bluuebunny/crossref_metadata_2025 huggingface dataset:
Receipt of rheumatology care and lupus-specific labs among young adults with systemic lupus erythematosus: A US Medicare retention in care cohort study
Authors: Schletzbaum Maria , Powell W Ryan , Garg Shivani , Kramer Joseph , Astor Brad C , Gilmore-Bykovskyi Andrea , Kind Amy J , Bartels Christie M
Published: April 2024

Objective

In systemic lupus erythematosus, poor disease outcomes occur in young adults, patients identifying as Black or Hispanic, and socioeconomically disadvantaged patients. These identities and social factors differentially shape care access and quality that contribute to lupus health disparities in the US. Thus, our objective was to measure markers of care access and quality, including rheumatology visits (longitudinal care retention) and lupus-specific serology testing, by race and ethnicity, neighborhood disadvantage, and geographic context.

Methods

This cohort study used a geo-linked 20% national sample of young adult Medicare beneficiaries (ages 18–35) with lupus-coded encounters and a 1-year assessment period. Retention in lupus care required a rheumatology visit in each 6-month period, and serology testing required ≥1 complement or dsDNA antibody test within the year. Multivariable logistic regression models were fit for visit-based retention and serology testing to determine associations with race and ethnicity, neighborhood disadvantage, and geography.

Results

Among 1,036 young adults with lupus, 39% saw a rheumatologist every 6 months and 28% had serology testing. White beneficiaries from the least disadvantaged quintile of neighborhoods had higher visit-based retention than other beneficiaries (64% vs 30%–60%). Serology testing decreased with increasing neighborhood disadvantage quintile (aOR 0.80; 95% CI 0.71, 0.90) and in the Midwest (aOR 0.46; 0.30, 0.71).

Conclusion

Disparities in care, measured by rheumatology visits and serology testing, exist by neighborhood disadvantage, race and ethnicity, and region among young adults with lupus, despite uniform Medicare coverage. Findings support evaluating lupus care quality measures and their impact on US lupus outcomes.
Coping strategies of intensive care unit nurses reducing moral distress: A content analysis study
Authors: Esmaeili Maryam , Navidhamidi Mojdeh , Varasteh Saeideh
Published: April 2024

Background

Moral distress has negative effects on physical and mental health. However, there is little information about nurses’ coping strategies reducing moral distress.

Aim

The purpose of this study was to investigate the coping strategies of intensive care unit nurses reducing moral distress in Iran.

Study design

This is a qualitative study with a content analysis approach.

Participants and research context

The research sample consisted of nurses working in intensive care units of teaching hospitals affiliated to Tehran University of Medical Sciences. Samples were selected among eligible nurses by purposive sampling. Data were obtained through 17 in-depth, individual, and semi-structured interviews with 17 nurses. Graneheim and Lundman’s (2004) 6-step content analysis method was used to analyze the data. Data management was also performed by MAXQDA software version 20. The COREQ checklist was used to report the study.

Ethical considerations

This project was approved by the Ethics Committee of Tehran University of Medical Sciences. All ethical guidelines in research were followed.

Finding

The data analysis resulted in the formation of two main categories of desirable coping strategies (with two subcategories of compensation and rejuvenation) and less desirable coping strategies (with three subclasses of indifference over time, escape and concealment).

Discussion

The intensive care unit nurses in dealing with ethical problems first try to solve the problem through discussion, but when they fail to resolve it peacefully, they resort to several coping strategies. Factors, such as increasing experience, lack of support from hospital managers and officials, poor communication between colleagues, the need to maintain hierarchy, fear of reprimand, and a sense of powerlessness, changed the nurses’ preferred strategies. It is important for managers to provide a blame/punishment-free atmosphere for expression of ethical experiences; a supportive atmosphere in which staff can engage in ethical discussions without fear of punishment. They should also provide opportunities for rest, rejuvenation, and adequate training for their employees.
Design, Development and Validation of a Customised Mind–Body Module Towards  Resilience Building and Wellness Promotion
Authors: Dhanasekar Haritha , Balakrishnan Arthi , Mathangi Damal Chandrasekar , Singh Sudhakar
Published: April 2024

Background: In today’s world, developing resilience is crucial for managing stress, preserving mental and emotional health, managing work–life balance, fostering self-growth and good relationships and promoting physical health. Nourishing the mind–body connection, using methods for stress reduction and self-care and incorporating a Mind Body Module can contribute to resilience-building initiatives as well as help in wellness promotion.

Purpose: This study aims to design, develop and validate a resilience-building module that incorporates mind–body practices.

Method: The existing literature on traditional yoga texts and published scientific studies in the area of mind–body practices was used to build the Mind Body Module. Through this approach, a total of 26 practices were identified based on the strength of evidence. Each of these practices was scored by subject matter experts, and the content validity ratio (CVR) was calculated using Lawshe’s formula for validation.

Result: The practices/techniques that scored ≥50% along with those suggested by the experts were grouped, and an eight-week module for resilience building and wellness promotion was developed.

Conclusion: The Mind Body Module crafted to foster resilience has brought together the knowledge from the Indian system and the well-being practices from the West in a cogent manner. The module’s viability and effectiveness will be evaluated appropriately.
Pyrogallol Suppresses the Tumor Progression via Modulating Aerobic Glycolysis and STAT2 Signaling Pathway in Non-small Cell Lung Carcinoma
Authors: Liu Hao , Chang Yanxiang , Jin Lei
Published: April 2024

Background

Pyrogallol, a bioactive compound derived from natural sources, is the focus of this study, aiming to investigate its anti-cancer properties against A549 lung cancer cells and uncover the underlying mechanisms.

Purpose

This study seeks to elucidate the therapeutic potential of pyrogallol as a novel anti-cancer agent for NSCLC by targeting aerobic glycolysis and signal transducer and activator of transcription 2 (STAT2) signaling pathway.

Background

Pyrogallol, a bioactive compound derived from natural sources, is the focus of this study, aiming to investigate its anti-cancer properties against A549 lung cancer cells and uncover the underlying mechanisms.

Materials and Methods

A range of pyrogallol doses was administered to A549 cells, followed by a comprehensive analysis utilizing bioinformatic tools like Gene Expression Omnibus (GEO), GEO2R, WebGestalt, and the Search Tool for Interactions of Chemicals database. Assessments of cytotoxicity were conducted using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and trypan blue assays post-treatment of A549 cells with pyrogallol. Cell cycle progression and cell death were evaluated via flow cytometry using Annexin V-fluorescein isothiocyanates/propidium iodide double staining. Network analysis helped identify pertinent signaling pathways, while RT-PCR validated mRNA expression changes in A549 cells. Auto dock docking studies were employed to gauge the binding affinity of pyrogallol with targets associated with the STAT2-mediated pathway.

Results

Pyrogallol notably impeded the progression of A549 cells by prompting cell cycle arrest in the G0/G1 phase and fostering apoptosis. Network analysis highlighted its role in regulating metabolism, apoptosis, and STAT2 targets linked to lung tumorigenesis. RT-PCR validation affirmed the downregulation of genes associated with cell cycle and apoptosis targets. Furthermore, docking studies indicated a robust binding affinity between pyrogallol and the signaling targets within the STAT2 pathway. Pyrogallol displays the potential to halt the growth of lung cancer cells, indicating its promise as a viable treatment for this condition.

Conclusion

These discoveries emphasize the need for additional research and clinical studies to fully harness its therapeutic benefits for lung cancer treatment.
Intimate Partner Abuse and Homicide During the COVID-19 Pandemic: A Situational Action Theory Analysis
Authors: Treiber Kyle
Published: April 2024

During the COVID-19 pandemic, stay-at-home restrictions significantly changed people’s daily lives around the world. Opportunity and strain theories predict this would lead to an increase in intimate partner abuse (IPA), including intimate partner homicide (IPH). This paper applies an alternative theoretical framework—situational action theory (SAT)—to explain mixed findings regarding changes in IPA and unexpected findings regarding (a lack of) changes in IPH. It is argued that SAT may contribute to explaining the impact of stay-at-home restrictions on IPA and IPH in three important ways:

1. by addressing the fact that motivation is necessary but not sufficient for explaining action and better specifying how motivation translates into IPA and IPH;

2. by addressing the fact that people perceive different alternatives for action and better specifying why some people come to see IPA and IPH as acceptable action alternatives;

3. by addressing the fact that exposure affects people differently and better specifying how stay-at-home restrictions shaped people’s activity fields and, in turn, their perceptions and action choices.
May It Please the Senate: Gender Norms and the Double Bind of US Supreme Court Confirmations
Authors: Romano Michael K. , Justice Nickelette M.
Published: April 2024

Increased focus on the judicial qualifications of female U.S. Supreme Court nominees prompts an examination of barriers obstructing women's rise to this apex position. Contrary to scholars who emphasize “pipeline” theories of how increased women in the law will de facto increase the number of women in the judiciary, or that ideology as the primary predictor of confirmation votes regardless of gender, we argue that women nominees appearing before the Senate Judiciary Committee must also clear an additional gendered hurdle. Incorporating the literature on the double bind and gender norm theories of women in leadership, we scrutinize all formal opening statements from Supreme Court nominees between 1981 and 2022 to decipher challenges female nominees' encounter. Using a structural topic model approach to compare opening statements from men and women nominees, we demonstrate how societal constructs compel women nominees to navigate a precarious path toward confirmation. We find that women nominees must fashion themselves as both strong legal advocate and soft, feminine wife and mother, exemplifying gendered social roles and the double bind for women in leadership. These findings bear significance for comprehending women's underrepresentation in the judiciary and how gender biases permeate the hearing process beyond Senatorial bias.
Fast Fourier transform method in peridynamic micromechanics of composites
Authors: Buryachenko Valeriy A
Published: April 2024

We consider a static linear bond–based peridynamic (proposed by Silling, see J. Mech. Phys. Solids 2000; 48:175–209) composite materials (CMs) of a periodic structure. In the framework of the second background of micromechanics (also called computational analytical micromechanics), one proved that local micromechanics (LM) and peridynamic micromechanics (PM) are formally analogous to each other for CM of both random and periodic structures. It allows a straightforward generalization of LM methods (including fast Fourier transform, FFT) to their PM counterparts. So, in the PM counterpart of the implicit periodic Lippmann–Schwinger (L-S) equation in LM, we have three convolution kernels corresponding to the properties of the matrix, inclusions, and interactive interface. Eshelby tensor in LM, depending on the inclusion shape, is replaced by PM counterparts depending on the shapes of inclusions, and the interaction interface (although the Eshelby concept of homogeneous eigenfields does not work in PM). The mentioned tensors are estimated once (as in LM) in a frequency domain (also by the FFT method). The possible incorrectness of FFT applications to PM is analyzed and corrected. The polarization schemes of the solution of the L-S equation in the Fourier space have one primary unknown variable (polarization), whereas the PM counterpart contains three primary ones estimated at each step, which are formally similar to the LM case. A description of the generalized basic scheme and the Krylov approach is presented. Computational complexities O(N log2 N) of the FFT methods are the same in both LM and PM.
Architectural design and managerial control: Lefebvre, Latour and the process of enrollment
Authors: McArthur Jenn , Dunne Stephen , Ivory Sarah Birrell
Published: April 2024

Organizational scholarship on architecture often applies Henri Lefebvre’s conceived, perceived, and lived framework. Karen Dale and Gibson Burrell, most notably, have illustrated how architectural design exploits each of these, exerting managerial control through processes of enchantment, emplacement, and enactment. Although this “3E framework” has been productively applied to buildings from the modern and postmodern periods, its weaknesses become apparent in the current occupant-centric design period. Drawing on Actor Network Theory’s account of translation, we propose enrollment—a 4th “E”—which enables us to better capture the nature of spatial control in the occupant-centric design period. Our 4E expanded spatial control framework recognizes the tensions that Lefebvre originally observed, tensions concealed by Dale and Burrell’s otherwise rightly influential work. This expanded framework also augments our understanding of modern and postmodern periods: the dominant Building Movements of the past Century, we claim, have each engaged in a recursive enrollment of socio-political ideals.
Assessing crack susceptibility in blended copper-stainless steel compositions during laser directed energy deposition-based additive manufacturing
Authors: Yadav Sunil , Paul Christ Prakash , Rai Arun Kumar , Jinoop Arackal Narayanan , Kausal Saurabh Sridhar , Dixit Sudhir Kumar
Published: April 2024

This study investigates the effect of composition and process parameters on the crack susceptibility of the Cu -SS304L system during laser directed energy deposition (LDED). The microstructure of LDED deposits is analysed aiming at elemental distribution and crack susceptibility. The trapping behaviour of Cu changes with Cu concentration. The crack susceptibility reduces with Cu concentration and escalates with an increase in laser power and scan speed, irrespective of composition. The mode of solidification cracking varied from the rupture of Cu film to crack-assisted porosity. Furthermore, the critical solidification cooling rate is estimated for LDED of different blended Cu -SS for crack-free deposition. The above findings offer insights into cracking behaviour and provide processing guidelines for LDED of Cu -SS.
Disability and pain after anterior cervical decompression and fusion: A group-based trajectory analysis
Authors: Widbom-Kolhanen Sara S. , Pernaa Katri I. , Lintuaho Roosa E. , Kotkansalo Anna , Saltychev Mikhail
Published: April 2024

Objectives:

This study aimed to identify the clusters of patients with different developmental trajectories of pain and disability after anterior cervical decompression and fusion (ACDF).

Methods:

Group-based trajectory analysis among 318 patients undergoing the ACDF.

Results:

Three developmental trajectories of disability were identified: “Steadily good functioning,” “Improved functioning,” and “Steadily poor functioning.” Three developmental trajectories of neck pain were identified: “Worsened pain,” “Pain relief,” and “Steadily severe pain.” Two developmental trajectories of arm pain were identified: “Decreased arm pain” and “Severe arm pain with only short-term relief.” No associations were found between sex, preoperative pain duration, or body weight and probability to be classified into a particular disability trajectory group. Female sex (relative risk ratio (RRR) 1.78) and longer history of preoperative pain (RRR 2.31–2.68) increased the probability to be classified into a group with steadily severe neck pain. Longer history of preoperative pain increased the probability to be classified into group with severe arm pain with only short-term pain relief (RRR 2.68).

Conclusion:

After the ACDF, dissimilar developmental trajectories of pain and disability were identified between the patient clusters. While sex, preoperative pain duration, and body weight were not associated with differences in improvement in disability level, female sex and longer duration of preoperative pain were correlated with more severe neck and arm pain after surgery.
How to (mis)align participatory approaches with the everyday life? Construction of an improved cookstove in India
Authors: Ghergu Cristian T , Sushama Preeti , de Witte Luc P , Meershoek Agnes
Published: April 2024

Improved cookstoves aimed at reducing exposure to indoor air pollution have had a lasting presence in development and health discussions. Through this article we contribute to current debates in the field by reflecting on our experiences during a cookstove participatory project in two ‘non-notified’ communities, or ‘slums,’ in Bangalore, India. We interrogate the alignment between some of the central tenets and methods of participation and the lived experiences of participating communities. The current predominant recommendations focus on developing and implementing cookstoves tailored for user needs. Yet, the project implementation entered a space of uncertainty where the priorities and needs of participants were diverse and changing. While urban infrastructures related to housing and work security, drainage systems, access to health care, and aspects of governance, citizenship and rights, may seem to fall outside the scope of ICS projects, our experiences show how inescapably they shape participatory processes and technologies. We highlight the need to take a closer look at how we can include these broader and changing priorities and needs in our methodologies and reflect on how we can better respond and align them with the ways in which people live.
Braking and Exiting: Referendum Games, European Integration and the Road to the UK’s Brexit Vote
Authors: Ganderson Joseph , Kyriazi Anna
Published: April 2024

The UK’s in-out referendum on European Union membership is often attributed to an incompatibility inherent in the UK–EU relationship, or else a rising tide of Euroscepticism forcing a reckoning. We argue that the referendum should be understood as the culmination of parliamentary ‘referendum games’ in the preceding years, whereby backbenchers periodically applied pressure to office-seeking leaders who strategically defused this by promising public votes. These games were episodic and escalatory, coinciding with integrative European treaties which activated transient Eurosceptic backlashes. While referendum avoidance was personally rational, leaders’ repeated parlays created a standalone referendum politics, ratcheting up the intensity of backbench demands based on past promises and democratic renewal. After the Lisbon Treaty, a tipping point was reached, transforming calls for a ‘brake’ on integration to demand for binary ‘exit’ vote at the next treaty moment. This accompanied the Euro-area crisis in 2011, effectively ending David Cameron’s discretion to continue the game. To show this, we plot all mentions of EU-related referendums and adjacent terms in the House of Commons between 2000 and 2015. We descriptively identify five peak salience flares around EU treaty moments and then analyse 263 interventions by Members of Parliament to show how referendum pressure ratcheted up over time.
Assessing the Impact of Social and Academic Integration on College Achievement Among Students With and Without Learning Disabilities
Authors: Sarid Miriam
Published: April 2024

The current study compared social and academic integration and commitment to higher education between 257 college students with ( n = 51) and without ( n = 206) learning disabilities (LDs). It was hypothesized that students with LDs would exhibit lower integration and commitment and that these factors would predict academic success. Students completed a questionnaire assessing integration and commitment. Academic achievement was obtained via GPA approximately 3 years later. Students with LDs displayed higher social but lower academic integration than peers. Overall, findings indicate that lower academic integration among students with LDs may reflect challenges with academic adjustment in college. Higher social integration was related to higher subsequent GPA only for students with LDs, suggesting they employ higher social integration to compensate for their academic challenges.
Seizing the Future: Predicting Epilepsy After TBI
Authors: Paz Jeanne T.
Published: April 2024

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The effect of actuation frequency on clot integration with the Tigertriever device: A preliminary in vitro study
Authors: Sadasivan Chander , Dashti Nakisa , Gopal Megha , Serna Rowan J , Fiorella David
Published: April 2024

Background

The Tigertriever stent retriever (Rapid Medical) can be actively expanded and contracted by the operator, which allows for several actuation-related parameters to be optimized to potentially improve device efficacy. These parameters have not yet been evaluated. We conducted a benchtop study to evaluate the effect of actuation frequency on clot integration within the stent.

Methods

A Tigertriever 17 device was deployed within a biological clot analog placed in a straight tube. The device was actuated between the maximally contracted and maximally expanded states with three different frequencies: passive (one-time opening, n = 6), slow (20 s/cycle, n = 6), and fast (5 s/cycle, n = 7). A flat-detector CT scan was acquired, the clot and stent wires were segmented, and the boundaries of the clot and stent wires were calculated on each axial slice. The intersection between the stent and clot boundaries throughout the volume was defined as the volume of clot integrated within the stent. The clot integration factor (ratio of integrated clot volume to total clot volume) was then statistically compared between the three frequencies as an estimate of clot capture efficiency.

Results

The clot integration factor was significantly higher (23% increase, p = 0.01) with the fast actuation as compared to the passive and slow actuations, with a post hoc test showing no difference ( p > 0.05) between the passive and slow groups.

Conclusions

Faster actuation frequencies may result in improved clot integration with the Tigertriever device. This effect needs to be validated by clinical data.
Long-term outcomes of endovascular therapy for right subclavian artery occlusive lesions: A multi-center experience
Authors: Huang Yulong , Xie Xinsheng , Huang Guoqiang , Lu Weifeng , Hong Shichai , Chen Yihui , Lin Yue , Fu Weiguo , Hong Xiang , Wang Lixin
Published: April 2024

Objective

To review our multi-institutional experience with endovascular therapy for right subclavian artery occlusive disease and to evaluate the long-term outcomes.

Methods

We retrospectively evaluated all patients with right subclavian artery stenosis and occlusive disease who underwent endovascular therapy between March 2014 and September 2022 at two institutions. Patient baseline demographics, lesion characteristics, treatment strategies, and in-hospital and follow-up outcomes were prospectively collected and retrospectively analyzed.

Results

Between March 2014 and September 2022, 73 patients underwent endovascular treatment at the two institutions. The dominant cause of lesions in this cohort was atherosclerosis. Three different types of lesions were summarized, and the corresponding endovascular strategies were performed. 66 patients (90.4%) underwent successful endovascular treatment, and 62 patients (84.9%) underwent balloon-expandable stent deployment. The mean perioperative in-hospital stay was 4.0 days (range, 3–6 days). Two patients died due to myocardial infarction, and one died of cerebral hemorrhage resulting from a traffic accident within 30 days of the intervention. The median follow-up time was 31.6 months (range, 12–96 months). No complications, including death, stroke, stent fractures, or migration, were noted in any patient during the follow-up period. The overall complication rate was 7/73 (9.6%), and 5/7 (6.9%) of the complications required reintervention.

Conclusions

Endovascular treatment of right subclavian artery lesions is safe, effective, and technically achievable. The reasonable use of balloon-expandable stents can achieve satisfactory outcomes with accurate orientation and promising patency.
Cultural adaptation of the Assessment of Coach Emotions to the Spanish sports context (ACE-E)
Authors: Ordeix Lídia , Alcaraz Saul , Belza Haizea , Viladrich Carme
Published: April 2024

Coaches’ emotional expression significantly influences sport environments and is mediated by the social and cultural construction of emotions. Therefore, this study aims to culturally adapt the Assessment of Coach Emotions for the Spanish sports context (ACE-E), provide evidence of its validity and reliability, and propose a suitable model for adapting observation instruments. The study involved coaches, sports psychologists, experts who study emotions, linguists, and translators. It was conducted in three phases. First, a literature review was conducted, and four coaches were interviewed. Secondly, the necessary linguistic and content changes were implemented. Finally, the ACE-E was tested by coding and analyzing 500 min of recordings of eight coaches’ performance and evaluated for reliability, usefulness, and feasibility. The results show that ACE-E receives the same support for validity and reliability as the original instrument in the English language, demonstrating the effectiveness of its cultural adaptation for assessing the emotional expression of Spanish coaches.
A retrospective observational study on characteristics, treatment patterns, and healthcare resource use of patients with myasthenia gravis in England
Authors: van Enkhuizen Jordy , Binns Jean , Betts April , Hosnijeh Fatemeh Saberi , Alexander Myriam , McCormack Mark , Jacob Saiju
Published: April 2024

Background:

There are limited data on the real-world healthcare resource use (HCRU) and management costs of myasthenia gravis (MG) in England.

Objective:

This study aims to assess the burden of disease for patients with MG in England.

Design:

A retrospective, observational cohort study of adult patients diagnosed with MG, using data from the Hospital Episode Statistics data warehouse.

Methods:

Patients with a first-ever recorded diagnosis of MG between 30 June 2015 and 30 June 2020 were followed up until 30 June 2021 or death, whichever occurred first. Post-diagnosis patient characteristics, treatment patterns, HCRU, and costs were described. Costs were evaluated using National Health Service reference costs.

Results:

A total of 9087 patients with a median follow-up time of 2.9 years (range, 1.7–4.3 years) were included. The mean age at diagnosis was 66.5 years and 53% of the patients were male. A large proportion of patients (72.8%) were admitted as inpatients during follow-up with a mean number of 1.3 admissions. Patients hospitalized for MG-related complications spent a mean of 9.7 days per patient-year in the hospital. During follow-up, 599 (6.6% of the total cohort) and 163 (1.8%) patients had a record of rescue therapy with intravenous immunoglobulin (IVIg) and plasma exchange (PLEX), respectively. Rituximab was administered to 81 (0.9%) patients and 268 (2.9%) patients underwent thymectomy. In those patients receiving rescue therapy or rituximab, >10% received at least three cycles of the same treatment. The average annual cost of hospital admissions across all patients treated with IVIg, PLEX, and rituximab were £907,072, £689,979, and £146,726, respectively.

Conclusion:

A majority of MG patients required hospitalization or accident and emergency attendance, resulting in high HCRU and costs. A subset of patients required rescue therapy (including IVIg and PLEX), rituximab administration, ventilation, or thymectomy.
Effects, Safety, and Treatment Experience of Advanced Hybrid Closed-Loop Systems in Clinical Practice Among Adults Living With Type 1 Diabetes
Authors: Singh Ramanjit , Imberg Henrik , Ahmadi Shilan Seyed , Hallström Sara , Jendle Johan , Tengmark Bengt-Olov , Folino Anna , Marie Ekström , Lind Marcus
Published: April 2024

Background:

There are few studies providing a more comprehensive picture of advanced hybrid closed-loop (AHCL) systems in clinical practice. The aim was to evaluate the effects of the AHCL systems, Tandem® t: slim X2™ with Control IQ™, and MiniMed™ 780G, on glucose control, safety, treatment satisfaction, and practical barriers for individuals with type 1 diabetes.

Method:

One hundred forty-two randomly selected adults with type 1 diabetes at six diabetes outpatient clinics in Sweden at any time treated with either the Tandem Control IQ (TCIQ) or the MiniMed 780G system were included. Glycated hemoglobin A1c (HbA1c) and glucose metrics were evaluated. Treatment satisfaction and practical barriers were examined via questionnaires.

Results:

Mean age was 42 years, median follow-up was 1.7 years, 58 (40.8%) were females, 65% used the TCIQ system. Glycated hemoglobin A1c was reduced by 0.6% (6.8 mmol/mol; 95% confidence interval [CI] = 0.5-0.8% [5.3-8.2 mmol/mol]; P < .001), from 7.3% to 6.7% (57-50 mmol/mol). Time in range (TIR) increased with 14.5% from 57.0% to 71.5% (95% CI = 12.2%-16.9%; P < .001). Time below range (TBR) (<70 mg/dL, <3.9 mmol/L) decreased from 3.8% to 1.6% ( P < .001). The standard deviation of glucose values was reduced from 61 to 51 mg/dL (3.4-2.9 mmol/L, P < .001) and the coefficient of variation from 35% to 33% ( P < .001). Treatment satisfaction increased, score 14.8 on the Diabetes Treatment Satisfaction Questionnaire (DTSQ) (change version ranging from −18 to 18, P < .001). Four severe hypoglycemia events were detected and no cases of ketoacidosis. Skin problems were experienced by 32.4% of the study population.

Conclusions:

Advanced hybrid closed-loop systems improve glucose control with a reasonable safety profile and high treatment satisfaction. Skin problems are common adverse events.
Modified Haoqin Qingdan Decoction Exerts Antioxidant Effect via Activating PI3K/Akt/Nrf2 Pathway on Allergic Asthma Mice
Authors: Dong Xiaojun , Zhang Qi , Gu Juan , Cai Mingxing , Gan Yuan , Ye Yanni , Yang Xun , Ding Dou , Xia Xiuwen
Published: April 2024

Objective

The aim of this study was to investigate the antioxidant effect and potential mechanism of Modified Haoqin Qingdan Decoction on ovalbumin (OVA)-induced allergic asthma (AA) mice.

Methods

The AA model of mice was induced by OVA combined with aluminum hydroxide. Resistance Index (RI) in airway was analyzed by AniRes2005 animal pulmonary function analyzer. H&E staining was used to evaluate the pathological changes of lung tissue. The apoptosis in lung tissue was detected by TUNEL staining. The percentage of EOS cells in bronchoalveolar lavage fluid was determined by flow cytometry. The levels of IL-1β, IL-6, IL-4, GM-CSF, TNF-α, and IFN-γ in serum were determined by ELISA. Biochemical kits were used to detect levels of SOD, MDA, and GSH-Px in lung tissue. The protein expression of PI3K, p-PI3K, Akt, p-Akt, and nucleoprotein Nrf-2 in lung tissue was detected by western blotting.

Result

Modified Haoqin Qingdan Decoction reduced RI, alleviated the degree of histopathological damage, inhibited apoptosis rate, reduced the proportion of EOS cells, downregulated IL-1β, IL-6, IL-4, GM-CSF, TNF-α, IFN-γ, and MDA, upregulated SOD, GSH-Px, p-PI3K, p-Akt, and nucleoprotein Nrf-2.

Conclusion

Modified Haoqin Qingdan Decoction activated nucleoprotein Nrf2 by regulating the PI3K/Akt signaling pathway to exert its protective effect against inflammatory and oxidative stress in AA mice.
Mechanism and Experimental Verification of Rhodiola rosea L. for the Treatment of Acute Lung Injury Through Network Pharmacology and Molecular Docking
Authors: Zhao Min , Lv Guanping , Huang Xi , Niu Yong , Zhang Qunhui , Li Wenhua
Published: April 2024

Objective: This article endeavors to dissect the bioactive elements, pharmacological effects, and potential mechanisms of Rhodiola rosea L. (RL) concerning acute lung injury (ALI) using a combined approach of network pharmacology and subsequent in vivo experimental validation. Methods: RL constituents and associated targets were retrieved from the Organchem database and pertinent articles. ALI-related targets were meticulously curated through comprehensive searches of GeneCards, OMIM, and DisGeNET databases. Utilizing Cytoscape 3.8.2 software, an intricate RL-ALI ingredients-targets network diagram was fashioned. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted using the Metascape database and microbiota software to unravel the functional and pathway implications of the identified interactions. AutoDock Vina and PyMOL were used to conduct molecular docking. Subsequently, the ALI rats were established by intraperitoneal injection of lipopolysaccharide (LPS) into Sprague Dawley rats, the potential mechanism for treating ALI was validated by kaempferol. Results: 18 active components of RL for ALI were screened, which were related to 306 targets of RL for ALI. Kaempferol (Kae) was a potential major component of ALI treatment. Molecular docking showed Kae had good binding ability to Epidermal Growth Factor Receptor (EGFR), nonreceptor tyrosine kinase, and serine/threonine kinase 1. In addition, at the animal level, Kae alleviated ALI by inhibiting the production of inflammatory cytokines. Lung tissue sections of the Kae-treated group at different doses showed reduced bleeding and reduced exudation of inflammatory factors compared to the LPS cohort. Compared with the LPS group, the secretion of Interleukin-6, tumor necrosis factor-alpha, and Phosphorylated Epidermal Growth Factor Receptor was significantly decreased in the Kae group, while the content of Phosphorylated Protein Kinase B was increased, and the lung injury was alleviated. Conclusion: Through network pharmacology and experimental verification, we identified Kae as the main active ingredient. Kae may reduce the expression of inflammatory factors and regulate the EGFR-AKT signaling pathway, subsequently exerting therapeutic effects in the treatment of ALI.
The national narrative in Chinese science fiction and the innovative transformation of traditional Chinese culture
Authors: Peng Chao
Published: April 2024

Chinese science fiction (sci-fi) draws nutrition from traditional Chinese culture to achieve a modern transformation and promote the development of the national narrative in Chinese sci-fi. There are three ways to realise the transformation. First, adapt and reproduce classic stories, myths, legends and history. By embracing modernity, this unlocks the connections between traditional culture and modern technology, and thus acquires supportive force for modern life. Second, reconstruct history by imagining new routes of technological evolution and thus open up new possibilities for history. By considering contemporary realities, this answers the contemporary call for a more advanced culture. Third, use the national spirit as the soul of Chinese sci-fi. When providing Chinese wisdom and solutions to global challenges, we should balance the relationship between the global vision and the national characteristics of Chinese sci-fi and develop future-oriented national characteristics.
Sleep and Alcohol Use Among Veterans Living With Long COVID
Authors: Bachrach Rachel L. , Tighe Caitlan A. , Beyer Nicole , Hruska Kristina , Phares Angela , Atchison Karley , Baniak Lynn , Haas Gretchen , Bramoweth Adam D.
Published: April 2024

Objectives:

Study objectives were to: (1) better understand sleep experiences and unhealthy alcohol use among Veterans with long COVID and (2) explore providers’ perceptions of barriers and facilitators to delivering evidence-based care for sleep problems and unhealthy alcohol use in patients with long COVID.

Methods:

VA electronic health records were used to conduct chart reviews (n = 57) of patients evaluated in a VA COVID-19 Recovery Clinic during 1 calendar year; semi-structured interviews were completed with Veterans (n = 5) and clinicians (n = 7) recruited from the clinic. Veteran participants also completed quantitative, self-report measures assessing sleep- and alcohol-related experiences and behaviors.

Results:

Data from chart reviews and interviews suggested that Veterans with long COVID often had pre-existing sleep problems that were exacerbated during long COVID. Patients and providers agreed that sleep interventions would be beneficial and acceptable in the COVID-19 Recovery clinic. Conversely, few Veterans with long COVID had a pre-existing alcohol use disorder (AUD) diagnosis; alcohol use occurred less frequently and was less often discussed between patients and providers. Providers had mixed viewpoints on delivering alcohol-related care in the clinic; some were highly amenable, others were unsure whether patients would be receptive.

Conclusions:

This study is among the first to take a mixed-method approach to understanding experiences of sleep-wake behaviors and unhealthy alcohol use in Veterans with long COVID. Characterizing sleep and alcohol-related experiences, examining associations with functioning, and exploring perspectives on treatment approaches is critical to support efforts to refine, personalize, and optimize evidence-based sleep and alcohol care for Veterans living with long COVID.
Factors Associated With Lack of Long-Term Follow-Up Data After Global Cardiac Surgery Missions
Authors: Lannon Christine M. , Nuchovich Nadine , Louis Clauden , Henson Janine , Connett John , Nina Rachel Haickel , Marath Aubyn
Published: April 2024

Background: Humanitarian medical missions attempt to lessen the burden of limited access to cardiac surgery in low- and middle-income countries. While organizations express difficulties obtaining follow-up information, there is currently little evidence to support the various assumptions for lack of data. This study examines the factors influencing long-term patient follow-ups on repeated short-term cardiac surgery missions across nine countries. Methods: A retrospective analysis of CardioStart International's database (RedCap) was conducted to investigate demographic, socioeconomic, and surgical factors associated with follow-ups. Results: A total of 550 pediatric (50%) and adult (50%) cardiac surgery patients displayed a follow-up rate of 14.7%, with no significant difference between populations ( P = 1). Mean follow-up time was 1.5 years postoperative. Countries were highly variable, with Dominican Republic and Vietnam showing follow-up rates of 30.4% and 43.2%, respectively, while Brazil, Nepal, and Tanzania had no follow-ups ( P < 0.0001). The 11 surrogate factors for socioeconomic status, including home amenities and technology access, were predominantly insignificant, with the exception of phone access showing an unexpectedly decreased follow-up rate (11.6%, P = 0.006). Surgical intervention was a significant factor ( P = 0.009). No adult cardiac surgery trends were noted; however, congenital cases demonstrated increased follow-ups in patients with higher Risk Adjusted Congenital Heart Surgery scores, with ventricular septal defects (32.5%) exceeding atrial septal defects (7.3%). Conclusions: Follow-ups correlate with mission factors, including location and types of intervention, more so than previously assumed socioeconomic and technological factors. Thus, certain missions may require more allocation of resources and adapted organizational policies to overcome site-specific barriers to follow-up.
Do TLIF and PLIF Techniques Differ in Perioperative Complications? - Comparison of Complications Rates of Two High Volume Centers
Authors: Mehren Christoph , Ostendorff Nicolas , Schmeiser Gregor , Papavero Luca , Kothe Ralph
Published: April 2024

Study Design

Retrospective bicentric Cohort Study.

Objective

Posterior (PLIF) and transforaminal lumbar interbody fusion (TLIF) have been clinically proven for the surgical treatment of degenerative spinal disorders. Despite many retrospective studies, the superiority of either technique has not been proven to date. In the literature, the complication rate of the conventional PLIF technique is reported to be significantly higher, but with inconsistent complication recording. In this retrospective bicentric study, a less invasive PLIF technique was compared with the conventional TLIF technique and complications were recorded using the validated SAVES V2 classification system.

Methods

1142 patients underwent PLIF (702) or TLIF (n = 440) up to 3 levels in two specialized centers. Epidemiological data, intra- and postoperative complications during hospitalization and after discharge were analyzed according to SAVES V2.

Results

The overall complication rate was 13.74%. TLIF-patients had slightly significant more complications than PLIF-patients (TLIF = 16.6%/PLIF = 11.9%, P = .0338). Accordingly, complications during revision surgeries were more frequent in the first cohort (TLIF = 20.9%/PLIF = 12.6%; P = .03252). In primary interventions, the surgical technique did not correlate with the complication rate (TLIF = 12.4%/PLIF = 11.7%). There were no significant differences regarding severity of complications.

Conclusions

An important component of this work is the complication recording according to a uniform classification system (SAVES V2). In contrast to previous literature, we could demonstrate that there is not a significant difference between the two surgical techniques.
Equity in Access to Nutrition through ICDS
Authors: Behera Jagannath , Acharya Sanghmitra S. , Pal G. C.
Published: April 2024

With the recognition of the problem of child malnutrition in India, the government provides supplementary nutrition under the flagship scheme of Integrated Child Development Services. The scheme has a specific focus on children from geographically and socio-economically disadvantaged groups. In the recent past, although several studies have looked into the access of children to supplementary nutrition services, the effectiveness of the services on children’s nutrition status through the lens of equity has however not drawn adequate attention. This article assesses the nutritional status of children across social groups based on the standard of ‘Nutritive Value of Indian Food’. Data collected from a sample of 286 children across social groups registered under the ICDS scheme covering ten villages in two rural districts of one state; reveals that although the supplementary nutrition meets the protein intake as per the Recommended Dietary Allowances norm, deficiencies are observed in the intakes of nutrients like calorie, calcium and iron. There are notable differentials among children across social groups in the intake of nutrients. The article calls for monitoring of adequacy of supplementary nutrition services for children from disadvantaged groups, and raising nutritional awareness among caregivers.
Patient and relative experiences of the ReSPECT process in the community: an interview-based study
Authors: Eli Karin , Harlock Jenny , Huxley Caroline J. , Bernstein Celia , Mann Claire , Spencer Rachel , Griffiths Frances , Slowther Anne-Marie
Published: April 2024

Background

The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) was launched in the UK in 2016. ReSPECT is designed to facilitate meaningful discussions between healthcare professionals, patients, and their relatives about preferences for treatment in future emergencies; however, no study has investigated patients’ and relatives’ experiences of ReSPECT in the community.

Objectives

To explore how patients and relatives in community settings experience the ReSPECT process and engage with the completed form.

Methods

Patients who had a ReSPECT form were identified through general practice surgeries in three areas in England; either patients or their relatives (where patients lacked capacity) were recruited. Semi-structured interviews were conducted, focusing on the participants’ understandings and experiences of the ReSPECT process and form. Data were analysed using inductive thematic analysis.

Results

Thirteen interviews took place (six with patients, four with relatives, three with patient and relative pairs). Four themes were developed: (1) ReSPECT records a patient’s wishes, but is entangled in wider relationships; (2) healthcare professionals’ framings of ReSPECT influence patients’ and relatives’ experiences; (3) patients and relatives perceive ReSPECT as a do-not-resuscitate or end-of-life form; (4) patients’ and relatives’ relationships with the ReSPECT form as a material object vary widely. Patients valued the opportunity to express their wishes and conceptualised ReSPECT as a process of caring for themselves and for their family members’ emotional wellbeing. Participants who described their ReSPECT experiences positively said healthcare professionals clearly explained the ReSPECT process and form, allocated sufficient time for an open discussion of patients’ preferences, and provided empathetic explanations of treatment recommendations. In cases where participants said healthcare professionals did not provide clear explanations or did not engage them in a conversation, experiences ranged from confusion about the form and how it would be used to lingering feelings of worry, upset, or being burdened with responsibility.

Conclusions

When ReSPECT conversations involved an open discussion of patients’ preferences, clear information about the ReSPECT process, and empathetic explanations of treatment recommendations, working with a healthcare professional to co-develop a record of treatment preferences and recommendations could be an empowering experience, providing patients and relatives with peace of mind.