bluuebunny/crossref_metadata_2025 huggingface dataset:
Synergistic Interactions of Insufficient Physical Activity and a High Systemic Immune-Inflammation Index on Psychological Problems in Indonesians With Type 2 Diabetes Mellitus
Authors: Rias Yohanes Andy , Tsai Hsiu Ting , Thato Ratsiri , Apriyanto Bagus Sholeh , Chou Kuei Ru , Ho Shu Chuan , Sun Chia Hsuan
Published: March 2023

Background

High-grade inflammation represents a critical contribution to the onset of depression and might be manageable by physical activity (PA). Nevertheless, no study has examined synergistic interactions of insufficient PA and high values of the systemic immune-inflammation index (SII) on psychological problems.

Objective

We investigated independent and synergistic interactions of insufficient PA and high SII levels on stress, anxiety, and depression in T2DM patients.

Methods

A cross-sectional research design with 294 T2DM patients was conducted. An XP-100 automated hematology analyzer was used to evaluate inflammatory biomarkers. Depression, Anxiety, and Stress Scale-21 items and a standardized questionnaire about PA were respectively used to measure psychological problems and metabolic equivalent of task (MET)-h/week.

Results

A multiple linear regression demonstrated that patients with insufficient PA were significantly more likely to have higher stress ( β = 1.84, 95% confidence interval (CI) = 1.03–2.65), anxiety ( β = 1.88, 95% CI = 1.81–2.96), and depression ( β = 2.53, 95% CI = 0.82–4.24) than those with active PA. A high SII level was a key predictor and was most strongly associated with stress ( β = 2.61, 95% CI = 2.02–3.20), anxiety ( β = 3.16, 95% CI = 2.37–3.94), and depression ( β = 3.72, 95% CI = 2.49–4.96) compared to those who had low SII levels. Notably, additive interaction results showed that combining insufficient PA and a high SII level had a significantly escalated 1.71-fold risk of stress, 1.82-fold risk of anxiety, and 2.69-fold risk of depression.

Conclusions

Active PA and a low SII had a positive synergistic effect of decreasing psychological problems.
Keratoconus in two siblings with congenital distichiasis
Authors: Dongre Pankaj , Bothra Nandini , Chaurasia Sunita
Published: March 2023

Purpose

To describe a previously unreported association of keratoconus in congenital distichiasis.

Methods

Observational case series of ocular findings in 2 siblings with congenital distichiasis.

Results

A 17-year-old male presented with tearing and photophobia in both eyes. His parents revealed that he was photophobic since birth. He had a lid surgery previously in both eyes. Clinical examination revealed a central scar with Descemet membrane tear suggestive of healed hydrops in the right eye. The left eye showed topographic features of keratoconus. His younger sibling, a 14-year-old female, also had similar symptoms of photophobia and tearing since birth. She had undergone electrolysis in both eyes. At the present visit, she had an epithelial defect with congestion in the right eye. Electrolysis of the distichiatic eyelashes was performed along with bandage contact lens application, which relieved her symptoms. Her topography revealed subclinical keratoconus in both eyes. The siblings’ father also had complaints of photophobia since birth and had lid surgery and electrolysis in the second decade of his life.

Conclusions

Patients with congenital distichiasis may have associated keratoconus. Chronic ocular irritation and subsequent eye rubbing in distichiasis could be the risk factor for keratoconus.
Direct anterior approach associated with lower dislocation risk after primary total hip arthroplasty in patients with prior lumbar spine fusion
Authors: Iturregui Jose M , Sebro Ronnie , Baranek Morgan , Garner Hillary W , Stanborough Rupert O , Goulding Krista A , Ledford Cameron K , Wilke Benjamn K
Published: March 2023

Background:

While there has been much interest in the increased dislocation rate in total hip arthroplasty (THA) patients with a lumbar spine fusion (LSF), there is minimal literature comparing the risk based on surgical approach. The purpose of this study was to determine if a direct anterior (DA) approach was protective against dislocation when compared to the anterolateral and posterior approaches in this high-risk patient population.

Methods:

A retrospective review was performed of 6554 THAs performed at our institution from January 2011 to May 2021. 294 (4.5%) patients had a prior LSF and were included in the analysis. The surgical approach, timing of LSF in relation to THA, vertebral levels fused, timing of THA dislocation, and the need for revision surgery were recorded for statistical analysis.

Results:

In total, 39.7.3% of patients underwent a DA approach (n = 117), 25.9% underwent an anterolateral approach ( n = 76), and 34.3% underwent a posterior approach ( n = 101). There was no difference in number of vertebral levels fused between groups (mean 2.5, all p > 0.05). There was a total of 13 (4.4%) THA dislocation events, with an average time from surgery to dislocation of 5.6 months (0.3–30.5 months). There were fewer dislocations in the DA cohort (0.9%) in comparison to both the anterolateral (6.6%, p = 0.036) and posterior groups (6.9%, p = 0.026).

Conclusions:

The DA approach demonstrated a significantly lower THA dislocation rate compared to both the anterolateral and posterior approaches in patients with a concomitant LSF.
Evaluation of Drinking Water Quality From Water Coolers in Makkah, Saudi Arabia
Authors: Ahmed Omar B
Published: March 2023

The quality of drinking water is an important health issue in crowded cities, so that an adequate drinking water with good quality must be provided, hence over hundreds of water coolers are distributed in Makkah city to cope with the increasing demand for drinking water. The present study aimed to determine the chemical and microbial quality of drinking water from coolers in Makkah city. Sixty-three samples from randomly selected water coolers were tested for chemical and bacteriological quality. For all samples, the mean value of physiochemical tests of pH (7.12), TDS (152.7 ppm), turbidity (2.56 NTU), free chlorine (0.312 ppm), fluoride (0.112 ppm), chloride (25.7 ppm), bromide (0.123 ppm), nitrate (0.616 ppm), sulfate (8.36 ppm), lithium (0.134 ppm), sodium (17.6 ppm), potassium (1.42 ppm), magnesium (1.95 ppm), calcium (19.2 ppm), chromium (0.025 ppm), cadmium (0.0026 ppm), and lead (0.0244 ppm) did not exceed the reference values of the drinking water regulations. The total coliform count was detected in 3.2% of the water samples. For total coliform count, the MPN in the majority of water samples (96.8%) was excellent while for E. coli count, the MPN in all water samples (100%) was excellent. Bacteriological quality has shown that no Pseudomonas, Salmonellae, or Legionellae species contamination detected. It was concluded that, the drinking waters in coolers in Makkah city were complied with international standards and within the acceptable limit. It is worth to continue periodic inspection and maintenance for the drinking water coolers during mass gatherings.
Repairing the breach: identity narratives of a Latin American woman in Andalusia
Authors: de la Mata-Benítez Manuel L , Español Alicia , Matías-García José Antonio , Lojo María , Villar-Toribio Cristina del
Published: March 2023

Migration can be understood as a breach in life experience, creating a transition, and identity narratives as a strategy to repair this breach. Our study focuses on how two classical dilemmas that characterize this process are navigated in the narrative of migration of the participant (An Ecuadorian migrant woman in Andalusia): self versus others, and continuity of the self over time, despite changes. A semi-structured interview was conducted to achieve the objectives of the study. The interview was transcribed and analyzed on three axes: 1) Migration settings, identifying the dominant spaces of interaction where the migration narrative takes place; 2) Migration I-positions and voices, identifying the I-positions and voices involved in the narrative; and 3) Continuities and discontinuities in the identity narrative. The results demonstrated that the main settings and positions in the narrative were related to nationality, gender, and religion in relation to the dilemmas of self versus others and continuity versus change. These positions help the participant negotiate self-continuity in front of the changes associated with migration and the resistance against xenophobic discourses and positions in the host country. Results support the analysis of the transition processes associated to migration based on the concept of proculturation.
Perception and gaze of diaspora: Analysis of affective, cognitive, & cultural factors in tourism
Authors: Wang Qiang , Ch’ng Eugene , Xu Xiaoshu , Wang Jun , Zhang Yunfeng
Published: March 2023

This research focuses on exploring the cognitive and affective perception of Hokkien ethnic Chinese born abroad visiting their hometown, Quanzhou, which is a UNESCO World Heritage Site. The study examines the interplay between the collective gaze, affective, and cognitive perception of diaspora visitors who visit Quanzhou to reclaim their cultural identity and explore new opportunities. The analysis was conducted using a combination of fuzzy set qualitative comparative analysis and natural language processing techniques for sentiment analysis, based on 44 tourist interviews and 10 local key informant interviews. The results suggest that the primary image formed after the visit has a significant effect on the affective image and the affective attribute has a significant impact on the collective gaze and overall perceived image of diaspora visitors. These findings have important implications for destination image marketing and the sustainability of diaspora tourism.
The impact of a critical fiction analysis based on using augmented reality technology on developing students’ critical thinking and critical writing at Tabuk University
Authors: Abdelrahim Azza A.M.
Published: March 2023

Critical thinking and second language (L2) critical writing are very important for students at the tertiary level. However, applied linguistics and L2 acquisition research has mostly focused on linguistic knowledge development. Second language research has yet given scarce attention for examining the development of critical thinking and critical writing. This article explores the impact of critical analysis based on augmented reality (AR) technology on developing critical thinking and critical writing. Two groups of L2 undergraduates ( n = 120) participated in this study. The experimental group used critical analysis based on AR, and the control group used online instruction based on a learning management system without AR. The findings showed that the experimental group outperformed the control group in critical thinking and writing. Elements of critical thinking were integrated into the experimental group’s critical writing. The findings highlight the importance of connecting critical writing assessment with critical thinking and using critical thinking elements as one of the important predictors of critical writing. Furthermore, the study provides important implications for future research on integrating AR into critical analysis for enhancing L2 learners’ critical thinking and writing.
Predicting and Analyzing Restenosis Risk after Endovascular Treatment in Lower Extremity Arterial Disease: Development and Assessment of a Predictive Nomogram
Authors: Chen Jinxing , Tang Yanan , Shen Zekun , Wang Weiyi , Hou Jiaxuan , Li Jiayan , Chen Bingyi , Mei Yifan , Liu Shuang , Zhang Liwei , Lu Shaoying
Published: March 2023

Purpose:

This study aimed to develop and internally validate nomograms for predicting restenosis after endovascular treatment of lower extremity arterial diseases.

Materials and Methods:

A total of 181 hospitalized patients with lower extremity arterial disease diagnosed for the first time between 2018 and 2019 were retrospectively collected. Patients were randomly divided into a primary cohort (n=127) and a validation cohort (n=54) at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression was used to optimize the feature selection of the prediction model. Combined with the best characteristics of LASSO regression, the prediction model was established by multivariate Cox regression analysis. The predictive models’ identification, calibration, and clinical practicability were evaluated by the C index, calibration curve, and decision curve. The prognosis of patients with different grades was compared by survival analysis. Internal validation of the model used data from the validation cohort.

Results:

The predictive factors included in the nomogram were lesion site, use of antiplatelet drugs, application of drug coating technology, calibration, coronary heart disease, and international normalized ratio (INR). The prediction model demonstrated good calibration ability, and the C index was 0.762 (95% confidence interval: 0.691-0.823). The C index of the validation cohort was 0.864 (95% confidence interval: 0.801-0.927), which also showed good calibration ability. The decision curve shows that when the threshold probability of the prediction model is more significant than 2.5%, the patients benefit significantly from our prediction model, and the maximum net benefit rate is 30.9%. Patients were graded according to the nomogram. Survival analysis found that there was a significant difference in the postoperative primary patency rate between patients of different classifications (log-rank p<0.001) in both the primary cohort and the validation cohort.

Conclusion:

We developed a nomogram to predict the risk of target vessel restenosis after endovascular treatment by considering information on lesion site, postoperative antiplatelet drugs, calcification, coronary heart disease, drug coating technology, and INR.

Clinical Impact

Clinicians can grade patients after endovascular procedure according to the scores of the nomograms and apply intervention measures of different intensities for people at different risk levels. During the follow-up process, an individualized follow-up plan can be further formulated according to the risk classification. Identifying and analyzing risk factors is essential for making appropriate clinical decisions to prevent restenosis.
The Allocation of Additional Slots for the FIFA World Cup
Authors: Krumer Alex , Moreno-Ternero Juan D.
Published: March 2023

How to select participants for a sports tournament when they are divided into different sets, and one should find a fair number of slots for each set? We propose to address this question by resorting to standard tools from the fair allocation literature. To frame our discussion, we focus on the increase in the number of participating teams in the FIFA World Cup. We explore the allocation of additional slots among continental confederations. We consider 10 different allocations. Based on our analysis, we can argue that the European soccer confederation (UEFA) has a solid basis to claim for additional slots.
Insider Action Research for Human Resource Development
Authors: Coghlan David , Holian Rosalie
Published: March 2023

While action research is well-established in the field of organization development and change (ODC) its profile in human resource development (HRD) is less visible. Even less visible within HRD are accounts of how action research is conducted within organizations by their managers and other members who adopt it as an approach to managing change and other organizational challenges. In order to share thoughts and ideas on doing action research we draw from academic knowledge as well as experience integrating theory and practice, from being engaged in designing, delivering, assessing and improving group and individual activities to support ongoing learning and development. In this guest editorial, we introduce insider action research and its potential for HRD research and offer views from professional and personal experience, analysis, thoughts and speculations about how action research is important and useful for HRD and how those who use and benefit from doing it may be able to be encouraged to more widely share case studies and to write up insider action research projects for publication.
Preoperative Workup of Operative Hip Fracture Patients: A Survey
Authors: Esper Garrett W. , Anil Utkarsh , Cavaleri Salvatore G. , Furgiuele David L. , Zaretsky Jonah , Konda Sanjit R. , Egol Kenneth A.
Published: March 2023

Background: There may be disagreement among stakeholders on the need for preoperative cardiac screening for elderly hip fracture patients. Purpose: We sought to assess preoperative workup perceptions among physicians for hip fracture patients across specialties, specifically considering a patient’s cardiovascular risk. Methods: A case-based survey was distributed to 50 physicians in each of the 4 departments involved in preoperative patient care: orthopedic surgery (OS), anesthesiology (A), cardiology (C), and hospital medicine (HM). The survey asked about which clinical presentations required a cardiology consult, as well as about further preoperative imaging and laboratory work. Single score intraclass correlation coefficient (ICC) was used to compare agreement. Results: Of the 200 surveys sent out, 33 responses (16.5% response rate) were received. Between all specialties, there was 72% agreement about preoperative cardiology consult need (intraclass correlation coefficient [ICC] = 0.063 or poor) and 71% agreement about preoperative transthoracic echocardiogram (TTE) need (ICC = 0.188 or poor). Within each specialty (A, C, HM, OS) ICCs measuring agreement for the need for cardiology consult were 0.812 (good), 0.561 (moderate), 0.457 (poor), and 0.414 (poor), respectively, and for the need for preoperative TTE were 0.852 (good), 0.441 (poor), 0.848 (good), and 0.188 (poor), respectively. Common preoperative testing requested included complete blood count, basic metabolic panel in all cases, and electrocardiogram with troponins if perioperative acute coronary syndrome symptoms were present. Conclusion: This survey suggests that there may be varying levels of agreement within specialties and poor agreement between specialties on the need for cardiology consultation and preoperative imaging for hip fracture patients. This suggests the need for established, reliable preoperative workup protocols with input from different specialties to streamline preoperative care for patients before hip fracture surgery.
Fit for Health? Levels of Physical Activity Among Preclinical and Clinical Medical Students
Authors: Connelly Madison , Waites Steven , Kaeley Dilpreet , Brewster Pamela , Sun Zhen , Randall Worth
Published: March 2023

Physical, mental, and emotional wellness are just some avenues to maintain a person’s overall well-being. These components of wellness influence each other; mental wellness is known to be affected by physical wellness. Physical wellness in the form of regular exercise stands as a method to mitigate the high rates of depression and burnout among medical students. This study examines the levels of physical activity among preclinical and clinical medical students. This is an observational, non-randomized study with data collection over one month. Fifty-nine percent of students surveyed met the CDC recommendation for exercise. The major reason to exercise was to improve mental health, with 37% of respondents citing this as a motivator. For those who did not meet the physical activity recommendation, lack of time was cited in 75% of respondents. Greater knowledge of prevention methods, risk factors, and outcomes of chronic health conditions may contribute to higher physical activity levels among medical students compared to the general population. Emphasizing exercise and physical wellness campaigns may be a solution for medical schools to improve the overall wellness of their students.
Modeling of combustion and emissions behavior on the effect of ethanol–gasoline blends in a four stroke SI engine
Authors: Elshenawy Ahmed Abdelrazik , Abdel Razik Sayed M , Gad M S
Published: March 2023

Researchers are increasingly coming up with creative solutions to reduce fuel consumption and harmful emissions due to the political unrest around crude oil and harsher environmental legislation around the globe. Using gasoline and ethanol blends as substitutes in SI engines is thought to be a promising approach. To lower the cost of experimental test, it is still necessary to provide a model to explore the emissions, performance and combustion of ethanol mixtures in petrol engine under various operating situations. A comprehensive quasi dimensional two zone model was used. This mathematical model could predict and analyze the engine combustion, emissions and performance parameters using MATLAB. The thermal efficiency was improved for E20 by 3%. Ethanol addition decreased SFC value by average 7.2% for E20 with respect to gasoline. In comparison to gasoline, the increases in output power were 1.1%, 3%, 4%, and 5.5% are obtained with E5, E10, E15, and E20. and 45% The highest increases in peak cylinder pressure and cylinder temperature for E20 about gasoline are 14 and 11%, respectively about gasoline. At 2500 rpm, the greatest percentage declines in NOx, CO, and HC emissions for E20 are 3.3, 23.5 and 45% about gasoline. The results of comparing the mathematical model’s validity to those acquired from experimental data and diesel RK software demonstrate that the MATLAB code is appropriate. The mathematical model proved that ethanol blending can be used up to 20% as alternative fuels to improve the gasoline engine performance, combustion and emissions.
A case of lupus erythematosus tumidus misdiagnosed as erysipelas
Authors: Zhu Qing , Zhu Chenglin , Zhang Jinfang , Zhang Yuli , Zhang Guoqiang
Published: March 2023

A patient presented with erythema and oedema on the right eyelid, malar region and left thigh with pruritus and pain. She was diagnosed with erysipelas and had been treated with anti-inflammatory drugs, but the symptoms did not improve. Laboratory investigation and biopsy showed that she was consistent with lupus erythematosus tumidus. It's a typical and rare diease relatively.
UniPseudo: A universal pseudoword generator
Authors: New Boris , Bourgin Jessica , Barra Julien , Pallier Christophe
Published: March 2023

Pseudowords are letter strings that look like words but are not words. They are used in psycholinguistic research, particularly in tasks such as lexical decision. In this context, it is essential that the pseudowords respect the orthographic statistics of the target language. Pseudowords that violate them would be too easy to reject in a lexical decision and would not enforce word recognition on real words. We propose a new pseudoword generator, UniPseudo, using an algorithm based on Markov chains of orthographic n-grams. It generates pseudowords from a customizable database, which allows one to control the characteristics of the items. It can produce pseudowords in any language, in orthographic or phonological form. It is possible to generate pseudowords with specific characteristics, such as frequency of letters, bigrams, trigrams, or quadrigrams, number of syllables, frequency of biphones, and number of morphemes. Thus, from a list of words composed of verbs, nouns, adjectives, or adverbs, UniPseudo can create pseudowords resembling verbs, nouns, adjectives, or adverbs in any language using an alphabetic or syllabic system.
Autism spectrum disorder in contemporary American sitcoms: Narrative and social implication
Authors: Kaklamanidou Betty
Published: March 2023

The Big Bang Theory (2007-19), Atypical (2017-21) and Community (2009-15) are sitcoms paradigmatic of a recent representational shift, in which center stage is assumed by individuals who face psychological and neurological challenges. Sheldon Cooper ( TBBT), Sam Gardner ( Atypical) and Abed Nadir ( Community) are young male protagonists who all fall somewhere on the spectrum of autism. These representations signal a breakthrough from past, mainly cinematic depictions, which stereotypically addressed mentally challenged individuals as unstable, problematic, and crazy. Our goal is to examine the narrative and social function of autism in these three sitcoms. The theoretical context uses Thomas Elsaesser ’s concept of “productive pathologies” (2009) to argue that autism is also a “productive pathology” that can be applied in the study of contemporary sitcoms. Autism spectrum disorder as a “productive pathology” is then combined with the Incongruity Theory of humour in order to analyze how Sheldon’s, Sam’s and Abed’s developmental disorder is used to create a distinct type of incongruous comedy and at the same time destabilize notions of identity and social “propriety.”
Relative energy deficiency in sport: Diagnosis and management in primary care
Authors: Shanley Donal , Hassan Amal , Lunan Emma , Carmody Sean
Published: March 2023

Relative energy deficiency in sport (RED-S) describes a syndrome that affects multiple bodily systems and functions in both recreational and elite athletes. It is, fundamentally, an imbalance between energy intake and exercise-related energy expenditure, leading to globally impaired physiological function as a result of low energy availability. RED-S developed from the ‘female athlete triad’, describing a relationship between low energy availability (with or without eating disorder), amenorrhea (menstrual dysfunction) and low bone mineral density; it is now recognised to occur across many other bodily systems and also to occur in males. Given its often subtle presentation and consequences early-on, but potentially devastating consequences further down the line, timely recognition and facilitation of management in primary care is crucial to allow safe return to physical activity and to prevent long-term sequelae.
The relationship between preoperative opioid use and adverse events following total shoulder arthroplasty
Authors: Kingston Kiera A. , Qin Charles , Qin Mia , Strelzow Jason , Shi Lewis
Published: March 2023

Introduction

Few studies have analyzed the effect of preoperative opioid use on postoperative outcomes after total shoulder arthroplasty (TSA).

Methods

Patients undergoing TSA were identified in the Pearldiver Humana Claims Dataset and stratified by level of preoperative opioid use. Primary outcomes were 90-day complications, readmissions, and revision surgery. Chi-square test and ANOVA were used to evaluate categorical and continuous variables respectively. A multivariable logistic regression analysis and a sub analysis excluding fracture as a primary diagnosis were completed.

Results

18,791 patients underwent aTSA and rTSA including 9933 opioid naïve patients, 3016 sporadic opioid users and 5842 persistent opioid users. Significant differences were found in complications (6.0% vs 6.1% vs 9.1%, p < .001), readmission (7.6% vs 8.2% vs 12.6%, p < .001), and revision procedures (1.1% vs 1.1% vs 2.3%, p < .001) which remained significant after excluding fractures. After adjusting for comorbidity burden, persistent opioid use was associated with increased likelihood of complications (OR 1.4, 1.2–1.6), readmission (OR 1.6, 1.5–1.8) and revision procedures (OR 1.9, 1.5–2.4). This association remained after excluding fractures.

Conclusion

Persistent preoperative opioid use is associated with increased risk of early postoperative complications, readmission, and revision surgery for patients undergoing shoulder arthroplasty.
The Frequency and Severity of Complications in Surgical Treatment of Osteochondral Lesions of the Talus: A Systematic Review and Meta-Analysis of 6,962 Lesions
Authors: Hollander Julian J. , Dahmen Jari , Emanuel Kaj S. , Stufkens Sjoerd A.S. , Kennedy John G. , Kerkhoffs Gino M.M.J.
Published: March 2023

Objective

The primary aim was to determine and compare the complication rate of different surgical treatment options for osteochondral lesions of the talus (OLTs). The secondary aim was to analyze and compare the severity and types of complications.

Design

A literature search was performed in MEDLINE (PubMed), EMBASE (Ovid), and the Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Primary outcome was the complication rate per surgical treatment option. Secondary outcomes included the severity (using the Modified Clavien-Dindo-Sink Complication Classification System for Orthopedic Surgery) and types of complications. The primary outcome, the severity, and the sub-analyses were analyzed using a random effects model. A moderator test for subgroup-analysis was used to determine differences. The types of complications were presented as rates.

Results

In all, 178 articles from the literature search were included for analysis, comprising 6,962 OLTs with a pooled mean age of 35.5 years and follow-up of 46.3 months. Methodological quality was fair. The overall complication rate was 5% (4%-6%; treatment group effect, P = 0.0015). Analysis resulted in rates from 3% (2%-4%) for matrix-assisted bone marrow stimulation to 15% (5%-35%) for metal implants. Nerve injury was the most observed complication.

Conclusions

In 1 out of 20 patients treated surgically for an OLT, a complication occurs. Metal implants have a significantly higher complication rate compared with other treatment modalities. No life-threatening complications were reported.
Multiple primary malignant tumours of lung and colorectal adenocarcinoma: A case report
Authors: Ibrahim Muhammad Amin , Dashuki Nuruliman , Mohd Noor Norizal , Rusli Siti Mayuha
Published: March 2023

Multiple primary malignant tumors of lung and colorectal incidence were extremely rare and in most cases, diagnosed incidentally. Due to its rarity, most physicians consider pulmonary lesions found in patients with a history of colorectal cancer as lung metastasis. To avoid misdiagnosis and treatment delays, it is critical to properly screen and explore for possible metastasis or the occurrence of a second primary tumor after a primary cancer has been diagnosed. We describe a 72-year-old woman who presented with rectal bleeding associated with altered bowel movement. Rectal biopsy revealed colon adenocarcinoma and subsequent CT scan showed sigmoid colon mass and right lower lobe lung mass with multiple mediastinal lymphadenopathies. Biopsies of the mediastinal lymph nodes also showed adenocarcinoma. PET/CT scans showed different SUVmax of lesions in the sigmoid colon and right lower lobe, which raised the possibility of separate colonic and lung primary tumors as opposed to colonic primary with lung metastasis. Further immunohistology studies confirmed separate primary lung tumor. These diagnoses facilitate the clinical approach and define treatment options for the patient.
Online counselling for family carers of people with young onset dementia: The RHAPSODY-Plus pilot study
Authors: Perin Stephanie , Lai Rhoda , Diehl-Schmid Janine , You Emily , Kurz Alexander , Tensil Maria , Wenz Michael , Foertsch Bettina , Lautenschlager Nicola T
Published: March 2023

Objective

Compared to late life dementia, Young Onset Dementia (YOD) has its own distinct challenges, including a lack of specialised and age-appropriate support services. Carers of people with YOD experience higher levels of psychological and physical symptoms, and lower quality of life. This study (RHAPSODY-Plus) assessed the acceptability and feasibility of combining RHAPSODY (Research to Assess Policies and Strategies for Dementia in the Young; a web-based information and skill-building programme for carers of people with YOD) with individually tailored support sessions with health professionals (a social worker and a clinical psychologist) provided via online videoconferencing.

Methods

Participants (n = 20) were informal carers aged over 18 years, who were caring for a person with YOD (either Alzheimer's disease or frontotemporal dementia type). Participants used the RHAPSODY programme for 4 weeks, then attended 2 support sessions. Participants and the health professionals then attended individual feedback sessions. Feedback was collected via open-ended and Likert-style questions.

Results

The majority of carers rated the RHAPSODY-Plus programme as good to very good, demonstrating a high level of acceptability. Positive feedback about the programme included being able to receive personal advice additionally to the information provided in RHAPSODY. The healthcare professionals also thought the programme was acceptable and beneficial for access to support. Some limitations in the feasibility of videoconferencing included network and technical issues and the loss of non-verbal communication.

Conclusions

This online pilot study had a high level of acceptability, demonstrating the potential of an individualised multi-modal intervention for carers of people with YOD which offers opportunities to overcome geographical and service access barriers.
Stumbling Blocks and Alternative Paths: Reconsidering the Walkthrough Method for Analyzing Apps
Authors: Duguay Stefanie , Gold-Apel Hannah
Published: March 2023

The walkthrough method was developed as a way to trace an app or platform’s technological mechanisms and cultural references to understand how it guides users. This article explores the method’s enduring strengths and emergent weaknesses regarding technological advances and developments in app studies. It engages with adjacent methods for understanding apps’ intensifying structural and economic complexity, datafication, algorithmic logic, and personalization as well as approaches fostering a feminist ethics of care toward users. Considering these perspectives, the article discusses challenges encountered in teaching the method and applying it to algorithmically driven apps. With TikTok as a central example, examining the walkthrough process demonstrates the method’s incongruence for investigating several aspects of the app, especially its automated personalization. These challenges highlight the need to combine, supplement, or exchange the method with other approaches as part of an expanding and flexible toolkit of methods in app studies.
Social Media, the Public Sphere, and Public Space in Authoritarian Settings: A Case Study of Egypt’s Tahrir Square and 18 Years of User Generated Content
Authors: Abdulla Rasha
Published: March 2023

Taking Egypt as a case study, this article examines the relationship between social media and Habermas’ public sphere and public space in less democratic settings. Using a survey of Tahrir Square protesters and process tracing to examine 18 years of social media use, the article proposes a theoretical model highlighting the role of social media in carving out an eventful public sphere, despite the lack of public space to promote communicative action in authoritarian settings. Unlike the process described by Habermas, which takes place in democratic societies, the narratives presented in this study reveal a different pattern of communication which centers around an event through which larger issues are discussed within a defiant space. This happens through initiating conversation and drawing attention to the event, engaging counterpublics, establishing links of affinity, and possibly, calling for action. Factors influencing the success of an eventful public sphere under state control include the nature of the event, its effect on the publics, the public’s affinity to the event, potential social or cultural resistance, the amount of risk involved, and the potential scope of participation.
Severe Aortic Root Dilatation in a Patient With Larsen Syndrome
Authors: Eletta Ruth , Pandey Abinash , Dharmasaputra Tarathya , Moreno Marcial , Oparaugo Yonna , Kumar TK Susheel , Beker Susan
Published: March 2023

We present a five-year-old female diagnosed with Larsen syndrome at birth with severe aortic root dilatation, failure to thrive, and developmental delay. This report highlights the specific physical findings, imaging, genetics, and surgical treatment, along with a brief overview of Larsen syndrome.
Airway Complications After Anterior Cervical Spine Surgery: Etiology and Risk Factors
Authors: Colón Luis Felipe , Barber Lauren , Soffin Ellen , Albert Todd J. , Katsuura Yoshihiro
Published: March 2023

Study Design

Narrative Review

Objective

To provide an overview of etiology and risk factors of airway complications after anterior cervical spine surgery (ACSS).

Methods

A search was performed in PubMed and adapted for use in other databases, including Embase, Cochrane Library, Cochrane Register of Controlled Trials, Health Technology Assessment database, and NHS Economic Evaluation Database.

Results

81 full-text studies were reviewed. A total of 53 papers were included were included in the review and an additional four references were extracted from other references. 39 papers were categorized as etiology and 42 as risk factors.

Conclusions

Most of the literature on airway compromise after ACSS is level III or IV evidence. Currently, there are no systems in place to risk-stratify patients undergoing ACSS regarding airway compromise or guidelines on how to manage patients when these complications do occur. This review focused on theory, primarily etiology and risk factors.
Symptoms of Cerebrospinal Shunt Malfunction in Young Children: A National Caregiver Survey
Authors: Dorner Rebecca A. , Lemmon Monica E. , Vazifedan Turaj , Johnson Erin , Boss Renee D.
Published: March 2023

Objective: This study aimed to describe shunt malfunction symptoms in children ≤5 years old. Results: In a national survey of 228 caregivers, vomiting (23.1%), irritability (20.8%), and sleepiness (17.2%) were the most frequent symptoms of malfunction. These symptoms also occurred in over 1/3 of “false alarms” experienced by 75% of respondents. Compared with malfunctions, irritability (OR = 1.39, 95% CI [1.05, 1.85], p = 0.022) and fever (OR = 2.22, 95% CI [1.44, 3.44], p < 0.001) were more likely false alarms. Caregivers counseled about “most” symptoms were more confident detecting malfunctions than those informed of “some” (p = 0.036). The majority of caregivers (85%) first contacted a neurosurgeon with concerns about malfunction, followed by neurologists (22%) and family/friends (19%). Most (85%) struggled to differentiate malfunction from regular development. Conclusions: Vomiting, irritability, and sleepiness were the most common symptoms of shunt malfunction and false alarms for children ≤5 years. Most caregivers reported challenges differentiating malfunctions from their child's development.
Activity patterns in Broca’s area during visual short-term memory tasks
Authors: Kunimi Mitsunobu
Published: March 2023

In this study, near infrared spectroscopy (NIRS) was used to measure activity in Broca’s area during a visual short-term memory task in young and older adults, comparing brain activity during three types of stimuli (numbers, easy-to-name shapes, and hard-to-name shapes) and examining how additive language functions are involved. We hypothesized that the Broca’s area would be activated in both age groups when memorizing numbers, but not when memorizing hard-to-name shapes. The results showed that visual memory capacity is reduced in the elderly, but not when easy-to-name stimuli are used. This indicates that adding a verbal function to the input of visual information by the elderly seemingly suppresses the effects of aging on memory capacity. This result indicates that the addition of verbal functions may complement other types of cognitive functions that have declined.
The Relationship Between Coping Strategies, Compassion Satisfaction, and Compassion Fatigue During the COVID-19 Pandemic
Authors: Abou Hashish Ebtsam Aly , Ghanem Atalla Amal Diab
Published: March 2023

Introduction

The rapid spread of COVID-19 poses a significant threat to nurses’ lives and health, resulting in varying degrees of mental distress. Nurses may experience compassion fatigue, and their professional quality of life and satisfaction may suffer as a result. Their coping mechanisms may vary as well, influencing their compassionate and safe care.

Objectives

The study's objectives are to explore levels of compassion satisfaction and fatigue among nurses and identify their coping strategies. Further, to investigate the relationship between coping strategies, compassion satisfaction, and compassion fatigue during the COVID-19 pandemic.

Methods

Using a descriptive correlational design, this study was conducted with a convenience sample of 443 nurses working in an Egyptian university hospital. Nurses completed the coping strategy indicator scale and the professional quality of life (compassion satisfaction and compassion fatigue) scale. The data were analyzed using descriptive statistics, Pearson correlation, and regression analysis.

Results

Nurses’ professional quality of life was average in terms of compassion satisfaction (2.95 ± 0.92) and compassion fatigue (2.38 ± 0.35). Nurses have a moderate use of coping strategies (2.13 ± 0.35). Problem-solving was rated as the highest coping strategy, while avoidance was rated as the lowest. Coping strategies showed a positive correlation with compassion satisfaction ( r = 0.503, p < .001) and a negative correlation with compassion fatigue ( r = −0.352, p < .001). In addition, coping strategies could predict 25.4% and 12.4% of compassion satisfaction and compassion fatigue, respectively ( p < .001).

Conclusion

Compassion satisfaction and fatigue are key determinants of nurses’ quality of work life. Coping strategies, especially problem-solving and support systems, are vital to increase compassion satisfaction and mitigate burnout and secondary stress syndrome. Nurse managers should establish supportive work environments that promote nurses’ well-being. Resilience-building programs and coping strategies’ training are recommended to enhance the nurses’ quality of work life and positive work attitudes.
Developing a national dataset of bicycle infrastructure for Canada using open data sources
Authors: Ferster Colin , Nelson Trisalyn , Manaugh Kevin , Beairsto Jeneva , Laberee Karen , Winters Meghan
Published: March 2023

High-quality and consistent cycling infrastructure data are needed to advance research into equity and safety and for planning active transportation. With recent growth in cycling and investments in cycling infrastructure, there are concerns that these investments have not been equitable across communities. There is no consistent and complete national dataset for cycling infrastructure in Canada. Our goal is to develop a national cycling infrastructure dataset by (1) classifying OpenStreetMap (OSM) using the Canadian Bikeway Comfort and Safety Classification System (Can-BICS) as consistent criteria and categorisation for comfort class and infrastructure type; (2) performing a site-specific accuracy assessment by comparing the classification with more than 2000 reference points from a stratified random sample in 15 cities; and (3) presenting summary results from the national dataset. Based on reference data collected in 15 test cities, the classification had an estimated accuracy of 76 ± 3% for presence or absence of infrastructure, 71 ± 4% for comfort class and 69 ± 4% (by length) for infrastructure type. High comfort infrastructure was slightly underestimated (since bike paths were sometimes confused with multi-use paths) and low comfort infrastructure was slightly overestimated. Nationally, we identified 22,992 km of cycling infrastructure meeting Can-BICS standards and 48,953 km of non-conforming infrastructure. Multi-use paths are the most common infrastructure type by length (16.6%), followed by painted bike lanes (11.0%), and then high comfort infrastructure (cycle tracks, local street bikeways and bike paths) (4.3%). There was a wider range in access to cycling infrastructure in small cities than in medium and large cities. To reduce repeated effort assembling data and increase reproducible active transportation research, we encourage contribution to OSM.
Prolonged response after TPO-RA discontinuation in primary ITP: results of a prospective multicenter study
Authors: Guillet Stephanie , Crickx Etienne , Azzaoui Imane , chappert pascal , Boutin Emmanuelle , Viallard Jean-François , Riviere Etienne , Gobert Delphine , Galicier Lionel , Malphettes Marion , Cheze Stéphane , Lefrere Francois , Audia Sylvain , Bonnotte Bernard , Lambotte Olivier , Noel Nicolas , Fain Olivier , Moulis Guillaume , Hamidou Mohamed , Gerfaud-Valentin Mathieu , Marolleau Jean-Pierre , Terriou Louis , Martis Nihal , Morin Anne-Sophie , Perlat Antoinette , Le Gallou Thomas , Roy-Peaud Frédérique , Robbins Ailsa , Lega Jean-Christophe , Puyade Mathieu , Comont Thibault , Limal Nicolas , Languille Laetitia , Zarour Anissa , Luka Marine , Ménager Mickaël Mathieu , Belmondo Thibaut , Hue Sophie , Canoui-Poitrine Florence , Michel Marc , Godeau Bertrand , Mahevas Matthieu
Published: March 2023

Sustained response off-treatment (SROT) after thrombopoietin receptor agonist (TPO-RA) discontinuation has been reported in ITP. This prospective multicenter interventional study enrolled adults with persistent or chronic primary ITP and complete response on TPO-RAs. The primary endpoint was the proportion of patients achieving SROT (platelet count > 30x109/L and no bleeding) at W24 with no other ITP-specific medications. Secondary endpoints included the proportion of sustained complete response off-treatment (SCROT, platelet count > 100x109/L and no bleeding) and SROT at W52, bleeding events, and pattern of response to a new course of TPO-RAs. We included 48 patients with median (IQR) age 58.5 years (41-73.5); 30/48 (63%) had chronic ITP at TPO-RA initiation. In the intention-to-treat analysis, 27/48 (56.2%, 95% CI, 41.2-70.5) achieved SROT; 15/48 (31.3%; 95% CI, 18.9-44.5) achieved SCROT at W24, and 25/48 (52.1%; 95% CI, 37.2-66.7) achieved respectively SROT and 14/48 (29.2%; 95% CI, 17.2-42.3) SCROT at W52. No severe bleeding episode occurred in patients who relapsed. Among patients re-challenged with TPO-RA, 11/12 achieved CR. We found no significant clinical predictors of SROT at W24. Single-cell RNA-seq revealed enrichment of a "TNFα signaling via NF-κB" signature in CD8+ T cells of patients with no sustained response after TPO-RA discontinuation, which was further confirmed by a significant overexpression of CD69 on CD8+ T cells at baseline in these patients as compared with those achieving SCROT/SROT. Our results strongly support a strategy based of progressive tapering and discontinuation of TPO-RAs for patients with chronic ITP who achieved a stable CR on treatment. Clinical trial number: NCT03119974