bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the role of disgust in hands and feet laterality judgement tasks
Authors: Brusa Federico , Suphi Erden Mustafa , Sedda Anna
Published: October 2023

The hand laterality task (HLT) and the foot laterality task (FLT) are used to explore motor imagery, the ability to imagine an action without executing it. With our limbs, we interact with our body, with others, and with the environment. These contacts might cause negative feelings, such as disgust. Disgust is elicited by different drivers. For instance, body products and body envelope violations provoke disgust to avoid contaminations and to avoid damaging our bodies. However, not much is known about how disgust changes our motor imagery processes. In this study, we examined whether there is any difference in the ability to imagine hands and feet when these are emotionally charged with reminders of disgust. Thirty-six participants completed an online version of a classic (neutral) HLT and FLT and two emotionally charged (disgust) versions. Our findings show that when body parts are modified so that they elicit emotional processing, disgust is salient overall, rather than being salient specifically for actions. This is true for both our hands and our feet.
Targeting inflammation to reduce recurrent stroke
Authors: Zietz Annaelle , Gorey Sarah , Kelly Peter J , Katan Mira , McCabe John J
Published: October 2023

Background:

Approximately one in four stroke patients suffer from recurrent vascular events, underlying the necessity to improve secondary stroke prevention strategies. Immune mechanisms are causally associated with coronary atherosclerosis. However, stroke is a heterogeneous disease and the relative contribution of inflammation across stroke mechanisms is not well understood. The optimal design of future randomized control trials (RCTs) of anti-inflammatory therapies to prevent recurrence after stroke must be informed by a clear understanding of the prognostic role of inflammation according to stroke subtype and individual patient factors.

Aim:

In this narrative review, we discuss (1) inflammatory pathways in the etiology of ischemic stroke subtypes; (2) the evidence on inflammatory markers and vascular recurrence after stroke; and (3) review RCT evidence of anti-inflammatory agents for vascular prevention.

Summary of review:

Experimental work, genetic epidemiological data, and plaque-imaging studies all implicate inflammation in atherosclerotic stroke. However, emerging evidence also suggests that inflammatory mechanisms are also important in other stroke mechanisms. Advanced neuroimaging techniques support the role of neuroinflammation in blood–brain barrier dysfunction in cerebral small vessel disease (cSVD). Systemic inflammatory processes also promote atrial cardiopathy, incident and recurrent atrial fibrillation (AF). Although several inflammatory markers have been associated with recurrence after stroke, interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) are presently the most promising markers to identify patients at increased vascular risk. Several RCTs have shown that anti-inflammatory therapies reduce vascular risk, including stroke, in coronary artery disease (CAD). Some, but not all of these trials, selected patients on the basis of elevated hsCRP. Although unproven after stroke, targeting inflammation to reduce recurrence is a compelling strategy and several RCTs are ongoing.

Conclusion:

Evidence points toward the importance of inflammation across multiple stroke etiologies and potential benefit of anti-inflammatory targets in secondary stroke prevention. Taking the heterogeneous stroke etiologies into account, the use of serum biomarkers could be useful to identify patients with residual inflammatory risk and perform biomarker-led patient selection for future RCTs.
Personalization of Trump and Xi in the U.S.–China trade conflict news: Comparison between the U.S. and China
Authors: Liu Shujun
Published: October 2023

News personalization in one-party dominant countries has been understudied or often analyzed through a Western lens. This study unpacked this phenomenon in one-party dominant country with the theory of leadership cult and soft power and compared news personalization of Xi Jinping in China with that of Donald Trump in the U.S. against the backdrop of the U.S.–China trade conflict. This study also investigated the influence of press ideology, political–geographical scope of news coverage and the trade conflict period on the presence and valence of personalization within each country. Results showed that leadership personalization was less prominent in China than in the U.S. The manifestation of news personalization in the U.S. was affected more by press ideology, while contextual factors, such as news political scope and the conflict period, played bigger roles in China. These findings provide insights into how news personalization is displayed in divergent political and media systems.
Modelling influenza and SARS-CoV-2 interaction: Analysis for Catalonia region
Authors: Fonseca i Casas Pau , Garcia i Carrasco Victor , Garcia i Subirana Joan
Published: October 2023

The aim is to analyse that, during the current pandemic situation, the reduction in the number of cases of influenza suggests that the non-pharmaceutical interventions (NPIs) applied to contain the expansion of SARS-CoV-2 also affect the influenza expansion. We analyse the interaction of influenza and SARS-CoV-2 spread based on an extended SEIRD model for the Catalonia region in Spain. We show that the dynamic evolution of the spread of SARS-CoV-2 and influenza generates a small interference. This interference causes a small reduction in the number of cases of seasonal influenza, reducing its expansion over the population. Other elements like the face mask mandates, social distancing and hand cleaning boost the reduction in both expansions. Influenza expansion will present a small reduction in the number of cases due to the interaction with SARS-CoV-2 expansion but mainly because the NPIs applied to the population.
Obesity Alters cytokine signaling and gut microbiome in septic mice
Authors: Bodilly Lauren , Williamson Lauren , Lahni Patrick , Alder Matthew N. , Haslam David B. , Kaplan Jennifer M.
Published: October 2023

Sepsis is a leading cause of mortality. Plasma cytokine levels may identify those at increased risk of mortality from sepsis. Our aim was to understand how obesity alters cytokine levels during early sepsis and its correlation with survival. Six-week-old C57BL/6 male mice were randomized to control (non-obese) or high fat diet (obese) for 5–7 weeks. Sepsis was induced by cecal ligation and perforation (CLP). Cytokine levels were measured from cheek bleeds 8 h after CLP, and mice were monitored for survival. Other cohorts were sacrificed 1 h after CLP for plasma and tissue. Septic obese mice had higher survival. At 8 h after sepsis, obese mice had higher adiponectin, leptin, and resistin but lower TNFα and IL-6 compared to non-obese mice. When stratified by 24-h survival, adipokines were not significantly different in obese and non-obese mice. TNFα and IL-6 were higher in non-obese, compared to obese, mice that died within 24 h of sepsis. Diet and to sepsis significantly impacted the cecal microbiome. IL-6 is a prognostic biomarker during early sepsis in non-obese and obese mice. A plausible mechanism for the survival difference in non-obese and obese mice may be the difference in gut microbiome and its evolution during sepsis.
Alemtuzumab following natalizumab is more effective in adult-onset than paediatric-onset multiple sclerosis
Authors: Puthenparampil Marco , Gaggiola Marta , Miscioscia Alessandro , Mauceri Valentina Annamaria , De Napoli Federica , Zanotelli Giovanni , Anglani Mariagiulia , Nosadini Margherita , Sartori Stefano , Perini Paola , Rinaldi Francesca , Gallo Paolo
Published: October 2023

Background:

Paediatric-onset multiple sclerosis (POMS) therapeutic approach derives from of adult-onset multiple sclerosis (AOMS) tailored algorithms.

Objectives:

To evaluate in a common clinical scenario the efficacy and safety of alemtuzumab (ALZ) in POMS and AOMS.

Methods:

All patients switching from natalizumab (NTZ) to ALZ for safety concerns (high anti-John Cunningham Virus Antibody Index value, anti-JCV Index) were enrolled in this single-centre, retrospective, case-control open-label study.

Results:

Ten POMS and 27 AOMS were followed up for 51.3 months. After month 12, we found a lower risk of clinical or radiological relapses among AOMS patients and among patients with older age at ALZ (both p < 0.05). Survival analysis revealed an increased risk of relapse in POMS compared with AOMS (logrank p = 0.00498) and patients starting ALZ before age 22.75 years than the elder ones (logrank p = 0.0018). Survival analysis did not disclose any difference between AOMS and POMS (logrank p = 0.27) in terms of progression independent of any relapse activity (PIRA). In addition, no evidence of relapse-associated worsening was observed. Autoimmune events were reported by 5 AOMS and no POMS (29.4% versus 0.0%, p = 0.057), and survival analysis was not significant (logrank p = 0.0786).

Conclusion:

ALZ seems more effective in AOMS than in POMS following NTZ. These findings underrate ALZ effectiveness when shifting from NTZ in POMS.
Combining Glucose Monitoring and Insulin Infusion in an Integrated Device: A Narrative Review of Challenges and Proposed Solutions
Authors: Schoemaker Michael , Martensson Anna , Mader Julia K. , Nørgaard Kirsten , Freckmann Guido , Benhamou Pierre-Yves , Diem Peter , Heinemann Lutz
Published: October 2023

The introduction of automated insulin delivery (AID) systems has enabled increasing numbers of individuals with type 1 diabetes (T1D) to improve their glycemic control largely. However, use of AID systems is limited due to their complexity and costs associated. The user must wear both a continuously monitoring glucose system and an insulin infusion pump. The glucose sensor and the insulin catheter must be inserted at two different body sites using different insertion devices. In addition, the user must pair and manage the different systems. These communicate with the AID software implemented on the pump or on a third device such as a dedicated display device or smart phone application. These components might be developed and commercialized by different manufacturers, which in turn can cause difficulties for patients seeking technical support. A possible solution to these challenges would be to integrate the glucose sensor and insulin catheter into a single device. This would allow the glucose sensor and insulin catheter to be inserted simultaneously, eliminating the need for pairing, and simplifying system management. In recent years, different technologies have been developed and evaluated in clinical investigations that combine the glucose sensor and the insulin catheter in one platform. The consistent finding of all these studies is that integration has no adverse effect on insulin infusion and glucose measurements provided that certain conditions are met. In this review, we discuss the perceived challenges of such an approach and discuss possible solutions that have been proposed.
The Scientific Knowledge of Bard and ChatGPT in Endocrinology, Diabetes, and Diabetes Technology: Multiple-Choice Questions Examination-Based Performance
Authors: Meo Sultan Ayoub , Al-Khlaiwi Thamir , AbuKhalaf Abdulelah Adnan , Meo Anusha Sultan , Klonoff David C.
Published: October 2023

Background:

The present study aimed to investigate the knowledge level of Bard and ChatGPT in the areas of endocrinology, diabetes, and diabetes technology through a multiple-choice question (MCQ) examination format.

Methods:

Initially, a 100-MCQ bank was established based on MCQs in endocrinology, diabetes, and diabetes technology. The MCQs were created from physiology, medical textbooks, and academic examination pools in the areas of endocrinology, diabetes, and diabetes technology and academic examination pools. The study team members analyzed the MCQ contents to ensure that they were related to the endocrinology, diabetes, and diabetes technology. The number of MCQs from endocrinology was 50, and that from diabetes and science technology was also 50. The knowledge level of Google’s Bard and ChatGPT was assessed with an MCQ-based examination.

Results:

In the endocrinology examination section, ChatGPT obtained 29 marks (correct responses) of 50 (58%), and Bard obtained a similar score of 29 of 50 (58%). However, in the diabetes technology examination section, ChatGPT obtained 23 marks of 50 (46%), and Bard obtained 20 marks of 50 (40%). Overall, in the entire three-part examination, ChatGPT obtained 52 marks of 100 (52%), and Bard obtained 49 marks of 100 (49%). ChatGPT obtained slightly more marks than Bard. However, both ChatGPT and Bard did not achieve satisfactory scores in endocrinology or diabetes/technology of at least 60%.

Conclusions:

The overall MCQ-based performance of ChatGPT was slightly better than that of Google’s Bard. However, both ChatGPT and Bard did not achieve appropriate scores in endocrinology and diabetes/diabetes technology. The study indicates that Bard and ChatGPT have the potential to facilitate medical students and faculty in academic medical education settings, but both artificial intelligence tools need more updated information in the fields of endocrinology, diabetes, and diabetes technology.
Comparison of Crude and Wine-Steamed Corni Fructus Based on UPLC-Q-TOF-MS Combined With Pharmacodynamics Screening
Authors: Jia Xiaozhou , Lv Weisheng , Yang XiaoLong , Luo Wenhui , Tang Hongmei , Chen Xiangdong , Sun Dongmei , Wei Mei
Published: October 2023

Introduction: The dry ripe sarcocarp of Cornus officinalis Sieb.et Zucc (in Chinese Shanyurou) has the properties of tonifying the liver and kidney. Wine-steamed Corni Fructus, as the main processed product from Corni Fructus, is widely used in traditional Chinese clinical medicine. This article aims to study the Corni Fructus composition changes when wine-steamed processed and to discuss the optimal processing technology of Corni Fructus combined with pharmacological experiments. Methods: The differences between Corni Fructus and wine-steamed Corni fructus constituents were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry. The effects of Corni Fructus and wine-steamed Corni Fructus with different processing times were studied from the aspects of immune activity, liver protection, and kidney yin deficiency. Results: A total of 132 compounds were identified in the wine-steamed process of Corni Fructus. There were no significant differences in immune function, liver protection, and kidney yin deficiency of Corni Fructus with different processing times. However, the effects of Corni Fructus processed by wine-steaming were significantly enhanced in all aspects. Conclusion: The wine-steamed Corni Fructus chemical composition may be the material basis for enhancing liver and kidney function. After processing, Corni Fructus can enhance immune function, liver protection function, and liver and kidney toning function.
Do News Frames Really Have Some Influence in the Real World? A Computational Analysis of Cumulative Framing Effects on Emotions and Opinions About Immigration
Authors: Guo Lei , Su Chris Chao , Chen Hsuan-Ting
Published: October 2023

This study examines how the news framing of immigration influences the public’s feelings toward immigrants and their preference for immigration policy in the United States. Unlike prior experimental research that documents the respondents’ immediate reactions to several hand-crafted news frames, this study provides strong empirical evidence for the association between the respondents’ real-world news exposure and their opinion change over time. Combining a computational media content analysis and a two-wave panel survey, the research demonstrates that while exposure to certain frames in the mainstream media would directly lead to public support for a stricter immigration policy, partisan media tend to affect public opinion indirectly by influencing their feelings toward immigrants in opposite directions.
Evaluation of Medication Exposure on Exacerbation of Disease in Patients With Myasthenia Gravis
Authors: Petrucelli Nick , Barra Megan E. , Koehl Jennifer L.
Published: October 2023

Background and Purpose

In patients with myasthenia gravis (MG), worsening of symptoms poses a risk of respiratory failure which can be precipitated by medication use. Although purported, the risks associated with administration of certain medications are not fully elucidated. Thus, clinical decision support involving a best practice alert was executed to caution providers of drug-disease interactions when ordering a potentially harmful medication. We performed an analysis of the alert overrides with subsequent medication exposure to determine the incidence of MG exacerbations.

Methods

This retrospective chart-review evaluated adult patients with MG at 2 large academic medical centers via electronic health records between November-2019 and November-2021 who received a medication following override of the clinical decision support tool. The primary outcome was proportion of patient encounters complicated by myasthenic exacerbations after potentially harmful medication administration. Secondary outcomes included changes in motor strength, length of stay, discharge disposition, unplanned level-of-care escalations, and changes to immunosuppressant therapy following medication administration.

Results

A total of 70 orders were assessed in 38 patients across 55 encounters. Medications administered during these encounters included macrolides, fluoroquinolones, β-blockers, calcium channel blockers, and magnesium sulfate. Exacerbation of disease occurred in 7 patient encounters (12.7%) and occurred after intravenous magnesium or intravenous labetalol. In 5/7 events, at least 1 other risk factor associated with a myasthenic exacerbation was present.

Conclusions

Of the medications reported to potentially worsen MG, intravenous labetalol and intravenous magnesium were the 2 agents associated with myasthenic exacerbations with a higher incidence in patients harboring additional risk factors.
Prevalence of myopia in school-age children in Ethiopia: A systematic review and meta-analysis
Authors: Lorato Merkineh Markos , Yimer Ali , Kebede Bizueneh Fassikaw
Published: October 2023

Objective:

This study aimed to estimate the pooled prevalence of myopia among school-age children in Ethiopia.

Methods:

Eligible articles were searched from PubMed, Embase, and Web of Science databases. In addition, Google Scholar and reference lists of the retrieved articles were searched from 30 July 2022 to 02 January 2023. The preferred reporting of items for systematic reviews and meta-analysis was used to report the search results. Microsoft Excel was used to keep the data. The qualities of eligible studies were checked using the Joanna Briggs Institute critical appraisal checklist for prevalence studies. Analysis was held using STATA Version 11. The degree of heterogeneity was checked using I² statistics. The possible sources of heterogeneity were examined using meta-regression and subgroup analyses. The funnel plot and Egger’s test were used to assess the potential publication bias. A correction was made for publication bias using Duval and Twee Die’s trim-and-fill analysis. The systematic review registration number is PROSPERO (#CRD42022330541).

Results:

We identified 21 eligible articles including 20,757 subjects. Of those participants, 10,601 (51.1%) and 10,156 (48.9%) were males and females, respectively. A total of 15,152 (73%) participants were urban residents. The estimated prevalence of myopia among school-age children in Ethiopia was found to be 5.26% (95% confidence interval: 4.09–6.42).

Conclusions:

The prevalence of myopia among school-age children in Ethiopia is considerable, affecting one in 20 school-age children. Therefore, the authors recommend the stakeholders take extra steps to speed up the implementation of the school vision screening program and its integration plan into the existing school nutrition program.
Inferior vena cava thrombosis extension into the right atrium: An unusual case report of renal cell carcinoma
Authors: Trifoi Mara , Levine Marc , Kim Andrew , Eden Brandon , Albert Adam
Published: October 2023

Inferior vena cava filling defects are common findings on computed tomography and magnetic resonance imaging, and accurate determination of pseudo, benign, or malignant thrombus is essential for clinical management. Inferior vena cava thrombosis involvement extending into the right atrium is a rare presentation of renal cell carcinoma. The degree of inferior vena cava and right atrium involvement is critical in determining management and prognosis of patients. Inferior vena cava thrombosis surgical thrombectomy is often a risky procedure due to the intraoperative determination of inferior vena cava thrombosis involvement. Accurate recognition of inferior vena cava thrombosis with right atrial involvement is critical in determining appropriate treatment options and preoperative level of involvement for surgical intervention. This case features a unique presentation of inferior vena cava thrombosis in renal cell carcinoma with right atrial involvement.
Acute fulminant amoebic colitis: A Case report
Authors: Romero Cedeño Carlos Alberto , Contreras-Yametti Javier , Ramírez Durini Lorenzo Javier , Cabrera Cepeda Freddy Patricio , Crespo Martinez Joseline Katherine , Merchan Dueñas Tamara Cristina , Tapia Calvopiña Milton Patricio , Contreras-Yametti Felipe
Published: October 2023

Amoebiasis is a parasitic infection that represents a public health problem in developing countries including Asia and Latin America where it is endemic (1000–5000 cases/100,000 habitants/year). The majority of patients have an asymptomatic course; however, 10% of patients develop complications with high morbidity and mortality, such as colonic perforation or fulminant amoebic colitis. We report a case in which a 73-year-old female presented with an acute abdomen that was initially attributed to a bowel obstruction that rapidly progressed to fulminant colitis with bowel perforation requiring total colectomy. Pre-surgical endoscopic histopathological examination revealed findings suggestive of Entamoeba histolytica trophozoites that were later confirmed in the colon post-surgical specimen leading to a diagnosis of fulminant amoebic colitis. This atypical presentation of amoebiasis, further expands the already broad differential diagnosis of acute abdominal pathology in the elderly population. A high index of suspicion is required for its prompt treatment and to prevent life-threatening complications.
A feasibility study on the efficacy of a patient-owned wound surveillance system for diabetic foot ulcer care (ePOWS study)
Authors: Lo Zhiwen J , Harish Keerthi B , Tan Elaine , Zhu Julia , Chan Shaun , Liew Huiling , Hoi Wai H , Liang Shanying , Cho Yuan T , Koo Hui Y , Wu Kyle , Car Josip
Published: October 2023

Objective

Wound image analysis tools hold promise in helping patients to monitor their wounds. We aim to perform a novel feasibility study on the efficacy of a patient-owned wound surveillance system for diabetic foot ulcer (DFU) care.

Methods

This two-institutional, prospective, single-arm pilot study examined patients with DFU. An artificial intelligence-enabled image analysis app calculating the wound surface area was installed and patients or caregivers were instructed to take pictures of wounds during dressing changes. Patients were followed until wound deterioration, wound healing, or wound stability at 6 months occurred and the outcomes of interest included study adherence, algorithm performance, and user experience.

Results

Between January 2021 and December 2021, 39 patients were enrolled in the study, with a mean age of 61.6 ± 8.6 years, and 69% ( n = 27) of subjects were male. All patients had documented diabetes and 85% ( n = 33) of them had peripheral arterial disease. A mean follow-up for those completing the study was 12.0 ± 8.5 weeks. At the conclusion of the study, 80% of patients ( n = 20) had primary wound healing whilst 20% ( n = 5) had wound deterioration. The study completion rate was 64% ( n = 25). Usage of the app for surveillance of DFU healing, as compared to physician evaluation, yielded a sensitivity of 100%, specificity of 20%, positive predictive value of 83%, and negative predictive value of 100%. Of those who provided user experience feedback, 59% ( n = 10) felt the app was easy to use, 47% ( n = 8) would recommend the wound analysis app to others but only 6% would pay for the app out of pocket ( n = 1).

Conclusion

Implementation of a patient-owned wound surveillance system is feasible. Most patients were able to effectively monitor wounds using a smartphone app-based solution. The image analysis algorithm demonstrates strong performance in identifying wound healing and is capable of detecting deterioration prior to interval evaluation by a physician. Patients generally found the app easy to use but were reluctant to pay for the use of the solution out of pocket.
Metadata for Efficient Management of Digital News Articles in Multilingual News Archives
Authors: Khan Muzammil , Alharbi Yasser , Alferaidi Ali , Alharbi Talal Saad , Yadav Kusum
Published: October 2023

The digital news preservation and management of low-resource languages are challenging tasks, especially in vast collections. Unique identification of individual digital objects is possible with well-defined attributes to assure efficient management, such as access, retrieval, preservation, usability, and transformability. The metadata element set is required to maximize the available attributes related to the digital objects. To create a comprehensive metadata set that contains all the necessary attributes and data about the digital news objects. It is more challenging and complicated when the archive contains articles from low-resourced and morphologically complex languages like Urdu and Arabic, which is difficult for machines to understand. The study presents challenges in low-resource languages (LRL) and research challenges. This metadata will help to link news articles based on similarity with other news articles stored in the digital news stories archive (DNSA) and ensures accessibility. In this study, we introduced 38 metadata elements set for the digital news stories preservation (DNSP) framework, of which 16 are explicit and 12 are implicit metadata elements. The paper presents how the digital news stories archive (DNSA) is enhanced to a multilingual archive and discusses the digital news stories extractor, which addresses major issues in implementing low-resource languages and facilitates normalized format migration. The extraction results are presented in detail for high-resource languages, that is, English, and low-resource languages (HRL), that is, Urdu and Arabic. The LRL encountered a high error rate during preservation compared to HRL, 10%, and 03%, respectively. The metadata extraction results show that HRL sources support all metadata elements as compared to LRL. The LRL has good support for explicit meta elements and many implicit meta elements with low extraction percentages. The LRL needs a more detailed study for accurate news content extraction and archiving for future access.
Sociocultural and Economic Barriers to Land Ownership Among Widows in Rural Western Kenya
Authors: Otieno Beatrice Adhiambo , Muga Geoffrey Otieno
Published: October 2023

Background

Widows still face immense barriers in owning land and get inferior reliable rights to land than males across most Kenyan communities. The objective of this study, therefore, was to establish the sociocultural and economic factors that continue to bar widows from owning land in rural Western Kenya.

Methods

A cross-sectional study employing qualitative data collection methods was adopted in this study where six widows participated in Case Narratives (CN), and two Focus Group Discussions (FGDs) each with five widows and one FGD comprising eight men were conducted. In addition, six widows were identified from the FGD participants for in-depth interviews (IDIs) and 10 key informant interviews with stakeholders were carried out. Data from the qualitative interviews were transcribed for coding and analysis. The thematic content analysis method was used to identify themes related to sociocultural and economic factors hindering women from land ownership.

Results

Economic marginalisation, traditional land ownership structures, and practices such as the skewed land inheritance that disfavour women due to the deep-rooted patriarchy, low level of education and lack of awareness of existing land laws were found to be the major hindrances to land ownership by widows. In addition, the tedious process of accessing land documents and widow inheritance is also to blame.

Conclusion

The study concludes that the existence of a legal regime that accords women and widows the right to own land may not be sufficient in realising the intended gains for women if it is not backed up with an effective implementation and awareness creation on the laws as well as economic empowerment of the widows through targeted social protection schemes.
A Case Report of Cushing’s Disease Presenting With Psychosis and Muscle Weakness Postpartum
Authors: Eskandari Delaram , Ziaee Amir , Samadanifard Seyed Hossein , Tavangar Seyed Mohammad , Tirkan Atefe , ZaeimYekeh Mohammad Amin
Published: October 2023

Cushing’s syndrome is a condition leading to overproducing of cortisol by the adrenal glands. If the pituitary gland overproduces cortisol, it is called Cushing’s disease. Cushing’s syndrome and even Cushing’s disease during and after pregnancy are rare events. There is not enough literature and guidance for managing and treating these patients. The diagnosis of Cushing’s syndrome in pregnancy is often delayed because the symptoms overlap. We presented a thin 31-year-old woman, admitted 2 months after a normal-term delivery, with an atypical presentation of Cushing’s disease, unusual clinical features, and a challenging clinical course. She had no clinical discriminatory features of Cushing’s syndrome. Given that the patient only presented with psychosis and proximal myopathy and had an uncomplicated pregnancy, our case was considered unusual. The patients also had hyperpigmentation and severe muscle weakness which are among the less common presentations of Cushing’s syndrome. Our findings suggest that an early diagnosis of Cushing’s disease is important in pregnancy period for its prevalent fetal and maternal complications, and it should be treated early to optimize fetal and maternal outcomes as there is an increasing trend toward live births in treated participants.
Tibial Tuberosity Rotation in Patients With Patellar Instability Versus Age- and Sex-Matched Controls
Authors: Polat Metin , Tandogan Reha Nevzat , Solak Evsen Polattas , Bekiroglu Gulnaz Nural , Beyzadeoglu Tahsin , Kayaalp Asim
Published: October 2023

Background:

Several methods have been described to measure external rotation of the tibial tuberosity; all use femoral landmarks.

Purpose:

To develop reproducible tibial-based methods to measure external rotation of the tibial tuberosity in patients with patellar instability.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Included were magnetic resonance images of 61 patients with patellar instability and 61 age- and sex-matched healthy controls. Three novel methods using tibial landmarks to measure the rotation of the tibial tuberosity (plateau axis-tuberosity axis [PA-TA] angle, tibial geometric center-tuberosity axis [GC-TA] angle, and plateau axis-midtuberosity point [PA-MT] angle) as well as a femoral-based rotational measurement (surgical transepicondylar axis-tuberosity axis [sTEA-TA] angle) and the tibial tuberosity-trochlear groove (TT-TG) distance were measured and compared in instability patients and controls using unpaired t tests, and the cutoff values for predicting instability were calculated using receiver operating characteristic curves. The correlations between the angle measurements and the TT-TG distance were analyzed.

Results:

Instability patients had significantly higher external rotation of the tibial tuberosity compared with controls with regard to the PA-TA angle (18.2° ± 9.6° versus 13.1° ± 6.8°; P = .001), GC-TA angle (8.4° ± 4.5° versus 11.5° ± 3.9°; P = .0001) and sTEA-TA angle (122° ± 8.5° versus 113.6° ± 6.3°; P = .0001). The mean TT-TG distance was also significantly higher in the instability group (18.2 ± 5.4 versus 11.5 ± 2.7 mm; P = .001). The cutoff values were 17.5° (area under the receiver operating characteristic curve [AUC] = 0.66) for PA-TA angle, 8.5° (AUC = 0.705) for GC-TA angle, 118.8° (AUC = 0.79) for sTEA-TA angle, and 15.2 mm for TT-TG distance (AUC = 0.863). PA-TA angle was significantly correlated with all other measurements ( r = 0.35-0.71; P ≤ .006 for all), whereas sTEA-TA angle had the strongest correlation with TT-TG distance ( r = 0.78; P = .001).

Conclusion:

The tibial tuberosity was externally rotated in patellar instability patients compared with age- and sex-matched controls, and this intrinsic malalignment of the proximal tibia was demonstrated in the tibial-based measurements.
Quality of Life among Ethiopian Cancer Patients: A Systematic Review of Literatures
Authors: Muhamed Ahmed Nuru , Chekole Bogale , Tafesse Fikremariam Endeshaw , Dessie Getnet , Bantie Berihun , Habtu Bisrat Fikadu , Shemsu Abdumejid Mustefa
Published: October 2023

Background

Assessment of quality of life (QoL) in cancer patients can provide an overall picture of the patient's adaptation to the disease and maintain long-term health and well-being. Determining the QoL in cancer patients could help with better care and could be as prognostic as medical factors and the survival benefit that pharmacological treatment could provide. The main objective of this review was to determine the prevalence of QoL among Ethiopian adult cancer patients.

Methods

A systematic review was conducted using the “Preferred Reporting Results of Systematic Reviews and Meta-Analyses” guidelines. Databases such as PubMed/Medline, CINAHL, AMED, Embase, the Cochrane Library, ScienceDirect, World Health Organization's Hinari portal, and African Journals Online databases were searched from January 2022 to June 2022. Google, Google Scholar, and university repositories were used to access unpublished studies. Two reviewers independently screened the data using a standardized data extraction format and appraised their quality using the Newcastle–Ottawa Scale.

Results

In this review, 10 studies were included. The prevalence of poor QoL ranged from 52 to 89.6. The physical, role, social, and emotional functioning were the most affected domains of QoL and have been significantly associated with QoL. Financial difficulty was the most important predictor of QoL among Ethiopian cancer patients. Pain, dyspnea, nausea, vomiting, and poor appetite were also reported as predictors of QoL. Low income, lower educational status, unmarried status, underweight, anxiety, and depression, advanced stage of cancer, patients with ≤2 cycles of chemotherapy, and the presence of comorbid diseases were significantly correlated with QoL.

Conclusions

The QoL of an Ethiopian cancer patient was low. Quality of life assessments, appropriate symptom management, integration of psycho-oncology care, and providing economic support shall be considered to improve their QoL.
The politics of living-with-difference: Local perception of diversity and coexistence around participatory place-making in a multiethnic neighbourhood
Authors: Ahn Byeongsun
Published: October 2023

While much has been said about the structural and spatial dimensions of living-with-difference in the city’s diverse places, existing research has seldom addressed its situatedness within a wider institutional context of place-making that shapes the everyday conditions of our encounters and experiences with ‘others’. As a result, little attention has been paid to the political dynamics of the governance process that engender a context-specific definition and meaning of urban diversity at the local scale. In this light, this article delves into the contextual embeddedness of urban diversity in regenerating a multiethnic neighbourhood, around which residents build their new social relations and belonging. It uses Vienna’s urban renewal model as a research window, through which to explore the political dimension of state-led urban renewal, including institutional and stakeholder arrangements, and its social implications for both old and new residents in everyday spaces. Building on the empirical evidence obtained through field observation and interviewing, it demonstrates how a ‘bottom-linked’ renewal process and its resultant outcome shape a place-specific mode of living-with-difference in the daily life. It concludes highlighting the need for greater attention to the enabling role of the city’s institutional arrangements and policy designs in current research on urban diversity and coexistence.
Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty in Patients Aged Over 70 Without a Full-Thickness Rotator Cuff Tear: A Systematic Review and Meta-Analysis
Authors: Dragonas Christos G. , Mamarelis Georgios , Dott Cameron , Waseem Saima , Bajracharya Abhijit , Leivadiotou Dimitra
Published: October 2023

This systematic review and meta-analysis compared the revision rates, complications, and outcomes in anatomic total shoulder arthroplasty (aTSA) and reverse TSA (rTSA) performed for primary glenohumeral osteoarthritis in patients aged over 70 years without a full-thickness rotator cuff tear.

We performed a systematic literature search identifying comparative studies meeting the above patient criteria and published from January 2010 to May 2022 from 3 databases: MEDLINE, EMBASE, and Cochrane Library. We performed the systematic review in accordance with PRISMA guidelines and the study was prospectively registered on PROSPERO.

From the 1798 studies identified from the initial literature search, 4 met our inclusion criteria. Two thousand seven hundred thirty-one shoulder arthroplasties (1472 aTSA and 1259 rTSA) were evaluated with a minimum follow up of 2 years. A statistically significant lower revision rate was observed in rTSA compared to aTSA (odds ratio [OR] 0.50, 95% confidence interval [CI]: 0.30, 0.84, p < .05). No significant difference was noted between aTSA and rTSA in overall complication rate (OR 0.98, 95% CI 0.34, 2.86, p = .97) while aTSA displayed a statistically significant improved postoperative Constant-Murley score [aTSA: 80(75; 82), rTSA: 68(66; 76.5), p < .001].

Higher revision rates were identified following aTSA in our study population, although admittedly this is within retrospective studies. aTSA displayed equal functional results and postoperative complications compared to rTSA in patients over 70 without a full-thickness rotator cuff tear. Given these similar results a shoulder surgeon must carefully consider each patient individually prior to deciding the optimal form of arthroplasty to offer.
Online Fabric Defects Detection Using Convolutional Neural Networks with Two Frameworks
Authors: Yu Zhiqi , Sheng Xiaowei , Xie Guosheng , Xu Yang , Sun Yize
Published: October 2023

Due to the suboptimal efficiency, accuracy, and increasing costs of manual defect detection in the textile industry, online visual inspection for fabric defects has emerged as an essential and promising research area. However, challenges such as the lack of defective samples and issues with industrial deployment still persist. This paper presents a novel defect detection technique based on deep learning, which primarily comprises two frameworks. First, we design an improved generative adversarial network with an encoder–decoder architecture to address the paucity of requisite defective samples. We use defect-free samples as input to the generator, ensuring that the generated defect samples maintain a similar pattern. We mitigate the vanishing gradient problem using Wasserstein distance as the loss function. Second, we enhance the Single Shot MultiBox Detector network by introducing Inception modules and feature fusion to detect defects across different scales. The AdaBound optimizer is selected to update the model parameters. We compare the proposed approach with other methods on self-generated fabric data sets that are partially produced by our generative adversarial network model. An online defect detection system is proposed to capture fabric images and evaluation in a production environment. Experiments demonstrate the superior performance of the proposed approach, achieving 97.5% accuracy in real time, making it well-suited for application in the industry.
COVID-19 – a potential trigger for MOGAD-associated optic neuritis: a case report and literature review
Authors: Bhardwaj Ankit , Mishra Hara Prasad , Goel Ayush , Gupta Ashi
Published: October 2023

SARS-CoV-2 affects the nervous system directly by neurotoxic action, by binding to angiotensin-converting enzyme-2 (ACE2) receptors or indirectly by inducing cytokine storm leading to disruption of the blood-brain barrier, immunological mediation, increasing blood coagulation and as a trigger for autoimmune-mediated demyelinating injuries in the central nervous system. In COVID-19 neuro-ophthalmological manifestations are not so common. Optic neuritis is the result of optic nerve inflammation and has varied causes. In many patients, signs of inflammation are not visible on the fundus, and it usually manifests as papillitis-anterior neuritis, retrobulbar neuritis or visible optic nerve oedema. We are reporting a case of a middle-aged adult diagnosed with myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis of the right eye post-COVID-19 disease. Routine biochemical and haematological investigations, including electrolytes and hepatic and renal functions, were normal. In cerebrospinal fluid (CSF) – glucose 63.8 mg/dL, protein 39.1 mg/dL and ADA – 1 µ/L. No oligoclonal bands of immunoglobulin G (IgG) were seen on high-resolution electrophoresis. Serum Anti-MOG-antibodies were positive. A gadolinium-contrast magnetic resonance imaging (MRI) of the brain and orbits shows post-contrast enhancement in the superior aspect of the right intraconal soft tissue. The right optic nerve appears bulky and heterogeneous with peripheral post-contrast enhancement along its entire length suggestive of neuritis. A diagnosis of MOG antibody-positive optic neuritis was made, and the patient was treated with an injection of Methylprednisolone with intravenous immunoglobulin. Each day, the evaluation of the right eye showed remarkable improvement from finger counting to 6/6 vision. The patient was discharged on the 9th day of admission. We can conclude that early diagnosis was essential for improving the long-term outcome of the patient.
Influence of provider openness and leadership behaviors on adherence to motivational interviewing training implementation strategies: Considerations for evidence-based practice delivery
Authors: Budhwani Henna , Alley Zoe M. , Chapman Jason E. , Aarons Gregory A. , Pooler-Burgess Meardith , Coyle Karin , Carcone April Idalski , MacDonnell Karen , Naar Sylvie
Published: October 2023

Background

Adherence to intervention training implementation strategies is at the foundation of fidelity; however, few studies have linked training adherence to trainee attitudes and leadership behaviors to identify what practically matters for the adoption and dissemination of evidence-based practices. Through the conduct of this hybrid type 3 effectiveness-implementation cluster randomized controlled trial, we collected Exploration, Preparation, Implementation, and Sustainment (EPIS) data and merged it with tailored motivational interviewing training adherence data, to elucidate the relationship between provider attitudes toward evidence-based practices, leadership behaviors, and training implementation strategy (e.g., workshop attendance and participation in one-on-one coaching) adherence.

Method

Our sample included data from providers who completed baseline (pre-intervention) surveys that captured inner and outer contexts affecting implementation and participated in tailored motivational interviewing training, producing a dataset that included training implementation strategies adherence and barriers and facilitators to implementation ( N = 77). Leadership was assessed by two scales: the director leadership scale and implementation leadership scale. Attitudes were measured with the evidence-based practice attitude scale (EBPAS-50). Adherence to training implementation strategies was modeled as a continuous outcome with a Gaussian distribution. Analyses were conducted in SPSS.

Results

Of the nine general attitudes toward evidence-based practice, openness was associated with training adherence (estimate [EST] = 0.096, p < .001; 95% CI = [0.040, 0.151]). Provider general (EST = 0.054, 95% CI = [0.007, 0.102]) and motivational interviewing-specific (EST = 0.044, 95% CI = [0.002, 0.086]) leadership behaviors were positively associated with training adherence ( p < .05). Of the four motivational interviewing-specific leadership domains, knowledge and perseverant were associated with training adherence ( p < .05). As these leadership behaviors increased, knowledge (EST = 0.042, 95% CI = [0.001, 0.083]) and perseverant (EST = 0.039, 95% CI = [0.004, 0.075]), so did provider adherence to training implementation strategies.

Conclusions

As implementation science places more emphasis on assessing readiness prior to delivering evidence-based practices by evaluating organizational climate, funding streams, and change culture, consideration should also be given to metrics of leadership. A potential mechanism to overcome resistance is via the implementation of training strategies focused on addressing leadership prior to conducting training for the evidence-based practice of interest.
Healthcare Utilization, Costs and Other Outcomes of Peroral Endoscopic Myotomy (POEM) Versus Heller Myotomy in the Inpatient Management of Achalasia in The United States: A 2016 to 2020 Nationwide Study
Authors: Kilani Yassine , Aldiabat Mohammad , Mubashir Maryam , Alsakarneh Saqr , Vohra Ammar Arif , Aljabiri Yazan , Hamo Falak , Vikash Fnu , Kumar Vikash , Samo Salih
Published: October 2023

Introduction:

Per-Oral Endoscopic Myotomy (POEM) is the recommended first-line treatment for all achalasia subtypes due to its minimally invasive nature. We aim to evaluate the trends of utilization, costs, and outcomes (mortality and complications) of POEM versus Heller Myotomy (HM) in U.S. hospitals.

Methods:

This is a retrospective study of individuals admitted with a primary diagnosis of achalasia. Data was obtained from Nationwide Inpatient Sample databases from the years 2016 to 2020 using ICD-10 codes. We assessed the therapeutic procedures employed, the trends and outcomes associated with POEM versus HM in terms of hospital utilization, mortality, morbidity, and the baseline characteristics of our study population.

Results:

A total of 26 880 adult individuals were diagnosed with achalasia. Of these, 11% underwent POEM, while 59% underwent HM. POEM rates increased from 6% to 10% of achalasia admissions, while HM decreased from 49% to 41% during the study period. No significant differences in total hospital charges or length of stay were observed between the 2 procedures. Regarding procedural complications, HM was associated with significantly reduced odds of pneumonia (adjusted Odds Ratio [aOR] = 0.09, 95% CI: 0.02-0.41), pneumoperitoneum (aOR = 0.11, 95% CI: 0.03-0.36), and pneumomediastinum (aOR = 0.21, 95% CI: 0.06-0.68), with no difference in the odds of esophageal perforation (aOR = 1.33, 95% CI: 0.27-6.48) and sepsis (aOR = 2.04, 95% CI: 0.22-18.40).

Conclusion:

While HM rates are currently declining in the U.S., POEM usage appears to be increasing. Despite being a less invasive measure than HM, POEM remains underutilized in the U.S.