bluuebunny/crossref_metadata_2025 huggingface dataset:
A objeção do self parfitiano na guinada política de John Rawls
Authors: Leite Rafaela Fernandes , Carvalho Yago Condé Ubaldo de
Published: July 2023

Neste artigo, tratamos de um desafio lançado inicialmente por Derek Parfit contra a teoria da justiça de Rawls, que diz respeito ao problema da identidade pessoal e como isso pode se relacionar com os princípios distributivos da justiça. Acreditamos, como indicado por Paul Weithman, que tal problema desempenha um papel relevante na guinada política de Rawls – movimento pelo qual designamos as transformações em sua teoria do período de Uma Teoria da Justiça para o da publicação de Political Liberalism. O próprio Weithman já forneceu uma análise acurada de como essa objeção, a qual daqui em diante nos referimos como a objeção do self parfitiano, minou a primeira tentativa de Rawls de mostrar como sua concepção de justiça seria estável. É provável, no entanto, que seja fácil perder o rumo desse debate, que foi de certa forma mediado por Samuel Scheffler. É por isso que fornecemos uma exposição cronológica desse debate na seção 1. Depois disso, na seção 2, reafirmamos o relato de Weithman de como o self parfitiano mina a estabilidade da concepção de justiça de Rawls em Uma Teoria da Justiça. Por fim, na seção 3, examinamos se essa dificuldade é devidamente tratada em Political Liberalism. Assim, sobretudo com este último passo, esperamos que esta abordagem possa acompanhar e complementar as contribuições anteriores de Weithman.
Intoxicação por chá de Brugmansia suaveolens (trombeta de anjo) em paciente jovem previamente hígido: relato de caso
Authors: Mamani Roxana Flores , Coelho David Richer Araujo , Mendes Isabel Cristina Melo , Gress Claudio Heitor Tavares , Oliveira Ana Luiza Martins de , Galliez Rafael Mello , Pimentel Clarisse
Published: July 2023

Introdução: A Brugmansia suaveolens, conhecida como “trombeta de anjo,” é uma planta com alcaloides anticolinérgicos que provocam inibição da atividade de receptores muscarínicos no sistema nervoso central e periférico. Sua toxicidade resulta em agitação, alucinações, hipertermia, taquicardia, rabdomiolise, insuficiência renal e morte. Objetivo: Descrever um caso de intoxicação aguda por chá de trombeta, cursando com hepatite fulminante. Materiais e Métodos: Trata-se de um relato de caso, com dados clínicos e laboratoriais coletados a partir dos registros em prontuário. Termo de Consentimento Livre e Esclarecido foi obtido com familiar e o projeto foi aprovado pelo Comitê de Ética em Pesquisa. Relato de Caso: Masculino de 19 anos, saudável, internado por quadro de febre de 41°C e crises convulsivas tônico-clônicas generalizadas, evoluindo para intubação orotraqueal. Apresentava midríase fixa e rigidez de nuca. Família relata que o paciente tinha feito uso de chá de “trombeta de anjo”. À admissão, realizou tomografia computadorizada de crânio, que não evidenciou desvio de linha média, líquor sem alterações, gasometria arterial com acidose metabólica grave, insuficiência renal aguda com necessidade dialítica e insuficiência hepática aguda fulminante. Conclusões: A intoxicação pelo “chá de trombeta” é uma emergência neurológica que deve ser rapidamente reconhecida por ser potencialmente fatal. Tendo meningite como diagnóstico diferencial, é importante obter história clínica completa para investigar possível contato prévio com a planta. Para nosso conhecimento, esse é o primeiro caso a relatar quadro de hepatite fulminante pela “trombeta de anjo,” além dos sintomas neurológicos já descritos em literatura, o que corrobora ainda mais para a importância do tema em questão.
28S rRNA gap deletion in two species of Girardia (Platyhelminthes, Tricladida, Dugesiidae).
Authors: Penha Bárbara Rosa , De Oliveira Matheus Salgado , Lopes Karla Andressa Ruiz , Morais Flavia Villaça , De Campos Velho Nádia Maria Rodrigues
Published: July 2023

Studies have shown atypical migration of the 28S rRNA molecule when exposed to heat, dissociates into two subunits (28Sα and 28Sβ), this event is due to a ‘gap deletion’ in the molecule. This rRNA degradation has been correlated to a UA-rich conserved segment. We show the atypical 28S rRNA molecule migration in Girardia tigrina and Girardia sp.. The presence of conserved motifs, 28S rRNA, was confirmed. The UA-rich segment was absent. The 5´-CGAAAGGG-3´ motif was present, indicating that the dissociation 28S rRNA is independent of the UA-rich signal. We propose the existence of a putative secondary structure for the D7a segment of the 28S rDNA molecule and suggest that the atypical RNA profile observed may occur across the Girardia genus.
Women in Political Bodies as Policymakers
Authors: Baskaran Thushyanthan , Hessami Zohal
Published: July 2023

We investigate how female representation impacts policymaking using the example of child care and new hand-collected data on local council elections in Bavaria. RDD estimations (mixed-gender races for last party-specific council seats) show that an additional female councilor accelerates the expansion of public child care by 40%. We also document an important nonlinearity: an additional woman accelerates the expansion of child care only in councils with few women. Council meeting minutes reveal that women can be effective in councils despite being a non-pivotal minority because they change “the conversation”.
Omitted Variable Bias in Interacted Models: A Cautionary Tale
Authors: Feigenberg Benjamin , Ost Ben , Qureshi Javaeria A.
Published: July 2023

We highlight that analyses using interaction terms to study treatment effect heterogeneity are susceptible to a form of omitted variable bias that is often overlooked in economics. Unlike most instances of omitted variable bias, the omitted variables in this case are available to the researcher but were not included in the model. We demonstrate that this exclusion matters based on a replication of 205 estimates across 17 papers published in the American Economic Review over a five-year period. For approximately 60% of these papers, failing to account for the omitted variables changes the majority of estimates by more than 100%.
Crafting Paul’s Masculinity: A Re-Reading of Philemon
Authors: Shields Marcus
Published: July 2023

This article uses the hermeneutics of masculinity to outline and review Paul’s interaction with Philemon. In the ancient context, masculinity was ascertained through education, training, and performance. Being a “man” is made through a Greco-Roman context. Paul asserts this masculinity: self-assertion and power, in his letter to Philemon.
Visual Communication of Probabilistic Information to Enhance Decision Support
Authors: Heggli Anne , Hatchett Benjamin , Tolby Zach , Lambrecht Kathryn , Collins Meghan , Olman Lynda , Jeglum Matthew
Published: July 2023

When hazardous weather is forecast, communicating probabilistic information (PI) can improve trust, confidence, and understanding of forecast information, resulting in improved decision-making by emergency managers and public audiences. With probabilistic forecast tools modernizing forecast operations, the National Weather Service is calling on regional offices to increase the use of PI. However, communicating PI can be challenging since the information is intrinsically more complex than single-value deterministic forecasts that do not include a measure of uncertainty. We suggest that effective PI visualization not only includes the PI graphic but also communicates potential impacts and issues preventative guidance to limit exposure to weather-related hazards. Decision support tools like PI benefit from, if not require, effective visual communication that capitalizes on the efficiency of the visual system to extract information, decrease the time to interpret information, and increase the understanding of uncertainties. Furthermore, PI visuals need to be accessible to disabled and neurodivergent audiences. To enhance the visual communication of PI, we synthesize literature from graphic design and social science to identify guiding principles for effective visual communication and provide a one-page printout quick guide. To showcase how forecasters can incorporate guiding principles in the local context, we provide examples built from readily usable templates to demonstrate how probabilistic forecast information extracted from tools like the National Blend of Models can be used to enhance the visual communication of PI to support more informed decision-making.
Mutual Sense-Censoring, Generative Exploration, and Collaborative Change: A Case Study of Headquarters–Subsidiary Relationships in Asia
Authors: Nagaishi Makoto
Published: July 2023

This study contributes to the literature on power processes within multinational corporations (MNCs) by finding that the headquarters and subsidiaries mutually censor their sensemaking and may opt for strategic inaction, depending on the relational context. It develops systematic explanations of the patterns in the headquarter–subsidiary partnership by proposing a model of evolutionary, co-existent meaning-making transition processes. In a Japanese manufacturing MNC, change practitioners helped balance paradoxical processes to create psychological safety in a dialogic space, leading members to move ahead with a sense of crisis. The study deals with collective reactions to change from a qualitatively grounded approach. It then proposes theoretical and practical implications for building collaboration capability in multistakeholder partnerships by inspiring people's spirit of inquiry.
‘It’s a Small Little Pub, but Everybody Knew Everybody’: Pub Culture, Belonging and Social Change
Authors: Thurnell-Read Thomas
Published: July 2023

Public houses have long served an important social role in the United Kingdom, yet in recent decades the conditions under which they operate have changed dramatically. While research has examined adaptations in the pub sector, there is little analysis of how this relates to social change as experienced in the lives of individuals and communities. Pubs are therefore a useful topic of sociological inquiry. Using focus groups data, this article examines how people experience the changing form and function of pubs reveals insights into perceptions of social change. Findings show that participants were aware of how pub culture has changed over recent decades and that this was linked to perceptions of wider social and cultural changes in society. Talking about pub going was a means to express dynamic feelings of belonging and attachment, particularly where they arise at the intersection of personal life changes and wider social transformations.
Arrhythmia Resolution After Successful Parathyroidectomy for Primary Hyperparathyroidism
Authors: Arowojolu Omotayo A. , Fong Juliana , Shane Lisa , Tan Jesse W.
Published: July 2023

The prevalence of primary hyperparathyroidism (PHPT) is increasing as routine laboratory testing for calcium and parathyroid hormone becomes more prevalent due to heightened awareness of the disease. PHPT affects multiple organ systems including the cardiovascular system. This case report highlights a patient with first degree atrio-ventricular block pre-operatively that resolved after resection of her parathyroid adenoma. This case emphasizes the importance of treating asymptomatic hyperparathyroidism to optimize cardiac function.
Investigation of the surface quality and machinability of AISI 316LVM
Authors: Ozdemir Emin , Gullu Abdulkadir
Published: July 2023

Surface quality has a significant effect on the reliability of an implant. The surface finish of the workpiece is influenced by machining parameters, tool wear and cooling–lubrication conditions. Typically, mineral oil-based conventional cutting fluids are employed for cooling and lubricating purposes in industrial machining processes. However, the use of these fluids places costly environmental and health responsibilities on companies. Consequently, it is preferable to utilize an affordable and environmentally friendly coolant/lubricant that does not generate liquid waste or have harmful side effects. In this work, we conducted experimental investigations to examine the effect of cutting forces, cutting temperature, tool wear and the quality of the machined surface on the machinability performance of medical grade AISI 316LVM austenitic stainless steel. Five different cutting conditions were employed in the machining experiments: dry cutting, flood, minimum quantity lubrication (MQL), cryogenic cutting with liquid carbon dioxide (LCO2) and cryogenic cutting with liquid nitrogen (LN2). Compared to the dry-cutting condition, the cutting temperature decreased by 42.1% under LN2 and flood conditions and by 40.4% under LCO2 conditions. The cutting tools exhibited small amounts of flank wear and nose wear, along with the formation of built-up edges (BUE); however, no crater wear was observed. The MQL method resulted in the lowest cutting forces, while the cryogenic methods yielded the highest cutting forces. Among the cutting conditions, the MQL and flood conditions produced the lowest roughness values and the best surface quality. Conversely, the cryogenic cutting conditions led to the highest roughness values and the poorest surface quality. Furthermore, the MQL condition resulted in the lowest dimensional deviations.
Teaching time as a social imaginary. Using speculative fabulation to deconstruct the hegemonic temporalities of modernity
Authors: Preda Marian , Matei Ștefania
Published: July 2023

In this paper, we discuss our experience in teaching time to university students. Our analysis suggests that students’ sociological imagination and fictional creativity might be used as means to deconstruct the hegemonic temporalities of modernity. Specifically, we exemplify our claims by considering a set of classroom activities that use speculative fabulation in order to make students question key assumptions about the objective nature of time. The activities we discuss are based on an original combination of exposure to cultural products, reflective writing exercises, and moderated group discussion, thus opening up new horizons of temporal experimentation, exploration, and interpretation. Our activities invite students to imagine alternative temporalities that are decoupled from prevalent mindsets and challenge the taken-for-granted assumptions about the temporal worlds. The assignments are designed as imaginative scenarios, in which students are asked to question the universal, commodified, and absolute notion of time while becoming familiar with the work of relevant thinkers in sociology and anthropology. Based on our results, we conclude that speculative fabulation holds a strong emancipatory potential and is able to bring about significant changes in how students think about time, because it promotes more empowering and meaningful ways of engagement with the world.
A Comparison of Postoperative Outcomes between Unilateral and Bilateral Palatoplasty: Analysis of 2015-2020 Pediatric NSQIP Data
Authors: Marquez Jessica L. , Patel Ashraf A. , Scott Kaylee B. , Sudduth Jack D. , Eddington Devin , Kim Erinn , Johns Dana , Kwok Alvin C. , Agarwal Jayant P.
Published: July 2023

Objective

We sought to identify differences in 30-day medical and surgical complications in unilateral versus bilateral palatoplasty.

Design

The NSQIP-P 2015-2020 database was queried to identify cleft palate repairs using CPT codes. Cases were stratified as unilateral (Veau III) and bilateral (Veau IV) using ICD-9 and −10 codes.

Setting

A nationally representative random sample.

Patients/Participants

A total of 3791 cases were identified with 2608 undergoing unilateral repair and 1183 undergoing bilateral repair.

Main Outcomes/Measures

The postoperative outcomes of interest included surgical complications (surgical site infections, wound dehiscence), medical complications (pneumonia, urinary tract infection, seizure, cardiac arrest, bleeding/transfusions, systemic sepsis, unplanned intubation), readmission, and reoperation.

Results

The bilateral cohort was older (696 days versus 619 days, P < .001) and had longer operative times (157.3 min versus 144.5 min, P < .001). The unilateral cohort had more comorbidities including developmental delay, structural CNS abnormalities, need for nutritional support, and bleeding disorders. The bilateral cohort had statistically significant higher occurrences of wound dehiscence (2.1% versus. 1.2%, P = .03) and readmission (3.2% versus 1.7%, P = .01). On multivariate analysis, bilateral cleft repair (OR: 1.83, CI: 1.176-2.840, P = .007) and ASA class 4 (OR: 13.1, CI 2.288- 62.586, P = .002) were associated with greater odds of readmission.

Conclusion

Patients who underwent bilateral cleft repair had a higher proportion of 30-day postoperative complications and a two-fold increased odds of readmission. While palatoplasty is generally regarded as a safe procedure in the pediatric population, identifying factors related to an increased risk of early postoperative complications can help surgical teams better manage high-risk individuals.
Safety and Hemostatic Effectiveness of SURGICEL® Powder in Mild and Moderate Intraoperative Bleeding
Authors: Al-Attar Nawwar , de Jonge Eric , Kocharian Richard , Ilie Bogdan , Barnett Ellie , Berrevoet Frederik
Published: July 2023

This postmarket clinical study evaluated the safety and effectiveness of the novel adjunctive topical hemostat SURGICEL® Powder (SURGICEL®-P), a powdered form of oxidized regenerated cellulose. In a prospective, open-label, single-arm multicenter trial, adult surgical subjects with mild-to-moderate bleeding for which conventional hemostatic methods were impractical/ineffective were treated with SURGICEL®-P. Descriptive analyses included hemostatic success rate at 3, 5, and 10 min, rebleeding and thromboembolic events, SURGICEL®-P-related serious adverse events requiring surgical intervention, and SURGICEL®-P ease of use (questionnaire). In 8 centers, 103 subjects were enrolled with a median (range) age of 64.0 (33.0-88.0) years. Surgeries were open (53.4%) or laparoscopic/thoracoscopic (46.6%) and mostly urological (37.9%) and abdominal (32.0%) procedures. Bleeding sites included various tissue types, with a median (range) surface area of 4 (0.02-72.0) cm2. Hemostatic success rates were 77.7%, 87.4%, and 92.2% at 3, 5, and 10 min, respectively. In 7 subjects (6.8%), investigators reverted to standard of care. No safety signals were identified. Two deaths occurred with causes unrelated to SURGICEL®-P. Investigators favorably evaluated the ease of use of the SURGICEL®-P device. SURGICEL®-P is safe and effective in controlling mild-to-moderate bleeding in a broad range of surgical procedures. The trial was registered at https://clinicaltrials.gov as NCT03762200.
Gamification in tourism research: A systematic review, current insights, and future research avenues
Authors: Pradhan Debasis , Malik Garima , Vishwakarma Pankaj
Published: July 2023

Gamification has now become an integral part of tourism research and practice. However, a structured review of this growing application of gamification still eludes tourism research. To this end, this research conducts a hybrid systematic review of the existing literature by combining a bibliometric and framework-based review. The purpose of the research is to identify key issues, offer insights into the potential of gamification in tourism, and suggest areas for future research. This study draws on an integrative framework of antecedents, decisions, and outcomes (ADO)—theory, context, and methods (TCM) to carry out this review. This review synthesizes the extant research on gamification in tourism since its evolution. This review is based on 64 relevant articles drawn from the Scopus database. The current hybrid systematic review identifies five clusters (i.e., customer gamification experience, gamification mechanics and design, gamification in tourism, gamification and tourist attraction, and gamification for sustainable tourism). This research suggests utilization of new, yet relevant theories for examining the underexplored areas of gamification in tourism. Furthermore, this study recommends the employment of machine learning techniques, EEG, eye-tracking method, and experimental research for gaining a nuanced understanding of this field. We conclude by offering key insights into future research avenues.
‘I feel more part of the world’: Participatory action research to develop post-diagnostic dementia support
Authors: Watson Julie , Wilcockson Jane , Houston Agnes , van Wyk Adele , Keyes Sarah , Murphy Damian , Hare Philly , Wiersma Elaine , Clarke Charlotte
Published: July 2023

Many people living with dementia are ‘on the margins’, not accessing services and support, despite policy and care advancements. The COVID-19 pandemic exacerbated this, with the closure of face-to-face support during lockdowns in the UK and globally. The aim of the ‘Beyond the Margins’ project was to develop, implement, and evaluate a face-face programme of support with, by and for people with direct experience of dementia who are on the margins of existing services and support. In March 2020 the project was interrupted by the outbreak of the COVID-19 pandemic and it changed to an online format. The three-phase participatory action research project included 40 people living with dementia, 26 care partners and 31 health and social care practitioners. A seven-week online personal development programme called Getting On with Life (GO) was developed, delivered, and evaluated. This paper focuses on the participatory approaches used to develop and implement the GO programme, and the resulting aspects of its approach to facilitation and content. Key features include the GO Programme’s principles of providing a safe and a respectful space, and the programme’s values of: Everyone who comes already knows things, can learn things and can teach things; Doing things ‘with’ each other, rather than ‘for’ or ‘to’ each other; Personalised goals—led by the needs of participants rather than an imposed agenda. A key finding was the importance of developing post-diagnostic programmes as a ‘sandwich’, providing a safe space for learning that is preceded by understanding pathways to access the programme and followed by explicit consideration of the next steps in increasing social engagement.
Histone Deacetylase 3 Inhibition Ameliorates Microglia-Mediated Neuro-Inflammation Via the SIRT1/Nrf2 Pathway After Traumatic Spinal Cord Injury
Authors: Chen Shoubo , Ye Jingfang , Wu Guozhong , Shi Jinnan , Li Xiang , Chen Xiangrong , Wu Wenhua
Published: July 2023

Background

Microglial-induced inflammation plays a crucial role in the pathophysiological process of nervous system injury, however, still lacks effective therapeutic agents. Previously, we discovered that the inhibition of histone deacetylase 3 (HDAC3) exerts anti-inflammatory effects after traumatic spinal cord injury (SCI), whereas little is known about its underlying mechanism. Therefore, the present study aimed to explore the effects and potential mechanisms of HDAC3 on neuroinflammation and microglial function.

Methods

Rats were randomized into 4 groups: sham group, SCI group, SCI + vehicle group, and SCI + RGF966 group. To examine the effect of HDAC3 on neurological deficit after SCI, we gathered data using the Basso Beattie Bresnahan locomotion scale, the inclined plane test, the blood-spinal cord barrier, junction protein expression, and Nissl staining. We also evaluated microglial activation and inflammatory factor levels. Immunofluorescence analysis, immunohistochemical analysis, western blotting, and quantitative real-time polymerase chain reaction were performed to examine the regulation of the Sirtuin 1 (SIRT1)/nuclear factor-erythroid 2-related factor 2 (Nrf2) pathway.

Results

The results showed that HDAC3 inhibition significantly ameliorated Basso–Beattie–Bresnahan (BBB) permeability, brain edema, and improved neurological functions and junction protein levels. Additionally, HDAC3 inhibition significantly inhibited microglial activation, thereby reducing the levels of SCI-induced pro-inflammatory factors. Moreover, HDAC3 inhibition dramatically enhanced the expression of SIRT1 and increased both Nrf2 nuclear accumulation and transcriptional activity, thereby increasing downstream heme oxygenase-1 and NAD(P)H quinone oxidoreductase 1 expression.

Conclusions

The results of this study suggest that HDAC3 inhibition protects the spinal cord from injury following SCI by inhibiting SCI-induced microglial activation and the subsequent inflammatory response via SIRT1/Nrf2 signaling pathway, highlighting HDAC3 as a potential therapeutic target for the treatment of SCI.
Development of Online Post-COVID Intervention Program for Students: Ensuring Effective Reintegration in the Physical Learning Space
Authors: Ponce Roy G. , Alonzo Dennis , Llanita Gorjel , Olandria Asterio , Catubig Ma. Cecilia , Regino Roselyn , Torreno Juvy Lyn , Vilela Eleanor , Polestico Rheacine
Published: July 2023

This study will develop an online intervention program to effectively support students reintegrating into the face-to-face learning space after the COVID-19 pandemic. It will provide an avenue for debriefing, sharing experiences, and listening to students’ narratives and experiences. In addition, the online program will also include a self-paced socialemotional assessment to identify students who need more support. Using the conservation of resource theory, we will employ a sequential exploratory mixed-method design. Thirty students will be recruited for focus group interviews to explore students' views, perceptions, preferences, and issues in returning to face-to-face classes. The results of the focus group interviews will be analysed to develop a survey to understand the perspectives of a wider student population. The survey results will be analysed using a factor analytic approach to develop a reliable and valid self-assessment tool. Findings from both qualitative and quantitative phases will be used to inform the development of the Online post-COVID intervention program for students (OPIPS).
Diagnostic value of procalcitonin, interleukin-6, serum amyloid A and C-reactive protein in simple and strangulated intestinal obstruction
Authors: Zhang Rui , Peng Jing , Ran Zhimin , Xu Ranning , Jin Zhiqiang , Sun Yan , Lang Lei , Tao Jing
Published: July 2023

Objective

To evaluate the value of single or combined detection of procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA) and c-reactive protein (CRP) in the differential diagnosis of simple and strangulated intestinal obstruction.

Methods

This retrospectively study collected 61 patients with intestinal obstruction. The patients were classified into the group of simple or strangulated intestinal obstruction according to operation. The age, sex, basic diseases, lesion sites and inflammatory indicators such as PCT, IL-6, SAA and CRP in two groups were collected and analyzed. The Students’ T-test and the Mann-Whitney U test were used to analyze normally and non-normally distributed data, respectively. The categorical variable was analyzed by the chi-square test. The receiver-operating characteristic (ROC) curve and the area under the curve (AUC) were used to predict the differential diagnostic value of single and combined detection of the above clinical inflammatory indicators.

Results

The serum levels of PCT, IL-6, SAA and CRP of the strangulated group were significantly higher than those of the simple group ( p < .05). The areas under the ROC curve (AUC) were 0.907 for PCT, 0.712 for IL-6, 0.723 for SAA and 0.681 for CRP. With the cutoff values of PCT (0.24 ng/L), IL-6 (19.55 pg/L), SAA (282.50 mg/L) and CRP (63.00 mg/L), the sensitivity and specificity were 86.40% and 87.20% for PCT, 68.20% and 76.90% for IL-6, 59.10% and 87.20% for SAA, 63.60% and 87.20% for CRP, respectively. And the sensitivity and specificity were 86.40% and 89.70% for combined model. The differences between PCT and the combined model are tiny and neither clinically nor statistically significant.

Conclusions

For discriminating strangulated intestinal obstruction from simple intestinal obstruction, PCT alone may be the preferred approach due to its simplicity.
Flexor tendon transfer for focal dystonia with involuntary flexion of the ring finger
Authors: Sato Kotaro , Takahashi Gaku , Murakami Kenya
Published: July 2023

We report a case of task-specific dystonia characterized by involuntary flexion of the ring finger. After resecting the flexor of the ring finger, the flexor digitorum profundus of the middle finger was transferred to the resected site.
Does primary treatment of proximal humerus fractures show favourable functional outcomes over secondary treatment with reverse shoulder arthroplasty?
Authors: Blaas Leanne S , Lameijer Charlotte M , Alta Tjarco DW , Yuan Jian Z , van Dieren Susan , Bloemers Frank W , van Noort Arthur , Derksen Robert Jan
Published: July 2023

Background

This multicentre retrospective cohort study assessed whether functional outcomes after primary reverse shoulder arthroplasty (RSA) are favourable compared to secondary placement in elderly patients with displaced proximal humerus fractures (PHFs).

Methods

Fifty-three patients with primary and 32 with secondary RSA were included. Patient-reported outcome measures (PROMs) were assessed: Constant–Murley Score (CMS), Oxford Shoulder Score (OSS), Disabilities of the Arm, Shoulder and Hand (DASH) score, and Visual Analogue Scale (VAS). In addition, range of motion (ROM) was compared between groups.

Result

For PROMs, the means (SD) for primary versus secondary were 25.4 (17.7), 29.4 (19.2) for DASH; 38 (8.6), 38 (9.1) for OSS; 63 (19.8), 59 (22.0) for CMS and 2 (2.0), 3 (2.3) for VAS. For ROM, the means were the following: forward flexion 113° (33.6), 106° (34.1); abduction 103° (33.4), 96° (37.3) and external rotation 20° (19.1), 20° (17.8). There were significant differences in favour of primary treatment in forward flexion (p = 0.003, B 19.85) and abduction (p = 0.034, B 17.34).

Discussion

ROM in patients with complex displaced PHFs after primary RSA is slightly better than that after secondary treatment. Therefore, RSA could be considered primary treatment, especially when optimal ROM is of great importance to the patient.

Level of evidence

level III, retrospective comparative study treatment study
Muslim peripheries: A world regional perspective
Authors: Akhter Majed
Published: July 2023

This commentary flags three key themes related to Muslim geographies. The first is the diversity and interconnectedness of Islam across regions, and the way Muslim practice is formed through a sense of place. The second is the need to rethink the spatial categories of core and periphery across Muslim space. Lastly, the third suggests that the contextualized study of Muslim geographies should reshape geographical knowledge, especially with respect to world regional geography.
Digital health technologies supporting the application of comprehensive geriatric assessments in long-term care settings or community care: A systematic review
Authors: Molinari-Ulate Mauricio , Mahmoudi Aysan , Parra-Vidales Esther , Muñoz-Sánchez Juan-Luis , Franco-Martín Manuel A , van der Roest Henriëtte G
Published: July 2023

Objective

To provide high-quality elderly care, digital health technologies (DHTs) can potentially assist in reaching the full capacity of comprehensive geriatric assessments (CGAs) to improve communication and data transfer on patients’ medical and treatment plan information and health decision-making. This systematic review aimed to describe the evidence on the feasibility and usability, efficacy and effectiveness, and implementation outcomes of DHTs developed to facilitate the administration of CGAs for long-term care settings or community care and to describe their technical features and components.

Methods

A search strategy was conducted in three databases, targeting studies evaluating the DHTs facilitating the administration of CGAs used in long-term care settings or community care. Studies in English and Spanish published up to 5 April 2023 were considered.

Results

Four DHTs supporting the administration of the CGAs were identified. Limited information was found on the technical features and required hardware. Some of the barriers identified regarding usability can be overcome with novel technologies; however, training of health professionals on the assessments and staff knowledge regarding the purpose of the data collected are not technology related and need to be addressed.

Conclusions

Barriers regarding usability were related to experienced difficulties navigating the software, unstable network connectivity, and length of the assessment. Feasibility obstacles were associated with the lack of training to use the DHT, availability and accessibility to hardware (e.g. laptops), and lack of insight into the clinical benefits of collected data. Further research must focus on these areas to improve the implementation and usefulness of these DHTs.
K-12 Christian school teachers’ open responses regarding faith and learning
Authors: Witwer Mark T.
Published: July 2023

Relating faith and learning is central to Christian education, but few large studies have examined how grade-school teachers understand this task. Witwer previously reported Likert-type data from 1059 teachers in Christian elementary and secondary schools. The present paper reports findings from 2356 open responses by 655 of those teachers. Teachers’ responses associated faith with attitudes about teaching, presenting a Christian perspective on content, and using standard pedagogical practices more often than they reported using distinctive pedagogical practices or limitations in faith’s influence on their teaching. These and other findings add to our understanding of how grade-school teachers perceive teaching Christianly.
The influence of bride price on the marriage quality of Chinese women and its differences between urban and rural areas
Authors: Li Ting , Huang Jingyi , Xiong Yinghong
Published: July 2023

The practice of bride price payment has a longstanding history in China and has become a customary procedure by which men are able to get married. Despite attracting significant research attention due to the escalating bride price amount, few studies have focused on its impact on marriage quality. Using data from the 2020 Beijing and Chengdu Household Survey, this study examined how the bride price amount affects women's marital quality, including marital happiness, marital relationship quality, and exposure to domestic violence, based on three theoretical perspectives: marriage repayment theory, marriage endowment theory, and marriage signal theory. The study also incorporated interaction terms to investigate potential differences in the effects of bride price on women's marital quality between urban and rural areas. The results indicate that the current bride price practice is more aligned with the marriage endowment theory and has a statistically significant positive effect on urban women's marital happiness and relationship quality, but no effect was observed in rural areas. The influence of the bride price amount on the frequency of domestic violence against women also varied between urban and rural areas. Because men in rural areas face a disadvantage in the marriage market and there is a scarcity of available women, they are less likely to resort to domestic violence to manage marital conflicts when paying a higher bride price.
Development and Validation of the Sinonasal Outcome Test-12
Authors: Al Sharhan Salma S. , Al Bar Mohammed H. , Al Saied Abdulmalik S. , Al Somali Maha I. , Abdel Wahab Moataza M.
Published: July 2023

Objectives:

Quality of life (QoL) questionnaires are widely used in clinical interviews to assess the impact of medical interventions or measure the outcomes of healthcare services. The main aim of such questionnaires is the subjective assessment of health status and its impact on QoL. This study aimed to develop an efficient, short sinonasal disease assessment instrument, the sinonasal outcomes test-12 (SNOT-12), and to compare it with the preexisting SNOT-22.

Methods:

This was a two-phase cross-sectional study. The study was performed between June 2019 and February 2020 using the electronic files of the ORL department outpatient clinics at King Fahd University Hospital, affiliated with Imam Abdulrahman Bin Faisal University. The study was performed in 2 phases: an item reduction phase, which resulted in an initial SNOT-12 scale, and a validation phase, using a comparative analysis of the initial SNOT-12 and the SNOT-22.

Results:

The developed short-form SNOT-12 maintained the 4 latent factors extracted in EFA (nasal, Sleep/extra nasal, psychological, ear/facial). It strongly correlated with SNOT-22 ( r = 0.973). It had good construct reliability (0.705-0.901) and validity and a higher discrimination power than the SNOT-22.

Conclusions:

The SNOT-12 is a short, valid, and reliable instrument that may prove useful for the initial screening and monitoring of patients with chronic rhinosinusitis.
Racial and Ethnic Disparity in 4Ms among Older Adults Among Telehealth Users as Primary Care
Authors: Yoo Ji Won , Kang Hee-Taik , Choe Ian , Kim Laurie , Han Dong-Hun , Shen Jay J. , Kim Yonsu , Reed Peter S. , Ioanitoaia-Chaudhry Iulia , Chong Maria Teresa , Kang Mingon , Reeves Jerry , Tabrizi Maryam
Published: July 2023

Telehealth has been widely accepted as an alternative to in-person primary care. This study examines whether the quality of primary care delivered via telehealth is equitable for older adults across racial and ethnic boundaries in provider-shortage urban settings. The study analyzed documentation of the 4Ms components (What Matters, Mobility, Medication, and Mentation) in relation to self-reported racial and ethnic backgrounds of 254 Medicare Advantage enrollees who used telehealth as their primary care modality in Southern Nevada from July 2021 through June 2022. Results revealed that Asian/Hawaiian/Pacific Islanders had significantly less documentation in What Matters (OR = 0.39, 95%, p = .04) and Blacks had significantly less documentation in Mobility (OR = 0.35, p < .001) compared to their White counterparts. The Hispanic ethnic group had less documentation in What Matters (OR = 0.18, p < .001) compared to non-Hispanic ethnic groups. Our study reveals equipping the geriatrics workforce merely with the 4Ms framework may not be sufficient in mitigating unconscious biases healthcare providers exhibit in the telehealth primary care setting in a provider shortage area, and, by extrapolation, in other care settings across the spectra, whether they be in-person or virtual.
Mental Health Effects of Income over the Adult Life Course
Authors: Rauf Tamkinat
Published: July 2023

While a gradient between income and depression is well documented, associational estimates are subject to bias due to measurement errors, reverse causation, and other sources of confounding. Causal studies are few and report small and divergent estimates, even in their direction. But prior research has important limitations for causal inference, such as relying on comparisons between individuals sensitive to each other’s relative income or capturing only a subset of pathways through which income affects well-being. This study leverages longitudinal and genomic data to assess how much some known biases affect the income-depression gradient and to what extent the gradient might be reflective of a causal effect. Findings from three U.S. samples—representing early midlife, late midlife, and older adulthood—are suggestive of a beneficial effect of income on mental health, especially in late midlife and beyond. The results have implications for interpreting the nature of socioeconomic disparities in mental health.
Interplay of TP53 allelic state, blast count, and complex karyotype on survival of patients with AML and MDS
Authors: Stengel Anna , Meggendorfer Manja , Walter Wencke , Baer Constance , Nadarajah Niroshan , Hutter Stephan , Kern Wolfgang , Haferlach Torsten , Haferlach Claudia
Published: July 2023

Several clinical and genetic factors impact overall survival (OS) in myelodysplastic neoplasms (MDS) and acute myeloid leukemia (AML), including complex karyotype (CK), TP53 allelic state, and blast count. We analyzed the interplay of these factors by performing Cox regression analysis and by determining the frequency of TP53 single-hit (sh) and double-hit (dh) events and OS in MDS (n = 747) with <5% blasts, with ≥5% but <10% blasts, and ≥10% but <20% blasts and AML (n = 772). MDS with <5% blasts showed the best outcome, followed by with ≥5% but <10% blasts, and ≥10% but <20% blasts, and AML (median OS: 75, 54, 27, and 18 months, respectively). The same hierarchy was observed when each subgroup was divided into TP53sh, TP53dh, and without TP53 alterations (alt), revealing a dismal outcome of TP53dh in all subgroups (17, 10, 8, and 1 month[s], respectively). MDS with <5% blasts differed from the other subgroups by showing predominantly TP53sh (76% of TP53alt cases), and by an independent adverse impact of CK on OS (hazard ratio, 5.2; P < .001). The remaining subgroups displayed many similarities, with TP53dh found at high frequencies (67%, 91%, and 71%, respectively) and only TP53alt but not CK independently influencing OS, and TP53dh showing the strongest influence. When the total cohort was split based on TP53 state, only the blast count and not CK had an independent adverse impact on OS in all subgroups. Thus, TP53dh is the strongest prognostic factor, further supporting its integration into risk stratification guidelines and classification as a separate entity. However, the blast count also influences OS independent of TP53 state, whereas CK plays a minor prognostic role.
Differential effects of two phosphodiesterase 4 inhibitors against lipopolysaccharide-induced neuroinflammation in mice
Authors: Kang Dong Ho , Ahn Sunjoo , Chae Jung Woo , Song Jin Sook
Published: July 2023

Background

Several phosphodiesterase 4 (PDE4) inhibitors have emerged as potential therapeutics for central nervous system (CNS) diseases. This study investigated the pharmacological effects of two selective PDE4 inhibitors, roflumilast and zatolmilast, against lipopolysaccharide-induced neuroinflammation.

Results

In BV-2 cells, the PDE4 inhibitor roflumilast reduced the production of nitric oxide and tumor necrosis factor-α (TNF-α) by inhibiting NF-κB phosphorylation. Moreover, mice administered roflumilast had significantly reduced TNF-α, interleukin-1β (IL-1β), and IL-6 levels in plasma and brain tissues. By contrast, zatolmilast, a PDE4D inhibitor, showed no anti-neuroinflammatory effects in vitro or in vivo. Next, in vitro and in vivo pharmacokinetic studies of these compounds in the brain were performed. The apparent permeability coefficients of 3 µM roflumilast and zatolmilast were high (> 23 × 10–6 cm/s) and moderate (3.72–7.18 × 10–6 cm/s), respectively, and increased in a concentration-dependent manner in the MDR1-MDCK monolayer. The efflux ratios were < 1.92, suggesting that these compounds are not P-glycoprotein substrates. Following oral administration, both roflumilast and zatolmilast were slowly absorbed and eliminated, with time-to-peak drug concentrations of 2–2.3 h and terminal half-lives of 7–20 h. Assessment of their brain dispositions revealed the unbound brain-to-plasma partition coefficients of roflumilast and zatolmilast to be 0.17 and 0.18, respectively.

Conclusions

These findings suggest that roflumilast, but not zatolmilast, has the potential for use as a therapeutic agent against neuroinflammatory diseases.
Identifying discrepancies between clinical practice and evidence-based guideline in recurrent pregnancy loss care, a tool for clinical guideline implementation
Authors: Youssef A. , Lashley E.E.L.O. , Vermeulen N. , van der Hoorn M.L.P.
Published: July 2023

Background

Practice variation in recurrent pregnancy loss (RPL) care is common. International guidelines vary in their recommendations for the management of RPL couples, which could lead to an increase of cross border reproductive care. Currently, the Dutch RPL guideline is being adapted from the European Society for Human Reproduction and Embryology (ESHRE) guideline. We aim to identify discrepancies between RPL guidelines and RPL practice. These discrepancies could be considered in the development of a new guideline and implementation strategies to promote adherence to new recommendations.

Methods

A nationwide survey on the management of RPL patients was conducted across all 107 hospital-based obstetrics and gynaecology practices in the Netherlands. The survey was sent via the Dutch Society for Obstetricians and Gynaecologists to all affiliated clinicians. The questionnaire consisted of 36 questions divided in four sections: clinician’s demographics, RPL definition, investigations and therapy. The data were compared to the recommendations given by the Dutch national guideline and the most recent guideline of the ESHRE.

Results

All hospital-based practices (100%; n = 107) filled in the online questionnaire. The majority of respondents defined RPL similarly, as two or more pregnancy losses (87.4%), not obligatory consecutive (93.1%). More than half of respondents routinely perform thrombophilia screening ( 58%), although not advised by the ESHRE, while thyroid function (57%), thyroid auto-immunity (27%) and β2-glycoprotein antibodies (42%) in the context of antiphospholipid syndrome (APS) are recommended but investigated less often. Regarding parental karyotyping, 20% of respondents stated they always perform parental karyotyping, without prior risk assessment. because of RPL. Treatment for hereditary thrombophilia was frequently (43.8% (n = 137)) prescribed although not recommended. And finally, a considerable part (12–16%) of respondents prescribe medication in case of unexplained RPL.

Conclusion

While many clinicians perform investigations recommended by the ESHRE, there is a considerable variation of RPL practice in the Netherlands. We identified discrepancies between RPL guidelines and RPL practice, providing possibilities to focus on multifaceted implementation strategies, such as educational intervention, local consensus processes and auditing and feedback. This will improve the quality of care provided to RPL patients and may diminish the necessity felt by patients to turn to multiple opinions or cross border reproductive care.