bluuebunny/crossref_metadata_2025 huggingface dataset:
Global research landscape on artificial intelligence in arthroplasty: A bibliometric analysis
Authors: Li Zhuo , Maimaiti Zulipikaer , Fu Jun , Chen Ji-Ying , Xu Chi
Published: June 2023

Background

Artificial intelligence (AI) has promising applications in arthroplasty. In response to the knowledge explosion resulting from the rapid growth of publications, we applied bibliometric analysis to explore the research profile and topical trends in this field.

Methods

The articles and reviews related to AI in arthroplasty were retrieved from 2000 to 2021. The Java-based Citespace, VOSviewer, R software-based Bibiometrix, and an online platform systematically evaluated publications by countries, institutions, authors, journals, references, and keywords.

Results

A total of 867 publications were included. Over the past 22 years, the number of AI-related publications in the field of arthroplasty has grown exponentially. The United States was the most productive and academically influential country. The Cleveland Clinic was the most prolific institution. Most publications were published in high academic impact journals. However, collaborative networks revealed a lack and imbalance of inter-regional, inter-institutional, and inter-author cooperation. Two emerging research areas represented the development trends: major AI subfields such as machine learning and deep learning, and the other is research related to clinical outcomes.

Conclusion

AI in arthroplasty is evolving rapidly. Collaboration between different regions and institutions should be strengthened to deepen our understanding further and exert critical implications for decision-making. Predicting clinical outcomes of arthroplasty using novel AI strategies may be a promising application in this field.
The Thermometer Broke! Digital Purdah, Class, and Gender Transgressions on Pakistani TikTok
Authors: Kamran Sidra
Published: June 2023

Research on women’s social media practices in Muslim societies has primarily focused on middle-class or elite women, such as influencers, activists, and members of online communities. However, we know little about working-class women’s use of social media in Muslim contexts. Using ethnography and interviews, I analyze TikTok’s early popularity with working-class women in Pakistan and report three main findings. First, TikTok’s initial reception in Pakistan was fractured across class lines; whereas middle-class and elite women dismissed it, working-class women flocked to it, and TikTok became associated with a “low-class” femininity. Second, women engaged in a range of gender transgressions on TikTok. Third, women simultaneously crafted new practices of “digital purdah,” or veiling, on TikTok. I contribute to scholarship on digital purdah by, first, showing how women combine tools available on TikTok with other veiling strategies to conceal their identity while expressing their sexuality and second, arguing that “digital purdah” is compatible, rather than incongruous, with gender transgressions on TikTok. By showing how co-constituted class and gender dynamics shaped the simultaneous popularity and moral disapproval of TikTok in Pakistan, I argue for increased attention to class dynamics in studies of new social media platforms.
Estimating the Determinants and Extent of Morocco’s Education and Skill Mismatch Through the STEP Survey
Authors: Draissi Zineb , Rong Yu
Published: June 2023

This study aimed to comprehend the patterns and scope of the education mismatch in the Moroccan labor market by collecting and analyzing an extensive database of the types of skills that fuel economic expansion and growth. A self-assessment approach was used to determine the extent of mismatch in Morocco by adopting the World Bank’s Skills Toward Employment and Productivity (STEP) survey, which applies mainly to low- and middle-income countries. The study sample consisted of 416 respondents who matched the stipulated criteria. Various statistical tests like the descriptive test, chi-square, and Spearman’s r coefficient were employed to determine the correlation between the three modules of the STEP program and demographic aspects of the respondents. Under the self-assessment approach, the results showed a preponderance of mismatched employees at 55.1%, while 44.9% were matched. The mismatch was found to be vertical. The findings imply that cognitive skills are statistically significant with the required job-specific skills. This is one of the few studies that address the skill mismatch in the North African region and the first to examine the Moroccan case.
Top Management Team Heterogeneity and the Performance of Cross-Border M&A
Authors: Wu Yingna , Ding Liang , Song Xuan , Chen Jun
Published: June 2023

In this paper, we aim to investigate the impact of the top management team (TMT) on the performance of cross-border M&A, using a sample of 270 cross-border M&A events of Chinese listed companies. We find that the heterogeneity of TMT characteristics could affect the performance of cross-border M&A in different ways. More specifically, a higher heterogeneity in gender can improve the M&A performance significantly, while more heterogeneities in tenure and overseas background lead to a significant reduction in long-term and short-term M&A performances, respectively. We believe that our study can contribute to a different perspective for the selection of the executive teams of M&A companies. This, in turn, is conducive to optimizing the structure of the senior management team, and may help companies make better decisions and improve their performance.
In the Wake of COVID-19: The Developmental and Mental Health Fallout Amongst South African University Students
Authors: Bain Katherine , Hassem Tasneem , Bemath Nabeelah , de Andrade Victor , Laher Sumaya
Published: June 2023

Multiple studies have noted the impacts on student mental health of the COVID-19 pandemic, associated national lockdowns and emergency remote teaching. In light of COVID-19 shifting from pandemic to endemic status, this study investigates the developmental and mental health consequences of the pandemic for a group of South African undergraduate students. A qualitative design allowed for the thematic analysis of the narratives of 140 humanities students, gathered through an online survey. This paper presents the ‘voices’ of this group to convey the intensity of their COVID-19 experience. The results suggest a loss of a sense of freedom and opportunities to explore and experiment, high levels of depression with a notable sense of hopelessness regarding the future and decreased motivation, and significant reports of social anxiety related to delays in the development of social skills due to social isolation, particular to the first-year cohort.
Quantitative medicine: Tracing the transition from holistic to reductionist approaches. A new “quantitative holism” is possible?
Authors: Saba Luca , Tagliagambe Silvano
Published: June 2023

The practice of medicine has evolved significantly over time, from a more holistic to a reductionist or mechanistic approach. This paper briefly traces the history of medicine and the transition to quantitative medicine, which has enabled more personalized and targeted treatments, and improved understanding of the underlying biological mechanisms of disease. However, this shift has also presented some challenges and criticisms, including the danger of losing sight of the patient as a unique, whole individual. This paper explores the underlying principles and key contributions of quantitative medicine, as well as the context for its rise, including the development of new technologies and the influence of reductionist philosophies. The challenges and criticisms of this approach, and the need to balance reductionist and holistic approaches in order to achieve a comprehensive understanding of human health will be discussed. Ultimately, by integrating insights from philosophy, physics, and other fields, we may be able to develop new and innovative approaches that bridge the gap between reductionism and holism and improve patient outcomes with the new “quantitative holism.”
Unexpected Barium Aspiration
Authors: Vangara Avinash , Gullapalli Dedeepya , Do Tuong Vi , Chan Regina , Kalafatis Kathleen , Ganti SubramanyaShyam
Published: June 2023

A barium esophagram is a diagnostic test used for the evaluation of dysphagia. However, this test has the potential risk for aspiration of the barium contrast. Barium aspiration typically localizes to the right lower lobe or left lingular lobe. We present a case of barium aspiration localized to the right middle lobe that persisted on chest X-ray. A 62-year-old male with a past medical history of hypertension, long-term back pain, gastritis, and anxiety presented with the complaints of hoarseness of voice, dysphagia, and weight loss for several months. During the esophagram, the patient aspirated the barium contrast. Chest X-ray confirmed the aspiration in the right middle lobe with a tree in bud appearance suggesting involvement of bronchioles. Three months later, a repeat chest X-ray revealed residual contrast. Pulmonary complications are directly related to the amount of aspirated barium and can include hypoxia, respiratory failure, secondary aspiration pneumonia, shock, and acute respiration distress syndrome. The prognosis of a barium aspiration is dependent on the amount of barium aspirated.
Injury Risk in Collegiate Football Players With Generalized Joint Hypermobility: A Prospective Cohort Study Over 2 Years
Authors: Nicolay Richard W. , Hartwell Matthew H. , Bigach Stephen D. , Fernandez Claire E. , Morgan Allison M. , Cogan Charles J. , Terry Michael A. , Tjong Vehniah K.
Published: June 2023

Background:

Generalized joint hypermobility (GJH) has been identified as a risk factor for injury in various athletic patient populations.

Purpose:

To evaluate GJH as a predisposing risk factor for injury in a population of National Collegiate Athletic Association (NCAA) Division I football players.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

The Beighton score was collected for 73 athletes during their preseason physical examinations in 2019. GJH was defined as a Beighton score ≥4. Athlete descriptive characteristics, including age, height, weight, and playing position, were recorded. The cohort was evaluated prospectively for 2 years, and the number of musculoskeletal issues, injuries, treatment episodes, days unavailable, and surgical procedures for each athlete during this period were recorded. These measures were compared between the GJH and no-GJH groups.

Results:

The mean Beighton score was 1.4 ± 1.5 for the 73 players; 7 players (9.6%) had a Beighton score indicating GJH. During the 2-year evaluation, there were 438 musculoskeletal issues, including 289 injuries. The mean number of treatment episodes per athlete was 77 ± 71 (range, 0-340), and the mean number of days unavailable was 67 ± 92 days (range, 0-432 days). There were 23 athletes who required 25 operations, the most common procedure being arthroscopic shoulder stabilization (n = 6). The number of injuries per athlete was not significantly different between the GJH and no-GJH groups (3.0 ± 2.1 vs 4.1 ± 3.0; P = .13), nor were there any between-group differences in the number of treatments received (74.6 ± 81.9 vs 77.2 ± 71.5; P = .47), days unavailable (79.6 ± 124.5 vs 65.3 ± 89.3; P = .61), or rates of surgery (43% vs 30%; P = .67).

Conclusion:

A preseason diagnosis of GJH did not place NCAA football players at a greater risk for injury during the 2-year study period. Based on the findings of this study, no specific preparticipation risk counseling or intervention is warranted for football players who are diagnosed with GJH as defined by the Beighton score.
Outcomes of Biceps Tenodesis Variations With Concomitant Rotator Cuff Repair: A Multicenter Database Analysis
Authors: Hagan David P. , Hao Kevin A. , King Joseph J. , Srinivasan Ramesh C. , Wright Thomas W. , Moser Michael W. , Farmer Kevin W. , Wright Jonathan O. , Pazik Marissa , Roach Ryan P.
Published: June 2023

Background:

Studies to date comparing biceps tenodesis methods in the setting of concomitant rotator cuff repair (RCR) have demonstrated relatively equivalent pain and functional outcomes.

Purpose:

To compare biceps tenodesis constructs, locations, and techniques in patients who underwent RCR using a large multicenter database.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A global outcome database was queried for patients with medium- and large-sized tears who underwent biceps tenodesis with RCR between 2015 and 2021. Patients ≥18 years of age with a minimum follow-up of 1 year were included. The American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, visual analog scale for pain, and Veterans RAND 12-Item Health Survey (VR-12) scores were compared at 1 and 2 years of follow-up based on construct (anchor, screw, or suture), location (subpectoral, suprapectoral, or top of groove), and technique (inlay or onlay). Nonparametric hypothesis testing was used to compare continuous outcomes at each time point. The proportion of patients achieving the minimal clinically important difference (MCID) at the 1- and 2-year follow-ups were compared between groups using chi-square tests.

Results:

A total of 1903 unique shoulder entries were analyzed. Improvement in VR-12 Mental score favored anchor and suture fixations at 1 year of follow-up ( P = .042) and the onlay tenodesis technique at 2 years of follow-up ( P = .029). No additional tenodesis comparisons demonstrated statistical significance. The proportion of patients with improvement exceeding the MCID did not differ based on tenodesis methods for any outcome score assessed at the 1- or 2-year follow-up.

Conclusion:

Biceps tenodesis with concomitant RCR led to improved outcomes regardless of tenodesis fixation construct, location, or technique. A clear optimal tenodesis method with RCR remains to be determined. Surgeon preference and experience with various tenodesis methods as well as patient clinical presentation should continue to guide surgical decision-making.
A Model for Online Delivery of Multiple Mini Interviews
Authors: Cork Simon C
Published: June 2023

Multiple mini interviews (MMIs) have become the mainstay of medical school admission interviews in the United Kingdom. During the COVID-19 pandemic, Government imposed restrictions on the meeting of people indoors precipitated a move towards conducting interviews online. Thus, the development of methodologies to conduct robust MMI style interviews remotely was required. In this article, a validated method for conducting remote MMIs is described. This method of delivery produced comparable candidate scores compared with pre-pandemic in-person interviews and maintained reliability.
Support and information needs of people with systemic sclerosis by time since diagnosis: A cross-sectional study
Authors: Provencher Sabrina , Henry Richard S , Bacalao Carolina , Carrier Marie-Eve , Kwakkenbos Linda , Thombs Brett D ,   the Scleroderma Patient-centered Intervention Network (SPIN) Support Group Project Advisory Team
Published: June 2023

Background:

How support and informational needs of people with systemic sclerosis (SSc) may differ by time since diagnosis is not known. Our objective was to determine if informational and support needs of recently diagnosed individuals with systemic sclerosis differ from people diagnosed for longer periods of time.

Methods:

The North American Scleroderma Support Group Members survey included 30 items on reasons for attending support groups. Respondents were classified by time since diagnosis of 0–3 years, 4–9 years or 10+ years. Survey item responses were dichotomized into Not Important or Somewhat Important versus Important or Very Important. We conducted Chi-square tests with Hochberg’s Sequential Method to identify item differences by time since diagnosis.

Results:

A total of 175 respondents completed the survey. Most support needs were rated as Important or Very Important by respondents, regardless of disease duration, particularly needs related to interpersonal and social support (10 items; median 81%) and learning about disease treatment and management strategies (11 items; median 82%). Discussing other aspects of living with systemic sclerosis (e.g. spirituality, discussing disease with family and friends) was rated lower (9 items; 44%). Respondents with 0–3 years since diagnosis were the highest on 29 of 30 items. Respondents with 0–3 years since diagnosis were significantly higher on items related to discussing medical care and 4 items on other aspects (spirituality, talking with family and friends, financial issues, sexual issues).

Conclusion:

People with systemic sclerosis have a wide range of information and support needs, regardless of their disease duration, but people with recent diagnoses have greater needs.
Identifying applications of virtual reality to benefit the stroke translational pipeline
Authors: Bone Matan , Malik Maham , Crilly Siobhan
Published: June 2023

As a leading cause of mortality and morbidity, stroke and its management have been studied extensively. Despite numerous pre-clinical studies identifying therapeutic targets, development of effective, specific pharmacotherapeutics remain limited. One significant limitation is a break in the translational pipeline – promising pre-clinical results have not always proven replicable in the clinic. Recent developments in virtual reality technology might help generate a better understanding of injury and recovery across the whole research pipeline in search of optimal stroke management. Here, we review the technologies that can be applied both clinically and pre-clinically to stroke research. We discuss how virtual reality technology is used to quantify clinical outcomes in other neurological conditions that have potential to be applied in stroke research. We also review current uses in stroke rehabilitation and suggest how immersive programmes would better facilitate the quantification of stroke injury severity and patient recovery comparable to pre-clinical study design. By generating continuous, standardised and quantifiable data from injury onset to rehabilitation, we propose that by paralleling pre-clinical outcomes, we can apply a better reverse-translational strategy and apply this understanding to animal studies. We hypothesise this combination of translational research strategies may improve the reliability of pre-clinical research outcomes and culminate in real-life translation of stroke management regimens and medications.
Is the noise still going on? Predicting repeat noise complaints with historical time course and random forest classifiers
Authors: Fan Zicheng , Signorelli Valerio
Published: June 2023

Noise can have serious adverse effects on residents' physical and mental health. Since the COVID-19 pandemic, the City of Westminster in London has seen a continuous increase in noise complaints, with a significant number of repeat complaints from the same address within a short time scale. The authorities' ability to respond to complaints is challenged. This study explores a method for predicting and identifying repeat complaints to improve the efficiency of the authorities in dealing with noise complaints. Taking the noise complaint records of the City of Westminster during 2018–2022 as research objects, the research explores the cumulative distribution characteristics and clustering pattern of noise complaints in different spatial and temporal dimensions. On this basis, for a noise complaint from a specific address, the study fits random forest classifiers to predict whether the same address is likely to have another noise complaint in future time scales. It is found that about 18.5% of all complaints had at least one previous complaint at the same address in the previous 7 days; during the lock-down period caused by the COVID-19 pandemic, areas with active commercial activities and higher housing prices experienced a significant decrease in complaints, while areas adjacent to parks and green spaces can share a similar upward trend in noise complaints. Prediction of repeat noise complaints with random forest classifiers is proved feasible. F1 scores of models to predict repeat complaints within 0 to 2nd days, 0 to 7th days and 0 to 30th days in the future are 0.55, 0.66 and 0.75, respectively. Suggestions are provided for local authorities to improve resource allocation related to noise complaint management.
Primary Cutaneous Malignant Perivascular Epithelioïd Cell Tumor (PEComa): Case Report With Review of the Literature
Authors: Elousrouti Layla Tahiri , Mouaddine Amal , Fadlallah Imane , Elhitmy Sofia , Elloudi Sara , Mernissi Fatimazahra , Elidrissi Mohammed , Hammas Nawal , Elfatemi Hinde , Chbani Laila
Published: June 2023

Perivascular epithelioïd cell tumor (PEComa) is a mesenchymal neoplasm with epithelioïd or spindled morphology with numerous thin-walled capillaries between tumor cells. They co-express markers of both melanocytic and smooth muscle differentiation. PEComas are rare, presenting in numerous anatomic sites including lung, kidney, liver, genitourinary tract, soft tissue, and skin. Primary cutaneous PEComas are very rare entity, and malignant ones are even more uncommon. Herein, we report the case of a 92-year-old female which was presenting with 7 cm exophytic, ulcerated, hemorrhagic nodular tumor, and rapidly growing for 8 months over the right thigh. On histologic examination, we found a dermal neoplasm formed by an atypical clear cell tumor with numerous branching capillaries between tumor cells. The mitotic count was found 6 mitotic figures/10 HPF. On immunohistochemistry, tumor cells co-expressed smooth muscle and melanocytic markers, CD10, and CD68. Based on these findings, the diagnosis of primary cutaneous malignant perivascular epithelioïd cell tumor (PEComa) was made. The large size (7 cm), the count of mitoses (6 mitotic figures/10 HPF), and the nuclear pleomorphism argued for malignancy. The absence of soft tissue or visceral localization argued for the cutaneous primitive origin. Adjuvant radiotherapy and targeted therapy with mTOR inhibitor (nab-sirolimus) was indicated. To the best of our knowledge, this is only the eighth case of a primary cutaneous malignant PEComa reported in the literature to date.
Understanding the Spectrum of Esophageal Cancer Disparities
Authors: Parikh Malhar J. , Gabriel Nielsen M. , Gryszko Veronica , Erkmen Cherie P.
Published: June 2023

Esophageal cancer carries an immense burden of disease. Despite advances in cancer care, the survival rate of esophageal cancer has not significantly improved over the last 30 years. The burden of disease is greater on minorities, immigrants, and lower socioeconomic groups in the United States. Research has consistently shown that these communities suffer from persistently worse outcomes. Minorities are noted to have increased risk of developing esophageal cancer, have worse stage at presentation, and limited access to the newest advancements and best treatment options. The reason for these disparities is multifactorial and the US health system must address and correct the underlying reasons to ensure just health care for all.
For multispecies liberatory futures: Three principles toward “progress” in anti-anthropocentric environmental geography
Authors: Narayanan Yamini
Published: June 2023

This review draws on the work of critical animal geographers to elicit the notion of environmental anthropocentrism through critiques of progress as human development that adversely incorporates or displaces animal bodies in the service of (green) capitalism and sustainability. It reflects on how ideas of “progress” in environmental geography become reshaped through a critical animal geographic approach that politicizes animal–nature relations in all their diversity, and centers the experiences of animals as individuals and species in development-induced ecological crises. To this end, it advances three principles for an anti-anthropocentric analytic of progress as multispecies liberatory futures: animating humans toward a shared (but not universal) animality; differentiating species for nonhierarchy beyond capitalism; and instituting anti-anthropocentrism in addressing difficult ethics and incommensurability in liberatory futures.
Node-negative colon cancer: histological, molecular, and stromal features predicting disease recurrence
Authors: Strous Maud T. A. , van der Linden Ragna L. A. , Gubbels Audrey L. H. M. , Faes Timothy K. E. , Bosscha Koop , Bronkhorst Carolien M. , Janssen-Heijnen Maryska L. G. , de Bruïne Adriaan P. , Vogelaar F. Jeroen
Published: June 2023

Background

Within the group of node-negative colon cancer patients, presumed to have a good prognosis, a significant percentage of patients develops cancer-recurrence. Current high-risk features prove inadequate to select these particular high-risk patients. In the process of tailor-made care and shared decision-making the need to identify these patients grows. In this study we investigate the value of adding molecular markers and the tumour-stroma ratio (TSR) to conventional histological tumour staging methods to improve the selection of high risk patients.

Methods

We retrospectively analysed 201 patients diagnosed with TNM-stage I-II colon cancer and treated by complete oncological resection between November 1st 2002 and December 31st 2012 at the Jeroen Bosch Hospital. Conventional histological tumour staging, BRAF mutations, KRAS mutations, MSI status and TSR were determined. Differences between groups based on TSR and mutation status, in disease free survival were analysed using Cox-Regression analyses.

Results

Poorly differentiated histology (p = 0.002), high-TSR (p = 0.033), BRAF-mutation (p = 0.008) and MSI (p = 0.011) were identified as significant risk factors for cancer recurrence. The risk of recurrence increased in the presence of both a BRAF-mutation and high-TSR compared to the absence of both factors or presence of only one factor (HR = 3.66 BRAF-mt/TSR-low (p = 0.006), HR 2.82 BRAF-wt/TSR-high (p = 0.015), HR = 4.39 BRAF-mt/TSR-high (p = 0.023)). This was also seen in tumours with MSI and high-TSR (HR = 2.46 MSS/TSR-high (p = 0.041), HR = 3.31 MSI/TSR-high (p = 0.045).

Conclusion

Judging by the higher HR for the combination of the prognostic factors TSR and BRAF compared to the HRs of these prognostic factors individually, the prognostication for disease free survival can be improved by determining both TSR and BRAF instead of BRAF alone, as is done in current daily practise. In this study MSI also shows additional value to TSR in the prognostication of disease free survival. Adopting TSR into daily diagnostics will be of additional value next to currently used molecular markers in risk stratification of patients with node negative colon cancer and is therefore advised.
Effect of Initial Microstructure Prior to Extrusion on the Microstructure and Mechanical Properties of Extruded AZ80 Alloy with a Low Temperature and a Low Ratio
Authors: Zhang Hang , Li Haipeng , Li Rongguang , Liu Boshu , Wu Ruizhi , Zhao Dongyue , Li Shanshan
Published: June 2023

Magnesium (Mg) alloys are the lightest metal structural material for engineering applications and therefore have a wide market of applications. However, compared to steel and aluminum alloys, Mg alloys have lower mechanical properties, which greatly limits their application. Extrusion is one of the most important processing methods for Mg and its alloys. However, the effect of such a heterogeneous microstructure achieved at low temperatures on the mechanical properties is lacking investigation. In this work, commercial AZ80 alloys with different initial microstructures (as-cast and as-homogenized) were selected and extruded at a low extrusion temperature of 220 °C and a low extrusion ratio of 4. The microstructure and mechanical properties of the two extruded AZ80 alloys were investigated. The results show that homogenized-extruded (HE) sample exhibits higher strength than the cast-extruded (CE) sample, which is mainly attributed to the high number density of fine dynamic precipitates and the high fraction of recrystallized ultrafine grains. Compared to the coarse compounds existing in CE sample, the fine dynamical precipitates of Mg17(Al, Zn)12 form in the HE sample can effectively promote the dynamical recrystallization during extrusion, while they exhibit a similar effect on the size and orientation of the recrystallized grains. These results can facilitate the designing of high-strength wrought magnesium alloys by rational microstructure construction.
Smooth Trajectory Planning for a Cable Driven Parallel Waist Rehabilitation Robot Based on Rehabilitation Evaluation Factors
Authors: Li Yuan , Zi Bin , Sun Zhi , Zhao Ping
Published: June 2023

Rehabilitation robots can help physiatrists to assist patients in improving their movement ability. Due to the interaction between rehabilitation robots and patients, the robots need to complete rehabilitation training on a safe basis. This paper presents an approach for smooth trajectory planning for a cable-driven parallel waist rehabilitation robot (CDPWRR) based on the rehabilitation evaluation factors. First, motion capture technology is used to collect the motion data of several volunteers in waist twisting. Considering the impact of motion variability, the feature points at the center of the human pelvis are obtained after eliminating unreasonable data through rationality judgments. Then, point-to-point waist training trajectory planning based on quintic polynomial and cycloid functions, and multipoint waist training trajectory planning based on quintic B-spline functions are carried out. The corresponding planned curves and kinematics characteristics using three methods are compared and analyzed. Subsequently, the rehabilitation evaluation factors are introduced to conduct smooth trajectory planning for waist training, and the waist trajectory with better compliance is obtained based on the safety and feasibility of waist motion. Finally, the physical prototype of the CDPWRR is built, and the feasibility and effectiveness of the proposed smooth trajectory planning method are proved by numerical analysis and experiments.
Association between SUMF1 polymorphisms and COVID-19 severity
Authors: Liang Shaohui , Gao Huixia , He Tongxin , Li Li , Zhang Xin , Zhao Lei , Chen Jie , Xie Yanyan , Bao Jie , Gao Yong , Dai Erhei , Wang Yuling
Published: June 2023

Background

Evidence shows that genetic factors play important roles in the severity of coronavirus disease 2019 (COVID-19). Sulfatase modifying factor 1 (SUMF1) gene is involved in alveolar damage and systemic inflammatory response. Therefore, we speculate that it may play a key role in COVID-19.

Results

We found that rs794185 was significantly associated with COVID-19 severity in Chinese population, under the additive model after adjusting for gender and age (for C allele = 0.62, 95% CI = 0.44–0.88, P = 0.0073, logistic regression). And this association was consistent with this in European population Genetics Of Mortality In Critical Care (GenOMICC: OR for C allele = 0.94, 95% CI = 0.90–0.98, P = 0.0037). Additionally, we also revealed a remarkable association between rs794185 and the prothrombin activity (PTA) in subjects (P = 0.015, Generalized Linear Model).

Conclusions

In conclusion, our study for the first time identified that rs794185 in SUMF1 gene was associated with the severity of COVID-19.
Varied hypoxia adaptation patterns of embryonic brain at different development stages between Tibetan and Dwarf laying chickens
Authors: Tang Qiguo , Yu Runjie , Wang Yubei , Xie Fuyin , Zhang Hao , Wu Changxin , Fang Meiying
Published: June 2023

Background

Tibetan chickens (Gallus gallus; TBCs), an indigenous breed distributed in the Qinghai-Tibet Plateau, are well adapted to the hypoxic environment. Currently, the molecular genetic basis of hypoxia adaptation in TBCs remains unclear. This study investigated hypoxia adaptation patterns of embryonic brain at different development stages by integrating analysis of the transcriptome with our previously published metabolome data in TBCs and Dwarf Laying Chickens (DLCs), a lowland chicken breed.

Results

During hypoxia, the results revealed that 1334, 578, and 417 differentially expressed genes (DEGs) (|log2 fold change|>1, p-value < 0.05) on days 8, 12, and 18 of development, respectively between TBCs and DLCs. Gene Ontology (GO) and pathway analyses revealed that DEGs are mainly related to metabolic pathways, vessel development, and immune response under hypoxia. This is consistent with our metabolome data that TBCs have higher energy metabolism than DLCs during hypoxia. Some vital DEGs between TBCs and DLCs, such as EPAS1, VEGFD, FBP1, FBLN5, LDHA, and IL-6 which are involved in the HIF pathway and hypoxia regulation.

Conclusion

These results suggest varied adaptation patterns between TBCs and DLCs under hypoxia. Our study provides a basis for uncovering the molecular regulation mechanism of hypoxia adaptation in TBCs and a potential application of hypoxia adaptation research for other animals living on the Qinghai-Tibet Plateau, and may even contribute to the study of brain diseases caused by hypoxia.
Exploring variation in implementation of multifactorial falls risk assessment and tailored interventions: a realist review
Authors: Alvarado Natasha , McVey Lynn , Wright Judy , Healey Frances , Dowding Dawn , Cheong V-Lin , Gardner Peter , Hardiker Nick , Lynch Alison , Zaman Hadar , Smith Heather , Randell Rebecca
Published: June 2023

Background

Falls are the most common safety incident reported by acute hospitals. In England national guidance recommends delivery of a multifactorial falls risk assessment (MFRA) and interventions tailored to address individual falls risk factors. However, there is variation in how these practices are implemented. This study aimed to explore the variation by examining what supports or constrains delivery of MFRAs and tailored interventions in acute hospitals.

Methods

A realist review of literature was conducted with searches completed in three stages: (1) to construct hypotheses in the form of Context, Mechanism, Outcome configurations (CMOc) about how MFRAs and interventions are delivered, (2) to scope the breadth and depth of evidence available in Embase to test the CMOcs, and (3) following prioritisation of CMOcs, to refine search strategies for use in multiple databases. Citations were managed in EndNote; titles, abstracts, and full texts were screened, with 10% independently screened by two reviewers.

Results

Two CMOcs were prioritised for testing labelled: FacilitationviaMFRA tools, and Patient Participation in interventions. Analysis indicated that MFRA tools can prompt action, but the number and type of falls risk factors included in tools differ across organisations leading to variation in practice. Furthermore, the extent to which tools work as prompts is influenced by complex ward conditions such as changes in patient condition, bed swaps, and availability of falls prevention interventions. Patient participation in falls prevention interventions is more likely where patient directed messaging takes individual circumstances into account, e.g., not wanting to disturb nurses by using the call bell. However, interactions that elicit individual circumstances can be resource intensive and patients with cognitive impairment may not be able to participate despite appropriately directed messaging.

Conclusions

Organisations should consider how tools can be developed in ways that better support consistent and comprehensive identification of patients’ individual falls risk factors and the complex ward conditions that can disrupt how tools work as facilitators. Ward staff should be supported to deliver patient directed messaging that is informed by their individual circumstances to encourage participation in falls prevention interventions, where appropriate.

Trial registration

PROSPERO: CRD42020184458.
Clinical effectiveness of rehabilitation in ambulatory care for patients with persisting symptoms after COVID-19: a systematic review
Authors: Dillen Hannelore , Bekkering Geertruida , Gijsbers Sofie , Vande Weygaerde Yannick , Van Herck Maarten , Haesevoets Sarah , Bos David A G , Li Ann , Janssens Wim , Gosselink Rik , Troosters Thierry , Verbakel Jan Y
Published: June 2023

Background

Lingering symptoms after acute COVID-19 present a major challenge to ambulatory care services. Since there are reservations regarding their optimal management, we aimed to collate all available evidence on the effects of rehabilitation treatments applicable in ambulatory care for these patients.

Methods

On 9 May 2022, we systematically searched articles in COVID-19 collections, Embase, MEDLINE, Cochrane Library, Web of Science, CINAHL, PsycArticles, PEDro, and EuropePMC. References were eligible if they reported on the clinical effectiveness of a rehabilitation therapy applicable in ambulatory care for adult patients with persisting symptoms continuing 4 weeks after the onset of COVID-19. The quality of the studies was evaluated using the CASP cohort study checklist and the Cochrane Risk of Bias Assessment Tool. Summary of Findings tables were constructed and the certainty of evidence was assessed using the GRADE framework.

Results

We included 38 studies comprising 2,790 participants. Physical training and breathing exercises may reduce fatigue, dyspnoea, and chest pain and may improve physical capacity and quality of life, but the evidence is very weak (based on 6 RCTs and 12 cohort studies). The evidence underpinning the effect of nutritional supplements on fatigue, dyspnoea, muscle pain, sensory function, psychological well-being, quality of life, and functional capacity is very poor (based on 4 RCTs). Also, the evidence-base is very weak about the effect of olfactory training on sensory function and quality of life (based on 4 RCTs and 3 cohort studies). Multidisciplinary treatment may have beneficial effects on fatigue, dyspnoea, physical capacity, pulmonary function, quality of life, return to daily life activities, and functional capacity, but the evidence is very weak (based on 5 cohort studies). The certainty of evidence is very low due to study limitations, inconsistency, indirectness, and imprecision.

Conclusions

Physical training, breathing exercises, olfactory training and multidisciplinary treatment can be effective rehabilitation therapies for patients with persisting symptoms after COVID-19, still with high uncertainty regarding these effects. These findings can guide ambulatory care practitioners to treat these patients and should be incorporated in clinical practice guidelines. High-quality studies are needed to confirm our hypotheses and should report on adverse events.
Disentangling pharmacological and expectation effects in antidepressant discontinuation among patients with fully remitted major depressive disorder: study protocol of a randomized, open-hidden discontinuation trial
Authors: Meißner Carina , Warren Claire , Fadai Tahmine , Müller Amke , Zapf Antonia , Lezius Susanne , Ozga Ann-Kathrin , Falkenberg Irina , Kircher Tilo , Nestoriuc Yvonne
Published: June 2023

Background

Antidepressants are established as an evidence-based, guideline-recommended treatment for Major Depressive Disorder. Prescriptions have markedly increased in past decades, with a specific surge in maintenance prescribing. Patients often remain on antidepressants longer than clinically necessary. When attempting to stop, many patients experience adverse discontinuation symptoms. Discontinuation symptoms can be debilitating and hinder successful discontinuation. While discontinuation symptoms can result from pharmacological effects, evidence on nocebo-induced side effects of antidepressant use suggests that patients' expectations may also influence occurrence.

Methods

To disentangle pharmacological and expectation effects in antidepressant discontinuation, patients with fully remitted Major Depressive Disorder who fulfill German guideline recommendations to discontinue will either remain on or discontinue their antidepressant. Participants' expectations will be manipulated by varying verbal instructions using an open-hidden paradigm. Within the open trial arms, participants will receive full information about treatment, i.e., high expectation. Within the hidden trial arms, participants will be informed about a 50% chance of discontinuing versus remaining on their antidepressant, i.e., moderate expectation. A total of N = 196 participants will be randomly assigned to either of the four experimental groups: open discontinuation (OD; n = 49), hidden discontinuation (HD; n = 49), open continuation (OC; n = 49), or hidden continuation (HC; n = 49). Discontinuation symptom load during the 13-week experimental phase will be our primary outcome measure. Secondary outcome measures include discontinuation symptom load during the subsequent 39-week clinical observation phase, recurrence during the 13-week experimental period, recurrence over the course of the complete 52-week trial evaluated in a time-to-event analysis, and stress, anxiety, and participants’ attentional and emotional processing at 13 weeks post-baseline. Blood and saliva samples will be taken as objective markers of antidepressant blood serum level and stress. Optional rsfMRI measurements will be scheduled.

Discussion

Until today, no study has explored the interplay of pharmacological effects and patients’ expectations during antidepressant discontinuation. Disentangling their effects has important implications for understanding mechanisms underlying adverse discontinuation symptoms. Results can inform strategies to manage discontinuation symptoms and optimize expectations in order to help patients and physicians discontinue antidepressants more safely and effectively.

Trial registration

ClinicalTrials.gov (NCT05191277), January 13, 2022.
Sleep duration trajectories and all-cause mortality among Chinese elderly: A community-based cohort study
Authors: Ding Rongxiu , Ding Pan , Tian Liuhong , Kuang Xiaodan , Huang Li , Shi Hongying
Published: June 2023

Background

China is among the largest and fastest aging countries. The elderly population is more vulnerable, with higher proportion of inappropriate sleep duration and risk of mortality, compared with young and middle-aged adults. Single-measured sleep duration has been associated with mortality, but the health effects of long-term sleep duration trajectories remain unknown. This study aimed to explore the prospective associations between sleep duration trajectories and all-cause mortality among Chinese elderly.

Methods

Participants (n = 3,895; median age: 82 years; females: 53.3%) who reported sleep duration in all three surveys (2005, 2008, and 2011) from the community-based Chinese Longitudinal Healthy Longevity Survey (CLHLS) were followed up until 2019 (about 8 years). We identified sleep duration trajectories by latent class mixed model and explored their association with all-cause mortality using Cox hazard proportional regression and Laplace regression models. Further, stratified analysis by demographic characteristics and lifestyles and sensitivity analysis by lag effect, health-related factors, and inverse probability weighting were used to verify the robustness of the association. In addition, we explored the threshold effect of baseline sleep duration on the risk of all-cause mortality.

Results

We documented 1,881 all-cause deaths during 16,689 person-years of follow-up. Five sleep duration trajectories were identified: moderately increased trajectory (28.1%), rapidly increased trajectory (7.2%), persistent sleep trajectory of 7 h (33.7%), moderately decreased trajectory (21.3%), and rapidly decreased trajectory (9.7%). Compared with the persistent sleep trajectory of 7 h, the multivariable-adjusted HRs (95%CI) for moderately increased trajectory, rapidly increased trajectory, moderately decreased trajectory, and rapidly decreased trajectory were 1.21 (1.08, 1.36), 1.21 (1.01, 1.44), 0.95 (0.82, 1.10), and 0.93 (0.78, 1.11), respectively; and the corresponding difference in median survival time (95%CI) were -0.53 (-1.01, -0.05), -0.43 (0.16, -1.02), 0.26 (-0.34, 0.86), and 0.25 (-0.51, 1.02), respectively. Stratified and sensitivity analyses showed consistent results. Threshold analysis indicated a sharply increased risk of mortality in participants whose sleep exceeds 9 h (HR = 1.20, 95%CI: 1.11, 1.30).

Conclusion

Compared with the persistent sleep trajectory of 7 h, moderately and rapidly increased sleep duration trajectories were associated with higher subsequent mortality in Chinese elderly. Those who report sleep exceeding 9 h may be at high risk for all-cause mortality.
Intersectional stigma and the arc of intranational migration: experiences of transgender adolescents and women who migrate within Peru
Authors: Perez-Brumer Amaya , Salazar Ximena , Nunez-Curto Aron , D’Amico Lynne , Aguayo-Romero Rodrigo , Reisner Sari L. , Silva-Santisteban Alfonso
Published: June 2023

Background

Migration is recognized as a key determinant of health. Yet, limited research addresses the arc of intranational migration and, even less, the experiences of transgender (trans) adolescents and women migrants and the associated health vulnerabilities. Using intersectional stigma as a theoretical frame, this study seeks to better understand the sexual health vulnerabilities and needs of trans women migrants in Peru.

Methods

Between October and November 2016, in-depth interviews (n = 14) and two focus groups (n = 20) were conducted in Spanish with trans women in three Peruvian cities. To explore pre- and during migration experiences, focus groups were conducted in Pucallpa and Iquitos, key cities in the Amazon where trajectories often originate. To assess during migration and post-migration experiences, we conducted interviews in Pucallpa, Iquitos, and Lima to better understand processes of relocation. Audio files were transcribed verbatim and analysed via an immersion crystallization approach, an inductive and iterative process, using Dedoose (v.6.1.18).

Results

Participants described migration as an arc and, thus, results are presented in three phases: pre-migration; during migration; and post-migration. Intersectional stigma was identified as a transversal theme throughout the three stages of migration. The pre-migration stage was characterized by poverty, transphobia, and violence frequently motivating the decision to migrate to a larger city. Exploitation was also described as pervasive during migration and in relocation. Many participants spoke of their introduction to sex work during migration, as key to economic earning and associated violence (police, clients).

Conclusion

Findings advance understandings of intranational migration and forced displacement as key determinants of trans women’s health. Dimensions of violence at the intersection of classism and cisgenderism render trans women highly vulnerable at every step of their migratory journeys. Experiences of intranational mobility and relocation were described as uniquely tied to age, intersectional transphobic stigma, engagement in sex work, and multiple forms of violence, which impact and can magnify sexual health vulnerabilities for transgender women in Peru who migrated intranationally.