bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of the Monocyte in the Generation and Dissolution of Arterial and Venous Thrombi
Authors: Burnand K. G. , Gaffney P. J. , McGuinness C. L. , Humphries J. , Quarmby J. W. , Smith A.
Published: September 2024

Monocyte infiltration into forming thrombus has been demonstrated in experimental models of venous thrombosis developed in our laboratories. These cells produce and release plasminogen activators as the thrombus organises and resolves. Monocytes are also capable of assembling and releasing procoagulant factors and the evidence for their importance in thrombogenesis is reviewed. The ability of monocytes to maintain this fibrinolytic balance suggests that they may have a role in both thrombosis and thrombus resolution. Control of the mechanisms which regulate these activities may therefore be important in preventing thrombus formation or stimulating its resolution.
Effect of α-Tocopherol, Taurine and Selenium on the Attenuation of Ischemia/Reperfusion Injury of Splanchnic Organs
Authors: Yoshida W. B. , Alasio T. , Mazziotta R. , Qin F. , Kashani M. , Lee S. , Dardik H.
Published: September 2024

Background:

Splanchnic artery occlusion shock is caused by increased capillary permeability and cellular injury precipitated by oxygen derived free radicals following ischemia and reperfusion of splanchnic organs. The purpose of this study was to assess the role of several well-known oxygen-derived free radical scavengers in ameliorating or preventing this syndrome.

Study design:

Anesthetized rats were subjected to periods of occlusion of the visceral arteries and reperfusion. Tocopherol, taurine, selenium or a ‘cocktail’ of these three agents was injected subcutaneously for 4 consecutive days prior to operation. Mean arterial blood pressure was measured throughout the experimental period. Fluorometry and technetium-99m pyrophosphate counting of the visceral organs were performed as well as a histologic grading system for intestinal viability.

Results:

Final mean arterial blood pressure associated with the ‘cocktail’ and selenium groups was 79.1 ± 27.4 mmHg and 83.6 ± 17.8 mmHg, respectively. These values were significantly higher than the control group, 40.8 ± 11.4 mmHg ( P < 0.05). Similar patterns of the benefit of selenium in contrast with the other groups were obtained with fluorescein perfusion, radioisotopic activity and histologic analysis.

Conclusion:

Pretreatment with selenium of splanchnic ischemia and reperfusion in the rat improves mean arterial blood pressure and microcirculatory visceral perfusion. Further analysis of the precise protective mechanism of selenium for reperfusion injury will enable visceral organs to withstand the consequences of increased capillary leakage and oxidant injury.
Endovascular Grafting for Abdominal Aortic Aneurysms: Changing Incidence and Indications for Conversion to Open Operation
Authors: May J. , White G. H. , Yu W. , Waugh R. , Stephen M. S. , Chaufour X. , Harris J. P.
Published: September 2024

The incidence and indications for conversion from endoluminal to open repair of abdominal aortic aneurysms are changing. This paper is based on a 5-year experience in which endoluminal repair of abdominal aortic aneurysms was undertaken in 156 patients. Primary conversion at the original operation was required in 14 patients and secondary conversion at a subsequent operation was required in 9 patients. The reasons for primary conversion were access problems ( n = 2), balloon related problems ( n = 2), endograft migration ( n = 4), endograft thrombosis ( n = 1) and failed deployment of a bifurcated endograft ( n = 5). Twelve of 14 primary conversions occurred in the first half of the study period, in which 59 endoluminal abdominal aortic aneurysms repairs were undertaken. Improvements in technology and interventional techniques for overcoming obstacles, as well as increasing experience, has resulted in primary conversion being limited to two patients in the most recent 2.5-year period in which 97 endoluminal repairs were undertaken. The reasons for secondary conversion were renal arteries covered by the endograft ( n = 2), increasing abdominal aortic aneurysm diameter in the absence of endoleak ( n = 1) and persistent endoleak ( n = 6). The latter group comprised three patients with intact aneurysms and three with known endoleaks who presented with ruptured aneurysms. The current indications for primary conversion include: (i) rupture of the aorta; (ii) complete migration of the endograft resulting in obstruction of the iliac arteries; and (iii) irreversible twisting of a non-modular bifurcated endograft. The current indications for secondary conversion include: (i) persistent endoleak; (ii) sealed endoleak with continued abdominal aortic aneurysms expansion; (iii) apparently successful endoluminal repair without evidence of endoleak but continued abdominal aortic aneurysms expansion; and (iv) infected endograft.
Bilateral Internal Carotid Artery Occlusion: Natural History and Surgical Alternatives
Authors: AbuRahma A. F. , Copeland S. E.
Published: September 2024

Purpose and background:

Bilateral internal carotid artery occlusion is an extremely rare entity, therefore, studies of the natural history of this disease are lacking in the English literature. The purpose of this study is to analyze the natural history and surgical alternatives for patients with bilateral internal carotid artery occlusion.

Patient population and methods:

Twenty-one patients with bilateral internal carotid artery occlusion were encountered with a mean age of 61 years (range of 48–73 years). Their clinical presentations included eight with hemispheric transient ischemic attacks, three with amaurosis fugax, five with strokes and five with non-hemispheric transient ischemic attack. Diagnosis was confirmed using carotid duplex ultrasound and angiography. The majority of patients had more than one risk factor for atherosclerosis: smoking in 100%. hyperlipidemia in 14/21 (67%), hypertension in 17/21 (81%), coronary artery disease in 15/21 (71%) and diabetes mellitus in 7/21 (33%). In addition to the usual medical treatment, 13 patients underwent surgical intervention: eight had an external carotid endarterectomy, four had a carotid—subclavian bypass (to increase external carotid or vertebral flow for tight stenosis or occlusion of the common carotid or subclavian artery) and one patient had an ascending aorta to innominate artery bypass. At a mean follow-up of 6 years (range 1–11 years), the overall mortality rates were 11/21 (52%). in the surgical group it was 5/13 (38%) and 6/8 (75%) in the medical group. The causes of death included seven myocardial infarctions (four in the surgical group and three in the medical group) and four strokes (one in the surgical group and three in the medical group). In the surgical group, 2/13 (15%) had late neurological deficits (one hemispheric transient ischemic attack and one stroke), in contrast to 6/8 (75%. three strokes and three hemispheric transient ischemic attacks) in the medical group.

Conclusions:

Bilateral internal carotid artery occlusions have grave prognoses and should be considered a marker for severe systemic disease. Various cerebrovascular reconstructive procedures, if feasible, may be beneficial for some of these patients.
Symptomatic Venous Hypertension Because of Occult Iliofemoral Deep Vein Thrombosis: A Report of Two Cases
Authors: Bautista E. , Martinez J. , Gagne P.
Published: September 2024

Two 25-year-old males with symptomatic venous hypertension (venous claudication, n = 1; swollen leg, n = 1) were evaluated for iliofemoral venous occlusive disease. One patient had a common femoral vein/external iliac vein occlusion with no history of deep vein thrombosis or trauma. The second patient had an acute deep vein thrombosis superimposed on a chronic external iliac vein stenosis. No source of extrinsic venous compression was identified in either patient. Venous reconstruction with vein bypass (patient no. 1) and vein patch angioplasty (patient no. 2) led to resolution of their hypertensive symptoms. Intraoperative examination of the involved vein segments revealed chronic changes consistent with a prior occult deep vein thrombosis in both patients. Occult iliofemoral deep vein thrombosis in young healthy males is rarely seen. The acute deep vein thrombosis may manifest minimal or no symptoms but it can lead to chronic venous occlusive disease and serious post-phlebitic morbidity. In this context, these two cases are discussed with a review of the pertinent literature.
Dilemmas of Proximity: Motives Influencing Portuguese Firms’ Internationalization to Morocco
Authors: Silva Joaquim Ramos , Neves Joana , Magrinho André , Franco Mário , Rodrigues Margarida
Published: September 2024

This study aims to identify Portuguese firms’ motives for internationalizing to Morocco. To achieve this objective, we used a mixed-method (quantitative and qualitative) approach, obtaining data from a questionnaire survey and interviewees from Portuguese enterprises involved in this internationalization process. From exploratory factor analysis (EFA), firms’ reasons for entering the Moroccan market were categorized into five dimensions: (a) Price and Business Infrastructure, (b) Regional Hub and Business Environment, (c) Financial Incentives and Raw Material, (d) Skilled Labour Force and (e) Weak Competition and International Business Partners. The study shows that the factors/dimensions identified are associated both with firms’ resources and capacities and with the characteristics that sometimes define the entrepreneur–manager’s perceptions. In addition, our study provides inside knowledge of this topic through small and medium-sized enterprise (SME) managers’ views on key aspects of their presence in Morocco, which leads to a more robust portrayal of this type of process.
Effects of Slow Breathing Exercises on Cardiac Autonomic Functions in Anxiety Disorder—A Randomised Control Trial
Authors: Kavitha Natarajan , Pal Pravati , Pal Gopal Krushna , Bharadwaj Balaji , Nanda Nivedita
Published: September 2024

Background

Anxiety disorders are commonly associated with a higher risk of fatal cardiovascular diseases (CVD). Anxiety disorders lead to dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, thus weakening the key neuronal components of the autonomic nervous system (ANS) that are involved in cardiovascular functions, leading to increased cardiovascular risk.

Purpose

Impaired ANS activity, as reduced parasympathetic tone is strongly associated with an increased risk of CVD in anxiety disorders. Slow pranayama influences the ANS by activating the parasympathetic tone and deactivating the sympathetic tone in healthy volunteers and various diseased conditions. Therefore, we aimed to study the effects of slow pranayama and savasana on cardiac autonomic function tests in anxiety disorder patients.

Methods

Anxiety disorder patients (N = 140) of either sex between the age group 18 and 40 years attending the psychiatry outpatient department (OPD) in JIPMER were recruited for the study and were randomly assigned into the pranayama group and control group. The Pranayama group practised slow pranayama and savasana for 8 weeks along with routine psychiatric care, while the control group continued with routine psychiatric care only. Outcome measures were heart rate variability (HRV), baroreflex sensitivity (BRS), 30:15 ratio during lying to standing, E: I ratio during deep breathing, and ∇DBP during isometric handgrip, which were assessed before and after the intervention period.

Results

After 8 weeks in the Pranayama group, the HRV parameters showed significant improvement towards the parasympathetic domain. Also, there was a significant increase in parasympathetic reactivity with a decrease in sympathetic reactivity and significant improvement in BRS.

Conclusion

Slow pranayama and savasana practice in anxiety disorder patients as an adjunct to routine psychiatric care effectively improves cardiac autonomic function with a shift towards parasympathetic predominance, with significant improvements in cardiovascular parameters. Slow pranayamas with savasana may be incorporated into the routine care of these patients to enhance their cardiovascular health.
Development of high-protein biscuits by the enrichment with mopane worm (Gonimbrasia belina) flour
Authors: Mashau Mpho Edward , Ramalisa Thompho , Ramashia Shonisani Eugenia , Mshayisa Vusi Vincent
Published: September 2024

Mopane worm (Imbrasia belina) has high protein content, unsaturated fatty acids and minerals. This study was carried out to determine the influence of incorporating mopane worm flour on the nutritional quality and technological and sensory properties of wheat flour biscuits. Wheat flour was partially replaced with 5%, 10%, 15%, 20%, 25% and 30% of mopane worm flour. The protein, fat and ash content of mopane worm flour was higher than wheat flour. Biscuits enriched with mopane protein flour had significantly higher protein, fat and ash content than the control biscuits. There was no significant difference ( p > 0.05) between the moisture of control and biscuits added with 5% to 20% mopane worm flour. Nevertheless, the moisture of biscuits added with 20% to 30% mopane worm flour significantly increased, ranging from 3.92% to 3.99%. The incorporation of mopane worm flour increased the amounts of leucine, phenylalanine and lysine in biscuits. Results obtained for colour analysis showed that there was a decrease in L* (56.41–41.10), a*(13.00–8.47) and b* (31.35–24.17) values of biscuits with the addition of mopane worm flour. Nevertheless, the diameter, thickness and weight of enriched biscuits decreased. Spread ratio (2.70–5.87) and hardness (26.83–37.17 g) of enriched biscuits increased. Sensory scores showed that the panellists accepted biscuits enriched with 5% to 15% mopane worm flour. The results of this study show that mopane worm flour improved the nutritional quality of biscuits, and its usage in bakery products should be encouraged.
Identification and Functional Annotation of Hypothetical Proteins of Pan-Drug-Resistant Providencia rettgeri Strain MRSN845308 Toward Designing Antimicrobial Drug Targets
Authors: Pal Dipta Chandra , Anik Tasnimul Arabi , Rahman Atiq Abrar , Mahfujur Rahman S M
Published: September 2024

Providencia rettgeri has increasingly been responsible for several infections, including urinary tract, post-burn wounds, neonatal sepsis, and others. The emergence of drug-resistant isolates of P rettgeri, accompanied by intrinsic and acquired antibiotic resistance, has exacerbated the challenge of treating such infections, necessitating the development of novel therapeutics. Hypothetical proteins (HPs) form a major portion of cellular proteins and can be targeted by these novel therapeutics. In this study, 410 HPs from a pan-drug-resistant (PDR) P rettgeri strain (MRSN845308) were functionally annotated and characterized by physicochemical properties, localization, virulence, essentiality, druggability, and functionality. Among 410 HPs, the VirulentPred 2.0 tool and VICMpred combinedly predicted 33 HPs as virulent, whereas 48 HPs were highly interacting proteins based on the STRING v12 database. BlastKOALA and eggNOG-mapper v2.1.12 predicted 13 HPs involved in several metabolic pathways like Riboflavin metabolism and Lipopolysaccharide biosynthesis. Overall, 83 HPs were selected as primary drug targets; however, only 80 remained after nonhomology searching and essentiality analysis. In addition, all were detected as novel drug targets according to DrugBank 5.1.12. Considering the potential of membrane and extracellular proteins, 29 HPs (extracellular, outer, and inner membrane) were selected based on the combined prediction from PSORTb v3.0.3, CELLO v.2.5, BUSCA, SOSUIGramN, and PSLpred. According to the prevalence of those HPs in different strains of P rettgeri sequences in National Center for Biotechnology Information Identical Protein Groups (NCBI-IPG), 5 HPs were selected as final drug targets. In addition, 5 other HPs annotated as transporter proteins were also added to the list. As no crystal structures of our targets are present, 3-dimensional structures of selected HPs were predicted by the AlphaFold Server powered by AlphaFold 3. Our findings might facilitate a better understanding of the mechanism of virulence and pathogenesis, and up-to-date annotations can make uncharacterized HPs easy to identify as targets for novel therapeutics.
Preliminary Survey Data From an App-Delivered Hypnosis Intervention for Smoking Cessation
Authors: Alldredge Cameron T. , Muñiz Vanessa , Ekanayake Vindhya , Elkins Gary R.
Published: September 2024

Introduction: Hypnosis-based apps geared toward smoking cessation are among the most downloaded by individuals wanting to reduce or stop smoking. However, to date, there are few evaluations regarding the use or efficacy of hypnosis apps for smoking cessation. Finito is an empirically-based mHealth app developed by Mindset Health designed to provide users with a three-week hypnotherapy program to quit smoking. This study aimed to examine demographic and clinical characteristics of Finito app users and conduct a preliminary analysis of survey data from participants of the program. Method: Finito app users were asked to voluntarily complete an online survey regarding their experience with the program, current smoking habits, app usability, relevant improvement, and demographic information. Retrospective data analyses were conducted to provide descriptive and inferential findings from the responses. Results: A total of 120 individuals responded to the survey. Respondents originated from over five different countries and approximately 72.5% reported completing the full Finito program. Approximately 58.3% of participants reported that they accomplished their goal with Finito with 50.8% of all respondents reporting that they quit smoking and an additional 25.8% reporting that their smoking was reduced. Among a variety of secondary outcomes, saving money was the most frequently reported secondary benefit with 46.7% of respondents endorsing that item. Conclusion: Our preliminary survey results suggest that Finito may be a useful, pleasant, and cost-effective tool in a patient’s journey to quit smoking. The majority of app users reported that they achieved their goal with Finito and completion of the program was associated with goal achievement. The Finito app may be effective in the dissemination and delivery of a helpful hypnotherapy intervention across a diverse population.
Ethical leaders’ search for meaning: Ancient Confucian wisdom in Modern East Asia
Authors: Chou Sophia Chia-Min
Published: September 2024

In secular Western societies, individuals often embark on an autonomous quest for meaning in life, which, however, can lead to frustration. In contrast, many East Asian ethical leaders draw on age-old teachings to find fulfillment—an underexplored topic that merits further investigation. By analyzing ancient Confucian tenets and the discourses of modern Confucian leaders, this paper unveils three key aspects of the Confucian meaning of life: The Heavenly Way (the comprehension that good begets good), the Heavenly Mandate (the purpose of doing good), and the Heavenly Nature (the significance of one’s inherent goodness). From a psychological perspective, this “Confucian meaning framework” has persisted for millennia because its elements not only exhibit internal consistency and structural robustness but also fulfill humanity’s psychological needs for meaningfulness, transcendence, justice, self-improvement, competence, altruism, relatedness, morality, moral autonomy, and self-esteem. Therefore, ancient Confucian wisdom effectively counters the contemporary existential vacuum in modern East Asia. This paper highlights the crucial role of cultural heritage in our existential quests, opening new avenues for blending philosophical insights with psychological research. It also illustrates the power of psychological theories to explain the lasting influence of certain ancient cultures on modern life, demonstrating the intriguing interplay between culture and psychology.
The effect of perceived risks and overall risk perception on international tourists’ behavioural intention: Insights from Bali
Authors: Setiawan Gunaro , Dewantara Made Handijaya , Nimri Rawan , Arli Denni
Published: September 2024

This research aims to investigate the effect of international tourists’ perceived risk factors on ( n = 257) overall risk perceptions and consequently on their behavioural intention (i.e. intention to revisit, to recommend destination and repeat same activities) from the lens of prospect theory. An online survey was circulated to the onsite international tourists who were visiting Bali. We found that human-induced and financial risk have significant effect on overall risk perception, while overall risk perception mediates the relationship between human-induced risk and behavioural intention. Financial risk has significant negative effect on behavioural intention, however, human-induced risk interestingly has significant positive effect on behavioural intention. While international tourists were concerned about the environmental issues in Bali, it does not affect their intention to revisit Bali. This study extends prospect theory in tourism literature and attempt to provide insights for destination marketers to mitigate and manage growing risk perceptions associated with international tourists’ behavioural intention.
‘The problem is the system’: Luis Rubiales, Jenni Hermoso and the sound of sealed lips
Authors: Zecchi Barbara
Published: September 2024

In this contribution, I explore the affordances of videographic criticism for feminist activism by dissecting a specific incident of power imbalance and toxic entitlement: the non-consensual kiss that the president of the Spanish Football Federation, Luis Rubiales, inflicted upon player Jenni Hermoso during the official ceremony for Spain’s victory in the Women’s Soccer World Cup in August 2023. Through a supercut set to the romantic song ‘As Time Goes By’ from Casablanca, mimicking the fanvid format, the video essay—”A Kiss is Not Just a Kiss” ( https://vimeo.com/908473856 )—juxtaposes footage of Rubiales’ kiss with representations of non-consensual kisses in mainstream films, where the woman reciprocates the kiss after a brief resistance. Slow-motion, zooming-in and repetition of the same narrative disrupt and challenge the normalization of sexual aggression. By selecting films, including animation features, that span seven decades (from 1937 to 2007), I aim to highlight the persistent nature of the issue. The superimposition of Jenni Hermoso’s voice interrupts the kisses, and a glitch with the text ‘System error’ obscures the action, arguing that the incident is part of a broader systemic problem of entrenched naturalization of sexual violence.
When and in what circumstances is patient-targeted googling acceptable for health and social care professionals? A narrative review and thematic analysis
Authors: Ryan-Blackwell Gemma , Jackson Jessica , Haider Sharif
Published: September 2024

Background: Patient-targeted Googling (PTG) is the use of Internet search engines by care professionals to source information about their patients. Objective: To thematically analyse research evidence on PTG and explain what, why and how it can be used for the benefit of patient care. Methods: The Scale for the Assessment of Narrative Review articles was used as a reporting tool. Studies were identified via AMED, CINAHL, MEDLINE and APA PsycInfo, ProQuest, and grey literature via Google Scholar. Results: 19 studies were included, and content was thematically analysed. Themes included practitioner behaviours, attitudes and experience, the nature of online information, when PTG is not acceptable, when, why and how is PTG acceptable and the need for education and training on PTG. Discussion & conclusion: In the absence of professional guidance, it makes practical recommendations about why and in what circumstances can use patient-targeted Googling for the benefit of patient care.
ChatGPT in the public eye: Ethical principles and generative concerns in social media discussions
Authors: Cohen Maayan , Khavkin Michael , Movsowitz Davidow Danielle , Toch Eran
Published: September 2024

With ChatGPT’s rapid adoption, concerns regarding generative artificial intelligence (AI) have shifted from theoretical to practical. Drawing upon the “algorithmic imaginary” framework from critical algorithm studies and the anthropological concept of “ordinary ethics,” we analyzed Twitter discourse during ChatGPT’s initial deployment, examining 368,359 tweets. Our analysis identified five topics reflecting functional and critical aspects of ChatGPT. We specifically point to two topics with a critical perspective: “Ethics” and “Concerns.” The first aligns with scholarly discussions in AI ethics on fairness and transparency, while the second focuses on ChatGPT’s generative capabilities. This highlights an emerging trend: While the academic discussion on AI ethics has gained popularity, especially in scrutinizing ChatGPT, the conversation is now expanding to more nuanced ethical deliberations. We analyzed the posts’ engagement and sentiment over time, demonstrating the AI ethics community’s influence in addressing the potential and harms of generative AI systems.
Brewing social capital: A case study of Thailand’s craft beer consumption community
Authors: Sakdiyakorn Malinvisa , Chirakranont Rangson
Published: September 2024

This study explores the development of Thailand’s craft beer community through a sociological lens, focusing on social capital and power dynamics. Despite originating much later than Western craft beer movements, Thailand’s scene has evolved rapidly since 2012, shaped by unique socio-economic and regulatory contexts. The research reveals how the community transitioned from homebrewers to a complex network seeking cultural legitimacy. Using Putnam’s and Bourdieu’s theories, the study highlights social capital’s role in fostering both cooperation and competition. Privileged groups use networks for economic and symbolic gains, while intermediaries shape the movement. Gender dynamics affect women moderately compared to other contexts. The COVID-19 pandemic spurred geographically close clusters and affinity groups, showcasing resilience amid regulatory challenges. These findings offer insights into craft beer consumption in non-Western contexts, stressing the importance of understanding social capital in emerging cultural industries.
Mr W Martin Nichols (1910–1979): From prisoner of war to first Aberdeen neurosurgeon
Authors: Pecover Mark , Nichols David , Bodkin Peter Alwyn
Published: September 2024

The Department of Neurosurgery at Aberdeen Royal Infirmary (ARI) marked its 75th anniversary in 2023. The unit began on 1 April 1948 when Mr W Martin Nichols became the first full-time neurosurgeon in the North of Scotland. Prior to World War II (WWII), there were only a handful of surgeons dedicated to the specialty in the UK. Martin Nichols was one of a new wave of pioneering surgeons who had sought out experience in this fledgling field and went on to establish post-war units in teaching hospitals across the country. Like others of his generation, the war had an enormous effect on his career. Here we discuss his early formative career gaining experience in the leading centres of the day, WWII and his 5 years as a prisoner of war, going on to set up the new unit in Aberdeen. We are fortunate to have had access to many of Nichols’ letters and other materials that provide valuable insights into the period.
Streaming K-dramas and C-dramas: The Different Paths of Korean and Chinese Online Television Distribution Overseas
Authors: Sarkar Anubha , Yang Xiao
Published: September 2024

This paper offers a comparative analysis of the international streaming trajectories of South Korean television dramas (K-dramas) and Chinese television dramas (C-dramas), highlighting their distinct approaches shaped by geopolitical and regulatory contexts. K-dramas have achieved global success through government support, strategic partnerships with platforms like Netflix, and diverse audience engagement, driving waves of Hallyu (the Korean cultural wave). In contrast, C-dramas initially lagged due to restrictive government policies and limited co-production but have gained momentum through the expansion of Chinese streaming platforms into Southeast Asia. Case studies of Kingdom (2019) and Empresses in the Palace (2015) illustrate these dynamics, revealing challenges such as platform imperialism and cultural reception. This analysis underscores the evolving landscape of digital media, streaming, and cultural exchange in East Asia, offering insights into non-Western media ecosystems.
Between Escapism and Social Engagement: Ted Lasso and the Privileges of Comfort Viewing in 2020
Authors: Sweeney Shannon
Published: September 2024

During the hectic context of 2020 America, television became a salve for many, while an increased middle-class emphasis on staying at home to mitigate COVID-19 spread softly benefited streaming services’ bottom lines. Ted Lasso (AppleTV+, 2020-2023) was beloved for its positive outlook and comforting tone during these unsettled times. This paper discusses three “discursive mantras” which white Ted Lasso fans deploy in interviews about the series, and argues that fans use these to code their engagement with television as acceptable and necessary. In their description of the series’ impact, white fans use Ted Lasso as an escape, but also as a way of thinking through the nation’s political, racial, and medical crises. In so doing, they reveal the position of white comfort viewers during the early pandemic, a group who are living through vast cultural unrest but privileged enough to be soothed by television.
A Network Meta-Analysis of Randomized Controlled Trials on the Comparative Efficacy of Stem Cells Therapy for Diabetic Foot Ulcer Healing
Authors: Mudgal Shiv Kumar , Kumar Subodh , Sharma Suresh K , Gaur Rakhi , Saikia Dibyajyoti , Singh Harminder , Varshney Saurabh , Grover Ashoo , Varikasuvu Seshadri Reddy
Published: September 2024

Stem cell therapy in diabetic foot ulcer has emerged as a promising treatment option to promote ulcer healing. This network meta-analysis was undertaken to evaluate how they compete with each other and their ranking with respect to chances of ulcer healing. A systematic search strategy to retrieve data from five databases, were used to identify potential studies. Randomized controlled trial or clinical controlled trial, published in English, using any type of stem cells as intervention in individuals aged over 18 years diagnosed with diabetic foot ulcers were included. This network meta-analysis was performed using frequentist method using R version 4.2.1. Eighteen clinical trials were included in the study which included 13 interventions. The study found that most of the stem cells were significantly promoting ulcer healing chances with human viable wound matrix (hVWM) [RR 2.91; CI: 1.28, 6.64], peripheral blood mononuclear cells (PBMNC) [RR 2.35; CI: 1.21, 4.55], bone marrow mesenchymal stem cells (BMMSCs) [RR 2.20; CI: 1.34, 3.60], were top three stem cell options among all. P score also suggested the same. Risk of bias study suggested that there was “some concern or “high risk’’ among majority of studies. It is evident from this study that bone marrow mononuclear cells were found to be most effective in wound healing in cases of diabetic foot ulcer in that order. Though there was no significant difference between these and more studies were required to ascertain whether they differ in term of efficacy for the clinical outcome of ulcer healing.
Comparison of the imaging performance of time-of-flight MRA and ultrashort echo time MRA in flow diverters: A phantom study
Authors: Akatsu Toshiya , Wada Akihiko , Suzuki Michimasa , Fukuchi Haruyuki , Ikenouchi Yutaka , Takano Nao , Yagisawa Fumihiro , Teranishi Kosuke , Ishii Akira , Kondo Akihide , Aoki Shigeki
Published: September 2024

Objective

Flow diverters (FD) are innovative treatments for wide-neck intracranial aneurysms. After-treatment verification of embolization and parent vessel patency is crucial. While evaluation using time-of-flight magnetic resonance angiography (TOF-MRA) is useful, it suffers from signal loss within the FD due to susceptibility effects. This study evaluates the usefulness of ultrashort echo time MRA (UTE-MRA) for after-FD assessment compared to TOF-MRA.

Methods

Vascular phantom experiments were conducted using FDs (FRED®, Pipeline®, Surpass Streamline®). TOF-MRA and UTE-MRA were performed under steady (10, 30, 50 cm/s) and pulsatile (17–61 cm/s, mean 34 cm/s) flow conditions using a 3 T MRI system. As evaluation metrics, relative in-FD signal (RIS) was calculated by comparing the signal intensity inside the FD to that without the FD to assess signal retention, and FD luminal to background signal ratio (FD-LBR) was calculated by comparing the signal intensity inside the FD to that of the surrounding background to evaluate vessel visibility.

Results

UTE-MRA showed higher FD-LBR values than TOF-MRA for all FDs ( p < 0.01). For RIS, UTE-MRA was significantly higher for FRED® ( p < 0.01), but different for other FDs except at 50 cm/s. FRED® exhibited the highest RIS and FD-LBR values under all conditions, followed by Pipeline® and Surpass Streamline®. Flow velocity changes resulted in minimal variations in RIS and FD-LBR values.

Conclusion

UTE-MRA provides superior image quality for after-FD assessment, particularly in terms of FD-LBR, compared to TOF-MRA. Differences in FD materials and structures affect image quality. These findings suggest UTE-MRA's clinical utility in follow-up after-FD assessment.
Hemorrhagic versus non-hemorrhagic presentation of presumed reversible cerebral vasoconstriction syndrome (RCVS): Presentations and outcomes
Authors: Madapoosi Adrusht , McGuire Laura Stone , Fuentes Angelica , Tshibangu Mpuekela , Theiss Peter , Mrad Tatiana Abou , Amin-Hanjani Sepideh , Alaraj Ali
Published: September 2024

Introduction

Reversible cerebral vasoconstriction syndrome (RCVS) can present with hemorrhage, ischemia, or both. We aim to compare the differences in presentation and outcomes between patients with RCVS.

Methods

The hemorrhagic presentation group had 58 patients, and the non-hemorrhagic presentations had 30 patients. Subgroup analysis compared patients with evidence of one or more types of hemorrhage ( n = 53), no evidence of hemorrhage or infarction ( n = 23), evidence of infarction only ( n = 7), and combination of hemorrhage and infarction ( n = 5). Clinical and radiographic data were analyzed.

Results

Migraine ( p = 0.030) and intracranial tumors ( p = 0.004) were more frequent in non-hemorrhagic presentation. Seizures on admission ( p = 0.047) and higher than average C-reactive protein (CRP) ( p = 0.037) were seen at a higher rate in patients with hemorrhagic presentation. RCVS2 scores were not unexpectedly higher in patients with hemorrhage than non-hemorrhagic presentations ( p = 0.010). Outcomes between the hemorrhagic and non-hemorrhagic groups were comparable. Subgroup analysis found a higher subset of patients with opiate use ( p = 0.046) in the hemorrhage-only group. Patients with hemorrhage presented with a thunderclap headache ( p < 0.001) more often when compared to the other three groups. RCVS2 score was not unexpectedly higher in the hemorrhage-only group compared with the other groups ( p = 0.004).

Conclusion

A history of migraines was associated with ischemia, while intracranial tumor was significantly associated with evidence of either an infarct, or no changes on imaging. Exposure to opiates, and seizures or thunderclap headache on presentation were associated with hemorrhage. If our data are reproducible, the RCVS2 score may benefit from inclusion of other, small hemorrhages as criterion for diagnosis for RCVS.
Optimizing the hemodynamics of hand injections in neuroangiography
Authors: Bayraktar Esref Alperen , Li Jiahui , Cortese Jonathan , Bilgin Cem , Ueki Yasuhito , Kadirvel Ramanathan , Brinjikji Waleed , Cloft Harry J , Kallmes David F
Published: September 2024

Purpose

Optimizing the preparation of a 10 ml syringe for manual injection of contrast media can help operators obtain easier and faster injections. This study aims to compare the flow rates of different contrast media injection methods.

Methods

Different contrast media solutions were compared: 100% contrast (10 ml contrast), mixed contrast solution (8:2 contrast/saline), and layered contrast below saline (“Parfait”) in different volumes. Contrast media were injected at room temperature (20°C) and after heating (37°C). Four operators injected 10 ml syringes filled with different mediums through 5-French angiographic catheters. The average flow rate was used to compare different contrast injection mediums. The Kruskal-Wallis test with post-hoc pairwise comparisons using Bonferroni correction or Mann-Whitney U-tests were employed depending on the type of comparison.

Results

Compared to the 100% contrast solution, every Parfait media and mixed contrast solution demonstrated significantly higher flow rates (p < 0.001). The 5 ml saline Parfait had the highest flow rate among the Parfait solutions. The 5 ml saline Parfait and the mixed solution had comparable flow rates (p = 0.237). Higher flow rates were observed upon heating both 100% contrast (p < 0.001) and mixed contrast solutions (p < 0.001) in comparison to their flow rates at room temperature.

Conclusion

This study demonstrates the capability of the Parfait and mixed contrast injections to achieve higher flow rates than the 100% contrast solutions. Heating the contrast media to 37°C also proves to be a viable strategy for further enhancing the flow rates for 100% and mixed contrast solutions.
The Impact of Collective Pre-game Organization in the Perceived Experience of Digital Management Simulations in Higher Education
Authors: Brassier Pascal , Favre-Bonte Véronique , Ralet Patrick
Published: September 2024

This study investigates the impact of pre-game preparation on the perceptions and outcomes of participants in a digital simulation game. Conducted on 542 students from 28 management schools, the research explores how team organization and strategic planning in the early stages influence game experience and performance in a business simulation context. The findings reveal that effective pre-game preparation significantly enhances both the participants’ perception of the game and their performance outcomes. These results underline the importance of structured team organization and the strategic definition of roles before the game begins. This study also contributes to the literature on simulation games by highlighting the crucial role of pre-game activities, especially in team-based settings. In addition, it offers practical insights for educators on optimizing the use of simulation games by focusing on preparation and organization strategies that mimic real-world business environments. This research not only fills a gap in our understanding of the preparatory phase of game-based learning but also enhances our knowledge of how simulation games can be effectively integrated into management education.
Portugali's creative folds
Authors: Stolk Egbert
Published: September 2024

This commentary explores the structure of Portugali’s work, which aims to bridge two urban cultures through a process which we propose to call ‘creative folding.’ Five key creative folds are identified in the work of Portugali: the origami metaphor, implicate relations, synergetic inter-representation networks, urban regulatory focus, and urban coordination dynamics. At the core of these folds are between-domain transfers, with the Bohm-Haken-Kelso conjunction—an interdisciplinary framework combining ideas from physics, synergetics, and neurodynamics—playing a pivotal role. The commentary also examines several challenges related to creative folding, such as managing cognitive load, developing engaging methods to unify diverse urban theories, and involving people from various backgrounds in collective creative folding. These challenges highlight the need for open dialogues to foster innovation and collaboration in developing unified urban theories.
Unraveling the impact of pH, sodium concentration, and medium osmolality on Vibrio natriegens in batch processes
Authors: Forsten Eva , Gerdes Steffen , Petri René , Büchs Jochen , Magnus Jørgen
Published: September 2024

Background

Vibrio natriegens, a halophilic marine γ-proteobacterium, holds immense biotechnological potential due to its remarkably short generation time of under ten minutes. However, the highest growth rates have been primarily observed on complex media, which often suffer from batch-to-batch variability affecting process stability and performance. Consistent bioprocesses necessitate the use of chemically defined media, which are usually optimized for fermenters with pH and dissolved oxygen tension (DOT) regulation, both of which are not applied during early-stage cultivations in shake flasks or microtiter plates. Existing studies on V. natriegens’ growth on mineral media report partially conflicting results, and a comprehensive study examining the combined effects of pH buffering, sodium concentration, and medium osmolality is lacking.

Results

This study evaluates the influence of sodium concentration, pH buffering, and medium osmolality on the growth of V. natriegens under unregulated small-scale conditions. The maximum growth rate, time of glucose depletion, as well as the onset of stationary phase were observed through online-monitoring the oxygen transfer rate. The results revealed optimal growth conditions at an initial pH of 8.0 with a minimum of 300 mM MOPS buffer for media containing 20 g/L glucose or 180 mM MOPS for media with 10 g/L glucose. Optimal sodium chloride supplementation was found to be between 7.5 and 15 g/L, lower than previously reported ranges. This is advantageous for reducing industrial corrosion issues. Additionally, an osmolality range of 1 to 1.6 Osmol/kg was determined to be optimal for growth. Under these optimized conditions, V. natriegens achieved a growth rate of 1.97 ± 0.13 1/h over a period of 1 h at 37 °C, the highest reported rate for this organism on a mineral medium.

Conclusion

This study provides guidelines for cultivating V. natriegens in early-stage laboratory settings without pH and DOT regulation. The findings suggest a lower optimal sodium chloride range than previously reported and establish an osmolality window for optimal growth, thereby advancing the understanding of V. natriegens’ physiology. In addition, this study offers a foundation for future research into the effects of different ions and carbon sources on V. natriegens.
Assessing the impact of Delta and Omicron in German intensive care units: a retrospective, nationwide multistate analysis
Authors: Lottes Matthäus , Grodd Marlon , Grabenhenrich Linus , Wolkewitz Martin
Published: September 2024

Background

The spread of several severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) variants of concern (VOCs) has repeatedly led to increasing numbers of coronavirus disease 2019 (COVID-19) patients in German intensive care units (ICUs), resulting in capacity shortages and even transfers of COVID-19 intensive care patients between federal states in late 2021. In this respect, there is scarce evidence on the impact of predominant VOCs in German ICUs at the population level.

Methods

A retrospective cohort study was conducted from July 01, 2021, to May 31, 2022, using daily nationwide inpatient billing data from German hospitals on COVID-19 intensive care patients and SARS-CoV-2 sequence data from Germany. A multivariable Poisson regression analysis was performed to estimate the incidence rate ratios (IRRs) of transfer (to another hospital during inpatient care), discharge (alive) and death of COVID-19 intensive care patients associated with Delta or Omicron, adjusted for age group and sex. In addition, a multistate approach was used for the clinical trajectories of COVID-19 intensive care patients to estimate their competing risk of transfer, discharge or death associated with Delta or Omicron, specifically concerning patient age.

Results

A total of 6046 transfers, 33256 discharges, and 12114 deaths were included. Poisson regression analysis comparing Omicron versus Delta yielded an estimated adjusted IRR of 1.23 (95% CI 1.16–1.30) for transfers, 2.27 (95% CI 2.20–2.34) for discharges and 0.98 (95% CI 0.94–1.02) for deaths. For ICU deaths in particular, the estimated adjusted IRR increased from 0.14 (95% CI 0.08–0.22) for the 0–9 age group to 4.09 (95% CI 3.74–4.47) for those aged 90 and older compared to the reference group of 60-69-year-olds. Multistate analysis revealed that Omicron was associated with a higher estimated risk of discharge for COVID-19 intensive care patients across all ages, while Delta infection was associated with a higher estimated risk of transfer and death.

Conclusions

Retrospective, nationwide comparisons of transfers, discharges and deaths of COVID-19 intensive care patients during Delta- and Omicron-dominated periods in Germany suggested overall less severe clinical trajectories associated with Omicron. Age was confirmed to be an important determinant of fatal clinical outcomes in COVID-19 intensive care patients, necessitating close therapeutic care for elderly people and appropriate public health control measures.
Un/met: a mixed-methods study on primary healthcare needs of the poorest population in Khyber Pakhtunkhwa province, Pakistan
Authors: Shaukat Maira , Imping Alina , Rogge Lisa , Khalid Fatima , Ullah Safat , Ahmad Fayaz , Kibria Zeeshan , Landmann Andreas , Khan Zohaib , De Allegri Manuela
Published: September 2024

Background

Access of all people to the healthcare they need, without financial hardship is the goal of Universal Health Coverage (UHC). As UHC initiatives expand, assessing the needs of vulnerable populations can reveal gaps in the system which may be covered by relevant policies. In this study we (i) identify the met and unmet primary healthcare needs of the poorest population of Khyber Pakhtunkhwa province (KP), Pakistan, and (ii) explore why the gaps exist.

Methods

We used Leveque’s Framework of Patient-centred Access to Healthcare to examine unmet primary healthcare (PHC) needs and their underlying causes for the poorest population in four districts of Khyber Pakhtunkhwa province, Pakistan. Using a triangulation mixed methods design, we analysed data from a quantitative household survey of744 households, 17 focus group discussions with household members and, 11 interviews with healthcare providers.

Results

Our results show that indicate that despite service utilization, PHC needs were not met, primarily due to prohibitively high costs at each stage of access. Furthermore, gaps in outreach and information (approachability), and varying availability of medicines and diagnostics at facilities (appropriateness) the supply side as well as difficulties in navigating the system (inability to perceive) and adhering to prescriptions (inability to engage) on the demand side, also led to unmet PHC needs. Going beyond utilization, our findings highlight that engagement with care is an important determinant of met needs for vulnerable populations.

Conclusion

Social health protection policies can contribute to advancing UHC for primary care. However, in our setting, enhancing communication and outreach, addressing gender and age disparities, and improving quality of care and health infrastructure are necessary to fully meet the needs of the poorest populations.