bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Remote Ischemic Conditioning in Ischemic Stroke Subtypes: A Post Hoc Subgroup Analysis From the RESIST Trial
Authors: Blauenfeldt Rolf Ankerlund , Mortensen Janne Kaergaard , Hjort Niels , Valentin Jan Brink , Homburg Anne-Mette , Modrau Boris , Sandal Birgitte Forsom , Gude Martin Faurholdt , Berhndtz Anne Brink , Johnsen Søren Paaske , Hess David C. , Simonsen Claus Ziegler , Andersen Grethe
Published: February 2024

BACKGROUND:

Remote ischemic conditioning (RIC) is a simple and noninvasive procedure that has proved to be safe and feasible in numerous smaller clinical trials. Mixed results have been found in recent large randomized controlled trials. This is a post hoc subgroup analysis of the RESIST trial (Remote Ischemic Conditioning in Patients With Acute Stroke), investigating the effect of RIC in different acute ischemic stroke etiologies, and whether an effect was modified by treatment adherence.

METHODS:

Eligible patients were adults (aged ≥18 years), independent in activities of daily living, who had prehospital stroke symptoms with a duration of less than 4 hours. They were randomized to RIC or sham. The RIC treatment protocol consisted of 5 cycles with 5 minutes of cuff inflation alternating with 5 minutes with a deflated cuff. Acceptable treatment adherence was defined as when at least 80% of planned RIC cycles were received. The analysis was performed using the entire range (shift analysis) of the modified Rankin Scale (ordinal logistic regression).

RESULTS:

A total of 698 had acute ischemic stroke, 253 (36%) were women, and the median (interquartile range) age was 73 (63–80) years. Median (interquartile range) overall adherence to RIC/sham was 91% (68%–100%). In patients with a stroke due to cerebral small vessel disease, who were adherent to treatment, RIC was associated with improved functional outcome, and the odds ratio for a shift to a lower score on the modified Rankin Scale was 2.54 (1.03–6.25);
P
=0.042. The association remained significant after adjusting for potential confounders. No significant associations were found with other stroke etiologies, and the overall test for interaction was not statistically significant (χ
2
, 4.33,
P
=0.23).

CONCLUSIONS:

In patients with acute ischemic stroke due to cerebral small vessel disease, who maintained good treatment adherence, RIC was associated with improved functional outcomes at 90 days. These results should only serve as a hypothesis-generating for future trials.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03481777.
Implementation of a Thrombectomy Stroke Center Triage Program in New York City Emergency Medical Services
Authors: Brandler Ethan S. , Lancet Elizabeth A. , Murphy Sheree , Lai Pamela H. , Carrano Vincent , Prezant David J. , Redlener Michael , Ben‐Eli David
Published: February 2024

Background

Due to the increased morbidity and mortality associated with acute cerebral ischemia caused by large vessel occlusions, the New York City (NYC) 9‐1‐1 Emergency Medical Services system implemented the NYC Stroke Triage Protocol with the intention of improving access to endovascular therapy for patients with suspected severe stroke.

Methods

Successful collaboration between multiple stakeholders enabled the NYC region to develop and implement a new stroke system of care for patients treated by Emergency Medical Services. Descriptive statistics including medians (interquartile range) and proportions were used as appropriate. Continuous data were compared using Mann–Whitney tests for medians and categorical data were compared by using Pearson chi‐square test.

Results

Between April 1, 2019 and March 31, 2022, 1337 (83.5%) patients directly transported under the NYC Stroke Triage Protocol by the NYC 9‐1‐1 Emergency Medical Services system to a Thrombectomy Stroke Center had a stroke diagnosis. Patients transported to a more distant Thrombectomy Stroke Center traveled an average of 5.7 minutes longer compared with those who were delivered to the closest Primary Stroke Center but the overall time between first patient contact and first pass at a Thrombectomy Stroke Center was an estimated 98.2 minutes shorter. Approximately 24% of directly transported patients with a stroke diagnosis underwent a thrombectomy.

Conclusions

The NYC Stroke Triage Protocol increased access to advanced interventional stroke care for eligible patients by decreasing time to treatment through prehospital identification of patients with severe stroke and directly transporting them to a stroke center capable of providing endovascular therapy.
Ko Wai Au – Ko Wai Au: Expressions of Wai
Authors: Denton Andrew , Gibbons Andrew , White Jayne , Williams Ngaroma M. , Martin Kaitlyn
Published: February 2024

As part of the international “Wash from the Start” omep (World Organization for Early Childhood Education) project, researchers shared time with children in three early childhood centre communities in the South Island of Aotearoa New Zealand – Te Wai Pounamu. The research explored young children’s engagement with local conditions of water through fieldwork annotations and photographic visual methods. The video article presented here is a photo essay that spans the researcher teams’ experiences in their encounters with the children and teachers they had the privilege to spend time with over a sunny week in Autumn 2022.
Enhanced Spectral Resolution and Two-Dimensional Correlation Spectroscopy (2D-COS)
Authors: Noda Isao
Published: February 2024

The apparent enhancement of spectral resolution is one of the attractive features of two-dimensional correlation spectroscopy (2D-COS). Highly overlapped adjacent bands often encountered in one-dimensional spectra may be effectively differentiated and identified by spreading peaks along the second dimension. This differentiating feature or selectivity is especially prominent in asynchronous spectra, where even a slight difference in the variation patterns of overlapped bands in response to a given perturbation results in the generation of cross-peaks. While cross-peaks in asynchronous spectra can identify signals originating from different moieties or bands, they do not effectively specify which regions of spectra actually share the same molecular origin. Overreliance on asynchronous spectra alone risks the potential false negative assessment or lack of sufficient specificity, leading to the failure of classifying signals into a reasonable set of component groups. The combined use of synchronous and asynchronous spectra coupled with the scaling techniques, elimination of anti-correlated negative synchronous peaks, and a robust line shape narrowing method provides a means to achieve both selectivity and specificity for resolution-enhancement of 2D-COS.
Simultaneous Application of Raman and Laser-Induced Breakdown Spectroscopy in the Gas Phase with a Single Laser and Detector
Authors: Kiefer Johannes
Published: February 2024

Raman spectroscopy and laser-induced breakdown spectroscopy (LIBS) are powerful tools for molecular and elemental analysis, respectively. Their combined application, however, is challenging due to the differences in the signal generation and detection characteristics. This note proposes three experimental schemes for the simultaneous application of Raman and LIBS for gas-phase diagnostics. Ring-cavity optical pulse stretchers facilitate shaping suitable pulse pairs from a Q-switched laser that enables the quasi-simultaneous detection of the Raman and LIBS signals on a single detector.
Fixed time containment control of multi-agent system under multi-source mismatched disturbance
Authors: Xiang Cheng , Jing He , Changfan Zhang , Xinliang Hu , Miaoying Zhang
Published: February 2024

Aiming at the cooperative control problem of multi-agent system, the fixed-time containment control of general second-order multi-agent system under mismatched disturbances is studied. Firstly, the problem of multi-agent system fixed-time containment control in ideal state is analyzed, and a distributed control protocol based on variable structure control is proposed. Then, a nonlinear fixed-time disturbance observer is designed, aiming at the mismatched disturbance, and a fixed-time control protocol based on the nonlinear disturbance observer is proposed. Finally, the effectiveness of the proposed control protocol under switching topology and multi-source disturbance is verified by numerical simulation.
Approaches to Successfully Delivering Rehabilitative Services in Prison: Perspectives from Non-Uniform Correctional Staff in Eight States
Authors: Dewey Susan , VandeBerg Brittany , Roberts Susan
Published: February 2024

Non-uniform staff help create prison social climate by providing services that include educational and vocational classes, mental health counseling, employment and reentry preparedness, and family-strengthening activities. The present study examines how non-uniform correctional staff perceive their association with successful delivery of rehabilitative services in correctional settings. After accompanying hundreds of non-uniform prison staff throughout their daily professional routines and conducting interviews with them in institutions supervised by eight different U.S. state prison systems, a threefold typology of approaches to successfully delivering rehabilitative services in prison was identified: holistic, pragmatic, and community-oriented.
John the Baptist: desert and diet
Authors: Binns John
Published: February 2024

The rise of the monastic movement in the fourth century led many monks to settle in the Judaean desert. They described how they lived in an inhospitable environment. This gives fresh insights into the life of John the Baptist, including his diet. He would have foraged for food, including the melagria plant, widely eaten by desert dwellers. Later scribes, who were unfamiliar with the desert, changed this to meli agrion, or wild honey.
Contexts of Convenience: Generalizing from Published Evaluations of School Finance Policies
Authors: Handel Danielle V. , Hanushek Eric A.
Published: February 2024

Recent attention to the causal identification of spending impacts provides improved estimates of spending outcomes in a variety of circumstances, but the estimates are substantially different across studies. Half of the variation in estimated funding impact on test scores and over three-quarters of the variation of impacts on school attainment reflect differences in the true parameters across study contexts. Unfortunately, inability to describe the circumstances underlying effective school spending impedes any attempts to generalize from the extant results to new policy situations. The evidence indicates that how funds are used is crucial to the outcomes, but such factors as targeting of funds or court interventions fail to explain the existing pattern of results.
The Real Consequences of Symbolic Social Policies: The Public Charge Rule and Benefits Use among Noncitizen Immigrants
Authors: Dias Felipe , Chance Joseph
Published: February 2024

This article examines the impact of the 2018 announcement of changes to the public charge rules on the benefits use of noncitizen immigrant households. Using data from the American Community Survey and difference-in-difference models, as well as an event-study approach, we document a decrease in Medicaid use in 2019 by members of low-income households with noncitizens compared to low-income households with only citizens, with larger effects for children. We find a similar decline in SNAP use but are unable to rule out differential pretrends before the announcement. Our findings suggest that the fear of being considered a public charge susceptible to deportation under the new rules likely explains the decrease in noncitizens’ public benefits in the postannouncement period.
Fumed nanosilica as filler for semi-rigid palm oil-based polyurethane foam: Mechanical, material, thermal, and fire response
Authors: Dzulkifli Mohd Haziq , Majid Rohah A , Ghazali Siti Khairunisah , Yahya Mohd Yazid
Published: February 2024

Incorporating nano-sized fillers into bio-based polyurethane (PU) foams typically enhances their properties. In present investigation, palm oil-based PU foams are fabricated with varied loadings (0 to 5 wt%) of fumed nanosilica. The foams are then characterized for their fire-retardancy, thermal stability, foam morphology, and also mechanical properties. Marginal improvement in Limiting Oxygen Index (LOI) values, as well as failure to be rated under UL-94 Vertical Combustion Test indicate limited potential of fumed silica in improving flammability of organic polymeric foams; suggesting exorbitant amount is required for any distinguishable effect to manifest. Interestingly; results from Thermogravimetry Analysis (TGA) shows marked improvements in terms of char residue with more than seven-fold increase at 5 wt% filler loading, possibly owed to the inert filler nature of fumed nanosilica forming a char barrier and acting as fuel diluent. Filled PU foams displayed an increased open-cell content, likely because the filler functioned as a cell opener. Removing the influence of density, the normalized compressive properties showed notable improvement up until a certain loading, which could be credited to the increased stiffness imparted by the filler itself. The results portray the potential of fumed nanosilica as filler for bio-based PU foams, offering enhanced thermal stability and limited fire retardancy.
Co-designing a culturally-sensitive theory-driven advance care planning game with Chinese older adults and healthcare providers
Authors: Liu Li , Wang Yao , Ho Tad Chun-Kwan , Li Miranda Man-Yee , Cheung Eddie Wai-Sum , Chow Rita Suk-Kuen , Gu Can , Chan Helen Yue-Lai
Published: February 2024

Background:

Advance care planning can be challenging because discussing end-of-life care often has negative connotations. Gamification is a novel approach to encourage advance care planning conversations in Western culture.

Aim:

To co-design a game with multiple stakeholders to promote advance care planning in Chinese communities.

Design:

A two-phase design guided by the Medical Research Council framework for developing complex interventions was adopted between May 2019 and August 2020. In phase I, a game prototype was developed based on literature review, expert consultation and end-user consultation. In Phase II, the game prototype was tested among end-users and refined according to their feedback and expertise of a multi-disciplinary team through an iterative process.

Setting/participants:

Experts in the field of aged care, palliative care, life education and game development and Chinese community-dwelling adults aged 60 years or older.

Results:

A board game called ‘ The Five Tastes Found in a Grocery Store’ was developed. The game design was shaped by Bandura’s Self-efficacy theory and feedback from experts and end-users. The participants generally found the gaming experience enjoyable and appreciated the opportunity to discuss end-of-life care openly.

Conclusions:

This study is the first to develop an evidence-informed, theory-based, culturally sensitive game for promoting advance care planning in the Chinese community using a co-design approach.
Heart-brain mapping: Cardiac atrial function is associated with distinct cerebral regions with high free water in older adults
Authors: Ji Fang , Wei Joseph Lim Kai , Leng Shuang , Zhong Liang , Tan Ru San , Gao Fei , Ng Kwun Kei , Leong Ruth LF , Pasternak Ofer , Chee Michael WL , Koh Woon-Puay , Zhou Juan Helen , Koh Angela S
Published: February 2024

Left atrial (LA) dysfunction has been linked to cognitive impairment and cerebrovascular dysfunction. Higher brain free-water (FW) derived from diffusion-MRI was associated with early and subtle cerebrovascular dysfunction and more severe cognitive impairment. We hypothesized that LA dysfunction would correlate with higher brain free-water (FW) among healthy older adults. 56 community older adults (73.13 ± 3.56 years; 24 female) with normal cognition and without known cardiovascular disease who had undergone cardiac-MRI, brain-MRI, and neuropsychological assessments were included. Whole-brain voxel-level general linear models were constructed to correlate brain FW measures with LA indices. We found lower scores in LA function measures were related to higher grey matter (GM) FW in regions including orbital frontal and right temporal regions (p < 0.01, family-wise error corrected). In parallel, LA dysfunction was associated with higher FW in white matter (WM) fibres including superior longitudinal fasciculus, internal capsule, and superior corona radiata. However, LA dysfunction was not related to WM tissue reduction and GM cortical thinning. Moreover, these cardiac-related higher brain FW were associated with lower executive function and higher serum B-type natriuretic peptide (p < 0.05, Holm–Bonferroni corrected). These findings may have implications for anti-ageing preventive strategies targeting cardiac and cerebral vascular functions to improve heart and brain outcomes.
Proposal of pharmacophore model for HIV reverse transcriptase inhibitors: Combined mutational effect analysis, molecular dynamics, molecular docking and pharmacophore modeling study
Authors: Annan Azzeddine , Raiss Noureddine , Lemrabet Sanae , Elomari Nezha , Elmir El Harti , Filali-Maltouf Abdelkarim , Medraoui Leila , Oumzil Hicham
Published: February 2024

Objectives: Antiretroviral therapy (ART) efficacy is jeopardized by the emergence of drug resistance mutations in HIV, compromising treatment effectiveness. This study aims to propose novel analogs of Effavirenz (EFV) as potential direct inhibitors of HIV reverse transcriptase, employing computer-aided drug design methodologies. Methods: Three key approaches were applied: a mutational profile study, molecular dynamics simulations, and pharmacophore development. The impact of mutations on the stability, flexibility, function, and affinity of target proteins, especially those associated with NRTI, was assessed. Molecular dynamics analysis identified G190E as a mutation significantly altering protein properties, potentially leading to therapeutic failure. Comparative analysis revealed that among six first-line antiretroviral drugs, EFV exhibited notably low affinity with viral reverse transcriptase, further reduced by the G190E mutation. Subsequently, a search for EFV-similar inhibitors yielded 12 promising molecules based on their affinity, forming the basis for generating a pharmacophore model. Results: Mutational analysis pinpointed G190E as a crucial mutation impacting protein properties, potentially undermining therapeutic efficacy. EFV demonstrated diminished affinity with viral reverse transcriptase, exacerbated by the G190E mutation. The search for EFV analogs identified 12 high-affinity molecules, culminating in a pharmacophore model elucidating key structural features crucial for potent inhibition. Conclusion: This study underscores the significance of EFV analogs as potential inhibitors of HIV reverse transcriptase. The findings highlight the impact of mutations on drug efficacy, particularly the detrimental effect of G190E. The generated pharmacophore model serves as a pivotal reference for future drug development efforts targeting HIV, providing essential structural insights for the design of potent inhibitors based on EFV analogs identified in vitro.
Allostatic Load, Morbidity, and Mortality Among Older Adults: A Multi-Wave Analysis From the National Health and Aging Trends Study
Authors: Polick Carri S. , Harris-Gersten Melissa L. , Dennis Paul A. , Noonan Devon , Hastings Susan N. , Calhoun Patrick S. , Rosemberg Marie Anne , Stoddard Sarah A.
Published: February 2024

Although allostatic load (AL) is a key concept to reflect physiologic wear and tear from stress, older adults are underrepresented in AL-related research, especially the oldest old (≥80). Further, attenuative factors are often unaccounted for. This longitudinal analysis using data from National Health and Aging Trends Study investigated relationships of AL in 2017 and multi-wave (1) comorbidity accumulation using multilevel Poisson modeling and (2) mortality risk using survival analysis. By year five (2022), each incremental AL increase that older adults ( n = 3614) experienced was associated with a 47% increase in comorbidity ( p < .001), and a 33% increased mortality risk ( p < .001). This research supports a shift to a more proactive, health promotion/risk mitigation paradigm through informing intervention research targeting AL, which is currently scarce. Identifying potentially modifiable and key driving factors influencing the relationship between AL and health among older adults is an important next step to inform intervention design.
Mechanical strength changes of combustible municipal solid waste components during their early pyrolysis stage and mechanism analysis
Authors: Jia Yifan , Chen Dezhen , Xu Sijia , Hu Yuyan , Yuan Guoan , Zhang Ruina , Yu Weiwei
Published: February 2024

Implementation of municipal solid waste (MSW) source segregation leads to a more convenient recycle of combustible MSW components. Textiles, plastics and papers are commonly available combustible components in MSW. Their shredding is conducive to resources recovery. But these components usually have high tensile strengths and are difficult to shred. To understand their mechanical strength changes in their early pyrolysis stage will help to address this problem. In this study, a universal electronic testing machine was used to determine the breaking strengths of the materials including cotton towel, polyethylene glycol terephthalate (PET), ivory board (IB), kraft paper (KP) and wool scarf in the temperature range of 30–250°C under N2 atmosphere, and the mechanisms of their strength changes were explored. The reaction force field molecular dynamics (ReaxFF-MD) simulation was used to explain the decomposition behaviours of different sugar groups of hemicellulose in cotton and paper and the change of van der Waals energy of wool during their early pyrolysis stages. The results showed that breaking strengths of all the combustible MSW components reduced as the temperature increased. The breaking strength of PET was found to have the highest descent rate with increasing temperature, then the descent rates of wool and cotton came as the second and third, respectively. Compared with cotton, the breaking strengths of KP and IB decreased more slowly. As the temperature increased, the breaking strength of cotton reduced mainly due to the decomposition of the glucuronic acid in hemicellulose, and the reduction was characterized by CO2 release. The breaking strength reduction of PET was caused by its molecular chain being relaxed. The breaking strength reduction of wool was firstly caused by the decrease in the van der Waals energy between its molecules, and then caused by molecular chain breaking. In addition, in order to understand the influence of material size on the breaking strength change during thermal treatment, the breaking strengths of cotton yarn bundles were correlated with their yarn number and temperature. This study lays the foundation for understanding changes in mechanical strengths of combustible MSW components during their early pyrolysis stage.
Influence of WC-12Co reinforcement on sliding wear performance of stainless steel-based MMC processed in a microwave oven
Authors: Pal Jatinder , Gupta Dheeraj , Singh Tejinder Paul
Published: February 2024

The high hardness, corrosion resistance, excellent resistance to wear of WC-12Co, and good formability of nickel-based EWAC make these materials suitable candidates used as a reinforcement in stainless steel SS316 for manufacturing various automobiles and anti-wear parts. In this study, the composite castings of SS316+15% Ni-based (EWAC)+WC-12Co (5%–15%) have been developed by microwave hybrid heating. The tribological performance of cast composite samples has been assessed by a Pin-on-disc sliding wear tester. The behavior of cumulative weight loss, wear rate, and coefficient of friction of the cast surface at variable WC-12Co was investigated. The maximum cumulative weight loss, of 12.2 mg occurred at a 4 kg normal load and 1.5 m/s of sliding speed for 5%WC-12Co reinforcement. The minimum cumulative weight loss of 2.1 mg for the 15%WC-12Co at a speed of 1.0 m/s and a normal load of 2 kg. The 5.8 times anti-wear properties have been developed at 15%WC-12Co than 5%WC-12Co. The lower wear rate of 0.002 mg/s was observed at 0.5 m/s and a load of 2 kg. The delamination, shear, de-bonding of particles, pitting, formation of cavities, craters, plastic deformation, and smeared oxide layer were the causes of wear. The MMC microhardness was improved. The microstructure morphology was free from visual defects.
Wind speed and wind power forecasting models
Authors: Lydia M. , Edwin Prem Kumar G. , Akash R.
Published: February 2024

Sustainable energy resources have proved to be the best alternative in the wake of environmental degradation, depletion of ozone layer and ever-increasing demand for energy. Though wind energy is a promising resource, the non-linear nature and non-stationary characteristics of wind have remained a formidable challenge. Variability in wind power has posed numerous challenges in managing the power systems, especially in grid evacuation, penetration and integration. Forecasting wind is one of the powerful solutions to solve this problem. As the penetration of renewable energy sources is poised to increase in future, an accurate prediction can go a long way in helping the electricity grid to perform well. This article presents a review of existing research and recent trends in the forecasting of wind power and speed with a critical analysis of the contribution of every researcher. A review of forecasting technologies, data, time horizons, various forecasting approaches and error metrics has been presented in detail. The plethora of research issues that continue to challenge power system operators, wind farm owners and other stakeholders has been highlighted. The development of models for wind power or wind speed forecasting with excellent reliability and outstanding accuracy is the need of the hour.
Cure models with adaptive activation for modeling cancer survival
Authors: Jiang Qi , Basu Sanjib
Published: February 2024

We propose a class of cure rate models motivated by analysis of colon cancer and triple-negative breast cancer survival data. This class is indexed by an adaptive activation parameter and a function. We establish that the class is stochastically ordered in the activation parameter and also establish two identifiability results for this class. The first- and last-activation models are members of this class whereas many cure rate models proposed in the literature are also part of this class. We illustrate that while first- and last-activation models may perform poorly under model misspecifications, the proposed model with adaptive activation provides appropriate inference in these cases. We apply the proposed approach to assess treatment-sex interaction on cure rate in a colon cancer study and to assess role of tumor heterogeneity and ethnic disparity in breast cancer.
The contribution of the nursing profession to the establishment of social justice: A grounded theory study
Authors: Hosseinzadegan Fariba , Habibzadeh Hosein , Jasemi Madineh
Published: February 2024

Background

Social inequities in the healthcare system threaten global health. Efforts to establish equity in healthcare is a key goal of healthcare systems worldwide. Social justice is a basic value of the nursing profession that always merits attention.

Objective

This study aimed to identify and explain the processes of the nursing profession’s participation in establishing social justice in healthcare system.

Research design and methods

This qualitative study was conducted using the grounded theory method.

Participants and research context

Data were collected through in-depth, semi-structured, individual interviews with 26 participants, 23 of whom were members of the nursing profession. Sampling started purposefully and, then, continued with theoretical sampling. Field notes were also taken for data collection. Data analysis was performed using Corbin and Strauss’ 2015 method.

Ethical considerations

The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran.

Findings

The “Professional Dynamics in the Path of Justice” was the study’s core category. This theory is the result of nine main categories: “inefficient professional authority,” “social justice, a neglected component in education,” “clinical concerns, barriers to nurses’ presence in society,” “individual input reserves to facilitate social justice,” “inadequate maturity of the profession in the path of equity in health,” “promoting justice in clinical practice,” “a tendency to community-oriented profession,” “use of personal approaches for justice promotion,” and “emerging justice-expanding nursing.” These categories cover the underlying factors, strategies, and outcomes of the nursing profession’s participation in establishing social justice process in healthcare.

Conclusion

The theory of professional dynamics in the path of justice can be used as a practical guide to describe the role of nurses in establishing social justice. Further studies with a quantitative approach to applying this theory are recommended.
Benign Adenomyoepithelioma: An Unrecognised Precursor of Ductal Carcinoma in Situ in Patient With Lynch Syndrome
Authors: Park Sean SW , Chan Marcus , Velaiutham Shanta , Vargas Ana Cristina
Published: February 2024

Currently, there is no robust evidence demonstrating a clear association between Lynch syndrome and non-malignant breast pathology such as adenomyoepithelioma. We report a case of benign breast adenomyoepithelioma, which after recurrence was associated with ductal carcinoma in-situ (DCIS) in a 41-year-old woman with Lynch syndrome, who lacked significant family history of breast or ovarian cancer. Both, the adenomyoepithelioma and DCIS were found to have nuclear loss of MSH2/MSH6 by immunohistochemistry, while germline testing confirmed MSH2 gene mutation. Concordant loss of MSH2 in both lesions in the context of a MSH2 pathogenic variant in this patient with Lynch syndrome illustrates that the benign adenomyoepithelioma behaved as a likely precursor of DCIS. Our report provides a novel perspective that in some patients with Lynch syndrome adenomyoepithelioma may represent a pre-malignant precursor lesion of DCIS.
Assessing Breast Cancer Screening and Outcomes Among First Nations Women in Alberta
Authors: Letendre Angeline , Shewchuk Brittany , Healy Bonnie A. , Chiang Bonnie , Bill Lea , Newsome James , Rahul Chinmoy Roy , Yang Huiming , Kopciuk Karen A.
Published: February 2024

Background

Breast cancer (BC) incidence rates for First Nations (FN) women in Canada have been steadily increasing and are often diagnosed at a later stage. Despite efforts to expand the reach of BC screening programs for FN populations in Alberta (AB), gaps in screening and outcomes exist.

Methods

Existing population-based administrative databases including the AB BC Screening Program, the AB Cancer Registry, and an AB-specific FN registry data were linked to evaluate BC screening participation, detection, and timeliness of outcomes in this retrospective study. Tests of proportions and trends compared the findings between FN and non-FN women, aged 50–74 years, beginning in 2008. Incorporation of FN principles of ownership, control, access, and possession (OCAP®) managed respectful sharing and utilization of FN data and findings.

Results

The average age-standardized participation (2013-8) and retention rates (2015-6) for FN women compared to non-FN women in AB were 23.8% ( P < .0001) and 10.3% ( P = .059) lower per year, respectively. FN women were diagnosed with an invasive cancer more often in Stage II ( P-value = .02). Following 90% completion of diagnostic assessments, it took 2–4 weeks longer for FN women to receive their first diagnosis as well as definitive diagnoses than non-FN women.

Conclusion

Collectively, these findings suggest that access to and provision of screening services for FN women may not be equitable and may contribute to higher BC incidence and mortality rates. Collaborations between FN groups and screening programs are needed to eliminate these inequities to prevent more cancers in FN women.
Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning: 2024 Update
Authors: Davis Christopher A. , Schmidt Andrew C. , Sempsrott Justin R. , Hawkins Seth C. , Arastu Ali S. , Giesbrecht Gordon G. , Cushing Tracy A.
Published: February 2024

The Wilderness Medical Society convened a panel to review available evidence supporting practices for acute management of drowning in out-of-hospital and emergency care settings. Literature about definitions and terminology, epidemiology, rescue, resuscitation, acute clinical management, disposition, and drowning prevention was reviewed. The panel graded available evidence supporting practices according to the American College of Chest Physicians criteria and then made recommendations based on that evidence. Recommendations were based on the panel's collective clinical experience and judgment when published evidence was lacking. This is the second update to the original practice guidelines published in 2016 and updated in 2019.
Seven-Year clinical outcomes after implantation of Eyecryl posterior chamber phakic intraocular lenses for high myopia
Authors: Kırgız Ahmet , Yalçınkaya Çakır Gülay , Çakır İhsan , Yıldırım Yusuf , Ağca Alper
Published: February 2024

Purpose

To evaluate the long-term clinical outcomes, safety and efficacy of Eyecryl posterior-chamber phakic intraocular lens implantation (pIOL) implantation in patients with high myopia.

Methods

Patients with myopia between −6.00 and −20.00 dioptres and with endothelial cell density (ECD) was ≥2300 cells/mm2 were included. Preoperative and postoperative first, fourth, and seventh years of refraction, uncorrected/corrected distance visual acuity (UDVA/CDVA), ECD, central vault were detected.

Results

Thirty-six eyes were analyzed. The mean UDVA and CDVA in postoperative seventh years were 0.25 ± 0.31 and 0.13 ± 0.24 logMAR, respectively. The safety and efficacy indices were 1.55 ± 0.54 and 1.24 ± 0.53, respectively. The mean cumulative ECD loss was 6.96% ( p < 0.001). The central vault at the 1st and the 7th year were 0.52 ± 0.14 and 0.49 ± 0.14 mm, respectively ( p = 0.25).

Conclusions

These findings supported the long-term stability, efficacy, safety of the Eyecryl pIOL for high myopia. Eyecryl posterior chamber pIOL is one of the effective refractive options in correcting high myopia.
Exploring the intermediary effects of TikTok on Generation Z’s visit intention
Authors: Fong Sook Fun , Ong Yi Xuan , Ating Rashid , Besa Maricar S.
Published: February 2024

Short video applications, specifically TikTok, have been widely used in the tourism industry to engage audiences during COVID-19 and the post-pandemic era. However, there is limited research on TikTok's influence on domestic tourism recovery post-COVID. Guided by the technology acceptance model (TAM), social cognitive theory, and source credibility model, this study proposes a research model to examine the effectiveness of social media influencer TikTok videos on Generation Z's visit intentions towards domestic tourism destinations in Malaysia. 201 Generation Z Malaysians participated in the self-administered online questionnaire and data were analysed using IBM SPSS and SmartPLS 4.0. The study highlighted the significant mediating effect of self-efficacy in the extended TAM model, indicating the influences of TikTok-related perceptions and SMI credibility in enhancing the audience's self-efficacy to travel to the marketed destination. This study extends existing TAM research on utilising TikTok videos with SMI as a domestic destination marketing tool in the post-COVID-19 era, offering valuable insights to practitioners on harnessing the strengths of TikTok as an effective destination marketing tool and fostering a sense of self-efficacy among tourists, thereby contributing to the sustainable recovery of the industry.
The association between exposure to hate speech or perceived discrimination and mental health problems among Korean residents in Japan
Authors: Matsumoto Takuya , Kitada Shiro , Suda Shiro
Published: February 2024

This study evaluated the effect of perceived discrimination and racism on the mental health state of Korean residents in Japan, with a particular focus on the risk of post-traumatic stress disorder (PTSD), depression, and psychological distress. Surveys were sent to Korean residents in Japan and a total of 240 valid responses were received. The valid response rate was 27.1%. The participants answered several questionnaire items, including demographic information and questions pertaining to their experiences of perceived discrimination, along with three self-reported measures of mental health, i.e., the Japanese version of Impact of Event Scale-Revised, the Zung Self-rating Depression Scale (SDS), and the 12-item General Health Questionnaire (GHQ-12). The results indicated that Korean residents in Japan experience hate speech and discrimination with a markedly high frequency (92.9% and 100%, respectively), and that factors such as employment discrimination and exposure to hate speech via social networking services were significant predictors of probable PTSD and psychological distress.
Barriers to use of interpreters in outpatient mental health care: Exploring the attitudes of psychotherapists
Authors: Gartner Kim , Mösko Mike , Becker Julia C. , Hanft-Robert Saskia
Published: February 2024

The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists who have not worked with professional interpreters in outpatient mental health care to identify factors that may prevent the use of interpreters in outpatient care and explore possible incentives to provide interpreter-mediated psychotherapy for migrants with limited language proficiency. Semi-structured interviews were conducted with 13 outpatient psychotherapists in Northern Germany who had not yet worked with professional interpreters in outpatient care. The interviews were audio recorded, transcribed and analysed using a structured content analysis approach. The psychotherapists named structural as well as subjective barriers and concerns. Findings suggest that improving structural factors, such as secure funding, minimal additional work, better preparation and training could facilitate the integration of professional interpreters into everyday treatment. Psychotherapists also mentioned concerns about their own confidence (e.g., insecurities regarding the triadic situation), the patient (e.g., reduced openness), the interpreter (e.g., doubts about suitability, motivation and empathy), as well as the therapeutic process (e.g., unclear allocation of roles). However, positive aspects and opportunities of interpreter-mediated psychotherapy were also described. These could be enhanced by the presence of conducive factors, such as existing trust between all parties and professional cooperation between interpreter and psychotherapist.
To foreignize or to domesticate? How media vary cross-nationally in their degrees of incorporating foreign events
Authors: van Dooremalen Thijs , Duyvendak Jan Willem
Published: February 2024

While the domestication literature indicates how national media link foreign events to a country’s domestic affairs, it has thus far only examined modes of domestication - the ways through which these links are created. In this article, we introduce a different dimension of the phenomenon: degrees of domestication. This includes the extents to which a foreign event gets connected with the domestic. By making a topic-modeling analysis of French and Dutch newspaper articles about 9/11, the 2004 tsunami in Southeast Asia, the Arab Spring and Donald Trump’s political rise, we provide an explorative case study of this dimension. We inductively arrive at a scale ranging from no to extreme domestication of the event, classified according to four degrees of domestication: (1) an entirely foreign affair; (2) a foreign political affair involving domestic actors; (3) a domestic political affair; (4) or a personal disruption. French newspapers score higher on the second degree, the Dutch ones on the third and fourth. A deepening of this pattern shows how these differences stem from two distinctive cultural repertoires that journalists and other media participants employ when relating to foreign events: a French one, which sees them as an opportunity to dominate the international political stage, and a Dutch one, which considers them a reason for reflecting on domestic or personal matters. These clear differences indicate the concept’s importance for the literature and for investigating it within other national media contexts.
OTDF platform: A new paradigm of homeownership for life with mobility and liquidity
Authors: Wang Jiaqi , Jiang Wanzhu
Published: February 2024

The rise of digital nomadism and shifting societal patterns necessitate a re-examination of traditional housing ownership. This study introduces the OTDF Platform, a pioneering homeownership trading platform that views residences as a user-driven distributed system. It establishes a continuous process consisting of tokenization, digitalization, and fluidization of ownership, enabling the free trade and rapid circulation of ownership to dynamically respond to changes in user housing demands and economic status. In methodological development, the platform extensively integrates various technologies and algorithms, including blockchain and space planning, to create a nested functional relationship among parameters, including requirements and expenditures, residential space conditions, and ownership values, thereby elucidating a transparent ownership calculation method. The OTDF Platform demonstrates a comprehensive and adaptable ownership model, reinstating the value of housing as a home within its liquidity, offering innovative insights for addressing housing challenges in the post-digital era.
Distal nerve transfers for peripheral nerve injuries: indications and outcomes
Authors: Bertelli Jayme A. , Tuffaha Sami , Sporer Matthias , Seltser Anna , Cavalli Erica , Soldado Francisco , Hill Elspeth
Published: February 2024

Distal nerve transfer is a refined surgical technique involving the redirection of healthy sacrificable nerves from one part of the body to reinstate function in another area afflicted by paralysis or injury. This approach is particularly valuable when the original nerves are extensively damaged and standard repair methods, such as direct suturing or grafting, may be insufficient. As the nerve coaptation is close to the recipient muscles or skin, distal nerve transfers reduce the time to reinnervation. The harvesting of nerves for transfer should usually result in minimal or no donor morbidity, as any anticipated loss of function is compensated for by adjacent muscles or overlapping cutaneous territory. Recent years have witnessed notable progress in nerve transfer procedures, markedly enhancing the outcomes of upper limb reconstruction for conditions encompassing peripheral nerve, brachial plexus and spinal cord injuries.
Personality disorders: A practical approach
Authors: Charlton Elizabeth , Charlton Professor Rodger
Published: February 2024

Approximately 1 person in 20 in the UK has a personality disorder (PD), and so GPs will often encounter people with a PD in routine clinical practice. However, PDs are poorly understood and can have severe consequences for a patient’s health, e.g. self-harm and their ability to function in society. Therefore, it is important for GPs to understand PDs, so that they can safely help patients, manage their care in the community and refer when needed. This article aims to provide a practical guide for GPs with information and guidance relevant to clinical practice.
Otorrhoea – the discharging ear
Authors: Wood Mr Fergus , Jaroenchasri Ms Rungphloy
Published: February 2024

Otorrhoea - discharge from the external auditory meatus – is a common presenting symptom in primary care in both children and adults. It may indicate infection or inflammation of the external or middle ear and is often accompanied by pain or hearing loss. Otorrhoea can be worrying and distressing for patients, and can impact school or work attendance. Both ear pain and discharge feature prominently within the clinical topic guide for ear nose and throat in the GP curriculum and commonly appears as a question in the Applied Knowledge Test examination. This article will review the most common causes of otorrhoea, how they may be differentiated, and their management.
Defining the Anthropocene tropical forest: Moving beyond ‘disturbance’ and ‘landscape domestication’ with concepts from African worldviews
Authors: Fraser James Angus , Cosiaux Ariane , Walters Gretchen , Asiyanbi Adeniyi , Osei-Wusu Adjei Prince , Addo-Fordjour Patrick , Fairhead James , Kialo Paulin , Laurier Engone Obiang Nestor , Oslisly Richard
Published: February 2024

How natural and cultural forces shaping tropical forested landscapes are conceptualised is of vital importance to Anthropocene debates. We examine two concepts: disturbance and landscape domestication. From the perspective of disturbance, humans – whether ancient or modern – are a priori negative for tropical forests, outside of and alien to nature. From this view, the Anthropocene is a planetary scale aggregation of disturbance. A more just vision of tropical forests, accepting anthropogenic influence on biodiversity, would combine ‘disturbance’ with other concepts that capture human agency and intentionality. Landscape domestication proposes that humans can shape ecology and plant and animal population demographics, making the landscape more productive and congenial for humans, upgrading or degrading the biodiversity of tropical forests. Herein, forest peoples shape the Anthropocene itself through their ‘domestication’ of the forest. Yet this approach can overdetermine culture, ignoring non-human agency, whilst human impacts can be seen as the outcome of intentional modifications to increase landscape productivity, at worst a disavowed projection of ‘economic man’. Using the convivial scholarship framework of Nyamnjoh, we argue that these ideas give incomplete views of tropical forests in the Anthropocene and can be enriched by concepts derived from African worldviews with ‘relationality’ and ‘wholeness’ at their core. These are expressed in ohanife, deriving from Igbo language, ubuntu, from the Nguni language and ukama, a notion from Shona culture. Together these concepts evince an ‘eco-bio-communitarianism’ embracing humans, God, spirits, ancestors, animals and inanimate beings in a ‘community of beings’ irreducible to the culture-nature divide (moving beyond disturbance) and allowing for the agency and personhood of non-humans (moving beyond historical ecology). This is consonant with Indigenous Amazonian worldviews, such as that of Kopenawa. Approaching human-nature relations from Nyamnjoh’s idea of conviviality, we elaborate a less incomplete and more just perspective on the cultural and natural shaping of Anthropocene tropical forests.