bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Plasma Exovesicles and Prothrombotic Biomarkers Suggest Prethrombotic Conditions in Chagas Cardiomyopathy in Colombia
Authors: Jaimes-Dueñez Jeiczon Elim , Álvarez Karen , Eduardo-Echeverria Luis , Cáceres-Rivera Diana Isabel , Rojas Lyda Z. , Gómez-Ochoa Sergio Alejandro , Daniela-Muñoz Laura , Cantillo-Reines María , Tique-Oviedo Marisol , Eresbey-Granada Yurany , Triana-Chávez Biol Omar
Published: November 2024

Chagas cardiomyopathy (CCC) is associated with coagulation disorders that frequently culminate in thrombotic events, contributing to increased mortality rates in this clinical condition. Considering the demonstrated effect that extracellular vesicles (EVs) have on regulating inflammatory processes, coagulation, and angiogenesis, the present study aims to characterize plasma EVs and their relationship with coagulation disorders in patients with CCC. A total of 78 patients were assessed with 46.1% (36/78) representing the CCC group, 8.9% (7/78) with cardiomyopathy unrelated to Chagas disease (CM group), and 44.8% (35/78) comprising the control group, which included individuals without cardiomyopathy and negative for T. cruzi infection. Plasma EVs concentration (EVs/mL) for each individual was evaluated by flow cytometry, along with the proportion of EVs expressing PSGL-1 (PSGL-1+ EVs), Tissue Factor (TF + EVs), and CD41a (CD41a + EVs). The ability of EVs to induce platelet aggregation was evaluated by spectrophotometry. We also evaluated other prothrombotic biomarkers, including platelet count, activated partial thromboplastin time (PTT), prothrombin time (PT), and D-dimer levels. The results revealed elevated D-dimer levels in the CCC group, accompanied by a decrease in the count of EVs per mL of plasma and a significant increase in the proportion of PSGL-1+ EVs ( P < .05) compared to the control group. Other parameters did not exhibit significant differences between groups. The elevated levels of PSGL-1+ EVs in the CCC group may be attributed to myocardial inflammatory processes, which, upon interaction with platelet-derived P-selectin, could promote thrombus formation, as indicated by the increased D-dimer levels in this group.
Analysis of the visual function with the continuous transitional focus intraocular lens Precizon Presbyopic
Authors: León-Ibáñez Luis , Piñero David P
Published: November 2024

Purpose

To evaluate the clinical outcomes of a refractive multi-segmented continuous transitional focus intraocular lens (IOL), analyzing the potential influence of patient pupil dynamics on these outcomes.

Methods

Retrospective consecutive case series study enrolling 40 eyes (20 patients, 47–81 years) implanted with the Precizon Presbyopic IOL (Ophtec BV). The following clinical outcomes were analyzed during a mean follow-up of 12.1 months (2–24 months): visual acuity, refraction, contrast sensitivity (CS) under photopic and mesopic conditions, binocular defocus curve and evaluation of the perception of disturbing visual symptoms with a validated questionnaire.

Results

Mean binocular uncorrected distance (UDVA), distance-corrected intermediate (DCIVA), uncorrected near (UNVA) and distance-corrected near visual acuities (DCNVA) were −0.09 ± 0.07, 0.04 ± 0.05, 0.17 ± 0.12, and 0.15 ± 0.10 logMAR, respectively. In the binocular defocus curve, mean distance-corrected visual acuity was over 0.20 logMAR for defocus levels from +1.50 to −3.00 D. No significant correlations of photopic pupil diameter with postoperative visual data were found (−0.165 ≤ r ≤ 0.192, p ≥ 0.235). Moderate correlations of mesopic pupil size were found with visual acuities for the defocus levels of −2.50 ( r = 0.454, p = 0.003), −3.00 ( r = 0.609, p < 0.001), −3.50 ( r = 0.519, p < 0.001), and −4.00 D ( r = 0.403, p = 0.010). Only significant differences were found between mesopic and photopic CS for 12 cycles/degree ( p = 0.010). No cases of severe glare or halos were detected. In contrast, 10% of patients referred the severe perception of starbursts postoperatively. Full spectacle independence was referred by almost all patients (90%).

Conclusions

The IOL demonstrates effective visual restoration at various distances, characterized by high levels of visual quality and minimal dependence on pupil dynamics.
Seasonality gaps and markets: A new methodology
Authors: Duro Juan Antonio , Turrión-Prats Judith
Published: November 2024

The specific seasonality gaps for any destination could be explained by the relevance of differential market specialisation vectors. In this sense, this paper proposes a novel methodology that allows us to precisely isolate the role played by specific specialisation (i.e., the structural component) and by the factors that affect every market (i.e., the transversal component) in determining the seasonality gaps. We understand that the results can be of interest to researchers and policy makers. The proposed methodology is applied, as an empirical exercise, to the analysis of inequalities in hotel demand seasonality for the main Spanish provinces over the 2006-2019 period. The results would indicate not only the existence (and increase) of disparities in seasonality at the territorial level, but also the greater weight of the transversal component compared to the structural component as a determinant of the gap.
Fast calculation of vehicle-road coupled response based on moving frequency response function
Authors: Zhang Qingxia , Hou Jilin , Li Chao , Jankowski Łukasz , An Xinhao , Duan Zhongdong
Published: November 2024

Vehicle–road coupled system is inherently time–varying, and its responses are traditionally calculated using time–domain methods which involves significant computational effort. Aiming to improve the efficiency of response calculation for the coupled system, this paper proposes a fast calculation method in frequency domain, based on the newly developed moving frequency response function (FRF). Firstly, considering the vibration characteristics of an infinitely long road, the road response is straightforwardly expressed using the road impulse response function (IRF). Subsequently, the concept of the road moving IRF is proposed and derived with respect to the moving observation points. The moving FRF is then obtained by applying Fourier transform, which allows the responses of the road moving observation points to be established in frequency domain for fast calculation under moving loads. Furthermore, by analyzing the vehicle–road coupled vibrations, based on the vehicle FRF and road moving FRF, a formula for the vehicle–road coupling force is derived in frequency domain, along with an expression for the responses at the vehicle–road contact points. Finally, the approach is illustrated in numerical simulations of vehicle–road coupled systems, and its computational efficiency and accuracy are verified through comparison with currently popular methods.
More Than a Theory: Conspiracy Theorising As a Practical Tradition
Authors: Koper Adam J
Published: November 2024

In answering the question, ‘What is a conspiracy theory?’ scholars typically take an epistemological view, with many asking whether the term’s pejorative use as a marker of obvious falsehood is justified. Especially among philosophers, a consensus has emerged that conspiracy theories should not be dismissed as prima facie false, that each should be judged on its own merits. However, while some philosophers have encouraged social scientists to embrace this epistemological view of conspiracy theories, this article argues that it is less useful for those of us working in political studies. We are right to worry about being too dismissive of all charges of conspiracy, but conspiracy theorising involves more than just making truth claims; it is about politics, history and culture too. In approaching it through the narrow lens of epistemology, we miss much of what is happening in conspiracy theorising. My aim in this article is to offer a new framework for analysing conspiracy theorising as a practice, rather than as a category of explanation. This framework builds on Michael Billig and Jovan Byford’s idea of the conspiracy theory tradition, showing conspiracy theorising to involve the recycling and adaptation of pre-existing ideas, themes and texts to fit new situations.
Screening for Diabetic Peripheral Neuropathy: Subjective Versus Objective Measures
Authors: Pleven Stephanie , Papanas Nikolaos , Gatt Alfred , Formosa Cynthia
Published: November 2024

This study compared subjective screening modalities recommended in diabetic foot screening guidelines for the detection of diabetic peripheral neuropathy (DPN) with an objective measure, the NC-Stat DPNCheck®. We assessed 63 participants (mean age 54.5 years ± 10.5) utilising subjective screening tools (Semmes-Weinstein 10-g monofilament, 128-Hz traditional tuning fork, neurothesiometer, O’Brien 128-Hz electronic tuning fork) and compared results with the objective automated sural nerve conduction test NC-Stat DPNCheck®. A significant difference was found in the number of limbs classified with DPN between all screening tools ( P < .05). Therefore, this suggests that some screening modalities are more sensitive in diagnosing DPN than others, highlighting the importance of using multiple screening tools to a comprehensive understanding of the patient's neurological status. The findings also emphasize the need to incorporate objective measures in diabetic foot screening and encourage future research to establish a gold standard tool for DPN diagnosis.
High-intensity focused ultrasound in adenomyosis treatment: Insights on safety, efficacy, and reproductive prospects
Authors: Bahutair Shadha Nasser , Alhubaishi Laila Yahya
Published: November 2024

The management of adenomyosis has undergone significant evolution, moving from traditional surgical interventions like hysterectomy to more conservative methods aimed at preserving fertility. Essential roles have been played by uterine-sparing surgeries and uterine artery embolization. Despite these advancements, there is a growing interest in less invasive alternatives. This review delves into the potential of high-intensity focused ultrasound (HIFU). HIFU employs focused ultrasound waves for precise ablation of adenomyotic lesions. The review conducts a thorough analysis of HIFU principles, safety, efficacy, and its possible synergies with other therapies. HIFU seems to be effective for adenomyosis treatment, demonstrating a favorable adverse effect profile and suitability for fertility preservation. Combining HIFU with hormonal treatment appears to enhance long-term symptom control, presenting a promising and comprehensive approach for managing adenomyosis. The goal of this article is to develop a comprehensive understanding of HIFU’s role in contemporary adenomyosis management and to explore areas requiring further research.
Comparison of three different ice hockey helmets using an ice hockey specific test protocol
Authors: Champoux Luc , Post Andrew , Gilchrist Michael D , Hoshizaki Thomas
Published: November 2024

Although there are currently no standard tests measuring rotational head motion for ice hockey, researchers have proposed test methods which induce rotational head motion from an impact and may reflect more closely how concussions occur in the sport. Recently, Meehan et al. developed a test method for ice hockey helmets to represent concussive injuries associated with ice hockey. While that provided a method that used impact parameters closer to what may be experienced, the research did not evaluate if different helmets would produce differing results under those loading conditions. The purpose of this study is to use the methods developed by Meehan et al. to evaluate the protective capacity of three different ice hockey helmet designs. This research used monorail drop rig and pneumatic ram systems to follow the protocol of Meehan with a bare headform condition and three different helmet designs, allowing for differences in linear and rotational acceleration, rotational velocity, and maximum principal strain to be determined. The results of this research found that the test method developed by Meehan et al. does result in significant differences between different helmets and helmet designs under identical impact conditions. However, these differences were limited which may be a reflection of the test method as well as commonality in terms of how ice hockey helmets are designed; the different models may not be sufficiently different enough to provide different results under these loading conditions.
Bone block options for treating glenoid bone loss and glenohumeral instability: A systematic review
Authors: Briggs Damon V , Hurley Eoghan T , Warren Eric , Amanah Alaowei Y , Levin Jay M , Lau Brian C , Dickens Jonathan F , Klifto Christopher S , Anakwenze Oke
Published: November 2024

Background

To systematically review the literature assessing glenoid bone loss restoration by different bone block options and compare their dimensions.

Methods

Systematic examination of articles in PubMed and EMBASE databases was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to find studies of bone grafts for treating anterior glenohumeral instability. Statistical analyses were conducted via Review Manager, and a p-value of <0.05 was statistically significant.

Results

Our review included 25 studies evaluating 870 shoulders. Traditional arc Latarjet (TL) had more depth than congruent arc Latarjet (CAL; p = 0.003). The coronal radii of curvature of TL, CAL, distal tibia, and iliac crest bone blocks were similar to native glenoid ( p = 0.400, 0.817, 0.467, 0.216, respectively). CAL coracoid bone blocks restored significantly more glenoid surface area (30.3%) than TL bone blocks ( p = 0.012). The glenoid width and surface area restoration by distal clavicle bone blocks were equivalent to TL ( p = 0.058 and p = 0.103, respectively).

Discussion

The CAL technique restored higher percentages of glenoid surface area than TL but has less depth, which may increase fracture risk during screw insertion. The distal clavicle bone block is a suitable substitute to TL as it was equivalent regarding glenoid width and surface area restoration.
Determining the optimum dose of remifentanil in combination with propofol for total intravenous anaesthesia in hysteroscopy under Narcotrend and SPI monitoring
Authors: Zhang Xiaoyu , Xu Tao , An Xiaohu , Wang Jianwei , Meng Qiong , Xu Zifeng
Published: November 2024

Background:

Outpatient hysteroscopic surgery requires patients to be anaesthetised and recover quickly, and the drugs used must be safe and effective. Remifentanil is typically co-administered with propofol as total intravenous anaesthesia (TIVA) for hysteroscopy because of its favourable pharmacokinetic and pharmacodynamic properties. However, the optimal dose of remifentanil when co-administered with propofol without neuromuscular blocking agents (NMBAs) has not been established.

Objectives:

In this sequential dose-finding study, the 90% effective dose (ED90) of remifentanil effect-site concentration (Ce) combined with propofol without NMBAs during outpatient hysteroscopy was calculated to minimise the side effects of using higher doses.

Design:

This sequential dose-finding study was conducted in August 2022.

Methods:

Forty patients who underwent outpatient hysteroscopy under TIVA were included in the study. With a biased coin up-and-down design, the initial remifentanil Ce was established at 2 ng/mL, and the subsequent remifentanil dosage was determined based on the reaction of the previous patient. The primary outcome was a remifentanil Ce that resulted in successful TIVA by maintaining a Narcotrend index < 60, surgical pleth index (SPI) < 50, and without patient movement throughout hysteroscopy. Secondary outcomes included rates of hypotension-related symptoms and interventions, drug consumption, post-anaesthesia care unit (PACU)-estimated visual analogue scale (VAS) and Ramsay sedation scores, modified Aldrete scores, and other adverse effects of anaesthesia. The ED90 and 95% confidence intervals (CI) were estimated using isotonic regression methods and bootstrapping.

Results:

For TIVA without NMBAs during outpatient hysteroscopy, the ED90 Ce of remifentanil combined with propofol was determined to be 2.75 ng/mL (95% CI, 2.50–3.00 ng/mL). The incidence of peri-operative adverse effects of anaesthesia was relatively low. All the patients had satisfactory VAS, Ramsay sedation, and modified Aldrete scores in the PACU.

Conclusion:

Remifentanil at a Ce of 2.75 ng/mL is recommended for TIVA combined with propofol in outpatient hysteroscopic surgery.

Trial registration:

http://www.chictr.org.cn (ChiCTR2200062284; 31/7/2022).
Application of privacy protection technology to healthcare big data
Authors: Shin Hyunah , Ryu Kyeongmin , Kim Jong-Yeup , Lee Suehyun
Published: November 2024

With the advent of the big data era, data security issues are becoming more common. Healthcare organizations have more data to use for analysis, but they lose money every year due to their inability to prevent data leakage. To overcome these challenges, research on the use of data protection technologies in healthcare is actively underway, particularly research on state-of-the-art technologies, such as federated learning announced by Google and blockchain technology, which has recently attracted attention. To learn about these research efforts, we explored the research, methods, and limitations of the most widely used privacy technologies. After investigating related papers published between 2017 and 2023 and identifying the latest technology trends, we selected related papers and reviewed related technologies. In the process, four technologies were the focus of this study: blockchain, federated learning, isomorphic encryption, and differential privacy. Overall, our analysis provides researchers with insight into privacy technology research by suggesting the limitations of current privacy technologies and suggesting future research directions.
An IoT-based cognitive impairment detection device: A newly proposed method in older adults care—choice reaction time-device development and data-driven validation
Authors: Vizitiu Cristian , Stara Vera , Antognoli Luca , Dinculescu Adrian , Mosoi Adrian , Kristaly Dominic M. , Nistorescu Alexandru , Rampioni Margherita , Dominey Kevin , Marin Mihaela , Rossi Lorena , Moraru Sorin-Aurel , Vasile Costin-Emanuel , Dugan Cosmin
Published: November 2024

Background

Research shows that older adults' performance on choice reaction time (CRT) tests can predict cognitive decline. A simple CRT tool could help detect mild cognitive impairment (MCI) and preclinical dementia, allowing for further stratification of cognitive disorders on-site or via telemedicine.

Objective

The primary objective was to develop a CRT testing device and protocol to differentiate between two cognitive impairment categories: (a) subjective cognitive decline (SCD) and non-amnestic mild cognitive impairment (na-MCI), and (b) amnestic mild cognitive impairment (a-MCI) and multiple-domain a-MCI (a-MCI-MD).

Methods

A pilot study in Italy and Romania with 35 older adults (ages 61–85) assessed cognitive function using the Mini-Mental State Examination (MMSE) and a CRT color response task. Reaction time, accuracy, and demographics were recorded, and machine learning classifiers analyzed performance differences to predict preclinical dementia and screen for mild cognitive deficits.

Results

Moderate correlations were found between the MMSE score and both mean reaction time and mean accuracy rate. There was a significant difference between the two groups’ reaction time for blue light, but not for any other colors or for mean accuracy rate. SVM and RUSBoosted trees were found to have the best preclinical dementia prediction capabilities among the tested classifier algorithms, both presenting an accuracy rate of 77.1%.

Conclusions

CRT testing with machine learning effectively differentiates cognitive capacities in older adults, facilitating early diagnosis and stratification of neurocognitive diseases and can also identify impairments from stressors like dehydration and sleep deprivation. This study highlights the potential of portable CRT devices for monitoring cognitive function, including SCD and MCI.
Telerehabilitation solutions in patient pathways: An overview of systematic reviews
Authors: Nicolas Benoit , Leblong Emilie , Fraudet Bastien , Gallien Philippe , Piette Patrice
Published: November 2024

Background

Telerehabilitation (TR), a branch of telemedicine, provides remote therapeutic rehabilitation through telecommunication. Driven by technological advances and benefits like remote monitoring and patient education, it has grown since 1998. The Coronavirus Disease 2019 (COVID-19) pandemic highlighted its importance in maintaining healthcare access.

Research question

What is the efficacy of TR compared to in-person rehabilitation? Are the assessment tools effective? Is TR well-accepted, and are costs reduced?

Methods

A bibliographic search on Medline, Cochrane and Google Scholar focused on systematic reviews (SRs) from 2014 to Mai 2024, comparing TR or home-based rehabilitation with in person treatments for various conditions. Independent reviewers conducted initial screenings, resolving disagreements by a third reviewer. Joanna Briggs Institute Critical Appraisal Checklist was used to evaluate the quality of review. The data was synthesised narratively.

Results

The search identified 665 SRs. After selection, 228 SR were included. TR models include synchronous (real-time video interactions), asynchronous (independent sessions through digital platforms) and mixed methods. Regardless of the medical fields, the conclusions of the SRs consistently point to the equivalence of TR compared to in-person rehabilitation. Remote evaluations via digital tools were reliable and valid for various assessments. TR is cost effectiveness and well accepted.

Conclusions

TR is a viable alternative or complement to traditional rehabilitation, offering enhanced accessibility, reduced costs and improved results. Barriers include technical issues, training and concerns about lack of physical contact. Mixed methods could address these challenges.
Mental Health Outcomes for Young People Accessing Individual Placement Support Services: A Cohort Study
Authors: Telford Nic , Albrecht Sabina , Wilkin Alice , Watts Carolyn , Rickwood Debra
Published: November 2024

Objective:

Mental health problems and vocational disengagement are often linked for young people in a self-reinforcing cycle. Integrated Individual Placement and Support (IPS) services can help to not only overcome educational/vocational challenges but also improve mental wellbeing.

Methods:

In a matched cohort study, we compared improvement rates in mental health and wellbeing outcomes for young people aged 15 to 25 who had received at least two integrated IPS services with those who had received standard youth mental health services only. Data came from headspace, Australia’s National Youth Mental Health Foundation. The sample comprised 2128 participants: 544 received integrated IPS services; 1584 received standard mental health services.

Results:

Four out of five IPS clients (81%) achieved positive outcomes on at least one of three mental health measures, a significantly higher proportion than matched clients who received standard services (75%). Logistic regressions estimated a 22% to 36% higher likelihood of achieving significant improvement for IPS clients. Greater improvements were evident for quality of life and potentially psychosocial functioning, but not psychological distress.

Conclusions:

Integrating an IPS program within a clinical setting not only achieves positive vocational outcomes, but also supports improvements in quality of life, psychosocial functioning and psychological distress that are greater or equal to the outcomes achieved through standard clinical care.
Government Ownership, Political Regime, and Flipping of IPOs in Pakistan: Evidence from Emerging Market
Authors: Anwar Ayesha , Mohd-Rashid Rasidah , Che-Yahya Norliza , Bouteraa Mohamed , Chekima Brahim
Published: November 2024

This study investigates how government ownership (state-owned IPOs) and the political regime affect the flipping of IPO shares, as well as the moderating impact of investor demand on the association between the political regime and flipping activity. Ordinary least square was employed to investigate the impact of government ownership and political regime on the flipping of IPO shares. The data set consists of 95 IPO firms listed on the Pakistan Stock Exchange (PSX) during the period of January 2000 to December 2019. The findings of this study reveal that government ownership and a political regime have a positive influence on the flipping of IPO shares, demonstrating the quality that creates liquidity in Pakistan’s IPO market. Furthermore, in Pakistan, investor demand has been reported to moderate the association between the political regime and IPO flipping activity. This research offers valuable insights that may result in abnormal trading behavior or flipping immediately after listing. Likewise, state-owned IPOs and the political regime appear to be more appealing to investors, signaling the firms’ high quality, causing in increased demand and higher levels of flipping. As a result, the government and regulators may devise policies to control unusual trading, ensuring that government investments in the capital market are successful and also that the government’s economic and political objectives are met. Moreover, this research is critical for investors and issuers making investment decisions.

JEL Classification: G12, G18, G32.
Influence of Diabetes Mellitus on Neurological Recovery in Older Patients With Cervical Spinal Cord Injury Without Bone Injury: A Retrospective Multicenter Study
Authors: Takeda Kazuki , Watanabe Kota , Nori Satoshi , Yamane Junichi , Kono Hitoshi , Yokogawa Noriaki , Sasagawa Takeshi , Nakashima Hiroaki , Segi Naoki , Funayama Toru , Eto Fumihiko , Furuya Takeo , Yunde Atsushi , Nakajima Hideaki , Yamada Tomohiro , Hasegawa Tomohiko , Terashima Yoshinori , Hirota Ryosuke , Suzuki Hidenori , Imajo Yasuaki , Ikegami Shota , Tonomura Hitoshi , Sakata Munehiro , Hashimoto Ko , Kawaguchi Kenichi , Suzuki Nobuyuki , Uei Hiroshi , Nakanishi Kazuo , Terai Hidetomi , Inoue Gen , Kiyasu Katsuhito , Iizuka Yoichi , Akeda Koji , Funao Haruki , Oshima Yasushi , Kaito Takashi , Yoshii Toshitaka , Ishihara Masayuki , Okada Seiji , Imagama Shiro , Kato Satoshi
Published: November 2024

Study Design

Retrospective study.

Objectives

To investigate the impact of diabetes mellitus on neurological recovery and determine the relationship between moderate-severe diabetes and neurological recovery in patients with cervical spinal cord injury (CSCI) without bone injury.

Methods

A retrospective study was conducted on 389 consecutive patients aged ≥65 years with CSCI without bone injury across 33 medical institutes. The patients were divided into a nondiabetic group (n = 270) and a diabetic group (n = 119). Neurological outcomes were compared between the two groups through propensity score matching. The impact of moderate-severe diabetes (defined as hemoglobin A1c ≥ 7.0% or requiring insulin treatment) on neurological recovery was evaluated through multiple linear regression analysis.

Results

Propensity score matching revealed no significant differences between the diabetic and nondiabetic groups in terms of American Spinal Injury Association (ASIA) impairment scale grade and mean total ASIA motor scores (AMS) at 6 months post-injury. Multiple linear regression analysis indicated that age on admission (B = −0.34; 95% confidence interval [CI], −0.59 to −0.08; P = 0.01), dementia (B = −16.50; 95% CI, −24.99 to −8.01; P < 0.01), and baseline total AMS (B = −0.62; 95% CI, −0.72 to −0.51; P < 0.01) were negative predictors of neurological recovery at 6 months post-injury. The presence of moderate-severe diabetes did not influence neurological recovery at 6 months post-injury.

Conclusions

Diabetic patients with CSCI without bone injury achieved improvements in neurological function comparable to those of nondiabetic patients. Moderate-severe diabetes did not affect neurological recovery in patients with CSCI without bone injury.
Time Required to Achieve Clinically Significant Outcomes After Anteroinferior Arthroscopic Capsular Release for Shoulder Adhesive Capsulitis
Authors: Pasqualini Ignacio , Rossi Luciano Andrés , Oyem Precious C. , Tanoira Ignacio , Hurley Eoghan T. , Ranalletta Maximiliano
Published: November 2024

Background:

The specific time required to reach clinically significant outcomes for patient-reported outcome measures (PROMs) after arthroscopic capsular release (ACR) for the treatment of shoulder adhesive capsulitis remains unknown.

Purposes:

To determine the time required to achieve the minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) score thresholds after ACR for visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons score (ASES), Single Assessment Numeric Evaluation (SANE), and Constant score and to identify patient factors associated with delayed achievement of these clinical benchmarks.

Study Design:

Case series; Level of evidence, 4.

Methods:

A prospective analysis was performed of patients who underwent ACR for the treatment of idiopathic shoulder adhesive capsulitis between October 2019 and October2020. Patients completed PROMs preoperatively and at 1, 2, 4, 6, and 12 months postoperatively. Threshold values for MCID and PASS were obtained from previous literature for the VAS, ASES, SANE, and Constant scores.

Results:

A total of 73 patients were included (mean age, 55.5 ± 9.3 years; body mass index [BMI], 26.6 ± 4.6 kg/m2). By 1-year follow-up, the cumulative percentage of patients achieving the MCID and PASS for VAS, ASES, SANE, and Constant scores was 98.6%, 100%, 100%, and 98.6%, and 95.8%, 91.7%, 98.6%, and 84.9%, respectively. The median time required to reach the MCID thresholds for VAS, ASES, SANE, and Constant scores was 1, 1, 2, and 1 month, respectively. The median time required to reach the PASS thresholds for VAS, ASES, SANE, and Constant scores was 4, 4, 4, and 2 months, respectively. Factors associated with delayed achievement of MCID for SANE included higher BMI (hazard ratio [HR], 0.94; 95% CI, 0.88-0.99) and diabetes (HR, 0.49; 95% CI, 0.2-0.99). Age was associated with delayed achievement of the PASS for VAS.

Conclusion:

Most patients undergoing ACR achieved clinically significant outcomes within a 4-month timeframe. The majority of patients reached MCID thresholds on outcome measures within 1 to 2 months and achieved satisfactory symptom states within 2 to 4 months postoperatively. By delineating the timeline of patient-perceived benefits, these results provide useful data to set appropriate expectations, guide rehabilitation, and optimize outcomes after ACR.
Behind the Scenes of Isotretinoin: My Journey and Recommendations
Authors: Singh Nupur
Published: November 2024

Isotretinoin is a form of Vitamin A used in treatment of severe, refractory acne vulgaris with treatment duration ranging anywhere from 3 to 12 months. The side effects of isotretinoin require monthly dermatologist visits and utilize a risk-management program called iPLEDGE REMS run by the Federal Drug Administration (FDA), which verifies that patients are not pregnant while starting or while taking isotretinoin. The physical and mental side effects experienced on isotretinoin are unique to each patient and can be severely debilitating. My own experience taking isotretinoin for 8 months was filled with multiple unexpected side effects that affected both my physical and mental health. As a result, I strongly believe dermatologists should help patients in analyzing the risk versus benefit profile of isotretinoin, present all other options, and ultimately emphasize patient-provider shared-decision making. Furthermore, at monthly visits dermatologists should be required to implement open dialogue regarding side effects to avoid patient feelings of fear and shame. Additionally, the iPLEDGE REMS system should consider creating a systematic documentation of symptoms to help normalize experiences and guide treatment plans.
Empowering or Exhausting? COVID-19 Experiences of Accredited Social Health Activists (ASHA) in Kerala
Authors: Krishna Niyathi R.
Published: November 2024

The study aims to understand the nature and intensity of Accredited Social Health Activists’ (ASHAs) work and its gendered significance in social and healthcare contexts, specifically during the COVID-19 scenario, by critically exploring the family, community and state responses as well as the work’s impact on their personal, relational and environmental levels. Employing a qualitative survey method, in-depth interviews were carried out with 52 ASHAs shortly after the pandemic. The findings reveal that while ASHAs view the altruistic, community service aspect of their work as empowering, the state must recognise the burden of underpaid community care work on women, which is exhausting and contributes to time poverty and a lack of leisure. This study advocates for policy interventions to regularise ASHAs’ services and increase their remuneration from a gender justice perspective.
Fostering timely integrated palliative care in nursing homes through critical companionship: experiences from a Padi-Palli interventional study in France
Authors: Bagaragaza Emmanuel , Umubyeyi Benoite , Leboul Danièle
Published: November 2024

Background:

One of the fundamental pillars of integrating a palliative approach in nursing home care is increasing professional competencies and institutional capacity. However, conventional training designs have been proven to fall short of supporting this integration. This paper details the results of a practice development intervention that used critical companionship as a learning design to facilitate the integration of a palliative approach in the care of nursing home residents in France.

Objectives:

This study aimed to explore the perceived outcomes of Padi-Palli critical companionship in supporting the integration of a palliative approach in the care of residents in nursing homes in France.

Design:

Qualitative multiple case study situated within a constructivist theoretic lens.

Methods:

This qualitative multiple case study is part of a larger interventional mixed-method study. Nurses with palliative care clinical expertise facilitated experiential learning with nursing home professionals for 10 months spread across three phases. At the end of the intervention, a purposive sampling method was used to select professionals from six nursing homes that participated, including leaders and critical companions. Focus groups and individual interviews were used to collect data between February 2023 and March 2024. Data analysis followed Braun and Clarke’s reflexive thematic analysis.

Results:

Four interrelated themes explained how Padi-Palli critical companionship enhanced the palliative care competencies of professionals, improved nursing home palliative care practices, supported organisational practices for palliative care and facilitated collaborative learning at the bedside. The collaborative and co-creative principles that informed the delivery of the Padi-Palli critical companionship program facilitated a culture shift towards integrating a palliative approach in resident care at individual, team and organisational levels.

Conclusion:

Critical companionship offers an innovative practice development approach that can support the delivery of timely palliative care for residents in nursing homes.

Trial registration:

ID-RCB 2020-A01832-37.
Solidarity Building in Antagonistic Political Discourse on GhanaWeb
Authors: Agbaglo Ebenezer
Published: November 2024

The advancement of technology has seen the growth of online news platforms where users can interact and share their views in the comments section. The comments section, therefore, has become a site for the expression of divergent views, leading to linguistic practices such as verbal attacks. This study sourced data from GhanaWeb, an online news platform that focuses on sociopolitical occurrences in Ghana, to demonstrate how users rely on insults, alongside other strategies like endorsement, irrelevancy claims, ill-wishes and unpalatable questions to create enmity with the out-group and build solidarity with the in-group. It was also found that there were cases where two participants or commenters who seem to share the same viewpoint were challenged by a third participant. This study makes a fair contribution to the emerging research on the linguistic practices on online communication platforms and highlights areas for further inquiry.
Mechanical Properties Optimization and Microstructure Analysis of Pure Copper Heterostructured Laminates via Rolling
Authors: Gao Zhihui , Wang Tao , Zhao Yunlai , Ding Hua , Huang Qingxue
Published: November 2024

Heterogeneous metallic structures constitute a novel class of materials with excellent mechanical properties. However, the existing process for obtaining heterostructures from a single material does not meet large-scale industrial requirements. In this study, a pure copper heterostructured laminate (HSL) composed of a surface elongated-grain layer and a central equiaxed-grain layer was fabricated by rolling bonding and annealing. To study the effect of the interface on the mechanical properties of gradient-structured materials, both laminate metal composite (LMC) and non-composite laminate (NCL) were fabricated by cold-rolling pretreatment of the center layer (60% reduction) and cold-rolling bonding of the whole blank (67% reduction). Then, the HSL was obtained by controlling the post-annealing regimes, the microstructure of each layer was optimized, and a larger degree of microstructural heterogeneities, such as grain size, misorientation angle, and grain orientation, was obtained, which resulted in obvious mechanical differences. Tensile tests of the HSL, surface layer, center layer, and NCL specimens revealed that the HSL annealed at 300 °C for 1 h had a significantly higher strength than the center layer and a higher elongation than the surface layer. The HSL had a tensile strength and elongation at fracture of 278.08 MPa and 46.2%, respectively, indicating a good balance of strength and plasticity. The improved properties were primarily attributed to the strengthening or strain hardening due to the inhomogeneous deformation of the heterogeneous layers in the laminate and the mutual constraint acquired by the distinct layers with strong mechanical differences. The HSL had an interfacial bonding strength of 178.5 MPa, which played a vital role in the coordinated deformation of the heterogeneous layers. This study proposes an HSL design method that effectively simplifies the process of obtaining heterostructures in homogeneous materials by controlling the cumulative deformation of the surface and center layers.
The effect of phenotyping, adult selection, and mating strategies on genetic gain and rate of inbreeding in black soldier fly breeding programs
Authors: Slagboom Margot , Nielsen Hanne Marie , Kargo Morten , Henryon Mark , Hansen Laura Skrubbeltrang
Published: November 2024

Background

The aim of this study was to compare genetic gain and rate of inbreeding for different mass selection breeding programs with the aim of increasing larval body weight (LBW) in black soldier flies. The breeding programs differed in: (1) sampling of individuals for phenotyping (either random over the whole population or a fixed number per full sib family), (2) selection of adult flies for breeding (based on an adult individual’s phenotype for LBW or random from larvae preselected based on LBW), and (3) mating strategy (mating in a group with unequal male contributions or controlled between two females and one male). In addition, the numbers of phenotyped and preselected larvae were varied. The sex of an individual was unknown during preselection and females had higher LBW, resulting in more females being preselected.

Results

Selecting adult flies based on their phenotype for LBW increased genetic gain by 0.06 genetic standard deviation units compared to randomly selecting from the preselected larvae. Fixing the number of phenotyped larvae per family increased the rate of inbreeding by 0.15 to 0.20% per generation. Controlled mating compared to group mating decreased the rate of inbreeding by 0.02 to 0.03% per generation. Phenotyping more than 4000 larvae resulted in a lack of preselected males due to the sexual dimorphism. Preselecting both too few and too many larvae could negatively impact genetic gain, depending on the breeding program.

Conclusions

A mass selection breeding programs in which the adult fly is selected based on their larval phenotype, breeding animals mate in a group and sampling larvae for phenotyping at random over the whole population is recommended for black soldier flies, considering the positive effect on rates of genetic gain and inbreeding. The number of phenotyped and preselected larvae should be calculated based on the expected female weight deviation to ensure sufficient male and female candidates are selected.
Exploring public perception and utilization of medication home delivery services in the United Arab Emirates: a cross-sectional study
Authors: Jirjees Feras , Othman Amna M , Odeh Mohanad , AlObaidi Hala , Kharaba Zelal , Adhari Hawraa , Elshenawy Menna , Almaazmi Fatima , Bashi Yahya H Dallal , Aldeyab Mamoon A , Al-Azayzih Ahmad , Farha Rana Abu , Eissa Nermin , Alzoubi Karem H
Published: November 2024

Introduction

The Medication Home Delivery (MHD) service from community pharmacies involves the safe and efficient delivery of pharmaceuticals (prescription and non-prescription medications), and health products directly to the patient’s/consumer’s home. There are several issues encountered by the users of the MHD service that have an impact on their satisfaction with the service. The study aimed to assess the public’s perceptions of the MHD service in the United Arab Emirates (UAE), their willingness to utilize it, and the practical use of the service.

Method

A cross-sectional exploratory study was conducted in the UAE using a validated online survey. The inclusion criteria were adults residing in the UAE. Statistical analysis was performed to identify the association between the variables, the service use, and the level of service efficiency.

Results

A total of 556 participants filled out the survey, with 69.4% of them using the service. The majority of participants were females (75.9%) and aged less than 40 years old (71.6%). Three variables showed a statistically significant association with the use of the MHD service (P < 0.05): the participant’s educational level, their medical/health background, and the frequency of visits to community pharmacies. The most common issues raised were receiving the wrong order, delay in delivery, and paying delivery fees. Most participants agreed that the MHD service reduces the risk of exposure during pandemics, serves the elderly, serves disabled people, makes it more comfortable for parents with children at home, and reduces overcrowding in health facilities, as well as the MHD service making pharmacy services more efficient.

Conclusion

The study indicated positive perceptions among the public in the UAE towards the MHD service. However, there was a concern that this service may diminish the communication between pharmacists and patients, which potentially minimizes the amount of information received by patients regarding their treatments.
General health and social outcomes 50 years after exposure to antenatal betamethasone: follow-up of a randomised controlled trial
Authors: Walters Anthony G. B. , Gamble Greg D. , Crowther Caroline A. , Dalziel Stuart R. , Eagleton Carl L. , McKinlay Christopher J. D. , Milne Barry J. , Harding Jane E.
Published: November 2024

Background

Antenatal corticosteroids are recommended for women at risk of preterm birth from 24 to 34 weeks’ gestation as they reduce neonatal morbidity and mortality, but evidence regarding their long-term effects on offspring is limited. This study assessed general health and social outcomes 50 years after antenatal exposure to corticosteroids.

Methods

We assessed 424 adult offspring of women who participated in the first randomised, double-blind, placebo-controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. The first 717 mothers received two intramuscular injections of betamethasone (6 mg betamethasone sodium phosphate and 6 mg betamethasone acetate) or placebo given 24 h apart and the subsequent 398 received two injections of double dose betamethasone (12 mg betamethasone sodium phosphate and 12 mg betamethasone acetate) or equivalent volume of placebo. Follow-up included a health questionnaire and consent for access to administrative data sources. Outcome categories included mental health (depression, anxiety, bipolar affective disorder, schizophrenia and treatment or hospital admission for any mental health disorder), general health (chronic kidney disease, cancer diagnosis, bone fracture, oral health, allergies, functional difficulties and physical activity) and social outcomes (educational attainment, employment and criminal convictions). Investigators remained blinded to treatment allocation. Analyses were adjusted for gestational age at entry, sex and clustering.

Results

We assessed 424 adult offspring (46% of survivors; mean [SD] age 49.3 [1.0] years; 212 [50%] female). There was no difference in mental health, general health and social outcomes between those exposed to betamethasone and those exposed to placebo, with the exception that osteoporotic site fracture in adulthood was more likely to have occurred in the betamethasone group compared with placebo (adjusted relative risk 1.57, 95% CI 1.00, 2.48, p = 0.05). No dose–effect relationship was evident and there was no difference in the proportion with at least one fracture. Follow-up rate and lack of in-person assessments were the main limitations.

Conclusions

There is no evidence that antenatal corticosteroids have clinically important effects on general health and social outcomes up to 50 years of age.