bluuebunny/crossref_metadata_2025 huggingface dataset:
Depressive Disorder and Trimalleolar Fractures: An Analysis of Outcomes and Costs
Authors: Fudala Maddie , Blank Lindsay , Tabbaa Ameer , Rodriguez Ariel , Conway Charles , Lam Aaron , Razi Afshin E. , Abdelgawad Amr
Published: July 2024

Introduction

Studies have suggested a strong association between depression and poor outcomes following various orthopaedic surgeries. However, depression’s impact on complications following open reduction/internal fixation (ORIF) of trimalleolar fractures has not been elucidated. Therefore, this study aimed to determine whether depression is associated with higher rates of readmissions and medical complications following ORIF of trimalleolar fractures.

Methods

A database query from January, 2020, through March, 2021, identifying adults who underwent trimalleolar ORIF generated 50 154 patients. Those with depression were matched 1:1 to controls without depression by age, sex, chronic obstructive pulmonary disease, anxiety, and other prominent comorbidities. Primary endpoints compared 90-day all-cause readmissions and medical complications. Odds ratios (ORs) of the effect of depression on readmissions and medical complications were calculated.

Results

Patients with depression who underwent ORIF of trimalleolar fractures had significantly higher odds of being readmitted within 90 days of the initial procedure (OR: 1.37; P < .0001). Ninety-day odds of developing medical complications were significantly higher (OR: 4.61; P < .0001) in patients with depression compared with patients within the control group.

Conclusion

Patients with depression undergoing trimalleolar ORIF face an increased risk of readmission and multiple postoperative complications. Orthopaedic surgeons should factor depression into their preoperative evaluation, given the already high burden of complications following ORIF of trimalleolar fractures.

Level of Evidence:

Level III: Retrospective cohort study
Journalism Practices in Western and Muslim Majority Countries: Culture Matters
Authors: Hamada Basyouni Ibrahim , Abdel-Salam Abdel-Salam G , Bebawi Saba
Published: July 2024

In this article, we suggest that the ideological cultural forces explain the differences in journalism practices in Western and Muslim majority countries (MMC). It is argued that the norms, values, and the deep political culture of the West and MMC have been materialized leading to different types of journalism practices. The statistical analysis of 11,246 interviews from twenty four Western and MMC conducted as part of the second wave of Worlds of Journalism Study demonstrates that journalists’ perception of influences, editorial autonomy, and journalistic roles reflect clear varied patterns, which resemble the overall cultural lines that shape their journalistic ideology. This article, we argue, has extended the hierarchical model of influences to embrace the wider regional cultural lines that avoid the trap of national media systems—centrism. Furthermore, it refutes the dominance of a global Western monoculture and, in turn, a singular global journalism practice.
Novel 3D printed TPMS scaffolds: microstructure, characteristics and applications in bone regeneration
Authors: Ma Jiaqi , Li Yumeng , Mi Yujing , Gong Qiannan , Zhang Pengfei , Meng Bing , Wang Jue , Wang Jing , Fan Yawei
Published: July 2024

Bone defect disease seriously endangers human health and affects beauty and function. In the past five years, the three dimension (3D) printed radially graded triply periodic minimal surface (TPMS) porous scaffold has become a new solution for repairing bone defects. This review discusses 3D printing technologies and applications for TPMS scaffolds. To this end, the microstructural effects of 3D printed TPMS scaffolds on bone regeneration were reviewed and the structural characteristics of TPMS, which can promote bone regeneration, were introduced. Finally, the challenges and prospects of using TPMS scaffolds to treat bone defects were presented. This review is expected to stimulate the interest of bone tissue engineers in radially graded TPMS scaffolds and provide a reliable solution for the clinical treatment of personalised bone defects.
Young artivists, social change and media literacy: Shifting the field through South-to-South connections in Kenya and Brazil
Authors: Rega Isabella , Medrado Andrea , Callus Paula
Published: July 2024

This article discusses the interplay between artivism and media literacy in plural Global South(s) and its fight against marginalisation. It reflects on the production of an experimental animation Portrait of Marielle by Kenyan and Brazilian young media activists and artivists. This animated film honours the legacy of Marielle Franco, a Brazilian human rights activist and politician murdered in 2018. The article explores how creative media practices can be used as tools for youth movement building in the Global South. It achieves this by analysing creative experiences that take place in ‘third spaces’ and considering how the application of creative techniques can establish South-to-South dialogical spaces for young people and mobilise memories and histories. Embracing an ethnographic approach, we trace the journeys of these artivists and their animated film, analysing the creative production processes and the exhibition of the animations’ frames in venues across both countries. This enables us to document the development of a collective ‘we’, nurtured by a dialogue between the young artivists and mediated by the creative artefacts, moving from individual to collective experiences. By following these journeys, we unpack how the spaces created by these interactions interplay with an agentive theory of change for media literacy, composed of four elements: Access, Awareness, Capability and Consequences. The focus is on the latter two: Capability, which involves young people using their media literacy for particular purposes in their lives, and Consequences, which occur when media literacy capabilities are combined with an active desire for a media environment that is conducive to equality and social justice. We suggest that working across these domains offers two important contributions to our field: a conceptual framework for digital and networked artivism that is intertwined with media literacy and a shift of the frames of reference for media literacy towards activism and social change.
Brunner’s gland adenomas in two cats
Authors: Hines Elizabeth S , Giaretta Paula Roberta , Cavasin João Pedro , Church Molly E , Sadanaga Kenneth K , Porter Brian F
Published: July 2024

Case series summary

Two cats, aged 13.5 and 14 years, presented with duodenal masses ultimately diagnosed as Brunner’s gland (BG) adenomas. In the first cat, the lesion was a firm, pale tan, proximal duodenal polyp adjacent to the major duodenal papilla that was composed histologically of a well demarcated, expansile mass of well-differentiated BGs separated by fibrovascular septa and few adipocytes. This patient was euthanized for otitis-related vestibular signs, and the clinical significance of the duodenal polyp is unknown. The second cat presented with a 6-month history of vomiting. This cat had a mural duodenal mass in the region of the major duodenal papilla of approximately 2 cm, which was histologically composed of a dense population of variably ectatic BGs expanding the submucosa and lamina propria. This patient’s mass was non-resectable, but the vomiting resolved after palliative gastroenterostomy loop surgery to allow ingesta to flow past the mass. The patient survived 35 months after the procedure.

Relevance and novel information

BG adenoma is a rare, typically benign tumor in humans with non-specific clinical manifestations and no clear etiopathogenesis. This lesion, and the related condition BG hyperplasia, has been documented rarely in animals (one dog, two horses, and in mice and rats). This is the first description of the lesion in the cat. The comparative pathology, differential diagnoses and possible significance of these lesions are discussed.
The 2012 Tuareg Uprising in Mali. An Analysis of AQIM’s, MUJAO’s, and Ansar Dine’s Access to Moral and Socio-Organizational Resources Under the Resource Mobilization Theory
Authors: Paradela-López Miguel , Jima-González Alexandra
Published: July 2024

This article contends that the appropriation, cooptation and creation of resources was a key element for the jihadist success during the 2012 Tuareg uprising in Mali. Based on the Resource Mobilization Theory (RMT), the article states that AQIM, MUJAO and Ansar Dine successfully appropriated and coopted moral and socio-organizational resources that were previously controlled by the Tuareg movement and, simultaneously, self-produced new resources taking advantage of the abandonment of local communities by the Malian government. Firstly, this article studies how the jihadist movements coopted legitimacy resources from the MNLA Tuareg movement: these groups provided an alternative political project for the Azawad, joined the Northern families through marriages and spread new trafficking networks. Secondly, the article analyzes how the jihadist organizations developed social assistance programs that integrated them within the Northern Mali communities and facilitated the spread of their ideology. Finally, this article concludes that the emergence and spread of jihadism in the Azawad region can be better explained by applying a RMT approach, focused on how jihadist organizations produced, coopted and appropriated moral and socio-organizational resources.
“Shall Absolute Power Corrupt Absolutely?”: A Perspective From Financial Constraints and Earnings Quality Under Government Control
Authors: Thanh Nguyen Cong , Hoang Hai Nguyen , Hoang Phu Nguyen , Ly Duc Minh
Published: July 2024

This research investigates the efficacy of government control in the context of financial constraints and earnings quality, focusing on Vietnam’s listed companies. Employing a dynamic approach and utilizing the System Generalized Method of Moments (SGMM) to mitigate endogeneity concerns, the study examines annual data from non-financial Vietnamese firms listed on the Hanoi and Ho Chi Minh Stock Exchange (HNX & HOSE) spanning 2012 to 2022. Non-financial firms are the study’s main focus because their operational dynamics, capital structures, and strategic priorities markedly differ from their financial counterparts. Moreover, non-financial companies in Vietnam contend with multifaceted challenges arising from government control including potential bureaucratic hurdles, regulatory constraints, and strategic limitations, directly affecting their financial flexibility, and consequently their ability to ensure earnings quality. Earnings quality is assessed through the average values of four key characteristics—persistence, predictability, variability, and smoothness—while financial constraints are proxied by firm size, foundation years, financial leverage, and dividend pay-outs. Findings reveal a deleterious impact of financial constraints on earnings quality, with state ownership exhibiting varying effects at different levels. Remarkably, the optimal range for state ownership, specifically State-Owned Enterprises (SOEs) rates from 35% to 50%, is identified as pivotal in ameliorating the adverse consequences of financial constraints on earnings quality. The research acknowledges limitations in the exclusive focus on specific earnings characteristics and the potential multicollinearity issue arising from the interaction variable in the SGMM model. Practically, the study proposes policies emphasizing the need for investors to discern financial constraint signals, companies to mitigate financial constraints, and governments to play a pivotal role in alleviating financial constraints to enhance earnings quality. Socially, the research underscores the imperative nature of earnings quality in investment decisions, cautioning against investing in companies masking inefficiencies with manipulated profits, thereby posing risks to individual investors and the overall financial market. The originality of this study lies in its alternative representations of financial constraints, nuanced examination of state ownership at different levels, and its elucidation of the moderating role of state ownership in the relationship between financial constraints and earnings quality.
External Debt, Transmission Channels, and Economic Growth: Evidence of Debt Overhang and Crowding-Out Effect
Authors: Dawood Muhammad , Feng Zhao Rui , Ilyas Muhammad , Abbas Ghulam
Published: July 2024

This study investigates the intricate relationship between external debt, debt service, and economic growth by using the panel data of 32 Asian Developing Economies (ADE) spanning 1995 to 2020. Employing a two-step system generalized method of moments (GMM) and a dynamic common correlated estimate (DCCE) model, the research explores key macroeconomic channels through which debt influences growth and rigorously tests for debt overhang and crowding-out effects. Findings reveal that public and private investment, total factor productivity, and national savings are pivotal channels transmitting the non-linear effect of external debt on economic growth. Notably, only private and public investment convey the non-linear effects of debt service to economic growth, while productivity and savings convey the linear effect. Evidence of debt overhang and crowding-out effects is identified in the sampled economies. The study suggests strategic measures for developing countries, emphasizing the productive use of accumulated debt, enhanced debt management, and timely project completion. Furthermore, it advocates for fostering economic growth through increased productivity, domestic savings, and private sector expansion to reduce dependence on foreign debt, facilitating both debt repayment and economic self-sufficiency.
What Makes Female Players Pay for Female Mobile Games?
Authors: Teng Zhuoqi , Wu Xin , Chen Chang , Nak-Hwan Choi
Published: July 2024

Extant mobile game research has paid great attention to men who play mobile games while ignoring female players. Although “willingness to pay” (WTP) is regarded as an important dependent variable in gaming research, few studies have explored this variable from an anthropomorphic perspective. To fill these gaps in the literature, this study aims to study the antecedents of WTP, with a focus on virtual in-game items and the mediating effect of work/play motivation. Based on the determinants of anthropomorphism, this work examines certain aspects of mobile games, including servant role in mobile games, a sense of communion, and the attractiveness of the characters. This study explores the effects of such characteristics on work/play motivation, as well as its influence on WTP. A game called “Love and Producer” was selected for this study, and the feedback from 230 female respondents was analyzed using Structural Equation Modeling (SEM). The results show that the servant role and the attractiveness of the characters affect female players’ desire to work with the characters, and the communion and the attractiveness of the characters affect female players’ desire to play with these characters. The female players’ desire to work and play with the characters directly influenced their willingness to pay for virtual game items. Moreover, the mediating effect that playing games has on female players’ desire to work/play with the characters was also validated. This article introduces new information on female game character design and interactivity in games.
Dispositional Predictors of Work/Family Interface Among Working Women
Authors: Sarfaraz Ayesha , Khalid Ayesha , Aman Zasheer
Published: July 2024

The current research was carried out to identify dispositional predictors of work/family conflict and enrichment faced by working women. Purposive sampling strategy was used to collect a sample of 265 working women, out of which 129 were married and 136 were unmarried, aged between 22 to 54 years ( M = 29.31, SD = 6.39). Data was collected via Big Five Inventory (BFI), Work/Family Conflict Self-Efficacy Scale, Work/Family conflict Scale and Work/Family Enrichment scale. Data was analyzed using correlation, MANOVA and multiple regression analysis. Results revealed that married women with children experienced higher levels of work/family conflict than unmarried working women and married women having one or no children. Moreover, women living in nuclear family system had higher levels of work to family conflict and women living in joint family system had higher levels of family to work conflict. Regression analysis showed conscientiousness, neuroticism and work/family conflict self-efficacy as salient predictors of work/family conflict and extraversion, agreeableness and work/family conflict self-efficacy to be significant predictors of work/family enrichment. These results have important implications for individuals as well as organizations as they demonstrate that dispositional factors do play a major role in determining the levels of work/family conflict and enrichment and will help in identifying women who are more or less prone to experiencing the negative side of work/family interface so that additional support may be provided to them in terms of family friendly workplace policy, social support, and employee counseling, etc.
The Differential Effect of Internal and External Remittances on Labor Participation and Employment Choices in Pakistan
Authors: Shair Waqas , Anwar Mumtaz , Hussain Saem , Kubra Neelam
Published: July 2024

This study scrutinizes the effect of external and internal remittances on the outcomes of the labor market of Pakistan. The study uses data from PSLM – HIES 2018-2019. The labor participation analysis used the IV Probit model, while the labor supply analysis utilized the IV technique. The Multinomial Logit model with endogenous covariates is employed for the employment choice. The results reveal that an individual from a remittance-receiving household is less likely to participate in labor vis-à-vis an individual from a non-receiving household. The external and internal remittance inflow increases the labor supply for the labor-participating individual. In addition, more external remittances increase the likelihood of participation in self-employment than wage employment, which supports the positive effect of remittance inflow on labor supply. The higher internal remittances are associated with an increase in the likelihood of participation in farming. In short, our analysis supports the fact that the effect of external remittance is more pronounced on labor market outcomes than internal remittances. The study’s findings assist the labor economist in observing the obstacles in the labor force participation and policymaker to understand the entrepreneurial level and economic activities in the remittance-receiving households to turn the effect of remittance into a job creator.

JEL Classification: C39, C24, J22, F24.
Why Do Online Crowdsourcing Platform (OCP) Visitors Recommend Idea Competition to Others?
Authors: Jo Hyeon , Ahn Hyun Yong
Published: July 2024

As more and more companies want to efficiently utilize good ideas from external personnel, the online crowdsourcing platform (OCP) has developed. Problem solvers, such as companies and organizations, post the idea recruitment information they need online. Solvers visit OCPs to search and participate in several idea contests. The objective of the current study is to explore the leading factors of recommendation intention of OCP visitors. This paper is based on a survey of OCP visitors in South Korea. The data were validated with structural model equations. The empirical results verified that outcome expectation has a significant positive effect on attitude and recommendation intention. Career promotion does not have a significant positive impact on attitude, while it affects recommendation intention. Corporate reputation is not significantly related to attitude, while it positively influences recommendation intention. The results pointed out that task identity does not have a significant influence on attitude and recommendation intention. Duration does not have a significant correlation with attitude, while it impacts recommendation intention. Attitude has a significant association with recommendation intention. The results of this study will provide useful information for seekers and solvers.
Lowering the Stakes: Quasi-Experimental, Mixed-Methods Evaluation of a Restructured Grading Approach in a Graduate Public Health Research Methods Course
Authors: Lang Delia L. , Barry Caroline M. , Ibragimov Umedjon , Rodriguez Juan L. , Walker Elizabeth Reisinger
Published: July 2024

In schools and programs of public health, active learning and restructured feedback strategies may improve student learning and course performance compared to traditional lecture-based formats and grading systems. To promote student engagement and active learning, we implemented the team-based learning (TBL) model and a restructured grading approach based on principles of “ungrading” in the required behavioral research methods course of a master’s level public health curriculum. We conducted a quasi-experimental, mixed-methods evaluation of the implementation of restructured grading approach (two sections, n = 46) compared to the traditional grading approach (two sections, n = 34). For the restructured grading sections, numeric grades were removed for weekly team quizzes and team assignments. We administered and analyzed pre- and post-course surveys to compare perceived mastery of course learning objectives, intrinsic motivation, and perceptions of grading and instructor feedback by grading approach. Additionally, we compared course grades and final paper grades by grading approach and conducted two focus groups (one for each approach). The results indicate that students’ learning, satisfaction, and perceptions of the course were mainly equivalent across grading approaches. Students in the restructured grading sections demonstrated a few modestly improved outcomes compared to their peers in the traditional grading courses. Students in the restructured grading sections had slightly higher mean course grades, reported greater increase in confidence to critically evaluate research designs, and found team quizzes to be more helpful. Removing grades for team quizzes and assignments supported student learning and reduced student stress.
“I Had Time to Do My Research, Had Time to Think and Educate Myself”: Using Information Work for Nonbinary and Genderfluid Identity Self-Recognition during COVID-19 Isolation
Authors: Stone Amy L. , Gallin-Parisi Alexandra
Published: July 2024

During the COVID-19 pandemic, nonbinary and genderfluid adults did information work to discover their gender identities as they explored information on social media, online, and in person. Due to cisnormative restrictions, this information was necessary to identify and validate their gender identity as authentic. During the pandemic, more nonbinary people were able to self-recognize their own gender because there was more time for reflection and more access to nonbinary narratives online, including representations of nonbinary life that defied White, thin, androgynous ideals. By analyzing interviews with 22 U.S. adults who came out as nonbinary during the pandemic, this qualitative study contributes to both the sociological study of nonbinary identity development and to the information science literature on deeply meaningful and profoundly personal information work. This study also contributes to further understanding of why it seems like more nonbinary and genderfluid people “came out” during the height of the pandemic.
Improving the performance of cutting fluids by using ZnO and ZrO2 nanoparticles
Authors: Naim Shaikh Mohd Bilal , Rosenkranz Andreas , Ali Mohammed , Ahmad Syed Afzal
Published: July 2024

Sustainability is nowadays a global research priority, especially in machining, where optimizing production processes for increased productivity, profits, and efficiency is key. Addressing this need, the adoption of nanofluids in minimum quantity lubrication machining has surged, aligning with environmental concerns and regulatory demands. In this study, sustainable zinc oxide (ZnO) and zirconium dioxide (ZrO2) nanoparticles fabricated using plant extracts have been incorporated into conventional cutting fluids to enhance their machinability performance under minimum quantity lubrication for turning process. The microstructural analysis confirms the successful synthesis of the targeted nanoparticles with excellent purity and size distribution. The addition of nanoparticles significantly enhanced thermal conductivity from 0.5916 W/(m⋅K) for the base fluid to 0.6286 W/(m⋅K) for ZnO and to 0.6242 W/(m⋅K) for ZrO2. Further, nanofluids exhibited an increased dynamic viscosity, 1.435 mPa.s for ZrO2 and 1.125 mPa.s for ZnO as compare to 0.7644 mPa.s of base fluid, attributed to the nanoparticle confinement effect whereas contact angle measurements indicated an improved wettability for all nanofluids. Machining experiments validate the efficacy of nanofluids, demonstrating reduced cutting temperatures and enhanced surface finish. Notably, ZrO2-based nanofluids exhibit improved tribological response, while ZnO-based nanofluids showcase exceptional heat transfer ability, offering promising solutions to key technical challenges in machining processes. In conclusion, this study underscores the potential of green, sustainable ZnO and ZrO2 nanoparticles as additives in cutting fluids, poised to revolutionize metalworking and manufacturing processes, thereby enhancing product quality and sustainability.
Complications, Readmissions, and Reoperations in Outpatient vs Inpatient Total Ankle Arthroplasty: A Systematic Review and Meta-analysis
Authors: Akhtar Muzammil , Razick Daniel , Mamidi Deeksha , Aamer Sonia , Siddiqui Fayez , Wen Jimmy , Shekhar Sakthi , Shekhar Adithya , Lin Jason S.
Published: July 2024

Background:

Total ankle arthroplasty (TAA) has primarily been performed in the inpatient setting. However, with the advent of fast-tracked joint arthroplasty protocols, TAA has slowly been shifting to the outpatient setting. Therefore, this systematic review aims to evaluate outcomes of outpatient TAA and compare them to inpatient TAA.

Methods:

A literature search was performed on October 23, 2023, in the PubMed, Embase, and CENTRAL databases using the PRISMA guidelines. Studies were included if they reported on outcomes of outpatient TAA or compared outcomes between outpatient and inpatient TAA. Pooled odds ratios (ORs) and mean differences were calculated using a random effects model. Quality assessment was performed using the MINORS criteria.

Results:

12 studies were included, with 4 outpatient-only and 8 outpatient-inpatient comparative studies. Patients in the outpatient group were relatively younger, had a lower body mass index, and had fewer comorbidities relative to the inpatient group. For outpatient vs inpatient TAA, the pooled complication rate was 2.6% vs 3.6%, readmission rate was 2.5% vs 4%, and reoperation rate was 3.6% vs 5.5%. We found significantly lower odds of complications (OR = 0.47, CI: 0.26-0.85; P = .01), readmissions (OR = 0.63, CI: 0.54-0.74; P < .00001), and reoperations (OR = 0.66, CI: 0.46-0.95; P = .03) in the outpatient vs inpatient group.

Conclusion:

Although this analysis is limited by the dominance of data included from a single study, we found that outpatient TAA was generally performed on lower-risk patients and was associated with lower rates of complications, readmissions, and reoperations compared with inpatient TAA.
OCT Features of the Donor Area in Autologous Retinal Transplant Surgery for Macular Hole
Authors: Medina-Medina Silvia , Ramírez-Estudillo Abel , Rojas Juárez Sergio
Published: July 2024

Purpose: To describe the structural features of the autologous retinal transplant donor tissue area seen on optical coherence tomography (OCT). Methods: This observational prospective study included patients who had vitrectomy and autologous retinal graft surgery for a macular hole. OCT of the donor area was performed in the postoperative period after gas reabsorption (mean, 16.2 days ±9.8 [SD] after surgery; range, 7 to 28 days), and structural findings in the harvest area were recorded and analyzed. Results: Of the 12 eyes included in the series, most showed glial tissue or some migration of the inner nuclear layer (INL) in the donor area. Hyperreflective dots and epiretinal membranes were present in a few cases; 2 eyes showed denuded retinal epithelial pigment. Conclusions: OCT revealed changes in the donor area, predominantly filled with glial tissue, INL migration, and inflammatory signs, that mostly resolved during follow-up.
Disaggregating Data Regarding Suicidal Ideation and Suicide Attempts among Post-9/11 Asian American and Pacific Islander Veterans
Authors: Monteith Lindsey L. , Forster Jeri E. , Holliday Ryan , Miller Christin , Bahraini Nazanin H. , Akhtar Fatema Z. , Schneiderman Aaron I. , Brenner Lisa A. , Hoffmire Claire A.
Published: July 2024

The suicide rate among Asian American and Pacific Islander veterans has increased; however, data aggregation for these groups, combined with underinclusion in research, limits understanding regarding risk. We conducted a secondary analysis of Comparative Health Assessment Interview Research Study 2018 data to compare suicidal ideation (SI) and suicide attempt (SA) prevalence among 668 post-9/11 veterans who identified as Asian American, Pacific Islander, or both and described SI and SA prevalence among specific subgroups. Veterans who identified as both Asian American and Pacific Islander were more likely to report experiencing SI (lifetime and during their military service), compared to those who identified solely as Asian American or Pacific Islander (military SI only). Statistically significant differences were not detected for SI preceding or following military service or for lifetime SA. Weighted estimates for lifetime SI and SA were 24.2% and 6.5%, respectively, and prevalence varied widely among specific Asian American and Pacific Islander groups. However, small cell sizes and wide confidence intervals were limitations. Increased clinical attention to screen for and mitigate suicide risk among veterans who identify as both Asian American and Pacific Islander may be warranted. To ensure that suicide prevention strategies optimally address their needs and experiences, research is needed to elucidate suicide drivers in this population. Considering the heterogeneity in SI and SA prevalence among different Asian American and Pacific Islander groups, continued research with larger subsamples that disaggregates analyses by race and ethnicity is essential to deliver prevention and health promotion strategies targeted to the highest-risk groups.
Seismic performance and damage assessment of bridges during the 2023 Kahramanmaras, Türkiye earthquakes (Mw = 7.8, Mw = 7.6)
Authors: Bas Selcuk , Hunt Jeffrey , Gencturk Bora , Jampole Ezra , Sonmezer Yetis Bulent , Chancellor Brent , Bassal Patrick , Celiker Murat , Apaydin Nurdan , Sezen Halil
Published: July 2024

This article presents a summary of the damage observed in bridges in the regions affected by the 6 February 2023 Kahramanmaras, Türkiye earthquake sequence. A bridge database was developed based on the observations from multiple reconnaissance groups that visited the bridges. These reconnaissance groups collectively visited 140 individual bridges that were subjected to various intensities of ground shaking. The severity of the observed damage ranged from no damage to total collapse. The types of damage to bridge components mainly included cracking and shifting of abutments, failure of pier cap shear blocks, shifting or dislodging of bearing pads, cracking of girders and loss of prestress, plastic hinging at pier bases, residual pier drift, and distress to deck surfaces, handrails, and carried utilities. Recorded and estimated seismic intensity measures are presented for each bridge site, and statistical information and correlations were developed considering the intensity of shaking, bridge parameters, and observed damage. Observations from a few visited sites are presented as case studies to illustrate the common failure mechanisms. The bridge database and presented results are expected to serve as a reference for further analysis, such as statistical verification, correlation, or damage estimations, and discussion regarding the mitigation of the observed vulnerabilities of bridges in Türkiye and those with similar construction worldwide.
The Prisoner’s Dilemma game as a tool to investigate cooperation and undergraduate education in evolution
Authors: Russell James E. , Xu Xin
Published: July 2024

Evolutionary theory is based on the conflict that arises when certain heritable variants out-compete others. Given this foundational conflict, a central question for evolutionary biologists concerns the presence of cooperation found throughout all levels of biological organization; from biochemical pathways to complex animal societies. Human behavior is often distinguished from other animal behavior by the presence of acts of cooperative behavior called altruism. Altruism is a cooperative act that penalizes the actor for actions that benefit the recipient. Any other form of cooperation, one that does not penalize the actor, is formally not considered altruistic. How can costly altruistic behavior evolve? This question was the basis for development of a web application tool incorporating a game theory model to investigate conditions affecting cooperative behavior. The game theory model described as Prisoner’s Dilemma incorporates acts of cooperation and non-cooperation (defection). Computer simulations of Prisoner’s Dilemma were developed and online applications were administered for five semesters at Georgia Gwinnett College, using two simulation environments referred to as Random and Non-random. Data collected from simulation runs were used to evaluate the effect of environment on student cooperative behavior and actively engage students in concepts associated with the evolution of cooperation and game theory. Results from student game play suggest group simulation environment played a significant role in the likelihood of observing cooperative behavior. Educational content and attitudinal surveys suggested that PD game play in the undergraduate evolution class at Georgia Gwinnett College improved student knowledge and self-confidence.
Cerebrovascular events and thrombolysis in pulmonary embolism-induced cardiac arrest: a case series and key challenges
Authors: Zhang Youping , Peng Shu , S.Marquez Karl Nelson , Fu Xiangning , Ai Bo , Yan Hua , Zhu Wei , Li Shusheng
Published: July 2024

Background and purpose

Cerebrovascular events during thrombolysis in cardiac arrest (CA) caused by pulmonary embolism (PE) is a life-threatening condition. However, the balance between cerebrovascular events and thrombolytic therapy in PE-induced CA remains a great challenge.

Methods

In this study, we reported three unique cases regarding main concerns surrounding cerebrovascular events in thrombolytic therapy in PE-induced CA.

Results

The patient in the case 1 treated with thrombolysis during CPR and finally discharged neurologically intact. The patient in the case 2 received delayed thrombolysis and died eventually. The patient in the case 3 was contraindicated to thrombolysis due to the complication of subarachioid hemorrahage and died within days.

Conclusions

Our case series highlights three proposed approaches to consider before administering thrombolysis as a treatment option in PE-induced CA patients: (1) prolonging the resuscitation, (2) administering thrombolysis promptly, and (3) ruling out cerebrovascular events.
"Re-evaluation of variants of uncertain significance in patients with hereditary arrhythmogenic disorders"
Authors: Martin Sarah , Jenewein Tina , Geisen Christof , Scheiper-Welling Stefanie , Kauferstein Silke
Published: July 2024

Background

Genetic diagnostics support the diagnosis of hereditary arrhythmogenic diseases, but variants of uncertain significance (VUS) complicate matters, emphasising the need for regular reassessment. Our study aims to reanalyse rare variants in different genes in order to decrease VUS diagnoses and thus improve risk stratification and personalized treatment for patients with arrhythmogenic disorders.

Methods

Genomic DNA was analysed using Sanger sequencing and next-generation sequencing (NGS). The Data was evaluated using various databases and in silico prediction tools and classified according to current ACMG standards by two independent experts.

Results

We identified 53 VUS in 30 genes, of which 17 variants (32%) were reclassified. 13% each were downgraded to likely benign (LB) and benign (B) and 6% were upgraded to likely pathogenic (LP). Reclassifications mainly occurred among variants initially classified in 2017–2019, with rates ranging from 50 to 60%.

Conclusion

The results support the assumption that regular reclassification of VUS is important, as it provides new insights for genetic diagnostics, that benefit patients and guide therapeutic approach.
Long-term effects of COVID-19 on endothelial function, arterial stiffness, and blood pressure in college students: a pre-post-controlled study
Authors: Peng Jianwei , Guo Wenhuang , Li Peilun , Leng Lu , Gao Dongdong , Yu Zhendong , Huang Jinglin , Guo Jinghui , Wang Shen , Hu Min , Huang Junhao
Published: July 2024

Background

The COVID-19 has been shown to have negative effects on the cardiovascular system, but it is unclear how long these effects last in college students. This study aimed to assess the long-term impact of COVID-19 on arterial stiffness, endothelial function, and blood pressure in college students.

Methods

We enrolled 37 college students who had been infected with COVID-19 for more than 2 months. Brachial artery flow-mediated dilation (FMD) was used to assess endothelial function, while arterial stiffness was evaluated using the ABI Systems 100, including variables such as ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), carotid-femoral pulse wave velocity (cfPWV), heart rate (HR), and blood pressure (BP).

Results

Our results showed that FMD was significantly impaired after COVID-19 infection (p < 0.001), while cfPWV and systolic blood pressure (SBP) were significantly increased (p < 0.05). Simple linear regression models revealed a significant negative correlation between post-COVID-19 measurement time and baPWV change (p < 0.01), indicating an improvement in arterial stiffness over time. However, there was a significant positive correlation between post-COVID-19 measurement time and diastolic blood pressure (DBP) change (p < 0.05), suggesting an increase in BP over time. There were no significant differences in ABI and HR between pre- and post-COVID-19 measurements, and no significant correlations were observed with other variables (p > 0.05). Conclusion: Our study demonstrated that COVID-19 has long-term detrimental effects on vascular function in college students. However, arterial stiffness tends to improve over time, while BP may exhibit the opposite trend.
Evaluation of perinatal anxiety assessment measures: a cognitive interview study
Authors: Meades Rose , Sinesi Andrea , Williams Louise R. , Delicate Amy , Cheyne Helen , Maxwell Margaret , Alderdice Fiona , Jomeen Julie , Shakespeare Judy , Yuill Cassandra , Ayers Susan , Best Catherine , Hann Agnes , Salmon Debra , Uddin Nazihah , Walker James , Gilbody Simon ,   the MAP Study Team
Published: July 2024

Background

Anxiety in pregnancy and postpartum is highly prevalent but under-recognised. To identify perinatal anxiety, assessment tools must be acceptable, relevant, and easy to use for women in the perinatal period.

Methods

To determine the acceptability and ease of use of anxiety measures to pregnant or postpartum women (n = 41) we examined five versions of four measures: the Generalised Anxiety Disorder scale (GAD) 2-item and 7-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS). Cognitive interviews were used to examine ease of comprehension, judgement, retrieval and responding.

Results

All measures were acceptable. Some items were deemed less relevant to the perinatal period e.g., difficulties sleeping. Ease of comprehension, judgement, retrieval and responding varied, with all measures having strengths and weaknesses. The SAAS and CORE-10 had the lowest mean number of problematic components. The GAD had the highest mean number of problematic components​. Non-binary response options were preferred. Preferences for time frames (e.g. one week, one month) varied. Qualitative data provides in-depth information on responses to each measure.

Conclusions

Findings can be used to inform clinical guidelines and research on acceptable anxiety assessment in pregnancy and after birth.
Non-genetic factors and breast cancer: an umbrella review of meta-analyses
Authors: Yiallourou Anneza , Pantavou Katerina , Markozannes Georgios , Pilavas Antonis , Georgiou Andrea , Hadjikou Andria , Economou Mary , Christodoulou Neophytos , Letsos Konstantinos , Khattab Elina , Kossyva Chrystalleni , Constantinou Maria , Theodoridou Melanie , Piovani Daniele , Tsilidis Konstantinos Κ. , Bonovas Stefanos , Nikolopoulos Georgios K.
Published: July 2024

Background

Previous research has found associations between various non-genetic factors and breast cancer (BrCa) risk. This study summarises and appraises the credibility of the available evidence on the association between non-genetic factors and BrCa risk.

Methods

We conducted an umbrella review of meta-analyses. Medline, Scopus, and the Cochrane databases were systematically searched for meta-analyses examining non-genetic factors and BrCa incidence or mortality. The strength of the evidence was graded in four categories (i.e., weak, suggestive, highly suggestive, convincing).

Results

A total of 781 meta-analyses from 280 publications were evaluated and graded. We included exposures related to anthropometric measurements, biomarkers, breast characteristics and diseases, diet and supplements, environment, exogenous hormones, lifestyle and social factors, medical history, medication, reproductive history, and pregnancy. The largest number of examined associations was found for the category of diet and supplements and for exposures such as aspirin use and active smoking. The statistically significant (P-value < 0.05) meta-analyses were 382 (49%), of which 204 (53.4%) reported factors associated with increased BrCa risk. Most of the statistically significant evidence (n = 224, 58.6%) was graded as weak. Convincing harmful associations with heightened BrCa risk were found for increased body mass index (BMI), BMI and weight gain in postmenopausal women, oral contraceptive use in premenopausal women, increased androstenedione, estradiol, estrone, and testosterone concentrations, high Breast Imaging Reporting and Data System (BIRADS) classification, and increased breast density. Convincing protective factors associated with lower BrCa risk included high fiber intake and high sex hormone binding globulin (SHBG) levels while highly suggestive protective factors included high 25 hydroxy vitamin D [25(OH)D] levels, adherence to healthy lifestyle, and moderate-vigorous physical activity.

Conclusions

Our findings suggest some highly modifiable factors that protect from BrCa. Interestingly, while diet was the most studied exposure category, the related associations failed to reach higher levels of evidence, indicating the methodological limitations in the field. To improve the validity of these associations, future research should utilise more robust study designs and better exposure assessment techniques. Overall, our study provides knowledge that supports the development of evidence-based BrCa prevention recommendations and guidance, both at an individual level and for public health initiatives.

Trial registration

PROSPERO CRD42022370675.
Clinical characteristics and outcome of critically ill children referred to a tertiary hospital in Indonesia: a prospective observational study
Authors: Rusmawatiningtyas Desy , Oktaria Vicka , Pudjiadi Antonius H , Makrufardi Firdian , Woensel Job. B.M. van
Published: July 2024

Background

The clinical characteristics of pediatric critically ill patients who need referral to a tertiary hospital is often unknown in resource limited settings where constraints in diagnosis capacity, resources, and infrastructures are common. There is a need to increase insight in the characteristics of these patients for capacity building strengthening and appropriate resource allocation. The aim of this study was to describe the clinical characteristics and outcomes of critically ill children who are referred to a tertiary referral teaching hospital in Yogyakarta.

Methods

A prospective observasional study was carried out from July 1st, 2022 -January 31st, 2023 which included all critically ill pediatric patients who were referred through the Integrated Referral System (SISRUTE) to the Pediatric Intensive Care Unit (PICU) of dr. Sardjito hospital. We excluded patients who were referred with a request for admission to the PICU, but were not admitted to the PICU due to their stable condition and lack of the need for intensive care.

Result

During the study period, we received 1046 emergency referral requests for pediatric patients via SISRUTE, of those, 562 (53.7%) patients were critically ill. The reasons of PICU referral request were the need of solely intensive care 504 (89.7%), the need of multidisciplinary team care, including intensive care 57 (10.1%) and parents request 1 (0.3%). The pre-referral emergency diagnosis was shock 226 (40.3%), respiratory distress/failure 151 (26.7%), central nervous system (CNS) dysfunction 135 (24.1%), trauma 33 (5.9%) and sepsis 17 (3%). Of the 562 critically ill PICU referral requests, 473 (84.2%) requests were accepted. One hundred and eighty-one (58.7%) patients were finally admitted to the PICU, 125 (40.3%) admitted to our regular ward due to stable condition, 4 (1.3%) patients died in Emergency Departement (ED). The remaining accepted patients on request did not arrive in our facility due to various reasons. The mean (SD) response time was 9.1 (27.6) minutes. The mean (SD) transfer time was 6.45 (4.73) hours. Mean (SD) PICU and hospital length of stay was 6.7 (8.3) days and 10.2 (9.2) days respectively. PICU and hospital mortality was 24.3% and 29.7%, respectively.

Conclusion

The mortality rate for critically ill pediatric patients referred to a tertiary PICU still high, with shock being the most common pre-referral emergency diagnosis. There is a discrepancy between the referring hospital’s and the referral hospital’s indication for PICU admission. The time required to reach the referral hospital is quite lengthy.