bluuebunny/crossref_metadata_2025 huggingface dataset:
An exploration of informal peer-support for dietary recommendations in haemodialysis
Authors: Morris Andrew , Lycett Deborah
Published: December 2023

People often seek feedback to compare aspects of their lives to others. For those undergoing haemodialysis, this may entail discussing dietary advice experiences with others to gain a sense of how well they are doing with their self-management skills. This informal peer-support may present opportunities and challenges for those undergoing haemodialysis. A total of 12 adults undergoing maintenance haemodialysis took part in semi-structured interviews which were transcribed verbatim and underwent thematic analysis. The self-evaluation model of social comparison informed data analysis and interpretation. Two major themes are reported. The major themes were ‘Joining the kidney family’, which represented a sense of solidarity among patients and ‘Social comparison to peers.’ Two sub-themes made up the theme ‘Social comparison to peers’, these were ‘Got it sorted’ and ‘On rocky ground’ and represented upwards comparisons from a self-evaluation perspective and down wards comparisons for self-enhancement. People form social relationships within a haemodialysis unit which are used to obtain evaluations on dietary self-management skills by social comparison. Positive self-evaluations involved downward and upward comparisons around dietary recommendations. Informal peer-support around dietary advice for haemodialysis is variable in terms of the accuracy and helpfulness of the information provided.
JAMES LIND ALLIANCE FIRST TIME SOFT TISSUE KNEE INJURIES PRIORITY SETTING PARTNERSHIP: TOP TEN RESEARCH PRIORITIES
Authors: Osmani H , Nicolaou N , Anand S , Gower J , Metcalfe A , McDonnell S
Published: December 2023

Introduction

The knee is the most commonly injured joint in sporting accidents, leading to substantial disability, time off work and morbidity (1). Treatment and assessment vary around the UK (2), whilst there remains a limited number of high-quality randomised controlled trials assessing first time, acute soft tissue knee injuries (3,4). As the clinical and financial burden rises (5), vital answers are required to improve prevention, diagnosis, treatment, rehabilitation, and delivery of care. In association with the James Lind Alliance, this BASK, BOSTAA and BOA supported prioritising exercise was undertaken over a year.

Methods

The James Lind Alliance methodology was followed; a modified nominal group technique was used in the final workshop. An initial survey invited patients and healthcare professionals to submit their uncertainties regarding soft tissue knee injury prevention, diagnosis, treatment, rehabilitation, and delivery of care. Seventy-four questions were formulated to encompass common concerns. These were checked against best available evidence. Following the interim survey, 27 questions were taken forward to the final workshop in January 2023, where they were discussed, ranked, and scored in multiple rounds of prioritisation by groups of healthcare professionals, patients, and carers.

Results

Over 1000 questions were submitted initially. Twenty-seven were taken forward to the final workshop following the surveys. Nearly half of the responses were from patients/carers. The Top 10 (Figure 1) includes prevention, diagnosis, treatment, and rehabilitation questions, reflecting the concerns of patients, carers, and a wider multidisciplinary team.

Conclusion

This validated process has generated an important, wide- ranging Top 10 priorities for future soft tissue knee injury research. These have been submitted to the National Institute for Health and Care Research and are now available for researchers to investigate. The final 27 questions which were taken to the final workshop have also been published on the James Lind Alliance website. Research into these questions will lead to future high-quality research, thus improving patient care & outcomes.

For any figures or tables, please contact authors directly.
MENISCAL ANOMALIES IN CONGENITAL CRUCIATE LIGAMENT DEFICIENCY: EXPERIENCE IN A TERTIARY CHILDREN'S KNEE UNIT
Authors: Basheer S , Kwaees T , Tang C , Ali F , Haslam P , Nicolaou N
Published: December 2023

Objectives

Congenital cruciate ligament deficiency is a rare condition that may occur in isolation or in association with longitudinal limb deficiencies such as fibular hemimelia or proximal femoral focal deficiency. Often anomalies of the menisci and their attachments can be very abnormal and impact on surgical management by standard techniques. Arthroscopic surgical knee reconstruction is undertaken to improve symptomatic instability and/or to stabilise and protect the knee for future planned limb lengthening surgery.

The aim of this study is to evaluate the arthroscopic findings of patients undergoing surgery for congenital cruciate ligament deficiency, and specifically to determine the frequency and types of meniscal anatomical variations seen in these cases.

Methods

Patients undergoing surgery for congenital cruciate ligament deficiency were identified from a prospectively collated database. Diagnosis was confirmed through review of the clinical notes and imaging. Operative notes and 4K saved arthroscopic images and video recordings for these cases were reviewed.

Results

Over a six-year period (July 2017 – September 2023), 42 patients underwent surgery for congenital ligament deficiency and tibiofemoral instability (45 surgical episodes). Median age of patients at time of surgery was 10 years (range 4 – 17 years). The most frequent diagnosis was congenital longitudinal limb deficiency syndromes in 27 cases, with the most frequent being fibular hemimelia. Isolated congenital ligament deficiency without any other associated extra-articular manifestations occurred in 11 cases. Absence of meniscal root attachments or hypertrophy of meniscofemoral ligaments acting as ‘pseudo-cruciates’ were seen in over 25% of patients. In isolated ACL deficiency these were injured causing onset of instability symptoms and pain following trauma. Often these abnormal structures required addressing to allow surgical reconstruction.

Conclusions

Our findings demonstrate that there are often meniscal variations seen in association with congenital absence or hypoplasia of the cruciate ligaments. In these patients hypertrophied meniscofemoral ligaments may act as cruciate-like structures and play a role in providing a degree of sagittal plane stability to the knee. However, when the knee becomes unstable to the point that cruciate ligament reconstruction is indicated, these meniscal variants may often require stabilisation using complex meniscal root repair techniques or variations to standard cruciate ligament reconstruction techniques to accommodate the variant anatomy.
IMPROVING THE OUTCOMES OF ANTERIOR CRUCIATE LIGAMENT SURGERY IN PROFESSIONAL ATHLETES: AN ANALYSIS OF 342 PATIENTS WITH A MEAN FOLLOW-UP OF 100 MONTHS
Authors: Hopper G , Haddock A , Pioger C , Philippe C , Helou A El , Campos J P , Gousopoulos L , Carrozzo Al , Vieira T Dutra , Sonnery-Cottet B
Published: December 2023

Introduction

Anterior cruciate ligament (ACL) injuries are one of the most common knee injuries amongst elite athletes and usually require an ACL reconstruction (ACLR) to enable return to sport. Secondary surgery can result in a longer rehabilitation period and often a

significant time away from sport which can have implications to the athlete including contract obligations and sponsorship. Advances in ACLR techniques and meniscal repair techniques as well as an awareness of meniscal root lesions, ramp lesions and lateral extraarticular procedures (LEAPs) during ACL surgery has improved outcomes. The purpose of this study was to evaluate the rates of secondary surgery following the introduction of a systematic arthroscopic evaluation of the knee, improved meniscal repair techniques and the addition of a concomitant LEAP This systematic approach was introduced after October 2012 (10/2012).

Methods

Professional athletes who underwent primary ACLR with a minimum follow-up of 2 years were identified from the (blinded for review). Those who had undergone major concomitant procedures such as multi-ligament reconstruction or osteotomy were excluded. Analysis of the database and review of medical records identified athletes who had underwent secondary surgery procedures.

Results

A total of 342 athletes with a mean follow-up of 100.2 +/− 51.9 months (range, 24–215 months) were analysed. 130 athletes underwent surgery before 10/2012 and 212 athletes underwent surgery after 10/2012. Overall, 74 patients (21.6%) underwent secondary surgery. 39 patients (30.0% including 13.1% for graft rupture) before 10/2012 and 35 patients (16.5% including 6.6% for graft rupture) after 10/2012. A multivariate analysis was performed using the Cox model and demonstrated that athletes undergoing ACLR before10/2012 were at almost 2-fold risk of secondary surgery (hazard ratio (HR), 1.768(1.103;2.836), p=0.0256) when compared with those undergoing ACLR after 10/2012. (Figure 1).

Conclusion

Professional athletes undergoing ACLR with a systematic arthroscopic evaluation with the use of advanced meniscal repair techniques and the combination with a LEAP result in a significantly lower rate of secondary surgery.

For any figures or tables, please contact authors directly.
WHAT DRIVES INNOVATION AND CHANGE IN ACL SURGERY? AN ANALYSIS OF 14,352 PATIENTS
Authors: Garneti A , Clark M , Stoddard J , Hancock G , Hampton M
Published: December 2023

Introduction

Anterior cruciate ligament reconstruction (ACLr) is the most widely published operation in the orthopaedic literature. Over recent years there has been increased interest in the surgical technique and role of concomitant procedures performed during ACLr. The National Ligament Registry (NLR) collects robust data on ACLr performed in the UK. In this registry analysis we explore trends in ACLr surgery and how they relate to published literature and the growing industry portfolio available to surgeons.

Methods

Using data from the NLR, 14,352 ACLr performed between 2013–2021 were analysed. High impact papers on ACLr were then cross referenced against this data to see if surgical practice was influenced by literature or whether surgical practice dictated publication. Common trends were also compared to key surgical industry portfolios (Arthrex, Smith and Nephew) to see how new technology influenced surgical practice.

Results

The number of ACLr performed in isolation is decreasing. The number of ACL reconstructions involving meniscal surgery shows an increasing trend since 2013, with 57% of ACLr in 2021 now involving meniscus surgery. The number of ACLr with lateral extra-articular tenodesis (LET) has increased sharply since 2018, preceding the stability trial publication in 2020. Graft preference and size has remained static despite the introduction of new graft harvest and fixation devices. Additional procedures such as other ligament reconstruction and additional cartilage surgery have also remained static over time.

Conclusion

In this analysis we looked at surgical trends in ACLr and their relation to literature and industry. Meniscal intervention is increasing, in keeping with the growing level of literature in this area. In the setting of LET, a high impact level 1 study appears to have significantly changed the practice of UK surgeons with a sharp increase in the number of LET procedures being performed. Industry appears to have little influence on the change in surgical trends, suggesting high quality evidence is what drives innovation in ACLr while industry supports rather than influences innovation. It will be interesting to see the impact of the stability 2 study, recent work on the medial structures of the knee and the commissioning of cartilage centres on future trends.
HOME-BASED REHABILITATION FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN THE KURDISTAN REGION OF IRAQ: EPIDEMIOLOGY AND OUTCOMES
Authors: Jones S , Kader N , Serdar Z , Banaszkiewicz P , Kader D
Published: December 2023

Introduction

Over the past 30 years multiple wars and embargos have reduced healthcare resources, infrastructure, and staff in Iraq. Subsequently, there are a lack of physiotherapists to provide rehabilitation after an anterior cruciate ligament reconstruction (ACLR). The implementation of home-based rehabilitation programmes may provide a potential solution to this problem. This study, set in in the Kurdistan region of Iraq, describes the epidemiology and outcomes of anterior cruciate ligament reconstruction (ACLR) followed by home-based rehabilitation alone.

Methods

A cohort observational study of patients aged ≥ 16 years with an ACL rupture who underwent an ACLR under a single surgeon. This was performed arthroscopically using a hamstring autograft (2 portal technique). Patients completed a home-based rehabilitation programme of appropriate simplicity for the home setting. The programme consisted of stretching, range of motion and strengthening exercises based on criterion rehabilitation progressions. A full description of the programme is provided at: https://ngmvcharity.co.uk/.

Demographics, mechanisms of injury, operative findings, and outcome data (Lysholm, Tegner Activity Scale (TAS), and revision rates) were collected from 2016 to 2021. Data were analysed using descriptive statistics.

Results

The cohort consisted of 545 patients (547 knees), 99.6% were male with a mean age of 27.8 years (SD 6.18 years). The mean time from diagnosis to surgery was 40.6 months (SD 40.3). Despite data attrition Lysholm scores improved over the 15-month follow-up period, matched data showed the most improvement occurred within the first 2 months post-operatively. A peak score of 90 was observed at nine months. Post-operative TAS results showed an improvement in level of function but did not reach pre-injury levels by the final follow-up. At final follow-up, six (1.1%) patients required an ACLR revision.

Conclusion

Patients who completed a home-based rehabilitation programme in Kurdistan had low revision rates and improved Lysholm scores 15 months post-operatively. To optimise resources, further research should investigate the efficacy of home-based rehabilitation for trauma and elective surgery in low- to middle-income countries and the developed world.
ANTERIOR CRUCIATE LIGAMENT INJURY PREVENTION PROGRAMMES IN WELSH NETBALL: SURVEY OF KNOWLEDGE, IMPLEMENTATION, AND BARRIERS AMONG PLAYERS AND COACHES
Authors: Abdul W , Moore I , Robertson A
Published: December 2023

Introduction

Anterior Cruciate Ligament (ACL) injury prevention programs can reduce injury risk in various sports. The perception of ACL injury prevention programs amongst professional netball players and coaches has not been studied. The purpose of the study was to determine (1) level of awareness and experience of ACL injury prevention programs; (2) use of ACL injury prevention programs; and (3) barriers and potential facilitators to implementing a sustainable ACL injury prevention program in netball.

Methods

This cross-sectional observational study was undertaken using the CHERRIES checklist. Female netball players representing Welsh senior and under-21 teams and elite and amateur coaches were invited electronically to participate in this web-based study between 1st May – 31st July 2021. Information on ACL injury susceptibility and seriousness, knowledge, experience, and implementation of ACL injury prevention programs were ascertained.

Results

Twenty-eight players (77.8%) and 29 coaches (13.2%) completed the questionnaire. Seventeen (60.7%) players and 15 (51.7%) coaches reported female athletes were at greater risk for sustaining ACL injuries. Over 90% of respondents identified netball as high-risk, whilst 89% of players and 76% of coaches reported these injuries to be preventable. Only two (7.1%) players and 6 (20.7%) coaches utilised an ACL injury prevention program with lack of time and engagement from coaches and players identified. Majority of respondents indicated that their club has neither promoted, advocated the use nor demonstrated exercises for ACL injury prevention. Over 90% of respondents would utilise an ACL injury prevention program if it minimised players risk with appropriate information and demonstration of exercises.

Conclusion

This study highlights limited knowledge of female athletes' increased susceptibility of ACL injuries amongst players and coaches with lack of communication and education of ACL injury prevention programs between sporting associations, coaches, and players. However, the results demonstrate willingness amongst both players and coaches to implement an ACL injury prevention program in netball.
12-MONTH CLINICAL OUTCOMES OF ARTHROSCOPIC LATERAL ANKLE LIGAMENT RECONSTRUCTION FOR CHRONIC ANKLE INSTABILITY: A PROSPECTIVE CASE SERIES
Authors: Lewis T , Franklin S , Vignaraja V , Ray R
Published: December 2023

Introduction

Chronic ankle instability is a common condition that can be effectively treated with arthroscopic lateral ankle ligament reconstruction to restore ankle stability and function. The aim of this study was to assess the functional outcomes of arthroscopic lateral ligament reconstruction using the MOXFQ, VAS, and EQ5D patient-reported outcome measures (PROMs).

Methods

This prospective series included 38 patients who underwent arthroscopic lateral ligament reconstruction for chronic ankle instability between December 2019 and April 2022. All patients completed the MOXFQ, VAS, and EQ5D PROMs preoperatively, as well as at6, and 12 months postoperatively. The MOXFQ is a disease-specific PROM that assesses foot and ankle function, while the VAS measures pain and the EQ5D evaluates health-related quality of life.

Results

At the 12-month follow-up, the mean MOXFQ Index score had improved significantly from 53.3 ± 23.1 preoperatively to 16.0 ±21.1 (p < 0.001). Similarly, the mean VAS score had improved from 36.2 ± 22.4 preoperatively to 14.7 ± 15.0 (p < 0.001), and the meanEQ5D score had improved from 0.55 ± 0.26 preoperatively to 0.87 ± 0.12 (p < 0.001). No major complications were observed.

Conclusion

Arthroscopic lateral ligament reconstruction is an effective treatment for chronic ankle instability, with significant improvements in clinical and health-related quality of life outcomes.
ASSESSING THE USE OF THE TEGNER ACTIVITY SCALE IN CHILDREN: IS IT A USEFUL TOOL?
Authors: Fawdry A , O'Dowd D
Published: December 2023

Introduction

Activity scales are used throughout orthopaedics as a component of PROMs. Tegner Activity Scale is commonly used and is validated in various knee injuries in adults. It has a reading age of 18 years presenting an understanding problem for children. An alternative is HSS-PediFABS, but this looks at specific skills like running, cutting, pivoting rather than sporting level. Our aim was to determine if children understood TAS and whether their answers compared to how their parents scored them and determine if our suggested sporting levels were more appropriate for them.

Method

We created a study form to compare levels given by children and their parent. We added our own suggested levels, with a reading age of 9, created by a discussion group of paediatric orthopaedic surgeons. Following ethics approval, a sample size was determined via power calculation. All patients over 7 and their parents presenting to the orthopaedic clinic at SCH over a 4-month period were asked to fill out the TAS, baseline questions and rank the new suggested sporting levels.

Results

51 patients and their parents were recruited, with a mean age of 13 (±0.31, 8–17). 35% female. The mean TAS score for children rating themselves was 7.04 (±0.32, 2–10) vs 6.43 (±0.37, 0–10) for parents rating the child (p=0.31). The average weekly activity time rated by children was 6.72 hours (±0.84, 0–30) vs 7.48 (±1.02, 0–36) rated by the parent (p=0.68). Our suggested levels for paediatric patients were ordered correctly by both groups (mode score). The mean new activity level for children was 4.9 (±0.24, 2–9) vs 4.81 (±0.26, 1–8) by their parent(p=0.79). The mean score difference for TAS was 1.42 vs 1.2 in the new score (p=0.38).

Conclusion

Paediatric patients had difficulty understanding the TAS and there was poor agreement of activity levels between patients and parents.
EMPODERAMENTO FEMININO NOS DESENHOS ANIMADOS DE CINEMA DO SÉCULO XXI
Authors: De Andrade Carla Borges , Alves Nogueira Souza Suzana , Guedes de Mattos Ivanilde , Leite Novaes Amanda
Published: December 2023

O empoderamento feminino tem sido um dos temas mais evidenciados na contemporaneidade, e o cinema tem abordado a temática em suas produções de animação rompendo com ideologias e tradições culturais que protagonizavam os homens como heróis poderosos e relegavam às mulheres a condição de coadjuvantes. Nosso objetivo neste estudo foi identificar e analisar os elementos que conferem empoderamento às personagens femininas dos desenhos animados de cinema do Século XXI. A metodologia constou de pesquisa documental e análise fílmica de catorze desenhos animados. Ficou evidenciada a diferença na construção do perfil feminino, projetando um empoderamento da mulher, que passa a revelar independência, determinação, força, questionamentos e ressignificação do seu papel e do seu lugar na sociedade.
ANÁLISE DA RELAÇÃO ENTRE A PRÁTICA DE ATIVIDADE FÍSICA E O CÂNCER DE MAMA:
Authors: Silva de Alcântara Pattrick , Duarte de oliveira. Nattaly , Amorim Machado Flávio , Borges de Andrade Carla
Published: December 2023

O presente trabalho de revisão bibliográfica que se configura como Estado do Conhecimento buscou investigar a relação entre a atividade física regular e o câncer de mama, identificando na literatura os impactos da prática sobre a redução do risco do surgimento da neoplasia, na diminuição da progressão e das complicações associadas, além de avaliar os possíveis benefícios na qualidade de vida das pacientes. Os resultados desta revisão bibliográfica corroboram a perspectiva dos benefícios que a prática regular de atividade física tem para desempenhar um papel crucial na redução do risco de câncer de mama, na melhora da qualidade de vida das pacientes diagnosticadas, na redução da recorrência da doença e no aumento da sobrevida em pacientes em tratamento, promovendo uma abordagem holística para o cuidado das pacientes afetadas por essa doença.
ESPORTES ADAPTADOS PARA PESSOAS COM DEFICIÊNCIA MOTORA:
Authors: Caterine Santos de Souza Moreira Caterine , De Jesus Bacelar Joice Ellen , Alves Nogueira Souza Suzana
Published: December 2023

RESUMO

Este artigo trata de uma investigação científica acerca do esporte adaptado para pessoas com deficiência motora, mais especificamente a paraplegia. O objetivo do estudo é demonstrar a importância de como o professor de Educação física pode trabalhar com pessoas com paraplegia, através dos esportes adaptados, contribuindo na reabilitação desses indivíduos no contexto em que vivem. Foi realizada uma pesquisa bibliográfica, de caráter descritivo e abordagem qualitativa na qual foi feita a análise descritiva de cinco produções científicas. Ficou evidenciado que com as adaptações realizadas pelo professor, as pessoas com paraplegia conseguem realizar as diversas possibilidades de práticas esportivas e corporais. Portanto, com as orientações de um professor de educação física observa-se melhorias em relação as habilidades motoras e bem-estar dos indivíduos com paraplegia.

 

ABSTRACT

This article deals with a scientific investigation into adapted sports for people with motor disabilities, more specifically paraplegia. The objective of the study is to demonstrate the importance of how physical education teachers can work with people with paraplegia, through adapted sports, contributing to the rehabilitation of these individuals in the context in which they live. A bibliographical research was carried out, with a descriptive nature and a qualitative approach, in which a descriptive analysis of five scientific productions was carried out. It was evident that with the adaptations made by the teacher, people with paraplegia are able to carry out the different possibilities of sports and body practices. Therefore, with the guidance of a physical education teacher, improvements can be observed in relation to the motor skills and well-being of individuals with paraplegia.
Obscure Desire: Goethe and the Imbalanced Pedagogy of What Maisie Knew
Authors: Duban James
Published: December 2023

Abstract: What is the importance of the children Mignon and Felix, in Wilhelm Meister’s Apprenticeship and Travels , for the themes of sexuality and pedagogy in What Maisie Knew ? Grounded in suggestive correspondences between geographically distant, but conceptually allied narratives, James’s novel appears to invert the moral compass of Goethe’s bildungsroman to craft Maisie’s misguidedness and perhaps that of her narrator. While distancing Maisie from the preconceptions of the narrator, I credit, as a foreshadowing of What Maisie Knew , James’s allusion—in his personal review of the Meister narratives—to “pernicious conclusions.” Features of both Mignon and Felix, as transposed by James, resurface in Maisie, while Wilhelm morphs into a predatory Sir Claude.
Daoist Yao Aiyun and Modern Education and Other Reforms in Late Qing Nanyang
Authors: Liu Xun
Published: December 2023

Abstract: This is a study of Daoist encounter with modernity. It reconstructs the history of Quanzhen Daoist monastic activism in late Qing educational and other modern reforms in Nanyang from the 1880s to the 1910s. Focusing on the life and career of the Quanzhen Daoist cleric Yao Aiyun (1845–1912), this study examines the intense Daoist activism carried out by prior Yao and the Monastery of Dark Mystery (Xuanmiao guan) in establishing three new schools from 1905 to 1908. Using evidence developed from new and previously underexplored primary sources, I show that prior Yao and his monastery paid for and operated three new schools to support the Qing state's push for modern education reforms in rural jurisdictions, and more importantly to meet the educational needs of the children in local communities in Nanyang. I further demonstrate that while the threat of temple expropriation by the late Qing state may have been a factor driving some Buddhist and Daoist temples to support to the state educational reforms, prior Yao and his monastery's efforts in establishing new schools must not be seen merely as self-serving or opportunistic instincts at times of crisis. Instead, I argue that they are best understood as a natural extension of the Quanzhen Daoist monastery's long and deep tradition of commitment and service to the local community in Nanyang. As I have shown elsewhere, these efforts trace their roots or origins to at least the early Qing re-construction of Nanyang in the mid-seventeenth century, and to the most recent valiant defense of the city against the Nian-Taiping rebels in the 1860s. I further argue that contrary to the Weberian thesis that religion would either wither under the impact of modernity or oppose the proliferation of science and knowledge, prior Yao's activism shows that Daoism rather willingly pioneered in efforts to establish new western-style schools for the sake of advancing modern education and science-based knowledge among the local population. In the process, prior Yao and his Quanzhen Daoist temple gained both official state recognition and popular respect, and grew stronger in both influence and power in local society in late Qing Nanyang. Indeed, the case of prior Yao also shows that Chinese traditional religions such as Daoism often found ingenious ways to not only adapt to and engage with forces of modernity, but they also evolved themselves and advanced their own interests by immersing themselves deeply in various new social and public institutions of the modernizing society in late Qing Nanyang.
“He’s Busy Espalliering Sylvia”: Ted Hughes, Sylvia Plath, and Assia Wevill
Authors: Goodspeed-Chadwick Julie
Published: December 2023

Abstract: Prompted by recent feminist recovery efforts, this essay traces and considers Assia Wevill (1927–1969) as a noteworthy woman writer, whose life and literary contributions were influenced and inspired by the Pulitzer Prize–winning Sylvia Plath (1932–1963) and the former British Poet Laureate Ted Hughes (1930–1998). Reflecting on the manner in which Assia has been understood as a femme fatale archetype, the article seeks to reframe our understanding of her life primarily and her work secondarily by foregrounding them in her own words. While Assia has conventionally been approached as an attendant figure in the biographies and poetry of Plath and Hughes, this piece maintains that her life and literary contributions provide material for literary scholars to engage with and make inroads in feminist scholarship, as well as to forge new pathways in Plath studies and Hughes studies. Increasingly more than a footnote to Plath and Hughes, Assia Wevill emerges as a relevant subject for scholars who wish to track and map gendered dynamics in connection with biography in twentieth-century literature and letters.
Spatial exclusion leads to “tug-of-war” ecological dynamics between competing species within microchannels
Authors: Rothschild Jeremy , Ma Tianyi , Milstein Joshua N. , Zilman Anton
Published: December 2023

Competition is ubiquitous in microbial communities, shaping both their spatial and temporal structure and composition. Classical minimal models of competition, such as the Moran model, have been employed in ecology and evolutionary biology to understand the role of fixation and invasion in the maintenance of population diversity. Informed by recent experimental studies of cellular competition in confined spaces, we extend the Moran model to incorporate mechanical interactions between cells that divide within the limited space of a one-dimensional open microchannel. The model characterizes the skewed collective growth of the cells dividing within the channel, causing cells to be expelled at the channel ends. The results of this spatial exclusion model differ significantly from those of its classical well-mixed counterpart. The mean time to fixation of a species is greatly accelerated, scaling logarithmically, rather than algebraically, with the system size, and fixation/extinction probability sharply depends on the species’ initial fractional abundance. By contrast, successful takeovers by invasive species, whether through mutation or immigration, are substantially less likely than in the Moran model. We also find that the spatial exclusion tends to attenuate the effects of fitness differences on the fixation times and probabilities. We find that these effects arise from the combination of the quasi-neutral “tug-of-war” diffusion dynamics of the inter-species boundary around an unstable equipoise point and the quasi-deterministic avalanche dynamics away from the fixed point. These results, which can be tested in microfluidic monolayer devices, have implications for the maintenance of species diversity in dense bacterial and cellular ecosystems where spatial exclusion is central to the competition, such as in organized biofilms or intestinal crypts.
Learning massive interpretable gene regulatory networks of the human brain by merging Bayesian networks
Authors: Bernaola Niko , Michiels Mario , Larrañaga Pedro , Bielza Concha
Published: December 2023

We present the Fast Greedy Equivalence Search (FGES)-Merge, a new method for learning the structure of gene regulatory networks via merging locally learned Bayesian networks, based on the fast greedy equivalent search algorithm. The method is competitive with the state of the art in terms of the Matthews correlation coefficient, which takes into account both precision and recall, while also improving upon it in terms of speed, scaling up to tens of thousands of variables and being able to use empirical knowledge about the topological structure of gene regulatory networks. To showcase the ability of our method to scale to massive networks, we apply it to learning the gene regulatory network for the full human genome using data from samples of different brain structures (from the Allen Human Brain Atlas). Furthermore, this Bayesian network model should predict interactions between genes in a way that is clear to experts, following the current trends in explainable artificial intelligence. To achieve this, we also present a new open-access visualization tool that facilitates the exploration of massive networks and can aid in finding nodes of interest for experimental tests.
FiMAP: A fast identity-by-descent mapping test for biobank-scale cohorts
Authors: Chen Han , Naseri Ardalan , Zhi Degui
Published: December 2023

Although genome-wide association studies (GWAS) have identified tens of thousands of genetic loci, the genetic architecture is still not fully understood for many complex traits. Most GWAS and sequencing association studies have focused on single nucleotide polymorphisms or copy number variations, including common and rare genetic variants. However, phased haplotype information is often ignored in GWAS or variant set tests for rare variants. Here we leverage the identity-by-descent (IBD) segments inferred from a random projection-based IBD detection algorithm in the mapping of genetic associations with complex traits, to develop a computationally efficient statistical test for IBD mapping in biobank-scale cohorts. We used sparse linear algebra and random matrix algorithms to speed up the computation, and a genome-wide IBD mapping scan of more than 400,000 samples finished within a few hours. Simulation studies showed that our new method had well-controlled type I error rates under the null hypothesis of no genetic association in large biobank-scale cohorts, and outperformed traditional GWAS single-variant tests when the causal variants were untyped and rare, or in the presence of haplotype effects. We also applied our method to IBD mapping of six anthropometric traits using the UK Biobank data and identified a total of 3,442 associations, 2,131 (62%) of which remained significant after conditioning on suggestive tag variants in the ± 3 centimorgan flanking regions from GWAS.
Determinants of knowledge, attitude, and practice among patients with type 2 diabetes mellitus: A cross-sectional multicenter study in Tanzania
Authors: Joho Angelina A. , Sandi Frank , Yahaya James J.
Published: December 2023

Improvement of primary care for patients with type 2 diabetes mellitus (T2DM) through the promotion of good knowledge, attitude, and practice is of paramount importance for preventing its related complications. This study aimed to assess the levels of knowledge, attitude, and practice and associated factors among patients with T2DM. This was a cross-sectional multicenter hospital-based study that included 979 patients from 8 health facilities in Tanzania. A standardized semi-structured interviewer-administered questionnaire was used to extract the required data. Factor analysis was used to determine the level of knowledge, attitude, and practice. Multivariable analysis under binary logistic regression analysis was used to determine the predictors of knowledge, attitude, and practice. P<0.05 was considered significant. The levels of adequate knowledge, positive attitude, and appropriate practice were 62.1%, 54%, and 30.9%, respectively. Being self-employed (AOR = 1.74, 95% CI = 0.28–0.91, p = 0.040) predicted adequate knowledge. Being male (AOR = 1.46, 95% CI = 1.06–2.01, p = 0.021 and visiting regional hospitals (AOR = 2.17, 95% CI = 1.33–2.51, p = 0.013) were predictors of positive attitude. Residing in rural areas and not having adequate knowledge of diabetes were less likely associated with appropriate practice. This study has shown a significantly low level of appropriate practice among patients with T2DM towards general issues on diabetes, risk factors, and related complications. Therefore, emphasis should be placed on improving good practices that can help prevent related complications.
Judgments of learning in bilinguals: Does studying in a L2 hinder learning monitoring?
Authors: Reyes Marta , Morales Mª Julia , Bajo Mª Teresa
Published: December 2023

Nowadays, use of a second language (L2) has taken a central role in daily activities. There are numerous contexts in which people have to process information, acquire new knowledge, or make decisions via a second language. For example, in academia and higher education, English is commonly used as the language of instruction and communication even though English might not be students’ native or first language (L1) and they might not be proficient in it. Such students may face different challenges when studying and learning in L2 relative to contexts in which they study and learn in their L1, and this may affect their metamemory strategies. However, little is yet known about whether metamemory processes undergo significant changes when learning is carried out in L2. The aim of the present study was to investigate the possible consequences on learning derived from studying materials in L2 and, more specifically, to explore whether the interplay between monitoring and control (metamemory processes) changes as a function of the language involved. In three experiments, we explored whether font type (Experiment 1), concreteness (Experiment 2), and relatedness (Experiment 3) affected judgments of learning (JOLs) and memory performance in both L1 and L2. JOLs are considered the result of metacognitive strategies involved in the monitoring of learning and have been reported to vary with the difficulty of the material. The results of this study showed that people were able to monitor their learning in both L1 and L2, even though they judged L2 learning as more difficult than L1. Interestingly, self-perceived difficulty did not hinder learning, and people recognized L2 materials as well or better than L1 materials. We suggest that this might be an example of a desirable difficulty for memory.
Seroprevalence of human adenovirus type 5 neutralizing antibodies in the Philippines
Authors: Francisco Abialbon G. , Reyes John Carlo B. , Tabios Ian Kim B. , Cruz Criselda Jean G. , Ang Mark Angelo C. , Heralde Francisco M. , Lacuna Azita Racquel G. , de Paz-Silava Sheriah Laine M.
Published: December 2023

Human adenovirus (HAdV), particularly the HAdV type 5 (HAdV-5), has been extensively utilized in the development of vector vaccines due to its high immunogenicity, good safety profile, and ease of propagation. However, one of the main challenges in its use is the presence of pre-existing immunity among vaccine recipients. Pre-existing neutralizing antibodies (NAbs) can prevent the uptake of HAdV-5 vectors and reduce vaccine efficacy. Hence, this study investigated the seroprevalence of NAbs against HAdV-5 in urban and rural regions of the Philippines. Luciferase-based neutralization assay was performed on 391 plasma/serum samples. Out of these samples, 346 or 88.5% were positive for HAdV-5 NAbs, and the majority of them (56.8%) had high titers against the virus. Among the regions included in this study, Bicol (Region V) had the highest seroprevalence rate (94.1%). Our findings show that a significant number of adults in the Philippines have pre-existing immunity against HAdV-5. This supports the recommendation that vaccination programs in the country should consider implementing vaccination techniques, such as a prime-boost regimen or addition of booster doses, to address the potential negative effects of pre-existing HAdV-5 immunity in the efficacy of adenoviral vector-based vaccines.
Quality of antenatal care and outcomes of Hypertensive Disorders in Pregnancy among antenatal attendees: A comparison of urban and periurban health facilities in Ghana
Authors: Boachie-Ansah Pauline , Anto Berko Panyin , Marfo Afia Frimpomaa Asare , Dassah Edward Tieru , Mozu Ivan Eduku , Attakora Joseph
Published: December 2023

Rural-urban-peri urban disparity assessments on health outcomes have been considered as critical determinants of health and health service outcomes. It is policy relevant in terms of the burden of disease and also provides focus on target interventions. This study aimed to assess the differences in the quality of Ante-natal Care (ANC) and the outcomes of Hypertensive Disorders in Pregnancy (HDPs) from selected health facilities in Ghana. This was a questionnaire-based cross-sectional study. Data on demographics, proportions of HDPs, quality of ANC and the outcomes of HDPs were collected. Logistic regression models were used to examine the association of the independent variables with the location of the health of facility. A total of 500 pregnant women were included in this study. There were 270 (54%) urban and 230 (46%) peri-urban dwellers. The proportion of HDPs varied with the location of the health facility. Women attending urban health facilities were more likely to be hypertensive (μ2 = 126.4; p<0.001), have chronic hypertension with superimposed pre-eclampsia (p< 0.001), have good quality ANC (μ2 = 41.28; p< 0.001), deliver full term (μ2 = 4.83; p = 0.028), and have excellent knowledge on HDPs (μ2 = 227.65; p< 0.001) compared to women receiving care in peri-urban health facilities. The method of delivery and outcome of birth did not statistically vary amongst the periurban and urban health facilities. There was an increase in the proportion in preterm in urban compared to periurban. The burden of HDPs was high in urban health facilities with high proportion of its mothers receiving quality ANC as well as having excellent knowledge on HDPs compared to mothers receiving care at the periurban health facilities. There is a need to target maternal care interventions to the periurban health facilities to improve obstetric health outcomes.
Prevalence of viral DNA in high-grade serous epithelial ovarian cancer and correlation with clinical outcomes
Authors: Robertson Sharon E. , Yasukawa Maya , Marchion Douglas C. , Xiong Yin , Naqvi Syeda Mahrukh Hussnain , Gheit Tarik , Tommasino Massimo , Wenham Robert M. , Giuliano Anna R. , Lancaster Johnathan M. , Shahzad Mian M. K.
Published: December 2023

Introduction

Currently 11 infectious agents are classified as carcinogenic but the role of infectious agents on outcomes of epithelial ovarian cancer is largely unknown.

Objective

To explore the association between infectious agents and ovarian cancer, we investigated the prevalence of viral DNA in primary ovarian cancer tumors and its association with clinical outcomes.

Methods

Archived tumors from 98 patients diagnosed with high-grade serous epithelial ovarian cancer were collected between 1/1/1994 and 12/31/2010. After DNA extraction, Luminex technology was utilized to identify polymerase chain reaction-amplified viral DNA for 113 specific viruses. Demographic data and disease characteristics were summarized using descriptive statistics. We used logistic regression and Cox proportional hazards model to assess associations between tumor viral status and disease outcome and between tumor viral presence and overall survival (OS), respectively.

Results

Forty-six cases (45.9%) contained at least one virus. Six highly prevalent viruses were associated with clinical outcomes and considered viruses of interest (VOI; Epstein-Barr virus 1, Merkel cell polyomavirus, human herpes virus 6b, and human papillomaviruses 4, 16, and 23). Factors independently associated with OS were presence of VOI (HR 4.11, P = 0.0001) and platinum sensitivity (HR 0.21, P<0.0001). Median OS was significantly decreased when tumors showed VOI versus not having these viruses (22 vs 44 months, P<0.0001). Women <70 year old with VOI in tumors had significantly lower median OS versus age-matched women without VOI (20 vs 57 months, P = 0.0006); however, among women ≥70 years old, there was no difference in OS by tumor virus status.

Conclusions

The presence of a VOI was significantly associated with a lower OS. These findings may have implications for clinical management of ovarian cancer but require additional studies.
Curricula for teaching end-users to kinesthetically program collaborative robots
Authors: Ajaykumar Gopika , Hager Gregory D. , Huang Chien-Ming
Published: December 2023

Non-expert users can now program robots using various end-user robot programming methods, which have widened the use of robots and lowered barriers preventing robot use by laypeople. Kinesthetic teaching is a common form of end-user robot programming, allowing users to forgo writing code by physically guiding the robot to demonstrate behaviors. Although it can be more accessible than writing code, kinesthetic teaching is difficult in practice because of users’ unfamiliarity with kinematics or limitations of robots and programming interfaces. Developing good kinesthetic demonstrations requires physical and cognitive skills, such as the ability to plan effective grasps for different task objects and constraints, to overcome programming difficulties. How to help users learn these skills remains a largely unexplored question, with users conventionally learning through self-guided practice. Our study compares how self-guided practice compares with curriculum-based training in building users’ programming proficiency. While we found no significant differences between study participants who learned through practice compared to participants who learned through our curriculum, our study reveals insights into factors contributing to end-user robot programmers’ confidence and success during programming and how learning interventions may contribute to such factors. Our work paves the way for further research on how to best structure training interventions for end-user robot programmers.
The subset of peroxisomal tail-anchored proteins do not reach peroxisomes via ER, instead mitochondria can be involved
Authors: Somborac Tamara , Lutfullahoglu Bal Güleycan , Fatima Kaneez , Vihinen Helena , Paatero Anja , Jokitalo Eija , Paavilainen Ville O. , Konovalova Svetlana
Published: December 2023

Peroxisomes are membrane-enclosed organelles with important roles in fatty acid breakdown, bile acid synthesis and biosynthesis of sterols and ether lipids. Defects in peroxisomes result in severe genetic diseases, such as Zellweger syndrome and neonatal adrenoleukodystrophy. However, many aspects of peroxisomal biogenesis are not well understood. Here we investigated delivery of tail-anchored (TA) proteins to peroxisomes in mammalian cells. Using glycosylation assays we showed that peroxisomal TA proteins do not enter the endoplasmic reticulum (ER) in both wild type (WT) and peroxisome-lacking cells. We observed that in cells lacking the essential peroxisome biogenesis factor, PEX19, peroxisomal TA proteins localize mainly to mitochondria. Finally, to investigate peroxisomal TA protein targeting in cells with fully functional peroxisomes we used a proximity biotinylation approach. We showed that while ER-targeted TA construct was exclusively inserted into the ER, peroxisome-targeted TA construct was inserted to both peroxisomes and mitochondria. Thus, in contrast to previous studies, our data suggest that some peroxisomal TA proteins do not insert to the ER prior to their delivery to peroxisomes, instead, mitochondria can be involved.