bluuebunny/crossref_metadata_2025 huggingface dataset:
Properties and tribological evaluation of graphene and fullerene nanoparticles as additives in oil lubrication
Authors: Sharuddin Muhammad Hazman bin , Sulaiman MH , Kamaruddin S , Dahnel AH , Abd Halim NFH , Ridzuan MJM , Abdul-Rani Ahmad Majdi
Published: May 2023

In this study, SAE-0W20 engine oil was mixed with graphene and fullerene nanoparticles. The goal of this study was to evaluate and compare the effects of different carbon nanoparticles on the thermal, rheological, and tribological properties of engine oil, such as thermal degradation, viscosity, friction, and wear. Using a two-step process, graphene and fullerene nanostructures were dispersed in low-viscosity SAE-0W20 engine oil at a concentration of 0.05 wt.%. The friction and wear characteristics were evaluated in a customized cylindrical block-on-ring tribology test according to the ASTM G77 standard. Graphene and fullerene nanoparticles protect contact surfaces by forming a very thin protective film between moving mechanical parts thus resulting in wear and friction reduction. The results showed graphene nanoparticles have improved significantly the tribological performance of SAE-0W20 engine oil.
Entrepreneurial and market orientations: The moderating role of social networks on post-entry performance of international new ventures
Authors: Presutti Manuela , Fratocchi Luciano , Odorici Vincenza
Published: May 2023

This paper investigates whether entrepreneurial and marketing orientations (respectively EOs and Mos) impact – individually or collectively – international new ventures’ (INVs’) post-entry performance growth. Furthermore, we investigate whether such relations are moderated by the foreign social networks, both formal and informal, of international new ventures. Using a survey, we test our hypotheses on a sample of Italian high-tech INVs located in a cluster near Rome. A quantitative analysis is used to test the hypotheses. We found that EOs and MOs positively impact the post-entry international performance growth of INVs. Moreover, while informal foreign social network ties significantly moderate the impact of EOs and MOs, formal foreign social network ties do not have a significant moderating effect. Many theoretical and practical contributions are discussed in the paper.
A Unique Model and Workforce to Address Health-Related Social Needs and Health Equity: Regional Health Connectors in Colorado
Authors: Carroll Jennifer K. , Fernald Douglas H. , Hall Tristen L. , Groves Hannah M. , Grant Gillian , Sherrill Ashley , Crispe Kristin , Brown Ashlie , Lampe Sarah , Perry Dickinson W.
Published: May 2023

Unmet health-related social needs contribute to high morbidity and poor population health. Improving social conditions are likely to reduce health disparities and improve the health of the overall U.S. population. The primary objective of this article is to describe an innovative workforce model, called Regional Health Connectors (RHCs), and how they address health-related social needs in Colorado. This is a program evaluation that analyzed field notes and interview data from 2021-2022. We applied our findings to the framework developed by the National Academies of Sciences, Engineering, and Medicine’s (NASEM’s) report on strengthening social care integration into health care (2019). We found that RHCs address the following health-related social needs most commonly: food insecurity ( n = 18 of 21 regions or 85% of all regions), housing ( n = 17 or 81% of all regions), transportation ( n = 11 or 52% of all regions), employment opportunities ( n = 10 or 48% of all regions), and income/financial assistance ( n = 11 or 52% of all regions). RHCs interacted across many sectors to address health-related social needs and provided multiple types of support to primary care practices at the organizational level. Examples of emerging impact of RHCs are described and mapped onto the NASEM framework. Findings from this program evaluation add to the growing landscape of knowledge and importance of detecting and addressing health-related social needs. We conclude that RHCs are a unique and emerging workforce that addresses multiple domains needed to integrate social care into health care.
Upper Extremity Wood Saw Injuries: Experience at a Single Level 1 Trauma Center
Authors: Hoffa Matthew T. , Benedick Alex , Simske Jeffrey S. , Vallier Heather A.
Published: May 2023

Background:

Saw injuries are common, with more 75 000 occurring each year in the United States alone. While these injuries occur frequently, management strategies are not universally agreed upon, and data regarding outcomes and complications are lacking. We propose to provide a comprehensive picture of upper extremity saw injury patterns, management strategies, complications, and outcomes.

Methods:

Patients presenting to a single level 1 trauma center between 2012 and2019 with upper extremity laceration, crush, or amputation were identified. In all, 10 721 patients were reviewed, and those without wood saw injuries were excluded. Patient demographic information, injury details, management strategy, and outcomes were collected.

Results:

In all, 283 upper extremity wood saw injuries were analyzed. Injuries most commonly affected the fingers (92.2%), and the frequencies of simple lacerations and complicated injuries were nearly identical. The table saw was the most commonly implicated saw (48%) with more than half of the injuries being complicated, the most common being bone injury. Most patients were treated nonsurgically (81.3%), with the majority undergoing wound care in the emergency department followed by home antibiotics (68.2%). Subsequent complications were exceedingly rare (4.2%), with wound infection occurring in 5 patients. Amputations occurred in 19.4% of patients, leading to permanent functional impairment.

Conclusions:

Wood saw injuries are common, generating functional and financial burden. While injuries range in severity, management can typically be conducted within the emergency department with local wound care and outpatient oral antibiotics. Injury complications and long-term issues are rare. Ongoing efforts to promote saw safety are required to minimize the burden of these injuries.
The Scratch-Collapse Test: A Systematic Review and Statistical Analysis
Authors: Jain Nirbhay S. , Zukotynski Brian , Barr Meaghan L. , Cortez Abigail , Benhaim Prosper
Published: May 2023

Background:

The scratch-collapse test (SCT) is a provocative maneuver used to diagnose compressive neuropathies. Despite multiple studies supporting its use, the SCT remains a controversial point in the literature in regard to its exact clinical application. We performed a systematic review and statistical analysis to provide statistical data on SCT outcomes and elucidate its role in diagnosing compressive conditions.

Methods:

We performed a systematic review of the literature according to Preferred Reporting for Systematic Reviews and Meta-Analyses guidelines. We extracted data of patients with outcomes on the SCT (yes/no) and on an accepted gold standard examination (electrodiagnostic studies). These data were analyzed using a statistical software program to generate the sensitivity and specificity values of the pooled data, as well as kappa agreement statistics.

Results:

For patients with carpal tunnel, cubital tunnel, peroneal, and pronator compressive neuropathies, the overall sensitivity of the SCT was 38%, and the specificity was 94%, with the kappa statistic approximately 0.4. Sensitivity and specificity values were higher for cubital tunnel syndrome and peroneal compression syndrome but lower for carpal tunnel syndrome. Pronator syndrome was also examined, but the data were inadequate for analysis.

Conclusions:

The SCT is a useful adjunct in the armament of diagnostic tools for the hand surgeon. Given its low sensitivity and high specificity, SCT should be used as a confirmatory test, rather than as a diagnostic screening test. More analyses are needed to identify subtler applications.
School Leader Lotería: How School Educators Respond to Latinx Student Performances of (Their) Lived Experiences With Racism in School
Authors: Domínguez Ashley D. , Casanova Carlos R.
Published: May 2023

Latinx youth exhibit educational leadership and possess unique insight into experiences of youth of color in K-12 schooling. Yet, adultism hinders authentic youth participation in educational decision making. In this study we address the following question: What types of behavior do K-12 school leaders demonstrate in response to Latinx youths’ experiences of racism? We share the story of a structured interaction, guided by social justice and forum theater, facilitated by Latinx youth to adult school leaders. We present our findings via the school leader lotería typology model and discuss the spectrum of adult educator behavior in response to youth voice.
The point is to change it: Locating community geography and praxis in a neoliberalizing academia
Authors: Ortega Arnisson Andre
Published: May 2023

Amid the COVID-19 pandemic and the multiple issues we are confronting at the contemporary moment, geographers are faced with the critical task of finding ways to address and grapple with these concerns. This commentary advocates for community geography as an important praxis-oriented intervention that utilizes theory and methods for community issues. However, the practice of community geography is constrained by academia's neoliberalizing terrain, whereby a globalizing deployment of ‘publish-or-perish’ productivity has been reconfiguring what geographers can and ought to be doing. By going against the neoliberal grain and practicing community geography, the possibilities for theoretical innovation and political potentials open up towards a geography that is socially relevant and directly addresses issues affecting the lives of marginalized community members.
An Optimal Proportion for Independent Directors in the Boardroom: An Empirical Study
Authors: Arora Akshita , Soni Tarun Kumar
Published: May 2023

The purpose of the article is threefold: (a) to analyze the causality between board independence and performance of the firm, (b) to examine the impact of board independence on financial performance, and (c) to ascertain whether the legislation of at least 50% of independent directors (IDs) influences the performance of the firm. We have employed a panel data framework for a sample of 442 Indian companies from 2013 to 2019. The estimation analysis has been conducted using panel Granger causality test, fixed effects method, and system generalized methods of moments. We further test whether the relationship differs across two categories of companies: one having IDs up to 50% and more; and second, the proportion is less than 50%. The results of our dynamic panel data analysis indicate that the ratio of IDs is found to have a positive association with the firm performance. Further, we found that firms with more than 50% IDs have a significantly higher firm performance than firms having less than 50% IDs. There should be an adequate ratio of independent members on board to avail benefits from their independent judgments without intervention in the ordinary course of business. It could be used as a preliminary study by the policymakers and regulatory authorities to set additional standards for the number and proportion of IDs.
Can the System of Rice Intensification Save Water and Increase Yield of Paddy?: A Study of Tank Irrigated Area
Authors: Devi G. Karthiga , Narayanamoorthy A. , Jothi P. , Sujitha K. S.
Published: May 2023

Owing to looming water scarcity, paddy cultivation (a water-intensive crop) under the conventional inundation method is going to be a very difficult venture for farmers. The new method of paddy cultivation (MCD) known as the System of Rice Intensification (SRI) appears to be very useful to paddy cultivating farmers to overcome the issue of water scarcity. SRI has been in practice over the last few years in India, but not many studies have attempted to find out whether the SRI MCD is useful to farmers in terms of saving water and increasing the yield of paddy using data collected from water-stressed tank irrigated area. In this study, an attempt has been made to fill this gap using data collected from a total of 100 sample farmers from a district in Tamil Nadu State. The study shows that SRI farmers can save 41% of water and harvest about 40% of higher productivity than non-SRI farmers. Through saving of water, fertiliser and other inputs, about 22% of the reduction in the cost of cultivation was also realised by SRI farmers. The increased productivity and reduced cost of cultivation, helped the SRI farmers to harvest an additional profit of ₹15,158/acre over the profit earned by the farmers cultivating paddy under the conventional inundation method.
Comparison of Analgesia Treatment Methods After Arthroscopic Rotator Cuff Repair: A Network Meta-analysis of 42 Randomized Controlled Trials
Authors: Su Peng , Liu Yijia , Zhang Lu , Bai Long-bin
Published: May 2023

Background:

The optimal method for postoperative analgesia after arthroscopic rotator cuff repair (ARCR) is still unclear.

Purpose:

To compare the efficacy of postoperative analgesic methods after ARCR through network meta-analysis of randomized controlled trials and prospective controlled trials.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Embase, and Web of Science from inception until April 12, 2022, for randomized controlled trials and prospective controlled trials evaluating neuraxial analgesia, peripheral nerve block, periarticular local anesthetic infiltration, intravenous patient-controlled analgesia, oral analgesia, or any combination of these methods for pain management after ARCR. Outcomes included pain scores at rest, morphine consumption, and complications (nausea and vomiting). Study quality was assessed using the Cochrane risk-of-bias tool. Network meta-analysis was used to assess the relative efficacy of the methods for postoperative analgesia. The best choice for postoperative analgesia was defined as the one with significant differences in pain scores and morphine consumption compared with placebo, with no significant difference in complications, during the initial 48 hours postoperatively.

Results:

Included were 42 studies with 3110 patients. Only suprascapular nerve block (SSNB) was significantly superior to placebo in pain scores (mean difference [MD], –0.93 [95% CI, –1.31 to –0.54] at 6 hours; MD, –2.34 [95% CI, –3.49 to –1.19] at 12 hours) and morphine consumption (MD, –17.70 [95% CI, –32.98 to –2.42] at 24 hours) ( P < .05 for all), with no difference in complications (odds ratio, 0.96 [95% CI, 0.21 to 4.32]; P > .05). Pain scores were significantly lower with interscalene nerve block compared with SSNB (MD, –0.69 [95% CI, –1.17 to –0.20] at 6 hours; MD, –1.44 [95% CI, –2.21 to –0.67] at 12 hours) and with SSNB + axillary nerve block compared with SSNB (MD, –3.09 [95% CI, –4.18 to –1.99] at 6 hours; MD, –0.87 [95% CI, –1.71 to –0.03] at 12 hours) ( P < .05 for all).

Conclusion:

Based on the current evidence, most analgesic methods lowered pain and morphine consumption compared with placebo. There were significant differences in pain scores between interscalene nerve block and SSNB during the first 12 hours postoperatively, and adding axillary nerve block to SSNB enhanced the analgesic effect.
How Social Media Use in B2B Export Selling Contributes to Sales Performance: The Media Synchronicity Theory Perspective
Authors: Zhou Jihong , Charoensukmongkol Peerayuth
Published: May 2023

Despite increasing interest in the role of social media use (SMU) in improving performance, limited studies have examined its impact on sales performance in B2B export sales contexts. And the underlying mechanisms of such effects remain underexplored. Drawing on Media Synchronicity Theory, we propose SMU in sales affects cross-cultural communication performance first, which in turn affects sales performance, and training and experience are appropriation factors of SMU in sales. A questionnaire survey was conducted among 751 B2B export salespeople from mainland China. The results show cross-cultural communication performance fully mediates the effect of SMU in sales on sales performance, and training and experience are antecedents of SMU in sales. The total effect of training on sales performance through SMU in sales and cross-cultural communication performance is stronger than that of experience. Theoretical and practical insights on how to leverage social media to support B2B export sales performance are discussed.
Intersectional approach of everyday geography
Authors: Vallée Julie , Lenormand Maxime
Published: May 2023

Hour-by-hour variations in spatial distribution of gender, age and social class within cities remain poorly explored and combined in the segregation literature mainly centred on home places from a single social dimension. Taking advantage of 49 mobility surveys compiled together (385,000 respondents and 1,711,000 trips) and covering 60% of France’s population, we consider variations in hourly populations of 2572 districts after disaggregating population across gender, age and education level. We first isolate five district hourly profiles (two ‘daytime attractive’, two ‘nighttime attractive’ and one more ‘stable’) with very unequal distributions according to urban gradient but also to social groups. We then explore the intersectional forms of these everyday geographies. Taking as reference the dominant groups (men, middle-age and high educated people) known as concentrating hegemonic power and capital, we analyze specifically whether district hourly profiles of dominant groups diverge from those of the others groups. It is especially in the areas exhibiting strong increase or strong decrease of ambient population during the day that district hourly profiles not only combine the largest dissimilarities all together across gender, age and education level but are also widely more synchronous between dominant groups than between non-dominant groups (women, elderly and low-educated people). These intersectional patterns shed new light on areas where peers are synchronously located over the 24-hour period and thus potentially in better position to interact and to defend their common interests.
A visibility-based approach to manage the vertical urban development and maintain visual sustainability of urban mountain landscapes: A case of Mufu Mountain in Nanjing, China
Authors: Zhang Guanting , Cheng Shi , Gao Yuan
Published: May 2023

China has experienced a continuous population increase in urban areas over the last few decades with limited land for construction, which has prompted upward growth in the urban environment. Rapid urbanization has encroached on mountain landscapes and deteriorated the visual landscape in different parts of China. This study aims to investigate and analyze the proper balance between visual landscape protection of urban mountains and vertical urban development using a visibility-based method. An interactive and quantitative method was developed in this research using multiple digital 2D and 3D platforms based on the specification of prohibited spaces for constructive expansion in building height control. A metropolitan area near Mufu Mountain in Nanjing, China, was selected as a case study to implement the proposed method and simulate multiple vertical urban development scenarios. According to the comparison of different scenarios, there is a better building height layout to simultaneously satisfy the requirement of sustaining the Mufu mountain’s visibility and the construction capacity proposed by the documented plan. Two polynomial models were generated to quantitatively investigate the relationship between the protection of mountain landscapes and vertical urban development and served as a reference basis for urban planners to formulate the construction volume control strategy around Mufu Mountain. The proposed method in this study can help planners and urban managers to seek an appropriate approach to control building heights and achieve visual sustainability.
Walking journeys into everyday climatic-affective atmospheres: The emotional labour of balancing grief and hope
Authors: Tschakert Petra , Bourgault du Coudray Chantal , Horwitz Pierre
Published: May 2023

The postapocalypse as a mobilising discourse for climate action operates largely out of anger over experienced and anticipated injustices as well as paradoxical hope that fuses loss and grief with freed-up solidarities in support of liveable futures. However, negotiating this emotional tension can be both draining and isolating. Here, we examine how white settler populations in Western Australia balance grief and hope in places they hold dear and the role emotions such as sadness, worry, disappointment, joy, and pride play in relational place making. Through an innovative in situ and mobile methodology we call Walking Journeys, we trace how participants navigate their climatic-affective atmospheres and make sense of their agency in changing ‘Places of the Heart’. We find evidence for emotional complexities of solastalgia where pessimistic outlooks for the future are wrapped up in prefigurative visions of a better world. By holding the tension between paralysis and restoration, urban and rural residents explore affective co-existence and differential belonging in their homes and the landscapes around them. We highlight the challenge of enfranchising emotions beyond individuals and conclude by endorsing entangled, reflexive, and (re-)generative responsibilities for hopeful postapocalyptic journeying.
A Psychometric Validation of the Claremont Purpose Scale with an Emerging Adult University Student Population
Authors: Veazey Lillie Grace , Weber Marcela C. , Schulenberg Stefan E.
Published: May 2023

Purpose is a key protective factor for well-being, resilience, and satisfaction with life. The Claremont Purpose Scale (CPS) was developed by Bronk and colleagues with adolescents and emerging adults to measure three dimensions of purpose: Meaning, Goal-Directedness, and Beyond-the-Self. The psychometric properties examined in the original scale development paper were replicated with our independent, emerging adult college student sample: confirmatory factor analysis (CFA) of a 3-factor model, good-to-excellent internal consistency, convergent validity with a measure of general perceived meaning in life (MLQ-P), and discriminant validity with a measure of self-reported depression (DASS-21-D). Additional psychometrics examined in this study were test–retest reliability, a 1-factor CFA model, correlations with stress and anxiety, and descriptive statistics that had not yet been reported in the literature. Beyond-the-self items did not load well onto the overall factor in the 1-factor model, and their correlations with other scales (MLQ-S, DASS-21 subscales) differed significantly from the correlations between these other scales and the CPS total, General Meaning, and Goal-Directedness scores. Implications of these data include strong support for the use of each subscale as a distinct, psychometric index, and we recommend the total scale score not be used as a measure of overall purpose. Clearly, there are separate, but related, facets to this measure that, while positive, undermine the utility of a global purpose score. A slightly changed naming of the CPS to the “Claremont Purpose Scales” could promote their use as three separate scales instead of a single, total scale score.
Coastal crossings, or what the environmental history of the island of Phú Quốc (Vietnam) teaches us
Authors: Quenet Grégory
Published: May 2023

Today, the island of Phú Quốc, off the south-west of Vietnam, in the Gulf of Siam, near the southern tip of Cambodia, encapsulates all the banality of international touristic destinations. These littoral societies survived across the centuries, in what seemed to be an eternal ebb and flow of opening and retrenchment. Yet at the present time, fewer and fewer of them still remain. The least that the historian can do is to use the material and ecological traces which exist throughout the landscape and the archives, but which remain effectively unseen, with the goal of giving life again to the human experiences of the coast, in an era in which they have been increasingly negated by capitalism and international tourism. By bringing out this anthropological and environmental dimension, the archives allow us to repopulate the islands with all the entities that have woven their territory, making it possible to see by contrast the extent to which the paradisiacal image of these islands depopulates them. But even more profoundly, this perspective reformulates the understanding of the island as a set of shifting boundaries that move over time and are meant to be crossed.
Considerations in Eyelid Reconstruction in Treacher Collins Syndrome: A Scoping Review
Authors: Vandevender John , Park Royce B. , Choudhary Akriti , Tran Ann Q. , Purnell Chad A.
Published: May 2023

Objective:

Treacher Collins syndrome (TCS) is a rare congenital craniofacial disorder with extensive associated eyelid deformities. Given its rarity and the breadth of manifestations, many treatment options have been previously described, but never summarized.

Design:

A literature review adherent to PRISMA guidelines and pertaining to surgical outcomes of TCS eyelid repair was performed. Successful surgical outcomes were defined as improvement or satisfaction as described by the authors.

Results:

A total of 144 patients and 212 procedures from 24 articles were included in this review. The mean age of first eyelid reconstruction was 13 years (range 1-36 years). Previous craniofacial surgery for malar insufficiency was performed in 57% of patients using a calvarial bone graft (n = 56), temporal osteomuscular flap (n = 21), split-rib graft (n = 3), and malar implant (n = 2). Patients underwent between 1 and 3 eyelid procedures (median 2). Most common eyelid defects included pseudocolobomas (54%), lateral canthal dystopia (38%), and true colobomas (8%). Coloboma repairs had the highest success rate (92%), followed by pseudocoloboma (80%), and lateral canthal dystopia repair (79%). Coloboma repair had the highest revision rate (13%), followed by pseudocoloboma repair (2%).

Conclusion:

TCS eyelid abnormalities most commonly present as pseudocolobomas, true colobomas, and lateral canthal dystopia. Given this diversity of presentations in TCS, surgical management must ultimately be tailored to the collective defects present with consideration of previous craniofacial reconstruction and current midface development.
Cybersecurity Workforce Landscape, Education, and Industry Growth Prospects in Southeast Asia
Authors: Dillon Roberto , Tan Kim-Lim
Published: May 2023

Given the chronic lack of qualified professionals in the cybersecurity industry, the present paper seeks to evaluate the current interest in cybersecurity across Southeast Asia nations and then compare it with the available educational offerings of related degrees in each country to identify eventual gaps in the market. The goal is to assess whether there is a need for additional degree programs in cybersecurity and to evaluate the potential for future growth in the industry by providing a solid educational foundation for aspiring professionals. To estimate current interest from prospective students and profesionals in cybersecurity across each country, leaderboards from the popular TryHackMe gamified cybersecurity training platform are referenced. We further discuss issues by considering the related formal education programmes offered by the top universities in each country, identified by their presence in the QS world university rankings. The data are then used to propose two new metrics: the ‘Cybersecurity Education Prospects Index’ (CEPI) and the ‘Cybersecurity Industry Prospects Index’ (CIPI), which show how most of the eleven countries in Southeast Asia do have an unmet demand for cybersecurity education and only a few of them have already developed an educational infrastructure that is ready to support the growing needs of the local and international industry.
A brief comment on Hawthorne (2023): “On the definition of distinct mineral species: A critique of current IMA-CNMNC procedures”
Authors: Bosi Ferdinando , Hatert Frédéric , Pasero Marco , Mills Stuart J. , Miyawaki Ritsuro , Hålenius Ulf
Published: May 2023

In this communication we present a brief response to Hawthorne (2023) who, in a paper in volume 87, doi.org/10.1180/mgm.2023.8 (this journal), claims evidence for violations of the electroneutrality principle in mineral formulae derived through IMA–CNMNC procedures: i.e. the dominant-constituent rule, the valency-imposed double site-occupancy, the dominant-valency rule, and the site-total-charge approach (STC).

His statement is not correct as the STC method is based on the end-member definition; thus, it cannot violate the requirements of an end-member, particularly the laws of conservation of electric charge. The STC was developed to address the shortcomings in the previous IMA–CNMNC procedures.

The real question is: which method to use to define an end-member formula? Currently, there are two approaches: (1) STC, which first identifies the dominant end-member charge arrangement and then leads to the dominant end-member composition; (2) the dominant end-member approach.
Synergistic inter-clonal cooperation involving crosstalk, co-option and co-dependency can enhance the invasiveness of genetically distant cancer clones
Authors: Carneiro Caroline S. , Hapeman Jorian D. , Nedelcu Aurora M.
Published: May 2023

Background

Despite intensive research, cancer remains a major health problem. The difficulties in treating cancer reflect the complex nature of this disease, including high levels of heterogeneity within tumours. Intra-tumour heterogeneity creates the conditions for inter-clonal competition and selection, which could result in selective sweeps and a reduction in levels of heterogeneity. However, in addition to competing, cancer clones can also cooperate with each other, and the positive effects of these interactions on the fitness of clones could actually contribute to maintaining the heterogeneity of tumours. Consequently, understanding the evolutionary mechanisms and pathways involved in such activities is of great significance for cancer treatment. This is particularly relevant for metastasis (i.e., tumor cell migration, invasion, dispersal and dissemination), which is the most lethal phase during cancer progression. To explore if and how genetically distant clones can cooperate during migration and invasion, this study used three distinct cancer cell lines with different metastatic potentials.

Results

We found that (i) the conditioned media from two invasive lines (breast and lung) increased the migration and invasion potential of a poorly metastatic line (breast), and (ii) this inter-clonal cooperative interaction involved the TGF-β1 signalling pathway. Furthermore, when the less aggressive line was co-cultured with the highly metastatic breast line, the invasive potential of both lines was enhanced, and this outcome was dependent on the co-option (through TGF-β1 autocrine-paracrine signalling) of the weakly metastatic clone into expressing an enhanced malignant phenotype that benefited both clones (i.e., a “help me help you” strategy).

Conclusions

Based on our findings, we propose a model in which crosstalk, co-option, and co-dependency can facilitate the evolution of synergistic cooperative interactions between genetically distant clones. Specifically, we suggest that synergistic cooperative interactions can easily emerge, regardless of the degree of overall genetic/genealogical relatedness, via crosstalk involving metastatic clones able to constitutively secrete molecules that induce and maintain their own malignant state (producer-responder clones) and clones that have the ability to respond to those signals (responder clones) and express a synergistic metastatic behaviour. Taking into account the lack of therapies that directly affect the metastatic process, interfering with such cooperative interactions during the early steps in the metastatic cascade could provide additional strategies to increase patient survival.
Incidence and predictors of mortality among traumatic brain injury patients admitted to Amhara region Comprehensive Specialized Hospitals, northwest Ethiopia, 2022
Authors: Demlie Tiruye Azene , Alemu Mahlet Temesgen , Messelu Mengistu Abebe , Wagnew Fasil , Mekonen Enyew Getaneh
Published: May 2023

Introduction

Traumatic brain injury is a substantial cause of mortality and morbidity with a higher burden in low and middle-income countries due to healthcare systems that are unable to deliver effectively the acute and long-term care the patients require. Besides its burden, there is little information on traumatic brain injury-related mortality in Ethiopia, especially in the region. Therefore, this study aimed to assess the incidence and predictors of mortality among traumatic brain injury patients admitted to comprehensive specialized hospitals in the Amhara region, northwest Ethiopia, 2022.

Methods

An institution-based retrospective follow-up study was conducted among 544 traumatic brain injury patients admitted from January 1, 2021, to December 31, 2021. A simple random sampling method was used. Data were extracted using a pre-tested and structured data abstraction sheet. Data were entered, coded, and cleaned into EPi-info version 7.2.0.1 software and exported to STATA version 14.1 for analysis. The Weibull regression model was fitted to determine the association between time to death and covariates. Variables with a P-value < 0.05 were declared statistically significant.

Results

The overall incidence of mortality among traumatic brain injury patients was 1.23 per 100 person-day observation [95% (CI: 1.0, 1.5)] with a median survival time of 106 (95% CI: 60, 121) days. Age [AHR: 1.08 (95% CI; 1.06, 1.1)], severe traumatic brain injury [AHR: 10 (95% CI; 3.55, 28.2)], moderate traumatic brain injury [AHR: 9.2 (95% CI 2.97, 29)], hypotension [AHR: 6.9 (95% CI; 2.8, 17.1)], coagulopathy [AHR: 2.55 (95% CI: 1.27, 5.1)], hyperthermia [AHR: 2.79 (95% CI; 1.4, 5.5)], and hyperglycemia [AHR: 2.28 (95% CI; 1.13, 4.6)] were positively associated with mortality while undergoing neurosurgery were negatively associated with mortality [AHR: 0.47 (95% CI; 0.27-0 0.82)].

Conclusion

The overall incidence of mortality was found to be high. Age, severe and moderate traumatic brain injury, hypotension at admission, coagulopathy, presence of associated aspiration pneumonia, undergoing a neurosurgical procedure, episode of hyperthermia, and hyperglycemia during hospitalization were the independent predictors of time to death. Therefore, interventions to reduce mortality should focus on the prevention of primary injury and secondary brain injury.
The Rapid Arterial oCclusion Evaluation (RACE) scale accuracy for diagnosis of acute ischemic stroke in emergency department – A multicenter study
Authors: Rafiemanesh Hosein , Barikro Negin , Karimi Somayeh , Sotoodehnia Mehran , Jalali Alireza , Baratloo Alireza
Published: May 2023

Objective

It seems that the available data on performance of the Rapid Arterial oCclusion Evaluation (RACE) as a prehospital stroke scale for differentiating all AIS cases, not only large vessel occlusion (LVO), from the stroke mimics is lacking. As a result, we intend to evaluate the accuracy of the RACE criteria in diagnosing of AIS in patients transferred to the emergency department (ED).

Method

The present study was a diagnostic accuracy cross-sectional study during 2021 in Iran. The study population consist of all suspected acute ischemic stroke (AIS) patients who transferred to the ED by emergency medical services (EMS). A 3-part checklist consisting of the basic and demographic information of the patients, items related to the RACE scale, and the final diagnosis of the patients based on interpretation of patients’ brain MRI was used for data collection. All data were entered in Stata 14 software. We used the ROC analysis to evaluate the diagnostic power of the test.

Result

In this study, data from 805 patients with the mean age of 66.9 ± 13.9 years were studied of whom 57.5% were males. Of all the patients suspected of stroke who transferred to the ED, 562 (69.8%) had a definite final diagnosis of AIS. The sensitivity and specificity of the RACE scale for the recommended cut-off point (score ≥ 5) were 50.18% and 92.18%, respectively. According to the Youden J index, the best cut-off point for this tool for differentiating AIS cases was a score > 2, at which sensitivity and specificity were 74.73% and 87.65%, respectively.

Conclusion

It seems that, the RACE scale is an accurate diagnostic tool to detect and screen AIS patients in ED, Of course, not at the previously suggested cut-off point (score ≥ 5), but at the score > 2.
Unsupervised anomaly detection of implausible electronic health records: a real-world evaluation in cancer registries
Authors: Röchner Philipp , Rothlauf Franz
Published: May 2023

Background

Cancer registries collect patient-specific information about cancer diseases. The collected information is verified and made available to clinical researchers, physicians, and patients. When processing information, cancer registries verify that the patient-specific records they collect are plausible. This means that the collected information about a particular patient makes medical sense.

Methods

Unsupervised machine learning approaches can detect implausible electronic health records without human guidance. Therefore, this article investigates two unsupervised anomaly detection approaches, a pattern-based approach (FindFPOF) and a compression-based approach (autoencoder), to identify implausible electronic health records in cancer registries. Unlike most existing work that analyzes synthetic anomalies, we compare the performance of both approaches and a baseline (random selection of records) on a real-world dataset. The dataset contains 21,104 electronic health records of patients with breast, colorectal, and prostate tumors. Each record consists of 16 categorical variables describing the disease, the patient, and the diagnostic procedure. The samples identified by FindFPOF, the autoencoder, and a random selection—a total of 785 different records—are evaluated in a real-world scenario by medical domain experts.

Results

Both anomaly detection methods are good at detecting implausible electronic health records. First, domain experts identified $$8\%$$

8
%

of 300 randomly selected records as implausible. With FindFPOF and the autoencoder, $$28\%$$

28
%

of the proposed 300 records in each sample were implausible. This corresponds to a precision of $$28\%$$

28
%

for FindFPOF and the autoencoder. Second, for 300 randomly selected records that were labeled by domain experts, the sensitivity of the autoencoder was $$22\%$$

22
%

and the sensitivity of FindFPOF was $$26\%$$

26
%

. Both anomaly detection methods had a specificity of $$94\%$$

94
%

. Third, FindFPOF and the autoencoder suggested samples with a different distribution of values than the overall dataset. For example, both anomaly detection methods suggested a higher proportion of colorectal records, the tumor localization with the highest percentage of implausible records in a randomly selected sample.

Conclusions

Unsupervised anomaly detection can significantly reduce the manual effort of domain experts to find implausible electronic health records in cancer registries. In our experiments, the manual effort was reduced by a factor of approximately 3.5 compared to evaluating a random sample.
Efficacy and safety of PD-1/PD-L1 inhibitors combined with anti-angiogenic therapy for the unresectable hepatocellular carcinoma and the benefit for hepatitis B virus etiology subgroup: a systematic review and meta-analysis of randomized controlled trials
Authors: Huang Danxue , Ke Liyuan , Cui Hongxia , Li Su
Published: May 2023

Background

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death, worldwide. The predominant causative factor for HCC is hepatitis B virus (HBV) infection. We conducted a meta-analysis to estimate the efficacy and safety of PD-1/PD-L1 inhibitors combined with anti-angiogenic therapy for the first-line treatment of the unresectable HCC and to evaluate the benefits of different geographic regions and etiology stratifications.

Methods

Randomized clinical trials published up to 12th November 2022 were searched by online databases. Moreover, effects of hazard ratio (HR) for overall survival (OS) and progression-free survival (PFS) were extracted from included studies. Pooled odds ratio (OR) and 95% CI for objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (TRAEs) were calculated.

Results

A total of 3057 patients from five phase III randomized clinical trials were collected and reviewed for this meta-analysis. The pooled HR of OS (HR = 0.71; 95% CI: 0.60–0.85) and PFS (HR = 0.64; 95% CI: 0.53–0.77) demonstrated significantly better benefit in PD-1/PD-L1 inhibitors combination group than targeted monotherapy to treat unresectable HCC. In addition, combination therapy showed better ORR and DCR, with ORs of 3.29 (95% CI: 1.92–5.62) and 1.88 (95% CI: 1.35–2.61), respectively. The subgroup analysis indicated that PD-1/PD-L1 inhibitors combination therapy was significantly superior to anti-angiogenic monotherapy for HBV-related HCC in terms of OS (HR = 0.64; 95% CI: 0.55–0.74) and PFS (HR = 0.53; 95% CI:0.47–0.59), while there was no significant difference in patients with HCV (OS, HR = 0.81, p = 0.1) or non-viral (OS, HR = 0.91, p = 0.37; PFS, HR = 0.77, p = 0.05).

Conclusions

Meta-analysis revealed for the first-time that PD-1/PD-L1 inhibitors combination therapy for unresectable HCC was associated with better clinical outcomes than anti-angiogenic monotherapy, especially for HBV infection and Asian population.
A cross-sectional study to assess the clinical utility of modern visual function assessments in patients with inherited retinal disease: a mixed methods observational study protocol
Authors: Taylor Laura J. , Josan Amandeep S. , Stratton Irene , Jolly Jasleen K. , MacLaren Robert E.
Published: May 2023

Background

Treatment options for patients with inherited retinal disease are limited, although research into novel therapies is underway. To ensure the success of future clinical trials, appropriate visual function outcome measures that can assess changes resulting from therapeutic interventions are urgently required. Rod-cone degenerations are the most common type of inherited retinal disease. Visual acuity is a standard measure but is typically preserved until late disease stages, frequently making it an unsuitable visual function marker. Alternative measures are required. This study investigates the clinical utility of a range of carefully selected visual function tests and patient reported outcome measures. The aim is to identify suitable outcome measures for future clinical trials that could be considered for regulatory approval.

Methods

This cross-sectional study involves two participant groups, patients with inherited retinal disease (n = 40) and healthy controls (n = 40). The study has been designed to be flexible and run alongside NHS clinics. The study is split into two parts. Part one includes examining standard visual acuity, low luminance visual acuity, the Moorfields acuity chart visual acuity, mesopic microperimetry and three separate patient reported outcome measures. Part two involves 20 min of dark adaptation followed by two-colour scotopic microperimetry. Repeat testing will be undertaken where possible to enable repeatability analyses. A subset of patients with inherited retinal disease will be invited to participate in a semi-structured interview to gain awareness of participants’ thoughts and feelings around the study and different study tests.

Discussion

The study highlights a need for reliable and sensitive validated visual function measures that can be used in future clinical trials. This work will build on work from other studies and be used to inform an outcome measure framework for rod-cone degenerations. The study is in keeping with the United Kingdom Department of Health and Social Care research initiatives and strategies for increasing research opportunities for NHS patients as part of their NHS care.

Trial registration

ISRCTN registry, ISRCTN24016133, Visual Function in Retinal Degeneration, registered on 18th August 2022.
Diagnosis of neonatal neurofibromatosis type 1: a case report and review of the literature
Authors: Zheng Qiuying , Xia Bei , Zhao Xiaoli , Wang Ruijie , Xie Fusui , Pei Nihui , Tao Hongwei , Ding Tingting , Liu Lei
Published: May 2023

Background

Neurofibromatosis Type 1 (NF1) is a rare genetic disorder characterized with the development of multiple benign tumors on the nerves and skin.

Case presentation

This report described a neonatal case with a large mass observed on the left side of the maxillofacial and cervical region at birth. Meantime, multiple cafe-au-lait macules (CALMs) were seen on the trunk and both lower extremities.

Conclusions

In this case, the clinical features of the rare NF1 neonate are discussed along with its ultrasound findings.
PsicAP transdiagnostic protocol of group cognitive-behavioral training for emotional disorders in Dominican Republic: a randomized controlled trial protocol
Authors: García-Batista Zoilo Emilio , Cantisano-Guzmán Luisa Marilia , Guerra-Peña Kiero , Alvarez Adriana , Moretti Luciana , Cano-Vindel Antonio , Muñoz-Navarro Roger , Medrano Leonardo Adrián , Baltra Ricardo Araya
Published: May 2023

Emotional disorders (ED) such as anxiety, depression and somatization are extremely prevalent disorders that can affect an individual’s quality of life and functionality. Primary Health Care (PHC) is the first place to identify most patients with these conditions. Mental health services in the Dominican Republic, as well as in Latin America and the Caribbean in general, are unable to provide appropriate care for most people with mental disorders. Using evidence-based treatment protocols is also crucial to make progress in helping people with ED. The PsicAP project is a group intervention that uses a transdiagnostic approach and is grounded in cognitive-behavioral techniques. The program is implemented in 7 group sessions, each lasting for one and a half hours. The program has been shown to be effective in reducing clinical symptoms, dysfunction, and in improving quality of life. It is also a non-time-intensive, low-cost treatment that is helpful for addressing EDs in a PHC context. The objective is to bring psychological treatments into PHC facilities of Dominican Republic, making them more accessible for a larger amount of the population.
A unique presentation of echo phenomena in a patient with catatonia: a case report and literature review
Authors: Hamlin Dallas , Mahgoub Yassir
Published: May 2023

Background

Catatonia is a complex syndrome notable for a highly variable presentation. Standardized exam and criteria can enumerate possible presentations, but recognition of novel catatonic phenomenon may facilitate better understanding of catatonia’s core features.

Case presentation

A 61 year-old divorced pensioner with history of schizoaffective disorder was hospitalized for psychosis in the setting of medication noncompliance. While hospitalized, she developed multiple classic catatonia signs such as staring and grimacing, as well as a bizarre echo phenomenon while reading text that improved alongside other catatonic symptoms with treatment.

Conclusion

Echo phenomenon are a component of catatonia often recognized when presenting as echopraxia or echolalia, but other echo phenomenon are well established in the literature. Recognition or novel catatonic symptoms like this can lead to improved recognition and treatment of catatonia.