bluuebunny/crossref_metadata_2025 huggingface dataset:
Adult Refugees and Asylum Seekers in University Preparation Programs: Competing Identities and Multiple Transitions Manifested in Stigma Consciousness and Student Self-Identification
Authors: Grüttner Michael , Schröder Stefanie , Berg Jana
Published: February 2024

Preparation for university studies is key to enabling adult refugees and asylum seekers to reestablish their educational and professional careers in the host country. While refugees’ transition to higher education (HE) is embedded in multiple transitions regarding social position, educational career, and migration, related identities may compete. We investigate how this is manifested in stigma consciousness and precarious student self-identification and how these factors influence the transition to HE. We combine novel quantitative and qualitative data on refugee students in prestudy programs in Germany. The results show that stigma consciousness impedes student self-identification. Moreover, stigma consciousness moderates the effect of student self-identification on the likelihood of enrolling in university. Qualitative interviews show how refugee students use strategies to deal with the stigma that unfortunately reproduces stigmatizing attributions. We provide implications for further research, educational counseling, and prestudy programs for refugees as an integral part of adult education.
A biochemical and histological evaluation of in vivo exposure of bisphenol P for multi-organ toxicity and pathology in rats
Authors: Sattar Saadia , Nadeem Asif , Shehzad Wasim , ur Rehman Habib , Javed Maryam
Published: February 2024

Bisphenol P (BPP) is a structural analog of bisphenol A (BPA) and is increasingly used as a substitute of BPA in commercial and household applications. In recent years, BPP has been frequently detected in terrestrial and aquatic ecosystems. Very little epidemiological and experimental information are available on the toxicity potential of BPP in human and animal systems, which is very concerning in view of its increasing use. The current study evaluated the biochemical and histopathological effects of BPP in rats. The seven experimental groups ( n = 5 rats/group) included BPA5 (5 mg), BPA50 (50 mg), BPA100 (100 mg), BPP5 (5 mg), BPP50 (50 mg), and BPP100 (100 mg) while the remaining one group served as untreated control. At the end of treatment, the organs (liver, kidney, heart, and lung) of rats were harvested for oxidative stress and histopathological analyses. A significant ( p < .05) decrease was observed in the weight of the liver, lungs, and kidneys in the BPP100 group similar to the BPA100 group compared with the control group. Further, a significant ( p < .05) decrease was also observed for concentrations of antioxidant enzymes (catalase, peroxidase, superoxide dismutase, and glutathione peroxidase) in the liver, lungs, kidneys, and heart at the highest two doses of BPP similar to the respective BPA groups compared with the control group. The two highest doses of BPP induced histopathological changes in the liver such as nuclei distortion, excessive necrosis of hepatocytes, nuclei shrinkage and pyknosis of cells with disrupted cell structure (BPP100), and cellular congestion and degeneration of hepatocytes (BPP50) similar to the two respective doses of BPA. The BPP treated groups also showed varying histopathological changes in kidney tissue, heart tissue, and lung tissue similar to BPA treated rats. In conclusion, the present study indicated that BPP has the potential to induce oxidative stress and alter the histomorphological architecture of different organs and is as deleterious as BPA.
Torque generation using synthetic jet actuators
Authors: Mittal Vardhan , Arumuru Venugopal
Published: February 2024

This article presents a novel method of utilizing the thrust generated by synthetic jet actuators to generate torque. Piezoelectric-based synthetic jet actuators were used to create a device with two isolated cavities and orifices. Weight balance and hotwire anemometry were used to quantify the thrust generated by the synthetic jet actuator. Each orifice provides a maximum thrust of 0.15gf, thereby generating a net maximum torque of 17.17gf mm. The torque generated can be used to produce a rotary motion. Such a novel device may be useful where a high-momentum rotary jet may be employed for heat transfer and mixing enhancement.
Optimal sizing and optimization of financial cost for EVs using SPOA-RBFNN technique
Authors: Kannan P , Sivakumar M , Ruban Raja R
Published: February 2024

This study proposes a hybrid technique for optimal sizing and cost optimization of hybrid energy storage systems (HESS) integrated into electric vehicles (EVs). The proposed technique, SPOA-RBFNN, combines a student psychology-based optimization algorithm (SPOA) and a radial-basis function neural network (RBFNN). The study aims to minimize the overall cost of the HESS by evaluating two design variables: the super-capacitor (SC) and battery pack size. SPOA is employed to optimize the hybrid HESS design variables, ensuring efficient exploration of solution spaces. The RBFNN method is then used to predict the relationship between these design variables and the overall cost of the HESS in electric vehicles. The results show that the proposed technique is more effective than existing techniques, with an efficiency of 97.99039% compared to 82.137% for GA and 77.26589% for particle swarm optimization (PSO). This work offers a comprehensive and innovative approach to optimizing HESS sizing in EVs, connecting the gap between performance optimization and financial cost analysis.
Analysis of microplastics distributed in the environment: Case studies in South Korea
Authors: Choi Doeun , Jung Sungyup , Lee Jechan , Kwon Eilhann E
Published: February 2024

The massive production and extensive distribution of microplastics, stemming from postconsumer plastics, have become problematic for the environment and human health. Various studies have reported the hazardous potential and toxicity of microplastics in living organisms, including animals and humans. As a precautionary measure to protect them from microplastic exposure, significant efforts have been made to analyze the distribution of microplastics in the environment. However, each research group individually examined the microplastic distribution in a specific location. Consequently, there is a lack of information regarding the presence of microplastics in wider district units, such as cities and across the nation. In this study, an overview of various case studies in South Korea is provided by discussing the presence and concentration of microplastics in South Korea and examining the reports and research articles on the analysis of microplastic distributions in different locations in South Korea. The current sampling and analysis methods used for microplastic distribution studies were also summarized, along with their technical challenges. The possible sources of primary and secondary microplastics were also discussed to determine the original plastic types of microplastics derived from industries and households.
A Purposeful Approach to LMX Differentiation: The Role of LMX With Key Members
Authors: Wang Chen , Ponnapalli Ajay R. , Sin Hock-Peng
Published: February 2024

A central idea in the leader-member exchange (LMX) literature is that leaders, due to the limited organizational and personal resources available to them, often struggle with developing and maintaining high-quality exchange relationships with all of their members. As a natural consequence, leaders typically form high-quality relationships with a select few members—often those who seem likable or are similar to the leader—while maintaining formal and distant relationships (i.e., low-quality LMX) with others. This form of differentiated treatment of members creates tensions in team dynamics. In this paper, we propose that leaders can mitigate the downsides of leader-member exchange differentiation (LMXD) for team dynamics by being more purposeful and strategic in how they differentiate in their treatment of members. Specifically, we posit that when leaders strategically develop high-quality LMX relationships with key members—individuals occupying influential positions in team social networks—such key members will engage in behaviors that buffer the negative impact of LMXD on team dynamics. Our framework integrates LMX theory with perspectives from social networks research to illustrate how strategic differentiation influences task and relational team dynamics. Finally, we discuss recommendations for empirically testing, theoretical extensions, and practical implications of this framework.
‘Everyone keeps telling us it's going to die’: A close examination of ‘myths’ clouding local newspaper futures in Australia
Authors: Hess Kristy , McAdam Alison
Published: February 2024

Digital adaptation is often considered the panacea to the local journalism crisis in Australia. As a result, this digital first agenda has perpetuated ‘death and doom’ narratives about some traditional strategies and practices, especially in regards to the future of printed local newspapers. This paper draws on interviews and focus groups with local news owners, journalists, editors, advertising staff and managers who work for small independently owned titles in rural and regional Australia to suggest there are three key myths which are deeply interwoven and impact perceptions of local news media realities: that print is dead, the traditional advertising model has collapsed and there are no jobs in journalism. We suggest these myths can cloud discussions around the targeted and systemic solutions needed to secure local news futures.
Developing Chinese lexical representations in Korean learner’s mind
Authors: Shang Nan
Published: February 2024

Aims and objectives/purpose/research questions:

The present research explores whether Korean learners of Chinese at different proficiency levels employ distinct processing strategies when processing Chinese words with identical or different orthographic representations.

Design/methodology/approach:

In this research, two experimental studies were carried out to examine how Korean learners with different Chinese language proficiency process orthography, pronunciation, and meanings of Chinese written words.

Data and analysis:

Reaction times and error rates were analyzed for each study. Revised hierarchical model (RHM) and Ontogenesis Model (OM) are the major models used to analyze and discuss the results.

Findings/conclusions:

The findings of the phonological task reveal that intermediate-level participants utilize first language mediators to access second language (L2) words, whereas high-level participants can directly activate L2 phonological representations without first language interference. Conversely, in the semantic task, participants from both proficiency levels seem to adopt the word association model regardless of orthographic representations.

Originality:

The originality of the present study lies in its examination of the processing strategies employed by Korean learners of Chinese at different proficiency levels, specifically when processing Chinese words with identical or different orthographic representations.

Significance/implications:

These findings suggest that L2 proficiency does not guarantee the elimination of native language influence on L2 lexical processing and various factors can affect L2 lexical processing. To improve L2 lexical learning, it is recommended to start language learning early, increase vocabulary size, and enhance exposure to L2 words.
Altered Anticipatory Postural Adjustments During Whole-Body Reaching in Subjects With Stroke
Authors: Tomita Yosuke , Mullick Aditi A. , Feldman Anatol G. , Levin Mindy F.
Published: February 2024

Background

Coordination between arm movements and postural adjustments is crucial for reaching-while-stepping tasks involving both anticipatory postural adjustments (APAs) and compensatory movements to effectively propel the whole-body forward so that the hand can reach the target. Stroke impairs the ability to coordinate the action of multiple body segments but the underlying mechanisms are unclear. Objective. To determine the effects of stroke on reaching performance and APAs during whole-body reaching.

Methods

We tested arm reaching in standing (stand-reach) and reaching-while-stepping (step-reach; 15 trials/condition) in individuals with chronic stroke (n = 18) and age-matched healthy subjects (n = 13). Whole-body kinematics and kinetic data were collected during the tasks. The primary outcome measure for step-reach was “gain” ( g), defined as the extent to which the hip displacement contributing to hand motion was neutralized by appropriate changes in upper limb movements ( g = 1 indicates complete compensation) and APAs measured as spatio-temporal profiles of the center-of-pressure shifts preceding stepping.

Results

Individuals with stroke had lower gains and altered APAs compared to healthy controls. In addition, step onset was delayed, and the timing of endpoint, trunk, and foot movement offset was prolonged during step-reach compared to healthy controls. Those with milder sensorimotor impairment and better balance function had higher gains. Altered APAs were also related to reduced balance function.

Conclusions

Altered APAs and prolonged movement offset in stroke may lead to a greater reliance on compensatory arm movements. Altered APAs in individuals with stroke may be associated with a reduced shift of referent body configuration during the movement
Early Readmission and Revision After Total Joint Arthroplasty: An Analysis of Cause and Cost
Authors: Bido Jennifer , Torres Ricardo , Kaidi Austin C. , Rodriguez Samuel , Rodriguez Jose A.
Published: February 2024

Background: Bundled payments for total joint arthroplasty (TJA) were instituted by the Centers for Medicare and Medicaid Services (CMS) to reimburse providers a lump sum for operative and 90-day postoperative costs. Gaining a better understanding of which TJA patients are at risk for early return to the operating room (OR) is critical in preoperative optimization of those with modifiable risks, which could improve bundled-payment performance. Purpose: We sought to identify the most common reason for readmissions, as well as patient characteristics and costs, associated with early return to the OR among TJA patients. Methods: This was a retrospective cohort study of Medicare patients who had undergone primary total hip or knee arthroplasty (THA or TKA) between 2013 and 2018 at a tertiary care hospital. We used the CMS research identifiable files database to identify the most common reasons for readmissions and revisions within 90 days of surgery. Total billing claims were used to determine the cost of early readmissions and revisions. Multivariate regression analysis was used to determine the characteristics associated with early readmission or revision. Results: Out of 20 166 primary TJA patients identified, we found 1349 readmissions (5.6%) and 163 (0.8%) revisions within 90 days of surgery. Dislocation was the most common indication for readmission, and periprosthetic joint infection was the most common indication for revision. Early return to the OR was associated with a mean $105,988 (standard deviation [SD] = $76,865) in CMS claims for the inpatient stay. Factors associated with a higher risk of early reoperation were female sex, THA, longer length of stay, and discharge to long-term care facility. Conclusions: This retrospective cohort study found that early return to the OR after TJA increased overall 90-day costs by 260%, suggesting that early reoperation might have a significant impact on bundled payments. Further study is warranted.
Endovascular neurointervention in Iraq: Realistic obstacles, a hopeful start with “Al-Hayat center”
Authors: Lafta Ghazwan A
Published: February 2024

Endovascular neurointervention nowadays plays an important role in the effective treatment of different head and neck vascular pathologies using minimally invasive means. In Iraq, until recently, endovascular neurointervention field is nearly absent. A new hope was started when an advanced neurointerventional center was created to improve and develop this field in Iraq.
The “sports wars”: A contest theory approach to cities hosting game
Authors: Minchuk Yizhaq
Published: February 2024

The competition among cities to host a sports team or a large-scale international sports event is modeled as a winner-pay contest with an entry fee. In the first stage, each contestant (city) decides whether to pay the entry fee (infrastructure required by the team, for example), which allows it to participate in the second stage, that is, the actual contest. We show that the contest organizer’s choice of the optimal entry fee does not depend on the number of contestants. Furthermore, in some cases, the result is a form of zero-sum game, in which the sports team or event organizer is the main beneficiary. The findings shed light on this type of competition and under what conditions on the entry fee a city might benefit from hosting a sports team or large-scale international sports event.
Different but the Same: Common Themes in Illness Experience Among People With Diverse Long COVID Symptoms and the Potential Benefits of Virtual Group Medical Visits
Authors: Barnhill Jessica , Chilcoat Aisha , Kavalakatt Bethany , Mata Raveena , Tiedt Malik , Roth Isabel
Published: February 2024

Long coronavirus disease 2019 (COVID-19) is poorly understood, widespread and debilitating. Integrative medical group visits (IMGVs) provide group medical care virtually or in person and are reimbursed by insurance payors. IMGV introduces integrative modalities such as mindfulness, nutrition, and acupressure in a person-centered, supportive, and educational environment. To evaluate a telehealth IMGV program called Nourish to Flourish (N2F) for patients with long COVID, three researchers conducted a qualitative analysis of pre- and post-group individual interviews. Twenty-five patients provided interviews, of which fifteen included pre- and post-group individual interviews. Main themes were unpredictable symptom patterns, a common range of emotions associated with long COVID experience, reconceptualizing self-identity, multiple barriers to care in conventional settings, and connections formed in N2F. Although symptoms varied, N2F participants found commonalities in their experiences of living with long COVID. They empathized with one another regarding changing symptoms, inconsistent social support, shifting identities, and barriers to effective medical care.
IP3Rs and nSOCE—Tied Together at Two Ends
Authors: Hasan Gaiti
Published: February 2024

All living organisms need to respond appropriately to changes in the extracellular milieu. Cellular mechanisms that enable such responses evolved in parallel with organismal complexity and intracellular Ca2+ signaling is one such mechanism where extracellular signals received at the cell membrane communicate with endoplasmic reticular stores of Ca2+, to stimulate appropriate Ca2+-mediated changes in cellular physiology. The amplitude and dynamics of endoplasmic reticulum (ER)-Ca2+ release in response to extracellular signals determines the nature of the cellular response. An understanding of how ER-Ca2+ channels might regulate cellular Ca2+ signaling in different cell types is lacking. In a recent paper, this question has been addressed in the context of neurons ( Chakraborty et al., 2023 ) and the implications of these new findings are discussed here.
Special Issue on Supported Decision-Making: Advancing Policy and Practice
Authors: Shogren Karrie A.
Published: February 2024

This special issue focuses on advances in research, policy, and practice in supported decision-making. It includes articles that highlight emerging policy and practice that can be used by practitioners, families, and self-advocates to enable supported decision-making across the life course. Implications and action steps for educators, policymakers, legal professionals, community support providers, and self-advocates and their families are emphasized.
Unveiling the power of neutral and inclusive language in tuberculosis prevention and care
Authors: Barbosa Pedro , Vieira Mariana , Ramos João Pedro , Duarte Raquel
Published: February 2024

Language plays a crucial role in shaping discourses and responses related to disease, particularly tuberculosis (TB). Stigmatising language and attitudes surrounding TB can lead to discrimination and marginalisation of affected individuals, creating barriers to seeking proper diagnosis and treatment. The terminology used to describe TB-affected individuals can be disempowering and criminalising, reinforcing an “othering” of those affected. To combat this, engaging with TB-affected communities is essential to co-construct a neutral and inclusive vocabulary that respects the dignity of individuals and fosters empathy and support. Thus, an inclusive language approach empowers affected individuals as active participants in their health management, encouraging open communication and the development of support networks. By adopting a neutral and inclusive language system, healthcare providers and communities can work together to remove unnoticed hurdles and align with the World Health Organization's TB care and prevention goals.
Single-domain antibodies against SARS-CoV-2 RBD from a two-stage phage screening of universal and focused synthetic libraries
Authors: Chen Fangfang , Liu Zhihong , Kang Wei , Jiang Fan , Yang Xixiao , Yin Feng , Zhou Ziyuan , Li Zigang
Published: February 2024

Background

Coronavirus disease 2019 (COVID-19) is an evolving global pandemic, and nanobodies, as well as other single-domain antibodies (sdAbs), have been recognized as a potential diagnostic and therapeutic tool for infectious diseases. High-throughput screening techniques such as phage display have been developed as an alternative to in vivo immunization for the discovery of antibody-like target-specific binders.

Methods

We designed and constructed a highly diverse synthetic phage library sdAb-U (single-domain Antibody - Universal library ) based on a human framework. The SARS-CoV-2 receptor-binding domain (RBD) was expressed and purified. The universal library sdAb-U was panned against the RBD protein target for two rounds, followed by monoclonal phage ELISA (enzyme-linked immunosorbent assay) to identify RBD-specific binders (the first stage). High-affinity binders were sequenced and the obtained CDR1 and CDR2 sequences were combined with fully randomized CDR3 to construct a targeted (focused) phage library sdAb-RBD, for subsequent second-stage phage panning (also two rounds) and screening. Then, sequences with high single-to-background ratios in phage ELISA were selected for expression. The binding affinities of sdAbs to RBD were measured by an ELISA-based method. In addition, we conducted competition ELISA (using ACE2 ectodomain S19-D615) and SARS-CoV-2 pseudovirus neutralization assays for the high-affinity RBD-binding sdAb39.

Results

Significant enrichments were observed in both the first-stage (universal library) and the second-stage (focused library) phage panning. Five RBD-specific binders were identified in the first stage with high ELISA signal-to-background ratios. In the second stage, we observed a much higher possibility of finding RBD-specific clones in phage ELISA. Among 45 selected RBD-positive sequences, we found eight sdAbs can be well expressed, and five of them show high-affinity to RBD (EC50 < 100nM). We finally found that sdAb39 (EC50 ~ 4nM) can compete with ACE2 for binding to RBD.

Conclusion

Overall, this two-stage strategy of synthetic phage display libraries enables rapid selection of SARS-CoV-2 RBD sdAb with potential therapeutic activity, and this two-stage strategy can potentially be used for rapid discovery of sdAbs against other targets.
Fostering the social and physical challenges of female recreational or professional athletes in pregnancy and postpartum
Authors: Santos-Rocha Rita , Szumilewicz Anna
Published: February 2024

Combining pregnancy and parenthood with sporting activities or a professional athletic career can be challenging. The objective of this Collection is to gain a deeper understanding of the effects of pregnancy and postpartum on female athletes, both recreational and professional, in order to improve their health and fitness outcomes and support their continued success in sports.
Alliance for clinical trials in Oncology (Alliance) trial A022101/NRG-GI009: a pragmatic randomized phase III trial evaluating total ablative therapy for patients with limited metastatic colorectal cancer: evaluating radiation, ablation, and surgery (ERASur)
Authors: Hitchcock Kathryn E. , Miller Eric D. , Shi Qian , Dixon Jesse G. , Gholami Sepideh , White Sarah B. , Wu Christina , Goulet Christopher C. , George Manju , Jee Kyung-Wook , Wright Chadwick L. , Yaeger Rona , Shergill Ardaman , Hong Theodore S. , George Thomas J. , O’Reilly Eileen M. , Meyerhardt Jeffrey A. , Romesser Paul B.
Published: February 2024

Background

For patients with liver-confined metastatic colorectal cancer (mCRC), local therapy of isolated metastases has been associated with long-term progression-free and overall survival (OS). However, for patients with more advanced mCRC, including those with extrahepatic disease, the efficacy of local therapy is less clear although increasingly being used in clinical practice. Prospective studies to clarify the role of metastatic-directed therapies in patients with mCRC are needed.

Methods

The Evaluating Radiation, Ablation, and Surgery (ERASur) A022101/NRG-GI009 trial is a randomized, National Cancer Institute-sponsored phase III study evaluating if the addition of metastatic-directed therapy to standard of care systemic therapy improves OS in patients with newly diagnosed limited mCRC. Eligible patients require a pathologic diagnosis of CRC, have BRAF wild-type and microsatellite stable disease, and have 4 or fewer sites of metastatic disease identified on baseline imaging. Liver-only metastatic disease is not permitted. All metastatic lesions must be amenable to total ablative therapy (TAT), which includes surgical resection, microwave ablation, and/or stereotactic ablative body radiotherapy (SABR) with SABR required for at least one lesion. Patients without overt disease progression after 16–26 weeks of first-line systemic therapy will be randomized 1:1 to continuation of systemic therapy with or without TAT. The trial activated through the Cancer Trials Support Unit on January 10, 2023. The primary endpoint is OS. Secondary endpoints include event-free survival, adverse events profile, and time to local recurrence with exploratory biomarker analyses. This study requires a total of 346 evaluable patients to provide 80% power with a one-sided alpha of 0.05 to detect an improvement in OS from a median of 26 months in the control arm to 37 months in the experimental arm with a hazard ratio of 0.7. The trial uses a group sequential design with two interim analyses for futility.

Discussion

The ERASur trial employs a pragmatic interventional design to test the efficacy and safety of adding multimodality TAT to standard of care systemic therapy in patients with limited mCRC.

Trial registration

ClinicalTrials.gov: NCT05673148, registered December 21, 2022.
Correlation between choroidal vascularity and retrobulbar ocular blood flow changes and thyroid-associated ophthalmopathy activity: a cross-sectional study
Authors: Sun Xinghong , Su Mengru , Zhang Xiaowen , Shen Haiyun , Xie Zhenggao , Kong Wentao , Zhu Dandan
Published: February 2024

Objective

To evaluate the alterations in retrobulbar color Doppler imaging (CDI) parameters and retinal/choroidal optical coherence tomography angiography (OCTA) parameters and their association with the clinical activity and severity in thyroid-associated orbitopathy (TAO) patients.

Methods

In this study, the retrobulbar flow parameters including resistance index (RI), Pulsatile Index(PI), peak systolic velocity (PSV) and end diastolic velocity (EDV) in posterior ciliary artery (PCA), central retinal artery (CRA) and ophthalmic artery (OA) were determined by CDI. Moreover, the retina and choroidal vascularity including the superficial vessel density (SVD), deep vessel density (DVD), choroidal thickness (ChT) and choroidal vascularity, including total choroidal area (TCA), luminal area (LA), stromal area (SA) and Choroidal Vascularity Index (CVI), were determined by OCTA. All patients grouped as active TAO and inactive TAO based on Clinical activity score (CAS). We picked the severe eye among the subjects and compared all parameters between two groups. We analyzed the correlations among those parameters.

Results

There was a significant difference in CAS score, proptosis value, ChT, LA, CVI between patients with active TAO and inactive TAO. In the active group, PSV and EDV of PCA were significantly higher than the inactive group. On logistic regression analysis, CAS was closely associated with PSV-PCA. On multiple linear regression, proptosis value was closely associated with ChT, LA, SA and CVI.

Conclusion

Choroidal vascularization and retrobulbar blood flow were concurrently higher in active TAO patients and several variables in choroid circulation was closely related to TAO clinical features.
The puppet interview to measure illness perceptions in paediatric oncology: development and psychometric properties in acute treatment and follow-up care
Authors: Herzog Kristina , Schepper Florian , Herrmann Jessy , Martini Julia
Published: February 2024

Background

Illness perceptions comprise assumptions about symptoms, timeline, consequences, controllability, and emotional responses to an illness. Recent evidence shows that illness perceptions are associated with coping and well-being. So far, assessment in paediatric care was based on parental report only, since no instrument for the direct assessment of young children was available. We aim to describe the development (incl. indication and contraindication) of an innovative puppet interview to assess illness perceptions in children with cancer from the age of four years. Moreover, we investigate longitudinal trajectories and examine psychometric properties.

Methods

The puppet interview was developed based on the Illness-Perception-Questionnaire-Revised and the Berkeley-Puppet-Interview. Longitudinal trajectories and psychometric properties were examined in a sample of patient-parent dyads (N = 75) in a prospective longitudinal study in acute treatment with a 1-year follow-up (study 1: nT1 = 41, nT2 = 27) and in a cross-sectional study in follow-up care (study 2, n = 34).

Results

The puppet interview is comprehensible and well-received by children in acute treatment and follow-up care. There were significant differences in perceptions of a chronic timeline (U = 301.00, p = .008), consequences (U = 251.00, p = .008), and emotional representations (U = 244.50, p = .020) between children in acute treatment and children in follow-up care. Over the course of one year, children in acute treatment perceived more symptoms as part of their illness (MT1 = 3.6, SDT1 = 2.9, MT2 = 4.5, SDT2 = 3.1, n = 27, Z = -2.603, p = .009). We found expected intercorrelations between illness perception dimensions, e.g. between perception of consequences and emotional representations (rτ = .27, p = .033), and between perception of a chronic timeline and consequences (rτ = .38, p = .001). Moreover, we found confirming results regarding construct validity, as child’s perceptions of symptoms correlated with their self-rated HRQoL (rτ = -.32, padj. = .014). Also parent-rated subscale on illness-specific aspects of child’s HRQoL correlated with child’s perception of symptoms (rτ = -.26, padj. = .016), cyclicity (rτ = -.28, padj. = .016), and consequences (rτ = -.34, padj. = .014). Acceptable internal consistency was shown for the dimensions timeline-acute/chronic and personal control.

Conclusions

Parental report can now be complemented by a self-report of illness perceptions in children aged four years and older. This will allow for the further adaptation of medical and psychosocial care during and after acute cancer treatment.

Trial registration

The study has been pre-registered at the German Clinical Trials Register (registered 30/06/2020; DRK-S00022034) and at the Open Science Foundation (https://osf.io/7xr6z).
Towards an intelligent malaria outbreak warning model based intelligent malaria outbreak warning in the northern part of Benin, West Africa
Authors: Gbaguidi Gouvidé Jean , Topanou Nikita , Filho Walter Leal , Ketoh Guillaume K.
Published: February 2024

Background

Malaria is one of the major vector-borne diseases most sensitive to climatic change in West Africa. The prevention and reduction of malaria are very difficult in Benin due to poverty, economic insatiability and the non control of environmental determinants. This study aims to develop an intelligent outbreak malaria early warning model driven by monthly time series climatic variables in the northern part of Benin.

Methods

Climate data from nine rain gauge stations and malaria incidence data from 2009 to 2021 were extracted from the National Meteorological Agency (METEO) and the Ministry of Health of Benin, respectively. Projected relative humidity and temperature were obtained from the coordinated regional downscaling experiment (CORDEX) simulations of the Rossby Centre Regional Atmospheric regional climate model (RCA4).

A structural equation model was employed to determine the effects of climatic variables on malaria incidence. We developed an intelligent malaria early warning model to predict the prevalence of malaria using machine learning by applying three machine learning algorithms, including linear regression (LiR), support vector machine (SVM), and negative binomial regression (NBiR).

Results

Two ecological factors such as factor 1 (related to average mean relative humidity, average maximum relative humidity, and average maximal temperature) and factor 2 (related to average minimal temperature) affect the incidence of malaria. Support vector machine regression is the best-performing algorithm, predicting 82% of malaria incidence in the northern part of Benin.

The projection reveals an increase in malaria incidence under RCP4.5 and RCP8.5 over the studied period.

Conclusion

These results reveal that the northern part of Benin is at high risk of malaria, and specific malaria control programs are urged to reduce the risk of malaria.
Marginal adaptation of bulk-fill resin composites with different viscosities in class II restorations: a micro-CT evaluation
Authors: Baltacioğlu İsmail Hakkı , Demirel Gülbike , Öztürk Burcu , Aydin Fulya , Orhan Kaan
Published: February 2024

Background

The purpose of this study is to evaluate the marginal adaptation of bulk-fill resin composites with different viscosities (paste-like and flowable) in Class II restorations using micro-CT imaging.

Methods

Forty extracted human molars were used. Mesial and distal Class II box cavities (approximately 3 mm x 3 mm x 4 mm) were prepared for each tooth, with cavity floors located 1 mm below the enamel-cementum junction. Following adhesive application, teeth were restored using eight different groups: Group XB: X-tra Base Bulk-fill Flowable (VOCO), Group XF: X-tra Fill Bulk-fill (VOCO), Group FB: Filtek Bulk-fill Posterior (3 M ESPE), Group FF: Filtek Bulk-fill Flowable (3 M ESPE), Group BB: Beautifil-Bulk (SHOFU), Group BF: Beautifil-Bulk Flowable (SHOFU), and Group CO: “as a control group”, Clearfil Majesty Posterior (KURARAY) and Group CF: “as a control group”, Clearfil Majesty Flow + Clearfil Majesty Posterior (KURARAY). The restored teeth underwent an aging protocol involving 1000 cycles in a water bath fluctuating between 5 ± 1.0 °C and 55 ± 1.0 °C. Post-aging, teeth were immersed in 50% silver nitrate solution for 24 h and then in a film developer solution for 8 h. Microleakage analysis was performed using micro-CT, evaluated with 3D Slicer software. A two-way ANOVA was employed for statistical analysis.

Results

Two-way ANOVA results indicated significant effects of both viscosity (p < 0.0001) and composite type (p < 0.0001) on marginal adaptation. Viscosity analysis (comparing flowable and paste-like) revealed no significant differences in the FB-FF, XB-XF and BB-BF groups but significant differences in the and CO-CF group, with flowable type exhibiting less microleakage than paste-like type.

Conclusions

The study suggests that while the viscosity of bulk-fill composites did not significantly affect marginal adaptation, the brand of bulk-fill composite did influence it.
Effect of clear aligner type on maxillary full-arch intrusion: 3D analysis using finite element method
Authors: Geramy Allahyar , Safari Fatemeh
Published: February 2024

Background

Vertical maxillary excess (VME) is one of the most common reasons for seeking orthodontic treatment. Total intrusion with aligners is a promising alternative to surgery in some cases. Considering the elastic deformation of aligners, this study aimed to evaluate the possible desirable and undesirable teeth displacements during full maxillary arch intrusion using clear aligners and temporary anchorage devices (TADs).

Methods

The maxillary arch and clear aligners were modeled in SolidWorks. Four aligner brands including Leon, Duran, Duran Plus, and Essix Plus were selected based on their material properties. Anterior and posterior intrusion forces of 80 and 300 g were applied from attachments between the canines and first premolars and between the first and second molars, respectively. Vertical and anteroposterior tooth displacements were determined.

Results

The greatest intrusion was recorded at the buccal of the second molar, followed by the first molar. The lowest value was measured at the palatal of the molars with all aligners except Duran, which indicated minimal intrusion in the central incisor. All teeth were mesially displaced at the incisal/occlusal except incisors that moved distally. All apices showed distal movement.

Conclusions

Total intrusion using clear aligners may be accompanied by other tooth movements, including buccal tipping and mesial-in rotation of the molars, retrusion of incisors, and mesial movement of other teeth.
Development of a predictive machine learning model for pathogen profiles in patients with secondary immunodeficiency
Authors: Liu Qianning , Chen Yifan , Xie Peng , Luo Ying , Wang Buxuan , Meng Yuanxi , Zhong Jiaqian , Mei Jiaqi , Zou Wei
Published: February 2024

Background

Secondary immunodeficiency can arise from various clinical conditions that include HIV infection, chronic diseases, malignancy and long-term use of immunosuppressives, which makes the suffering patients susceptible to all types of pathogenic infections. Other than HIV infection, the possible pathogen profiles in other aetiology-induced secondary immunodeficiency are largely unknown.

Methods

Medical records of the patients with secondary immunodeficiency caused by various aetiologies were collected from the First Affiliated Hospital of Nanchang University, China. Based on these records, models were developed with the machine learning method to predict the potential infectious pathogens that may inflict the patients with secondary immunodeficiency caused by various disease conditions other than HIV infection.

Results

Several metrics were used to evaluate the models’ performance. A consistent conclusion can be drawn from all the metrics that Gradient Boosting Machine had the best performance with the highest accuracy at 91.01%, exceeding other models by 13.48, 7.14, and 4.49% respectively.

Conclusions

The models developed in our study enable the prediction of potential infectious pathogens that may affect the patients with secondary immunodeficiency caused by various aetiologies except for HIV infection, which will help clinicians make a timely decision on antibiotic use before microorganism culture results return.
Barriers and facilitators associated with the upscaling of the Transmural Trauma Care Model: a qualitative study
Authors: Ratter Julia , Wiertsema Suzanne , Ettahiri Ilham , Mulder Robin , Grootjes Anne , Kee Julia , Donker Marianne , Geleijn Edwin , de Groot Vincent , Ostelo Raymond W. J. G. , Bloemers Frank W. , van Dongen Johanna M.
Published: February 2024

Background

To assess the barriers and facilitators associated with upscaling the Transmural Trauma Care Model (TTCM), a multidisciplinary and patient‐centred transmural rehabilitation care model.

Methods

Semi-structured interviews were conducted with eight trauma surgeons, eight hospital-based physiotherapists, eight trauma patients, and eight primary care physiotherapists who were part of a trauma rehabilitation network. Audio recordings of the interviews were made and transcribed verbatim. Data were analysed using a framework method based on the “constellation approach”. Identified barriers and facilitators were grouped into categories related to structure, culture, and practice.

Results

Various barriers and facilitators to upscaling were identified. Under structure, barriers and facilitators belonged to one of five themes: “financial structure”, “communication structure”, “physical structures and resources”, “rules and regulations”, and “organisation of the network”. Under culture, the five themes were “commitment”, “job satisfaction”, “acting as a team”, “quality and efficiency of care”, and “patients’ experience”. Under practice, the two themes were “practical issues at the outpatient clinic” and “knowledge gained”.

Conclusion

The success of upscaling the TTCM differed across hospitals and settings. The most important prerequisites for successfully upscaling the TTCM were adequate financial support and presence of “key actors” within an organisation who felt a sense of urgency for change and/or expected the intervention to increase their job satisfaction.

Trial registration

NL8163 The Netherlands National Trial Register, date of registration 16-11-2019.
Broadening the phenotype and genotype spectrum of novel mutations in pontocerebellar hypoplasia with a comprehensive molecular literature review
Authors: Ghasemi Mohammad-Reza , Tehrani Fateh Sahand , Moeinafshar Aysan , Sadeghi Hossein , Karimzadeh Parvaneh , Mirfakhraie Reza , Rezaei Mitra , Hashemi-Gorji Farzad , Rezvani Kashani Morteza , Fazeli Bavandpour Fatemehsadat , Bagheri Saman , Moghimi Parinaz , Rostami Masoumeh , Madannejad Rasoul , Roudgari Hassan , Miryounesi Mohammad
Published: February 2024

Background

Pontocerebellar hypoplasia is an umbrella term describing a heterogeneous group of prenatal neurodegenerative disorders mostly affecting the pons and cerebellum, with 17 types associated with 25 genes. However, some types of PCH lack sufficient information, which highlights the importance of investigating and introducing more cases to further elucidate the clinical, radiological, and biochemical features of these disorders. The aim of this study is to provide an in-depth review of PCH and to identify disease genes and their inheritance patterns in 12 distinct Iranian families with clinically confirmed PCH.

Methods

Cases included in this study were selected based on their phenotypic and genetic information available at the Center for Comprehensive Genetic Services. Whole-exome sequencing (WES) was used to discover the underlying genetic etiology of participants' problems, and Sanger sequencing was utilized to confirm any suspected alterations. We also conducted a comprehensive molecular literature review to outline the genetic features of the various subtypes of PCH.

Results

This study classified and described the underlying etiology of PCH into three categories based on the genes involved. Twelve patients also were included, eleven of whom were from consanguineous parents. Ten different variations in 8 genes were found, all of which related to different types of PCH. Six novel variations were reported, including SEPSECS, TSEN2, TSEN54, AMPD2, TOE1, and CLP1. Almost all patients presented with developmental delay, hypotonia, seizure, and microcephaly being common features. Strabismus and elevation in lactate levels in MR spectroscopy were novel phenotypes for the first time in PCH types 7 and 9.

Conclusions

This study merges previously documented phenotypes and genotypes with unique novel ones. Due to the diversity in PCH, we provided guidance for detecting and diagnosing these heterogeneous groups of disorders. Moreover, since certain critical conditions, such as spinal muscular atrophy, can be a differential diagnosis, providing cases with novel variations and clinical findings could further expand the genetic and clinical spectrum of these diseases and help in better diagnosis. Therefore, six novel genetic variants and novel clinical and paraclinical findings have been reported for the first time. Further studies are needed to elucidate the underlying mechanisms and potential therapeutic targets for PCH.
Stress hyperglycemia ratio as a prognostic indicator for long-term adverse outcomes in heart failure with preserved ejection fraction
Authors: Mohammed Abdul-Quddus , Luo Yongqiang , Wang Kaitao , Su Yang , Liu Lu , Yin Guoqing , Zhang Wen , Alifu J Jiasuer. , Mareai Redhwan M. , Mohammed Ayman A. , Xu Yawei , Abdu Fuad A. , Che Wenliang
Published: February 2024

Background

Recent studies highlighted that stress hyperglycemia ratio (SHR) is a potential predictor for future risk in heart failure (HF) patients. However, its implications specifically in HF with preserved ejection fraction (HFpEF) are not yet fully elucidated. We aimed to investigate the association between SHR and long-term clinical outcomes in HFpEF patients.

Methods

HFpEF patients enrolled between 2015 and 2023, were followed (mean 41 months) for a composite outcome of all-cause, cardiovascular mortality, and HF rehospitalization. SHR was established as the ratio of acute-chronic glycemia from admission blood glucose and glycated hemoglobin. The optimal cut-off for SHR to predict outcomes based on event prediction was determined through ROC analysis, and the cutoff was identified at 0.99. The effect of SHR on adverse risk was examined through the Cox hazards and Kaplan-Meier survival methods. A Pearson correlation analysis was conducted to assess the relationship between SHR and the severity of HF, as indicated by N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Furthermore, the incremental prognostic value of SHR was further assessed by the integrated discrimination improvement (IDI) and the net reclassification improvement (NRI).

Results

Among the 400 enrolled patients, 190 individuals (47.5%) encountered composite events over the 41-month follow-up period. SHR was significantly elevated in patients with events compared with those without (p < 0.001). All patients were stratified into high SHR (n = 124) and low SHR (n = 276) groups based on the SHR cutoff. The high SHR group had a significantly higher incidence of adverse events than the low SHR group (log-rank; p < 0.001). Additional analysis indicated a poorer prognosis in patients with low left ventricular EF (LVEF) levels (50 < LVEF < 60) and high SHR (SHR > 0.99) in comparison to the other groups (log-rank p < 0.001). In adjusted analysis, after accounting for age, sex, diabetes, and NT-proBNP, elevated SHR remained independently predictive of adverse outcomes (adjusted HR: 2.34, 95% CI 1.49–3.67; p < 0.001). Furthermore, adding SHR to a model with MAGGIC score provided an incremental improvement in predicting adverse events. Additionally, SHR displayed a slight correlation with NT-proBNP.

Conclusion

Elevated SHR was independently associated with an increased risk for composite events of all-cause, cardiovascular mortality, and HF readmission than those with lower SHR. SHR is a valuable tool for predicting and stratifying long-term adverse risks among HFpEF patients.