bluuebunny/crossref_metadata_2025 huggingface dataset:
Precision medicine in axial spondyloarthritis: current opportunities and future perspectives
Authors: So Jacqueline , Tam Lai-Shan
Published: October 2024

Axial spondyloarthritis (axSpA) is a complex disease characterized by a diverse range of clinical presentations. The primary manifestation is inflammatory lower back pain, often accompanied by other clinical manifestations such as peripheral arthritis, enthesitis, uveitis, psoriasis, and inflammatory bowel disease. However, the presentation of axSpA can vary widely among patients. Despite extensive research, the precise pathogenesis of axSpA remains largely unknown. The lack of complete understanding poses challenges in subgrouping the disease, developing specific treatment approaches, and predicting treatment response. In this review, we will explore the limitations in diagnosing and treating axSpA. In addition, we will examine the current knowledge and potential opportunities provided by various omics and technological advancements in enhancing the diagnosis and personalized treatment of axSpA.
The case for a circular Blue Card for young non-EU professionals
Authors: Theus Willem
Published: October 2024

Due to the challenging demographics in Europe, a new approach to labour migration to the EU is necessary. Such an approach should be more targeted and thus entail a more proactive and integrated stance. Whilst some moves in this direction have been made in recent years, more are required. This article charts one possible route to a more proactive and integrated policy by proposing the creation of European university campuses outside of Europe to act as hubs of academic, cultural, linguistic and labour exchange, similar to the American system. This approach would not only address the current labour force challenges but would also hold the potential to significantly enhance academic and cultural exchange. Many of the required elements are already in place: numerous bilateral universities, for example, already exist, such as the German Jordanian University, as do various European research and cultural institutes. Such campuses, combined with a new circular Blue Card for young non-EU professionals, would have benefits for both the member states and the selected partner countries. The article concludes by proposing the implementation of concrete test cases in the European neighbourhood.
Dramatic Reanimation and Spontaneous Re-Canalization of a Fourth Ventricular Hemorrhage: “REVIVE” Phenomenon
Authors: Salman Saif , Janu Andrea , Sharma Rohan , McLaughlin Diane , Hardman Morgan , Tawk Rabih , Freeman W David
Published: October 2024

Background

Intraventricular hemorrhage is a calamitous type of stroke where bleeding into the ventricular system can be defined as: primary, if confined within the ventricles; or secondary, due to intracerebral hemorrhage extending from adjacent parenchyma. Intraventricular blood clot can lead to secondary insult and inflammatory responses that culminates in hydrocephalus as the most common cause of death.

Purpose

THerein, we report a patient with a high modified Graeb scale and low Glasgow coma scale. She spontaneously recanalized her fourth ventricle, decompressed her reticular activating system with remarkable spontaneous bilateral eye opening, and a consequently experienced a halfway drop in her mGS.

Results

This is the first reported case of a spontaneous recanalization of 4th ventricle obstruction secondary to IVH without intervention and subsequent dramatic neurological improvement. We believe that the apixaban primarily preserved the liquid state of hemorrhage and her presumed elevated ICP was sufficient to push out the liquified blood in the 4th ventricle into the upper spinal canal , recanalizing the 4th ventricle by continuously creating downward CSF pressure waves. Given the RAS location around the 4th ventricle, we hypothesize spontaneous decompression from the clot lysis triggered the RAS activation with sudden arousal manifested as spontaneous bilateral eyes opening. Hence, we refer to this as the reticular activating system reactivation after ventricular hemorrhage evacuation, or simply the “REVIVE” phenomenon.

Conclusion

This dramatic improvement from coma to awake state is worthy of recognition for future neurotherapeutic interventions.
The resurrection of the political offence exception to extradition in UK law
Authors: Arnell Paul , Walker Clive
Published: October 2024

The resurrection of the political offence exception to extradition in UK law would be worthwhile. Once providing protection to persons sought for offences of a political character, the exception was removed from UK law in 2004. A number of factors weigh in favour of its reintroduction. Those relevant at the time of its development in the 19th century have become increasingly relevant again, supporting contemporary considerations. The cases of Julian Assange and Clara Ponsati illustrate the need for reintroduction. A new exception, a ‘constitutionalism bar’, founded upon the rule of law, human rights and democracy could protect the foundations of modern liberal democracies as well as individuals at risk of persecution.
The hygienist’s role in the management of the implant patient in primary care
Authors: Reading Kate , Knowles Lisa , Towns Sarah
Published: October 2024

The scope of practice for dental hygienists includes the care of implants and peri-implant tissues. Hygienists in primary care settings must therefore be competent and confident in assessing, managing, and treating implant restorations and their peri-implant health. Dental hygienists also play a key role in the education of patients on oral health as part of their daily practice, a recognised and valued aspect of their clinical care responsibilities. Dental hygienists and therapists therefore have a pivotal role as adjunct support in a patient’s implant journey where they can offer essential support throughout their treatment period and can provide guidance and education at regular intervals.

Using current guidelines, dental hygienists and therapists can create and implement practice protocols to help deliver the necessary clinical care during pre-implant, peri-implant, and post-implant phases of care. This article discusses the processes required to achieve a healthy implant patient, how the dental team can support the patient, and how clinicians can work together to achieve the best possible clinical outcome. This article will explore current evidence-based guidance and how to implement guidance in a practice setting, with protocols for all members of the dental team, with the final goal of a dentally healthy, motivated patient.
Dentolegal aspects of dental implants
Authors: Henderson Stephen , Darcey James
Published: October 2024

Dentists providing implant dental treatment need to fully appreciate the legal and clinical issues that are relevant to implant dentistry. The legal aspects of implant dentistry, according to UK law, are described in this article. Suggestions for how the risks of implant treatment might be mitigated, with tips and examples are provided.
The edentulous patient: the impact of implants on quality of life
Authors: Jawad Sarra
Published: October 2024

Edentulism (total tooth loss) can be managed with four possible options: no prosthetic replacement, conventional complete dentures, implant-retained overdentures (removable), or implant-supported bridgework (fixed). Selection of these choices is influenced by social, medical, anatomical, technical, and economic factors. The care team involved in the decision-making process (be it patients, clinicians and occasionally commissioners of services) should be aware of the different treatment options and their potential impact on the patient’s quality of life (QoL). The cost effectiveness of this impact can also be evaluated. Knowledge of the life-long sequelae of edentulism will also help practitioners guide patients in their treatment planning decisions when they may be approaching an edentulous state, preparing them for the challenges that may lie ahead. This paper aims to address the impact that edentulism has on QoL and the treatment options, focusing on the patient perspective.
A case report of nasal myiasis caused by Musca domestica in a patient with respiratory failure
Authors: Xu Hua , Fan Wen , Li Wenhua , Wang Hongfei , Dou Lin
Published: October 2024

Nasal myiasis is a nasal infestation caused by myiasis, a parasitic disease affecting the nasal cavity. It is a rare condition. The nasal cavity is in close proximity to the sinuses, eyes, and cranial cavity. If the fly larvae migrate into this location, it may result in significant complications. The prompt and appropriate removal of maggots and the administration of an efficacious treatment can effectively prevent further deterioration of the disease. In this case study, we present the case of a 55-year-old woman who was admitted to the intensive care unit with severe respiratory failure. On the fourth day following admission, the patient remained unconscious, and several white larvae emerged from the nasal cavity. Through identification, the larvae were determined to be Musca domestica larvae. Subsequently, saline irrigation was performed under nasal endoscopy, and anti-inflammatory therapy was administered to the patient to prevent intracranial infection. Following treatment, the patient’s symptoms were effectively managed, and the prognosis remained favorable until the 1-month follow-up. This case report presents a literature review of the reported cases of nasal myiasis caused by M. domestica and discusses the susceptibility factors and treatment modalities for nasal myiasis.
Multiple Pyoderma Gangrenosum Overlying AV Fistula Treated With Colchicine: A Case Report
Authors: Derstenfeld Alex , Meunier Rosalie-Sélène , Bouchard Josée , Mereniuk Alexandra
Published: October 2024

Rationale:

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis which gives rise to painful ulcers. Pyoderma gangrenosum can be triggered by trauma, a phenomenon called pathergy. Here, we report the first case of PG arising from pathergy due to needle insertion overlying an arteriovenous fistula (AVF). This case report seeks to inform nephrologists about PG, this yet unreported presentation, and management in the context of hemodialysis.

Presenting concerns:

A 69-year-old woman presented to dermatology clinic for erythemato-violaceous plaques with central ulceration at the site of needle insertion overlying her AVF. The patient was known for chronic renal insufficiency secondary to C3 glomerulonephritis, for which she received hemodialysis. After an accidental burn which lead to appearance of a painful ulcer, following each needle insertion for hemodialysis, she would develop an erythematous papule that progressed to a painful ulcer with erythematous-violaceous borders.

Diagnosis:

Pyoderma gangrenosum was clinically diagnosed and both clinical and paraclinical evaluation did not reveal any secondary cause of PG.

Intervention:

Dialysis via AVF was suspended due to the risk of triggering more PG and was temporarily pursued by central venous catheter. The patient was initially treated with prednisone and topical corticosteroids. Furthermore, owing to the high recurrence rate of PG, colchicine was initiated in prevention to avoid resorting to immunosuppressive or long-term corticotherapy.

Outcomes:

The patient’s lesions improved on prednisone, which was then tapered over 1 month. Following prednisone taper and continuing improvement of PG on colchicine and topical corticosteroids alone, the decision was taken to recommence dialysis via AVF after performing a negative pathergy test. Topical corticosteroids were ceased due to the risk of cutaneous atrophy and were replaced by pimecrolimus ointment. The patient has continued dialysis via AVF ever since, without recurrence.

Novel Finding:

This is the first case reported of PG arising from pathergy due to needle insertion overlying an AVF. Colchicine may be a safe and effective therapy for long-term treatment of PG in the context of hemodialysis.
Assessing the Extent and Types of Hate Speech in Fringe Communities: A Case Study of Alt-Right Communities on 8chan, 4chan, and Reddit
Authors: Rieger Diana , Kümpel Anna Sophie , Wich Maximilian , Kiening Toni , Groh Georg
Published: October 2024

Recent right-wing extremist terrorists were active in online fringe communities connected to the alt-right movement. Although these are commonly considered as distinctly hateful, racist, and misogynistic, the prevalence of hate speech in these communities has not been comprehensively investigated yet, particularly regarding more implicit and covert forms of hate. This study exploratively investigates the extent, nature, and clusters of different forms of hate speech in political fringe communities on Reddit, 4chan, and 8chan. To do so, a manual quantitative content analysis of user comments ( N = 6,000) was combined with an automated topic modeling approach. The findings of the study not only show that hate is prevalent in all three communities (24% of comments contained explicit or implicit hate speech), but also provide insights into common types of hate speech expression, targets, and differences between the studied communities.
Trust Assessment Skills Among Close Friends in a Ubiquitous Social Media Environment
Authors: Colvin Randy G.
Published: October 2024

For ages, individuals have relied on trust assessment skills to evaluate spoken words and accompanying body language social signals (BLSS) in friendships. This interactive process seeks to avoid harmful associations and unreliable information. However, with widespread social media use, assessment of BLSS is difficult, and users commonly report harm from defective estimations of interactions. This study evaluates how individuals adjust their trust assessment skills for close social media friendships, given the importance they place on BLSS in its role as a moderator. The research utilizes PLS-SEM, ANOVA, and cluster analysis to evaluate 247 U.S. online survey participants aged 18 to 67. The study adapts Mayer et al.’s trust model using social learning and cognitive dissonance theories. The independent variables, ability, benevolence, and integrity, strongly predict the dependent trust belief. In line with cognitive dissonance theory, BLSS has a negative and significant moderating effect on ability. BLSS reflects a small effect and widely insignificant moderating relationship with benevolence; analysis shows that a moderating relationship should not apply to benevolence. Counter to the hypothesized direction, BLSS produced a positive moderating effect on integrity, which was insignificant by a narrow margin. The analysis explains the basis for the positive relationship. Lastly, statistical analysis reveals an age-based shift in the relevancy of BLSS; younger users place less importance on BLSS, whereas older users place more importance on BLSS. This position for younger users aligns with their exposure and acclimation to social environments with widespread mobile communication and social media use since childhood.
Online Political Participation of Refugees in Germany: Analysis of a Survey in Bavaria
Authors: Schmidbauer Simon , Becker Maria , Haug Sonja
Published: October 2024

New media are an important resource for the political participation of marginalized groups. However, there is still a lack of knowledge about the factors that influence whether this opportunity is used. Influencing factors emerge from both the Civic Voluntarism Model and previous research on migrants’ political activity. Using data collected in 2019/2020 from 486 refugees living in Bavaria, we estimate linear probability models to investigate facilitating factors for the use of new media for political participation. The analysis shows that refugees in Germany who inform themselves about politics online tend to be predominantly male, higher educated, and politically involved. Language skills and the duration of stay also appear to be important. For the expression of one’s political opinion online, gender and language skills have an impact, but informing oneself about German politics, political interest, and offline political activity in Germany are the most relevant factors. This indicates that there is a close link between on- und offline activity. However, using the internet requires particular resources, so that people with lower language skills, for example, are particularly disadvantaged.
Learning and Development Program’s Admission Requirements and Student Engagement as Success Determinants in Accountancy
Authors: Ayaya Onesmus , Moswatsi Michael Kgorompe
Published: October 2024

This study focuses on the admission criteria of a bachelor of accountancy (BAcc) degree program as one of many factors influencing students’ success in graduating in the regulated time frames. The present study used constructivist learning and student engagement theories as connected lenses to explore the effect of admission criteria on first-year-level students’ academic performance. The research findings emanate from a mixed methods methodology using logistic regression, one of the choice models in the International Business Machines (IBM) Statistical Package for Social Scientists (SPSS), and semi-structured interviews. A sample of 43 was randomly selected from the list of 91 students with NSC-level accounting to match the number of 43 students who did not do NSC-level accounting offered in South African high schools. This gave the researchers a study sample 86, which reduced 81 following incomplete data submission by five students. The study’s findings suggest a sensitive understanding of students’ engagement with program materials and admission criteria. The admission criteria embraces prior high school knowledge reflected in the NSC-level admission points score (APS) and NSC-level mathematics. In addition, student dedication is a dimension of student engagement that we explored. The value of the study is a contribution to the reconsideration of student engagement alongside program admission requirements, leading to the integration of constructivist learning and student engagement theories. Prior studies have not integrated constructivist learning and student engagement theories into their research design. We recommend the continued use of the NSC-level APS score and mathematics in the admission requirements of the BAcc learning and development programs. We also recommend using teaching and learning activities that bring out student dedication. More research should be done on all aspects of student engagement premised on graduating students.
Extend UTAUT2 Model to Analyze User Behavior of China Construction Bank Mobile App
Authors: Jiang Jianhua , Ma Jianing , Huang Xiaoqing , Zhou Jinping , Chen Taibo
Published: October 2024

The outbreak of COVID-19 has been accelerating the digital transformation of financial institutions all over the world. Mobile banking APPs become an important channel to provide financial services in the Internet and Big Data era. Factors that restrict its development have attracted the close attention of scholars and practitioners around the world. Different from a general APP software, mobile banking APPs naturally have some financial attributes which set high requirements for personal privacy protection and other security issues. For this reason, this paper extends the original UTAUT2 model by incorporating a new constructor: perceived risks. The study carefully selects China Construction Bank’s mobile banking app (short as “the CCB APP”), as she is the biggest bank in China and has good novelty and representativeness in financial technology. This paper constructs an extended UTAUT2-based model using questionnaires and structural equation modeling the user behavior of CCB APP and tests the influencing factors of the proposed model through empirical analysis. Similar to other studies using the UTAUT2 model, the findings of this paper indicate that performance expectations, effort expectations, social influence, facilitators, and habits, all have a positive impact on CCB APP users’ intentions. Their intention to use was a mediating variable of user behavior, while facilitators directly influenced CCB users’ behavior. However, the study finds that perceived risk negatively affects the CCB users’ intention while hedonic motivation and price value do not significantly affect users’ decision-making process. Based on these findings, the misdirection should to be avoided in regard to financial APP development by financial institutions is discussed and the future research direction concerning mobile banking app adoption is illustrated.
The Use of Smart Lockers in China’s Smart Villages Construction: Expanding UTAUT With Price Value and Technical Anxiety
Authors: Zhang Mengyao , Zhang Hongyan
Published: October 2024

With the rapid development of e-commerce, Online shopping has not only brought convenience to people’s lives, but also accelerated the explosion of express delivery. As a device that provides 24-hr self-service pickup and delivery services, smart lockers are increasingly accepted by more and more express delivery companies and consumers. However, in rural China, there are few outlets and low usage rates for express delivery cabinets. Especially for the elderly, the use and acceptance of smart lockers are significantly lower. Therefore, how to improve the usage intention of intelligent express delivery cabinets has become a problem that needs to be solved in the development process of smart rural areas. This study develops a theoretical model based on the Unified Theory of Acceptance and Use of Technology (UTAUT), and conducts empirical testing to determine the key factors affecting the willingness of rural Chinese consumers to use smart lockers. This study used a questionnaire survey method to collect data, and a total of 240 valid questionnaires were collected. The partial least squares (PLS) method was used to measure and test the research hypotheses. The results indicate that performance expectancy, facilitating conditions, price value and technology anxiety have a positive impact on consumers’ intention to use. There is no significant relationship between effort expectancy and social influence and users’ behavioral intention to use smart lockers. The results of this study will help enrich UTAUT, provide valuable information for enterprises, and contribute to the implementation of smart villages strategies.
Wipe Disinfection of Reusable Elastomeric Half-Mask Respirators for Health Care Use
Authors: Erukunuakpor Kimberly , Nielsen Karen Emily , Lane Morgan A. , Hornbeck Adam , McClain Caitlin , Fernando Rohan , Sietsema Margaret , Kraft Colleen S. , Casanova Lisa M.
Published: October 2024

Background:

During shortages, elastomeric half-mask respirators (EHMRs) are an alternative to reusing N95 filtering facepiece respirators but require between-use disinfection. The objectives of this study were to (a) measure microbial reductions on EHMR surfaces under laboratory conditions by a standardized procedure using wipes impregnated with health care disinfectants and to (b) measure microbial reductions on EHMRs disinfected by volunteer health care providers.

Method:

We inoculated EHMR (Honeywell model RU8500) surfaces with Pseudomonas aeruginosa, Bacillus atrophaeus spores, and bacteriophages MS2 and Φ6, and disinfected them using two wipes with hydrogen peroxide (HP), alcohols, and quaternary ammonium compounds (QACs). Then, we randomized 54 volunteer subjects into three groups (Group 1: two wipes with instructions, Group 2: five wipes with instructions, Group 3: no instructions or set number of wipes) and used 0.5% HP wipes without precleaning on EHMRs inoculated with Raoultella terrigena and MS2.

Findings:

The laboratory study demonstrated that all organisms achieved at least 4 log10 median reductions (HP>QAC/alcohol>QAC>QAC/saline). Pseudomonas was highly susceptible to HP and QAC/alcohol and Φ6 to all disinfectants. MS2 reduction was highest using HP and lowest using QAC/saline. Bacillus was least susceptible. The volunteer study showed a 3 to 4 log10 average reductions of bacteria and virus; Raoultella reductions were greater than MS2, with variability within and between subjects. Conclusions: HP disinfectant wipes used in laboratory and by volunteers reduce bacteria and viruses on EHMRs by 3 to 4 log10 on average.

Implications for Practice:

Commercially available hospital disinfectant wipes reduce bacteria and viruses on EHMRs and can fill the need for between-use disinfection. HP and combination QAC/alcohol have the greatest efficacy under our test conditions.
E-Cigarette and Vaping Perspectives: Recommendations for Occupational Health Nurses
Authors: Quinn Sheila A. , Olszewski Kim , Wolf Debra M.
Published: October 2024

Background:

Statistics from the Centers for Disease Control indicate that the use of e-cigarettes, vaping, and other electronic nicotine delivery systems (ENDS) are increasing although data on their safety is limited. While most employers ban smoking in the workplace, tobacco-free policies do not always extend specifically to e-cigarette products.

Methods:

An IRB approved exploratory, cross-sectional study was conducted to investigate occupational health professionals’ (OHPs) knowledge of e-cigarettes, vaping and ENDS and the ability to create change in tobacco-free workplace policies. A 91-item electronic survey was sent via email to 3248 OHPs who were members of the American Association of Occupational Health Nurses.

Findings:

A total of 299 surveys were returned, but only 230 completed the entire survey. Of those who completed the entire survey, those with advanced education had higher attitude toward change summary scores ( p = .043) and those with lower years of practicing had low scores for transformational leadership ( p = .039). Approximately 40% of individuals did not have or were unsure that a tobacco-free program was in place that included e-cigarettes, but the majority (90%) perceived their organizational leaders as interested in safety changes.

Conclusions:

The majority of respondents understood the health issues inherent in e-cigarettes, were open to implementing policies that included e-cigarettes but needed education and both managerial and employee support to implement policy changes.

Application to Practice:

OHPs are well positioned to be advocates for workplace education, policy development, and worker health promotion for smoking and vaping cessation by leading organizational change.
Staff Safety Alert Banner Program Against Workplace Violence at an Urban American Hospital
Authors: Li Crystal , Bentley Stephanie , Gulati Mangla S. , Snedeker Kristie , Marks Madeline R.
Published: October 2024

Background:

Workplace violence (WPV) in healthcare has become an issue worldwide, with increasing prevalence after the COVID-19 pandemic. Notably, WPV in any setting has individual and systemic repercussions. However, despite extensive literature reporting the prevalence of WPV in healthcare worldwide, effective, standardized prevention policies have not been established. We developed and piloted a WPV initiative at an urban hospital in the state of Maryland. Here, we aim to describe our program development methods and implementation.

Methods:

The 6-month program utilized a reporting tool developed within patients’ electronic medical records (EMRs) to request the display of a Staff Safety Alert (SSA) banner to alert healthcare professionals of patients who engaged in violent behavior and are at increased risk of subsequent behavior. This tool was piloted on 21 patient care units. A review committee either approved or denied case requests filed by frontline workers, with holistic consideration involving patient status, potential biases, and communication flaws.

Results:

Twenty-one banner requests were filed during the course of the pilot. Of which, eight were approved, and 13 were denied. The multi-trauma intermediate care floor filed the most case requests for a safety banner.

Conclusions/Application to Practice:

Our pilot program offers a patient-centered intervention program where extensive personnel training and patient-focused considerations were applied prior to the approval or denial of a banner display. The SSA program was the initial step in institutionally combatting WPV in healthcare as staff are encouraged to officially document unsafe events followed by careful action in response.
The Moderating Role of Discrimination in the Association between Same-Race/Ethnicity Friends and Negative Ethnic-Racial Identity Affect over Time
Authors: Elias Maria de Jesus , Williams Chelsea Derlan , Bravo Diamond Y. , Safdar Mehwish , Santana Arlenis , Smith Tricia , Adkins Amy , Lozada Fantasy T. , Thomas Nathaniel , Bolte Constance , Dick Danielle M.
Published: October 2024

The current study assessed the moderating role of perceived discrimination on the association between same-race/ethnicity friends and negative ethnic-racial identity (ERI) affect among Asian, Black, and Latinx students of color over time. Diverse college students ages 18-25 (73.7% female) provided self-reports of same-race/ethnicity friends, racial discrimination, and negative ERI affect at the beginning of a semester (T1) and end of a semester 4 months later (T2). Results indicated that T1 discrimination was a significant moderator of the relations between T1 same-race/ethnicity friends and T2 negative ERI affect (controlling for T1 negative ERI affect). Specifically, having same-race/ethnicity friends predicted an decrease in negative ERI affect over time, but only when discrimination was low. When discrimination was high, the relation between same-ethnicity friends and negative ERI affect was not significant over time. In other words, discrimination acted as a disrupter of same-race/ethnicity friends being associated with a reduction in negative ERI affect over time.
Exploring Family Caregivers’ Likelihood of Adopting a Novel App That Connects Care Teams of Persons Living With Dementia: A Mixed-Methods Study
Authors: Fernandez Cajavilca Moroni , Zheng Amy , Bamidele-Sanni Kehinde , Sadarangani Tina
Published: October 2024

Family caregivers of persons living with dementia (PLWD) are often expected to coordinate and manage all aspects of a loved one’s day-to-day care across settings with limited modern, user-friendly resources to support them. We developed CareMOBI, a mHealth app prototype that aims to support improved care coordination and communication between care team members. A concurrent mixed-methods triangulation design was used to assess the acceptability and likelihood of adopting CareMOBI among family caregivers of PLWD. Caregivers ( n = 13) completed the Technology Acceptance Model questionnaire (quantitative) and semi-structured interviews (qualitative). Integration occurred using the four themes of the Technology Acceptance Model. There was strong agreement among family caregivers that CareMOBI had a high perceived value for care ( M = 6.23/7), was easy to use ( M = 6.20/7), and enhanced current workflows ( M = 5.86/7). However, training in utilizing mHealth apps and the need for a Spanish-language version were cited as necessary enhancements to increase the widespread adoption of CareMOBI.
Examining the Relationship Between Obesity and Income Distribution Using Body Mass Index (BMI) and Body Shape and Size Index (BSSI): A Case Study of Pakistan
Authors: Hussain Waqas Ghulam , Shehzad Farrukh , Akbar Atif
Published: October 2024

Introduction:

Obesity and income (wage) distribution have emerged as one of the most serious public health concerns but in this research, the study is continued under body mass index (BMI) and body shape and size index (BSSI) among children and adults in Pakistan.

Methods:

This cross-sectional study investigated the health-related behaviors and outcomes of 2,223 children and adults aged 2 to 19 years from Multan, Pakistan, including both males and females, providing a comprehensive understanding of the health status in this population. Data about gender, weight, height, age, family income and other demographic measures are recorded. For the measurement of BMI and BSSI, the latest formulas and methods were used. Different variables were applied through statistical description understudy. To check out the wage distribution in BSSI and BMI, the comparative approach was used and performed a role in making charts for BSSI and BMI against family income, age group and gender.

Results:

The mean BMI and BSSI for complete data are 18.00 and 0.23 for the age group of 2 to 5 years of children with family income less than 10,000. Similarly, these figures are 20.59 and 0.29 for the family income greater than 50,000.

Conclusion:

Most important things have been observed by this study, that income greatly affected the rate of obesity. BMI and BSSI increased by increasing the family income of children and adults in Pakistan. BMI and BSSI show high figures for female respondents as compared to male ones, observed by this research.
Imaging-Guided Classification of Neovascularization in Neovascular Age-Related Macular Degeneration: Progress to Date
Authors: Staurenghi Giovanni , Souied Eric H. , Iida Tomohiro , Chow David R. , Wolf Armin , Gallego-Pinazo Roberto , Viola Francesco , Kaiser Peter K.
Published: October 2024

Purpose: To review the evolution of terminology describing the classification of lesions in neovascular age-related macular degeneration (nAMD) based on retinal imaging technologies. Methods: A review of the current and historical literature on imaging-guided classification of neovascularization in nAMD was performed. Results: Imaging-guided classification of neovascularization in nAMD facilitates an understanding of the pathological mechanisms and disease progression. Neovascularization classification has evolved with advances in imaging technologies, from earlier classifications based on neovascularization patterns assessed by fluorescein angiography to multimodal imaging patterns, resulting in varied descriptions of lesions depending on the techniques used. Until recently, there has been a lack of consensus regarding the clinical features of choroidal neovascularization lesion types as a result of the imaging modalities initially used to define them; a recent consensus on classification has the potential to simplify and clarify descriptions of neovascularization in nAMD. The use of multimodal imaging techniques will improve lesion identification and has the potential to individualize treatment plans and improve outcomes. Conclusions: Widespread adoption of a consensus-based, image-guided classification system for neovascular lesions in nAMD and the appropriate imaging techniques used to identify them will aid clinical research and could potentially improve patient outcomes by individualizing treatment plans in the future.
Exploring COVID-19 vaccine adverse events among pregnant women: a cross-sectional study, 2022
Authors: Amer Ahmed A. , Amer Samar A. , Badokhon Amerah , Hammad Sherif M. , Wasfy Mohamed A. , Khan Misha , Ateyah Al-Harbi Tahani , Alobaid Sadah Qamous , Eskander Georgette , Abdel-Azeem Amro , Alshowair Abdulmajeed , Ramadan Mohamed Sh.
Published: October 2024

Background:

Clear and trustworthy information is crucial to improving public acceptance of COVID-19 vaccinations, especially among pregnant women. Given the increased risk of severe viral pneumonia in pregnant women, it is critical to foster confidence in the vaccine’s safety and understand any potential adverse events (AEs). So, we did this study in Jeddah, Saudi Arabia (SA), from March to May 2022 to compare women who did not get any doses of the COVID-19 vaccine during pregnancy (Group A) to women who did get at least one dose during pregnancy (Group B) regarding (1) the frequency, types, AEs, and management of its AEs of the COVID-19 vaccination; and (2) exploring pregnancy, delivery, and fetus-related complications (e.g., miscarriage, birth defects, and preterm labor)

Methods:

A cross-sectional study targeted 438 women who gave birth or were pregnant within the previous 8 weeks. Data was collected through face-to-face interviews with skilled nurses in 13 randomly selected primary healthcare facilities, using a validated, well-structured questionnaire that included the Centers for Disease Control (CDC) COVID-19 vaccination-related AEs. We analyzed the collected data using SPSS version 27.

Results:

Most participants were aged 25 to less than 35 (58.8%), and 287 (61.3%) were university graduates. There was no statistically significant difference among the studied groups regarding demographics. However, women in Group B had a significantly higher rate of abortions, oligohydramnios (24.4%), abnormal placentas (size and location), 103 (42.7%) abnormal fetal growth, 122 (53.7%) problems breastfeeding, blood pressure problems, and more cases of malaise, headaches, chest pain, breathing problems, and sleep problems than women in Group A. After the second and third doses, the confirmed post-vaccination COVID-19 rates in Group B were lower than those in Group A.

Conclusion:

The COVID-19 vaccine significantly reduces post-vaccination COVID-19. Although COVID-19 vaccine-related AES are prevalent, analgesics and antipyretics effectively treat most of them.
Causes of intraprocedural discomfort in colonoscopy: a review and practical tips
Authors: Ahmed Jabed F. , Darzi Ara , Ayaru Lakshmana , Patel Nisha
Published: October 2024

Colonoscopy is a commonly performed procedure in the United Kingdom and the gold standard for diagnosis and therapy in the gastrointestinal tract. Increased levels of pain during colonoscopy have been associated with reduced completion rates and difficulties in maintaining attendance for repeat procedures. Multiple factors play a role in causing discomfort intra-procedurally: patient factors, such as gender, anatomy and pre-procedure anxiety; operator factors, such as patient position and level of experience and other factors, such as bowel preparation and total procedure time. A literature search was performed to identify papers that explained how patient, operator and endoscopy factors influenced pain and discomfort in endoscopy. A further search then also identified papers describing solutions to pain and discomfort that have been explored. After review of the literature, key methods are selected and discussed in this paper. Solutions and aids that can resolve and improve pain and discomfort include endoscopic methods such as variable stiffness and ultrathin scopes. Operator improvements in techniques and ergonomics alongside the use of newer technologies such as propelled endoscopy, computer-assisted endoscopy and task distraction. To improve patient experience and outcomes, the investigation and research into improving techniques to reduce pain is crucial. This review aims to identify the modifiable and non-modifiable factors associated with intra-procedural discomfort during colonoscopy. We discuss established methods of improving pain during colonoscopy, in addition to newer technologies to mitigate associated discomfort.
Needs and Preferences for Remote-Delivered Mindfulness-Based Cognitive Therapy in Patients After Acute Coronary Syndrome: A Qualitative Study
Authors: Luberto Christina M. , Crute Sydney , Wang Amy , Li Runnan , Yeh Gloria Y. , Huffman Jeff C. , Celano Christopher M. , Victorson David , Hoeppner Bettina B. , Park Elyse R.
Published: October 2024

Background

Following acute coronary syndrome (ACS), up to 40% of patients report elevated depressive symptoms which is associated with a two-fold increase in mortality risk due to behavioral and biological mechanisms. Mindfulness-Based Cognitive Therapy (MBCT) delivered via synchronous group videoconferencing could help reduce depressive symptoms.

Objective

To guide MBCT adaptation for ACS patients for a future clinical trial, this qualitative study aimed to explore ACS patients’ (1) symptoms after ACS, (2) needs for behavioral health treatment, (3) perspectives on mindfulness intervention and group videoconference delivery, and (4) willingness to self-collect dried blood spots in a research study.

Methods

We compared ACS patients with and without depressive symptoms to highlight particularly relevant treatment topics for patients developing depression following ACS experience. From 2/2019-11/2019, we conducted semi-structured individual telephone interviews with N = 23 patients after ACS (N = 13 with and N = 10 without elevated depressive symptoms; 63.4 (SD = 8.5) years, 87% male, 96% non-Hispanic white, 7.1 (SD = 7.5) years since ACS). In qualitative content analyses, four independent coders coded each interview.

Results

Participants with depressive symptoms experienced emotional, physical, social, and health behavior problems, while those without depressive symptoms made positive health behavior changes and struggled with anxiety symptoms. Both groups were interested in a behavioral health treatment for emotional and social support. Most were willing to participate in a mindfulness group via videoconferencing; some preferred in-person, but accessibility and convenience outweighed these cons. Almost all were willing to self-collect dried blood spots and some were already familiar with this technique.

Conclusion

ACS patients, especially those with depressive symptoms, need help managing a multitude of quality of life concerns that can be targeted with an adapted MBCT approach. A videoconference-delivered MBCT approach is of interest. Suggestions for adapting MBCT to target the needs of ACS patients are discussed.
Respiratory phenotype and health care utilization patterns by adults with sickle cell disease
Authors: Agawu Atu , Nortey Nii , Jacobs Charleen , Zebrowski Alexis , Lin Michelle P. , Glassberg Jeffrey
Published: October 2024

Adults with sickle cell disease (SCD) and asthma have increased mortality and health care utilization; however, there are individuals with respiratory symptoms (including cough and wheeze) without asthma. These individuals may have similar patterns of increased mortality and health care utilization. To characterize the association between respiratory phenotype and health care utilization by adults with SCD. Cross-sectional study of adults with SCD presenting for emergency and inpatient hospital care from 2012 to 2014 in Florida, Iowa, and New York using state-level health care utilization databases. Outcomes of interest included all-cause, SCD-related acute, painful episode, and acute chest syndrome–related care. Respiratory phenotype was defined as SCD + asthma, SCD + respiratory symptoms, and SCD + none. We built multivariable logistic regression and negative binomial regression models to evaluate the association adjusting for demographics, social determinant of health proxies, year of care, and state. Of 29 952 identified individuals, 3.4% had intermittent respiratory symptoms, and a larger proportion (15.6%) had asthma. There was a high rate of inpatient hospitalizations (43%) and emergency department visits (60%). Individuals with asthma had a higher annual risk of inpatient hospitalizations (48% vs 37%) but lower annual risk of an emergency department visit (62% vs 86%) than individuals with intermittent respiratory symptoms. The pattern of increased health care utilization among individuals with intermittent respiratory symptoms was consistent across each utilization type. In this large cohort of adults with SCD, we identified some with intermittent respiratory symptoms who had significantly increased health care utilization. This warrants further evaluation to understand potential etiologies and interventions.
Universal protection of allogeneic T-cell therapies from natural killer cells via CD300a agonism
Authors: Zhang Shu-Qi , Thomas Faith , Fang Justin , Austgen Kathryn , Cowan Chad , Welstead G. Grant
Published: October 2024

Immunogenicity limits the persistence of off-the-shelf allogeneic cell therapies and transplants. Although ablation of HLA removes most T cell and humoral alloreactivity, no solution has enabled universal protection against the resulting natural killer (NK) cell response. Here, we engineered trans-antigen signaling receptors (TASRs) as a new class of NK inhibitory ligands and discovered CD300a, a previously inaccessible receptor, as a functional target. CD300a TASR outperformed leading alternative strategies in focused screens, including CD47 and HLA-E, and was solely capable of universally protecting allogeneic T cells against a large human cohort (45/45 donors), spanning diverse demographics and NK cell phenotypes. A model allogeneic T-cell therapy coexpressing an anti-CD19 chimeric antigen receptor and CD300a TASR, produced using multiplexed nonviral integration, exhibited enhanced B-cell killing potency under allogeneic immune pressure. CD300 TASR represents a universal solution to NK alloreactivity, broadening the population that could be effectively treated by next-generation allogeneic cell therapies.
Novel machine learning technique further clarifies unrelated donor selection to optimize transplantation outcomes
Authors: Spellman Stephen R. , Sparapani Rodney , Maiers Martin , Shaw Bronwen E. , Laud Purushottam , Bupp Caitrin , He Meilun , Devine Steven M. , Logan Brent R.
Published: October 2024

We investigated the impact of donor characteristics on outcomes in allogeneic hematopoietic cell transplantation (HCT) recipients using a novel machine learning approach, the Nonparametric Failure Time Bayesian Additive Regression Trees (NFT BART). NFT BART models were trained on data from 10 016 patients who underwent a first HLA-A, B, C, and DRB1 matched unrelated donor (MUD) HCT between 2016 and 2019, reported to the Center for International Blood and Marrow Transplant Research, then validated on an independent cohort of 1802 patients. The NFT BART models were adjusted based on recipient, disease, and transplant variables. We defined a clinically meaningful impact on overall survival (OS) or event-free survival (EFS; survival without relapse, graft failure, or moderate to severe chronic graft-versus-host disease) as >1% difference in predicted outcome at 3 years. Characteristics with <1% impact (within a zone of indifference) were not considered to be clinically relevant. Donor cytomegalovirus, parity, HLA-DQB1, and HLA-DPB1 T-cell epitope matching fell within the zone of indifference. The only significant donor factor that associated with OS was age, in which, compared with 18-year-old donors, donors aged ≥31 years old were associated with lower OS. Both donor age (≤32 years) and use of a male donor, regardless of recipient sex, improved EFS. We, therefore, recommend selecting the earliest available donor within the 18 to 30 years age range for HCT to optimize OS. If several donors in the 18 to 30 years age range are available, a male donor may be chosen to optimize EFS.