bluuebunny/crossref_metadata_2025 huggingface dataset:
Attention Mobilization as a Modulator of Listening Effort: Evidence From Pupillometry
Authors: Johns M. A. , Calloway R. C. , Karunathilake I. M. D. , Decruy L. P. , Anderson S. , Simon J. Z. , Kuchinsky S. E.
Published: April 2024

Listening to speech in noise can require substantial mental effort, even among younger normal-hearing adults. The task-evoked pupil response (TEPR) has been shown to track the increased effort exerted to recognize words or sentences in increasing noise. However, few studies have examined the trajectory of listening effort across longer, more natural, stretches of speech, or the extent to which expectations about upcoming listening difficulty modulate the TEPR. Seventeen younger normal-hearing adults listened to 60-s-long audiobook passages, repeated three times in a row, at two different signal-to-noise ratios (SNRs) while pupil size was recorded. There was a significant interaction between SNR, repetition, and baseline pupil size on sustained listening effort. At lower baseline pupil sizes, potentially reflecting lower attention mobilization, TEPRs were more sustained in the harder SNR condition, particularly when attention mobilization remained low by the third presentation. At intermediate baseline pupil sizes, differences between conditions were largely absent, suggesting these listeners had optimally mobilized their attention for both SNRs. Lastly, at higher baseline pupil sizes, potentially reflecting overmobilization of attention, the effect of SNR was initially reversed for the second and third presentations: participants initially appeared to disengage in the harder SNR condition, resulting in reduced TEPRs that recovered in the second half of the story. Together, these findings suggest that the unfolding of listening effort over time depends critically on the extent to which individuals have successfully mobilized their attention in anticipation of difficult listening conditions.
Latinx/a/o Senior Leaders in U.S Higher Education: A Systematic Review of the Literature
Authors: Burmicky Jorge , Duran Antonio , Muñoz Natalie
Published: April 2024

Latinx/a/o senior leaders remain underrepresented in the executive ranks, and more research is needed to adequately address equity gaps in higher education leadership. By employing a systematic literature review approach, we examined 57 pieces of scholarship that focused on the experiences of senior Latinx/a/o leaders in postsecondary education. This exploration was aimed at equipping higher education scholars and practitioners with the tools to understand how Latinx/a/o leaders navigate challenges and opportunities in higher education. We identified three major themes: 1) scholarship focusing on individual traits and important identity-based differences; 2) research describing the environmental and structural conditions that shape these leaders’ realities; and 3) literature describing these individuals’ leadership pathways. As an effort to make this body of work more accessible to researchers and decision-makers, we provided implications for research and practice to shape the field of Latinx/a/o leadership in higher education.
Avoiding relapses after crises: Exploring the influence of firm investors’ characteristics on organizational resilience
Authors: Mellado-Garcia Elena , Ortiz-de-Mandojana Natalia , Aragon-Correa Juan Alberto
Published: April 2024

Many firms may successfully navigate an organizational crisis, but may find themselves entangled in another soon after. Building on a resource-dependence perspective, this study evaluates how certain investor characteristics foster organizational resilience during a crisis by preventing a relapse following recovery. Drawing on data from 2014 to 2019, we analyzed 359 firms that faced a crisis in 2015, as indicated by their Altman Z-score values. Our findings reveal that diversity and patience of investors prevent firms from relapsing into upcoming crises; however, the probability of relapse increases when concentrated investors boost the firm’s capital during the in-crisis period. We bridge the gap between the resource-dependence theory and literature on organizational resilience and contribute by extending previous analyses on the relevance of investors to recover from a crisis to identify how in-crisis investors’ features also state the foundations to avoid future relapses.

JEL CLASSIFICATION: D74; D81; G01; G32; P45
Tourism dreams in rubble: Mass demolition and the reconfiguration of growth coalitions within China's ecological civilization
Authors: Zhao Yawei
Published: April 2024

Amidst the mounting interest in China's Ecological Civilization (EC) campaign, this paper examines its ground-level implementation and its influences on fostering eco-conscious urban governance. Employing a temporal approach to scrutinize the change in local priorities over time, this paper conducts a detailed case study of Dali, a tourist destination in Southwest China. Environmental protection has escalated in this city over the last decade, manifesting in diverse measures adopted by the local government, including the demolition of hundreds of buildings in the core conservation zone of the lake Erhai. This paper demonstrates how the campaign of EC has strengthened environmental efforts locally, while emphasizing that local compliance relies on heightened oversight and financial support from the central government. Moreover, this paper argues that, despite resembling a degrowth strategy in terms of rhetoric and short-term effects, EC-led demolition serves as a spatio-temporal fix that has helped the local government to address both ecological and political imperatives, with growth coalitions being reconfigured. Overall, this paper contributes to scholarly discussions on the impacts of the EC campaign, expands the comprehension of the dynamic process of greening urban governance, and spotlights the analytical prowess of the demolition lens in such studies.
Garcinia dulcis Extract Alleviates Inflammation in Kidney and Liver of the 2-Kidney-1-Clip Hypertensive rat
Authors: Thongsepee Nattaya , Himakhun Wanwisa , Parachat Ratsikan , Martviset Pongsakorn , Chantree Pathanin , Sornchuer Phornphan , Sangpairoj Kant , Hiranyachattada Siriphun
Published: April 2024

Garcinia dulcis (GD) extract possesses anti-hypertensive property that are poorly characterized. This study aimed to investigate an anti-inflammatory effect of GD flower extract in the 2-kidney-1-clip (2K1C) hypertensive compared to sham operative (SO) rat. Male Wistar rats were divided into 2 groups; the 2K1C group in which a silver clip was placed around renal artery to induce hypertension, and the SO normotensive group. Four weeks later, each group of rats were further divided into 2 subgroups, each subgroup was orally gavaged of either corn oil (vehicle) or 50 mg/kg BW GD extract daily for 4 weeks. The malondialdehyde (MDA) levels in serum, liver, and kidney were determined. Hematoxylin and eosin staining was carried out for histological examination, Periodic acid – Schiff staining for glomerular injury, Masson's trichrome staining for renal fibrosis, and immunohistochemistry for either tumor necrosis factor alpha (TNF-α) or endothelial nitric oxide synthase (eNOS) investigation. Taken together, our results demonstrated that GD flower extract decreased the MDA level in both serum and liver and kidney tissue and suppressed the expression of TNF-α in both liver and kidney of 2K1C hypertensive rats. Mesangial cell proliferation, expansion of mesangial matrix, widening Bowman's capsule space, congestion of glomerular capillary and vessel, cloudy swelling of renal tubular epithelial cell, and renal fibrosis were observed in the kidneys of 2K1C rats. Therefore, we concluded that GD flower extract can alleviate liver and kidney inflammation in which partially attenuates the glomerular injury in the 2K1C rat.
Turkish adaptation and verification of the incident-reporting attitude scale used for staff in long-term care facilities
Authors: Yılmaz Ayşegül , Yıldız Keskin Ayşe , Duygulu Sergül , Yeşildal Müjdat
Published: April 2024

Background

Determining nurses’ attitudes and behaviors toward error reporting is important in providing safe, high-quality patient care. The current study aimed to test Turkish validity and reliability of the Incident-Reporting Attitude Scale for Staff in Long-Term Care Facilities.

Methods

This psychometric study was conducted in two stages with 395 nurses and nurse managers in long-term care at a university hospital between May 2021 and January 2022. First, the Turkish adaptation of the scale was performed. The scale's internal consistency was evaluated using Cronbach's alpha and corrected item-total score correlation. Content validity indices were used for content validity, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity. Discriminant analysis and internal consistency coefficient were used for reliability analyses.

Results

The results showed that the Turkish scale adaptation is adequate for language and content equivalence. According to CFA, the scale comprising 31 items and two subscales in the original version showed a significantly good fit in a 26-item and five-factor model. The Cronbach's alpha of the modified scale was 0.92; it was 0.88, 0.94, 0.82, 0.96, and 0.90 for the subscales, respectively.

Conclusions

The Turkish scale adaptation has consistently shown acceptable psychometric reliability and validity characteristics. It can be used by healthcare services and nursing managers to evaluate nurses’ attitudes toward incident reporting in healthcare facilities providing long-term care.
The Evolution of Mindfulness-Based Stress Reduction Teacher Training Programs for People Who Serve Historically Underrepresented Racial and Ethnic Groups
Authors: Dejene Abraham , Carter Zoie , Woo Erin , Sun Shufang , Loucks Eric B. , Proulx Jeffrey
Published: April 2024

Background

There is a lack of mindfulness instructors from underserved/underrepresented communities who have completed systematic mindfulness teacher-training programs to meet the growing demand for culturally responsive mindfulness training in those communities.

Objectives

To investigate strategies for increasing the representation of Mindfulness-Based Stress Reduction (MBSR) teachers who serve historically underrepresented racial and ethnic groups.

Methods

Conducted through 4 one-hour Zoom focus groups (n = 54; women = 74%), this study queried individuals with experience serving underrepresented racial and ethnic communities, and had mindfulness experience, on how to increase participation from underrepresented communities in mindfulness. Thematic analysis of transcripts of participant responses involved double-coding by three team members, supporting rigorous evaluation of the data. All respondents who expressed interest in participating enrolled (no dropout from study enrollment to participation in focus groups).

Results

The study identified four key themes that illuminate challenges and essential adaptations for MBSR teacher training aimed at individuals serving historically underrepresented racial and ethnic groups. These themes include: (1) Cost and time commitment; (2) Trauma sensitivity; (3) Cultural Awareness; and (4) Diversity in teachers.

Conclusion

Participants provided actionable recommendations poised to facilitate the expansion of MBSR into more diverse communities, emphasizing optimal benefits and effective communication of inherent healing strengths within these communities. The findings underscore the compelling interest among leaders in marginalized communities to extend the reach of MBSR through culturally responsive approaches. This involves guiding pertinent adjustments and encouraging greater involvement of underserved communities in MBSR teacher training programs.
Relationships between economic complexity, renewable energy uptake and environmental degradation: A global study
Authors: Anwar Muhammad Awais , Ul-Durar Shajara , Arshed Noman
Published: April 2024

A persistent rise in the emission of CO2 among several economies in the world makes it challenging to fulfil the aims of the Sustainable Development Goals. The present study empirically examines the connection between economic complexity, which is understood to be structural conversion headed for more refined information-based production, renewable energy demand, per capita income, trade openness, industrialisation, and CO2 emissions among income-based groups of nations from 1998–2021. It also incorporates partner economies of the One Belt One Road (OBOR) project because these cover 65% of the global population. The findings of the panel autoregressive distributed lag model confirms that virtually all of the chosen samples of the various economies, aside from high-income economies, show that economic complexity degrades the environment. On the other hand, the demand for renewable energy enhances global environmental quality. The study highlights the significance of clean energy ventures and the production of greener quality products globally to minimise environmental damage.
Alternative Approaches to Innovation Project Portfolio Governance
Authors: Tuominen Siiri , Martinsuo Miia
Published: April 2024

The governance of projects is often treated operationally, as project portfolio management. Project portfolio governance is more strategic and continuous than project portfolio management, but its various approaches are weakly understood. This study explores project portfolio governance in innovative companies. The resulting framework characterizes governance approaches in terms of the authority given to portfolio actors and the rhythm of using governance practices. Differences among the delegated, regulated, and consultative governance approaches appear to stem from the industry clock speed, innovation portfolio type, and organizational context. This study differentiates project portfolio governance approaches as part of organizational project management governance.
Geomorphic changes after the 2021 Central European flood in the Ahr Valley by LiDAR-based differences
Authors: Steinritz Vanessa , Bellanova Piero , Schmidt Bernd , Schüttrumpf Holger , Schwarzbauer Jan , Reicherter Klaus
Published: April 2024

Background

In July 2021, destructive floods in Western Europe were triggered by enormous precipitation rates related to a low-pressure system named "Bernd." These catastrophic events led not only to major damage to infrastructure, severe economic losses, and the loss of lives but also to significant landscape changes and modifications. Here, we focus, as a case study, on the flood aftermath of the Ahr Valley in Rhineland-Palatinate state in western Germany, as it was one of the most affected and destroyed regions by the flood. We utilize high-resolution Digital Terrain Models (DTMs) based on airborne Light Detection and Ranging (LiDAR) that were taken shortly before and after the flood to investigate insights into geomorphic changes.

Results

By calculating Digital Terrain Models of Difference (DoD), we are able to quantify volumetric and areal changes caused by erosional and depositional processes for different sites in the Ahr Valley. Due to the morphology of the narrow Ahr Valley, most of the erosion and deposition is located within the deeply incised canyon of the Ahr River. The comprehensive analysis reveals notable morphological modifications throughout the study area, with a calculated erosion/deposition areal ratio of 0.46 and an erosion/deposition volumetric ratio of 0.63. Our findings indicate massive deposition regarding both areal and volumetric. We selected six different locations along the Ahr Valley that showcase distinct aspects of flood-induced fluvial morpho-dynamics. Deposition occurred mainly in point bars and downstream of destroyed artificial levees, in a braided river style.

Conclusion

Our investigations contribute to an overview and assessment of the morphological response to the destructive flood in the Ahr Valley. The results emphasize the necessity for implementing effective flood management strategies, as most of the urban areas in the Ahr Valley were flooded. Moreover, our results provide valuable insights into the impacted areas, highlighting vulnerable locations for flood-related erosion and deposition. This information could contribute to future mitigation and protection efforts, aiding in the development of comprehensive strategies to minimize the impact of similar events in the future.
Genomic insights into local adaptation and vulnerability of Quercus longinux to climate change
Authors: Sun Pei-Wei , Chang Jui-Tse , Luo Min-Xin , Liao Pei-Chun
Published: April 2024

Background

Climate change is expected to alter the factors that drive changes in adaptive variation. This is especially true for species with long life spans and limited dispersal capabilities. Rapid climate changes may disrupt the migration of beneficial genetic variations, making it challenging for them to keep up with changing environments. Understanding adaptive genetic variations in tree species is crucial for conservation and effective forest management. Our study used landscape genomic analyses and phenotypic traits from a thorough sampling across the entire range ofQuercus longinux, an oak species native to Taiwan, to investigate the signals of adaptation within this species.

Results

Using ecological data, phenotypic traits, and 1,933 single-nucleotide polymorphisms (SNPs) from 205 individuals, we classified three genetic groups, which were also phenotypically and ecologically divergent. Thirty-five genes related to drought and freeze resistance displayed signatures of natural selection. The adaptive variation was driven by diverse environmental pressures such as low spring precipitation, low annual temperature, and soil grid sizes. Using linear-regression-based methods, we identified isolation by environment (IBE) as the optimal model for adaptive SNPs. Redundancy analysis (RDA) further revealed a substantial joint influence of demography, geology, and environments, suggesting a covariation between environmental gradients and colonization history. Lastly, we utilized adaptive signals to estimate the genetic offset for each individual under diverse climate change scenarios. The required genetic changes and migration distance are larger in severe climates. Our prediction also reveals potential threats to edge populations in northern and southeastern Taiwan due to escalating temperatures and precipitation reallocation.

Conclusions

We demonstrate the intricate influence of ecological heterogeneity on genetic and phenotypic adaptation of an oak species. The adaptation is also driven by some rarely studied environmental factors, including wind speed and soil features. Furthermore, the genetic offset analysis predicted that the edge populations ofQ. longinuxin lower elevations might face higher risks of local extinctions under climate change.
The responses of pepper plants to nitrogen form and dissolved oxygen concentration of nutrient solution in hydroponics
Authors: Roosta Hamid Reza
Published: April 2024

Background

The presence of oxygen in the growth medium is absolutely essential for root development and the overall metabolic processes of plants. When plants do not have an adequate oxygen supply for respiration, they can experience a condition known as hypoxia. In order to investigate the impact of different nitrogen forms and varying oxygen levels in nutrient solutions on the growth, photosynthesis, and chlorophyll fluorescence parameters of bell pepper plants, a comprehensive study was conducted. The experiment was designed as a factorial experiment, considering two main factors: nitrogen forms (calcium nitrate and ammonium sulfate) with a fixed nitrogen concentration of 5 mM, and the oxygen levels of the nutrient solutions (ranging from 1.8 ± 0.2 to 5.3 ± 0.2 mg. L-1).

Results

The study examined the effects of nitrogen (NH4+ and NO3−) application on various parameters of vegetative growth. The results demonstrated that the use of ammonium (NH4+) led to a reduction in the most measured parameters, including the fresh and dry mass of both the root and shoot, at low O2 concentrations of 1.8 ± 0.2; 2.6 ± 0.2 and 3.8 ± 0.2 mg. L-1. However, an interesting observation was made regarding the impact of oxygen levels on root growth in plants grown with nitrate (NO3−). Specifically, the highest levels of oxygen significantly increased root growth in NO3−-fed plants. Additionally, the application of NH4+ resulted in an increase in chlorophyll concentration in the leaves, particularly when combined with high oxygen levels in the nutrient solution. On the other hand, leaves of plants fed with NO3− exhibited higher photosynthetic rate (A), intrinsic water use efficiency (iWUE), and instantaneous carboxylation efficiency (A/Ci) compared to those fed with NH4+. Furthermore, it was found that NO3−-fed plants displayed the highest instantaneous carboxylation efficiency at oxygen levels of 3.8 and 5.3 mg. L-1, while the lowest efficiency was observed at oxygen levels of 1.8 and 2.6 mg. L-1. In contrast, NH4+-grown plants exhibited a higher maximal quantum yield of PSII photochemistry (Fv/Fm), as well as increased variable fluorescence (Fv) and maximum fluorescence (Fm), compared to NO3−-grown plants. Interestingly, the NO3−-fed plants showed an increase in Fv/Fm, Fv, and Fm with the elevation of oxygen concentration in the nutrient solution up to 5.3 mg. L-1.

Conclusion

This study showed that, the growth and photosynthesis parameters in bell pepper plants are sensitive to oxygen stress in floating hydroponic culture. Therefore, the oxygen level in the nutrient solution must not be lower than 3.8 and 5.3 mg. L-1 in NH4+ and NO3− –supplied culture media or nutrient solutions, respectively.
Do emergency medical dispatchers choose the same response to serious injury in men and women – a qualitative study
Authors: Mellum Marlene , Saei Raika , Brattebø Guttorm , Wisborg Torben
Published: April 2024

Background

Recent research has indicated that sex is an important determinant of emergency medical response in patients with possible serious injuries. Men were found to receive more advanced prehospital treatment and more helicopter transportation and trauma centre destinations and were more often received by an activated trauma team, even when adjusted for injury mechanism.

Emergency medical dispatchers choose initial resources when serious injury is suspected after a call to the emergency medical communication centre. This study aimed to assess how dispatchers evaluate primary responses in trauma victims, with a special focus on the sex of the victim.

Methods

Emergency medical dispatchers were interviewed using focus groups and a semistructured interview guide developed specifically for this study. Two vignettes describing typical and realistic injury scenarios were discussed. Verbatim transcripts of the conversations were analysed via systematic text condensation. The findings were reported in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.

Results

The analysis resulted in the main category “Tailoring the right response to the patient”, supported by three categories “Get an overview of location and scene safety”, “Patient condition” and “Injury mechanism and special concerns”. The informants consistently maintained that sex was not a relevant variable when deciding emergency medical response during dispatch and claimed that they rarely knew the sex of the patient before a response was implemented. Some of the participants also raised the question of whether the Norwegian trauma criteria reliably detect serious injury in women.

Conclusions

The results indicate that the emergency medical response is largely based on the national trauma criteria and that sex is of little or no importance during dispatch. The observed sex differences in the emergency medical response seems to be caused by other factors during the emergency medical response phase.
Racial/ethnic differences in 21-gene recurrence score and survival among patients with estrogen receptor-positive breast cancer
Authors: Gill Jasmin , Yendamuri Keerti , Chatterjee Udit , Yao Song , Oladeru Oluwadamilola T. , Singh Anurag K. , Ma Sung Jun
Published: April 2024

Background

Despite numerous studies on racial/ethnic disparities among patients with breast cancer, there is a paucity of literature evaluating racial/ethnic differences in 21-gene recurrence score (RS) and survival differences stratified by RS risk categories. We thus performed an observational cohort study to examine racial/ethnic disparities in the context of RS.

Methods

The National Cancer Database (NCDB) was queried for female patients diagnosed between 2006 and 2018 with estrogen receptor (ER)-positive, pT1-3N0-1aM0 breast cancer who received surgery followed by adjuvant endocrine therapy and had RS data available. Logistic multivariable analysis (MVA) was built to evaluate variables associated with RS ≥ 26. Cox MVA was used to evaluate OS. Subgroup analyses were performed to compare the magnitude of racial/ethnic differences stratified by RS. P values less than 0.017 were considered statistically significant based on Bonferroni correction.

Results

A total of 140,133 women were included for analysis. Of these, 115,651 (82.5%), 8,213 (5.9%), 10,814 (7.7%), and 5,455 (3.9%) were NHW, Hispanic, Black, and API women, respectively. Median (IQR) follow up was 66.2 months (48.0–89.8). Logistic MVA showed that, compared with NHW women, Black women were associated with higher RS (≥ 26 vs < 26: adjusted odds ratio [aOR] 1.19, 95% confidence interval [CI] 1.12–1.26, p < 0.001), while HW (aOR 0.93, 95% CI 0.86–1.00, p = 0.04) and API women (aOR 1.03, 95% CI 0.95–1.13, p = 0.45) were not. Cox MVA showed that, compared with NHW women, Black women had worse OS (adjusted hazards ratio [aHR] 1.10, 95% CI 1.02–1.19, p = 0.012), while HW (aHR 0.85, 95% CI 0.77–0.94, p = 0.001) and API (aHR 0.66, 95% CI 0.56–0.77, p < 0.001) women had better OS. In subgroup analysis, similar findings were noted among those with RS < 26, while only API women were associated with improved OS among others with RS ≥ 26.

Conclusion

To our knowledge, this is the largest study using nationwide oncology database to suggest that Black women were associated with higher RS, while HW and API women were not. It also suggested that Black women were associated with worse OS among those with RS < 26, while API women were associated with improved OS regardless of RS when compared to NHW women.
Global burden of self-harm and interpersonal violence and influencing factors study 1990–2019: analysis of the global burden of disease study
Authors: Zhou Xiaoding , Li Ruyu , Cheng Peixia , Wang Xiaonan , Gao Qi , Zhu Huiping
Published: April 2024

Introduction

Widespread concern exists in today’s world regarding self-harm and interpersonal violence. This study to analyze the changes in temporal trends and spatial patterns of risk factors and burdens of self-harm and interpersonal violence using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019.

Methods

Temporal trends in self-harm and interpersonal violence were initially summarized using the estimated annual percentage change (EAPC). Data were compiled and visualized to delineate changes in disease burden and factors influencing self-harm and interpersonal violence from 1990 to 2019, stratified by gender, age and GBD region.

Results

In 2019, the DALY rates of self-harm were 424.7(95% UI 383.25, 466.93). Over the period from 1999 to 2019, self-harm exhibited an overall decreasing trend, with the EAPC of -1.5351 (95% CI -1.6194, -1.4507), -2.0205 (95% CI -2.166, -1.8740) and -2.0605 (95% CI -2.2089, -1.9119), respectively. In contrast, the incidence rate of interpersonal violence was significantly higher than self-harm, with a rate of 413.44 (95% UI 329.88, 502.37) per 100,000 population. Mortality and DALYs of interpersonal violence were lower than those of self-harm, at 5.22 (95% UI 4.87, 5.63) and 342.43 (95% UI 316.61, 371.55). Disease burden of self-harm and interpersonal violence varied by gender, age groups and region. Specific risk factors showed that alcohol use, high temperature and drug use were the main risk factors for self-harm, while alcohol use, intimate partner violence and high temperature were associated with interpersonal violence. Low temperature was a common protective factor for both self-harm and interpersonal violence. The burden of self-harm and interpersonal violence was attributed to different factors influences in different SDI regions.

Conclusions

The study explored temporal trends and spatial distribution of the global disease burden of self-harm and interpersonal violence, emphasizing the significant impact of factors such as alcohol use, temperature, and drug use on disease burden. Further research and policy actions are needed to interpret recent changes of disease burden of self-harm and interpersonal violence, and dedicated efforts should be implemented to devise evidence-based interventions and policies to curtail risk factors and protect high-risk groups.
Novel anthropometric indices for predicting type 2 diabetes mellitus
Authors: Sadeghi Erfan , Khodadadiyan Alireza , Hosseini Seyed Ali , Hosseini Sayed Mohsen , Aminorroaya Ashraf , Amini Massoud , Javadi Sara
Published: April 2024

Background

This study aimed to compare anthropometric indices to predict type 2 diabetes mellitus (T2DM) among first-degree relatives of diabetic patients in the Iranian community.

Methods

In this study, information on 3483 first-degree relatives (FDRs) of diabetic patients was extracted from the database of the Endocrinology and Metabolism Research Center of Isfahan University of Medical Sciences. Overall, 2082 FDRs were included in the analyses. A logistic regression model was used to evaluate the association between anthropometric indices and the odds of having diabetes. Furthermore, a receiver operating characteristic (ROC) curve was applied to estimate the optimal cutoff point based on the sensitivity and specificity of each index. In addition, the indices were compared based on the area under the curve (AUC).

Results

The overall prevalence of diabetes was 15.3%. The optimal cutoff points for anthropometric measures among men were 25.09 for body mass index (BMI) (AUC = 0.573), 0.52 for waist-to-height ratio (WHtR) (AUC = 0.648), 0.91 for waist-to-hip ratio (WHR) (AUC = 0.654), 0.08 for a body shape index (ABSI) (AUC = 0.599), 3.92 for body roundness index (BRI) (AUC = 0.648), 27.27 for body adiposity index (BAI) (AUC = 0.590), and 8 for visceral adiposity index (VAI) (AUC = 0.596). The optimal cutoff points for anthropometric indices were 28.75 for BMI (AUC = 0.610), 0.55 for the WHtR (AUC = 0.685), 0.80 for the WHR (AUC = 0.687), 0.07 for the ABSI (AUC = 0.669), 4.34 for the BRI (AUC = 0.685), 39.95 for the BAI (AUC = 0.583), and 6.15 for the VAI (AUC = 0.658). The WHR, WHTR, and BRI were revealed to have fair AUC values and were relatively greater than the other indices for both men and women. Furthermore, in women, the ABSI and VAI also had fair AUCs. However, BMI and the BAI had the lowest AUC values among the indices in both sexes.

Conclusion

The WHtR, BRI, VAI, and WHR outperformed other anthropometric indices in predicting T2DM in first-degree relatives (FDRs) of diabetic patients. However, further investigations in different populations may need to be implemented to justify their widespread adoption in clinical practice.
How the Plants for Joints multidisciplinary lifestyle intervention achieved its effects: a mixed methods process evaluation
Authors: Wagenaar Carlijn A. , Toonstra Alie , Walrabenstein Wendy , van Schaardenburg Dirkjan , van Nassau Femke
Published: April 2024

Background

Plants for Joints (PFJ) is a multidisciplinary intervention centered around a whole-food plant-based diet, physical activity, and sleep and stress management. The PFJ intervention successfully improved disease activity and symptoms in people with rheumatoid arthritis (RA) or osteoarthritis (OA), respectively, and metabolic health. To investigate how these effects were achieved a mixed methods process evaluation was conducted to understand the context, implementation, and mechanism of impact of the PFJ intervention. Also, the relationship between degree of implementation and lifestyle changes was explored.

Methods

Quantitative and qualitative data were collected across the evaluation domains context (i.e. reach), implementation (i.e. recruitment and delivery), and mechanism of impact (i.e. responsiveness) of both the participants and coaches (incl. dietitians, sport coaches) according to the UK MRC guidelines for process evaluations. Data was collected from the participants via focus groups and questionnaires after the intervention, and interviews with coaches. Qualitative data were analyzed thematically, and quantitative data were assessed with descriptive statistics and linear regression analyses. Degree of implementation was quantified using a theory-driven implementation index score composed of different process evaluation constructs.

Results

Of the 155 participants who participated in the PFJ intervention, 106 (68%) took part in the questionnaire and 34 (22%) attended a focus group. Participants felt the intervention was complete, coherent, and would recommend the intervention to others (mean score 9.2 (SD 1.4) out of 10). Participants felt heard and empowered to take control of their lifestyle and health outcomes. Components perceived as most useful were self-monitoring, social support, practical and theoretical information, and (individual) guidance by the multidisciplinary team. Participants perceived the intervention as feasible, and many indicated it effectively improved their health outcomes. In an explorative analysis there was no significant difference in healthy lifestyle changes across implementation index score groups.

Conclusion

This process evaluation offers important insights into why the PFJ intervention works and how the intervention can be optimized for future implementation. Results indicating the intervention’s high satisfaction, feasibility, and perceived effectiveness, further support the use of plant-based lifestyle interventions as an additional treatment option for patients with RA, OA, or other chronic diseases.

Trial registration

International Clinical Trial Registry Platform numbers: NL7800, NL7801, and NL7802, all registered 17-06-2019.
The effects of psychological distress after surgery in patients undergoing lumbar spinal fusion
Authors: Li Qiang , Luan Jian , Lin Yong , Kong Meng , Guo Xinhu , Zhao Jindong
Published: April 2024

Background

The aim of this study was to evaluate the psychological distress pre-operatively, at 3, 6, and 12 months in patients who underwent lumbar spine fusion surgery.

Methods

A total of 440 patients received instrumented lumbar spine fusion were enrolled. Psychological distress was evaluated using the Modified Somatic Perception Questionnaire (MSPQ) and the Modified Zung Depressive Index (ZDI). The results of lumbar fusion surgery were evaluated using the Oswestry Disability Index (ODI), the Japanese Orthopedic Association (JOA-29), and the visual analog scale (VAS).

Results

Psychological distress was reported among 23% of patients and 7, 5.5, and 4.0% of the patients preoperatively, at 3, 6, and 12 months after lumbar surgery, respectively. The mean MSPQ score decreased from 8.78 (before surgery) to 4.30, 3.52, and 3.43 at 3, 6 and 12 months in after surgery, respectively, in patients with psychological distress patients (p < 0.001). The mean ZDI score decreased from 17.78 to 12.48, 10.35, and 9.61 (p < 0.001). The mean ODI score decreased from 22.91 to 11.78, 10.13, and 9.96 (P < 0.001). The mean JOA score increased from 13.65 to 22.30, 23.43, and 23.61 (P < 0.001). The mean low back pain (LBP) VAS score decreased from 4.48 to 1.96, 1.52, and 1.51 (P < 0.001); moreover, the mean leg pain (LP) VAS score decreased from 5.30 to 1.30, 1.04, and 1.03 (P < 0.001).

Conclusions

Patients with psychological distress may experience surgical intervention benefits equal to those of ordinary patients. Moreover, reduced pain and disability after surgical intervention may also alleviate psychological distress. Hence, we highly recommend that patients with psychological distress undergo surgical intervention as normal patients do, but appropriate screening measures and interventions are necessary.
Real-time imaging of ipsilateral parathyroid glands by retrograde injection of methylene blue into the superior thyroid artery: a new intraoperative parathyroid protection method
Authors: Guo Hanjie , Zhang Yuxing , Ren Saiyu , Yang Xiaodong , Tian Lei , Huang Yun , Zhang Chaojun , Zhang Xiliang
Published: April 2024

Background

Postoperative hypoparathyroidism caused by parathyroid injury is a problem faced by thyroid surgeons. The current technologies for parathyroid imaging all have some defects.

Methods

Patients with differentiated thyroid carcinoma (DTC) who underwent unilateral thyroidectomy plus ipsilateral central lymph node dissection were recruited. We dissected the main trunk of the superior thyroid artery entering the thyroid gland and placed the venous indwelling tube into the artery. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated.

Results

A total of 132 patients enrolled in this single-arm clinical trial, 105 of them completed retrograde catheterization via the superior artery. The sensitivity was 69.23 and 83.33% respectively. The specificity was 72.91 and 64.89%. The accuracy was 72.91 and 64.89%. The PPV was 85.71 and 81.08%. The NPV was 22.58 and 45.45%. There were no patients with allergic reactions to the methylene blue, or methylene blue toxicity.

Conclusions

Retrograde injection of methylene blue via the superior thyroid artery is an effective and safe method to visualize parathyroid glands. This method can accurately locate the target organ by ultraselecting the blood vessel and injecting the contrast agent while avoiding background contamination and reducing the amount of contrast agent.

Trial registration

Clinical trial registration numbers and date of registration: ChiCTR2300077263、02/11/2023.
A new technique for closure of pericardial defects: pericardial rug weave
Authors: Fındık Göktürk , Çetin Mehmet , Nomenoğlu Hakan , Türk İlteriş , Acemoğlu Serdar , Solak Necati , Can Mehmet Ali
Published: April 2024

Background

Pericardial defect that occurs after intrapericardial pneumonectomy can cause many fatal complications, and closing the defect with mesh is a widely used surgical method to prevent these complications.

Methods

Data of patients who underwent intrapericardial pneumonectomy and pericardial resection in our clinic between October 2010 and June 2022 were retrospectively reviewed. Patients were divided into two groups, those who had prolene mesh used to close the pericardial defect and those who underwent the “Rug Weave” technique we proposed as an alternative, and the results were compared.

Results

The study included 23 patients, one of whom was female. All patients underwent surgery due to malignancy. The vast majority of the patients had a diagnosis of squamous cell lung carcinoma (86.9%). Atrium was added to three patients and rib resection was added to one patient during intrapericardial pneumonectomy and pericardial resection. There was no significant difference between the two groups in terms of average age, gender, and length of hospital stay. There was no significant difference between the two groups in terms of complications, including atrial fibrillation, which is commonly seen in these patients (p = 0.795). The Rug Weave group had an average defect width of 23.96 cm2 and was found to be advantageous in terms of overall survival compared to the mesh group (p = 0.017).

Conclusions

The “Rug Weave” technique we proposed for closing pericardial defects after pneumonectomy can be used as a cheaper method safely and effectively that reduces complications as much as the traditional method of using mesh.
Single-port robotic-assisted laparoscopic synchronous surgery in pediatric patent processus vaginalis
Authors: Li Geng , Gao Heyun , Yu Shanzhen , Guo Yunkai , Hu Tao , Liu Yifan , Du Guowei , Huang Guangbin , Zhang Wen
Published: April 2024

Purpose

Patent processus vaginalis (PPV) is usually observed in pediatric abdominal surgery; however, robotic single-port surgery in repairing processus vaginalis has not been reported in children. Herein, we present our clinical experiences in single-port robotic surgeries for PPV repair to evaluate both efficacy and safety.

Methods

Retrospective analysis of patients underwent single-port robotic-assisted laparoscopic surgery for genitourinary diseases from May 2020 and May 2023 in our center. Among these patients, 21 children had PPV repaired at the same time. The case characteristics and follow-up data were recorded.

Results

Twenty-one of the 53 children were found to have PPV during genitourinary surgery. The simultaneous treatment of the primary disease and PPV with a single-port robotic-assisted platform was both convenient and safe. There was no significant increase in total operation time, and no excessive intraoperative hemorrhage was observed in any of the operations. There were no complications observed on follow-up.

Conclusion

With a high incidence of PPV in children, a single-port robotic-assisted procedure is feasible and effective if simultaneously performed when addressing a primary abdominal disease.
Does a novel 3D printed individualized guiding template based on cutaneous fiducial markers contribute to accurate percutaneous insertion of pelvic screws? A preliminary phantom and cadaver study
Authors: Tao Xingguang , Lyu Fei , Sugand Kapil , Zhou Kaihua , Wang Huixiang
Published: April 2024

Background

Most 3D-printed guiding templates require dissection of soft tissues to match the corresponding surfaces of the guiding templates. This study sought to explore the accuracy and acceptability of the novel 3D printed individualized guiding templates based on cutaneous fiducial markers in minimally invasive screw placement for pelvic fractures.

Methods

The printed template was tested on five high-fidelity biomimetic phantom models of the bony pelvis and its surrounding soft tissues as well as on two fresh frozen cadavers. Four cutaneous fiducial markers were transfixed on each phantom model prior to performing CT scans to reconstruct their 3D models. Personalized templates for guiding screw insertion were designed based on the positions of the fiducial markers and virtually planned target screw channels after scanning, followed by 3D printing of the guide. Phase 1 consisted of five expert surgeons inserting one anterograde supra-pubic screw and one sacroiliac screw percutaneously into each phantom model using the 3D-printed guide. The deviation of screw positions between the pre-operative planned and post-operative actual ones was measured after registering their 3D modelling. A Likert scale questionnaire was completed by the expert surgeons to assess their satisfaction and acceptability with the guiding template. Phase 2 consisted of repeating the same procedures on the fresh frozen cadavers in order to demonstrate face, content and concurrent validity.

Results

In Phase 1, all ten screws were successfully implanted with the assistance of the guiding template. Postoperative CT scans confirmed that all screws were safely positioned within the bony pelvic channels without breaching the far cortex. The mean longitudinal deviation at the bony entry point and screw tip between the pre-operative planned and post-operative actual screw paths were 2.83 ± 0.60 mm and 3.12 ± 0.81 mm respectively, with a mean angular deviation of 1.25 ± 0.41°. Results from the Likert questionnaire indicated a high level of satisfaction for using the guiding template among surgeons. In Phase 2, results were similar to those in Phase 1.

Conclusions

The 3D-printed guiding template based on cutaneous fiducial markers shows potential for assisting in the accurate insertion of percutaneous screws in the pelvis.
Relationship of skin complexion with gingival tissue color and hyperpigmentation. A multi-ethnic comparative study
Authors: Koppolu Pradeep , Almutairi Haifa , Yousef Safa al , Ansary Nisren , Noushad Mohammed , Vishal Mantri Bharath , Swapna Lingam Amara , Alsuwayyigh Nouf , Albalawi Malak , Shrivastava Deepti , Srivastava Kumar Chandan
Published: April 2024

Background and Objective

The most frequently seen intra-oral soft tissue is the gingiva. Most often, it is seen as coral-pink tissue that surrounds the neck of the teeth. Gingiva that encircles the tooth necks and covers the alveolar processes of the jaws is an intra-oral tissue that exhibits biomimetic features. The wide range of colors of the gingiva depends on the configuration of gingival vascularity, the degree of epithelial cornification, level of melanogenesis, and the depth of epithelialization. However, the color of the gingiva varies depending on the degree of melanin pigmentation. The current study aimed to identify the different distribution patterns of gingival color and determine the correlation between skin color, gender, and geographical area of origin.

Materials and methods

A total of 839 subjects were involved in the study where the gingival color and skin tone were measured using the Dummett-Gupta Oral pigmentation Index (DOPI) combined with VITA VMK MASTER and skin shade method developed by Revlon (USA) and L’Oreal (France) for makeup foundation shades. One investigator was calibrated for the examination of the colors after being tested for normal color vision and color aptitude using the line test.

Results

A significant association was found between skin color and gingival pigmentation (χ2 value (6) = 114.48; P = 0.001). It was also found that females (67.1%) significantly had darker gingiva than males (58.3%). The study statistics display that location of the individual was also statistically associated with melanin pigmentation of the gingiva (χ2 value (57) = 559.33; P = 0.001).

Conclusion

The study concluded that gender, skin color, and individual location are significantly associated with gingival melanin pigmentation.