bluuebunny/crossref_metadata_2025 huggingface dataset:
Postural orthostatic tachycardia syndrome
Authors: George Tara , Antonio Tawanda Oscar
Published: October 2024

Postural orthostatic tachycardia syndrome (PoTS) is a disabling autonomic disorder characterised by tachycardia on standing with symptoms of orthostatic intolerance. It may present with syncope. The syndrome affects female: male patients in a ratio of 4:1 and is more commonly present in younger patients aged 15–45 years. The term ‘PoTS’ was first coined in 1993 and used to describe a syndrome that may be idiopathic, triggered by viruses, or associated with neurodivergent and hypermobility conditions. The COVID-19 pandemic has increased interest and research on the topic, as PoTS features are not uncommon in patients with post-COVID-19 syndrome.
Patient-reported treatment satisfaction in essential tremor: levels of satisfaction and predictors of satisfaction
Authors: Varghese Anjali , Berry Diane S. , Ghanem Ali , Hernandez Nora C. , Louis Elan D.
Published: October 2024

Background:

Although managing symptoms is paramount for both essential tremor (ET) patients and their healthcare providers, studies of treatment satisfaction are surprisingly lacking.

Objectives:

We evaluated the satisfaction of patients who used a range of treatments and assessed the relation of a wide array of factors to satisfaction.

Methods:

One hundred four ET participants (age = 74.5 ± 10.2 years) completed a battery of self-report items. These included demographic information, measures of tremor and clinical history, psychological state, current ET treatment, and a series of questions about satisfaction with treatment.

Results:

Analyses of responses to the four current treatment satisfaction questions revealed that the proportion of participants who were satisfied ranged from 35.0% to 57.3% (i.e., approximately 1/3 to 1/2); conversely, the proportion who were dissatisfied ranged from 9.2% to 37.0%. The remainder were neutral. Higher satisfaction levels were observed in participants who were included in treatment selection and who had undergone deep brain stimulation surgery, p’s < 0.05. Lower levels of satisfaction were found in participants with a negative psychological state, higher self-rated tremor severity, head/voice/jaw tremors, and more severe physical side effects; and who used botulinum toxin therapy, p’s < 0.05.

Conclusion:

Between 1/3 and 1/2 of patients were satisfied with their treatment, whereas up to 1/3 were dissatisfied. In this initial exploration of correlates of treatment satisfaction in ET patients, we identified a number of associations between satisfaction and clinical, psychological and treatment variables. Additional research is warranted to further explore the nature of these relations over time.
Comprendre l’adoption et la continuation de l’utilisation du diaphragme Caya au Bénin : une étude à méthodes mixtes
Authors: Zinsou Cyprien , Guedegbe Ghyslain , Angel Alexandra , Bouanchaud Paul , Jackson Ashley , Kikissagbe Isidore , Brogaard Beth
Published: October 2024

Résumé

Le diaphragme Caya, de taille unique, est une méthode de contraception efficace dans multiples contextes. Pourtant, la recherche sur son acceptabilité, utilisation, et continuation en Afrique de l’Ouest francophone reste limitée. Ce projet pilote a introduit Caya à Cotonou et Bohicon, Bénin pour mieux comprendre comment Caya est utilisé. 225 adoptantes ont participé à une enquête, six mois après avoir choisi la méthode. 30 adoptantes, 15 hommes de la communauté et 15 prestataires ont participé à des entretiens approfondis. L’étude a révélé que les adoptantes choisissent la méthode parce qu’elle était non hormonale et ne provoque pas d’effets secondaires. Six mois après avoir adopté Caya, 76,4 % des adoptantes continuaient à l’utiliser ; celles moins instruites et avec 1 enfant ou plus, étaient plus susceptibles de continuer à utiliser Caya. Cela indique que dans ce contexte, Caya est une méthode acceptable qui ajouterait de la valeur aux autres méthodes contraceptives.
Procedural Justice, Representation, and Institutional Trust in Mexico
Authors: Somuano Ventura María Fernanda , Takahashi Yuriko
Published: October 2024

Both theoretical and empirical studies suggest that confidence in institutions is crucial for the functioning of democratic political systems and is an important element of the citizen–state relationship. Trust in institutions has been mainly explained in terms of institutional performance or as an extension of interpersonal trust. Using data from the 2020 National Survey of Civic Culture (Encuesta Nacional de Cultura Cívica), we examined the determinants of Mexicans’ trust in two institutions elected via popular vote: Congress and the Presidency. We focus on procedural justice and representation to account for trust in both institutions. We found positive relationships (of different magnitudes) between citizens’ trust in both Congress and the Presidency and the indicators of perceived representation, procedural justice, institutional performance, and interpersonal trust. In addition, we found different and significant effects of party identification on trust levels in both institutions.
Evaluation of Bioactive Compounds in Tetrapleura tetraptera (Uyayak) and Its Activity Against Dihydropteroate Synthase (1AJ2) of E. coli: In-Sight from ADMET Profiling and Molecular Docking
Authors: Bebia Glory P. , Edet Uwem Okon , Eyo Aniekan-Augusta Okon , Ugwu Joy Chinweokwu , Mbim Elizabeth Nkagafel , Ogba Ofonime Mark , Ogar, Agbor Yeneochia , Nwaokorie Francisca O.
Published: October 2024

Background: The prevalence of multi-drug-resistant E. coli isolates is on the increase around the world. This study was designed to evaluate the antimicrobial activity of Tetrapleura tetraptera (Uyayak) fruit bioactive compounds against E. coli using an in silico approach. Methods: Gas chromatography coupled to mass spectrophotometry (GC-MS) was used to identify the bioactive compounds in our sample T. tetraptera. The resulting bioactive compounds from GC-MS were converted into canonical strings and used for target and absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties predictions using the pkCSM and SWISSADME tools, respectively. Bioactive compounds that met Lipinski's rule of five (ROF) were docked against the dihydropteroate synthase of E. coli using the AutoDock Vina tool, and the resulting interactions were visualized in 2-D using Biovia Discovery Studio 21. Results: The GC-MS analysis returned a total of twenty-eight (28) bioactive compounds, out of which 13 did not violate Lipinski's ROF. ADMET analysis of the screened bioactive compounds showed better absorption (intestinal and water solubility) and toxicity (AMES and hepatoxicity) profiles than trimethoprim, the control drug. Molecular docking gave docking scores that ranged from −4.0 to −5.3 kcal/mol for the bioactive compounds while that of trimethoprim was −6.5 kcal/mol. Target prediction showed that all the bioactive compounds are capable of reaching various targets, with the nuclear receptor being the most abundant target. Conclusion: The bioactive compounds of T. tetraptera fruits examined showed favorable docking scores and pharmacokinetics, suggesting the need for further studies to validate their potential as antimetabolites.
Crocin Inhibited Epithelial-Mesenchymal Transition in Renal Tubular Epithelial Cells to Treat Diabetic Nephropathy Through Improving AMPK/mTOR-Mediated Autophagy
Authors: Su Jinhao , Chen Wei , Zhang Hui , Li Hanzhou , Pan Baochao , Ma Ziang , Wang Yuansong , Cui Huantian , Lv Shuquan
Published: October 2024

Objectives

Diabetic nephropathy (DN), a severe microvascular complication of diabetes mellitus, is a leading cause of end-stage renal disease. Crocin (CRO), an active ingredient extracted from Crocus sativus and Gardenia jasminoides, has multiple bioactivities such as anti-oxidative, anti-inflammatory, anti-tumor, and anti-depressive activities. However, the potential effects and mechanisms of CRO in the treatment of DN are still unclear.

Methods

In this study, we aimed to assess the efficacy of CRO in treating DN using in vivo and in vitro experiments, and intensively investigate the potential therapeutic mechanisms of CRO against DN based on the inhibition of epithelial-mesenchymal transition (EMT) by inducing adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR)-mediated autophagy.

Results

The results showed that CRO had a therapeutic effect and anti-EMT effect in kidney of DN mice. CRO also moderated AMPK/mTOR pathway and improved autophagy in kidney of DN mice. In high glucose (HG)-induced tubular epithelial cell EMT model, CRO inhibited EMT, moderated AMPK/mTOR pathway and improved autophagy. AMPK inhibitor abolished the above effects of CRO on tubular epithelial cells.

Conclusion

CRO exhibited considerably therapeutic and anti-EMT effects on DN both in vivo and in vitro, these may be associated with restoring autophagy through regulating AMPK/mTOR pathway.
Supporting Satisfaction, Satisfying Support: Bidirectional Associations of Social Support and Life Satisfaction
Authors: Chia Jonathan L. , Hartanto Andree , Tov William
Published: October 2024

Existing literature has explored the impact of social support (SS) on life satisfaction (LS). However, the reciprocal relationship—that is, the influence of LS on SS—remains understudied, despite extant theoretical support. In addressing this gap, the present study employed bivariate latent growth modeling to examine bidirectional associations between SS and LS trajectories among 8,449 middle-aged and older adults in Singapore, over seven waves spanning almost 6 years. Results provided evidence supporting the notion of bidirectional associations. Specifically, baseline SS positively predicted subsequent changes in LS, and baseline LS positively predicted subsequent changes in SS. Findings underscore the potential for interventions and policies aimed at enhancing well-being among older individuals to capitalize on this bidirectional relationship. By targeting either LS or SS, interventions could potentially trigger positive feedback loops, amplifying their collective impact on overall well-being.
Critical pedagogical engagement with Muslim geographies
Authors: Sammar Iram Rehman
Published: October 2024

In this commentary, I delve into critical pedagogical engagement with Muslim geographies and the Dīn of Islam, daring to go beyond the decolonial. I begin with an exploration of Sidaway's (2023a) discussion of ‘decolonising Muslim Geographies’ in the context of the pedagogical engagement of a female Muslim teacher of geography. I will develop an argument which will encourage critical geographers to ‘learn’ from Muslim geographies in deep and meaningful ways through the rich influential and intellectual traditions within the Dīn of Islam. My reflections will directly respond to Sidaway's call for a possible paradigm shift within the parameters of Eurocentric thinking to share Islamic epistemologies embedded in my own pedagogical approach. This will encompass rich and diverse intellectual traditions of Islam and geographical understanding of the concept of al-Mizān (balance) for the world that we all share.
The perils of ‘tech for good’ lie in its politics of helping
Authors: Richey Lisa Ann , Fejerskov Adam Moe
Published: October 2024

Vexing political questions of power, inequality and coloniality permeate the tech sector and its growing use of global ‘virtual’ assembly lines that see them penetrate even refugee camps in efforts to extract value. As a response, tech companies have been expanding non-commercial activities within a presumed framework of humanitarianism, in part, trying to outweigh the negative implications of unjust business practices often characterised by third-party avoidance of responsibility. This commentary focuses on tech companies’ engagement with people in the Global South – not as recipients of tech beneficence – but as labourers who make tech possible. First, we document why companies are brought into humanitarian crises, and then we briefly chart examples of the practices of tech companies in the Global South. Then, we argue that ‘tech for good’, often presumed as altruistic, instead reproduces an expansive history of questionable corporate social responsibility efforts that sustain inequalities more than assuaging them. We conclude by reflecting on the impact of commodifying compassion for humanitarian helping and argue that tech companies should stop trying to ‘help’ through self-perceived altruistic activities. Instead, corporations should focus on remaking their core business practices in an image of justice, protection, and equal value creation, particularly in contexts characterised by vulnerability.
Stroke survivors’ telemedicine experiences during the COVID-19 pandemic: A phenomenological investigation
Authors: Kimmel Barbara , Walder Annette , Ovalle Anette , Venkatasubba Rao Chethan P , Savitz Sean I , Goldberg Mark , Warach Steven , Cruz-Flores Salvador , Olson DaiWai M , Anderson Jane A
Published: October 2024

Purpose

This study aimed to describe stroke survivors’ experiences receiving telemedicine visits at the Lone Star Stroke Consortium during the COVID-19 pandemic.

Materials and Methods

A qualitative descriptive phenomenological design was applied to gather patients’ telemedicine experiences through in-depth interviews, using a study guide. Audio-recorded interviews were conducted via ZOOM and transcribed verbatim. Two independent reviewers used the Giorgi descriptive method to analyze the data and search for the essence of stroke survivors’ follow-up telemedicine experiences during the COVID-19 pandemic.

Results

Fifteen underserved patients were recruited: mean age, 51.8 (15.7), and 9 (60%) females. Three themes emerged: (1) vivid memory of the stroke acute phase, (2) poststroke care experiences, and (3) perceived telemedicine experiences.

Conclusions

The phenomenon of follow-up telemedicine visits during COVID-19 pandemic, as experienced by the stroke survivors, was positive. It showed patients’ improved care access for poststroke visits. Telemedicine was satisfactory, except where the full medical exam was needed. Study findings highlight the individual approach was important, as well as the need for reliable internet and training to improve patients’ technological skills. A hybrid approach for post-pandemic follow-up visits (in-person and telemedicine) was recommended by stroke survivors. These findings suggest that telemedicine is feasible and effective for poststroke care. Additional strategies are needed to improve future telemedicine integration into the continuum of care.
Effectiveness of digital health interventions to increase cardiorespiratory fitness: A systematic review and meta-analysis
Authors: Rowland Sheri , Bach Christina , Simon Krystyna , Westmark Danielle M , Sperling Edie
Published: October 2024

Background

Interventions using commercial digital health tools do favorably affect health outcomes. However, the effect of digital tools on cardiorespiratory fitness, a more novel indicator cardiovascular risk, is unclear.

Purpose

Synthesize the digital health intervention literature and answer the following question: What is the effect of interventions using mobile health apps, wearable activity trackers, and/or text messaging on cardiorespiratory fitness?

Methods

A systematic review and a meta-analysis (PROSPERO CRD42023423925) were conducted to evaluate the immediate digital health intervention effect on adult cardiorespiratory fitness. In March 2023, a search of databases Embase, MEDLINE, CINHAL, and Cochrane Library was completed. Studies were included if the intervention used a mobile health app, text messaging, and/or activity tracker. Studies were excluded if an objective measure of fitness was not used; the sample included children; the setting was hospital-based; and the digital health technology was only used for data collection or described as virtual reality. Using a random-effects model, two separate meta-analyses were completed: one for single-group studies and one for multi-group studies. Standardized mean difference effect sizes (Cohen's d) were calculated. Study quality was evaluated with the Cochrane Risk of Bias tool and ROBINS-I tool.

Results

Fifty-three studies (3657 individuals) with pre-post designs (12 single-group, 41 multi-group) were included. Most studies targeted participants with a specific chronic health condition. Digital health interventions in the single-group studies had a moderate-to-large effect size ( d = 0.62, 95% confidence interval ( CI) [0.41–0.84], p < 0.001), and multi-group studies had small-to-moderate effect size ( d = 0.38, 95% CI 0.21–0.55, p < 0.001). Significant heterogeneity of effects was observed in both the single-group and multi-group studies.

Conclusions

Interventions using text messaging, a mobile app, or activity tracker alone or in combination are effective in improving cardiorespiratory fitness in adults, particularly for those with a chronic health condition.
District health information system 2 data utilization among health professionals in Amara region private hospitals, Ethiopia
Authors: Mesele Abraraw Gebre , Birhanu Abreham Yeneneh , Shiferaw Atsede Mazengia , Baykemagn Nebebe Demis
Published: October 2024

Background

Globally, health information systems have been improved by District Health Information System Version 2 (DHIS2), which promotes consistency and integrity in collecting data, processing, and utilization. This success has been attributed to its user-friendly interface and incorporation of advanced data analysis and validation features.

Objective

This study aimed to assess DHIS2 data utilization among health professionals working at private hospitals in the Amara region.

Methods

An Institution-based cross-sectional study design was conducted from 9 May to 30 June 2022. A simple random sampling technique was used to select participants, with a total of 395 health professionals participating. Data was collected using a self-administered paper-based questionnaire. Data entry was performed using the Kobo Collect tool, and data analysis was conducted using STATA version 14.0. Bivariable and multivariable logistic regression analyses were used and p < .05 with a 95% CI was considered to measure statistically significant variables.

Result

Out of 395 participants, about 37.72% of the participants had good DHIS2 data utilization. Had good data analysis skills (adjusted odds ratio (AOR) = 6.5, 95% CI [3.1–13.8]), regular supportive supervision and feedback (AOR = 5.2, 95% CI [2.8–9.5]), monthly salary > 5000 ETB (AOR = 2.0, 95% CI [1.1–3.7]), ease of use (AOR = 5.4, 95% CI [2.8–10.2]), and district health information system training (AOR = 4.2, 95% CI [2.2–7.3]) were enabling factors for utilization of DHIS2 data.

Conclusion

Private healthcare providers had limited utilization of DHIS2 data. It is highly recommended to provide DHIS2 training, supervision, and feedback focused on private health facilities. Additionally, enhancing data analysis skills and prioritizing ease of use are crucial to improving DHIS2 data utilization.
Utilizing deep learning models for ternary classification in COVID-19 infodemic detection
Authors: Luo Jia , El Baz Didier , Shi Lei
Published: October 2024

Objective

To address the complexities of distinguishing truth from falsehood in the context of the COVID-19 infodemic, this paper focuses on utilizing deep learning models for infodemic ternary classification detection.

Methods

Eight commonly used deep learning models are employed to categorize collected records as true, false, or uncertain. These models include fastText, three models based on recurrent neural networks, two models based on convolutional neural networks, and two transformer-based models.

Results

Precision, recall, and F1-score metrics for each category, along with overall accuracy, are presented to establish benchmark results. Additionally, a comprehensive analysis of the confusion matrix is conducted to provide insights into the models’ performance.

Conclusion

Given the limited availability of infodemic records and the relatively modest size of the two tested data sets, models with pretrained embeddings or simpler architectures tend to outperform their more complex counterparts. This highlights the potential efficiency of pretrained or simpler models for ternary classification in COVID-19 infodemic detection and underscores the need for further research in this area.
e-Health literacy and online health information utilization among Jordanians: A population-based study
Authors: Al-Ruzzieh Majeda A. , Al-Helih Yahia M. , Al-Soud Zaid
Published: October 2024

Background

The internet has become an essential part of empowering people to access health-related information. Huge amounts of health-related information are available online, but few people have the skills to assess its validity and reliability. Accordingly, the concept of ehealth literacy competencies emerged to measure the skills necessary to validate such information. As a result, the purpose of this study was to assess Jordanian people’s e-health literacy, online health information utilization, and associated factors.

Methods

This population-based cross-sectional study was conducted from March to December 2023.

Results

Results: The study found that participants rated their e-health literacy at 28.94 out of 40, indicating a sufficient level of health literacy, and their online health information utilization at 39.62, indicating a high level of engagement with online health resources. Furthermore, it is revealed that e-health literacy is associated with gender and geographic region, whereas online health information utilization is associated only with chronic disease.

Conclusion

In Jordan, there is a balance between traditional and online health information use. While healthcare providers and primary health centers are the main sources of information, Jordanians show a sufficient level of e-health literacy, with females and the capital region exhibiting higher levels. Furthermore, Jordanians were more likely to use online health information. Nevertheless, it is crucial to work on improving internet platforms to enhance the quality of online health-related information.
Patient-initiated video consultations: A qualitative study on reasons for patient-booking in Danish general practice
Authors: Van den Heuvel Johannes , Assing Hvidt Elisabeth , Dahl-Larsen Rasmus , Thomsen Janus Laust , Hoffmann Merrild Camilla
Published: October 2024

Objective

This qualitative study explores when and why patients book video consultations through an online booking platform within the context of Danish general practice and how the technology affects patients’ use of this consultation type.

Methods

We conducted thirteen semi-structured interviews with patients from the same general practice who were experienced users of video consultations scheduled through the clinic's online booking platform. Interviews were analysed using thematic analysis and drawing on actor-network theory and Bruno Latour's concept of technical mediation as an analytical framework.

Results

We introduce the concept of “hybrid patients,” highlighting how values tied to video consultation that motivates patients to book them emerge through technical mediation in the network between patients, general practitioners (GPs) or practice staff, and the video technology. We identified three emerging values: efficiency, control and diminished presence. Video consultation affords efficient consultations that save patients’ time. It mediates patients’ sense of control when they experience certainty concerning their health issues. Video consultation mediates diminished presence that increases relational distance. However, it simultaneously allows for efficiency and emotional distance between patients and their GP, and between patients and their health issues.

Conclusions

When initiating the use of video consultation, the patient plays an active and conscious role in adjusting to the mediated values (efficiency, control and diminished presence) linked to this form of consultation. These emerging values are context-specific, and patients employ them based on their individual requirements. Patients trust their GPs to prevent severe or vulnerable topics from being discussed in a video consultation.
Cesarian sections in women with multiple sclerosis: A Canadian prospective pregnancy study
Authors: Sadovnick Dessa , Criscuoli Maria , Yee Irene , Carruthers Robert , Devonshire Virginia , Smyth Penelope , Krysko Kristen M
Published: October 2024

Background

An increasing number of women with multiple sclerosis (wMS) are considering pregnancy. Prior studies suggest increased rate of elective cesarian sections (C-sections) in wMS.

Methods

The Canadian Multiple Sclerosis Pregnancy Study (CANPREG-MS) is a prospective study on pregnant wMS. This report shows comparisons between (i) CANPREG-MS wMS delivered by C-section and the general population and (ii) C-section and vaginal deliveries in this study cohort.

Results

CANPREG-MS has resulted in 170 deliveries with 63 by C-section. The proportion with C-sections in CANPREG-MS (37.1%) was significantly higher than that for the Canadian population (28%) ( p = .0085). The majority (66.7%) of C-sections were not planned, and typically were performed for obstetrical indications. C-sections were performed at an earlier gestational age than vaginal deliveries, although birthweight did not differ by mode of delivery in wMS. MS relapses (3.2%) and pseudo-relapses (3.2%) were rare in the first month after C-section deliveries, regardless of disease modifying therapy decisions during gestation and postpartum.

Conclusions

C-sections were more common in wMS than the general population, but few were because of maternal MS. CANPREG-MS provides informative data for pregnancies in wMS with well-managed and relatively mild disease. This information is helpful to obstetrical and MS healthcare providers.
Weekend (Keyboard) Warriors: Differences in Social Media Consumption and Production Between NFL and College Football Fans
Authors: Abdallah J.C. , Arth Zachary W.
Published: October 2024

Sports fans are often some of the most passionate groups of fans and the use of social media can intensify those feelings, both in expressing their feelings and consumption of content. Football fans are a unique group in American sports culture, but how much difference is there within that group in terms of these behaviors? Using a social identity approach, this manuscript analyzed the degree to which team identification and fan identification played a role in the social media consumption and production in college football and National Football League (NFL) fans. A total of 586 fans responded to a survey that examined respondent’s team and fan identification, as well as social media consumption, creation, and sharing behaviors. Results indicated that college football fans generally identified with fellow fans of their favorite football team and consumed, created, and shared social media more frequently and with greater intensity than their NFL counterparts. Key differences between college football and NFL fans included fan identification predicted social media consumption and creation, while team identification predicted social media sharing among both college and NFL fans.
Cardiovascular disease and psychiatric disorders: An-up-to date review
Authors: Parlati Antonio Luca Maria , Nardi Ermanno , Basile Christian , Paolillo Stefania , Marzano Federica , Chirico Alfonsina , Buonocore Davide , Colella Angela , Fontanarosa Sara , Gallo Luca , Fierro Maria Francesca , Carbone Francesca , Gargiulo Paola , Prastaro Maria , Delle Grottaglie Santo , Santoro Ciro , Marchesi Anna , Marchetti Maria Francesca , Giovanni Carta Mauro , Perrone Filardi Pasquale , Montisci Roberta
Published: October 2024

Cardiovascular diseases (CVD) and mental health disorders (MHD) are respectively the first and second most prevalent diseases in high-income countries and the two most relevant causes of disability worldwide. The close association between the two conditions has been known for a long time and research has been able to document how the co-morbidity between cardiovascular disorders and mental health disorders is a negative prognostic factor for both conditions. This strong connection and the relevance of the impact of the association have led to define a new branch of cardiology, known as behavioral cardiology. The aim of the new branch is just to study the nexus CVD-MHD in order to prevent or decrease the burden of MHD on CVD and vice versa. This review describes the epidemiological evidence of the relationship between MHD on CVD at the state of the art among clinical research.
Biomechanical Comparison of Suture-Relay All-Suture Anchors and Conventional Suture Anchors for Posterior Medial Meniscus Root Repair in Porcine Models
Authors: Saengpetch Nadhaporn , Prasitmeeboon Napat , Janyawongchot Tanapol , Aroonjarattham Panya , Somtua Chompunut , Thamyongkit Sorawut
Published: October 2024

Background:

Posterior medial meniscus root (PMMR) tears (PMMRTs) can be repaired using various techniques to promote healing. However, the biomechanical properties of suture-relay all-suture anchor (ASA) versus conventional suture anchor (CSA) and loop-locking transtibial pullout (TTP) have not been well established.

Purpose:

To compare the biomechanical properties of PMMR repairs using suture-relay ASA, CSA, and loop-locking TTP.

Study Design:

Controlled laboratory study.

Methods:

A total of 33 fresh-frozen porcine knee joints with intact medial menisci were randomly divided into 3 groups, with 11 specimens in each group: ASA, CSA, and TTP. The study involved cyclic loading, with displacement measurements taken after 100, 500, and 1000 cycles. Subsequently, the specimens were loaded until clinical failure (defined as 3-mm displacement) and then to ultimate failure of the construct, with data recorded for displacement after cyclic loading, load to 3-mm displacement, and ultimate load to failure.

Results:

After 1000 cyclic loadings, the suture-relay ASA group showed considerably less displacement than the loop-locking TTP group (1.8 ± 0.7 mm vs 2.9 ± 0.3 mm; P < .001), but the displacements did not differ considerably between the suture-relay ASA and CSA groups (2.2 ± 0.9 mm; P > .05). The mean loads to clinical failure were significantly greater in the suture-relay ASA and CSA groups (61.3 ± 6.5 and 57.5 ± 9.7 N, respectively) than in the loop-locking TTP group (38.3 ± 9.4 N; P < .05). The ultimate load to failure was significantly greater in the suture-relay ASA group than in the loop-locking TTP group (153 ± 55.1 N vs 102 ± 12.9 N; P < .05). All specimens in the loop-locking TTP group failed by suture elongation mode, whereas only 2 specimens (18%) in the suture-relay ASA group and 5 specimens (45%) in the CSA group failed by suture elongation. Nine specimens (82%) in the suture-relay ASA group and 6 specimens (55%) in the CSA group failed due to suture cutout through the meniscal tissue.

Conclusion:

The biomechanical properties after PMMR repair did not statistically differ between the suture-relay ASA and CSA groups. The suture-relay ASA technique had a higher load to failure than the loop-locking TTP technique.

Clinical Relevance:

The suture-relay ASA technique is a promising option for the repair of PMMRTs; its repairing strength is also comparable to that of the CSA technique. Notably, the suture-relay ASA technique can be utilized without establishing a posteromedial portal, resulting in decreased procedure time and mitigating challenges associated with working from the posterior aspect of the knee.
Methodological Insights About Photovoice as a Pedagogical Tool From Implementation With Graduate Students as Co-Researcher-Participants
Authors: Kersten Marjorie , Avelar Sandra , Montgomery Amanda , Castañeda Dolores , Hebert-Beirne Jeni
Published: October 2024

Experiential learning is important in preparing the next generation of public health professionals to address health inequities. Students who aspire to work in community health must learn to engage with communities and advocate for change that aligns with community priorities. Learning about Community-Based Participatory Research (CBPR) and related methodologies can facilitate students’ understanding of community engagement and community organizing. Photovoice, a CBPR methodology, provides a unique opportunity to understand the lived experiences of participants while identifying community-led solutions to address public health challenges. Photovoice has been used as a pedagogical tool to engage students as participants in reflection, critical thinking, discussion, and experiential learning. However, the peer-reviewed literature often lacks detailed accounts of methodology, and barriers and facilitators to engaging participants in photovoice. We provide a detailed account of our methodology as we co-learned with 23 graduate students as co-researcher-participants in a photovoice experiential learning project as part of a CBPR course at the University of Illinois Chicago School of Public Health. Students reflected on their experience with the methodology by completing a series of fieldnotes while participating in photovoice. Fieldnotes were analyzed using an iterative inductive coding process. We present five themes from student reflections that convey barriers and facilitators to engaging in photovoice, and share related recommendations for using photovoice as a pedagogical tool to prepare the next generation of public health professions.
Improving organisation to improve care: ERN ReCONNET organisational reference model for systemic sclerosis patients’ care pathway
Authors: Talarico Rosaria , Marinello Diana , Palla Ilaria , Cannizzo Sara , Galetti Ilaria , Farrington Sue , Aguilera Silvia , Andersen Jeanette , Ceccatelli Eva , Cornet Alain , Cutillas Gema , Esteves Marco , Frank Charissa , Leite Catarina , Niehaus Gabi , Perez Gomez Elisabeth , Polfliet Katleen , Sandulescu Silvia , Schriemer Rita , Barsotti Simone , Bellando-Randone Silvia , Beretta Lorenzo , Bernardino Vera , Boleto Goncalo , Bombardieri Stefano , Burmester Gerd , Cavazzana Ilaria , Codullo Veronica , Cutolo Maurizio , Dalm Virgil , Damian Laura , Della Rossa Alessandra , Doria Andrea , Farhat Meryem-Maud , Fonseca João Eurico , Hachulla Eric , Houssiau Frédéric , Grazia Lazzaroni Maria , Limper Maarten , Lorenzoni Valentina , Montecucco Carlomaurizio , Mosca Marta , Mouthon Luc , Müeller-Ladner Ulf , Pha Micheline , Ponte Cristina , Spierings Julia , Sulli Alberto , Taulaigo Anna Viola , Ticciati Simone , Tincani Angela , Toplak Natasha , Trieste Leopoldo , van Hagen P.M. , van Laar Jacob , Vanthuyne Marie , Vigone Barbara , de Vries-Bouwstra Jeska K. , Zen Margherita , Turchetti Giuseppe , Smith Vanessa , Matucci Cerinic Marco
Published: October 2024

Objective:

To optimise the organisation of care and encourage the adoption of good clinical practices, the RarERN Path© methodology was designed within ERN ReCONNET. The aim of our work was to report the application of RarERN Path© on systemic sclerosis within the ERN ReCONNET centres, providing a feasible and flexible organisational reference model for optimising the systemic sclerosis care pathway in different countries.

Methods:

RarERN Path© is a six-phase methodology which enables the creation of a reference organisational model co-designed on the basis of the expertise of different stakeholders. It foresees six phases, ranging from the map of existing patients’ care pathways and patients’ stories, to the consensus on a common organisational patient care pathways, and its key performance indicators definition.

Results:

The agreed reference model highlights the importance of having an organisational flow for referrals that foresees how patients may access directly the specialised unit from the different referrals. Specific specialised visits were considered as mandatory to be organised and they included cardiologist, pneumologist, gastroenterologist, psychologist, nephrologist, dermatologist, wound care specialist/nurses and other healthcare professionals (such as nurses, social workers and nutritional counselling). Moreover, specific services related to therapy were highlighted as strongly recommended to be organised, mainly represented by infusion therapy and wound care, as well as occupation therapy and physiotherapy.

Conclusion:

The organisational model emerged from our investigation emphasises that the organisation of specific services for systemic sclerosis treatment should be organised as a solid support for implementing the existing recommendations on systemic sclerosis management in real life.
Arthroscopic Anterior and Inferior Labral Repair for Traumatic Shoulder Instability
Authors: Marcaccio Stephen , Buerba Rafael , Arner Justin , Bradley James
Published: October 2024

Background:

Anterior glenohumeral instability is common in the young and athletic population and can develop from a dislocation or subluxation event. Avulsion of the anterior inferior glenoid labrum (Bankart lesion) occurs in over 90% of these events. In patients who have unsuccessful conservative management or present with a high risk for redislocation, surgical intervention is indicated. This video presents our technique for arthroscopic anterior and inferior labral repair.

Indications:

In addition to those patients who have unsuccessful conservative management, surgical management of anterior glenohumeral instability is indicated in patients who are at high risk for redislocation after an initial instability event. These patients include young age and participation in contact sports. Generally, glenoid bone loss over 25% warrants open bony augmentation, but arthroscopic bony augmentation techniques are evolving. Further, the management of “near-track” lesions, or “on-track” lesions with a small distance to dislocation value, remains controversial.

Technique Description:

This procedure is performed in the lateral decubitus position. A second anterior portal is created distal and lateral to the first anterior portal, entering the shoulder joint just above the subscapularis. The anterior-inferior labrum is prepared with an arthroscopic elevator, followed by a rasp and superior labral anterior and posterior burr. A suture tape is then shuttled around the labrum and the anchor drilled in the appropriate position at the glenoid rim, not violating the cartilage. Anchor placement occurs from an inferior to a superior fashion until the entire labral injury is repaired.

Results:

This video presents a technique to achieve arthroscopic fixation of an anterior-inferior labral tear in a young athlete with anterior glenohumeral instability. Patients are taken through 3 phases of rehabilitation before return to sport-specific activities, such as contact sports, around 6 months postoperatively. Return-to-sport rates for contact and collision athletes range from 80% to 100%, with recurrent rates ranging from 5% to 20%.

Discussion/Conclusion:

Arthroscopic anterior-inferior labral repair is a useful technique for minimally invasive glenohumeral stabilization in indicated patients who have minimal glenoid bone loss. Portal placement, labral mobilization, and glenoid preparation are paramount in optimizing the healing potential of the fixation construct.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
GSDME-mediated pyroptosis contributes to chemotherapy-induced platelet hyperactivity and thrombotic potential
Authors: Xue Ruyi , Li Min , Zhang Ge , Zhang Wei , Han Liping , Bo Tao , Zhong Haoxuan , Yao Dingjin , Deng Yiran , Chen She , Zhang Si
Published: October 2024

Thrombotic complications due to platelet hyperreactivity are a major cause of death in patients undergoing chemotherapy. However, the underlying mechanisms are not fully understood. Herein, using human platelets and platelets from mice lacking gasdermin E (GSDME), we show that GSDME is functionally expressed in anucleate platelets, and that GSDME-mediated pyroptosis, a newly identified form of cell death in mammalian nucleated cells, contributes to platelet hyperactivity in cisplatin-based chemotherapy. Cisplatin or etoposide activates caspase-3 to cleave GSDME, thereby releasing the N-terminal fragment of GSDME (GSDME-N) toward the platelet plasma membrane, subsequently forming membrane pores and facilitating platelet granule release. This eventually promotes platelet hyperactivity and thrombotic potential. We identified flotillin-2, a scaffold protein, as a GSDME-N interactor that recruits GSDME-N to the platelet membrane. Loss of GSDME protects mice from cisplatin-induced platelet hyperactivity. Our results provide evidence that targeting GSDME-mediated pyroptosis could reduce thrombotic potential in chemotherapy.
The Polk Country Fire Rescue screening tool for detecting subarachnoid hemorrhage
Authors: Patel Krish , Konda Sanjana , Ganti Latha , Banerjee Anjali , Banerjee Paul
Published: October 2024

Introduction

The subarachnoid space in the brain contains crucial blood vessels and cerebrospinal fluid. Aneurysms in these vessels can lead to subarachnoid hemorrhage (SAH), a serious stroke subtype with high morbidity and mortality rates. SAH treatment includes procedures like coiling and clipping, but these are available only at comprehensive stroke centers (CSCs), necessitating urgent diagnosis and transfer to specialized facilities.

Methods

This IRB-approved study was conducted by Polk County Fire Rescue (PCFR) in Florida. PCFR, serving an 850,000-person population, implemented a three-step SAH protocol. The protocol uses both Ottawa SAH criteria and recurring symptoms, such as new-onset seizures and high systolic blood pressure, that were identified by EMS. Acute management included administering labetalol, levetiracetam, and ondansetron.

Results

Of 2175 stroke patients, 80 screened positive for SAH and were eligible for transfer. Patients had a median age of 66, and 33% had an initial systolic BP over 220 mmHg. The interfacility transfer rate dropped from 12.9 to 3.6% after implementing the protocol.

Conclusion

The PCFR protocol’s effectiveness suggests its potential for nationwide implementation. Early SAH recognition and prompt transfer to CSCs reduce complications and improve outcomes. Accurate field diagnosis by EMTs can prevent unnecessary transfers and enhance patient care. Future improvements may include portable diagnostic tools and enhanced EMT training to further improve SAH patients’ pre-hospital care.
The association of pre-operative biomarkers of endothelial dysfunction with the risk of post-operative neurocognitive disorders: results from the BioCog study
Authors: Moazzen Sara , Janke Jürgen , Slooter Arjen J. C. , Winterer Georg , Spies Claudia , Pischon Tobias , Feinkohl Insa
Published: October 2024

Introduction

Endothelial dysfunction (ED) promotes the development of atherosclerosis, and studies suggest an association with age-related neurocognitive disorders. It is currently unclear whether ED is also associated with the risk of perioperative neurocognitive disorders.

Method

We included 788 participants aged ≥ 65 years of the BioCog study. Patients were scheduled to undergo elective surgery with expected duration > 60 min. Blood was collected before surgery for measurement of 5 biomarkers of ED: asymmetric and symmetric dimethylarginine (ADMA; SDMA), intercellular and vascular adhesion molecule (ICAM-1, VCAM-1), and von Willebrand factor (vWF). Patients were monitored for the occurrence of postoperative delirium (POD) daily until the 7th postoperative day. 537 (68.1%) patients returned for a 3-month follow-up. Post-operative cognitive dysfunction (POCD) was defined from the change in results on a battery of 6 neuropsychological tests between baseline and 3 months, compared to the change in results of a control group during the 3-month interval. The associations of each of the 5 ED biomarkers with POD and POCD respectively were determined using multiple logistic regression analyses with adjustment for age, sex, surgery type, pre-morbid IQ, body mass index, hypertension, diabetes, HbA1C, triglyceride, total and HDL cholesterol.

Results

19.8% of 788 patients developed POD; 10.1% of 537 patients had POCD at 3 months. Concentrations of ED biomarkers were not significantly associated with a POD. A higher VCAM-1 concentration was associated with a reduced POCD risk (adjusted odds ratio 0.55; 95% CI: 0.35–0.86). No further statistically significant results were found.

Conclusion

Pre-operative concentrations of ED biomarkers were not associated with POD risk. We unexpectedly found higher VCAM-1 to be associated with a reduced POCD risk. Further studies are needed to evaluate these findings.
A mixed method evaluation of knowledge, attitude and practice on dengue fever among Lalitpur Metropolitan City residents: a cross-sectional investigation
Authors: Ghimire Sushmita , Pangeni Shraddha
Published: October 2024

Background

Dengue poses a significant global public health challenge, including in Nepal. Understanding community’s knowledge, attitudes, and behaviors concerning dengue fever is imperative to developing effective prevention and control strategies. This study aimed to assess the knowledge, attitude, and practices related to dengue fever among residents of Lalitpur Metropolitan City.

Methods

A descriptive cross-sectional household study was conducted using a mixed-method approach, which included quantitatively studying 636 individuals and conducting 20 qualitative interviews. The data was collected between April 2023 and June 2023. The multistage cluster sampling method was applied for household selection during the quantitative study and a purposive judgmental sampling method was used to identify participants for the qualitative interviews. Face-to-face interviews were conducted using a structured questionnaire for the quantitative study and an interview guide for the qualitative study. Quantitative data were analysed using logistic regression in STATA version 13, and thematic analysis was applied to the qualitative data. The findings were validated through triangulation of results from both the qualitative and quantitative study.

Results

Regarding knowledge, 64.94% (n = 413/636) reported being informed about dengue fever. In terms of attitude, a substantial majority, 91.51% (n = 582/636), expressed a positive attitudes toward dengue fever, indicating a favorable perception and knowledge of its significance. Concerning practice, 49.84% (n = 317/636) of respondents reported actively engaging in dengue fever prevention measures. The variables gender, previous history of dengue fever and residency were the determinants of dengue fever knowledge. Additionally, gender, residency, and attitude were predictors of preventive practices concerning dengue fever.

Conclusion

Our study revealed that while the community demonstrated good knowledge of dengue fever and positive attitudes toward prevention, their preventive practices were inconsistent, indicating a gap between knowledge and action. A positive attitude was linked to better adherence to preventive measures. To address this gap, it is crucial to promote a positive attitude toward dengue prevention through initiatives like education efforts and social mobilization programs. Implementing Social and Behavior Change Communication (SBCC) programs focused on dengue prevention and control measures can help bridge this knowledge-action gap.