bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute promyelocytic leukemia: long-term outcomes from the HARMONY project
Authors: Voso Maria Teresa , Guarnera Luca , Lehmann Söhren , Döhner Konstanze , Döhner Hartmut , Platzbecker Uwe , Russell Nigel , Dillon Richard , Thomas Ian , Ossenkoppele Gert , Haferlach Torsten , Vignetti Marco , La Sala Edoardo , Piciocchi Alfonso , Fazi Paola , Ramiro Angela Villaverde , Giménez Laura Tur , Gurnari Carmelo , Bullinger Lars , Hernández-Rivas Jesús María
Published: November 2024

Treatment outcomes for acute promyelocytic leukemia (APL) have improved with the widespread use of targeted therapy with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). Our study aimed to validate these data in a large patient cohort, and to redefine prognostic factors. Leveraging the HARMONY Platform, we analyzed 1438 newly diagnosed patients with APL, diagnosed between 1999 and 2022. Patient data derived from the 2 international multicenter Gruppo Italiano Malattie EMatologiche dell’Adulto (GIMEMA)-APL0406 and National Cancer Research Institute (NCRI)-AML17 trials and 4 European registries: the Haemato Oncology Foundation for Adults in the Netherlands, Belgium and Luxembourg (HOVON), AML Study Group (AMLSG), Swedish AML Registry, and Study Alliance Leukemia (SAL). The study cohort included 721 males and 717 females, with a median age of 50.5 years (range, 16-94 years). Of 1309 patients starting therapy, 562 received ATRA-ATO, and 747 idarubicin-based chemotherapy (AIDA-like CHT). Early death (ED) occurred in 85 of 1438 patients (5.9%) at a median of 9 days after APL diagnosis and was independently associated with increasing age and high Sanz risk score (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.04-1.08; and OR, 4.65; 95% CI, 2.55-8.51, respectively). The median follow-up was 5.5 years (interquartile range, 3.2-7.5 years). ATRA-ATO regimen was associated with the best outcome, reaching 91% 7-year overall survival (vs 81% for AIDA-like CHT; hazard ratio [HR], 2.14; 95% CI, 1.51-3.05), 89% event-free survival (vs 71% for AIDA-like CHT; HR, 2.72; 95% CI, 2.01–3.69), and 3% relapse (vs 13% for AIDA-like CHT; HR, 4.19; 95% CI, 2.38-7.39; P < .001 for all outcomes). The survival advantage of ATRA/ATO was independent of patients’ age, Sanz risk score, and treatment scenario. Our study confirms the superiority of ATRA-ATO over ATRA-chemotherapy in patients with APL. Reducing the risk of ED still represents an unmet medical need, in particular in older patients and in high-risk APL.
Ocular loaiasis in France: the first case report from Brittany
Authors: Kerkouri Sarah , Monfort Thomas , Quinio Dorothée , Cochener-Lamard Béatrice
Published: November 2024

We report the case of a 21-year-old Cameroonian woman residing in France for one year, who presented to our department with left eye discomfort and itching. Examination revealed a mobile translucent cord beneath the nasal-inferior conjunctiva, prompting suspicion of loaiasis. Anesthesia was administered for extraction, revealing a 31 mm male Loa loa. A positive microfilarial load, albeit low, confirmed the diagnosis and the diagnostic workup excluded other locations. Treatment with diethylcarbamazine was well-tolerated. This case highlights the importance of considering loaiasis in non-endemic regions and underscores the need for interdisciplinary collaboration in its diagnosis and management.
Beat-based dancing to music has evolutionary foundations in advanced vocal learning
Authors: Patel Aniruddh D.
Published: November 2024

Dancing to music is ancient and widespread in human cultures. While dance shows great cultural diversity, it often involves nonvocal rhythmic movements synchronized to musical beats in a predictive and tempo-flexible manner. To date, the only nonhuman animals known to spontaneously move to music in this way are parrots. This paper proposes that human-parrot similarities in movement to music and in the neurobiology of advanced vocal learning hold clues to the evolutionary foundations of human dance. The proposal draws on recent research on the neurobiology of parrot vocal learning by Jarvis and colleagues and on a recent cortical model for speech motor control by Hickock and colleagues. These two lines of work are synthesized to suggest that gene regulation changes associated with the evolution of a dorsal laryngeal pitch control pathway in ancestral humans fortuitously strengthened auditory-parietal cortical connections that support beat-based rhythmic processing. More generally, the proposal aims to explain how and why the evolution of strong forebrain auditory-motor integration in the service of learned vocal control led to a capacity and proclivity to synchronize nonvocal movements to the beat. The proposal specifies cortical brain pathways implicated in the origins of human beat-based dancing and leads to testable predictions and suggestions for future research.
Learning ballet technique modulates the stretch reflex in students with cerebral palsy: case series
Authors: López-Ortiz Citlali , He Maxine , Gaebler-Spira Deborah , Levin Mindy F.
Published: November 2024

Background

Cerebral palsy (CP) is considered the most prevalent developmental motor disorder in children. There is a need for training programs that enhance motor abilities and normalize function from an early age. Previous studies report improved motor outcomes in dance interventions for CP. Investigating the neurophysiological mechanisms underlying such improvements is necessary for efficient and safe intervention design. This study reports changes in stretch reflex responses as the primary neurophysiological motor outcome of a targeted ballet class intervention.

Results

A case series of participants with mixed spastic and dyskinetic CP (n = 4, mean age = 12.5 years, SD = 6.9S years, three female, one male) who learned ballet technique in a course of one-hour classes twice per week for six weeks is presented. Changes in stretch reflex responses and in clinical motor tests as secondary outcomes were observed after the course and at one-month follow-up. Quantitative measures of elbow or ankle stretch reflex were obtained using electromyography and electrogoniometry. The joint angle of the stretch reflex onset varied across velocities of stretch, and its variability decreased after the intervention. Within-subject tests of the central tendency of stretch reflex angle coefficients of variation and frequency distribution demonstrated significant changes (p-values < 0.05). Secondary outcomes included the Quality of Upper Extremity Skills Test (QUEST), Pediatric Balance Scale (PBS), Modified Tardieu Scale (MTS), Dyskinesia Impairment Scale (DIS), and Selective Control Assessment of the Lower Extremity (SCALE). All the participants demonstrated improvements larger than the minimal clinical important difference (MCID) or the smallest detectable difference (SDD), as applicable.

Conclusions

Evidence of changes in the stretch reflex responses in these four cases of mixed CP was observed. The observed variability in the stretch reflex responses may be due to the dyskinetic component of the mixed CP presentations. More studies with a larger sample size and longer duration of learning and practice of ballet technique are necessary to establish the extent of possible modulation and adaptation of the stretch reflex response as a neurophysiological basis for observed improvements in clinical measures.

Trial registration: This study was registered in the Clinical Trials Protocol Registration and Results System (NCT04237506, January 17, 2020).
Centre-level fluid management practices in the BISTRO trial and their lack of association with participant fluid status and blood pressure in non-anuric haemodialysis patients
Authors: Johal Neena , Sharma Radha , Belcher John , Coyle David , Lindley Elizabeth J. , Keane David , Caskey Fergus J. , Dasgupta Indranil , Davenport Andrew , Farrington Ken , Mitra Sandip , Ormandy Paula , Wilkie Martin , Macdonald Jamie , Solis-Trapala Ivonne , Sim Julius , Davies Simon J.
Published: November 2024

Introduction

Fluid assessment and management is a key aspect of good dialysis care and is affected by patient-level characteristics and potentially centre-level practices. In this secondary analysis of the BISTRO trial we wished to establish whether centre-level practices with the potential to affect fluid status were stable over the course of the trial and explore if they had any residual associations with participant’s fluid status.

Methods

Two surveys (S) of fluid management practices were conducted in 32 participating centres during the trial, (S1: 2017–18 and S2: 2021–22). Domains interrogated included: dialysate sodium concentration, (D-[Na+]), fluid and salt intake, residual kidney function, use of diuretics, incremental start, approaches to fluid assessment, management and dialysate temperature, (D-oC). Associations of these practices with the closeness of the participant’s post-dialysis target weight to their normally hydrated weight, pre- and post-dialysis systolic (SBP) and diastolic blood pressure, (DBP), were analysed using intra-class correlations and multilevel modelling with adjustment for visit, age, sex and comorbidity burden.

Results

Variations in centre practices were reported but did not change during the trial, apart from some relaxation in salt and fluid restriction in S2. For our measures of fluid status, measured 2501 times in 439 non-anuric incident haemodialysis patients, centre-level intraclass correlations were extremely low, whereas patient-level correlations ranged between 0.12 and 0.47, strongest for pre- and post-dialysis-SBP, less so for post-dialysis-DBP. Multi-level analysis found no associations between D-[Na+], or assessment methods of fluid status. In S2, one centre, routinely using a D-Co of 35°C had more divergence between the target and normally hydrated weight, but this was not observed in S1, and no other associations were found.

Conclusions

Centre-level fluid management practices were stable over the course of the BISTRO trial, and in contrast to patient-level factors, no centre-level associations were detected with fluid status or blood pressure. This may be because the trial imposed a standardised approach to fluid assessment in all trial participants who at least initially had residual kidney function, potentially over-riding the effects of other centre practices. Survey responses revealed substantial scope for developing and evaluating standardised protocols to optimise fluid management.
High anaemia and iron deficiency prevalence among pregnant women living in low groundwater iron areas of Bangladesh
Authors: Hasan Mohammed Imrul , Ahmed Shamim , McLean Alistair R. D. , M Quaiyum Rahman A. , Bhuiyan Mohammad Saiful Alam , Tipu S. M. Mulk Uddin , Braat Sabine , Arifeen Shams El , Hamadani Jena D. , Pasricha Sant-Rayn , Davidson Eliza M.
Published: November 2024

Background

Anaemia is a significant public health concern in Bangladesh, yet data on the prevalence of anaemia in pregnancy and the contribution of iron deficiency are limited. Given the reliance on groundwater for drinking, a better understanding of the role of drinking water iron in anaemia aetiology is also required to inform anaemia prevention strategies.

Methods

This cross-sectional study enrolled 1500 pregnant women from Narayanganj district, Bangladesh, during their second or third trimester. Anaemia and iron status were described and their relationship with drinking water iron assessed using regression analyses.

Results

The prevalence of anaemia was 38% (95% confidence interval, CI: 35%, 40%), with 10% (95% CI: 9%, 12%) experiencing moderate-to-severe anaemia. Iron deficiency affected 48% (95% CI: 45%, 50%) of participants. Although drinking water iron concentrations were generally low (median: 0 mg/L; interquartile range: 0–1), high concentrations (≥ 2 mg/L) were associated with increased ferritin levels but did not significantly impact iron deficiency (95% CI: 0·73, 1·02) or anaemia (95% CI: 0·79, 1·17) prevalence. Iron deficient women had a 1·86 (95% CI: 1·61, 2·15) adjusted prevalence ratio for anaemia and a 4·22 (95% CI: 2·89, 6·17) adjusted prevalence ratio for moderate-to-severe anaemia, compared to iron replete women.

Conclusions

Anaemia and iron deficiency are highly prevalent among pregnant women in Narayanganj. These findings challenge the assumption of low iron deficiency prevalence throughout Bangladesh and highlight iron deficiency in pregnancy as a potentially underrecognized public health problem, particularly in regions with low drinking water iron. Further research is needed to clarify the contribution of drinking water iron to iron deficiency and anaemia in Bangladesh.

Trial registration

The study is registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12621000982819, registered 26/07/2021)
Medical students‘ leadership competence in health care: development of a self-assessment scale
Authors: Ogurek Barbara , Harendza Sigrid
Published: November 2024

Background

Medical leadership plays an increasing role already in early career stages. Undergraduate medical students in the transition to postgraduate education feel not well prepared for their leadership roles. While leadership curricula have been developed, instruments for students’ self-assessment of leadership competences as part of their professional development are still missing. The aim of our study was to develop a self-assessment scale for undergraduate medical students’ leadership competences.

Methods

The medical leadership competence scale (MeLeCoS) for undergraduate medical students was developed in twelve steps. For item generation, we employed the Medical Leadership Competence Framework (MLCF), which is also used as a framework for many leadership curricula and includes five leadership domains for three fields of education: undergraduate education, postgraduate education, and continuing practice. In a pretest, 67 items were tested with n = 88 undergraduate medical students. For content validation we performed group discussions with a total of 17 students. After item reduction a test-version with 45 items and a 5-point Likert scale (1: ‘never’, 2: ‘rarely’, 3: ‘sometimes’, 4: ‘often’, 5: ‘always’) was used in a test-sample of final-year students (n = 129). Descriptive statistics and factor analyses were performed.

Results

The final version of the MeLeCoS includes 37 items and the scale’s Cronbach’s alpha was 0.87. Six factors could be identified and two of them, respectively, represent leadership aspects from the following three areas: (1) the medical students themselves, (2) the interrelation of the medical students with a healthcare organisation regarding general management and improvement, and (3) general leadership aspects of medical students within undergraduate medical studies and the healthcare system. The overall mean of the MeLeCoS was 3.50 ± 0.39. Factor 2 (‘Demonstrating responsible behaviour and shaping relations’) reached the highest mean (4,36 ± 0.37) and factor 5 (‘Promoting improvement and innovation in undergraduate medical education’ the lowest (1.91 ± 0.87).

Conclusions

The medical leadership competence self-assessment scale (MeLeCoS) is a reliable instrument for undergraduate medical students’ self-assessment of leadership competence with good content validity. It could be used for students’ self-reflection on leadership competences in addition to rater-based assessments in leadership curricula and for longitudinal development of students’ professional identity.
“If government is saying the regulations are important, they should be putting in funding to back it up.”- An in-depth analysis of local authority officers’ perspectives of the Food (Promotion and Placement) (England) Regulations 2021
Authors: Dhuria Preeti , Muir Sarah , Jenner Sarah , Roe Emma , Lawrence Wendy , Baird Janis , Vogel Christina
Published: November 2024

Background

As part of the UK government’s obesity strategy, the Food (Promotion and Placement) (England) Regulations 2021 were implemented in October 2022 to restrict the prominent placement of products high in fat, sugar, or salt (HFSS) in most retail settings. Local authority (LA) officers have been tasked with enforcement of these regulations. This qualitative study examined the perspectives of LA officers including, trading standards, environmental health, and public health officers to understand enforcement approaches and requirements to optimise business compliance with the regulations.

Methods

Semi-structured interviews were conducted via MS Teams with a purposive sample of LA officers across England. Data were analysed using inductive thematic analysis.

Results

The 22 participants comprised 13 officers from Trading Standards, six from Environmental Health, and three from Public Health teams. The key messages include the following: (i) the regulations are complex and do not align with existing enforcement approaches, (ii) officers’ professional background will result in variable enforcement practices, and (iii) compliance assessment is an arduous task. LAs are facing resource and workforce constraints and have to prioritise regulations addressing high health risks (e.g., allergens). Therefore, officers will mostly apply a light touch approach to enforcement, raising awareness and engaging with businesses rather than issuing notices. To develop a consistent enforcement approach across LAs, officers asked for (i) further leadership from central government in the form of funding, training, and tools to determine in-scope businesses and products, (ii) cross-departmental collaboration to raise the regulations’ priority at local and regional levels, and (iii) greater consumer demand for healthier retail environments.

Conclusion

It is crucial to address both structural challenges such as resource allocation, workforce, and prioritisation issues as well as the inherent complexity of the regulations to strengthen enforcement efforts. Our findings highlight the necessity of supporting enforcement activities at national and regional government levels to avoid potential false conclusions about ineffectiveness of regulations.
Lost in translation: the lack of agreement between surgeons and scientists regarding biomaterials research and innovation for treating bone defects
Authors: Laubach Markus , Whyte Stephen , Chan Ho Fai , Frankenbach-Désor Tina , Mayer-Wagner Susanne , Hildebrand Frank , Holzapfel Boris M. , Kneser Ulrich , Dulleck Uwe , Hutmacher Dietmar W.
Published: November 2024

Background

With over 2 million grafts performed annually, bone ranks second only to blood in the frequency of transplants. This high demand is primarily driven by the persistent challenges posed by bone defects, particularly following trauma or surgical interventions such as tumour excision. The demand for effective and efficient treatments has increased exponentially in the twenty-first century. Limitations associated with autologous bone grafts drive exploration into replacements, including allografts, synthetic substitutes, and 3D-printed scaffolds. This research aimed to unravel disparities in the knowledge and evaluation of current and future bone defect treatments between surgeons and biomaterial scientists.

Methods

A prospective cross-sectional survey, pre-registered with the OSF (https://osf.io/y837m/?view_only=fab29e24df4f4adf897353ac70aa3361) and conducted online from October 2022 to March 2023, collected data on surgeons’ views (n = 337) and scientists (n = 99) on bone defect treatments.

Results

Scientists were significantly more optimistic than surgeons regarding the future replacement of autologous bone grafts with synthetic or tissue-engineered substitutes (p < 0.001). Accordingly, scientists foresee a paradigm shift from autologous bone grafts to biomaterial and tissue-engineered solutions, reflecting their confidence in the ongoing advancements within this field.

Furthermore, regulatory trepidations for 3D-printed bone scaffolds were acknowledged, with scientists emphasizing the need for a more significant focus on clinical relevance in preclinical studies and regulatory clarity. In a ranked categorical assessment, witnessing the technology in action was deemed most influential in adopting new bone regeneration methods by both scientists and surgeons.

Conclusions

To conclude, this study was conducted through a web-based survey, highlighting a substantial translational gap. It underscores the immediate need (“call to action”) for meaningful interdisciplinary collaboration between surgeons and scientists, often referred to as the need to “walk the talk”. The findings underscore the critical importance of aligning clinical needs, research outcomes, and regulatory frameworks to improve the development and implementation of biomaterial-based bone graft substitutes that demonstrate efficacy and efficiency in bone defect treatment.
Recombinant characterization and pathogenicity of a novel L1C RFLP-1-4-4 variant of porcine reproductive and respiratory syndrome virus in China
Authors: Huang Xinyi , Liu Guoqing , Chang Tong , Yang Yongbo , Wang Tao , Xia Dasong , Qi Xinyu , Zhu Xulong , Wei Ziyi , Tian Xiaoxiao , Wang Haiwei , Tian Zhijun , Cai Xuehui , An Tongqing
Published: November 2024

Porcine reproductive and respiratory syndrome (PRRS) is one of the most significant diseases affecting the pig industry worldwide and is caused by the PRRS virus (PRRSV), which has complex genetic variation due to frequent mutations, indels, and recombination. The emergence of PRRSV L1C.5 in 2020 in the United States has raised worldwide concerns about PRRSV with the RFLP 1-4-4 pattern and lineage 1C. However, studies on the pathogenic characteristics, epidemiological distribution, and effectiveness of vaccines against PRRSV with L1C and RFLP1-4-4 pattern in China are still insufficient. In this study, a novel recombinant variant of PRRSV with RFLP 1-4-4 and lineage 1C features, different from L1C.5 in the United States, was isolated in China in 2021. In pathogenicity experiments in specific pathogen-free piglets or farm piglets, 60–100% of artificially infected experimental piglets died with high fever and respiratory symptoms. Inflammatory cytokine and chemokine levels were upregulated in infected piglets. A commercially modified live vaccine against highly pathogenic PRRSV did not provide effective protection when the vaccinated piglets were challenged with the novel L1C-1-4-4 variant. Therefore, this strain merits special attention when devising control and vaccine strategies. These findings suggest that extensive joint surveillance is urgently needed and that vaccine strategies should be updated to prevent the disease from spreading further.
Comparative analysis of active period and oxidative stress of DDVP and ginger (Zingiber officinale) oil on Indian meal moth (Plodia interpunctella Hübner) infesting maize grain
Authors: Olufemi-salami Folasade Kemisola , Akinneye Joseph Onaolapo , Adeyemi Joseph Adewuyi
Published: November 2024

Background

Indian meal moth (Plodia interpunctella) is a significant pest infesting stored grains, particularly maize. Over time, synthetic insecticides have been employed to control insect. The residual effects posed on non-target organisms have called for replacement of synthetic insecticides with botanicals. This study therefore aimed at comparing the insecticidal consistency and oxidative stress invoked by dichlorvos (DDVP) and the oil extract of ginger (Zingiber officinale) on Indian meal moth infesting maize. Disinfested maize grains were treated with DDVP and ginger oil extract separately. Adults P. interpunctella were introduced to the treated grains daily using complete replacement method. The percentage mortality was calculated daily for 10 d. Furthermore, the oxidative stress caused by DDVP and ginger oil extract on the moth was evaluated by measuring the level of some oxidative stress biomarkers such as glutathione S-transferase, superoxide dismutase, glutathione peroxidase (GPx), and catalase (CAT) activity in the exposed insects.

Results

Preliminary results indicated that both DDVP and ginger oil extract exhibited insecticidal properties against Indian meal moth infesting maize. However, the insecticidal (active) period of ginger oil extract was found to be longer than that of DDVP. Nevertheless, DDVP provoked greater oxidative stress in the exposed moth.

Conclusions

Ginger oil extract and DDVP show potential for controlling Indian meal moth infestations in stored maize. Yet, ginger oil offers a longer-lasting effect on pest suppression and control. Consequently, it could be a replacement or synergistic insecticide with DDVP to provide ecofriendly insecticide application.
Relationship between global warming and autism spectrum disorder from 1990 to 2019
Authors: Zhou Qinfeng , Chen Junjun , Ma Junxiong , Jiao Wangteng , Liang Zhisheng , Du Runming , Pan Yuhang , Liu Lu , Qian Qiujin , Sun Shengzhi , Ji Yuelong , Zhang Zhenyu
Published: November 2024

Background

Despite mounting evidence linking neurological diseases with climate change, the link between autism spectrum disorder (ASD) and global warming has yet to be explored.

Aims

To examine the relationship between the incidence of ASD and global warming from 1990 to 2019 and estimate the trajectory of ASD incidence from 2020 to 2100 globally.

Method

We extracted meteorological data from TerraClimate between 1990 and 2019. To estimate the association between global ASD incidence and temperature variation, we adopted a two-stage analysis strategy using a generalised additive regression model. Additionally, we projected future ASD incidence under four representative shared socioeconomic pathways (SSPs: 126, 245, 370 and 585) by bootstrapping.

Results

Between 1990 and 2019, the global mean incidence of ASD in children under 5 years old was 96.9 per 100 000. The incidence was higher in males (147.5) than in females (46.3). A 1.0 °C increase in the temperature variation was associated with a 3.0% increased risk of ASD incidence. The association was stronger in boys and children living in a low/low-middle sociodemographic index region, as well as in low-latitude areas. According to the SSP585 scenario, by 2100, the children living in regions between 10 and 20° latitude, particularly in Africa, will experience a 68.6% increase in ASD incidence if the association remains. However, the SSP126 scenario is expected to mitigate this increase, with a less than 10% increase in incidence across all latitudes.

Conclusions

Our study highlights the association between climate change and ASD incidence worldwide. Prospective studies are warranted to confirm the association.
School-based eating disorder prevention programmes and their impact on adolescent mental health: systematic review
Authors: Wong Rosa S. , Chan Bianca N. K. , Lai Sok Ian , Tung Keith T. S.
Published: November 2024

Background

Growing evidence indicates an association between disordered eating and a range of mental health problems, including anxiety, depression and emotional dysregulation.

Aims

This study aimed to explore whether reducing risk factors for eating disorders, such as body dissatisfaction and low self-esteem, through school-based programmes can enhance adolescent mental health.

Method

We searched PubMed, PsycINFO, EMBASE and Web of Science from the date of inception to 15 October 2023. Data were synthesised by using a systematic narrative synthesis framework, and formal assessments were conducted to assess the quality of the included studies.

Results

After title/abstract screening and full-text assessment, 13 articles met the pre-specified inclusion criteria, comprising a total of 14 studies (n = 5853). Notably, three studies encompassed multiple programmes, leading to the identification of 17 eating disorder prevention programmes. Among these programmes, seven (41%) employed dissonance-based approaches. Topics covered in the programmes included psychoeducation, body acceptance, sociocultural issues, nutrition and physical activities, self-esteem and stress coping. Ten (59%) of the programmes were effective in improving adolescent mental health. Six of the 14 studies (43%) did not specify follow-up time, and quality assessments found the majority to be of either high (five studies, 36%) or fair (eight studies, 57%) quality.

Conclusions

The findings from the ten effective programmes consistently support the use of body acceptance strategies in improving the mental health of adolescent students. Brief interventions delivered by trained, non-licensed facilitators appear good for the sustainable implementation of in-school psychological services to support well-being among adolescents.
Investigating changes in mental illness stigma and discrimination after the Time to Change programme in England
Authors: Ronaldson Amy , Henderson Claire
Published: November 2024

Background

Between 2008 and 2019, we reported positive change relating to mental health stigma and discrimination among the adult population of England, supporting the effectiveness of the Time to Change campaign.

Aims

Using data from the Attitudes to Mental Illness survey (2008/2009 to 2023), we investigated the extent to which positive changes in stigma were sustained by 2023, 2 years after the programme's end in 2021.

Method

We used regression analyses to evaluate trends in outcomes. Measures were of stigma-related knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes toward the Mentally Ill scale (CAMI)) and desire for social distance (Reported and Intended Behaviour Scale (RIBS)). We also examined willingness to interact with people based on vignettes of depression and schizophrenia, and attitudes toward workplace discrimination, using data from the British Social Attitudes Survey for comparison.

Results

CAMI scores improved between 2008 and 2023 (s.d. 0.24, 95% CI 0.16–0.31), but decreased since 2019 (P = 0.015). After improvements between 2009 and 2019, 2023 MAKS and RIBS scores no longer differed from 2009 scores, indicating decreases in stigma-related knowledge (MAKS scores declined 7.8%; P < 0.001) and willingness to interact (RIBS scores declined by 10.2%; P < 0.001) since 2019. Conversely, comparison with British Social Attitudes Survey data indicated that willingness to interact with people with depression and schizophrenia increased gradually between 2007, 2015 and 2023, and attitudes to workplace discrimination also improved.

Conclusions

The lasting positive changes reflect support for non-discrimination and willingness to interact with someone after a sense of familiarity is evoked. Besides the end of Time to Change, interpretations for declines in other outcomes include the COVID-19 pandemic and economic stress.
Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine
Authors: Lim Grace , Carvalho Brendan , George Ronald B. , Bateman Brian T. , Brummett Chad M. , Ip Vivian H.Y. , Landau Ruth , Osmundson Sarah S. , Raymond Britany , Richebe Philippe , Soens Mieke , Terplan Mishka
Published: November 2024

Pain management in pregnant and postpartum people with an opioid-use disorder (OUD) requires a balance between risks associated with opioid tolerance, including withdrawal or return to opioid use, considerations around social needs of the maternal-infant dyad, and the provision of adequate pain relief for the birth episode that is often characterized as the worst pain a person will experience in their lifetime. This multidisciplinary consensus statement between the Society for Obstetric Anesthesia and Perinatology (SOAP), Society for Maternal-Fetal Medicine (SMFM), and American Society of Regional Anesthesia and Pain Medicine (ASRA) provides a framework for pain management in obstetric patients with OUD. The purpose of this consensus statement is to provide practical and evidence-based recommendations and is targeted to health care providers in obstetrics and anesthesiology. The statement is focused on prenatal optimization of pain management, labor analgesia, and postvaginal delivery pain management, and postcesarean delivery pain management. Topics include a discussion of nonpharmacologic and pharmacologic options for pain management, medication management for OUD (eg, buprenorphine, methadone), considerations regarding urine drug testing, and other social aspects of care for maternal-infant dyads, as well as a review of current practices. The authors provide evidence-based recommendations to optimize pain management while reducing risks and complications associated with OUD in the peripartum period. Ultimately, this multidisciplinary consensus statement provides practical and concise clinical guidance to optimize pain management for people with OUD in the context of pregnancy to improve maternal and perinatal outcomes.
Association Between Two Muscle-Related Parameters and Postoperative Complications in Patients Undergoing Colorectal Tumor Resection Surgery
Authors: Gao Danyang , Miao Huihui , Sheng Weixuan , Liu Lei , Wang Rengui , Shi Hanping , Li Tianzuo
Published: November 2024

BACKGROUND:

This study aimed to investigate the associations of 2 preoperative muscle-related parameters, the third lumbar vertebra skeletal muscle index (L3 SMI) for muscle mass and the Hounsfield unit average calculation (HUAC) for muscle density, with the occurrence of postoperative complications among patients undergoing colorectal tumor resection surgery under general anesthesia. We hypothesized that muscle-related parameters are associated with the occurrence of postoperative complications.

METHODS:

This was a single-center, retrospective observational study. Adult patients who underwent colorectal tumor resection surgery under general anesthesia between 2018.09.01 and 2021.09.01 were enrolled. The last abdominal computed tomography (CT) scan images obtained within 3 months before surgery were used to calculate the L3 SMI and HUAC. The primary outcome was defined as the occurrence of any postoperative complications corresponding to Clavien-Dindo classification before discharge. The secondary outcome was defined as the occurrence of any severe postoperative complications (Clavien-Dindo grade ≥3) before discharge. Multivariable logistic regression analyses were used to estimate the association between muscle-related parameters and incidence of postoperative complications. Patients’ baseline demographics, past medical history and intraoperative parameters were adjusted in the multivariable logistic regression analysis.

RESULTS:

A total of 317 patients with a median age of 66 (58–72) years were included. Sarcopenia (muscle mass reduction) patients in our cohort and myosteatosis (muscle density decline) were present in 254 (80.1 %) and 79 (24.9%) patients, respectively. A total of 135 patients (42.6 %) developed postoperative complications. According to the multivariable logistic regression, myosteatosis (odds ratio [OR], 1.8, 95% confidence interval [CI], 1.0–3.3, P = .039) was significantly associated with postoperative complications.

CONCLUSIONS:

A significant association was observed between myosteatosis and postoperative complications (corresponding to Clavien-Dindo classification before discharge), especially severe postoperative complications (Clavien-Dindo grade ≥3) in patients undergoing colorectal tumor resection. Screening for myosteatosis with HUAC using the CT before surgery may help clinicians identify high-risk perioperative patients early.
Cannabinoids and General Anesthetics: Revisiting Molecular Mechanisms of Their Pharmacological Interactions
Authors: Echeverria-Villalobos Marco , Fabian Catherine A. , Mitchell Justin G. , Mazzota Elvio , Fiorda Diaz Juan C. , Noon Kristen , Weaver Tristan E.
Published: November 2024

Cannabis has been used for recreation and medical purposes for more than a millennium across the world; however, its use’s consequences remain poorly understood. Although a growing number of surgical patients are regular cannabis consumers, little is known regarding the pharmacological interactions between cannabis and general anesthetics; consequently, there is not a solid consensus among anesthesiologists on the perioperative management of these patients. The existing evidence about the molecular mechanisms underlying pharmacological interactions between cannabinoids and anesthetic agents, both in animal models and in humans, shows divergent results. While some animal studies have demonstrated that phytocannabinoids (tetrahydrocannabinol [THC], cannabidiol [CBD], and cannabinol [CBN]) potentiate the anesthetic effects of inhalation and intravenous anesthetics, while others have found effects comparable with what has been described in humans so far. Clinical studies and case reports have consistently shown increased requirements of GABAergic anesthetic drugs (isoflurane, sevoflurane, propofol, midazolam) to achieve adequate levels of clinical anesthesia. Several potential molecular mechanisms have been proposed to explain the effects of these interactions. However, it is interesting to mention that in humans, it has been observed that the ingestion of THC enhances the hypnotic effect of ketamine. Animal studies have reported that cannabinoids enhance the analgesic effect of opioids due to a synergistic interaction of the endogenous cannabinoid system (ECS) with the endogenous opioid system (EOS) at the spinal cord level and in the central nervous system. However, human data reveals that cannabis users show higher scores of postoperative pain intensity as well as increased requirements of opioid medication for analgesia. This review aims to improve understanding of the molecular mechanisms and pharmacological interactions between cannabis and anesthetic drugs and the clinical outcomes that occur when these substances are used together.
Hostile and Hospitable Programmatic Architectures
Authors: Von Bergen Megan K.
Published: November 2024

Much of the conversation about ungrading has thus far focused on its impacts in the classroom, improving student learning and addressing ongoing inequities. Yet addressing the administrative structures necessary to sustain ungrading is equally important, especially considering the labor conditions of contingent, minoritized, or otherwise vulnerable faculty. This article proposes hostile/hospitable programmatic architectures as a framework for understanding how institutional ecologies may be configured in ways that undermine or support the use of equitable assessment practices. Where hostile programmatic architecture neglects the risk vulnerable faculty take on in using a new assessment practice, a hospitable programmatic architecture, deliberately attentive to faculty labor conditions and institutional locatedness, relies on supportive, cross-hierarchical relationships and ample material and affective resources to open institutional spaces for the effective use of ungrading. The article closes with a brief heuristic for writing program administrators and other departmental/university leaders interested in assessing the hospitality of their own program.
Vestibular Schwannoma Koos Grade II International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K2 Study
Authors: Bin-Alamer Othman , Abou-Al-Shaar Hussam , Peker Selcuk , Samanci Yavuz , Pelcher Isabelle , Begley Sabrina , Goenka Anuj , Schulder Michael , Tourigny Jean-Nicolas , Mathieu David , Hamel Andréanne , Briggs Robert G. , Yu Cheng , Zada Gabriel , Giannotta Steven L. , Speckter Herwin , Palque Sarai , Tripathi Manjul , Kumar Saurabh , Kaur Rupinder , Kumar Narendra , Rogowski Brandon , Shepard Matthew J. , Johnson Bryan A. , Trifiletti Daniel M. , Warnick Ronald E. , Dayawansa Samantha , Mashiach Elad , Vasconcellos Fernando De Nigris , Bernstein Kenneth , Schnurman Zane , Alzate Juan , Kondziolka Douglas , Sheehan Jason P.
Published: November 2024

BACKGROUND AND OBJECTIVES:

This study assessed the efficacy and safety of stereotactic radiosurgery (SRS) in comparison with watchful waiting for managing Koos grade II vestibular schwannomas (VS).

METHODS:

A retrospective, multicentric analysis was conducted, focusing on patients with Koos grade II VS who either received SRS (SRS group) or were observed (observation group). To ensure comparability between groups, propensity score matching was used, including factors such as demographic characteristics, tumor dimensions, and hearing assessments. The primary end points examined were tumor control, maintenance of serviceable hearing, and neurological outcomes.

RESULTS:

A total of 92 patients were equally matched across both cohorts, with a median follow-up of 37 months for the SRS group and 27.5 months for those observed. The SRS cohort exhibited superior tumor control over observation across 3, 5, and 8 years, achieving a 100% control rate vs 47.9%, 40.1%, and 34.3% for the observation group at these time intervals, respectively (P < .001). Serviceable hearing preservation rates were comparable between the 2 groups throughout 3, 5, and 7 years (72.9% for SRS vs 65.4% for observation at 3 years; P = .86). Moreover, SRS management correlated with a lower incidence of vestibular symptoms (odds ratio = 0.11, P = .002), with no significant disparity in the deterioration of cranial nerve (CN) V or CN VII functions. Notably, the likelihood of experiencing any CN impairment was significantly diminished in the SRS cohort (odds ratio = 0.47, P = .04).

CONCLUSION:

For patients with Koos grade II VS, SRS offers superior tumor control rate and a lower risk of CN dysfunction without sacrificing hearing preservation.
Alexander Hamilton’s Report on Manufactures and Industrial Policy
Authors: Sylla Richard
Published: November 2024

Hamilton’s 1791 state paper on manufactures is a forward-looking argument for US industrialization supported by public policies designed to encourage it. Conventional wisdom circa 1790, along with static considerations of comparative advantage indicated that the United States should stick to farming, export its agricultural surpluses, and import European manufactures. Mercantilist trade policies of the major European empires, however, were barriers to US exports. Hamilton therefore contended that US manufacturing using the latest machine technologies would alleviate the effects of European trade restrictions by creating domestic demand for agricultural surpluses. His report specifies industries worthy of support, and policy measures to encourage their development. During the century that followed, US governments adopted nearly all of Hamilton’s recommendations. These measures contributed to an average annual rate of growth of industrial output of 5 percent during that century, helping the United States to become the world’s leading manufacturing nation.
Semiconductors and Modern Industrial Policy
Authors: Bown Chad P. , Wang Dan
Published: November 2024

Semiconductors have emerged as a headline in the resurgence of modern industrial policy. This paper explores the political economic history of the sector, the changing nature of the semiconductor supply chain, and the new sources of concern that have motivated the most recent turn to government intervention. It also explores details of that turn to industrial policy by the United States, China, Japan, Europe, South Korea, and Taiwan. Modern industrial policy for semiconductors has included not only subsidies for manufacturing, but also new import tariffs, export controls, foreign investment screening, and antitrust actions.
Ο αποκλεισμός εταίρου Ο.Ε. και Ε.Ε.
Authors: Λαμπριανίδου Αγγελική
Published: November 2024

Σκοπό της διατριβής αποτελεί η ενδελεχής εξέταση του δικαιώματος αποκλεισμού εταίρου στην ομόρρυθμη και ετερόρρυθμη εταιρία, το οποίο ρυθμίζεται στη διάταξη του άρθρου 263 του νέου δικαίου των προσωπικών εταιριών (Ν. 4072/2012). Η διατριβή αποτελείται από εισαγωγή και τέσσερα κεφάλαια· η, δε, ύλη της κατανέμεται σε δεκαέξι παραγράφους. Αναλυτικότερα : Η διατριβή εκκινεί με γενικές παρατηρήσεις για το νέο δίκαιο των προσωπικών εταιριών (§ 1). Ακολουθεί μια πρώτη γνωριμία με τη διάταξη για τον αποκλεισμό εταίρου (§ 2). Η εισαγωγή ολοκληρώνεται με την επισκόπηση της ρύθμισης του δικαιώματος αποκλεισμού σε άλλες μορφές εμπορικών εταιριών (§ 3). Στο πρώτο κεφάλαιο αναλύεται αρχικά ο νομοθετικός σκοπός της θέσπισης του δικαιώματος αποκλεισμού (§ 4). Στη συνέχεια, αναλύεται η νομική φύση και ο χαρακτήρας του δικαιώματος αποκλεισμού (§ 5). Στο δεύτερο κεφάλαιο εξετάζονται διεξοδικά οι προϋποθέσεις που πρέπει να συντρέχουν για την άσκηση του δικαιώματος αποκλεισμού, ήτοι : η ύπαρξη εταιρίας, από την οποία θα ζητείται να αποκλειστεί ο εταίρος (§ 6), και η συνδρομή στο πρόσωπο του εταίρου σπουδαίου λόγου αποκλεισμού (§ 7). Το δεύτερο κεφάλαιο ολοκληρώνεται με αναφορά στις δυνατές καταστατικές διαμορφώσεις των προϋποθέσεων άσκησης του δικαιώματος αποκλεισμού (§ 8). Στο τρίτο κεφάλαιο εξετάζεται η προβλεπόμενη από τον νόμο διαδικασία αποκλεισμού εταίρου Ο.Ε. ή Ε.Ε. Ειδικότερα, μελετώνται: η αίτηση αποκλεισμού (§ 9), η διαδικασία εκδίκασης της αίτησης αποκλεισμού (§ 10), οι διάδικοι της δίκης (§ 11), η νομική θέση του υπό αποκλεισμό εταίρου κατά τη διάρκεια της δίκης (§ 12), η δικαστική απόφαση που απαγγέλλει τον αποκλεισμό (§ 13). Το τρίτο κεφάλαιο ολοκληρώνεται με την παράγραφο δεκατέσσερα (§ 14), η οποία αναφέρεται στην καταστατική διαμόρφωση της διαδικασίας αποκλεισμού. Στο τέταρτο και τελευταίο κεφάλαιο εξετάζονται οι συνέπειες του αποκλεισμού στις εσωτερικές και εξωτερικές σχέσεις της εταιρίας (§§ 15, 16).
Το ηθικό αδιέξοδο και η σχέση του με τα επίπεδα υγείας και ενσυναίσθησης σε νοσηλευτικό προσωπικό
Authors: Γαμβρούλη Μαρία
Published: November 2024

ΕΙΣΑΓΩΓΗ: Η αξιολόγηση του ηθικού αδιεξόδου (MD), των επιπέδων γενικής υγείας (GH), του δευτερογενούς τραυματικού στρες (STS) και της ενσυναίσθησης σε καταστάσεις έκτακτης δημόσιας υγείας, όπως η πανδημία COVID-19, είναι κρίσιμη. Τέτοιες κρίσεις εντείνουν τη σωματική, ψυχολογική και ηθική δυσφορία του νοσηλευτικού προσωπικού, επηρεάζοντας την ενσυναίσθηση, την αυτοαποτελεσματικότητα και την επαγγελματική τους στάση. Η διερεύνηση των σχέσεων μεταξύ του ηθικού αδιεξόδου, των επιπέδων γενικής υγείας, του δευτερογενούς τραυματικού στρες και της ενσυναίσθησης στο νοσηλευτικό προσωπικό είναι σημαντική. ΣΚΟΠΟΣ: Η παρούσα διατριβή επιδιώκει να αξιολογήσει το ηθικό αδιέξοδο και τη συσχέτισή του με τα επίπεδα γενικής υγείας, δευτερογενούς τραυματικού στρες και ενσυναίσθησης σε νοσηλευτές οκτώ δημόσιων νοσοκομείων στην Αττική. ΜΕΘΟΔΟΣ: Πραγματοποιήθηκε συγχρονική μελέτη από Ιανουάριο έως Μάρτιο 2020 σε οκτώ νοσοκομεία του Λεκανοπεδίου Αττικής. Το δείγμα αποτελούνταν από νοσηλευτές σε παθολογικά, χειρουργικά και ψυχιατρικά τμήματα έξι γενικών και δύο ψυχιατρικών νοσοκομείων. Οι ερωτηθέντες συμπλήρωσαν τις ελληνικές εκδόσεις των κλιμάκων MDS-R, JSE-HP, GHQ-28 και STSS, καθώς και ένα έντυπο με δημογραφικά, εκπαιδευτικά και επαγγελματικά χαρακτηριστικά. Λόγω της πίεσης της πανδημίας COVID-19, συλλέχθηκαν πρόσθετα ερωτηματολόγια από νοσηλευτές που διαχειρίζονταν αρρώστους με COVID-19 και συγκρίθηκαν με τα δείγματα πριν από την πανδημία. ΑΠΟΤΕΛΕΣΜΑΤΑ: Από τα 350 ερωτηματολόγια, επιστράφηκαν 267 (76,3%). Από τα ερωτηματολόγια της πανδημίας, επιστράφηκαν 95 από τα 100 (95%). Το νοσηλευτικό προσωπικό παρουσίασε μέτρια συχνότητα και ένταση ηθικού αδιεξόδου, μέτρια προς υψηλά επίπεδα γενικής υγείας, μέτρια επίπεδα δευτερογενούς τραυματικού στρες και μέτρια προς υψηλά επίπεδα ενσυναίσθησης. Οι νοσηλευτές ψυχικής υγείας είχαν χαμηλότερα επίπεδα δευτερογενούς τραυματικού στρες και καλύτερα επίπεδα γενικής υγείας σε σχέση με τους γενικούς νοσηλευτές. Οι νοσηλευτές πριν την πανδημία είχαν χαμηλότερα επίπεδα δευτερογενούς τραυματικού στρες και καλύτερα επίπεδα γενικής υγείας από αυτούς κατά τη διάρκεια της πανδημίας, οι οποίοι είχαν υψηλότερα επίπεδα ενσυναίσθησης. Η πολυμεταβλητή ανάλυση έδειξε ότι το αυξημένο δευτερογενές τραυματικό στρες επιδεινώνει τα επίπεδα γενικής υγείας και η συχνότητα του ηθικού αδιεξόδου αυξάνει την έντασή του. ΣΥΜΠΕΡΑΣΜΑΤΑ: Οι νοσηλευτές παρουσίασαν μέτρια συχνότητα και ένταση ηθικού αδιεξόδου, μέτρια προς υψηλά επίπεδα γενικής υγείας, μέτρια επίπεδα δευτερογενούς τραυματικού στρες και μέτρια προς υψηλά επίπεδα ενσυναίσθησης. Οι διοικητές των νοσοκομείων στην Ελλάδα πρέπει να αναπτύξουν προγράμματα για την ενίσχυση των δεξιοτήτων, τη βελτίωση της επικοινωνίας και τη διαχείριση του άγχους, δίνοντας έμφαση στην αυτοφροντίδα.