillai Anand
Published: December 2024

Background

The management of diabetic foot osteomyelitis (DFO) is complex. The targeted use of adjuvant local antibiotics, in the form of biocomposite bone void filler, in DFO, can enhance patient outcomes while minimising the adverse effects associated with systemic antibiotic therapy and its shortcomings.

Methods

We reviewed a series of 105 consecutive patients who underwent surgical management for diabetic foot osteomyelitis. In the NLAB group, (no adjuvant local antibiotic use), 49 patients, received the current standard of care treatment with no use of adjunctive local antibiotic therapy. In group LAB, (adjuvant use of local antibiotics), 56 patients received additional adjuvant local antibiotic therapy. Patient outcomes were compared between both groups.

Results

Infection healing was demonstrated in 10 (20.41%) patients from group NLAB and 41 (73.21%) from group LAB (p < 0.0001). Persistence of infection with no evidence of wound healing, 6 months from surgery, was observed in 15 (30.61%) patients in group NLAB. Among the LAB group, only 4 (7.14%) patients demonstrated infection persistence (p = 0.00183). Reinfection was observed in 24 of 49 patients in group NLAB (49%) and in only 11 out of 56 patients in group LAB (20%) (p = 0.001466). 7 (6.67%) patients required major amputation with 6 (12.24%) belonging to group NLAB. Only 1 (1.78%) patient in group LAB underwent major amputation. A higher 5-year mortality rate was noted within patients in group NLAB, 27 (55.1%). The mortality rate in group LAB was (12.5%).

Conclusion

The adjuvant use of antibiotic loaded bio-composite bone void filler locally was associated with increased infection clearance rates regarding diabetic foot osteomyelitis when compared with the standard care of treatment while achieving lower rates of infection persistence and recurrence. It also has the potential to reduce amputation and mortality rates with further research.
Effect of childhood epilepsy and antiepileptic drugs on visual evoked potential response and optical coherence tomography
Authors: Moussa Amira Ahmed , Nassef Ayman , Nada Maha A. , Karim Marwa A. , Khater Shaimaa S. , El deen Nahed Salah
Published: December 2024

Background

Epileptic seizures arise from an excessively synchronous and sustained discharge of a group of neurons. The single feature of all epileptic syndromes is a persistent increase of neuronal excitability. Visual affection in epileptic children could be attributed to the disease itself or the use of anti-epileptic drugs, these changes may involve abnormal electro-physiological response. This biphasic study, conducted at the neuro-pediatric clinic at neurology department, aimed to investigate effect of idiopathic childhood epilepsy per se on (1) visual evoked potential and (2) optical coherence tomography and effect of selected two antiepileptic medications on them. All subjects were exposed to visual evoked potential and only cooperative subjects exposed to ocular coherence tomography before and after anti-epileptic drugs and were followed up over 2 years.

Results

The study included 50 newly diagnosed epileptic children and 50 healthy controls, the mean P100 latency in the right eyes of the control group was 110.4 ± 3.76ms, while in the patients group was 114.94 ± 12.81ms that showed significant difference between the two groups with p value (0.020). After 2 years of treatment by levetiracetam and valproate, the mean P100 latency of the right and left eyes in the valproate group was 112.34 ± 7.05 ms and 112.59 ± 5.2 ms, respectively, and it was 114.85 ± 10.39 ms and 116.14 ± 9.84 ms, respectively, in the valproate group, which showed insignificant difference between the two groups. The mean average of retinal nerve fiber layer thickness between patients and controls was significant in both right and left eyes with p value 0.002 and < 0.001, respectively. After 1 year of treatment by levetiracetam in the first group and valproate in the second group, there was no significant difference between the two groups neither regarding retinal nerve fiber layer thickness nor ganglion cell complex in both eyes.

Conclusions

There was prolonged latency in the epileptic children before starting anti-epileptic drugs more than the control group; also there was thinning of the retinal nerve fiber layer thickness and average part of the ganglion cell complex thickness more in the epileptic children than in the healthy controls.
Characteristics of knowledge and stigma of autism spectrum disorder among university students in Jordan: a nationwide cross-sectional study
Authors: AlSamhori Jehad Feras , Kakish Diala Ra’Ed Kamal , Ellayyan Layla , Mohammad Tala , Hijazeen Talin , Kheir Sewar , Bejad Ghala , Boland Ritaj , Alkhaldi Ban , Aburahmeh Malek , Abu-Suaileek Mamoun Hamed Ali , Banimustafa Radwan , Qaswal Abdallah Barjas
Published: December 2024

Background

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication and repetitive behaviors. It often coexists with other mental health conditions like depression. Despite growing awareness, stigma and limited understanding persist, particularly in Jordan, influencing medical help-seeking behaviors. This study aimed to investigate the knowledge and stigma among medical and non-medical students towards ASD.

Methods

This descriptive cross-sectional study, conducted between June and July 2024, examined knowledge and stigma toward ASD among undergraduate students in Jordan. Using a convenience sample, data were collected via self-administered surveys on social media and at universities. The Autism Sigma and Knowledge Questionnaire (ASK-Q) assessed participants’ knowledge and stigma. Statistical analysis included Chi-square and multiple linear regression.

Results

The questionnaire was completed by 1200 students, with a mean age of 21.11 ± 1.73 years, and 725 (60.4%) female respondents. Good economic status was reported by 945 (78.8%) participants, and 886 (73.8%) lived in urban areas. Medical students made up 811 (67.6%) of the sample, and 328 (27.3%) had prior knowledge of autism. The mean knowledge score was 44.50 ± 13.70, with significant associations found between knowledge subscales (diagnosis, etiology, treatment) and factors like gender, marital status, major, and prior knowledge. Urban residence, medical studies, and prior knowledge were positive predictors of higher knowledge scores. Stigma was reported by 18.3% of students, influenced by location, major, and prior autism knowledge.

Conclusion

This study reveals knowledge gaps about ASD among Jordanian students, where medical students were a positive factor for having stigma, underscoring empathy-based education’s importance.
Design and implementation of a low-cost datalogger for solar irradiance and PV module temperature
Authors: Yungho Edickson Bobo , Nfah Eustace Mbaka , Tchahou Tchendjeu Achille Ecladore
Published: December 2024

Photovoltaic module temperature and solar irradiance are two essential parameters that greatly affect the performance of solar plants. The measured information concerning these parameters is needed to size as well as predict future energy production of the plant. These data are often available at hourly intervals or more from meteorological stations and are expensive to acquire depending on the number of data points needed or from websites linked to satellites. Consequently, a method that can provide data at smaller time intervals is required to capture changes in irradiance and temperature. This paper presents a simple and cost-effective datalogger that measures the irradiance, relative humidity, module, and environmental temperatures. It used a 50 W photovoltaic module as an irradiance sensor. LM35 and DHT22 sensors were used for PV module and ambient temperature measurements, respectively. An interrupt service routine function implemented with the Arduino Mega microcontroller ensured a repetitive switching sequence of parallel resistance networks and the storage of desired current and voltage coordinates every 4s from 6 a.m. to 6 p.m. The irradiance computed was based on power at the maximum point with a load-switching network and in a short-circuit condition. The entire cost of the datalogger system was 153.12 euros, and major results show that the power at maximum power point method and ambient temperature give the best estimate of the photovoltaic module temperature. Consequently, the irradiance determined by the maximum power point method with ambient temperature can be used to evaluate the performance of photovoltaic modules using the single-diode model.